tbuckley/cabot-search huggingface dataset:
Trials of treatment are needed before trials of screening
Authors: S Sandhu, R Morris, V Matveev, A V Kaisary
Journal: BMJ (1996)

would have yielded false positive results, so someone with a positive result on screening would have a 1 in 19 chance of developing clinical prostate cancer within three years.The authors do not mention this but instead invoke calculations based on population based data (not from this study) to argue that looking at men aged 60-74 would give the much more impressive specificity quoted in their conclusion.We must speculate why we are not told how many of the men aged 60-74 who were studied had : 12 times the normal median concentration of prostate specific antigen but did not get prostate cancer.The investigators must know these data, and omitting them severely damages the credibility of the conclusion.
Abstract 835: Left Ventricular Expression of Lectin-Like Oxidized Low-Density Lipoprotein Receptor-1 Serves as a Biomarker of Heart Failure in the Salt-Sensitive Dahl Rat Model of Hypertension
Authors: Tomohide Takaya, Tatsuya Morimoto, Yoichi Sunagawa, Hiromichi Wada, Teruhisa Kawamura, Akira Shimatsu, Masatoshi Fujita, Yoshiko Fujita, Tatsuya Sawamura, Koji Hasegawa
Journal: Circulation (2008)

Lectin-like oxidized low-density lipoprotein (LDL) receptor-1 (LOX-1) was originally identified as an endothelial receptor for oxidized LDL, and now is recognized as a multi-ligand receptor. LOX-1 expression in cardiomyocytes can be induced by oxidative stress and various hormonal stimuli. Activation of the LOX-1 pathway in cardiomyocytes induces apoptosis in vitro and deteriorates ischemia-reperfusion injury in vivo . However the role of LOX-1 in chronic heart failure is unknown. We examined the left ventricular (LV) expression of LOX-1 in a salt-sensitive Dahl (DS) rat model of hypertension. Compared with control salt-resistant Dahl (DR) rats, a high-salt diet, started at the age of 6 weeks, induced marked hypertension and apparent concentric LV hypertrophy on echocardiography in DS rats. The LV hypertrophy was moderate at the age of 11 weeks and marked at 18 weeks. The LV systolic function was preserved at 11 weeks, and decreased at 18 weeks. Quantitative real-time PCR revealed a 4.7-fold increase in LV levels of LOX-1 mRNA in DS rats compared with DR rats at 11 weeks, and a 32-fold increase at 18 weeks. The LV LOX-1 mRNA levels were significantly correlated with the LV end-systolic dimension (R=0.640, p=0.0002), and LV posterior wall thickness (R=0.555, p=0.0022), as well as the LV/body weight ratio (R=0.647, p=0.0002), and systolic blood pressure (R=0.751, p&lt;0.0001). LOX-1 levels were also connected with an increase in LV mRNA levels of heme oxygenase-1 (R=0.692, p&lt;0.0001), a marker of oxidative stress. Importantly, LOX-1 levels were strongly associated with a decrease in the LV ejection fraction (R=0.774, p&lt;0.0001) and an increase in mRNA levels of BNP (R=0.814, p&lt;0.0001), a representative marker of LV wall stress and heart failure. Immunohistochemistry demonstrated LOX-1 expression in cardiomyocytes as well as vessel walls of both DS and DR rat hearts. However, expression in cardiomyocytes was greater in DS than in DR. These findings demonstrate that LV cardiomyocyte expression of LOX-1 is markedly increased in proportion to the extent of heart failure and possibly involved in the deterioration of systolic function in the DS rat model of hypertension.
Continuing rise in emergency admissions
Authors: J. Townsend, A. Frank, M. Piper
Journal: BMJ (1996)

could not be reliably predicted from the international normalised ratio obtained over that period.Despite the small reduction in the warfarin dose on day 6 the international normalised ratio might have been expected to continue to rise over the following days even if the patient had not been exposed to accumulating concentrations of amiodarone.2.5-0 , 2.0-0 1.0-0 1 2 3 4 5 Days after starting warfarin Fig 1-Changes in intemational norrnalised ratio after start of treatment with warfarinAn alternative lesson of this case is that, in the absence of an appropriate loading regimen, the international normalised ratio should be monitored beyond the usual five to six days because of the delay in reaching a steady state effect.
Donor immunization with Haemophilus influenzae type b (HIB)-conjugate vaccine in allogeneic bone marrow transplantation
Authors: DC Molrine, EC Guinan, JH Antin, SK Parsons, HJ Weinstein, C Wheeler, C McGarigle, P Blanding, NR Phillips, K Kinsella, K Deans, A Ciamarra, A Goorin, S George, DM Ambrosino
Journal: Blood (1996)
Five year follow up of a phase II study of cytotoxic immunotherapy combined with radiation in newly diagnosed prostate cancer
Authors: L. K. Aguilar, B. Teh, W. Mai, J. Caillouet, G. Ayala, E. Aguilar-Cordova, E. Butler
Journal: Journal of Clinical Oncology (2006)

4635 Background: In the U.S. there are about 70,000 annual prostate cancer recurrences. The purpose of this study is to evaluate a product to decrease incidence of recurrence. This study is based on objective clinical responses in Phase I studies with AdV-tk (ProstAtak™, Advantagene, Inc) as monotherapy in recurrent disease and preclinical data demonstrating synergy between AdV-tk and radiation. AdV-tk is an adenoviral vector expressing the herpes thymidine kinase gene delivered to the prostate via TRUS-guided injection followed by 14 days of oral prodrug. The mechanisms of function involve direct tumor cytotoxicity, local elicitation of danger signals, recruitment and activation of antigen presenting cells and stimulation of systemic anti-tumor T-cell immunity. Method: AdV-tk was evaluated in combination with radiation in 66 newly diagnosed patients: 33 low risk (Arm A, PSA &lt;10, Gleason &lt;7, and T1c-T2a) and 33 intermediate-high risk (Arm B, PSA ≥10, Gleason ≥7, or T2b-T3). Arm A received two treatments with AdV-tk, immediately before and 14 days into radiation. Arm B received an additional treatment at initiation of androgen deprivation therapy. Results: Two surrogate and one definitive end-point were evaluated. Frequency of patients in Arm A with PSA nadir ≤0.2 ng/ml was 71% vs 56% in a control group of concurrent patients without AdV-tk. The two-year pathologic complete response (pCR) rate by sextant biopsy was 90% in Arm A and 94% in Arm B, compared to an expected range of 70–73%. Freedom from failure (FFF) after 60 month median follow up is 100% for Arm A and 90% for Arm B (95% for intermediate, 75% for high risk) vs best reported results of 79–90% for low risk and 48–79% for intermediate-high risk patients. The three failures in Arm B occurred within months after treatment leading to a Kaplan-Meier curve that plateaus at 90% beyond year 3. This is notably different than previous reports in which the curves continue to drop beyond year 5. Conclusion: These results suggest that AdV-tk combined with radiation therapy may significantly reduce the recurrence rate in patients with prostate cancer, particularly in patients with intermediate-high risk disease. A randomized controlled trial is warranted. [Table: see text]
Abstract 9969: Are Men or Women More Likely to Call 911 During an Acute Coronary Syndrome (ACS)?
Authors: Jonathan Newman, Paul Muntner, Melinda J Chang, Siqin Ye, Sarah Perez, Daichi Shimbo, Karina W Davidson
Journal: Circulation (2011)

Introduction : Many patients with ACS fail to call 911. Several studies have identified gender differences in 911 use during an ACS. It may be that general health seeking behaviors impact differently on men and women, which may manifest as an increase in 911 calls. If present, the effect of general health seeking on gender differences in 911 use would be expected for both unstable angina (UA) and myocardial infarction (MI). To examine the effect of increased general health seeking behaviors, participants were stratified as either UA or MI in our examination of the association between gender and 911 use at ACS presentation. Methods : Participants were hospitalized patients with an ACS ( N = 476) enrolled in a prospective cohort study. Demographic, psychosocial and clinical factors were assessed within 7 days of enrollment via clinical interview or chart review. Calling 911 was determined by self-report and verified through a random selection of 20% of medical charts. Results : Of the 476 participants, 292 (61.3%) had UA and 184 (38.7%) had an MI. Women and men with UA were equally likely to call 911 (14.9% vs. 12.6%, P = 0.59). In contrast, women with an MI were much more likely to call 911 than men (56.7% vs. 28.2%, P &lt; 0.001). In a multivariable model adjusted for socio-demographic factors (age, race/ethnicity, public health insurance status, health insurance (within 2 years), high school education and martial status) and history of MI, women remained significantly more likely than men to call 911 during an MI (Prevalence Ratio 2.03; 95% C.I. 1.39 - 2.98, P &lt; 0.001), Table. Conclusion: Our study shows that women with an MI are two times as likely than men to call 911, independent of possible socio-demographic explanatory factors. Women with UA did not differ from men in calling 911. Our findings suggest that gender differences in calling 911 are unlikely to be related to either health seeking behaviors or socio-demographic factors.
Real-Time Magnetic Resonance Imaging–Guided Transarterial Aortic Valve Implantation
Authors: Philipp Kahlert, Nina Parohl, Juliane Albert, Lena Schäfer, Renate Reinhardt, Gernot M. Kaiser, Ian McDougall, Brad Decker, Björn Plicht, Raimund Erbel, Holger Eggebrecht, Mark E. Ladd, Harald H. Quick
Journal: Journal of the American College of Cardiology (2012)
Aspirin for the Primary Prevention of Cardiovascular Events: Recommendation and Rationale
Journal: Annals of Internal Medicine (2002)

This statement summarizes the recommendation of the third U.S. Preventive Services Task Force (USPSTF) for aspirin for the primary prevention of cardiovascular events, as well as the supporting scientific evidence. The complete information on which this statement is based, including evidence tables and references, can be found in a companion article in this issue. Copies of this document, the summary of the evidence, and the systematic evidence review can be obtained through the USPSTF Web site (www.ahrq.gov/clinic/uspstfix.htm) and in print through the Agency for Healthcare Research and Quality Publications Clearinghouse (800-358-9295). *For a list of the members of the U.S. Preventive Services Task Force, see the Appendix.
Rethinking Consultants: Alternative models of organisation are needed
Authors: F. Moss, M. McNicol
Journal: BMJ (1995)

prescribing options offers the better quality.To achieve this all four aims would be considered as ordinal scales within a problem.When we use the example given at the start of this paper we see that the effectiveness and risk of both hypnotics were equal and so irrelevant to the decision.This clarifies that the trade off was between the cost saving resulting from using the cheaper treatment against respecting the choice ofthe patient.Had I been using the aims ofgood prescribing proposed in this paper I hope my decision would have been a better one.I am grateful to
Abstract 10226: M2 Macrophages Contribute to Postnatal Lymphangiogenesis as Lymphatic Endothelial Cell Progenitors
Authors: Yuuki Shimizu, Satoshi Shintani, Rei Shibata, Yusuke Izumi, Yasuhiro Ogura, Masakazu Ishii, Toyoaki Murohara
Journal: Circulation (2011)

Introduction: Macrophages possess two characteristics, pro-inflammatory and anti-inflammatory ones. Respective macrophages are called M1 and M2 type. M2 macrophages have been shown to predict a poo...
Safety and Efficacy of Second-Generation Everolimus-Eluting Xience V Stents Versus Zotarolimus-Eluting Resolute Stents in Real-World Practice
Authors: Kyung Woo Park, Joo Myung Lee, Si-Hyuck Kang, Hyo-Suk Ahn, Han-Mo Yang, Hae-Young Lee, Hyun-Jae Kang, Bon-Kwon Koo, Janghyun Cho, Hyeon-Cheol Gwon, Sung Yoon Lee, In-Ho Chae, Tae-Jin Youn, Jei Keon Chae, Kyoo-Rok Han, Cheol Woong Yu, Hyo-Soo Kim
Journal: Journal of the American College of Cardiology (2012)
Outreach programme in Kenya was based on extensive community participation
Authors: S. A Murray
Journal: BMJ (1996)

EDITOR,—Paul Johnstone and Isobel McConnan suggest that a wealth of knowledge about primary health care exists in developing countries and is now relevant to the NHS.1 I learnt much from supporting a successful community based health care programme in sub-Saharan Africa for six years.

Chogoria Hospital provides complete medical care for 350000 people in Meru district of Kenya. Having gained local credibility because of its effective curative services, the hospital developed an outreach programme for maternal and child …
Recovery After Stem-Cell Transplantation for Hematologic Diseases
Authors: Stephanie J. Lee, Diane Fairclough, Susan K. Parsons, Robert J. Soiffer, David C. Fisher, Robert L. Schlossman, Joseph H. Antin, Jane C. Weeks
Journal: Journal of Clinical Oncology (2001)

PURPOSE: Although the number of autologous and allogeneic stem-cell transplantations (SCT) is increasing, relatively little information about recovery after transplantation is available. Quantitative information appropriate for patient counseling is difficult to discern from the literature. We sought to suggest reasonable expectations for recovery and symptoms after SCT for hematologic malignancies and other disorders using the following measures: (1) objective measures of health status, such as frequency of clinic visits, need for rehospitalization, medication usage, work status, and overall and event-free survival; (2) qualitative assessment of quality of life, such as returning to a normal life, resumption of normal activities, satisfaction with appearance, and whether recovery has occurred; and (3) quantification of specific bothersome symptoms. PATIENTS AND METHODS: Autologous and allogeneic SCT recipients at a tertiary-care transplant center participated in the prospective, longitudinal questionnaire study. RESULTS: Three hundred twenty patients were studied. Questionnaire response rates at 6, 12, and 24 months range from 85% to 88% among survivors. Although autologous patients had better event-free and overall survival, fewer symptoms, and more complete recovery at 6 months, these advantages had largely equalized by 12 months. Specific bothersome symptoms were reported by less than 24% of patients after transplantation, except for fatigue and financial and sexual difficulties, which were more prevalent. CONCLUSION: These findings may help counsel patients considering transplantation and educate them about reasonable expectations for recovery. Overall, the low level of bothersome symptoms and continued recovery through the first year after transplantation are encouraging.
Abstract 14020: Patients With Diabetes in Addition to Manifest Cardiovascular Disease are More Likely to Achieve LDL-Cholesterol-Target in Clinical Practice in Europe and Canada: Results of the Dyslipidemia International Study
Authors: Anselm K Gitt, Claus Juenger, Wenefrieda Smolka, John Kastelein, Dysis Study-Group
Journal: Circulation (2011)

Background: Chronic statin treatment is well established for patients with dyslipidemia and high risk for subsequent cardiovascular events and its use is widespread in clinical practice. Patients w...
Abstract 004: Independent Effects of 1.5 Ounces/Day Almonds on Lipids, Lipoproteins, and Apolipoproteins in Mildly Hypercholesterolemic Adults
Authors: Claire E Berryman, Sheila G West, Peter L Bordi, Jennifer A Fleming, Penny M Kris-Etherton
Journal: Circulation (2013)

Introduction: Almonds have been studied in the context of blood cholesterol-lowering diets, which consistently show beneficial effects on CVD risk factors. The independent effects of almonds beyond...
Abstract 4686: Noncontrast Three Dimensional Dark Blood Magnetic Resonance Imaging in Adult Congenital Heart Disease Patients After Transcatheter Intervention
Authors: Marshall W Winner, Subha V Raman, Orlando P Simonetti, Yiu-Cho Chung, Lindsay Arnott, Georgeta Mihai, Stephen C Cook
Journal: Circulation (2008)

Background : Adults with congenital heart disease (ACHD) often require transcatheter therapies as a result of residual lesions. CT is well-suited for evaluation of stents but exposes young adults to radiation. Gradient echo MRI suffers from artifact limiting assessment of stented segments. We investigate the use of a novel 3D turbo spin echo (TSE) MRI sequence in these patients. Methods: ACHD patients presenting for MRI with prior interventions underwent an additional T1-weighted 3D dark blood navigator respiratory gated TSE scan on a1.5 Tesla system. Type of CHD, prior CT, radiation dose, length of time between examinations, and luminal diameters on each study were obtained. Continuous variables analyzed using Student’s t-test and Bland-Altman plots. Results: Eleven patients underwent both MRI and CT. Diagnoses were coarctation of the aorta (n=6) and tetralogy of Fallot (n=5) with intervention in the aorta or pulmonary arteries respectively. Average radiation dose was 19.57mSv; average time between CT and MRI was 99 ± 160 days. Luminal diameters of stented vessels correlated closely between TSE MRI and CT (r 2 = .85) with a small bias toward overestimation with MRI (mean 22.4 +/− 4.3 mm and 20.9 +/− 3.7 mm, p&lt; .01). There were no cases of in-stent stenosis demonstrated by CT. Conclusion: Metallic artifact is significantly reduced with 3D navigator respiratory gated TSE MRI allowing visualization of anatomy in the vicinity of stents, providing a potential method for assessment of complex anatomy without radiation exposure or use of contrast agents. Further studies of this technique are warranted, particularly in patients with in-stent stenosis.
Efficacy and Safety of Drug-Eluting Stents in Chronic Total Coronary Occlusion Recanalization
Authors: Humberto J. Colmenarez, Javier Escaned, Cristina Fernández, Liliana Lobo, Sara Cano, Juan G. del Angel, Fernando Alfonso, Pilar Jimenez, Camino Bañuelos, Nieves Gonzalo, Eulogio García, Rosana Hernández, Carlos Macaya
Journal: Journal of the American College of Cardiology (2010)
Abstract 16817: Utility of Digital Assessment of Endothelial Function for Cardiovascular Risk Stratification in Patients with Diabetes Mellitus
Authors: Yasushi Matsuzawa, Seigo Sugiyama, Sumida Hitoshi, Koichi Sugamura, Toshimitsu Nozaki, Keisuke Ohba, Masaaki Konishi, Junichi Matsubara, Eiichi Akiyama, Satomi Iwashita, Kunihiko Matsui, Satoshi Umemura, Kazuo Kimura, Hisao Ogawa
Journal: Circulation (2011)

Background: Patients with diabetes have an increased risk in developing cardiovascular complications, caused by endothelial dysfunction and accelerated atherosclerosis. However, among patients with diabetes, the degree of atherosclerosis is various. Endothelial dysfunction could provide a significant prognostic value to predict future cardiovascular events. Digital reactive hyperemia-peripheral arterial tonometry (RH-PAT) is a noninvasive and operator-independent method to evaluate endothelial function. We examined whether the assessment of endothelial dysfunction could provide comprehensive cardiovascular risk stratification in patients with diabetes. Methods: This study included 160 consecutive stable high-risk patients with diabetes suspected of coronary artery disease (CAD). The RH index (RHI) was measured before cardiac catheterization, and examined the presence of CAD by angiography (&gt;50% stenosis). Coronary plaques were classified angiographically as simple or complex according to Ambrose criteria. Results: In diabetic patients, the values of RHI were significantly attenuated in patients with CAD (n = 140) compared to those without CAD (n = 20) (non-CAD: 0.72 ± 0.23, versus CAD: 0.51 ± 0.17, p &lt; 0.01). Furthermore, RHI values of diabetic patients with complex coronary lesion (n = 92) were significantly lower than those with simplex coronary lesion (n = 48) (simple-CAD: 0.56 ± 0.14, versus complex-CAD: 0.48 ± 0.18, p &lt; 0.01). Multivariable logistic regression analysis among various risk factors identified lower RHI values as an independent determinant of coronary plaque complexity in patients with diabetes (the odds ratio was 0.69 [95% confidence interval: 0.56 to 0.85], p &lt; 0.01). By receiver operating characteristics analysis, RHI had a significant prognostic value to predict complex coronary plaques (the area under the curve: 0.73 [95% confidence interval: 0.65 to 0.81], p &lt; 0.001). Conclusions: Advanced endothelial dysfunction significantly correlated with the presence of CAD, particularly with the coronary complex plaque in patients with diabetes. Among diabetic patients, the assessment of endothelial function can provide clinically important information to identify vulnerable patients with vulnerable plaque.
Abstract 14499: Serum Parathyroid Hormone is Independently Associated With Atrial Fibrillation: Insights From the LURIC Study
Authors: Nicolas Verheyen, Martin Grubler, Stefan Pilz, Katharina Kienreich, Martin Gaksch, Johannes Schmid, Lara Alexandra Bersuch, Burkert Pieske, Elisabeth Kraigher-Krainer, Astrid Fahrleitner-Pammer, Bernhard Otto Boehm, Winfried Marz, Andreas Tomaschitz
Journal: Circulation (2013)

Introduction: Recent evidence from observational studies indicates that in patients with atrial fibrillation (AF) parathyroid hormone (PTH) levels are increased and related to left atrial diameter ...
Abstract 9045: Electrocardiographic Changes Associated with Smoking and Smoking Cessation: Outcomes from a Randomized Controlled Trial
Authors: Adam D Gepner, Megan E Piper, Miguel A Leal, Michael C Fiore, Timothy B Baker, James H Stein
Journal: Circulation (2012)

Background Cardiovascular disease (CVD) prevalence and risk can be detected and quantified by analysis of the electrocardiogram (ECG), however the effects of smoking and smoking cessation on the ECG have not been characterized. Methods ECGs were performed on subjects enrolled in a prospective, randomized, placebo-controlled clinical trial of the effects of 5 smoking cessation pharmacotherapies. 12-lead ECGs from the baseline and 3-year visits were read in duplicate. Smoking burden was described by pack-years. Current smoking was described by cigarettes/day. Abnormalities were classified using the Minnesota ECG Code Classification (major and minor criteria). The effects of (i) smoking burden on the prevalence of ECG findings, and (ii) smoking and smoking cessation on ECG changes after 3 years were investigated by multivariable linear and multinomial regression analyses. Results At baseline, the 532 smokers were (mean [SD]) 43.3 (11.5) years old, smoked 20.6 (7.9) cigarettes/day, and had a smoking burden of 26.7 (18.6) pack-years. Major and minor ECG criteria were identified in 87 (16.4%) and 131 (24.6%) of subjects, respectively. After adjusting for age, sex, race, education, body-mass index, fasting glucose, and lipids, major ECG criteria were associated with greater pack-years (p=0.02), but not current cigarettes/day (p=0.23). After 3 years, 42.9% of subjects were abstinent from smoking. New major and minor ECG criteria were observed in 7.2% and 15.6% of subjects respectively, but in a similar number of abstinent subjects and continuing smokers (p&gt;0.2 for both). Continuing smokers had a significant reduction in current smoking (-8.4 [8.8] cigarettes/day, p&lt;0.001) compared to baseline. Conclusions Even in relatively young adults, major ECG abnormalities are independently associated with smoking burden. After 3 years, continued smoking was not associated with an increase in ECG abnormalities, though cigarettes smoked per day decreased among continuing smokers.