tbuckley/cabot-search huggingface dataset:
Inconsistency of the slope and the volume intercept of the end-systolic pressure-volume relationship as individual indexes of inotropic state in conscious dogs: presentation of an index combining both variables.
Authors: A J Crottogini, P Willshaw, J G Barra, R Armentano, E I Cabrera Fischer, R H Pichel
Journal: Circulation (1987)

We tested the ability of the slope (Emax) and the volume intercept (Vo) of the end-systolic pressure-volume relationship (ESPVR) to indicate contractility changes in conscious dogs instrumented with sonomicrometers measuring left ventricular diameter in three orthogonal axes and a left ventricular pressure microtransducer. ESPVRs were generated by inferior vena caval occlusion under control conditions (C1 and C2) and during enhanced (I+) and depressed (I-) inotropic states achieved by infusion of dobutamine and injection of propranolol, respectively. No significant difference between the first control (C1) and I+ or between the second control (C2) and I- were found for either Emax (C1, 5.31 +/- 1.68 mm Hg/ml, mean +/- SD; I+, 5.37 +/- 1.44; C2, 5.20 +/- 1.62; I-, 4.18 +/- 1.32) or Vo (C1, 10.3 +/- 9.6 ml; I+, 7.3 +/- 9.1; C2, 9.9 +/- 9.0; I-, 12.7 +/- 12.5), despite significant changes in other indexes of contractility. Comparison of changes in Emax in individual animals in response to I+ and I- revealed that 63% were nonsignificant, 28% were significant and expected, and 9% were significant and paradoxical. Within defined volume limits and irrespective of individual changes in Emax and Vo, in all animals I+ shifted the ESPVR above and to the left of C1 and I- shifted the ESPVR below and to the right of C2. We thus integrated the changes in Emax and Vo by measuring the area beneath each ESPVR between defined limits of end-systolic volume. The values for area were: C1, 612 +/- 150 mm Hg.ml; I+, 745 +/- 191 (p less than .001); C2, 520 +/- 198; I-, 420 +/- 139 (p less than .001). We conclude that (1) neither Emax nor Vo are individually reliable indexes of changed contractility, and (2) the area beneath the ESPVR between defined end-systolic volume limits is a consistent indicator of variations in inotropic state.
Ischemic Cerebrovascular Disease (Stroke)
Authors: John Stirling Meyer
Journal: JAMA (1963)

One-hundred fifty-two patients with a diagnosis of stroke were routinely admitted to the hospital and studied by bilateral carotid and vertebral arteriography. Complication rate was 3.5%. Obstructive lesions were seen in 95% of cases. Incidence and location of atherosclerosis and associated disease, age, sex, racial factors, surgical accessibility, and results of medical and surgical treatment were evaluated. Surgical reconstruction was performed in 13.2%. Fifteen per cent of patients died, 20% worsened neurologically, 35% improved, and 30% were unchanged. Medical treatment is best adjusted to each patient. Oxygen therapy, adequate airway, hydration, nutrition, and optimum cardiac output are important in acute strokes. Anticoagulant plus fibrinolysin therapy has produced clot lysis, demonstrated by arteriography, and clinical assessment of a double blind-treated series of 40 patients has shown that this form of treatment can be carried out without danger.
Logistic discriminant analysis improves diagnostic accuracy of exercise testing for coronary artery disease in women.
Authors: A R Robert, J A Melin, J M Detry
Journal: Circulation (1991)

BACKGROUND Diagnostic accuracy of the exercise electrocardiogram in women has been shown to be limited for the detection of coronary artery disease. New diagnostic methods based on computer analysis of the exercise electrocardiogram and multivariate analysis have improved the diagnostic value of exercise testing in male subjects. The aim of the present study was to assess whether the diagnostic value of exercise testing can be enhanced in women by using multivariate analysis of exercise data. METHODS AND RESULTS Between 1978 and 1984, 135 infarct-free women underwent exercise testing and coronary angiography. Significant coronary artery disease was present in 41% of the patients. In this first group, maximal exercise variables were submitted to a stepwise logistic analysis. Work load, heart rate, and ST60X were selected to build a diagnostic model. The model was tested in a second group of 115 catheterized women (significant coronary artery disease in 47%) and of 76 volunteers. We compared the present model with conventional analysis of the exercise electrocardiogram, with ST changes adjusted for heart rate, and with a previously described analysis. In both groups, sensitivity was better with the present model (66% and 70%) than by conventional (68% and 59%) and by the previously described analysis (57% and 44%) without a loss of specificity (85% and 93%). Receiver-operator characteristic curves showed also a better diagnostic accuracy with the present model. CONCLUSIONS In women, logistic analysis of exercise variables improves the diagnostic value of exercise testing. It yields a significantly better sensitivity without a loss of specificity.
Stressful Life Events, Depression and Demoralization as Risk Factors for Acute Coronary Heart Disease
Authors: Chiara Rafanelli, Renzo Roncuzzi, Yuri Milaneschi, Elena Tomba, Maria Cristina Colistro, Leonardo Goffredo Pancaldi, Giuseppe Di Pasquale
Journal: Psychotherapy and Psychosomatics (2005)

&lt;i&gt;Background:&lt;/i&gt; While the effect of psychological stress and depression on the course of heart disease is commonly recognized, the relationship between recent life events, major depression, depressive symptomatology and the onset of acute coronary heart disease (CHD) has been less considered. The aim of this study was to investigate the presence of stressful life events, major and minor depression, recurrent depression and demoralization in the year preceding the occurrence of a first acute myocardial infarction (AMI) and/or a first episode of instable angina and to compare stressful life events, also related with mood disorders, in patients and healthy controls. &lt;i&gt;Methods:&lt;/i&gt; 97 consecutive patients with a first episode of CHD (91 with AMI and 6 with instable angina) and 97 healthy subjects matched for sociodemographic variables were included. All patients were interviewed with Paykel’s Interview for Recent Life Events, a semistructured interview for determining the psychiatric diagnosis of mood disorders (DSM-IV), a semistructured interview for demoralization (DCPR). Patients were assessed while on remission from the acute phase. The time period considered was the year preceding the first episode of CHD and the year before the interview for controls. &lt;i&gt;Results:&lt;/i&gt; Patients with acute CHD reported significantly more life events than control subjects (p &lt; 0.001). All categories of events (except entrance events) were significantly more frequent. 30% of patients were identified as suffering from a major depressive disorder; 9% of patients were suffering from minor depression, 20% from demoralization. Even though there was an overlap between major depression and demoralization (12%), 17% of patients with major depression were not classified as demoralized and 7% of patients with demoralization did not satisfy the criteria for major depression. Independently of mood disorders, patients had a higher (p &lt; 0.001) mean number of life events than controls. With regard to life events, the same significant difference (p &lt; 0.001) compared to controls applied to patients with and without mood disorders. &lt;i&gt;Conclusions:&lt;/i&gt; Our findings emphasize, by means of reliable methodology, the relationship between life events and AMI. These data, together with those regarding traditional cardiac risk factors, may have clinical and prognostic implications to be verified in longitudinal studies.
Natural History of Sigmoid Colon Cancer: Report of a Patient Observed for 4 Years
Authors: Y. Tomiki, T. Kamano, Y. Hayashida, S. Takekawa, T. Watanabe, M. Tsurumaru, S. Hirai, S. Natsukawa
Journal: Endoscopy (2001)

We report a case of sigmoid colon cancer that was left untreated for a period of 4 years, because the patient declined treatment. A 59-year-old man was found to have an early carcinoma of the sigmoid colon measuring approximately 12 mm in diameter. The lesion, initially a flat cancer, increased in height and became sessile 4 months later. Subsequently, the central portion of the lesion became ulcerated, leaving an elevated ring along its periphery. The lesion eventually evolved into an ulcerated, invasive cancer. This sequence has not been observed with colonoscopy before.
SENSITIZATION OF THE SKIN TO SUNLIGHT: TREATMENT BY PEPTONE INJECTIONS.
Authors: W. F. CASTLE
Journal: British Journal of Dermatology (1925)

Journal Article SENSITIZATION OF THE SKIN TO SUNLIGHT: TREATMENT BY PEPTONE INJECTIONS. Get access W. F. CASTLE, D.S.C., M.D.Cantab., M.R.C.P.Lond. W. F. CASTLE, D.S.C., M.D.Cantab., M.R.C.P.Lond. Dermatologist to the Queen's Hospital for Children Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology and Syphilis, Volume 37, Issue 6, 1 June 1925, Pages 267–268, https://doi.org/10.1111/j.1365-2133.1925.tb09958.x Published: 01 June 1925
Depletion of myocardial creatine kinase, lactate dehydrogenase, myoglobin and K+ after coronary artery ligation in dogs
Authors: R. N JOHNSON, N. L SAMMEL, R. M NORRIS
Journal: Cardiovascular Research (1981)

In order to compare the time-course of disappearance of macromolecules and electrolytes from ischaemic myocardium, measurements of creatine kinase and lactate dehydrogenase activity and myoglobin, K+ and Na+ concentration were made on myocardial extracts from dogs which had left anterior descending coronary artery ligation for 3, 6, 12 and 24 h (4 groups of 6 dogs each). Intensity of ischaemia was assessed by myocardial blood flow measured with 15 ± 5 μm microspheres at 15 min after ligation. Creatine kinase and lactate dehydrogenase activities and K+/Na+ concentration ratios were at all times correlated with the magnitude of collateral blood flow in the ischaemic myocardium, while myoglobin concentration was correlated with blood flow only at 12 and 24 h. Comparisons of the intensity of depletion at the various times after ligation showed that K +, K+/Na+ and creatine kinase had all reached a steady state at 12 h after ligation while lactate dehydrogenase and myoglobin had still to reach a steady state at 24 h. We conclude that these indices are mutually supportive markers of the intensity of ischaemia of 24 h duration, but K+ or K+/Na+ may be the most reliable indices for shorter periods of ischaemia of 3 to 6 h duration.
Medical Examiners, Forensic Pathologists, and Coroners-Reply
Authors: Randy Hanzlick
Journal: JAMA (1997)

In Reply.  —The generalizations by Dr DiMaio about coroners hold truths and echo the viewpoint of many Americans. Di-Maio is correct that coroner training courses are not a singular solution to the systemic problems that he cites. However, my article was written to offer constructive suggestions for improving existing coroner systems, not, as inferred, to advocate perpetuation of coroner systems. I recommended that states set a goal of reducing long-term training needs. One outcome of such planning might be to create medical examiner systems rather than spending considerable time, effort, and money on continual coroner training. However, even if all coroners were replaced with forensic pathologist medical examiner systems, training needs would exist for the death investigators who assist the medical examiner in tasks such as receiving and documenting reports of deaths and conducting death scene investigations,1-3tasks that forensic pathologist medical examiners are not able or willing to do
A Randomized Clinical Trial of Trimetazidine, a Partial Free Fatty Acid Oxidation Inhibitor, in Patients With Heart Failure
Authors: Gabriele Fragasso, Altin Palloshi, Patrizia Puccetti, Carmen Silipigni, Alessandra Rossodivita, Mariagrazia Pala, Giliola Calori, Ottavio Alfieri, Alberto Margonato
Journal: Journal of the American College of Cardiology (2006)
The Ethics of Placebo-Controlled Trials — A Middle Ground
Authors: E J Emanuel, F G Miller
Journal: New England Journal of Medicine (2001)

The first placebo-controlled trial was probably conducted in 1931, when sanocrysin was compared with distilled water for the treatment of tuberculosis.1 Ever since then, placebo-controlled trials have been controversial, especially when patients randomly assigned to receive placebo have forgone effective treatments.25 Recently, the debate has become polarized. One view, dubbed “placebo orthodoxy” by its opponents, is that methodologic considerations make placebo-controlled trials necessary.611 The other view, which might be called “active-control orthodoxy,” is that placebo orthodoxy sacrifices ethics and the rights and welfare of patients to presumed scientific rigor.1014 The latest revision of the Declaration of Helsinki, . . .
Immediate Cerebral Angiography and Mechanical Fragmentation of Cerebral Embolus after Percutaneous Myocardial Revascularization
Authors: Eelco F.M. Wijdicks, Kent R. Thielen, Guy S. Reeder
Journal: Annals of Internal Medicine (2000)

Letters16 May 2000Immediate Cerebral Angiography and Mechanical Fragmentation of Cerebral Embolus after Percutaneous Myocardial RevascularizationEelco F.M. Wijdicks, MD, Kent R. Thielen, MD, and Guy S. Reeder, MDEelco F.M. Wijdicks, MDMayo Clinic; Rochester, MN 55905 (Wijdicks)Mayo Clinic; Rochester, MN 55905 (Thielen)Mayo Clinic; Rochester, MN 55905 (Reeder)Search for more papers by this author, Kent R. Thielen, MDMayo Clinic; Rochester, MN 55905 (Wijdicks)Mayo Clinic; Rochester, MN 55905 (Thielen)Mayo Clinic; Rochester, MN 55905 (Reeder)Search for more papers by this author, and Guy S. Reeder, MDMayo Clinic; Rochester, MN 55905 (Wijdicks)Mayo Clinic; Rochester, MN 55905 (Thielen)Mayo Clinic; Rochester, MN 55905 (Reeder)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-10-200005160-00032 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Cardiac catheterization may be associated with complications, but ischemic stroke is rare (1, 2). With the recent availability of endovascular procedures and intra-arterial thrombolysis, treatment should be considered when a patient with ischemic stroke is encountered in an angiography suite. However, because of the risk for life-threatening bleeding, thrombolysis is probably contraindicated when the procedure involves laser techniques. We describe a patient with an acute middle cerebral artery occlusion who underwent immediate cerebral angiography after percutaneous myocardial revascularization and recovered fully after mechanical disruption of the embolus.A 75-year-old man was admitted to the coronary care unit ...References1. Ayas N, Wijdicks EF. Stroke following cardiac catheterization complicated by stroke. Cerebrovasc Dis. 1995;5:304-7. CrossrefGoogle Scholar2. Sandoval AE, Laufer N. Thromboembolic stroke complicating coronary intervention. Acute evaluation and management in the cardiac catheterization laboratory. Cathet Cardiovasc Diagn. 1998;44:412-4. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Mayo Clinic; Rochester, MN 55905 (Wijdicks)Mayo Clinic; Rochester, MN 55905 (Thielen)Mayo Clinic; Rochester, MN 55905 (Reeder) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 16 May 2000Volume 132, Issue 10Page: 846-847KeywordsAngiographyCerebral arteriesHemorrhageIschemic strokePatient advocacyRevascularizationStable coronary artery diseaseStenosisThalliumThrombosis Issue Published: 16 May 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Single coronary artery, and dissecting aneurysm of ascending aorta following resection of coarctation of aorta
Authors: J. D. Alderson
Journal: Thorax (1972)

A patient who developed a dissecting aneurysm of the ascending aorta 14 years after satisfactory resection of a coarctation of the aorta is reported. He was found to have an absent right coronary artery at necropsy following unsuccessful excision and repair of the aneurysm.
THE EVALUATION OF ACTIVE RESISTANCE TO PNEUMOCOCCUS INFECTION IN RABBITS
Authors: Kenneth Goodner, Ernest G. Stillman
Journal: The Journal of Experimental Medicine (1933)

The dermal pneumococcus infection has been employed to determine the active resistance of rabbits against infection, and an evaluating scale of the gradient of resistance has been established. The significance of the various degrees of resistance has been discussed, and the possible general inferences of the findings indicated.
The Reno-Vascular A2B Adenosine Receptor Protects the Kidney from Ischemia
Authors: Almut Grenz, Hartmut Osswald, Tobias Eckle, Dan Yang, Hua Zhang, Zung Vu Tran, Karin Klingel, Katya Ravid, Holger K Eltzschig
Journal: PLoS Medicine (2008)

Acute renal failure from ischemia significantly contributes to morbidity and mortality in clinical settings, and strategies to improve renal resistance to ischemia are urgently needed. Here, we identified a novel pathway of renal protection from ischemia using ischemic preconditioning (IP).For this purpose, we utilized a recently developed model of renal ischemia and IP via a hanging weight system that allows repeated and atraumatic occlusion of the renal artery in mice, followed by measurements of specific parameters or renal functions. Studies in gene-targeted mice for each individual adenosine receptor (AR) confirmed renal protection by IP in A1(-/-), A2A(-/-), or A3AR(-/-) mice. In contrast, protection from ischemia was abolished in A2BAR(-/-) mice. This protection was associated with corresponding changes in tissue inflammation and nitric oxide production. In accordance, the A2BAR-antagonist PSB1115 blocked renal protection by IP, while treatment with the selective A2BAR-agonist BAY 60-6583 dramatically improved renal function and histology following ischemia alone. Using an A2BAR-reporter model, we found exclusive expression of A2BARs within the reno-vasculature. Studies using A2BAR bone-marrow chimera conferred kidney protection selectively to renal A2BARs.These results identify the A2BAR as a novel therapeutic target for providing potent protection from renal ischemia.
Research on Minors, Prisoners and the Mentally Ill
Authors: Robert Q. Marston
Journal: New England Journal of Medicine (1973)

IN the chain of events stretching from the first biomedical research concept to ultimate delivery of improved medical services, the most critical link is the human research subject. If through lack of care or an excess of investigative zeal, we allow abuse of the human subject, we endanger the beneficial forward march of research and fall short as professionals. However, we must make it clear that there is immorality in not carrying out research involving human subjects. It follows that we must ensure that all those involved as subjects in medical research be as fully protected as humanly possible.Over . . .
Effect of montelukast on lung function in asthma patients with allergic rhinitis: analysis from the COMPACT trial
Authors: D. B. Price, A. Swern, C. A. Tozzi, G. Philip, P. Polos
Journal: Allergy (2006)

The Clinical Outcomes with Montelukast as a Partner Agent to Corticosteroid Therapy (COMPACT) trial demonstrated that montelukast added to budesonide (MNT + BD) was as efficacious as double the dose of budesonide (dBD) in improving morning peak expiratory flow (AM PEF) in adult asthmatics. Recent studies have demonstrated that montelukast is also effective in treating daytime and nighttime allergic rhinitis (AR) symptoms in asthmatic patients. This analysis was designed to examine whether asthmatic patients with comorbid AR respond differently than patients without comorbid AR in terms of asthma control (lung function).There were 216 asthmatic patients in the MNT+BD group and 184 patients in the dBD group with AR. Treatment differences in the change from baseline in AM PEF were compared. Least square (LS) mean and 95% confidence interval (CI) were derived from an anova model adjusting for baseline and study site.There was a 9.2% increase in AM PEF from baseline in the MNT+BD group compared with a 6% increase in the dBD group. The LS mean difference [(MNT+BD)-dBD] was 14.2 l/min (P=0.028). Other secondary endpoints were similar between groups.In the subgroup of asthmatic patients with AR, a combined treatment approach that included montelukast and budesonide provided significantly greater efficacy in reducing airflow obstruction compared with doubling the dose of budesonide. These results support recommendations by the Allergic Rhinitis and its Impact on Asthma initiative that suggest a unified approach aimed at treating the airway inflammation common to both diseases is beneficial for the large proportion of asthmatics who also suffer from AR.
The Hidden Psychosis of Open-Heart Surgery
Authors: Richard S. Blacher
Journal: JAMA (1972)

In the observation of patients undergoing cardiac surgery, it has become evident that many of the emotional aspects of cardiotomy are hidden, in good measure because of the anxiety these procedures evoke in both patient and staff. For this reason, serious mental difficulties are often revealed only by careful interviewing. In this study, 12 apparently normal patients were examined. Eight of these patients were found to have suffered a major psychiatric upheaval and yet had managed to hide this from their medical attendants. This suggests that psychosis after openheart surgery is more common than anticipated and may be almost universal. The role of awe, as a response to having one's heart incised, is seen as a prominent feature among the several organic and psychological factors leading to the psychosis.
Two Mechanisms of Cardiac Arrest Produced by Potassium
Authors: BORYS SURAWICZ, LEONARD S. GETTES, JAMES C. SHIVE, HARRY O. BROOKS
Journal: Circulation Research (1963)

Ventricular arrest occurs in isolated heart perfused with potassium-deficient solution when the extracellular potassium concentration is suddenly raised to a physiological concentration. This is known as a paradoxical phenomenon of Zwaardemaker and Libbrecht. Records of electrocardiograms, and ventricular and atrial transmembrane potentials from perfused rabbit hearts before, during and after this type of arrest revealed that its mechanism differs from the mechanism of cardiac arrest produced by an increase of external [K] above physiological concentration. The Zwaardemaker-Libbrecht phenomenon is associated with a striking increase in the velocity of repolarization while the typical effects of high-K concentration on the resting membrane potential and amplitude and upstroke velocity of the action potential are either very slight or absent. Conduction in the atria, ventricles and between the atria and the ventricles apparently is not disturbed during the Zwaardemaker-Libbrecht phenomenon; therefore, we attribute the cardiac arrest to a selective inhibition of the pacemaker activity. This might be due to an inhibition of the diastolic depolarization of the pacemaker fibers. A speculation is made that the type of imbalance between the intra- and extracellular K concentration in the myocardium which causes the Zwaardemaker-Libbrecht effect in the isolated heart could occur in situ and cause sudden death.