bluuebunny/crossref_metadata_2025_split huggingface dataset:
Idade, tabagismo, hipertensão arterial, altura e sexo feminino são determinantes de envelhecimento vascular avaliados pela segunda derivada da fotopletismografia digital
Authors: Silva Bruno Caldin da , Deus Fernanda Marques de , Santos Denise V. , Lauretti Cristiane Nogueira , Mattos Fernando R. , Fernandes Adriana M. , Bortolotto Luiz Aparecido 
Published: June 2014

OBJETIVO: Avaliar os fatores de risco cardiovascular (RCV) determinantes dos índices de função arterial obtidos pela segunda derivada da fotopletismografia digital (SDPTG) em uma população de funcionários de uma instituição de ensino privado da cidade de São Paulo. MÉTODOS: Foram obtidos dados antropométricos e clínicos, medidas de pressão arterial (PA) com aparelho automático Microlife em 238 indivíduos de 23 a 72 anos (média 40,1 ± 9), 105 mulheres / 133 homens. A SDPTG foi registrada automaticamente pelo dispositivo Dynapulse, com o sensor localizado no 2º dígito da mão direita; da SDPTG obtivemos ondas a, b, c e d na sístole e e na diástole, e foram calculados as relações b/a, d/a e o índice de envelhecimento vascular (AGI) = [(b-c-d-e)/a], respectivamente, marcadores de distensibilidade arterial, intensidade das ondas de reflexão e envelhecimento vascular. A idade vascular (IVS) foi estimada a partir de dados comparativos do AGI obtido e valores de uma população normal. Os indivíduos foram considerados com índices vasculares piores, se tivessem valores superiores à média mais o desvio padrão. Hipertensão arterial (HA) foi definida como PA>140x90mmHg ao exame ou referida pelo paciente. RESULTADOS: Na análise de regressão logística, a possibilidade de AGI elevado relacionou-se positiva e independentemente com idade > 50anos (Odds Ratio-OR = 17,24), tabagismo (O.R. = 3,82) e sexo feminino (O.R. = 6,05); menor relação b/a com idade > 50 anos (O.R. = 6,37), enquanto a relação d/a relacionou-se com sexo feminino (O.R. = 3,90). A maior IVS relaciona-se à idade (OR = 8,85), sexo feminino (OR= 4,0) e HAS (OR = 2,42). A análise multivariada mostrou que altura se relaciona com AGI (Mean Square – MS = 0,701) e D/A (MS = 0,279), enquanto que este último parâmetro também é influenciado pela PA diastólica (MS = 0,168) e PA média. CONCLUSÕES: Os índices vasculares obtidos pela SDPTG têm influência dos principais fatores de RCV e outros fatores a serem considerados em sua análise. A distensibilidade arterial (b/a) é relacionada à idade enquanto a intensidade da reflexão das ondas de pulso (d/a) tem influência do sexo feminino, altura e PA. O envelhecimento vascular sofre influências da HA, do tabagismo, idade e altura.
Lesão da artéria ilíaca interna bilateral associada com trauma pélvico, tratada por intervenção arteriografia com embolização
Authors: Bezerra Tiago Santoro , Garcia Diogo , Silva Francisco S. Collet e , Poggetti Renato Sergio , Fontes Belchor , Birolini Dario 
Published: June 2014

Ruptura traumática do anel pélvico resulta geralmente de impacto com grande dispêndio de energia levando à ruptura do complexo ósteo-ligamentar levando a hemorragia retroperitoneal oriunda do plexo venoso posterior da pelve e de superfícies ósseo-esponjosas, que juntamente com lesões associadas acarreta cerca de 15% a 25% de mortalidade nos pacientes com lesão do anel pélvico(1). Em menos de 10% dos casos ocorre sangramento de artérias conhecidas, e em menos de 1% é relatado sangramento de vasos ilíacos ou femorais(2,3,4). O objetivo do presente estudo é relatar o caso de um paciente vítima de trauma contuso com fratura pélvica e instabilidade hemodinâmica persistente após fixação pélvica externa, tendo se diagnosticado por arteriografia lesão artérial ilíaca interna bilateral, e tratado por radiologia inervencionista com embolização.
Esclerose concêntrica de Baló – relato de caso
Authors: Volpato Marília Granzotto , Klaus Daniele Gehlen , Carvalho Diélly Cunha de , Gomes Nathalia Tavares , Claudino Rinaldo 
Published: June 2014

Objetivos: O caso descrito a seguir busca incentivar a suspeição do médico frente a um provável diagnóstico de Esclerose Concêntrica de Baló (ECB). Métodos:Relato de caso associado à revisão da literatura científica a partir artigos publicados sobre o tema. Resultados: Há grande dificuldade na determinação da etiopatologia da ECB, já que há amplas áreas de desmielinização do sistema nervoso central (SNC) que podem ser observadas em várias doenças neurológicas. A RNM faz grande suspeição diagnóstica, mas a confirmação só é realmente obtida através de biópsia cerebral. O tratamento consiste no uso de esteróides em doses altas com neuroimagem seriada de controle. Discussão: Uma vez determinada a natureza inflamatória da lesão, a dificuldade de determinar sua etiopatologia reside no fato de que amplas áreas de desmielinizaçãodo sistema nervoso central (SNC) podem ser observadas em várias doenças neurológicas.Clinicamente os pacientes com esclerose concêntrica de Balo se apresentam com sintomas agudos ou subagudos, sugerindo lesão expansiva encefálica. A doença tem um curso imprevisível, que varia de uma rápida evolução em semanas ou meses sem remissão até uma condição autolimitada que incluem vários sintomas cognitivos como cefaléia, afasia, distúrbios de comportamento, disfunção visual e ataxia.
Somatostatinoma de papila maior e menor associado a tumor do estroma gastrointestinal (GIST)
Authors: Sartorelli Junior Alberto de Almeida , Santana Jéssica Andrea Bravo , Pereira Mariana Fabbri Guazzelli de O. , Jukemura José , Cunha José Eduardo Monteiro da , Assunção Neto Romeu Nunes de 
Published: June 2014

Os somatostatinomas são tumores neuroendócrinos extremamente raros quepossuem positividade imunohistoquímica para somatostatina. A incidência destes tumores émaior nos pacientes portadores da síndrome de Von Recklinghausen. Existem quatro casosrelatados na literatura que mostram coexistência entre somatostatinoma e tumores do estroma gastrointestinal (GIST), todos em pacientes com neurofibromatose. Neste relato, descrevemosuma paciente não portadora da síndrome que apresentou dois somatostatinomas primários de papila maior e menor e nove nódulos jejunais de GIST. O diagnóstico foi confirmado pelo anátomo-patológico e imunohistoquímica, e o tratamento consistiu em uma duodenopancreatectomia associada à ressecção dos nódulos jejunais. A paciente evoluiu com gastroparesia no pós-operatório, e recebeu alta no 34º PO com aceitação de dieta oral. Este é o primeiro caso de toda a literatura que descreve apresentação simultânea destes tumores em paciente não portadora de neurofibromatose.
PR Interval Identifies Clinical Response in Patients With Non–Left Bundle Branch Block
Authors: Kutyifa Valentina , Stockburger Martin , Daubert James P. , Holmqvist Fredrik , Olshansky Brian , Schuger Claudio , Klein Helmut , Goldenberg Ilan , Brenyo Andrew , McNitt Scott , Merkely Bela , Zareba Wojciech , Moss Arthur J. 
Published: June 2014

Background—
In Multicenter Automatic Defibrillator Implantation Trial–Cardiac Resynchronization Therapy (MADIT-CRT), patients with non–left bundle branch block (LBBB; including right bundle branch block, intraventricular conduction delay) did not have clinical benefit from cardiac resynchronization therapy with defibrillator (CRT-D). We hypothesized that baseline PR interval modulates clinical response to CRT-D therapy in patients with non-LBBB.

Methods and Results—

Non-LBBB patients (n=537; 30%) were divided into 2 groups based on their baseline PR interval as normal (including minimally prolonged) PR (PR <230 ms) and prolonged PR (PR ≥230 ms). The primary end point was heart failure or death. Separate secondary end points included heart failure events and all-cause mortality. Cox proportional hazards regression models were used to compare risk of end point events by CRT-D to implantable cardioverter defibrillator therapy in the PR subgroups. There were 96 patients (22%) with a prolonged PR and 438 patients (78%) with a normal PR interval. In non-LBBB patients with a prolonged PR interval, CRT-D treatment was associated with a 73% reduction in the risk of heart failure/death (hazard ratio, 0.27; 95% confidence interval, 0.13–0.57;
P
<0.001) and 81% decrease in the risk of all-cause mortality (hazard ratio, 0.19; 95% confidence interval, 0.13–0.57;
P
<0.001) compared with implantable cardioverter defibrillator therapy. In non-LBBB patients with normal PR, CRT-D therapy was associated with a trend toward an increased risk of heart failure/death (hazard ratio, 1.45; 95% confidence interval, 0.96–2.19;
P
=0.078; interaction
P
<0.001) and a more than 2-fold higher mortality (hazard ratio, 2.14; 95% confidence interval, 1.12–4.09;
P
=0.022; interaction
P
<0.001) compared with implantable cardioverter defibrillator therapy.

Conclusions—
The data support the use of CRT-D in MADIT-CRT non-LBBB patients with a prolonged PR interval. In non-LBBB patients with a normal PR interval, implantation of a CRT-D may be deleterious.

Clinical Trial Registration—

http://clinicaltrials.gov
; Unique Identifier: NCT00180271.
Validity of Claims-Based Stroke Algorithms in Contemporary Medicare Data
Authors: Kumamaru Hiraku , Judd Suzanne E. , Curtis Jeffrey R. , Ramachandran Rekha , Hardy N. Chantelle , Rhodes J. David , Safford Monika M. , Kissela Brett M. , Howard George , Jalbert Jessica J. , Brott Thomas G. , Setoguchi Soko 
Published: June 2014

Background—
The accuracy of stroke diagnosis in administrative claims for a contemporary population of Medicare enrollees has not been studied. We assessed the validity of diagnostic coding algorithms for identifying stroke in the Medicare population by linking data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) Study to Medicare claims.

Methods and Results—

The REGARDS Study enrolled 30 239 participants ≥45 years in the United States between 2003 and 2007. Stroke experts adjudicated suspected strokes, using retrieved medical records. We linked data for participants enrolled in fee-for-service Medicare to claims files from 2003 through 2009. Using adjudicated strokes as the gold standard, we calculated accuracy measures for algorithms to identify incident and recurrent strokes. We linked data for 15 089 participants, among whom 422 participants had adjudicated strokes during follow-up. An algorithm using primary discharge diagnosis codes for acute ischemic or hemorrhagic stroke (
International Classification of Diseases, Ninth Revision, Clinical Modification
codes: 430, 431, 433.x1, 434.x1, 436) had a positive predictive value of 92.6% (95% confidence interval, 88.8%–96.4%), a specificity of 99.8% (99.6%–99.9%), and a sensitivity of 59.5% (53.8%–65.1%). An algorithm using only acute ischemic stroke codes (433.x1, 434.x1, 436) had a positive predictive value of 91.1% (95% confidence interval, 86.6%–95.5%), a specificity of 99.8% (99.7%–99.9%), and a sensitivity of 58.6% (52.4%–64.7%).

Conclusions—
Claims-based algorithms to identify stroke in a contemporary Medicare cohort had high positive predictive value and specificity, supporting their use as outcomes for etiologic and comparative effectiveness studies in similar populations. These inpatient algorithms are unsuitable for estimating stroke incidence because of low sensitivity.
Apolipoprotein A-I Mimetic Peptide 4F Rescues Pulmonary Hypertension by Inducing MicroRNA-193-3p
Authors: Sharma Salil , Umar Soban , Potus Francois , Iorga Andrea , Wong Gabriel , Meriwether David , Breuils-Bonnet Sandra , Mai Denise , Navab Kaveh , Ross David , Navab Mohamad , Provencher Steeve , Fogelman Alan M. , Bonnet Sébastien , Reddy Srinivasa T. , Eghbali Mansoureh 
Published: June 2014

Background—
Pulmonary arterial hypertension is a chronic lung disease associated with severe pulmonary vascular changes. A pathogenic role of oxidized lipids such as hydroxyeicosatetraenoic and hydroxyoctadecadienoic acids is well established in vascular disease. Apolipoprotein A-I mimetic peptides, including 4F, have been reported to reduce levels of these oxidized lipids and improve vascular disease. However, the role of oxidized lipids in the progression of pulmonary arterial hypertension and the therapeutic action of 4F in pulmonary arterial hypertension are not well established.

Methods and Results—
We studied 2 different rodent models of pulmonary hypertension (PH): a monocrotaline rat model and a hypoxia mouse model. Plasma levels of hydroxyeicosatetraenoic and hydroxyoctadecadienoic acids were significantly elevated in PH. 4F treatment reduced these levels and rescued preexisting PH in both models. MicroRNA analysis revealed that microRNA-193-3p (miR193) was significantly downregulated in the lung tissue and serum from both patients with pulmonary arterial hypertension and rodents with PH. In vivo miR193 overexpression in the lungs rescued preexisting PH and resulted in downregulation of lipoxygenases and insulin-like growth factor-1 receptor. 4F restored PH-induced miR193 expression via transcription factor retinoid X receptor α.

Conclusions—
These studies establish the importance of microRNAs as downstream effectors of an apolipoprotein A-I mimetic peptide in the rescue of PH and suggest that treatment with apolipoprotein A-I mimetic peptides or miR193 may have therapeutic value.
Plasma Levels of Fetuin‐A and Risk of Coronary Heart Disease in US Women: The Nurses' Health Study
Authors: Sun Qi , Jiménez Monik C. , Townsend Mary K. , Rimm Eric B. , Manson JoAnn E. , Albert Christine M. , Rexrode Kathryn M. 
Published: June 2014

Background

Fetuin‐A may be involved in the etiology of coronary heart disease (
CHD
) through opposing pathways (ie, promoting insulin resistance and inhibiting ectopic calcification). We aimed to explicitly examine whether systemic inflammation, a factor leading to elevated vascular calcification, may modify the association between fetuin‐A and
CHD
risk.

Method and Results

During 16 years of follow‐up (1990–2006), we prospectively identified and confirmed 466 incident fatal or nonfatal
CHD
case in the Nurses' Health Study. For each case, 1 healthy control was selected using risk‐set sampling from 26 245 eligible participants. Cases and controls were matched for age, smoking status, fasting status, and date of blood draw. After multivariate adjustment for lifestyle factors, body mass index, diet, and blood lipids, fetuin‐A levels were not associated with
CHD
risk in the whole population: odds ratio (
OR
) (95%
CI
) comparing extreme quintiles of fetuin‐A was 0.79 (0.44 to 1.40). However, a significant inverse association was observed among participants with higher C‐reactive protein levels (
P
interaction
=0.04). The
OR
(95%
CI
) comparing highest versus lowest quintiles of fetuin‐A was 0.50 (0.26 to 0.97;
P
trend
=0.004) when
C‐reactive protein
levels were above population median (0.20 mg/dL), whereas among the remainder of the participants, the corresponding
OR
(95%
CI
) was 1.09 (0.58 to 2.05;
P
trend
=0.75).

Conclusions

In this population of
US
women, fetuin‐A levels were associated with lower
CHD
risk when
C‐reactive protein
levels were high, but null association was observed among participants with lower
C‐reactive protein
levels. This divergent pattern of association needs replication in future studies.
Persistent Cognitive Impairment After Transient Ischemic Attack
Authors: van Rooij Frank G. , Schaapsmeerders Pauline , Maaijwee Noortje A.M. , van Duijnhoven Dirk A.H.J. , de Leeuw Frank-Erik , Kessels Roy P.C. , van Dijk Ewoud J. 
Published: June 2014

Background and Purpose—
By definition, the symptoms of a transient ischemic attack (TIA) subside completely within 24 hours. Imaging studies show signs of persistent ischemic tissue damage in a substantial amount of patients with TIA. Cerebral infarction can cause permanent cognitive impairment. Whether permanent cognitive impairment occurs after TIA is unclear, as is its profile.

Methods—

Patients with TIA aged 45 to 65 years without prior stroke or dementia underwent comprehensive neuropsychological testing within 3 months.
Z
scores per cognitive domain were obtained, based on the mean of a control group within the same age range. Cognitive impairment was defined as a domain
z
score <−1.65. Patients underwent either computed tomography or MRI brain imaging.

Results—
One hundred seven patients with TIA (63% women, mean age, 56.6 years) were included and compared with 81 controls (56% women, mean age, 52.9 years). Patients performed worse on all cognitive domains except episodic memory. Working memory (25%), attention (22%), and information processing speed (16%) were most frequently impaired and more often than in the control group (age- and sex-adjusted odds ratios, respectively, 22.5 [95% confidence interval, 2.9–174.3], 6.8 [1.9–24.3], 7.1 [1.5–32.5]). More than 35% of patients with TIA had impairment of ≥1 cognitive domain. Presence of silent brain infarcts was related to worse executive functioning but did not explain the whole relationship between TIA and cognitive impairment.

Conclusions—
More than a third of patients with TIA have impairment of ≥1 cognitive domain within 3 months after their TIA. The affected domains fit in the vascular cognitive impairment profile.
ATP-Evoked Sustained Vasoconstrictions Mediated by Heteromeric P2X1/4 Receptors in Cerebral Arteries
Authors: Harhun Maksym I. , Povstyan Oleksandr V. , Albert Anthony P. , Nichols Claire M. 
Published: June 2014

Background and Purpose—
Current knowledge states that vasoconstrictor responses to ATP are mediated by rapidly desensitizing ligand-gated P2X1 receptors in vascular smooth muscle cells (VSMCs). However, ATP is implicated in contributing to pathological conditions involving sustained vasoconstrictor response such as cerebral vasospasm. The purpose of this study is to test the hypothesis that the stimulation of VSMC P2XR receptors (P2XRs) contributes to ATP-evoked sustained vasoconstrictions in rat middle cerebral arteries (RMCAs).

Methods—
Reverse transcription- polymerase chain reaction, Western blot, and immunocytochemistry were used to analyze expression of mRNA and proteins in RMCAs VSMCs. Ionic currents and calcium responses were investigated using patch-clamp and confocal imaging techniques, respectively. Functional responses were confirmed using wire myography.

Results—

Expression of mRNA and protein for P2X1R and P2X4R subunits was identified in RMCA VSMCs. Confocal imaging in fluo-3-loaded VSMCs showed that ATP and a selective P2XR agonist, αβmeATP, evoked similar dose-dependent increases in [Ca
2+
]
i
. Patch-clamp experiments identified 2 components of P2XR-mediated currents: consisting of a fast desensitizing phase mediated by homomeric P2X1Rs and a slowly desensitizing phase involving heteromeric P2X1/4Rs. Isometric tension measurements showed that ≈80%:20% of initial ATP-evoked vasoconstriction in RMCA is mediated by homomeric P2X1Rs and heteromeric P2X1/4Rs, respectively. The sustained slowly desensitizing and rapidly recovering from desensitization responses are mediated by heteromeric P2X1/4Rs.

Conclusions—
This study reveals for the first time that apart from rapidly desensitizing homomeric P2X1Rs, heteromeric P2X1/4Rs contribute to the sustained component of the purinergic-mediated vasoconstriction in RMCA. Our study, therefore, identifies possible novel targets for therapeutical intervention in cerebral circulation.
Effects of Different Configurations of the East Asian Subtropical and Polar Front Jets on Precipitation during the Mei-Yu Season
Authors: Li Li , Zhang Yaocun 
Published: June 2014

Abstract
Observational analysis indicates that the East Asian jet stream consists of two separate branches: the East Asian subtropical jet (EASJ) and the East Asian polar front jet (EAPJ). The impacts of different intensity configurations of the EASJ and EAPJ on precipitation during the mei-yu season are investigated using the NCEP–NCAR Reanalysis Project (NNRP) dataset and daily gauge observations in East China. The intensity and location of precipitation are associated with different configurations of the EASJ and EAPJ. Precipitation intensity increases with intensification of the EASJ and EAPJ. The rainband is located to the north of the mei-yu region when the EASJ intensifies and the EAPJ weakens. Further analyses indicate that the intensity changes of the EASJ and EAPJ are linked to the cold and warm airmass activities. For cases with strong EASJ and EAPJ, both the warm-moist and cold air masses are active. When the warm-moist and cold air masses meet near 30°N, abundant precipitation occurs in the Yangtze-Huai River basin (YHRB). For cases with weak EASJ and EAPJ, both the cold and warm-moist air masses are inactive, and no significant precipitation occurs in the YHRB. For cases with strong EASJ and weak EAPJ, the warm-moist air mass moves northward while the cold air mass is weak. Precipitation concentrates to the north of YHRB. For cases with weak EASJ and strong EAPJ, cold air extends farther south while the warm-moist air mass is inactive. Precipitation occurs to the south of YHRB.
Multiple Zonal Jets in a Differentially Heated Rotating Annulus
Authors: Smith Carlowen A. , Speer Kevin G. , Griffiths Ross W. 
Published: June 2014

AbstractA laboratory experiment of multiple baroclinic zonal jets is described, thought to be dynamically similar to flow observed in the Antarctic Circumpolar Current. Differential heating sets the overall temperature difference and drives unstable baroclinic flow, but the circulation is free to determine its own structure and local stratification; experiments were run to a stationary state and extend the dynamical regime of previous experiments. A topographic analog to the planetary β effect is imposed by the gradient of fluid depth with radius supplied by a sloping bottom and a parabolic free surface. New regimes of a low thermal Rossby number (RoT ~ 10−3) and high Taylor number (Ta ~ 1011) are explored such that the deformation radius Lρ is much smaller than the annulus gap width L and similar to the Rhines length. Multiple jets emerge in rough proportion to the smallness of the Rhines scale, relatively insensitive to the Taylor number; a regime diagram taking the β effect into account better reflects the emergence of the jets. Eddy momentum fluxes are consistent with an active role in maintaining the jets, and jet development appears to follow the Vallis and Maltrud phenomenology of anisotropic wave–turbulence interaction on a β plane. Intermittency and episodes of coherent meridional jet migration occur, especially during spinup.
Interarytenoid Sodium Carboxymethylcellulose Gel Injection for Management of Pediatric Aspiration
Authors: Horn David L. , DeMarre Kim , Parikh Sanjay R. 
Published: June 2014

Objective: This study aimed to investigate the role of interarytenoid injection laryngoplasty (IL) for the management of pediatric aspiration. Methods: Medical records of 30 patients, 9 female, with radiographically confirmed chronic aspiration who underwent intraoperative IL were retrospectively reviewed. Clinical improvement was defined as successful advancement of feeds to thinner consistencies. Results: Clinical improvement was observed in 57% of patients. Six children with type 1 posterior laryngeal cleft (PLC-1) were not significantly more likely to show improvement compared to the children without PLC-1. Type 1 posterior laryngeal cleft was associated with older age and higher prevalence of neurodevelopmental risk factors relative to absence of PLC-1. Patients with PLC-1 were more likely than noncleft patients to show recurrence of symptoms after initial improvement with IL. Five patients underwent endoscopic repair. Repair was successful in 3 patients who improved after IL but not in 2 patients who did not improve after IL. Conclusion: Chronic aspiration can improve after IL even in patients with normal anatomy. Injection laryngoplasty can be performed to improve selection of PLC-1 patients for definitive endoscopic repair. Further prospective research, with a randomized control group, is needed to understand whether interarytenoid incompetence plays a role in some patients with chronic aspiration, who do not have a PLC-1.