tbuckley/cabot-search huggingface dataset:
Abstract 18101: Three-Dimensional Echocardiography Identify Mechanisms of Early Post Operative Valve Failure in Pediatric and Congenital Heart Disease
Authors: Norazah Zahari, Timothy Colen, Somjate Suntratonpipat, Mohammed Al-Habdan, David Ross, Mohammad Al-Aklabi, Ivan M Rebeyka, Jeffrey F Smallhorn, Nee S Khoo
Journal: Circulation (2013)

Background: Three-dimensional echocardiography (3DE) is an accurate and informative imaging modality routinely used in pre-operative assessment for surgical planning. There is however little information on 3DE role in early post-operative valve failure assessment. This is a report on our 5 years experience of 3DE in early post-operative mitral/left atrioventricular valve (MV/LAVV) failure assessment, its impact on our understanding of its mechanism and the clinical decision for returning to the operating theatre for re-repair. Methods and results: We retrospectively reviewed all patients chart and echo with MV/LAVV surgery between 2008 and 2012, excluding primary repair of atrioventricular septal defect (AVSD) and primary valve replacement. Early valve failure (EVF) is defined as moderate or greater MV/LAVV regurgitation within 30 days post repair. There were 132 MV/LAVV surgeries consisting of repaired complete AVSD (n=85), congenital MV abnormality (n= 17) and primum AVSD (n= 16). Pre operative moderate or greater regurgitation was present in 55 (42%) and post op EVF in 33 patients (25%). 3DE were performed in 22 (67%) of 33 EVF with 8 patients returning to the operating room for re-repair due to poor clinical progress in intensive care unit. Six of 8 re-repair were infants. 3DE accurately identified the mechanism of regurgitation such as suture dehiscence at base of cleft, leaflet tears and patch failure (see Figure). Four of 8 patients MV/LAVV regurgitation improved to mild or less regurgitation at follow-up (median 2 months), 3 remained unchanged and 1 subsequently died from intractable heart failure despite MV/LAVV regurgitation improving from severe to moderate. Conclusion: Although patient returning for re-repair of EVF were mainly driven by poor clinical progress in intensive care. 3DE accurately identified the mechanism of early post-operative valve failure thus facilitating surgical planning and decision for re-repair.
Abstract 15008: Multi-Disciplinary Approach to Patent Foramen Ovale and Cryptogenic Stroke or Transient Ischemic Attack.
Authors: Naqibullah Mirzada, Per Ladenvall, Per-Olof Hansson, Tony Lundh, Bjorn Runmarker, Eva Furenas, Peter Eriksson, Mikael Dellborg
Journal: Circulation (2010)
Biomarker development trial of satraplatin in patients with metastatic castrate-resistant prostate cancer.
Authors: Bobby Chi-Hung Liaw, Sonia Maria Seng, Matt D. Galsky, Che-Kai Tsao, Phillip G. Febbo, William K. Oh
Journal: Journal of Clinical Oncology (2014)

170 Background: While satraplatin, a fourth generation oral platinum analogue, failed to improve overall survival (OS) in an unselected metastatic castrate-resistant prostate cancer (mCRPC) population (Sternberg, JCO 2009), anti-tumor activity was demonstrated, suggesting a “platinum-sensitive” subset of patients. Predictive biomarkers may not only select patients most likely to benefit from novel “targeted” therapies but also from standard (even discarded) cytotoxic agents. Development of predictive biomarkers in mCRPC is hampered by the fact that PC is associated with a long natural history and evolving genetic changes, highlighting the need for immediate pre-treatment metastatic tissue samples for biomarker development. In this trial, we sought to determine the feasibility of obtaining metastatic biopsies in patients with mCRPC treated with satraplatin. Methods: Docetaxel-refractory mCRPC patients underwent image-guided biopsy of metastatic lesions prior to treatment with satraplatin 80 mg/m 2 PO on days 1 to 5 of a 35-day cycle and prednisone 5 mg PO twice daily. Biopsy samples are analyzed by whole exome and RNA sequencing, and peripheral blood samples are undergoing transcriptional profiling, to facilitate biomarker development. Results: Thirteen patients were enrolled with a median age of 71 (range: 55 to 80), prostate-specific antigen (PSA) of 82 ng/ml (0.04-3057), and Gleason score 8 (7 to 9). All patients received prior docetaxel, four (31%) had more than or eqaul to two prior chemotherapies, and two (15%) received abiraterone. Drug-related grade 3/4 toxicities included leukopenia (23%), neutropenia (8%), thrombocytopenia (8%), fatigue (8%), renal failure (8%), dysphagia (17%), and diarrhea (8%). A median of four cycles of satraplatin were completed, with declines of serum PSA of greater than or equal to 30% achieved in 4 of 13 patients (31%; 95% CI, 57.3 to 85.4%). Median time to PSA progression was 12.4 weeks (95% CI, 7.2 to 29.7+ weeks). Metastatic pre-treatment biopsies were collected in all study patients; genomic analysis is ongoing. Conclusions: This study confirms that satraplatin has anti-cancer activity in a subset of patients with mCRPC. Trials that require pre-treatment metastatic tumor biopsies are feasible. Analysis of the correlation between molecular signatures and treatment response will be presented at the meeting. Clinical trial information: NCT01289067.
Pharmacokinetic Results of Two Phase III Clinical Studies of Coagulation Factor IX (Recombinant) Albumin Fusion Protein (rIX-FP) in Previously Treated Patients with Hemophilia B (PROLONG-9FP)
Authors: Elena Santagostino, Iris C. Jacobs, Christine Voigt, Annettee Feussner, Tharin Limsakun
Journal: Blood (2014)
Abstract 14342: Does Fixed-Dose Regadenoson Induce Comparable Myocardial Perfusion Reserve in Patients of Widely Varying Body Size? A Quantitative MRI Study
Authors: Sheldon E Litwin, Jacob Fluckiger, Liyoung Chen, Tae H Kim, Nathan Pack, Brian Matthews, Chris McGann, Ronny Jiji, Suman Kuppahally, Tiffany Priester, Edward V Dibella
Journal: Circulation (2010)

Background: A fixed dose of the A2a receptor agonist, regadenoson, is equivalent to weight-adjusted adenosine for assessment of myocardial ischemia during SPECT imaging. However, it is unknown whet...
Statement on the Care of the Child with Chronic Lung Disease of Infancy and Childhood
Authors: Allen J, Zwerdling R, Ehrenkranz R, Gaultier C, Geggel R, Greenough A, Kleinman R, Klijanowicz A, Martinez F, Ozdemir A, Panitch Hb, Nickerson B, Stein Mt, Tomezsko J, Van Der Anker J
Journal: American Journal of Respiratory and Critical Care Medicine (2003)
Fibrin Sealing of the Liver Bed after Laparoscopic Cholecystectomy: A Prospective Randomized Study
Authors: P. Schrenk, R. Woisetschläger, W. Wayand
Journal: Endoscopy (1995)

The effect of fibrin sealing of the liver bed on the amount of postoperative drainage fluids after laparoscopic cholecystectomy was investigated prospectively in 20 patients (group I) and compared to 20 patients in whom hemostasis was achieved by electrocautery alone (group II). Mean drainage of fluids measured after 24 and 48 h postoperatively revealed a slight increase in group II patients (day 1, 26.6 ± 18.6 versus 36.5 ± 32.2 ml; day 2, 0 versus 2.3 ± 38.1 ml) but not of statistical significance. After uncomplicated laparoscopic cholecystectomy control of bleeding can be adequately achieved by electrocautery. However, in case of extensive and diffuse bleeding or aberrant bile duct fibrin sealing may be of advantage.
Abstract 2393: Angiotensin-Converting Enzyme Inhibitors Associated with Statins Prevent Anthracycline-Induced Alterations of the Left Ventricular Systolic Performance, with no Influence on Mitral Diastolic Filling Indices' Deterioration
Authors: Dan Radulescu, Sorin Pripon, Elena Buzdugan, Paulina Mitrea, Gavril Saplacan, Gheorghe Sebestyen, Andreea Parv, Maria L Radulescu, Laurentiu Stoicescu
Journal: Circulation (2008)

Introduction: Treatment-induced impairment of left ventricular (LV) function is a well-established consequence of anthracyclines. Hypothesis: We assessed the hypothesis that treatment with ACE inhi...
Bullying in medicine
Authors: T. Field
Journal: BMJ (2002)

Successful leadership requires range of stylesEditor-Treasure's views and comments after the NHS Confederation's leadership conference make interesting reading. 1 The leadership style of consultants covers a broad spectrum that could be described as ranging from "huggy touchy feely" all the way up to "Attila the Hun meets Genghis Khan."A similar spectrum exists in managers.The British government's own Cabinet Office expert report on public service leadership indicates that successful leaders need to adopt a range of styles depending on the situation. 2That may include having to resort at times to coercive, browbeating styles.Many consultants would perhaps choose to operate in the lower or middle range of the style spectrum.At times when managers do not listen to consultants' reasonable concerns about the delivery of safe, effective, high quality services there may be no option but reluctantly to wheel out Attila and Genghis to protect both patients and consultants.Treasure is very fortunate to be in a specialty that is comparatively rich in resources and having its concerns addressed by major
Alterations in serum prothrombotic markers induced by treatment with bevacizumab-based chemotherapy regimens
Authors: C. Murphy, F. Crotty, E. C. Smyth, G. Healy, O. S. Breathnach, L. Grogan, F. Ni Ainle, P. Murphy
Journal: Journal of Clinical Oncology (2008)

15034 Background: An increase in thrombotic events has been observed during treatment with chemotherapy and bevacizumab in patients with metastatic carcinoma. A better understanding of the effect of bevacizumab on haemostasis is necessary to determine the true thrombogenic potential of this drug. Methods: 10 patients with metastatic colorectal cancer (mCRC) commencing first line or salvage chemotherapy with bevacizumab were included in this prospective trial. Plasma samples were drawn at baseline, after the first cycle of treatment containing chemotherapy alone and after the second cycle containing chemotherapy plus bevacizumab. The study evaluated alterations of markers of procoagulant activation, natural anticoagulants, endothelial cell and platelet activation. The markers analysed were: prothrombin time (PT), activated partial thromboplastin (aPTT), D-Dimer (D-Di), fibrinogen (Fibn), factor VIII (FVIII), activated protein C (APCR), protein C (PC), free protein S (fPS), soluble P-selectin (sP-sel), platelet count (plt), von Willebrand factor antigen (vWF:ag) and von Willebrand factor activity (vWF:act). Results: The mean basal levels of D-Di and Fibn were increased above the normal range and remained elevated throughout the course of treatment analysed. Significant differences were noted in the levels of PC, plt and vWF:ag between the basal values and post-cycle 2 results (p=0.003, p=0.007 and p=0.05 respectively). The mean pre-treatment and post-chemotherapy cycle 1 levels of sP-sel were also above the normal range but were in the normal range after the second cycle. A thrombotic event occurred in one patient after the second cycle of chemotherapy. Conclusion: Metastatic CRC is associated with a prothrombotic state. A reduction in natural anticoagulation (PC) and increased vascular activation (vWF:ag) was seen in patients treated with bevacizumab. Platelet activation, as demonstrated by P-selectin levels was reduced with chemotherapy and normalised with the addition of bevacizumab. These data not only support prior observations of the prothrombotic state in cancer patients treated with chemotherapy, but also provides in vivo evidence of the mechanisms of the procoagulant effect of bevacizumab-based chemotherapy. No significant financial relationships to disclose.
Abstract 2773: Long-Term Administration of Thiazolidinedione Reverses Ultrasonic Manifested Atherosclerotic Processes Independent of Diabetic Improvement for Type-2 Diabetics
Authors: Tatsuaki Murakami, Hiromasa Kokado
Journal: Circulation (2006)

Background: Insulin resistance and type-2 diabetes mellitus are thought to be highly involved in complex atherothrombogenic processes, but the long-term effects of insulin sensitizing agents remain...
Abstract 6253: Increased Expression of Thioredoxin Interacting Protein Promotes Oxidative Stress and Contributes to the Pathogenesis Of Diabetic Cardiomyopathy
Authors: Kim A Connelly, Darren J Kelly, Michael Zhang, Kerri Thai, Andrew Advani, Henry Krum, Richard E Gilbert
Journal: Circulation (2008)

Background: Alterations in the thioredoxin (TRX) antioxidant system have been implicated in the pathogenesis of cardiac injury, particularly in the diabetic setting. While constitutively present, TRX activity is reduced by the presence of its endogenous inhibitor, thioredoxin interacting protein (TxnIP). We hypothesized that by increasing TxnIP, diabetes may reduce TRX activity and contribute to oxidative stress. Methods: Cell culture studies were performed using the H9C2 rat cardiomyoblast cell line and neonatal cardiomyocytes isolated from 1 day old Sprague Dawley rat neonates. In-vivo studies were performed using a hemodynamically-validated rodent model of diabetic diastolic heart failure, the diabetic (mRen-2)27 transgenic rat (Ren-2). Urinary 8-hydroxy-2′-deoxyguanosine (8-OHdG) was used as a measure of oxidative stress. Results: In- vitro, high glucose (25mmol/l) resulted in increased TxnIP mRNA expression in both neonatal cardiomyocytes as well as H92C cells (2.21 ± 0.6 v 1.00 ± 0.19, p&lt;0.05 compared to normoglycaemic conditions) with a 45% reduction in TRX activity (0.11 ± 0.01 v 0.061± 0.003, p&lt;0.01). In-vivo, diabetes led to a 250% rise in TxnIP mRNA expression compared to control (2.54 ± 0.5 v 1.00 ± 0.11, p&lt;0.001) that was accompanied by a three fold rise in urinary 8-OHdG (680 ± 280 v 1395 ± 391 ng/ml, p&lt;0.001). Conclusion: In both the in vitro and in vivo settings, high glucose leads to TxnIP over-expression associated with reduced TRX activity thereby increasing oxidative stress and implicating this system in the pathogenesis of the cardiac dysfunction that characterizes the diabetic state. Pharmacological manipulation of the TRX-TxnIP system may represent a novel target to reduce diabetic complications.
全科医生要提供"全人"的照顾
Authors: 周仲华
Journal: BMJ (2006)

我有一个女患者,35岁,是一个家庭主妇.她的丈夫是商人,比她年长10岁,他们有一个9岁的女儿,看上去一家经济条件不错,生活也较安稳.可是,每次我见到这个患者的时候,她的脸上都带着一种愁苦的表情.在最近2年里她患了较严重的月经异常,表现为月经周期紊乱,经量增多,经期长短不一,有时月经淋漓不断持续半个月.此外,她还有一个肥胖的问题,身高1.65米的她体重达到了86 kg[体重指数(BMI)为31.5].妇科检查子宫大小在正常范围,没有其他异常体征.她结婚10年,9年前生育后一直用自然避孕法,没有用过宫内节育器或口服避孕药等措施,无肝病、血液病及甲状腺、肾上腺或垂体疾病史.自我初次接诊这个患者以来,我曾给她做过基础体温测定,结果显示基础体温呈单项,提示无排卵;也曾给她做过诊断性刮宫,结果显示子宫内膜简单型增生过长;盆腔超声显示子宫卵巢未见异常。
Abstract 16148: The Impact of Response to Cardiac Resynchronization Therapy on Ventricular Arrhythmic Events in CUBIC Registry
Authors: Kenji Ando, Satoshi Shizuta, Satoki Fujii, Kouichi Inoue, Natsuhiko Ehara, Takeshi Arita, Yoshimitsu Soga, Kazuaki Kaitani, Takeshi Kimura, Takaaki Isshiki, Masakiyo Nobuyoshi, Cubic Investigators
Journal: Circulation (2011)

Background: It's well known that cardiac resynchronization therapy (CRT) is effective to reduce heart failure hospitalization and prolong survival. However, the impact of response to CRT on ventric...
Abstract 2193: Genetically-mediated Torsades De Pointes During Complete Heart Block
Authors: Rajesh N Subbiah, Michael H Gollob, George J Klein, Stephen M Chihrin, Allan C Skanes, Lorne J Gula, Peter Leong-Sit, Andrew Krahn
Journal: Circulation (2007)

Background: Torsades de pointes (TdP) is a well known arrhythmic sequela in congenital and acquired long QT syndromes (LQTS). Less frequently, bradyarrhythmias are associated with QT prolongation and TdP. Although some observations have been made on the predictors of TdP in bradyarrhythmias, there is limited data on cellular mechanisms or genetic predisposition to bradycardia-induced TdP. Methods: In a retrospective case-control study, we identified 11 patients who were referred with CHB and TdP. Comprehensive assessment was performed in these patients, including, history, examination, ECG parameters (baseline, in CHB and pre-TdP) and genetic testing of repolarization related ion channel genes. 33 control patients with CHB and no TdP were selected for comparison of ECG parameters. All patients received either a pacemaker or implantable cardioverter defibrillator, with outpatient follow-up. Results: Four out of 11 patients with CHB and TdP had a genetic mutation identified involving ion channels responsible for cardiac repolarization (36%), involving hERG (n=3) and SCN5A (n=1). The key observations were that Tpeak to Tend interval was significantly longer in patients with a genetic abnormality at baseline, in CHB and pre-TdP (see Table 1 ). Compared to controls, patients who had TdP complicating CHB had significantly longer QTc and Tpeak to Tend intervals in CHB. Conclusion: TdP in the setting of CHB appears to identify patients who have an underlying genetic predisposition to reduced repolarization reserve. In particular, the terminal phase of repolarization (Tpeak to Tend) appears to be a marker for patients who have a cardiac ion channel abnormality. Given these findings, genetic testing should be considered in patients with TdP in the setting of CHB.
Abstract P029: Diabetes Mellitus and Disabling Dementia among Japanese: The Circulatory Risk in Communities Study (CIRCS)
Authors: Eri Eguchi, Kazumasa Yamagishi, Ai Ikeda, Choy-Lye Chei, Hiroyuki Noda, Tetsuya Ohira, Akihiko Kitamura, Hironori Imano, Masahiko Kiyama, Yoshinori Ishikawa, Takashi Asada, Hiroyasu Iso
Journal: Circulation (2012)

Introduction: The evidence for the relation between diabetes mellitus and risk of dementia in Asian population has been limited. This study investigated the association between diabetes mellitus and risk of dementia in community-based samples of Japanese. Hypothesis: There is an association between diabetes mellitus and risk of disabling dementia Methods: We performed a nested case-control study based on a cohort of about 6,000 Japanese aged 45-69 at baseline between 1984 and 1994. The information of the status of diabetes at baseline was collected for 174 disabling dementia cases incident between 1999 and 2004 and 348 controls matched with cases by age±3, sex and baseline-year. Incident disabling dementia was defined as dependent individuals who had moderate to severe dementia-related behavioral disturbance or cognitive impairment. This criterion was previously validated with 5-cog test. Dementia cases were further classified according to presence of history of stroke. The conditional odds ratio (OR) for dementia was calculated according to the status of (1) glucose intolerance; fasting serum glucose 110-125mg/dl or non-fasting serum glucose 140-199 mg/dl; and (2) diabetes; fasting serum glucose ≥126 mg/dl, non-fasting serum glucose ≥200 mg/dl, and/or the use of glucose-lowering medication or insulin therapy. Variables for multivariable adjustment were body mass index, smoking status, total cholesterol and hypertension status (140≤SBP&lt;160 mmHg, 90≤DBP&lt;95 mmHg for hypertension of grade 1, SBP ≥160 mmHg, DBP ≥95mmHg for hypertension of grade 2 and 3, and the treatment with an antihypertensive drug). Sex-specific analysis was also conducted as subanalysis. Results and Conclusions: Mean follow-up year was 11.4 years. The proportion of men was 32.8% and the prevalence of glucose intolerance and diabetes among controls were 16.7% and 5.8%, respectively. Of dementia cases, 44.8% had history of stroke. Compared with persons with normal glucose level, ORs (95%CI) for glucose intolerance and diabetes were 1.12 (0.68-1.84) and 2.18 (1.13-4.22), and multivariable ORs were 0.98 (0.58-1.65) and 2.04 (1.03-4.03), respectively. For sex stratified analysis, ORs for diabetes were 1.39 (0.45-4.31) for men, and 2.79 (1.20-6.50) for women. The association of diabetes was primarily observed in dementia cases with stroke history [OR=3.19 (1.04-9.82)], but not in those without it [OR=1.78 (0.78-4.07)]. In conclusion, we found an association between diabetes mellitus and risk of disabling dementia. The association was confined to women, and dementia with stroke history.
Screening for Copy Number Variation in Genes Associated With the Long QT Syndrome
Authors: Julien Barc, François Briec, Sébastien Schmitt, Florence Kyndt, Martine Le Cunff, Estelle Baron, Claude Vieyres, Frédéric Sacher, Richard Redon, Cédric Le Caignec, Hervé Le Marec, Vincent Probst, Jean-Jacques Schott
Journal: Journal of the American College of Cardiology (2010)
Abstract 16675: Acute Effects of Dietary Bisphenol A on Arterial Health
Authors: Paul D Chantler, Ibra S Fancher, Sara B Fournier, Evan DeVallance, Trey S Rottgen, Corey A Nida, Suzanne Bell, Gregory M Dick
Journal: Circulation (2013)

Background: Bisphenol A (BPA) is present in canned goods and detectable in the urine of >95% of US adults. Animal studies suggest a link between BPA and cardiovascular disease (CVD). Yet, in humans...
Abstract 4754: Determining the Optimal Cross-sectional Analysis Interval for OCT Assessment of Coronary Stenting
Authors: Hiram G Bezerra, Giulio Guagliumi, Hiroyuki Kyono, Satoko Tahara, Noah Rosenthal, Giuseppe Musumeci, Vasile Sirbu, Orazio Valsecchi, Alessandro Aprile, Daniel Simon, Marco A Costa
Journal: Circulation (2009)

Introduction: Intracoronary Optical Coherence Tomography (OCT) provides high resolution images and allows detailed stent strut level analysis (SLA). SLA was proposed recently as a surrogate endpoint for DES safety. We aim to define the “optimal” sampling interval for SLA: combining minimal data variability with optimal post-processing time of analysis. Methods: A total of 14.716 cross-sections from 192 patients and 4 different stents type (Endeavor, Taxus, Cypher and Liberte (BMS)) were studied. A total of 456 stent segments were analyzed. Data sampling every five frames (0.3 mm) for cross-sectional area (0.06mm) for SLA were considered the reference method. Data sampling at increments 5 frames for area measurement and 1 frame for percentage of strut coverage were compared with the reference interval to define variability. Variability was calculated as absolute difference from the reference method at different analysis interval. Results: A low variability (&lt;10%) was observed for minimal lumen and stent area measurements for all tested interval analyses. At the maximum tested interval (40 frames, 2.4 mm) the variability (%, SD) for minimal lumen and stent area was 9.6±16.2, 5.8±6, respectively. Detection of any uncovered struts showed good agreement (Kappa&gt;0.8) up to every-7-frame SLA sampling (0.42 mm intervals). However, the variability for percentage of uncovered struts was high even at the lowest (every 2 frames) analysis interval (11.7±25) and reached unacceptable 51.9±132 at 15 frames (~1 mm) analysis interval. Conclusion: Lumen and stent area measurements by OCT showed low variability in all tested analysis intervals. However, percentage of uncovered struts has high variability even at high data sampling. The ideal cross-section data sampling for OCT stent analysis is highly dependent on the variable of interest. Variability related with the analysis interval