The New England journal of medicine
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To evaluate whether the nicotine and carbon monoxide content of cigarette smoke is related to the risk of nonfatal first myocardial infarction in young men, we compared 502 cases with 835 hospital controls, all between the ages of 30 and 54 years. As expected, the estimated risk of myocardial infarction increased with the number of cigarettes smoked; overall, the relative-risk estimate for current smokers was 2.8 (95 per cent confidence interval, 2.0 to 4.0). The risk did not appear to vary according to the amount of nicotine or carbon monoxide in the cigarette, and the mean amounts of both substances per cigarette were similar for the cases and controls. The results suggest that men who smoke the newer cigarettes with reduced amounts of nicotine and carbon monoxide do not have a lower risk of myocardial infarction than those who smoke cigarettes containing larger amounts of these substances.
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Effects of digoxin in infants with a congested circulatory state due to a ventricular septal defect.
Digoxin alone was used to treat a congested circulatory state in 21 infants (mean age, 2.7 months; mean weight, 3.8 kg) with a ventricular septal defect. The dose was adjusted on the basis of pharmacokinetics to achieve a mean steady-state concentration of 1.6 +/- 0.3 ng of digoxin per milliliter of serum. ⋯ These results show that not all infants with a congested circulatory state due to a ventricular septal defect benefit from digoxin therapy. Furthermore, in some subjects clinical improvement occurs in the absence of a measurable inotropic response.