tbuckley/cabot-search huggingface dataset:
P519Correlation of PEP and pulse wave velocity in diagnosis of subclinical high cardiovascular risk in diabetic patients
Authors: JMS Shah
Journal: Cardiovascular Research (2014)

Purpose: PEP ( Presystolic period) and PWV(Pulse wave velocity ) measurements to assess and predict early cardiac (sub clinical) involvement in asymptomatic diabetic patients. Methods : 610 diabetic patients coming to Om Diabetes Centers without known heart history or complaints - subjected to routine investigations like Colin vascular profiler 1000( U S FDA approved) were at randomly selected for the study. All these patients history ,Clinical parameters ,waist -hip ratio BMI- biochemical parameters , and ECG were studied retrospectively. All these 610 Colin vascular reports analysis done retrospectively for systolic time intervals like PEP, ET, ET/PEP ratio and baPWV. PARAMETER NORMAL VALUES INTERPRETATION OF ABNORMAL VALUES : PEP (Pre Ejection Period) 86-106 ms deviation beyond 2SD (66ms&126 ms) warrants left Ventricular Dysfunction ET (Ejection Time) 260-310 ms deviation beyond 2SD (210ms- 360ms) warrants left Ventricular Dysfunction ET/PEP (Ejection Index) 2.5 -3.6 deviation beyond 2SD (1.4&4.7) warrants left ventricular Dysfunction PEP/ET (PEP Index) 30%to 40% deviation beyond 2SD (20% and 50%) warrants left ventricular Dysfunction BaPWV 1400cm/s more than 1400 cm/s implies significant atherosclerosis value up Value above 36% high CV risk Results : ET and ET /PEP was abnormal only in 8 and 25 patients respectively and this finding was not statistically significant. However out 610 patients total 63 (10%) patients had abnormal PEP warranting sub clinical left ventricular dysfunction. 210 patients had both leg ba PWV abnormal implying significant atherosclerosis and high CV risk and all these values were statistically highly significant. But there was no statistically significant difference between male and female in both PEP and baPWV interpretation. Table: PARAMETERS MALE FEMALE TOTAL NO OF PATIENTS 323(53%) 287(47%) 610 PEP 35 ( 11%) 28( 10%) 63(10%) BaPWV 114( 35% ) 96(33%) 210(34%) Conclusion: Analyses of specific intervals of the cardiac cycle have indicated that the systolic pre ejection period (PEP) may serve as a reliable index of SNS activity independent of parasympathetic inhibition. Use of systolic time intervals to predict early left ventricular dysfunction and pulse wave velocity to predict high CV risk can be used to plan therapeutic interventions and therapeutic exercise in asymptomatic diabetic patients well in advance. Thus measuring this parameters periodically as routine investigations my help in preventing and to some extent reversing early atherosclerosis and thus reducing Future cardiovascular risk in diabetic patients.
Recent advances: Tropical medicine
Authors: H. W Murray
Journal: BMJ (2000)

Considerable progress has been made towards three key objectives in tropical infectious diseases in recent years: a clearer understanding of basic microbiology, pathogenesis, and host defence; expanded epidemiology; and new approaches to overall clinical management.However, problems have also emerged.Development of vaccines has been slow or non-existent, the efficacy of conventional treatment has fallen, HIV has affected the course of some diseases, 1 the cost of some new drugs has prohibited their use, and drug development for tropical diseases has fallen. 2Inadequate vector control; poor nutrition, sanitation, and drinking water; civil war; and bare bones health budgets continue to present obstacles to preventing and controlling epidemics. 2 3 This report highlights the current state of and recent advances made in diagnosis, treatment, and prevention in five tropical infections: African trypanosomiasis, leishmaniasis, lymphatic filariasis, malaria, and schistosomiasis.We have focused on these diseases because of their high level morbidity or mortality. 2Although we have discussed only clinical management, experimental work in research laboratories continues to drive these clinical advances. 4 MethodsThis article is based on the hands-on clinical and laboratory research knowledge of the authors, who are experts in the diseases discussed.HWM wrote the section on leishmaniasis, JP the section on African trypanosomiasis, TBN the section on lymphatic filariasis, SLH the section on malaria, and AAFM the section on schistosomiasis.Personal knowledge was supplemented by review of relevant recent literature.
Cardiac Response to Repeated Doses of Isoproterenol Aerosol
Authors: CHANG SHIM
Journal: Annals of Internal Medicine (1975)

We studied 18 patients with moderate to severe asthma for cardiac response to repeated doses of isoproterenol aerosol. In only 1 patient was there a significant increase in heart rate immediately after inhalation of isoproterenol aerosol, and it lasted only for 1 minute. In 2 patients increased heart rate was either due to breathholding or to the propellant in the aerosol. There was no cumulative effect on heart rate. Arrhythmias did not develop at any time despite repeated doses of aerosol every 5 to 20 minutes. Peak expiratory flow rate increased 5 minutes after the first dose, and it increased even further after repeated doses; at no time did it decrease after repeated doses.
Review: Hemoglobin-based blood substitutes increase mortality and myocardial infarction in surgical, trauma, and stroke settings
Authors: Lillian S. Kao
Journal: Annals of Internal Medicine (2008)

Source Citation Natanson C, Kern SJ, Lurie P, Banks SM, Wolfe SM. Cell-free hemoglobin-based blood substitutes and risk of myocardial infarction and death: a meta-analysis. JAMA. 2008;299:2304-12. 18443023
BLOOD PRESSURE, CHOLESTEROL CONTENT OF SERUM AND TISSUES, AND ATHEROGENESIS IN THE RAT
Authors: Q. B. Deming, E. H. Mosbach, M. Bevans, M. M. Daly, L. L. Abell, E. Martin, L. M. Brun, E. Halpern, R. Kaplan
Journal: The Journal of Experimental Medicine (1958)

Rats on a stock diet with added cholesterol, cholic acid, and thiouracil developed increased concentrations of cholesterol, total lipide, and beta lipoprotein in the serum, and an increased content of cholesterol in the liver and carcass, despite the fact that the diet produced a cessation of endogenous cholesterol synthesis. Rats with high serum lipide concentrations developed intimal lesions similar to those of human atherosclerosis. The induction of hypertension by desoxycorticosterone and salt accelerated the development of hypercholesterolemia, hyperlipemia, increase in tissue cholesterol content, and atherosclerotic changes in the intima. Hypertension induced by renal artery constriction also intensified the hypercholesterolemia and hyperlipemia. On the other hand, rats receiving desoxycorticosterone acetate without salt or salt without desoxycorticosterone acetate did not show any intensification of hypercholesterolemia or hyperlipemia. The extent of the atherosclerotic lesions was correlated with the concentration of cholesterol in the serum. There was also a positive correlation between blood pressure and the degree of hypercholesterolemia. It remained uncertain whether the increase in atherosclerosis in the hypertensive animals was dependent on the increased lipide content of serum and tissues or on a local effect of the elevated blood pressure.
A Comparison of Coronary Angioplasty with Fibrinolytic Therapy in Acute Myocardial Infarction
Authors: Henning R. Andersen, Torsten T. Nielsen, Klaus Rasmussen, Leif Thuesen, Henning Kelbaek, Per Thayssen, Ulrik Abildgaard, Flemming Pedersen, Jan K. Madsen, Peer Grande, Anton B. Villadsen, Lars R. Krusell, Torben Haghfelt, Preben Lomholt, Steen E. Husted, Else Vigholt, Henrik K. Kjaergard, Leif Spange Mortensen
Journal: New England Journal of Medicine (2003)

For the treatment of myocardial infarction with ST-segment elevation, primary angioplasty is considered superior to fibrinolysis for patients who are admitted to hospitals with angioplasty facilities. Whether this benefit is maintained for patients who require transportation from a community hospital to a center where invasive treatment is available is uncertain.We randomly assigned 1572 patients with acute myocardial infarction to treatment with angioplasty or accelerated treatment with intravenous alteplase; 1129 patients were enrolled at 24 referral hospitals and 443 patients at 5 invasive-treatment centers. The primary study end point was a composite of death, clinical evidence of reinfarction, or disabling stroke at 30 days.Among patients who underwent randomization at referral hospitals, the primary end point was reached in 8.5 percent of the patients in the angioplasty group, as compared with 14.2 percent of those in the fibrinolysis group (P=0.002). The results were similar among patients who were enrolled at invasive-treatment centers: 6.7 percent of the patients in the angioplasty group reached the primary end point, as compared with 12.3 percent in the fibrinolysis group (P=0.05). Among all patients, the better outcome after angioplasty was driven primarily by a reduction in the rate of reinfarction (1.6 percent in the angioplasty group vs. 6.3 percent in the fibrinolysis group, P<0.001); no significant differences were observed in the rate of death (6.6 percent vs. 7.8 percent, P=0.35) or the rate of stroke (1.1 percent vs. 2.0 percent, P=0.15). Ninety-six percent of patients were transferred from referral hospitals to an invasive-treatment center within two hours.A strategy for reperfusion involving the transfer of patients to an invasive-treatment center for primary angioplasty is superior to on-site fibrinolysis, provided that the transfer takes two hours or less.
Value of magnifying chromoendoscopy and narrow band imaging (NBI) in classifying colorectal polyps: a prospective controlled study
Authors: J. Tischendorf, H. Wasmuth, A. Koch, H. Hecker, C. Trautwein, R. Winograd
Journal: Endoscopy (2007)

See also: Commentaire de travail de J. W. Tischendorf et al., pp. 1092Endoscopy 2007; 39(12): 87-87DOI: 10.1055/s-0032-1308895
Labour with Cardiac Failure: Low Spinal Anaesthesia
Authors: H. Burton
Journal: BMJ (1943)

MEDBCRtLTJOHRN 389 measure except in the case of gross nasal obstruction or where it forms a contributory factor in the causation of catarrhal deafness or sinusitis.3. Diphthleria.-Thiswas treated at one central hospital where there were special nursing facilities.The cases seen here, though few in number, were of marked virulence, and although antidiphtheritic serum was given early in adequate doses it did not appear to have the usual effect.Peripheral neuritis seemed much more common and severe. SummaryAn analysis is made of ear, nose, and throat casualties occurring in a general hospital in the Middle East.The commonest diseases were acute tonsillitis, otitis media, otitis extema, and sinusitis.Suggestions are made by which (a) the incidence of these diseases may be lowered; (b) the period of admission to hospital decreased; (c) mcre adequate treatment in general instituted.Miscellaneous notes connected with ear, nose, and throat work are included.My thanks are due to Col. H.
The Left Ventricle in “Chronic Bronchitis and Emphysema”
Authors: Alfred P. Fishman
Journal: New England Journal of Medicine (1971)

By the early 1940's, clinicians and pathologists were agreed that the heart was apt to be enlarged in chronic "emphysema." And, although the links between "emphysema" and cardiomegaly remained unclear, speculation was rife that abnormal blood gases were somehow involved. Suspicion had been aroused by two bits of evidence: acute hypoxia and hypercapnia had been shown to increase the work of the right ventricle; and right ventricular hypertrophy was found to be a common feature of life at high altitude — i.e., of chronic hypoxia.During the 1950's and 1960's, a rapid succession of clinical anatomic and physiologic insights helped . . .
Coroner is asked to review deaths of nursing home residents
Authors: Susan Mayor
Journal: BMJ (2005)

A coroner has been asked to look into the deaths of 13 elderly residents who died in a UK nursing home after a review found that standards there raised “serious concerns.”

Twenty eight residents died at the Maypole Nursing Home in Birmingham between 2002 and 2003. The home, which has 36 beds, failed to notify care standard officials of 15 of these deaths. It was closed in March 2003 after an inspection by the Commission for Social Care Inspection.

Birmingham and Black Country Strategic Health Authority then coordinated a wide ranging review, which found that the home was failing …
T-tubules and ryanodine receptor microdomains: on the road to translation
Authors: K. R. Sipido, H. Cheng
Journal: Cardiovascular Research (2013)

The concept of localized signalling in the coupling between L-type Ca2+ channels, LTCC, in the sarcolemma and ryanodine receptors, RyR, in the sarcoplasmic reticulum was introduced in the late 1980s to address one of the conundrums of excitation–contraction coupling. The tightly regulated Ca2+ signals observed in isolated cardiac myocytes under voltage clamp conditions, or in skinned myocytes, were hard to explain in a global control cell model in which intracellular calcium is uniform everywhere at all time. However, they could be understood in a concept of local control within a microdomain as proposed in the theoretical studies by Stern1 and others. Concomitant insight into the ultrastructure of the dyadic cleft and gating properties of single LTCC and RyR channels provided the critical elements to develop the microdomain concept where clusters of RyR interact with clusters of LTCC in the dyad. Such a functional unit was termed a couplon, consisting of clusters of RyR and LTCC in close juxtaposition (∼12 nm) of the two membranes. Sparks, spontaneous Ca2+ release events from RyR, were the first visualization of the local events2 and were typically associated with the dyad near T-tubules, TTs. Spurred by improved imaging of Ca2+ signals and of myocyte ultrastructure, and by computational modelling and genetic manipulations, our knowledge on the characteristics and functional impact of microdomain signalling near TTs has grown tremendously. The evidence that modulation and remodelling of these microdomains is involved in global cardiac dysfunction in hypertrophy and failure has further fuelled research.

This spotlight issue gives an update of current knowledge emphasizing the outlook for signalling and cardiac remodelling, and highlighting the novel and emerging research directions.

Early models pictured a couplon as consisting of geometrical arrays of RyRs with estimates for the number of molecules between 15 and >100 …
Investigation of Coronary Vessels in Microscopic Dimensions by Two- and Three-dimensional NMR Microscopic Imaging in the Isolated Rat Heart
Authors: Wolfgang R. Bauer, Karl-Heinz Hiller, Fridtjof Roder, Stefan Neubauer, Alexander Fuchs, Christoph Große Boes, Rene Lutz, Peter Gaudron, Kai Hu, Axel Haase, Georg Ertl
Journal: Circulation (1995)

Background Nuclear magnetic resonance (NMR) imaging of macroscopic coronary vessels is rapidly advancing, whereas little attention has focused on development of NMR techniques for investigation of coronary microvessels. Such techniques would be of particular importance, since conventional methods to visualize coronary microvessels have specific limitations. The aim of our study was to develop two- and three-dimensional (2D and 3D) high-resolution imaging of coronary microvessels. Quantitative analysis of vessel size was performed in tomograms and applied to evaluate the vasoconstrictor effect of endothelin 1. Methods and Results Angiographic imaging was performed on an 11.75-T magnet by 2D and 3D gradient-echo pulse sequences. In tomograms, the validity of this method in providing correct vessel size was tested by phantom experiments. Experiments were carried out in the isolated constant-pressure–perfused rat heart with continuous registration of coronary flow and left ventricular pressure. NMR pulse sequences were pressure-triggered in mid diastole. Four groups of hearts were studied. In group 1 (n=20), 2D imaging perpendicular and parallel to the long axis of the heart was performed. Cross sections of vessels with diameter &gt;140 μm were clearly detectable. In group 2 (control, n=5) and group 3 (n=13), tomograms perpendicular to the long axis were obtained before and after administration of vehicle (group 2) and 200 pmol endothelin 1 bolus (group 3). Vehicle had no effect on vessel cross section. Endothelin 1, which decreased global coronary flow by 47%, reduced vessel cross section by 38±19%. A weak but, on average, significant inverse correlation between area of cross section and vessel size was found. In group 4 (n=10), 3D imaging was performed in 7 normal hearts and 3 hearts with anterior myocardial infarction. A 3D image of the entire coronary artery tree was obtained, revealing excellent agreement with anatomic studies. In infarcted rat hearts, occlusion of the left coronary artery was demonstrated. Conclusions Visualization and quantification of coronary microvessels are feasible by NMR microscopy. NMR microscopy bears the potential of becoming a powerful tool for the investigation of the coronary microcirculation.
Prospective six year follow up of patients withdrawn from a randomised study comparing parenteral gold salt and methotrexate
Authors: O. Sander, G. Herborn, E. Bock, R. Rau
Journal: Annals of the Rheumatic Diseases (1999)

<h3>OBJECTIVE</h3> To confirm the impression of a better outcome of patients withdrawn from parenteral gold salt therapy compared with those withdrawn from methotrexate. <h3>METHODS</h3> Patients with early, active, and erosive RA were randomised for a double blind trial to receive either weekly 15 mg intramuscular methotrexate or 50 mg goldsodiumthiomalate. If the drug had to be withdrawn because of side effects treatment was continued with the other drug in still active disease. Patients with insufficient response were treated with a combination of both drugs. All patients were followed up by an extended clinical and radiographic evaluation. <h3>RESULTS</h3> 64 patients each were allocated to methotrexate and gold treatment. After 72 months a complete record was available for 88% of patients. Within the first 36 months 38 patients withdrew from gold treatment (95% because of side effects) and 23 patients withdrew from methotrexate (57% because of side effects). A significant 40% to 70% improvement of all parameters (erythrocyte sedimentation rate, C reactive protein, swollen and tender joints, radiological progression) compared with baseline was observed in patients completing their randomised treatment with gold or methotrexate. The same improvement over three years was seen in patients who withdrew from gold treatment, while patients withdrawing from methotrexate experienced a deterioration of their disease. <h3>CONCLUSION</h3> Withdrawals represent the majority of patients in long term drug trials. Patients with early RA stopping gold because of side effects show almost the same sustained improvement as patients continuing gold or methotrexate. Patients withdrawn from methotrexate experience a reactivation of their disease.
Utilization of tyrosine-containing dipeptides and N-acetyl-tyrosine in hepatic failure
Authors: Wilfred Druml, Wolfgang Hübl, Erich Roth, Herbert Lochs
Journal: Hepatology (1995)

The impact of hepatic dysfunction on the elimination and hydrolysis of three potential tyrosine sources for total parenteral nutrition, the dipeptides L-alanyl-L-tyrosine (Ala-Tyr) and glycyl-L-tyrosine (Gly-Tyr), and N-acetyl-L-tyrosine (Nac-Tyr) were evaluated in six patients with hepatic failure (five chronic, one acute) and seven healthy subjects. In controls, whole-body clearance (Cltot) of Ala-Tyr was higher than of Gly-Tyr (3,169 +/- 214 vs. 1,780 +/- 199 mL/kg/min, P < .01), and both exceeded clearance of Nac-Tyr (309 +/- 29 mL/kg/min, P > .01). Both dipeptides were hydrolyzed and released tyrosine immediately. In hepatic failure, elimination and hydrolysis of Ala-Tyr and Gly-Tyr were comparable to controls, but Cltot of Nac-Tyr was reduced (236 +/- 26 mL/kg/min). Neither in controls nor in patients an increase in plasma tyrosine concentration was seen after Nac-Tyr, and the major part of Nac-Tyr infused was lost in urine. The Cltot of tyrosine as evaluated after Ala-Tyr infusion (with the immediate release of tyrosine) was severely reduced in hepatic failure (152.7 +/- 38.4 vs. 484.4 +/- 41.4 mL/kg/min, P < .001) and half-life (kle) was retarded from 14.4 +/- 1.4 to 90.2 +/- 32.2 minutes (P < .03). The authors conclude that acute and chronic hepatic dysfunction does not affect elimination and hydrolysis of the dipeptides Ala-Tyr and Gly-Tyr and the constituent amino acids are released immediately. Nac-Tyr elimination was not grossly affected by hepatic failure, but neither in healthy subjects nor in hepatic failure patients was an increase of tyrosine seen. Both dipeptides but not Nac-Tyr may serve as a tyrosine source in parenteral nutrition. Moreover, by its rapid hydrolysis, the use of Ala-Tyr, for the first time, enables a simple rapid nonisotope evaluation of tyrosine kinetics for assessment of liver function.
Planar xanthoma due to cholestasis in graft versus host disease
Authors: T. Moriue, K. Yoneda, J. Katsuura, Y. Matsuoka, K. Nakai, I. Yokoi, Y. Matsuda, N. Nibu, I. Miyamoto, T. Demitsu, Y. Kubota
Journal: British Journal of Dermatology (2007)
Cell count and lymphocyte immunophenotyping of bronchoalveolar lavage fluid in healthy Brazilian children
Authors: I.F. de Mendonça Picinin, P. Camargos, R.F. Mascarenhas, S.M.E. Santos, C. Marguet
Journal: European Respiratory Journal (2011)

To the Editors:

Bronchoalveolar lavage (BAL) is an invaluable tool in the diagnosis and follow-up of childhood lung diseases and is considered to be a safe procedure with low complication rates [1]. The information gathered through the interpretation of the BAL cellular profile, clinical findings and thorax imaging provide a clinical decision without the need for more invasive methods, such as an open-lung or transbronchial biopsy [2, 3]. Furthermore, T-lymphocyte flow cytometry immunophenotyping has also proved to be another diagnostic tool for lung diseases in paediatric patients [4].

The interpretation of BAL cellular profiles in children with lung diseases is performed via a comparison with reference values produced by studies conducted with healthy children [5]. Most of these studies were conducted in Europe in the mid-1990s, during laryngeal stridor management [2, 6–8] or with children undergoing elective surgery under general anaesthesia for nonpulmonary illnesses [3, 9]. However, to date, no similar study has been conducted in a low- or middle-income country.

This study was conducted to assess the total and differential BAL count, and to conduct lymphocyte subset analysis in Brazilian children from low-income families …
THE DEVELOPMENT AND LOCALIZATION OF THE DERMAL PNEUMOCOCCIC LESION IN THE RABBIT
Authors: Kenneth Goodner
Journal: The Journal of Experimental Medicine (1931)

An attempt has been made to analyze the factors involved in the development and localization of the dermal pneumococcic lesion in the rabbit. The character and quantity of the edema fluid which forms during the early phases of the lesion are intimately concerned in its development and spread. It contains an antithrombic substance, probably derived from the pneumococci, and delayed coagulation probably facilitates its movement through the tissue. The direction of spread in the skin is determined by gravity, and the fluid finally localizes in the more dependent regions. The distance that the pneumococcic lesion travels and the local tissue characters have much to do with the amount of fluid that accumulates. Studies are also reported of some factors which alter the rate of spread of the edema fluid. An acceleration in rate occurs when H. influenzae is used as an associative infective agent with the Pneumococcus.