tbuckley/cabot-search huggingface dataset:
Successful treatment and prophylaxis of scalp seborrhoeic dermatitis and dandruff with 2% ketoconazole shampoo: results of a multicentre, double-blind, placebo-controlled trial
Authors: R.U PETER, U. RICHARZ-BARTHAUER
Journal: British Journal of Dermatology (1995)

Pityrosporum ovale appears to play an important role in the pathogenesis of seborrhoeic dermatitis. Ketoconazole is an antimycotic agent with a high in vitro and in vivo efficacy against P. ovale. We performed a multicentre study to investigate the efficacy of ketoconazole 2% shampoo in the treatment and prophylaxis of seborrhoeic dermatitis and dandruff. Five hundred and seventy‐five patients presenting with moderate to severe seborrhoeic dermatitis and dandruff of the scalp were treated with 2% ketoconazole shampoo twice weekly for 2–4 weeks, producing an excellent response in 88%. Of those patients who responded, 312 were included in a prophylactic phase, lasting 6 months. These patients were treated with the active preparation (shampoo containing 2% ketoconazole) once‐weekly, once every other week, alternating with placebo (shampoo without ketoconazole), or with placebo only once‐weekly. Forty‐eight (47%) patients in the placebo group experienced a relapse of seborrhoeic dermatitis, compared with 23 (19%) patients in the active treatment group, and 31 (31%) patients in the active/placebo group. The medication was well tolerated in all three groups. We conclude that ketoconazole 2% shampoo is highly effective, not only in clearing scalp seborrhoeic dermatitis and dandruff, but also in preventing relapse of the disease when used prophylactically once weekly.
Kinetics of electrophysiologic changes during oral loading of amiodarone and after withdrawal of amiodarone in the unsedated dog.
Authors: I C Tuna, A C Qi, C Gornick, R M Bolman, D G Benditt
Journal: Circulation (1985)

We examined the temporal kinetics of onset and offset of the cardiac electrophysiologic effects of orally administered amiodarone in chronically instrumented, unsedated adult dogs (n = 8). Right atrial (RA), atrioventricular nodal (AVN), and right ventricular (RV) effective refractory period (ERP), and AVN functional refractory period (FRP), were determined daily for 21 days during amiodarone loading (24 mg/kg/day) and for 21 days after cessation of amiodarone. Left ventricular (LV) ERP was assessed in four of eight animals. Group mean RA-ERP peaked and plateaued early during amiodarone loading (time to reach one-half observed peak change [t1/2 onset] = 1.2 +/- 0.5 days) and rapidly returned toward baseline after cessation of drug (decay time to one-half peak value [t1/2 offset] = 2.0 +/- 1.7 days). Group mean RV-ERP rose in a linear manner throughout the loading period (t1/2 onset = 9.3 +/- 2.1 days) and remained elevated after cessation of drug (t1/2 offset greater than 21.0 days). Group mean AVN-ERP and FRP exhibited temporal kinetics intermediate between those of the RA-ERP and RV-ERP, both during amiodarone loading and after cessation of the drug. Group mean LV-ERP onset kinetics (assessed in a limited number of animals, n = 4) appeared to differ from RV-ERP onset kinetics (t1/2 onset = 2.5 +/- 2.5 days), whereas LV-ERP and RV-ERP offset kinetics appeared similar (t1/2 offset greater than 21 days). In summary, our findings demonstrate that during oral loading, the temporal sequence of onset of amiodarone-induced electrophysiologic effects is site dependent. Similarly, after cessation of amiodarone, the persistence of drug-induced electrophysiologic effects is both variable and site dependent.
Martindale: The extra pharmacopeia (29th ed)
Authors: D. Wingate
Journal: Gut (1989)

the use of oral bile acid therapy, mechanical and contact solvent dissolution by the experts in each field.There is well balanced discussion of the implications of new non-surgical approaches to gall stone disease, predictions about the future of these techniques and a final section on the number of manufacturers of lithotripters with helpful technical details.Overall this is an excellent summary of the place and the results of gall stone lithotripsy in its many forms and will no doubt form the first of a series of such publications resulting from future international symposia.This is essential reading for any clinician, investi- gator, basic scientist or medical administrator currently who are likely to be involved with the non- surgical management of patients with gall stone disease.This book heralds the beginning of a new era in gall stone treatment.
Leptin and leptin receptor expression in asthma
Authors: Andreina Bruno, Elisabetta Pace, Pascal Chanez, Delphine Gras, Isabelle Vachier, Giuseppina Chiappara, Maurizio La Guardia, Stefania Gerbino, Mirella Profita, Mark Gjomarkaj
Journal: Journal of Allergy and Clinical Immunology (2009)
900 TELAPREVIR OR BOCEPREVIR THERAPY IN CHRONIC HEPATITIS C PATIENTS WITH END STAGE RENAL DISEASE ON HEMODIALYSIS IS SAFE, TOLERABLE AND FEASIBLE
Authors: S. Sclair, A. Patel, O. Junaidi, V. Copado, P. Martin, M. Rudraraju, K.R. Bhamidimarri
Journal: Journal of Hepatology (2013)
Stokes-Adams Seizures
Authors: FORD K. HICK
Journal: Circulation (1954)

A patient presenting syncope and convulsions was shown to have spontaneous attacks of ventricular standstill without preceding or subsequent partial heart block and with the auricles beating regularly throughout. Carotid sinus pressure reproduced one such attack. This is a demonstration of nervous control in the heart below the auriculoventricular node and perhaps in the ventricle itself. Cookson's term "paroxysmal ventricular standstill" is uniquely fitting. The presence of right bundle branch block raises the question of a lesion affecting both the left and right branches of the bundle of His.
Fast Determination of Regional Myocardial Strain Fields From Tagged Cardiac Images Using Harmonic Phase MRI
Authors: Jérôme Garot, David A. Bluemke, Nael F. Osman, Carlos E. Rochitte, Elliot R. McVeigh, Elias A. Zerhouni, Jerry L. Prince, João A. C. Lima
Journal: Circulation (2000)

Tagged MRI of the heart is difficult to implement clinically because of the lack of fast analytical techniques. We investigated the accuracy of harmonic phase (HARP) imaging for rapid quantification of myocardial strains and for detailed analysis of left ventricular (LV) function during dobutamine stimulation.Tagged MRI was performed in 10 volunteers at rest and during 5 to 20 microg(-1). kg(-1). min(-1) dobutamine and in 9 postinfarct patients at rest. We compared 2D myocardial strains (circumferential shortening, Ecc; maximal shortening, E(2); and E(2), direction) as assessed by a conventional technique and by HARP. Full quantitative analysis of the data was 10 times faster with HARP. For pooled data, the regression coefficient was r=0.93 for each strain (P<0.001). In volunteers, Ecc and E(2) were greater in the free wall than in the septum (P<0.01), but recruitable myocardial strain at peak dobutamine was greater in the LV septum (P<0.01). E(2) orientation shifted away from the circumferential direction at peak dobutamine (P<0.01). HARP accurately detected subtle changes in myocardial strain fields under increasing doses of dobutamine. In patients, HARP-determined Ecc and E(2) values were dramatically reduced in the asynergic segments as compared with remote (P<0.001), and E(2) direction shifted away from the circumferential direction (P<0.001).HARP MRI provides fast, accurate assessment of myocardial strains from tagged MR images in normal subjects and in patients with coronary artery disease with wall motion abnormalities. HARP correctly indexes dobutamine-induced changes in strains and has the potential for on-line quantitative monitoring of LV function during stress testing.
The Rate of Change of Left Ventricular Volume in Man
Authors: K. E. HAMMERMEISTER, R. C. BROOKS, J. R. WARBASSE
Journal: Circulation (1974)

The rate of left ventricular volume change (dV/dt) is by definition left ventricular ejection rate during systole and filling rate during diastole, and in the absence of valvular regurgitation or intracardiac shunts, is equal to systolic aortic valve flow and diastolic mitral valve flow respectively. A computerized technique for the calculation of instantaneous left ventricular dV/dt from cineangiographically measured left ventricular volume is presented. Curve smoothing was accomplished by passing a second degree polynomial through nine consecutive volume points using the least squares technique. Validity of this technique was demonstrated by the high degree of correlation of systolic dV/dt with instantaneous ascending aortic blood velocity (flow) measured simultaneously with an electromagnetic catheter-tip velocity transducer in ten patients. Peak left ventricular systolic ejection rate (S dV/dt) was calculated from single plane cineangiographically measured left ventricular volumes in 113 adult patients and related to other measures of cardiovascular function. Mean S dV/dt for the group of 29 normal patients was 427 ± 129 cc per second and was not significantly different in patients with coronary artery disease (21), aortic stenosis (13), mitral stenosis (11), or cardiomyopathy (9), but was increased significantly in patients with valvular regurgitation (19). S dV/dt correlates poorly with the ejection fraction and with left ventricular end-diastolic pressure (LVEDP) and is not a reliable measure of left ventricular function. The primary determinant of S dV/dt appears to be total left ventricular stroke volume. When S dV/dt is divided by end-diastolic volume (EDV), the resultant S dV/dt/EDV correlates well with peak normalized circumferential fiber shortening rate ( r = 0.89, P &lt; 0.01) and with ejection fraction ( r = 0.69, P &lt; 0.01). The correlation coefficient of S dV/dt/DV with LVEDP was r = 0.36 ( P &lt; 0.01) and with arterio-venous oxygen difference, r = 0.38 ( P &lt; 0.01). Thus, S dV/dt/EDV appears to be a measure of ventricular function. S dV/dt occurs in midsystole in normal subjects and in patients with mitral regurgitation and is not delayed in patients with aortic stenosis. The three patients with idiopathic hypertrophic subaortic stenosis appeared to have characteristic changes in the left ventricular ejection rate curve with an increase in S dV/dt (and especially S dV/dt/EDV), with S dV/dt occurring earlier in systole than normal.
Energy Sources for Contraction of the Rat Ventricle in Phosphate Media
Authors: DAVID A. BERMAN, PAUL R. SAUNDERS
Journal: Circulation Research (1955)

Various substrates were tested for their ability to restore the amplitude of contraction of hypodynamic electrically-stimulated rat ventricle strips suspended in a phosphate-buffered medium. Greatest recovery of the contractile activity was obtained with pyruvate; lactate, β-hydroxybutyrate and acetate were more effective than succinate and glucose. The finding that glucose, in contrast to pyruvate, was relatively ineffective as an energy source for contraction, when a phosphate-buffered medium was employed, suggests that the defect was due to a rate-limiting step in the conversion of glucose to pyruvate, rather than to an impairment in the functioning of the Krebs cycle.
Association Between Number of Physician Visits and Influenza Vaccination Coverage Among Diabetic Adults With Access to Care
Authors: Leonard E. Egede
Journal: Diabetes Care (2003)

OBJECTIVE—The proportion of diabetic adults that receives the influenza vaccine is less than ideal. This study determined the relationship between the number of physician visits in the previous 12 months and the likelihood of influenza vaccination among diabetic adults with access to care. RESEARCH DESIGN AND METHODS—Data on 1,807 diabetic adults with access to care in the 1999 National Health Interview Survey (NHIS) were analyzed. Prevalence of influenza vaccination was determined by number of physician visits. Logistic regression was used to determine the independent association between number of physician visits and influenza vaccination coverage, controlling for age, sex, race/ethnicity, education, income, employment census region, and comorbidity. STATA was used for analyses to account for the complex sampling design of NHIS. RESULTS—Overall, 56% of subjects received the influenza vaccine. Proportions vaccinated by number of physician visits were as follows: 35% (no visit), 47% (1–3 visits), 58% (4–9 visits), and 61% (≥10 visits). Compared with people with no physician visit, people with 4–9 visits (odds ratio [OR] 2.61) and ≥10 visits (2.96) were significantly more likely to be vaccinated. However, after controlling for covariates, only people with ≥10 visits (2.34) were significantly more likely to be vaccinated. CONCLUSIONS—In this nationally representative sample, repeated physician visits by diabetic adults with access to care were associated with only modest increases in influenza vaccination coverage. In adjusted analysis, odds of influenza vaccination were not significantly associated with number of physician visits, except in people with ≥10 visits.
A system-wide challenge for UK food policy
Authors: S. A. Jebb
Journal: BMJ (2012)

Single issue solutions won’t prevent diet related diseases with complex causes 

Diet related disease leads to about 70 000 premature deaths in the United Kingdom.1 The rising prevalence of obesity is a signal that the food system is out of kilter with public health priorities. Ahead of the World Health Assembly (21-26 May in Geneva), which will discuss the World Health Organization’s progress on strengthening action for preventing non-communicable diseases, Mytton and colleagues (doi:10.1136/bmj.e2931) consider the evidence for specific food taxes to improve health,2 while Hawkes (doi:10.1136/bmj.e2801) makes the case that global health policies should be embedded within the wider food economy.3

Under successive governments, UK policies on diet have relied heavily on more and better education for consumers to make healthy choices, based on the notion that consumer behaviour will shape markets. More recently, basic information campaigns have given way to a social marketing approach, epitomised by Change4Life, a campaign run by the Department of Health in England that offers encouragement and support to achieve a healthier lifestyle. It is well known that putting knowledge into practice needs clear nutritional labelling, …
Reasons for increased incidence of tuberculosis
Authors: M R Law, J K Morris, N Bhatti, R Halliday, J Moore-Gillon
Journal: BMJ (1995)

EDITOR,—A Hayward and colleagues1 disagree with our conclusion that the 12% increase in the incidence of tuberculosis in England and Wales between 1988 and 1992 affected the “low risk” white and West Indian communities as well as the “high risk” Indian subcontinent, African, and refugee communities.2 They restate our conclusion that the data on incidence by local authority districts in England and Wales are uninformative on this point because the …
The protective effect of hyperosmotic mannitol in myocardial ischemia and necrosis.
Authors: W J Powell, D R DiBona, J Flores, A Leaf
Journal: Circulation (1976)

Morphologic and hemodynamic changes that occur following coronary occlusion are examined. The effectiveness of hyperosmotic mannitol in lessening the extent of myocardial damage is assessed and mechanisms for its action discussed. Forty and 60 min of coronary vascular occlusion followed by 15 and 45 min of reflow were associated with a persistence of ischemia following reflow of blood, as established by infusions of silastic into the aortic root. Electron microscopic studies demonstrated myocardial and endothelial cell swelling at the end of the reflow period. The process of cell swelling appeared to be initiated during the period of arterial occlusion. This cell swelling was reduced by elevation of serum osmolality by 30-40 mOsm above control with the administration of mannitol during and following occlusion. There was an associated 40-50% reduction of vascular resistance following occlusion if mannitol was administered. In addition, the extent of necrosis, which was widespread in untreated hearts 12 hours after occlusion, was strikingly less in the hearts of dogs which received mannitol. Thus, in ischemic myocardium, elevation of osmolality by mannitol reduces myocardial necrosis, probably through its restoration of normal cell volume.
Diagnosis of mild hypertension by ambulatory blood pressure monitoring.
Authors: M A Weber, J M Neutel, D H Smith, W F Graettinger
Journal: Circulation (1994)

BACKGROUND Between 20% and 30% of patients with clinically diagnosed hypertension have normal blood pressure (BP) values during automated ambulatory 24-hour BP monitoring. It has not been clear, however, whether these patients can be regarded as normotensive or whether they should be treated in the same way as confirmed hypertensive patients. METHODS AND RESULTS Ambulatory BP monitoring was performed in 88 normal control subjects and 171 hypertensive patients (office diastolic BP &gt; or = 90 mm Hg on three visits; never treated or off treatment for more than 6 months). Hypertensive patients were classified as nonconfirmed or white coat (n = 58) if their 24-hour diastolic averages were &lt; 85 mm Hg and at least 15 mm Hg lower than their office values. For comparisons, white coat patients were pair-matched with normal subjects by 24-hour diastolic averages and sex, and by similar age and weight; there were 40 such pairs. White coat patients were likewise pair-matched with confirmed hypertensive patients by identical office BPs (51 pairs). Participants were studied by individualized treadmill testing, Doppler echocardiography, and assays of resting plasma catecholamines, upright plasma renin and aldosterone, and lipid, glucose, and insulin concentrations. Because of the matching, compared with normal subjects, patients with white coat hypertension and normal subjects had identical 24-hour BP averages. The white coat patients exhibited slightly greater variability among individual readings (obtained each 15 minutes) throughout the day [P &lt; .05]), but there were no differences in hemodynamic responses to exercise. Plasma norepinephrine (P &lt; .05), renin and aldosterone (P &lt; .01 for each), and insulin and low-density lipoprotein cholesterol levels (P &lt; .01 for each) were higher in the white coat group, as were left ventricular septal wall (P &lt; .05) and muscle mass (P = .07) echocardiographic measurements. When compared with the confirmed hypertensive patients, the white coat patients had higher renin (P &lt; .01) but were otherwise similar. Within the white coat group, plasma norepinephrine correlated with total cholesterol and triglycerides (P &lt; .05 for each), and aldosterone correlated with left ventricular mass (P &lt; .01); there were no significant correlations within the normal control subject or confirmed hypertension groups. CONCLUSIONS Patients with white coat hypertension differ in metabolic, neuroendocrine, and cardiac findings from normal control subjects and have greater BP variability. These changes appear to be mediated by heightened activity of the sympathetic and renin-angiotensin systems. Although these characteristics could reflect an alerting reaction in the clinic due to awareness of their diagnosis, the white coat hypertensive patients also have evidence for additional, more-sustained differences from normal subjects. Thus, this condition appears to be a true variant of hypertension.
THE PREPARATION OF BACILLUS PERTUSSIS VACCINE FOR IMMUNIZATION
Authors: Louis W. Sauer
Journal: JAMA (1934)

For immunization against whooping cough to be free from unnecessary hazards, the recently isolated strains of Bordet-Gengou bacilli should be grown only on Bordet medium, made with 20 per cent fresh, defibrinated human blood. A total of from 7 to 8 cc. of such vaccine, containing 10,000 million bacilli, is necessary to confer prolonged immunity.1 Because the amount of culture medium blood protein that is unavoidably carried over when the forty-eight hour growth is harvested is not negligible, the growth is scraped off. To flood off the harvest would carry over appreciably more, at times sufficient to give the product a pink tinge. To rid the vaccine of such transferred blood protein by washing, centrifugation and replacement of the supernatant fluid would weaken, i. e., decrease, the antigenic content of the vaccine. I have found the original supernatant fluid to contain an appreciable amount of soluble toxin. The use of
Medical Responsibility for the Prolongation of Life
Authors: Francis D. Moore
Journal: JAMA (1968)

It is certainly appropriate to discuss transplantation in this seminar, not only because it may prolong the life of somebody who is crtitically ill but also because it requires a specific decision in many cases as to precisely when death has occurred; or, speaking in modern terms, when it is no longer to the good of society or the individual to prolong outward semblances of life in a body that lives while the brain is dead. <h3>I</h3> The various aspects bearing on the ethics of transplantation are to be analyzed under two headings: the ethics of the trial of new operations, and the ethical considerations involved with the donor. Although neither is in any sense new, the interpretation of cardiac transplantation in the light of these two problems has brought a new set of ideas and perplexities to the general public. A surprising number of eminent people, who appear to
Cohen's coefficient 
Authors: P. Sedgwick
Journal: BMJ (2012)

Chest radiographs are the best method for diagnosing pneumonia but are often not available in developing countries. Therefore, in 1990 the World Health Organization developed guidelines for diagnosis of non-severe pneumonia that comprised clinical symptoms of fast breathing alone. However, fast breathing can have causes other than pneumonia, and thus children who are given a diagnosis of non-severe pneumonia on the basis of fast breathing alone may receive antibiotics unnecessarily.

Children aged 2 to 59 months with non-severe pneumonia diagnosed on the basis of the WHO guidelines were invited to participate from outpatient departments of six hospitals in Pakistan. In total 2000 children were enrolled, for whom 1848 chest radiographs were available for assessment. Two consultant radiologists used standardised criteria to evaluate the chest radiographs, with no clinical information available to them. The primary outcome was diagnosis of pneumonia (absent or present) from chest radiographs.1

Cohen’s coefficient κ for agreement between the two radiologists in their diagnoses was 0.46. A small number of children were given a diagnosis of bronchiolitis. The researchers concluded that most children with non-severe pneumonia diagnosed on the basis of the current WHO definition had normal chest radiographs.

Which of the following statements, …