tbuckley/cabot-search huggingface dataset:
Abstract 3730: Celecoxib Does Not Deteriorate Antiplatelet Effects of Aspirin and Clopidogrel in Healthy Volunteers
Authors: Wonjae Lee, Dong-A Kwon, Hyun-Ju Cho, Jung-Won Suh, Su-Yeon Choi, Sang-Hyun Kim, Chul-Ho Kim, Byung-Hee Oh, Young-Bae Park, Hyo-Soo Kim
Journal: Circulation (2008)

Background: Celecoxib, cyclooxygenase (COX)-2 inhibitor, has been reported to inhibit neointimal hyperplasia in animal studies and to reduce restenosis after coronary stenting in COREA-TAXUS clinical trial. The main concern is that celecoxib would increase thrombogenecity by inhibiting the synthesis of prostacyclin in endothelial cells. However, it is not known whether the administration of celecoxib would weaken antiplatelet effects of aspirin and clopidogrel which are used after stenting. Methods: We recruited healthy volunteers (n=40) and randomized them into five subgroups. Each subject received the medication for 6 days and blood samples were taken day 0 and 7. Celecoxib 200mg twice a day, and/or aspirin 100mg daily, and/or clopidogrel 75 mg daily was administered. We compared platelet function by using light transmittance aggregometry and arachidonic acid metabolite assay among subgroups. Results: Celecoxib single treatment did not significantly affect platelet aggregation. Dual asprin and Plavix treatment inhibited platelet aggregation by 53%, which was not affected by addition of celecoxib showing 52% inhibition (t-test: p = 0.873). The changes of prostacyclin level did not differ among each treatment group (ANOVA: p=0.193). Although statistically not significant, celecoxib seems to lower the thromboxane level further when added to antiplatelet agents. Conclusion: Celecoxib treatment did not interfere with antiplatelet effect of aspirin or clopidogrel, suggesting that celecoxib as anti-restenosis agent would be administered safely during coverage of dual antiplatelet therapy in patients with coronary stenting without increasing thrombogenecity.
Abstract 3066: Left Atrial Asynchrony Before And After Electrical Cardioversion: Mechanical Resynchronization And Improvement Of Atrial Function After One Month Of Synus Rhythm
Authors: Elisa Rondano, Gabriele Dell’Era, Cristina Piccinino, Giuseppe De Luca, Giorgio Bellomo, Paolo N Marino
Journal: Circulation (2007)

Background: Dispersed conduction due to atrial fibrillation (AF) is linked to cavity remodelling and loss of filling and emptying properties. Cardioversion (CV) should remodulate function through recovery of atrial mechanical synchronism (AMS). Purpose: To assess if conversion of AF to sinus rhythm (SR) is associated with improvement of AMS, 101 patients (pts) with AF, age 70±8 yrs, with or without (n=5) structural heart disease were echoed 1 week before electrical CV (all pts) and 1 month later only in case of SR maintenance (n=53). Methods: Atrial volume was calculated from anteroposterior diameter and area according to the formula: 4.2 * diameter/ 2 * area/2. 2D strain (speckle tracking technique) was used to estimate peak and standard deviation (SD) of the time-to-peak (% of R-R’ interval) of the deformation of 6 segments arbitrarily identified along the septum, the roof and the lateral wall of the atrial cavity, as imaged in a 4-chamber view. BNP was also measured 1 week before in all pts and 1 month after CV, if SR was maintained. Results: There was a significant decrement in atrial volume after SR was restored (from 59.6 ±20.4 ml/m 2 [59.5±19.7 ml/m 2 for all pts] to 52.8±21.3 ml/m 2 ; p=0.002) together with an increase in mean peak strain (from 9.6±4.9% [9.7±4.8% for all pts] to 15.9±7.0%, p&lt;0.001). There was no change in time-to-peak of individual strains before and after CV (from 52.3±12.7% [52.2±12.0% for all pts] to 50.4±11.3%; p=NS), but SD significantly decreased (from 19.1±7.6% [20.2±8.1% for all pts] to 15.6±7.4%; p=0.015) suggesting improved AMS. Also BNP decreased significantly (from 128±99 pg/ml [118±87 pg/ml for all pts] to 87±90 pg/m; p&lt;0.001) and its change corresponded to the reduction in atrial volume (P=0.016). A logistic regression analysis identified SD as the only predictor of maintenance of SR post CV (p=0.076), with a 1.5 increment, per 10 SD reduction, in the chance of maintaining SR at 1 month. Duration of AF, atrial volume, peak strain, BNP and ventricular EF did not exert any effect on SR persistence. Conclusion: In AF patients that maintain SR 1 month after CV AMS is significantly decreased and this improvement favourably modulates atrial strain, volume and dismission of BNP, the extent of AMS pre-CV can predict maintenance of SR at 1 month.
Abstract 5863: Rate and Correlates of Aortic Regurgitation Progression in a Cohort of 4128 Patients with Mild or Mild to Moderate Aortic Regurgitation
Authors: Reena Patel, Ashvin Kamath, Padmini Varadarajan, Srikanth Krishnan, Ramdas G Pai
Journal: Circulation (2008)

Background : Though the natural history of aortic stenosis is well studied, rate of progression of aortic regurgitation (AR) is not clear. This information is valuable for clinical decision making in patients with milder degrees of AR undergoing non aortic valve cardiac surgery. Methods : Our echocardiographic database between the years 1993 and 2007 was screened for patients with 1 or 2+ AR who had follow up echocardiograms at least 3 months later. AR severity was graded 1–4 based on standard criteria. A change in AR grade was annualized. Results : Of the 4128 patients, 3266 had 1+ and 862 had 2+ AR on the initial echocardiogram: age was 67±15 years, duration of follow up 4.2±2.7 years. Of those with 1+ AR on the initial echocardiogram, 95% had no change over a mean interval of 4.2 years and 2% increased the grade by ≥1+ per year. The average increase in AR grade was 0.04 per year. Of those with 2+ AR on initial echo, 90% had no change over this period and 2% increased the grade by ≥1+ per year. The average increase in grade was 0.07 per year. In the whole cohort, the AR progression correlated positively with age (p=0.03), ventricular septal thickness (p&lt;0.0001), stroke distance (p=0.0003), increased transaortic velocity (p=0.01) and gradient (0.01) and initial AR severity (p&lt;0.0001). Conclusions : The rate of AR progression is extremely slow and prophylactic aortic valve replacement during non aortic surgery may not be indicated in those with 1 or 2+ AR. AR progression seems to be higher in the elderly and those with aortic stenosis, higher cardiac output and greater AR severity. On the average, it would take 25 years to progress from grade 1+ to 2+ AR and 14 years to progress from grade 2+ to 3+ assuming linear progression.
Abstract 2645: Magnesium Sulfate Administered During Cardiopulmonary Resuscitation and Early Post-resuscitation Phase Improves Cerebral Perfusion and Neurological Outcomes via Akt-eNOS Signaling
Authors: Wei-Tien Chang, Chun-Pei Lee, Chiang-Ting Chien, Lay-San Gan, Chien-Hua Huang, Huei-Wen Chen, Chiung-Yuan Hsu, Min-Shan Tsai, Hsiao-Ju Cheng, Shyr-Chyr Chen, Yuan-Teh Lee, Wen-Jone Chen
Journal: Circulation (2009)
Abstract 2800: Assessment of Computational Fluid Dynamics to Calculate Individual Coronary Wall Shear Stress In-Vivo
Authors: Johannes Rieber, Thomas Redel, Holger Hetterich, Tobias Potzger, Konstantin Nikolaou, Carsten Rist, Volker Klauss
Journal: Circulation (2008)

Beyond classic risk parameters non physiologic or oscillating wall shear stress (WSS) has been proven to act as a local factor for initiation and progression of atherosclerosis as well as for plaque rupture. Direct measurement of WSS in-vivo is difficult and restricted to animal models. Computational fluid dynamics (CFD) is a validated tool to compute flow parameters and WSS. For this purpose an exact model of the underlying patient specific geometry of the coronary tree is a prerequisite. Using 3D-IVUS or modern multislice computed tomographic coronary angiography (CTA) with submilimeter resolution these data can be provided. The aim of this study was to 1.) demonstrate feasibility of in-vivo CFD calculation of human coronaries based on CTA and 2.) to correlate the findings with radio frequency tissue information derived by intravascular ultrasound. We prospectively included 10 patients with suspected coronary artery disease who received CTA (Dual source 64 slice CT) and invasive conventional coronary angiography. Intravascular ultrasound and ECG-triggered radio frequency analysis (VH) was attempted in all three epicardial vessels. In the CTA-dataset the coronaries were segmented and a mesh model for CFD was generated. CFD calculations were performed using a commercial available software package with laminar flow and blood as a Newtonian fluid as boundary conditions. Coronary models were stationary with rigid vessel walls, while the pulsatile inflow characteristics was derived from invasive Doppler velocity measurement. Flow pattern calculations, vessel wall shear stress and IVUS analysis were successfully performed in 24/30 and 17/30 coronary arteries. The presence of high shear stress and non turbulent flow was inversely correlated with the presence of plaque as determined by intravascular ultrasound. No correlation of any CFD parameter with the radio frequency tissue information could yet be observed. The findings of the present study demonstrate the feasibility of assessing fluid tissue interactions in human coronary arteries using CTA and its correlation to invasive findings. The possible impact of CFD parameters on risk- and treatment stratification has to be determined in a large scale prospective trial.
Abstract 292: Validation of a Peripheral Blood Mononuclear Cell Gene Expression Network. A Systems Biological Approach to the Identification of Immunomodulatory Gene Targets.
Authors: Martin Cadeiras, Manuel P von Bayern, Anshu Sinha, Wei-Keat Lim, Teresa Palomero, Russel Dedrick, Charles C Marboe, Nicole Suciu-Foca, Andrea Califano, Mario C Deng
Journal: Circulation (2007)

Background: Reconstruction of intracellular networks underlying complex processes is a formidable challenge. We hypothesized that the human peripheral blood mononuclear cell (PBMC) molecular network can be delineated using a systems-biological/computer-driven approach. Method: We used a large PBMC microarray library, an information-theoretic, reverse-engineering algorithm (ARACNe, Algorithm for the Reconstruction of Accurate Cellular Networks) and Chromatin Immunoprecipitation (ChIP) assay to reconstruct and validate a putative gene interaction network. Results: Gene expression data from 285 focused-microarrays obtained from 98 heart transplant patients enrolled in the Cardiac Allograft Rejection Gene expression Observational (CARGO) study was analyzed by ARACNe to identify highly connected “hub” genes. Biological criteria identified Transcription Factor CREB and its subnetwork as important candidates involved in the regulation of the alloimmune response. ARACNe predicted 29 putative direct interactions (first neighbor genes) of CREB (Fig. 1A ). Eleven of these (Fig. 1A red nodes) were previously reported (p&lt;0.001) and 18 were not (Fig 1A , pink nodes). Out of the non validated, 14 suitable primers were identified and 11 could be immunoprecipitated (Fig 1B ), demonstrating binding of CREB to their promoter in vivo. Overall, 22 (75%) inferred CREB targets were validated; a significantly higher fraction than randomly expected (p&lt;0.001, Fisher’s exact). Conclusion Our results confirm the accuracy of ARACNe to reconstruct the PBMC transcriptional network. Systems biological approaches may be used to identify immunomodulatory pharmacological targets. Figure 1
Interventional paediatric cardiology
Authors: K. P Walsh
Journal: BMJ (2003)

Interventional paediatric cardiology mainly involves dilatation of stenotic vessels or valves and occlusion of abnormal communications. Many transcatheter techniques—such as balloon dilatation, stent implantation, and coil occlusion—have been adapted from adult practice. Devices to occlude septal defects, developed primarily for children, have also found application in adults.

Interventional procedures follow a common method. General anaesthesia or sedation is required, and most procedures start with percutaneous femoral access. Haemodynamic measurements and angiograms may further delineate the anatomy or lesion severity. A catheter is passed across the stenosis or abnormal communication. A guidewire is then passed through the catheter to provide a track over which therapeutic devices are delivered. Balloon catheters are threaded directly, whereas stents and occlusion devices are protected or constrained within long plastic sheaths.

### Septostomy

Balloon atrial septostomy, introduced by Rashkind 35 years ago, improves mixing of oxygenated and deoxygenated blood in patients with transposition physiology or in those requiring venting of an atrium with restricted outflow. Atrial septostomy outside the neonatal period, when the atrial septum is much tougher, is done by first cutting the atrial septum with a blade.

### Balloon valvuloplasty

#### Pulmonary valve stenosis

Balloon valvuloplasty has become the treatment of choice for pulmonary valve stenosis in all age groups. It relieves the stenosis by tearing the valve, and the resultant pulmonary regurgitation is mild and well tolerated. Surgery is used only for dysplastic valves in patients with Noonan's syndrome, who have small valve rings and require a patch to enlarge the annulus.

Valvuloplasty is especially useful in neonates with critical pulmonary stenosis, where traditional surgery carried a high mortality. In neonates with the more extreme form of pulmonary atresia with an intact ventricular septum, valvuloplasty can still be done by first perforating the pulmonary valve with a hot wire. Pulmonary valvuloplasty can also alleviate cyanotic spells in patients with tetralogy of Fallot …
Abstract 1947: Presence of Ventricular Dyssynchrony and Hemodynamic Impact of Right Ventricular Pacing in Adults with Tetralogy of Fallot and Right Bundle Branch Block
Authors: Jean B Thambo, pierre bordachar, Frederic Sacher, Julien Laborderie, Sylvain Reuter, Antoine Deplagne, Xavier Iriart, Pierre Jais, Michel Haissaguerre, Stephane Lafitte, Jacques Clementy, Maria Jimenez
Journal: Circulation (2006)

Introduction: Late after surgical repair, adults with Tetralogy of Fallot (TOF) are used to present with right ventricular (RV) dysfunction and right bundle branch block (RBBB). The aims of the pre...
Faking it
Authors: Theodore Dalrymple
Journal: BMJ (2007)

Sometimes I wake in a sweat having dreamt that my school exam papers have been marked again, and it has been determined that I failed. As a result, my entry to medical school was invalid and the rest of my subsequent career fraudulent. I shall have to begin my life all over again.

This is a common dream, of course, though I am not sure whether in my case it signifies general anxiety or is a manifestation of what the great political print artist James Gillray called “the horrors of digestion.” He who eats late at night must expect to fail his exams repeatedly.

One of the most remarkable books that I have read in recent years is The Adversary by Emmanuel Carrere. It recounts the life of Jean-Claude Romand, a medical student at Lyon who, having failed to turn up for his second year exams, lied to his parents that he had passed them.

He maintained the lie for the next 20 years, passing himself off after his equally fictitious qualification as a doctor working for the World Health Organization in Geneva. He lived with his wife, whom he managed to deceive just as he deceived everyone else, on the French side of the border, going off every day to “work,” that is, to say spending time in the public parts of the WHO building, or in cafes and parks, reading books and newspapers. Sometimes he would claim to have gone to conferences abroad, and would return with jet lag and appropriate presents for the children, but would have spent the time in local hotels. There he would read up on information about the country he was supposed to have visited.

He maintained his expensive lifestyle, commensurate with a WHO salary, by using the savings of his parents and others, acting as an intermediary for lucrative investments in Switzerland.

He kept the lies going for many years but when exposure became inevitable he killed his parents, his wife, and his two children, and then burnt his house down, having taken barbiturates, in an attempt at suicide. He was rescued, however, and survived.

The author manages the difficult trick of evoking compassion for “Dr” Romand, while not minimising his crime in any way. What drove Jean-Claude Romand to such a pass? I think it was the ordinary sin of pride, and because we all commit that sin very often we can enter imaginatively into his predicament.

Once when I was in Argentina a man who had been a famous neurologist was exposed as a fraud, as having no medical qualification whatsoever. He really did attend international conferences, where he would always begin his presentations on abstruse subjects with words to the effect that “You don't have to be a doctor to be a neurologist.” Everyone laughed: how he must have loved to hear scores or hundreds of properly qualified people made a fool of in this way!

After reading Carrere, my dream recurred several times, and for a short time I found myself in a panic anxiously asking, to quote a famous medical student and poet, “Do I wake or sleep?”

He would always begin his presentations on abstruse subjects with words to the effect that “You don't have to be a doctor to be a neurologist”
Abstract 17752: Altered Expression of Chloride Transporters in Rat Pulmonary Arterial Smooth Muscle Associated with Chronic Hypoxic Pulmonary Hypertension
Authors: Hui Sun, Omkar Paudel, James S Sham
Journal: Circulation (2014)

Chloride channels play an important role in regulating smooth muscle contraction and proliferation, and contribute to the enhanced vasoconstriction in pulmonary hypertension (PH). The intracellular Cl- concentrations ([Cl-]i) determine the driving force for Cl- conductance, thereby the functional consequence of channel activation. We have previously found that the [Cl-]i was increased in pulmonary artery (PA) smooth muscle cells of rats with chronic hypoxic PH (CHPH), which may lead to an increased depolarizing Cl- efflux during channel activation. Yet how the [Cl-]i is regulated in PA is unknown. Here we examined the expression profile in rat PAs of SLC12 family cation-coupled Cl- cotransporters (CCCs) and SLC4 family of Cl/HCO3 anion exchangers (AEs) that have been shown to regulate the intracellular Cl- homeostasis in other tissues. CHPH was induced by exposing rats to 10% O2 for 3 weeks. Conventional and real-time PCR were used to detect and quantify the mRNA expression in endothelium-denuded intralobal PAs. Normoxic PAs expressed all 9 CCCs and both Na+- dependent (SLC4A8) and -independent AEs (SLC4A1-3). SCL12A2 encoding for Na-K-2Cl cotransporter 1 (NKCC1) showed 45- and 12-fold higher expression than NKCC2-encoding SCL12A1 and Na-Cl cotransporter-encoding SLC12A3, respectively. Among the 4 genes that encode for K-Cl cotransporters (KCC) 1-4, the expression of SLC12A4, 6 and 7 was about 100-1000 fold higher than that of SCL12A5. Control PAs also showed higher SLC4A2 and 3 expression than SLC4A1 and 8. In hypoxic PAs, the expression of SCL12A2 encoding for Cl--accumulating NKCC1 was increased (copy number normalized to that of cyclophilin A served as an internal control: 1.23x10-2±.001, n=6 vs. 6.19x10-3±.0002, n=6, p&lt;0.001) while that of SLC12A7 encoding for Cl--extruding KCC4 was reduced (4.92x10-3±.0005, n=6 vs. 1.14x10-2±.002, n=6, p&lt;0.01), consistent with our previous functional findings. This study provides the first characterization of Cl- transporter expression profile and the first evidence of CHPH-associated transcriptional alterations in Cl- transporters in pulmonary arterial smooth muscle.
Book: An Evidence-Based Resource for Pain
Authors: J. Hardy
Journal: BMJ (1998)

Oxford University Press, £65, pp 272 ISBN 0 19 263048 2 Johnathan Cape £17.99, pp 292 ISBN 0224 06 0309 Rating: ![Graphic][1]</img>![Graphic][2]</img>![Graphic][3]</img> physicians' preference and the anecdote are dead—long live evidence based medicine. McQuay and Moore, from the University of Oxford's Pain Relief Unit, present the evidence to date of the effectiveness of various analgesic interventions in pain control by systematic review of all existing trials that have pain or adverse events as outcomes. One of the most striking aspects of this book is what it does not contain. In particular, it highlights the paucity of trials investigating cancer pain. Pain is one of the most common and certainly the most feared symptom … [1]: /embed/inline-graphic-1.gif [2]: /embed/inline-graphic-2.gif [3]: /embed/inline-graphic-3.gif
Abstract 17783: Calmodulin Mutants Associated With Long QT Syndrome Suppress Inactivation of Cardiac L-type Ca2+ Currents and Prolong Action Potentials in Guinea-Pig Ventricular Myocytes
Authors: Worawan Limpitikul, Rosy Joshi-Mukherjee, Ivy E Dick, Alfred L George, David T Yue
Journal: Circulation (2013)

Background: Calmodulin (CaM) mutations have recently been identified in infants with severe long QT syndrome (LQTS), frequent T-wave alternans, and recurrent cardiac arrest. Yet, the underlying mec...
Abstract P57: Atmospheric Conditions Predict an Occurrence of Out-of-Hospital Cardiac Arrests: A 9-year Population-based Utstein-style survey in Osaka
Authors: Kayo Tanigawa, Taku Iwami, Chika Nishiyama, Tetsuhisa Kitamura, Masahiko Ando, Masashi Goto, Atsushi Hiraide, Kentaro Kajino, Tatsuya Nishiuchi, Yasuyuki Hayashi, Hisashi Ikeuchi, Takashi Kawamura
Journal: Circulation (2008)

Introduction: Although an association between low temperatures and an increase in sudden cardiac arrest occurrence is reported, it is unclear other weather conditions including atmospheric pressure influence the occurrence of out-of-hospital cardiac arrest (OHCA). Methods: Design Population-based cohort study. Participants We enrolled all OHCA of presumed cardiac etiology in adults (&gt;17 years old) treated by emergency medical service (EMS) in Osaka Prefecture (population, 8.8 million), Japan from May 1 st 1998 through December 31 st 2006. Data collection and analyses Patients’ data were prospectively collected by EMS personnel using an Utstein-style database. Meteorological data including mean and circadian variation of temperature and atmospheric pressure were collected from the database of Japan Meteorological Agency. We stratified temperature data to tertile categories and atmospheric pressure to quintile, and an association between a daily event rate of OHCA and weather conditions was analyzed. Results: There were 25,026 OHCA patients of presumed cardiac etiology during the period. Daily OHCA incidence increased with a decreasing of temperature. The higher atmospheric pressure was also associated with the increased daily event rate of OHCA on the days with middle temperature (12.0 –21.9 °C) (Pearson’s correlation coefficient, 0.02; p&lt;0.05, Figure ). Conclusions: Data from a large-scaled population-based cohort suggests that atmospheric conditions including atmospheric pressure influence the occurrence of OHCA. FIGURE. Cardiac arrest daily event rates by atmospheric condidtion