tbuckley/cabot-search huggingface dataset:
Immediate and Remote Prognostic Significance of Fascicular Block during Acute Myocardial Infarction
Authors: ROBERT A. WAUGH, GALEN S. WAGNER, THOMAS L. HANEY, ROBERT A. ROSATI, JAMES J. MORRIS
Journal: Circulation (1973)

The electrocardiograms of 538 patients with acute myocardial infarction were searched to identify all instances of atrioventricular (A-V) and intraventricular (I-V) conduction disturbances. Data concerning mode of therapy and clinical complications were obtained by review of the record. These variables were then analyzed for significance in relation to the development of type II A-V block acutely and syncope or sudden death during the first year of follow-up. The most accurate predictor for both these events was the status of A-V conduction in combination with the status of I-V conduction. At highest risk (50%) for type II progression were patients with acute adjacent fascicular block plus P-R prolongation, i.e., left anterior hemiblock plus right bundle-branch block (RBBB), or left bundle-branch block (LBBB), or patients with acute nonadjacent fascicular block, i.e., RBBB plus left posterior hemiblock or alternating bundle-branch block. The nonpaced survivors from this same group, plus any other patients with transient type II progression, were also at high risk (45%) for syncope or sudden death in follow-up. No syncope or sudden death has occurred in seven patients with type II progression discharged with a pacemaker. All other patients were at lower risk for these acute and chronic complications. Thus, the electrocardiogram in acute myocardial infarction can identify a high-risk group for acute type II progression in whom prophylactic pacer insertion may be beneficial. Similarly, the electrocardiogram can identify a high-risk group for syncope or sudden death in follow-up and implicates progression to higher degrees of A-V block as an important pathophysiologic mechanism.The possible role of permanent pacemaker therapy in preventing syncope or sudden death in this high-risk group is also suggested.
Comparison of sequence changes of precore and core promoter regions in HBeAg-positive chronic hepatitis B patients with and without HBeAg clearance in lamivudine therapy
Authors: Chien-Hung Chen, Chuan-Mo Lee, Sheng-Nan Lu, Chi-Sin Changchien, Jyh-Chwan Wang, Jing-Houng Wang, Chao-Hung Hung, Tsung-Hui Hu
Journal: Journal of Hepatology (2005)
Spinal subarachnoid haemorrhage in patient with coarctation of aorta.
Authors: A B Watson
Journal: BMJ (1967)

Memorandawith hypertrophic changes on the medial aspect of the joint and with shift of the patella laterally.Neurological examination revealed hypotonia and absent deep tendon reflexes.Cerebellar function appeared intact.Light touch and position sense were normal, but vibration sense was somewhat diminished and pain sensation greatly reduced.Temperature sensa- tion also appeared to be diminished.Figs. 2-4 show the right knee, the radiological changes in the left knee being similar but less severe.At age 11, soon after the initial symptoms in the right knee, there was considerable destructive change involving principally the lateral aspect of the epiphysis (Fig. 2).A year later (Figs. 3 and4) soft-tissue calcification and ossification were visible.There was subluxation and irregularity of the femoral condyles.The ossification was compatible with Pelligrini-Stieda fracture, indicating recurrent trauma to the joint. COMMENTIn attempting near complete ascertainment of cases in the North American continent we (McKusick et al., 1967) have obtained first-hand information on 164 families (200 patients).Among the 60 children examined in detail we have found two further young adults with similar joints-one with a painless, acutely swollen, disorganized knee joint and the other with a painless arthropathy of the shoulder.Charcot joints occurring before closure of the epiphyses are rather uncommon and present different radiographic findings from the more usual adult picture.Though most reports of familial dysautonomia have appeared in the American literature, there are three reports in British journals (McKendrick, 1958;
All the World's a Stage
Authors: Joe Chiovaro
Journal: Annals of Internal Medicine (2013)

On Being a Doctor5 February 2013All the World's a StageJoe Chiovaro, MDJoe Chiovaro, MDFrom Portland Veterans Affairs Medical Center, Portland, Oregon.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-3-201302050-00014 Audio Reading - “All the World's a Stage” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "All the World's a Stage," by J. Chiovaro. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail “All the world's a stage,” I thought as I entered the room, washing my hands slowly, sensing the room before I really saw it. There before me, enveloped in silence, were five members of his immediate family. I met each person's eyes with my own.There was much in that initial look. There was hope, that I might be the one who could make him better. There was doubt, that I could do that because I was the youngest person in the room. There was mistrust, that I may be more loyal to the institution I served than to the ... Author, Article, and Disclosure InformationAffiliations: From Portland Veterans Affairs Medical Center, Portland, Oregon.Corresponding Author: Joe Chiovaro, MD, P3 Med-Department of Medicine, Portland Veterans Affairs Medical Center, 3710 SW U.S. Veterans Hospital Road, Portland, OR 97239; e-mail, [email protected]. PreviousarticleNextarticle Advertisement Audio Reading - “All the World's a Stage” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "All the World's a Stage," by J. Chiovaro. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics 5 February 2013Volume 158, Issue 3Page: 215-216KeywordsArmed forcesChildrenEmotionsHearingInfertilityMemoryPersonality ePublished: 5 February 2013 Issue Published: 5 February 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Management of Heel Pain
Authors: Leo Lewin
Journal: JAMA (1978)

To the Editor.—  I must take serious exception to the answer by Dr Giannestras to the question entitled Morning Heel Pain in Elderly Heart Patient May Have Circulatory Cause.  It is stated  physical findings and roentgenograms of the foot are within normal limits. This would seem to indicate  the femoral, popliteal, and dorsalis pedis pulses were present and normal in amplitude and  vascular calcifications were not seen. These observations directly contradict the presumption of peripheral vascular disease.  Even granting the existence of circulatory deficit, the recommendation that you sleep with a heat pad applied to the foot as a trial form of therapy given to this mildly diabetic patient could easily lead to catastrophic loss of the foot. This advice ignores a basic tenet of foot care in the diabetic: avoidance of hot applications in any form.  As a diagnostic minimum, this patient should probably have nerve
Intracellular Signaling in the Gonads*
Authors: PETER C. K. LEUNG, GILLIAN L. STEELE
Journal: Endocrine Reviews (1992)

THE OVARY and testis share homology of structure and function in the production of gametes and in the regulation of steroidogenesis. The dependence of gametogenesis on local synthesis of steroids necessitates a greater understanding of which endocrine factors are involved, the mechanisms by which they act, and how they affect biosynthetic pathways. In view of the abundance of hormones involved in the regulation of steroid synthesis, the gonads provide an ideal model for the study of endocrine, paracrine, autocrine, and intracrine mechanisms. The aim of this review is to provide an updated examination of our knowledge of the factors involved in gonadal function and the intracellular signaling mechanisms by which they act. Both the ovary and the testis are characterized by two functionally separate compartments that facilitate the production of gametes and the synthesis of steroids and other gonadal hormones. The similarities of structure and function between theca interna and Leydig cells, and granulosa and Sertoli cells are well recognized (1–3). As illustrated in Fig. 1, granulosa (in ovary) and Sertoli cells (in testis) are separated from the theca interna and Leydig cells, respectively, by a basal lamina. They share in the ability to synthesize and secrete proteins and steroid hormones in response to FSH and to form a diffusion barrier between germ cells and substances in blood and lymph. Theca interna and Leydig cells have the common ability to synthesize and secrete steroids in response to peripherally derived LH.
INFLUENCE OF CHRONIC KIDNEY DISEASE ON THE EFFICACY OF PRIMARY PREVENTION IMPLANTABLE CARDIOVERTER DEFIBRILLATORS: A META-ANALYSIS OF THREE RANDOMIZED TRIALS
Authors: Patrick Hank Pun, Sana M. Al-Khatib, Rex Edwards, Gust Bardy, J. Thomas Bigger, Alfred Buxton, Arthur Moss, Kerry Lee, Richard Steinmann, Paul Dorian, Al Hallstrom, Riccardo Cappato, Alan Kadish, Peter Kudenchuk, Daniel Mark, Lurdes YT Inoue, Gillian D. Sanders
Journal: Journal of the American College of Cardiology (2013)
Effects of single nightly injections of growth hormone—releasing hormone (GHRH 1–29) in healthy elderly men
Authors: Janet Vittone, Marc R. Blackman, Jan Busby-Whitehead, Chris Tsiao, Kerry J. Stewart, Jordan Tobin, Tom Stevens, Michele F. Bellantoni, Marc A. Rogers, Gerhard Baumann, Jesse Roth, S.Mitchell Harman, Richard G.S. Spencer
Journal: Metabolism (1997)

Age-related reductions in growth hormone (GH) and insulin-like growth factor-I (IGF-I) may contribute to decreased muscle mass and strength in older persons. The relationship of this phenomenon to skeletal muscle bioenergetics has not been reported. We sought to determine whether administration of GH-releasing hormone (GHRH) would sustain increases in GH and IGF-I and improve skeletal muscle function and selected measures of body composition and metabolism. We measured GH secretion, muscle strength, muscle histology, and muscle energy metabolism by phosphorus nuclear magnetic resonance spectroscopy (31P-NMRS), body composition, and endocrine-metabolic functions before and after 6 weeks of treatment. Eleven healthy, ambulatory, non-obese men aged 64 to 76 years with low baseline IGF-I levels were treated at home as outpatients by nightly subcutaneous self-injections of 2 mg GHRH for 6 weeks. We measured GH levels in blood samples obtained every 20 minutes from 8:00 PM to 8:00 AM; Ann serum levels of IGF-I, IGF binding protein-3 (IGFBP-3), and GH binding protein (GHBP); muscle strength; muscle histology; the normalized phosphocreatine abundance, , and intracellular pH in forearm muscle by NMRS during both sustained and ramped exercise; body composition by dual-energy x-ray absorptiometry (DEXA); lipid levels; and glucose, insulin, and GH levels during an oral glucose tolerance test (OGTT). GHRH treatment increased mean nocturnal GH release (P < .02), the area under the GH peak ([AUPGH] P < .006), and GH peak amplitude (P < .05), with no change in GH pulse frequency or in levels of IGF-I, IGFBP-3, or GHBP Two of six measures of muscle strength, upright row (P < .02) and shoulder press (P < .04), and a test of muscle endurance, abdominal crunch (P < .03), improved. GHRH treatment did not alter exercise-mediated changes in or intracellular pH, but decreased or abolished significant relationships between changes in or pH and indices of muscle strength. GHRH treatment did not change weight, body mass index, waist to hip ratio, DEXA measures of muscle and fat, muscle histology, glucose, insulin, or GH responses to OGTT, or lipids. No significant adverse effects were observed. These data suggest that single nightly doses of GHRH are less effective than multiple daily doses of GHRH in eliciting GH- and/or IGF-I—mediated effects. GHRH treatment may increase muscle strength, and it alters baseline relationships between muscle strength and muscle bioenergetics in a manner consistent with a reduced need for anaerobic metabolism during exercise. Thus, an optimized regimen of GHRH administration might attenuate some of the effects of aging on skeletal muscle function in older persons.
CDC says 20% of US citizens visited an emergency department in 2007
Authors: J. H. Tanne
Journal: BMJ (2010)

The US Centers for Disease Control and Prevention reported that the demand for emergency services in the United States has been rising since 1996, although many emergency departments have been closing. The result is overcrowding and longer waits.

In 2007, there were 116.8 million visits to emergency departments, compared with 90.3 million in 1996. 

The report, which covers 2007, looks at how race and ethnicity, insurance status, age, family income, and urgency of need for care affected visits to emergency departments. It used data from the 2007 National Health Interview Survey and the 2007 …
Targeting JAK1/2 and mTOR in murine xenograft models of Ph-like acute lymphoblastic leukemia
Authors: Shannon L. Maude, Sarah K. Tasian, Tiffaney Vincent, Junior W. Hall, Cecilia Sheen, Kathryn G. Roberts, Alix E. Seif, David M. Barrett, I-Ming Chen, J. Racquel Collins, Charles G. Mullighan, Stephen P. Hunger, Richard C. Harvey, Cheryl L. Willman, Jordan S. Fridman, Mignon L. Loh, Stephan A. Grupp, David T. Teachey
Journal: Blood (2012)
Increased Resting Energy Expenditure in Hemodialysis Patients with Severe Hyperparathyroidism
Authors: Lilian Cuppari, Aluizio Barbosa de Carvalho, Carla Maria Avesani, Maria Ayako Kamimura, Rose[Combining Acute Accent]lia Ribeiro dos Santos Loba[Combining Tilde]o, Se[Combining Acute Accent]rgio Antonio Draibe
Journal: Journal of the American Society of Nephrology (2004)

Several metabolic derangements, including enhanced protein catabolism, have been suggested to be associated with increased circulating parathyroid hormone (PTH) in patients with secondary hyperparathyroidism (HPT). Such conditions, therefore, might lead to an increase in energy expenditure. The present study examined by indirect calorimetry the resting energy expenditure (REE) of 15 hemodialysis patients who have severe HPT (PTH = 1457 +/- 676 pg/ml) and were pair-matched for age and gender to 15 hemodialysis patients with mild to moderate HPT (PTH = 247 +/- 196 pg/ml). Both groups were also pair-matched for age and gender to a group of 15 healthy adult subjects (control). In six patients from the severe HPT group submitted to total parathyroidectomy, REE was determined 6 mo after the surgery. The groups were not different regarding lean body mass (LBM) measured by bioelectric impedance, serum C-reactive protein, and bicarbonate. Thyroid-stimulating hormone was within the normal range in all groups. Nonadjusted REE was significantly higher in the severe HPT group (1674 +/- 337 kcal/d) compared with patients with mild to moderate HPT (1388 +/- 229 kcal/d; P < 0.05). Both groups did not differ from the control group (1468 +/- 323 kcal/d). When adjustment of REE for LBM was performed using the multiple regression analysis, patients with mild to moderate HPT and control subjects had significantly lower REE (-231 and -262 kcal, respectively) than that of the severe HPT group. Considering all patients together, nonadjusted REE correlated directly with LBM (r = 0.61; P < 0.01). PTH correlated strongly with LBM in the severe HPT group (r = -0.82; P < 0.01). In the multiple linear regression analysis, only LBM and PTH were independent determinants of REE (n = 30; R(2) = 0.47). REE decreased significantly in the six patients who were evaluated 6 mo after parathyroidectomy (from 1617 +/- 339 to 1226 +/- 253; P = 0.02). These results demonstrate that hemodialysis patients with severe HPT have increased REE that might be reduced after parathyroidectomy.
PART II. PATHOLOGY
Authors: W. G. MacCallum
Journal: JAMA (1918)

The material for the following study was derived from thirty-seven necropsies performed on the bodies of patients who died in the base hospital of Fort Sam Houston, Texas. They were selected as cases of pneumonia, but in three of them it proved that death had resulted from other causes. Nevertheless, the lungs in these patients, as well as those from several other miscellaneous cases in which the necropsies were performed by the resident staff, were studied. The results are by no means easy to analyze, since there are many complications, many combinations of different infections, and many variations arising from differences in the stages of the disease at which the patient died. Briefly stated, however, it appears that two main types of bacterial infection are concerned. On the one hand, there are cases due to infection with one or another form of the pneumococcus; on the other hand, many cases
Ultrasoundcardiographic Studies of the Mitral Valve Region in Young Infants with Mitral Atresia, Mitral Stenosis, Hypoplasia of the Left Ventricle, and Cor Triatriatum
Authors: NILS-RUNE LUNDSTRÖM
Journal: Circulation (1972)

Reflected ultrasound has been used for investigation of the mitral valve region in early infancy. The material consists of two patients with mitral atresia, three patients with mitral stenosis and aortic valvular atresia, five patients with mitral and aortic valvular stenosis, one patient with cor triatriatum, and one patient with severe degree of aortic valvular stenosis with a normal mitral valve. The results are compared with ultrasoundcardiographic findings in ten infants without heart disease. A specific abnormal echo was obtained in cases with mitral atresia and cor triatriatum. The patients with a combination of mitral and aortic valvular lesions could be separated into two groups by means of ultrasoundcardiography. This separation reflected the functional state of the left ventricle based on the degree of mitral stenosis and hypoplasia of the left ventricle. This noninvasive technic has been found useful as a complementary method for the investigation of the mitral valve region. It can even be performed in seriously ill infants.
Steps toward mapping the human vasculature by phage display
Authors: Wadih Arap, Mikhail G. Kolonin, Martin Trepel, Johanna Lahdenranta, Marina Cardó-Vila, Ricardo J. Giordano, Paul J. Mintz, Peter U. Ardelt, Virginia J. Yao, Claudia I. Vidal, Limor Chen, Anne Flamm, Heli Valtanen, Lisa M. Weavind, Marshall E. Hicks, Raphael E. Pollock, Gregory H. Botz, Corazon D. Bucana, Erkki Koivunen, Dolores Cahill, Patricia Troncoso, Keith A. Baggerly, Rebecca D. Pentz, Kim-Anh Do, Christopher J. Logothetis, Renata Pasqualini
Journal: Nature Medicine (2002)
Wire-guided biliary cannulation should be considered to be standard practice
Authors: L. Fuccio, V. Cennamo
Journal: Endoscopy (2010)

We read with great interest the recent Expert approach paper by Bourke and co-workers [1] on biliary cannulation technique during endoscopic retrograde cholangiopancreatography (ERCP). The authors suggest that the wire-guided cannulation technique should be preferred to the contrast-assisted method because of several theoretical advantages. Indeed, deep biliary cannulation may easily be achieved using a soft-tipped, hydrophilic guide wire and fluoroscopically confirmed, avoiding potentially damaging pancreatic duct opacification.
Mapping of body surface potentials in patients with the idiopathic long QT syndrome.
Authors: L De Ambroggi, T Bertoni, E Locati, M Stramba-Badiale, P J Schwartz
Journal: Circulation (1986)

Body surface potential maps were recorded from 140 chest leads in 25 patients affected by the idiopathic long QT syndrome (LQTS) and in 25 healthy control subjects matched for age and sex. Potential time integrals of the QRST and ST-T intervals were calculated at each lead point and displayed as isointegral (ISOI) maps. The main abnormalities noted on the QRST and ST-T ISOI maps were one area of negative values larger than normal in the right anterior and inferior thorax and a complex multipeak distribution of the integral values. At least one abnormality was present in 19 (76%) of the patients with LQTS and four (16%) of the control subjects (p less than .001). Each ISOI map was also represented as a weighted sum of nine fundamental components (eigenvectors) to detect and quantitate the nondipolar content. The percent contribution of the nondipolar eigenvectors (all eigenvectors beyond the third) was significantly higher in the LQTS group than in the control group (p less than .005). Specifically, an abnormally high nondipolar content on the QRST ISOI maps was observed much more frequently for patients with LQTS than for control subjects (nine or 36% vs one or 4%), and this was also true on the ST-T ISOI maps (14 or 56% vs one or 4%). No correlation was found between the major abnormalities on body surface maps and syncopal episodes. However, the high prevalence (76%) of these alterations among the patients with LQTS and their infrequent occurrence in the control population strongly suggests that they may be useful markers for the diagnosis of atypical cases. The prominent electronegative area on the anterior thorax can be related to delayed repolarization of a portion of the anterior wall of the heart. This finding is in agreement with the hypothesis that lower than normal right cardiac sympathetic activity is the main pathogenetic mechanism of LQTS. Multipeak distribution and high nondipolar content suggest regional electrical disparities in the ventricular recovery process. This may in part account for the high susceptibility of patients with LQTS to malignant arrhythmias.
In black and pathless woods.
Authors: G Dunea
Journal: BMJ (1983)

Of the many souls doomed to languish in Dante's hell as thorny trees in a black and pathless wood, none inspire more pity than those that tore themselves violently from their bodies in their youth. For we like to look back on adolescence as a time of unbounded serenity and think it tragic that a young person should die in despair. Yet since time immemorial suicide has periodically erupted into epidemics, from the maidens who flocked to hang themselves in ancient Miletus to the young men in blue coats and yellow vests who rushed to die in sympathy with the unfortunate Werther.
Cultivation of a Novel Type of Common-cold Virus in Organ Cultures
Authors: D. A. J. Tyrrell, M. L. Bynoe
Journal: BMJ (1965)

Fourfold or eightfold rise.All sera were tested against influenza A, B, and C, para-influenza 1 and 3 by haemagglutination-inhibition test and against these plus para-influenza 2, mumps V and S antigen, respiratory syncytial virus, herpes simplex, adenoviruses, psittacosis, Rickettsia burnetii, Mycoplasma pneumoniae by complement-fixation test. Clinical Features of Colds Produced by B814 VirusThe frequency of some symptoms, clinical signs, and certain other data regarding volunteers who developed colds after inoculation with B814 material are listed in Table V.This shows that the illnesses were slightly more frequent, were more 1468 5 June 1965Common-cold Viruses-Tyrrell and Bynoe * In first passages control fluids were collected from uninoculated cultures har- vested and stored exactly as the test cultures.For later passages the control fluids were passed serially in parallel with the test cultures.t Identical volunteers