tbuckley/cabot-search huggingface dataset:
Ventricular reentry around a fixed barrier. Resetting with advancement in an in vitro model.
Authors: R C Bernstein, L H Frame
Journal: Circulation (1990)

We studied an in vitro model of reentrant tachycardia in a ring of ventricular endocardial tissue surrounding the canine mitral and aortic valves to understand how the response of a reentrant tachycardia to premature impulses can provide insight into the underlying tachycardia mechanism, circuit characteristics, and nature of the central barrier. Reproducible regular reentrant tachycardias (cycle length range, 177-450 msec) were induced with programmed stimulation in 19 intact preparations studied at 34-38 degrees C. Tachycardias were sustained and stable until terminated by programmed stimulation in 95% of preparations. Reentry was reliably reinitiated during experiments lasting 2-15 hours. Data supporting reentry as the mechanism of these tachycardias included sequential activation around the ring that spanned the cycle length of the tachycardia, unidirectional block during initiation of the reentrant rhythm, and termination of the tachycardia after interruption of the circuit. Tachycardias in 13 preparations were systematically reset by premature stimuli. During reentry, each of these preparations had full recovery of excitability by the end of their excitable gap as evidenced by a flat portion along their resetting response curve (eight of 13) or by lack of faster conduction velocity during the second poststimulus beat after premature impulses that produced a long return cycle (13 of 13). From analysis of the conduction of premature impulses and their return cycles, we reached several conclusions useful for interpreting resetting response curves when the reentrant circuit is not fully accessible for study. The duration of a flat portion of the resetting response curve indicated the duration of the shortest fully recovered excitable gap in the reentrant circuit. The window of reset of the tachycardia reflected only the local excitable gap at the site of stimulation and did not define the shortest excitable gap within the circuit. The extent of advancement of the tachycardia provided a lower-limit estimate of the shortest excitable gap in the reentrant circuit. Advancement of a tachycardia in time by premature stimuli indicated advancement at each point in the circuit. Finally, for tachycardias advanced by premature impulses, the length of the reentrant path cannot be determined by the recovery of a refractory barrier.
The development of myocardial insulin resistance in conscious dogs with advanced dilated cardiomyopathy
Authors: L Nikolaidis
Journal: Cardiovascular Research (2004)

Background: The failing heart demonstrates a preference for glucose as its metabolic substrate. Advanced, severe DCM is characterized by depletion of adenosine triphosphate (ATP) stores, which may be a consequence of impaired insulin mediated glucose uptake and oxidation at a time when the myocardium prefers glucose as its substrate. We examined the time course and magnitude of myocardial insulin resistance during the evolution of dilated cardiomyopathy. Methods and results: Thirty-four conscious, chronically instrumented dogs were studied at four stages during the evolution of dilated cardiomyopathy (DCM) induced by rapid RV pacing [control, early, late and advanced severe]. Transmyocardial glucose, lactate, and non-esterified fatty acid (NEFA) concentrations were measured in the fasting state. The cellular insulin signaling cascade and ATP levels were measured on myocardial samples. NEFA and insulin concentrations increased early and progressively in DCM in association with increased norepinephrine concentrations and progressive hemodynamic impairment. In advanced DCM but not earlier stages, myocardial ATP levels were decreased by 34%. There was decreased myocardial glucose uptake evident under both basal (−29±5%) and insulin stimulated (−32±4%) conditions in advanced, severe DCM, associated with a 31% reduction in GLUT-4 translocation. Importantly, there were no alterations in proximal steps in insulin signaling, but significant reductions in serine (Ser473) phosphorylation of Akt-1. Conclusions: Advanced, severe DCM is associated with the development of myocardial insulin resistance. There is impaired myocardial glucose uptake and altered myocardial insulin signaling, involving decreased Ser 473 phosphorylation of Akt-1. Myocardial insulin resistance in advanced, severe DCM was also associated with reduced myocardial ATP levels.
Characteristics of chronic hepatitis B: Lower alanine transaminase level to start treatment in HBEAG Negatives
Authors: M. S. Alam, G. Azam, G. Mustafa, N. Ahmad, M. Khan
Journal: Gut (2011)

<h3>Introduction</h3> Chronic hepatitis B (CHB) is being divided into two groups scientifically with respect to HBeAg status. Different DNA levels are considered for starting treatment in two groups. We have designed this study to explore different characteristics of CHB. <h3>Methods</h3> We have included 2453 CHB patients of male predominating 2193 (89.4%) during the period of March 2007–October 2009. Other causes of hepatitis were excluded. Histological activity index (HAI) and fibrosis were studied in 463 cases and multivariate logistic regression analysis were done with different factors. Sensitivity and specificity were determined from receiver operating characteristic curve. <h3>Results</h3> Of the total, 1288 (52.5%) were HBeAg negative who were significantly older, containing less DNA and alanine transaminase (ALT) and more fibrotic than HBeAg positives with insignificant differences in histological activity. Log DNA (p= 0.002; 0.006) and ALT (p= 0.001; 0.04) had strong positive correlation with HAI and fibrosis in HBeAg negatives. ALT level of 60 had better prediction of HAI 9 than that of 80 U/l. Only ALT had positive correlation with HAI and fibrosis (p= 0.01) in HBeAg positives. Age, sex and AST/ALT didn9t influence histological changes in both groups. <h3>Conclusion</h3> ALT and DNA level have strong positive correlation with histological changes in HBeAg negatives but DNA doesn9t have with HBeAg positives. ALT level of 60 U/L is recommended to start treatment in HBeAg negative CHB.
Fluorouracil as an Adjuvant to Colorectal Cancer Surgery
Authors: Richard M. Hansen
Journal: JAMA (1976)

To the Editor.—  The recent article by Li and Ross raises a number of unresolved questions regarding the adequacy of historical controls. I am specifically concerned about the adequacy of assessment of metastatic disease in the study. I assume that the diligence used to rule out hepatic disease (scans and biopsies) was probably less in the retrospective group than in the control group, since the extent to which one would look for metastases would depend on one's therapeutic plan. Since the two curves for Dukes C patients are nearly parallel, after two years an alternate explanation would be that the historical control contains many more patients with distant metastases who die in the first two years. The exclusion of 15 patients who were lost or died is not easily justified. The figure accounts for only 183 of the 213 patients—were the others stage 1 (not stated) or were they also
940 SAFETY, TOLERABILITY AND PHARMACOKINETICS OF THE HCV POLYMERASE INHIBITOR VCH-222 FOLLOWING SINGLE DOSE ADMINISTRATION IN HEALTHY VOLUNTEERS AND ANTIVIRAL ACTIVITY IN HCV-INFECTED INDIVIDUALS
Authors: C. Cooper, R. Larouche, B. Bourgault, N. Chauret, L. Proulx
Journal: Journal of Hepatology (2009)
Paget's disease: a family with six cases.
Authors: J V Jones, M F Reed
Journal: BMJ (1967)

severe enough to cause considerable difficulty in blood grouping and saline cross-matching.There are at present few published accounts dealing with this aspect of dextran 110.Ricketts (1966) found rouleaux formation a hindrance to satisfactory saline cross-matching in only two cases, and then with serum concentrations of modified dextran considerably higher than
Is surgical closure of the back lesion in open neural tube defects necessary?
Authors: G T Deans, V E Boston
Journal: BMJ (1988)

families to look after.A low educational level of the mother was associated only with a high prevalence of cough (p<005).It may be inappropriate to compare educational background of ethnic groups, particularly those educated abroad, as educational categories may not be directly comparable.Two other factors previously associated with respiratory illness in children-namely, belonging to a one parent family'5 and exposure to indoor air pollution from gas cookers and paraffin heaters" 1617 could be studied only in Afro-Caribbeans and whites.Belonging to a one parent family is likely to measure poor social circumstances, but a single parent may be more aware of a child developing respiratory illness.The association of respiratory illness with the combined use of gas cookers and paraffin heaters might reflect poor social circumstances as well as high concentrations of nitrogen dioxide indoors, which may sometimes exceed the European Community's directive for outdoor concentrations of nitrogen dioxide.'8Parental smoking habit was not analysed, though smoking has been reported to be more common among Afro-Caribbeans and whites than Asians.12 This survey highlights the problem of respiratory disease in children living in inner cities.Such disease was significantly more prevalent in whites compared with all groups in the national sample and varied considerably among ethnic groups.Strong evidence suggests that childhood respiratory illness leads to poor respiratory health in adulthood.6We intend to study the variation in respiratory illness among ethnic groups further.We thank Professor W W Holland for his encouragement and the doctors, nurses, teachers, clerks, and fieldworkers in the national study of health and growth for their help.
The Measures of Medicine: Benefits, Harms, and Costs
Authors: T. Jefferson
Journal: BMJ (1995)

Richard K Riegelman Blackwell Science, pounds sterling29.50, pp 177 ISBN 0 86542 280 X

The Measures of Medicine is a book in two parts, written to bridge the gap between individual and population based medicine. The first part introduces the reader to the science of quantitative decision making by illustrating the relation between the benefits and harms of each decision we take. The second part adds the economic perspective to the decision making process.

Each chapter is illustrated by examples …
The Practice of Pediatric Neurology
Authors: Charles M. Poser
Journal: JAMA (1976)

It is somewhat unfortunate that book reviews, in particular those concerned with major opuses of this type, must be written before one can really use the book as a working instrument! This takes time, since this 1,082 pages "War and Peace" of child neurology is hardly something to curl up with at night for relaxation! Nevertheless, at first glance, it must be considered as a significant contribution that will prove to be of immense usefulness to all those who deal with diseases of the nervous system of children. This book has been awaited for quite a long time by the pediatric neurology community. It is encyclopedic in scope and represents the efforts, although not always the consensus, of 44 authors. The book has a number of features that make it highly useful. It is divided into three parts: the first one dealing with the evaluation of problems, the second one
Cardiac Standstill Simulating Repeated Epileptic Attacks
Authors: Robert H.A. Haslam
Journal: JAMA (1973)

Loss of consciousness, cessation of electroencephalographic activity, and brief convulsions can occur in that order between eight and 15 seconds after ventricular asystole. A person may experience many hundred such attacks without apparent permanent ill effects. The electrocardiogram and electroencephalogram may be useful in the diagnosis of the cause of syncope and convulsion.
Thomas Anthony Harris, MD
Authors: Rachel N. Klein
Journal: JAMA (1995)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Letter: Attitudes of relatives of mentally handicapped patients.
Authors: D A Spencer
Journal: BMJ (1974)

Meningococcal Infection SIR,-We are concerned about the recent upsurge in meningococcal infection in the London area and have been impressed by the severity of the disease and its fulninant course.We would like to emphasize the importance of early diagnosis and prompt treatment in reducing mortality, which still remains unacceptably high.Indications for chemoprophylaxis are de- bata'ble, but when this course of action has been decided upon the choice of drugs rests between a sulphonamide, minocycline, or rifampicin.We suggest that rifampicin should not be used because of the rapid development of drug resistance in vitro.Of the remaining alternatives sulphonamide, which has ibeen well tried and has given good results, is preferable unless local strains are known to be resistant.The overall incidence of sulphonamide-resistant meningococci in the United Kingdom appears to be 10-15%, but our experience in London suggests that such resistance is un- usual.Minocycline has been shown to be of value in prophylaxis, especially when there is a high proportion of sulphonamideresistant strains, but experience with this antibiotic is limited and further critical assessment is necessary.Penicillin, which is essential in treatment, is not effective in prophylaxis.-Weare, etc.,
Angioplasty of residual stenosis after severe anteroseptal myocardial infarction: is it able to improve systolic function and to prevent cardiac failure?
Authors: Marcel Toussaint, Françoise Guyomard, Amine Meliani, Xuan Tran‐Thanh, Christine Jouannon, Florence Durup, Jean‐Yves Devaux
Journal: European Journal of Heart Failure (2003)
Selective Estrogen-Receptor Modulators — Mechanisms of Action and Application to Clinical Practice
Authors: B. Lawrence Riggs, Lynn C. Hartmann
Journal: New England Journal of Medicine (2003)

The selective estrogen-receptor modulators, or SERMs, chemically diverse nonsteroid compounds, have tertiary structures that permit binding to the estrogen receptor. These compounds have either selective agonist or antagonist effects, depending on the target tissue. This article reviews current information concerning the molecular basis of SERM action and the tissue-selective agonist–antagonist effects of this class of medication. The article also offers a perspective on the therapeutic uses of SERMs and compares the SERMs with estrogen and nonestrogen alternatives.
The Use of Para-Aminobenzoic Acid in a Case of Rocky Mountain Spotted Fever
Authors: John O. Niles, George C. Bourne
Journal: New England Journal of Medicine (1948)

PARA-AMINOBENZOIC acid was first reported in the treatment of louse-borne rickettsial diseases in 1942 by Snyder and his associates.1 After experimental work on the Rickettsia of Rocky Mountain spotted fever by Hamilton, Plotz and Smadel2 among others, its subsequent use in the treatment of human beings was reported by Rose et al.3 and other investigators. The patient in the following case was treated according to a schedule reported by Greeley.4 Case ReportA 4 1/2-year-old girl was admitted to the hospital on June 4, 1947, with a history of fever and rash over the upper and lower extremities of 2 . . .
Hepatitis B Infection From Medical Personnel
Authors: David R. Snydman
Journal: JAMA (1976)

<h3>To the Editor.—</h3> In a recent commentary (233:1061, 1975), Allan Redeker, MD, discussed the risk of hepatitis B infection from hepatitis B surface antigen (HB<sub>s</sub>Ag)-positive medical personnel and outpatients. The discussion properly emphasized current knowledge about the risks involved; however, it contained one inaccuracy. The statement that "there has been no recorded instance wherein antigen-positive medical personnel have been clearly implicated in the transmission of infection to patients" is not correct. There have been at least two such instances. The first was a well-documented outbreak of hepatitis transmitted to 11 patient contacts of a nurse incubating acute hepatitis that was diagnosed on clinical and epidemiologic grounds as hepatitis B.<sup>1</sup>The second case, although not available to Dr Redeker at the time of his writing, was a small outbreak of hepatitis B that we recently traced to an inhalation therapist, who was also incubating acute hepatitis B.<sup>2</sup>
English government to show how social enterprises will work
Authors: C. White
Journal: BMJ (2008)

Government plans to encourage frontline NHS staff to set up their own businesses in the community will take a step forward later this month, when the Department of Health publishes its guidance on the subject.

The guide, which will be published on 20 November, will explain how the right of staff to ask to set up a social enterprise will work in practice.

That right, which was mooted in Ara Darzi’s next stage review, published in June, entitles NHS staff to make the request of their primary care trust and for it to be formally considered.Social enterprises are businesses with social aims. Their profits are ploughed …
A Confusion of Vitamin D's
Authors: Lawrence G. Raisz
Journal: New England Journal of Medicine (1972)

The path of vitamin D research has always been marked with confusing signposts. After the discovery, more than 40 years ago, that active vitamin D could be produced by irradiation of plant sterols, the first apparently pure material isolated was called vitamin D1. This was later found to be a molecular addition product of active and inactive isomers, so that when the active sterol produced by irradiation of ergosterol was identified, it became vitamin D2 (ergocalciferol). The natural form of vitamin D, which is produced in the skin by irradiation of 7-dehydrocholesterol, was identified much later and . . .
Hepatocyte regeneration in acute fulminant and nonfulminant hepatitis: A study of proliferating cell nuclear antigen expression
Authors: Helmut K. Wolf, George K. Michalopoulos
Journal: Hepatology (1992)

It has been suggested that in fulminant hepatitis it is the lack of hepatocyte regeneration that in the presence of an ongoing loss of hepatocytes leads to hepatic failure and ultimately determines the grim prognosis of this disease. However, little data are available concerning hepatocyte regeneration in human acute hepatitis. We compared the nuclear expression of proliferating cell nuclear antigen with the incorporation of bromodeoxyuridine in formalinfixed, paraffin–embedded liver tissues of rats at different stages of regeneration after two–thirds partial hepatectomy. Immunohistochemical staining for proliferating cell nuclear antigen was performed using the monoclonal antibody 19F4. A good correlation was seen between nuclear labeling for bromodeoxyuridine and proliferating cell nuclear antigen, which indicates that the immunoreactivity for proliferating cell nuclear antigen accurately reflects hepatocyte prolifeation. Subsequently, we determined the nuclear expression of proliferating cell nuclear antigen on archival paraffin–embedded samples of the normal human liver (8 cases), acute nonfulminant hepatitis (10 cases) and fulminant hepatitis (4 cases). The mean proliferating cell nuclear antigen labeling indices were the following: normal liver = 0.4%; acute nonfulminant hepatitis = 43.0%; and fulminant hepatitis = 45.9%. The indices for proliferating cell nuclear antigen were significantly greater in acute hepatitis than in the normal liver, reflecting the high cell turnover in hepatitis. However, no significant difference was seen between the expression of prolifernting cell nuclear antigen in nonfulminant and fulminant acute hepatitis. These data suggest that the net loss of hepatocytes in fulminant hepatitis may not be caused by a lack of hepatocyte regeneration but rather results from overwhelming hepatocyte injury with subsequent cell death. (Hepatology 1992;15:707-713).
Government will not bail out trusts in difficulty, minister says
Authors: Kathryn Godfrey
Journal: BMJ (2004)

NHS trusts in financial trouble will no longer be bailed out by the government, the health secretary, John Reid, told the parliamentary select committee on health last week.

Mr Reid said that “deficits would lie where they occur,” unlike in previous times. “In the past we would take money from elsewhere, but that just means that somewhere else a patient has to wait longer in pain.”

During the House of Commons Health Committee's inquiry into annual public expenditure he said that the way …
Shock occurrence and survival in 241 patients with implantable cardioverter-defibrillator therapy.
Authors: W Grimm, B T Flores, F E Marchlinski
Journal: Circulation (1993)

BACKGROUND The purpose of this study was to determine the influence of clinical characteristics on shock occurrence and survival in 241 patients with implantable cardioverter-defibrillator (ICD) therapy. METHODS AND RESULTS Two hundred forty-one consecutive patients underwent ICD implantation between November 1982 and November 1991 and were subsequently followed for 26 +/- 22 months (intention-to-treat analysis). Actuarial incidence of "appropriate" shocks was 13%, 42%, and 63%, and the incidence of any spontaneous shocks was 15%, 51%, and 76% at 1, 3, and 5 years of follow-up, respectively. Poor left ventricular function (ejection fraction &lt; or = 30%) was associated with an earlier occurrence of both appropriate and any spontaneous ICD shocks (p = 0.001). Appropriate and any spontaneous shocks occurred significantly later in patients who presented with cardiac arrest and in patients in whom only ventricular fibrillation but no uniform ventricular tachycardia was induced during preoperative programmed stimulation. In addition, amiodarone treatment at implant was associated with later occurrence of any spontaneous shocks. Cumulative survival from all-cause mortality including perioperative mortality was 84%, 62%, and 57%, and survival from arrhythmic death was 97%, 89%, and 83% at 1, 3, and 5 years, respectively. Ejection fraction &lt; or = 30% was the best predictor of both total arrhythmic death (p = 0.019) and total mortality (p = 0.003). Antiarrhythmic therapy with class 1 agents at implant was also associated with a higher total mortality during follow-up (p = 0.023) but not with total arrhythmic death. Age, sex, underlying heart disease, clinical presentation, and preoperative response to programmed stimulation did not predict long-term survival. In addition, survival curves were similar for patients with and without spontaneous shocks. CONCLUSIONS The majority of patients receive shocks during long-term follow-up. The occurrence of appropriate or any spontaneous shocks during follow-up is not associated with increased arrhythmic or total mortality consistent with effective prevention of sudden cardiac death with ICD therapy in this high-risk patient population. Although low ejection fraction is the strongest predictor of both shock occurrence and mortality during follow-up, no easy algorithm can be derived from the analyzed clinical characteristics to predict which patients will benefit most from ICD implantation.