tbuckley/cabot-search huggingface dataset:
Abstract 19307: A Selective Tgfβ Ligand Trap Attenuates Pulmonary Hypertension
Authors: Lai-Ming Yung, Ivana Nikolic, Samuel Paskin-Flerlage, Scott Pearsall, Ravindra Kumar, Paul Yu
Journal: Circulation (2016)

Introduction: Transforming Growth Factor-β (TGFβ) ligands signal via type I and type II serine-threonine kinase receptors to regulate broad transcriptional programs. Excessive TGFβ-mediated signaling is implicated in the pathogenesis of pulmonary arterial hypertension (PAH), based in part on the ability of broad inhibitors of TGFβ/Activin/GDF/Nodal receptors ALK4/5/7 to attenuate experimental pulmonary hypertension (PH). These broad inhibition strategies do not delineate the specific contribution of TGFβ vs. a multitude of other ligands, and their translation is limited by cardiovascular and systemic toxicity. Hypothesis: We tested whether or not TGFBRII-Fc, a selective TGFβ1/3 ligand trap, reverses PH and vascular remodeling in experimental PH models. Methods: Signaling studies utilized cultured human pulmonary artery smooth muscle cells. PH was studied in monocrotaline-treated Sprague-Dawley rats, SUGEN/hypoxia-treated Sprague-Dawley rats and SUGEN/hypoxia-treated C57BL/6 mice. PH, cardiac function, vas...
Abstract 12136: Bag-mask Ventilation Without Lung Inflation is Common During Out-of-Hospital 30:2 Cardiopulmonary Resuscitation
Authors: Andrew Fredericks, Yuanzheng Lu, Lindsay Schroeder, Thomas Cooper, Lawson Floyd, Mary Chang, Ahamed H Idris
Journal: Circulation (2016)

Introduction: American Heart Association guidelines for cardiopulmonary resuscitation (CPR) recommend recurring cycles of 30 chest compressions interrupted by a pause for two ventilations when an advanced airway device has not been placed. Few studies have measured lung inflation during pauses for ventilation in 30:2 CPR for out-of-hospital cardiac arrest (OOHCA). Objective: To determine the number of ventilation pauses with measureable lung inflation during 30:2 CPR for OOHCA. Methods: This is an observational, retrospective analysis of non-traumatic, OOHCA in patients ≥18 years old who received 30:2 CPR by emergency medical service (EMS) rescuers. Data is from the Dallas-Fort Worth site of the Resuscitation Outcomes Consortium cardiac arrest registry. Ventilation data are derived from defibrillator electronic recordings during the first six minutes of CPR when rescuers used a bag-mask device for ventilation. The recordings display thoracic bioimpedance waveforms of chest compressions and lung inflations. An interruption for ventilation is defined as a pause in chest compressions of 3 to 15 seconds. We assessed the presence of lung inflation waveforms during the pause for ventilation. Lung inflation was defined as a waveform with at least 2 mm (0.4 ohm) amplitude and at least 1-second duration. Results: We analyzed 200 patients with OOHCA who received 30:2 CPR cycles by EMS from February 2012 to June 2014. A total of 1,590 ventilation pauses were analyzed; of the 1,590 ventilation pauses, 57% did not have any measurable lung inflation waveforms (Table). Twenty-five (12.5%) patients had no lung inflation during the first six minutes of CPR. Return of spontaneous circulation occurred in 21%. Conclusions: The majority of patients did not receive lung inflation during 50% or more of each 30:2 CPR episode. This could be a factor in explaining why ventilation has not been shown to improve survival outcomes. Further studies should evaluate this topic in greater detail.
Abstract 13826: Patient Characteristics and Prognosis of OCT Verified Calcified Nodules in Acute Coronary Syndrome
Authors: Tsuyoshi Nishiguchi, Atsushi Tanaka, Akira Taruya, Shigetoshi Hikimoto, Junko Morimoto, Kazuya Mori, Yoshinori Asae, Daisuke Higashioka, Tetsuya Tamaki, Hiroshi Aoki, Ikuko Teraguchi, Takeyoshi Kameyama, Keishi Okouchi, Yasutsugu Shiono, Makoto Orii, Akio Kuroi, Tomoyuki Yamaguchi, Takashi Yamano, Yoshiki Matsuo, Yasushi Ino, Takashi Kubo, Takeshi Hozumi, Takashi Akasaka
Journal: Circulation (2015)

Backgrounds: Pathological studies have shown that calcified nodule (CN) is one of important causes for acute coronary syndrome (ACS). Optical coherence tomography (OCT) is able to identify CN in vivo. No data, however, is available for prognosis of CN. Purpose: The purpose of this study was to investigate the prognosis of CN. Methods: This study consisted of 492 patients with ACS on native coronary artery who underwent pre-PCI OCT to explore the culprit artery. Patients were divided into a CN group and a non-CN group according to OCT findings. The OCT criterion of CN was defined when fibrous cap disruption was detected over a calcified plaque characterized by protruding calcification, superficial calcium, and the presence of substantive calcium proximal and/or distal to the lesion. The primary end-point was overall survival. The secondary end-point was composite of major adverse cardiac events (MACE) including cardiac death, non-fetal myocardial infarction (MI), and unstable angina pectoris (uAP). Results: The prevalence of OCT-CN was 4.5% (n=22). Patients with CN were significantly older (CN: 75.4±9.0 vs. non-CN: 66.7±11.3, p&lt;0.01), and more likely to female (CN: 50% vs. non-CN: 23%, p&lt;0.01). Compared with non-CN patients, hypertension (CN: 95% vs. non-CN: 71%, p&lt;0.01), and hemodialysis (CN: 18% vs. non-CN: 3%, p&lt;0.01) were more common in CN. Mean follow-up period was 25.4 (range 1-60) month. During the period, cardiac death occurred in 19 (CN: 1, non-CN: 18), non-cardiac death in 15 (CN: 3, non-CN: 12), non-fatal MI in 7 non-CNs, and uAP in 11 non-CNs. Kaplan-Meier curve showed significantly low overall survival in CN (Figure A, p&lt;0.05), while MACE were similar in both groups (Figure B, p=0.42). Conclusions: The prevalence of OCT-CN was 4.5%. Patients with CN were older, and had more co-morbidities including hypertension and kidney dysfunction. The overall survival was significantly poor in patients with CN, although the MACE free survival were similar between groups.
Abstract 17961: Circulating MicroRNA-122 is Associated With Incident Metabolic Syndrome and Type-2-diabetes
Authors: Peter Willeit, Xiaoke Yin, Dorothee Kaudewitz, Philipp Skroblin, Anna Zampetaki, Alexander R Moschen, Cristina M Ramirez, Leigh Goedeke, Noemi Rotllan, Enzo Bonora, Alun D Hughes, Siegfried Weger, Carlos Fernandez-Hernando, Herbert Tilg, Johann Willeit, Stefan Kiechl, Manuel Mayr
Journal: Circulation (2015)

Background: MicroRNA-122 (miR-122) is highly abundant in the liver and has been implicated in lipid and glucose homeostasis. Methods: Circulating miR-122 levels were measured in the prospective population-based Bruneck Study (n=810) and the ASCOT trial (n=155 pre/post atorvastatin initiation). Using mass spectrometry, we measured 135 lipid subspecies and 93 plasma proteins in Bruneck participants. We also conducted mechanistic studies in pre-clinical models and cultured hepatocytes. We calculated risk ratios over up to 15 years follow-up for cardiometabolic diseases using pooled logistic and Cox regression, incorporating repeated miR-122 measurements. Results: In the Bruneck Study, miR-122 was associated with an adverse metabolic profile, including insulin resistance, obesity, and prevalent metabolic syndrome and diabetes. MiR-122 positively correlated with lipid subspecies containing fatty acids that can be derived from hepatic de novo lipogenesis. In mice, miR-122 inhibition with antagomiR treatment down-regulated hepatic enzymes implicated in de novo lipogenesis and cholesterol synthesis. In the ASCOT trial, 10mg atorvastatin treatment led to a reduction in circulating miR-122 levels. A similar statin response was observed in mice and in primary hepatocytes. In the Bruneck Study, miR-122 was closely related to circulating levels of afamin, zinc-alpha-2-glycoprotein, and a wide range of apolipoproteins. The adjusted relative risk per SD higher log miR-122 was 1.60 (1.30-1.96; P&lt;0.001) for metabolic syndrome, 1.37 (1.03-1.82; P=0.021) for type-2 diabetes, and 1.10 (0.90-1.33; P=0.330) for cardiovascular disease. Risk ratios were similar upon further adjustment, for women and men, and by clinical categories of adiposity. Conclusion: This study provides strong evidence for an involvement of miR-122 in glucose and lipid metabolism. High miR-122 levels correlate with an adverse lipid profile and multiple metabolic abnormalities and are associated with a higher risk of new-onset metabolic syndrome and diabetes in the general community.
Abstract 209: Association Between Cannabis Use and TakoTsubo Cardiomyopathy (TTC): Analysis from the NIS 2012 - 2014
Authors: Samson Alliu, Adeyinka Adejumo, Oluwole Adegbala, Vinod Namana, Pendkar Chetana, Borovinskaya Yevgeniya, Melvyn Hecht, Lawrence Wolf, Stephan Kamholz, Gerald Hollander, Jacob Shani, Modupeolowa Durojaiye
Journal: Circulation Research (2017)

Background and Objective: Marijuana use causes catecholamine surge with consequent tachycardia and elevation of both systolic and diastolic blood pressure. It is unclear if the catecholamine surge associated is sufficient to cause left ventricular wall apical ballooning (TakoTsubo Cardiomyopathy (TTC)). Given the similarity in the pathophysiology of TTC and mechanism of action of cannabis, we sought to investigate if there is any association. Methods: We obtained data from the HCUP-NIS of all patients older than 45 years hospitalized between 2012 - 2014. Our main outcome was diagnosis of TTC, and main exposure variables was cannabis use both identified using the ICD-9 codes. Using the SURVEYLOGISTICS procedure, we performed logistic regressions to estimate the odds of TTC diagnosis and in-hospital mortality among cannabis users adjusting for demographics, comorbidities, and other recreational drugs. Results: Of the 7,805,400 hospitalized patients who were &gt; 45 years, 10,160 (0.1%) had a diagnosis of TTC, 54,311 (0.7%) were nondependent cannabis user and 5,045 (0.1%) were dependent cannabis users. We observed a significant association between TTC and nondependent cannabis use (OR 1.35, 95% CI: 1.10-1.65), but the association was nonsignificant for dependent cannabis use. After adjusting for potential confounders such as age, race, gender, comorbidities, cocaine, amphetamine and alcohol, nondependent cannabis use was associated with a 2-fold increased odds of TTC (AOR 2.00, 95% CI: 1.61-2.40). However, the association remained nonsignificant for dependent cannabis users (AOR 0.70, 95% CI: 0.25-1.92). Also, among patients diagnosed with TTC, there was no significant difference in the odds of in-hospital mortality among cannabis users (dependent and nondependent) when compared to nonusers (AOR 1.04, 95% CI: 0.39 - 2.70). Conclusion: In our study population, nondependent cannabis use was associated with significantly increased odds of TTC. However, among patients with TTC, in-hospital mortality rate was the same irrespective of cannabis exposure.
Abstract 18994: Impact of Hospital Volume on Catheter Ablation of Atrial Fibrillation-Data From the Largest Inpatient Registry (2011-2014)
Authors: Parshva Patel, Kanishk Agnihotri, Kriti Sharma, Ghanshyam Shantha, Subir Bhatia, Nilay Patel, Anil K Jonnalagadda, Abhishek Kumar, Danesh Kella, Ekta Aneja, Hakan Paydak, Abhishek Deshmukh
Journal: Circulation (2017)

Introduction: Contemporary large scale data on adverse outcomes arising from atrial fibrillation (AF) catheter ablation is limited. The aim of our study was to examine frequency of adverse events d...
Doctor who falsified notes after failure to remove IUD is suspended for six months
Authors: Clare Dyer
Journal: BMJ (2018)

A doctor who falsified patient notes and enlisted an unwitting colleague in her cover-up attempt after receiving a letter about a potential clinical negligence claim has been suspended from the UK medical register for six months.

Neera Watts was an associate specialist in sexual and reproductive health at the Le Bas Centre in St Helier, Jersey, when she received a letter from Jersey’s health department in February 2017 requesting copies of a patient’s medical records in relation to a potential negligence claim dating from 2012.

Looking back at her records, she realised that she had inserted a Mirena intrauterine system without first …
The NACSTOP Trial: A Multicenter, Cluster‐Controlled Trial of Early Cessation of Acetylcysteine in Acetaminophen Overdose
Authors: Anselm Wong, Richard McNulty, David Taylor, Marco Sivilotti, Shaun Greene, Naren Gunja, Zeff Koutsogiannis, Andis Graudins
Journal: Hepatology (2018)

Historically, intravenous acetylcysteine has been delivered at a fixed dose and duration of 300 mg/kg over 20 to 21 hours to nearly every patient deemed to be at any risk for hepatotoxicity following acetaminophen overdose. We investigated a 12‐hour treatment regimen for selected low‐risk patients. This was a multicenter, open‐label, cluster‐controlled trial at six metropolitan emergency departments. We enrolled subjects following single or staggered acetaminophen overdose with normal serum alanine transaminase (ALT) and creatinine on presentation and at 12 hours, and less than 20 mg/L acetaminophen at 12 hours. Patients were allocated to intervention (250 mg/kg over 12‐hour) or control (300 mg/kg over 20‐hour) regimens by site. The primary outcome was incidence of “hepatic injury” 20 hours following initiation of acetylcysteine treatment, defined as ALT doubling and peak ALT greater than 100 IU/L, indicating the need for further antidotal treatment. Secondary outcomes included incidence of hepatotoxicity (ALT &gt; 1,000 IU/L), peak international normalized ratio (INR), and adverse drug reactions. Of the 449 acetaminophen overdoses receiving acetylcysteine, 100 were recruited to the study. Time to acetylcysteine (median 7 hours [interquartile ratio 6,12] versus 7 hours [6,10]) and initial acetaminophen (124 mg/L [58,171] versus 146 mg/L [66,204]) were similar between intervention and control groups. There was no difference in ALT (18 IU/L [13,22] versus 16 IU/L [13,21]) or INR (1.2 versus 1.2) 20 hours after starting acetylcysteine between groups. No patients developed hepatic injury or hepatotoxicity in either group (odds ratio 1.0 [95% confidence interval 0.02, 50]). No patients represented with liver injury, none died, and 96 of 96 were well at 14‐day telephone follow‐up. Conclusion : Discontinuing acetylcysteine based on laboratory testing after 12 hours of treatment is feasible and likely safe in selected patients at very low risk of liver injury from acetaminophen overdose.
Abstract 18725: Current Era Survival and Prevalence of Pulmonary Hypertension-Specific Therapy in Adult Patients With Eisenmenger Syndrome
Authors: Hideo Matama, Shigefumi Fukui, Takeshi Ogo, Jin Ueda, Akihiro Tsuji, Teruo Noguchi, Kengo Kusano, Toshihisa Anzai, Satoshi Yasuda
Journal: Circulation (2016)

Background: We have previously reported that patients with Eisenmenger syndrome (ES) without diagnosis until adulthood had a poor prognosis. Those patients were enrolled before 1998, when any pulmo...
Abstract 17560: Characteristics Associated With Symptom Diary Use in Patients With Heart Failure
Authors: Linda G Park, Kathleen Dracup, Mary A Whooley, Debra K Moser, Michele M Pelter, Martha Biddle, Robyn A Clark, Jill Howie-Esquivel
Journal: Circulation (2015)

Introduction: Health care providers regularly counsel heart failure (HF) patients to monitor symptoms and weight changes daily in order to detect and quickly treat HF exacerbations. We found diary use is associated with higher survival rates in chronic HF patients; however, the factors related to diary use are unknown. Therefore, the aim of this study was to determine the factors associated with diary use. Methods: We conducted a secondary analysis of a 3-arm randomized controlled trial among rural HF patients with two intervention groups (Fluid Watchers LITE and PLUS) and usual care. The two intervention groups were asked to use daily diaries for 2 years to track weight, HF symptoms, and response to symptom changes. The intervention groups received education on HF self-care and a script to call their health care provider; however, the 2 groups varied on the number of follow-up phone calls received. Patient groups were categorized by duration of adherence to diary use: None, Low (1-3 months), Medium (4-12 months), and High (13-24 months). Multivariable ordinal logistic regression using step-wise forward selection was conducted to determine factors that were associated with diary use. Results: Patients were 66 ± 13 years old, 58% were male, and 50% had systolic HF with 67% (N=264/393) of patients who completed diaries. After controlling for age, depression, and death in the multivariable logistic ordinal regression, depression (OR, 0.95; 95% CI, 0.92-0.98; P=0.002) and sedentary lifestyle (OR, 0.61; 95% CI, 0.42-0.89; P=.01) were associated with less diary use. In contrast, older age (OR, 1.59; 95% CI, 1.07-2.3; P=.02) and HF self-care (OR, 1.03; 95% CI, 1.01-1.06; P=.01) were associated with more diary use. Conclusions: Since diary use is associated with higher survival rates in HF patients, it is important to recognize that depression and sedentary lifestyle were negatively associated with diary use whereas older age and HF self-care were positively associated with diary use. Addressing modifiable psychosocial factors may have meaningful impact on improving survival in this vulnerable population of HF patients who suffer from frequent rehospitalizations and early death related to their disease.
Abstract 9449: Feasibility and Accuracy of High Resolution 4D Echocardiography for Evaluation of Left Ventricular Mass and Stroke Volume: An in vitro Phantom Study
Authors: Cole Streiff, Jill Panosian, Meihua Zhu, Glenn R Lie, Gunnar Hansen, Muhammad Ashraf, David J Sahn
Journal: Circulation (2013)

Background: This study was designed to determine the accuracy and feasibility of a new 4D echo-based semi-automated quantification of left ventricular (LV) mass (LVM) and stroke volume (SV) in an in vitro phantom model. Methods: Ten freshly harvested adult pig and sheep hearts (147-326 grams) were passively driven using a pulsatile pump to simulate normal cardiac motion. Each heart was pumped at 3 stroke rates (SR) (40, 65, and 85 strokes/min) and 3 SVs (30, 50, and 70 ml at each SR). Full-volume 4D cine loops were collected with a 3V Matrix transducer interfaced with a GE Vivid E9 ultrasound system at a maximized frame rate (≥25 FPS) using multi-beat acquisition. Images were analyzed offline using EchoPAC PC for semi-automated quantification of SV and LVM and compared to displacement values. Results: No significant differences were detected between the values of either SV or LVM at different stroke rates (P=0.99). Data showed excellent linear correlation between 4D echo-derived SV and LVM, and displacement data (SV: R 2 =0.96, p&lt;0.001; LVM: R 2 =0.99, p&lt;0.001). Bland-Altman analyses revealed 98% and 99% of points within a 95% CI for SV and LVM respectively. Interobserver variability was shown to be excellent (SV: R 2 =0.92, p&lt;0.001; LVM: R 2 =0.99, p&lt;0.001). Conclusions: 4D echo-based quantification may be an accurate and feasible method for determination of LV mass and stoke volume and a physiologically relevant range of stroke volumes and stroke rates.
Abstract 19530: Cardiac Fibroblasts Derived Exosomes Enhanced Endothelial to Mesenchymal Transition and Associated Fibrotic Signaling
Authors: Suresh K Verma, Venkata N Girikipathi, Moshin Khan, Cynthia Benedict, Emily Nickoloff, David Goukassian, Raj Kishore
Journal: Circulation (2016)

Background: Endothelial to mesenchymal transition (EndMT), play critical role in pressure overload-induced pathological fibrosis. Recent studies suggested the contribution of fibroblasts-derived ex...
Increasing burden of noninfectious lung disease in persons living with HIV: a 7-year study using the French nationwide hospital administrative database
Authors: Thomas Maitre, Jonathan Cottenet, Guillaume Beltramo, Marjolaine Georges, Mathieu Blot, Lionel Piroth, Philippe Bonniaud, Catherine Quantin
Journal: European Respiratory Journal (2018)

An overall reduction in the incidence of AIDS and a change in the spectrum of lung disease have been noticed in persons living with HIV (PLHIV). Our aim was to provide an epidemiological update regarding the prevalence of lung diseases in PLHIV hospitalised in France. We analysed the prevalence of lung disease in PLHIV hospitalised in France from 2007 to 2013, from the French nationwide hospital medical information database, and assessed the association between HIV and incident noninfectious disease over 4 years of follow-up. A total of 52 091 PLHIV were hospitalised in France between 2007 and 2013. Among PLHIV hospitalised with lung disease, noninfectious lung diseases increased significantly from 45.6% to 54.7% between 2007 and 2013, whereas the proportion of patients with at least one infectious lung disease decreased significantly. In 2010, 10 067 prevalent hospitalised PLHIV were compared with 8 244 682 hospitalised non-PLHIV. In 30–49-year-old patients, HIV infection was associated with chronic obstructive pulmonary disease (COPD), chronic respiratory failure, emphysema, lung fibrosis and pulmonary arterial hypertension (PAH) even after adjustment for smoking. The emergence of noninfectious lung disease, in particular COPD, emphysema, lung fibrosis, PAH and chronic respiratory disease, in PLHIV would justify mass screening in this population.
Abstract 20164: Leukemia is Associated With a High Prevalence of Major Adverse Cardiac Events After Anthracycline-Based Chemotherapy
Authors: Bruna M Assuncao, Lin Wang, Marielle Scherrer-Crosbie
Journal: Circulation (2016)

Background: Leukemia is a systemic disease with high pro-inflammatory cytokines release and possible direct leukemic cells infiltration of the heart. The objective of the study was to investigate whether leukemia is associated with major adverse cardiac event (MACE) in a cohort of cancer patients after anthracycline-based chemotherapy. Methods: We studied 2285 consecutive cancer patients who underwent an echocardiogram before anthracyclines therapy. Major adverse cardiac events (MACE) were defined based on examination of the records as cardiac death or symptomatic heart failure. Cox regression analysis without and with adjustment for baseline characteristics was used to determine the variables associated with MACE. Results: The baseline characteristics of patients with leukemia and other types of cancer are summarized in the Table. Sixty five patients (2.8%), had a MACE over a follow-up period of 706 (235-1665) days. The incidence rate of MACE was 8 times higher in leukemia patients (55.3 events/1000 pers...