tbuckley/cabot-search huggingface dataset:
The genesis of arrhythmias during myocardial ischemia. Dissociation between changes in cyclic adenosine monophosphate and electrical instability in the rat.
Authors: A SManning, KKinoshita, EBuschmans, D JColtart, D JHearse
Journal: Circulation Research (1985)

It has been proposed that increases in tissue cyclic adenosine monophosphate during ischemia may be responsible for the induction of arrhythmias that occur during the early minutes of ischemia. We have tested this hypothesis using the isolated perfused rat heart with coronary artery occlusion for 30 minutes. In control hearts, after a transient small rise, cyclic adenosine monophosphate content remained close to its preischemic value (3.0 +/- 0.1 nM/g dry weight) throughout the period of occlusion. Eight percent (1/12) of the hearts fibrillated. Ninety-two percent (11/12) of the hearts exhibited ventricular tachycardia, and the mean total number of premature ventricular complexes was 528 +/- 121. Inclusion of epinephrine (1.0 microM) in the perfusion fluid elevated cyclic adenosine monophosphate prior to coronary occlusion (to 10.7 +/- 0.6 nM/g dry weight) and also throughout the ischemic period. It also increased arrhythmias such that 83% (20/24) of hearts fibrillated, 100% exhibited ventricular tachycar...
Expanding the sport and exercise medicine online community and quality international education: join the SMA journey in 2021!
Authors: Liam Richard West, Joanne Kemp
Journal: British Journal of Sports Medicine (2021)

Sports Medicine Australia (SMA) has prioritised the health of Australians during COVID-19. We are proud of the central role we have played in enabling the graduated and near complete return to sport following the COVID-19 shutdowns, across both community and elite level competitions in Australia. SMA’s webinars have guided sports trainers (students, parents or first-aid volunteers) to operate in a COVID-19 safe environment and return athletes safely to sport, while also covering the essentials of telehealth in sports medicine and importance of infection control in sport (https://bit.ly/3a5N07K).

SMA has used COVID-19 literature to inform its guidance on safe return across all levels of sporting competition in Australia. We direct the reader to Dr Solomon’s review that operationalises return to sport considerations in the current COVID-19 environment for the five North American professional sports leagues (see page 417) . While centred on the elite sporting environment, the key messages are relevant to all sporting levels and codes globally. Unfortunately, even with optimal planning and hygiene practices, positive cases among athletes and their …
Oral contraceptives and hypertension.
Journal: BMJ (1970)

3DCAL JOUL more sourly since he ended his song.By the late 1950s its lower reaches had become so lifeless as to differ from the moon (the subject of a neighbouring exhibit) only in being wetter.But in the last ten years the measures taken to control its pollution have had their effect.Fish have reappeared, and a few of those that did not get away-probably owing to their small size-were shown for all to see.If not altogether "sweet," that noble river does at least show signs of life again.
Letter by Angiolillo et al Regarding Article, “Cangrelor, Tirofiban, and Chewed or Standard Prasugrel Regimens in Patients With ST-Segment–Elevation Myocardial Infarction: Primary Results of the FABOLUS FASTER Trial”
Authors: Dominick J. Angiolillo, Deepak L. Bhatt, Gregg W. Stone
Journal: Circulation (2021)
Dilation of normal and constriction of atherosclerotic coronary arteries caused by the cold pressor test.
Authors: E GNabel, PGanz, J BGordon, R WAlexander, A PSelwyn
Journal: Circulation (1988)

Increased vascular constriction has been observed at the site of atherosclerotic lesions, suggesting an association between atherosclerosis and altered vascular tone. While atherosclerosis may increase sensitivity to exogenous vasoconstrictors, little is known about the response of normal and atherosclerotic coronary arteries to an exogenous stimulus that excites the sympathetic nervous system. Therefore, we studied the response to cold pressor test (CPT) using quantitative angiography and Doppler flow velocity measurements in eight patients with angiographically normal coronary arteries (group I), nine patients with mild coronary atherosclerosis (less than 50% diameter narrowing) (group II), and 13 patients with advanced coronary stenoses (greater than 50% diameter narrowing) (group III). In 31 segments of angiographically smooth arteries in group I, the CPT produced vasodilation from a control mean diameter of 2.68 +/- 0.09 (mean +/- SE) to 2.99 +/- 0.09 mm at peak CPT (p less than 0.001), a 12 +/- 1% i...
Low-dose dobutamine echocardiography detects reversible dysfunction after thrombolytic therapy of acute myocardial infarction.
Authors: S CSmart, SSawada, TRyan, DSegar, LAtherton, KBerkovitz, P DBourdillon, HFeigenbaum
Journal: Circulation (1993)

BACKGROUNDDysfunction after thrombolytic therapy of acute myocardial infarction (MI) may be reversible. Early after myocardial infarction, both reversible and irreversible injury may be manifested by regional wall motion abnormalities. Improved wall thickening during dobutamine infusion (dobutamine-responsive wall motion) may accurately identify reversibly injured segments.METHODS AND RESULTSTo determine whether dobutamine-responsive wall motion accurately detects reversible postischemic dysfunction irrespective of infarct location, multistage (baseline, 4 and 12 micrograms.kg-1.min-1, and peak) dobutamine echocardiography (DE) was performed within 7 days of thrombolytic therapy. Resting echocardiography was repeated > or = 4 weeks after MI, and reversible dysfunction was defined as improved wall motion. The accuracy of dobutamine-responsive wall motion was compared with that of signs of early reperfusion, non-Q-wave MI, and peak creatine kinase (CK). Sixty-three patients underwent DE without complication...
Letter by Boschetti et al Regarding Article, “Predictors of Outcome in Medically Treated Patients With Acute Coronary Syndromes After Angiographic Triage: An Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) Substudy”
Authors: Enrico Boschetti, Marcella De Paolis, Federica Piccioni
Journal: Circulation (2010)
The absent pulmonary valve syndrome. Considerations of management.
Authors: W WPinsky, M RNihill, C EMullins, GHarrison, D GMcNamara
Journal: Circulation (1978)

The absent pulmonary valve syndrome consists of a severely hypoplastic pulmonary valve with anular stenosis, aneurysmal dilatation of the main pulmonary artery with one or both pulmonary branches also dilated, and a ventricular septal defect. From 1955 to 1975, 15 patients were seen at Texas Children's Hospital with this syndrome. Although anatomically similar to tetralogy of Fallot, the most significant symptoms during early infancy were secondary to bronchial compression resulting from the dilated pulmonary arteries and enlarged left atrium. Intracardiac repair performed on two infants at four months of age failed to ameliorate the respiratory symptoms and both died. Seven patients from 2.3 to 16 years of age were operated upon, with one late postoperative death. Five other patients have not yet received surgical intervention. We recommend vigorous continual respiratory therapy for for infants and small children and intracardiac repair in older children since repair in infancy does not relieve respirato...
Dopa responsive dystonia.
Journal: BMJ (1989)

Objective To deepen the understanding and attention to dopa-responsive dystonia(DRD)[also hereditary progressive dystonia(HPD)or Segawa disease].Methods The clinical manifestations,labo-ratory findings and treatment in seven patients with DRD from different families diagnosed in this hospital dur-ing the recent 3years were analyzed,and the related literatures were reviewed.Results Seven patients with DRD(1male and6female)whose onset ages were6to29years,averaged(13.43±7.93)years.The mean course before diagnosis was1.5years in four cases;and the others had longer course s(25,47and16years respectively).The clinical symptoms in all of the cases were slow onset with stiffness and weakness of ex-tremities,or associated with tremor,toe flexion and talipes varus,and characterized by alleviation in the morn-ing and aggravation in the afternoon or evening.Somatoscopy showed rigid tension or cogwheel rigidity of the limbs,active tendon reflexes or hyperreflexia in both lower extremities in all cases and pathological reflex oc-curring in four cases.Other examinations including serologic test,cerebrospinal fluid,brain CT and MRI,and neuroelectrophysiological examination were all in normal range.There were significant effect on all patients treated with small dose of madopar.The average dosage was105.17mg /d.The longest treatment with madopar had been lasting for14years and the dosage needed not increasing.Conclu sion DRD is a rare hereditary movement disorder.The diagnosis of the disease is not difficult in patients with typical manifes-tions.There is significant and sustained effect on DRD with small dose of dopa preparations,treatment with artane or amantadine is effective in the early course.The attention should be payed in differentiating DRD from Parkinson's disease.[
Evolution of infarct size during the early use of nifedipine in patients with acute myocardial infarction: the Norwegian Nifedipine Multicenter Trial.
Authors: P ASirnes, KOverskeid, T RPedersen, JBathen, ADrivenes, G SFrøland, J KKjekshus, KLandmark, RRokseth, K ESirnes
Journal: Circulation (1984)

In a multicenter double-blind study, 227 patients with suspected acute myocardial infarction (AMI) were randomized within 12 hr from onset of symptoms to treatment with nifedipine (112 patients) or placebo (115 patients). AMI was confirmed in 74 patients on nifedipine and in 83 on placebo. Patients with AMI received nifedipine 5.5 +/- 2.9 hr (mean +/- SD) after onset of symptoms. Infarct size was assessed by the release of creatine kinase isoenzyme MB (CK-MB). Infarct size index (CK-MB geq/m2) was 25 +/- 16 (n = 71) in the nifedipine group and 23 +/- 13 (n = 77) in the placebo group (NS). After the first 10 mg of nifedipine systolic blood pressure fell from 147 +/- 30 to 135 +/- 28 mm Hg (p less than .01) and heart rate rose from 75 +/- 18 to 79 +/- 19 beats/min (p less than .01). No change was observed after the first placebo dose. The treatment was continued for 6 weeks. Over this period there were 10 deaths in each group. Early treatment with nifedipine in patients with AMI does not seem to reduce infa...
Regional left ventricular wall thickening. Relation to regional uptake of 18fluorodeoxyglucose and 201Tl in patients with chronic coronary artery disease and left ventricular dysfunction.
Authors: PPerrone-Filardi, S LBacharach, VDilsizian, SMaurea, J AFrank, R OBonow
Journal: Circulation (1992)

BACKGROUNDIn previous studies comparing regional 201Tl (201Tl) and 18fluorodeoxyglucose (FDG) activity in patients with chronic coronary artery disease and left ventricular dysfunction, we hypothesized that regions with mild-to-moderate reduction in FDG activity and regions with mild-to-moderate irreversible 201Tl defects after 3- to 4-hour redistribution represent viable myocardium. In the present study, regional FDG and 201Tl activities were compared with regional systolic wall thickening by gated magnetic resonance imaging (MRI) to confirm the presence of viable myocardium in these territories.METHODS AND RESULTSTwenty-five patients with chronic stable coronary artery disease and left ventricular dysfunction (ejection fraction, 28 +/- 10) underwent exercise 201Tl tomographic imaging (SPECT), using a reinjection protocol, positron emission tomography (PET) with FDG and H2(15)O, and gated MRI. Matched SPECT, PET, and MRI tomograms were analyzed. From the PET data, 105 regions had matched reduction in FDG...
Effect of increased free fatty acids on myocardial oxygen extraction and angina threshold during atrial pacing.
Authors: G RDagenais, BJalbert
Journal: Circulation (1977)

To evaluate whether elevated arterial free fatty acids (FFA) increase myocardial oxygen demand and ischemia, 15 fasting patients with coronary artery disease underwent a standardized atrial pacing test before (PTI) and during (PT2) heparin infusion. The patients were monitored for clinical and electrocardiographic (ECG) manifestations of ischemia. Myocardial extraction of lactate, inorganic phosphate, oxygen and FFA was measured before and during each PT. The control arterial FFA was 0.65 +/- 0.03 micromole/ml and rose to 1.83 +/- 0.16 micromole/ml during heparin influsion. Myocardial oxygen extraction at rest and during PT was not affected by the increase in arterial FFA. Seven patients asymptomatic during PT1 did not develop ischaemic manifestations during PT2. In eight patients with angina during both PTs, increased arterial FFA concentration did not modify the severity of anginal pain, the amount of ST-segment depression and the myocardial balance of lactate or inorganic phosphate. Elevation of arteri...
OC-071 Epithelial cytoplasmic hmgb1, epithelial nuclear runx3 and dynamic stromal lymphocytic phenotype are associated with oesophageal neoplastic progression
Authors: RJ Porter, DP Brice, GI Murray, RD Petty, M McLean
Journal: Gut (2017)

Introduction  Barrett’s oesophagus (BO) defined by metaplastic columnar epithelium in the distal oesophagus is a pre-malignant lesion for oesophageal adenocarcinoma (OAC). HMGB1 impacts genomic stability, influences epithelial cell behaviour and immune response. We previously reported loss of nuclear and emergence of cytoplasmic epithelial HMGB1 in BO and dysplasia. Our aim was to define expression of HMGB1 in upper GI malignancy, assess expression of HMGB1 downstream effector proteins p53 and RUNX3 and characterise lymphocytic infiltrate in oesophageal neoplastic progression.  Method  Tissue was sourced from the Grampian Biorepository (n=241 total). Intensity of epithelial nuclear and cytoplasmic expression of target proteins were assessed immunohistochemically in a tissue microarray representing 150 upper gastrointestinal cancers (58 OAC, 9 oesophageal squamous cancer, 83 gastric adenocarcinoma), 15 normal oesophageal mucosa, 24 normal gastric mucosa and 14 BO mucosa adjacent to OAC. Expression of p53, RUNX3 and lymphocytic inflammatory cell infiltrate was also assessed in 78 and 13 biopsies from 19 and 10 patients with non-dysplastic or dysplastic BO. Data was analysed by relative frequencies of staining correlated to clinico-pathological data, Fisher’s exact test and Mann-Whitney U test.  Results  There was loss of nuclear HMGB1 across all cancer phenotypes. Epithelial cytoplasmic HMGB1 expression was associated with OAC compared to normal epithelium (p  Conclusion  This study offers new insight into the pathogenesis of oesophageal neoplastic progression. The biological significance of dynamic localisation and intensity of HMGB1 and RUNX3, and changes in adjacent stromal inflammatory cell infiltrate warrant further investigation to determine a protective or pathogenic role in oesophageal neoplasia.  Disclosure of Interest  None Declared
After correcting for worse baseline characteristics, women treated with thrombolytic therapy for acute myocardial infarction have the same mortality and morbidity as men except for a higher incidence of hemorrhagic stroke. The Investigators of the International Tissue Plasminogen Activator/Streptokinase Mortality Study.
Authors: H DWhite, G IBarbash, MModan, JSimes, RDiaz, J RHampton, JHeikkilä, AKristinsson, SMoulopoulos, E APaolasso
Journal: Circulation (1993)

BACKGROUNDIn the prethrombolytic era, women with myocardial infarction were reported to have a worse outcome than men. This analysis evaluates the association of sex with morbidity and mortality after thrombolytic therapy.METHODS AND RESULTSData were analyzed from 8261 of the 8387 randomized patients with acute myocardial infarction who received thrombolytic therapy in the International Tissue Plasminogen Activator/Streptokinase Mortality Study (baseline data were missing for 126 patients) and were followed for 6 months. Women made up 23% (n = 1944) of the study population. Baseline characteristics were worse in women: they were 6 years older, were more likely to have a history of previous infarction (P < .01), antecedent angina (P < .01), hypertension (P < .0001), or diabetes (P < .0001); were in a higher Killip class on admission (P < .0002); and received thrombolytic therapy 18 minutes later than men (P < .0001). Fewer women were smokers (P < .0001). Women had a higher hospital (12.1% versus 7.2%, P < ...
Oral Pharmacologic Treatment of Type 2 Diabetes Mellitus
Authors: Robert S. Moskowitz
Journal: Annals of Internal Medicine (2012)

Letters3 July 2012Oral Pharmacologic Treatment of Type 2 Diabetes MellitusRobert S. Moskowitz, MDRobert S. Moskowitz, MDFrom Staten Island, NY 10314.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-157-1-201207030-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Qaseem and colleagues touted metformin for its efficacy and benefits in a recent clinical guideline (1), and then went on to say “metformin is contraindicated in patients with impaired kidney function ..., heart failure, and any condition that might lead to lactic acidosis.” These contraindications leave out most elderly patients who are the best candidates for metformin use (for example, patients with no hypoglycemia or those with positive cardiovascular effects).Metformin is safe to use except in patients with severe renal impairment (2, 3) and has caused less lactic acidosis than other oral agents (4). Many diabetic ...References1. Qaseem A, Humphrey LL, Sweet DE, Starkey M, Shekelle P; Clinical Guidelines Committee of the American College of Physicians. Oral pharmacologic treatment of type 2 diabetes mellitus: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2012;156:218-31. [PMID: 22312141] LinkGoogle Scholar2. Heaf JG, Van Biesen W. Metformin and chronic renal impairment: a study of choices and ugly ducklings. Clin Diabetes. 2011;29:97-101. CrossrefGoogle Scholar3. Jones GC, Macklin JP, Alexander WD. Contraindications to the use of metformin [Editorial]. BMJ. 2003;326:4-5. [PMID: 12511434] CrossrefMedlineGoogle Scholar4. Bodmer M, Meier C, Krähenbühl S, Jick SS, Meier CR. Metformin, sulfonylureas, or other antidiabetes drugs and the risk of lactic acidosis or hypoglycemia: a nested case-control analysis. Diabetes Care. 2008;31:2086-91. [PMID: 18782901] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Robert S. Moskowitz, MDAffiliations: From Staten Island, NY 10314.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoOral Pharmacologic Treatment of Type 2 Diabetes Mellitus: A Clinical Practice Guideline From the American College of Physicians Amir Qaseem , Linda L. Humphrey , Donna E. Sweet , Melissa Starkey , Paul Shekelle , and Metrics 3 July 2012Volume 157, Issue 1Page: 75KeywordsConflicts of interestElderlyHeart failureHypoglycemiaKidneysLactic acidosisType 2 diabetes ePublished: 3 July 2012 Issue Published: 3 July 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Nurses for nursing.
Authors: R Uldall
Journal: BMJ (1973)

ried out with the patients in group B, ex- cept they were told that the new drug was acting and that their blood pressure had decreased.The true blood pressures, all of which showed decreases, were recorded each day as percentages of the patient's basic systolic and diastolic levels established before treat- ment began.The mean of these percentages were then taken for each patient in each group and the average of these means taken as representative of each group for com- parison with the other group.These showed that in group A at the end of the treatment the systolic blood pressure was 90-8% of the pretreatment level and the diastolic pressure 93 0% of the pretreatment level.The corres- ponding figures for group B were 95-8% and 97 2%.The differences in the systolic and diastolic values between the two groups were not statistically significant (P > 0-1 and > 0 2).Our results in this short trial show that posi- tive or negative information given to the patient does not influence the changes of blood pressure produced by effective hypo- tensive agents.Therefore the doctor's attitude toward the patient probably does not affect the evaluation of antihypertensive drugs.-Weare, etc.,
Echocardiography of cardiac valves in pericardial effusion.
Authors: N CNanda, RGramiak, C MGross
Journal: Circulation (1976)

Nine adult patients with large pericardial effusions (PE) demonstrated echocardiographic motion abnormalites of cardiac valves in systole. In four cases (Group 1), the abnormal findings consisted of prominent systolic anterior movements of the mitral valve resembling those seen in idiopathic hypertrophic subaortic stenosis. In Group 2(five cases), typical mitral valve prolapse patterns with large posterior midsystolic displacements well below the C point were observed. Additional abnormalities in Group 2 included tricuspid valve prolapse patterns (four cases), early systolic movement of the aortic valve toward closure (three cases), midsystolic notching of the pulmonary valve (two cases) and abnormal or attenuated motion of the aortic root in all patients. Marked decrease or resolution of PE resulted in complete disappearance of all the observed abnormalities. These findings appeared to be related to large fluid collections behind the left atrium and abnormal movement of the heart in the pericardial space...
Effect of angioplasty-induced endothelial denudation compared with medial injury on regional coronary blood flow.
Authors: E RBates, M JMcGillem, T FBeals, S FDeBoe, J KMikelson, G BMancini, R AVogel
Journal: Circulation (1987)

To determine the effect of angioplasty-induced arterial injury on regional coronary blood flow, resting and postocclusion reactive hyperemic flows were measured in the left anterior descending (LAD) and circumflex (LCx) coronary arteries of 32 dogs after one of four interventions in the LAD with a balloon angioplasty catheter: group A, no injury; group B, endothelial denudation; group C, medial injury; group D, pretreatment with 325 mg of aspirin 2 hr before medial injury. Resting flows did not change in any group. In group C, hyperemic flow decreased in both the LAD and LCx by 15% to 20% (p less than .001) over 30 to 90 min, suggesting that a circulating substance changed coronary resistance. Histologic and ultrastructural studies of the LADs demonstrated an intact endothelial cell layer in group A, endothelial disruption with a few adherent platelets in group B, medial injury with a dense layer of adherent platelets in group C, and medial injury with a few adherent platelets in group D. Thus endothelial...
Cap Assisted Endoscopic Mucosal Resection For Rectal Neuroendocrine Tumours: An Effective Option
Authors: M João, M Areia, L Elvas, S Alves, S Saraiva, D Brito, AT Cadime
Journal: Endoscopy (2021)

Aims The incidence of rectal neuroendocrine tumours (NETs) is increasing and most small rectal NETs can be treated endoscopically. The optimal endoscopic approach is still under discussion. Conventional (inject and cut) endoscopic mucosal resection (EMR) leads to frequent incomplete resection. Endoscopic submucosal dissection allows higher complete resection rates but is also associated with higher complication rates. Some studies suggested modified (cap assisted) EMR as an effective and safe alternative. This study aimed to evaluate the efficacy and safety of a type of cap assisted EMR for rectal NETs < 10mm without muscularis propria invasion or lymphovascular infiltration.