tbuckley/cabot-search huggingface dataset:
Abstract 16794: Is 30-Day Readmission Preventable after Acute Myocardial Infarction? A New MI Patient-Specific Derivation of the Intermountain Risk Score for 30-Day Readmission
Authors: Benjamin D Horne, Jeffrey L Anderson, Joseph B Muhlestein, Kimberly D Brunisholz, Heidi T May, Jason M Lappe, Tami L Bair, Donald L Lappe
Journal: Circulation (2012)

Background: Composed of the complete blood count (CBC), basic metabolic profile (BMP), and age, the Intermountain Risk Score (IMRS) is a sex-specific clinical decision tool derived to predict morta...
Continuing Medical Education
Authors: Lina F. Kanj, Spencer Van B. Wilking, Tania J. Phillips
Journal: Journal of the American Academy of Dermatology (1998)

Pressure ulcers are localized areas of tissue necrosis that result from unrelieved pressure. They are graded or staged according to the degree of tissue damage observed. The main etiologic factors include pressure, shearing forces, friction, and moisture. The clinical course may be complicated by several conditions including infection, sepsis, osteomyelitis, fistulas, and carcinoma. Preventive measures in persons at risk can significantly reduce the incidence of pressure ulcers. Successful management should address the four etiologic factors as well as the general condition of the patient. (J Am Acad Dermatol 1998;38:517-36.) Learning Objective: At the conclusion of this learning activity, participants should be able to discuss the classification, etiology, complications, prevention, as well as the management of pressure ulcers.
Abstract 4669: Does Long-QT Syndrome Involve the Sinus Node?
Authors: Vladimir Shusterman, Jan Nemec, Marie Buncova, Bruce Winter, Win-Kuang Shen, Michael J Ackerman
Journal: Circulation (2008)

Background: The hallmark of Long QT Syndrome (LQTS) is a prolongation of the ventricular electrical action potential caused by mutations involving key cardiac ion channels on the surface membrane of ventricular myocytes. Different mutations are associated with specific modes of arrhythmia initiation and distinct changes in cardiac rhythm prior to these events. We hypothesized that some LQTS-causing mutations might involve the sinus node, leading to aberrations in cardiac rhythm. To test this hypothesis, we examined the features of cardiac rhythm in 23 genotyped patients with LQTS and 14 matched controls (C) using Holter ECG data (6hrs). Methods: QRS-complexes were identified using custom software and verified by an experienced ECG reader; series of sinus beats were extracted and gaps in time series were linearly interpolated. The mean, max, and min heart rate (HR), the time (SD, SDNN, SDANN, RMSSD, pNN50) and frequency-domain (Total (TP), Very low (VLF), Low (LF), High (HF) frequency powers, and LF/HF) indices of heart rate variability (HRV) were calculated in each 5-min interval and over the entire recording. The short-long-short irregularity was examined using the novel multiscale rhythmogenetic analysis (MRA), which quantifies changes in the HRV indices during the transition from one time-scale window to another. Results: The maximum heart rate was slower in LQTS than in C (101±13 and 119±19bpm, p=0.001). The high-frequency power (HF) was lower in LQTS than in C (80±76 and 113±58ms 2 , p&lt;0.05). However, the short-term irregularity (quantified by the difference in RMSSD between the 75ms and 2000ms time scales) was 4 times greater in LQTS compared to C (p=0.003). Inclusion or exclusion of two patents who were on β-blockers did not change the results. Conclusions: LQTS is associated with specific changes in cardiac rhythm, including: diminished acceleration capacity, decreased high-frequency power, and enhanced short-long-short irregularity. This suggests that LQTS involves channel modifications in the sinus node, which might contribute to arrhythmogenesis. Rhythm characterization in genetic sub-types of LQTS might improve arrhythmia risk stratification in this heterogeneous patient population.
Serum YKL-40 in risk assessment for colorectal cancer. A population based, prospective study of 4,987 subjects at risk of colorectal cancer
Authors: J. S. Johansen, I. J. Christensen, P. A. Price, N. Brunner, H. J. Nielsen
Journal: Journal of Clinical Oncology (2008)

4136 Background: Early detection of colorectal cancer (CRC) translates into improved survival. YKL-40 is produced by CRC cells and tumor associated macrophages. YKL-40 may play a role in cancer cell proliferation and differention, metastasis potential and angiogenesis. High serum YKL-40 is a potential biomarker of poor prognosis in patients with cancer, including CRC, and is independent of CEA and LDH. Highest serum YKL-40 is found in patients with metastatic cancer. We tested the hypothesis that serum YKL-40 would improve detection of CRC. Methods: Serum YKL-40 was determined by ELISA (Quidel) in a prospective, population based study of 4,987 subjects (age 18–97 years, 2,284 males and 2,704 females) referred to endoscopy (sigmoideoscopy n=1,720, colonoscopy n=3,206, rectoscopy n=53, unknown n=9) due to symptoms or risk factors for CRC. The subjects had a blood sample collected at the time of endoscopy (Jan 2004 - Dec 2005). Baseline variables including life style variables, current medication and co-morbidity including malignant disease (registered using ICD-10 codes) within the last 5 years. The measurements of serum YKL-40 were performed blinded in a randomized order at the completion of the study. Results: 189 colon cancers (3.8%), 114 rectal cancers (2.3%), 921 adenomas (18.5%), 10 other cancers (0.2%), and 1,217 other findings (24.4%) were found. Co-morbidity was observed in 2,624 subjects. Univariate analysis showed that high serum YKL-40 predicted CRC (OR=1.6, 95% CI: 1.4–1.7, p<0.0001, AUC=0.69 (AUC is the area under the ROC curve)). Restricting the analysis to subjects without other findings or co-morbidity demonstrated increased discrimination of serum YKL-40 (OR=2.5, 95% CI: 2.2–2.9, p<0.0001, AUC=0.79) Multivariate logistic regression analysis including serum YKL-40, age, sex, BMI, smoking, alcohol intake and co-morbidity demonstrated that serum YKL-40 independently predicted CRC (OR=1.56, 95% CI: 1.34–1.81, p<0.0001, AUC=0.75). Restricting the analysis to subjects with no co-morbidity showed that serum YKL-40 was significant (OR=1.95, 95% CI:1.53–2.48, p<0.0001, AUC=0.80). Conclusion: These results suggest that serum YKL-40 could be useful in the assessment of risk for colorectal cancer. No significant financial relationships to disclose.
Cinderella syndrome: children who simulate neglect
Authors: J Goodwin, C G Cauthorne, R T Rada
Journal: American Journal of Psychiatry (1980)

The authors describe three adopted girls, aged 9 and 10, who falsely alleged that their adoptive mothers dressed them in rags, made them do all the chores, and favored their stepsiblings. Underlying these false accusations of abuse was a history that included 1) actual abuse of the child in a previous placement, 2) early loss of a mothering figure, and 3) emotional abuse in the adoptive home. Professional involved in child protection eed to recognize this syndrome because intensive family therpay and temporary placement of the child outside the home are required in all cases. The child's false accusation of abuse is a cry for help and should not be dismissed as a manipulative fabrication.
Abstract 4682: Impact of Multivessel Coronary Artery Disease on Early Ischemic Injury, Late Clinical Outcome and Remodeling in Patients With Acute Myocardial Infarction Treated by Primary Coronary Angioplasty
Authors: Giuseppe Tarantini, Nicola Gasparetto, Massimo Napodano, Luisa Cacciavillani, Enrico Favaretto, Martina Perazzolo Marra, Chiara Fraccaro, Elena Osto, Michela Facchin, Renato Razzolini, Giuseppe Musumeci, Sabino Iliceto, Angelo Ramondo
Journal: Circulation (2009)

Background Multi-Vessel Disease (MVD) adversely affects the outcome of ST elevation myocardial infarction (STEMI) patients. We assessed whether the impact of MVD on outcome of STEMI patients is due...
A pilot study of treatment of social phobia with alprazolam
Authors: J Reich, W Yates
Journal: American Journal of Psychiatry (1988)

Fourteen patients with DSM-III social phobia were treated with alprazolam in an open study. Multiple measures of symptoms and disability showed significant improvement. The symptoms improved during the first and second weeks, and disability improved at 3 weeks and beyond. After medication withdrawal the symptom and disability measures were no longer significantly different from those at baseline.
Abstract 227: Inhibition Of Protein Tyrosine Phosphatase Improves Hyperglycemic Impaired Angiogenesis
Authors: Jian Xiong Chen, Heidi Yu, Qinhui Tuo
Journal: Circulation (2007)

Our previous study shows that hyperglycemia impairs myocardial angiogenesis via impairment of angiopoietin-1(Ang-1)/Akt/eNOS phosphorylation. Protein tyrosine phosphatase (PTP) plays an essential role in intracellular signal transduction by regulating tyrosine phosphorylation. PTP inhibitor has been shown to modulate Akt/eNOS phosphorylation, but little is known about the inhibition of PTP on angiogenesis under hyperglycemic conditions. We investigated the role of inhibition of PTP on hyperglycemia-induced impairment of angiogenic signaling pathways and angiogenesis. Our data demonstrate that exposure of mouse heart microvascular endothelial cells (MHMECs) to hyperglycemia leads to an increase in caspase-3 activity. Pretreatment of cells with the protein tyrosine phosphatase inhibitor, sodium orthovanadate (OV, 5 μM), significantly enhances the Ang-1-inhibitory effect on caspase-3 activity both under normal or hyperglycemic conditions. Pretreatment of MHMEC with the PTP inhibitor OV (0.5–20 μM) significantly enhances cell survival in a dose dependent manner under hyperglycemic conditions as measured by MTT assay. Pretreatment of MHMEC with OV (5 μM) enhances the effect of Ang-1 on endothelial cell survival under hyperglycemic conditions. As expected, Ang-1-induced Akt and eNOS phosphorylation is minimal under hyperglycemic conditions. Pretreatment of MHMEC with OV (5 μM) for 30 minutes leads to an increase in Akt phosphorylation at baseline and augments Ang-1-induced Akt and eNOS phosphorylation under hyperglycemic conditions. Additionally, systemic administration of bis(maltolato) oxovanadium(IV) (BMOV, 0.2g/L) in db/db mice results in a dramatic decrease in plasma glucose levels and an increase in vessel outgrowth in response to Ang-1 (250 ng/ml) stimulation. Treatment of db/db mice with BMOV significantly increases myocardial ischemia-induced HIF expression. Furthermore, bone marrow differentiation into endothelial cell progenitor cell is also significantly improved in the BMOV treated db/db mice. Our data implicate that upregulation of Ang-1/Akt/eNOS phosphorylation by PTP inhibitors should be considered as a new therapeutic strategy for the treatment or prevention of diabetic impaired angiogenesis.
Help-seeking pathways: a unifying concept in mental health care
Authors: L H Rogler, D E Cortes
Journal: American Journal of Psychiatry (1993)

The authors argue that the concept of help-seeking pathways, defined generically, oriented toward institutional structures, and put at the forefront of research, can help integrate much of what we know about the use of mental health care and how to make such care more accessible and effective among underserved populations. They focus the concept of help-seeking pathways on current issues and research findings pertinent to the onset of psychological distress, the contacting of mental health care facilities, and treatment in such facilities. Pathways are not random; they are structured by the convergence of psychosocial and cultural factors and have sufficient integrity to be studied directly as unfolding processes.
Abstract 257: The Induction of Mild Hypothermia Improves Myocardial β-Adrenergic Responsiveness During Endotoxemia in Pigs
Authors: Markus Wallner, Michael Schwarzl, Sebastian Seiler, Stefan Huber, Paul Steendijk, Heinrich Mächler, Martini Truschnig-Wilders, Burkert Pieske, Dirk von Lewinski, Heiner Post
Journal: Circulation (2011)

Background: Mild hypothermia (MH) exerts anti-inflammatory effects in experimental settings. We tested the effect of MH on myocardial ß-adrenergic responsiveness during experimental endotoxemia. Methods: Anesthetized pigs (65±2 kg) were acutely instrumented (closed chest) with a series of catheters including a Swan-Ganz catheter, a left ventricular (LV) pressure-volume catheter, an intraaortic balloon catheter and an intravascular cooling device. Endotoxemia, a model of septic shock, was induced by lipopolysaccharid (LPS) infusion at 0.5 µg/kg/h for 1 hour and 1 µg/kg/h for further 3 hours. With the beginning of LPS infusion, pigs were assigned to either normothermia (NT, 38 °C, n=7) or MH (33 °C, n=6). Animals were followed for a total of 8 hours. After sacrifice, ventricular muscle strips were isolated, stretched to optimal length in Tyrode solution containing 2,5 mmol calcium, stimulated at 1 Hz and exposed to increasing concentrations of isoproterenol. All muscle strips were examined at 38 °C. Results: In vivo, LV pressure-time (dP/dt) and pressure-volume analysis indicated a similar impairment of LV contractile parameters. In vitro, the increase of developed force in response to isoproterenol was higher in muscle strips isolated from hearts of the MH group than of the NT group. The logEC50% was not different between groups. Conclusion: These data indicate that MH counteracts the loss of myocardial ß-adrenergic responsiveness typically associated with the development of sepsis. MH may be a therapeutic option for septic cardiomyopathy.
Abstract 18865: Novel Cardiovascular Risk Factor Prediction of Cardiovascular Events in the (Type 2 Diabetes) FIELD Study and Effects of Fenofibrate
Authors: Anthony C Keech, Jenkins Alicia, Malcolm Whiting, Philip Barter, David R Sullivan, Mark Donoghoe, Andrej Januszewski, Connie Karschimkus, Stefan Blankenberg, John Simes, Russell Scott, Markku Laakso, Marja-Riitta Taskinen, James D Best
Journal: Circulation (2010)

Background: Inflammation and oxidative stress are implicated in the pathogenesis of cardiovascular disease (CVD). In the Fenofibrate and Event Lowering in Diabetes (FIELD) study, comicronized fenof...
Abstract 17288: GTP Cyclohydrolase I Rescues microRNA-34a Impairment of Endothelial Progenitor Cell Angiogenesis in Aging
Authors: Dandan Chen, Ting Zhao, Jian Li, Alex F Chen
Journal: Circulation (2011)

Introduction: Endothelial progenitor cells (EPCs) are critically regulated by eNOS for their angiogenic functions. eNOS and its essential cofactor tetrahydrobiopterin (BH4) are reduced during aging, and aged EPCs exhibit decreased proliferation, migration and survival. We recently reported that microRNA 34a (miR-34a) induces EPC senescence and inhibits its angiogenesis by targeting silent information regulator 1 (SIRT1). However, whether miR-34a regulation of EPC angiogenesis involves eNOS and BH4 in aging is unknown. We hypothesized that miR-34a promotes impairment of EPC angiogenesis in aging, which could be rescued by GTP cyclohydrolase I (GTPCH I, the rate-limiting enzyme for BH4 biosynthesis). Methods: Bone marrow-derived EPCs from young (8-10 weeks) C57BL/6 (wild type, WT), GTPCH I transgenic (Tg-GCH, endothelial-specific GTPCH I overexpression), hph-1 (BH4-deficient), aged (18-20 months) C57BL/6 (WT) and eNOS/GCH double-transgenic (Tg-eNOS/GCH) mice (all males) were used. Results: Aged WT mice showed significantly impaired recovery of hindlimb ischemia, compared with young WT mice (0.40±0.13 vs. 0.68±0.12, n=3, p&lt;0.05). Consistently, EPCs from aged WT mice showed impaired Matrigel angiogenesis (0.46±0.03 vs. 1.00±0.04, n=4, p&lt;0.01). Reactive oxygen species (ROS) level was significantly elevated in EPCs from aged WT mice (~1.6 folds vs. young WT mice, n=3, p&lt;0.05), accompanied by reduced GTPCH I expression (0.63±0.07 vs. 1.00±0.08, n=3, p&lt;0.05). Suppression of miR-34a in EPCs from aged WT mice rescued their impaired angiogenesis, while overexpression of miR-34a in EPCs from young WT mice impaired their angiogenesis in vitro. Moreover, miR-34a expression was decreased in EPCs from aged Tg-eNOS/GCH double-transgenic mice vs. aged WT mice (0.83±0.07 vs. 1.91±0.07, n=3, p&lt;0.01), with a concomitant augmentation of SIRT1 level (1.14±0.02 vs. 0.54±0.06, n=3, p&lt;0.01). Finally, miR-34a expression was down-regulated in EPCs from Tg-GCH mice with an increase in SIRT1 level, and was up-regulated in EPCs from BH4-deficient hph-1 mice with a decrease in SIRT1 level vs. WT mice. Conclusion: These findings demonstrate, for the first time, that miR-34a promotes impairment of EPC angiogenesis in aging, which could be rescued by GTPCH I/BH4.
Isolated Third, Fourth, and Sixth Cranial Nerve Palsies from Presumed Microvascular versus Other Causes
Authors: Madhura A. Tamhankar, Valerie Biousse, Gui-Shuang Ying, Sashank Prasad, Prem S. Subramanian, Michael S. Lee, Eric Eggenberger, Heather E. Moss, Stacy Pineles, Jeffrey Bennett, Benjamin Osborne, Nicholas J. Volpe, Grant T. Liu, Beau B. Bruce, Nancy J. Newman, Steven L. Galetta, Laura J. Balcer
Journal: Ophthalmology (2013)
Abstract 3366: Imaging of Peroxidase Activity in Injured Myocardium
Authors: Matthias Nahrendorf, David E Sosnovik, John Chen, Jose-Luis Figueiredo, Peter Panizzi, Elena Aikawa, Ralph Weissleder
Journal: Circulation (2007)

Ischemic myocardial injury causes timed recruitment of neutrophils and monocyte/macrophages, which produce significant amounts of myeloperoxidase (MPO). MPO leads to the formation of reactive chlorinating species capable of oxidizing proteins. We developed a small molecule based MPO substrate for MRI, Gd-bis-5-HT-DPTA, which is first radicalized, and then oligomerized and covalently bound to matrix proteins, all leading to enhanced R1-relaxivity and delayed wash out kinetics. Mice were subjected to coronary artery ligation and injected with 0.3mmol/kg Gd-bis-5-HT-DPTA (or Gd-DTPA as control). We performed T1-weighted cardio-respiratory gated MRI 10–120min later, followed by immunoreactive staining for MPO. 3 mice each were studied at day 1, 2, 4, 8, and &gt;1 month after MI. Subsequently, MPO tissue activity was determined with the guaiacol method. MPO activity peaked 2 days after MI (contrast-to-noise-ratio (CNR) day 1, 26+/−4; day 2, 39+/−10; day 4, 29+/−3), and tissue levels of MPO over time correlated well with probe activity in vivo (r2=0.65, p&lt;0.01). CNR following Gd-DTPA peaked ten minutes after injection (10.5+/−0.2), and returned to pre-injection values at 60min. In contradistinction, following injection Gd-bis-5-HT-DPTA, CNR was higher and peaked later (p&lt;0.05 vs. Gd-DTPA, arrows depict MI in figure ). Immunoreactive staining for MPO correlated well with enhancement (r2=0.92, p&lt;0.05). Gd-bis-5-HT-DPTA facilitates in-vivo assessment of MPO activity in injured myocardium. This approach allows non-invasive probing of the inflammatory response to ischemia and has the potential to guide the development and application of novel cardioprotective therapies.
Abstract 3088: Association between Coronary Plaque Burden as Measured by Multidetector Computed Tomography and Inflammatory Biomarkers in Patients with Acute Chest Pain
Authors: Fabian Bamberg, Wolfgang Koenig, Emily G Kurtz, John H Nichols, Gerlinde Trischler, Tobias J Nagurney, Sujith Seneviratne, Javed Butler, Udo Hoffmann
Journal: Circulation (2007)

Objective: Both the extent of coronary artery disease (CAD) and increased levels of inflammatory markers are associated with cardiovascular risk. However, the association of these markers with different types of atherosclerotic plaque as detected by multidetector computed tomography (MDCT) is unknown. Methods: In this cross-sectional study, we examined consecutive patients who were admitted ith acute chest pain to the ED but had no evidence of ACS during their index hospitalization and 6- month follow up. All patients underwent contrast enhanced 64-slice coronary MDCT. Commercially available assays were used to determine the levels of hs-CRP, matrix metalloproteinase 2 and 9, oxidized low-density lipoprotein (ox-LDL), tumor necrosis factor alpha, interleukin-6, soluble E-selectin, and lipoprotein-associated phospholipase A2 at the time of initial ED triage. Two independent observers determined the extent of CAD (number of coronary segments containing calcified and/or non-calcified plaque). Log-transformed biomarkers associated with the extent of CAD were determined in univariate and multivariable regression analysis (adjusted for age, gender, body mass index, diabetes mellitus, smoking, hypertension, and hyperlipidemia/ use of cholesterol lowering medication). Results: We analyzed inflammatory biomarkers and extent of CAD in 78 patients (mean age: 51.2 years, 42% female). In univariate analysis, hs-CRP (r=0.24, &gt;p=0.02), and ox-LDL (r=0.33, p=0.008) were significantly correlated to the extent of any plaque, and non-calcified plaque, respectively. In multivariable analysis only ox- LDL remained an independent predictor of the extent of non-calcified plaque (beta coefficient: 1.81, p=0.005). The models including traditional risk factors and hs-CRP or ox-LDL explained 34.3%, and 24.5% of the variability of overall, and non-calcified plaque burden, respectively. Conclusions : In this exploratory analysis, we found that in patients with acute chest pain levels of ox-LDL were independent predictors of the extent of non-calcified plaque as detected by MDCT. Further studies are needed to confirm a complementary role of local (plaque) and systemic biomarkers of atherosclerosis to identify subjects at high probability of ACS.
Violence begins at home
Authors: D. Hall, M. A Lynch
Journal: BMJ (1998)

Physical violence in the family probably blights the lives of more people than all genetic disorders put together, yet research on the issue has struggled to achieve scientific legitimacy.1 Violence in the family includes “any act or omission committed within the framework of the family by one of its members that undermines the life, the bodily or psychological integrity, or liberty of another member of the same family or that seriously harms the development of his or her personality.”2 Separating the causes and effects of domestic violence from those of poor parenting, poverty, homelessness, substance abuse, and violent neighbours and schools is a tough research challenge.3

Estimates of how many people experience violence in the family depend on definition, circumstances, and the method of inquiry,1 but even the lowest figures show that this is a common and serious problem. Several forms of violence and abuse may occur …