tbuckley/cabot-search huggingface dataset:
Abstract 2422: Depression and Anxiety in Adult Patients with Congenital Heart Disease
Authors: Mayumi Ohta, Yuri Kurosawa, Toshio Nakanishi
Journal: Circulation (2007)

Background: Advances in the management of congenital heart disease (CHD) have resulted in increased survival of patients (pts) into adulthood, but those pts may encounter new medical and social problems in adulthood. Further, even if their medical condition may be good, social adaptation may be insufficient because of the psychiatric and/or psychological problems. However, little is known about psychosocial functioning of adults with CHD. The aim of this study was to evaluate psychopathological problems in adult pts with CHD. Methods: We evaluated psychopathological adjustment in 60 consecutive adult pts (20 –52 yrs of age) with CHD, who were hospitalized at our institute, including tetralogy of Fallot (9 pts), transposition of the great arteries (8 pts), single ventricle (7 pts), tricuspid atresia (5 pts), ventricular septal defect (3 pts), and miscellaneous (28 pts). Severity of cardiac conditions, psychiatric/ psychological symptoms, education, and career were assessed, and psychiatric analysis was performed in each patient. We used a standardized semi-structured psychiatric interview with the self-administered scale Minnesota Multiphasic Personality Inventory (MMPI). Results: 17% (10 pts) had clinical symptoms of depression and anxiety, and these pts met the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) for depression and anxiety, based on the diagnostic interview and MMPI. In addition, 23% (14 pts) showed abnormality in several scales, such as hypochondriasis, depression, and hysteria in MMPI, although they did not meet the criteria of psychopathology. In these pts, emotional problems were expressed as physical and general malaise in MMPI data. A statistically significant correlation was observed between the MMPI data and medical severity. The MMPI data did not correlate with the social background, such as education and work experience. Conclusions: The frequency of depression and anxiety is high in adults with CHD, especially in severe CHD, irrespective of education and career. Even if there may be no psychological symptoms and pts appear to be well adapted, there is a potential risk of depression and anxiety in adults with CHD. Optimal psychiatric interventions remain to be clarified.
Abstract 10269: Angiotensin II Potentiates α-Adrenergic Vasoconstriction in the Elderly
Authors: Zachary Barrett-O'Keefe, John McDaniel, Anette S Fjeldstad, Melissa A Hayman, Joel D Trinity, Jamie Conklin, Sean Runnels, David Morgan, Mark A Supiano, Russell S Richardson, David W Wray
Journal: Circulation (2010)

Introduction: Aging is associated with increased activity of both the adrenergic and renin-angiotensin-aldosterone systems (RAAS), which may contribute to the well-known elevation in peripheral vasoconstriction with age, as well as the sequelae of geriatric hypertension. The individual contribution of each pathway may be exacerbated by the potentiating effects of ANG-II on alpha-adrenergic vasoconstriction, though this interaction has not been studied in healthy aging. Hypothesis: We hypothesized that: (1) Alpha-adrenergic vasoconstriction would be similar between young and older, and (2) ANG-II-mediated vasoconstriction would be greater in the elderly than in young, but this age effect would be ablated in the presence of alpha-adrenergic antagonism. Methods: Eleven subjects (n=6 young, 25±1 yrs; n=5 older, 65±1 yrs) underwent brachial artery catheterization for local administration of ANG-II (0.8–25 ng/dl/min), NE (2.5–80 ng/dl/min) and ANG-II with concomitant alpha adrenergic antagonism (phentolamine, 1...
Outcomes of Daytime Procedures Performed by Attending Surgeons after Night Work
Authors: Anand Govindarajan, David R. Urbach, Matthew Kumar, Qi Li, Brian J. Murray, David Juurlink, Erin Kennedy, Anna Gagliardi, Rinku Sutradhar, Nancy N. Baxter
Journal: New England Journal of Medicine (2015)

Sleep loss in attending physicians has an unclear effect on patient outcomes. In this study, we examined the effect of medical care provided by physicians after midnight on the outcomes of their scheduled elective procedures performed during the day.We conducted a population-based, retrospective, matched-cohort study in Ontario, Canada. Patients undergoing 1 of 12 elective daytime procedures performed by a physician who had treated patients from midnight to 7 a.m. were matched in a 1:1 ratio to patients undergoing the same procedure by the same physician on a day when the physician had not treated patients after midnight. Outcomes included death, readmission, complications, length of stay, and procedure duration. We used generalized estimating equations to compare outcomes between patient groups.We included 38,978 patients, treated by 1448 physicians, in the study, of whom 40.6% were treated at an academic center. We found no significant difference in the primary outcome (death, readmission, or complication) between patients who underwent a daytime procedure performed by a physician who had provided patient care after midnight and those who underwent a procedure performed by a physician who had not treated patients after midnight (22.2% and 22.4%, respectively; P=0.66; adjusted odds ratio, 0.99; 95% confidence interval, 0.95 to 1.03). We also found no significant difference in outcomes after stratification for academic versus nonacademic center, physician's age, or type of procedure. Secondary analyses revealed no significant difference between patient groups in length of stay or procedure duration.Overall, the risks of adverse outcomes of elective daytime procedures were similar whether or not the physician had provided medical services the previous night. (Funded by the University of Toronto Dean's Fund and others.).
Effects of Concomitant Immunomodulator Therapy on Efficacy and Safety of Anti–Tumor Necrosis Factor Therapy for Crohn’s Disease: A Meta-analysis of Placebo-controlled Trials
Authors: Jennifer L. Jones, Gilaad G. Kaplan, Laurent Peyrin-Biroulet, Leonard Baidoo, Shane Devlin, Gil Y. Melmed, Divine Tanyingoh, Laura Raffals, Peter Irving, Patricia Kozuch, Miles Sparrow, Fernando Velayos, Brian Bressler, Adam Cheifetz, Jean-Frederic Colombel, Corey A. Siegel
Journal: Clinical Gastroenterology and Hepatology (2015)
Factors Predictive of Severe Hypoglycemia in Type 1 Diabetes
Journal: Diabetes Care (2011)

OBJECTIVE Identify factors predictive of severe hypoglycemia (SH) and assess the clinical utility of continuous glucose monitoring (CGM) to warn of impending SH. RESEARCH DESIGN AND METHODS In a multicenter randomized clinical trial, 436 children and adults with type 1 diabetes were randomized to a treatment group that used CGM (N = 224), or a control group that used standard home blood glucose monitoring (N = 212) and completed 12 months of follow-up. After 6 months, the original control group initiated CGM while the treatment group continued use of CGM for 6 months. Baseline risk factors for SH were evaluated over 12 months of follow-up using proportional hazards regression. CGM-derived indices of hypoglycemia were used to predict episodes of SH over a 24-h time horizon. RESULTS The SH rate was 17.9 per 100 person-years, and a higher rate was associated with the occurrence of SH in the prior 6 months and female sex. SH frequency increased eightfold when 30% of CGM values were ≤70 mg/dL on the prior day (4.5 vs. 0.5%; P &amp;lt; 0.001), but the positive predictive value (PPV) was low (&amp;lt;5%). Results were similar for hypoglycemic area under the curve and the low blood glucose index calculated by CGM. CONCLUSIONS SH in the 6 months prior to the study was the strongest predictor of SH during the study. CGM-measured hypoglycemia over a 24-h span is highly associated with SH the following day (P &amp;lt; 0.001), but the PPV is low.
Media: "Butchers and gropers"
Authors: K. Abbasi
Journal: BMJ (1998)

From dangerous to salacious, the medical profession's indiscretions have been repeatedly laid bare in this Annus horribilis. Wisheart, Dhasmana, Ledward, Walmsley, and others have been named and shamed. They are probably only the tip of the iceberg. Horror stories of medical incompetence, arrogance, and libidinousness have filled newspapers; broadsheets and tabloids have been united in their condemnation of a profession unable to regulate itself except when it's too late.

Did you hear the one about the dodgy heart surgeons with the highest death rate in the country? Or the one about the gynaecologist who dressed in riding pants and told his patients that it was just bad luck that he'd bungled their operations? The fastest gynaecologist in the south east, he called himself. Then there's the dirty old GP who loved examining his female patients' naughty bits—unnecessarily. And the psychologist who mixed psychoanalysis with sex. And the physiotherapist who knew exactly where he wanted to stick his acupuncture needle. Even Caligula would have blushed, but the press have feasted daily on the medical professions' misery: sex and violence sell. Nurses are good, doctors are bad; patients are pure, doctors are evil.

It started with the Bristol inquiry in May. Cardiac surgeon James Wisheart and former chief executive Dr John Roylance were struck off by the General Medical Council after it was revealed that 29 of the 53 children operated on in Bristol between 1988 and 1995 had died—far higher than the national average. Consequently, the press were well prepared when the latest spate of medical blunders was revealed. The Sun , not known for a principled stand on matters of equality, cottoned on to the fact that the medical perpetrators were men and …
Abstract 16954: Burden of Sports-Related Sudden Cardiac Death in a US Community
Authors: Eloi Marijon, Audrey Evanado, Carmen Teodorescu, Kyndaron Reinier, Kumar Narayanan, Adriana Huertas Vazquez, Katherine Jerger, Ronald Mariani, Eric Stecker, Harpriya Chugh, Jo Navarro, Xavier Jouven, Karen Gunson, Jon Jui, Sumeet Chugh
Journal: Circulation (2013)

Introduction:  Sports-related sudden cardiac death (SCD) constitutes an important problem with devastating effects on society. Existing studies have focused principally on young competitive athletes and there is no information regarding the burden of sports-related SCD in the US general population.   Hypothesis:  Sports related SCD represents a unique subset of SCD with distinctive characteristics and outcomes.   Methods:  SCD cases aged 15-75 yrs were identified in a large, ongoing, prospective, population-based study in a Northwestern US metro region (population approx. 1 million) (2002-2012). Cases occurring during sports activity were compared to those unrelated to sports in terms of incidence, characteristics, and outcomes.   Results:  The overall incidence of SCD was 437.4 (95%CI 430.3-444.5) per million per year, more frequent among men compared to women (RR 2.14, 95% CI 1.84-2.49). Of the 1894 SCD cases, 82 (4.3%) occurred during sports, yielding an incidence of 14.7 (95% CI 7.6-21.8) per million per year. The incidence of sport-related SCD was higher among men compared to women, especially in the 35-54 year age group (RR 10.66, 95% CI 1.37-82.57). The 3 most common sport activities during the SCD event were running (27%), basketball (15%), and cycling (15%). Cases of sports-related SCD, compared to those unrelated to sports, were younger (mean age 50.6±12 vs. 55.9±14, P   Conclusions:  SCD during sports has distinct characteristics and outcome compared to overall SCD, with women appearing to have a particularly low risk. These findings could have implications for future screening and management, but should be confirmed in other US populations.
LPAAT-B is a prognostic and therapeutic target in epithelial ovarian cancer
Authors: Jakob Dupont, Gregory Springett, Amanda Hummer, Dipika Misra, Robert Soslow, Jack Singer, David Spriggs
Journal: Cancer Research (2004)

3858   LPAAT-b (Lysophosphatidic acid acyltransferase-B) has been identified as a new target for cancer therapy after recent studies have revealed its impact on the RAS/RAF/ERK and AKT/mTOR pathway. Initially only recognized for its activity in lipid biosynthesis, LPAAT catalyzes the conversion of LPA (lysophosphatidic acid) to PA (phosphatidic acid), which has been implicated in a number of signaling pathways such as tyrosine kinase signaling, vesicle trafficking, cell motility, Raf translocation to membranes, mTOR activation, and EGFR internalization. H-Ras transformed Rat-1 Fibroblast cells have shown increased LPAAT and PA activity suggestive of the association of LPAAT in the cell signaling cascade. Further studies with Xenopus Oocytes have shown ectopic overexpression of LPAAT-B activates the Ras/Raf/Erk pathway and inhibition of LPAAT-b blocks signaling in both the Ras/Raf/Erk and PI3K/Akt pathways. LPAAT has been correlated with malignancy after several neoplastic tissues demonstrated increased expression of LPAAT. Lung, bladder, prostate, brain and cervical neoplasms immunostained (IHC) with isoform specific monoclonal antibody have shown to strongly express LPAAT-b with minimal expression in normal tissue. The strong correlation between LPAAT and tumor formation led to the development of specific inhibitors of LPAAT. CT-32228 (N-(4-bromo-phenyl)-6-(5-chloro-2-methyl-phenyl)-[1,3,5]triazine-2,4-diamine), a non-competitive allosteric LPAAT-b inhibitor, has resulted in mitotic catastrophe in tumor cells while most normal cells simply arrest or become quiescent. IHC expression of LPAAT-b was assessed for 87 ovarian cancers representing all major histological subtypes and grades including carcinomas and borderline tumors. IHC was performed with an LPAAT-b specific monoclonal antibody and results were correlated with patient outcome. 38 out of 87 tumors (44%) over-expressed LPAAT-b. 32 out of 70 carcinomas (46%) and 6 of 17 borderline tumors (35%) were LPAAT-b high. LPAAT-b was over-expressed by 12 of 18 (67%) of serous, 10 of 15 (67%) of clear cell, 7 of 13 (54%) of endometroid, 2 of 7 (29%) mixed histology, and 1 of 17 (6%) of mucinous carcinomas. The median follow-up of patients was 46 months (range, 1-241 months). Kaplan Meier analysis revealed that LPAAT-b over-expression was associated with poor survival compared to patients without over-expression (p = 0.007). Ovarian tumor cell lines (SKOV-3 and the primary MHOC-59 line) were exposed to CT-32228 or to the structurally similar analog CT-32212, which lacks LPAAT-b inhibitory potential. Both ovarian cell lines were killed by nM concentrations of CT-32228 with IC50 of 60nM and 100nM for SKOV-3 and MHOC-59, respectively. The analog CT-32212 did not kill the ovarian tumor cells. LPAAT-b is an emerging prognostic and therapeutic target in epithelial ovarian cancer and the LPAAT-b inhibitor CT-32228 has excellent in vitro activity against ovarian cancer.
Abstract 12583: Sensitivity of the National Thoracic Aortic Disease Guideline Diagnostic Algorithm for Identification of Acute Aortic Dissection at Initial Presentation: Results from the International Registry of Acute Aortic Dissection (IRAD)
Authors: Adam M Rogers, Luke K Hermann, Anna M Booher, Christoph A Nienaber, David M Williams, Ella A Kazerooni, James B Froehlich, Patrick O' Gara, Daniel G Montgomery, Jeanna V Cooper, Kevin M Harris, Stuart Hutchison, Arturo Evangelista, Eric M Isselbacher, Kim A Eagle
Journal: Circulation (2010)

Background: In March 2010, the American Heart Association (AHA), American College of Cardiology (ACC), and other societies released new guidelines for the diagnosis and management of patients with ...
Induction of resistance to the Abelson inhibitor STI571 in human leukemic cells through gene amplification
Authors: Philipp le Coutre, Elena Tassi, Marileila Varella-Garcia, Rossella Barni, Luca Mologni, Gonçalo Cabrita, Edoardo Marchesi, Rosanna Supino, Carlo Gambacorti-Passerini
Journal: Blood (2000)
extracellular matrix derived human α1 type IV collagen NC1 domain inhibits endothelial and tumor cellular invasion by blocking the activation of matrix metalloproteinase 2
Authors: Sudhakar Akulapalli, Chandra Shekhar Boosani
Journal: Cancer Research (2006)

Proc Amer Assoc Cancer Res, Volume 47, 2006

4354 

Activation of proMMP-2 by MT1-MMP is considered to be a critical event in cancer cell invasion. In the activation step, TIMP-2 bound to MT1-MMP on the cell surface acts as a receptor for proMMP-2. Subsequently, adjacent TIMP-2-free MT1-MMP activates the proMMP-2 in the ternary complex. In this study, we demonstrate that the mechanism of cellular invasion, inhibition of matrix metallproteinase-2 activation by recombinant human α1(IV)NC1. α1(IV)NC1 significantly reduced endothelial as well as tumor cellular invasion into the reconstituted basement membrane in vitro . Gelatin zymographic analysis revealed that activation of proMMP-2 secreted from endothelial cells was inhibited by α1(IV)NC1, by forming complex with proMMP-2. Studies with recombinant MMPs confirmed that α1(IV)NC1 inhibited proMMP-2 activation, mediated by both membrane-type 1 MMP and 4-aminophenylmercuric acetate. Furthermore, in vitro experiments demonstrated that α1(IV)NC1 upregulated TIMP-2 expression in endothelial conditioned medium. Finally, co-immunoprecipitation and ISCO gradient fractionation experiments revealed that α1(IV)NC1 formed a tight complex with proMMP-2. These novel findings would, at least in part, explain the mechanism of the potent anti-angiogenic activities of α1(IV)NC1. Taken together, our data support a role for the α1(IV)NC1 in anti-angiogenesis and describe, for the first time, a signaling mechanism for α1(IV)NC1 in this process.
Intensive care
Authors: Emilie Perrier
Journal: BMJ (2007)

I am a 27 year old French woman and have lived in London since 2002.I came here to learn English, to meet people from other countries and to work.I had never been ill in my life, never been allergic to anything, and had no worries about my health.In February 2003, on holiday in France, I had severe diarrhoea.After a few days, I was admitted to hospital with peritonitis.A few weeks later I was diagnosed with Crohn's disease.It changed my life completely.I spent three months in hospital before returning to England, where my husband was waiting for me.As I learnt about my new life and new diet, I also started to become an old lady in my body.I developed a lot of joint pain from arthritis.At the end of October, back in France, my gastroenterologist prescribed sulfasalazine for my pain.The treatment went well for two weeks and I returned to London, but then I began to feel really sick.I had a high fever, pain everywhere in my body and I vomited everything I ate.I had shivers, could not sleep, and collapsed repeatedly.On 20 November, we called an ambulance, but they said it was probably flu and that I should see my general practitioner, who prescribed paracetamol.Within two days, I was very ill; my skin had become very red and I was collapsing more frequently.At the St Charles Hospital in London, the doctor gave me penicillin, believing I had meningitis.I was sent to St Mary's Hospital, where I saw several doctors, who thought my illness could be a bladder problem related to Crohn's disease.I had several CT scans and was told I was a "very interesting case."Nobody wondered
Abstract 5838: Successful Replacement of Aortic Valves by Decellularized Allografts in the Sheep: First Long-Term Results
Authors: Hassina Baraki, Serghei Cebotari, Igor Tudorache, Maike Braun, Klaus Hoeffler, Adelheid Goerler, Christoph Bara, Alex Calistru, Gudrun Brandes, Andres Hilfiker, Axel Haverich
Journal: Circulation (2008)

Immunogenicity of human allografts leads to gradual valve degeneration. Pulmonal cell-free valvular scaffolds obtained by methods of tissue engineering have proved to induce in-vivo guided tissue regeneration and represent a promising valve substitute especially for children. Here we describe the successful orthotopic implantation of decellularized aortic valves in the systemic circulation in sheep. Allogenic detergent decellularized (0.5% sodium deoxycholate/0.5% SDS) aortic valve (AV) conduits (n = 12) were implanted orthotopically as root replacement in lambs (35–45 kg). Fresh native AV conduits served as controls (n = 6). After three and nine months follow-up the valves were investigated for functionality by echocardiography, for morphology and histological appearance. Decellularization resulted in complete loss of cells in AV wall, cusp and myocardial cuff, no influence on scaffold microarchitecture was observed. During 9 months follow-up no signs of conduit dilatation, aortic stenosis (transvalvular gradient max. 6.1 ± 5.1mmHg) or reduction of cusp mobility were observed in the decellularized group. Regurgitation in these valves was trivial in all cases. The grafts showed no histological signs of rejection and partial repopulation of the valvular scaffolds with autologous cells. In contrast, control animals developed mild to severe AV insufficiency. Histological investigation revealed significant calcific degeneration and massive rejection of these valves. Decellularized AV conduits may represent a durable AV substitute resistant to high systemic pressure. Furthermore, cell-removal prevents the allograft valve from immunologic deterioration and early graft degeneration.
Abstract 6121: Acute Effects of Cardiac Resynchronization Therapy on Left Ventricular Twist
Authors: Matteo Bertini, Nina Ajmone Marsan, Victoria Delgado, Rutger J van Bommel, Gaetano Nucifora, C Jan Willem Borleffs, Giuseppe Boriani, Mauro Biffi, Edward R Holman, Ernst E van der Wall, Martin J Schalij, Jeroen J Bax
Journal: Circulation (2008)
A fifth of Americans contact their doctor as a result of direct to consumer drug advertising
Authors: Scott Gottlieb
Journal: BMJ (2002)

One in five Americans says that direct to consumer advertising prompted them to call or visit their doctor to discuss an advertised drug, a new consumer survey has found.

The August PharmTrends survey by the US market research firm Ipsos-NPD also shows that 50% of consumers recalled seeing advertising for prescription drugs, such as the one for epoetin alfa (Procrit) above, in the previous 12 months. This was up from 47% in the first PharmTrends survey, conducted in February 2002.

Sildenafil (Viagra) tops the list for advertisement recall among consumers: 98% of purchasers of Viagra remembered seeing an advertisement for the product. Celecoxib (Celebrex), with a recall of 78% of buyers, came at the bottom of the top 10 drugs.


PharmTrends surveyed 25182 respondents, a statistically representative sample of the US population.
Walking to school has future benefits
Authors: I. Roberts
Journal: BMJ (1996)

Nomogram for number needed to treat will be of limited use EDITOR,-Gilles Chatellier and colleagues suggest that in calculations of the "number needed to treat" a nomogram based on the formula 1 should be used in Pc x relative risk reduction preference to 1The two formulas are, PC...Pi however, equivalent and will both suffer from the same problems when Pc and Pi differ by an amount greater than Pc.The nomogram is consequently useful in only a limited number of circumstances-for example, when published study results have been adjusted for confounding effects and only relative risks or odds ratios are reported.In these cases such estimates could then be combined with an estimate of the baseline risk to yield the number needed to treat.