tbuckley/cabot-search huggingface dataset:
Abstract 1280: Transcriptional Profiling Of Young And Old Mesenchymal Stem Cells For Their Response To Oxygen Deprivation And Myocardial Reparability
Authors: Shujia Jiang, Husnain K Haider, Niagara Muhammad Idris, Rafeeq Ahmed, Asmat Salim, Muhammad Ashraf
Journal: Circulation (2007)

Background: Most clinical studies used autologous bone marrow stem cells (BMSCs) for myocardial repair in elderly patients. Accounting for the limited success in clinical studies, we hypothesized that aging impairs the reparability of BMSCs which limits their therapeutic efficacy. Methods and Results : We compared MSCs from young ( Yng MSCs; 8–12 weeks) and old ( Old MSCs; 24–26 weeks) rats for their responsiveness to anoxia and therapeutic potential. A significantly higher expression of angiogenic growth factors was observed by Yng MSCs under anoxia as compared with Old MSCs, cultured either alone or in co-culture ( Co-old MSCs) with Yng MSCs. Likewise, Yng MSCs showed significantly higher ability to form tubular structures during Matrigel assay. LDH release assay showed that Yng MSCs were more tolerant to apoptotic stimuli (glucose and serum starvation under anoxia) as compared with Old MSCs and Co-old MSCs, with a possible role for pro-survival proteins p21 and p27 which showed increased gene expression (&gt;8-fold and 13-fold respectively) in Yng MSCs under anoxia as compared with Old MSCs. For in vivo studies, acute myocardial infarction model was developed in Fisher-344 rats (n=38). The animals were grouped to receive 70μl DMEM without cells (group-1) or containing 3×10 6 Yng MSCs (PKH67 labeled; group-2), or Old MSCs (PKH26 labeled; group-3) and mixture of Yng MSCs+ Old MSCs (1.5×10 6 cells each, group-4). Histological studies revealed that by day-7, Yng MSCs were already showing elongated morphology with orientation similar to the host muscle architecture. Transmission electron microscopy and confocal imaging after immuno-staining for vonWillebrand Factor-VIII, myosin heavy chain, cardiac actinin and connexin-43, showed superior angiomyogenic potential of Yng MSCs. Echocardiography showed significantly improved indices of left ventricle contractile function in group-4. Conclusions: Aging significantly weakened the responsiveness of Old MSCs to anoxia and their differentiation potential. Their reparability of infarcted heart was also impaired with aging which was not improved by the presence of Yng MSCs. Hence, transplantation of stem cells from young donors should be considered for heart cell therapy in elderly patients for better prognosis.
Abstract 3095: Prognostic Significance Of Post-revascularisation Irreversible Myocardial Injury Detected By Cardiovascular Magnetic Resonance Imaging
Authors: Joseph B Selvanayagam, Kazem Rahimi, Adrian Banning, Adrian S Cheng, Tammy J Pegg, Theodoros D Karamitsos, David P Taggart, Stefan Neubauer, Stefan Neubauer
Journal: Circulation (2007)

Background The prognostic significance of revascularization procedure related myocardial injury is uncertain. Delayed enhancement CMR (DE-CMR) has been shown to reliably identify areas of irreversible myocardial injury. We evaluated the prognostic significance of procedure related myocardial injury in a consecutive series of patients undergoing high risk PCI or CABG. Methods/Results 152 patients underwent DE-CMR pre and 1– 6 days post elective PCI or CABG. Primary endpoint was defined as total mortality, non-fatal MI, ventricular arrhythmia terminated by ICD (VA), and unstable angina or heart failure requiring hospitalization. Secondary endpoint was the composite of total mortality, non-fatal MI and VA. During a median follow-up of 2.9 years, 27 patients (18%) reached the primary endpoint and 12 patients (8%) the secondary endpoint. 49 patients (32%) had evidence of new myocardial hyperenhancement (HE) with a median mass of 5.0g (IQR 4.8 –7.1). In a univariate analysis, age, LV EF post intervention, and presence of new HE were predictive of the primary outcome. Elevated troponin (at 24 h) showed a trend towards poorer outcome. In a multivariate Cox regression analysis only age and presence of new HE (HR 2.7, 95% CI 1.1, 5.8) remained independently correlated with occurrence of the primary endpoint. New myocardial HE was the single independent predictor of the composite secondary endpoint (HR 4.2 95% CI 1.2, 16.1). Conclusion Even small amounts of procedure-related myocardial injury are associated with poorer medium term clinical outcomes. CMR identified myocardial injury may be a stronger prognostic marker than cardiac troponin in the setting of coronary revascularisation.
Primary care groups: Tackling organisational change in the new NHS
Authors: D. Wilkin
Journal: BMJ (2001)

This is the first in a series of five articles 

The organisational centrepiece of the Labour government's reforms of the NHS was the establishment of 481 primary care groups in England in April 1999 and their anticipated progression to trust status. 1 2 For the first time since the founding of the NHS in 1948, primary and community health services have come together in a single organisation that controls a unified budget for delivering health care to and improving the health of communities of about 100 000 people.3 Although they will initially operate as subcommittees of health authorities, they will become freestanding primary care trusts as they show that they can manage budgets and services. As trusts they will have full control of their budgets and be responsible for providing and managing a wide range of community based services as well as for commissioning hospital services on behalf of their patients. Seventeen trusts were established in April 2000, a further 23 in October 2000, and 124 in April 2001. It is anticipated that all groups will become fully fledged trusts within the next two years.4

#### Key points of the NHS plan

#### Summary points

The establishment of primary care groups and trusts in England …
EMPYEMA COMPLICATING A PARAPHARYNGEAL ABSCESS
Authors: Edward Press
Journal: JAMA (1942)

Empyema as a complication of parapharyngeal abscesses is rare and generally occurs by spread from a mediastinitis.<sup>1</sup>The occurrence of empyema in the absence of mediastinitis is extremely rare, and, although Grodinsky<sup>2</sup>described a direct connection between the axilla and one of the fascial spaces of the neck, we have been unable to find previous reports of an abscess extending into the pleura from this space. The following is a case report of this condition: <h3>REPORT OF CASE</h3> N. P., an Italian girl aged 3 years, entered Lincoln Hospital on June 11, 1941 with the complaints of fever, irritability, and pain in the left axilla. The birth and development had been normal. At 7 months of age she had pertussis followed by pneumonia. Although the patient was subject to frequent colds, especially in the winter, she had had no other serious illnesses. Two weeks before admission she received
Abstract P189: Associations between Lactation and Maternal Measures of Total and Regional Adiposity 15 Years Postpartum: Results from the Study of Women’s Health Across the Nation
Authors: Candace K McClure, Christina M Shay, Ping G Tepper, Molly B Conroy, Barbara Sternfeld, Imke Janssen, Kim Sutton-Tyrrell, Eleanor B Schwarz
Journal: Circulation (2013)

Objective: It has been reported that mothers who do not breastfeed are at an increased risk of T2DM, metabolic syndrome, and CVD. We hypothesize that lactation may influence cardio-metabolic risk by altering maternal body composition. We examined the extent to which lactation was associated with regional and total adiposity in a sample of US women 15 years after their last birth. Study Design : Cross-sectional analysis of data provided by 1,268 women aged 45-58 who enrolled in the Study of Women’s Health Across the Nation (1996 -1997). Adiposity was assessed using dual-energy X-ray absorptiometry. History of lactation was self-reported and categorized into three groups: mothers who breastfed for ≥3 months after every birth, those who discontinued lactation within 3 months of some births, and those who never breastfed. Results: Compared with mothers who breastfed after every birth for at least 3 months, mothers who never breastfed had 0.87 kg greater trunk fat mass (FM), 1.3% greater % trunk FM, 1.3% lower % leg FM, and 0.075 greater trunk to leg FM ratio after adjustment for age, parity, height, years since last birth, race/ethnicity, socioeconomic, lifestyle, psychological, and family history variables, maximum gestational weight gain, and menopausal status. After additional adjustment for current BMI, women who never breastfed had 0.40 kg greater trunk FM and 0.053 greater trunk to leg FM ratio than mothers who breastfed every child for ≥3 months. Similarly, mothers who discontinued lactation within 3 months of some births had 0.28 kg greater trunk FM and 0.87% lower % leg FM than mothers who consistently breastfed. Conclusion : Women who did not breastfeed for at least 3 months after every birth exhibit less favorable body fat distributions 15 years postpartum. These results provide a potential physiologic basis for prior findings that women who do not breastfeed their children face increased risk of diabetes, the metabolic syndrome, and cardiovascular disease. Given existing disparities in rates of lactation, obesity and CVD, these findings have great clinical relevance and suggest the need for targeted lactation support for women at risk of cardiovascular disease.
Comparative Assessment of Short-Term Adverse Events in Acute Heart Failure With Cystatin C and Other Estimates of Renal Function
Authors: W.H. Wilson Tang, Matthias Dupont, Adrian F. Hernandez, Adriaan A. Voors, Amy P. Hsu, G. Michael Felker, Javed Butler, Marco Metra, Stefan D. Anker, Richard W. Troughton, Stephen S. Gottlieb, John J. McMurray, Paul W. Armstrong, Barry M. Massie, Robert M. Califf, Christopher M. O’Connor, Randall C. Starling
Journal: JACC Heart Failure (2014)
Barriers to discussions of fertility issues prior to cancer treatment
Authors: C. M. Duffy, S. M. Allen, C. Dube, M. S. Wool
Journal: Journal of Clinical Oncology (2008)

20550 Background: Despite its importance, discussions regarding fertility changes related to cancer treatment may not occur. This qualitative study explored the barriers to these discussions from both oncologists and breast cancer survivors’ perspectives. Methods: Oncologists were recruited from a physician registry and cancer centers in authors’ state. Breast cancer survivors (BCS) were recruited from local support agencies and cancer centers. All BCS were premenopausal at diagnosis and completed treatment within the last three years. Experienced facilitators conducted two focus groups and nine individual interviews among oncologists (one focus group and three interviews) and BCS (one focus group and six interviews) which were tape-recorded, transcribed and entered into NVivo software to facilitate analysis. All authors read through initial transcripts to identify preliminary themes. A hierarchical coding structure was developed by author CD, which was then refined by all authors, adding additional codes to the structure as needed. Results: Common themes raised by both oncologists and BCS included: 1) the need for oncologists’ primary focus at the time of diagnosis to be cure; 2) patients are emotionally overwhelmed at the time of diagnosis which may hamper discussing fertility issues; 3) the need to tailor discussions regarding fertility to meet the individual needs of the patient, and 4) women’s right to be informed of fertility risks with treatment. Oncologists perceived more barriers to fertility discussions (structural, attitudinal, and knowledge) than did cancer survivors. BCS felt it was a right to pursue fertility preservation regardless of their personal or medical circumstances. Conclusions: Barriers to fertility discussions cited by both oncologists and BCS may account for research indicating these discussions do not always occur, or are inadequate. Research Implications: This study suggests the need to improve communication between oncologists and women diagnosed with breast cancer regarding fertility, and to address some of the structural and knowledge barriers to having fertility discussions prior to cancer treatment. No significant financial relationships to disclose.
Canicola Fever
Authors: C. C. Kennedy, T. H. Crozier, A. C. Houston
Journal: BMJ (1953)

Succinylcholine is a safe relaxant for E.C.T.It can be used to abolish the convulsion completely; even with the doses necessary to do this the patient's recovery from the fit is always rapid.Succinylcholine produces a slight rise of blood pres- sure which is generally unimportant.If necessary, this can be controlled by blocking the autonomic ganglia.When complete muscular relaxation is advisable succinylcholine can be administered with safety without any elaborate system of dosage.In such cases the presence of a fit can be detected by the simple manceuvre described.We wish to thank Dr. H. C. Beccle, physician-superintendent, for his advice and encouragement, and for permission to publish.
Synthesis and Secretion of Alpha-2-Macroglobulin by Cultured Adherent Lung Cells
Authors: Deane F. Mosher, Olli Saksela, Antti Vaheri
Journal: Journal of Clinical Investigation (1977)

We studied the synthesis and secretion of alpha-2-macroglobulin by cultures of human adherent cells. Much more alpha-2-macroglobulin (measured by radioimmunoassay) accumulated in media of established strains of adherent cells derived from embryonic lung than in media of established strains derived from adult skin or rheumatoid synovium. Alpha-2-macroglobulin accumulated in media of primary cultures of adherent cells from a variety of embryonic tissues. However, the amount of alpha-2-macroglobulin accumulating in media of subsequent passage of these cells declined for all strains except those derived from lung. Immunodiffusion and double-antibody immunoprecipitation studies of cell extracts and media after incubation of cells with l-[35S]methionine supported the radioimmunoassay finding that adherent cells from lung synthesized and secreted more alpha-2-macroglobulin than adherent cells from skin. Intracellular alpha-2-macroglobulin could not be detected by radio-immunoassay or visualized by immunofluorescent microscopy, suggesting that synthesized alpha-2-macroglobulin is rapidly secreted. Plasminogen-rich fibrin clots were lysed in culture media of adherent cells from embryonic lung and, to a lesser extent, heart. Adherent cells from other tissues, which produced less alpha-2-macroglobulin, did not lyse fibrin clots. However, all cultures of adherent cells contained pericellular fibronectin, a large, external, transformation-sensitive glycoprotein known to be cleaved by plasmin. We speculate that production of alpha-2-macroglobulin may be a means for protease-secreting normal cells to preserve cell surface integrity and that alpha-2-macroglobulin synthesized locally in lung may protect lung tissues from a variety of proteases.
Clinical futures
Authors: M. Marinker, M. Peckham
Journal: BMJ (1998)

Speculation about the future of medicine often centres on anticipated or imagined breakthroughs in science and technology and on the possible impact of these advances in preventing and treating disease. Yet much of the thinking about health policy has stemmed from the perspectives of political, social, economic, legal, and organisational theory. It is time to move the two closer together.

This week sees the publication of a book of essays by a number of distinguished clinical investigators who were invited to take a freewheeling look at the likely trends in diagnosis and treatment over the coming decades.1 Our concern in undertaking this exercise was to redress a balance and to create a forum for the strategic thinking of clinicians and others engaged in pushing forward the boundaries of medical science and services.

Doctors, and …
Abstract 8886: Seasonal Variation of Atrial Fibrillation Hospitalizations
Authors: Abhishek Deshmukh, Gagan Kumar, Sadip Pant, Apurva Badheka, Kaustubh Dabhadkar, Tushar Tuliani, Maithili Shenoy, Hakan Paydak, Jawahar L Mehta
Journal: Circulation (2012)

Introduction: Atrial Fibrillation (AF) hospitalization has emerged as an important clinical end point to assess outcomes of AF. There has been an interest in seasonal variation of cardiovascular hospitalizations.We assessed seasonal variation in hospitalizations for AF from a large national hospitalization database in the past decade. Methods: The Nationwide Inpatient Sample database was used to estimate the annual number of hospitalizations with AF from 2000-2008.Identification of AF related hospitalizations was based on the designation of the International Classification of Diseases (9th Edition) Clinical Modification (ICD-9-CM) diagnosis code 427.31 (AF) as the principal discharge diagnosis. The frequency of hospitalization for each month cumulative over 8 years was calculated and divided by number of days in that month to obtain the mean hospitalizations per day for each month. All calculations were carried out using the weighted estimates approximating nationwide population estimates Results: An estimated 2909423 hospitalizations with primary diagnosis of AF occurred in the United States from the beginning of the calendar year 2000 to the end of the calendar year 2008. The number of hospitalizations per day in each month is shown in Figure 1.The number of hospitalization was maximum in the winter months and minimum in summer months. Specifically, the mean number of hospitalization each day (averaged over 8 years) was least in July (7532). There was a rising trend from July to February. The average number of hospitalization was highest in February (8260); thereafter, the hospitalization rate dropped to a nadir in July. Conclusion: We identified for the first time in United States an impressive pattern of seasonal variation in hospitalizations for AF.Further efforts must be made to identify triggers and methods to prevent AF hospitalizations and reduce its burden on health care system.
Abstract 17833: Efficacy of Hydralazine and Nitrate Therapy in ACE Intolerant Heart Failure Patients
Authors: Don Pham, Vincent Wong, Claire Simister, Luke Cunningham, Wenyaw Chan, Biykem Bozkurt
Journal: Circulation (2012)

Background: Hydralazine and nitrate combination has been demonstrated to be an effective add-on therapy in African American heart failure (HF) patients with systolic dysfunction. Similarly, the com...
Abstract 18367: High Density Lipoprotein Independently Modulates Insulin Sensitivity and Secretion During Acute Phase of Myocardial Infarction
Authors: Luiz Sérgio F Carvalho, Riobaldo M Cintra, Ana Laura R Araújo, Filipe A Moura, José Carlos Quináglia e Silva, Otávio R Coelho, Andrei C Sposito
Journal: Circulation (2011)

During myocardial infarction (MI), a transient decrease of both insulin sensitivity and secretion triggers stress hyperglycemia which is followed by a substantial increase in mortality. Recent data indicate that HDL modulates insulin sensitivity and secretion. To date, however the role of HDL on stress hyperglycemia remains unknown. We explored the influence of HDL on stress hyperglycemia during acute phase of MI. Consecutive non-diabetic patients with ST-elevation MI (n=183) were selected from the Brasilia Heart Study for this investigation. Blood glucose and plasma insulin and C-peptide were measured in the first 24 hours and at the fifth day after MI onset. Patients were divided into HDL-C quartiles for the analyses (Q1:&lt;31, Q2:31-38, Q3:38-47 and Q4:&gt;47 mg/dL). On admission, no difference was found between the quartiles in blood glucose (p=0.6), plasma insulin (p=0.6), plasma C-peptide (p=0.5), HOMA2S (p=0.9) and HOMA2B (p=1.0). On the fifth day there was a reduction in blood glucose whose intensity was directly proportional to HDL-C quartile (-1±32, -13±46, -19±25, -27±21; respectively, p&lt;0.001). In parallel, there was a reduction in plasma insulin [-7.1(-25,1), -5.5(-22,-1), -9.9(-26,-1), -17.7(-32,-9); respectively, p&lt;0.001] and C-peptide [0(-3,1), -1.2(-3,1), -1.7(-3,0), -2.4(-4,0); respectively, p&lt;0.001] whose magnitude was inversely proportional to HDL-C quartile. Consistently, the change in HOMA2S [1(-11,15), 7(-15,17), 10(-5,30), 15(-8,28); respectively, p&lt;0.001] and HOMA2B [-11(-43,31), 16(-45,48), 22(-8,44), 24(-23,61); respectively, p=0.01] and disposition index (DI) [159(-1693,1988), 1104(-1561,3329), 2444(1099,3899), 2447(1052,4856); respectively, p&lt;0.001] were also proportional to HDL-C quartiles. Furthermore, in a multivariate analysis model, HDL-C levels were positively and independently associated with a higher change in DI (B=0.068; Exp(B)=1.071; p&lt;0.001). This study provides the first evidence that patients with higher HDL plasma levels may be more protected against stress hyperglycemia during MI via acceleration of the improvement in insulin secretion and sensitivity.
European Collaborative Paediatric Database on Cerebral Venous Thrombosis: Risk Factors for Recurrent Venous Thromboembolism.
Authors: Gili Kenet, Fenella Kirkham, Thomas Niederstadt, Karin Kurnik, Rosemarie Schobess, Ralf Knofler, Barbara Zieger, Ulrike Nowak-Gottl
Journal: Blood (2006)
Abstract 6013: Troponin I, High sensitive C-reactive protein and Neopterin in Percutaneous Coronary Interventions: insight from Cardiac Magnetic Resonance Imaging
Authors: Didier Locca, Giuseppe Ferrante, Chiara Bucciarelli-Ducci, Alessio La Manna, Agata Grasso, Sanjay Prasad, Peter Barlis, Dudley Pennell, Juan Carlos Kaski, Carlo Di Mario
Journal: Circulation (2008)

Background.  Cardiac Magnetic Resonance Imaging (CMR) can identify myocardial damage due to embolization after percutaneous coronary interventions (PCI). Late Gadolinium Enhancement (LGE) can non-invasively detect myocardial fibrosis however the association of High sensitive C-reactive protein (HS-CRP) or Neopterin levels with myocardial damage in PCI is currently unknown.   Methods.  Patients admitted with potential PCI were enrolled. LGE CMR scan was performed 24hours pre- and 24 hours post-PCI. Fourty five patients were enrolled, 61±12 yrs old, 33(73%) male. CMR performed pre PCI failed to show LGE in the area of the target vessel. TnI were not elevated at baseline. New LGE areas in the 2nd CMR scan were classified in distal (> 10 mm downstream from the stent) or adjacent (close to the stent). Troponin I was assessed at baseline and at 12 and 24 hours after PCI.   Results.  In 35 out of 45 pts, baseline levels of HS-CRP and neopterin were measured.Troponin I elevation occurred in 26 (58%) patients, 0.56 ng/ml (0.26 –1.23). New areas of LGE were detected in 15/45 (33%) patients, 0.83 grams (0.32–1.3), all with troponin rise after PCI. In 7 out of 15 (47%) patients new LGE areas were distal to the stent, in 8 (53%) patients adjacent. Grams of myocardial damage correlated with troponin levels after PCI, r = 0.64, p   Conclusions.  Patients who develop myocardial damage due to distal embolization show a trend toward higher baseline CRP levels. This suggests that increased systemic inflammation may be a marker of higher friability of coronary plaques and/or of enhanced inflammatory response of myocardium to embolizing particles, responsible for subsequent myocardial damage. Larger studies are needed to confirm these preliminary hypothesis generating data.
Abstract 18607: Impact of Procedure-Related Vessel Wall Injury on Coronary Aneurysm Formation After Drug-Eluting Stent Implantation: A Serial Optical Coherence Tomography Study.
Authors: Satoko Tahara, Giulio Guagliumi, Vasile Sirbu, Hiram G Bezerra, Hiroyuki Kyono, Giuseppe Musumeci, Nicolos Lortkipanidze, Wei Wang, Emile Mehanna, Hideyuki Ikejima, Alexander Matiashvili, Stan Pokras, Marco A Costa
Journal: Circulation (2010)