tbuckley/cabot-search huggingface dataset:
Early Changes in Regional and Global Left Ventricular Function After Aortic Valve Replacement
Authors: Xu Y. Jin, Derek G. Gibson, John R. Pepper
Journal: Circulation (1995)

The clinical effects of different cardioplegic methods on left ventricular (LV) function have not been fully elucidated, particularly in the setting of myocardial hypertrophy.Sixty-four patients (mean age, 62 +/- 12 years; 41 men, 23 women) who were undergoing elective aortic valve replacement (stenosis, 49; regurgitation, 15; concomitant coronary artery bypass grafting, 22), with LV mass index 230 +/- 70 g/m2, were randomized to the following groups: antegrade crystalloid cardioplegia (CCP, 21 patients), antegrade/retrograde cold blood cardioplegia (CBP, 23 patients), or continuous retrograde warm (37 degrees C) blood cardioplegia (WBP, 20 patients). Mean aortic cross-clamp and cardiopulmonary bypass times were 100 +/- 20 and 126 +/- 24 minutes. Positive inotropic drug therapy was required postoperatively in 9 patients after CBP, 14 after CCP, and 18 after WBP. Perioperative LV function was assessed using transesophageal M-mode echocardiography, combined with high-fidelity LV pressure recording and thermodilution cardiac output, before bypass and 0.5, 1, 3, 6, 12, and 20 hours after cross-clamp removal. There was a similar fall in LV peak circumferential wall stress at constant LV end-diastolic dimension in each group after aortic valve replacement. The increase in contraction velocity was significant from 0.5 hour with CBP; however, no significant increase occurred until 12 hours with CCP and until 20 hours with WBP. The rate and extent of LV pressure fall and early diastolic filling rate both increased with CBP, and only in this group did ventricular coordination improve. LV stroke work index was maintained with CBP throughout the postoperative period with less inotropic support than with the other two methods.In the hypertrophied LV, CBP offers the best preservation of myocardial physiological response and ventricular function with less inotropic support.
Bloody Pleural Fluid Following Pulmonary Infarction
Authors: Paul F. Griner
Journal: JAMA (1967)

The frequency of morbidity and death from pulmonary embolization represents a cause of increasing concern to the medical community. Symptoms and signs in this disorder are not specific. Accurate diagnosis, accordingly, demands critical appraisal of all findings. Previously accepted observations may need to come under closer scrutiny. For example, it is commonly taught that a bloody or serosanguineous pleural effusion is anticipated following pulmonary infarction. Standard medical texts and reviews on pulmonary embolism 1-3 emphasize this finding. Agreement, however, is not universal. At least one author cautions against overemphasizing the frequency of this finding. 4 Excessive reliance on the demonstration of blood-tinged pleural fluid in patients with suspected pulmonary infarction may lead to errors of omission. Likewise, errors of commission may occur when sanguineous pleural effusion has another cause.  The findings reported here indicate that physicians in the community of Rochester, NY, are in general agreement with the classical teachings
Spurious tricuspid regurgitation: Three conditions mimicking tricuspid regurgitation diagnosed at operation
Authors: A. H. Brown, M. V. Braimbridge
Journal: Thorax (1973)

<b>Brown, A. H., and Braimbridge, M. V. (1973).</b><i>Thorax</i>, <b>28</b>, 495-497. <b>Spurious tricuspid regurgitation: Three conditions mimicking tricuspid regurgitation diagnosed at operation.</b> The diagnosis of tricuspid incompetence is difficult. Three patients are described in whom the diagnosis of tricuspid regurgitation was made but disproved by the findings at surgery. The first patient had aortic regurgitation, mitral regurgitation from chordal rupture, and constrictive pericarditis; the right atrium was compressed between the pulsating left atrium and the tight pericardium. The chordal rupture caused the mitral murmur to radiate parasternally. The second patient had severe mitral and aortic regurgitation and an interatrial septal defect with transmission of the left-sided `v9 waves to the right atrium. The third patient had an iatrogenic Gerbode defect from a previously repaired ostium primum atrial septal defect. Intracardiac phonocardiography failed to distinguish the anatomical situation from tricuspid regurgitation. The best assessment of tricuspid valvular disease is still that of the surgeon at operation.
Acute abdominal pain caused by a prolapsed duodenal polyp that resolved when the polyp broke off spontaneously
Authors: K. Kim, G. Lee
Journal: Endoscopy (2007)

A 48-year-old woman presented with a 1-day history of acute abdominal pain after a bout of drinking-related vomiting. She had no significant medical history or family history and was not taking any medications. There were no abnormal findings on careful physical examination, and the standard laboratory results were also within normal ranges. Upper gastrointestinal endoscopy revealed a long stalk arising from the duodenal bulb that had prolapsed into the distal portion of the duodenum (Figure [1 a] ). The scope could not be advanced more distally because the stalk was impacted in the duodenal lumen. A small-bowel series showed a large polypoid mass with a long stalk (Figure [1 b] ).
TAR CANCER OF THE LIP IN FISHERMEN
Authors: PHILIP SHAMBAUGH
Journal: JAMA (1935)

The problem of tar cancer in fishermen was brought to my attention by an interesting case observed in the surgical wards of the Peter Bent Brigham Hospital. A brief summary of this case follows: R. C., a healthy-appearing laborer, aged 41, admitted in September 1932, had a moderately painful swelling of the right side of the neck which had been present for six months. This was at first taken to represent tuberculous lymphadenitis, and the patient was treated for a month in the outdoor department with the ultraviolet lamp. Since there was no improvement he was sent into the hospital, where a mass of hard adherent tissue was removed, which proved microscopically to be epidermoid carcinoma involving the lymph nodes and invading the submaxillary gland. The primary source of the growth, however, was obscure, since there was no discernible lesion about the mouth. Finally the chance observation of a very
Medical Care in the Streets
Authors: Nancy L. Caroline
Journal: JAMA (1977)

AN EMERGENCY medical services delivery system is as strong as its weakest link. 1,2 As data on acute myocardial infarction and multiple trauma have been accumulated over the past several years, it has become clear that a considerable portion of morbidity and mortality occurs outside the hospital, before the patient reaches medical care. 3 It has similarly become clear that implementation of high standards of advanced prehospital life support—at the scene and in transport—can improve the outcome of critically ill and injured patients, thus reducing the need for prolonged, often futile, terminal intensive care. Because of increasing awareness of these facts, the past several years have seen a burgeoning of paramedicstaffed mobile intensive care units (MICUs), equipped to deliver sophisticated medical care on the scene for a variety of medical and surgical emergencies. Advanced emergency medical technicians, or paramedics, are trained in arrhythmia recognition, administration of medications, intravenous infusion, endotracheal
Deaths from rare protozoan encephalitis in Karachi blamed on unchlorinated water
Authors: A. N. Kazi, T. Riaz
Journal: BMJ (2013)

The re-emergence of the deadly water borne Naegleria fowleri in the city of Karachi in Pakistan has been blamed on failure to chlorinate the city’s water supply.

There were 10 deaths from the amoebic disease in the city in 2012, and one reported death so far in 2013.1 In 2012, Karachi was the only city in Pakistan to report cases of the disease.

N fowleri , commonly known as “brain-eating amoeba,” is a free living …
RUPTURED SUBARACHNOID ANEURYSM: A NOTE ON A PROBABLE CASE
Authors: M. C. Andrews
Journal: BMJ (1929)

THOSE WhO were present at the Section of Surgery at the Aniniuial Meeting of the British Medical Association in 1927, or who read tlhe report of its excellent discussion on-clhronic appendicitis, must have been strucik by the small diagnostic value which attaches to any one sign.'Compared with the acute form, chronic appendicitis presents a vague clinical picture; the appendix, like the hand of a clock, may point in any direction, anid it is not surpr-ising that tenderness may appear in widely different areas.I pointed out, how- ever, in a letter published in the same issue with the report, that at tihe discussionino one had mentioned the diagnostic value of x rays.2Yet radiology, taken in conjunction with clinical signs and symptoms, probably gives us miiore definite hell) in (liagnosis than any other eieans.I cite the followilng case, referr-ed' to me by Dr. Mathieson of Harrow, in illustration.Clinical History.The patient, a woman aged 44, had severe abdominal pains, particularly in the left costal region.They were intermittent, lasting one to, three days, with similar periods of intermission, and were much worse at the menstrual periods.The whole abdomeni was tender, more so at some times than at others.Occa- sionally her complexion was sallow.Radiographical Report.The stomach was of the fish-hook type, normal in position.Its size was increased and peristalsis more rapid than usual.There were no tender points.It indented easily with pressure.The duodenal cap was normal.Radiographic examination five days later: A round collection of barium was seen in the pelvis, and streaks of barium were present in the colon. Cholecystogram: Sodium tetraiodoplhenolphtlhalein was giveynDrally.The gall-bladder was not seen.An undissolved capsule and streaks of the dr'ug were seen in the ascending colon.Conclusion: "The presence of barium probalAy in the appendix five days after the meal is strongly suggestive of chronic appendic- itis.The association of pain with the menstrual periods leads onle to suppose that the appendix is involving the ovary or tube.The failure of the gall-bladder to fill suggests that this is diseased.The flatuilence and occasional change in her complexion would be explained by cholecystitis."Opera tion.
The Importance of Exfoliative Cytology in the Diagnosis of Cancer of the Upper Gastrointestinal Tract.
Authors: Duane C. Taebel
Journal: Annals of Internal Medicine (1965)

s1 May 1965The Importance of Exfoliative Cytology in the Diagnosis of Cancer of the Upper Gastrointestinal Tract.Duane C. Taebel, M.D., Joao C. Prolla, M.D., Joseph B. Kirsner, M.D., F.A.C.P.Duane C. Taebel, M.D.Search for more papers by this author, Joao C. Prolla, M.D.Search for more papers by this author, Joseph B. Kirsner, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-5-1080_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptDuring the period april, 1955, through december, 1963, esophageal exfoliative cytology was performed in 210 patients and gastric exfoliative cytology in 2,127 patients, with adequate follow-up of at least 6 months.Among the 210 cases of esophageal cytology, there were 64 proven malignant tumors of the esophagus and cardia. The positive cytological report was correct in 56, an accuracy of 87%. The 2,127 cases of gastric cytology included 215 malignant tumors. The cytological report was correct in 189, an accuracy of 86%. The over-all accuracy of the negative reports for both organs was practically the same, approximately 98%.Well-differentiated squamous... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Duane C. Taebel, M.D.; Joao C. Prolla, M.D.; Joseph B. Kirsner, M.D., F.A.C.P.Affiliations: Chicago, Illinois PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1965Volume 62, Issue 5Page: 1080-1080KeywordsCardiaCell biologyEsophagusGastrointestinal tractMalignant tumors ePublished: 1 December 2008 Issue Published: 1 May 1965 PDF downloadLoading ...
Immunity of School Children Two Years After Oral Poliomyelitis Vaccination
Authors: Martha L. Lepow
Journal: JAMA (1967)

A serologic survey of the poliovirus immunity of children in a suburban school system was performed in 1964, two years after a mass oral vaccination program. Approximately 6% of the school children were studied and 96% had antibody titers of 8 or greater to all three types of poliovirus. Antibody levels declined during the two-year period, but only significantly so for types 2 and 3 in children who had not received a booster. Antibody titers to types 2 and 3 poliovirus in children who had been given a booster were significantly higher than those who had not received one. A single feeding of a trivalent live oral poliovirus vaccine resulted in a rise in antibody titer in slightly less than half of the subjects with low type 3 titers.
Angiotensin-Converting Enzyme Gene Polymorphism Is Associated With Carotid Arterial Wall Thickness in Non–Insulin-Dependent Diabetic Patients
Authors: Masayuki Hosoi, Yoshiki Nishizawa, Kyoko Kogawa, Takahiko Kawagishi, Toshiaki Konishi, Kiyoshi Maekawa, Masanori Emoto, Shinya Fukumoto, Atsushi Shioi, Tetsuo Shoji, Masaaki Inaba, Yasuhisa Okuno, Hirotoshi Morii
Journal: Circulation (1996)

The insertion/deletion (I/D) polymorphism of the ACE gene has been shown to be associated with cardiovascular disease in healthy subjects as well as in patients with non-insulin-dependent diabetes mellitus (NIDDM). We investigated the relationship between the ACE gene polymorphism and the wall thickness of both carotid and femoral arteries in NIDDM patients.We measured the intimal plus medial thickness (IMT) of both carotid and femoral arteries using high-resolution B-mode ultrasonography in 288 Japanese NIDDM patients (160 men, 128 women). No significant differences among the three genotypes were found with respect to age, sex, duration of diabetes, body mass index, blood pressure, plasma glucose, hemoglobin AIC, total cholesterol, triglycerides, HDL cholesterol, or cigarette-years. Plasma ACE levels were strongly associated with I/D polymorphism, with an additive effect of the D alleles. The carotid IMT of the patients carrying the D allele (DD+ID genotype) was significantly higher than that of the patients not carrying the D allele (II genotype) (P = .037), whereas the femoral IMT was not affected by the I/D polymorphism. Multiple regression analysis demonstrated that the risk factors for carotid IMT of patients with NIDDM were age, non-HDL cholesterol, and D allele of the ACE gene (R2 = .155, P < .0001).The D allele of the ACE gene may be a risk factor for the development of wall thickening of the carotid but not the femoral artery in NIDDM patients.
Drugs companies are defrauding healthcare systems, conference hears
Authors: Lynn Eaton
Journal: BMJ (2004)

Pharmaceutical companies are among those deliberately defrauding healthcare systems throughout Europe, a conference in London heard this week.

More than 150 delegates from 20 of the 25 European Union states attended the two day event looking at fraud and corruption across the European healthcare system. Although delegates considered everything from health tourism (where individuals from one country go to another to receive free or cheap health care) to how to identify fraud, a recurring concern was the blatant fraud by some drug companies.

“In any country, pharmaceutical fraud is a big problem,” said Marieke Koken-Vossestein, head of the department of claim control at the Zorgverzekeraars Nederland (a Dutch department …
A Contribution to School Hygiene
Authors: R. Liebreich
Journal: BMJ (1873)

make the two following statements.I never anywhere said or sug- gested that a force of " four pounds" was required to pass a probe in a healthy woman, nor a force of even half a pound.Dr. Bennet's assertions as to the state of the healthy ora uteri, externum and internum, are, I am convinced, erroneous and inconsistent with anatomy, physi- ology, pathology, and daily experience.It is well-known that some gynmecologists speak and treat as if every woman suffering from dysmenorrhcea or sterility had a strictured cervix; but it is not necessary, in order to account for such proceedings, to resort to Dr. Bennet's dictum that the os uteri internum is normally closed during life, except at certain times.These remarks render it unnecessary for me-specially to consider the observations of Dr. Boulton; and those of Dr. Greenhaigh raise no question upon which I am called to make comment.I thank each of the gentlemen above referred to for their valued criticisms; and I end by saying that I believe the treatment of spasmodic dysmenorrhcea by mechanical means appears to me, at present, to be best effected by the use of a graduated series of metallic bougies, applied as I have elsewhere described-
THE FREQUENCY OF POSTURAL SCOLIOSIS
Authors: STEVENSON SMITH
Journal: JAMA (1927)

The 350 children whose scoliosis was measured and who form the basis for this report were unselected cases and represent a fair sample of the general population. One hundred and twenty were Jewish children, but these do not differ in any significant way from the others. There were equal numbers of boys and girls. They ranged in age from 6 to 13 years, with a mean age of 9.4 years (probable error 1.42). The method of measurement was as follows: An ink dot was placed on the skin over the center of each spinous process. The child stood with feet together and weight equally distributed. A piece of rubber band was then stretched from the center of the seventh cervical to the center of the coccyx. At the level of greatest spinal deviation from straightness an ink dot was placed in the line of the rubber band. The mark over
Second-Generation Replication-Competent Oncolytic Adenovirus Armed with Improved Suicide Genes and ADP Gene Demonstrates Greater Efficacy without Increased Toxicity
Authors: Kenneth N. Barton, Dell Paielli, Yingshu Zhang, Sweaty Koul, Stephen L. Brown, Mei Lu, John Seely, Jae Ho Kim, Svend O. Freytag
Journal: Molecular Therapy (2005)

Replication-competent adenovirus-mediated suicide gene therapy has proven to be safe in humans when delivered intraprostatically. Although signs of efficacy are emerging, it is likely that further improvements will be needed before this technology will have widespread applicability in the clinic. Toward this end, we have developed a second-generation, replication-competent adenovirus (Ad5-yCD/mutTK(SR39)rep-ADP) containing an improved yeast cytosine deaminase (yCD)/mutant(SR39) herpes simplex virus thymidine kinase fusion (yCD/mutTK(SR39)) gene and the adenovirus death protein (ADP) gene. Relative to the first-generation Ad5-CD/TKrep adenovirus, Ad5-yCD/mutTK(SR39)rep-ADP demonstrated greater tumor cell kill in vitro and significantly greater tumor control in preclinical models of human cancer. Quantification of transgene volume following direct injection of fadenovirus into human tumor xenografts and the naïve canine prostate demonstrated that ADP enhanced adenoviral spread in vivo. Toxicology studies were performed to determine whether the improved yCD/mutTK(SR39) fusion and ADP genes increased toxicity. Intraprostatic injection of Ad5-yCD/mutTK(SR39)rep-ADP did not result in significantly increased toxicity relative to the parental Ad5-CD/TKrep adenovirus, the latter of which has proven to be safe in two Phase I prostate cancer clinical trials. Together, these results provide the scientific basis for evaluating the safety and efficacy of the second-generation Ad5-yCD/mutTK(SR39)rep-ADP adenovirus in humans.
The natural course of gold nephropathy: long term study of 21 patients.
Authors: C L Hall, N J Fothergill, M M Blackwell, P R Harrison, J C MacKenzie, A G MacIver
Journal: BMJ (1987)

To clarify the natural course of gold nephropathy and thereby facilitate its clinical management 21 patients with rheumatoid arthritis who developed proteinuria during treatment with intramuscular sodium aurothiomalate were studied in detail throughout their renal illnesses. Renal biopsies were performed, and creatinine clearance and proteinuria were measured serially for 60 months (range 16-130 months). Ten patients developed proteinuria after six months9 treatment, 15 after 12 months, and 18 after 24 months. When treatment was stopped the proteinuria reached a median peak of 2.1 g/day (range 0.7-30.7 g/day) at two months (range 1-13 months) before resolving spontaneously, in eight patients by six months, in 13 by 12 months, and in 18 by 24 months. All patients were free of proteinuria by 39 months, the median duration being 11 months. The median first and last measurements of creatinine clearance showed no significant change (77 ml/minute and 59 ml/minute, respectively), and no patient died from or needed treatment for renal failure. HLA-B8 or DR3 alloantigens, or both, were identified in seven patients. Renal biopsy specimens showed membranous glomerulonephritis in 15 patients, a minimal change nephropathy in two, mesangial electron dense deposits in two, and no appreciable glomerular changes in two. In these 21 patients the proteinuria of gold nephropathy resolved completely when treatment was withdrawn. Renal function did not deteriorate, corticosteroids were unnecessary, and several different renal lesions were seen.
Renal outcome in patients with congenital anomalies of the kidney and urinary tract
Authors: Simone Sanna-Cherchi, Pietro Ravani, Valentina Corbani, Stefano Parodi, Riccardo Haupt, Giorgio Piaggio, Maria L Degli Innocenti, Danio Somenzi, Antonella Trivelli, Gianluca Caridi, Claudia Izzi, Francesco Scolari, Girolamo Mattioli, Landino Allegri, Gian Marco Ghiggeri
Journal: Kidney International (2009)
Management for health.
Authors: R Maxwell
Journal: BMJ (1973)

down-draught extractor fans are installed and protective clothing is worn. It is almost impossible to sterilize bone products and it would be a costly, indeed uneconomic, process. At a symposium at the Veterinary Public Health Association meeting in 1964 it was concluded that considering the widespread distribution of anthrax spores in imported animal products, coupled with the small number of cases in man, then man's resistance must be considerable. Extensive disinfection processes seem hardly justified since effective immunization is available to those at risk and effective chemotherapy for established cases. Few cases of anthrax among bone meal workers in this area have been seen since anthrax inoculation became routine. The odd case has occurred in those whose inoculation schedules had not been completed. I believe that professional gardeners should also be vaccinated against anthrax and that bone meal fertilizers should be packed in sacks carrying a prominent warning that gloves should be worn.
Travelers' Diarrhea: Can It Be Eluded?
Authors: Herbert L. DuPont, Charles D. Ericsson, Barbara E. Murray
Journal: JAMA (1983)

In this issue ofThe Journal(p 1176), Steffen and colleagues have helped to put into perspective the relative risk of acquiring diarrhea when a large number of persons trek from an industrialized region to countries that differ in their rates of endemicity of acute diarrhea. The number of the subjects (16,568), the diversity of the 13 world regions, and the methods of data collection make the study unique. Airline cabin crews of 162 charter flights administered a seven-page questionnaire to Swiss international tourists and to a limited number of German international tourists as they traveled home.  Evidence was presented that these captive participants complied with the study requirements if they were able to read the questionnaire and if the survey was not administered during the dark of night. Rates of diarrhea were high among travelers to tropical (East and West Africa, Sri Lanka, Thailand, the Far East, Brazil, and