tbuckley/cabot-search huggingface dataset:
Repolarization Abnormalities, Arrhythmia and Sudden Death in Canine Tachycardia-Induced Cardiomyopathy
Authors: Peter H Pak, H.Bradley Nuss, Richard S Tunin, Stefan Kääb, Gordon F Tomaselli, Eduardo Marban, David A Kass
Journal: Journal of the American College of Cardiology (1997)

Objectives. This study sought to determine whether the canine model of tachycardia-induced heart failure (HF) is an effective model for sudden cardiac death (SCD) in HF. Background. Such a well established HF model that also exhibits arrhythmias and SCD, along with repolarization abnormalities that could trigger them, may facilitate the study of SCD in HF, which still eludes effective treatment. Methods. Twenty-five dogs were VVI-paced at 250 beats/min for 3 to 5 weeks. Electrocardiograms were obtained, and left ventricular endocardial monophasic action potentials (MAPs) were recorded at six sites at baseline and after HF. Weekly Holter recordings were made with pacing suspended for 24 h. Results. Six animals (24%) died suddenly, one with Holter-documented polymorphic ventricular tachycardia (VT). Holter recordings revealed an increased incidence of VT as HF progressed. Repolarization was significantly (p < 0.05) prolonged, as indexed by a corrected QT interval (mean [±SD] 311 ± 25 to 338 ± 25 ms) and MAP duration measured at 90% repolarization (MAPD90) (181 ± 19 to 209 ± 28 ms), and spatial MAPD90dispersion rose by 40%. We further tested whether CsCl inhibition of repolarizing K+currents, which are reportedly downregulated in HF, might preferentially prolong the MAPD90in HF. With 1 mEq/kg body weight of CsCl, MAPD90rose by 86 ± 100 ms in dogs with HF versus only 28 ± 16 ms in control animals (p = 0.002). Similar disparities in CsCl sensitivity were observed in myocytes isolated from normal and failing hearts. Conclusions. Tachycardia-induced HF exhibits malignant arrhythmia and SCD, along with prolonged, heterogeneous repolarization and heightened sensitivity to CsCl at chamber and cellular levels. Thus, it appears to be a useful model for studying mechanisms and therapy of SCD in HF.
On a Peculiar Crackling (Emphysematous) Sensation in the Vaginal Canal
Authors: J. Oliver
Journal: BMJ (1894)

ORN 8;5 it can account for many, and other circumstances, of which direct and carele s contact with the sick is the most important, will account for many others.It does not exclude the influence of local conditions upon the prevalence of cholera.The epidemic in Rassia has indeed furnished 4strong evidence that local conditions, such as elevation and -dampness of the soil, are important factors in the cholera problem.But to discuss this evidence here would be to enter upon the whole question of the etiology of cholera, and would far exceed the limits of tie pres -nt paper.
Diagnosing and managing occupational disease
Authors: A. Seaton
Journal: BMJ (1995)

and high technology must be shown to be inextricably linked.Leading consultants and senior clinicians must not be complacent and should be worried that their skills are waning.The royal colleges and specialist societies should emphasise the need, and lay down guidelines, for teaching clinical methods in both undergraduate and postgraduate training programmes.Now that the undergraduate medical curriculum is undergoing reform, emphasis on teaching clinical skills is vital.If regular tests of continuing competence to practise are to be introduced these should include an assess- ment of clinical skills as well as knowledge of the latest advances in diagnosis and treatment.The problem is urgent because the more complex high technology becomes,
Diseases of modern civilisation
Authors: H. Trowell, D. Burkitt
Journal: BMJ (1981)

drawn from community medicine, epidemi- ology, and allied subjects, passed a resolution that "medical and other personnel who are drawn into planning to cope with medical emergencies arising from a nuclear attack should indicate to the relevant authorities the limits to their power to prevent massive suffering,.and the need to acquaint the communities for which they are responsible of these limits."It is hoped that this view will be widely shared within the health services and that, using information such as that containea in your articles, people who are in a position te publicise the facts about the medical consequences of nuclear war will do so as vigorously as possible.
It Was Hot Springs.
Authors: J. Berrien Lindsley
Journal: JAMA (1895)

Tennessee State Board of Health, Nashville, Dec. 20,1895. <h3>To the Editor:</h3> —On page 1000, December 7,Journal of the American Medical Association, second column, line 10 (from bottom), " Little Rock" should read "Hot Springs." Much fault is found with me because of this error. It is proper to state that I read no paper, only said a few sentences in a conversational way. No proof of the proceedings was sent me, as should have been done. The error is doubtless that of the reporter. You know too well how these things happen. Please make necessary correction, and oblige, Very respectfully,
THE PELVES OF RICKETY CHILDREN AS THE PRECURSORS OF THE RICKETY FLAT PELVES OF WOMEN
Authors: H. T. Ashby
Journal: BMJ (1922)

food.The temperature should be kept, if possible, below the 1030 line by cold sponging, or, if hyperpyrexial, by the wet pack, care being taken to give a stimulant if -necessary.Sweats should not be shortened.A continued type of tem- perature shows a high dearee of toxaemia or the presence of probable pulmonary compYication.Arthritis should be treated with belladonna or opium applications, and the neuritis by mild hypnotics, suclh as sulphonal, trional, or paraldellyde; a patient should never be allowed to pass sleepless nights.If the pain is very acute morphine must be given, but slhould be avoided if possible.I)rugs.-Theseare of very little use.Quinine, camphor, methyl- blue, collargol, and electrargol have given some satisfactory results lately when administered intravenously.Piazzc's phenolo- lipoid N is recommended-1 c.cm. of a 10 per cent.solution in oil given subcutanieously for an aver ige of eight days was able to cure guinea-pigs which had received lethal doses of Mll.mielitenisis.It is antitoxic and bWctericidal.Burney Yeo's mixture was useful.Digitalis, strychnine, and stimulants, as required by symptoms, mtust be given.Scrumiiis.-Donzelloand Trambusti had a nucleo-protein serum, and lately Nogre and Sergent have prepared a polyvalent serum which has given good results.Vaccine Treatcment.
The effects of the rate of intravenous infusion of streptokinase and the duration of symptoms on the time interval to reperfusion in patients with acute myocardial infarction.
Authors: A S Lew, P Laramee, B Cercek, L Rodriguez, P K Shah, W Ganz
Journal: Circulation (1985)

We studied the influence of the following variables on the time interval from initiation of an intravenous infusion of 750,000 U of streptokinase until reperfusion (reperfusion time) in 140 consecutive patients with an evolving acute myocardial infarction: (1) the rate of infusion of streptokinase, (2) the duration of chest pain before initiation of treatment, (3) patient age, (4) patient sex, (5) location of infarction, (6) history of previous myocardial infarction, and (7) pretreatment pathologic Q waves. The time of reperfusion was recognized by clinical criteria that were completely concordant with the anatomic findings in all 119 patients in whom patency or occlusion of the artery of infarction was established at delayed angiography (n = 116) or at postmortem examination (n = 3). The mean reperfusion time for the 129 patients for whom data were available was 49 +/- 36 min. The reperfusion time was inversely related to the rate of infusion of streptokinase (r = .41, p less than .001), but this effect of infusion rate appeared to plateau at rates of greater than 500 U/kg/min. In the 64 patients receiving infusions at rates of 500 U/kg/min or less, the mean reperfusion time was 60 +/- 40 min, whereas in the 58 patients receiving the drug at rates greater than 500 U/kg/min it was 35 +/- 22 min (p less than .001). The duration of chest pain before treatment was the only other studied variable found to influence the reperfusion time, but only at infusion rates of less than 250 U/kg/min (r = .6, p less than .01).(ABSTRACT TRUNCATED AT 250 WORDS)
Comparison of fluoroscopically guided and blind corticosteroid injections for greater trochanteric pain syndrome: multicentre randomised controlled trial
Authors: S. P Cohen, S. A Strassels, L. Foster, J. Marvel, K. Williams, M. Crooks, A. Gross, C. Kurihara, C. Nguyen, N. Williams
Journal: BMJ (2009)

<b>Objective</b> To determine whether fluoroscopic guidance improves outcomes of injections for greater trochanteric pain syndrome. <b>Design</b> Multicentre double blind randomised controlled study. <b>Setting</b> Three academic and military treatment facilities in the United States and Germany. <b>Participants</b> 65 patients with a clinical diagnosis of greater trochanteric pain syndrome. <b>Interventions</b> Injections of corticosteroid and local anaesthetic into the trochanteric bursa, using fluoroscopy (n=32) or landmarks (that is, "blind" injections; n=33) for guidance. <b>Main outcome measures</b> Primary outcome measures: 0-10 numerical rating scale pain scores at rest and with activity at one month (positive categorical outcome predefined as ≥50% pain reduction either at rest or with activity, coupled with positive global perceived effect). Secondary outcome measures included Oswestry disability scores, SF-36 scores, reduction in drug use, and patients' satisfaction. <b>Results</b> No differences in outcomes occurred favouring either the fluoroscopy or blind treatment groups. One month after injection the average pain scores were 2.7 at rest and 5.0 with activity in the fluoroscopy group compared with 2.2 and 4.0 in the blind injection group. Three months after the injection, 15 (47%) patients in the blind group and 13 (41%) in the fluoroscopy group continued to have a positive outcome. <b>Conclusion</b> Although using fluoroscopic guidance dramatically increases treatment costs for greater trochanteric pain syndrome, it does not necessarily improve outcomes. <b>Trial registration</b> Clinical trials NCT00480675
DEBAKEY TYPES I AND II ARE DISTINCT SUBSETS WITHIN TYPE A DISSECTION: A REPORT FROM THE INTERNATIONAL REGISTRY OF ACUTE AORTIC DISSECTION
Authors: Nilla Majahalme, Louis Kohl, Artur Evangelista Masip, Mark Russo, Stuart Hutchison, Eduardo Bossone, Toru Suzuki, Reed Pyeritz, Peter J. Oberwalder, Lori Conklin, Daniel Montgomery, Eric Isselbacher, Christoph Nienaber, Kim Eagle, Kevin Harris
Journal: Journal of the American College of Cardiology (2013)
Fire in Libraries
Authors: Claude E. Welch
Journal: New England Journal of Medicine (1972)

Libraries serve as valuable repositories of past intellectual achievements, but, as is true of all human institutions, tend to decay unless rewarded with care. Preservation of records of past experience is difficult enough, even in normal times. But in an age that has frequently been characterized as anti-intellectual such records are at even greater risk. Destruction no longer is due to mildew, rot or the bookworm but now is caused not only by readers who surreptitiously cut leaves from publications but, above all, by fire.It is apparent that such buildings, if they are to be of any value at . . .
Multiple Sclerosis
Authors: Milton J. Koch
Journal: JAMA (1974)

A cluster of six patients with multiple sclerosis (MS) occurred in Mossyrock, a community in the state of Washington, with a current population of 415. The estimated prevalence rate in this town was 20 times higher than that for the state of Washington, which has one of the highest rates of MS in the United States. A strong familial pattern was observed. All patients and many unaffected people had smallpox or measles during a major epidemic in 1924. While numerous other environmental factors were shared by the patients during childhood, no other unusual exposures were detected. (<i>JAMA</i>228:1555-1557, 1974)
Impact of 5 years of growth hormone replacement therapy on cardiovascular risk factors in growth hormone–deficient adults
Authors: Maria Claudia Peixoto Cenci, Flávia Lúcia Conceição, Débora Vieira Soares, Luciana Diniz Carneiro Spina, Rosane Resende de Lima Oliveira Brasil, Priscila Marise Lobo, Eduardo Michmacher, Mario Vaisman
Journal: Metabolism (2007)
P689 DIFFERENTIATION OF PATIENTS WITH HBeAg NEGATIVE HEPATITIS VERSUS HBeAg NEGATIVE INACTIVE CARRIER STATUS BY SERUM CYTOKINES AND CHEMOKINES
Authors: S.B. Wiegand, A. Wranke, C. Falk, K. Deterding, M.P. Manns, H. Wedemeyer, M. Cornberg
Journal: Journal of Hepatology (2014)
Controlling the NHS drugs budget
Authors: A Herxheimer
Journal: BMJ (1994)

trusts.A variety of options for purchasing on district, regional, or national lines are floated.There should be formal arrangements, initially at national level, for maintaining standards and safety and for ensuring the general adequacy of service provision.The central welcome message of the Reed report is that high security care can no longer be provided in remote institutions blighted by geographical and (more important) professional isolation.There are no queues for consultant vacancies-institutions depend on locum appointments.Despite valiant efforts the creation of the Special Hospitals Service Authority has not brought these hospitals into the body of the NHS.Unacceptable standards, as at Ashworth' but also previously identified at Rampton6 and Broadmoor,7 will be less likely in settings where observa- tion by the professions and the public is part of everyday life.
Small, Dense Low-Density Lipoprotein Particles and Coronary Heart Disease Risk
Authors: Josef Coresh
Journal: JAMA (1996)

Two articles in this issue of The Journal<sup>1,2</sup>examine prospectively whether smaller low-density lipoprotein (LDL) particle size predicts coronary heart disease (CHD) incidence. The heterogeneity of LDL particles with respect to size, density, and composition is well recognized. A predominance of small LDL particles in the plasma is often accompanied by hepatic overproduction of very low-density lipoproteins (VLDLs) and hypertriglyceridemia. Exchange of triglycerides from the VLDL core with cholesteryl esters from the LDL core and subsequent hydrolysis of the triglycerides result in smaller LDL particles. These smaller LDL particles are denser since they still contain the same amount of protein (apolipoprotein B [apo B]) as other LDL particles but a smaller amount of lipids, which are more buoyant. Thus, the LDL apo B level measures the number of LDL particles, while LDL cholesterol (LDL-C) is a measure which combines the number of particles and their cholesterol content. See also
Coordinated Adaptation of Oxygen Transport in Cardiopulmonary Disease
Authors: Connie C.W. Hsia
Journal: Circulation (2001)

I n chronic cardiopulmonary disease, functional impairment develops in all oxygen transport organs, regardless of the specific cause of the disease.Some abnormalities, such as pulmonary edema in heart failure or right ventricular failure in destructive lung disease, are direct consequences of the primary pathological process.Others, such as skeletal muscle dysfunction that cannot be fully ascribed to edema, electrolyte imbalance, or exogenous medication or fully reversed by physical training or supplemental oxygen, seem paradoxical and resemble changes during acclimatization to high altitude.To understand these secondary responses, the lung-heart muscle axis must be considered as an integrated unit.Then, it becomes apparent that oxygen transport is regulated like any other metabolic pathway, whether organized at a systemic, organ, cellular, or subcellular level, and it follows established principles of metabolic control.Of particular importance is the concept of coordinated adaptation, where a single disturbance in a multistep pathway triggers adaptation in other steps to seek new levels of functional equilibrium within the constraints imposed by the primary disorder.This article discusses (1) fundamental principles of metabolic control, (2) adaptive mechanisms in oxygen transport, (3) coordinated adaptation as a unifying concept to explain diverse secondary responses in disturbed oxygen transport and how seemingly paradoxical responses may, in fact, be beneficial if the underlying physiology is understood, and (4) clinical application of this concept to therapy.
The Continuing Failure to Understand and Treat Hypertension
Authors: Irvine H. Page
Journal: JAMA (1979)

TWO YEARS ago I wrote a philippic regarding the egregious errors involved in measuring blood pressure (BP) and in treating hypertension. Little or nothing has been accomplished by my scolding. Most students of the subject have not seen fit to collect the evidence; consequently, I have no epidemiologic study or comprehensive statistics to prove my point. One useful article written by John Askey, MD, of Los Angeles, elaborating on some of the errors, could not find a publisher; hence, a private printing. I attribute some of the indifference to government and private "educational programs" designed to dispense with any need for professional management or understanding of high BP. In brief, the thesis is that any amateur can measure BP and treat his own hypertension if he has it. Follow the printed directions on the drug package and the disease will soon be under good control. This utter nonsense shows how
BLOOD TRANSFUSION BY THE CITRATE METHOD IN HEMORRHAGES OF THE NEW-BORN
Authors: FREDERICK H. FALLS
Journal: JAMA (1923)

The use of whole blood injections is a well recognized clinical procedure in cases of hemorrhage occurring in new-born babies. Several methods have been devised for this procedure, all of which have certain features to recommend them. The simplest method is the use of subcutaneous or intramuscular injections, from 10 to 20 c.c. being employed at a time. These are often repeated two or three times in a given case, if the primary injection is not successful in arresting the hemorrhage. This is a perfectly safe method, and can be carried out under any circumstances by a physician of ordinary skill. The objection to its routine use is that frequently cases fail to respond favorably; moreover, such injections are frequently painful and irritating to the recipient.  A second method is the direct transfusion through anastomosis of veins by means of cannulas, the median basilic vein of the donor being united
Aortic Stenosis
Authors: VIKING OLOV BJÖRK, INGEMAR CULLHED, HERMAN LODIN
Journal: Circulation (1961)

In 36 cases of valvular heart disease with a clinical diagnosis of isolated or significant aortic stenosis we have performed percutaneous intercostal puncture of the left ventricle for pressure measurements and, in all but one case, left ventricular angiocardiography. The possible correlations between the pressure gradient and the angiocardiographic findings are discussed. With the exception of the unsatisfactory angiocardiograms due to oblique projection of the valvular planes, valuable information was obtained regarding the degree of aortic stenosis. This was especially the case if the aortic stenosis was combined with mitral valve disease, resulting in a small or no systolic pressure gradient.
Changes in Attack and Survival Rates of Acute Myocardial Infarction
Authors: Kenrad E. Nelson
Journal: JAMA (1986)

To the Editor.—  We read with great interest the report of the Worcester Heart Attack Study by Goldberg et al.1We agree with the authors of this elegant study that it is critical that population-based epidemiologic data be collected and analyzed to determine the major reasons for the substantial decline in coronary heart disease (CHD) mortality rates in the United States in the past two decades.  In this study, the incidence and in-hospital and out-of-hospital casefatality rates for CHD were collected for the Worcester Standard Metropolitan Statistical Area for three years (1975, 1978, and 1981), during which time there was a steady decline in age-adjusted mortality from CHD. The authors conclude that the recently observed declines in the mortality rates of CHD may reflect decreases in out-of-hospital coronary deaths and improving trends in the in-hospital survival of patients with acute myocardial infarction.  While it is true that the in-hospital
Evaluation of Q wave and non-Q wave myocardial infarction by magnetic resonance imaging
Authors: Ibraim Pinto, Ricardo Pavanello, Rodrigo Barretto, Alexandre Abizaid, Leopoldo Piegas, Enilton Egito, Marcos Barbosa, Edson Romano, Amanda Sousa, J.Eduardo Sousa
Journal: Journal of the American College of Cardiology (1996)
Improving surveillance of MRSA bacteraemia
Authors: Barry Neish, Thomas Gillespie, Kenneth G Liddell
Journal: BMJ (2005)

Improving surveillance of MRSA bacteraemiaData from north west England support Oxfordshire findings Editor-Wyllie et al conclude that admission cultures accounted for 24% of total hospital methicillin resistant Staphylococcus aureus (MRSA) bacteraemia episodes over seven years to March 2004. 1 Data collected from five district general hospitals and one university hospital in Cheshire and Merseyside and one district general hospital in greater Manchester support this view.This group of hospitals has collected enhanced MRSA bacteraemia surveillance data using published case definitions from the Department of Health since April 2004.Anonymised data are collected on paper forms and analysed using the FORMIC data capture system.In all, 534 cases of S aureus bacteraemia were identified between April 2004 and March 2005, 334 being methicillin sensitive S aureus bacteraemia and 200 MRSA bacteraemia.Sixty six of the MRSA bacteraemia cases occurred within 48 hours of arrival in hospital, 16 being related to a previous hospital admission, 25 in patients known to have been colonised with MRSA, and 13 in patients admitted from nursing or residential homes.Thirty five cases were admitted as medical specialties, 25 of them in patients over 65.Our results support the suggestion by Wyllie et al that anti-MRSA treatment should be considered for patients with possible staphylococcal sepsis who have previously been admitted or known to be colonised with MRSA.In a predominantly district general hospital setting, anti-MRSA treatment should also be considered for possible staphylococcal sepsis in elderly medical admissions and admissions from nursing homes.