tbuckley/cabot-search huggingface dataset:
Abstract 5153: Pericardial Fat, Intra-Thoracic Fat, and Left Ventricular Mass: The Framingham Heart Study
Authors: Caroline S Fox, Philimon Gona, Udo Hoffmann, Carol J Salton, Joseph Massaro, Daniel Levy, Martin Larson, Ralph B D’Agostino, Christopher J O’Donnell, Warren J Manning
Journal: Circulation (2008)

Pericardial fat is in direct anatomic contact with the myocardium and may lead to increased left ventricular mass (LVM). Whether the association of pericardial fat and LVM are independent of the systemic effects of obesity has not been fully explored. Participants from the Framingham Heart Study Offspring cohort (n=1006, mean age 60 years, 54% women) who underwent chest and abdominal computed tomography (CT) scanning and cine cardiac magnetic resonance imaging for left ventricular mass (LVM) quantification were included. CT scans were quantified for pericardial fat (fat within the pericardial sac), intra-thoracic fat (fat adherent to the heart but outside the pericardium), and abdominal visceral adipose tissue (VAT) using a volumetric method. Sex-specific multivariable linear regression was used to model the association of pericardial fat and of intra-thoracic fat with LVM after adjustment for age, smoking, alcohol use, menopausal status, systolic blood pressure, hypertension treatment, and height, and then additionally for VAT. Both pericardial and intra-thoracic fat were correlated with LVM in women (r=0.35, p&lt;0.001 [pericardial fat]; r=0.37, p&lt;0.001 [intra-thoracic fat]) and men (r=0.19, p&lt;0.001 [pericardial fat]; r=0.17, p&lt;0.001 [intra-thoracic fat]). In multivariable-adjusted models, both pericardial and intra-thoracic fat were associated with LVM (Table ). However, after adjusting for VAT, these associations were no longer significant (Table ). Both pericardial fat and intra-thoracic fat are associated with LVM in women and men. However, after accounting for VAT, a measure of systemic adiposity, neither pericardial fat nor intra-thoracic fat remain associated with LVM. These findings suggest that observed associations between pericardial fat and LVM are primarily due to the systemic effects of obesity. Beta coefficients of LVM (std error), per gram expressed per SD of pericardial/intra-thoracic fat
Natural disasters
Authors: Anthony D Redmond
Journal: BMJ (2005)

Disasters are commonly divided into “natural” and “man made,” but such distinctions are generally artificial. All disasters are fundamentally human made, a function of where and how people choose or are forced to live. The trigger may be a natural phenomenon such as an earthquake, but its impact is governed by the prior vulnerability of the affected community.​community.



Figure 1

Most search and rescue is done by survivors, not external teams



Poverty is the single most important factor in determining vulnerability: poor countries have weak infrastructure, and poor people cannot afford to move to safer places. Whatever the disaster, the main threat to health often comes from the mass movement of people away from the scene and into inadequate temporary facilities.
Abstract 2755: Increased Efficacy of Catheter Ablation Of Atrial Fibrillation by Using Adenosine to Reveal Dormant Pulmonary Vein Conduction
Authors: Laurent Macle, Atul Verma, Paul Novak, Paul Khairy, Mario Talajic, Peter G Guerra, Bernard Thibault, Marc Dubuc, Denis Roy, Stanley Nattel
Journal: Circulation (2008)

Recurrences of atrial fibrillation (AF) after catheter ablation are frequently associated with recovery of conduction between the pulmonary veins (PV) and the atrium. The recovery of PV conduction could be explained by the presence of dormant conduction between the PV and the atrium. Adenosine can be used during AF ablation procedures to reveal transient re-conduction of the isolated pulmonary vein (dormant PV conduction). We prospectively evaluate the utility of iv adenosine to guide elimination of dormant PV conduction by additional radiofrequency (RF) applications during AF ablation procedures. Thirty-four consecutive patients (30 male; age 51+/−8 years) referred for catheter ablation of drug-refractory AF (Paroxysmal 31/Persistent 3) were studied. Electrical PV isolation (PVI) was performed using Irrigated-tip radiofrequency (RF) ablation and was guided by a circular mapping catheter. After PVI, the presence of dormant conduction in each vein was assessed by injection of 12 mg of adenosine. If dormant conduction was present, additional RF energy was delivered at sites of transient re-conduction. Abolition of the dormant conduction was then demonstrated by repeated injections of adenosine. The recurrence rate of arrhythmia after one procedure was evaluated. The results were compared to an historical control group comprising the previous 34 consecutive patients who underwent PVI without the use of adenosine. Electrical PVI was achieved in 100% of PV’s and all 34 patients underwent the adenosine evaluation. Dormant PV conduction was observed in 17/34 patients and could be eliminated in all by additional RF delivery. Procedural and fluoroscopy times were 163±30 and 49±13 minutes, respectively. After a mean follow-up of 8.0±3.1 months, 6/34 (18%) patients experienced AF recurrence with 28/34 (82%) remaining free of arrhythmia without the use of antiarrhythmic drugs. When compared to the 14/34 patients (41%) from the historical control group who had AF recurrence, a significant reduction was observed (P&lt;0.01). The use of adenosine to guide elimination of dormant PV conduction increases the success rate of AF ablation procedures. This needs to be evaluated in a randomized multicenter trial.
Abstract 16926: Inhibition of Large Conductance K+ Channels (BKCa) Improves Cardiac Functional Recovery Following Cold Hyperkalemic Cardioplegic (CP) Arrest in Isolated Hearts
Authors: Richard T Clements, Brenda Cordeiro, Jun Feng, Cesario Bianchi, Frank W Sellke
Journal: Circulation (2011)

Introduction: Cardioplegia during heart surgery subjects myocardium to reversible ischemic injury that impairs cardiac function (a.k.a - “myocardial stunning”). BKCa blockers have established the protective role of BKCa activators for ischemic injury and preconditioning. However, the effect of BKCa blockers alone in the setting of ischemic injury associated with hyperkalemic CP is unknown. Surprisingly, we found that inhibition of BKCa channels, with two distinct BKCa blockers, greatly increased functional recovery following CP. Methods: Isolated perfused rat hearts were subjected to 2 hours intermittent cold cardioplegia (St Thomas II) followed by 30 minutes normothermic reperfusion. CP was delivered every 30 min, for 1 min. During CP, hearts were maintained at 10 deg C. Hearts were treated with or without (CP, n=10) the BKCa channel inhibitors paxilline (CP + Pax, 1uM (n=4) and 100 nM (n=4)) or iberiotoxin (10 nM (n=2)) supplied in the cardioplegia. Hearts constantly perfused with KHB served as controls. Results: Baseline parameters of cardiac function were similar between groups (mean values: LVDP: 120±5.1 mmHg, ±dP/dt:3298±132, 2465±126). CP reduced cardiac function 30 min post reperfusion (LVDP:61±3.8%,±dP/dt: 67±4.4%, 59±5.1% recovery compared to baseline). Treatment with 100 nM paxilline significantly improved CP-induced reductions in cardiac function (LVDP: 92±4.3%., ±dP/dt: 108±5.6%, 104 ± 6.0% compared to baseline, (p&lt;.01 for LVDP and ±dP/dt, CP+Pax 100 nM vs CP)). Similar results were obtained with both 1 uM paxilline treatment and iberiotoxin. There were no significant changes in heart rate or coronary flow associated with BKCa channel blockade. Paxilline blocked CP-induced phosphorylation of the akt signaling cascade, activation of which is associated with depressed cardiac contractility. Conclusions: In contrast to known protective effects of BKCa openers in the setting of ischemic injury, BKCa channel blockers (as a CP additive) profoundly improve cardiac recovery in the context of hyperkalemic cardioplegic arrest.
Integrated medicine
Authors: A. Carr
Journal: BMJ (2001)

<b>Background:</b> Obstructive sleep apnoea syndrome (OSAS) is a chronic inflammatory disease regulated by T lymphocytes. Th17 is a key effector in the immune response and play critical roles in the development of autoimmunity by producing IL-17, TNF-α and IL-6. <b>Aim:</b> To determine the pattern regulatory of IL-17 in children with OSAS. <b>Method:</b> Obese children 12-17 years who attended polysomnography at University Malaya Medical Centre were recruited. They grouped into non-OSA (Apnoea hypopnea index (AHI) &lt; 1 event/hr (n=8)), mild-OSA (1&lt;AHI&lt;5, (n=6)) and moderate to severe-OSA (AHI &gt; 5 events/hr (n=11)). 22 non-obese children were recruited as controls. , Plasma samples were analysed for inflammatory cytokines using bead–based bioplexing technique to determined their expression fold changes with p-value &lt;0.05. Canonical regulatory profile of the cytokines and their role in the OSAS severity was determined. <b>Results:</b> IL-17 in mild OSA and moderate to severe OSA groups is a key component in differential regulation of cytokine production, in macrophages and T-helper cells. In addition to the high level of IL-17, enhancement in level of expression of IL-6, IL-10, IL-13 and CCL2 may be associate with OSAS severity. <b>Conclusion:</b> OSAS severity in children is associated with enhancement of differential regulation of cytokine production in macrophages and T helper cells by IL-17. We showed a significant involvement of Th2 lymphocytes in OSAS severity. These results opened an alternative explanation for the substantial activation of immune cells in OSAS and the development of related complications.
Abstract 17079: In Vitro Modeling of Duchenne Muscular Dystrophy (DMD) Cardiomyopathy Using Human Induced Pluripotent Stem Cells (hiPSC)
Authors: Forum Kamdar, Andre Klaassen Kamdar, Christopher Chapman, Michelle Doyle, Jamie Lohr, Joseph Belanto, Evelyne Houang, Naoko Koyano-Nakagawa, James Ervasti, Joseph Metzger, Daniel J Garry
Journal: Circulation (2013)

Introduction: Duchenne Muscular Dystrophy (DMD) is the most common and debilitating X-linked muscular dystrophy characterized by absence of dystrophin. A significant cardiomyopathic phenotype is seen in DMD and has emerged as a leading cause of death in DMD. There is limited knowledge of pathophysiology of DMD cardiomyopathy due to the limited availability of patient tissues and no human cardiomyocyte model of DMD exists. We hypothesized the pathophysiology of DMD cardiomyopathy can be modeled by utilizing DMD hiPSC CM and interrogating them at the cellular and molecular level. Methods: Dermal fibroblasts were obtained from patients with DMD cardiomyopathy (dystrophin deletion of exon 4-43) and normal healthy controls. The fibroblasts were reprogrammed to hiPSC using retroviral vectors containing the human transcription factors, OCT4, SOX2, KLF4 and C-MYC. The DMD and control hiPSC lines were differentiated to CM using a directed differentiation protocol. Molecular and physiologic assays were performed at...
Abstract 1867: Beta-Blockade Augments Low Frequency Muscle Sympathetic Spectral Power in Human Heart Failure
Authors: John S Floras, Toshihiko Kubo, Eduardo Azevedo, Gary Newton, Peter Picton, John Parker
Journal: Circulation (2006)

Background: Oscillations in central sympathetic discharge to muscle within the low frequency (LF) range encompassing 0.13Hz disappear as chronic heart failure (CHF) progresses. This altered central modulation of sympathetic outflow is improved by atrial natriuretic peptide infusion and by cardiac transplantation. We tested the hypothesis that chronic therapy with lipophilic β-adrenoceptor antagonists augments muscle sympathetic nerve activity variability (MSNAV) within this LF range. Methods and results: In 21 CHF ACE inhibitor-treated patients (age: 53±2, ejection fraction: 20±2%), resting heart rate (HR), blood pressure and MSNA were recorded before and after 4 months of randomized double-blind allocation of β-blockade with either metoprolol (up to 50 mg b.i.d.) or carvedilol (up to 25 mg b.i.d.). MSNAV was assessed by coarse graining spectral analysis. Both drugs had similar effects on HR (−13±2 bpm; p<0.001). Neither affected MSNA burst frequency (−7±4 bursts/min, n.s.). Before β-blockade, harmonic MS...
Modification of Lethal Irradiation Injury in Mice by Injection of Homologous or Heterologous Bone
Authors: E LORENZ, C C CONGDON
Journal: JNCI Journal of the National Cancer Institute (1954)

Journal Article Modification of Lethal Irradiation Injury in Mice by Injection of Homologous or Heterologous Bone Get access Egon Lorenz, Egon Lorenz Search for other works by this author on: Oxford Academic PubMed Google Scholar Charles C. Congdon Charles C. Congdon Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 14, Issue 4, February 1954, Pages 955–965, https://doi.org/10.1093/jnci/14.4.955 Published: 01 February 1954 Article history Received: 05 November 1953 Published: 01 February 1954
Antenatal corticosteroids to prevent neonatal respiratory distress syndrome
Authors: C. Spencer
Journal: BMJ (2000)

Administering corticosteroids to pregnant women at risk of preterm birth to reduce the severity of neonatal respiratory distress syndrome is an established intervention. The origins of this practice came in 1972 from the pioneering work of Liggins and Howie, who showed a significant reduction in the incidence of respiratory distress syndrome in preterm babies whose mothers had received antenatal corticosteroids.1 These agents are thought to improve surfactant production, and there is also an associated reduction in the risk of neonatal intraventricular haemorrhage, necrotising enterocolitis, hyperbilirubinaemia, and neonatal death. What remains unclear, however, is whether repeat doses should be given if delivery does not occur shortly after the initial course.

Most obstetric units in the United Kingdom administer either betamethasone or dexamethasone as a course of two doses over 24 hours. The evidence for this practice is mainly based on only a single course of antenatal corticosteroids in singleton pregnancies given for up to seven days before delivery and included few multiple pregnancies or …
Abstract 8885: Prognostic Significance of Dyspnea versus Chest Pain in Patients Referred for Stress Echocardiography
Authors: Siu-Sun Yao, Vikram Agarwal, Farooq A Chaudhry
Journal: Circulation (2011)

Background: Stress echo (SEcho) is an established modality for diagnosis and risk stratification of patients with known or suspected coronary artery disease. The purpose of this study was to examine the prognostic significance of dyspnea versus chest pain in patients referred for SEcho. Methods: We evaluated 1335 patients (63 ± 13 years; 40% male) undergoing SEcho (49% treadmill, 51% dobutamine). Resting left ventricular ejection fraction and regional wall motion were assessed. The left ventricle was divided into 16 segments and scored on 5-point scale of wall motion. Abnormal SEcho was defined as stress-induced ischemia (wall-motion score of ≥1 grade). Followup (3.5 ± 1.5 years) for non-fatal myocardial infarction (n = 42) and cardiac death (n = 39) were obtained. Results: By univariate analysis, both number of new ischemic wall motion abnormalities (p&lt;0.0001) and ejection fraction (p&lt;0.0001) were significant predictors of cardiac events. Cumulative survival was signficantly worse in patients with dyspnea vs. chest pain (2.3%/year vs. 1.4%/year, p=0.02). SEcho was further able to risk stratify normal (n = 289) vs. abnormal (n = 155) groups for dyspnea (1.0%/year vs. 4.4%/year; p &lt; 0.001), and normal (n = 608) vs. abnormal (n = 283) groups for chest pain (0.8%/year vs. 2.9%/year; p &lt; 0.001)(Figure). Multivariate logistic regression analysis identified number of new ischemic wall motion abnormalities as the strongest predictor of cardiac events (RR 1.7, 95% CI 1.0-2.9, p&lt;0.05). Conclusions: In patients referred for stress echocardiography, self-reported dyspnea identified a group of patients at increased risk for cardiac events. Stress echocardiography results (normal or abnormal) was further able to risk stratify both dyspnea and chest pain subgroups. Assessment of dyspnea should be incorporated into routine clinical evaluation of patients referred for stress echocardiography.
Abstract 18321: D-dimer is Prognostic for Stroke, Major Bleeding and Death During Anticoagulation of Atrial Fibrillation - a RELY Substudy
Authors: John Eikelboom, Ziad Hijazi, Jonas Oldgren, Ulrika Andersson, Stuart J Connolly, Michael D Ezekowitz, Paul A Reilly, Salim Yusuf, Lars Wallentin, Agneta Siegbahn
Journal: Circulation (2010)

Background: The D-dimer level during anticoagulation treatment of atrial fibrillation (AF) is related to the risk of thromboembolic events. The prognostic value of D-dimer in addition to CHADS2 ris...
2008 Ancel Keys Memorial Lecture—Screening for Coronary Artery Disease: Is It Too Soon to Think Clinically?
Authors: Michael Lauer
Journal: Circulation (2008)

Screening is a mainstay of modern preventive medicine. Physicians routinely screen patients for breast or colorectal cancer, as well as hypertension, hypercholesterolemia, and abdominal aortic aneurysm. In each of these cases, randomized trials demonstrated that screening saves lives or prevents major morbidity. As coronary artery disease remains the number one cause of death in Western society, there is interest in screening for the disease itself, as opposed to just its risk factors. Some investigators have argued for routine screening of adults with coronary artery calcium testing; proponents have used direct-to-consumer advertising, legislative lobbying, and appeals in the mass media. Although it is true that coronary calcium scores correlate well with clinical events, the evidence base has not yet reached the level of established tests. We may fall into a too-often ignored trap, where strategies based on logic or risk markers turn out to be ineffective or even dangerous. When a seemingly healthy person undergoes a screening test and is found to have disease, that person becomes a patient subject to clinical thinking. If this translates into improved outcome, clinical thinking is appropriate. We must remember, though, that screening is supposed to prevent clinical events. When it merely detects subclinical disease, leading to unnecessary tests or procedures, it instead exposes people to the risks of thinking clinically. We must have the ambition, willingness, and patience to develop the evidence base needed to introduce new screening technologies to the clinic at the right time.
European Union SHIPSAN ACT Joint Action: Preparedness for the response to Ebola virus disease in the maritime transport sector
Authors: V A Mouchtouri, G Nichols
Journal: Eurosurveillance (2015)

Preview this article: European Union SHIPSAN ACT Joint Action: Preparedness for the response to Ebola virus disease in the maritime transport sector, Page 1 of 1 < Previous page | Next page > /docserver/preview/fulltext/eurosurveillance/20/1/art20997-en-1.gif
Abstract 1921: Clinical Impact of Heterozygous Carrier of Autosomal Recessive Hypercholesterolemia on Asymptomatic Hyperlipidemic Patients: Evidence From Familial Gene Analysis
Authors: Hayato Tada, Masa-aki Kawashiri, Tohru Noguchi, Chiaki Nakanishi, Masayuki Tsuchida, Mutsuko Takata, Atsushi Nohara, Akihiro Inazu, Junji Kobayashi, Hiroshi Mabuchi, Masakazu Yamagishi
Journal: Circulation (2008)

Autosomal recessive hypercholesterolemia (ARH) is an extremely rare genetic defect, and is recognized only around 50 cases in all over the world. The genetic cause of ARH is mutation in an adaptor protein involved in low-density lipoprotein (LDL) receptor internalization, which results in marked elevation of serum LDL cholesterol (LDL-C) and premature atherosclerosis. Therefore, few data exist regarding the clinical significance about the heterozygous carrier of ARH. We recently identified the second ARH patient (Ins C 599 ) in Japan and his some relatives who have the same single mutation (heterozygous). We identified 11 heterozygous ARH carriers (male=5, mean age=48.2) and 7 non-carriers (male=3, mean age=53.3) in the same family. In addition, we screened the same mutations in unrelated consecutive 500 hyperlipidemic patients (male=32, mean age=49.4) with mean LDL-C of 225.2±6.1mg/dl using PCR to determine its frequency and examined their clinical features. We identified an unrelated heterozygous ARH carrier and a non-carrier in the same family among unrelated to the original family. Serum LDL-C levels of heterozygous ARH carriers (mean=153.8±35.8mg/dl) were significantly higher than those of non-carriers (mean=108.2±41.4mg/dl, p&lt;0.05). Serum triglyceride (151.9±110.7mg/dl vs 140.4±48.8mg/dl) and high-density lipoprotein cholesterol (57.4±11.0mg/dl vs 54.0±11.9mg/dl) levels were not different between them. Interestingly, heterozygous ARH carriers didn’t show any xanthomas including Achilles tendon (6.4±1.1mm vs 5.7±1.1mm) in contrast to FH, which is frequently associated with typical xanthoma. These results demonstrate that heterozygous ARH (Ins C 599 ) carriers show higher LDL-C levels compared with non-carrier family member without tendon xanthomas observed in FH. We suggest that heterozygous ARH (Ins C 599 ) carrier may explain a part of primary hypercholesterolemia.
Noninvasive diagnostic test in breast cancer; utopia or option with serum proteomics?
Authors: M. de Noo, M. van der Werff, H. Gelderblom, A. Deelder, R. Tollenaar
Journal: Journal of Clinical Oncology (2007)

21118 Background: With a lifetime risk currently estimated 1 in 9, breast cancer is among the most common diagnosed malignancies. Proteomic expression profiling generated by mass spectrometry has been suggested as a potential tool for the early diagnosis of cancer. The objective of our study was to assess and validate the feasibility of this approach for the detection of breast cancer. Methods: In a randomized block design pre-operative serum samples obtained from 63 breast cancer patients and 73 controls were used to generate high-resolution MALDI-TOF protein profiles as a calibration set. The median age of the patient and control group was respectively, 52 (20–81) and 57 years (39–87). The MALDI-TOF spectra generated using WCX magnetic beads assisted mass spectrometry (Ultraflex) were smoothed, binned and normalized after baseline correction. After pre-processing of the spectra, linear discriminant analysis with double cross-validation, based on principal component analysis, was used to classify the protein profiles. Consequently, the classifier constructed on the first 2 plates was applied on the spectra of an independent validation set. This validation set consisted of serum samples from 29 breast cancer patients and 38 controls. The median age was 59 years (26–87) and 57 years (24–71) for the patient and control group respectively. Results: Double cross-validatory analysis carried out on the protein spectra of the calibration set yielded a total recognition rate of 86%, a sensitivity of 88% and a specificity of 84% for the detection of breast cancer within the calibration set. The AUC of this classifier was 90.3%. When this classifier was applied on the spectra of the independent validation set a total recognition rate of 80.9%, a sensitivity of 72% and a specificity of 89% were found. Conclusions: The use of a randomized block design, but mainly an independent validation set proves that discriminating protein profiles can be detected between breast cancer patients and healthy controls. Although further validation in larger series and identification of the discriminating proteins must be achieved, the high sensitivity and specificity indicate that serum protein profiles could be an option for the detection of breast cancer. No significant financial relationships to disclose.