tbuckley/cabot-search huggingface dataset:
Impact of an Intensive Care Unit Telemedicine Program on Patient Outcomes in an Integrated Health Care System
Authors: Boulos S. Nassar, Mary S. Vaughan-Sarrazin, Lan Jiang, Heather S. Reisinger, Robert Bonello, Peter Cram
Journal: JAMA Internal Medicine (2014)

Intensive care unit (ICU) telemedicine (TM) programs have been promoted as improving access to intensive care specialists and ultimately improving patient outcomes, but data on effectiveness are limited and conflicting.To examine the impact of ICU TM on mortality rates and length of stay (LOS) in an integrated health care system.Observational pre-post study of patients treated in 8 "intervention" ICUs (7 hospitals within the US Department of Veterans Affairs health care system) during 2011-2012 that implemented TM monitoring during the post-TM period as well as patients treated in concurrent control ICUs that did not implement an ICU TM program.Implementation of ICU TM monitoring.Unadjusted and risk-adjusted ICU, in-hospital, and 30-day mortality rates and ICU and hospital LOS for patients who did or did not receive treatment in ICUs equipped with TM monitoring.Our study included 3355 patients treated in our intervention ICUs (1708 in the pre-TM period and 1647 in the post-TM period) and 3584 treated in the control ICUs during the same period. Patient demographics and comorbid illnesses were similar in the intervention and control ICUs during the pre-TM and post-TM periods; however, predicted ICU mortality rates were modestly lower for admissions to the intervention ICUs compared with control ICUs in both the pre-TM (3.0% vs 3.6%; P = .02) and post-TM (2.8% vs 3.5%; P < .001) periods. Implementation of ICU TM was not associated with a significant decline in ICU, in-hospital, or 30-day mortality rates or LOS in unadjusted or adjusted analyses. For example, unadjusted ICU mortality in the pre-TM vs post-TM periods were 2.9% vs 2.8% (P = .89) for the intervention ICUs and 4.0% vs 3.4% (P = .31) for the control ICUs. Unadjusted 30-day mortality during the pre-TM vs post-TM periods were 7.7% vs 7.8% (P = .91) for the intervention ICUs and 12.0% vs 10.2% (P = .08) for the control ICUs. Evaluation of interaction terms comparing the magnitude of mortality rate change during the pre-TM and post-TM periods in the intervention and control ICUs failed to demonstrate a significant reduction in mortality rates or LOS.We found no evidence that the implementation of ICU TM significantly reduced mortality rates or LOS.
Mexiletine for Treatment of Myotonia
Authors: Eric P. Hoffman, Henry J. Kaminski
Journal: JAMA (2012)

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
Repeated Intravesical Instillations of an Adenoviral Vector in Patients With Locally Advanced Bladder Cancer: A Phase I Study of <i>p53</i> Gene Therapy
Authors: Lance C. Pagliaro, Afsaneh Keyhani, Dallas Williams, Denise Woods, Baoshun Liu, Paul Perrotte, Joel W. Slaton, James A. Merritt, H. Barton Grossman, Colin P. Dinney
Journal: Journal of Clinical Oncology (2003)

Purpose: We investigated the feasibility, safety, and biologic activity of adenovirus-mediated p53 gene transfer in patients with locally advanced bladder cancer. Patients and Methods: Patients with measurable, locally advanced transitional-cell carcinoma of the bladder who were not candidates for cystectomy were eligible. On a 28-day cycle, intravesical instillations of INGN 201 (Ad5CMV-p53) were administered on days 1 and 4 at three dose levels (10 10 particles to 10 12 particles) or on either 4 or 8 consecutive days at a single dose level (10 12 particles). Results: Thirteen patients received a total of 22 courses without dose-limiting toxicity. Specific transgene expression was detected by reverse transcriptase polymerase chain reaction in bladder biopsy tissue from two of seven assessable patients. There were no changes in p53, p21 waf1/cip1 , or bax protein levels in bladder epithelium evident from immunohistochemical analysis of 11 assessable patients. Outpatient administration of multiple courses was feasible and well tolerated. A patient with advanced superficial bladder cancer showed evidence of tumor response. Conclusion: Intravesical instillation of Ad5CMV-p53 is safe, feasible, and biologically active when administered in multiple doses to patients with bladder cancer. Observations from this study indicate that this treatment has an antitumor effect in superficial transitional-cell carcinoma. Improvements in the efficiency of gene transfer and the levels of gene expression are required to develop more effective gene therapy for bladder cancer.
Freestanding Abortion Clinics
Authors: Christopher Tietze
Journal: New England Journal of Medicine (1972)

Because New York State's abortion law is the most liberal in the United States and because New York City lies at the heart of one of the world's largest concentrations of peoples, the city has indeed become the "abortion capital of the nation." During the first 12 months after the implementation of a new and liberalized abortion law on July 1, 1970, about 168,000 legal abortions were performed in New York City, of which about 105,000 involved nonresident women.1 This vast expansion of a highly specialized service, without any serious disruption of other medical services, could not have been achieved . . .
A Clinical and Pathological Study of Fatal Cases of Status Asthmaticus
Authors: J. C. Houston, S. De Navasquez, J. R. Trounce
Journal: Thorax (1953)

Altho,ugh over 200 fatal cases of asthma have been reported with detailed microscopic findings (Unger, 1945) the train of events leading to death in status asthmaticus is still not fully understood.
Journals in Bits and Bytes
Authors: Jerome P. Kassirer
Journal: New England Journal of Medicine (1992)

The new capacity to transmit information from one computer to another made the introduction of a fully electronic medical journal inevitable. The recent announcement by the American Association for the Advancement of Science that their new Online Journal of Clinical Trials will appear this spring1 has prompted speculation about how the revolution in electronics may affect readers, authors, and editors. In its initial incarnation, the Online Journal will transmit reports of new clinical trials as soon as they are accepted for publication. Subscribers who have a fast personal computer with a moderately large memory and a modem, a color monitor, . . .
Abstract P3-14-23: Affitoxin — A Potent Therapeutic Agent for Treatment of HER2- Overexpressing Tumors
Authors: R Zielinski, I Lyakhov, M Hassan, M Kuban, K Shafer-Weaver, J. Capala
Journal: Cancer Research (2010)

Abstract Introduction: Cancers overexpressing HER2 gene are usually described as more aggressive and are associated with poor prognosis. Although introduction of trastuzumab, a HER2-specific humanized antibody, significantly improved the outcome, there are still number of patients who do not respond or acquire resistance to HER2-targeted therapy. We have previously described the construction, expression, and in vitro characterization of Affitoxin, a recombinant protein combining HER2- specific Affibody and modified Pseudomonas exotoxin A (PE 38) that blocks protein synthesis by ADP ribosylation of eEF-2 (Zielinski et al. 2009). In this report we present in vivo data. Materials and Methods. Recombinant Affitoxins were expressed and purified from the soluble fraction of E.coli. HER2 specificity was confirmed in vitro by measurement of the residual ATP level in N87 cells treated with Affitoxin and “Non-specific” toxin. containing “off-target” instead of HER2 - Affibodies. Acute toxicity and immunogenicity studies were performed in female Balb/c mice. Affitoxin clearance rate was determined by ELISA and residual serum toxicity. Biodistribution in subcutaneous BT474 tumors model was determined by NIR optical imaging. In vivo efficacy of the drug was verified in subcutaneous (BT474, SKOV3) and intraperitoneal (SKOV3-luc-D3) tumor models. Results. In this work we have confirmed that HER2-specific Affitoxin is a potent agent eliminating HER2-overexpressing cells in vitro at low picomolar concentration range, while non-specific toxin-containing offtarget Affitoxin is four orders of magnitude less efficient. Acute toxicity studies showed that Affitoxin is well tolerated by mice with LD50 = 0.572±0.051 mg/kg. Injection of six doses every third day neither lead to significant weigh loss of the animal nor induced severe liver problems. Pharmacokinetic data indicated fast clearance of Affitoxin from the circulation with half-life shorter than 10 min. Using human tumor xenograft models, we have shown that Affitoxin accumulates in HER2- overexpressing BT474 tumors, leading not only to reduction of growth rate but also permanent shrinkage of relatively large (&amp;lt;1000mm3) xenografts. Treatment with non-specific toxin did not affect the BT474 tumors. Affitoxin was also shown to delay the growth of both SKOV3 subcutaneous and intraperitoneally spread tumors. Immunogenicity studies indicated that Affitoxin is less immunogenic than toxin containing antibody fragments fused to PE38 (HA22). Conclusions. Affitoxin is a novel recombinant protein, using high affinity Affibody molecules to target HER2 receptors. Our in vitro and in vivo data strongly suggest that Affitoxin might be an attractive alternative or complement for existing HER2 targeted therapies Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-14-23.
Echocardiographic Characterization of Cardiomyopathy in Friedreich’s Ataxia With Tissue Doppler Echocardiographically Derived Myocardial Velocity Gradients
Authors: David P. Dutka, J. Elisabeth Donnelly, Przemysław Palka, Aleksandra Lange, Derek J. R. Nunez, Petros Nihoyannopoulos
Journal: Circulation (2000)

Background —Conventional and tissue Doppler echocardiographically derived myocardial velocity gradients (MVGs) were used to characterize the myocardium in patients with Friedreich’s ataxia (FRDA), and the relationship between MVGs and the mutation in the FRDA gene, a GAA triplet repeat expansion, was investigated. Methods and Results —We studied 29 patients with FRDA (10 men, mean age 31±9 years) who were homozygous for the GAA expansion in the FRDA gene and were without cardiac symptoms. A comparison was made with a group of 30 age-matched control subjects. In patients with FRDA, interventricular septal thickness (1.17±0.26 versus 0.85±0.13 cm, P &lt;0.005), posterior left ventricular wall thickness (1.00±0.24 versus 0.88±0.15 cm, P &lt;0.01), and left atrial diameter (3.3±0.5 versus 2.9±0.3 cm, P =0.01) were increased compared with control subjects. MVGs were reduced in FRDA during systole (3.1±1.2 versus 4.5±0.5 s −1 , P &lt;0.0001) and in early diastole (4.9±2.7 versus 8.8±1.8 s −1 , P &lt;0.0001) but increased in late diastole (2.0±1.3 versus 1.1±0.9 s −1 , P &lt;0.01). The strongest relationship was seen between age-corrected early diastolic MVGs and the GAA expansion in the smaller allele of the FRDA gene ( r =−0.68, P &lt;0.0001). Conclusions —MVGs offer a means of further characterizing the myocardial abnormalities in patients with FRDA. Early diastolic MVGs appear to relate most closely to the genetic abnormality and the consequential reduction in frataxin protein.
Developments in the rat adjuvant arthritis model and its use in therapeutic evaluation of novel non-invasive treatment by SOD in Transfersomes
Authors: S.I. Simões, T.C. Delgado, R.M. Lopes, S. Jesus, A.A. Ferreira, J.A. Morais, M.E.M. Cruz, M.L. Corvo, M.B.F. Martins
Journal: Journal of Controlled Release (2005)
Interval versus Continuous High-Intensity Exercise in Chronic Obstructive Pulmonary Disease
Authors: Milo A. Puhan, Gilbert Büsching, Holger J. Schünemann, Evelien vanOort, Christian Zaugg, Martin Frey
Journal: Annals of Internal Medicine (2006)

Background: Guidelines recommend high-intensity continuous exercise to reduce peripheral muscle dysfunction in patients with chronic obstructive pulmonary disease but acknowledge that interval exercise might be an equally effective alternative that is better tolerated by patients. Objective: To assess whether interval exercise is no less effective than high-intensity continuous exercise and whether it is tolerated better by patients with severe chronic obstructive pulmonary disease. Design: Randomized, noninferiority trial. Setting: Publicly funded rehabilitation hospital in Switzerland. Patients: 98 patients with severe chronic obstructive pulmonary disease, with or without recent exacerbations. Intervention: 12 to 15 supervised interval or high-intensity continuous exercise sessions (over 3 weeks) followed by exercise at home. Measurements: Health-related quality of life determined by using the Chronic Respiratory Questionnaire (CRQ) (scores from 1 [most severe impairment] to 7 [no impairment]) after 5 weeks and number of unintended breaks during supervised exercise. Results: Both groups experienced large improvements in health-related quality of life (increase of CRQ total scores of 1.00 [SD, 0.98] for the interval exercise group and 1.02 [SD, 1.05] for the continuous exercise group). Adjusted between-group differences between the interval exercise group and the continuous exercise group (–0.05 [95% CI, –0.42 to –0.32] for CRQ and 1.1 meters [CI, –25.4 to 27.6 meters] for 6-minute walking distance) were within the a priori defined boundaries of noninferiority (0.5 for CRQ and 45 meters for 6-minute walking distance). Twenty-one (47.9%) patients using interval exercise and 11 (24.0%) patients using continuous exercise were able to adhere to the protocol (difference, 23.9 percentage points [CI, 5.0 to 42.8 percentage points]; P = 0.014). The median number of unintended breaks lasting 1 minute or more was 2 (interquartile range, 0 to 16) for patients in the interval exercise group and 11 (interquartile range, 2 to 26) for patients in the continuous exercise group (P = 0.023). Limitations: The study focused on initiation of exercise and not on outpatient or home-based maintenance of exercise. Conclusions: Clinicians and patients can choose either of the 2 exercise plans to initiate physical exercise. International Standard Randomized Controlled Trial number: SRCTN11611768.
Public Health Effects of Occupational and Environmental Radiation Exposure-Reply
Authors: Steve Wing
Journal: JAMA (1991)

<h3>In Reply.</h3> —Our study showed that the previously reported elevation of the leukemia SMR at Oak Ridge National Laboratory<sup>1</sup>continued with longer follow-up, was confined to the time period after 1965 among workers hired before 1960, and was larger in a subgroup of workers monitored for internal radionuclide contamination than in the cohort as a whole. We nowhere concluded that the leukemia excess was due to occupational radiation; however, these results are not inconsistent with an occupational effect. Relationships between mortality and radiation exposure were studied among the workers; the general population was not used as "unexposed" controls. Dose-response estimates for leukemia were highly unstable, reflecting in part the small number of leukemia deaths and the generally low occupational exposures. There were no leukemia deaths between 40 mSv and 120 mSv and 1.9 expected; all the observed and expected values in Table 5 are summarized by the dose coefficient
294 TLR 9 INHIBITION: A NOVEL TARGET OF THERAPY FOR PRIMARY LIVER CANCER
Authors: F.E.Z. Mohamed, S. Minogue, D. Dhar, N. Shah, N. Davies, A. Habtesion, T.V. Luong, A. Winstanley, A.P. Dhillon, R.P. Mookerjee, R. Jalan
Journal: Journal of Hepatology (2012)
An evaluation of the inflammatory response of lipopolysaccharide-treated primary dental pulp cells with regard to calcium silicate-based cements
Authors: Wei-Yun Lai, Chia-Tze Kao, Chi-Jr Hung, Tsui-Hsien Huang, Ming-You Shie
Journal: International Journal of Oral Science (2014)

This study compared the biological changes of lipopolysaccharide (LPS)-treated dental pulp (DP) cells directly cultured on mineral trioxide aggregate (MTA) and calcium silicate (CS) cements. DP cells were treated with LPS for 24 h. Then, the LPS-treated DP cells were cultured on MTA or CS cements. Cell viability, cell death mechanism and interleukin (IL)-1β expressions were analysed. A one-way analysis of variance was used to evaluate the significance of the differences between the means. A significantly higher IL-1β expression (2.9-fold) was found for LPS-treated cells (P<0.05) compared with DP cells without LPS treatment at 24 h. Absorbance values of LPS-treated cells cultured on CS cement were higher than a tissue culture plate. A significant difference (P<0.05) in cell viability was observed between cells on CS and MTA cements 24 h after seeding. At 48 h, a high concentration of Si (5 mM) was released from MTA, which induced LPS-treated DP cell apoptosis. The present study demonstrates that CS cement is biocompatible with cultured LPS-treated DP cells. MTA stimulates inflammation in LPS-treated DP cells, which leads to greater IL-1β expression and apoptosis. A new cement for tooth root repair may offer better biocompatibility and lower risk of inflammation than currently used materials. Mineral trioxide aggregate (MTA) has proven highly effective for endodontic repair procedures, but Ming-You Shie and colleagues at Taiwan's Chung Shan Medical University have developed a calcium silicate (CS) cement that may prove safer. To simulate conditions in the mouth, they cultured dental pulp cells on both MTA and CS, and exposed them to a toxic compound produced by oral bacteria. Cells cultured on MTA exhibited an elevated and prolonged inflammatory response, possibly arising from silicon released from MTA. In contrast, cells cultured on CS showed improved viability and reduced inflammation over time. The researchers propose that this new cement may offer a useful alternative to MTA.
Augmentation of Myocardial Production of 15-Epi-Lipoxin-A <sub>4</sub> by Pioglitazone and Atorvastatin in the Rat
Authors: Yochai Birnbaum, Yumei Ye, Yu Lin, Sheldon Y. Freeberg, Shawn P. Nishi, Juan D. Martinez, Ming-He Huang, Barry F. Uretsky, Jose R. Perez-Polo
Journal: Circulation (2006)

Both statins and thiazolidinediones have antiinflammatory properties. However, the exact mechanisms underlying these effects are unknown. We investigated whether atorvastatin (ATV) and pioglitazone (PIO) increase the myocardial content of lipoxin-A4 and 15(R)-epi-lipoxin-A4 (15-epi-LXA4), both arachidonic acid products with strong antiinflammatory properties.In experiment 1, rats received 3-day pretreatment with water; PIO 2, 5, or 10 mg x kg(-1) x d(-1); ATV 2, 5, or 10 mg x kg(-1) x d(-1); or PIO 10 mg x kg(-1) x d(-1)+ATV 10 mg x kg(-1) x d(-1). In experiment 2, rats received water; PIO 10 mg x kg(-1) x d(-1)+ATV 10 mg x kg(-1) x d(-1); PIO+ATV and valdecoxib, a selective cyclooxygenase-2 (COX-2) inhibitor; PIO+ATV and zileuton, a selective 5-lipoxygenase inhibitor; or zileuton alone. There were 4 rats in each group. Hearts were harvested and analyzed for myocardial lipoxin-A4 and 15-epi-LXA4 levels and for COX-2 and 5-lipoxygenase protein expression. ATV and PIO at 5 and 10 mg x kg(-1) . d(-1) significantly increased myocardial 15-epi-LXA4 levels compared with the sham-treated group (0.51 +/- 0.02 ng/mg). Myocardial 15-epi-LXA4 were significantly higher in the PIO+ATV group (1.29 +/- 0.02 ng/mg; P < 0.001 versus each other group). Both valdecoxib and zileuton abrogated the PIO+ATV increase in 15-epi-LXA4, whereas zileuton alone had no effect. PIO, ATV, and their combination resulted in a small increase in myocardial lipoxin-A4 levels, which was not statistically significant. ATV alone or in combination with PIO markedly augmented COX-2 expression. PIO had a much smaller effect on COX-2 expression. Myocardial expression of 5-lipoxygenase was not altered by PIO, ATV, or their combination.Both PIO and ATV increase myocardial levels of 15-epi-LXA4, a mediator with antiinflammatory properties. This finding may explain the antiinflammatory properties of both PIO and ATV.
Exploiting Genome Data to Understand the Function Regulation and Evolutionary Origins of Toxicologically Relevant Genes
Authors: N Ballatori
Journal: Environmental Health Perspectives (2002)

The wealth of new information coming from the many genome sequencing projects is providing unprecedented opportunities for major advances in all areas of biology, including the environmental health sciences. To facilitate this discovery process, experts in the fields of functional genomics and informatics and the emerging field of toxicogenomics recently gathered at the Mount Desert Island Biological Laboratory in Salisbury Cove, Maine, site of a National Institute of Environmental Health Sciences Marine and Freshwater Biomedical Science Center, to share their ideas and latest research findings. The goal of the symposium was to highlight approaches that may be used to identify and characterize toxicologically relevant genes being discovered in the genome sequencing projects. Many of the approaches rely heavily on comparative models as a way of identifying gene homology, ontology, and physiologic function, and on the availability of databases that facilitate storage, analysis, interpretation, and widespread dissemination of relevant data.