tbuckley/cabot-search huggingface dataset:
Abstract 3226: The “Single-Big-Cryo-Balloon” Technique for Pulmonary Vein Isolation - A New Ice Age?
Authors: Julian Chun, Matthias Antz, Feifan Ouyang, Kazuhiro Satomi, Dietnar Bansch, Roland Tilz, Thomas Zerm, Karl-Heinz Kuck
Journal: Circulation (2007)

Background: Cryothermal-energy (CTE) applied via a balloon catheter (Arctic Front, Cryocath) represents a novel technology which may facilitate accomplishing the challenging endpoint of complete electrial pulmonary vein isolation (PVI). However, as in all balloon based PVI approaches, phrenic nerve (PN) injury remains a concern. Therefore, we pursued the ,,single big cryo-balloon technique“ deploying proximal (antral) CTE to achieve complete electrical PVI and avoid PN palsy in patients (pts) with paroxysmal atrial fibrillation (PAF). Methods: After double transseptal punctures one lasso catheter and the big 28 mm Cryo-balloon catheter (10.5 F) using a steerable sheath (15F) were inserted into the left atrium (LA). PV angiographies and ostial lasso recordings from all PVs were obtained. Selective PV occlusion angiographies were used to evaluate balloon to LA-PV junction contact. One CTE freezing cycle lasted 300 seconds. To early identify PN injury, the PN was constantly paced (10 V, 2.9 ms) from the superior caval vein while applying energy at the right superior PV (RSPV). Follow up included weekly telephonic interviews, holter ECGs, office visits after 1, 3 and 6 months and additional daily tele ECGs. Results: Twenty-six pts (18 males, mean age: 56 ± 9, LA size: 41.5 ± 5.2) with highly symptomatic paroxysmal atrial fibrillation (mean duration: 6.7 ± 5.8 years) despite antiarrhythmic drug therapy (3 ± 1) were included in this study. Complete electrical PV isolation was achieved in 93/95 PVs (98%) using exclusively the big balloon technique. Mean procedural-, balloon- and fluoroscopy-time were 239 ± 99, 135 ± 66, and 56 ± 22 min, respectively. One persistent PN palsy occurred due to an unanticipated ablation inside the RSPV (inner balloon defect). A total of 17 pts (62 %) remained in sinusrhythm during a mean follow up of 142 ± 114 days. Conclusion: Using exclusively the “single big cryo-balloon” technique, the vast majority of all PVs (98%) can be electrically isolated resulting in an acceptable clinical success rate after one procedure. PN palsy is avoided as long ablation is performed at the proximal LA-PV junction.
Reply
Authors: An Verrijken, Sven Francque, Ilse Mertens, Luc Van Gaal
Journal: Hepatology (2014)

We thank Dr. Kountouras et al. for their comment on our study, "Prothrombotic factors in histological proven nonalcoholic fatty liver disease and nonalcoholic steatohepatitis".1 Our study results suggest increased levels of plasminogen activator inhibitor-1 (PAI-1) to be one of the possible mechanisms linking nonalcoholic fatty liver disease (NAFLD) to the development of cardiovascular disease (CVD) in obese subjects. The reflection by Kountouras et al. on the role of Helicobacter pylori (Hp) in the induction of PAI-1 and other prothrombotic and -inflammatory agents in NAFLD is interesting. Hp has indeed been associated with CVD, although some controversy does still exist.2, 3 In addition, a link between obesity and Hp has been suggested,4 which could be interesting in light of our study results. Kountouras et al. also report on an association between Hp and fibrinogen and von Willebrand facor (vWF). However, in our study, we did not find an independent association between liver histology and fibrinogen and vWF when corrected for metabolic factors, which is hence not supportive for their hypothesis. In our article, we postulate on a few possible mechanisms linking NAFLD to increased PAI-1 levels, such as increased liver fat or inflammation parameters, as direct triggers for production of PAI-1 by hepatocytes. We did not assess the presence of Hp in our study population. Serology testing on spare samples would be the only way to test the hypothesis of Kountouras et al. on our study cohort, but serology does not reflect active infection and is hence inaccurate for this research question. We estimate that the potential link between NAFLD, Hp, and CVD should be assessed in appropriately designed studies. An Verrijken, M.Sc.1 Sven Francque, M.D., Ph.D.2 Ilse Mertens, Ph.D.1 Luc Van Gaal, M.D., Ph.D.1 1Department of Endocrinology, Diabetology and Metabolism Antwerp University Hospital University of Antwerp Antwerp, Belgium 2Department of Gastroenterology and Hepatology Antwerp University Hospital University of Antwerp Antwerp, Belgium
Abstract 17013: Transverse (T)-tubules Are Widespread in the Human Atrium
Authors: Mark A Richards, Jessica D Clarke, Palaniappan Saravanan, Niels A Voigt, Dobromir Dobrev, David A Eisner, Andrew Trafford, Katharine M Dibb
Journal: Circulation (2011)

Background: T-tubules are invaginations of the sarcolemma, present in mammalian ventricular myocytes. T-tubules bring the cell interior close to sarcolemmal membrane, allowing a rapid rise in intracellular Ca upon stimulation. The atria was generally assumed to lack t-tubules due to their virtual absence in the atria of small mammals; therefore Ca release occurs only slowly from the cell centre. Recent work has however shown t-tubules in sheep atria resulting in rapid Ca release in the cell interior, fundamentally altering our view of atrial function. Furthermore atrial t-tubules are lost in disease, dramatically slowing intracellular Ca. The purpose of this study was to determine if the human atrium possesses t-tubules. Methods: Samples of right atrial appendage from 9 patients in sinus rhythm were frozen in OCT, sectioned, fixed and incubated with wheat germ agglutinin (WGA)-, Alexa Fluor® 488 conjugate to stain t-tubules and surface membrane. Image stacks were captured confocally, deconvolved and analyzed in Image J. Results: T-tubules were present in each sample. The figure shows a transverse, 2 μ m thick human atrium section following staining. T-tubules are clearly present in 3 cells to varying degrees. T-tubules were present in 59 from 86 cells (51 tissue sections) i.e. 69% of human atrial cells. To quantitatively assess the importance of t-tubules in bringing the cell interior close to sarcolemmal membrane we have calculated the distance that points in the cell lie from the surface sarcolemma and surface and t-tubular sarcolemma together. Excluding t-tubules, half the points lie within 2.2 ± 0.2 μ m of sarcolemma and this distance is approximately halved by considering surface and t-tubule sarcolemma together (1.0 ± 0.2 μ m; p &lt;0.001, n=9 cells from 4 patients). Conclusion: We have shown, for the first time, the presence of t-tubules in human atrium. The role of human atrial t-tubules during excitation contraction coupling and disease remains to be determined.
Cytogenetic Abnormalities in Primary Myelodysplastic Syndrome Are Highly Predictive of Outcome After Allogeneic Bone Marrow Transplantation
Authors: Thomas J. Nevill, Henry C. Fung, John D. Shepherd, Douglas E. Horsman, Stephen H. Nantel, Hans-G. Klingemann, Donna L. Forrest, Cynthia L. Toze, Heather J. Sutherland, Donna E. Hogge, Sheldon C. Naiman, Alan Le, Daphne A. Brockington, Michael J. Barnett
Journal: Blood (1998)
Open trial of fluoxetine in obsessive-compulsive disorder
Authors: M A Jenike, L Buttolph, L Baer, J Ricciardi, A Holland
Journal: American Journal of Psychiatry (1989)

A 12-week open trial of fluoxetine in 61 obsessive-compulsive disorder patients significantly improved depressive and obsessive-compulsive symptoms. Baseline depression scores were not related to improvement on two obsessive-compulsive scales. The results reinforce the hypothesis of serotonergic abnormalities in obsessive-compulsive disorder.
Abstract 18593: Predictors of Sudden Cardiac Arrest with Preserved Left Ventricular Systolic Function
Authors: Kyndaron Reinier, Audrey Uy-Evanado, Carmen Teodorescu, Harpriya Chugh, Ronald Mariani, Karen Gunson, Jonathan Jui, Sumeet S Chugh
Journal: Circulation (2010)

Introduction: Though severely reduced left ventricular ejection fraction (EF) is proven to increase sudden cardiac arrest (SCA) risk, community-based studies indicate that most SCAs occur in indivi...
Age-Adjusted Combined Immunochemotherapy without Radiotherapy in Newly Diagnosed PCNSL – A Phase II Trial of the Nordic Lymphoma Group
Authors: Elisa Jacobsen Pulczynski, Peter Kamper, Unn-Merete Fagerli, Martin Erlanson, Outi Kuittinen, Alexander Fosså, Bjørn Østenstad, Oystein Fluge, Martin Maisenhølder, Hans Hagberg, Mikael Eriksson, Marie Nordstrøm, Sirpa Leppa
Journal: Blood (2011)
Abstract 18288: Flow Shear Stress and Osmotic Stretch Both Enhance Intracellular Ca2+ in PASMC From Patients With Idiopathic Pulmonary Arterial Hypertension
Authors: Shanshan Song, Hisao Yamamura, Ayako Makino, Jason X.-J. Yuan
Journal: Circulation (2013)

Idiopathic pulmonary arterial hypertension (IPAH) is a fatal and progressive disease which is attributed to elevated pulmonary arterial pressure and pulmonary vascular resistance due in part to sustained pulmonary vasoconstriction and vascular remodeling. Pulmonary arterial smooth muscle cells (PASMC) are normally shielded from exposure to shear stress and sense small flow shear through transmural interstitial flow driven by transvascular pressure differential. However, in the context of endothelial injury or enhanced vascular permeability caused by increased pulmonary arterial pressure, PASMC are exposed to shear stress or to enhanced transmural interstitial flow. The decreased extracellular osmotic pressure caused by enhanced vascular permeability will exert osmotic stretch on PASMC. Both shear stress and osmotic stretch increase cytosolic Ca2+ concentration ([Ca2+]cyt). An increase in [Ca2+]cyt in PASMC is a major trigger for vasoconstriction and a key stimulus for cell proliferation, which contribute to vascular remodeling. We show here that flow shear stress and osmotic stretch induced increased [Ca2+]cyt in PASMC from patients with IPAH compared with control. Flow shear induced enhanced transient and plateau [Ca2+]cyt and larger Ca2+ oscillation amplitude in IPAH PASMC than in control. Expression of TRPM7, a Ca2+ channel implicated in response to shear stress, is increased in IPAH PASMC. TRPM7 blockers 2-APB and SK&amp;F96365 inhibited flow shear-induced enhanced [Ca2+]cyt in control and IPAH PASMC, and the TRPM7 agonist bradykinin induced enhanced [Ca2+]cyt in IPAH PASMC than in control. Osmotic stretch also induced a transient increase in [Ca2+]cyt in IPAH PASMC, but not in control. La3+, an inhibitor of TPRM3, a Ca2+ channel important for responses to osmotic stress, completely inhibited osmotic stretch-induced increase in [Ca2+]cyt in IPAH PASMC. Furthermore, the TRPM3 agonist PregS induced a transient increase in [Ca2+]cyt in IPAH PASMC but not in control. These results demonstrate that flow shear stress and osmotic stretch induce enhancement of [Ca2+]cyt in IPAH PASMC through the Ca2+ channels, TRPM7 and TRPM3, and that mechanical sensitive channels TRPM7 and TRPM3 play a critical role in PAH by modulating [Ca2+]cyt homeostasis.
Genotyping to predict for response and toxicity to capecitabine in advanced colorectal cancer patients (pts)
Authors: R. Sharma, J. Hoskins, P. Beale, K. Li, S. Clarke
Journal: Journal of Clinical Oncology (2004)

2013 Background: The thymidylate synthase (TS) gene promoter is polymorphic, with double (2R) or triple (3R) tandem repeats of a 28 base-pair sequence. Homozygosity for 3R predicts for a greater response to 5-FU. This effect is abolished by a single nucleotide polymorphism (SNP) (G→C) in the 2nd repeat of 3R. Deletion polymorphisms of the 3' untranslated region (3UTR) of TS may also impact on response. A SNP in methylenetetrahydrofolate reductase (MTHFR 677 C→T) is associated with increased clinical response to 5-FU. SNPs in MTHFR and TS predict for homocysteine (HC) and folate levels, which may also predict for outcome. Aims: 1) To evaluate the impact of genotype on response and toxicity in pts treated with fixed dose capecitabine; 2) To correlate genotype with pre-treatment plasma levels of folate and HC. Methods: PCR and RFLP were used to genotype genomic DNA. Response was assessed by RECIST criteria. Toxicities were graded by CTC V2.0. Results: 56 pts (36 male), median age 73yrs (range 41–85), median cycles received - 5 (range 1–8), response rate 26%, median survival 498 days (range 84–672), 27% pts experienced grades 3/4 toxicity (diarrhoea 11%). Incidences of the combined genotypes; TS: 2R/2R 6; 2R/3G 14; 2R/3C 15; 3G/G 8; 3G/C 8; 3C/C 2; 4R/2R 1, 3UTR: +/+ 19; +/- 29; -/- 6, MTHFR: c/c 27; c/t 20; t/t 7. Genotype was not predictive of response or overall survival. MTHFR allele did not correlated with response. Homozygous gene deletion of 3UTR was associated with worse toxicity (p=0.03). A SNP in MTHFR was predictive for high serum folate and HC levels (p<0.01) and TS for HC (p=0.03). Conclusions: In this study genotyping for TS and MTHFR polymorphisms do not predict for response and toxicity in pts with advanced colorectal cancer treated with capecitabine. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Roche
Abstract 5458: VIA-3196, a Liver-directed Thyroid Beta Agonist for Treating Cardiometabolic Disease
Authors: Rebecca Taub, Joseph Grimsby, J. D Larigan, Sherrie Pietranico, Mark Dvorozniak, Karin Conde-Knape
Journal: Circulation (2009)

Thyroid hormone has beneficial metabolic benefits such as cholesterol, triglyceride and glucose lowering primarily through its action in the liver. However, in excess, TH causes adverse effects in heart and bone primarily mediated by the THR-alpha receptor. VIA-3196 is a novel THRbeta receptor selective (17/1 relative to TH) thyromimetic with high hepatic uptake and the possibility of providing metabolic benefits and avoiding adverse effects on the thyroid axis, heart and bone. In a rodent hypothyroid model, as compared with TH (T3), VIA-3196 showed no upregulation of a TH regulated gene in the heart even at high doses. In hypercholesterolemic rabbits, VIA- 3196 lowered non-HDL cholesterol alone or in synergy with atorvastatin up to 50% (p&lt;0.001), increased the HDL/LDL ratio, and lowered plasma triglycerides 35% (p&lt;0.05) alone and 50% (p&lt;0.001) in combination with atorvastatin. In hypercholesterolemic rats, VIA-3196 lowered non-HDL cholesterol 73%, (p&lt;0.005) and liver triglycerides 66% (p&lt;0.0001), and did not decrease TSH, whereas T3 had little effect on cholesterol or liver triglycerides at doses that suppressed TSH. Steatosis is a major cause of liver insulin resistance (IR) and non-alcoholic steatohepatitis. In preclinical mouse models of IR, at doses as low as 0.3 mg/kg VIA-3196 reduced plasma cholesterol 40% (p&lt;5×10 −6 ) and liver triglycerides 51% (p&lt;0.05). In mouse models of IR, VIA-3196 at 1 mg/kg improved insulin sensitivity as demonstrated by an insulin tolerance test (p&lt;0.05), lowered glucose to a near normal level (p&lt;0.05) similar to rosiglitazone, and unlike rosiglitazone, did not cause weight gain. Hepatic gene expression studies suggest that VIA-3196 may lower cholesterol through increasing cholesterol metabolism and biliary excretion (upregulation of Cyp7A1, ABCB11), perhaps increasing reverse cholesterol transport. Interestingly, VIA-3196 downregulated hepatic inflammatory genes CRP and Saa2 (serum amyloid a2) that are associated with cardiovascular risk. VIA-3196 demonstrates good pharmaceutical properties predictive of qd dosing in humans. VIA-3196 has the potential to provide benefit to patients with diabetes and dislipidemia and ultimately, reduce their risk from atherosclerotic cardiovascular disease.
Regulation of integrated health care
Authors: Rhona MacDonald
Journal: BMJ (2001)

A simple web search on any health related topic finds an unmanageable number of sites of varying reliability. Integrated medicine is no exception. Quackwatch is a non-profit making organisation whose purpose is to “combat health related frauds, myths, fads and fallacies.” The term “quackery” derives from the word “quacksalver”—someone who boasts about his salves—and modern dictionaries define “quack” as a pretender to medical …
Abstract 16704: Alterations in Metabolism of Bone Marrow-Derived Mononuclear Cells of Patients With Chronic Heart Failure: Implications for Cell Functionality
Authors: Anja Derlet, Tina Rasper, Andreas M Zeiher, Stefanie Dimmeler, Florian Seeger
Journal: Circulation (2013)

Modulation of energy metabolism allows cells to match the divergent demands of the environment. Recent evidence implicates nutrient-responsive metabolites as mediators of crosstalk between metaboli...
Abstract 11: Medical Emergency Teams Reduce Unexpected Cardiac Arrests, But Not Overall Hospital Costs Per Case
Authors: Harish Manyam, Michael S Cratty
Journal: Circulation (2007)

Introduction : Medical emergency teams (MET) have been developed to meet the growing needs of hospitalized patients. Medical emergency teams have been shown to reduce unexpected cardiac arrests, unexpected ICU transfers, length of stay (LOS), and inpatient mortality. However, there is no data on overall hospital cost per case with the addition of a MET team. Hypothesis : We hypothesized that the addition of a MET to our hospital would reduce our hospital cost per case by reducing unexpected cardiac arrest. Methods : A MET was developed at our 714-bed teaching hospital in March 2006. Our goal was to perform a retrospective analysis of hospital costs per case related to cardiac arrest and MET responses before and after establishment of a MET team. The first comparison group included unexpected cardiac arrests for a 6-month period from March 2005-September 2005 before establishment of the MET team. The second group included unexpected cardiac arrest patients and patients seen by the MET team that required unexpected transfer to the ICU for a similar 6-month period from March 2006-September 2006 after development of the MET team. Results : Group 1 from 2005 included 76 unexpected cardiac arrest patients and Group 2 from 2006 included 48 unexpected cardiac arrests and 95 unexpected transfers to the ICU. Both groups had similar overall severity scores of 1.7. Overall we had a 37% reduction in unexpected cardiac arrests in the first 6 months after initiation of the MET team. The overall mean LOS was lower in group 2 at 15 days compared to 17 days in group 1, however there was no statistical significance (p=0.59). There was no difference in the mean total cost per case in group 2, $34,653± $32,500 compared to group 1, $37,657± $38,517 (p=0.58). Conclusion : The implementation of the medical emergency team at our hospital decreased unexpected cardiac arrests, but did not decrease mean total cost per case for patients suffering unexpected cardiac arrests and unexpected ICU transfer during activation of the medical emergency team.
Erythrocytosis Post Allogeneic Stem Cell Transplantation, An Observational Study Of Hemoglobin Levels On Long-Term Follow Up Post Transplantation In Patients With Fanconi Or Acquired Aplastic Anemia
Authors: Mouhab Ayas, Khawar Siddiqui, Abdulrahman Al-Musa, Hassan El-Solh, Abdullah Al-Jefri, Ali Al-Ahmari, Ashraf Khairi, Samer Markiz, Amal Mohamad, Amal Al-Seraihy
Journal: Blood (2013)
Drug-Eluting Stent Restenosis
Authors: John Cosgrave, Gloria Melzi, Giuseppe G.L. Biondi-Zoccai, Flavio Airoldi, Alaide Chieffo, Giuseppe M. Sangiorgi, Matteo Montorfano, Iassen Michev, Mauro Carlino, Erminio Bonizzoni, Antonio Colombo
Journal: Journal of the American College of Cardiology (2006)
Hepatic Ischemia/Reperfusion Injury Is Prevented By The Deletion Of Hint1
Authors: Olivier Maurhofer, Pamela Romanque, Karin Schmitter, Monika Ledermann, Gisele Ferrand, Haiyang Li, Jean-Froncois Dufour, Juliette Martin
Journal: Hepatology (2009)

Reference EPFL-CONF-159118View record in Web of Science Record created on 2010-11-30, modified on 2017-05-12
Abstract 9461: Prevalence and Characteristics of Spontaneous and Adenosine-Induced Acute PV Reconnection Associated With IV Corticosteroid Use During Pulmonary Vein Isolation
Authors: Laurent Macle, Jason Andrade, Agustin Vanella, Stanley Nattel, Lena Rivard, Peter G Guerra, Marc Dubuc, Bernard Thibault, Mario Talajic, Katia Dyrda, Blandine Mondesert, Anna Nozza, Denis Roy, Paul Khairy
Journal: Circulation (2013)

Background: Atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) is associated with PV to left atrium re-conduction. Intraprocedural corticosteroids may limit RF-induced tissue edema and prevent post-ablation inflammatory responses. We prospectively evaluated the impact of pre-ablation IV corticosteroids on the prevalence of spontaneous and adenosine-induced acute PV reconnection following PVI and on long-term success rates after ablation. Methods: Prior to wide circumferential PVI 45 patients received a single IV bolus of 250 mg of hydrocortisone immediately following transseptal access (steroid group), whereas another 45 consecutive patients underwent standard PVI without IV hydrocortisone (non-steroid group). Post PVI, acute PV reconnection was systematically assessed in each PV (prevalence and location) using a circular mapping catheter during a 20-min waiting period (spontaneous PV reconnection), followed by provocation with IV adenosine (dormant conduction). All patients were followed at 3, 6, and 12 months. Results: Spontaneous PV reconnection during the 20-min waiting period was observed in 9% of PVs (31/358), with no significant difference between the 2 groups (5.5% steroid vs 11.4% non-steroid; p=0.10). Dormant conduction was unmasked in a significantly higher proportion of PVs in the steroid group when compared to the non-steroid group (32.8% of PVs [60/183] vs. 21.1% of PVs [37/175] P=0.03). On multivariate GEE analysis, steroid use remained independently associated with dormant PV conduction (P=0.03). There was no difference in the segmental distribution of reconnection between the two groups. The one-year freedom from recurrent AF did not differ between groups (P=0.37). Radiofrequency time was significantly longer in the steroid group (58±21 vs. 48±18 minutes, P=0.006), whereas procedure duration and fluoroscopy time were comparable (p=0.55, and p=0.44). Conclusions: A single bolus of hydrocortisone 250 mg IV prior to PVI results in greater RF requirements for PV isolation and higher prevalence of dormant PV conduction unmasked by adenosine without affecting long-term outcomes. The utility of these approaches requires evaluation in a long-term prospective randomized study.