tbuckley/cabot-search huggingface dataset:
Is standardization of left ventricular chamber elastance necessary?
Authors: H H Hsia, M R Starling
Journal: Circulation (1990)

Because of the relation between left ventricular (LV) chamber elastance and heart size, it has been hypothesized that maximum time-varying elastance (Emax) must be standardized to differentiate between preserved and depressed LV systolic performance. To test this hypothesis, we studied 66 patients, of whom 25 had a normal LV, 20 had aortic regurgitation, 14 had mitral regurgitation, and seven had cardiomyopathy, with micromanometer-determined LV pressures and radionuclide angiograms during multiple LV loading conditions. Multiple regression analysis established that Emax was independently related to LV end-diastolic volume (r = -0.69). When the Emax and LV end-diastolic volume (EDV) data from all patients were plotted, a curvilinear relation was evident. Data transformation to the base e identified two distinct linear relations, one in the normal patients of lnEmax = -0.60 (lnEDV) +4.34 (r = -0.67, p less than 0.001); and one in the patients with cardiac pathology of lnEmax = -1.06 (lnEDV) +6.12 (r = -0.73, p less than 0.001), which differed from each other (p less than 0.01). When a mathematical standardization was applied to these data to eliminate the independent contribution of heart size to the reduction in lnEmax, the normal patients had a standardized lnEmax versus lnEDV slope of 0, whereas that in the patients with cardiac pathology remained negative and continued to differ from that in the normal patients (p less than 0.001). Dichotomization of patients with cardiac pathology into those with preserved and depressed LV chamber elastance by lnEmax or standardized lnEmax provided highly concordant data (k = 0.73, p less than 0.001). Moreover, the estimated contribution of LVEDV to the reduction in Emax in patients with cardiac pathology averaged only 14 +/- 7%. We conclude from these data that LV chamber elastance calculated with radionuclide angiography has an independent relation with LVEDV, that a mathematical standardization of Emax for heart size does not significantly alter the dichotomization of patients with cardiac pathology into those with preserved and depressed LV systolic performance, and that heart size makes a relatively small contribution to the reduction in this index of LV systolic performance. Thus, standardization for heart size may not be necessary to identify whether preserved or depressed LV chamber elastance exists in an individual adult patient with cardiac pathology compared with normal adult patients.
Recurrent Headaches in Children, and Associated Pathological Conditions
Authors: F. Warner
Journal: BMJ (1879)

can be brought about by any means, it is worth our efforts as physicians.For the damaged mechanism, if it cannot be repaired, can, to a certain extent, be re-educated; and, by learning to make allowance for certain errors, the nerve-centres may reacquire a certain amount of the lost power of co-ordination.Thus we may have apparent, but only apparent, improvement.Our patient Ritchie, by finding that his forefinger, when he tried to touch his nose, went two inches beyond it, learned by practice to correct this error, and could after a time, with his eyes shut, hit the mark much better.In the earlier stages of the disease, when there is reason to believe that there is a good deal of congestion or even of inflammation, ergot of rye in full doses-a drachm of the liquid extract three times a day- or bromide of potassium or sodium, may be given.Under this treatment, Joseph Hunter, who was in Ward 7 in I877, and whose case, although not severe, was an unquestionable one and in the early stage, improved greatly.The electric-like pains disappeared, and he recovered the power, which he had lost, of standing with his heels and toes together and his eyes closed, although he swayed from side to side a good deal.Nitrate of silver in quarter-grain doses has been extolled by many authorities, and my experience of it has been satisfactory.The constant galvanic current to the spine and nerves is often useful.The actual cautery is most worthy of trial, having been employed in some cases with encouraging results.The electric-like pains are best treated by means of the subcutaneous injection of morphia.Where a syphilitic history is present, the prognosis is more hopeful, and bichloride of mercury with iodide of potassium should be given.Some of the facts brought out in these cases seem to indicate that an mportant part of treatment may consist in stimulating the anaesthetic areas.However, I hope to be able to speak more fully and decidedly on this subject in a future lecture.
Too Expensive to Treat? Finitude, Tragedy, and the Neonatal ICU
Authors: Derek S. Wheeler
Journal: JAMA (2011)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Extracts from an Introductory Lecture to a Course of Lectures on Clinical Medicine
Authors: J. D. Heaton
Journal: BMJ (1861)

Dr. Barker, of Bedford, fed a pig for three months with the discharges from intestinal fever, anid found that the health of the animal in nio wise suffered from this strange additioni to its diet.The iniference which the fact might, at first sight, seem to suggest- that these discharges are not infectious, is, I need scarcely say, quite unwarranted by it The true inference to draw from it is, thatjpigs are not men.
Liver and aging—1982: Liver &amp; drugs. Proceedings of the Second Tokyo Symposium on Liver &amp; Aging—Liver &amp; Drugs, Held in Tokyo, Japan, on August 18–20, 1982. By Kenichi Kitani. 410 pp. + xiii. New York: Elsevier, 1982
Authors: David J. Greenblatt
Journal: Hepatology (1985)
AN ENORMOUS CALCULOUS PYONEPHROSIS
Authors: Montague L. Boyd
Journal: JAMA (1926)

Many varieties of changes are encountered at operation in chronically infected kidneys containing stones. There is ordinarily, however, a tendency to the eventual formation of only three pathologic types, and the great varieties of changes seen are usually stages in their development. They are: 1. A pyonephrotic, multilocular sac, with reduced blood supply, and more or less complete destruction of renal functions, and perirenal changes not as extensive as those encountered in the other two types. 2. An atrophic, almost functionless kidney with, usually, very dense and often very marked perirenal adhesions. 3. A generalized enlargement of the kidney as a result of an increase in the fibrous tissue, a large blood supply, impaired renal function, and very marked fibrolipomatous, perirenal changes. The case reported here belongs in the third class, and illustrates (1) how painless an enormous enlargement of the kidney with very large calculi may be and (2)
Aerobic Physical Exercise and Atherosclerosis in Men
Authors: Th. F.M. Fennis, J. W. Vredeveld
Journal: Annals of Internal Medicine (2004)

Letters7 December 2004Aerobic Physical Exercise and Atherosclerosis in MenTh. F.M. Fennis, MD and J. W. Vredeveld, MD, PhDTh. F.M. Fennis, MDFrom Atrium Medical Centre, 6401 CX Heerlen, the Netherlands.Search for more papers by this author and J. W. Vredeveld, MD, PhDFrom Atrium Medical Centre, 6401 CX Heerlen, the Netherlands.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-141-11-200412070-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Rauramaa and colleagues (1) reported that physical exercise slows progression of atherosclerosis in men not taking statins. Their way of measuring the progression of atherosclerosis is, however, invalid. They reported using an ultrasound device with a high-resolution 10-MHz transducer to measure the intima–media thickness in the carotid bifurcation. The velocity of sound in tissue is 1540 m/s. Wavelength is calculated by dividing this velocity through frequency; thus, wavelength (λ) equals 0.154 mm. It is commonly accepted that the standard measurement error is 2 to 3 times this wavelength. In Rauramaa and colleagues' study, the difference noted in ...Reference1. Rauramaa R, Halonen P, Väisänen SB, Lakka TA, Schmidt-Trucksäss A, Berg A, et al. Effects of aerobic physical exercise on inflammation and atherosclerosis in men: the DNASCO Study: a six-year randomized, controlled trial. Ann Intern Med. 2004;140:1007-14. [PMID: 15197018] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Atrium Medical Centre, 6401 CX Heerlen, the Netherlands. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffects of Aerobic Physical Exercise on Inflammation and Atherosclerosis in Men: The DNASCO Study Rainer Rauramaa , Pirjo Halonen , Sari B. Väisänen , Timo A. Lakka , Arno Schmidt-Trucksäss , Aloys Berg , Ilkka M. Penttilä , Tuomo Rankinen , and Claude Bouchard Aerobic Physical Exercise and Atherosclerosis in Men Rainer Rauramaa , Timo A. Lakka , and Pirjo Halonen Metrics 7 December 2004Volume 141, Issue 11Page: 889KeywordsAtherosclerosisExerciseFallsStatinsUltrasound imaging ePublished: 7 December 2004 Issue Published: 7 December 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Neuropsychiatric development and health in children with and without congenital heart block born to mothers with Ro/SSA autoantibodies – a retrospective follow-up
Authors: Amanda Skog, Joanna Tingström, Stina Salomonsson, Sven-Erik Sonesson, Marie Wahren-Herlenius
Journal: Annals of the Rheumatic Diseases (2012)

<h3>Background and objectives</h3> Women with Ro/SSA autoantibodies have an increased risk of having a child with neonatal lupus erythematosus (NLE) which includes manifestations such as congenital heart block (CHB). Some studies indicate that the CNS may be affected in children with NLE, and other studies have shown that children of women with SLE have an increased risk for learning disabilities. However, it still seems uncertain whether exposure to Ro/SSA autoantibodies during fetal development may impair neuropsychiatric development in children with and without CHB. The authors therefore investigated neuropsychiatric development in children with and without CHB born to mothers with Ro/SSA autoantibodies. <h3>Patients and methods</h3> Individuals were selected from a population-based cohort of CHB patients if fulfilling the criteria of having a mother with Ro/SSA autoantibodies and being born between 1980 and 2010. Medical records for siblings with and without CHB were retrieved from children primary healthcare centers and school health services and data on skin manifestations, and neuropsychiatric development (including locomotor skills, hearing, speech, attention, learning, behavior, anxiety and depression) was extracted. Records from 109 individuals, 58 with CHB and 51 of their siblings without CHB were collected. A questionnaire was sent to the mothers to gather information on maternal diagnosis and treatment during pregnancy. <h3>Results</h3> The median time of follow-up was 12.7 years (25th–75th percentile: 8.1–17.5 years). Neuropsychiatric symptoms or disease were reported in 22 (20%) of the 109 children, 15 of which had CHB and 7 without CHB. Among the mothers of these 22 children, only one was steroid-treated during pregnancy. The most commonly reported problems were speech, locomotor, learning and hearing impairment, reported in 9%, 7%, 7% and 7% of all children. Two categories observed reached a statistical difference between the groups, attention deficit; 10% in the CHB group and 0% in siblings (p&lt;0.02) and learning impairment; 12% in the CHB group and 2% in siblings (p&lt;0.05). Among the nine mothers of children with attention deficit and/or learning impairment, seven mothers (78%) were diagnosed with SLE (p&lt;0.01). None of the siblings had any reported neuropsychiatric diagnosis, whereas 4 children with CHB had a reported neuropsychiatric diagnosis. One female had dyslexia, one male had autism and two males had ADHD. <h3>Conclusions</h3> Our data suggest that impairment in neuropsychiatric development in terms of attention deficit and learning impairment is more frequent in children with CHB than in their siblings. However, this risk appears predominantly confined to children of mothers with SLE.
The Medical Annual
Authors: J. H. Sequeira
Journal: British Journal of Dermatology (1912)

REVIEW.of granular yellow pigment, which for the most part gave the reaction of hsmosiderin."It was chiefly massed in the liver-cells, and in slightly greater aniount toward the periphery of the parencliyniatous islets.The lymphatics in the fibrous areas of the liver commonly contained heavily pigmented mononucleated cells.The pigment was composed of small granules of more or less nniform size, bright yellow in colour, and gave rapidly the iron reaction of hemosiderin.Some of the granules failed to give this reaction and therefore resembled hsmofuscin.The authors discuss the relationship of the pigmentation to the disease in the liver and in the pancreas, and give a considerable, though by no means complete, bibliography of recorded cases.I n their concluding paragraph they say : " From what may be gatliered in the literature and from the study of our own case it would seem as if to-day we are warranted in stating only that cirrhosis of the liver is the primary condition ; that pancreatic involvement with diabetes is a sequence or coincident event to this ; that the heniochromatosis, always in slight degree in liver cirrhosis, is in some cases very excessive, and causes a general pigmentation which eventually also involves the skin ; and finally, that the whole process is not any definite symptom-complex, but a cliain of circumstance which rarely seeni s to be completed." LUPUS FOLLICULARIS DISSEMINATUS. BRUUSGAARD. (Avchiw f.The disease was spread over his face, affecting especially the root of the nose, the forehead.the eyelids, chin and beard region.The lesions varied from the size of a pin's head to that of a liempseed.They were violet in colour, and on pressing out the blood revealed a yellow infiltration.The patient was found to have softening at the right apex, and tubercle bacilli were demonstrated in his sputum.The deposit of pigment in the cirrliosed liver was very extensive.
Visualization of the interaction of native and modified lipoproteins with parenchymal, endothelial and Kupffer cells from human liver
Authors: Monique F. Kleinherenbrink-Stins, Hans J. van de Boom, Donald Schouten, Paul J. M. Roholl, Niels M. van der Heyde, Adriaan Brouwer, Theo J. C. V. Berkel, Dick L. Knook
Journal: Hepatology (1991)

The interaction of low density lipoprotein, acetylated low density lipoprotein and apolipoprotein E—free high density lipoprotein with parenchymal, endothelial and Kupffer cells of human liver was visualized. For this purpose, the fluorescent phospholipid analog 1,1′-dioctadecyl-3,3,3′,3′-tetramethyl indocarbocyanine perchlorate was used to label the lipoproteins. The involvement of both parenchymal and nonparenchymal cells in the uptake of 1,1′-dioctadecyl-3,3,3′,3′-tetramethyl indocarbocyanine perchlorate—labeled low density lipoprotein and acetylated low density lipoprotein was studied using in vitro perfusion of human liver tissue blocks. In addition, primary hepatocyte cultures were used to visualize the interaction with 1,1′-dioctadecyl-3,3,3′,3′-tetramethyl indocarbocyanine perchlorate-labeled apolipoprotein E—free high density lipoprotein and (modified) low density lipoprotein. 1,1′-dioctadecyl-3,3,3′,3′-tetramethyl indocarbocyanine perchlorate-low density lipoprotein showed a time-dependent and concentration-dependent interaction with both hepatocytes and Kupffer cells, although the intensity of the interaction with parenchymal cells varied strongly among the liver donors. Uptake of 1,1′-dioctadecyl-3,3,3′,3′-tetramethyl indocarbocyanine perchlorate-low density lipoprotein by both cell types was strongly inhibited by the presence of excess unlabeled low density lipoprotein in the (perfusion) medium. Methylation and hydroxyac-etaldehyde treatment of low density lipoprotein prevented the uptake of low density lipoprotein. This indicated that the uptake of low density lipoprotein by Kupffer and parenchymal cells was mediated by the low density lipoprotein receptor. 1,1′-dioctadecyl-3,3,3′,3′-tetramethyl indocarbocyanine perchlorate-acetylated low density lipoprotein was mainly taken up in situ by liver endothelial cells and by a minor population of Kupffer cells. Polyinosinic acid, a known inhibitor of the scavenger receptor, prevented the uptake by liver endothelial cells. Therefore human liver endothelial cells express active scavenger receptors on their surface. Apolipoprotein E—free 1,1′-dioctadecyl-3,3,3′,3′-tetramethyl indocarbocyanine perchlorate-high density lipoprotein was found to be associated with the membrane of cultured liver parenchymal cells but was not taken up intracellularly, indicating a cholesterol exchange process occurring extracellularly at the plasma membrane. The cellular localization of lipoprotein receptors and uptake of the various classes of lipoproteins are comparable with the situation in rats. (HEPATOLOGY 1991;13:79-90.)
Predicting Long-Term Outcome in Group Treatment of Atopic Dermatitis
Authors: Ulrich Stangier, Anke Ehlers, Uwe Gieler
Journal: Psychotherapy and Psychosomatics (2004)

&lt;i&gt;Background:&lt;/i&gt; Psychological group treatments are effective adjuncts to dermatological treatments in improving dermatological symptoms and quality of life. However, no data are available on variables that may predict which patients benefit from such group treatments. &lt;i&gt;Methods:&lt;/i&gt; On the basis of data from the Marburg group treatment study, we explored which variables are associated with successful treatment. Treatment outcome was defined by a marked reduction of dermatological symptoms at 1-year follow-up. &lt;i&gt;Results:&lt;/i&gt; Regardless of the treatment condition, a high pretreatment level of scratching, a low serum IgE level, low scores on the internal Health Locus of Control Scale and a high frequency of coping-related cognitions regarding itching predicted good outcome at 1 year. Logistic regression analyses indicated that the predictive power of locus of control and itch-related cognitions differed between different treatment conditions. &lt;i&gt;Conclusion:&lt;/i&gt; In patients with atopic dermatitis, indication for psychological treatment may be based on the assessment of psychological target problems including excessive scratching and dysfunctional cognitions.
Complication of Central Venous Catheterization
Authors: Hangyuan Guo
Journal: New England Journal of Medicine (2007)

A 40-year-old man with Crohn's disease underwent an uncomplicated operation involving lysis of adhesions that were causing intestinal obstruction. After surgery, a cardiologist inserted a central venous catheter through the left subclavian vein. No problems with catheterization were noted. Three weeks later, after discharge, mild pain and edema developed in the patient's right lower leg. He was treated with antibiotics for 1 week, and his symptoms diminished. Six months after the operation, the patient presented with posterior cervical pain. A guide wire, presumably lost during the insertion of the central venous catheter, was protruding from the back of his neck (Panel A, arrow). A computed tomographic scan showed the fractured guide wire in the central venous system (Panel B, arrows). The wire protruding from the back of the neck was removed easily; however, it was difficult to remove the part of the wire involving the saphenous vein, and an open procedure with general anesthesia was required. The involved leg vein was thrombosed and occluded. At 1 year of follow-up, the patient was free of symptoms and signs. A 40-year-old man with Crohn's disease underwent an uncomplicated operation involving lysis of adhesions that were causing intestinal obstruction. After surgery, a cardiologist inserted a central venous catheter through the left subclavian vein. No problems with catheterization were noted. Three weeks later, after discharge, mild pain and edema developed in the patient's right lower leg. He was treated with antibiotics for 1 week, and his symptoms diminished. Six months after the operation, the patient presented with posterior cervical pain. A guide wire, presumably lost during the insertion of the central venous catheter, was protruding from the back of his neck (Panel A, arrow). A computed tomographic scan showed the fractured guide wire in the central venous system (Panel B, arrows). The wire protruding from the back of the neck was removed easily; however, it was difficult to remove the part of the wire involving the saphenous vein, and an open procedure with general anesthesia was required. The involved leg vein was thrombosed and occluded. At 1 year of follow-up, the patient was free of symptoms and signs. Hangyuan Guo, M.D.Shaoxing People's Hospital, Shaoxing, Zhejiang 31200 China ghangyuan@hotmail.com
Matching between ventricle and arterial load. An evolutionary process.
Authors: G Elzinga, N Westerhof
Journal: Circulation Research (1991)

The hemodynamic properties of the ventricle are related to those of the arterial load. However, the precise nature of this relation is not known. At least three different matching criteria have been described in the literature: optimization of heart rate, of power output, and of external efficiency. Although these suggestions are based on experimental findings, there is little understanding of the underlying principles. We now suggest that the balance between the ventricle and its load is a result of the evolutionary process. To support our view, three simple assumptions are proposed regarding the evolutionary determinants underlying the relation between ventricle and arterial load: 1) Arterial pressure and flow to be generated by the ventricular pump under normal (control) conditions are set by the demands of the body. 2) Mechanical properties of contractile machinery and arterial wall material are given. 3) The heart and arterial system should have minimum size. On the basis thereof, we argue that heart rate is related to maintenance of diastolic pressure and show that the ventricle operates close to optimum power and efficiency to attain minimum size.