tbuckley/cabot-search huggingface dataset:
Abstract 11239: Significance of Residual Paravalvular Aortic Regurgitation (PAR) after Transfemoral Aortic Valve Implantation (TAVI)
Authors: Polykarpos Christos Patsalis, Fadi Al-Rashid, Matthias Riebisch, Björn Plicht, Daniel Wendt, Matthias Thielmann, Heinz Jakob, Holger Eggebrecht, Raimund Erbel, Philipp Kahlert
Journal: Circulation (2011)

Background: Residual PAR after TAVI is common. However, systematic data on its severity and its clinical impact are sparse. We, therefore, thought to evaluate incidence, severity and outcome of residual PAR after TAVI. Methods: We analyzed data from 167 consecutive TAVI patients treated with either the Medtronic-CoreValve (n=88) or the Edwards Sapien (n=79) bioprosthesis. PAR was graded angiographically according to the Sellers criteria at the end of the procedure. In addition, invasive hemodynamics post implantation (pressure difference: diastolic aortic pressure - LVEDP (ΔPDAP-LVEDP)) were analyzed. Results: TAVI was technically successful in all patients with overall mortality rates of 9%, 13 % and 20% at 30 days, 6 months and 1 year, respectively. PAR was observed in 113 patients (67%) whereof 89 (78,8%) showing mild, 21 (18,6%) moderate and 3 (2,7%) severe PAR. Cardiovascular mortality at 30 days, 6 months and 1-year was significantly increased in patients with moderate/severe PAR compared to those w...
Amoxicillin for otitis media in general practice
Authors: A. Thornett
Journal: BMJ (2000)

Editor—The study by Damoiseaux et al adds greatly to the evidence that antibiotics are of limited use in children of all ages with uncomplicated otitis media.1 In consultations in general practice, however, the decision to prescribe is greatly influenced by considerations arising from the doctor-patient relationship.2 Often doctors find it difficult to convince worried parents that watchful waiting is acceptable treatment for their child.

Many parents see watchful waiting as no treatment and are disappointed by the outcome of the consultation. Sleepless nights, the effort spent in attending the surgery, previous experience, and views of relatives may all increase the expectation of treatment. The challenge in general practice is to present the evidence in such a way that parents feel empowered at the end of the consultation and more able to cope with the problems their children experience, rather than disempowered when their expectations are not met. General practitioners are faced with this dilemma every day. In their qualitative study of the reasons why antibiotics were prescribed for sore throats, Butler et al found that patients' expectations were seldom explicit, and many were not met.2 A third of patients clearly expected a prescription for antibiotics, but satisfaction was not necessarily related to receiving antibiotics, many patients instead seeking reassurance, further information, and pain relief. Educational campaigns may help to reassure parents,3 and general practitioners' confidence may be improved with the increasing use of decision aids in the surgery. These aids stimulate patients to be more active in decision making without increasing their anxiety, but unfortunately have little effect on satisfaction.4

Repeating the evidence for lack of effectiveness is unlikely to change doctors' prescribing. Instead, Butler et al concluded that information should be presented in terms of the risk to individual patients, emphasising the positive aspects of not being treated with an antibiotic and their general lack of efficacy. Further research is needed to help us as doctors to understand our patients' perspectives and improve our ability to be health educators rather than just healthcare providers.
Surgery for Obesity
Authors: Mike Mitka
Journal: JAMA (2003)

AS BARIATRIC SURGERY FOR THE treatment of patients with morbid obesity surges in popularity in the United States, ethical and scientific questions about the approach are mounting. While bariatric surgery has been performed since the 1960s, improvements in laproscopic methods and a 1991 Consensus Statement by the National Institutes of Health (NIH) that established criteria for eligibility for surgical treatment of morbid obesity opened the door for insurance coverage and set the stage for an explosive increase in its use. According to the American Society for Bariatric Surgery (ASBS), about 47000 surgeries for treatment of morbid obesity were performed in 2001. Last year about 63000 bariatric surgeries were performed and this year an estimated 98000 will be done. The majority of procedures are: Roux-en-Y gastric bypass, stapled gastroplasty, and adjustable gastric banding—all of which are designed to reduce stomach size and thus control calorie intake ( JAMA. 2002;288:2793-2796). The NIH criteria for obesity surgery eligibility are a well informed and motivated patient with a body mass index (BMI) of greater than 40, or a patient with less severe obesity (BMI greater than 35) who has high-risk, comorbid conditions such as type 2 diabetes and cardiopulmonary problems.
Data linkage is useful in setting up a register
Authors: H. Howie, A. F Bisset
Journal: BMJ (1996)

The risk and consequences of salmonella infection in sickle cell disease are well established, though patients' susceptibility to this micro-organism remains unexplained.Simple preventive measures, however, may limit exposure to the micro-organism.We recommend that all patients with sickle cell disease who develop diarrhoea are investigated for infection with Sal- monella spp and given antibiotics.If Gram negative bacteraemia is found to be present an antibiotic that is effective in salmonella infection should be started.Other measures to reduce the risk of salmonellosis-for example, the provision of education about scrupulous food hygiene and information on food sources of salmonellashould also be taken.
National pneumococcal vaccination programmes for children in Europe, 2001-2007: update from Ireland
Authors: S Cotter
Journal: Eurosurveillance (2009)

Preview this article: National pneumococcal vaccination programmes for children in Europe, 2001-2007: update from Ireland, Page 1 of 1 < Previous page | Next page > /docserver/preview/fulltext/eurosurveillance/14/18/art19201-en-1.gif
Abstract 9361: Role of 3 D Speckle Tracking Echocardiography to Detect Left Ventricular Dysfunction. Initial Experience in a Routine Clinical Laboratory
Authors: Samir Saha, Anatoli Kiotsekoglou, Rena Toole, Aasha S Gopal
Journal: Circulation (2011)

Background: Left ventricular (LV) volumes and strain obtained by 3D speckle tracking echocardiography requires investigation to assess the relative discriminatory power of one over the other that has not been studied in a clinical laboratory, thereby justifying the rationale of this study. Methods: 38 human subjects with normal echocardiogram and 88 subjects (58 ±14 years, 53 M) with abnormal echocardiogram (structural and/or coronary artery disease) underwent 3 D speckle tracking echocardiography (3D-STE) using a custom SW (Tomtec). The data obtained were end- systolic and diastolic volumes (ESV, EDV), LVEF, 3D strain, 3D circumferential strain (CS %) and 3D radial strain (RS %). Objective of the study was to assess the comparative diagnostic power of the 3D STE data to identify diseased LV. Results: ROC analyses yielded areas under the curve (AUC) values for ESV (0.85), LVEF (0.84),3D strain ( 0.81), 3D RS%( 0.79), 3D CS%( 0.76), and EDV ( 0.76). Pairwise comparison of the AUC showed that ESV had a significantly greater AUC than EDV (p&lt;0.0001),and global CS% (p&lt;0.05). LVEEF was however superior to GCS% ( p&lt;0.01). 3D strain differed from global CS% (p&lt;0.05) as well. 3D- LVEF could be predicted from linear regression equation using both 3D global strain (y = 6.8376 + -1.2022 x, R2= 0.78, P&lt;0.0001) as well as by 3 D circumferential strain (y = 16.2762 + -1.3113 x, R2 = 0.78, P&lt;0.0001). Conclusions: The association of LVEF with the strain indicates the validity of 3 D strain as a possible surrogate for LVEF with a fairly acceptable regression value. The data also suggest that 3D STE is a robust technique and that the volumetric parameters (ESV, LVEF) appear to be more powerful to discriminate normal from abnormal LV compared with 3D-STE strain obtained from multiple myocardial vectors.
GPIHBP1, the Endothelial Cell Transporter for Lipoprotein Lipase
Authors: Stephen G. Young
Journal: Circulation (2011)

The discovery, by Drs. Beigneux, Fong, and Young, of severe chylomicronemia in GPIHBP1-deficient mice reignited interest in the lipolytic processing of triglyceride-rich lipoproteins. GPIHBP1 is a glycophosphidylinositol-anchored protein expressed exclusively in capillary endothelial cells, and it binds lipoprotein lipase (LPL) avidly. GPIHBP1 has two noteworthy protein domains, an amino-terminal acidic domain and a cysteine-rich Lymphocyte antigen 6 (Ly6) domain, and both are important for binding LPL. The localization of GPIHBP1 in capillaries, along with its ability to bind LPL, initially prompted speculation that GPIHBP1 served as an LPL binding site within the capillary lumen (creating “a platform for lipolysis”). More recent studies have identified a second and more intriguing role for GPIHBP1—picking up LPL in the subendothelial spaces (where it is secreted by myocytes and adipocytes) and then transporting it across endothelial cells to the capillary lumen, where it acts to hydrolyze the triglycerides within the plasma lipoproteins. Over the past few years, significant progress has been made in defining the amino acids within LPL and GPIHBP1 residues that are important for GPIHBP1–LPL interactions. Also, the human genetics of chylomicronemia has come into sharper focus. Some cases of chylomicronemia in humans are caused by mutant GPIHBP1 proteins that lack the ability to bind LPL, and others are caused by mutant LPL proteins that lack the ability to bind to GPIHBP1. The discovery of GPIHBP1 as the LPL transporter is a significant development in our understanding of lipoprotein physiology, and one that should lead to a vastly improved understanding of triglyceride metabolism and hyperlipidemia.
Familial association between attention deficit disorder and anxiety disorders
Authors: J Biederman, S V Faraone, K Keenan, R Steingard, M T Tsuang
Journal: American Journal of Psychiatry (1991)

This study tested hypotheses about patterns of familial association between attention deficit disorder (ADD) and anxiety disorders among 356 first-degree relatives of 73 clinically referred children with ADD and 26 normal comparison children. Through structured diagnostic interviews with trained raters, relatives were assessed for adult and childhood psychopathology. After stratifying the sample of ADD probands into those with anxiety disorders and those without, the authors examined patterns of aggregation of ADD and anxiety disorders in the relatives of these probands as well as in the relatives of the normal comparison subjects.Familial risk analyses revealed that 1) familial risk for anxiety disorders was higher among all ADD probands than among the normal subjects; 2) familial risk for ADD was similar in the relatives of the ADD probands and of the probands with ADD and anxiety disorder; 3) the relatives of the ADD probands with and without anxiety disorders were at greater risk for ADD than the relatives of the normal subjects; 4) the risk for anxiety disorders was two times higher in the relatives of the probands who had ADD with anxiety disorder than in those of the ADD probands without anxiety disorders; and 5) there was a tendency for ADD probands' relatives who themselves had ADD to have a higher risk for anxiety disorders than ADD probands' relatives who did not have ADD (cosegregation).The results were most consistent with the hypotheses indicating that ADD and anxiety disorders segregate independently in families.
Cryptosporidiosis in England and Wales: prevalence and clinical and epidemiological features. Public Health Laboratory Service Study Group.
Authors: S. R. Palmer, A. H. Biffin
Journal: BMJ (1990)

In a two year study carried out by 16 public health laboratories in England and Wales 62,421 patients with presumed infective diarrhoea were investigated. Cryptosporidium infection was identified in 2% (1295), ranging from 0.5% to 3.9% among laboratories. The positivity rate for cryptosporidium was highest in 1-4 year olds, and in children cryptosporidium was the second commonest pathogen after campylobacter. Illness was usually limited to abdominal cramps and watery diarrhoea with six motions/24 hours at worst and lasting seven days. Fewer than half the patients reported fever or vomiting. More severe illness with fever, abdominal cramps, vomiting, and watery diarrhoea of frequency greater than five motions in 24 hours was reported by only a tenth of cases but with a significantly increased prevalence in young adult males. One hundred and fifty five patients (12%) probably acquired their infection abroad; 102 (9%) of patients who acquired their infection at home reported drinking raw milk in the month before onset, and 253 (22%) reported close contact with farm animals. Most laboratories experienced sudden infrequent increases in incidence in the community, only one of which was attributed to a recognised outbreak, which occurred in a nursery. Cryptosporidium should be routinely sought by laboratories investigating acute infectious diarrhoea, especially in children; up to a quarter of cases may be directly zoonotic, and the remainder may be due to person to person spread and waterborne infection.
Abstract 2892: Inhibition of Toll-like Receptor-2 May Limit Cardiac Dysfunction After a Myocardial Infarction by Reducing Apoptosis via a p38 MAPK-dependent Pathway
Authors: Brenda B Su, Zhuo Sun, Hiroko Fujii, Jun Wu, Zhihong Li, Richard D Weisel, Terrence Yau, Ren-Ke Li
Journal: Circulation (2007)

Background: Inhibition of toll-like receptors (TLRs) may be a new treatment to prevent congestive heart failure during post-myocardial infarction (MI) surgical interventions. TLR2 knockout (KO) mice provide an opportunity to predict the effects of inhibitors and to establish the mechanisms responsible for their beneficial effects. This study was performed to establish the pathways responsible for myocardial protection in the absence of TLRs after MI. Methods and Results: In vivo study: MI was induced in TLR2 KO and wild-type (WT) C56B/6J mice by anterior coronary artery ligation. Cardiac function was preserved in the KO mice compared to the WT mice (echocardiography demonstrated higher fractional shortening and fractional area change, p&lt;0.05) at 3, 7 and 28 days after the MI. To evaluate the mechanisms responsible for the functional improvements, cardiac cytokine production was measured. TNF-α, IL-1β and IL-6 were significantly decreased in the infarct region of KO compared to WT mice at 3 days post-MI. On day 7, IL-6 production was significantly decreased in the infarct region and TNF-α was decreased in the non-infarcted region of KO compared to WT mice. Phosphorylation of p38 MAPK was prevented, and the number of TUNEL positive nuclei was reduced in the infarct region of KO compared to WT mice. Phosphorylation of Akt was upregulated in the non-infarcted region of KO mice at 3 days after MI. There were no differences in the phosphorylation of ERK or JNK at the same time point. In vitro study: Myocardial fibroblasts were isolated from KO and WT mice, cultured, and then exposed to hydrogen peroxide. Compared to cells from WT mice, cells from KO mice exhibited greater protection (less cell death) and reduced p38 phosphorylation as early as 5 and 15 minutes after hydrogen peroxide stimulation. Conclusions: TLR2 KO mice allow the assessment of the potential benefits of TLR inhibitors. Reducing TLR2 after an infarction will decrease cytokine production and cell death in a p38 MAPK-dependent manner, which in turn will contribute to the preservation of cardiac function. Early inhibition of TLR2 function may represent a new target to prevent heart failure after MI.
Brain morphology in first-episode schizophrenia
Authors: P Nopoulos, I Torres, M Flaum, N C Andreasen, J C Ehrhardt, W T Yuh
Journal: American Journal of Psychiatry (1995)

Neuroimaging studies have provided robust evidence that schizophrenia is associated with structural brain abnormalities. However, the underlying pathophysiology of these changes is still unknown. By evaluating brain morphology early in the course of illness, confounding effects of treatment and duration of illness are minimized. The goal of this study was to evaluate brain structure in patients early in the course of schizophrenia who had received no or minimal neuroleptics.Magnetic resonance imaging was used to evaluate 12 male and 12 female patients experiencing their first episode of schizophrenia (mean duration of psychotic episode = 14 weeks) and 12 male and 12 female normal volunteers equivalent in age, height, and parents' socioeconomic status. A totally automated method was used to analyze scans, yielding volumes of brain tissue and CSF, divided into lobes.The patient group had significantly more total CSF than the comparison subjects. This was accounted for by higher levels of intersulcal CSF as well as ventricular CSF. There were no differences in total volume of brain tissue between the two groups, but patients had a significant regionally specific decrement in frontal lobe tissue compared with the normal subjects.These findings indicate that structural brain abnormalities are present very early in schizophrenia and may not be due to factors such as treatment or chronicity of illness. Rather, since the abnormalities are present near the onset of the illness, a neurodevelopmental mechanism may be suggested.
Abstract 13738: Release Kinetic of Troponin T Measured With a High Sensitive Assay in Patients With Acute Myocardial Ischemia
Authors: Christoph Liebetrau, Holger Nef, Sebastian Szardien, Christian Troidl, Jedrzej Hoffmann, Rixe Johannes, Andreas Rolf, Christian Hamm, Helge Mollmann
Journal: Circulation (2011)
Abstract 1900: Coronary MDCT based Detection of Coronary Stenosis and Plaque in the Assessment of Patients with Acute Chest Pain: Update from ROMICAT I
Authors: Udo Hoffmann, Fabian Bamberg, Sujith Seneviratne, Ian S Rogers, Quynh A Truong, John H Nichols, Michael D Shapiro, Suhny Abbara, Ricardo C Cury, Thomas J Brady, Stephan Achenbach, John T Nagurney
Journal: Circulation (2007)

Objective : To determine CT angiographic patterns of coronary plaque and stenosis and diagnostic test characteristics of these findings to predict ACS in patients presenting with acute chest pain to the emergency department (ED). Methods : We conducted a blinded, prospective, observational cohort study in patients presenting with acute chest pain to the ED between May 2005 and July 2006, who were admitted to the hospital to rule out acute coronary syndrome (ACS) with no ischemic ECG changes and negative initial biomarkers. Contrast-enhanced 64-slice cardiac CT was performed immediately before admission and caregivers were blinded to the cardiac CT results. An expert panel determined the presence or absence of ACS (unstable angina pectoris [UAP], Non-ST-Elevation Myocardial Infarction [MI] according to AHA/ACC criteria). Two independent observers evaluated cardiac CT data sets for the presence of (1) coronary atherosclerotic plaque, and (2) significant coronary artery stenosis (&gt;50%). Results: Of 221 consecutive patients (44% female, mean age 55±12 years), 31 patients had ACS (10 NSTEMI, 21 UAP). The presence of any coronary atherosclerotic plaque could be excluded in 82 patients (37%). None of these subjects was determined to have ACS (Sensitivity and NPV: 100%, (95% CI: 0.91–1.00 and 0.96–1.00; respectively). The presence of a significant coronary artery stenosis could be excluded in 152 subjects (69%). Overall, three of these patients had ACS during the index hospitalization (NPV, 98 %; 95% CI: 0.94–1.00). In 69 patients (31%), a significant stenosis was either detected or could not be completely excluded. Among them were 28/31 patients with ACS (specificity: 78%, 95% CI: 0.72– 0.84; PPV: 41% 95% CI: 0.29 – 0.53). Conclusions : These data extend initial observations that nearly 40% and 70% of patients with acute chest pain demonstrate no detectable CAD or no significant coronary artery stenosis on cardiac MDCT, respectively. Randomized diagnostic trials are warranted to determine how this information will be used by ED physicians and whether it will decrease the number of unnecessary admissions.
Abstract 20967: Decreased Arylesterase Activity is Associated with Adverse Outcomes in Outpatients with Heart Failure
Authors: Andreas P Kalogeropoulos, W.H. Wilson Tang, Vasiliki V Georgiopoulou, Athanasios Anadiotis, Constantina Masoura, Kunal Bhatt, Lucy Fike, Sandra B Dunbar, Grigorios Giamouzis, Andrew Smith, Stan L Hazen, Javed Butler
Journal: Circulation (2010)

Introduction: Decreased arylesterase (ArylE) activity of paraoxonase-1, a HDL-associated protein with anti-inflammatory and antioxidant properties, has been associated with increased risk for cardi...
Abstract 2512: Knowledge and Self-Management Behaviors of Patients with Recently Detected Atrial Fibrillation
Authors: Pamela J McCabe, Shauna Schad
Journal: Circulation (2006)

Background: At least 2.3 million people have been diagnosed with atrial fibrillation (AF). Because AF primarily affects the elderly, cases of AF will double in 50 years. AF is a major cause of stro...
Disaster at Buffalo Creek. Family and character change at Buffalo Creek
Authors: J L Titchener, F T Kapp
Journal: American Journal of Psychiatry (1976)

Psychiatric evaluation teams used observations of family interaction and psychoanalytically oriented individual interviews to study the psychological aftereffects of the 1972 Buffalo Creek disaster, a tidal wave of sludge and black water released by the collapse of a slag waste dam. Traumatic neurotic reactions were found in 80% of the survivors. Underlying the clinical picture were unresolved grief, survivor shame, and feelings of impotent rage and hopelessness. These clinical findings had persisted for the two years since the flood, and a definite symptom complex labeled the "Buffalo Creek syndrome" was pervasive. The methods used by the survivors to cope with the overwhelming impact of the disaster--first-order defenses, undoing, psychological conservatism, and dehumanization--actually preserved their symptoms and caused disabling character changes.
Comparison of buprenorphine and methadone in the treatment of opioid dependence
Authors: E C Strain, M L Stitzer, I A Liebson, G E Bigelow
Journal: American Journal of Psychiatry (1994)

This study compared the efficacy of buprenorphine and methadone in the treatment of opioid dependence.Participants (N = 164) were relatively treatment-naive, opioid-dependent applicants to a 26-week treatment program who were randomly assigned to either methadone or buprenorphine treatment. Dosing was double-blind and double-dummy. Patients were stabilized on a regimen of either methadone, 50 mg, or buprenorphine, 8 mg, with dose changes possible through week 16 of treatment. Urine samples were collected three times a week, and weekly counseling was provided.Buprenorphine (mean dose = 8.9 mg/day) and methadone (mean dose = 54 mg/day) were equally effective in sustaining retention in treatment, compliance with medication, and counseling regimens. In both groups, 56% of patients remained in treatment through the 16-week flexible dosing period. Overall opioid-positive urine sample rates were 55% and 47% for buprenorphine and methadone groups, respectively; cocaine-positive urine sample rates were 70% and 58%. Evidence was obtained for the effectiveness of dose increases in suppressing opioid, but not cocaine, use among those who received dose increases.The results of this study provide further support for the utility of buprenorphine as a new medication in the treatment of opioid dependence and demonstrate efficacy equivalent to that of methadone when used during a clinically guided flexible dosing procedure.