tbuckley/cabot-search huggingface dataset:
The Pluricausal Cardiopathies; the Beaumont Lecture
Authors: Harold D. Levine
Journal: JAMA (1962)

It is well known that some people suffer from heart disease which is the conjoint effect of more than one cause. Heart disease in one individual due to arterial hypertension plus coronary artery disease or due to rheumatic fever plus thyrotoxicosis are clinical examples. Because of his complexity, the interrelationship between these various factors is difficult to define in man. Recourse must be had to the experimental animal in whom the conditions of observation can be fixed with considerable precision. The present volume, an expansion and elaboration of the author's earlier ideas expressed in "The Chemical Prevention of Cardiac Necroses," is a detailed exposition of the author's researches in this field. It is intended both for the clinician and the experimental pathologist. The work is principally concerned with the rat. Selye has shown how the concerted effect of a number of manipulations, some obligatory, some conditional and including changes in
Factor VIII related antigen in the assessment of vasculitis.
Authors: A D Woolf, G Wakerley, T B Wallington, D G Scott, P A Dieppe
Journal: Annals of the Rheumatic Diseases (1987)

Factor VIII related antigen, an endothelial cell product, was markedly raised in systemic necrotising arteritis, reflecting disease activity, but was not raised in active cutaneous vasculitis. In rheumatoid arthritis high levels were only found in systemic vasculitis or Felty9s syndrome, but in other connective tissue diseases increased levels were more frequently detected and usually related to disease activity. It did not correlate with C reactive protein. It was also raised in non-inflammatory peripheral vascular disease and after surgery and was not specific for vasculitic endothelial damage. Factor VIII related antigen may be useful in identifying and monitoring systemic necrotising and large vessel arteritis.
Differential effects of enalapril and atenolol on proteinuria and renal haemodynamics in non-diabetic renal disease.
Authors: A J Apperloo, D de Zeeuw, H E Sluiter, P E de Jong
Journal: BMJ (1991)

OBJECTIVE--To compare the antihypertensive, renal haemodynamic and antiproteinuric effect of enalapril and atenolol in patients with proteinuria of non-diabetic origin. DESIGN--Prospective, double blind, randomised 16 week study after a pretreatment period of at least three weeks. SETTING--Outpatient nephrology and hypertension unit. PATIENTS--27 patients with proteinuria (greater than 300 mg protein/day) of non-diabetic origin, moderately impaired renal function (creatinine clearance 30-90 ml/min), and a pretreatment diastolic blood pressure of greater than 80 mm Hg. INTERVENTIONS--Treatment with enalapril (10 mg/day, adjusted between 5 and 40 mg, if necessary) or atenolol (50 mg/day, adjusted between 25 and 100 mg if necessary) titrated against a target fall in diastolic blood pressure to less than 95 mm Hg or of greater than 10 mm Hg, or both. MAIN OUTCOME MEASURES--Blood pressure, renal haemodynamics, and urinary protein excretion. RESULTS--No differences were detected between the two groups before treatment. The falls in systolic and diastolic blood pressures during treatment were not significantly different between both groups. Proteinuria fell slightly with atenolol but significantly more with enalapril (mean change -0.38 (95% confidence interval -0.78 to 0.03) v -1.2 (-1.70 to -0.69) g/day respectively, p less than 0.02) as did filtration fraction (mean change -1.8 (-2.9 to -0.7) v -3.8 (-4.9 to -2.8)% respectively. Serum potassium concentration increased with enalapril (mean change 0.63 (SD 0.51) v 0.19 (0.47) mmol/l, p less than 0.05). CONCLUSIONS--Enalapril lowers proteinuria more than atenolol in patients with non-diabetic renal disease despite a similar blood pressure lowering effect of both drugs, and its antiproteinuric effect seems to be associated with the characteristic renal haemodynamic effect of angiotensin converting enzyme inhibitors.
Glucose Measurement: Confounding Issues in Setting Targets for Inpatient Management
Authors: Kathleen Dungan, John Chapman, Susan S. Braithwaite, John Buse
Journal: Diabetes Care (2007)

Van den Berghe et al. (1) reported a significant reduction in mortality with normoglycemia (target value 80–110 mg/dl) in patients whose medical intensive care unit (ICU) stay was >72 h and reduced morbidity in all patients, regardless of the duration of ICU stay. Although severe hypoglycemia did not occur in the Van den Berghe et al. study, 18.7% of patients in the intensive treatment group compared with 3.1% of those who received conventional therapy did experience hypoglycemia (defined as glucose <40 mg/dl), albeit with no adverse consequences reported. However, altered consciousness is common in the ICU, and even severe hypoglycemia may be unrecognized. Other studies (2,3) examining intensive insulin protocols in various inpatient settings have suggested benefits in clinical outcomes associated with improved glycemic control. In a mixed ICU population, Van den Berghe et al. (2) previously demonstrated reduced morbidity and mortality with three- to fourfold less hypoglycemia than the medical ICU population (2). Thus, careful assessment of glucose measurement and how it may impact the targets selected in the hospital are critical safety issues in intensive management of hyperglycemia. As a result of increasing evidence that tight glycemic control is beneficial in the management of inpatients with diabetes, the American Diabetes Association (ADA) currently recommends a glucose target “as close to 110 mg/dl as possible and generally <180 mg/dl” for critically ill patients (4). The American Association of Clinical Endocrinologists recommends the “upper limits for glycemic targets” of 110 mg/dl in critically ill patients (5).

In practice, it may be difficult to obtain the level of glycemic control (average glucose 111 mg/dl in the intensively managed group) achieved by Van den Berghe et al. Though a wider range of glucose values has been targeted, rarely have mean glucose values between 80 and 110 mg/dl been achieved, …
Immunological changes associated with a successful outcome of pollen immunotherapy
Authors: A. G. Fennerty, K. P. Jones, B. H. Davies, R. Fifield, J. Edwards
Journal: Allergy (1988)

Changes in immunological measurements thought to be important in the mechanism of immunotherapy for hay fever were related lo objective measurements of treatment outcome. Antigen‐specific IgE and IgG, and T suppressor cell status, using monoclonal antibodies and a specific functional assay, were measured before and after immunotherapy. Treatment outcome was assessed using nasal and conjunctival challenge tests. Seventeen subjects received immunotherapy for 6 months. Nine showed a decrease in nasal and/or conjunctival sensitivity, compared with 2 of 13 control subjects ( P &lt; 0.05). Subjects responding to immunotherapy had a significantly higher post treatment IgE level and a higher pre‐ and post‐treatment IgG level than non‐responders and controls. Immunotherapy had no effect on suppressor cell status.
861-1 Direct, selective, factor Xa inhibition in patients with non-ST elevation acute coronary syndromes from the United States, Canada, and Japan: Results of the XaNADU-ACS trial
Authors: John H Alexander, Hongqiu Yang, Richard C Becker, Kazuhisa Kodama, Christopher K Dyke, Shaun G Goodman, Neal S Kleiman, Judith S Hochman, Peter B Berger, Eric A Cohen, Michael Lincoff, Edwin G Bovill, Chuichi Kawai, Paul W Armstrong, Robert A Harrington
Journal: Journal of the American College of Cardiology (2004)
Is there still a negative side to noninvasive ventilation?
Authors: N.S. Hill
Journal: European Respiratory Journal (2004)

Negative pressure ventilation, the intermittent application of subatmospheric pressure around the chest and abdomen to assist breathing, is founded on sound physiological principles. As long as atmospheric pressure is maintained at the mouth and nose (and the upper airway remains patent), the negative peri-thoracic and -abdominal pressure increases the transpulmonary gradient, expanding the chest wall and lungs to assist inhalation. Exhalation is achieved mainly via passive recoil of the chest wall and lungs, although it is possible to assist this by imposing a supra-atmospheric peri-thoracic and -abdominal pressure, as was the case with the “iron lung” used by Corrado et al. 1, as described in the current issue of the European Respiratory Journal .

In fact, negative pressure ventilation has a long and important history in the annals of mechanical ventilation, dating back to the 1800s, when the first tank-type negative pressure ventilator was described as a manually powered resuscitation device 2. The need for respiratory assist devices greatly increased during the polio epidemics of the first half of the 20th century, and the use of electrically powered “iron lungs”, such as that described by Drinker and Shaw 3, began to increase, becoming the main means of ventilatory support outside of the anaesthesia suite. These devices enclosed patients up to their necks in bulky, heavy metal chambers that limited access to patients for nursing care. Consequently, a number of smaller, more portable negative pressure devices were created, including the “cuirass” ventilator, which consisted of a rigid shell that was applied over the anterior chest and abdomen 4, and the “jacket” ventilator that consisted of a rigid cage suspended over the chest and abdomen that was placed within an impervious jacket 5. Both of these devices saw …
TCT-796 The MitraClip Procedure For Functional Mitral Regurgitation Results In A Significant Change In Procedural Hemodynamics
Authors: Wen Loong Yeow, Mamoo Nakamura, Takashi Matsumoto, Hassan Jlaihawi, Asma Hussaini, Moody Makar, Swaminatha V. Gurudevan, Robert Siegel, Saibal Kar
Journal: Journal of the American College of Cardiology (2012)
NOTES ON SURGICAL WORK IN A GENERAL HOSPITAL: With Special Reference to the Carrel-Dakin Method of Treatment
Authors: J. S. Dunne
Journal: BMJ (1918)

GENERAL HOSPITAL.[ BTs.DICBaJoRn 283' the ileum were closed, as was the distal end of the colon.The proximal end of the colo was.-ligaturedwhere crished, and the end brough.tto.the surface at X (eig.A,b)eing fastened in position by several sutures.rehe flap was re- placed without TO X (Fir Z) drainage.The fistula soon only (lischarged clear nmucus, which 'vas not very irritat- ing,, anid rapidly k; § , -, ; begani to contract an(i jeal round the %N Cw g 2 exposed bowel, whiclibecame much less vascular, and did niot show such active peristalsis as _C)CAL ti 7ul formierly.Thle end \L.Ef,vscOU u , of the transverse VALVE colon brougiit out at X (Fig. 1) unfortunately dis- appeared beneath the fiap, and muctus -with clear watery 1IG.2.-The bilateralls excluded bowel fluid escaped at its is shaded, and is the portion removed at left lateral margin.
127 THE ACTIVATING NK CELL RECEPTOR NKP46 MAY BE INVOLVED IN ANTI-FIBROTIC ACTIVITY OF NK CELLS IN CHRONIC HEPATITIS C
Authors: B. Kramer, C. Körner, C. Zwank, M. Eisenhardt, A. Glassner, P. Kokordelis, F. Wolter, H.D. Nischalke, T. Sauerbruch, U. Spengler, J. Nattermann
Journal: Journal of Hepatology (2012)
Body Weight and Diabetes-Reply
Authors: John B. O'Sullivan
Journal: JAMA (1983)

<h3>In Reply.—</h3> Rimm et al expand on my cautionary comment on the power of the test applied to the negative control subjects. Their discussion relates to a type II error, that of a test failing to reject the null hypothesis. It becomes an error only when the proportions differ to an important extent, and, therefore, its control begins with the investigator's specification of what difference is of sufficient importance to him.<sup>1</sup>Consequently, the criticism of Rimm et al is dependent on the assumptions they chose to adopt. Curiously, they estimated the relative risk for diabetes from a selected, highly specialized subset of the population to derive the risk attributable to obesity. Using the obese high-risk subjects who previously had transient glucose intolerance disregards possible unique interactions with obesity. If obesity indeed confers a high-risk status for subsequent diabetes, then a more defensible approach would have been to use the
Bradycardia and the Role of β-Blockade in the Amelioration of Left Ventricular Dysfunction
Authors: Masayoshi Nagatsu, Francis G. Spinale, Masaaki Koide, Hirofumi Tagawa, Gilberto DeFreitas, George Cooper, Blase A. Carabello
Journal: Circulation (2000)

Background —It is clear that β-blockers are effective for treatment of congestive heart failure, but their mechanism of action remains controversial. Hypothesized mechanisms include normalization of β-receptor function and myocardial protection from the effects of catecholamines, possibly by the institution of bradycardia. We hypothesized that β-blockade–induced bradycardia was an important mechanism by which these agents were effective for correction of LV dysfunction. Methods and Results —In 2 groups of dogs with mitral regurgitation and LV dysfunction, β-blockers were instituted. In 1 group that received β-blockers and pacing (group β+P), a pacemaker prevented the natural bradycardia that β-blockers cause. In both groups, substantial LV dysfunction developed. Before β-blockade, the end-systolic stiffness constant decreased from 3.5±0.1 to 2.7±0.2 ( P &lt;0.01) at 3 months in group β+P. A similar reduction occurred in the group that eventually received only β-blockers (group βB). In group βB, end-systolic stiffness improved after 3 months of β-blockade from 2.9±0.2 to 3.5±0.4 and was not different from baseline. However, in group β+P, end-systolic stiffness failed to improve (2.7±0.2) after 3 months of mitral regurgitation, and was 2.9±0.2 at the end of the studies. The contractile function of cardiocytes isolated from the ventricles at the end of the studies confirmed these in vivo estimates of contractility. Conclusions —We conclude that institution of bradycardia is a major mechanism by which β-blockers are effective for restoration of contractile function in a model of LV dysfunction.
Long term suppression of prolactin concentrations after bromocriptine induced regression of pituitary prolactinomas.
Authors: K W Hancock, J S Scott, J T Lamb, R M Gibson, C Chapman
Journal: BMJ (1985)

Peptic ulcers induced by piroxicamPiroxicam is a commonly used non-steroidal anti-inflammatory drug.Its advantages include its high efficacy, its long plasma half life (mean of 38 hours), which enables it to be taken as a single daily dose, and its supposedly low incidence of gastrointestinal side effects.We report, however, on four patients with peptic ulcers induced by piroxicam seen over four months.None had had dyspeptic symptoms previously, and none was taking other ulcerogenic drugs.
More on HTLV-III Antibodies in Immune Globulin
Authors: William H. Wolfe
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Recently, concern has been raised about the passive transmission of human T-cell lymphotropic virus type III (HTLV-III) antibodies during immune globulin (IG) administration.<sup>1</sup>Some contend that these antibodies could cause a transient "false-positive" reaction on enzyme-linked immunosorbent assay (ELISA) screening tests for the HTLV-III antibody. The military services administer IG to large numbers of personnel on active duty and also screen all military personnel for evidence of HTLV-III antibodies. Any transient positive screening results caused by the administration of IG would, therefore, have a significant impact on the military program. White et al<sup>2</sup>indicated that hypogammaglobulinemic patients demonstrated increased HTLV-III antibody absorbance values following infusion of IG. However, these increases were not great enough to exceed the cutoff range of positivity. Such results are not surprising when one considers the dilution involved. We conducted a serological study, using ELISA methodology, to assess the effect of
Shee Hung Yu
Authors: M H Yu
Journal: BMJ (2009)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Shee Hung Yu Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Adherence with montelukast or fluticasone in a long-term clinical trial: Results from the Mild Asthma Montelukast Versus Inhaled Corticosteroid Trial
Authors: Cynthia Rand, Andrew Bilderback, Kathleen Schiller, Jonathan M. Edelman, Carolyn M. Hustad, Robert S. Zeiger
Journal: Journal of Allergy and Clinical Immunology (2007)
European Commission looking to cut junior doctors' hours
Authors: R. Watson
Journal: BMJ (1997)

The weekly working hours of thousands of doctors in training could be reduced under plans being considered by the European Commission.

The commission is currently canvassing the degree of support for extending existing European Union rules that stipulate a maximum 48 hour week to the small group of professions that was originally excluded from the legislation when it was adopted in 1993.

According to the social affairs commissioner, Padraig Flynn: “The exclusion of certain categories of workers from …
Helping Bone Marrow Cells to Regrow
Authors: Andrew Skolnick
Journal: JAMA (1991)

THE ADVENT of hematopoietic colony-stimulating factors is making it possible to accelerate the growth of transplanted marrow cells, as well as helping marrow cells repopulate in patients who receive chemotherapy without a marrow transplant. At the American Cancer Society's seminar in Phoenix, Ariz, James A. Niedhart, MD, director of the University of New Mexico Cancer Center, Albuquerque, described the results of phase 1 trials of granulocyte macrophage colony-stimulating factor (GM-CSF) in patients who were treated with high-dose chemotherapy without a bone marrow transplant. The use of GM-CSF substantially reduced the duration of cytopenia, incidence of infection, and need for hospitalization, Niedhart reports. Trials are now under way using interleukin 3 alone and in combination with GM-CSF, he says. <h3>Score of Patients</h3> To date Neidhart's group has treated 19 patients with refractory lymphomas. "We have been able to obtain about a 50% complete remission rate in this very tough-to-treat group of
Becoming a Physician: Medical Education in Britain, France, Germany, and the United States
Authors: Ronald L. Numbers
Journal: JAMA (1996)

Over a century has passed since the plucky German scholar Theodor Puschmann issued his comprehensive history of medical education. During that time historians have published a small library of monographs and articles on various aspects of medical education, but most have focused on a particular country, institution, or educator. Until now, no single author, to my knowledge, has possessed the intellectual bravery and linguistic skills needed to undertake a study spanning centuries and cultures. But in<i>Becoming a Physician</i>, Thomas N. Bonner, a distinguished medical historian and sometime university president, draws on published and archival sources in three languages to provide a sweeping comparative analysis of medical education in France, Britain, the German-speaking areas of Europe, and North America during the two centuries between 1750 and 1945. In addition to its impressive chronological and geographical range,<i>Becoming a Physician</i>possesses other strengths. In contrast to many historians of medical education
Positive and Negative Feedback Mechanisms in the Neural Regulation of Cardiovascular Function in Healthy and Spinal Cord–Injured Humans
Authors: J. M. Legramante, G. Raimondi, M. Massaro, F. Iellamo
Journal: Circulation (2001)

Background —We tested the hypothesis that in humans, hypertension/tachycardia and hypotension/bradycardia nonbaroreflex sequences that occur within spontaneous arterial pressure (AP) and R-R interval fluctuations are an expression of positive feedback mechanisms neurally regulating the cardiovascular system. Methods and Results —We studied 15 spinal cord–injured (SCI) subjects (8 tetraplegics and 7 paraplegics) and 8 healthy subjects. The occurrence of nonbaroreflex (NBseq) and baroreflex (Bseq) sequences, ie, hypertension-bradycardia and hypotension-tachycardia sequences, was assessed during rest and head-up tilt (HUT). The ratio between Bseq and NBseq (B/NB ratio) was also calculated. In resting conditions, the occurrence of NBseq was significantly lower ( P &lt;0.05) in tetraplegics (7.9±1.5) than in paraplegics (16.2±3.2) and normal subjects (19.0±3.5), whereas the occurrence of Bseq was not significantly different between the 3 groups (38.6±11.9 versus 45.4±6.0 versus 47.0±11.9). In tetraplegics, the B/NB ratio showed a marked, significant decrease (from 8.4±4.2 to 1.9±0.8, P &lt;0.05) in response to HUT, whereas in normal subjects, it showed a significant increase (from 3.5±0.7 to 9.4±2.7, P &lt;0.05). In paraplegics, the B/NB ratio did not change significantly in response to HUT (from 4.5±1.6 to 4.8±1.1). Conclusions —Our data suggest that nonbaroreflex sequences occur in humans and might represent the expression of an integrated, neurally mediated, feed-forward type of short-term cardiovascular regulation that is able to interact dynamically with feedback mechanisms of baroreflex origin.
IMPACT OF LOCAL ARTERIAL COMPLIANCE AND SHEAR STRESS ON BARORECEPTOR FUNCTION IN CHILDREN WITH REPAIRED COARCTATION OF THE AORTA
Authors: Damien P. Kenny, Jaimie Polson, Sian Curtis, Ron Hartely-Davies, Massimo Caputo, Rob Martin, John Cockcroft, Julian Paton, Dirk Wilson, Andrew Wolf, Mark Hamilton
Journal: Journal of the American College of Cardiology (2012)
FATALITIES FOLLOWING "STILBAMIDINE" THERAPY
Authors: Robert Cohen
Journal: JAMA (1952)

<h3>To the Editor:</h3> —The article "Successful Treatment of Actinomycosis with `Stilbamidine'" by J. Miller and associates in the Sept. 6 issue ofThe Journal, page 35, is indeed a commendable contribution; however, this article and the previous article by Schoenbach, Miller, and associates (<i>J. A. M. A.</i><b>146</b>:1317 [Aug. 4] 1951) on blastomycosis failed to mention that fatalities do occur following therapy with "stilbamidine." I reported one fatality as a result of yellow atrophy of the liver in disseminated coccidioidomycosis (Cohen, R.; Bos, J., and Webb, P. A.: Coexisting Coccidioidomycosis and Tuberculosis in Children: Report of 3 Cases,<i>Arch. Pediat.</i><b>69</b>:267 [June] 1952). Dr. Ian McDonald of Los Angeles told me that he was aware of another patient with acute yellow atrophy of the liver who died following "stilbamidine" therapy for a neoplastic disease. The authors, in my opinion, should have mentioned in this article that "stilbamidine" solutions
Nodular prurigo responds to cyclosporin
Authors: J. BERTH-JONES, S.G. SMITH, R.A.C. GRAHAM-BROWN
Journal: British Journal of Dermatology (2006)

Nodular prurigo is a distressing disease which is difficult to treat. Two patients with severe nodular prurigo were treated with cyclosporin for periods of 36 and 24 weeks, respectively, using doses of 3-4.5 mg/kg per day. In both cases there was a reduction in the severity of pruritus after 2 weeks of treatment. In one patient there was a considerable, although incomplete response, and in the other almost complete resolution of the disease was achieved. The improvement was maintained throughout the treatment period, and the drug was generally well tolerated, although in one patient there was a rise in serum creatinine during treatment, which later returned to normal.