tbuckley/cabot-search huggingface dataset:
Abstract 2138: Fontan Fenestration Closure Has No Effect On Exercise Capacity But Improves The Ventilatory Response To Exercise
Authors: Jeffery Meadows, Peter Lang, Gerald Marx, Tracy Curran, Julie Sheehan, Jonathan Rhodes
Journal: Circulation (2007)

Introduction: For patients undergoing Fontan procedures for palliation of single ventricle physiology the addition of a fenestration to the procedure, which permits intracardiac right-to-left shunting, mitigates perioperative morbidity. While some fenestrations may close spontaneously, many remain patent and subject patients to arterial hypoxemia and risk for paradoxical emboli. For this reason fenestration closure is routinely performed post-operatively in the cardiac catheterization laboratory. Fenestration closure typically results in improved arterial oxygenation, but decreased cardiac index. We assessed the hypothesis that sum effect of these physiologic changes would have not improve exercise capacity. Methods: Nineteen consecutive patients, age 4.8–46 (median 10) years underwent pre and post-fenestration closure exercise testing with expiratory gas analysis. Results: Prior to fenestration closure, peak oxygen consumption (VO2) was low. Arterial desaturation was present at rest and worsened with exercise. The ventilatory response to exercise was excessive, characterized by elevation of the minute ventilation vs. CO2 production slope (VE/VCO2 slope) and a low end tidal pCO2 at the ventilatory anaerobic threshold (pETCO2). Following fenestration closure, arterial saturation (at rest and at peak exercise) improved significantly. However, there was no change in VO2, heart rate, or oxygen pulse at peak exercise. In contrast, ventilatory abnormalities improved considerably. The VE/VCO2 slope fell 25% and pETCO2 rose from 27.9+/−4.2 to 34.1+/−3.2 mmHg. Conclusion: Elective Fontan fenestration closure does not improve peak VO2. However, the reduction in right-to-left intracardiac shunting improves arterial oxygen saturation during exercise and reduces the patient’s need to ventilate during exercise. These changes may reduce the Fontan patient’s perception of dyspnea during exercise. Pre and Post-Fenestration Exercise Data
Abstract 4729: The Effect of Loading Alterations on Left Ventricular Torsion: A Simultaneous Catheterization and Two-dimensional Speckle Tracking Echocardiographic Study
Authors: Sung-Ji Park, Rick A Nishimura, Paul Sorajja, Barry A Borlaug, Jamil A Tajik
Journal: Circulation (2008)

Background A preliminary study showed that LV torsion increases in patients with mild diastolic dysfunction and normal EF before decreases with worsening of diastolic function. We hypothesized load...
Abstract 12705: Exchange Protein Directly Activated by cAMP (Epac): A Novel Signaling Pathway Underlying Ionic Remodeling by Beta-Adrenergic Activation in Guinea Pig Hearts
Authors: Mona Aflaki, Ling Xiao, Balazs Ordog, Xiaobin Luo, Artak Tadevosyan, Xiao Yan Qi, Ange Maguy, Stanley Nattel
Journal: Circulation (2011)

Background: Heart failure (HF) produces chronic β-adrenoceptor (βAR) activation, which contributes to sudden death risk. K+ channel downregulation is important in HF arrhythmogenesis. This study assessed the role of Epac1 protein, an alternative to the PKA pathway, in slow delayed rectifier current (IKs) downregulation with chronic βAR activation. Methods: Isolated guinea pig LV cardiomyocytes were cultured and exposed to Isoproterenol (Iso, 1 μ M) or vehicle (CTL) for 30 hrs. Parallel sets of CTL, Iso, Iso + intervention or intervention-only cells were studied in each set of expts to have comparable conditions. IKs was recorded with whole cell patch clamp. Results: Iso decreased IKs from 2.4±0.2 pA/pF to 1.0±0.2 pA/pF at +60 mV (*** P<0.001). Iso reduced KCNQ1 (-62%*, *p<0.05) and KCNE1 (-51%*) protein (immunoblots) and membrane immunofluorescence by 73%*** and 70%*** respectively. KCNQ1 mRNA (qPCR) was unchanged but KCNE1 mRNA was reduced by 50% (**P<0.01). To study underlying mechanisms, LV cells were ...
Abstract 9012: Comparison of Clinic and Ambulatory Blood Pressure Variability as Predictors for Cardiovascular Events in Patients with Hypertension
Authors: Kazuo Eguchi, Satoshi Hoshide, Kazuyuki Shimada, Kazuomi Kario
Journal: Circulation (2011)

Background: Clinic blood pressure variability (BPV) has been shown to be a prognostic indicator in hypertensive patients. However, it is not known if clinic BPV is superior to ambulatory blood pressure (ABP) variability in predicting cardiovascular disease (CVD). Methods: We performed ABP monitoring in 457 hypertensives. The clinic BP readings during follow up were picked up from the medical records, and calculated as the means or standard deviations (SDs). The mean age of the subjects was 67.0 ± 9.2 years, and they were followed for 66 ± 27 months. Stroke, myocardial infarction, and sudden cardiac death were defined as Hard CVD events, and these plus angina, heart failure, and other CVD were defined as All CVD events. Cox regression analyses were performed with adjustment for significant covariates. Results: As shown in the Figures , increased clinic BPV was associated with All CVD events, while increased sleep BPV was associated with Hard CVD events. In multivariable analyses, SD in clinic BP was an independent predictor for All CVD events (P=0.008), even when the SD in awake SBP or sleep SBP was entered in the same model. On the other hand, SD in sleep SBP (P=0.04), but not SD in awake SBP (P=0.23), was an independent predictor for Hard CVD events when they were entered with SD in clinic SBP (P=0.20) in the same model. With regard to mean BP, both ambulatory and clinic mean SBP predicted All CVD events, but the predictability of mean awake SBP (P=0.02) and mean sleep SBP (P=0.008) were better than that of mean clinic SBP (P=0.11 and 0.09, respectively). Conclusions: Clinic BPV was better than ambulatory BPV in predicting All cardiovascular events including angina and heart failure, but ambulatory BPV was better in the case of Hard outcomes. These findings suggest that each BPV measure can be separately used for the prediction of cardiovascular outcomes.
Abstract 9876: Relative Efficacy of Aspirin Therapy in Relation to C-Reactive Protein Levels in Type 2 Diabetic Patients: Subgroup Analysis Derived From the JPAD Trial
Authors: Hirofumi Soejima, Masafumi Nakayama, Takeshi Morimoto, Mio Sakuma, Sadanori Okada, Shiro Uemura, Masao Kanauchi, Naofumi Doi, Hideaki Jinnouchi, Seigo Sugiyama, Masako Waki, Yoshihiko Saito, Hisao Ogawa
Journal: Circulation (2011)

Background: The Japanese primary prevention of atherosclerosis with aspirin for diabetes (JPAD) trial was undertaken to examine the efficacy of aspirin therapy. It was a multicenter, prospective, randomized, open label, blinded end-point trial conducted from 2002 through 2008 and it had a median follow-up of 4.37 years. Low-grade chronic inflammation, as indicated by levels of the inflammatory marker C-reactive protein (CRP), prospectively defines the risk of atherosclerotic complications. Methods: CRP levels were measured in 1529 patients (772 aspirin therapy patients; and, 757 non-aspirin therapy patients) of the JPAD trial at enrollment. In this subgroup analysis of the JPAD trial, we divided the 1529 patients into either a high CRP group (CRP≥ 0.1 mg /dl) or a low CRP group (CRP&lt; 0.1 mg/dl) according to the baseline CRP levels. We compared the incidence rates of primary cardiovascular events in aspirin users and non-aspirin users, respectively. Results: There were no significant differences in the incidence rates of acute myocardial infarction between the High CRP Group and the Low CRP Group (hazard ratio, 1.45; 95% confidence interval, 0.46-6.37; log-rank P=0.5623). The incidence rate of stroke events though was significantly higher in the High CRP Group (44 patients (pts) of 1131) than in the Low CRP Group (7 pts of 398; log-rank P=0.0361, Figure). There was no significant difference in the incidence rates of stroke events between the High CRP Group (20 pts of 562) and the Low CRP Group (5 pts of 210) in the aspirin users, but there was a significant difference between the High CRP Group (24 pts of 569) and the Low CRP Group (2 pts of 188) in the non-aspirin users (Figure). Conclusions: Our subgroup analysis of the JPAD trial demonstrates that CRP level predicts the incidence of stroke events in patients with type 2 diabetes mellitus. Aspirin therapy is significantly more effective at preventing stroke events, especially in high CRP patients with type 2 diabetes mellitus.
Glitazones are associated with reduced risk of Parkinson’s disease
Authors: Zosia Kmietowicz
Journal: BMJ (2015)

Patients who take the antidiabetes drugs rosiglitazone or pioglitazone have a lower risk of developing Parkinson’s disease than patients taking other drugs for diabetes, a study published in PLoS Medicine indicates.1

Researchers from the London School of Hygiene and Tropical Medicine used electronic health records from the UK Clinical Practice Research Datalink to match …
Dutch model limits choice
Authors: L Mascarenhas, F Biervliet, H Gee, M Whittle
Journal: BMJ (1994)

limited by their specific range of skill and their professional role.Not all forms of protection count as medical care.While, for example, a doctor has a responsibility to protect Salman Rushdie from the consequences of an attempt on his life, he or she has no responsibility to protect him from that attack.Otlers, of course, do.
Abstract 8301: Clopidogrel Plus Aspirin is Cost-Effective for Stroke Prevention in Patients with Atrial Fibrillation in Whom Warfarin is Unsuitable
Authors: Craig I Coleman, Andrew D Straznitskas, Diana M Sobieraj, Jeffrey Kluger
Journal: Circulation (2011)

Introduction: Updated guidelines for atrial fibrillation (AF) now recommend clopidogrel plus aspirin as an alternative stroke prevention strategy in patients whom warfarin is unsuitable. Objective: To evaluate the cost-effectiveness of clopidogrel plus aspirin compared to aspirin alone for stroke prevention in patients with nonvalvular AF (NVAF). Methods: A Markov model was conducted from the societal prospective using data from the Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events (ACTIVE)-A trial and other published studies of anticoagulation. Drug cost was estimated using the average wholesale price and the cost of complications and adverse events was based on values from the Healthcare Cost and Utilization Project and CMS reimbursement rates. The base-case analysis evaluated patients aged 65 years with NVAF, a CHADS 2 score of 2 and a low risk for major bleeding. Patients received clopidogrel 75 mg daily plus aspirin (recommended dose of aspirin: 75-100 mg daily) or aspirin alone. Patients were followed for up to 35 years. Outcomes included quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs). Costs were inflated to 2011US$ using the Consumer Price Index for Medical Care. Future costs and QALYs were discounted at a rate of 3% annually. Results: Quality-adjusted life expectancy and therapy-related costs were 9.37 QALYs and $88,751 with clopidogrel plus aspirin and 9.01 QALYs and $79,057 with aspirin alone. The ICER for clopidogrel plus aspirin was $26,928/QALY. Upon one-way sensitivity analysis, using a willingness-to-pay (WTP) threshold of $50,000/QALY, clopidogrel plus aspirin was no longer cost-effective when CHADS 2 score was ≤1, major bleeding risk with aspirin was ≥2.50%/patient-year and the relative risk reduction for ischemic stroke with clopidogrel plus aspirin vs. aspirin alone was &lt;25%. Monte Carlo simulation demonstrated that clopidogrel plus aspirin was cost-effective in 55% and 73% of 10,000 iterations, assuming WTP thresholds of $50,000 and $100,000/QALY. Conclusion: Clopidogrel plus aspirin appears cost-effective compared to aspirin alone for stroke prevention in patients with NVAF who have at least a CHADS 2 of 2 and a low risk of bleeding.
Abstract 753: Immunomodulation of IL-6 Gene Expression by Thymulin in Monocrotaline Model of Pulmonary Hypertension
Authors: Tiago Henriques-Coelho, Filipe L Carvalho, Silvia M Oliveira, Mario Santos, Roberto Roncon-Albuquerque, Jorge Correia-Pinto, Adelino F Leite-Moreira
Journal: Circulation (2006)

Inflammation has an important pathophysiologic role in Pulmonary Hypertension (PH). Indeed, inflammatory cells recruitment and activation, with the release of cytokines (such as IL-6 and IL-1) and ...
Clinical Experience with Dexamethasone
Authors: C H WALTON
Journal: JAMA (1963)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Atrial Arrhythmias After Surgical Maze
Authors: Oussama M. Wazni, Walid Saliba, Tamer Fahmy, Dhanunjaya Lakkireddy, Sergio Thal, Mohamed Kanj, David O. Martin, J. David Burkhardt, Robert Schweikert, Andrea Natale
Journal: Journal of the American College of Cardiology (2006)
Selection: Unexplored and underexplored realms
Authors: David A. Eckerman, Steven M. Kemp
Journal: Behavioral and Brain Sciences (2001)

A profound problem in viewing operant learning as selection appears to be the identification of replicators. Given the lack of consensus on what constitutes the appropriate unit of analysis for behavior, there may be multiple levels at which the metaphor of selection may be usefully applied. A final difficulty: The elements of selection in the evolution of species are objects. In behavior, they are events.
May not be used when required
Authors: A. Wood, S. O'Brien
Journal: BMJ (1995)

Amoxycillin 34 (29 6) 2274 (86.2) 1190 (83 6) 1084 (89 3) 172 (915) Co-amoxiclav 6 (5 2) 434 (16 5) 232 (16 3) 202 (16 6) 94 (50 0) Co-trimoxazole 79 (68 7) 1329 (50 4) 726 (51 0) 603 (49 7) 71 (37 8) Erythromycin 112 (97 4) 2284 (86-6) 1231 (86 4) 1053 (86 7) 151 (80 3) Tetracycline 34 (29 6) 343 (13-0) 159 (11-2) 184 (15-2) 25 (13-3) Trimethoprim 24 (20 9) 1024 (38 8) 521 (36 6) 503 (41-4) 85 (45 2) Cephalosporins 63 (54 8) Data not aggregated in these surveys 35 (18-6) Metronidazole 18 (15-7) 409 (15-5) 228 (16-0) 181 (14-9) 1 (0 5) Chloramphenicol: Oral 12 (10-4) Topical 3(2 6)
The Radiological Examination of the Male Urethra.
Authors: Gordon S. Foulds
Journal: JAMA (1926)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Abstract 2184: Prospective Evaluation of a Comprehensive Genetic Risk Score for Future Cardiovascular Events Among 19,313 Initially Healthy Women: The Women's Genome Health Study
Authors: Nina Paynter, Daniel I Chasman, Guillaume Pare, Julie E Buring, Nancy R Cook, Paul M Ridker
Journal: Circulation (2009)

Background: While multiple genetic markers associated with CVD have been identified by genome wide association studies (GWAS), their aggregate effect on risk prediction beyond traditional factors i...
Abstract 5902: High Dose Rosuvastatin Loading Before Percutaneous Coronary Intervention Improves Long-term Outcomes in Patients With Acute Coronary Syndrome
Authors: Kyeong Ho Yun, Seok Kyu Oh, Sang Jae Rhee, Nam Jin Yoo, Nam-Ho Kim, Jin-Won Jeong
Journal: Circulation (2009)

Background: High dose statin loading therapy before percutaneous coronary intervention (PCI) is associated with reduced incidence of short-term adverse events and periprocedural myocardial infarcti...
Androgen deprivation therapy to prevent bladder cancer recurrence.
Authors: Hiroji Uemura, Koji Izumi, Masataka Taguri, Hiroshi Miyamoto, Satoshi Morita, Yasuhide Miyoshi, Yoshinori Hara, Takeshi Kishida, Kimio Chiba, Tetsuo Murai, Kotaro Hirai, Kotaro Suzuki, Kiyoshi Fujinami, Teiichiro Ueki, Koichi Udagawa, Kazuo Kitami, Masatoshi Moriyama, Futoshi Tsuchiya, Ichiro Ikeda, Kazuki Kobayashi
Journal: Journal of Clinical Oncology (2015)

329 Background: Accumulating preclinical evidence indicates the involvement of androgen receptor signals in bladder cancer (BC) development and further suggests androgen deprivation therapy (ADT) as a new therapeutic option for BC. However, the clinical efficacy of ADT in BC recurrence remains unclear. We compared the rates of BC recurrence in prostate cancer (PC) patients between who did and did not receive ADT. Methods: We retrospectively reviewed 20,328 patients with PC diagnosed during1991-2013 and identified 239 (1.2%) men having primary BC. Among them, 162 patients met the inclusion criteria. Using Kaplan-Meier analyses and Cox proportional hazard models, we assessed the prognostic significance of ADT and other clinical variables for recurrence-free survival (RFS) and cumulative recurrence. Results: With a median follow-up of 62 months, 38 (50%) of 76 control patients experienced BC recurrence, while 19 (22%) of 86 did in ADT group. Thus, patients having received ADT showed a significantly lower risk of BC recurrence (5-year actuarial RFS: 76% v 40%; P &lt; 0.001) compared to the control group. ADT patients also had a significantly smaller number of recurrence episodes (5-year cumulative recurrence: 0.44 v 1.54; P &lt; 0.001) compared to control patients. A multivariate analysis revealed ADT as an independent prognosticator (hazard ratio, 0.29; 95% confidence interval, 0.17-0.49) for BC recurrence. Conclusions: This is the first clinical study showing that ADT significantly reduces the risk of BC recurrence. Randomized clinical trials are required to confirm these findings. Clinical trial information: 000012926.
Abstract 4576: Validation and Clinical Outcome of Less Invasive Goal-Directed Hemodynamic Management by the Transpulmonary Thermodilution in Patients after Subarachnoid Hemorrhage
Authors: Tatsushi Mutoh, Ken Kazumata, Tatsuya Ishikawa, Shunsuke Terasaka, Nobuyuki Yasui
Journal: Circulation (2008)

Assessment of cardiac output (CO) and intravascular volume is of high importance for adequate cerebral perfusion and oxygen delivery in patients suffering from cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH), but is often precluded by the invasiveness and complexity of a pulmonary artery catheter (PAC) placement. We sought to evaluate the utility of less invasive goal-directed volumetric and hemodynamic monitoring by advanced transpul-monary thermodilution (PiCCO ™ , Pulsion, Germany) utilizing only central venous and peripheral arterial catheters compared with standard circulatory management after SAH. One-hundred fourteen patients with SAH treated within 24 hours of ictus were investigated. Validation of transpulmonary dilution-derived intermittent and calibrated continuous CO (TPCO and PCCO) and cardiac preload (GEDV, global end-diastolic volume) were compared with PAC-derived reference CO (PACO), pulmonary capillary wedge pressure (PCWP), or central venous pressure (CVP) in 14 patients diagnosed with vasospasm. In a subsequent prospective trial of 100 cases, the clinical course and outcome of this method (n=53) was compared to those of CVP or PCWP and PACO guided conventional therapy (n=47), after the establishment of each fluid protocol for treatment of vasospasm (triple-H therapy). TPCO and PCCO (indexed to the BSA) showed excellent correlation ( r = .91 and .86) and small bias (+0.07 and +0.24 L/min/m 2 ) with a low percentage error (10.2 and 12.4%), when compared to PACO. The relationship between GEDV and stroke volume in response to defined volume loading was stronger ( r = .71) than that between CVP or PCWP and stroke volume ( r = .16 and .26). Frequency of cardiopulmonary complications (0 vs 10%) and vasospasm-related cerebral infarction (9 vs 17%), amount of daily fluid intake (4,210±968 vs 5,681±1,019 mL), and length of ICU stay (14±2 vs 17±2 days) were significantly reduced (p&lt;0.05) in the transpulmonary themodilution group. Transpulmonary thermodilution enables clinically acceptable monitoring in patients following SAH. Goal-directed therapy guided by the volumetric and hemodynamic parameters with this method has a potential advantage over conventional methods.