tbuckley/cabot-search huggingface dataset:
Sudden death in hypertrophic cardiomyopathy: a profile of 78 patients.
Authors: B JMaron, W CRoberts, S EEpstein
Journal: Circulation (1982)

The clinical profile of 78 patients with hypertrophic cardiomyopathy who died suddenly (or experienced cardiac arrest and survived) was analyzed. At the time of cardiac catastrophe, 71% of the patients were younger than 30 years of age, 54% were without functional limitation and 61% were performing sedentary or minimal physical activity. Nineteen of the 78 patients (24%) were taking propranolol in apparently adequate dosages, indicating that this drug does not provide absolute protection against sudden death. No clinical or morphologic variable was particularly reliable in identifying patients at risk for sudden death. Forty-eight of 62 patients (77%) who died suddenly had a markedly increased ventricular septal thickness of 20 mm or more; however, mean septal thickness was similar in patients who died suddenly (25.2 +/- 0.9 mm) and in age- and sex-matched control patients with hypertrophic cardiomyopathy who have survived (23.6 +/- 0.8 mm). An abnormal ECG was present as often in patients who died sudden...
A comparison of the acute and long-term hemodynamic effects of ventricular inhibited and atrial synchronous ventricular inhibited pacing.
Authors: IKruse, KArnman, T BConradson, LRydén
Journal: Circulation (1982)

Sixteen patients treated with a noninvasively programmable pacemaker were examined after a prolonged period of ventricular inhibited (VVI) and atrial synchronous ventricular inhibited (VDD) pacing. Maximal working capacity was determined by bicycle ergometry. Atrial and ventricular rates, brachial artery cuff pressure and breathing rate were determined at rest and during exercise. There was a mean increase in working capacity of 24% with VDD compared with VVI pacing (p less than 0.001). Thirteen of the patients were catheterized. During VDD pacing, cardiac output was significantly higher, particularly during exercise (+/- 32%) due to the capability of heart rate increase and despite a substantial compensatory stroke volume increase during VVI pacing. Arteriovenous oxygen difference was much higher during VVI pacing, reaching 164 +/- 14 ml/l during the highest work load, while the corresponding level during VDD pacing was 140 +/- 14 ml/l (p less than 0.001). During exercise, arterial blood lactate was sign...
Immediate diagnosis of acute myocardial infarction by two-dimensional echocardiography.
Authors: R SHorowitz, JMorganroth, CParrotto, C CChen, JSoffer, F JPauletto
Journal: Circulation (1982)

To define the role of portable two-dimensional echocardiography (2-D echo) in the immediate diagnosis of acute chest pain syndrome, 80 consecutive patients were studied. Adequate 2-D echo studies were obtained in 65 (81%). Thirty-three patients had clinical evidence of transmural or nontransmural acute myocardial infarction (AMI), 18 of whom had nondiagnostic initial ECGs. Thirty-two did not have a clinical AMI. Thirty-one of the 33 (94%) patients with clinical AMI had regional wall motion abnormalities on the initial 2-D echo; the other two had uncomplicated nontransmural AMIs, diagnosed only by ECG in one and by ECG and moderate elevation of CK-MB isoenzyme in the other. Twenty-seven of the 32 patients without clinical AMI had normal regional wall motion on the initial 2-D echo and none had a complication (severe arrhythmia, recurrent pain, heart failure or death) during the hospital course. Conversely, 10 of the 36 patients with initial 2-D echo regional wall motion abnormalities had a complication (p ...
Primary oxalosis with pan-conduction cardiac disease: electrophysiologic and anatomic correlation.
Authors: B MMassie, SBharati, M MScheinman, MLev, JDesai, ERubeson, WSchmidt
Journal: Circulation (1981)

A 27-year-old man with primary oxalosis and extensive visceral involvement was maintained on long-term chronic hemodialysis. He had an episode of presyncope associated with electrocardiographic findings of an erratic atrial rhythm, atrioventricular dissociation due to an accelerated junctional rhythm and right bundle branch block. Electrophysiologic studies showed irregular atrial depolarizations probably associated with multiple atrial pacemakers, atrial inexcitability, atrioventricular dissociation and infranodal conduction delay. These findings correlated well with extensive oxalate infiltration of the sinoatrial node and its approaches, the atrial preferential pathways, the approaches to the atrioventricular node, the atrioventricular node, and the His bundle and bundle branches. This is the first reported case of cardiac electrophysiologic abnormalities due to oxalate infiltration in a patient with primary oxalosis.
Radiation dose and fraction in immunotherapy: one-size regimen does not fit all settings, so how does one choose?
Authors: Sandra Demaria, Chandan Guha, Jonathan Schoenfeld, Zachary Morris, Arta Monjazeb, Andrew Sikora, Marka Crittenden, Stephen Shiao, Samir Khleif, Seema Gupta, Silvia Chiara Formenti, Bhadrasain Vikram, C Norman Coleman, Mansoor M Ahmed
Journal: Journal for ImmunoTherapy of Cancer (2021)

Recent evidence indicates that ionizing radiation can enhance immune responses to tumors. Advances in radiation delivery techniques allow hypofractionated delivery of conformal radiotherapy. Hypofractionation or other modifications of standard fractionation may improve radiation's ability to promote immune responses to tumors. Other novel delivery options may also affect immune responses, including T-cell activation and tumor-antigen presentation changes. However, there is limited understanding of the immunological impact of hypofractionated and unique multifractionated radiotherapy regimens, as these observations are relatively recent. Hence, these differences in radiotherapy fractionation result in distinct immune-modulatory effects. Radiation oncologists and immunologists convened a virtual consensus discussion to identify current deficiencies, challenges, pitfalls and critical gaps when combining radiotherapy with immunotherapy and making recommendations to the field and advise National Cancer Institute on new directions and initiatives that will help further development of these two fields.This commentary aims to raise the awareness of this complexity so that the need to study radiation dose, fractionation, type and volume is understood and valued by the immuno-oncology research community. Divergence of approaches and findings between preclinical studies and clinical trials highlights the need for evaluating the design of future clinical studies with particular emphasis on radiation dose and fractionation, immune biomarkers and selecting appropriate end points for combination radiation/immune modulator trials, recognizing that direct effect on the tumor and potential abscopal effect may well be different. Similarly, preclinical studies should be designed as much as possible to model the intended clinical setting. This article describes a conceptual framework for testing different radiation therapy regimens as separate models of how radiation itself functions as an immunomodulatory 'drug' to provide alternatives to the widely adopted 'one-size-fits-all' strategy of frequently used 8 Gy×3 regimens immunomodulation.
Effects of anesthesia on the canine carotid chemoreceptor reflex.
Authors: MZimpfer, S PSit, S FVatner
Journal: Circulation Research (1981)

We studied the effects of alpha-chloralose (100 mg/kg, iv), Na pentobarbital (25 mg/kg, iv) and halothane (1 vol% and 2 vol%) on the response to carotid chemoreceptor stimulation (CCRS) in eight chronically instrumented dogs. CCRS was accomplished by means of intracarotid injections of nicotine while ventilation was held constant in the unanesthetized state and following administration of one of three different anesthetics. In the conscious state, CCRS elicited intense bradycardia and peripheral vasoconstriction as reflected by a 173 +/- 14% increase in initial cardiac cycle length and a 216 /+- 22% increase in mean iliac vascular resistance. Each anaesthetic, studied on separate days, attenuated these responses to CCRS strikingly (P less than 0.01). For instance, after alpha-chloralose, CCRS increased iliac resistance by only 55 +/- 14% and cardiac cycle length by only 27 +/- 13%. After Na pentobarbital, CCRS increased iliac resistance by 12 +/- 4% and cardiac cycle length by 8 +/- 5%. After inhalation o...
Structural remodeling of cardiac myocytes in patients with ischemic cardiomyopathy.
Authors: A MGerdes, S EKellerman, J AMoore, K EMuffly, L CClark, P YReaves, K BMalec, P PMcKeown, D DSchocken
Journal: Circulation (1992)

BACKGROUNDChronic ischemic heart disease may lead to ventricular dilation and congestive heart failure (ischemic cardiomyopathy [ICM]). The changes in cardiac myocyte shape associated with this dilation, however, are not known.METHODS AND RESULTSLeft ventricular myocyte dimensions were assessed in cells isolated from explanted human hearts obtained from patients with ICM (n = 6) who were undergoing heart transplantation. Cells were also examined from three nonfailing donor hearts with normal coronary arteries (NCA). Compared with cells from patients with NCA, myocyte length was 40% longer in hearts from patients with ICM (197 +/- 8 versus 141 +/- 9 microns, p less than 0.01), cell width was not significantly different, and cell length/width ratio was 49% greater (11.2 +/- 0.9 versus 7.5 +/- 0.6, p less than 0.01). Sarcomere length was the same in myocytes from both groups. The extent of myocyte lengthening is comparable to the increase in end-diastolic diameter commonly reported in patients with ICM.CONCL...
Complication rate of coronary arteriography. A review of 5250 cases studied by a percutaneous femoral technique.
Authors: M GBourassa, JNoble
Journal: Circulation (1976)

Distressing rates of embolic complications from coronary arteriography performed by the percutaneous femoral approach have been reported since 1972. From 1970-1974, 5250 patients underwent coronary arteriography in our laboratory by the same percutaneous femoral technique with preformed polyethylene catheters and no systemic heparinization. Data were recorded during and for 24 hours postcatheterization. The annual mortality rate averaged 0.23% and remained relatively stable. Our incidence of embolic complications was very low. In patients with normal coronary arteries, no fatal or serious nonfatal complications occurred. Left main coronary artery disease was present in all cases of mortality and greater than or equal to 60% stenosis was shown in nine of 12 instances. Thus major risk was proportional to the severity of disease in the left coronary system. The use of more aggressive supportive measures in these high-risk cases appears essential to reduce the total complication rate from coronary arteriograp...
Hypoxia inhibits myogenic reactivity of renal afferent arterioles by activating ATP-sensitive K+ channels.
Authors: R DLoutzenhiser, M JParker
Journal: Circulation Research (1994)

Recent findings implicate K+ channels as important modulators of myogenic tone and possible mediators of the vasodilatory effects of hypoxia. In the present report, we examined the effects of hypoxia on myogenic vasoconstriction of renal afferent arterioles. Using the in vitro perfused hydronephrotic rat kidney model, we observed precisely graded decreases in arteriolar diameter when renal perfusion pressure was increased. Normal myogenic reactivity was observed over PO2 levels of 150 to 80 mm Hg. Reducing PO2 to 60, 40, and 30 mm Hg resulted in a significant progressive inhibition of myogenic reactivity. At approximately 20 mm Hg, myogenic vasoconstriction was essentially abolished, whereas the vasoconstriction induced by 30 mmol/L KCl was unaffected. The addition of 1.0 mumol/L glibenclamide completely restored myogenic vasoconstriction during hypoxia. In contrast, 1.0 mmol/L tetraethylammonium did not alter the effects of hypoxia. To investigate the relation between hypoxia-induced vasodilation and smo...
Views of health professionals on climate change and health: a multinational survey study
Authors: John Kotcher, Edward Maibach, Jeni Miller, Eryn Campbell, Lujain Alqodmani, Marina Maiero, Arthur Wyns
Journal: The Lancet Planetary Health (2021)

Climate change arguably represents one of the greatest global health threats of our time. Health professionals can advocate for global efforts to reduce emissions and protect people from climate change; however, evidence of their willingness to do so remains scarce. In this Viewpoint, we report findings from a large, multinational survey of health professionals (n=4654) that examined their views of climate change as a human health issue. Consistent with previous research, participants in this survey largely understood that climate change is happening and is caused by humans, viewed climate change as an important and growing cause of health harm in their country, and felt a responsibility to educate the public and policymakers about the problem. Despite their high levels of commitment to engaging in education and advocacy on the issue, many survey participants indicated that a range of personal, professional, and societal barriers impede them from doing so, with time constraints being the most widely reported barrier. However, participants say various resources—continuing professional education, communication training, patient education materials, policy statements, action alerts, and guidance on how to make health-care workplaces sustainable—can help to address those barriers. We offer recommendations on how to strengthen and support health professional education and advocacy activities to address the human health challenges of climate change.
Cardiac Device Infective Endocarditis and Patient Survival—Reply
Authors: Eugene Athan, Andrew Wang
Journal: JAMA (2012)

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
A randomized comparison of the effects of gradual prolonged versus standard primary balloon inflation on early and late outcome. Results of a multicenter clinical trial. Perfusion Balloon Catheter Study Group.
Authors: E MOhman, J FMarquis, D RRicci, R IBrown, M LKnudtson, D JKereiakes, J KSamaha, J RMargolis, A LNiederman, L SDean
Journal: Circulation (1994)

BACKGROUNDObservational studies have suggested that prolonged balloon inflation during coronary angioplasty is associated with a high clinical success rate. This randomized clinical trial sought to evaluate the impact of primary gradual and prolonged inflations versus standard short dilatations in patients undergoing elective angioplasty.METHODS AND RESULTSIn phase 1 of the study, patients were randomized to receive two to four standard (1 minute) dilatations or one or two prolonged (15 minutes) dilatations after a perfusion balloon had been placed across a single target lesion. Patients with unsuccessful angiographic appearance after phase 1 dilatations had further dilatations in phase 2. Patients were followed for 6 to 12 months after the procedure. Of 478 patients, 242 received a median of one prolonged dilatation of 15 minutes' duration, and 236 received three dilatations for a median of 1 minute. Patients assigned to prolonged dilatations had a higher success rate (< or = 50% residual visual stenosis...
OWE-001 Acetic acid guided biopsies versus mapping biopsies for barrett’s surveillance: the ABBA study
Authors: Gaius Longcroft-wheaton, Carole Fogg, John DeCaestecker, Hugh Barr, David Poller, Bernard Higgins, Lisa Gadeke, Jansuz Jankowski, Pradeep Bhandari
Journal: Endoscopy (2018)

<h3>Introduction</h3> Barrett's surveillance traditionally requires mapping biopsies to identify neoplasia. Acetic acid (AA) allows only targeted biopsies, potentially reducing the number of biopsies required. This study aims to compare neoplasia detection with AA targeted biopsies and protocol guided non-targeted biopsies during Barrett's surveillance. <h3>Methods</h3> Multicentre randomised crossover feasibility study in UK secondary care. Patients under surveillance for Barrett's metaplasia (&gt;2 cm) with no history of dysplasia or cancer were recruited. All patients underwent two gastroscopies 8 weeks apart, one with AA guided biopsy of abnormal areas only (Portsmouth Protocol) and one with non-targeted mapping biopsies (Seattle Protocol). Neoplasia yield (low grade dysplasia LGD, high grade dysplasia (HGD) and cancer) from each strategy was evaluated and the number of biopsies recorded. <h3>Results</h3> 200 patients recruited from 6 centres. Mean age 66 years. 145 were male. Mean length C4M6. 175 patients completing both procedures. The prevalence of LGD, HGD and cancer was 11/192 (5.8%). All HGD and cancer was found with both protocols and confirmed with definitive treatment. One LGD was found with Portsmouth protocol not found with Seattle. 5 LGD were found with Seattle protocol not found with Portsmouth. This difference was not significant (p=0.2188), and on follow up gastroscopy no neoplastic changes were found in any of the LGD cases. 2139 biopsies were taken using Seattle protocol at a cost of £1 25 987 (306 biopsies per neoplasia, £18,023). 226 biopsies with Portsmouth Protocol at a cost of £13 311 (75 biopsies per neoplasia, £6,656) a 4 fold difference. In terms of HGD/cancer, 1070 biopsies/neoplasia found using Seattle protocol and 113 biopsies/neoplasia using Portsmouth Protocol, a 9.5 fold difference. <h3>Conclusions</h3> This is the first RCT comparing these techniques. No HGD or cancer was missed with either technique. There was a 4 fold reduction in biopsies per neoplasia detected with Portsmouth compared to Seattle protocol and a 9.5 fold difference when restricted to high risk neoplasia. If implemented nationally then this could lead to a massive reduction in histopathology work load and costs. LGD remains controversial and we believe inflammation could have resulted in false positive LGD as subsequent OGD and biopsies did not reveal any LGD. This feasibility data would support a definitive trial of AA targeted biopsies in a surveillance population.
Local cerebral blood volume response to carbon dioxide in man.
Authors: J HGreenberg, AAlavi, MReivich, DKuhl, BUzzell
Journal: Circulation Research (1978)

We used an emission tomographic brain scanner to investigate the relationship between local cerebral blood volume (LCBV) and arterial blood carbon dioxide tension (PaCO2) in normal awake man. Measurements were made separately in three dimensions in various regions of grey and white matter, and the resting LCBV as well as the difference in sensitivity among these regions were compared. Over the range of PaCO2 studied (20-42 torr), the response of both the grey matter and the white matter to carbon dioxide was linear. The LCBV sensitivity of the grey matter to changes in PaCO2 was 0.053 ml/100 g per torr PaCO2 and in the white matter this sensitivity was 0.046 ml/100 g per torr PaCO2. These sensitivities were found not to be significantly different, yielding a slope of 0.049 ml/100 g per torr PaCO2 for the LCBV-PaCO2 curve for the entire brain. This is in excellent agreement with the other data for the whole brain. The resting cerebral blood volume of the grey matter at a PaCO2 of 34.4 torr, which was the a...
Ten-year incidence of myocardial infarction and prognosis after infarction. Department of Veterans Affairs Cooperative Study of Coronary Artery Bypass Surgery.
Authors: PPeduzzi, KDetre, M LMurphy, JThomsen, HHultgren, TTakaro
Journal: Circulation (1991)

BACKGROUNDThe 10-year incidence of myocardial infarction (fatal and nonfatal) and the prognosis after infarction were evaluated in 686 patients with stable angina who were randomly assigned to medical or surgical treatment in the Veterans Administration Cooperative Study of Coronary Artery Bypass Surgery.METHODS AND RESULTSMyocardial infarction was defined by either new Q wave findings or clinical symptoms compatible with myocardial infarction accompanied by serum enzyme elevations with or without electrocardiographic findings. Treatment comparisons were made according to original treatment assignment; 35% of the medical cohort had bypass surgery during the 10-year follow-up period. The overall cumulative infarction rate was somewhat higher in patients assigned to surgery (36%) than in medical patients (31%) (p = 0.13) due to perioperative infarctions (13%) and an accelerated infarction rate after the fifth year of follow-up (average, 2.4%/yr in the surgical group versus 1.4%/yr in the medical group). The...
127P Real-world evidence and clinical characteristics in patients (pts) with advanced non-small cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICI)
Authors: P. Iranzo, A. Callejo, D. Marmolejo, J.D. Assaf, N. Pardo, A. Navarro, A. Martinez-Marti, S. Cedres, N.M. Diaz Mejia, C. Carbonell, R. Amat, J. Frigola, E. Felip
Journal: Journal of Thoracic Oncology (2021)
Thallium 201 imaging and gated cardiac blood pool scans in patients with ischemic and idiopathic congestive cardiomyopathy. A clinical and pathologic study.
Authors: B HBulkley, G MHutchins, IBailey, H WStrauss, BPitt
Journal: Circulation (1977)

In ischemic cardiomyopathy (CM) fibrosis replaces large segments of myocardium, but in idiopathic congestive CM the myocardium contains only small foci of fibrosis or is morphologically normal. As coronary disease and myocardial infarction may be clinically silent, it is not always possible to distinguish ischemic from idiopathic congestive CM during life without cardiac catheterization. To determine whether noninvasive methods, thallium 201 myocardial (Tl) imaging and technetium 99m gated cardiac blood pool scans (GCBPS), could separate the entities, we evaluated radioisotope images of the heart in 13 patients with ischemic, and eight patients with idiopathic congestive CM, and 14 patients with normal hearts. Diagnosis was setablished by cardiac catherterization and/or autopsy in each of the 35 patients. The 14 normals could be readily distinguished from CM, and ischemic could be distinguished from idiopathic dilated CM in 20 of 21 patients. All patients with myocardiopathy showed hypokinetic and dilated...