tbuckley/cabot-search huggingface dataset:
A prospective evaluation of the Björk-Shiley, Hancock, and Carpentier-Edwards heart valve prostheses.
Authors: PBloomfield, A HKitchin, D JWheatley, P RWalbaum, WLutz, H CMiller
Journal: Circulation (1986)

From 1975 to 1979, 540 patients undergoing valve replacement were entered into a randomized trial and received either a Bjork-Shiley (273 patients) or a porcine heterograft prosthesis (initially a Hancock valve [107 patients] and later a Carpentier-Edwards prosthesis [160 patients]). Two hundred and sixty-two patients required mitral valve replacement, 210 required aortic valve replacement, 60 required mitral and aortic valve replacement, and eight also required associated tricuspid valve replacement (six mitral valve replacement; two mitral plus aortic valve replacement). Analysis of 34 preoperative and operative variables showed the treatment groups to be well randomized. In-hospital mortality was not significantly different among patients receiving the three prostheses for aortic valve replacement (7.6% overall) and mitral plus aortic valve replacement (10% overall), but there was a higher in-hospital mortality for patients undergoing mitral valve replacement with the Carpentier-Edwards prosthesis (15....
Case mix and resource utilization by uninsured hospital patients in the Boston metropolitan area
Authors: J. Weissman
Journal: JAMA (1989)

Rising competitive pressures may place uninsured patients at risk for receiving fewer services than insured patients with similar medical conditions. To examine this possibility we studied the case mix, length of stay, and number of procedures for 65 032 patients listed as self-pay or free care, Blue Cross, or Medicaid at 52 hospitals in the Boston, Mass, area during 1983. We found that the overall case mix severity index (based on expected length of stay per diagnosis related group) for uninsured patients was 30% higher in public hospitals and 8% higher in major teaching hospitals compared with other institutions. Across all hospitals, the severity index of uninsured patients was similar to that of insured patients. However, after adjusting for diagnosis related group case mix, uninsured patients had, on average, 7% shorter stays (5.36 vs 5.79 days) and underwent 7% fewer procedures (1.16 vs 1.25) than Blue Cross patients, the differences varying with hospital type. Uninsured patients also had shorter stays on average than Medicaid patients (5.36 vs 5.87 days), but they underwent a similar number of procedures. These results suggest that patients who lack insurance may receive unequal treatment even after being hospitalized. (<i>JAMA</i>. 1989;261:3572-3576)
Effects of a cardiac glycoside in combination with propranolol on the ischemic heart of conscious dogs.
Authors: S FVatner, HBaig, W TManders, P AMurray
Journal: Circulation (1978)

The effects of coronary occlusion and of subsequent propranolol and ouabain administration were examined in 12 conscious dogs. Overall left ventricular (LV) function was assessed by measurement of LV pressure and dP/dt, and regional myocardial function was assessed by measurements of segment length (SL), velocity of SL shortening and regional myocardial work, i.e., pressure-length loops in normal and moderately and severely ischemic zones. Regional intramyocardial electrograms were measured at the same sites as function along with regional myocardial blood flow as determined by the radioactive microsphere technique. Coronary occlusion resulted in graded loss of function from the normal to severely ischemic zones, along with graded flow reductions and graded elevation of the ST segment. Propranolol, 1 mg/kg, depressed overall LV function and function in the normal zone more than in ischemic zones. Propranolol reduced flow to the normal zone and increased flow to ischemic zones, while not affecting ST-seg...
Dyslipidemia and ischemic heart disease mortality among men and women with diabetes.
Authors: M GGoldschmid, EBarrett-Connor, S LEdelstein, D LWingard, B ACohn, W HHerman
Journal: Circulation (1994)

BACKGROUNDWe investigated whether the greater increased risk of ischemic heart disease mortality associated with diabetes among women compared with men could be explained by their more pronounced lipoprotein abnormalities.METHODS AND RESULTSSeventy-six men and 45 women with diabetes and 327 men and 496 women without diabetes were followed for an average of 16 years in a population-based study. Cox proportional hazards models were used to determine the relative hazard of ischemic heart disease mortality for changes in lipoprotein subfractions after adjustment for age, hypertension, obesity, smoking, exercise, alcohol consumption, and estrogen use (among women). The relative hazard of ischemic heart disease mortality among diabetic women was 1.76 (P = .10) for a 10-mg/dL decrement in high-density lipoprotein cholesterol (HDL-C) and 3.13 (P = .01) for a 1-U increment in log very-low-density lipoprotein cholesterol (VLDL-C). The risk of ischemic heart disease mortality among diabetic women relative to nondiab...
Importance of temporal heterogeneity in assessing the contraction abnormalities associated with acute myocardial ischemia.
Authors: A EWeyman, T DFranklin, R DHogan, L DGillam, P SWiske, JNewell, E FGibbons, R AFoale
Journal: Circulation (1984)

A number of recent two-dimensional echocardiographic studies have attempted to relate quantitative changes in short-axis left ventricular radial wall motion to underlying myocardial ischemia/infarction. The significance of temporal variation in the contraction sequence within these ischemic regions in the overall evaluation of segmental left ventricular dysfunction, however, remains undefined. To assess this, we examined the motion of 192 individual radii that intersected known ischemic segments at 16.7 msec intervals from end-diastole to end-systole. The studies were performed in 13 dogs 1 hr after acute coronary ligation (six of the left anterior descending and seven of the circumflex coronary artery). Zones of infarction were confirmed by triphenyltetrazolium chloride staining at the termination of the experiment and by a corresponding decrease of more than 75% in myocardial perfusion at the 1 hr sampling period. Dyskinesis (defined for each radius as negative or outward excursion relative to the end-d...
The prolonged pressor response to renin in the nephrectomized rat.
Authors: G WBoyd
Journal: Circulation Research (1979)

Angiotension I dose-response curves and renin clearances were studied in nephrectomized and paired sham-nephrectomized control rats under pentobarbital anesthesia. Both threshold and slope of the angiotensin dose-response curves were decreased 22 hours after nephrectomy. In addition, the ratio of renin  (determined during renin infusions) in the 22-hour-nephrectomized rat to that in paired 22-hour sham-nephrectomized controls was 0.50 +/- 0.03 (mean +/- SEM, P less than 0.001, n = 12 pairs). The finding of reduced renin  was confirmed by an indirect assessment of effective renin clearance based on a comparison of the blood pressure decline after renin injections with angiotensin I dose-response curves in the same rat. Overall, approximately half of the 50% fall in renin  could be accounted for by an immediate effect of removal of the kidney on renin clearance. This role of the kidney in renin  was confirmed by the finding of a renal venous-arterial renin ratio of 0.9 ...
A comparative analysis of antegrade and retrograde conduction patterns in man.
Authors: MAkhtar, A NDamato, W PBatsford, J NRuskin, J BOgunkelu
Journal: Circulation (1975)

Patterns of antegrade and retrograde conduction and refractory periods were studied using His bundle electrogram recordings, incremental atrial and ventricular pacing and the extrastimulus technique. In 36/50 patients antegrade conduction was better than retrograde conduction (group I), as evidenced by a) onset of retrograde atrioventricular (A-V) nodal Wenckebach phenomenon at a slower rate compared to the antegrade counterpart (25 patients: group IA) or b) no ventriculo-atrial conduction at all ventricular paced rates (11 pts: group IB). The site of retrograde block in group IB patients was the A-V node. In eight patients (group II), antegrade and retrograde conduction appeared to be equal up to maximum paced rates of 160 beats/min. In six patients (group III) retrograde conduction was better than antegrade conduction, as indicated by onset of antegrade A-V nodal Wenckebach periods at slower rates than retrograde Wenckebach periods. During antegrade refractory period studies the area of maximum refr...
Borderline hypertension and obesity: two prehypertensive states with elevated cardiac output.
Authors: F HMesserli, H OVentura, EReisin, G RDreslinski, F GDunn, A AMacPhee, E DFrohlich
Journal: Circulation (1982)

Systemic, renal and splanchnic hemodynamics, intravascular volume, circulating catecholamine levels and plasma renin activity were compared in 39 patients with borderline hypertension and 28 normotensive subjects, who were less than 5% (n = 42, lean patients) or more than 40% overweight (n = 25, obese patients). Lean borderline hypertensive patients had greater cardiac output (p less than 0.05), heart rate (p less than 0.01) and renal blood flow (p less than 0.05); cardiopulmonary redistribution of intravascular volume (p less than 0.05); and higher circulating norepinephrine levels (p less than 0.05). Obese normotensive subjects also showed an increased cardiac output (p less than 0.005), stroke volume (p less than 0.01), left ventricular stroke work (p less than 0.05), and renal blood flow (p less than 0.05) (but not respective indexes), but intravascular volume was expanded (p less than 0.05) without redistribution and circulating catecholamine levels were normal. Obese borderline hypertensive patients...
Assessment of Diagnosis and Triage in Validated Case Vignettes Among Nonphysicians Before and After Internet Search
Authors: David M. Levine, Ateev Mehrotra
Journal: JAMA Network Open (2021)

<h3>Importance</h3> When confronted with new medical symptoms, many people turn to the internet to understand why they are ill as well as whether and where they should get care. Such searches may be harmful because they may facilitate misdiagnosis and inappropriate triage. <h3>Objective</h3> To empirically measure the association of an internet search for health information with diagnosis, triage, and anxiety by laypeople. <h3>Design, Setting, and Participants</h3> This survey study used a nationally representative sample of US adults who were recruited through an online platform between April 1, 2019, and April 15, 2019. A total of 48 validated case vignettes of both common (eg, viral illness) and severe (eg, heart attack) conditions were used. Participants were asked to relay their diagnosis, triage, and anxiety regarding 1 of these cases before and after searching the internet for health information. <h3>Exposures</h3> Short, validated case vignettes written at or below the sixth-grade reading level randomly assigned to participants. <h3>Main Outcomes and Measures</h3> Correct diagnosis, correct triage, and flipping (changing) or anchoring (not changing) diagnosis and triage decisions were the main outcomes. Multivariable modeling was performed to identify patient factors associated with correct triage and diagnosis. <h3>Results</h3> Of the 5000 participants, 2549 were female (51.0%), 3819 were White (76.4%), and the mean (SD) age was 45.0 (16.9) years. Mean internet search time was 12.1 (95% CI, 10.7-13.5) minutes per case. No difference in triage accuracy was found before and after search (74.5% vs 74.1%; difference, −0.4 [95% CI, −1.4 to 0.6];<i>P</i> = .06), but improved diagnostic accuracy was found (49.8% vs 54.0%; difference, 4.2% [95% CI, 3.1%-5.3%];<i>P</i> &lt; .001). Most participants (4254 [85.1%]) were anchored on their diagnosis. Of the 14.9% of participants (n = 746) who flipped their diagnosis, 9.6% (n = 478) flipped from incorrect to correct and 5.4% (n = 268) flipped from correct to incorrect. The following groups had an increased rate of correct diagnosis: adults 40 years or older (eg, 40-49 years: 5.1 [95% CI, 0.8-9.4] percentage points better than those aged &lt;30 years;<i>P</i> = .02), women (9.4 [95% CI, 6.8-12.0] percentage points better than men;<i>P</i> &lt; .001), and those with perceived poor health status (16.3 [95% CI, 6.9-25.6] percentage points better than those with excellent status;<i>P</i> = .001) and with more than 2 chronic diseases (6.8 [95% CI, 1.5-12.1] percentage points better than those with 0 conditions;<i>P</i> = .01). <h3>Conclusions and Relevance</h3> This study found that an internet search for health information was associated with small increases in diagnostic accuracy but not with triage accuracy.
Noninvasive detection of skeletal muscle underperfusion with near-infrared spectroscopy in patients with heart failure.
Authors: J RWilson, D MMancini, KMcCully, NFerraro, VLanoce, BChance
Journal: Circulation (1989)

The present study was undertaken to determine whether near-infrared spectroscopy can be used to noninvasively assess skeletal muscle oxygenation in patients with heart failure. The difference between light absorption at 760 and 800 nm was used to assess hemoglobin-myoglobin oxygenation. Initial studies conducted in isolated canine gracilis muscle demonstrated that 760-800-nm absorption correlated closely (r = -0.97 +/- 0.01) with venous hemoglobin O2 saturation when the muscle was stimulated to contract at 0.25-5.0 Hz. In normal subjects (n = 6) and patients with heart failure (n = 8), 760-800-nm absorption changes from the vastus lateralis muscle were monitored at rest, during progressive maximal bicycle exercise, and during thigh cuff inflation to suprasystolic pressure, an intervention designed to assess minimal hemoglobin-myoglobin oxygenation. Absorption changes were expressed relative to the full physiologic range noted from rest to thigh cuff inflation. During exercise, normal subjects exhibited an...
Saroglitazar, a PPAR‐α/γ Agonist, for Treatment of NAFLD: A Randomized Controlled Double‐Blind Phase 2 Trial
Authors: Samer Gawrieh, Mazen Noureddin, Nicole Loo, Rizwana Mohseni, Vivek Awasty, Kenneth Cusi, Kris V. Kowdley, Michelle Lai, Eugene Schiff, Deven Parmar, Pankaj Patel, Naga Chalasani
Journal: Hepatology (2021)

NAFLD is characterized by insulin resistance and dysregulated lipid and glucose metabolism. Saroglitazar, a dual peroxisome proliferator activated receptor-α/γ agonist, improves insulin sensitivity, and lipid and glycemic parameters. Saroglitazar improved NASH histology in animal studies. In this randomized controlled clinical trial, we evaluated the efficacy and safety of saroglitazar in patients with NAFLD/NASH.A total of 106 patients with NAFLD/NASH with alanine aminotransferase (ALT) ≥ 50 U/L at baseline and body mass index ≥25 kg/m2 were randomized in a 1:1:1:1 ratio to receive placebo or saroglitazar 1 mg, 2 mg, or 4 mg for 16 weeks. The primary efficacy endpoint was percentage change from baseline in ALT levels at week 16. Liver fat content (LFC) was assessed by MRI proton density fat fraction. The least-squares mean percent change from baseline in ALT at week 16 was -25.5% (5.8), -27.7% (5.9), and -45.8% (5.7), with saroglitazar 1 mg, 2 mg, and 4 mg, respectively, versus 3.4% (5.6) in placebo (P < 0.001 for all). Compared with placebo, saroglitazar 4 mg improved LFC (4.1% [5.9] vs. -19.7% [5.6]), adiponectin (-0.3 μg/mL [0.3] vs. 1.3 μg/mL [0.3]), homeostatic model assessment-insulin resistance (-1.3 [1.8] vs. -6.3 [1.7]), and triglycerides (-5.3 mg/dL [10.7] vs. -68.7 mg/dL [10.3]) (P < 0.05 for all). Saroglitazar 4 mg also improved lipoprotein particle composition and size and reduced lipotoxic lipid species. Saroglitazar was well-tolerated. A mean weight gain of 1.5 kg was observed with saroglitazar 4 mg versus 0.3 kg with placebo (P = 0.27).Saroglitazar 4 mg significantly improved ALT, LFC, insulin resistance, and atherogenic dyslipidemia in participants with NAFLD/NASH. (ClinicalTrials.gov identifier: NCT03061721.).
P86.01 Phase 1 Study of the AXL Inhibitor DS-1205 in Combination With Osimertinib in Subjects With Metastatic or Unresectable EGFR-Mutant NSCLC
Authors: J.C. Yang, W. Su, C. Chiu, H. Shiah, K. Lee, T. Hsia, M. Uno, N. Crawford, H. Terakawa, W. Chen, G. Takayama, T. Limsakun, C. Hsu, E. Slosberg, G. Chang
Journal: Journal of Thoracic Oncology (2021)
Immediate and sustained hemodynamic and clinical improvement in chronic heart failure by an oral angiotensin-converting enzyme inhibitor.
Authors: RAder, KChatterjee, TPorts, BBrundage, BHiramatsu, WParmley
Journal: Circulation (1980)

The hemodynamic effects of an oral angiotensin-converting enzyme inhibitor, captopril, were evaluated in 10 symptomatic patients with chronic congestive heart failure. In all patients there was a significant increase in cardiac output (average 28%), stroke volume (49%), and stroke work index (26%), along with a decrease in pulmonary capillary wedge pressure (48%), indicating improved left ventricular function. Modest decreases in heart rate and arterial pressure were also observed. In seven patients maintained on captopril therapy, repeat hemodynamic studies at 2 months revealed sustained effects. These beneficial hemodynamic effects were accompanied by clinical improvement and improved exercise tolerance during maintenance therapy. These findings suggest that captopril may be a useful therapeutic adjunct for the long-term management of patients with chronic congestive heart failure.
Abstract 11261: The Impact of Repeated Cardioversions and Escalation of Rhythm Control Therapies on Atrial Fibrillation Patients
Authors: Victoria Jacobs, Heidi T May, Tami L Bair, J P Weiss, John D Day, Brian G Crandall, Michael J Cutler, Jeffrey S Osborn, Charles D Mallender, Viet T Le, T J Bunch
Journal: Circulation (2018)

Introduction: Rhythm control approaches are used to improve quality of life in atrial fibrillation (AF) patients. A direct current cardioversion (DCCV) is a first line approach to restore sinus rhy...
Re: Oral Contraceptives and the Risk of Breast Cancer in BRCA1 and BRCA2 Mutation Carriers
Authors: G. H. de Bock, R. A. E. M. Tollenaar, H. Papelard, T. P. M. V. Vlieland, P. Devilee, C. J. Cornelisse, J. P. Vandenbroucke
Journal: JNCI Journal of the National Cancer Institute (2003)
Effect of temperature change on the permeability of eel rete capillaries.
Authors: E ARasio, MBendayan, C AGoresky
Journal: Circulation Research (1992)

The changes in the permeability properties of the rete capillaries of the eel in response to temperature shifts were studied during countercurrent perfusion at constant flow and pressure. Tracers and oxygen were added to the arterial perfusate. From the ratio of end concentrations of arterial to venous capillaries divided by surface area, calculated from rete weight, a value for the ratio of permeability to flow, P/F, with dimensions in centimeters-2 was estimated. Because flow and surface area are constant, this provides an index of how permeability varies with time. A group of paracellular (albumin, sucrose, and sodium) and cellular (antipyrine, water, and oxygen) probes were used. When the temperature of the perfusate was raised abruptly from 25 degrees C to 35 degrees C, P/F values rose continuously and irreversibly from 0.042 +/- 0.009 to 0.281 +/- 0.112 cm-2 (mean +/- SEM) for 125I-albumin, from 0.082 +/- 0.006 to 1.74 +/- 0.070 cm-2 for [14C]sucrose, and from 0.32 +/- 0.06 to 2.78 +/- 0.62 cm-2 for...
Myosin light chain isoforms and their phosphorylation in arterial smooth muscle.
Authors: FErdödi, MBárány, KBárány
Journal: Circulation Research (1987)

Arterial smooth muscle myosin contains nonphosphorylated and phosphorylated light chains that appear as 4 spots on two-dimensional, Coomassie blue-stained gel electrophoretograms at the 20,000-molecular weight level (referred to as spots 4 through 1 in order of decreasing isoelectric points). Anti-light chain recognizes the proteins in all 4 light chain spots. Complete dephosphorylation of light chain in muscle homogenate, by inhibiting myosin light chain kinase and by adding phosphatase, leads to 2 spots on two-dimensional gel electrophoretograms; both spots are visible on immunoblots. Stimulation (K+ or stretch) of smooth muscle results in increased light chain phosphorylation. Autoradiography of the gel electrophoretograms reveals that radioactive components are contained in spots 3, 2, 1, and in an additional spot with lower isoelectric point, referred to as spot 0. Phosphoamino acid analysis shows that spots 3 and 1 contain phosphoserine, whereas spots 2 and 0 contain phosphoserine and phosphothreoni...
Effects of adenosine and adenine nucleotides on the atrioventricular node of isolated guinea pig hearts.
Authors: LBelardinelli, JShryock, G AWest, H FClemo, J PDiMarco, R MBerne
Journal: Circulation (1984)

The primary goal of this study was to determine whether the slowing of atrioventricular (AV) conduction by ATP is caused by ATP per se or is mediated by adenosine formed from ATP degradation. We assessed the effects of ATP, beta, gamma-methylene ATP, ADP, AMP, and adenosine on AV conduction time in the isolated perfused guinea pig heart. The cardiac effluent was collected and analyzed for its content of adenine nucleotides and nucleosides. Perfused ATP was rapidly and almost completely broken down to AMP and adenosine; only 2.5 +/- 0.5% of the infused ATP was recoverable in the effluent. A significant correlation was found between the effluent concentration of adenosine and atria-to-His bundle (A-H) conduction time. Compounds that altered the effect of adenosine on A-H conduction likewise altered the effect of ATP: (1) aminophylline, a competitive antagonist of adenosine, antagonized the ATP-induced A-H prolongation; (2) adenosine deaminase, the enzyme responsible for the deamination of adenosine to inosi...
Influence of thyroid status on intracellular distribution of cardiac adrenoceptors.
Authors: CLimas, C JLimas
Journal: Circulation Research (1987)

Previous studies have suggested that thyroid hormones influence the number of membrane-bound cardiac adrenoceptors, but their effect on the intracellular distribution of adrenoceptors has not been examined. A plasma cell membrane and a vesicular fraction devoid of membrane markers were prepared from hearts of euthyroid and hyperthyroid rats and were used to compare beta- and alpha-adrenoceptors. During daily injection of l-thyroxine, cardiac hypertrophy developed within 4 days and remained unchanged thereafter. The number of membrane-bound beta-receptors increased progressively and plateaued within 2 weeks of thyroxine administration. Vesicular beta-receptors, on the other hand, increased more gradually and to a lesser extent so that after 2 weeks of l-thyroxine injection, they constituted a smaller proportion of the total beta-receptor population compared to normal rats. In contrast, the number of cardiac alpha 1-adrenoceptors declined rapidly to about 80% of that in euthyroid animals and did not change ...