JAMA : the journal of the American Medical Association
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To determine the incidence and effect of unrecognized cardiac injury in critically ill patients. ⋯ The incidence of myocardial injury defined by elevated levels of cardiac troponin I was unexpectedly high and associated with increased morbidity and mortality. Clinically, it was often unrecognized.
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To test the hypothesis that insulin resistance precedes impaired insulin secretion in individuals genetically predisposed to non-insulin-dependent diabetes mellitus (NIDDM). ⋯ In this study population, heterogeneous defects in insulin secretion were demonstrated, while defects in insulin sensitivity were not evident. We therefore conclude that since the earliest defects identified in a group genetically at high risk to develop NIDDM are those related to insulin secretion, defects in insulin secretion rather than insulin sensitivity are likely the major genetic factor predisposing to development of NIDDM.
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To develop and validate a simple prognostic scoring system to identify patients in nontraumatic coma at high risk for poor outcomes using data available early in the hospital course. ⋯ Five readily available clinical variables identify a large subgroup of patients in nontraumatic coma at high risk for poor outcomes. This risk stratification approach offers physicians, patients, and patients' families information that may prove useful in patient care decisions and resource allocation.
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A study of 222 intraracial domestic homicides in Atlanta, Ga, found that when black and white populations were unstratified, the relative risk of homicide in black populations was 5.8 (95% confidence interval [CI], 4.3 to 8.0); when black and white populations were stratified by rates of household crowding, the relative risk of homicide in black populations was no longer significantly elevated (relative risk [RR], 1.2; 95% CI, 0.7 to 2.0). The current study sought to replicate, or not replicate, these findings in New Orleans, La. ⋯ The findings of the Atlanta homicide study are replicated in the current study of homicide in New Orleans. In both cities, sixfold differences in black and white rates of intraracial domestic homicide are entirely accounted for by differences in socioeconomic status between the respective black and white populations. There are no significant residual differences requiring cultural explanations.