tbuckley/cabot-search huggingface dataset:
High amylase activity in pleural fluid and primary bronchogenic adenocarcinoma
Authors: O Devuyst, M Lambert, J M Scheiff, J Francart
Journal: European Respiratory Journal (1990)

We report a case of primary bronchogenic adenocarcinoma, complicated by pleural effusion, in which very high pleural amylase activity was found, whilst serum amylase was normal. Isoamylase determination showed a salivary-type amylase. Concerning the origin of this enzyme, ultrastructural study of the malignant cells obtained from the pleural fluid suggested a local amylase synthesis. The pathophysiological significance of electron-dense granules found in these cells is also discussed.
Use of beta-agonist therapy prior to hospital attendance for severe exacerbations of asthma
Authors: Mitesh Patel, Janine Pilcher, Robert Hancox, Davitt Sheahan, Dominick Shaw, Mark Weatherall, Richard Beasley
Journal: European Respiratory Journal (2013)

Background  Patterns of use of inhaled beta-agonist therapy during severe exacerbations prior to hospital attendance are poorly understood.  Aims  An exploratory analysis of data from a six-month clinical trial in 303 adult asthma patients randomised to combination budesonide/formoterol inhaler as part of a single maintenance and reliever therapy regimen (‘SMART’) or fixed-dose budesonide/formoterol with salbutamol as reliever (‘Standard’).  Methods  Patterns of beta-agonist use for the 14 days before hospital attendance were determined by electronic monitoring of inhaler use.  Results  Electronic data were available for 7/7 and 9/11 hospital attendances in SMART and Standard respectively. The median (min,max) daily number of actuations 14 days prior to hospital attendance was 4 (2,12) budesonide/formoterol in SMART and 4 (0,26) salbutamol and 2 (0,8) budesonide/formoterol in Standard. This increased to 11 (6,39) budesonide/formoterol in SMART and 25 (3,86) salbutamol and 4 (0,39) budesonide/formoterol in Standard, in the 24-hours before attendance. The median (min,max) maximum daily number of actuations was 14 (9,63) budesonide/formoterol in SMART and 46 (6,95) salbutamol in Standard with 4 (0,10) budesonide/formoterol actuations on the day of maximal salbutamol use. Repeated days of no inhaled corticosteroid (ICS) use occurred in 3/9 patients on Standard therapy, despite marked salbutamol use.  Conclusions  Very high doses of beta-agonist are commonly self-administered by patients without seeking medical review prior to hospital presentation with severe asthma. The SMART regimen reduced non-adherence with ICS therapy during severe exacerbations.  Funding  Health Research Council of New Zealand.
Late mortality of long-term survivors of childhood cancer.
Authors: M M Hudson, D Jones, J Boyett, G B Sharp, C H Pui
Journal: Journal of Clinical Oncology (1997)

PURPOSE To determine the frequency and patterns of late mortality among long-term survivors of childhood cancer. MATERIALS AND METHODS Medical records of patients who survived at least 5 years after the diagnosis of childhood cancer were reviewed to determine the causes of subsequent deaths. Estimated 15-year survival and standardized mortality ratios for deaths from nonneoplastic treatment complications were compared with adjusted United States population estimates. The study included 2,053 patients who had survived &gt; or = 5 years, grouped by treatment eras that reflected increased intensity of therapy and significantly improved survival (early era, 1962 to 1970; recent era, 1971 to 1983). RESULTS There have been 258 subsequent deaths in the 2,053 childhood cancer survivors; 169 occurred 5 to 10 years postdiagnosis and 89 &gt; or = 10 years post diagnosis. For the study period as a whole, deaths were attributed to recurrent primary malignancy in 61% of cases, second malignancy in 20%, nonneoplastic treatment complication in 10%, and unintentional injury/suicide in 8%. Late death from recurrent disease decreased significantly for survivors treated in the recent era (P &lt; .0001), while the risk of death from second malignancies increased, although not statistically significantly (P = .10). Projected 15-year survival estimates for all &gt; or = 5-year survivors in both treatment eras was greater than 90%, but differed from expected rates. CONCLUSION Late mortality from recurrence after treatment for childhood cancer decreases with more effective initial therapy. Prolonged disease-free status is associated with an expected survival that approaches that of the general population for patients treated from 1971 through 1983. The impact of more recent intensified and novel therapies for high-risk patients remains to be determined.
Cyclic Nucleotide Levels in Mouse Mammary Epithelial Cells During Growth Arrest and Growth Initiation in Culture 2
Authors: Eugene F. Howard, David F. Scott, John O. Manter
Journal: JNCI Journal of the National Cancer Institute (1977)

Intracellular levels of cyclic AMP (cAMP) and cyclic GMP (cGMP) were measured in high and low tumorigenic mouse mammary epithelial cells during growth arrest in 1% fetal bovine serum and during the first 60 minutes after serum stimulation of cell proliferation in arrested cultures. Stationary MCG-T14 cells, which are highly tumorigenic and grow to high densities in 1% serum, exhibited lower levels of cAMP, higher levels of cGMP, and a lower ratio of cAMP to cGMP than quiescent MCG-V14 cells, which have low tumorigenicity and achieve low cell densities in 1% serum. Within 5–10 minutes after cell growth was initiated in arrested cultures by the addition of serum, both cell lines responded with a fourfold to fivefold increase in cGMP and a concomitant 50% decrease in cAMP. MCG-T14 cells exhibited the highest intracellular levels of cGMP and the lowest cAMP to cGMP ratio within 10 minutes after serum addition.
Unilateral lung infiltrate. Lipoid pneumonia
Authors: KK Guntupalli, PB Francis
Journal: European Respiratory Journal (1991)

A case of unilateral lipoid pneumonia, proven by alveolar lavage and transbronchial lung biopsy, is presented. Following a stroke, which resulted in difficulty in swallowing, the patient slept only on his right side accounting for the unilateral lung infiltrate. He had been taking mineral oil for several years accounting for the lipoid pneumonia.
Rates of Kidney Transplantation From Living and Deceased Donors for Blacks and Whites in the United States, 1998 to 2011
Authors: Akshay Sood, Newaj M. Abdullah, Firas Abdollah, Marwan S. Abouljoud, Quoc-Dien Trinh, Mani Menon, Jesse D. Sammon
Journal: JAMA Internal Medicine (2015)

This database review found that by 2010 the incidence of kidney transplantation for black and white patients with end-stage renal disease was equivalent, but kidney transplants from living donors were 43.2% for whites and only 22.2% for blacks.
Reversal of apnoea by aspiration reflex in anaesthetized cats
Authors: Z Tomori, R Benacka, V Donic, R Tkacova
Journal: European Respiratory Journal (1991)

Various flow and timing characteristics of breathing as well as electrocorticographic (ECoG) records were analysed in a model of reversible respiratory failure induced by N2 inhalation in 27 anaesthetized cats. During the first minute of respiratory arrest, nasopharyngeal stimulation by an elastic nylon fibre elicited a typical sniff- or gasp-like aspiration reflex (in 88.8% of cases), whilst similar tracheobronchial irritation evoked a weak cough reaction in one third of cases (34.2%). The aspiration reflex could also be evoked in progressive stages of apnoea characterized by very low and even isoelectric ECoG activity immediately before imminent irreversible respiratory failure, and it could interrupt and replace the periodic gasping sometimes occurring during apnoea. The reflex, comprising powerful inspiration efforts, could be evoked during apnoea many times in succession. Repeated aspiration reflexes alone resulted in recovery from hypoxic apnoea with gradual normalization of ECoG and subsequent restitution of spontaneous breathing even more frequently than it occurred in periodic gasping. Successful resuscitation from hypoxic apnoea by the aspiration reflex in cats suggests that nasopharyngeal stimulation can affect the mechanisms underlying the failure and restitution of breathing at least in some forms of apnoea.
Fecal Microbiota Transplantation for <i>Clostridium difficile</i> Infection
Authors: Dimitri Drekonja, Jon Reich, Selome Gezahegn, Nancy Greer, Aasma Shaukat, Roderick MacDonald, Indy Rutks, Timothy J. Wilt
Journal: Annals of Internal Medicine (2015)

The role of fecal microbiota transplantation (FMT) for Clostridium difficile infection (CDI) is not well-known.To assess the efficacy, comparative effectiveness, and harms of FMT for CDI.MEDLINE (1980 to January 2015), Cochrane Library, and ClinicalTrials.gov, followed by hand-searching references from systematic reviews and identified studies.Any study of FMT to treat adult patients with CDI; case reports were only used to report harms.Data were extracted by 1 author and verified by another; 2 authors independently assessed risk of bias and strength of evidence.Two randomized, controlled trials (RCTs); 28 case-series studies; and 5 case reports were included. Two RCTs and 21 case-series studies (516 patients receiving FMT) reported using FMT for patients with recurrent CDI. A high proportion of treated patients had symptom resolution; however, the role of previous antimicrobials is unclear. One RCT comparing FMT with 2 control groups (n = 43) reported resolution of symptoms in 81%, 31%, and 23% of the FMT, vancomycin, or vancomycin-plus-bowel lavage groups, respectively (P < 0.001 for both control groups vs. FMT). An RCT comparing FMT route (n = 20) reported no difference between groups (60% in the nasogastric tube group and 80% in the colonoscopy group; P = 0.63). Across all studies for recurrent CDI, symptom resolution was seen in 85% of cases. In 7 case-series studies of patients with refractory CDI, symptom resolution ranged from 0% to 100%. Among 7 patients treated with FMT for initial CDI, results were mixed.Most studies were uncontrolled case-series studies; only 2 RCTs were available for analysis.Fecal microbiota transplantation may have a substantial effect with few short-term adverse events for recurrent CDI. Evidence is insufficient on FMT for refractory or initial CDI treatment and on whether effects vary by donor, preparation, or delivery method.U.S. Department of Veterans Affairs.
High versus Low PEEP in ARDS
Authors: Alexandre T Rotta
Journal: New England Journal of Medicine (2004)

to the editor: I wonder how the results of the National Heart, Lung, and Blood Institute ARDS Clinical Trials Network study (July 22 issue) 1 would have looked if the recruitment maneuvers had been performed in all 276 patients who were assigned to a higher positive end-expiratory pressure (PEEP). These patients had a clinical outcome similar to that in the lower-PEEP group, although they had less favorable baseline characteristics (older age, a lower ratio of the partial pressure of arterial oxygen to the fraction of inspired oxygen [PaO 2 :FiO 2 ], a higher rate of primary acute respiratory distress syndrome [ARDS] or acute lung injury [i.e., that due to pneumonia or aspiration], and a higher Acute Physiology, Age, and Chronic Health Evaluation score). The investigators stopped using the maneuvers after the first 80 patients because the “subsequent mean increase in arterial oxygenation was small and transient.” Is it correct, however, to assess the validity of this decision simply on the basis of a possible improvement in oxygenation? Improved oxygenation depends not only on an increase in aerated lung regions but also on ventilation–perfusion matching and other factors. An improved clinical outcome probably does not depend solely on improved oxygenation. Were there any effects on biologic markers after the recruitment maneuvers, independent of improved oxygenation?
The effects of real-time telemedicine consultations between hospital-based nurses and severe COPD patients discharged after exacerbation admissions
Authors: Anne Dichmann Sorknæs, Peder Jest, Mickael Bech, Lise Hounsgaard, Finn Olesen, Birte Østergaard
Journal: European Respiratory Journal (2013)

Introduction: Hospitalisation with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) causes a major burden for the COPD patients and is a common cause for admissions and readmissions to medical wards.

Primary outcome: consisted of the total number of readmissions within 26 weeks after discharge.

Methods: Patients with severe COPD admitted with AECOPD at two different locations were randomly assigned (1:1) to daily teleconsultation between hospital-based respiratory nurses and discharged patients or conventional treatment. The tele-equipment consisted of a briefcase with built-in computer including a web camera, microphone and measurement equipment.

Results: A total of 266 patients (mean age 71.5 years, SD 9.5 years) were allocated to either TVC (n=132) or CT (n=134). The unconditional mean number of readmissions after 26 weeks was 1.42 (SD 2.07) in the TVC group and 1.56 (SD 2.40) in the CT group. No significant difference was noted between the groups (p = 0.62). No significant difference in mortality, readmission with AECOPD or readmission days after four, eight, twelve and twenty-six weeks.

Discussion: For location 2 there seemed to be a tendency of teleconsultations reducing the readmission rate, readmissions days and time to first readmission after four, eight, twelve and twenty-six weeks in contrary to location 1.

Conclusion: One week of teleconsultations between hospital-based telenurses and patients with severe COPD discharged after hospitalisation with AECOPD does not significantly reduce readmissions.
Determining psychological characteristics of newly diagnosed TB patients using Lüscher test
Authors: Ludmila Pankratova, Natalia Kazimirova
Journal: European Respiratory Journal (2011)

The course of pulmonary TB depends, to a great degree, on the state of regulatory mechanisms (of CNS and psychic sphere) that determines patients9 adaptation and their ability to adequately withstand stress. We used Luscher Color Selection Test to determine the objective psychological characteristics of our patients. 46 newly diagnosed patients (36 males and 10 females aged 21 to 71) were tested. 30 healthy individuals were tested as a control.   Results:  The color green was the most frequently selected in the TB patient group, indicating defensiveness and passive aggressive reaction (14 first-choice selections). The color violet, corresponding to maladaptation, personality problems, individualism and emotional immaturity, followed closely (11 selections). The color yellow was third (8 selections) reflecting activity, desire to communicate and expansiveness. Lastly, the color black (5 selections) reflected protest against the situation.  In the control group, almost all the colors of the main group were predominantly selected (red - 8 selections, yellow - 7, violet - 5, green 5 and blue - 3) indicating satisfactory adaptation abilities of this group. In the TB patient group, on the contrary, only two colors of the main gropu were selected with sufficient frequency (green - 14 and yellow - 11). This group showed preference for violet (second-frequent) and even black, which correspond to hesitancy, emotional imbalance, excessive sensitivity and the feeling of being stonewalled.   Conclusion:  Luscher Color Selection Test revealed signs of maladaptation, personality problems, instability and frustration in TB patients.
ADAM33 protein found in bronchial brushings and biopsies is increased in bronchial carcinomas
Authors: Romana Mikes, Bernd Lamprecht, Allison-Lynn Andrews, Stephen T. Holgate, Donna E. Davies, Michael Studnicka, Hans Michael Haitchi
Journal: European Respiratory Journal (2012)

Background  The asthma and COPD susceptibility gene,  ADAM33 , is selectively expressed in mesenchymal cells and the activity of soluble ADAM33 has been linked to angiogenesis and airway remodeling.   Aims  We hypothesized that  ADAM33  mRNA & protein are differentially expressed in bronchial biopsies from healthy airways and bronchial carcinomas.   Methods  Paired primary bronchial fibroblasts (n=4) from healthy and tumor tissue were grown +/-TGFβ2 to induce myofibroblast differentiation. Fibroblasts, bronchial biopsies (n=12) and brushings (n=12) were analysed for ADAM33 expression using quantitative RT-PCR and western blotting. Immunohistochemistry for ADAM33 was performed on bronchial biopsies.   Results  TGFβ2 caused induction of α-SMA and suppression of  ADAM33  mRNA expression in normal and tumor fibroblasts.  ADAM33  mRNA expression tended to be decreased in tumor biopsies whereas ADAM33 protein expression was significantly increased (bands of 45 and 75 kDa). In bronchial brushings  ADAM33  mRNA was not detectable. However, there was a single band at ∼75kDa for ADAM33 and also specific staining for ADAM33 in the epithelium of bronchial biopsies.   Conclusions  Similar to cells from healthy and asthmatic volunteers TGFβ suppressed expression of  ADAM33  mRNA in normal and tumor fibroblasts. ADAM33 protein was increased in bronchial tumor biopsies suggesting potential roles in tumorigenesis and growth. The presence of ADAM33 protein in bronchial brushings and biopsies in the absence of ADAM33 mRNA expression in brushings suggests that the mesenchyme is the source for ADAM33 protein in the epithelium.  * R.M. was supported by an ERS short-term research training fellowship in 2010/2011 in Southampton, UK.
Commentary on “Computer-based quantification of the mean Achilles tendon thickness in ultrasound images: effect of tendinosisComputer-based quantification of the mean Achilles tendon thickness in ultrasound images: effect of tendinosis”
Authors: Klaus-Michael Braumann
Journal: British Journal of Sports Medicine (2007)

The determination of the thickness of the Achilles tendon (AT) is an important tool to monitor the course of an acute or chronic inflammation. A …
Automated identification of asthma patients within an electronical medical record database using machine learning
Authors: Marjolein Engelkes, Zubair Afzal, Hettie Janssens, Jan Kors, Martijn Schuemie, Katia Verhamme, Miriam Sturkenboom
Journal: European Respiratory Journal (2012)

Background:  Use of electronic medical record (EMR) databases for epidemiological research on asthma/COPD is increasing. A key challenge for use of these huge databases is disease validation. The conventional method is labor intensive and often non-systematic. One strategy to address this, is the use of machine learning (ML) to identify cases.   Aim:  To investigate the performance of ML in the automated identification of children with asthma.   Methods:  From the IPCI database, a GP database with medical records of > 1 million patients, all potential asthma patients, aged 6-18 years between 2000-2011, were identified with a broad automated search on asthma codes, free text and asthma drugs. First, a random sample (n=5039) of all potential cases (n=64327) was manually reviewed by 2 MDs and categorized according to a predefined algorithm. Second, based on this sample set, ML recognizes complex patterns to automatically generate decision trees for case identification. Training and testing was done by 5-fold cross validation.   Results:  The sample set consisted of 6% definite, 24% probable, 2% doubtful cases and 68% non-cases. Depending on the sampling strategy, the positive predictive value (PPV) varies from 0.11-0.26, sensitivity (Sn) 0.57-0.94 and specificity (Sp) 0.52-0.89 for definite cases (diagnosis by specialist). For probable cases (diagnosis by GP) PPV varies from 0.49-0.51, Sn 0.84-0.86 and Sp 0.69-0.73.   Conclusion:  ML for automatic identification of asthma cases in a huge EMR database performs well. The optimal ML method depends on the research question e.g. incidence/prevalence studies require a method with a large Sn, while outcome studies require a large Sp.
Role of Abram's pleural biopsy in determining the cause of empyema thoracis
Authors: Shaista Ghazal, Ashok Kumar, Nusrat Idrees, Nadeem Rizvi, Maria Malik
Journal: European Respiratory Journal (2012)

Introduction

Empyema thoracis remains a major problem in developing countries. Clinical outcomes in tuberculous empyema are generally believed to be worse than in non-tuberculous. So with the help of Abram pleural biopsy early detection of the cause of empyema and its treatment could be possible.

Objectives

To evaluate the role of Abram's pleural biopsy in determining the cause of empyema thoracis.

Methods

A prospective study of patient's data was undertaken at the Pulmonology department at the largest public tertiary care centre in Karachi, Pakistan. Pleural biopsies for histopathology were obtained using Abram's pleural biopsy needle from 46 patients admitted with empyema thoracis between August 2010 and August 2011; along with pus for Gram staining, routine culture, AFB smear and AFB culture, and the results of these variables were compared for diagnostic efficiency.

Results

A comparison of the diagnostic tools used showed positive Gram staining in 28 out of 46 (60.9%) cases. Bacterial cultures were positive in 24 (52.1%) of the cases, with 10 (21.7%) positive for Streptococcus pneumonia, 8 (17.4%) positive for Pseudomonas aeruginosa, 6 (13%) positive for Staphylococcus aureus; and 15 (32.6%) with AFB growth on pus culture. Only 4 (8.6%) had a positive AFB smear. Whereas histopathology revealed 28 (60.9%) cases as having acute on chronic pyogenic inflammation, 12 (26.1%) with chronic non-specific inflammation, and 6 (13%) with acute on chronic granulomatous inflammation.

Conclusions

In comparison to other diagnostic techniques, there is no benefit of performing Abram's pleural biopsy in determining the cause of empyema thoracis. Pus culture has a better yield in specifying the cause in most cases.
Analysis of IgE and C-reactive protein as possible predictors of exacerbation patients with asthma
Authors: Besim Prnjavorac, Adlija Cauševic, Sabina Semiz, Tanja Dujic, Maja Malenica, Ekrema Mujaric, Tamer Bego
Journal: European Respiratory Journal (2011)

Aim:  To study correlation of IgE level and C-reactive protein (CRP) for exacerbation of the disease in asthmatic patients.   Methods:  Asthmatic subject were examined for achieving of asthma control according to GINA recommendation. Numbers of exacerbation of asthma during one month were analyzed. The patients were followed in six month period (since first January to 30th of Jun. Average monthly days of exacerbations was calculated. IgE level in the blood was measured using Enzyme-linked Immunoassay (ELISA), and CRP was measured by immunotubidimetry. Assessment of asthma control was considered using Asthma Quality of Life Questionnaire (AQLQ).   Results:  The study includes 63 patients with asthma. Average level of IgE was 674 IU/mL (SD 167), range 56-3785 IU/mL, 1 IU=3,2 ng; average level of CRP was 16,4 mg/mL (SD 6,3), range 5-48; Average number of days in exacerbation during one month was 3,6 (SD 2,4), and varied from zero, patients with no exacerbation, to 21. Using test of multiple correlation it was shown statistical significant correlation (level p   Conclusion:  In this study CRP was shown as stronger predictor of asthma exacerbation and worse quality of life than total IgE level in asthmatic subjects.