tbuckley/cabot-search huggingface dataset:
Incidence and prognosis of asthma to age 33
Authors: K. Hinshaw
Journal: BMJ (1996)

# Bleeding in first 27 weeks of pregnancy had protective effect {#article-title-2}

EDITOR,—As an obstetrician with mild asthma, I was interested to read David P Strachan and colleagues' paper on their long term cohort study of the incidence and prognosis of asthma.1 Several perinatal factors showed an independent association with asthma in the study population: the odds ratio …
Abstract 18959: Minimally Invasive CABG: Results to 6 years
Authors: Joseph T McGinn, Masood Shariff, Harry Lapierre, Benjamin Sohmer, Nikhil Goyal, Marc Ruel
Journal: Circulation (2012)

OBJECTIVE: To evaluate the longitudinal outcomes of minimally invasive CABG (MICS CABG). METHODS: We prospectively followed 800 consecutive patients who underwent MICS CABG, performed through a 4-6 cm thoracotomy in the left 5th intercostal space. During MICS CABG, the left internal thoracic artery was harvested under direct vision with long instruments, proximal anastomoses were handsewn onto the ascending aorta after mobilizing it in a stepwise fashion, and all myocardial territories were accessed for distal anastomoses by using an apical positioner and/or epicardial stabilizer. All operations were performed by either one of two surgeons. Mean follow-up was 2.2 years (maximum 6.4 years). RESULTS: Mean patient age was 63.5 ± 10.8 years and 197 patients were female (24.6%). A mean of 2.2 ± 0.8 grafts were performed. Peripheral cardiopulmonary bypass assistance was used in 77 patients (9.6%). There were 25 (3.1%) conversions to sternotomy, and 26 (2.7%) reoperations for bleeding. New onset atrial fibrillation occurred in 187 (23.4%). Overall, the median hospital length of stay was 4 days, and perioperative mortality was 1.0% (8/800). No deep wound infection occurred. At 2 years postoperatively, mid-term survival after MICS CABG was 98.0 ± 0.7%, and 22 patients (2.8%) had undergone percutaneous coronary reintervention. CONCLUSIONS: These results indicate that MICS CABG constitutes a feasible and increasingly established minimally invasive alternative for patients in need of multivessel CABG. It is associated with a short hospital length of stay, no deep wound infections, and is a safe, reproducible operation yielding survival and durability results in par with that of conventional CABG.
Abstract 827: High Serum Level of Neopterin Is a Risk Factor of Patients with Heart Failure
Authors: Toshiki Sasaki, Yasuchika Takeishi, Tetsuro Shishido, Tetsu Watanabe, Joji Nltobe, Takuya Miyamoto, Takehiko Miyashita, Satoshi Nishiyama, Isao Kubota
Journal: Circulation (2008)

Neopterin is produced by activated monocytes/macrophages, and serum neopterin concentrations reflect the level of oxidative stress. We assessed the hypothesis that serum neopterin is a risk factor for heart failure and predicts adverse clinical outcomes in patients with heart failure. Serum neopterin concentration was measured in 198 patients with heart failure and 62 control subjects by a competitive enzyme-linked immunosorbent assay. Patients were prospectively followed during a median follow-up period of 745 days with end points of cardiac death or re-hospitalization due to progressive heart failure. Serum concentration of neopterin was significantly higher in New York Heart Association (NYHA) Class III/IV patients than in NYHA class I/II patients (P &lt; .001). From the receiver operating characteristic (ROC) curve analysis, the cut-off value of serum neopterin level was determined as 10 nmol/L. Kaplan-Meier analysis clearly demonstrated that the high neopterin group had a significantly higher incidence of cardiac events than occurred in the low neopterin group (P &lt; .0001). Patients were divided into 4 groups based on the serum neopterin levels, the highest 4th quartile was associated with the highest risk of cardiac events (11.1-fold compared with 1st quartile). In the multivariate Cox analysis, serum neopterin concentration was an independent risk factor for cardiac events (hazard ratio 1.70, 95% confidence interval 1.16–2.50, P = 0.0068). Serum neopterin concentration is an independent prognostic factor for heart failure, and may be useful for risk stratification of patients with heart failure.
泌尿外科学基础知识（一）：泌尿系统评估
Authors: Hugh, Whitfield, Chris, Dawson, 杨勇（译）
Journal: BMJ (2006)

需要去全科医师或泌尿外科专科医师处就诊的、最常见的泌尿系统主诉可分为两类，一类与下尿路相关，另一类与上尿路相关。尽管对于。肾绞痛或睾丸扭转这类患者，根据一份详尽的病史就可能作出诊断，但多数临床症状为非特异性的，很难进行合理的解释。
Abstract P19: Feasibility Of Transnasal Cooling Without Airway Protection During Cardiopulmonary Resuscitation
Authors: Giuseppe Ristagno, Denise Barbut, Jun H Cho, Shijie Sun, Max H Weil, Wanchun Tang
Journal: Circulation (2008)

Objectives.  The present study investigated the feasibility of transnasal cooling during CPR with chest compressions (CC) only, without airway protection or ventilation in a porcine model of cardiac arrest. We hypothesized that transnasal cooling during CPR without airway protection or ventilation would not affect resuscitation and survival.   Materials and methods.  Ventricular fibrillation (VF) was electrically induced and untreated for 7 min in domestic male pigs. Continuous CC were then delivered for 5 min prior to defibrillation. At the onset of CC, animals were subjected to transnasal cooling with the BeneChill device, which sprays oxygen and liquid coolant PFC into the nasal cavity. No airway protection or ventilation were established. Immediately after return of spontaneous circulation (ROSC), animals were intubated and ventilated. Arterial PO 2  was continuously monitored. Animals survived 96 hrs.   Results.  All animals were successfully resuscitated with a CPR duration of 317 ± 24 sec and following a single defibrillation attempt. Arterial PO 2  was 105 ± 3 mmHg at baseline, 85 ± 14 mmHg after 7 min of untreated VF and 233 ± 169 mmHg after the 5 min of unventilated CC with cooling (PR in Table). FiO2 was 100% post-ROSC and was progressively tapered to 21% over 3.5 ± 2 hrs. PFC was aspirated during chest compression and confirmed radiologically. Subsequent respiratory care included positive pressure ventilation with low tidal volume and prone position for 8 ± 4 hrs. There were no adverse respiratory effects. Animals were successfully extubated. At 24 and 96 hrs, all animals were breathing normally.   Conclusions.  In this model, transnasal cooling during CPR with chest compressions only and without airway protection or ventilation is feasible for oxygenation, resuscitation and survival.
Abstract 1298: Adipocytes Produce The Angiogenesis Inhibitor, Soluble Fms-like Tyrosine Kinase (sflt-1)
Authors: Florian Herse, Lydia Hering, Juergen Janke, Kerstin Gorzcelniak, Stefan Engeli, Nina K Harsem, Friedrich C Luft, Anne C Staff, Dominik N Mueller, Ralf Dechend
Journal: Circulation (2007)

Vascular endothelial growth factor (VEGF) exerts its effects via receptors, including Flt-1. sFLT-1 is a soluble splice variant that binds VEGF locally so that the molecule cannot signal; sFLT-1 is implicated in preeclampsia, a condition associated with obesity. Adipose tissue has a dense vascular network regulated in part by LYVE-1-expressing macrophages and VEGF. The role of sFLT-1 in adipose tissue angiogenesis has not been investigated. We used RT-PCR and found that sFlt-1 was 2.6-fold upregulated in adipose tissue from preeclamptic women, 2.5-fold in decidua, and 6.9-fold in placenta. Circulating sFlt-1 was 2.4-fold elevated (all compared to pregnant nonpreeclamptic controls; p&lt;0.05). We next cultured human preadi-pocytes and adipocytes to examine sFlt-1 and VEGF. sFlt-1 expression increased 9-fold as preadipocytes matured to adipocytes. Adipocytes actively secreted sFlt-1 into the supernatant. Hypoxia (O2 tension reduced to 3%) did not alter sFlt-1 mRNA, while VEGF expression increased 4-fold. Tumor necrosis factor (TNF)- α (100 ng/ml, 48 h) induced VEGF 2-fold, but reduced sFlt-1 production 4-fold. Angiotensin II, insulin, hydrocortisone, pioglitazone, and 17β-estradiol all had no influcence on adipocyte sFlt-1 expression. In fat tissue biopsies from 69 postmenopausal women, sFlt-1 correlated inversely with BMI (r=-0.36, p=0.002), but directly with adiponectin expression (r=0.33, p=0.01). No significant correlation was found to blood pressure, insulin, or microalbuminuria. Our study shows that sFlt-1 is elevated in the circulation, placenta, and is upregulated in adipose tissue from preeclamptic women. sFlt-1 is expressed and secreted by adipocytes. sFlt-1 is elevated during fat cell differentiation and downregulated by TNF-α. In healthy postmeonopausal women, adipose tissue sFlt-1 correlates with low BMI and high adiponectin expression. We speculate that secreted sFlt-1 from adipocytes may contribute to the vascular damage during preeclampsia. Furthermore, sFlt-1 may play a regulatory role in adipose tissue under other circumstances, perhaps as an angiogenesis regulating factor.
Abstract 16143: Limited Value of Traditional Restenosis Predictors after Recurrent Drug-eluting Stent Failure
Authors: Gabriel Maluenda, Itsik Ben-Dor, Michael A Gaglia, Michael Mahamoudi, Kohei Wakabayashi, Manuel A Gonzalez, Adrian D Margulies, Rebecca Torguson, Zhenyi Xue, William O Suddath, Nelson L Bernardo, Lowell F Satler, Kenneth M Kent, Augusto D Pichard, Ron Waksman
Journal: Circulation (2010)

Background: Therapeutic options to treat in-stent restenosis (ISR) after initial therapy with a drug-eluting stent (DES) include repeat DES implantation, vascular brachytherapy (VBT) or conventiona...
Abstract 798: Ca <sup>2+</sup> Sparks are Modulated by the Mitochondrial Energy State
Authors: Lufang Zhou, Miguel A Aon, Brian O’Rourke
Journal: Circulation (2007)

Mitochondria produce reactive oxygen species (ROS) but are also a target of oxidative stress that can induce rapid oscillations of mitochondrial inner membrane potential (ΔΨ m ). The proximity of mitochondria to SR Ca 2+ release sites suggests that the mitochondrial energy state will determine the local redox and energetic status of the Ca 2+ handling subsystem. Because ryanodine receptors, SERCA, and L-type Ca 2+ channels are all sensitive to ATP, Mg 2+ and thiol oxidation, we investigated whether laser flash-triggered mitochondrial ΔΨ m oscillations influence resting Ca 2+ spark frequency in fluo-4 + TMRE-loaded cardiomyocytes using two-photon microscopy to monitorΔΨ m , cytosolic [Ca 2+ ], and [NADH]. The correlation between resting Ca 2+ spark frequency and ΔΨ m was analyzed over several cycles of ΔΨ m oscillation in each cell. Notably, Ca 2+ spark frequency increased with ΔΨ m depolarization and decreased withΔΨ m repolarization, indicative of close coupling between energetics and Ca 2+ cycling (See Figure ). Moreover, spontaneous Ca 2+ waves were often observed when mitochondria were depolarized but not whenΔΨ m recovered. There were no significant effects on Ca 2+ spark durations or rise times. In conclusion, the results show that stress-induced mitochondrial depolarization (involving NADH oxidation, ROS release, and depletion of glutathione) leads to increased Ca 2+ spark frequency, most likely as a result of modification of the local redox status near the dyad. These findings provide important insights into the connection between metabolism and Ca 2+ cycling in the heart with relevance to the mechanism of contractile and electrical dysfunction in cardiac disease states.
Abstract 2311: The Complete Supraannular Concept - In-vivo Hemodynamics of Bovine and Porcine Aortic Bioprostheses
Authors: Daniel J Ruzicka, Walter B Eichinger, Ina M Hettich, Andrea Hutter, Sabine Bleiziffer, Catalin C Badiu, Robert Bauernschmitt, Ruediger Lange
Journal: Circulation (2008)

Complete supraannular placement of an aortic bioprosthesis is one approach to optimize the hemodynamic result of an aortic valve replacement. It is achieved with the combination of a special valve design and the supraannular sewing technique with non-everted mattress sutures. We evaluated five bioprostheses designed for complete supraannular placement to assess potential hemodynamic differences due to other factors (e.g. valve material) than implantation position. In 336 patients (mean age 72.0 ± 7.1 years; 143 females) hemodynamics including mean pressure gradients (MPG), effective orifice areas (EOA), and indices (EOAi) and incidence of patient-prosthesis-mismatch (PPM) were evaluated 6 months postoperatively. Annulus diameter was measured intraoperatively. Patients received the CE Perimount Magna (Magna n = 169), Medtronic Mosaic (Mosaic n = 46), Mosaic Ultra (Ultra n = 17), SJM Epic Supra (n = 46) and the Sorin Soprano (Soprano n = 58). MPG, EOA and EOA i for all patients divided by annulus size groups are presented in table 1 . Severe PPM was observed more frequently in patients with the Mosaic (12/46; 26.1%) and Ultra (3/17; 17.6%) prostheses. Complete supraannular placement cannot prevent high pressure gradients or patient-prosthesis-mismatch thoroughly, but the choice of a bovine prosthesis can optimize hemodynamic performance.
Improved survival for stage III/IV melanoma from an unknown primary site (MUP): An Italian multicentric study.
Authors: M. Guida, A. Muggiano, D. Albano, R. Ridolfi, A. Testori, V. Chiarion-Sileni, M. R. Sertoli, A. Romanini, G. Parmiani, G. Colucci
Journal: Journal of Clinical Oncology (2010)

e19025 Background: MUP are estimated to comprise between 3.7% and 6% of all melanomas. It represents an interesting phenomenon not clearly explained yet and also its natural history is controversial. One commonly accepted theory is that an unrecognized primary lesion has undergone spontaneous regression mediated by a strong endogenous immune response. The need to clarify this disparity prompted us to analysed our experience. Methods: We reviewed retrospectively database of several melanoma Italian centres from 1991 to 2009 and all pts with MUP were identified and analysed. Pts characteristics (age, sex, PS), MUP characteristics (tumor-involved basin and number of involved nodes for stage III; LDH level, sites and number of metastatic sites for stage IV) and clinical outcomes were recorded and estimated. Approval for the study was obtained from the local ethical committee. Results: 94 pts with MUP were globally identified, 54 diagnosed in stage III (1 LN 15 pts, 1-3 LN 17 pts, > 3 LN 17 pts, unknown 5 pts) and 40 in stage IV (M1a 6 pts, M1b 4 pts, M1c 30 pts). For stage III, the median OS was 55 months, and the 2-year and 5-year OS rates were 90 % and 54%, respectively. For stage IV, the response rate was 45% and the OS was 22 months (1-year and 2-year OS rates 80% and 40%, respectively). For stage III, the OS was inversely correlated with the number of LN involved and for stage IV with the M1 category and with the number of metastatic sites. Conclusions: 94 pts with MUP were globally identified, 54 diagnosed in stage III (1 LN 15 pts, 1-3 LN 17 pts, > 3 LN 17 pts, unknown 5 pts) and 40 in stage IV (M1a 6 pts, M1b 4 pts, M1c 30 pts). For stage III, the median OS was 55 months, and the 2-year and 5-year OS rates were 90 % and 54%, respectively. For stage IV, the response rate was 45% and the OS was 22 months (1-year and 2-year OS rates 80% and 40%, respectively). For stage III, the OS was inversely correlated with the number of LN involved and for stage IV with the M1 category and with the number of metastatic sites. No significant financial relationships to disclose.
Long-term Effect of 1-Piece and 3-Piece Hydrophobic Acrylic Intraocular Lens on Posterior Capsule Opacification
Authors: Christina Leydolt, Sofija Davidovic, Stefan Sacu, Rupert Menapace, Thomas Neumayer, Ana Prinz, Wolf Buehl, Oliver Findl
Journal: Ophthalmology (2007)
Abstract 15774: Red Cell Distribution Width Relates to Exercise Capacity in Chronic Heart Failure but Provides Prognostic Information Incremental to Peak Oxygen Consumption
Authors: Nabeela Zaman, Anthony J Barron, Roland Wensel, Charlotte Manisty, Martin Thomas, Simon Woldman, Jamil Mayet, Darrel P Francis, Darlington O Okonko
Journal: Circulation (2011)

Background: Red cell distribution width (RDW), an index of the variability in size of circulating erythrocytes, is a surrogate of many aberrations (iron deficiency, inflammation, oxidative stress) ...
Challenges in diagnosing extrapulmonary tuberculosis in the European Union, 2011
Authors: I Solovic, J Jonsson, M Korzeniewska- Koseła, D I Chiotan, A Pace-Asciak, E Slump, R Rumetshofer, I Abubakar, S Kos, P Svetina-Sorli, W Haas, T Bauer, A Sandgren, M J van der Werf
Journal: Eurosurveillance (2013)

In the European Union (EU) 72,334 tuberculosis (TB) cases were notified in 2011, of which 16,116 (22%) had extrapulmonary tuberculosis (EPTB). The percentage of TB cases with EPTB ranged from 4% to 48% in the reporting countries. This difference might be explained by differences in risk factors for EPTB or challenges in diagnosis. To assess the practices in diagnosis of EPTB we asked European Union/European Economic Area (EU/EEA) countries to participate in a report describing the diagnostic procedures and challenges in diagnosing EPTB. Eleven EU Member States participated and reports showed that in the majority EPTB is diagnosed by a pulmonologist, sometimes in collaboration with the doctor who is specialised in the organ where the symptoms presented. In most countries a medical history and examination is followed by invasive procedures, puncture or biopsy, to collect material for confirmation of the disease (by culture/histology/cytology). Some countries also use the tuberculin skin test or an interferon-gamma-release-assay. A wide variety of radiological tests may be used. Countries that reported challenges in the diagnosis of EPTB reported that EPTB is often not considered because it is a rare disease and most medical professionals will not have experience in diagnosing EPTB. The fact that EPTB can present with a variety of symptoms that may mimic symptoms of other pathologies does pose a further challenge in diagnosis. In addition, obtaining an appropriate sample for confirmation of EPTB was frequently mentioned as a challenge. In summary, diagnosis of EPTB poses challenges due to the diversity of symptoms with which EPTB may present, the low level of suspicion of clinicians, and due to the difficulty in obtaining an adequate sample for confirmation.
Abstract 2092: Effect Of Recipient Genotype On Donor Cardiac Allograft Function In Children And Young Adults
Authors: Scott R Auerbach, Cedric Manlhiot, Sushma Reddy, Marc Richmond, Dorota Gruber, Brian McCrindle, Jonathan M Chen, Linda J Addonizio, Wendy K Chung, Seema Mital
Journal: Circulation (2007)

Background The renin-angiotensin-aldosterone (RAAS) and adrenergic receptor (ADR) genotypes affect cardiac function in heart failure. It is not known if recipient genotype affects function of the transplanted heart. We investigated the influence of recipient RAAS or ADR genotype on cardiac function and outcomes after transplant (Tx). Methods Patients (Pts) &lt; 25 yrs old, post cardiac Tx, were enrolled (2003–06) and genotyped for polymorphisms in genes associated with RAAS upregulation (ACE-D, AGTR1-C, AGT-G, CYP11B2-G and CMA1-A) and β-ADR downregulation (β1Arg389 and β2Gly16). Hetero- or homozygosity for the high risk allele was considered a high-risk genotype. Univariate associations between genotypes and incidence of rejection, cardiac dysfunction (hemodynamic/echocardiographic), graft vasculopathy (GV), death and reTx were assessed via logistic or linear regression models with time dependent models as needed. Results Of 222 pts transplanted, 107 pts were studied. Age at Tx was 8.4±6.8 yrs (follow-up, 6.3±5.3 yrs; 42% male). The high risk allele frequency was: ACE 51%, AGTR1 23%, AGT 59%, CYP 35%, CMA 42%, β1Arg389 74% and β2Gly16 37% (in Hardy-Weinberg equilibrium). During follow-up, 81% pts had rejection, 51% graft dysfunction, 13% developed GV, 7% died and 8% were re-transplanted. 24% pts were receiving ACE/Angiotensin receptor inhibitors and 5% were receiving β-blockers at 5 yrs post-Tx. The presence of a high risk AGT or AGTR genotype was associated with greater severity of graft dysfunction at last follow-up (p=0.05), elevated CVP and PA pressures (p&lt;0.001) and higher mortality. ADR genotype had no effect on outcomes. Cumulatively, a higher number of homozygous high risk RAAS genotypes was associated with a higher incidence of rejection (Hazard ratio/HR,1.3), graft dysfunction (HR,1.5) and higher probability of death (HR,2.5) (p&lt;0.05). Conclusion RAAS polymorphisms in the recipient are associated with higher mortality after cardiac Tx possibly related to greater impairment of graft function with rejection. Whether wider use of RAAS inhibitors in this high risk cohort can improve outcomes after Tx requires further investigation. The lack of effect of the ADR genotype may relate to sympathetic denervation of the transplanted heart.
Abstract 3666: Major Role of Ly6chi/7/4hi/ccr2+ Monocytes in Post-ischemic Neovascularization
Authors: Clément Cochain, Mathieu Rodéro, José Vilar, Céline Loinard, Alice Récalde, Yasmine Zouggari, Micheline Duriez, Bernard Lévy, Ziad Mallat, Christophe Combadière, Jean-Sébastien Silvestre
Journal: Circulation (2008)

Circulating mouse monocytes consist of two main subsets, Ly6CHi7/ 4HiCCR2+CX3CR1loCCR5+ and Ly6Clo7/4loCCR2-CX3CR1HiCCR5+ monocytes.We sought to investigate their respective role in postischemic neovascularization and unravel the mechanisms involved in their recruitment to ischemic tissues. Postischemic neovascularization was impaired in MCP-1−/− or CCR2−/− but not in CCR5−/− or CX3CR1−/− mice with operatively-induced hindlimb ischemia (n=10 per groups). Overexpression of MCP-1 in the ischemic muscle by plasmid electrotransfer improved foot perfusion, angiographic score and capillary density by 1.4-, 1.8- and 1.4-fold, respectively (p&lt;0 .01 versus control). In contrast, overexpression of Fractalkine or Rantes, the ligands of CX3CR1 and CCR5 respectively, had no significant effects (n=10 per groups) suggesting that recruitment of 7/4HiCCR2+ monocytes play a significant role in this setting. In this line, flow cytometry analysis revealed that monocytes infiltration in ischemic muscle peaked at day 3 and dropped to levels comparable to those in non ischemic muscle on day 7. 7/4Hi monocytes predominated from day 1 to day 3 (52% of infiltrated Cd11b+ cells) whereas 7/4lo prevailed from day 7 onward. MCP-1 or CCR2 deficiency fully abrogated infiltration of both monocytes subsets, while overexpression of MCP-1 in the ischemic muscle selectively increased 7/4Hi monocytes infiltration (287% of wild-type, p&lt;0.05). In contrast, monocytes subsets infiltration was slightly reduced in CX3CR1−/− mice (p&lt;0.05 versus MCP-1−/−) and unchanged in CCR5−/− mice. Interestingly, MCP-1 deficiency or upregulation also led to changes in monocyte subtypes levels in both bone marrow and blood. MCP-1/CCR2 signaling plays a major role in monocytes mobilization from the bone marrow and recruitment to the ischemic tissue. We also suggest that inflammatory 7/4Hi/CCR2 monocytes represent a major component of the inflammatory response in post-ischemic neovascularization.