tbuckley/cabot-search huggingface dataset:
Abstract 12115: Adult Congenital Heart Disease Centre Care: A Population Based Analysis of Impact on Mortality
Authors: Ariane Marelli, Raluca Ionescu-ittu, Michal Abrahamowicz, Paul Khairy, Judith Therrien, Andrew Mackie, Tao Gao, Louise Pilote
Journal: Circulation (2011)

Background: The first Canadian Consensus Conference on Adult Congenital Heart Disease (ACHD) was held in l996, with proceeds published in 1998 recommending referral of ACHD care to specialized centers. Over a decade later, no study has documented that specialized ACHD care improves outcomes. We undertook an analysis to determine the impact of ACHD care on mortality. Methods: Time-series analyses from 1990-2005 were performed using the Quebec ACHD database. ACHD centers were defined as hospital centers where > 500 ACHD patients were seen yearly. The study population consisted of patients aged 18-65 years identified with CHD in the 7 years prior to the year of measurement. Patients were considered referred to an ACHD center if they visited a qualifying ACHD center in the year of measurement. Yearly referral and mortality rates were analyzed using Joinpoint regression to detect the year at which a significant change occurred, and Poisson regression to analyze time trends before and after change-points. Resul...
Abstract 20204: Cost-Effectiveness of Computed Tomography of the Coronary Arteries for Patients with Indeterminate or Positive Stress Tests in the Observation Unit
Authors: Brian W Patterson, Emilie S Powell, D M Courtney, Rahul K Khare
Journal: Circulation (2010)

Objectives: One strategy for excluding coronary artery disease (CAD) among patients presenting with low risk chest pain is observation unit (OU) admission with serial cardiac enzymes and stress testing for cardiac risk stratification. In our OU patient population, only 8% of indeterminate stress tests and 36% of positive stress tests yielded confirmed CAD on catheterization. The aim of this study is to estimate the cost-effectiveness of computed tomography of the coronary arteries (CTCA) in the OU for the evaluation of low-risk chest pain patients with indeterminate or positive stress test results.

Methods: We used a multivariate Monte-Carlo model to compare health outcomes and costs between three cardiac risk stratification strategies in a population of patients at low cardiac risk admitted to the OU who subsequently had indeterminate or positive stress tests. The patient population and test characteristics were based on the published literature and a retrospective cohort review of 1194 low risk patients admitted to our OU. Three strategies were compared: (1) CTCA: patients with positive or indeterminate stress tests subsequently underwent CTCA, and only received catheterization if CTCA results were positive (2) standard-of-care: all patients with positive or indeterminate stress tests were admitted for catheterization, and (3) do-nothing: all patients were discharged home after stress testing regardless of outcome. Outcomes measured were cost of care and life expectancy.

Results: Both CTCA and standard-of-care strategies were cost effective when compared to the do-nothing strategy. The incremental cost effectiveness ratio (ICER) for standard-of-care vs. CTCA of was $352,651 per year of life gained. This translates to cost savings were $1967 per patient, with a decrease in life expectancy of only 2 days when instituting a CTCA strategy over standard-of-care. Sensitivity analysis demonstrated that the CTCA strategy was significantly less costly than standard-of-care with no significant decrease in life expectancy.

Conclusion: The addition of CTCA following positive or indeterminate stress test to an OU cardiac risk-stratification pathway for low risk chest pain patients achieved significant cost savings with minimal change in life expectancy.
Stage IIB Hodgkin's disease: the Stanford experience.
Authors: M J Crnkovich, R T Hoppe, S A Rosenberg
Journal: Journal of Clinical Oncology (1986)

Between 1968 and 1982, 126 patients with pathologic stage (PS) IIB Hodgkin's disease were treated at Stanford University with either irradiation alone or irradiation combined with chemotherapy. Actuarial survival and freedom from relapse rates at 10 years for the overall group were 81% and 74% respectively, with no statistically significant difference between the treatment approaches. The impact of the severity and number of constitutional (B) symptoms, as defined by the Ann Arbor Conference, was analyzed. Patients who presented with all three B symptoms had significantly poorer survival and freedom from relapse compared with those patients with only one or two B symptoms (for survival differences, P = .005 and .007; for freedom from relapse differences, P = .002 and .04). Male sex was the only other prognostic factor that correlated with a poor outcome. At 10 years, the survival rate was 66% for males v 84% for females (P = .01), and the freedom from relapse rate was 75% for males v 89% for females (P = .02). The presence of extralymphatic sites of involvement, age greater than 40, or involvement of greater than three lymphoid sites had no significant adverse effect on either freedom from relapse or survival. Patients with large mediastinal masses treated with irradiation alone had a 10-year freedom from relapse rate of 54% v 81% for those treated with combined-modality therapy (P = .15), but there was no significant difference in survival rates (85% for irradiation alone v 71% for combined modality therapy). Treatment recommendations for stage IIB Hodgkin's disease are discussed.
A phase I/II dose escalation trial of EPO906 every 3 weeks in patients with non-small cell lung cancer (NSCLC)
Authors: K. Oesterlind, J. M. Sanchez, P. Zatloukal, M. C. Perry, J. T. Hamm, C. P. Belani, E. S. Kim, J. F. Vansteenkiste, E. Felip, M. Berton
Journal: Journal of Clinical Oncology (2004)

7248 Background: Patients (pts) with newly diagnosed advanced NSCLC usually receive a platinum-containing doublet. However, these regimens are associated with cumulative toxicity (myelosuppression and peripheral neuropathy) and the vast majority of pts eventually relapse and die of their disease. Clearly, improved cytotoxic agents are needed for the treatment of advanced NSCLC. EPO906, a novel epothilone, is a potent microtubule stabilizer that causes cell death and is active in a variety of tumors, including those that are resistant to taxanes. We conducted a phase I/II study to determine the maximum tolerated dose (MTD) and investigate the safety and efficacy of EPO906 in pts with stage IIIB/IV NSCLC who had relapsed after platinum-based therapy. Methods: Pts who had received 1 prior platinum-containing regimen and did not have symptomatic brain metastases were enrolled. During the phase I study, dose escalation will follow the standard 3 + 3 design until the MTD is reached. Pts received EPO906 at a starting dose of 6.5 mg/m2 as a 5-min IV infusion once every 3 weeks with dose escalation in 0.5 mg/m2 increments. During the phase II portion of the study, pts will be treated at the MTD until disease progression or unacceptable toxicity occurs. Results: To date, 9 pts (6 male, 3 female) have been enrolled into the phase I portion of the study. Eight of 9 pts had achieved a partial response or stable disease with prior therapy. The ninth pt had progressed while receiving docetaxel plus platinum as first-line therapy. Median age was 61 years (range, 44 – 77), and median performance status was 1. Three pts were enrolled in cohort 1 (6.5 mg/m2), 3 in cohort 2 (7.0 mg/m2), and 3 in cohort 3 (7.5 mg/m2). Only 2 severe adverse events have been reported, including 1 grade 3 diarrhea responding to medication (cohort 1) and 1 grade 3 asthenia reversed in 5 days (cohort 3). All other adverse events were grade 1 or 2; no serious hematologic toxicities were reported. The MTD has not been reached, and dose escalation continues. Conclusion: Preliminary results suggest that EPO906 is generally well-tolerated in pts with advanced NSCLC. Dose escalation continues and updated results will be presented. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Novartis Pharma AG Amgen; Novartis Pharma AG Novartis Pharma AG Amgen; AstraZeneca Novartis Pharmaceuticals
Electroacupuncture is a potentially valuable treatment
Authors: A. White
Journal: BMJ (1995)

EDITOR,—In their review of fibromyalgia1 Michael Doherty and Adrian Jones omit to mention electroacupuncture, which is a potentially valuable treatment. Deluze et al described a controlled study of 70 patients who met rigorous criteria for the diagnosis of fibromyalgia.2 The group that was treated …
Patients With Hibernating Myocardium Show Altered Left Ventricular Volumes and Shape, Which Revert After Revascularization
Authors: Erberto Carluccio, Paolo Biagioli, Gianfranco Alunni, Adriano Murrone, Claudio Giombolini, Temistocle Ragni, Paolo N. Marino, Gianpaolo Reboldi, Giuseppe Ambrosio
Journal: Journal of the American College of Cardiology (2006)
Abstract 17185: Diastolic Dysfunction is a Risk Factor for Mortality in Patients Undergoing Liver Transplantation
Authors: Andrea M Cordero-Reyes, Jerry D Estep, Gulliermo Torre-Amione, Carlos M Orrego
Journal: Circulation (2011)

Introduction. Cardiac dysfunction in cirrhotic patients is a compilation of manifestations that lead to a hyperdynamic state. The influence of the cardiovascular system and its derangements in these patients has been described but its influence on prognosis and outcome is not well defined. Methods. A retrospective review of 348 patients that underwent liver transplantation at The Methodist Hospital from 2004-2010 was performed under an approved IRB protocol. Charts were obtained from the liver transplant database and information collected regarding cardiovascular profile previous to transplant. Logistic regression adjusted for confounders was performed and statistical significance is defined as p &lt; 0.05. Results. Patient demographics are described in table 1. 65% of the patients were male and 35% female. 65% were also Caucasian, 18% Hispanic and 10% African-American. There were several cardiovascular manifestations in this patient population such as prolonged QTc in 32%, rhythm abnormalities (predominantly heart block) in 9% of patients, pulmonary AV fistula in 18%, PFO in 9% and diastolic dysfunction was present in 22% of patients. When adjusting for possible confounders, Diastolic Dysfunction, independent of filling pressures, was the only predictor of mortality with a p &lt;0.05 with an Odds Ratio and Confidence Interval of 2.3, 2.0-3.2 respectively. Conclusions. In conclusion, Diastolic Dysfunction is a risk factor that needs to be considered when evaluating and managing cirrhotic patients that will undergo liver transplantation in order to reduce morbidity and mortality.
Abstract 3575: Carotid Intima-media Thickness Improves Coronary Heart Disease Risk Prediction In The Atherosclerosis Risk In Communities (ARIC) Study
Authors: Vijay Nambi, Lloyd Chambless, Aaron R Folsom, Yijuan Hu, Thomas H Mosley, Kelly Volcik, Eric Boerwinkle, Christie M Ballantyne
Journal: Circulation (2007)

Background: Carotid intima-media thickness (CIMT) is an independent predictor of cardiovascular disease. It has been suggested by some that CIMT be used as a screening tool in the general populatio...
The Clinical Utility of the Diagnostic Criteria for Psychosomatic Research: A Review of Studies
Authors: Piero Porcelli, Jenny Guidi
Journal: Psychotherapy and Psychosomatics (2015)

Background: The Diagnostic Criteria for Psychosomatic Research (DCPR) are a set of 12 psychosomatic syndromes and are provided with a reliable diagnostic structured interview. The DCPR have been proposed 20 years ago as an integrative assessment strategy that supplements the traditional psychiatric nosography for identifying patients within a given illness population whose psychosocial factors have clinical significance. This paper reviews their clinical utility, conceived as the degree and the amount of influence that the instrument has on multiple decisions and outcomes in clinical practice. Methods: Published reports which involved the use of the DCPR were identified by searching electronic databases. Studies which best displayed the clinical utility of the DCPR system were then selected and reviewed. Results: The DCPR system showed its clinical utility regarding the following clinical issues: (1) subtyping medical patients, (2) identifying subthreshold or undetected syndromes, (3) evaluating the burden of somatic syndromes, and (4) predicting treatment outcomes and identifying risk factors. Conclusions: The DCPR may help clinicians during the assessment process to recognize clinical conditions underlying symptom presentation, with important therapeutic and prognostic implications.
Abstract 4680: Rapid Growth in Hospitalizations for Adults with Congenital Heart Disease in the United States
Authors: Alexander R Opotowsky, Omar Siddiqi, Gary D Webb
Journal: Circulation (2008)

Background: Adults with congenital heart disease (ACHD) constitute a growing population due to advances in pediatric care and diagnostic testing. This study aimed to better define the growth in ACHD hospitalizations and to provide data on the cost of hospitalization for these patients. Methods: We utilized data from the 1998 –2005 Nationwide Inpatient Survey, the largest all-payer nationally representative hospital discharge database, to analyze trends in ACHD hospitalizations. We included all patients over 17 years of age with Clinical Classification Software diagnostic code 213 (Cardiac and Circulatory Anomalies). National estimates of hospitalizations and hospital charges by year for ACHD diagnoses were calculated, as were equivalent estimates for specific subsets of patients. Results: The number of ACHD hospitalizations increased 67% between 1998 and 2005, from 53,212 to 88,610 per year. Over this period, the annual number of admissions increased for both simple (44,781 to 75,911) and complex diagnoses (8,431 to 12,699)(Table ). Patients 55 years or older made up approximately 51% of all ACHD patients, and 40% of those with complex disease. Rates of hospitalization increased similarly for patients under and over 55 years old among all diagnostic categories. Inpatient mortality decreased from 2.6+/−0.2% to 1.7+/−0.1% for simple diagnoses, and 4.4+/−0.5% to 3.7+/−0.4% for complex diagnoses. Mean hospital charges per hospitalization increased 66% from $21,485 to $35,565, and the estimated total national charges for these hospitalizations increased from $1.1 billion to $3.1 billion in 2005 (all in 1998 dollars). In 1998, admissions for ACHD accounted for 0.31% of estimated total national charges for hospitalizations of patients 18 years or older, as compared with 0.47% in 2005. Conclusions: There has been a striking increase in hospitalizations for ACHD, and the cost of these admissions is rising out of proportion to overall hospital costs. Number of Adult Congenital Heart Disease Admissions per Year
Abstract 2198: Rhythmic Risk in Idiopathic Dilated Cardiomyopathy Depending on the Evolution of Left Ventricular Ejection Fraction in Patients with Implantable Cardioverter Defibrillators
Authors: Claude Kouakam, Guillaume Theodore, Christelle Marquie, Didier Klug, Laurence Guedon-Moreau, François Brigadeau, Sylvestre Marechaux, Pascal de Groote, Dominique Lacroix, Salem Kacet
Journal: Circulation (2007)

Background : Patients with idiopathic dilated cardiomyopathy (DCM) receiving an ICD often improve their left ventricular dysfunction in the year following implantation due to reverse remodelling and/or optimization of concomitant drug therapy. We examined whether this improvement impacts the benefit of ICD in terms of appropriate therapy. Methods : The study comprised 93 consecutive DCM patients with LVEF &lt;35% and an indication for ICD (primary prevention = 37, secondary prevention = 56). Follow-up duration was 12 to 42 (median 25) months. LVEF was reassessed 5 to 13 (median 7) months after implantation and compared with baseline value at implantation. Concomitant drug therapy with ACE inhibitors and beta blockers was optimized during the same period, according to recent guidelines. All arrhythmic events were assessed by ICD memory interrogation during follow-up. Major (MaAE) and minor (MiAE) arrhythmic events were defined as appropriate shock or ATP for sustained ventricular tachyarrhythmias &gt;200 bpm or &lt;200 bpm respectively. Early events (before LVEF evaluation) were separated from late events (after LVEF evaluation). Results : Overall the mean LVEF increased by 7.2 % from 24.6±7% at baseline to 31.8±12% at revaluation. Two patterns were observed: 23 patients had a &gt;14% LVEF increase (group 1) whereas 70 others had an increase &lt;14% in LVEF (group 2). In group 1, 3 MaAE and 1 MiAE occurred in the early period but no event in the late period. In contrast, MaAE were observed in 15 and MiAE in 31 patients from group 2 during the late period. On multivariate analysis, changes in LVEF was an independent predictor of MaAE (OR=0.85; 95% CI 0.77 to 0.95; p=0.005) and MiAE (OR=0.91; 95% CI 0.84 to 0.99; p=0.02) during the late period. On multivariate analysis LVEF improvement was negatively correlated to diuretic use and QRS duration at baseline and to the absence of moderate or severe mitral regurgitation. Conclusions : In DCM, rhythmic risk is dynamic and inversely related to the improvement in LVEF. Reverse remodelling under optimal therapy is associated with a late favourable outcome, but 17% of these patients however benefit from ICD therapy in the early period.
Circumferential Pulmonary Vein Isolation With the Cryoballoon Technique
Authors: Thomas Neumann, Jürgen Vogt, Burghard Schumacher, Anja Dorszewski, Malte Kuniss, Hans Neuser, Klaus Kurzidim, Alexander Berkowitsch, Marcus Koller, Johannes Heintze, Ursula Scholz, Ulrike Wetzel, Michael A.E. Schneider, Dieter Horstkotte, Christian W. Hamm, Heinz-Friedrich Pitschner
Journal: Journal of the American College of Cardiology (2008)
Abstract 2906: Longitudinal Rotation: An Unrecognized Motion Pattern in Patients with Left Bundle Branch Block and Dilated Cardiomyopathy
Authors: Ali ahmad, Zoran Popovic, Carlos Benejam, Neil L Greenberg, Richard Grimm, James D Thomas
Journal: Circulation (2006)

Background: We recently observed that the left ventricle (LV) of patients with idiopathic dilated cardiomyopathy (DCM) and left bundle branch block (LBBB) frequently displays clockwise rotation whe...
God and nature revisited: When Science and Christianity Meet edited by D.C. Lindberg and R.L. Numbers. University of Chicago Press, 2003 £20.50 hbk (368 pages) ISBN 0226482146.: When Science and Christianity Meet edited by D.C. Lindberg and R.L. Numbers. University of Chicago Press, 2003 £20.50 hbk (368 pages) ISBN 0226482146.
Authors: Robert T. Pennock
Journal: Trends in Ecology & Evolution (2004)
Common Genetic Variants Do Not Associate with Ifn-Induced Neutropenia in a Genome-Wide Association Study of Chronic Hepatitis C Patients in the Ideal Study
Authors: Alexander J. Thompson, Paul J. Clark, Abanish Singh, Dongliang Ge, Jacques Fellay, Mark S. Sulkowski, Andrew J. Muir, Hans L. Tillman, Keyur Patel, Susanna Naggie, Kevin Shianna, Nezam H. Afdhal, Ira M. Jacobson, Rafael Esteban, Fred Poordad, Eric Lawitz, Jonathan McCone, Mitchell L. Shiffman, Greg Wayne Galler, John W. King, Paul Y. Kwo, Lisa Nyberg, Stephanie Noviello, Navdeep Boparai, Kenneth J. Koury, Lisa Pedicone, Clifford A. Brass, Janice K. Albrecht, David B. Goldstein, John G. McHutchison
Journal: Hepatology (2010)
New Approach to Bacterial Vaccines
Authors: L GREENBERG
Journal: JAMA (1963)

Immunizing antigens against only 10 bacterial diseases-cholera, diphtheria, paratyphoid, pertussis, plague, scarlet fever, staphylococcal disease, tetanus, tuberculosis and typhoid-have been licensed for sale in Canada and the United States. Convincing evidence of efficacy is available for only four of these-diphtheria and tetanus toxoids, and pertussis and typhoid vaccines.The principles which determine the efficacy of different immunizing antigens are not always the same. Toxoids, for example, stimulate the formation of antitoxin-producing mechanisms which can neutralize toxins produced by invading organisms, thereby rendering them harmless. Conversely, vaccines stimulate the formation of antibacterial mechanisms which stop the growth of organisms before they can produce disease.Use of enzyme-lysed vaccines for prevention of staphylococcal disease represents a new approach in vaccine research. Animal tests have shown lysed vaccines to be 10 to 100 times less toxic, and about eight times more effective, than whole bacterial vaccines. Studies with lysed vaccines for other diseases are now in progress.
Abstract 15506: Ischemic Time: a Better Predictor Than Door-to-Balloon Time for Infarct Size in STEMI by Cardiac Magnetic Resonance Imaging
Authors: Manuel M Reyes, Ashley L Gunter, Nicoleta Daraban, Catalin Loghin, Daniel W Maland, Eugene F Stautberg, H.V. Anderson, Ali E Denktas, Stefano M Sdringola, Colin M Barker, James McCarthy, Richard W Smalling
Journal: Circulation (2011)

Background: Current STEMI treatment guidelines strongly recommend early revascularization with optimal ischemic time (IT) <120 min and door-to-balloon (D2B) time <90 min. Revascularization delays l...
Abstract 2482: Fate of Targeted Ultrasound Contrast Agents After Endothelial Adhesion: A Time Course Study
Authors: Shivani Bowry, Jianjun Wang, Sue Ottoboni, Tom Ottoboni, William R Wagner, Flordeliza Villanueva
Journal: Circulation (2007)

Background: Targeted microsphere (μSPH) adhesion to endothelial epitopes forms the basis for ultrasound molecular imaging. The fate of targeted μSPH, once bound to the endothelial target, is unknown. This has limited the optimization of ultrasound imaging strategies; for example, the appropriate time to commence imaging after μSPH injection is uncertain, and in part depends on the time course and duration of μSPH binding. We therefore sought to characterize the behavior of adhered μSPH as a function of time using serial observations of rat cremaster microcirculation after μSPH injection. Methods: Fluorescent nitrogen-encapsulated polymer μSPH (diameter 3.0 ± 1.4 μm) bearing control non-specific IgG (μSPH CTL ) or monoclonal antibody against VCAM (μSPH VCAM ) or ICAM (μSPH ICAM ) were prepared. Inflamed cremaster muscle of 21 anesthetized Wistar rats was exteriorized for intravital microscopy 4 hours after intrascrotal injection of TNF-α (5μg). Each rat received 1 venous injection of a single μSPH species (n=7 rats/μSPH; 10 8 μSPH/injection). An index venule was identified for serial microscopic observation every 5 min starting 10 min after μSPH injection. Results: The cumulative sum of adhered μSPH during 1 hr observation was higher for μSPH ICAM (24±11) and μSPH VCAM (18±1) than μSPH CTL (3±2, p=0.005). The number of μSPH ICAM adherent to the index venule was stable over time (10 min: 2 ± 3; 30 min: 3±2; 80 min: 3 ± 5, ANOVA p=0.9). The number of adhered μSPH VCAM trended downwards (10 min: 5±4; 30 min: 2±2; 80 min: 1±2; ANOVA p=0.08). By 1 hr, adhered μSPH appeared altered in shape; no μSPH transmigration was seen. Conclusions: Nitrogen-filled polymer μSPH targeted to leukocyte adhesion molecules adhere to inflamed endothelium. The extent of μSPH adhesion remains relatively constant over a time period relevant for imaging applications, although beyond 1hr, the μSPH appear morphologically altered and could have different acoustic properties. These data provide a useful and broad time window for effective ultrasound imaging of molecular targets. The time course of μSPH attachment to endothelium is an important consideration when devising strategies for ultrasound molecular imaging and should be characterized in a μSPH- and target- specific manner.