tbuckley/cabot-search huggingface dataset:
Assessing asthmatic patients' satisfaction with inhalation devices
Authors: Eleftherios Zervas, Mina Gaga, Katerina Athanassiou, Katerina Papataxiarchou, Nikolaos Grekas
Journal: European Respiratory Journal (2012)

INTRODUCTION : Patients9 satisfaction with their asthma medication devices is usually decided by using properly designed questionnaires. These questionnaires are to be used to evaluate patients9 opinion, which is considered important for the selection of a device.   OBJECTIVES : The aim of this study was to reliably estimate the ease of use and the satisfaction of asthmatic patients with different marketed dry powder inhalers (DPIs). Feeling of satisfaction with inhalers (FSI-10) questionnaire was selected as the appropriate measuring tool.   METHODS : A four week, open, non-interventional, multicenter, parallel study, was performed. 560 asthmatic patients (355 women), aged 19 to 97 years, participated in three groups using different DPIs (Elpenhaler®, Turbuhaler® and Diskus®). Demographics of the groups were comparable. Patients had already achieved mastery of their inhalers, were receiving their asthma treatments exclusively via the inhaled route and agreed to complete the questionnaire in the second visit. They were recruited in 79 private medical offices and hospital centers all over Greece.   RESULTS : 523 participants completed the study and the questionnaire. Although consistent and satisfactory results were obtained with all DPIs tested, certain statistically significant differences in the ratings between the devices were observed (Elpenhaler® was rated first in 7 out of 10 questions, having also the highest mean total score). No significant differences in scores from patients of different ages were observed in any of the tested devices.   CONCLUSIONS : Certain statistically significant differences were found in ratings between the tested DPIs. Devices were similarly acceptable to adult patients of different ages.
Pediatric desmoid tumor: retrospective analysis of 63 cases.
Authors: L B Faulkner, S I Hajdu, U Kher, M La Quaglia, P R Exelby, G Heller, N Wollner
Journal: Journal of Clinical Oncology (1995)

This study was conducted to evaluate clinical prognostic factors predictive of the probability of recurrence of desmoid tumor (DT).Sixty-three patients with histologically confirmed diagnosis of DT were retrospectively studied. Median age at diagnosis was 13 years. Patient distribution by site was as follows: 61% extremities, 18% head and neck, 13% trunk (including 5% intraabdominal), and 8% multicentric lesions. All patients had partial or complete resections; 20 patients also received radiotherapy and/or chemotherapy.At a median follow-up time of 6 years since first treatment, the overall actuarial probability of having one or more recurrences was 75%. Age, sex, site, size, or number of previous recurrences had no significant impact on the likelihood of recurrence. The only factor associated with an increased proportion of recurrence-free patients was a negative margin of resection (70% v 15% with positive margins; P = .006). Of the four patients with more than 3 years follow-up since chemotherapy, two recurred, and of the 11 patients with the same follow-up after radiotherapy, four recurred, including two of five patients who received a dose of 50 Gy or more. No deaths directly related to tumor invasion were observed.A surgical approach aiming at clear margins is presently the best treatment option. When this cannot be accomplished without severe disfigurement or function impairment, partial resection is an acceptable alternative, but one associated with a high risk of regrowth. Whether adjuvant strategies should be used in this situation remains to be addressed.
Exercise increases the hydrogen peroxide release in exhaled breath condensate
Authors: Eike Maximilian Marek, Juliane Volke, Wolfgang Marek, Petra Platen
Journal: European Respiratory Journal (2012)

Background: Exhaled breath condensate (EBC) contains numerous mediators of oxidative stress (NO, H 2 O 2 ). Exercise is characterised by an increase of reactive oxygen species (ROS), which can also be found in EBC. Building of hydrogen peroxide (H 2 O 2 ) can be induced by ROS. In order to get inside into the correlation of H 2 O 2  release in EBC and exercise, we investigated H 2 O 2  release at rest and at different levels of exercise.  Methods: 20 healthy subjects, (23.3±1.5 years), were investigated, during resting conditions as well as at 60%, 75%, and 90% of maximal work capacity(p max ) (each lasting 5 minutes) on a cycle ergometer. 100 L exhaled air along with capillary blood samples were collected under stationary load conditions. EBC was obtained by cooling the exhaled air volume to -20°C. H 2 O 2  was analyzed using the EcoCheck device (EcoCheck, FILT). H 2 O 2  was analyzed using the EcoCheck device (EcoCheck, FILT). In further analysis the release per minute and the release for the total amount of water from 100 L exhaled breath were calculated.  Results: At rest H 2 O 2  concentration in EBC was 216±52 nmol/L, H 2 O 2  release in the collected EBC was 115±45 pmol/min. At 60%, 75% and 90% of p max , H 2 O 2  concentration in EBC increased to 288±80, 322±71, 334±95 nmol/L (p 2 O 2  release increased to 160±75, 250±88 and 357±162 pmol/min (p 2 O 2  release and ventilation can be described by r=0.8.  Conclusions: In healthy subjects, a nearly 3-fold increased of H 2 O 2  release in EBC was found during exhausting exercise. The elevated levels of H 2 O 2  may be interpreted as an increase of ROS during exhausting exercise.
Abstract 4132: Do N-3 Polysunsaturated Fatty Acids Reduce Risk of Sudden Cardiac Death and Ventricular Arrhythmias? A Meta-analysis of Randomized Trials
Authors: Marcin Kowalski, Ernesto Eusebio, David N Kenigsberg, Sanjaya Khanal
Journal: Circulation (2006)

Introduction: N-3 polyunsaturated fatty acids (PUFA) have been demonstrated to have antiarrhythmic properties. However, randomized studies have shown inconsistent results. Objective: We performed a...
Rapidly Growing, Painful Nodule on the Upper Cutaneous Lip
Authors: Audrey Dean, Hagger Ali, Christina Cernik
Journal: JAMA Dermatology (2015)

A 41-year-old woman presented with a rapidly growing, painful nodule on her upper cutaneous lip (Figure, A) as well as several smaller papules on her face and neck, all of which had developed within the preceding 6months. She was otherwise asymptomatic. The patient’s medical history included diabetes mellitus type 2, hypercholesterolemia, hypertension, and depression. Review of her family medical history revealed that her paternal grandfather died from melanoma and that her father died from colon cancer. She stated that most of the men in her family had died from some form of cancer by the fourth decade of life. On physical examination, a tender, centrally depressed, firm, pink 1.1-cm nodule was present on her upper cutaneous lip (Figure, A). Three other skin-colored to pink papules werepresentonher faceandneck.Shavebiopsiesofall4skin lesionswereperformed(Figure, B and C). Quiz at jamadermatology.com Clinical image A Specimen from upper cutaneous lip B
Abstract 219: Obligatory Role of Nrf2-Dependent Upregulation of Extracellular Superoxide Dismutase in Cardioprotection Afforded by Heme Oxygenase-1 Gene Therapy
Authors: Qianhong Li, Yiru Guo, Wei Tan, Qinghui Ou, Wen-Jian Wu, Diana Sturza, Gregg D Rokosh, Xiaoqin Lu, Roberto Bolli
Journal: Circulation (2006)

Upregulation of HO-1 leads to elevated expression of Ec-SOD, a major defense of cellular armamentarium against excess levels of ROS, which in turn protects against myocardial ischemic injury. Howev...
The contribution of lung hyperinflation to the reproducibility of arterial stiffness measurements in COPD: A comparison of techniques
Authors: Ian S. Stone, Steffen E. Petersen, Neil C. Barnes
Journal: European Respiratory Journal (2013)

Introduction Raised arterial stiffness may explain the cardiovascular morbidity in COPD. Studies report that certain interventions may impact on this surrogate endpoint despite lacking reproducibility data in COPD, who may have large intra-thoracic pressure swings with variations in the pulse wave. Aims 1. To compare pulse wave velocity (PWV) and augmentation index (AI) between cuff-based operator-independent (Vicorder) and tonometric (SphymoCor) devices 2. Assess the effect of lung hyperinflation (LH) on measurement variabililty in COPD. Methods Between October 2011 and August 2012 repeat measurements of PWV and AI were made on 33 consecutive COPD patients. (Age 67.5±8.2 years, FEV1 52.9±19.0% and Residual Volume (RV) 157.5±47.7% predicted) prospectively recruited from an inner-city teaching hospital outpatients. Results Comparing devices Vicorder recorded lower values (PWV mean = 9.1 m/s, bias = - 0.64±1.00 m/s, p=0.02; AI mean = 24.0±7.6%, bias = -4.0±7.2 %, p=0.002). There was however, a strong linear relationship (PWV r = 0.76 p<0.001; AI r = 0.56, p = 0.01) with Bland-Altman plots confirming satisfactory agreement (PWV Co-efficient of variation (COV) = 11 %, limits of agreement (LOA) = -2.66 - + 1.38 m/s; AI COV = 30 %, LOA = -18.4 – 10.4 %). Path length and transit time differences, although strongly correlated, contributed to variability of PWV and AI whereas LH (as measured by RV, total lung capacity, or the ratio of inspiratory capacity to residual volume) did not. Conclusion Measurement of PWV in COPD is highly reproducible, not affected by lung hyperinflation, and a suitable surrogate endpoint in trials.
Geographical variation in the risk of childhood pneumonia and relationships to socio-economic and health deprivation
Authors: MF Thomas, AP Blain, Mdf Shirley, C Simmister, MA Elemraid, R Gorton, Pearce, JE Clark, SP Rushton, DA Spencer
Journal: European Respiratory Journal (2011)

Introduction:  Socio-economic deprivation is a recognised risk factor for childhood pneumonia, while the relevance of health deprivation is unknown. The aim of this study was to establish whether there is significant spatial variation in risk of childhood pneumonia and whether this risk was determined by health and socio-economic deprivation.   Methods:  Data on childhood hospital admissions in NE England from May 1997- April 2007 (0-14 years) with a diagnosis of bacterial or lobar pneumonia were extracted from the Hospital Episode Statistics database. The spatial unit was a postcode district, which was linked with data from the health and socio-economic domains of the UK Child Wellbeing Index. Bayesian convolution models were used to model the association between standardised relative risk of admission to hospital with pneumonia in postcode districts and the deprivation indicators.   Results:  There were 3874 admissions. From a total of 116 districts, 53 had a significantly different relative risk (RR) using a 95% Bayesian confidence interval (BCI) than that predicted by population alone (31 lower risk, 22 higher risk). The lowest RR was 0.32 and the highest 2.34. When the deprivation indices were included, the median effect of health deprivation was 0.43 (95% BCI 0.27-0.58). The model using only health deprivation provided the best explanation for the data (Deviance Information Criterion for null model 749.68 vs. 744.08 for health deprivation model).   Conclusions:  There is substantial variation in the relative risk of pneumonia in different areas of NE England. Health deprivation better explains the spatial variation in risk than socio-economic deprivation.
CD4 T Lymphocyte–mediated Lung Disease
Authors: Dunja Bruder, Astrid M. Westendorf, Robert Geffers, Achim D. Gruber, Marcus Gereke, Richard I. Enelow, Jan Buer
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

Although considerable evidence indicates a role for CD4(+) T lymphocytes (T cells) in airway inflammation, little data exist regarding the mechanisms underlying the induction and regulation of CD4(+) T cell reactivity to lung-specific antigens. To dissect the immunologic and molecular mechanisms of CD4(+) T cell dysregulation, reactivity to a self-antigen expressed in the lung of mice bearing a major histocompatibility complex class-II-restricted T cell receptor specific for this antigen was studied. Transgenic mice developed a progressive interstitial pneumonitis characterized by massive lymphocytic and plasmacytic infiltration of interalveolar septa, a clinical picture closely resembling some of the interstitial lung diseases. Pulmonary inflammation reached a plateau state in older mice with prominent formation of lymphoid follicles but reduced interstitial infiltration. Extensive immunologic characterization of self-reactive CD4(+) T cells isolated from the inflamed lung suggested the induction of regulatory T cells in the site of inflammation. Moreover, inflammation was accompanied by broad changes in the gene expression pattern toward a profile partially resembling that of activated, but strikingly, also that of regulatory CD4(+) T cells. Together our data provide important insights into functional and molecular alterations being associated with the induction and/or regulation of T cell-mediated pulmonary inflammation.
A prospective study of low pressure non invasive ventilation (NIV) in management of type 2 respirtory failure with acute exacerbation of COPD with comorbidities
Authors: Ravindra Kedia, Patel Prashant, Bloor Michelle, Jo Simcock
Journal: European Respiratory Journal (2011)

Introduction:  NIV has shown to improve the in hospital mortality and morbidity associated with AECOPD with type 2 respiratory failure. BTS recommends in NIV guidelines (2009) to increase the ventilatory pressure as much possible in first hours of initiation of NIV to correct the acid base imbalance. it is recognised that some patients with COPD and comorbidities are intolerant of high pressure and associated air leak with poor compliance with pressure support. In a prospective study we assessed the patient tailored approach with low pressure NIV by Bipap in ward setting in these patients   Method:  All patients admitted with type 2 respiratory failure with AECOD with comorbidities who require NIV tranferred to ward based NIV unit. Patient condition was assessed by medical specialist and a patient tailored approach with gradual and low pressure ventilation was inititiated by trained NIV team.   Results:  Results are summarised in the table.   Conclusion:  In this small prospective observational study low pressure NIV in patient with AECOPD with comorbidities and type 2 respiratory failure has shown to improve the morbidity and mortality and patient compliance. We recommend that use of low pressure NIV in these cohort of patients is a safe and alternative approach. This should be further assessed in a proper randomised controlled trial with conventional approach as recommended by BTS.
Clonal typing of P.aeruginosa strains in non-CF bronchiectasis
Authors: Máire Drain, Lan Wei, Deirdre Gilpin, Michael Tunney, Dervla Kenna, Stuart Elborn
Journal: European Respiratory Journal (2012)

Introduction

P.aeruginosa is the most clinically significant infecting organism in non-CF bronchiectasis.

Aims and Objectives

To determine the whether there are clonal strains within the non-CF bronchiectasis population in Northern Ireland.

Methods

In total 50 P.aeruginosa isolates from 26 patients were analyzed by pulse field gel electrophoresis (PFGE).

Results

There were 10 individual strains identified by PFGE band pattern after DNA macrorestriction. 5/50 isolates were unique novel strains from 5 separate individuals. There were two dominant strains in this cohort. BELFCITPA-1 in 14/50 isolates in 5 patients. 12/50 isolates in 7 patients were identified as BELFCITPA-5. Stable patients were found to have one strain per sample whereas there was greater diversity within the samples collected from patients with an exacerbation, 1.25 strains on average.

ConclusionThere are a number of common strains of P.aeruginosa found in the sputum of non-CF bronchiectasis patients. Although there are at least 2 clonal strains identified in this small cohort, it is unclear whether this is because they are common environmental strains in the region or because of cross-infection between individuals.
Detection of Metastatic Tumors in Nude Mice: Brief Communication2
Authors: Sam D. Graham, Don D. Mickey, David F. Paulson
Journal: JNCI Journal of the National Cancer Institute (1978)

Homozygous nude (nu/nu) mice were inoculated ip with either highly malignant human bladder transitional cell carcinoma or human prostate adenocarcinoma. These animals were subsequently given injections of normal human T-lymphocytes to restore the known T-lymphocyte deficiency present in homozygous nude mice. Metastatic spread of the prostate and bladder carcinomas was evident In mice given human T-lymphocytes. Although tumor growth was observed at the sites of tumor inoculation, no tumor spread was observed in mice not receiving T-lymphocytes.
Rationale for Specific Immunotherapy of Grass Pollen Allergy with Extracts of Rye Pollen
Authors: H. Løwenstein, J.‐Å. Wihl, K. Bache Billesbølle, H. Bøwadt
Journal: Allergy (1984)

In immunotherapy of grass pollen allergy, an extract of rye ( Secale cerebale ) is often included. The aim of this study was to investigate by skin prick test (SPT) and immunochemical methods whether rye pollen contains specific allergens justifying the use of this extract separately. Twenty grass pollen allergic patients were skin prick tested with a dialysed freeze‐dried raw extract of rye pollen (Sc), timothy extract (Soluprick® SQ, 1 HEP) and two other rye extracts (Soluprick®). Sera from the patients were RAST‐tested using Sc and timothy (Pp). CRIE was performed using Sc and rabbit‐anti grass (aNG) antibodies. The antigenic relations between rye and common grasses were investigated by CLIE using Sc and aNG as references, and by RAST inhibition. The ability of aNG to absorb the allergen activity of Sc was also tested. Significant correlations were found between timothy and rye when compared by means of SPT and RAST. The immunochemical analyses did not reveal any rye antigens containing rye epitopes only. However, the possibility of rye antigens with several epitopes, of which at least one is specific for rye, could not be excluded. Clinical symptoms supposedly elicited by rye alone can be explained quantitatively by the strongly time‐limited and concentrated natural exposition. Diagnosis and treatment can, however, be performed with extracts of common grasses.
Persistent strains of coagulase-negative staphylococci in a neonatal intensive care unit: virulence factors and invasiveness
Authors: C. Klingenberg, A. Rønnestad, A.S. Anderson, T.G. Abrahamsen, J. Zorman, A. Villaruz, T. Flægstad, M. Otto, J. Ericson Sollid
Journal: Clinical Microbiology and Infection (2007)
Mechanisms and Consequences of Cancer Genome Instability: Lessons from Genome Sequencing Studies
Authors: June-Koo Lee, Yoon-La Choi, Mijung Kwon, Peter J. Park
Journal: Annual Review of Pathology Mechanisms of Disease (2016)

During tumor evolution, cancer cells can accumulate numerous genetic alterations, ranging from single nucleotide mutations to whole-chromosomal changes. Although a great deal of progress has been made in the past decades in characterizing genomic alterations, recent cancer genome sequencing studies have provided a wealth of information on the detailed molecular profiles of such alterations in various types of cancers. Here, we review our current understanding of the mechanisms and consequences of cancer genome instability, focusing on the findings uncovered through analysis of exome and whole-genome sequencing data. These analyses have shown that most cancers have evidence of genome instability, and the degree of instability is variable within and between cancer types. Importantly, we describe some recent evidence supporting the idea that chromosomal instability could be a major driving force in tumorigenesis and cancer evolution, actively shaping the genomes of cancer cells to maximize their survival advantage.
Congenital tracheal diverticulum seen in adult age: Two cases
Authors: Aykut Eliçora, Serife Tuba Liman, Salih Topçu, Asli Gül Akgül, Hasan Tahsin Sarisoy, Sevtap Gümüstas, Seymur Salih Mehmetoglu, Ahmet Ilgazli
Journal: European Respiratory Journal (2011)

Tracheal diverticulum is a very rare entity. Congenital ones appear 4-5 cm below the vocal cords and in right lateral wall of trachea. Usually diagnosed incidentally. We present here two tracheal diverticulum diagnosed incidentally.

Case 1: A 65-year old male patient was admitted to our clinic with back ache and cough. The CT scan of the chest showed posterior mediastinal mass and tracheal diverticulum which was in the middle of trachea at posterolateral wall. Fiberoptic bronchoscopy demonstrated the communication between the trachea and the diverticulum. The patient was operated because of posterior mediastinal mass, not considered for tracheal diverticulum.

Case 2: A 51-year-old male patient was admitted to clinic of nephrology with chronic renal failure. The patient was referred to our clinic with dyspne. The CT scan of the chest showed pleural effusion and a tubular air-filled structure, which was adjacent to the posterolateral wall of the trachea at the level of thoracic inlet. Fiberoptic bronchoscopy demonstrated a communication between trachea and diverticulum. The patient was treated conservative management with antibiotics and bronchodilators.

![Figure][1] 



Treatment options of tracheal diverticulum include surgical resection and conservative management. Treatment options change depending on the patient's symptoms, age and physical state. Surgery is recommended for symptomatic patients, conservative medical treatment for elderly and debilitated patients.

 [1]: pending:yes
Efficacy and safety of laparoscopic Toupet fundoplication surgery in lung transplant recipients
Authors: Pauline Badrignans, Olivier Risse, Michele Fior-Gozlan, Caroline De Traversay-Leroy, Sebastien Quetant, Christel Saint-Raymond, Bruno Bonaz, Jean Boutonnat, Hubert Roth, Christophe Pison, Boubou Camara
Journal: European Respiratory Journal (2014)

Introduction: Fundoplication for gastro-esophageal reflux disease (GERD) may improve lung function and survival in lung transplant (LT) recipients, but morbidity and effects remain to be better reported.

Methods: Data were collected between 2002 and 2013 in 25 consecutive LT recipients who underwent fundoplication. Esophageal Impedance, pH studies and lipophage index (LI) in BAL were conducted before and after surgery.

Results: 25 LT recipients, 68% males, 44.9±16.6 years old, 11 cystic fibrosis, 6 COPD, 3 bronchiectasis, 2 pulmonary hypertension and 2 pulmonary fibrosis patients, had fundoplication for digestive symptoms of GERD (n=10, 40%), high LI in BAL (n=4, 16%), suspected cases of lung allograft dysfunction (n=7, 28%), and abnormal pH studies without digestive symptoms (n=4, 16%). Before surgery, 20/24 (83%) patients had pathological pH studies, 8/25 (32%) had abnormal impedance measurement and median \[min-max] of LI in BAL was 9 [0-228]. Laparoscopic Toupet fundoplication was performed with 3 conversions in laparotomy. The median of hospital stay was 4 days [2-7]. After surgery, 0/22 patient had abnormal pH studies and 0/21 had abnormal impedance measurement. There was a significant improvement in reflux symptoms after surgery for all patients who had fundoplication for digestive symptoms. FEV1 increases from 2.57±0.99 L, 79.2±25.6% pred. to 2.82±0.98 L (p=0.0009) and 87.2±23.6% (p=0.002), BMI was unchanged and median of LI decreased from 9 to 8 [0-91\] (p=0.59).

Conclusion: Our results show that laparoscopic fundoplication for GERD is safe in LT recipients and significantly improve FEV1. Outcomes of LI in BAL need to be further studied after fundoplication.