tbuckley/cabot-search huggingface dataset:
Regression of Hypertensive Left Ventricular Hypertrophy by Losartan Compared With Atenolol
Authors: Richard B. Devereux, Björn Dahlöf, Eva Gerdts, Kurt Boman, Markku S. Nieminen, Vasilios Papademetriou, Jens Rokkedal, Katherine E. Harris, Jonathan M. Edelman, Kristian Wachtell
Journal: Circulation (2004)

Background— An echocardiographic substudy of the Losartan Intervention for Endpoint Reduction in Hypertension (LIFE) trial was designed to test the ability of losartan to reduce left ventricular (LV) mass more than atenolol. Methods and Results— A total of 960 patients with essential hypertension and LV hypertrophy (LVH) on screening ECG were enrolled at centers in 7 countries and studied by echocardiography at baseline and after 1, 2, 3, 4, and 5 years’ randomized therapy. Clinical examination and blinded readings of echocardiograms in 457 losartan-treated and 459 atenolol-treated participants with ≥1 follow-up measurement of LV mass index (LVMI) were used in an intention-to-treat analysis. Losartan-based therapy induced greater reduction in LVMI from baseline to the last available study than atenolol with adjustment for baseline LVMI and blood pressure and in-treatment pressure (−21.7±21.8 versus −17.7±19.6 g/m 2 ; P =0.021). Greater LVMI reduction with losartan was observed in women and men, participants &gt;65 or &lt;65 years of age, and with mild or more severe baseline hypertrophy. The difference between treatment arms in LVH regression was due mainly to reduced concentricity of LV geometry in both groups and lesser increase in LV internal diameter in losartan-treated patients. Conclusions— Antihypertensive treatment with losartan, plus hydrochlorothiazide and other medications when needed for pressure control, resulted in greater LVH regression in patients with ECG LVH than conventional atenolol-based treatment. Thus, angiotensin receptor antagonism by losartan has superior efficacy for reversing LVH, a cardinal manifestation of hypertensive target organ damage.
Emergency Medical Systems Act Of 1973
Authors: Eugene L. Nagel
Journal: JAMA (1975)

To the Editor.—  Dr Eliastam (232:135, 1975) criticized Dr Harvey's description of the Emergency Medical Systems (EMS) Act (230:1139, 1974) as being idealistic and unrealistic. This latter word was perhaps not used, but I think it adequately describes the content of his communication. It seemed to be his point that there would be no guarantee of Utopia under the Act and that there are doubts regarding the effect of the Act thus far, if and to what extent it will further be funded; and, finally, the ultimate product of the Act. All of these doubts and reservations are valid and are shared by many of us who work in the field of emergency care. The doubt is not, however, specific for emergency care, but extends into all activities of human endeavor, since very little is assured by virtue of either legislation or funding. There was a dearth of substance, however,
Stereokineradiography
Authors: Majic S. Potsaid
Journal: New England Journal of Medicine (1964)

KINERADIOGRAPHY (radiography of kinetics or things in motion) is intended as an all-inclusive term to denote studies of motion obtained by radiologic means regardless of the augmenting system. It covers such x-ray methods as direct rapid serial radiography, conventional fluoroscopy, motion-picture photography of fluorescent screens or the output side of image tubes, television methods, including films of a kinescope or televised images retained on videomagnetic tape, and any other device that may be used for the purpose of studying and interpreting function through radiologic images in motion. In the past stereopsis has meant the visual appreciation of depth by whatever . . .
ABC of intensive care: Organisation of intensive care
Authors: D. Bennett, J. Bion
Journal: BMJ (1999)

Intensive care dates from the polio epidemic in Copenhagen in 1952. Doctors reduced the 90% mortality in patients receiving respiratory support with the cuirass ventilator to 40% by a combination of manual positive pressure ventilation provided through a tracheostomy by medical students and by caring for patients in a specific area of the hospital instead of across different wards. Having an attendant continuously at the bedside improved the quality of care but increased the costs and, in some cases, death was merely delayed.

These findings are still relevant to intensive care today, even though it has expanded enormously so that almost every hospital will have some form of intensive care unit. Many questions still remain unanswered regarding the relation between costs and quality of intensive care, the size and location of intensive care units, the number of nursing and medical staff and intensive care beds required, and how to direct scarce resources towards those most likely to benefit.

Intensive care beds are occupied by patients with a wide range of clinical conditions but all have dysfunction or failure of one or more organs, particularly respiratory and cardiovascular systems. Patients usually require intensive monitoring, and most need some form of mechanical or pharmacological support such as mechanical ventilation, renal replacement therapy, or vasoactive drugs. As patients are admitted from every department in the hospital, staff in intensive care need to have a broad range of clinical experience and a holistic approach to patient care.



“Experimental” intensive care ward, St George's Hospital, 1967



The length of patient stay varies widely. Most patients are discharged within 1-2 days, commonly after postoperative respiratory and cardiovascular support and monitoring. Some patients, however, may require support for several weeks or months. These patients often have multiple organ dysfunction. Overall mortality in intensive care is 20-30%, with …
Long term administration of L-arginine, L-NAME, and the exogenous NO donor molsidomine modulates urinary nitrate and cGMP excretion in rats
Authors: R. H Boger, S. M Bode-Boger, U. Gerecke, J. C Frolich
Journal: Cardiovascular Research (1994)

Objective: The effects of long term oral administration of L-arginine, NG-nitro-L-arginine methyl-ester (L-NAME), or molsidomine v placebo on blood pressure and the urinary excretion rates of NO3− and cyclic GMP were studied in Munich Wistar Frömter (MWF) rats. Methods: L-arginine (2 g·kg−1 body weight, n = 8), NG-nitro-L-arginine methylester (L-NAME; 5 mg·kg−1, n = 8), or molsidomine (3 mg·kg−1, n = 8) were given in drinking water and compared with placebo (n = 8) over a period of five months. Urinary excretion rates of NO3− (by gas chromatography) and cyclic GMP (by radioimmunoassay) were assessed in monthly intervals, as well as systolic blood pressure (tail plethysmography). Results: Mean basal blood pressure was 143.5(SEM 2.2) mm Hg. It was unaffected by L-arginine or molsidomine, but continuously and significantly increased during L-NAME treatment to 199.3(6.4) mm Hg (p<0.05). Urinary excretion of NO3− increased by 20-41% v controls in L-arginine and molsidomine treated rats (p<0.05), and decreased by 5-15% in L-NAME treated rats (p<0.05). Urinary excretion of cyclic GMP increased by 9-38% v controls in the L-arginine and molsidomine treated groups and decreased by 5-20% in the L-NAME treated animals. Consistent with their higher blood pressure, L-NAME treated animals displayed cardiac hypertrophy. Conclusions: Determination of urinary NO3− excretion by gas chromatography is a sensitive and specific method to assess NO formation in vivo. Long term oral administration of L-arginine in MWF rats increases NO production (as assessed by the urinary excretion rates of NOf and cyclic GMP), but does not significantly influence systolic bood pressure, whereas L-NAME induces sustained hypertension and cardiac hypertrophy due to inhibition of NO formation. Cardiovascular Research 1994;28:494-499
Resourceful Women Unmask Cactus Spines
Authors: Malcolm B. Lawton
Journal: JAMA (1985)

To the Editor.—  Dr Gelbard's 1 letter, Removal of Small Cactus Spines From the Skin, reminded me of two similar experiences. In one experience, I rubbed the lateral aspect of my index finger against the rough edge of a fiberglass sheet, resulting in many very small fibers partially embedded in the skin. In the other incident, the lateral aspect of my hand slipped against a rough weathered piece of redwood, resulting in a multitude of quite small slivers in the skin.  In both these incidents, tweezers were ineffective, because of the small size and large number of fibers embedded. At the suggestion of my resourceful wife, a peel-off facial mask was applied generously to the area. It air-dried in five minutes, but could be dried in one to two minutes using a hair drier. Once dry, the facial mask was peeled off, extracting the fibers in one instance and the slivers
Surgical Correction of Congenital Intracardiac Defects in Adult Patients
Authors: J. Gordon Scannell, W. Gerald Austen
Journal: New England Journal of Medicine (1965)

OVER the past seven years approximately 400 patients have been surgically treated at the Massachusetts General Hospital with the assistance of cardiopulmonary bypass. The majority of these patients have been twenty-one or more years of age, including 84 adults who underwent surgical correction of a congenital heart lesion. The present communication concerns this group of 84.Case Material and ResultsThe 84 patients ranged in age from twenty-one to fifty-seven, with an average age of thirty-six years (Table 1). The sex distribution was equal. Nineteen patients had an ostium-secundum type of atrial septal defect, 5 a sinus-venosus atrial . . .
Identification of an obesity quantitative trait locus on mouse chromosome 2 and evidence of linkage to body fat and insulin on the human homologous region 20q.
Authors: A V Lembertas, L Pérusse, Y C Chagnon, J S Fisler, C H Warden, D A Purcell-Huynh, F T Dionne, J Gagnon, A Nadeau, A J Lusis, C Bouchard
Journal: Journal of Clinical Investigation (1997)

Chromosomal synteny between the mouse model and humans was used to map a gene for the complex trait of obesity. Analysis of NZB/BINJ x SM/J intercross mice located a quantitative trait locus (QTL) for obesity on distal mouse chromosome 2, in a region syntenic with a large region of human chromosome 20, showing linkage to percent body fat (likelihood of the odds [LOD] score 3.6) and fat mass (LOD score 4.3). The QTL was confirmed in a congenic mouse strain. To test whether the QTL contributes to human obesity, we studied linkage between markers located within a 52-cM region extending from 20p12 to 20q13.3 and measures of obesity in 650 French Canadian subjects from 152 pedigrees participating in the Quebec Family Study. Sib-pair analysis based on a maximum of 258 sib pairs revealed suggestive linkages between the percentage of body fat (P < 0.004), body mass index (P < 0.008), and fasting insulin (P < 0.0005) and a locus extending approximately from ADA (the adenosine deaminase gene) to MC3R (the melanocortin 3 receptor gene). These data provide evidence that a locus on human chromosome 20q contributes to body fat and insulin in a human population, and demonstrate the utility of using interspecies syntenic relationships to find relevant disease loci in humans.
Critical study of 5% guanethidine in ocular manifestations of Graves's disease
Authors: N. E. F. Cartlidge, A. L. Crombie, J. Anderson, R. Hall
Journal: BMJ (1969)

Assessment was made of 5% local guanethidine in treating eye manifestations in euthyroid patients with either treated thyrotoxicosis or ophthalmic Graves9s disease. In a double-blind crossover study guanethidine caused greater improvement in lid retraction than a control solution. A long-term study showed that this improvement was maintained. A much lower incidence of side-effects was noted with 5% guanethidine than with 10% solution.
DUSP4-mediated accelerated T-cell senescence in idiopathic CD4 lymphopenia
Authors: Alexandre Bignon, Alexis Régent, Laurence Klipfel, Aude Desnoyer, Pierre de la Grange, Valérie Martinez, Olivier Lortholary, Ali Dalloul, Luc Mouthon, Karl Balabanian
Journal: Blood (2015)
Dorsal column stimulation in multiple sclerosis.
Authors: C H Hawkes
Journal: BMJ (1980)

Size of tumour and operation performed in relation to length of history, 1979 Short* Intermediate Longt history history history No of inoperable tumours 1 2 7 Average tumour diameter (cm) 16 2-6 3-1 No of mastectomies 19 29 8 No of wide local excisions 16 22 1 Total No of patients 36 53 16*Short history .onemonth.tLong history-one year.radiotherapy.The selection of patients for conservative surgery is on the basis of the relative volume of the tumour to the breast and on its position.Patients with central tumours still undergo mastectomy but patients with relatively small medial or lateral tumours have wide local excision.If wide local excision and postoperative radiotherapy can control local disease as effectively as mastectomy, then our message to the public is not that shorter delay neces- sarily means longer survival but that shorter delay means less radical surgery.
The biochemical pharmacology of thromboxane synthase inhibition in man.
Authors: G A FitzGerald, I A Reilly, A K Pedersen
Journal: Circulation (1985)

Selective inhibitors of thromboxane synthase have two theoretical advantages over inhibitors of the cyclooxygenase enzyme as potential antithrombotic compounds. First, they do not prevent formation of prostacyclin, a platelet-inhibitory, vasodilator compound, coincident with inhibiting thromboxane biosynthesis. Second, the prostaglandin endoperoxide substrate that accumulates in the platelet in the presence of thromboxane synthase inhibition may be donated to endothelial prostacyclin synthase at the site of platelet-vascular interactions (endoperoxide "steal"). Selective inhibition of thromboxane biosynthesis coincident with enhanced prostacyclin formation in vivo has been observed after administration of these compounds to man. Despite these attractive features and the efficacy of these compounds in diverse short-term animal preparations of thrombosis, investigations of their efficacy in human disease have proven disappointing. This may reflect on the importance of thromboxane A2 in the diseases that have been investigated. Alternatively, the lack of drug efficacy may have resulted from either incomplete suppression of thromboxane biosynthesis and/or substitution for the biological effects of thromboxane A2 by prostaglandin endoperoxides during long-term dosing studies. Given that selective inhibition of thromboxane formation can be approached with aspirin, the particular value of these compounds is dependent on enhancing prostacyclin formation. Aspirin inhibits thromboxane-dependent platelet activation, but many platelet agonists are likely to act in concert in vivo and prostacyclin inhibits platelet aggregation induced by both thromboxane-dependent and thromboxane-independent mechanisms. To test the hypothesis that thromboxane synthase inhibitors are efficacious in human disease, compounds of longer duration of action are required. Combination with antagonists of the prostaglandin/thromboxane A2 receptor may be necessary to reveal their full beneficial action.
Modulating drug release with cyclodextrins in hydroxypropyl methylcellulose gels and tablets
Authors: Beatriz Pose-Vilarnovo, Carmen Rodrı́guez-Tenreiro, José Fernando Rosa dos Santos, Juan Vázquez-Doval, Angel Concheiro, Carmen Alvarez-Lorenzo, Juan J Torres-Labandeira
Journal: Journal of Controlled Release (2004)
Targeting secondary immune responses to cetuximab: CD137 and the outside story
Authors: Julie E. Bauman, Jennifer R. Grandis
Journal: Journal of Clinical Investigation (2014)

Cetuximab is a murine-human chimeric IgG1 mAb directed against the EGFR that is approved for use in patients with colorectal and head and neck carcinomas. While some patients benefit greatly from cetuximab, many do not; therefore, strategies to increase the efficacy of this drug are of great clinical interest. In this issue of the JCI, Kohrt and colleagues report a strategy for enhancing the secondary immune response to cetuximab that involves sequential targeting with an agonist mAb against CD137 expressed on NK and T cells.
Cerebral Vasculitis Associated With Cocaine Abuse or Subarachnoid Hemorrhage?-Reply
Authors: Brian R. Kaye
Journal: JAMA (1988)

<h3>In Reply.</h3> —We would like to thank Drs Levine, Welch, and Brust for raising the interesting possibility of subarachnoid hemorrhage as the etiology for the neurological events that occurred in our patient. Certainly, subarachnoid hemorrhage, arteriovenous malformations, cerebral ischemia, and cerebral vasculitis can all present with similar clinical manifestations. It is unfortunate that the cerebrospinal fluid obtained from our patient was not examined for xanthochromia because it makes it difficult to know whether the blood in the cerebrospinal fluid was the result of a traumatic spinal tap. We also should note that the left-sided cerebral circulation, as mentioned in our article, was normal. The distal vessels of the right-sided cerebral circulation did not fill with dye. Although the cerebral angiographic findings in our patient could be the result of vasospasm following a subarachnoid hemorrhage, there are several radiographic features that make this diagnosis less likely. First of all, in patients
MHRA works hard to ensure that medical devices work and are safe
Authors: S. Ludgate
Journal: BMJ (2012)

<h3><b>Background and Purpose</b></h3> People with severe, long-standing anorexia nervosa (AN) often develop physical manifestations of medical starvation. Functional deficits are not well described, and little information is available to guide physical intervention. This case report describes the physical therapy clinical decision-making process and intervention provided to a patient with severe AN. <h3><b>Case Description</b></h3> The patient was a 48-year-old woman admitted to an acute care hospital with medical complications associated with AN and requiring medical stabilization. On admission, she was unable to complete basic functional activities (eg, bed mobility, transfers, ambulation). She was considered at risk for falls, with a score of 17 on the Performance-Oriented Motor Assessment (POMA) and a score of 19.27 seconds on the Timed “Up &amp; Go” Test (TUG). Physical therapist examination and intervention focused on functional testing and training, strengthening, and postural stability training for return to independence. <h3><b>Outcomes</b></h3> In 9 weeks, the patient returned to independence in basic activities of daily living, as measured by 3 items from the motor domain (bed mobility, transfers, and ambulation) of the Functional Independence Measure, with improvements from 1 (“total assistance”) to 6 (“modified independence”) on each item. Postural stability improved to “low risk” for falls (POMA score of 24). Her TUG score improved to 11.00 seconds. Walking speed improved from 0.35 to 0.81 m/s. Once she attained medical stability, she was discharged home with her parents with outpatient services. <h3><b>Discussion</b></h3> Physical therapist management of this severely deconditioned patient hospitalized with severe AN focused on the restoration of functional activities, with intervention intensity being guided by physiologic responses. Traditional aerobic and endurance training were de-emphasized to minimize kilocalorie expenditure and tendencies toward exercise compulsion in this patient population.
Cupping, Baltimore, 1962
Authors: Frank L. Iber
Journal: JAMA (1963)

CUPPING, a simplified type of venesection, has largely disappeared from contemporary medical practice. 1 A patient with edema due to cirrhosis of the liver was recently studied at the Johns Hopkins Hospital. The patient was 59 years old when seen on April 25, 1961. He was born on the island of Rhodes, but came to Baltimore in 1920 at the age of 18, and has remained in the United States since then working as a chef in various Greek restaurants. He lived in the homes of Greek families from Rhodes until 1953 when he returned there to acquire a wife. He then established his own home in the Rhodes community in Baltimore in 1954. He enjoyed good health until the summer of 1960, when he developed intermittent swelling of the ankles and legs. He consulted an elderly Greek woman near his home who prescribed cupping with scarification. This treatment was
Upregulation of Angiotensin-Converting Enzyme During the Healing Process After Injury at the Site of Percutaneous Transluminal Coronary Angioplasty in Humans
Authors: Mitsuru Ohishi, Makiko Ueda, Hiromi Rakugi, Atsunori Okamura, Takahiko Naruko, Anton E. Becker, Kunio Hiwada, Atsushi Kamitani, Kei Kamide, Jitsuo Higaki, Toshio Ogihara
Journal: Circulation (1997)

Background Balloon injury models in rat have shown enhanced expression of ACE in the developing neointima. However, neointimal lesions in human coronary arteries are complex due to atherosclerosis and different types of wall laceration. This study was designed to investigate whether ACE is present in the neointima of humans, including patients with restenosis after percutaneous transluminal coronary angioplasty (PTCA). Methods and Results Thirty-seven sites with angioplasty injury, obtained at autopsy, were studied using immunocytochemical techniques. Sites with injury limited to a fibrous plaque and those with injury extending into the media (&lt;2 months after PTCA) showed fibrocellular repair tissue composed mainly of smooth muscle cells that were distinctly positive for ACE. In cellular reactions at the site of injury limited to the atheromatous plaque (&lt;2 months after PTCA), the expression of ACE appeared first in accumulated macrophages; once smooth muscle cells appeared in the repair tissue, they also expressed ACE. At a later stage (3 months after PTCA), the number of cells with ACE expression decreased markedly; from 7 months on, ACE was no longer expressed within the repair tissue. Basically, there were no differences with regard to ACE expression during the healing process after PTCA between segments with and those without angiographic evidence of restenosis. Conclusions These results show that PTCA injury in humans results in upregulation of ACE at sites of active repair and, therefore, ACE could play an important role as one of the mediators of the healing process after PTCA.