tbuckley/cabot-search huggingface dataset:
Efficacy and Safety of Controlled-Release Niacin in Dyslipoproteinemic Veterans
Authors: David R. Gray
Journal: Annals of Internal Medicine (1994)

Objective: To evaluate the safety and efficacy of controlled-release niacin in patients with hyperlipoproteinemia. Design: A retrospective cohort study. Setting: A Department of Veterans Affairs Medical Center. Patients: A consecutive sample of 969 predominantly elderly male veterans treated for dyslipoproteinemia with controlled-release niacin between October 1988 and October 1991. Main Outcome Measures: Primary outcomes were lipid levels and lipoprotein cholesterol response, alterations in levels of hepatic enzymes and blood chemistry test results, and characterization of niacin-induced hepatotoxicity abstracted from the patient's medical, laboratory, and pharmacy records. Results: 93% (896 of 969) of the cohort was evaluable. Patients (age, 61.7 years [9.4 years], mean [SD]) were treated for 1 to 36 months (13.0 months [9.7 months]) with an average maintenance dose of 1.67 g/d (0.8 g/d). Niacin was discontinued in 48.5% (435 of 896) of the patients primarily because of adverse effects. Poor glycemic control led to discontinuation in 40.6% (43 of 106) of the patients with diabetes mellitus. The lipoprotein response was dose-related and favorable (levels of total cholesterol, −19.1%;low-density lipoprotein cholesterol, −24.0%;high-density lipoprotein cholesterol, +5.7%; and triglycerides, −32.5%).Statistically but not clinically meaningful dose-related increases were seen in levels of liver enzymes and serum glucose (aspartate aminotransferase, +29%; alanine aminotransferase, +23%; alkaline phosphatase, +25%; and glucose, +7%; P = 0.0001). Twenty of 896 (2.2%) and 42 of 896 (4.7%) patients met biochemical criteria for probable and for possible or probable niacin-induced hepatotoxicity, respectively. Predisposing factors included high dose, alcohol use, preexisting liver disease, and concurrent oral sulfonylurea therapy. Conclusions: Controlled-release niacin is effective in treating dyslipoproteinemia in selected middle-aged and elderly veterans, but approximately one half of patients discontinued the drug because of adverse effects or other causes including noncompliance. Niacin should be avoided in patients with hepatic dysfunction or a history of liver disease, patients with diabetes mellitus, and patients who abuse alcohol. Because controlled-release niacin seems to be more potent than crystalline niacin, product substitution without dose adjustment should be avoided.
TALMA'S OPERATION IN CIRRHOSIS OF THE LIVER.
Authors: M. L. HARRIS
Journal: JAMA (1903)

Since Greenough's recent article<sup>1</sup>contains a list in detail of the cases of ascites due to cirrhosis of the liver operated on up to the end of 1902, no attempt will be made to review the literature. The author desires, however, to briefly mention his own experience in operating on this variety of cases. In an article on this subject inThe Journalof the American Medical Association, May 3, 1902, the author reviewed the available literature up to that date and published two cases of his own. Since then he has operated on four more cases, making six altogether. The two cases previously reported were: <h3>Case 1.</h3> —Man, aged 56, hard drinker; atrophic liver, enlarged spleen, jaundice, ascites; duration about one year; tapped nine times. Omentum greatly thickened and very vascular. Operation March 30, 1900. Abdomen closed without drainage. Recovery. No improvement. Died in three weeks. Autopsy
Radiation pneumonitis in mice. Some effects of corticosteroids on mortality and pulmonary physiology.
Authors: N J Gross
Journal: Journal of Clinical Investigation (1980)

The fall in pulmonary compliance in mice with radiation pneumonitis is associated with increased microvascular leakage of plasma proteins into the alveolar spaces and increased surfactant phospholipids in the lung and alveolar fluid. In the present experiments we examined the effect of corticosteroid adminitration on these two effects and on pulmonary mechanics 16 wk after x irradiation of the thorax. Survival in irradiated animals that received corticosteroids was markedly better during the period of corticosteroid administration than that of irradiated animals that received no corticosteroids. The development of abnormalities in pulmonary mechanics and alveolar fluid surface tension appeared to be inhibited in the irradiated animals receiving corticosteroids as compared with irradiated animals not receiving corticosteroids. The increased microvascular protein leakage seen in the lungs of irradiated mice was not significantly different in the corticosteroid-treated group. However, corticosteroid adminstration was associated with a marked increase in the amount of phosphatidyl choline that could be recovered from the alveolar spaces by lavage, over and above the increase resulting from irradiation, and a significant increase in the incorporation of [14C]palmitate into phosphatidyl choline by lung slices. The beneficial effects of steroids in this variety of adult respiratory distress syndrome may be the result of augmented surfactant production which may contribute to the maintenance of relatively normal pulmonary mechanics despite substantial leakage of plasma proteins into the alveolar space.
Isolated Chloroma: The Effect of Early Antileukemic Therapy
Authors: Kevin R. Imrie
Journal: Annals of Internal Medicine (1995)

Objective: To evaluate the effect of antileukemic chemotherapy administered at diagnosis on the survival of patients with isolated chloroma. Design: Retrospective review of locally identified patients and analysis of cases from the medical literature. Patients: The records of all patients with isolated chloroma identified at three teaching hospitals in Toronto between 1980 and 1994 were reviewed. A MEDLINE search was done to identify all cases of isolated chloroma reported in the English-language medical literature. Patients with a previous known hematologic disorder were excluded. Measurements: The effect of therapy on 1) the interval between diagnosis of chloroma and diagnosis of acute myeloid leukemia and 2) survival was determined. Results: 7 local patients and 83 published cases were identified, for a total of 90 evaluable patients. For the entire group, the median time to the diagnosis of acute myeloid leukemia was 9 months, and median survival was 22 months. Chemotherapy was administered to 49 patients (54%) at diagnosis of chloroma. Significantly fewer patients treated with chemotherapy subsequently developed acute myeloid leukemia (41% compared with 71%; P = 0.001). Survival was longer in patients treated with chemotherapy (> 50% alive with a median follow-up of 25 months compared with a median survival of 13 months for those initially untreated; P = 0.001). Multivariate analysis showed that neither local radiotherapy nor surgery had an effect on survival. Conclusions: Administration of antileukemic chemotherapy at diagnosis of chloroma is associated with a significantly lower probability of developing acute myeloid leukemia and with longer survival.
Synthesis of Ribonucleic Acid in Rabbit Blood Cells In Vivo*
Authors: Robert H. DeBellis, Norman Gluck, Paul A. Marks
Journal: Journal of Clinical Investigation (1964)

Erythroid cells constitute a model particularly suitable for study of the relationship between cell maturation and nucleic acid and protein synthesis.Circulating reticulocytes, nonnucleated cells ca- pable of prolonged protein synthesis, are derived from cells in the bone marrow that proceed from an apparently multipotential nucleated stem cell through various stages of increasingly mature or differentiated cell types (2-5).Protein synthesis in reticulocytes proceeds on ribosomes (6, 7), in particular those ribosomes characterized by sedimentation coefficients in excess of 110 S, referred to as polyribosomes (8-10).In ad- dition to ribosomal RNA, transfer RNA and, presumably, "messenger" RNA are required for protein synthesis in reticulocytes.It vitro stud- ies have shown that reticulocytes cannot syn- thesize RNA (8).The present investigations were designed to determine when, in the course of in vivo maturation of erythroid cells, the RNA of reticulocytes is synthesized.In these experiments, the synthesis of RNA in rabbit erythroid cells in vivo was evaluated by following the time course of incorporation of ad- ministered PS2 into cellular RNA.The findings indicate that RNA of reticulocytes is synthesized in a relatively early precursor cell stage of erythroid cell maturation.RNA, once synthesized, can remain functional through the reticulocyte stage.Our study also provides evidence that nu- cleated leukocytes, in contrast to reticulocytes, can synthesize RNA.
Believability of relative risks and odds ratios in abstracts: cross sectional study
Authors: Peter C Gøtzsche
Journal: BMJ (2006)

To compare the distribution of P values in abstracts of randomised controlled trials with that in observational studies, and to check P values between 0.04 and 0.06.Cross sectional study of all 260 abstracts in PubMed of articles published in 2003 that contained "relative risk" or "odds ratio" and reported results from a randomised trial, and random samples of 130 abstracts from cohort studies and 130 from case-control studies. P values were noted or calculated if unreported.Prevalence of significant P values in abstracts and distribution of P values between 0.04 and 0.06.The first result in the abstract was statistically significant in 70% of the trials, 84% of cohort studies, and 84% of case-control studies. Although many of these results were derived from subgroup or secondary analyses, or biased selection of results, they were presented without reservations in 98% of the trials. P values were more extreme in observational studies (P < 0.001) and in cohort studies than in case-control studies (P = 0.04). The distribution of P values around P = 0.05 was extremely skewed. Only five trials had 0.05 < or = P < 0.06, whereas 29 trials had 0.04 < or = P < 0.05. I could check the calculations for 27 of these trials. One of four non-significant results was significant. Four of the 23 significant results were wrong, five were doubtful, and four could be discussed. Nine cohort studies and eight case-control studies reported P values between 0.04 and 0.06, but in all 17 cases P < 0.05. Because the analyses had been adjusted for confounders, these results could not be checked.Significant results in abstracts are common but should generally be disbelieved.
Medical Education and the Rise of Hospitals
Authors: Genevieve Miller
Journal: JAMA (1963)

THE 18TH CENTURY has been called the Age of Hospitals in Britain and her colonies, an appellation certainly justified by numbers alone, for it has been estimated that 46 were organized during this period.<sup>2</sup>The century was also characterized by an empirical attitude among British physicians and surgeons who had been influenced by the scientific revolution of the preceding century. These phenomena interacted and influenced the form of medical education in Britain and her American colonies. The trends of British economic, political, and social life which led to the creation of institutions for the sick poor have been skillfully elucidated by George Rosen.<sup>3</sup>The "fashion of benevolence," a sense of responsibility toward the less fortunate in society, was part of the moral climate of the British aristocracy and intelligentsia. Economic well-being provided the means whereby the voluntary hospital movement flourished, while the mercantilist policy designed to increase the
Irradiation to Prevent Foodborne Illness
Authors: Philip R. Lee
Journal: JAMA (1994)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Respiratory complications of preterm birth
Authors: Jenny Fraser, Moira Walls, William McGuire
Journal: BMJ (2004)

Respiratory complications of preterm birth are an important cause of infant mortality and morbidity. This article looks at how advances in perinatal care have improved outcomes for preterm infants with respiratory distress syndrome and chronic lung disease.

Respiratory distress syndrome of prematurity is a major cause of morbidity and mortality in preterm infants. Primarily, respiratory distress syndrome is caused by deficiency of pulmonary surfactant. Surfactant is a complex mixture of phospholipids and proteins that reduces alveolar surface tension and maintains alveolar stability. As most alveolar surfactant is produced after about 30-32 weeks' gestation, preterm infants born before then will probably develop respiratory distress syndrome. In addition to short gestation, several other clinical risk factors have been identified.

   ![][1] 

Pathogenesis of respiratory distress syndrome is a “vicious cycle”

Preterm infants with respiratory distress syndrome present immediately or soon after birth with worsening respiratory distress. The presenting features include tachypnoea (respiratory rate > 60 breaths per minute); intercostal, subcostal, and sternal recession; expiratory grunting; cyanosis; and diminished breath sounds.

View this table:

Risk factors for respiratory distress syndrome



If untreated, infants may become fatigued, apnoeic, and hypoxic. They may progress to respiratory failure and will need assisted ventilation. High airway pressures may be required to ventilate the stiff, non-compliant lungs, thereby increasing the risk of acute respiratory complications, such as pneumothorax, pneumomediastinum, and pulmonary interstitial emphysema.

   ![][2] 

Endotracheal intubation and ventilation: intercostal drain for pneumothorax

Over the past 20-30 years, two major advances in perinatal management—the use of antenatal corticosteroids and exogenous surfactant replacement—have greatly improved clinical outcomes for preterm infants with respiratory distress syndrome.

### Antenatal corticosteroids

Corticosteroids that cross the placenta (dexamethasone or betamethasone) given to women at risk of preterm delivery accelerate fetal surfactant production and lung maturation. The beneficial effects for preterm infants, including a 40% reduced risk of mortality, respiratory distress syndrome, and intraventricular haemorrhage …

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Deprivation payments to general practitioners: limitations of census data
Authors: F A. Majeed, D. Martin, T. Crayford
Journal: BMJ (1996)

After primary treatment is completed women with breast cancer are usually followed up for some years * Broadly, the goals of follow up are to detect recurrence, detect new contralateral primaries, and provide psychosocial support * For women who are free of disease, general prac- tice follow up was not associated with increased time to diagnosis of recurrence or deterioration in health related quality of life
Missing from the Table: Role of the Environmental Public Health Community in Governmental Advisory Commissions Related to Marcellus Shale Drilling
Authors: Bernard D. Goldstein, Jill Kriesky, Barbara Pavliakova
Journal: Environmental Health Perspectives (2012)

The Marcellus Shale is a vast natural gas field underlying parts of Pennsylvania, New York, West Virginia, Virginia, and Maryland. Rapid development of this field has been enabled by advances in hydrofracking techniques that include injection of chemical and physical agents deep underground. Response to public concern about potential adverse environmental and health impacts has led to the formation of state and national advisory committees.We review the extent to which advisory committees formed in 2011 by President Obama and governors of the states of Maryland and Pennsylvania contain individuals with expertise pertinent to human environmental public health. We also analyze the extent to which human health issues are of concern to the public by reviewing presentations at the public meeting of the Secretary of Energy Advisory Board (SEAB) Natural Gas Subcommittee formed by the U.S. President's directive.At a public hearing held by the SEAB Natural Gas Subcommittee 62.7% of those not in favor of drilling mentioned health issues. Although public health is specified to be a concern in the executive orders forming these three advisory committees, we could identify no individuals with health expertise among the 52 members of the Pennsylvania Governor's Marcellus Shale Advisory Commission, the Maryland Marcellus Shale Safe Drilling Initiative Advisory Commission, or the SEAB Natural Gas Subcommittee.Despite recognition of the environmental public health concerns related to drilling in the Marcellus Shale, neither state nor national advisory committees selected to respond to these concerns contained recognizable environmental public health expertise.
MB Fraction of Creatine Kinase
Authors: Stuart B. Dubin
Journal: JAMA (1981)

<h3>To the Editor.—</h3> In a recent BRIEF REPORT (1980;244:580) Siegel and Dawson correctly point out that small levels of the MB fraction of creatine kinase (CK) can be detected in the undiluted sera of patients without myocardial involvement if the total CK levels are substantially elevated. Since numerous studies, including those they cite, demonstrate that the MB fraction in noncardiac patients is typically 0% to 2% of the total CK activity and if we accept the authors' assessment that about 5 IU/L is the minimum detectable level of CK by the fluorescent method, then it is clear that many noncardiac patients with total CK activity of about 500 IU/L will possess detectable levels of CK-MB in their undiluted sera. This underscores the need for a percentage quantitation of the CK-MB as a fraction of the total CK level, although the absolute level of CK-MB is also generally regarded as important
Adverse events among 2408 unrelated donors of peripheral blood stem cells: results of a prospective trial from the National Marrow Donor Program
Authors: Michael A. Pulsipher, Pintip Chitphakdithai, John P. Miller, Brent R. Logan, Roberta J. King, J. Douglas Rizzo, Susan F. Leitman, Paolo Anderlini, Michael D. Haagenson, Seira Kurian, John P. Klein, Mary M. Horowitz, Dennis L. Confer
Journal: Blood (2009)
Mulberry-like dual-drug complicated nanocarriers assembled with apogossypolone amphiphilic starch micelles and doxorubicin hyaluronic acid nanoparticles for tumor combination and targeted therapy
Authors: Ke Li, Hao Liu, Wei Gao, Mu Chen, Yun Zeng, Jiajun Liu, Liang Xu, Daocheng Wu
Journal: Biomaterials (2014)
FLIP: a novel regulator of macrophage differentiation and granulocyte homeostasis
Authors: Qi-Quan Huang, Harris Perlman, Zan Huang, Robert Birkett, Lixin Kan, Hemant Agrawal, Alexander Misharin, Sandeep Gurbuxani, John D. Crispino, Richard M. Pope
Journal: Blood (2010)

FLIP is a well-established suppressor of death receptor-mediated apoptosis. To define its essential in vivo role in myeloid cells, we generated and characterized mice with Flip conditionally deleted in the myeloid lineage. Myeloid specific Flip-deficient mice exhibited growth retardation, premature death, and splenomegaly with altered architecture and extramedullary hematopoiesis. They also displayed a dramatic increase of circulating neutrophils and multiorgan neutrophil infiltration. In contrast, although circulating inflammatory monocytes were also significantly increased, macrophages in the spleen, lymph nodes, and the peritoneal cavity were reduced. In ex vivo cultures, bone marrow progenitor cells failed to differentiate into macrophages when Flip was deleted. Mixed bone marrow chimera experiments using cells from Flip-deficient and wild-type mice did not demonstrate an inflammatory phenotype. These observations demonstrate that FLIP is necessary for macrophage differentiation and the homeostatic regulation of granulopoiesis.
Cell Transplantation for the Treatment of Acute Myocardial Infarction Using Vascular Endothelial Growth Factor–Expressing Skeletal Myoblasts
Authors: Ken Suzuki, Bari Murtuza, Ryszard T. Smolenski, Ivan A. Sammut, Noriko Suzuki, Yasufumi Kaneda, Magdi H. Yacoub
Journal: Circulation (2001)

Vascular endothelial growth factor (VEGF) is a promising reagent for inducing myocardial angiogenesis. Skeletal myoblast transplantation has been shown to improve cardiac function in chronic heart failure models by regenerating muscle. We hypothesized that transplantation of VEGF-expressing myoblasts could effectively treat acute myocardial infarction by providing VEGF-induced cardioprotection through vasodilatation in the early phase, followed by angiogenesis effects in salvaging ischemic host myocardium combined with the functional benefits of newly formed, skeletal myoblast-derived muscle in the later phase.Primary rat skeletal myoblasts were transfected with the human VEGF(165) gene using hemagglutinating virus of Japan-liposome with >95% transfection efficiency. Four million of these myoblasts (VEGF group), control-transfected myoblasts (control group), or medium only (medium group) was injected into syngeneic rat hearts 1 hour after left coronary artery occlusion. Myocardial VEGF-expression increased for 2 weeks in the VEGF group, resulting in enhanced angiogenesis without the formation of tumors. Grafted myoblasts had differentiated into multinucleated myotubes within host myocardium. Infarct size (33.3+/-1.4%, 38.1+/-1.4%, and 43.7+/-1.6% for VEGF, control, and medium groups, respectively; P=0.0005) was significantly reduced with VEGF treatment, and cardiac function improved in the VEGF group (maximum dP/dt: 4072.0+/-93.6, 3772.5+/-101.1, and 3482.5+/-90.6 mm Hg/s in the 3 groups, respectively; P=0.0011; minimum dP/dt: -504.2+/-68.5, -2311.3+/-57.0, and -2124.0+/-57.9 mm Hg/s, respectively; P=0.0008).This combined strategy of cell transplantation with gene therapy could be of importance for the treatment of acute myocardial infarction.
Medullary Thyroid Carcinoma
Authors: LOUIS LAFLAMME, RAYMOND TAILLEFER, ANDR?? DURANCEAU, MAURICE VERDY, WALTER SCH??RCH
Journal: Clinical Nuclear Medicine (1988)

An I-131 metaiodobenzylguanidine (MIBG) scan was performed in a patient with a familial history of multiple endocrine neoplasia (MEN) type 2 and recurrent medullary thyroid carcinoma (MTC). The scan revealed a mediastinal metastasis from her MTC and there was also an imaging pattern of bilateral adreno-medullary hyperplasia. Although the literature indicates that I-131-MIBG scanning is not sufficiently sensitive for the detection of MTC, this procedure has proven to be of value in the management of chosen patients with MEN-associated MTC.