tbuckley/cabot-search huggingface dataset:
Comparison of blood-flow velocity waveforms in different coronary artery bypass grafts. Sequential saphenous vein grafts and internal mammary artery grafts.
Authors: T Fujiwara, F Kajiya, S Kanazawa, S Matsuoka, Y Wada, O Hiramatsu, M Kagiyama, Y Ogasawara, K Tsujioka, T Katsumura
Journal: Circulation (1988)

Characteristics of blood-flow velocities were investigated at different sites in two types of coronary artery bypass grafts, sequential saphenous vein grafts (SSVG) and internal mammary artery grafts (IMAG). The latter appear to have the longest life span. The patency rate of the side-to-side anastomosis of the SSVG is better than that of the end-to-side anastomosis. The SSVG was anastomosed to the major diagonal branch by side-to-side anastomosis and to the left anterior descending coronary artery (LAD) by end-to-side anastomosis in 13 patients who had 75-100% and 75-90% stenoses in the LAD and major diagonal branch, respectively. IMAG anastomoses were performed to the LAD in 10 patients with 75-100% stenoses of the artery. The blood-flow velocities were measured by the 20-MHz, eighty-channel ultrasound pulsed Doppler method during surgery. In six patients in the SSVG group, we investigated the configuration of velocity profiles at the region just proximal to the side-to-side anastomosis and at the bridge portion between the side-to-side and end-to-side anastomosis. In the other seven patients, we measured the blood-flow velocity at several centimeters proximal to the side-to-side anastomosis and compared it with that in the IMAG. At the region just proximal to the side-to-side anastomosis, the velocity profile skewed toward the anastomosis side wall in all patients, and the flow velocity near the wall opposite to the side-to-side anastomosis was reversed in five of six patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Hypertension and ethnic group: Not as simple as black or white
Authors: Onyebuchi E Okosieme
Journal: BMJ (2006)

EDITOR—Brown makes a case for making treatment choices in patients with hypertension on the basis of ethnic group.1 However, it is unclear if his use of the term ethnic group refers to skin pigmentation or common ancestry. Common ancestry would certainly be difficult to accurately determine from the clinical encounter, and the usefulness of skin pigmentation would …
Alteplase given 3 to 4.5 hours after stroke reduced disability and improved global outcome
Authors: Michael D. Hill
Journal: Annals of Internal Medicine (2009)

ACP Journal Club20 January 2009Alteplase given 3 to 4.5 hours after stroke reduced disability and improved global outcomeMichael D. Hill, MD, MSc, FRCPCMichael D. Hill, MD, MSc, FRCPCHotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (M.D.H.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-2-200901200-02013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Source CitationHacke W, Kaste M, Bluhmki E, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med. 2008;359:1317-29. https://pubmed.ncbi.nlm.nih.gov/18815396Clinical Impact RatingsGIM/FP/GP: Emergency Med: Hospitalists: Hematology: Neurology: References1 Hacke W, Donnan G, Fieschi C, et al. Association of outcome with early stroke treatment: pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet. 2004;363:768-74. [PMID: 15016487] Google Scholar2 Dzialowski I, Hill MD, Coutts SB, et al. Extent of early ischemic changes on computed tomography (CT) before thrombolysis: prognostic value of the Alberta Stroke Program Early CT Score in ECASS II. Stroke. 2006;37:973-8. [PMID: 16497977] Google Scholar Author, Article, and Disclosure InformationAffiliations: Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (M.D.H.)This article was published at Annals.org on 6 January 2009. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByCost-Effectiveness of Optimizing Acute Stroke Care Services for Thrombolysis 20 January 2009Volume 150, Issue 2Page: JC1-13KeywordsComputed axial tomographyIschemic strokePlateletsSafetyStrokeTrauma surgery ePublished: 20 January 2009 Issue Published: 20 January 2009 CopyrightCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
The Possible Dangers of Intramuscular Succinylcholine
Authors: Francis F. Foldes
Journal: JAMA (1961)

DESPITE the relatively few articles referring to the intramuscular use of succinylcholine,<sup>1-3</sup>this technique has been employed with increasing frequency in the last few years. Investigation of the neuromuscular effect of 4.0 mg. of intramuscular succinylcholine per kilogram of body weight in adults<sup>4</sup>revealed that this dose produced apnea of 14.7 ± 1.5 minutes' duration in 155 ± 15.6 seconds. The tidal volume of respiration returned to control in 30.3 ± 2.1 minutes. It had been reported earlier that the duration of action of intravenously injected succinylcholine was inversely proportional to the plasma cholinesterase level in patients who had severe cirrhosis of the liver.<sup>5</sup>It is also known that the neuromuscular effects of intravenous succinylcholine are excessively prolonged, out of proportion to the decrease of the plasma cholinesterase level, in seemingly normal subjects whose plasma cholinesterase is "atypical."<sup>6</sup>The relationship between the enzymatic hydrolysis rate of
Meditation Programs for Psychological Stress and Well-being
Authors: Madhav Goyal, Sonal Singh, Erica M. S. Sibinga, Neda F. Gould, Anastasia Rowland-Seymour, Ritu Sharma, Zackary Berger, Dana Sleicher, David D. Maron, Hasan M. Shihab, Padmini D. Ranasinghe, Shauna Linn, Shonali Saha, Eric B. Bass, Jennifer A. Haythornthwaite
Journal: JAMA Internal Medicine (2014)

<h3>Importance</h3> Many people meditate to reduce psychological stress and stress-related health problems. To counsel people appropriately, clinicians need to know what the evidence says about the health benefits of meditation. <h3>Objective</h3> To determine the efficacy of meditation programs in improving stress-related outcomes (anxiety, depression, stress/distress, positive mood, mental health–related quality of life, attention, substance use, eating habits, sleep, pain, and weight) in diverse adult clinical populations. <h3>Evidence Review</h3> We identified randomized clinical trials with active controls for placebo effects through November 2012 from MEDLINE, PsycINFO, EMBASE, PsycArticles, Scopus, CINAHL, AMED, the Cochrane Library, and hand searches. Two independent reviewers screened citations and extracted data. We graded the strength of evidence using 4 domains (risk of bias, precision, directness, and consistency) and determined the magnitude and direction of effect by calculating the relative difference between groups in change from baseline. When possible, we conducted meta-analyses using standardized mean differences to obtain aggregate estimates of effect size with 95% confidence intervals. <h3>Findings</h3> After reviewing 18 753 citations, we included 47 trials with 3515 participants. Mindfulness meditation programs had moderate evidence of improved anxiety (effect size, 0.38 [95% CI, 0.12-0.64] at 8 weeks and 0.22 [0.02-0.43] at 3-6 months), depression (0.30 [0.00-0.59] at 8 weeks and 0.23 [0.05-0.42] at 3-6 months), and pain (0.33 [0.03- 0.62]) and low evidence of improved stress/distress and mental health–related quality of life. We found low evidence of no effect or insufficient evidence of any effect of meditation programs on positive mood, attention, substance use, eating habits, sleep, and weight. We found no evidence that meditation programs were better than any active treatment (ie, drugs, exercise, and other behavioral therapies). <h3>Conclusions and Relevance</h3> Clinicians should be aware that meditation programs can result in small to moderate reductions of multiple negative dimensions of psychological stress. Thus, clinicians should be prepared to talk with their patients about the role that a meditation program could have in addressing psychological stress. Stronger study designs are needed to determine the effects of meditation programs in improving the positive dimensions of mental health and stress-related behavior.
306 STRATEGY TO OVERCOME CHEMORESISTANCE IN HEPATOCELLULAR TUMOURS BY ENHANCING THE EXPRESSION OF THE DRUG TRANSPORTER OATP1B1
Authors: O. Briz, E. Herraez, L. Sanchez-Vicente, J. Vaquero, E. Lozano, S. Jimenez, B. Castaño, J.J.G. Marin
Journal: Journal of Hepatology (2012)
Abnormal FDG PET Imaging in Tuberculosis Appearing Like Lymphoma
Authors: Yen-Kung Chen, Yeh-You Shen, Chia-Hung Kao
Journal: Clinical Nuclear Medicine (2004)

A 57-year-old woman had a history of rheumatic heart disease after mitral valve replacement, afternoon chills and fever for 3 weeks, and weight loss of 12 kg in 1 month. She underwent a gallium scan and subsequently an F-18 FDG PET study. A gallium scan revealed vague uptake in bilateral neck, axillary, and hilar lymph nodes; and the spleen. F-18 FDG PET showed increased uptake in the bilateral neck, axillary, and hilar lymph nodes; the spleen; and the left inguinal, right external and common iliac and para-aortic lymph nodes. However, mycobacterium tuberculosis growth was found in the sputum culture. After antituberculosis treatment for 3 months, a repeat FDG PET scan showed remission of most of the lesions.
The Aetiology of the Hyperventilation Syndrome
Authors: J.M. Pfeffer
Journal: Psychotherapy and Psychosomatics (1978)

The aetiology of the hyperventilation syndrome is reviewed with special emphasis on psychological aspects. Early reports linking overbreathing and the emotions can be found as far back as the 16th century. During the last 50 years research has been carried out into respiration in psychiatric disorders but as far as the hyperventilation syndrome is concerned there have been few psychiatric studies. Though many people believe that hyperventilation occurs as a response to anxiety, it has recently been suggested that it is due to a bad breathing habit. Whichever view should prove to be correct, most people would agree that the distressing symptoms produced by hyperventilation may themselves cause anxiety and exacerbate the hyperventilation, thus setting up a vicious circle. By the time the patient presents, this vicious circle has usually become established.
Compound Mutations
Authors: Peter Westenskow, Igor Splawski, Katherine W. Timothy, Mark T. Keating, Michael C. Sanguinetti
Journal: Circulation (2004)

Long QT syndrome (LQTS) predisposes affected individuals to sudden death from cardiac arrhythmias. Although most LQTS individuals do not have cardiac events, significant phenotypic variability exists within families. Probands can be very symptomatic. The mechanism of this phenotypic variability is not understood.Genetic analyses of KVLQT1, HERG, KCNE1, KCNE2, and SCN5A detected compound mutations in 20 of 252 LQTS probands (7.9%). Carriers of 2 mutations had longer QTc intervals (527+/-54 versus 489+/-44 ms; P<0.001); all had experienced cardiac events (20 of 20 [100%] versus 128 of 178 [72%]; P<0.01) and were 3.5-fold more likely to have cardiac arrest (9 of 16 [56%] versus 45 of 167 [27%]; P<0.01; OR, 3.5; 95% CI, 1.2 to 9.9) compared with probands with 1 or no identified mutation. Two-microelectrode voltage clamp of Xenopus oocytes was used to characterize the properties of variant slow delayed rectifier potassium (I(Ks)) channels identified in 7 of the probands. When wild-type and variant subunits were coexpressed in appropriate ratios to mimic the genotype of the proband, the reduction in I(Ks) density was equivalent to the additive effects of the single mutations.LQTS-associated compound mutations cause a severe phenotype and are more common than expected. Individuals with compound mutations need to be identified, and their management should be tailored to their increased risk for arrhythmias.
The functional significance of dobutamine-induced ST-segment elevation before and after coronary artery bypass grafting in patients with old Q wave myocardial infarction
Authors: A. Elhendy, J.H. Cornel, J.R.T.C. Roelandt, P.R. Nierop, G.M. El-Satd, M.M. Ibrahim, J.D. Kasprzak, R.T. van Domburg
Journal: Journal of the American College of Cardiology (1998)
The role of mepolizumab in atopic and nonatopic severe asthma with persistent eosinophilia
Authors: Hector Ortega, Geoffrey Chupp, Philip Bardin, Arnaud Bourdin, Gilles Garcia, Benjamin Hartley, Steve Yancey, Marc Humbert
Journal: European Respiratory Journal (2014)

To the Editor: 

Atopy is a common finding in asthma, but at least one third of severe asthmatics have no evidence of atopy (so-called “intrinsic” asthma) [1]–[4]. Despite the uncertainty of the mechanisms leading to nonatopic asthma, these patients have no history of allergic respiratory disease, no detectable specific IgE to common aeroallergens, and no positive skin-prick test. One hypothesis suggests that differences in the phenotypes might be driven by the local, and not by the systemic, production of IgE [5]. Eosinophils are involved in diverse inflammatory responses irrespective of atopy. Eosinophilic inflammation and IgE production are promoted by T-helper cell (Th)2 cytokines, such as interleukin (IL)-5, IL-4 and IL-13. IL-4/IL-13 are major factors involved in Th2 differentiation and IgE class switching [6], while IL-5 is involved primarily in eosinophil growth, survival, activation, and in mediating inflammation.

Recurrent asthma exacerbations are a major problem in some patients and can predominate in a subgroup of asthmatics with elevated eosinophils, irrespective of their atopic status [2], [7]. Mepolizumab, a humanised monoclonal antibody against IL-5, selectively inhibits eosinophilic airway inflammation and has been shown to be associated with a significant reduction in severe asthma exacerbations irrespective of the baseline IgE levels or radioallergosorbent test (RAST) status in the Dose Ranging Efficacy And safety with Mepolizumab in severe asthma (DREAM) trial [7]. In this post hoc analysis of the DREAM trial, we aimed to: examine and discuss the effect of treatment with mepolizumab on the frequency of exacerbations in the atopic and nonatopic subgroups; to present the analyses of seasonal patterns of response by subgroup; and to evaluate changes in lung function and exhaled nitric oxide fraction ( F eNO) according to subgroup. Specific details …
Acute Myocardial Infarction Secondary to Thromboembolism from a Fractured Prosthetic Aortic Valve
Authors: FREDARICK L. GOBEL, HENRY M. HAWKINS, RUSSELL HANSON, YANG WANG
Journal: Circulation (1968)

A case of coronary artery embolism from thrombus in a fracture in an aortic Starr-Edwards prosthesis was documented at necropsy. This 40-year-old white man had replacement of the aortic and mitral valves by ball-valve prostheses 5 years prior to his death. Following surgery, he was able to return to full-time work. He did not return for follow-up for 2 years, and when next seen he had an acute myocardial infarction and left ventricular failure. An embolus to the left anterior descending coronary artery was demonstrated at the postmortem examination. The mitral ball was intact, but the aortic ball had two large fractures which contained thrombi.
Mortality Rates in Elderly Patients Who Take Different Angiotensin-Converting Enzyme Inhibitors after Acute Myocardial Infarction: A Class Effect?
Authors: Louise Pilote, Michal Abrahamowicz, Eric Rodrigues, Mark J. Eisenberg, Elham Rahme
Journal: Annals of Internal Medicine (2004)

Background: Several randomized, controlled trials show that angiotensin-converting enzyme (ACE) inhibitors improve survival in patients who have had an acute myocardial infarction. However, existing data from trials do not address whether all ACE inhibitors benefit patients similarly. Objective: To evaluate whether all ACE inhibitors are associated with similar mortality in patients 65 years of age or older who have had an acute myocardial infarction. Design: Retrospective cohort study that used linked hospital discharge and prescription databases containing information on 18 453 patients 65 years of age or older who were admitted for an acute myocardial infarction between 1 April 1996 and 31 March 2000. Setting: 109 hospitals in Quebec, Canada. Patients: 7512 patients who filled a prescription for an ACE inhibitor within 30 days of discharge and who continued to receive the same drug for at least 1 year. Measurements: The association between the specific drugs and clinical outcomes was measured by using Cox proportional hazards models, with adjustment for demographic, clinical, physician, and hospital variables and dosage categories, represented by time-dependent variables. Results: Enalapril, fosinopril, captopril, quinapril, and lisinopril were associated with higher mortality than was ramipril; the adjusted hazard ratios and 95% CIs were 1.47 (95% CI, 1.14 to 1.89), 1.71 (CI, 1.29 to 2.25), 1.56 (CI, 1.13 to 2.15), 1.58 (CI, 1.10 to 2.82), and 1.28 (CI, 0.98 to 1.67), respectively. The adjusted hazard ratio associated with perindopril was 0.98 (CI, 0.60 to 1.60). Limitations: The administrative databases did not contain detailed clinical information, and unmeasured factors associated with a patient's risk for death may have influenced physicians' prescription choices. Conclusion: Survival benefits in the first year after acute myocardial infarction in patients 65 years of age or older seem to differ according to the specific ACE inhibitor prescribed. Ramipril was associated with lower mortality than most other ACE inhibitors.
Cyanosis in an Infant With Visceral Anomalies
Authors: Robert A. Nebesar, James J. Pollard
Journal: JAMA (1964)

Dr. Frederick Rundlett: This was the first Massachusetts General Hospital admission of a 9-month-old female who had had cyanosis and spells of apnea since birth. The patient was the product of an uncomplicated pregnancy and delivery, with respiratory difficulty appearing after birth. She had occasional apneic spells and her skin was cyanotic in color, especially during periods of crying. When the patient was 2 months old the family noted increasing duskiness, especially with frequent crying at night. During the week prior to admission she had periods of rigidity and apnea lasting for approximately 30 seconds. An x-ray examination of the chest revealed an enlarged heart, and the patient was referred here. Physical examination revealed a poorly developed, cyanotic child who became deeply blue when crying. The heart rate varied from 160 to 180 beats per minute. The respiratory rate was 40 per minute while at rest, but 80 when active.
Autologous Blood Transfusion-Reply
Authors: Ross H. Weaver
Journal: JAMA (1987)

<h3>In Reply.—</h3> The recommendation for antibody screening, serological testing for syphilis, and hepatitis B surface antigen screening is taken directly from the cited reference.<sup>1</sup>Most blood banks require ABO and Rh group testing and antibody screening because of their inherent concern about possible complications and blood mix-ups. The remaining tests are ordered more to protect blood bank personnel than for patient care. Crossmatching is expensive and is not required. However, it is recognized that crossmatching is currently done at many centers with ongoing autologous transfusion programs. Dr Schmidt and I agree in our goal of establishing autologous blood transfusions as a regular form of transfusion therapy.
Metabolic Effects of a Growth Hormone–Releasing Factor in Patients with HIV
Authors: Julian Falutz, Soraya Allas, Koenraad Blot, Diane Potvin, Donald Kotler, Michael Somero, Daniel Berger, Stephen Brown, Gary Richmond, Jeffrey Fessel, Ralph Turner, Steven Grinspoon
Journal: New England Journal of Medicine (2007)

Visceral adipose tissue accumulates during antiretroviral therapy in many patients who are infected with the human immunodeficiency virus (HIV); this process is associated with an increased cardiovascular risk. We assessed the use of a growth hormone–releasing factor analogue, tesamorelin, to decrease visceral adiposity.
Management of penetrating stab wounds of the chest: an assessment of the indications for early operation.
Authors: F A Sandrasagra
Journal: Thorax (1978)

Haemothorax, haemopneumothorax, and pneumothorax were the most common complications in 85 patients with penetrating stab injuries of the chest. These complications were amenable to conservative treatment by aspiration or drainage of the pleural space. Immediate operation was indicated in 30 cases. Indications for surgery were haemorrhage from a major systemic or pulmonary vessel or the heart, cardiac tamponade, diaphragmatic penetration, oesophageal and bronchial tears, and sucking chest wounds. The need for immediate operation was clinically obvious at presentation in most cases. It should have been suspected from the situation of the entry wound, the nature of the weapon used, the size of the haemothorax, and the clinical findings in the others. All 11 deaths occurred in that group in which early operation was indicated, and some could have been averted had the need for operation been suspected early. Seven patients developed an empyema; five were in the group that required immediate surgery and in the other two infection occurred in a clotted haemothorax. Early repair of the associated visceral injuries and complete evacuation of a haemothorax, either fluid or clotted, could reduce the incidence of empyema.
Methotrexate-lnduced Ventriculitis: Appearance on Routine Radionuclide Scan and Emission Computed Tomography
Authors: P TODD MAKLER, MATTHEW F. GUTOWICZ, DAVID E. KUHL
Journal: Clinical Nuclear Medicine (1978)

A 9-year-old boy with acute lymphocytic leukemia underwent intrathecal methotrexate (MTX) treatment over a period of one year because of CNS symptoms. After a sudden rapid deterioration, radionuclide imaging demonstrated marked ventricular wall concentration, presumed related to MTX toxicity. After cessation of MTX treatment, the patient improved, and subsequent radionuclide images reverted to normal appearance.
Courvoisier's Gallbladder
Authors: Peter J. Bromley, Frederick S. Keller
Journal: New England Journal of Medicine (2001)

Figure 1. A 55-year-old man had a one-month history of painless jaundice. Endoscopic ultrasonography showed a 2.5-cm lesion in the head of the pancreas. Biopsy of the pancreas confirmed the diagnosis of adenocarcinoma. A digital subtraction angiographic evaluation showed a markedly enlarged gallbladder, extending far below the costal margin. A pylorus-sparing Whipple's procedure was performed, and the patient recovered without serious complications. The resected gallbladder measured 14 by 5 cm (normal size, 7 to 10 by 3 cm) and contained no stones. Although Ludwig Courvoisier's famous observations on the relation between obstruction of the common bile duct and the size . . .
Arrhythmias induced by device antitachycardia therapy due to diagnostic nonspecificity
Authors: Nancy J. Johnson, Francis E. Marchlinski
Journal: Journal of the American College of Cardiology (1991)

New technology has produced automatic cardioverter-defibrillators capable of delivering antitachycardia pacing, as well as low and high energy shocks and backup bradycardia pacing. These expanded treatment options have led to a wider range of clinical applications for such devices, including the treatment of ventricular tachycardias with longer cycle lengths, which may overlap the cycle lengths of some supraventricular arrhythmias. The diagnostic capability of these devices, although improved, has not advanced sufficiently to ensure reliable discrimination between all supraventricular and ventricular arrhythmias. Two cases are presented in which device-mediated pacing therapy, triggered by supraventricular arrhythmias, induced ventricular tachycardia requiring additional therapeutic intervention. This report illustrates the therapeutic versatility and some of the potential pitfalls, of the recently developed devices and reviews the status of automatic arrhythmia identification technology.