tbuckley/cabot-search huggingface dataset:
Abstract 3574: Comparative Study Between De novo and Upgrade Cardiac Resynchronization Therapy patients on Echocardiographic and Clinical Outcomes
Authors: Kenji Ando, Takashi Yamada, Masahiko Goya, Yoshimitsu Soga, Shinichi Shirai, Masashi Iwabuchi, Hiroyoshi Yokoi, Hitoshi Yasumoto, Hideyuki Nosaka, Masakiyo Nobuyoshi
Journal: Circulation (2006)

Background: Cardiac resynchronization therapy (CRT) has been shown to significantly benefit patients (pts) with moderate to severe heart failure and electro-mechanical dyssynchrony. However, clinic...
Abstract 16378: Growth Differentiation Factor-15 Independently Predicts 2 Year Mortality in Patients With Acute Coronary Syndrome: Observations From the A to Z Trial
Authors: Ethan C Kosova, James A de Lemos, Petr Jarolim, Jianping Guo, Eugene Braunwald, Marc S Sabatine, David A Morrow
Journal: Circulation (2014)

BACKGROUND: Growth Differentiation Factor-15 (GDF-15) is an inflammatory biomarker upregulated in the setting of myocardial stress that we and others have shown to have potential prognostic value in cardiovascular (CV) disease. However, any role for GDF-15 along with traditional CV risk factors and biomarkers in predicting long term mortality after ACS remains investigational. METHODS: We measured the plasma concentration of GDF-15 after stabilization of ACS in 4,179 patients (pts) presenting with UA/NSTEMI or STEMI enrolled in the A to Z Trial. Established, pre-specified cutoffs of GDF-15 (&lt;1200, 1200-1800, and &gt;1800 ng/L) were used for analysis. Outcomes were followed through the end of the study (median 2 years). RESULTS: Pts with GDF-15 &gt;1800 ng/L had significantly higher 2 year mortality rates than those with levels of 1200-1800 or &lt;1200 ng/L (14.8%, 9.7%, and 3.2%, respectively; P&lt;0.001, Fig-1A). After adjusting for age, sex, hypertension, diabetes, renal function, STEMI vs NSTEACS, heart failure, B-type natriuretic peptide (BNP) and C-reactive protein (CRP), pts with GDF-15 &gt;1800 ng/L were at a significantly higher risk of death at 2yr (HR 1.88; 95% CI, 1.25-2.83) compared to those with GDF-15 levels &lt;1200 ng/L. Even in pts with low baseline BNP levels (&lt;80 pg/mL), a GDF-15 level &gt;1800 ng/L was associated with higher mortality risk compared with pts with levels of 1200-1800 or &lt;1200 ng/L (11.8%, 7.9%, and 3.0% respectively; P&lt;0.001, Fig-1B). Addition of GDF-15 to a model including traditional cardiovascular risk factors, BNP, and CRP resulted in significant net reclassification improvement (P&lt;0.001). CONCLUSIONS: GDF-15 obtained in patients with established CAD stabilized after ACS is independently associated with increased mortality at 2 yrs. GDF-15 identifies additional mortality risk not currently captured by cardiovascular risk factors, BNP, or CRP. This finding supports GDF-15 as a potential aid for prognostic assessment in patients with ACS.
Radionuclide Therapy of Bone Metastases
Authors: H. Palmedo
Journal: Clinical Nuclear Medicine (2008)

Radionuclide therapy of bone metastases represents a systemic therapy with intravenous administration of open radioactive agents. It is the aim of each radiation therapy to apply a maximal dose to the target — in this case bone metastases — and a minimal dose to the rest of the body. The dose to the rest of the body determines the frequency and intensity of side effects and limits treatment efficacy.
Abstract 637: A Pharmacogenetic Screen for Modifiers of Drug Induced QT Prolongation Reveals 15 Novel Genes.
Authors: David J Milan, Ian L Jones, Adam H Amsterdam, David S Rosenbaum, Dan Roden, Calum A MacRae
Journal: Circulation (2007)

Introduction: Variability in response to therapeutic drugs is a vexing problem that has recently begun to yield to intense investigatory efforts. Rigorous pharmacogenetic studies will require model systems that recapitulate the complexity of individual drug responses. Methods: We have employed the voltage sensitive fluorescent dye di 4-ANEPPS and high speed CCD camera acquisition to study cardiac repolarization in embryonic zebrafish. We used a known zebrafish KCNH2 mutant, anemone toxin II (ATXII) and dofetilide to perturb cardiac repolarization. We also undertook a screen of a known panel of 294 mutant zebrafish lines to identify genes that modify the response to IKr block. Results: Using optical mapping, we demonstrate action potential prolongation (Figure 1a,b ), reduced repolarization reserve (Figure 1d ), and spontaneous early afterdepolarizations in zebrafish harboring a mutation in KCNH2. We also show that augmentation of late sodium current using anemone toxin II prolongs action potential duration (Figure 1c ). Using this model we have conducted a pharmacogenetic screen for modifiers of drug-induced QT prolongation, and have identified 15 genes that modulate the response to IKr block, including three members of the heg-san-vtn pathway. Conclusion: Together these data implicate a complex network of non-ion channel proteins functioning in membrane microdomains to regulate channel function, and validate high-throughput screening in zebrafish to dissect complex biologic systems.
Antithrombotic prophylaxis had little effect on overall mortality
Authors: K C Kong
Journal: BMJ (1995)

used in the multivariate analysis.For instance, could social class factors (smoking history, body mass index) or other factors (drug treatment) have varied among the hospital populations and affected the results?Similarly, could the large observed differences between the sexes indicate particular comorbidities that were not measured?The proportion of the total variability in 90 day mortality that was due to the casemix factors used in the model is not stated.If this proportion was small there may have been other casemix factors that were not taken into consideration; the modelling process used by the authors could be better judged if all the factors considered were stated and the extent of the total variability in 90 day mortality explained by the model was recorded.It seems implausible that treatment in hospital 6 should have exerted such a pronounced protective effect.Appreciable variations in survival due to differences in the processes of care among hospitals are difficult to identify after adjustment for casemix.2Adequate adjustment for casemix is difficult, and many studies tend to collect few data with which to attempt such adjustments.This study may have considered too few casemix factors for any reliable comment to be made about the effect of the processes of care in the different hospitals.
Back to Basics
Authors: Ilan Gabriely, James P. Leu, Uriel S. Barzel
Journal: New England Journal of Medicine (2008)

A 41-year-old woman was brought by her husband to the emergency department with a history of 72 hours of epigastric pain, nausea, repeated vomiting, and altered mental status. Her blood calcium was found to be 18.9 mg per deciliter (4.7 mmol per liter).
乏力-软瘫-低血钾
Authors: 张莉, 余妹, 于园, 刘蕾, 段宇, 刘超
Journal: BMJ (2009)

患者男,21岁,江苏省盐城人.因反复双下肢乏力3年余,加重半年入院.患者于2005年3月起无明显诱因下反复出现双下肢乏力,并出现发作性软瘫两次、晕厥一次.其后多次检查血钾在1.64～2.87 mmoL/L之间,给予补钾治疗后症状缓解.2008年3月起双下肢无力症状明显,频繁发作软瘫,于2008年8月22日入我院.病程中患者否认利尿剂、缓泻剂等药物使用史。
What about the WHO guidelines?
Authors: T. Harding
Journal: BMJ (1995)

of the genital tract significantly increases the rate of transmission of HIV.4 Genitourinary medicine services have a pivotal role in preventing HIV infection by education, counselling, and the management of other sexually transmissible infections.It is thus of particular concern that many prisons in Scotland have no specific genitourinary medicine services, and the few existing services may be under threat.Policies to reduce harm need to address all aspects of potential transmission of HIV and not to concentrate on injecting drug use to the exclusion of others.Furthermore, the provision of entirely confidential, high quality open access genitourinary medicine services to this group of people should be an important component of such policies.
Abstract 6014: Impact of Metabolic Risk-factors Clustering on Post-Procedural Myocardial Injury and Clinical Outcomes in Patients Underwent Elective Coronary Intervention with Drug-Eluting Stents
Authors: Tadayuki Uetani, Tetsuya Amano, Ayako Kunimura, Soichiro Kumagai, Hirohiko Ando, Kiminobu Yokoi, Tomohiro Yoshida, Bunichi Kato, Masataka Kato, Nobuyuki Marui, Michio Nanki, Tatsuaki Matsubara, Hideki Ishii, Hideo Izawa, Toyoaki Murohara
Journal: Circulation (2008)

The metabolic syndrome (MS) is associated with higher incidence of cardiovascular events. However association between clustering of MS components and clinical outcomes after elective PCI was unclear. We prospectively evaluated 438 consecutive patients who underwent elective PCI with drug-eluting stents. The metabolic factors were defined according to NCEP-ATPIII definition except for west circumference (≥90cm for men and ≥80cm for women; ethnic specific value of Japanese). Patients were divided into three stratified groups according to MS factors (0 –1, 2–3 and 4 –5). Post-procedural myocardial injury was evaluated by analysis of troponin-T (TnT) 18 hours after PCI. Cardiac event was defined as the composite end-point of death of any cause, MI and revascularization. Number of MS factors significantly correlated with post-procedural TnT after adjusting for age, gender and coronary risk factors in multivariate regression analysis (beta-coefficient 0.122, t-value 2.224, p=0.03). Increased accumulation of MS factors is associated with higher post-procedural TnT and worse clinical outcomes after PCI (Figure ). In Cox proportional hazard models, the number of MS factors was a significant predictor of cardiac events after adjusting for age, gender and coronary risk factors (OR 1.397, 95%CI 1.174 –1.663, p&lt;0.01) Accumulation of MS factors associated with worse clinical outcome even in patients treated with drug-eluting stents.
Abstract 751: Retrograde Acute Type A Aortic Dissection: Are Outcomes Worse Than Classic Acute Aortic Dissection?
Authors: Anthony L Estrera, Charles C Miller, Ali Azizzadeh, Taek-Yeon Lee, Saad Abdullah, Jon-Cecil Walkes, Hazim J Safi
Journal: Circulation (2008)

Introduction: Recent reports of retrograde acute type A aortic dissection (RTAAD) following thoracic aortic endovascular repair have been associated with poor outcomes. This raises concerns about outcomes with RTAAD in general. We report and compare outcomes of retrograde acute Type A aortic dissection repair with classic acute aortic dissection (CAAD). Methods: Between 8/1991 and 5/2008, we repaired 322 patients with acute type A dissection. This cohort was divided into two groups: RTAAD Group (52 cases), and CAAD Group (270 cases). RTAAD was defined as the presence of a dissection tear originating distal to the arch as identified intra-operatively. Tears in the ascending aorta denoted dissection as classic. Repairs using circulatory arrest were similar between groups, p&gt;0.33. Preoperative, operative, and post-operative variables were analyzed retrospectively. Results: Retrograde type A aortic dissection occurred in 16.1% (52/322) of patients. RTAAD differed from CAAD in the median time from initial symptoms to operation (75+−87 hours vs. 47+−61 hours) and specific presenting conditions. (See Table 1 ) Outcomes (stroke: RTAAD, 2.1% vs. CAAD, 3.6%, bleeding: 4% vs. 9%, myocardial infarction: 6% vs. 6%, and mortality: 11% vs. 18%) did not differ significantly between the groups, p&gt;0.05. Conclusions: RTAAD presented later for repair and less frequently with redo-sternotomy and aortic valvular insufficiency. Despite these differences, outcomes from surgical repair did not differ significantly. Acceptable outcomes may be achieved with timely intervention. Table 1: Preoperative Variables
Abstract 228: High Incidence of Hyperventilation Associated with Defibrillation Shock Delivery During Out-of-Hospital Cardiac Arrest Patient Resuscitation
Authors: Mohamud Daya, Reza Firoozabadi, Eric Helfenbein, Dana Edelson, Ahamed Idris, Saeed Babaeizadeh, Sophia Zhou
Journal: Circulation (2011)

Background Previous studies have highlighted the importance of avoiding hyperventilation during resuscitation of patients with out-of-hospital cardiac arrest (OHCA). Despite this, hyperventilation is often detectable on recorded capnograms, and the causative factors remain undefined. We studied the relationship between hyperventilation and defibrillation shocks. We hypothesized that immediately before and after shock delivery, a link to hyperventilation may exist due to the extreme high stress levels of the rescuers. Objective To evaluate quantitatively the time difference between hyperventilation events and shock delivery. Methods CO2 and shock data were collected from 270 OHCA patients from two EMS agencies based in Oregon and Texas between 2008 and 2010. We applied an automated hyperventilation detection algorithm with thresholds of respiratory rate &gt; 12 bpm and EtCO2 &lt; 20 mmHg, and manually reviewed results to obtain a total of 209 hyperventilation events from 83 patients who also had a shock (n=476) delivered within 20 minutes. Each hyperventilation event time was subtracted from the nearest shock time to generate the distribution of this difference. To investigate that this distribution actually shows a relation between hyperventilation and shock time that is not random, we generated a similar distribution of the difference between equally spaced points at 10 second intervals to shock times. The variances of the distributions were compared using a two-sample F-test. Results The figure shows the distribution of hyperventilation events in relationship to the closest defibrillation shock, and the distribution of all 10 second intervals to shock times. The variances of the distributions were significantly different (p &lt; 0.0001). A total of 48 (23%) hyperventilation events occurred within 1 minute of a defibrillation shock. Conclusion Hyperventilation is particularly common immediately before and after shock delivery during OHCA resuscitation.
Abstract 13455: Consecutive and Systematic Transcatheter Closure of Secundum Atrial Septal Defects with the Amplatzer Septal Occluder: a Single Center Study on Pediatric Patients
Authors: Daniel Velasco Sanchez, Sylvia Abadir, Nagib Dahdah, Christine Boutin, Marie-Josee Raboisson, Jean-Luc Bigras, Myriam Brassard, Nicolaas Van Doesburg, Joquim Miro
Journal: Circulation (2011)

Introduction: Transcatheter closure of ostium secundum atrial septal defect (OSASD) has gradually replaced surgical closure. Most centers are selective for surgical versus percutaneous approach. In...
Abstract 9426: Is Aspirin Beneficial for Primary Prevention of Cardiovascular Events in High-Risk Diabetic Patients? -Insights from the JPAD Trial
Authors: Sadanori Okada, Takeshi Morimoto, Hisao Ogawa, Mio Sakuma, Hirofumi Soejima, Masafumi Nakayama, Naofumi Doi, Atsushi Kubo, Yasuhiro Akai, Takahiro Kawano, Hideaki Jinnouchi, Masako Waki, Seigo Sugiyama, Shiro Uemura, Yoshihiko Saito
Journal: Circulation (2011)

Benefit of low-dose aspirin for primary prevention of cardiovascular events remains controversial in diabetic patients. Recently, the ADA, AHA and ACCF jointly recommended that low-dose aspirin use is reasonable for high-risk diabetic patients: older patients with additional cardiovascular risk factors. Thus, we evaluated aspirin's benefit in diabetic patients stratified by cardiovascular risk factors in the JPAD trial. This study is a subanalysis of the JPAD trial: a randomized, controlled trial to assess whether low-dose aspirin reduced cardiovascular events in patients with type 2 diabetes and no history of cardiovascular disease. We randomly assigned 2,539 patients to the aspirin group (81 or 100 mg daily) or the no aspirin group, and followed for 4.4 years. We classified all participants into four subgroups according to the following risk stratification: age (men, &gt;50 or ≤50 years; women, &gt;60 or ≤60 years) and one or more additional risk factors (smoking, hypertension, dyslipidemia, family history of coronary artery disease, and proteinuria). Most of the participants were older patients with risk factors (group A: n = 1,804); however, aspirin did not reduce cardiovascular events in the group A (hazard ratio [HR]: 0.83, 95% confidence interval [CI]: 0.58 to 1.17). On the other hand, in older patients without risk factors (group B: n = 268), aspirin significantly reduced cardiovascular events (HR: 0.24, 95% CI: 0.04 to 0.89). Either in younger patients with risk factors (group C: n = 402) or without risk factors (group D: n = 58), we could not detect aspirin's benefit (group C, HR: 0.93, 95% CI: 0.27 to 2.9; group D, HR: 1.26, 95% CI: 0.05 to 32). In the present study, low-dose aspirin was beneficial for primary prevention not in older diabetic patients with additional risk factors but in those without additional risk factors. Further investigations should be needed to confirm whether low-dose aspirin is beneficial for primary prevention in diabetic patients at high risk.
Abstract 5615: A Comparison of Early Invasive Versus Conservative Therapy for Non-ST Elevation Myocardial Infarction Patients Excluded from Clinical Trials
Authors: Nitin V Sajnani, Alpesh A Amin, Richard G Bach, David J Cohen, Philip G Jones, John C Messenger, John S Rumsfeld, William S Weintraub, Lan Xiao, John A Spertus
Journal: Circulation (2008)

Background: Randomized clinical trials (RCT) have tested the efficacy of early invasive (EI) versus conservative (CON) strategies for managing non-ST-elevation myocardial infarction (NSTEMI). However, RCT’s often have restricted entry criteria that limit external validity and exclude high risk patients. This leaves clinicians with little evidence to guide the appropriate management of NSTEMI patients that would have been ineligible for traditional RCT’s.  Methods: We sought to understand the outcomes of EI versus CON strategies in managing NSTEMI in a prospective cohort of patients that would have been ineligible for entry into the TACTICS TIMI 18 trial. The data source for this study is PREMIER. PREMIER is a multi-center observational registry of 1,409 NSTEMI patients. The definitions for EI and CON strategies were the same as in TACTICS TIMI 18. Propensity score matching was used to adjust for biases in treatment selection, baseline characteristics and site between the EI and CON groups. Stratified proportional hazards regression was used to compare 1-and 3-year survival and 1-year rehospitalization between groups.  Results: Of the 1,409 NSTEMI patients enrolled in PREMIER, 686 patients (49%) would have been excluded from TACTICS TIMI 18. Of these, 227 (33%) received an EI approach and 459 (67%) received a CON approach to managing their NSTEMI. With propensity score matching 174 pairs were identified for comparison. After matching, there were no significant differences in baseline characteristics between the EI and CON groups. While there was no difference in 1-year rehospitalization between CON vs. EI patients (HR 1.18, 95% CI 0.79 –1.77), the CON group had a significantly higher 1-year (HR 2.27, 95% CI 1.24 – 4.16) and 3-year mortality (HR 1.67, 95% CI 1.06 –2.62).  Conclusion: Nearly half of all NSTEMI patients enrolled in PREMIER would have been ineligible for enrollment into TACTICS TIMI 18, and two thirds of these ineligible patients received a CON approach. Compared with CON management among propensity-matched ineligible patients, the EI approach was associated with significantly lower 1 and 3-year mortality. These results suggest that NSTEMI patients ineligible for TACTICS TIMI 18 still benefit from management by an EI approach.
Abstract 14779: Relative Roles of Endogenous Thrombolytic and Anti-Thrombotic Axes in Cardiac Allograft Vasculopathy
Authors: Keigo Fukase, Daniel Lawrence, David J Pinsky
Journal: Circulation (2010)

Introduction: Nonimmune mechanisms of vascular injury contribute to cardiac allograft vasculopathy (CAV) pathogenesis. To analyze antigen-independent mechanisms contributing to CAV, we hypothesized...
Abstract P3-11-09: Elevated peripheral blood lymphocyte-to-monocyte ratio predicts favorable response and prognosis in locally advanced breast cancer after neoadjuvant chemotherapy
Authors: Lei Wang, Xiao-Jian Ni, Guo-Wei Qian, Qian-Wen Ou-Yang, Xiao-Lan Zhang, Yi-Zhou Jiang, Sheng Chen, Xin Hu, Zhi-Ming Shao
Journal: Cancer Research (2015)

Abstract Neoadjuvant chemotherapy (NAC) is the standard of care for locally advanced breast cancer (LABC). However, the lack of efficient method to predict the treatment response and prognosis limits the clinical evaluation of the patient eligibility. Elevated lymphocyte-to-monocyte ratio (LMR) has been reported to be associated with favorable prognosis in some hematology malignancies and nasopharyngeal carcinoma, but has not been studied in breast cancer. The purpose of this study is to evaluate whether the LMR is a predictor of the curative impact of LABC patients after NAC and short/long-term mortality. A retrospective cohort of 542 LABC patients who received NAC was recruited between May 2002 and August 2011. The counts for peripheral absolute lymphocyte and monocyte before NAC were retrieved, and the LMR was calculated. Receiver operating characteristic curve analysis, univariate and multivariate Cox proportional hazards analyses were applied to evaluate the associations of LMR with overall survival (OS) and disease-free survival (DFS) respectively. Univariate analysis revealed that higher LMR level (≥4.25) was significantly related to better overall response rate (P = 0.005). Univariate analysis revealed that higher LMR level (≥4.25) was significantly associated with superior OS (P = 0.014), DFS (P = 0.009). The higher lymphocyte count (≥1.5×109/L) was significantly associated with better OS (P = 0.035), while the lower monocyte count (&amp;lt;0.4×109/L) was associated with better OS (P = 0.007) and DFS (P = 0.01), respectively. Multivariate Cox proportional hazard analysis showed that higher LMR level was a significantly independent predictor for superior OS (hazard ratio or HR = 0.636, 95% confidence interval or 95% CI = 0.432-0.937; P = 0.022), DFS (HR = 0.666, 95% CI = 0.495-0.896; P = 0.007) respectively. The traditional predictive factors, including tumor size, lymph node status, hormone receptor status and HER2 status, were also independent prognostic factors of OS and DFS. The elevated pre-NAC peripheral LMR level was a significant favorable factor for NAC LABC prognosis and this easily accessed variable may serve as a potent marker to predict the outcomes of LABC patients after NAC. Citation Format: Lei Wang, Xiao-Jian Ni, Guo-Wei Qian, Qian-Wen Ou-Yang, Xiao-Lan Zhang, Yi-Zhou Jiang, Sheng Chen, Xin Hu, Zhi-Ming Shao. Elevated peripheral blood lymphocyte-to-monocyte ratio predicts favorable response and prognosis in locally advanced breast cancer after neoadjuvant chemotherapy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P3-11-09.