tbuckley/cabot-search huggingface dataset:
Abstract 95: Coronary Intervention After Out-of-Hospital Cardiopulmonary Resuscitation: Chances and Limitations
Authors: Hans-Richard Arntz, Simon Strauss, Hans-Christian Mochmann
Journal: Circulation (2014)

Background: Actual guidelines recommend an invasive approach (CORO) in case an ischemic cause of sudden cardiac arrest (SCD) can`t be excluded. Methods: In a retrospective study we investigated procedures and course of 767 consecutive OHCA pts. of whom 220 pts who survived to hospital admission and 166 were admitted to our hospital. Results: CORO was performed in 91 pts. Of these 83 had a prehospital ECG or an ECG at admission: Thirty-nine (47%) of the pts with CORO had typical ECG signs of a STEMI (SECG), 44 pts had CORO without a SECG. On the other side 52 of 58 (89%) pts without CORO had not a typical SECG. A “culprit lesion” was detected in 30 of 39 (70%) of pts with an SECG but also in 21 of 44 (46%) pts without an SECG. Creatinine levels a admission were elevated in pts with CORO (1.4 mg/l) as well as in pts without CORO (1.8 mg/l). During hospital stay hemodialysis/CVVH was considered necessary in 28 of 91 pts (31%) with CORO and 21 of 75 pts (28%) without CORO (p=ns). We did not observe a selection bias concerning admission of pts to our hospital or other hospitals respectively. With regard to perform CORO, however, there was a significant tendency to preference of prognostic favorable groups i.e. younger pts &lt;65years (p=0.042), pts with VF/VT as initial rhythm (p&lt;0.01) and a trend to pts with bystander resuscitation. With CORO survived 42 of 55 pts (76%) with a CPC score of 1 or 2 and 22 of 32 pts (69%) with a CPC score of 3 or 4. Twenty-seven of the 91 pts (36%) with CORO and 48 of the 71 pts (67%) without CORO died (p&lt;0.001). Conclusion: Intervention is principally justified in resuscitated pts in whom an ischemic cause has to be assumed. Without a randomized prospective study, however, it will remain unclear, to which extend CORO improves prognosis after CPR or if CORO is only an “add-on” of minor relevance in a group of pts with a basically good prognosis.
The effect of body position on the arterial oxygen saturation of healthy premature neonates
Authors: Zohre Torabi, Behnaz Falakaflaki, Akefeh Ahmadiafshar
Journal: European Respiratory Journal (2011)

Background:  Since the first time, when the prone position was introduced as a therapeutic maneuver in lung diseases, numerous studies in both adult and pediatric subjects have almost uniformly reported an improvement in PaO2 in the prone position compared to supine.   Aims and objective:  This study was conducted to determine the effect of body position on the arterial oxygen saturation of healthy premature neonates in Vali-e-asr hospital, Zanjan, Iran.   Method:  In this trial, totally 88 healthy premature neonates which were just feeding and being prepared to discharge, randomly selected. The neonates first randomly placed in prone or supine position, and 30 min later SpO2 was measured during 30 minutes. Then, the infants turned from prone to supine or from supine to prone, and a repeat set of measurement was made. The collected data was analyzed by utilizing SPSS 11.5 for windows package, using Paired Sample T Test.   Results:  60.2% (53 cases) of neonates were male and 39.8% (35 cases) were female. Their mean birth weight and gestational age were 2330.9 gram (range: 1080-3400) and 34.3 weeks (range: 26-36), respectively. Their mean postnatal age was 4.2 days (range: 1-28). Mean SpO2 of these neonates during 30 min in supine position was significantly higher than prone position (94.5±3.3 Vs 91.8±5; P   Conclusion:  These finding suggest that prone position have not offer any advantage over the supine position in the improvement of arterial oxygenation of healthy premature neonates.
Abstract 9179: Free Oxidized Fatty Acids Contribute to Pro-Inflammatory HDL
Authors: Brian J Van Lenten, Alan C Wagner, Srinivasa T Reddy, Mohamad Navab, Alan M Fogelman
Journal: Circulation (2011)

Background: Based on previous studies we thought it likely that the content of oxidized phospholipids would be elevated in pro-inflammatory HDL. While total plasma levels of oxidized phospholipids were increased in mouse models of atherosclerosis and in humans with coronary heart disease (CHD), the content of these oxidized phospholipids in HDL was NOT increased. This led us to look for other lipid components of HDL that might contribute to pro-inflammatory HDL. Methods &amp;Results: HDL was isolated from sucrose-cryopreserved plasma by ultracentrifugation in the presence of anti-oxidants. The content of free 5-HETE, 9-HETE, 12-HETE, 15-HETE, 9-HODE, and 13-HODE were determined by LC-MS/MS and found to be significantly (p&lt;0.0001; p = 0.0008; p = 0.0289; p = 0.0028; p = 0.0052; and p = 0.0029, respectively) elevated in HDL of 10 patients with CHD (all of whom had pro-inflammatory HDL as determined by cell-based assay) compared to 10 healthy controls (all of whom had anti-inflammatory HDL as determined by cell-based assay). To determine if free oxidized fatty acids contributed to the formation of pro-inflammatory HDL these oxidized fatty acids were added to anti-inflammatory HDL in amounts similar to that found in the CHD patients. The addition of 5-HETE, 9-HETE, and 15-HETE significantly (p = 0.0199; p = 0.0249; p = 0.0382, respectively) reduced the ability of the anti-inflammatory HDL to inhibit cytokine production in cultures of human aortic endothelial cells exposed to oxidized phospholipids. In contrast, addition of saturated non-oxidized free fatty acids such as decanoic or stearic acid did not alter the anti-inflammatory properties of HDL. Conclusions: These results suggest that i) HDL from CHD patients contains elevated levels of free oxidized fatty acids; ii) Free oxidized fatty acids can convert anti-inflammatory HDL to pro-inflammatory HDL.
Abstract 16439: Accuracy of Automated Coronary Atherosclerotic Plaque Quantification Algorithm on Coronary Computed Tomography Angiography: Comparison With Intravascular Ultrasound
Authors: Hyung-Bok Park
Journal: Circulation (2013)

Background: Coronary computed tomographic angiography (cCTA) has emerged as a promising non-invasive modality not only to detect coronary artery stenosis, but to assess atherosclerotic plaque surro...
Chronic Glomerulonephritis with Hypertension and Marked Nitrogen Retention but No Eye-ground Changes
Authors: Edward Weiss
Journal: Annals of Internal Medicine (1929)

Article1 July 1929Chronic Glomerulonephritis with Hypertension and Marked Nitrogen Retention but No Eye-ground ChangesEDWARD WEISS, M.D.EDWARD WEISS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-3-1-55 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptAlmost since the time of Bright hypertension, cardiac hypertrophy, nitrogen retention, and eye-ground changes have been recognized as nearly constant accompaniments of certain forms of chronic nephritis. Within recent years the eye-ground changes in vascular and renal disease have been particularly stressed, both from diagnostic and prognostic standpoints. Bannick1has reported severe chronic glomerulo-nephritis without hypertension, cardiac hypertrophy or retinal changes, and occasionally there have appeared case reports of advanced chronic nephritis terminating in uremia with slight or no nitrogen retention. As another variant in the picture of advanced chronic kidney disease the following case showing hypertension, cardiac hypertrophy and...1 BANNICK EG : Severe Chronic Glomerulonephritis without Hypertension, Cardiac Hypertrophy or Retinal Changes, Arch. Int. Med. 39: 741 (May) 1927. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia*From the Department of Medicine, Jefferson Medical College. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 July 1929Volume 3, Issue 1Page: 55-56KeywordsCardiac hypertrophyChronic kidney diseaseGlomerulonephritisHypertensionNephritisRenal diseases ePublished: 1 December 2008 Issue Published: 1 July 1929 PDF downloadLoading ...
AN INSTANCE OF CORONARY EMBOLISM IN SUBACUTE BACTERIAL ENDOCARDITIS
Authors: Harry Parks
Journal: Annals of Internal Medicine (1942)

Case Reports1 February 1942AN INSTANCE OF CORONARY EMBOLISM IN SUBACUTE BACTERIAL ENDOCARDITISHARRY PARKS, M.D.HARRY PARKS, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-16-2-339 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn recent literature on heart disease coronary thrombosis has occupied an increasingly important part of discussions on cardiac infarction. On the other hand, embolism of the coronary arteries with resultant cardiac infarction is infrequently mentioned. Up to 1933 Saphir1was able to find only 11 proved cases of this type, and to these he added three. During the last six years additional cases have been reported by Böger and Paradi,2Hoseason,3and by Cobo, Quirno, and del Rio.4The rare occurrence of coronary embolism is usually attributed to the anatomical situation of the coronary arteries. These vessels leave the aorta...References1. SAPHIR O: Coronary embolism, Am. Heart Jr., 1933, viii, 312-322. CrossrefGoogle Scholar2. BÖGERPARADI AGW: Coronarembolie, Klin. Wchnschr., 1934, xiii, 724-726. CrossrefGoogle Scholar3. HOSEASON AS: Coronary embolism, Lancet, 1935, i, 928-930. CrossrefGoogle Scholar4. COBOQUIRNODEL RIO JLNJG: Case of occlusion of right coronary artery due to embolism, importance of breast-shoulder lead (Lead IV) for exact diagnosis of occlusion, Rev. argent. de cardiol., 1935, ii, 248-263. Google Scholar5. VIRCHOW R: Ueber capilläre Embolie, Virchow's Arch. f. oath. Anat., 1856, ix, 307. CrossrefGoogle Scholar6. FITZ R: A case of angina pectoris with cardiac infarct induced by the intravenous injection of sodium tetraiodophenolphthalein, and followed by relief of anginal symptoms, Trans. Assoc. Am. Phys., 1928, xliii, 292. Google Scholar7. WOODWOLFERTH FCCC: Angina pectoris. The clinical and electrocardiographic phenomena of the attack and their comparison with effects of experimental coronary occlusion, Arch. Int. Med., 1931, xlvii, 339. CrossrefGoogle Scholar8. STEINBERG CL: The prognosis of coronary thrombosis based on the non-protein nitrogen in the blood, Jr. Lab. and Clin. Med., 1934, xx, 279-287. Google Scholar9. JEGHERSBAKST HHJ: The syndrome of extrarenal azotemia, ANN. INT. MED., 1938, xi, 1861-1899. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Atlanta, Georgia*Received for publication December 9, 1939.From the Robert Dawson Evans Memorial for Clinical Research and Preventive Medicine, Boston. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCoronary embolismCoronary Embolism: Review of the Literature and Report of a Unique Case 1 February 1942Volume 16, Issue 2Page: 339-349KeywordsAortaCardiovascular therapyCoronary arteriesCoronary heart diseaseEndocarditisHeart diseasesInfarctionPreventive medicineThrombosis ePublished: 1 December 2008 Issue Published: 1 February 1942 PDF downloadLoading ...
Abstract 4695: Complete Revascularization versus Culprit-only Revascularization in Patients With ST-Segment Elevation Myocardial Infarction and Multivessel Disease: A Meta-Analysis
Authors: Sripal Bangalore, Sabrina Sawhney, Scott Kinlay, David P Faxon
Journal: Circulation (2009)

Background: The ACC/AHA guidelines for management of patients with ST-elevation myocardial infarction (STEMI) recommend culprit artery only percutaneous coronary intervention (PCI) based on safety ...
Abstract 10063: Can Cardiac MRI be the ‘Crystal Ball’ for Risk Stratification in Dilated Cardiomyopathy; the Impact of an LV Mid-Myocardial Stripe on Subsequent Risk of LVAD, Transplantation and Death
Authors: Jose Venero, Mark Doyle, Srinivas Murali, Diane Vido, Vikas Rathi, Saundra Grant, June Yamrozik, Ronald Williams, Raymond Benza, George Sokos, Peter Olson, Robert W Biederman
Journal: Circulation (2011)

Introduction Patients with newly diagnosed dilated cardiomyopathy (DCM) and advanced heart failure have a very high morbidity and mortality with an unpredictable clinical course. We investigated th...
Abstract 15322: Trifecta vs. Mitroflow: Superior Hemodynamics Despite Similar Design
Authors: Mahmoud Diab, Gloria Faerber, Ivliane Tsanava, Martin Breuer, Mario Walther, Paulo A Amorim, Torsten Doenst
Journal: Circulation (2014)

Purpose: Hemodynamic results of stented tissue valves are influenced by both valve design and sizing strategy. The Mitroflow and the Trifecta have an innovative design where the pericardium is wrapped around the stent. The goal of this study was to compare both valves giving special consideration to the suggested sizing strategies. Methods: We obtained pressure gradients from discharge echocardiograms from all patients having received an isolated Trifecta (n=104) or Mitroflow (n=246) between 01/2007 and 01/2014. We compared the results by size label and by the most likely selected size according to the suggested sizing strategy. This is important because the prostheses, despite having a similar design, have different diameters for the same size label and different sizing strategies. Results: The majority of implanted valves were size labels 21 and 23 (82.7% of the Trifecta and 74.8% of the Mitroflow). Mean pressure radients were lowest with Trifecta (Trifecta vs. Mitroflow, label-21: 11.4±4.65 vs 13.6±5.23 mmHg, label-23: 9.23±3.38 vs. 11.8±4.42 mmHg, p&lt; 0.05, and label-25: 11.2±4.97 vs 12.0±4.46 mmHg, n.s.). The sizers for the Trifecta are metric, while those for the Mitroflow are 2-3 mm larger than the corresponding size label. It is therefore likely that for a patient with a 23 mm aortic annulus, a 23 Trifecta but often only a 21 Mitroflow is selected. Thus, comparing the Trifecta to the Mitroflow not by size label but by selected valve (e.g., 23 vs. 21) would therefore only increase the difference. Conclusion: The Trifecta shows a hemodynamic advantage over the Mitroflow which is not likely associated with the applied sizing strategy.
Abstract 4184: Assessment of Heterogeneity of Strut-Level Neointima Hyperplasia After Stent Implantation by Optical Coherence Tomography
Authors: Hiroyuki Kyono, Giulio Guagliumi, Vasile Sirbu, Noah Rosenthal, Satoko Tahara, Giuseppe Musumeci, Luigi Fiocca, Orazio Valsecchi, Daniel Simon, Hiram G Bezerra, Marco A Costa
Journal: Circulation (2009)
Abstract 17073: Avoiding Shocks by Programming a High Number of Antitachycardia Pacing Attempts for Fast Ventricular Tachycardia: A Prospective Study
Authors: Raphaël P Martins, Hugues Blangy, Lucian Muresan, Luc Freysz, Laurent Groben, Pierre-Yves Zinzius, Jérôme Scwartz, Jean-Marc Sellal, Etienne Aliot, Nicolas Sadoul
Journal: Circulation (2011)

Purpose: Antitachycardia pacing (ATP) is a painless therapy reducing defibrillation shocks in implantable cardioverter-defibrillator (ICD) recipients. One or 2 ATP attempts are usually programmed to terminate fast ventricular tachycardia (FVT) episodes and avoid shocks without delaying successful treatment in case of ATP failure. Programming more ATP attempts could probably reduce the occurrence of shocks. Objective: We sought to analyze the long-term efficacy and safety of programming a high number of ATP attempts for FVT. Methods: All patients receiving a first ICD in our center for coronary artery disease (CAD) and dilated cardiomyopathy in primary and secondary prevention indications between 2000 and 2009 were prospectively included in the study. ICDs were programmed to deliver 10 ATP attempts for FVT cycle lengths (CL) of 250 to 300 ms (200 to 240 bpm) before high energy shock delivery (5 bursts, then 5 ramps; 8 to 10 extrastimuli at 81 to 88% of the FVT CL; minimal pacing CL 180 ms). Results: We prospectively included 770 patients (men 84%; CAD 75.5%; age 63.2 ± 11 years; secondary indication 54.3%; left ventricular ejection fraction 30.3±9%), followed for 40.6 ± 25.6 months. Among them, 137 patients (17.8%) had a total of 1839 episodes of FVT (mean frequency 209 ± 9.2 bpm). ATP terminated 1713 episodes of FVT (unadjusted efficacy, 93.1%; GEE adjusted 81.7%) and acceleration occurred in 5.8% of episodes. A large majority of episodes were successfully treated (98.3%) by 1 or 2 ATP sequences. Conversely, the patient-based analysis showed that 17 (12.4%), 8 (5.8%) and 5 patients (2.1%) had one episode or more treated by at least 3, 4 or 5 ATP attempts, respectively. These patients would have been shocked with a conventional ICD programming. The benefit of this strategy was reduced for 6 to 10 attempts and only 10 patients were shocks for ATP failure (20 episodes, 1.1%). Despite the high number of attempts programmed, FVT episodes were mainly asymptomatic and found during device interrogation: syncope and pre-syncope occurred in 0.2% and 0.4% of episodes, respectively. Conclusions: Programming a high number of ATP attempts (at least 4 or 5 ATP sequences) in the FVT zone is both safe and useful. It could prevent painful shocks for FVT in a high proportion of ICD recipients.
Abstract 11566: Beyond LDL Cholesterol: Carriers of the PCSK9 R46L Variant Are Characterized by an Anti-Atherogenic Lipoprotein Profile Assessed by Nuclear Magnetic Resonance Spectroscopy
Authors: Benoit J Arsenault, S. Matthijs Boekholdt, G. Kees Hovingh, John J Kastelein, Nicholas J Wareham, Kay-Tee Khaw
Journal: Circulation (2014)

Background: Carriers of the PCSK9 R46L genetic variant are characterized by low levels of low-density lipoprotein (LDL) cholesterol and a decreased risk of cardiovascular disease (CVD). Whether these individuals are characterized by other features of a more beneficial lipoprotein-lipid profile is unknown. Methods and Results: We measured the lipoprotein-lipid profile of 2373 participants of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk study by nuclear magnetic resonance spectroscopy. Among them, 77 participants carried at least one allele of the R46L genetic variant. Carriers and non-carriers had comparable clinical characteristics (age, body mass index, blood pressure, smoking and diabetes prevalence). As expected, carriers had lower LDL cholesterol levels compared to non-carriers (3,75±0,99 vs. 4,16±1,01 mmol/L, p&lt;0.001 in carriers vs. non-carriers, respectively). Carriers were characterized by a lower very low-density lipoprotein (VLDL) particle concentration and a lower LDL particle concentration of any size (Table). Total high-density lipoprotein (HDL) particle concentration was not different in carriers vs. non-carriers. However, carriers had a higher concentration of large HDL particles and a higher mean HDL particle size. We also found that carriers were characterized by a lower secretory phospholipase A2 (sPLA2) activity (4,21±0,88 vs. 4,61±1,26, nmol/ml/min p=0.004 in carriers vs. non-carriers, respectively) and a lower lipoprotein-associated phospholipase A2 (Lp-PLA2) activity (47,5±14,1 vs. 52,4±16,2 nmol/ml/min, p=0.008 in carriers vs. non-carriers, respectively). Conclusions: Results of this study suggest that on top of having low LDL cholesterol levels, carriers of the PCSK9 R46L genetic variant have a lower VLDL and LDL particle concentration, a higher concentration of large HDL particles and lower sPLA2 and Lp-PLA2 activity. This anti-atherogenic profile may explain to a certain extent the reduced CVD risk observed in carriers of the PCSK9 R46L genetic variant.
Doxepin as an adjunct to smoking cessation: a double-blind pilot study
Authors: N B Edwards, J K Murphy, A D Downs, B J Ackerman, T L Rosenthal
Journal: American Journal of Psychiatry (1989)

In a double-blind study, 19 adults received bedtime doses of either 150 mg of doxepin hydrochloride (N = 9) or placebo (N = 10). After 3 weeks the subjects were instructed to stop smoking and continue taking medication for 4 additional weeks. Cessation was reported by all nine doxepin subjects 1 week after cessation and by seven doxepin subjects 9 weeks after cessation. One placebo subject reported cessation. Cotinine assays generally confirmed cessation but were subject to interpretation. Doxepin assays suggested that the precessation level was associated with cessation. Further studies with larger samples and extended follow-up are needed to determine the reliability of these results.
A Randomized, Controlled Trial of 3.0 mg of Liraglutide in Weight Management
Authors: Xavier Pi-Sunyer, Arne Astrup, Ken Fujioka, Frank Greenway, Alfredo Halpern, Michel Krempf, David C.W. Lau, Carel W. le Roux, Rafael Violante Ortiz, Christine Bjørn Jensen, John P.H. Wilding
Journal: New England Journal of Medicine (2015)

Obesity is a chronic disease with serious health consequences, but weight loss is difficult to maintain through lifestyle intervention alone. Liraglutide, a glucagon-like peptide-1 analogue, has been shown to have potential benefit for weight management at a once-daily dose of 3.0 mg, injected subcutaneously.We conducted a 56-week, double-blind trial involving 3731 patients who did not have type 2 diabetes and who had a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of at least 30 or a BMI of at least 27 if they had treated or untreated dyslipidemia or hypertension. We randomly assigned patients in a 2:1 ratio to receive once-daily subcutaneous injections of liraglutide at a dose of 3.0 mg (2487 patients) or placebo (1244 patients); both groups received counseling on lifestyle modification. The coprimary end points were the change in body weight and the proportions of patients losing at least 5% and more than 10% of their initial body weight.At baseline, the mean (±SD) age of the patients was 45.1±12.0 years, the mean weight was 106.2±21.4 kg, and the mean BMI was 38.3±6.4; a total of 78.5% of the patients were women and 61.2% had prediabetes. At week 56, patients in the liraglutide group had lost a mean of 8.4±7.3 kg of body weight, and those in the placebo group had lost a mean of 2.8±6.5 kg (a difference of -5.6 kg; 95% confidence interval, -6.0 to -5.1; P<0.001, with last-observation-carried-forward imputation). A total of 63.2% of the patients in the liraglutide group as compared with 27.1% in the placebo group lost at least 5% of their body weight (P<0.001), and 33.1% and 10.6%, respectively, lost more than 10% of their body weight (P<0.001). The most frequently reported adverse events with liraglutide were mild or moderate nausea and diarrhea. Serious events occurred in 6.2% of the patients in the liraglutide group and in 5.0% of the patients in the placebo group.In this study, 3.0 mg of liraglutide, as an adjunct to diet and exercise, was associated with reduced body weight and improved metabolic control. (Funded by Novo Nordisk; SCALE Obesity and Prediabetes NN8022-1839 ClinicalTrials.gov number, NCT01272219.).
Acute Vulvovaginitis
Authors: Linda O. Eckert
Journal: New England Journal of Medicine (2006)

A 24-year-old sexually active woman presents with a three-day history of vaginal pruritus and increased vaginal discharge. One year before presentation, she had the same symptoms, which resolved with use of an over-the-counter antifungal agent. She uses oral contraceptives for birth control. The physical examination reveals vulvar erythema and normal-appearing vaginal discharge. How should she be evaluated and treated?