tbuckley/cabot-search huggingface dataset:
Relation between myocardial perfusion and left ventricular function following acute coronary occlusion: disproportionate effects of anterior vs. inferior ischemia.
Authors: R M Schneider, K G Morris, A Chu, K B Roberts, R E Coleman, F R Cobb
Journal: Circulation Research (1987)

This study examined the relation between left ventricular (LV) function and the severity of acute myocardial ischemia in a conscious dog model. The LV ejection fraction (EF) was measured by multigated equilibrium radionuclide angiography, and regional myocardial blood flow was measured with radioactive microspheres before and 10 minutes after distal and then proximal occlusion of the left anterior descending (LAD, 13 dogs) or left circumflex (LC, 13 dogs) coronary artery. Two methods were used to evaluate the extent of ischemia. The first method determined the mass of myocardium that was ischemic based on different degrees of reduced blood flow. The second method estimated the severity of ischemia expressed as blood flow deficit resulting from each coronary occlusion. Global LV function was very sensitive to ischemia, and the relation between change in function and the degree of ischemia were described best by linear functions. The best linear correlation between mass of ischemic myocardium and percent reduction in EF resulted from the ischemic region defined as all tissue with 25% or greater reduction in blood flow, r = 0.84 for LAD (Y = 0.96X + 1.8) and r = 0.75 for LC (Y = 0.53X + 2.0) occlusions. Defining ischemic mass by more severe reduction in blood flow resulted in exclusion of ischemic myocardium that affected function. The myocardial blood flow deficit also correlated linearly with percent reduction in EF, r = 0.89 for LAD (Y = 1.31X + 2.7) and r = 0.81 for LC (Y = 0.83X - 0.1) occlusions. The slope of the regression lines using both analyses of ischemia were significantly greater (p less than 0.01) for LAD than LC occlusions, indicating that for comparable degrees of ischemia LAD as compared to LC occlusion decreased EF to a greater extent. Calculation of EF from attenuated corrected volumes resulted in small changes in LAD, but not LC, EF and did not account for the disproportionate effects of LAD and LC ischemia. In a separate group of studies (n = 18) EF measured by radionuclide angiography after LAD or LC occlusions correlated well with biplane contrast angiography r = 0.93, SEE 5.1. These data suggest that disproportionately greater effects of LAD compared to LC ischemia on global EF in the dog are due primarily to different pathophysiologic responses to ischemia.
SYNTAX Score is a Predictor of Angiographic No-Reflow in Patients with ST Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention
Authors: Durmuş Yıldıray Şahin, Mustafa Gür, Zafer Elbasan, Osman Kuloğlu, Taner Şeker, Ali Kıvrak, İbrahim Halil Tanboğa, Gökhan Gözübüyük, Sinan Kırım, Murat Çaylı
Journal: Journal of the American College of Cardiology (2013)
Hirschsprung's Disease: Congenital Intestinal Aganglionosis
Authors: W. H. J. SUMMERSKILL
Journal: JAMA (1965)

Should a dissertation be published as an original paper, review article, or book, or remain in relative obscurity in the university library? Dr. Madsen has chosen to publish his observations on Hirschsprung's disease in a monograph. In it the information is presented in logical sequence; illustrations are above average, and the references are comprehensive. The translation is adequate, but simple errors in spelling and grammar cause irritation, while more concise use of the English language and greater discrimination between the data would substantially shorten the book. Dr. Madsen pays tribute to his fellow Dane by perpetuating the term Hirschsprung's disease, although pointing out that other authorities described the disorder earlier. A choice from nomenclatures which indicate the concept of ganglion deficiency in the bowel would seem more appropriate. The clinical material comprises 157 patients and is therefore an important addition to the literature, although the diagnosis is supported by histological
Using Electronic Health Records for Surgical Quality Improvement in the Era of Big Data
Authors: Jamie E. Anderson, David C. Chang
Journal: JAMA Surgery (2014)

Risk adjustment is an important component of quality assessment in surgical health care. However, data collection places an additional burden on physicians. There is also concern that outcomes can be gamed depending on the information recorded for each patient.To determine whether a number of machine-collected data elements could perform as well as a traditional full-risk adjustment model that includes other physician-assessed and physician-recorded data elements.All general surgery patients from the National Surgical Quality Improvement Program database from January 1, 2005, to December 31, 2010, were included. Separate multivariate logistic regressions were performed using either all 66 preoperative risk variables or only 25 objective variables. The area under the receiver operating characteristic curve (AUC) of each regression using objective preoperative risk variables was compared with its corresponding regression with all preoperative variables. Subset analyses were performed among patients who received certain operations.Mortality or any surgical complication captured by the National Surgical Quality Improvement Program, both inpatient and within 30 days postoperatively.Data from a total of 745 053 patients were included. More than 15.8% of patients had at least 1 complication and the mortality rate was 2.8%. When examining inpatient mortality, the AUC was 0.9104 with all 66 variables vs 0.8918 with all 25 objective variables. The difference in AUC comparing models with all variables with objective variables ranged from -0.0073 to 0.1944 for mortality and 0.0198 to 0.0687 for complications. In models predicting mortality, the difference in AUC was less than 0.05 among all patients and subsets of patients with abdominal aortic aneurysm repair, pancreatic resection, colectomy, and appendectomy. In models predicting complications, the difference in AUC was less than 0.05 among all patients and subsets of patients with pancreatic resection, laparoscopic cholecystectomy, colectomy, and appendectomy.Rigorous risk-adjusted surgical quality assessment can be performed solely with objective variables. By leveraging data already routinely collected for patient care, this approach allows for wider adoption of quality assessment systems in health care. Identifying data elements that can be automatically collected can make future improvements to surgical outcomes and quality analyses.
MUMPS IN ADULTS: AN ANALYSIS OF 694 CASES
Authors: G. Macleod
Journal: BMJ (1919)

5-MIUMPS IN @ADUL1.fittest in'the vesiculac seminles, anida pt6teeti1" p6ioveion of lTtire'?Tire most mrntrked degeneratitve 6hanges in tile spermbto-oa were found in dementia praecox.
Relation of gene expression (allotypes) of the fourth component of complement to insulin dependent diabetes and its microangiopathic complications.
Authors: C Mijovic, J Fletcher, A R Bradwell, T Harvey, A H Barnett
Journal: BMJ (1985)

About a quarter of insulin dependent diabetics have low concentrations of the fourth component of complement (C4), and a low concentration of C4 is associated with diabetic microangiopathy. The variability of the expression of the C4 gene was compared in insulin dependent diabetics with and without microangiopathy and controls. Of the two genes coding for C4, the A gene (C4A) was not expressed--that is, C4A null--in 16 (13%) of the 126 insulin dependent diabetics compared with none of the 93 controls (p less than 0.001), and all these 16 subjects had low concentrations of C4. Lack of expression of the other C4 gene (C4B) was not associated with insulin dependent diabetes, but a rare variant, C4B3, was significantly increased in the diabetics (21/126; 17%) compared with the controls (none) (p less than 0.001). The prevalence of C4B3 was also increased in the diabetics with complications when compared with those without (14/50 (28%) v 7/76 (9%), p less than 0.01). Low plasma C4 concentrations in insulin dependent diabetics are at least partly due to variation in the expression of the C4 gene. The association of the rare C4B3 variant with microangiopathy suggests a genetic component of its aetiology.
The sickening of medical research
Authors: S. S Siegelman
Journal: BMJ (1988)

Another factor that contributes to the development and especially the severity of the infection is deficiency of the comiiplement component properdin.Meningococcal infections associated with properdin deficiency have a fatality rate approaching 75"!0I.Propcrdin stabilises the in- herentlv labile (3 and C5 convertases."The severe meningococcal infCctions in people with properdin deficiencv contrast with the mild disease in people with deficiencies of the terminal components of complement.'Several factors mav influence the outcome in patients with properdin deficiencv.Opsonisation is unimpaired in terminal deficiencies, but pro- perdin deficiency is associated with impaired serum opsonisation and bactcricidal rcactions.The abilitv to dissolve immunocomplexes in vivo is absent in serum dcficicnt in properdin."The ability to opsonisc cndotoxin coatcd oil drops is also absent., and inability to clear endotoxin could influence the progression of the diseasc.
Contribution of Quantitative Assay Technics to the Understanding of the Clinical Pharmacology of Digitalis
Authors: THOMAS W. SMITH
Journal: Circulation (1972)

Despite recent advances in understanding of the pharmacokinetics and electrophysiologic effects of cardiac glycosides, digitalis toxicity remains distressingly common in clinical practice. Another substantial group of patients is markedly underdigitalized, failing to gain the full therapeutic benefits of optimal use of these drugs. Since cardiac digitalis toxicity is a dose-related phenomenon, and serum or plasma digoxin and digitoxin concentrations rise with increasing doses, at least a statistical correlation between circulating levels and clinical state might be expected. Increasing availability of serum or plasma digitalis concentration measurements thus offers the clinician a potential means of improving the patient's chances of benefiting from treatment with cardiac glycosides. Assay methods in current use include a double-isotope dilution derivative method (digitoxin), red cell 86 Rb-uptake inhibition (digitoxin and digoxin), Na + -K + ATPase inhibition (digitoxin), ATPase enzymatic displacement (digitoxin and digoxin), gas chromatography (digoxin), and radioimmunoassay (digitoxin, digoxin, and ouabain). The rapidly expanding literature reporting clinical experience with these technics reflects general agreement that mean serum or plasma digoxini and digitoxin levels are significantly higher in patients with clinical evidence of toxicity compared with nontoxic patients. Nevertheless, multiple factors influence individual responses, and blood level data must be interpreted in the overall clinical context. Hypokalemia, hypercalcemia, hypomagnesemia, acid-base disturbances, hypoxemia, and hypothyroidism all tend to decrease tolerance to any given digitalis dose or blood level. Autonomic nervous system tone and other drugs concurrently received must also be considered. Advanced heart disease in general, and coronary artery disease in particular, appear to predispose patients to apparent digitalis toxicity at relatively lower serum or plasma levels. Cardiac glycoside assay technics have also proven useful in various studies of the clinical pharmacology of digoxin, digitoxin, and ouabain. Handling of digoxin by patients on cardiopulmonary bypass has been assessed, and gastrointestinal absorption has been evaluated in normal subjects; poor and erratic absorption of the drug has been documented in patients with malabsorption syndromes. Potentially important drug-drug interactions of agents such as phenobarbital and phenylbutazone with digitoxin have been studied, as well as the effects of steroid-binding resins on digoxin and digitoxin metabolism. Studies of ouabain pharmacokineties by radioimmunoassay have demonstrated a plasma half-life of 21 hours, indicating that, as in the case of digoxin and digitoxin, half-life of serum or plasma concentration after establishment of blood-tissue equilibrium bears a close relationship to duration of clinical effect.
Process and impact of mergers of NHS trusts: multicentre case study and management cost analysis
Authors: N. Fulop
Journal: BMJ (2002)

<h3>Abstract</h3> <b>Objective</b>: To study the processes involved in and impact of mergers between NHS trusts, including the effect on management costs. <b>Design</b>: Cross sectional study involving in depth interviews and documentary analysis; case study to compare savings in management costs between case trusts and control trusts. <b>Setting</b>: Nine trusts (cross sectional study) and four trusts (case study) in London. <b>Participants</b>: 96 interviews with trust board members, other senior managers, clinicians, service managers, and representatives of health authorities, regional office, community health councils, local authorities, other trusts in the area, and primary care groups and trusts. <b>Main outcome measures</b>: Stated and unstated drivers, and impact of merger on delivery and development of services, management structures, and staff recruitment, retention, and morale. Effects of difference in trust size before and after the merger. Savings in management costs two years after merger. <b>Results</b>: Some important drivers for merger are not publicly stated. Mergers had a negative effect on delivery of services because of a loss of managerial focus on services. Planned developments in services were delayed by at least 18 months. Trusts9 larger sizes after mergers had unintended negative consequences, as well as predicted advantages. The tendency for one trust9s management team to dominate over the other resulted in tension. No improvement in recruitment or retention of clinical and managerial staff was reported. Perceived differences in organisational culture were an important barrier to bringing together two or more organisations. Two years after merger, merged trusts had not achieved the objective of saving £500 000 a year in management costs. <b>Conclusions</b>: Important unintended consequences need to be accounted for when mergers are planned. Mergers can cause considerable disruptions to services, and require greater management support than previously acknowledged. Other organisations undergoing restructuring, such as primary care groups developing into primary care trusts and health authorities merging into strategic health authorities, should take these findings into account.
The Effect of Histamine on Skin and Deep Temperatures in Man With Particular Reference to Liver Temperature
Authors: W. Graf
Journal: Journal of Clinical Investigation (1957)

Among the numerous investigations on the ef- fects of histamine on regional temperatures and heat regulation the following reports deserve mention as they deal with problems related to the present investigation:Dale and Laidlaw (1) reported that a large dose of histamine lowered the body temperature of dogs and guinea-pigs.Harmer and Harris (2) ad- ministered a moderate dose of histamine to hu- mans, resulting in an increase of the skin temperature and a rise of rectal temperature.These authors suggested that the opposite effect on the rectal temperature would have seemed more likely.Thiessen and Snell (3), in a series of peptic ulcer cases, found that subsequent to a histamine dose gastric temperature fell whereas oral and rectal temperatures rose.Deutsch, Spitzy and Wohlrab (4) stated that after a dose of histamine the gastric temperature fell to the same extent in achlorhydric cases as in normals.The conclusion was drawn that gastric temperature and secretion are not re- lated to each other.Henning, Demling and Kinzl-
Contamination of Potable Water Distribution Systems by Multiantimicrobial-Resistant Enterohemorrhagic <i>Escherichia coli</i>
Authors: Siya Ram, Poornima Vajpayee, Rishi Shanker
Journal: Environmental Health Perspectives (2007)

The contamination of processed or unprocessed drinking water by fecal coliform bacteria has been reported worldwide. Despite a high incidence of waterborne diseases, entero-hemorrhagic Escherichia coli (EHEC) is an underacknowledged pathogen of concern to public health in India. Although the presence of EHEC is recorded in surface water resources of India, drinking water sources are yet to be investigated.The goal of this study was to analyze potable water samples for the presence of virulence determinants of EHEC and to determine the sensitivity of the virulence determinants to antimicrobials.We enumerated coliform bacteria in potable water samples collected from six locations in Lucknow, a major city in northern India, using the most probable number method. E. coli (n = 81), randomly isolated by membrane-filtration technique from four sites, were identified by biochemical characterization. E. coli were not detected in samples from two other sites. We screened 15 randomly selected isolates from each site for virulence determinants of EHEC using polymerase chain reaction (PCR). The isolates positive for virulence determinants (n = 18) were screened for sensitivity to 15 antimicrobials by the disk diffusion method.Both stx1 and stx2 genes were present in 33.3% of isolates, whereas others possessed either stx1 (11.1%) or stx2 (55.6%). eaeA, hlyA, and chuA genes were present in 100, 23.3, and 16.7% of isolates, respectively. Resistance to multiple antimicrobials was observed in potential EHEC.The occurrence of multiantimicrobial-resistant EHEC in potable water is an important health concern because of the risk of waterborne outbreaks.
Airway remodelling: the future
Authors: L-P. Boulet, P. J. Sterk
Journal: European Respiratory Journal (2007)

The research of structural changes in airway diseases is relatively recent compared with studies on physiological or inflammatory features. In airway diseases such as asthma and chronic obstructive pulmonary disease (COPD), structural alterations have been observed, such as: epithelial desquamation or hyperplasia; increases in smooth muscle mass; angiogenesis; increases in subepithelial collagen deposition, proteoglycans and elastin content; cartilage changes; and goblet cell and glandular hyperplasia, in addition to increased airway wall thickening 1.

During the past months, the European Respiratory Journal has published a series on airway remodelling in order to review the state of knowledge in this increasingly important domain 2–6. We learnt from this series that airway remodelling is by no means a single entity. It is a complex and dynamic process with multiple components, evolving differently in various conditions, according to the type and extent of the structural responses to inflammatory or physical stimuli, probably under genetic influences modulating host response to the latter. The various in vitro and animal models developed to study the pathways involved in the changes in the bronchial structure induced by airways allergic reactions or other stimuli confirm this vast heterogeneity. The possible clinical significance of these structural changes and the effects of treatment are even more diverse. Hence, at this stage we will need to further elaborate on the main challenges for research in this field in order to help better understand the mechanisms of airway remodelling and to decide if, how and when to intervene on this process.

Some of the key questions on airway remodelling are itemised in table 1⇓. Here are some of what we consider to be the vital remaining domains of research in this field.

View this table:

Table 1— 
Remaining questions on airway remodelling



### What is the time-course of the various remodelling changes?

Animal models and studies of groups such as asymptomatic subjects with …
“Magical number 5” in a chimpanzee
Authors: Nobuyuki Kawai, Tetsuro Matsuzawa
Journal: Behavioral and Brain Sciences (2001)

One of our recent studies has revealed that a numerically trained chimpanzee can memorize a correct sequence of five numbers shown on a monitor. Comparative investigations with humans show very similar patterns of errors in the two species, suggesting humans and chimpanzee share homologous memory processes. Whether or not 5 is a pure capacity limit for the chimpanzee remains an empirical question.
Distinct progenitor populations in skeletal muscle are bone marrow derived and exhibit different cell fates during vascular regeneration
Authors: Susan M. Majka, Kathyjo A. Jackson, Kirsten A. Kienstra, Mark W. Majesky, Margaret A. Goodell, Karen K. Hirschi
Journal: Journal of Clinical Investigation (2003)

Vascular progenitors were previously isolated from blood and bone marrow; herein, we define the presence, phenotype, potential, and origin of vascular progenitors resident within adult skeletal muscle. Two distinct populations of cells were simultaneously isolated from hindlimb muscle: the side population (SP) of highly purified hematopoietic stem cells and non-SP cells, which do not reconstitute blood. Muscle SP cells were found to be derived from, and replenished by, bone marrow SP cells; however, within the muscle environment, they were phenotypically distinct from marrow SP cells. Non-SP cells were also derived from marrow stem cells and contained progenitors with a mesenchymal phenotype. Muscle SP and non-SP cells were isolated from Rosa26 mice and directly injected into injured muscle of genetically matched recipients. SP cells engrafted into endothelium during vascular regeneration, and non-SP cells engrafted into smooth muscle. Thus, distinct populations of vascular progenitors are resident within skeletal muscle, are derived from bone marrow, and exhibit different cell fates during injury-induced vascular regeneration.
Alterations in Cardiac Function Following Electrical Conversion of Atrial Fibrillation to Normal Sinus Rhythm.
Authors: William Shapiro
Journal: Annals of Internal Medicine (1967)

s1 May 1967Alterations in Cardiac Function Following Electrical Conversion of Atrial Fibrillation to Normal Sinus Rhythm.William Shapiro, M.D., Garner Klein, M.D.William Shapiro, M.D.Search for more papers by this author, Garner Klein, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-1039_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptEvaluation of cardiac performance requires analysis of both pressure and flow data. Eleven right heart catheterizations were performed (six included exercise observations) to compare measurements of pressure and flow before and immediately after conversion of atrial fibrillation to normal sinus rhythm (NSR). Six patients (seven studies), mean age 62, had ischemic or idiopathic heart disease. Four patients, mean age 41.5, had undergone previous mitral valvulotomy. Digitalis, quinidine, and anesthesia were managed routinely. With NSR, right atrial (RA) mean "a" pulse pressure was only 1.9 ± 1.6 mm Hg, mean RA "a" height was 3.4 mm Hg, and "a" waves were... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Dallas, Texas PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1967Volume 66, Issue 5Page: 1039-1039KeywordsAnesthesiaAtrial fibrillationBlood pressureCardiovascular therapyCatheterizationExerciseHeartLongitudinal studies Issue Published: 1 May 1967 PDF downloadLoading ...