tbuckley/cabot-search huggingface dataset:
Sound Spectrographic Diagnosis of Aortic Ball Variance
Authors: JOHN C. HYLEN, FRANK E. KLOSTER, RODNEY H. HERR, ALBERT STARR, HERBERT E. GRISWOLD
Journal: Circulation (1969)

Abnormalities in the silastic poppets of cardiac valve prostheses have been detected with increasing frequency. Ball variance can cause serious mechanical dysfunction of the prosthesis and can result in sudden death. Contour sound spectrograms were recorded on 12 patients with ball variance confirmed by operation and 25 controls. In ball variance the frequency of the aortic opening sound at the second right intercostal space was decreased, with the peak frequency recorded being below 1,300 cycles/sec in 11 of the 12 patients. The peak frequency was greater than 1,300 cycles/sec in 24 of the 25 control patients. The remaining patient had peak frequencies in both the normal and abnormal range. The diagnosis of aortic ball variance in patients with triple valve replacement remains difficult because of the nearly synchronous tricuspid closing and aortic opening sounds. The sound spectrographic findings have been the most reliable objective evidence of ball variance in patients with Starr-Edwards aortic prostheses of the Model 1000 series.
Conjugate Vaccines Hold Hope for Countering Resistant Pneumococcus
Authors: Joan Stephenson
Journal: JAMA (1995)

THE INCREASING spread of drugresistant strains of bacteria such as pneumococci and enterococci is mirrored by increasing concern among infectious disease experts, who fear that the microbes are uncomfortably close to being able to take whatever human beings and the pharmaceutical industry can dish out. "There has been an explosion in pneumococcal resistance throughout the world in the last 5 years," noted Keith Klugman, MD, at the annual Interscience Conference on Antimicrobial Agents and Chemotherapy (ICAAC) held in San Francisco, Calif. See also p 1333. In the United States, for example, where resistance to<i>Streptococcus pneumoniae</i>was less than 5% in 1990, about 25% of pneumococci are now resistant to antibiotics, said Klugman, head of medical microbiology at the South Africa Institute of Medical Research in Johannesburg. Other regions experiencing "massive problems" include Europe, the Middle East, South Africa, and at least some Asian countries, including South Korea and Japan.
Stroke aetiology and predictors of outcome in patients with heart failure and acute stroke: a 10‐year follow‐up study
Authors: Kostas Vemmos, George Ntaios, Paraskevi Savvari, Anastasia M. Vemmou, Eleni Koroboki, Efstathios Manios, Anna Kounali, Gregory Y.H. Lip
Journal: European Journal of Heart Failure (2011)
Reviews and Notes: Pulmonary Medicine: Pulmonary and Critical Care Medicine
Authors: Jonathan F. Gottlieb
Journal: Annals of Internal Medicine (1994)

Literature of Medicine1 June 1994Reviews and Notes: Pulmonary Medicine: Pulmonary and Critical Care MedicineJonathan F. GottliebJonathan F. GottliebJefferson Medical College, Philadelphia, PA 19107Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-120-11-199406010-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Pulmonary and Critical Care MedicineRoger C. Bone, David R. Dantzker, Ronald B. George, Richard A. Matthay, and Herbert Y. Reynolds; eds. St. Louis, Missouri: Mosby-Year Book; 1993. $225.00.If each member of a group of accomplished and erudite medical scientists in the field of pulmonary medicine was asked to write a short treatise, a book such as Pulmonary and Critical Care Medicine would probably be produced. This substantial text is presented in two three-ring binders that occupy about 8 inches of shelf space. The text is set in an attractive typeface, and the figures are clearly drawn and well ... Author, Article, and Disclosure InformationAffiliations: Jefferson Medical College, Philadelphia, PA 19107 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1994Volume 120, Issue 11Page: 975-976KeywordsCritical careInfectious disease immunologyInterstitial lung diseasesLungsNosocomial infectionsPulmonary diseasesPulmonary medicineSepsisSigns and symptomsThorax Issue Published: 1 June 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Ga-67 Imaging of Amiodarone Pulmonary Toxicity with Pseudocavitary Lung Lesion
Authors: BA D. NGUYEN, GILBERT H. ISAACS, NAWAR ALHAKIM, ROBERT YAKULIS
Journal: Clinical Nuclear Medicine (1992)

Pulmonary toxicity is a serious and potentially lethal complication of amiodarone therapy. Ga-67 scintigraphy has been widely used in the assessment of interstitial pneumonitis/alveolitis caused by this antiarrhythmic benzofuran agent. Reported scintigraphic patterns include focal, patchy, and/or diffusely increased lung uptake. The authors present a case of amiodarone pulmonary toxicity with an unusual doughnut-shaped pattern, mimicking a cavitary lung lesion.
Comparative incidence of concussion and return to play time in two Canadian minor hockey groups over the 2011–2012 season
Authors: D J Rhine, T Lamvohee
Journal: British Journal of Sports Medicine (2013)

Objective Report concussion incidence and Return to Play (RTP) times over a minor hockey season (2011–12) in two sub-groups, a community hockey association (A) and a private hockey academy (B). Design Retrospective, cohort study. Setting Elite hockey players from A and B. Subjects 354 subjects in two sub-groups. A: 222 (191 Males/31 Females). B: 132 (114 Males/18 Females). Intervention Subjects were educated and baseline tested at the start of the 2011–12 season using Symptom Inventory, SCAT2, BESS and neuro-cognitive testing. The Zurich 2008 RTP protocol was utilised. Subjects were followed with serial testing until recovered to baseline or within 5% of baseline. Medical authorisation was given to RTP. Outcome Measures The incidence of concussion and the average RTP in the two groups. Results A. Concussion incidence – Overall 23% ▸ A 18% (n=39) ▸ B 32% (n=42) B. RTP (Average No. Days to RTP) Overall: 22 ▸ A: 27 ▸ B: 14 Conclusions Concussion incidence approximated that reported by Echlin. The higher incidence in the B group reflects the experience of coaches and full-time athletic therapists in recognising and dealing with concussions, and a willingness to report concussion injury. Overall RTP time was longer in both groups than the previously reported 12.8 days average. For B, the RTP time was less than A (14 vs 27 days), reflecting daily access to supportive care (athletic therapists and physician), daily access to the gym for Steps 2 and 3, and daily ice-time for Steps 4 and 5 of the RTP protocol.
THE ETIOLOGY OF DIABETIC ACIDOSIS
Authors: I. ARTHUR MIRSKY
Journal: JAMA (1942)

Early in the history of the study of diabetic coma it became apparent that acidosis plays an important part in the production of this syndrome. Subsequently it was demonstrated that this state is due primarily to the accumulation of large amounts of organic acids in the tissues, particularly beta-hydroxybutyric and acetoacetic acids, and that the excretion of these, together with smaller amounts of other organic acids, results in a depletion of base. The loss of base causes a dehydration and intensifies the acidosis and a vicious cycle ensues. For some time minor controversies occurred with reference to the relative importance of the acidosis or the toxic effects of the acetone bodies themselves in the production of the coma. Today the physician is aware that both are important. In view of the predominant role of the acetone bodies in the development of diabetic acidosis and coma it became of interest to
Cost Containment in Oregon: As Simple as A×B?
Authors: Michael L. Goris
Journal: JAMA (1992)

<h3>To the Editor.</h3> —In his review of Oregon's methods for cost containment, Dr Eddy<sup>1</sup>argues with his usual clarity that the failure was due to errors in the data (specifically cost data errors and imprecision in Quality of Well-Being Scale state definitions), the omission of important value elements (eg, the Rule of Rescue or the vicarious utility), and the misapplication of one particular method, directed toward "egalitarian" goals, when another priority setting should have been adopted. His argument does not allow for inherent failures or shortcomings of cost analysis per se. But in his defense he should have, while in the process of allowing for multiple-weighting factors and cost or benefit scales, at least asked the question whether the numerical expressions of the different scales and weighting values form numbering systems that are isomorphic to each other. If they are not, accurate estimates of all the value systems
The role of therapeutic drug monitoring in individualised drug dosage and exposure measurement in tuberculosis and HIV co-infection
Authors: Alper Daskapan, Wiel C.M. de Lange, Onno W. Akkerman, Jos G.W. Kosterink, Tjip S. van der Werf, Ymkje Stienstra, Jan-Willem C. Alffenaar
Journal: European Respiratory Journal (2015)

We read with interest the paper by Esposito et al. [1] reporting a difficult-to-treat extensively drug-resistant tuberculosis (TB) case. TB treatment in HIV-positive individuals can also be particularly challenging. An HIV-positive 26-year-old male showing excessive weight loss (body mass index 17.5 kg·m−2) and clinical deterioration was admitted to the Beatrixoord Tuberculosis Centre (University Medical Center Groningen, Haren, the Netherlands) for the treatment of pulmonary TB. Mycobacterium tuberculosis isolated from sputum appeared susceptible to all first-line drugs tested. The patient received rifampicin (RIF) (600 mg), isoniazid (300 mg), pyrazinamide (1500 mg) and ethambutol (1200 mg) under directly observed therapy. He started with emtricitabine (200 mg), tenofovir (245 mg) and raltegravir (800 mg twice daily) 2 weeks later as combination antiretroviral therapy. Wider use of TDM in complex TB cases could improve therapeutic management and prevent emergence of drug resistance <http://ow.ly/CQx9j>
Proximal Jet Size by Doppler Color Flow Mapping Predicts Severityof Mitral Regurgitation
Authors: Donato Mele, Pieter Vandervoort, Igor Palacios, J. Miguel Rivera, Robert E. Dinsmore, Ehud Schwammenthal, Jane E. Marshall, Arthur E. Weyman, Robert A. Levine
Journal: Circulation (1995)

Background Recent studies have shown that many instrument and physiological factors limit the ability of color Doppler total jet area within the receiving chamber to predict the severity of valvular regurgitation. In contrast, the proximal or initial dimensions of the jet as it emerges from the orifice have been shown to increase directly with orifice size and to correlate well with the severity of aortic insufficiency. Only limited data, however, are available regarding the value of proximal jet size in mitral regurgitation, and it has not been examined in short-axis or transthoracic views. The purpose of the present study, therefore, was to evaluate the relation between proximal jet size and other measures of the severity of mitral regurgitation. Methods and Results In 49 patients, the anteroposterior height of the proximal jet as it emerges from the mitral valve was measured in the parasternal long-axis view; proximal jet width and area were measured in the short-axis view at the same level. Results were compared with regurgitant volume and fraction by pulsed Doppler subtraction of aortic and mitral flows in 47 patients without more than trace aortic insufficiency; with angiographic grade determined within 24 hours in 33 catheterized patients; and with angiographic regurgitant fraction in 13 patients who were in normal sinus rhythm and had no significant aortic and tricuspid insufficiency. Proximal jet height, width, and area correlated well with Doppler regurgitant volume and fraction ( r =.86 to .95; SEE=7.7 to 9.0 mL; 5.9% to 7.3%). Proximal jet size could also be used to distinguish angiographic grades of mitral regurgitation with minimal overlap ( P &lt;.0001) and correlated well with angiographic regurgitant fraction ( r =.85 to .91; SEE=4.1% to 5.1%). Conclusions Proximal jet size correlates well with established measures of the severity of mitral regurgitation. It is conveniently available with transthoracic clinical scanning and should be useful in the routine evaluation of patients with mitral regurgitation.
Syndrome of Inappropriate Antidiuretic Hormone Secretion Associated With Amitriptyline Administration
Authors: Dwight Beckstrom
Journal: JAMA (1979)

<h3>To the Editor.—</h3> Hyponatremia and the syndrome of inappropriate antidiuretic secretion (SIADH) have been associated with the administration of a number of medications. We would like to add our case report to that of Luzecky et al,<sup>1</sup>who first reported the association of SIADH with the administration of amitriptyline. <h3>Report of a Case.—</h3> A 51-year-old woman was treated for depression with amitriptyline hydrochloride, 50 mg three times per day. She was otherwise in good health and was receiving no other medications. Six weeks after starting the amitriptyline treatment, she was found in her home in a comatose state. Shortly after admission to the hospital, she had a generalized tonicoclonic seizure. There had been no history of excessive water intake noted by the family. The patient was said to have behaved normally on the morning of her admission. Physical examination was unremarkable, except for conspicuous lethargy. There was no evidence
Abstract 19988: Long Term Evaluation of Stent Implantation in Arch Coarctation- What have we Achieved?
Authors: Gareth J Morgan, Cameron Slorach, Wei Hui, Taisto Sarkola, Rajiv Chaturvedi, Kyong-Jin Lee, Tim Bradley, Luc Mertens, Lee Benson
Journal: Circulation (2010)

Introduction: Stent implantation is a recognized treatment strategy for coarctation. However, the general arterial nature of lesion suggests that resolution of stenosis may not be a curative event....
Immunoglobulin M Is Required for Protection Against Atherosclerosis in Low-Density Lipoprotein Receptor–Deficient Mice
Authors: Myles J. Lewis, Talat H. Malik, Michael R. Ehrenstein, Joseph J. Boyle, Marina Botto, Dorian O. Haskard
Journal: Circulation (2009)

Background— Immunoglobulin M (IgM) natural antibodies bind oxidatively-modified low-density lipoprotein (LDL) and apoptotic cells and have been implicated as being important for protection against atherosclerosis. We have directly investigated the requirement for IgM by studying the effects of IgM deficiency in LDL receptor–deficient ( Ldlr −/− ) mice. Methods and Results— Mice deficient in serum IgM (sIgM) or complement C1q were crossed with Ldlr −/− mice and studied on both low-fat and high-fat semisynthetic diets. On both diets, en face and aortic root atherosclerotic lesions in sIgM.Ldlr −/− mice were substantially larger and more complex, with accelerated cholesterol crystal formation and increased smooth muscle cell content in aortic root lesions. Combined C1q and IgM deficiency had the same effect as IgM deficiency alone. Increased apoptosis was observed in aortic root lesions of both sIgM.Ldlr −/− and C1qa.Ldlr −/− mice. Because lesions were significantly larger in IgM-deficient mice than in the absence of C1q, IgM protective mechanisms appear to be partially independent of classical pathway activation and apoptotic cell clearance. Levels of IgG antibodies against copper-oxidized LDL were lower in sIgM.Ldlr −/− mice fed a high-fat diet, suggesting compensatory consumption of IgG in the absence of IgM. Conclusions— This study provides direct evidence that IgM antibodies play a central role in protection against atherosclerosis. The mechanism appears to be at least partly independent of classical pathway complement activation by C1q.
"TREATMENT OF TABES BY EPIDURAL INJECTIONS OF NEOARSPHENAMINE"
Authors: Norman Viner
Journal: JAMA (1928)

<h3>To the Editor:</h3> —InThe Journal, February 25, under this title, Hassin reports a favorable influence on ataxia girdle pains, and lightning pains enabling a hitherto bedridden patient to walk. In the course of some years of experiment with the simple epidural injection (nonmedicinal) I have tried out many conditions of lower body segment pain, generally with good results. Among these patients have been a number with tabes, practically all of whom have benefited by this method without the use of arsenicals. I have had relief in two cases for respectively one and two years. Several patients have obtained relief for many months. In one series of four cases in Foix's clinic in Paris in August, 1925, I obtained immediate relief after the first treatment, two of the patients receiving the full series of three injections. How long the relief lasted in that series (beyond one month) I am unaware.
Elevated serum levels in human pregnancy of a molecule immunochemically similar to eosinophil granule major basic protein.
Authors: D E Maddox, J H Butterfield, S J Ackerman, C B Coulam, G J Gleich
Journal: The Journal of Experimental Medicine (1983)

We have shown that serum levels of a molecule immunochemically similar to eosinophil granule major basic protein (MBP) are elevated in pregnant women throughout gestation. MBP levels increase during gestation and plateau at approximately 7,500 ng/ml by the 20th wk (greater than 10-fold above normal). Levels return to normal after delivery, with a T1/2 of 13.7 d. The MBP in pregnancy serum is remarkably similar to the eosinophil granule MBP in that: (a) pregnancy MBP fully inhibits the binding of radiolabeled MBP standard in a double antibody radioimmunoassay; (b) this inhibition reaction is specific for human MBP because pregnancy serum produces no inhibition of the binding of radiolabeled guinea pig MBP in the guinea pig MBP radioimmunoassay; (c) in a two-site immunoradiometric assay for MBP, slopes of dose-response curves for pregnancy serum, purified MBP, and serum from a patient with hypereosinophilic syndrome are identical, and maximal binding is comparable; (d) reduction and alkylation of pregnancy sera increases measured MBP 100-fold, as previously shown for eosinophil granule MBP in serum; and (e) the MBP in pregnancy serum demonstrates the same pattern of heat lability as has been previously reported for MBP. Four observations have raised the possibility that the eosinophil is not the source of the MBP in pregnancy serum: (a) no correlation between serum MBP level and peripheral blood eosinophil count exists in pregnant women, in contrast to previous studies of patients with eosinophilia; (b) levels of three other eosinophil-associated proteins are normal or low in pregnancy sera, whereas the serum levels of these proteins are elevated in patients with eosinophilia; (c) the slopes of dose-response curves for pregnancy sera and MBP standards differ in the double antibody radioimmunoassay; and (d) the molecule in pregnancy serum elutes from Sephadex G-50 columns at the void volume, while eosinophil granule MBP and the MBP in serum of patients with eosinophilia elute at a volume consistent with the previously established molecular weight of 9,300. These findings suggest that the MBP in pregnancy serum is derived from a source other than the eosinophil.
Panorama. The Hospital That Failed Women
Authors: Nigel Bundred
Journal: BMJ (2006)

T his episode of the BBC's flagship documentary Panorama —the latest of several recent episodes to have focused on NHS related issues—looked at whether some women treated for breast cancer at Bradford NHS Trust had missed out on a critical part of their treatment. The basis for the programme was a statistical analysis of data from the Northern and Yorkshire Cancer Registry, which includes Bradford, carried out by Michel Coleman, professor of epidemiology at the London School of Hygiene and Tropical Medicine, and deputy chief medical statistician at the Office for National Statistics from 1995 to 2004.

Panorama 's claims related to radiotherapy, widely recognised to be an integral part of treatment after breast conserving surgery. Since 1995 Department of Health guidelines have been that all women who undergo breast conserving surgery should also receive radiotherapy. Professor Coleman, who analysed data on almost 30 000 women with breast cancer who had been treated in Yorkshire hospitals between 1982 and 2003, said that there was “a strikingly different pattern of breast conserving surgery and radiotherapy” for women treated by one consultant in Bradford “than all other experienced surgeons.”

Radiotherapy was given after breast conserving surgery in Bradford through the 1990s only in between …
Entonox in the Ambulance Service
Authors: R. Binning, W. S. Parker, E. R. Kimber
Journal: BMJ (1970)

was 14.4 mg./100 ml., and serum phosphorus 4-5 mg./l00 ml.The serum alkaline phosphatase was 20 King-Armstrong units, and the 24-hour calcium excretion in the urine was 400 mg.
Whole transcriptome sequencing reveals recurrent NOTCH1 mutations in mantle cell lymphoma
Authors: Robert Kridel, Barbara Meissner, Sanja Rogic, Merrill Boyle, Adele Telenius, Bruce Woolcock, Jay Gunawardana, Christopher Jenkins, Chris Cochrane, Susana Ben-Neriah, King Tan, Ryan D. Morin, Stephen Opat, Laurie H. Sehn, Joseph M. Connors, Marco A. Marra, Andrew P. Weng, Christian Steidl, Randy D. Gascoyne
Journal: Blood (2011)
IRRADIATION AND STERILITY
Authors: Shields Warren
Journal: JAMA (1952)

<h3>To the Editor:</h3> —The report of Dr. I. C. Rubin ("Third Generation Follow-Up in Woman Receiving Pelvic Irradiation") inThe Journal, Sept. 20, 1952, page 207, adds an interesting bit of information to the complex problem of the effect of ionizing radiation on women and their progeny. It is our feeling, however, that insufficient data have yet been obtained to permit the optimistic conclusions drawn by Dr. Rubin. With regard to his comments concerning the irradiation of the pregnant uterus, it is important to point out that not only the x-ray dosage but also the time in the development of the embryo at which the irradiation is received is important, as pointed out by the work of Hicks, Liane Russell, and many others. The effects of irradiation on the embryo and fetus are the result of a direct effect on growing tissues, not a genetic effect, of course. It is
Adeno-associated Virus-Mediated Expression and Constitutive Secretion of Galanin Suppresses Limbic Seizure Activity in Vivo
Authors: Thomas J. McCown
Journal: Molecular Therapy (2006)

Intractable temporal lobe epilepsy presents an ideal target for gene therapy, but therapeutic success depends upon the ability to suppress limbic seizure activity. Adeno-associated virus vectors (AAV) were constructed in which the fibronectin secretory signal sequence (FIB) preceded the coding sequence for galanin (AAV-FIB-GAL) or green fluorescent protein (AAV-FIB-GFP), constructs that express and constitutively secrete the gene product. Bilateral AAV-FIB-GAL infusion into the rat piriform cortex (2 μl/side) significantly attenuated kainic acid-induced seizures (10 mg/kg, ip) such that 11/12 rats exhibited no limbic seizures, while the remaining rat exhibited only a brief, single class III seizure. This AAV-FIB-GAL infusion also prevented electrographic seizure activity. In contrast, bilateral AAV-FIB-GFP infusion did not alter either behavioral or electrographic seizure activity. Since prior seizure exposure could influence vector efficacy, another group of rats received daily electrical stimulation of the piriform cortex until three consecutive class V seizures were elicited. Subsequently, AAV-FIB-GAL or AAV-FIB-GFP (3 μl/30 min) was infused into the area of the electrode. One week later the AAV-FIB-GAL rats exhibited a significant increase in the stimulation current necessary to evoke limbic seizure activity, while AAV-FIB-GFP did not alter the seizure threshold. Thus, AAV-mediated galanin expression and secretion significantly suppress limbic seizure activity in vivo.