tbuckley/cabot-search huggingface dataset:
Hyperbaric oxygen in carbon monoxide poisoning
Authors: C D Scheinkestel
Journal: BMJ (2000)

Editor—We would like to clarify some of the statements that Weaver made about our double blind randomised trial of hyperbaric compared with normobaric oxygen treatment of carbon monoxide poisoning.1,2 Weaver expresses concern that concomitant depression and use of psychoactive drugs might have influenced the results, given the large percentage of suicide attempts in our cohort of patients. Depression and the use of drugs may indeed have resulted in a higher incidence of poor outcome overall, but this would not have biased the comparison between normobaric and hyperbaric groups: patients were specifically stratified for attempted suicide before randomisation to treatment.

Weaver seems to be concerned about the delay in receiving hyperbaric oxygen treatment. Although the geometric mean treatment delay was 7.1 hours, we performed subgroup analysis of patients treated within four hours (all patients, and severely poisoned patients alone). We also analysed outcome in four groups according to time to treatment ( 12 hours) and found no difference in outcome between hyperbaric and normobaric oxygen groups. Further multivariable analysis did not identify delay in treatment as a predictor of poor outcome. Thus there was no evidence that delay to treatment might have explained the lack of benefit of hyperbaric oxygen.

Weaver also questions our use of cluster randomisation. With this we allocated more than one person simultaneously to the same treatment on 22 occasions (two on 12 occasions, three on five occasions, and four on five occasions). Overall, 14 clusters (40 patients) were allocated to hyperbaric oxygen and eight clusters (19 patients) to normobaric oxygen. Continuous outcome variables were analysed by the mixed procedures in SAS, which allows a repeated measures analysis of variance, with the variable cluster being treated as a random repeated measurement, thus adjusting for within cluster variation.3

We also repeated the analysis excluding all patients who were allocated as part of a cluster and further repeated it adjusting for the three variables (exposure time, time to carboxyhaemoglobin measurement, and time to treatment) that uniquely defined the cluster. These analyses suggest that our results were not biased by cluster randomisation.

Weaver refers to Thom et al's findings of no relapses in their patients given hyperbaric oxygen, but it is important to note that all five relapses in our study occurred in patients given hyperbaric oxygen (P=0.03).
Abstract 5684: Long-Term Outcomes after Catheter Ablation of Atrial Flutter: A Meta-Analysis
Authors: Francisco J Perez, Christine M Schubert, Babar Parvez, Vishesh Pathak, Kenneth A Ellenbogen, Mark A Wood
Journal: Circulation (2008)

Clinical outcomes after catheter ablation of atrial flutter (AFL) vary widely in reported literature. The puropose of this study was to analyze long-term outcomes after cathteter ablation of AFL using meta-analys. Meta-analysis was performed of articles published from 1988 – 2007 with outcomes after catheter ablation of cavotricuspid isthmus (CTI) dependent AFL. The analysis included 110 studies comprising 7946 patients (79% male, 59.8±0.5 years, 43% left atrial enlargement, 49% heart disease, 16±12 months follow up). The acute success rate was 97% (95% CI 95–98%) with cooled (8 –10mm tip or irrigated) radiofrequency catheters and 95% (94 –96%) when bidirectional CTI block was the endpoint. Recurrence rate of AFL was 4% (3– 6%) with cooled catheters. Use of bidirectional CTI block as ablation endpoint decreased AFL reccurrence to 8% (^−10%) versus 18% (14 –22%) without CTI as endpoint. AFL recurrence rate did not increase over time. Mortality was 3% (2– 4%) during follow up. The overall occurrence rate of atrial fibrillation (AF) after AFL ablation was 25% (21–29%). In patients with AF prior to ablation, AF occurred in 46% (41–51%) compared to 16% (11–22%) without AF prior to ablation. Five years after ablation, the AF rates were similar in those with and without AF prior to ablation (Figure ). Antiarrhythmic drug use post ablation was 28% (22–36%). The long term use of coumadin was not described. AF is common after AFL ablation and may limit the clinical utility of this procedure. 28% of patients require antiarrhythmic drugs after AFL ablation. AF before ablation may indicate a more advanced electrical disease.
Depressed immunity and impaired proliferation of hematopoietic progenitor cells in patients with complete spinal cord injury
Authors: Per Ole Iversen, Nils Hjeltnes, Bjørn Holm, Torun Flatebø, Inger Strøm-Gundersen, Wenche Rønning, Johan Stanghelle, Haakon B. Benestad
Journal: Blood (2000)
Abstract 2311: New Predictors of Arrhythmic Event in Brugada Syndrome: Manifest T-wave Alternans after Sodium Channel Blocker Administration
Authors: Takeshi Tada, Kengo F Kusano, Satoshi Nagase, Kimikazu Banba, Nobuhiro Nishii, Atsuyuki Watanabe, Yoshiaki Sakai, Masato Murakami, Kouhei Miyaji, Kazufumi Nakamura, Satoru Sakuragi, Tohru Ohe
Journal: Circulation (2006)
Abstract 13904: The SYNTAX Score Predicts Major Bleeding after Drug-Eluting Stent implantation in the All-Comers population
Authors: Raisuke Iijima, Ken Yamazaki, Tadashi Araki, Yoshinobu Nagashima, Masato Nakamura, Kaoru Sugi
Journal: Circulation (2012)

Purpose: The bleeding complication has been one of frequent complications in the drug-eluting stent (DES) era. Previous study reported that percutaneous coronary intervention (PCI) in complex lesio...
Abstract 1203: Mild Renal Dysfunction Caused by Uninephrectomy Accelerated the Development of Atherosclerosis by Augmented Monocyte Mobilization from Bone Marrow via CCR2-Mediated Signals
Authors: Hiroyuki Kawahito, Hiroyuki Yamada, Yoshinori Tsubakimoto, Hirokazu Yokoi, Hiroki Takata, Hideyo Hirai, Jiro Imanishi, Tomosaburo Takahashi, Mitsuhiko Okigaki, Yasukiyo Mori, Hiroaki Matsubara
Journal: Circulation (2007)
Abstract 2125: Severity of Left Ventricular Dyssynchrony in Patients with Ischemic and Non-Ischemic Cardiomyopathy: a Cardiovascular Magnetic Resonance Tissue Synchronization Mapping Study
Authors: Kayvan Khadjooi, Paul W Foley, Shajil Chalil, Beatrice A Dyer, Berthold Stegemann, Russell E Smith, Michael Frenneaux, Francisco Leyva
Journal: Circulation (2007)

Aims: Studies on cardiac resynchronization therapy (CRT) for heart failure have shown a differential response in patients with ischemic (ICM) and non-ischemic cardiomyopathy (NICM). Increasing dyssynchrony has been shown to relate to a poor prognosis in patients with heart failure. We hypothesized that ICM and NICM have varying effects on left ventricular (LV) synchrony. Methods: The recently described cardiovascular magnetic resonance tissue synchronization index (CMR-TSI), which predicts benefit from CRT, was quantified in 181 patients (age: 66.4 ± 10.6 yrs, NYHA class III or IV, LVEF: 23.5 ± 10.8%, QRS = 139.8 ± 32.0 ms) with ICM (n=105) or NICM (n=76) and age-matched, healthy controls (n=24). The maximum time-to-peak radial wall motion in a short axis stack of LV images (steady-steady free precession imaging) was fitted to an empirical sine wave [y = a + b * sin (t/RR + c)]. The CMR-TSI was calculated as the SD of all segmental phase shifts of the radial wall motion extracted from this wave (see Figure for bull’s eye maps). Results: CMR-TSI was higher in ICM (105.8 ± 44.2, ANOVA p&lt;0.0001) and in NICM (68.1 ± 30.5, p&lt;0.0001) than in controls (22.5 ± 8.6) (see Figure ). In multivariate analyses including ICM and NICM patients only, ischemic aetiology emerged as a positive predictor of CMR-TSI, independent of QRS duration, LV end-systolic and end-diastolic volumes, and LVEF (all p&lt;0.0001). Conclusions: ICM is associated with a greater degree of dyssynchrony than NICM, independently of QRS duration, LV volumes and LVEF. These findings may account for the differential response to CRT observed with patients with ICM and NICM.
Symptom dimensions and outcome in schizophrenia.
Authors: Raimo K R Salokangas
Journal: World Psychiatry (2003)

Since Kraepelin, outcome has been one of the most frequently used criteria for testing the validity of diagnosis in psychiatry. Factor analytic methods have showed, however, that the symptomatology of psychiatric patients can be divided into symptom dimensions, which also correlate with outcome. The aim of the present study was to explore how diagnostic sub-categories and symptom dimensions correlate with outcome in first-episode and chronic patients with schizophrenia. In samples of first-episode schizophrenia patients (n=156) and chronic schizophrenia patients (n=1571), symptom variables were factored and the five symptom dimensions obtained were correlated with outcome variables. In both samples, symptom dimensions were more powerful in explaining variance of outcome than categorical sub-diagnoses. Thus, a dimensional approach seems to be valuable not only in describing the illness picture, but also in predicting outcome in schizophrenia.
Abstract 775: Substrate Availability Regulates Energy Metabolism via Transcriptional Mechanisms
Authors: Jie Yan, Martin E Young, Gary D Lopaschuk, Ronglih Liao, Rong Tian
Journal: Circulation (2006)

The present study investigated the mechanisms by which enhanced substrate availability regulates cardiac metabolism and function. Chronic elevation of intracellular glucose levels were achieved by overexpressing GLUT1 in mouse hearts (TG), while chronic elevation of fatty acids (FA) availability were achieved by feeding wild-type (WT) and TG mice a high fat (HF) diet (45% energy from fat) for 20 weeks.  13 C-NMR studies showed that fatty acid oxidation (FAO) failed to increase in HF-TG hearts, although it increased by 50% in HF-WT hearts (p
Abstract 553: Iodofiltic Acid I 123 SPECT Provides Incremental Diagnostic Value over Initial Clinical Information in Emergency Department Patients with Suspected Acute Coronary Syndrome
Authors: Michael C Kontos, Jonathan H Goldman, Yong Li, Katherine A Kacena, Norman D LaFrance, John W Babich, James E Udelson
Journal: Circulation (2008)

Objectives: Emergency department (ED) diagnosis of chest pain (CP) is problematic, and often requires hospital admission or prolonged observation. Iodofiltic acid I 123 (BMIPP) SPECT detects recent...
Opportunity to Increase Life Span in Narrow QRS Cardiac Resynchronization Therapy Recipients by Deactivating Ventricular Pacing
Authors: S.M. Afzal Sohaib, Judith A. Finegold, Sukhjinder S. Nijjer, Ruhella Hossain, Cecilia Linde, Wayne C. Levy, Richard Sutton, Prapa Kanagaratnam, Darrel P. Francis, Zachary I. Whinnett
Journal: JACC Heart Failure (2015)
Role of busulfan and total body irradiation on growth of prepubertal children receiving bone marrow transplantation and results of treatment with recombinant human growth hormone
Authors: G Giorgiani, M Bozzola, F Locatelli, P Picco, M Zecca, M Cisternino, S Dallorso, F Bonetti, G Dini, C Borrone
Journal: Blood (1995)
Anti-Phosphorylcholine IgG Antibodies Reduce Restenosis and Vascular Inflammation by Inhibition of the Unfolded Protein Response in a Mouse Model of Accelerated Atherosclerosis
Authors: M. Ewing, S. Karabina, K. Pettersson, R. Atout, M. de Vries, D. Sexton, H. Lettesjo, J. Frostegard, J.W. Jukema, E. Ninio, P. Quax
Journal: Circulation (2010)
Forget the old days of medical officers of health
Authors: R. Jewkes
Journal: BMJ (1994)

Unanimity in the professionDon't pretend to be unanimous EDITOR,-The first two editorials in the issue of 29 October sit strangely together.While the first, by Ian Morrison and Richard Smith, takes an imaginative view of the future,' the second, by Tony Grabham, is a fine example of the authori- tarian and corporatist attitude that has characterised "doctors' leaders" for too long.2Morrison and Smith urge doctors to see themselves as part of a wider society, characterised by sophisticated con- sumers and shifts in the boundaries of health and medicine.Grabham, however, reminisces back to the days of Harold Wilson and Barbara Castle, when a display of professional unity apparently influenced government policy.If the profession is unanimous then there is no point arguing for unanimity.If it is not then the pretence of unanimity if a deception.I reject the notion that breaking ranks and expressing a contrary view is wrong.It is about time that medical leaders (and the public) stopped regarding
Abstract 8886: Five-Year Clinical Outcomes of Patients with Sirolimus-Eluting Stent Implantation for Chronic Total Occlusion: Insihgt from the j-Cypher Registry
Authors: Masafumi Kato, Hideo Nishikawa, Takeshi Morimoto, Fumiya Uchida, Kazuaki Miyata, Akio Iwata, Hiroyuki Suzuki, Kazuaki Mitsudo, Takeshi Kimura
Journal: Circulation (2011)

Introduction Little is known about long-term efficacy and safety of sirolimus-eluting stent (SES) implantation for chronic total occlusion (CTO), compared with for non-CTO. Hypothesis Successful recanalization of CTO with SES confers equally favorable clinical outcome as that of non-CTO. Methods The design of the j-Cypher registry was multicenter prospective enrollment of consecutive patients who underwent SES implantation from 41 centers in Japan. From 5 year follow-up information of the j-Cypher registry, we divided 10759 patients treated exclusively and successfully with SES into 2 groups (CTO group: 1210 patients underwent revascularization for CTO, non-CTO group: 9549 patients for non-CTO only). A CTO was defined as complete obstruction with estimated duration ≥1 month. Baseline characteristics and cumulative incidences of major adverse cardiovascular events were compared between the 2 groups. Furthermore the 2 groups were stratified according to their ejection fraction (EF&lt;40% or ≥40%) and studied on their 5 year overall mortality. Results The median follow-up duration was 1,640 days. The CTO group was younger (67±11 years vs. 69±10 years, p&lt;0.001), had less diabetes mellitus (44% vs. 48%, p=0.023), and had more multivessel disease (61% vs. 49%, p&lt;0.001). The crude event rates through 5 years such as total death (13% vs. 14%, p=0.562), myocardial infarction (4.2% vs. 3.6%, p=0.349), and definite stent thrombosis (1.9% vs.1.6%, p=0.758) did not differ significantly among the 2 groups, though target lesion revascularization was significantly higher in CTO group (21% vs. 15%, p&lt;0.001). In stratified analysis by EF&lt;40%, CTO group showed better overall survival rate (Figure A), despite no significant difference between the 2 groups with EF≥40% (Figure B). Conclusions SES implantation for CTO seems equivalently effective and safe to that for non-CTO. Stratified by EF&lt;40%, SES implantation for CTO could bring better long-term survival.
Significant arrhythmias associated with Interleukin-2 therapy
Authors: L. C. Natali, P. Maddukuri, R. Lucariello, S. Malik, N. Bhagwati, G. Fernaine, P. Wiernik, J. P. Dutcher
Journal: Journal of Clinical Oncology (2005)

2588 Background: A side effects of Interleukin-2 (IL-2) is the vascular leak syndrome. High dose IL-2 produces a reduction of mean arterial pressure and systemic vascular resistance as well as increased heart rate and cardiac output similar to early septic shock. Cardiac arrhythmias have been reported in 14–21% of the patients undergoing IL-2 therapy. Methods: A retrospective study of 92 patients treated at OLMMC with IL-2 for renal cell carcinoma and or melanoma in 2003was done. Patients age ranged from 24 to 74 years (mean of 56 years). Eligibility criteria included normal left ventricular systolic function, normal pulmonary function tests, normal stress test (no evidence of cardiac ischemia), normal renal function, resected locally advance or metastatic renal cell carcinoma, no prior systemic therapy and excellent organ function. All patients treated with IL-2 either high dose or intermediate dose were monitored. EKGs performed before initial infusion demonstrated normal sinus rhythm. Results: Patients included 52 male (56.6%) and 40 females (43.4%). Ten male and eight female patients developed cardiac arrhythmias. Eight patients had AF (8.7%), 8 patients had narrow complex supraventricular tachycardia (8.7%), 2 patients had ventricular tachycardia (0.2%). AF was treated with iv and/or po diltiazam. SVT was treated with iv diltiazem and digoxin; VT was treated with iv procainamide, diltiazam and digoxin. All arrhythmias resolved. Among the 15 patients treated with high dose IL-2, 6 (6.5%) developed AF, 2 (0.2%) developed VT, and 7 (46.6%) developed SVT. Two patients treated with intermediate dose IL-2 developed AF, and 1 developed SVT. The most striking electrolyte imbalances were hyperkalemia and hypercalcemia, although below parameters for arrhythmias. Conclusions: 19.56% of patients treated with iv IL-2 showed significant cardiac arrhythmias that necessitated iv and po management. Several patients required po treatment at home, especially the patients with AF. The patients with AF responded to diltiazem with no need for long-term anticoagulation with warfarin. The VT resolved without sequelae. Despite careful cardiac pre-screening, IL-2 can induce Arrythmias thru physiologic pathways. Therefore, cardiac monitoring continues to be necessary. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Chiron Chiron Chiron
Abstract 12601: Intelligence in Late Adolescence is Inversely Associated with Waist-Hip-Ratio in Early Middle-Age
Authors: Andreas Rosenblad, Jerzy Leppert
Journal: Circulation (2011)

Introduction: Body mass index (BMI) and waist-hip-ratio (WHR), measuring different kinds of obesity, are well-known risk factors for cardiovascular events. Intelligence (IQ) is known to predict BMI...
Abstract 3754: Fibrosis, AGEs or Stiff Cardiomyocytes: Which One to Blame for the High Diastolic Stiffness of the Diabetic Heart?
Authors: Loek van Heerebeek, Martin L Handoko, Nazha Hamdani, Hans W Niessen, Jolanda van der Velden, Ger Stienen, Gerrit J Laarman, Walter J Paulus
Journal: Circulation (2006)
Abstract P132: Blazing Saddles: The Brugada-pattern Electrocardiographic Characteristics in a Large Southwestern Teaching Hospital
Authors: Kathleen Benson, Mohamad Altriki, Nahel Farraj, Claudia Dima, Richard Gerkin, Marshal Burns, Nathan Laufer, Kenneth Desser
Journal: Circulation (2009)

Purpose: The Brugada syndrome has important clinical implications. As there is an increasing awareness of this disease state, the Brugada-pattern has been identified in many patients, often associa...
Judging emotions of normal and schizophrenic subjects
Authors: E Gottheil, R V Exline, R Winkelmayer
Journal: American Journal of Psychiatry (1979)

Thirty-two nursing students were shown silent films in which 10 normal and 10 schizophrenic women described a happy, sad, and an angry personal experience. Accuracy in judging the content of films of normal subjects was associated with social detachment and mechanical interests, whereas accuracy in judging the emotions of the schizophrenic subjects was associated with social involvement and nursing interests. Further, the students nurses' ability to relate to patients, as judged by their nursing supervisors, was associated with their ability to accurately identify the nonverbal emotional communications of the schizophrenic patients but not of the normal persons.
Abstract 2461: Low Thromboembolism and Pump Thrombosis Potential of the HeartMate II (HM) LVAD
Authors: Andrew J Boyle, Stuart D Russell, Jeffrey J Teuteberg, Nader Moazami, Stephanie A Moore, Mark Slaughter, David J Farrar, Ranjit John
Journal: Circulation (2007)

Introduction: The HM continuous flow LVAD has been shown to have good reliability and an excellent safety profile when used as a bridge to transplantation (BTT). Initially, there were concerns that the continuous flow and design of the HM might pre-dispose patients to thromboembolic events or pump thrombosis and therefore oral anticoagulation with coumadin was recommended. Our study evaluates the risk of thromboembolism and pump thrombosis related to the degree of anticoagulation as reflected by the International Normalized Ratio (INR). Methods: We evaluated all patients enrolled in the HM BTT pivotal trial from 1 to 6 months post-implant in order to eliminate perioperative events unrelated to anticoagulation. All patients were on aspirin and some also on persantine. An INR was measured monthly per protocol. Each individual INR sample from each time interval was assigned to ranges of INR values. Adverse events analyzed were ischemic (I) and hemorrhagic (H) stroke, pump thrombosis (T), and GI bleeding (G). Patients with adverse events were associated with the most recent INR at the start of the time interval. Results: The median duration of support for 189 patients was 132 days (range: 1–672 days) (cumulative: 96.9 patient years). There were 7 (3.7 %) patients with thrombotic events and 11 (5.8 %) patients with hemorrhagic events. The only pump thrombosis occurred with an INR &gt; 2.5 (0.5 %). Conclusions: The rates of thromboembolism, including stroke and pump thrombosis appear to be low with the HM as BTT. The thrombotic events appear to be offset by an equivalent number of hemorrhagic events. There appears to be no correlation between the degree of anticoagulation with warfarin, as reflected by the INR, and the frequency of thrombotic or hemorrhagic events. Therefore, particularly in patients having recurrent episodes of bleeding, the risk of lowering the target INR appears to be small.