Bibliographic record
Abstract
In the review article by Dr. Kostopanagiotou et al. (1) concerned with transplant recipients undergoing non-transplant surgery, it is indicated that “neostigmine usually has no effect in the denervated heart.” This opinion, espoused in many earlier reviews on pharmacological considerations of the transplanted heart, has little evidence to support it. I wish to challenge this opinion which continues to be expressed despite recent evidence to the contrary. Neostigmine produces a dose-dependent, atropine-sensitive reduction in heart rate in cardiac transplants, and patients who have received transplants more than six months before the administration of neostigmine may be particularly sensitive to its bradycardic effect (2–4). Edrophonium also evokes a reduction in heart rate in cardiac transplants, although the magnitude of the bradycardia is smaller and less variable (5). Animal studies suggest anticholinesterases produce bradycardia in the denervated heart by their direct stimulation of cholinergic receptors in the peripheral cardiac parasympathetic pathway or by their anticholinesterase action, which protects the hydrolysis of acetylcholine tonically released from cardiac parasympathetic postganglionic cells (6,7). I believe the anticholinesterase effects on the transplanted heart are not merely curiosities without clinical significance. A case report attributes bradycardia and cardiac arrest in two cardiac transplant patients to the parasympathomimetic effects of neostigmine (8). These findings have prompted us to caution that when administering anticholinesterases to heart transplant patients, a muscarinic antagonist should always be coadministered to block the cardiac and other muscarinic side effects (9). S. B. Backman MDCM, PhD, FRCPC
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".