tbuckley/cabot-search huggingface dataset:
Pressure Recovery in Bileaflet Heart Valve Prostheses
Authors: Pieter M. Vandervoort, Neil L. Greenberg, Min Pu, Kimerly A. Powell, Delos M. Cosgrove, James D. Thomas
Journal: Circulation (1995)

Background We investigate pressure recovery in central and side orifices of St Jude valves and the effect of mitral versus aortic position on the relation between Doppler- and catheter-derived pressure gradients. Methods and Results Maximum, transvalvular, and net pressure gradients are calculated and compared with Doppler-derived gradients in an in vitro model. Pressure recovery and pressure loss coefficients are calculated. Simultaneous Doppler and catheter gradients are obtained intraoperatively in five patients undergoing mitral valve replacement. Centerline Doppler gradients correspond closely with maximum catheter gradients but are higher than transvalvular and net pressure gradients. Thirty-six percent of the initial pressure drop is recovered between the valve leaflets and is independent of valve size or configuration. A variable amount of postvalvular pressure recovery is observed depending on aortic or mitral configuration. Side orifice velocities are 85±4% of the centerline velocities. Incorporation of the pressure loss coefficient in the simplified Bernoulli equation shows close agreement between centerline Doppler gradients and transvalvular gradients ( r =.99, y =1.11 x −0.19). Conclusions Gradients across the St Jude valve measured by Doppler ultrasound are higher than transvalvular or net catheter gradients due to downstream pressure recovery. This is more marked for Doppler gradients based on centerline velocities than side orifice velocities and is more pronounced for valves in an aortic than a mitral configuration. Therefore, to be comparable with invasive transvalvular catheter gradients, either Doppler gradients should be calculated based on side orifice velocity measurements or the Doppler gradient calculation should include the pressure loss coefficient when based on central orifice velocities.
The Skin and Systemic Disease: A Colour Atlas &amp; Text, 2nd Edition.
Authors: K Armstrong
Journal: British Journal of Dermatology (2004)

Journal Article The Skin and Systemic Disease: A Colour Atlas & Text, 2nd Edition. Get access K Armstrong, Dr K Armstrong, Dr Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 151, Issue 2, 1 August 2004, Pages 525–526, https://doi.org/10.1111/j.1365-2133.2004.06215_1.x Published: 01 August 2004
138 A NOVEL BILE SALT-PHOSPHOLIPID CONJUGATE URSODEOXYCHOLYL-LYSOPHOSPHATIDYLETHANOLAMIDE AS A HEPATIC CYTOPROTECTIVE AGENT
Authors: W. Chamulitrat, J. Burhenne, T. Rehlen, A. Pathil-Warth, W. Stremmel
Journal: Journal of Hepatology (2008)
The primary health care non-team?
Authors: P. Pearson, K. Jones
Journal: BMJ (1994)

Is the primary health care team a myth? Teams can be defined in a variety of ways—whether as “beasts of burden yoked together” (Oxford English Dictionary) or “a small group of people who relate to each other to contribute to a common goal.”1 Successive governments and professional organisations have advocated the creation and maintenance of “the primary health care team.”2 3 4 5 Teamwork in primary care, it is suggested, is the way forward, and by implication, the way to achieve high quality care for patients. But what is the evidence for this and what are we aspiring to? Do we have teams or non-teams?

The literature yields few empirical data on the topic. Work in Newcastle upon Tyne indicated some consensus among practitioners regarding core participants, who generally include medical, nursing, and reception staff.6 But much less agreement exists regarding membership of the extended team—members are drawn in as necessity dictates. Some of the variation in composition may be attributable to differing definitions of the team, depending on whether shared function, employment status, or clinical practice is its defining characteristic.

Gregson and her colleagues looked at the collaboration of doctor-nurse pairs and concluded that factors such as a shared base (for example, in a health centre) and stable attachment were important in encouraging such collaboration.7 More recently the same unit has described some of the misunderstandings and mismatches of perception among members in 20 practices in Northumberland.8 This confusion reflects the experience of many practitioners for whom teamwork …
1164-125 Development of murine fibrotic cardiomyopathy is dependent on monocyte chemoattractant protein 1
Authors: Oliver Dewald, Guofeng Ren, Christina Klemm, Kim Winkelmann, Anna Koerting, George Taffet, Lloyd H Michael, Mark L Entman, Nikolaos G Frangogiannis
Journal: Journal of the American College of Cardiology (2004)
Novel proline substitution mutations in keratin 16 in two cases of pachyonychia congenita type 1
Authors: F.J.D. Smith, M. Del Monaco, P.M. Steijlen, C.S. Munro, M. Morvay, C.M. Coleman, F.J.R. Rietveld, J. Uitto, W.H.I. Mclean
Journal: British Journal of Dermatology (1999)

Pachyonychia congenita (PC) is a group of inherited ectodermal dysplasias, the characteristic phenotype being hypertrophic nail dystrophy. Two main clinical subtypes, PC-1 and PC-2, are inherited as autosomal dominant disorders, but other less well characterized clinical forms also exist. The PC-1 phenotype may be distinguished by the absence of the epidermal cysts found in PC-2, and it has been shown to be caused by mutations in either keratin K16 or its expression partner, the K6a isoform of K6. Mutations in K16 have also been shown to cause a milder related phenotype, focal non-epidermolytic palmoplantar keratoderma. Recently, we have developed a long-range polymerase chain reaction (PCR) strategy which allows specific amplification of the entire functional K16 gene (KRT16A), without amplification of the two K16 pseudogenes (psiKRT16B and psiKRT16C), enabling mutation analysis based on genomic DNA. Here, using this methodology, we describe novel mutations R127P and Q122P in the helix 1A domain of K16 in two families presenting with PC-1. Both mutations were excluded from 50 normal unrelated individuals by restriction enzyme analysis of K16 PCR fragments. In one family, ultrastructural analysis was performed, revealing distinctive tonofilament abnormalities. Specifically, keratin filament bundles were greatly condensed, but did not form the dense amorphous aggregates seen in a number of other keratin disorders. In the second kindred, autosomal dominant cataract was present in some but not all members affected by PC. As the cataract phenotype did not fully cosegregate with the K16 mutation, and given that K16 is not expressed in the lens, these two phenotypes may be coincidental.
Exorcising Ghosts and Unwelcome Guests
Authors: Adam Jacobs
Journal: Annals of Internal Medicine (2006)

Letters17 January 2006Exorcising Ghosts and Unwelcome GuestsAdam Jacobs, PhD, MScAdam Jacobs, PhD, MScFrom Dianthus Medical Limited, London SW19 3TZ, United Kingdom.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-144-2-200601170-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I was pleased to read Drs. Laine and Mulrow's editorial about ghosts and guests, which I thought steered a very sensible course through a difficult topic (1). I feel that 1 minor point of clarification is required, however. The GATE principles referred to in the editorial were not described by the European Medical Writers Association but were described in an editorial (2) that accompanied the association's guidelines. Readers of Annals may also be interested in the original guidelines (3), which were not cited by Drs. Laine and Mulrow in their editorial.References1. Laine C, Mulrow CD. Exorcising ghosts and unwelcome guests [Editorial]. Ann Intern Med. 2005;143:611-2. [PMID: 16230729] LinkGoogle Scholar2. Daskalopoulou SS, Mikhailidis DP. The involvement of professional medical writers in medical publications [Editorial]. Curr Med Res Opin. 2005;21:307-10. [PMID: 15802002] CrossrefMedlineGoogle Scholar3. Jacobs A, Wager E. European Medical Writers Association (EMWA) guidelines on the role of medical writers in developing peer-reviewed publications. Curr Med Res Opin. 2005;21:317-22. [PMID: 15802003] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Dianthus Medical Limited, London SW19 3TZ, United Kingdom.Disclosures: Dr. Jacobs is a former president of the European Medical Writers Association and is a coauthor of the association's guidelines on the role of medical writers in developing peer-reviewed publications. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoExorcising Ghosts and Unwelcome Guests Christine Laine and Cynthia D. Mulrow Exorcising Ghosts and Unwelcome Guests Stella S. Daskalopoulou and Dimitri P. Mikhailidis Metrics Cited byRe: Marchington JM, Burd GP. Author attitudes to professional medical writing support. Curr Med Res Opin 2014 Jul 9:1-6 17 January 2006Volume 144, Issue 2Page: 149KeywordsConflicts of interest ePublished: 17 January 2006 Issue Published: 17 January 2006 Copyright & PermissionsCopyright © 2006 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Intracavitary irradiation of brain tumor
Authors: Phil Gunby
Journal: JAMA (1980)

The little girl became blind in the right eye at the age of 6 years because of a craniopharyngioma. Fifteen years later, after four operations for the recurrent brain tumor, there appeared to be little more that could be done surgically as vision in her left eye began to fail, short-term memory became erratic, lethargy became commonplace, and she continued to try to cope with diabetes insipidus, panhypopituitarism, and a shunt to drain fluid buildup. At this point, Jesse C. Yap, MD, assistant professor of neurosurgery at the University of Minnesota (Minneapolis) Medical School and chief of stereotaxic surgery for the Minneapolis Veterans Administration Hospital, saw the patient on referral. While pondering what could be done, he recalled that radioactive yttrium had been injected into brain tumors for therapeutic reasons by neurosurgeons in Sweden, France, Britain, and elsewhere. However, yttrium is not approved by the Food and Drug Administration for
Ten year mortality in patients with suspected acute myocardial infarction
Authors: J Launbjerg, P Fruergaard, J K Madsen, L S Mortensen, J F Hansen
Journal: BMJ (1994)

<h3>Abstract</h3> <b>Objective</b>: To describe the 10 year mortality in patients with suspected cute myocardial infarction. <b>Design</b>: Follow up of all patients below 76 years of age admitted with acute chest pain to 16 coronary care units participating in the Danish verapamil infarctin trail in 1979-81. <b>Subjects</b>: Of the 5993 patients included, 2586 had definite infarction, 402 had probable infarction, and 3005 did not have infarction. Main outcome measures - Death and cause of death. Standardised mortality ratio (observed mortality/expected mortality in background population). <b>Results</b>: The estimated 10 year mortalities were 58.8%, 55.5% and 42.8% in patients with definite, probable, and no infarction, respectively (P&lt;0.0001). Stratified Cox9s analysis identified a hazard ratio for mortality of 1.25 (95% confidence interval 1.08 to 1.44) for probable infarction compared with no infarction and of 1.15 (1.00 to 1.32) for definite compared with probable infarction. The standardised mortality ratio in the first year was 7.1 (6.5 to 7.8) for definite infarction, 5.0 (3.6 to 6.3) for probable infarction, and 4.7 (4.2 to 5.2) for no infarction. From the second year and onwards the annual standardised mortality ratio in the three groups did not differ significantly. Cardiac causes of deaths were recorded in 89%, 84%, and 71% of the deaths in patients with definite, probable, and no infarction, respectively. <b>Conclusions</b>: The 10 year mortality of patients with and without infarction is significantly higher than in the background population. Most deaths are caused by coronary heart disease, and these patients should consequently be further evaluated at the time of discharge and followed up closely.
Effect of acute volume load on refractoriness and arrhythmia development in isolated, chronically infarcted canine hearts.
Authors: H Calkins, W L Maughan, H F Weisman, S Sugiura, K Sagawa, J H Levine
Journal: Circulation (1989)

In normal isolated, perfused canine ventricles, increased ventricular volume leads to shortening of refractoriness. To test the hypothesis that myocardium within an infarction zone is more susceptible to volume-induced changes in refractoriness than is normal myocardium, we measured strength-interval curves at low and high end-diastolic volumes at control and infarcted sites in 14 isolated, blood perfused, canine hearts with chronic (greater than 25 days) infarctions. In addition, the effect of volume load on inducing ventricular arrhythmias was studied at one to six sites in 11 hearts. Differences in refractoriness and inducibility at low (22 +/- 5 ml) and high (48 +/- 6 ml) end-diastolic volumes were compared. At control sites, volume load reduced the absolute refractory period from 178 +/- 16.5 to 175 +/- 16.7 msec (p less than 0.05), but no significant change in the relative refractory period occurred. At infarcted sites, the change in refractoriness with volume load was greater, and the absolute refractory period decreased from 171.5 +/- 21 to 160.6 +/- 26.3 msec (p less than 0.01), and the relative refractory period decreased from 180.1 +/- 22.1 to 169.9 +/- 26 msec (p = 0.05). This differential effect of volume load on refractoriness led to an increased dispersion of overall refractoriness at high volume. Infarcted sites showing the largest changes in refractoriness were characterized by patchy scars extending at least to the midmyocardium, whereas sites located within areas of transmural scar, endocardial scar, or rare microfoci of fibrosis showed no increased sensitivity to volume load. Of eight hearts in which no tachyarrhythmias were inducible during programmed electrical stimulation at low volume, four had tachyarrhythmias induced at high volume. Sites of stimulation associated with a conversion from noninducible to inducible tachyarrhythmias showed a larger degree of shortening of refractoriness (change in absolute refractory period: 24.7 +/- 16.5 vs. 3.9 +/- 6.5 msec, p less than 0.05). These data indicate that volume loading may have electrophysiologic significance and that it may be of greater functional importance under pathologic conditions.
Atherosclerosis impairs endothelium-dependent vascular relaxation to acetylcholine and thrombin in primates.
Authors: P C Freiman, G G Mitchell, D D Heistad, M L Armstrong, D G Harrison
Journal: Circulation Research (1986)

To test the hypothesis that atherosclerosis impairs endothelium-dependent vascular relaxation, we examined the effect of the endothelium-dependent vasodilators acetylcholine and thrombin and the endothelium-independent vasodilator nitroglycerin on iliac arteries from normal cynomolgus monkeys and cynomolgus monkeys with diet-induced atherosclerosis. Rings of iliac artery were suspended in organ chambers at their optimal length for generating tension. After preconstriction with prostaglandin F2 alpha, cumulative concentration-response curves to acetylcholine, thrombin, and nitroglycerin were examined. The presence of endothelium was confirmed in each vessel by scanning electron microscopy. Atherosclerotic vessels showed morphologic evidence of moderate to severe atherosclerosis. Acetylcholine produced a maximal relaxation of 65 +/- 10% in the normal group and 27 +/- 10% in atherosclerotic vessels (P less than 0.05). Thrombin (10.0 U/ml) produced relaxation of 39 +/- 9% in the normal group and 13 +/- 7% in atherosclerotic iliac arteries (P less than 0.05). Nitroglycerin relaxed both normal and atherosclerotic blood vessels to an equal extent; maximal relaxation was 92 +/- 4% in normal vessels and 98 +/- 2% in atherosclerotic vessels. To determine if hypercholesterolemia alone produces an abnormality in endothelium-dependent relaxation, we performed two additional studies. First, because veins are exposed to hypercholesterolemia, but do not develop atherosclerosis, we studied relaxation responses to acetylcholine and thrombin in veins from normal monkeys and monkeys with diet-induced atherosclerosis. Veins from normal and atherosclerotic monkeys relaxed to a similar extent upon exposure to the endothelium-dependent vasodilators acetylcholine and thrombin.(ABSTRACT TRUNCATED AT 250 WORDS)
Thymine-Requiring Enterococci
Authors: JAMES J. PLORDE
Journal: Annals of Internal Medicine (1979)

Letters and Corrections1 July 1979Thymine-Requiring EnterococciJAMES J. PLORDE, M.D., THEODORE BAILEY, M.D.JAMES J. PLORDE, M.D.Search for more papers by this author, THEODORE BAILEY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-1-134_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Recent reports have focused attention on the isolation of a variety of thymine-requiring pathogens from patients with various infectious processes. Many of these pathogens have been isolated from the urinary tract of patients undergoing treatment with co-trimoxazole. We have recently isolated thymine-requiring enterococci from the urine of two patients and believe this to represent the first report of thymine-requiring pathogens in the United States.The first case was that of a 34-year-old man with T8paraplegia secondary to a gunshot wound. This patient had a suprapubic catheter and a long history of chronic urinary-tract infections sometimes treated...References1. MASKELLOKUBADEGOPAYNE ROR. Thymine-requiring bacteria associated with co-trimoxazole therapy. Lancet. 1976;1:834-5. CrossrefMedlineGoogle Scholar2. MASKELLOKUBADEJOPAYNEPEAD RORL. Human infections with thymine-requiring bacteria. J Med Microbiol. 1977;11:33-45. CrossrefGoogle Scholar3. TANNERBULLIN EC. Thymine-dependent Escherichia coli infection and some associated laboratory problems. J Clin Pathol. 1974;27:565-8. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Veterans Administration Medical Center University of Washington Affiliated Hospitals Residency Training Program Seattle, WA 98108 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByThymidine-dependent microorganisms: Their recognition and clinical significance 1 July 1979Volume 91, Issue 1Page: 134-134KeywordsCathetersEnterococcus infectionsFirearm injuriesParaplegiaPathogensUrinary tract infectionsUrine Issue Published: 1 July 1979 PDF DownloadLoading ...
CONTRACT MEDICAL ATTENDANCE UPON SICK CLUBS
Authors: H. L. Browne
Journal: BMJ (1902)

years of age would be 68o cases and 279 deaths; fatality, 41.0 per cent. The exact numbers indicating the extent of the vaccination default in London up to date are not available, so I have been obliged to take the vaccination defaults for twenty years previous to and inclusive of I898.The average number of children not finally accounted for during these years as regards vaccination was in London 14.35 per cent. 6The average vaccination default for London was: I875-79, 7.5 per cent.;I880-84, 6.5 per cent.;I885-89, 9.o per cent.; 1890-94, 17.5 per cent.
Autologous transfusions. Experience in a community blood center
Authors: A. J. Silvergleid
Journal: JAMA (1979)

Review of the clinical records of 103 patients participating in a community-blood-bank-sponsored autologous transfusion program confirmed the safety of autologous blood and the practically of such a community-centered program. There were no transfusion reactions, increased morbidity, or reports of hepatitis among the autologous donor-patients. A previously unobserved phenomenon was that surgeons tended to transfuse less blood to patients who had autologous blood available, rarely exceeding the number donated, although this varied from one to three units for similar surgery. Only eight of the 103 patients intentionally received a transfusion with homologous blood in addition to their autologously donated blood. Patients, their physicians, and the blood bank can all benefit substantially from such a program.
Q-Wave vs Non—Q-Wave Myocardial Infarction
Authors: Arthur J. Moss
Journal: JAMA (1992)

The diagnosis of myocardial infarction requires enzyme confirmation if we are to separate anginal syndromes from coronary disorders involving necrosis of myocardial tissue. Patients with a first myocardial infarction are more homogeneous in their risk profile and are more accurately categorized into different electrocardiographic subsets than are patients with prior infarctions. The electrocardiogram has been used to classify two types of myocardial infarction—the Q-wave (transmural) infarction, with the implication that a Q wave represents through-and-through endocardial-to-epicardial necrosis, and the non—Q-wave (nontransmural) infarction, with the implication that the absence of a Q wave indicates less extensive myocardial damage and possibly an increased potential for recurrent coronary events. See also p 1545. Non—Q-wave myocardial infarction is a heterogeneous group of disorders and includes true posterior transmural ("Q-wave") infarctions without manifest Q waves on the scalar 12-lead electrocardiogram, subendocardial infarctions with transient ST-wave and T-wave changes, intramural infarctions with giant negative T waves
Intranasal Cobalamin: A Warning
Authors: Douglas C. Heimburger
Journal: JAMA (1991)

<h3>To the Editor.—</h3> The Commentary by Dr Lederle<sup>1</sup>and the accompanying editorial of Drs Hathcock and Troendle<sup>2</sup>provide a straightforward and compelling argument for the use of oral cobalamin for the treatment of pernicious anemia whenever possible. In my experience, the vicissitudes and costs of monthly intramuscular cobalamin injections often result in discontinuation of the therapy entirely, putting patients at risk for recurrent deficiency. Oral therapy should ameliorate this problem. However, there may be another alternative that the authors did not describe, and of which few physicians are aware: nasal cobalamin. For a number of years, an intranasal cyanocobalamin gel called Ener-B has been available over the counter. It is sold in packages of 12 unit-dose tubes, each containing 400 μg of cyanocobalamin. The manufacturer (Nature's Bounty, 90 Orville Dr, Bohemia, NY 11716) has targeted the product at the health-foods market and has not promoted it among physicians
Learning to Play God: The Coming of Age of a Young Doctor
Authors: Susan Reitz O'Neil
Journal: JAMA (1992)

Describing his experiences from premed through residency, Dr Robert Marion provides a realistic view of current medical education in the United States. From the introduction through the epilogue, Dr Marion details the dehumanization of idealistic, caring individuals who go to medical school. The process of training young doctors, he concludes, robs physicians of one of their most precious qualities, their compassion. Not all of them, he laments, are able to recover this quality when they complete their training.<i>Learning to Play God</i>is about the evolution from young student to doctor. Dr Marion's experiences, recounted chronologically in vignettes from his training, are typical of medical education everywhere. The text provides a valuable opportunity for all of us who have come through this process to reflect on the changes we underwent. As Dr Marion reminds us in one chapter, most patients get better on their own without us. Those responsible for