tbuckley/cabot-search huggingface dataset:
ECG Quantification of Myocardial Scar in Cardiomyopathy Patients with or without Conduction Defects: Correlation with Cardiac Magnetic Resonance and Arrhythmogenesis
Authors: David G. Strauss, Ronald H. Selvester, Joao A. Lima, Håkan Arheden, Julie M. Miller, Gary Gerstenblith, Eduardo Marban, Robert G. Weiss, Gordon F. Tomaselli, Galen S. Wagner, Katherine C. Wu
Journal: Circulation (2008)

Background— Myocardial scarring from infarction or nonischemic fibrosis forms an arrhythmogenic substrate. The Selvester QRS score has been extensively validated for estimating myocardial infarction scar size in the absence of ECG confounders, but has not been tested to quantify scar in patients with hypertrophy, bundle branch/fascicular blocks, or nonischemic cardiomyopathy. We assessed the hypotheses that (1) QRS scores (modified for each ECG confounder) correctly identify and quantify scar in ischemic and nonischemic patients when compared with the reference standard of cardiac magnetic resonance using late-gadolinium enhancement, and (2) QRS-estimated scar size predicts inducible sustained monomorphic ventricular tachycardia during electrophysiological testing.

Methods and Results— One hundred sixty-two patients with left ventricular ejection fraction ≤35% (95 ischemic, 67 nonischemic) received 12-lead ECG and cardiac magnetic resonance using late-gadolinium enhancement before implantable cardioverter defibrillator placement for primary prevention of sudden cardiac death. QRS scores correctly diagnosed cardiovascular magnetic resonance scar presence with receiver operating characteristics area under the curve of 0.91 and correlation for scar quantification of r =0.74 ( P <0.0001) for all patients. Performance within hypertrophy, conduction defect, and nonischemic subgroups ranged from area under the curve of 0.81 to 0.94 and r =0.60 to 0.80 ( P <0.001 for all). Among the 137 patients undergoing electrophysiological or device testing, each 3-point QRS-score increase (9% left ventricular scarring) was associated with an odds ratio for inducing monomorphic ventricular tachycardia of 2.2 (95% CI, 1.5 to 3.2; P <0.001) for all patients, 1.7 (1.0 to 2.7, P =0.04) for ischemics, and 2.2 (1.0 to 5.0, P =0.05) for nonischemics.

Conclusions— QRS scores identify and quantify scar in ischemic and nonischemic cardiomyopathy patients despite ECG confounders. Higher QRS-estimated scar size is associated with increased arrhythmogenesis and warrants further study as a risk-stratifying tool.

Received June 12, 2008; accepted October 17, 2008. 

# CLINICAL PERSPECTIVE {#article-title-2}
Abstracts 1677–1879
Authors: A. Hall, N. Raja, S. D. Chamberlain, E. Gorovits, G. W. Henson, J. T. Hutchins, J. Muhammad, J. Patti, J. Vernachio, J. Wang, Karolina Madela, Mohamed Aljarah, Sarah Louise Jones, Christopher McGuigan
Journal: Hepatology (2010)
High prevalence of blaCTX-M extended-spectrum β-lactamase genes in Escherichia coli isolates from pets and emergence of CTX-M-64 in China
Authors: Y. Sun, Z. Zeng, S. Chen, J. Ma, L. He, Y. Liu, Y. Deng, T. Lei, J. Zhao, J.-H. Liu
Journal: Clinical Microbiology and Infection (2010)
Cutaneous CD56 natural killer and natural killer-likeT-cell lymphoma
Authors: D.N. Slater
Journal: British Journal of Dermatology (2000)

Journal Article Cutaneous CD56 natural killer and natural killer‐likeT‐cell lymphoma Get access D.N. Slater D.N. Slater Department of Histopathology, Royal Hallamshire Hospital, Sheffield, U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 142, Issue 5, 1 May 2000, Pages 853–855, https://doi.org/10.1046/j.1365-2133.2000.03527.x Published: 01 May 2000
NCIC-CTG MA.20: An intergroup trial of regional nodal irradiation in early breast cancer.
Authors: T. J. Whelan, I. Olivotto, I. Ackerman, J. W. Chapman, B. Chua, A. Nabid, K. A. Vallis, J. R. White, P. Rousseau, A. Fortin, L. J. Pierce, L. Manchul, P. Craighead, M. C. Nolan, J. Bowen, D. R. McCready, K. I. Pritchard, M. N. Levine, W. Parulekar
Journal: Journal of Clinical Oncology (2011)

LBA1003 Background: Randomized trials have demonstrated that locoregional radiation after mastectomy reduces locoregional recurrence and improves overall survival (OS) in women with node positive breast cancer treated with adjuvant systemic therapy. MA.20 evaluated the addition of regional nodal irradiation (RNI) to whole breast irradiation (WBI) following breast conserving surgery (BCS). Methods: Women with high risk node-negative or node-positive breast cancer treated with BCS and adjuvant chemotherapy and/or endocrine therapy were stratified by positive nodes, axillary nodes removed, chemo- and endocrine therapy and randomized to WBI (50Gy in 25 fractions +/- boost irradiation) or WBI plus RNI (45Gy in 25 fractions) to the internal mammary, supraclavicular, and high axillary lymph nodes. The primary outcome was OS. The Data Safety Monitoring Committee approved the analysis plan for the protocol specified interim analysis of relapse patterns, survival and toxicity at 5 years. Upon review of the data, they recommended release of the results. Results: Between March 2000 to March 2007, 1,832 women were randomly assigned to WBI+RNI (916) or WBI (916). Median follow-up was 62 months. Characteristics of the study population were: mean age, 53.3 years; node negative, 10%; 1-3 positive nodes, 85%; &gt; 4 positive nodes, 5%; adjuvant chemotherapy, 91%; and adjuvant endocrine therapy, 71%. WBI+RNI in comparison to WBI alone was associated with an improvement in isolated locoregional disease free survival (DFS; HR=.59, p=.02, 5 year risk: 96.8% and 94.5% respectively), distant DFS (HR=.64, p=.002, 5 year risk: 92.4% and 87.0% respectively), DFS (HR=.68, p=.003, 5 year risk: 89.7% and 84.0% respectively) and OS (HR=.76, p=.07, 5 year risk: 92.3% and 90.7% respectively). WBI+RNI in comparison to WBI was associated with an increase in grade 2 or greater pneumonitis (1.3% and 0.2% respectively, p=.01), and lymphedema (7.3% and 4.1% respectively, p=.004). Conclusions: The majority of women with node positive breast cancer are now managed by BCS followed by WBI and adjuvant systemic therapy. Results from MA.20 demonstrate that additional RNI reduces the risk of locoregional and distant recurrence, and improves DFS with a trend in improved OS.
Abstract 15724: Prevalence of Statin Use among Medicare Beneficiaries with Coronary Heart Disease by Income, Region, and Race/Ethnicity
Authors: Emily Levitan, Huifeng Yun, Lingli Guo, Todd Brown, Monika Safford, Elizabeth Delzell, Michael Farkouh, Robert Rosenson, Paul Muntner
Journal: Circulation (2012)

Background: To meet LDL-cholesterol treatment goals, patients with coronary heart disease (CHD) often need lipid-lowering drugs such as statins. With Medicare Part D, prescription drug insurance is...
Abstract 6151: Non Syndromic Mitral Valve Prolapse: Evidence of Tgf-beta Pathway Activation in Surgically Resected Leaflets
Authors: Stefania Rizzo, Elisa Carturan, Gino Gerosa, Adolfo Paolin, Gaetano Thiene, Cristina Basso
Journal: Circulation (2008)

BACKGROUND Mitral valve prolapse (MVP) is the leading cause of mitral valve incompetence in western countries. Although its etiopathogenesis remains uncertain, a genetic defect has been identified in syndromic (ie, Marfan syndrome) and non syndromic cases. The finding that TGF-beta dysregulation may play an important role in the development of syndromic MVP prompted us to evaluate whether the Smad receptor-mediated intracellular TGF-beta pathway is activated also in isolated MVP. METHODS Myxomatous mitral valve specimens were obtained from patients (15 cases, 12 males, mean age 55.5± 12.7 years) who underwent surgical repair of MVP due to mitral valve incompetence. Age and sex-matched control mitral valves were obtained from homograft Tissue Bank (10 cases, mean age 49±9 years). Valve morphology and thickness were assessed on routinely stained histology sections. Primary antibodies recognizing active phosphorylated form of Smad2 (P-Smad2, Dako) in valvular myofibroblasts were used. To evaluate some target...
Comparison of the Effects of Atropine and Glycopyrrolate on various End-Organs<sup>1</sup>
Authors: R K Mirakhur, J W Dundee
Journal: Journal of the Royal Society of Medicine (1980)

Atropine and glycopyrrolate (glycopyrronium bromide), a quaternary ammonium drug, were evaluated in volunteers following intramuscular administration with respect to effects on various end-organs with cholinergic innervation. Glycopyrrolate appears to be five to six times more potent than atropine in its antisialogogue effect and also exhibits a selective, though prolonged, effect on salivary secretion and sweat gland activity. It has minimal cardiovascular, ocular and central nervous system effects.
Time constant of respiratory muscle relaxation in patients with cystic fibrosis
Authors: Theodore Dassios, Athanasios Kaditis, Anna Katelari, George Chrousos, Stavros Doudounakis, Gabriel Dimitriou
Journal: European Respiratory Journal (2014)

Background:  Patients with cystic fibrosis (CF) are at increased risk of respiratory muscle fatigue and respiratory failure, secondary to lower airway obstruction and malnutrition. Testing for respiratory muscle fatigue involves complex methodology and the physical presence of the patient in a research facility. The time constant of respiratory muscle relaxation (τ) is a simple bedside test which can be alternatively used to assess CF patients for respiratory muscle fatigue.   Measures:  For this cross-sectional study, we measured body mass index z-score (BMI), upper arm muscle area (UAMA), Forced Expiratory Volume in 1 second z-score (FEV 1 ), Forced Vital Capacity z-score (FVC), maximal inspiratory pressure (Pi max ), τ after maximal inspiration (τ-Pi max ), maximal expiratory pressure (Pe max ) and τ after maximal expiration (τ-Pe max ).   Results:  Fifty-three CF patients [median age 14 years (interquartile range: 11-19.5)] and 53 age- and sex-matched healthy controls [14 years (11-19.5)]were recruited.Pi max  and Pe max  did not differ significantly between patients and controls.Median (IQR) τ-Pi max  in CF subjects [253(188-406)] was significantly increased compared to median (IQR) τ-Pi max  in controls [117(81-185); p max  in CF subjects [232 (105-344)] was significantly increased compared to median (IQR) τ-Pe max  in controls [101 (78-143); p max  was significantly related to FEV 1  (r=-0.205, p=0.031) and FVC (r=-0.294, p=0.002) but not to BMI or UAMA.   Conclusions:  Our findings suggest that CF patients are predisposed to respiratory muscle fatigue as described by slow respiratory muscle relaxation, which is significantly associated with severity of spirometric abnormalities.
Phase III Comparative Study of Vinorelbine Combined With Doxorubicin Versus Doxorubicin Alone in Disseminated Metastatic/Recurrent Breast Cancer: National Cancer Institute of Canada Clinical Trials Group Study MA8
Authors: B. Norris, K.I. Pritchard, K. James, J. Myles, K. Bennett, S. Marlin, J. Skillings, B. Findlay, T. Vandenberg, P. Goss, J. Latreille, L. Rudinskas, W. Lofters, M. Trudeau, D. Osoba, A. Rodgers
Journal: Journal of Clinical Oncology (2000)

PURPOSE: This phase III study was performed to determine the superiority of doxorubicin (DOX) and vinorelbine (VNB) (arm 1) versus DOX alone (arm 2) in metastatic breast cancer (MBC) for overall survival (OS), time to treatment failure (TTF), toxicity, and quality of life (QOL). PATIENTS AND METHODS: Three hundred three patients were randomized to DOX 50 mg/m 2 intravenously (IV) on day 1 and VNB 25 mg/m 2 IV on days 1 and 8 (arm 1) or DOX 70 mg/m 2 IV on day 1 (arm 2). Both regimens were given every 3 weeks until a cumulative DOX dose of 450 mg/m 2 . After 16 of the first 65 randomized patients experienced febrile neutropenia (FN), the doses were reduced to DOX 40 mg/m 2 on day 1 and VNB 20 mg/m 2 on days 1 and 8 versus DOX 60 mg/m 2 on day 1. Eligible patients were vinca alkaloid and anthracycline naive. Chemotherapy was first-line or second-line for MBC. RESULTS: Three patients were ineligible. Thus, 300 patients were assessable for toxicity and to determine time to disease progression (TTP), TTF, and OS. Two hundred eighty-nine patients were assessable for response, and 99 responders were assessable for response duration (RD). The response rates, QOL, and median RD, TTP, and TTF were not significantly different between the arms. Median OS was 13.8 months for arm 1 versus 14.4 months for arm 2 (P = .4). Grade 3 or 4 granulocytopenia was equivalent in both arms but more grade 3/4 neurotoxicity, mild venous toxicity, and FN were seen on arm 1. CONCLUSION: The survival with DOX and VNB is not superior to DOX alone in MBC.
Primary pulmonary interstitial glycogenosis. Long term outcome
Authors: Olaia Sardon, Sandra Rovira, Paula Corcuera, Javier Korta, Joan Carles Ferreres, Elena Perez, Eduardo G. Perez-Yarza, Antonio Moreno
Journal: European Respiratory Journal (2013)

Background: Pulmonary interstitial glycogenosis (PIG) or infantile cellular interstitial pneumonia (ICIP) is a rare and poorly understood entity of the infant lung.

Objectives: Describe clinical presentation and long term clinical outcome of infants diagnosed with primary PGI or ICIP.

Methods: Multicentre prospective study of patients diagnosed by lung biopsy between October 2003 and December 2012.

Results: Eight patients were included; 6 term born infants and 2 preterm infants (GA 36-32+2 weeks).Three infants were male. Four had respiratory distress and two required mechanical ventilation.Two infants had prolonged hypoxemia and the others were studied because of persistent tachypnea (median respiratory rate 57.5; range 45-70).Hospital admission because of acute bronchiolitis or wheezing bronchitis was required in 5/8 cases.CT-scan showed ground glass attenuation (n=8), parenchymal bands (n= 7) and septal thickening (n=8). Median age at diagnosis was 5 months (range 2-9).Patients were treated with intravenous methylprednisolone (7/8), hydroxychloroquine (4/8), and home oxygen (3/8; range 11-36 months). Median follow-up was 6.5 years (1-9 years). All patients enhanced clinically with resolution of tachypnea and hypoxemia.All infants had wheezing bronchitis until the median age of 3 years (range 1.5-8). Spirometry results (6/8) showed a median FVC of -1.76 z-score (range 0.07 to -2.85) and a median FEV1 of -2.27 z-score (range -0.54 to -4.37) suggesting a restrictive pattern (5/6) or a mixed pattern (1/6).Plethysmographic study confirmed a restrictive pattern in 4/5 patients.

Conclusions: Although patients with ICIP/PIG showed a good long term clinical outcome they have significant functional, mainly restrictive, defects.
Junior doctors' hours
Authors: C. Wong
Journal: BMJ (1995)

lead to nationally agreed terms and conditions of work and much enhanced status.We still urge all women who can to work as principals, but we recognise the need for officially recognised, short term, part time posts in general practice.Vocationally trained doctors who cannot take on the commitment that a post as a principal entails have no such option at present, and the alternatives available-assistantships, locum work, and the retainer scheme-tend to be poorly rewarded and poorly regarded.We regret the Department of Health's refusal to upgrade the retainer scheme, despite the evident need for this, and will continue to collect evidence on the scheme's use from all those interested.We would welcome correspondence on this as well as the other issues mentioned.The need for more flexible working patterns extends throughout medicine as more women enter medicine and more men seek a better way to combine their home and working lives.Flexible working patterns and changes in ways of providing cover for out of hours services would help to maintain the health and morale of
Treatment of Metastatic Carcinoid Tumors With Radiolabeled Biologic Molecules
Authors: David Bushnell
Journal: Journal of the National Comprehensive Cancer Network (2009)

Treatment options in advanced-stage neuroendocrine tumors are limited. A promising new category of therapy was recently introduced for these tumors in which radioactive atoms are attached to molecules that target and bind to neuroendocrine cancer cells. 90Yttrium-DOTA-Phe1-Tyr3-octreotide and radioactive drugs which targets cells by binding to somatostatin receptors. 131Iodine-metaiodobenzylguanidine also targets neuroendocrine tumors using the amine transporter system. Both agents, along with the somatostatin analogue 177Lutetium-DOTATATE, have shown objective response rates in approximately 30% of patients with progressive metastatic disease. Symptomatic improvement is observed in most patients receiving these drugs and evidence of survival benefit is also mounting. Serious side effects are uncommon.
Comparison of complete vs. incomplete fissure in patients with advanced emphysema
Authors: Ralf Eberhardt, Daniela Gompelmann, Maren Schuhmann, Konstantina Kontogianni, Arschang Valipour, Felix J.F. Herth
Journal: European Respiratory Journal (2014)

Objective: Up to data, it is still unclear, whether the interlobar fissure integrity in patients with COPD has an impact on the progression of disease.  Methods: Comparing longitudinal outcomes of patients with complete and incomplete fissure in the control arm of VENT (US VENT/Euro Vent).  Results: In 152 out of 161 patients, fissure status was recorded. 91 patients had an incomplete fissure whereas 61 patients had a complete interlobar fissure. Despite slightly higher 6-MWD in patients with incomplete fissures, there were no significant differences between groups at baseline.  During the 1-year follow up, both groups of patients experienced a decline in FEV1 and 6-MWD but no statistical difference was observed between those with complete and those with incomplete fissures.  Discussion: The integrity of the interlobar fissure appears to have no impact on the progression of patients with emphysematous type of COPD.
Evaluation of two methods for measurement of cardiac output during exercise in patients with COPD
Authors: Ioannis Nasis, Dimitris Athanasopoulos, Evgenia Cherouveim, Zafiris Louvaris, Maroula Vasilopoulou, Helmut Habazettl, Harriet Wagner, Peter David Wagner, Spyros Zakynthinos, Ioannis Vogiatzis
Journal: European Respiratory Journal (2011)

Introduction:  Indicator-Dilution (ID) is considered as the standard method for the measurement of cardiac output (CO), but is invasive and therefore difficult to use in clinical practice. A non-invasive device reported to work during exercise and based on impedance cardiography (Physioflow, PF) has become available.   Aim:  To simultaneously measure CO during exercise with (PF) and (ID) in patients with COPD.   Methods:  Ten patients with COPD, (aged 60±7 years, FEV 1 = 50±6%predicted) were studied.Exercise consisted of four constant-load tests, for (5min at 25% and 50%, 3 min at 75% and 2 min at 100% of their WRpeak). VO 2  and CO 2  were recorded breath-by-breath, and CO was measured at each exercise level using PF and ID (using indocyanine green) over the last minute of exercise.   Results:  CO by PF exceeded that by ID by 2.6±0.3 L/min (Mean±SE) averaged across all exercise levels (p=0.001).   Conclusion:  Compared to IT, PF overestimates CO across different levels of exercise but its slope of change relative to VO 2  is very similar. Hence PF can accurately estimate changes from resting CO during exercise in COPD.
Bipartite structure of the inactive mouse X chromosome
Authors: Xinxian Deng, Wenxiu Ma, Vijay Ramani, Andrew Hill, Fan Yang, Ferhat Ay, Joel B. Berletch, Carl Anthony Blau, Jay Shendure, Zhijun Duan, William S. Noble, Christine M. Disteche
Journal: Genome biology (2015)

Abstract Background In mammals, one of the female X chromosomes and all imprinted genes are expressed exclusively from a single allele in somatic cells. To evaluate structural changes associated with allelic silencing, we have applied a recently developed Hi-C assay that uses DNase I for chromatin fragmentation to mouse F1 hybrid systems. Results We find radically different conformations for the two female mouse X chromosomes. The inactive X has two superdomains of frequent intrachromosomal contacts separated by a boundary region. Comparison with the recently reported two-superdomain structure of the human inactive X shows that the genomic content of the superdomains differs between species, but part of the boundary region is conserved and located near the Dxz4 / DXZ4 locus. In mouse, the boundary region also contains a minisatellite, Ds-TR , and both Dxz4 and Ds-TR appear to be anchored to the nucleolus. Genes that escape X inactivation do not cluster but are located near the periphery of the 3D structure, as are regions enriched in CTCF or RNA polymerase. Fewer short-range intrachromosomal contacts are detected for the inactive alleles of genes subject to X inactivation compared with the active alleles and with genes that escape X inactivation. This pattern is also evident for imprinted genes, in which more chromatin contacts are detected for the expressed allele. Conclusions By applying a novel Hi-C method to map allelic chromatin contacts, we discover a specific bipartite organization of the mouse inactive X chromosome that probably plays an important role in maintenance of gene silencing.
Comparative analysis of multiple protein-sequence alignment methods.
Authors: M A McClure, T K Vasi, W M Fitch
Journal: Molecular Biology and Evolution (1994)

We have analyzed a total of 12 different global and local multiple protein-sequence alignment methods. The purpose of this study is to evaluate each method's ability to correctly identify the ordered series of motifs found among all members of a given protein family. Four phylogenetically distributed sets of sequences from the hemoglobin, kinase, aspartic acid protease, and ribonuclease H protein families were used to test the methods. The performance of all 12 methods was affected by (1) the number of sequences in the test sets, (2) the degree of similarity among the sequences, and (3) the number of indels required to produce a multiple alignment. Global methods generally performed better than local methods in the detection of motif patterns.
Sleep related disorder of breathing in syndromic and nonsyndromic craniosynosotosis
Authors: Shaikh Iqbal, Muslim AlSaadi, Essam Elgamal
Journal: European Respiratory Journal (2011)

Aims:  To look at sleep related disorderd breathing (SRDB) in syndromic {SC} & non-syndromic craniosynostosis{NSC} children in our hospital.   Background:  SRBD is highly prevalent in SC [1] children. Neuropsychological deficits [2] and not SRDB is reported in NSC children.   Methods:  Children with no SRDB history (Group1-SC, n=4) & (Group2-NSC, n=10) were referred for polysomnography (PSG) between Sep2007 to Nov2010 preoperatively.   Results:  The median total apnea-hypopnoea index (TAHI) were 8.80 (range 1.8-18.2); 2.8 (range 0.2-21.4) & central apnea index (CAI) were 0.6 (range 0-2.1); 0.1 (range 0-1.2) group-1 & group-2, respectively.   Conclusion:  Asymptomatic SC & NSC children have PSG evidence of SRDB.   References:   1Al-Saleh S et al SRDB with syndromic craniosynostosis.J Cranio maxillo fac Surg. 2010 Jun.  2Kapp-Simon KA et al Childs Neurodevelopment of children with single suture craniosynostosis, Nerv Syst. 2007 Mar;23(3):269-81.