tbuckley/cabot-search huggingface dataset:
Changes in left ventricular volume, mass, and function during the development and regression of supraventricular tachycardia-induced cardiomyopathy. Disparity between recovery of systolic versus diastolic function.
Authors: M Tomita, F G Spinale, F A Crawford, M R Zile
Journal: Circulation (1991)

Chronic supraventricular tachycardia causes a dilated cardiomyopathy in man. Terminating this tachycardia appears to result in symptomatic improvement; however, its effects on left ventricular (LV) volume, mass, and function have not been fully examined. Accordingly, hemodynamic studies using simultaneous echocardiography and catheterization were performed in three groups of pigs: 1) those subjected to rapid left atrial pacing (240 beats/min) for 3 weeks (SVT, n = 8), 2) those subjected to supraventricular tachycardia for 3 weeks followed by termination of pacing and a 4-week recovery period (PSVT, n = 9), and 3) sham-operated controls (CTR, n = 10). Systolic pump function was assessed using fractional shortening (FS), peak ejection rate [peak (-)dD/dt], and maximum rate of pressure development [peak (+)dP/dt]. Diastolic function was assessed using the time constant of isovolumic pressure decline (tau), peak early diastolic filling rate [peak (+)dD/dt], the chamber stiffness constant (Kc), and the myocardial stiffness constant (Km). Supraventricular tachycardia caused LV dilation (end-diastolic dimension [EDD] increased from 3.5 +/- 0.4 cm in CTR to 4.9 +/- 0.5 cm in SVT, p less than 0.05) but no change in LV mass (LV weight-to-body weight ratio [LV/BW]) was 2.58 +/- 0.3 g/kg in CTR and 2.66 +/- 0.4 g/kg in SVT), all indexes of systolic function became abnormal (FS fell from 30 +/- 4% in CTR to 13 +/- 5% in SVT, p less than 0.05), and the indexes of relaxation and filling were slowed (tau increased from 36 +/- 3 msec in CTR to 51 +/- 13 msec in SVT, p less than 0.05). There were no significant changes in Kc or Km. After terminating the supraventricular tachycardia, LV volume fell but remained greater than that in CTR (EDD was 4.2 +/- 0.4 cm in PSVT, p less than 0.05 versus CTR) and substantial LV hypertrophy developed (LV/BW was 3.48 +/- 0.5 g/kg in PSVT, p less than 0.05 versus CTR). Systolic function returned to normal (FS was 31 +/- 5% in PSVT) but diastolic function remained abnormal. In PSVT, tau remained prolonged (49 +/- 12 msec, p less than 0.05 versus CTR), Kc increased from 3.7 +/- 1.0 in CTR to 7.4 +/- 1.2 (p less than 0.05), and Km increased from 4.4 +/- 1.5 in CTR to 13.9 +/- 9.7 (p less than 0.05). Thus, the improvement in systolic function that occurs after the termination of supraventricular tachycardia is associated with the development of LV hypertrophy and persistent diastolic dysfunction.
THE KNOWN AND THE UNKNOWN ABOUT PSORIASIS
Authors: JAY FRANK SCHAMBERG
Journal: JAMA (1924)

Psoriasis, the great dermatologic mystery, is an affliction that has been known since the days of the early Greeks. Much has been learned concerning its symptomatology, its diagnosis, its course, its histopathology, and not a little about its treatment. Concerning its true nature and cause, a maze of speculation has been indulged in, which still clutters the textbooks of today.  In this communication, an effort will be made to separate the wheat from the chaff, and to formulate what has been demonstrated and should therefore be retained, and what should be discarded as untenable conjecture.  I have analyzed the histories of 592 private psoriasis patients that have been under my care.  Regarding sex, there were 281 males suffering from psoriasis, and 244 females. The preponderance of males is rather less marked than in some European figures. Concerning the age at which the psoriasis first developed, data are available on 492
Immunologic Aspects of Cardiovascular Disease
Authors: Jordan N. Fink
Journal: JAMA (1982)

<h3>ACUTE RHEUMATIC FEVER</h3><h3>Clinical Findings</h3> RHEUMATIC fever is an acute febrile illness characterized by inflammation of the heart, joints, and subcutaneous tissues. Characteristic diagnostic features have been grouped into so-called major and minor criteria. Among the major clinical manifestations of the disease are polyarthritis, carditis, subcutaneous nodules, erythema marginatum, and chorea. Minor manifestations include fever, arthralgia, a history of previous rheumatic fever or rheumatic heart disease and the presence of certain laboratory findings. Among these laboratory findings are an elevated erythrocyte sedimentation rate, prolongation of the PR interval on the ECG, leukocytosis, and the presence of acute phase reactants in the blood (such as C reactive protein). The criteria require, in addition, evidence of a preceding streptococcal infection detected by antibody studies, results of throat culture, or history of scarlet fever. Features of cardiac involvement consist of heart murmurs, cardiomegaly, congestive heart failure, pericardial friction rubs, or signs of effusion.
Expiratory muscle activity increases intrinsic positive end-expiratory pressure independently of dynamic hyperinflation in mechanically ventilated patients.
Authors: M R Lessard, F Lofaso, L Brochard
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Intrinsic positive end-expiratory pressure (PEEPi) has usually been interpreted as suggesting dynamic hyperinflation, but expiratory muscle activity may also increase end-expiratory alveolar pressure without any additional increase in end-expiratory lung volume. The aim of this study was to assess the influence of expiratory muscle activity, which increases abdominal pressure during expiration and is followed by a sudden drop at end-expiration, on PEEPi measurement in mechanically ventilated patients. We studied eight tracheally intubated patients breathing in an assisted mode in whom expiratory muscle activity was present. PEEPi was measured from the fluctuations of esophageal pressure (Pes) while continuous recording of gastric pressure (Pga) and of changes in abdominal cross-sectional area assessed expiratory muscle activity. PEEPi was also measured by the airway occlusion method in one patient, and diaphragmatic electromyographic activity was recorded to determine the timing of inspiratory muscle activity in two patients. Varying the level of ventilatory support (pressure support level, peak flow rate, or PEEP level) induced increases in measured PEEPi from 6.7 +/- 3.4 to 13.2 +/- 5.9 cm H2O. Concomitantly, the expiratory rise in Pga increased from 3.1 +/- 2.7 to 8.6 +/- 5.0 cm H2O, and the abrupt decay in Pga observed at the end of expiration increased from 4.2 +/- 3.7 to 10.6 +/- 6.1 cm H2O. The drop in Pga and the drop in Pes at end-expiration were synchronous, and these changes, together with electromyographic measurements, were consistent with a concomitant relaxation of the expiratory muscles and activation of the inspiratory muscles.(ABSTRACT TRUNCATED AT 250 WORDS)
Changes in grafts and coronary arteries after saphenous vein aortocoronary bypass surgery: results at repeat angiography.
Authors: M G Bourassa, L Campeau, J Lespérance, C M Grondin
Journal: Circulation (1982)

We studied the patency of saphenous vein aortocoronary bypass grafts in nonconsecutive and consecutive subgroups of our first 600 patients. The patency rates were 87-93% within 1 month and 74-85% approximately 1 year after surgery. The attrition rate of grafts averaged 2.2% per year between 1 and 6 years. Early occlusion was due to thrombosis; occlusion at 1 year was caused by fibrous intimal proliferation of grafts, which also led to variable reduction in caliber and to significant (greater than 50%) segmental stenoses in 5-15% of patent grafts. The most important determinant of graft patency at 1 year was the runoff capacity of the recipient arteries, followed by the quality of the surgical techniques. Late occlusion was related to atherosclerosis that became manifest only after at least 2 years. Coronary atherosclerosis progressed in more than 50% of proximal segments of grafted arteries during the first year, but little additional deterioration occurred between 1 and 6 years. During the first year, only 10% of preexisting stenoses in nongrafted arteries showed progression of disease; progression in these vessels increased to 46% at 6 years and was no longer different, for preexisting lesions greater than 50%, from that of grafted arteries. A close correlation was observed between changes in grafts and in coronary arteries and long-term survival or relief of angina. Ninety-four percent of patients with all grafts patent and 98% with an optimal correction were alive at 6 years compared with 70% of patients without patent grafts or surgical correction. Changes in grafts or coronary arteries were observed in two-thirds of patients in whom functional deterioration occurred between 1 and 6 years, compared with 18% in whom improvement persisted after surgery.
Abstract 2458: The expression of hyaluronan and hyaluronidases in cutaneous melanoma
Authors: Hanna Siiskonen, Mari Poukka, Kristiina Tyynelä, Raija H. Tammi, Reijo Sironen, Sanna M. Pasonen-Seppänen
Journal: Cancer Research (2012)

Abstract Aberrant hyaluronan expression implicates aggressive disease progression and metastatic potential in many cancers. In tumors originating from simple epithelium, hyaluronan amount is increased both in the epithelial and stromal component and it correlates with patient's poor overall prognosis. The role of hyaluronan degrading enzymes (hyaluronidases, HYAL1-2) in cancer progression is controversial. Hyaluronidases are proposed to be both tumor suppressors and tumor promoters. In this retrospective study, we characterized the expression levels of HYAL1 and HYAL2 and correlated their expression to hyaluronan in the different stages of primary skin melanoma as well as in metastatic melanoma. Superfically (pT1) and deeply (pT4) invasive melanoma (Breslow &amp;lt; 1mm (n=18) and Breslow &amp;gt; 4mm (n=18)), in situ melanoma (n=17), lymph node metastasis (n=19), dysplastic nevi (n=28) and benign nevi samples (n=29) were analyzed for hyaluronan staining and HYAL1 and HYAL2 immunoreactivity (ABCAM antibodies) in paraffin tissue sections. Stainings were evaluated for their intensity and coverage. The tissue area for hyaluronan and HYAL1/HYAL2 positive staining was estimated with a five-level scoring from 0-4 and the staining intensity of melanocytic cells was evaluated with a four-level scoring (0-3; no color, weak, moderate and strong) by two independent observers. Compared to benign nevi and in situ melanoma, the cell-associated hyaluronan staining coverage and intensity were clearly reduced in the invasive part of melanoma with advanced Breslow depth. Strong hyaluronan staining intensity was detected in 36% of in situ melanoma cases and in 21% of superficial melanoma (Breslow &amp;lt; 1mm) cases, while in the deeply invasive melanoma group (Breslow &amp;gt; 4mm), only 6% of cases showed strong hyaluronan staining intensity. In addition, in lymph node metastases the melanoma cells showed low hyaluronan staining intensity or were totally hyaluronan negative. However, the tumor stroma was highly hyaluronan positive in all groups. HYAL1 immunoreactivity was found in melanocytic cells both in benign nevi and melanoma samples while the tumor stromal cells were negative. The coverage of HYAL2 immunoreactivity was parallel to HYAL1, although its staining intensity was lower than that of HYAL1. Our results suggest that hyaluronan content is clearly decreased in invasive primary and metastatic melanoma compared to benign nevi. The results from hyaluronan stainings will be compared with clinical follow-up data to study the prognostic value of hyaluronan in melanoma. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2458. doi:1538-7445.AM2012-2458
Normal pregnancy or neoplasia?
Authors: A. Rozenholc, P. Petignat
Journal: BMJ (2008)

A 24 year old woman, gravida 1 para 1, presented with a request for contraception four months after delivery of a healthy baby and a normal placenta. She did not breastfeed, was asymptomatic, and did not have a return of menses (postpartum amenorrhea). A urinary pregnancy test was performed, which was positive. Transvaginal ultrasonography showed no intrauterine or extrauterine pregnancy; the endometrium was regular, 3 mm thick; and the ovaries were normal. The concentration of serum human chorionic gonadotrophin (hCG) was 92 713 IU/l (normal <5 IU/l), and one week later it was 117 056 IU/l. She underwent dilatation and curettage, and the pathological specimen showed no decidua or trophoblastic tissue. Hysteroscopy and laparoscopy showed a normal uterine cavity, tubes, and ovaries. A thoraco-abdominal computed tomography scan and magnetic resonance imaging of the brain showed no abnormality. ### Short answers
Variations in Rates of Hospitalization of Children in Three Urban Communities
Authors: James M. Perrin, Charles J. Homer, Donald M. Berwick, Alan D. Woolf, Jean L. Freeman, John E. Wennberg
Journal: New England Journal of Medicine (1989)

Abstract Hospitalization accounts for a large portion of the expenditures for child health care, and differences in the rate of hospitalization may produce important variations in the cost of that care. We studied the rates of hospitalization in Boston, Rochester (N.Y.), and New Haven (Conn.) in 1982. We assigned the risk of hospitalization in Rochester a score of 1.00. Boston children were hospitalized at more than twice the rate of Rochester children for most medical diagnostic categories (relative risk, 2.65; 95 percent confidence interval, 2.53 to 2.78), and the rate for the New Haven group was intermediate (relative risk, 1.80; 95 percent confidence interval, 1.68 to 1.93). Rates of inpatient surgery differed less (Boston relative risk, 1.12; New Haven relative risk, 0.93). The relative risks of hospitalization (as compared with Rochester children) for Boston and New Haven children, respectively, were 3.8 and 2.3 for asthma, 6.1 and 2.9 for toxic ingestions, and 2.6 and 2.7 for head injuries. Fractures of the femur, appendicitis, and bacterial meningitis (conditions uniformly treated in the hospital) had similar rates of hospitalization across the three cities, but the relative risk of hospitalization for aseptic meningitis was 3.7 in Boston. The rates of hospitalization of children in all three communities were below the national averages in 1982. Although this study does not define the reasons for the variation in rates of hospitalization, it is possible that they were related in part to differences in socioeconomic status or access to primary care. The implications of these data for the cost and quality of pediatric care therefore remain to be determined. (N Engl J Med 1989; 320:1183–7.)
Preprocedural lesion morphology as assessed by intravascular ultrasound predicts thrombolysis in myocardial infarction frame counts following percutaneous coronary intervention for the infarct-related artery
Authors: Jun-ichi Kotani, Gary S. Mintz, Chalak O. Berzingi, Marco T. Castagna, Augusto D. Pichard, Lowell F. Satler, Ron Waksman, William O. Suddath, Kenneth M. Kent, Neil J. Weissman
Journal: Journal of the American College of Cardiology (2003)
How is the Early Diagnosis of Pulmonary Tuberculosis to be Made?
Authors: E. E. Prest
Journal: BMJ (1917)

C m lmJoU 741 for them free of charge under those Acts; h-lowever, such cases can be multiplied indefinitely wlhere people consider it more desirable to employ a handy-woman wlho remains in residence during the lying-in, period, and washes and liouselieeps for the household, wllile the unremunerated disiensary doctor is compelled to take over the work, and also the opprobritum of the untrained midwives' too- frequently-fatal mistakes.Where in the bill are we empowered to expel untrained women from the charge of a " Poor Law emnergency case " and substitute our trained lnurse?No suclh provision is made.Is the Local Government Board prepared to
Conference plans rebuilding of Southern Sudan's health services
Authors: Peter Moszynski
Journal: BMJ (2005)

Interim health ministers from Sudan's new government of national unity and from the semi-autonomous government of Southern Sudan met in London last week, with other health experts, to consider how to rebuild Southern Sudan's shattered health services.

The new governments were established earlier this month as part of a peace agreement ending Africa's longest conflict.

The conference's organiser, Mohamed Baraka, a consultant ear, nose, and throat surgeon at Royal Lancaster Infirmary and formerly a professor at King Faisal …
Penicilloyl-Polylysine Skin-Test Reactions
Authors: Martin L. Lee
Journal: JAMA (1966)

<h3>To the Editor:—</h3> At a time when the medical profession has been subject to criticism for alleged disregard of human safety in pursuing clinical investigation which appears to be more curious than sane, the report of Resnik and Shelley (<b>196</b>:740, 1966) relating to the production of anaphylaxis with the penicilloylpolylysine (PPL) skin test should not go without comment and criticism. Prior to the production of anaphylaxis in the reported subject they had satisfactorily demonstrated specific PPL sensitivity. I cannot imagine what was in the authors' minds when, following a systemic reaction to the PPL skin test, this test was repeated using more concentrated material. Certainly, on the basis of past experience with reactions of this type, one would have anticipated and predicted the more severe reaction (anaphylaxis) which occurred. The potential hazard of anaphylaxis had been pointed out by Drs. Ettinger and Kaye (<i>New Eng J Med</i><b>271</b>:1105,
Anorectal Bleeding vs Penile Activity A Potential Diagnostic Problem
Authors: LAWRENCE A. GILBERT, EDWARD B. SILBERSTEIN, G CHRIS RAUF, RUTH NOLL, VICTORIA MADDEN
Journal: Clinical Nuclear Medicine (1984)

Intrapenile blood pool activity may be a source of artefact in interpreting a gastrointestinal bleeding study employing Tc-99m sulfur colloid or erythrocytes. Proper positioning should avoid a false reading of rectal bleeding.
Mechanisms of Exercise Intolerance
Authors: Stanislaw J. Skaluba, Sheldon E. Litwin
Journal: Circulation (2004)

A decreased ratio of early to late diastolic mitral inflow velocities (E/A <1.0) reflects slowing of left ventricular (LV) relaxation. This finding is widely believed to indicate significant diastolic dysfunction. However, E/A <1.0 is common during normal aging and often is not associated with symptoms of heart failure. We asked (1) whether slowed LV relaxation is associated with exercise intolerance and (2) whether tissue Doppler imaging of the early diastolic mitral annular velocity (Ea) is helpful in understanding mechanisms of exercise intolerance.Patients (n=121) underwent echocardiography before maximal exercise testing. Fifty-nine subjects had E/A <1.0, and 36 subjects had E/Ea > or =10. Exercise capacity was similar in the population with a normal mitral inflow pattern and those with a slow relaxation pattern when E/Ea was <10. In contrast, the subjects with slow relaxation and E/Ea > or =10 had reduced exercise tolerance. Of all the echo and clinical parameters assessed, E/Ea had the best correlation with exercise capacity (r=-0.684, P<0.001) and was the strongest independent predictor of exercise capacity < or =7 METs by multivariate analysis (prevalence-corrected odds ratio=12.6, P<0.001). E/Ea continued to be strongly associated with exercise capacity in all age groups and in those with preserved or reduced systolic function.Of the subjects with slow LV relaxation, only those with E/Ea > or =10 have objective evidence of reduced exercise tolerance. These data suggest that elevated LV filling pressures rather than slow relaxation per se reduce exercise capacity.
Port-wine stains unresponsive to pulsed dye laser: explanations and solutions
Authors: None Lanigan
Journal: British Journal of Dermatology (1998)

The flashlamp-pumped pulsed tunable dye laser has represented a significant advance in the treatment of port-wine stains (PWS). However, not all patients will respond. In this review, the clinical features influencing the response of PWS to the pulsed dye laser will be discussed. Theoretical and clinical data are presented to explain why not all PWS will respond to this laser. Methods to overcome the problems of non-responding PWS are suggested, including new treatment devices and techniques.
Prevention of post-ERCP pancreatitis: a little antacid might go a long way
Authors: A. B Nagar, F. Gorelick
Journal: Gut (2008)

A major procedural complication in gastroenterology is post-endoscopic retrograde cholangiopancreatography (ERCP) acute pancreatitis. This occurs in 4–10% of patients undergoing ERCP. While the severity of post-ERCP pancreatitis is generally mild, up to 10% of cases may be severe and complicated by necrosis, multi-organ failure and even death.1 Prevention of this complication has proven only partially successful with patient selection and procedural measures contributing significantly to decreases in this complication. Although many pharmacological interventions have been used, few have demonstrated consistent or substantial benefits.1 A possible exception may be non-steroidal anti-inflammatory agents.2 In this issue of the journal, Noble and co-workers3 ( see page 1566 ) surprisingly identify the pH of the contrast media used to opacify the pancreatic duct as a potential factor in post-ERCP pancreatitis.

Certain manipulations increase the risk of developing post-ERCP pancreatitis. These include sphincter of Oddi dysfunction, repeated attempts at cannulation, repeated contrast injection, and papillotomy. Each of these interventions can result in increased pressure within the pancreatic duct. Thus, the empirical use of temporary pancreatic duct stents to reduce intraductal pressure and prevent post-ERCP pancreatitis began about 15 years ago. The literature has consistently supported their use, particularly in reducing severe pancreatitis.4 The contributory role of contrast agents in post-ERCP pancreatitis has been explored. Osmolality was thought to be a causative factor, but the use of low osmolality contrast agents has not resulted in a lower incidence of post-ERCP pancreatitis.5 In this issue, Noble and co-workers explore a previously unexamined property of contrast media, its pH.

Noble describes a potentially important response to the contrast media …
G-CSF mobilizes CD34 <sup>+</sup> regulatory monocytes that inhibit graft-versus-host disease
Authors: Maud D’Aveni, Julien Rossignol, Tereza Coman, Shivajanani Sivakumaran, Stephen Henderson, Teresa Manzo, Pedro Santos e Sousa, Julie Bruneau, Guillemette Fouquet, Flora Zavala, Olinda Alegria-Prévot, Meriem Garfa-Traoré, Felipe Suarez, Hélène Trebeden-Nègre, Mohamad Mohty, Clare L. Bennett, Ronjon Chakraverty, Olivier Hermine, Marie-Thérèse Rubio
Journal: Science Translational Medicine (2015)

G-SCF–mobilized CD34 + monocytes inhibit graft-versus-host disease by the production of nitric oxide and the induction of regulatory T cells.