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At least 1,099 records · Page 61Linked to original sources
PubMed2006

Effect of rimonabant, a cannabinoid-1 receptor blocker, on weight and cardiometabolic risk factors in overweight or obese patients: RIO-North America: a randomized controlled trial.

CONTEXT: Rimonabant, a selective cannabinoid-1 receptor blocker, may reduce body weight and improve cardiometabolic risk factors in patients who are overweight or obese. OBJECTIVE: To compare the efficacy and safety of rimonabant with placebo each in conjunction with diet and exercise for sustained changes in weight and cardiometabolic risk factors over 2 years. DESIGN, SETTING, AND PARTICIPANTS: Randomized, double-blind, placebo-controlled trial of 3045 obese (body mass index > or =30) or overweight (body mass index >27 and treated or untreated hypertension or dyslipidemia) adult patients at 64 US and 8 Canadian clinical research centers from August 2001 to April 2004. INTERVENTION: After a 4-week single-blind placebo plus diet (600 kcal/d deficit) run-in period, patients were randomized to receive placebo, 5 mg/d of rimonabant, or 20 mg/d of rimonabant for 1 year. Rimonabant-treated patients were rerandomized to receive placebo or continued to receive the same rimonabant dose while the placebo group continued to receive placebo during year 2. MAIN OUTCOME MEASURES: Body weight change over year 1 and prevention of weight regain during year 2. Additional efficacy measures included changes in waist circumference, plasma lipid levels, and other cardiometabolic risk factors. RESULTS: At year 1, the completion rate was 309 (51%) patients in the placebo group, 620 (51%) patients in the 5 mg of rimonabant group, and 673 (55%) patients in the 20 mg of rimonabant group. Compared with the placebo group, the 20 mg of rimonabant group produced greater mean (SEM) reductions in weight (-6.3 [0.2] kg vs -1.6 [0.2] kg; P<.001), waist circumference (-6.1 [0.2] cm vs -2.5 [0.3] cm; P<.001), and level of triglycerides (percentage change, -5.3 [1.2] vs 7.9 [2.0]; P<.001) and a greater increase in level of high-density lipoprotein cholesterol (percentage change, 12.6 [0.5] vs 5.4 [0.7]; P<.001). Patients who were switched from the 20 mg of rimonabant group to the placebo group during year 2 experienced weight regain while those who continued to receive 20 mg of rimonabant maintained their weight loss and favorable changes in cardiometabolic risk factors. Use of different imputation methods to account for the high rate of dropouts in all 3 groups yielded similar results. Rimonabant was generally well tolerated; the most common drug-related adverse event was nausea (11.2% for the 20 mg of rimonabant group vs 5.8% for the placebo group). CONCLUSIONS: In this multicenter trial, treatment with 20 mg/d of rimonabant plus diet for 2 years promoted modest but sustained reductions in weight and waist circumference and favorable changes in cardiometabolic risk factors. However, the trial was limited by a high drop-out rate and longer-term effects of the drug require further study. Clinical Trials Registration ClinicalTrials.gov Identifier: NCT00029861.

Adult↗
PubMed2000

Efficacy and safety of selamectin against fleas and heartworms in dogs and cats presented as veterinary patients in North America.

A series of randomized, controlled, masked field studies was conducted to assess the efficacy and safety of selamectin in the treatment of flea infestations on dogs and cats, and in the prevention of heartworm infection in dogs. In addition, observations were made on the beneficial effect of selamectin treatment on dogs and cats showing signs of flea allergy dermatitis (FAD). In all studies selamectin was applied topically, once per month, in unit doses providing a minimum dosage of 6mgkg(-1). Dogs and cats with naturally occurring flea infestations, some of which also had signs associated with FAD, were assigned randomly to receive three months of topical treatment with selamectin (220 dogs, 189 cats) or a positive-control product (dogs: fenthion, n=81; cats: pyrethrins, n=66). Selamectin was administered on days 0, 30, and 60. Day 0 was defined as the day that the animal first received treatment. Flea burdens were assessed by flea comb counts and clinical evaluations of FAD were performed before treatment, and on days 14, 30, 60, and 90. On days 30, 60, and 90, mean flea counts in selamectin-treated dogs were reduced by 92.1, 99.0, and 99.8%, and mean flea counts in fenthion-treated dogs were reduced by 81.5, 86.8, and 86.1%, respectively, compared with day 0 counts. Also, on days 30, 60, and 90, mean flea counts in selamectin-treated cats were reduced by 92.5, 98.3, and 99.3%, and mean flea counts in pyrethrin-treated cats were reduced by 66.4, 73.9, and 81.3%, respectively, compared with day 0 counts. Selamectin also was beneficial in alleviating signs in dogs and cats diagnosed clinically with FAD. A total of 397 dogs free of adult heartworm infection from four heartworm-endemic areas of the USA were allocated randomly to six months of treatment with selamectin (n=298) or ivermectin (n=99). Selamectin achieved a heartworm prevention rate of 100%, with all dogs testing negative for microfilariae and adult heartworm antigen on days 180 and 300. Selamectin was administered to a total of 673 dogs and 347 cats having an age range of 6 weeks to 19 years (3954 doses). The animals included 19 purebred or crossbred Collies (Bearded, Border, and unspecified). There were no serious adverse events. Results of these studies indicated that selamectin was highly effective in the control of flea infestations in dogs and cats without the need for simultaneous treatment of the environment or of in-contact animals and also was beneficial in alleviating signs associated with FAD. Selamectin also was 100% effective in preventing the development of canine heartworms and was safe for topical use in dogs and cats.

Animals↗
PubMedDate not supplied

Treatment-seeking behavior for acute myocardial infarction symptoms in North America and Australia.

OBJECTIVE: The goal of this study was to compare North American and Australian patients' sociodemographic, clinical, cognitive, emotional, and social factors associated with behavior in seeking treatment for symptoms of acute myocardial infarction. PATIENTS: Subjects included 277 North Americans (mean age, 58 +/- 12 years; 72% men) and 147 Australians (mean age, 62 +/- 13 years; 66% men) with acute myocardial infarction. METHODS: Data were obtained with the Response to Symptoms Questionnaire and from the patients' hospital records. RESULTS: In both groups, patients who delayed longer (P </=.05) had lower incomes, known diabetes mellitus, and symptom onset while at home; in addition, they appraised their symptoms as not serious, waited for symptoms to go away, and worried about troubling others. Additional factors associated with longer delay in North Americans (P </=.05) were older age, intermittent symptoms, and attribution of symptoms to a noncardiac cause; other contributing factors include not recognizing the symptoms as cardiac and fearing the consequences of seeking help. In Australians (P </=. 05), contributing factors were fewer years of education, a history of hypertension, and embarrassment about seeking help. CONCLUSION: Programs to reduce delay in response to acute myocardial infarction symptoms must take account of cognitive and emotional processes and differences in response in the particular cultures of patients.

Adult↗
PubMed1979

Specialty certification in North America: a comparative analysis of examination results.

The pass/fail results of 44 North American medical specialty certification examinations are compared and analyzed. A calculated annual failure rate was used to equate one- and two-part examinations. Failure rates on American boards generally varied between 8 and 61 percent. Foreign medical graduates (FMGs) had failure rates two to three times higher than those of North American graduates in almost all specialties. Failure rates for comparable North American and FMG candidates tended to be higher on Royal College of Physicians and Surgeons of Canada specialty certification examinations than on equivalent American specialty board examinations. The place of specialty certification in the continuum of American graduate medical education is delineated. Questions are raised concerning the standards required for specialty certification.

Canada↗
PubMed1990

Inebriate institutions in North America, 1840-1920.

This paper analyses two contemporaneous types of 19th-century North American inebriate institutions and attempts by their promoters to develop a public treatment system. Inebriate 'homes' or 'retreats' descended from a tradition of therapeutic temperance that originated in the Washingtonian Movement of the 1840s. They were small, urban, private and charitable, dedicated to voluntaristic and Christian principles, and were intimately connected with local temperance groups that provided support after residential treatment. Inebriate asylums took inspiration from insane asylums and were large, public, coercive and isolated in rural areas. Their promoters were steeped in the deterministic, hereditarian neurologism of Victorian psychiatry. Asylum enthusiasts dominated the public treatment movement, but developed a largely disciplinary and custodial vision that undermined their political appeal. As inebriate asylums could not easily be distinguished from insane asylums, almshouses or jails, legislators regarded them as superfluous and very few were established. Prohibition destroyed what public inebriate institutions existed. Inebriate colonies, usually connected with county jails, were the only survivors of the 19th-century treatment movement apart from private sanitaria and a few inebriate wards in city or county hospitals.

Alcoholism↗
PubMed1990

Alcoholism--North America and Asia. A comparison of population surveys with the Diagnostic Interview Schedule.

The Diagnostic Interview Schedule (DIS) is a highly structured instrument that enables lay examiners to gather the clinical information necessary to generate psychiatric disorders according to the DSM-III, Feighner, and Research Diagnostic Criteria. It was developed originally as the diagnostic interview for the Epidemiologic Catchment Area (ECA) survey. Because it adheres to DSM-III and can be used by lay interviewers, thus making it practical for studies involving large samples, it has been used for other population surveys in North and South America, Europe, and Asia. This investigation compares the epidemiology of DSM-III-defined alcohol abuse and addiction in DIS-based population surveys cross-nationally (in St Louis, Mo; Edmonton, Canada; Puerto Rico; Taipei City, Taiwan; and South Korea). We found considerable variation in the lifetime prevalence of alcoholism but a similarity in the age of onset, the symptomatic expression, and the associated risk factors. We also found an inverse correlation between the prevalence of alcoholism and the strength of the association of the risk factors we examined. The work described herein demonstrates the utility of consistent definition and method in cross-cultural psychiatric research. The substantive findings have implications for the definition of alcoholism and for a better understanding of genetic and environmental interactions in its etiology.

Adolescent↗
PubMed2001

Gold allergy in North America.

OBJECTIVE: To determine the prevalence of allergic reactions to gold among patients tested by the North American Contact Dermatitis Group (NACDG) from 1996 to 1998. METHODS: This is a prospective analysis of patch test results from the 12 centers that comprise the NACDG. Gold was tested as gold sodium thiosulfate (0.5% in petrolatum [pet]), along with 49 other screening allergens, in patients presenting with possible contact dermatitis. RESULTS: Of 4,101 patients tested, 388 (9.5%) had a positive patch test result to gold. Women accounted for 62.8% of the subjects tested and 90.2% of patients positive to gold (P < .0001). The most common sites of dermatitis in gold-allergic patients were the hands (29.6%), face (19.3%), and eyelids (7.5%). Nickel and cobalt allergies, respectively, also were present in 33.5% and 18.3% of gold allergic individuals, as compared with 14.2% and 9.0% of the total population. Gold was the only positive reaction in 15.2% of the 388 patients. CONCLUSION: Gold is a more common allergen than previously reported and might cause facial and eyelid dermatitis. Hypersensitivity to gold is statistically linked to female gender and to allergic reactions to nickel and cobalt.

Allergens↗
PubMed2006

Exacerbation of Avellino corneal dystrophy after LASIK in North America.

PURPOSE: To report the first case of Avellino corneal dystrophy exacerbation after LASIK in a white or North American patient. METHODS: Case report and literature review. RESULTS: A 25-year-old white female developed progressive corneal opacities after LASIK. Preoperative examination had revealed only subtle white corneal opacities in each eye. The patient's mother had similar corneal opacities. DNA analysis of the patient revealed a heterozygous mutation at the R124H location in the BIGH3 gene. CONCLUSIONS: LASIK can exacerbate Avellino corneal dystrophy and should be avoided in patients with this condition. A careful history and genetic analysis can identify affected patients and those at risk.

Adult↗
PubMed1996

Labial gland chemistry of three species of bumblebees (Hymenoptera: Apidae) from North America.

The volatile secretion emanating from the cephalic part of the paired labial gland in male bumblebees of three North American species, viz. Bombus sonorus Say, Bombus huntii Greene and Psithyrus insularis (F. Smith) has been analysed by GC-MS and GC-FTIR. The secretion, which is deposited as a marking secretion on various objects along a repetitive flight path, is composed of isoprenoids, (acyclic sesqui- and diterpenes) and straight-chain fatty acid derivatives (alcohols containing 14, 16 and 18 carbon atoms, and odd numbered hydrocarbons ranging from 23 to 27 carbons). The secretions are species-specific with just a few major components. In B. sonorus (Z)-11-octadecen-1-ol is the main compound accompanied by geranylgeraniol and tetradecan-1-ol; in B. huntii the dominating compound is trans-2,3-dihydrofarnesol and it also contains (Z)-11-octadecen-1-ol and hexadecan-1-ol; P. insularis is characterized by geranylcitronellol, together with the (Z)-11-octadecen-1-ol and hexadecan-1-ol. These results agree with analyses of 36 species and two forms of Scandinavian bumblebees analysed previously.

Animals↗
PubMed1995

Libyostrongylus dentatus n. sp. (Nematoda: Trichostrongylidae) from ostriches in North America, with comments on the genera Libyostrongylus and Paralibyostrongylus.

Libyostrongylus dentatus sp. n. is described from ostriches on farms from North Carolina and Texas. Nematodes were recovered from the posterior proventriculus and under the koilon lining of the gizzard; the parasites occurred in mixed infections with Libyostrongylus douglassii. The species is distinguished from congeners by the presence of a prominent, dorsal, esophageal tooth; in males by the structure of the dorsal ray and spicules; and in females by small eggs (52-62 microns in length), a sublateral vulva situated at 93% of the body length from the anterior, and a strongly curled, digitate, tail with cuticular inflations at the anus. Conflicts in the generic diagnoses of Libyostrongylus and Paralibyostrongylus were apparent, based on the structure of the dorsal ray or position of rays 3-5 of the copulatory bursa. These can only be resolved based on phylogenetic analyses of the 11 nominal species referred to these genera.

Animals↗
PubMed1996

National Hockey League players from North America are more violent than those from Europe.

It is commonly believed by hockey fans that European hockey players rely more on skill while. North American players are more violent. The number of penalty minutes gathered by European and North American players in the National Hockey League's 1995-1996 season was examined. When corrected for the low proportion of European players, North American players had significantly more penalty minutes than European players.

Aggression↗
PubMed2006

A new species of Rhabdias from lungs of the wood frog, Rana sylvatica, in North America: the last sibling of Rhabdias ranae?

Rhabdias bakeri n. sp. is described from specimens found in lungs of the wood frog, Rana sylvatica, from North Dakota. The new species has previously been mistakenly identified as Rhabdias ranae Walton, 1929, a common parasite of the leopard frog, Rana pipiens. The new species differs from R. ranae and Rhabdias joaquinensis Ingles, 1935 by the shape and size of pseudolabia, shape and size of buccal capsule, and wider esophageal bulb. Molecular analysis based on the partial sequences of nuclear 18S rDNA gene, complete sequences of internal transcribed spacer region, and partial sequences of 28S gene demonstrates clear differences between Rhabdias from Ra. sylvatica and Ra. pipiens, and supports the status of R. bakeri as a new species.

Animals↗
PubMed2001

Divergent consequences of success and failure in japan and north america: an investigation of self-improving motivations and malleable selves.

Self-enhancing and self-improving motivations were investigated across cultures. Replicating past research, North Americans who failed on a task persisted less on a follow-up task than those who succeeded. In contrast, Japanese who failed persisted more than those who succeeded. The Japanese pattern is evidence for a self-improving orientation: Failures highlight where corrective efforts are needed. Japanese who failed also enhanced the importance and the diagnosticity of the task compared with those who succeeded, whereas North Americans did the opposite. Study 2 revealed that self-improving motivations are specific to the tasks on which one receives feedback. Study 3 unpackaged the cultural differences by demonstrating that they are due, at least in part, to divergent lay theories regarding the utility of effort. Study 4 addressed the problem of comparing cultures on subjective Likert scales and replicated the findings with a different measure.

Creativity↗
PubMed1994

Prevention of venous thromboembolism in North America: results of a survey among general surgeons.

PURPOSE: The purpose of this study was to analyze current attitudes toward the prevention of postoperative venous thromboembolism among North American general surgeons. METHODS: A survey regarding awareness of the problem of venous thromboembolism and preferred modalities of prophylaxis was sent to 3500 randomly selected Fellows of the American College of Surgeons. RESULTS: A total of 1018 (29.1%) surveys was returned. Most of the responding surgeons consider venous thromboembolism a serious health problem. Ninety percent of the surgeons use prophylaxis against venous thromboembolism routinely. The most frequently used modalities are intermittent pneumatic compression, low-dose heparin, and elastic stocking. A combination of physical and pharmacologic methods is used by one fourth of respondents, and only 50% start pharmacologic prophylaxis before the surgical procedure. The thrombosis risk factors that are most frequently considered by surgeons when deciding about using prophylaxis are history of venous thromboembolism, immobility, and length of operation. CONCLUSIONS: North American surgeons who responded to this survey are well aware of the problem of venous thromboembolism and their approach to prevention has been significantly modified in the last 10 years. Compared with similar European surveys this survey reveals a higher implementations of physical methods such as intermittent pneumatic compression and elastic stockings. Because of the limited response rate and possibility of sampling bias, these findings should be interpreted with caution.

Adult↗
PubMed2003

The teaching of dermatology in veterinary education in North America (2002).

The purpose of this study was to collect and report the current quantity and content of dermatology taught in the nonclinical and clinical curricula of North American veterinary colleges. This is the first published record of this information and was gathered from 29/30 colleges. Half of the respondents of the questionnaire thought that veterinary students currently receive sufficient didactic dermatology course work. A separate didactic dermatology course is required at 16/29 colleges, which provides a mean of 31.31 instructional units. Twenty-four of 29 veterinary colleges offer a separate clinical dermatology rotation. Thirteen schools report that students who desire a clinical rotation through dermatology usually attain it. However, it is only required for graduation in seven colleges. This report serves as a tool for veterinary schools assessing their existing curriculum and allows them to compare the education they provide in this specialty with that of other colleges.

Animals↗