tbuckley/cabot-search huggingface dataset:
Intraoperative detection of myocardial ischemia in high-risk patients: electrocardiography versus two-dimensional transesophageal echocardiography.
Authors: J SSmith, M KCahalan, D JBenefiel, B FByrd, F WLurz, W AShapiro, M FRoizen, ABouchard, N BSchiller
Journal: Circulation (1985)

Because acute segmental wall motion abnormalities (SWMAs) of the left ventricle are highly sensitive and specific indicators of myocardial ischemia, this study compared the incidence and significance of ischemia, as detected by two-dimensional transesophageal echocardiography and surface electrocardiography, during anesthesia and surgery in patients at high risk of myocardial ischemia. During surgery, 24 of the 50 patients studied had new SWMAs, whereas only six had ST segment changes. All patients with ST segment changes also had new SWMAs: in three instances, SWMAs occurred before the ST segment change, and in three instances, they occurred simultaneously. All three patients who had intraoperative myocardial infarctions also had persistent intraoperative SWMAs, whereas only one patient had ST segment changes. Ten healthy patients requiring noncardiovascular surgery were monitored similarly; none of these had SWMAs, ST segment changes, or myocardial infarction. This study demonstrates the superiority of ...
Is There Evidence That Oral Hypoglycemic Agents Reduce Cardiovascular Morbidity or Mortality? No
Authors: Sameer A. Kassem, Itamar Raz
Journal: Diabetes Care (2009)

Diabetes induces a high degree of morbidity and significant reduction of life expectancy in affected subjects. Microvascular complications include retinopathy, nephropathy, and neuropathy, which frequently are underlying factors of major morbidity and disability associated with diabetes. However, macrovascular complications, and mainly cardiovascular disease, are still the leading causes of death in diabetic subjects. Thus, improved cardiovascular outcome will have a clearly favorable effect on mortality in this group of patients.

Since the introduction of the U.K. Prospective Diabetes Study (UKPDS) trials in 1998, it has become widely accepted that controlling hyperglycemia improves microvascular outcome in diabetic patients (1,2). However, to date, there is no compelling evidence that improving glycemic control has, in itself, beneficial effects on macrovascular complications and cardiovascular clinical end points.

Although hyperglycemia is the hallmark of diabetes, it is still unclear whether there is a causative relationship between increased blood glucose levels and the evolution of arterial atherosclerosis. Moreover, other metabolic disorders that have been clearly linked to plaque formation seem to coexist with, rather than being caused by, hyperglycemia. These metabolic abnormalities include dyslipidemia, abdominal obesity, hypertension, low-grade inflammation, and coagulopathies. This hypothesis is supported by the findings of Haffner et al. (3) from a population-based study of diabetes and cardiovascular disease. In this study, it was demonstrated that normoglycemic subjects who subsequently developed diabetes had an atherogenic pattern of risk factors, including dyslipidemia, overweight, insulin resistance, and hypertension, years before frank diabetes was diagnosed (3). In another study, Haffner et al. (4) clearly demonstrated that diabetic patients without previous myocardial infarction (MI) have as high a risk of MI as nondiabetic patients with previous MI. Overall, these findings support the hypothesis that diabetes and other atherogenic risk factors are manifestations of one entity leading to arterial atherosclerosis. The constellation of insulin resistance and …
Reply to “Wild-type AAV Insertions in Hepatocellular Carcinoma Do Not Inform Debate Over Genotoxicity Risk of Vectorized AAV”
Authors: Manfred Schmidt, Irene Gil-Farina, Hildegard Büning
Journal: Molecular Therapy (2016)

We greatly appreciate the letter by Jean-Charles Nault and colleagues1 in response to our recent editorial2 in Molecular Therapy discussing their paper, "Recurrent AAV2-Related Insertional Mutagenesis in Human Hepatocellular Carcinomas."3 In particular, we welcome the authors' clear statement that "AAV2 insertions in spontaneous human HCC...are clearly unrelated to vectorized AAV used in gene therapy" and the open discourse on the interpretation of the authors' scientific findings with regard to wild-type (wt) AAV2 biology and cancer.
Effect of early and advanced atherosclerosis on vascular responses to serotonin, thromboxane A2, and ADP.
Authors: J ALopez, M LArmstrong, D JPiegors, D DHeistad
Journal: Circulation (1989)

In monkeys with early and advanced atherosclerosis, we examined responses to the three major vasoactive agonists that are released when platelets aggregate. Measurements were obtained in normal cynomolgus monkeys and in monkeys fed an atherogenic diet for 4 +/- 1, 9 +/- 1, and 19 +/- 1 months (mean +/- SEM). Morphometry of femoral and iliac arteries indicated that 4 months of atherogenic diet produced only slight intimal thickening, 9 months produced early lesions, and 19 months produced approximately 5-10 fold greater intimal proliferation than did 9 months of atherogenic diet. Serotonin and adenosine 5'-diphosphate (ADP), which are endothelium-dependent agonists, and adenosine and phenylephrine, which are endothelium-independent agonists, were injected intra-arterially into the perfused hind limb. Thromboxane A2 analogue U46619 also was studied. Vasoconstrictor responses to serotonin were potentiated, and vasodilator responses to ADP were impaired by early and advanced atherosclerosis. In contrast, vaso...
Sustained depolarization-induced outward current in human atrial myocytes. Evidence for a novel delayed rectifier K+ current similar to Kv1.5 cloned channel currents.
Authors: ZWang, BFermini, SNattel
Journal: Circulation Research (1993)

Depolarization of human atrial myocytes activates a transient outward current that rapidly inactivates, leaving a sustained outward current after continued depolarization. To evaluate the ionic mechanism underlying this sustained current (Isus), we applied whole-cell voltage-clamp techniques to single myocytes isolated from right atrial specimens obtained from patients undergoing coronary bypass surgery. The magnitude of Isus was constant for up to 10 seconds at +30 mV and was unaffected by 40 mmol/L tetraethylammonium, 100 nmol/L dendrotoxin, 1 mmol/L Ba2+, 0.1 mumol/L atropine, or removal of Cl- in the superfusate. Isus could be distinguished from the 4-aminopyridine (4AP)-sensitive transient outward current (Ito1) by differences in voltage-dependent inactivation (1000-millisecond prepulse to -20 mV reduced Ito1 by 91.7 +/- 0.1% [mean +/- SEM], P < .001, versus 9.4 +/- 0.4% reduction of Isus) and 4AP sensitivity (IC50 for block of Ito1, 1.96 mmol/L; for Isus, 49 mumol/L). Isus activation had a voltage t...
Need for Randomized Trials to Support Procedural Interventions—Reply
Authors: Christopher J. D. Wallis, Allan S. Detsky, Eddy Fan
Journal: JAMA (2019)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Congenital abnormalities of the conduction system in two patients with tachyarrhythmias.
Authors: SBharati, RBauernfiend, MScheinman, BMassie, MCheitlin, PDenes, DWu, MLev, K MRosen
Journal: Circulation (1979)

Serial sections of the conduction system (CS) were performed in two patients with recurrent tachyarrhythmias. Case 1, a 34-year-old female who had dual atrioventricular (AV) nodal pathways with recurrent paroxysmal supraventricular tachycardia, committed suicide. Autopsy revealed an abnormally formed atrial septum with insertion of eustachian valve on the AV part of the pars membranacea. The intercuspid portion of the pars membranacea was muscular. The AV node was located adjacent to the membranous part of the ventricular septum rather than the central fibrous body. In addition, there was an accessory anterior AV node on the parietal wall of the right atrium. Case 2, a 13-year-old boy with history of recurrent ventricular tachycardia, died suddenly. CS revealed a right-sided, markedly septated bundle. The first part of right bundle branch was divided into three parts, which later joined together. Both cases showed fatty infiltration of the atrial septum, more than normal for the age of the patients. The r...
Effect of positive inotropic agents on the relation between oxygen consumption and systolic pressure volume area in canine left ventricle.
Authors: HSuga, RHisano, YGoto, OYamada, YIgarashi
Journal: Circulation Research (1983)

We analyzed the effect of positive inotropic agents on the relation between left ventricular oxygen consumption and the systolic pressure-volume area. Pressure-volume area is a measure of total mechanical energy for ventricular contraction, and is a specific area in the ventricular pressure-volume diagram circumscribed by the end-systolic and end-diastolic pressure-volume relation curves and the systolic segment of the pressure-volume trajectory. Either epinephrine (1 microgram/kg per min, iv) or calcium ion (0.03 mEq/kg per min, iv) was administered to canine excised cross-circulated hearts. These agents increased an index of ventricular contractility, Emax, or the slope of the end-systolic pressure-volume line, by 70%. The regression lines of ventricular oxygen consumption on pressure-volume area in control and in enhanced contractile states were of the same formula: ventricular oxygen consumption (ml O2/beat per 100 g) equals A times pressure-volume area (mm Hg ml/beat per 100 g) plus a constant B. Coe...
Hemodynamic studies in children four to ten years after the Mustard operation for transposition of the great arteries.
Authors: M JGodman, BFriedli, APasternac, B SKidd, G ATrusler, W TMustard
Journal: Circulation (1976)

Fourteen patients have been studied hemodynamically 4-10 years (mean 5.5 years) after the Mustard operation for transposition of the great arteries. Investigation was directed principally at 1) the detection of baffle obstruction by catheterization of the pulmonary veins (PV) and venae cavae and recording of simultaneous right ventricular (RV) and pulmonary capillary wedge pressures (PCW); 2) the detection of intra-atrial baffle leaks by dye curves and selective angiography; 3) the assessment of RV and LV function by calculating peak VCE (dp/dt/28p) from high fidelity recordings in 11 patients. Severe baffle obstruction to the PV return was found in only one patient. The others had no or minimal gradients between RV end-diastolic and PCW pressures (mean 1.3 +/- 0.69 mm Hg). Cardiac output was normal at rest (4.1 +/- .22) and increased to 7.1 +/- .62 L/min/m2 (+73%) but the gradient between the RV end-diastolic and PCW pressures remained insignificant (2.2 +/- 1.13 mm Hg). No evidence of caval obstruction ...
Does fish oil lower blood pressure? A meta-analysis of controlled trials.
Authors: M CMorris, FSacks, BRosner
Journal: Circulation (1993)

BACKGROUNDIn a meta-analysis of 31 placebo-controlled trials on 1356 subjects, we examined the effect of omega-3 fatty acids in fish oil on blood pressure by grouping studies that were similar in fish oil dose, length of treatment, health of the subjects, or study design.METHODS AND RESULTSThe mean reduction in blood pressure caused by fish oil for the 31 studies was -3.0/-1.5 mm Hg (95% confidence intervals: systolic blood pressure: -4.5, -1.5; diastolic blood pressure: -2.2, -0.8). There was a statistically significant dose-response effect when studies were grouped by omega-3 fatty acid dose: -1.3/-0.7 mm Hg at doses < or = 3 g/d, -2.9/-1.6 mm Hg at 3.3 to 7 g/d, and -8.1/-5.8 mm Hg at 15 g/d. Both eicosapentaenoic acid and docosahexaenoic acid were significantly related to blood pressure response. There was no effect on blood pressure in eight studies of healthy persons (mean reduction, -0.4/-0.7 mm Hg) at an overall mean dose of 4.2 g omega-3 fatty acids/d. By contrast, there was a significant effec...
44P Inter-reader variability of lung parenchymal observations on chest CT among COVID-19 RT-PCR negative lung cancer patients treated with chemo-radiation: Potential pitfalls of pulmonary findings in different readers with various experience levels
Authors: A. Jajodia, H. Prosch, U. Batra, B. Amrith, J. Goyal, S. Pasricha, A. Mehta, D.C. Doval, S. Puri, A. Chaturvedi
Journal: Journal of Thoracic Oncology (2021)
Direct determination of vasa recta blood flow in the rat renal papilla.
Authors: CHolliger, K VLemley, S LSchmitt, F CThomas, C RRobertson, R LJamison
Journal: Circulation Research (1983)

Blood flow in vasa recta capillaries of the exposed renal papilla of young antidiuretic rats (n = 18) was determined by an adaptation of the video-photometric technique of Intaglietta. The erythrocyte velocity and capillary diameter in vasa recta (n = 97) were measured at the same location by means of fluorescence video microscopy, with fluorescein-labeled bovine gamma-globulin as a plasma marker. A factor relating erythrocyte velocity to mean cross-sectional blood velocity was determined in vitro to permit the calculation of single vasa recta blood flows from the measured indices, erythrocyte velocity and capillary diameter. Mean blood flow in descending vasa recta was 8.83 +/- 0.96 (SE) nl/min, significantly greater than that in ascending vasa recta, 4.82 +/- 0.34 nl/min. The total numbers of ascending and descending vasa recta at the base of the exposed papilla were also determined. Over 1500 vasa recta were identified as ascending vasa recta or descending vasa recta in electron micrographs of three pa...
Patterned growth of neonatal rat heart cells in culture. Morphological and electrophysiological characterization.
Authors: SRohr, D MSchölly, A GKléber
Journal: Circulation Research (1991)

A culture method was developed that permits patterning of the growth of ventricular myocytes of neonatal rats. Regions were created on the culture substrate that either prevented (photoresist coat) or supported (glass surface) attachment of cells. In this way the geometry of interconnecting growth channels could be specified. Single-layered myocyte strands of variable length and with widths of as little as 65 micron (three to four cells wide) were obtained. The shape and orientation of the individual myocytes were a function of growth-channel width: the narrower the channel, the more elongated the cells and the more likely was the long axis to be oriented along the channel axis. In channels with width of 100 micron or less, cells were aligned longitudinally and cross-striated as in vivo. A high degree of morphological cell differentiation required the presence of contractile activity. Maximal diastolic potential (-71 mV), action potential amplitude (93 mV), and maximal upstroke velocity (140 V/sec) did no...
In vivo microscopy of the cerebral microcirculation using neonatal allografts in hamsters.
Authors: W LJoyner, RYoung, DBlank, C AEccleston-Joyner, J PGilmore
Journal: Circulation Research (1988)

Studies were performed to characterize the morphology and vascular reactivity of the allografted cerebral microcirculation. Cerebral cortical tissue was allografted into the cheek pouch of the hamster so that cerebral parenchymal vessels could be studied. The vascular morphology was characterized by a large number of looping vessels. The ultrastructural examination indicated viable cerebral tissue containing typical vessels, that is, tight junctions, not like those of the cheek pouch. Also, the microvasculature was impermeable to 150, 70, and 20 kDa fluorescein isothiocyanate dextrans. Angiotensin II and norepinephrine caused constriction of the cerebral vessels whereas adenosine caused dilation. Isoproterenol did not affect cerebral arterioles; however, it dilated cheek pouch arterioles. Thus, this preparation provides a satisfactory model for studying the living cerebral microcirculation.
What's Been Added to 1989 Certificate? Well...
Authors: None Suzann
Journal: JAMA (1989)

THE COMMITTEE that revised the national death certificate model for 1989 has provided more detailed instructions for the cause-of-death section and added two examples of how to fill it out. One illustrates a possible natural cause (a heart attack), and the other, a traumatic cause (an automobile accident). Further instructions and more examples appear in an accompanying handbook, the<i>Physicians' Handbook on Medical Certification of Death</i>(Dept of Health and Human Services publication [PHS]87-1108). Committee members (a subgroup of the Panel to Evaluate the US Standard Certificates and Reports) also added more space in the cause-of-death section itself. "We're seeing that physicians enter more and more detailed information," says Harry M. Rosenberg, MD, National Center for Health Statistics, Hyattsville, Md. "It [the section] has been too cramped." <h3>How Much Is Enough?</h3> Daniel Fife, PhD, director of research at the New Jersey Department of Health, Trenton, suggests that just adding space
Adenosine production in the ischemic kidney.
Authors: W LMiller, R AThomas, R MBerne, RRubio
Journal: Circulation Research (1978)

We conducted experiments to determine (1) tissue, blood, and urine levels of adenosine produced by the ischemic kidney under conditions of renal artery occlusion, and (2) the site(s) of production and release of adenosine by the kidney. Concentrations of adenosine, inosine, and hypoxanthine in the dog urine were found to increase after 2 minutes of renal artery occlusion as were concentrations of these metabolites in renal tissue after 10 minutes of renal artery occlusion. Renal venous plasma levels of inosine and hypoxanthine also were elevated after 3 minutes of arterial occlusion. In modified stop-flow experiments, adenosine appeared in the urine in a peak that corresponded most closely with proximal tubule fluid. 5'-Nucleotidase, the enzyme which catalyzes the dephosphorylation of 5'-AMP or 5'-IMP to adenosine or inosine, respectively, was found to be located primarily on the external membranes and mitochondria of proximal tubule cells, but not in distal tubule or collecting duct cells. Since adenosin...
Lung water and urea indicator dilution studies in cardiac surgery patients. Comparisons of measurements in aortocoronary bypass and mitral valve replacement.
Authors: K LBrigham, S LFaulkner, R DFisher, H WBender
Journal: Circulation (1976)

We measured transpulmonary indicator dilution curves of 51Cr-erythrocytes, 125I-albumin, 14C-urea, and 3H-water before and six and 24 hours after operation in seven patients undergoing aortocoronary bypass (ACB) and eight patients undergoing mitral valve replacement (MVR). We calculated cardiac output (CO), extravascular lung water (EVLW), the difference between 125I-albumin and 51Cr-erythrocyte distribution volumes (EV albumin), the difference between 14C-urea and 51Cr-erythrocyte distribution volumes (EV urea) and 14C-urea extraction (E) and permeability -surface ares (PS) products. Comparisons between 16 ACB studies and 17 MVR studies showed the MVR group to have a higher EVLW (P less than 0.01). Extravascular lung water decreased after operation. The ratio of EV urea to EV albumin averaged 1.35 in the MVR group and 0.91 in the ACB group (P less than 0.001). 14C-urea E was also higher in the MVR group (P less than 0.05), but PS was similar in the two groups. None of the differences was related to the t...
Efficacy and safety of tofacitinib versus baricitinib in patients with rheumatoid arthritis in real clinical practice: analyses with propensity score-based inverse probability of treatment weighting
Authors: Yusuke Miyazaki, Kazuhisa Nakano, Shingo Nakayamada, Satoshi Kubo, Yoshino Inoue, Yoshihisa Fujino, Yoshiya Tanaka
Journal: Annals of the Rheumatic Diseases (2021)

Objectives The differences of efficacy between each Janus kinase (JAK) inhibitors have not been clarified in the patients with rheumatoid arthritis (RA) in clinical practice. Here, we compared the efficacy between tofacitinib (TOFA) and baricitinib (BARI) in clinical practice. Methods The efficacy of TOFA (n=156) in patients with RA was compared with BARI (n=138). Selection bias was reduced to a minimum using propensity score-based inverse probability of treatment weighting (IPTW). The Clinical Disease Activity Index (CDAI) trajectory for patients who started TOFA or BARI was analysed using growth mixture modelling (GMM). Results No significant difference was observed in patient characteristics between the TOFA and BARI groups in after adjustment by propensity score-based IPTW. The BARI group had a significantly higher rate of CDAI remission at week 24 after the introduction of JAK inhibitors than the TOFA group. The treatment-resistant group defined by GMM, comprising patients who did not achieve low disease activity at week 24, was more likely to include those who had received many biological disease-modifying antirheumatic drugs (bDMARDs) before the introduction of JAK inhibitors and those who received TOFA. Among patients with RA who received TOFA, those who had received ≥4 bDMARDs before the introduction of TOFA were more likely to be classified into the treatment-resistant group. Conclusions BARI showed a similar safety profile and better clinical outcome when compared with TOFA after reduction to a minimum of selection bias. However, these were observed in a small population. Accordingly, further investigation is required in an accurately powered head-to-head trial.
Ventricular tachycardia rate and morphology determine energy and current requirements for transthoracic cardioversion.
Authors: R EKerber, M GKienzle, BOlshansky, A LWaldo, DWilber, M DCarlson, A MAschoff, SBirger, LFugatt, SWalsh
Journal: Circulation (1992)

BACKGROUNDThe electrical current and energy required to terminate ventricular tachyarrhythmias are known to vary by arrhythmia: Ventricular tachycardia (VT) is generally considered to require less energy than ventricular fibrillation (VF). The hypothesis of our study was that current requirements for transthoracic termination of VT are further determined by VT rate and QRS complex morphology.METHODS AND RESULTSWe prospectively studied 203 patients who received a total of 569 shocks for VT or VF by following a current-based protocol. This protocol recommended shocks for VT beginning at 18 A (70 +/- 22 J) and shocks for VF beginning at 25 or 30 A (137 +/- 52 J or 221 +/- 70 J). The ventricular tachyarrhythmias were subclassified as monomorphic VT (MVT): uniform QRS complex morphology on surface electrocardiogram and heart rate greater than 100 beats per minute; polymorphic VT (PVT): nonuniform QRS complex morphology and heart rate less than or equal to 300 beats per minute; or VF: nonuniform QRS complex mor...