tbuckley/cabot-search huggingface dataset:
The Diving-Bell and the Butterfly
Authors: David Warriner
Journal: BMJ (2007)

Translated from the French, The Diving-Bell and the Butterfly is a beautiful and poignant account of a 45 year old father of two falling victim to a catastrophic stroke. The resulting “locked-in syndrome” means he is unable to speak or move—his only means of interaction is through blinking his left eye.

The book focuses on his room in a naval hospital on the north coast of France. He discusses scabrous orderlies, “arrogant, brusque, sarcastic” doctors, and a fear of losing the use of the “only window to his cell,” his left eye. Only Sandrine, his speech therapist, reaches out with kindness, patience, and empathy. Using an intuitive alphabet, through blinking, he learns to communicate, and painstakingly dictates this book.

Likening this suspended animation to “a giant invisible diving-bell holding my whole body prisoner” he describes the unforgiving reality of disability and the banality of complete dependence for communication, ablutions, or even changing the television channel—something many doctors, patients, and carers can identify with.

To escape, his “mind takes flight like a butterfly” and he finds solace in fantasies of wine, women, and song. He also takes us on a vivid voyage through his memories of his work, holidays, and family.

In Alexandre Dumas' The Count of Monte-Cristo, the character Noirtier de Villeforte also suffered this “monstrous, iniquitous, revolting, horrible” condition. “His inner life was like the distant gleam of a candle which a traveller sees by night across some desert place, and knows that a living being dwells beyond the silence and obscurity,” writes Dumas. Akin to Noirtier, Dauby feels a “zombie father” and “unpredictable animal” to his children, unable to embrace, school, or counsel them.

Sharing his decline is his 93 year old, decrepit father who, unable to visit, telephones the son “who can never reply.” Both are trapped in failing bodies, unable to care for their children; only his father's fate is timely and just.

Mourning for what was and what will never be, Bauby poetically describes his life as a string of missed opportunities: “the women we were unable to love, the chances we failed to seize, and the moments of happiness we allowed to drift away.”

This book is undoubtedly a medical masterpiece because of its uncompromising account of human nature; how it wilts under sufferance and pain but blossoms with even a trace of kindness and love. It is pertinent to our professional and personal lives, reminding us to treat patients (or indeed anyone) as we would wish to be treated ourselves. Finally, it shows how fragile and transient our health and lives are and how much we take for granted.
Abstract 11260: Placental Abnormalities in Fetal Congenital Heart Disease
Authors: Donna A Goff, Eileen M McKay, Brooke T Davey, Deepika Thacker, Nhala Khalek, Susan R Miesnik, Julie S Moldenhauer, Dale S Huff, Jack Rychik
Journal: Circulation (2011)

Background: The placenta is a complex organ that influences fetal growth and development, and through vascular programming may impact long-term postnatal health and well-being. Despite its likely i...
Abstract 2925: An inherited mutation of AKAP9 (Yotiao) causes Long QT Syndrome (LQTS)
Authors: Lei Chen, Michelle L Marquardt, David J Tester, Kevin Sampson, Michael J Ackerman, Robert S Kass
Journal: Circulation (2007)

A-Kinase Anchoring Protein 9 (AKAP9), or Yotiao, binds to the carboxy-terminus (C-T) of the IKs channel alpha subunit KCNQ1 and recruits cAMP-dependent protein kinase A (PKA) and protein phosphatase 1 (PP1) to the channel to control its phosphorylation state. Previously, an inherited LQT1-causing mutation in the KCNQ1 C-T/Yotiao binding domain was shown to disrupt the complex and render the channel functionally insensitive to cAMP-dependent regulation. Despite the critical role of Yotiao in mediating this fundamental physiological response, the large size of the Yotiao protein (over 200 kD) has hindered patient screens and, to date, no disease-linked mutations have been found in this adaptor protein. The objectives of the present study were first to locate reciprocal binding site(s) for KCNQ1 on Yotiao and to test whether mutation(s) in the binding module(s) might cause LQTS. Using GST fusion protein pull down and immunoprecipitation (IP) techniques, we identified two regions in Yotiao necessary for binding to KCNQ1: one within the Yotiao N-terminus (residues 29 – 46), and a second within its C-terminus (1574 –1643). Targeted sequence analysis was then carried out in fifty clinically diagnosed but genotype negative LQTS patients in the coding regions for these two KCNQ1 binding domains in AKAP9-encoded Yotiao. This analysis identified a novel missense mutation, S1570L-Yotiao, present in two siblings diagnosed with LQTS but absent in the normal population. We found that the S1570L mutation, located close to the Yotiao C-T binding motif for KCNQ1, disrupted the interaction between the two proteins and significantly reduced both basal and exogenous cAMP-induced KCNQ1 phosphorylation. Perforated patch experiments in CHO cells revealed that expression of S1570L-Yotiao significantly reduced basal IKS channel activity and completely ablated the response of the IKs channel to cAMP plus the phosphatase inhibitor okadaic acid. These reconstituted cellular consequences of the inherited S1570L-Yotiao mutation are consistent with delayed repolarization of the ventricular action potential observed in the affected siblings. Thus, we have demonstrated for the first time a link between an inherited AKAP mutation and human disease, LQTS.
Evaluation of lymphatic drainage of cold thyroid nodules with intratumoral injection of Tc-99m nanocolloid.
Authors: MURATHAN SAHIN, OKTAY YAPICI, ADEM DERVISOGLU, TARIK BASOGLU, FEVZIYE CANBAZ, SELAHATTIN ALBAYRAK, AYSE CITAK
Journal: Clinical Nuclear Medicine (2001)

The lymphatic system may show variations throughout the entire body. Knowledge of the variations and aberrant lymph drainage are important when planning surgical treatment and radiotherapy. The aim of this study was to evaluate the intratumoral injection technique in the detection of lymphatic drainage of proved or possibly malignant cold thyroid nodules.The study group consisted of 13 patients with palpable solitary cold thyroid nodules. None of the patients had cystic nodules on ultrasound examination. After fine-needle aspiration biopsy (at least 3 days later), 15 MBq (0.4 mCi) Tc-99m nanocolloid particles in a small volume (0.2 ml) were injected into the nodule. Dynamic images (60 frame x 1 minute) were acquired during the first hour, followed by static anterior and lateral images at 90 and 120 minutes.Radiopharmaceutical was present in the systemic circulation in two patients, possibly as a result of paratumoral injection. Eleven patients had intratumoral accumulation in early frames. Lymph nodes draining the thyroid nodule were visualized in 10 of 11 patients. In the dynamic acquisition period of 7 of 10 patients, the first draining lymph node could also be identified. Only 5 of 13 patients had malignant nodules. Lymphatic metastases were detected in one patient's specimens.Preoperative visualization of lymphatic pathways may be used when planning for thyroid cancer surgery. Sentinel node detection could yield valuable additional information in these patients.
Abstract 15500: Increased Dimethylarginines in Rats and Humans Exposed to Chronic Intermittent Hypobaric Hypoxia
Authors: Nicole Luneburg, Vashti Lopez, Edzard Schwedhelm, Julio Brito, Rainer H Boger, Patricia Siques
Journal: Circulation (2010)

Background: Working and living at high altitude above 4000m exposes human beings to labor conditions involving chronic intermittent hypobaric hypoxia (CIHH). Approximately 4% of people exposed to s...
Abstract 3128: Nocturnal Non-Dipping of Pulse Rate Predicts Cardiovascular Events Independent of Non-Dipping of BP in Hypertensive/Diabetic Patients
Authors: Kazuo Eguchi, Joji Ishikawa, Satoshi Hoshide, Thomas G Pickering, Joseph E Schwartz, Kazuyuki Shimada, Kazuomi Kario
Journal: Circulation (2008)
Genetic and Phenotypic Analysis of a Large (122-Member) Protein S–Deficient Kindred Provides an Explanation for the Familial Coexistence of Type I and Type III Plasma Phenotypes
Authors: Rachel E. Simmonds, Bengt Zöller, Helen Ireland, Elizabeth Thompson, Pablo Garcı́a de Frutos, Björn Dahlbäck, David A. Lane
Journal: Blood (1997)
Predictors of retrograde amnesia following ECT
Authors: C Sobin, H A Sackeim, J Prudic, D P Devanand, B J Moody, M C McElhiney
Journal: American Journal of Psychiatry (1995)

Substantial progress has been made in identifying how the treatment parameters used in ECT impact on cognitive side effects. However, there is limited information regarding individual differences in vulnerability to these side effects. The authors examined patients' pretreatment global cognitive status and postictal orientation recovery time as potential predictors of the magnitude of retrograde amnesia for autobiographical memories after ECT.Seventy-one inpatients with major depressive disorder were randomly assigned to four ECT conditions that varied in electrode placement (right unilateral versus bilateral) and stimulus dosage (low versus high intensity). Orientation recovery time was assessed at virtually every session during the course of ECT. Global cognitive status was assessed with the modified Mini-Mental State examination before treatment, during the week after termination of treatment, and 2 months after treatment ended. Retrograde amnesia was assessed at these same time points with the Autobiographical Memory Interview.Pre-ECT global cognitive status and the duration of postictal disorientation were strong predictors of the magnitude of retrograde amnesia in the week after the course of ECT and at 2-month follow-up. In general, these relationships were maintained regardless of technical parameters in the administration of the ECT.Patients who manifest global cognitive impairment before treatment and patients who experience prolonged disorientation in the acute postictal period may be the most vulnerable to persistent retrograde amnesia for autobiographical information.
The Sulfonylurea Controversy: More Questions From the Heart 11This study was supported by a Clinician-Investigator Fellowship from General Mills, Rochester, Minnesota; by the American Heart Association, Minnesota Affiliate, Minneapolis; by the Miami Heart Research Institute, Miami, Florida; and by the Bruce and Ruth Rappaport Program in Vascular Biology and Gene Delivery, Geneva, Switzerland.
Authors: Peter A Brady, Andre Terzic
Journal: Journal of the American College of Cardiology (1998)
Abnormal CT Scans of the Brain in Children with ALL: The Role of Intravenous MTX Therapy
Authors: A. Postma, A. Jonkers, D. M. Mehta, W. A. Kamps, S. S. N. de Graaf
Journal: Neuro-Oncology (1980)

Twenty-five years ago acute lymfocytic Leukemia in childhood was a fatal disease in most cases.
Abstract 12053: Traf2 Does Not Modulate Atherogenesis in Mice and is Not Associated With Atherosclerosis in Humans
Authors: Peter Stachon, Anna Missiou, Carina Walter, Nerea Varo, Constantin von zur Muhlen, Katja Zirlik, Maike Buchner, Peter Libby, Christoph Bode, Andreas Zirlik
Journal: Circulation (2010)

Introduction: Tumor necrosis factor receptor-associated factor 2 (TRAF2) participates in signaling of established pro-inflammatory cytokines such as CD40L and TNFα. Through its ability to activate ...
Abstract 1447: The Dilated Cardiomyopathy Gly 159 Asp Troponin C Mutation Abolishes the Effect of Troponin I PKA Phosphorylation in Skinned Trabeculae
Authors: Brandon J Biesiadecki, Tomoyoshi Kobayashi, John S Walker, Veronica L Rundell, R J Solaro, Pieter P de Tombe
Journal: Circulation (2006)

Contraction of cardiac muscle is regulated by the thin filament through Ca2+ binding to the troponin C subunit of the troponin (Tn) complex, composed of troponin I (TnI), troponin T and troponin C ...
Abstract 3672: Loss of Perivascular Adipocyte Paracrine Function Leads to Increased Vascular Tone and Glucose Intolerance in Hypertension
Authors: Kaivan Khavandi, Adam Greenstein, Sarah Withers, Kazuhiko Sonoyama, Sarah Lewis, Maria Jeziorska, Ian Laing, Allen Yates, Philip Pemberton, Rayaz A Malik, Anthony M Heagerty
Journal: Circulation (2008)

In order to investigate the contribution of perivascular adipose tissue (PVAT) to arterial function, a total of 55 small arteries harvested from 35 skin biopsies of patients with Metabolic Syndrome and matched controls were mounted as ring preparations in a wire myograph. Contractility to cumulative doses of Norepinephrine in the presence or absence of PVAT showed an anticontractile effect in arteries from healthy volunteers (p=0.009), which was lost in patients with Metabolic Syndrome. Bioassay studies confirmed that PVAT releases a hydrophilic anticontractile factor in health, which is absent in obesity. Using a soluble fragment of the human Type 1 receptor, we identified that the anticontractile factor was adiponectin, which is the sole mediator of vasodilation, acting by increasing endothelial bioavailability of nitric oxide. Significant endothelial dysfunction was observed in patients with Metabolic Syndrome (p&lt;0.001). Quantitative image analysis of adipose tissue revealed significantly increased adipocyte cell size in patients with Metabolic Syndrome, compared with healthy controls (p&lt;0.006). There was immunohistochemical evidence of inflammation with upregulation of TNF-alpha receptor 1 in these patients (p&lt;0.001). Application of exogenous TNF-alpha abolished the anticontractile effect of PVAT by reducing adiponectin bioavailability. Oxidative stress also induced by cytokines TNF-alpha and IL-6 but not IL-1, reduced adiponectin production from PVAT and increased basal tone. When the obese microenvironment was replicated in vitro by inflicting hypoxia on PVAT, adiponectin activity was lost but then rescued by incubation with cytokine antagonists. Further application of the adiponectin receptor fragment abolished PVAT relaxation. We conclude that in healthy arteries, PVAT releases adiponectin which reduces vascular tone. In obesity, this is lost by a cascade of adipocyte hypertrophy, hypoxia, inflammation and oxidative stress. The resulting vasoconstriction contributes to hypertension, hypertriglyceridaemia and insulin resistance. Direct targeting of adiponectin release from PVAT therefore provides a novel therapeutic opportunity in the Metabolic Syndrome.
Abstract 15973: Comparison Between Unipolar and Bipolar Radiofrequency Lesions Using an Irrigated Multi-Electrode Circular Ablation Catheter in the Canine Thigh Muscle Preparation: Effects of Electrode Contract on Lesion Size
Authors: Atsushi Ikeda, Hiroshi Nakagawa, Assaf Govari, Ofer Klemm, Tushar Sharma, Jan Pitha, Ralph Lazzara, Warren M Jackman
Journal: Circulation (2013)
Health Disparities in the United States: Social Class, Race, Ethnicity, and Health
Authors: Donald A. Barr
Journal: JAMA (2008)

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Abstract 84: Hyperventilation Alert During Out-of-Hospital Cardiopulmonary Resuscitation Using an Automated Capnogram Analysis Algorithm
Authors: Mohamud Daya, Eric Helfenbein, Ahamed Idris, Dana Edelson, Reza Firoozabadi, Saeed Babaeizadeh, Sophia Zhou
Journal: Circulation (2011)

Background Hyperventilation during cardiopulmonary resuscitation (CPR) inhibits venous blood return, decreases coronary perfusion pressure, and is associated with decreased survival rates. Accurate computation of ventilation rate during CPR by defibrillator-based algorithms is difficult due to artifact induced on impedance waveforms. Real time capnography may help detect inadvertent hyperventilation during resuscitation. Objective To evaluate an automated defibrillator-based capnogram (CO2) analysis method to alert for excessive ventilation rate in the presence of low end-tidal CO2 (EtCO2). Methods Recordings from 270 OHCA patients with capnogram waveforms were collected between 2008 and 2010 from two EMS agencies based in Oregon and Texas. The hyperventilation detection algorithm was added to a previously reported EtCO2 analysis program. The hyperventilation algorithm employs exponentially-weighted moving-average filtering (alpha=0.25) to compute respiration rate (RR) and EtCO2 trends from individual breath-breath intervals and breath EtCO2 measurements. A combination of RR and EtCO2 is used in the decision tree. The algorithm was tested using a threshold of RR &gt; 12 bpm and EtCO2 &lt; 20 mmHg. The added requirement of a low EtCO2 avoids false detection on post-resuscitation spontaneous respirations which are unlikely to have low EtCO2. Hyperventilation alerts generated by algorithm were manually validated by two reviewers who had access to CO2, ECG, compression, and impedance-based respiration waveforms. Results The automated program generated 414 hyperventilation alerts in 148 (55%) patients. A total of 24 alerts were identified as false positive due to artifacts in the capnogram waveform. No false negative alert was identified. This yields an algorithm sensitivity of 100% and positive-predictive value 94%. During validated hyperventilation, the average maximum ventilation rate was 25 ±11 bpm, with an average minimum EtCO2 of 6 ±4 mmHg. Conclusion Hyperventilation is common in OHCA resuscitation. An automated capnogram analysis method can accurately detect episodes of hyperventilation and has the potential to alert EMS personal to excessive ventilation rates during OHCA resuscitation.
Abstract 12420: Reversal of Low Molecular Weight Heparin and Fondaparinux by a Recombinant Antidote (r-Antidote, PRT064445)
Authors: Genmin Lu, Francis R DeGuzman, Stanley J Hollenbach, Peng Luan, Keith Abe, Gail Siu, Pamela B Conley, David R Phillips, Uma Sinha
Journal: Circulation (2010)

Anticoagulants, including indirect factor Xa (fXa) inhibitors low molecular weight heparin (LMWH) and fondaparinux, are widely used for the treatment and prevention of thrombosis but have the liabi...
Controlled study of verapamil for treatment of panic disorder
Authors: E Klein, T W Uhde
Journal: American Journal of Psychiatry (1988)

The authors conducted a 16-week double-blind, crossover study in 11 patients with panic disorder to study the effects of verapamil, a calcium channel blocker commonly used in the treatment of cardiovascular disorders, on the treatment of panic disorder. Their findings suggest that verapamil has modest antianxiety and antipanic properties.
Abstract 9757: Randomized Trial of Ezetimibe versus Nutraceuticals in Statin-intolerant Patients Treated With Percutaneous Coronary Intervention
Authors: Giuseppe Marazzi, Francesco Pelliccia, Maurizio Volterrani, Daniela Righi, Luca Cacciotti, Giuseppe Campolongo, Barbara Sposato, Fabrizia Grieco, Vincenzo Pasceri, Cesare Greco, Giuseppe Rosano, Carlo Gaudio
Journal: Circulation (2012)

Treatment with statins has a class IA indication after percutaneous coronary intervention (PCI), but it's often discontinued by patients (pts) due to side effects. Pharmacologic alternatives, including ezetimibe and nutraceuticals (i.e. compounds derived from foods with cholesterol lowering actions), have been shown to be useful after PCI. However, which of these 2 therapeutic approaches is more effective after PCI is still not known. To clarify this point, a prospective, randomized pilot trial has been performed to compare the efficacy and tolerability of ezetimibe vs. a nutraceutical-based protocol in statin-intolerant pts treated with PCI. Methods . At time of PCI, 100 pts, with stable angina who had previously experienced statin withdrawn for intolerance, were selected. Pts were randomized to receive for 3 months either ezetimibe (10 mg/day) or a commercially available nutraceutical combined pill (1 capsule/day containing red yeast rice 200 mg, policosanol 10 mg, and berberine 500 mg). Primary outcome included achievement of therapeutic goals by pts, secondary outcomes were plasma lipids levels, tolerability and safety. Results . At entry, 50 pts were randomized to ezetimibe (group A) and 50 to nutraceutical combined pill (group B). Baseline clinical features and lipid profiles were similar between groups. During the 3 months trial, 3 patients of group B stopped the pill due to myalgia whereas in the group A 2 patients had gastrointestinal intolerance. At third month evaluation, levels of triglyceride, liver enzymes or creatine kinase were similar between groups. Conversely, while in the group A none of the patients achieved the therapeutic target, 16 patients reached the target in the group B. Also cholesterol level showed a significantly higher reduction in group B compared to group A (in particular, LDL cholesterol decreased from 175 ± 10 to 165 ± 8 mg/dl (-5,8 %) in group A, and from 175 ± 13 to 133 ± 10 mg/dl (-24%) in group B (P=0.001). Conclusions: our results strongly suggest that a combination of nutraceuticals with lipid-lowering biological activity can significantly decrease cholesterol levels without causing clinical or metabolic side effects and that it is more effective than ezetimibe 10 mg/day in statin-intolerant patients treated with PCI.