tbuckley/cabot-search huggingface dataset:
Relative importance of thrombin compared with plasmin-mediated platelet activation in response to plasminogen activation with streptokinase.
Authors: K JWinters, S ASantoro, J PMiletich, P REisenberg
Journal: Circulation (1991)

BACKGROUNDPlatelet activation occurs in vivo during pharmacologic thrombolysis and may contribute to recurrent thrombosis. Plasmin does not directly activate platelets except at high concentrations; thus, the mechanisms for platelet activation during thrombolysis remain undefined. Increases in thrombin activity also occur in patients treated with fibrinolytic agents and may contribute to activation of platelets. We have shown that one mechanism for increased thrombin activity is activation of the coagulation system by plasmin.METHODS AND RESULTSIn the present study we sought to determine whether activation of platelets in response to pharmacologic activation of plasminogen in plasma is due primarily to plasmin or mediated by increased thrombin activity. Platelet-rich citrated plasma (PRP) was recalcified and incubated with 1,000 IU/ml of streptokinase or 1.0 caseinolytic units/ml of plasmin. Concentrations of fibrinopeptide A, a marker of thrombin activity, increased markedly over 10 minutes in plasma inc...
Linking: a dynamic electrophysiologic phenomenon in macroreentry circuits.
Authors: M HLehmann, SDenker, RMahmud, AAddas, MAkhtar
Journal: Circulation (1985)

The term linking has been used specifically to describe the mechanism for perpetuation of functional anterograde bundle branch block: namely, repetitive transseptal retrograde concealed penetration by impulses propagating along the contralateral bundle. We present selected examples that demonstrate tht linking-type phenomena actually have a wide spectrum of expression in human macroreentry circuits, particularly those incorporating either the bundle branches and His bundle or the normal pathway and Kent bundle. The examples presented are as follows: (1) persistent retrograde functional conduction delays in the His-Purkinje system during right ventricular pacing, (2) anterograde Kent bundle condution at rapid rates, dependent on prior block in the normal pathway, (3) persistent anterograde functional infra-His block of atrial impulses during rapid ventricular pacing in the presence of a retrogradely conducting accessory pathway, and (4) transient advancement of His activation with ventricular fusion comp...
Pembrolizumab as Second-Line Therapy for Advanced Hepatocellular Carcinoma: A Subgroup Analysis of Asian Patients in the Phase 3 KEYNOTE-240 Trial
Authors: Masatoshi Kudo, Ho Yeong Lim, Ann-Lii Cheng, Yee Chao, Thomas Yau, Sadahisa Ogasawara, Masayuki Kurosaki, Naoki Morimoto, Kazuyoshi Ohkawa, Tatsuya Yamashita, Kyung-Hun Lee, Erluo Chen, Abby B. Siegel, Baek-Yeol Ryoo
Journal: Liver Cancer (2021)

KEYNOTE-240 investigated the efficacy and safety of pembrolizumab plus best supportive care (BSC) in sorafenib-treated patients with advanced hepatocellular carcinoma (HCC). Results for the subgroup of patients from Asia are described.Adults with advanced HCC previously treated with sorafenib were randomized 2:1 to pembrolizumab or placebo plus BSC. Here, the Asian subgroup comprised patients enrolled in Hong Kong, Japan, Korea, the Philippines, Taiwan, and Thailand. Primary endpoints were progression-free survival (PFS) per blinded central imaging review and overall survival (OS). Secondary endpoints included objective response rate (ORR) per blinded central imaging review, duration of response (DOR), and safety.The Asian subgroup included 157 patients. As of January 2, 2019, the median follow-up in this subgroup was 13.8 months for pembrolizumab and 8.3 months for placebo. The median PFS was 2.8 months for pembrolizumab (95% confidence interval [CI] 2.6-4.1) versus 1.4 months (95% CI 1.4-2.4) for placebo (hazard ratio [HR] 0.48; 95% CI 0.32-0.70). The median OS was 13.8 months (95% CI 10.1-16.9) for pembrolizumab versus 8.3 months (95% CI 6.3-11.8) for placebo (HR 0.55; 95% CI 0.37-0.80). ORR was 20.6% (95% CI 13.4-29.5) for pembrolizumab versus 2.0% (95% CI 0.1-10.6) for placebo (difference: 18.5%; 95% CI 8.3-27.6). The median DOR was 8.6 and 2.8 months for pembrolizumab and placebo, respectively. Any grade treatment-related adverse events (TRAEs) occurred in 63 patients (58.9%) receiving pembrolizumab and 24 patients (48.0%) receiving placebo; 14 (13.1%) and 2 (4.0%) patients experienced grade 3-5 TRAEs, respectively. No treatment-related deaths occurred.Pembrolizumab demonstrated antitumor activity and was well tolerated in the Asian subgroup of KEYNOTE-240. A trend toward greater benefit with pembrolizumab in the Asian subgroup was observed compared with the overall cohort, supporting further evaluation of pembrolizumab treatment in this population.
Pretreatment Endoscopy - Pro &amp; Contra: Endoscopy Is Needed before Treatment in All Patients with Gastroesophageal Reflux Disease
Authors: F. Pace, G. Manes, M. Conio, G. Bianchi Porro
Journal: Endoscopy (2006)

Most current endoscopic guidelines do not recommend the use of routine esophagoscopy in the evaluation of patients with typical symptoms of gastroesophageal reflux disease (GERD), unless alarm features are present. In patients with known reflux esophagitis, esophagoscopy is considered to have no role either in the further management or follow-up. Screening of reflux patients for Barrett's esophagus is not considered to be cost-effective. On the basis of a critical review of the available literature, and of some recent papers in particular, we disagree with these suggestions. We would argue, on the contrary, that a negative esophagoscopy can provide the GERD patient with reassurance, and that esophagoscopy allows targeted therapy to be offered if it is positive for esophagitis. When Barrett's esophagus is diagnosed, it usually leads to a surveillance program being initiated. The potential benefits of endoscopy for the patient's quality of life are probably underestimated when financial issues alone are taken into account. Even if it is true that a large percentage of GERD patients do not have endoscopic abnormalities (those with nonerosive reflux disease), surrogate tests such as the proton-pump inhibitor test or symptom questionnaires do not provide a more accurate diagnosis. We would therefore suggest that, at least in the specialist setting, all patients with suspected GERD should undergo accurate symptom analysis as well as endoscopic evaluation before treatment is started.
In vivo aortic muscle cell growth kinetics. Differences between thoracic and abdominal segments after intimal injury in the rabbit.
Authors: I DGoldberg, M BStemerman, B JRansil, R LFuhro
Journal: Circulation Research (1980)

Focal proliferation of smooth muscle cell (SMC) is an integral part of atherosclerotic plaque formation: characterization of regional variation in SMC growth kinetics is therefore important to the understanding of atherogenesis. SMC growth kinetics of rabbit abdominal and thoracic segments were compared. Rabbit aortas were denuded of endothelium and the animals killed after 3H-thymidine and Evans blue injections at 0 to 48 days after denudation. Incorporation of 3H-thymidine into both aortic segments peaked at 48 hours; no detectable incorporation occurred in the first 24 hours. Abdominal segment DNA specific activity (SA, dpm/micrograms DNA) and total kinetic activity (TKA, dpm/0.1 mm internal elastic lamina) at 48 hours were significantly greater than values for the thoracic aorta. Abdominal SA and TKA curves decreased exponentially after the 48-hour peak and parallel thoracic levels after day 7. SA and TKA values for each segment reflected the subsequent SMC intimal growth rates as measured morphometri...
Peristaltic Contractions Help Snaring During Underwater EMR of Colonic Non-Granular Pseudodepressed LST
Authors: H Uchima, J Colán-Hernández, I Marín, R Temiño, A Mata, R López, C Fumagalli, A Hernández, M Rosinach, M Ble, N Caballero, F Cañete, I Iborra, R Turro, J Michelena, J Turro, J Espinós, V Moreno, K Binmoeller
Journal: Endoscopy (2021)

En bloc resection of LST-NG pseudodepressed type is mandatory due to a high-risk of submucosal invasion. Sometimes it might be difficult to snare these lesions. During Underwater EMR (UEMR) the colonic lesion “floats” in a lumen filled with fluid and muscularis propria retains a circular configuration and does not follow involutions of the mucosa and submucosa even during peristaltic contractions.
Effect of early diastolic loading on myocardial relaxation in the intact canine left ventricle.
Authors: SNikolic, E LYellin, KTamura, TTamura, R WFrater
Journal: Circulation Research (1990)

Early transmitral flow (MiF) patterns depend strongly on the rate of fall of measured left ventricular pressure (Pm) determined by both the active decay of pressure (Pa) due to myocardial relaxation and the increase in pressure due to stretch of passive elements during filling (Pp). This study was designed to uncouple passive forces from deactivation in order to reveal the instantaneous rate and duration of myocardial relaxation. We assumed a parallel combination of passive and active elements: Pm(t,V) = Pa(t) + Pp(V), with no constraints on the form of Pa(t), where t is time and V is ventricular volume. Pp(V) was determined by a retrospective analysis of data obtained in 11 anesthetized dogs instrumented for volume clamping with a remote-controlled mitral valve, with left atrial and left ventricular micromanometers, and with an electromagnetic probe to measure MiF. The passive pressure-volume relation (both positive and negative portions) was determined by clamping at end-systolic volume or after various...
Carcinoma of the Anal Canal
Authors: David P. Ryan, Carolyn C. Compton, Robert J. Mayer
Journal: New England Journal of Medicine (2000)

Carcinoma of the anal canal accounts for 1.5 percent of digestive-system cancers in the United States, with an estimated 3400 new cases in 2000.1 Thirty years ago, anal cancer was believed to be caused by chronic, local inflammation of the perianal area2,3 and was treated with an abdominoperineal resection, necessitating a permanent colostomy.4 As the result of a series of epidemiologic studies, it is now apparent that the development of anal cancer is associated with infection by human papillomavirus, which is usually sexually transmitted. Moreover, in the majority of patients, the condition can be cured by concurrent chemotherapy and . . .
Black-white differences in cholesterol levels of serum high-density lipoprotein subclasses among children: the Bogalusa Heart Study.
Authors: S RSrinivasan, D SFreedman, L SWebber, G SBerenson
Journal: Circulation (1987)

Cholesterol levels of serum high-density lipoprotein (HDL) subclasses, HDL2 and HDL3, were examined in a random subsample (n = 561) of children (7 to 17 years of age) from a total biracial community. Overall, black children in younger (7 to 10 years) and older (11 to 17 years) age groups alike had significantly higher HDL2 cholesterol (HDL2-C) and HDL3-C than their white counterparts. In addition, black children had a relatively higher frequency of joint occurrence of high levels of both HDL2-C and HDL3-C. A significant sex-related difference, with girls showing higher values than boys, was noted among younger age groups for HDL2-C. A male-female crossover trend in HDL2-C levels was apparent only among white children, with girls showing higher values after age 11. Both age and sexual maturation were inversely associated with HDL3-C levels in white children, irrespective of sex (p less than .001). Serum triglycerides were inversely related to both HDL2-C and HDL3-C only in white children (p less than .001)...
Comment on: Inzucchi et al. Management of Hyperglycemia in Type 2 Diabetes: A Patient-Centered Approach. Position Statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care 2012;35:1364–1379
Authors: Andrea Giaccari, Carlo B. Giorda, Gabriele Riccardi, Alberto De Micheli, Graziella Bruno, Luca Monge, Simona Frontoni
Journal: Diabetes Care (2012)

Management of hyperglycemia in type 2 diabetes is certainly one of the most debated fields in medicine (1). Although poor possibilities in drug choice for years maintained the discussion only on what glucose target should be reached, the recent introduction of new drugs playing on different mechanisms of action compelled the debate on what drug should be chosen. Unfortunately, most drugs share similar efficacy, and this generated several comments and recommendations usually based on experts’ opinion rather than on evidence-based medicine (2,3). A clear demonstration of the subjectivity of the previous and the present consensus statements by the American Diabetes Association and the European Association for the Study of Diabetes is the …
Comparison of Estimated Effectiveness of Case-Based and Population-Based Interventions on COVID-19 Containment in Taiwan
Authors: Ta-Chou Ng, Hao-Yuan Cheng, Hsiao-Han Chang, Cheng-Chieh Liu, Chih-Chi Yang, Shu-Wan Jian, Ding-Ping Liu, Ted Cohen, Hsien-Ho Lin
Journal: JAMA Internal Medicine (2021)

<h3>Importance</h3> Taiwan is one of the few countries with initial success in COVID-19 control without strict lockdown or school closure. The reasons remain to be fully elucidated. <h3>Objective</h3> To compare and evaluate the effectiveness of case-based (including contact tracing and quarantine) and population-based (including social distancing and facial masking) interventions for COVID-19 in Taiwan. <h3>Design, Setting, and Participants</h3> This comparative effectiveness study used a stochastic branching process model using COVID-19 epidemic data from Taiwan, an island nation of 23.6 million people, with no locally acquired cases of COVID-19 reported for 253 days between April and December 2020. <h3>Main Outcomes and Measures</h3> Effective reproduction number of COVID-19 cases (the number of secondary cases generated by 1 primary case) and the probability of outbreak extinction (0 new cases within 20 generations). For model development and calibration, an estimation of the incubation period (interval from exposure to symptom onset), serial interval (time between symptom onset in an infector-infectee pair), and the statistical distribution of the number of any subsequent infections generated by 1 primary case was calculated. <h3>Results</h3> This study analyzed data from 158 confirmed COVID-19 cases (median age, 45 years; interquartile range, 25-55 years; 84 men [53%]). An estimated 55% (95% credible interval [CrI], 41%-68%) of transmission events occurred during the presymptomatic stage. In our estimated analysis, case detection, contact tracing, and 14-day quarantine of close contacts (regardless of symptoms) was estimated to decrease the reproduction number from the counterfactual value of 2.50 to 1.53 (95% CrI, 1.50-1.57), which would not be sufficient for epidemic control, which requires a value of less than 1. In our estimated analysis, voluntary population-based interventions, if used alone, were estimated to have reduced the reproduction number to 1.30 (95% CrI, 1.03-1.58). Combined case-based and population-based interventions were estimated to reduce the reproduction number to below unity (0.85; 95% CrI, 0.78-0.89). Results were similar for additional analyses with influenza data and sensitivity analyses. <h3>Conclusions and Relevance</h3> In this comparative effectiveness research study, the combination of case-based and population-based interventions (with wide adherence) may explain the success of COVID-19 control in Taiwan in 2020. Either category of interventions alone would have been insufficient, even in a country with an effective public health system and comprehensive contact tracing program. Mitigating the COVID-19 pandemic requires the collaborative effort of public health professionals and the general public.
Prognostic significance of the electrocardiogram after Q wave myocardial infarction. The Framingham Study.
Authors: N DWong, DLevy, W BKannel
Journal: Circulation (1990)

The prognostic value of abnormalities on the electrocardiogram (ECG) present 1 year after initial myocardial infarction (MI) is examined in relation to reinfarction and coronary death throughout 32 years (mean, 10.1 years) of follow-up in the Framingham Heart Study. Resting 12-lead ECGs were available in 251 survivors (190 men and 61 women) of clinically recognized Q wave MI. The ECG reverted to normal in 31 (12.4%) cases and was abnormal but without Q waves in 37 (14.7%). Q waves persisted without other significant abnormalities in 108 (43.0%) and with other abnormalities in 75 (29.9%) cases. Electrocardiographic abnormalities at follow-up were more common in women and in those persons whose initial MI was anterior as compared with inferior. Nonspecific T wave, ST segment changes, and electrocardiographic left ventricular hypertrophy on the ECG before or after MI were powerful predictors (p less than 0.01) of coronary death. The relation of these residual post-MI electrocardiographic findings to reinfarc...
Metabolic responses of hibernating and infarcted myocardium to revascularization. A follow-up study of regional perfusion, function, and metabolism.
Authors: T HMarwick, W JMacIntyre, ALafont, J JNemec, E ESalcedo
Journal: Circulation (1992)

BACKGROUNDThe presence of persistent myocardial uptake of 18F-deoxyglucose (FDG) within hypoperfused, dysfunctional segments has been shown to predict the recovery of regional contractile function after revascularization. The spectrum of metabolic responses of such hibernating tissue to revascularization is less clear.METHODS AND RESULTSSixteen patients with previous infarction were studied before and after revascularization by myocardial perfusion imaging using 82Rb positron emission tomography, digitized two-dimensional echocardiography, and imaging of postexercise FDG uptake. Hibernation was identified in 35 of 85 segments showing perfusion and wall motion disturbances before intervention. At follow-up (4.9 +/- 2.6 months after revascularization), hibernating segments were characterized by reduction of wall motion score (p less than 0.001), improvement of perfusion (p less than 0.001), and reduction of FDG activity (p less than 0.001). Of the 35 hibernating segments, however, 10 still had abnormal elev...
Role of epicardial mesothelial cells in the modification of phenotype and function of adult rat ventricular myocytes in primary coculture.
Authors: HEid, D MLarson, J PSpringhorn, M AAttawia, R CNayak, T WSmith, R AKelly
Journal: Circulation Research (1992)

Adult rat ventricular myocytes undergo a well-documented sequence of phenotypic changes during adaptation to primary culture. However, we observed that coculture of myocytes with a specific subset of nonmyocyte cardiac cells could slow and even reverse the process of adaptation. These nonmyocyte cells were isolated and identified by immunohistochemical and ultrastructural criteria as being of epicardial mesothelial origin. When added to long-term primary cultures of adult ventricular myocytes, epicardial mesothelial cells appeared to induce myofibrillar arrays that were more organized than those seen in noncocultured myocytes; these changes that occurred were concurrent with the appearance of large amplitude contractions and multicellular synchronous beating that was facilitated by gap junctions between myocytes and epicardial mesothelial cells. The changes in morphology and function were accompanied by a marked increase in beta-myosin heavy chain isoform transcription in cocultured myocytes, a return to ...
Shall The Journal be Removed to Washington?
Authors: C. N. Udell
Journal: JAMA (1891)

<h3>To the Editor:</h3> As a member of the A. M. A. I am decidedly opposed to the removal ofThe Journalto Washington, or to any other point at present. I am also opposed to locating our annual meeting at any one point. By all means let the Association remain National in character, and let it itinerate, gathering new members from all parts of our country. To permanently locate the annual meeting somewhere in the East or South, would be practically inviting our brethren on the Pacific slope to withdraw, which they would probably do. I vote to letThe Journalremain in Chicago until after the Columbian exposition at least, and let special inducements be offered all visiting physicians in good standing to visit the editor and subscribe forThe Journal. I have no fault to find with the present, or past, management ofThe Journal. Blakesburg, Iowa,
The QT interval throughout the first 6 months of life: a prospective study.
Authors: P JSchwartz, MMontemerlo, MFacchini, PSalice, DRosti, GPoggio, RGiorgetti
Journal: Circulation (1982)

A prospective electrocardiographic study was designed to establish baseline values for electrocardiographic measurements, with specific reference to the  interval during infancy, and to test the QT hypothesis for the sudden infant death syndrome (SIDS). In this ongoing study, ECGs are recorded on the fourth day of life and in the second, fourth and sixth months. The state of health at 1 year is ascertained by a phone call. So far, 4205 newborns have been enrolled. The mean QTc (QT interval corrected for heart rate) was 397 +/- 18 msec (+/- SD) at the fourth day, 409 +/- 15 msec (p less than 0.0001) at the second month, and 406 +/- 15 msec at the fourth month; by the sixth month, it returned to 400 +/- 14 msec. In 88 newborns, the QTc increased by over 40 msec at the second month. Among the 2000 infants checked at 1 year, there have been three sudden and unexpected deaths. The QTc of one of the victims at the fourth day was 563 msec, which exceeded the mean by more than 9 standard deviations, while the...
Metastasis-associated Protein S100A4 Contributes to Cardiac Fibrosis through the Modulation of PTEN
Authors: Tamaki Yodo, Iwanaga Yoshitaka, Okuda Junji, Niizuma Shinichiro, Kawashima Tsuneaki, Katoh Takao, Inuduka Yasutaka, Shioi Tetsuo, Ono Ko, Koshimizu Takaaki, Miyazaki Shunichi, Kita Toru, Kimura Takeshi
Journal: Circulation (2011)
Characterization of activity behavior using a digital medicine system and comparison to medication ingestion in patients with serious mental illness
Authors: Jeffrey M. Cochran, Zahra Heidary, Jonathan Knights
Journal: npj Digital Medicine (2021)

Abstract Activity patterns can be important indicators in patients with serious mental illness. Here, we utilized an accelerometer and electrocardiogram incorporated within a digital medicine system, which also provides objective medication ingestion records, to explore markers of patient activity and investigate whether these markers of behavioral change are related to medication adherence. We developed an activity rhythm score to measure the consistency of step count patterns across the treatment regimen and explored the intensity of activity during active intervals. We then compared these activity features to ingestion behavior, both on a daily basis, using daily features and single-day ingestion behavior, and at the patient-level, using aggregate features and overall ingestion rates. Higher values of the single-day features for both the activity rhythm and activity intensity scores were associated with higher rates of ingestion on the following day. Patients with a mean activity rhythm score greater than the patient-level median were also shown to have higher overall ingestion rates than patients with lower activity rhythm scores ( p = 0.004). These initial insights demonstrate the ability of digital medicine to enable the development of digital behavioral markers that can be compared to previously unavailable objective ingestion information to improve medication adherence.