tbuckley/cabot-search huggingface dataset:
Radionuclide quantitation of right-to-left intracardiac shunts in children.
Authors: C APeter, B EArmstrong, R HJones
Journal: Circulation (1981)

A simple, noninvasive method for measurement of right-to-left intracardiac shunts would enhance the management of patients with congenital heart disease. This study describes application of data processing techniques used previously in dye-indicator curves to data recorded during the initial transit of radioactive bolus through the central circulation. Radionuclide angiocardiograms were performed in 20 children, mean age 30 months, immediately after cardiac catheterization for congenital heart disease. The radionuclide data recorded over the carotid artery were used to replace arterial sampling required for dye indicators, and forward triangles were fitted to calculate the right-to-left shunt in an approach similar to that of Wood for indicator-dilution curves. Ten of the children had right-to-left shunts by Fick and radionuclide measurement, and 10 of the children with septal defects had no right-to-left shunt by either technique. Both the radionuclide and Fick measurements correlated well (r = 0.95). Th...
Attenuation of long-lasting effects of sympathetic stimulation after repeated stimulation.
Authors: G THall, T DGardner, E KPotter
Journal: Circulation Research (1990)

Neuropeptide Y (NPY) is stored with norepinephrine in sympathetic nerves throughout the cardiovascular system and is released during activation of the sympathetic nervous system in humans and other animals. After stimulation of the cardiac sympathetic nerves in anesthetized dogs, the action of the vagus nerve on heart rate is attenuated for a prolonged period. This attenuation of cardiac vagal action is also seen after injection of NPY. Both sympathetic stimulation and exogenous NPY inhibit cardiac vagal effects by acting on postganglionic vagal nerves. Because the supply of neuropeptides to nerve terminals is by axonal transport, it might be expected that repeated stimulation of cardiac sympathetic nerves would deplete the sympathetic neural factor, proposed to be NPY. In all 11 dogs of this study, repeated episodes of stimulating the cardiac sympathetic nerve (16 Hz for 1 minute each) had a diminishing effect in attenuating cardiac vagal action. However, the episodes of sympathetic stimulation did not s...
Multimedia: Di Bella: the Man, the Cure, a Hope for All
Authors: Abi Berger
Journal: BMJ (1999)

Vincenzo Brancatisano (translated by Vicki Satlow)


Quartet Books, £7, pp 137 




ISBN 0 7043 8093 5

———————

Rating: ★★

Despite the enormous leaps taken by science and medical technology in recent times, the myths that surround cancer remain intact, for patients at least. Cancer remains the bogeyman of medicine in the 20th century and still brings the fear of God into people in a way I have not seen with any other disease. And, despite all I have heard and read about Di Bella’s cure for cancer, I remain sceptical about what doctors really have to offer.

I was hoping that Brancatisano’s book would dispel my cynicism, but, sadly, it has succeeded only in confirming it. Di Bella is held up as an unsung hero: a gentle giant who has devoted his life to the care of others and found a cure for cancer, yet has been consistently shunned and rejected by the medical community. This is a naive and uncritical account of Di Bella’s life and times. It is wistful (in a way usually reserved for the dead) and onesided: readers could well come away with undue paranoia, distrust, and animosity towards the medical fraternity. 

Di Bella’s cure consists of an unpublished concoction of four substances: melatonin, somatostatin, retinoids, and bromocriptine. This recipe is said to work by galvanising the body’s immune system and slowing cell proliferation, rather than by simply inducing cell death. The evidence is observational and anecdotal, none of it having been published in peer reviewed medical journals. He is reported to have cured thousands of people and delayed the death of as many again. He is hailed as the last hope for people who feel they have been failed by conventional oncology.

Di Bella is clearly a healer, not a quack to be dismissed out of hand, and his holistic view of medicine in general, and cancer in particular, is tremendously appealing. In addition to giving them drugs, he encourages people to take control of their lives and to live with cancer rather than die from it. I am not convinced by the pharmacology story alone, but I would argue that if his approach “works,” it is because of the immense power of the placebo effect induced by one charismatic person, and the time and the energy that he can devote to individuals desperately looking for a way of cheating death.

Would that we in general practice had a fraction of the time Di Bella devotes to his patients. Although not included in the book, it has since become apparent that only 3 of the 386 patients who volunteered to take part in independent trials of Di Bella’s regimen in Italy have shown partial recovery (see Editorial by Mullner and p 224). Di Bella allegedly plans to sue the doctors who conducted the trials, on the grounds that they did not use his treatment. I would argue, however, that the failure might more reasonably be put down to the absence of the man himself.
Superoxide anion release from blood and bone marrow neutrophils is altered by endotoxemia.
Authors: FCerasoli, P JMcKenna, D LRosolia, K HAlbertine, S PPeters, M HGee
Journal: Circulation Research (1990)

In vivo endotoxin infusion produces neutrophil-mediated acute lung injury and increases superoxide anion release from phorbol myristate acetate (PMA)-stimulated blood neutrophils collected 18-24 hours after the infusion. Because the turnover time of circulating blood neutrophils is only 6-8 hours, it was hypothesized that the prolonged increase in superoxide anion release from peripheral blood neutrophils is associated with increased superoxide anion release from bone marrow neutrophils. To test this hypothesis, two doses of Escherichia coli endotoxin (5.0 and 0.5 micrograms/kg) were infused into chronically instrumented awake sheep. Blood and bone marrow neutrophils were collected 24 hours after the infusion, and superoxide anion release from unstimulated and PMA-stimulated neutrophils was measured in vitro. Endotoxin infusion produced an increase in pulmonary microvascular permeability, in intravascular activation (degranulation) of blood neutrophils, and in circulating blood neutrophils 24 hours after ...
Thalidomide for the treatment of severe intestinal bleeding
Authors: J. Bauditz
Journal: Endoscopy (2008)

The interesting observations of Alberto et al. extend our findings in patients with multiple angiodysplasias [1], and further supports existing literature that thalidomide provides an effective therapy for recurrent bleeding related to vessel malformations within the gastrointestinal system. In cases like the one presented, hormonal therapy is commonly employed. However, a large randomized study in patients with angiodysplasias demonstrated that hormonal therapy is ineffective in this clinical setting [2]. Although the results of this study do not completely rule out that there may be some efficacy of hormones in Osler’s disease, the therapeutic potential of hormonal therapy is obviously limited.
Echocardiographic observations on ventricular septal rupture complicating acute myocardial infarction.
Authors: P AChandraranta, P KBalachandran, P MShah, MHodges
Journal: Circulation (1975)

Echocardiograms were performed on three patients with ventricular septal rupture complicating myocardial infarction. The pulmonary artery mean pressure was 30 mm Hg or more in all three patients. The size of the ventricular septal defect, determined at operation or autopsy, was 2 cm or greater in each patient. The salient echocardiographic abnormality was dilatation of the right ventricle. The direction of septal motion was normal in all the patients. The left atrial diameter was slightly increased in one patient and was normal in the other two. In one patient, and unusual pattern of mitral valve motion was seen. Complete closure of the reopening of the valve. This pattern was suggestive of increased blood flow through the mitral valve. Although some of these findings are nosspecific, the combination of echocardiographic findings may provide useful clues to the diagnosis of septal perforation.
Left ventricular remodeling after myocardial infarction: a corollary to infarct expansion.
Authors: R GMcKay, M APfeffer, R CPasternak, J EMarkis, P CCome, SNakao, J DAlderman, J JFerguson, R DSafian, WGrossman
Journal: Circulation (1986)

Dilatation of infarcted segments (infarct expansion) may occur during recovery from myocardial infarction, but the fate of noninfarcted segments is uncertain. Accordingly, left ventricular geometric changes were assessed by left ventricular angiography and M mode echocardiography on admission and 2 weeks later in 30 patients with their first acute transmural myocardial infarction. All patients demonstrated chest pain, ST segment elevation with subsequent development of Q waves (15 anterior, 15 inferior), and elevation of cardiac enzymes. Sequential left ventricular angiographic and hemodynamic findings were available in these patients by virtue of their participation in a study of thrombolysis in acute myocardial infarction. By that study design, all patients treated successfully with thrombolytic therapy and demonstrating improvement of flow in an occluded coronary artery underwent repeat cardiac catheterization. At 2 weeks there was a significant decrease in left ventricular and pulmonary capillary wedg...
Disproportionate alpha- and beta-mRNA sodium pump subunit content in canine vascular smooth muscle.
Authors: J CAllen, R MMedford, XZhao, T APressley
Journal: Circulation Research (1991)

Total RNA isolated from canine saphenous vein smooth muscle cells was examined for Na+ pump alpha- and beta-mRNA content by three increasingly sensitive methods: Northern analysis, RNase protection assay, and polymerase chain reaction. Northern analysis clearly showed the presence of beta-mRNA. An  1 signal was not demonstrable using either Northern analysis with a 1.5-kb cDNA probe or RNase protection. However, an alpha 1-like transcript was detected using polymerase chain reaction with two sets of primers constructed to selected areas of the rat  1-cDNA. These data suggest that beta-mRNA in canine blood vessels is in large excess of the  1-mRNA. This discrepancy may be reflected in the relatively low number of Na+ pump sites in this tissue.
Meta grayscale adaptive network for 3D integrated renal structures segmentation
Authors: Yuting He, Guanyu Yang, Jian Yang, Rongjun Ge, Youyong Kong, Xiaomei Zhu, Shaobo Zhang, Pengfei Shao, Huazhong Shu, Jean-Louis Dillenseger, Jean-Louis Coatrieux, Shuo Li
Journal: Medical Image Analysis (2021)
The hemodynamic effects of induced supraventricular tachycardia in man.
Authors: B NGoldreyer, J AKastor, K LKershbaum
Journal: Circulation (1976)

The circulatory effects of supraventricular tachycardia (SVT) were studied in eight patients who reported disabling symptoms during paroxysms of the arrhythmia. Supraventricular tachycardia was induced in each patient by rapid atrial pacing or with atrial premature stimuli. Hemodynamic parameters in sinus rhythm and following the initiation of SVT were recorded and compared. The following mean values were observed in sinus rhythm (SR) and SVT. Heart rate (beats/min): SR 79, SVT 183; P-R interval (msec): during SR, 154; during SVT, 256; ratio of mean P-R intervals to mean R-R cycl lengths: SR 20%, SVT 76%; brachial artery pressures (mmHg): SR 141, SVT 99; cardiac index (L/min/m2): SR 3.6, SVT 2.2; pulmonary artery pressures (mmHg): SR 18/7, SVT 26/15; peak right atrial pressures (mm Hg): SR 4, SVT 17. Large waves appeared in the right atrium during SVT due to atrial contraction against closed tricuspid valves. Pulsus alternans were observed in each case during SVT. Despite the presence of chest pain during...
151P Osimertinib versus standard-of-care EGFR-TKI as first-line treatment for advanced NSCLC with EGFR-positive mutation patients: A systematic review
Authors: S. Chen, E. Marcella, B. Susanto, J. Tandiono, R.S. Heriyanto, F. Wijovi, A. Tancherla, A. Kurniawan
Journal: Journal of Thoracic Oncology (2021)
Exercise capacity in patients with severe left ventricular dysfunction.
Authors: WBenge, R LLitchfield, M LMarcus
Journal: Circulation (1980)

Normal or near-normal exercise capacity has been thought to reflect normal left ventricular function. Many compensatory mechanisms could preserve exercise capacity in patients with severe left ventricular dysfunction. We evaluated exercise capacity using a treadmill exercise test in 26 patients with severe left ventricular dysfunction defined by a left ventricular ejection fraction of 30% or less by isotope ventriculography. One half of the patients had normal exercise capacity and a normal cardiothoracic ratio on chest x-ray. This study indicates that traditional predictors of left ventricular function that have been widely used in clinical evaluation of the patients with cardiac disease (cardiothoracic ratio and exercise capacity) can be normal in a significant number of patients with severe left ventricular dysfunction. Thus, left ventricular function cannot be accurately estimated using these traditional predictors and should be assessed quantitatively. The isotope ventriculogram appears to be ideal f...
Cardiovascular development. Prospects for a genetic approach.
Authors: M CFishman, D YStainier
Journal: Circulation Research (1994)

Genetics is a powerful tool, especially when used in combination with embryology, in the seeking of genes necessary for assembly of the cardiovasculature. The first questions must address the types of cellular decisions that are made during development. As for simpler systems in C elegans and D melanogaster, the lineage and cell-fate decisions of the cardiovascular progenitors need to be assessed. In addition it is likely that new paradigms will emerge for multicellular assembly. The study of cardiovascular mutations will define individual genetic steps that define organotypic decisions. A genetic approach is a natural extension of embryology, physiology, and anatomy, fields of great sophistication with regard to the cardiovasculature, because, like them, it focuses on integrative biology and on the intact organism. The zebrafish is particularly well suited to a combination genetic-embryologic study of the fashioning of the cardiovasculature.
Left ventricular ejection fraction calculated from volumes and areas: underestimation by area method.
Authors: J AWisneski, C NPfeil, D GWyse, RMitchell, S HRahimtoola, E WGertz
Journal: Circulation (1981)

The   is one of the most widely used measurements of left ventricular systolic function. Angiographic measurement of   is based on determination of roentgenographic magnification and calculation of end-diastolic and end-systolic volumes, assuming a prolated ellipse. Because it is simple and radiographic magnification may not have been determined, some laboratories have obtained an ejection fraction by comparison of end-diastolic and end-systolic areas. A comparison of the two methods was made using ventriculograms of 538 patients from three cardiac catheterization laboratories. The area method of   calculation consistently underestimates   from left ventricular volumes. A regression equation was derived that allows adjustment of the   obtained from areas to that from volumes.
Osteoblastic Cell-Derived Extracellular Vesicles Transfer Small RNAs That Alter the Physiology of Hematopoietic Cells <i>In Vivo</i>
Authors: Youmna Kfoury, Anthony Anselmo, Jefferson Seidl, Ani Papazian, Francois Mercier, David B Sykes, Nicolas Severe, Borja Saez, Ruslan I Sadreyev, David T. Scadden
Journal: Blood (2017)
Molecular evidence for induction of intracellular adhesion molecule-1 in the viable border zone associated with ischemia-reperfusion injury of the dog heart.
Authors: K AYouker, H KHawkins, G LKukielka, J LPerrard, L HMichael, C MBallantyne, C WSmith, M LEntman
Journal: Circulation (1994)

BACKGROUNDAcute inflammation may play a role in injury during reperfusion following myocardial ischemia. Studies in vitro suggest that intracellular adhesion molecule-1 (ICAM-1) mediates neutrophil adherence to cardiac myocytes and neutrophil-mediated injury. We have shown cytokine activity in postischemic cardiac lymph sufficient to maximally express ICAM-1 on myocytes and that ICAM-1 mRNA is found in the previously ischemic myocardium early in reperfusion.METHODS AND RESULTSIn the present study, we used in situ hybridization techniques to detect ICAM-1 mRNA and examine the cells of origin, relation to cell injury, and relation to inflammatory infiltration after 1 hour of ischemia and varying times of reperfusion. By 1 hour of reperfusion, ICAM-1 mRNA was detected in much of the ischemic myocardium, except in areas of contraction band necrosis. At 2 and 3 hours, a clear demarcation of necrotic areas surrounding ischemic areas of viable myocardium with ICAM-1 mRNA staining was present, and ICAM-1 mRNA sta...
Utilising biomarkers to predict right heart maladaptive phenotype: a step toward precision medicine
Authors: Soni Savai Pullamsetti, Khodr Tello, Werner Seeger
Journal: European Respiratory Journal (2021)

Pulmonary hypertension (PH) is associated with pressure overload of the right ventricle (RV), which initially provokes adaptive RV changes, such as increased wall thickness and contractility [1] In this regard, adaptive RV hypertrophy is characterised by preserved cardiac output, maintained RV ejection fraction, and, as a consequence, largely maintained exercise capacity. In some patients, or in the later course of the disease, however, persistently increased afterload results in maladaptive, pathological remodelling processes, RV uncoupling, and right heart failure. These changes are associated with worse outcomes [1] and, importantly, RV failure is one of the strongest predictors of mortality in PH. Moreover, left heart diseases, considered as major causes of PH, may also be associated with RV remodelling/dysfunction, adversely affecting outcomes in these patient populations [2–5]. Hence, it is important to develop diagnostic tools and, in particular, biomarkers that are able to discriminate left ventricular from right ventricular hypertrophy/failure, to assess RV disease severity and detect early maladaptive changes in RV size, function and structure [1]. There is now growing evidence that such biomarkers may be identified. Utilising biomarkers to predict right heart maladaptive phenotype: a step toward precision medicine <https://bit.ly/35N5czX>
Coronary cyclic flow variations "precondition" ischemic myocardium.
Authors: MOvize, R AKloner, S LHale, KPrzyklenk
Journal: Circulation (1992)

BACKGROUNDRepeated brief episodes of myocardial ischemia performed by mechanical clamping of a coronary artery precondition the heart and reduce infarct size after a subsequent sustained ischemia. It is not known, however, whether spontaneous episodes of transient ischemia caused by formation of platelet thrombi, which may occur in unstable angina, have a similar cardioprotective effect.METHODS AND RESULTSTherefore, our objective was to determine whether brief spontaneous thrombotic episodes of ischemia/reperfusion could limit infarct size and preserve contractile function following 60 minutes (protocol 1) or 90 minutes (protocol 2) of sustained ischemia and 4-4.5 hours of reperfusion in the canine model. Before the sustained coronary occlusion, dogs underwent a 30-minute treatment period consisting of: no intervention (control group), four repeated episodes of 3-minute mechanical occlusion plus 5-minute reperfusion (preconditioned group), or coronary artery stenosis and endothelial injury, resulting ...
Cyclin E and Survival in Patients with Breast Cancer
Journal: New England Journal of Medicine (2003)

A BSTRACT Background Cyclin E, a regulator of the cell cycle, affects the behavior of breast-cancer cells. We investigated whether levels of cyclin E in the tumor correlated with survival among patients with breast cancer. Methods Tumor tissue from 395 patients with breast cancer was assayed for cyclin E, cyclin D1, cyclin D3, and the HER-2/ neu oncogene with the use of Western blot analysis. Full-length, low-molecular-weight, and total cyclin E were measured. Immunohistochemical assessments of cyclin E were also made of 256 tumors. We sought correlations between levels of these molecular markers and disease-specific and overall survival. Results The median follow-up was 6.4 years. A high level of the low-molecular-weight isoforms of cyclin E, as detected by Western blotting, correlated strongly with disease-specific survival whether axillary lymph nodes were negative or positive for metastases (P< 0.001). Among 114 patients with stage I breast cancer, none of the 102 patients with low levels of cyclin E in the tumor had died of breast cancer by five years after diagnosis, whereas all 12 patients with a high level of low-molecular-weight cyclin E had died of breast cancer within that period. In multivariate analysis, a high total cyclin E level or high levels of the low-molecularweight forms of cyclin E were significantly correlated with poor outcome. The hazard ratio for death from breast cancer for patients with high total cyclin E levels as compared with those with low total cyclin E levels was 13.3 — about eight times as high as the hazard ratios associated with other independent clinical and pathological risk factors. Conclusions Levels of total cyclin E and low-molecular-weight cyclin E in tumor tissue, as measured by Western blot assay, correlate strongly with survival in patients with breast cancer. (N Engl J Med 2002;347: 1566-75.)
Determinants of prolonged length of hospital stay after coronary bypass surgery.
Authors: W SWeintraub, E LJones, JCraver, RGuyton, CCohen
Journal: Circulation (1989)

The length of hospital stay after coronary surgery was studied in 4,683 patients undergoing cardiac catheterization followed by coronary surgery at Emory University Hospital or Crawford Long Hospital between the years 1981 and 1986. Length of stay after coronary surgery had a median and modal value of 7 days. There was, however, a long statistical tail of patients with a prolonged length of stay extending out to more than 180 days. Prolonged length of stay (greater than 10 days) could be correlated with preprocedural variables such as age, elective versus emergency status, angina class, ejection fraction, and gender. Length of stay increased from a mean of 6.9 +/- 1.4 days under the age of 40 years to 10.9 +/- 12.1 days over the age of 70 years (p less than 0.0001). Length of stay was correlated with the periprocedural variables of wound infection, neurologic event, arrhythmias, pneumonia, postoperative myocardial infarction, mortality, and pericarditis. Length of stay increased from 8.8 +/- 9.6 days with...