tbuckley/cabot-search huggingface dataset:
Complete interruption of the aortic arch. 2. Characteristic angiographic features with emphasis on collateral circulation to the descending aorta.
Authors: R BJaffe
Journal: Circulation (1976)

The angiocardiograms of 17 patients with aortic arch interruption are reviewed to emphasize the variations in arch interruption and origin of the brachiocephalic vessels, and collateral circulation to the descending aorta. Depending on the anatomical type and subtype of arch interruption, collateral flow to the descending aorta in the presence of a stenotic or closed ductus will be dependent on the development of intercostal collaterals and/or the presence of retrograde flow in all brachiocephalic vessels arising from the descending aorta. Familiarity with the potential pathways for collateral circulation may permit differentiation into types and subtypes on chest radiograph. Patients with Type I interruption may have bilateral rib notching if the right subclavian artery originates normally from the innominate artery, but will have rib notching confined to the left side if the origin of the right subclavian artery is aberrant. Type II or Type III interruption patients will have rib notching confined to th...
It's Almost Over— More Letters on Debbie
Authors: Aaron Spital
Journal: JAMA (1988)

To the Editor.—  According to Lundberg, 1 It's Over, Debbie 2 was published to stimulate thought and discussion about euthanasia. The resultant letters 3 and commentaries 4,5 show that this purpose has been served. But as if the euthanasia question was not complicated enough, the responses by some members of the medical profession, and several ethicists in particular, raise what is perhaps an even more troubling issue: the dogmatic approach often taken by physicians when their values differ from those of their patients. Some physicians seem unwilling or incapable of hearing the voices that echo around them.  The problem is exemplified in the COMMENTARY 'Doctors Must Not Kill,' 4 in which four renowned medical ethicists speak in certain and absolute terms, as if they know what's right and what's wrong. But how can they be so sure? As Lundberg points out, there is no science of ethics, no database, no
Do doctors have to have the covid-19 vaccine?
Authors: Abi Rimmer
Journal: BMJ (2021)

Do doctors have to have the covid-19 vaccine?Abi Rimmer asks four experts whether doctors must be vaccinated against covid-19 Abi RimmerWe have a duty to protect patients Vageesh Jain, public health specialty registrar, University College London, says, "As it stands, legally, you don't have to have a covid vaccine.But ethically, clinically, epidemiologically-whichever way you slice it-I would argue you do.
Identification of distinct phenotypic clusters in heart failure with preserved ejection fraction
Authors: Alicia Uijl, Gianluigi Savarese, Ilonca Vaartjes, Ulf Dahlström, Jasper J. Brugts, Gerard C.M. Linssen, Vanessa van Empel, Hans‐Peter Brunner‐La Rocca, Folkert W. Asselbergs, Lars H. Lund, Arno W. Hoes, Stefan Koudstaal
Journal: European Journal of Heart Failure (2021)

We aimed to derive and validate clinically useful clusters of patients with heart failure with preserved ejection fraction (HFpEF; left ventricular ejection fraction ≥50%).We derived a cluster model from 6909 HFpEF patients from the Swedish Heart Failure Registry (SwedeHF) and externally validated this in 2153 patients from the Chronic Heart Failure ESC-guideline based Cardiology practice Quality project (CHECK-HF) registry. In SwedeHF, the median age was 80 [interquartile range 72-86] years, 52% of patients were female and most frequent comorbidities were hypertension (82%), atrial fibrillation (68%), and ischaemic heart disease (48%). Latent class analysis identified five distinct clusters: cluster 1 (10% of patients) were young patients with a low comorbidity burden and the highest proportion of implantable devices; cluster 2 (30%) patients had atrial fibrillation, hypertension without diabetes; cluster 3 (25%) patients were the oldest with many cardiovascular comorbidities and hypertension; cluster 4 (15%) patients had obesity, diabetes and hypertension; and cluster 5 (20%) patients were older with ischaemic heart disease, hypertension and renal failure and were most frequently prescribed diuretics. The clusters were reproduced in the CHECK-HF cohort. Patients in cluster 1 had the best prognosis, while patients in clusters 3 and 5 had the worst age- and sex-adjusted prognosis.Five distinct clusters of HFpEF patients were identified that differed in clinical characteristics, heart failure drug therapy and prognosis. These results confirm the heterogeneity of HFpEF and form a basis for tailoring trial design to individualized drug therapy in HFpEF patients.
Cellular mechanism of the functional refractory period in ventricular muscle.
Authors: B MRamza, R CTan, TOsaka, R WJoyner
Journal: Circulation Research (1990)

A premature action potential elicited in ventricular muscle during the functional refractory period of a preceding action potential requires an increased stimulus intensity for successful propagation. We measured the cellular basis for these relative decreases in tissue excitability during the recovery phase by performing parallel experiments on rabbit left papillary muscle and isolated rabbit ventricular cells in addition to conducting theoretical studies with numerical simulations of action potential initiation. For each experimental preparation, the pacing protocol consisted of a train of 10 stimuli (S1) at an S1-S1 interval of 500 msec with a premature stimulus (S2) of variable S1-S2 intervals following the tenth S1 action potential. The stimulus threshold for initiation of an S2 action potential (I2) was then measured as a function of the time of occurrence of the S2 stimulus relative to the time of 95% repolarization of the tenth S1 action potential (stimulus delay [SD] time). In the tissue preparat...
Cortisone and Aspirin in Rheumatoid Arthritis
Authors: J. W. Todd
Journal: BMJ (1954)

<h3>Abstract</h3> The novel coronavirus (SARS-CoV-2/ 2019-nCoV) identified in December 2019 has caused great damage to public health and economy worldwide. Previous research has suggested an involvement of meteorological conditions in the spread of droplet-mediated viral diseases, such as influenza. However, as for the recent novel coronavirus, few studies have discussed systematically about the role of daily weather in the epidemic transmission of the virus. Here, we examine the relationships of meteorological variables with the severity of the outbreak on a worldwide scale. The confirmed case counts, which indicates the severity of COVID-19 spread, and four meteorological variables, i.e., air temperature, relative humidity, wind speed, and visibility, were collected daily between January 20 and March 11 (52 days) for 430 cities and districts all over China, 21 cities/ provinces in Italy, 21 cities/ provinces in Japan, and 51 other countries around the world. Four different time delays of weather (on the day, 3 days ago, 7 days ago, and 14 days ago) as to the epidemic situation were taken formodeling and we finally chose the weather two weeks ago to model against the daily epidemic situation as its correlated with the outbreak best. Taken Chinese cities as a discovery dataset, it was suggested that temperature, wind speed, and relative humidity combined together could best predict the epidemic situation. The meteorological model could well predict the outbreak around the world with a high correlation (<i>r</i><sup><i>2</i></sup> &gt; 0.6) with the real data. Using this model, we further predicted the possible epidemic situation in the future days for several high-latitude cities with potential outbreak. This model could provide more information for government’s future decisions on COVID-19 outbreak control.
Massive Cytoreduction Of Gastric Leiomyosarcoma Using Endoscopic Ultrasound Guided Radiofrequency Ablation (EUS-RFA)
Authors: F Junquera, S Machlab, A Lira, V Puig-Diví, E Martínez-Bauer, E Frisancho, L Hernández, P Pedregal, E Brullet, R Campo
Journal: Endoscopy (2021)

A woman with gastrointestinal bleeding from gastric leiomyosarcoma was evaluated. Gastroscopy showed a 3 cm polypoid eroded mass in the stomach. EUS revealed an hypoechogenic transmural lesion. The tumor was punctured under EUS guidance with a 19G RFA (radiofrequency) needle. During ablation, a hyperechogenic halo was visible, releasing 50W. Different punctures were performed using fanning technique until became entirely hyperechogenic. After two RFA sessions, a 5mm residual erosion was observed. EUS-RFA procedures were performed on an outpatient basis, without complications and with good tolerance.
Widespread and sustained target engagement in Huntington’s disease minipigs upon intrastriatal microRNA-based gene therapy
Authors: Astrid Vallès, Melvin M. Evers, Anouk Stam, Marina Sogorb-Gonzalez, Cynthia Brouwers, Carlos Vendrell-Tornero, Seyda Acar-Broekmans, Lieke Paerels, Jiri Klima, Bozena Bohuslavova, Roberta Pintauro, Valentina Fodale, Alberto Bresciani, Roman Liscak, Dusan Urgosik, Zdenek Starek, Michal Crha, Bas Blits, Harald Petry, Zdenka Ellederova, Jan Motlik, Sander van Deventer, Pavlina Konstantinova
Journal: Science Translational Medicine (2021)

Striatal delivery of microRNA-gene therapy results in widespread brain huntingtin protein lowering in Huntington’s disease minipigs up to 1 year.
Myocardial relaxation: effects of preload on the time course of isovolumetric relaxation.
Authors: W HGaasch, J DCarroll, A SBlaustein, O HBing
Journal: Circulation (1986)

We studied the effect of an isolated increase in preload on isovolumetric relaxation in the intact dog heart and isometric relaxation in isolated cardiac muscle (dog and rat) preparations. In eight anesthetized dogs, 8 to 12 ml of blood was infused into the left ventricle during a single diastole. The exponential time constant (T) of isovolumetric relaxation was measured in single-beat experiments in which the left ventricular systolic pressure increased (112 +/- 2 to 128 +/- 3 mm Hg; p less than .05, n = 62). In a second series of experiments, left ventricular systolic pressure was held constant (109 +/- 2 to 107 +/- 2 mm Hg; p = NS, n = 23) by simultaneous ventricular infusion and aortic unloading. In the first protocol, T increased from 28.0 +/- 0.4 to 30.7 +/- 0.4 msec (p less than .05), whereas in the second protocol (constant systolic pressure) there was no change in T. The time course of isometric relaxation was also studied in six rat left ventricular papillary muscles and four dog right ventricul...
T-Lymphocyte Subsets in Intravenous Drug Users With HIV-1 Infection
Authors: Warren Winkelstein
Journal: JAMA (1992)

<h3>To the Editor.</h3> —Recently, Margolick et al<sup>1</sup>reported on changes in CD4 and CD8 T-lymphocyte subsets in intravenous drug users (IVDUs). In their words, "The principal finding was the slow rate of decline in CD4 lymphocyte counts in HIV-1 [human immunodeficiency virus type 1] seropositive IVDUs over a 2.5-year period of observation." (Actual observation period was 18 months.) The authors assert that this finding contradicts "the common perception that HIV-1 infection in IVDUs leads to rapid decline in CD4 lymphocytes." Howev Follow-up, Acquired Immunodeficiency Syndrome (AIDS) Incidence, and Rates of Change in CD4<sup>+</sup>Lymphocyte Numbers in the San Giovanni Hospital Subcohort of the MPH Study, by CD4<sup>+</sup>Lymphocyte Level at Baseline* Baseline CD4 Level, Cells/μL Developed AIDS No. (%) Incidence† Median Follow-up, Semesters 1.16 Changes/6 mo Median Mean &lt;150 4(44) 34.36 -42.92 10.90 150-299 20 4(20) 2.08 2.42 6.25 23.80 26 6(23) 6.37 -15.31 450-599 45 6(13) 3.19 3.66 -29.79
Electrophysiologic characteristics of human ventricular and Purkinje fibers.
Authors: K HDangman, PDanilo, A JHordof, LMary-Rabine, R FReder, M RRosen
Journal: Circulation (1982)

We studied the electrophysiologic characteristics of ventricular muscle and Purkinje fibers from the hearts of five patients undergoing cardiac transplantation. All five patients had congestive failure and coronary artery disease before surgery and were receiving digitalis therapy. Ventricular muscle had a maximal diastolic potential (MDP) of -78 +/- 1 mV (mean +/- SEM), an action potential (AP) amplitude of 104 +/- 2 mV, a phase 0 upstroke velocity (Vmax) of 297 +/- 19 V/sec and an AP duration at 50% repolarization (APD50) of 190 +/- 4 msec. Purkinje fibers had an MDP of -80 +/- 2 mV, an AP amplitude of 107 +/- 2 mV, a Vmax of 388 +/- 25 V/sec and an APD50 of 195 +/- 9 msec. Fibers from infarcted sections of the heart had significantly longer APD than those from noninfarcted, which resulted in marked dispersion of APD in infarcted and adjacent zones. Both epinephrine and ouabain induced delayed after depolarizations in Purkinje fiber. This suggest that delayed after depolarizations and resultant triggere...
Mechanism of histamine actions in human coronary arteries.
Authors: NToda
Journal: Circulation Research (1987)

Helical strips of human coronary arteries contracted in response to histamine concentration dependently, they relaxed with low concentrations and contracted with high concentrations. Treatment with cimetidine potentiated contraction in the strips with intact and damaged endothelium to a similar extent and attenuated relaxation. Removal of endothelium abolished relaxation and potentiated contraction in the cimetidine-treated strips. Methylene blue increased the contractile response to histamine in the strips with endothelium but did not alter the response in the damaged-endothelium strips. Histamine-induced relaxations in the intact strips were suppressed or abolished by treatment with ETYA, AA861, a lipoxygenase inhibitor, and by chlorpheniramine but were unaffected by indomethacin. Chlorpheniramine also abolished amine-induced contraction. It may be concluded that histamine-induced contraction in human coronary arteries is mediated by H1 receptors in smooth muscle, and relaxation is mediated by H2 recept...
Advance prediction of transthoracic impedance in human defibrillation and cardioversion: importance of impedance in determining the success of low-energy shocks.
Authors: R EKerber, CKouba, JMartins, KKelly, RLow, RHoyt, DFerguson, LBailey, PBennett, FCharbonnier
Journal: Circulation (1984)

The purposes of this study were to evaluate a method that predicts transthoracic impedance in advance of defibrillating shocks in humans and to assess the importance of transthoracic impedance in low-energy defibrillation. Via defibrillator electrodes we applied 31 kHz current to the chest during the defibrillator charge cycle, before the defibrillating shock was actually delivered. The current flow was limited by transthoracic impedance; a microprocessor monitored the predischarge current flow and determined the predischarge impedance by calibration against known resistance values. Actual impedance to the defibrillating shock was also determined and compared with the predicted impedance. With this approach we predicted impedance in 19 patients who received 66 shocks for ventricular and atrial arrhythmias. Predicted impedance (y) correlated very well with actual impedance (x):y = .90x + 11.3; r = .97. To determine the importance of impedance in defibrillation and cardioversion, we prospectively gathered d...
Expanded Clinical Evaluation of Lovastatin (EXCEL) study results. Effect of patient characteristics on lovastatin-induced changes in plasma concentrations of lipids and lipoproteins.
Authors: C LShear, F AFranklin, SStinnett, D PHurley, R HBradford, A NChremos, D TNash, ALangendorfer
Journal: Circulation (1992)

BACKGROUNDLovastatin produces consistent dose-related reductions in plasma levels of low density lipoprotein (LDL) cholesterol along with variable decreases in triglycerides and increases in high density lipoprotein (HDL) cholesterol. Patient characteristics from the Expanded Clinical Evaluation of Lovastatin (EXCEL) study were examined to determine their association with the magnitude of lovastatin-induced changes in these lipids and lipoproteins.METHODS AND RESULTSAfter a baseline period consisting of dietary therapy, 8,245 patients with moderate hypercholesterolemia were randomized to five groups that received 48 weeks of treatment with either placebo or daily doses of lovastatin ranging from 20 to 80 mg. By use of linear statistical models, 20 different patient characteristics were examined for modification of the dose-dependent responses observed. For LDL cholesterol, the following were associated with enhanced lowering (p less than 0.05; percent changes are placebo-corrected, adjusted mean changes f...
Endothelium-dependent relaxation to aggregating platelets in isolated basilar arteries of control and hypercholesterolemic pigs.
Authors: HShimokawa, PKim, P MVanhoutte
Journal: Circulation Research (1988)

The role of the endothelium was examined in the response to aggregating platelets in cerebral arteries from normal and hypercholesterolemic animals. Male Yorkshire pigs were fed either a normal diet or a 2% high-cholesterol diet for 10 weeks. Endothelium-dependent responses were examined in vitro. In rings of basilar arteries from control animals aggregating platelets caused endothelium-dependent relaxations, which were significantly inhibited by apyrase, an adenosine diphosphatase and triphosphatase, but were augmented by methiothepin, a combined S1- and S2-serotonergic blocker. In quiescent rings platelets induced contractions that were inhibited by the presence of the endothelium; these contractions were significantly inhibited by methiothepin, but not by ketanserin (an S2-serotonergic blocker) or dazoxiben (a thromboxane-synthetase blocker) in the presence or absence of SQ29548 (a thromboxane-receptor blocker). Adenosine diphosphate but not serotonin caused endothelium-dependent relaxations. In choles...
Overlap of SEC23A and SEC23B Function Suggests a Novel Therapeutic Approach for Congenital Dyserythropoietic Anemia Type II
Authors: Rami Khoriaty, Angela Weyand, Geoffrey Hesketh, Amélie Bernard, Lesley Everett, Guojing Zhu, Beth McGee, Bin Zhang, Daniel Klionsky, Anne-Claude Gingras, Jordan A. Shavit, David Ginsburg
Journal: Blood (2017)
Comparative Effectiveness of Digital Breast Tomosynthesis for Breast Cancer Screening Among Women 40-64 Years Old
Authors: Ilana B Richman, Jessica B Long, Jessica R Hoag, Akhil Upneja, Regina Hooley, Xiao Xu, Natalia Kunst, Jenerius A Aminawung, Kelly A Kyanko, Susan H Busch, Cary P Gross
Journal: JNCI Journal of the National Cancer Institute (2021)

Abstract Background Digital breast tomosynthesis (DBT) may have a higher cancer detection rate and lower recall compared with 2-dimensional (2 D) mammography for breast cancer screening. The goal of this study was to evaluate screening outcomes with DBT in a real-world cohort and to characterize the population health impact of DBT as it is widely adopted. Methods This observational study evaluated breast cancer screening outcomes among women screened with 2 D mammography vs DBT. We used deidentified administrative data from a large private health insurer and included women aged 40-64 years screened between January 2015 and December 2017. Outcomes included recall, biopsy, and incident cancers detected. We used 2 complementary techniques: a patient-level analysis using multivariable logistic regression and an area-level analysis evaluating the relationship between population-level adoption of DBT use and outcomes. All statistical tests were 2-sided. Results Our sample included 7 602 869 mammograms in 4 580 698 women, 27.5% of whom received DBT. DBT was associated with modestly lower recall compared with 2 D mammography (113.6 recalls per 1000 screens, 99% confidence interval [CI] = 113.0 to 114.2 vs 115.4, 99% CI = 115.0 to 115.8, P &amp;lt; .001), although younger women aged 40-44 years had a larger reduction in recall (153 recalls per 1000 screens, 99% CI = 151 to 155 vs 164 recalls per 1000 screens, 99% CI = 163 to 166, P &amp;lt; .001). DBT was associated with higher biopsy rates than 2 D mammography (19.6 biopsies per 1000 screens, 99% CI = 19.3 to 19.8 vs 15.2, 99% CI = 15.1 to 15.4, P &amp;lt; .001) and a higher cancer detection rate (4.9 incident cancers per 1000 screens, 99% CI = 4.7 to 5.0 vs 3.8, 99% CI = 3.7 to 3.9, P &amp;lt; .001). Point estimates from the area-level analysis generally supported these findings. Conclusions In a large population of privately insured women, DBT was associated with a slightly lower recall rate than 2 D mammography and a higher cancer detection rate. Whether this increased cancer detection improves clinical outcomes remains unknown.
Regional myocardial blood flow and coronary vascular reserve in unanesthetized young calves exposed to a simulated altitude of 3500 m for 8--10 weeks.
Authors: MManohar, C MParks, M ABusch, W JTranquilli, G EBisgard, T AMcPherron, M CTheodorakis
Journal: Circulation Research (1982)

We determined regional myocardial blood flow (15-micrometer tracer microspheres) and hemodynamics in nine normal calves, seven calves with right ventricular (RV) hypertrophy induced by pulmonary artery banding (PAB) at sea level, and five calves exposed to simulated high altitude (HA) of 3,500 m (PB = 500 mm Hg) for 8--10 weeks. Progression of RV hypertrophy was very rapid in HA calves. RV weight:body weight ratio of 2.74 +/- 0.20 g/kg at 8--10 weeks of sojourn at HA significantly exceeded that in PAB calves (1.98 +/- 0.11 g/kg) 20 weeks post-banding. All calves were studied unanesthetized at sea level before (control) and during maximal coronary vasodilation (iv adenosine; 4 microM/kg per min). Normal and HA calves were also studied during acute hypoxemia (PaO2: 42 +/- 1 mm Hg) induced by administration of 12--13% O2 + N2 in the inhaled gas. RV myocardial blood flow was significantly increased only in PAB calves, whereas in HA calves it was similar to that in normal calves. Left ventricular (LV) mass and...
Abstract 14788: African Americans and Hispanics Are Disproportionately Impacted by Obesity: National Health and Nutrition Examination Surveys (NHANES) 2003-2018
Authors: michael K palmer, Peter P Toth
Journal: Circulation (2020)

Introduction: There are numerous health disparities impacting African Americans and Hispanics compared to other racial and ethnic groups in the US leading to poorer clinical outcomes. Obesity is an important risk factor predisposing to cardiac and renal diseases and it is important to quantify differences in obesity in greater detail. Hypothesis: African Americans and Hispanics may be disproportionately and adversely impacted by obesity. Methods: From 77007 participants in 8 NHANES surveys (between 2003-2004 and 2017-2018), we included 39952 aged 20-79 years. Participants with BMI data (n = 39440, 98.7%) were categorized as being underweight (BMI &lt; 18.5), normal (BMI 18.5 - &lt;25), overweight (BMI 25 - &lt;30), obese (BMI 30 - &lt;40) or morbidly obese (BMI 40+). Results were extrapolated to the entire US population (50 states plus the District of Columbia) using the direct method to the US Census 2000 population. The R language was used to perform statistical analyses. Results: Morbid obesity is as more common in black women (16%) compared with white or Hispanic women (both 8%). Black women are more overweight, obese, or morbidly obese compared with black men (80% vs 71%). Black men (7%) have a higher prevalence of morbid obesity compared to white (5%), Hispanic (5%), or “other” (race other than Hispanic, black, Asian, or white) racial/ethnic groups (4%). Hispanic men (80%) and African American women (80%) have the highest prevalence of overweight/obesity/morbid obesity. Normal weight is more common among race/ethnicity ‘other’ in both men and women. White women have a higher prevalence of normal weight compared to white men (34% vs 25%). Conclusion: There are important differences in the prevalence of obesity and morbid obesity between racial and ethnic groups in US adults. More emphasis needs to be placed on preventing/treating morbid obesity, particularly in Hispanic men and African American women, to reduce CV risk and correct disparities in health outcomes.