tbuckley/cabot-search huggingface dataset:
Sympathetic and Parasympathetic Interactions upon the Left Ventricle of the Dog
Authors: MATTHEW N. LEVY, MANUEL NG, PAUL MARTIN, HARRISON ZIESKE, Thomas Rogoff
Journal: Circulation Research (1966)

In canine, isovolumetric, left ventricle preparations, stimulation of the cardiac end of a cut cervical vagus nerve evokes a biphasic change of left ventricular systolic pressure (LVSP). Characteristically, there is a definite reduction of LVSP during the stimulus, followed by a slight increase of LVSP after cessation of stimulation. The magnitude of the reduction of LVSP during vagal stimulation is considerably augmented when sympathetic activity is increased either directly (by electrical stimulation of the left stellate ganglion) or reflexly (by lowering carotid sinus pressure). These results indicate that the effect of vagal stimulation is mediated, at least in part, by antagonizing the positive inotropic influence of the prevailing sympathetic nervous activity. The mechanism of the poststimulation rebound is unknown. It may be due to cardiac sympathetic fibers in the canine vagosympathetic nerve trunks and to the release of catecholamine-like substances in the myocardium.
XII. Acute Hemorrhage from the Upper Gastrointestinal Tract
Authors: Donald E. Wilson, Thomas C. Chalmers
Journal: New England Journal of Medicine (1966)

ONE of the most challenging situations facing the physician today is the successful treatment of the patient with acute hemorrhage from the upper gastrointestinal tract. In recent years newer diagnostic procedures have become available, blood-transfusion technics have become more refined, and surgical and anesthetic skills have improved considerably. The optimal treatment of acute gastrointestinal hemorrhage is by no means established, however, and the success rate has apparently not changed in the last twenty-five years.An increased awareness of the possibility of bleeding from the gastrointestinal tract as a cause of a patient's presenting complaints represents the first major step in . . .
Breast cancer treatment delays affect survival
Authors: J. Jones
Journal: BMJ (1999)

Cutting delays in detecting and treating breast cancer saves lives, according to a review of more than 100000 cases worldwide. Women waiting three months or more for treatment are less likely to survive beyond five years than those facing shorter delays, according to the study (Lancet 1999; 353:1119-26).

From 1 April all patients suspected of having breast cancer must be seen by a hospital specialist within 14 days of an urgent referral by their GP, Baroness Hayman, the health minister, announced on the eve of publication of the study.

New …
Molecular Imaging of Bone Marrow Mononuclear Cell Survival and Homing in Murine Peripheral Artery Disease
Authors: Koen E.A. van der Bogt, Alwine A. Hellingman, Maarten A. Lijkwan, Ernst-Jan Bos, Margreet R. de Vries, Juliaan R.M. van Rappard, Michael P. Fischbein, Paul H. Quax, Robert C. Robbins, Jaap F. Hamming, Joseph C. Wu
Journal: JACC. Cardiovascular imaging (2012)
Hemodynamic effects of nitroglycerin in acute myocardial infarction.
Authors: D O Williams, E A Amsterdam, D T Mason
Journal: Circulation (1975)

Nitroglycerin (NTG) has recently been suggested to decrease myocardial ischemia and enhance cardiac pump function during acute myocardial infarction (AMI). To evaluate the sublingual agnet in this condition, the hemodynamic effects of 0.4 mg NTG administered to 16 supine patients during the first 72 hours of AMI were determined serially 5, 10 to 15, and 20 to 30 minutes post-NTG. Data were evaluated for the entire group, as well as for six patients with normal pulmonary artery wedge pressure (PAW) (less than or equal to 12 mm Hg; mean 7) who formed group I and for ten patients with elevated PAW (greater than 12 MM Hg; mean 19) who comprised group II. In the 16 patients, NTG resulted in significant decreases in PAW (14 TO 7 MM Hg; P less than .01), mean systemic arterial pressure (MAP) (95 TO 82 MM Hg; P less than .01), cardiac index (CI) (1.79 TO 1.46 L/min/m-2; P less than .02), stroke index (SI) (24 TO 18 CC/M-2; P less than .01) and stroke work index (SWI) (27 TO 20 GM TIMES M/M-2; P less than .01). These alterations were significant in both subgroups, with the decline in PAW greater (P less than .05), while there was no change in group II. There was no significant change in total peripheral vascular resistance (TPVR) for the entire group or in the two subgroups. This study demonstrates that, regardless of initial left ventricular filling pressure, sublingual NTG given in the acute phase of AMI results in rapid fall in PAW, concomitant with decreases in systemic blood pressure, cardiac output and SWI, without changes in TPVR and with little or no effect on heart rate. Since TPVR was unaltered, the decline in MAP was due to fall in cardiac output. Thus, the principal action of sublingual NTG in AMI appears to be systemic venodilation with consequent reduction of ventricular preload. This effect is translated into decline ofpump output even in patients with high initial filling pressures. Although NTG may rapidly relieve pulmonary congestion and lower myocardial oxygen consumption, use of the agent sublingually is limited in AMI because these salutary effects are accomppanied by potentially deleterious fall in cardiac output and systemic blood pressure.
Aviation medicine. Problems of altitude I: hypoxia and hyperventilation.
Authors: R M Harding, F J Mills
Journal: BMJ (1983)

Even modern aircraft still expose their passengers to some risks from lowered atmospheric pressure."'Concorde commonly cruises at altitudes of 50 000-60 000 ft (15 240-18 288 m) where, if unprotected, its occupants would be unconscious within 15 seconds and dead four to six minutes later from lack of oxygen.2Even at the more usual cruising altitudes of commercial aircraft-30 000-40 000 ft (9144-12 192 m)- unprotected passengers and crew would rapidly succumb.Of course this does not happen, thanks to the protection of the aircraft pressure cabin.The well being of the air traveller within this artificial environment is, however, always threatened by the problems of altitude extending beyond lack of oxygen to decompression sickness, cold, and simple pressure effects. Physics of the atmosphereAscent to altitude is associated with a fall in air pressure parallel by decreases in density and temperature.Thus at 18 000 ft (5486 m) atmospheric pressure has fallen to half its value at sea level and the ambient temperature to about -20°C
Depressed Fracture of the Sternum
Authors: J. H. Kirkham
Journal: BMJ (1941)

MEDICAL JOIJRNA^;in the sections.The mucous membrane was partly necrotic.Many large foci of lymphocytes were seen in all the layers, and there was an extensive eosinophilic infiltration.Except for the eosinophilia the appearances were characteristic of tubercle; but this type of lesion is usually regarded as non-tuberculous, and was described by Crohn as regional ileitis.Our patient showed no sign of tuberculosis else-where.COMMENTARY Crohn's disease is not common, and for it to appear as an acute obstruction is still less so.Usually the patient is operated upon through a small incision for chronic appendicitis, and the appendix is removed without the v-eal nature of the disease being realized.The condition then goes on to fistula formation or the patient has repeated attacks -of subacute obstruction.This might well have happened in our case had not the pea caused an acute obstruction at a relatively early date.
Experts launch action on acrylamide in staple foods
Authors: F. Fleck
Journal: BMJ (2002)

Food science experts and officials from Europe and the United States are taking concerted action to try to reduce potentially dangerous levels of acrylamide, a toxin known to cause cancer, in staple foods.

The possible health risk was discussed at a meeting convened by the World Health Organization in Geneva last month, after the announcement in March by Swedish scientists that acrylamides were present in a wide range of foods, particularly …
THE LEUKOTOXIC ACTION OF STREPTOCOCCI
Authors: Armine T. Wilson
Journal: The Journal of Experimental Medicine (1957)

Following phagocytosis of certain streptococci human neutrophils undergo a rapid disintegration: the leukotoxic reaction. Monocytes and eosinophils are similarly injured, as are polymorphonuclear cells of rabbit and guinea pig blood. The leukotoxic injury is not produced by culture filtrates of leukotoxic cocci nor does it follow phagocytosis of heat-killed cocci. The leukotoxic effect does not appear to be due to action of any presently known streptococcal product. The distribution of leukotoxicity among streptococci is not random, for it was found in all strains tested of certain types of group A (6, 12), and was absent from almost all strains of other types (5, 14, 30). Still other types (3, 4) had both leukotoxic and non-leukotoxic representatives. The injury was also produced by some group C and G strains. Often the streptococci that cause leukocyte death remain alive and proliferate in the cellular debris, but sometimes they are injured by the phagocyte before the latter disintegrates and are unable to proliferate on the slides. The capacity of a strain of streptococcus to injure leukocytes does not necessarily confer virulence on it. This is thought to be because a chain of streptococci, having survived its sojourn in a leukocyte it has killed, is still susceptible to phagocytosis by a fresh leukocyte, and serial phagocytoses may continue until the chain has been exposed sufficiently to the unfavorable intracellular environment to be, itself, killed. Whether leukotoxicity plays a role in naturally occurring streptococcal disease is unknown. The high incidence of leukotoxicity in Type 12 strains suggested that it might be involved in acute hemorrhagic nephritis, but if so there must be other factors since leukotoxic strains are present in types and groups not now known to be associated with nephritis.
Some Observations on the Temperature of Coma
Authors: J. E. H. Sawyer
Journal: BMJ (1903)

DLe. 26, Igo3 might be taken as a fairly accurate measurement of the 0-oxybutyric acid it contains.And now to explain the precise relationship of the acid to the coma-a relationship first suggested by Stadelmann.I incline distinctly to the opinion shared by many others, that we are dealing here with an acid-intoxication, or acidosis as it is sometimes termed.The acid for its elimination requires a base, for it does not appear in the urine in the free state.It cannot obtain from the body enough soda or potash, and therefore unites with ammonia (which explains the high excretion of this substance), this ammonia being the result of the metabolism of proteids, and destined under ordinary cir- cumstances to become urea.This ammonia is given up to protect the alkali of the blood.If now, as a result of gastric disturbance or defective nutrition this supply is cut off, the acid utilizes the alkali of the blood as a base, reduces its alkalescence, and stupor supervenes.In support of this view may be mentioned the fact proved experimentally by Walther that the introduction into the system of large quantities of dilute mineral acid, such as hydrochloric, can cause
The Dying Patient: The Medical Management of Incurable and Terminal Illness
Authors: John Neville
Journal: JAMA (1982)

The first half of this book discusses various typically incurable illnesses. The best sections, such as those on renal failure and breast cancer, consider treatment options in the light of the patient's overall condition, social situation, and general prognosis. The chapters on cardiac disease and lesscommon malignancies, however, lose this theme and become little more than briefer versions of what may be better found in standard texts. The treatment of lung cancer is interesting in its discussion of palliation, but should be more up to date on chemotherapy. Worthwhile sections on dementia and on terminal illness in the elderly highlight the role of social problems and solutions in this area, where the purely medical approach often falls short. Stress is also placed on the importance of diagnosis in approaching each new problem in a chronically ill person. Coverage of caring for children with cancer emphasizes a team approach, including the
Association Between Visceral Adipose Tissue Area and Coronary Plaque Morphology Assessed by CT Angiography
Authors: Norihiko Ohashi, Hideya Yamamoto, Jun Horiguchi, Toshiro Kitagawa, Eiji Kunita, Hiroto Utsunomiya, Toshiharu Oka, Nobuoki Kohno, Yasuki Kihara
Journal: JACC. Cardiovascular imaging (2010)
Ernest Saunders: diagnostic dilemma.
Authors: R. Howard, S. Lovestone, R. Levy
Journal: BMJ (1992)

the risk of an increase in tuberculosis related to HIV is small.2An audit of cases of tuberculosis (April 1990-March 1991) in Riverside Health Authority showed two problems with the current surveillance of HIV infection and tuberculosis based on notifi- cation data.Firstly, tuberculosis in HIV infected people is less likely to be notified than that in other people.In our study only four (40%) of 10 dual infections were notified; in contrast, 50 (74%) of 68 cases of tuberculosis in people not known to be infected with HIV were notified.Furthermore, HIV positive patients given antituberculous treat- ment without bacteriological evidence being sought were even less likely to be notified (one
Treatment of Diabetic Neuropathy With γ-Linolenic Acid
Authors: Harry Keen, Jose Payan, Jaffar Allawi, James Walker, Goran A Jamal, Andrew I Weir, Lesley M Henderson, Elizabeth A Bissessar, Peter J Watkins, Michael Sampson, Edwin A M Gale, John Scarpello, Hugh G Boddie, Kevin J Hardy, Peter K Thomas, Peter Misra, Jukka-Pekka Halonen
Journal: Diabetes Care (1993)

Objective— To compare the effects of placebo and GLA on the course of mild diabetic neuropathy over 1 yr. Research Design and Methods— We entered 111 patients with mild diabetic neuropathy from seven centers into a randomized, double-blind, placebo-controlled parallel study of GLA at a dose of 480 mg/day. MNCV, SNAP, CMAP, hot and cold thresholds, sensation, tendon reflexes, and muscle strength were assessed by standard tests in upper and lower limbs. Results— For all 16 parameters, the change over 1 yr in response to GLA was more favorable than the change with placebo, and for 13 parameters, the difference was statistically significant. Sex, age, and type of diabetes did not influence the result, but treatment was more effective in relatively well-controlled than in poorly-controlled diabetic patients. Conclusions— GLA had a beneficial effect on the course of diabetic neuropathy.
1032-125 Electrocardiographic pattern of giant negative T wave in hypertrophic cardiomyopathy: Is it a specific feature of “Apical” hypertrophic cardiomyopathy?
Authors: Makoto Okawa, Hiroaki Kitaoka, Yoshihisa Matsumura, Toru Kubo, Naohito Yamasaki, Takashi Furuno, Jun Takata, Yoshinori Doi, Barry J Maron
Journal: Journal of the American College of Cardiology (2004)
THE RENAL RESPONSE TO CHRONIC RESPIRATORY ACIDOSIS 1
Authors: W. James Sullivan, Philip J. Dorman, Martha Barrett MacLeod, Mary Ellen Parks
Journal: Journal of Clinical Investigation (1955)

An increase in the carbon dioxide tension of the body fluids is accompanied by an increase in the concentration of bicarbonate bound base, a fact which minimizes the change in pH that would otherwise ensue (1, 2). A priori, it is evident that an elevated plasma bicarbonate concentration can be maintained only by enhancement of the rate of renal tubular reabsorption of bicarbonate. That such enhancement occurs in response to acute respiratory acidosis has been established by experiments performed in our laboratory as well as in other laboratories (3-5). It has also been shown that the elevated pCO2, and not the change in pH, is the stimulus responsible for enhancing this tubular activity.
Monitoring and Modeling of Emissions from Concentrated Animal Feeding Operations: Overview of Methods
Authors: Bryan Bunton, Patrick O’Shaughnessy, Sean Fitzsimmons, John Gering, Stephen Hoff, Merete Lyngbye, Peter S. Thorne, Jeffrey Wasson, Mark Werner
Journal: Environmental Health Perspectives (2006)

Accurate monitors are required to determine ambient concentration levels of contaminants emanating from concentrated animal feeding operations (CAFOs), and accurate models are required to indicate the spatial variability of concentrations over regions affected by CAFOs. A thorough understanding of the spatial and temporal variability of concentration levels could then be associated with locations of healthy individuals or subjects with respiratory ailments to statistically link the presence of CAFOs to the prevalence of ill health effects in local populations. This workgroup report, which was part of the Conference on Environmental Health Impacts of Concentrated Animal Feeding Operations: Anticipating Hazards—Searching for Solutions, describes instrumentation currently available for assessing contaminant concentration levels in the vicinity of CAFOs and reviews plume dispersion models that may be used to estimate concentration levels spatially. Recommendations for further research with respect to ambient air monitoring include accurately determining long-term average concentrations for a region under the influence of CAFO emissions using a combination of instruments based on accuracy, cost, and sampling duration. In addition, development of instruments capable of accurately quantifying adsorbed gases and volatile organic compounds is needed. Further research with respect to plume dispersion models includes identifying and validating the most applicable model for use in predicting downwind concentrations from CAFOs. Additional data are needed to obtain reliable emission rates from CAFOs.
Merck appeals rofecoxib verdict
Authors: Janice Hopkins Tanne
Journal: BMJ (2007)

Merck will appeal against the decision that a New Jersey state court jury made on 12 March to award compensatory and punitive damages of $47.5m (£24.4m; €35.7m) to an Idaho man, Frederick Humeston, and his wife Mary, for a heart attack he had in 2001, when he was 56.

The damages, awarded after the retrial of an earlier case that Mr Humeston lost, were $18m to Mr Humeston, $2m to his wife, and $27.5 in punitive damages. The jury decided that Merck was negligent in not warning Mr Humeston of the risk of taking rofecoxib (Vioxx).

Merck voluntarily withdrew rofecoxib, a cyclo-oxygenase-2 inhibitor, from the market on 30 September 2004 because it increased the risk of heart attacks and strokes ( BMJ 2005;329:816).

Merck faces more than 27 000 …
Evaluation of P53 Protein Overexpression, Ki67 Proliferative Activity and Mitotic Index as Markers of Tumour Recurrence in Superficial Transitional Cell Carcinoma of the Bladder
Authors: P. Gontero, G. Casetta, A. Zitella, R. Ballario, D. Pacchioni, C. Magnani, G.H. Muir, A. Tizzani
Journal: European Urology (2000)
Ultrasound-Guided Fine-Needle Aspiration Biopsy and Ultrasonographic Features of Infracentimetric Nodules in Patients with Nodular Goiter: Correlation with Pathological Findings
Authors: Mustafa Sahin, Aysegul Sengul, Zeynep Berki, Neslihan B. Tutuncu, Nilgun D. Guvener
Journal: Endocrine Pathology (2006)
ON THE TREATMENT OF STRANGULATED HERNIA AFTER OPERATION
Authors: E. Morris
Journal: BMJ (1854)

MI OIAL MWCATIso MA Lsanu, the is no longer room for doubt o Xs. mbjest.Taking the mea of .11Dr. Davy's expenr _4nts, the specihc gravity of venos blood is eind to be 1053, that of arterial blood but 1.0W.The specific, avity of the srm of venous blood, ain, he found in t ma to be 1.026, that of the erum of arterial blood 1.022.In repeating those inquiies into the specific grvity of the different kinds of blood, I very constantly found the serum of venous blood of somewhat higher density than that of arterial blood; and even when, through imperfection of apparatus, the difference between the two seemed very slight, or was even inappreciable, I still found, an putting the two kinds of serum into an apparatus for showing endosmose, that a current of considerable force was established from the arterial to the venonis side.And this is the process, in fact, which, as carried on between the fluids that tmnsude the arteries, for the purpose of nutrition and vital endowment, and the contents of the veins in the living body, constitutes venous absorption; the condition indisenable to this, viz., the higher density of the blood i the veins or returning channels than in the arte- ries or efferent vessels in all the peripheral parts of the body, being mainly due to the influence of the sudoriparous glan3s distributed through the texture of the common in- tegument.This view of the function of the skin will be seen to harmonise perfectly with the fact that the grand product of the action of the skin is simple water.It also explains satisfactorily the fatal effects of the entire sup- p.ession of the cutaneous transpiration, as in the experi- ments of Fourcault and of Becquerel and Breschet.Finally, it sheds a new light on the cause of the great amount of disturbance in the general health that follows every even partial interference with this truly vital function.It would have been easy for me to have greatly ex- tended this communication, and to have shown the views it involves in a variety of practical applications; but I have purposely avoided doing more than exposing an esseial idea which has now for many years possessed my mind.and directing the attention of the intelligent members of the Medical Society of London to a subject which I feel assured is pregnant with much that is of the highest importance in the theory and practice of medicine.
Superior mesenteric artery syndrome diagnosed with linear endoscopic ultrasound
Authors: F. Di Matteo, F. Picconi, I. Sansoni, M. Pandolfi, M. Martino, R. Rea, E. Zardi, G. Costamagna
Journal: Endoscopy (2010)

We present two cases of superior mesenteric artery (SMA) syndrome, which were diagnosed with the aid of linear endoscopic ultrasound (EUS).
Polydactyly reported by Raphael
Authors: D. Mimouni, F. B Mimouni, M. Mimouni
Journal: BMJ (2000)

We were surprised to count six toes on the left leg of St Joseph in Raphael's famous painting of “The Marriage of the Virgin” (Milan, Pinacoteca di Brera), painted in 1504 (below). This is probably not due to the carelessness of this painter, well known for his attention …
Should Major Vascular Surgery Be Delayed Because of Preoperative Cardiac Testing in Intermediate-Risk Patients Receiving Beta-Blocker Therapy With Tight Heart Rate Control?
Authors: Don Poldermans, Jeroen J. Bax, Olaf Schouten, Aleksandar N. Neskovic, Bernard Paelinck, Guido Rocci, Laura van Dortmont, Anai E.S. Durazzo, Louis L.M. van de Ven, Marc R.H.M. van Sambeek, Miklos D. Kertai, Eric Boersma
Journal: Journal of the American College of Cardiology (2006)
Metronidazole and Cancer
Authors: Gary D. Friedman
Journal: JAMA (1989)

<h3>To the Editor.—</h3> The recent report by the Mayo Clinic group of an elevated risk of all cancers and of lung cancer among the cohort of 771 women who had received metronidazole (Flagyl) for vaginal trichomoniasis in the years 1960 through 1969<sup>1</sup>prompts this update of follow-up on 2460 patients (2236 female and 224 male) who received the drug in the years 1969 through 1973 from the Kaiser Permanente pharmacy in San Francisco. Beard et al<sup>2</sup>previously reported no statistically significant increase in the incidence of cancers of all sites or of any site except the lung after about ten to 19 years of follow-up. In three to seven years of follow-up we found 45 cases of cancer, with 33 expected on the basis of the age-sex adjusted incidence among 143 574 pharmacy users.<sup>3,4</sup>The excess was attributable entirely to cervical cancer, whose association with metronidazole-treated vaginitis