animals

To assess a physician’s expertise on the basis of whether the doctor checks a patient’s QT interval would be excessive, but the fact remains that in many cases, checking it saves lives. The author of a respected textbook on electrocardiography1 wrote, “The measurement of the QT interval has little usefulness” in 1957 — the same year in which Jervell and Lange-Nielsen published their first report on the association between QT-interval prolongation and sudden death in a family with congenital deafness,2 which was soon followed by similar findings reported by Romano and colleagues3 and by Ward4 in patients with normal hearing. In 1975, Romano–Ward syndrome and Jervell–Lange-Nielsen syndrome were grouped under the name long QT syndrome.5
Long QT syndrome is an uncommon disease of genetic origin with a documented prevalence of 1 in 2000 live births6; however, the actual prevalence is probably higher because the original prospective study, which involved 44,000 infants,6 did not include genotype-positive–phenotype-negative persons. The syndrome is characterized by prolongation of the QT interval on an electrocardiogram (ECG) obtained when the patient was at rest and by a propensity for life-threatening arrhythmias that occur mostly under conditions of physical or emotional stress.5,7 The clinical importance of the timely diagnosis of the syndrome stems from the fact that sudden cardiac death is often the first symptom, which makes remedying diagnostic or therapeutic errors impossible. As stated 50 years ago,5 given the high efficacy of current therapies, the existence of patients with undiagnosed — and therefore untreated — long QT syndrome is nowadays inexcusable; unfortunately, missed diagnosis is still too often the case.

Author/s:

Peter J. Schwartz, Lia Crotti

Venomous Snakes and Snakebites

Megan George — Tue, 02 Sep 2025 13:14:37 +0000

Date Added:

September 2, 2025

Journal/Publication:

JAMA

Publication Date:

August 28, 2025

URL:

Venomous Snakes and Snakebites

Type:

Patient Education Materials

Format:

Article

DOI (1):

10.1001/jama.2025.13080

Keywords

Toxicology

jama Patient Information

PMID (1):

40875216

MeSH

Poison Control Centers

Blood Coagulation

paralysis

Information for patients about venomous snake bites. James W. Mold, MD, MPH

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This JAMA Patient Page describes the venomous snakes found in the US as well as snakebite symptoms, treatment, and prevention.

Author/s:

Kevin Lieu, MD, Kathy T. LeSaint, MD, Zhanna Livshits, MD

The monkeypox virus

Saige Blanchard — Tue, 14 Jun 2022 05:00:00 +0000

Date Added:

June 14, 2022

Journal/Publication:

Canadian Medical Association Journal

Publisher:

CMA Impact Inc.

Publication Date:

June 2, 2022

URL:

The monkeypox virus

Type:

Meta-analyses, Reviews, and Guidelines

DOI (1):

10.1503/cmaj.220795

Keywords

PMID (1):

35654445

MeSH

A concise summary of the things you need to know about monkey pox. James W. Mold, MD, MPH

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Monkeypox is a viral infection with person-to-person
transmission through direct contact or fomites
The virus is endemic to West and Central Africa.1
Animal-to-human transmission may initiate outbreaks, and person-to-person transmission
occurs through direct, close contact with a person during their infectious
stage through droplets, contact with infectious bodily fluids or via fomites
(e.g., linens). Airborne transmission is thought to be less common.

Author/s:

Halani, S., Mishra, S., Bogoch, I. I.

Button battery ingestions in children

Bethie Seay — Tue, 28 Sep 2021 05:00:00 +0000

Date Added:

September 28, 2021

Journal/Publication:

CMAJ

Publication Date:

September 27, 2021

Issue:

Volume:

193

Pages:

E1498

Type:

Meta-analyses, Reviews, and Guidelines

DOI (1):

10.1503/cmaj.210572

MeSH

Constriction, Pathologic

caregivers

outpatients

Poisons

Electric Power Supplies

Esophageal Fistula

Abdomen

Gastrointestinal Hemorrhage

vomiting

hospitals

Eating

A concise review of button battery ingestions in children and what to do about them.

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1. Injuries in children from ingesting button batteries are
increasing
2. The type and size of the ingested battery influence the
likelihood of complications
3. Urgency of management depends on the location of the battery
4. Honey or sucralfate should be administered after battery
ingestion
5. Children should be monitored for long-term complications

Author/s:

Zipursky, A. R., Ratnapalan, S.

A Battery of Easily Accessible, Simple Tools for the Assessment of Concussion in Children

Devin Evans — Wed, 27 Jan 2021 06:00:00 +0000

Date Added:

January 27, 2021

Journal/Publication:

The Journal of Pediatrics

Volume:

229

Pages:

232-239

URL:

A Battery of Easily Accessible, Simple Tools for the Assessment of Concussion in Children

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1016/j.jpeds.2020.10.012

Keywords

PMID (1):

33068568

MeSH

Neurologic Examination

Athletic Injuries

Simple, accurate tests to monitor children post-concussion. James W. Mold, MD, MPH

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Objective: To determine whether a non-proprietary, novel testing battery can identify recently concussed children within 8 weeks of injury.

Study design: In total, 568 clinic outpatients aged 10-18 years were sorted into 3 groups: 316 had never been concussed, 162 had ever been concussed before 8 weeks earlier, and 90 had been recently concussed within 8 weeks. At initial and any subsequent visits, a neurologic examination and 4 procedures were performed: Stick Drop, Wall Ball, Sharpened Modified Romberg (SMR), and Animal Naming. Analysis included inter-group and intra-person performance differences using a series of t tests on the Stick Drop, Wall Ball, SMR, and Animal Naming.

Results: The recently concussed group performed worse (P < .01 for all) on Stick Drop, total Wall Ball bounces and drops, and SMR compared with never-concussed and ever-concussed groups. This effect for Stick Drop, SMR, and Wall Ball but not Animal Naming persisted beyond the 4 weeks commonly stated to define recovery. Of 59 recently concussed subjects who returned for ≥1 visit, there were improvements in Stick Drop average (P = .004) and maxima (P = .02) as well as SMR (P = .01) but not Animal Naming between initial and subsequent visits.

Conclusions: This novel, rapid testing battery distinguished groups of children ages 10-18 years who had and had not experienced a recent concussion. A view that physical concussion symptoms resolve within a month of injury may be incomplete. Deployment of this readily available, inexpensive and non-proprietary battery should be compared with other tools and studied further in serial assessments.

Author/s:

Brown, William D., Baird, Janette, Kriz, Peter K.

Association Between Plant and Animal Protein Intake and Overall and Cause-Specific Mortality

Brian Desmarais — Wed, 22 Jul 2020 16:00:16 +0000

Date Added:

July 22, 2020

Journal/Publication:

JAMA Intern Medicine

Publisher:

JAMA Network

Publication Date:

July 13, 2020

URL:

Association Between Plant and Animal Protein Intake and Overall and Cause-Specific Mortality

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1001/jamainternmed.2020.2790.

MeSH

Plant Proteins, Dietary

fruit

cardiovascular diseases

Analysis of a huge cohort of adults found that eating more plant protein (vs. animal protein) reduces cardiovascular mortality and increases life expectancy. James W. Mold, MD, MPH

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Importance: Although emphasis has recently been placed on the importance of high-protein diets to overall health, a comprehensive analysis of long-term cause-specific mortality in association with the intake of plant protein and animal protein has not been reported.

Objective: To examine the associations between overall mortality and cause-specific mortality and plant protein intake.

Design, setting, and participants: This prospective cohort study analyzed data from 416 104 men and women in the US National Institutes of Health-AARP Diet and Health Study from 1995 to 2011. Data were analyzed from October 2018 through April 2020.

Exposures: Validated baseline food frequency questionnaire dietary information, including intake of plant protein and animal protein.

Main outcomes and measures: Hazard ratios and 16-year absolute risk differences for overall mortality and cause-specific mortality.

Results: The final analytic cohort included 237 036 men (57%) and 179 068 women. Their overall median (SD) ages were 62.2 (5.4) years for men and 62.0 (5.4) years for women. Based on 6 009 748 person-years of observation, 77 614 deaths (18.7%; 49 297 men and 28 317 women) were analyzed. Adjusting for several important clinical and other risk factors, greater dietary plant protein intake was associated with reduced overall mortality in both sexes (hazard ratio per 1 SD was 0.95 [95% CI, 0.94-0.97] for men and 0.95 [95% CI, 0.93-0.96] for women; adjusted absolute risk difference per 1 SD was -0.36% [95% CI, -0.48% to -0.25%] for men and -0.33% [95% CI, -0.48% to -0.21%] for women; hazard ratio per 10 g/1000 kcal was 0.88 [95% CI, 0.84-0.91] for men and 0.86 [95% CI, 0.82-0.90] for women; adjusted absolute risk difference per 10 g/1000 kcal was -0.95% [95% CI, -1.3% to -0.68%] for men and -0.86% [95% CI, -1.3% to -0.55%] for women; all P < .001). The association between plant protein intake and overall mortality was similar across the subgroups of smoking status, diabetes, fruit consumption, vitamin supplement use, and self-reported health status. Replacement of 3% energy from animal protein with plant protein was inversely associated with overall mortality (risk decreased 10% in both men and women) and cardiovascular disease mortality (11% lower risk in men and 12% lower risk in women). In particular, the lower overall mortality was attributable primarily to substitution of plant protein for egg protein (24% lower risk in men and 21% lower risk in women) and red meat protein (13% lower risk in men and 15% lower risk in women).

Conclusions and relevance: In this large prospective cohort, higher plant protein intake was associated with small reductions in risk of overall and cardiovascular disease mortality. Our findings provide evidence that dietary modification in choice of protein sources may influence health and longevity.

Conflict of interest statement

Conflict of Interest Disclosures: None reported.

Author/s:

Huang, J., Liao, L.M., Weinstein, S.J., Sinha, R., Graubard, B.I., Albanes, D.

Pets Are Associated with Fewer Peer Problems and Emotional Symptoms, and Better Prosocial Behavior: Findings from the Longitudinal Study of Australian Children

Brian Desmarais — Wed, 22 Apr 2020 23:44:31 +0000

Date Added:

April 22, 2020

Journal/Publication:

Journal of Pediatrics

Publication Date:

February 21, 2020

URL:

Pets Are Associated with Fewer Peer Problems and Emotional Symptoms, and Better Prosocial Behavior: Findings from the Longitudinal Study of Australian Children

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1016/j.jpeds.2020.01.012.

Keywords

MeSH

Family Characteristics

social change

Surveys and Questionnaires

This study supports pet ownership to support healthy childhood development. James W. Mold, MD, MPH

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Abstract

OBJECTIVE:

To investigate the longitudinal association between pet ownership and children's social-emotionaldevelopment.

STUDY DESIGN:

Two time-points of data from the Longitudinal Study of Australian Children were analyzed for children at ages 5 (n = 4242) and 7 (n = 4431) years. The Strengths and Difficulties Questionnaire (SDQ) measured children's social-emotional development. Pet ownership status and type (dog, cat, other) as well as sociodemographic and other potential confounders were collected. Longitudinal panel regression models were used.

RESULTS:

Overall, 27% of children had abnormal scores on 1 or more SDQ scales. By age 7, 75% of children had pets with ownership highest in single-child households. Owning any type of pet was associated with decreased odds of abnormal scores for emotional symptoms (OR, 0.81; 95% CI, 0.67-0.99), peer problems (OR, 0.71; 95% CI, 0.60-0.84), and prosocial behavior (OR, 0.70; 95% CI, 0.38-0.70), compared with non-pet owners. Dog ownership was associated with decreased odds of abnormal scores on any of the SDQ scales (OR, 0.81; 95% CI, 0.71-0.93). For children without any siblings, only the prosocial behavior scale was significantly associated with pet ownership (OR, 0.21; 95% CI, 0.07-0.66). In longitudinal models, cat-only and dog-only groups were associated with feweremotional symptoms and peer problems compared with non-pet owners.

CONCLUSIONS:

Early school age is an important period for family pet acquisition. Pets may protect children from developing social-emotional problems and should be taken into account when assessing child development and school readiness. Children without siblings may benefit most in terms of their prosocial behavior.

Author/s:

Christian, H., Mitrou, F., Cunneen, R., Zubrick, S.R.

Metabolic Effects of Intermittent Fasting

John Bayhi — Thu, 16 Jan 2020 16:35:23 +0000

Date Added:

January 16, 2020

Journal/Publication:

Annual Review of Nutrition

Publisher:

Annual Reviews

Publication Date:

August 21, 2017

Volume:

Pages:

371-393

URL:

Metabolic Effects of Intermittent Fasting

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1146/annurev-nutr-071816-064634

Keywords

circadian rhythm

gut microbiome

modifiable lifestyle behavior

postprandial

PMID (1):

28715993

MeSH

gastrointestinal microbiome

Humans

male

sleep

An evidence-based review of what we currently know about the metabolic effects of intermittent fasting. James W. Mold, MD, MPH

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The objective of this review is to provide an overview of intermittent fasting regimens, summarize the evidence on the health benefits of intermittent fasting, and discuss physiological mechanisms by which intermittent fasting might lead to improved health outcomes. A MEDLINE search was performed using PubMed and the terms "intermittent fasting," "fasting," "time-restricted feeding," and "food timing." Modified fasting regimens appear to promote weight loss and may improve metabolic health. Several lines of evidence also support the hypothesis that eating patterns that reduce or eliminate nighttime eating and prolong nightly fasting intervals may result in sustained improvements in human health. Intermittent fasting regimens are hypothesized to influence metabolic regulation via effects on (a) circadian biology, (b) the gut microbiome, and (c) modifiable lifestyle behaviors, such as sleep. If proven to be efficacious, these eating regimens offer promising nonpharmacological approaches to improving health at the population level, with multiple public health benefits.

Author/s:

Patterson, RE, Sears, DD

Clinical Approach to Lactose Intolerance

John Bayhi — Fri, 27 Sep 2019 14:15:56 +0000

Date Added:

September 27, 2019

Journal/Publication:

JAMA

Publisher:

American Medical Association

Publication Date:

September 26, 2019

URL:

Clinical Approach to Lactose Intolerance

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.1001/jama.2019

Keywords

lactose intolerance

lactase deficiency

diagnostic tests

PMID (1):

31556907

MeSH

Lactose Tolerance Test

Lctase-Phlorizin Hydrolase

Irritable Bowel Syndrome

A concise review of the evaluation and management of suspected lactose intolerance. James W. Mold, MD, MPH

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Lactose intolerance refers to the clinical syndrome in which symptoms of bloating, flatulence, abdominal discomfort, and diarrhea arise following the consumption of lactose-containing foods. Lactose malabsorption results from congenital lactase deficiency, secondary lactose intolerance, and, most commonly, from acquired primary lactase deficiency, a highly prevalent condition affecting 65% to 74% of the worldwide population, with wide regional and ethnic variations. Symptoms arising from lactose malabsorption result from fluid shifts into the intestinal lumen driven by an osmotic gradient and subsequent fermentation of lactose by bacteria residing in the gastrointestinal tract. In this article we review the development of clinical lactose intolerance, diagnostic testing, and treatment of individuals presenting with symptoms of lactose intolerance.

Author/s:

Micic, D, Rao, VL, Rubin, DT