tbuckley/cabot-search huggingface dataset:
Glass Microspheres 90Y Selective Internal Radiation Therapy and Chemotherapy as First-Line Treatment of Intrahepatic Cholangiocarcinoma
Authors: Julien Edeline, Fanny Le Du, Michel Rayar, Yan Rolland, Luc Beuzit, Karim Boudjema, Tanguy Rohou, Marianne Latournerie, Boris Campillo-Gimenez, Etienne Garin, Eveline Boucher
Journal: Clinical Nuclear Medicine (2015)

Purpose of the Report Intrahepatic cholangiocarcinoma's incidence is increasing. We studied the efficacy of 90Y selective internal radiation therapy (SIRT) as first-line treatment, with chemotherapy, and compared with the results of chemotherapy alone. Patients and Methods We retrospectively studied data from patients treated at our institution with glass microspheres SIRT for intrahepatic cholangiocarcinoma as part of first-line treatment in combination with chemotherapy. We compared results with those of similar patients treated in the ABC-02 study (a study in advanced biliary tract cancer that defined the current standard chemotherapy), assessed as not progressing after the first evaluation. We assessed progression-free survival (PFS) and overall survival (OS). Results Twenty-four patients were treated with SIRT. Chemotherapy was given concomitantly in 10 (42%), as induction before SIRT in 13 (54%) or after SIRT in 1 (4%). Grade 3 adverse events were reported in 1 (4%). Median PFS after SIRT was 10.3 months. Longer PFS was observed when chemotherapy was given concomitantly than when chemotherapy was given before SIRT, with respective median of 20.0 versus 8.8 months (P = 0.001). Median OS after SIRT was not reached. Eleven patients went to surgery (46%). Thirty-three patients in ABC-02 had locally advanced nonextrahepatic cholangiocarcinoma, not progressing after first evaluation. From the start of any treatment, the median PFS was 16.0 months in our cohort versus 11.3 months in ABC-02 (P = 0.25), whereas the median OS was significantly higher in our cohort, not reached versus 17.9 months, respectively (P = 0.026). Conclusions Selective internal radiation therapy combined with concomitant chemotherapy seems a promising strategy as first-line treatment for unresectable intrahepatic cholangiocarcinoma.
Abstract 270: A Novel Mechanism of Preconditioning: Attenuating Reperfusion Injury through Enhanced Myocardial Substrate Uptake via Insulin-Stimulated Akt and AMPK Activation
Authors: Lele Ji, Xiaoqing Cai, Wenchong Liu, Feng Fu, Xiaoming Gu, Weidong Yang, Jing Wang, Haifeng Zhang, Haichang Wang, Feng Gao
Journal: Circulation (2011)

Introduction: Ischemic preconditioning (IPC) is an intrinsic protective mechanism which markedly enhanced the ability of the heart to withstand a subsequent ischemic injury. We previously found that IPC cardioprotection was markedly attenuated in diabetic rats. Therefore, we hypothesized that insulin-regulated myocardial substrate metabolism may play a key role in IPC-afforded cardioprotection. Methods: Adult male rats were subjected to 30 min of myocardial ischemia and 3 h of reperfusion (MI/R). IPC was achieved by two cycles of 5 min ischemia and 5 min reperfusion. Myocardial glucose and fatty acid (FA) uptake were assessed at the end of 1 h reperfusion by determining 18 F-2-deoxy-2-fluoro-D-glucose uptake and fatty acid translocase (FAT)/CD36 translocation, respectively. Results: IPC significantly improved cardiac function (n=8, P &lt;0.05) with reduced myocardial infarction, apoptotic cell death and blood creatine kinase/lactate dehydrogenase levels following MI/R (all P &lt;0.05). Myocardial glucose uptake was markedly elevated after IPC treatment (17.0±1.5 vs. 12.4±1.0 in MI/R, n=10-12, P &lt;0.05), as well as translocation of glucose transporter 4 (GLUT4) to plasma membrane (PM) ( P &lt;0.01). Meanwhile, myocardial PI3K expression and Akt phosphorylation were significantly enhanced in IPC group ( P &lt;0.05). Interestingly, IPC also increased CD36 translocation to PM and AMPK phosphorylation ( P &lt;0.05). Wortmannin not only abrogated the cardioprotective effect of IPC, but also inhibited IPC-induced Akt/AMPK phosphorylation and subsequent GLUT4/CD36 translocation. Furthermore, the cardioprotection of IPC was markedly blunted in STZ-induced insulin-deficient diabetic hearts with failure of increase in glucose/FA uptake and impaired IPC-stimulated PI3K-Akt and AMPK signaling (n=6, P &lt;0.05). Conclusions: These results suggest that IPC increases both glucose and FA uptake during early reperfusion to resist myocardial injury via insulin-stimulated, and PI3K-dependent Akt and AMPK activation. Therefore, augmenting insulin signaling may be a potential therapy to improve myocardial substrate uptake and restore the cardioprotection of IPC in diabetic hearts.
Abstract # 16325: Robust MCARD-mediated {beta}ARKct Expression in Ovine Ischemic Cardiomyopathy
Authors: Jabaris D Swain, Anthony S Fargnoli, Michael G Katz, Catherine E Tomasulo, Marina Sumaroka, Mihail Petrov, Hansell Stedman, Walter J Koch, James J Pilla, Charles R Bridges
Journal: Circulation (2010)
Abstract 3215: Effects of Selective and Non-Selective Beta-Blockers on Cardiovascular Risk in Patients with Heart Failure or Acute Coronary Syndrome: a Meta-Analysis.
Authors: Olav R de Peuter, Federico Lussana, Pieter W Kamphuisen
Journal: Circulation (2007)

Background: Guidelines generally recommend the use of beta-blockers in patients with heart failure (HF) and acute coronary syndrome (ACS). It has recently been suggested that non-selective beta-blockers were more effective than selective beta-blockers in HF. However, a better efficacy of different beta-blockers, specifically analyzing total and cardiovascular (CV) mortality and morbidity, in patients with HF or ACS is unclear. Methods: We performed a meta-analysis of randomized controlled trials (RCTs) through Medline, EMBASE, and Cochrane Library databases to identify RCTs comparing selective or non-selective beta-blockers with placebo (29 studies, 31,856 patients), or directly comparing the two different beta-blockers (5 studies, 3,733 patients). Studies were selected using a priori defined criteria and data on study characteristics, study quality and outcomes were abstracted. All included studies had (cardiovascular) mortality as primary or secondary endpoint. Results: In patients with HF non-selective beta-blockers were associated with a reduction in total mortality (RR 0.75, 95%CI 0.61–0.92), and with a non significant decrease in CV mortality. Selective beta-blockers decreased total and CV mortality (RR 0.76, 0.68–0.84 and RR 0.78, 0.66–0.92, respectively). In patients with ACS non-selective beta-blockers were associated with a significant decrease in total mortality (RR 0.73, 0.64–0.82), CV mortality (RR 0.69, 0.60–0.80) and CV morbidity. Selective beta-blockers however had no effect on total mortality (RR 0.88, 0.68–1.15) or CV mortality (RR 0.89, 0.69–1.15). In HF, direct comparison showed a significantly decreased mortality (RR 0.86, 0.78–0.94) for non-selective beta-blockers compared to selective beta-blockers. For ACS, only one study directly compared different beta-blockers. Conclusions: In patients with HF, selective and non-selective beta-blockers seem equally effective in reducing mortality. In patients with ACS, selective beta-blockers had no influence on total and cardiovascular mortality, in contrast to non-selective beta-blockers. This meta-analysis suggests that patients with ACS should specifically be treated with non-selective beta-blockers to reduce total and cardiovascular mortality.
Knowledge and Attitudes Regarding Antibiotic Use Among Adult Consumers, Adult Hispanic Consumers, and Health Care Providers — United States, 2012–2013
Authors: Louise K. Francois Watkins, Guillermo V. Sanchez, Alison P. Albert, Rebecca M. Roberts, Lauri A. Hicks
Journal: MMWR Morbidity and Mortality Weekly Report (2015)

Appropriate antibiotic use, in particular avoidance of antibiotics for upper respiratory infections likely to be caused by viruses, is a key component of efforts to slow the increase in antibiotic-resistant infections. Studies suggest that Hispanic consumers might differ from non-Hispanic consumers in their knowledge and attitudes regarding antibiotic use (4). To better understand health care provider and consumer knowledge and attitudes that influence antibiotic use, CDC analyzed national internet survey data collected from participants living in the United States during 2012-2013. The participants represented three groups: 1) the total population of adult consumers (all ethnicities); 2) adult Hispanic consumers; and 3) health care providers. Hispanic consumers were more likely than all consumers to believe that if they have a cold, antibiotics would help them to get better more quickly (48% versus 25%), and more likely to obtain antibiotics not prescribed by a clinician, such as antibiotics left over from a previous illness (25% versus 9%), obtained from a neighborhood grocery store (23% versus 5%), or obtained from a friend or family member (17% versus 6%). Most providers surveyed (54%) reported that they believed their patients expect antibiotics during visits for a cough or cold, whereas 26% of all consumers reported this expectation. To maximize knowledge about appropriate antibiotic use among outpatients in the United States, public health initiatives should target Hispanic as well as general audiences.
针灸治疗慢性头痛的初级保健：大样本、实用的随机试验
Authors: AndrewJVickers, RebeccaWRees, CatherineEZollman, RobMcCarney, ClaireSmith, NadiaEllis, PeterFisher, RobbenVanHaselen
Journal: BMJ (2005)

目的与“不用针灸”对比，确定“使用针灸”的治疗方法对慢性头痛患者的头痛、健康状况及无病时间的影响。设计随机对照试验。试验场所英格兰和成尔士的开业医生诊所。受试对象401位慢性头痛患者，主要是偏头痛患者。干预患者被随机分配进入针灸治疗组(在3个月内接受12次针灸治疗)和对照组(接受常规治疗)。主要结果测定指标治疗前、治疗后3个月及12个月对头痛积分，SF-36健康状况及用药量进行评估。每3个月对治疗方法作1次评估。头痛积分即判定疗效的主要终点指标。结果针灸组治疗后12个月的头痛积分(针灸组161例患者，平均头痛积分为16．2，标准差13．7，比治疗前减少34％)比对照组低(对照组140例患者，平均头痛积分为22．3，标准差17．0，比治疗前减少16％)。两种方法调整后的差异为4．6(95％可信区间为2．2-7．0；P=0．0002)。对于包含缺失数据的灵敏度分析，该结果也是肯定的。针灸组的患者每年少头痛22(8-38)天。尽管达到统计学差异的项目仅有生理功能、精力和健康改变等，SF-36的资料也有利于针灸组。与对照组相比，针灸组的患者减少了15％的服药量(P=0．02)，减少了25％的就诊量(P=0．10)，同时减少15％的病休时间(P=0．2)。结论针灸在初级保健中用于治疗慢性头痛，特别是偏头痛，可以产生与临床相关的持久益处。应当考虑扩大英国国家医疗保险体系中针灸治疗的范围。
Review: Methotrexate does not increase risk for lung disease in psoriasis, psoriatic arthritis, or IBD
Authors: Malcolm D. Smith
Journal: Annals of Internal Medicine (2015)

Source Citation Conway R, Low C, Coughlan RJ, O’Donnell MJ, Carey JJ. Methotrexate use and risk of lung disease in psoriasis, psoriatic arthritis, and inflammatory bowel disease: systematic literature review and meta-analysis of randomised controlled trials. BMJ. 2015;350:h1269. 25770113
右下腹痛-发热-稀便
Authors: 庄则豪, 陈玉铃, 王承党, 吴婷
Journal: BMJ (2009)

41岁女性，以“反复右下腹痛、发热1月余”为主诉入院。入院前1个月余起无诱因右下腹不规则闷痛，午后体温38．5～39．0℃。无寒战、盗汗，无关节肿痛、皮肤红斑，无视物模糊、口腔破溃。外院查血白细胞10．1×10^9／L，分类中性粒细胞0．732；肥达反应、流行性出血热、钩端螺旋体病、恙虫病抗体、血培养均阴性，不规则使用头孢哌酮钠舒巴坦钠治疗无效。
Abstract 8110: Dobutamine versus Mirlinone for Intensive Hyperdynamic Therapy to Relieve Focal Cerebral Ischemia Caused by Vasospasm after Subarachnoid Hemorrhage
Authors: Tatsushi Mutoh, Shinya Kobayashi, Ken Kazumata, Tatsuya Ishikawa, Akifumi Suzuki
Journal: Circulation (2011)

Therapeutic hemodynamic augmentation by increasing cardiac output (CO) is a valuable method of elevating cerebral blood flow and oxygenation in the dysautoregulated vascular territories affected by vasospasm after subarachnoid hemorrhage (SAH). We prospectively assessed the effect of hyperdynamic therapy with dobutamine (DOB) or milrinone (MIL) on regional cerebral oxygenation (rSO 2 ) for reversing vasospasm-induced cerebral ischemia, using an integrative monitoring incorporated with uncalibrated pulse contour CO analysis and multi-channel near-infrared spectroscopy. One-hundred ten SAH patients diagnosed to have clinical deterioration due to vasospasm were assigned to receive hemodynamic augmentation with DOB or MIL (n=55 per each group). For hyperdynamic therapy, each inotrope was initiated at low dose (DOB: 3 μg/kg/min; MIL 0.15 μg/kg/min) and then increased in each dose increment until resolution of the symptoms unless any adverse effects occur during the therapy, based on our predefined hemodynamic regimen to induce similar dose-related increase in CO. Real-time CO and rSO 2 changes in conjunction with the assessment of neurological improvements were compared. A total of 418 dose increment challenges (DOB, n=192; MIL, n=226) were performed. In spasm-affected territories, decreased and/or fluctuating rSO 2 was detected compared with recordings in other brain region. Patients who exhibited rapid elevation of CO by each challenge had subsequent uptake and stabilization of rSO 2 . The responses (total number and degree of neurological improvements) were more significant in patients treated with DOB than those treated with MIL ( P &lt; 0.05), although tachycardia that may affect stroke volume depression during the DOB therapy was more evident (DOB 27% vs. MIL 9%). Area under the ROC curve to predict rSO 2 elevation or neurological improvement for both drug groups were significant ( P &lt; 0.0001) and the values were significantly greater in DOB than in MIL ( P &lt; 0.05). In conclusion, DOB can provide more effective hemodynamic augmentation in relieving focal cerebral ischemia in patients suffering from vasospasm after SAH. MIL is also effective in the hyperdynamic therapy but may be used as a second line in a patient subgroup where DOB was contraindicated.
Abstract 2047: Effect of Amlodipine on the Clinical Outcome in Diabetic Patients with Coronary Artery Disease after Angioplasty : Results from the Cardiovascular Events Follow-up Trial in Kokura (CAVEFT-Kokura)
Authors: Hiroyoshi Yokoi, Masashi Iwabuchi, Hitoshi Yasumoto, Hideyuki Nosaka, Masakiyo Nobuyoshi
Journal: Circulation (2007)

Background: CAMELOT Study showed that the administration of amlodipine to diabetic patients with coronary artery disease (CAD) resulted in reduced adverse cardiovascular events, especially repeat coronary revascularization. Objective: To compare the effects of amlodipine versus placebo on restenosis and clinical outcome after percutaneous coronary intervention (PCI) for diabetic patients. Methods: In a prospective, double-blind design, 540 patients with 659 denovo lesions were randomized to receive 5–10mg of amlodipine or placebo. Diabetic patients were enrolled in171 patients (32%). The primary angiographic endpoint was minimal lume diameter (MLD) at 6 month assessed by follow-up (FU) quantitative coronary angiography (QCA). Clinical end points were death, myocardial infarction, coronary bypass surgery and repeat any PCI at 12 months. Results: Angioplasty was performed in all patients without complications ;461 patients (85%) had received coronary stent implantation.FU QCA was obtained in all patients. The MLD at FU was significantly larger in the amlodipine group (1.50±0.52mm in the amlodipine group versus 1.42±0.52mm in the placebo group: p=0.035). The loss index was tendency to be lower in the amlodipine group (0.54±0.66 in the amlodipine group versus 0.61±0.56 in the placebo group: p=0.076). The binary restenosis (defined as &gt;50% diameter stenosis at FU) rate was 22.6% in the amlodipine group versus 28.5% in the placebo group (p=0.078). The composite incidence of clinical events were occurred in 89 patients (32%) in the amlodipine group versus 102 patients (39%) in the placebo group (p=0.103). The composite incidence of clinical events in diabetic patients were occurred in 30 patients (37%) in the amlodipine group versus 51 patients (57%) in the placebo group (p=0.007). Conclusion: Administration of amlodipine in diabetic patients resulted in reduced adverse cardiovascular events after PCI.
Abstract 18300: Development of the Minnesota Stroke Needs Assessment for Survivor and Caregivers
Authors: Ruth Lindquist, Mary Zwygart-Stauffacher, Shige Watanuki, Niloufar Hadidi, Kay Savik
Journal: Circulation (2011)

The Minnesota Stroke Needs Assessment (MSNA) was an initiative to determine the needs of survivors and caregivers after stroke. The purpose of this abstract is to describe the development of the MSNA surveys to assess and compare the needs of stroke survivors and caregivers. A preliminary list of needs was generated from a literature review and further refined with the aid of input from focus groups of survivors and caregivers. Two survey of needs were constructed, pretested, pilot tested, refined and then administered to survivors and caregivers who rated each need as none, somewhat and great. Factor analysis was performed to identify domains of need. Eighty-two items were factor analyzed with a sample of 281 survivors, and 95 items factor analyzed with a sample of 223 caregivers (age = 63, SD = 14, female = 70%) using the principal components method. For the survivors (age = 70, SD = 14, male = 52%, years since stroke = 3, SD = 3.2), 6 factors, retaining 51 items, which accounted for 54% of the total variance were extracted including disease specific information, health care information, psychological, physical services, and work/role. For the caregivers, 6 factors, retaining 66 items, which accounted for 56% of the total variance were extracted including physical needs, emotional needs, stress management, healthcare information, service/economic/work needs and recreational needs. The identified factors for both groups agreed to a large extent with broad areas of needs identified by the focus groups. Assessment of the original tools with the information provided by the factor analyses will allow refining and shortening of subsequent versions without the loss of any important domain of need. The shorter versions could be useful in assessing the needs of survivors and their caregivers in clinical settings.
Abstract 17788: Heavy Smoking in the Past Is a Risk Factor for Incident Heart Failure in Older Adults Despite >=15 Years of Abstinence: Findings from a Prospective Population Study
Authors: Amiya A Ahmed, Mustafa Ahmed, Ravi Desai, Jason Guichard, Marjan Mujib, Yan Zhang, Margaret A Feller, Gregg C Fonarow, Ali Ahmed
Journal: Circulation (2010)
Abstract 1077: Non-Invasive MRI Assessment of Coronary Endothelial-Dependent Vasoreactivity
Authors: Allison G Hays, Glenn A Hirsch, Sebastian Kelle, Gary Gerstenblith, Matthias Stuber, Robert G Weiss
Journal: Circulation (2008)

Endothelial-dependent coronary artery vasoreactivity is an important indicator of vascular function and is traditionally measured invasively. We hypothesized that coronary vasoreactivity can be measured non-invasively and abnormal function detected using high-field MRI. We studied 16 healthy adults (mean age ± SD 41.1±14.1 years, seven men) and eight patients with coronary artery disease (CAD, mean age 56.6±11.3, two men). To measure endothelial-dependent vasoreactivity, 3T coronary MRI was performed before and during continuous isometric hand-grip exercise, a known endothelial-dependent stressor. Cross-sectional coronary artery area and peak diastolic coronary flow velocities were quantified. In healthy adults, coronary arteries significantly dilated and increased in flow velocity with stress (baseline vs. stress area: 13.0±3.0 vs.14.9±4.1mm2, p&lt;0.001; and velocity: 23.4±7.7 vs. 31.2±11.2 cm/s, p&lt;0.0001). In CAD patients, the coronary arteries did not dilate (baseline vs. stress area: 18.4±5.2 vs. 17.5±4.5mm2, p=0.11) and decreased in flow velocity with stress (24.2±9.2 vs. 20.6±5.9cm/s, p=0.04). Relative changes are shown in Figure 1 . We provide first evidence that MRI and isometric handgrip exercise, an established endothelial-dependent stressor, non-invasively detects significant changes in two common indices of coronary endothelial vasoreactivity: coronary artery area and flow velocity. This novel technique demonstrates physiologic coronary artery vasodilation and increased flow velocity in healthy subjects in response to handgrip stress, and their pathologic absence in patients with CAD. Figure 1. Percent change in coronary artery area and peak diastolic coronary flow velocity from baseline to stress (isometric handgrip exercise) in healthy adults (n=16) and CAD patients (n=8). (*,† p&lt;0.0001 healthy vs. CAD)
Abstract 26: Long-Term Prognosis Following Out-of-Hospital Cardiac Arrest: Role of Etiology and Initial Rhythm
Authors: Florence Dumas, Benjamin A Stubbs, Jennifer Silver, Lindsay White, Carol Fahrenbruch, Xavier Jouven, Thomas D Rea
Journal: Circulation (2011)

Background: The proportion of out-of-hospital cardiac arrest due to non-shockable rhythms or non-cardiac etiology is increasing. Little is known about long-term prognosis following resuscitation, especially as it relates to the presenting rhythm or arrest etiology. We investigated long-term survival among those discharged alive following resuscitation overall and according to presenting rhythm and etiology. Methods: We conducted a cohort investigation of all adults suffering out-of-hospital cardiac arrest in a large metropolitan EMS system between Jan 1,2001 and Dec 31,2009 who were resuscitated and discharged from hospital. We prospectively collected pre-hospital data including initial rhythm and arrest etiology. Long-term vital status was ascertained using death certificate records through Dec 31,2010. We used Kaplan Meier and Cox regression to evaluate survival. Results: During the study period, 6149 adults received EMS resuscitation,of whom 4165 (69%) presented a non-shockable rhythm and 2198 (36%) had a non-cardiac etiology. A total of 1001 were discharged alive, of whom 316/1001 (32%) presented a non-shockable rhythm and 213/1001 (21%) had a non-cardiac etiology. Overall median survival was 9.8 yrs with 62% surviving &gt;5-yrs after hospital discharge. Five-year survival was 42% for non-shockable rhythms compared to 71% for shockable rhythms,and 45% for non-cardiac etiology compared to 66% for cardiac etiology (p&lt;0.01 respectively) (Fig1). Conclusion: Cardiac arrest due to non-shockable rhythm or non-cardiac etiology comprises a substantial proportion of those who survive and are discharged from the hospital. Although long-term survival in these groups is less than their shockable or cardiac etiology counterparts, over half are alive 4 years following hospital discharge, a finding that suggests meaningful survival and supports continued efforts to improve resuscitation care for those with non-shockable rhythms or non-cardiac cause.
Abstract 16507: Frequency Dependent Phosphorylation of Cardiac Myosin Binding Protein-C Mediates Acceleration of Myocardial Relaxation to Support Normal Diastolic Function
Authors: Carl W Tong, Xin Wu, Sakthivel Sadayappan, Andy Hudmon, Mariappan Muthuchamy, J C Ralphe, Hector H Valdivia, Richard L Moss
Journal: Circulation (2010)
Intracellular transduction of TAT-Hsp27 fusion protein enhancing cell survival and regeneration capacity of cardiac stem cells in acute myocardial infarction
Authors: Hye Jung Kim, Myoung-Hun Kim, Jong Tae Kim, Won-Jin Lee, Eunjung Kim, Kwang Suk Lim, Jang Kyoung Kim, Young Il Yang, Ki Dong Park, Yong-Hee Kim
Journal: Journal of Controlled Release (2015)