tbuckley/cabot-search huggingface dataset:
Antiarrhythmic effects of selective prolongation of refractoriness. Electrophysiologic actions of sematilide HCl in humans.
Authors: P TSager, KNademanee, MAntimisiaris, APacifico, CPruitt, RGodfrey, B NSingh
Journal: Circulation (1993)

BACKGROUNDRecent data have suggested that antiarrhythmic agents that act largely by delaying conduction may not be as effective in controlling ventricular arrhythmias as those that prolong repolarization. Recently, numerous pure class III agents have been developed.METHODS AND RESULTSThe antiarrhythmic and electrophysiologic profiles of sematilide, a pure class III agent, were determined in 27 patients with clinical ventricular arrhythmias and inducible sustained ventricular tachycardia during electrophysiologic study. After treatment with oral sematilide (mean dose, 133 +/- 29 mg every 8 hours), the patients underwent repeat 24-hour ambulatory ECG monitoring and electrophysiologic study. The baseline sinus cycle length and QT, QTc, JT, and JTc intervals were significantly increased 8 to 17% by sematilide (P = .001 to .029). There were no changes in the PR or QRS intervals. Sematilide (at a paced cycle length of 600 ms) significantly increased the atrial effective refractory period (238 +/- 32 to 264 ...
The NASA syndrome revisited
Authors: J. R. Merrill
Journal: JAMA (1992)

<h3>In Reply.</h3> —Invoking the spirit of Abraham Lincoln, we have stated that even 127 years after our War Between the States, access to basic medical care for all of our inhabitants is still not a reality. We alleged that longstanding, systematic, institutionalized racial discrimination lay at the core of the problem. Many disagreed with that view in 1991. In 1992, based on hard data published in peer-reviewed journals,<sup>1</sup>as well as obvious observation of historical events, few disagree. A consistent medical underclass not only suffers from lack of insurance; even when well insured, it receives unequal care.<sup>2</sup>interest groups because their primary interest must be in the welfare of their patients, clients, or the religious laity—the people themselves who, in aggregate, gave the physicians, the lawyers, and the clergy the privileges and power they have. If sometime they do become primarily self-interest groups, society—which has given them the
Multiple factors contribute to acetylcholine-induced renal afferent arteriolar vasodilation during myogenic and norepinephrine- and KCl-induced vasoconstriction. Studies in the isolated perfused hydronephrotic kidney.
Authors: KHayashi, RLoutzenhiser, MEpstein, HSuzuki, TSaruta
Journal: Circulation Research (1994)

Acetylcholine (ACh) elicits vasodilation by releasing a number of endothelium-derived relaxing factors (EDRFs). We used the isolated perfused hydronephrotic rat kidney to examine the characteristics of ACh-induced vasodilation of renal afferent arterioles during different types of underlying vasoconstriction. Basal arteriolar tone was increased by either elevating perfusion pressure to 180 mm Hg (myogenic), administering 0.3 mumol/L norepinephrine (NE), or elevating medium potassium concentration to 30 mmol/L (KCl). ACh (10 mumol/L) completely reversed myogenic and NE-induced vasoconstriction and reversed KCl-induced vasoconstriction by 80 +/- 5%. However, whereas ACh produced a sustained vasodilation during KCl- and NE-induced vasoconstriction, only a transient reversal of myogenic vasoconstriction was observed, and myogenic tone recovered within 5 to 10 minutes. ACh-induced vasodilation of arterioles preconstricted with KCl was markedly inhibited by either indomethacin (100 mumol/L) or nitro-L-arginine ...
Identification of patients with coronary disease at high risk for loss of employment. A prospective validation study.
Authors: D BMark, L CLam, K LLee, N EClapp-Channing, R BWilliams, D BPryor, R MCaliff, M AHlatky
Journal: Circulation (1992)

BACKGROUNDWork disability is common in patients with coronary artery disease and adversely affects both economic well-being and quality of life. The purpose of this study was to construct a model to predict premature departure from the work force of patients with coronary disease and to validate this model prospectively in an independent cohort of patients.METHODS AND RESULTSWe enrolled 1,252 coronary disease patients referred for diagnostic cardiac catheterization who were less than age 65, employed, and without prior coronary angioplasty or coronary bypass surgery. Medical, functional, psychological, economic, and job-related variables were measured at the time of baseline diagnostic cardiac catheterization, and all patients were followed for 1 year. Three hundred twelve patients underwent percutaneous transluminal coronary angioplasty (PTCA) within 60 days of catheterization, and 449 had coronary artery bypass graft surgery (CABG) within 60 days of catheterization. The remaining 491 patients were treat...
The Impact Of Artificial Intelligence On The Adenoma Detection Rate (ADR): A Comparison Between Experienced And Trainee Endoscopists’ ADR
Authors: S Bernhofer, A Maieron
Journal: Endoscopy (2021)

Aims Colorectal cancer (CRC) is the second most common cause of cancer death in the European Union. Most cases of CRC arise out of adenomas, which could be easily treated in a timely manner by endoscopic removal. Many studies have proven that a high adenoma detection rate (ADR) reduces the incidence of CRC. Artificial Intelligence (AI) is a promising new tool to achieve a high ADR. The aim of this study is to evaluate the impact of AI on the frequency of adenoma detection by endoscopists in training in comparison to the frequency of detection by senior endoscopists.
Determination of the most appropriate velocity threshold for applying hemispheric flow convergence equations to calculate flow rate: selected according to the transorifice pressure gradient. Digital computer analysis of the Doppler color flow convergence region.
Authors: Y BDeng, TShiota, RShandas, JZhang, D JSahn
Journal: Circulation (1993)

BACKGROUNDWhile flow convergence methods have been promising for calculating volume flows from color Doppler images, it appears that the velocity threshold used and the transorifice pressure gradient dramatically influence the accuracy of application of the simple hemispheric flow convergence equation for calculation of flow rate. The present in vitro study was performed to determine whether the value of velocity threshold at which the shape of proximal isovelocity surface best fits given shape assumptions with different orifice sizes and flow rates is predictable as a function independent of orifice size from clinically measurable peak velocity or transorifice pressure gradient information.METHODS AND RESULTSIn an in vitro model built to facilitate ultrasound imaging, steady flow was driven through circular discrete orifices with diameters of 3.8, 5.5, and 10 mm. Flow rates ranged from 2.88 to 8.28 L/min with corresponding driving pressure gradients from 14 to 263 mm Hg. At each flow rate, Doppler color-...
Randomized, controlled trial of percutaneous cryoablation versus radiofrequency ablation in hepatocellular carcinoma
Authors: Myung Han Hyun, Sang Mi Chung
Journal: Hepatology (2015)

Potential conflict of interest: Nothing to report. To the Editor: We read the article by Wang et al.1 with great interest regarding percutaneous cryoablation (CRYO) and radiofrequency ablation (RFA) in early hepatocellular carcinoma (HCC) up to 4 cm in diameter. The researchers found that the 3‐year tumor progression rate for CRYO is lower than that of RFA with comparable major complications rates. One of the most interesting findings is that patients with relatively large (>3 cm) early HCC showed a significantly lower tumor progression rate in the CRYO group (7.7% vs. 18.2%; P = 0.041). Current Barcelona Clinic Liver Cancer Group HCC management guidelines do not recommend RFA owing to marked decrease in efficacy when tumor size exceeds 3 cm.2 Theoretically, CRYO therapy has important advantages, including concurrent placement of multiple probes under precisely guiding ice‐ball formation during procedure, which is not available with RFA.3 It was a well‐designed first randomized trial that reports on these potential benefits, which is consistent with previous nonrandomized studies.5 However, the subgroup analyses are still losing their statistical power owing to the small number of patients, which is sensitively influenced by aberrant cases. Additional information, including baseline characteristics and 1‐, 3‐, and 5‐year progression free survival (adjusted by multivariate regression model, if necessary) for each of the >3 cm HCC patient subgroups would be required to reduce perceived bias. Besides, the researchers provided informative data regarding the alternative treatment for those with distant tumor recurrence (110 patients; 30%). Given that combination therapy using transarterial chemoembolization (TACE), sorafenib, and local ablation were associated with patients' survival,7 detailed proportion for postablative treatments with HCC patient (3‐4 cm) subgroups would be helpful to understand why the benefits of tumor progression rate cannot extend the overall survival rates. This information may be supportive for clinicians who consider percutaneous CRYO therapy for relatively large early‐stage HCC.
The global dissemination of hospital clones of Enterococcus faecium
Authors: Sebastiaan J. van Hal, Rob J. L. Willems, Theodore Gouliouris, Susan A. Ballard, Teresa M. Coque, Anette M. Hammerum, Kristin Hegstad, Hendrik T. Westh, Benjamin P. Howden, Surbhi Malhotra-Kumar, Guido Werner, Katsunori Yanagihara, Ashlee M. Earl, Katherine E. Raven, Jukka Corander, Rory Bowden
Journal: Genome Medicine (2021)

Abstract Background The hospital-adapted A1 group of Enterococcus faecium remains an organism of significant concern in the context of drug-resistant hospital-associated infections. How this pathogen evolves and disseminates remains poorly understood. Methods A large, globally representative collection of short-read genomic data from the hospital-associated A1 group of Enterococcus faecium was assembled ( n = 973). We analysed, using a novel analysis approach, global diversity in terms of both the dynamics of the accessory genome and homologous recombination among conserved genes. Results Two main modes of genomic evolution continue to shape E. faecium : the acquisition and loss of genes, including antimicrobial resistance genes, through mobile genetic elements including plasmids, and homologous recombination of the core genome. These events lead to new clones emerging at the local level, followed by the erosion of signals of clonality through recombination, and in some identifiable cases producing new clonal clusters. These patterns lead to new, emerging lineages which are able to spread globally over relatively short timeframes. Conclusions The ability of A1 E. faecium to continually present new combinations of genes for potential selection suggests that controlling this pathogen will remain challenging but establishing a framework for understanding genomic evolution is likely to aid in tracking the threats posed by newly emerging lineages.
Atrial septal aneurysm: a cause for midsystolic click. Report of a case and review of the literature.
Authors: M DAlexander, K RBloom, PHart, FD'Silva, J PMurgo
Journal: Circulation (1981)

A patient who was evaluated for a midsystolic click was found to have an aneurysm of the atrial septum as an isolated anomaly. Bulging of this aneurysm into the right atrium was associated with the production of the click. Echo-, phono-, and angiocardiographic features are presented, with a review of the literature on atrial septal aneurysms. These aneurysms, although rare, should be considered in the differential diagnosis of patients with midsystolic click.
Robot-assisted Cystectomy with Intracorporeal Urinary Diversion After Pelvic Irradiation for Prostate Cancer: Technique and Results from a Single High-volume Center
Authors: Pietro Piazza, Giuseppe Rosiello, Victor Tames Chacon, Stefano Puliatti, Marco Amato, Rui Farinha, Riccardo Schiavina, Eugenio Brunocilla, Camille Berquin, Dries Develtere, Celine Sinatti, Hannah Van Puyvelde, Ruben De Groote, Peter Schatteman, Geert De Naeyer, Frederiek D’Hondt, Alexandre Mottrie
Journal: European Urology (2021)
Cost-effectiveness of Novel Treatment Sequences for Transplant-Ineligible Patients With Multiple Myeloma
Authors: Hedwig M. Blommestein, Margreet G. Franken, Chrissy H. Y. van Beurden-Tan, Nicole M. A. Blijlevens, Peter C. Huijgens, Pieter Sonneveld, Carin A. Uyl-de Groot, Sonja Zweegman
Journal: JAMA Network Open (2021)

<h3>Importance</h3> Although the number of treatments for elderly patients with non–transplant-eligible (NTE) multiple myeloma (MM) has increased substantially, evidence is lacking on the clinical effectiveness and cost-effectiveness of novel treatment sequences. <h3>Objective</h3> To determine the optimal sequence of treatment for patients with NTE MM from the perspective of the patient, physician, and society. <h3>Design, Setting, and Participants</h3> Using data from a Dutch observational registry, this economic evaluation combined evidence from network meta-analyses in a patient-level simulation model and modeled time-to-event and types of events from a hospital perspective with a lifetime horizon. Data analysis was performed from June 2019 to September 2020. <h3>Interventions</h3> Thirty treatment sequences, including up to 3 lines of therapy, were compared with bortezomib-melphalan-prednisone (VMP)–lenalidomide-dexamethasone (LenDex)–pomalidomide-dexamethasone (PomDex). <h3>Main Outcomes and Measures</h3> The primary outcomes of the model were overall survival (OS), quality-adjusted life-years (QALYs), costs, and cost-effectiveness. <h3>Results</h3> Sequences starting with daratumumab-VMP (second line: carfilzomib-lenalidomide-dexamethasone or elotuzumab-lenalidomide-dexamethasone) or bortezomib-melphalan-prednisone-thalidomide-maintenance bortezomib-thalidomide (VMPT-VT) (second line: daratumumab-lenalidomide-dexamethasone) had the largest expected OS (7.5 years), which is 3.5 additional life-years compared with VMP-LenDex-PomDex. Total costs per patient for these sequences ranged between $786 024 and $1 085 794. The sequence VMPT-VT-carfilzomib-lenalidomide-dexamethasone–panobinostat-bortezomib-dexamethasone had the most favorable cost-effectiveness ratio ($98 585 per life-year gained and $132 707 per QALY gained vs VMP-LenDex-PomDex). <h3>Conclusions and Relevance</h3> These findings suggest that sequences including novel treatments were highly effective, but the cost-effectiveness ratios were above currently accepted willingness-to-pay thresholds. Treating MM with novel agents necessitates either a large increase in budget or a substantial reduction of drug costs by price negotiations, and these findings can support these reimbursement decisions and price negotiations.
Sudden death during ambulatory monitoring. Clinical and electrocardiographic correlations. Report of a case.
Authors: A HGradman, P ABell, R FDeBusk
Journal: Circulation (1977)

A man with known coronary heart disease underwent treadmill exercise testing to determine his functional capacity. The test was negative for ischemia. Ventricular ectopic activity was noted at rest and in the recovery period. On the same day, while viewing a sporting event at home, the patient died suddenly. An ambulatory electrocardiographic recording documented ventricular fibrillations as the terminal mechanism. Ventricular ectopic activity and heart rate increased in the two hours prior to death, and ischemic ST-segment depression was noted at the time of the terminal arrhythmia. It is postulated that myocardial ischemia and catecholamine response lowered the threshold to ventricular fibrillation, thus facilitating the emergence of the fatal arrhythmia.
Catheter ablation using radiofrequency current to cure symptomatic patients with tachyarrhythmias related to an accessory atrioventricular pathway.
Authors: MSchlüter, MGeiger, JSiebels, WDuckeck, K HKuck
Journal: Circulation (1991)

BACKGROUNDRecent investigations have shown that cure of patients with symptomatic tachyarrhythmias related to an accessory atrioventricular pathway may be achieved by closed-chest electrode catheter ablation of the accessory connection. Direct current shocks have primarily been used for this purpose, but its applicability is limited because of the lack of controlled titration of electrical energy, the infliction of barotrauma, and the need for general anesthesia. Radiofrequency current has been proposed as an alternate energy source.METHODS AND RESULTSSeventy-three symptomatic patients with Wolff-Parkinson-White syndrome and 19 patients with only retrogradely conducting (concealed) pathways underwent ablative therapy with radiofrequency current. There were 71 accessory pathways located on the left side of the heart (57 free-wall and 14 posteroseptal pathways) and 25 on the right side (11 free-wall, seven posteroseptal, and seven midseptal or anteroseptal pathways). In patients with right-sided pathways, a...
Effects of extracellular calcium and sodium on depolarization-induced automaticity in guinea pig papillary muscle.
Authors: B GKatzung
Journal: Circulation Research (1975)

Regenerative discharge of action potentials is induced in mammalian papillary muscles by passage of small depolarizing currents. In this paper, the effects of various extracellular calcium and sodium concentrations and of tetrodotoxin on this phenomenon were studied in guinea pig papillary muscles in a sucrose gap chamber. Phase 4 diastolic depolarization was found to be associated with an increase in membrane resistance. The slope of phase 4 depolarization was decreased by reductions in extracellular calcium or sodium concentration. The range of maximum diastolic potentials and the thresholds from which regenerative potentials arose were reduced, especially at the positive limit of potentials, by a reduction in either ion. It was concluded that both calcium and sodium influence diastolic depolarization and participate in the regenerative action potentials of depolarization-induced ventricular automaticity.
Predictors Of Gastrointestinal Transit Times In Colon Capsule Endoscopy
Authors: S Moen, FER Vuik, T Voortman, E Kuipers, MCW Spaander
Journal: Endoscopy (2021)

Aims To obtain images of the entire gastrointestinal tract by Colon Capsule Endoscopy (CCE), transit times have to be fast enough to achieve completion while not missing any lesions. We aimed to identify predictors for CCE transit times in a population-based cohort.
Body surface late potentials: effects of endocardial resection in patients with ventricular tachycardia.
Authors: N HMarcus, R AFalcone, A HHarken, M EJosephson, M BSimson
Journal: Circulation (1984)

We studied 37 patients undergoing endocardial resection for medically refractory ventricular tachycardia (VT). Each was studied before and after surgery by programmed ventricular stimulation and signal-averaged electrocardiography. Low-amplitude late potentials were identified preoperatively in 76% of patients. In the 24 patients without postoperative VT the effect of surgery was to shorten the filtered QRS duration (137 +/- 27 to 121 +/- 26 msec; p = .003), increase the voltage in the last 40 msec of the filtered QRS (16.5 +/- 16.1 to 39.0 +/- 29.4 microV; p = .003), and decrease the incidence of late potentials (71% to 33%; p = .03). The filtered QRS complex was unchanged in 13 patients whose VT persisted after surgery. No preoperative variable predicted which patients would not have inducible VT after surgery. However, loss of a late potential after surgery in nine of 10 patients was associated with absence of inducible VT (p less than .02). Loss of a late potential was not necessary for surgical succe...
Relative effects of alpha 1-adrenoceptor blockade, converting enzyme inhibitor therapy, and angiotensin II subtype 1 receptor blockade on ventricular remodeling in the dog.
Authors: K MMcDonald, MGarr, P FCarlyle, G SFrancis, KHauer, D WHunter, TParish, AStillman, J NCohn
Journal: Circulation (1994)

BACKGROUNDProgressive ventricular remodeling after myocardial damage is associated with a poor prognosis. Optimal prevention of the histopathological processes involved in remodeling requires a more complete understanding of the mechanisms involved in initiating and maintaining these structural changes. Since the sympathetic nervous system and the renin-angiotensin system may be involved in the remodeling process, the structural effects of pharmacological inhibitors have been evaluated in a canine model of localized myocardial injury resulting from transmyocardial DC shock.METHODS AND RESULTSThe study is comprised of two protocols run in series. In protocol 1, zofenopril (Z), a converting enzyme inhibitor (CEI), prevented the increase in left ventricular mass (LVM) and end-diastolic volume (LVV) observed in the control group (C) at 16 weeks (Z: LVM, 69.8 +/- 3.4 to 65.4 +/- 2.6 g, P = NS; LVV, 45.4 +/- 2.7 to 51.6 +/- 2.7 mL, P = NS; C: LVM, 68.4 +/- 3.2 to 91.4 +/- 2.9 g, P = .0001; LVV, 56.6 +/- 3.0 to ...
Finite element analysis of myocardial diastolic function using three-dimensional echocardiographic reconstructions: application of a new method for study of acute ischemia in dogs.
Authors: D DMcPherson, D JSkorton, SKodiyalam, LPetree, M PNoel, RKieso, R EKerber, S MCollins, K BChandran
Journal: Circulation Research (1987)

The effect of acute myocardial ischemia on the myocardial elastic modulus has been a matter of controversy. To evaluate this question, diastolic elastic modulus was assessed by finite element analysis of left ventricular geometry using three-dimensional echocardiographic reconstructions and right and left ventricular pressure recordings. Elastic properties were estimated before and after coronary occlusion in 6 open-chest dogs. Elastic modulus values were derived by means of a computer program that determined the global elastic modulus that best predicted the diastolic changes in left ventricular geometry. In the finite element analysis after coronary occlusion, two analyses were performed: one utilizing the control elastic modulus for all segments of the left ventricle and one in which ischemic (dyskinetic) segments were assigned a higher elastic modulus. Results showed that the control elastic modulus was a poor predictor of diastolic left ventricular expansion after coronary occlusion. The finite eleme...
A simplified method for quantitating left-to-right shunts from arterial dilution curves.
Authors: B EVictorica, I HGessner
Journal: Circulation (1975)

This report presents a new, simple and reliable method of quantitating left-to-right shunts from arterial dilution surves. When indicatior (e,g., indocyanine green) is injected centrally (right venticle or pulmonary artery) and blood is withdrawn rapidly from either the aorta or other central systemic artery, in the presence of a left-to-right shunt to recorded indicator-dilution curve usually shows two discrete peaks: p-1 of the magnitude of the shunt expressed as percent of pulmonary blood flow, Experimental and clinical data demonstrate that this method is accurate in quantitating shunts from such curves.
Quality of Upper Gastrointestinal Bleeding Risk Stratification and Pre-Endoscopic Management at an Irish University Teaching Hospital
Authors: M Elsiddig, M McKenna-Barry, R Varley, C Dunne, F MacCarthy, S McKiernan, DO Toole, D Kevans, K Hartery
Journal: Endoscopy (2021)

Aims To audit of admission risk stratification and quality of pre-endoscopic management using the 2015 European Society of Gastrointestinal Endoscopy (ESGE) Upper GI Non-Variceal Bleeding guideline as a standard.