tbuckley/cabot-search huggingface dataset:
Prevalence of circadian variations and spontaneous variability of cardiac disorders and ECG changes suggestive of myocardial ischemia in systemic arterial hypertension.
Authors: M Zehender, T Meinertz, S Hohnloser, A Geibel, U Gerisch, M Olschewski, H Just
Journal: Circulation (1992)

BACKGROUND Systemic hypertension is a well-known risk factor for coronary artery disease and sudden cardiac death. Recent interest focused on the presence of malignant ventricular arrhythmias (VA) and myocardial ischemia in hypertensive patients and provided a potential link for fatal tachyarrhythmic events. METHODS AND RESULTS We studied 150 untreated normokalemic hypertensive patients (56 +/- 9 years; 56 women and 94 men) without manifest coronary artery disease to determine prevalence, severity, and interaction of VA and significant ST segment changes induced by daily activities. One third of the patients were randomized to 4 weeks of placebo and restudied for spontaneous variability of the two parameters. All patients were included in a 3-year follow-up study. VA were observed in 129 of 150 hypertensive patients (86%) and peaked in the early morning and late afternoon. Twenty-two patients (15%) had ventricular pairs, and 20 patients (13%) had nonsustained ventricular tachycardia. Transient ST segment depression observed in 47 patients (33%; mean incidence, 2.7 +/- 0.8 episodes/24 hr) showed a characteristic circadian variation similar to VA and were asymptomatic in 93% of the episodes. At the time of transient ST segment depression, VA increased 4.6 times (p less than 0.01). After 4 weeks of placebo, marked variations in the incidence of VA (VA suppression rate -100%, or increase greater than 400%) were observed in 29% of the patients, and in 60% of all patients repetitive VA were present in only one of the two Holter recordings. Day-and-night variations of VA and transient ST segment changes were highly reproducible during the placebo period. After 3 years of follow-up, eight of 146 patients (5%) had suffered myocardial infarction, and five patients had died from cardiac events (three patients died from sudden cardiac death). Logistic regression analysis revealed left ventricular hypertrophy (relative risk, 6.1; p less than 0.01) and transient ST segment abnormalities during daily activities (relative risk, 4.4; p less than 0.05) to be of independent prognostic significance to predict cardiac events during follow-up instead of repetitive VA (relative risk, 1.3; NS). CONCLUSIONS VA associated with a high spontaneous variability and predominantly asymptomatic transient ST segment changes are common in hypertensives; the interaction of both risk factors may provide an important link for fatal VA. Antiarrhythmic therapy is not to be recommended in the majority of patients. Presence of left ventricular hypertrophy and transient ST segment changes were the most powerful predictors of cardiac events during the follow-up.
Control efforts aren't enough for malaria targets in millennium development goals to be met, warns WHO
Authors: P. Moszynski
Journal: BMJ (2011)

Although last year saw a further decline in numbers of cases of and deaths from malaria and greater roll out of malaria control measures, progress has been slower than anticipated and the available funds less than needed to meet the United Nations’ millennium development goal targets, finds the latest World Malaria Report .

There were an estimated 216 million episodes of malaria and around 655 000 deaths from malaria in 2010, says the World Health Organization’s report. Most cases (81%) and deaths (91%) were in WHO’s Africa region, and 86% of deaths there were in children under 5 years of age, it says.

The estimated incidence of malaria has …
Age-related patterns of immunoglobulin and T-cell receptor gene rearrangements in precursor-B-ALL: implications for detection of minimal residual disease
Authors: V H J van der Velden, T Szczepanski, J M Wijkhuijs, P G Hart, P G Hoogeveen, W C J Hop, E R van Wering, J J M van Dongen
Journal: Leukemia (2003)
Preservation of atrioventricular nodal conduction during radiofrequency current catheter ablation of midseptal accessory pathways.
Authors: K H Kuck, M Schlüter, S Gürsoy
Journal: Circulation (1992)

Septal accessory atrioventricular (AV) pathways may be located in close vicinity of the His bundle-AV nodal conduction system. Attempts at surgical or electrical interruption of these pathways may therefore result in impairment of normal AV conduction. This study focuses on a subset of septal pathways with an atrial insertion located inside the triangle of Koch. In this study, they were called "midseptal."Six patients with a midseptal accessory pathway (mean +/- SD age, 40 +/- 12 years; five with Wolff-Parkinson-White syndrome and one with a concealed accessory pathway) underwent attempts at ablation of their pathway using 500-kHz radiofrequency current applied to the atrial insertion of the accessory connection. Guided by the recording of accessory pathway activation potentials, the ablation catheter was positioned in all patients in an area bounded anteriorly by the tip electrode of the His bundle catheter and posteriorly by the coronary sinus ostium. All pathways were successfully ablated without the induction of complete heart block. First-degree AV conduction block occurred in one patient in whom a concealed accessory connection was located closer to the AV node than to the coronary sinus ostium.Radiofrequency current catheter ablation may be used effectively for midseptal accessory pathways and should be preferred in experienced centers as a safe alternative to surgical therapy.
learning to stay vigilant about conditions that are rare but important
Authors: E. Peile
Journal: BMJ (2003)

All doctors who look after children need to recognise the presentation of Kawasaki disease: theconsequences of missing it are potentially drastic for the affected child. The question is how we reinforce our undergraduate learning about rare but important conditions. Many years in practice without seeing a case may erode the vigilance of the generalist who has many common and important conditions jostling for …
Treatment of Status Epilepticus
Authors: Joseph H. Siris
Journal: JAMA (1976)

To the Editor.—  Dr Schneider, while conceding that anticonvulsant medication is effective in the treatment of hypoglycemic and hypocalcemic status epilepticus, advocates delay in administering anticonvulsant drugs (ACDs) pending determination of glucose and calcium blood levels. This view does not seem to take into account that status epilepticus is often a medical emergency that can be lethal. Moreover, there is no way of knowing how much additional brain damage can be inflicted by a prolonged, severe episode of status epilepticus.  We agree it is necessary to obtain a blood sample, particularly to determine ACD-plasma levels. In dealing with a known epileptic in this state, the patient's plasma will often be found to contain little or no ADC. This is usually a result of noncompliance. If a patient is seen for the first time and is not known to be seizure-prone, it may be helpful to determine glucose and calcium levels,
Dose-response study of chloroform carcinogenesis in the mouse and rat: status report.
Authors: T A Jorgenson, C J Rushbrook, D C Jones
Journal: Environmental Health Perspectives (1982)

Chloroform is being administered to male Osborne-Mendel rats and to female B6C3F1 mice at concentrations of 0 (negative control), 200, 400, 900 or 1800 ppm in the drinking water. Matched control groups of both species receive a volume of water identical to that consumed by the corresponding 1800 ppm groups. At this writing, the animals have completed 23 months on test. Negative control and CHCl3-treated rat groups have shown typical growth curves, with dose-related relative decrements in body weight evident throughout the study. Following decreases in CHCl3 groups during the first 8 weeks, rat water consumption values have continued to increase slowly, but persistent relative dose-related decrements are evident. No initial treatment-related decrements are evident. No initial treatment-related mortality was seen in the rats. Survival is 21, 41, 45, 76, 70 and 64% for the negative control, 200, 400, 900, 1800 ppm and matched control groups, respectively. Survival values for mice at three weeks were 99, 94, 74 and 76% for the 200, 400, 900 and 1800 ppm groups, respectively. Mortality was apparently related to markedly decreased fluid consumption among some of the treated mice. Subsequent mortality has been less than 15% for all mouse groups. Except for acclimation effects during the first 2-3 weeks, body weights for the treated mouse groups have been generally within 10% of negative control values. Tissue changes in decedents have been similar in treated and control groups, both in rats and mice. Terminal sacrifice and histologic evaluations will be initiated after completion of 24 months on test.
SURGI CAL MANAGEMENT OF ULCERATIVE COLITIS
Authors: H. E. Bacon
Journal: JAMA (1953)

Noteworthy progress in the therapeutic approach to chronic ulcerative colitis is rapidly being achieved in the field of surgery. The general practitioner, internist, gastroenterologist, and psychiatrist alike are viewing surgical intervention with increasing assurance, and less and less frequently are seriously ill patients reaching the operating table too late for curative treatment. This fact is self-evident when one examines the remarkable fall in surgical mortalities in ulcerative colitis during the past decade as compared with previous decades. A no less significant observation is the fall in the incidence of emergency ileostomies. By virtue of awakened interest and cooperation between all fields of therapy, surgical measures are well planned and it is common to see the successful completion of total colectomy with cure of the disease brought about in two operative stages or less.  In our series of 331 patients with chronic ulcerative colitis, 81, or 24.5%, have undergone surgical intervention.
Charles Frederick Rolland
Authors: J. Cox
Journal: BMJ (2008)

Charles Rolland was educated at Loretto School in Edinburgh and at Cambridge and Edinburgh Universities. He played first team rugby throughout and obtained first class honours.

His father, William, a pathologist, was an author of a classic 1917 Lancet paper which first described deaths from what was to become the 1918 influenza pandemic.

As an accomplished athlete with a love of climbing, Charles joined the Royal Army Medical Corps and volunteered to join the commandos. At the same time, a less adventurous friend of his volunteered to go to India. Not unusually then or now, military wires got crossed and his friend was sent to train as a reluctant commando while Charles set off for India with the Royal West African Frontier Force.

He was married two weeks before he embarked …
495 Intrapulmonary vascular dilatation and nitric oxide in hypoxemic rats with chronic bile duct ligation
Authors: X ZHANG, Y KATSUTA, T AKIMOTO, M OHSUGA, Y KATO, T NAGATO, S SHIMIZU, H KOMEICHI, K SATOMURA, T ARAMAKI
Journal: Hepatology (2003)

Hepatic production and release of endothelin-1 (ET-1) binding to endothelin B (ETB) receptors, overexpressed in the lung microvasculature, is associated with accumulation of pro-angiogenic monocytes and vascular remodeling in experimental hepatopulmonary syndrome (HPS) after common bile duct ligation (CBDL). We have recently found that lung vascular monocyte adhesion and angiogenesis in HPS involve interaction of endothelial C-X3-C motif ligand 1 (CX3CL1) with monocyte CX3C chemokine receptor 1 (CX3CR1), although whether ET-1/ETB receptor activation influences these events is unknown. Our aim was to define if ET-1/ETB receptor activation modulates CX3CL1/CX3CR1 signaling and lung angiogenesis in experimental HPS. A selective ETB receptor antagonist, BQ788, was given for 2 weeks to 1-week CBDL rats. ET-1 (±BQ788) was given to cultured rat pulmonary microvascular endothelial cells overexpressing ETB receptors. BQ788 treatment significantly decreased lung angiogenesis, monocyte accumulation, and CX3CL1 levels after CBDL. ET-1 treatment significantly induced CX3CL1 production in lung microvascular endothelial cells, which was blocked by inhibitors of Ca2+ and mitogen-activated protein kinase (MEK)/ERK pathways. ET-1–induced ERK activation was Ca2+ independent. ET-1 administration also increased endothelial tube formation in vitro, which was inhibited by BQ788 or by blocking Ca2+ and MEK/ERK activation. CX3CR1 neutralizing antibody partially inhibited ET-1 effects on tube formation. These findings identify a novel mechanistic interaction between the ET-1/ETB receptor axis and CX3CL1/CX3CR1 in mediating pulmonary angiogenesis and vascular monocyte accumulation in experimental HPS.
Steroid Elution Improves the Stimulation Threshold in an Active-Fixation Atrial Permanent Pacing Lead
Authors: George H. Crossley, Jeffrey A. Brinker, Dwight Reynolds, William Spencer, W. Ben Johnson, Howard Hurd, Lisa Tonder, Matt Zmijewski
Journal: Circulation (1995)

Background Prior work suggests that the addition of a steroid-eluting reservoir to a passive-fixation permanent pacemaker lead improves the stimulation threshold; however, no large randomized study has addressed this issue. Over the last several years, there has been an increase in enthusiasm for the use of active-fixation permanent pacemaker leads for various reasons in spite of the generally accepted notion that active-fixation leads have higher stimulation thresholds. Methods and Results This multicenter, randomized, controlled study examined the difference in performance between a standard active-fixation atrial lead (Medtronic model 4058) and a steroid-eluting lead (Medtronic model 4068). Stimulation thresholds were obtained in a four-point strength-duration fashion. Evaluations of sensing and impedance were performed as well. These evaluations were performed at implantation, at weeks 1 through 4, and at weeks 6, 12, 24, and 52. Stimulation thresholds were significantly better in the steroid lead than in the nonsteroid lead at each measurement point from 1 week to 12 months. The mean 1.6-V stimulation threshold at 12 months was 0.19±0.2 ms in the steroid lead and 0.41±0.30 ms in the control lead. No acute peaking was observed with the steroid lead, whereas significant peaking was observed with the control lead. There was no difference in long-term sensing or impedance. Conclusions Inclusion of a steroid-eluting reservoir in an active-fixation permanent pacing lead improved stimulation thresholds in both the subacute and chronic periods and therefore should extend pulse-generator longevity.
A randomised trial of differentiated prednisolone treatment in active rheumatoid arthritis. Clinical benefits and skeletal side effects
Authors: M. Hansen, J. Podenphant, A. Florescu, M. Stoltenberg, A. Borch, E. Kluger, S. F. Sorensen, T. M. Hansen
Journal: Annals of the Rheumatic Diseases (1999)

<h3>OBJECTIVES</h3> To study benefits and skeletal side effects of carefully monitored prednisolone treatment in patients with active rheumatoid arthritis. <h3>METHODS</h3> One hundred and two patients with active rheumatoid arthritis were randomly allocated to treatment with disease modifying anti-inflammatory drug (DMARD) alone or DMARD and prednisolone in a one year follow up study. Prednisolone was given in a dose regimen adapted to the disease activity of the individual patient. The mean dose was 6 mg and the mean cumulated dose was 2160 mg. Patients were followed up with disease activity parameters, radiograph of the hands (Larsen score), and bone mineral density (BMD) of the lumbar spine, distal forearm and hand. At one year 26 patients had withdrawn from the investigation leaving 76 patients for evaluation. <h3>RESULTS</h3> The results showed that disease activity in the prednisolone treated group was reduced within two weeks. In the DMARD alone group disease activity was gradually reduced over months. At six months there was no difference between the groups as evaluated by an improvement score using a number of ACR criteria. Prednisolone in the present set up was not able to protect significantly against radiological disease progression, although there was a trend towards less progression in Larsen score in the prednisolone group, a matter that was further underlined in an intention to treat analysis. BMD data revealed a significant reduction in spinal BMD in the prednisolone group, whereas prednisolone seemed to have a protective effect against bone loss in the hand and distal forearm. <h3>CONCLUSIONS</h3> This study does not allow any firm conclusions for or against the treatment of rheumatoid arthritis with prednisolone. The data suggest that the beneficial effects of prednisolone are not as clear cut in established rheumatoid arthritis as in early disease. Furthermore the data indicate that treatment in the chosen relatively low dose does not provide sufficient control of disease. On the other hand the spinal bone loss observed in the prednisolone group does invite considerations about using higher doses.
Computed Cranial Tomography in Acoustic Tumor Diagnosis
Authors: Matthew L. Wong
Journal: JAMA (1981)

With the development of computed cranial tomography (CCT), many physicians have come to rely on this technique as their sole means of excluding a diagnosis of acoustic neurinoma. In our series of 237 patients with acoustic tumors, 29% of tumors were not detected by CCT. New thin-section scanners improve this detection rate. Tumors within the internal auditory canal, however, will not be detected without special techniques. We recommend that contrast studies of the posterior fossa be employed to exclude definitely the diagnosis of acoustic tumor when one is suspected.
Systemic Mannitol-Induced Hyperosmolality Amplifies rAAV2-Mediated Striatal Transduction to a Greater Extent Than Local Co-infusion
Authors: Corinna Burger, Frederic N. Nguyen, Jie Deng, Ronald J. Mandel
Journal: Molecular Therapy (2004)

Recombinant viral vectors derived from adeno-associated virus serotype 2 (rAAV2) have been investigated as highly effective vehicles for gene transfer to the central nervous system (CNS). Transduction with rAAV2 vectors results in long-term transgene expression in CNS neurons. Optimal injection parameters leading to efficient targeting and spread of the transgene to large neuroanatomical regions are important in molecular gene therapy studies of the CNS. In the present study, we reexamined the effects of both local and systemic administration of mannitol-induced hyperosmolality on facilitation of transgene expression and vector distribution in the CNS. Systemic intraperitoneal administration of mannitol prior to vector administration improved gene transfer to striatal neurons, increasing the total number of transduced cells by 400% and vector distribution by 200%. On the other hand, local coadministration of mannitol in the striatum increased the number of transduced striatal neurons by 25% and had little effect on transduction volume. In conclusion, we have demonstrated that systemic coadministration of mannitol significantly enhances transgene spread of rAAV2 viral delivery in the brain to a much greater degree than local coadministration.
Ventricular Tachycardia-Reply
Authors: Donald Lorentzen
Journal: JAMA (1976)

ABSTRACT I appreciate Dr Reiffel's letter regarding my article.I respect Dr Reiffel's alternate hypothesis of an A-V nodal reentry rhythm. However, it is of interest that the QRS deflections of the slower terminating ventricular rhythm is so similar to the QRS deflection of the tachycardia rhythm, thus suggesting an identical origin of the depolarization impulse.I agree completely with the desirability of intracardiac electrophysiologic study during the episode of rhythm disturbance for more definite detail. Unfortunately, the setting in which the situation occurred was one of a therapeutical nature and resources and facilities were not available for full research study, involving intracardiac electrophysiologic study. This, of course, would have been desirable.Dr Reiffel's final comment is well stated concerning caution in using carotid sinus massage in attempts to terminate ventricular tachycardia in elderly patients due to the potential hazard of ventricular standstill. It would seem logical, however, that
LONG‐TERM TRANSFER FACTOR TREATMENT IN SEVERE ATOPIC DERMATITIS
Authors: H. THULIN, J. ELLEGAARD, K. THESTRUP‐PEDERSEN, H. ZACHARIAE
Journal: Allergy (1977)

Transfer factor therapy was applied in three patients with severe atopic dermatitis and given at regular intervals for 1 1/2 years. Clinically, slight improvements were seen, attacks of impetigo ceased and admissions to hospital were not necessary. However, IgE concentrations in serum remained constantly high in all cases and the absolute number of T and B lymphocytes was continuously subnormal despite treatment. The in vitro cellular reactivity to PPD as assayed by a leucocyte migration test was not significantly altered in the patients, although a slight increase was found early on in the therapy. Finally, a serum factor inhibiting leucocyte migration and appearing simultaneously with attacks of impetigo disappeared during treatment. In conclusion, no convincing effect of transfer factor therapy was encountered in immune parameters and no major alterations were found in the status of the patients' atopic dermatitis.
PUBLICATION OF PERCUTANEOUS CORONARY INTERVENTION APPROPRIATENESS USE CRITERIA DOES NOT HAVE AN IMPACT ON PATIENT OUTCOME: A SINGLE-CENTER EXPERIENCE
Authors: Israel Barbash, Danny Dvir, Rebecca Torguson, Zhenyi Xue, salem badr, William Suddath, Lowell Satler, Kenneth Kent, Augusto Pichard, Ron Waksman
Journal: Journal of the American College of Cardiology (2012)
The Use of 2-Deoxy-d-glucose for Genital Herpes
Authors: Lawrence Corey
Journal: JAMA (1980)

To the Editor.—  We have several questions concerning the methods and results of the study by Blough and Giuntoli (241:2798, 1979) on the use of 2-deoxy-D-glucose in the treatment of genital herpes simplex virus (HSV). Although the authors claimed to have performed a double-blind, placebo-controlled trial, 36 patients received 2-deoxy-D-glucose, while for ethical reasons only 15 received the placebo therapy.  Was a formal randomization design employed, and was this compatible with a double-blind study design? In addition, in evaluating the conditions of patients with first episodes of genital  stratification by serological tests into those with true  genital herpes, ie, those who are experiencing their first exposure to HSV and those who have experienced prior HSV type 1 infection, must be performed, because patients with primary genital herpes experience a longer duration of viral shedding (mean, 13.0 days) than those with previous HSV type 1 infection (mean, 7.5 days).