tbuckley/cabot-search huggingface dataset:
Risk Stratification after Myocardial Infarction
Authors: Heather L. Horton
Journal: Annals of Internal Medicine (1997)

Letters1 December 1997Risk Stratification after Myocardial InfarctionHeather L. Horton, MD, PhDHeather L. Horton, MD, PhDMoosic, PA 18507Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-127-11-199712010-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The recent clinical guidelines on myocardial infarction risk stratification [1] are meant to represent evidence-based medicine, but they seem to recommend discharge on day 4 or 5 in patients with an uncomplicated course who have only had an electrocardiographic stress test. The data provided to support early discharge include PAMI-2 (Primary Angioplasty in Myocardial Infarction-2) participants, who had already been identified as low risk by their coronary anatomy from emergent cardiac catheterization [2]; a small trial of patients treated with lytic therapy who had negative results on stress thallium tests [3]; and several statistical analyses attempting to ...References1. Peterson ED, Shaw LJ, Califf RM. Risk stratification after myocardial infarction. Ann Intern Med. 1997; 126:561-82. Google Scholar2. Schreiber T, Marsalese D, Griffin J, Donohue B, Sampaolesi A, Constantini C, et al. Identification of ultra low-risk patients following primary angioplasty for acute myocardial infarction [Abstract]. Circulation. 1996; 94:I-168. Google Scholar3. Topol EJ, Burek K, O'Neill WW, Kewman DG, Kander NH, Shea MJ, et al. A randomized, controlled trial of hospital discharge three days after myocardial infarction in the era of reperfusion. N Engl J Med. 1988; 318:1083-8. Google Scholar Author, Article, and Disclosure InformationAffiliations: Moosic, PA 18507 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRisk Stratification after Myocardial Infarction Eric D. Peterson , Leslee J. Shaw , and Robert M. Califf Metrics 1 December 1997Volume 127, Issue 11Page: 1040KeywordsElectrocardiographyEvidence based medicineExerciseInfarctionMyocardial infarctionNegative predictive valueSafetySafety studiesStatistical dataThallium Issue Published: 1 December 1997 Copyright & PermissionsCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Negative Chronotropic Effect of β-Blockade Therapy Reduces Myocardial Oxygen Expenditure for Nonmechanical Work
Authors: Hideyuki Yamakawa, Motoshi Takeuchi, Hideyuki Takaoka, Katsuya Hata, Masuki Mori, Mitsuhiro Yokoyama
Journal: Circulation (1996)

The negative chronotropic effect of beta-blocking agents is likely to provide hemodynamic and energetic advantages. However, the negative chronotropic effect on cardiac energetics observed on the initiation of beta-blockade therapy has not been fully elucidated.In 18 patients with heart failure, left ventricular pressure and volume, external work (EW), myocardial oxygen consumption per beat (total Vo2), mechanical efficiency (EW/total Vo2), and Vo2 for nonmechanical work (total Vo2-2.EW) were measured with the use of conductance catheter and Webster catheter at the following three states: under control conditions and after beta-blockade (0.15 +/- 0.07 mg/kg propranolol IV) with and without atrial pacing to keep the heart rate at control levels. Heart rate decreased after atrial pacing was stopped. EW decreased during beta-blockade with pacing and returned to the control level after pacing was stopped. Total Vo2 did not change during beta-blockade with or without pacing, whereas Vo2 for nonmechanical work increased with pacing and returned to the control level after pacing was stopped. As a result, mechanical efficiency decreased during beta-blockade with pacing and returned to the control level after pacing was stopped.The negative chronotropic effect of a beta-blocking agent may offset the mechanoenergetical deterioration resulting from its negative inotropic effect through a reduction in oxygen expenditure for nonmechanical work. These findings suggest that the negative chronotropic effect is an important aspect of beta-blockade therapy.
Glycerol clearance in alcoholic liver disease.
Authors: D G Johnston, K G Alberti, R Wright, P G Blain
Journal: Gut (1982)

Glycerol clearance was studied by a primed dose-constant infusion technique in 14 patients with alcoholic liver disease and six normal control subjects. Fasting blood glycerol concentrations were raised in the alcoholic subjects (0.09 +/- 0.01 vs 0.06 +/- 0.01 mumol/l, p less than 0.05) and glycerol clearance was impaired (24.5 +/- 1.9 vs 37.5 +/- 3.2 ml/kg/min, p less than 0.005). Endogenous production rate of glycerol and distribution space at steady state were similar in alcoholic and control subjects. The metabolic clearance rate of glycerol correlated negatively with basal glycerol concentrations. Thus tissue uptake of glycerol is impaired in liver disease. As glycerol is metabolised primarily in the liver by conversion to glucose, these data suggest a defect of gluconeogenesis in alcoholic liver disease.
ULTRAVIOLET RAY THERAPY IN PERITONEAL AND GLANDULAR TUBERCULOSIS OF CHILDREN
Authors: HENRY J. GERSTENBERGER
Journal: JAMA (1924)

In the United States, the literature is barren as to the value of the ultraviolet rays in the treatment of peritoneal and glandular tuberculosis of children, even though various authors, such as Selma Meyer,<sup>1</sup>in 1918, and R. Hamburger,<sup>2</sup>in 1920, from Czerny's clinic, have reported very favorably on its use in tuberculosis of the peritoneum and of the glands. Recently Finkelstein,<sup>3</sup>and Rohr,<sup>4</sup>Birk<sup>5</sup>and Kleinschmidt<sup>6</sup>have made similar reports, although Birk is inclined to prefer the roentgen ray in many instances. Since the fall of 1921, we have been interested in carrying out this treatment in the various forms of tuberculosis that have come to our limited service. Ten cases have been observed since then, and the observations made on them form the basis of this report. All our patients were exposed to one of the same sources of light, namely, a
Bruton's Tyrosine Kinase and Phospholipase Cγ2 Mediate Chemokine-Controlled B Cell Migration and Homing
Authors: David J.J. de Gorter, Esther A. Beuling, Rogier Kersseboom, Sabine Middendorp, Janine M. van Gils, Rudolf W. Hendriks, Steven T. Pals, Marcel Spaargaren
Journal: Immunity (2007)
Ways of assessing capacity to complete an advance directive should be developed
Authors: S. Fazel, T. Hope, R. Jacoby
Journal: BMJ (1998)

EDITOR—The green paper Who Decides? highlights two central issues: whether advance directives should have a statutory basis, and how capacity should be assessed in patients who may be unable to make decisions for themselves.1 A potentially important problem brings these two issues together: how should doctors assess the capacity of a patient to complete an advance directive?

Healthy people may not be well placed to make decisions concerning their future incompetent selves1 because …
Low adjusted‐dose acenocoumarol therapy in sickle cell disease: A pilot study
Authors: J.B. Schnog, A.P. Kater, M.R. Mac Gillavry, A.J. Duits, L.R. Lard, F.P.L. van der Dijs, D.P.M. Brandjes, H. ten Cate, L.W. Statius van Eps, R.A. Rojer
Journal: American Journal of Hematology (2001)

Abstract Vasoocclusion is a continuous process in sickle cell disease (SCD) and accumulates to significant end organ damage, mostly irrespective of the occurrence of manifest acute vasoocclusive events. As there are indications that reversing the hypercoagulable state may be of clinical benefit in sickle cell patients, we performed a randomized, double blind, placebo‐controlled, cross‐over pilot study to assess the efficacy and safety of low‐adjusted dose acenocoumarol therapy (International Normalized Ratio: 1.6–2.0) in SCD. Treatment consisted of either acenocoumarol or placebo for 14 weeks, after which treatment was discontinued for a period of five weeks. Then, patients initially on acenocoumarol received placebo (and vice versa) for 14 weeks. Therapy efficacy was assessed by comparing the frequency of vasoocclusive complications, the occurrence of bleeding, and clotting activation between acenocoumarol and placebo treatment of each individual patient. Twenty‐two patients (14 homozygous [HbSS] and 8 double heterozygous sickle‐C [HbSC]; aged 20–59 years) completed the entire study. Acenocoumarol treatment did not result in a significant reduction of acute vasoocclusive events (three painful crises during acenocoumarol, five painful crises during placebo). There was a marked reduction of the hypercoagulable state (depicted by a decrease in plasma levels of prothrombin F1.2 fragments [ P = 0.002], thrombin‐antithrombin complexes [ P = 0.003], and D‐dimer fragments [ P = 0.001]) without the occurrence of major bleeding. Even though no clinical benefit (pertaining to the frequency of painful crises) was detected in this pilot study, the value of low adjusted‐dose acenocoumarol for preventing specific events (such as strokes) and as a long‐term treatment of sickle cell patients should be subject of further study. Am. J. Hematol. 68:179–183, 2001. © 2001 Wiley‐Liss, Inc.
THE ECONOMIC IMPORTANCE OF VISUAL DISABILITY IN INDUSTRY
Authors: LEONARD GREENBURG
Journal: JAMA (1941)

Physicians are fortunate that they have in the American Medical Association a forum before which they can discuss some of the diverse and interesting problems in the field of the protection of life and the preservation of health in industry. The Council on Industrial Health has served, and no doubt will continue to serve, in directing the attention and efforts of an ever increasing number of physicians to the important problems of preventive medicine in industry. There begins to be a fuller realization of the importance of these problems to the medical profession, industry and the nation as a whole. Under the chairmanship of Dr. Bartle, four phases of the problem of industrial ophthalmology are presented for consideration. The task set for me is an appraisal of the economic importance of visual disability in industry. Physicians are fortunate in having an opportunity to appraise this problem from several points of
Emergence of Proteus mirabilis carrying the blaVIM-1 metallo-β-lactamase gene
Authors: S. Vourli, H. Tsorlini, H. Katsifa, M. Polemis, L.S. Tzouvelekis, A. Kontodimou, A.C. Vatopoulos
Journal: Clinical Microbiology and Infection (2006)
Ankylosis of the Temporomandibular Joint Following Burn
Authors: Emanuel E. Schwartz
Journal: JAMA (1976)

DEEP, as well as subcutaneous, tissues in the vicinity of burns are subjected to severe damage. Soft-tissue fibrosis is a common problem and may be followed by calcification and ossification.<sup>1,2</sup>Bone or joint involvement, however, is rare. The following case of joint destruction in a child after a severe burn is unusual in that it involved the temporomandibular joint. <h3>Report of a Case</h3> A 10-year-old black girl was first hospitalized for second- and third-degree burns over 40% of her body surface on Dec 31, 1968, one day before her fifth birthday. The afflicted areas included the right side of her face, buttocks, and legs. Treatment consisted of fluid, blood, antibiotics, debridement, nitrofurazone dressings and skin-grafting. Dislocation of her right hip was discovered and reduced by manipulation and tenotomy of the abductor muscles in March 1969. Eight months after the burn, scars were observed on her face, back, chest, and
Metformin Improves Hemodynamic and Rheological Responses to L-Arginine in NIDDM Patients
Authors: Raffaele Marfella, Rita Acampora, Giovanni Verrazzo, Patrizia Ziccardi, Nicoletta De Rosa, Riccardo Giunta, Dario Giugliano
Journal: Diabetes Care (1996)

OBJECTIVE The endothelium plays a pivotal role in the regulation of vascular tone by releasing nitric oxide (NO). Increased availability of L-arginine, the natural precursor of NO, induces vasodilatation and inhibits platelet activity. We studied the effect of metformin on hemodynamic and rheological responses to L-arginine in patients with NIDDM. RESEARCH DESIGN AND METHODS Ten newly diagnosed NIDDM patients with mild fasting hyperglycemia (7.5 ± 0.3 mmol/l) and without evidence of both micro- and macrovascular complications were investigated. They received an intravenous infusion of L-arginine (1 g/min for 30 min) with evaluation of plasma glucose and insulin, systolic (sBP) and diastolic (dBP) blood pressure, heart rate and plasma catecholamines, platelet aggregation, and blood viscosity and filterability. The L-arginine test was repeated after an 8-week treatment with metformin (850 mg b.i.d.). RESULTS Metformin treatment significantly reduced basal fasting plasma glucose, HbA1c, and platelet aggregation to ADP (P &amp;lt; 0.05); the other parameters did not change. During pretreatment test, L-arginine infusion decreased sBP (from 137 ± 4.1 to 129 ± 4.5 mmHg, P &amp;lt; 0.01) and dBP (from 79 ± 1.9 to 75 ± 1.2 mmHg, P &amp;lt; 0.01) without affecting heart rate or plasma catecholamines. Both platelet aggregation and blood viscosity showed significant decrements after L-arginine, while blood filterability did not change. After metformin treatment, the decrease in blood pressure after L-arginine infusion was significantly enhanced, with a maximal decrease of sBP of 12 ± 3.4 mmHg (8 ± 2.5 mmHg pretreatment, P &amp;lt; 0.05) and dBP of 9.5 ± 2.4 mmHg (4.5 ± 1.9 mmHg pretreatment, P &amp;lt; 0.01). Heart rate, plasma norepinephrine levels, and blood filterability also rose significantly (P &amp;lt; 0.05–0.01). The decrease in both platelet aggregation and blood viscosity after L-arginine was significantly amplified after metformin. CONCLUSIONS We conclude that L-arginine infusion in newly diagnosed NIDDM patients without vascular complications produces relevant hemodynamic and theological changes, which are amplified by an 8-week treatment with metformin. Whether these vascular effects of metformin will improve the poor cardiovascular outlook of the diabetic patient is still unknown.
THE EFFECT OF ELECTRONIC PRESCRIPTION UPON ATTAINMENT OF GUIDELINE-BASED CHOLESTEROL GOALS
Authors: Katherine C. Michelis, Bassel Hassouna, Mina Owlia, Yousef Bader, Douglas V. Clarke, Lena Furmark, Shireen Khoury, Nina Kukar, Rayan Alhazmi, Raman S. Dusaj, Vandana Toteja, Heather A. Young, Brian G. Choi
Journal: Journal of the American College of Cardiology (2010)
High risk groups are still not being vaccinated
Authors: Adam R Winstock
Journal: BMJ (2005)

Monitoring global health Problems are primarily nationalEditor-Murray et al urge for improved global reporting of health data. 1 They also highlight the difficulty of showing national decision makers that good health data can strongly support decision making.Why is this?A reason may be that data are always subject to interpretation.The article by Murray et al is a case in point.They want to establish "an independent monitoring organisation," arguing that the World Health Organization is not fit to undertake the job because of tension between advocacy, monitoring, and evaluation.But evidence that it is this tension that leads to poor monitoring by WHO is weak, at best.In reality, the problems of global health reporting are primarily national (and subnational).The fact that the sum of deaths claimed by different programmes is greater than the actual number of deaths reflects epidemiological methods and the current limitations in global health reporting, more than any WHO failure.The global burden of disease project was limited by these issues, but it was undertaken as effectively in WHO as in any other organisation.Not only are there problems in capacity, understanding the value of surveillance, and coverage of health services.The reporting of health events can be politically sensitive or even economically damaging.It is therefore likely that political interference will continue (whoever collects the data) until governments can be shown that honesty pays.It is perhaps this failure that needs to be dealt with rather than setting up yet another organisation without a proper analysis of the reasons (and locus) for failures in global health reporting.
Colitis-induced neuroplasticity disrupts motility in the inflamed and post-inflamed colon
Authors: Gary M. Mawe
Journal: Journal of Clinical Investigation (2015)

Effective colonic motility involves an intricate pattern of excitatory and inhibitory neuromuscular signals that arise from the enteric neural circuitry of the colon. Recent investigations have demonstrated that inflammation leads to a variety of changes in the physiological properties of the neurons in this circuitry, including hyperexcitability of neurons at the afferent end of the peristaltic reflex, synaptic facilitation, and attenuated inhibitory neuromuscular transmission. Furthermore, links have been established between these changes and disrupted motor activity in the colon, and we now know that some of these changes persist long after recovery from inflammation. It is highly likely that inflammation-induced neuroplasticity, which is not detectable by clinical diagnostics, contributes to disrupted motility in active and quiescent inflammatory bowel disease and in functional gastrointestinal disorders.
Spatial Association Between Ambient Fine Particulate Matter and Incident Hypertension
Authors: Hong Chen, Richard T. Burnett, Jeffrey C. Kwong, Paul J. Villeneuve, Mark S. Goldberg, Robert D. Brook, Aaron van Donkelaar, Michael Jerrett, Randall V. Martin, Alexander Kopp, Jeffrey R. Brook, Ray Copes
Journal: Circulation (2013)

Background— Laboratory studies suggest that exposure to fine particulate matter (≤2.5 μm in diameter) (PM 2.5 ) can trigger a combination of pathophysiological responses that may induce the development of hypertension. However, epidemiological evidence relating PM 2.5 and hypertension is sparse. We thus conducted a population-based cohort study to determine whether exposure to ambient PM 2.5 is associated with incident hypertension. Methods and Results— We assembled a cohort of 35 303 nonhypertensive adults from Ontario, Canada, who responded to 1 of 4 population-based health surveys between 1996 and 2005 and were followed up until December 31, 2010. Incident diagnoses of hypertension were ascertained from the Ontario Hypertension Database, a validated registry of persons diagnosed with hypertension in Ontario (sensitivity=72%, specificity=95%). Estimates of long-term exposure to PM 2.5 at participants’ postal-code residences were derived from satellite observations. We used Cox proportional hazards models, adjusting for various individual and contextual risk factors including body mass index, smoking, physical activity, and neighbourhood-level unemployment rates. We conducted various sensitivity analyses to assess the robustness of the effect estimate, such as investigating several time windows of exposure and controlling for potential changes in the risk of hypertension over time. Between 1996 and 2010, we identified 8649 incident cases of hypertension and 2296 deaths. For every 10-µg/m 3 increase of PM 2.5 , the adjusted hazard ratio of incident hypertension was 1.13 (95% confidence interval, 1.05–1.22). Estimated associations were comparable among all sensitivity analyses. Conclusions— This study supports an association between PM 2.5 and incident hypertension.
Present Status of Plastic Surgery
Authors: Kathryn Lyle Stephenson
Journal: JAMA (1975)

THE ADVANCES in plastic surgery during the past year have been made in diverse areas. The field of plastic surgery has been extended by increased knowledge of the principles and techniques of microvascular anastomosis. Replantation of extremities and transplantation of large, free, compound grafts of tissue have been the result. Chinese surgeons,<sup>1</sup>because of their country's rapid rate of industrialization, have encountered a great number of cases suitable for replantation and have developed the following principles: (1) The anastomosis of two veins for each artery is necessary to minimize edema. (2) Primary nerve repair gives superior results and, as a result, protective sensation permits lower-extremity replants. (3) Definitive musculotendinous repairs at the time of replantation are preferable. Their experience with successful reimplantation after an ischemic period of up to 36 hours, if the amputated part had been immediately cooled, has made it obligatory for any physician caring for such
Dystrophic Calcification and Accentuated Localized Argyria After Fractionated Carbon Dioxide Laser Therapy of Hypertrophic Scars
Authors: Amanda R. Shaub, Patrick J. Brown, Todd T. Kobayashi, Michael R. Lewin-Smith, George P. Lupton, Chad M. Hivnor
Journal: JAMA Dermatology (2014)

should be considered in the decision to treat burn patients with ultrapulsed CO 2 laser therapy based on the clinical and histologic features presented above.Continual surveillance for traumatic calcification should also be considered because fractionated treatments for burn scars continue to gain popularity.
INCIDENCE OF UNDULANT FEVER
Authors: Charles M. Carpenter
Journal: JAMA (1949)

To the Editor:—  In a letter to the Editor inThe Journal, May 28, 1949, Dr. Frederick Stenn reported the incidence of undulant fever among 100 patients observed in private practice from the stockyards district of Chicago. He observed only 1 person with a positive reaction to an agglutination test and 1 patient with a history of brucellosis.  The agglutination test cannot be relied on as the only means for the detection of brucellosis. Several reports have been published indicating the decided variation in the results of the test obtained in different laboratories (Carpenter, C. M., and Boak, R. A.: The Significance of Brucella Abortus Agglutinins in Human Serum, J. Immunol.  17 [July] 1929. Eisele, C. W.; McCullough, N. B., and Beal, G. A.: Discrepancies in the Agglutination Test for Brucellosis as Performed with Various Antigens and as Reported from Different Laboratories, J. Lab. & Clin. Med.  32 , 7 [July]
A CASE OF ERYSIPELAS TERMINATING IN ACUTE THYROIDITIS
Authors: L. M. Weeks
Journal: BMJ (1920)

Josaglands, wllich miglht subsequently be aggravated by psychic trauma or conflict, or by other toxins.In dementia praecox there seemcd to be both physical and psychic factors.If this idea of the origin were correct, we must look for prevenltion, not to the school doctor, but to the ante-natal clinic.