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 report updated national trends in traumatic brain injury deaths from 1979 through 1992. ⋯ These data highlight the success of efforts to prevent traumatic brain injury due to motor vehicles and failure to prevent such injuries due to firearms. The increasing importance of penetrating injury has important implications for research, treatment, and prevention of traumatic brain injury in the United States.