tbuckley/cabot-search huggingface dataset:
The use of non-invasive ventilation after liver transplantation in pediatric patients: Changes in the need for reintubation
Authors: Kimihiko Murase, Chihara Yuichi, Chikara Yoshimura, Tomohiro Handa, Toru Oga, Hajime Segawa, Michiaki Mishima, Kazuhiko Fukuda, Shinji Uemoto, Kazuo Chin
Journal: European Respiratory Journal (2011)

Introduction & aim:  The role of non-invasive ventilation (NIV) in preventing reintubation after abdominal surgery in paediatric patients is uncertain and should be investigated.   Method:  Our team has performed more than 700 liver transplantations (LT) for pediatric patients since 1990. Beginning in 2005 we began full introduction of NIV to these patients from 2005. We screened all medical records of pediatric patients less than 12 years old who underwent LT during two 4-year periods: 2001-2004 (pre full introduction of NIV) and 2006-2009 (post full introduction of NIV) and retrieved data on cases at high risk of respiratory failure. Data and clinical outcome for these cohorts were retrospectively analyzed and compared.   Results:  Included in the analysis were 54 cases (53 patients) from the pre-NIV period and 29 cases (28 patients) from the post-NIV period. After full introduction of NIV, NIV was applied more frequently within one week after extubation in these patients (16/54 cases (29.6%) vs. 22/29 cases (75.9%), p   Conclusion:  NIV is an acceptable method of respiratory management of pediatric patients undergoing LT. NIV may also stabilize their respiratory condition and decrease the need for reintubation after scheduled extubation.
More than 50% of patients visit a general practitioner (GP), general physician (Gen P) or a pediatrician (P) in India for respiratory symptoms: Results of a one-day point-prevalence study in 2,04,912 patients across 22 states and 5 union territories in India
Authors: Komalkirti Apte, Monica Barne, Sapna Madas, Jaideep Gogtay, Sushmeeta Chhowala, Nadar Mahajan, Sundeep Salvi
Journal: European Respiratory Journal (2012)

A better understanding of the disease pattern and symptoms for which a patient visits a doctor will help design appropriate health care management strategies. This study was aimed to investigate the symptoms for which a patient visits a general healthcare provider in India using a 1-day point-prevalence cross-sectional study design. Method: 13,225 practicing GPs, Gen Ps and Ps, randomly selected from 880 cities and towns in India based on a proportionate random sampling strategy were invited to participate in this study. On 1st February 2011, all participating doctors completed a questionnaire based on the validated ICD-10 classification, wherein they captured age, gender and symptoms of all patients who visited their clinic. Data was collected, cleaned and entered in Epi Info software and simple descriptive analysis was performed. Results: A total of 2,04,912 patients visited 7400 doctors who consented and gave clean data. Amongst these, 50.6% presented with respiratory symptoms (31.8% cough, 15.8% rhinitis, 9.4% sore throat, 8.4% wheeze and 6.9% breathlessness), 25% presented with gastrointestinal symptoms, 18% cardiovascular, 5% dermatology and 3% for endocrine related symptoms/diagnosis. These observations were generally uniform across 22 states and 5 union territories in India with no hot spot regions. Conclusion: Respiratory symptoms account for over 50% of symptoms for which a patient visits a doctor in India, which extrapolates to at least 20 million patient visits for respiratory symptoms every day in India.
Selective Mobilization of Specifically Cytotoxic T-Lymphocytes at Sites of Inflammation in Relation to BCG-Induced Resistance to Implants of Syngeneic Sarcoma in Mice 2
Authors: Iris B. Parr, Elizabeth Wheeler, Peter Alexander
Journal: JNCI Journal of the National Cancer Institute (1977)

The heightened and long-persisting resistance of BCG-immunized C57BLt6 mice (10-week-old males and females) to challenge with syngeneic sarcoma cells was largely restricted to the site of inoculation of the BCG. The specific cytotoxicity of peritoneal T-cells and the total number of T-cells that could be recovered from the peritoneal cavity were more than ten times greater in mice that had received BCG ip 2-4 weeks prior to inoculation of tumor than in non-BCG-treated mice. The specific T-cell-mediated cytotoxic potential of the peritoneal exudate of mice immunized with tumor was therefore at least 100 times greater in mice that had received BCG ip. This effect was detectable by 3 days after inoculation of BCG and reached a maximum 2-4 weeks later. The protection against tumor offered by pretreatment with BCG could be explained by the selective recruitment of committed T-lymphocytes to sites of chronic inflammation. The induction of nonspecifically cytotoxic macrophages and systemic changes such as generalized stimulation of the reticuloendothelial system were not contributing factors.
Chitinase 3–like–1 and its receptors in Hermansky-Pudlak syndrome–associated lung disease
Authors: Yang Zhou, Chuan Hua He, Erica L. Herzog, Xueyan Peng, Chang-Min Lee, Tung H. Nguyen, Mridu Gulati, Bernadette R. Gochuico, William A. Gahl, Martin L. Slade, Chun Geun Lee, Jack A. Elias
Journal: Journal of Clinical Investigation (2015)

Hermansky-Pudlak syndrome (HPS) comprises a group of inherited disorders caused by mutations that alter the function of lysosome-related organelles. Pulmonary fibrosis is the major cause of morbidity and mortality in patients with subtypes HPS-1 and HPS-4, which both result from defects in biogenesis of lysosome-related organelle complex 3 (BLOC-3). The prototypic chitinase-like protein chitinase 3–like–1 (CHI3L1) plays a protective role in the lung by ameliorating cell death and stimulating fibroproliferative repair. Here, we demonstrated that circulating CHI3L1 levels are higher in HPS patients with pulmonary fibrosis compared with those who remain fibrosis free, and that these levels associate with disease severity. Using murine HPS models, we also determined that these animals have a defect in the ability of CHI3L1 to inhibit epithelial apoptosis but exhibit exaggerated CHI3L1-driven fibroproliferation, which together promote HPS fibrosis. These divergent responses resulted from differences in the trafficking and effector functions of two CHI3L1 receptors. Specifically, the enhanced sensitivity to apoptosis was due to abnormal localization of IL-13Rα2 as a consequence of dysfunctional BLOC-3–dependent membrane trafficking. In contrast, the fibrosis was due to interactions between CHI3L1 and the receptor CRTH2, which trafficked normally in BLOC-3 mutant HPS. These data demonstrate that CHI3L1-dependent pathways exacerbate pulmonary fibrosis and suggest CHI3L1 as a potential biomarker for pulmonary fibrosis progression and severity in HPS.
Doctors and scientists urge Wellcome Trust to divest from fossil fuels
Authors: Z. Kmietowicz
Journal: BMJ (2015)

More than 50 senior doctors and academics have signed a letter to the Wellcome Trust urging it to support action on climate change by pulling all of its investments from the world’s 200 largest fossil fuel companies over the next five years.

The call is part of the Guardian newspaper’s “Keep it in the ground” campaign, launched in March this year. The campaign recognises that to avoid the mean global temperature rising by more than 2°C, 80% of known coal reserves will have to stay underground, along with half the gas and a third of the oil reserves.1

The Guardian said that more than 200 institutions, worth over $50bn (£31.8bn; €44.7bn), have committed to divesting from fossil fuels—including universities, …
Maintaining a good ventilatory efficiency in the transition between normoxia (N) and hypoxia (H) at rest predicts a better oxygenation (SaO2) during exercise in hypoxia
Authors: Giovanni Papi Renzetti, Guido Giardini, Gaia Mandolesi, Bruna Catuzzo, Annalisa Cogo
Journal: European Respiratory Journal (2014)

Ventilatory efficiency in hypoxic conditions can be defined as the amount of ventilation (VE) required to achieve a given level of SaO2. Index of ventilatory efficiency (IE) is the ratio SaO2/VE corrected by height. A good IE has been proved advantageous during exposure to high altitude (1). Moreover, a ventilatory pattern characterized by low respiratory rate (RR) and high tidal volume (VT) for the same amount of VE is associated to better SaO2 (2). We tested the ventilatory adaptation in relation to SaO2 in 36 mountain guides (M, age 29-57) at rest in N and at rest and during exercise in H simulating 4500m (Altitrainer, Simtec, CH; Quark, COSMED, I) ). For each frame we calculated the mean value of VE, VT, RR and the IE. Data during exercise refer to the same work intensity. As expected, VE increased and SaO2 decreased in H vs. N, changing further during exercise. According to the difference in IE between N and H at rest (ΔSaO2/VE) we divided the subjects into 4 groups: High Efficiency (IE = + 1.36), Moderate (-1.16), Mild (-3) and Low (-5.4). In group High, the SaO2 during exercise is higher than in group Low (76.8 vs. 64.66 p = 0.027) with a significantly greater increase in VT as compared to RR for the same increase in VE. A significant correlation is found between the ΔSpO2/VE at rest and the oxygen desaturation during exercise in H (r=0.46 p=0.005). We conclude that subjects with a better IE at rest in H, spontaneously adopting slower and deeper ventilation have the capability to maintain a better oxygenation during exercise in H.  1) Bernardi L, Eur J Appl Physiol 2007 2) Bernardi L J Hypertens, 2001.
FGL2 as a Multimodality Regulator of Tumor-Mediated Immune Suppression and Therapeutic Target in Gliomas
Authors: Jun Yan, Ling-Yuan Kong, Jiemiao Hu, Konrad Gabrusiewicz, Denada Dibra, Xueqing Xia, Amy B. Heimberger, Shulin Li
Journal: JNCI Journal of the National Cancer Institute (2015)

Fibrinogen-like protein 2 (FGL2) may promote glioblastoma multiforme (GBM) cancer development by inducing multiple immune-suppression mechanisms.The biological significance of FGL2 expression was assessed using the The Cancer Genome Atlast (TCGA) glioma database and tumor lysates analysis. The therapeutic effects of an anti-Fgl2 antibody and the role of immune suppression regulation by Fgl2 were determined in immune-competent, NOD-scid IL2Rgammanull (NSG), and FcɣRIIB-/- mice (n = 3-18 per group). Data were analyzed with two-way analysis of variance, log-rank survival analysis, and Pearson correlation. All statistical tests were two-sided.In low-grade gliomas, 72.5% of patients maintained two copies of the FGL2 gene, whereas 83.8% of GBM patients had gene amplification or copy gain. Patients with high levels of FGL2 mRNA in glioma tissues had a lower overall survival (P = .009). Protein levels of FGL2 in GBM lysates were higher relative to low-grade glioma lysates (11.48±5.75ng/mg vs 3.96±1.01ng/mg, P = .003). In GL261 mice treated with an anti-FGL2 antibody, median survival was 27 days compared with only 17 days for mice treated with an isotype control antibody (P = .01). The anti-FGL2 antibody treatment reduced CD39(+) Tregs, M2 macrophages, programmed cell death protein 1 (PD-1), and myeloid-derived suppressor cells (MDSCs). FGL2-induced increases in M2, CD39, and PD-1 were ablated in FcɣRIIB-/- mice.FGL2 augments glioma immunosuppression by increasing the expression levels of PD-1 and CD39, expanding the frequency of tumor-supportive M2 macrophages via the FcγRIIB pathway, and enhancing the number of MDSCs and CD39(+) regulatory T cells. Collectively, these results show that FGL2 functions as a key immune-suppressive modulator and has potential as an immunotherapeutic target for treating GBM.
Capillary protein leak syndrome appears to explain fluid retention in cancer patients who receive docetaxel treatment.
Authors: K A Semb, S Aamdal, P Oian
Journal: Journal of Clinical Oncology (1998)

The aim of our study was to elucidate whether the fluid retention syndrome induced by docetaxel is caused by capillary protein leakage or by other mechanisms.Twenty-four patients with advanced or metastatic non-small-cell lung cancer (NSCLC; 23 patients) or metastatic head and neck cancer (one patient) were included on this prospective, nonrandomized trial. Docetaxel 100 mg/m2 was administered every 3 weeks with 5 days of dexamethasone prophylaxis to avoid hypersensitivity reactions and edema formation. Transcapillary forces, ie, colloid osmotic pressure of plasma (COPpl) and interstitial fluid (COPint) and interstitial hydrostatic pressure (Pint), were measured before the start of treatment and after total docetaxel doses of 200 and 500 mg/m2 by means of the well-documented wick and wick-in-needle methods. Body weight, degree of edema, blood pressure, and heart rate and hemoglobin, hematocrit, albumin, and total protein values were registered in parallel.After a total docetaxel dose of 200 mg/m2, COPpl, COPint, and hemoglobin, hematocrit, albumin, and total protein values had decreased significantly; Pint and body weight were unchanged; and only mild edema was observed. These findings suggest a plasma volume increase followed by enhanced fluid filtration to the interstitium. After a cumulative docetaxel dose of 500 mg/m2, the COPpl continued to decrease significantly, but COPint remained unchanged despite a significant increase in mean body weight and edema formation. These observations support the theory of a capillary protein leakage.Docetaxel appears to induce an initial enhancement of fluid filtration followed by a capillary protein leakage that leads to edema formation.
Performance of activities of daily living as a predictor of rehospitalization for patients following an exacerbation of COPD
Authors: Brian Carlin, Dan Easley, Kim Wiles
Journal: European Respiratory Journal (2012)

Purpose: To evaluate the rehospitalization rates for patients with COPD using performance of activities of daily living (ADLs) as a metric marker.  Method: The Discharge, Assessment, and Summary @ Home (D.A.S.H., Klingensmith HealthCare, Ford City, Pennsylvania) program is a respiratory therapist driven home care based program for patients with COPD who are using supplemental oxygen following discharge from the hospital following a COPD exacerbation. The program includes the performance of four patient selected ADLs (e.g walking the four points of the home, loading the dishwasher) on days #1, #7, and #30 post-hospitalization. Oxygen saturation is maintained above 90% using a SmartDose Oxygen delivery system. Each ADL is measured as either fully completed or not.  Results: A total of 229 patients were entered into the study and had four ADLs performed at each of the three visits. 9% (23/229) of the patients were readmitted to the hospital within a 30 day period. Of those, 8 (3.5%) were readmitted with a COPD exacerbation and 15 (6.6%) were readmitted for other reasons. For those patients who performed 1 or less of 4 ADLs (n=42) to completion by day #7 of the program, 8 (19%) were readmitted while for those patients who could perform 2 or more ADLs (n=187) to completion, 15 (8%) readmitted.  Conclusions: Those patients with COPD who were oxygen dependent following hospital discharge for an exacerbation of COPD who could perform one or less ADLs to completion by 7 days following discharge have a higher 30 day readmission rate to the hospital than those who could perform 2 or more ADLs to completion.
Pazopanib for Metastatic Soft Tissue Sarcoma (Sts) with or Without Denosumab
Authors: H. Narahara, K. Yasuda, K. Morita, N. Dan, R. Takeda, Y. Takeda, K. Yanagawa, J. Fukushima, H. Matsumoto, K. Matsunaga, S. Ueda, Y. Yasunaga, Y. Inui, S. Kawata, M. Yamamura, K. Takahashi
Journal: Annals of Oncology (2014)
Puncture Wounds of the Foot: Can Infective Complications Be Avoided?
Authors: A Pennycook, R Makower, A-M O'Donnell
Journal: Journal of the Royal Society of Medicine (1994)

The bacteriological flora of the foot and shoe was studied concurrently in 200 volunteers without foot injuries, and 80 patients with puncture wounds of the foot. Seven of 28 child patients developed clinical infections, three with Pseudomonas aeruginosa. Eleven of 52 adult patients also developed infections. No patients developed infection if oral antibiotics were given within the first 24 h after injury (P < 0.05). Oral antibiotic prophylaxis is recommended for puncture wounds of the foot.
Spatiotemporal Evolution of the Primary Glioblastoma Genome
Authors: Jinkuk Kim, In-Hee Lee, Hee Jin Cho, Chul-Kee Park, Yang-Soon Jung, Yanghee Kim, So Hee Nam, Byung Sup Kim, Mark D Johnson, Doo-Sik Kong, Ho Jun Seol, Jung-Il Lee, Kyeung Min Joo, Yeup Yoon, Woong-Yang Park, Jeongwu Lee, Peter J Park, Do-Hyun Nam
Journal: Cancer Cell (2015)
The Effect of State Policies on Organ Donation and Transplantation in the United States
Authors: Paula Chatterjee, Atheendar S. Venkataramani, Anitha Vijayan, Jason R. Wellen, Erika G. Martin
Journal: JAMA Internal Medicine (2015)

Shortages in transplantable solid organs remain a critical public health challenge in the United States. During the past 2 decades, all states have implemented policies to increase organ supply, although their effectiveness is unknown.To determine the effects on organ donation and transplantation rates of state policies to provide incentives for volunteer donation.Using a quasi-experimental design and difference-in-differences regression analyses, we estimated the effect of policies in all 50 states and the District of Columbia on organ donors per capita and the number of transplantations from January 1, 1988, to December 31, 2010. Analyses were also stratified by type of donor (living vs deceased). Data were derived from the United Network for Organ Sharing. All data collection occurred between July 7 and September 27, 2013.Policies of interest were the presence of first-person consent laws, donor registries, dedicated revenue streams for donor recruitment activities, population education programs, paid leave for donation, and tax incentives. Information on states' passage of various policies was obtained from primary legislative and legal sources.The number of organ donors and transplantations per state, per year, during the study period.From 1988 to 2010, the number of states passing at least 1 donation-related policy increased from 7 (14%) to 50 (100%). First-person consent laws, donor registries, public education, paid leave, and tax incentives had no robust, significant association with either donation rates or number of transplants. The establishment of revenue policies, in which individuals contribute to a protected state fund for donation promotion activities, was associated with a 5.3% increase in the absolute number of transplants (95% CI, 0.57%-10.1%; P = .03). These associations were driven by a 4.9% increase in organ donations (95% CI, 0.97%-8.7%; P = .01) and an 8.0% increase in transplants (95% CI, 3.1%-12.9%; P = .001) from deceased donors as opposed to changes among living donors or transplants from living donors.Nearly all state-level policies to encourage organ donation have had no observable effect on the rate of organ donation and transplantation in the United States. The one exception was the establishment of revenue policies to promote organ donation, which may have led to small increases in organ donations and transplantations from deceased donors. New policy designs are needed to increase donation rates and curtail the widening gap between organ supply and demand.
Multicycle High-Dose Chemotherapy and Filgrastim-Mobilized Peripheral-Blood Progenitor Cells in Women With High-Risk Stage II or III Breast Cancer: Five-Year Follow-Up
Authors: Russell L. Basser, L. Bik To, John P. Collins, C. Glenn Begley, Dorothy Keefe, Jonathan Cebon, John Bashford, Simon Durrant, Jeffrey Szer, Dusan Kotasek, Christopher A. Juttner, Ian Russell, Darryl W. Maher, Ian Olver, William P. Sheridan, Richard M. Fox, Michael D. Green
Journal: Journal of Clinical Oncology (1999)

PURPOSE: To determine the safety and efficacy of multiple cycles of dose-intensive, nonablative chemotherapy in women with poor-prognosis breast cancer. PATIENTS AND METHODS: Women with stage II breast cancer and 10 or more involved nodes or four or more involved nodes and estrogen receptor–negative tumors and women with stage III disease received three cycles of epirubicin 200 mg/m 2 and cyclophosphamide 4 g/m 2 , with progenitor cell and filgrastim support every 28 days (n = 79) or 21 days (n = 20). Patients were reviewed at least twice yearly thereafter. Twenty-six patients had bone marrow and apheresis collections assessed for the presence of micrometastatic tumor cells. RESULTS: Ninety-nine women (median age, 43 years; range, 24 to 60 years) were treated. Ninety-two completed all three cycles of chemotherapy. The major toxicity was severe, reversible myelosuppression that was more prolonged with successive cycles, and this did not differ between patients given treatment every 28 days and those treated every 21 days. Febrile neutropenia occurred in 176 (61%) of 287 cycles. Severe mucositis (grade 3 or 4) occurred in 23% of cycles but tended to be short-lived and was reversible. The cardiac ejection fraction fell by a median of 4% during treatment, and three patients developed evidence of cardiac failure after chemotherapy. Two patients (2%) died of acute toxicity. Three of 26 patients had evidence of circulating micrometastatic tumor cells. The actuarial distant disease-free and overall survival rates at 60-month follow-up were 64% (95% confidence interval [CI], 53% to 75%) and 67% (95% CI, 56% to 78%), respectively. CONCLUSION: Multiple cycles of dose-intensive, nonablative chemotherapy is a feasible and safe approach. Disease control and survival are similar to those in other studies of myeloablative chemotherapy in poor-prognosis breast cancer. The regimen is being evaluated in a randomized trial of the International Breast Cancer Study Group.
Inspiratory muscle strength and endurance in patients with COPD: A propose outcome with manovacuometry and PowerBreathe®
Authors: Renata Basso, Eloisa Regueiro, Valéria Pires Di Lorenzo, Mauricio Jamami, Dirceu Costa
Journal: European Respiratory Journal (2011)

Background:  Reduced respiratory muscle force and endurance are commonly observed in patients with COPD and contributes to dyspnea, oxygen desaturation and reduced exercise capacity, hence respiratory muscle assessment is clinically relevant.   Aim:  To propose an assessment method of respiratory muscle endurance in patients with COPD and to verify it relationship with maximal inspiratory pressure (MIP) and maximal voluntary ventilation (MVV).   Method:  18 patients (GOLD 1-4; 63±9years) performed the MIP and an incremental and constant respiratory muscle endurance test using the PowerBreathe® device. The incremental test started with 10cmH2O, increasing 10cmH2O each 2min, with 1min of rest between them, which determined the maximal pressure sustained (MPS). The endurance test was 80% of the MPS. The limit time (tlim) was determined. Comparisons and correlations were determined using Paired t-test and Pearson correlation.   Results:  The MIP was 52±20cmH2O, MVV (%pred) 44±15, MPS 48±23cmH2O, tlim 10±8 min and 80%MPS 35±21cmH2O. The MIP and MPS were not different. Correlation was found between MIP and MPS (r=0.5; p=0.03) and MIP and MVV (r=0.6; p=0.03).   Conclusion:  The MPS and MIP were similar in the endurance test and showed a relationship with MVV; with suggest to be a reasonable test to assess the respiratory performance in these patients.  Funding: CAPES - Brazil