tbuckley/cabot-search huggingface dataset:
Long-Term Follow-Up of Individuals With the Electrocardiographic Pattern of Right Bundle-Branch Block and ST-Segment Elevation in Precordial Leads V <sub>1</sub> to V <sub>3</sub>
Authors: Josep Brugada, Ramon Brugada, Charles Antzelevitch, Jeffrey Towbin, Koonlawee Nademanee, Pedro Brugada
Journal: Circulation (2002)

Background — The electrocardiographic pattern of right bundle-branch block with ST-segment elevation in leads V 1 to V 3 is increasingly recognized among patients who have aborted sudden cardiac death, but also in asymptomatic individuals, raising questions about its prognostic significance. Methods and Results — The clinical, electrophysiological, and follow-up data of 334 patients with the Brugada phenotype were analyzed. A total of 79 women and 255 men with a mean age at diagnosis of 42±16 years were studied. The abnormal ECG was recognized after a resuscitated cardiac arrest in 71 patients (group A), after a syncopal episode in 73 patients (group B), and in 190 asymptomatic individuals (group C). Sustained ventricular arrhythmias were inducible in 83%, 63%, and 33% of patients in group A, group B, and group C, respectively. During 54±54 and 26±36 months of follow-up, respectively, 62% of patients in group A and 19% of group B patients had a new arrhythmic event. Inducibility of ventricular arrhythmias was the only predictor of arrhythmia occurrence in both groups. During a mean follow-up of 27±29 months, 8% of group C individuals had a first arrhythmic event. In these individuals, inducibility of ventricular arrhythmias and a basal abnormal ECG were predictors of arrhythmia occurrence. Conclusions — An ECG showing right bundle-branch block and ST-segment elevation in the right precordial leads is a marker of malignant ventricular arrhythmias and sudden death. Recurrence of malignant arrhythmias is high after the occurrence of symptoms. Among asymptomatic individuals, those with a spontaneously abnormal ECG and inducible to ventricular arrhythmias have the poorer prognosis.
Oral Contraceptives, Serum Folate, and Hematologic Status
Authors: Gary Merritt
Journal: JAMA (1975)

<h3>To the Editor.—</h3> Authors of a recent BRIEF REPORT (231:731, 1975) must be commended for their simple and clear data presentation. I have, however, a few observations that should be taken into account, as their data enter the growing list of publications on the topic of the impact of contraceptive hormones on micronutrient metabolism. While I am eager to accept their conclusion that "the incidence of subnormal serum folate values was no greater in the group using oral contraceptives than in the control group...," their data do not reinforce this propositon.<i>Incidence</i>is not studied, since only one measurement series was obtained and no changes were investigated; ie, the study was cross-sectional, not prospective. There was no<i>control</i>group, only a group of patients self-selected into the category of "any contraceptive method other than birth control pills," whose inclusion permits comparison but not control. Of most interest, however, is the
Making too much of a weak case
Authors: B. E. C. Nordin, R. M. Daly, J. Horowitz, A. V. Metcalfe
Journal: BMJ (2010)

The paper by Bolland and colleagues is seriously flawed in many respects, the first being its misleading title.1 It is not a meta-analysis in the usually accepted sense—that is, a review of published trials. Most of the data are unpublished, were obtained by direct request from the relevant authors, and are impossible to investigate independently.

The review provides some …
TCT-185 Three-Year Safety And Efficacy Of Newer Generation Limus-Eluting Stents Compared To Bare Metal Stents and First-Generation Sirolimus-eluting Stents In Patients With Acute Coronary Syndrome
Authors: Alfazir Omar, Hironori Kitabata, lakshmana Pendyala, Marco A. Magalhaes, Joshua P. Loh, Israel Barbash, Salem Badr, Sa'ar Minha, Hideaki Ota, Fang Chen, Rebecca Torguson, Kenneth Kent, Augusto Pichard, Lowell F. Satler, William O. Suddath, Ron Waksman
Journal: Journal of the American College of Cardiology (2013)
Differential Leukotriene Constrictor Responses in Human Atherosclerotic Coronary Arteries
Authors: Sean Allen, Michael Dashwood, Karen Morrison, Magdi Yacoub
Journal: Circulation (1998)

Leukotrienes are a class of biologically active lipids that have potent effects on the heart. To assess their role in coronary artery disease, we compared the contractile responses of leukotriene C4 (LTC4) and leukotriene D4 (LTD4) and their binding activity in both atherosclerotic and nonatherosclerotic human coronary arteries. We also studied expression of the enzymes that control their formation to understand how the 5-lipoxygenase (5-LO) pathway is activated in the coronary arteries.The capacity of leukotrienes to affect coronary vessel tone and the influence of atherosclerosis was tested in organ baths. Leukotriene receptors were examined by autoradiography, and antibody binding to the various enzymes responsible for their formation was assessed by use of immunocytochemistry. Nonatherosclerotic coronary artery ring segments were unresponsive to LTC4 and LTD4. In contrast, LTC4 and LTD4 induced concentration-dependent contractions in atherosclerotic coronary arteries. Specific [3H]-LTC4 but not LTD4 binding to atherosclerotic coronary artery was evident, with no evidence of specific binding of [3H]-leukotrienes to nonatherosclerotic coronary artery. High-resolution autoradiography identified specific [3H]-LTC4 binding sites to smooth muscle cell and to regions of intimal proliferation and plaque. Cells showing positive antibody binding to 5-LO, FLAP (5-lipoxygenase activating protein), and leukotriene A4 hydrolase were also present in the coronary arteries and had a similar distribution to macrophages.Atherosclerosis is associated with a specific leukotriene receptor(s) capable of inducing hyperreactivity of human epicardial coronary arteries in response to LTC4 and LTD4.
Mechanism of the ventilatory response to carbon monoxide.
Authors: T V Santiago, N H Edelman
Journal: Journal of Clinical Investigation (1976)

The effects of carbon monoxide on ventilation were studied in unanesthetized goats. Responses to single breaths of 10-25% CO in O2, which rapidly raised carboxyhemoglobin (COHb) from 5 to 60%, were considered to reflect peripheral chemoreceptor-mediated reflexes whereas responses to continuous inhalation of 1% CO in O2, which slowly raised COHb from 0 to 60%, were considered to reflect both peripheral chemoreceptor and nonperipheral chemoreceptor mechanisms. In each of six goats, single breaths of CO failed to elicit any immediate ventilatory response. However, slow buildup of carboxyhemoglobinemia in the same animals always elicited ventilatory stimulation (from a mean of 7.43 to 16.02 liter/min, P less than 0.001) beginning 5-6 min after onset of 1% CO in O2 inhalation when COHb saturation reached 50-60%. In eight studies of six animals HCO3- concentration fell (from 21.3 to 15.8 meq/liter; P less than 0.001) and lactate concentration rose (from 2.5 to 4.2 meq/liter; P less than 0.05) in the cisternal cerebrospinal fluid during the CO-induced hyperpnea. Additional studies ruled out ventilatory stimulation from left heart failure or enhanced chemo-sensitivity to carbon dioxide. Although the delayed hyperpnea was associated with a hyperdynamic cardiovascular response to CO, blockade of these circulatory effects with propranolol (2 mg/kg) failed to abolish the delayed hyperpnea; however, the propranolol did unmask an element of ventilatory depression which preceded the hyperpnea. Conclusions were: (a) hyperventilation in response to CO inhalation is not mediated by the carotid bodies; (b) the delayed hyperpnea in response to CO inhalation is primarily due to brain-cerebrospinal fluid acidosis; (c) mobilization of body CO2 stores due to the circulatory response to CO may obscure an initial depression of ventilation by CO.
Report highlights recruitment crisis in general practice
Authors: L. Beecham
Journal: BMJ (1996)

There is a serious recruitment problem in general practice now and this will deteriorate unless specific measures are taken. This is the conclusion of a report on medical workforce from a General Medical Services Committee's task force. The GMSC congratulated the task force's chairman, Dr Michael Wilson, on what many speakers said was an excellent report although it painted a gloomy picture. The committee endorsed the report and the suggestion that the GMSC should cooperate with the Royal College of General Practitioners in getting the recommendations implemented.

The health departments and the review body have said repeatedly that …
PATHOGENESIS OF THE COAGULATION DEFECT DEVELOPING DURING PATHOLOGICAL PLASMA PROTEOLYTIC (“FIBRINOLYTIC”) STATES. II. THE SIGNIFICANCE, MECHANISM AND CONSEQUENCES OF DEFECTIVE FIBRIN POLYMERIZATION*
Authors: Norma Alkjaersig, Anthony P. Fletcher, Sol Sherry
Journal: Journal of Clinical Investigation (1962)

A clinical syndrome characterized by a coagulation defect, hypofibrinogenemia, often an associated hemorrhagic diathesis and manifestations of whole blood or plasma fibrinolysis (spontaneous lysis of whole blood or plasma clots), has long been recognized. Usually developing acutely after the trauma of surgery or in association with certain obstetric complications, it may also present as a chronic syndrome complicating the course of long-term medical disease (reviews noted in References 1, 2). Moreover, the iatrogenic induction of the syndrome, usually in a mild form, frequently accompanies the treatment of the acute thromboembolic complications of vascular disease by enzymatic means (3-6).
THE FREQUENCY OF BACILLUS INFLUENZÆ IN THE NOSE AND THROAT IN ACUTE LOBAR PNEUMONIA
Authors: Ernest G. Stillman
Journal: The Journal of Experimental Medicine (1922)

1. Bacillus influenza is frequently found in association with lobar pneumonia. 2. In lobar pneumonia both Bacillus influenza and pneumococcus are frequently found in the nose. 3. The influenza bacilli found in the upper respiratory tract of cases of lobar pneumonia are of various types. 4. The exact significance of these findings is at the present time not clear.
The Perception of Respiratory Work and Effort Can Be Independent of the Perception of Air Hunger
Authors: ROBERT W. LANSING, BRIAN S.-H. IM, JULIE I. THWING, ANNA T. R. LEGEDZA, ROBERT B. BANZETT
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Dyspnea in patients could arise from both an urge to breathe and increased effort of breathing. Two qualitatively different sensations, “air hunger” and “respiratory work and effort,” arising from different afferent sources are hypothesized. In the laboratory, breathing below the spontaneous level may produce an uncomfortable sensation of air hunger, and breathing above it a sensation of work or effort. Measurement of a single sensory dimension cannot distinguish these as separate sensations; we therefore measured two sensory dimensions and attempted to vary them independently. In five normal subjects we obtained simultaneous ratings of air hunger and of work and effort while independently varying Pco 2 or the level of targeted voluntary breathing. We found a difference in response to the two stimulus dimensions: air hunger ratings changed more steeply when Pco 2 was altered and ventilation was constant; work or effort ratings changed more steeply when ventilation was altered and Pco 2 was constant. We conclude that “air hunger” is qualitatively different from “work and effort” and arises from different afferent sources.
<i>HFE</i>C282Y/H63D compound heterozygotes are at low risk of hemochromatosis-related morbidity
Authors: Lyle C. Gurrin, Nadine A. Bertalli, Gregory W. Dalton, Nicholas J. Osborne, Clare C. Constantine, Christine E. McLaren, Dallas R. English, Dorota M. Gertig, Martin B. Delatycki, Amanda J. Nicoll, Melissa C. Southey, John L. Hopper, Graham G. Giles, Gregory J. Anderson, John K. Olynyk, Lawrie W. Powell, Katrina J. Allen
Journal: Hepatology (2009)

Abstract The risk of hemochromatosis-related morbidity is unknown among HFE compound heterozygotes (C282Y/H63D). We used a prospective population-based cohort study to estimate the prevalence of elevated iron indices and hemochromatosis-related morbidity for compound heterozygotes. In all, 31,192 subjects of northern European descent were genotyped for HFE C282Y and H63D. An HFE -genotype stratified random sample of 1,438 subjects, followed for an average of 12 years to a mean age of 65 years, completed questionnaires and gave blood. Clinical examinations were blinded to HFE genotype. A total of 180 (84 males) clinically examined C282Y/H63D participants were compared with 330 (149 males) controls with neither HFE mutation; 132 (65 males) and 270 (122 males), respectively, had serum iron measures at both timepoints. Mean serum ferritin (SF) and transferrin saturation (TS) were significantly greater for male and female compound heterozygotes than for wild-types at baseline and follow-up (all P &lt; 0.02) except for females who were premenopausal at baseline, where SF was similar in both genotype groups. For subjects with serum measures from both baseline and follow-up, mean SF and TS levels did not change significantly for men or for postmenopausal women, but for premenopausal women SF levels increased from 43 to 109 μg/L for compound heterozygotes and from 35 to 64 μg/L for wild-types (both P &lt; 0.001). Male and female compound heterozygotes had a similar prevalence of hemochromatosis-related morbidity to wild-types. One of 82 males and zero of 95 females had documented iron overload-related disease. Conclusion: For male compound heterozygotes, mean iron indices do not change during middle age but for female compound heterozygotes menopause results in increased mean SF. Although compound heterozygotes might maintain elevated iron indices during middle age, documented iron overload-related disease is rare. (Hepatology 2009;50:94–101.)
Chemical reactivity-absorption, retention, metabolism, and elimination of hexachlorocyclopentadiene.
Authors: H M Mehendale
Journal: Environmental Health Perspectives (1977)

Hexachlorocyclopentadiene is eliminated from the body efficiently by urinary excretion. Although direct evidence is not available, it appears that expiration may be another important route of elimination. Of the administered dose 9% is excreted in the bile in 1 hr, approximately equal to the amount of fecal excretion in 7 days, suggesting enterohepatic circulation. After a single dose, HCPD decays from the blood biexponentially with a terminal phase half-life of 60 min. Of the tissues analyzed kidney, followed by liver, concentrate HCPD 1 hr or 7 days after exposure to any significant extent. Subcellularly, HCPD is predominantly associated with cytosol fractions of both kidney as well as liver, observations consistent with rapid elimination of HCPD after a single exposure. Preexposure to HCPD (50 mg/kg-day for 3 days) resulted in unaltered blood decay curves and biliary excretion, but increased the concentration in the kidneys after a single subsequent challenge.
Conjugation of salmon calcitonin to a combed-shaped end functionalized poly(poly(ethylene glycol) methyl ether methacrylate) yields a bioactive stable conjugate
Authors: Sinéad M. Ryan, Xuexuan Wang, Guiseppe Mantovani, Claire T. Sayers, David M. Haddleton, David J. Brayden
Journal: Journal of Controlled Release (2009)
With the Dying
Authors: Beret E. Strong
Journal: JAMA (1993)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
GMC is criticised for refusing to disclose reasons behind its advice to support prescribing for Lucentis rather than Avastin for wet AMD
Authors: D. Cohen
Journal: BMJ (2015)

Doctors, commissioners, and drug safety experts have criticised the UK General Medical Council for a lack of transparency over its prescribing guidance and for conflating European laws governing drug marketing with laws governing drug prescribing.

The criticism came after a BMJ investigation showed that ophthalmologists in the United Kingdom were loth to prescribe the cheap and effective drug bevacizumab (Avastin) for wet age related macular degeneration rather than the more expensive ranibizumab (Lucentis), out of fear of legal action.1

Their reluctance to prescribe the cheaper drug arises from guidance issued by the GMC, which says that doctors should not prescribe an “unlicensed” drug when there is a licensed alternative and that they should not prescribe a drug for an indication or condition for which it hasn’t a licence (off-label prescribing).

The GMC maintains its position despite the fact that a Cochrane review has found that the cheaper drug was just as effective as the more expensive one.

Writing …
Atlas of Human Paleopathology
Authors: John B. Gregg
Journal: JAMA (1982)

In this presentation, the authors have provided much needed information to help bridge two large and longstanding gaps in the scientific study of diseases and health-related problems that affected people in the past: the dearth of documentation and exemplary specimens showing known pathological findings in dry bones, which might be used for comparison to identify unknown abnormalities in old dry bones; and the lack of controlled studies demonstrating unequivocally the effects that the mummification process has on the histological appearance of various tissues, normal and diseased. Abnormalities in dry bones often present a very different appearance than they do in the living specimen, making identification of pathological conditions difficult. In mummified tissues moreso than in skeletons, identification of the pathological condition that existed during life is difficult because of autolytic changes superimposed on those produced by the process of preservation. The information presented in this book should be helpful in
VALUE OF MUSCLE TRAINING IN TREATMENT OF VOCAL DEFECTS.
Authors: G. HUDSON MAKUEN
Journal: JAMA (1899)

At the last meeting of this Section, I had the pleasure of reporting five cases of falsetto voice in the male and their successful treatment by means of direct muscle training. As considerable interest was manifested in the subject, I thought it might be well at this time to give a brief outline of the method employed, suggesting some conditions in which it may be indicated and explaining somewhat in detail its practical application. Whatever may be the remote causes of vocal defects, the direct cause is always a faulty musculation in the vocal mechanism. The method of training hitherto used to correct this faulty musculation has been for the most part an indirect one. It has been an effort to develop the muscles through the medium of approximately correct tones, and the method of direct muscle training, independently of voice, has played but little if any part in the
Acromegaly After Pituitary Apoplexy
Authors: Alfredo A. Sadun
Journal: JAMA (1987)

To the Editor.—  I enjoyed reading Candrina and Giustina's 1 article in the Dec 5, 1986, issue of JAMA on pituitary apoplexy. As the authors correctly point out, pituitary apoplexy is a neurosurgical emergency that needs to be dealt with promptly. Immediate surgical decompression may prevent the further destruction of the contents of the nearby cavernous sinus and possibly irreversible damage to the overlying optic chiasm. Failure to perform prompt decompression may lead to serious morbidity and even mortality. 2,3   It is for this reason that I wanted to address several atypical aspects of their case and of their management of it. Their patient presented with headache and projectile vomiting. No mention is made of any cranial nerve palsy. More commonly, patients with pituitary apoplexy complain of extremely severe headache and either diplopia (due to cavernous sinus syndrome) or visual loss (which may be unilateral or bilateral).  Candrina and Giustina's
Uptake of 99mTc Pyrophosphate in Chest Wall Tissues Due to Defibrillation
Authors: LAWRENCE J. SLUTSKY, ANTHONY M. PASSALAQUA, ZVI H. OSTER, PHILIP BRAUNSTEIN
Journal: Clinical Nuclear Medicine (1977)

A case is presented in which uptake of 99mTcpyrophosphate occurred due to local injury to the chest wall by the electrodes following defibrillation. It is important to differentiate this from myocardial accumulation of the agent.
Abdominal Bruit and Hypertension
Authors: Stanley P. Bohrer
Journal: JAMA (1963)

Dr. James J. Pollard: This was the first admission of a 33-yr-old married woman with high blood pressure, first noted 10 yr ago on a routine physical examination. Her only symptom has been frequent, severe, throbbing occipital headaches. She has had two uncomplicated pregnancies. She had one episode of burning and frequency 8 yr ago which cleared spontaneously. Her local physician recently heard a right flank bruit and referred her to the Massachusetts General Hospital.  Physical examination showed a well-developed, well-nourished female in no acute distress. Temperature, pulse, and respiration were normal. Her blood pressure was 180/110 mm Hg in the right arm and 200/120 mm Hg in the right leg. The fundi showed slightly tortuous arteries but no spasm, hemorrhage, or exudates. The left border of cardiac dullness was in the midclavicular line and the lungs were clear. There was a systolic bruit heard over the right side of
Rapid immunochromatographic test for serum granulysin is useful for the prediction of Stevens-Johnson syndrome and toxic epidermal necrolysis
Authors: Yasuyuki Fujita, Naoya Yoshioka, Riichiro Abe, Junko Murata, Daichi Hoshina, Hirokatsu Mae, Hiroshi Shimizu
Journal: Journal of the American Academy of Dermatology (2011)
De Subitaneis mortibus. XVI. Intractable tachycardia in infancy.
Authors: C Brechenmacher, P Coumel, T N James
Journal: Circulation (1976)

Intractable tachycardia in a boy proved fatal at the age of one year. A cousin still living has the same problem. Special electrocardiographic studies in the boy demonstrated a consistent abnormality which included complete atrioventricular dissociation with a normal atrial rate but a ventricular rate usually about 240 beats/minute; a His bundle comples preceded each QRS and all QRS complexes were narrow and uniform in configuration without a delta wave. At postmortem examination there were changes due to congestive failure and the heart was enlarged but otherwise normal except for the His bundle. In its midportion the His bundle was split into several thin and irregular longitudinally oriented strands, within which there were many areas of focal degeneration. There was no myocarditis and no focal degeneration elsewhere in the heart. Although the etiology of this process is uncertain, some possibilities are discussed.