tbuckley/cabot-search huggingface dataset:
Endoscopic Balloon Dilation of Gastroenteric Anastomotic Stricture After Laparoscopic Gastric Bypass
Authors: J. Ahmad, J. Martin, S. Ikramuddin, P. Schauer, A. Slivka
Journal: Endoscopy (2003)

Laparoscopic gastric bypass is a recently introduced treatment option for morbid obesity, with promising initial results. Stenosis of the gastroenterostomy is a recognized complication. The efficacy and safety of endoscopic balloon dilation for the management of this type of anastomotic stenosis has not been studied.450 patients who underwent laparoscopic gastric bypass at our institution were followed prospectively. All patients had a 15 ml gastric pouch and either a 75 cm or 150 cm jejunal Roux limb depending on whether obesity was morbid (body mass index (BMI) < 50 kg/m 2) or super-morbid (BMI > 50 kg/m 2). Patients who developed symptoms compatible with stenosis of the gastrojejunostomy were referred for upper gastrointestinal endoscopy.14 patients, 11 women and three men, underwent a total of 27 endoscopies, with 23 balloon dilations. Their average age was 46 years (range 33 - 59 years), average preoperative BMI was 47 kg/m 2, and they presented an average of 2.7 months after surgery (range 0.3 - 15.7 months). Of the 14 patients, 13 had a stricture of the gastrojejunostomy and one patient had edema. For initial dilation, a 15 mm hydrostatic balloon was used in 12 patients and an 18 mm balloon in two patients. There was response to treatment with the 15 mm balloon in seven of the 12 patients (58 %), and they required no further dilation; in one there was a response to a further 15 mm balloon dilation; in three patients a response to subsequent 18 mm balloon dilation; and one patient required 18 mm and 25 mm balloon dilations. The two patients treated with an initial 18 mm balloon dilation required no further dilations. The average length of follow-up after successful dilation was 18 months (range 7 - 30 months). There were no complications with any of the 23 dilations performed.Stenosis of the gastroenterostomy after laparoscopic gastric bypass occurred in 3.1 % of the patients in this series. It can be successfully and safely treated with endoscopic balloon dilation with good long-term follow-up.
Abstract 5521: Rosuvastatin Prevents Ischemia and Reperfusion-Induced Endothelial Dysfunction by a COX-2 Dependent Mechanism
Authors: Andrew Liuni, Mary Clare Luca, Tommaso Gori, John D Parker
Journal: Circulation (2009)

BACKGROUND: Animal studies have demonstrated that rosuvastatin (RSV) can limit the damage induced by ischemia-reperfusion (IR) in the cardiac, cerebral and mesenteric circulation. It remains unknown whether this beneficial effect of RSV can also be demonstrated in humans, and by what mechanism this may occur. METHODS AND RESULTS: Twenty healthy volunteers were randomized to a single dose of oral RSV (40 mg) or placebo. 24 hours later, endothelium-dependent, flow-mediated dilation (FMD) of the radial artery was measured before and after IR (15 minutes of ischemia at the level of the brachial artery followed by 15 minutes of reperfusion). There was no difference in pre-IR FMD between groups (P=NS). In the placebo group, FMD was significantly blunted after IR (FMD pre-IR: 6.4+/−0.4%, post-IR: 1.1+/−1.2%, P&lt;0.01). This impairment in FMD with IR was prevented with RSV (Table ; FMD before IR: 7.5+/−1.0%; after IR: 6.2+/−1.2%, P =NS compared with RSV before IR; P&lt;0.05 vs. placebo). In a separate protocol, 18 healthy volunteers received the cyclooxygenase-2 (COX-2) inhibitor celecoxib (200mg BID p.o.) for 5 days. On day 4, subjects were randomized to a single dose of RSV (40mg) or placebo and 24 hours later underwent the same protocol as above. Pretreatment with celecoxib completely abolished RSV’s protective effect (Table ; FMD pre-IR: 8.0±2.2%, post-IR: 1.4±2.0%, P&lt;0.001 before versus after IR, P=NS vs. placebo). IR did not modify resting arterial diameter, baseline blood flow or peak hyperemic blood flow during FMD in either protocol (Table ; P=NS for all). CONCLUSIONS: The present findings demonstrate, for the first time in humans, the ability of RSV to pharmacologically prevent the development of IR-induced endothelial dysfunction. In addition, these data demonstrate the importance of COX-2 in the manifestation of this preconditioned phenotype, evidence that also provides potential mechanistic insight into the observed cardiovascular toxicity with COX-2 inhibitors.
Abstract 16274: Association Between Spontaneous Echocardiographic Contrast and CHADS2
Authors: Ewa Konik, Naser Ammash, Alfonso Tafur, Robert McBane, Diane Grill, Joshua Slusser, Waldemar Wysokinski
Journal: Circulation (2010)

Background: Spontaneous echo contrast (SEC) is associated with increased risk of left atrial appendage thrombus (LAAT) and stroke in non-valvular atrial fibrillation (NVAF). The relation between SE...
Abstract 3367: Pregnancy and Long Term Outcomes in Women With Congenital Aortic Stenosis
Authors: Nikolaos Tzemos, Candice Silversides, Jack M Colman, Cairrine Sloggett, Jennifer Mason, Evelyn Cocoara, Mathew Sermer, Samuel C Siu
Journal: Circulation (2006)

Introduction Whether pregnancy affects late outcomes in pregnant women with congenital aortic stenosis (AS) has not been systematically examined. The objective of this study was to examine the late...
Expression of LEKTI correlates with perineural invasion in oral cavity carcinoma
Authors: T. D. Shellenberger, R. A. Madero-Visbal, A. E. Naggar, A. Jayakumar, G. Clayman
Journal: Journal of Clinical Oncology (2008)

6036 Background: Invasion may result from imbalance of proteinase enzymes and their inhibitors that favors degradation of extracellular matrix (ECM). Lymphoepithelial kazal-type inhibitor (LEKTI) is a serine proteinases inhibitor we identified by constitutive expression in normal oral mucosa and lost or downregulated expression in patients with head and neck squamous cell carcinoma (HNSCC). Previously, we found that expression of LEKTI in HNSCC cell lines regulates the expression and secretion of matrix metalloproteinases critical to ECM degradation. Furthermore, using an orthotopic mouse model, we found increased perineural invasion (PNI) in tongue tumors derived from OSC- 19 cells compared to those derived from clones expressing LEKTI. We hypothesized that loss of LEKTI expression in primary tumors correlates with aggressive biologic behavior in patients with HNSCC. Methods: We assembled a retrospective, inception cohort of 81 consecutive, previously untreated patients who underwent surgery as initial treatment for SCC of the oral tongue with at least 18 months of follow-up. Primary tumor specimens were recut and stained with a purified mouse anti-LEKTI monoclonal antibody. Slides were reviewed and scored by two independent investigators. Surgical pathology reports were reviewed for covariate and clinical follow-up data. Time-to-event analysis was performed by Kaplan-Meier method for patients stratified by LEKTI-staining pattern. Results: LEKTI expression was negative in 31, intermediate in 44, and strong in 6 patients. PNI was present in 12 of 31 patients with LEKTI-negative tumors, in contrast to 6 of 50 patients with LEKTI-positive tumors. Therefore, the relative risk of PNI was 3.2 (95% CI from 1.2 to 8.9) in patients with LEKTI-negative tumors compared to those LEKTI-positive tumors (p = 0.007 by Chi Square Test). Patients with LEKTI-negative expression had a 20% increased risk of disease recurrence (HR 1.2 and 95% CI 0.61 to 2.33, p = 0.23 by Logrank test) and an 80% increased risk of death from all causes (HR 1.8 and 95% CI 0.34 to 9.41, p = 0.48). Conclusions: Loss of LEKTI expression in HNSCC results in a cellular phenotype with locally aggressive behavior. Our findings shed new light on mechanisms of PNI, offer prognostic value, and may aid in the selection of therapeutic approaches. No significant financial relationships to disclose.
Abstract 14754: Role Of The Cardiac Conduction System In Pathophysiology Of Congestive Heart Failure
Authors: George Hart, Xue Cai, Joseph Yanni, Caroline Jones, Antonio Corno, Robert Hutcheon, Oliver Monfredi, Guoliang Hao, Jonathan Jarvis, Halina Dobrzynski, Mark R Boyett
Journal: Circulation (2011)

A proportion of heart failure patients die of bradyarrhythmias, presumably from dysfunction of the cardiac conduction system. Here we studied the cardiac conduction system in rabbits with congestiv...
Abstract 12293: RNAi Knockdown of Klotho Gene Causes Hypertension and Kidney Damage
Authors: Lora Bailey-Downs, Zhongjie Sun
Journal: Circulation (2010)

Background & Hypothesis: Klotho is a recently-discovered anti-aging gene. Genetic mutation of klotho results in multiple premature aging phenotypes and significantly shortens lifespan. In contrast, overexpression of klotho extends lifespan. Thus, klotho may be an aging-suppressor gene that can delay aging when overexpressed and accelerate aging when disrupted. In humans, the level of the circulating klotho declines with age while the prevalence of hypertension increases with age. The objective of this study was to assess our hypothesis that knockdown of klotho leads to hypertension and kidney damage in rats. Methods and Results: The in vivo RNAi knockdown of klotho was achieved by AAV delivery of klotho shRNA (KLshRNA). In vivo expression of anti-inflammatory cytokine IL-10 was achieved by AAV delivery of human IL-10 full-length cDNA (IL10). RNAi knockdown of klotho significantly increased systolic and diastolic blood pressure. The KLshRNA-induced hypertension may be mediated by inflammation because it ca...
Abstract 2094: Cardiovascular Risk Factors and Metabolic Syndrome in Alcohol-Dependent Men and Women
Authors: Carolyn M Jarvis, Laura L Hayman, Lynne T Braun, Dorie W Schwertz, Carol E Ferrans, Mariann R Piano
Journal: Circulation (2006)

Background: Cardiovascular disease (CVD) is a leading cause of mortality among alcoholics; however, minimal data exist on the CVD risk factor profile in this high-risk population. The purpose of th...
Abstract 18969: Estrogen Rescues Severe Pulmonary Hypertension and Increases Survival Through Stimulation of Neoangiogenesis and Suppression of Inflammation
Authors: Soban Umar, Humann Matori, Andrea Iorga, Rod Partow-Navid, Federica Maltese, Mansoureh Eghbali
Journal: Circulation (2010)

Introduction: Pulmonary hypertension (PH) is a chronic lung disease that leads to right ventricular (RV) failure. Recently we found that estrogen (E2) can rescue severe PH. As E2 has anti-inflammat...
Abstract 4574: Validation of Early Biomarkers of Acute Kidney Injury After Pediatric Cardiac Surgery
Authors: Catherine D Krawczeski, Prasad Devarajan, Mai Nguyen, Thelma Kathman, Zhu Wang, Chirag Parikh
Journal: Circulation (2008)

Body: Previous high-throughput proteomic analysis using SELDI-TOF-MS ( JASN 17 : 49A , 2006 ) identified three urinary proteins, namely α1-microglobulin (A1M), α1-acid glycoprotein (AAG), and albumin (Alb), that were over-expressed at 2 hr after cardiac surgery in subjects who subsequently developed acute kidney injury (AKI). In order to validate the potential role of these biomarkers in clinical AKI, we prospectively collected serial urine samples at 0, 2, 6, 12, 24 and 48 hr after initiation of cardiopulmonary bypass from pediatric patients undergoing surgery for congenital heart disease. The biomarkers were measured by a standard clinical laboratory platform (Dade-Behring BN Prospec). Results: 365 patients were enrolled with a mean age of 3.5 ± 4.5 years. 53% were males. 135 (37%) of patients developed AKI (50% increase in serum creatinine from baseline). In this group, 46% showed moderate AKI (100% increase in serum creatinine) and 5% displayed severe AKI (dialysis requirement). AKI based on serum creatinine was diagnosed at 2.2 ± 0.74 days after surgery. In contrast, the mean concentrations of all three biomarker proteins were significantly different at very early time points after surgery for various severities of AKI (Table 1 ). The performance (area under ROC curve) of all three biomarkers peaked at 6 hr after surgery with accuracies of 86% (A1M), 90% (AAG), and 79% (Alb). The quartiles of biomarker values at 6 hr were also prognostic for peak serum creatinine, duration of AKI, and length of hospital stay (all p&lt;0.001). Conclusion: A1M, AAG, and Alb represent excellent early biomarkers for the diagnosis and prognosis of AKI after cardiac surgery. This research has received full or partial funding support from the American Heart Association, AHA Great Rivers Affiliate (Delaware, Kentucky, Ohio, Pennsylvania &amp; West Virginia). Urinary Biomarkers After Cardiac Surgery
Abstract 876: Feasibility of a Four-Point Test to Screen for Cardiac Abnormalities in Asymptomatic At-Risk Children (Houston Early Age Risk Testing and Screening or HEARTS)
Authors: John P Higgins, Susan T Laing, J. Jason West, Gurur Biliciler-Denktas, Joshua Samuels, Amol Rajmane, John T Holste, Monica Patel, Manuel M Reyes, Francisco J Cordova, Jason A Yoho, William J McKee, David D McPherson
Journal: Circulation (2009)
Intra-arterial Therapy of Liver Tumours
Authors: E. Garin, P. Bourguet
Journal: Clinical Nuclear Medicine (2008)

Hepatocellular carcinoma (HCC) is one of the most frequent cancers worldwide; in fact, it is ranked fifth in importance with approximately 437,000 new cases per annum (Bosch et al. 1999). Its incidence is increasing in many countries (Trinchet and Beaugrand 1999; Taylor-Robinson et al. 1997; Deuffic and Poynard 1998; El-Serag and Mason 1999). The first recognized risk factor is the presence of a cirrhosis that may be associated with various possible aetiologies (B and C viral infections, alcohol, haemochromatosis). This increased incidence is related to the better health care of patients suffering from cirrhosis, but also to a strong increase in chronic hepatitis C (Trinchet and Beaugrand 1999; Taylor-Robinson et al. 1997; Deuffic and Poynard 1998; Okuda 2000). Indeed, in France, approximately 500,000 people would appear to be infected by the hepatitis C virus (Trinchet and Beaugrand 1999). It is estimated that about 66 % present with chronic hepatitis and that 20 % will develop cirrhosis in 10–20 years in the absence of treatment. In France, it is estimated that the mortality linked to HCC occurring with hepatitis C virus cirrhosis will increase by 150% in men and 200% in women from now until 2020 (Deuffic et al. 1999). We may thus consider that, in the years to come, HCC will pose a problem for public health.
Abstract 12588: Identifying Downstream Targets of Bone Morphogenetic Protein Receptor II Relevant to Pulmonary Arterial Hypertension via Inter-study Meta-analysis of DNA Microarrays
Authors: Molong Li, Tero-Pekka Alastalo
Journal: Circulation (2010)

Dysfunctional bone morphogenetic protein receptor (BMPR)II-mediated signaling is a well recognized risk factor for the development of pulmonary arterial hypertension (PAH). These patients exhibit a...
Abstract 1911: P947-enhanced MRI allows For In Vivo Monitoring of MMP activity and detection of Atherosclerotic Plaque Regression in Hypercholesterolemic Rabbits
Authors: Esad Vucic, Fabien Hyafil, Jean-Christophe Cornily, Vardan Amirbekian Amirbekian, Eric Lancelot, Claire Claire, Laurent J Feldman, Zahi A Fayad
Journal: Circulation (2007)

Introduction. Matrix metalloproteinases (MMPs) are involved in atherosclerotic plaque growth and rupture. P947 (Guerbet) is a new MRI contrast agent with high affinity for MMPs. Hypothesis. MMP act...
Abstract 15207: Endothelial Function in Postmenopausal Women with High Nighttime Systolic Blood Pressure
Authors: Faye S Routledge, Alan L Hinderliter, Judith A McFetridge-Durdle, Andrew Sherwood
Journal: Circulation (2011)

Background: Nighttime systolic blood pressure (SBP) is more predictive of adverse cardiovascular events than daytime SBP and recent evidence suggests that this relationship may be stronger for wome...
Abstract 15987: CD74 Knockout Rescues Against Obesity-Induced Cardiac Hypertrophy and Contractile Dysfunction: Role of Autophagy and ER Stress
Authors: Yingmei Zhang, Zhi Xia, Kacy L Richmond, Richard Bucala, Jun Ren
Journal: Circulation (2011)

Obesity, which is characterized by continuous energy and nutrient exposure, triggers metabolic and oxidative stress, inflammatory response and increased risk of heart disease. CD74, the main compon...
Abstract 1354: Estrogen predisposes prepubertal Long QT Syndrome 2 (LQT2) rabbits to cardiac arrhythmias
Authors: Katja E Odening, Michael Brunner, Lorraine Schofield, Lenny Chaves, Xuwen Peng, Manfred Zehender, Malcolm Kirk, Gideon Koren
Journal: Circulation (2007)

Introduction: Adult women with LQT2 are at higher risk for clinical events and sudden cardiac death (SCD) than men. We have created transgenic LQT2 rabbits selectively over-expressing a pore mutant of the human HERG in the heart. All episodes of SCD in these LQT2 females occurred after sexual maturation. We hypothesize that sex hormones modulate cardiac repolarization and incidence of polymorphic VT in female LQT2 rabbits. Methods: In this ongoing study, prepubertally ovariectomized females were implanted with 90 day-release-pellets of estradiol (EST, 150mg), or dihydrotestosterone (DHT, 200mg), or placebo (OVX). A fourth group consisted of sham-operated females (SHAM). All groups underwent telemetric ECG monitoring, surface ECG after 30 days of hormone treatment, and in vivo electrophysiological studies (EPS) under isoflurane (2–5%) after 60 days. Results: EST steepened the QT/RR slope of prepubertal rabbits mimicking the adult LQT2 female phenotype (baseline: 0.608 ± 0.09, after 4 weeks: 0.69 ± 0.1, n=5, p&lt;0.05; SHAM females: 0.699 ± 0.07, n=4). In contrast, DHT decreased the QT/RR slope (baseline: 0.739 ± 0.11, after 4 weeks: 0.521 ± 0.08, n=3, p=0.02). A smaller decrease was seen in OVX: 0.677 ± 0.01 vs. 0.599 ± 0.08, n=2. EST prolonged QT- and QTpeak-index compared to DHT rabbits. (EST, n=2: QT: 112.6% ± 1.5; QTp: 95.8% ± 1.6 vs. DHT, n=2: QT: 105.4% ± 4.1, p=0.07; QTp: 87.6% ± 0.9, p&lt;0.05 vs. SHAM females, n=2: QT: 123.4% ± 9.5; QTp: 102.3% ± 2.5) EPS revealed a longer AERP and VERP in EST than in DHT rabbits - and a trend towards longer refractoriness than in OVX - reaching similarly prolonged refractoriness as in SHAM females (EST, n=2: AERP: 165.0 ± 35.4ms; VERP: 225.0 ± 25.0ms vs. DHT, n=3: AERP: 90.00 ± 5.8ms, p=0.03; VERP: 193.3 ± 8.8ms, p=0.07 vs. OVX, n=2: AERP: 125.0 ± 25.0ms, VERP: 205.0 ± 5.0ms, vs. SHAM females, n=2: AERP: 145.0 ± 5.0ms, VERP: 220.0 ± 20.0ms). One out of four EST-treated prepubertal rabbits died at the age of 96 days of spontaneous polymorphic VT. Conclusion: EST increases the QT/RR slope and prolongs QT and cardiac refractoriness mimicking the adult LQT2 female phenotype, whereas DHT decreases the QT/RR slope and shortens QT and refractoriness mimicking a male phenotype. EST predisposes prepubertal LQT2 rabbits to spontaneous polymorphic VT.
Abstract 5011: Role of Autonomic Nervous System Dysregulation and Inflammation in the Increased Risk of Depression for Cardiovascular Mortality: The Cardiovascular Health Study
Authors: Willem J Kop, Phyllis K Stein, Joshua I Barzilay, Russell P Tracy, John S Gottdiener
Journal: Circulation (2008)

The increased cardiovascular (CV) risk associated with depression is hypothesized to be explained by autonomic nervous system (ANS) dysregulation and inflammatory processes. This study determines the role of ANS dysregulation and inflammation in the predictive value of depression for CV mortality. 908 participants of the Cardiovascular Health Study (age 71±5 yrs) free of CV disease were evaluated for depression (CES-D scale), ANS dysregulation by abnormal non-linear heart rate variability (decreased short-term fractal scaling exponent), and inflammation (IL-6, CRP, fibrinogen and WBC). Predictors of CV mortality were examined using Cox regression analysis, adjusting for age, sex, race, systolic blood pressure, diabetes, subclinical disease, use of beta-blockers, smoking status, BMI, and physical activity (median follow-up=13.3 yrs). Risks were calculated for subgroups based on the presence or absence of depression, and ANS or inflammatory CV risk factors (Figure ). Depression was predictive of CV mortality (RR=1.88, CI=1.23–2.86), ANS dysregulation (p=0.014) and inflammatory markers (IL-6 p=0.072; WBC p=0.033; and fibrinogen p=0.050) were correlated with depression. The association of depression with CV mortality occurred primarily in the presence of ANS dysregulation and/or inflammation (Figure ). Addition of ANS and inflammatory markers to the multivariate model did not substantially reduce the CV mortality risk of depression (adjusted RR=1.65, CI=1.03–2.65). Depression is predictive of cardiovascular mortality, and the elevated risk is additive to autonomic nervous system dysregulation and inflammation
NICE recommends greater use of thrombolytics
Authors: Susan Mayor
Journal: BMJ (2002)

More patients with acute myocardial infarction should be treated with thrombolytics, given intravenously in hospital or by bolus injection in pre-hospital settings, the National Institute for Clinical Excellence (NICE) recommended last week.

The NICE guidance says that only an estimated 50000 of the 240000 patients who have an acute myocardial infarction each year in England and Wales currently receive thrombolysis, even though it is the established, standard treatment.

The appraisal committee, chaired by David Barnett, professor of clinical pharmacology at the University of Leicester, noted: “Evidence suggests that thrombolysis continues to be underused.” After reviewing available research, the committee recommended: “In hospital, the choice of thrombolytic drug should take account of the likely balance of benefit and harm (for example, stroke) to which each of the thrombolytic agents would expose the individual patient.”

The committee concluded that standard alteplase was as effective as streptokinase, reteplase was at least as effective as streptokinase, and tenecteplase was as effective as accelerated alteplase in reducing mortality in the hospital setting.
Influence of clinical trial participation with regard to overall survival (OS) and progression-free survival (PFS) for patients with advanced breast cancer.
Authors: M. Kiechle, N. S. Simstich, U. R. Schwarz-Boeger, S. Paepke
Journal: Journal of Clinical Oncology (2010)

1144 Background: According to several reports in literature a survival benefit for patients with early breast cancer can been seen only due to the fact that women participate in clinical trials. This is based on the hypothesis that participation in clinical studies includes controlled trial conditions and the introduction of new medication which results in a survival benefit. However the data in literature regarding this question is inconsistent. Concerning advanced breast cancer no analysis has been published so far. Methods: 152 women with advanced breast cancer who were treated in our clinic from 2002 to 2006 were included in this retrospective analysis. 72 women were treated within a clinical trial, whereas 80 patients received guideline therapy. No significant differences in the two study populations regarding significant prognostic markers such as age, disease-free survival, or type of metastases were existent. Patients from eleven different clinical trials were considered for this analysis. Results: With regard to PFS and OS no significant difference was seen in the two groups. The median time of progression-free survival was 11 months in the group of study participants in comparison to 12 months in the standard therapy group. Only the univariate analysis showed a not significant trend towards a longer PFS in the clinical trial group. Furthermore no significant difference for the OS in both groups could be detected. 95 months was the median time of survival after progression in both groups. The 2-year and 5-year survival rate also showed no significant difference. Conclusions: In comparison to guideline therapy, clinical trial participation does not account for a benefit in PFS or OS in women with advanced breast cancer. No significant financial relationships to disclose.