tbuckley/cabot-search huggingface dataset:
Fibrin Sealing in Endoscopic Surgery
Authors: D. Wallwiener, S. Rimbach, D. Pollmann, W. Stolz, J. F. H. Gauwerky, G. Bastert
Journal: Endoscopy (1995)

The special merits of fibrin sealing are the possibility of simple atraumatic tissue union and hemostasis and, thus, decreased duration of surgical intervention. This technique is therefore already well established for a number of indications in surgical gynecologic endoscopy. These include, in particular, the reshaping of an ovary after extirpation of a cyst, the application during tubal anastomosis, and the sealing of iatrogenic perforations of the uterus. Unequivocal evidence of the efficacy of fibrin sealing of serous and peritoneal defects with the purpose of adhesion prophylaxis is not yet available. Whereas fibrin sealing due to its good long-term results is regarded as the preferred method for the first-mentioned indications, further studies with a large number of cases and long follow-up are necessary to enable a final evaluation of this technique for the latter indications. No complications were evident in the postoperative course or during follow-up in the 75 laparoscopic fibrin sealings carried out to date. In addition to its wound healing properties, fibrin sealing was found to be intraoperatively superior as the time-consuming endoscopic sutures were replaced in a simple and atraumatic manner; furthermore, a simultaneous hemostyptic action was attained.
Abstract 17134: Misleading Long PPI-TCL from Entrainment of Cavotricuspid Isthmus-Dependent Right Atrial Flutter
Authors: Dirk Vollmann, William G Stevenson, Bruce M Koplan, Usha Tedrow, Roy M John, Gregory F Michaud
Journal: Circulation (2010)

Background: Entrainment from the cavotricuspid isthmus (CTI) is consistent with CTI-dependent atrial flutter (AFL) if the post-pacing interval (PPI) matches the tachycardia cycle length (TCL). Cond...
Abstract 16516: A Tumor Suppressor Lats2 Mediates Ischemia/Reperfusion Injury Through Downregulation of Foxo and Decreases in Antioxidants
Authors: Dan Shao, Peiyong Zhai, Junichi Sadoshima
Journal: Circulation (2011)

Lats2 is a tumor suppressor and a serine/threonine kinase, acting downstream of mammalian sterile 20 like kinase1 (Mst1), which stimulates apoptosis in cardiomyocytes (CMs). Lats2 is activated by i...
Drug points: Pravastatin: interaction with oral anticoagulant?
Authors: N. Given, T. Trenque, H. Choisy, M.-L. Germain
Journal: BMJ (1996)

Pravastatin is a hydrophilic competitive inhibitor of 3-hydroxy-3-methyl glutaryl coenzyme A, the enzyme responsible for the rate limiting step of endogenous cholesterol synthesis. Interaction studies with oral anticoagulants have shown no change in prothrombin time or in the pharmacokinetic variables of pravastatin.1 On the other hand, when lovastatin2 or simvastatin3 and coumarin are administered concomitantly, prothrombin time may be increased in …
Abstract 2162: Mechano-energetic Superiority Of Left Ventricular Apex And Left Ventricular Septal Pacing
Authors: Robert W Mills, Larry J Mulligan, Marion Kuiper, Arne van Hunnik, Anniek Lampert, Nick D Skadsberg, Frank van Wijk, Richard Cornelussen, Frits W Prinzen
Journal: Circulation (2008)

Objective: Previous studies showed hemodynamic benefits over right ventricular (RV) apex pacing by left ventricular (LV) septal or LV apex pacing. We investigated whether this benefit is also reflected in mechanical efficiency. Methods: After AV-nodal ablation, dogs received 16 weeks of VDD pacing at the RV apex (RVa; n = 8), LV apex (LVa; n = 7) or LV septum (LVs; n = 8; transventricular-septal approach). After chronic pacing, LV stroke work (SW; conductance catheter) was measured, as well as relative myocardial oxygen consumption (MVO 2 , coronary flow velocity and arterial-coronary sinus O 2 difference). Baseline efficiency (SW/MVO 2 ) was assessed during implant site (IS), RVa, LVa, and RVa + LV lateral (BiV) pacing. In order to investigate the effect of pacing site udner different conditions, measurements were performed during baseline and dobutamine infusion +/− partial aortic occlusion. The O 2 cost of generating SW, corrected for end-systolic elastance and effective arterial elastance, was calculated using the Suga model of mechano-energetics. Results: RVa pacing after chronic LV pacing reduced SW/MVO 2 (Figure a ; mean ± SD, *p&lt;0.05 vs. 1) and increased O 2 cost (Figure b ) in combination with a 12% fall in LV dP/dt-max. However, LVa or BiV pacing after chronic RVa pacing did not significantly alter efficiency, despite a 12% increase in LV dP/dt-max. LVa pacing improved efficiency over LVs and collectively over BiV pacing (p&lt;0.05). Conclusions: Acutely, LVa pacing results in the greatest mechanical efficiency. The lack of improvement in efficiency despite increasing contractility when switching from chronic RVa pacing to LV based pacing may indicate contractile remodeling.
Abstract 11862: Differences of Histological and Clinical Characteristics Between Fresh and Matured Thrombus in Acute Coronary Syndrome
Authors: Tetsuo Sakai, Shin Inoue, Genyo Ogawa, Yuji Hamazaki, Hidekazu Ota, Youichi Kobayashi
Journal: Circulation (2011)

Background: Unexpectedly, older thrombus was occasionally found in thrombectomy samples from patients with acute coronary syndrome (ACS). To clarify relevance between thrombus maturity and clinical...
Abstract 9890: The Short- and the Long-Term Outcomes of Percutaneous Coronary Intervention for Chronic Total Occlusions in Elderly Patients
Authors: Yutaka Tanaka, Satoshi Takeshita, Junya Matsumi, Shingo Mizuno, Kazuya Sugitatsu, Futoshi Yamanaka, Yumiko Oosaka, Yu Nomura, Koki Shishido, Hidetaka Suenaga, Masato Murakami, Saeko Takahashi, Shigeru Saito
Journal: Circulation (2011)

Introduction: We investigated the safety and the efficacy of percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs) in elderly patients. Methods: Between 2005 and 2009, 301 consecutive patients underwent PCI for a total of 323 CTO lesions. The short and the long-term outcomes of PCI were retrospectively evaluated by comparing patients with ≥ 75 years (n = 71, 23.6%) and those with &lt; 75 years (n = 230, 76.4%). Results: Procedural success was achieved in 78.7% of the patients in the elderly group and 78.2% in the younger group (P = 0.73). No significant differences were observed in the incidences of procedural-related complications between the two groups (2.8% vs. 5.2%; P = 0.40). At a mean follow-up of 3.1 years, the incidence of major adverse cardiac events (MACE: all-cause death, myocardial infarction and target lesion revascularization [TLR]) was significantly higher in the elderly group (27.8% vs. 5.4%; P &lt; 0.001). TLR was not significantly different between the groups (12.4% vs. 19.2%; P = 0.64). When comparing patients with successful and failed PCI among elderly group, incidences of MACE did not show significant differences (54.0 vs. 66.0%; P = 0.53). However, those with successful PCI showed significantly improved cardiac survival compared to those with failed PCI (92.2% vs. 72.0%; P = 0.011), the level of which was similar to those observed in the younger group irrespective of their procedural success (98.7% with successful PCI and 100% with failed PCI). After multivariate analysis, only successful PCI was found to be the independent factor associated with a reduction of cardiac death in the elderly group (HR: 0.134; 95% CI: 0.022-0.815; P = 0.029). Conclusions: This retrospective study demonstrates that PCI for CTO lesions in elderly patients is associated with the improved cardiac survival after successful PCI. PCI for CTO lesions may become a viable treatment strategy even in elderly patients.
Abstract 16579: Oxygen Uptake Kinetics Are Closely Related to Right Ventricular-Pulmonary Vascular Function During Exercise in Heart Failure
Authors: Neal A Chatterjee, Ryan M Murphy, Rajeev Malhotra, Stacyann S Hough, Paul P Pappagianopoulos, Marc J Semigran, Gregory D Lewis
Journal: Circulation (2011)

Introduction The ability to augment oxygen uptake (VO2) upon initiation of exercise is blunted in patients with heart failure and reduced left ventricular ejection fraction (HFrEF). Delayed O2 kine...
Abstract 2754: Pulmonary Vein Isolation Using Irrigated vs. Conventional 4-mm Tip Catheters- Do Short and Long-Term Outcomes Differ?
Authors: Ganesh S Kamath, Harikrishna Makani, Jorge Silva Enciso, Sunil Kumar, Suneet Mittal, Jonathan S Steinberg
Journal: Circulation (2008)

Open saline-irrigated tip ablation catheters have largely supplanted standard 4 mm tip ablation catheters for pulmonary vein isolation (PVI) of atrial fibrillation (AF), based on the assumption that the procedure is safer and more efficacious. However, outcomes after procedures that use identical techniques but different radiofrequency ablation catheters have not been compared. We studied 432 consecutive patients (age 57 ± 11 yrs) with AF (duration 7.9 ± 6.1 yrs) who underwent PVI; 320 (74 %) using a conventional 4 mm catheter and 112 (26 %) using an open irrigated tip catheter. Segmental PVI targeting the earliest LA-PV activation for all PVs in each patient was used for all patients regardless of catheter for the entire study cohort. Radiofrequency energy was delivered for ≥60 secs at each target site. The pts in the 2 groups were similar with respect to age, gender and duration of AF. All 432 pts had successful complete PVI. There was no significant difference in the total number of lesions delivered per PV in the conventional 4 mm group and the irrigated tip group (Table ) at the initial procedure. Following a single procedure, 227/ 320 (71%) patients in the conventional 4 mm and 75/112 (67%) in the irrigated group were AF-free on no antiarrhythmic drug at 12 mos (p=0.43). The number of patients who required repeat procedures was similar in the conventional group (57/320, 18%) and the irrigated tip group (22/112, 20%) (p=0.66). Serious complications were also similar (2.2% vs. 1.0 %, p=0.21) Contrary to conventional wisdom, the safety and 12 month efficacy of PVI for management of AF was similar for the two types of ablation catheters. These data suggest that PVI cohorts derived from differing ablation techniques can be combined for purposes of clinical investigation. Longer term outcomes may differ and should be studied as well.
Abstract 12993: Hepatocyte-Specific Angiotensinogen Deficiency Markedly Reduces Hypercholesterolemia-Induced Atherosclerosis and Diet-Induced Obesity in Mice
Authors: Congqing Wu, Hong Lu, Lisa Cassis, Alan Daugherty
Journal: Circulation (2011)

Background and Objective: We previously developed angiotensinogen (AGT) hypomorphic mice in an LDLr −/− background and demonstrated that whole body reduction of AGT profoundly reduced hypercholeste...
Abstract 3430: Ethnic Differences in the Prevalence and Treatment of Cardiovascular Risk Factors in Outpatients with Peripheral Arterial Disease: Insights from the REACH Registry
Authors: Telly A Meadows, Deepak L Bhatt, Alan T Hirsch, Mark A Creager, Robert M Califf, E. M Ohman, Chris P Cannon, Kim A Eagle, Mark Alberts, Shinya Goto, Peter W Wilson, Ph. G Steg
Journal: Circulation (2007)

Background : In the United States, African Americans have been reported to have an increased prevalence of peripheral arterial disease (PAD) with poorer outcomes as compared to whites. Whether this can be attributed to differences in the presence and treatment of traditional coronary artery disease (CAD) risk factors versus other factors specifically related to ethnicity is unknown. Methods : We identified 2,235 patients from the United States with documented PAD with and without concomitant CAD and cerebrovascular disease (CVD) at one year enrolled in the REduction of Atherothrombosis for Continued Health (REACH) Registry. We compared the baseline demographics, risk factor profiles, medication use, and one-year outcomes between the 236 African Americans and 1,810 non-Hispanic whites. Results : Among the traditional atherosclerotic risk factors, African Americans were more likely than whites to have diabetes (64.0% vs. 48.6%, p&lt;0.0001), hypertension (95.3% vs. 86.5%, p=0.0001), obesity (45.9% vs. 34.3%, p=0.0002), and isolated PAD (44.9% vs. 28.7%, p&lt;0.0001). In comparison to whites, African Americans were less likely to be on aspirin (62.0% vs. 72.4%, p=0.0009) and lipid-lowering therapy (76.1% vs. 83.2%, p=0.0071), and more likely to have an elevated blood pressure (BP ≥140/90 mmHg: 54.9% vs. 38.1%, p&lt;0.0001) and fasting cholesterol (&gt;200 mg/dL: 41.7% vs. 24.9%, p&lt;0.0001) at baseline. Overall, there were no significant difference in all-cause mortality (4.70% vs. 5.32%, p=0.97) or CV death, MI, or stroke (4.92% vs. 6.20%, p=0.79) between African Americans and whites in this cohort (data adjusted for age and sex). Conclusion : Among U.S. outpatients with PAD, African Americans are more likely than whites to have risk factors for cardiovascular disease, but less likely to receive aspirin or lipid-lowering therapy. In this registry, one-year event rates are relatively high, but similar in both groups.
Abstract 10891: Optical Coherence Tomography Assessment of Novel Fully Bioabsorbable Salicylate-Based Sirolimus-Eluting Stent 540 Days after implantation in Pig Coronary Artery
Authors: Daisuke Matsumoto, Toshiro Shinke, Sarah Geva, Nicolas Chronos, Refat Jabara
Journal: Circulation (2010)

Background: Fully biodegradable stent is an attractive alternative strategy for current permanent metallic stents. The BTI stent is synthesized entirely from salicylic acid bioabsorbable polymer derivates coated with a bioabsorbable salicylate-based polymer. We evaluated a novel, fully bioabsorbable sirolimus-eluting stent (8.3μg sirolimus/mm stent) with optical coherence tomography (OCT) 540 days after inplantation in pig coronary models. Methods: Bioabsorbable balloon-expandable stents (n=93) were implanted in pig coronaries using QCA to optimize stent apposition. Animals underwent restudy at 1 month (1M), 3 month (3M), 6 month (6M), 9 month (9M), 12 month (12M), 15 month (15M) and 18 month (18M). Stent area, lumen area, struts thickness and strut area were measured by OCT. Results: Though stent strut area could not be measured due to nearly disappearance of stent struts after 12M, stent struts maintained sufficient area up to 12M (1M: 6.50 mm2 vs 3M: 6.40 mm2, P=0.76, 3M vs 6M: 6.55mm2, P=0.62, 6M vs 9...
Risks of Eosinophil-Related End-Organ Damage, Hematological Malignancies and Death Are Significantly Increased Even below Consensus Threshold Criteria for Blood Eosinophilia
Authors: Christen Lykkegaard Andersen, Volkert Siersma, Hanne Vestergaard, Peter Felding, Hans Carl Hasselbalch, Niels de Fine Olivarius, Ole Weis Bjerrum
Journal: Blood (2013)
Abstract 5847: IGF-1 Receptor and Insulin Receptor Stoichiometry is a Critical Determinant of Nitric Oxide Bioavailablity in vivo
Authors: Afroze Abbas, Helen Imrie, Hema Viswambharan, Adil Rajwani, Shouhong Xuan, Stephen Wheatcroft, Peter Grant, Mark Kearney
Journal: Circulation (2009)
Abstract 901: Effects of Bucindolol on Cardiovascular Mortality and Morbidity are Determined by the Beta-1 389 Arg/Gly Receptor Polymorphism
Authors: Michel White, Peter Carson, Inder S Anand, Stephen S Gottlieb, JoAnn Lindenfeld, Christopher O’Connor, Alan Miller, Jonathan Plehn, Marc A Silver, Mona Fiuzat, Alastair D Robertson, Michael R Bristow
Journal: Circulation (2007)

Introduction: Bucindolol is a nonselective beta-adrenergic blocker with potent sympatholytic properties. The Beta-blocker Evaluation of Survival Trial (BEST) reported that the administration of bucindolol resulted in a nonsignificant decrease in total mortality (HR = 0.89 (0.78, 1.02), unadjusted p=0.10) in patients with advanced, NYHA Class III-IV heart failure (HF). Recent observations from that trial also reported that the amino acid arginine (Arg/Arg) or glycine (any Gly) in position 389 of the beta-1 receptor plays a significant role on the clinical response to bucindolol. The impact of bucindolol on cardiovascular mortality and morbidity (cardiovascular hospitalizations) has been incompletely investigated, because hospitalizations had been evaluated from case report forms (CRFs) only, and never adjudicated by the endpoints committee (EPC). Methods: The BEST data base consists of 2708 patients with a mean follow-up of 2.0 years. Cardiovascular (CV) mortality and hospitalizations have now been evaluated by EPC, which further subclassified total hospitalizations into cardiovascular (CV) and those due to worsening heart failure (HF). The impacts of Arg or Gly encoded at amino acid position 389 on endpoints were further investigated in the 1040 patient substudy. Results: Time to event results for adjudicated CV endpoints are presented below. Conclusions: Chronic administration of bucindolol results in a significant reduction in cardiovascular hospitalizations and mortality. Effects on either are strikingly beta-1 389 Arg/Gly specific, with the higher functioning, Arg/Arg version of the receptor associated with large treatment effects and Gly carriers exhibiting little or no evidence of efficacy. Genetic targeting of the β 1 -ΑR 389 polymorphism may improve the clinical responses to bucindolol for CV mortality and morbidity.
Abnormal Carbohydrate Metabolism in Chronic Renal Failure
Authors: Sheldon Rubenfeld, Alan J. Garber
Journal: Journal of Clinical Investigation (1978)

To delineate the potential role of disordered glucose and glucose-precursor kinetics in the abnormal carbohydrate metabolism of chronic renal failure, alanine and glucose production and utilization and gluconeogenesis from alanine were studied in patients with chronic compensated renal insufficiency and in normal volunteers. With simultaneous primed injection-continuous infusions of radiolabeled alanine and glucose, rates of metabolite turnover and precursor-product interrelationships were calculated from the plateau portion of the appropriate specific activity curves. All subjects were studied in the postabsorption state. In 13 patients with chronic renal failure (creatinine = 10.7+/-1.2 mg/100 ml; mean+/-SEM), glucose turnover was found to be 1,035+/-99.3 mumol/min. This rate was increased 56% (P = 0.003) over that observed in control subjects (664+/-33.5 mumol/min). Alanine turnover was 474+/-96.0 mumol/min in azotemic patients. This rate was 191% greater (P = 0.007) than the rate determined in control subjects (163+/-19.4 mumol/min). Gluconeogenesis from alanine and the percent of glucose production contributed by gluconeogenesis from alanine were increased in patients with chronic renal failure (192% and 169%, respectively) as compared to controls (P < 0.05 for each). Alanine utilization for gluconeogenesis was increased from 40.2+/-3.86 mumol/min in control subjects to 143+/-39.0 mumol/min in azotemic patients (P < 0.05). The percent of alanine utilization accounted for by gluconeogenesis was not altered in chronic renal insufficiency. In nondiabetic azotemic subjects, mean fasting glucose and immunoreactive insulin levels were increased 24.3% (P = 0.005) and 130% (P = 0.046), respectively.These results in patients with chronic renal failure demonstrate (a) increased glucose production and utilization, (b) increased gluconeogenesis from alanine, (c) increased alanine production and utilization, and (d) a relative impairment to glucose disposal. We conclude that chronic azotemia is characterized by increased rates of glucose and glucose precursor flux and by a relative impairment to glucose disposal. These findings may suggest an underlying hepatic and peripheral insensitivity to the metabolic action of insulin in patients with chronic renal insufficiency.
Pacritinib, a Dual JAK2/FLT3 Inhibitor: An Integrated Efficacy and Safety Analysis Of Phase II Trial Data In Patients With Primary and Secondary Myelofibrosis (MF) and Platelet Counts ≤100,000/µl
Authors: Srdan Verstovsek, James P. Dean, Paul Cernohous, Rami S Komrokji, John F. Seymour, Ruben A. Mesa, Mary S Campbell, Susan E. Caldwell, Lixia Wang, Han Myint
Journal: Blood (2013)
Interrelation between Alcohol and Accidents
Authors: P A B Raffle
Journal: Journal of the Royal Society of Medicine (1989)

The proportion of the 545000 trauma cases admitted to hospital each year which is associated with alcohol is not known but two useful studies of BACs (blood alcohol concentration) in admissions to Accident and Emergency (A&E) Departments in Great Britain are available, at Salford and at Broxburn in Scotland. Of the casualties at the English hospital, 13.2 percent had positive BACs and 18.3 percent of the Scottish study: 9.3 percent of the Salford cases were over the legal limit for driving, 10.2 percent of the Broxburn study. The two studies give similar figures for the source of the accidents. For road accidents, 14.22 percent of the casualties had positive BACs with 11-17.4 percent over the legal limit. This compares with 38 percent positive and 28 percent over the legal limit in driver fatalities, and 20 percent over the legal limit in roadside screening breath tests where drivers had been involved in an accident. The accumulated evidence strongly supports an association between alcohol and accidents leading to injury, but association does not necessarily mean causation. Causation is plausible from the known effects of alcohol on human performance. The decrements in performance with alcohol found in a range of perceptual and motor tasks result more from impaired information processing rather than from decreased sensory responsiveness or motor ability. The decrements are progressive with increasing BAC. Above all, adequate research is needed into the uncertainty about the relationship between acute and chronic alcohol misuse on the one hand, and on the other, the immediate mortality, the severity of injuries as measured by a suitable injury severity score, and the outcome of the injuries in terms of survival, length of stay in hospital and disability. (Author/TRRL)
Expenditures
Authors: John K. Iglehart
Journal: New England Journal of Medicine (1999)

The United States operates a health care system that is unique among nations. It is the most expensive of systems, outstripping by over half again the health care expenditures of any other country.1 The number of people without insurance continues to increase, however, reaching 43.4 million, or 16.1 percent of the population, in 1997 — the highest level in a decade.2 By many technical standards, U.S. medical care is the best in the world,3 but leaders in the field declared recently at a national round table that there is an “urgent need to improve health care quality.”4 The stringency of . . .
Die diagnostische Effektivität der Gastrobiopsie
Authors: K. Elster, W. Kudlich
Journal: Endoscopy (1971)

Based on 4.374 gastric biopsies a confrontation of histological diagnosis and clinical question is performed. Guided biopsy results in a high percentage of congruence in localized lesions like erosion, ulcer, polyp and carcinoma. The importance of the perfection of the examiner is stressed as well as the fact that the percentage of positive results is not a objective measure for the value of a method.