tbuckley/cabot-search huggingface dataset:
Abstract 3005: Surgical Treatment of Severe Right Ventricular Cardiomyopathy
Authors: Juan Chachques, Thomas Lavergne, Robert Frank, Francoise Hidden-Lucet, Guy Fontaine, Jean-Louis Hebert, Yves Lecarpentier, Vlad Ciobotaru, Alain Carpentier, Jean-Noel Fabiani
Journal: Circulation (2007)

Objective: Chronically depressed right ventricular (RV) function presents an unresolved therapeutic challenge. Despite recent advances in medical and surgical therapies, prognosis remains poor and patient’s quality of life and mortality are frequently unacceptable. The aim of this work is to present the surgical technique and long-term results of RV dynamic cardiomyoplasty applied in patients with RV failure due to isolated RV cardiomyopathies. Methods: Twelve consecutive patients (8 males, 4 females), mean age 37±9 years, were enrolled. All pts had predominant RV dysfunction, associated with tricuspid regurgitation in 11 cases. Etiology of RV failure was arrhythmogenic cardiomyopathy (8 cases), Uhl’s disease (2 cases) and ischemic (2 cases). Patients were in preoperative NYHA FC III. Mean pre-operative EF measured by isotopic technique, was 20 ± 4.2 % for the RV and 37 ± 8 % for the LV. Right ventricular dynamic cardiomyoplasty consists in wrapping the RV free wall with the left Latissimus Dorsi Muscle (LDM) flap. The distal part of the LDM is fixed to the diaphragm and then electrostimulated in synchrony with cardiac function. Eleven patients required associated tricuspid valve surgery (10 annuloplasty rings and 1 valve replacement). In 6 pts an ICD was implanted prior to surgery. Results: Nine patients are alive (mean follow-up: 10 ± 3.5 years), seven in NYHA functional class I and two in class II. Three deaths occurred: one patient died postoperatively due to infection, one patient died at day 45 due to gastroenteric complication and one patient died at year 7 due to stroke, while in functional class II. At long term follow-up, mean RVEF is 32 ± 6 % and LVEF is 51 ± 9 %. Conclusions: The results of this long-term study demonstrate hemodynamic and functional improvements following RV cardiomyoplasty with no long-term malignant arrhythmias and RV dysfunction related deaths. The effects of RV cardiomyoplasty can be related to chronic systolic compression and diastolic dilatation restriction (positive remodeling), which may reduce tension and excitability of myocardial fibers. This study suggests that cardiomyoplasty is a safe alternative or long-term bridge to heart transplantation in these patients with relatively preserved LV function.
Abstract P089: Does Social Support Attenuate the Impact of Poverty Status on Body Mass Index?
Authors: Kiarri N Kershaw, Arlene L Hankinson, Mercedes R Carnethon
Journal: Circulation (2012)

Background: Chronic stress associated with living in poverty may lead to higher levels of adiposity due to the adoption of obesity-promoting stress coping behaviors. Social support may provide an alternative means of coping with stress, but very few studies have investigated whether high levels of social support can mitigate the adverse impact of poverty on adiposity. Hypothesis: We hypothesized that social support modified the association between poverty and BMI whereby the association of poverty with BMI was weaker among adults who reported higher social support. Methods: National Health and Nutrition Examination Survey (2005–2008) participants ages 40+ (n=5,768) responded to questions about availability and adequacy of emotional social support (adequate, inadequate, and none) and about availability of financial support (yes/no). Poverty was defined as a poverty:income ratio ≤ 1.3. BMI (kg/m 2 ) was calculated from measured height and weight. Sex-stratified multivariable linear regression with interaction terms for poverty and each measure of social support were used to test for effect measure modification in the relationships between poverty and BMI. Associations of each measure of social support with BMI were modeled separately. Results: Approximately 74.7% of women and 78.3% of men reported adequate emotional support. Available financial support was reported by 80.3% of women and 73.6% of men. Among women, higher poverty was related to higher mean BMI (beta=0.96; SE=0.32). Women who reported adequate emotional support had lower BMI than those who reported inadequate support (beta= −0.83; SE=0.35). Those who reported no available emotional support also had marginally lower mean BMI than women who reported inadequate support (beta= −1.27; SE=0.65; P =0.06). Women who reported having available financial support had lower BMI than those who reported no financial support (beta= −0.97; SE=0.40). There were no significant social support*poverty interactions. The relationship between poverty and BMI was similar in magnitude across levels of emotional support. Poverty was related to higher mean BMI for women who reported available financial support (beta=1.14; SE=0.45) but there was no difference in BMI among those who reported none (beta=0.02; SE=0.54). Neither measure of support was associated with BMI among men. Conclusions: Inadequate emotional support was associated with higher mean BMI in women than those who reported adequate support and those who reported no support. Lack of financial support was also associated with higher mean BMI in women. High social support did not offset the impact of poverty on BMI among women, suggesting social support may not be a sufficient strategy for coping with the stress of poverty.
Abstract 4174: Adenosine-Stress CT Myocardial Perfusion Imaging: Comparison with Stress Myocardial Perfusion MRI in Patients with Coronary Artery Disease
Authors: Masaki Ishida, Hajime Sakuma, Shingo Kato, Motonori Nagata, Nanaka Ishida, Mashio Nakamura, Hiroshi Nakajima, Masaaki Ito, Kan Takeda
Journal: Circulation (2008)

Background: CT coronary angiography with vasodilator stress might be of great value in detecting both myocardial ischemia and morphological stenoses of the coronary arteries. Stress myocardial perfusion MRI has been shown to provide accurate assessment of presence and extent of myocardial ischemia in patients with coronary artery disease(CAD). The aim of this study was to determine the value of stress myocardial perfusion CT for the detection of myocardial ischemia by using stress perfusion MRI as a reference method. Methods: The study protocol was approved by the institutional review board and all participants gave written informed consent. Cardiac CT was performed in 12 patients with suspected CAD by using a 64-detector MDCT scanner. Beta-blocker was orally administered prior to CT study. During continuous injection of adenosine, contrast enhanced CT images of the heart were acquired with retrospectively gated helical CT protocol. Adenosine stress myocardial perfusion MRI was performed within 2 weeks from CT perfusion study in all patients. Stress myocardial perfusion MDCT and MR images were qualitatively assessed by two observers using a 16-segment model. Results: All patients completed stress CT study protocol without significant side-effect. Averaged heart rate was 62+/−10 beats/min in the baseline state and 74+/−14 beats/min during adenosine stress. Perfusion abnormality during stress was observed in 83 (43.2%) of 192 segments by MDCT and in 89 (46.4%) of 192 segments by MRI. On a vessel based analysis, stress CT and stress MRI findings are concordant in 30 (83.3%) of 36 territories. The sensitivity, specificity and accuracy of adenosine stress myocardial perfusion CT for the predicting abnormal perfusion on stress perfusion MRI was 84.6%, 80% and 83.3%, respectively. Conclusion: Adenosine stress myocardial perfusion CT can be successfully performed in patients with CAD. Excellent agreement between stress myocardial perfusion CT and MRI observed in this study indicates the value of stress CT approach for comprehensive assessment of morphology and functional significance of CAD.
Abstract P104: Impact of Avocado Enriched Diets on Serum Lipids: A Meta-Analysis
Authors: Sachin A Shah, Fanny Yan
Journal: Circulation (2013)

Introduction: Diet is integral to the management of dyslipidemia. Evidence suggests that diets rich in monounsaturated fatty acids (MUFA) benefit the serum lipid profile. Avocados offer a plant based source of MUFA, but the magnitude of benefit from avocado consumption remains unknown. We performed a meta-analysis to assess the impact of avocados on total cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C), and triglycerides (TG). Methods: A literature search using the term “avocado” and “Persea Americana” was done using PubMed, CINAHL, Cochrane Database of Systemic Reviews and by hand searching of relevant primary and review articles. Studies were included for analysis if, controlled trials in human subjects evaluating avocado in the diet with adequate data reported for either, TC, LDL-C, HDL-C or TG. A weighted mean difference from baseline was calculated using the DerSimonian-Laird random-effects model. Subgroup analyses and the Q statistic were used to assess for heterogeneity. Publication bias was assessed through the Egger bias statistic and inspection of funnel plots. Results: From the 841 screened studies, 9 were included in the final analysis incorporating 186 unique subjects for all lipid endpoints. Dietary avocado intake resulted in a statistically significant decrease in TC and LDL-C of -15.30 mg/dl (CI -22.25 to -8.35) and -12.55 mg/dl (CI -19.89 to -5.21), respectively. TG reduced significantly by -24.17mg/dl (CI -41.94 to -6.41). HDL-C decreased non-significantly by -1.27mg/dl (CI -4.46 to 1.91). Subgroup analyses suggested that replacing regular dietary fats with avocado based fats results in a higher reduction in TC, LDL-C and TG compared to simply adding avocado to a free diet. The Q statistic was significant for all endpoints (p&lt;0.001) while the Egger bias statistic showed a lack of publication bias for all endpoints except TG. Conclusion: Avocado enriched diets can lower TC, LDL-C and TG by 15, 13, and 24 mg/dl respectively. HDL-C is not significantly impacted. Of note, the reduction appears beneficial with a fat substitution strategy rather than the general addition of avocados to a free diet.
Hospital-acquired infections due to multidrug-resistant organisms in Hungary, 2005-2010
Authors: S Caini, A Hajdu, A Kurcz, K Böröcz
Journal: Eurosurveillance (2013)

Healthcare-associated infections caused by multidrug-resistant organisms are associated with prolonged medical care, worse outcome and costly therapies. In Hungary, hospital-acquired infections (HAIs) due to epidemiologically important multidrug-resistant organisms are notifiable by law since 2004. Overall, 6,845 case-patients (59.8% men; median age: 65 years) were notified in Hungary from 2005 to 2010. One third of case-patients died in hospital. The overall incidence of infections increased from 5.4 in 2005 to 14.7 per 100,000 patient-days in 2010. Meticillin-resistant Staphylococcus aureus (MRSA) was the most frequently reported pathogen (52.2%), but while its incidence seemed to stabilise after 2007, notifications of multidrug-resistant Gram-negative organisms have significantly increased from 2005 to 2010. Surgical wound and bloodstream were the most frequently reported sites of infection. Although MRSA incidence has seemingly reached a plateau in recent years, actions aiming at reducing the burden of HAIs with special focus on Gram-negative multidrug-resistant organisms are needed in Hungary. Continuing promotion of antimicrobial stewardship, infection control methodologies, reinforced HAI surveillance among healthcare and infection control practitioners, and engagement of stakeholders, hospital managers and public health authorities to facilitate the implementation of existing guidelines and protocols are essential.
Use of randomisation in early clinical trials
Authors: Sjúr∂ur F Olsen
Journal: BMJ (1999)

Editor—The issue of 31 October marking 50 years of the randomised controlled trial, with historical accounts on trial methodology, made me look up the trial undertaken by Theobald. He studied the combined effect of calcium, vitamin A, and vitamin C supplementation on toxaemia in 100 pregnant women, apparently using true individual randomisation.1,2 This was in 1936, a decade before the streptomycin trial.3

Although not all aspects of the randomisation procedure are entirely clear from Theobald’s report,1,2 he was obviously a thoughtful researcher. He provided evidence that the groups had similar age and parity distributions, had a statistician (E S Pearson) to assess the extent to which his results (that symptoms of toxaemia were less common in the treatment group) could have arisen by chance, and even used blinding of the primary outcome assessors. Despite these facts Theobald’s trial seems to be little cited in the literature.

Another London trial is interesting from a methodological point of view. During 1938-9 the People’s League of Health allocated over 5000 pregnant women from 10 hospitals to receive either no supplement or a supplement containing calcium, vitamin A, and vitamin C as well as other substances.4,5 The trial was an enormous achievement, not only because of its size but also because of its methodological standard.5

The People’s League of Health trial used alternate allocation rather than true randomisation, although the team concerned must have known about Theobald’s trial: its medical secretary (W C W Nixon) was affiliated to St Mary Abbots Hospital, where Theobald had conducted his trial. Further, in his report Theobald had foreshadowed the People’s League of Health trial by stating that “experiments conducted on these lines would show to what degree the different protective substances are associated with toxaemia symptoms” and that he published the results “in the hope that further experiments on a larger scale will be conducted elsewhere.”

We can only speculate why the People’s League of Health team did not adopt Theobald’s idea of implementing true randomisation; feasibility could be one reason. Perhaps someone knows the relation between these trials and their conduct.
Radiologic Techniques for Detection and Evaluation of Liver Cancer
Authors: Errol Lewis, Sidney Wallace
Journal: Liver Cancer (1985)

In the diagnosis of the presence, nature, and location of hepatobiliary neoplasms, the diagnostic radiologist assumes a primary responsibility. This has come about largely due to the developments in the noninvasive modalities of radionuclide scintigraphy (RN), ultrasonography (US), and computed tomography (CT) as well as the refinements in the invasive procedures of angiography and percutaneous biopsy. The place of digital subtraction angiography (DSA) [1] and nuclear magnetic resonance (NMR) [2–4] has not been defined as yet. This chapter highlights the radiologist's role in the diagnosis of patients with hepatic tumors.
Outcomes Following Pre-Operative Clopidogrel Administration in Patients With Acute Coronary Syndromes Undergoing Coronary Artery Bypass Surgery
Authors: Ramin Ebrahimi, Cornelius Dyke, Roxana Mehran, Steven V. Manoukian, Frederick Feit, David A. Cox, Bernard J. Gersh, E. Magnus Ohman, Harvey D. White, Jeffrey W. Moses, James H. Ware, A. Michael Lincoff, Gregg W. Stone
Journal: Journal of the American College of Cardiology (2009)
Abstract 10023: Comparison of Delayed Myocardial Contrast Enhancement during Dual Energy Computed Tomography in Acute Coronary Syndrome and Magnetic Resonance Imaging
Authors: Hideyuki Saeki, Teruhito Kido, Susumu Shigemi, Kouki Watanabe
Journal: Circulation (2012)

[Background] Delayed contrast enhancement of the myocardium during cardiac magnetic resonance imaging (MRI) is useful for diagnosing myocardial infarction and evaluating myocardial viability. Delayed myocardial contrast enhancement (DE) similar to that seen in cardiac MRI is observed in cardiac computed tomography (CT). SOMATOM Definition Flash (Siemens) is an advanced device equipped with 2 pairs of X-ray tubes and detectors that enable dual energy imaging using 2 types of energy. The present study was undertaken to compare the DE during CT scan (dual energy imaging technique) and MRI in patients with acute coronary syndrome.

[Methods] The study involved 12 patients (men/women = 10/2; mean age, 65.2 ± 8.5 years) with acute coronary syndrome who were hospitalized for emergency percutaneous coronary intervention (PCI), which resulted in successful reperfusion, between April 2010 and March 2012. CT and MRI were performed on each patient about 2 weeks after the onset of the disease. The devices used were Siemens Dual Source CT and GE 1.5T MRI. Delayed-phase imaging was initiated at 6 min with CT and 15 min with MRI. During CT, an additional 50 mL of the contrast material was intravenously injected slowly (0.2 mL/s) after coronary artery CT and delayed-phase imaging was performed. For MRI, the contrast material was injected at an ordinary dose level (0.2 mL/kg body weight). CT was performed using the helical imaging technique (pitch, 0.17-0.25) with 2 tubes (100 kV and 140 kV). Image reconstruction employed the Heart PBV (heart perfused blood volume). The volume of the myocardium showing DE was calculated as ∑ (DE area × slice thickness).

[Results] In all subjects, DE during MRI and CT were identical. Both the DE volume (MRI, 15,377.5 ± 9702.7 cm3 vs CT, 11,796.5 ± 9278.0 cm3, p = 0.0025) and the percentage of this volume relative to the entire myocardial volume (MRI, 14.6% vs CT, 12.7%, p = 0.0268) were significantly greater for MRI than for CT, but the DE volume correlated significantly between MRI and CT (p < 0.0001).

[Conclusion] Patients with acute coronary syndrome showed a good correlation in the delayed contrast enhancement of the myocardium during dual energy CT and MRI, which suggested that this imaging modality would be clinically useful.
Abstract 429: The Failing Senescent Heart Contains a Pool of Functionally Competent Progenitor Cells
Authors: Arantxa Gonzalez, Marcello Rota, Daria Nurzynska, Yu Misao, Jochen Tillmanns, Caroline Ojaimi, Elena Padin-Iruegas, Patrick Mueller, Grazia Esposito, Claudia Bearzi, Serena Vitale, Buddhadeb Dawn, Mathue Baker, Thomas H Hintze, Roberto Bolli, Konrad Urbanek, Toru Hosoda, Jan Kajstura, Piero Anversa, Annarosa Leri
Journal: Circulation (2007)

A critical question concerns whether myocardial aging affects uniformly all cardiac progenitor cells (CPCs) or a subset of functionally competent CPCs persists in the senescent heart suggesting that these cells may be activated to form new contracting myocardium. CPCs isolated from the heart of rats at 3, 12, 16 and 24 months were found to express IGF-1-IGF-1R, HGF-c-Met and the components of the renin-angiotensin system (RAS). Although mRNA for angiotensinogen and AT1-receptors decreased in old CPCs, the quantity of these proteins did not vary with aging. Renin mRNA increased at 12 and 16 months and returned to baseline at 24 months. Additionally, Ang II synthesis was 3-fold higher in old than in young CPCs and this difference persisted after ligand activation. Conversely, a decrease in IGF-1R, IGF-1 and HGF mRNA, and IGF-1R and c-Met proteins occurred in old CPCs. Baseline values for IGF-1 secretion were similar in young and old CPCs, but in response to ligand stimulation IGF-1 synthesis was 8-fold higher in young CPCs. HGF did not vary. Collectively, these results indicate that aging led to an increase in RAS function and a decrease in IGF-1-IGF-1R and HGF-c-Met function in CPCs. However, whether these aging effects involved the entire CPC pool remained unknown. Based on the expression of the senescence-associated protein p16 INK4a and telomere length, CPCs in the old heart consisted of two subsets: a large compartment of p16 INK4a -positive CPCs with short telomeres and a small pool of p16 INK4a -negative CPCs with long telomeres. CPCs expressing IGF-1-IGF-1R and HGF-c-Met were consistently negative for p16 INK4a while p16 INK4a was detected in CPCs positive for Ang II and AT1-receptors. Therefore, the ability of IGF-1 and HGF to induce CPC proliferation was attenuated but not abolished in old CPCs which also showed a modest 29% decrease in telomerase activity. Ang II stimulated apoptosis in both young and old CPCs but oxidative DNA damage was higher in old cells. Studies in vivo were then performed documenting that CPCs can be activated in the old heart by the local injection of growth factors. By this strategy, the senescent heart phenotype was partially corrected and the improvement in cardiac hemodynamics resulted in prolongation of maximum lifespan.
Similarities between parents and offspring on a personality inventory
Authors: R E Peck, J E Everson
Journal: American Journal of Psychiatry (1975)

The authors administered a personality inventory that has been used as a psychiatric screening test to 28 children and their natural parents. By intercorrelations between the tests of parents and offspring they attempted to find out whether the offspring resembled the parent of same sex, the parent of the opposite sex, or a composite of both parents. They found that the offspring resembled their peer group more often than either parent or a composite of both parents.
Abstract 9812: Dietary Supplementation of Nitrite Reduces Chronic Cardiotoxicity of Doxorubicin: Role of Activation of Protein Kinase G and Down-Regulation of Endothelial Nitric Oxide Synthase in Heart
Authors: Shu-Guang Zhu, Anindita Das, David E Durrant, Rakesh C Kukreja, Lei Xi
Journal: Circulation (2011)

Background: Doxorubicin (DOX) is one of the most effective and commonly used chemotherapeutic agents for cancer. Clinical use of DOX is limited because of its serious dose-dependent cardiotoxicity. We recently demonstrated that oral intake of inorganic nitrate (NaNO3) protects against acute cardiotoxicity of DOX. The present study was designed to further elucidate if dietary supplementation of nitrite (NaNO2) also limits the cardiotoxic effects following chronic, multiple low-dose treatment of DOX. Methods &amp; Results: Adult male CF-1 mice were divided into 4 groups (n=6/group): 1) Saline [0.2 ml, IP]; 2) DOX [3 x weekly IP injection of 5 mg/kg DOX; cumulative dose = 15 mg/kg]; 3) Nitrite - NaNO2 was added into drinking water at concentration of 50 mg/L for entire duration of 32 days; 4) Nitrite+DOX - mice received nitrite-enriched water 7 days before the first DOX injection and throughout the 32-day period. Five days after the last DOX injection, echocardiography and pressure-volume Millar microtip catheterization were performed to assess left ventricular (LV) contractile function and other hemodynamic indices. As shown in the Table below, LV systolic and diastolic function was significantly improved in Nitrite+DOX group as compared with DOX group. Oral nitrite intake augmented plasma level of nitrite, but not nitrate or sum of nitrate+nitrite (NOx). Further molecular studies revealed that nitrite intake enhanced cardiac activity of cGMP-dependent protein kinase (PKG) and reduced expression of endothelial nitric oxide synthase (eNOS) as compared with Saline or DOX (n=3/group). Conclusion: We have provided novel evidence showing that dietary nitrite supplementation reduces cardiotoxicity following chronic DOX treatment. The cardioprotective effect of nitrite may be mediated by the enhanced PKG signaling and the decreased expression of likely uncoupled eNOS in the heart. Nitrite could be a promising therapeutic agent in combating chronic DOX cardiotoxicity.
Endoscopic submucosal dissection: the best way to deal with subsquamous metaplasia?
Authors: Maximilien Barret, Marine Camus, Sarah Leblanc, Romain Coriat, Stanislas Chaussade, Frédéric Prat
Journal: Endoscopy (2015)

We read with great interest the article by Chevaux et al. reporting the results of a large prospective study of endoscopic submucosal dissection (ESD) for Barrett’s neoplasia [1].