tbuckley/cabot-search huggingface dataset:
Stimulation of dorsal column in multiple sclerosis.
Authors: C H Hawkes, M Myke, A Desmond, M I Bultitude, G S Kanegaonkar
Journal: BMJ (1980)

The effect of stimulating the dorsal column in 19 selected patients with multiple sclerosis was studied in detail over two weeks. Before and during stimulation the patients were examined clinically; videotape recordings made of their movements; psychomotor performance tested; electrolaryngography performed; and urodynamic studies carried out. Improvement was seen in walking speed, power in certain muscle groups, chronic pain, and bladder function. The motor improvement was thought to be related to the effects of high motivation and practice, and therefore to be of doubtful importance. The changes in bladder function were more convincing and justify further study.
Very Long-Term Survival Implications of Heart Valve Replacement With Tissue Versus Mechanical Prostheses in Adults &lt;60 Years of Age
Authors: Marc Ruel, Vincent Chan, Pierre Bédard, Alexander Kulik, Ladislaus Ressler, B. Khanh Lam, Fraser D. Rubens, William Goldstein, Paul J. Hendry, Roy G. Masters, Thierry G. Mesana
Journal: Circulation (2007)

Several centers favor replacing a diseased native heart valve with a tissue rather than a mechanical prosthesis, even in younger adult patients. However, long-term data supporting this approach are lacking. We examined the survival implications of selecting a tissue versus a mechanical prosthesis at initial left-heart valve replacement in a cohort of adults <60 years of age who were followed for over 20 years.Comorbid and procedural data were available from 6554 patients who underwent valve replacement at our institution over the last 35 years. Of these, 1512 patients contributed follow-up data beyond 20 years, of whom 567 were adults <60 years of age at first left-heart valve operation (mean survivor follow-up, 24.0+/-3.1 years). Late outcomes were examined with Cox regression. Valve reoperation, often for prostheses that are no longer commercially available, occurred in 89% and 84% of patients by 20 years after tissue aortic and mitral valve replacement, respectively, and was associated with a mortality of 4.3%. There was no survival difference between patients implanted with a tissue versus a mechanical prosthesis at initial aortic valve replacement (hazard ratio 0.95; 95% CI: 0.7, 1.3; P=0.7). For mitral valve replacement patients, long-term survival was poorer than after aortic valve replacement (hazard ratio 1.4; 95% CI: 1.1, 1.8; P=0.003), but again no detrimental effect was associated with use of a tissue versus a mechanical prosthesis (hazard ratio 0.9; 95% CI 0.5, 1.4; P=0.5).In our experience, selecting a tissue prosthesis at initial operation in younger adults does not negatively impact survival into the third decade of follow-up, despite the risk of reoperation.
The Inhibition of Glucose-U-C_14 and Palmitate-U-C_14 Oxidation in Heart Muscle by Quinidine.
Authors: L. E. Crevasse
Journal: Annals of Internal Medicine (1963)

s1 April 1963The Inhibition of Glucose-U-C14 and Palmitate-U-C14 Oxidation in Heart Muscle by Quinidine.L. E. Crevasse Jr., M.D. (Associate), J. C. Shipp, M.D. (Associate)L. E. Crevasse Jr., M.D. (Associate)Search for more papers by this author, J. C. Shipp, M.D. (Associate)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-58-4-712_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThis study was designed to determine the effects of the cardiac depressant, quinidine, on the metabolism of glucose and free fatty acids, major substrates for energy production by heart muscle, as a possible explanation for its pharmacological action on the heart.Dog heart tissue slices, 150 mg, were incubated in Krebs Ringer phosphate and bicarbonate buffers containing 10 mmole glucose-U-C14 or 0.0125 mmole palmitate-U-C14 with 1 X 10-4M, 5 X 10-4M, and 1 X 10-3M quinidine sulfate. Oxygen consumption, glucose uptake, net lactate formation, net glycogen change, and the incorporation of glucose-U-C14 and palmitate-U-C14 into C14O2 were measured directly.Oxygen... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1963Volume 58, Issue 4Page: 712-713KeywordsGlucoseGlycogensHeartLactatesLongitudinal studiesMyocardiumOxygenOxygen consumptionPhosphatesSulfates Issue Published: 1 April 1963 PDF DownloadLoading ...
The oxygen delivery/consumption controversy. Approaches to management of the critically ill.
Authors: J A Russell, P T Phang
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

There is no doubt that physiologic dependence of VO2 on DO2 occurs in patients in shock. Whether pathologic dependence of VO2 on DO2 occurs in the critically ill has not yet been conclusively shown, partly because of the problem of mathematical coupling of shared measurement error of cardiac output and arterial oxygen content in many studies. In our opinion, contradicting RCTs of increased DO2 and the problems encountered in the RCTs to date do not support the practice of increasing DO2 to supranormal levels. Finally, we suggest that until technology is available to better assess DO2 and VO2 of vital organs and tissues, the clinician can negotiate this controversial area in individual patients by applying careful clinical assessment and judgement of patient response to changes in DO2.
Clinical Tropical Dermatology
Authors: Iris M. Krupp
Journal: JAMA (1976)

This, the first update on tropical dermatology since Simon's comprehensive work of 1952, is a much needed contribution to the dermatologist. Travel has made exotic areas readily available to all income levels, the world population has become extremely mobile, and hitherto "tropical" diseases are likely to be seen by physicians anywhere in the United States. The text is divided into 11 sections; the first five cover the dermatoses due to fungi, viruses, treponemata, bacteria, and animals (protozoa, helminths, and arthropods). Each section is divided into tropical infections and cosmopolitan infections of tropical interest. Other sections cover malnutrition, the exogenous and endogenous eczemas, venereal diseases, cutaneous manifestations of systemic tropical diseases, and miscellaneous dermatoses in the tropics. There is an impressive list of contributors who have done an excellent job of considering pertinent information and presenting it in an interesting and readable style. The book is well written, with sections on
Venous Thromboembolism in the Hematologic Malignancies
Authors: Anna Falanga, Marina Marchetti
Journal: Journal of Clinical Oncology (2009)

Patients with hematologic malignancies are at high risk of thrombotic or hemorrhagic complications. The incidence of these events is greatly variable and is influenced by many factors, including the type of disease, the type of chemotherapy, and the use of a central venous device. As in solid tumors, a number of clinical risk factors have been identified and contribute to the increasing thrombotic rate in hematologic malignancies. Biologic properties of the tumor cells can influence the hypercoagulable state of patients with these malignancies by several mechanisms. Of interest, oncogenes responsible for neoplastic transformation in leukemia also may be involved in clotting activation. Epidemiologic data allow an estimate of the incidence of venous thromboembolism (VTE) in acute leukemia, lymphomas, and multiple myeloma (MM). In this review, we focus on the epidemiology, pathogenesis, and VTE management in these three hematologic malignancies. No recommendation for routine thromboprophylaxis in these conditions, with the exception of MM, is available. Large, prospective, randomized clinical trials are needed to establish the best practice for thromboprophylaxis and treatment of VTE in these types of cancers.
Reply to Katsinelos et al.
Authors: S. Misra, M. Dwivedi
Journal: Endoscopy (2008)

We read with interest the report by Katsinelos et al [1], of their successful removal of an impacted Dormia basket using balloon dilation. We have used this technique to extract difficult bile duct stones that could not be removed after endoscopic sphincterotomy using conventional accessories and techniques [2]. Their report also underlines the wider utility of balloon dilation.
Studies on the Renal Circulation and Renal Function in Mitral Valvular Disease
Authors: LARS WERKÖ, EDVARDAS VARNAUSKAS, HARALD ELIASCH, JAN EK, HÄRJE BUCHT, BENGT THOMASSON, JONAS BERGSTRÖM
Journal: Circulation (1954)

In 31 patients with mitral stenosis of varying severity the effect of light, steady exercise during 15 to 17 minutes on renal function and renal circulation has been studied during heart catheterization. The results have been compared with the values obtained at rest in 72 patients with mitral stenosis. Exercise produced a decrease in clearance of para-aminohippurate and sodium excretion and an increase in renal resistance, changes not produced in normal individuals. Cardiac output and pulmonary pressures increased. In patients with right heart failure exercise produced increased pressures but no increase in cardiac output, and only slight changes in clearance but increase in renal resistance and renal venous pressure.
Intra-arterial Blood Pressure Measurements
Authors: Elemer K. Zsigmond
Journal: JAMA (1981)

<h3>To the Editor.—</h3> Often there is a great reliance placed on the monitoring of intra-arterial blood pressure (BP) by sophisticated transducers and recorders without the awareness of potential pitfalls in methodology. Since 1960 when I started using intraarterial BP measurements in the management of critically ill patients, I encountered scores of cases in which blind reliance on the directly monitored arterial pressure led to catastrophic iatrogenic complications or death. Proper selection of the arterial catheterization site, the type of the catheter, the method of the anticoagulation, the type of connecting lines and transducers, the adequacy of the recording equipment, and the frequency and accuracy of recalibration can substantially alter the systolic or peak pressures, mean pressures, and diastolic or minimum BPs. Comparison of direct intra-arterial BP with noninvasive computerized oscillometric measurements on the contralateral extremities of patients without vascular diseases showed greater reliability and dependability of the oscillometric than the
Elderly patients in acute medical wards: factors predicting length of stay in hospital
Authors: A. M Dunn, G. V Boswell
Journal: BMJ (1986)

referenced with a colleague or senior member of the nursing staff.Further evidence of incom- petence must be presented to senior colleagues.The options open to them will be explained by the personnel officer of the district and may include secondment to a more supervised post for the remainder of this man's contract.It is most important for the registrar to realise that he is not alone in this dilemma.Many of us have faced it and I have had to persuade both doctors and paramedical staff to reconsider their career plans in the light of such findings of incompetence.
Misfolded, protease-resistant proteins in animal models and human neurodegenerative disease
Authors: Dennis W. Dickson
Journal: Journal of Clinical Investigation (2002)

Neurodegeneration in the substantia nigra has been known to be a constant feature of Parkinson disease (PD) since the early part of the twentieth century, when Tretiakoff (1) correlated the clinical findings of patients with PD with postmortem pathology. A few years earlier, Lewy had described concentric hyaline inclusions within neurons, which are now referred to as Lewy bodies (LBs) (2). LBs are a sine qua non for the neurodegeneration that characterizes PD, but they are also found in nonparkinsonian disorders, most notably dementia with Lewy bodies (3). LBs are composed of filamentous aggregates of α-synuclein (4), and immunohistochemistry for synuclein is currently the most sensitive method for detecting LBs in brain tissue. Ubiquitin is another key component of LBs (5), and widespread use of immunohistochemical methods for detecting LBs, first with ubiquitin and later with synuclein antibodies, demonstrated that pathology in these disorders extended beyond LBs within neuronal perikarya to fibrillar lesions within neuritic processes, so-called Lewy neurites. Neuritic pathology is more widespread than LBs and affects regions of the brain, such as the hippocampus (6), that were not previously considered affected in PD. More recently, using antibodies to modified forms of α-synuclein (7) or sensitive antigen retrieval methods, it has been discovered that LBs are more prevalent and Lewy neurites more widespread than previously recognized. For example, LBs are present in a high proportion of Alzheimer brains (8), and the basal ganglia contain many Lewy neurites (7). The report by Neumann et al. in this issue of the JCI moves the field forward another step (9). The authors have employed a method for detecting abnormal forms of α-synuclein that may not necessarily be composed of fibrillar structures, which are the feature that permits ready detection of α-synuclein in LBs and Lewy neurites in tissue sections.
Prolonged reduction in polymorphonuclear adhesion following oral colchicine.
Authors: J N Fordham, J Kirwan, J Cason, H L Currey
Journal: Annals of the Rheumatic Diseases (1981)

Polymorphonuclear leucocyte (PMN) function was studied in 7 healthy subjects before and after 5 mg of colchicine taken in divided doses over 24 hours. Mean adherence to nylon fibre colums fell from a pretreatment level of 51% to 33.6% by day 1, remained low (31.8%) at day 5, and returned to pretreatment levels only by about day 9. Random motility (agarose plate method) fell from 932 micrometers to 688 micrometers by day 1, but had returned to normal by day 5. Directed migration and the phagocytic index (opsonised Candida albicans method) were not affected by colchicine treatment. In this marked and prolonged reduction in PMN adhesion implies an influence on maturing PMN precursors in bone marrow. Adherence to nylon fibres may reflect in-vivo properties of PMN which are important in the pathogenesis of acute gouty arthritis.
1121-53 Long-term clinical follow-up after diffuse in-stent restenosis
Authors: Hiroyoshi Yokoi, Kei Nishiyama, Shinichi Shirai, Kenji Ando, Takashi Yamada, Koyu Sakai, Jiro Ando, Masashi Iwabuchi, Hideyuki Nosaka, Masakiyo Nobuyoshi
Journal: Journal of the American College of Cardiology (2004)
Health impact assessment
Authors: A. Scott-Samuel
Journal: BMJ (1996)

concerned with sports and leisure safety.Its remit would be to promote safety in the pursuit of all sporting and leisure activ- ity.Three tasks merit urgent attention.Firstly, all existing sources of data on sports and leisure injury need to be collated and disseminated.Secondly, formal linkages (healthy alli- ances) should be further developed between sports organisa- tions (such as sports councils) and health agencies to improve communication, exchange information, pool expertise and experience, and promote joint preventive action.Thirdly, a programme of research designed to provide better understand- ing of the causes and possible prevention of these injuries should be constructed and implemented.The NHS has an 1 Secretary of State for Health.The health of the nation.
Conservative Therapy of Juvenile Hyperthyroidism
Authors: William S. Reveno
Journal: JAMA (1965)

<h3>To the Editor:—</h3> In answering the question regarding juvenile hyperthyroidism and malignant exophthalmos (<i>JAMA</i><b>192</b>:927 [June 7] 1965) I would suggest a more conservative approach than is recommended by the consultant. Progression in the exophthalmos in spite of an achieved euthyroid state forebodes worsening of the exophthalmos, particularly following radical therapy. Conservation of thyroid function is indicated for its braking effect on the anterior lobe of the pituitary gland. As an initial step, I would gradually reduce and eliminate the prednisone since it no longer serves a useful purpose. At the same time, the doses of methimazole should be reduced by 6 mg every eight hours at weekly intervals until it too has been discontinued. The sodium levothyroxine may then be increased gradually by 0.05 mg daily up to 0.2 mg daily as long as euthyroidism continues. Should hyperthyroidism recur, remission may be readily achieved with small 5-to 10-mg
Virus-Induced Diabetes Mellitus
Authors: Ji-Won Yoon, Marshall Austin, Takashi Onodera, Abner Louis Notkins
Journal: New England Journal of Medicine (1979)

A healthy 10-year-old boy was admitted to the hospital in diabetic ketoacidosis within three days of onset of symptoms of a flu-like illness. He died seven days later and post-mortem examination showed lymphocytic infiltration of the islets of Langerhans and necrosis of beta cells. Inoculation of mouse, monkey and human cell cultures with homogenates from the patient's pancreas led to isolation of a virus. Serologic studies revealed a rise in the titer of neutralizing antibody to this virus from less than 4 on the second hospital day to 32 on the day of death. Neutralization data showed that the virus was related to a diabetogenic variant derived from Coxsackievirus B4. Inoculation of mice with the human isolate produced hyperglycemia, inflammatory cells in the islets of Langerhans and beta-cell necrosis. Staining of mouse pancreatic sections with fluorescein-labeled antiviral antibody revealed viral antigens in beta cells. Both the clinical picture and animal studies suggested that the patient's diabetes was virus induced.
Production of Artificial "Case Histories" by using a Small Computer
Authors: F. T. de Dombal, J. C. Horrocks, J. R. Staniland, P. J. Guillou
Journal: BMJ (1971)

This paper describes a method of producing artificial "case histories" by using probability theory and clinical data from a series of 600 patients with acute abdominal pain. A series of 12 such cases were distributed to clinicians, medical students, medical secretaries and technicians, and members of the general public. For each "case" most clinicians concurred with the intended diagnosis. So did the medical secretaries and technicians; indeed this group were more confident of their chosen diagnoses than were the clinicians.It is suggested that clinicians are concerned to a large extent with the consequences of a diagnosis as well as its accuracy, and are motivated to some degree by a fear of the consequences of failure. They may be justified in adopting this policy, for when "errors" in diagnosis are harshly penalized the clinicians were infinitely more effective than any of the other groups.
Hyperosmolar non-ketotic diabetes mellitus associated with metolazone
Authors: O. Odugbesan, A. H Barnett
Journal: BMJ (1985)

Six years have passed since the outbreak of severe acute respiratory syndrome (SARS). Previous studies indicated that specific Abs to SARS-related coronavirus (SARS-CoV) waned over time in recovered SARS patients. It is critical to find out whether a potential anamnestic response, as seen with other viral infections, exists to protect a person from reinfection in case of another SARS outbreak. Recovered SARS patients were followed up to 6 y to estimate the longevity of specific Ab. The specific memory B cell and T cell responses to SARS-CoV Ags were measured by means of ELISPOT assay. Factors in relation to humoral and cellular immunity were investigated. Six years postinfection, specific IgG Ab to SARS-CoV became undetectable in 21 of the 23 former patients. No SARS-CoV Ag-specific memory B cell response was detected in either 23 former SARS patients or 22 close contacts of SARS patients. Memory T cell responses to a pool of SARS-CoV S peptides were identified in 14 of 23 (60.9%) recovered SARS patients, whereas there was no such specific response in either close contacts or healthy controls. Patients with more severe clinical manifestations seemed to present a higher level of Ag-specific memory T cell response. SARS-specific IgG Ab may eventually vanish and peripheral memory B cell responses are undetectable in recovered SARS patients. In contrast, specific T cell anamnestic responses can be maintained for at least 6 y. These findings have applications in preparation for the possible reemergence of SARS.
Autonomic Neural Dysfunction in Recently Diagnosed Diabetic Subjects
Authors: Michael A Pfeifer, Clare R Weinberg, Daniel L Cook, Andrew Reenan, Jeffrey B Halter, John W Ensinck, Daniel Porte
Journal: Diabetes Care (1984)

Because onset of autonomic neural dysfunction in the diabetic syndrome has not been well established, sensitive and quantitative measures of autonomic nervous system (ANS) function were made in 19 non-insulin-dependent (NIDD) and 14 insulin-dependent (IDD) recent-onset diabetic subjects. The known duration of diabetes mellitus in the NIDD subjects was ≤ 12 mo. The duration in the IDD subjects was ≤ 24 mo. RR-variation during beta adrenergic blockade (an index of an ANS reflex involving the cardiac parasympathetic nervous system [PNS] pathway) was smaller than that of control subjects in both NIDD (P &amp;lt; 0.001) and IDD subjects (P &amp;lt; 0.01). This PNS abnormality was not likely to be due to volume depletion since acute volume depletion induced by furosemide in six normal subjects (1608 ± 105 ml, mean ± SEM) did not change RR-variation. Dark-adapted pupil size after topical PNS blockade (an index of iris sympathetic nervous system [SNS] activity) was also smaller in both groups of diabetic subjects (NIDD, P &amp;lt; 0.01; IDD, P &amp;lt; 0.05). Pupillary latency time (an index of an ANS reflex involving iris PNS pathway) was prolonged in the NIDD subjects (P &amp;lt; 0.005) but was not significantly altered in the IDD subjects. Thus, it would appear that the ANS is impaired soon after the diagnosis of diabetes mellitus. We hypothesize that early impairment of the ANS is common in IDD and NIDD subjects. This finding is consistent with the hypothesis that abnormal carbohydrate metabolism is an important factor in the etiology of diabetic autonomic neuropathy.
Treatment of “poor risk” acute nonlymphocytic leukemia with continuously infused low‐dose cytosine arabinoside
Authors: Edward P. Balaban, John V. Cox, Nancy R. Schneider, Cheryl A. Harth, Barbara B. Haley, Richard Sheehan, Eugene P. Frenkel
Journal: American Journal of Hematology (1988)

Abstract There is currently little experience using a continuous intravenous infusion of low‐dose cytosine arabinoside (LDARA‐C) in the treatment of acute nonlymphocytic leukemia (ANLL). We report the results in 12 patients with ANLL described as either relapsed ANLL, ANLL with a preceding myelodysplastic phase, or ANLL in the elderly treated with 14 days of continuous intravenous LDARA‐C (20 mg/m 2 /day). Complete responses (CR) were seen in five patients (42%) and partial responses (PR) in three patients (25%). Treatment resulted in overall and clonal cytoreduction, which was evident by serial bone marrow exams and bone marrow cytogenetic analysis. The ability to obtain a CR correlated with the finding of a low initial marrow cellularity ( P &lt; .05). This study finds that continuous intravenous infusion of LDARA‐C for ANLL can achieve response rates comparable to standard induction programs in a subset of patients traditionally defined as having a poor prognosis.