bluuebunny/crossref_metadata_2025_split huggingface dataset:
Coronary heart disease associated with the use of human immunodeficiency virus (HTV)‐1 protease inhibitors: Report of four cases and review
Authors: Duong Michel , Buisson Marielle , Cottin Yves , Piroth Lionel , Lhuillier Isabelle , Grappin Michele , Chavanet Pascal , Wolff Jean‐Eric , Portier Henri 
Published: February 2009

AbstractFour cases of human immunodeficiency virus (HlV)‐infected patients who developed coronary heart disease (CHD) while under treatment with a protease inhibitor (PI) are described, and the epidemiologic and clinical features of 18 cases reported in the literature are analyzed. Cardiac manifestations mostly included myocardial infarctions. Smoking and hyperlipidemia were the most common risk factors for CHD, reported in 72 and 81% of the patients, respectively. Hypercholesterolemia was observed in 75% of the cases at the time of the cardiovascular event. Ninety percent of the patients with pretreatment normal lipid values experienced a rise in the plasma lipid levels during PI therapy. Although a definite relationship between the development of CHD and HIV Pis can not be made, this analysis suggests that Pi‐induced hyperlipidemia may play a role in accelerating coronary atherosclerosis in patients with concomitant risk factors. Evaluation and control of risk factors for CHD should be performed in each patient for whom treatment with a PI is indicated.
Left ventricular geometry and operative mortality in patients undergoing mitral valve replacement
Authors: Gomez‐Doblas Juan Jose , Schor John , Vignola Paul , Weinberg Denis , Traad Ernest , Carrillo Rogerio , Williams Donald , Lamas Gervasio A. 
Published: February 2009

AbstractBackground: Distortion of left ventricular (LV) shape is often associated with LV dysfunction and is thought to be an independent predictor of survival in patients with coronary disease.Hypothesis: The purpose of this study was to examine the relationship between LV geometry and hospital mortality in patients with mitral regurgitation (MR) undergoing mitral valve surgery.Methods: A consecutive series of patients (aged 68 ± 12 years, 47% men) (n = 149) with MR who underwent cardiac catheterization, left ventriculography, and mitral valve surgery from 1995 to 1996 at Mount Sinai Medical Center was studied. Left ventriculograms, clinical records, and hemodynamics were reviewed. Left ventricular volumes and ejection fraction were calculated using standard techniques. Left ventricular shape in diastole and systole was evaluated using the sphericity index, which is defined as the end‐systolic LV volume (X 100) divided by the volume of a sphere whose diameter is equal to the LV long axis.Results: In the patients studied, the etiology of mitral insufficiency was mitral valve prolapse in 40.9%, ischemic heart disease in 40.3%, rheumatic heart disease in 11.4%, and prosthetic valvular dysfunction in 7.4%. The average ejection fraction was 65% ± 17. Systolic sphericity index (SSI) was 36% ± 15 in patients who died, compared with 25% ± 11 in patients who lived (p < 0.001). A multivariate model was constructed using hemodynamic and angiographic indices derived during preoperative cardiac catheterization. Systolic sphericity index (odds ratio = 1.6 for each point increase, p < 0.01) was found to be an independent predictor of postoperative survival in the global population, as well as in patients with coronary disease (p<0.01).Conclusion: Left ventricular geometry is an independent angiographic risk factor for survival following mitral valve replacement. Sphericity index is a simple method for assessing LV geometry which should be calculated in patients as part of risk stratification.
Effects of acute exercise on hemorheological, endothelial, and platelet markers in patients with chronic heart failure in sinus rhythm
Authors: Gibbs Christopher R. , Blann Andrew D. , Edmunds Mrcpath, Eiry , Watson Robert D. S. , Lip Gregory Y. H. 
Published: February 2009

AbstractBackground: Chronic heart failure (CHF) is associated with an increased risk of thrombosis and thromboembolic events, including stroke and venous thromboembolism, which may be related to a prothrombotic or hypercoagulable state. Acute vigorous exercise has been associated with activation of hemostasis, and this risk may well be particularly increased in patients with CHF.Hypothesis: The study was undertaken to determine whether acute exercise would adversely affect abnormalities of hemorheological (fibrinogen, plasma viscosity, hematocrit), endothelial (von Willebrand factor), and platelet markers (soluble P selectin) in patients with CHF.Methods: We studied 22 ambulant outpatients (17 men; mean age 65 ± 9 years) with stable CHF (New York Heart Association class II—HI and a left ventricular ejection fraction of ≤ 40%) who were exercised to exhaustion on a treadmill. Results were compared with 20 hospital controls (patients with vascular disease, but free of CHF) and 20 healthy controls.Results: Baseline von Willebrand factor (p = 0.01) and soluble P‐selectin (p=0.006) levels were significantly elevated in patients with CHF when compared with controls. In the patients with CHF who were exercised, plasma viscosity, fibrinogen, and hematocrit levels increased significantly, both immediately post exercise and at 20 min into the recovery period (repeated measures analysis of variance, all p < 0.05). There was a positive correlation between exercise workload and the maximal changes in plasma viscosity in the patients with CHF (Spearman r = 0.5, p = 0.02). Plasma viscosity levels increased with exercise in the hospital control group, although no other exercise‐induced changes were noted in this group.Conclusion: The present study indicates that the hemorheological indices, fibrinogen, and hematocrit specifically increase during acute exercise in patients with CHF. Although moderate exercise should be encouraged in patients with CHF, vigorous exercise should probably be avoided in view of its potential prothrombotic effects in this high‐risk group of patients.
Identification of patients with coronary artery disease by assessing diastolic abnormalities during isometric exercise
Authors: Manolas Jan , Chrysochoou Christina , Kastelanos Stamatis , Aggeli Konstantina , Panagiotakos Demosthenes B. , Stefanadis Christodoulos , Toutouzas Pavlos 
Published: February 2009

AbstractBackground: Previous clinical studies using invasive and noninvasive methods have shown handgrip‐induced diastolic abnormalities in patients with coronary artery disease (CAD).Hypothesis: The study was undertaken to determine the utility of Doppler echo‐ and pressocardiography during handgrip in discriminating patients with coronary artery disease (CAD) and in those with normal coronary arteries.Methods: Both methods were obtained in 96 patients with suspected CAD within 24 h before coronary angiography. An abnormal handgrip‐Doppler was defined by an early (E) to late (A) transmittal flow velocities ratio (E/A) < 1 during handgrip and a positive handgrip pressocardiographic test (HAT) by an abnormal increase in the A wave/total excursion or prolongation of the absolute or relative (heart‐rate corrected) total relaxation time during isometric exercise.Results: Of the 96 patients studied, 23 had normal coronary arteries and 73 showed CAD. In patients with normal coronary arteries, handgrip‐Doppler showed an abnormal average E/A at rest and during handgrip, whereas all variables of HAT were within normal limits. In patients with CAD, handgrip‐Doppler showed only a moderate handgrip‐induced increase in average A (+ 19%, p < 0.001), whereas HAT showed a significant (p < 0.001) increase in mean A wave/total excursion (+ 60%) and decrease in the relative total relaxation time (‐17%). Furthermore, handgrip‐Doppler and HAT were abnormal in 15 of 23 (65%, specificity 35%) and the HAT in 5 of 23 (22%, specificity 78%) patients with normal coronary arteries, as well as in 57 of 73 (sensitivity 78%) and 69 of 73 (95%) patients with CAD.Conclusions: Our study demonstrates that these noninvasive stress tests can become a useful new diagnostic modality for detecting patients with unknown or suspected CAD.
Should functional cardiac murmurs be diagnosed by auscultation or by doppler echocardiography?
Authors: Bloch Antoine , Crittin Jean , Jaussi Andres 
Published: February 2009

AbstractBackground: For many years, cardiac auscultation has been the only available method for distinguishing between functional and organic murmurs; however, a more reliable differential diagnosis can now be achieved with Doppler echocardiography. The question remains as to whether a Doppler echocardiogram needs to be routinely recorded in the presence of a heart murmur or whether the auscultatory diagnosis of a functional murmur is sufficient.Hypotltesis: This prospective study attempts to answer this important question at a time when medical costs have to be curbed.Methods: The three cardiologists involved in this study saw 516 new patients in their private practice over a 10‐month period; of these, 321 (63.6%) underwent Doppler echocardiography. All patients underwent careful auscultation prior to echocardiography. At the end of their examinations, the cardiologists noted whether they considered the murmur to be of functional or organic origin. Minimal mitral or aortic regurgitations of short duration and low velocity occurring on non‐thickened valves were considered functional.Results: The results for cardiac auscultation and Doppler echocardiography were considered to be concordant, that is, both techniques diagnosed either a functional or organic murmur in 250 of 321 patients (77.9%). The results for cardiac auscultation and Doppler echocardiography showed a major discordance in just six cases (1.9%). All were mitral regurgitations of moderate severity.Conclusion: The prevalence of cardiac murmurs in the general population is very high. As echocardiography currently represents a significant proportion of cardiac medical expenditure, it would be wise to limit the use of this technique to essential indications. This study confirms that both cardiac auscultation and Doppler echocardiography possess important limitations. Nevertheless, it also shows that well‐trained cardiologists can identify the vast majority of functional murmurs on auscultation. Better training of nonspecialist physicians in cardiac auscultation may help in containing medical expenses.
Correlates of bundle‐branch block in patients undergoing primary angioplasty for acute myocardial infarction
Authors: Sugiura Tetsuro , Yamasaki Fumiyasu , Hatada Kengo , Nakamura Seishi , Iwasaka Toshiji 
Published: February 2009

AbstractBackground: Early reperfusion therapy has reduced the infarct size and mortality rate in patients with acute myocardial infarction (AMI). The occurrence of bundle‐branch block in AMI is related to the amount of myocardial damage and the insult to the conduction system.Hypothesis: To evaluate the clinical and angiographic factors related to the occurrence of bundle‐branch block (BBB) in patients with primary percutaneous transluminal coronary angioplasty (PTCA), we investigated consecutive series of patients with their first Q‐wave AMI and successful PTCA.Methods: Coronary angiogram at the time of admission, electrocardiogram, and echocardiogram were evaluated in 279 patients with their first Q‐wave AMI and successful PTCA.Results: Bundle‐branch block was detected in 26 patients (9%) 16 patients had transient and 10 patients had persistent block, while 16 patients had bifascicular block and 10 patients had right BBB. The patients with BBB had a significantly larger number of left ventricular asynergic segments, higher incidence of total occlusion of infarct‐related artery, angiographic no reflow, and pericardial rub than those without BBB. When the multivariate analysis was performed using five clinical markers of infarct severity, angiographic no reflow (F = 20.2, p < 0.001) and total occlusion of infarct‐related artery (F = 4.2, p = 0.04) were found to be the significant variables related to BBB.Conclusions: Despite successful primary PTCA, absence of antegrade flow in the infarct‐related artery at the onset of AMI and/or angiographic no reflow resulted in more severe transmural myocardial damage and, hence, the occurrence of BBB.
Right ventricular electrocardiographic leads for detection of brugada syndrome in sudden unexplained death syndrome survivors and their relatives
Authors: Sangwatanaroj Somkiat , Prechawat Somchai , Sunsaneewitayakul Buncha , Sitthisook Surapun , Tosukhowong Piyarat , Tungsanga Kriang 
Published: February 2009

AbstractBackground: Sudden unexplained death syndrome (SUDS) is a sudden death syndrome in previously healthy Southeast Asian young adults without any structural causes of death. Many SUDS survivors show electrocardiographic (ECG) evidence of RSR' and ST elevation in leads V1 to V3, which is similar to the ECG pattern in Brugada syndrome. However, in many cases transient normalization of the ECG does not make diagnosis with standard 12‐lead ECG possible.Hypothesis: To overcome this problem, we utilized the new right ventricular ECG leads to detect the Brugada syndrome in SUDS survivors.Methods: The subject was a Thai male patient who presented with a SUDS‐like syncopal attack. He had cardiac arrest due to idiopathic ventricular fibrillation.Results: Post‐resuscitation standard 12‐lead ECG showed no diagnostic features of Brugada syndrome. However, ECG patterns of RSR' and ST elevations typical for Brugada syndrome could be detected at the higher intercostal space leads V1 to V3. We observed similar findings in 2 of the other 10 SUDS survivors and 4 of 23 healthy family members.Conclusions: Our data suggest that these new right ventricular leads ECG may be helpful in detecting Brugada syndrome in SUDS survivors and their relatives.
Morphology, binding behavior and MR‐properties of paramagnetic collagen‐binding liposomes
Authors: Sanders H. M. H. F. , Strijkers G. J. , Mulder W. J. M. , Huinink H. P. , Erich S. J. F. , Adan O. C. G. , Sommerdijk N. A. J. M. , Merkx M. , Nicolay K. 
Published: February 2009

AbstractCollagen is an important component of the extracellular matrix (ECM) and plays an important role in normal tissue maturation and in pathological processes such as atherosclerosis and myocardial infarction. The diagnostics of the latter diseases using MRI could strongly benefit from the use of collagen‐specific contrast agents. The current study aimed to develop a bimodal liposomal MR contrast agent that was functionalized with CNA35, a collagen adhesion protein of the Staphylococcus aureus bacterium. The liposomes were characterized in terms of CNA35 protein conjugation and loading. The overall morphology was assessed with DLS and cryo‐TEM, while cryo‐TEM tomography was used to visualize the protein coverage of the liposomes. The binding properties of the contrast agent were investigated using a fluorescence assay based on the rhodamine content of the liposomes. The bulk relaxivity was determined using regular relaxometry while the MR‐properties of liposomes in their bound state were studied using NMR depth profiling. This CNA35 functionalized contrast agent and the set of in vitro experiments we performed indicate the potential of this technology for in vivo molecular imaging of collagen. Copyright © 2009 John Wiley & Sons, Ltd.
HPV detection rate in discordant Pap tests between cytotechnologists and pathologists
Authors: Chhieng David C. , Bakdounes K. , Connolly Mary , Gallaspy Sandra , Roberson Janie , Eltoum Isam 
Published: February 2009

AbstractWhen a Pap test is referred for pathologist review, it is accompanied by the cytotechnologist's provisional interpretation. Discordant interpretations between pathologists and cytotechnologists are sometimes noted. The objective is to correlate HPV detection rate with both estimated false‐negative fraction (EFNF) and ASC to SIL ratio among discordant ASC cases. ThinPrep Pap tests in which the cytotechnologists' provisional interpretations were up‐ or down‐graded by pathologists to ASC were retrieved between January and December 2006. HPV DNA testing was performed using hybrid capture technique. EFNFs and ASC to SIL ratio were estimated for cytotechnologists and pathologists, respectively. Overall, the EFNF ratio was 3.4% and the high‐risk HPV DNA detection rates in cases that were “over‐” or “under‐” interpreted by technologists were 0.71 and 0.40, respectively. The overall ASC to SIL ratio was 1.41 and the high‐risk HPV DNA detection rates in cases that were upgraded or downgraded to ASC were 0.40 and 0.71, respectively. In conclusion, our ASC to SIL ratios and EFNF were within acceptable range. We did not observe any association between ASC to SIL ratio and HPV detection rate in cases that were upgraded or downgraded to ASC by pathologists or between EFNF ratio and HPV detection rate in cases that were “over‐interpreted” (or “under‐interpreted”) by cytotechnologists. The HPV detection rates for ASC cases that were originally “over‐interpreted” by cytotechnologists were comparable to the HPV detection rates for LSIL, whereas those that were underinterpreted were comparable to the HPV detection rate for ASC. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.
Cytologic diagnosis of osseous lesions: A review with emphasis on the diagnosis of primary neoplasms of bone
Authors: Layfield Lester J. 
Published: February 2009

AbstractFine‐needle aspiration has been utilized as the initial diagnostic technique at a large number of body sites for over three quarters of a century. As early as the 1930s, fine‐needle aspiration (FNA) was used to investigate lesions of the musculoskeletal system. In many early reports, FNA was most frequently and successfully used for the diagnosis of metastatic disease to bone. Less emphasis was placed on its utility for the investigation of primary neoplasms of bone and soft tissue. Current utilization of FNA continues to de‐emphasize its application to the diagnosis of primary lesions of the musculoskeletal system.Recent advances in imaging techniques, immunohistochemistry, and molecular diagnostics along with an increasing familiarity among pathologists with the cytologic appearance of primary osseous tumors has led to reevaluation of the technique for investigation of these tumors. The diagnostic accuracy of FNA along with its relatively low cost and high degree of safety makes it a desirable technique for the investigation of primary lesions of the musculoskeletal system. This article reviews issues of diagnostic accuracy, optimal practice procedures, and benefits of the technique including cost reduction.The article will review criteria for selection of appropriate tissue targets for FNA to reduce the number of unsatisfactory specimens. Cytomorphologic features of the more common primary neoplasms of bone will be summarized along with recommendations for the utilization of immunohistochemistry and molecular diagnostics in the work‐up of primary neoplasms of bone. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.
Use of streamed Internet video for cytology training and education: www.PathLab.org
Authors: Poller David , Ljung Britt‐Marie , Gonda Peter 
Published: February 2009

AbstractAn Internet‐based method is described for submission of video clips to a website editor to be reviewed, edited, and then uploaded onto a video server, with a hypertext link to a website. The information on the webpages is searchable via the website sitemap on Internet search engines. A survey of video users who accessed a single 59‐minute FNA cytology training cytology video via the website showed a mean score for usefulness for specialists/consultants of 3.75, range 1–5, n = 16, usefulness for trainees mean score was 4.4, range 3–5, n = 12, with a mean score for visual and sound quality of 3.9, range 2–5, n = 16. Fifteen out of 17 respondents thought that posting video training material on the Internet was a good idea, and 9 of 17 respondents would also consider submitting training videos to a similar website.This brief exercise has shown that there is value in posting educational or training video content on the Internet and that the use of streamed video accessed via the Internet will be of increasing importance. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.
Cervical intraepithelial neoplasia and aneusomy of TERC: Assessment of liquid‐based cytological preparations
Authors: Ramsaroop Reena , Oei Paul , Ng Daniel , Kumar Nirup , Cotter Philip D. 
Published: February 2009

AbstractThe implementation of effective screening programs has decreased the incidence and mortality of cervical carcinoma. However, single screening tests are subjective and carry a significant false‐negative rate. Therefore, supplementary tests to support the Papanicolaou (PAP) smear are being developed. Human papillomavirus (HPV) testing has increased the specificity of the PAP smear, but has high sensitivity rate. This has proven unhelpful in low‐grade lesions and in young women.Cervical carcinogenesis is a multifactorial disorder. In addition to exposure to oncogenic HPV, which is regarded as the initiator, there must be a promoter to eventuate in invasive disease. The promoter factor appears to be the acquisition of extra copies of chromosome 3q and has been shown to be a constant recurrence in cervical carcinoma (squamous and adenocarcinomas). The 3q region contains the RNA sequence of the human telomerase gene TERC. Recent studies have shown a strong correlation between high‐grade cervical lesions and abnormalities of TERC.This study supports the previous studies and examines the status of the TERC gene in low and high‐grade cervical intraepithelial lesions, diagnosed on cytology. ASC‐H smears are also examined in an attempt to categorize lesions that are more likely to progress. Potentially this may help identify women in need of close clinical follow‐up and early treatment. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.
Cytologic diagnosis of pulmonary adenocarcinoma with micropapillary pattern: Does it correlate with the histologic findings?
Authors: Rudomina Dorota E. , Lin Oscar , Moreira Andre L. 
Published: February 2009

AbstractMicropapillary adenocarcinoma is associated with poor‐prognosis in several organs including the lung. The presence of small tight balls of neoplastic cells devoid of fibrovascular core in cytological preparations (micropapillary tufts) has been described as characteristic of micropapillary adenocarcinoma. In the lung, however, this criterion has not been validated. The cytological material of 46 cases of histologically proven pulmonary adenocarcinoma with a micropapillary component was compared to 33 cases with no micropapillary component to determine the specificity of micropapillary tufts for the histologic diagnosis of micropapillary adenocarcinoma. Other histologic patterns of invasive pulmonary adenocarcinomas (acinar, papillary, and solid) were also compared with patterns of neoplastic cell aggregates in cytological preparations. There were no significant differences in the distribution of micropapillary clusters between the two groups. The positive predictive value for the cytologic diagnosis of a micropapillary component in lung adenocarcinomas was of 64%. Similar findings were observed for other invasive patterns. Therefore, the detection of micropapillary tufts in cytology is not specific for the diagnosis of a pulmonary micropapillary adenocarcinoma in the lung. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.