tbuckley/cabot-search huggingface dataset:
His Bundle Recordings in Bilateral Bundle-Branch Block Combined with Wolff-Parkinson-White Syndrome
Authors: R. A. MASSUMI
Journal: Circulation (1970)

An example of bilateral bundle-branch block (RBBB) in the presence of WPW syndrome in which diagnosis was established with the aid of His bundle recordings is presented. Complete RBBB and intermittent block of the superior and inferior divisions of the left bundle branch were coexistent for at least 2 years before complete heart block (trifascicular block) occurred. It was demonstrated that the preexcitation pathway conducted and blocked together with the normal pathways. It is suggested that the anomalous bundle in this case traveled with the normal pathways and that this close relationship is more common than has been suspected. Retrograde V-A conduction at 1:1 ratio was present during electrical stimulation of the right ventricle and the anomalous bundle was used for retrograde spread of activation from the ventricles to the atria. The retrograde P waves, thus produced, conducted antegrade through the His bundle (reciprocation) but reached the ventricles only when they appeared near the end of the T waves of the preceding beats. The mechanism of supramaximal conductivity or excitability, therefore, appears to be a plausible explanation.
REPORT OF A FEW CASES OF FOREIGN BODIES IN THE STOMACH WHICH HAVE COME UNDER MY OBSERVATION IN THE PAST TWENTY YEARS.
Authors: W. T. KENDALL
Journal: JAMA (1892)

The first case was one in the larynx; a young man while running through a field struck a dry stalk of cockle burr and one burr flew in his mouth and in deep inspiration lodged in the lower larynx. I was called to see him at once; arriving at the patient's house late at night and not having a pair of laryngeal angle forceps in the country at that time, and being unable to do anything with a pair of ordinary forceps, I made an instrument out of a piece of white oak split, but found it impossible to dislocate the burr with the means at hand. The patient was breathing very well, so I concluded to wait until morning. After a good night's rest the patient experienced very little inconvenience from the burr. I made one more effort to dislocate it with my improvised instrument and not accomplishing anything
Hospital admission through the emergency department
Authors: D. M. Hoffman
Journal: JAMA (1992)

To the Editor.  —As a visitor working in your country, I am troubled by the emphasis of the Editorial1that concluded, We need a system that ensures equitable reimbursement so that no patient will be discouraged from receiving needed medical   The problems besetting EDs are multifactorial, but surely the major problem stems from the millions of Americans who, lacking other avenues, use the ED for primary care. Patients who present to EDs should have clinical problems that are of acute onset or have suddenly become worse. They need attention and should receive it promptly from staff who are not overwhelmed by the need to provide more routine primary care. Addressing the health care needs of nonemergency patients requires not more money to reimburse care givers, but a restructuring of the system for provision of outpatient health care to link the patient with the appropriate health care professional and
Adverse Effect of Ventricular Pacing on Heart Failure and Atrial Fibrillation Among Patients With Normal Baseline QRS Duration in a Clinical Trial of Pacemaker Therapy for Sinus Node Dysfunction
Authors: Michael O. Sweeney, Anne S. Hellkamp, Kenneth A. Ellenbogen, Arnold J. Greenspon, Roger A. Freedman, Kerry L. Lee, Gervasio A. Lamas
Journal: Circulation (2003)

Background— Dual-chamber (DDDR) pacing preserves AV synchrony and may reduce heart failure (HF) and atrial fibrillation (AF) compared with ventricular (VVIR) pacing in sinus node dysfunction (SND). However, DDDR pacing often results in prolonged QRS durations (QRSd) as the result of right ventricular stimulation, and ventricular desynchronization may result. The effect of pacing-induced ventricular desynchronization in patients with normal baseline QRSd is unknown. Methods and Results— Baseline QRSd was obtained from 12-lead ECGs before pacemaker implantation in MOST, a 2010-patient, 6-year, randomized trial of DDDR versus VVIR pacing in SND. Cumulative percent ventricular paced (Cum%VP) was determined from stored pacemaker data. Baseline QRSd &lt;120 ms was observed in 1339 patients (707 DDDR, 632 VVIR). Cum%VP was greater in DDDR versus VVIR (90% versus 58%, P =0.001). Cox models demonstrated that the time-dependent covariate Cum%VP was a strong predictor of HF hospitalization in DDDR (hazard ratio [HR], 2.99 [95% CI, 1.15 to 7.75] for Cum%VP &gt;40%) and VVIR (HR 2.56 [95% CI, 1.48 to 4.43] for Cum%VP &gt;80%). The risk of AF increased linearly with Cum%VP from 0% to 85% in both groups (DDDR, HR 1.36 [95% CI, 1.09, 1.69]; VVIR, HR 1.21 [95% CI 1.02, 1.43], for each 25% increase in Cum%VP). Model results were unaffected by adjustment for known baseline predictors of HF hospitalization and AF. Conclusions— Ventricular desynchronization imposed by ventricular pacing even when AV synchrony is preserved increases the risk of HF hospitalization and AF in SND with normal baseline QRSd.
989 BENEFICIAL PARACRINE EFFECTS OF CANNABINOID CB2 RECEPTORS ON LIVER INJURY AND REGENERATION
Authors: F. Teixeira-Clerc, M.-P. Belot, S. Manin, V. Deveaux, A. Zimmer, T. Tordjmann, A. Mallat, S. Lotersztajn
Journal: Journal of Hepatology (2010)
In Vivo Requirement for Atg5 in Antigen Presentation by Dendritic Cells
Authors: Heung Kyu Lee, Lisa M. Mattei, Benjamin E. Steinberg, Philipp Alberts, Yun Hee Lee, Alexander Chervonsky, Noboru Mizushima, Sergio Grinstein, Akiko Iwasaki
Journal: Immunity (2010)
Notes of a Case of Separation of the Uterus from the Body by Laceration during Labour
Authors: T. Paget, E. R. C. Denton
Journal: BMJ (1869)

fibrine were found obstructing the passage of the blood, more especially on the left side, where they extended for about an inch and a half into the primary divisions of the pulmonary artery.Beyond these the arteries were nearly empty, containing only a little fluid blood.These clots were of a yellowish or buLff colour, very firm, but not moulded to the vessel in which they lay, and were very different from the soft gelatinous clot in the right ventricle.They were of a leathery con- sistence, and were not surrounded by any black coagulum.On sec-
A New Mode of Performing the Operation of Paracentesis Thoracis
Authors: T. J. Maclagan
Journal: BMJ (1872)

two years and a half, when he was able to resume his work as a collier.His present condition as regards sensation has not altered in the slightest degree since the fourth month after the accident, and is as fol- lows.The sensibility in the soles of both feet, and in the posterior portion of both legs, is much impaired; and around the anus, perinaeum, inner part of both buttocks, scrotum, and penis, it is entirely destroyed.Although there is a slight sensation under pressure in the testicles, so complete is the absence of sensation in the buttocks, that when, last summer, he sat down on a garden-flue, ignorant of the fact of its being heated, his trousers were burnt through, and the skin com- pletely charred, yet he was unaware of the fact till his wife noticed it, three days afterwards, whilst he was washing.The slough was some- what deep, and the scar is still visible.Whilst at work in the pit, he frequently gets severe scratches and cuts on the soles of his feet, which he hardly feels.Each day, on his return from work, he regularly goes to the closet, and, by dint of powerful efforts, forces the faeces to pass when solid, for, when liquid, they are not retained.At this time, the urine runs involuntarily in a stream, though at other times it drips continuously into an India- rubber urinal which he wears permanently; but in neither case is there any feeling of the passage of faeces or urine.
Long-term Distress After Radical Prostatectomy Versus Watchful Waiting in Prostate Cancer: A Longitudinal Study from the Scandinavian Prostate Cancer Group-4 Randomized Clinical Trial
Authors: Anna Bill-Axelson, Hans Garmo, Lars Holmberg, Jan-Erik Johansson, Hans-Olov Adami, Gunnar Steineck, Eva Johansson, Jennifer R. Rider
Journal: European Urology (2013)
The Future of Rural Maternity Units
Authors: A. S. Cunningham
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Hein<sup>1</sup>pleads for the preservation of rural maternity units and, based on regionalized perinatal care in Iowa, shows that they can provide excellent care at reasonable cost. Iowa's experience parallels that of New Zealand, where the smallest maternity units have the lowest perinatal mortality rates.<sup>2</sup>Perinatal care in upstate New York is not so well organized. Recent data highlight certain problems that add perspective to Hein's observations. Excluding New York City, the neonatal mortality rate in 1983 for all babies born in hospitals with fewer than 500 annual births was 6.6 per 1000. The same hospitals in Iowa (Hein's class Ia) had a rate of 2.7. There must be several reasons for this difference, but an important one is that too many high-risk babies are still being delivered in small hospitals asNew York's system of perinatal care continues to evolve. Table 1 shows that
Mortality and Sudden Death in Pediatric Left Ventricular Noncompaction in a Tertiary Referral Center
Authors: Samuel T. Brescia, Joseph W. Rossano, Ricardo Pignatelli, John L. Jefferies, Jack F. Price, Jamie A. Decker, Susan W. Denfield, W. Jeffrey Dreyer, O’Brian Smith, Jeffrey A. Towbin, Jeffrey J. Kim
Journal: Circulation (2013)

Left ventricular noncompaction is a cardiomyopathy characterized by excessive trabeculation of the left ventricle, progressive myocardial dysfunction, and early mortality. Left ventricular noncompaction has a heterogeneous clinical presentation that includes arrhythmia and sudden cardiac death.We retrospectively reviewed all children diagnosed with left ventricular noncompaction at Texas Children's Hospital from January 1990 to January 2009. Patients with congenital cardiac lesions were excluded. Two hundred forty-two children were diagnosed with isolated left ventricular noncompaction over the study period. Thirty-one (12.8%) died, and 13 (5.4%) were received a transplant. One hundred fifty (62%) presented with or developed cardiac dysfunction. The presence of cardiac dysfunction was strongly associated with mortality (hazard ratio, 11; P<0.001). ECG abnormalities were present in 87%, with ventricular hypertrophy and repolarization abnormalities occurring most commonly. Repolarization abnormalities were associated with increased mortality (hazard ratio, 2.1; P=0.02). Eighty children (33.1%) had an arrhythmia, and those with arrhythmias had increased mortality (hazard ratio, 2.8; P=0.002). Forty-two (17.4%) had ventricular tachycardia, with 5 presenting with resuscitated sudden cardiac death. In total, there were 15 cases of sudden cardiac death in the cohort (6.2%). Nearly all patients with sudden death (14 of 15) had abnormal cardiac dimensions or cardiac dysfunction. No patient with normal cardiac dimensions and function without preceding arrhythmias died.Left ventricular noncompaction has a high mortality rate and is strongly associated with arrhythmias in children. Preceding cardiac dysfunction or ventricular arrhythmias are associated with increased mortality. Children with normal cardiac dimensions and normal function are at low risk for sudden death.
Initial Report of the Results of Percutaneous Laser Ablation of Benign Cold Thyroid Nodules: Evaluation of Histopathological Changes After 2 Years
Authors: Bekir Cakir, Nevzat Serdar Ugras, Kamile Gul, Reyhan Ersoy, Birol Korukluoglu
Journal: Endocrine Pathology (2009)
Echocardiographic Abnormalities in the Mitral Valve Prolapse Syndrome
Authors: RICHARD L. POPP, OWEN R. BROWN, JAMES F. SILVERMAN, DONALD C. HARRISON
Journal: Circulation (1974)

Two echocardiographic patterns of the mitral valve have been found to correlate with anatomic and/or angiocardiographic appearance of redundancy of the mitral valve. The echocardiographic abnormality may be found in the presence or absence of auscultatory findings, while the apparent separation of the anterior and posterior mitral leaflets on echocardiogram does not seem to represent anatomic separation leading to mitral regurgitation. Since the echocardiographic abnormality is found in the absence of various parts of the syndrome, it may be used as a tool to diagnose the mitral valve prolapse syndrome, discover its incidence and follow its natural history.
Ethics and Complementary and Alternative Medicine
Authors: Karen E. Adams
Journal: Annals of Internal Medicine (2003)

Letters3 June 2003Ethics and Complementary and Alternative MedicineKaren E. Adams, MDKaren E. Adams, MDOregon Health and Science University; Portland, OR 97201Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-11-200306030-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Professor Ernst raises an important question: How can we improve communication with CAM providers to promote our patients' understanding of their situation and options? Clearly, in the case of Ms. P., surgery would be life-saving, and ideally her CAM providers as well as her allopathic providers would encourage that choice. But as Professor Ernst notes, CAM providers are not always open to allopathic treatments or to partnering with allopathic providers, just as allopaths can be resistant to collaboration with CAM providers.A truly integrative health care system would encourage such collaboration to the benefit of all concerned, and ... Author, Article, and Disclosure InformationAuthors: Karen E. Adams, MDAffiliations: Oregon Health and Science University; Portland, OR 97201 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEthical Considerations of Complementary and Alternative Medical Therapies in Conventional Medical Settings Karen E. Adams , Michael H. Cohen , David Eisenberg , and Albert R. Jonsen Ethics and Complementary and Alternative Medicine Edzard Ernst Metrics Cited byEthical and legal issues at the interface of complementary and conventional medicine 3 June 2003Volume 138, Issue 11Page: 940KeywordsComplementary and alternative medicineHealth careHealth care providersSurgery ePublished: 3 June 2003 Issue Published: 3 June 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Immunofluorescent studies in ocular cicatricial pemphigoid
Authors: J.N. LEONARD, C.M. HOBDAY, G.P. HAFFENDEN, C.E.M. GRIFFITHS, A.V. POWLES, P. WRIGHT, L. FRY
Journal: British Journal of Dermatology (1988)

Twenty nine patients with cicatrizing conjunctivitis were studied; 17 with a clinical diagnosis of cicatricial pemphigoid, five with a clinical diagnosis of pseudopemphigoid caused by long‐term application of topical medication and seven who had a cicatrizing conjunctivitis from other causes. Biopsies from clinically uninvolved bulbar conjunctiva were taken for direct immunofluorescence and blood was taken for indirect immunofluorescence using normal human conjunctiva, oral mucosa and skin as substrates. On direct immunofluorescence, in vivo bound immunoglobulins were found along the basement membrane in 10 of the 17 patients with cicatricial pemphigoid, one of the five with pseudopemphigoid and two of the seven with a cicatrizing conjunctivitis associated with other diseases. Circulating anti‐basement membrane zone antibodies were found only when conjunctiva was used as a substrate. These were present in seven of the patients with cicatricial pemphigoid, three of those with pseudopemphigoid and two of those with a cicatrizing conjunctivitis caused by other diseases. These results indicate that direct immunofluorescence is a useful, but not absolute diagnostic marker for ocular cicatricial pemphigoid. The results in the pseudopemphigoid group argue that this is an immunologically mediated disorder indistinguishable from spontaneous cicatricial pemphigoid and probably triggered by the drugs. The presence of circulating antibodies should allow for precise identification of the antigen involved in cicatricial pemphigoid using SDS electrophoresis and Western blot analysis.
GANGRENE OF THE ARM AND DEATH FOLLOWING HYPODERMIC INJECTION
Authors: Marks [ill]. Shaine
Journal: JAMA (1926)

As the result of the high pressure salesmanship methods of some pharmaceutic houses, the use of hypodermic and intravenous medication is growing by leaps and bounds. Some physicians have almost discarded prescription blanks, and their offices are veritable stock rooms filled with hundreds of ampules of various kinds. That there is real danger in needle administration of drugs is proved by the cases of Tennant and of Doane mentioned by Fantus.<sup>3</sup>The case here to be described, which concerned a relative, is similar and warrants the warning not only to use the same strict asepsis in administering a hypodermic injection that one would use in a major operation, but also not to use hypodermic or intravenous medication except with those drugs which have little or no effect when administered by mouth. M. L., a woman, aged 32, married, complained of weakness and lassitude. Her physician found a moderate anemia
Oral Reactions to Penicillin
Authors: W. G. Cross
Journal: BMJ (1949)

<b>Background:</b> There is an urgent need for large longitudinal registries to evaluate the long-term clinical course of IPF and impact of treatment in real-world clinical setting. In November 2017, we started the first Latin American registry (REFIPI) with participation of 11 countries. <b>Methods:</b> In the first year, 433 IPF patients confirmed by central multidisciplinary diagnostic team were added. ILD without HRCT or biopsy UIP-pattern confirmation were ruled out. Demographic variables, functional tests, treatment and evolution were analyzed. <b>Results:</b> Mean(SD) age was 71+8 years, 77% males, most former smokers (53%). Family history of pulmonary fibrosis was reported in 6%. Time of symptoms before diagnosis was 18+17 months, 99% with Velcro rales, 42% clubbing and 38% had gastroesophageal reflux. All of them had restrictive pattern in spirometry and DLCO was 55+41% of predicted at diagnosis. In HRCT 71% has UIP and 29% possible UIP. Lung biopsy was obtained in 16% of the patients showing UIP pattern. At inclusion, 68% received pirfenidone, 18% nintedanib, and 3% azathioprine, prednisone, n-acetylcysteine, 11% weren’t receiving treatment. 9% presented an acute exacerbation and 92% of them were treated with high dose of corticosteroids during the event. In this first year, 13% of patients died, 81% IPF related. <b>Conclusions:</b> A large number of patients were enrolled in our initial Latino American registry of IPF. Our results are similar to reported male and smoking predominance, and some with family history of lung fibrosis. Time of symptoms befor diagnosis indicate the lack of knowledge about this disease by general clinicians. However, most patients seen by pulmonologist, received antifibrotic drugs.
Deaths from Poisoning
Authors: Merrill Moore, Leo Alexander, Johannes Ipsen
Journal: New England Journal of Medicine (1952)

A CONSIDERABLE number of deaths are caused annually by poisoning — absorption of gaseous, liquid or soluble chemicals. The mortality of deaths from poisoning exceeds, at present, that of all infectious diseases together, with the exception of tuberculosis, and is clearly a public-health problem that warrants attention. The heterogeneous group of causes that is included in official reporting as "poisoning" comprises many phases of medical, epidemiologic and sociologic concern, and the information to be had from an analysis of deaths from poisoning is related to such more specific problems of public health, toxicology and medicine as suicide, accidents, alcoholism and . . .
Shall The Journal be Removed to Washington?
Authors: J. C. HOAG
Journal: JAMA (1891)

<h3>THE ACTION OF THE CHICAGO MEDICAL SOCIETY.</h3><h3>To the Editor:</h3> At the January 19 meeting of the Chicago Medical Society a committee was appointed to consider the matter of removingThe Journal of the American Medical Associationfrom its present location. After considering the matter the committee reported at the February 2 meeting and recommended the passage of the following resolutions, which were unanimously adopted: <i>Resolved</i>, That the Chicago Medical Society as a body is opposed to the removal ofThe Association Journal, deeming that such change is unnecessary, at the present time, and contrary to the best interests ofThe Journaland the Asssociation, and be it <i>Resolved</i>, That the delegates from this Society to the forthcoming meeting of the American Medical Association, be and are hereby instructed to oppose such removal, and be it further <i>Resolved</i>, That the committee appointed at the last meeting be continued to take
Effects of incubation temperature and estrogen exposure on aromatase activity in the brain and gonads of embryonic alligators.
Authors: Matthew R Milnes, Robert N Roberts, Louis J Guillette
Journal: Environmental Health Perspectives (2002)

During embryogenesis, incubation temperature and the hormonal environment influence gonadal differentiation of some reptiles, including all crocodilians. Current evidence suggests that aromatase, the enzyme that converts androgens to estrogens, has a role in sexual differentiation of species that exhibit temperature-dependent sex determination (TSD). During the temperature-sensitive period (TSP) of sex determination, we compared aromatase activity in the brain and gonads of putative male and female alligator embryos to determine if aromatase activity in the embryonic brain could provide the hormonal environment necessary for ovarian development in a TSD species. In addition, we assessed the pattern of aromatase activity in the brain and gonads of embryos treated with estradiol-17beta (E(2)) and incubated at male-producing temperatures to compare enzyme activity in E(2) sex-reversed females to control males and females. This has particular significance regarding wildlife species living in areas contaminated with suspected environmental estrogens. Gonadal aromatase activity remained low during the early stages of the TSP in both sexes and increased late in the TSP only in females. Aromatase activity in the brain increased prior to gonadal differentiation in both sexes. These results suggest that aromatase activity in the brain is not directly responsible for mediating differentiation of the gonad. E(2) exposure at male-producing temperatures resulted in sex-reversed females that had intermediate gonad function and masculinized brain activity. This study indicates the need to examine multiple end points and to determine the persistence of developmental alterations in contaminant-exposed wildlife populations.
Efficacy and Safety of Oral Chelators in Treatment of Patients With Wilson Disease
Authors: Karl Heinz Weiss, Florentine Thurik, Daniel Nils Gotthardt, Mark Schäfer, Ulrike Teufel, Franziska Wiegand, Uta Merle, Daniela Ferenci–Foerster, Andreas Maieron, Rudolf Stauber, Heinz Zoller, Hartmut H. Schmidt, Ulrike Reuner, Harald Hefter, Jean Marc Trocello, Roderick H.J. Houwen, Peter Ferenci, Wolfgang Stremmel
Journal: Clinical Gastroenterology and Hepatology (2013)