tbuckley/cabot-search huggingface dataset:
Prevalence of the factor V Leiden mutation in hepatic and portal vein thrombosis.
Authors: A E Mahmoud, E Elias, N Beauchamp, J T Wilde
Journal: Gut (1997)

BACKGROUND: The factor V Leiden (FVL) mutation has been shown to be the most frequent cause of hereditary thrombophilia. The prevalence of the mutation in patients with Budd-Chiari syndrome (BCS) and portal vein thrombosis (PVT) has not been fully elucidated. AIMS: To investigate the association between the FVL mutation and BCS and PVT. PATIENTS: Thirty patients with BCS, 32 patients with PVT, and a control group of 54 patients with liver disorders and no history of thrombosis. METHODS: The factor V gene was analysed for the presence of the FVL mutation by a polymerase chain reaction (PCR) technique. The presence of the mutation was confirmed by DNA sequencing. RESULTS: Seven (23%) patients with BCS, one (3%) patient with PVT, and three (6%) patients in the control group were identified as having the FVL mutation. There of the BCS patients had coexisting hypercoagulable states. The prevalence of the FVL mutation was significantly higher in patients with BCS compared with patients with PVT and controls (p &lt; 0.04). The FVL mutation was the second most common aetiology associated with BCS. CONCLUSION: The FVL mutation is an important factor in the pathogenesis of BCS and screening for the disorder must be included in the investigation of patients presenting with this condition. In contrast, the FVL mutation is not a major predisposing factor in the pathogenesis of PVT.
Rate control of physiologic pacemakers by central venous blood temperature.
Authors: E Alt, C Hirgstetter, M Heinz, H Blömer
Journal: Circulation (1986)

Heart rate and central venous blood temperature (CVT) were measured in 31 people with different exercise capacities by means of a thermistor integrated into a lead that was placed in the right ventricle. Bicycle ergometric and treadmill stress tests with increasing workloads were performed. The maximum increase in CVT with ergometric exercise was found to be 1.3 degrees C at 250 W in healthy young volunteers and 1.0 degrees C at 125 W in cardiac patients. Despite a relatively greater increase in CVT in the elderly patients compared with the volunteers, the correlation between the increase in CVT and that in heart rate at the end of each exercise stage was found to be very high (r = .9693 in volunteers and r = .9864 in cardiac patients), independent of physical fitness. Even with everyday activities such as walking there was a marked increase in CVT. Due to its close relationship to human metabolism, CVT represents a good parameter for physiologic control of pacing rate.
Comparison Efficacy and Safety of Inhaled Magnesium Sulfate to Intravenous Magnesium Sulfate in Childhood Severe Asthma Exacerbation
Authors: Sureerat Watanatham, Gun Pongsamart, Mukda Vangveeravong, Tassalapa Daengsuwan
Journal: Journal of Allergy and Clinical Immunology (2015)
Red cell carriage of label: its limiting effect on the exchange of materials in the liver.
Authors: C A Goresky, G G Bach, B E Nadeau
Journal: Circulation Research (1975)

The red cell membrane is a permeability barrier that limits the equilibration of a variety of solutes between red cell and plasma water. We utilized the multiple indicator dilution technique to investigate the effect of this barrier on the exchange in the liver of a group of tracer substances that are not removed in net fashion from the hepatic circulation: thiourea, urea, and chloride. We demonstrated that, after preequilibration of the label with red cells, a red cell carriage effect appeared (the trapping and translocation of label in the red cells), that this effect was most marked when the permeability of the red cell was relatively low for the substance under consideration (thiourea), and that the effect became small when the permeability of the red cells was large for the exchanging substance (urea and chloride). We developed a theoretical description of the retarding effect of the red cell permeability barrier on the extravascular exchange of label and were able to use this description to obtain estimates of the red cell permeability from the in vivo dilution curves. We examined the effect of plasma injection, of changing the input in such a fashion that the label was not preequilibrated with red cells, and found both experimentally and theoretically, that for substances of low permeability the transit time from these experiments, if multiplied by the total water flow or solute flux, gave an overestimate of both the apparent total volume of distribution and the mass of traced material in the system. This last effect is of great importance for the practical design of many biological experiments. Reliable volume and mass estimates can be made only when the labeled material has been preequilibrated with red cells.
From the authors
Authors: S. Konstantinides
Journal: European Respiratory Journal (2005)

As D. Jimenez correctly pointed out, our study [1] was based on a large registry, which focused on patients with major, i.e. massive or submassive, pulmonary embolism (PE).This is the critical patient population in which not only confirmation of PE itself, but also, particularly a high level of suspicion and the prompt diagnosis (or exclusion) of right ventricular dysfunction may have enormous prognostic and therapeutic implications.We could show that the presence of at least one of pre-specified ECG abnormalities on admission was, apart from the clinical findings at presentation, a predictor of outcome in the acute phase.The message of our study is, therefore, that the ECG may be useful as a simple, noncostly initial (baseline) tool for assessing the patients' prognosis and for guiding further diagnostic work-up.We did not claim that the ECG should, or could, be used as an alternative to imaging studies, such as echocardiography or helical computed tomography, to diagnose RV dysfunction, or that ECG changes, such as the ones we examined could, by themselves, suffice to set the indication for thrombolytic treatment in PE.Rather, the value of a pathological ECG lies in the fact that it may help a large number of clinicians, regardless of their specialty, suspect and seek to confirm right ventricular dysfunction more frequently than is presently the case.
Influence of chlorpromazine on lysosomal alterations during myocardial ischaemia
Authors: K. R CHIEN, J S. CRIE, R. S DECKER, K. WILDENTHAL
Journal: Cardiovascular Research (1983)

Ligation of the circumflex artery of anaesthetised, open-chest rabbits caused a progressive increase in nonsedimentable cathepsin D activity in severely ischaemic myocardium and an anatomical redistribution of the enzyme from lysosomes into the cytosol, along with progressive ultrastructural signs of cellular damage and necrosis. Chlorpromazine pretreatment (15 mg X kg-1 intravenously) reduced the increase in nonsedimentable cathepsin D activity slightly, but no appreciable protective effect on the anatomical redistribution of the enzyme or the development of ultrastructural signs of necrosis could be detected. It is concluded that in this experimental model of myocardial infarction, high concentrations of chlorpromazine have a mild stabilising action on lysosomes, but the drug has minimal if any effect in protecting the heart from ischaemic damage.
THE INCOME TAX INQUIRY
Authors: W. Gordon
Journal: BMJ (1906)

Broad based bifurcation aneurysms are challenging. Various endovascular techniques aim at stabilizing the coil package in the aneurysm. Among these, the waffle cone technique provides a viable alternative to Y stenting in selected cases, incorporating a less complex delivery, and the reduced inherent risk of a single stenting procedure compared with the use of two stents in Y configuration. Unlike conventional stents, the distal end of the new pCONus device opens like a blossoming flower inside of the aneurysm to facilitate the waffle cone technique. In a case with tandem unruptured broad based middle cerebral artery bifurcation aneurysms, the complex anatomical challenge was resolved by a unique combination of both techniques: two pCONus deployed in Y configuration, offering stable neck coverage for coiling both aneurysms. The angiographic results with complete occlusion of both aneurysms and the uneventful clinical course at 90 days with continued daily administration of dual antiplatelet therapy are encouraging.
Predictive Accuracy of the Liverpool Lung Project Risk Model for Stratifying Patients for Computed Tomography Screening for Lung Cancer
Authors: Olaide Y. Raji, Stephen W. Duffy, Olorunshola F. Agbaje, Stuart G. Baker, David C. Christiani, Adrian Cassidy, John K. Field
Journal: Annals of Internal Medicine (2012)

Background: External validation of existing lung cancer risk prediction models is limited. Using such models in clinical practice to guide the referral of patients for computed tomography (CT) screening for lung cancer depends on external validation and evidence of predicted clinical benefit. Objective: To evaluate the discrimination of the Liverpool Lung Project (LLP) risk model and demonstrate its predicted benefit for stratifying patients for CT screening by using data from 3 independent studies from Europe and North America. Design: Case–control and prospective cohort study. Setting: Europe and North America. Patients: Participants in the European Early Lung Cancer (EUELC) and Harvard case–control studies and the LLP population-based prospective cohort (LLPC) study. Measurements: 5-year absolute risks for lung cancer predicted by the LLP model. Results: The LLP risk model had good discrimination in both the Harvard (area under the receiver-operating characteristic curve [AUC], 0.76 [95% CI, 0.75 to 0.78]) and the LLPC (AUC, 0.82 [CI, 0.80 to 0.85]) studies and modest discrimination in the EUELC (AUC, 0.67 [CI, 0.64 to 0.69]) study. The decision utility analysis, which incorporates the harms and benefit of using a risk model to make clinical decisions, indicates that the LLP risk model performed better than smoking duration or family history alone in stratifying high-risk patients for lung cancer CT screening. Limitations: The model cannot assess whether including other risk factors, such as lung function or genetic markers, would improve accuracy. Lack of information on asbestos exposure in the LLPC limited the ability to validate the complete LLP risk model. Conclusion: Validation of the LLP risk model in 3 independent external data sets demonstrated good discrimination and evidence of predicted benefits for stratifying patients for lung cancer CT screening. Further studies are needed to prospectively evaluate model performance and evaluate the optimal population risk thresholds for initiating lung cancer screening. Primary Funding Source: Roy Castle Lung Cancer Foundation.
FDA Authority Questioned
Authors: Neill F. David
Journal: JAMA (1976)

<h3>To the Editor.—</h3> After reading the editorial, "Clonazepam: A New Anticonvulsant" (235:1480, 1976), I am compelled to write, "Shame on the editor emeritus." The fifth paragraph of his otherwise satisfactory editorial contains the following: "The drug (clonazepam) is not approved by the FDA for treatment of grand mal, partial seizures with complex symptoms... or focal seizures." The fact is that the Food and Drug Administration (FDA) has no legal authority to approve<i>uses</i>of drugs that it sanctions for marketing. The FDA can approve only a drug's labeling, which may or may not recommend uses. If the FDA had the degree of authority attributed to it by the editor emeritus, lidocaine hydrochloride, for example, would never have been used in patients with cardiac arrhythmias, and propranolol hydrochloride probably would not be available for treating angina pectoris.
Agency criticises drug trial
Authors: Michael Day
Journal: BMJ (2006)

The failure of a drug trial that left six volunteers fighting for their lives in a London hospital cannot be blamed on the way the drug was made or administered, the final report of a government investigation has concluded. It did, however, criticise aspects of the trial's administrative procedures.

The report by the Medicine and Healthcare Products Regulatory Agency (MHRA) on events in March at the Northwick Park Hospital ( BMJ 2006;332: 683, 25 Mar) concludes that an “unpredicted biological action” of the experimental antibody treatment TGN1412 caused multiple organ failure in all six previously healthy male recipients. …
Problem Headaches: Physical Identification of Extracranial Pain Sources.
Authors: J. D. Kabler
Journal: Annals of Internal Medicine (1964)

s1 February 1964Problem Headaches: Physical Identification of Extracranial Pain Sources.J. D. Kabler, M.D., F.A.C.P.J. D. Kabler, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-2-334_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe majority of chronically recurrent severe headaches have their origin outside, rather than inside, the skull.The branches of the external carotid arteries are implicated in vascular headaches of the migraine type; the erector colli muscles and the muscles of mastication are major sources of muscle contraction headaches. Referred pain in the head can arise from the temporomandibular joints and from articulations in the neck.Despite the accessibility of these extracranial structures to examination, these common pain sources often escape identification. Appropriate diagnostic methods quickly yield pertinent information and do not require special skills or elaborate equipment.Specific techniques for... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Madison, Wisconsin PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 February 1964Volume 60, Issue 2_Part_1Page: 334-334KeywordsArthralgiaCarotid arteriesMigraineMusclesSkullTemporomandibular joint ePublished: 1 December 2008 Issue Published: 1 February 1964 PDF downloadLoading ...
Determinants of Serum Alpha-Fetoprotein Levels in Hepatitis C–Infected Patients
Authors: Peter Richardson, Zhigang Duan, Jennifer Kramer, Jessica A. Davila, Gia L. Tyson, Hashem B. El-Serag
Journal: Clinical Gastroenterology and Hepatology (2011)

Little information is available about what factors determine serum levels of alpha fetoprotein (AFP) (eg, demographic, virologic, or clinical features) among individuals who do not develop hepatocellular carcinoma (HCC). This information might improve AFP-based algorithms for HCC detection.We examined data from patients in the national Veterans' Affairs Hepatitis C Virus (HCV) Clinical Case Registry who received at least 1 AFP test (258,275 AFP tests in 76,357 patients; 1.9% developed HCC). We constructed hierarchical multivariate models of AFP levels. Potential predictors of AFP values included patients' sex, race, cirrhosis status, Model for End-Stage Liver Disease (MELD) score, HCV genotype, level of alanine aminotransferase (ALT) within 30 days before the AFP test, time to diagnosis of HCC, and time elapsed from the HCV index date.Significant determinants for increased levels of AFP included presence of cirrhosis, higher MELD scores, and increased levels of ALT. AFP levels were also affected by the interaction between ALT levels and the presence and time to development of HCC. Among patients who did not have HCC, the AFP level increased with the level of ALT; the AFP values in the presence of ALT 37-56 U/L, ALT 57-92 U/L, or ALT >92 U/L were 16%, 35%, and 68% higher, respectively, than AFP values at ALT 0-36 U/L. However, patients who developed HCC within 30 days of receiving the AFP test had a lower rate of increase in AFP with each higher category of ALT level, with increases of 31%, 39%, and 37% for the same respective ALT categories.In patients with chronic HCV infection, AFP and ALT values correlate; however, among patients with HCC, levels of AFP increase disproportionately to or unaccompanied by increases in levels of ALT. The prognostic and diagnostic value of AFP levels might be increased by adjusting for ALT values.
Periurethral Enterobacterial Carriage in Pathogenesis of Recurrent Urinary Infection
Authors: W. R. Cattell, M. A. McSherry, A. Northeast, E. Powell, H. J. L. Brooks, F. O'Grady
Journal: BMJ (1974)

Periurethral carriage rates of enterobacteria have been studied in 20 normal women, 34 patients between episodes of bacteriuria, 34 patients with the “urethral syndrome,” and 15 asymptomatic abacteriuric patients with a previous history of frequency and dysuria. Over a six-week period no difference in the Escherichia coli carriage rate was shown between these four groups. The carriage of all enterobacteria was slightly but significantly (P &lt;0.05) lower in normal women compared with the patient groups but no difference was observed between the latter. There was no difference in the recovery rate and carriage of individual E. coli serotypes between the four groups. It is concluded that the presence of enterobacteria or E. coli on the periurethral area is not the principal determinant factor in the pathogenesis of recurrent urinary tract infection or the urethral syndrome and that definition of carriage status is of little practical value in management.
THE PROFILE OF PATIENTS ATTENDING NATIONAL HEALTH SERVICE SPORT AND EXERCISE MEDICINE CLINICS: A QUESTIONNAIRE BASED SURVEY
Authors: C Watura, P O'Halloran, N Maffulli, C Hughes, D Morrissey
Journal: British Journal of Sports Medicine (2013)

In 2005, sport and exercise medicine (SEM) became a specialty in the United Kingdom to provide expert treatment of musculoskeletal injuries and promote physical activity (Cullen et al . BJSM 2005;39:250). There is no published research on the utilisation of publicly-funded SEM clinics. We investigated National Health Service (NHS) SEM patient sociodemographics, exercise participation, injuries and management in order to assess clinic accessibility and inform the development of services and SEM specialist training to better meet patient demands. This was a longitudinal observational study using a two-part questionnaire, Part A completed by patients and Part B by clinicians. We attempted to include all patients during December 2011 to April 2012 at all NHS SEM clinics in the London Deanery and two in the Oxford and West Midlands Deaneries. Exercise medicine referrals were not seen in these clinics so could not be included. Two clinics in London, four clinicians, 27 patients participated. Overall 70% (19/27) male, 67% (18/27) white, mean age 30, all employed, in full-time education or retired. Injuries were chronic instability, joint sprain, muscle, cartilage and tendon injury, from running 26% (7/27), football, non-sports, other sports each 15% (4/27). Eleven percent (3/27) did no sport. Six of seven that answered required imaging. Onward referrals were to orthopaedics, physiotherapy, general practise and podiatry. Descriptive analysis showed clinic demographics reflected area residents. Most injuries were at the knee with high demand for MRI and referral to orthopaedic services. Future studies should increase sample sizes to better understand sociodemographics, whether patients see multiple physicians before appropriate referral to NHS SEM clinic (O'Halloran et al . BJSM 2009;43(14):1143–8), if injury types are generalisable across clinics, and whether exercise medicine is being delivered alongside care of musculoskeletal injuries.
Alteration of human right bundle branch refractoriness by changes in duration of the atrial drive train.
Authors: W M Miles, E N Prystowsky
Journal: Circulation (1986)

We studied the effect of drive train duration on human right bundle branch refractoriness. Seven patients with a QRS duration of 0.10 sec or less and no preexcitation had functional right bundle branch block induced reproducibly with premature atrial stimulation. Refractoriness of the right bundle branch was defined as the longest H1H2 interval resulting in right bundle branch block and was determined in each patient at a constant pacing cycle length but at five to seven different atrial drive train durations varying from four to 99 complexes. In all seven patients, right bundle branch refractoriness decreased with increasing drive train duration (mean 15 msec). One-third of this decrease (5.0 msec) occurred between drive train durations of four and eight complexes, and close to two-thirds (9.3 msec) occurred between drive train durations of eight and 64 complexes. Very little further decrease (0.7 msec) occurred between 64 and 99 complexes. We conclude that right bundle branch refractoriness shortens progressively as the preceding drive train duration increases. This phenomenon may in part explain the disappearance of functional right bundle branch block during supraventricular tachycardia after a variable number of complexes without a change in cycle length of tachycardia.
Treatment with Lamivudine, Zidovudine, or Both in HIV-Positive Patients with 200 to 500 CD4+ Cells per Cubic Millimeter
Authors: Joseph J. Eron, Sharon L. Benoit, Joseph Jemsek, Rodger D. MacArthur, Jorge Santana, Joseph B. Quinn, Daniel R. Kuritzkes, Mary Ann Fallon, Marc Rubin
Journal: New England Journal of Medicine (1995)

The reverse-transcriptase inhibitor lamivudine has in vitro synergy with zidovudine against the human immunodeficiency virus (HIV). We studied the activity and safety of lamivudine plus zidovudine as compared with either drug alone as treatment for patients with HIV infection, most of whom had not previously received zidovudine.
"A Gigantic Medical Abuse."
Authors: E. H. Ryan-Tenison
Journal: BMJ (1894)

is a Bill to autlhorise the city of Paris to issue a loan of 117,000,000 francs for the purpose of carrying out important sanitary works for the benefit of the capital.It is proposed to adopt the system of getting rid of all waste matter by means of the sewers, and to establish a sewage farm instead of turning the sewage into the Seine as heretofore.AI.
Comparison of the tine and Mantoux tuberculin tests. Report of the Tuberculin Subcommittee of the Researched Committee of the British Thoracic Association.
Authors: J A Lunn, A J Johnson
Journal: BMJ (1978)

Intracutaneous (Mantoux 5 TU) and tine tuberculin tests were performed on the opposite arms of 307 people. The results of each test were read by two independent observers at either 48 or 72 hours. Positive readings were recorded in 59% of the Mantoux tests; induration was 10 mm or more in 34.7% of cases. Positive readings were recorded for 3.9% of the tine tests, and a further 15.5% were recorded in the doubtful category. The tine test is unsuitable for epidemiological use because of the high proportion of negative and doubtful results in people positive on the Mantoux test. For the same reasons its usefulness in clinical practice is very limited.