tbuckley/cabot-search huggingface dataset:
Will improved clinical information help realise the new NHS ?
Authors: J. C Wyatt
Journal: BMJ (1998)

In 1995 the Audit Commission urged the NHS to revise its information systems, changing their goal from managing financial data to improving clinical information.1 In his foreword to the white paper Tony Blair promises “a new NHS information superhighway that links GP surgeries to any specialist centre in the country,” and we are invited to judge progress towards the new NHS by the efficiency of this highway and the NHS direct information service for the public. Suddenly, improved clinical information is central to modernising the NHS, facilitating integrated care, and ensuring that NHS organisations focus on quality and clinical accountability, or “governance.”

The 1 shows the new information services and flows underlying the new NHS, the main innovations being the following.



Proposed additional clinical information flows in the new

NHS



NHS Direct patient information service —This help line should ensure a more informed public—a key feature of 21st century health care2 —by providing “immediate, convenient access to advice and information.” Free …
Abstract 18484: Cardiovascular Progenitors Derived from Induced Pluripotent Stem Cells (iPS) -- A Promising Cell Source for Myocardial Restoration
Authors: Christina Mauritz, Andreas Martens, Sebastian Rojas, Tilman Schnick, Robert Zweigerdt, Axel Haverich, Ulrich Martin, Ingo Kutschka
Journal: Circulation (2010)
Abstract 14546: Contemporary Pre-Hospital Management of Acute Coronary Syndromes Patients: Results From the EPICOR Asia Study
Authors: Yong Huo, Stephen Wai-Luen Lee, Jitendra Pal Singh Sawhney, Hyo-Soo Kim, Rungroj Krittayaphong, Vo Thanh Nhan, Angeles Alonso, Nobuya Hayashi, Lin Zhang, Ya Ling Han, Junbo Ge, Chee Tang Chin, Tiong Kiam Ong
Journal: Circulation (2013)

Purpose: Little is known about current pre-hospital management in acute coronary syndromes (ACS) patients in Asia. In this study we describe baseline pre-hospital management patterns of ACS patient...
Abstract 3381: Usefulness of Carperitide as an Adjunctive Therapy for Acute Myocardial Infarction in Patients with Chronic Kidney Disease -Subgroup Analysis of J-WIND-ANP trial
Authors: Masanori Asakura, Jiyoong Kim, Hiroshi Asanuma, Masafumi Myoishi, Osamu Seguchi, Yasunori Shintani, Hitonobu Tomoike, Masafumi Kitakaze
Journal: Circulation (2007)

Background Chronic kidney disease (CKD) is highly prevalent in patients with cardiovascular disease. Recent investigation suggests that nesiritide (human brain natriuretic peptide) increases the risk of worsening renal function in patients with acute heart failure, whereas carperitide (human atrial natriuretic peptide) has beneficial effects on renal function. Methods We evaluated the usefulness of carperitide as an adjunctive therapy for acute myocardial infarction (AMI) in 158 patients with low eGRF (&lt;60ml/min) estimated by the modified MDRD equation in J-WIND-ANP trial. Of 158 patients, 78 received carperitide (67±9 years old, male 54 patients) and 80 received placebo (67±9 years old, male 54 patients). Other risk factors such as hypertension, diabetes mellitus, and smoking were comparable between two groups. There was no difference in elapsed time between carperitide group (3.6hr 95%CI 3.0hr–5.9hr) and placebo group (3.5hr 95%CI 2.5hr-5.5hr). We analyzed the effects of carperitide on AUC of CK, ejection fraction (EF) at 6 months, and cardiac events. Results Carperitide administration reduced AUC of CK compared with placebo (carperitide group 65,040 mg/dl vs placebo group 79,286 mg/dl, p&lt;0.05). Carperitide increased EF at 6 months after the onset of AMI compared with placebo (carperitide group 48.1±7.6% vs placebo group 44.0±10.0%, p&lt;0.05). We found no significant difference in total death, cardiac events and reperfusion injury between both groups. Conclusions Carperitide reduced infarct size and improved chronic left ventricular function in AMI patients with CKD. These results suggest that carperitide is useful as an adjunctive therapy for AMI in AMI patients with CKD.
Targeted proteomics signature identifies corticosteroid binding globulin peptides as highly predictive of treatment response in IL28B unfavorable genotype patients
Authors: Susanna Naggie, Anu Osinusi, Tiffany Himmel, Joseph Lucas, J. W. Thompson, Laura G. Dubois, Martin A. Moseley, Paul J. Clark, Shyam Kottilil, Keyur Patel
Journal: Hepatology (2012)
Abstract 14019: Nucleostemin is Induced by Pim-1-Mediated c-Myc Stabilization That Enhances Regenerative Potential and Survival of Cardiac Progenitor Cells
Authors: Nirmala Hariharan, Daniele Avitabile, Christopher T Cottage, Mark A Sussman
Journal: Circulation (2011)

Myocardial regeneration and repair in response to injury is governed by cell survival and proliferation. Signaling molecules and pathways mediating enhanced survival and proliferation are of signif...
Abstract 65: Using Percutaneous Cardiopulmonary Bypass in Patients with Cardiac Arrest Caused by Accidental Hypothermia
Authors: Katsutaka Hashiba, Kazuo Kimura, Yoshio Tahara, Toshiaki Ebina, Kiyoshi Hibi, Tsukahara Kengo, Jun Okuda, Masami Kosuge, Takayuki Kosuge, Hiroshi Toyoda, Shinju Arata, Yoshihiro Moriwaki, Noriyuki Suzuki, Mitsugi Sugiyama, Satoshi Umemura
Journal: Circulation (2006)
Abstract 1592: Electrical Stimulation of LV Fibroblasts Causes Frequency-Dependent Modulation of Matrix Metalloproteinase Release and Increase in Tissue Inhibitors of Metalloproteinases
Authors: Rupak Mukherjee, Nina J Sheats, Shenikqua Bouges, Eileen I Chang, Robert E Stroud, Paul J McDermott, Francis G Spinale
Journal: Circulation (2008)

LV fibroblasts (LVMFs), which form a cellular netwrork throughout the myocardium including electrical connectivity to myocytes, are a primary cell type that contributes to remodfeling of the extracellular matrix through the synthesis of matrix metalloproteinases (MMP) and tissue inhibitors of the MMPs (TIMPs). While cytokines and other signaling molecules can induce MMP and TIMP synthesis and release from LVMFs, whether and to what degree LVMFs respond to changes in electrical stimulation with respect to modulation of MMP/TIMP release remains unknown. Porcine LVMFs were grown to confluence, serum deprived for 24 hours, and then randomized to electrical stimulation (6x10 5 cells/well, 130V 5ms pulses) for 24 hours at 1, 2, and 4 Hz (n=6 wells/frequency). Unstimulated cells (0 Hz) served as controls. Electrical stimulation had no effect on LVMF morphology. Cell media and pellets were collected for levels of MMP-2, MMP-9 (zymography), MT1-MMP, and TIMP-4 (immunoblotting). Changes in MMP and TIMP levels with stimulation are reported as a percentage of unstimulated values (TABLE ). MMP-2, MMP-9, and TIMP-1 levels were higher than unstimulated levels at 2 and 4 Hz. MT1-MMP levels were lower than unstimulated levels at 1 and 2 Hz. Ratios for each of the MMPs to TIMP-1 were computed (TABLE ). While the MMP-2/TIMP-1 and MMP-9/TIMP-1 ratios remained similar to unstimulated values, the MT1-MMP/TIMP-1 ratio was lower than unstimulated values at 1 and 2 Hz. The unique findings of this study are two-fold. First, in vitro electrical stimulation of LVMFs, which are generally considered to be electrically inert, resulted in demonstrable changes in the release of specific MMP and TIMP species. Second, the reduced MT1-MMP to TIMP-1 ratio suggests electrical stimulation of LVMFs caused a shift in the stoichiometric balance between MMPs and TIMPs that may favor accumulation of extracellular matrix components.
Abstract 2542: Early Rhythm Control Strategy by Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation: The 4-year Results of a Randomized Follow-up Study Comparing Catheter Ablation and Antiarrhythmic Drug Therapy: The APAF 2 Study
Authors: Vincenzo Santinelli, Andrea Radinovic, Gabriele Vicedomini, Giuseppe Ciconte, Giuseppe Augello, Simone Sala, Alessia Pappone, Massimo Saviano, Cristiano Ciaccio, Simone Gulletta, Patrizio Mazzone, Carlo Pappone
Journal: Circulation (2009)
Management of preterm labour
Authors: D N M Papatsonis, H P van Geijn, G A Dekker, P. Steer
Journal: BMJ (1999)

Editor—Steer and Flint stated in their article in the ABC of labour care that the use of sympathomimetics is generally the safest choice for the mother and the fetus and that calcium channel blockers cause significant hypotension.1 We disagree with this.

In studies in pregnant women nifedipine has minimal cardiovascular and metabolic effects during clinical use, in contrast with β2 sympathomimetics such as ritodrine.2 Nifedipine in the management of preterm labour is associated with significantly fewer maternal side effects than ritodrine.3,4 In our study we never had to stop treatment in the nifedipine group because of severe maternal side effects, whereas we did in 12 patients in the ritodrine group.3 No patients in the nifedipine group had hypotension while receiving treatment. Two patients in the ritodrine group had such changes on the electrocardiogram that the drug had to be stopped; this did not occur in any of the patients in the nifedipine group.

In our opinion, nifedipine is a safe and effective firstline tocolytic agent.
Abstract 2029: The Incidence, Predictors and Outcome of New Lesions Treated With Percutaneous Coronary Intervention in Patients Presenting with Myocardial Infarction
Authors: Gilles Lemesle, Axel de Labriolle, Laurent Bonello, Probal Roy, Daniel H Steinberg, Tina L Pinto Slottow, Rebecca Torguson, Kimberly Kaneshige, Zhenyi Xue, William O Suddath, Lowell F Sattler, Kenneth M Kent, Joseph Lindsay, Augusto D Pichard, Ron Waksman
Journal: Circulation (2008)

Patients presenting with ST elevation myocardial infarction (STEMI) often require percutaneous treatment of lesion not targeted at the time of the primary percutaneous coronary intervention (PCI). This study aimed to detect the incidence, predictors and outcome of recurrent PCI that was not staged and not related to the initial treatment of the STEMI. Between January 2003 and December 2005, 1007 consecutive patients presenting with a STEMI were screened. Of these 94 (10.5%) pts returned within 36 months for a second PCI, not planned and not related to the index procedure at the time of the primary PCI. The baseline and the angiographic features of these patients were compared to 913 patients who did not require a subsequent PCI. Patients who were subjected for subsequent PCI were followed clinically for additional 12 months for major adverse cardiovascular events (MACE) including death, MI and target lesion revascularization (TLR). The median time to the second PCI was 396 days. The clinical presentation at the time of the recurrent PCI was a non-ST-elevation ACS in 46.1% and a new ST elevation in 9.7%. Independent predictors of recurrent PCI occurrence are detailed in the table . At 1 year after the recurrent PCI, there were 9 (9.6%) deaths, 4 Q-Wave MI (4.3%), 4 TLR (4.3%) and 17 MACE (18%). Following STEMI, nearly 10% of patients experiencing a cardiac event that requires subsequent unplanned PCI unrelated to the initial PCI. Patients with diabetes and peripheral vascular disease are at high risk to develop such an event which is associated with high mortality and morbidity. Aggressive preventive and medical management should be applied to this population for prevention of these subsequent events. Table: Independent predictors of recurrent PCI by multivariate Cox analysis.
Functional Recovery After Acute Myocardial Infarction
Authors: Robin Nijveldt, Aernout M. Beek, Alexander Hirsch, Martin G. Stoel, Mark B.M. Hofman, Victor A.W.M. Umans, Paul R. Algra, Jos W.R. Twisk, Albert C. van Rossum
Journal: Journal of the American College of Cardiology (2008)
Abstract 12996: Atherogenic Lipoprotein Particle Size and Number Despite Normal Lipid Profiles in Psoriasis
Authors: Parasuram Krishnamoorthy, YiDing Yu, Jules Antigua, Anna Raper, Amanda Baer, Stephanie Derohannessian, Mackenzie Wilcox, Abby S. Van Vorohees, Joel M Gelfand, Nehal N Mehta
Journal: Circulation (2011)

Introduction: Psoriasis is a chronic inflammatory skin disease associated with increased risk of myocardial infarction (MI). Advanced lipoprotein biomarkers measured by nuclear magnetic resonance (...
Fortnightly review: Polymyalgia rheumatica and temporal arteritis: diagnosis and management
Authors: A J Swannell
Journal: BMJ (1997)

Polymyalgia rheumatica and temporal arteritis are regarded as clinical syndromes affecting elderly people. They may occur in the same patient, producing constitutional symptoms with increased acute phase reactants. Both syndromes respond rapidly to corticosteroids, and in both syndromes temporal artery biopsy may show arteritis with giant cells (biopsy proved giant cell arteritis). The syndromes are considered to be different manifestations of giant cell arteritis. Dixon et al obtained 10 positive temporal artery biopsy samples in 29 patients with polymyalgia rheumatica.2

The incidence of temporal arteritis, whether diagnosed clinically alone or confined to biopsy proved cases, varies geographically. The disease is almost always confined to white people, and the incidence is higher in Scandinavia and northern Europe (between 17 and 18 cases per 100 000 population aged over 50)1 3 4 than in middle France, Spain,4 and Israel.5

The incidence of polymyalgia rheumatica alone is more difficult to determine. Salvarini et al studied the incidence of polymyalgia rheumatica in northern Italy and found a figure of 12.7 cases/100 000 population aged over 50.6 By contrast, studies from Sweden and Denmark using the same definition of polymyalgia rheumatica obtained figures of 20.47 and 68.3/100 000.1

Giant cell arteritis rarely presents below the age of 50.8 It affects many arteries throughout the body, producing symptoms and signs which mimic many other medical and surgical conditions.

Jones has suggested a useful classification of the presenting symptoms of giant cell arteritis9:

1.  Systemic –malaise, anorexia, fever, night sweats, weight loss, and depression

2.  Myalgic –proximal, symmetrical muscle pain and stiffness of polymyalgia rheumatica

3.  Arteritic –involvement of the artery may produce:


 

1.  Pain, swelling, erythema, and tenderness over the affected artery

2.  Partial occlusion resulting in “claudication-like” symptoms

3.  Total occlusion resulting in ischaemia and necrosis of structures supplied by the …
PCA3: A urine-based genetic assay for detection of prostate cancer in men with elevated PSA
Authors: K. Drewnowska, E. D. Crawford, J. Qian, S. Varvel, M. Wilk, L. Mason, J. Kaminetsky, T. K. Huisman, M. Bilowus, S. J. Freedman, D. G. Bostwick
Journal: Journal of Clinical Oncology (2009)

5054 Background: Currently, early detection of prostate cancer relies primarily on an abnormal digital rectal examination (DRE) and an elevated prostate-specific antigen (PSA) level leading to a prostate biopsy. However, because of low positive predictive values, up to 75% of men with elevated PSA and/or suspicious DRE have a negative biopsy. We investigated the value of a new molecular marker–PCA3 in predicting the likelihood of prostate cancer. Methods: We undertook a prospective, multi-practice, community-urologist-based, and IRB approved clinical trial to evaluate PCA3. Urine samples were obtained from 974 men with elevated serum PSA (&gt; 2.5ng/ml) and/or abnormal digital rectal examination prior to routine minimum 10-core prostate biopsy following standard study protocol in 30 medical practices. Urine samples were processed within 48 hours of collection. PCA3 and PSA mRNA were isolated, amplified and quantified by magnetic target capture, transcription-mediated amplification, and chemiluminescent hybridization protection assay technologies. The PCA3 value was determined using the ratio of PCA3 mRNA copy number to the PSA mRNA copy number multiplied by 1,000. Results: In total, 380 of 974 patients (39%) were diagnosed with prostate cancer, with a mean Gleason score of 7 (range, 6–9) and 26% (range 1–100%) of the biopsy specimens involved by cancer. An additional 106 cases (11%) had only high-grade PIN and/or atypical small acinar proliferation suspicious for cancer (ASAP), and 488 cases (50%) were benign. The mean PCA3 value in men with prostate cancer was significantly higher than in those without cancer (48 vs. 26, p &lt; 0.0001). PCA3 score was associated with the presence of cancer (p &lt; 0.0001) and Gleason score (p = 0.0001), but was not associated cancer volume (p = 0.56). Using a cutoff value of 35, PCA3 had an odds ratio of 2.6 for predicting prostate cancer. PCA3 had a specificity of 77% and a sensitivity of 44% for the diagnosis of prostate cancer, while the specificity and sensitivity for serum PSA were 22% and 87%, respectively. Conclusions: We found that the PCA3 urine test significantly improved the specificity for the detection of prostate cancer compared to serum PSA. Further evaluation of this urinary marker in screening for prostate cancer appears indicated. No significant financial relationships to disclose.
The Pulmonary-Alveolar Macrophage
Authors: William G. Hocking, David W. Golde
Journal: New England Journal of Medicine (1979)

(Second of Two Parts)Immunologic Functions of the Pulmonary-Alveolar Macrophage (PAM)The PAM functions importantly in pulmonary defense by participating in specific immunologic reactions and by interacting with other components of the immune system. The composition of the bronchoalveolar lymphoid system has been studied by means of bronchopulmonary lavage. These washings contain lymphocytes with T and B-surface markers as well as lymphocytes with "null" characteristics.111 112 113 114 In one study of human subjects, T cells comprised 47 per cent of the bronchial lymphocyte population, B cells 19 per cent and null cells 34 per cent.111 Human bronchopulmonary-lavage fluid contains IgA (both 11S . . .
Abstract 1323: Proangiogenic Properties of QK, a Peptide Mimicking VEGF/KDR Binding Interface
Authors: Michele Ciccarelli, Alfonso Campanile, Gaetano Santulli, Gennaro Galasso, Luca D'Andrea, Annarita Del Gatto, Giovanna Giuseppina Altobelli, Vincenzo Cimini, Federico Piscione, Bruno Trimarco, Guido Iaccarino
Journal: Circulation (2006)
Altered Na+Currents in Atrial Fibrillation
Authors: Samuel Sossalla, Birte Kallmeyer, Stefan Wagner, Marek Mazur, Ulrike Maurer, Karl Toischer, Jan D. Schmitto, Ralf Seipelt, Friedrich A. Schöndube, Gerd Hasenfuss, Luiz Belardinelli, Lars S. Maier
Journal: Journal of the American College of Cardiology (2010)
Abstract 2797: Progression of Coronary Artery Disease as Assessed by Serial 64-Slice Contrast Enhanced Computed Tomography
Authors: Sam J Lehman, Fabian Bamberg, Christopher L Schlett, Hang Lee, Leon Shturman, Patrick M Donnelly, Ian S Rogers, Thomas J Brady, Udo Hoffmann
Journal: Circulation (2008)

Volumetric methods to quantify coronary atherosclerotic plaque suffer from high measurement variability, limiting the assessment of plaque progression. We propose a novel semi-quantitative assessment of coronary plaque and determined the rate and predictors of progression in patients with acute chest pain within 2-years. We included 69 patients (mean age 55±12 years, 59% male) from the Rule-Out Myocardial Infarction using Computer Assisted Tomography (ROMICAT) trial who underwent 64-slice coronary CT at baseline and after 2-years (24±3 months). At baseline and follow-up CT, 1-mm cross-sections of the proximal 40 mm of each major coronary artery were reconstructed and assessed for the presence of calcified and non-calcified plaque by two blinded observers. We determined inter- and intra-observer agreement, number of cross-sections with plaque, significance of plaque progression using paired t-test, and predictors of plaque progression over time (adjusted for age and gender) using longitudinal regression analysis. Intra- and inter-observer agreement (k=0.95 and k=0.93) was excellent. At baseline, any plaque, calcified plaque, and non-calcified were detected in 12.5%, 10.1%, and 4.4% of cross-sections per patient. There was significant progression in the mean number of cross section containing any plaque (16.5±25.3 versus 18.6±25.5, p=0.01) and non-calcified plaque (3.1±5.8 versus 4.4_7.0, p=0.04), and no significant increase in calcified plaque (13.3±23.1 versus 14.2±22.0, p=0.2). In unadjusted longitudinal regression models age, male gender, hypertension, hyperlipidemia, smoking, history of CAD, Framingham risk score, and the presence of baseline plaque were significantly associated with plaque progression (P&lt;0.05). After adjustment for age, gender and the follow up time interval, the presence of baseline plaque and smoking were independently associated with increase in plaque progression (P&lt;0.05). We introduce a highly reproducible method to quantify coronary plaque that is able to detect progression over a 2-year follow up period. Increase in plaque was associated with known cardiovascular risk markers.
Abstract 17945: Abnormal Left Ventricular Torsion Assessed by Speckle Tracking Echocardiography in Orthotopic Heart Transplant Patients as Early Predictor of the Acute Myocardial Rejection
Authors: Nishant Kalra, Vincent L Sorrell, Dipak B KC, Aiden Abidov
Journal: Circulation (2011)

Background LV torsion is a critical aspect of cardiac biomechanics and hold promise for better understanding the ventricular dysfunction. The aim of this study was to determine whether LV torsion assessed by 2D-speckle tracking imaging can predict rejection in transplanted hearts. Methods From Oct 2010 to Feb 2011, patients who had transplant and underwent echocardiogram as well as RV biopsies in our Center, were analyzed. The echocardiograms and RV biopsies were done within 3 days of each other. Patients who did not have any prior cardiac surgeries or valvular heart disease were analyzed for comparison (controls). Torsion measurements were performed off-line using commercially available software. Basal and apical short-axis views were used for measurement of torsion. LV torsion was calculated as (apical LV rotation minus basal LV rotation)/LV diastolic longitudinal length. By speckle tracking echocardiography, global longitudinal strain was also calculated in all the patients. LVEF was assessed using modified Simpson's method. Patients with incomplete data were excluded. Results 14 transplant patients were compared with 6 matching controls. 4 transplanted patients had a biopsy-confirmed rejection. Torsion, global strain and LVEF were all reduced in patients with rejection as compared to those without rejection and with controls. When mean value of torsion in controls was applied as a normal threshold to the study population, 75% (3/4) of the patients with rejection had an abnormal torsion despite normal LVEF. Torsion analysis provided a sensitivity and specificity of 75% and 70% for detecting rejection in transplant patients. Conclusion To our knowledge this is the first study to demonstrate the value of LV torsion in predicting rejection in patients post heart transplant. In patients with rejection, abnormal LV torsion at initial presentation can be utilized as an early non-invasive predictive marker to help in identification of these patients.
Inhibition of p38 Mitogen-Activated Protein Kinase Attenuates Vascular and Systemic Inflammation in Patients with Atherosclerosis as Assessed by 18-F Fluorodeoxyglucose PET-CT
Authors: Maysoon Elkhawad, James H Rudd, Lea Sarov-Blat, Mike Marber, Robin P Choudhury, L C Davies, David J Collier, Gengqian Cai, Robert N Willette, Fergus V Gleeson, John J Lepore, Bill Davis, Ian B Wilkinson, Dennis L Sprecher, Joseph Cheriyan
Journal: Circulation (2010)

Macrophage infiltration and associated cytokines, growth factors and metalloproteinases feature prominently in inflamed atherosclerotic plaque, accompanied by activation of p38 mitogen-activated pr...
Abstract 1932: The Effects of Respiration and Ventricular Diastolic Function on the Fontan Circulation: An Analysis of Pulmonary Artery Pressure Waves
Authors: Keiichi Itatani, Kagami Miyaji
Journal: Circulation (2009)

Background: In Fontan circulation, pulmonary blood flow is thought to be continuous and be “sucked” into a single ventricle. However, pulmonary arterial pressure waves demonstrate complex fluctuati...