tbuckley/cabot-search huggingface dataset:
Lyme Carditis: An Important Cause of Reversible Heart Block
Authors: Hugh F. McAlister
Journal: Annals of Internal Medicine (1989)

Lyme disease is a tick-borne spirochetal infection, characterized by erythema chronicum migrans and an acute systemic illness. The disease is endemic in many parts of the northeastern United States. Without treatment, late rheumatic, neurologic, and cardiac complications frequently occur. We report four serologically confirmed cases of Lyme carditis in previously healthy young men (mean age, 45 years) from endemic areas. Each presented with severe symptomatic atrioventricular block, three with episodes of prolonged ventricular asystole. Two had permanent pacemakers implanted (one was later removed), and another, very nearly did, before diagnosis. All four patients were treated with antibiotics, and in each case their rhythm returned to sinus, though one patient has Wenckebach second degree block with atrial pacing at 120 beats/min 16 months later. Carditis occurs in 4% to 10% of cases of Lyme disease and usually begins 3 to 6 weeks after the initial illness. It manifests as a transient myocarditis with varying degrees of atrioventricular block. The diagnosis is made primarily on clinical grounds and confirmed by serologic testing. Temporary cardiac pacing is frequently needed by patients who have severe heart block with hemodynamic instability. The evidence suggests that, in most cases, the block is at the level of the atrioventricular node. The block generally resolves completely with antibiotic treatment. Complete heart block rarely persists more than 1 week and the long-term prognosis appears to be excellent. Consideration and prompt recognition of this potentially lethal, but reversible, cause of heart block is crucial in order to avoid inappropriate permanent pacemaker implantation.
Continuous Ambulatory Peritoneal Dialysis
Authors: ROBERT P. POPOVICH
Journal: Annals of Internal Medicine (1978)

The technique of continuous ambulatory peritoneal dialysis was evaluated in nine patients during 136 patient weeks. The major objectives were to see if continuous ambulatory peritoneal dialysis would provide [1] acceptable control of serum chemistries by usual criteria, [2] adequate removal of sodium and water, [3] tolerable protein losses, and [4] a low prevalence of peritonitis with episodes responsive to therapy with continuing continuous ambulatory peritoneal dialysis. Preliminary findings suggest continuous ambulatory peritoneal dialysis represents an effective ambulatory, portable, internal dialysis technique. Larger-solute clearances per week may approach values six times greater than with most hemodialysis techniques. Small-solute clearances approach dialysate flow rate (8.3 ml/min) and are comparable to other dialysis techniques on a weekly basis. Edema is readily controlled and protein losses should be tolerable with adequate protein intake. Peritonitis occurs on the average every 10 weeks but responds to therapy promptly with continuing continuous ambulatory peritoneal dialysis. If the prevalence of peritonitis can be reduced, continuous ambulatory peritoneal dialysis appears to represent a very attractive dialysis technique.
MYIASIS DERMATOSA DUE TO THE OXWARBLE FLIES
Authors: ROBERT T. MILLER
Journal: JAMA (1910)

Myiasis dermatosa, or infection of the skin with the larval stage of dipterous insects, is fairly common in the tropics though less so in temperate zones, the infection in man most commonly being due to the screw-worm (<i>Compsomyia macellaria</i><sup>2</sup>) or to<i>Dermatobia hominis</i>.<sup>3</sup>The following case of human infection due to<i>Hypoderma lineata</i>, one of the ox-warble flies and a parasite of cattle almost exclusively, merits report because of its rarity. <h3>Patient.—</h3> H. S., a white boy, aged 11, of Roanoke, Va., was admitted to Johns Hopkins Hospital, Baltimore, March 13, 1908, complaining of "swelling under the chin." His family and personal history are negative. <h3>Present Illness.—</h3> In December, 1907, the boy noticed a small round lump just below the left knee; this lump was slightly red and very tender especially at night. About two days later the lump had disappeared from the original position and was found
Loading and performance of the heart as muscle and pump
Authors: D. L. BRUTSAERT, W. J. PAULUS
Journal: Cardiovascular Research (1977)

Evaluation of ventricular muscle-pump function of the failing heart still constitutes a major problem in cardiology. More than a decade ago it was proposed that the mechanical performance of the heart should be approached as a muscle rather than as a pump. The purpose was to find properties of cardiac muscle which would help in distinguishing alterations of ventricular performance due to changes in loading conditions (Frank-Starling adaptation; heterometric autoregulation) from either positive (circulating catecholamines, changes in heart rate) or negative (myocardial or muscle failure) inotropic alterations (homeometric autoregulation; changes in contractility). Obviously, the pragmatic aim was to distinguish a good from a bad heart more accurately. Several contractile properties of isolated mammalian cardiac muscle have since been well characterised and recent studies have permitted a coherent and unifying description of cardiac muscle performance. The basis of it is that mechanical activity of myocardial muscle can be defined in terms of the interrelationship between force development, instantaneous length during shortening, and velocity of shortening, independently of the time course of activation. This analysis provides a model independent description of what muscle really does and how it behaves when its loading conditions are altered (Brutsaert, 1974). Yet, the application of these basic muscle concepts to the intact heart still remains controversial for several reasons: insufficient understanding of basic cardiac muscle mechanics, failure to take into consideration some conceptual limitations, the many oversimplified assumptions in modelling the ventricle, the complex physiological loading of a combined muscle-pump system, etc. Pragmatic usefulness as the only justification for applying muscle concepts to the intact ventricle is no longer tenable as a sufficient argument. The ventricle is primarily a combined muscle-pump system and neither a papillary muscle nor even less a skeletal muscle. The nature of loading during muscle shortening in the ventricular wall is quite different from that in the isolated muscle since the ventricle is not called on to lift a weight but to eject a viscous fluid into a viscoelastic vascular system (Abbott and Gordon, 1975; Milnor, 1975). Muscle concepts as directly derived from skeletal muscle physiology should therefore no longer be forcibly applied to the intact heart for ventricular function evaluation. Instead, emphasis should be placed on the integration of muscle and pump function and on properties of heart muscle that help to define its behaviour as an integral part of the wall of a pumping system (Paulus et al.,1976).
Dealing With Pediatric Sleep Disorders Can Call for a Wide Range of Expertise
Authors: Lynne Lamberg
Journal: JAMA (2008)

AMELIA ISLAND, FLA—Poor sleep in a child’s early years may not only interfere with normal growth and development, but also strain family life. At the fourth annual pediatric sleep medicine conference, sponsored by the Warren Alpert Medical School of Brown University, Providence, RI, talks and workshops explored the translation of basic research to clinical practice. The diversity of attendees at the meeting—whichincludedpediatricians, pulmonologists, otolaryngologists,neurologists, psychiatrists, dentists, and others—“reflectsburgeoningmultidisciplinary and interdisciplinary activity in our field,”saidconferencecochair Judith Owens,MD,MPH,associateprofessorof pediatrics at Brown and director of pediatricsleepdisordersatHasbroChildren’s Hospital, also in Providence.
Changes in serum haptoglobin level after allergen challenge test in asthmatic children
Authors: C. K. Kim, C. Y. Chung, Y. Y. Koh
Journal: Allergy (1998)

Bronchial asthma is characterized by airway inflammation, which underlies the phenomenon of bronchial hyperresponsiveness. Previous studies have shown that this correlates with the serum concentration of haptoglobin. The occurrence of the late asthmatic response (LAR) after an allergen challenge test is associated with airway inflammation. The objectives of this study were to examine serum levels of haptoglobin during the 24 h after allergen challenge and to compare changes between the subjects with and without LAR. We studied two groups of children with perennial asthma who developed the early asthmatic response (EAR) only (group 1: n = 14), and EAR but also LAR (group II: n = 14) after an allergen (Dermatophagoides pteronyssinus) challenge test. Serum concentrations of haptoglobin were measured at baseline, at EAR, and at 2 h (recovery), 8 h (LAR), and 24 h after the challenge. Baseline levels were similar in the two groups (group I: 128±57 mg/dl: group II: 129±50 mg/dl). In group I, there was no significant change in the level at any time point; in contrast, the subjects in group II showed a relative fall (92±40 mg/dl) at 8 h, and an increase (161±79 mg/dl) at 24 h after the challenge. Our results indicate that the serum concentration of haptoglobin decreases at the time of LAR and is subsequently replenished during the ensuing time. Although further studies are needed, we think that haptoglobin may be inflused into the airways during the inflammatory process associated with LAR, and that this may be followed by “overshooting” production.
Micturition Syncope— Not a Single Entity
Authors: Bruce S. Schoenberg
Journal: JAMA (1974)

A 68-year-old patient with syncope associated with an urge to urinate differed from other cases of micturition syncope with respect to age, presence of cardiovascular and urinary disease, lack of association with recumbency, and loss of consciousness before onset of micturition. Investigation incriminated vagal stimulation from the distended bladder with transient blocking of the atrioventricular node as the likely mechanism. The patient was successfully treated with a permanent demand pacemaker. Micturition syncope is probably not a single entity, but a symptom complex arising as a result of several mechanisms. (<i>JAMA</i>229:1631-1633, 1974)
IgA class switch in I alpha exon-deficient mice. Role of germline transcription in class switch recombination.
Authors: G R Harriman, A Bradley, S Das, P Rogers-Fani, A C Davis
Journal: Journal of Clinical Investigation (1996)

Studies have implicated defective Ig class switch in the pathogenesis of IgA deficiency. To understand better the molecular events that regulate IgA class switch, a 1.4-kb region of the IgA locus containing the I alpha exon was replaced with a human hypoxanthine phosphoribosyltransferase minigene by gene targeting in murine embryonic stem cells. The I alpha exon-deficient mice derived from these embryonic stem cells had normal IgA levels in serum and secretions and normal numbers of IgA B cells in Peyer's patches and spleen. Further, I alpha exon-deficient B cells efficiently underwent IgA class switch in vitro, despite the absence of I alpha exon-containing germline transcripts. Notably, I alpha exon-deficient B cells did not require TGF-beta for IgA class switch since stimulation with LPS alone led to IgA expression. Nonetheless, whereas I alpha exon-deficient B cells constitutively expressed human hypoxanthine phosphoribosyltransferase transcripts, they did not produce IgA in the absence of LPS stimulation. These results demonstrate that the I alpha exon or transcripts containing the I alpha exon are not required for IgA class switch. Further, the effects of TGF-beta on I alpha locus transcription can be supplanted by expression of a heterologous minigene at that locus, but a second signal is required for the induction of IgA class switch.
Risk for cytomegalovirus disease in patients receiving polymerase chain reaction–based preemptive antiviral therapy after allogeneic stem cell transplantation depends on transplantation modality
Authors: Holger Hebart, Wolfram Brugger, Ulrich Grigoleit, Barbara Gscheidle, Juergen Loeffler, Hansjörg Schäfer, Lothar Kanz, Hermann Einsele, Christian Sinzger
Journal: Blood (2001)
AN ARTICLE CONTRIBUTED TO AN ANNIVERSARY VOLUME IN HONOR OF DOCTOR JOSEPH HERSEY PRATT
Authors: HYMAN MORRISON
Journal: Annals of Internal Medicine (1937)

Article1 September 1937AN ARTICLE CONTRIBUTED TO AN ANNIVERSARY VOLUME IN HONOR OF DOCTOR JOSEPH HERSEY PRATTOTTMAR ROSENBACH, PIONEER IN THE DEVELOPMENT OF THE CONCEPT OF FUNCTIONAL DISEASE AND FUNCTIONAL DIAGNOSIS IN INTERNAL MEDICINE*HYMAN MORRISON, M.D.HYMAN MORRISON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-11-3-527 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptOttmar Rosenbach holds a place among the notables in medicine by virtue of the part he played in the development of the concept of functional disease and functional diagnosis. This idea of recognizing and treating disease before structural pathology had actually taken place marks an epoch-making advance in internal medicine, historically in line with its several evolutionary stages.First, there was the descriptive period dominated by Sydenham (1624-1689). A keen, painstaking observer, Sydenham re-introduced the old Hippocratic method of studying disease at the bedside and during epidemics, and grouped symptoms into clear-cut disease pictures previously undifferentiated or unrecognized.The next...Bibliography GUTTMANN W: Ausgewählte Abhandlungen von Ottmar Rosenbach, 1909, Leipzig. Google Scholar FABER K: Nosography in modern internal medicine, 1923, New York. Google Scholar GUTTMANN W: Ottmar Rosenbach, Berl. klin. Wchnschr., 1907, xliv, 490-491. Google Scholar ROSIN H: Ottmar Rosenbach, Deutsch. med. Wchnschr., 1907, xxxiii, 725. CrossrefGoogle Scholar ESCHLE E: Ottmar Rosenbach, München. med. Wchnschr., 1907, liv, 734-735. Google Scholar ESCHLE E: Ottmar Rosenbach, Ztschr. f. Krankenpflg., 1907, xxix, 97-101. Google Scholar ROSE A: Ottmar Rosenbach, Medical Brief, St. Louis, 1904, xxxii, 273. Google Scholar ROSE A: Ottmar Rosenbach, Medical Brief, St. Louis, 1907, xxxv, 367. Google Scholar SEMON F: Ottmar Rosenbach, Internat. Centralbl. f. Laryng., 1907, xxiii, 194-195. Google Scholar KLEMPERER G: Personal reminiscences. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: HYMAN MORRISON, M.D.Affiliations: Boston, Massachusetts*Received for publication March 17, 1937. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAortic Regurgitation Murmurs 1 September 1937Volume 11, Issue 3 Page: 527-536 ePublished: 1 December 2008 Issue Published: 1 September 1937 PDF downloadLoading ...
Rhodotorula Fungemia Complicating Staphylococcal Endocarditis
Authors: Palmer F. Shelburne
Journal: JAMA (1962)

A 56-year-old man with diabetes and staphylococcal endocarditis received intermittent, brief courses of broad-spectrum antibiotics. Fungal superinfection with Rhodotorula resulted. Rhodotorula was cultured repeatedly from the blood and urine during a period of high fever, while the patient was on adequate antibiotic therapy for staphylococcus. During and after treatment with amphotericin B and massive doses of penicillin, repeated blood cultures were sterile, and the patient recovered from this infection and superinfection. Amphotericin B was given intravenously in gradually increasing amounts until a daily dosage of 1.0 mg. per kilogram was achieved for 3 weeks. One can only speculate whether the fungus actually invaded the heart valves, but therapy was continued for this period because of this possibility. Fourteen months after discharge from the hospital, the patient was well except for a residual right hemiparesis.
Targeting Pain Where It Resides … In the Brain
Authors: Reza Sharif-Naeini, Allan I. Basbaum
Journal: Science Translational Medicine (2011)

Chronic pain is estimated to be the third most prevalent health problem in the world. Although scientists have made great strides in our understanding of the molecular mechanisms through which chronic pain develops, this knowledge has not been translated into new therapies. In this issue of Science Translational Medicine, Wang and colleagues report on the development of a selective antagonist of type 1 adenylate cyclase (AC1), which is induced in subsets of neurons in the central nervous system during the development of neuropathic pain. Blockade of AC1 significantly alleviates the mechanical hypersensitivity that occurs in a mouse model of neuropathic pain without affecting acute pain responsiveness or cognitive and motor function. These features make AC1 a potential therapeutic target for the treatment of neuropathic pain.
Signs of Life: The Language and Meaning of DNA
Authors: Frank Virzi
Journal: JAMA (1994)

This is a magnificent book. Robert Pollack, a renowned molecular biologist and teacher at Columbia University, presents here a notably candid, elegant, and penetrating meditation for the general reader on the revolutionary changes under way in the field of human genetics, the rapidly expanding (and exploited) set of technologies based on the manipulation of the genetic material deoxyribonucleic acid—DNA—and the im
Low-Protein Diets in Renal Disease
Authors: Kathleen R Zeller
Journal: Diabetes Care (1991)

End-stage renal disease is a major cause of morbidity and mortality in the U.S. population and a significant contributor to national health-care expenditures. In recent years, a growing body of literature has accumulated from studies in animals and humans to suggest that dietary protein restriction can significantly retard the progression of chronic renal insufficiency. This article reviews the relevant literature and outlines the questions that remain for future investigation.
Beyond prosody and infant-directed speech: Affective, social construction of meaning in the origins of language
Authors: Barbara J. King, Stuart Shanker
Journal: Behavioral and Brain Sciences (2004)

Our starting point for the origins of language goes beyond prosody or infant-directed speech to highlight the affective, multimodal, and co-constructed nature of meaning-making that was likely present before the split between African great apes and hominins. Analysis of vocal and gestural caregiving practices in hominins, and of meaning-making via gestural interaction in African great apes, supports our thesis.
Myocardial protective effects of adenosine. Infarct size reduction with pretreatment and continued receptor stimulation during ischemia.
Authors: C F Toombs, S McGee, W E Johnston, J Vinten-Johansen
Journal: Circulation (1992)

BACKGROUND We hypothesized that 1) endogenous adenosine released during ischemia conferred an inherent cardioprotection, and 2) a pretreatment dose of adenosine before ischemia would provide additional protection independent of hemodynamic effects. METHODS AND RESULTS Thirty-six anesthetized New Zealand White rabbits underwent 30 minutes of regional ischemia produced by coronary occlusion followed by 2 hours of reperfusion. The adenosine group (ADO, n = 9) received a 5-minute pretreatment infusion of 140 micrograms/kg/min of adenosine before ischemia. A control group (SAL, n = 9) received saline before ischemia. To separate the effects of adenosine used as a pretreatment versus the effects during ischemia, a third group (ADO+SPT, n = 9) received adenosine as pretreatment followed by 10 mg/kg 8-p-sulfophenyl theophylline (8-SPT), an A1/A2-receptor antagonist given before ischemia, thus allowing pretreatment with adenosine but antagonizing its effects during ischemia. To preclude any protection from endogenous adenosine released during ischemia, the fourth group (SAL+SPT, n = 9) received saline as pretreatment and 8-SPT before ischemia. Area of necrosis within the area at risk (infarct size) was determined with tetrazolium and Evans blue stains, and transmural blood flow was measured using radioactive microspheres. Collateral blood flow in the area at risk was similar in all groups, as was the size of the area at risk. Infarct size was reduced by adenosine pretreatment (ADO, 8.4 +/- 7.2%) in contrast to saline vehicle (SAL, 27.8 +/- 6.3%; p less than 0.05 versus ADO). alpha 1/alpha 2-Receptor blockade after adenosine pretreatment abolished the ischemic protection provided by pretreatment adenosine (ADO+SPT, 42.7 +/- 8.3%; p less than 0.05 versus ADO). Finally, receptor blockade of endogenously released adenosine without adenosine pretreatment increased infarct size by 24% over the nonpretreated saline group (SAL+SPT, 51.5 +/- 9.0%; p less than 0.05 versus SAL). CONCLUSIONS We conclude that 1) endogenous adenosine building up during ischemia is cardioprotective, and 2) pretreatment with adenosine confers cardioprotection independent of hemodynamic effects. Whether pretreatment effects of adenosine subsequently modulate the effects of endogenous adenosine (through alterations in receptor population or sensitivity) or endogenous and exogenous adenosine represent additive compartments is unclear.
Alcohol and the Heart
Authors: SAMUEL ZONERAICH
Journal: Annals of Internal Medicine (1983)

Letters and Corrections1 May 1983Alcohol and the HeartSAMUEL ZONERAICH, M.D., MAYER BALLAS, M.D., OLGA ZONERAICH, M.D., FRED ROSNER, M.D.SAMUEL ZONERAICH, M.D.Search for more papers by this author, MAYER BALLAS, M.D.Search for more papers by this author, OLGA ZONERAICH, M.D.Search for more papers by this author, FRED ROSNER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-98-5-671 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We read with interest the article by Greenspon and Schaal (1) and the accompanying editorial (2) on "the holiday heart" and its relation to acute alcohol ingestion. We agree that chronic alcoholics not under the influence of alcohol do not develop significant arrhythmias. In a group of 67 consecutive alcoholics with a history of daily intake of 360 mL of alcohol for at least 5 years and no evidence of heart disease, we saw only sinus tachycardia in 5 and persistent ST-T wave changes in 8 patients (3). Arrhythmias occurred only in those under the influence of...References1. GREENSPONSCHAAL AS. The "holiday heart": electrophysiological studies of alcohol effects in alcoholics. Ann Intern Med. 1983;98:135-9. LinkGoogle Scholar2. LUCKENGEL JT. Arrhythmias and social drinking [Editorial]. Ann Intern Med. 1983;98:253. LinkGoogle Scholar3. ZONERAICHBALLASWEIN SMP. Evaluation of subclinical alcoholic cardiomyopathy by mechanocardiography. Proceedings of the European Congress of Mechanocardiography: 1982;87. Google Scholar4. BALLASZONERAICHYUNISZONERAICHROSNER MSMOF. Noninvasive cardiac evaluation in chronic alcoholic patients with alcohol withdrawal syndrome. Chest. 1982;82:148-53. CrossrefMedlineGoogle Scholar5. BALLASZONERAICHZONERAICHROSNER MSOF. Noninvasive evaluation of 50 patients with acute alcohol withdrawal syndrome [Abstract]. Clin Res. 1982;30:169A. Google Scholar6. STEINBERGHAYDEN JM. Prevalence of clinically occult cardiomyopathy in chronic alcoholism. Am Heart J. 1981;4:461-4. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Queens Hospital Center—Long Island Jewish—Hillside Medical Center State University of New York at Stony Brook Jamaica, NY 11432 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byArrhythmias and left ventricular function in chronic alcoholics with alcoholic cirrhosis 1 May 1983Volume 98, Issue 5_Part_1Page: 671-672KeywordsAlcoholicsAlcoholsArrhythmiaCardiovascular therapyHeartIngestionTachycardia Issue Published: 1 May 1983 PDF downloadLoading ...