tbuckley/cabot-search huggingface dataset:
Long term care for older people
Authors: T. R Dening
Journal: BMJ (2002)

Reducing blood transfusion BMJ 's cover and headline exaggerated importance of study's findingsEditor-The randomised controlled trial on mechanical methods of reducing blood transfusion in cardiac surgery by McGill et al is laudable, but we challenge the BMJ for highlighting this paper on the front cover with the headline: "Cell salvage reduces the need for a transfusion." 1 We believe that the journal has a responsibility not to exaggerate the perceived importance of findings, either in press releases or by other means. 2 The authors themselves highlighted the main limitations of the study in their discussion, and we believe that such declarations are important safeguards against widespread use of the described methods without further scientific evaluation.The authors comment on the high cost of transfusion, but they did not include a cost analysis in their study.We understand the risks associated with transfusion and agree that these in themselves may justify any added cost.However, introducing strict transfusion guidelines and monitoring their use is certainly a step that should precede the introduction of new equipment.We have been reinforcing transfusion guidelines for the past two years in our institution and are continuously monitoring blood transfusion in our hospital.Interestingly, when looking at a similar patient population to that of McGill et al, but lacking the research methods and statistics, we have achieved a similar decrease in use of all blood products, mainly by insuring that blood is transfused only when required and blood products given when need is documented (table).Despite our programme, blood products are still administered too often outside the hospital guidelines, and we think that we could decrease their use even further before introducing new expensive equipment to our routine practice.The BMJ 's cover may only reinforce incorrect practices by encouraging widespread use of techniques without common sense.We agree that the combination of acute normovolaemic haemodilution and cell salvage did not confer any benefit in this study, but McGill et al have not explored acute normovolaemic haemodilution as such and therefore no conclusion can be made with certainty about the absence of benefit of acute normovolaemic haemodilution itself.In the author's own words, this study adds to many others that are inconclusive because of the quality of the evidence.We believe that the BMJ 's cover, while attractive, may have mislead readers, and we therefore question the rationale behind such a decision.
Blood levels and acute response to bupropion
Authors: P J Goodnick
Journal: American Journal of Psychiatry (1992)

Twenty-three patients with major depressive disorder were treated with bupropion in an open-design protocol. Fifteen (65.2%) of the 23 responded with a more than 50% decrease in scores on the Beck Depression Inventory. Patients with trough blood levels of 10-29 ng/ml had a significantly better response than those with trough levels of 30 ng/ml or more. This preliminary result warrants further, double-blind evaluation.
Impact of Blood Transfusion and Other Bleeding Measures on Subsequent Mortality Among Patients Undergoing Primary PCI for Acute Myocardial Infarction: The HORIZONS-AMI Trial
Authors: AJ Kirtane, R Mehran, H Parise, B Witzenbichler, G Guagliumi, JZ Peruga, B Brodie, D Dudek, S Pocock, TC Clayton, Tourkova, GD Dangas, AJ Lansky, GW Stone
Journal: Circulation (2008)
Unacceptable Variation in the Core Diameters of Some ao Type Cancellous Screws
Authors: W J P Radford, J L Pozo, W F G Muirhead-Allwood
Journal: Journal of the Royal Society of Medicine (1988)

This study assesses the variability in core diameter of a series of cancellous screws and its effect on torque strength. Analysis of a series of 107 cancellous screws revealed a wide variation of the core diameters in our sample. Tests to evaluate the effect of this variation showed that torsional strength is directly proportional to the cube of the radius of the core; a 30% reduction in radius resulting in a 70% loss in torsional strength. Conclusions drawn from this experimental data indicate that variability in core dimensions below the recommended specifications is unacceptable in clinical practice.
Asymmetric Dimethylarginine Determines the Improvement of Endothelium-Dependent Vasodilation by Simvastatin
Authors: Gerhild I. Böger, Tanja K. Rudolph, Renke Maas, Edzard Schwedhelm, Ekaterina Dumbadze, Anneke Bierend, Ralf A. Benndorf, Rainer H. Böger
Journal: Journal of the American College of Cardiology (2007)
Abstract 10375: Right (Not Left) Bundle Branch Block is Associated with Large Anteroseptal Infarcts
Authors: David G Strauss, Ronald H Selvester, Galen H Wagner, Zak A Loring, Gary Gerstenblith, Robert G Weiss, Katherine C Wu
Journal: Circulation (2011)

Background: Among patients receiving cardiac resynchronization therapy (CRT), mortality is highest with right bundle branch block (RBBB), intermediate with nonspecific intraventricular conduction d...
Relationship Between Clinical Trial Site Enrollment With Participant Characteristics, Protocol Completion, and Outcomes
Authors: Javed Butler, Haris Subacius, Muthiah Vaduganathan, Gregg C. Fonarow, Andrew P. Ambrosy, Marvin A. Konstam, Aldo Maggioni, Robert J. Mentz, Karl Swedberg, Faiez Zannad, Mihai Gheorghiade
Journal: Journal of the American College of Cardiology (2012)
Abstract 15396: HASF, a Novel Paracrine Stem Cell Factor Protein Stimulates Neonatal Cardiomyocyte Cell Cycle Progression Through PI3K-Akt-CDK7 Pathway
Authors: Farideh Beigi, Jeffrey Schmeckpeper, Pete Pow-anpongkul, J. Alan Payne, Hui Mu, Richard E Pratt, Zhiping Zhang, Maria Mirotsou, Victor J Dzau
Journal: Circulation (2011)

Introduction The regenerative capacity of the mouse heart is lost during the first few days after birth coinciding with withdrawal of cardiomyocytes from cell cycle. Consequently, the adult mammali...
ST-Segment Elevation Myocardial Infarction Resulting From Stent Thrombosis
Authors: Bruce R. Brodie, Charles Hansen, Ross F. Garberich, Joseph A. Browning, Patrick Tobbia, Chauncy B. Handran, M. Nicholas Burke, Hemal Kadakia, Thomas D. Stuckey, Timothy D. Henry
Journal: Journal of the American College of Cardiology (2012)
The Taxes of Sin
Authors: Willard G. Manning
Journal: JAMA (1989)

We estimate the lifetime, discounted costs that smokers and drinkers impose on others through collectively financed health insurance, pensions, disability insurance, group life insurance, fires, motor-vehicle accidents, and the criminal justice system. Although nonsmokers subsidize smokers' medical care and group life insurance, smokers subsidize nonsmokers' pensions and nursing home payments. On balance, smokers probably pay their way at the current level of excise taxes on cigarettes; but one may, nonetheless, wish to raise those taxes to reduce the number of adolescent smokers. In contrast, drinkers do not pay their way: current excise taxes on alcohol cover only about half the costs imposed on others. (<i>JAMA</i>. 1989;261:1604-1609)
Abstract 25: Effect of Thrombolytics on the Immediate Prognosis for Out-of-Hospital Cardiac Arrest
Authors: Aurelien Renard, Daniel Jost, Catherine Verret, Frederique Briche, David Fontaine, Isabelle L Banville, Anne-Celine Martin, Ecole du Val-de-Grâce, Patrick Benner, Andre Spiegel, Claude Fuilla
Journal: Circulation (2007)

Immediate care of out-of-hospital cardiac arrest (CA) is standardized by the established ILCOR ACLS Guidelines. Studies concerning the impact of thrombolysis, generally for CA of cardiac etiology have not shown a benefit. We sought to evaluate the rate of hospital admission for all CA patients treated with pre-hospital thrombolytics. Methods: Non-randomized retrospective study was conducted from 09/1/2005 to 02/15/2007 of non-traumatic CA patients treated with (T+) or without (T-) thrombolysis. The protocol for administration of thrombolytics was at the discretion of the field physician, aiming for within 20 minutes of collapse in almost all cases, and prior to return of spontaneous circulation. The primary endpoint was admission alive to the hospital. We performed multivariate analysis by logistic regression to identify risk factors independently associated with outcome: age, gender, response time, defibrillation, witnessed arrest, bystander CPR. Results: We reviewed 1331 consecutive patient records, of which 116 (8.7%) received thrombolytics. Both T+ and T- groups had comparable response times, witnessed arrest, and bystander CPR. Patients in T+ were significantly younger (59±14 vs 67±19 years old), predominantly males (81% vs 61%), and received more defibrillation shocks (61% vs 26 %). Significantly more patients T+ arrived alive to hospital for admission (45% vs 24%). Risk factors independently associated with hospital admissions were thrombolysis, age, response time, witnessed arrest, and bystander CPR. The impact of thrombolysis was different whether or not the patient was defibrillated (odds ratio with shocks 1.1 [95%CI: 0.2–5.0] vs without shocks 3.6 [95%CI: 1.9 – 6.9]), despite a greater overall rate of hospital admission for shocked patients. Conclusion: Thrombolysis appears to improve the rate of admission alive to the hospital in patients that were not defibrillated with adjustment for age, gender, response time, witnessed arrest, and bystander CPR. These preliminary results should be confirmed by a prospective randomized study. This analysis can help determine appropriate inclusion criteria for a future study.
Abstract 2487: Relationship Between Heart Rate, Blood Pressure and In-hospital Mortality in Patients with Non-ST-segment Elevation Acute Coronary Syndromes: Results in 139,194 Patients
Authors: Sripal Bangalore, Fang-Shu Ou, Jacqueline Tamis-Holland, Matthew T Roe, Franz H Messerli, Eric D Peterson
Journal: Circulation (2006)
Abstract 17709: Central Coronary Venous Troponin Concentrations as a Guide to the Identification of the Culprit Vessel in Multivessel Coronary Artery Disease
Authors: Gilbert E Cramer, Helmut Gehlmann, Wim R Aengevaeren, Hendrik-Jan Dieker, Wessel Keuper, Harry Suryapranata, Freek W Verheugt, Marc A Brouwer
Journal: Circulation (2011)

Background: In patients with non ST elevation acute coronary syndromes (NSTE ACS) culprit vessel identification remains a challenge. Notably, in the FAME trial routine multivessel stenting was not superior to FFR-guided revascularization. We hypothesized that a culprit stenosis in the LAD can be identified because troponin concentrations assessed in the great cardiac vein (GCV) would be higher than elsewhere in the coronary venous tree. In addition, in case of a RCX/RCA culprit we expected the concentration to be higher elsewhere in the coronary venous tree. Methods: we studied 36 consecutive patients with NSTE ACS who underwent early coronary angiography. In case of normal coronary arteries or a total occlusion a patient was excluded. Right sided catheterization and cannulation of the coronary sinus was performed. The catheter was introduced in the GCV with subsequent blood sampling. This procedure was repeated at the orifice of posterolateral vein and the middle cardiac vein. The culprit was assessed by a blinded committee using ECG, echo and coronary angiography. Results: As proof of concept 12 patients with single vessel disease were studied. All 5 with a LAD culprit had the highest troponin concentration in the GCV. In 6/7 patients with a non-LAD culprit the highest concentration was measured distally from the GCV in the coronary venous tree. As a pilot validation set, performed in multivessel disease patients with a definite culprit, the distinction LAD/non-LAD was correct in 14/15. In 9 patients in whom the culprit was unclear, the GCV concentration was highest in two. Conclusion: Despite careful study by a blinded committee, the culprit vessel can not be identified with certainty in ~25% of patients with NSTE ACS using conventional information. Assessment of the troponin concentration in the great cardiac vein can reliably distinguish between LAD and non-LAD culprits. Additional studies will address the diagnostic accuracy with regard to RCX and RCA culprits.
Abstract 3525: Long-term Survival of Ischemic Heart Failure Patients After Cardiac Resynchronization Therapy: Role of Left Ventricular Dyssynchrony, Left Ventricular Lead Position and Myocardial Scar
Authors: Victoria Delgado, Rutger J van Bommel, Matteo Bertini, C Jan Willem Borleffs, Nina Ajmone Marsan, Gaetano Nucifora, Nico R van de Veire, Claudia Ypenburg, Eduard R Holman, Ernst E van der Wall, Martin J Schalij, Jeroen J Bax
Journal: Circulation (2009)

Background: The incremental prognostic value of left ventricular (LV) dyssynchrony, LV lead position and myocardial scar on long-term prognosis after CRT remains unknown. Objectives: To evaluate th...
Abstract 491: Triggered Sarcoplasmic Reticulum Ca Release Mediated By Na-ca Exchanger And Brain Na Channels In Rabbit Ventricular Cells
Authors: Eleonora Savio-Galimberti, Joshua I Goldhaber, John H Bridge
Journal: Circulation (2007)

We tested the hypothesis that sarcoplasmic reticulum (SR) Ca release triggered by cardiac action potentials is significantly affected by Na influx through brain isoforms of the Na channel. These channels are reportedly located in the t-tubules and could therefore activate reverse Na-Ca exchanger (NCX) and contribute to triggered release. In the complete absence of a Na gradient (Li replacement) Ca transients evoked by action potentials were delayed, their upstrokes slowed and their peak values diminished (SR Ca content not depleted under these conditions). Ca spikes recorded under these conditions occurred at significantly lower probability and became asynchronous (see figure ). Tetrodotoxin 200 nM (this concentration selectively blocks brain Na channel isoforms Nav 1.1, 1.3 and 1.6) reduced the magnitude and rate of rise of Ca transients in a way that resembled the effect of removing the Na gradient. We suggest that early activation of brain type Na channels leads to elevation of Na in the dyadic cleft. This causes reverse NCX, which primes the junction with Ca before L-type Ca channels (LCC) have opened. Since the junction has been primed with Ca, short LCC openings can effectively gate ryanodine receptors (RyRs). Because these LCC openings have short latencies and occur with high probability they produce spikes with short latencies at high probability. In the absence of a Na gradient longer LCC openings are required to fill the junction and gate RyRs. These occur with lower probability and greater latency. We conclude that brain Na channels together with NCX significantly increase LCC-RyR coupling fidelity and synchronize spikes.
Buying respectability
Authors: S. Chapman
Journal: BMJ (1996)

Both my approach and that of Sharpe and colleagues recognise that negative mood states and social problems must be dealt with.Another common aspect of management is that emphasis is on a "collaborative rather than an-adversarial approach."A turning point is often when a patient develops confidence and starts to feel able to exert some control over the illness.3At this stage energy levels are higher and activity also increases, but I do not recommend an emphasis on greater activity until a patient feels 80% normal.3I believe that the patients' beliefs about the chronic fatigue syndrome-that it was mainly physical, was caused by a virus, or was myalgic encephalomyelitis-were not a major factor in the improvement of Sharpe and colleagues' patients.It was probably far more important that there was collaboration to deal with the patients' problems with a definite regimen, regular appointments, and clear objectives.
Abstract 2965: QT Interval Prolongation during Severe Acute Rejection is Predictive of Sudden Cardiac Death in Heart Transplant Recipients
Authors: Bojan Vrtovec, Francois Haddad, Vivian Tsai, Amin Al-Ahmad, Tobias Deuse, Michael Pham, Patrick Fisher, William Fearon, Hannah Valantine, Sharon Hunt
Journal: Circulation (2008)

Background. QT interval prolongation is considered a risk factor for sudden cardiac death (SCD) in various non-transplant populations. Since acute allograft rejection is associated with a prolonged QT interval, we sought to investigate the effects of rejection-induced QT interval changes on SCD in heart transplant recipients. Methods. Of all patients who underwent heart transplantation between 1998 and 2007, we enrolled those with severe acute cellular rejection episodes (ISHLT grade 3A or higher, accompanied with hemodynamic compromise). In this cohort, baseline ECGs were obtained within 7 days after transplantation; follow-up ECGs were recorded at the time of the rejection episode. On all ECGs, QT interval was defined as the mean duration QT interval measurements in all leads, and corrected for heart rate with Bazett formula. A significant increase of QTc during rejection (dQTc) was defined as a relative change in QTc ≥10%. Patients were followed for SCD for 1 year after the rejection episode. Results. Of 80 patients with a severe rejection episode, 9 (11%) were excluded because of the inadequate quality of ECG recordings. Within the 1-year follow-up, 21 of 71 (30%) patients died. Of these, 14 (67%) died of SCD, and 7 (23%) died of other causes. Patients who died of SCD and survivors did not differ with regards to age (44 ± 12 years in SCD group vs. 46 ± 16 years in survivors, P = 0.61), gender (male: 83% vs. 58%, P = 0.06), incidence of infections (0.21 ± 0.43 vs. 0.20 ± 0.40, P = 0.91), malignancy (0% vs. 8%, P = 0.84), or allograft vasculopathy (29% vs. 26%, P = 0.85). No difference in Qtc prolonging drug was noted. During acute rejection, QTc interval was significantly longer in SCD group than in survivors (475 ± 57 ms vs. 437 ± 36 ms, P = 0.01), and the same was true for the incidence of dQTc &gt; 10% (50% vs. 16%, P = 0.008). SCD-free survival as evaluated by Kaplan-Meier analysis was significantly lower in patients with dQTc &gt; 10% (P = 0.013). On multivariate analysis, dQTc &gt; 10% was the only independent predictor of SCD (P = 0.02). The multivariate model included left ventricular dysfunction (LVEF &lt; 30%) and dQTc. Conclusion. Heart transplant recipients who display a significant (&gt; 10%) prolongation of QT interval during a severe acute rejection episode may be at increased risk for SCD.
The Wee1 Inhibitor MK1775 In Combination With Cytarabine (AraC) Has Potent Activity In AML By Completely Abrogating DNA Damage and Cell Cycle Checkpoint Repair Capacity Via The Mrn/NBS1 Complex
Authors: Leena Chaudhuri, James M Bogenberger, Lisa Sproat, James L Slack, Veena Fauble, Raoul Tibes
Journal: Blood (2013)
Abstract 5411: Hmgb1 in Ischemia-Reperfusion Injury of the Heart
Authors: Martin Andrassy, Christian H Volz, Benjamin Funke, Sebastian N Eichberger, Ziya Kaya, Frank Autschbach, Sven T Pfleger, Florian Bea, Stefan E Hardt, Marco E Bianchi, Peter P Nawroth, Andrew Remppis, Hugo Katus, Angelika Bierhaus
Journal: Circulation (2008)
Abstract 5647: Autonomic Nervous System Dysregulation in Implantable Cardioverter Defibrillator Patients with Depression and Anxiety
Authors: Willem J Kop, Jennifer L Francis, Mark C Haigney, Ali A Weinstein, Phyllis K Stein, John S Gottdiener, David S Krantz
Journal: Circulation (2008)

Background : Autonomic nervous system (ANS) dysregulation increases risk of ventricular arrhythmias in patients with implantable cardioverter defibrillators (ICD). ANS dysregulation is common in depression and anxiety, but the relationship between these psychological factors and ANS dysregulation has not been investigated in ICD patients. Methods : ANS indices reflecting parasympathetic control of heart rate were obtained using heart rate variability (HRV) analyses in 44 ICD patients with documented coronary artery disease (age 62±9 yrs; ejection fraction 35.9±12.7%). Ambulatory 24-hr ECG recordings were used to calculate HRV (rMSSD and pNN50). Depression was assessed using the Beck Depression Inventory (BDI) and anxiety using the Taylor Manifest Anxiety Scale (TMA). Validated cut-off scores were used (depression: BDI≥10; anxiety: TMa≥9), and data were analyzed using Analysis of Variance. Results : ICD patients with depression symptoms (n=12) had significantly lower HRV markers of ANS parasympathetic activity (rMSSD:15.2±5.7 ms vs. 25.0±13.4 ms, p=0.002; pNN50:1.8±2.7% vs. 5.6±5.7%, p=0.006) than patients with low depression symptoms (n=32). High anxiety (n=10) was related to lower rMSSD (p =0.014). Comorbid depression and anxiety was associated with substantial HRV reduction (p&lt;0.001) (Figure ). Conclusion : Depression and anxiety in ICD patients are associated with autonomic nervous system dysregulation (reduced HRV markers of parasympathetic control). Reduced parasympathetic activity may therefore contribute to the elevated risk of life-threatening cardiac arrhythmias in ICD patients with depression and anxiety. Figure 1. RMSSD among depression/anexity groups
Abstract 1282: Interleukin-11 Prevents Cardiac Remodeling after Myocardial Infarction with Neovascularization in Murine Model.
Authors: Masanori Obana, Makiko Maeda, Yasuhiro Yamamoto, Takashi Ito, Tomomi Mohri, Tomohiko Iwakura, Nozomi Hayata, Mika Takai, Akiko Hayama, Koichi Matsuda, Kouhei Yamashita, Yasushi Fujio, Junichi Azuma
Journal: Circulation (2007)

Background: Cardiac remodeling after myocardial infarction (MI) results in ischemic cardiomyopathy, one of major causes of heart failure. Cardiac remodeling is positively or negatively modified by ...
Abstract 2558: QT Variability Predicts Mortality in GISSI-HF
Authors: Craig Dobson, Maria Teresa LaRovere, Gian Domenico Pinna, Robert E Goldstein, Cara Olsen, Luigi Tavazzi, Mark C Haigney
Journal: Circulation (2009)

Increased temporal variability of repolarization, as reflected by QT interval variability measured over 10 minutes, predicted spontaneous ventricular arrhythmias in ICD patients, but it is unclear ...
Abstract 2919: Feasibility, Validation and Diagnostic Accuracy of Semi-Automated Regional Strain Maps: Comparison with Coronary Angiography and Magnetic Resonance
Authors: Hsin-Yueh Liang, Anne Capriotti, Albert Lardo, Allen Keel, Kalpana Prakasa, Theodore Abraham
Journal: Circulation (2006)

Background: Regional strain analysis by echocardiography has several potential clinical uses but is limited by the need for extensive operator input and variability. We determined the feasibility, ...