tbuckley/cabot-search huggingface dataset:
Abstract 2033: Sildenafil Prevents Rebound Pulmonary Hypertension After Discontinuation of Inhaled Nitric Oxide: A Randomized, Double-Blind Placebo-Controlled Study in Children
Authors: P Namachivayam, U Theilen, SM Cooper, W Butt, DJ Penny, LS Shekerdemian
Journal: Circulation (2006)

INTRODUCTION:Post operative pulmonary hypertension(PHT) is common after surgery for congenital heart disease and nitric oxide(NO) is a widely accepted treatment in this group of sick infants.Rebound PHT can complicate the weaning of inhaled NO, and is in part related to transient depletion of intrinsic cyclic-GMP during NO therapy.We hypothesised that prevention of breakdown of pulmonary vascular cyclic-GMP, using sildenafil, a phosphodiesterase-5 inhibitor, may prevent rebound PHT.  METHODS: Thirty patients (median weight 4.2Kg) were enrolled and 29 completed study. Patients were randomized to receive 0.4mg/kg of sildenafil or placebo, 1 hour before NO was stopped.PA pressures and blood gases were measured before giving the study drug, and one and 4 hours after stopping NO.Data are given as mean(SD) or median (IQR) as appropriate. RESULTS:Rebound PHT occurred in 10/14 placebo patients, and 0/15 sildenafil patients (P  CONCLUSION: A single dose of enteral sildenafil prevented the development of rebound PHT and also reduced the duration of mechanical ventilation in children.
Abstract 15073: Type B Human Natriuretic Peptide Receptor with a novel gain-of-function mutation provides therapeutic potential in the treatment of pulmonary arterial hypertension
Authors: Nobutoshi Nawa, hidekazu Ishida, Sigetoyo Kogaki, Toshiki Uchikawa, Yoko Okada, Jun Narita, Shu Maekawa, Hiroaki Ichimori, Seiko Mihara, Hiroki Baden, Shinichi Katuragi, Koji Miura, Keiichi Ozono
Journal: Circulation (2011)

Introduction: Cyclic GMP (cGMP) is a ubiquitous second messenger that plays a central role in diverse physiologic processes. In humans, type B natriuretic peptide receptor (NPR-B) is one of the tra...
Bowel involvement in advanced epithelial ovarian cancer as a prognostic factor
Authors: M. L. Arora, S. Saha, S. J. Sirop, S. Manyam, D. Iddings, M. Ghanem, N. Dutt, N. Kulkarni, D. Wiese, T. Singh, D. Eilender
Journal: Journal of Clinical Oncology (2008)

16536 Background: Epithelial Ovarian cancer (OvCa) often presents in advanced stages(stage IIIC and IV). Bowel involvement (BI) at the time of the diagnosis suggests bulky advanced disease and has been associated with poor prognosis. A retrospective analysis was done to assess the impact of BI at the time of diagnosis of OvCa on the recurrence and overall survival. Methods: A retrospective review of 154 consecutive patients (pts) with epithelial OvCa was undertaken, 86 pts had advanced stages(IIIC and IV). Data was obtained for age, stage of the disease, operative procedure, pathology, recurrence and survival. Results: Of the 86 pts with advanced OvCa, 48 pts, group A, had BI at the time of diagnosis while 38 pts, group B, did not have BI. In group A, 32 had large BI, 5 had small BI, 6 had both small and large BI and 5 had stomach involvement. All pts in group A underwent radical bowel resection to achieve optimal cytoreduction (OCR) followed by adjuvant chemotherapy. Bowel continuity without colostomy was maintained in 37 pts (77.1%). Twenty six (55%) pts in group A and 20 pts in group B (57%) had more extensive disease and received neoadjuvant chemotherapy (NAC). The median CA125 level for pts in group A was 499 as compared to 213 for pts in group B. OCR was achieved in 79% of pts in group A (92% of pts who received NAC vs 66% of pts who underwent primary debulking surgery) and in 68 % of pts in group B. Overall median survival in group A vs group B was similar (35 vs 36 months). Recurrent/Persistent disease developed in 56% of pts in group A as compared to 57% of pts in group B (p=.0.64). There was no difference in the median disease-free interval (DFS) of the two groups (16 vs 18 months, p=0.67). Conclusions: BI did not independently effect the overall survival, DFS or recurrence of pts with stage IIIC and IV EpOvCa if radical bowel resection and chemotherapy could be performed. NAC is associated with increased rates of OCR in pts with BI Table1: Comparison between pts with BI and with no BI at the time of diagnosis Variable Group A Group B P value Stage IIIC (# of pts) 43 30 0.22 IV (# of pts) 5 8 0.22 Age (years) 65 64 0.6 OCR (# of pts/percentage) 38/79% 26/68% 0.32 CA 125 at diagnosis 499 213 0.25 NAC (# of pts/percentage) 26/55% 20/57% 1.0 Recurrent/persistent disease (# of pts/percentage) 27/56% 22/57% 1.0 Follow up Median survival (months) 35 34 0.25 Median diease free survival (months) 16 18 0.1 Group A: 48 pts with BI Group B: 38 pts with no BI No significant financial relationships to disclose.
Lesson of the Week: Value of opinion by oral physician in diagnosing Wegener's granulomatosis
Authors: J M Zakrzewska, J Feehally, J J H Gilkes
Journal: BMJ (1994)

Adequate and appropriate oral biopsy by an oral physician may help diagnose potentially life threatening systemic disease

It has long been appreciated that the mouth is the mirror of the rest of the body. Many systemic diseases have oral symptoms, which often coincide with widespread evidence of disease. In some cases, however, oral symptoms may be the sole presenting sign of systemic disease. This may cause difficulty in diagnosis, yet little attention is paid to examination of the oral cavity in medical undergraduate training. It is therefore important that patients with oral lesions are referred to specialists in oral medicine for diagnosis, investigation, and management. We report on a patient in whom the diagnosis and treatment of a potentially life threatening systemic disease was delayed owing to poor appreciation of the clinical importance of oral lesions.

A 53 year old woman presented with a history of bleeding gingiva. She had had ulcerative colitis for 12 years, which was controlled by sulphasalazine treatment. Her general dental practitioner had extracted all her remaining teeth on the assumption that her bleeding gingiva and mobile teeth were due to periodontal disease. No biopsy specimen was taken at this time. Dentures were made, but she could not tolerate them, and the gingiva continued to bleed.

She was next seen by an oral surgeon, who, …
Abstract 576: The Prognostic Value of the Long Pentraxin 3 as Compared to B-Type Natriuretic Peptide and High-Sensitive C-Reactive Protein, and their Combination, as a Prognostic Marker of Mortality in Acute Chest Pain Patients
Authors: Trygve Brügger-Andersen, Volker Pönitz, Frederic Kontny, Harry Staines, Heidi Grundt, Kyoko Miyamoto, Chihiro Miyazawa, Tadashi Matsuura, Mina Sagara, Dennis W.T. Nilsen
Journal: Circulation (2008)

Elevated plasma levels of long pentraxin 3 (PTX3), high-sensitive C-reactive protein (hsCRP) and B-type natriuretic peptide (BNP) are found in acute coronary syndromes (ACS). The aim of this study was to assess the prognostic value of PTX3 as compared to BNP and hsCRP, and their combination, as a prognostic marker of mortality in acute chest pain patients. PTX3 was measured in EDTA plasma with a new, high-sensitive ELISA method (PPMX, Tokyo, Japan). BNP was analysed in EDTA plasma using the Microparticle Enzyme Immunoassay (MEIA) Abbott AxSYM®. HsCRP was measured with the use of an immunoturbidimetric assay (Tinaquant® C-reactive protein (latex) high sensitive assay, Roche Diagnostics). The blood samples were taken on admission in 795 patients. The patients were followed for 24 months concerning mortality. For statistical analysis, the study cohort was divided into quartiles (Q1–4) according to PTX3 levels. A multiple logistic regression was fitted which included standard risk measures. At 24 months follow-up, 121 of the 784 patients included in the model had died. The odds ratio for comparing Q4 versus Q1 for PTX3, BNP and hsCRP were 4.34, 3.35 and 0.52 (p=0.001, p=0.024 and p=0.096), respectively, and the combination of PTX3 and BNP showed an incremental prognostic value (figure ). PTX3 is a new independent marker that strongly predicts long-term all-cause mortality in patients with acute chest pain and the combination of this marker with BNP adds substantially to the prognostic value as compared to either marker alone. Figure The number of biomakers greater than the median for % death in 24 months (p&lt;0.001 for comparing the groups)
Dealing with research misconduct in the United Kingdom An American perspective on research integrity Conduct unbecoming---the MRC's approach An editor's response to fraudsters Deception: difficulties and initiatives Honest advice from Denmark
Authors: D. Rennie, I. Evans, M. J G Farthing, C. Chantler, S. Chantler, P. Riis
Journal: BMJ (1998)

# Dealing with research misconduct in the United Kingdom {#article-title-2} After years of inactivity over the problem of research misconduct in the United Kingdom, there is now an enthusiasm and drive to do something. But how should medical fraud be tackled? Representatives from medical journals (both British and American), the Medical Research Council, a medical school and a medical charity, and a member of the Danish Committee on Medical Dishonesty give their views on this important topic. # An American perspective on research integrity {#article-title-3} Editorial by Smith News by White An allegation of scientific fraud can ruin the careers of both the accused and the accuser, divide faculties, bring a research institution's functions to a halt, provide a field day for the media, and, when the scientific establishment is unprepared, result in a loss of confidence in the entire research enterprise. Yet, despite repeated demonstrations that this is the case, scientists are still reluctant to face up to such an unpleasant problem. Three years ago, at a meeting on research misconduct held by the BMJ , I warned that many extremely embarrassing incidents at a variety of institutions would be required before anyone took any action in the United Kingdom. This seems to have been borne out. At a meeting organised by the Committee on Publication Ethics (COPE) in London, I was depressed that so few seemed to have paid the slightest attention to the rich, well documented and instructive experience of the United States, where an energetic attempt to face up to the problem has been made. Such parochialism may doom the UK to repeat the many mistakes already made by others. To the American observer, the news from the UK about incidents of misconduct in research is, as baseball's greatest philosopher, Yogi Berra, remarked, "déjà vu all over again." I began to be seriously concerned about the problem in 1979 when, as deputy editor of the … Correspondence to: Sir Cyril Chantler
Panic disorder and quality of life: variables predictive of functional impairment
Authors: M Hollifield, W Katon, B Skipper, T Chapman, J C Ballenger, S Mannuzza, A J Fyer
Journal: American Journal of Psychiatry (1997)

The authors sought to characterize the functional impairment in patients with panic disorder, specifically the variance in impairment explained by demographic and clinical variables.Sixty-two patients with panic disorder and 61 comparison subjects from three primary care clinic sites were assessed with an adapted form of the Structured Clinical Interview for DSM-III-R. Impairment was assessed according to three measures from the 36-item Short-Form Health Survey (general health perception, mental health, and physical functioning) as well as a principal component factor of the survey. Subjects were also compared with respect to personality variables, presence and severity of chronic medical illness, and demographic characteristics. Stepwise multiple regressions with and without pairwise interactions were used to construct models of disability in the patients with panic disorder.The patients with panic disorder were more impaired than comparison subjects on each measure of the Short-Form Health Survey. The panic disorder diagnosis combined with major depression, increasing neuroticism and age, less education, and an interaction between panic disorder and age accounted for 48%-77% of the variance in impairment scores. Gender and ethnicity contributed modestly to the variance in impairment in physical functioning, whereas no contribution was demonstrated for chronic medical illness or city of residence.Factors in addition to panic phenomena contribute to the severe impairment seen in patients with panic disorder. Further research about factors that affect impairment may help improve clinical approaches to this illness.
Abstract 192: Double Doses of Tea Polyphenols Are as Effective as a Single Dose in an Asphyxial Rat Model
Authors: Feng-Qing Song, Meng-Hua Chen, Dong-Ming Fang, Lu Xie, Xue-Li Qu
Journal: Circulation (2011)

Background: Cerebral ischemia/reperfusion injury following cardiac arrest and cardiopulmonary resuscitation (CPR) has been demonstrated. Oxidant injury plays a critical role in the process. Since tea polyphenols from green tea are efficient free radical and singlet oxygen scavengers, and we have demonstrated single dose of tea polyphenols improved the outcome of CPR in an asphyxia rat model. Theoretically, more tea polyhenols will be more efficient. Therefore, we hypothesized that double doses of tea polyphenols will better improve the outcome of CPR via counteracted the oxidant injury than single dose of that. Methods: Male Sprague-Dawley rats, weighing 200-400 g, were induced cardiac arrest by clamping the trachyeal tubes. At the end of 8 min of clamping, mechanical chest compression at a rate of 180/min was performed. Ventilation was started with room air at 70 breaths per min and tidal volume adjusted to 6 ml. Epinephrine was administered at 1 min of CPR. Animals were randomly divided into three groups: Sal-gro, TP-gro1 and TP-gro2 (treated with either saline, 10mg/kg tea polyphenols or 10mg/kg tea polyphenols following ROSC and with saline, saline, or 10mg/kg tea polyphenols after one hour of ROSC). Results: There were no significant differences in regard to hemodynamics among three groups before asphyxia. Time from the initiation of asphyxia to cardiac arrest and the duration of CPR were not significant difference among three groups. However, neurological deficit score were better in TP-gro1 and TP-gro2 than that in Sal-gro (P&lt;0.05). And survival time were longer in TP-gro1 and TP-gro2 than that in Sal-gro (P&lt;0.05). There were no significant about neurological deficit score and survival time between TP-gro1 and TP-gro2. Conclusion: Double doses of tea polyphenols were as effective as single dose of that in a rat of asphyxia cardiac arrest model.
Captopril for Refractory Hypertension in Patients with Impaired Renal Function
Authors: M S Laher, J F O'Donohoe, P O'Regan, T B Counihan
Journal: Journal of the Royal Society of Medicine (1985)

The use of captopril in 19 patients with renal parenchymal disease and refractory hypertension was studied for a mean period of 12 months. There was a significant reduction in the systolic and diastolic blood pressures, with a reduction in the mean arterial pressure of 29 mmHg. The mean maintenance dose of captopril was 142 mg daily in three divided doses. All but one of the patients required a diuretic for satisfactory blood pressure control and 3 patients were also given a beta-blocker. In all patients a simplification of the previous therapeutic regimen was achieved. A significant rise in serum creatinine was noted in 2 patients, one of whom had to be withdrawn from the study. Despite the presence of renal functional impairment, proteinuria did not occur de novo nor did established proteinuria increase. Leukopenia was noted in any of the patients in this group.
Abstract 15199: Long-Term Prognostic Impact of No-Reflow Phenomenon After Primary Percutaneous Coronary Intervention in Patients With St-Segment Elevation Myocardial Infarction
Authors: Eunho Choo
Journal: Circulation (2013)

Background: Previous studies have demonstrated a strong association between no-reflow phenomenon, infarct size and adverse cardiovascular outcome in patients with ST-segment elevation myocardial in...
Global Environmental Change: What Can Health Care Providers and the Environmental Health Community Do About It Now?
Authors: Brian S. Schwartz, Cindy Parker, Thomas A. Glass, Howard Hu
Journal: Environmental Health Perspectives (2006)

The debate about whether global environmental change is real is now over; in its wake is the realization that it is happening more rapidly than predicted. These changes constitute a profound challenge to human health, both as a direct threat and as a promoter of other risks. We call on health care providers to inform themselves about these issues and to become agents of change in their communities. It is our responsibility as clinicians to educate patients and their communities on the connections between regressive policies, unsustainable behaviors, global environmental changes, and threats to health and security. We call on professional organizations to assist in educating their members about these issues, in helping clinicians practice behavior change with their patients, and in adding their voices to this issue in our statehouses and Congress. We call for the development of carbon and other environmental-labeling of consumer products so individuals can make informed choices; we also call for the rapid implementation of policies that provide tangible economic incentives for choosing environmentally sustainable products and services. We urge the environmental health community to take up the challenge of developing a global environmental health index that will incorporate human health into available "planetary health" metrics and that can be used as a policy tool to evaluate the impact of interventions and document spatial and temporal shifts in the healthfulness of local areas. Finally, we urge our political, business, public health, and academic leaders to heed these environmental warnings and quickly develop regulatory and policy solutions so that the health of populations and the integrity of their environments will be ensured for future generations.
Abstract 8734: Loading of Aspirin and Clopidogrel: Effect of Dose on Stroke Outcome in the Rabbit Small Clot Embolic Model
Authors: Dawn M Meyer, Margaret P Compton, Jo-Ann Eastood, Karen Gylys, Justin A Zivin
Journal: Circulation (2010)

Background and Purpose: No acute therapy exists for the hundreds of thousands of ischemic stroke patients who present ineligible for thrombolytic treatment. The purpose of this proof of concept stu...
Abstract 1993: Can STEMI Patients Transferred For 1{degrees} Angioplasty Receive Treatment Within 90-Minutes in a Rural Setting?
Authors: James C Blankenship, Marie Sledgen, Peter B Berger, G C Wood, Kimberly A Skelding, Thomas Scott, Francis J Menapace, Michael A Donegan
Journal: Circulation (2007)

Introduction: For STEMI patients (pts) presenting to non-PCI hospitals, the feasibility of rapid transfer for 1° PCI within 90 minutes of initial presentation is unclear. Hypothesis: A rapid triage/transfer/treatment protocol can provide 1° PCI ≤ 90 minutes to STEMI pts presenting to rural community hospitals. Methods: On Jan 1, 2005 we implemented a STEMI program in rural central PA to transport STEMI pts up to 25 minutes away by helicopter. One call from a community hospital to an emergency physician at the PCI center leads to dispatch of a helicopter and simultaneous activation of the cath lab. Local hospitals were encouraged to meet time milestones to diagnose, administer specific medical therapies and transfer pts rapidly. Incremental improvements in the program were made since implementation. We prospectively recorded presentation (Door1) to helicopter dispatch (Dis), Dispatch to cath lab arrival (Door 2), and Door2 to wire cross (WC) times for all patients using flight logs, cath lab logs, EKGs, an...
Abstract 604: Targeting Cx43 Prevents Growth Factor-Induced Phenotypic Change in Pig Coronary Artery Smooth Muscle Cells
Authors: Christos E Chadjichristos, Sandrine Morel, Jean-Paul Derouette, Anne Brisset, Isabelle Roth, Esther Sutter, Marie-Luce Bochaton-Piallat, Brenda R Kwak
Journal: Circulation (2007)

Percutaneous coronary intervention (PCI) is commonly used to treat atherosclerotic coronary arteries, but its efficacy is limited by restenosis at the site of the intervention. We reported previously that reducing the expression of the gap junction protein connexin43 (Cx43) in mice restricted neointima formation after acute vascular injury by limiting the inflammatory response as well as the proliferation and migration of smooth muscle cells (SMCs) towards the damaged site. SMC populations isolated from the pig coronary artery exhibit distinct phenotypes: spindle-shaped (S) and rhomboid (R). S-SMCs are predominant in the normal media, whereas R-SMCs are recovered in higher proportion from stent-induced intimal thickening suggesting that they participate in the intimal thickening. Here, we further investigate the relationship between connexin expression and SMC phenotype using the distinct types of pig coronary artery SMCs. We show that Cx40 was highly expressed in normal media of porcine coronary artery in vivo, whereas Cx43 was barely detectable. In contrast, Cx40 was down-regulated and Cx43 was markedly up-regulated in SMCs of stent-induced intimal thickening. In vitro, S-SMCs expressed Cx40 and Cx43. Cx43 expression was increased in R-SMCs and these cells no longer expressed Cx40. When S-SMCs were treated with 10 ng/ml platelet-derived growth factor (PDGF-BB) they acquired a rhomboid phenotype and their migratory activity increased (from 40.3±5.7 to 185.9±27.3 migrating cells; mean±SEM, N=4, P&lt;0.01). These changes were accompanied by an increase in Cx43 and loss of Cx40 expression. Importantly, PDGF-BB-induced phenotypic change of S-SMCs was prevented by reducing Cx43 expression with 100 uM antisense for Cx43. Thus, Cx43 antisense-treated SMCs retained their typical elongated appearance and the expression of some SMC differentiation markers, such as alpha-SM actin, whereas the appearance of S100A4, a typical marker of R-SMCs, was prevented. In conclusion, limiting Cx43 expression in SMCs prevents growth factor-induced changes towards a deleterious phenotype. Our findings suggest that Cx43 might be an additional target for local delivery strategies aimed at reducing restenosis after PCI.