tbuckley/cabot-search huggingface dataset:
Cardiac Electrophysiology: From Cell to Bedside
Authors: Peter T. Kuo
Journal: JAMA (1995)

<i>Cardiac Electrophysiology</i>contains the latest developments in 14 areas, from "Molecular Bases of Ion Channel Activity" to "Arrhythmia Mechanisms" to "Surgery." In the past few years, there has been an explosive growth in the field of cardiac electrophysiology. This book has met the greatly increased demand for knowledge about what is new in basic cardiac electrophysiology and its effect on clinical cardiology practice. Additionally, it provides readers with a series of fresh concepts and a wealth of information that can be used to improve understanding of cardiac electrophysiology at the bedside and in laboratory research. Chapter authors are distinguished either in basic research or in clinical research and patient care. The book has sought to cover all the critical issues of cardiac electrophysiology and to advance cardiovascular research and its clinical application. I heartily recommend<i>Cardiac Electrophysiology</i>to all who are interested in cardiology, from medical students to internists and
Underage Drinking-Reply
Authors: John Shosky
Journal: JAMA (1993)

<h3>In Reply.</h3> —Dr Callan notes that underage drinking has decreased slightly over the last 10 years (from greater than 93% of high school seniors in 1980 to 88% in 1991). Of course, any reduction is welcome. However, the author seems to have missed the landscape by looking at a leaf. Underage drinking is still a mysterious health problem shrouded in fantasy, hearsay evidence, ignorance, and indifference. Parents, educators, and medical professionals desperately require hard data to answer the many vital questions about underage drinking, especially about what beverages are consumed, the motivations for drinking, the effect of advertising, and how to craft successful interventions. We need comprehensive, accurate, and relevant information. The eight invaluable and illuminating studies by the Department of Health and Human Services Office of Inspector General,<sup>1-8</sup>conducted at the request of Surgeon General Antonia C. Novello, were designed to search out the available data, fill in
Automobile Head Restraint Injury
Authors: Lawrence E. Fetterman
Journal: JAMA (1970)

To the Editor.—  We are writing to demonstrate an unusual traumatic result related to one of the safety features of our modern automobiles. This 14-year-old girl was riding in the rear seat of an automobile which was involved in an accident, without a seat belt on. She was thrown forward and struck the upper part of her chest on the front seat head restraint, breaking both clavicles in midshaft (Figure).  Her attending physicians considered it miraculous that she did not sustain possibly fatal tracheal or laryngeal trauma at the same time.  This points out two things: first, the value of rear seat safety belts and second, that head restraints in the front seat possibly should be redesigned to allow some forward motion in order to prevent such an accident as this.
ABC of clinical electrocardiography: Acute myocardial infarction---Part I
Authors: F. Morris
Journal: BMJ (2002)

In the clinical assessment of chest pain, electrocardiography is an essential adjunct to the clinical history and physical examination. A rapid and accurate diagnosis in patients with acute myocardial infarction is vital, as expeditious reperfusion therapy can improve prognosis. The most frequently used electrocardiographic criterion for identifying acute myocardial infarction is ST segment elevation in two or more anatomically contiguous leads. The ST segment elevation associated with an evolving myocardial infarction is often readily identifiable, but a knowledge of the common "pseudo" infarct patterns is essential to avoid the unnecessary use of thrombolytic treatment. #### Indications for thrombolytic treatment ST segment depression or enzymatic change are not indications for thrombolytic treatment ![][1]</img> In the early stages of acute myocardial infarction the electrocardiogram may be normal or near normal; less than half of patients with acute myocardial infarction have clear diagnostic changes on their first trace. About 10% of patients with a proved acute myocardial infarction (on the basis of clinical history and enzymatic markers) fail to develop ST segment elevation or depression. In most cases, however, serial electrocardiograms show evolving changes that tend to follow well recognised patterns. The earliest signs of acute myocardial infarction are subtle and include increased T wave amplitude over the affected area. T waves become more prominent, symmetrical, and pointed ("hyperacute"). Hyperacute T waves are most evident in the anterior chest leads and are more readily visible when an old electrocardiogram is available for comparison. These changes in T waves are usually present for only five to 30 minutes after the onset of the infarction and are followed by ST segment changes. ![][2]</img> In practice, ST … [1]: /embed/graphic-1.gif [2]: /embed/graphic-2.gif
Assessing the Reliability of Two Toxicity Scales: Implications for Interpreting Toxicity Data
Authors: M. D. Brundage, J. L. Pater, B. Zee
Journal: JNCI Journal of the National Cancer Institute (1993)

The toxicity of a given cancer therapy is an important end point in clinical trials examining the potential costs and benefits of that therapy. Treatment-related toxicity is conventionally measured with one of several toxicity criteria grading scales, even though the reliability and validity of these scales have not been established.We determined the reliability of the National Cancer Institute of Canada Clinical Trials Group (NCIC-CTG) expanded toxicity scale and the World Health Organization (WHO) standard toxicity scale by use of a clinical simulation of actual patients.Seven experienced data managers each interviewed 12 simulated patients and scored their respective acute toxic effects. Inter-rater agreement (agreement between multiple raters of the same case) was calculated using the kappa (kappa) statistic across all seven randomly assigned raters for each of 18 toxicity categories (13 NCIC-CTG and five WHO categories). Intra-rater agreement (agreement within the same rater on one case rated on separate occasions) was calculated using kappa over repeated cases (where raters were blinded to the repeated nature of the subjects). Proportions of agreement (estimate of the probability of two randomly selected raters assigning the same toxicity grade to a given case) were also calculated for inter-rater agreement. Since minor lack of agreement might have adversely affected these statistics of agreement, both kappa and proportion of agreement analyses were repeated for the following condensed grading categories: none (0) versus low-grade (1 or 2) versus high-grade (3 or 4) toxicity present.Modest levels of inter-rater reliability were demonstrated in this study with kappa values that ranged from 0.50 to 1.00 in laboratory-based categories and from -0.04 to 0.82 for clinically based categories. Proportions of agreement for clinical categories ranged from 0.52 to 0.98. Condensing the toxicity grades improved statistics of agreement, but substantial lack of agreement remained (kappa range, -0.04-0.82; proportions of agreement range, 0.67-0.98).Experienced data managers, when interviewing patients, draw varying conclusions regarding toxic effects experienced by such patients. Neither the NCIC-CTG expanded toxicity scale nor the WHO standard toxicity scale demonstrated a clear superiority in reliability, although the breadth of toxic effects recorded differed.
AN INTERESTING RESULT FROM THE USE OF PARATHYROID EXTRACT IN A CASE OF OSTEITIS DEFORMANS (PAGET'S DISEASE)
Authors: Anthony Bassler
Journal: JAMA (1926)

Suggested by the work of Collip on parathyroidectomized dogs in which the administration of extracts of parathyroid glands raised the calcium content of the blood, this substance was employed in a case of osteitis deformans with a happy result. Nov. 6, 1923, a retired business man, aged 66, came to seek help for a case of well developed Paget's disease. His mother had died at 72, following a fracture of the hip, and his father at 59, of pneumonia. He had two brothers and one sister, all younger than he and all well. There was no personal history of past illness except scarlet fever at the age of 7 which destroyed the sight of his left eye. About six years previously he noticed a slowly developing stiffness and weakness in his legs between the ankles and knees, which gradually ascended into both thighs. He recorded that the trouble began rather
316 IMMUNOSUPPRESSION MODULATES THE COURSE OF HEPATITIS B VIRUS (HBV) INFECTION IN HYDRODYNAMIC INJECTION MOUSE MODEL
Authors: J.Z. Wang, B.J. Wang, S.M. Huang, J. Wu, Z.N. Zhu, B. Zhu, H.H. Ding, X.M. Feng, Y. Yin, M. Roggendorf, M.J. Lu, D.L. Yang
Journal: Journal of Hepatology (2011)
Effects of nebulizedNG-nitro-L-arginine methyl ester in patients with hepatopulmonary syndrome
Authors: Federico P. Gómez, Joan A. Barberà, Josep Roca, Felip Burgos, Concepción Gistau, Robert Rodríguez-Roisin
Journal: Hepatology (2006)

Enhanced pulmonary production of nitric oxide (NO) has been implicated in the pathogenesis of hepatopulmonary syndrome (HPS). NO inhibition with N G-nitro-L-arginine methyl ester (L-NAME) in both animals and humans with HPS has improved arterial hypoxemia. We assessed the role of enhanced NO production in the pathobiology of arterial deoxygenation in HPS and the potential therapeutic efficacy of selective pulmonary NO inhibition. We investigated the effects of nebulized L-NAME (162.0 mg) at 30 and 120 minutes on all intrapulmonary and extrapulmonary factors governing pulmonary gas exchange in 10 patients with HPS (60 ± 7 [SD] yr; alveolar–arterial oxygen gradient, range 19–76 mm Hg; arterial oxygen tension, range 37–89 mm Hg). Nebulized L-NAME maximally decreased exhaled NO (by −55%; P &lt; .001), mixed venous nitrite/nitrate (by −12%; P = .02), and cardiac output (by −11%; P = .002) while increased systemic vascular resistance (by 11%; P = .008) and pulmonary vascular resistance (by 25%; P = .03). In contrast, ventilation-perfusion mismatching, intrapulmonary shunt and, in turn, arterial deoxygenation remained unchanged. In conclusion , gas exchange disturbances in HPS may be related to pulmonary vascular remodeling rather than to an ongoing vasodilator effect of enhanced NO production. (Hepatology 2006;43:1084–1091.)
Diagnostic Strategies for Common Medical Problems
Authors: A. S. Abraham
Journal: JAMA (1992)

This paperback book is a serious attempt to present a critical approach to the quantitative interpretation of clinical and diagnostic test information for common problems in internal medicine. Most of us, from the newly qualified to the old hand, make day-to-day decisions regarding diagnosis, workup, and treatment of our patients on the basis of our reading and interpretation of the literature, experience, common sense, and other such difficult to define and quantitate skills. All of this we bring to bear on the results of our history and physical examination in order to reach a working diagnosis, which, in turn, brings a request for a series of diagnostic tests together with decisions about management and treatment. What Panzer, Black, and Griner attempt here is to present to the clinician a format for a critical and quantitative appraisal of the information available and decisions to be made. The first chapters of the
Tuberculosis Screening of Applicants for US Immigration-Reply
Authors: Michael F. Cantwell
Journal: JAMA (1995)

<h3>In Reply.</h3> — As correctly pointed out by Dr Bayuk, the current overseas medical examination procedures for persons applying for immigration to the United States are designed to exclude applicants with infectious TB. According to the regulations, a person is considered to have infectious TB if the CXR is compatible with active TB and one or more sputum smear examinations is positive for acid-fast bacilli (AFB).<sup>1</sup> The decision to define infectiousness on the results of sputum smears rather than culture is based on the lower risk of transmission among persons who are AFB smear-negative<sup>1</sup>and on at least two practical considerations. First, immigrants and refugees come from more than 100 countries, many of which do not have the laboratory capabilities to conduct mycobacterial culture. Also, drug susceptibility testing is rarely available, making it difficult to prescribe an appropriate regimen in countries with relatively high rates of drug resistance.
THE COLLECTED WORKS OF CARL WEIGERT.
Authors: E. K. Dunham
Journal: JAMA (1907)

The publication of the collected works of the great pathologic anatomist, Carl Weigert, is a notable event for the many persons interested in the progress of discovery and thought in medicine, for between the covers of these carefully edited volumes may be found the records of methods of investigation, of observations and of generalizations that are exerting a deep and lasting influence on medical science. This influence is the more remarkable because it emanates from a man who was singularly modest and gentle, unapt to contend for the prestige of his views—a man who spoke his message to science not from the vantage-ground of the authority that belongs to high academic rank but from the more obscure and independent focus of an unpretentious laboratory without university connections. So intimate is the relation between the character of this man and the work which he did that it seems fitting to sketch,
Body composition and knee cartilage properties in healthy, community-based adults
Authors: Y. Wang, A. E Wluka, D. R English, A. J Teichtahl, G. G Giles, R. O'Sullivan, F. M Cicuttini
Journal: Annals of the Rheumatic Diseases (2007)

<b>Background:</b> Although obesity is widely accepted as a risk factor for knee osteoarthritis, whether weight per se or the specific components of body composition are the major determinants of properties of articular knee cartilage is unclear. <b>Objective:</b> To examine associations between anthropometric and body composition measures and knee cartilage properties in healthy adults. <b>Methods:</b> 297 healthy adults with no clinical knee osteoarthritis were recruited from an existing community-based cohort. Anthropometric measures and body composition, including fat-free mass and fat mass assessed using bioelectrical impedance analysis, were measured at baseline (1990–4) and current follow-up (2003–4). Tibial cartilage volume and tibiofemoral cartilage defects were assessed using MRI at follow-up. <b>Results:</b> After adjustment for potential confounders, baseline and current fat-free mass, independent of fat mass, were positively associated with tibial cartilage volume (all p&lt;0.001). Increased fat-free mass over the time period was positively associated with tibial cartilage volume (p&lt;0.001). Current fat mass was negatively associated with tibial cartilage volume (p = 0.004). Baseline and current fat mass were weakly associated with increased tibiofemoral cartilage defects (p = 0.06 and p = 0.07, respectively), independent of fat-free mass. <b>Conclusion:</b> The findings suggest a beneficial effect of fat-free mass, but a deleterious effect of fat mass, on knee cartilage properties in healthy adults. This suggests that weight-loss programmes aimed at reducing fat mass but maintaining muscle mass may be important in preventing the onset and/or progression of knee osteoarthritis.
Raised intraocular pressure: an alternative method of referral.
Authors: M Kljakovic, J G Howie, C I Phillips, R S Bartholomew, J G Brown
Journal: BMJ (1985)

To assess delay in referring patients with suspected glaucoma two methods were studied in a randomised trial: direct referral from optician to ophthalmologist and referral through the patient9s general practitioner. Direct referral was reliable for all 49 patients involved, whereas, of the 44 patients referred through their general practitioner, seven waited over three weeks for referral.
Medical Botany: Plants Affecting Man's Health
Authors: William K. Beatty
Journal: JAMA (1977)

Lewis, professor of botany at Washington University and senior botanist at the Missouri Botanical Garden, and Elvin-Lewis, associate professor and chairman of Dental Microbiology at Washington University, have written a book based on their multidisciplinary undergraduate course in medical botany. The authors have arranged a vast amount of material drawn from many publications, folklore, and contemporary medicine, in three broad categories: plants that are injurious, those that heal or nourish, and those that affect the conscious mind. The authors' style is serious and straightforward. Throughout the book the authors emphasize familial relationships, and in an appendix, which outlines the classification of the plant kingdom, families containing important medicinal plants are printed in boldface. A glossary defines many medical and botanical terms. In addition to the literature cited at the end of each chapter, there are in the second appendix references on herbal medicine arranged geographically. The illustrations, most of which
Cardiac failure and folate deficiency.
Authors: F P Retief
Journal: BMJ (1970)

Cardiac Failure and Folate Deficiency SIR,-Your interesting leading article on cardiac failure and folate deficiency (24 January, p. 188) commented on the possible causes of this association, and factors like impaired dietary intake and gastrointestinal malabsorption were mentioned.A contributory cause could well be excessive folate loss in the urine.Urinary folate excretion has been poorly studied, but we recently re- ported an unexpected increase of urinary folate in association with congestive cardiac failure.'As much as 61 6,tg.folate was lost per day, while normal controls excreted 0-1-18-0,ug.folate per day.Urinary folate loss is unlikely to be the sole cause of folate deficiency in these patients, but could well be an important contributory factor in a patient with pro- longed anorexia.One could speculate that excessive urinary folate results from ab- normal folate liberation secondary to the liver damage of chronic congestive failure.Urinary folate excretion is increased in cirrhosis and acute hepatitis' and also after surgical trauma.2-Iam, etc.,
Downregulation of phorbol 12-myristate 13-acetate–induced tumor necrosis factor–alpha and interleukin-1β production and gene expression in human monocytic cells by human alpha-fetoprotein
Authors: Wei Wang, Elliot Alpert
Journal: Hepatology (1995)

We previously identified a specific receptor of alpha-fetoprotein (AFP) on human monocytes. Although AFP alters many immune cell functions, the effect of AFP on monocyte cytokine production is unknown. Because tumor necrosis factor--alpha (TNF-alpha) and interleukin-1 beta (IL-1 beta) are important cytokines in immunoregulation, we investigated whether AFP could modulate TNF-alpha and IL-1 beta production in U937, a human monocytic cell line. Our results showed that U937 cells secreted TNF-alpha and IL-1 beta in response to either phorbyl 12-myristate 13-acetate (PMA) or IFN-gamma + LPS. In contrast, AFP significantly suppressed PMA-induced TNF-alpha and IL-1 beta production by U937 cells in a time and dose dependent fashion. Pretreatment of U937 cells with AFP resulted in maximal inhibition of PMA-stimulated TNF-alpha and IL-1 beta production by 58% and 67% respectively. AFP also inhibited interferon-gamma plus lipopolysaccharide (IFN-gamma + LPS)-induced TNF-alpha and IL-1 beta production. Furthermore, Northern blot analysis showed that AFP suppressed PMA-mediated TNF-alpha and IL-1 beta messenger RNA (mRNA) expression. PMA-induced prostaglandin E2 (PGE2) production by U937 cells was enhanced by AFP. Pretreatment with indomethacin, a cyclooxygenase inhibitor, reversed AFP-inhibited TNF-alpha production by 78%. Thus, we conclude that AFP downregulates TNF-alpha and IL-1 beta production via a PGE2-dependent mechanism.
Post-menopausal Oestrogen Production
Authors: R. A. Struthers
Journal: BMJ (1956)

MEDBAISH RNAL1331insipidus itself the action of adrenal cortical hormones un- inhibited by A.D.H. may be contributory to the observed polyuria.Both Sirek and Best (1952) and Swingle et al. (1953) have produced experimental evidence in support of this.They were able to induce diabetes insipidus by injecting dogs with large doses of cortisone."Pituitrin" was effective in controlling the polyuria and polydipsia only when administered in large amounts.The latter authors concluded that the increased urine volume was brought about by (1) thirst due to sodium retention, (2) inhibition of tubular reabsorption of water, and (3) probably by reduc- tion of the amount of A.D.H. released by the posterior pituitary. Clinical StudiesGarrod and Burston (1952) observed the effects of cortisone on water diuresis in patients with either Addison's disease or panhypopituitarism.The diuretic response was defective in all patients initially, but was restored to normal after cortisone was given.And, although cortisone raises the glomerular filtration rate and renal plasma flow, this is only a partial factor.The main role of cortisone is to enable the renal tubules to regulate the reabsorption of water.Another important and interesting feature was that cortisone induced a transient diabetes insipidus in one of their patients with impaired anterior pituitary and neuro- hypophysial function due to a suprasellar cyst.This is almost analogous to the state of affairs that existed in our case, except that it is uncertain in our patient what part the focal necrosis in the anterior pituitary played.Prunty (1953), in a study of the effects of cortisone in patients with Addison's disease, came to the conclusion that, while sodium and chloride retention occurs, this may not persist as long as the hormone is administered.Under cer- tain conditions diuresis may occur with increased excretion of these ions.There is thus some evidence from previous studies to support the hypothesis that an excess of adrenal cortical hormones (in our case exogenous cortisone), acting without or with only negligible A.D.H., can convert temporarily a mild diabetes insipidus to a severe form.We wish to emphasize one further point.Cortisone actually made this leukaemia worse.This is in accord with the recent observations of Fessas et al. (1954).They found that cortisone and corticotrophin were of benefit in the acute lymphoblastic leukaemia, whereas they were of no use, or even accelerated the leukaemic process, in cases of acute mveloblastic or monoblastic leukaemia. SummaryA case of monocytic (paramyeloblastic) leukaemia with diabetes insipidus is reported.Necropsy changes in the pituitary and other organs are described.The effect of cortisone in increasing the polyuria is observed and the possible modes of action are discussed.We are grateful to Dr. P. R. Evans for his helpful advice, to Drs.R. L. Waterfield and J. T. Cecil for their reports on the marrow and blood films, to Dr. A. J.
ABO blood group and secretor status in relation to clinical characteristics of peptic ulcers
Authors: M. J. S. Langman, R. Doll
Journal: Gut (1965)

EDITORIAL SYNOPSIS A large series of peptic ulcer patients divided into groups according to those who bled, those who required operation, and those who had neither bleeding nor operation showed a dissociation between ABO blood group and secretor status.Patients who had undergone operation showed a higher proportion of non-secretors for both gastric and duodenal ulcers than others.Ulcer patients who bled showed an increased frequency of blood group 0 compared with the others, but there was no difference as between the operation and non-operation groups.A careful statistical analysis of results and review of previous work on this subject makes the findings in this paper important, particularly as a possible guide to prognosis.