tbuckley/cabot-search huggingface dataset:
PARTIAL HEART BLOCK DUE TO INCREASED VAGUS ACTION; A CASE REPORT
Authors: Robert C. Levy
Journal: Annals of Internal Medicine (1939)

Case Reports1 March 1939PARTIAL HEART BLOCK DUE TO INCREASED VAGUS ACTION; A CASE REPORTROBERT C. LEVY, M.D.ROBERT C. LEVY, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-12-9-1525 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThis rare case of severe heart block due to vagus influences is reported because of the paucity of such cases in the literature. It is felt that the report of such cases will help to draw attention to what must be of more frequent occurrence than the published instances would indicate.CASE REPORTR. A., a 14 year old school boy, was referred to us in the Medical Clinic on December 30, 1933 to determine the cause of his fainting spells. He had been admitted to the Surgical Clinic on March 25 for a recent fracture of the right humerus,...Bibliography1. WEISSFERRIS SEB: Adams-Stokes syndrome with transient complete heart block of vagovagal reflex origin: mechanism and treatment, Arch. Int. Med., 1934, liv, 931. CrossrefGoogle Scholar2. WEISS S: Syncope and related syndromes, Oxford System of Medicine, 1929, ii, 250. Google Scholar3. MORZAHN H: Klinischer Beitrag zur Frage funktioneller Reizleitungsstörungen, Klin. Wchnschr., 1936, xv, 486. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Chicago, Illinois*Received for publication May 16, 1938.From the Cardiovascular Department, Michael Reese Hospital, Chicago, Illinois.Aided by the A. D. Nast Fund for Cardiac Research. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byWenckebach A-V block: A frequent feature following heavy physical trainingRelationships between psychological factors and cardiac rhythm and electrical disturbancesSinoauricular Block with Wenckebach Periods, with Concurrent Second Degree Atrioventricular Block with Wenckebach Periods: Their Occurrence in a Presumably Healthy Young AdultDAILY RUNNING CAUSING WENCKEBACH HEART-BLOCKThe Adams-Stokes syndrome during normal sinus rhythm and transient heart blockDie Rhythmusstörungen des Herzens (einschließlich der intramuralen Leitungsstörungen und des Alternans)Second degree heart block with Wenckebach phenomenon: Its occurrence over a period of several years in a young healthy adultSecond-degree heart block and Wenckebach phenomenon associated with anxietyPartial A-V Block and Duodenal UlcerIncomplete heart block produced by changes in postureStudies on the auriculoventricular conduction time of normal children and of rheumatic children without signs of rheumatic activity 1 March 1939Volume 12, Issue 9Page: 1525-1529KeywordsHeartHumerusResearch fundingSyncope Issue Published: 1 March 1939 PDF downloadLoading ...
Abstract 13953: High-Sensitivity Troponin I Values Depend on Patient's Age and Gender
Authors: Julia Searle, Anna Slagman, Christian Mueller, Reinhold Muller, Fabian Holert, Joern O Vollert, Martin Mockel
Journal: Circulation (2012)

Purpose: High sensitivity Troponin (hsTn) assays are increasingly being introduced for routine purposes. We evaluated a hsTnI assay in an apparently healthly, working population to assess assay characteristics and marker distribution. Hypothesis: TnI values assessed with a high sensitivity assay differ between men and women and in different age groups. Methods: 300 apparently healthy staff members (150 men and 150 women, 50% below and above 40 years of age, respectively) of the University Hospital Charite Berlin were recruited. Subjects with a medical history of cardiac, renal or metabolic diseases were excluded. HsTnI was analyzed from frozen samples using the prototype ARCHITECT STAT hsTnI assay. Results: The overall CV (coefficient of variation) of the assay at 20 pg/ml (99th percentile value 23.72 pg/mL) was 3.96 %. Median age in our cohort was 39 (25th/75th %ile 33/46) years. Median hsTnI value for all subjects was 0.55 (0.0/1.45) pg/ml in EDTA plasma with a 99th%ile cut-off at 23.72 pg/mL. hsTnI va...
Fortnightly Review: Diagnosis and management of sinusitis
Authors: K. L Evans
Journal: BMJ (1994)

Sinusitis is an important source of morbidity and loss of income and may exacerbate chest disease.1 2 3 Most uncomplicated acute sinusitis is managed in Britain in primary care, whereas most chronic sinusitis is managed by rhinologists. Patients commonly seek advice on recurring symptoms of rhinorrhoea, congestion, intermittent facial pain, and postnasal drip, and it is important to distinguish chronic sinusitis from rhinitis. The course and character of sinusitis are influenced by (a) repeated episodes of mucosal oedema and hypersecretion in response to infection or allergy; and (b) anatomical variants which may impair sinus ventilation and mucociliary clearance. A broader understanding of these factors helps to direct medical management either alone or with surgery.4 The paranasal sinuses comprise four paired cavities: the frontal, maxillary, ethmoid, and sphenoid sinuses. Each is lined with ciliated pseudostratified columnar epithelium and has a narrow ostium that opens into the nasal cavity. The ostia of the frontal, maxillary, and anterior ethmoid sinuses open into the ostiomeatal complex, which lies in the middle meatus, lateral to the middle turbinate. The posterior ethmoid and sphenoid sinuses open into the superior meatus and sphenoethmoid recess respectively. The anatomy is variable and has been extensively reviewed.5 A protective mucous blanket, which envelops bacteria and other irritants, covers the respiratory cilia and is moved constantly along predetermined pathways to the sinus ostia. In the frontal sinus mucus passes up along the intersinus septum, then across the roof of the sinus before returning across the sinus floor to the frontal recess and the middle meatus.6 In the maxillary sinus mucus is moved from the floor of the sinus radially and up the walls of the sinus to the superiorly placed ostium (fig 1). FIG 1 Mucociliary pathways in the maxillary and frontal sinuses #### Summary points
Abstract 14294: Comparison of Procedural Outcomes in Patients Undergoing Right Versus Left Trans-Radial Percutaneous Coronary Procedures: A Meta-Analysis of Randomized Clinical Trials
Authors: Tejaskumar Shah, Mukesh Singh, Sasikanth Adigopula, Param Singh, Vamsi Kodumuri, Daniela Kovacs, Rohit Arora, Sandeep Khosla
Journal: Circulation (2011)

Background: Majority of the transradial procedures are performed by using right radial approach (RRA). The left radial approach (LRA) has anatomical advantage of being direct access to the ascendin...
Clonal architecture of del(5q) myelodysplastic syndromes: aberrant CD5 or CD7 expression within the myeloid progenitor compartment defines a subset with high clonal burden
Authors: U Oelschlaegel, M Alexander Röhnert, B Mohr, K Sockel, S Herold, G Ehninger, M Bornhäuser, C Thiede, U Platzbecker
Journal: Leukemia (2015)

Myelodysplastic syndromes (MDSs) represent a heterogeneous hematopoietic stem cell disorder.1 A precise estimation of the prognosis within the various MDS subgroups is essential for tailored therapeutic decisions. Especially, MDS patients with an isolated deletion of the long arm of chromosome 5 (del(5q)) represent a distinct subgroup regarding clinical outcome with a favorable prognosis in the majority of cases.2 Furthermore, they present with characteristic cytomorphological features, such as hypolobated megakaryocytes, macrocytic anemia and a normal or increased peripheral platelet count.3 Recently, flow cytometry (FCM) has been shown to serve as a valuable additional diagnostic and prognostic tool, especially to separate between unilineage and multilineage dysplasia.4, 5 Besides, it is known that abnormal antigen expression on myeloid progenitor cells (myPCs) is associated with a poor outcome.6, 7 In fact, aberrant CD7 expression on myPC of anemic lower-risk MDS patients predicts for a significantly lower response rate to erythropoiesis-stimulating agent (ESA) therapy irrespective of comparable other clinical predictive markers (erythropoietin level, transfusion burden).8 The pathophysiological background for this observation is still unknown. Notably, it has not been shown so far whether these distinct immunophenotypic characteristics correlate with presence and extent of clonal hematopoiesis, which in turn might not be responsive to growth factor stimulation. Therefore, in this study we separated different hematopoietic cell compartments of del(5q) MDS patients by fluorescence-activated cell sorting (FACS) and quantified the respective distribution of clonal burden with interphase fluorescence in situ hybridization (iFISH).
Prognostic Value of Global MR Myocardial Perfusion Imaging in Women With Suspected Myocardial Ischemia and No Obstructive Coronary Disease
Authors: Mark Doyle, Nicole Weinberg, Gerald M. Pohost, C. Noel Bairey Merz, Leslee J. Shaw, George Sopko, Anthon Fuisz, William J. Rogers, Edward G. Walsh, B. Delia Johnson, Barry L. Sharaf, Carl J. Pepine, Sunil Mankad, Steven E. Reis, Diane A. Vido, Geetha Rayarao, Vera Bittner, Lindsey Tauxe, Marian B. Olson, Sheryl F. Kelsey, Robert W.W. Biederman
Journal: JACC. Cardiovascular imaging (2010)
Abstract 15945: An Immunosuppressive Drug, Cyclosporin A Induces Cardiac Differentiation of P19 Embryonic Stem Cells Through Activation of BMP Pathway and Inhibition of TGF-β-Activin Pathway
Authors: Seung-Cheol Choi, Ji-Hyun Choi, Jong-Ho Kim, Chi-Yeon Park, Hyung-Joon Joo, Jae-Hyoung Park, Chul-Min Ahn, Soon-Jun Hong, Do-Sun Lim
Journal: Circulation (2012)

Background: An Immunosuppressive Drug, Cyclosporin A (CsA) is known to have pleiotropic effects to the proliferation, differentiation and survival of somatic cells as well as stem cells. However, l...
Abstract 836: Impact of Hypoadiponectinemia on Left Ventricular Remodeling after Primary Coronary Intervention for Acute Myocardial Infarction
Authors: Yukio Arita
Journal: Circulation (2008)

Left ventricular (LV) remodeling after acute myocardial infarction (AMI) is a precursor of the development of overt heart failure and is an important predictor of mortality. Adiponectin (AN) is an adipose-derived plasma protein that has the cardio-protective role against ischemia-reperfusion injury. Altered activity of matrix metalloproteinase (MMP) family has been implicated in the development of LV remodeling after myocardial infarction. Serum AN levels affect MMPs and tissue inhibitor of MMP (TIMP) levels, and attenuate adverse LV remodeling after AMI. In 88 consecutive patients with AMI successfully treated with primary percutaneous coronary intervention (PCI), serum levels of AN, MMP-2, MMP-9, and TIMP-1 were measured on admission, at day 7, and at 6 months after the onset. LV end-diastolic volume index (EDVI) and ejection fraction (EF) were assessed with 99m− Tc-tetrofosmin quantitative gated single-photon emission computed tomography within 10 days (early) and six months (chronic) after the onset. Serum AN and MMP-2 levels were decreased and serum MMP-9 and TIMP-1 levels were increased at day 7 compared to those at the onset and 6 months. Chronic/early EDVI ratio was negatively correlated with log AN at day 7 (r= −0.265, p=0.013), log AN at 6 months (r= −0.335, p=0.008), log MMP-2 at day 7 (r= −0.229, p=0.042), and positively correlated with log MMP-9 at day 7 (r= 0.237, p=0.037), log TIMP-1 on admission (r=0.277, p=0.0408). Chronic EF was positively correlated with log AN at day 7 (r=0.225, p=0.0374) and negatively correlated with log TIMP-1 at day 7 (r= −0.281, p=0.0133). Multiple logistic regression analyses revealed that chronic/early EDVI ratio independently correlated with log AN (r= −0.249, p=0.034) at day 7, although Log AN correlated positively log MMP-2, and negatively with log MMP-9 both at day 7 and 6 months. Measurement of AN at subacute phase can predict adverse cardiac remodeling in patients with AMI successfully treated with PCI.
Abstract 17758: Lower Coronary Wall Shear Stress is Associated with Endothelial Dysfunction in Patients with Non-Obstructive Coronary Artery Disease
Authors: Michel T Corban, Marina Piccinelli, Lucas H Timmins, Tiziano Passerini, Parham Eshtehardi, Ravi A Nanjundappa, Emad Rasoul-Arzrumly, Michael McDaniel, John Oshinski, Arshed A Quyyumi, Alessandro Veneziani, Don P Giddens, Habib Samady
Journal: Circulation (2012)

Background: Both low wall shear stress (WSS) and endothelial dysfunction have been associated with various stages of coronary atherosclerosis. However, the relationship between WSS and endothelial ...
The tobacco industry and scientific publications
Authors: A J Hedley, P. Whidden
Journal: BMJ (1997)

Introducing the postoperative care team Effective postoperative care remains surgeons' roleEditor-I am concerned that the suggestions made by David R Goldhill might be taken too seriously rather than remain a point for discussion. 1 Goldhill is right in his assertion that patients can fare badly in their postoperative course because of lack of attention by their attendants and lack of understanding of common postoperative complications.I believe, however, that he has missed the opportunity to lay the blame at the correct door.Surely it is the surgeons' role to carry out preoperative assessment, surgery, and effective postoperative care.If they choose to emphasise their importance in the operating theatre, delegating their other responsibilities to their trainees, the nurse practitioners, and the anaesthetists, why should we encourage this path?Undoubtedly, anaesthetists are fast becoming the new generalists, with an increasing role outside the operating theatre.These new skills and responsibilities include pain control, intensive care, and transoesophageal echocardiography, to name but a few.Some of my professional colleagues may relish even more diversification and abhor my comments.Goldhill implies that anaesthetists and postoperative care nurses will lead the postoperative care team; indeed, this is already happening in North America, where they have been sent to run preoperative assessment clinics by surgeons based in the operating room.If the surgical ward round in your hospital has become a quick look through the laboratory results and a glance at the chest radiograph before a rush to the changing rooms then I suggest that waiting for the confidential inquiry into perioperative deaths to point out the obvious is not the solution.
2007 Katharine A. Lembright Award and Lecture—Stage D Heart Failure: Quality-of-Life Outcomes After Transplantation and Mechanical Support
Authors: Kathleen Grady
Journal: Circulation (2007)

Approximately 5 million individuals have heart failure in the United States. The 1-year mortality rate for patients with New York Heart Association class IV heart failure is 50%. Treatment options for patients with refractory symptoms and stage D heart failure include heart transplantation and mechanical circulatory support devices. Improved outcomes have been demonstrated in these advanced heart failure patients who undergo surgical therapies. Prolongation of life is relevant only if quality of life (QOL) is improved. Improvement in QOL outcomes has been demonstrated before and after heart transplantation, including improved outcomes when bridged to transplantation with left ventricular assist devices (LVADs). While listed for transplantation, worse QOL is significantly related to more symptoms, psychological distress, and functional disability. Patients who are bridged to heart transplantation with an LVAD report significantly improved QOL and decreased symptoms from before to early after LVAD implantation, as well as fairly good and stable QOL outcomes through 1 year after implantation. At 1 year after transplantation, better QOL is significantly related to less psychological distress, functional disability, and symptom distress; older age; and fewer complications. At 5 to 10 years after heart transplantation, QOL is positive and stable. Improved QOL is significantly related to biopsychosocial variables, including less depression, more positive emotions, more social support, and less fatigue. Thus, for stage D heart failure patients, heart transplantation conveys significant short-and long-term QOL benefit, including in those patients who are bridged to transplantation with an LVAD.
Developing CAHPS for cancer care prototype: Progress and next steps.
Authors: Steven Garfinkel, Elizabeth Frentzel, Christian Evensen, San Keller, Kathleen J. Yost, Judith Sangl, Neeraj K. Arora
Journal: Journal of Clinical Oncology (2013)

134 Background: The CAHPS Survey for Cancer Care Prototype (application for CAHPS trademark in process) represents a significant advancement towards helping cancer care providers understand patients’ experiences of care. Although a number of standard commercial surveys are in use, currently none are available that both (1) capture the aspects of care most important to patients and (2) allow comparisons of those aspects of care across treatment centers and modalities. Methods: We developed a survey instrument that incorporated patient, clinician, and other stakeholder input throughout the development process. The survey measures patients’ perceptions of observable provider behaviors that are indicative of high quality care. Field test data were collected from 1,367 of 2,826 eligible patients (48% response rate) treated with surgery, radiation, or medical oncology from 6 accredited cancer treatment centers across the US. Classical psychometric methods were used to evaluate the measurement properties of composite scales per standard CAHPS methodology. Results: Based on a priori conceptualization, patient and stakeholder input, and empirical analyses, we identified 5 composites measuring shared decision-making, exchanging information about treatment, affective communication, access to care, and patient self-management. A confirmatory factor analysis using structural equation modeling showed an excellent fit (CFI &gt; 0.96; RMSEA &lt; 0.05) between the observed data and the structure for these five composites. Cronbach’s alpha for these composites ranged from 0.71-0.88, discriminant validity was good for all scales, and correlations with overall ratings of cancer care providers were moderate (0.31) to high (0.69). Evaluation of the precision with which the composites distinguish among cancer centers indicated that the measures were reliable; however, a second field test with a greater number and variety of centers will be needed to establish a standard sampling approach and confirm these results. Conclusions: We anticipate wide-spread adoption of this measure by cancer care providers to direct quality improvement efforts due to great interest and involvement in this project on the part of stakeholders.
Abstract 3090: Exercise After an ICD Improves Cardiorespiratory Fitness and Heart Rate Variability
Authors: Cynthia Dougherty, Robb Glenny, Robert Burr, Peter Kudenchuk
Journal: Circulation (2006)

Exercise is often not prescribed for patients who have an implantable cardioverter defibrillator (ICD) because patients are fearful of receiving an ICD shock with exercise, and providers are unsure how to prescribe exercise in this population.   Purpose : The purpose of this study was to determine the impact of an aerobic exercise program on cardiorespiratory fitness and heart rate variability (HRV) after sudden cardiac arrest and ICD implantation.   Methods : A single group 8-week pre-post test design within 6 months after receiving an ICD was used. Aerobic exercise consisted of treadmill and home walking for 5 hours/week at 60 – 80% of peak maximal oxygen uptake (V0 2 ) for 8 weeks. Exercise took place 3 hours a week in a supervised outpatient rehab setting, with home walking 2 hours/week documented with a Polar Heart Rate Monitor with recording capability. Outcomes:  cardiorespiratory fitness [peak V0 2 , exercise time, V0 2  at anaerobic threshold (AT), 0 2  pulse (V0 2 /HR), mean heart rate (HR)], and  HRV [24 hour holter monitor: time and frequency domain measures].   Results : Ten patients with an ICD for secondary prevention of cardiac arrest, mean age 54.3±10 years, Caucasian (100%), male (90%), mean EF% = 39.9±21, & taking beta blocker medication (100%) completed 8 weeks of exercise. Using paired t-tests, significant improvements were noted in cardiorespiratory fitness [0 2  pulse, p = 0.05; V0 2  at AT, p = 0.05; mean HR, p = 0.04] and HRV [standard deviation of all R-R intervals (SDNN), p = 0.02; High frequency power, p = 0.02]. Trends for improvement were demonstrated in other fitness measures (exercise time, peak V0 2 , METS) and HRV measures (standard deviation of 5 minute segments (SD5 min), low frequency (LF) power, total power). There were no hospitalizations related to the exercise program. There were no ICD shocks during exercise testing.   Conclusion : Aerobic exercise, strenuous enough to improve cardiorespiratory fitness and HRV, is safe and feasible to implement in those with an ICD. Future research should test exercise programs that can be implemented in the home setting. Even with a small sample size, this is one of the first reports to demonstrate safety and feasibility in implementing aerobic exercise in patients who have complex cardiac arrhythmias and an ICD.
University and Hospital Training of Public Health Physicians in Canada
Authors: W H le Riche
Journal: JAMA (1963)

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ECT response in depressed patients with and without a DSM-III personality disorder
Authors: M Zimmerman, W Coryell, B Pfohl, C Corenthal, D Stangl
Journal: American Journal of Psychiatry (1986)

Twenty-five inpatients with DSM-III major depressive disorder received ECT and were interviewed with the Structured Interview for DSM-III Personality Disorders. Patients with and patients without a personality disorder had similar short-term responses to ECT. The results of a 6-month prospective follow-up showed that depressed patients with a personality disorder were significantly more symptomatic and eight times more likely to be rehospitalized.
Abstract 12557: Prevalence and Long Term Prognosis of Patients with Complete Bundle Branch Block with Normal Left Ventricular Ejection Fraction Referred for Stress Echocardiogram
Authors: Azhar A Supariwala, Firas Kaddaha, Sameh Mohareb, Alexandros Briasoulis, Zainab I Mian, Michael Chiang, Ahmed Otokiti, Farooq Chaudhry, Siu-Sun Yao
Journal: Circulation (2012)