tbuckley/cabot-search huggingface dataset:
Frequency-dependent effects of quinidine on the relationship between action potential duration and refractoriness in the canine heart in situ.
Authors: M R Franz, A Costard
Journal: Circulation (1988)

To determine the normal relationship in vivo between action potential duration (APD) and effective refractory period (ERP) over a large range of steady-state cycle lengths (CLs) and to determine how a sodium channel-blocking agent, quinidine, affects this relationship, we developed a new contact electrode technique for simultaneous measurements of monophasic action potentials and refractoriness at a single site in the beating heart in situ. Recordings were made from left ventricular epicardium in open-chest dogs during steady-state pacing at CLs from 220 to 600 msec both before and after therapeutic intravenous administration of quinidine. During baseline both APD at 90% repolarization (APD90) and ERP were linearly correlated to CL with nearly identical slopes: y = 0.24x CL + 83.0 (r = 1.0; p less than .0001) for APD90 and y = 0.22x CL + 82.3 (r = 1.0; p less than .0001) for ERP. Expressed in percent repolarization, ERP coincided with a repolarization level of 79% to 83%, with no appreciable influence of CL on this relationship. Quinidine increased APD90 by a small but significant amount (8 to 12 msec), which was independent of CL. In contrast, the effect on ERP of quinidine exhibited marked frequency dependence (p less than .0002), producing progressively greater ERP increase at shorter CLs, as compared with both baseline ERP and concomitant APD90. The duration by which ERP exceeded APD90 reached 44 +/- 14 msec at a CL of 220 msec.(ABSTRACT TRUNCATED AT 250 WORDS)
Globalisation and the challenges to health systems
Authors: Julio Frenk, Octavio Gómez-Dantés
Journal: BMJ (2002)

In this article, based on a talk given to a recent meeting on global health, Julio Frenk and Octavio Gomez-Dantes argue that, although there are many threats inherent in globalisation, improving health is a unifying activity. They suggest that “exchange, evidence, and empathy” should characterise international activities to improve health and health care for all the world's people

In the aftermath of the events of 11 September Britain's prime minister, Tony Blair, reminded us of what he called “the fragility of our frontiers in the face of the world's new challenges” (Labour Party Conference, Brighton, October 2001). This shift of human affairs from the restricted frame of the nation state to the vast theatre of planet earth is not only affecting trade, finance, science, the environment, crime, and terrorism; it is also changing the nature of health challenges facing people all over the world.1

In 1997 an influential report by the US Institute of Medicine stated: “Distinctions between domestic and international health problems are losing their usefulness and are often misleading.”2 We are all coming closer to each other. One of the great revolutions of the 20th century was, in the words of the historian Eric Hobsbawm, the virtual annihilation of time and distance.3

#### Summary points

Globalisation is affecting health as well as other aspects of human activity

All countries must deal with the international transfer of risks—whether this is of microbes, unregulated distribution of drugs, or tobacco marketing

On the other hand, globalisation makes the sharing of information on health care easier

The aspiration for good health is also a unifying factor across different parts of the world, cultures, and religions

Intense international contacts are not new. From time immemorial the forces of trade, migration, war, and conquest have bound together people from distant places. The expression “citizen …
Are Serial BNP Measurements Useful in Heart Failure Management?
Authors: James L. Januzzi, Richard Troughton
Journal: Circulation (2013)

To deny the fact that standard HF care has substantial opportunity for improvement is at the peril of even worse outcomes in our patients affected by the disorder. We have presented a strong rationale for the value of BNP- and NTproBNP–guided HF management. Experience gained in biomarker-guided HF trials suggests that the approach results in improvement in the quality of care without an excess of adverse events related to more aggressive management. This alone is difficult to ignore given the gaps in care that exist between RCTs and real-world practice. Beyond this fact, studies examining the strategy of biomarker-guided HF care have shown substantial improvement in outcome compared with well-managed control arms, benefits that are confirmed in meta-analysis and pooled data analyses, and justifies the imminent launch of the pivotal RCT that will lead to more widespread adoption of the approach. Compared with standard management, biomarker-guided care appears cost effective, may improve patient quality of life, and may promote reverse ventricular remodeling. Although certain subgroups such as the elderly may respond in a less vigorous manner to the approach, this may reflect the effects of age on HF therapy and how the strategy is deployed in elders rather than a weakness of the approach in older patients. A fair-minded assessment of the available data suggests that care supported by BNP/NT-proBNP–guided HF treatment—as an adjunct to standard clinical acumen—is superior to standard care. The limitation of standard care strategies is evident from the suboptimal uptake and application of proven therapies documented in HF registries. Far from being a crutch to support what we should already be doing (namely, optimally evaluating and managing our patients solely with clinical means), the inclusion of NP measurement within the HF management strategy augments the quality of monitoring and treatment. Denial of the benefits of NP monitoring potentially retards advances in the care of a high-risk population of patients that continues to grow in size and importance every day.
KNOTTING OF THE DUODENAL TUBE IN SITU
Authors: F. T. Billings
Journal: JAMA (1923)

Mrs. M. B., admitted to the Western Pennsylvania Hospital, Feb. 23, 1923, and discharged, March 12, 1923, came to the hospital complaining of "gas on the stomach," pain over the right side of the abdomen, and a vaginal discharge. The family history was unimportant. For the last two years she had experienced flatulence, accompanied by belching, but no nausea. The attacks generally followed meals, and came in definite periods of pain and indigestion. She had lost 16 pounds (7 kg.) during the last six months. At the time of admission, she complained of considerable gaseous distention of the abdomen, especially pronounced after meals, but not necessarily dependent on them. During deep inspiration, the patient experienced a feeling of "goneness" of the stomach and intestine. There was also a sore, dull, aching pain in the upper right quadrant of the abdomen, accentuated at times to a sharp knifelike intensity radiating upward
AN OSMOTIC SYSTEM WITHIN THE CYTOPLASM OF CELLS
Authors: Eugene L. Opie
Journal: The Journal of Experimental Medicine (1948)

The cytoplasm of cells of the liver and of the kidney is in large part occupied by bodies which respond to the water content of these cells and are modified by dissolved substances in the surrounding fluid or by physical change such as freezing. These bodies, in part mitochondria but designated more broadly cytochondria, constitute an osmotic system within the cytoplasm of cells. When the specific gravity of liver or kidney tissue is used as an index of changes in the water content of tissue, swelling of cytochondria in general follows the intake of water but this relation may be modified by a variety of conditions. When liver that has been frozen and thawed is immersed in water, cytochondria become swollen though the containing cells diminish in size. Solutions of sodium and of potassium chloride isotonic with blood plasma cause delayed swelling of cells and cytochondria, greater with the potassium salt; solutions of calcium chloride of equal molar concentration cause immediate swelling of cells and cytochondria. The basophile material of the cytoplasm (ribonucleic acid and related substances) and the material that gives to mitochondria their characteristic stain are removed by immersion in water but their disappearance is retarded by isotonic solutions of sodium or of potassium chloride and further delayed by hypertonic solutions. When the intensity of staining reactions is diminished by the partial loss of basophile substance or of the distinctive mitochondrial material, these are found at the surfaces of the cytoplasmic bodies, held perhaps by adsorption. When water, isotonic solutions of sodium chloride, or Ringer's solution comes into contact with immersed liver, they remove basophile and mitochondrial material from a superficial zone and substances with similar staining reactions appear in the cytoplasm of cells at a deeper level. Osmotic changes in the cytoplasmic bodies may be reversible. When liver tissue which has been for a short time immersed in water is transferred to a solution that is approximately isotonic in relation to blood plasma, swollen cytochondria return in part or completely to their former size; but with continued immersion in water, this reversibility becomes increasingly less complete.
Foreign-body granuloma and IgE-pseudolymphoma after multiple bee stings
Authors: B. HERMES, N. HAAS, J. GRABBE, B.M. CZARNETZKI
Journal: British Journal of Dermatology (1994)

Journal Article Foreign‐body granuloma and IgE‐pseudolymphoma after multiple bee stings Get access B. HERMES, B. HERMES Department of Dermatology, University Clinics Rudolf Virchow, Free University, Berlin, Germany Dr B.Hermes, Hautklinik, UKRV, FU Berlin, Augustenburger Platz 1, D‐13344 Berlin, Germany. Search for other works by this author on: Oxford Academic Google Scholar N. HAAS, N. HAAS Department of Dermatology, University Clinics Rudolf Virchow, Free University, Berlin, Germany Search for other works by this author on: Oxford Academic Google Scholar J. GRABBE, J. GRABBE Department of Dermatology, University Clinics Rudolf Virchow, Free University, Berlin, Germany Search for other works by this author on: Oxford Academic Google Scholar B.M. CZARNETZKI B.M. CZARNETZKI Department of Dermatology, University Clinics Rudolf Virchow, Free University, Berlin, Germany Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 130, Issue 6, 1 June 1994, Pages 780–784, https://doi.org/10.1111/j.1365-2133.1994.tb03419.x Published: 01 June 1994 Article history Accepted: 22 October 1993 Published: 01 June 1994
The Editor,'The British Jouriial of Dermatology.'
Authors: F. F. Hellieb
Journal: British Journal of Dermatology (1956)

Journal Article The Editor,‘The British Jouriial of Dermatology.’ Get access F. F. Hellieb F. F. Hellieb Leeds Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 68, Issue 10, 1 October 1956, Pages 342–343, https://doi.org/10.1111/j.1365-2133.1956.tb12761.x Published: 01 October 1956
Vaginal vibrator lodged in rectum.
Authors: J S Haft, H B Benjamin, M Wagner
Journal: BMJ (1976)

Vaginal vibrator lodged in rectumVaginal vibrators and other sexual surrogates are readily available in most metropolitan areas in the USA, often over the counter in pharmacies.Although usually not advertised as such, they are designed for use within the vagina, which, being fairly short, makes their retrieval comparatively easy.But increasingly these devices are being used to gratify anal erotism and may easily be inserted beyond the anal sphincters.These tend to close and to force a foreign object up the tract out of reach of the user, so that it has to be retrieved by surgery.We think these cases are increasing and that therefore the following reports are timely.
Massive Pleural Effusion Due to Pleural AA Amyloidosis
Authors: Yasuo Shimizu, Katsuaki Endou, Yutaka Hashizume, Tadayoshi Kawata, Takeo Horie, Hidemi Ogura, Masaru Obokata, Mitsuo Toyoda, Hideaki Ito, Atsushi Takise
Journal: American Journal of Respiratory and Critical Care Medicine (2012)
Diastolic Asynchrony Is More Frequent Than Systolic Asynchrony in Dilated Cardiomyopathy and Is Less Improved by Cardiac Resynchronization Therapy
Authors: Iris Schuster, Gilbert Habib, Christophe Jego, Franck Thuny, Jean-François Avierinos, Geneviève Derumeaux, Lionel Beck, Christine Medail, Frederic Franceschi, Sebastien Renard, Ange Ferracci, Jean Lefevre, Roger Luccioni, Jean-Claude Deharo, Pierre Djiane
Journal: Journal of the American College of Cardiology (2005)
Systematic Evaluation of Genetic Variants in Three Biological Pathways on Patient Survival in Low-Stage Non-small Cell Lung Cancer
Authors: V. Shane Pankratz, Zhifu Sun, Jeremiah Aakre, Yan Li, Cassandra Johnson, Yolanda I. Garces, Marie C. Aubry, Julian R. Molina, Dennis A. Wigle, Ping Yang
Journal: Journal of Thoracic Oncology (2011)
Severe cholestasis induced by cholic acid feeding in knockout mice of sister of P-glycoprotein
Authors: Renxue Wang, Ping Lam, Lin Liu, Dana Forrest, Ibrahim M. Yousef, Diane Mignault, James M. Phillips, Victor Ling
Journal: Hepatology (2003)

Intrahepatic cholestasis is often associated with impairment of biliary bile acid secretion, a process mediated by the sister of P-glycoprotein (Spgp or Abcb11) also known as the bile salt export pump (Bsep). In humans, mutations in the Spgp gene are associated with a fatal childhood disease, type 2 progressive familial intrahepatic cholestasis (PFIC2). However in mice, the "knockout" of Spgp only results in mild cholestasis. In this study, we fed spgp(-/-) knockout mice with a cholic acid (CA)-supplemented diet to determine whether a more pronounced PFIC2-like phenotype could be induced. Such mice developed severe cholestasis characterized by jaundice, weight loss, elevated plasma bile acid, elevated transaminase, cholangiopathy (proliferation of bile ductules and cholangitis), liver necrosis, high mortality, and wide-ranging changes in the mRNA expression of major liver genes (16/36 examined). A surprising observation was that the bile acid output and bile flow in CA-fed mutant mice was significantly higher than anticipated. This suggests that the spgp(-/-) mice are able to utilize an alternative bile salt transport system. However, unlike Spgp, this system is insufficient to protect the knockout mice from cholestasis despite its high capacity. In conclusion, the spgp(-/-) mice provide a unique model to investigate molecular pathways associated with cholestasis and related diseases.
An immature immunophenotype of bone marrow mast cells predicts for multilineage D816V KIT mutation in systemic mastocytosis
Authors: C Teodosio, A C García-Montero, M Jara-Acevedo, I Álvarez-Twose, L Sánchez-Muñoz, J Almeida, J M Morgado, A Matito, L Escribano, A Orfao
Journal: Leukemia (2011)
Variation in operation rates by primary care trust
Authors: Paul Aylin, Susan Williams, Brian Jarman, Alex Bottle
Journal: BMJ (2005)

Variation in the use of surgical procedures has been well documented in the US, England and Norway.w1 w2 With increasing emphasis in health care on clinical guidelines,w3 service frameworks,w4 and evidence based medicine,w5 w6 one might expect to see less variation in practice over time. Using hospital episode statistics, we looked at trends in variation between primary care trusts in operation rates for 10 common procedures over six years from 1998-9 to 2003-4. #### The bottom line
To appraise developmental difficulty or mental demand, relational complexity is not enough
Authors: Juan Pascual-Leone
Journal: Behavioral and Brain Sciences (1998)

Two assertions of Halford et al. are critiqued: their claim of priority in relational complexity analysis and the sufficiency for cognitive development of their relational-complexity analysis of tasks. Critical discussion of concrete task analyses (i.e., the relational complexity of proportionality problems, of balance scale problems, and the Tower of Hanoi) serves, by way of counterexamples, to highlight problems in their method.
Indirect effect of insulin to suppress endogenous glucose production is dominant, even with hyperglucagonemia.
Authors: S D Mittelman, Y Y Fu, K Rebrin, G Steil, R N Bergman
Journal: Journal of Clinical Investigation (1997)

Suppression of endogenous glucose production (EGP) is one of insulin's primary metabolic effects and failure of this action is a major contributor to fasting hyperglycemia of type 2 diabetes mellitus. Classically, insulin was thought to suppress the liver directly, via hyperinsulinemia in the portal vein. Recently, however, we and others have demonstrated that at least part, and possibly most of insulin's action to suppress EGP is normally mediated via an extrahepatic (i.e., indirect) mechanism. We have suggested that this mechanism involves insulin suppression of adipocyte lipolysis, leading to lowered FFA and reduced EGP ("Single Gateway Hypothesis"). Previous studies of the indirect insulin effect from this laboratory were done under conditions of lowered portal glucagon. Because of the possibility that the direct (i.e., portal) effect of insulin may have been underestimated with hypoglucagonemia, these studies examined the relative importance of portal insulin, versus peripheral insulin (administered at one-half the dose to equalize peripheral insulin levels) at four rates of portal glucagon infusion: 0, 0.65 (under-), 1.5 (basal-), and 3.0 ng/kg per min (over-replacement). Portal versus peripheral insulin suppressed steady-state EGP to the same extent (52%), confirming that the primary effect of insulin to suppress EGP is via the peripheral mechanism. This conclusion was maintained regardless of portal glucagonemia, although there was some evidence for an increase in the direct insulin effect at hyperglucagonemia. The indirect effect of insulin is the primary mechanism of steady-state EGP suppression under normal conditions. The direct effect increases with hyperglucagonemia; however, the indirect effect remains predominant even under those conditions.
Danger in the Use of Intrathecal Methylene Blue
Authors: Joseph P. Evans
Journal: JAMA (1960)

Methylene blue has been used for some years to reveal the presence of block within the ventricular system. Information gained from the procedure has been considered valuable, the drug harmless. Reactions were considered anaphylactic in type. Experimental observations emphasize, however, that the untoward effects are akin to phenomena resulting from the intrathecal administration of alcohol. The dye becomes fixed to neural tissue and the subsequent course is irreversible. Efforts to drain and irrigate the spinal subarachnoid space have failed to control or relieve the process. In patients there is bilateral optical atrophy, anosmia, and quadriplegia; the lower extermities become flaccid and paralyzed. Dementia has been noted.
Topical Oropharyngeal Anesthesia in Patients with Obstructive Sleep Apnea
Authors: Paul C. Deegan, Eithne Mulloy, Walter T. McNicholas
Journal: American Journal of Respiratory and Critical Care Medicine (1995)

Topical oropharyngeal anesthesia (TOPA) increases obstructive sleep apnea (OSA) frequency in both normal subjects and loud snorers. The effects of TOPA in established OSA were assessed in six male patients with a mean age (+/- SEM) of 50 +/- 5.3 yr. Following an acclimatization night, each subject underwent two overnight sleep studies, randomly assigned to TOPA (10% lidocaine spray and 0.25% bupivocaine gargle) and control (C) (saline placebo). Patients demonstrated sleep efficiencies of 93 +/- 2.9% (mean +/- SEM) during C and 88 +/- 2.9% during TOPA. Overall apnea-hypopnea (AH) frequency, using inductance plethysmography, showed little change: 21.2 +/- 3.6 on C versus 25.1 +/- 3.5 events/h on TOPA nights (p = 0.12). There was no significant increase in AH duration with TOPA, and oxygen desaturation (> or = 4%) frequency was similar: 21.1 +/- 3.9 per hour during TOPA versus 23.6 +/- 5.9 during C. However, obstructive AHs showed a change in thoracoabdominal motion from C to TOPA nights, with an increase in events with abdominal paradox from 3.1 +/- 1.1 to 10.3 +/- 3.1 per hour (p = 0.03), and a reduction in events with ribcage paradox from 13.1 +/- 1.6 to 8.2 +/- 2.4 per hour (p = 0.08). Central and mixed AHs demonstrated similar frequencies on both nights. These data support an impairment of upper airway (UA) protective reflexes among patients with OSA.
Total body fat and abdominal visceral fat response to exercise training in the HERITAGE family study: Evidence for major locus but no multifactorial effects
Authors: T. Rice, Y. Hong, L. Pérusse, J.-P. Després, J. Gagnon, A.S. Leon, J.S. Skinner, J.H. Wilmore, C. Bouchard, D.C. Rao
Journal: Metabolism (1999)
Chronic kidney disease and risk of major cardiovascular disease and non-vascular mortality: prospective population based cohort study
Authors: E. Di Angelantonio, R. Chowdhury, N. Sarwar, T. Aspelund, J. Danesh, V. Gudnason
Journal: BMJ (2010)

<b>Objective</b> To quantify associations of chronic kidney disease stages with major cardiovascular disease and non-vascular mortality in the general adult population. <b>Design</b> Prospective population based cohort study. <b>Setting</b> Reykjavik, Iceland. <b>Participants</b> 16 958 people aged 33-81 years without manifest vascular disease and with available information on stage of chronic kidney disease (defined by both estimated glomerular filtration rate and urinary protein) at study entry. <b>Main outcome measures</b> Hazard ratios for time to major coronary heart disease outcomes and mortality. <b>Results</b> 1210 (7%) of participants had chronic kidney disease at entry. During a median follow-up of 24 years, 4010 coronary heart disease outcomes, 559 deaths from stroke, and 3875 deaths from non-vascular causes were recorded. Compared with the reference group (estimated glomerular filtration rate 75-89 ml/min/1.73 m<sup>2</sup> and no proteinuria), people with lower renal function within the normal range of glomerular filtration rate did not have significantly higher risk of coronary heart disease. By contrast, in 1210 (7%) participants with chronic kidney disease at entry, hazard ratios for coronary heart disease, adjusted for several conventional cardiovascular risk factors, were 1.55 (95% confidence interval 1.02 to 2.35) for stage 1, 1.72 (1.30 to 2.24) for stage 2, 1.39 (1.22 to 1.58) for stage 3a, 1.90 (1.22 to 2.96) for stage 3b, and 4.29 (1.78 to 10.32) for stage 4. Information on chronic kidney disease increased discrimination and reclassification indices for coronary heart disease when added to conventional risk factors (P&lt;0.01). The incremental gain provided by chronic kidney disease was lower than that provided by diabetes or smoking (C index increases of 0.0015, 0.0024, and 0.0124 respectively). Hazard ratios with chronic kidney disease were 0.97 (0.82 to 1.15) for cancer mortality and 1.26 (1.07 to 1.50) for other non-vascular mortality. <b>Conclusions</b> In people without manifest vascular disease, even the earliest stages of chronic kidney disease are associated with excess risk of subsequent coronary heart disease. Assessment of chronic kidney disease in addition to conventional risk factors modestly improves prediction of risk for coronary heart disease in this population. Further studies are needed to investigate associations between chronic kidney disease and non-vascular mortality from causes other than cancer.