tbuckley/cabot-search huggingface dataset:
Abstract 17398: Prediction of Improvement in Cardiac Function by Dobutamine Echocardiography in Patients with Recent Onset Dilated Cardiomyopathy
Authors: Dong Heon Yang, Ju Hwan Lee, Kyun Hee Kim, Sun Hee Park
Journal: Circulation (2011)

Background: Clinical and echocardiographic variables have been used to predict prognosis in patients with DCM. The aim of this study was to investigate whether the contractile reserve on dobutamine stress echocardiography (DSE) could predict the myocardial contractile reversibility or prognosis in patients with recent-onset DCM. Method: High-dose DSE was performed in 22 patients with recently diagnosed DCM in incremental stages lasting 5 min each. Left ventricular (LV) volume and ejection fraction (EF) was measured by Simpson's biplane method. LV end-systolic elastance (Ees), effective arterial elastance (Ea) and ventriculo-vascular coupling index (VVID) were also calculated. A follow-up echocardiography was done at 9±6 months. Results: Fourteen patients were men and age was 46±16 years. Resting LVEF, LV end-diastolic volume and LV end-systolic volume was 24±6%, 174±53 mL and 133±44 mL. LVEF were increased to 31±9% at low dose dobutamine and to 36±9% at peak dose dobutamine stimulation. Follow-up LVEF was 39±15% after 9±6 months . Resting LVEF, LV volume, stroke volume, E/E', Ees, Ea and VVID could not predict follow-up LVEF. However, LVEF, LV volumes, Ees and VVID at peak dose on high-dose DSE, not at low dose, was well correlated with follow-up LVEF, especially peak LVEF was most strongly correlated (Fig 1). During follow-up period, 3 died of cardiac causes and 5 readmitted for aggravation of heart failure. In patients with cardiac events, LVEF was lower, LV volumes were higher and changes of LVEF from resting to peak dobutamine were lower. The addition of high-dose DSE resulted in significant incremental improvement in the predictive value of the other parameters (Fig 2). Conclusion: High-dose DSE could predict late spontaneous improvement in cardiac function in patients with recent-onset DCM and had prognostic values for future cardiac events.
Abstract 3207: Role of Ischemic Preconditioning and Inflammatory Response in the Development of Malignant Ventricular Arrhythmias after Reperfused Acute Myocardial Infarction
Authors: Hidehiro Kaneko, Toshihisa Anzai, Kotaro Naito, Koji Ueno, Yusuke Jo, Toshiyuki Takahashi, Akio Kawamura, Tsutomu Yoshikawa, Satoshi Ogawa
Journal: Circulation (2007)

Background: Malignant ventricular arrhythmias, such as sustained ventricular tachycardia and ventricular fibrillation (VT/VF), are fatal complications after acute myocardial infarction (MI) even in the era of reperfusion therapies. We sought to clarify the determinants of VT/VF after reperfused MI. Methods: A total of 528 consecutive acute MI patients, who were treated with primary percutaneous coronary intervention, were divided into 2 groups according to the presence or absence of VT/VF during hospitalization. Serum C-reactive protein (CRP) level and peripheral white blood cell (WBC) count were serially measured for every 24 hours. As a substudy, left ventricular (LV) function and long-term clinical outcome were compared between patients with early (&gt;48 hours after the onset) and late VT/VF (&gt;48 hours). Results: VT/VF was observed in 58 patients (11%). Prior MI and anterior MI are more common in patients with VT/VF than those without. Prevalence of preinfarction angina was less in patients with VT/VF than those without. Peak CRP (14.7±10.1 vs. 8.8±7.1 mg/dl, p&lt; 0.0001), WBC on admission (12833±3513 vs. 10906±4771 /mm 3 , p=0.03) and maximum WBC (14808±5335 vs. 12531±4348 /mm 3 , p=0.009) were higher in patients with VT/VF than those without. Multivariate analysis revealed that prior MI (RR=4.57, p=0.02), absence of preinfarction angina (RR=2.44, p=0.02) and peak serum CRP ≥10 mg/dl (RR=3.37, p=0.003) were independent determinants of VT/VF. Early VT/VF was observed in 49 patients, while late VT/VF in 9 patients. Prevalence of prior MI, preinfarction angina or peak CRP ≥10mg/dl was comparable between early and late VT/VF. LV end-diastolic and end-systolic dimensions are greater in patients with late VT/VF than those with early VT/VF (p&lt; 0.05). Incidence of readmission for heart failure and sudden cardiac death tended to be higher in patients with late VT/VF than those with early VT/VF. Conclusions: VT/VF after reperfused acute MI was associated with prior history of MI, absence of preinfarction angina and increased inflammatory markers. VT/VF occurred in late phase was related to depressed LV function. Lack of ischemic preconditioning, enhanced inflammatory response and subsequent LV remodeling could contribute to the development of VT/VF after MI.
Abstract 3232: Risk Factor of the Thrombogenicity Related to Left Atrial Catheter Ablation for Atrial Fibrillation
Authors: Taro Date, Teiichi Yamane, Keiichi Inada, Yasuko Kanzaki, Kenri Shibayama, Ikuo Taniguchi, Seiichiro Matsuo, Ken-ichi Sugimoto, Michihiro Yoshimura
Journal: Circulation (2007)

Introduction: Although electrical pulmonary veins antral isolation (PVAI) has been shown to be beneficial in patients with drug-refractory atrial fibrillation (AF), cerebral embolism and stroke are still serious complications of AF ablation. We examined the risk factor of cerebral embolism caused by left atrial and PV catheter ablation, as detected by sensitive cerebral diffusion-weighted magnetic resonance imaging (DW-MRI). Methods: The subjects of this study were 52 patients (mean age 58 years, 44 males) with AF undergoing only PVAI (n =34), or PVAI+CFEA (continuous fragmented electrogram ablation, n =18). DW-MRI was performed 2 days after the procedures. Adequate heparin was given during the procedure to keep the activated clotting time 200 –250s, with following warfarin administration. Radiofrequency energy was delivered with a power limit of 30 or 35 W. Results: Postprocedural DW-MRI revealed new small embolic cerebral lesions (bright DW lesions) in 9 of 52 patients in cerebellum (5), frontal lobe (2), white matter (2), and parietal lobe (1). However, clinical neurological exam before and after the procedure was normal in all 9 patients. There was no statistical significance in age, history of AF, echocardiographic parameters, and procedure time between the patients with and without embolic cerebral lesions. The applied direct-current cardioversion during ablation procedure was only significantly associated with the occurrence of silent cerebral thromboembolism (p&lt;0.05). Additional CFEA to the PVAI did not increase the incidence of thrombogenicity. However, in the patients who underwent CFEA, radiofrequency application with a power limit of 35 W (not 30W) was associated with higher prevalence of positive DW-MRI findings (4/7 (max. 35W) vs. 0/11 (max 30W), p&lt;0.05). Conclusions: Our results demonstrate unexpectedly higher incidence of asymptomatic cerebral embolism related to the left catheter ablation procedures. Radiofrequency application to the LA with higher power limit (35 W) during CFEA and the applied direct-current cardioversion during the ablation procedures were associated with the thrombogenicity of left atrial catheter ablation.
Is there a need for training when using an oscillatory positive expiratory pressure device
Authors: Thibault Coppens, Grégory Reychler, Jean Roeseler, Pierre Delguste, Giuseppe Liistro
Journal: European Respiratory Journal (2011)

Introduction:  Oscillatory positive expiratory pressure with Acapella® is routinely used to remove secretions. The system uses a counterweighted plug and a magnet to generate pressure and airflow oscillations. To be efficient, this pressure must be higher than 10 cm H 2 O. There is no recommendation about the instructions for the patient and the interface (mouthpiece or facemask) to use with the system. The aim of this study was to measure the pressure generated by subjects after basic instructions.   Material and method:  Eight healthy subjects (28.7 yrs.± 8.0) were recruited. They were instructed to breathe through Acapella® with two interfaces (mouthpiece and facemask) and with different resistance settings in a randomized crossover design. Continuous recordings of airway pressure and airflow were performed. Sequence was composed by 5 breathes at each resistance setting. Success rate was defined as an expiratory pressure higher than 10cm H 2 O.   Results:  Depending on interface, significant differences (mouthpiece vs facemask) were measured for Pe max (11.23cm H 2 O±3.6 vs. 10.3cm H 2 O±2.52; p=0.001), Pe mean (6.67cm H 2 O±1.58 vs. 6.2cm H 2 O±1.43; p=0.001), inspiratory (3.04s±0.94 vs. 3.47s±1.11; p=0.001) and expiratory time (5.94s±2.05 vs 6.23s±2.01; p=0.01). Time spent with Pe ≥ 10cm H2O (1.24s±1.33 vs. 1.19s±1.48; p=0.69) was similar between interface. Success rate was low (59%). Neither difference in success rate (p=0.896) nor resistance (p=0.563) was observed depending on interface. Time with a pressure higher than 10cm H 2 O was only 20% of total expiratory time.   Conclusion:  Without specific training, efficient expiratory pressure (higher than 10cm H 2 O) was obtained in less than 60% of breathing.
The Right to Health in the Americas: A Comparative Constitutional Study
Authors: Hernán L. Fuenzalida-Puelma, Susan Scholle Connor
Journal: Annals of Internal Medicine (1990)

This monograph gives lawmakers an understanding of the importance of the  to  and aims to promote among health professionals an awareness of laws role in health.  The monograph consists of 3 chapters.  Chapter 1 deals with basic concepts.  29 national analyses are contained in Chapter 2.  The analyses consist of constitutional framework historical health treatment in legislation and the constitution current treatment of health in legislation and the constitution and recognition of other rights related to the health right in the Constitution.  There include protection of work life human dignity and liberty the environment the family and the right to form and join trade unions.  There is also the protection derived from the Social Security system.  Conclusions and notes and references end the analyses.  In Chapter 3 the constitutional history and evolution of Portuguese America Hispanic America the Caribbean and North America are described.  This includes civil and common law systems; forms and structure of government; characteristics of constitutions; the concept of the  to health; and other health-related human rights.  There are 5 tables and 3 appendices.
Abstract 925: Rit GTPase Protects Cells from Oxidative Damage
Authors: Jennifer L Rudolph, Geng-Xian Shi, Susan M Harrison, Douglas A Harrison, Douglas A Andres
Journal: Circulation (2007)

Signaling cascades that contribute to the regulation of cellular survival influence many cardiovascular diseases. Elucidating the mechanisms of these cascades is thus important for understanding basic biology and for therapeutic intervention. We have identified an evolution-arily conserved group of Ras-related GTPases, including two mammalian genes (Rit and Rin) and a single Drosophila ortholog (Ric), that we hypothesize plays a critical role in trophic factor-mediated anti-apoptotic signaling. Expression of activated Rit in PC6 cells induces potent activation of the MAP kinases ERK1/2 and p38, and promotes neurite outgrowth and cell survival. Furthermore, RNAi-mediated Rit silencing sensitized PC6 cells to a wide variety of stresses, in part by inhibiting NGF-mediated activation of ERK and p38 MAP kinases and CREB. Here we present studies from two genetic models designed to further assess our hypothesis. First, we generated a transgenic mouse over-expressing constitutively activated Rit (RitL79). To begin to assess the contribution of Rit signaling to cellular survival, we examined the ability of cortical neuronal cultures isolated from Rit-TG versus wild-type littermates to survive reactive-oxygen-species (ROS)-mediated cell death. Cell viability for wild-type cortical neurons following a 4 h exposure to H2O2 (60 μM) was reduced approximately 90%, while cortical neurons isolated from Rit-TG mice were largely unaffected by this treatment. Thus, RitL79-mediated signaling protects cortical neurons against ROS-mediated apoptosis. As further confirmation of the important role this protein family plays in survival from stress, we generated a Drosophila strain null for D-Ric. Mutants are homozygous viable and show no obvious developmental abnormalities. However, D-Ric mutants are susceptible to environmental stresses, including heat stress and dry starvation. Taken together, these studies suggest a conserved role for Rit/Ric in promoting cellular survival and suggest that Rit signaling is a potential target for pharmaceutical intervention. We look forward to assessing Rit’s role in other systems including cardiac and vascular cell types. This work was supported by a Predoctoral Fellowship from the AHA.
Soundings: Duty doctor
Authors: Trisha Greenhalgh
Journal: BMJ (2003)

Being a medical Jack of all trades, and making no secret of my taste for adventure, I am often approached by people who seek to include a medic in some ambitious scheme or other. Would I oversee a sponsored swim in a pool in someone's back garden, with 50 children aged 4 to 17 (and, by the way, they all have diabetes)? Would I fly to South America to escort the wayward offspring of a friend of a friend whose gap year exploits had landed him cocooned in plaster of Paris?

At one short-staffed school fete, they stationed me on bash the rat where I managed a five hour stint, breaking off periodically to attend to a bilious toddler or pick the gravel from a scraped knee. The only incident that merited recording in the official log book was when I poked myself in the eye with the aerial of the walkie-talkie.

Then there was the unfortunate farmer who had fallen on hard times and (against his better judgment) taken to organising children's birthday parties. He had been up all night lambing, and when our party arrived was up to the elbows in a struggling ewe. With 25 brats demanding his services for donkey rides and hide and seek, I offered my assistance.

I was thinking of holding the leading rein, but he passed me the rubber gloves and galloped away with the parting shot that if a head came down, I was to shove it back and fish around for a pair of hind legs. By the time that he had returned from the treasure hunt, I had delivered quads.

One of my sons, wise to this kind of improvisation, had the cheek to ask the credentials of the gentleman who came forward when he was stretchered off the rugby pitch.

“Actually,” replied the doctor as he administered the bucket and sponge, “I'm a gynaecologist.”

When all else fails, bluff. A few years back I turned up to run a marathon that started at high noon. Among the crowds I spotted the duty doc—an old chum from medical school who had proved squeamish and retreated into public health immediately after her house jobs.

“Good grief!” I said, “You wouldn't have any idea what to do if one of us collapsed.”

“True,” she said, eyeing the cloudless sky and unforgiving sun. “But I'd know what to do if a thousand of you all collapsed at the same time.”
Hypofibrinogenemia Associated With a Heterozygous Missense Mutation γ153Cys to Arg (Matsumoto IV): In Vitro Expression Demonstrates Defective Secretion of the Variant Fibrinogen
Authors: Fumiko Terasawa, Nobuo Okumura, Kiyoshi Kitano, Nobuaki Hayashida, Makoto Shimosaka, Mitsuo Okazaki, Susan T. Lord
Journal: Blood (1999)
Uptake and Binding of 3′-(3-Cyano-4-morpholinyl)-3′-deaminoadriamycin and 3′-(4Morpholinyl)-3′-deaminoadriamycin in L5178Y Lymphoblasts In Vitro
Authors: Asher Begleiter, Michael I. Jesson, James B. Johnston
Journal: Cancer Communications (1990)

3'-(3-Cyano-4-morpholinyl)-3'-deaminoadriamycin (CMA) and 3'-(4-morpholinyl)-3'-deaminoadriamycin (MA) are analogues of Adriamycin, with altered cytotoxic activity. CMA is 100- to 1500-fold more cytotoxic than Adriamycin and possesses unique DNA crosslinking activity. Intact MA does not crosslink DNA and has a cytotoxicity equivalent to Adriamycin, but it retains its activity in anthracycline-resistant cells. In this study, uptake and binding of [3H]CMA and [3H]MA in L5178Y lymphoblasts were examined. Both CMA and MA were rapidly taken up by cells at 37 degrees C and concentrated almost exclusively in the nucleus. All of the intracellular MA was TCA-soluble, but only 45% of this drug effluxed from the cells by 4 hr. More than 50% of CMA in the cells was TCA-insoluble, and approximately 40% effluxed from the cells by 4 hr through loss of the TCA-soluble fraction. CMA differed from other alkylating agents in that more than 97% of the bound drug was associated with DNA. The bound drug was partially lost from the DNA by a process that may have involved DNA repair.
Screening and mortality from cervical cancer
Authors: J. S Vaidya, M. Baum, M J Quinn, P J Babb, J Jones, P. Adab, S. McGhee, A. Hedley
Journal: BMJ (1999)

Editor—We were rather non-plussed to read that the conclusion of the paper by Quinn et al on screening for cervical cancer1 is not supported by their data, and we wonder whether so called political correctness had anything to do with it. The statement “800 deaths might have been prevented in 1997” is based on a projected mortality of a completely arbitrarily (alas, not randomly) selected part of a subset of graphs showing trends in mortality. The opposite conclusion may be reached using the same graphs. For example, in women aged 35-44 mortality fell from 10 per 100 000 to 5 per 100 000 in the period 1960 to 1975, and it should have approached zero by 1997 assuming that the trend had continued. Similarly, with the same age groups as in the original paper, in women aged 25-34 mortality fell from 2.5 per 100 000 to 1.1 per 100 000 in the period 1955 to 1965, so by 1997 it should have again approached zero. Since the only new intervention has been screening, and the mortality is excessive at 5 per 100 000, screening may have caused up to 2900 extra deaths in 1997—by the same logic.
Reducing number of postcodes that cannot be ascribed would increase validity of method
Authors: R. A Lyons, S. Monaghan, M. Heaven, A. Willson
Journal: BMJ (1995)

EDITOR,--Glen Scrivener and David C E F Lloyd conclude that allocating census data to general practice populations is not sufficiently accurate for the purposes of explaining variations in prescribing despite their finding correlation coefficients of up to 0.84 from two of their methods.1 They acknowledge that perfect correlation is impossible in an ecological comparison. Nevertheless, the correlation coefficients might have been higher if the 11710 patients (3.2%) whose postcode could not be matched had been included in the analysis. This …
Abstract 16027: Mitochondrial ATP-Binding Cassette Protein-1 (mABC1) Protects Against Doxorubicin-Mediated Cardiotoxicity
Authors: Yoshihiko Ichikawa, Marina Bayeva, Mohsen Ghanefar, R. Kannan Mutharasan, Rongxue Wu, Hossein Ardehali
Journal: Circulation (2011)

Background: Doxorubicin (DOX) is an anticancer drug that causes cardiomyopathy through iron-mediated oxygen radical damage. We had previously shown that mitochondrial ATP-biding cassette protein-1 ...
In vitro biosynthesis of leukemia inhibitory factor/human interleukin for DA cells by human endothelial cells: differential regulation by interleukin-1 alpha and glucocorticoids
Authors: C Grosset, B Jazwiec, JL Taupin, H Liu, S Richard, FX Mahon, J Reiffers, JF Moreau, J Ripoche
Journal: Blood (1995)
I Love a Sunburnt Country ... Tripartite Collaborative Approaches to Bringing Stereotactic Ablative Body Radiotherapy (Sabr) Lung to the People of Regional Australia
Authors: Fiona Hegi-Johnson, Eric Hau, Kylie Unicomb, Jeffrey Barber, Melissa Rains, Dan Lu, Michael Bailey, Jianje Luo, Matthew Foote, Roland Yeghiaian-Alvandi
Journal: Journal of Thoracic Oncology (2013)
Statistics notes
Authors: G L Dickie, S Fleminger, D G Altman, J M Bland
Journal: BMJ (1994)

unknown referee as any evidence of these could then be referred back to the referee's institution.The bench test of a piece of research is its shelf life: will it still be of interest or relevant in 10 years' time?This test could equally well apply to negative findings.Many important discoveries throughout history have initially been considered to be unacceptable on religious or cultural grounds.As the ultimate peer reviewer is the wider medical audience, the medical referee should perhaps just
Update: influenza activity - United States, August 30-October 31, 2009.
Authors: L. Brammer, S. Epperson, L. Blanton, R. Dhara, T. Wallis, L. Finelli, T. Fiore, L. Gubareva, J. Bresee, L. Kamimoto, X. Xu, A. Klimov, C. Bridges, N. Cox, C. Cox
Journal: MMWR Morbidity and Mortality Weekly Report (2009)
Medicine and books: Current Issues in Cardiology: Management Strategies
Authors: Ron J G Peters
Journal: BMJ (1998)

Ed Jean R McEwan 

BMJ Publishing Group, £30, pp 245 

ISBN 0 7279 1010 8 

In this age of overwhelming medical information, it is more than welcome when knowledgeable people summarise and interpret the literature for us, even if the conclusions are personal and might have been slightly different. This book is a good example of how complex data can be synthesised to understandable formats for average users of the information, provided the authors know their business. These 15 authors, all British and 12 from London, have succeeded in being concise and clear, and the conclusions are, in general, useful in daily practice. 

Chapter 10, by the editor, is particularly interesting. Entitled “Implementing cardiovascular strategies in hospital practice,” its appendix summarises the current local acute cardiology handbook that is used in University College London Medical School. There it is issued in a convenient size for carrying in coat pockets. We rarely read about actual hospital rules for admission and discharge, indications for thrombolysis, and the rest. The authors are to be commended for their courage to disclose their everyday strategies to a larger audience. 

The other nine chapters concern subjects in cardiology that have been studied extensively in recent years (thrombolysis, heart failure, anticoagulation, risk factor management, etc). The results of clinical trials on all of these subjects force us to update our practice regularly, and this book truly helps. Conclusions drawn from the same literature may, however, be different in other countries. Depending on resources, ethical and cultural issues, and infrastructure, the recommendations may vary. Therefore, the reach of this book is largely limited to Great Britain. For example, the statements about primary angioplasty in acute myocardial infarction are remarkably conservative compared with the opinions of cardiologists from other Western countries. With the same factual observation, one may consider the glass half full or half empty, and both are right. 

This type of book will probably be extinct in a few years. The changes in medicine, based on results from ever newer trials, make them outdated before the ink is dry, and McEwan’s book has not been spared in this respect. We are moving toward electronic publication of summaries of the literature, guidelines, and treatment protocols. The new media have important advantages over printed versions. The information is more widely and more easily available (also during out of office hours), and it can be continuously updated without confusions over old and new editions. Published by national societies of medical specialists, they can have the authority of a true standard and will facilitate and standardise audits of local practices.