tbuckley/cabot-search huggingface dataset:
ASSOCIATION OF INSULIN RESISTANCE TRAJECTORY OVER 25 YEARS WITH LEFT VENTRICULAR SYSTOLIC AND DIASTOLIC FUNCTION IN MIDDLE-AGED ADULTS: THE CORONARY ARTERY RISK DEVELOPMENT IN YOUNG ADULTS (CARDIA) STUDY
Authors: Satoru Kishi, Jared Reis, Laura A. Colangelo, Samuel Gidding, Bharath A. Venkatesh, Akihiro Isogawa, Cora E. Lewis, Colin Wu, David Jacobs, Kiang Liu, Joao Lima
Journal: Journal of the American College of Cardiology (2014)
Safer use of traditional remedies Clinical trials may fail to get ethical approval
Authors: D J M Reynolds
Journal: BMJ (1994)

EDITOR, - In his editorial on the safer use of traditional remedies David J Atherton called for “opening of channels of communication in an atmosphere less pervaded by suspicion and hostility.”1 One of the most effective approaches to reducing any existing hostility to traditional remedies would be to determine their efficacy and safety by subjecting them to scientific scrutiny in well designed clinical trials. Orthodox Western medicine …
Effect of blockers on mortality after myocardial infarction in adults with COPD: population based cohort study of UK electronic healthcare records
Authors: J. K. Quint, E. Herrett, K. Bhaskaran, A. Timmis, H. Hemingway, J. A. Wedzicha, L. Smeeth
Journal: BMJ (2013)

<b>Objectives</b> To investigate whether the use and timing of prescription of β blockers in patients with chronic obstructive pulmonary disease (COPD) having a first myocardial infarction was associated with survival and to identify factors related to their use. <b>Design</b> Population based cohort study in England. <b>Setting</b> UK national registry of myocardial infarction (Myocardial Ischaemia National Audit Project (MINAP)) linked to the General Practice Research Database (GPRD), 2003-11. <b>Participants</b> Patients with COPD with a first myocardial infarction in 1 January 2003 to 31 December 2008 as recorded in MINAP, who had no previous evidence of myocardial infarction in their GPRD or MINAP record. Data were provided by the Cardiovascular Disease Research using Linked Bespoke studies and Electronic Health Records (CALIBER) group at University College London. <b>Main outcome measure</b> Cox proportional hazards ratio for mortality after myocardial infarction in patients with COPD in those prescribed β blockers or not, corrected for covariates including age, sex, smoking status, drugs, comorbidities, type of myocardial infarction, and severity of infarct. <b>Results</b> Among 1063 patients with COPD, treatment with β blockers started during the hospital admission for myocardial infarction was associated with substantial survival benefits (fully adjusted hazard ratio 0.50, 95% confidence interval 0.36 to 0.69; P&lt;0.001; median follow-up time 2.9 years). Patients already taking a β blocker before their myocardial infarction also had a survival benefit (0.59, 0.44 to 0.79; P&lt;0.001). Similar results were obtained with propensity scores as an alternative method to adjust for differences between those prescribed and not prescribed β blockers. With follow-up started from date of discharge from hospital, the effect size was slightly attenuated but there was a similar protective effect of treatment with β blockers started during hospital admission for myocardial infarction (0.64, 0.44 to 0.94; P=0.02). <b>Conclusions</b> The use of β blockers started either at the time of hospital admission for myocardial infarction or before a myocardial infarction is associated with improved survival after myocardial infarction in patients with COPD. <b>Registration</b>NCT01335672.
Abstract SY02-04: Overlapping mechanisms in CNS development and gliomagenesis
Authors: David H. Rowitch
Journal: Cancer Research (2014)

Abstract Glioblastoma multiforme (GBM) is a lethal brain cancer resistant to therapy in part because of its highly invasive nature. GBMs are a highly vascular tumor with heterogeneous histological features, but they are generally considered to derive from glial lineage progenitors. We have defined Olig2, a bHLH transcription factor, as a critical determinant of oligodendrocyte progenitor identity during development. Olig2 is expressed in human GBMs, raising the possibility of similar features between oligodendrocyte progenitors and glioma-propagating cells, a concept is supported by expression profiling and mouse models. This talk will review functions for OPCs during development, including proliferation, migration into adult parenchymal tissue and angiogenesis. As such, there are provocative similarities between normal OPCs and progenitors for GBM. Citation Format: David H. Rowitch. Overlapping mechanisms in CNS development and gliomagenesis. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr SY02-04. doi:10.1158/1538-7445.AM2014-SY02-04
The Role of Pacing Modality in Determining Long-Term Survival in the Sick Sinus Syndrome
Authors: Elena B. Sgarbossa
Journal: Annals of Internal Medicine (1993)

Objective: To determine whether the atrial-based pacing modalities (physiologic pacing) improve survival when compared with single-chamber ventricular pacing in patients with the sick sinus syndrome. Design: Retrospective, nonrandomized study. Setting: A tertiary care teaching hospital. Patients: A total of 507 patients with a mean age of 66 years who received an initial pacemaker for the sick sinus syndrome between January 1980 and December 1989. Pacing modes were ventricular (22%), atrial (4%), and dual-chamber (74%). Measurements: Total and cardiovascular mortality rates. Mean follow-up was 66 months. Results: Independent predictors of total mortality by the Cox proportional-hazards model were 1) New York Heart Association functional class [hazard ratio =1.67/class; 95% CI, 1.31 to 2.11]; 2) age [hazard ratio = 1.62/12-year increment; CI, 1.28 to 2.05]; 3) peripheral vascular disease [hazard ratio = 2.21; CI, 1.42 to 3.42]; 4) bundle branch block [hazard ratio = 2.04; CI, 1.33 to 3.13]; 5) coronary artery disease [hazard ratio = 1.66; CI, 1.15 to 2.39]; and 6) valvular heart disease (hazard ratio = 1.71; CI, 1.08 to 2.69). The same variables were independent predictors of cardiovascular mortality, with cerebrovascular disease reaching borderline statistical significance (hazard ratio = 1.69; CI, 1.00 to 2.86). Using univariate analysis, single-chamber ventricular pacing had more than 40% increased risk for both total and cardiovascular death, but the difference was of borderline statistical significance (total mortality: P = 0.053; hazard ratio = 1.43; CI, 0.99 to 2.07; cardiovascular mortality: P = 0.15; hazard ratio = 1.41; CI, 0.87 to 2.29). Conclusions: Because the role of the ventricular pacing mode as a long-term predictor of total and cardiovascular mortality remains inconclusive, a large, randomized study is necessary to confirm whether physiologic pacing provides a substantial reduction in mortality when compared with ventricular pacing.
T cell receptor gamma and delta gene junctional sequences in SCID mice: excessive P nucleotide insertion.
Authors: L J Kienker, W A Kuziel, P W Tucker
Journal: The Journal of Experimental Medicine (1991)

The severe combined immunodeficiency (SCID) mutation has been postulated to affect a V(D)J recombinase activity involved in coding joint formation. Analysis of 38 joints from 34 distinct sequences of normally rearranged T cell receptor (TCR) gamma and delta genes from adult, SCID thymocytes reveals coding joints with an increased number of P nucleotides. One-third of P sequences are greater than or equal to 4 nucleotides in length and P elements of up to 15 bases are observed. This suggests that the SCID defect deregulates P nucleotide addition. Consequently, essential V(D)J recombination intermediates may seldom be generated.
Effect of left intraventricular pressure on magnitude of vascular waterfall in the epicardial coronary veins
Authors: R. J Domenech, P. Macho, F. Barros
Journal: Cardiovascular Research (1990)

Study objective – The aim was to test the hypothesis of a vascular waterfall in the epicardial veins due to compression by the left ventricular (LV) pressure. If this were so, the epicardial venous pressure should be a direct function of the LV pressure. Design – Canine arrested hearts were used, without autoregulation and perfused with the Langendorff technique. Coronary flow and outflow pressure were measured in the great cardiac vein, which was the only outflow of the system. The pressure in an epicardial vein was also measured. The measurements were done with LV pressures varying from zero to 40 mm Hg. The outflow pressure was progressively increased until a steady decrease in flow occurred. This pressure was considered the critical outflow pressure. Experimental material – 19 mongrel dogs, 18-25 kg, were used. The animals were anaesthetised and the hearts perfused in the Langendorff manner with homologous blood. Measurements and main results – The epicardial venous pressure before outflow pressure was increased was higher than LV pressure (even at zero LV pressure), and increased linearly with the increase in LV pressure (epicardial venous pressure = 0.74 LV pressure +6.18; r = 0.93). The increase in outflow pressure did not modify flow until it reached a value (critical outflow pressure) similar to epicardial venous pressure. Critical outflow pressure was linearly related to LV pressure (critical outflow pressure = 0.65 LV pressure +5.13, r = 0.87). Conclusions – The results support the hypothesis of a waterfall circulation in the epicardial veins during diastole, the magnitude of which is a function of the LV pressure.
Tissue Oxygen Delivery and Cor Pulmonale in Chronic Obstructive Pulmonary Disease
Authors: Edward H. Bergofsky
Journal: New England Journal of Medicine (1983)

The physiologic derangements of patients with chronic obstructive pulmonary disease can be grouped in two categories: those that stem from the anatomic alterations produced by the disease and those that represent adaptations that, if optimally carried out, prolong survival. For instance, increased airway resistance, hyperinflation, ventilation–perfusion inhomogeneity, and hypoxemia can all be considered direct consequences of the anatomic changes in the lung. But polycythemia, increased cardiac output, hypoxic pulmonary vasoconstriction, and chronic shifts in the oxyhemoglobin dissociation curve can more readily be considered in the category of adaptive physiology.Support for such a grouping can be adduced from recent studies . . .
Implantation by electrophysiologists of 100 consecutive cardioverter defibrillators with nonthoracotomy lead systems.
Authors: S A Strickberger, J D Hummel, E Daoud, M Niebauer, B D Williamson, K C Man, L Horwood, A Schmittou, S J Kalbfleisch, J J Langberg
Journal: Circulation (1994)

Traditional lead systems for implantable cardioverter defibrillators (ICDs) require a thoracotomy for placement. Nonthoracotomy lead systems are available and are usually implanted by an electrophysiologist and a surgeon. The purpose of this study was to prospectively evaluate the safety and efficacy of ICD implantation with a nonthoracotomy lead system by electrophysiologists.A consecutive series of 100 patients (mean age, 61 +/- 13 years, +/- SD) underwent ICD implantation with a nonthoracotomy lead system while intubated and under general anesthesia. Seventy-seven patients had coronary artery disease, 15 had idiopathic cardiomyopathy, 6 had miscellaneous heart disease, and 2 had structurally normal hearts. The mean ejection fraction was 0.29 +/- 0.13. Sixty-eight patients had suffered a cardiac arrest, and 32 had had ventricular tachycardia or syncope. All patients except 9 underwent electrophysiological testing and had failed 1 +/- 1 drug trials before ICD implantation. Three types of nonthoracotomy lead systems were used. The nonthoracotomy lead with an ICD was successfully implanted in 96 patients (96%). Of the unsuccessful implants, 1 patient did not have venous access, the passive fixation lead in 1 would not remain lodged, 1 had elevated defibrillation thresholds, and 1 developed a hemopneumothorax while venous access was being obtained. The mean defibrillation threshold was 17 +/- 6 J. The mean procedure duration was 161 +/- 57 minutes. When a subcutaneous patch was used (n = 58), the procedure duration was 189 +/- 5 minutes, and when a subcutaneous patch was not required (n = 40), the procedure lasted 123 +/- 37 minutes (P < .0001). Patients remained in the hospital 4.5 +/- 4.1 days after implantation, with no procedure-related deaths. Acute complications occurred in 10 patients; 2 had lead dislodgments, 1 with previous abdominal surgery had his abdominal cavity entered (without other complications) while the ICD pocket was being made, 1 had postoperative heart failure, 1 developed a large hematoma when anticoagulation therapy was initiated, 3 required reintubation because of excessive anesthesia, 1 developed superficial cellulitis, and 1 developed a hemopneumothorax secondary to a lacerated subclavian vein. During 6 +/- 3 months of follow-up, 2 patients developed lead fractures.(1) Electrophysiologists can implant an ICD with a nonthoracotomy lead system safely and with a high success rate; (2) use of a subcutaneous patch correlates with longer procedure durations; and (3) special precautions should be taken in patients with previous abdominal surgery.
Can new parameters of flow propagation velocity of early filling mitral flow and of E-FPV detect the severity of diastolic dysfunction in patients with severe mitral regurgitation? Usefulness of flow propagation velocity and E-FPV analysis
Authors: Eiichi Enya, Kentaro Yamamoto, Haruyuki Taguchi, Hiroyuki Okura, Toshiyuki Shibutani, Iku Toda, Masataka Morishita
Journal: Journal of the American College of Cardiology (2003)
Informed Consent, Texas Style: Disclosure and Nondisclosure by Regulation
Authors: William J. Curran
Journal: New England Journal of Medicine (1979)

THE medical-malpractice-insurance crisis of the mid-1970's produced some effective reforms in the litigation of claims as well as in the availability of adequate insurance coverage for beleaguered physicians and hospitals.1 It also resulted in some oddities in medicolegal relations. One of the strangest has been the attempt of the Texas Legislature to bring certainty and predictability to one of the foggiest and deepest quagmires of all malpractice law, the requirements of informed consent.The complaint of physicians has been that the scope of adequate or, even worse, of fully informed consent can never be satisfactorily defined or predicted. The judges . . .
Clinical and Pathological Bearings of Malformation of the Heart as Seen in (A) Patent Foramen Ovale; (B) Imperfect Ventricular Septum
Authors: T. Oliver
Journal: BMJ (1889)

10TL RTS EIA ORA.[a.5 89 of breath, her health had been good.She had never been told CLINICAL AND PATHOLOGICAL BEARINGS OF that her lips were bluer than they ought to have been, or that MALFORMATION OF THE HEART AS she was thie subject of heart disease.Her father died from SEEN IN (A) PATENT FORAMEN bronchitis, and her mother from old age; and whilst nine brothers and sisters, out of a family of twelve, had died, no cause of death OVALE; 'B) IMPERFECT YEN- could be given by patient of any of them. TRC LR SETMiWhen admitted she was extremely cyanosed, was suffering so TRICULAR SEPTUM.,
Psychiatrists in restraints.
Authors: G Dunea
Journal: BMJ (1979)

and a third where there is no obvious injury but the accident has been so bad that the drivers are sent to hospital for observation and tests. Another ambition that David Nancekievill has had for years ?now, he says, unlikely to be realised?is to be medical officer on an offshore lifeboat. He has, however, been drawn into rescuing casualties in power-boat accidents. Like the motor racing, this happened accidentally : he bought a power boat for water skiing and was told that his best chance of being accepted as a member of the Chase Water Power Boat Club was to volunteer as medical officer. This he did, and now much enjoys this aspect of his leisure. The club has adopted a marvellous British invention?the first of its kind in the world?in the shape of a 17 ft Dell Quay Dory boat, which is unsinkable, and has a dropdown front (like a tank-landing craft) which enables the boat to be flooded to a depth of 6 inches or 1 foot so that casualties may be floated on board without having to be dragged over the side. When the flap is raised the water is automatically pumped out. The injuries are much the same as those in motor racing, with the added hazard of water, and the crew of the boat consists of one doctor (expert in resuscitation), two divers, and the driver. David NancekievilPs alternative occupation is something of a busman's holiday, and not exactly what he set out to do in the first place, but it provides him with excitement and a chance to watch motor and power-boat racing, and he obviously very much enjoys the challenge of on-site medicine. He has found this work helpful in his everyday work?and his work in intensive care has helped him in his rescue work?and particularly so when he was senior anaesthetist at the Moorgate tube-train disaster a few years ago. He was in the train in the tunnel most of the day, and found his on-site medical experience invaluable. No one who has met him can doubt that his drive and enthusiasm have had much to do with the present excellent rescue services available in Britain ?and he has lured many other doctors away from their gardens to help out. The drivers have much to thank him for.
Left Atrial Pressure Pulses in the Presence of Myxoma
Authors: ROBERT G. FISH, TIMOTHY TAKARO, THOMAS CRYMES
Journal: Circulation (1959)

Findings of transbronchial left heart catheterization in the presence of an atrial myxoma and a normal mitral valve are presented. The genesis and possible significance of unusual differences in contour between high and low left atrial pressure pulses are discussed.
Health Care as an International Concern: A Call for United States Initiative
Authors: Henry L. Feffer
Journal: New England Journal of Medicine (1974)

No hard data are available, but the United States has provided about two fifths of the total Free World aid to the more than 100 developing countries, with the other assisting countries providing the rest. Figures on the substantial contribution from the communist world obviously are even less accessible. We know, however, that the flow of public and private resources into low-income countries from the non-communist world alone exceeds $18 billion annually. The portion allocated to technical assistance has gradually increased and now represents about 25 per cent of total official aid flow. Although no statistical breakdown has been made, . . .
Symptomatic Myelolipoma of the Adrenal Gland
Authors: Livingston Parsons, James E. Thompson
Journal: New England Journal of Medicine (1959)

MYELOLIPOMA of the adrenal gland is a rare tumor, reports of which have sporadically appeared in the literature for the past twenty-five years. It has always been described as an incidental finding at autopsy, and the case reported below is of interest, since we believe it to be the first recorded case in which a myelolipoma has reached a large enough size to produce symptoms necessitating operative removal.Case ReportM.G., a 51-year-old woman, was admitted to Roosevelt Hospital in October, 1956, with a 2-month history of malaise, anorexia and poorly localized discomfort in the upper abdomen. These symptoms were . . .
EKSIP AND DIABETES
Authors: R. D. Book
Journal: JAMA (1924)

<h3>To the Editor:</h3> —This is offered as of additional interest in your answer to Dr. C. R. Baker's query on page 1706 ofThe Journal, Nov. 22, 1924. [The question was about the nostrum "Eksip," sold by Matthew Richartz as a cure for diabetes.—Ed.] Some time ago a man came to me with a specimen of urine for urinalysis. At its completion, when I notified him that the specimen was loaded with sugar, he appeared crestfallen and confessed that he had long been suffering with diabetes. A friend had made a special trip from a distance and urged him to buy a little book called "Eat and Get Well." I was given to understand that either the book or the friend gave positive assurance that if he followed the directions and took the medicine, at the end of six months he could take a specimen of urine to any
A CASE OF ATROPHY OF HAND MUSCLESWITH LOCALIZED SENSORY DISTURBANCES; POSSIBLE EARLY SYRINGOMYELIA.
Authors: D. I. WOLFSTEIN
Journal: JAMA (1904)

The following case is reported because it possesses very interesting features: <h3>History.</h3> —Miss L., aged 27, consulted me first, Feb. 27, 1903, sent by her family physician because of a localized wasting of the thumb. There is no neuropathic family taint, nor has any myopathie disease ever been present in the family so far as known. Two other sisters were examined carefully with negative results. The girl is unusually tall and very slender. While tallness is a family characteristic, she is the tallest of all. Tuberculosis has not existed in the family, and patient is also free therefrom. Pain in the right arm has been noticed since her twelfth year. The arm has also seemed weaker at times than the other, but she has performed all the arduous duties of laundry and house work for many years. There is no history of the supervention of the pain and weakness after
Role of endothelium in the maintenance of low pulmonary vascular tone in normal children.
Authors: D S Celermajer, C Dollery, M Burch, J E Deanfield
Journal: Circulation (1994)

BACKGROUND Resting vascular tone is low in the normal pulmonary circulation, and experimental studies have suggested that this may be due to the continuous release of endothelium-derived nitric oxide (NO), a locally acting vasodilator. We have investigated whether NO contributes to the normal control of pulmonary vascular tone and resistance in children. METHODS AND RESULTS We studied the hemodynamic effects of NG-monomethyl-L-arginine (L-NMMA), a specific inhibitor of NO synthesis, on the pulmonary circulation of six children 2 to 17 years old (mean, 9 years) with congenital heart disease but normal pulmonary blood flow, pressure, and resistance (all had isolated left heart obstructive lesions). The diameter of a segmental pulmonary artery and pulmonary blood flow velocity were measured by quantitative angiography and intra-arterial Doppler catheters. There was a consistent, dose-dependent fall in pulmonary blood flow velocity in response to three increasing doses of L-NMMA (compared with baseline, flow velocity fell to 75 +/- 7%, 62 +/- 8%, and 40 +/- 10%, P &lt; .01). Flow velocity returned to control values with subsequent infusion of L-arginine, the substrate for NO. Thereafter, acetylcholine, an endothelium-dependent dilator, produced an increase in flow velocity (56 +/- 10% greater than baseline, P &lt; .01). Arterial diameter was unchanged during L-NMMA and L-arginine infusions, indicating that the major effect of each agent is to alter vascular tone distal to the segmental pulmonary arteries. CONCLUSIONS The dilator action of endothelium-derived NO contributes to the maintenance of low resting pulmonary tone in normal children. Impairment of NO production may contribute to the elevated pulmonary vascular resistance that complicates some cases of congenital heart disease.