tbuckley/cabot-search huggingface dataset:
Abstract 243: Time-Dependent Benefit of Biphasic Defibrillators in Patients with Witnessed Out-of-Hospital Cardiac Arrest from VF/Pulseless VT
Authors: Soichi Nakashiro, Tetsuya Matoba, Naohiro Yonemoto, Hiroshi Nonogi, Hiromi Seo, Hiroyuki Yokoyama, Ken Nagao, Takeshi Kimura
Journal: Circulation (2011)

Background: Biphasic defibrillator is shown to be superior to monophasic one to terminate VF; however, it remains unclear whether biphasic defibrillator improves neurological outcome in patients of witnessed out-of-hospital cardiac arrest (OHCA) from shockable ventricular arrhythmia. Hence we examined that the superiority of biphasic defibrillator in association with the time from the onset to first shock in patients of witnessed OHCA. Methods and Results: We prospectively analyzed the data collected by Japanese official EMS at Ministry of Internal Affairs and Communications in Japan from April 1, 2006 to December 31, 2009. There were 15,040 patients of witnessed OHCA with VF or pulseless VT aged ≥18, and for whom shock was delivered within 30 minutes from the onset. We performed multivariate analysis and found that age, use of biphasic defibrillator, chest compression by bystander, and some other factors predicted better 1-month survival with Glasgow-Pittsburgh cerebral performance category 1 or 2. Shock was delivered using monophasic defibrillator in 3,242 patients (21.6%, monophasic group) and biphasic defibrillator in 11,798 patients (78.4%, biphasic group). The probability of 1-month survival with CPC 1 or 2 was higher in biphasic group than monophasic group when first shock was delivered 6 to 11 minutes after the onset (Figure, *P&lt;0.05 by Fisher's exact test). Odds ratio (OR) for the outcome was time-dependent, and biphasic defibrillator was better when first shock was delivered at 6-10 min (OR 0.64, 95% CI 0.54-0.75) or 11-15 min (OR 0.68, 95% CI 0.56-0.82) after the onset (Figure). No significant benefit of the use of biphasic defibrillator was observed during earlier or later period. Conclusions: Biphasic defibrillator improved 1-month survival with favorable neurological outcome in witnessed OHCA from VF/pulseless VT. The beneficial effect was time-dependent and significant when the first shock is delivered 6 to 15 minutes after the witness.
Induction of inflammation, oxidative stress and autophagy in human alveolar type I epithelial cells following exposure to silver nanoparticles
Authors: Martina Zambianchi, Andrew Thorley, Teresa Tetley
Journal: European Respiratory Journal (2012)

The use of silver nanoparticles (AgNP) in health products is increasing due to their antimicrobial activity. However, their impact on health is poorly understood. It is known that the particle reactivity increases as size decreases, thus AgNPs may induce inflammatory responses that their bulk sized counterparts do not. It is known that 50% of inhaled nano-sized (  Human alveolar type I epithelial cells (TT1) were exposed to 80nm AgNPs for up to 24h. IL-6 and IL-8 release was measured by ELISA and reactive oxygen species (ROS) production measured by dihydroethidium staining. n-acetylcysteine (NAC) was used to evaluate the role of ROS in mediator release. The plasmid assay was used to assess free radical-induced DNA damage and the autophagy markers LC3II/LC3I measured by immunoblotting.  AgNPs induced significant oxidative stress within 4h and IL-6 and IL-8 by 24h. NAC pre-treatment inhibited Ag50μg/ml-stimulation of IL-6 by 60% (P  Our study shows that AgNPs induce oxidative stress-dependent inflammation, DNA damage and a unique finding of autophagy responses in TT1 cells suggesting that AgNPs may have adverse effects on the lung.
Mild Asthma
Authors: Edward T. Naureckas, Julian Solway
Journal: New England Journal of Medicine (2001)

A 26-year-old man with an eight-year history of asthma has shortness of breath and cough about three times a week. He wheezes routinely with exercise, but his asthma does not usually bother him at night. Office spirometry shows that the forced expiratory volume in one second is 85 percent of his predicted value. How should he be treated?
Psychological problems after mefloquine and chloroquine
Authors: P. Lench
Journal: BMJ (1995)

EDITOR,--Most doctors will have taken chloroquine for short periods when travelling to exotic destinations. I had done so in Egypt, Jordan, and Syria: I had taken chloroquine for six weeks at any one time and felt confident about taking it for two years when I came to Papua New Guinea.

Initially I felt well, but after one month I became lethargic and would fall asleep in meetings. I had early morning waking and …
Effects of two novel cationic staphylococcal proteins (NP-taseand p70) and enterotoxin B on IgE synthesis and interleukin-4 and interferon-γ production in patients with atopic dermatitis
Authors: A. Jahreis, P. Beckheinrich, U-F. Haustein
Journal: British Journal of Dermatology (2000)

We have characterized the cell-mediated and humoral immune response of patients with atopic dermatitis (AD) and healthy controls in response to two novel staphylococcal antigens (NP-tase, p70) and the superantigen staphylococcal enterotoxin B (SEB). The parameters studied were IgE, interleukin (IL)-4 and interferon (IFN)-gamma synthesis by peripheral blood mononuclear cells (PBMC) after stimulation with NP-tase, p70 and SEB in vitro. Both antigens, as well as SEB, induced IL-4 and IFN-gamma secretion in patients and controls. However, patients with AD showed a significantly diminished IFN-gamma production in response to NP-tase or SEB. Furthermore, we demonstrated a good correlation between antigen-stimulated IgE production and the IL-4/IFN-gamma ratio in vitro. A distinct subgroup of PBMC showed impaired IFN-gamma synthesis and enhanced IL-4 secretion after incubation with p70 or NP-tase. These data support evidence that a subgroup of patients with AD, synthesizing low levels of IFN-gamma after stimulation with staphylococcal antigens, may have impaired abilities to clear Staphylococcus aureus colonization. Persistent staphylococcal antigens could then be responsible for inflammatory and allergic skin reactions in patients with AD. We therefore conclude that, besides superantigens, staphylococcal antigens may also play a part in the pathogenesis of AD.
Abstract 2298: Impact of Preopeartive Anemia on Long-term Outcomes Following Isolated Coronary Artery Bypass Surgery
Authors: Yan Li, Zhe Zheng, Shiju Zhang, Xianqiang Wang, Huawei Gao, Shengshou Hu
Journal: Circulation (2008)

Background: The prognostic and clinical value of preopeartive anemia in patients undergoing cardiac surgery has recently been recognized. However, very limited information exists on the impact of preopeartive anemia on long-term outcomes following coronary artery bypass graft (CABG) surgery. This study aimed at examining the degree to which preopeartive anemia affects long-term outcomes after isolated CABG surgery. Methods: A unicenter study was conducted on 5488 consecutive survivors of isolated CABG between January 1999 and December 2005. Preopeartive anemia was defined according to the World Health Organization definition (hemoglobin &lt; 13g/dL for male; hemoglobin &lt; 12g/dL for female). Long-term outcomes of interest were total mortality, myocardial infarction (MI), repeated revascularization, and major adverse cardiac events (MACEs=total mortality or MI or repeated revascularization). These outcomes were compared after adjustment for differences in baseline risk factors among the patients. Results: 1437 (26.2%) patients had preoperative anemia. After a mean follow-up of 43.3±18.3 months, preoperative anemia was found to be an independent risk factor for total mortality (hazard ration [HR]: 1.490; 95% CI: 1.074 to 2.067; p=0.017), MI (HR: 1.595; 95% CI: 1.028 to 2.474; p=0.037) and MACEs (HR: 1.363; 95% CI: 1.059 to 1.755; p=0.016). We also found that aspirins and beta-blockers were underused in patients with anemia during follow-up. Conclusions: Preopeartive anemia has a strong negative impact on long-term outcomes following isolated CABG. Our data also suggest that the incorporation of preoperative anemia into the risk assessments of long-term outcomes after CABG is recommended. Future intense and systematic studies are needed to help ensure high-quality cardiac care of patients with anemia.
IL-33 and airway remodelling in paediatric severe therapy resistant asthma
Authors: Nicola Ullmann, Alex Adams, Cara J. Bossley, Tim Oates, Claire M. Lloyd, Andy Bush, Sejal Saglani
Journal: European Respiratory Journal (2012)

Background   Associations have been reported between epithelial interleukin (IL)-33 expression and severe asthma in adults, but its role in the pathophysiology of paediatric severe therapy resistant asthma (STRA) remains unknown.   Objectives   We quantified IL-33 expression in endobronchial biopsies from children with STRA and explored its relationship with parameters of airway remodelling.   Methods   Children (n=45) (median age 11.3 [range 5.4-16.4] years) with STRA underwent detailed investigations including bronchoscopy and endobronchial biopsy. IL-33+ cells were quantified in the epithelium, smooth muscle and submucosa in biopsies from children with STRA and compared to that in age matched non-asthmatic controls. Reticular basement membrane (RBM) thickness was quantified as a marker of airway remodelling, and related to IL-33+ cells.   Results   Submucosal, but not epithelial or smooth muscle IL-33+ cells were significantly higher in children with STRA compared to controls (p=0.01, 0.21, 0.68 respectively).  In addition, there was a positive correlation between IL-33+ cells and RBM thickness in children with STRA (Spearman r=0.35, p=0.018), but not in controls (p=0.33).   Conclusions  In contrast to adult studies, we have shown increased submucosal IL-33 expression in children with STRA, and for the first time have shown an association between this mediator and airway remodelling. These data suggest therapies that block IL-33 may be suitable for paediatric STRA, and specifically may impact on structural airway changes.
Abstract 3311: Causes of Syncope in Wolff-Parkinson-White Syndrome and Results of the Treatment
Authors: Beatrice Brembilla-Perrot, Frederic Chometon, Julien Bertrand, Daniel Beurrier, Ning Zhang, Olivier Marcon, Fabrice Duhoux, Olivier Huttin, Etienne Aliot, Marius Andronache, Francois Marcon
Journal: Circulation (2006)

Background : Syncope in Wolff-Parkinson-White syndrome (WPW) may reveal an arrhythmic event, but also can be without relationships with WPW. At the time of the curative treatment by catheter ablation of accessory pathway (AP), to establish rapidly the diagnosis is important. The purpose of the study was to evaluate the causes of syncope by noninvasive techniques in WPW.   Methods:  52 patients (pts), 29 men, 23 women aged from 11 to 72 years, (mean 31±16) with WPW were admitted for unexplained dizziness and/or syncope; they had no other heart disease and had no documented arrhythmias. Two noninvasive studies were performed without hospitalization:  electrophysiological study (EPS) by transesophageal route which consisted of atrial pacing up to 2 nd d AV block, programmed atrial stimulation using 1 and 2 extrastimuli in control state and after isoproterenol  Head-up tilt test.  Results:  EPS: paroxysmal junctional tachycardia (PJT) was induced in 23 pts (44 %). Atrial fibrillation >1 min (AF) and/or antidromic tachycardia was induced in 21 pts (40 %); among pts with inducible tachycardias, 9 had both tachycardias, PJT and AF. A potentially dangerous form (rapid conduction in accessory pathway (AP) > 240 /min in control state or > 300 b/min after isoproterenol and AF or antidromic tachycardia induction) was noted in 21 pts (40 %).  Tilt test was positive in 19 pts, 9 with abnormal EPS and 10 with negative EPS.  At the term of the studies, syncope was related to a rapid tachyarrhythmia in 21 pts and to a PJT followed by a vagal reaction in 15 pts. Syncope was not related to WPW in 15 pts, but to a vasovagal phenomenon in 10 of them. The follow-up (5±2 years) indicated that pts with inducible arrhythmias were treated by AP catheter ablation and became free of syncope; those with vasovagal hypertonia were not treated; they remained free of arrhythmias during the follow-up, but 3 had still dizziness. In 3 other pts with negative studies, AP catheter ablation did not suppress syncope.   Conclusion : Syncope in WPW syndrome frequently is directly related to the preexcitation and the AP ablation suppress the symptoms. However, in 29 % of the patients, syncope was unrelated to WPW, was generally of benign significance and was not suppressed by AP ablation.
Abstract 16399: Exercise Stress Testing With Strain Echocardiography is Superior to Resting Echocardiography in Identifying Doxorubicin-Induced Preclinical LV Dysfunction in Breast Cancer Patients
Authors: Michel G Khouri, Whitney Hornsby, Eric J Velazquez, Lee W Jones, Pamela S Douglas
Journal: Circulation (2011)

Introduction: In current clinical practice, the cardiovascular toxicity of chemotherapy is determined by resting LVEF which has limited ability to detect early-stage myocardial dysfunction. While r...
Abstract 13653: Everolimus Prevents Endomyocardial Remodelling After Heart Transplantation
Authors: Nicola E Hiemann, Ernst Wellnhofer, Hans B Lehmkuhl, Christoph Knosalla, Roland Hetzer, Rudolf Meyer
Journal: Circulation (2010)

Background:  Endomyocardial remodelling after heart transplantation is characterized by a patho-anatomical shift from a regular myocardial syncytium to progressive fibrosis and scars. The potential of everolimus to prevent this process has not been evaluated as yet.   Methods:  We studied prospectively 132 patients who underwent biopsy follow-up at 4 weeks, 1 year and 3 years after heart transplantation. Fibrosis and scars (Zeiss Vision, in Sirius), collagens III and IV (immunohistochemistry) and cellular rejection (HE 6.8±0.6% vs. 8.4±0.7%, p=0.013; 6.6±0.6% vs.10.9±1.9%, p=0.007) and less scarring at 3 years post-transplant (19.9±1.9% vs. 31.9±4.6%, p=0.006). Patients with angiographic peripheral obliterations showed in the 1- and 3-year follow-up higher amounts of fibrosis (9.9±0.9% vs. 7.9±0.6%, p=0.030; 7.1±0.6% vs. 10.0±1.6%, p=0.041). In regression analysis, everolimus and beta blockers were identified as anti-fibrotic factors, while peripheral obliterations were pro-fibrotic. Acute cellular rejection episodes were not correlated to biopsy findings or immunosuppression.   Conclusions:  Everolimus prevents endomyocardial remodelling after heart transplantation and has beneficial effects on preservation of the myocardial syncytium. Angiographic peripheral obliterations are linked to increased amounts of endomyocardial fibrosis, suggesting a relevant effect on microvascular perfusion.
Forced vital capacity decreases rapidly in patients with idiopathic upper lobe-dominant pulmonary fibrosis
Authors: Kentaro Watanabe, Taishi Harada, Takako Hirota, Kazuki Nabeshima, Masaki Fujita, Nobuhiko Nagata
Journal: European Respiratory Journal (2011)

We present five patients with upper lobe-dominant pulmonary fibrosis of unknown etiology that does not fit any of the currently defined subsets of idiopathic interstitial pneumonias. We describe the clinical, functional, and pathological characteristics of this disorder, which we have provisionally termed idiopathic upper lobe-dominant pulmonary fibrosis (iULPF).

All patients were slender, with a body mass index of 16.0–17.9 kg/m2. Four of the five patients had recurrent pneumothorax. Their pathological characteristics were as follows: 1) upper lobe-dominant subpleural proliferation of elastic fibers associated with deposition of mature collagen in alveolar lumens; 2) isolated fibrotic areas containing alveolar lumens filled with mature collagen were occasionally found in the lung parenchyma distant from the subpleural fibroelastosis; 3) visceral pleura adjacent to the subpleural fibroelastosis were often thickened and contained hyalinized collagen fibers; 4) there was an abrupt transition from subpleural fibrotic areas to less-involved pulmonary parenchyma; and 5) destruction of the lung architecture was minimal and fibroblastic foci were rarely seen. Ventilatory impairment was also characteristic of this condition. The median yearly decline in forced vital capacity in iULPF patients was –20.3% (range, –7.7% to –27.1%), which was more rapid than that reported for chronic fibrosing interstitial pneumonias such as idiopathic pulmonary fibrosis.

iULPF is a unique pulmonary fibrosis that results in rapid deterioration of ventilatory function. It should be differentiated from other idiopathic fibrosing interstitial pneumonias.
Remodeling of Alveolar Walls after Elastase Treatment of Hamsters
Authors: EDGAR C. LUCEY, RONALD H. GOLDSTEIN, PHILLIP J. STONE, GORDON L. SNIDER
Journal: American Journal of Respiratory and Critical Care Medicine (1998)

Treatment of hamster lungs with porcine pancreatic elastase (PPE) causes emphysema and a decrease in lung elastin content, which returns to control level by Day 30. To explore the mechanism of alveolar wall remodeling after elastolytic injury, we examined the expression of elastin and alpha1(I) collagen mRNAs by in situ hybridization at 1, 2, 3, 5, 7, and 30 d after intratracheal PPE. The lungs of control animals displayed weak signals for elastin and alpha1(I) collagen mRNA in pleura, large arteries, veins, and airways. There was little or no signal in respiratory air space walls. Increased expression of elastin and alpha1(I) collagen mRNA began by Day 1 after PPE and reached an asymptote by Day 3 that was maintained by elastin until Day 7; expression of alpha1(I) collagen mRNA waned earlier. Elastin and, to a lesser extent, alpha1(I) collagen mRNA were heavily expressed in pleura, blood vessels, and airways. Analysis of serial sections showed elastin message was minimal in the walls of respiratory air spaces and when present, at 3, 5, and 7 d, was primarily found at the free margins of alveolar septa. Collagen message was very sparse in respiratory air space walls. By 30 d, elastin mRNA expression was reduced but still above control levels and emphysema was widespread and severe. Rank score of elastin mRNA expression in individual subpleural air spaces showed a positive correlation with air space size. In conclusion, most expression of elastin and alpha1(I) collagen mRNA occurs in the pleura, airway, and vascular walls. In respiratory air space walls, expression of elastin mRNAs occurs in damaged tissue at free septal margins.
Abstract 3643: Consciousness of Reduced Salt Diet and Actual Achievement of Salt Reduction Estimated from 24hr Urinary Na Excretions in General Populations in Japan, PRC, UK and US: The INTERMAP Study
Authors: Nagako Okuda, Hirotsugu Ueshima, Akira Okayama, Shigeyuki Saitoh, Hideaki Nakagawa, Kiyomi Sakata, Takashi Kadowaki, J. David Curb, Liancheng Zhao, Paul Elliott, Jeremiah Stamler
Journal: Circulation (2007)

OBJECTIVES: Assess the percentage of persons with consciousness of reduced salt diet (RSD) in general population samples and estimate actual differences in Na intake between RSD participants and others based on two timed 24hr urinary (24hr-U) Na excretions. METHODS: Data from 4680 men and women ages 40 –59yr randomly selected from 17 general populations in four countries, Japan (n=1145), PRC (n=839), UK (n=501) and US (n=2195), in the International Study of Macro- and Micro-nutrients and Blood Pressure (INTERMAP). Awareness of RSD was surveyed by questionnaire. Participants provided timed 24hr-U samples twice; Na and K were measured. Means of 24hr-U Na, K excretions and Na/K ratio were compared between RSD and non-RSD participants. Values were also estimated adjusted for body weight, age and sex (multiple regression analysis). RESULTS: RSD participants were few, 3.1% (Japan), 1.3% (PRC), 4.8% (UK) and 7.2% (US). Similarly among hypertensive (HTN) participants, 9.0% (Japan), 5.8% (PRC), 10.3% (UK) and 14.7% (US). Mean 24hr-U Na excretions (SE)(mmol) for RSD and non-RSD participants were 184.3(7.8) vs. 198.8(1.7)(p=0.129) (Japan); 191.2(19.3) vs. 228.0(3.5)(p=0.228) (PRC); 167.3(14.0) vs. 144.1(2.2)(p=0.114) (UK); and 150.9(4.7) vs. 163.5(1.3)(p=0.010) (US); adjusted Na excretions, 180.0(8.6) vs. 198.9(1.5)(p=0.031) (Japan); 172.4(27.4) vs. 228.2(3.1)(p=0.043) (PRC); 156.3(9.2) vs. 144.6(2.0)(p=0.217) (UK); 149.9(4.2) vs. 163.6(1.2)(p=0.002) (US). There were no significant differences in adjusted K excretions; Na/K ratios gave results similar to those for Na for all four countries. Adjusted Na excretions for HTN participants were significantly lower than for non-HTN participants in Japan (186.5(4.0) vs. 200.3(1.6)(p=0.002)); significant differences were not observed for other countries. CONCLUSIONS: Only a small percent of all and of HTN participants reported following consciously RSD. While 24hr-U Na excretions tended to be significantly lower for RSD participants, total salt intakes were still high. To prevent CVD, it is important to implement salt reduction guidelines more aggressively.
Abstract 1311: Bone Marrow Angiotensin II Type 1 Receptor Augments Atherosclerosis by Promoting Monocyte/Macrophage Lineage Differentiation from Hematopoietic Stem Cells
Authors: Yoshinori Tsubakimoto, Hiroyuki Yamada, Hirokazu Yokoi, Hiroki Takata, Hiroyuki Kawahito, Hideyo Hirai, Jiro Imanishi, Eishi Ashihara, Taira Maekawa, Tomosaburo Takahashi, Mitsuhiko Okigaki, Hiroaki Matsubara
Journal: Circulation (2007)

[BACKGROUND] The angiotensin II (Ang II) type 1 (AT 1 ) receptor is crucially involved in atherogenesis, but bone marrow (BM) AT 1 -mediated proatherogenic action remains undefined- . [METHOD AND RESULT] BM-derived mononuclear cells (BM-MNCs) more abundantly express AT 1 than VSMCs (2.2 fold) with similar affinities to Ang II. BM cells in 8-week-old apoE-deficient −/− ) or wild-type (Agtr1 + / + ) cells. Four (apoE-KO) mice were replaced with AT 1 -deficient (Agtr1 weeks after the initiation of western diet and Ang II infusion (500ng/kg/min), atherosclerotic lesion area in aortic root was examined. ApoE-KO mice reconstituted with Agtr1 −/− marrow (apoE-KO/BM-Agtr1 −/− ) showed a significant reduction in atherosclerotic lesions compared with apoE-KO/BM-Agtr1 + / + mice (55%, P &lt;0.05). The accumulation of macrophages was attenuated in apoE-KO/BM-Agtr1 −/− mice (55%, P &lt;0.05), concomitant with a decrease in the number of circulating Ly-6C hi monocytes (76%, P &lt;0.01). The numbers of circulating CCR2 + and CX3CR1 + monocytes were also reduced in apoE-KO/BM-Agtr1 −/− mice (87±16 vs 298±66; CCR2 + monocyte, 72±12 vs 550±119 cells/μl; CX3CR1 + monocyte, respectively, P &lt;0.01). Furthermore, the number of macrophage progenitor cells defined by M-CSF stimulated macrophage colony-forming unit was markedly reduced by 82 % (p&lt;0.01) in Agtr1 −/− compared with Agtr1 + / + mice. We next examined the effect of BM-AT 1 on the number of hematopoietic stem cells (HSCs), common myeloid progenitors (CMP), and granulocyte/macrophage progenitors (GMP) to determine at which point of the lineage pathway, BM-AT 1 is involved. The number of HSCs did not differ between the two groups (3.6±0.8 vs 2.9±0.6 × 10 3 cells/tibia, P =n.s.), whereas the numbers of CMP and GMP were much lower in apoE-KO/BM-Agtr1 −/− mice (4.7±0.7 vs 10.2±1.4 ×10 3 cells/tibia, 9.9±2.7 vs 20.2±2.8 × 10 3 cells/tibia, respectively, P &lt;0.05). [CONCLUSION] BM-MNCs expressed the abundant densities of AT1, and AT1-mediated signals on BM-MNCs exaggerated atherosclerotic lesion development. BM-AT 1 is closely implicated in the differentiation of HSCs into macrophage progenitors and the behavior of monocytes/macrophages, indicating that BM-AT 1 could be a promising therapeutic target for the prevention of cardiovascular events.