tbuckley/cabot-search huggingface dataset:
Randomized trial of thrombolysis versus heparin in unstable angina.
Authors: T LSchreiber, DRizik, CWhite, G VSharma, MCowley, GMacina, P SReddy, LKantounis, G CTimmis, AMargulis
Journal: Circulation (1992)

BACKGROUNDThe clinical usefulness of intravenous thrombolytic therapy in unstable angina is currently unknown, despite the pathogenetic similarity of this entity to acute myocardial infarction, for which thrombolysis has enjoyed great success. To compare the clinical benefit of intravenous urokinase with that of conventional antithrombotic therapy in preventing the progression of unstable angina to new myocardial infarction, intractable angina, or death within the first 96 hours after hospitalization, 149 patients with unstable angina were randomized to one of two intravenous thrombolytic strategies.METHODS AND RESULTSForty-nine patients received 3 million units urokinase i.v. over 90 minutes plus intravenous heparin (group A); 47 patients received unblinded 3 million units urokinase i.v. plus 325 mg aspirin p.o. daily (group B); and 53 patients received placebo thrombolytic infusion plus full-dose heparin (group C). The primary end point of this trial was 96-hour clinical status. There were no significan...
Platelet membrane activation markers are predictive for increased risk of acute ischemic events after PTCA.
Authors: DTschoepe, H PSchultheiss, PKolarov, BSchwippert, KDannehl, H KNieuwenhuis, BKehrel, BStrauer, F AGries
Journal: Circulation (1993)

BACKGROUNDWe wished to investigate whether platelet activation is related to the clinical outcome during the 24 hours immediately after elective percutaneous transluminal coronary angioplasty (PTCA).METHODS AND RESULTSIn 102 patients with high-grade coronary stenosis admitted for elective PTCA, preprocedural platelet activation was characterized by flow cytometric measurement of the proteins CD62, CD63, and thrombospondin expressed on the platelet surface membrane. The prevalence of acute ischemic events during the 24 hours immediately after the procedure was then related to the pre-PTCA platelet activation status. Fifty-six patients were classified as nonactivated, whereas 46 patients showed an increased percentage of  platelets. Two patients developed acute occlusion (1.96%) and four patients high-grade restenosis (3.92%), as confirmed by second-look coronary angiography. All events occurred in patients classified as activated (six of 46, or 13%). None of these patients received beta-blocke...
Physicians, Probabilities, and Populations—Estimating the Likelihood of Disease for Common Clinical Scenarios
Authors: Arjun K. Manrai
Journal: JAMA Internal Medicine (2021)

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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Internal Medicine journal
Adding Epoetin Alfa to Intense Dose-Dense Adjuvant Chemotherapy for Breast Cancer: Randomized Clinical Trial
Authors: V. Moebus, C. Jackisch, A. Schneeweiss, J. Huober, H.-J. Lueck, A. du Bois, C. Thomssen, C. Kurbacher, W. Kuhn, U. Nitz, I. B. Runnebaum, A. Hinke, R. Kreienberg, M. Untch
Journal: JNCI Journal of the National Cancer Institute (2013)

BackgroundThe AGO-ETC trial compared 5-year relapse-free survival of intense dose-dense (IDD) sequential chemotherapy with epirubicin (E), paclitaxel (T), and cyclophosphamide (C) (IDD-ETC) every 2 weeks vs conventional scheduled epirubicin/cyclophosphamide followed by paclitaxel (EC→T) (every 3 weeks) as adjuvant treatment in high-risk breast cancer patients.The objective of this study was to evaluate the safety and efficacy of epoetin alfa in a second randomization of the intense dose-dense arm. MethodsOne thousand two hundred eighty-four patients were enrolled; 658 patients were randomly assigned to the IDD-ETC treatment group.Within the IDD-ETC group, 324 patients were further randomly assigned to the epoetin alfa group, and 319 were randomly assigned to the non-erythropoiesis-stimulating agent (ESA) control group.Primary efficacy endpoints included change in hemoglobin level from baseline to Cycle 9 and the percentage of subjects requiring red blood cell transfusion.Relapse-free survival, overall survival, and intramammary relapse were secondary endpoints estimated with Kaplan-Meier and Cox regression methods.Except for the primary hypothesis, all statistical tests were two-sided. ResultsEpoetin alfa avoided the decrease in hemoglobin level (no decrease in the epoetin alfa group vs -2.20 g/dL change for the control group; P < .001)and statistically significantly reduced the percentage of subjects requiring red blood cell transfusion (12.8% vs 28.1%; P < .0001).The incidence of thrombotic events was 7% in the epoetin alfa arm vs 3% in the control arm.After a median follow-up of 62 months, epoetin alfa treatment did not affect overall survival, relapse-free survival, or intramammary relapse. ConclusionsEpoetin alfa resulted in improved hemoglobin levels and decreased transfusions without an impact on relapsefree or overall survival.However, epoetin alfa had an adverse effect, resulting in increased thrombosis.
Rate-dependent changes in intraventricular conduction produced by procainamide in anesthetized dogs. A quantitative analysis based on the relation between phase 0 inward current and conduction velocity.
Authors: SNattel, WJing
Journal: Circulation Research (1989)

Antiarrhythmic drug effects on maximal upstroke velocity (Vmax) are frequency dependent, which implies that the effects of these drugs on conduction should also be rate dependent. Previous in vivo studies have been limited by assumptions about unchanging propagation pathway, and by the empirical use of a first-order recovery model. To explore time-dependent antiarrhythmic drug-induced conduction slowing in vivo, we used 56-electrode epicardial mapping in chloralose-anesthetized dogs with formalin-induced atrioventricular block. Interval-dependent changes in conduction time were assessed under control conditions and then after three loading and maintenance infusions of procainamide. Under control conditions, epicardial activation time (86 +/- 26 msec at a basic cycle length of 300 msec) was unchanged (87 +/- 24 msec) by pauses up to 6.6 +/- 2.2 seconds. Procainamide caused conduction slowing that dissipated as a function of recovery interval, with 94 +/- 6% recovery over a maximum pause of 6.7 +/- 1.5 seco...
A Case Of Eosinophilic Esophagitis In Adolescent: Similarities And Differences With Gastroesophageal Reflux Disease
Authors: N Zavhorodnia, N Zhigir, S Tarabarov
Journal: Endoscopy (2021)

Results A 16-year-old male Caucasian patient initially addressed to an otolaryngologist with complaints of frequent respiratory infection, sore throat, and retrosternal chest discomfort which has been observing for two years. After a detailed examination patient was referred to a gastroenterologist due to the association of retrosternal chest discomfort with swallowing. Moreover, the patient had persistent heartburn, epigastric pain after eating. He did not have any allergic reactions before and family histories of an allergic disease. Physical examination revealed a weight deficit (BMI = 17.89 corresponds to -1.5 sigma). Gastroesophageal reflux disease (GERD) was suspected and the patient referred to esophagogastroduodenoscopy (EGD). EGD showed: circular and longitudinal furrows in all segments of the esophagus, edema, decreased vascularity, in the middle third of the esophagus are identified three papillomas (removed by “cold resection”). Biopsies were obtained from the proximal and distal esophagus, in which eosinophilic infiltration (> 30 eos/hpf) of the esophageal mucosa was observed. Laboratory tests revealed specific immunoglobulins E to milk proteins, Alternaria alternatа, immunoglobulins G to gliadin (˃10ULN). Based on the clinical, endoscopic, histological, and laboratory findings, the patient was diagnosed with eosinophilic esophagitis (EoE). Dairy-free and gluten-free diet for 3 months and proton pump inhibitors were prescribed. After a 4-week initial therapy, the patient noted the resolution of symptoms.
Biliary Stenting In The Management Of Difficult Common Bile Duct Stones: A Single Tertiary Center Experience
Authors: K Amalou, F Belghanem, A Bousseloub
Journal: Endoscopy (2021)

Aims If common bile duct (CBD) stones (choledocholithiasis) are left untreated, they may cause increases in morbidity and mortality due to several conditions.
The incidence of major subtypes of primary brain tumors in adults in England 1995-2017
Authors: Hiba A Wanis, Henrik Møller, Keyoumars Ashkan, Elizabeth A Davies
Journal: Neuro-Oncology (2021)

Primary brain tumors are a complex heterogenous group of benign and malignant tumors. Reports on their occurrence in the English population by sex, age, and morphological subtype and on their incidence are currently not available. Using data from the National Cancer Registration and Analysis Service (NCRAS), the incidence of adult primary brain tumor by major subtypes in England will be described.Data on all adult English patients diagnosed with primary brain tumor between 1995 and 2017, excluding spinal, endocrinal, and other CNS tumors, were extracted from NCRAS. Incidence rates were standardized to the 2013 European Standard Population. Results are presented by sex, age, and morphological subtype.Between 1995 and 2017, a total of 133 669 cases of adult primary brain tumor were registered in England. Glioblastoma was the most frequent tumor subtype (31.8%), followed by meningioma (27.3%). The age-standardized incidence for glioblastoma increased from 3.27 per 100 000 population per year in 1995 to 7.34 in men in 2013 and from 2.00 to 4.45 in women. Meningioma incidence also increased from 1.89 to 3.41 per 100 000 in men and from 3.40 to 7.46 in women. The incidence of other astrocytic and unclassified brain tumors declined between 1995 and 2007 and remained stable thereafter.Part of the increase in the incidence of major subtypes of brain tumors in England could be explained by advances in clinical practice including the adoption of new diagnostic tools, classifications and molecular testing, and improved cancer registration practices.
Influence of vascular smooth muscle heterogeneity on angiotensin converting enzyme activity in chicken embryonic aorta and in endothelial cells in culture.
Authors: STopouzis, J DCatravas, J WRyan, T HRosenquist
Journal: Circulation Research (1992)

The smooth muscle of the abdominal region of the chicken aorta derives from locally recruited mesenchyme (mesenchymal smooth muscle), whereas that of the thoracic region derives from the neural crest (ectomesenchymal smooth muscle). We hypothesized that this smooth muscle heterogeneity might affect important enzymatic functions of the vessel wall. Therefore, we measured angiotensin converting enzyme (ACE) activity in homogenates of chicken thoracic and abdominal aorta at different embryonic stages (days 10, 14, and 18 of gestation). ACE activity increased in both regions over the time of gestation (p less than 0.001 in both cases); the increase was steeper and ACE activity was higher in thoracic than in abdominal segments (p less than 0.001). Km values were similar (approximately 7 microM) at all times and between the two segments, whereas changes in Vmax values closely paralleled those in enzyme activity, indicating gestation-dependent increases in the amount of enzyme. Neural crest ablation at an early ...
Endothelin reverses the effects of acidosis on the intracellular Ca2+ transient and contractility in ferret myocardium.
Authors: JWang, J PMorgan
Journal: Circulation Research (1992)

Endothelin may play an important role in modulating myocardial contractility under certain pathophysiological conditions. To determine whether endothelin beneficially modulates myocardial contractility in the common clinical condition of acidosis, we compared the effects of endothelin-1 on intracellular Ca2+ transients and isometric contractions under normal (extracellular pH [pH(o)] 7.4) and acidotic (pH(o) 6.4) conditions in ferret papillary muscles (n = 33) loaded with the Ca(2+)-regulated bioluminescent indicator aequorin. A pH(o) of 6.4 was induced by replacing 92% of HCO3- with Cl- in the bathing medium. The effects of endothelin at pH(o) 6.4 differed from the effects at pH(o) 7.4 in that 1) the minimally effective concentration of endothelin was 30-fold lower (1 x 10(-10) M at pH(o) 6.4; 3 x 10(-9) M at pH(o) 7.4) and the concentration-response curve of endothelin was significantly shifted to the left with a decrease in log EC50 from -7.83 +/- 0.13 to -8.92 +/- 0.10 (p less than 0.001), indicating ...
Expression and subcellular distribution of basic fibroblast growth factor are regulated during migration of endothelial cells.
Authors: SBiro, Z XYu, Y MFu, GSmale, JSasse, JSanchez, V JFerrans, WCasscells
Journal: Circulation Research (1994)

Migration of endothelial cells is involved in normal and pathological angiogenesis and in re-endothelialization after vascular injury or rupture of atherosclerotic plaques. Several types of endothelial cells are known to synthesize basic fibroblast growth factor (bFGF); in some of these, migration is increased by exogenous bFGF and inhibited by anti-bFGF antibodies. Using immunocytochemical techniques and RNase protection analysis, we studied endothelial cells from bovine coronary arteries and veins as well as from adrenal microvessels. We found that bFGF mRNA and peptide were present in confluent endothelial cells and were upregulated during migration stimulated by removal of some cells from the monolayer. During migration, extracellular matrix stores of bFGF were depleted, and bFGF immunoreactivity began to accumulate in the cytoplasm of endothelial cells between 2 and 6 hours. After migration had begun, but before the initiation of DNA synthesis, bFGF immunoreactivity increased in the nuclei and nucleo...
Fats and atheroma.
Authors: A Lewis
Journal: BMJ (1979)

of the aorta was found but no atheroma of the coronary arteries.Another of the eight patients, a woman aged 44, had a serum cholesterol concentration of 7 mmol/l (273 mg/ 100 ml) before thyroidectomy and a concentra- tion of 6 mmol/l (230 mg/100 ml) before she died four years later.These eight patients are as relevant to the debate on fat and atheroma as the flowers that bloom in the spring.It is time that this out- worn reference was given a well-deserved rest.
Platelet factor 4 efficiently reverses heparin anticoagulation in the rat without adverse effects of heparin-protamine complexes.
Authors: J JCook, SNiewiarowski, ZYan, LSchaffer, WLu, G JStewart, D MMosser, J AMyers, T EMaione
Journal: Circulation (1992)

BACKGROUNDIt has been observed that the reversal of heparin anticoagulation in humans by protamine sulfate (PS) results in various adverse reactions including leukopenia, thrombocytopenia, activation of complement, increased vascular permeability, systemic hypotension, pulmonary vasoconstriction, and pulmonary edema. The purpose of this study was to compare the efficacy and effects of native platelet factor 4 (PF4) and recombinant platelet factor 4 (rPF4) with those of PS in heparin neutralization in vivo, using a rat model.METHODS AND RESULTSSprague-Dawley rats were anesthetized with sodium pentobarbital, and the right femoral vein and carotid artery were cannulated. For determination of activated partial thromboplastin time, platelet count, white blood cell count, and complement titer, arterial blood samples were taken before and immediately after heparin (10 units/100 g) infusion and at several time points after the infusion of the neutralizing agent (PS, 0.1 mg/100 g; PF4, 0.5 mg/100 g). In separate g...
‘Comparative outcomes of cefazolin versus anti-staphylococcal penicillins in methicillin-susceptible Staphylococcus aureus infective endocarditis: a post-hoc analysis multicentre French cohort study’—author's reply
Authors: Raphaël Lecomte, Colin Deschanvres, Sandrine Coudol, Matthieu Wargny, Fabrice Camou, David Boutoille
Journal: Clinical Microbiology and Infection (2021)
Reduction of atrial natriuretic factor circulating levels by endogenous sympathetic activation in hypertensive patients.
Authors: MVolpe, NDeLuca, S AAtlas, M JCamargo, CIndolfi, GLembo, BTrimarco, MCondorelli, J HLaragh
Journal: Circulation (1988)

The effects of endogenous activation of sympathetic nervous system on systemic and regional hemodynamics and on plasma levels of atrial natriuretic factor (ANF) were studied in subjects with essential hypertension. Stimulation of sympathetic nervous system was reflex-induced by a selective deactivation of carotid baroreceptors obtained by increasing external neck-tissue pressure (NTP) by means of a neck chamber. The effects of graded levels (+30, +45, and +60 mm Hg) and one single and sustained level (+45 mm Hg for 15 min) of NTP were studied. As expected, NTP caused reflex increases in blood pressure, heart rate, and forearm vascular resistance, whereas atrial pressures did not change significantly and cardiac output tended to increase. In the studies based on graded levels of NTP, immunoreactive ANF (irANF) progressively fell (from 31.7 +/- 10 to 13.3 +/- 4 fmol/ml; p less than .05) and the changes in irANF were significantly correlated with those observed in FVR (r = -.671, p less than .001). Both hemo...
Effect of ischemia on calcium-dependent fluorescence transients in rabbit hearts containing indo 1. Correlation with monophasic action potentials and contraction.
Authors: H CLee, RMohabir, NSmith, M RFranz, W TClusin
Journal: Circulation (1988)

The effects of acute global ischemia on cytosolic calcium transients were studied in perfused rabbit hearts loaded with the fluorescent calcium indicator indo 1. Indo 1-loaded hearts were illuminated at 360 nm, and fluorescence was recorded simultaneously at 400 and 550 nm from the epicardial surface of the left ventricle. The F400/F550 ratio was calculated by an analog circuit, which allowed cancellation of optical motion artifact. Resulting calcium transients demonstrated a rapid upstroke and slow decay similar to those recorded in isolated ventricular myocytes. Global ischemia rapidly suppressed contraction, but it produced a concurrent increase in the systolic and diastolic levels of the calcium transients, together with an increase in the duration of the peak. The effects of ischemia were reversed by reperfusion, inhibited by verapamil, and mimicked by perfusion of nonischemic hearts with acidified (CO2-rich) solution. In addition to elevation of the calcium transients, ischemia caused a pattern of i...
Consequences of regional inotropic stimulation of ischemic myocardium on regional myocardial blood flow and function in anesthetized swine.
Authors: RSchulz, SMiyazaki, MMiller, EThaulow, GHeusch, JRoss, B DGuth
Journal: Circulation Research (1989)

Determination of the effect of inotropic stimulation on regionally ischemic and hypokinetic myocardium is complicated when intravenous administration of the inotropic agent also causes stimulation of nonischemic adjacent and distant regions, thereby altering global ventricular hemodynamics. To obviate such events, 16 anesthetized swine were studied during regional inotropic stimulation by infusion of dobutamine hydrochloride (2.5 +/- 1 microgram/min) into the cannulated left anterior descending coronary artery. Coronary inflow was controlled by a pump in an extracorporeal circuit. Two groups of swine with different degrees of ischemia were studied. In the first group of animals (n = 8), reduction in coronary inflow to produce a fall in coronary artery pressure (CAP) from 114 +/- 7 mm Hg to 62 +/- 2 mm Hg caused a decrease in percent systolic wall thickening (%WTh) from 34.6 +/- 8.1% to 25.4 +/- 5.8% (p less than 0.005). In the second group of animals (n = 8), CAP was decreased to 46 +/- 5 mm Hg (control: ...
The neurohumoral and hemodynamic response to orthostatic tilt in patients with congestive heart failure.
Authors: T BLevine, G SFrancis, S RGoldsmith, J NCohn
Journal: Circulation (1983)

Thirty-five patients with varying degrees of congestive heart failure were subjected to 60 degrees upright tilt. Eight of the patients with normal resting hemodynamics had elevated resting plasma norepinephrine levels (PNE) (p less than 0.001), but their response to upright tilt was similar to that in normal subjects: All had increases in heart rate, plasma norepinephrine (from 263 +/- 32 to 483 +/- 78 pg/mg, p less than 0.02) and plasma renin activity (from 4.8 +/- 0.9 to 13.7 +/- 7.6 ng/ml/hour, p less than 0.05). In 27 patients with high resting pulmonary wedge pressure and low cardiac index, resting PNE was higher (668 +/- 71 ng/ml), but PNE, plasma renin activity and heart rate did not increase significantly during tilt despite a fall in pulmonary capillary wedge pressure and cardiac index. In 18 of these patients, PNE rose during tilt, whereas in nine it did not change or fell; the resting hemodynamics and the hemodynamic response to tilt were not significantly different in these two groups. These d...
Exercise thallium-201 scintigraphy in dogs: effects of long-term coronary occlusion and collateral development on early and late scintigraphic images.
Authors: M VCohen, R MSteingart
Journal: Circulation (1985)

To examine the effects of coronary collateral development on thallium-201 (201Tl) distribution the left circumflex coronary artery was ligated in eight dogs. Three days later these animals ran on a treadmill, and 201-thallous chloride was injected into the right atrium at peak exercise. Scintigraphic scanning was begun within 10 min and continued for 3 hr. Scanning was repeated weekly for 6 weeks. In the last week radioactive microspheres were injected into the left atrium at peak exercise to measure regional myocardial blood flow. The scintigraphically determined disparity between perfusion of the ischemic and normal myocardium was most marked at 3 days after ligation. This difference gradually lessened over the first 4 weeks until there was no difference in 201Tl distribution to normally perfused myocardium and tissue distal to the ligation. Concomitant with the improvement in the scintigrams, exercise hemodynamics also improved over this 4 week period with significant increases in cardiac output and de...