tbuckley/cabot-search huggingface dataset:
Abstract 4844: Influence of Early Stage Chronic Kidney Disease on Coronary Spastic Angina
Authors: Seiji Koga, Satoshi Ikeda, Tomohiko Yasunaga, Tomoo Nakata, Masayoshi Takeno, Yuji Koide, Koji Maemura
Journal: Circulation (2009)

Background: Chronic kidney disease (CKD) is associated with the morbidity and mortality of cardiovascular disease through atherosclerotic processes. However, the relationship between CKD and coronary artery spasm has not been elucidated. The aim of this study was to investigate whether CKD is associated with coronary spastic angina (CSA). Methods: We evaluated 127 patients (mean age 60 ± 12 years) who underwent coronary angiography with intracoronary acetylcholine or ergonovine provocation test. CSA was defined as total or subtotal coronary vasoconstriction with chest pain and ischemic ST segment changes on electrocardiography after provocation that were resolved by an intracoronary injection of isosorbide dinitrate, and the absence of organic coronary stenosis. Kidney function was determined by the estimated glomerular filtration rate (eGFR). Patients with eGFR ≤ 29 mL/min/1.73 m 2 were excluded. Results: There were 53 and 74 patients with and without CSA, respectively. Age and proportion of smokers, hypertension, diabetes mellitus, and obesity were similar between the two groups. The proportion of male gender and dyslipidemia was higher among the patients with, than without CSA (72 vs. 46 %, P = 0.004, and 49 vs. 31 %, P = 0.040). As compared with patients without CSA, patients with CSA had significantly lower eGFR value (70.4 ± 14.8 vs. 79.2 ± 17.2 mL/min/1.73 m 2 , P = 0.003) and higher proportion of eGFR category ≤ 59 mL/min/1.73 m 2 (25 vs. 11 %, P = 0.040). Prevalence of CSA was 56 % in the lowest eGFR quartile (&lt; 63.9 mL/min/1.73 m 2 ) and 55% in second lower quartile (63.9 – 75.0 mL/min/1.73 m 2 ), which was significantly increased compared to 23 % in highest quartile (≥ 85.3 mL/min/1.73 m 2 ) (P = 0.006 and P = 0.009, respectively). No significant difference was observed between highest and second highest quartile (75.0 – 85.3 mL/min/1.73 m 2 ). Logistic regression analysis showed that independent factors associated with CSA were male gender (OR, 3.938; 95%CI, 1.725 to 8.988) and eGFR (OR, 0.658; 95%CI, 0.506 to 0.857). Conclusions: Mildly and moderately decreased eGFR is associated with a higher prevalence of CSA, suggesting that early stage CKD is related to a relatively initial stage of atherosclerosis. Management for CKD might lower the incidence of CSA.
Abstract 3179: Intraoperative Transoesophageal Echocardiographic Predictors of Recurrent Aortic Regurgitation after Aortic Valve Repair.
Authors: Jean-Benoit le Polain de Waroux, Anne-Catherine Pouleur, Céline Goffinet, David Vancraeynest, Bernhard L Gerber, Agnes Pasquet, Gébrine El khoury, Phillippe Noirhomme, Jean-Louis Vanoverschelde
Journal: Circulation (2007)

Background. Surgical valve repair for aortic regurgitation (AR) has significant advantages over valve replacement, but little is known about the mechanisms of its failure. This echocardiographic study examines the intraoperative features associated with “late failure” of valve repair, eventually necessitating reoperation. Method. Intraoperative transesophageal echocardiography (TEE) after cardiopulmonary bypass was performed in 168 consecutive patients (pts) undergoing valve repair for AR over a 10-year period. From this cohort, we carefully reviewed all clinical, pre-operative, intraoperative and follow-up TEE data of 62 pts (group A, 53 ± 13 years) with no or trivial AR at follow-up and 31 pts (group B, 46 ± 15 years) with recurrent severe AR at follow-up of whom 17 needed a re-operation. In these pts, echocardiography identified the cause of repair failure as rupture of a pericardial patch in 2 pts, residual cusp prolapse in 18 pts, restrictive cusp motion in 8 pts, aortic dissection in 2 pts and endocarditis in the remaining pt. Results. Pre-operatively, both groups were similar for aortic root dimensions and incidence of bicuspid valve (39 ± 4 % vs 35 ± 5 %, χ 2 = 0.4). Marfan disease and restrictive cusp motion or endocarditis were more frequent in group B than in group A (16 ± 4% vs 0% and 48 ± 5% vs 14 ± 3%, χ 2 = 0.001). After cardiopulmonary bypass, the coaptation length was shorter (2.2 ± 1.5 vs. 6.8 ± 2.8 mm, p&lt;0.001), the level of coaptation (relative to the annulus) was lower (0.0 ± 4.4 vs 6.9 ± 3.9 mm, p&lt;0.001), the aortic annulus was larger (27 ± 5 vs 22 ± 4 mm, p&lt;0.001) and the vena contracta was wider (2.4 ± 1.0 vs 0.05 ± 0.9 mm, p&lt;0.001) in group B than in group A pts. Interestingly, 13/18 (72%) pts in whom recurrent AR was due to a cusp prolapse, had eccentric AR jets before leaving the operating room. With multivariate analysis, only a coaptation length &lt; 5 mm (OR=13.1, 95%CI [2.4; 70.5] p=0.003), the presence of an eccentric jet (OR=8.02, 95%CI [2.1; 30.4] p=0.002) and the level of coaptation relative to the aortic annulus (OR=4.7, 95%CI [1.0; 21.6] p=0.049) were found to independently predict late AR recurrence. Conclusion. Our results demonstrate that intraoperative TEE can be used to identify pts undergoing AR repair who are at increased risk for late repair failure.
Life events and the onset of panic disorder
Authors: Peter P. Roy-Byrne, Marilla Geraci, Thomas W. Uhde
Journal: American Journal of Psychiatry (1986)

The authors examined the number, type, and effect of life events during the year before the onset of panic attacks in 44 patients with a Research Diagnostic Criteria diagnosis of panic disorder and 44 healthy control subjects matched for age, sex, and time of retrospection. The patients had significantly more life events, and these events had a more adverse impact on them. Furthermore, the types of events experienced by the patients were more typically distressing than those experienced by the control subjects. The patients reported events involving moves to other neighborhoods and/or cities far more frequently than did the control subjects.
Hormonal relationships in homosexual men
Authors: G Tourney, A J Petrilli, L M Hatfield
Journal: American Journal of Psychiatry (1975)

The authors note that previous data on the role of biological factors in homosexuality have been suggestive rather than definitive. They investigated hormonal metabolism in heterosexual and homosexual men and found no indication of disturbed functioning in the homosexual subjects. The authors discuss problems with research in this area, suggesting the need for larger samples, attention to the factor of diurnal variations in hormonal secretion, and methodological refinements.
Arguments should be based on ratio of benefits to risks
Authors: S. Bewley
Journal: BMJ (1996)

herbal medicines are in fact the effects of other herbal material used in error.This type of mistake is typified by the irritatingly common practice of naming vincristine and related anticancer compounds as Vinca alkaloids although they are derived from Catharanthus roseus.Unfortunately, classical taxonomists and phytoanalysts do not have the same glamour and potential to attract money as some other scientists and so are an endangered species.Their demise will result in mistakes more serious than the one in the editorial.
Abstract 2021: Adrenergic Receptor Polymorphisms and Prevention of Ventricular Arrhythmias with Bucindolol in Patients with Heart Failure
Authors: William Sauer, Christopher M Lowery, Chakra Budhathoki, Brian D Lowes, Michael R Bristow
Journal: Circulation (2007)

Background: β-blockers have been shown to prevent ventricular arrhythmias (VT/VF) in patients with low left ventricular ejection fraction (LVEF) and chronic heart failure (CHF). We hypothesized that there may be genotype specific responses to β-blocker therapy for prevention of VT/VF. Methods: The β-blocker Evaluation of Survival Trial (BEST) is a randomized trial of bucindolol in patients with NYHA Class III – IV CHF and LVEF ≤0.35. From a substudy of 1040 genotyped subjects, we identified those with the high functioning Arg389 β1 adrenergic receptor polymorphism and the loss of function 322–325 α2c adrenergic receptor deletion polymorphism. The incidence of VT/VF was prospectively recorded as an adverse event during the trial. Results: Of the 1040 subjects in the genotyped cohort, there were a total of 493 Arg389 β1 homozygotes vs. 547 Gly389 carriers and 207 α2c deletion carriers vs. 833 wild-types. The diplotypes included 418 subjects with both Arg/Arg389 β1 receptors and wild type α2c, 484 with one of these, and 134 carrying both the α2c deletion and β1 Gly389. For the genetic substudy, bucindolol was associated with less VT/VF that placebo (5.5% vs. 12.1%; p&lt;0.01) There was a significant drug-gene interaction for prevention of VT/VF with both polymorphisms (β1 overall p&lt;0.01; α2c overall p&lt;0.01). Arg389 homozygotes randomized to bucindolol had a lower incidence of VT/VF during the trial than those randomized to placebo (4.3% vs. 14.4%; P&lt;0.01) as for wild type α2c homozygotes (5.4% vs. 12.7%; p&lt;0.01). This reduction in VT/VF was not significant in other genotypes (β1 Gly389 carriers: 6.6% vs. 10.4%; P=0.13 and α2c deletion carriers: 4.9% vs. 10.6%; P=0.19). Subjects with the Arg/Arg389 β1/wild type α2c receptor diplotype randomized to bucindolol had a lower rate of VT/VF occurrence than those with only one or neither of these genotypes (both: 4.7% vs. 14.6%; p&lt;0.01; one: 4.9% vs. 11.2%; p=0.01; neither: 8.5% vs. 9.3%; p=1.0). Conclusion: Subjects with CHF and Arg/Arg389 β1 or wildtype α2c adrenergic receptors treated with bucindolol had a lower rate of VT/VF than those randomized to placebo. This treatment effect was not observed in the population of β1 Gly389 or the α2c deletion carriers, indicating a pharmacogenetic interaction.
Abstract 4128: Evaluating Sex Differences in Population-Based Utilization of Implantable Cardioverter Defibrillators (ICDs): The Role of Cardiac Conditions and Non-Cardiac Comorbidities
Authors: Derek R MacFadden, Jack V Tu, Alice Chong, Peter C Austin, Douglas S Lee
Journal: Circulation (2008)

BACKGROUND: Although sex differences exist in the use of ICDs, reasons for the disparities are poorly understood. We determined if age, comorbid conditions, or ICD indication explained the sex differences. METHODS: We examined all patients in Ontario, Canada, with cardiac arrest (CA, 1998 –2007), myocardial infarction (MI, 2002–2007), or heart failure (HF, 2005–2007), using the Canadian Institute for Health Information Database. MI and HF cohorts excluded those with prior CA, and included patients post-MADIT-2 and SCD-HeFT trials. Patients were followed until ICD implant using Cox regression, with hazard ratio (HR) &gt;1.0 indicating greater likelihood of ICD implant in men. RESULTS: Among 9246 patients eligible for ICD implantation after CA, 237 (2.6%) women and 725 (7.8%) men received ICDs. In 105,516 primary prevention MI patients, 172 (0.2%) women and 836 (0.8%) men received ICDs. Among 61,160 primary prevention HF patients, 221 (0.4%) women and 852 (1.4%) men received ICDs. The rate of ICD implant was significantly higher in men across indications adjusting for age, prior arrhythmia, and comorbidities (Figure ). Post-CA, the HR for secondary prevention ICD was 1.92 (95%CI, 1.66 –2.23). Men were more likely to undergo ICD implant than women for primary prevention, with HRs 3.00 (95%CI, 2.53–3.55) post-MI and 3.01 (95%CI, 2.59 –3.50) in HF patients. Although death after primary prevention ICD did not differ by sex, mortality risk was higher in men after CA (HR 1.42; 95%CI, 1.03–1.95). CONCLUSIONS: Differences in ICD use for all indications were not explained by age or comorbidities. Despite increased use, men had reduced post-implant survival after cardiac arrest.
Abstract 929: Nitric Oxide Generated by eNOS Exerts Cardioprotection by Increasing the Mitochondrial Biogenesis and Decreasing Electron Leakage for Superoxide Production by Mitochondrial Succinate Cytochrome c Reductase.
Authors: Yeong-Renn Chen, Chwen-Lih Chen, Jay L Zweier
Journal: Circulation (2007)

Nitric oxide (NO) produced from endothelial cells has the capacity to modulate mitochondrial functions in regulation of metabolism, respiration, and mitochondrial biogenesis. The succinate ubiquino...
2009 pandemic influenza A(H1N1) virus in Scotland: geographically variable immunity in Spring 2010, following the winter outbreak
Authors: W E Adamson, S Maddi, C Robertson, S McDonagh, P J Molyneaux, K E Templeton, W F Carman
Journal: Eurosurveillance (2010)

We determined the age- and location-specific seroprevalence of antibodies against 2009 pandemic influenza A(H1N1) virus in Scotland following the first two waves of infection. Serum samples collected following the winter outbreak were analysed by microneutralisation assay. The proportion of positive sera varied significantly between cities and, in the case of Inverness, between age groups (with younger adults more likely to be positive than older individuals). This study demonstrates that older people are no longer more likely to have antibodies against the virus than younger adults.
Abstract 20664: Prognostic Impact of Angiotensin-Converting Enzyme Inhibitor Therapy in Patients With Acute Coronary Syndromes despite Nonobstructive Coronary Artery Disease
Authors: Olivia Manfrini, Christine Morrell, Rajiv Das, Julian H Barth, Raffaele Bugiardini, Alistar S Hall, Emmace Investigators
Journal: Circulation (2010)

Purpose Patients with nonobstructive coronary artery disease (CAD) despite an acute coronary syndrome (ACS) are usually dismissed from specialty care with the belief that they do not have serious cardiac disease. Available data on the treatment and prognosis of these patients are limited.   Methods:  The EMMACE-2 registry enrolled patients who had been hospitalized for an ACS. We analyzed the data of the British EMMACE 2 (Evaluation of Methods and Management of Acute Coronary Events) in an attempt to clarify the effects of early intensive medical therapy in these patients. There were 1602 patients who had cardiac catheterization that were used for this analysis. The main outcome measures were evidence based therapies prescribed at discharge and 6-month incidence of all cause mortality.   Results:  The cohort consisted of 1252 patients with obstructive CAD (>50% luminal diameter obstructed) and 350 patients without obstructive CAD. In the overall population, in-hospital standard ACS therapies were used: aspirin (78.9%), beta-blockers (66.5%), statins (81.8%) and ACE-inhibitors (64.4%). The rates of death at 6-month were 20.6% in the obstructive CAD group and 3.1% in the nonobstructive CAD group. The risk reduction of evidence based therapies on 6-month mortality was of greatest magnitude and statistical significance (p   Conclusion:  ACE-inhibitor therapy was independently associated with a significant decrease in 6-month mortality in patients with and without obstructive CAD. Patients with nonobstructive CAD showed a greater benefit of ACE-inhibitor therapy than patients with obstructive CAD.
Abstract 3990: Regulation of AIF Nuclear Translocation is a Critical Step in Cardiac Apoptosis in Mice Lacking Hsp70 During Ischemia/Reperfusion in vivo
Authors: Sangita Choudhury, Qingen Ke, Soochan Bae, Peter M Kang
Journal: Circulation (2009)

Heat shock protein 70 (Hsp70) has been shown to have an anti-apoptotic effect, possibly by regulating apoptosis inducing factor (AIF), a key mediator of caspase-independent apoptosis. Here, we exam...
Abstract 12597: Progressive Induction of Pressure Overload in a Large Animal Model Causes a Unique Matrix Signature and Remodeling: Relation to LV Function and Stiffness
Authors: William M Yarbrough, Jennifer A Dixon, William T Rivers, Richard A McKinney, Robert E Stroud, Risha K Patel, Corey B Prescott, Rupak Mukherjee, Michael R Zile, Francis G Spinale
Journal: Circulation (2010)

Background: Patients with severe pressure overload (PO), secondary to aortic stenosis often present with signs and symptoms of heart failure secondary to LV hypertrophy (LVH), matrix remodeling and...
Abstract 2311: Clinical Predictors Of Survival In Heart Failure Patients Following Cardiac Resynchronization Therapy
Authors: Daniel M Couri, Grace Lin, Tracy L Webster, Peter A Brady
Journal: Circulation (2007)

Introduction: Appropriate selection of patients (pts) with heart failure (HF) who may benefit from cardiac resynchronization therapy (CRT) is difficult. We sought to identify a clinical risk score to better risk stratify patients prior to CRT implantation. Methods: Pts undergoing CRT at Mayo Clinic from 2000 –2005 were included. Multiple clinical variables (age, gender, anemia (Hgb &lt;10g/dL), RF (creatinine clearance ≤ 60ml/min/1.73m 2 ), hyponatremia (Na ≤130mEq/L), elevated BNP level (&gt;500pg/ml), etiology, EF ≤20%, and advanced HF (NYHA functional class III–IV) were assessed with outcomes following CRT. Multivariate analysis was used to determine a clinical risk score. Results: A total of 496 patients (80% males) age 68 ± 12 years (62% ischemic cardiomyopathy, EF 22% ± 8%) were included. In univariate analysis relative risk (RR) was &gt; 1 for RF (RR 1.8, CI 1.3–2.8; p = 0.002), anemia (RR 3.3, CI 1.8 –5.5; p = 0.001), hyponatremia (RR 3.4, CI 1.4 – 6.9; p = 0.008), elevated BNP (RR 2.9, CI 1.6 –5.7; p &lt; 0.001), ischemic cardiomyopathy (ICM) (RR 1.8, CI 1.2–2.7; p &lt; 0.002), EF ≤ 20% (RR 1.5, CI 1.0 –2.1; p = 0.033), and advanced HF (RR 2.5, CI 1.5– 4.9; p &lt; 0.001). Following multivariate analysis RF, anemia, ICM, and advanced HF remained significant predictors of poor outcome (p &gt;0.01 for all). Survival with 3 or more of these clinical risk factors was significantly worse than with less risk factors (p &lt;0.01, Figure ). Conclusions: Pre-implant clinical risk factors including anemia, RF, ICM and advanced HF predict worse outcome following CRT with ≥3 variables predicting &gt;2-fold increased risk of death or heart transplantation. These factors should be considered when selecting pts prior to CRT.
Providers and receivers in the private psychiatric Medicaid system
Authors: S Nagelberg, A H Schwartz, B B Perlman, M Paris, J C Thornton
Journal: American Journal of Psychiatry (1980)

The authors investigated the credentials of foreign medical graduate (FMG) and U.S. medical graduate (USMG) psychiatrists providing a substantial amount of Medicaid care and compared them with those of a group of other psychiatric practitioners in New York City. USMGs were more likely to be Board certified, but FMGs were as likely to have APA membership, psychoanalytic training, medical school and hopsital affiliation, and fellowships. The credentials of the Medicaid psychiatrists and the group of New York psychiatrists were similar. Hispanic FMG psychiatrists provided a major service for the Spanish-speaking community, but the poor black population underused Medicaid services. Diagnosis did not appear to be influenced by racial bias.
Abstract 4876: Leptin Reverses Hyperlipidemia and Vascular Dysfunction in Mice Exposed to Intermittent Hypoxia
Authors: Ronghua Yang, Gautam Sikka, Christian Reinke, Karen Miller, Xiaolin Liu, Koenraad M Vandegaer, Vsevolod Y Polotsky, Christopher P O’Donnell, Dan E Berkowitz, Lili A Barouch
Journal: Circulation (2009)

Obesity and sleep apnea contribute to poor vascular health. Lack of leptin and exposure to intermittent hypoxia (IH) both lead to greater vascular stiffness and endothelial dysfunction, accompanied by dyslipidemia. We previously showed that leptin deficient ob/ob mice exposed to IH showed greater vascular stiffness, fully reversed with leptin repletion. In this study, we tested the hypothesis that leptin treatment in lean mice exposed to IH can improve dyslipidemia, vascular compliance and endothelial function. C57BL6/J mice with or without leptin infusion (0.3 mg/kg/day via subcutaneous osmotic pumps) were exposed to IH or room air for 4 weeks. Pulse wave velocity (PWV) was measured by Doppler to assess vascular stiffness (n=8–20). Vascular relaxation response to acetylcholine (ACh) was measured in preconstricted aortic rings (n=10–21) to indicate endothelial function. In mice exposed to room air, leptin did not affect PWV (3.53±0.07 vs. 3.48±0.04 m/s in control, p=NS) or endothelium-dependent relaxation (Emax 79.7±2.1 vs. 77.5±3.4 % in control; p=NS). Mice exposed to IH had higher PWV, i.e. increased vascular stiffness, vs. control (3.92±0.06 m/s; p&lt;0.001). There was a trend toward improved PWV in IH+leptin mice (3.74±0.08 m/s; p=0.08 vs. IH, p&lt;0.05 vs. control). ACh-induced aortic ring relaxation was attenuated in IH (Emax 65.5±2.0 %; p&lt;0.001 vs. control) but normal in IH+leptin (Emax 78.1±1.8 %; p&lt;0.001 vs. IH, p=NS vs. control). Fasting serum total cholesterol was lower in IH+leptin vs. IH mice (82.6±3.2 vs. 102.6±5.1 mg/dL, p&lt;0.001), as was total triglycerides (26.3±3.5 vs. 38.3±3.4 mg/dL, p&lt;0.05). Hepatic protein expression of stearoyl-Coenzyme A desaturase 1 (SCD-1), which catalyzes monounsaturated fatty acid synthesis and is transcriptionally inhibited by leptin, was also lower in IH+leptin vs. IH by Western blot (0.65±0.07 vs. 1.00±0.05 arb. units; p&lt;0.01). In summary, we describe a novel role for leptin in protecting against IH-induced vascular stiffness and endothelial dysfunction, associated with improved dyslipidemia and reduced SCD-1 in mice. Leptin’s inhibitory actions on fatty acid synthesis may provide vascular benefits in sleep apnea and hyperlipidemia and offer new therapeutic strategies in patients with these conditions.
Abstract 65: Defining Lay Bystanders' Knowledge, Attitudes and Beliefs Toward Cardiopulmonary Resuscitation Training and Performance
Authors: Audrey L Blewer, Danielle M Haley, Julie Xu, C Jessica Dine, Marion Leary, Benjamin S Abella
Journal: Circulation (2011)

Background: Since less than 30% of lay witnesses to cardiac arrest attempt cardiopulmonary resuscitation (CPR), understanding the public's perception of CPR training and performance is essential to inform future CPR training methods. Little is known regarding layperson perspectives on CPR in context of the 2010 resuscitation guidelines and the development of hands-only CPR. Objectives: We hypothesized that bystanders would feel more confident performing CPR when made aware of the new guidelines support for hands-only CPR. Methods: Subjects participated in an hour-long semi-structured qualitative interview. The interview script covered general questions designed to understand subject's perspectives on CPR training and performance. Following transcription, all responses were coded and processed using NVivo 9 qualitative analysis software. Results: Interviews were completed by 19 subjects, of whom 11% were untrained, 47% had completed a training course within the past 5 years and 42% had completed a course in the past 5+ years. Less than 49% of the subjects could describe when to perform CPR, and those who described using CPR incorrectly confused the lifesaving skill with first aid (64%) or clearing of the airway (27%). Subjects described incomplete training, lack of hands-on practice time (38%) and difficulty with skill retention (21%) as top themes surrounding their previous CPR training. Lack of confidence in CPR skills was a commonly reported theme among 79% of interviewees, despite 41% of these respondents having been trained within 5 years. When asked about hands-only CPR, 74% of the subjects had not heard of the new technique and 68% were unaware of the updated 2010 CPR guidelines. When briefly educated about the 2010 guidelines, 89% felt more confident with performing CPR if they had the option of employing “hands-only” CPR (p&lt;0.01). Conclusions: CPR trained individuals lacked confidence and retention of CPR knowledge, and were not aware of hands-only CPR and the 2010 resuscitation guidelines update. When informed about the option for hands-only CPR, individual's self-reported confidence increased significantly. This has implications for future public messaging surrounding layperson CPR and the need to promote hands-only CPR more broadly.