tbuckley/cabot-search huggingface dataset:
Contribution of each wall to biventricular function
Authors: K. S Li, W. P Santamore
Journal: Cardiovascular Research (1993)

Objective: Common muscle fibres encircle both ventricles and the ventricles share a common septal wall. This close anatomical association suggests that regional ischaemia and structural integrity may alter systolic function in both the right and the left ventricle. To examine this possibility, we investigated the contribution of each wall to biventricular function. Methods: Isolated hearts, obtained from anaesthetised rabbits, were perfused with physiological salt solution under constant pressure. Balloons were placed in the right and left ventricles to measure isovolumetric pressure, and pressure-volume curves were obtained. In separate sets of experiments, the left ventricular free wall, right ventricular free wall, or septum was made ischaemic, incised, or injected with glutaraldehyde, respectively. Pressure-volume curves were obtained again. Results: After left ventricular free wall ischaemia (n=11), right ventricular developed pressure decreased significantly from 27.9(SD 8.9) to 14.1(6.6) mm Hg (p < 0.05), and remained depressed when the left ventricular free wall was further damaged by glutaraldehyde. Cutting the left ventricular free wall (n=6) decreased right ventricular developed pressure from 28.9(8.6) to 17.8(4.8) mm Hg (p < 0.05), while reapproximating the left ventricular free wall by suturing re-established right ventricular developed pressure. After right ventricular free wall ischaemia (n=7), right ventricular developed pressure decreased from 26.8(6.6) to 24.1(5.7) mm Hg (NS) and left ventricular developed pressure was unaltered. Cutting the right ventricular free wall (n=7) had no effect on left ventricular developed pressure. Cutting the septum (n=7) had no obvious influence on right ventricular developed pressure, but dramatically decreased left ventricular developed pressure from 79.2(55.2) to 43.7(32.2) mm Hg (p < 0.05). Injecting glutaraldehyde into the septum (n=7) decreased both right and left ventricular developed pressures from 22.1(8.5) to 14.0(8.8) and from 78.2(50.5) to 47.9(37.9), respectively. Conclusions: The results show that the heart should be viewed as a mechanical syncytium. The left ventricular free wall plays a critical role in right ventricular systolic function and may help to explain the right ventricular response to left ventricular ischaemia. On the other hand, in the isolated heart preparation, right ventricular free wall ischaemia has only a minimal effect on left ventricular systolic developed pressure. Altering ventricular septal function affects both right and left ventricular systolic function. Cardiovascular Research 1993;27:792-800
Kelly West Lecture 1991 Challenges in Diabetes Epidemiology—From West to the Rest
Authors: Paul Z Zimmet
Journal: Diabetes Care (1992)

The application of epidemiology to the study of non-insulin-dependent diabetes mellitus (NIDDM) is providing new insights into many aspects of this major public-health problem, including its natural history, prevalence, incidence, morbidity, and mortality in diverse populations around the globe. The main impetus came from the late Kelly West's book Epidemiology of Diabetes and its Vascular Lesions. These studies are providing direction for research into the possible moleculardefect or defects and biochemical mechanism or mechanisms underlying NIDDM and important information on the extrinsic (social, cultural, environmental) risk determinants. Studies have highlighted the importance of regional adipose tissue distribution, particularly upper-body obesity, and physical inactivity in enhancing risk of NIDDM. These findings have important implications for the primary prevention of NIDDM, particularly in populations with increased genetic susceptibility such as Polynesians, Micronesians, American and Asian Indians, Mexican Americans, and Australian aborigines.
Case 10-1977
Authors: Ruben F. Gittes, Karl H. Proppe
Journal: New England Journal of Medicine (1977)

Presentation of CaseA 36-year-old man was admitted to the hospital because of a testicular seminoma.The patient was an abuser of methamphetamine and heroin; six years previously he had hepatitis secondary to the injection of drugs. Four years before admission he was treated elsewhere for a lung abscess.Seventeen months before entry he was admitted to another hospital because of severe low-back pain, fever and jaundice. An intravenous pyelographic examination showed a double collecting system. Fever persisted despite the administration of multiple antibiotics, and he was transferred to this hospital. Further evaluation disclosed staphylococcal septicemia, toxic hepatitis, deep thrombophlebitis . . .
Clinical Evaluation of the Use of the M2A Patency Capsule System Before a Capsule Endoscopy Procedure, in Patients with Known or Suspected Intestinal Stenosis
Authors: M. Delvaux, E. Ben Soussan, V. Laurent, E. Lerebours, G. Gay
Journal: Endoscopy (2005)

The main complication of video capsule endoscopy (VCE) is the blocking of the capsule by a gastrointestinal stenosis. The "patency capsule" is a self-dissolving capsule that is the same size as the video capsule. It contains a radiofrequency identification (RFID) tag that allows it to be detected by a scanning device placed on the abdominal wall. When its passage is blocked by a stenosis, the patency capsule dissolves in 40-80 hours after ingestion. The aim of this study was to evaluate the usefulness of this system in patients with suspected intestinal stenosis but also requiring VCE.22 patients (16 men; 46 +/- 18 years; 15 with diagnosed or suspected Crohn's disease, two with suspected intestinal tumor, and two on nonsteroidal anti-inflammatory drugs) were first investigated with an abdominal CT plus enteroclysis (entero-CT, n = 15) or a small-bowel follow-through (SBFT, n = 7). The patency capsule was then administered at around 09.00 to fasting patients. The presence of the patency capsule in the digestive tract was assessed 30 hours later using the hand-held scanner. When the patency capsule was detected, a plain abdominal film was obtained, and this was repeated every 24 hours until capsule expulsion.At 30 hours after ingestion, the patency capsule was detected in 17 patients (72.3 %): in the area of the small intestine (n = 6) and in the colon (n = 11). In all the patients in whom the capsule was blocked in the small intestine, the stenosis had been suspected on CT or SBFT. In three patients, the delay in progression of the patency capsule led to cancellation of the VCE procedure. In three patients, the patency capsule induced a symptomatic intestinal occlusion, which resolved spontaneously in one and required emergency surgery in two. Although these two patients would have been obliged to undergo operation for their primary disease in any case, the procedure had to be brought forward. In one patient, the capsule passed through the stenosis without symptoms. All patients in whom the progression of the patency capsule was delayed had an established or suspected diagnosis of Crohn's disease.The current technical development of the patency capsule limits its use in clinical practice, as it did not detect stenoses undiagnosed by CT or SBFT. The start of dissolution at 40 hours after ingestion is too slow to prevent episodes of intestinal occlusion. Patients with Crohn's disease are most likely to be at risk of blockage of progression of the capsule and should benefit from a CT investigation before VCE. However, a careful interview eliciting the patient's medical history and symptoms remains the most useful indicator with regard to suspicion of an intestinal stenosis.
Gelsenkirchen Typhoid Epidemic of 1901, Robert Koch, and the Dead Hand of Max von Pettenkofer
Authors: N. Howard-Jones
Journal: BMJ (1973)

child and was able to lead a more normal life without any form of drug therapy.At the end of the four-year period of observation she remained well. ConclusionThough relatively few patients were involved in this exercise, the time and effort required to arrest legal prescribing of amphe- tamines was disproportionately high.On the whole the method used produced acceptable results.The number of patients who could be regarded as addicted was probably only three.For them, the abandoning of legal prescribing seemed to be of little consequence in so far as two committed suicide and one con- tinued illegal association with amphetamines.It was, however, apparent that amphetamines had made no significant contri- bution to the relief of depression and the drug may, for some women, have created more problems than were relieved.The arrest of prescribing for these patients was a necessary pre- cursor of more effective treatment.The exercise also showed in a small way that some patients attach a high degree of significance to consultant opinion and are willing to use such opinion to manipulate the action of the general practitioner.The problems presented by the voluntary withdrawal of amphetamine prescribing should not be underestimated.Sui- cide can provoke powerful emotional reactions in the doctor.The supportive role of a sympathetic coroner was a significant contribution which allowed me to continue to pursue a policy which might otherwise have been abandoned.
Evaluation of the Initial Care of Hypertensive Patients
Authors: Edward D. Frohlich
Journal: JAMA (1971)

Patterns of patient care were evaluated retrospectively from the records of 994 patients hospitalized at a university hospital, a community hospital, and two Veterans Administration hospitals. Arterial pressure was not obtained by the admitting physician in 26% of the patients; and in those in whom a blood pressure was recorded, it was elevated in 18%. Of 200 patients discharged with the primary diagnosis of hypertension, the history, physical examination, and diagnostic evaluation were clearly inadequate. Thus, unless physician-recognition and adequate evaluation are improved (through education) the practice of massive public health screening programs seems pointless.
Transient outward current carried by potassium and sodium in quiescent atrioventricular node cells of rabbits.
Authors: T Nakayama, H Irisawa
Journal: Circulation Research (1985)

Single atrioventricular node cells were dispersed by treating the rabbit heart with collagenase. In Tyrode's solution, the cells became rounded, and about 20% of them showed spontaneous activity, whereas the rest remained quiescent. When those quiescent cells were whole-cell clamped, depolarizing clamp pulses from the holding potential of -83 mV induced an outward current which decayed quickly, with a time course similar to that of the transient outward current in the Purkinje fiber. The amplitude of the current became larger when progressively more positive clamp pulses were given from a very negative holding potential. The inactivation time course of this current consisted of two exponential components. Single-channel current recordings from those cells revealed a class of channels that activated more frequently during the initial part of depolarizing pulses. Summation of those unitary currents reproduced activation and inactivation time courses of the macroscopic current well, suggesting that this channel corresponds to the transient outward current. The current-voltage relationship of the channel was linear with the slope conductance of 19.9 +/- 1.8 pS (n = 7), and the reversal potential was near the resting potential of the atrioventricular node cell with 5.4 mM potassium chloride and 134.6 mM sodium chloride in the pipette. The channel was passing mainly potassium ions, but sodium ions also seemed to carry a fraction of the current. The possible role of the transient outward current in the quiescent node cell is discussed.
Advanced Squamous Cell Carcinoma of the Bulbar Conjunctiva Seen on PET/CT
Authors: Li-Fan Lin, Chih-Yung Chang, Shiou-Chi Cherng
Journal: Clinical Nuclear Medicine (2008)

A 78-year-old female with a previous history of endometrial lymphoma was referred to our hospital for F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) imaging on account of a growing tumor mass in the left eyeball with gradual visual loss for 5 months. The F-18 FDG PET/CT images showed a focal lesion with intense FDG uptake in the left bulbar conjunctiva with intraocular invasion. Excisional biopsy was performed under the impression of a malignant neoplasm, and the pathologic diagnosis confirmed squamous cell carcinoma.
Foodborne Illness in the 1990s
Authors: Mark A. Young
Journal: JAMA (1993)

<h3>To the Editor.</h3> —The December 9, 1992, issue contains an enlightening report on a recent cheese-related<i>Salmonella</i>outbreak affecting four states.<sup>1</sup> The report underscores the fact that there is an emerging health crisis in the United States. From 1985 through 1990, a total of 46 deaths were reported among 10253 cases of<i>Salmonella enteritidis</i>infection recorded by the CDC.<sup>2</sup> The authors correctly call for increased awareness of the potential pathogenicity of cheese items and a greater commitment to addressing this problem. But state and local governmental agencies must not limit themselves to the cheese and dairy industry, since there are many others equally culpable. The spread of the<i>Salmonella</i>scourge to the fast-food restaurant industry is a case in point.<sup>3</sup>Because federal surveillance data do not differentiate between poisoning due to fast-food establishments from those of other eating facilities, the exact number of poisonings attributed to fast-food
WHO urges governments to build better hospitals that can withstand disasters
Authors: J. Zarocostas
Journal: BMJ (2009)

<h3>ABSTRACT</h3> In a context of climate change, identifying the genes underlying adaptations to extreme environments is essential. Small ruminants are adapted to a wide variety of habitats and thus, are promising study models. Here, we considered 17 goat and 25 sheep local Mediterranean breeds, in Italy, France and Spain. We proposed, and empirically tested a new methodology to highlight selection signatures in relation to the environments. Based on historical archives, we selected the breeds potentially most linked to a territory and defined their original geographical cradle, including transhumant pastoral areas. For both species, the cradles were arranged along latitudinal gradient of aridity and altitude. Then we used the programs PCAdapt and LFMM. Considering cradles, instead of current GPS coordinates, markedly improved the sensitivity of the LFMM analyses. All the results combined with a systematic literature review, revealed a set of genes with potentially key adaptive roles. Some of these genes, have been found implicated in lipid metabolism (SUCLG2, BMP2), hypoxia/heat stress (UBE2R2/UBAP2), lung function (BMPR2), seasonal patterns (SOX2, DPH6) or neuronal function (TRPC4, TRPC6). For the intergenic region between PCDH9 and KLH1, as well as NBEA, identified in both species, the adaptive role could be strong. We found for RXFP2, associated with sheep horn development, and MSRB3 and SLC26A4, both associated with hearing of sheep, a strong association with the environment gradient. We conclude that our new methodology, which considers breeds in their historical, environmental and anthropological context, provides novel and essential information on local breeds and their unique adaptations.
Physician-Citizens—Public Roles and Professional Obligations
Authors: Russell L. Gruen
Journal: JAMA (2004)

Although leaders and other commentators have called for the medical profession's greater engagement in improving systems of care and population health, neither medical education nor the practice environment has fostered such engagement. Missing have been a clear definition of physicians' public roles, reasonable limits to what can be expected, and familiarity with tasks that are compatible with busy medical practices. We address these issues by proposing a definition and a conceptual model of public roles that require evidence of disease causation and are guided by the feasibility and efficacy of physician involvement. We then frame a public agenda for individual physicians and physician organizations that focuses on advocacy and community participation. By doing so, we aim to stimulate dialogue about the appropriateness of such roles and promote physician engagement with pressing health issues in the public arena.
Tobacco industry sought to prevent Islamic fatwas against smoking
Authors: O. Dyer
Journal: BMJ (2015)

For three decades the tobacco industry has fought a secret battle against Islamic scholars who seek to discourage smoking, show industry documents reported in a new study in the American Journal of Public Health .1

Tobacco firms have sought to recruit Islamic scholars to argue against strict prohibitions and have asked industry lawyers to study Islamic theology and provide interpretations of the Koran that are friendlier to tobacco. “The industry has sought to distort and misinterpret the cultural beliefs of these communities and to reinterpret them to serve the industry’s interests,” said Kelley Lee of Vancouver’s Simon Fraser University, one of the authors of the study. “All to sell a product that kills half of its customers.”

Islam was historically neutral towards smoking, but as the health dangers emerged many scholars began to argue that it was “markrooh” (discouraged) or “haram” (prohibited). Documents from British American Tobacco (BAT) show that it identified this development as a major threat to future …
Effects of asphyxia on lung fluid balance in baby lambs.
Authors: T N Hansen, T A Hazinski, R D Bland
Journal: Journal of Clinical Investigation (1984)

The purpose of this study was to assess the effects of combined hypoxia and hypercapnia and of severe asphyxia on lung water balance and protein transport in newborn lambs. We studied ten 2-4-wk-old anesthetized lambs which were mechanically ventilated first with air for 2-3 h, then with 10-12% oxygen in nitrogen for 2-4 h, and then with 10-12% oxygen and 10-12% carbon dioxide in nitrogen for 2-4 h. Next we stopped their breathing for 1-2 min to produce severe asphyxia, after which we followed their recovery in air for 2-4 h. In 5 of the 10 lambs we intravenously injected radioactive albumin and measured its turnover time between plasma and lymph during the baseline period and after recovery from asphyxia. During alveolar hypoxia alone, mean pulmonary arterial pressure increased 60% and lung lymph flow increased 74%, whereas lymph protein concentration decreased from 3.47 +/- 0.13 to 2.83 +/- 0.15 g/dl. Cardiac output, left atrial pressure, and plasma protein concentration did not change. When carbon dioxide was added to the inspired gas mixture, pulmonary arterial pressure increased 22%, cardiac output increased 13%, lung lymph flow increased 33%, and lymph protein concentration decreased from 2.83 +/- 0.15 to 2.41 +/- 0.13 g/dl. Left atrial pressure and plasma protein concentration did not change. After 60-90 s of induced asphyxia, vascular pressures and lung lymph flow rapidly returned to values the same as those obtained during the baseline period. The turnover time for radioactive albumin between plasma and lymph was the same between the baseline and recovery periods (185 +/- 16 vs. 179 +/- 12 min). The ratio of albumin to globulin in lymph relative to the same ratio in plasma did not change during any phase of these experiments. Five lambs killed after recovery from asphyxia had significantly less blood and extravascular water in their lungs than control lambs had. We conclude that in the newborn lamb both alveolar hypoxia and alveolar hypoxia with hypercapnia increase lung lymph flow by increasing filtration pressure in the microcirculation, but neither hypoxia with hypercapnia nor brief severe asphyxia alters the protein permeability of the pulmonary microcirculation.
Endometrial assessment with Isaacs cell sampler.
Authors: J D Hutton, A R Morse, M C Anderson, R W Beard
Journal: BMJ (1978)

The value of the Isaacs endometrial cell sampler in the cytologic assessment of the endometrium was studied in 121 unanaesthetised patients aged over 40. Satisfactory aspirates for cytological diagnosis of endometrial state were obtained in 111 patients (91%) whereas endometrial specimens for histological diagnosis were obtained in only 89 patients (79%). In only four out of 83 cases were there diagnostic discrepancies between the aspirates and the curettings. It is concluded that the technique is safe, quick, comfortable, and reliable for assessing endometrial state. It should therefore prove valuable for screening, particularly in the management of menopausal women requiring oestrogen treatment.
Effect of combined hormone replacement therapy on thrombotic and fibrinolytic potentials and Lp(a) levels in elderly women
Authors: Otavio C. Gebara, Margareth Venturinell, Jose M. Aldrighi, Nubia Vieira, Amit Nussbacher, Humberto Pierri, Serro-Azul João, Elbio D'Amico, Mauricio Wajngarten, Giuseppe Rosano, Jose A. Ramires
Journal: Journal of the American College of Cardiology (2002)
The effect of weather on respiratory and cardiovascular deaths in 12 U.S. cities.
Authors: Alfésio L F Braga, Antonella Zanobetti, Joel Schwartz
Journal: Environmental Health Perspectives (2002)

We carried out time-series analyses in 12 U.S. cities to estimate both the acute effects and the lagged influence of weather on respiratory and cardiovascular disease (CVD) deaths. We fit generalized additive Poisson regressions for each city using nonparametric smooth functions to control for long time trend, season, and barometric pressure. We also controlled for day of the week. We estimated the effect and the lag structure of both temperature and humidity based on a distributed lag model. In cold cities, both high and low temperatures were associated with increased CVD deaths. In general, the effect of cold temperatures persisted for days, whereas the effect of high temperatures was restricted to the day of the death or the day before. For myocardial infarctions (MI), the effect of hot days was twice as large as the cold-day effect, whereas for all CVD deaths the hot-day effect was five times smaller than the cold-day effect. The effect of hot days included some harvesting, because we observed a deficit of deaths a few days later, which we did not observe for the cold-day effect. In hot cities, neither hot nor cold temperatures had much effect on CVD or pneumonia deaths. However, for MI and chronic obstructive pulmonary disease deaths, we observed lagged effects of hot temperatures (lags 4-6 and lags 3 and 4, respectively). We saw no clear pattern for the effect of humidity. In hierarchical models, greater variance of summer and winter temperature was associated with larger effects for hot and cold days, respectively, on respiratory deaths.