tbuckley/cabot-search huggingface dataset:
Abstract MP011: Effect of a Low-Carbohydrate Versus a Low-Fat Weight Loss Program on Endothelial Function
Authors: Kerry J Stewart, Pamela Ouyang, Harry A Silber, Sammy Zakaria, Dipan Desai, Edward P Shapiro, Devon A Dobrosielski
Journal: Circulation (2012)

Background: A concern about low-carbohydrate (CHO) diets is that a higher fat intake may adversely affect vascular health. We hypothesized that the effect of two weight loss programs on endothelial function would be similar. Each program included exercise but differed in that one included a low-CHO diet whereas the other a low-fat diet. Methods: Overweight or obese but otherwise healthy persons (n=77), 30–65 years old, were randomly assigned to 6-months of an isocaloric low-CHO or low-fat diet, plus 3 times per week supervised aerobic and resistance exercise training. Endothelial function was assessed with non-invasive peripheral arterial tonometry using the Endopat device. Reactive hyperemia was induced after 5 minutes of upper arm occlusion of SBP. The reactive hyperemia peripheral arterial tonometry index (RH-PAT), the ratio between the digital pulse volume during reactive hyperemia and at rest was measured at baseline and after 6 months, as were body weight, BMI, waist circumference, total body fat and trunk fat percent, and BP. Results: Sixty subjects (low-CHO group: n=31,74% women; low-fat group, n=29, 72% women) completed the study. At baseline, there were no group differences in the following variables and the combined values are: age, 50.0±8.7 years; weight, 215.4±32.7 lbs; BMI, 34.2±3.8 kg/m 2 ; waist circumference, 103.1±8.7 cm; total body fat, 43.3±7.2%; trunk fat, 46.4±5.7%; SBP, 124.7±13.5 mm Hg; DBP, 74.2±9.5, RH-PAT, 2.32±0.44%. After 6 months, low-CHO versus low-fat subjects had a greater reduction in weight, −28.9±11.0 versus −18.7± 2.0 lbs, p&lt;0.001; BMI, −4.7±2.0 versus −2.9±1.7, p&lt;0.001; waist circumference, −12.1±6.0 versus −6.2±7.8 cm, p&lt;0.01; body fat, −6.8±4.5 versus −4.0±3.9%, p&gt;0.02. The groups did not differ in reduction of trunk fat percent, with an overall loss of − 5.5±5.7%, p&lt;0.001, or BP, overall reduction −10.7±12.1/−8.6±8.2 mm Hg, p&lt;0.001. After 6 months, there was no overall change in RH-PAT, p=0.64. By regression analysis, 6-month RH-PAT, adjusted for the baseline value, did not differ by group. However, an absolute 1% drop in trunk fat percent was associated with an absolute 0.29% (or relative 12.5%) increase in RH-PAT, p=0.05. Conclusions: A key finding was the lack of an adverse effect on a marker of endothelial function in the low-CHO group. Successful weight loss and reductions in total and abdominal fat, and BP were achieved with both programs. Greater reductions in weight, BMI, waist circumference, and body fat occurred in the low-CHO group. Though overall endothelial function did not change in either group, when individual variations were examined, a greater percent loss in trunk fat was associated with enhanced endothelial function. These data suggest that loss of central fat is associated with improved vascular health, independent of the dietary content of the weight loss program.
Systems Approach to Discovery of Therapeutic Targets for Vein Graft Disease: PPARα Pivotally Regulates Metabolism, Activation, and Heterogeneity of Macrophages and Lesion Development
Authors: Julius L. Decano, Sasha A. Singh, Cauê Gasparotto Bueno, Lang Ho Lee, Arda Halu, Sarvesh Chelvanambi, Joan T. Matamalas, Hengmin Zhang, Andrew K. Mlynarchik, Jiao Qiao, Amitabh Sharma, Shin Mukai, Jianguo Wang, Daniel G. Anderson, C. Keith Ozaki, Peter Libby, Elena Aikawa, Masanori Aikawa
Journal: Circulation (2021)

Vein graft failure remains a common clinical challenge. We applied a systems approach in mouse experiments to discover therapeutic targets for vein graft failure.Global proteomics and high-dimensional clustering on multiple vein graft tissues were used to identify potential pathogenic mechanisms. The PPARs (peroxisome proliferator-activated receptors) pathway served as an example to substantiate our discovery platform. In vivo mouse experiments with macrophage-targeted PPARα small interfering RNA, or the novel, selective activator pemafibrate demonstrate the role of PPARα in the development and inflammation of vein graft lesions. In vitro experiments further included metabolomic profiling, quantitative polymerase chain reaction, flow cytometry, metabolic assays, and single-cell RNA sequencing on primary human and mouse macrophages.We identified changes in the vein graft proteome associated with immune responses, lipid metabolism regulated by the PPARs, fatty acid metabolism, matrix remodeling, and hematopoietic cell mobilization. PPARα agonism by pemafibrate retarded the development and inflammation of vein graft lesions in mice, whereas gene silencing worsened plaque formation. Pemafibrate also suppressed arteriovenous fistula lesion development. Metabolomics/lipidomics, functional metabolic assays, and single-cell analysis of cultured human macrophages revealed that PPARα modulates macrophage glycolysis, citrate metabolism, mitochondrial membrane sphingolipid metabolism, and heterogeneity.This study explored potential drivers of vein graft inflammation and identified PPARα as a novel potential pharmacological treatment for this unmet medical need.
Protocolized Postextubation Respiratory Support to Prevent Reintubation: A Randomized Clinical Trial
Authors: Jonathan D. Casey, Erin M. Vaughan, Bradley D. Lloyd, Peter A. Billas, Karen E. Jackson, Eric J. Hall, Alexandra H. Toporek, Kevin G. Buell, Ryan M. Brown, Roger K. Richardson, J. Craig Rooks, Reagan B. Buie, Li Wang, Christopher J. Lindsell, E. Wesley Ely, Wesley H. Self, Gordon R. Bernard, Todd W. Rice, Matthew W. Semler
Journal: American Journal of Respiratory and Critical Care Medicine (2021)

Rationale: Respiratory support (noninvasive ventilation or high-flow nasal cannula) applied at the time of extubation has been reported to reduce reintubation rates, but concerns regarding effectiveness have limited uptake into practice.Objectives: To determine if providing postextubation respiratory support to all patients undergoing extubation in a medical ICU would decrease the incidence of reintubation.Methods: We conducted a pragmatic, two-armed, cluster–crossover trial of adults undergoing extubation from invasive mechanical ventilation between October 1, 2017, and March 31, 2019, in the medical ICU of an academic medical center. Patients were assigned to either protocolized postextubation respiratory support (a respiratory therapist–driven protocol in which patients with suspected hypercapnia received noninvasive ventilation and patients without suspected hypercapnia received high-flow nasal cannula) or usual care (postextubation management at the discretion of treating clinicians). The primary outcome was reintubation within 96 hours of extubation.Measurements and Main Results: A total of 751 patients were enrolled. Of the 359 patients assigned to protocolized support, 331 (92.2%) received postextubation respiratory support compared with 66 of 392 patients (16.8%) assigned to usual care, a difference driven by differential use of high-flow nasal cannula (74.7% vs. 2.8%). A total of 57 patients (15.9%) in the protocolized support group experienced reintubation compared with 52 patients (13.3%) in the usual care group (odds ratio, 1.23; 95% confidence interval, 0.82 to 1.84; P = 0.32).Conclusions: Among a broad population of critically ill adults undergoing extubation from invasive mechanical ventilation at an academic medical center, protocolized postextubation respiratory support, primarily characterized by an increase in the use of high-flow nasal cannula, did not prevent reintubation compared with usual care.Clinical trial registered with www.clinicaltrials.gov (NCT0328831).
The Relationship Between Diverticular Disease And Neoplastic Colorectal Lesions
Authors: H Jlassi, M Sabbah, N Bellil, D Trad, N Bibani, A Ouakaa, H Elloumi, D Gargouri
Journal: Endoscopy (2021)

Aims Evolving data suggested that diverticulosis and neoplastic colorectal lesions share a common epidemiological trends and risk factors related to lower fiber diet and increasing age. However, the data on a relationship between diverticular disease (DD) and neoplastic colorectal lesions (NCL) are conflicting.
Why Estimates of Physician Supply and Requirements Disagree
Authors: Vic Velanovich
Journal: JAMA (1993)

<h3>To the Editor.</h3> —The article by Feil et al<sup>1</sup>on why estimates of physician supply and requirements for physicians disagree was interesting not only for its subject matter, but also for certain theoretical considerations on predictability. The authors examined six studies forecasting physician supply and requirements. They found that the estimates of the number of physicians by the year 2000 varied by up to 200 000 and that the surplus and deficit estimates varied by up to 300000 depending on the assumptions made by the study authors. These data provide an example of three principles from chaos theory that may explain the variances seen. Chaos theory is used in the study of a wide variety of phenomena, including the natural sciences (physics, chemistry, biology, and the like) and some of the social sciences (economics, political behavior). Briefly, chaos theory holds that many events that appear random are so because
Decreased endothelium-dependent hyperpolarization to acetylcholine in smooth muscle of the mesenteric artery of spontaneously hypertensive rats.
Authors: KFujii, MTominaga, SOhmori, KKobayashi, TKoga, YTakata, MFujishima
Journal: Circulation Research (1992)

The endothelium-dependent vascular relaxation to acetylcholine (ACh) in spontaneously hypertensive rats (SHR) may be impaired because of an imbalance of endothelium-derived relaxing factor and contracting factor. However, the role of the endothelium-dependent hyperpolarization remains undetermined. We examined the ACh-induced hyperpolarization and its contribution to relaxation in arteries of SHR. Membrane potentials were recorded from the mesenteric artery trunk of 6-8-month-old male SHR and also Wistar-Kyoto (WKY) rats. Endothelium-dependent hyperpolarization to ACh was unaffected by NG-nitro-L-arginine, indomethacin, or glibenclamide; was reduced by tetraethylammonium or high K+ solution; and was enhanced by low K+ solution or methylene blue, thereby indicating that hyperpolarization is not mediated by nitric oxide (endothelium-derived relaxing factor) but is presumably mediated by a hyperpolarizing factor and is due to an opening of K+ channels that probably differ from the ATP-sensitive ones. Hyperpo...
Effect of physical training on calcium transport by rat cardiac sarcoplasmic reticulum.
Authors: SPenpargkul, D IRepke, A MKatz, JScheuer
Journal: Circulation Research (1977)

Cardiac microsomes enriched in fragmented sarcoplasmic reticulum (SR) were isolated from hearts of physically trained rats and were compared to those from sedentary rats. Preparations from conditioned rats were found to transport calcium to a greater extent than those from sedentary rats both in the absence and in the presence of 1 mM oxalate. Higher oxalate concentrations abolished the differences in calcium accumulation by cardiac microsomes from conditioned and sedentary rats and indicated a qualitative change in SR from conditioned hearts. We conclude that the increased transport by SR from hearts of conditioned rats may provide one mechanism for enhanced contractile reserve in these hearts.
Concealed intraventricular conduction in the His bundle electrogram.
Authors: H CCohen, ID'Cruz, APick
Journal: Circulation (1976)

Multiple areas of concealed intraventricular conduction are deduced on the basis of aftereffects observed in His bundle recordings. Electrocardiograms and His bundle recordings are presented from two patients with unstable bilateral bundle branch block, the instability of which depended on the interval at which ventricular depolarization was initiated by sinus or paced impulses. This circumstance allows postulation of 1) concealed transseptal retrograde penetration of the left bundle branch system; 2) concealed transseptal retrograde penetration of the right bundle branch system; 3) alternate beat Wenckebach phenomenon with two areas of block in the bundle branch system with concealed penetration of the proximal area; 4) concealed re-entry in the right bundle branch system during an H-V Wenckebach cycle with resetting of the sequence of 2:1 H-V block and return of the re-entry wave to the A-V node causing subsequent A-H block; 5) proximal 2:1 block and distal Wenckebach block producing only two consecutiv...
Endoscopic Diagnosis of Helicobacter Pylori Infection by the Arrangement of Collecting Venules in Patients Treated with Proton Pump Inhibitors: A Multicenter Validation trial in european Population
Authors: R Garcés-Duran, M Galdin-Ferreyra, P Delgado-Guillena, M Cuatrecasas, H Córdova, A García-Rodríguez, MT Rodrigo Calvo, M Jimeno, I Araujo, A Ginès, J Llach, G Fernández-Esparrach
Journal: Endoscopy (2021)

Aims Regular arrangement of collecting venules (RAC) in gastric mucosa accurately identifies patients without Helicobacter pylori (H pylori) infection. The aim of our study was to evaluate the value of RAC in patients under proton pump inhibitors (PPIs) and the reproducibility in a European country.
Impaired inotropic responses to alpha-adrenergic stimulation in experimental left ventricular hypertrophy.
Authors: F MFouad, KShimamatsu, M MHanna, P AKhairallah, R CTarazi
Journal: Circulation (1985)

We have previously reported that left ventricular hypertrophy in two-kidney, one-clip renal hypertensive rats (2K-1C RHRs) was associated with diminished inotropic responsiveness to isoproterenol and glucagon, suggesting an alteration in the receptor-adenylate cyclase cascade. The present study was performed to investigate the hypothesis that in these same hearts, inotropic responses to alpha-adrenergic stimuli could be enhanced as a compensatory mechanism. alpha-Adrenergic stimulation was achieved by graded phenylephrine infusion (1.02 to 41.2 microM/min) in the presence of propranolol (10(-7) M). The inotropic response was evaluated in the isovolumetric isolated rat heart (Langendorff preparation) paced at 260 beats/min. Results showed a significantly reduced inotropic response to alpha 1-adrenergic stimulation in 2K-1C RHR hearts irrespective of perfusion pressure (50 or 80 mm Hg [PP50 or PP80]) (+427.5 +/- 62.1 vs +1236 +/- 216.4 mm Hg X sec-1 at PP50, p less than .01 and +339 +/- 98.3 vs +1440 +/- 25...
Comparison Of Assessment Tools in Acute Upper Gastrointestinal Bleeding: which one for Which Decision
Authors: R Marmo, M Soncini, C Bucci, A Zullo
Journal: Endoscopy (2021)

Aims Upper GI bleeding (UGIB) remains a common emergency with significant mortality. Scores help in triaging patients, but which score should be used in the different decision moment to identify patients at high or low death risk remains unclear. We aimed to compare the overall performances of the more validated scores and their cut off performances in different time-point. Secondary outcomes were to compare the scores’ performance for predicting the need for therapeutic endoscopy, transfusion(s), rebleeding and surgery/interventional radiology.
Isolated atrial septal defect with pulmonary vascular obstructive disease--long-term follow-up and prediction of outcome after surgical correction.
Authors: P MSteele, VFuster, MCohen, D GRitter, D CMcGoon
Journal: Circulation (1987)

We examined the cases of 702 patients found to have isolated atrial septal defect of the secundum or sinus venosus type at catheterization from 1953 to 1978. Forty patients (6%), 34 women and six men, had pulmonary vascular obstructive disease, with a total pulmonary resistance greater than 7 U/m2; of these patients 26 (mean age 47 years) underwent surgical closure and 14 (mean age 44 years) received medical treatment. All patients were followed for at least 4 years, with a median follow-up of 12 years. At the most recent follow-up, 17 of the 40 patients were dead. Of the 22 surgically treated patients with total pulmonary resistance less than 15 U/m2, 19 were alive with significant regression of symptoms. All four surgically treated patients with total pulmonary resistance greater than or equal to 15 U/m2 were dead. Of the five medically treated patients with total pulmonary resistance less than 15 U/m2, four had died, and one was alive with significant progression of symptoms. Of the nine medically trea...
Kallikrein messenger RNA in rat arteries and veins.
Authors: G MSaed, O ACarretero, R JMacDonald, A GScicli
Journal: Circulation Research (1990)

Glandular kallikrein (EC 3.4.21.8) belongs to a subgroup of serine proteases coded by a multigene family. A kininogenase resembling glandular kallikrein has been identified in vascular tissue; however, it is not clear whether it is synthesized by vascular tissue or taken up from plasma. To determine the potential for kallikrein synthesis in vascular tissues, we tested whether messenger RNA (mRNA) for glandular kallikrein is present in rat arteries and veins. Poly(A+) RNA was isolated from pools of arteries or veins (n = 3, 30 rats each). Poly(A+) RNA from the kidney and liver was used as a positive and negative control, respectively. As a probe, we used rat pancreatic kallikrein 32P-labeled complementary DNA, which recognizes mRNA of the entire rat kallikrein family. Slot-blot analysis indicated that kallikrein mRNA was present in mRNA from the arteries, veins, and kidney but not from the liver. Poly(A+) RNA from arteries and veins contained approximately 1% as much kallikrein mRNA as that from the kidney...
Systemic Mastocytosis the Great Mimicker - a Rare Haematological Neoplasm Presenting With Diarrhoea, Anaphylaxis and Rash
Authors: TL Muller, K Van Der Merwe, A Said, C Steele, D Crosnoi, M Papanikolaou, G O’Dowd, V Parihar
Journal: Endoscopy (2021)

Aims: Background Eosinophilic Gastrointestinal Disorders (EGIDs) cause gastrointestinal symptoms with eosinophilia (biochemically and histologically). A history of anaphylaxis raises suspicion that Systemic Mastocytosis (SM) is the rare yet highly likely differential. In these rare cases, serum tryptase levels with tissue staining for c-kit (histological marker of mast cells) confirms the diagnosis since mast cells/eosinophils are indistinguishable on routine histological stains. SM, a haematological neoplasm characterized by accumulation of clonal mast cells in systemic tissues, causes debilitating symptoms.
Modulation of drug effects by regional sympathetic denervation and supersensitivity.
Authors: M SStanton, D PZipes
Journal: Circulation (1991)

BACKGROUNDRegional sympathetic denervation, such as that produced by a myocardial infarction, causes electrophysiological heterogeneity in the ventricles. The purpose of this study was to test the hypothesis that such denervation could cause drugs to exert heterogeneous myocardial effects.METHODS AND RESULTSSympathetic stimulation increases the amplitude of cesium chloride-induced early afterdepolarizations (EADs). The amplitude of these induced EADs was used to determine whether drug responses were different in innervated versus denervated areas of the heart. A canine model of sympathetic denervation was created at the cardiac apex by either transmural myocardial infarction (n = 19) or phenol application (n = 11). Cesium chloride (84 mg/kg) was infused while monophasic action potential recordings were simultaneously obtained from the base and apex of the left ventricle using an epicardial contact electrode. We found that control (innervated) dogs (n = 17) showed no difference in the EAD amplitude recorde...
Primary T wave abnormalities caused by uniform and regional shortening of ventricular monophasic action potential in dog.
Authors: GAutenrieth, BSurawicz, C SKuo, MArita
Journal: Circulation (1975)

We correlated primary T wave changes with the changes of monophasic action potentials (MAP) recorded with suction electrodes from the ventricular surface of the dog heart following systemic or intracoronary infusions of small doses of isoproterenol (ISP). The portions of the heart perfused with ISP were excised and weighed to determine the mass of perfused tissue. ISP shortened the ventricular MAP by an average of 12-18 msec in the entire ventricular mass following systemic administration, in 34 plus or minus 6 per cent of the ventricular mass after injection into the left circumflex coronary artery (LCA), in 8.5 plus or minus 2.6% of the ventricular mass after injection into a branch of LCA and in 17 plus or minus 8 per cent of the ventricular mass after injection into the right CA. The MAP changes induced by ISP were similar to the transmembrane action potential changes recorded with microelectrodes from papillary muscles excised from the same dogs. The most important results of this study showed that: ...
Study of Diagnostic Accuracy of Fecal Immunochemical Test for Colorectal Cancer Screening
Authors: SS Lin, N Ni, MM Aung, TH Oo, WPP Myint, M Htun, KLA Hmu, N Lin, K Sithu, NN Aung, PS Aye, TMM Win
Journal: Endoscopy (2021)

Methods It was a cross-sectional descriptive study. 305 healthy volunteers who fulfilled the selection criteria were enrolled and the study was performed at Mandalay General Hospital, Myanmar from January 2018 to June 2019. Qualitative FIT was tested for one time. Colonoscopy was done to all cases on the scheduled date .Data were entered into Microsoft Office Excel 2007 software and data analysis was done by Stata13 software.
Fibrin formation and platelet aggregation in patients with severe coronary artery disease: relationship with the degree of myocardial ischemia.
Authors: AGallino, AHaeberli, H RBaur, P WStraub
Journal: Circulation (1985)

Fibrinopeptide A (FpA) concentrations in plasma and in 24 hr urine specimens as well as beta-thromboglobulin (BTG) in plasma were measured in 17 patients with severe angina pectoris, including both stable and unstable angina, and in 19 patients with acute myocardial infarction. Patients with unstable angina had plasma FpA and BTG levels of 5.2 +/- 1.7 ng/ml and 91 +/- 23 ng/ml, respectively. The corresponding concentrations of FpA in the 24 hr urine specimens were 8.2 +/- 1.4 micrograms/24 hr. These values were similar to those measured in patients with acute myocardial infarction and higher than the corresponding levels in patients with stable angina (p less than .05) and in normal control subjects (p less than .01). The similarity of the platelet and coagulation findings in patients with unstable angina and in those with myocardial infarction favors the hypothesis that coronary thrombosis may play a major role in the pathogenesis of acute myocardial infarction.
Endoscopic Submucosal Dissection For Coalescent Polyps In The Anal Transitional Zone After Restorative Proctocolectomy And Ileal-Pouch Anal Anastomosis In A Patient With Familial Adenomatous Polyposis
Authors: C O’Neill, P Barreiro, R Mendo, C Félix, T Santos, C Chagas
Journal: Endoscopy (2021)

48-years-old male with familial adenomatous polyposis(FAP), underwent proctocolectomy and ileal-pouch-anal-anastomosis(RPC-IPAA) in 2004. He presented with rectal bleeding. Endoscopy showed multiple coalescent polyps occupying the anal transitional zone and anastomosis. ESD revealed severe fibrosis, surgical clips at the anastomosis, some of which were removed. En-bloc complete excision of the remaining rectal mucosa was achieved.