tbuckley/cabot-search huggingface dataset:
Abstract 2148: Sirolimus-eluting Stent Versus Bare-metal Stent In Diabetic Patients: Results Of The Italian Multicenter, Randomized “Dessert” Study.
Authors: Aleardo Maresta, Elisabetta Varani, Marco Balducelli, Matteo Aquilina, Giuseppe Vecchi
Journal: Circulation (2007)

Background: The real benefit of DES in diabetic patients is still debated since few studies have performed a direct randomized comparison between DES and BMS in such a population. Methods : The “Dessert” study is a multicenter, randomized trial conducted in Italy to demonstrate the efficacy of sirolimus-eluting stents (SES) compared to BMS in de novo lesions in native coronary arteries of diabetic patients, treated with insulin and/or oral antidiabetics for at least 3 months. Intraprocedural abciximab or pre-procedural tirofiban were administered to all patients. The primary end point was in-stent late loss as assessed by centralized quantitative coronary angiography at 8-month follow up. Centrally adjudicated composite MACE (death, Q wave and non-Q wave myocardial infarction, emergent bypass surgery or repeat target lesion revascularization) and target vessel failure (TVF: death, treated vessel related AMI, TLR) at 30 days, 9 and 12 months, and binary restenosis 8 months post-procedure were the secondary endpoints. Results: One hundred fifty patients were randomized to SES (75 patients, 109 lesions) or BMS (75 patients, 109 lesions). The two groups were well balanced for clinical, anatomic and procedural characteristics. On average, 45% of patients had multivessel or multilesion PCI, reference diameter was 2.66±0.43 mm and lesion length was 14.9±7.1 mm. In-stent late lumen loss was reduced from 0.96±0.61 mm for BMS to 0.14±0.33 mm for SES (p&lt;0.001); in-segment binary restenosis resulted 38.8% vs 3.6% respectively (p&lt;0.001). Twelve-month clinical events were significantly lower in the sirolimus group: MACE 22.1% vs 38.6%, p=0.035; TLR 5.9% vs 30%, p&lt;0.001; TVF 14.7% vs 34.3%, p=0.008. One case of subacute stent thrombosis occurred in sirolimus group, and one late stent thrombosis in bare-metal group. At multivariable analysis, stent type confirmed as independent predictor of in-segment late loss (p&lt;0.001), binary restenosis (p&lt;0.001), 12 month TVF (p=0.010) and 12-month MACE (p=0.037). Conclusions: The randomized “Dessert” study demonstrated that SES are safe and efficacious in reducing both angiographic and clinical parameters of restenosis compared with BMS in diabetic patients with de novo 1 or 2 vessel coronary stenoses.
Rectal Cancer Clinical Practice Guidelines in Oncology
Authors: Paul F Engstrom, Al B Benson, Yi-Jen Chen, Michael A Choti, Raza A Dilawari, Charles A Enke, Marwan G Fakih, Charles Fuchs, Krystyna Kiel, James A Knol, Lucille A Leong, Kirk A Ludwig, Edward W Martin, Sujata Rao, M Wasif Saif, Leonard Saltz, John M Skibber, Alan P Venook, Timothy J Yeatman
Journal: Journal of the National Comprehensive Cancer Network (2005)

The NCCN Rectal Cancer Guidelines panel believes that a multidisciplinary approach is necessary for treating patients with colorectal cancer. Patients with T1 or T2 lesions that are node negative by endorectal ultrasound and who meet carefully defined criteria can be managed with a transanal excision. Abdominal peritoneal resection or low anterior resection with total mesorectal excision is appropriate for all other rectal lesions. Either preoperative chemoradiation or postoperative chemoradiotherapy is standard for patients with suspected or proven serosal invasion (pT3) or regional node involvement. Patients with recurrent localized disease should be considered for resection with or without radiotherapy. Chemotherapy regimens using irinotecan or oxaliplatin should be considered for patients with distant metastasis. The panel endorses the concept that treating patients in a clinical trial has priority over standard or accepted therapy.
γc Gene Transfer in the Presence of Stem Cell Factor, FLT-3L, Interleukin-7 (IL-7), IL-1, and IL-15 Cytokines Restores T-Cell Differentiation From γc(−) X-Linked Severe Combined Immunodeficiency Hematopoietic Progenitor Cells in Murine Fetal Thymic Organ Cultures
Authors: S. Hacein-Bey, G. De Saint Basile, J. Lemerle, A. Fischer, M. Cavazzana-Calvo
Journal: Blood (1998)
Abstract 2508: Different Early Changes of Coronary Plaque Composition according to Plaque Stability following Statin Initiation in Acute Coronary Syndromes: Classification and Analysis with IntraVascular UltraSound-Virtual Histology
Authors: Sang Gon Lee, Eun Seok Shin, Shin Jae Kim, Dae Sung Hwang, Sang Hyun Kim
Journal: Circulation (2008)

Previous trials using intravascular ultrasound(IVUS) have demonstrated that the lipid lowering therapy with statin decrease plaque volume and increase plaque echogenecity in patients with coronary artery disease. The aim of this study was to demonstrate the early effect of statin on plaque composition by IVUS-Virtual Histology(VH) during half a year after coronary event. Thirty six patients with ACS were prospectively enrolled. One target segment was determined in a non-PCI site (&gt;5 mm proximal or distal to the PCI site) with a reproducible index side branch or from the ostium of target vessel. We classified and analyzed the target plaques into two types according to plaque stability: thin-cap fibroatheroma (TCFA, n=10); and non TCFA(n=26) In 6 months after statin therapy, no change was demonstrated in mean percentage of the lipid core(16.9 ± 8.5% to 16.2 ± 10.1%, p=0.67), whereas plaque volume and LDL-cholesterol level were significantly reduced. There was a significant reduction of lipid core percentage in the TCFA type (21.1 ± 7.6 % to 10.9 ± 5.8 %, p= 0.001), but not in the non-TCFA type. The percentage change in lipid core showed a significant relation with the change in high-sensitivity C-reactive protein(r=0.4, p=0.03). Changes in LDL cholesterol and lipid core demonstrated no significant associations. A clear reduction of lipid core was observed only in the TCFA type which suggest that the changes of plaque composition following statin therapy might occur earlier in vulnerable plaque than stable plaque and appears related to their anti-inflammatory effects.
Abstract 515: Expression of Leptin, Adiponectin, and Activation of AMP Kinase in Failing and Mechanically Unloaded Human Hearts
Authors: Kenneth McGaffin, Benjamin Burkhead, Gregory Gibson, Christine Moravec, Charles McTiernan
Journal: Circulation (2007)

Introduction: The failing heart displays contractile dysfunction, increased workload and energy demands, and a switch in substrate utilization for ATP production from free fatty acid to glucose oxidation. ATP production is regulated by AMP Kinase (AMPK). In skeletal muscle, the cytokines leptin (OB) and adiponectin (AD) stimulate AMPK activity and result in preferential glucose metabolism. Both OB and AD are elevated in human heart failure (HF), but it is unknown whether these cytokines may alter AMPK activation in the failing and/or mechanically unloaded heart. Hypothesis : In human HF, elevated OB and AD levels: 1) are in part due to increased production by the cardiomyocyte; 2) are associated with cardiac AMPK activation; and 3) are downregulated under conditions of reduced workload and ATP requirement such as occurs with mechanical unloading. Methods/Results: Left ventricular tissue was obtained from 5 non-failing (NF), 10 end stage failing (F), and 8 paired pre/post ventricular assist device (VAD) patients. Results reported are fold change ± SEM relative to NF or pre VAD, compared by t-test . Relative to NF, F hearts showed (Real-time PCR) increased mRNA for BNP (4.4±0.4, P =0.04), OB (5.4±0.3, P =0.03), OBR (7.3±0.2, P =0.01) and AD (9.1±0.9, P =0.01), while levels of an unrelated gene, the grehlin receptor, were decreased (0.10±0.01, P =0.01). Immunoblotting confirmed similar changes in OB, OBR and AD protein levels, and immunoflurescence localized these proteins to the cardiomyocyte. Increased activation of AMPKα was observed in F hearts (1.9±0.2 fold increase vs NF, P =0.02) as assessed by the ratio of phosphorylated to total AMPKα. In paired pre and post VAD supported hearts, these changes were reversed after mechanical unloading as decreased BNP (0.020±0.001, P =0.01), OB (0.030±0.001, P =0.03), OBR (0.25±0.01, P =0.02) and AD (0.22±0.01, P =0.04) mRNAs were seen relative to the pre VAD state, whereas increased grehlin receptor mRNA was observed (7.6±0.5, P &lt;0.01 ) Further, relative to the pre VAD heart, post VAD showed a 1.7±0.2 fold ( P =0.04) decrease in the activation of AMPK. Conclusions: OB and AD are produced by failing cardiomyocytes and may contribute to preferential use of glucose for energy production in HF through activation of AMPK.
Lord, protect me from my friends : Public needs to be educated
Authors: Ian Frankel
Journal: BMJ (2000)

Editor—I am appalled by Farrell's attitude in his Soundings column.1 I question whether a doctor who prescribes antibiotics for flu for the purpose of “sporting one-upmanship” and “tactical gratification,” in spite of “academically impeccable advice” given by his partner, and for paediatric otitis media to “keep the parents happy” should be prescribing at all, let alone be allowed to air his views in a serious medical journal.

This sort of attitude is undoing all the work done by those of us trying to educate the public about the difference between viral and bacterial infections and the role of antibiotics in order to stem the growing tide of bacterial resistance. His patients will no doubt turn up to their local accident and emergency department expecting to be treated with antibiotics for minor ailments and may well become agitated or aggressive if refused.

Many times I have heard the line, “But my GP gives me antibiotics when I get this,” and have had to stand my ground in the face of significant verbal abuse in some cases. In this respect, Farrell had succeeded with his “screw them before they screw you” attitude because the correct practice of the hospital is seen by the patient as doing nothing and being uncaring, thus antagonising the already strained relationship between general practitioners and hospital doctors when in truth we should be working together for the benefit of our patients. My sympathy goes to Farrell's partner, who no doubt gets tarred with the same brush in discussions at the local accident and emergency department, and I would end with a prayer for him and the rest of us—Lord, protect us from doctors like Farrell.
Abstract 1284: The Calmodulin Kinase II (CaMKII)-p38 MAPK-ATF6 Pathway Is Involved in the Endoplasmic Reticulum (ER) Stress and Myocyte Apoptosis in {beta}1-Adrenergic Receptor (AR) Peptide Induced Cardiomyopathy
Authors: Weike Mao, Jiahao Liu, Shuji Fukuoka, Chikao Iwai, Michael Fu, Chang-seng Liang
Journal: Circulation (2006)
Abstract 2999: Single Versus Paired Blood Pressure Components and Risk for Cardiovascular Disease: The Framingham Heart Study
Authors: Stanley S Franklin, Victor A Lopez, Nathan D Wong, Gary F Mitchell, Martin G Larson, Ramachandran S Vasan, Daniel Levy
Journal: Circulation (2008)

The utility of any single versus paired blood pressure (BP) components in predicting cardiovascular disease (CVD) risk is not established. We compared the importance of paired systolic BP (SBP) and...
Abstract 11322: Drug Eluting Stents With Biodegradable Polymer: Do They Reduce Stent Thrombosis During the First Year After Implantation? A Meta-Analysis of Seven Randomized Trials
Authors: Pablo Salinas, Raul Moreno, Angel Sanchez-Recalde, Guillermo Galeote, Luis Calvo, Santiago Jimenez-Valero, Alejandro Saez, Ignacio Plaza, Jose Lopez-Sendon
Journal: Circulation (2010)

Introduction:  one of the proposed advantages of the new generation of drug eluting stents (DES) is the presence of a biodegradable polymer, which could reduce the rate of stent thrombosis. We assessed the hypothesis that DES with biodegradable polymer (DES-BP) would reduce stent thrombosis rate during the first year after implantation compared to DES with a persistent polymer (DES-PP).   Methods:  we performed a meta-analysis of 7 randomized clinical trials comparing DES-BP and DES-PP, including overall 6999 patients.   Results:  No significant difference in the stent thrombosis rate was found during the first year between DES-BP and DES-PP (1.16% vs. 1.23%, respectively; p = 0.96; OR 1.01, 95%CI 0.66 – 1.50; see figure); or during months 2–12 (0.27% vs. 0.45%, respectively; p = 0.33; OR 0.68; 95%CI 0.32 – 1.48).   Conclusions:  during the first year after implantation, stent thrombosis rate is not reduced with the new DES-BP compared to DES-PP. The potential benefits of these new devices regarding stent thrombosis rate, therefore, should be evaluated in studies with longer-term follow-up.
Management of Status Epilepticus
Authors: Joseph I Sirven, Elizabeth Waterhouse
Journal: New England Journal of Medicine (1982)

Status epilepticus is an increasingly recognized public health problem in the United States. Status epilepticus is associated with a high mortality rate that is largely contingent on the duration of the condition before initial treatment, the etiology of the condition, and the age of the patient. Treatment is evolving as new medications become available. Three new preparations--fosphenytoin, rectal diazepam, and parenteral valproate--have implications for the management of status epilepticus. However, randomized controlled trials show that benzodiazepines (in particular, diazepam and lorazepam) should be the initial drug therapy in patients with status epilepticus. Despite the paucity of clinical trials comparing medication regimens for acute seizures, there is broad consensus that immediate diagnosis and treatment are necessary to reduce the morbidity and mortality of this condition. Moreover, investigators have reported that status epilepticus often is not considered in patients with altered consciousness in the intensive care setting. In patients with persistent alteration of consciousness for which there is no clear etiology, physicians should be more quickly prepared to obtain electroencephalography to identify status epilepticus. Physicians should rely on a standardized protocol for management of status epilepticus to improve care for this neurologic emergency.
Abstract 3240: High Speed Rotational Coronary Venous Angiography Improves Delineation of Coronary Venous Anatomy during Cardiac Resynchronization Therapy
Authors: Masayoshi Kofune, Ichiro Watanabe, Sonoko Ashino, Yasuo Okumura, KIazunori Kawauchi, Tatsuya Kofune, Kimei Ohkubo, Kenichi Hashimoto, Atsushi Shindo, Hidezou Sugimura, Toshiko Nakai, Satoshi Saito, Atsushi Hirayama
Journal: Circulation (2007)

Background: The implantation of the left ventricular lead for biventricular devices can be challenging due to anatomic variation in the branching pattern of the coronary sinus (CS). Standard coronary venous (CV) angiography (SCVA) provides a static, fixed projection of the CV tree. Typically multiple contrast injections are obtained to gain a better understanding of vessels overlap and foreshortening. But, even in this situation, the site of side branch takeoff, its angulation and course cannot be reliably predicted - particularly in the presence of complex branching patterns. High-speed rotational CV angiography (RCVA) permits a dynamic, multi angle visualization of the CV anatomy. Objective: To compare RCVA with SCVA during cardiac resynchronization therapy. Methods: Digitally acquired RCVA from 10 patients were analyzed. RCVA uses a rapid isocentric rotation over a 180° arc, RAO 54° to LAO 54° in 4 sec, acquiring 121 frames /angiogram with a single injection of 20 ml of contrast (Infinix, Toshiba). The CV anatomy assessed by RCVA was compared with 2 static perpendicular views: RAO 45° and LAO 45°. Results: Three-dimensional models of the venous tree were reconstructed (Figure ), and the rotational images were analyzed using a full range of gantry angles, providing the operator with considerably more information about the CV anatomy than SCVA images. Conclusion: RCVA provides a better understanding of the CV anatomy and the special relationship of its branches. The SCVA view which optimally displayed the appropriate CS branch for left ventricular lead implantation was often different from the conventional RAO and LAO views.
Verteporfin therapy of subfoveal choroidal neovascularization in pathologic myopia
Authors: Kevin J. Blinder, Mark S. Blumenkranz, Neil M. Bressler, Susan B. Bressler, Guy Donati, Hilel Lewis, Jennifer I. Lim, Ugo Menchini, Joan W. Miller, Jordi M. Mones, Michael J. Potter, Constantin Pournaras, Al Reaves, Philip Rosenfeld, Andrew P. Schachat, Ursula Schmidt-Erfurth, Michel Sickenberg, Lawrence J. Singerman, Jason S. Slakter, H. Andrew Strong, Gianni Virgili, George A. Williams
Journal: Ophthalmology (2003)
Radioiodine Therapy for Benign Thyroid Disease
Authors: S. E. M. Clarke
Journal: Clinical Nuclear Medicine (2008)

Diseases of the thyroid constitute the most common form of endocrine disorders and, over the past 60 years, nuclear medicine has contributed significantly to the management of thyroid patients, both in terms of diagnosis and treatment (Williams et al. 1949). Radionuclide therapy for both benign disease (thyrotoxicosis and goitre) and thyroid cancer has served as a model for the development of other radionuclide therapies in recent years.
Abstract 2019: Untrained Volunteers Perform High Quality CPR When using an Automatic External Defibrillator with a CPR Voice Prompting Algorithm
Authors: Benjamin S Abella, Salem Kim, Alexandra Colombus, Cheryl L Shea, Lance B Becker
Journal: Circulation (2007)

Background: Recent investigations have demonstrated that CPR performance among trained providers can be improved by audiovisual prompting and real-time feedback, and higher quality CPR before defibrillation can improve shock success and has the potential to improve patient outcomes. Objective: We hypothesized that simplified voice prompts incorporated into an automatic external defibrillator (AED) can lead to improvements in CPR performance by untrained lay rescuers. Methods: Adult volunteers with no prior CPR training were assessed in their use of an AED with chest compression voice instructions and metronome prompts on a CPR-recording manikin. Volunteers were given minimal instructions regarding use of the device and were given no instructions regarding CPR performance. The AED was designed to prompt five cycles of 30 chest compressions between defibrillatory attempts. Chest compression rates and depths were measured via review of videotape and manikin recording data, respectively. Results: A total of 60 adults were assessed in their use of the AED, with a mean age of 33.6±12.8; 36/63 (57%) were female. Mean chest compression rate was 103±12 and mean depth was 37±14 mm. Furthermore, minimal decay in chest compression rates occurred over 5 cycles of chest compressions, with mean rate of 101±19 during the first cycle and 104±10 during the 5 th cycle. No volunteers were unable to use the AED or complete 5 cycles of chest compressions. Conclusions: Our work demonstrates that with appropriate real-time prompts delivered even in the absence of training or human coaching, laypersons can perform CPR that has a quality often similar to trained providers. This finding has important implications for AED design especially in light of the renewed importance of both CPR and the interaction of quality chest compressions and defibrillatory success.
Abstract 17934: MicroRNA-223 Regulates Macrophage Polarization and Protects Mice from Diet-Induced Insulin Resistance and Adipose Tissue Inflammation
Authors: Guoqing Zhuang, Cong Meng, Xin Guo, Hang Xu, Gang Wang, Honggui Li, Lei Shi, Chaodong Wu, Beiyan Zhou
Journal: Circulation (2011)

Macrophage-mediated adipose tissue inflammation is a crucial contributor to the risk of Cardiovascular disease (CVD) associated obesity. microRNAs are important regulators for various basic cell functions, such as proliferation, differentiation and apoptosis. We found that miR-223, a microRNA with high abundance in the bone marrow, can regulate adipose tissue inflammation by modulating macrophage polarization. In order to elucidate how miR-223 regulates the function of macrophages, we generated bone marrow-derived macrophage (BMDM) and tested their response to different stimuli. Our results showed that miR-223 deficiency did not affect macrophage formation in mice. However, miR-223 deficiency enhanced the classical activation (M1) but delayed alternative activation (M2) in macrophages. When stimulated by LPS, miR-223 -/- BMDMs exhibited stronger response compared to wild type control cells at various time points, accompanied by increased phosphorylation of p65, suggesting enhanced NF-κB signaling. On the contrary, alternative stimulation by IL-4 led to delayed response in BMDM with miR-223 deficiency judged by surface marker detection using FACS analysis. Consequently, co-culture of miR223-deficient macrophages with wild-type adipocytes led to increased adipocyte inflammatory response and decreased insulin signaling. In addition we investigated the modulation of adipose tissue inflammation by miR-223 in vivo. Upon high-fat diet (HFD) feeding, miR223-deficient mice exhibited a greater increase in the severity of systemic insulin resistance compared to wild-type littermates. Additionally, miR223-deficient mice exhibited a marked increase in HFD-induced adipose tissue inflammatory response. Using a combination of computational prediction and luciferase reporter assays, we identified several genes that are crucial for macrophage activation as miR-223 targets, including Nfat5 and Pknox1. Our findings suggest that miR223 protect against diet-induced adipose tissue inflammatory response by modulating macrophage polarization. thus provides a new layer of regulatory circuit in the network governing adipose tissue inflammation.
Influence of Beta-Blocker Continuation or Withdrawal on Outcomes in Patients Hospitalized With Heart Failure
Authors: Gregg C. Fonarow, William T. Abraham, Nancy M. Albert, Wendy Gattis Stough, Mihai Gheorghiade, Barry H. Greenberg, Christopher M. O'Connor, Jie Lena Sun, Clyde W. Yancy, James B. Young
Journal: Journal of the American College of Cardiology (2008)