tbuckley/cabot-search huggingface dataset:
Myocardial ischemia: platelet and thromboxane concentrations in cardiac lymph and the effects of ibuprofen and prostacyclin.
Authors: L H Michael, J R Hunt, R M Lewis, M L Entman
Journal: Circulation Research (1986)

Blood platelets have been implicated in several mechanisms leading to and/or modifying myocardial ischemia. Cardiac lymph examination allows insight into the extracellular fluid that is in equilibrium with the capillary blood. In order to obtain an index of platelet activation during coronary artery events in the awake chronic animal, we wished to ascertain whether evaluation of cardiac lymph would detect changes in platelet activation resulting from a vascular occlusion. The study used conscious dogs in which cardiac lymph vessels had been previously cannulated by open-chest surgical protocol. The concentrations of immunoreactive thromboxane B2 and platelet counts were assessed in the cardiac lymph during the control period, the 10-60 minute occlusions, and the reperfusion periods. The same protocols were effected on another series of dogs after infusion of ibuprofen or prostacyclin. Initially, immunoreactive thromboxane B2 concentrations in the systemic blood and cardiac lymph were identical. A three-fold increase in immunoreactive thromboxane B2 concentrations occurred in untreated animals and was accompanied by a fall in platelet count in the lymph. The infusion of ibuprofen or prostacyclin, which inhibit platelet aggregation by different mechanisms, prevented both the decrease in platelets and the increase in immunoreactive thromboxane B2. In this study, intravascular events resulting from coronary occlusion invoke a rapid rise of immunoreactive thromboxane B2 in the extravascular fluid. A decrease in platelet escape into the extravascular compartment is interpreted as a result of intravascular aggregation promoting decreased platelet numbers. Thus, examination of continuously flowing cardiac lymph allows rapid detection of intravascular activation of platelets in the awake animal in the absence of surgical trauma.
Alpha-1-Antitrypsin Levels and Genetic Variation of the Alpha-1-Antitrypsin Gene in Peyronie’s Disease
Authors: Ekkehard W. Hauck, Arne Hauptmann, Simone M. Haag, Anette Bohnert, Wolfgang Weidner, Gregor Bein, Holger Hackstein
Journal: European Urology (2004)
Study of Transfused Platelets in a Case of Congenital Hypoplastic Thrombocytopenia
Authors: A. D. Bell, J. W. Mold, R. A. M. Oliver, S. Shaw
Journal: BMJ (1956)

MEDICALTJUHA!The results are discussed and are considered to indicate that erythrocytic malaria in Gambian children exerts its main effects in the first two years of life, chiefly through the clinical illness produced by the acute attack.Malarious children, once they have acquired sufficient resistance to the noxious effects of clinical malaria, appear rapidly to make good lost ground despite the persistence of moderately dense parasitaemia.A consistent relationship between hepatomegaly and erythrocytic malaria is defined.The view is expressed that the srum.protein changes observed in malarious children may in part be due to the formation of humoral antibodies.We wish to thank Dr.
Using economics to set pragmatic and ethical priorities
Authors: Stuart Peacock, Danny Ruta, Craig Mitton, Cam Donaldson, Angela Bate, Madeleine Murtagh
Journal: BMJ (2006)

<i>Doctors and managers have to make tough decisions about what services to provide from their budgets. Economic approaches can help, but they also need to take into account the practical and ethical challenges faced by healthcare professionals</i>
Variation Exists in Rates of Admission to Intensive Care Units for Heart Failure Patients Across Hospitals in the United States
Authors: Kyan C. Safavi, Kumar Dharmarajan, Nancy Kim, Kelly M. Strait, Shu-Xia Li, Serene I. Chen, Tara Lagu, Harlan M. Krumholz
Journal: Circulation (2013)

Background— Despite increasing attention on reducing relatively costly hospital practices while maintaining the quality of care, few studies have examined how hospitals use the intensive care unit (ICU), a high-cost setting, for patients admitted with heart failure (HF). We characterized hospital patterns of ICU admission for patients with HF and determined their association with the use of ICU-level therapies and patient outcomes. Methods and Results— We identified 166 224 HF discharges from 341 hospitals in the 2009–2010 Premier Perspective database. We excluded hospitals with &lt;25 HF admissions, patients &lt;18 years old, and transfers. We defined ICU as including medical ICU, coronary ICU, and surgical ICU. We calculated the percent of patients admitted directly to an ICU. We compared hospitals in the top quartile (high ICU admission) with the remaining quartiles. The median percentage of ICU admission was 10% (interquartile range, 6%–16%; range, 0%–88%). In top-quartile hospitals, treatments requiring an ICU were used less often; the percentage of ICU days receiving mechanical ventilation was 6% for the top quartile versus 15% for the others; noninvasive positive pressure ventilation, 8% versus 19%; vasopressors and/or inotropes, 9% versus 16%; vasodilators, 6% versus 12%; and any of these interventions, 26% versus 51%. Overall HF in-hospital risk-standardized mortality was similar (3.4% versus 3.5%; P =0.2). Conclusions— ICU admission rates for HF varied markedly across hospitals and lacked association with in-hospital risk-standardized mortality. Greater ICU use correlated with fewer patients receiving ICU interventions. Judicious ICU use could reduce resource consumption without diminishing patient outcomes.
Hospital Behavior Under Competition and Cost-Containment Policies
Authors: Glenn A. Melnick
Journal: JAMA (1988)

Previous studies of hospital competition have found that greater competition leads to higher hospital costs. We describe herein the change in behavior of California's hospitals since the introduction of competitive and cost-containment programs. To examine the impact of California's pro-competition policies on hospital performance, we grouped the state's short-term hospitals according to the level of competition within their markets. From 1983 through 1985, total inpatient costs (inflation adjusted) increased by less than 1% in hospitals in low-competition markets compared with a decrease of 11.29% in hospitals located in highly competitive markets. After controlling for the effects of the Medicare prospective payment system program, the rate of increase in cost per discharge in hospitals in highly competitive markets was 3.53% lower than the rate of increase in hospitals in low-competition markets during the period from 1983 through 1985. We conclude that these pro-competition policies are having dramatic and potentially far-reaching effects on the nature of hospital competition, leading to increased competition based on price.
Endoscopic Ultrasonography and Magnetic Resonance Cholangiopancreatography in Abdominal Pain: What Makes Sense?
Authors: J. J. Sung
Journal: Endoscopy (2001)

Diagnostic endoscopy (including gastroscopy and colonoscopy) and diagnostic endoscopic retrograde cholangiopancreatography (ERCP) have been facing severe challenges from other imaging modalities in recent years. Might diagnostic endoscopy and ERCP become obsolete? Are the new modalities accurate and cost-effective? Should training of endoscopists be focused on therapy? Recently, magnetic resonance cholangiopancreatography (MRCP) and endoscopic ultrasonography (EUS) have been tested as investigation tools for abdominal pain. Does this make sense?
Multicenter Randomized Trial of Centralized Nurse-Led Telephone-Based Care Coordination to Improve Outcomes After Surgical Resection for Colorectal Cancer: The CONNECT Intervention
Authors: Jane M. Young, Phyllis N. Butow, Jennifer Walsh, Ivana Durcinoska, Timothy A. Dobbins, Laura Rodwell, James D. Harrison, Kate White, Andrew Gilmore, Bruce Hodge, Henry Hicks, Stephen Smith, Geoff O'Connor, Christopher M. Byrne, Alan P. Meagher, Stephen Jancewicz, Andrew Sutherland, Grahame Ctercteko, Nimalan Pathma-Nathan, Austin Curtin, David Townend, Ned S. Abraham, Greg Longfield, David Rangiah, Christopher J. Young, Anthony Eyers, Peter Lee, Dean Fisher, Michael J. Solomon
Journal: Journal of Clinical Oncology (2013)

To investigate the effectiveness of a centralized, nurse-delivered telephone-based service to improve care coordination and patient-reported outcomes after surgery for colorectal cancer.Patients with a newly diagnosed colorectal cancer were randomly assigned to the CONNECT intervention or usual care. Intervention-group patients received standardized calls from the centrally based nurse 3 and 10 days and 1, 3, and 6 months after discharge from hospital. Unmet supportive care needs, experience of care coordination, unplanned readmissions, emergency department presentations, distress, and quality of life (QOL) were assessed by questionnaire at 1, 3, and 6 months.Of 775 patients treated at 23 public and private hospitals in Australia, 387 were randomly assigned to the intervention group and 369 to the control group. There were no significant differences between groups in unmet supportive care needs, but these were consistently low in both groups at both follow-up time points. There were no differences between the groups in emergency department presentations (10.8% v 13.8%; P = .2) or unplanned hospital readmissions (8.6% v 10.5%; P = .4) at 1 month. By 6 months, 25.6% of intervention-group patients had reported an unplanned readmission compared with 27.9% of controls (P = .5). There were no significant differences in experience of care coordination, distress, or QOL between groups at any follow-up time point.This trial failed to demonstrate substantial benefit of a centralized system to provide standardized, telephone follow-up for postoperative patients with colorectal cancer. Future interventions could investigate a more tailored approach.
Chronic Accelerated Idioventricular Rhythm
Authors: GEORGE KLEIN
Journal: Annals of Internal Medicine (1975)

Letters1 September 1975Chronic Accelerated Idioventricular RhythmGEORGE KLEIN, M.D., DWIGHT I. PERETZ, M.D., F.R.C.P.(C), F.A.C.P.GEORGE KLEIN, M.D.Search for more papers by this author, DWIGHT I. PERETZ, M.D., F.R.C.P.(C), F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-83-3-372 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAccelerated idioventricular rhythm is a type of idioventricular rhythm characterized electrocardiographically by runs of widened ventricular complexes occurring at a rate similar to the dominant sinus rhythm (1). The dysrhythmia is most frequently observed within the first 48 hours after myocardial infarction. Previous reports have stressed the transient nature of the arrhythmia; we describe here "chronic" accelerated idioventricular rhythm in a patient.A 48-year-old female nurse was referred to this centre for cardiological assessment, due to an abnormal electrocardiogram. The electrocardiogram showed accelerated idioventricular rhythm that could be abolished by exercise or atropine and brought out again by carotid sinus...References1. MASSUMI R and ALI N: Accelerated isorhythmic ventricular rhythms. Am J Cardiol 26:170-185, 1970 CrossrefMedlineGoogle Scholar2. NORRIS R and MERCER C: Significance of idioventricular rhythms in acute myocardial infarction. Prog Cardiovasc Dis 16:455-468, 1974 CrossrefMedlineGoogle Scholar3. ROTHFEL E, ZUCKER I, and PARSONNET V: Idioventricular rhythm in acute myocardial infarction. Circulation 35 (suppl 2):227-228, 1967 MedlineGoogle Scholar4. CASTELLANOS A, LEMBERG L, and ARCEBAL A: Mechanisms of slow ventricular tachycardias in acute myocardial infarction. Dis Chest 56:470-476, 1969 CrossrefMedlineGoogle Scholar5. SCHAMROTH L: Idioventricular tachycardia. J Electrocardiol 1:205-212,1968 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: GEORGE KLEIN, M.D.; DWIGHT I. PERETZ, M.D., F.R.C.P.(C), F.A.C.P.Affiliations: Division of Cardiology Department of Medicine St. Paul's Hospital 1081 Burrard Street Vancouver, British Columbia V6Z 1Y6 Canada PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAccelerated Idioventricular Rhythm in Patients Without Acute Myocardial Infarction 1 September 1975Volume 83, Issue 3Page: 372-373KeywordsArrhythmiaAtropineElectrocardiographyExerciseMyocardial infarctionNurses ePublished: 1 December 2008 Issue Published: 1 September 1975 PDF downloadLoading ...
TCT-216 Predictors Of Patient-Oriented And Device-Oriented Outcomes Among Patients Undergoing Primary Percutaneous Coronary Intervention
Authors: Masanori Taniwaki, Giulio G. Stefanini, Lorenz Raber, Henning Kelbaek, Miodrag C. Ostojic, Andreas Baumbach, David Tüller, Clemens von Birgelen, Marco Roffi, Giovanni Pedrazzini, Ran Kornowski, Klaus Weber, Dik Heg, Christian M. Matter, Thomas F. Luescher, Bernhard Meier, Peter Jüni, Patrick W. Serruys, Manel Sabate, Stephan Windecker
Journal: Journal of the American College of Cardiology (2013)
The Panorama of Vesalius: A 'Lost' Design From Titian's Studio
Authors: John E. Skandalakis
Journal: JAMA (1997)

... few disciplines are more surely based on the work of one man than is Anatomy on Vesalius.<sup>1</sup> Andreas Vesalius of Brussels is acclaimed for three towering publications:<i>Tabulae anatomicae sex</i>of 1538,<i>De humani corporis fabrica libri septum</i>of 1543 and 1555, and the<i>Epitome</i>of 1543. With the brashness of Icarus, yet borne aloft on wings of genius, he penned the preface to the<i>Fabrica</i>: "I am aware that by reason of my age—I am at present twenty-eight years old—my efforts will have little authority, and that, because of my frequent indication of the falsity of Galen's teachings, they will find little shelter from the attacks of those who were not present at my anatomical demonstrations." Cavanagh's full folio size recreation of the original artwork of the 14 Vesalian From<i>The Panorama of Vesalius</i>, plates I-XIV. muscle men of the second book of the<i>Fabrica</i>is not only
Influence of hepatitis B virus genotypes on the intra- and extracellular expression of viral DNA and antigens
Authors: Masaya Sugiyama, Yasuhito Tanaka, Takanobu Kato, Etsuro Orito, Kiyoaki Ito, Subrat K. Acharya, Robert G. Gish, Anna Kramvis, Takashi Shimada, Namiki Izumi, Masahiko Kaito, Yuzo Miyakawa, Masashi Mizokami
Journal: Hepatology (2006)

Various genotypes of the hepatitis B virus (HBV) induce liver disease of distinct severity, but the underlying virological differences are not well defined. Huh7 cells were transfected with plasmids carrying 1.24-fold the HBV genome of different genotypes/subgenotypes (2 strains each for Aa/A1, Ae/A2, Ba/B2 and D; 3 each for Bj/B1 and C). HBV DNA levels in cell lysates, determined by Southern hybridization, were the highest for C followed by Bj/Ba and D/Ae (P < .01), and the lowest for Aa (P < .01), whereas in culture media, they were the highest for Bj, distantly followed by Ba/C/D and further by Ae/Aa (P < .01). The intracellular expression of core protein was more than 3-fold lower for Ae/Aa than the others. Hepatitis B e antigen (HBeAg) was excreted in a trend similar to that of HBV DNA with smaller differences. Secretion of hepatitis B surface antigen (HBsAg) was most abundant for Ae followed by Aa, Ba, Bj/C and remotely by D, which was consistent with mRNA levels. Cellular stress determined by the reporter assay for Grp78 promoter was higher for C and Ba than the other genotypes/subgenotypes (P < .01). Severe combined immunodeficiency mice transgenic for urokinase-type plasminogen activator (uPA/SCID), with the liver replaced for human hepatocytes, were inoculated with virions passed in mouse and recovered from culture supernatants. HBV DNA levels in their sera were higher for C than Ae by 2 logs during 4-7 weeks after inoculation. In conclusion, virological differences among HBV genotypes were demonstrated both in vitro and in vivo. These differences may influence HBV infections with distinct genotypes in clinical and epidemiological settings.
Can physical activity mitigate the effects of aging in middle-aged women?
Authors: J F Owens, K A Matthews, R R Wing, L H Kuller
Journal: Circulation (1992)

BACKGROUND Aging is associated with an increased risk of women dying from coronary heart disease as well as from all causes combined. Alterations in the major biological risk factors for early coronary heart disease and all-cause mortality are frequently seen in aging. METHODS AND RESULTS The present investigation tested the hypothesis that high levels of physical activity could protect against age-associated changes in biological risk factor levels. In the Healthy Women Study, 507 women were evaluated at study entry and 3 years later. Weekly physical activity level was measured at each examination via the Paffenbarger Physical Activity Questionnaire. During the 3-year period, women increased significantly in weight, blood pressure, levels of total and low-density lipoprotein cholesterol, triglycerides, and insulin and decreased significantly in levels of total high-density lipoprotein cholesterol (HDL-C) and HDL2-C. CONCLUSIONS Consistent with the study hypothesis, women who reported higher levels of activity at baseline had less weight gain over time. Furthermore, women who increased their activity during the 3-year interval had the smallest increases in weight and tended to have the smallest decreases in total HDL-C and HDL2-C. The changes in lipids due to activity were largely independent of changes in body weight.
Birth weight reduction associated with residence near a hazardous waste landfill.
Authors: M Berry, F Bove
Journal: Environmental Health Perspectives (1997)

We examined the relationship between birth weight and mother's residence near a hazardous waste landfill. Twenty-five years of birth certificates (1961-1985) were collected for four towns. Births were grouped into five 5-year periods corresponding to hypothesized exposure periods (1971-1975 having the greatest potential for exposure). From 1971 to 1975, term births (37-44 weeks gestation) to parents living closest to the landfill (Area 1A) had a statistically significant lower average birth weight (192 g) and a statistically significant higher proportion of low birth weight [odds ratio (OR) = 5.1; 95% confidence interval (CI), 2.1-12.3] than the control population. Average term birth weights in Area 1A rebounded by about 332 g after 1975. Parallel results were found for all births (gestational age > 27 weeks) in Area 1A during 1971-1975. Area 1A infants had twice the risk of prematurity (OR = 2.1; 95 CI, 1.0-4.4) during 1971-1975 compared to the control group. The results indicate a significant impact to infants born to residents living near the landfill during the period postulated as having the greatest potential for exposure. The magnitude of the effect is in the range of birth weight reduction due to cigarette smoking during pregnancy.
High initial multidrug-resistant tuberculosis rate in Buenaventura, Colombia: a public–private initiative: Table 1–
Authors: Sonia L. Villegas, Beatriz E. Ferro, Carlos M. Perez-Velez, Cesar A. Moreira, Liliana Forero, Ernesto Martínez, Nalin Rastogi, Jose Antonio Caminero
Journal: European Respiratory Journal (2012)

pressure may reveal upper airway collapsibility.This is especially useful for detecting obstructive sleep apnoea syndrome in obese snorers [4,10].Thus, in the present case, the NEP technique would have allowed the recognition of extrathoracic EFL, which may have contributed to our patient's hypoxaemia.However, when this phenomenon extends to the whole expiration during NEP, it may preclude the detection of intrathoracic EFL with this method [10].Actually, it is unlikely that upper airway collapse may account for the acute cardiorespiratory disaster experienced by our patient.The patient was awake, he was moved and positive pressure NIV was continuously applied with 8 cmH 2 O PEEP during this period.Finally, a growing body of evidence suggests that the deterioration of pulmonary gas exchange that occurs when obese patients are lying down may be the result of ventilation/perfusion mismatch rather than a consequence of hypoventilation [7,8].When morbidly obese patients are lying down, their small airways may extensively collapse in the posterior dependent lung zones.These nonaerated pulmonary areas are well perfused in the supine position and may rapidly lead to severe refractory hypoxaemia [8].To summarise, it is noteworthy that the sitting position not only ensures comfort but may also be part of a strategy preventing severe cardiorespiratory complications in superobese patients.
Fresh Whole Blood versus Reconstituted Blood for Pump Priming in Heart Surgery in Infants
Authors: Steven S. Mou, Brett P. Giroir, Erica A. Molitor-Kirsch, Steven R. Leonard, Hisashi Nikaidoh, Frank Nizzi, Deborah A. Town, Lonnie C. Roy, William Scott, Daniel Stromberg
Journal: New England Journal of Medicine (2004)

In an attempt to reduce the coagulopathic and inflammatory responses seen after cardiopulmonary bypass, the use of fresh whole blood during heart operations has become the standard of care for neonates and infants at many institutions. We compared the use of fresh whole blood with the use of a combination of packed red cells and fresh-frozen plasma (reconstituted blood) for priming of the cardiopulmonary bypass circuit.