tbuckley/cabot-search huggingface dataset:
Relation of left ventricular hemodynamic load and contractile performance to left ventricular mass in hypertension.
Authors: A Ganau, R B Devereux, T G Pickering, M J Roman, P L Schnall, S Santucci, M C Spitzer, J H Laragh
Journal: Circulation (1990)

The weak relation of systolic blood pressure to left ventricular mass in hypertensive patients is often interpreted as evidence of nonhemodynamic stimuli to muscle growth. To test the hypothesis that left ventricular chamber size, reflecting hemodynamic volume load and myocardial contractility, influences the development of left ventricular hypertrophy in hypertension, we studied actual and theoretic relations of left ventricular mass to left ventricular diastolic chamber volume, pressure and volume load, and an index of contractility. Data were obtained from independently measured M-mode and two-dimensional echocardiograms in 50 normal subjects and 50 untreated patients with essential hypertension. Two indices of overall left ventricular load were assessed: total load (systolic blood pressure x left ventricular endocardial surface area) and peak meridional force (systolic blood pressure x left ventricular cross sectional area). A theoretically optimal left ventricular mass, allowing each subject to achieve mean normal peak stress, was calculated as a function of systolic blood pressure and M-mode left ventricular end-diastolic diameter. Left ventricular mass measured by M-mode echo correlated better with two-dimensional echocardiogram derived left ventricular end-diastolic volume (r = 0.56, p less than 0.001) than with systolic blood pressure (r = 0.45, p less than 0.001) and best with total load or peak meridional force (r = 0.68 and 0.70, p less than 0.001). In multivariate analysis both end-diastolic volume and blood pressure were independent predictors of systolic mass (p less than 0.001) and explained most of its variability (R = 0.75, p less than 0.001). Theoretically optimal left ventricular mass was more closely related to end-diastolic volume (r = 0.72, p less than 0.001) than to systolic blood pressure (r = 0.46, p less than 0.001); thus, the relatively weak correlation between blood pressure and optimal mass reflected the influence of left ventricular cavity size, rather than a lack of proportionality between load and hypertrophy. Actual and theoretically optimal left ventricular mass were closely related (r = 0.76, p less than 0.001), indicating that left ventricular hypertrophy in most cases paralleled hemodynamic load. Left ventricular mass was positively related to stroke index and inversely to contractility (as estimated by the end-systolic stress/volume index ratio), the main determinants of left ventricular chamber volume. In multivariate analysis, systolic blood pressure, stroke index, and the end-systolic stress/volume index ratio were each independently related to left ventricular mass index (all p less than 0.001, multiple R = 0.81) and accounted for 66% of its overall variability.(ABSTRACT TRUNCATED AT 400 WORDS)
Serum Transaminase Levels in Experimental Myocardial Infarction
Authors: CLARENCE M. AGRESS, HOWARD I. JACOBS, HARVEY F. GLASSNER, MARIANNE A. LEDERER, WM. G. CLARK, FELIX WROBLEWSKI, ARTHUR KARMEN, JOHN S. LADUE
Journal: Circulation (1955)

Serum glutamic oxalacetic transaminase concentrations rise sharply after myocardial infarction produced by bead embolization of the coronary tree in the closed chest dog. The peak concentration is reached in 9 to 23 hours post injury. Rises 20 to 30 times greater than normal may be obtained and are directly correlated with the amount of infarction estimated at autopsy. Serial serum transaminase levels may provide a clinical tool to supplement the electrocardiogram in the diagnosis of acute myocardial infarction as well as provide a roughly quantitative estimate of the amount of myocardium involved.
Likely mode of death may be a consideration
Authors: J. Alterman
Journal: BMJ (1995)

Background and objectives: Higher phosphate is associated with mortality in dialysis patients but few prospective studies assess this in nondialysis patients managed in an outpatient nephrology clinic. This prospective longitudinal study examined whether phosphate level was associated with death in a referred population. Design, setting, participants &amp; measurements: Patients (1203) of nondialysis chronic kidney disease (CKD) in the Chronic Renal Insufficiency Standards Implementation Study were assessed. Survival analyses were performed for quartiles of baseline phosphate relative to GFR, 12-month time-averaged phosphate, and baseline phosphate according to published phosphate targets. Results: Mean (SD) eGFR was 32 (15) ml/min per 1.73 m<sup>2</sup>, age 64 (14) years, and phosphate 1.2 (0.30) mmol/L. Cox multivariate adjusted regression in CKD stages 3 to 4 patients showed an increased risk of all-cause and cardiovascular mortality in the highest quartile compared with that in the lowest quartile of phosphate. No association was found in CKD stage 5 patients. Patients who had values above recommended targets for phosphate control had increased risk of all-cause and cardiovascular death compared with patients below target. The highest quartile compared with the lowest quartile of 12-month time-averaged phosphate was associated with an increased risk of mortality. Conclusions: In CKD stages 3 to 4 patients, higher phosphate was associated with a stepwise increase in mortality. As phosphate levels below published targets (as opposed to within them) are associated with better survival, guidelines for phosphate in nondialysis CKD patients should be re-examined. Intervention trials are required to determine whether lowering phosphate will improve survival.
The Effects of L-Thyroxine Sodium on Nontoxic Goiter, on Myxedema and on the Thyroid Uptake of Radioactive Iodine
Authors: Solomon Papper, Belton A. Burrows, Sidney. H. Ingbar, John H. Sisson, Joseph F. Ross
Journal: New England Journal of Medicine (1952)

SYNTHETIC thyroxine is apparently absorbed and physiologically active when ingested, although it has generally been used intravenously.1 2 3 4 5 6 Clinical studies employing oral administration of 1-thyroxine sodium have demonstrated its effectiveness in treating and maintaining athyreotic patients.5 , 6 The possible advantages inherent in a therapeutic agent of constant potency and composition have prompted further clinical evaluation of 1-thyroxine sodium in patients with myxedema. In addition, we have studied the suppressive effect of 1-thyroxine administration on the thyroid uptake of radioactive iodine, as well as its influence on the size of nontoxic goiters.MethodsUptakes of radioactive iodine were determined in 7 patients with . . .
Contemplating the White Coat
Authors: Stewart P. Seigle
Journal: Annals of Internal Medicine (1999)

Letters6 July 1999Contemplating the White CoatStewart P. Seigle, MDStewart P. Seigle, MDOsprey, FL 34229 (Seigle)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-1-199907060-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Dr. Wear has written an interesting and provocative article on white coats and professional development (1). It took me back to my medical school days of 1936 to 1940. I must admit that a long white coat with a stethoscope peeping shyly from a side pocket made me feel rather medically grown-up.But the significance of the white coat was much greater and more practical. 1) Often it was supplied by the hospital, which in Depression days was a real plus. 2) With a clean shirt, a bow tie [worn instead of a necktie, which would droop ...Reference1. Wear D. On white coats and professional development: the formal and the hidden curricula. Ann Intern Med. 1998;129:734-7. LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Stewart P. Seigle, MDAffiliations: Osprey, FL 34229 (Seigle) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOn White Coats and Professional Development: The Formal and the Hidden Curricula Delese Wear Contemplating the White Coat Mark M. Paulsen Contemplating the White Coat William T. Branch Jr. Contemplating the White Coat David G. De Marco Metrics Cited byDiscourses of student orientation to medical education programsCloak of compassion, or evidence of elitism? An empirical analysis of white coat ceremonies 6 July 1999Volume 131, Issue 1Page: 74KeywordsBloodKneesResidencyUrine ePublished: 15 August 2000 Issue Published: 6 July 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Superoxide Dismutase Improves Oxygenation and Reduces Oxidation in Neonatal Pulmonary Hypertension
Authors: Satyan Lakshminrusimha, James A. Russell, Stephen Wedgwood, Sylvia F. Gugino, Jeffrey A. Kazzaz, Jonathan M. Davis, Robin H. Steinhorn
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Rationale: Hyperoxic ventilation in the management of persistent pulmonary hypertension of the newborn (PPHN) can result in the formation of reactive oxygen species, such as superoxide anions, which can inactivate nitric oxide (NO) and cause vasoconstriction and oxidation.Objective: To compare the effect of intratracheal recombinant human superoxide dismutase (rhSOD) and/or inhaled NO (iNO) on systemic oxygenation, contractility of pulmonary arteries (PAs), and lung reactive oxygen species (isoprostane, 3-nitrotyrosine) levels in neonatal lambs with PPHN.Methods: Six newborn lambs with PPHN (induced by antenatal ductal ligation) were killed at birth. Twenty-six PPHN lambs were ventilated for 24 h with 100% O2 alone (n = 6) or O2 combined with rhSOD (5 mg/kg intratracheally) at birth (n = 4), rhSOD at 4 h of age (n = 5), iNO (20 ppm, n = 5), or rhSOD + iNO (n = 6). Contraction responses of fifth-generation PAs to norepinephrine and KCl, lung isoprostane levels, and 3-nitrotyrosine fluorescent intensity were measured.Results: Systemic oxygenation was impaired in PPHN lambs and significantly improved (up to threefold) in both rhSOD groups with or without iNO. Oxygenation improved more rapidly with the combination of rhSOD + iNO compared with either intervention alone. Norepinephrine- and KCl-induced contractions and lung isoprostane levels were significantly increased by 100% O2 compared with nonventilated newborn lambs with PPHN. Both rhSOD and iNO mitigated the increased PA contraction response and lung isoprostane levels. Intratracheal rhSOD decreased the enhanced lung 3-nitrotyrosine fluorescence observed with iNO therapy.Conclusion: Intratracheal rhSOD and/or iNO rapidly increase oxygenation and reduce both vasoconstriction and oxidation in newborn lambs with PPHN. This has important implications for clinical trials of rhSOD and iNO in newborn infants with PPHN.
New microscope techniques take the stage
Authors: M. Annexton
Journal: JAMA (1978)

The world under the microscope continues to expand. At the recent meeting of the American Society for Microbiology in Atlanta, the application of a new method for viewing viruses in their fluids was described. In general, biopsy or autopsy specimens have been most amenable to scrutiny by the electron microscope (EM). Now, using the pseudoreplica technique, Andre Nahmias, MD, and associates from the Emory University School of Medicine have detected viruses in body fluids with the EM with considerable speed and accuracy. In the pseudoreplica method, an impression of a specimen adheres to a grid that is placed under the EM for analysis. What is viewed are virus particles unadulterated by extraneous material. Specimens can be processed for viral examination in less than half an hour. Viruses are distinct and definable, according to Nahmias. A major asset of the method is its rapidity. In addition, the technique facilitates definition of
Another battle royal--but elsewhere--taking place between physicians and government
Authors: G. D. Lundberg
Journal: JAMA (1989)

PHYSICIANS in the United States who have so much in common with their British colleagues might be amazed to realize that an apparent majority of them, and virtually all of organized medicine in the United Kingdom, is united in seeking to preserve socialized medicine—the National Health Service (NHS)—from partial privatization by the Conservative government. Elsewhere in this issue, Michael F. Loudon, BM, BCh, details the situation from the scene.  It seems that almost anywhere one looks these days (be it the First, Second, or Third Worlds), there is great unhappiness with the health care delivery system. Many countries are grasping for the right mix of public and private medicine that is personal, caring, and compassionate while being competitive and efficient, engendering respect and trust, encouraging recruitment and professionalism, and distributing the fruits of new knowledge and technology quickly without excess cost, waste, or profiteering.  Anthony J. Byrne, a pharmacist and
Adiposity as Compared with Physical Activity in Predicting Mortality among Women
Authors: Frank B. Hu, Walter C. Willett, Tricia Li, Meir J. Stampfer, Graham A. Colditz, JoAnn E. Manson
Journal: New England Journal of Medicine (2004)

Whether higher levels of physical activity can counteract the elevated risk of death associated with adiposity is controversial.We examined the associations of the body-mass index and physical activity with death among 116,564 women who, in 1976, were 30 to 55 years of age and free of known cardiovascular disease and cancer.During 24 years of follow-up, 10,282 deaths occurred--2370 from cardiovascular disease, 5223 from cancer, and 2689 from other causes. Mortality rates increased monotonically with higher body-mass-index values among women who had never smoked (P for trend <0.001). In combined analyses of all participants, adiposity predicted a higher risk of death regardless of the level of physical activity. Higher levels of physical activity appeared to be beneficial at all levels of adiposity but did not eliminate the higher risk of death associated with obesity. As compared with women who were lean (i.e., they had a body-mass index lower than 25) and active (they spent 3.5 or more hours exercising per week), the multivariate relative risks of death were 1.55 (95 percent confidence interval, 1.42 to 1.70) for lean and inactive women, 1.91 (95 percent confidence interval, 1.60 to 2.30) for women who were obese (defined as a body-mass index of 30 or higher) but active, and 2.42 (95 percent confidence interval, 2.14 to 2.73) for inactive, obese women. Even modest weight gain during adulthood, independent of physical activity, was associated with a higher risk of death. We estimate that excess weight (defined as a body-mass index of 25 or higher) and physical inactivity (less than 3.5 hours of exercise per week) together could account for 31 percent of all premature deaths, 59 percent of deaths from cardiovascular disease, and 21 percent of deaths from cancer among nonsmoking women.Both increased adiposity and reduced physical activity are strong and independent predictors of death.
Cartilage-containing tumours of the lung: Relationship between the purely cartilaginous type (chondroma) and the mixed type (so-called hamartoma): an unusual case of multiple tumours
Authors: E. M. Bateson
Journal: Thorax (1967)

An unusual case is reported of a woman aged 27 years who presented with four intrapulmonary cartilage-containing tumours which were resected from the left lung. The appearance of two new shadows in the chest several years later suggested that two of the resected tumours had recurred. Three of the four resected tumours consisted entirely of cartilage and bone and other connective tissues. The fourth tumour, although consisting almost entirely of cartilage and connective tissue, also contained epithelial tissue in the form of two small clefts, one in the periphery and the other in a connective tissue septum between the lobules of cartilage of the tumour. These tumours are regarded as a variation of the more typical cartilage-containing tumour of the lung which contains many spaces lined by respiratory epithelium and is regarded as a neoplasm arising in the connective tissue beneath the mucosa of a small bronchus with subsequent expansion into its lumen and enclosing spaces lined by the mucosal epithelium during its eccentric growth. The tumours consisting almost entirely of cartilage without spaces lined by epithelial cells are thought to expand into the adjacent lung tissue and not into the bronchial lumen. Therefore there is no inclusion of respiratory epithelium from the mucosa of the bronchus of origin.
Exchange Transfusion as Treatment of Acute Hepatic Failure Due to Antituberculosis Drugs
Authors: RICHARD J. LEDERMAN
Journal: Annals of Internal Medicine (1968)

Successful exchange transfusion is reported for the fast time in a patient with drug-related hepatic failure and coma. Antituberculosis therapy with para-aminosalicylic acid and isoniazid was considered responsible for the fulminant hepatitis that was observed. Two successive exchange procedures, performed via indwelling arterial and venous Silastic catheters, were temporally related to the resolution of coma and normalization of prothrombin time. Before exchange the patient had received, without clinical improvement, high-dose corticosteroid therapy and a routine regimen for the management of hepatic coma. Her tuberculosis has been treated readily with secondary antituberculosis drugs. It is suggested that exchange transfusion be given further trials in patients with drug-related fulminant hepatic failure.
PRSS23 is essential for the Snail-dependent endothelial-to-mesenchymal transition during valvulogenesis in zebrafish
Authors: I-Hui Chen, Hsueh-Hsiao Wang, Yi-Shan Hsieh, Wei-Chang Huang, Hung-I Yeh, Yung-Jen Chuang
Journal: Cardiovascular Research (2012)

Cardiac valve disease is a common cause of congenital heart failure. Cardiac valve development requires a complex regulation of assorted protease activities. Nevertheless, the regulation of these proteases during atrioventricular (AV) valve formation is poorly understood. Previously, PRSS23, a novel vascular protease, is shown to be highly expressed at the AV canal during murine heart development; however, its function remains unknown. In this study, we sought to characterize the functional role of PRSS23 during cardiac valve formation. We used a transgenic zebrafish line with fluorescently labelled vasculature as a tool to study the function of PRSS23. We first cloned the zebrafish prss23 and confirmed its sequence conservation with other vertebrate orthologues. Expression of prss23 was detected in the ventricle, atrium, and AV canal during zebrafish embryonic development. We found that morpholino knockdown of Prss23 inhibited the endothelial-to-mesenchymal transition (EndoMT) at the AV canal. Moreover, in human aortic endothelial cell-based assays, PRSS23 knockdown by short-hairpin RNA not only repressed the transforming growth factor-β-induced EndoMT, but also reduced Snail transcription, suggesting that Snail signalling is downstream of PRSS23 during EndoMT. We further demonstrated that human PRSS23 and SNAIL could rescue the prss23 morpholino-induced AV canal defect in zebrafish embryos, indicating that the function of PRSS23 in valvulogenesis is evolutionarily conserved. We demonstrated for the first time that the initiation of EndoMT in valvulogenesis depends on PRSS23-Snail signalling and that the functional role of PRSS23 during AV valve formation is evolutionarily conserved.
The bottlewasher and the ambassador
Authors: S. V Ramanan
Journal: BMJ (1999)

“If he says his hand hurts, put it on his hand; if his head hurts, put it on his head. That's what your father does.”

I had just completed a year of internship and, with all the knowledge and wisdom of a new graduate, I had joined my father in family practice It seemed strange, returning to the old familiar surroundings in a new garb. From the time I was a toddler I had visited my father in his office, looking in admiration at the huge oak desk behind which he sat. In one corner was a pile of copies of the BMJ and the Lancet , some obviously read, others unopened. There was a profusion of pens and pencils with a jar of royal blue Quink—ball point pens had not yet been invented. By his right hand was a heavy ledger which served as medical record, account book, and anything else worth writing about, all rolled into one tome. Just outside his office, and a little beyond what we would now call a treatment room, was the dispensary. This resembled a pharmacy of old, a large glass fronted cabinet with some bottles containing liquids of varying color and viscosity. Other widemouthed bottles contained crystals, large and small. I was intrigued by the curious names on the labels: Aq Menth Pip Conc , Tr Card Co , Sodii Sal , Extr Thyr Sic , to name some. A few large jars contained ointments such as Antiphlogistine , Whitfield's , and Icthyol c. Belladonna .

Private …
China's blueprint puts healthcare reform high on political agenda
Authors: J. Parry
Journal: BMJ (2009)

China has released a blueprint of its plan to reform the country’s healthcare system, originally announced in October 2008, but observers say the plan still does not have enough practical detail to ascertain how the reforms will be implemented.

The blueprint, released on 6 April and jointly endorsed by the central committee of the Communist party of China and the state council, China’s cabinet, spells out the target of universal access to health care for all of China’s 1.3 billion people by 2020.

The main planks of the reform are better primary care (especially in rural areas); equitable distribution of …
Strategies for preventing wheezing and asthma in small children
Authors: M. Wickman, E. Melén, N. Berglind, S. Lennart Nordvall, C. Almqvist, I. Kull, M. Svartengren, G. Pershagen
Journal: Allergy (2003)

To assess the effects of living in agreement with allergy preventive guidelines on wheezing and asthma at 2 years of age.Prospective birth cohort study (BAMSE). Questionnaires on heredity and environmental factors were answered when the child was 2 months, and detailed questionnaires on symptoms at 1 and 2 years of age.4089 children, born during 1994-1996.Child Health Centres in central and north-western parts of Stockholm, Sweden.Wheezing and asthma up to the age of 2.The effects of preventive guidelines regarding breastfeeding, maternal tobacco smoke and home dampness on wheezing and asthma were assessed in multiple logistic regression models. The cumulative incidence of recurrent wheezing at 2 years of age was 12.6% and of asthma 6.8% among those with a lifestyle in agreement with all guidelines and 24.1 and 17.9%, respectively, in families exposed to at least two of the three risk factors. Among children with no heredity, family lifestyle according to the guidelines gave a twofold reduction of asthma (5.3 vs. 10.5%), while the group with heredity had a threefold reduction (9.1 vs. 27.3%). The attributable fraction for asthma associated with the guidelines was 23% in total and 33% among those with heredity.In this observational study, family lifestyle according to preventive guidelines is associated with an important reduction of recurrent wheezing and asthma at 2 years of age, especially among children with allergic heredity. A follow-up will determine whether there still a risk reduction of both symptoms and disease.