tbuckley/cabot-search huggingface dataset:
Plummer–Vinson Syndrome
Authors: Rania Hefaiedh, Yosra Boutreaa, Asma Ouakaa-Kchaou, Dalila Gargouri, Héla Elloumi, Asma Kochlef, Malika Romani, Afef Kilani, Jamel Kharrat, Abdeljabbar Ghorbel
Journal: New England Journal of Medicine (1943)

Plummer - Vinson syndrome is one of the names given to the constellation of dysphagia, iron- deficiency anemia, and esophageal webbing. It is a rare affection which affects mainly white women.The purpose of this study is to precise epidemiological, clinical, paraclinical and therapeutic features of the affection.We report a retrospective study enrolled over 6 years (2002 - 2008). Were studied the age, the sex, the main symptoms and the biological parameters (full blood cell, albumin, hepatic, renal and lipidic balance sheet). Patients were explored by an upper endoscopy.Ten patients with the diagnosis of Plummer-Vinson syndrome were collected. There were 9 women, the average age was 57 years old. Dysphagia was the main symptom, observed in 100% of the cases. Fifty per cent of our patients had iron-deficiency anemia. Iron supplementation was indicated each time there is an iron- deficiency anemia. All the patients were treated with endoscopic dilatation and three of them needed multiple session of endoscopic dilatation. Eighty per cent had a favorable evolution. The malignancy was observed in 2 cases.Dysphagia is the main symptom of the Plummer-Vinson syndrome, which must indicate an upper endoscopy. This syndrome is known to be associated with an increased risk of squamous cell carcinoma of the upper airway tract, so the patients should be followed closely. Endoscopic dilatation is the procedure of choice in the treatment of cervical web of the esophagus.
Effects of a chronic treatment by nisoldipine, a calcium antagonistic dihydropyridine, on arteries of spontaneously hypertensive rats.
Authors: TGodfraind, SKazda, MWibo
Journal: Circulation Research (1991)

Earlier studies have shown that relaxation in response to several agents is impaired in arteries from spontaneously hypertensive rats (SHR). We had previously reported that SHR aortas present a delayed relaxation when first exposed for 35 minutes to a 100 mM KCl solution and then transferred into physiological solution. The first phase of relaxation appeared similar in SHR and Wistar-Kyoto rat arteries, but the second phase was markedly slowed down in SHR arteries, giving rise to a postcontraction tone. In this study, we found that this postcontraction tone could be demonstrated not only in the aorta but also in the mesenteric artery, was independent of the presence of endothelium, increased with the age of SHR, and disappeared progressively when arterial segments were submitted to successive cycles of KCl depolarization followed by reimmersion in physiological solution. Chronic treatment of SHR with nisoldipine at doses that blocked the development of hypertension and attenuated the concomitant hypertrop...
Hemodynamics after surgical repair with right ventricle to pulmonary artery conduit.
Authors: A PRocchini, ARosenthal, J FKeane, A RCastaneda, A SNadas
Journal: Circulation (1976)

To assess the results of cardiac repair utilizing a right ventricular to pulmonary artery conduit, we reviewed postoperative hemodynamic data in 16 patients catheterized 0.5 to 5 years after repair. In 12 patients, a Hancock conduit (dacron conduit with porcine valve) was used; the conduit in the remaining four patients was made with an aortic homograft. All patients in whom an aortic homograft was utilized developed severe obstruction and calcification of their graft. The majority of patients, 9/12, with a Hancock conduit, had only mild to moderate conduit obstruction; the remaining three had severe obstruction (gradients greater than 70 mm Hg). The sites of Hancock conduit obstruction were at the distal end of the conduit in 8/12, proximal end of conduit in 6/12, and at the porcine valve in 4/12 patients. The data suggest that repair with a Hancock conduit is hemodynamically more satisfactory than with aortic homograft.
Clinical Trials of Oil-adjuvant Influenza Vaccines, 1960-3
Authors: V UJHAZY
Journal: BMJ (1964)

Influenza vaccine prepared by emulsifying an aqueous suspension of inactivated virus in mineral oil is a far more potent antigen than the aqueous suspension alone.This fact was confirmed by the Committee in serological trials carried out in 1953 (M.R.C., 1955), but subsequent large-scale clinical trials in 1954-5 failed to show any protective effect, almost certainly because there was very little influenza during that winter (M.R.C., 1957).Unfortunately a small proportion (3.0 per thousand) of the volunteers who received oil-adjuvant vaccine developed persistent local reactions, similar to those described in the United States by Philip et al. (1954).These reactions were usually first noticed as fibrotic nodules several months after inoculation and took a year or more to resolve.In about half the cases (1.8 per thousand) the nodules became large and fluctuant and cleared only after incision.In an attempt to overcome this problem, small-scale studies were made during 1956-8, using a different oil (Drakeol No. 6 instead of Bayol F), a more pure preparation of the emulsifier (Arlacel A) and vaccine of various viscosities (Himmelweit, 1960).The results of this work showed that vaccines of low viscosity gave as good an antibody response as those of higher viscosity, and it seemed possible that a low- viscosity vaccine might be less likely to produce a foreign-body reaction and subsequent necrosis.The number of subjects studied was too few, however, to allow any conclusions to be drawn on the risk of serious local reactions.Encouraged by the result of this work, a large field trial was begun in the autumn of 1960 in which over 6,000 adult volunteers were inoculated with low-viscosity vaccines by general practitioners, chest physicians, and industrial medical officers.The trial was continued for three winters, and its results are the subject of this report. Material and MethodsVaccines.-Twovaccines were used, one containing an egg- adapted influenza virus A2 strain (A2/Singapore/l/57) and the other an egg-adapted influenza virus B strain (B/England/939/ 59).Both vaccines were water-in-oil emulsions of low viscosity containing 2,000 haemagglutinating units of virus per dose (0.25 ml.); they were prepared by Dr. F. Himmeiweit at the
Regional changes in hemodynamics and cardiac myocyte size in rats with aortocaval fistulas. 1. Developing and established hypertrophy.
Authors: ZLiu, D RHilbelink, W BCrockett, A MGerdes
Journal: Circulation Research (1991)

The effects of a large arteriovenous fistula on left and right ventricular hemodynamics and cardiac myocyte size were examined in adult rats at 1 week and 1 month after surgery. Cardiac output, left ventricular function, and right ventricular function were evaluated before obtaining isolated myocytes for cell size measurements. Average heart weight increased 35% at 1 week and 86% at 1 month in rats with fistulas. In general, myocyte hypertrophy was due to a proportional increase in length and width (length/width ratio remained constant). This change was more evident in the large hearts from rats with 1-month fistulas. At both the 1-week and 1-month intervals, the hypertrophic response of right ventricular myocytes was slightly greater than that observed in the left ventricle or interventricular septum. Left ventricular systolic pressure and dP/dtmax were significantly reduced at 1 week but returned to normal after 1 month of overloading. Left ventricular end-diastolic pressure was increased approximately ...
Effects of cardiac transplantation on bioenergetic abnormalities of skeletal muscle in congestive heart failure.
Authors: J RStratton, G JKemp, R CDaly, MYacoub, BRajagopalan
Journal: Circulation (1994)

BACKGROUNDPatients with advanced heart failure have bioenergetic abnormalities of skeletal muscle metabolism during exercise. Using 31P magnetic resonance spectroscopy, we sought to determine whether skeletal metabolic responses to exercise are normalized by orthotopic cardiac transplantation.METHODS AND RESULTSFour groups were studied: healthy normal volunteers (n = 9), subjects awaiting heart transplantation (n = 10), subjects   6 months (mean, 15 months) after transplant (n = 8). None of the posttransplant patients had biopsy evidence of rejection at the time of study. There were no significant differences in age, preoperative functional class, or symptom duration among the three patient groups. Metabolic responses were monitored in the dominant arm during incremental weight pull exercise and 10 minutes of recovery by 31P magnetic resonance spectroscopy, with measurement of pH and the phosphocreatine (PCr)/(PCr + inorganic phosphate [Pi...
Development of a Machine Learning Model Using Electronic Health Record Data to Identify Antibiotic Use Among Hospitalized Patients
Authors: Rebekah W. Moehring, Matthew Phelan, Eric Lofgren, Alicia Nelson, Elizabeth Dodds Ashley, Deverick J. Anderson, Benjamin A. Goldstein
Journal: JAMA Network Open (2021)

<h3>Importance</h3> Comparisons of antimicrobial use among hospitals are difficult to interpret owing to variations in patient case mix. Risk-adjustment strategies incorporating larger numbers of variables haves been proposed as a method to improve comparisons for antimicrobial stewardship assessments. <h3>Objective</h3> To evaluate whether variables of varying complexity and feasibility of measurement, derived retrospectively from the electronic health records, accurately identify inpatient antimicrobial use. <h3>Design, Setting, and Participants</h3> Retrospective cohort study, using a 2-stage random forests machine learning modeling analysis of electronic health record data. Data were split into training and testing sets to measure model performance using area under the curve and absolute error. All adult and pediatric inpatient encounters from October 1, 2015, to September 30, 2017, at 2 community hospitals and 1 academic medical center in the Duke University Health System were analyzed. A total of 204 candidate variables were categorized into 4 tiers based on feasibility of measurement from the electronic health records. <h3>Main Outcomes and Measures</h3> Antimicrobial exposure was measured at the encounter level in 2 ways: binary (ever or never) and number of days of therapy. Analyses were stratified by age (pediatric or adult), unit type, and antibiotic group. <h3>Results</h3> The data set included 170 294 encounters and 204 candidate variables from 3 hospitals during the 3-year study period. Antimicrobial exposure occurred in 80 190 encounters (47%); 64 998 (38%) received 1 to 6 days of therapy, and 15 192 (9%) received 7 or more days of therapy. Two-stage models identified antimicrobial use with high fidelity (mean area under the curve, 0.85; mean absolute error, 1.0 days of therapy). Addition of more complex variables increased accuracy, with largest improvements occurring with inclusion of diagnosis information. Accuracy varied based on location and antibiotic group. Models underestimated the number of days of therapy of encounters with long lengths of stay. <h3>Conclusions and Relevance</h3> Models using variables derived from electronic health records identified antimicrobial exposure accurately. Future risk-adjustment strategies incorporating encounter-level information may make comparisons of antimicrobial use more meaningful for hospital antimicrobial stewardship assessments.
The economy of isometric force development, myosin isoenzyme pattern and myofibrillar ATPase activity in normal and hypothyroid rat myocardium.
Authors: CHolubarsch, R PGoulette, R ZLitten, B JMartin, L AMulieri, N RAlpert
Journal: Circulation Research (1985)

Hypothyroidism was induced in Wistar-Kyoto rats by adding propylthiouracil to the drinking water (0.8 mg/ml). Initial heat, total activity-related heat, and resting heat rate were measured in left ventricular papillary muscle preparations of propylthiouracil-treated and control rats contracting isometrically at 12 beats/min (21 degrees C), using Hill type, planar vacuum-deposited bismuth and antimony thermopiles. In the propylthiouracil preparations, relative to control, time-to-peak tension increased from 288 +/- 27 (mean +/- SD) to 411 +/- 25 msec (P less than 0.001), dp/dtmax decreased from 38.3 +/- 9.5 to 20.4 +/- 3.5 g X mm-2/sec (P less than 0.001), and peak developed tension decreased from 6.11 +/- 1.75 to 4.64 +/- 0.89 g X mm-2 (P less than 0.05). In the propylthiouracil preparations, initial heat was significantly (P less than 0.001) reduced by 27 or 43% when normalized to peak twitch tension or tension-time integral, respectively. In experiments where the papillary muscles were tetanized, the sl...
Effect of digitalis glycosides on norepinephrine release in the heart. Dual mechanism of action.
Authors: RKranzhöfer, MHaass, TKurz, GRichardt, ASchömig
Journal: Circulation Research (1991)

The effect of ouabain on exocytotic and nonexocytotic norepinephrine release was investigated in perfused rat and guinea pig hearts. The overflow of endogenous norepinephrine and its neuronal metabolite 3,4-dihydroxyphenylethyleneglycol (DOPEG) was determined by high-pressure liquid chromatography. DOPEG served as the indicator of free axoplasmic norepinephrine concentrations. The overflow of the norepinephrine cotransmitter neuropeptide Y (NPY) was determined by radioimmunoassay and NPY was used as marker for exocytotic release. Electrical stimulation of the left stellate ganglion resulted in exocytotic norepinephrine release in rat and guinea pig hearts. Ouabain caused an increase in stimulation-induced norepinephrine overflow from rat and guinea pig hearts by 40%. However, overflow of NPY was decreased by 40%, indicating a reduced exocytosis rate. Ouabain increased both norepinephrine and NPY overflow, suggesting enhancement of exocytosis, when neuronal catecholamine uptake (uptake1) was blocked by des...
Body surface potential maps in patients with pulmonic valvular and aortic valvular stenosis of mild to moderate severity.
Authors: G SSohi, E WGreen, N CFlowers, D EMcMartin, R RMasden
Journal: Circulation (1979)

Multiple-lead surface potential maps were compared throughout ventricular activation in nine patients with mild-to-moderate pulmonic stenosis and in 12 patients with mild-to-moderate aortic stenosis. Abnormal patterns of potential distribution were found in aortic stenosis, including three patients without electrocardiographic evidence of left ventricular enlargement. When related to the onset of depolarization, abnormal departures started later, peaked later, lasted longer, and were more intense, more uniform and discrete in aortic stenosis. In pulmonic stenosis, abnormal departures started earlier, but were more dispersed in timing and location than in aortic stenosis. The left ventricle appears to be the more remote, though more powerful and compact, generator. The right ventricular shell, however, is nearer to the surface, and is more anatomically extended in surface area, permitting much wider shifts in wavefront location and orientation as a result of small differences in pressure, or volume, or loc...
Beneficial effects of atrial natriuretic peptide on exercise-induced myocardial ischemia in patients with stable effort angina pectoris.
Authors: C PLai, KEgashira, HTashiro, HNarabayashi, SKoyanagi, TImaizumi, ATakeshita
Journal: Circulation (1993)

BACKGROUNDIt has been shown that atrial natriuretic peptide (ANP), an endogenous vasodilator, dilates coronary arteries and decreases coronary vascular resistance. The purpose of this study was to determine whether an intravenous administration of ANP attenuated exercise-induced myocardial ischemia in 14 patients with stable effort angina pectoris.METHODS AND RESULTSThe first 12 patients (patients 1-12) who had exercise-induced ST segment depression underwent treadmill exercise testing and the last seven patients (patients 8-14) underwent the exercise 201Tl-single-photon emission computed tomography (SPECT) study while synthetic 28-amino acid alpha-human ANP (0.1 micrograms/kg per minute) or saline was intravenously infused in a double-blind, cross-over manner. The duration of exercise testing was the same during ANP and saline infusion, which was determined in preliminary exercise testings in each patient to cause a transient perfusion defect and/or ischemic ST segment depression. During saline infusion,...
86P Post-operative radiotherapy (PORT) vs non-PORT in non-small cell lung cancer patients: A systematic review and meta-analysis
Authors: A. Hadisurya, F. Tandy, M. Suciningtias, R.S. Heriyanto, C. Chrystelle, F. Wijovi, A. Tancherla, T.I. Hariyanto, A. Kurniawan
Journal: Journal of Thoracic Oncology (2021)
Evaluation of infradiaphragmatic total anomalous pulmonary venous connection with two-dimensional echocardiography.
Authors: A RSnider, N HSilverman, KTurley, P AEbert
Journal: Circulation (1982)

In three newborn infants with infradiaphragmatic total anomalous pulmonary venous connection, the common pulmonary vein was visualized with two-dimensional echocardiography and validated with saline contrast injections. The transducer was placed in the subcostal region in a sagittal body plane so as to image the descending aorta and the vertebral column. The common pulmonary vein, which connected the pulmonary veins to a systemic vein in the abdomen, was seen lying parallel and anterior to the descending aorta and to the left of the inferior vena cava. With peripheral venous contrast injections, contrast echoes first filled the inferior vena cava and then the descending aorta because of obligatory right-to-left atrial shunting. The common pulmonary vein was the only structure that remained free of contrast echoes. Thus, contrast echocardiography provided a method for identifying the site of pulmonary venous drainage and for distinguishing the common pulmonary vein from other structures such as the inferio...
Results of sympathetic denervation in the canine heart: supersensitivity that may be arrhythmogenic.
Authors: HInoue, D PZipes
Journal: Circulation (1987)

Latex-induced transmural myocardial infarction or epicardial application of phenol interrupts sympathetic fibers innervating myocardium apical to the infarction or to the phenol-painted area. These denervated regions subsequently show supersensitive shortening of effective refractory period (ERP) in response to the infusion of norepinephrine (denervation supersensitivity). The purpose of this study was to test the hypothesis that such denervation supersensitivity is arrhythmogenic. Ventricular arrhythmias were elicited by programmed ventricular stimulation (PVS) during a control period, during bilateral stimulation of the ansae subclaviae (4 msec pulses, 4 Hz and 3 mA), and during the infusion of norepinephrine (0.5 microgram/kg/min). Study groups consisted of 14 sham-operated dogs, 16 dogs with phenol painted over a diagonal branch, 13 dogs with latex embolization of a diagonal branch that resulted in transmural myocardial infarction, 14 dogs with a one-stage ligation of a diagonal branch producing nontr...
Synthesis and pharmacology of a noncompetitive antagonist of angiotensin-induced contractions of vascular smooth muscle. [Sarcosyl]1-[cysteinyl (s-methyl)]8-angiotensin II.
Authors: R JFreer, J CSutherland, A RDay
Journal: Circulation Research (1980)

The synthesis of an angiotensin II (A II) antagonist, sarcosyl1-cysteinyl(S-methyl)8-angiotensin II [Sar1-Cys(Me)8-A II], showing partial organ selectivity and properties of a noncompetitive antagonist, is described. The compound was found to be an extremely potent antagonist on vascular smooth muscle both in vitro (pA2 for rabbit aorta approximately equal to 9.2) and in vivo on rat blood pressure (dose ratio of 103 for ED25 mm Hg during 1 microgram/kg per min infusion of antagonist). It was without effect on norepinephrine responses in both assay systems. In contrast, it was a considerably weaker antagonist on visceral smooth muscle (pA2 for guinea pig ileum = 8.5; pA2 for rat uterus = 7.9). Interestingly, in the vascular smooth muscle preparations, the compound also exhibited elements of a noncompetitive antagonist in that both the slope and maximum of the A II dose-response curves were reduced markedly. Qualitatively similar results were obtained with sarcosyl1-alanyl8-angiotensin II (Saralasin) on rab...
Covid-19: EMA defends AstraZeneca vaccine as Germany and Canada halt rollouts
Authors: Owen Dyer
Journal: BMJ (2021)

The Oxford AstraZeneca covid-19 vaccine is facing a further wave of scepticism and restrictions as Canada and Germany halt its use in younger patients, citing reports of clotting disorders in recently vaccinated people.

On 30 March, Canadian provinces suspended the use of the vaccine in people aged under 55. The pause was recommended by the country’s National Advisory Committee on Immunization (NACI), which pointed to reports of “rare cases of serious blood clots” in Europe.1 These included instances of cerebral venous sinus thrombosis (CVST), the agency said. Most but not all cases had occurred in women aged under 55, and the syndrome typically appeared 4 to 16 days after receiving the vaccine. The fatality rate among those developing such clots had been as high as 40%, said Shelley Deeks, vice chair of NACI, announcing the recommendations. “There is substantial uncertainty about the benefit of providing AstraZeneca covid-19 vaccines to adults under 55, given the potential risks,” she said, presenting the recommendation as a temporary measure while more data are gathered.

The announcement came just as Canada …
Coronary atherosclerosis in subjects with mitral stenosis.
Authors: S MTadavarthy, ZVlodaver, J EEdwards
Journal: Circulation (1976)

The coronary arteries were examined in 60 specimens from patients with mitral stenosis. In three, localized obstruction was nonatherosclerotic in nature (in one, arterial dysplasia; in two, embolic). In 18 of the remaining 57 cases (31.5%), significantly obstructive atherosclerosis in one or more segments of the coronary arterial system was found. This represented 46% of the males and 27% of the females. The incidence of involvement of three or more arteries by significantly obstructive atherosclerosis was 39%, while in a cited series of subjects with angina pectoris three or more vessels were involved in 79% of the cases. It may be concluded that, on the average, the distribution of lesions in patients with mitral stenosis and significant coronary atherosclerosis is less wide than in subjects with clinical coronary disease.
Abstract 11131: Transesophageal Echocardiography, Mortality and Length of Hospitalization After Cardiac Valve Surgery
Authors: Emily J MacKay, Nimesh D Desai, Mark D Neuman, Jacob T Gutsche, Prakash A Patel, John G Augoustides, Peter W Groeneveld
Journal: Circulation (2019)

Introduction: There is no randomized evidence to support the use of intraoperative TEE in open, cardiac valve repair or replacement surgery. Hypothesis: We hypothesized that intraoperative TEE moni...