Personality differences among black, white, and Hispanic-American male heroin addicts on MMPI content scales

Used MMPI Content Scale scores (Wiggins, 1966) to assess personality differences among black, white, and Hispanic-American heroin addicts. Ss were 423 male veterans who volunteered for the first time for treatment between 1972 and 1979 to an inpatient Drug Dependence Treatment Program (DDTP) of a Veterans Administration Medical Center. Two hypotheses were tested: First, that minority group heroin addicts (blacks and Hispanics) will show better adjustment than majority group (white) heroin addicts; second, that Hispanic-American heroin addicts will evidence personality characteristics unlike those of either whites or blacks. Both hypotheses were confirmed. Results were interpreted as supporting cultural theories of substance abuse and providing implications for diagnosis and treatment of substance abuse disorders among minority ethnic groups.     

Ixazomib with cyclophosphamide and dexamethasone in relapsed or refractory myeloma: MUKeight phase II randomised controlled trial results

The all-oral combination of ixazomib, cyclophosphamide, and dexamethasone (ICD) is well tolerated and effective in newly diagnosed and relapsed multiple myeloma (MM). We carried out MUKeight, a randomised, controlled, open, parallel group, multi-centre phase II trial in patients with relapsed MM after prior treatment with thalidomide, lenalidomide, and a proteasome inhibitor (ISRCTN58227268), with the primary objective to test whether ICD has improved clinical activity compared to cyclophosphamide and dexamethasone (CD) in terms of progression-free survival (PFS). Between January 2016 and December 2018, 112 participants were randomised between ICD (n = 58) and CD (n = 54) in 33 UK centres. Patients had a median age of 70 years and had received a median of four prior lines of therapy. 74% were classed as frail. Median PFS in the ICD arm was 5.6 months, compared to 6.7 months with CD (hazard ratio (HR) = 1.21, 80% CI 0.9–1.6, p = 0.3634). Response rates and overall survival were not significantly different between ICD and CD. Dose modifications or omissions, and serious adverse events (SAEs), occurred more often in the ICD arm. In summary, the addition of ixazomib to cyclophosphamide and dexamethasone did not improve outcomes in the comparatively frail patients enroled in the MUKeight trial.Subject terms: Drug development, Cancer therapy, Cancer therapy     

Neuropsychological performance in lateralized parkinsonism

Seven dextral patients with Parkinson's disease (PD) who had predominant right-sided motor signs were compared on neuropsychological tests with eight dextral patients with PD who had predominant left-sided signs. Objective criteria for group designation were developed from clinical ratings. The patient subgroups were matched on age, education, estimated premorbid IQ, severity of motor signs, and medication usage. Patients with signs lateralized to the right were more impaired on tests of dominant hemisphere function (serial digit learning, confrontation naming, and verbal associative fluency), but no differences were found on tests of nondominant hemisphere function (form sequence learning, line orientation, facial recognition), indicating some correlation of neuropsychological performance with lateralization of predominant motor signs. Findings demonstrate that the cognitive deficits (particularly visuospatial) previously reported in the literature are not seen consistently in all subjects with PD.     

Prognostic significance and beneficial effect of diltiazem on the incidence of early recurrent ischemia after non-Q-wave myocardial infarction: results from the Multicenter Diltiazem Reinfarction Study

Of 576 patients with non-Q-wave acute myocardial infarction enrolled in the Diltiazem Reinfarction Study, 246 (43%) had 1 or more episodes of angina at rest or with minimal effort during 10.5 days of treatment with either diltiazem (90 mg every 6 hours) or placebo. Reinfarction (12.2% vs 3.6%, p less than 0.0001) or death (6.1% vs 1.5%, p = 0.003) was more likely to occur within 2 weeks of randomization in patients with postinfarction angina than in those without angina. Based on serial electrocardiographic data, 115 of the 246 patients with angina had transient ST-T changes and 131 did not. Comparison of the 14-day event rates in these 2 groups showed that the 115 patients with electrocardiographic evidence of ischemia had a higher frequency of reinfarction (20% vs 5.3%, p less than 0.001), more extensive damage as assessed by peak MB-creatine kinase levels (91 +/- 76 vs 37 +/- 19 IU/liter, p = 0.059 [Wilcoxon rank sum]) and a higher mortality rate (11.3% vs 1.5%, p = 0.001). Angina associated with transient ST-T changes occurred in 70 of the 289 patients in the placebo group but in only 45 of the 287 patients in the diltiazem group--a 28% reduction in cumulative life-table incidence (p = 0.0103 [2-tail, log rank]; 95% confidence interval, 9.3 to 53.8%). It is concluded that patients with early postinfarction angina are at increased risk of reinfarction and death, and angina associated with transient electrocardiographic changes identified a very high risk subset. This subset appeared to have a larger area of viable but jeopardized myocardium and benefited from prophylactic therapy with diltiazem.     

Calcification of healed myocardial infarcts

Clinical and necropsy findings are described in 21 patients, aged 43 to 78 years (mean 63) (19 men [90%]), who had grossly visible calcified myocardial infarcts. The interval from the first clinically apparent acute myocardial infarct to death (20 patients) ranged from 2 to 26 years (mean 12). This interval was greater than 5 years in 17 patients (85%) and greater than 10 years in 11 patients (55%). The ages at the first clinically apparent acute myocardial infarct ranged from 36 to 72 years (mean 51). Of the 21 patients, 17 (81%) had clinical evidence of chronic congestive heart failure; 12 (57%) had left ventricular aneurysms; 8 (38%) had documented episodes of ventricular tachycardia; and 5 had angina pectoris. At necropsy, the heart weight was increased (greater than 400 g) in all (mean 557 g), the left ventricular cavity was dilated in all, and at least 1 and usually 2 or 3 (86%) major epicardial coronary arteries were narrowed greater than 75% in cross-sectional area by atherosclerotic plaque. Thus, patients with calcified myocardial infarcts are usually men, they usually have a myocardial infarct that calcifies at a relatively young age, the calcified wall is usually part of an aneurysmal wall, the left ventricular cavity is almost always dilated, heart weight is increased, and progressive congestive heart failure is the usual mode of death.     

Success of re-use of cardiac electrode catheters

The feasibility of cardiac electrode catheter re-use was prospectively evaluated over a 5-year period (1981 to 1986), during which time 178 catheters were used 1,526 times for 847 electrophysiologic procedures. Detailed records of catheter testing and use were maintained. No complications were encountered during the study period. All re-used catheters functioned for cardiac pacing and electrographic recording. Surveillance cultures and biologic indicators revealed that adequate sterilization procedures were used. Thus, electrode catheters may be safely re-used provided a thorough cleaning, testing and record-keeping system is instituted. This may result in lower patient cost (approximately $30 per re-use vs [200 per single use) for electrophysiologic catheterization.