tbuckley/cabot-search huggingface dataset:
Abstract 261: Effect of Therapeutic Hypothermia After Out-of-Hospital Cardiac Arrest in Early Phase of Implementation: Propensity-Score Matching and Inverse Probability of Treatment-Weighted Analysis
Authors: Soo H Kim, Young M Kim, Chun S Youn, Sang H Oh, Han J Kim, Kyu N Park
Journal: Circulation (2011)

Introduction: Therapeutic hypothermia (TH) is usually applied to selective patients in the early phase of implementation due to many local barriers. Thus therapeutic effects of TH could be overestimated or underestimated during the period. The objective of this study was to determine whether TH is associated with increased survival to discharge and favorable neurological outcome for adult out-of-hospital cardiac arrest (OHCA) patients during the first five years of implementation in a tertiary teaching hospital. Hypothesis: We hypothesized that TH would be associated with increased survival and favorable neurological outcome at hospital discharge in adult comatose survivors of OHCA during the early phase of implementation. Methods: Adult comatose survivors of OHCA from January 2006 to September 2010 were enrolled in the study. Favorable neurologic outcome was defined as cerebral performance category 1 or 2 at the time of hospital discharge. To reduce the effect of treatment-selection bias and potential confounding in the study, we performed rigorous adjustment for significant differences in the baseline characteristics of patients with the use of propensity-score (PS) matching and inverse probability of treatment weighted (IPTW) analysis. The adjusted odds ratio (OR) and its 95% confidence interval (95% CI) for the outcomes between TH and standard care group were calculated. Results: During the implementation period, 163 OHCA patients (41%) regained spontaneous circulation. Of those patients, 49 (30%) were treated with mild (32-34°C) TH for 24 hours. Using PS matching, 32 patients were equally assigned to each group. The adjusted OR for the survival and favorable neurological outcome at hospital discharge was 9.13 (95% CI 2.92-28.50) and 4.39 (95% CI 1.08-17.89), respectively in the PS-matched patients. Using the IPTW analysis, the adjusted OR for the survival and favorable neurological outcome at hospital discharge was 6.82 (95% CI 3.05-15.24) and 3.27 (95% CI 1.18-9.08), respectively. Conclusions: TH was associated with significant improvements in survival and neurologic outcomes at hospital discharge in adult comatose survivors of OHCA even in the early phase of implementation.
Abstract 14794: Arrhythmic Risk Stratification In Non-ischemic Dilated Cardiomyopathies: Additional Value Of Left Ventricular Myocardial Scar Visualized By Contrast-enhanced Cardiac Magnetic Resonance
Authors: Martina Perazzolo Marra, Manuel De Lazzari, Francesco Corbetti, Francesco Tona, Federico Migliore, Alessandro Zorzi, Gaetano Thiene, Cristina Basso, Domenico Corrado, Sabino Iliceto
Journal: Circulation (2011)

Purpose: the role of myocardial fibrosis for risk stratification of adverse arrhythmic events in non-ischemic dilated cardiomyopathy (DCM) is still unclear. The aim of the present study was to asse...
Hematologic and Immunologic Function and Patient Well-Being for the Phase III RESONATETM Study of Ibrutinib Vs Ofatumumab in Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma
Authors: Jacqueline C. Barrientos, Susan O'Brien, Jennifer R. Brown, Neil E. Kay, Nishitha M. Reddy, Steven Coutre, Constantine Tam, Stephen Mulligan, Ulrich Jaeger, Steve Devereux, Christopher Pocock, Tadeusz Robak, Stephen J. Schuster, Anna Schuh, Devinder Gill, Adrian Bloor, Claire Dearden, Carol Moreno, Gavin Cull, Michael Hamblin, Jeffrey A. Jones, Tanja Kierschniak, Karl Eckert, Samuel Suzuki, Emily Hsu, Danelle F. James, John C. Byrd, Peter Hillmen
Journal: Blood (2014)
Abstract 3201: Pseudo-Pheochromocytoma: A New Autoimmune Hypertensive Syndrome
Authors: David C Kem, Xichun Yu, Janet Heuser, Adda Blanco, Eugene Patterson, Bela Szabo, Leann Olansky, Shijun Huang, Madeleine Cunningham
Journal: Circulation (2006)

A 56 yr old female with poorly controlled type 1 diabetes mellitus was seen in 2000. Her blood pressure was 147/92 and higher. Moderate cardiomegaly was present and a diagnosis of diabetic cardiomy...
PPARアルファが強化する、IL‐1ベータおよびIL‐6で誘導した肝細胞内トランスフェリン受容体2(TRF2)の発現
Authors: Mitsuyoshi H, Yasui K, Endoh M, Tsuji K, Itch Y, Yoshikawa T
Journal: Hepatology (2008)
Patients' priorities
Authors: T. Richards
Journal: BMJ (1999)

Education and debate p 318 

A revolution is under way in health care. After decades of patriarchal provision of services governments are now accepting that patients should have a say in what is provided. Debates on priority setting have brought the case for public participation in difficult healthcare choices sharply into focus.1 Each new high profile drug launch or controversial therapy spurs further public discussion about what a national health service should provide and who should decide (p 273).2 At the level of individual patients there is a growth in demand for information,3 and a review published this week draws attention to the need to improve its quality (p 318).4 The launch of a new journal to promote debate about public participation in health care5 and the Council of Europe's recommendation that patients must be involved in defining quality of care underline that the movement is gaining momentum.

If services are to be shaped by patients' views, methodologically sound ways of …
Method of detection of DCIS to predict HER2 overexpression.
Authors: S. Schrading, E. Wardelmann, W. Kuhn, H. H. Schild, C. K. Kuhl
Journal: Journal of Clinical Oncology (2010)

1557 Background: Overdiagnosis of DCIS has become a major concern. Overexpression of the human epidermal growth factor receptor-2 (HER2) has been introduced as a prognostic marker that correlates with a higher biologic aggressiveness of breast cancer. We investigated the rate of HER2 overexpression of DCIS diagnosed by breast MRI compared to the DCIS diagnosed by mammography. Aim was to find out whether the additional DCIS diagnosed by MRI represents prognostically relevant disease or whether it will lead to additional overdiagnosis. Methods: During a 5-year period 7,319 women underwent breast MRI in addition to mammography for screening or for diagnostic assessment. A total of 167 women received the final surgical pathology diagnosis of pure DCIS. HER2 receptor status was established by standardized methods and dichotomized as positive (DAKO score 3+ or c-erbB2-amplifikation at FISH) or negative (DAKO score < 3+ or FISH negative). It was available in 127/137 women. We investigated the detection rate of breast MRI and of mammography for DCIS. We compared the HER2 receptor status of all MRI-detected versus all mammography-detected DCIS. Furthermore we compared the HER2 receptor status off only mammography-detected versus only MRI-detected DCIS. Results: Of the 127 DCIS, 95 (75%) were categorized as HER2 negative, and 32 (25%) as HER2 positive. Of the 32 HER2 positive DCIS, 13 (41%) were diagnosed through mammography, and 31 (97%) through MRI. Of the 10 DCIS which were only mammography-detected, one (10%) was HER2 positive. Of the 52 DCIS which were only MRI detected, 21 (40%) were HER2 positive. In the entire cohort, two-thirds of HER2-positive DCIS (66%, 21/32) were only detected by MRI (p < 0.005). Conclusions: DCIS not visible at MRI is virtually always HER2 negative. Two-thirds of HER2 positive DCIS are not visible on mammography, but only diagnosed by MRI. The method of detection of a DCIS correlates with its biologic aggressiveness: Detectability by mammography is correlated with a lower aggressiveness compared with detectability by MRI. MRI-detected additional DCIS are associated with a higher biologic aggressiveness. We conclude that MRI-detected DCIS do not add to mammography-induced overdiagnosis, but represent prognostically relevant disease. No significant financial relationships to disclose.
Abstract 688: Risk of Radiation Induced Cancer from Cardiac CT in a Real-Life Clinical Patient Population
Authors: Walter Huda, U. Joseph Schoepf, Joseph Abro, James G Ravenel, Philip Costello, Donald Frey
Journal: Circulation (2008)

Previous studies on lifetime cancer risks from radiation at cardiac CT are based on extrapolation of data unrelated to medical imaging and on presumptive scan protocols but not on actual patient cohorts. We aimed to determine the realistic risk of radiation induced cancer based on a real-life clinical patient population undergoing cardiac CT. We studied 104 consecutive patients undergoing 64-slice cardiac CT (Siemens). Data were obtained on patient demographics (sex, age, weight) as well as CT technique (kV, mAs, scan length, DLP) which were used to determine median values and the 10th and 90th percentiles. Organ dose estimates were obtained using the ImPACT dosimetry spreadsheet. Organ doses were converted into patient lifetime risk of developing radiation induced fatal and non-fatal cancer using the BEIR VII approach. Patient cancer risks were adjusted taking into account patient sex, age and weight, the latter being an often neglected factor influencing radiation risk. The majority of patients (62%) were males, with a median patient age of 59 years (41–72) and a median weight of 92 kg (69–116). All scans were performed at 120 kV, and the median DLP was 1124 mGy-cm (940–1500). In normal sized patients, the organs receiving the highest radiation doses were the lung (76 mGy) and the female breasts (92 mGy). The average patient lifetime risk for developing a radiation induced cancer was 0.12%, of which 90% would be fatal. Approximately 85% of the radiation risk arises from the irradiation of the lung. Patients with an age and weight at the 10th percentile, who receive a DLP at the 90th percentile would have a cancer risk double the average value. In a typical clinical population undergoing cardiac CT patients are predominantly male, heavier set, and in their 5th–7th decade of life. In such a patient population the realistic risk of radiation induced cancer from cardiac CT is 0.12%, with the risk to the most sensitive patients being about twice this value. Thus, in a real-life clinical patient cohort the realistic risk of radiation induced cancer from cardiac CT is substantially lower than previously reported for general populations. Appropriate patient selection and indication remain the most important means for radiation protection.
Childhood sexual and physical abuse as factors in adult psychiatric illness
Authors: J B Bryer, B A Nelson, J B Miller, P A Krol
Journal: American Journal of Psychiatry (1987)

Using objective measures, the authors found a high rate of childhood sexual and physical abuse in a sample of 66 female psychiatric inpatients. Childhood abuse experiences were correlated with severity of adult psychiatric symptoms. The authors explore the usefulness of adult psychological symptoms, diagnoses, and prescribed medications as factors in the identification of patients who have histories of early sexual and physical abuse.
Abstract 8506: Adaptive Servo Ventilation Improves Cardiac Function and Prognosis in Chronic Heart Failure Patients with Cheyne-stokes Respiration After Cardiac Resynchronization Therapy
Authors: Makiko Miyata, Akiomi Yoshihisa, Satoshi Suzuki, Shinya Yamada, Masashi Kamioka, Yoshiyuki Kamiyama, Takayoshi Yamaki, Koichi Sugimoto, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-ichi Saitoh, Yasuchika Takeishi
Journal: Circulation (2011)

Backgrounds: Cheyne-Stokes respiration (CSR) is frequently observed in chronic heart failure (CHF) patients and is associated with adverse prognosis. Although it has been reported that cardiac resynchronization therapy (CRT) partly improves CSR, CSR often persists after CRT implantation. Therefore, we examined whether adaptive servo ventilation (ASV) improves cardiac function and prognosis of CHF patients with CSR after CRT. Methods: Polysomnography was performed at 12 months after CRT defibrillator (CRTD) implantation. Twenty two patients with CSR post CRTD implantation (mean age 62.0 years, AHI 36.3±19.2 /h) were enrolled in this study and randomly assigned into 2 groups: 11 patients treated with ASV (ASV group) and 11 patients without ASV (Non-ASV group). Plasma B-type natriuretic peptide (BNP) levels, estimated right ventricular systolic pressure (RVPs), and the ratio of early transmitral flow velocity to mitral annular velocity (E/E') were determined before and 6 months later in each group. Patients were followed up to register cardiac events (cardiac deaths and rehospitalization due to worsening heart failure). Results: In ASV group, indices for apnea-hypopnea, central apnea, and oxyhemoglobin saturation were improved on ASV. Levels of plasma BNP (Figure A), RVPs (38.1±16.8 vs. 27.4±18.4 mmHg, P&lt;0.05) and E/E' (16.5±6.5 vs. 9.2±4.1, P&lt;0.01) were improved with ASV treatment for 6 months, but not in Non-ASV group. Importantly, event free rate was significantly higher in ASV group than in Non-ASV group (91% vs. 45%, P&lt;0.05) as shown in Figure B. Conclusions: ASV improved CSR, cardiac overload, diastolic function, and prognoisis of CHF patients with CRTD. CHF patients with CSR and post CRTD implantation would get benefits by treatment with ASV.
Abstract P388: Association of Clinical Characteristics and Cardiopulmonary Risk Factors with Aortic and Pulmonary Arterial Enlargement by Magnetic Resonance
Authors: Michael L Chuang, Philimon Gona, Carol J Salton, Connie W Tsao, Susan B Yeon, Christopher J O’Donnell, Warren J Manning
Journal: Circulation (2013)

Purpose: To determine the association of clinical characteristics and cardiopulmonary risk factors with aortic and main pulmonary artery (MPA) enlargement by cardiovascular magnetic resonance (CMR). Methods: 1794 Framingham Offspring cohort members (65±9 y, 844 M) underwent axial 2D black-blood T2-weighted thoracoabdominal CMR. MPA and ascending (ASC) and descending (DSC) thoracic aortic diameters were measured at MPA-bifurcation level, abdominal (ABD) aortic diameter at 5 mm above renal artery origins. We assessed relationship of arterial diameters to height (HT) and body surface area (BSA) using Pearson correlation and determined sex-specific 90th percentile cutpoints (p90) for ASC, DSC, ABD, and MPA in a referent group free of obesity (BMI≥30), emphysema, myocardial infarction, heart failure, and any history of hypertension (HTN) or smoking. For the overall study sample, multivariable logistic regression was used to determine the association of high (≥p90) vessel diameters with the above risk factors and age, sex and pack-years smoked. Results: 370 Offspring (157 M) met referent-group criteria. In men neither HT nor BSA correlated with aortic diameter. In women DSC, ABD and MPA correlated with HT and BSA (r=0.14 - 0.25, all p≤0.045), but BSA-indexation gave inverse correlations with HT and BSA (all p&lt;0.0001); HT-indexation gave inverse correlations with HT (all p≤0.045). Thus we used unindexed p90 cutpoints of (M,W): ASC=34.9, 31.8mm; DTA=25.3, 22.7mm; ABD=20.0, 17.3mm; MPA=26.6, 24.2mm. Prevalence of and MV-adjusted odds ratios for high diameter are in the Table (N=1794). Obesity was globally and most strongly associated with overall vessel enlargement. ABD enlargement was associated with total pack-years, but not with positive smoking history. Conclusions: ABD enlargement was slightly more prevalent in women. In both sexes MPA and general aortic enlargement are associated with greater age and obesity, but smoking (as pack years) was associated with ABD enlargement only and HTN with the thoracic aorta only.
Abstract 5086: Low Cardiorespiratory Fitness Fails to Predict Mortality in Severe (Class II or Greater) Obesity
Authors: Bilal Aijaz, Zehra Haider, Stephen L Kopecky, Ray W Squires, Randal J Thomas, Thomas G Allison
Journal: Circulation (2008)

Obesity is associated with reduced functional aerobic capacity (FAC). Even though low FAC strongly predicts mortality in normal weight persons; the relationship between FAC and mortality in obese p...
The influence of the 21-gene recurrence score assay on decision making about adjuvant chemotherapy in stage I-II estrogen receptor-positive breast cancer: Experience at a single center with a uniform treatment policy.
Authors: D. B. Geffen, S. Abu-Ghanem, N. Sion-Vardy, R. Braunstein, M. Tokar, S. Ariad, B. Delgado, M. Bayme, M. Koretz
Journal: Journal of Clinical Oncology (2010)

660 Background: The 21-gene assay (OncotypeDx) recurrence score (RS) has been validated in retrospective studies as prognostic of distant disease recurrence and predictive of benefit of chemotherapy in estrogen receptor (ER)-positive breast cancer. Published data on the impact of the assay on clinical practice is limited. We analyze the influence of the RS on decision making in 135 patients seen in a single practice with a unified treatment policy. Methods: Patients with stage I and II breast cancer, ER-positive, Her2-negative who had no contraindications to chemotherapy were eligible. Clinical and pathologic data were recorded, as was the recommendation on adjuvant chemotherapy both before and after obtaining the RS. The test was performed by Genomic Health (Redwood City, CA, USA) on paraffin imbedded tissue from surgical specimens or biopsies. Our treatment policy was to give adjuvant chemotherapy for high risk RS (> 30), endocrine therapy alone for low risk RS (< 18), and for intermediate risk RS (18-30) to decide based on classical clinicopathologic features. Results: From 2/2006 to 6/2009 RS was obtained on 135 patients, including 3 males. Median age 58 (range 33-75). Histologic grade: low 36 (26.7%), intermediate 82 (60.7%), high 7 (5.2%), undetermined 10 (7.4%). Node-negative: 115 (85.2%). RS results: median 19 (range 1-57). RS risk: low 70 (51.9%), intermediate 50 (37%), high 15 (11.1%). Prior to RS result, 64 (47.4%) were recommended for chemotherapy, while after RS result 50 (37.0%) were recommended for chemotherapy. Of the 34 (25.2% [95%CI 17.9-32.5]) patients for whom recommendation was changed, 10 (7.4%) were changed to chemotherapy, and 24 (17.8%) were changed to endocrine therapy. Recommendation was unchanged in 101 (74.8% [95%CI 67.4-82.1%]). RS was independent of T stage, Ki67, and ethnic group. There were insufficient cases of high grade to evaluate correlation with grade. Conclusions: The 21-gene RS, when applied in a consistent manner in early stage breast cancer, changes the treatment plans in one quarter of patients tested. No significant financial relationships to disclose.
Principles for the Selection of Doses in Chronic Rodent Bioassays
Authors: Jeffery A. Foran
Journal: Environmental Health Perspectives (1997)

consensus set of principles for dose selection, including selection of the highest dose for chronic rodent bioassays. The principles encourage a move away from sole reliance on a maximum tolerated dose (MTD), as it has been traditionally defined (primarily by body weight and histopathology), and toward the use of sound scientific and toxicologic principles for the selection of all doses in the chronic bioassay. Specifically, the principles recommend that dose selection for chronic studies must be based on sound toxicologic principles; dose selection should consider human exposure; dose selection should be based on a variety of endpoints and effects derived from prechronic studies; and dose selection should consider physicochemical and other factors. Implementation of the principles internationally will have two important benefits: improvement in the quality and consistency of the rodent bioassay and international harmonization of dose selection procedures.
Aortic Valve Papillary Fibroelastoma Associated With Severe Aortic Regurgitation
Authors: Saranya Buppajarntham, Sudarat Satitthummanid, Poonchavist Chantranuwatana, Kittichai Luengtaviboon, Pairoj Chattranukulchai, Smonporn Boonyaratavej, Sarinya Puwanant
Journal: Journal of the American College of Cardiology (2012)
Abstract 4886: Hydrogen Peroxide Prevents Impaired Endothelium-dependent Dilation Following Acute Exertion in Chronic Exercising but Not in Sedentary Subjects
Authors: Shane A Phillips, Jing-Tan Bian, Emily C Church, Emon K Das, Mladen Vidovich, David D Gutterman
Journal: Circulation (2009)

Introduction: Exercise-induced hypertension increases reactive oxygen species (ROS) generation and threatens vascular endothelial health. Recent studies indicate conditioned subjects (EX) are protected from endothelial dysfunction observed in sedentary (SED) subjects after acute hypertension induced by weight lifting (WL). Hypothesis: We hypothesized that: chronic exercise protects against endothelial dysfunction induced by acute exertion and the mechanism of maintained dilation after acute hypertension involves hydrogen peroxide (H 2 O 2 ) in microvessels from exercise trained subjects. Methods: Healthy, lean SED and EX subjects (runners &gt; 15 miles/week or WL &gt; 3x/week), underwent a single progressive 15 minute leg press WL session. Brachial artery flow- mediated dilation (FMD) and nitroglycerin (NTG; 0.4 mg) dilations were measured with ultrasound. Isolated arterioles (gluteal fad pad biopsies) from the same subjects were cannulated to assess dilation to acetylcholine (ACh; 10 −9 –10 −4 M) pre and post WL. Separately, H 2 O 2 production was assessed with DCF fluorescence. Results: All subjects were free of hypertension with similar blood pressure responses to WL (max SBP: 183.7±5 mmHg). Brachial artery FMD was maintained after WL in EX (+2.0±0.3%; p&lt;0.001 vs. SED; n=48) but not SED (−3.0±0.2%; n = 28). Dilation to ACh was maintained in EX [Max dilation (MD): 87±3 %; n = 10] but not SED (50±5%; n = 10) post WL. Inhibition of NOS with LNAME eliminated baseline ACh dilation in EX but not post WL (73±6%). Indomethacin and 17-ODYA had no effect on post WL ACh responses. In EX subjects, WL increased hydrogen peroxide (DCF fluorescence ratio: 3.4±0.4; p = 0.001 vs. baseline; n = 9). The H 2 O 2 scavenger PEG-catalase (500 U/ml) reduced DCF fluorescence and ACh dilation post WL (29±7%; p&lt;0.001 vs. pre WL) but had no effect before WL. Endothelium-independent responses to papaverine were similar pre and post WL. In conclusion, these data indicate chronic exercise protects against microvascular endothelial dysfunction after exertion and although NOS is responsible for ACh dilation before acute weight lifting in EX, H 2 O 2 maintains endothelium-dependent dilation in microvessels after exposure to exercise-induced hypertension.
Abstract 2447: Impact of Optimal Medical Therapy With or Without PCI on Long-term Cardiovascular Endpoints in Patients with Stable Coronary Artery Disease: Tertiary Outcomes from the COURAGE Trial
Authors: William E Boden, Koon K Teo, Pamela M Hartigan, William S Weintraub, David J Maron, William J Kostuk, Bernard R Chaitman, John Mancini, John A Spertus, Marcin R Dada, David C Booth, Robert A O'Rourke
Journal: Circulation (2007)

Background: The main results of the COURAGE Trial showed no significant differences in all-cause mortality or non-fatal MI (primary endpoint), the composite of death, MI or stroke, or hospitalizati...