tbuckley/cabot-search huggingface dataset:
Abstract 17878: Kindlin-2 is a Novel Regulator of Hemostasis
Authors: Elzbieta Pluskota, Dorota Szpak, Yi Ma, Yan-Qing Ma, Dmitry A Soloviev, Tatiana Byzova, James J Dowling, Jeffrey A Golden, Carla Nestor, Eugene A Podrez, Edward F Plow
Journal: Circulation (2011)

Kindlin-2, a widely distributed cytoskeletal protein, has been implicated in integrin activation, and its absence is embryonically lethal in mice. We previously demonstrated that kindlin-2 is a key contributor to angiogenesis since it was defective in kindlin-2 +/- mice and zebrafish. In the present study, we tested the hypothesis that kindlin-2 may regulate hemostasis utilizing the kindlin -2 +/- mice. Tail bleeding time was significantly prolonged (+ 45%, P=0.02) and blood loss was 4-fold more (P=0.005) in kindlin-2 +/- mice as compared to WT animals. In addition, time to carotid artery occlusion after FeCl 3 injury was increased by 30% (P=0.02) in the kindlin-2 +/- mice. Fibrinogen, vWF, t-PA, TFPI levels or activities were similar in plasma of WT and kindlin-2 +/- mice. Platelet count, platelet expression levels of integrin αIIbβ3, P-selectin and GPIbα as well as ex vivo platelet aggregation in response to various agonists were similar in both mouse strains. Bone marrow transplantation from kindlin-2 +/- donors to WT mice did not transfer the bleeding prolongation to recipients, indicating the defect was not associated with bone marrow-derived cells in kindlin-2 +/- mice. However, mouse aortic endothelial cells (ECs) isolated from the kindlin-2 +/- mice showed significantly enhanced capacity to inhibit ADP-induced platelet aggregation as compared to WT ECs (75% platelet aggregation in the presence of WT ECs vs 20% aggregation in the presence of kindlin-2 +/- ECs). Although eNOS expression and phosphorylation were similar in both WT and kindlin-2 +/- ECs, FACS analyses revealed increased (by 2-3-fold) levels of ATP diphosphohydrolase (CD39) and Ecto-5’-Nucleotidase (CD73) on the surface of the kindlin-2 +/- ECs. Accordingly, 2-3 fold more ADP and AMP were hydrolyzed on kindlin-2 +/- ECs than on WT ECs, and supernatants collected from ADP-treated kindlin-2 +/- ECs did not trigger platelet aggregation as efficiently as those from WT cells. In control experiments, overexpression of kindlin-2 in the kindlin-2 +/- EC, decreased CD39 and CD73 levels and blunted the antiplatelet activities of these cells. Taken together, endothelial kindlin-2 regulates ADP levels and ADP-dependent platelet responses and, thereby, plays an important role in thromboregulation.
Abstract 14183: Some Like It Cool - Seasonal Temperature, as Well as Clinical And Demographic Factors, Predicts Compliance With the Wearable Cardioverter Defibrillator
Authors: Edmond M Cronin, Nicole R Bianco, Roy Chung, Jo Ann Glad, Jay Sengupta, Steven J Szymkiewicz, Mina K Chung
Journal: Circulation (2011)

Introduction: The wearable cardioverter defibrillator (WCD) is a non-invasive alternative to the ICD in patients requiring short-term protection against sudden cardiac death (SCD). While compliance...
Nested Polymerase Chain Reaction With Sequence-Specific Primers Typing for HLA-A, -B, and -C Alleles: Detection of Microchimerism in DR-Matched Individuals
Authors: Anthony S. Carter, Lucia Cerundolo, Mike Bunce, Dicken D.H. Koo, Kenneth I. Welsh, Peter J. Morris, Susan V. Fuggle
Journal: Blood (1999)
Abstract 4716: Prognostic Value of Coronary Artery Calcium Scoring and Multi-slice Computed Tomography Coronary Angiography in Symptomatic Patients with Suspected Coronary Artery Disease
Authors: Jacob Van Werkhoven, Joanne Schuijf, Oliver Gaemperli, J Wouter Jukema, Eric Boersma, William Wijns, Gabija Pundziute, Arthur Scholte, Ernst Van der Wall, Philipp Kaufmann, Jeroen Bax
Journal: Circulation (2008)

Objectives: Extensive data support the prognostic value of coronary calcium scoring (CS). Only preliminary data are available on the prognostic value of multi-slice computed tomography coronary ang...
Abstract 9757: Transcatheter Valve Replacement is a Cost-Effective Alternative to Conventional Surgery in Selected High-Risk Patients
Authors: Hemal Gada, Samir R Kapadia, E M Tuzcu, Lars G Svensson, Thomas H Marwick
Journal: Circulation (2011)

Background: Transfemoral transcatheter aortic valve replacement (TAVR) is cost-effective for management of severe aortic stenosis (AS) in patients with unacceptable risk for aortic valve replacement (AVR). However, the relative cost-effectiveness of TAVR and tissue AVR is ill-defined in high-risk patients where surgery is an option. We developed a Markov model to inform the choice between transfemoral TAVR and AVR in high-risk patients. Methods: A Markov model was developed to examine the progression of patients between health states, defined as peri- and post-procedural, post-complication, and death. The mean and variance of risks, transition probabilities, utilities and cost of TAVR and AVR were derived from meta-analysis of relevant registries, studies and trials. Outcome and cost were derived from 10,000 simulations. Sensitivity analyses were based on the likelihood of mortality, stroke, and other commonly observed outcomes. Further analyses evaluated situations thought to favor tissue AVR or TAVR. Results: In the reference case (age 80, peri-operative mortality of transfemoral TAVR and AVR 5.8 vs 9.1%, annual mortality 22.2 vs 22.5%), the utility of TAVR was greater than AVR (1.71 vs 1.64 QALY). As the cost of TAVR was greater than AVR ($26,176 vs $19,361), the incremental cost-effectiveness ratio (ICER) was $97,357/QALY. In sensitivity analyses, variations in stroke, peri-operative and annual mortality are the main drivers of variation in health outcomes. The current risk profile of transfemoral TAVR offered net health benefits when peri-operative AVR mortality was &gt;5.2%, or stroke post-TAVR was &lt;11.3% (Figure). In a scenario analysis based only on operable PARTNER patients (Cohort A), QALYs for TAVR and AVR were 1.69 and 1.63, with an ICER of $70,633/QALY. Conclusion: TAVR may provide net health benefits at acceptable cost in selected high-risk patients among whom AVR is the current procedure of choice.
Comparison of the prognostic value of cardiac iodine-123 metaiodobenzylguanidine imaging and heart rate variability in patients with chronic heart failure
Authors: Takahisa Yamada, Tsuyoshi Shimonagata, Masatake Fukunami, Kazuaki Kumagai, Hisakazu Ogita, Akio Hirata, Mitsutoshi Asai, Nobuhiko Makino, Hidetaka Kioka, Hideo Kusuoka, Masatsugu Hori, Noritake Hoki
Journal: Journal of the American College of Cardiology (2003)
Abstract 14512: Cerebral Microembolization After Bioprosthetic Aortic Valve Replacement: An Open-Label Study of Daily Warfarin+Aspirin Versus Aspirin Alone
Authors: Talal Al-Atassi, Harry Lapierre, Munir Boodhwani, Khanh Lam, Melissa Forgie, Fraser Rubens, Paul Hendry, Roy Masters, William Goldstein, Pierre Bedard, Thierry Mesana, Marc Ruel
Journal: Circulation (2011)

Background: No mechanistic data exist as to whether aspirin alone is as effective as daily warfarin+aspirin in preventing cerebral embolization in the early postoperative period after bioprosthetic...
Abstract 1589: Variation in the Choice of PCI vs CABG for Patients With Multivessel Coronary Disease in Northern New England
Authors: David J Malenka, Craig W Langner, Bruce J Leavitt, Mirle A Kellett, John F Robb, Lawrence J Dacey, Richard A Boss, Peter N Ver Lee, Robert A Clough, David Goldberg, David C Charlesworth, Gerald T O'Connor
Journal: Circulation (2009)

BACKGROUND: The many randomized trials of PCI versus CABG for patients with multivessel CAD have reported consistent results - comparable longterm survival, better early angina relief following CAB...
Depression and anxiety in heroin addicts: a placebo-controlled study of doxepin in combination with methadone
Authors: George E. Woody, Charles P. O'Brien, Karl Rickels
Journal: American Journal of Psychiatry (1975)

Narcotic addicts may manifest symptoms of depression that aggravate their addiction. In this double-blind study of 35 mildly depressed patients in a methadone maintenance program, subjects who received doxepin improved significantly more than control subjects. Even in this short-term study, the reduction in depression was associated with a trend toward better performance in other areas of rehabilitation.
Ex Vivo Expansion of Genetically Marked Rhesus Peripheral Blood Progenitor Cells Results in Diminished Long-Term Repopulating Ability
Authors: J.F. Tisdale, Y. Hanazono, S.E. Sellers, B.A. Agricola, M.E. Metzger, R.E. Donahue, C.E. Dunbar
Journal: Blood (1998)
High-Sensitivity C-Reactive Protein Is Within Normal Levels at the Very Onset of First ST-Segment Elevation Acute Myocardial Infarction in 41% of Cases
Authors: Nicole Cristell, Domenico Cianflone, Alessandro Durante, Enrico Ammirati, Diego Vanuzzo, Michela Banfi, Giliola Calori, Azeem Latib, Filippo Crea, Giancarlo Marenzi, Monica De Metrio, Luciano Moretti, Hui Li, Neal G. Uren, Dayi Hu, Attilio Maseri
Journal: Journal of the American College of Cardiology (2011)
A Curious Case of Chest Pain
Authors: Aaron W. Aday, Joshua M. Liao, Robert F. Padera, Anand Vaidya, Garrick C. Stewart
Journal: New England Journal of Medicine (2013)

A 67-year-old man presented to the emergency department with chest pain. He had presented to the emergency department at another hospital 10 days earlier with an episode of periumbilical discomfort, nausea, and nonbloody emesis. At that time, laboratory tests revealed minor thrombocytosis, and an abdominal computed tomographic (CT) scan, obtained after the intravenous . . .
Patients perspective of an oncology day ward: A questionnaire based survey
Authors: I. Haidar, C. Grant, J. Asgher, K. I. Quintyne, A. Shah, J. Power, A. Wakeford, P. M. Calvert, G. D. Leonard
Journal: Journal of Clinical Oncology (2008)

17543 Background: Most of the published literature in medical oncology is based on understanding the biology and or treatment (Rx) of cancer. There is minimal data dedicated to the environment in which the Rx is delivered. We devised a questionnaire to explore the views of patients using an oncology day ward facility. Methods: We assessed all patients receiving treatment in our oncology day ward over a one month period. The day ward staff comprises of one doctor and 4–6 nurses. Patients were given a questionnaire assessing their satisfaction with the staffing, physical environment, and efficiency of the day ward. The questions were qualitative and quantitative and were filled in independently by patients with no involvement of the day ward team in an attempt to reduce bias. Results: One hundred and sixty patients were given the questionnaire and 105 responded (68%). Staffing: Patients were very satisfied with the level of physician and nursing care (88% and 96% respectively) and their availability (78% & 90% respectively). Physical Enviroment: Few patients were satisfied with the level of privacy when talking to a doctor or nurse (54% & 60% respectively). Satisfaction with the comfort level while waiting for Rx or while on Rx was also low ( 51% & 60% respectively). Efficiency: Allowing for the same day phlebotomy, the optimum would be initiation of Rx within 40 mins after blood tests, however this was achieved in only 17% of our patients. Conclusions: Most patients were very positive about the care they received from medical staff in our oncology day ward but expressed concerns regarding efficiency and the physical environment. In addition to providing experienced and motivated staff it also essential to adequately resource the environment in which the treatment is delivered in order to optimize patient care. No significant financial relationships to disclose.
Simultaneous Antagonism of Interleukin-5, Granulocyte-Macrophage Colony-Stimulating Factor, and Interleukin-3 Stimulation of Human Eosinophils by Targetting the Common Cytokine Binding Site of Their Receptors
Authors: Q. Sun, K. Jones, B. McClure, B. Cambareri, B. Zacharakis, P.O. Iversen, F. Stomski, J.M. Woodcock, C.J. Bagley, R. D’Andrea, A.F. Lopez
Journal: Blood (1999)
Child mental health: who is responsible? An overextended remit
Authors: R. Goodman
Journal: BMJ (1997)

Child mental health: who is responsible?The labelling of all childhood ills as mental health problems diverts doctors into child welfare work that is more properly the province of social services or education, argues child psychiatrist Robert Goodman.The result, he claims, is that many children who could have benefited from medical assessment and treatment for their emotional and behavioural problems do not get that help.We asked another child psychiatrist, an educational psychologist, and a social worker to respond to Dr Goodman's challenge. An overextended remit Robert GoodmanParents and teachers are seriously dissatisfied with the behaviour of many children.Other children experience considerable stress, misery, or anxiety.Epidemiological studies suggest that roughly 20% of all children and teenagers are maladjusted or distressed, 1 with some estimates being substantially higher. 2 In the child psychiatric literature and government strategy documents these maladjusted and distressed children are referred to as having psychiatric disorders or mental health problems. 3 4I believe that this medicalisation of all maladjustment and distress is a serious "own goal" for the health service, generating unrealistic expectations of what child mental health services can deliver and diverting health professionals from their areas of expertise.The medicalisation of maladjustment and distress is enshrined in the contemporary psychiatric classifications of the World Health Organisation and the American Psychiatric Association. 5 6Perhaps both these classifications were overinfluenced by the World Health Organisation's otherworldly definition of health as "a state of complete physical, mental and social wellbeing, and not merely the absence of disease and infirmity" 7 ; falling short of this ideal is then a lack of health, and it is only a small step to define any serious shortfall as a disease.Cynics will also note that the medicalisation of maladjustment and distress generates employment for doctors and persuades health insurers to foot at least some of the bill.An overinclusive notion of child mental health may have encouraged health providers to fill the vacuum as successive funding crises have led social services and education to withdraw from much of their traditional child and family guidance work.Antisocial behaviour in adults is usually seen as a social problem: similar behaviour in children is often categorised as a mental health problem
Longitudinal self-reported and serum-based assessment of tobacco or nicotine use in head and neck cancer patients during definitive radiotherapy or chemoradiotherapy.
Authors: M. R. Kudrimoti, S. M. Arnold, J. Valentino, M. Randall, G. W. Warren
Journal: Journal of Clinical Oncology (2010)

1594 Background: Tobacco use during cancer treatment is associated with a poor prognosis, but tobacco or nicotine use (TNU) assessment in cancer treatment patients is poorly characterized. Methods: Patients with measurable squamous cell carcinoma of the head and neck (HNSCC) treated with definitive radiotherapy (RT) or chemoradiotherapy (CRT) were eligible for enrollment. Entry and weekly self-reported TNU was measured in combination with objective serum cotinine (SC, an established quantitative measure of TNU). Results: At interim analysis, 50 patients are enrolled and SC assessments are complete for 37 patients. Of 37 patients, 81% are male (median age at diagnosis 53, range 39-75), 68% have oropharyngeal tumors, 84% are node positive, 81% presented at stage III-IVB, and 89% were treated with CRT. Any tobacco use was reported in 78% (median pack-year history of 32.5, range 3-138). Successful tobacco cessation was reported in 54% with 1-3 years median duration (range 2 wks to 40 yrs). At diagnosis, 30% of patients reported TNU; however, 41% of patients were SC positive at some time throughout RT or CRT. Of 30% of patients reporting second-hand smoke (SHS) exposure, 45% denied TNU at study entry. Of 19% of patients reporting social help with cessation, 71% reported that a friend or family helped and only 29% reported that doctors helped. SC values varied widely in individual patients over the course of RT or CRT. Of 41% of SC positive patients, 93% were SC positive at study entry, 73% at mid-treatment (week 4), and 53% during the final week of treatment. Conclusions: Data demonstrate that most HNSCC patients presenting with TNU at the beginning of RT or CRT continue TNU throughout treatment. Multiple TNU and SHS assessments are necessary to accurately characterize TNU during cancer treatment and the effects on clinical outcome. No significant financial relationships to disclose.
Abstract 49: Optimal CPR Loop Duration for Asystole and Pulseless Electrical Activity During In-Hospital Cardiac Arrest
Authors: Trond Nordseth, Dana P Edelson, Daniel Bergum, Theresa M Olasveengen, Trygve Eftestøl, Benjamin Abella, Eirik Skogvoll
Journal: Circulation (2011)

Background Cardiopulmonary resuscitation (CPR) is a process where time-cycled “loops” of chest compressions form the basis of action. Optimal loop duration is a compromise between interrupting compressions and detecting a change in the clinical state. Current CPR guidelines recommend a two-minute loop duration. The aim of this study was to investigate optimal loop duration in asystole (ASY) and pulseless electrical activity (PEA). Material and methods Detailed defibrillator recordings from 261 in-hospital cardiac arrests at the University of Chicago Hospital (Chicago, Ill., U.S) and St.Olav University Hospital (Trondheim, Norway) were analyzed. The clinical states ASY, PEA, ventricular fibrillation/-tachycardia (VF/VT), return of spontaneous circulation, and death were annotated along the time axis. We analyzed the development of clinical states ASY and PEA, both as initial and secondary states. As the development of initial VF/VT depended on heterogeneous shock strategies implemented by providers, these patients (n=46) were excluded from further analysis. Results The figure shows the development of PEA and ASY as Kaplan-Meier plots.ASY and PEA behaves similarly. By 5 minutes 50% percent of the patients with initial ASY/PEA have progressed to a different clinical state; by 8 minutes 25 % remain. Secondary ASY/PEA progresses earlier to other clinical states. Discussion To minimize pauses in chest compressions it is reasonable to aim between the 50th and 25th percentile, when a change of state most likely has occurred. Optimal loop in initial PEA and asystole appears to be between 5 and 8 minutes, and between 1 and 3 minutes in secondary PEA and ASY.
Blood Transfusion
Authors: Janet M. Torpy
Journal: JAMA (2004)

Blood TransfusionB lood transfusion can be life-saving.Blood products include whole blood (blood with all of its components, rarely used now), packed red blood cells (blood cells that carry oxygen), platelets (cells in the blood that allow blood clots to form), plasma (the liquid portion of blood without cells), and concentrated clotting factors.When packed red blood cells are transfused, an individual' s blood count increases.This blood count is usually measured as the hemoglobin level.Hemoglobin is a protein that carries oxygen to the tissues and cells of the body.Normal hemoglobin levels are about 12 to 15 grams per 100 milliliters of blood for women and about 14 to 17 for men.Although individual circumstances can be different, anemia (low red blood cell count) requiring transfusion usually occurs when the hemoglobin is about 7. Medical research has shown that significant decreases in tissue oxygen delivery occur when the hemoglobin drops to that level.The October 6, 2004, issue of JAMA includes an article about blood transfusion in the setting of acute coronary syndrome (heart attack).
Abstract 17294: Medication Discrepancies in Heart Failure: an Independent Predictor of Hospitalizations
Authors: Katherine E Small, Kathleen A Prendergast, Sanjiv Shah
Journal: Circulation (2011)

Background: One advantage of the recent mandate by the U.S. government for electronic medical records (EMR) is the ability to reconcile medications in order to limit adverse effects of polypharmacy, thereby potentially improving outcomes. High-risk patients on multiple medications, such as those with heart failure (HF), stand to benefit greatly from the EMR. While medication discrepancies still occur in the EMR, their association with adverse outcomes in HF has not previously been examined. Hypothesis: The number of medication discrepancies in the EMR of HF patients is associated with adverse outcomes. Methods: We prospectively studied 99 HF patients and compared medications lists in the EMR with patient-reported medications to determine the number of medication discrepancies. We dichotomized patients into 2 groups: “Low Discrepancies” (0-1) and “High Discrepancies” (2 or greater). Multivariable linear regression was performed to determine whether increased number of medication discrepancies was independently associated with increased number of hospitalizations over a 1-year period. Results: Patients with increased medication discrepancies (≥ 2) were more symptomatic based on NYHA class, had a higher number of health care providers, and had more hospitalizations over a 1 year period (Table). On multivariable linear regression analysis, the number of medication discrepancies was independently associated with the number of hospitalizations (beta-coefficient 0.17, 95% CI 0.08-0.25), p&lt;0.0001 per each medication discrepancy after adjusting for age, sex, ethnicity, NYHA class, and total number of medications. Conclusion: Despite the use of a well-established EMR in HF patients, medication discrepancies still exist. The number of medications discrepancies is an independent predictor of number of hospitalizations in patients with HF. Improving EMR medication reconciliation, especially in HF patients who have multiple providers, is critical.