tbuckley/cabot-search huggingface dataset:
Dapagliflozin and Recurrent Heart Failure Hospitalizations in Heart Failure With Reduced Ejection Fraction: An Analysis of DAPA-HF
Authors: Pardeep S. Jhund, Piotr Ponikowski, Kieran F. Docherty, Samvel B. Gasparyan, Michael Böhm, Chern-En Chiang, Akshay S. Desai, Jonathon Howlett, Masafumi Kitakaze, Mark C. Petrie, Subodh Verma, Olof Bengtsson, Anna-Maria Langkilde, Mikaela Sjöstrand, Silvio E. Inzucchi, Lars Køber, Mikhail N. Kosiborod, Felipe A. Martinez, Marc S. Sabatine, Scott D. Solomon, John J.V. McMurray
Journal: Circulation (2021)

Patients with heart failure (HF) and reduced ejection fraction will experience multiple hospitalizations for heart failure during the course of their disease. We assessed the efficacy of dapagliflozin on reducing the rate of total (ie, first and repeat) hospitalizations for heart failure in the DAPA-HF trial (Dapagliflozin and Prevention of Adverse-Outcomes in Heart Failure). The total number of HF hospitalizations and cardiovascular deaths was examined by using the proportional-rates approach of Lei-Wei-Yang-Ying and a joint frailty model for each of recurrent HF hospitalizations and time to cardiovascular death. Variables associated with the risk of recurrent hospitalizations were explored in a multivariable Lei-Wei-Yang-Ying model. Of 2371 participants randomly assigned to placebo, 318 experienced 469 hospitalizations for HF; of 2373 assigned to dapagliflozin, 230 patients experienced 340 admissions. In a multivariable model, factors associated with a higher risk of recurrent HF hospitalizations included higher heart rate, higher N-terminal pro-B-type natriuretic peptide, and New York Heart Association class. In the Lei-Wei-Yang-Ying model, the rate ratio for the effect of dapagliflozin on recurrent HF hospitalizations or cardiovascular death was 0.75 (95% CI, 0.65-0.88), P=0.0002. In the joint frailty model, the rate ratio for total HF hospitalizations was 0.71 (95% CI, 0.61-0.82), P<0.0001, whereas, for cardiovascular death, the hazard ratio was 0.81 (95% CI, 0.67-0.98), P=0.0282. Dapagliflozin reduced the risk of total (first and repeat) HF hospitalizations and cardiovascular death. Time-to-first event analysis underestimated the benefit of dapagliflozin in HF and reduced ejection fraction. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03036124.
Cardiac imaging using a phased array ultrasound system. II. Clinical technique and application.
Authors: JKisslo, O TvonRamm, F LThurstone
Journal: Circulation (1976)

A new two-dimensional ultrasound imaging system capable of producing high resolution tomographic images of the heart in real time has been developed. This system relies on phased array principles to rapidly steer the ultrasound beam through the structures under investigation. A hand-held linear array of 16 ultrasound transducers with overall dimensions of 14 mm at the site of contanct may be readily manipulated to image various cardiac structures. The resulting images are displayed in a circular sector format, 60 degrees in azimuth and typically 15 cm in range. At his maximum range, image frames consisting of 256 lines are generated at the rate of 20 frames/second. High azimuthal resolution throughout the field of view is assured by a focused transmit beam and by sweeping the focus of the receiver is synchrony with the range of returning echoes. Azimuthal resolution varies from 2 to 5 mm throughout the field of view while range resolution is 1.5 mm. This imaging system has proven particularly useful for t...
Cadmium and the Kidney
Authors: Lars Friberg
Journal: Environmental Health Perspectives (1984)

The paper is a review of certain aspects of importance of cadmium and the kidney regarding the assessment of risks and understanding of mechanisms of action. The review discusses the following topics: history and etiology of cadmium-induced kidney dysfunction and related disorders; cadmium metabolism, metallothionein and kidney dysfunction; cadmium in urine as indicator of body burden, exposure and kidney dysfunction; cadmium levels in kidney and liver as indicators of kidney dysfunction; characteristics of early kidney dysfunction; the critical concentration concept; critical concentrations of cadmium in kidney cortex; and prognosis.
Minimal Brain Dysfunction
Authors: Robert J. Baumann
Journal: JAMA (1976)

<h3>To the Editor.—</h3> Dr Newton's editorial, "Minimal Brain Dysfunction" (235: 2524, 1976) emphasizes a major public health problem: evaluation of the cases of children who perform poorly in the traditional schoolroom. He is certainly correct in pointing out that the diagnostic criteria often used in evaluating these cases are "extremely confusing and in some cases, basically unscientific." It is disappointing that he then proceeds to endorse the concept of an entity called minimal brain dysfunction (MBD) and alleges that it is distinct from "hyperactivity, learning disability and behavior problems." Increasingly, workers in the field are coming to just the opposite conclusion: there is no such entity as MBD!<sup>1</sup>It is a ragtag hodgepodge term describing children with a striking variety of problems, due (in all probability) to a number of different etiologic mechanisms. Lumping all these diverse youngsters together in one group has greatly inhibited progress in this field.
Pressure ulcers preventable, say many clinicians
Authors: V. Cowart
Journal: JAMA (1987)

PRESSURE ULCERS, the scourge of immobilized patients, can usually be prevented. That is the view of many physicians who attended the first national symposium on the subject recently. These include a University of Chicago dermatologist, who notes that up to 7% of hospitalized patients have pressure ulcers, as do an estimated 15% to 20% of patients in nursing homes. Moreover, says Allan L. Lorincz, MD, patients who already have pressure ulcers can be successfully treated. Lorincz is professor and head of the section of dermatology and codirector of the Wound Healing Research Center of the University of Chicago Hospitals and Clinics. It is estimated that between 1.5 million and 3 million persons in the United States have pressure ulcers. Lorincz contends there is a lack of interest in the problem that he attributes, in part, to "the attitude that patients who develop pressure sores are not very salvageable in terms
Suppression of repolarization-related arrhythmias in vitro and in vivo by low-dose potassium channel activators.
Authors: F AFish, CPrakash, D MRoden
Journal: Circulation (1990)

Marked prolongation of cardiac action potentials and of QT intervals has been associated with early afterdepolarizations and triggered activity in vitro and with ventricular tachycardia in vivo. Because the antihypertensive potassium channel activators pinacidil and cromakalim are known to accelerate repolarization in cardiac tissues, we performed in vitro and in vivo experiments to test the hypothesis that these agents would block the arrhythmogenic effects of delayed repolarization. Early afterdepolarizations and triggered activity were elicited in canine cardiac Purkinje fibers driven at cycle lengths of 4 seconds or more (K0, 2.7 mM) during superfusion with quinidine, cesium, or sematilide, a methylsulfonylamino parasubstituted analogue of procainamide with class III antiarrhythmic activity. The potassium channel activators invariably (17 of 17) abolished this form of abnormal automaticity. This effect was observed at low concentrations that did not alter action potential characteristics at shorter cy...
De subitaneis mortibus. XII. Asymmetrical hypertrophy of the heart.
Authors: T NJames, T KMarshall
Journal: Circulation (1975)

Subjects with asymmetrical hypertrophy of the heart are prone to sudden death. Neither the pathogenesis of the eccentric hypertrophy nor the mechanism of sudden death is fully understood. In this report we describe certain postmortem findings in the hearts of 22 subjects who died suddenly, silently and unexpectedly, and in whom the only significant abnormality at autopsy was asymmetrical hypertrophy of the heart. Deep clefts were present in the septum in seven hearts, the small coronary arteries were abnormally narrowed in ten, the sinus node was sclerosed by fibrosis in 12, there was variable narrowing of the atrioventricular (A-V) node artery in many and the His bundle was too thin in three. There were multiple cysts or channels in the central fibrous body and of the adjacent A-V node and His bundle in four hearts. Most of the hearts displayed a fetal dispersion of the A-V node and His bundle throughout the central fibrous body, but this was particularly conspicuous in 13 hearts. These abnormalities in ...
Coronary diastolic pressure-flow relation and zero flow pressure explained on the basis of intramyocardial compliance.
Authors: J ASpaan
Journal: Circulation Research (1985)

In the controversy about the mechanisms determining the high zero flow pressures and the further interpretation of coronary diastolic pressure flow relations, this paper takes a stand in favor of intramyocardial compliance as the primary cause of the high zero flow pressures. An attempt has been made to estimate the compliance distribution within the coronary circulation and to show the specific effect of intramyocardial compliance on arterial and venous pressure-flow relations. Since no data are available on the distensibility of coronary arterioles and capillaries, these data were taken from studies on mesenteric vessels. Based on these data, it is shown that, depending on the transmural pressure, smooth muscle tone may either increase or decrease arteriolar compliance. A compliance distribution has been proposed based on assumed pressure, volume, and distensibility distributions. For all but the venous division of the circulation, experimental data on volume could be found in the literature. Based on t...
Myocyte cellular hyperplasia and myocyte cellular hypertrophy contribute to chronic ventricular remodeling in coronary artery narrowing-induced cardiomyopathy in rats.
Authors: JKajstura, XZhang, KReiss, ESzoke, CLagrasta, WCheng, ZDarzynkiewicz, GOlivetti, PAnversa
Journal: Circulation Research (1994)

To determine whether cardiac failure produced by chronic coronary artery stenosis was associated with the activation of myocyte cellular hyperplasia in the myocardium, the changes in number and size of left ventricular myocytes were measured in rats 3 months after surgery. The hypertrophied left ventricle was found to possess 44%, 32%, 49%, and 48% fewer mononucleated, binucleated, trinucleated, and tetranucleated myocytes, respectively. In contrast, the hypertrophied right ventricle contained 1.49 x 10(6) more myocytes as a result of a 2.1-fold, 1.4-fold, and 1.4-fold increase in mononucleated, binucleated, and tetranucleated myocytes. Myocyte cell volume was seen to increase 49% and 21% in left and right ventricular myocytes, respectively. The process of myocyte cellular hyperplasia in the right ventricular myocardium was accompanied by capillary proliferation, and these events were responsible for the parallel addition of newly formed cells and capillaries within the wall and mural thickening. Moreover...
Synergistic inhibition of platelet aggregation by fibrinogen-related peptides.
Authors: BAdelman, CGennings, JStrony, EHanners
Journal: Circulation Research (1990)

We have evaluated the ability of the fibrinogen-related peptides Gly-Arg-Gly-Asp-Ser (GRGDS), Gly-Gln-Gln-His-His-Leu-Gly-Gly-Ala-Lys-Gln-Ala-Gly-Asp-Val (gamma-chain peptide), and Gly-Pro-Arg-Pro (GPRP) to inhibit platelet aggregation in platelet-rich plasma individually and in combination. When used alone, GRGDS totally inhibited ADP-induced aggregation of human platelets in platelet-rich plasma; however, the maximum inhibitory effect of the other peptides was less than 80%. The concentrations necessary to inhibit platelet aggregation in plasma by 50% were 100 mumols/l and 1 and 3.2 mmol/l for GRGDS, gamma-chain peptide, and GPRP, respectively. When evaluating the effect of peptide mixtures, we discovered that the combination GPRP + GRGDS worked together synergistically (p less than 0.001, analysis by surface response methodology), whereas GPRP + gamma-chain peptide did not. For example, our analysis indicated that a mixture of 50 mumols/l GRGDS plus 180 mumols/l GPRP would produce 50% inhibition of pla...
It's Over, Debbie
Authors: David C. Thomasma
Journal: JAMA (1988)

To the Editor.  —A professional association must be able to encompass many different points of view in our secular and democratic society.  Although I do not wish to condone the actions of the unnamed resident as detailed in It's Over, Debbie, 1 I do think it is important for the American Medical Association to consider the problems in caring for sick and dying patients, one of which is active euthanasia.  It makes no sense to hide our heads in the sand when many different forms of active euthanasia are currently being practiced in the United States. Discussing these may help bring about a social consensus that would support traditional physician reluctance to engage in active euthanasia.  Problems do exist, however, in prolonging life beyond any reasonable and comfortable limit. These problems must be thoroughly discussed by our health professional societies as well as by our citizens.  Therefore, I strongly support
Effects of angiotensin II on the blood flow and its distribution in fetal lambs.
Authors: H SIwamoto, A MRudolph
Journal: Circulation Research (1981)

We studied the effects of intravenous infusion of angiotensin II on the circulation of the fetus in lambs in utero through chronically maintained intravascular catheters. Angiotensin II infused in doses of 29-280 ng/min per kg fetal weight resulted in an increase in plasma angiotensin II from a control value of 87 +/- 17 to 341 +/- 129 (mean +/- SE) pg/ml; these levels are similar to those observed following hemorrhage in fetal lambs. Fetal mean arterial blood pressure increased from 46 +/- 2.0 to 56 +/- 2.7 torr and fetal heart rate increased from 172 +/- 6 to 189 +/- 6 beats/min, an effect which was not altered by beta-adrenergic or cholinergic blockade. Fetal cardiac output and its distribution were measured before and during infusion of angiotensin II by the radionuclide-labeled microsphere technique. Combined ventricular output increased significantly from 526 +/- 32 to 616 +/- 24 ml/min per kg fetal body weight. Angiotensin constricted the umbilical-placental circulation as well as the gastrointesti...
Predictors of High Risk Isolated Gastric Varices: Who Should be Screened?
Authors: A Hanafy
Journal: Endoscopy (2021)

Aims Isolated gastric varices (GV) type 1 is common to bleed.GV occur due to hepatofugal flow and empty into the systemic circulation via 2 pathways in the portosystemic collateral drainage the gastroesophageal or azygous venous system and the gastrophrenic venous system We evaluated clinical and laboratory parameters in predicting the presence of risky IGV 1 in patients with portal hypertension for proper diagnosis and treatment.
RE:<i>nab</i>-Paclitaxel Plus Gemcitabine for Metastatic Pancreatic Cancer: Long-Term Survival From a Phase III Trial
Authors: Lavanniya K. Palani Velu, Colin W. Steele, Euan J. Dickson, C. Ross Carter, Colin J. McKay, Paul G. Horgan, Donald C. McMillan, Nigel B. Jamieson
Journal: JNCI Journal of the National Cancer Institute (2015)

We read with interest the article by Goldstein and colleagues that reports the long-term results of the large phase III rand omized trial (IMPACT) of nab-paclitaxel plus gemcitabine or gemcitabine alone in patients with metastatic pancreatic can cer, extending support for the superior efficacy of this combination therapy ( 1). They reported that the presence of a systemic inflammatory response, as evidenced by an elevated neutrophil lymphocyte ratio (NLR), effectively stratified survival independent of the trial treatment. A pooled treatment analysis demonstrated that patients with an NLR of 5 or less had a statistically significantly prolonged survival compared with patients with an NLR of more than 5 (median = 9.1 vs 5.0 months, P < .001). In the nab-Paclitaxel plus gemcitabine arm there was a statistically significantly longer overall survival vs the gemcitabine arm alone in patients with an NLR of 5 or less (P < .001). Furthermore, when there was evidence of a raised systemic inflammatory response, a trend was evident favoring prolonged survival in the nab-paclitaxel plus gemcitabine arm vs the gemcitabine alone group ( = .079). These results confirm our previous observations in patients with pancreatic adenocarcinoma, that an elevated NLR is an impor tant independent prognostic factor (
Characteristics of ventricular function in single ventricle.
Authors: SKitamura, YKawashima, YShimazaki, TMori, SNakano, SBeppu, TKozuka
Journal: Circulation (1979)

Funtional characteristics of the single ventricle were studied by means of biplane angiocardiography in 34 patients. Group 1 consisted of 14 patients with normal or increased pulmonary vascular marking on chest film and no pulmonary stenosis. Group 2 included 20 patients with severe angiographic pulmonary stenosis and decreased pulmonary vascular marking. Ventricular volume parameters were calculated according to Simpson's rule and were compared with normal values. The sum of the normal left and right ventricular volumes was assumed to be 100%. In group 1, ventricular end-diastolic volumes averaged 143 +/- 11% and were significantly (p less than 0.001) larger than end-diastolic volumes in group 2 (81 +/- 4%). The presence or absence of severe pulmonary stenosis affecting pulmonary blood flow was a main factor regulating the ventricular chamber size in single ventricle. In both groups, the ejection fraction of a single ventricle was significantly lower than that of a normal left or right ventricle. Ventric...
Validity of enzyme-linked immunosorbent assays of cross-linked fibrin degradation products as a measure of clot lysis.
Authors: P REisenberg, A SJaffe, D CStump, DCollen, E GBovill
Journal: Circulation (1990)

Concentrations of cross-linked fibrin degradation products (XL-FDPs) in plasma, measured by enzyme-linked immunosorbent assays (ELISAs) based on monoclonal antibodies (MAbs) raised against fragment D-dimer of cross-linked fibrin, increase when patients are given fibrinolytic agents. Whether XL-FDPs derive from circulating cross-linked fibrin polymers in plasma, compared with clot-associated fibrin, has been questioned because increases in XL-FDP are measured by some assays after fibrinolysis in vitro in the absence of clot. We characterized the source of XL-FDP immunoreactivity in plasma of patients with acute myocardial infarction and ischemic heart disease and the response to plasminogen activation in vitro induced by pharmacological concentrations of tissue-type plasminogen activator (t-PA) and streptokinase. XL-FDPs were measured with two different ELISA. One, pan-specific tag ELISA, was based on a capture MAb specific for XL-FDP and a tag MAb that recognizes an epitope exposed in the fragment D reg...
Low level in vivo gene transfer into the arterial wall through a perforated balloon catheter.
Authors: M YFlugelman, M TJaklitsch, K DNewman, WCasscells, G LBratthauer, D ADichek
Journal: Circulation (1992)

BACKGROUNDGene transfer into the arterial wall may provide a novel therapeutic strategy for the treatment of coronary artery restenosis. Previously described methods for gene transfer into the arterial wall require total vessel occlusion for 30 minutes. We sought to develop a protocol for gene transfer within a more clinically relevant time frame.METHODS AND RESULTSWe used a perforated balloon (Wolinsky) catheter to inject retroviral vector-containing virions into rabbit aortas in vivo. The virions were injected within 1 minute. Aortas were removed 5-14 days after injection and analyzed for evidence of gene transfer. In initial studies, nine rabbits were injected with a vector expressing the beta-galactosidase gene, and nine rabbits were injected with either non-beta-galactosidase-containing vectors or with a vehicle control. Histochemical staining of aortic tissues revealed blue (positive) cells in eight of nine experimental rabbits and six of nine controls. Because of the lack of specificity of the beta...
Pulmonary ventilation/perfusion defects induced by epinephrine during cardiopulmonary resuscitation.
Authors: WTang, M HWeil, R JGazmuri, SSun, CDuggal, JBisera
Journal: Circulation (1991)

BACKGROUNDEpinephrine has been shown to impair pulmonary excretion of CO2 during resuscitation. This phenomenon was investigated in a rodent model of cardiac arrest and conventional resuscitation.METHODS AND RESULTSThe effects of racemic epinephrine were compared with the selective alpha 1-agonist methoxamine and with saline placebo during cardiac resuscitation in 15 Sprague-Dawley rats mechanically ventilated with gas containing 70% oxygen. Epinephrine and methoxamine but not saline placebo significantly increased coronary perfusion pressure from approximately 32 to 55 mm Hg. Following epinephrine, end-tidal PCO2 decreased from approximately 10 to 5 mm Hg. This was associated with a time-coincident decrease in PaO2 from approximately 130 to 74 mm Hg and an increase in PaCO2 from approximately 26 to 40 mm Hg. These changes indicated increases in alveolar dead space ventilation concomitant with increases in pulmonary arteriovenous admixture. No such effects were observed after administration of either meth...
Asthma phenotypes, associated comorbidities, and long‐term symptoms in COVID‐19
Authors: Lauren E. Eggert, Ziyuan He, William Collins, Alexandra S. Lee, Gopal Dhondalay, Shirley Y. Jiang, Jessica Fitzpatrick, Theo T. Snow, Benjamin A. Pinsky, Maja Artandi, Linda Barman, Rajan Puri, Richard Wittman, Neera Ahuja, Andra Blomkalns, Ruth O'Hara, Shu Cao, Manisha Desai, Sayantani B. Sindher, Kari Nadeau, R. Sharon Chinthrajah
Journal: Allergy (2021)

It is unclear whether asthma and its allergic phenotype are risk factors for hospitalization or severe disease from SARS-CoV-2. All patients over 28 days old testing positive for SARS-CoV-2 between March 1 and September 30, 2020, were retrospectively identified and characterized through electronic analysis at Stanford. A sub-cohort was followed prospectively to evaluate long-term COVID-19 symptoms. 168,190 patients underwent SARS-CoV-2 testing, and 6,976 (4.15%) tested positive. In a multivariate analysis, asthma was not an independent risk factor for hospitalization (OR 1.12 [95% CI 0.86, 1.45], p = .40). Among SARS-CoV-2-positive asthmatics, allergic asthma lowered the risk of hospitalization and had a protective effect compared with non-allergic asthma (OR 0.52 [0.28, 0.91], p = .026); there was no association between baseline medication use as characterized by GINA and hospitalization risk. Patients with severe COVID-19 disease had lower eosinophil levels during hospitalization compared with patients with mild or asymptomatic disease, independent of asthma status (p = .0014). In a patient sub-cohort followed longitudinally, asthmatics and non-asthmatics had similar time to resolution of COVID-19 symptoms, particularly lower respiratory symptoms. Asthma is not a risk factor for more severe COVID-19 disease. Allergic asthmatics were half as likely to be hospitalized with COVID-19 compared with non-allergic asthmatics. Lower levels of eosinophil counts (allergic biomarkers) were associated with a more severe COVID-19 disease trajectory. Recovery was similar among asthmatics and non-asthmatics with over 50% of patients reporting ongoing lower respiratory symptoms 3 months post-infection.