tbuckley/cabot-search huggingface dataset:
Evaluation of left ventricular size and function by echocardiography. Results in normal children.
Authors: H P Gutgesell, M Paquet, D F Duff, D G McNamara
Journal: Circulation (1977)

Left ventricular (LV) size and function were studied by echocardiography in 145 normal children. The LV end-diastolic diameter (EDD) and its percentage change with systole (%deltaLVD) were measured and mean velocity of circumferential fiber shortening (Vcf) calculated. The LV pre-ejection period (PEP) and ejection time (LVET) were determined from recordings of aortic valve motion. The EDD increased by approximately threefold during childhood and was best correlated with the log of body weight (r = 0.95) and the log of body surface area (r = 0.96). The mean %deltaLVD was 36 +/- 4 (SD), and this index of LV function was independent of age and heart rate. Mean Vef was higher, and the absolute values of PEP and LVET shorter, in younger children with a faster heart rate. The mean ratio of PEP/LVET was 0.31 +/- 0.003, and was relatively independent of age (r = 0.41) and heart rate (r = 0.37). The %deltaLVD and PEP/LVET appear to be particularly useful indices of LV function because they remain constant during the course of childhood.
All brain work – including recall – is state-dependent
Authors: Dietrich Lehmann, Martha Koukkou
Journal: Behavioral and Brain Sciences (2000)

The continuous ongoing mentation is experienced as dreams in some functional states. Mentation occurs with high speed, is driven by individual memory, and uses state-dependent processing strategies, context material, storage options, and retrieval access. Retrieval deserves more attention. Multiple state-shifts owing to individual meaning as extracted also during sleep concatenate dream narratives and define access to segments for awake recall. [Hobson et al.; Nielson; Solms]
Effects of fish oil rich in eicosapentaenoic acid on serum lipid in hyperlipidemic hemodialysis patients
Authors: Tomohito Hamazaki, Ryoichi Nakazawa, Sumio Tateno, Hideo Shishido, Kazuo Isoda, Yoshihiro Hattori, Toyohiko Yoshida, Takao Fujita, Saburo Yano, Akira Kumagai
Journal: Kidney International (1984)
Mechanism of Action of Tris (Hydroxymethyl) Aminomethane on the Negative Inotropic Effect of Carbon Dioxide
Authors: NORBERTO C. GONZALEZ, HORACIO E. CINGOLANI, ALICIA R. MATTIAZZI, JUAN C. MARSIGLIA, JUAN R. SERUR
Journal: Circulation Research (1971)

Administration of isotonic THAM to the blood of the heart-lung preparation induced a decrease in the negative inotropic effect of CO 2 , suggested by the fact that, at constant stroke work, an increase in P co 2 of 26 ± 1.9 mm Hg was followed by an increase in left ventricular end-diastolic pressure (LVEDP) of 3.8 ± 0.2 mm Hg before the infusion of THAM; after THAM was given, a similar increase in P co 2 induced an increase in LVEDP of 1.8 ± 0.2 mm Hg (P&lt;0.01). When pH was increased by 0.15 M NaHCO 3 , no changes in myocardial contractility or in the tolerance of the heart to CO 2 were found. On the other hand, hemodilution with isotonic sucrose reproduced the effect of THAM. Either sucrose or THAM produced a decrease in plasma Na. Myocardial contractility, previously increased by THAM or sucrose, returned to control after plasma Na was restored. When cat papillary muscles were immersed in Ringer's solution with normal (142 m M ) and low (112 m M ) Na concentration, it was observed that a similar increase in P co 2 originated a smaller decrease in contractility when the muscles were in the low Na solution. It is concluded that the effect of THAM in the present experiments is due, at least to an important extent, to changes in extracellular Na.
Palliation of Malignant Oesophageal Obstruction by Endoscopic Alcohol Injection
Authors: S. C. S. Chung, H. T. Leong, C. Y. C. Choi, J. W. C. Leung, A. K. C. Li
Journal: Endoscopy (1994)

Thirty six-patients with inoperable cancers of the oesophagus or gastric tumour in the cardia were treated by endoscopic alcohol injection. After dilatation using Savary dilators, absolute alcohol was injected in 0.5-1 ml aliquots into protuberant parts using a sclerotherapy needle. The mean volume per session was 7.8 ml. The mean dysphagia score improved from 2.7 before treatment to 1.4 after treatment (p < 0.001). Complications included mediastinitis in one patient and tracheo-oesophageal fistulas in two patients. The mean duration of palliation before the development of recurrent dysphagia was 35 days. The mean survival was 82 days. Endoscopic alcohol injection is effective in relieving malignant dysphagia. This inexpensive and easily available technique merits comparative studies with more established forms of therapy, such as laser photocoagulation.
Metabolic Changes Associated With Obesity Before and After Weight Reduction
Authors: Donald Berkowitz
Journal: JAMA (1964)

Carbohydrate, lipid, hepatic, and thyroid metabolic tests have been carried out on 100 obese subjects. Fifty-eight showed abnormal oral glucose tolerance. Intravenous tolbutamide tolerance was normal in 17 of these, indicating an hepatic cause for their hyperglycemia. Hypercholesterolemia was present in 37 patients, whereas the free fatty acids were elevated in 70. The triglycerides were usually normal. Liver function studies, particularly sulfobromophthalein (Bromsulphalein) excretion, frequently yielded abnormal results. Thyroid tests were normal in most cases. The photomotogram, however, was in the hypometabolic range in 28 subjects. This was associated with a decreased lipidmobilizing response to epinephrine in four of eight patients studied. Weight reduction was accompanied by improvement in all of these parameters. Sodium liothyronine (triiodothyronine) treatment, unlike that of amphetamine phosphate, caused a reversion of a prolonged Achilles reflex to normal.
Biguanides and Sulfonylureas as Combination Therapy in NIDDM
Authors: Leif S Hermann
Journal: Diabetes Care (1990)

Oral combination therapy with biguanides (metformin) and sulfonylureas is discussed. The rationale for the use of this combination is based on the different sites of action of the two kinds of drugs and the possibility for obtaining additive or potentiating effects and reduced side effects. The clinical usefulness of chlorpropamide and glyburide in combination with metformin has been demonstrated in some clinical trials. The combination may provide satisfactory glycemic control for several years, and possibly insulin therapy can be postponed or even avoided. No special safety problems are encountered with the use of the combination other than those attributed to the use of metformin or sulfonylurea alone, i.e., lactic acidosis and hypoglycemia, respectively. The lethality risks of these associated conditions are comparable. It is concluded that more data are needed to evaluate the full clinical potential and the mechanism of action of oral combination therapy.
Childhood obesity: time for action, not complacency
Authors: G. Fruhbeck
Journal: BMJ (2000)

The lack of agreement between different studies over the classification of obesity in children and adolescents makes it impossible to give an overview of the global prevalence of obesity for these age groups. Nevertheless, whatever method is used to classify obesity, studies consistently report a high prevalence of obesity and rates are on the increase.1 The national studies of health and growth carried out from 1972 to 1990 on English and Scottish children showed a roughly twofold increase in weight for height in all age groups and both sexes.2 Similar trends have been observed in Europe and the United States.3 Paediatricians face problems of overweight in around one in four of their patients. Interestingly, childhood obesity is not only confined to industrialised countries.1 Therefore a rational clinical approach needs to be applied to preventing and treating this disorder.

The most successful weight reduction programmes are those that combine diet and exercise within a framework of behaviour modification.4-5 Limited information is available about the use of aggressive treatment such as drugs …
Effect of phospholipids and their molecular species on cholesterol solubility and nucleation in human and model biles.
Authors: Z Halpern, M Moshkowitz, H Laufer, Y Peled, T Gilat
Journal: Gut (1993)

Much research in the pathophysiology of gall stones has been devoted to various molecular species of bile salts. Recent findings have shown the importance of phospholipids in biliary pathophysiology. In the present study the addition of increasing doses of egg lecithin to human and model biles progressively prolonged the nucleation time. Concurrently biliary cholesterol was shifted from the vesicular to the non-vesicular carrier(s) while the cholesterol/phospholipid ratio of the remaining vesicles was progressively lowered. Model bile solutions of identical lipid concentration were prepared using phosphatidylcholine, phosphatidylserine, and phosphatidylethanolamine as the only phospholipid. With phosphatidylethanolamine most of the cholesterol was shifted to the vesicular carrier while phosphatidylserine shifted most of the cholesterol to the non-vesicular carrier(s). With phosphatidylcholine the cholesterol was distributed in both carriers. Phosphatidyl choline species composed of various acyl fatty acids in the sn-1 and sn-2 positions were used as the sole phospholipid in otherwise identical model bile solutions. With palmitic acid in the sn-1 position and arachidonic acid in the sn-2 position most of the cholesterol was found in the non-vesicular carrier. When stearic acid was used in sn-2 position instead of arachidonic acid most of the cholesterol was found in the vesicular carrier. These and other variations in phospholipid molecular species shifted cholesterol among its carriers and also modified the nucleation time of model biles. Most of these effects were also found upon addition of the various phospholipid species to human biles. These findings show the importance of phospholipid species in biliary pathophysiology and may be useful when trying to manipulate cholesterol carriers and solubility in bile.
Expansion of Health Care to the Uninsured and Underinsured Has to Be Cost-Neutral
Authors: N. Gleicher
Journal: JAMA (1991)

Any attempt to address the problem of more than 30 million uninsured and 25 million seriously underinsured citizens in the United States has to be able to offer medical services to this 20% of the population in a cost-neutral way for the US economy, since present economic conditions do not permit further expansion in health care costs. A medical system compartmentalized by medical specialty should be able to save approximately 20% of present-day health care expenditures within each specialty, which then can be used to provide the necessary coverage. Some suggestions are made as to how such cost savings can be achieved. Only an effort spearheaded by physicians can achieve the outlined targets, since, otherwise, physician efforts will easily subvert such attempts. A physician initiative that could solve the crisis would reestablish physicians as leaders in determining national health care policy and should consequently improve the recently disappointing societal image of the profession.
Glaucoma and Impotence
Authors: Allan J. Flach
Journal: JAMA (1990)

To the Editor.—  Drs Swartz and Todd 1 discuss the safety of intracavernous papaverine for the treatment of impotence in patients who have glaucoma. I wish to add a further note about the coexistence of these two common conditions.  Glaucoma medications can cause impotence. This is true for β-adrenergic blocking eye drops, such as timolol, levobunolol, and betaxolol, 2 as well as for oral carbonic anhydrase inhibitors. 3 A change of glaucoma medication may relieve impotence, thereby preventing the morbidity of medical or surgical treatment for erectile dysfunction.
Doxycycline and HIV Infection Suppress Tuberculosis-induced Matrix Metalloproteinases
Authors: Naomi F. Walker, Simon O. Clark, Tolu Oni, Nuria Andreu, Liku Tezera, Shivani Singh, Luísa Saraiva, Bernadette Pedersen, Dominic L. Kelly, Julia A. Tree, Jeanine M. D'Armiento, Graeme Meintjes, Francesco A. Mauri, Ann Williams, Robert J. Wilkinson, Jon S. Friedland, Paul T. Elkington
Journal: American Journal of Respiratory and Critical Care Medicine (2012)

Rationale: Tuberculosis kills more than 1.5 million people per year, and standard treatment has remained unchanged for more than 30 years. Tuberculosis (TB) drives matrix metalloproteinase (MMP) activity to cause immunopathology. In advanced HIV infection, tissue destruction is reduced, but underlying mechanisms are poorly defined and no current antituberculous therapy reduces host tissue damage.Objectives: To investigate MMP activity in patients with TB with and without HIV coinfection and to determine the potential of doxycycline to inhibit MMPs and decrease pathology.Methods: Concentrations of MMPs and cytokines were analyzed by Luminex array in a prospectively recruited cohort of patients. Modulation of MMP secretion and Mycobacterium tuberculosis growth by doxycycline was studied in primary human cells and TB-infected guinea pigs.Measurements and Main Results: HIV coinfection decreased MMP concentrations in induced sputum of patients with TB. MMPs correlated with clinical markers of tissue damage, further implicating dysregulated protease activity in TB-driven pathology. In contrast, cytokine concentrations were no different. Doxycycline, a licensed MMP inhibitor, suppressed TB-dependent MMP-1 and -9 secretion from primary human macrophages and epithelial cells by inhibiting promoter activation. In the guinea pig model, doxycycline reduced lung TB colony forming units after 8 weeks in a dose-dependent manner compared with untreated animals, and in vitro doxycycline inhibited mycobacterial proliferation.Conclusions: HIV coinfection in patients with TB reduces concentrations of immunopathogenic MMPs. Doxycycline decreases MMP activity in a cellular model and suppresses mycobacterial growth in vitro and in guinea pigs. Adjunctive doxycycline therapy may reduce morbidity and mortality in TB.
Lack of awareness of problems with treatments threatens malaria control efforts
Authors: P. Moszynski
Journal: BMJ (2010)

Despite the widespread availability of effective new drugs and diagnostic tools, malaria still poses a risk to half the world’s population, and each year about a million people die of the disease, heard a seminar held at the London School of Hygiene and Tropical Medicine to mark world malaria day on 25 April.

The United Nations has called for universal provision of insecticide treated bed nets and prompt treatment for all people at risk of malaria by the end of this year, to achieve the goal of near zero deaths by 2015.

Yet major problems remain. Issues such as misdiagnosis and overprescription of treatments, counterfeit drugs, problems in supply and delivery, and emerging resistance to drugs “all hamper effective treatment.” A lack of awareness among …
Wall stress measurements in non-beating canine hearts: application of a method tested in rubber models
Authors: R. M. HUISMAN, P. SIPKEMA, N. WESTERHOF, G. ELZINGA
Journal: Cardiovascular Research (1979)

We have devised a method for measuring the forces in the left ventricular wall in more detail than was hitherto possible, making use of three force transducer elements in a delta-rosette arrangement. The readings from the three elements were combined to obtain the measured stresses. This procedure took into account the fact that a force transducer inserted in a material is sensitive to forces in two perpendicular directions instead of only the intended one. Tests in rubber ellipsoids showed that with this method the principal stresses and the angles that they make with the transducer can be measured accurately. Using our method we measured stresses in the circumferential and apex-base directions in 11 passively distended canine hearts and also calculated wall stresses from pressure and geometry, using a simple ellipsoidal model. In three experiments measured circumferential stresses were higher than calculated stresses; in three experiments measured and calculated circumferential stresses were approximately equal; and in five experiments measured stress was lower. In the apex-base direction the results were similar. Thus, calculated stress did not consistently under- or overestimate measured stress, although such a consistency did exist within each experiment. In 10 of the 11 hearts, negative shear stress values were found, suggesting that the principal directions of stress in the heart do not correspond exactly to the circumferential and apex-base direction but are shifted slightly counterclockwise. The consistent difference found between the calibration constants in directions making angles of -30° and + 30° with the equator is evidence for considerable anisotropy in the left ventricular wall.
SUBGLOTTIC NEOPLASMS.Read in the Section of Laryngology and Otology, at the Forty-second Annual Meeting of the American Medical Association, Washington, D. C.
Authors: JONATHAN WRIGHT
Journal: JAMA (1891)

From clinical experience in hospital and private practice in diseases of the nose and throat, including a large number of cases, it seems evident to me that disease of the larynx and trachea of any description is not so frequently met with in New York, as the records of foreign, especially German and French, experience would lead us to believe. Neoplasms of the larynx are certainly not as frequently met with, either benign or malignant, as they are in Europe, or else they are given an undue prominence in foreign literature. While it may be true that benign laryngeal neoplasms exist in the proportion of 1 to ½ percent, of all laryngeal cases in this country, laryngeal affections in general are much less common than abroad. This personal opinion may not be sustained by the experience of other Americans, but there is reason to believe that I am not alone
Simon Baruch: Rebel in the Ranks of Medicine, 1840-1921
Authors: Bernadine Z. Paulshock
Journal: JAMA (1995)

Simon Baruch was just 15 years old when he left his family to emigrate from a region now part of Poland to South Carolina to obtain a medical education. The chapters on his education in Patricia Spain Ward's biography are revealing of the time: for instance, formaldehyde for cadavers was not yet invented, so classes in dissection were possible in winter months only. At 22, immediately after his graduation, Baruch signed on as a physician in the Confederate Army. He was captured several times and held prisoner once. The chapters describing the young physician's military experiences reveal many chilling truths about military medicine at the time of the Civil War. When the war ended, Baruch was so weakened by typhoid that he needed crutches on his hike home to Camden, South Carolina. There was no mail, nor bridges, nor railroads; the problems for physicians were almost as dreadful as they
Frequency of BRCA1 Dysfunction in Ovarian Cancer
Authors: J. P. Geisler
Journal: JNCI Journal of the National Cancer Institute (2002)

Background: Ovarian cancer is one of the most common hereditary cancers in women. Mutations in the BRCA1 gene increase a woman's risk of ovarian cancer. Testing for BRCA1 mutations is cumbersome and impractical for large populations. Therefore, we developed an efficient strategy to detect various types of BRCA1 dysfunction and also determined the relative frequency of BRCA1 dysfunction in ovarian cancer. Methods: Tumors from 221 patients with epithelial ovarian cancer were screened for loss of heterozygosity (LOH) at the BRCA1 locus. BRCA1 complementary DNA (cDNA) and genomic DNA from all cancers with BRCA1 LOH (106 tumors) or noninformative status (15 tumors) were polymerase chain reaction (PCR) amplified and analyzed for protein truncation in a coupled transcription/translation test. When truncated BRCA1 protein was detected, the BRCA1 gene from both the tumor and a paired blood sample was sequenced. When BRCA1 expression in tumor cDNA was not detected with a protein truncation test, a methylation-specific PCR was used to determine whether the promoter region of BRCA1 was methylated and thus inactivated. All statistical tests were two-sided. Results: Fifty-one (23.1%) of 221 tumors had BRCA1 dysfunction, including 18 with germline mutations, 15 with somatic mutations, and 18 with monoallelic or biallelic hypermethylated promoters. By the consideration of only tumors with LOH or that were noninformative, the efficiency for detecting BRCA1 dysfunction improved to 45 (37.2%) of 121 tumors. Therefore, LOH/noninformative was a strong predictor of mutation status (Fisher's exact test, P<.001). However, this subset of tumors did not include those with BRCA1 missense mutations (estimated at six [2.7%] of 221 not detected by our method) or biallelic promoter methylation (estimated at six [2.7%] of 221). Conclusions: BRCA1 dysfunction in ovarian cancer is common and occurs via multiple mechanisms. The use of LOH, rather than a family history of ovarian cancer, as a first step in a screening strategy, followed by protein truncation testing, appears to increase the chance of identifying tumors with BRCA1 dysfunction.
The SHP-1 protein tyrosine phosphatase negatively modulates glucose homeostasis
Authors: Marie-Julie Dubois, Sébastien Bergeron, Hyo-Jeong Kim, Luce Dombrowski, Mylène Perreault, Bénédicte Fournès, Robert Faure, Martin Olivier, Nicole Beauchemin, Gerald I Shulman, Katherine A Siminovitch, Jason K Kim, André Marette
Journal: Nature Medicine (2006)
Ketamine for Posttraumatic Stress Disorder—Reply
Authors: Adriana Feder, James W. Murrough
Journal: JAMA Psychiatry (2015)

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The Use of Molecular Profiling to Predict Survival after Chemotherapy for Diffuse Large-B-Cell Lymphoma
Authors: Andreas Rosenwald, George Wright, Wing C. Chan, Joseph M. Connors, Elias Campo, Richard I. Fisher, Randy D. Gascoyne, H. Konrad Muller-Hermelink, Erlend B. Smeland, Jena M. Giltnane, Elaine M. Hurt, Hong Zhao, Lauren Averett, Liming Yang, Wyndham H. Wilson, Elaine S. Jaffe, Richard Simon, Richard D. Klausner, John Powell, Patricia L. Duffey, Dan L. Longo, Timothy C. Greiner, Dennis D. Weisenburger, Warren G. Sanger, Bhavana J. Dave, James C. Lynch, Julie Vose, James O. Armitage, Emilio Montserrat, Armando López-Guillermo, Thomas M. Grogan, Thomas P. Miller, Michel LeBlanc, German Ott, Stein Kvaloy, Jan Delabie, Harald Holte, Peter Krajci, Trond Stokke, Louis M. Staudt
Journal: New England Journal of Medicine (2002)

The survival of patients with diffuse large-B-cell lymphoma after chemotherapy is influenced by molecular features of the tumors. We used the gene-expression profiles of these lymphomas to develop a molecular predictor of survival.