tbuckley/cabot-search huggingface dataset:
Abstract 13900: Very Low Cardiac Event Rate in Patients Achieving >=10 METS Regardless of Peak Exercise Heart Rate With No Supplemental Value of SPECT Myocardial Perfusion Imaging
Authors: Jamieson M Bourque, Denny D Watson, George A Beller
Journal: Circulation (2010)

Background:  Patients achieving high exercise workloads or high peak exercise heart rates are reported to have lower cardiac event rates than patients with poor exercise tolerance. We sought to prospectively determine if myocardial perfusion imaging (MPI) provided additional prognostic information over peak exercise METS achieved, even in patients who failed to attain ≥85% of maximum age-predicted heart rate (MAPHR).   Methods:  A group of 463 consecutive patients with intermediate-to-high probability of coronary artery disease (CAD) referred for exercise MPI who attained ≥10 METS were divided into those achieving ≥85% MAPHR (Group 1, n=395) or  99m Tc-sestamibi MPI and were followed-up for cardiac death, nonfatal MI, and late revascularization (>2 months post-MPI).   Results:  Group 2 patients had a higher prevalence of diabetes (23.5% vs. 10.9%, p=0.004), tobacco abuse (45.6% vs. 23.0%, p   Conclusions:  Thus, patients at intermediate risk for CAD or known CAD achieving ≥10 METS have a very low prevalence of ≥10% LV ischemia and very low rates of cardiac mortality, nonfatal MI, and late revascularization, irrespective of heart rate achieved. Cardiac events did not correlate with abnormalities on the index MPI study. These results suggest that patients who attain ≥10 METS during exercise stress have an excellent prognosis over an intermediate term of follow-up, regardless of peak exercise heart rate achieved. The added value of MPI to standard exercise ECG testing in this population is questionable.
Abstract 2978: Long-Term Results After Unprotected Left Main Stenting With Drug-Eluting Stents. Insights From the French Left Main Taxus Registry
Authors: Beatriz Vaquerizo, Thierry Lefèvre, Olivier Darremont, Marc Silvestri, Helen Routledge, Federico De Marco, Pierre Dumas, Alice Ohanessian, Marie-Claude Morice, Philippe Garot
Journal: Circulation (2007)

Drug-eluting stents (DES) have reduced restenosis rate and are now emerging as an alternative to bypass surgery (CABG) for treating unprotected left main (ULM) stenosis. A prospective registry was set up in France to explore the role of DES in this setting. Consecutive patients (Pts) with de novo ULM stenosis undergoing PCI with Paclitaxel eluting stent (PES) in 4 French centers were prospectively included in this real world study. Acute MI and cardiogenic shock were the only criteria for exclusion. Pts had a loading dose (450 to 600 mg) of plavix before the procedure, aspirin (≥75 mg) and plavix (75 to 150 mg/day) for at least 6 months. Clinical outcome was planned up to 3 years and repeat angiography was strongly recommended at 6 months. Between March 2003 and June 2005, 291 Pts were included: 69±11 yrs old, 77% male, 29% diabetic, 5% renal failure, 17% previous or recent MI, 38% acute coronary syndrome and 25% 3-vessel disease. Euroscore was 4.8±3.4 (predicted in-hospital mortality in case of CABG 6.3±10.4). Provisional T stenting (distal LM in 78.4%) was used in 92% of cases and final kissing balloon in 96.8%. Angiographic success was obtained in 99.7%. Other lesions (1.2±0.9) were treated during the same hospitalization in 77%. Repeat angiogram was performed in 182 Pts (63%) at 7.0±4.0 months. Restenosis was observed in 8.7%. The clinical outcome is summarized below: By multivariate analysis Euroscore (OR 1.245; 95% CI 1.077–1.439; p=0.003), terminal renal failure with dialysis therapy (OR 0.018; 95% CI 0.002– 0.172; p=&lt;0.001) and LM bifurcation angle T-type (OR 0.205; 95% CI 0.071– 0.593; p=0.003) were the only independent predictors of death. The incidence of definite or probable LM stent thrombosis (ST) as defined by the ARC was at 2-years 2.09% (3 early ST and 3 late or very late ST). LM stenting using PES with a strategy of provisional side branch T stenting in case of distal lesion provides excellent acute angiographic results and very acceptable long-term outcome.
GPs' records may have little diagnostic validity
Authors: S. Brandon
Journal: BMJ (1996)

EDITOR,—H Lavender's and P H Smee's articles reopen the question of confidentiality of patients' records.1 I am not reassured by the soothing words of Smee, who is head of life insurance at the Association of British Insurers: my experience suggests that many arbitrary decisions are taken by insurance companies on the basis of inadequate evidence, particularly where nervous illness is …
Abstract 5802: Whole-Heart Coronary Angiography using Volume Computed Tomography in Comparison to Conventional Coronary Angiography
Authors: Marc Dewey, Elke Zimmermann, Florian Deissenrieder, Michael Laule, Hans-Peter Dübel, Wolfgang Rutsch, Bernd Hamm
Journal: Circulation (2008)

This is an initial report on the use of the recently introduced whole-heart 320-slice computed tomography (CT) scanner for noninvasive coronary angiography compared with conventional coronary angiography (CCA). Whole-heart CT avoids overscanning and overranging as necessary for helical coronary CT acquisitions thereby significantly reducing the effective radiation dose. Twelve patients with suspected coronary artery disease (4 women, 8 men; mean age 64.6 ± 11 years) have undergone coronary CT angiography using a 320-slice scanner (Aquilion ONE, Toshiba; 0.35 s gantry rotation time, 120 kV, and 350 – 450 mA) prior to clinically indicated CCA. CT images were manually reconstructed in motion-free phases with 0.5-mm slice thickness and 0.25-mm slice increment. Independent blinded assessment of CT and CCA (using quantitative analysis) was performed to detect significant (at least 50%) diameter stenoses. Of the 12 patients, in 8 patients, single-heart beat CT acquisition was performed, resulting in an effective dose of 5.6 ± 1.1 mSv and an image reconstruction window length of 175 msec. In the other 4 patients, because of higher heart rates, 2 or 3 heart beats were used for acquisition, resulting in higher radiation exposure (on average 17 mSv) and the possibility to perform multisegment reconstruction with improved temporal resolution (88 and 58 msec image reconstruction windows, respectively). Per-patient sensitivity and specificity for CT compared to CCA were 100%. Per-vessel sensitivity and specificity were 88% and 95%, respectively. Intraindividual comparison of CT with CCA revealed a nonsignificantly smaller effective radiation dose (9.4 ± 7.2 mSv vs. 10.5 ± 5.3 mSv, p&lt;0.69) but significantly smaller contrast agent amount (80 ±0 ml vs. 107.3 ± 17.8 ml, p&lt;0.01) for 320-slice CT. Whole-heart CT significantly reduces the contrast agent amount compared to CCA while radiation exposure is reduced in patients with slow heart rates. This initial report also indicates that diagnostic accuracy of coronary CT angiography using up to 320 simultaneous detector rows remains high as compared with CCA as the reference standard.
Toll of anthrax cases reaches 15
Authors: Deborah Josefson
Journal: BMJ (2001)

Concern about the anthrax outbreak is mounting in the United States after several new cases of both the cutaneous and inhaled forms of the disease were confirmed and many governmental offices and postal sorting facilities were found to harbour anthrax spores.

The incidents have exposed cracks in the epidemiological investigation, surveillance, and tracking systems of the United States. They …
Abstract 539: Atypical PKc Zeta Mediates TNF Induced Endothelial Dysfunction
Authors: Gwenaele Garin, Junichi Abe, Chen Yan, Weimin Liu, Andrew Newby, Arshad Rahman, Bradford C Berk
Journal: Circulation (2006)

TNF-a stimulates pro-atherogenic signaling events including activation of JNK, expression of ICAM-1, VCAM-1 and apoptosis. Recently, atypical PKCz, an abundant PKC isoform in endothelial cells (EC)...
Abstract 1471: Development and Characterization of Force Generating Human Engineered Heart Tissue from Embryonic Stem Cells
Authors: Christina Rogge, Michael Didié, Erich Wettwer, Ursula Ravens, Ralph Graichen, Xiuqin Q Xu, Alan Colman, Bruce Davidson, Robert Zweigerdt, Thomas Eschenhagen, Wolfram H Zimmermann
Journal: Circulation (2007)

Engineered Heart Tissue (EHT) from neonatal rat cardiomyocytes has been used successfully as in vitro model and in cardiac repair. Here, we hypothesized that human embryonic stem cells (hESC) can be used to generate EHT with properties of native myocardium. Methods: hESC (hES3-ENVY) were differentiated in embryoid bodies, enzymatically dispersed, and subjected to EHT-generation in circular casting molds (1.5x10 6 cells, 0.4 mg collagen, 10% Matrigel/EHT; inner/outer diameter - 2/4 mm). Contractile function was assessed 10 days after casting under isometric conditions (37°C, 1.5 Hz, Tyrode’s solution). Action potentials (AP) were recorded in spontaneously contracting EHTs with intracellular electrodes (37°C, Tyrode’s solution). Calcium gradients were assessed by confocal laser scanning microscopy (CLSM) after rhod-2 loading. EHT-morphology was examined by CLSM and electron microscopy (EM). Results: hESC-EHTs contracted synchronously and spontaneously at 1.1±0.1 Hz (n=3). Increasing concentrations of extracellular calcium (0.2–2.4 mM) enhanced force of contraction from 53±8 to 199±22 μN (n=8, p&lt;0.05; EC 50 : 0.8±0.04 mM). Isoprenaline (1 μM) at 0.4 mM calcium increased twitch tension from 61±7 to 108±15 μN (n=8, p&lt;0.05) and shortened relaxation time from 111±6 to 87±4 ms (n=3, p&lt;0.05). Cardiomyocytes within EHTs formed a functional syncytium composed of predominantly oriented muscle strands with a high degree of sarcomere differentiation (CLSM, EM). Cell-cell contacts through adherens junctions were identified by EM. Synchronous calcium gradient spread in spontaneously contracting EHTs indicated electrical coupling of individual cells within the multicellular constructs. AP recordings identified pacemaker cells (spontaneous diastolic depolarization) and cells with a flat phase 4 of the AP (working myocardium-like cells). Pharmacological studies demonstrated the presence and functional relevance of I Na (10–30 μM flecainide), I Ca (1 μM nisoldipine), and I Kr (1–5 μM E4031). Conclusion: Human force-generating EHT with functional and morphological properties of native myocardium can be generated. Ultimately, hESC-EHTs may constitute a model system for substance screening and could further be utilized in cardiac repair.
Agent orange as a risk factor for positive prostate biopsy.
Authors: N. J. Ansbaugh, J. Shannon, M. Mori, P. E. Farris, L. Collins, M. Garzotto
Journal: Journal of Clinical Oncology (2011)

178 Background: Agent Orange (AO), a defoliate contaminated with the known carcinogen dioxin, has become a prominent concern as veterans of the Vietnam War who were exposed to AO are now reaching the age at which prostate cancer is most prevalent. While sufficient evidence has linked AO exposure to many diseases, only limited but suggestive evidence exists to support a positive association between AO and prostate cancer. Despite mixed findings, recent studies have found that the risk of prostate cancer in those exposed to AO was as high as twice the risk in those not exposed. The goal of this study was to examine this association between AO exposure and prostate cancer in a cohort of men referred for a prostate biopsy. Methods: In this retrospective cohort-design, risk factors were identified using historical clinical data from a population of veterans referred to the Portland VA Hospital for a prostate biopsy between 1993 and 2010. In addition to AO exposure, covariates included prostate specific antigen density (PSAD), results of the digital rectal exam (DRE), age at biopsy, family history, body mass index (BMI), race, and medication use. Outcomes of the biopsies were defined as either positive or negative according to the pathology report and risk factors were compared between individuals found to have prostate cancer and those without cancer. Multiple logistic regression was used to evaluate the effect of AO on risk of prostate cancer after adjustment for confounders. Results: Of the 2,720 veterans who underwent prostate biopsy, 896 (32.9%) were found to have prostate cancer. After adjustment for significant confounders including PSAD, DRE, age at biopsy, and family history of prostate cancer, veterans with prostate cancer were 49% more likely to have been exposed to AO as compared to those without prostate cancer (odds ratio = 1.49; 95% CI: 1.06-2.11, p=0.022). Conclusions: Agent Orange exposure was associated with a significant increase in prostate cancer detection in men referred for a prostate biopsy. The limitations in identifying biologically significant levels of AO exposure in this study may suggest potential for underestimation of the true risk. This study supports the findings of recent studies suggesting that AO exposure increases the risk of prostate cancer. No significant financial relationships to disclose.
Abstract 241: Role of CD73, Ecto-5' Nucleotidases, in Human Coronary Arteriolar Dilation to Adenine Nucleotides
Authors: Kazuyoshi Toyama, Ossama A Hatoum, David D Gutterman, Hiroto Miura
Journal: Circulation (2006)

Adenosine triphosphate (ATP) has been proposed as a metabolic regulator of microcirculation. We previously reported in human coronary arterioles (HCA) that vasodilation to ATP or ADP is mediated by adenosine. Since ecto-nucleotidases or alkaline phosphatases rapidly and efficiently hydrolyze circulating ATP, adenosine diphosphate (ADP) and adenosine monophos-phate (AMP) to adenosine, we tested the hypothesis that vasodilation to adenine nucleotides is associated with CD73 activity in HCA.   Methods:  Changes in internal diameter to ATP, ADP, AMP or inosine were recorded in HCA (156±12μm, n=24) dissected from right atrial appendage and in left anterior descending coronary arteries (mLAD) of CD73 knockout mice (165±7μm, n=7) with videomicroscopy. CD73 localization or adenosine production was examined by immunohistochemistry or by liquid chromatography-electrospray ionization-mass spectrometry (LC/ESI-MS).   Results:  ATP, ADP and AMP but not inosine potently dilated HCA in a dose-dependent manner. α,β-methylene adenosine 5′-diphosphate (10 −4  M, a competitive inhibitor of CD73) partially but significantly inhibited these vasodilations, whereas pyridoxal phosphate-6-azo(benzene-2,4-disulfonic acid) (10 −4  M, a selective P2 receptor antagonist) had no effect. LC/ESI-MS showed that a large amount of adenosine accumulates in the perfusate from HCA treated with 10 −4  M ADP (≅500 pg/μl), whereas perfusion without ADP yields little adenosine production (≅1 pg/μl). Immunohistochemistry revealed CD73 localization in HCA, similar to mLAD, showing abundant expression of CD73 in endothelial cells but no or little expression in the medial layer or adventitia. Intraluminal application of hCD73 antibody 1E9 (10μg/ml, an hCD73 blocker) abolished vasodilation to ATP (%Max dilation; 1±9% vs control 83±7 at 10 −5  M). CD73 deficiency similarly abolished vasodilation of mLAD to ATP (1±9 vs control 83±8% at 10 −5  M). None of the inhibitors affected dilation to papaverine.   In conclusion:  Vasodilation to adenine nucleotides is dependent largely upon endothelial CD73 activity but not upon P2 receptor activation. Thus CD73 activity may play an important role in the regulation of human coronary microcirculation through adenine nucleotide hydrolyzation.
Abstract 1830: New ECG Criteria for Diagnosis of Arrhythmogenic Right Ventricular Dysplasia/Cardiomyopathy
Authors: Moniek G Cox, Arthur A Wilde, Ans C Wiesfeld, Richard N Hauer
Journal: Circulation (2007)

Introduction Desmosomal changes, electrical uncoupling and surviving myocardial bundles embedded in fibrofatty tissue are hallmarks of activation delay (AD) in arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C). AD is pivotal for reentrant mechanisms and thereby ventricular tachycardia (VT). At present, generally accepted Task Force Criteria (TFC) are used for clinical diagnosis of ARVD/C. We propose additional criteria (AC) on AD and VT to improve identification of affected individuals. Methods AD and VT-related electrocardiographic criteria were studied, while off drugs, in 42 patients with proven ARVD/C according to TFC, and 23 controls with idiopathic VT from the RV outflow tract. TFC assessed: epsilon waves, QRS width &gt;110ms in V1–3 in absence of RBBB and negative T-waves in V2 and beyond. The 3 new AC are: prolonged S-wave upstroke in V1–3 (≥55ms from nadir of S to end of depolarization) occurrence of LBBB like VT with axis −30° to −150°and number of different monomorphic VT morphologies (different when Δ axis ≥30°; spontaneous and induced by programmed electrical stimulation (PES)). All ARVD/C patients were screened for mutations in genes encoding desmosomal proteins. Results For comparison of ARVD/C patients (pts) and controls: see table . In ARVD/C pts mean S-wave upstroke duration was 63±20 ms (range 40–140), mean number of different spontaneous VTs 1.8±0.95 (range 0–5) and mean number of spontaneous+induced VTs 2.8±1.08 (range 1–5). All VTs showed LBBB morphology. Plakophilin-2 mutations were identified in 25 (60%) of ARVD/C pts. Parameters measured were not significantly different between mutation carriers and non-carriers. Conclusions The newly proposed criteria are sensitive and specific for ARVD/C and thereby useful for its diagnosis, independent of outcome of DNA analysis. Prolonged S-wave upstroke is the most sensitive ECG indicator of activation delay during sinus rhythm. PES contributes to yield of VT morphologies.
Production of Antibodies Specific for Fc, Fab′, and Streptokinase-Streptodornase In Vitro by Peripheral Blood Cells from Patients with Rheumatoid Arthritis and Normal Donors
Authors: Holly H. Birdsall, Roger D. Rossen
Journal: Journal of Clinical Investigation (1982)

To study antibody (Ab) biosynthesis in rheumatoid arthritis (RA), the immunoglobulin (Ig)M anti-Fc, anti-Fab′, and antistreptokinase-streptodornase (SKSD) produced by peripheral blood lymphocytes (PBL) were measured at intervals from 1 to 19 d in culture. PBL from 17 seropositive patients with active RA and 30 age-matched controls were evaluated. Within the first 24 h, PBL from six of eight patients released >30 ng IgM anti-Fc, even in the absence of pokeweed mitogen (PWM). This early release of Ab was blocked by cycloheximide. With or without PWM, PBL from normal donors did not release IgM anti-Fc until after 3-5 d in vitro. By day 9, unstimulated PBL from seven patients made > 100 ng IgM anti-Fc. Un-stimulated PBL from normals never made >95 ng of this Ab.
Medical Scribes and Electronic Health Records—Reply
Authors: George A. Gellert, Ricardo Ramirez, S. Luke Webster
Journal: JAMA (2015)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 5810: Perivascular Cells Are a Potential Source of Chondrocyte-Like Cells in Atherosclerotic Lesions of Apolipoprotein E Deficient Mice
Authors: Michael R Preusch, Kiranmayi Srirangam, Nicholas Ieronimakis, Andrea Callegari, Morayma Reyes, Michael E Rosenfeld
Journal: Circulation (2009)

Introduction: The presence of chondrocyte-like cells is a common phenomenon in mouse models of advanced atherosclerosis. However the source of those cells is still unclear. Since stem cell antigen-1 (Sca-1) positive cells have been found in the adventitia of apoE−/− mice and chondrogenic transformation of mesenchymal stem cell lineages has been described, we hypothesized that a possible source of the chondrocyte-like cells are perivascular Sca-1 positive cells. Methods: Innominate arteries of 23 weeks apoE−/− mice were immunostained for Sca-1, CD 45, CD 31 and Mac-2 and analyzed by fluorescence microscopy. The thoracic aortas, aortic arches and innominate arteries of apoE−/− mice and C57BL/6 controls were harvested from 13, 23 and 34 week old mice. The adventitia and attached perivascular tissue and the remaining aorta were both enzyme digested. The isolated cells were stained for Sca-1, CD 45, CD 31, CD 34, CD11b and F4/80 and sorted by flow cytometry using positive selection for Sca-1, CD 34 and negative selection for CD 45, CD 31, CD 11b and F4/80. RNA was isolated from the sorted cells and the expression of Cbfa1/Runx2 was determined by PCR. Results: Sca-1 positive, CD 45, CD 31 and Mac-2 negative cells were observed in the vascular wall by immunofluorescence and were located within close proximity to the chondrocyte-like cells within the atherosclerotic lesions. FACS analyses confirmed the presence of these cells within the aorta, aortic adventitia, aortic arch and the innominate artery of the apoE −/− mice and BL6 controls. Furthermore the perivascular cells also express Cbfa1/Runx2. Conclusions: Our data suggest that perivascular derived Sca-1 positive cells exist within both atherosclerotic lesions and within arteries from wild type controls of different ages. These cells also express Cbfa1/Runx2, a transcription factor associated with osteogenesis and therefore may be a source of the chondrocyte-like cells found in adavanced lesions of apoE−/− mice.
Uncommon Radiological Features of Chronic Arthritis in Childhood: A Review
Authors: Barbara M Ansell
Journal: Journal of the Royal Society of Medicine (1981)

Radiological changes depend on the age of onset as well as the pattern of disease present (Ansell &amp; Kent 1977). Seronegative disease tends to be associated with modelling abnormalities of the epiphyses, loss of joint space and the late development of erosions, although an occasional polyarthritis following systemic disease has a very destructive arthritis and overall failure of growth. Pauciarticular disease is associated with growth anomalies of epiphyses and also metaphyses in asymmetrical fashion. In spondylitic children, enthesiopathies are marked and there is a high incidence of hip involvement. Seropositive juvenile rheumatoid arthritis shows a severe erosive arthropathy early, combined with minor growth changes, particularly bony overgrowth in the hands and feet in the early teens. The hallmark of the psoriatic is the asymmetry and, in a few cases, the destructive nature of asymmetrically involved joints.
Abstract 14482: Tricuspid Annular Plane Systolic Excursion Does Not Correlate with Right Ventricular Volumes or Function in Adults with Repaired Tetralogy of Fallot
Authors: Benjamin A D'Souza, Jeffrey Arkles, Saurabh Jha, Harold Litt, Martin St. John Sutton, Gary D Webb, Tsun-Hou Chang, Edward N Marcus, Alexander R Opotowsky
Journal: Circulation (2010)

Introduction: Tricuspid annular plane systolic excursion (TAPSE) correlates reasonably well with right ventricular (RV) function in patients with structurally normal hearts and has been validated i...
Venous Thromboembolism (VTE) In Patients With Pancreatic Cancer
Authors: Kyoung Ha Kim, Seug Yun Yoon, Jina Yoon, Han Jo Kim, Se Hyung Kim, Hyun Jung Kim, Sang-Cheol Lee, Sang Byung Bae, Chan-Kyu Kim, Namsu Lee, Sung Kyu Park, Jong-Ho Won, Dae Sik Hong, Hee Sook Park
Journal: Blood (2013)