tbuckley/cabot-search huggingface dataset:
AN ARTICLE CONTRIBUTED TO AN ANNIVERSARY VOLUME IN HONOR OF DOCTOR JOSEPH HERSEY PRATT
Authors: DAVID RIESMAN
Journal: Annals of Internal Medicine (1937)

Article1 August 1937AN ARTICLE CONTRIBUTED TO AN ANNIVERSARY VOLUME IN HONOR OF DOCTOR JOSEPH HERSEY PRATTTHOUGHTS ON HYPERTENSION*DAVID RIESMAN, M.D., SC.D., LL.D., F.A.C.P.DAVID RIESMAN, M.D., SC.D., LL.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-11-2-335 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptWhether hypertension is a disease or a symptom is a much debated question. It can, I believe, be answered rather easily, for the present at least, in the following way. When we know the cause or the apparent cause we emphasize it and consider the hypertension as part of the symptom complex. When we do not know the cause we look upon the hypertension as the disease itself. On this basis such hypertension as that of chronic nephritis or aortic insufficiency is a symptom, while that of unknown cause is a disease entity. Such a disease entity is represented by...References1. FOSTER JH: Practice of medicine in China and New England with observations on hypertension, New England Jr. Med., 1930, cciii, 1073-1076. CrossrefGoogle Scholar2. GUNEWARDENE HO: High blood pressure and its common sequelae, 1935, Wood, London, p. 24. Google Scholar3. RIESMANFITZ-HUGH DT: Epilepsa tarda, ANN. INT. MED., 1927, i, 273-282. Google Scholar4. ADSONCRAIGBROWN AWWMGE: Surgery in its relation to hypertension Surg., Gynec. and Obst., 1936, lxii, 314-331. Google Scholar5. PAGEHEUER IHGJ: Treatment of essential and malignant hypertension by section of anterior nerve roots, Arch. Int. Med., 1937, lix, 245-298. CrossrefGoogle Scholar6. PAGEHEUER IHGJ: Effect of splanchnic nerve resection on patients suffering from hypertension, Am. Jr. Med. Sci., 1937, 820. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, Pennsylvania*Read by invitation before the Academy of Medicine of Northern New Jersey, Newark, New Jersey, May 11, 1937. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBLOOD PRESSURE STUDIES ON UNIVERSITY STUDENTS, INCLUDING THE EFFECT OF EXERCISE ON ESSENTIAL HYPERTENSION, HYPOTENSION, AND NORMAL SUBJECTS*E. A. THACKER, M.S., M.D. 1 August 1937Volume 11, Issue 2Page: 335-344KeywordsHypertensionNephritis Issue Published: 1 August 1937 PDF downloadLoading ...
The Use of Blood Cultures
Authors: Andrew P. Gutow
Journal: JAMA (1993)

<h3>To the Editor.</h3> —I commend Strand et al<sup>1</sup>for their interesting and informative article detailing the overall rate of blood culture contamination in an emergency department and the lower rate obtained with iodine tincture compared with iodophor skin preparation. Their data also allow some interesting conclusions to be made about the cost per pathogen-positive blood culture. Of 8467 blood cultures, 626 (7.39%) yielded a pathogen, and 421 (4.97%) grew a skin contaminant. These data are similar to a smaller study including emergency department and inpatient blood cultures, where of 917 blood cultures, 57 (6.21%) yielded a pathogen and 13 (1.41%) were deemed contaminated.<sup>2</sup>
Performance of neonatal screening programme must be monitored
Authors: A. Galloway, J. Stevenson
Journal: BMJ (1996)

EDITOR,—We agree with Francesco P Cappuccio and colleagues that monitoring the performance of the neonatal screening programme for phenylketonuria and congenital hypothyroidism is difficult at district level,1 but our experience in the Northern region shows that it is not impossible. While neonatal screening is complex and involves many health professionals—midwives, health visitors, laboratory staff, consultants with responsibility for neonatal screening, child health …
THE CHLORIDE CONTENT OF THE TISSUES OF THE DOG AFTER EXPERIMENTAL GASTROINTESTINAL TRACT OBSTRUCTION
Authors: Russell L. Haden, Thomas G. Orr
Journal: The Journal of Experimental Medicine (1926)

Comparative observations are reported on the chloride content of the blood, liver, and muscle of the dog after obstruction of the upper gastrointestinal tract. After obstruction of the pylorus there is a marked fall in the chloride content of the liver, and a slight fall in the muscle. Similar changes are observed after obstruction of the jejunum. With obstruction of the cardiac end of the stomach no change was observed.
Research related to medical treatment of cardiovascular disease.
Authors: R S Ross
Journal: Circulation (1979)

Medical treatment of heart disease has improved significantly in the past 30 years. The spectacular change in the natural history of rheumatic heart disease is apparent from a 1948 article that reported that 42% of children with rheumatic heart disease died of rheumatic infection or bacterial endocarditis. Antibiotics and cardiac surgery have improved the outcome from rheumatic heart disease. Cardiopulmonary resuscitation has had a major impact on the treatment of myocardial infarction and on the management of sudden death. The fundamental principle underlying the discovery of cardiopulmonary resuscitation is reviewed, and recent developments emphasizing the importance of intrathoracic pressure in the hemodynamics of cardiopulmonary resuscitation are highlighted. The important new drugs of the last 30 years include the oral diuretics, the antihypertensives and the antiarrhythmic agents. The development of the beta-blocking agents is cited as an example of the translation of basic physiological research to medical care. Finally, the role of epidemiologic techniques in the design of clinical trials to evaluate medical therapy and hence improve medical management is discussed.
Reduced subjective awareness of bronchoconstriction provoked by methacholine in elderly asthmatic and normal subjects as measured on a simple awareness scale.
Authors: M J Connolly, J J Crowley, N B Charan, C P Nielson, R E Vestal
Journal: Thorax (1992)

BACKGROUND: Asthma death rates are rising, with the greatest rise and highest death rates in old age. A reduced cardiovascular response in the elderly may lead to the underestimation by physicians of the severity of acute asthma attacks. This would be compounded if elderly patients had reduced awareness of bronchoconstriction. METHODS: Methacholine provoked bronchoconstriction was compared in 34 elderly (17 asthmatic, 17 normal; age 60-83, mean 68 years) and 33 young subjects (16 asthmatic, 17 normal; 20-46, mean 30 years). None were smokers. All underwent inhaled methacholine challenge by the Newcastle dosimeter method, monitored by maximal expiratory flow-volume loops (MEFVL). The endpoints were a 35% fall in forced expiratory flow at 50% vital capacity or cumulative inhalation of 6.4 mg methacholine. The one second forced expiratory volume (FEV1) was derived from MEFVL. After challenge and before bronchodilatation subjects graded awareness of respiratory discomfort from 1 (no symptoms) to 4 (pronounced symptoms needing immediate treatment). RESULTS: Despite a greater fall in FEV1 in elderly asthmatic patients (mean (SE) 27.4% (2.2%)) than in young asthmatic patients (21.5% (1.7%)) elderly patients were less aware of bronchoconstriction (awareness score 2.00 (SE 0.15) than young patients (3.06 (0.11)). Similar differences in awareness score were seen between elderly normal subjects (1.53 (0.17)) and young normal subjects (2.76 (0.22)), despite no difference in degree of bronchoconstriction. CONCLUSIONS: Reduced awareness of moderate acute bronchoconstriction in old age may delay self referral in acute asthma and contribute to higher asthma mortality in the elderly.
REHABILITATION OF THE PHYSICALLY HANDICAPPED
Authors: R. M. LITTLE
Journal: JAMA (1924)

A rehabilitation service for the physically handicapped has been established by the federal government and thirty-six states. It is not a new form of charitable service that attempts to mitigate the losses and sufferings of industrial workers occasioned by accident, disease or congenital defects, but it is an effort to return citizens suffering from physical defects that interfere with their vocational opportunities, to remunerative occupations, that they may lead independent, self-supporting lives. The persons who are eligible for the service must be 14 years of age or over, citizens of the states in which they reside, and not feebleminded, epileptic or maintained in custodial institutions. They may have met with their handicaps in industry or otherwise; that is, they may be the victims of accidental injury or be suffering from the result of disease or congenital defects, but they must be normal mentally and susceptible of rehabilitation. This national program
Start in private practice.
Authors: A E Young
Journal: BMJ (1987)

One hundred and twenty five men with psychogenic or organic impotence used autoinjection of the penile corpora cavernosa with eitherxpapaverine or papaverine and phentolamine for a mean period of 10-5 months (range 1-24 months) to achieve penile erection for sexual intercourse.Prolonged (over four hours) painless erection resulted from 34 of the 3513 self administered injections.This seems to be a highly effective approach to treating impotence irrespective of the aetiology.
TREATMENT OF ORIENTAL SORE BY PHOSPHORATED OIL
Authors: A. Castellani
Journal: BMJ (1923)

in each case.Eight remained well for over a year, and the remaining four for periods varying from over six months to a year, all having passed the period at which a recurreuce was due. CONCLUSION.In conclusion, it should bs noted tllat the foregoing remarks are not put forward in any sense as a critical study, but melely represent a brief record of individual experience concerning a certain line of treatment, witlh its results.
Contact dermatitis with cervical lymphadenopathy following exposure to the hide beetle, <i>Dermestes peruvianus</i>
Authors: S. RAMACHANDRAN, J. HERN, J. ALMEYDA, J. MAIN, K.S. PATEL
Journal: British Journal of Dermatology (1997)

Contact with beetles of the family Dermestidae can produce a variety of disorders including skin, gastrointestinal and respiratory tract disease. Dermatological disorders include dermatitis, vesicular, pustular and vasculitic lesions. In addition, there may be pruritus, desquamation and urticaria. We report a patient who developed dermatitis, a vasculitic eruption, cervical lymphadenopathy and pulmonary nodular interstitial infiltration as a result of contact with the 'hide beetle' Dermestes peruvianus.
The Present Status of Child Psychiatry in Pediatrics
Authors: Michael S. Jellinek
Journal: New England Journal of Medicine (1982)

Pediatricians and child psychiatrists share a dedication to the well-being of children. For almost 100 years senior members of both fields have advocated collaboration in training and patient care.1 2 3 4 5 6 7 8 9 10 As individuals and members of their respective professional organizations, both acknowledge the impact of psychosocial factors on child development, illness, and family functioning.11 Recent epidemiologic studies have documented that 5 per cent of all pediatric visits are primarily psychiatric,12 and up to 50 per cent are related to behavioral, educational, or social concerns.13 , 14 Although child psychiatry has its own serious shortcomings, not the least of which is its failure to require . . .
IMPACT OF POST-DILATATION STRATEGIES ON ACUTE STENT EXPANSION: AN EXPERIMENTAL STUDY USING OPTICAL COHERENCE TOMOGRAPHY
Authors: Hideki Kitahara, Katsuhisa Waseda, Ryotaro Yamada, Teruyoshi Kume, Kaori Nakagawa, Tomohiko Teramoto, Fumiaki Ikeno, Peter Fitzgerald, Yasuhiro Honda
Journal: Journal of the American College of Cardiology (2012)
Walking through angina.
Authors: B L Pentecost
Journal: BMJ (1985)

Walking through anginaMany patients know that the amount of physical activity that provokes angina varies throughout the day.Often relatively little effort is enough early on-towelling down after a shower or taking a short walk to the garage or bus stop -whereas later substantially more vigorous exertion may be undertaken without provoking pain.This "first effort angina," or "warming up phenomenon," appears to be related to the less common variant of "walk through angina," in which a patient on first experiencing angina is able to continue walking at a steady pace only for the pain gradually to slacken and eventually cease.One consequence of these variations is that a patient may be so impressed by the inconsistency ofthe effects of effort on his pain that he may dismiss the possibility of angina from his mind and delay seeking medical help.The warm up phenomenon has been recognised by clinicians for many years, but its underlying mechanism is still not clearly understood.'One possibility is that the initial effort of the day causes vasodilatation and increased coronary blood flow and that this persists, thus providing an increased nutritional blood flow to the heart for subsequent activity.If that were the explanation the increased exercise tolerance should be linked with increased myocardial oxygen con- sumption.The latter is usually measured as the product of heart rate and systolic blood pressure (rate-pressure product).Early studies suggested that in any particular patient angina recurred at a particular rate-pressure product in a highly reproducible way when repeated cardiac stress was imposed by either exercise or atrial pacing.23More recently, however, repeated episodes of stress have been shown to cause an adaptive process whereby patients either experience angina at higher rate-pressure products or, where this is held steady on serial testing, the electrocardiographic evidence of myocardial ischaemia diminishes.`46These observations are compatible with an increased coronary arterial flow either as a result of persistent vasodilatation or through the release of pre-existing spasm of the coronary arteries.7By no means everyone, however, believes that the adaptive mechanism is the result of improved myocardial blood supply.Williams et al recently showed improved tolerance to serial pacing among a group of patients with angina.When two periods of atrial pacing were undertaken at the same rate-
Hospital Workers in Dispute — Harmonizing Europe
Authors: John Lister
Journal: New England Journal of Medicine (1973)

THE prolonged strike in which the hospital porters and other ancillary staff were recently involved was an unhappy and uncharacteristic episode in the life of the hospitals, where a friendly spirit of co-operation is usually to be found among all grades of staff. Indeed, in the early phase of the dispute there were doctors and nurses as well as members of the public who had considerable sympathy for the underpaid hospital workers whose pay rise had been caught in the freeze, but their sympathy began to run out when sick patients had to be turned away from hospitals and as . . .
Concepts of Psychosomatic Disorders in ICD-10: Results of the Research Criteria Study
Authors: Günter Jantschek, Klaus Rodewig, Jörn von Wietersheim, Aribert Muhs
Journal: Psychotherapy and Psychosomatics (1995)

The multicenter study with the research criteria in the field of psychotherapy/psychosomatic medicine considered nine cases. One patient with cardiac neurosis (F45.3) and one patient with a persistent somatoform pain disorder (F54.4) were diagnosed in category F45.x. The rater agreement was 63-68%. 54% of the correct diagnoses made for three cases of colitis ulcerosa and Crohn's disease concurred (28%, 50%, and 80%). The case of anorexia nervosa (F50.0) was coded correctly by all of the raters, while the agreement for bulimia (F50.2) was 82%. Only 50% of the raters correctly assigned the dissociative disorder (F44.4). The agreement achieved for factitious disorder (F68.1) was 54%. Across all the psychosomatic disorders in ICD-10 there was an agreement of 65%. This result is markedly lower than the overall agreement of the Research Criteria Study (78%). Cardiac neurosis and bulimia were given a favorable prognosis. A more reticent psychotherapeutic commitment was seen for the classical psychosomatic disorders, persistent pain disorder, and factitious disorder. Anorexia nervosa and dissociative disorder assumed an intermediate position.
Diagnostic Value of Pericardial Biopsy
Authors: Petar M. Seferović, Arsen D. Ristić, Ružica Maksimović, Vujadin Tatić, Miodrag Ostojić, Vladimir Kanjuh
Journal: Circulation (2003)

The clinical significance of pericardial biopsy is controversial. The aim of this study was to assess the feasibility and diagnostic value of 3 approaches to pericardial biopsy: fluoroscopic control and standard sampling, pericardioscopy guidance with standard sampling, and pericardioscopy guidance with extensive sampling.Forty-nine subsequent patients with a large pericardial effusion underwent parietal pericardial biopsy. In group 1 (12 patients, 66.7% males, age 46.7+/-12.2 years), pericardial biopsy was guided by fluoroscopy (3 to 6 samples per patient). Group 2 included 22 patients (50% males, age 50.8+/-10.4 years) undergoing 4 to 6 pericardial biopsies per patient guided by pericardioscopy (16F flexible endoscope). In group 3, extensive pericardial sampling was performed, guided by pericardioscopy (15 patients, 53.3% males, age 53.7+/-12.8 years, 18 to 20 samples per patient). Sampling efficiency was better with pericardioscopy (group 2, 84.9%; group 3, 84.2%) compared with fluoroscopic guidance (group 1, 43.7%; P<0.01). Diagnostic value was defined as a new diagnosis uncovered, etiology revealed, clinical diagnosis confirmed, and the biopsy false-negative. Pericardial biopsy in group 3 had higher diagnostic value than in group 1 in revealing new diagnosis (40% versus 8.3%, P<0.05) and etiology (53.3% versus 8.3%, P<0.05). In group 2, pericardial biopsy had a higher yield in establishing etiology than in group 1 (40.9% versus 8.3%; P<0.05). Pericardial biopsy was false-negative in 58.3% in group 1 in contrast to 6.7% in group 3 (P<0.01). There were no major complications.Pericardioscopic guidance enhanced pericardial sampling efficiency. The diagnostic value of pericardial biopsy was significantly improved by extensive sampling made possible by pericardioscopy.
Book Review Fetal and Neonatal Haematology Edited by I.M. Hann, B.E.S. Gibson, and E.A. Letsky. 322 pp., illustrated. Philadelphia, Baillière Tindall, 1991. $35. ISBN 0–521–38357–9 .
Authors: Joan E. Hodgman
Journal: New England Journal of Medicine (1992)
TRUE CHOLESTEATOMA OF THE CECUM
Authors: CHARLES E. HUMISTON
Journal: JAMA (1925)

As far as we are able to learn from the literature, we are presenting the first reported case of intestinal cholesteatoma (epidermoid). This is rather puzzling, because twelve cases of dermoid cysts, which, from a histogenetic point of view, stand close to epidermoids, are reported in the region of the colon, and about twenty more in the mesentery of the small intestine.1Cases of ovarian dermoid cysts are sometimes localized quite close to the intestine.  Under the name cholesteatoma, two different things are understood. First there are rare cystic tumors with thin epithelial lining and a silvery content, which is formed of epithelial cells and cholesterol tablets. Such tumors are found in the skull, the spinal cord and very rarely in the cranial bones—frontal sinuses2—and temporal bones. These are supposed to be true tumors originating from meninges or displaced embryonic epidermic germs. At some place in the
Long-Term Effects of Fish Oil on Insulin Resistance and Plasma Lipoproteins in NIDDM Patients With Hypertriglyceridemia
Authors: Angela A Rivellese, Ada Maffettone, Ciro Iovine, Lucrezia Di Marino, Giovanni Annuzzi, Mario Mancini, Gabriele Riccardi
Journal: Diabetes Care (1996)

OBJECTIVE The aim of this study was to evaluate the long-term (6-month) effects of moderate fish oil supplementation on insulin sensitivity and plasma lipoproteins in NIDDM patients with hypertriglyceridemia. RESEARCH DESIGN AND METHODS The study has been performed according to a randomized double-blind placebo-controlled design with a parallel group sequence. After a washout period of 4 weeks and a run-in period of 3 weeks, 16 NIDDM patients with hypertriglyceridemia (triglyceride [TG], 2.25–5.65 mmol/l) were randomly assigned to either fish oil (2.7 g/day eicosapentaenoic plus docosahexaenoic acid for 2 months, then 1.7 g/day for 4 more months) (n = 8) or placebo (n = 8). Diet and hypoglycemic drugs remained unchanged throughout the whole experiment. At baseline and after 6 months, insulin sensitivity was measured by euglycemic hyperinsulinemic clamp (insulin infused, 2.0 mIU · kg−1 body wt · min−1). At the same time, blood glucose control, fasting and postprandial serum insulin and nonesterified fatty acid (NEFA) concentrations, and fasting plasma lipoprotein concentrations were evaluated. RESULTS In the group treated with ffish oil compared with the baseline, there was: 1) a significant reduction in both plasma TG (2.92 ± 0.23 vs. 3.85 ± 0.32 [mean ± SE] mmol/l, P &amp;lt; 0.001) and VLDL-TG (2.35 ± 0.24 vs. 4.25 ± 0.66 mmol/l, P &amp;lt; 0.01), without significant changes in blood glucose control; 2) a significant reduction in fasting NEFA concentrations (572 ± 100 vs. 825 ± 131 μmol/l, P &amp;lt; 0.01); and 3) a significant enrichment in long-chain ω-3 fatty acids of erythrocyte membrane phospholipids. In the placebo group, there were no changes in any of the variables analyzed. The insulin-mediated glucose uptake was unchanged in both groups (fish oil, 4.04 ± 0.82 mg · kg−1 · min−1 at baseline and 3.96 ± 0.50 mg · kg−1 · min−1 at 6 months; placebo, 3.51 ± 0.62 mg · kg−1 · min−1 at baseline and 4.09 ± 0.49 mg · kg−1 · min−1 at 6 months). CONCLUSIONS In NIDDM patients with hypertriglyceridemia, moderate amounts of fish oil induce a long-term significant reduction in plasma triglycerides, VLDL triglycerides, and NEFA and a significant enrichment in the erythrocyte phospholipid content of long-chain ω-3 fatty acids, without deteriorating blood glucose control. However, this amount of ω-3 fatty acids was unable to improve insulin sensitivity in this group of patients.
Risk of pancreatic ductal adenocarcinoma in chronic pancreatitis
Authors: N Howes
Journal: Gut (2002)

Patients with chronic pancreatitis have a markedly increased risk of pancreatic cancer compared with the general population

Chronic pancreatitis has been proposed as an independent risk factor for the development of pancreatic cancer in a number of important studies.1–3 Problems with methodology however, such as patient selection, ascertainment bias, small patient numbers, and stringency of patient selection have been major criticisms, leading some authors to believe that the risk of pancreatic cancer in chronic pancreatitis is confounded by other risk factors such as smoking.4 The study presented by Malka and colleagues5 in this issue of Gut has addressed some of these considerations, in that it has prospectively followed a cohort of 373 patients with proven chronic pancreatitis, defined by stringent criteria, over a median of 9.2 years [see page 849] . The high incidence of pancreatic calcification (83%), elective surgery (60%), diabetes mellitus (54%), pseudocysts (46%), and venous occlusive disease (21%) leave little room for doubt that this is a true cohort of patients with chronic pancreatitis. Patients with pancreatic cancer were confirmed histologically in all cases and careful consideration was given to patients that were lost to follow up. The results of the study suggest a significantly overall increased risk of pancreatic cancer …