tbuckley/cabot-search huggingface dataset:
Long-term Risk of Hypertension After Surgical Repair of Congenital Heart Disease in Children
Authors: Jason H. Greenberg, Eric McArthur, Heather Thiessen-Philbrook, Michael Zappitelli, Ron Wald, Sunjay Kaushal, Derek K. Ng, Allen D. Everett, Rahul Chanchlani, Amit X. Garg, Chirag R. Parikh
Journal: JAMA Network Open (2021)

<h3>Importance</h3> The long-term risk of hypertension in children after surgery for congenital heart disease (CHD) is unclear. <h3>Objective</h3> To assess the incidence of hypertension after cardiac surgery in children with CHD. <h3>Design, Setting, and Participants</h3> A multicenter retrospective matched cohort study was conducted in Ontario, Canada, using administrative databases. A total of 3600 children with surgical repair of CHD were matched to 10 children (n = 36 000) from the general population without CHD on age, sex, index date, rurality, and neighborhood income. <h3>Main Outcomes and Measures</h3> Diagnosis of hypertension over a median follow-up time of 9.8 years (interquartile range, 6.8-12.9 years) after surgery. The last follow-up was March 31, 2019. <h3>Results</h3> Overall, in 3600 children with surgical repair of CHD, the median age at first surgery was 150 days (interquartile range, 40-252 days) and 2005 (55.7%) were boys. During follow-up, 445 (12.4%) children with surgical repair of CHD developed hypertension compared with 398 (1.1%) in the matched control group. The incidence rate of hypertension in children who received surgery for CHD was 141.3 (95% CI, 128.8-155.1) per 10 000 person-years compared with children in the matched control group, who had a rate of 11.1 (95% CI, 10.1-12.3) per 10 000 person-years. The risk of hypertension was higher in children with index surgical dates at an age of less 150 days compared with those who had surgical dates at an age of 150 days or older (<i>P</i> = .006 for interaction). The risk of hypertension was increased in children with more complex surgery, particularly children with hypoplastic left heart syndrome (49 of 140 [35.0%]), and in children who received dialysis (22 of 126 [17.5%]; hazard ratio, 1.67; 95% CI, 1.09-2.56) during the index cardiac surgery hospitalization. <h3>Conclusions and Relevance</h3> The incidence of long-term hypertension in this study was 12 times higher in children with surgical repair of CHD compared with children in the matched control group. The findings suggest that interventions aimed at reducing the long-term risk of hypertension after cardiac surgery in this population are needed.
Regional differences in myocardial performance in the left ventricle of the dog.
Authors: M MLeWinter, R SKent, J MKroener, T ECarew, J WCovell
Journal: Circulation Research (1975)

To determine whether significant regional differences in shortening exist in the canine left ventricle, the shortening characteristics of small segments of the circumferentially oriented hoop axis fibers and the more longitudinally oriented fibers near the epicardium were examined using pairs of ultrasound crystals placed at three levels of the left ventricular free wall in the open-chest dog. Mean control shortening of the hoop axis fibers near the apex of the left ventricle averaged 20% of the end-diastolic length, significantly greater than shortening at the midventricular (13%) or basal (14%) levels. During transient periods of aortic constriction, end-diastolic length increased significantly and the extent of shortening was maintained for the hoop axis fibers at the apical and midventricular levels; end-diastolic length did not change and shortening decreased at the basal level. The epicardial fibers shortened an average of 5.6% of their end-diastolic length during control conditions at all three sit...
Developmental trajectory of the healthy human gut microbiota during the first 5 years of life
Authors: Josefine Roswall, Lisa M. Olsson, Petia Kovatcheva-Datchary, Staffan Nilsson, Valentina Tremaroli, Marie-Christine Simon, Pia Kiilerich, Rozita Akrami, Manuela Krämer, Mathias Uhlén, Anders Gummesson, Karsten Kristiansen, Jovanna Dahlgren, Fredrik Bäckhed
Journal: Cell Host & Microbe (2021)

The gut is inhabited by a densely populated ecosystem, the gut microbiota, that is established at birth. However, the succession by which different bacteria are incorporated into the gut microbiota is still relatively unknown. Here, we analyze the microbiota from 471 Swedish children followed from birth to 5 years of age, collecting samples after 4 and 12 months and at 3 and 5 years of age as well as from their mothers at birth using 16S rRNA gene profiling. We also compare their microbiota to an adult Swedish population. Genera follow 4 different colonization patterns during establishment where Methanobrevibacter and Christensenellaceae colonize late and do not reached adult levels at 5 years. These late colonizers correlate with increased alpha diversity in both children and adults. By following the children through age-specific community types, we observe that children have individual dynamics in the gut microbiota development trajectory.
Time course of increased collateral arterial and venous endothelial cell turnover after renal artery stenosis in the rat.
Authors: NIlich, N KHollenberg, D HWilliams, H LAbrams
Journal: Circulation Research (1979)

We induced left renal artery stenosis in rats and studied collateral arterial formation by angiography, histology, and radioautography with tritiated thymidine. Endothelial cell turnover was estimated by radioautography with tritiated thymidine in the periureteric blood supply of 10 normal and 38 collateral-forming kidneys 1 to 100 days after stenosis. Periureteric arterial endothelial cell labeling showed a highly significant (P less than 0.005) increase, apparent within 1 day and gradually falling as the vessels grew, until a baseline was reached in 35 days. A smaller but statistically significant increase in the labeling index also was found in endothelial cells of the renal vein during the first week (P less than 0.01), and had a similar time course. A marked increase in epithelial cell labeling in the ureters draining the stenotic kidneys also was evident (P less than 0.005). Thus, collateral vessel development is characterized by active DNA synthesis in the cellular elements which is maximal during ...
A Proposed Revision of the Stepwise Treatment Algorithm in Asthma
Authors: Richard Beasley, Pepa Bruce, Lee Hatter, Irene Braithwaite, Alex Semprini, Ciléin Kearns, Mark Weatherall, Ian D. Pavord
Journal: American Journal of Respiratory and Critical Care Medicine (2021)

To the Editor:The stepwise approach to the pharmacologic treatment of asthma is a core foundation of asthma guidelines (1).Through this approach, treatment intensity is increased in discrete steps to obtain symptom control and reduce exacerbation risk and is decreased after a period of prolonged control.The stepwise approach is usually shown by an algorithm, as illustrated in the 2020 Global Initiative for Asthma (GINA) strategy update (Figure 1).Here, we review the 2020 GINA stepwise algorithm and suggest alternative evidence-based algorithms that address potential problems with the currently recommended approach.Currently at each step, the GINA algorithm aligns treatment recommendations based on inhaled corticosteroid (ICS)/formoterol reliever therapy with those of the traditional short-acting b 2 -agonist (SABA) reliever therapy.This assumes that the efficacy of treatment incorporating ICS/formoterol reliever therapy at each step aligns more closely with the corresponding alternative treatment incorporating a SABA reliever at the same step, rather than at adjacent higher or lower steps, which is not the case (2-4).This is illustrated by the recent systematic review and network meta-analysis that reported that the relative risk of a severe exacerbation with low-dose ICS/formoterol maintenance and reliever therapy at GINA step 3 compared with lowdose ICS/long-acting b 2 -agonist (LABA) plus SABA therapy (GINA step 3), medium-dose ICS/LABA plus SABA (GINA step 4), and highdose ICS/LABA plus SABA (GINA step 5) was 0.55 (95% confidence interval [CI], 0.47-0.64),0.71 (95% CI, 0.56-0.91),and 0.78 (95% CI, 0.51-1.21)respectively (3).Thus, low-dose ICS/formoterol maintenance and reliever therapy at GINA step 3 aligns most closely in terms of efficacy with high-dose ICS/LABA plus SABA therapy at GINA step 5 and then progressively aligns to a lesser extent with medium-dose ICS/LABA plus SABA therapy at GINA step 4 and then with low-dose ICS/LABA plus SABA therapy at GINA step 3.This ranking of efficacy is thus discordant with the current algorithm.This structural problem could be resolved by separating the instructions for the stepwise approach incorporating ICS/formoterol reliever therapy from those incorporating SABA reliever therapy by using two separate algorithms, as was undertaken in the New Zealand asthma guidelines in 2020 (5).This avoids the problem of step misalignment and the potential inadvertent mixing of the two approaches.It is possible to simplify the
A requiem for vagotomy.
Journal: BMJ (1991)

mortality: age-specific effects in Nijmegen project, 1975-82. Lancet 1985;i:865-6. 10 Collette HJA, Rombach JJ, Day NE, de Waard F. Evaluation of screening for breast cancer in a non-randomised study (the DOM project) by means of a case-control study. Lancet 1984;i: 1224-6. 11 Palli D, del Turco MR, Buiatti E, et al. A case-control study of the efficacy of a non-randomized breast cancer screening program in Florence (Italy). IntJ Cancer 1986;38:501-4.
Distinct behavior of cardiac myosin heavy chain gene constructs in vivo. Discordance with in vitro results.
Authors: P MButtrick, M LKaplan, R NKitsis, L ALeinwand
Journal: Circulation Research (1993)

Transcriptional thyroid hormone responsiveness of the cardiac alpha-myosin heavy chain (alpha-MHC) gene has been demonstrated in transfections into fetal and neonatal cardiomyocytes and in transgenic mice. However, the correspondence between the regulation of MHC expression in dissociated cells with that in the intact heart is unclear. Given the cost and time involved in generating multiple transgenic lines for the characterization of gene regulatory elements, we used direct cardiac gene transfer to identify elements regulating both basal and thyroid hormone responsive cardiac alpha-MHC gene expression in the adult heart in vivo. Sequences upstream of the rat alpha-MHC gene linked to a luciferase reporter gene were injected into the hearts of adult rats subjected to various thyroid manipulations. The 161-bp sequence upstream of the transcription start site, which contains a TATA box, a CCAATT box, and a thyroid hormone response element, was transcriptionally active but not thyroid hormone responsive. The ...
Feedforward control of coronary blood flow via coronary beta-receptor stimulation.
Authors: J KMiyashiro, E OFeigl
Journal: Circulation Research (1993)

It is usually assumed that the increase in coronary blood flow observed with norepinephrine occurs through local metabolic vasodilation secondary to cardiac beta-receptor activation. However, direct feedforward beta-receptor-mediated coronary vasodilation is also a possibility. In dogs with alpha-receptor blockade, the left circumflex artery was perfused at constant pressure. The vasodilator effect of intracoronary norepinephrine injections was determined during prolonged diastoles to avoid the chronotropic and intropic effects of norepinephrine. Norepinephrine caused a dose-dependent increase in coronary blood flow that was attenuated by both the selective beta 1-antagonist practolol and the selective beta 2-antagonist ICI 118,551. These data indicate that norepinephrine activates beta 1- and beta 2-receptors in coronary resistance vessels to cause vasodilation independent of inotropic and chronotropic effects. The physiological significance of coronary beta-receptor-mediated vasodilation was investigate...
Plasma norepinephrine concentration and plasma dopamine-beta-hydroxylase activity in patients with congestive heart failure.
Authors: MMinami, HYasuda, NYamazaki, SKojima, HNishijima, NMatsumura, HTogashi, YKoike, HSaito
Journal: Circulation (1983)

The relationship between plasma norepinephrine (NE), epinephrine (E) and dopamine-beta-hydroxylase activity (DBH) was studied in 90 cardiac patients (New York Heart Association [NYHA] classes I-IV), 85 healthy control subjects and 18 competitive skiers. The cardiac patients in NYHA classes III and IV had significantly higher NE (p less than 0.001) and lower DBH (p less than 0.001) levels than the controls, whereas the skiers had significantly lower NE (p less than 0.001) and higher DBH (p less than 0.05) levels than the controls. Seven cardiac patients in whom successful cardiac surgery was performed had decreased NE (p less than 0.001) and increased DBH (p less than 0.02), as well as significantly improved NYHA cardiac status (p less than 0.001). These findings demonstrate an inverse relationship between NE and DBH in a population of athletes, normal subjects and cardiac patients; the same inverse relationship holds for these patients when sequential studies are done after a change in cardiac status.
Platelets protect against myocardial dysfunction and injury induced by ischemia and reperfusion in isolated rat hearts.
Authors: B CYang, RVirmani, W WNichols, J LMehta
Journal: Circulation Research (1993)

Platelets are a source of vasoactive mediators that regulate vascular tone. Platelets also play a role in intravascular thrombus formation and dynamic coronary constriction that result in myocardial ischemia. However, effects of platelets on myocardial function after ischemia and reperfusion are unknown. In this study, we examined the effects of platelets on myocardial dysfunction caused by ischemia/reperfusion. Buffer-perfused isolated rat hearts, after global ischemia (15 minutes) and reperfusion (10 minutes), developed marked myocardial dysfunction, indicated by a 65 +/- 4% decrease in the force of cardiac contraction (FCC) and a 26 +/- 7% increase in coronary perfusion pressure (CPP). Ischemia/reperfusion was also associated with release of creatine kinase (CK) and ATP metabolites in the coronary effluents. Perfusion of hearts with buffer containing washed rat platelets (3-8 x 10(7) cells/ml) protected hearts against dysfunction from ischemia/reperfusion, indicated by minimal changes in CPP (-1 +/- 1%...
Case 6-2008
Authors: Jonathan Kay, Hasan Bazari, Laura L. Avery, Aashiyana F. Koreishi
Journal: New England Journal of Medicine (2008)

A 46-year-old woman was seen by a rheumatology consultant because of stiffness of the joints and skin. She had been well until 7 years earlier, when an episode of group A streptococcal pneumonia complicated by septic shock left her with chronic kidney disease and a painful peripheral neuropathy. Three years later, gradually progressive stiffness of the skin of her hands and feet developed, with pain and stiffness of the joints; renal failure worsened, and respiratory distress and congestive heart failure developed. A diagnostic procedure was performed.
Thermolabile defect of methylenetetrahydrofolate reductase in coronary artery disease.
Authors: S SKang, E LPassen, NRuggie, P WWong, HSora
Journal: Circulation (1993)

BACKGROUNDTo determine whether or not a moderate genetic defect of homocysteine metabolism is associated with the development of coronary artery disease, we studied the prevalence of thermolabile methylenetetrahydrofolate reductase, which is probably the most common genetic defect of homocysteine metabolism.METHODS AND RESULTSThree hundred thirty-nine subjects who underwent coronary angiography were classified into three groups: (1) patients with severe coronary artery stenosis (> or = 70% occlusion in one or more coronary arteries or > or = 50% occlusion in the left main coronary artery), (2) patients with mild to moderate coronary artery stenosis (< 70% occlusion in one or more coronary arteries or < 50% occlusion in the left main coronary artery), and (3) patients with non-coronary heart disease or noncardiac chest pain (nonstenotic coronary arteries). The thermolability of methylenetetrahydrofolate reductase was prospectively determined in all subjects. Plasma homocyst(e)ine levels were then measured ...
Single film retrograde umbilical aortography in the diagnosis of hypoplastic left heart syndrome with aortic atresia.
Authors: RRosengart, J MJarmakani, G CEmmanouilides
Journal: Circulation (1976)

Single film retrograde umbilical aortography was used successfully in confirming the diagnosis of hypoplastic left heart in three neonates. The method involves injecting Renografin 75% (1.25 cc/kg body weight) into the umbilical artery catheter according to the following sequence. First, the tip of the catheter is positioned at the level of the ductus arteriosus. The infant heart beats are then counted from one to three. The contrast media injection is begun manually on the count of one and an anterior-posterior chest film is taken on the count of three. Thus the film is taken one diastolic period after completion of the injection. The proper timing of the contrast media injection and filming is essential for obtaining a diagnostic film. This procedure was diagnostic in the three infants studied and eliminated the need of transferring two sick infants from affiliated hospitals.
Short-Term Statin Therapy and Cardiac Function and Symptoms in Patients With Idiopathic Dilated Cardiomyopathy
Authors: Pim van der Harst, Adriaan A. Voors, Dirk J. van Veldhuisen
Journal: Circulation (2004)

With great interest we read the article by Node et al 1 concerning short-term statin therapy in patients with idiopathic dilated cardiomyopathy (IDC).The demonstrated improvement of left ventricular ejection fraction (LVEF) by simvastatin therapy is intriguing.The authors speculated on several possible mechanisms, including a decrease in plasma cytokines and neurohormones.Although this may certainly have played a role, we think that another potential mechanism should have been discussed.We hypothesize that improvement of LVEF by simvastatin in the present study might be caused by the beneficial effects on myocardial blood flow (MBF) reserve.In healthy subjects with hypercholesterolemia, statin treatment improves MBF reserve, as measured by positron emission tomography. 2 In patients with IDC, MBF reserve is impaired in proportion to the severity of heart failure. 3,4 Therefore, it is very likely that a decrease of cholesterol levels in patients with IDC will also lead to an improvement of MBF reserve.Whether such an improvement in MBF reserve in patients with IDC automatically translates into an increase in LVEF may be disputed.Nevertheless, recent work from our institution using positron emission tomography has demonstrated that regional impairment of MBF reserve is associated with decreases in contractile reserve and LVEF. 4 The observed improvement in LVEF in the study by Node et al 1 may well have been caused by improvement of MBF reserve leading to increased LVEF.
Two-dimensional echocardiographic assessment of left ventricular volumes and ejection fraction in children.
Authors: J CMercier, T GDiSessa, J MJarmakani, TNakanishi, SHiraishi, JIsabel-Jones, W FFriedman
Journal: Circulation (1982)

The ability of two-dimensional echocardiography to measure left ventricular volumes and ejection fraction was evaluated in 25 children with congenital heart disease. Dimensions and planimetered areas were obtained in the short-axis view at the mitral valve and high and low papillary muscle levels and in the apical two- and four-chamber views. Eight algorithms using five geometric models were assessed. Left ventricular end-diastolic volume, end-systolic volume and ejection fraction were compared with data from biplane cineangiocardiograms. The correlation varied with the algorithm used. Algorithms using short-axis views appeared superior to those using only apical long-axis views. Four algorithms estimated left ventricular volumes with equal accuracy (Simpson's rule, assuming the ventricle to be a truncated cone; Simpson's rule, assuming the ventricle to be a truncated ellipse; hemisphere cylinder; and ellipsoid biplane). The single algorithm that best estimated left ventricular ejection fraction was the e...
Prospective study of phobic anxiety and risk of coronary heart disease in men.
Authors: IKawachi, G AColditz, AAscherio, E BRimm, EGiovannucci, M JStampfer, W CWillett
Journal: Circulation (1994)

BACKGROUNDTo examine prospectively the association between self-reported symptoms of phobic anxiety and subsequent risk of coronary heart disease, a 2-year follow-up study was conducted of a cohort of 33,999 US male health professionals, aged 42 to 77 years in 1988, who were free of diagnosed cardiovascular disease at baseline. Levels of phobic anxiety were assessed using the Crown-Crisp index, a short, diagnostic self-rating scale used for common phobias. Main outcomes were incidents of coronary heart disease consisting of nonfatal myocardial infarction (MI) and fatal coronary heart disease (CHD).METHODS AND RESULTSOne hundred sixty-eight incident cases of CHD occurred during 2 years of follow-up (128 cases of nonfatal MI and 40 cases of fatal CHD). The age-adjusted relative risk of fatal CHD among men with highest levels of phobic anxiety (scoring 4 or higher on the Crown-Crisp index) was 3.01 (95% confidence interval, 1.31 to 6.90) compared with men with the lowest levels of anxiety (scoring 0 or 1 on ...
Determinants of sensitivity and specificity of electrocardiographic criteria for left ventricular hypertrophy.
Authors: DLevy, S BLabib, K MAnderson, J CChristiansen, W BKannel, W PCastelli
Journal: Circulation (1990)

Numerous electrocardiographic criteria, which are largely dependent on fixed voltage thresholds, have been proposed for the diagnosis of left ventricular hypertrophy (LVH). Electrocardiographic criteria for LVH were examined in 4,684 subjects of the Framingham Heart Study who underwent echocardiographic study for LVH. Echocardiographic LVH was detected in 290 men (14.2%) and 465 women (17.6%). Electrocardiographic features of LVH were present in 2.9% of men (60/2,042) and 1.5% of women (39/2,642). The overall sensitivity of the electrocardiographic diagnosis of LVH was 6.9%, whereas specificity was 98.8%. Sensitivity of the electrocardiogram (ECG) for LVH was marginally lower in women than in men (5.6% vs. 9.0%, p = 0.075). Obesity was inversely associated with sensitivity (p less than 0.05, both sexes combined, sex-adjusted). Smoking was also inversely related to sensitivity (p = 0.001, both sexes combined, sex-adjusted). In contrast, sensitivity of the ECG increased with age (p less than 0.001, both sex...
B 형 만성 간질환 환자 자녀들의 B 형 간염 바이러스 감염률 - 특히 0 - 19 세 자녀들의 감염률 -
Authors: 공휘(Hwi Kong), 김지훈(Ji Hoon Kim), 조남영(Nam Young Cho), 김윤홍(Yoon Hong Kim), 정길만(Kil Man Jung), 연종은(Jong Eun Yeon), 김재선(Jae Seon Kim), 박영태(Young Tae Bak), 조경환(Kyung Hwan Cho), 박용규(Yong Kyu Park), 변관수(Kwan Soo Byun), 이창홍(Chang Hong Lee)
Journal: Clinical and Molecular Hepatology (2001)

Background / Aims : This study aimed to estimate the seroepidemiology of hepatitis B virus(HBV) infection with emphasis on the transmission of HBV infection between mother`s and their children. Methods : For 452 patients with HBV associated chronic liver disease, and 1,098 of their offspring, who visited Korea University Kuro Hospital from February, 2000 to February,2001, HBsAg was tested by radioimmunoassay. Results : Among siblings whose mothers were HBsAg - positive, the overall prevalence rate of HBV infection was 44.9%(140/312) and decreased with decreasing age(54.7% in ≥ 20 years old age group, 33.3% in 10-19 years old age group, 7.6% in < 10 years old age group). The estimated proportion of perinatal infection out of modes of HBV transmissions in the general population was 38% in < 10 years and 63.4% in 10-19 years. Conclusion : The present hepatitis B vaccination strategies-especially against perinatal infection of Korea have performed to their utmost. More effective methods for prevention of HBV transmission are now needed.