tbuckley/cabot-search huggingface dataset:
Long-Term Mortality After Cardiac Allograft Vasculopathy
Authors: Shikhar Agarwal, Akhil Parashar, Samir R. Kapadia, E. Murat Tuzcu, Dhruv Modi, Randall C. Starling, Guilherme H. Oliveira
Journal: JACC Heart Failure (2014)

This study compared the prognosis of patients with proximal cardiac allograft vasculopathy (CAV) treated with percutaneous intervention (PCI) to the prognosis of those with severe CAV not amenable to PCI.CAV is a progressive form of arterial narrowing affecting patients with orthotopic heart transplants (OHTs). PCI has been used to treat patients with focal CAV, but its efficacy remains unclear.Of 853 patients undergoing OHT and subsequent coronary angiographies at the Cleveland Clinic, all patients with at least moderate CAV (>30%) on any coronary angiogram following OHT were included. Of remaining patients with no/mild CAV, 200 patients were randomly chosen to represent the comparison group. All angiograms of the included patients were reviewed and graded according to the International Society of Heart and Lung Transplantation (ISHLT) nomenclature.Of the 393 included patients, 100 patients underwent definitive intervention for CAV. Of these 100 patients, 90 patients underwent PCI only, 6 patients underwent coronary artery bypass grafting, and 4 patients underwent repeat OHT. We observed a progressive increase in long-term mortality with worsening CAV. Patients with ISHLT grade 3 CAV had the highest long-term mortality compared with other groups. In addition, there was a significant reduction in the risk for mortality at 2-year follow-up (adjusted odds ratio: 0.26; 95% confidence interval [CI]: 0.08 to 0.82) and 5-year follow-up (adjusted odds ratio: 0.28; 95% CI: 0.09 to 0.93) after PCI compared with patients diagnosed with ISHLT grade 3 CAV, who were deemed unsuitable for PCI. Furthermore, statin use was associated with a significant survival benefit in patients with CAV (hazard ratio: 0.21; 95% CI: 0.07 to 0.61).Worsening severity of CAV was associated with progressively worse long-term survival among heart transplant recipients. Among patients with CAV, long-term survival in those with CAV amenable to PCI was greater than that in those with severe CAV not treatable with PCI.
Abstract 236: Systematic CPR Training in Elementary Schools and Students' Attitudes Toward CPR and AED Use
Authors: Taku Iwami, Tetsuhisa Kitamura, Chika Nishiyama, Kunio Ohta, Hiroshi Kaneko, Tomoo Kanna, Hiroyuki Takahashi, Sho Nachi, Hideyuki Matsumi, Takahiro Yonezawa, Hideharu Tanaka
Journal: Circulation (2011)

Introduction: Despite the proven effectiveness of bystander cardiopulmonary resuscitation (CPR), actual bystander CPR remains infrequent. The Japanese Society for Emergency Medicine started an activity to encourage schools (elementary schools/junior high schools/high schools) and school teachers to conduct a CPR training course as a systematic approach to increase bystander CPR in Japan. Objective: The objective of this study is to compare students' attitude towards CPR before and after CPR training, and to evaluate their sense of achievement after the training among young children. Method: Designs: A questionnaire survey. Main outcome measure: The positive attitude towards CPR and automated external defibrillator (AED) use. Participants: 5th- to 6th-grade elementary school students. A questionnaire survey was carried out before and after the CPR training program in schools among 1017 children. Result: A questionnaire was completed and collected from 925 (90.9%) students both before and after the CPR training. Before the training, 46.6% and 30.1% answered yes and maybe yes, respectively, to the question: “Do you feel you could check the responses of someone collapsed in front of you? Or call for emergency assistance? ”. The proportion increased to 73.1% and 19.4%, respectively, after the CPR training (Figure). Among 340 (36.8%) children, the attitude towards CPR improved after the training. For the question: “Do you understand how to perform chest compressions?”, 63.6% and 34.6% of children answered yes and almost, respectively, after the training. 72.2% and 26.2% answered yes and almost, respectively, for the question on acquisition of AED use. Conclusion: Elementary school children can understand basic CPR skills and AED use, and CPR training can improve their attitude towards CPR and AED use. Systematic CPR training in schools including elementary schools should be more enhanced to spread CPR.
2000 Albert Lasker Medical Research Awards
Authors: M F Goldsmith
Journal: JAMA (2000)

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
MEDICAL ASPECTS OF HIGH ALTITUDE FLIGHT
Authors: David N. W. Grant
Journal: Annals of Internal Medicine (1943)

Article1 June 1943MEDICAL ASPECTS OF HIGH ALTITUDE FLIGHTDAVID N. W. GRANTDAVID N. W. GRANTSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-18-6-1006 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSince civilization moved north from the warm climates of the southeastern Mediterranean, man has been required to devote some part of his energies to adjusting himself to his physical environment. Historians wish to emphasize that man's migration into new environments is but an expression of progress, and tell us that the restless spirit finds its greatest examples among the hearty of a race who seek "new worlds to conquer." Be that as it may, certainly in recent times many men have not been content with conquering the surface of the earth, but have directed their energies to mastering that which... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: AUS The Air SurgeonWashington, D. C.*Delivered before the New England Regional Meeting of the American College of Physicians, Boston, Mass., February 5, 1943. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 June 1943Volume 18, Issue 6Page: 1006-1011KeywordsRacial and ethnic issues ePublished: 1 December 2008 Issue Published: 1 June 1943 PDF downloadLoading ...
The role of prior corticosteroid use on the clinical course of Stevens-Johnson syndrome and toxic epidermal necrolysis: a case-control analysis of patients selected from the multinational EuroSCAR and RegiSCAR studies
Authors: H.Y. Lee, A. Dunant, P. Sekula, M. Mockenhaupt, P. Wolkenstein, L. Valeyrie-Allanore, L. Naldi, S. Halevy, J.C. Roujeau
Journal: British Journal of Dermatology (2012)

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are immunologically mediated, severe cutaneous adverse reactions involving cytotoxic T cells, natural killer cells and various mediators. In large studies, up to 15% of SJS/TEN occurred in patients with chronic corticosteroid use. It is unclear if this prior exposure to corticosteroids modified the disease course.To evaluate whether systemic corticosteroid usage prior to the onset of SJS/TEN modified the clinical course and outcome. If a disease-modifying effect is present, information from such an analysis may have implications on the therapeutic use of corticosteroids in SJS/TEN.This is a case-control study based on data collected in the EuroSCAR and RegiSCAR studies. Ninety-two cases of SJS/TEN with exposure to corticosteroids prior to the onset of disease, and 321 randomly selected SJS/TEN patients without prior exposure were included. Primary outcomes included progression of disease, disease severity and mortality. A secondary analysis of latency between the beginning of drug use and the onset of disease, based on exposure to a single high-risk drug, was also performed.On multivariate analysis, cases with prior exposure to corticosteroids had a longer progression of disease by 2·2 days [95% confidence interval (CI) 1·1-3·2]. The disease severity and mortality outcome were unaffected. In addition, there is evidence that corticosteroids delayed the onset of SJS/TEN in patients with exposure to high-risk drugs by 7·1 days (CI -0·2 to 14·5).The prior use of corticosteroids prolonged the period of disease progression without influencing the disease severity or mortality. In addition, when SJS/TEN is preceded by use of a single high-risk drug, the latency between the drug intake and the onset of SJS/TEN may also be increased. These findings suggest that corticosteroids have a mild impact on the course of SJS/TEN, and further studies are required to clarify any potential therapeutic effects.
Abstract 18049: Epigenomic Switch by Wnt/β-catenin Signaling Directs Cardiomyocyte Differentiation
Authors: Seitaro Nomura, Takanori Fujita, Atsuhiko T Naito, Aya Nonaka, Yoshio Kobayashi, Issei Komuro, Hiroyuki Aburatani
Journal: Circulation (2014)

Cell fate is determined by extrinsic developmental signals. During this process, transcriptional networks and epigenomic landscapes must be precisely switched. However, how cells integrate extrinsic signals into intrinsic transcriptional networks and re-organize their epigenomes for fate determination remains elusive. During heart development, Wnt/β-catenin signaling regulates mesoderm induction and cardiac mesoderm specification. Here, through integrative analysis of single-cell-transcriptome and epigenome dynamics during cardiomyocyte differentiation, we show that Wnt/β-catenin signaling switches transcriptional networks and epigenomic landscapes by redirecting the pluripotency factor Oct4 (Pou5f1) during cardiac mesoderm specification. Upon differentiation, activation of Wnt signaling induces nuclear accumulation of β-catenin/Brachyury complex, which physically interacts with Oct4 and redirects it from pluripotency enhancers to mesoderm/cardiac mesoderm enhancers. Redirected Oct4 epigenetically activates enhancers by recruiting AT-rich interactive domain-containing protein 1A (Arid1a), which then serves as a platform for the ATP-dependent helicase Brg1 for nucleosome depletion, the methylcytosine dehydrogenases Tet1/Tet2 for DNA demethylation and the histone acetyltransferases p300/CBP for H3K27ac induction. Wnt-induced Oct4 redirection also promotes rapid nucleosome formation at pluripotency enhancers and decommissions the pluripotency gene program, resulting in activation of Oct4/polycomb-repressed cardiac specification genes. Collectively, Wnt signal-induced cardiac mesoderm specification is based on cooperative pioneering binding of β-catenin/Brachyury to enhancer elements for Oct4 redirection, subsequent recruitment of Arid1a-Brg1-Tet1/2-p300/CBP epigenetic activator complex, and Oct4 redirection-induced withdrawal of the pluripotency circuit. We propose that developmental signal-induced regulator-redirection is essential for epigenomic switch in precise conversion of cell fate.
PHLDA1 (TDAG51) is a follicular stem cell marker and differentiates between morphoeic basal cell carcinoma and desmoplastic trichoepithelioma
Authors: K. Sellheyer, D. Krahl
Journal: British Journal of Dermatology (2010)

Morphoeic basal cell carcinoma (BCC) and desmoplastic trichoepithelioma can often be difficult to differentiate on routine sections and few reliable immunohistochemical markers are currently available. Recent cDNA microarray studies revealed the pleckstrin homology-like domain, family A, member 1 protein (PHLDA1) as a highly reliable marker of the hair follicle stem cells. Given the differentiation of trichoepithelioma along the follicular lineage and the proposed role of PHLDA1 as a follicular stem cell marker, we examined the staining pattern of PHLDA1 in the desmoplastic variant of trichoepithelioma and in its differential diagnostic conundrum, morphoeic BCC.To describe the expression pattern of PHLDA1 in morphoeic BCC and desmoplastic trichoepithelioma.Evaluation of the staining pattern for PHLDA1 was performed using standard immunohistochemical techniques. For comparison reasons, we analysed staining for PHLDA1 in normal skin structures with particular reference to the hair follicle.With the exception of one case, all 16 desmoplastic trichoepitheliomas were immunoreactive with more than 80% of the cells stained, whereas all 14 morphoeic BCCs were PHLDA1-negative with the exception of ulcerated tumours. In the latter, the tumour islands close to the ulcer were PHLDA1-positive whereas the deeper located tumour portions remained immunonegative. PHLDA 1 was prominently expressed in the hair follicle bulge of terminal and vellus hair follicles.The hair follicle bulge marker PHLDA1 differentiates between desmoplastic trichoepitheliomas and nonulcerated examples of morphoeic BCCs. We suggest incorporating PHLDA1 in the diagnostic work-up of difficult to differentiate basaloid tumours.
Abstract 14636: Upregulation of Cardiac β3-Adrenergic Signaling Promotes Heart Failure Progression: Evidence from Chronic β3-Adrenoceptor (AR) deficiency or β3-AR Blockade Mice
Authors: Heng-Jie Cheng, Peng Zhou, Tiankai Li, Dalane Kitzman, Michael F Callahan, Satoshi Masutani
Journal: Circulation (2014)

Background:  Heart failure (HF) is associated with the upregulation of β 3 -adrenergic receptor (AR)-mediated cardiac inhibitory pathway. This suggests cardiac β 3 -AR activation may contribute to HF progression and be a therapeutic target. We hypothesize that if upregulation of β 3 -AR is maladaptive, isoproterenol (ISO)-induced HF will be prevented in β 3 -AR knockout (β 3 KO) mice or reversed with chronic treatment of β 3 -AR antagonist (β 3 -ANT).   Methods:  We compared left ventricular (LV) and myocyte function and myocyte β-AR and SR Ca 2+ -ATPase (SERCA2a) protein expression over 16 weeks in 5 groups (6/group) of male mice. Three ISO-treated groups: wild-type (WT) and β 3 KO mice received ISO (170 mg/kg sq for 2 days), and one group WT mice after ISO injection for 12 weeks (W), L-748,337, a selective β 3 -ANT (10 -7  M/kg/day sq by mini pump) was initiated and was given for 4W. Two control groups of WT and β 3 KO mice received saline.   Results:  Compared with controls and ISO-treated β 3 KO, only ISO-treated WT (ISO/WT) mice had HF onset at 4W after ISO and progressed to severe HF at 16W with significantly elevated plasma levels of norepinephrine and increased LV myocyte protein levels of β 3 -AR (0.34 vs 0.12), but significantly decreased β 1 -AR (0.32 vs 0.62) and SERCA 2a (0.25 vs 0.68). These changes were followed by a progressive fall in LV contractility (E ES ) (0.7 vs 1.2 mmHg/μl); reductions in the peak velocity of myocyte shortening (79.4 vs 162.8 μm/s) and relengthening (73.5 vs 146.4 μm/s) and decreased peak [Ca 2+ ] iT  (0.15 vs 0.29) accompanied by a diminished myocyte inotropic response to β-AR agonist, ISO (10 -8  M). Chronic β 3 -ANT prevented the HF-induced decreases in LV and myocyte contraction, relaxation, peak [Ca 2+ ] iT ,   and restored normal myocyte contractile response to ISO stimulation. With ISO/WT plus β 3 -ANT, levels of plasma norepinephrine, myocyte β 1 -AR and SERCA2a protein expression were similar to that obtained from ISO/β 3 KO mice and all were remained close to control values of WT and β 3 KO.   Conclusions:  β 3 -AR deficiency prevented and chronic β 3 -ANT reversed HF-caused downregulation of myocyte β 1 -ARs and SERCA2a leads to the preservation of LV and myocyte function, [Ca 2+ ] iT , and β-AR responsiveness. Thus, blocking β 3 -AR may provide a new strategy for the treatment of HF.
Abstract 4113: In-Vitro Characterization of Ablation Lesions Using Oct
Authors: Christine P Fleming, Lee M Barwick, Kara J Quan, Andrew M Rollins
Journal: Circulation (2008)

Radiofrequency ablation (RFA) is a clinical procedure that destroys tissue to cure cardiac arrhythmias. Presently, there is no direct method to monitor RFA lesion formation in real-time. Real time direct monitoring of the tissue could guide ablation and prevent complications such as tissue disruption that leads to perforation. Optical coherence tomography (OCT) provides real-time subsurface imaging with high spatial resolution in three dimensions. We hypothesized that OCT can distinguish necrotic ablated tissue from viable cardiac tissue. Freshly excised right ventricular wedges from swine were placed in a bath with phosphate buffered saline (PBS) maintained at 37°C with super-perfusion flow. RFA lesions were created with a temperature controlled (70°C) protocol, maximum delivered power of 50W for 10, 20, 30, and 60 seconds. Endocardial lesions were created using a 7Fr, 4mm tip RFA catheter. OCT imaging was conducted on a system with a 1310 nm light source and 10μm axial and 18 μm lateral resolution. Staining with 0.1% triphenyltetrazolium chloride in PBS for 15 minutes was used to confirm necrosis and quantify lesion size. The single scattering model of OCT images was used to extract three parameters (attenuation, backscattering, and correlation) to give an indication of tissue scattering, reflectivity, and heterogeneity respectively. OCT images of control (n=26) and ablated tissue (n=87) were analyzed with OCT. Viable tissue had a banding appearance due to the bifriengence property of highly organized myocardial tissue, absent in necrotic tissue caused by ablation. RFA lesions were characterized by increased imaging depth, increased scattering, and a heterogeneous appearance in OCT images. The real-time changes in tissue were detected after onset of ablation. 29 tissue samples had early detection of crater formation and tissue disruption before any adverse effect could occur. The correlation and attenuation coefficients of necrotic tissue were significantly smaller than viable tissue (p&lt;0.01). Using OCT imaging, healthy endocardium and myocardium can be readily distinguished from necrotic tissue produced by RFA. This real-time monitoring may guide ablation by allowing the operator to see ablated tissue before an adverse event can occur.
Abstract 17330: Relation Between Coronary Plaque Characteristics in Culprit Lesions and C-Reactive Protein Elevation after Percutaneous Coronary Intervention in Patients with Effort Angina Pectoris
Authors: Eisuke Miura, Syouji Iwaya, Keiji sakamoto, Yuichi ujiie, Yoshitane Seino, Mikihiro Kijima, Yukio Maruyama
Journal: Circulation (2011)

Background: A significant increase in plasma C-reactive protein(CRP) after percutaneous coronary intervention(PCI) has been reported to be a predictor of long term cardiovascular events in patients with stable angina pectoris. The aim of this study was to investigate the relation between the plasma CRP before and after PCI and the coronary plaque characteristics in patients with effort angina pectoris. Methods: 54 patients with effort angina pectoris who underwent intravascular ultrasound(IVUS) and optical coherence tomography(OCT) before PCI were included. Patients were divided into a high increment in CRP one day after PCI(high-delta CRP) group(n=14, ≥3mg/l: 14.4±10.6mg/l) and a low-delta CRP group(n=40, &lt;3mg/l: 0.84±1.1mg/l). Arterial remodeling of culprit lesion was assessed by IVUS. OCT plaque characteristics for lipid content, thrombus and fibrous cap thickness were examined using previously validated criteria. In addition, the presence of lipid-laden intima with characterized a high signal band with attenuation and a diffuse border was evaluated. Results: Ruptured plaque was not observed. The thickness of the fibrous cap in the low-delta CRP group was significantly larger than that of high-delta CRP group(112.3±42.5μ m vs. 77.1±28.1μ m P&lt;0.01). And, lipid-laden intima was more frequently observed in high-delta CRP group than in the low -delta CRP group(84% vs. 25%, respectively; P&lt;0.05). Higher CRP values before PCI were observed in high-delta CRP group(2.9±2.9 mg/l vs. 1.1±1.4 mg/l, respectively; P&lt;0.05). Remodeling index, calcified and lipid plaque frequency and lipid profile were comparable between two groups. An increment of Troponin-I level after PCI had a tendency to be higher in high-delta CRP group than low-delta CRP group(2.75±3.39 ng/ml vs. 0.97±2.57 ng/ml, respectively; p=0.067). Conclusion: This result suggests that existence of thin fibrous cap with non-ruptured lipid plaque accelerates to inflammatory process in coronary atherosclerotic lesion by mechanical stress due to PCI and that OCT is useful for detecting the appearance of coronary plaque instability in patients with effort angina pectoris.
Gastrointestinal Disorders: A Pathophysiologic Approach.
Authors: Norton J. Greenberger
Journal: Annals of Internal Medicine (1986)

versial is the notion that it may be safe to lower the pressure abruptly to normal levels, a strat- egy that.can lead to cerebral and optic nerve ischemia.On balance the misinforma- tion in this book outweighs the information.
Letter from Chengdu: China takes to the roads
Authors: I. Roberts
Journal: BMJ (1995)

countries who prefer these jobs to working in their own countries.Another option would be to use increasingly the services of nurses and health workers for primary health care.In summary, South Africa's medical workforce is inadequate and unevenly distributed.It is in a state of flux, with doctors emigrating from and immigrating to South Africa.The immediate shortage will inevitably be made up by foreign medical graduates.These problems are not unique to South Africa, and the way South Africa goes about solving them will be of interest to health planners in other areas of the world.1 Pick W. The development of human resources for health in South Africa: ethical dilemmas post apartheid.
A Novel Hybrid Of On-Pump Beating Heart Coronary Artery Bypass Grafting Results Produces Significant Myocardial Injury Compared to Conventional Cardioplegic Arrest
Authors: T J Pegg, J Francis, T Karamitsos, Z Maunsell, Yu L-M., S Neubauer, D Taggart, J B Selvanayagam
Journal: Circulation (2008)