tbuckley/cabot-search huggingface dataset:
Surgery of violence. IV. Blast injuries of the ear.
Authors: A G Kerr, J E Byrne
Journal: BMJ (1975)

The shock front of a blast wave is irregular and can be deflected by obstacles in its pathway, depending on their size and position. Consequently, the injurious effects of blast tend to be capricious, and one person may be unharmed while those around him are killed or severely injured. In most explosions solid material is changed suddenly into a gas with an enormous increase in volume and thus of pressure. The blast wave spreads outwards from the site of the explosion, initially faster than the speed of sound. The wave consists of a short positive phase followed by a much longer, but less distinct, negative phase. The positive phase may reach very high pressures, and its duration is usually a few milliseconds. The magnitude of the negative phase cannot be greater than atmospheric pressure, but the duration is much longer than that of the positive phase and is usually tens of milliseconds.
Survival after bilateral renal artery occlusion.
Authors: R J McGonigle, J A Trafford, P Sharpstone, J S Tapson
Journal: BMJ (1979)

DiscussionOur findings indicate, firstly, that a therapeutic degree of anticoagulation can be maintained even though hormonal contraceptives are being administered simultaneously, and, secondly, that oral contraceptives seem to potentiate the action of oral anticoagulants, although this effect is not clinically significant, and slight adjustments in the anticoagulart dose are enough to maintain prothrombin activity within the therapeutic range.Our second conclusion does not agree with the generally accepted belief that oral contraceptives would diminish the effects of oral anticoagulants.3This has been thought to occur through procoagulant action at three levels: (a) increased concentrations of certain coagulation factors, mainly factor VII and factor X4 5; (b) diminished concentrations of antithrombin 1116; and (c) a local effect on vascular endothelia.7 Nevertheless, interaction between oral anticoagulants and oral contraceptives is quite possible at other levels, some of them imperfectly understood.The synthetic oestrogens contained in oral contra- ceptives may produce enzymatic inhibition in the microsomes of the hepatic cells8 9 which would potentiate the action of anti- coagulants through retarded metabolic degradation.' 0The resultant interaction may represent only the net balance of opposing actions, which will require further study and clarification.
Physical examination and classification of murmur findings into patterns improved diagnosis of systolic murmurs in adult inpatients
Authors: Srinivas Merugu
Journal: Annals of Internal Medicine (2011)

ACP Journal Club15 March 2011Physical examination and classification of murmur findings into patterns improved diagnosis of systolic murmurs in adult inpatientsSrinivas Merugu, MDSrinivas Merugu, MDSt. Vincent Charity Medical Center, Cleveland, Ohio, USA (S.M.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-6-201103150-02012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationMcGee S. Etiology and diagnosis of systolic murmurs in adults. Am J Med. 2010;123:913-21. https://pubmed.ncbi.nlm.nih.gov/20920693Clinical Impact RatingsGIM/FP/GP: Hospitalists: Cardiology: References1 Grais IM. Bedside skills: a 50-year personal retrospective. Tex Heart Inst J. 2010;37:629-32. [PMID: 21224929] Google Scholar2 Fred HL. Hyposkillia: deficiency of clinical skills. Tex Heart Inst J. 2005;32:255-7. [PMID: 16392201] Google Scholar Author, Article, and Disclosure InformationAuthors: Srinivas Merugu, MDAffiliations: St. Vincent Charity Medical Center, Cleveland, Ohio, USA (S.M.)This article was published at Annals.org on 1 March 2011. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 March 2011Volume 154, Issue 6Page: JC3-12KeywordsHeartInpatientsLikelihood ratioMedical educationMitral insufficiencyStenosisSystolic ejection murmurThoraxValvular diseasesVital signs ePublished: 15 March 2011 Issue Published: 15 March 2011 Copyright & PermissionsCopyright © 2011 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Expression of DNA methyltransferases DNMT1,3A, and 3B in normal hematopoiesis and in acute and chronic myelogenous leukemia
Authors: Shin-ichi Mizuno, Takahito Chijiwa, Takashi Okamura, Koichi Akashi, Yasuyuki Fukumaki, Yoshiyuki Niho, Hiroyuki Sasaki
Journal: Blood (2001)
Testosterone-binding globulins in human plasma: studies on sex distribution and specificity
Authors: William Rosner, Susan M. Deakins
Journal: Journal of Clinical Investigation (1968)

When human plasma is mixed with testosterone-3H and subjected to electrophoresis on paper in glycine acetate buffer at pH 8.6, at least two proteins other than albumin bind the testosterone. In normal women 80.5 ± 1.9% (SEM) of the recovered radioactivity migrates with the β-globulins, 7.3 ± 0.80% with the inter-α-globulins, and 4.3 ± 0.40% with albumin. In normal men the percentages are 69.3 ± 3.0%, 14.3 ± 1.6%, and 6.2 ± 1.1%, respectively. These differences between men and women in binding among the β-globulins and inter-α-globulins are statistically significant (P < 0.001). The highest percentages of radioactivity associated with the β-globulins are seen in infants of both sexes, men receiving diethylstillbestrol, and pregnant women. These same subjects have the lowest percentages of radioactivity associated with the inter-α-globulins. Experiments with carrier testosterone indicate that at least some of the differences between the normal men and women and infants can be explained by differences in the concentration of endogenous testosterone. This factor alone, however, cannot explain the increased binding among the β-globulins in the men receiving diethylstilbestrol or in the pregnant females. In this system estrone, estradiol, dehydroisoandrosterone, androsterone, 17α-hydroxyprogesterone, and 19-nortestosterone compete with testosterone for binding sites on the proteins. None is as potent as testosterone itself.
EXPERIMENTAL NEEDLE BIOPSY OF THE MYOCARDIUM OF DOGS WITH PARTICULAR REFERENCE TO HISTOLOGIC STUDY BY ELECTRON MICROSCOPY
Authors: Kenneth C. Price, Jules M. Weiss, Daikichi Hata, John R. Smith
Journal: The Journal of Experimental Medicine (1955)

Our experience with needle biopsy of the heart in dogs indicates that myocardial tissue can be sampled one or more times in each animal with comparative safety. Tamponade, pericarditis, serious arrhythmias, or myocardial infarction due to the interruption of coronary vessels was not observed. Excellent specimens were obtained for critical study by light and electron microscopy. Casten and Marsh (1) have used biochemical techniques to study myocardial tissue obtained in similar fashion. Histochemical methods would also be applicable. Although limited to animal studies at present, the technique may conceivably be adapted to the study of human disease. Myocardial puncture has been carried out (20-22) in patients for the recording of intracardiac pressures and for other diagnostic purposes without apparent harm. Our study of the myocardium of dogs by electron microscopy generally confirms the observations of other workers, except that presence of significant numbers of red blood cells in the extravascular spaces of the heart had not been previously described (and is possibly an artifact). Nevertheless, it is notable that the tissue cells, cellular membranes, and intracellular structures appeared to be intact and undistorted in the tissue specimens which were obtained, fixed, and examined by these methods.
Booster Vaccinations against Cancer Are Critical in Prophylactic but Detrimental in Therapeutic Settings
Authors: Alessia Ricupito, Matteo Grioni, Arianna Calcinotto, Rodrigo Hess Michelini, Renato Longhi, Anna Mondino, Matteo Bellone
Journal: Cancer Research (2013)

Abstract Although cancer vaccines are in the clinic, several issues remain to be addressed to increase vaccine efficacy. In particular, whether how and how frequently a patient should be boosted remains to be defined. Here, we have assessed the ability of dendritic cell (DC)-based vaccines to induce a long-lasting tumor-specific CTL response in either prophylactic or therapeutic settings by taking advantage of transplantable and spontaneous mouse tumor models. Implementing a 24-hour ex vivo intracellular cytokine production assay, we have found that priming with a DC-based vaccine induced a long-lasting CTL response in wild-type mice, and homologous boosting better sustained the pool of central memory T cells, which associated with potent protection against B16F1 melanoma challenge. Appropriate timing of booster vaccination was also critical, as a tight boosting schedule hindered persistence of IFN-γ–competent memory CD8+ T cells and mice survival in prophylactic settings. Conversely, prime/boost vaccination proved to be of no advantage or even detrimental in therapeutic settings in B16F1 and transgenic adenocarcinoma of the mouse prostate (TRAMP) models, respectively. Although DC priming was indeed needed for tumor shrinkage, restoration of immune competence, and prolonged survival of TRAMP mice, repeated boosting did not sustain the pool of central memory CTLs and was detrimental for mice overall survival. Thus, our results indicate that booster vaccinations impact antitumor immunity to different extents, depending on their prophylactic or therapeutic administration, and suggest evaluating the need for boosting in any given patient with cancer depending on the state of the disease. Cancer Res; 73(12); 3545–54. ©2013 AACR.
GASTRO-ENTEROTOMY FOR INTESTINAL OBSTRUCTION. TWO CASES—BOTH FATAL.
Authors: W. M. FUQUA
Journal: JAMA (1883)

In the summer of 1880, I visited a negro man on the premises of Mr. Campbell, in Trigg county, in consultation with Drs. Boyd, Edwards and Worthington, of LaFayette. He had suffered from obobstructed intestine for about a week; was 35 or 40 years old, and in the main had good health. The patient presented the following condition: Tenderness and tympanitis over the whole abdomen, right side of abdomen most prominent and resonant; pulse 130; respiration 24; stercoraceous vomiting; skin cool, and tendency to collapse. Rectal examination revealed nothing. After a careful and thorough discussion, it was unanimously agreed to make an abdominal section, entertaining the idea that the patient labored under intussusception, looping of the intestine, or some other form of acute obstruction. After administering chloroform, and drawing off the urine, the abdomen was laid open from the umbilicus to the pubes. The intestines, distended to their utmost, gushed
Leptin Prevents Respiratory Depression in Obesity
Authors: CHRISTOPHER P. O'DONNELL, CHARLES D. SCHAUB, ABBY S. HAINES, DAN E. BERKOWITZ, CLARKE G. TANKERSLEY, ALAN R. SCHWARTZ, PHILIP L. SMITH
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

Human obesity leads to an increase in respiratory demands. As obesity becomes more pronounced some individuals are unable to compensate, leading to elevated arterial carbon dioxide levels (PaCO2 ), alveolar hypoventilation, and increased cardiorespiratory morbidity and mortality (Pickwickian syndrome). The mechanisms that link obesity and hypoventilation are unknown, but thought to involve depression of central respiratory control mechanisms. Here we report that obese C57BL/6J-Lep ob mice, which lack circulating leptin, also exhibit respiratory depression and elevated PaCO2 ( > 10 mm Hg; p < 0.0001). A role for leptin in restoring ventilation in these obese, mutant mice was investigated. Three days of leptin infusion (30 μ g/d) markedly increased minute ventilation (V˙ e) across all sleep/wake states, but particularly during rapid eye movement (REM) sleep when respiration was otherwise profoundly depressed. The effect of leptin was independent of food intake, weight, and CO2 production, indicating a reversal of hypoventilation by stimulation of central respiratory control centers. Furthermore, leptin replacement in mutant mice increased CO2 chemosensitivity during non–rapid eye movement (NREM) (4.0 ± 0.5 to 5.6 ± 0.4 ml/min/%CO2; p < 0.01) and REM ( − 0.1 ± 0.5 to 3.0 ± 0.8 ml/min/%CO2; p < 0.01) sleep. We also demonstrate in wild-type mice that ventilation is appropriately compensated when obesity is diet-induced and endogenous leptin levels are raised more than tenfold. These results suggest that leptin can prevent respiratory depression in obesity, but a deficiency in central nervous system (CNS) leptin levels or activity may induce hypoventilation and the Pickwickian syndrome in some obese subjects. O'Donnell CP, Schaub CD, Haines AS, Berkowitz DE, Tankersley CG, Schwartz AR, Smith PL. Leptin prevents respiratory depression in obesity.
Relation Between Cardiac Sympathetic Activity and Hypertensive Left Ventricular Hypertrophy
Authors: Markus P. Schlaich, David M. Kaye, Elisabeth Lambert, Marcus Sommerville, Flora Socratous, Murray D. Esler
Journal: Circulation (2003)

Background— Left ventricular (LV) hypertrophy is an independent risk factor for cardiovascular morbidity and mortality in hypertensive subjects. Sympathetic activation has been suggested to contribute to LV hypertrophy, but this has not yet been conclusively validated in humans. Methods and Results— We comprehensively assessed total systemic and regional sympathetic activity by radiotracer dilution methods and microneurography in 15 untreated hypertensive subjects with echocardiographic evidence of LV hypertrophy (EH+), 11 hypertensive subjects with similar blood pressure but without LV hypertrophy (EH−), and 10 age-matched normotensive control subjects (NT). LV mass index was 87±15 g/m 2 in NT, 106±11g/m 2 in EH−, and 138±17g/m 2 in EH+ ( P &lt;0.001). Total body and renal norepinephrine spillover were higher in both hypertensive groups compared with NT (total norepinephrine spillover, NT 223±145 versus EH− 418±135 versus EH+ 497±303 ng/min; renal norepinephrine spillover, NT 38.8±25.3 versus EH− 88.6±58.0 versus EH+ 103.4±56.2 ng/min; both P &lt;0.05). However, muscle sympathetic nerve activity (NT 25±6 versus EH− 38±20 versus EH+ 57±19 bursts per 100 heartbeats; P &lt;0.01) and cardiac norepinephrine spillover (NT 11.7±6.2 versus EH− 13.1±7.2 versus EH+ 28.6±17.4 ng/min; P &lt;0.01) were only increased in EH+. Cardiac norepinephrine spillover correlated positively with LV mass index in all subjects ( r =0.52; P &lt;0.001). Conclusions— Our findings demonstrate that hypertensive LV hypertrophy is associated with increased sympathetic activity largely confined to the heart, suggesting that increased cardiac norepinephrine release is related to the development of LV hypertrophy.
961-81 Time Domain and Spectral Turbulence Analysis of Signal Averaged Electrocardiography as Prognostic Determinants in Idiopathic Dilated Cardiomyopathy
Authors: Yi Gang, Philip J. Keeling, Jonathan H. Goldman, Katerina Hnatkova, Sonia Bent, William J. McKenna, Marek Malik
Journal: Journal of the American College of Cardiology (1995)
A role for NLRP3 inflammasome in acute myocardial ischaemia-reperfusion injury? Reply
Authors: O. Sandanger, T. Ranheim, L. E. Vinge, M. Bliksoen, G. Valen, P. Aukrust, A. Yndestad
Journal: Cardiovascular Research (2013)

We thank Mezzaroma et al . and Jong and Zuurbier for their interest in our article,1 and also for their valuable comments and concerns regarding our results and interpretations.

As stated by Mezzaroma et al ., several studies have now addressed the role of inflammasomes in the heart. We fully agree with the authors that in order to understand the role of NLRP3 in the myocardium, identification of the cell types involved in NLRP3-mediated responses is of great importance. We also share the authors' claim that cardiomyocytes are the most prominent cell type in the heart. Likewise, loss of contractile tissue is also the most important consequence of a myocardial infarction. However, this does not necessarily imply that the NLRP3 inflammasome needs to be functional in the cardiomyocytes. In fact, while we clearly do not exclude a functional role of NLRP3 inflammasome in cardiomyocytes, we, in line with the study of Kawaguchi et al. ,2 suggest that myocardial fibroblasts, being a potent inflammatory cell, could contribute to NLRP3-mediated inflammation …
The Trend of Federal and Private Support of Research as Applied to Anesthesiology
Authors: Honorio T. Benzon, Harry W. Linde, Edward A. Brunner
Journal: JAMA (1982)

The trend of federal and private support of research as applied to anesthesiology increased from 1940 to 1975 and declined after 1975. Articles published in the<i>journal Anesthesiology</i>were supported primarily by private organizations in 1940 to 1955, funded equally by federal and private organizations in 1956 to 1960, and funded mostly by governmental agencies since 1961. (<i>JAMA</i>1982;247:1166-1167)
Dawn of a New Decade for<i>JAMA Surgery</i>
Authors: Melina R. Kibbe
Journal: JAMA Surgery (2015)

During her 10 years of editorial leadership, Dr Freischlag led JAMA Surgery with many new initiatives that strengthened the journal's impact, contributions, and relevance to the field of surgery, including the move to publishing all content online first and changing the journal title from Archives of Surgery to JAMA Surgery.All of these initiatives, along with the input and contributions of the editorial board and international advisory board, have placed JAMA Surgery among the top-ranked surgery journals.So, what lies ahead for JAMA Surgery?My goal is simple, to provide the most relevant and important peer-reviewed content pertaining to the practice of surgery.We plan to continue publishing important research that will contribute to and advance the care of patients with surgical disease.At the same time, we want to supply a vehicle through which surgeons can remain up to date on current standards of care and provide surgeons with novel data and innovative concepts and approaches that challenge current paradigms, forcing us to think more broadly about how we treat patients with surgical disease to develop better and safer ways to care for them.To help me achieve this goal, I welcome an energetic team of thoughtful, innovative, and accomplished surgeons as
Family Violence Research
Authors: Harriet L. MacMillan, C. Nadine Wathen
Journal: JAMA (2005)

adults, 1993-2002. Am J Prev Med. 2003;28:346-350. 16. Roizen J. Epidemiological issues in alcohol-related violence. Recent Dev Alcohol. 1997;13:7-40. 17. Swahn MH, Simon TR, Hammig BJ, Guerrero JL. Alcohol consumption behaviors and risk for physical fighting and injuries among adolescent drinkers. Addict Behav. 2004;29:959-963. 18. Macdonald S, Cherpitel CJ, Borges G, DeSouza A, Giesbrecht N, Stockwell T. The criteria for causation of alcohol in violent injuries based on emergency room data from six countries. Addict Behav. 2005;30:103-113. 19. Fagan J. Intoxication and aggression. In: Tonry M, Morris N, eds. Crime and Justice: A Review of Research. Chicago, Ill: University of Chicago Press; 1990: 241-320. 20. Babor TF, Caetano R, Casswell S, et al. Alcohol: No Ordinary Commodity— Research and Public Policy. New York, NY: Oxford University Press; 2003. 21. Chaloupka F. The effects of price on alcohol use, abuse, and their consequences. In: Bonnie R, O’Connell ME, eds. Reducing Underage Drinking: A Collective Responsibility. Washington, DC: National Academies Press; 2004. 22. Sloan FA, Reilly BA, Schenzler C. Effects of tort liability and insurance on heavy drinking and drinking and driving. J Law Econ. 1995;38:49-77. 23. Markowitz S, Grossman M. The effects of beer taxes on physical child abuse. J Health Econ. 2000;19:271-282. 24. Centers for Disease Control and Prevention. Enhanced enforcement of laws to prevent alcohol sales to underage persons—New Hampshire, 1999-2004. MMWR Morb Mortal Wkly Rep. 2004;53:452-454. 25. Fleming MF, Barry KL, Manwell LB, Johnson K, London R. Brief physician advice for problem drinking. JAMA. 1997;277:1039-1045. 26. US Preventive Services Task Force. Screening for Alcohol Misuse. Rockville, Md: Agency for Healthcare Research and Quality. April 2004. Available at: http: //www.ahrq.gov/clinic/uspstf/uspsdrin.htm. Accessibility verified June 28, 2005.
Pneumocystis carinii Pneumonia Among US Children With Perinatally Acquired HIV Infection
Authors: R. J. Simonds
Journal: JAMA (1993)

<h3>Objective.</h3> —To describe epidemiologic characteristics of<i>Pneumocystis carinii</i>pneumonia (PCP) among children with perinatally acquired human immunodeficiency virus (HIV) infection to guide prevention efforts. <h3>Design.</h3> —National acquired immunodeficiency syndrome (AIDS) surveillance of children aged 0 through 12 years, a multisite surveillance study of HIV infection in children aged 0 through 12 years, and the national HIV serosurvey of childbearing women. <h3>Setting.</h3> —Surveillance conducted by state and local health departments and reported to the Centers for Disease Control and Prevention 1982 through 1992. <h3>Results.</h3> —<i>Pneumocystis carinii</i>pneumonia was reported in 1374 (37%) of 3665 perinatally acquired AIDS cases. Over half of these cases occurred between 3 and 6 months of age. In 183 (64%) of 275 PCP cases reported in the special surveillance study, PCP was the first or only AIDS-defining condition diagnosed, and in 44% of cases, the child had not been evaluated for HIV infection before diagnosis of PCP. The estimated median survival after diagnosis of PCP was 19 months. <h3>Conclusions.</h3> —<i>Pneumocystis carinii</i>pneumonia is a common and serious opportunistic infection that affects young children with HIV infection. Effective efforts to prevent PCP in this population will require identification as early as possible of children who may be infected with HIV. (<i>JAMA</i>. 1993;270:470-473)
Akt Activation Preserves Cardiac Function and Prevents Injury After Transient Cardiac Ischemia In Vivo
Authors: Takashi Matsui, Jingzang Tao, Federica del Monte, Kyung-Han Lee, Ling Li, Michael Picard, Thomas L. Force, Thomas F. Franke, Roger J. Hajjar, Anthony Rosenzweig
Journal: Circulation (2001)

The serine-threonine kinase Akt is activated by several ligand-receptor systems previously shown to be cardioprotective. Akt activation reduces cardiomyocyte apoptosis in models of transient ischemia. Its role in cardiac dysfunction or infarction, however, remains unclear.We examined the effects of a constitutively active Akt mutant (myr-Akt) in a rat model of cardiac ischemia-reperfusion injury. In vivo gene transfer of myr-Akt reduced infarct size by 64% and the number of apoptotic cells by 84% (P<0.005 for each). Ischemia-reperfusion injury decreased regional cardiac wall thickening as well as the maximal rate of left ventricular pressure rise and fall (+dP/dt and -dP/dt). Akt activation restored regional wall thickening and +dP/dt and -dP/dt to levels seen in sham-operated rats. To better understand this benefit, we examined the effects of myr-Akt on hypoxic cardiomyocyte dysfunction in vitro. myr-Akt prevented hypoxia-induced abnormalities in cardiomyocyte calcium transients and shortening. Akt activation also enhanced sarcolemmal expression of Glut-4 in vivo and increased glucose uptake in vitro to the level seen with insulin treatment.Akt activation exerts a powerful cardioprotective effect after transient ischemia that probably reflects its ability to both inhibit cardiomyocyte death and improve function of surviving cardiomyocytes. Akt may represent an important nodal target for therapy in ischemic and other heart disease.