tbuckley/cabot-search huggingface dataset:
Abstract 5717: Cardiovascular Abnormalities and Outcomes in a Large Williams Syndrome Cohort
Authors: Ronnie T Collins, Paige Kaplan, Jonathan J Rome
Journal: Circulation (2008)

Background: Williams syndrome (WS) is a congenital developmental disorder caused by microdeletion of approximately 28 genes on chromosome 7q11.23, affecting the vascular, connective tissue, and central nervous systems of 1 in 8,000 live births. Previous reports have reported high frequencies of cardiovascular abnormalities (CVA) in small cohorts of patients with WS. Methods: A retrospective review was undertaken of patients (pts) with WS evaluated at the Children’s Hospital of Philadelphia from 1/1/1980 through 12/31/2007. WS was diagnosed by the clinical phenotype assessed by an experienced medical geneticist and/or by fluorescence in situ hybridization. Congenital CVA were diagnosed by echocardiography and/or cardiac catheterization. Freedom from intervention was determined using Kaplan-Meier analysis. Results: Two hundred and seventy two pts were identified and constituted the study group. Pts presented to our center at 5.2 ± 8.2 yrs with an average length of follow-up of 8.2 ± 7.8 yrs (0 – 43 yrs). Congenital CVA were present in 220/272 (81%) pts. The commonest lesions were supravalvar (SV) aortic stenosis (AS) in 120/272 (44%) and branch pulmonary stenosis (PS) in 84/272 (31%); 44/272 (16%) had both. Other common lesions included mitral valve prolapse and regurgitation in 32/272 (12%), VSD in 30/272 (11%), and SVPS in 29/272 (11%). A number of other CVA occurred with frequencies less than 10%. Surgical or catheter-based interventions were performed in 55/220 (25%) pts with CVA. SVAS most commonly required intervention (28/120 pts, 23%). Branch PS was second with 13/84 (15%). Freedom from intervention in all pts with CVA was 91, 78, 75, 69, and 66% at 1, 5, 10, 20, and 40 years, respectively. Death occurred in 7 pts with an average of 1 death per 345 pt-yrs. Conclusion: Though CVA are common in WS, in this, the largest cohort ever reported analyzing CVA and outcomes, SVAS and branch PS occur less frequently than previously reported. In WS pts with CVA, interventions are commonly required and usually occur by 5 years of age. Most WS pts do not require intervention on long-term follow-up and overall mortality in these pts is low.
Experience in Maternal Mortality Study in Nova Scotia
Authors: M G TOMPKINS
Journal: JAMA (1963)

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Abstract 18052: Does Therapeutic Hypothermia Influence Hospital Length of Stay in Cardiac Arrest Survivors
Authors: Harsha V Ganga, Sanjeev Nair, Vinay Gulati, Pampana Gowd, Nishant Patel, Justin Lundbye
Journal: Circulation (2012)

Introduction  Therapeutic Hypothermia (TH) is standard of care in improving neurological outcomes in cardiac arrest survivors. Whether the use of TH influences the hospital length of stay (LOS) in these patients is of interest since LOS is a major driver of medical care costs. We investigated the influence of TH on hospital LOS in cardiac arrest survivors.   Methods  A retrospective analysis was performed on 263 consecutive cardiac arrest patients admitted to a tertiary medical center from December 2003 to June 2012. Patients were categorized into two groups: patients who did not undergo TH (controls) and those that underwent TH (hypothermia). The LOS was defined as time period from date of cardiac arrest to the date of discharge from the hospital. Data was collected on age, gender, history of CHF, type of presenting rhythm, time to return to spontaneous circulation (ROSC), serum creatinine, pH and ejection fraction (EF) on admission. Patients who did not survive till hospital discharge (n=166) were excluded from the analysis.   Results  The mean hospital LOS for hypothermia patients was 11.78 ± 9.75 days as compared to 8.74 ± 7.36 days in the control group (P=0.398). On multivariable analysis using multiple linear regression, EF on admission( 95 % CI 0.037-0.230, P=0.008) and time to ROSC( 95 % CI -0.49-0.16, P=0.004) were independent predictors of hospital LOS.   Conclusion  The use of TH does not influence hospital LOS in cardiac arrest survivors. However, EF on admission and time to ROSC are predictive of hospital LOS in cardiac arrest survivors.
Abstract 16425: Larger Left Atrial Appendage is an Independent Predictor of Stroke in Patients With Atrial Fibrillation
Authors: Jaemin Shim, Jae-Sun Uhm, Hye Jin Hwang, Hui-Nam Pak, Moon-Hyoung Lee, Boyoung Joung
Journal: Circulation (2011)

Background: Left atrial appendage (LAA) is an important source of thromboembolism and stroke in patients with atrial fibrillation (AF). However, the relationships between LAA and stroke have not be...
Abstract 336: Coronary Angiography in Cardiac Arrest Patients Without ST-Segment Elevation
Authors: Christoph Weiser, Christoph Testori, Clemens Gangl, Andreas Schober, Raphael Van Tulder, Fritz Sterz
Journal: Circulation (2014)

Objectives:  Guidelines advice early coronary angiography in patients suffering from out-of-hospital-cardiac-arrest (OHCA) without obvious extra-cardiac cause and ST-elevations in the ECG at hospital admission. Current opinions emphasize to go for early coronary angiography with all survivors without obvious extra-cardiac cause of OHCA. We matched these opinions with our local OHCA registry.   Methods:  Prospectively collected data of 1,277 OHCA patients between 2005 and 2010 from a registry at a tertiary care university hospital were analysed for patients without obvious extra-cardiac cause and who have no ST-segment elevation or new left bundle branch block in the ECG at hospital admission.   Results:  We could include 199 (15%) OHCA patients. During their hospital stay 90 (45%) patients got coronary angiography - 13 (7%) patients had intervention with stent implantation (PCI) and 8 (4%) patients got coronary artery bypass graft. Overall 115 (58%) patients survived one year with cerebral performance categories (CPC) 1 or 2.  In a subgroup of 39 (20%) prior healthy patients - defined as no known chronic medical conditions and no smokers prior to arrest - 23 (59%) got coronary angiography, 2 (7%) patients had PCI and 1 (3%) patient got coronary artery bypass graft. In this subgroup 28 (71%) patients survived one year with CPC 1/2.   Conclusion:  Acute occlusion of a coronary artery seems to be just a part of underlying cardiac arrest cause in OHCA patients without ST-elevation in the ECG at emergency department admission. Even in the small subgroup of prior healthy patients occlusion of coronary artery does not be dominant reason for cardiac arrest. This study represents a small retrospective analysed population, therefor selection bias which patient got angiography must be presumed.
Preventing Primate GvHD Using a Novel Antagonistic Anti-CD28 Antibody Plus Rapamycin: Downregulation of CD8 Activation and Preservation of the Naïve Cell Phenotype Predicts GvHD-Free Survival
Authors: Benjamin Watkins, Aneesah P. Garrett, Jingyang Chen, Scott N. Furlan, Kelly Hamby, Bernard Vanhove, Leslie S. Kean
Journal: Blood (2014)
Abstract 321: Factors Associated with Readmission Within 48 Hours to a Cardiac Critical Care Unit
Authors: Grace Williamson, Richard Neal, Hadi Mohseni-Bod, Christopher Parshuram, Afrothite Kotsakis
Journal: Circulation (2012)

Introduction: Readmission to the cardiac Critical Care Unit (CCCU) is associated with increased morbidity and mortality and is increasingly used as a measure of quality of care. We have previously shown that introduction of a Medical Emergency Team (MET) following CCCU discharges did not affect rates of readmission within 48 hours in our institution and most readmissions were within 8 hours. The objectives of this study were to identify factors which increase the risk of readmission to CCCU within 48 hours of discharge and to identify the consequences of readmission. Methods: A retrospective review was performed. We included discharges from a cardiac Critical Care Unit (CCCU) at a quaternary academic health science centre in the 25 months ending January 2009. We defined index admission as that preceding readmission, and abstracted demographic information, admission details and physiologic parameters preceding discharge from an electronic patient record. Data were represented as means and compared using t-test and linear regression. Results: There were 1266 discharges, with 54 (4.3%) children readmitted within 48 hours. Children readmitted were of similar age (2.67 v 2.95 yr, p=0.99), and had not been admitted more frequently in the previous 2 years (0.81 v 0.52 admissions, p=0.21). Length of index admission was not significantly different (160 v 138 hr, p=0.84), however discharge oxygen saturation was lower (90 v 93%, p=0.03) and Bedside PEWS score was higher (4.5 v 3.2, p=0.004) for those children readmitted within 48 hours. Discharge PELOD scores were similar (p=0.63). The PIM2 score at readmission was not significantly different (-4.12 v -4.31, p=0.11) and there was a trend suggesting greater length of CCCU stay (257 v 137 hr, p=0.05) for readmission. Five children (9%) who were readmitted died. Conclusions: The rate of readmissions within 48 hrs over this period was higher than previously reported for our institution (4.3% v 2.4%). Factors associated with increased risk of readmission were lower discharge oxygen saturation and a higher composite physiological score (Bedside PEWS). Children had not spent longer in the unit. Children readmitted had a slightly longer stay during their readmission, and 9% of these children subsequently died.
Abstract 15139: Safety and Efficacy of Extracorporeal Membrane Oxygenation for Bridge-to-Heart Transplantation Among Us Children
Authors: Christopher Almond, TP Singh, Kim Gauvreau, Francis Fynn-Thompson, Gary Piercey, Peter Rycus, Robert Bartlett, Ravi Thiagarajan
Journal: Circulation (2010)

Background: FDA-approval of emerging pediatric ventricular assist devices (VADs) may involve some comparison of first-generation VADs to extra-corporeal membrane oxygenation (ECMO) given its role as the historical treatment standard. Because ECMO has never been formally reviewed by the FDA for the indication of bridge-to-transplant, data on the utility and safety of ECMO when used specifically for bridge to heart transplant (HT) are limited. Methods: Data from the Extra-corporeal Life Support Organization Registry (ELSO) and the Organ Procurement and Transplantation Network (OPTN) were merged to identify children with severe heart failure who were supported with ECMO while actively listed for HT between 1990 and 2009. Logistic regression was used to identify independent predictors of survival to transplant and survival to hospital discharge conditional upon transplant. Results: Of 773 children who met the study inclusion criteria, the median age was 2.3 years (IQR 0.5 to 9.7); 45% were female, 28% had car...
Abstract 307: Transmission of Prehospital 12-Lead ECGs Significantly Reduces Time of Emergency Department Arrival to Arrival in the Angiography Suite and Door-to-Balloon Time in Patients with a STEMI
Authors: Michael R Jorolemon, Lorissa Plis, Karen Sigona, Michael Allain, Rob Pikarsky, Susie Surprenant, Troy Hogue, Lynette Johnson
Journal: Circulation (2012)

Background: Studies have shown that EMS obtained pre-hospital 12 Lead ECG’s have a positive impact on the treatment and mortality of patients experiencing an acute myocardial infarction. Many PCI centers do not have cardiac angiography staff in house 24/7. The response and prep time to bring an angiography suite to functional readiness is at least 20 minutes during the off hours. Objective: To assess our hypothesis that transmission of the pre-hospital 12 Lead ECGs decreases door to balloon time for patients experiencing a STEMI and decreases time spent in the Emergency Department. Methods: All STEMI patients that presented via EMS to an urban Hospital between January 1, 2010 and December 31, 2011 and went to the cardiac angiography suite were reviewed. Analysis was performed to investigate the relationship on door to balloon time and time spent in the Emergency Department between transmissions vs. non-transmission of the pre-hospital 12 lead ECG. Results: Of all STEMI patients that presented via EMS in 2010 - 2011 (N=83), 59.0% had a pre-hospital notification of the STEMI resulting in an average door to balloon time of 36.4 minutes (p-value of 0.0008). The STEMI patients that arrived via EMS without transmission of the 12 Lead ECG had a longer average door to balloon time of 53.2 minutes (p-value of 0.0004). There was not a statistical difference in the average EMS on scene time between the groups (11 minutes for the transmission group and 13 minutes for the non-transmission group). There was a 28.1 minute reduction in the time of arrival in the Emergency Department to arrival in the angiography suite time for the patient in which a pre-hospital 12 Lead ECG was transmitted (9.9 minutes for the transmission group vs. 38.0 minutes for the non-transmission group, p-value of 0.000002). Conclusion: Transmission of the pre-hospital 12 Lead ECG for patients experiencing a STEMI significantly decreases the time from arrival in the Emergency Department to arrival in the angiography suite and decreases the overall door to balloon time for those patients. The time saved with transmission of the pre-hospital 12 ECG for patients experiencing a STEMI facilitates by-passing the Emergency Department, allowing a STEMI patient to go directly to the cardiac angiography suite.
Abstract 21315: Serum Spla2 Activity, Spla2-IIa Mass and Oxldl Levels Are Related to the Significance of the Coronary Stenosis in Patients With Stable Coronary Artery Disease
Authors: olivier muller, Argyris Ntalianis, Leen Delrue, Fabio Mangiacapra, Catalina Trana, Aaron Peace, Reto Auer, MIchalis Hamilos, Emmanuel Valentin, william Wijns, Bernard De Bruyne, Marc Vanderheyden, Emanuele Barbato, Jozef Bartunek
Journal: Circulation (2010)
Abstract 3637: Expression of the NOS3 Activator S100A1 is Negatively Regulated by a NO-dependent Posttranslational Mechanism in Cardiac Endothelial Cells
Authors: Cornelius Busch, Felix Laube, Sven T Pleger, Andrew B Remppis, Walter J Koch, Hugo A Katus, Patrick Most
Journal: Circulation (2008)

Background: The calcium (Ca) sensor protein S100A1 has recently been found to be expressed in endothelial cells (ECs) and loss of EC S100A1 diminishes NO availability and results in impaired vascular relaxation and hypertension in S100A1 knockout mice. Vice versa, S100A1 gene transfer to ECs results in enhanced NOS3 activity and NO production. Given the importance of NO homeostasis for regulation and integrity of vascular function, we hypothesized that EC NO levels might directly regulate expression of the NOS3 regulator S100A1. Methods and Results: Rat cardiac ECs were enzymatically isolated and S100A1 mRNA and protein abundance were determined by semiquantitative RT-PCR analysis and Western blotting normalized to unchanged 18s and GAPDH signals. Exposure of cultured ECs to the NO-donor GSNO (10 μM) and SNP (10 μM) resulted in a significant 55±2%* and −49±7%* decrease of S100A1/18s mRNA after 8 and 24 hours (*P<0.05, n=5) in accord with accelerated NO release from GSNO. In further support of our hypothes...
Abstract 19684: Abnormal Aortic Wall Properties in Children with Isolated Bicuspid Aortic Valve
Authors: Shobha S Natarajan, Andrew C Glatz, Elizabeth Goldmuntz, Meryl S Cohen
Journal: Circulation (2014)

Introduction: Abnormal aortic wall properties have been reported in patients with isolated bicuspid aortic valve (IBAV) even in the absence of significant aortic stenosis or regurgitation. Hypothesis: We sought to assess aortic distensibility (DIS) and stiffness index (SI) in children with IBAV compared to age group-matched subjects with normal tricuspid aortic valves (TAV) and to determine whether these abnormalities in the aortic wall properties correlate with bicuspid valve morphology or left ventricular systolic or diastolic function. Methods: Children ages 8-18 years with an IBAV and age group-matched controls with a TAV were prospectively enrolled. Subjects with greater than mild stenosis or mild regurgitation were excluded. Using echo, aortic valve morphology, aortic root (AoR) and ascending aorta (AAo) diameters and z-scores were determined. Left ventricular shortening fraction (LVSF), DIS and SI were measured using M-mode echo. Diastolic function was determined using mitral valve septal E/Ea. Blood pressure (BP) was measured at the time of echo. Results: Nineteen had IBAV and 17 had TAV. There were no significant differences in age, weight, height or BP between the two groups. In the IBAV group, 11 had right-left type (R/L) and 8 had right-non type (R/N). There was no significant difference in AoR z-scores between groups. The IBAV group had larger AAo z-scores (2.48±1.9 vs. -0.02±0.98, p&lt;0.0001), decreased DIS (9.6±4 vs. 12.3±3.1 cm2 dynes-1 x 10-6, p&lt;0.05) and increased SI (21.4±9.2 vs. 14.4±3.8, p=0.007) compared to the TAV group. There were no differences in these variables between the R/L or R/N subgroups. No correlation was seen between aortic wall properties and ventricular function in the IBAV group. By multivariate regression, presence of an IBAV (coefficient = -2.4, p=0.03), LVSF (coefficient = -0.35, p=0.01) and age-adjusted systolic BP (coefficient = -0.13, p=0.03) were independently associated with DIS. Similarly, presence of an IBAV (coefficient = 6.7, p=0.005) and age (coefficient=0.85, p=0.02) were independently associated with SI. Conclusions: Children with IBAV have decreased DIS and SI even without hemodynamic abnormalities. Long-term studies to determine the impact of these findings on cardiovascular risk are needed.
Ovarian Cancer
Authors: Robert J. Morgan, Ronald D. Alvarez, Deborah K. Armstrong, Lee May Chen, Larry Copeland, Jeff Fowler, David K. Gaffney, David Gershenson, Benjamin E. Greer, Carolyn Johnston, Johnathan M. Lancaster, Shashikant Lele, Ursula Matulonis, Robert F. Ozols, Steven W. Remmenga, Paul Sabbatini, John Soper, Nelson Teng
Journal: Journal of the National Comprehensive Cancer Network (2006)

Ovarian neoplasms consist of several histopathologic entities, and treatment depends on the specific tumor type. Epithelial ovarian cancer comprises most malignant ovarian neoplasms; however, other pathologic subtypes (such as less common ovarian histopathologies) must be considered. These guidelines discuss epithelial ovarian cancer as well as less common ovarian histopathologies, including germ cell neoplasms, mixed müllerian tumors of the ovary, and ovarian stromal tumors. For the most recent version of the guidelines, please visit NCCN.org
Abstract 3024: Sensitivity of Molecular MRI for Low Levels of Cardiomyocyte Apoptosis in an In-Vivo Model of Dilated Cardiomyopathy
Authors: David E Sosnovik, Matthias Nahrendorf, Takashi Matsui, Fred Reynolds, Gerald Dorn, Anthony Rosenzweig, Ralph Weissleder, Lee Josephson
Journal: Circulation (2006)

Background: Cardiomyocyte (CM) apoptosis has been successfully imaged in-vivo by MRI in acutely injured myocardium. However, significantly lower levels of CM apoptosis are seen in dilated cardiomyo...
Coeliac Disease in Adults: Variations on a Theme
Authors: A Bhattacharyya, M K Patel, D J Tymms
Journal: Journal of the Royal Society of Medicine (1999)

In childhood, coeliac disease (gluten enteropathy) tends to show itself with failure to thrive and growth retardation; in adult life with malabsorption syndromes. We report six cases in adults who presented atypically, with features including clotting disorder, hypoglycaemia, weight loss, anaemia and angina pectoris, all of which responded to gluten withdrawal.
Time to Reject the Linear-No Threshold Hypothesis and Accept Thresholds and Hormesis
Authors: Carol S. Marcus
Journal: Clinical Nuclear Medicine (2015)

On February 9, 2015, I submitted a petition to the U.S. Nuclear Regulatory Commission (NRC) to reject the linear-no threshold (LNT) hypothesis and ALARA as the bases for radiation safety regulation in the United States, using instead threshold and hormesis evidence. In this article, I will briefly review the history of LNT and its use by regulators, the lack of evidence supporting LNT, and the large body of evidence supporting thresholds and hormesis. Physician acceptance of cancer risk from low dose radiation based upon federal regulatory claims is unfortunate and needs to be reevaluated. This is dangerous to patients and impedes good medical care. A link to my petition is available: http://radiationeffects.org/wp-content/uploads/2015/03/Hormesis-Petition-to-NRC-02-09-15.pdf, and support by individual physicians once the public comment period begins would be extremely important.
Abstract 3039: Differences In Epidemiology And Prognosis From Infective Endocarditis Between Gender In A Tertiary-care Hospital.
Authors: Antonia Sambola, Teresa Gonzalez-Alujas, Bernard Serra, Nuria Fernandez-Hidalgo, Benito Almirante, Albert Pahissa, Pilar Tornos
Journal: Circulation (2007)
Lithium prophylaxis of depression in bipolar I, bipolar II, and unipolar patients
Authors: R R Fieve, T Kumbaraci, D L Dunner
Journal: American Journal of Psychiatry (1976)

The authors investigated lithium prophylaxis of depression in bipolar I (N=35), bipolar II (N=18), and unipolar I (N=28) outpatients. Depression indices included frequency of depressive episodes, three measures of severity, dropouts due to depression, and time in study. There were significantly fewer episodes and dropouts due to depression in the lithium-treated than in the placebo-treated bipolar I patients. Lithium was superior to placebo on all indices in the bipolar II group (although the sample size did not permit statistical analysis) and on 3 indices in the unipolar group. The authors believe that lithium prophylaxis of depression has been demonstrated in these three subtypes but note the need for further research particularly in the use of tricyclic antidepressants.