tbuckley/cabot-search huggingface dataset:
Direct assessment of right ventricular transmural pressure.
Authors: W P Santamore, M Constantinescu, W C Little
Journal: Circulation (1987)

Although the measurement of transmural pressure is important, calculation of transmural pressure is complicated by the difficulties in measuring pericardial pressure. Recently, flat balloons have been proposed to measure pericardial pressure. Over a wide range of volumes, right ventricular diastolic pressure and pericardial balloon pressure were similar in diastole, suggesting that the right ventricle is unstressed at physiologic volumes and that right atrial pressure can be used to estimate pericardial pressure. To evaluate these concepts and to assess indirectly the accuracy of measuring pericardial pressure using flat balloons, six canine hearts were examined postmortem. The pericardium was removed and the hearts were submerged in cold cardioplegic solution. Balloons were inserted into the right and left ventricles, and right and left ventricular pressure-volume curves were obtained. Right ventricular transmural pressures of 2.6 +/- 0.5, 3.9 +/- 0.9, 5.9 +/- 1.4, and 8.9 +/- 2.4 mm Hg were required to distend the right ventricle to 10, 20, 30, and 40 ml, respectively. For the left ventricle, transmural pressures of 3.4 +/- 0.7, 5.4 +/- 1.2, 8.6 +/- 2.1, and 14.1 +/- 3.8 mm Hg were recorded at volumes of 10, 20, 30, and 40 ml, respectively. Although the right ventricular transmural pressures were less than the left ventricular transmural pressures over the physiologic range, right ventricular transmural pressures were always positive and increased with increments in ventricular volume. Thus the right ventricle is not unstressed over the entire range of physiologic volumes, suggesting that pericardial balloon pressures may overestimate pericardial pressure and that right atrial pressure cannot be used to estimate pericardial pressure.
Tracheal Replacement with Aortic Allografts
Authors: Alain Wurtz, Henri Porte, Massimo Conti, Jacques Desbordes, Marie Christine Copin, Jacques Azorin, Emmanuel Martinod, Charles-Hugo Marquette
Journal: New England Journal of Medicine (2006)

To the Editor: We report tracheal replacement with fresh aortic allografts in two patients with large chemotherapy-resistant and radiotherapy-resistant tumors (mucoepidermoid and adenoid cystic car...
Impact of Computed Tomography on Subdural Hematoma
Authors: Michael Garraway, Rolland Dickson, Jack Whisnant, Teresa Turney
Journal: JAMA (1985)

The Mayo Clinic (Rochester, Minn) medical record linkage and indexing system was used to examine the impact of computed tomography (CT) on the diagnostic investigation, management, and outcome of all cases of subdural hematoma (SDH) that occurred in Olmsted County, Minnesota, from 1965 through 1980. Comparisons were made between an eight-year period prior to the introduction of CT (1965 through 1972) and a similar period after CT became available in this community (1973 through 1980). The advent of CT did not change the treatment, course of the disease, or prognosis of SDH. However, the introduction of CT had a marked effect on the pattern of neurological investigations carried out. This resulted in a 15% reduction in the cost of diagnosing SDH in this community, while the overall cost of health care in the United States rose by 87% during the same period.
CLINICAL, MORPHOLOGICAL AND BIOCHEMICAL STUDIES OF A VIRILIZING TUMOR IN THE TESTIS*
Authors: Kenneth Savard, Ralph I. Dorfman, Billy Baggett, Linda L. Fielding, Lewis L. Engel, Harry T. McPherson, Leonard M. Lister, David S. Johnson, Edwin C. Hamblen, Frank L. Engel
Journal: Journal of Clinical Investigation (1960)

Although there is considerable indirect evidence indicating that virilizing testicular tumors exert their effects by producing androgenic steroid hor- mones, few attempts have been made to determine the exact nature of the compounds produced.One type of tumor which exerts particularly marked virilizing effects when found in prepubertal boys is that classified as an interstitial cell tumor of the testes (1-21).It has been well established that * This work was supported by Contracts no.
Large Pleural Effusions Occurring after Coronary Artery Bypass Grafting
Authors: Richard W. Light
Journal: Annals of Internal Medicine (1999)

Background: Large pleural effusions sometimes occur after coronary artery bypass grafting (CABG), but their characteristics and clinical course are largely unknown. Objective: To describe the clinical course and pleural fluid findings in patients with large pleural effusions occurring after CABG. Design: Retrospective case series. Setting: Tertiary care, university-affiliated, nonprofit teaching hospital. Patients: 3707 patients who had CABG between 1 February 1996 and 1 August 1997. Measurements: Chest radiographs were reviewed, and information on pleural fluid findings, pleural effusion treatment, and cardiac surgery was obtained from medical records and a cardiac surgery database. Results: Pleural effusions that occupied more than 25% of the hemithorax were found in 29 patients (0.78%). Seven of the effusions were attributed to congestive heart failure, 2 were attributed to pericarditis, and 1 was attributed to pulmonary embolism. The explanation for the remaining 19 effusions was unclear. All but 2 effusions were predominantly left-sided. Of these 19 effusions, 8 were bloody and 11 were nonbloody. Bloody effusions usually occurred earlier, contained higher lactic acid dehydrogenase levels, and were frequently eosinophilic. Nonbloody effusions tended to be more difficult to manage. Conclusions: Large pleural effusions may develop in a small proportion of patients after CABG. The cause of many of these effusions is unclear. Most bloody effusions can be managed with one to three therapeutic thoracenteses. Resolution of nonbloody effusions may require anti-inflammatory agents, tube thoracostomy, or intrapleural injection of sclerosing agents. *For members of Cardiovascular Surgery Associates, PC, see the Appendix.
METEOROLOGICAL OBSERVATIONS ON CHOLERA
Authors: J. A. Hingeston
Journal: BMJ (1854)

OUL~inIL-:T e llustrtins wil, I trus, make evidet what I man by the term plasticity.e this prnciplo view, let us consider what takes place in th production of vaularity.At first, it is aditted that thee streamlets of blood pas thrugh mere channels in the scarcely concrete substance: thee i no distinct vessel, but this in ll probability is soon formed, in virtue of the same principle of coagulation at the surface.The surface of the little current becomes a tube.Where oppsite currents are established in such a
Angina Pectoris—200 Years.
Authors: Thomas M. Durant
Journal: Annals of Internal Medicine (1968)

s1 May 1968Angina Pectoris—200 Years.Thomas M. Durant, M.D., F.A.C.P.Thomas M. Durant, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-68-5-1153_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThis paper presented important facts and lessons to be learned from the history of angina pectoris on the two-hundredth anniversary of the initial description by Heberden. This was a predominantly British history.Heberden's Description:This was a classical example of accurate observation and clear description to which little could be added today. Included were [1] male predominance; [2] relationship of attack to exertion, emotion, meals; [3] location of distress and radiation; [4] angor animi; [5] instantaneous relief with rest; [6] general good health at beginning of illness, but often progression to attacks today recognized as infarction; and [7] the effect... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, Pennsylvania PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1968Volume 68, Issue 5Page: 1153-1154KeywordsAnginaEmotionsInfarction Issue Published: 1 May 1968 PDF DownloadLoading ...
Public health doctors vote for their faculty to oppose the health bill
Authors: M. Limb
Journal: BMJ (2012)

Members of the Faculty of Public Health have defied their leadership and voted for it to fight to oppose the Health and Social Care Bill.

The faculty announced on 26 January that it will be asking its entire membership in a survey whether it should continue its current approach of lobbying and pushing amendments to the bill.

Nearly 200 members attended a “passionate” emergency general meeting in Birmingham on 25 January. It was called to debate grass roots opposition to the governing board’s “inadequate” stance on the government’s health changes. 

The meeting was closed to the press; the BMJ spoke to faculty members beforehand and afterwards.

Alex Scott-Samuel, clinical senior lecturer in public health at Liverpool University and a …
The case for differential capitation fees based on age in British general practice.
Authors: D. M. Fleming
Journal: BMJ (1988)

A study was performed to assess whether the existing differential capitation fees for general practitioners accurately assess differential workloads. Data from the third morbidity study in general practice were used to compare capitation fees with relative workload in differing age and sex groups. The population mix which determined the payment by capitation for the 143 principals in the study provided the basis for examining the advantage or disadvantage the general practitioner got from the existing system. Capitation fees for the elderly underestimated the increased workload by 21% for those aged 65-74 and by 54% for those aged 75 or over but overestimated the workload for male adults aged up to 65. Nevertheless, 60% of the participating general practitioners were not advantaged or disadvantaged by more than 2.5% of their capitation fees (450 pounds a year for the average practitioner with a list of 2000 patients). Similarly 88% were not advantaged or disadvantaged by more than 5%; none were advantaged or disadvantaged by more than 10%. A three scale capitation fee for the age groups 0-64, 65-74, and 75 or over should be applied in the ratio of 3:5:7 rather than in the present ratio of 3:4:5, but given the present population mix in practices there is no case for differential capitation fees by sex or differential fees for the age group 0-4 years.
Case-control studies of relation between childhood cancer and neonatal vitamin K administration
Authors: S J. Passmore, G. Draper, P. Brownbill, M. Kroll
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objective</b>: To investigate the possible link between neonatal administration of intramuscular vitamin K and childhood cancer. <b>Design</b>: Matched case-control study. <b>Setting</b>: Selected large maternity units in England and Wales. <b>Subjects</b>: Children with cancer born 1968-85, diagnosed 1969-86; controls matched for sex, month of birth, and hospital of birth. <b>Main exposure measures</b>: Neonatal administration of vitamin K, length of gestation, birth weight, type of delivery, admission to special care baby unit. <b>Results</b>: After exclusion of cases with missing notes or unknown hospital vitamin K policy, 597 cases and matched controls were studied. Written records on the use of vitamin K were available for only about 40% of these, and to avoid possible bias from selective recording it was assumed that the stated hospital policy was followed. The association between cancer generally and intramuscular vitamin K was of borderline significance (odds ratio 1.44, P=0.05); the association was strongest for leukaemia. There was, however, also an effect of abnormal delivery, which could explain some of the findings. <b>Conclusions</b>: The lack of consistency between the various studies so far published, including this one, and the low relative risks found in most of them suggest that the risk, if any, attributable to the use of vitamin K cannot be large, but the possibility that there is some risk cannot be excluded. A comparison of the predicted consequences of various policies shows that even a 10% increase would imply that prophylaxis using the commonly recommended 1 mg intramuscular dose should be restricted to babies at particularly high risk of vitamin K deficiency bleeding; alternatively a lower dose might be given to a larger proportion of those at risk. <h3>Key messages</h3> Intramuscular vitamin K given to babies is known to be effective in the prevention of vitamin K deficiency bleeding but it has been suggested that these preparations, or one of their constituents, may increase the risk of childhood cancer Most studies have not shown a significant association between childhood cancer and vitamin K but are unable to exclude the possibility that its use increases the risk of childhood cancer by up to 10% Intramuscular vitamin K has been given to "high risk" babies as part of all the various prophylaxis policies in the United Kingdom; this should continue As a small risk cannot at present be excluded it seems prudent to recommend a policy of giving intramuscular vitamin K only to those babies at particularly high risk and giving it orally to others It is essential that a record should be made of whether or not vitamin K is given and of the preparation, route of administration, and dose
Effect of intense pulsed light treatment on human skin<i>in vitro</i>: analysis of immediate effects on dermal papillae and hair follicle stem cells
Authors: D. Larouche, D.H. Kim, G. Ratté, C. Beaumont, L. Germain
Journal: British Journal of Dermatology (2013)

Hair follicles house a permanent pool of epithelial stem cells. Intense pulsed light (IPL) sources have been successfully used for hair removal, but long-term hair reduction may require several treatments. Many questions remain regarding the impact of IPL treatment on the structure of the hair follicle, more specifically on hair follicular stem cells and dermal papilla cells, a group of specialized cells that orchestrate hair growth.To characterize the destruction of human hair follicles and surrounding tissues following IPL treatment, with more attention paid to the bulge and the bulb regions.Human scalp specimens of Fitzpatrick skin phototype II were exposed ex vivo to IPL pulses and were then processed for histological analysis, immunodetection of stem cell-associated keratin 19, and revelation of the endogenous alkaline phosphatase activity expressed in dermal papilla cells.Histological analysis confirmed that pigmented structures, such as the melanin-rich matrix cells of the bulb in anagen follicles and the hair shaft, are principally targeted by IPL treatment, while white hairs and epidermis remained unaffected. Damage caused by heat sometimes extended over the dermal papilla cells, while stem cells were mostly spared.IPL epilation principally targets pigmented structures. Our results suggest that, under the tested conditions, collateral damage does not deplete stem cells. Damage at the dermal papilla was observed only with high-energy treatment modalities. Extrapolated to frequently treated hairs, these observations explain why some hairs grow back after a single IPL treatment.
The Uses of Annual Meetings
Authors: C. H. Roper
Journal: BMJ (1876)

fact, although it only comprises one of our assertions regarding the normal urine of a healthy man, that we still find sterility of the urine rendered alkaline by letting fall into it a piece of solid potash, of determined weight, in the case of urine absolutely normal when dis- charged from the bladder, and collected with the precautions which I have indicated in the second chapter of my recent work on beer, in order to avoid the contact of atmospheric germs.Dr. Bastian is a conscientious seeker after truth.There is now no alternative conclusion.I have the firm hope that he will abandon his belief in spontaneous generation and in the proofs which he believes he has given of it.
Bacteremia After the Use of an Oral Irrigation Device
Authors: STEPHEN A. BERGER
Journal: Annals of Internal Medicine (1974)

Eight of 30 persons with normal-appearing gingiva developed bacteremia after using an oral irrigation device. In comparison, none of 30 persons using toothbrushes developed bacteremia. This difference is statistically significant and suggests that the use of an oral irrigation device is contraindicated in persons at risk of bacterial endocarditis.
Prevention Important in Soviet Antialcohol Efforts, but Medical Treatment Also Emphasized
Authors: Timothy F. Kirn
Journal: JAMA (1987)

ACCORDING TO OFFICIALS from the Soviet Union's All-Union Voluntary Temperance Promotion Society, their country's antialcohol campaign is a crusade to treat alcoholism by preventing it from occurring in the first place. One official made an analogy to preventing people from diving into a dangerous swimming hole. Either you can take your chances, he says, trying to find those who get into trouble and hopefully fishing them out in time, or you can block the access, preventing anyone from getting into danger. But that does not mean the Soviets are selling treatment short, officials insist. Soviet researchers and<i>vrachi</i>(physicians) have been making a concerted effort to explore new alcoholism treatment methods for the past four years, says A. M. Mockburev, MD, deputy minister of health. Many Soviet alcoholism specialists say they are watching alcoholism therapy in the United States closely, and they appear to be adopting some similar approaches. In
A patient's view: endoscopy
Authors: A. Samuels
Journal: BMJ (1995)

Unpleasant but not painful, said my general practitioner. “They knock you out,” said a general practitioner pal. I was deeply apprehensive of this examination. The endoscopy was done in a central London hospital because it is my university vacation and my doctor in Wales, now a budget holder, arranged for the examination. It is a credit to a national health scheme that the whole operation was carried out with such smooth efficiency. I received a clear leaflet, written in a tone of becalming reassurance, setting out the procedures for the investigation. It pointed out that there were slight variations, and I thought that a nice and intelligent touch. The leaflet, which was beginning to assume the position of a sacred text in my …
Renal Involvement in Organophosphate Poisoning
Authors: Gregory P. Wedin
Journal: JAMA (1984)

<h3>To the Editor.—</h3> The toxic potential of organophosphate insecticides resides in the anticholinesterase activity of these compounds. The resulting accumulation of acetylcholine in the body causes muscarinic (increased secretions, bradycardia, miosis, and vomiting), nicotinic (muscular twitching and weakness), and CNS manifestations (anxiety, drowsiness, and depression of respiratory and circulatory centers).<sup>1</sup>We wish to report a case in which renal involvement occurred in addition to the typical clinical picture. <h3>Report of a Case.—</h3> On Aug 31, 1983, a 26-year-old man came to a local emergency department about one hour after ingesting an 8-oz mixture of an unknown concentration of the organophosphate insecticide dimpylate (Diazinon) in water in an apparent suicide attempt. Physical examination revealed a conscious, oriented man with vomiting, diaphoresis, bradycardia (55 beats per minute), and hypoactive bowel sounds. An initial 3-mg total dose of atropine resulted in marked improvement of symptoms. The patient was admitted to the coronary
THE NOD MOUSE: A Model of Immune Dysregulation
Authors: Mark S. Anderson, Jeffrey A. Bluestone
Journal: Annual Review of Immunology (2004)

▪ Abstract Autoimmunity is a complex process that likely results from the summation of multiple defective tolerance mechanisms. The NOD mouse strain is an excellent model of autoimmune disease and an important tool for dissecting tolerance mechanisms. The strength of this mouse strain is that it develops spontaneous autoimmune diabetes, which shares many similarities to autoimmune or type 1a diabetes (T1D) in human subjects, including the presence of pancreas-specific autoantibodies, autoreactive CD4 + and CD8 + T cells, and genetic linkage to disease syntenic to that found in humans. During the past ten years, investigators have used a wide variety of tools to study these mice, including immunological reagents and transgenic and knockout strains; these tools have tremendously enhanced the study of the fundamental disease mechanisms. In addition, investigators have recently developed a number of therapeutic interventions in this animal model that have now been translated into human therapies. In this review, we summarize many of the important features of disease development and progression in the NOD strain, emphasizing the role of central and peripheral tolerance mechanisms that affect diabetes in these mice. The information gained from this highly relevant model of human disease will lead to potential therapies that may alter the development of the disease and its progression in patients with T1D.
Direct Intracoronary Evidence of Collateral Steal in Humans
Authors: Christian Seiler, Martin Fleisch, Bernhard Meier
Journal: Circulation (1997)

Background Coronary steal is defined as a fall in blood flow toward a certain vascular region in favor of another area during arteriolar vasodilatation, ie, a coronary flow velocity reserve (CFVR) &lt;1. The purpose of this study was to determine the frequency of steal in patients with a wide range of collateral supply to a vascular area of interest and to assess whether steal is associated with the amount of collateral flow. Methods and Results One hundred patients 57±9 years old with a coronary artery stenosis to be dilated were examined with intracoronary (IC) Doppler guidewires. IC adenosine–induced CFVR&lt;1 obtained distal to the stenosis was defined as steal. An index for collateral flow was determined by positioning the Doppler guidewire in the collateral-dependent vessel distal to the stenosis and measuring the flow velocity time integral during (Vi occl , cm) and after (Vi ø-occl ) balloon occlusion. Vi occl /Vi ø-occl was determined without and with intravenous adenosine (140 μg · kg −1 · min −1 ). Coronary steal occurred in 10 of 100 patients. Patients with steal showed superior collaterals compared with those without steal: Vi occl /Vi ø-occl =0.65±0.24 in patients with steal versus 0.29±0.18 in those without steal ( P =.0001). In all patients with steal, there was a reduction in collateral flow during intravenous adenosine–induced hyperemia, whereas in the majority (70%) of patients without steal, collateral flow increased or remained unchanged during hyperemia. Conclusions Coronary steal assessed by intracoronary Doppler flow velocity measurements occurs in 10% of patients with a wide range of coronary collaterals to the vascular area from which blood flow is redistributed. There is a direct association between the presence of steal away from and the amount of collateral flow toward the region under investigation. Collateral flow to the vascular region studied decreases during adenosine-induced hyperemia, which indicates a mechanism of steal via the extensive collaterals.
THE RELATION OF THE MEDICAL PROFESSION TO THE PUBLIC.
Authors: U. GRANT GIFFORD
Journal: JAMA (1896)

The stream rises no higher than its source, the fabric partakes of the color and character of its component fibers; and the medical profession is no exception to this rule. Certainly it is not to be denied that medicine stands sponsor for much that is intimately associated with human progress, happiness and well-being. We look with satisfaction at the record of medical science and point proudly to her achievements in the relief of human suffering and in the prolongation of human life. Vaccination, anesthesia and antiseptics compare well with any of the discoveries that grace the annals of human progress in any field. Pathology and bacteriology have thrown beneficent light on many of the hidden problems and have placed some of the older tenets of medical faith on a scientific basis. In the virgin but fertile field of preventive medicine a few furrows have been turned, some seed scattered, and