tbuckley/cabot-search huggingface dataset:
Ventilator-Induced Lung Injury
Authors: Andreas Geipel, Hans Will, Wolfram Gerlich
Journal: New England Journal of Medicine (2014)

During mechanical ventilation, high end-inspiratory lung volume (whether it be because of large tidal volume (VT) and/or high levels of positive end-expiratory pressure) results in a permeability type pulmonary oedema, called ventilator-induced lung injury (VILI). Previous injury sensitises lung to mechanical ventilation. This experimental concept has recently received a resounding clinical illustration after a 22% reduction of mortality was observed in acute respiratory distress syndrome patients whose VT had been reduced. In addition, it has been suggested that repetitive opening and closing of distal units at low lung volume could induce lung injury but this notion has been challenged both conceptually and clinically after the negative results of the Acute Respiratory Distress Syndrome clinical Network Assessment of Low tidal Volume and Elevated end-expiratory volume to Obviate Lung Injury (ARDSNet ALVEOLI) study. Experimentally and clinically, involvement of inflammatory cytokines in VILI has not been unequivocally demonstrated. Cellular response to mechanical stretch has been increasingly investigated, both on the epithelial and the endothelial side. Lipid membrane trafficking has been thought to be a means by which cells respond to stress failure. Alterations in the respiratory system pressure/volume curve during ventilator-induced lung injury that include decrease in compliance and position of the upper inflection point are due to distal obstruction of airways that reduce aerated lung volume. Information from this curve could help avoid potentially harmful excessive tidal volume reduction.
Long-term control of Chagas disease in Venezuela: effects on serologic findings, electrocardiographic abnormalities, and clinical outcome.
Authors: HAcquatella, FCatalioti, J RGomez-Mancebo, VDavalos, LVillalobos
Journal: Circulation (1987)

To evaluate the long-term effects (20 years) of a Chagas control program (CCP) in Venezuela, a prospective serologic evaluation was carried out from 1981 to 1984 on 5771 inhabitants (8%) of Roscio county. This region was selected as a representative area where the national CCP was implemented effectively. Comparison with a serologic survey performed in the same region before the CCP disclosed a reduction in seropositive subjects from 47.8% to 17.1% (p less than .001), most marked amongst children and teenagers from 29.9% to 1.9%, suggesting that transmission of the disease had diminished. Similar seropositivity changes after the CCP were observed nationwide. Because decreased superinfection would also be expected to occur, we tried to ascertain whether the clinical outcome of seropositive individuals living in Roscio county had improved. The mean age of seropositive subjects between both surveys increased significantly from 34.9 +/- 17.3 to 46.7 +/- 15.1 years (p less than .001). Additionally, we examined...
Estimation of the probability of exercise-induced ischemia by quantitative ECG analysis.
Authors: M LSimoons, P GHugenholtz
Journal: Circulation (1977)

In order to improve the value of exercise tests for the detection of coronary artery disease (CAD) a system for on-line computer processing of the Frank lead exercise ECG was developed. Data were analyzed from 95 patients with CAD and 129 ostensibly healthy men. All subjects had a normal ECG at rest. Visual ECG interpretation during exercise yielded a sensitivity of 50% and a specificity of 95%. A large number of QRS and ST measurements were compared by discriminant function analysis in a group of 86 normal subjects and 52 patients (designated training group). Best results were obtained with a combination of two ST amplitudes from lead X: sensitivity, 85%, specificity, 90%. This was confirmed in a test group of 43 patients and 43 normal subjects. The results of the discriminant function were expressed as the likelihood ratio for an abnormal or normal ST segment at a given heart rate, a figure which provides a quantitative assessment of the degree of exercise-induces ischemia. This is a more realistic appr...
Power spectral analysis of heart rate and arterial pressure variabilities as a marker of sympatho-vagal interaction in man and conscious dog.
Authors: MPagani, FLombardi, SGuzzetti, ORimoldi, RFurlan, PPizzinelli, GSandrone, GMalfatto, SDell'Orto, EPiccaluga
Journal: Circulation Research (1986)

In 57 normal subjects (age 20-60 years), we analyzed the spontaneous beat-to-beat oscillation in R-R interval during control recumbent position, 90 degrees upright tilt, controlled respiration (n = 16) and acute (n = 10) and chronic (n = 12) beta-adrenergic receptor blockade. Automatic computer analysis provided the autoregressive power spectral density, as well as the number and relative power of the individual components. The power spectral density of R-R interval variability contained two major components in power, a high frequency at approximately 0.25 Hz and a low frequency at approximately 0.1 Hz, with a normalized low frequency:high frequency ratio of 3.6 +/- 0.7. With tilt, the low-frequency component became largely predominant (90 +/- 1%) with a low frequency:high frequency ratio of 21 +/- 4. Acute beta-adrenergic receptor blockade (0.2 mg/kg IV propranolol) increased variance at rest and markedly blunted the increase in low frequency and low frequency:high frequency ratio induced by tilt. Chroni...
Abstract 19564: Short Term Improvement in Subtle Cardiac Dysfunction in Severely Obese Patients After Bariatric Surgery is Not Associated With Changes in Nt-pro-bnp: A Speckle Tracking Study
Authors: Marcela Rodríguez-Flores, Julie Martin, Paul Poirier
Journal: Circulation (2015)

Background and objective: The impact of bariatric surgery on sub-clinical alteration of cardiac function assessed using speckle-tracking strain and its relationship with metabolic changes is unknown. We assessed in obese patients with normal left ventricle (LV) systolic function who underwent the biliopancreatic diversion with duodenal switch (BPD-DS); 1) prevalence of subclinical cardiac dysfunction and dyssynchrony in comparison with gender-matched subjects and, 2) the impact of bariatric surgery on myocardial function and its association with changes in NT-proBNP levels and insulin sensitivity. Methods: Prospective, observational study of the effect of BPD-DS after six months on strain, strain rate (SR) and displacement curves using a repeated measures mixed linear regression model analysis. Changes in systolic (LV end-systolic dimension, longitudinal strain) and diastolic (E/A, ESr) parameters were correlated with changes in body mass index (BMI), HOMA and NT-proBNP. Results: Thirty-eight severely obese patients (BMI 48.4±7.4 Kg/m 2 ) had decreased longitudinal strain (-17.0±2.5%) in comparison with 20 patients without obesity (-19.7±1.5%) (p&lt;0.001), which was comparable to controls after surgery (19.3±1.8%) at a mean BMI of 35.7±6 mg/m 2 . Eighteen patients (47%) had a global longitudinal strain considered clinically abnormal. Following surgery, 94% of these patients improved their LV mechanics, with normalization of their global longitudinal strain (p&lt;0.001). Changes in longitudinal strain were not related with changes in NT-proBNP or improvement in insulin sensitivity. Conclusions: There is significant subclinical cardiac dysfunction in patients with severe obesity with normal systolic function. Improvement in longitudinal strain after surgery was not explained by improved insulin sensitivity or changes in NT-proBNP.
Dietary salt intake. A determinant of cardiac involvement in essential hypertension.
Authors: R ESchmieder, F HMesserli, G EGaravaglia, B DNunez
Journal: Circulation (1988)

Because a given increase in afterload does not consistently produce the same degree of left ventricular hypertrophy, we evaluated several clinical, hemodynamic, and endocrine factors that are prone to modify the adaptation of left ventricular structure in patients with mild essential hypertension (World Health Organization stages I or II). Dietary salt intake assessed by sodium excretion over 24 hours was a powerful determinant of posterior wall thickness (r = 0.64, p less than 0.001), relative wall thickness (r = 0.67, p less than 0.001), and left ventricular mass (r = 0.37, p less than 0.05). In contrast, diastolic pressure, body mass index, hematocrit, and epinephrine were found to be weaker determinants of left ventricular structure (r = 0.31-0.40, p less than 0.05). A stepwise multiple regression analysis revealed that sodium excretion was the strongest predictor for posterior wall thickness (p less than 0.02) and relative wall thickness (p less than 0.05) independent of the other examined variables....
Development of COVIDVax Model to Estimate the Risk of SARS-CoV-2–Related Death Among 7.6 Million US Veterans for Use in Vaccination Prioritization
Authors: George N. Ioannou, Pamela Green, Vincent S. Fan, Jason A. Dominitz, Ann M. O’Hare, Lisa I. Backus, Emily Locke, McKenna C. Eastment, Thomas F. Osborne, Nikolas G. Ioannou, Kristin Berry
Journal: JAMA Network Open (2021)

<h3>Importance</h3> A strategy that prioritizes individuals for SARS-CoV-2 vaccination according to their risk of SARS-CoV-2–related mortality would help minimize deaths during vaccine rollout. <h3>Objective</h3> To develop a model that estimates the risk of SARS-CoV-2–related mortality among all enrollees of the US Department of Veterans Affairs (VA) health care system. <h3>Design, Setting, and Participants</h3> This prognostic study used data from 7 635 064 individuals enrolled in the VA health care system as of May 21, 2020, to develop and internally validate a logistic regression model (COVIDVax) that predicted SARS-CoV-2–related death (n = 2422) during the observation period (May 21 to November 2, 2020) using baseline characteristics known to be associated with SARS-CoV-2–related mortality, extracted from the VA electronic health records (EHRs). The cohort was split into a training period (May 21 to September 30) and testing period (October 1 to November 2). <h3>Main Outcomes and Measures</h3> SARS-CoV-2–related death, defined as death within 30 days of testing positive for SARS-CoV-2. VA EHR data streams were imported on a data integration platform to demonstrate that the model could be executed in real-time to produce dashboards with risk scores for all current VA enrollees. <h3>Results</h3> Of 7 635 064 individuals, the mean (SD) age was 66.2 (13.8) years, and most were men (7 051 912 [92.4%]) and White individuals (4 887 338 [64.0%]), with 1 116 435 (14.6%) Black individuals and 399 634 (5.2%) Hispanic individuals. From a starting pool of 16 potential predictors, 10 were included in the final COVIDVax model, as follows: sex, age, race, ethnicity, body mass index, Charlson Comorbidity Index, diabetes, chronic kidney disease, congestive heart failure, and Care Assessment Need score. The model exhibited excellent discrimination with area under the receiver operating characteristic curve (AUROC) of 85.3% (95% CI, 84.6%-86.1%), superior to the AUROC of using age alone to stratify risk (72.6%; 95% CI, 71.6%-73.6%). Assuming vaccination is 90% effective at preventing SARS-CoV-2–related death, using this model to prioritize vaccination was estimated to prevent 63.5% of deaths that would occur by the time 50% of VA enrollees are vaccinated, significantly higher than the estimate for prioritizing vaccination based on age (45.6%) or the US Centers for Disease Control and Prevention phases of vaccine allocation (41.1%). <h3>Conclusions and Relevance</h3> In this prognostic study of all VA enrollees, prioritizing vaccination based on the COVIDVax model was estimated to prevent a large proportion of deaths expected to occur during vaccine rollout before sufficient herd immunity is achieved.
Preterm Birth and the Development of Visual Attention During the First 2 Years of Life
Authors: Or Burstein, Zipi Zevin, Ronny Geva
Journal: JAMA Network Open (2021)

<h3>Importance</h3> Preterm birth is associated with an increased risk for long-lasting attention deficits. Early-life markers of attention abnormalities have not been established to date but could provide insights into the pathogenesis of attention abnormalities and could help identify susceptible individuals. <h3>Objective</h3> To examine whether preterm birth is associated with visual attention impairments in early life, and if so, in which attention functions and at which developmental period during the first 2 years of life. <h3>Data Sources</h3> PubMed and PsycINFO were searched on November 17, 2019, to identify studies involving visual attention outcomes in infants born preterm vs full term. <h3>Study Selection</h3> Peer-reviewed studies from the past 50 years met the eligibility criteria if they directly assessed visual attention outcomes until the age of 2 years in generally healthy infants born preterm or full term. The selection process was conducted by 2 independent reviewers. <h3>Data Extraction and Synthesis</h3> The Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline was followed. Random-effects models were used to determine standardized mean differences. The risk of bias was assessed both within and between studies. <h3>Main Outcomes and Measures</h3> Five nascent indices of visual attention were analyzed, including very basic functions—namely, the abilities to follow and fixate on visual targets—and more complex functions, such as visual processing (ie, habituation), recognition memory (ie, novelty preference), and the ability to effortfully focus attention for learning. <h3>Results</h3> A total of 53 studies were included, with 69 effect sizes and assessing a total of 3998 infants (2047 born preterm and 1951 born full term; of the 3376 for whom sex was reported, 1693 [50.1%] were girls). Preterm birth was associated with impairments in various attention indices, including visual-following in infancy (Cohen<i>d</i>, −0.77; 95% CI, −1.23 to −0.31), latency to fixate (Cohen<i>d</i>, −0.18; 95% CI, −0.33 to −0.02), novelty preference (Cohen<i>d</i>, −0.20; 95% CI, −0.32 to −0.08), and focused attention (Cohen<i>d</i>, −0.28; 95% CI, −0.45 to −0.11). In the neonatal period, preterm birth was associated with superior visual<i>-</i>following (Cohen<i>d</i>, 0.22; 95% CI, 0.03 to 0.40), possibly owing to the additional extrauterine exposure to sensory stimulation. However, this early association waned rapidly in infancy (Cohen<i>d</i>, –0.77; 95% CI, –1.23 to –0.31). <h3>Conclusions and Relevance</h3> The findings suggest that preterm birth is associated with impingements to visual attention development in early life, as manifested in basic and then complex forms of attention. Advancements in neonatal care may underlie improvements found in the current era and accentuate several early protective factors.
Safety of maximal exercise testing in patients at high risk for ventricular arrhythmia.
Authors: D ZYoung, SLampert, T BGraboys, BLown
Journal: Circulation (1984)

While maximal exercise testing is useful for detection of arrhythmias and assessment of antiarrhythmic drug efficacy, few reports have documented the safety of this procedure in patients with malignant ventricular arrhythmias. We reviewed the complications of symptom-limited exercise in 263 patients with such arrhythmias who underwent a total of 1377 maximal treadmill tests. Seventy-four percent of the population studied had a history of ventricular fibrillation or hemodynamically compromising ventricular tachycardia and the remainder had experienced ventricular tachycardia in the setting of either recent myocardial infarction or poor left ventricular function. A complication was defined as the occurrence of arrhythmia during exercise testing--ventricular fibrillation, ventricular tachycardia, or bradycardia--that mandated immediate medical treatment (cardioversion, use of intravenous drugs, or closed-chest compression). Complications were noted in 24 patients (9.1%) during 32 tests (2.3%), whereas 239 pa...
Acceleration of the ventricular response during atrial fibrillation in the Wolff-Parkinson-White syndrome after verapamil.
Authors: SGulamhusein, PKo, S GCarruthers, G JKlein
Journal: Circulation (1982)

We examined the electrophysiologic effects of verapamil in eight patients with the Wolff-Parkinson-White syndrome. Verapamil shortened the antegrade effective refractory period of the accessory pathway in three patients and abbreviated the shortest cycle length with 1:1 conduction over the accessory pathway in two patients. More significantly, verapamil decreased the shortest RR interval between preexcited ventricular complexes during atrial fibrillation (279 +/- 20 msec vs 236 +/- 18 msec, mean +/- SEM; p less than 0.01). After verapamil, two patients required cardioversion for hemodynamic deterioration after acceleration of the ventricular response during atrial fibrillation. In the four patients with predominantly preexcited ventricular complexes during atrial fibrillation the ventricular rate accelerated after verapamil, whereas in patients with predominantly normal ventricular complexes, the average ventricular rate decreased or did not change after verapamil. Verapamil may result in significant acce...
Activation patterns in healed experimental myocardial infarction.
Authors: AKadish, C WBalke, J FLevine, E NMoore, J FSpear
Journal: Circulation Research (1989)

The maximum amplitude of vector loops formed by summing orthogonally recorded bipolar electrograms has been shown to reflect the direction of activation in cardiac muscle. To investigate whether components of vector loops could provide information about different activation directions in local areas of myocardium, we correlated instantaneous vectors with isochronal activation patterns in an in vitro preparation of experimental myocardial infarction. In thirteen 3 mm x 3 mm regions studied (from 11 tissues), at least 16 microelectrode impalements with a minimum density of 0.8 mm between sites were made. In seven situations in which notched, irregular, and prolonged duration electrograms were present, vector loops pointed in the same general direction throughout their entire time course. In these preparations, microelectrode impalements demonstrated only a single major direction of activation. In five of six areas in which multidirectional vector loops were present, two or more separate local directions o...
Left ventricular diverticulum and mitral incompetence in asymptomatic children.
Authors: MGueron, MHirsch, IOpschitzer, PMogel
Journal: Circulation (1976)

Two children with congenital apical left ventricular diverticulum and significant mitral incompetence are reported. The angiographic and anatomic findings of the few previously reported patients with congenital diverticula and aneurysm were analyzed and a new classification differentiating between the two is proposed. The clinical data analyzed in apical diverticula and aneurysm are similar to those patients with anomalous origin of the left coronary artery from the pulmonary artery. Left ventriculography is the best diagnostic tool. The place of surgery in the treatment of the congenital apical diverticula with or without mitral incompetence in asymptomatic children is not clear. Further observations are needed to reveal its natural history.
Clinical evaluation of atenolol in hypertensive patients.
Authors: M MIbrahim, RMossallam
Journal: Circulation (1981)

Atenolol, a cardioselective beta-adrenergic blocking agent, was given as the sole hypotensive drug for 8-12 weeks to 20 patients with hypertension of varying degrees of severity. Initial systolic blood pressure ranged from 162-238 mm Hg (mean +/- SEM 196 +/- 5.5 mm Hg) and diastolic blood pressure ranged from 105-143 mm Hg (118 +/- 2.5 mm Hg). Three patients had accelerated hypertension, six had cardiomegaly with recent exertional dyspnea and three were diabetics. Atenolol, 100-300 mg once daily, controlled both the supine and standing blood pressure and markedly attenuated the initial hypertensive response to severe exercise. In 17 patients (85%), atenolol therapy reduced blood pressure more than 20/10 mm Hg; however, adequate blood pressure control was not achieved in severe hypertension. A significant hypotensive action developed within 2 weeks of treatment, and control of hypertension was maintained for 2 weeks after sudden interruption of therapy. No patient had postural or postexercise hypotension. ...
A new intracavitary probe for detecting the site of origin of ectopic ventricular beats during one cardiac cycle.
Authors: BTaccardi, GArisi, EMacchi, SBaruffi, SSpaggiari
Journal: Circulation (1987)

An olive-shaped probe (25 X 12 mm) with 41 evenly distributed recording electrodes on its surface was introduced into the left ventricles of seven open-chest dogs via the left atrium. In two other dogs a cylindrical probe (40 X 3 mm) was used. Electrical stimuli were delivered at 66 endocardial, midwall, or epicardial sites in the left and right ventricular walls and the septum. Mechanical stimuli were also applied at various epicardial sites. On-line mapping of equipotential contour lines on the surface of the probe invariably revealed a clear-cut potential minimum on the electrode that faced the pacing site. Time of appearance of potential minimum was 3 to 5 msec after endocardial stimuli, 10 to 25 msec for midwall and epicardial pacing, and 30 msec or more for right ventricular stimulation. Simultaneous stimulation at two sites 1.2 cm apart gave rise to two separate minima on the maps. Pseudoisochrones derived from electrograms recorded by the new probe were slightly less accurate in indicating the s...
7P STK11 and Galectin-3 tissue expression entails a prognostic signature in immunotherapy treated NSCLC patients
Authors: G. Mazzaschi, R. Minari, L. Gnetti, N. Campanini, T. Zielli, M. Baucina, F. Perrone, A. Leonetti, F. Quaini, M. Tiseo
Journal: Journal of Thoracic Oncology (2021)
Ultrastructural distribution of vasodilator and constrictor nerves in cat cerebral arteries.
Authors: T JLee
Journal: Circulation Research (1981)

This study examined the ultrastructural distribution of agranular vesicle-containing nerve (AVN) and granular vesicle-containing nerve (GVN) in cat cerebral blood vessels fixed in KMnO4. The percentages of the AVN and GVN throughout the adventitial layer in the basilar, middle cerebral, and anterior cerebral arteries were 63.4 and 36.7, 53.9 and 46.1, and 60.2 and 39.8, respectively. The AVN in the cat basilar artery is approximately 37 times denser than that in the rabbit basilar artery. This morphological result, in correlation with the previous pharmacological findings, provides indirect evidence that the AVN are the dilator nerves. The lack of neurogenic vasoconstriction in the cat basilar, middle cerebral, and anterior cerebral arteries may be attributable in part to a combination of denser dilator than constrictor nerves, a possible closer synaptic cleft distance for dilator than for constrictor nerves, and the reported insensitivity of the postsynaptic alpha-receptors. The small pial vessels (branc...