tbuckley/cabot-search huggingface dataset:
Therapy of Angina Pectoris: A Comprehensive Guide for the Clinician
Authors: Marcis T. Sodums
Journal: JAMA (1987)

This volume in the series "Basic and Clinical Cardiology" is intended to provide a basis for intelligent selection of pharmacologic and invasive therapies for the patient with symptomatic myocardial ischemia. There are ten chapters written by different authorities. Pathophysiology of ischemic heart disease and angina pectoris is briefly reviewed in the first chapter. Chapter 2, "Evaluation of the Patient With Angina Pectoris," begins with a concise but interesting review of the natural history of angina pectoris and the influence of coronary artery bypass grafting and angioplasty. It then adequately reviews the standard noninvasive tests applicable to patients with angina pectoris. Strategies for evaluating patients with stable angina, unstable angina, and variant angina conclude this chapter. The up-to-date and practical recommendations for treatment of different subclasses of patients with angina pectoris make this chapter particularly useful for the practicing physician. The third chapter briefly summarizes approaches to evaluating antianginal therapy and
Mouse liver T cells: Their change with aging and in comparison with peripheral T cells
Authors: A Tsukahara, S Seki, T Iiai, T Moroda, H Watanabe, S Suzuki, T Tada, H Hiraide, K Hatakeyama, T Abo
Journal: Hepatology (1997)

Mouse liver contains both IL-2Rβ- (or low positive) high T-cell receptor (TCR(hi)) cells and IL-2Rβ+ intermediate TCR (TCR(int)) cells. TCR(int) cells consist of natural killer 1.1 (NK1)+ and NK1- subsets. NK1- TCR(int) cells increase constantly with age whereas TCR(hi) cells decrease. NK1+ TCR(int) cell proportions in the liver increase until middle age and decrease thereafter. Although NK1+ TCR(int) cells in other organs are few regardless of age, NK1- TCR(int) cells gradually appear in other lymphoid organs with aging. Skewed usage of Vβ7 and Vβ8 TCR was observed in NK1+ TCR(int) cells in the liver but the predominance was less obvious in NK1- TCR(int) and TCR(hi) cells in the liver and other organs. TCR V α14 messenger RNA (mRNA) was detected in NK1+ TCR(int) cells but not in the other two populations. In contrast, although NK1+ TCR(int) cells contain virtually no V α11+ T cells, NK1- TCR(int) cells contain a much higher proportion (approximately 12%) of V α11+ T cells, whereas approximately 4% of TCR(hi) cells are V α11+. NK activities of liver mononuclear cells (MNC) and splenocytes decrease with aging, although the former is always greater than the latter. NK activity of liver MNC is a function of NK cells, partly NK1+ TCR(int) cells but not NK1- TCR(int) cells or TCR(hi) cells. These results suggest that lymphocytes of liver and other organs at old age are no longer occupied solely by conventional thymus-derived T cells, and the increase of extrathymic IL-2Rβ+ NK1- TCR(int) cells in liver and periphery could be closely related to immunological changes with aging.
Healthcare workers should get top priority for vaccination against A/H1N1 flu, WHO says
Authors: J. Zarocostas
Journal: BMJ (2009)

The World Health Organization said on Monday 13 July that healthcare workers in all countries should be vaccinated against the A/H1N1 flu virus “as a first priority.” They should be followed by high risk groups such as people with chronic conditions and pregnant women.

The decision comes after WHO’s adoption of recommendations from its strategic advisory group of experts on immunisation, drawn up after the group held an extraordinary meeting on 7 July.

“Some groups, such as pregnant women and persons with asthma and other chronic conditions such as morbid obesity, appear to be at increased risk for severe disease and death from infection,” the advisory group said.

Prioritising vaccination of health …
Metastatic Brain Lesions May Demonstrate Photopenia on FDG-PET
Authors: Yiyan Liu
Journal: Clinical Nuclear Medicine (2008)

Metastatic brain lesions generally demonstrate hypermetabolic foci on fluorine-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) images. A large area of photopenia of the brain on FDG-PET is most likely consistent with a benign etiology. The author reports 2 cases of cerebral metastases from lung cancers, which display complete photopenia on FDG-PET. The brain is a special organ with high background uptake on PET and significant cytotoxic edema surrounding the metastatic deposits. In some cases, it is a dilemma to identify malignant intracranial foci on PET. Anatomic imaging, for example, MRI or CT correlation is needed for proper interpretation of brain PET on evaluation of metastases.
Product inhibition of the actomyosin subfragment-1 ATPase in skeletal, cardiac, and smooth muscle.
Authors: J S Drew, V A Harwalkar, L A Stein
Journal: Circulation Research (1992)

We studied product inhibition of the actin-activated ATPase of myosin subfragment-1 (S-1) from the three types of muscle tissue: skeletal, cardiac, and smooth. Increasing levels of [MgADP] in the 0-1-mM range caused significant inhibition of the actin-activated MgATPase activity of cardiac and gizzard but not skeletal muscle S-1. When total nucleotide concentration ([ATP] + [ADP]) was kept constant at 1 mM, ATPase activity was inhibited by 50% at an ADP/ATP ratio of 6:1 for cardiac S-1 and 3:1 for gizzard S-1. For skeletal S-1, however, even a 19:1 ratio did not cause 50% inhibition of ATPase activity. The observed effect was not due to changes in pH or inorganic phosphate concentration, nor could it be explained by substrate (ATP) depletion. In the absence of actin, ADP had little or no inhibitory effect on the ATPase activity of S-1, and these observations imply that ADP is competing directly for the ATP binding site of the actin-S1 complexes of cardiac and smooth muscle S-1. ADP has previously been shown to be a weak competitive inhibitor of the ATPase activity in skeletal muscle. The current data imply that ADP is a very effective competitive inhibitor for the actin-activated ATPase activity of cardiac and gizzard S-1 and, therefore, that ADP may be a physiologically important modulator of contractile activity in cardiac and smooth muscle.
Nocturnal Ulcer Pain Relief From Tricyclic Antidepressants
Authors: A. Racoma
Journal: JAMA (1987)

<h3>To the Editor.—</h3> In the Oct 10, 1986, issue of<i>JAMA</i>, there was the following question<sup>1</sup>: "A 43-year-old woman with well-documented peptic ulcer disease complained of frequent and annoying nocturnal awakening due to pain, despite the use of ranitidine, sucralfate, and antacids. The nocturnal pain disappeared completely when she was given a nighttime dose of amitriptyline hydrochloride; however, she suffered from jitteriness, constipation, and... weight gain while taking the tricyclic agent." Suggestions were sought as to how to proceed with the therapy. The answer mentioned possible explanations of the effects of tricyclic antidepressants, which include sedative effects and an acid antisecretory effect due to anticholinergic properties. However, the property of tricyclic antidepressants as histamine2-receptor blockers was not mentioned. Tricyclic antidepressants are both histamine1-and histamine<sub>2</sub>-receptor blocking agents.<sup>2-4</sup> Controlled clinical trials using 50 mg/d of trimipramine (as the maleate salt) showed it to be superior to a placebo
A young athlete with bradycardia
Authors: N. Sheikh, S. Sharma
Journal: BMJ (2013)

A 17 year old male athlete was referred for specialist investigation after an abnormal electrocardiogram (ECG) was found on routine pre-participation cardiovascular evaluation. He swam for 20 hours a week during peak training at club level, in addition to cycling for six hours a week. He was asymptomatic apart from occasional dizziness after exercise. He had no medical, drug, or family history of note. Examination was normal apart from bradycardia of 40 beats/min. Figure 1⇓ shows the 12 lead electrocardiography trace. A two dimensional transthoracic echocardiogram showed a structurally normal heart.





### 1 What is the electrocardiographic diagnosis?

#### Short answer

Second degree atrioventricular block.

#### Long answer

The ECG shows second degree atrioventricular block but this cannot be classified further into Mobitz type 1 (Wenckebach) or type 2 block. 

Mobitz type 1 block usually occurs in the atrioventricular node and is most commonly caused by functional suppression of nodal conduction—for example, by drugs, ischaemia, or increased vagal tone. Under these circumstances, nodal cells exhibit progressive fatigue—seen on the ECG as a gradually increasing PR interval—which eventually culminates in failure of conduction and a “dropped” beat. Subsequent recovery of the nodal cells occurs during the ensuing pause, resulting in shortening of the next conducted PR interval. Although this is the typical “textbook” definition, atypical patterns are also seen, and in some instances (particularly when associated with a broad (≥120 msec) QRS complex) type 1 block can occur in the His-Purkinje system.1 Nodal type 1 block is usually reversible and benign.

In contrast, Mobitz type 2 atrioventricular block is an “all or nothing” phenomenon, resulting from disease in the His-Purkinje system. Cells …
Repeated tissue sampling with a dental broach A TRIAL IN CUTANEOUS LEISHMANIASIS
Authors: W.A.D. GRIFFITHS, W. DUTZ
Journal: British Journal of Dermatology (1975)

A simple and almost painless technique for repeated sampling of dermal infiltrates with a dendritic broach was used in the diagnosis of cutaneous leishmaniasis. This technique can be used to advantage to obtain organisms and cell underneath crusted lesions and to evaluate not only the number of organisms but also the cell pattern at different depths of the lesion. It can be used repeatedly on the same lesions without appreciably disturbing the natural progress of the disease and is therefore well suited to monitor the in vivo effects of therapeutic agents on organisms. Its use in twenty-one cases of cutaneous leishmaniasis and one case of cutaneous leprosy is described.
Serum Cholesterol Levels after Myocardial Infarction
Authors: W. C. Watson, K. D. Buchanan, C. Dickson
Journal: BMJ (1963)

Boyden, S. V. (1951). J. exp. Med., 93, 107. Davies, A. M., and Lazarov, E. (1960). J. Hyg. (Camb.), 58, 263. Dresdale, D. T., Ripstein, C. B., Guzman, S. V., and Greene, M. A. (1956). Amer. J. Med., 21, 57. Dressier, W. (1962). Amer. Heart J., 63, 757. Ehrenfeld, E. N., Gery, I., and Davies, A. M. (1961). Lancet, 1, 1138. Ito, T., Engle, M. A., and Goldberg, H. P. (1958). Circulation, 17, 549. Kaplan, M. H. (1960). Ann. N.Y. Acad. Sci., 86, 974. Mounsey, P. (1959). Brit. Heart J., 21, 123. Segal, F., and Tabatznik, B. (1960). Amer. Heart J., 59, 175. Soloff, L. A., Zatuchni, J., Janton, 0. H., O'Neill, T. J. E., and Glover, R. P. (1953). Circulation, 8, 481. Stavitsky, A. B. (1954). J. Immunol., 72, 360.
CELIO-HERNIOTOMY FOR IRREDUCIBLE INGUINAL OR FEMORAL HERNIA.
Authors: T. E. SCHUMPERT
Journal: JAMA (1894)

There is, perhaps, no operation described within the pages of surgery that ought to be better understood by, or will present itself more certainly and imperatively to the general practitioner, at some time or other, during his professional career than this. An ovariotomy, nephrotomy, gastrotomy, hysterectomy, etc., can be postponed until a more suitable time, but a strangulated hernia demands immediate surgical procedure. I will admit that this operation as generally performed is notât all times easy; that there is danger of doing some vital injury, that the experienced operator, as well as the inexperienced, will at times find himself puzzled to know whether he is contending with the sac or the gut. The theory of cutting down on the hernia and being able to recognize the tissues, layer by layer, is altogether a delusion, and from the fact that it can not be done is calculated to discourage the
Sclerodermalike Esophageal Disease in Children of Mothers With Silicone Breast Implants
Authors: Michael D. Levine
Journal: JAMA (1994)

<h3>To the Editor.</h3> —I read with interest the report by Drs Levine and Ilowite.<sup>1</sup>Unfortunately, no description of the site of the breast implants was included. Because breast implants can be placed subglandular (superficial to the pectoralis musculature) or submuscular (deep to the pectoralis musculature), at least two additional clinical subsets exist that could significantly affect the theory of "silicone contamination of breast milk." In the situation where the implant lies in the subglandular position, it is essentially surrounded by breast parenchyma. The submuscular position, however, interposes a significant layer of muscle tissue and fascia (although variable at times) between the implant and the breast parenchyma.
CONCOMITANT SQUINT WITH SOME REMARKS ON ITS ETIOLOGY AND TREATMENT
Authors: A. EDWARD DAVIS
Journal: JAMA (1910)

The etiology of concomitant squint was but ill understood until Donders' masterly work on accommodation and refraction of the eye was published in 1864. Many fanciful theories and guesses were advanced to account for the "evil eye," as the Italians called it, some even attributing the affection to the agency of the evil one, as the name "evil eye" implies; while others gave such causes as sucking of fingers, looking at the tip of the nose, or at a curl at the side of the head, imitating the cross-eye of a companion, etc. Such etiologic factors as the above were advanced by the laity, who then, as now, were only too ready to give explanations of things not understood. It must be admitted, however, that the members of the "learned profession" were able to give but little better explanation as to the cause of squint; hence the professional advice as to
Cardiac Arrhythmias: Their Mechanisms, Diagnosis, and Management
Authors: Harry B. Greenberg
Journal: JAMA (1981)

<h3>The Disorders of Cardiac Rhythm,</h3> by Leo Schamroth, 2 vol, ed 2; 736+ pp, with illus, $175, Oxford, England, Blackwell Scientific Publications (St Louis, Blackwell Mosby Book Distributors), 1980. Is prophylactic therapy with antiarrhythmic drugs desirable for all patients with myocardial infarctions? According to Scherlag and Lazzara, in<i>Cardiac Arrhythmias</i>, the verdict is still out. They note, however, that premonitory ectopic complexes may not precede serious arrhythmias. Nor is electroversion without risk. Resnekov, who describes its techniques and indications, cites the raised serum enzyme levels that follow application of high-energy electrical currents. Like the other contributors to Dr Maridel's book, he relies on data from the electrophysiological laboratory to illustrate his discussions. Baurenfeind and colleagues tell how electrophysiological studies clarify the mechanisms of supraventricular tachycardia. They usually prefer the treatment that increases refractoriness in a reentrant pathway. Antiarrhythmic drugs that are compared by Singh and Mandel include
Values for upper limit of normal should be given for liver enzymes
Authors: Emanuel K. Manesis
Journal: Hepatology (2008)

I read with great interest the article by Korman et al.,1 in which they demonstrated the high sensitivity and specificity of the ratios of serum alkaline phosphatase (ALP) to total bilirubin and the aspartate aminotransferase (AST) to alanine aminotransferase (ALT) as simple tools in the early diagnosis of Wilson disease in patients with acute liver failure. Reading the article, however, I could not find any mention of the upper limit of normal (ULN) for the ALP, AST, and ALT values used by the authors. Even if expressed in IU/L, these enzyme tests have widely different ULN depending on the commercial supplier of the respective kit. Indeed, the ULN for the ALP in adults may vary from 92-279 IU/L, the AST from 30-45 IU/L, and the ALT from 31-65 IU/L. Normal reference intervals of liver enzymes may also be affected by other factors such as sex, age, and ethnicity.2-4 Best known is the effect of age on serum ALP levels, with children and adolescents having much higher ULN than adults.5 For the above reasons, it would be most valuable to know the ULN of the liver enzymes used in the article by Korman et al., in order to apply their findings in our clinical practice. Emanuel K. Manesis M.D.*, * University of Athens Medical School, Athens, Greece.
Health targets in the NHS: lessons learned from experience with breast feeding targets in scotland
Authors: H. Campbell, A. Gibson
Journal: BMJ (1997)

Goal and target setting is a basic precondition to effective management and the basis for accountability for both the use of health services and for achieving health care outcomes1

Target setting has long been seen within business as an essential part of formulating any strategy. Targets should be related to actions known to be effective, be achievable but challenging, and be able to be monitored through indicators (see box).2 Targets can highlight key aspects of policy and act as a stimulus to increase commitment to policy implementation. Careless target setting, however, based on inadequate data or unrealistic short term objectives, can be counterproductive in that the resulting targets may discourage action and place unnecessary stress on those expected to achieve them.3 4 5

#### Health targets: desirable features

The publication of the consultative documents The Health of the Nation in 1991 and Scotland's Health: A Challenge To Us All in 1992 heralded a new government approach to health planning, central to which was a need to identify clear objectives and specific targets for improving health.6 7 These targets were to be identified in each of the key areas of greatest health concern and where the greatest opportunity for real improvements in health could be realised. Their main aim is to stimulate and direct coordinated action.6

Although it was envisaged that the results of target setting would be assessed, no published reports …
The Role of Growth Hormone in the Development of Diabetic Retinopathy
Authors: Aus A Alzaid, Sean F Dinneen, L Joseph Melton, Robert A Rizza
Journal: Diabetes Care (1994)

OBJECTIVE To determine the role of growth hormone (GH) in the development of diabetic retinopathy. RESEARCH DESIGN AND METHODS Medical records of 1,423 patients who had undergone insulin tolerance tests (1976–1991) at the Mayo Clinic were examined, and diabetic subjects were identified as either GH-deficient (GH increment after hypoglycemia &amp;lt;5 μg/L and peak &amp;lt;10 μg/L) or GH-suificient. Prevalence of retinopathy was determined in these cases and in a cohort group of diabetic subjects selected to match the GH-deficient cases. These control patients (32 cases) were selected from medical records of individuals who had received medical care at Mayo during the same interval but who had not undergone insulin tolerance testing. RESULTS Twenty-four patients with diabetes were identified, of whom 16 were GH-deficient and 8 GH-sufficient. Despite comparable age, duration of diabetes, and metabolic control, the prevalence of diabetic retinopathy in the GH-deficient group (2 of 16; 12.5%) was less (P &amp;lt; 0.05) than that observed in the GH-sufficient group (5 of 8; 62.5%). Prevalence in the GH-deficient group also was lower than that observed in the cohort control group (15 of 32, 47%). CONCLUSIONS These data strongly suggest that GH contributes to the development of diabetic retinopathy in humans.
A “kiss” before conception: triggering ovulation with kisspeptin-54 may improve IVF
Authors: Steven L. Young
Journal: Journal of Clinical Investigation (2014)

A 30-year-old primigravid (G1P000) female with infertility secondary to her partner's oligospermia and her chronic anovulation presented 13 days after an oocyte retrieval for in vitro fertilization (IVF) with a positive home pregnancy test, abdominal distention, a 5-pound weight gain, nausea, shortness of breath, and reduced urinary frequency. Her IVF cycle included the usual cocktail for gonadotropin stimulation and was uncomplicated, except for excessively stimulated ovaries that led to a peak estradiol level of 6,000 pg/ml and the retrieval of 30 oocytes. Her past history was relevant only for anovulation due to polycystic ovarian syndrome (PCOS), though her preprocedure body mass index was normal at 21 kg/m2. Pelvic ultrasound revealed abundant ascites and enlarged ovaries, at 8 cm average diameter. Serum human chorionic gonadotropin (hCG) concentration was 200 mIU/ml; she was hemoconcentrated (hemoglobin 16 g/dl), with normal liver function and coagulation testing. An ultrasound guided, transvaginal paracentesis removed 4 liters of straw-colored fluid, resulting in significant short-term symptom relief.
Free radicals and reperfusion arrhythmias. Commentaries on this month's Controversy articles From Mike Curtis
Authors: M. J Curtis
Journal: Cardiovascular Research (1994)

Journal Article Free radicals and reperfusion arrhythmias. Commentaries on this month's Controversy articles From Mike Curtis Get access Michael J Curtis Michael J Curtis Pharmacology Group, King's College, Manresa Rd, London SW3 6LX, UK. Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 28, Issue 3, March 1994, Page 426, https://doi.org/10.1093/cvr/28.3.426a Published: 01 March 1994
James Gordon Hill
Authors: Graham Thomas
Journal: BMJ (2006)

​FormerFormer consultant obstetrician and gynaecologist Pembury Hospital, Tunbridge Wells, Kent (b 1931; q Glasgow 1955; FRCS, FRCOG), died from a heart attack on 21 June 2006.



Figure 1



After qualifying Gordon Hill did his national service in the Royal Air Force in Cyprus, where he met and formed a famous partnership with his wife, Nancy. As a consultant in a district general hospital he was exceptionally committed to teaching and research. He successfully applied conceptual research to clinical problems, publishing work on breech deliveries, recurrent miscarriages, heparin prophylaxis, and tumour resistance in ovarian cancer. This led to a succession of MD projects by research registrars at Pembury. He worked with his college as regional adviser and with the training of overseas doctors. His adrenaline addiction led to the discovery of sailing and skiing in retirement. He leaves Nancy, two children, and two grandchildren.
The Kernel of Listerism.
Authors: J. D. POINDEXTER
Journal: JAMA (1900)

Fort Reno, Okla., Sept. 21, 1900. <h3>To the Editor:</h3> —Your editorial entitled "Pathologic Asepsis" on page 691 ofThe Journalof Sept. 15, 1900, helps to answer the query: What, after all, does the good residuum consist of when Listerism has been boiled down, filtered, and, in general, freed from all extraneous and worthless ingredients? That there will be a good residuum is beyond doubt. It has long been known that germs are necessary for digestion, for producing fermentation, and for bringing about useful decay of dead bodies, vegetable or animal. In other words they promote progress. The best garden-soil reeks with germs, poisonous and non-poisonous. Sterilized soil plus sterilized water will bring forth nothing, whether sown or not sown. Your editorial implies that, without the little organisms, wounds will not heal. In other words, life—for germs represent, and the word "germ" primarily means, life, or the first principle—is needed
Use of the Scintillation Camera to Reduce Radioisotope Scanning Time
Authors: Alexander Gottschalk
Journal: JAMA (1965)

The scintillation camera, when used either with positron or gamma-ray emitters, will image organs in a much shorter time than the focused-collimator scanner. Frequently, pictures can be taken in one tenth the time required for conventional scanning. As a result, acutely ill, agitated, or uncooperative patients can be examined. In addition, the short exposures encourage obtaining oblique and lateral views. These permit a more precise localization of the lesion and improve the diagnostic accuracy of the scanning procedure. Clinical use of the scintillation camera is expected to become widespread in years to come. It should be particularly valuable for stop-motion studies of dynamic physiological processes.