tbuckley/cabot-search huggingface dataset:
Abstract 16974: Gender Differences in Patients Undergoing Transcatheter Aortic Valve Replacement: a Single Center Experience
Authors: Josephine L Warren, Usman Baber, Jennifer Yu, Melissa Aquino, Arjun Bhat, Sandeep Basnet, George Dangas, Roxana Mehran, Robert Pyo, Jason Kovacic, Samin K Sharma, Annapoorna S Kini
Journal: Circulation (2014)

Background: Current data suggest that women experience different outcomes to men following transcatheter aortic valve replacement (TAVR). We reviewed the Mount Sinai valve database to compare men and women undergoing TAVR according to procedural characteristics and outcomes. Methods: 124 patients underwent TAVR at Mount Sinai from May 2012-2014. All patients received Edwards Sapien valves. Follow-up was conducted at 30-days. Results: Women accounted for 61% (n=76) of the TAVR cohort. The mean age of women was 80.7, and 82.2 for men (p=0.30). Men were more likely to have undergone previous cardiac bypass surgery and were more likely to be on dialysis and have a pacemaker or intra-cardiac defibrillator in-situ (27.1% vs. 7.9%, p=0.004). Women had lower baseline hemoglobin. These disparities did not translate to differences in STS Risk Score or EuroScore. In women, the aortic annulus (21.2mm vs. 23.4mm, p&lt;0.0001), left atrial (24.6mm vs. 27.2mm, p = 0.02) and left ventricular (3.09mm vs. 4.11mm, p&lt;0.001) areas were smaller, as was the ilio-femoral artery diameter (7.4mm vs. 8.03mm, p=0.02). In contrast, men had a lower left ventricular ejection fraction (49.9% vs. 57.6%, p=0.004) and mean aortic valve gradient (43.5mmHg vs. 48.8mmHg, p=0.004). Procedural length did not differ between genders, nor did the method of approach. Women were less likely to experience conduction complications requiring pacemaker insertion both intra-procedurally (2.6% vs. 12.5%, p=0.03) and 30-days post-discharge (2.7% vs. 13.2%, p = 0.03). Women were more likely to receive in-hospital transfusion (51.3% vs. 18.8%, p=0.0003), but mortality rates did not differ between genders (7.0% vs. 6.7%, p=0.5). Conclusion: Despite discrepancies in some important pre-procedural parameters, as well as rates of post-procedural conduction abnormalities and in-hospital transfusion, these did not translate into differences in mortality rates between genders in patients undergoing TAVR.
Abstract 3036: Initial Experience With Aortic Root C-arm CT During Transcatheter Aortic Valve Implantation in Swine
Authors: Uma Numburi, Samir Kapadia, Paul Schoenhagen, E. M Tuzcu, Martin von Roden, Sandra S Halliburton
Journal: Circulation (2009)

Purpose: To evaluate the clinical feasibility of aortic root C-arm CT during transcatheter aortic valve implantation (TAVI) in swine. Methods: Four pigs were imaged with C-arm CT (Axiom Artis, Siem...
Abstract 4607: Lycopene Intake Predicts Event-Free Survival in Patients with Heart Failure
Authors: Martha J Biddle, Seongkum Heo, Eun Kyeung Song, Terry A Lennie, Sandi Dunbar, Susan J Pressler, JinShil Kim, Debra K Moser
Journal: Circulation (2008)

Background: Higher intake of the dietary carotenoid lycopene may be beneficial for heart disease. A main source of lycopene is processed tomato products, which are high in sodium. Increased dietary sodium intake is a primary reason for heart failure (HF) exacerbation and may counter the positive effects of lycopene. Purpose: To determine whether lycopene intake stratified by sodium intake predicts event-free survival. Methods: Detailed 4-day food diaries were kept by 149 HF pts (age 60 ± 12, 38% female). A registered dietitian reviewed the diaries with pt to verify serving sizes and preparation methods. Nutrient analysis was performed using Nutrition Data System software ™ . Pts were stratified into 2 groups by sodium intake based on the median of 2913 mg. Outcomes were then compared in these strata by 2 groups of lycopene intake formed by the median intake of the sample (2624 mcg). Kaplan Meier and Cox regression survival techniques were used to detect differences in event-free survival (survival free of HF or cardiac hospitalization) between lycopene groups in the 2 sodium strata. Results: High lycopene compared to low lycopene intake was associated with greater event free survival. (p=.012, figure ). This finding held in both sodium strata, although the best event-free survival was in the high lycopene group with the low sodium intake (p=.019). High lycopene intake was a predictor of event-free survival after controlling for age, gender, NYHA and EF (p=.014). Conclusion: These findings suggest the naturally occurring antioxidant lycopene has the potential for substantial impact on event free survival rates in HF pts, but its positive effect is attenuated by high sodium intake.
Abstract 13475: Rates and Predictors of Invasive Coronary Angiography and Coronary Revascularization Following Coronary Computed Tomographic Angiography: Results From 15,223 Patients within the CONFIRM Registry (Coronary CT Angiography Evaluation for Clinical Outcomes: An InteRnational Multicenter Registry)
Authors: Leslee J Shaw, Daniel S Berman, Stephan Achenbach, Mouaz Al-Mallah, Matthew J Budoff, Fillippo Cademartiri, Tracy Q Callister, Hyuk-Jae Chang, Kavitha Chinnaiyan, Victor Cheng, Benjamin Chow, Ausustin Delago, Allison Dunning, Martin Hadamitzky, Jorg Hausleiter, Philipp Kaufmann, Fay Lin, Erica Maffei, Gilbert Raff, Todd C Villines, James K Min
Journal: Circulation (2011)

Background. Coronary CT angiography (CCTA) is a non-invasive method that allows for direct visualization of the extent and severity of anatomic coronary artery disease (CAD). Patterns of follow-up ...
Nodal Irradiation after Breast-Cancer Surgery in the Era of Effective Adjuvant Therapy
Authors: Harold J. Burstein, Monica Morrow
Journal: New England Journal of Medicine (2015)

Among women with breast cancer, rates of local recurrence in the ipsilateral breast, chest wall, or regional lymph nodes have decreased dramatically during the past 20 years.1 Contributing factors include standardized clinical approaches to breast imaging, surgery, pathological analysis, and radiotherapy, but a critical element has been the near universal application of adjuvant systemic therapy. Almost all patients with breast cancer now receive some form of adjuvant drug treatment. Systemic treatments have proved to be highly effective at reducing the risk of both distant relapse and local or regional recurrence, and stepwise innovations in systemic therapy have correspondingly further reduced . . .
Reduction in Lipoprotein(a) With PCSK9 Monoclonal Antibody Evolocumab (AMG 145)
Authors: Frederick J. Raal, Robert P. Giugliano, Marc S. Sabatine, Michael J. Koren, Gisle Langslet, Harold Bays, Dirk Blom, Mats Eriksson, Ricardo Dent, Scott M. Wasserman, Fannie Huang, Allen Xue, Moetaz Albizem, Rob Scott, Evan A. Stein
Journal: Journal of the American College of Cardiology (2014)
Abstract 3738: A Novel Critical Pathway for the Management of Hyperglycemia Facilitates a Rapid Intensive Glycemic Control in Critical Care Patients Without Causing any Hypoglycemic Episodes
Authors: Emad F Aziz, Raffy Khan, Sripal Bangalore, Afag Seidova, Dan Musat, Deborah Tormey, Olivier Frankenberger, Nicholas Mezitis, Eyal Herzog
Journal: Circulation (2007)
Abstract 2750: Multi-detector Computed Tomography Is An Accurate Screening Imaging Modality For Detection Of Thrombus In Patients Undergoing Catheter Ablation Of Atrial Fibrillation
Authors: Matthew W Martinez, Jacobo Kirsch, Eric E Williamson, Yong-Mei Cha, Paul A Friedman, Samuel J Asirvatham, Steve R Ommen, Mark J Callahan, Imran S Syed, DaLi Feng, Douglas S Beinborn, Douglas L Packer, Peter A Brady
Journal: Circulation (2007)

Introduction Multi-detector computed tomography (MDCT) is commonly used to identify pulmonary vein and left atrial anatomy prior to catheter ablation for atrial fibrillation (CAAF). Additionally, transesophageal echocardiography (TEE) is utilized to exclude left atrial/left atrial appendage thrombus (ICT). Whether MDCT alone can be used to exclude thrombus obviating the need for TEE is unknown. Methods All Pts referred for CAAF at Mayo Clinic between March 2004 and October 2006 were included. Clinical data (including CHADS score), 64 slice MDCT (non-ECG gated), TEE and intra-cardiac echocardiograph (ICE) were all performed and recorded. Image data was reviewed independently and blinded. The left atrial appendage (LAA) was defined as fully opacified or underfilled. An underfilled LAA was further interrogated using a region of interest over the filling defect and mean attenuation in Hounsfield Units (HU) were recorded. Results In total 400 Pts (mean age 56 ± 10 yrs; 76% male; EF 56 ± 10 % ) were included. 362 had no ICT by TEE nor filling defect by MDCT. 38 patients had an underfilled LAA in whom ICT was confirmed by TEE in 7. Sensitivity and specificity of MDCT for ICT was 100% and 92% respectively with a NPV of 100%. In 19 Pts with underfilled LAA’s, a mean LAA emptying velocity was found to be significantly reduced at 26 cm/s (6 – 61 cm/s). Those with a thrombus had a mean attenuation value below 70 HU. CHADS2 score was higher (2.0 versus 1.0) in Pts with LAA filling defect versus those without LAA filling defect. All Pts with confirmed thrombus were taking Warfarin. ICT was not seen in any Pts aged &lt;52 yrs with CHADS score ≤1. Conclusions Sensitivity and specificity of MDCT for detection of LAA thrombus is high. LAA filling defects on MDCT correlate with low emptying velocities by TEE and low attenuation value in HU. These data would suggest that in the absence of MDCT filling defect, no further imaging is required. TEE should be utilized prior to CAAF to investigate MDCT filling defects. Multidetector Computed Tomography for the Detection of LAA Thrombus
冲突与灾害知识（二）——战伤救治原则
Authors: Steve, Mannion, Eddie, Chaloner, 李平（译）, 周元国（校）
Journal: BMJ (2005)

目前，战伤的处理不再是外科军医的“专利”，随着现代冲突中的非战斗人员受伤数量的增加，和平时期的外伤救治设备和技术已不能满足救治要求。为此，本文论述普遍外科医生利用有限的资源和技术进行现代战伤救治方法。在冲突中，头、胸和腹部伤的早期高死亡率最高，这也是战伤的标志之一，因此在医院中的伤员以四肢伤为主。
Abstract 9789: Gender is Strongly Associated with the Presence of Atherosclerotic Plaque Hemorrhage and an Effect Modifier in the Relation between Plaque Hemorrhage and Cardiovascular Outcome
Authors: Joyce E Vrijenhoek, Hester M den Ruijter, Gert Jan de Borst, Dominique P de Kleijn, Jean-Paul P de Vries, Aryan Vink, Frans L Moll, Gerard Pasterkamp
Journal: Circulation (2012)

Background Plaque hemorrhage may lead to accelerated progression of atherosclerotic disease. In patients who undergo carotid or femoral endarterectomy, the presence of local plaque hemorrhage predicts future cardiovascular events in any vascular territory. We assessed the hypothesis that gender has an effect on the prevalence of local plaque hemorrhage and the predictive value of plaque hemorrhage for the occurrence of cardiovascular events. Methods Atherosclerotic plaques from 1008 patients (688 male, 320 female) who underwent carotid endarterectomy were analyzed histologically for the presence of plaque hemorrhage. All patients were followed-up for cardiovascular events (non-fatal stroke, non-fatal myocardial infarction, vascular death, vascular intervention) during 3 years. Results Plaques from male patients showed a significantly higher prevalence of plaque hemorrhage compared to women (75% vs. 61%, p&lt;0.001). After a median follow-up of 2.97 years, 208 events had occurred in males (30%) and 80 in females (25%). In a multivariable Cox proportional hazards model, there was a significant interaction between gender and plaque hemorrhage. Cumulative event rate of males with plaque hemorrhage was 32.3% [95% CI=29.1-37.5] compared to 19.1% [95% CI=12.9-24.8] in males without plaque hemorrhage. In females, this event rate was 23.4% [95% CI=17.1-29.3] versus 25.4% [95% CI=17.0-32.9] respectively. Gender-stratified analysis showed that plaque hemorrhage was a strong predictor for events in males (HR 1.8, [95% CI=1.3-2.7]), but this relationship was completely abolished in females (HR 1.1, [95% CI=0.71-1.8]). Conclusions In conclusion, atherosclerotic carotid plaques obtained from females reveal a lower prevalence of plaque hemorrhage compared with males. Local plaque hemorrhage is a strong predictor for secondary manifestations of cardiovascular disease in males but not in females.
Bone Marrow Involvement in Unknown Acute Myeloid Leukemia Detected by 18F-FDG PET/MRI
Authors: Gaetano Paone, Georg Stüssi, Marco Pons, Luca Giovanella, Luca Ceriani
Journal: Clinical Nuclear Medicine (2015)

A 83-year-old patient with inflammatory syndrome, unknown fever, and intense lumbar pain underwent diagnostic imaging for suspicion of spondylodiscitis. Fused F-FDG PET/MRI images showed heterogeneous hypermetabolism in the lumbar spine characterized by infiltrative lesions and adjacent necrotic tissue. Peripheral blood analysis revealed leukoerythroblastic changes, whereas bone marrow biopsy was highly hypercellular and revealed an acute myeloid leukemia with 70% infiltration of blasts of erythroid lineage. The intensive lumbar pain and elevated lactate dehydrogenase level are suggestive of bone marrow necrosis as seen in the PET/MRI. Our case emphasizes the usefulness of fused PET/MRI imaging for metabolic characterization of AML.
Novel Putative Driver Gene Mutations in Chronic Lymphocytic Leukemia (CLL): Results from a Combined Analysis of Whole-Exome Sequencing of 262 Primary CLL Samples
Authors: Dan A. Landau, Chip Stewart, Johannes G. Reiter, Michael Lawrence, Carrie Sougnez, Jennifer R. Brown, Armando Lopez-Guillermo, Stacey Gabriel, Eric Lander, Donna S. Neuberg, Carlos López-Otín, Elias Campo, Gad Getz, Catherine J. Wu
Journal: Blood (2014)
Abstract 17419: Differential Roles of Rap1 Isoforms in Regulation of Vascular Permeability and Endothelial Cell Barrier
Authors: Magdalena Sobczak, Magdalena Chrzanowska-Wodnicka
Journal: Circulation (2011)

Dynamic regulation of vascular permeability is critical for normal vessel function as evidenced in pathological conditions such as edema or inflammation; yet underlying mechanisms are not fully understood. Small G protein Rap1 has been implicated in promoting endothelial cell-cell (EC) junction formation upon elevation of cellular cAMP but also in promoting angiogenic responses to VEGF. However, what role Rap1 plays in regulation of vascular permeability in vivo is not known. The project's objective was to investigate the function of two Rap1 isoforms, Rap1A and 1B, in the formation and maintenance of adherens junctions (AJ) in ECs and in regulation of vessel permeability in vivo. To accomplish this, we used Cre-lox P method and Tie2 promoter to generate endothelial-specific knockout mice deficient in Rap1A (EC-Rap1A KO), Rap1B (EC-Rap1B KO) or partially depleted of both isoforms (EC-Rap1A KO; Rap1B +/- ). We found that vessel leakage of Evans blue dye was significantly increased only in lungs from EC-Rap1A KO; Rap1B +/- mice but not from EC-Rap1B KO mice suggesting that Rap1A is a main isoform promoting vessel barrier. Using bone marrow chimeras we showed that vessel barrier protection by Rap1 is EC-autonomous. In vitro, confocal microscopy revealed that Rap1A-deficiency in ECs led to altered organization of AJs with dispersed β-catenin distribution across AJs in contrast to narrow distribution in control or Rap1B KO ECs, suggesting that Rap1A may regulate endothelial barrier properties by spatially organizing AJ proteins. However, the kinetics of barrier reformation was not altered in Rap1A-deficient ECs, but was slower in Rap1B-deficient ECs, as evidenced by diminished cell monolayer electrical resistance measured by electric cell-substrate impedance sensing (ECIS) and slower VE-cadherin fluorescence recovery at AJs after junction disruption with EGTA. Recovery of β-catenin at cell-cell contacts was slower in Rap1B-depleted ECs also after AJs disruption using VEGF, suggesting that Rap1B may play a role in regulating AJs formation kinetics. Overall, these results suggest that two Rap1 isoforms may play differential roles in ECs: Rap1A is required for vascular barrier maintenance, while Rap1B is involved in dynamic regulation of AJs formation.
Cognitive behaviour therapy should be compared with placebo treatments
Authors: J. Pearce
Journal: BMJ (1996)

EDITOR,—Lest Michael Sharpe and colleagues' paper lends respectability to the notion that the chronic fatigue syndrome is a diagnostic entity or suggests that cognitive behaviour therapy has any value specific to the condition,1 I wish to make three points.

Firstly, the disorder that the authors treated is heterogeneous, the …
Abstract 325: Administration Of Apelin Modulates Myocardial Expression Of Apelin-apj And Improves Right Ventricular Performance In Mct-induced Pulmonary Hypertension
Authors: Inês Falcao-Pires, Nadia Gonçalves, Tiago Henriques-Coelho, Roberto Roncon-Albuquerque, Moreira-Gonçalves Daniel, Adelino Leite-Moreira
Journal: Circulation (2008)

Background: Apelin (AP) is the endogenous vasoactive ligand of APJ receptor. It is widely expressed in the heart and lungs and has important cardiovascular functions such as endothelium-dependent vasodilatation and positive inotropic effect. However, the role of apelin-APJ system in pulmonary hypertension (PH) remains to be clarified. Objective: To evaluate the chronic effects of apelin in: right ventricular (RV) myocardial function; cardiac expression of apelin and APJ in healthy and MCT-PH rats Methods: Male Wistar rats were randomly injected with MCT (60mg/Kg, sc) or vehicle (CTR, day 0). One week later, half of these animals were randomly treated with Pyr-apelin-13 (200μg/Kg/day, ip) or a similar volume of vehicle. The study resulted in 4 groups: CTR; AP; MCT and MCT+ AP. At day 24, animals were instrumented to record RV peak systolic (Pmax) pressures, dP/dtmax, dP/dtmin and time constant Tau. Also, heart and lungs were weighted and transmural RV samples were collected for relative quantification of mRNA by real-time RT-PCR. Results are on table . Conclusions: In healthy rats, exogenous apelin potentiates its endogenous production with no significant changes in APJ. MCT-induced PH resulted in a significant down-regulation of apelin-APJ system, which might play a role in the systolic and diastolic dysfunction observed in this model. This down-regulation was completely reverted by chronic administration of exogenous apelin. Therefore, apelin upregulates the cardiac apelin-APJ system exerting beneficial effects on cardiac remodeling and function, namely, by decreasing PH, RV diastolic function and hypertrophy. These results reveal the importance of apelin-APJ system in the pathophysiology of PH, suggesting that apelin is a potential therapeutic target in this disease. Results table
Abstract 16915: Preoperative Risk Assessment of Patients with Advanced Heart Failure Evaluated for Cardiac Transplantation to Predict Survival Following Heart Transplantation
Authors: P. Christian Schulze, Jeffrey Jiang, Jonathan Yang, Faisal Cheema, Maryjane Farr, Yoshifumi Naka, Donna Mancini
Journal: Circulation (2011)

Background: Heart transplantation (HTx) is the only curative treatment of patients with advanced heart failure (HF) but is of limited availability due to severe organ shortage. Appropriate candidate selection is crucial for successful outcomes following cardiac transplantation. We, therefore, analyzed preoperative factors of patients undergoing HTx in order to define clinical factors that would allow risk stratification of patients evaluated for HTx. Methods: We retrospectively analyzed 769 patients undergoing HTx at Columbia University Medical Center between 1999 and 2010. Preoperative laboratory values at the time of HTx, medical history, donor characteristics, perioperative clinical events and postoperative outcome were collected from electronic medical records. Survival was confirmed using the social security death index and clinical follow-up at our center. Univariate and multivariate proportional hazard ratios were calculated for 61 individual characteristics to identify factors associated with short and long-term survival after HTx. Significant factors were summarized in a prognostic scoring system for the prediction of survival after HTx. The predictive power of this system was validated in the United Network of Organ Sharing (UNOS) dataset (n=29,734). Results: Our analysis identified liver dysfunction (albumin&lt;3.5 mg/dL or total bilirubin&gt;1.3 mg/dL) and renal dysfunction (GFR&lt;40 ml/min), re-HTx, prior stroke or cancer, amyloid, diabetes mellitus, age&gt;65 yrs and more than 2 prior thoracic surgeries with sternotomy as factors associated with poor survival following HTx. The prognostic risk score derived from these factors effectively stratified high risk (4+ points) versus low risk (0-3 points) patients in regard to survival following HTx (86.2% vs. 77.8% at 1-yr and 74.3% vs. 55.9% at 5-yrs post-HTx; p&lt;0.001). These findings were validated and confirmed in the UNOS dataset (88.2% vs. 83.5% at 1-yr and 74.2% vs. 67.2% at 5-yrs post-HTx; p&lt;0.0001). Conclusion: Survival of patients following HTx may be improved by use of this noninvasive risk-stratification model for the selection of transplant candidates.
Abstract 10050: Peripheral Blood Metabolic Profiles Predict the Future Occurrence of New Onset Atrial Fibrillation
Authors: Adriano A Truffa, Kyle R White, Renato D Lopes, Karen S Pieper, Christopher B Granger, Christopher B Newgard, William E Kraus, Patrick M Hranitzky, Robert M Califf, Svati H Shah, L. Kristin Newby
Journal: Circulation (2011)
Somatic Mutations and Loss-Of-Heterozygosity Impair The DNA Repair Functions Of CUX1 in Myelodysplastic Syndromes (MDS)
Authors: Naoko Hosono, Zubaidah M Ramdzan, Ranjana Pal, Hideki Makishima, Bartlomiej P Przychodzen, Mikkael A. Sekeres, Kenichi Yoshida, Yuichi Shiraishi, Satoru Miyano, Seishi Ogawa, Alain Nepveu, Jaroslaw P. Maciejewski
Journal: Blood (2013)
Abstract 8236: Effect of Telmisartan on Paroxymal Atrial Fibrillation in Hypertensive Patients with Different Left Atrial Size
Authors: Roberto Fogari, Amedeo Mugellini, Giuseppe Derosa, Paola Preti
Journal: Circulation (2011)

Aim of this study was to evaluate the effect of telmisartan (T) and amlodipine (A) on atrial fibrillation (AF) recurrence in hypertensive patients with paroxymal AF and normal or increased left atrial (LA) size. We studied 288 mild hypertensive outpatients in sinus rhythm but will at least 2 ECG-documented episodes of AF in the previous 6 months; half of them had an inferior-superior LA dimension &lt;45 mm, and the other half &gt;45 mm. The patients were randomized to T 80-160 mg/od (n=72 with LA &lt;45 mm, n= 72 with LA &gt;45 mm) or to A 5-10 mg/od (n=72 with LA &lt;45 mm, n= 72 with LA &gt;45 mm) for one year. Blood pressure and a 24 h ECG were evaluated monthly. Patients were asked to report any episode of symptomatic AF and to perform an ECG as early as possible. SBP and DBP were significantly and similarly reduced by the 2 treatments (p&lt;0.001 vs baseline) in the 4 groups of patients. Among those with LA dimension &gt;45 mm a total of 35 (48.6%) patients treated with A had a recurrence of AF as did 18 (25%) patients treated with T (p&lt;0.05 vs A) Among the patients with LA dimension &lt;45 mm a total of 23 (31.9%) patients treated with A had a recurrence of AF as did 8 (11.1%) patients treated with T (p&lt;0.01 vs A). Despite a similar BP lowering T was more effective than A in preventing new episodes of AF and it was particularly evident in patients with normal LA size. It suggest that in this type of patients ARB treatment is to prefer to Ca blocker treatment and that earlier it is begun greater is the prevention of AF recurrences.