tbuckley/cabot-search huggingface dataset:
Therapy of Complete Heart Block Complicating Recent Myocardial Infarction
Authors: Louis Levy, Harold M. Albert
Journal: JAMA (1964)

ONE OF THE therapeutically reversible acute complications of recent myocardial infarction is the development of complete heart block. When the heart rate falls below 25 to 30 beats per minute, syncopal or convulsive seizures develop accompanied by the clinical picture of shock. This emergency requires immediate therapy not only for survival, but to prevent cerebral, cardiac, and renal complications resulting from repeated episodes of inadequate circulation. In the above situation we have employed a procedure similar to that described by Dr. C. W. Lillehei<sup>1</sup>for therapy of heart block complicating surgical repair of ventricular septal defects. The procedure consists of inserting a No. 18 spinal needle into the right ventricular cavity by puncturing the chest wall just medial to the point of maximal impulse and directing the needle superiorly and medially toward the second right costochondral junction. Then a No. 26 stainless steel wire is passed through the needle
Mechanisms of improved ischemic regional dysfunction by bradycardia. Studies on UL-FS 49 in swine.
Authors: C Indolfi, B D Guth, T Miura, S Miyazaki, R Schulz, J Ross
Journal: Circulation (1989)

In anesthetized swine, the left anterior descending coronary artery was cannulated and perfused at constant blood flow levels during two grades of ischemia. In one group (n = 10), moderate ischemia reduced percent systolic wall thickening (by sonomicrometry) from 25 +/- 7% to 6 +/- 2%, whereas in the other group (n = 7), severe ischemia reduced percent wall thickening from 24 +/- 6% to -0.5 +/- 4%. Heart rate was paced in both groups at 91 beats/min. After reperfusion and complete return to control conditions, administration of the bradycardic agent UL-FS 49 (0.37 mg/kg i.v.) decreased the heart rate to 55 +/- 5 beats/min. During subsequent ischemia at the same coronary inflow as before bradycardia, percent wall thickening in the ischemic zone during moderate ischemia was increased from 6 +/- 2% to 25 +/- 6% (p less than 0.01) (not significantly different from control without ischemia), and during severe ischemia, percent wall thickening increased from -0.5 +/- 4% to 13 +/- 7% (p less than 0.01). During moderate ischemia, bradycardia caused an increase in the subendocardial blood flow from 0.24 +/- 0.60 to 0.42 +/- 0.17 (ml/min)/g (p less than 0.009) and during severe ischemia, bradycardia caused an increase from 0.14 +/- 0.08 to 0.2 +/- 0.1 (ml/min)/g (p less than 0.001). At each level of ischemia, a more marked improvement occurred in subendocardial blood flow per beat ([(ml/min)/g]/heart rate). The relation between myocardial blood flow and wall function at a heart rate of 55 beats/min (n = 14) was plotted and compared with that studied at a heart rate of 122 beats/min in another group of pigs (n = 14). The increase in subendocardial blood flow per minute during bradycardia was not sufficient to explain the striking increase in function; thus, an independent relation (p less than 0.05) between blood flow per minute and contractile function (percent wall thickening) was found for for each heart rate. In contrast, when myocardial blood flow was normalized for heart rate and expressed per beat, data from both heart rate groups could be described by a single relation. Thus, the subendocardial blood flow per beat predicted wall function independently of heart rate and accounted for changes in both oxygen supply and demand.
Screening for Trisomies in Circulating DNA
Authors: Michael F. Greene, Elizabeth G. Phimister
Journal: New England Journal of Medicine (2014)

In the broadest sense, noninvasive prenatal testing began in the 1970s, when the first articulated-arm diagnostic ultrasound machines produced two-dimensional images of fetuses in utero. Initially, the crude new imaging technology was eagerly adopted for the simple measurement of embryos, fetuses, and fetal parts to develop normative data for gestational-age determination. But as technology and image quality rapidly improved, it quickly became obvious that fetal anatomy could be defined with increasing precision.At approximately the same time, Brock and Sutcliffe1 recognized that alpha-fetoprotein, which is found in very high concentrations in fetal blood and cerebrospinal fluid, could be measured in . . .
The roles of magnetic resonance and endoscopic retrograde cholangiopancreatography (MRCP and ERCP) in the diagnosis of patients with suspected sclerosing cholangitis: a cost-effectiveness analysis
Authors: S. Meagher, I. Yusoff, W. Kennedy, M. Martel, V. Adam, A. Barkun
Journal: Endoscopy (2007)

See also: Commentaire de travail de S. Meagher et al., pp. 222Endoscopy 2007; 39(03): 265-265DOI: 10.1055/s-0032-1306918
Dealing with Limited Resources
Authors: H G Welch, E B Larson
Journal: New England Journal of Medicine (1988)

IN the spring of 1987, the Joint Ways and Means Committee of the Oregon legislature faced a painful choice. The Division of Adult and Family Services, charged with administering the state Medicaid program, framed the options for the next two years. During the next biennium — the basic funding period in Oregon — Medicaid could either extend its funding for basic health care to include about 1500 persons not covered previously, or continue to fund a program of organ transplantation (bone marrow, heart, liver, and pancreas) for a projected 34 patients.In a dramatic example of the type of painful . . .
A comparison of the expression of known basement membrane components with the linear IgA disease antigens using the novel substrate cylindroma
Authors: None Wojnarowska, None Allen, None Collier, None Leigh
Journal: British Journal of Dermatology (1999)

Linear IgA disease (LAD) is characterized by IgA basement membrane zone autoantibodies. Immunofluorescence, immunoblotting and immunoelectron microscopy studies have established the complexity and heterogeneity of the target antigens. We have studied the expression of the LAD antigens by cylindroma, a benign epithelial tumour that secretes abundant basement membrane, using 57 LAD sera categorized by indirect immunofluorescence on intact and salt-split skin. The expression of known components of hemidesmosomes, the anchoring filaments, extracellular matrix and the anchoring fibrils could be differentiated and were compared with the expression of the LAD antigens. The results showed that the LAD sera bound to the cylindroma tumour in two distinctive patterns. Thirty-three sera were positive on cylindroma. Twenty-seven sera bound to the basement membrane around the tumour clusters and the islets within the clusters in a thin linear band that was occasionally discontinuous. This was similar to the pattern observed with antibodies to the hemidesmosome components, the α6β4 integrin and the bullous pemphigoid antigens BP230 and BP180. This pattern was observed with sera that bound to the epidermal (11) and the dermal (3) aspects of split skin or were negative (11), and with one serum which bound only to intact skin. Seven sera, all binding to the dermal aspect of split skin, bound the tumour cluster basement membrane in a thick band that was identical in appearance to that seen with antibodies to collagen VII; however, binding to the islets was either identical to collagen VII or similar but differentiated with double staining. Some sera were negative on cylindroma. Using fluorescence overlay antigen mapping we demonstrated colocalization of some epidermal-associated LAD target antigens with known hemidesmosome proteins, and colocalization of some dermal-associated LAD target antigens with anchoring fibril components. The results using cylindroma as substrate suggest that LAD autoantibodies may react with three or more target antigens. We propose from the results of this study that the autoantibodies in LAD target multiple antigens associated with hemidesmosomes and anchoring fibrils.
Characteristics of Psychiatric Inpatients Who Stalk, Threaten, or Harass Hospital Staff After Discharge
Authors: David A. Sandberg, Dale E. McNiel, Renée L. Binder
Journal: American Journal of Psychiatry (1998)

OBJECTIVE: The purpose of this study was to identify demographic and clinical characteristics of psychiatric inpatients who stalk, threaten, or harass hospital staff after discharge. METHOD: The authors retrospectively summarized the demographic and clinical characteristics of 17 inpatients who engaged in this type of behavior and a comparison group of 326 inpatients. RESULTS: The patients who stalked, threatened, or harassed staff after discharge were significantly more likely than the comparison patients to have a diagnosis of personality disorder and/or paranoid disorder, erotomanic subtype, and to have a history of physically assaultive or fear-inducing behavior. The data suggest that they were more likely to be male and never married and to have histories of multiple hospitalizations, suicidal or self-injurious behavior, and substance abuse or dependence. CONCLUSIONS: The findings reveal several risk factors that may be useful in identifying a subgroup of patients who pose a risk of directing aggressive behavior toward hospital staff after discharge. (Am J Psychiatry 1998; 155:1102–1105)
Family Consent to Orders Not to Resuscitate-Reply
Authors: Tom Tomlinson
Journal: JAMA (1991)

<h3>In Reply.—</h3> We agree wholeheartedly with the reasons given by Dr Doukas for disclosure to the patient and family of the physician's decision against offering futile resuscitation, and we would add that we also agree fully with Dr Youngner's<sup>1</sup>editorial warning against the conclusion that if consent isn't required, neither is communication. In the normal situation, there are plenty of good reasons for talking with patients or families about the wisdom of limiting treatment, even if protecting the patient's rights to choose treatment is no longer one of them. Dr Paradis is right to remind us that the involvement of multiple family members inevitably complicates discussion, which should take place despite the difficulties. If families are not offered the authority to make a decision about futile resuscitation, it may at least help avoid the attempted exercise of veto powers by individuals and the standoffs that result. Finally, we agree
Trans-ancestry mutational landscape of hepatocellular carcinoma genomes
Authors: Yasushi Totoki, Kenji Tatsuno, Kyle R Covington, Hiroki Ueda, Chad J Creighton, Mamoru Kato, Shingo Tsuji, Lawrence A Donehower, Betty L Slagle, Hiromi Nakamura, Shogo Yamamoto, Eve Shinbrot, Natsuko Hama, Megan Lehmkuhl, Fumie Hosoda, Yasuhito Arai, Kim Walker, Mahmoud Dahdouli, Kengo Gotoh, Genta Nagae, Marie-Claude Gingras, Donna M Muzny, Hidenori Ojima, Kazuaki Shimada, Yutaka Midorikawa, John A Goss, Ronald Cotton, Akimasa Hayashi, Junji Shibahara, Shumpei Ishikawa, Jacfranz Guiteau, Mariko Tanaka, Tomoko Urushidate, Shoko Ohashi, Naoko Okada, Harsha Doddapaneni, Min Wang, Yiming Zhu, Huyen Dinh, Takuji Okusaka, Norihiro Kokudo, Tomoo Kosuge, Tadatoshi Takayama, Masashi Fukayama, Richard A Gibbs, David A Wheeler, Hiroyuki Aburatani, Tatsuhiro Shibata
Journal: Nature Genetics (2014)
Anaphylaxis From Chymopapain
Authors: Karl Agre
Journal: JAMA (1984)

<h3>To the Editor.—</h3> Dr I. Leonard Bernstein's<sup>1</sup>recent letter concerning the incidence of anaphylaxis and mortality during chemonucleolysis for herniated lumbar intervertebral disks was based in part on information also published inThe Journal.<sup>2,3</sup>An ongoing, postmarketing surveillance program initiated by Smith Laboratories at the time the Food and Drug Administration approved Chymodiactin, our formulation of chymopapain, has provided important data from an additional 18,323 patients that can now be added to the data from the approximately 1,600 patients who participated in our clinical trials before FDA release. First, none of the 18,323 patients described in the surveillance program as of Aug 29, 1983, has died of an allergic reaction, leading to an overall mortality rate for Chymodiactintreated patients of 0.01%. This is markedly reduced from the 0.15% mortality figure cited by Dr Bernstein and is considerably less than the 0.12% mortality reported for laminectomy (<i>Acta Med Scand</i>1972;142:1-95).
Kaposi's Sarcoma, Vascular Permeability, and Scientific Integrity
Authors: Barbara Ensoli
Journal: JAMA (1994)

<h3>To the Editor.</h3> —After a careful reading of the article by Dr Witte and colleagues,<sup>1</sup>a scientific response to the authors is necessary. The authors claim that both the vascular permeability model and the KS-like lesion model used by Nakamura et al<sup>2</sup>to demonstrate the effect of SP-PG in KS are invalid or at least not reproducible in their hands. I have used both models for a variety of studies on KS pathogenesis and found both extremely reproducible and fundamentally the same as described by Nakamura et al in their article. Injection of AIDS KS cells (KS2, KS4, and KS6 cell strains) cultured in conditioned media from human T-cell lymphotropic virus type II (HTLV-II)—transformed T cells as described by Nakamura et al<sup>2</sup>indeed induces vascular permeability and edema (12 hours after injection). These features depend on the number of inoculated cells and increase with higher cell number.
Loss of Cytochrome c Oxidase Promotes RAS-Dependent ROS Production from the ER Resident NADPH Oxidase, Yno1p, in Yeast
Authors: Jane E. Leadsham, Geraldine Sanders, Samantha Giannaki, Emma L. Bastow, Rachael Hutton, Wesley R. Naeimi, Michael Breitenbach, Campbell W. Gourlay
Journal: Cell Metabolism (2013)
Non-B hepatitis in Melbourne: a serological study of hepatitis A virus infection.
Authors: I D Gust, J L Dienstag, R H Purcell, C R Lucas
Journal: BMJ (1977)

A study was performed to establish the value of immune adherence haemagglutination tests for antibody to hepatitis A virus in the diagnosis of non-B hepatitis. Infection with hepatitis A virus was confirmed in 14 out of 16 patients from six families and seven out of nine patients in whom the source of infection was unknown. One additional patient, who had had two episodes of jaundice, was shown to have had an attack of hepatitis A followed by an attack of hepatitis B. In patients with acute hepatitis A antibody detectable by immune adherence haemagglutination becomes detectable three or four weeks after the onset of symptoms and reaches peak levels about five weeks later.
Experiences of the Janus Serum Bank in Norway.
Authors: E Jellum, A Andersen, P Lund-Larsen, L Theodorsen, H Orjasaeter
Journal: Environmental Health Perspectives (1995)

The ongoing JANUS project was started in 1973. The serum bank comprises 424,938 serum samples consolidated from 293,692 donors. The specimens are stored at -25 degrees C. From 1 to 13 consecutive samples are available from each donor. Up to October 1993 about 14,000 of the donors had developed some form of cancer. Frozen serum samples collected from a few months to 19 years prior to clinical recognition of their disease are available for research purposes. The principle aim of the JANUS project is to search in the premorbid sera for chemical, biochemical, immunological or other changes that might be indicative of cancer development at early stages. Gas chromatography-mass spectrometry and two-dimensional protein electrophoresis have been used to evaluate the stability of the frozen sera. Some recent findings are: CA-125 may be elevated months prior to the diagnosis of ovarian cancer; serum thyroglobulin may be a preclinical tumor marker in subgroups of thyroid cancer; low levels of selenium in serum reflects increased risk of thyroid cancer; raised antibodies in serum against Epstein-Barr virus is a risk factor for development of Hodgkins disease; prostate-specific antigen may be elevated years prior to clinical diagnosis of prostate cancer; and linoleic acid in serum phospholipids is inversely related to breast cancer risk. The serum bank is, in principle, suitable for environmental studies, e.g., human exposure assessment. The steering committee of the JANUS project is open to suggestions for collaborative research on this topic.
Atrial Tachycardia with Block Treated with Digitalis
Authors: WILLIAM L. MORGAN, GERALD M. BRENEMAN
Journal: Circulation (1962)

Fifteen cases of atrial tachycardia with block were seen at the Henry Ford Hospital in 1 year. In nine cases the arrhythmia was not a result of digitalis excess. One of these nine patients has had the arrhythmia for 5 years, and two others had not received prior digitalis. In four cases, stopping digitalis and adding potassium did not affect the arrhythmia. Two patients experienced a brief episode of the arrhythmia while continuing digitalis. The addition of digitalis or a continued maintenance dose was necessary to control congestive heart failure or a rapid ventricular rate in all nine patients. The six remaining patients with atrial tachycardia with block had digitalis intoxication. When one first encounters this arrhythmia, the possibility of digitalis intoxication should immediately be considered. Digitalis and diuretics should be stopped and potassium added. If the arrhythmia persists despite this therapy, digitalis intoxication becomes less likely and the administration of the drug may be indicated.
Prognostic implications of left ventricular hypertrophy and its regression in the old old: The bronx longitudinal aging study
Authors: William Frishman, Shoshonah Wolfson, Wee Lock Ooi, Mark Heiman, Jeremy Nadelmann, Samuel Weissman, Eliot Lazar, Miriam Aronson
Journal: Journal of the American College of Cardiology (1991)
Reliance on erythema scores may mask severe atopic dermatitis in black children compared with their white counterparts
Authors: M.A. Ben-Gashir, P.T. Seed, R.J. Hay
Journal: British Journal of Dermatology (2002)

Summary Background The prevalence of atopic dermatitis (AD) has been shown to be higher in London‐born black Caribbean children than in their white counterparts, but little is known about the severity of the disease. Objectives To carry out a longitudinal survey to investigate potential risk factors for AD severity in children. We report our findings in relation to differences in disease severity between white and black children and the effect of inclusion and exclusion of erythema scores on this comparison. Methods The recruited children were identified by their general practitioners (GPs) as having presented with AD, and the U.K. diagnostic criteria for AD were used to verify the diagnosis. Interview and clinical examination of children took place up to four times, 6 months apart. Each time, the same observer assessed AD severity using the SCORAD (SCORe Atopic Dermatitis) index. Potential risk factors and confounders were evaluated with a five‐page questionnaire. Non‐parametric tests were used for statistical analysis and the study participant remained the unit of the analysis. Results In total, 137 children (82 urban and 55 rural) were recruited, and each seen up to four times. This gave 380 observations (69% of an expected 548). The urban population contained 42 (51%) white children, 26 (32%) black children and 14 (17%) from other races. The rural population was entirely white. The 14 children from other races were completely excluded from the statistical analysis. The black children were all born in the U.K. On crude analysis, children with black skin showed a non‐significantly lower risk of severe disease when compared with white children (odds ratio, OR 0·84; 95% confidence interval, CI 0·4–1·76; P = 0·65), while a highly significantly increased risk was found after adjusting for erythema score (OR 5·93; 95% CI 1·94–18·12; P = 0·002). The difference remained significant even after controlling for other potential confounders. Conclusions Black children with AD are about six times more at risk of having severe AD than their white counterparts. GPs and dermatologists should note that erythema can be a misleading indicator of severity in black children. Difficulties of assessment due to skin pigmentation might mean that severe cases are not being detected and appropriately treated.
Bacterial Endocarditis Caused by Coagulase-negative Staph. albus
Authors: C. C. Cobb
Journal: BMJ (1952)

MEDICAL MEMORANDAI.(6.5, 8, 16, and 32 mg.) on the first, second, third, and fourth days, respectively, and then + gr. (32mg.) on each of the' remaining 14 days of the in-patient period: the subse- quent increments (see Table ) were prescribed from the out-patient clinic.Within 19 days of the beginning of Dosage of Dry Thyroid and Weight of Infant Age in Months Averge Daily Dose Weight of Dry Thyroid (B.P.) 5-6 .. ..
AN UNUSUAL VARIANT OF LUPUS ERYTHEMATOSUS OR LICHEN PLANUS*
Authors: P. W. MONCKTON COPEMAN, ARNOLD L. SCHROETER, ROBERT R. KIERLAND
Journal: British Journal of Dermatology (1970)

Four patients with a similar eruption of distinct livid plaques are presented. Clinically, the lesions were difficult to diagnose as either lichen planus or lupus erythematosus. However, histological studies with standard and immunofluorescence staining methods were more consistent with lichen planus. In contrast, certain laboratory findings and the clinical course were suggestive of lupus erythematosus.
Collaborative Management of Chronic Illness
Authors: Michael Von Korff
Journal: Annals of Internal Medicine (1997)

In chronic illness, day-to-day care responsibilities fall most heavily on patients and their families. Effective collaborative relationships with health care providers can help patients and families better handle self-care tasks. Collaborative management is care that strengthens and supports self-care in chronic illness while assuring that effective medical, preventive, and health maintenance interventions take place. In this paper, the following essential elements of collaborative management developed in light of behavioral principles and empirical evidence about effective care in chronic illness are discussed: 1) collaborative definition of problems, in which patient-defined problems are identified along with medical problems diagnosed by physicians; 2) targeting, goal setting, and planning, in which patients and providers focus on a specific problem, set realistic objectives, and develop an action plan for attaining those objectives in the context of patient preferences and readiness; 3) creation of a continuum of self-management training and support services, in which patients have access to services that teach skills needed to carry out medical regimens, guide health behavior changes, and provide emotional support; and 4) active and sustained follow-up, in which patients are contacted at specified intervals to monitor health status, identify potential complications, and check and reinforce progress in implementing the care plan. These elements make up a common core of services for chronic illness care that need not be reinvented for each disease.