tbuckley/cabot-search huggingface dataset:
Abstract 2807: Is Invasive Strategy A Feasible Alternative For Acute Coronary Syndromes In Patients Older Than 80 Years?
Authors: Ulf Stenestrand, Lars Wallentin, Olle Melander, Klas Gränsbo, Jörg Carlsson
Journal: Circulation (2007)

Background: Lack of consensus regarding use of an invasive strategy in the very elderly with coronary artery disease has repeatedly been demonstrated. This is in part due to the fear of complications and to the assumption that nothing can be done in most of these cases because of advanced disease. At the same time, the number of these patients is increasing in western societies. Methods: Data from the Register of Information and Knowledge about Swedish Heart Intensive care Admissions (RIKS-HIA) was analyzed in 54850 patients of age 80 years or older admitted between the years 2000–2005 with an acute coronary syndrome (ACS). To evaluate potential early hazard or benefit from revascularization performed within 14 days 1-year mortality was evaluated both in all patients and in 14-days survivals (n=47865). A multivariable Cox regression analysis was performed including 15 covariates. Results : Crude 1-year mortality in patients revascularized within 14 days of admission was 16.0% (857/5369) vs. 35.6% (17596/ 49481) in those revascularized later or not at all (p&lt;0.001) comparing patients from the admission day, and when only 14-day survivors were compared 9.4% (345/3664) vs. 25.9% (9407/36260) (p&lt;0.001). In the Cox regression analysis revascularization was associated with reduced 1-year mortality RR 0.52 (95% CI, 0.48–0.56; p&lt;0.001) in all patients and RR 0.43 (95% CI, 0.42–0.51; p&lt;0.001) in 14-day survivors. Conclusion: Also in patients older than 80 years with ACS revascularization is feasible and with the selection done by physicians associated with improved survival when comparing patients with similar comorbidity and risk factors.
Lehrbuch der Magen- und Darmkrankheiten.
Authors: Walter Zweig
Journal: JAMA (1924)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 5769: Correlation of Bicuspid Valve Morphology and Pattern of Aortic Root Dilatation: A Substudy of the Aortic Stenosis Progression Observation Measuring Effects of Rosuvastatin (ASTRONOMER) Study
Authors: Kapil M Bhagirath, Davinder S Jassal, James W Tam, Randy A Sochowski, Jean G Dumesnil, P J Giannoccaro, John Jue, A S Pandey, C D Joyner, K K Teo, Kwan L Chan
Journal: Circulation (2008)

Bicuspid aortic valve is the leading cause of aortic stenosis in patients younger than the age of 50. A classification scheme of bicuspid aortic valves (BAV) was recently proposed based upon leaflet orientation: Type A (fusion of right and left coronary cusps) and Type B (fusion of right and non-coronary cusps). The correlation between BAV leaflet orientation and aortic root pathology however remains ill defined. To describe a potential relationship between BAV leaflet morphology and aortic root measurements in the ASTRONOMER study, a multicentre study to assess the effect of Rosuvastatin on the progression of AS. Transthoracic echocardiography was performed with 2D and Doppler imaging following a standardized protocol. BAV morphology was classified as Type A or Type B orientation following review of the parasternal short-axis view. Echo measurements including left ventricular and aortic root dimensions were obtained according to the ASE recommendations. We identified 89 patients (56±11 years; 44 males). There were 63 patients with Type A and 26 with Type B BAV. Baseline demographic, hemodynamics, aortic root and left heart dimensions are listed in Table 1 . Patients with Type A BAV had larger aortic and ascending root dimensions than those patients with Type B BAV (p&lt;0.05). Aortic valvular calcification and mitral annular calcification were similar between the two groups. All values are expressed as mean±SD. In patients with mild to moderate asymptomatic BAV, the presence of Type A valve orientation was associated with significantly greater aortic root parameters compared to Type B valve orientation. Whether the morphology of BAV may predict a subset of patients who will respond to statin therapy in preventing the progression of AS remains to be determined upon completion of the ASTRONOMER trial.
Abstract 8169: Relationship Between the Ratio of Serum Eicosapentaenoic Acid to Arachidonic Acid and the Risk of Death: the Hisayama Study
Authors: Toshiharu Ninomiya, Yasufumi Doi, Yutaka Kiyohara
Journal: Circulation (2011)

Background: Recent evidence emerged to imply that greater intakes of omega-3 fatty acids reduce the risk of atherosclerotic disease. Some epidemiological studies suggested that a ratio of serum eicosapentaenoic acid to arachidonic acid (EPA/AA) is a possible good biomarker of risk for cardiovascular disease and death, but this issue has not been fully evaluated. We assessed the hypothesis that subjects with lower EPA/AA levels would be at increased risk of death from any causes and cardiovascular causes. Methods: We followed a total of 3,103 community-dwelling Japanese individuals aged 40 years or older, without history of cardiovascular disease, and with available EPA/AA data, for 5 years, and examined the relationship between EPA/AA levels and the risk of death from any and cardiovascular causes by using the Cox proportional hazards model. Results: The median value of EPA/AA levels in the study population was 0.41 (interquartile range, 0.29-0.59). During the follow-up, 191 subjects died in total, 48 of which were deceased from cardiovascular causes. The mortality rate from any causes increased gradually with lower EPA/AA levels: The risk of death from any causes increased significantly with EPA/AA levels of &lt;0.25, 0.25-0.49, 0.5-0.74, and ≥0.75, being 23.5, 11.8, 12.8, and 11.5 per 1,000 person-years, respectively (p for trend =0.01). Likewise, there was an increasing trend in the mortality rate from cardiovascular causes with lower EPA/AA levels: 4.9, 4.0, 2.2, and 1.6 per 1,000 person-years for EPA/AA levels of &lt;0.25, 0.25-0.49, 0.5-0.74, and ≥0.75, respectively (p for trend =0.03). After adjusting for potential confounding factors: namely, age, sex, hypertension, diabetes, total cholesterol, use of lipid-modifying agents, body mass index, smoking habits, and alcohol intake, subjects with EPA/AA level of &lt;0.25 had a 2.04-fold (95% confidence interval [CI], 1.18-3.41) and 2.90-fold (95% CI, 0.78-10.77) greater risk of deaths from any causes and cardiovascular causes, as compared to those with EPA/AA level of ≥0.75. Conclusions: Our findings suggest that lower EPA/AA level is associated with a greater risk of death in the general Japanese population.
Abstract 5466: In Vivo Molecular Imaging Revealed Chronic Inflammation and Increased Adhesion Molecules in Obese Adipose Tissue in Mice
Authors: Satoshi Nishimura, Mika Nagasaki, Ichiro Manabe, Kinya Seo, Takashi Kadowaki, Seiryo Sugiura, Ryozo Nagai
Journal: Circulation (2008)

Metabolic syndrome is a major risk factor of cardiovascular events, and obese visceral adipose tissue remodeling and malfunctioning based on chronic inflammation plays a central role. To assess dynamic multi-cellular interplay, a novel ex vivo (a–c) and in vivo (d–f) adipose tissue imaging method was developed. We found close spatial and temporal interrelationships between angiogenesis and adipogenesis, and both were augmented in obese adipose (c,arrow). In addition, we found increased leukocyte-platelet-endothelial cell interactions in the micro-circulation of obese visceral adipose that were indicative of activation of the leukocyte adhesion cascade, a hallmark of inflammation (e,f). Both macrophages and endothelial cells showed increased adhesion molecules including ICAM-1 and Selectin families, and P-selectin positive platelets were increased locally in obese adipose. Up-regulated expression of adhesion molecules on multiple cell types suggests their increased interactions contribute to local activation of inflammatory processes within visceral obese adipose tissue. Interestingly, the heightened leukocyte-platelet-endothelial interactions were not observed in obese subcutaneous fat pads. Our results demonstrated the power of our imaging technique to analyze complex inflammatory cellular interplays in vivo and to evaluate new therapeutic interventions against them. Results also indicate that visceral adipose tissue obesity is an inflammatory disease.
908. Evaluation of the Sleeping Beauty Transposon System in OTC Deficient Spf-Ash Mice: A Non-Viral Approach to a Cell Autonomous Metabolic Disease
Authors: Inborn Errors, Jaap Rip, Melchior C. Nierman, Jeroen A. Sierts, Colin J. Ross, Michael R. Hayden, Albertine de Jong, Paul Dijkhuizen, Wim Hermens, Jaap Twisk, John J. Kastelein, Jan Albert Kuivenhoven, Janneke M. Meulenberg, Andy Wilber, Joel Frandsen, Hiroki Morizono, Scott McIvor
Journal: Molecular Therapy (2005)

relatively high intrahepatic pressures achieved, there was minimal evidence of liver injury; no histological abnormalities were observed and only minimal and transient elevation of AST and ALT were noted. The procedure itself was uneventful and very well tolerated with no clinical manifestations of acute or chronic toxicities. This novel method of delivering HDAd is simple, minimally invasive, and clinically relevant since it increases the therapeutic index of HDAd for liver-directed gene therapy by allowing high efficiency hepatic transduction with low vector doses and with negligible acute or chronic toxicities.
The prognostic role of quality-of-life assessment in lung cancer.
Authors: D. P. Braun, D. Gupta, J. F. Grutsch, E. D. Staren
Journal: Journal of Clinical Oncology (2010)

9096 Background: There is accumulating evidence that various quality of life (QoL) domains provide information on patient longevity independent of known prognostic factors. We investigated whether QoL functional domains and symptom items could identify lung cancer patients at high or low risk of treatment failure. Methods: 1,194 lung cancer patients treated at two single-system cancer centers between Jan 2001 and Dec 2008. QoL was evaluated prior to initiation of treatment using EORTC-QLQ-C30 which incorporates a global, 5 functional and 9 symptom scales. Univariate and multivariate Cox regression analyses evaluated survival. Results: Mean age at presentation was 58.3 years. There were 605 analytic (newly diagnosed) and 589 non-analytic patients (recurrent disease); 601 males and 593 females. Stage of disease at diagnosis was I, 100; II, 63; III, 348; IV, 656; and 27 indeterminate. Median overall survival was 8.8 months (95% CI: 8.0-9.5). Mean global QoL score was 53.8 and 53.1 for locoregional and metastatic disease (p=0.63) and 56.1 and 50.9 for analytic and non-analytic disease (p=0.001). On univariate analysis, QoL scales predictive of survival were physical (p<0.001), role (p<0.001), emotional (p=0.04), cognitive (p=0.003), social (p<0.001), fatigue (p<0.001), nausea/vomiting (p=0.001), pain (p<0.001), dyspnea (p<0.001), loss of appetite (p<0.001), constipation (p=0.001) and diarrhea (p=0.02). Upon multivariate analyses, only physical function (p<0.001), pain (p=0.05) and insomnia (p=0.03) were predictive of survival independent of other QoL scales, age, gender, stage, and treatment history. Higher stage of disease, prior treatment history and male gender predicted worse survival (p <0.001 for all). Physical function, nausea/vomiting, insomnia, and diarrhea (p<0.05 for all) in analytic patients while only physical function (p<0.001) in nonanalytic patients were independently predictive of survival. Conclusions: In newly diagnosed patients, a cluster of symptoms—insomnia, nausea/vomiting and diarrhea—identified patients at high risk for treatment failure. While this symptom cluster was uninformative in patients with recurrent disease, low physical function identified patients at high risk of treatment failure. No significant financial relationships to disclose.
What Is the Most Cost-Effective Strategy for Treating Newly Diagnosed Chronic Phase Chronic Myeloid Leukemia (CML) after Imatinib Loses Patent Exclusivity?
Authors: Richard A. Larson, Rena Conti, William V. Padula, Jane F. Apperley, Michele Baccarani, Ekkehard Eigendorff, Francois Guilhot, Joelle Guilhot, Francois-Xavier Mahon, Giovanni Martinelli, Jiri Mayer, Martin C. Mueller, Dietger Niederwieser, Susanne Saussele, Charles A. Schiffer, Richard T. Silver, Bengt Simonsson, Rudiger Hehlmann
Journal: Blood (2014)
Characteristics of the adult corticosteroid-dependent severe asthma in UBIOPRED consortium
Authors: A.R. Sousa, Ioannis Pandis, Yang Xian, Uruj Hoda, Anthony Rowe, Julie Corfield, Elizabeth Jeyasingham, Aruna Bansal, Wolfgang Seibold, Ariane Wagener, Per Bakke, Graham Roberts, Florian Singer, Urs Frey, Horváth Ildikó, Riccardo Polosa, Norbert Krug, Roelinde Middelveld, Sven-Erik Dahlen, Jacek Musial, David Gibeon, Louise Fleming, Stephen Fowler, Laurie Pahus, Dominic Shaw, Peter Howarth, David Myles, Chris Compton, Tim Higenbottam, Paolo Montuschi, Jorgen Vestbo, Ulf Nihlen, Thomas Sandström, Scott Wagers, Ratko Djukanovic, Elisabeth Bel, Peter Sterk, Fan Chung
Journal: European Respiratory Journal (2014)

Patients with severe refractory asthma often need regular oral corticosteroid (CS) therapy in addition to inhaled CS. We determined whether CS-dependent subjects are a distinct group by comparing their clinical features and inflammatory biomarkers to those of non-CS-dependent subjects. The severe asthma UBIOPRED cohort consisted of 372 patients, with 44% classified as CS-dependent. Severe asthma was defined according to the IMI-criteria (Bel  et al . Thorax 2011; 66: 910-7).  There was a similar female preponderance and BMI in both groups, but the CS-dependent group had greater exacerbation rate (3 vs 2/year; p=0.001), prevalence of nasal polyps (48% vs 23%; p=0.0003) and GINA severity score (p=0.01), associated with greater use of nebulised bronchodilators and theophylline. They also had lower pre-bronchodilator FEV 1  (63.1% vs 66.4%; pl0.05). Blood neutrophil count was higher but eosinophils were lower. In induced sputum, eosinophils were non-significantly increased (5.2% vs 2.0%; p=0.063), but sputum macrophages were lower (13.9% vs 27.8%; p=0.01). There was an increase in the mixed granulocytic profile in sputum (26 vs 8%) and a reduction in the paucigranulocytic profile (10% vs 31%). In blood, neutrophil counts increased while eosinophils decreased, indicating a systemic effect of CS. FE NO  was higher (30 vs 22 ppb; p=0.001).  This preliminary analysis indicates that CS-dependent severe asthma represents a more severe group with higher inflammatory biomarkers with lesser sensitivity to CS beneficial effects, characterised by an eosinophilic and neutrophilic sputum profile. Further -omics analysis in progress will provide a more precise delineation of this phenotype.
Abstract 9020: Utilizing Speckle Tracking Echocardiography to Analyze Strain Patterns in Pediatric Patients with Suspected Myocarditis
Authors: Aparna Prasad, Darren Klugman, Marcin Gierdalski, Russell Cross
Journal: Circulation (2011)

Background: Myocarditis is a rare disease involving inflammation of the myocardium which causes significant morbidity and mortality in children. Currently, endomyocardial biopsy is the only definitive way to diagnose myocarditis but techniques such as echocardiography and cardiac MRI can be utilized to aid in diagnosis. New advances such as speckle tracking echocardiography (STE) can analyze myocardial strain patterns which are a more sensitive measure of ventricular function. The primary aim of this study is to determine if 2D strain imaging via STE in children with suspected myocarditis correlates with other methodologies currently used in making the diagnosis. Methods: A retrospective review was conducted to identify all patients with suspected myocarditis from 2004-2010.Standard 2D echocardiograms were analyzed off-line using the Syngo Velocity Vector imaging software to determine global strain and strain rate in the longitudinal and circumferential views. Results: A total of 66 patients with suspected myocarditis were compared to 29 age matched controls. Of the 66 study patients, 48% (32/66) underwent endomyocardial biopsy and/or MRI. Global longitudinal and circumferential strain and strain rates were lower in the suspected myocarditis group compared to controls ( P &lt;0.005). Patients who underwent further workup with either biopsy and/or MRI had significantly decreased circumferential strain rate ( P &lt;0.03) and especially decreased longitudinal strain rate ( P &lt;0.003) when compared to those who did not have further diagnostic testing with biopsy or MRI. Furthermore, all patients with biopsy or MRI proven myocarditis had decreased longitudinal and circumferential global strain and strain rates as compared to controls ( P &lt;0.0008). Conclusions: : STE can be a useful diagnostic tool in identifying patients with suspected myocarditis. In our study, all global strain and strain rate values were significantly decreased in patients with proven myocarditis as compared to controls. Specifically, longitudinal strain rate may be a more sensitive diagnostic tool to select patients who merit further testing. Further work is needed to determine if STE correlates with segmental abnormalities on MRI in children with suspected myocarditis.
Abstract 3115: Ankle Brachial Pressure Index (ABI) Is A Better Predictor Of Cardiovascular Mortality Than Toe-Brachial Index (TBI) Or Abnormal Doppler Flow Curves In Both Diabetic And Non-diabetic Subjects: The Hoorn Study.
Authors: Maya S Huijberts, Isabel Ferreira, Nicolaas C Schaper, Jacqueline M Dekker, Giel Nijpels, Robert J Heine, Coen D Stehouwer
Journal: Circulation (2007)

Introduction: Individuals with peripheral arterial disease (PAD) have a high risk of future cardiovascular events. Many studies have demonstrated that low (&lt;0.9) Ankle Brachial Index (ABI) predicts cardiovascular mortality in both diabetic and non-diabetic subjects. However, in diabetic subjects the measurement of the ABI is complicated by the presence of medial arterial calcification which results in falsely elevated ABI-values despite the presence of significant PAD. Therefore, we investigated whether the Toe-Brachial Index (TBI) or abnormal Doppler flow curves would be better predictors of PAD-associated cardiovascular mortality (CVM). Methods: Associations between measures of PAD and CVM were studied in an age-, sex,- and glucose tolerance stratified sample (n = 631) of a population based cohort aged 50 –75 years followed for 15 years. Measures included Doppler assisted ABI, flow velocity tracings of the femoral, popliteal and crural arteries and measurement of the TBI. Predictors of CVM were determined by Cox proportional hazards multiple regression analysis. Results are described as hazards ratios (HR) and 95% confidence intervals (CI). Results : At baseline ABI &lt; 0.9 was present in 10.5% (6.9% in non-diabetic vs 17.2% in diabetic individuals), TBI &lt; 0.7 was present in 21.0% (18.9% vs 24.3%), and abnormal Doppler flow curves in 20.3% (16.0% vs 29.3%). After 15 years of follow-up 141 patients had died of cardiovascular causes. After adjusting for age, sex, hypertension, total and HDL-cholesterol, triglycerides, BMI and smoking, HR (95% CI) were 3.19 (1.91–5.34) P&lt;0.001 for ABI&lt;0.9, 2.80 (0.97– 8.05) P=0.056 for presence of abnormal flow-curves, and 1.58 (0.97 – 2.57) P=0.068 for TBI&lt;0.7. When entering the three measures simultaneously in the regression model only ABI&lt;0.9 was an independent predictor of CVM, HR=2.81 (1.47 – 5.39) P=0.002. In diabetic individuals this effect was as least as strong, HR=3.30 (1.39 – 7.99) P=0.007. Conclusion: Although an ABI&lt; 0.9 may underestimate the presence of PAD in individuals with type 2 diabetes, this measure is a powerful independent predictor of CVM in both diabetic and non-diabetic subjects. Assessment of the ABI should be used more often to identify high-risk patients, especially in the diabetic population.
Screening and Behavioral Counseling Interventions in Primary Care To Reduce Alcohol Misuse: Recommendation Statement
Journal: Annals of Internal Medicine (2004)

This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on behavioral counseling interventions to reduce alcohol misuse in primary care patients and updates the 1996 recommendations on this topic. The complete information on which this statement is based, including evidence tables and references, is available in the accompanying article in this issue and in the systematic evidence review on this topic. The complete USPSTF recommendation statement (which includes a brief review of the supporting evidence), the accompanying journal article, and the complete systematic evidence review are available through the USPSTF Web site (www.preventiveservices.ahrq.gov). The journal article and the USPSTF recommendation statement are available in print through the Agency for Healthcare Research and Quality Publications Clearinghouse (telephone, 800-358-9295; e-mail, ahrqpubs@ahrq.gov). *For a list of the members of the U.S. Preventive Services Task Force, see the Appendix.