tbuckley/cabot-search huggingface dataset:
Anatomy of the Normal Left Atrial Appendage
Authors: John P. Veinot, Phillip J. Harrity, Federico Gentile, Bijoy K. Khandheria, Kent R. Bailey, Jeffrey T. Eickholt, James B. Seward, A. Jamil Tajik, William D. Edwards
Journal: Circulation (1997)

Transesophageal echocardiography (TEE) is the diagnostic modality of choice for visualizing the left atrial appendage (LAA). This study defined the morphology of the LAA in normal autopsy specimen hearts and considered the implications of these findings for TEE studies.Five hundred normal autopsy hearts were reviewed (25 male and 25 female subjects from each decade for 10 decades). LAA length, width, orifice size, and number of lobes were recorded. Number of lobes was compared between sexes with the rank sum test and regressed against age. Mean length, width, and orifice size increased with age, up to age 20 years, in both sexes. Rates were significantly different between sexes for LAA size (P=.011) and width (P=.006). After age 20, statistically significant but clinically insignificant age-related changes were observed. Fifty-four percent of LAAs had two lobes (range, 1 to 4), with no age or sex differences. Lobes exist in different planes of the heart. Most pectinate muscles were > or = 1 mm in width. Pectinate muscles < 1 mm (2.6% of cases) were seen in only the first and last decades.Age- and sex-related differences in LAA dimensions exist. These differences and the existence of multilobed appendages are important in the accurate TEE evaluation of LAA. Because lobes exist in different planes, imaging must be done in multiple planes to visualize the entire LAA.
Concentration-dependent regulation of thyrotropin receptor function by thyroid-stimulating antibody
Authors: Takao Ando, Rauf Latif, Terry F. Davies
Journal: Journal of Clinical Investigation (2004)

Thyrotropin receptor (TSHR) Ab's of the stimulating variety are the cause of hyperthyroid Graves disease. MS-1 is a hamster mAb with TSHR-stimulating activity. To examine the in vivo biological activity of MS-1, mice were treated with purified MS-1 intraperitoneally and the thyroid response evaluated. MS-1 induced a dose-dependent increase in serum thyroxine (T4), with a maximum effect after 10 ∝g of MS-1 was administered. MS-1–secreting hybridoma cells were then transferred into the peritoneum of nude mice to study chronic thyroid stimulation. Serum MS-1 levels detected after 2 weeks were approximately 10–50 ∝g/ml, and the serum TSH was suppressed in all animals. Serum triiodothyronine levels were elevated, but only in animals with low serum MS-1 concentrations. In addition, there was a negative correlation between serum T4 and the serum MS-1 concentrations. These in vivo studies suggested a partial TSHR inactivation induced by excessive stimulation by MS-1. We confirmed this inactivation by demonstrating MS-1 modulation of TSHR function in vitro as evidenced by downregulation and desensitization of the TSHR at concentrations of MS-1 achieved in the in vivo studies. Thus, inactivation of the TSHR by stimulating TSHR autoantibodies (TSHR-Ab's) in Graves disease patients may provide a functional explanation for the poor correlation between thyroid function and serum TSHR-Ab concentrations.
A Course on the Social Functions of Prescription Drugs
Authors: JOHN P. MORGAN
Journal: Annals of Internal Medicine (1972)

A brief, elective seminar course for second-year medical students focused on the social determinants of prescription-drug use. Students and instructors discussed social, economic, and philosophical determinants of physician, patient, and third-party behavior pertinent to drug taking. The course was well received and highly rated by the students. Because drug prescribing is not as scientific as we generally believe, the information from the readings and particularly the ideas formulated during discussion are important for students seeking to be good presenters. The outline, readings, and some questions considered are given to encourage others to similarly instruct medical students.
The transcriptional repressor Nab1 is a specific regulator of pathological cardiac hypertrophy
Authors: Monika Buitrago, Kristina Lorenz, Alexander H Maass, Silke Oberdorf-Maass, Ursula Keller, Eva M Schmitteckert, Yuri Ivashchenko, Martin J Lohse, Stefan Engelhardt
Journal: Nature Medicine (2005)
SUGGESTIONS AS TO TREATMENT OF ALCOHOLISM.
Authors: DANIEL R. BROWER
Journal: JAMA (1899)

The more thorough pharmacologic studies that have been made of ethyl alcohol in the last few years have placed it in the class of anesthetics with chloroform and ether, and displaced it from its former association as a stimulant with strychnia and digitalis. This most important fact must be borne in mind in considering the therapy of its poisonous effects. We may recognize three forms of alcoholism from a therapeutic standpoint: 1, acute alcoholic intoxication; 2, acute alcoholic delirium or alcoholic mania, and, 3, chronic alcoholism. These types of poisoning each alike demand for their successful treatment the immediate withdrawal of the alcohol. In my earlier experience with alcoholism, thirty years ago, I withdrew the alcohol gradually, under the impression that it was a stimulant, and that danger would follow any other course, but in later years a more abundant clinical experience has satisfied me that this plan was an
Choosing the best method for radiological assessment of patellofemoral osteoarthritis.
Authors: F M Cicuttini, J Baker, D J Hart, T D Spector
Journal: Annals of the Rheumatic Diseases (1996)

OBJECTIVE: To assess the reproducibility of different methods of radiological assessment of patellofemoral osteoarthritis (OA) and to determine which is the best view as a research tool in epidemiological studies of knee OA requiring explicit diagnostic criteria to classify the disease in the general population. METHODS: A population based study of 252 unrelated, normal individuals (504 knees) was performed. Lateral and skyline radiographs from each individual were graded for joint space narrowing and osteophytes using a standard atlas. Reproducibility was assessed by two observers on 50 knees. Radiographic features were assessed on their ability to predict knee pain. RESULTS: The skyline views performed better than the lateral views in the assessment of patellofemoral joint OA. The reproducibility for osteophytes was high (kappa &gt; 0.8) and that for joint space narrowing moderate (kappa &gt; 0.6) for both lateral and skyline views. Although the specificity for detecting knee pain was similar in both views, the sensitivity of skyline views in the assessment of knee pain was greater (52.8% versus 30%). The odds ratio for skyline osteophytes as a predictor of knee pain was 7.66 (95% confidence interval (CI) 3.68 to 15.90); that for osteophytes seen on lateral view was 1.83 (95% CI 0.96 to 3.49). Narrowing on both views was a poor predictor of pain. There was frequent disagreement between the lateral and skyline views for detecting osteophytes. CONCLUSION: In a community based study, skyline views performed better than lateral views in terms of reproducibility and for identifying symptomatic patellofemoral joint OA. Skyline radiographs should be the preferred method for examining the patellofemoral joint in such studies.
Role of drug exposure in aphthous ulcers: a case–control study
Authors: S. Boulinguez, S. Reix, C. Bedane, C. Debrock, M.L. Bouyssou‐Gauthier, A. Sparsa, V. Le Brun, P. De Vencay, P. Bernard, J.M. Bonnetblanc
Journal: British Journal of Dermatology (2000)

Drug-induced aphthous ulcers have been the subject of several isolated and heterogeneous case reports for the last three decades.To perform a case-control study to evaluate the risks linked to drug exposure in aphthous ulcers.Eighty patients with typical clinical patterns of aphthous ulcers and 152 control patients who had had consultations for skin tumours were studied. A standardized questionnaire, concerning clinical features, life-style and medications taken during the last month, was completed for each patient.Case patients had a much higher intake of medications than control patients, respectively, 5.1 and 2. 8 medications per patient (P < 0.0001). Multivariate paired analysis showed an association between aphthous ulcers and two classes of drugs: non-steroidal anti-inflammatory drugs (P < 0.001) and beta-blockers (P = 0.002). Smoking could have a protective effect against aphthous ulcers (P < 0.001).Previous case reports and the results of this study suggest a real link between beta-blockers and aphthous ulcers. Our study did not confirm a role of other drugs but a few interesting case reports with positive reintroduction have to be considered. These results could be beneficial for patients, as healing may occur when the incriminated drug is discontinued.
Reflex versus tonic vagal activity as a prognostic parameter in patients with sustained ventricular tachycardia or ventricular fibrillation.
Authors: S H Hohnloser, T Klingenheben, A van de Loo, E Hablawetz, H Just, P J Schwartz
Journal: Circulation (1994)

The autonomic nervous system has been demonstrated to play a decisive role in the genesis of sudden cardiac death. The loss of protective vagal reflexes, in particular, appears to be associated with an increased incidence of malignant ventricular tachyarrhythmias. Two clinically applicable methods for assessment of cardiac autonomic control have been developed: determination of heart rate variability and evaluation of baroreflex sensitivity.To compare the potential predictive value of both methods, two groups of patients were studied. Group 1 comprised 14 postinfarction patients who had experienced at least one episode of ventricular fibrillation or sustained ventricular tachycardia and who were studied after this event. Group 2 consisted of 14 postinfarction patients without tachyarrhythmic events after their infarct. Both groups were carefully matched with respect to age, sex, infarct location, extent of coronary artery disease, left ventricular ejection fraction, blood pressure, and heart rate at rest. Heart rate variability was assessed from 24-hour Holter recordings, and baroreflex sensitivity was determined by means of the phenylephrine method. Indices of heart rate variability were not significantly different between the two groups (SD of the mean RR interval, 84 +/- 30 milliseconds versus 103 +/- 20 milliseconds; proportion of adjacent RR intervals > 50 milliseconds different, 2.8 +/- 3.2% versus 5.0 +/- 4.1% in group 1 versus 2). Baroreflex sensitivity, however, showed a striking difference: Group 1 patients had a mean value of 1.75 +/- 1.63 ms/mm Hg compared with 9.17 +/- 5.40 ms/mm Hg in group 2 (P = .0002). Eleven of 14 group 1 patients had a baroreflex sensitivity < or = 3.0 ms/mm Hg. By contrast, only 1 of 14 group 2 patients had such a depressed value.The results of this study indicate that postmyocardial infarction patients who develop life-threatening ventricular tachyarrhythmias, compared with carefully matched postinfarction patients without major arrhythmic episodes, differ strikingly in terms of baroreflex sensitivity but not in terms of heart rate variability. This finding may have implications for the risk stratification of postinfarction patients and may lead to a differential therapeutic strategy based on autonomic testing.
CARTs on the Road for Myeloma
Authors: Marcela V. Maus, Carl H. June
Journal: Clinical Cancer Research (2014)

Chimeric antigen receptors redirect T cells to surface antigens. Discovery and validation of appropriate target antigens expands the possible indications for chimeric-antigen receptor (CAR) T cells. CS1 is expressed at high levels by multiple myeloma cells, but also to some extent on other lymphocytes. CS1 may be a viable target for CAR T cells in multiple myeloma.
Some independent treatment centres have a high cancellation rate, audit finds
Authors: Andrew Cole
Journal: BMJ (2005)

The administration of ‘consolidation’ therapy is designed to maximize the benefits achieved from primary chemotherapy, to both improve progression-free and overall survival. Paclitaxel is an excellent agent to consider for a consolidation strategy in ovarian cancer, based on its activity in the disease, its cycle-specificity, and the lack of serious cumulative toxicity (except for neuropathy). A recently reported randomized trial conducted by the South-west Oncology Group and the Gynecologic Oncology Group revealed that 12-monthly cycles of single-agent paclitaxel (175 mg/m<sup>2</sup> over 3 h) improves progression-free survival (PFS), compared to 3-monthly cycles of the agent (median PFS: 28 months versus 21 months, <i>P</i> = 0.0023, and hazard ratio 2.31). Further exploration of consolidation/maintenance therapy in the management of ovarian cancer is indicated, focusing on agents that are easy to administer (eg, oral) and that result in limited cumulative toxicity.
Effects of Diabetes and Level of Glycemia on All-Cause and Cardiovascular Mortality: The San Antonio Heart Study
Authors: Ming Wei, Sharon P Gaskill, Steven M Haffner, Michael P Stern
Journal: Diabetes Care (1998)

OBJECTIVE Although the level of hyperglycemia is clearly a risk factor for microvascular complications in diabetic patients, its role in macrovascular complications remains controversial. We followed 4,875 subjects (65% Mexican-American) for 7–8 years to investigate the effects of diabetes and hyperglycemia on all-cause and cardiovascular disease (CVD) mortality. These end points were also analyzed according to quartiles of baseline fasting plasma glucose among diabetic participants. RESEARCH DESIGN AND METHODS The Cox proportional hazards model was used to estimate the relative risks (RRs) for all-cause and CVD mortality. RESULTS Diabetes was significantly associated with increased all-cause mortality (RR [95% CI] = 2.1 [1.3–3.5] in men; 3.2 [1.9–5.4] in women) and increased CVD mortality (3.2 [1.4–7.1] in men; 8.5 [2.8–25.2] in women). Among diabetic subjects, those in quartile 4 had a 4.2-fold greater risk of all-cause mortality (P &amp;lt; 0.001) and a 4.7-fold greater risk of CVD mortality (P = 0.01) than those in quartiles 1 and 2 combined. After further adjustment for other potential risk factors, subjects in quartile 4 had a 4.9-fold greater risk of all-cause mortality and a 4.9-fold greater risk of CVD mortality than those in quartiles 1 and 2. In addition, hypertension, current smoking, and cholesterol &amp;gt;6.2 mmol/1 were significant predictors of CVD mortality using Cox models. CONCLUSIONS We conclude that diabetes is a predictor of both all-cause and CVD mortality in the general population and that both hyperglycemia and common CVD risk factors are important predictors of all-cause and CVD mortality in diabetic subjects.
Role of Obesity and Fat Distribution in Non-insulin-dependent Diabetes Mellitus in Mexican Americans and Non-Hispanic Whites
Authors: Steven M Haffner, Michael P Stern, Helen P Hazuda, Marc Rosenthal, J Ava Knapp, Robert M Malina
Journal: Diabetes Care (1986)

Recent data have suggested that central obesity is related positively to the prevalence of non-insulindependent diabetes mellitus (NIDDM). We examined whether central obesity (measured by the ratio of subscapular to triceps skinfold) was predictive of NIDDM prevalence independently of overall obesity (measured by body mass index, BMI) in 1231 Mexican Americans and 939 non-Hispanic whites who participated in the San Antonio Heart Study, a population-based survey of diabetes and cardiovascular risk factors. Mexican Americans are characterized by higher rates of NIDDM, greater overall obesity, and more central body fat distribution than age-matched non-Hispanic whites. Using multiple logistic regression with age, ethnicity, BMI, and central obesity as covariates, overall obesity was positively associated with NIDDM prevalence in both sexes (P &amp;lt; 0.001) but central obesity was related to NIDDM prevalence only in women. Our data suggest that the effect of centrality decreases at higher levels of centrality. While both BMI and centrality narrow the ethnic difference in NIDDM prevalence, Mexican Americans still have an increased risk of NIDDM (odds ratio = 2.33 in men and 1.80 in women), suggesting that other factors, possibly genetic, may also be important determinants of the ethnic differences in NIDDM prevalence.
Absorption and metabolism of nicotine from cigarettes.
Authors: A K Armitage, C T Dollery, C F George, T H Houseman, P J Lewis, D M Turner
Journal: BMJ (1975)

Eight men volunteers each smoked a single cirgarette containing 14C-nicotine and gave arterial blood samples during and for 50 minutes after smoking. The maximum concentration of nicotine in the arterial blood ranged from 31 to 41 mug/l in four regular cigarette smokers who inhaled. Two non-smokers achieved maximum levels of 2 and 4 mug/l. On a separate occasion two of the inhalers received 1 mg. 14C-nicotine in 10 divided doses injected intravenously. In both cases the peak arterial nicotine concentrations bore a similar relationship to the intravenous dose, as did the peak nicotine concentrations to the retained doses during smoking.
Pelvic Tumour Complicating Pregnancy
Authors: J. W. Taylor
Journal: BMJ (1886)

isF8iS 7Z17gv [)1,aafi JOLTEN4L.IMapqh 2O, 188I.2.The onc,rence of, bemrorage into the a44dogkui cav ity, due t tIie-rupture of a Graafian follicle duringmmenstruation, is undoubtedly pre ; i but it is, notwithstanding, admittedc by vapipus writers on,Ob- #tetiics, and notably Dr. Graily Hewitt.HasTirhe, in this case, evidently took plce very slowly, occupyinig -it least nine hours, while the quantity of blood extravasated wvas enormous.It seemed as if the whole body had been drainqd into the abdominal cayity; and the facts above stated, to opr.rqinds,:so clearly indicated tbe ovaries as the seat of the hwmorrhage, that, I had no hesitation in statirg such to be the cause of death at the coxoner's inquest.
THINNER FIBROUS CAP AND GREATER INCIDENCE OF PLAQUE RUPTURE CHARACTERIZE CULPRIT LESIONS IN PROXIMAL SEGMENTS OF CORONARY ARTERIES AS ASSESSED BY OPTICAL COHERENCE TOMOGRAPHY
Authors: Maria Riga, Konstantinos Toutouzas, Maria Drakopoulou, John Karampelas, Antonis Karanasos, Eleftherios Tsiamis, Dimitrios Tousoulis, Elli Stefanadi, Christodoulos Stefanadis
Journal: Journal of the American College of Cardiology (2010)
ONE HUNDRED CASES OF ACUTE ARTHRITIS AMONG NEGRO LABORERS ON THE PANAMA CANAL
Authors: WALTER BAETZ
Journal: JAMA (1913)

The diagnosis of acute articular rheumatism is, to my mind, as frequently misapplied in acute arthritis as that of influenza in pulmonary affections and that of malaria in obscure febrile conditions. Under acute articular rheumatism should be included, of course, only those cases of acute arthritis in which there is a rapid invasion, similar to that in an infectious disease, with high temperature, hot, swollen, tender joint or joints, acid sweats, marked leukocytosis with polynuclear increase, and a marked tendency to endocarditis, and in which the administration of salicylates proves them to be a specific remedy. It is unfortunate that the term "rheumatism" has ever been used to designate other joint affections. Some of the most noted authorities in tropical medicine declare that acute articular rheumatism and scarlatina are both practically non-existent among natives in the tropics. No one will deny that scarlatina occurs in Panama in imported cases only,
Mercuric chloride poisoning in a 23 month old child.
Authors: T Stack, J G Bissenden, G Hoffman, W B Yeoman
Journal: BMJ (1983)

CommentHollow fibre artificial kidneys are now in common use.They consist of a plastic cylinder about 20 cm long and 8 cm in diameter.Running the length of the cylinder are 10 000-14 000 capillary tubes, through which the blood flows.Their ends are embedded in a rubber
Coronary microvascular responses to reductions in perfusion pressure. Evidence for persistent arteriolar vasomotor tone during coronary hypoperfusion.
Authors: W M Chilian, S M Layne
Journal: Circulation Research (1990)

The goals of this study were to test the following hypotheses: 1) Coronary autoregulatory adjustments to decreases in perfusion pressure occur primarily in coronary arterioles (less than 150 microns in diameter). 2) Small coronary arteries (greater than 150 microns in diameter) can be recruited to participate in the autoregulatory adjustments as perfusion pressure is progressively lowered. 3) Small arterioles are the location of vasodilator reserve in the coronary microcirculation during hypoperfusion. Studies were performed in anesthetized open-chest dogs in which coronary perfusion pressures were reduced to 80, 60, 40, and 30 mm Hg. During reductions in coronary perfusion pressure, measurements were made of systemic hemodynamics, myocardial blood flow (radioactive microspheres), and coronary microvascular diameters. Arterial pressure and heart rate were largely unchanged during the experimental maneuvers. Measurements of microvascular diameters in the beating heart were performed during epi-illumination via a stroboscopic light source synchronized to the cardiac cycle using fluorescence intravital microscopy. Coronary autoregulatory adjustments were evident during reductions in perfusion pressure from control (96 mm Hg) to 80 and 60 mm Hg. Blood flow was unchanged from control, and active vasodilation of coronary arterioles was observed. At 80 mm Hg, only coronary arterioles dilated (4.4 +/- 1.2%), whereas at 60 mm Hg both small arteries (4.9 +/- 2.2%) and arterioles (6.9 +/- 1.2%) demonstrated significant vasodilation (p less than 0.05). The magnitude of dilation (i.e., percent increase in diameter) was inversely related to the initial diameter; that is, the arterioles dilated to a greater extent, percentage wise, than the small arteries. At 40 mm Hg, myocardial blood flow decreased slightly from that under control conditions, but coronary arterioles dilated to a greater extent than at 60 mm Hg (8.1 +/- 1.6%); yet, microvessels were incompletely vasodilated, because adenosine produced a further increase in microvessel diameter (12.5 +/- 2.1%) (p less than 0.05). At a perfusion pressure of 30 mm Hg, arterioles demonstrated a decrease in vascular diameter (-0.2 +/- 2.1%), which was reversed by adenosine (11.1 +/- 3.1%). From these results we concluded the following: 1) Coronary autoregulatory adjustments involve primarily coronary arteriolar vessels, but small coronary arteries can be recruited to participate in the autoregulatory response. 2) The magnitude of vessel dilation appears to be inversely related to vascular diameter. 3) Coronary arterioles are not maximally vasodilated during coronary hypoperfusion, and these vessels may be the source of persistent vasomotor tone during coronary insufficiency.