tbuckley/cabot-search huggingface dataset:
Right heart volume characteristics in transposition of the great arteries.
Authors: T P Graham, G F Atwood, R J Boucek, R C Boerth, J H Nelson
Journal: Circulation (1975)

Right and left heart volume data were obtained during 44 cardiac catheterizations in 24 patients with complete transposition of the great arteries (TGA) prior to "corrective surgery." Patients were divided into three hemodynamic groups: I)TGA with intact ventricular septum, N = 23 studies in 13 patients, ages 1 day-22 months; II)TGA with ventricular septal defect (VSD), N = 12 studies in six patients, ages 7 days-15 months; III)TGA with VSD plus pulmonary stenosis, N = 9 studies in five patients, ages 5 days-5.6 years. In group I, right ventricular end-diastolic volume (RVEDV) averaged 170 plus or minus 52% of normal (P smaller than 0.001), RV ejection fraction (EF) was 0.48 plus or minus 0.09, 74% of normal (P smaller than 0.001), and RV systolic output (SO) was 123 plus or minus 34% (NS). In group II, RVEDV was 163 plus or minus 25% of normal (P smaller than 0.001), RVEF 0.59 plus or minus 0.08, 91% of normal (NS), and RVSO was 158 plus or minus 52% (P smaller than 0.02). In group III, RVEDV averaged 124 plus or minus 26% of normal (P smaller than 0.04), RVEF 0.58 plus or minus 0.15, 89% of normal (NS), and RVSO 125 plus or minus 57% (NS). Right atrial maximal volume was increased in 21 or 22 studies and averaged 185 plus or minus 47% of normal (P smaller than 0.001). RVEDV was greater than left ventricular end-diastolic volume in all but one patient in group I, but RVEDV/LVEDV was smaller than 1.00 in four VSD patients with very large pulmonary flows. A majority of patients with TGA without VSD have abnormal right heart function as indicated by an increased RVEDV and a low ejection fraction. Longitudinal studies of right ventricular performance in these patients continue to be important in assessment of current methods of therapy.
Peroxynitrite formation during rat hepatic allograft rejection
Authors: Yasuo Yamaguchi, Kazutoshi Okabe, Fujio Matsumura, Eiji Akizuki, Teishi Matsuda, Hajime Ohshiro, Jian Liang, Shinwa Yamada, Katsutaka Mori, Michio Ogawa
Journal: Hepatology (1999)

The role of nitric oxide (NO) on tissue injury of hepatic allografts during rejection remains controversial. We investigated inducible nitric oxide synthase (iNOS) expression and formation of peroxynitrite in ACI rat liver grafts implanted in recipients. Animals were divided into four experimental groups: group I, isografts; group II, untreated hepatic allografts; group III, allografts treated with FK506; and group IV, allografts pretreated with donor-specific blood transfusion (DST). Serum nitrite/nitrate, interferon-gamma (IFN-gamma), and tumor necrosis factor-alpha (TNF-alpha) concentrations increased significantly in group II rats after transplantation but were significantly lower in groups I, III, and IV. The numbers of macrophages that reacted with an antimacrophage iNOS monoclonal antibody as well as iNOS messenger RNA (mRNA) levels in liver specimens were also much lower in groups I, III, and IV as compared with group II. Immunostaining and Western blot analysis showed prominent tissue nitrotyrosine expression in untreated hepatic allografts, but not in allografts treated with FK506 or donor-specific blood. These results suggest that one of the mechanisms by which production of NO results in injury in rat hepatic allografts may be because of its reaction with superoxide to form peroxynitrite.
Cyclosporin A Does Not Delay Insulin Dependency in Asymptomatic IDDM Patients
Authors: Benjamin Rakotoambinina, Jose Timsit, Ingeborg Deschamps, Kathleen Laborde, Joseph Jos, Christian Boitard, Roger Assan, Jean Jacques Robert
Journal: Diabetes Care (1995)

OBJECTIVE To measure the effects of cyclosporin A (CyA) with no insulin therapy on glucose tolerance and β-cell function in the preclinical phase of insulin-dependent diabetes mellitus (IDDM). RESEARCH DESIGN AND METHODS β-cell responses to the intravenous glucose tolerance test (IVGTT), hyperglycemic clamp, intravenous arginine, and intravenous glucagon were evaluated before and after a 6-month course of CyA in seven patients (mean age 19.6 years) with asymptomatic IDDM. RESULTS Initial insulin secretory responses were severely decreased when the patients were compared with eight healthy control subjects: IVGTT (1 + 3 min): 106 ± 16 vs. 884 ± 190 pmol/l (P &amp;lt; 0.001); hyperglycemic clamp: 102 ± 16 vs. 310 ± 42 pmol/l (P &amp;lt; 0.001); intravenous arginine: 346 ± 72 vs. 1104 ± 168 pmol/l (P &amp;lt; 0.01); and intravenous glucagon: 170 ± 37 vs. 247 ± 35 pmol/l (NS). The β-cell responses remained markedly abnormal after 6 months of CyA, although the response to intravenous glucose and oral glucose tolerance tests improved in three subjects. All the patients became insulin-dependent after 5–36 months. CONCLUSIONS CyA alone is not a suitable treatment for asymptomatic IDDM. Earlier identification of subjects with substantial β-cell secretory capacity and newer nontoxic intervention strategies are required for the prevention of IDDM.
TSLP in Asthma — A New Kid on the Block?
Authors: Sven-Erik Dahlén
Journal: New England Journal of Medicine (2014)

Asthma is a complex inflammatory disease in which the airways narrow too easily, too much, and too often. Despite the availability of bronchodilators to widen the constricted airways and inhaled glucocorticoids, many patients with asthma still have uncontrolled airway obstruction. Lack of adherence to inhaled therapies may explain treatment failures, but it is also clear that there is a need for a better understanding of the pathobiologic mechanisms that could lead to a greater repertoire of treatments for asthma.Gauvreau et al.1 now report in the Journal the results of a study that introduces a potential new target for such . . .
Neuroblastoma — Linking a Common Allele to a Rare Disease
Authors: Brian H. Kushner, Nai-Kong V. Cheung
Journal: New England Journal of Medicine (2008)

Neuroblastoma has a notorious reputation among solid tumors of childhood because of its frequently massive and widespread tumor burden. Yet stage for stage, this embryonal neoplasm of the sympathetic nervous system has become the most curable of the common pediatric solid tumors.1 More than 90% of patients with localized neuroblastomas, including those with spread to the regional lymph nodes, will survive, often with little or no cytotoxic therapy. Rates of cure of metastatic neuroblastoma exceed 90% among infants (who are usually treated with low-dose chemotherapy) and are approximately 25% among toddlers; in contrast, osteomedullary metastases associated with other pediatric solid . . .
Enhancing effect of dipyridamole inhalation on adenosine‐induced bronchospasm in asthmatic patients
Authors: N. Crimi, F. Palermo, R. Oliveri, C. Maccarrone, B. Palermo, C. Vancheri, R. Polosa, A. Mistretta
Journal: Allergy (1988)

The study was performed on 13 asthmatic patients to determine whether inhaled dipyridamole would act directly by inducing bronchoconstriction or indirectly by potentiating the adenosine‐induced bronchoconstriction. The study was performed in 3 consecutive days. On the first day adenosine challenge was performed and the PD 20 value calculated. On the other days the adenosine challenge was done 5 min after randomized inhalations of dipyridamole or a control solution. The mean percent change in FEV 1 after dipyridamole (Δ%= 2.0) and control solution (Δ%= 1.0) was not significant. Inhaled adenosine caused bronchoconstriction with a geometric mean PD 20 of 1.09 mg. After control solution inhalation, a mean PD 20 value of 1.31 mg was observed. Dipyridamole inhalation increased adenosine hyperresponsiveness and in all subjects shifted the dose‐response curves of adenosine challenge to the left with a mean PD 20 value of 0.40 mg. This enhancing effect of dipyridamole was significant when compared with the baseline value ( P &lt; 0.01) and control solution ( P &lt; 0.O1). The study demonstrated that dipyridamole inhalation increased airway responsiveness to adenosine in all subjects. This effect is due to indirect activity of dipyridamole on airways without changes in baseline airway caliber.
The Quality of Care: How Can It Be Assessed?
Authors: Dale A. Rublee
Journal: JAMA (1989)

<h3>To the Editor. —</h3> Dr Donabedian<sup>1</sup>makes an ambiguous assertion when he claims that the technical quality of the health care provided by physicians is based on the health outcomes they achieve in patients, while at the same time acknowledging that physicians are obligated to serve the best interests of patients. Problems ensue when one argues that health outcome is the primary grounds on which to define quality and that medicine allows concerns beyond health. The problem is that the outcome approach to quality binds medicine to the goal of opposing disease, despite the fact that diseases can be preferred to health. For example, some patients in rational fashion choose the drawbacks (including side effects) detrimental to health brought about by the oral contraceptive to have greater autonomy, freedom to enjoy career choices, preferred spacing of children, and other benefits. Consequently, Dr Donabedian cannot hold that the goal of
Treatment of Megaesophagus with Forced Dilatation of Cardia through Hydrostatic Balloon Attached to a Fiberesophagoscope
Authors: P. Sakai, S. Ishioka, H. Pinotti, G. Ellenbogen, A. Raia
Journal: Endoscopy (1979)

The treatment of megaesophagus through the forced dilatation of the cardia has been used in Brazilian medical centers for the treatment of megaesophagus in the initial stage. In patients with advanced megaesophagus without surgical conditions due to the involvement of various systems or those who present severe degrees of malnutrition it is necessary to perform the dilatation of the cardia even with an temporary effect for the improvement of the general condition. The dilatation balloon usually employed does not permit the device to be used safely due to the deviation of the axis of the distal third of the esophagus. A hydrostatic balloon attached to the fiberesophagoscope was adapted to allow the dilating apparatus to be introduced under direct vision for greater safety. Twenty-one patients were treated under the above mentioned conditions and the results justified the indication.
Carbon monoxide and exercise tolerance in chronic bronchitis and emphysema.
Authors: P M Calverley, R J Leggett, D C Flenley
Journal: BMJ (1981)

The effects of carbon monoxide on exercise tolerance as assessed by the distance walked in 12 minutes were studied in 15 patients with severe chronic bronchitis and emphysema (mean forced expiratory volume in one second 0.56 1, mean forced vital capacity 1.54 1). Each subject walked breathing air and oxygen before and after exposure to sufficient carbon monoxide to raise their venous carboxyhaemoglobin concentration by 9%. There was a significant reduction in the walking distance when the patients breathed air after exposure to carbon monoxide (p less than 0.01), and the significant increase in walking distance seen after exercise when breathing oxygen at 2 1/minute via nasal cannulae was abolished if carbon monoxide has previously been administered. Thus concentrations of carboxyhaemoglobin frequently found in bronchitic patients who smoke may reduce their tolerance of everyday exercise, possibly by interfering with the transport of oxygen to exercising muscles.
Malaria prophylaxis: postal questionnaire survey of general practitioners in south east Wales.
Authors: A Williams, D J Lewis
Journal: BMJ (1987)

Postal questionnaires were sent to 494 general practitioners in south east Wales asking about their experience and understanding of antimalarial prophylaxis; 293 were returned, giving a response rate of 59%. Forty eight (16%) of the respondents reported being consulted by immigrants returning home for advice about malaria prophylaxis, of whom 13 (27%) overestimated the time for which their protective immunity might last after leaving the malarious area. Two hundred and eighty respondents (96%) considered that they were responsible for advising travellers and 195 (67%) would always consult a publication before giving chemoprophylactic advice (magazines were particularly popular), but only 18 (6%) would always consult a specialist centre--the Ross Institute in eight cases (3%), a local centre in 39 (13%). Only about half of the doctors were aware of chloroquine resistance in Kenya and Thailand. Over half would withhold chloroquine in pregnancy, and many chose pyrimethamine alone or sulfadoxine-pyrimethamine as suitable chemoprophylactic drugs, though neither is still recommended by the World Health Organisation. One hundred and ninety two respondents (66%) would give advice about protective measures other than chemoprophylaxis. More must be done to encourage general practitioners to contact specialist centres and to educate them in the use of antimalarial chemoprophylactic drugs.
Alterations of the Lesions of Acute Rheumatic Myocarditis during Cortisone Therapy
Authors: ABNER GOLDEN, JOHN WILLIS HURST
Journal: Circulation (1953)

The changes in the cardiac lesions of a patient dying with acute rheumatic heart disease treated with cortisone are reported. The findings indicate that the effect of this hormone upon the lesions consists in an inhibition of the inflammatory reaction without demonstrable alteration of the collagen injury.
Points from Letters: Anti-catarrh Vaccine
Authors: M. Newton
Journal: BMJ (1964)

DRIISH N 779 of men in a free society would have tolerated; the position is changing rapidly with fewer doctors prepared to enter general practice and an expanding population.I hope that my fellow practitioners will grasp the opportunity provided by present events to express themselves individually and collec- tively as forcefully as possible, so that our representatives, our politicians, and the public at large shall be left in no doubt as to the feelings and desires of the active prac- titioner of the 1960's if he is to continue to work in a National Health Service.-Iam, etc., Sheffield 11.
PRESENT POSITION OF RADIOTHERAPY IN MEDICAL PRACTICE
Authors: W. WINDEYER
Journal: JAMA (1949)

The development of the art and science of radiotherapy has proceeded with such rapidity that it has been difficult to keep continually abreast of the progress that has been made. This is particularly true in regard to the last ten years, during which time the discoveries have been of such far reaching importance as to open up entirely new fields and new possibilities of methods of treatment by the use of roentgen rays and the radiations from radioactive substances. At the same time, owing to the war, maintenance of close contacts among the workers in this branch of medicine in different countries has not been possible. In consequence the radiotherapy of each country has developed along individual lines to a greater extent than in the prewar period. It is possible that this tendency to isolation has resulted in excessive attention being paid to certain aspects of the subject and in
Modern Practice in Crown and Bridge Prosthodontics
Authors: Leonard M. Nevins
Journal: JAMA (1960)

This book is concerned with the construction of crowns to rebuild teeth and fixed partial dentures to replace missing teeth. It is comprehensive but not encyclopedic in scope and presents basic knowledge and accepted techniques in a manner which will enable the neophyte student or active practitioner of dentistry to assimilate and apply clinically. The print is easily read and there are excellent descriptive photographs and demonstrations of many practical crown and bridge techniques which make them clear and easily reproducible. There are instructions for specific instruments and the variety of materials to be used for this special phase of dentistry, with the laboratory techniques involved in their fabrication. There is an excellent section covering replacements of one or more missing teeth, with multiple diagnoses for the number and distribution of abutment teeth for the fixed bridges. The planning and proper construction of partial dentures is also considered. The authors
Reduced Arterial Dilator Capacity : A Characteristic Abnormality of the Peripheral Vascular Bed in Human Congestive Heart Failure.
Authors: Robert Zelis
Journal: Annals of Internal Medicine (1967)

s1 May 1967Reduced Arterial Dilator Capacity : A Characteristic Abnormality of the Peripheral Vascular Bed in Human Congestive Heart Failure.Robert Zelis, M.D., Dean T. Mason, M.D. (Associate), Eugene Braunwald, M.D., F.A.C.P.Robert Zelis, M.D.Search for more papers by this author, Dean T. Mason, M.D. (Associate)Search for more papers by this author, Eugene Braunwald, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-1039_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAlthough vasoconstriction characteristic of congestive heart failure is attributed to augmented sympathetic nervous activity, the possibility of an abnormality inherent in the vessel wall was considered. The responses of the resistance bed in the forearm to the restoration of circulation after inflow occlusion (reactive hyperemia), to hand exercise (active hyperemia), and to local heating were compared in 13 patients with congestive heart failure and 12 normal subjects. Forearm blood flow was measured plethysmographically. In the normal subjects, total reactive hyperemia blood flow after 3, 5, and 10 min of arterial occlusion averaged 6.1, 12.6, and 29.5 ml and was significantly... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Bethesda, Maryland PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1967Volume 66, Issue 5Page: 1039-1039KeywordsBlood flowExerciseHeart failureVasoconstriction Issue Published: 1 May 1967 PDF DownloadLoading ...
More than one third of diabetic patients have poor blood glucose control, shows audit
Authors: S. Mayor
Journal: BMJ (2011)

More than one third of patients diagnosed with type 1 or type 2 diabetes have blood glucose levels above recommended targets putting them at high risk of complications, warn results from the latest audit of diabetes care in England.

The annual audit reviewed data from general practices and hospitals on core components of diabetes care for more than 80% of the estimated 2.34 million people aged 17 and over with diagnosed diabetes in England. Data for 68 000 patients were also collected in Wales, where the audit process has been introduced more recently.

Results for HbA1c measurements showed that 37% of people diagnosed with diabetes in England had levels …
Cutaneous T-cell lymphoma occurring with intestinal B-cell lymphoma
Authors: S Imai, H Umezu
Journal: British Journal of Dermatology (1999)

Sir, The simultaneous occurrence in the same patient of cutaneous T‐cell lymphoma (CTCL) and B‐cell malignancy affecting the skin, lymph node and blood1, 2 has rarely been reported. To our knowledge, CTCL associated with intestinal B‐cell lymphoma has not been documented previously. We describe a 66‐year‐old‐man with atypical skin lesions (Fig. 1a), in whom the histological picture was characteristic of CTCL. The patient had had surgery for a jejunum perforation in December 1995. On histological and immunohistochemical study, the excised bowel showed malignant lymphoma of the jejunum, with a diffuse medium size and B‐cell phenotype (Fig. 1b and Table 1). The tumour cells were of marginal origin. The intestinal tumour was completely removed, and no relapse has occurred. He had a raised white cell count (12.3 × 109/L; normal 4.0–9.0) without atypical lymphocytes. Computed tomography of the chest and scintigraphy of the skeleton were normal. He was treated with systemic chemotherapy consisting of two courses of CHOP (cyclophosphamide 1.0 g, adriamycin 75 mg and vincristine 2 mg intravenously, with oral prednisone 90 mg/day for 7 days).
Transcatheter occlusion of the persistently patent ductus arteriosus. Forty-month follow-up and prevalence of residual shunting.
Authors: M C Hosking, L N Benson, N Musewe, J D Dyck, R M Freedom
Journal: Circulation (1991)

Percutaneous closure of the persistently patent ductus arteriosus with the Rashkind prosthesis is an established effective therapeutic modality, although some patients are left with residual shunting. To evaluate this, a retrospective study of the prevalence of persistent shunting over a 40-month period in the first 190 patients was undertaken.All patients (male 45, female 145; mean age, 3.9 +/- 3.6 years; range, 5 months to 20 years) had serial clinical and color-flow echocardiographic follow-up at 6-12-month intervals (range, 6-40 months). Four patients required surgical removal of an embolized device, leaving a cohort of 186 patients in whom 196 procedures were performed, resulting in successful placement of 195 devices (43 17-mm [22%] and 152 12-mm [78%]). Complications occurred in seven of 195 procedures (3.6%). Nine of 10 attempted reocclusions (all with 12-mm devices) were successful. The prevalence of residual shunting was 38% at 1 year, 18% at 2 years, and 8% at 40 months. Patients with ductus measuring less than 4 mm had a higher success of initial occlusion. Thirty-four patients were left with residual shunting determined by color-flow Doppler study, but no anatomic or echocardiographic features were found predictive for residual shunting. All remain asymptomatic with 26 (76%) having no detectable murmur, two (6%) a continuous murmur, and six (18%) a systolic murmur.Catheter occlusion will obviate the need for surgery in the majority of patients presenting with persistently patent ductus arteriosus. Reocclusion has been found feasible in those with continuous murmurs (nine of nine) and should be offered early because it is unlikely for spontaneous closure to occur in this group. It appears prudent to follow those with small residual shunting because further spontaneous closure can occur.
BMA calls for 10% pay increase for doctors
Authors: Linda Beecham
Journal: BMJ (1997)

The BMA has called for the average pay of doctors to be increased by not less than 10% in 1998 as a first step in reducing the gap between the pay of doctors and that in comparable professions, such as lawyers, accountants, and actuaries.

For the first time the association has published its evidence to the Doctors' and Dentists' Review Body in full in advance of the review body making its recommendations. The BMA has deplored the government's action in phasing this year's pay award (2.35% in April …
Early rheumatoid disease. I. Onset.
Authors: A Fleming, J M Crown, M Corbett
Journal: Annals of the Rheumatic Diseases (1976)

We describe features with onset in 102 patients seen within the first year of rheumatoid disease. The male:female ratio was approximately 3:4, suggesting a near equal sex incidence at onset. The disease started more often in the colder months and was usually insodious, symmetrical, and involved the upper limbs. The patients were followed prospectively and outcome was assessed after a mean of 4.5 years. Older patients fared worse and there was a trend for a poorer prognosis to be indicated by an insidious onset and early progression to symmetrical involvement.
Evidence of harm is unconvincing
Authors: R. L. Prince, K. Zhu, J. R. Lewis
Journal: BMJ (2011)

We were surprised to read the latest meta-analysis by Bolland and colleagues,1 now including calcium and vitamin D,2 because it raises questions about study design, appropriate selection of adverse cardiovascular events, data management, and levels of significance.1

Firstly, in their reanalysis of the Women’s Health Initiative paper,3 Bolland …