tbuckley/cabot-search huggingface dataset:
Oral hydralazine therapy for chronic refractory heart failure.
Authors: KChatterjee, W WParmley, BMassie, BGreenberg, JWerner, SKlausner, ANorman
Journal: Circulation (1976)

The hemodynamic effects of oral hydralazine were investigated in ten patients (nine in NYHA Class IV and one in Class III) with chronic refractory heart failure. With hemodynamic monitoring, adequate oral doses of hydralazine (50 or 75 mg) were determined and then administered every six hours. Hemodynamics were determined at 2-3, 6-8 and 24 hours on hydralazine therapy. Arterial pressure decreased slightly (5%) and systemic vascular resistance decreased significantly (42%). Cardiac and stroke volume index increased by 70 and 66%, respectively, without any significant change in heart rate, pulmonary capillary wedge or right atrial pressure. Hemodynamic improvement was associated with clinical improvement without a major complication. During the follow-up period of 3-7 months, seven of nine patients were in NYHA Class II and one in Class III. One other patient died suddenly six weeks after discharge. These findings suggest that hydralazine in an effective oral vasodilator for the treatment of refractory hea...
Abstract 14827: Risk of Venous Thromboembolism in Hospitalized COVID-19 Patients Undergoing Thromboprophylaxis: Meta-analysis of Cohort Studies
Authors: Adeel Jamil, Umer Jamil, Suraj Dahal, Vamsikrishna Gunnam, Homa Najafi, Sahar Memar Montazerin, Fahimehalsadat Shojaei, Farima Kahe, Jolanta Marszalek, Jane Lee, Gerald Chi
Journal: Circulation (2020)

Introduction: Preliminary evidence indicates that prophylactic-dosing thromboprophylaxis may be inadequate to control the increased risk of venous thromboembolism (VTE) in coronavirus disease 2019 (COVID-19) patients, and the usefulness of D-dimer measurement as a biomarker for VTE risk classification in this setting remains unclear. The study aimed to estimate the incidence of VTE and examine the difference in D-dimer levels among anticoagulated COVID-19 patients with and without VTE incident. Methods: This study was conducted in accordance with the PRISMA guidelines, and the protocol was registered in PROSPERO (Registration Number: CRD42020189192). A comprehensive literature search of PubMed from inception to May 2020 was performed to harvest original studies that reported the frequency of VTE and death among COVID-19 patients who received thromboprophylaxis on hospitalization. The endpoints included VTE (a composite of pulmonary embolism [PE] or deep vein thrombosis [DVT]), PE, DVT, and mortality. Results: A total of 11 cohort studies were included. Among hospitalized COVID-19 patients, 23.9% (95% confidence interval [CI], 16.2% to 33.7%) developed VTE despite anticoagulation. PE and DVT were detected in 11.6% (95% CI, 7.5% to 17.5%) and 11.9% (95% CI, 6.3% to 21.3%) of patients, respectively. Patients in the intensive care unit had a higher risk for VTE (30.4% [95% CI, 19.6% to 43.9%]) than those in the ward (13.0% [95% CI, 5.9% to 26.3%]). The mortality was estimated at 21.3% (95% CI, 17.0% to 26.4%). COVID-19 patients who developed VTE had higher D-dimer levels than those who did not develop VTE (mean difference, 2.05 μg/mL; 95% CI, 0.30 to 3.80 μg/mL; P=0.02). Conclusions: Heightened risk of VTE in COVID-19 despite prophylactic anticoagulation calls into research on optimal thromboprophylaxis and risk stratification. Prominent elevation of D-dimer may be associated with VTE development and can be used to identify high-risk subsets.
Julian Leff: innovator in the treatment of schizophrenia
Authors: John Illman
Journal: BMJ (2021)

If anyone was born to be a radical, it was the polymath Julian Leff, one of the most creative psychiatrists of his generation, and a pioneer in the treatment of schizophrenia and in the development of social and cultural psychiatry. (He also studied silk screening, ceramics, sculpture, and silver smithing.)

His communist father, Sam, was one of the NHS founders and author of The Health of the People (1950) and The School Health Service (1959). His mother, also a communist, the novelist Vera Levy, was one of the three founder members of the Campaign for Nuclear Disarmament. Her books include Going Our Way (1945) a romantic novel about the Socialist Medical Association.

Sam and Vera met on the Jarrow March in 1936 when some 200 hungry, foot sore men in their Sunday best walked some 300 miles from the north east to Hyde Park, London, to highlight the misery of poverty, overcrowding, poor housing, and high mortality.

Born above his father’s surgery in Archway, north London, near where Dick Whittington was urged to turn again, Leff inherited from his parents a deep rooted conviction about the fundamental importance of family and environment on mental …
Chronic aortic regurgitation: reassessment of the prognostic value of preoperative left ventricular end-systolic dimension and fractional shortening.
Authors: W GDaniel, W PHood, ASiart, DHausmann, UNellessen, HOelert, P RLichtlen
Journal: Circulation (1985)

The prognostic significance of a preoperative echocardiographic left ventricular end-systolic dimension (ESD) greater than 55 mm and/or fractional shortening (FS) of 25% or less was evaluated retrospectively in 84 patients who had undergone aortic valve replacement for isolated chronic aortic regurgitation due to various causes. Postoperative survival, improvement in symptoms, and echocardiographic evidence of regression of left ventricular dilatation and hypertrophy were compared between patients with a preoperative ESD greater than 55 mm (category 1) and those with an ESD of 55 mm or less (category 2) and between patients with FS of 25% or less (category 3) and those with FS greater than 25% (category 4). Patients in categories 1 and 3 had a higher preoperative left ventricular end-diastolic dimension (EDD) and cross-sectional area than those in categories 2 and 4, respectively, but their preoperative functional impairment (NYHA class) was similar. There were 13 deaths, only two of which (one early, one...
Troponin I isoform expression in human heart.
Authors: N MHunkeler, JKullman, A MMurphy
Journal: Circulation Research (1991)

Troponin I is the inhibitory component of troponin, the thin filament regulatory complex in striated muscle. Separate genes encode cardiac-specific fast and slow skeletal-specific isoforms of this protein. We have previously described gene switching from the slow skeletal to the cardiac troponin I mRNA expression in developing rat heart. The purpose of this work was to characterize the expression of the different troponin isoforms in the human heart. Human cardiac and slow skeletal troponin I cDNA probes were obtained by screening an adult cardiac cDNA library and by Taq polymerase amplification of RNA from an infant's heart, respectively. We found that the cardiac troponin I isoform is tissue-specific in its expression in normal adult tissues. RNA blot analysis of cardiac ventricular RNA from infants with congenital heart disease and from an adult with cardiomyopathy revealed expression of human cardiac troponin I in all analyzed specimens. In addition, we found expression of slow skeletal troponin I mRN...
Adopting a “Compound” Exposome Approach in Environmental Aging Biomarker Research: A Call to Action for Advancing Racial Health Equity
Authors: Jamaji C. Nwanaji-Enwerem, Chandra L. Jackson, Mary Ann Ottinger, Andres Cardenas, Katherine A. James, Kristen M.C. Malecki, Jiu-Chiuan Chen, Andrew M. Geller, Uchechi A. Mitchell
Journal: Environmental Health Perspectives (2021)

In June 2020, the National Academies of Sciences, Engineering, and Medicine hosted a virtual workshop focused on integrating the science of aging and environmental health research. The concurrent COVID-19 pandemic and national attention on racism exposed shortcomings in the environmental research field's conceptualization and methodological use of race, which have subsequently hindered the ability of research to address racial health disparities. By the workshop's conclusion, the authors deduced that the utility of environmental aging biomarkers-aging biomarkers shown to be specifically influenced by environmental exposures-would be greatly diminished if these biomarkers are developed absent of considerations of broader societal factors-like structural racism-that impinge on racial health equity.
Prognostic factors in leptomeningeal metastases
Authors: Emilie Le Rhun, Patrick Devos, Johannes Weller, Katharina Seystahl, Francesca Mo, Anette Compter, Anna S Berghoff, Joost L M Jongen, Fabian Wolpert, Roberta Rudà, Dieta Brandsma, Martin van den Bent, Matthias Preusser, Ulrich Herrlinger, Michael Weller
Journal: Neuro-Oncology (2021)
Influence of lovastatin plus gemfibrozil on plasma lipids and lipoproteins in patients with heterozygous familial hypercholesterolemia.
Authors: D RIllingworth, SBacon
Journal: Circulation (1989)

We investigated the hypocholesterolemic effects of lovastatin alone and in combination with gemfibrozil on plasma lipids and lipoproteins in 12 adult patients with well-characterized heterozygous familial hypercholesterolemia. Plasma concentrations of low density lipoprotein (LDL) cholesterol decreased from 321 +/- 14 mg/dl on diet only to 207 +/- 8 mg/dl (-35.5%) on single-drug therapy with lovastatin at a dose of 40 mg twice daily, whereas triglyceride concentrations fell by 27.6% (from 145 +/- 20 to 105 +/- 20 mg/dl). Subsequent addition of gemfibrozil at a dose of 600 mg twice daily resulted in a nonsignificant further reduction in LDL cholesterol to 194 +/- 7 mg/dl (-39.6% change from baseline), whereas triglycerides decreased to 80 mg/dl (-44.8%, p less than 0.05 vs. single-drug therapy with lovastatin). Plasma concentrations of high density lipoprotein (HDL) increased slightly during lovastatin and combined drug therapy (from 45 +/- 4 mg/dl at baseline to 46 +/- 4 mg/dl on lovastatin to 48 +/- 4 mg...
Treatment of depression in primary care.
Authors: E. S. Paykel, P. Freeling
Journal: BMJ (1992)

and, frequently, by severe symptoms.Their uncertainty is not alleviated by prolonged investigations that delay palliation and generally fail to answer their questions about the origin of the tumour and the prognosis.Patients deserve prompt palliation, appropriate investigation, and adequate support and counselling through what is too often a terminal illness.
Electrotonic interaction during canine ventricular repolarization.
Authors: HToyoshima, M JBurgess
Journal: Circulation Research (1978)

Canine ventricular refractory periods were measured during test site drive, during drive of single ectopic sites, during fusion drive from two ectopic sites, and during fusion drive from an ectopic site and the test site. Refractory period duration was dependent on the driving modes employed. Refractory periods were 2.63 +/- 0.73%, 3.42 +/- 0.87%, 3.54 +/- 100%, and 4.68 +/- 1.36% (mean +/- SD) shorter during drive of single ectopic sites 2, 4, 6, and 40-60 mm, respectively, from the test site than during test site drive. During fusion drive from two ectopic sites, refractory periods were an average of 2.44 +/- 1.04 msec (mean +/- SD) less than during drive from a single ectopic site (P less than 0.005). When fusion of activation, induced by ectopic and test site drive, was located within 4 mm or less of the test site, refractory periods during fusion drive were also significantly shorter than during test site drive (P less than 0.05). Refractory periods were as much as 10 msec shorter when fusion occurre...
First-Episode Schizophrenia and Diabetes Risk—Reply
Authors: Toby Pillinger, Katherine Beck, Oliver Howes
Journal: JAMA Psychiatry (2017)

In Reply We thank Bortolasci, Mangurian, and Cui and their respective colleagues for their comments on our article.1 Both type 2 diabetes and schizophrenia have complex pathoetiologies with genetic and environmental roots, and their letters reflect this.
Influence of aortic insufficiency on the hemodynamic significance of a coronary artery narrowing.
Authors: R LFeldman, W WNichols, C JPepine, C RConti
Journal: Circulation (1979)

The coronary hemodynamic effects of controlled aortic insufficiency (AI) were studied in 10 dogs. Coronary blood flow (CBF), before and during reactive hyperemia (RH) with graded coronary diameter narrowings (CN), aortic (Ao) and left ventricular (LV) pressures (P), and aortic blood flow (AoF) were recorded. Opening an adjustable basket catheter, positioned across the aortic valve, created reversible AI quantitated from phasic AoF. AI was regulated so that mean CBF was similar with or without AI. During AI, heart rate and systolic AoP were unchanged, but diastolic AoP declined 14 mm Hg (mean) and end-diastolic LVP increased 8 mm Hg, both p less than 0.05. With CN greater than or equal to 85%, mean CBF decreased with or without AI. Coronary resistance was similar with or without AI. During AI with no CN, peak RH CBF declined significantly and was similar to peak RH with 70% CN without AI. Furthermore, AI with 60% CN caused additional reduction in peak RH and was similar to peak RH with 80% CN without AI. T...
Altered norepinephrine turnover and metabolism in diabetic cardiomyopathy.
Authors: P KGanguly, K SDhalla, I RInnes, R EBeamish, N SDhalla
Journal: Circulation Research (1986)

Cardiac norepinephrine turnover and metabolism were examined in rats 8 weeks after the induction of chronic diabetes by an intravenous injection of streptozotocin (65 mg/kg). Cardiac norepinephrine concentration, norepinephrine turnover, and norepinephrine uptake were markedly increased in chronic diabetes in comparison with control values; these changes were reversible by 28-day insulin therapy. When the animals were exposed to cold for 6 hours, norepinephrine turnover rate constant increased in control and decreased in diabetic animals; cold exposure also increased norepinephrine concentration in diabetic hearts. Both cardiac norepinephrine concentration and turnover rate in diabetic rats were restored toward control values by ganglionic blockade with pentolinium. The conversion of [3H]tyrosine to [3H]catecholamine was enhanced and tyrosine hydroxylase as well as dopa decarboxylase activities were increased in diabetic hearts. The higher concentrations of [3H]normetanephrine and deaminated catechols ind...
Echocardiographic recognition and implications of ventricular hypertrophic trabeculations and aberrant bands.
Authors: AKeren, M EBillingham, R LPopp
Journal: Circulation (1984)

The accuracy of two-dimensional echocardiography in the recognition of aberrant ventricular bands and pathologic trabeculations (hypertrophic, fibrotic, or both) was assessed in 35 patients who underwent cardiac transplantation and pathologic examination. At pathologic study the prevalence of specific intracavitary structures ranged from 28% to 43%. Left ventricular thrombi were found in 12 patients (34%) and right ventricular thrombi in three (9%). Echocardiography accurately defined left ventricular aberrant bands and left ventricular thickened or fibrotic trabeculations. Bands, trabeculations, and thrombi each showed characteristic echocardiographic patterns. In the right ventricle, these structures were recognized, but accurate discrimination among them was not possible by echocardiography. Aberrant bands and pathologic trabeculations mimicked or obscured fresh or organized thrombi in three patients on two-dimensional echocardiography. Left ventricular longitudinal bands and pathologic right ventricul...
Day-to-day variations in inducibility of ventricular tachyarrhythmias during the late postmyocardial infarction phase in conscious dogs.
Authors: S MCobbe, EHoffmann, ARitzenhoff, JBrachmann, WKübler, JSenges
Journal: Circulation (1985)

The inducibility of ventricular tachyarrhythmias was studied daily on days 3 through 8 after experimental myocardial infarction in 15 conscious dogs. Although a sustained ventricular tachyarrhythmia was produced on one or more occasions in 11 of 15 dogs (73%), there was marked daily variation in the results of programmed stimulation. Ventricular fibrillation or sustained ventricular tachycardia was elicited in six dogs on day 3 after infarction. In two of these dogs, no sustained tachycardia could be induced by day 7. In nine dogs sustained ventricular arrhythmias were not inducible on day 3. By day 6 to 7, sustained ventricular tachycardia was inducible in five of these dogs. In clinical practice similar variation in the inducibility of sustained ventricular arrhythmias may conceivably complicate the use of results of programmed ventricular stimulation as determinants of risk of sudden death after myocardial infarction.
Contribution of myocardium responsible for ventricular tachycardia to abnormalities detected by analysis of signal-averaged ECGs.
Authors: M AHood, S MPogwizd, JPeirick, M ECain
Journal: Circulation (1992)

BACKGROUNDCurrent methods of signal-averaged ECG analysis interrogate the terminal 40 msec of the QRS complex and/or the ST segment and have a low positive-predictive accuracy for detecting vulnerability to sustained ventricular tachycardia (VT). The extent to which abnormalities detected during these ECG intervals are generated by myocardial tissue responsible for VT has not been well defined. The purpose of this study was to determine when, during sinus rhythm, myocardium responsible for VT is activated.METHODS AND RESULTSThree-dimensional ventricular activation maps were analyzed during sinus rhythm and during 10 VTs in eight patients with healed myocardial infarctions undergoing arrhythmia surgery for sustained monomorphic VT. The mechanism of VT was focal in five instances and macroreentrant in five. During sinus beats, myocardium responsible for all focal VTs activated 43 +/- 38 msec before the onset of the terminal 40-msec interval of the QRS complex. During sinus rhythm, activation of the myocardi...
Coronary bypass graft fate: angiographic grading of 1400 consecutive grafts early after operation and of 1132 after one year.
Authors: G MFitzGibbon, J RBurton, A JLeach
Journal: Circulation (1978)

All 1400 coronary bypass grafts, in 409 survivors of 414 patients undergoing 440 consecutive bypass operations, were selectively opacified in multiplane cineangiograms prior to hospital discharge and 1132 (81%) were restudied at one year. Grafts were graded A (excellent), B (fair) or O (occluded) by separate assessment of proximal and distal anastomoses and bypass trunks. In early graft studies 89% were patent (A and B), 79% graded A; at one year, 81% were patent, 74% graded A. Circumflex-marginal grafts fared less well early, but similarly late, compared with other grafts. Of all grafts graded B early, 37% became A, 39% remained B and 24% were occluded at one year; 90% of early graded A grafts remained so, 4% became B and 6% occluded; the grading system seems to have had useful predictive value. Distal anastomosis defects dictated early B grading in 81.3% of cases, trunk defects in 12.5% and proximal anastomosis defects in 2.7%. Trunk defects carried a worse prognosis for occlusion than did distal anasto...
Alasdair Cameron Macdonald
Authors: A J Macdonald
Journal: BMJ (2003)

Former consultant physician and psychotherapist Glasgow (b Argyll 1916; q Glasgow 1939; VRD, FRCP Glas, FRCP), d 6 November 2003.​2003.




Figure 1




In 1941 Alasdair Cameron Macdonald joined the Royal Marines and served on escort vessels in the north Atlantic. He was the first doctor in the Royal Navy to qualify as a watch-keeping officer. Thereafter he was engaged in research at the Royal Air Force Institute of Aviation Medicine, developing ejector seats and related safety equipment. He returned to Glasgow after the war and became a consultant physician in 1953. He was interested in the emotional aspects of physical disorders, and in 1992 he published Could It Be Stress?: Reflections on Psychosomatic Disorders. He leaves a wife; three children; and seven grandchildren.
Beneficial effects of hydralazine in severe mitral regurgitation.
Authors: B HGreenberg, B MMassie, B HBrundage, E HBotvinick, W WParmley, KChatterjee
Journal: Circulation (1978)

The severity of mitral regurgitation is, in part, determined by aortic impedance to left ventricular outflow. Sodium nitroprusside acutely decreases regurgitant flow, but the importance of its dual vasodilating effects, the lowering of peripheral vascular resistance and increasing of venous capacitance, is unclear. We studied the hemodynamic response to intravenous hydralazine, which selectively acts on the arteriolar resistance bed, in 10 patients with severe mitral regurgitation. Hydralazine produced a 50% increase in forward stroke volume (22 +/- 2 to 33 +/- 3 ml/m2, P less than 0.001) and a 33% reduction in regurgitant stroke volume (40 +/- 6 to 27 +/- 6 ml/m2, P less than 0.001), with a resultant fall in pulmonary capillary wedge v wave and mean pressures. Unlike nitroprusside, it did not alter left ventricular end-diastolic volume or pressure. Oral hydralazine maintained this hemodynamic improvement for at least 48 hours and, in three patients, provided more sustained clinical improvement. We conclu...
Role of shear stress and endothelial prostaglandins in flow- and viscosity-induced dilation of arterioles in vitro.
Authors: AKoller, DSun, GKaley
Journal: Circulation Research (1993)

We have studied the effect of changes in shear stress on diameter of isolated arterioles of rat cremaster muscle. The steady-state active diameter of arterioles at a constant perfusion pressure (60 mm Hg) was 80 +/- 1.2 microns. The vessels' passive diameter (Ca(2+)-free solution) was 156 +/- 1.8 microns. Changes in shear stress were induced either by an increase in flow (velocity) or by an increase in viscosity of the perfusion solution. At a constant perfusion pressure, the stepwise increase in perfusion flow (0-80 microliters/min in 10-microliters/min steps) elicited, with a delay of approximately 20 seconds, a gradual increase in diameter up to 46%. At a constant 20-microliters/min flow rate, increases in viscosity of the perfusate (2%, 4%, and 6% dextran [molecular weight, 77,800]) caused a gradual vasodilation up to 22%. Varying flow and viscosity of the perfusate simultaneously resulted in an upward shift of the flow-diameter curve. Both flow- and viscosity-induced dilations were eliminated by the ...
An Approach to Examining Tightly Coiled Hair Among Patients With Hair Loss in Race-Discordant Patient-Physician Interactions
Authors: Ciara Grayson, Candrice Heath
Journal: JAMA Dermatology (2021)

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