tbuckley/cabot-search huggingface dataset:
Ribcage and abdomen synchrony at different exercise intensities in healthy subjects
Authors: Leticia Z. Cardenas, Jeferson G. Ferreira, Pauliana V. Santana, Renata Pletsch, Luiz F. Orlandin, Marcelo Macchione, Pedro Caruso, Carlos R.R. Carvalho, Andre L.P. Albuquerque
Journal: European Respiratory Journal (2013)

Background: The asynchronous movement between ribcage and abdomen during inspiration and its sensorial repercussions in respiratory patients as COPD has been outstanding (Priori R, J Appl Physiol 2013 InPress). However, the behavior in healthy subjects at different exercise intensities is not fully described.  Aims: To evaluate the synchronic or asynchrony displacement of ribcage and abdomen during inspiration at rest and during mild, moderate and intense exercise intensities in healthy subjects undergone maximal incremental cycle.  Methods: Eleven healthy subjects were monitored with respiratory inductance plethysmography in the axillar level for the ribcage and in the umbilical level for abdomen, during resting and mild, moderate and strenuous efforts based on the respective tertile. The synchrony between ribcage and abdomen was measured based on the phase shift obtained by the Lissajuos approach [θ = sin-1(m/s)].  Results: The phase shift at rest and mild exercise is near to zero (complete synchrony) with a low range (mean 0.63, from -5.0 to 8.0). However, moderate and mainly intense exercise resulted in higher phase shift and higher range (mean 10.6, -35.0 to 51.0), with predominance of ribcage expansion.  Conclusion: In healthy subjects, the synchrony between ribcage and abdomen during inspiration is dependent of exercise intensity. The activation of ribcage is predominant than abdomen recruitment during exercise progression.
Cisplatin, fluorouracil, and high-dose leucovorin for recurrent or metastatic head and neck cancer.
Authors: E E Vokes, K E Choi, R L Schilsky, W J Moran, C M Guarnieri, R R Weichselbaum, W R Panje
Journal: Journal of Clinical Oncology (1988)

We added high-dose oral leucovorin to the combination of cisplatin and fluorouracil (5-FU) to assess the efficacy of this regimen in the treatment of patients with head and neck cancer. Cisplatin, 100 mg/m2, was followed by a 5-FU continuous infusion at 600 mg/m2/d for five days. Leucovorin, 50 mg/m2, was administered at the start of cisplatin and every six hours throughout the duration of the 5-FU infusion. The dose of 5-FU was escalated to 800 mg/m2 and 1,000 mg/m2 according to observed toxicity. In a second phase of the study, the dose of leucovorin was escalated to 50 mg/m2 every four hours. A total of 25 patients were registered: 23 had recurrent disease after extensive prior treatment; and two had newly diagnosed metastatic disease. The maximally tolerated dose of 5-FU was 800 mg/m2/d with leucovorin administered every six hours. Toxicities at that level included mild to moderate myelosuppression and dose-limiting mucositis in the previously irradiated field. Identical toxicities were observed when administering 800 mg/m2/d of 5-FU with leucovorin every four hours. Eighteen patients were evaluated for response: one had a pathologic complete response; nine had a partial response (including four who received prior cisplatin and 5-FU as induction chemotherapy); and eight patients failed to respond. The mean peak and trough plasma leucovorin concentrations were 2.61 (+/- 1.07) mumol/L and 2.46 (+/- 0.95) mumol/L with administration of the drug every six hours, and 2.75 (+/- 2.15) mumol/L and 2.52 (+/- 1.48) mumol/L with administration every four hours. We conclude that the combination of cisplatin, 5-FU, and leucovorin has activity in the treatment of recurrent head and neck cancer. The maximally tolerated dose of 5-FU in this study was 800 mg/m2/d, with mucositis in previously irradiated sites being dose-limiting. Plasma leucovorin concentrations exceeding 1 mumol/L are achieved following oral administration of this drug.
BCG vaccination is associated with decreased severity of tuberculosis in Karachi, Pakistan
Authors: Nisar Rao, Zahra Hasan, Muhammad Irfan, Javaid Khan
Journal: European Respiratory Journal (2013)

Background: Pakistan ranks 6th amongst high-burden countries worldwide and has an incidence of 231/100,000 population. Vaccination with Bacille Calmette–Gue9rin (BCG) is given at birth to protect against tuberculosis (TB) in Pakistan.  Objective: To determine whether BCG has any protective effect against more severe forms of TB in Karachi, Pakistan.  Material and Methods: This was a cross-sectional multi-center hospital-based study. TB patients (n = 218) with pulmonary (PTB, n = 120) or extrapulmonary (ETB, 98) were recruited, and the presence of a BCG vaccination scar was documented.  Cases were further classified into minimal, moderate and advanced PTB or less severe (LETB) or severe disseminated (D-ETB) disease. The association of age, gender and severity of TB infections with BCG vaccination of the individual TB cases was investigated.  Results:  No difference was found of the BCG vaccination status of PTB and ETB cases, or in relation to age or gender. Patients under 29 years of age comprised the largest group. There were more females with ETB than PTB. The largest group within ETB comprised those with tuberculous lymphadenitis (LNTB, 39%). A significantly greater number of LNTB cases had received BCG vaccinations than had those with pleural (unilateral) TB (p = 0.004), and tuberculous meningitis (p = 0.027) groups. Also, there were more immunized patients with pulmonary as compared with pleural disease (p = 0.001).  Conclusion:  LNTB represents localized granulomatous disease and the observation of higher vaccination rates in this group suggests that BCG has protected against more severe forms of TB in this high-burden region.
Interleukin-4 and Interleukin-5 Gene Expression and Inflammation in the Mucus-secreting Glands and Subepithelial Tissue of Smokers with Chronic Bronchitis
Authors: JIE ZHU, SWATI MAJUMDAR, YUSHENG QIU, TAREQ ANSARI, ALESSANDRO OLIVA, JOHAN C. KIPS, ROMAIN A. PAUWELS, VIRGINIA DE ROSE, PETER K. JEFFERY
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

We wished to determine if the inflammatory cells surrounding the airway mucus-secreting glands in chronic bronchitis (CB) were associated with interleukin (IL)-4 and IL-5 mRNA expression and whether the CD8 T cell population expressed these cytokines. Digoxigenin-labeled IL-4 and IL-5 antisense RNA probes were used to detect gene expression in 11 asymptomic smokers (AS), 11 smokers with CB alone with normal lung function, and 10 smokers with chronic bronchitis and coexisting chronic obstructive pulmonary disease (CB+COPD; FEV(1)% of predicted of 43-77% and FEV(1)/ FVC of 51-68%). There were approximately three times as many IL-4 than IL-5 mRNA(+) cells. The highest number of IL-4 mRNA(+) cells were in the submucosal glands of the CB group with normal lung function (216/mm(2)), significantly higher than the values in either the AS (63/mm(2)) or the CB+COPD (87/mm(2)) groups, respectively (p < 0.01). There were similar group differences when the total numbers of inflammatory cells were compared. Accordingly, there was a positive correlation between the number of IL-4 mRNA(+) cells and the total number of inflammatory cells in both the subepithelium and glandular compartments (r = 0.60; p = 0.01 and r = 0.70; p = 0.02, respectively). There were no significant associations between the numbers of CD8(+) and IL-4 or IL-5 mRNA(+) cells. Of 1328 IL-4(+) and 1404 CD8(+) cells counted none was double labeled. Of 727 IL-5(+) and 1569 CD8(+) cells, none was double labeled. In contrast, as a positive control, 34% of tumor necrosis factor (TNF)-alpha(+) cells were also CD8(+) and 15% of CD8(+) cells were TNF-alpha positive. Thus, cells other than the CD8(+) phenotype produce IL-4 and IL-5 in CB. We conclude that there is increased inflammation and IL-4 gene expression in the mucus-secreting glands and the airway mucosa of smokers with bronchitis: both are lower in those with CB and coexisting COPD suggesting that airway inflammation in CB is reduced when airway obstruction develops.
Analysis of Immune Surveillance of Sequentially Derived Cell Lines That Differ in Their Tumorigenic Potential&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Y Lin, P Q Patek, J L Collins, M Cohn
Journal: JNCI Journal of the National Cancer Institute (1985)

The immune surveillance hypothesis suggests that cancer evolves as a multistage process. Further, it predicts that cells intermediate on the pathway to cancer are susceptible to host protective mechanisms, and only those variants that are able to escape the protective mechanisms are able to grow as tumors. We have isolated, as lineages, fibroblast lines that express phenotypes predicted by the surveillance hypothesis. The lineages were derived by treating nontransformed cells (N-cells) with chemical carcinogens and by isolating transformed variants in vitro. From the transformants that are tumorigenic in immune-depressed ATXFL mice but rejected by normal mice (I-cells), variants were selected in vivo that had escaped the rejection mechanism(s) and had grown as tumors in normal mice (C-cells). Thus lineages were established comprised of sequentially derived cell lines with the following phenotypes: nontransformed, transformed but susceptible to host protective mechanisms, transformed and resistant to host protective mechanisms (i.e., N→I→C). With the use of in vivo cross-protection experiments, two independently derived I-cell lines were shown to express non-cross-reactive antigens that are not expressed by the parental nontransformed N-cells (i.e., transformation-associated antigens). The transformation-associated antigens are expressed at an equivalent level on the cells that are susceptible to rejection (i.e., I-lines) and those that have escaped rejection (i.e., C-lines). In addition, although the transformation-associated antigens expressed by I-cells induce an effective immune response capable of rejecting both the I-line and C-line, the expression of these antigens on C-cells does not induce an effective immune response. The role of host defense mechanisms in the rejection of these chemically transformed I-cells and the possible mechanisms by which C-cells escape rejection are discussed.
The Role of Socioeconomic Status in Hospital Outcomes Measures
Authors: Harlan M. Krumholz, Susannah M. Bernheim
Journal: Annals of Internal Medicine (2015)

Letters5 May 2015The Role of Socioeconomic Status in Hospital Outcomes MeasuresHarlan M. Krumholz, MD, SM and Susannah M. Bernheim, MD, MHSHarlan M. Krumholz, MD, SMFrom Yale University School of Medicine, New Haven, Connecticut.Search for more papers by this author and Susannah M. Bernheim, MD, MHSFrom Yale University School of Medicine, New Haven, Connecticut.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5087-2 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:There is much in common between the letter writers and us. We all agree that this a complex area in which causal pathways influence decisions about adjustment and there is important work remaining to understand the interaction of SES and outcomes. Our main point is that we can either assume that differences based on SES are unrelated to hospital quality and adjust them away, or allow that they might have a relationship to hospital quality and that hospitals are likely to be able to mitigate any disparities and not adjust the differences away. Given our nation's history and ... Author, Article, and Disclosure InformationAffiliations: From Yale University School of Medicine, New Haven, Connecticut.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M14-2308. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoConsidering the Role of Socioeconomic Status in Hospital Outcomes Measures Harlan M. Krumholz and Susannah M. Bernheim Considering the Role of Socioeconomic Status in Hospital Outcomes Measures Harlan M. Krumholz and Susannah M. Bernheim The Role of Socioeconomic Status in Hospital Outcomes Measures Alan M. Zaslavsky and Ashish K. Jha The Role of Socioeconomic Status in Hospital Outcomes Measures Alan M. Zaslavsky and Ashish K. Jha Metrics Cited byWhat is the impact of a clinically related readmission measure on the assessment of hospital performance? 5 May 2015Volume 162, Issue 9Page: 670KeywordsDisclosureMedicarePopulation statistics ePublished: 5 May 2015 Issue Published: 5 May 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Correlation of stress factors with sustained depression of natural killer cell activity and predicted prognosis in patients with breast cancer.
Authors: S Levy, R Herberman, M Lippman, T d'Angelo
Journal: Journal of Clinical Oncology (1987)

Natural killer (NK) cell activity and psychological status were measured at baseline and at 3 months into treatment, as part of the National Cancer Institute (NCI) Protocol 79-C-111, randomizing breast cancer patients to lumpectomy/radiation v mastectomy. Patients who were found to have positive axillary lymph nodes also received combination chemotherapy (Adriamycin [Adria Laboratories, Columbus, OH], plus Cytoxan [Mead Johnson Pharmaceuticals, Evansville, IN] or methotrexate, plus 5-fluorouracil [5-FU]). Seventy-five patients were entered onto this behavioral immunology protocol at the time of data analysis. We reported in an earlier publication that NK activity was an important predictor of patient baseline prognosis relevant to nodal status. In that study, by using multiple regression analyses, 51% of the baseline NK activity variance could be accounted for by entering three distress indicators into the equation (patient "adjustment," lack of social support, and fatigue/depression symptoms). On reassessment of NK activity after 3 months, it was found that NK activity was not affected by the interim administration of chemotherapy and/or radiotherapy. However, consistent with our earlier findings, NK activity levels remained markedly lower in patients with positive nodes than in patients with negative nodes (at 60 to 1 effector to target cell [E:T] ratio, mean of 18% lytic activity v mean of 31% lytic activity [t = 1.87, P less than .05]). Even though average levels of NK activity were lower for patients with more tumor burden, there was still a substantial range of NK activity levels within the node positive patient group, as well as within the patient group as a whole. We hypothesized that differences in levels of NK activity could be predicted on the basis of baseline distress factors found to be significant in our earlier report. In fact, we found that we could account for 30% of NK activity level variance at 3 months follow-up on the basis of baseline NK activity, fatigue/depression, and lack of social support. Therefore, although neither radiation nor chemotherapy appeared to affect NK activity, tumor burden was again clearly associated with NK activity levels, and a significant amount of baseline and 3-month NK activity could be predicted on the basis of CNS-mediated effects. At the least, such factors provide a psychological marker of host biological status.
Prolonged esophageal pH monitoring in the evaluation of gastroesophageal reflux in children with bronchial asthma
Authors: Ianos Adam, Svetlana Sciuca, Rodica Selevestru
Journal: European Respiratory Journal (2013)

Aim: Evaluation of the 24 - hour esophageal monitoring results in children with GERD associated with asthma.

Methods : In 41 children with asthma and GERD (16 erosive and 25 non-erosive cases of GERD) prolonged esophageal pH monitoring was performed. GINA-2010 and ESPGHAN-2009 criteria were applied.

Results: 24 hours monitoring of the acid (pH 8) exposition of esophageal mucosa showed a significantly longer exposition time in children during asthma exacerbation (acid - 164 minutes, 11.42±3.9%; alkaline - 104 min., 7.19±1.8%) comparing with GERD associated with controlled asthma (acid - 103 min., 7.14±2.3%; alkaline - 44.7 min., 1.86±0.9%), p< 0.05. A significant increase of frequency of alkaline reflux in asthma exacerbation was seen as compared with remission period (277.5±40.3 vs. 58.3±4.5, p<0.05). Also, analysis of the integrated DeMeester score showed increased values in uncontrolled asthma (59.72±12.6) comparing with controlled asthma (27.01±8.8; p<0.05). There was a correlation of DeMeester score and asthma severity (mild asthma – 21.1±7.5; moderate – 46.17±8.5; severe – 75.0±31.6 (p<0.05), that demonstrates an increase of acid and alkaline reflux with increasing severity of asthma. In mild asthma this score is equal to 82.0±5.8 acid and 92.4±10.2 alkaline reflux episodes; in moderate asthma – 154.9±31.9 and 304.5±48.2; in severe asthma only acid ones (185.6±9.6). Conclusion : Children with asthma associated with GERD have disorders of the esogastric junction motility during asthma exacerbations manifested with increase of reflux frequency and acid or alkaline exposition of the esophageal mucosa that correlates with asthma severity.
E-cigarettes could addict a new generation of youth to nicotine, doctors are told
Authors: Michael McCarthy
Journal: BMJ (2015)

The US Food and Drug Administration should regulate e-cigarettes and other electronic nicotine delivery systems (ENDS) as it does other tobacco products, imposing similar age restrictions and banning their advertising and media promotion, the American Academy of Pediatrics has said in a policy statement1 released on 26 October at its national conference, held in Washington, DC.

“There is a critical need for ENDS regulation, legislative action, and counter-promotion to protect youth. ENDS have the potential to addict a new generation of youth to nicotine and reverse more than 50 years of progress in tobacco control,” the academy said.

ENDS …
Risk Factors for Doxorubicin-lnduced Congestive Heart Failure
Authors: DANIEL D. VON HOFF
Journal: Annals of Internal Medicine (1979)

Potential risk factors responsible for development of doxorubicin-induced congestive heart failure were examined through retrospective analysis of 4018 patient records. The overall incidence of drug-induced congestive heart failure was 2.2% (88 cases). The probability of incurring doxorubicin-induced congestive heart failure was related to the total dose of doxorubicin administered. There was a continuum of increasing risk as the cumulative amount of administered drug increased. A weekly dose schedule of doxorubicin was associated with a significantly lower incidence of congestive heart failure than was the usually employed every 3-week schedule. An increase in drug-related congestive heart failure was also seen with advancing patient age. Performance status, sex, race, and tumor type were not risk factors. These data will enable clinicians to better estimate the risk/benefit ratio in individual patients receiving prolonged administration of doxorubicin. They also provide a basis for the investigation of less cardiotoxic anthracycline analogues or for designing measures to prevent doxorubicin-induced cardiomyopathy.
Abstract 2769: Bradycardia-Dependent Augmentation of J-wave Elevation in Patients with Idiopathic Ventricular Fibrillation
Authors: Koichi Mizumaki, Akira Fujiki, Masao Sakabe, Tamotsu Sakamoto, Yosuke Nakatani, Takayuki Tsuneda, Hiroshi Inoue
Journal: Circulation (2008)

Although J-wave elevation (JWE) in the inferior or lateral leads is characteristic of subtype of idiopathic ventricular fibrillation (IVF), difference between malignant and benign JWE remains to be elucidated. So, we assessed the hypothesis that the rate dependent changes in JWE could be different between patients with IVF and control subjects. Six male patients with IVF and 18 age matched male controls with JWE (&gt;2 mm) in the lateral leads were studied. CM-5 lead digital Holter ECG was recorded and J wave amplitude was automatically measured. J/RR relationships were evaluated by means of J/RR linear regression lines for 24 hours, and according to four 6-hour periods. From J-RR linear regression lines, J-RR slope (mm/sec), J wave amplitude (mm) at RR intervals of both 0.6 sec and 1.2 sec (J (0.6) and J (1.2) ) were determined. In all 6 patients with IVF, the time of spontaneous episodes of VF were investigated from the implantable cardioverter defibrillator (ICD) stored data. For 24 hours, J-RR slope was greater in IVF patients than in controls (3.5±0.7 vs 2.4±0.8, p&lt;0.01). (J (0.6) ) wasn’t different between 2 groups; however, J (1.2) was greater in IVF patients than in controls (2.8±0.9 vs 2.0±0.6, p&lt;0.05). In IVF patients, ST/RR slope was highest during 18:00–24:00; however, these circadian changes were blunted in controls. J(1.2) was greater during 18:00 – 6:00 in IVF patients than in controls. Seven (59%) of total 9 episodes of spontaneous VF of IVF patients occurred during 18:00 – 6:00. In patients with subtype of IVF, JWE augmented during bradycardia especially at night. This could relate to nighttime occurrence of IVF.
Natural Killer/Natural Killer-Like T-Cell Lymphoma, CD56+, Presenting in the Skin: An Increasingly Recognized Entity With an Aggressive Course
Authors: Serena Mraz-Gernhard, Yasodha Natkunam, Richard T. Hoppe, Philip LeBoit, Sabine Kohler, Youn H. Kim
Journal: Journal of Clinical Oncology (2001)

To describe and identify the clinical and pathologic features of prognostic significance for natural killer (NK) and NK-like T-cell (NK/T-cell) lymphoma presenting in the skin.This study was a retrospective review of 30 patients with CD56+ lymphomas initially presenting with cutaneous lesions, with analysis of clinical and histopathologic parameters.The median survival for all patients was 15 months. Those with extracutaneous manifestations at presentation (11 patients) had a shorter median survival of 7.6 months as compared with those without extracutaneous involvement (17 patients), who had a more favorable median survival of 44.9 months (P =.0001). Age, gender, extent of cutaneous involvement, and initial response to therapy had no statistically significant effect on survival. Seven patients (24%) had detectable Epstein-Barr virus (EBV) within neoplastic cells. The patients with tumor cells that coexpress CD30 (seven patients) have not yet reached a median survival after 35 months of follow-up as compared with those with CD30- tumor cells (20 patients), who had a median survival of 9.6 months (P <.02). Routine histopathologic characteristics had no prognostic significance nor did the presence of CD3epsilon, EBV, or multidrug resistance.NK/T-cell lymphoma is an aggressive neoplasm; however, a subset with a more favorable outcome is identified in this study. The presence of extracutaneous disease at presentation is the most important clinical variable and portends a poor prognosis. The extent of initial skin involvement does not reliably predict outcome. Patients from the United States with NK/T-cell lymphoma presenting in the skin have a low incidence of demonstrable EBV in their tumor cells. Patients with coexpression of CD30 in CD56 lymphomas tend to have a more favorable outcome.