tbuckley/cabot-search huggingface dataset:
Diagnostic performance/learning curve and tolerance of endobronchial ultrasound (EBUS)
Authors: Estefanía Luque, María Pavón, Ana Gómez-Bastero, Virginia Almadana, Agustín Valido, Teodoro Montemayor
Journal: European Respiratory Journal (2012)

OBJECTIVES :To analyze the diagnostic performance of transbronchial needle aspiration guided by endobronchial ultrasound(EBUS-TBNA) in diagnosing hilar/mediastinal lymphadenopathies and/or lung masses in our department and the possible effects of the learning curve.To evaluate the tolerance of the procedure by both the patient and the doctor and its complications. MATERIALS AND METHODS: Retrospective study of all patients referred to our department(January2010-October2011)to perform EBUS-TBNA.At the end of the technique, both the patients and bronchoscopist answered a tolerance questionnaire(scale of 0 to7). RESULTS :n=129 patients. 325 aspirations were performed.The most common indication was suspicion of malignancy(48.8%).The most frequent final diagnosis was normal lymph nodes(46.5%),followed by neoplasm(35.6%).The sensitivity(S)and negative predictive value(NPV)for the final diagnosis of malignancy was 93,4% and 95.5%,respectively.In order to analyze learning curve effects,we study the first 25 cases and the remainder,separately,with the S and NPV of 83.3% and 94.1%,respectively,without statistically significant differences.In 63.56%,the tolerance of the technique was 5.18 ± 2.12vs4.62 ± 2.41(patient vs.bronchoscopist).With regard to complications,90.7% did not register any complication. CONCLUSIONS :EBUS-TBNA is a diagnostic tool with a high profitability in the study of hilar/mediastinal lymphadenopaties which was higher in neoplastic lymphadenopathy.In our case,there were no statistically significant differences regarding the diagnostic performance of the technique during the learning curve. EBUS-TBNA is a safe and well-tolerated method by both the patient and the endoscopist.
Sequential induction chemotherapy and concomitant chemoradiotherapy in the management of locoregionally advanced laryngeal cancer
Authors: C.A. Mantz, E.E. Vokes, M.S. Kies, B. Mittal, M.E. Witt, M.A. List, R.R. Weichselbaum, D.J. Haraf
Journal: Annals of Oncology (2001)
Abstract 18896: Preliminary Analysis of the National Child Death Review Database for Cardiovascular Deaths
Authors: Victoria L Vetter, Theresa M Covington, Heather Dykstra, Mary Overpeck, V. Ramesh Iyer, Noreen P Dugan, Danielle M Haley, Rachel Hammond, Justine Shults
Journal: Circulation (2012)

Background: The National Center for the Review and Prevention of Child Deaths (NCRPCD) maintains a unique multistate database supported by the US Maternal and Child Health Bureau to record circumstances of child deaths with data submitted by state Child Death Review teams. Methods: We aim to describe circumstances of child cardiovascular deaths (CVD) in the NCRPCD database and to identify modifiable risk factors, potential disparities, and their contribution to sudden cardiac death (SCD) and non-sudden CVD. An analytical dataset involving 16 states was developed for analysis of CVD cases occurring in 2005-2009. We developed algorithms to identify SCD and non-sudden CVD cases. Logistic regression was used to identify correlates of SCD among all CVD cases. Results: CVD cases (1099) were 0.6 (0.1, 9.6) yrs median (IQR) with 55% ≤1 yr and 22% ≥12 yrs; Male 58%; White 70%, Black 22%, Asian 2%, Other 5%; Hispanic ethnicity 19%. Prior conditions, present in 47%, included congenital heart defects (CHD), 23%; cardiomyopathy (CM), 4%; arrhythmia (AR), 2%. Most deaths occurred at home/school, 30% or in the hospital, 40%. Common causes of death were CHD 21%; AR 17%; and CM 8%. Reclassification indicated 59.1% (649/1099) of CVD were SCD and 33.8% (371/1099) were non-sudden CVD. Differences in SCD (versus non-sudden death) were noted by race with SCD in 73.2% blacks vs. 60.9% whites (p=0.02). More SCD occurred in the suburban (84.9%) than in urban sites (57.6%) p&lt;0.0005. Among SCD, 911 was called in 92.6% of suburban and 78.6% of urban SCD (p=0.006). In a multivariable logistic regression model (Table) being black, older (&gt;6 months), Hispanic, and living in the suburbs were significantly associated with SCD. Conclusions: The NCRPCD database contains valuable information to help understand and prevent SCD. Evaluation of risk factors for SCD indicated a higher risk by race, age, ethnicity, and location.
Effect of rehabilitation course in COPD patients with emphysema phenotype
Authors: Elena Venturelli, Guido Vagheggini, Katia Foglio, Pierluigi Paggiaro, Francesco de Blasio, Franco Pasqua, Gherardo Siscaro, Fabrizio Mezzasalma, Michele Vitacca, Ernesto Crisafulli, Nicolino Ambrosino, Enrico M. Clini
Journal: European Respiratory Journal (2013)

A retrospective study has recently shown that exercise tolerance and symptoms gain a significant benefit following rehabilitation in COPD patients with lung hyperinflation when compared without ( Crisafulli E, et al. Intern Emerg Med 2012 ). We therefore conducted a prospective multicenter trial to confirm these findings.

We have enrolled 319 consecutive COPD patients (age 70±8 yrs, 77% M) admitted to a standard hospital-based rehabilitation course in 6 italian centres. Population has been divided into two distinct groups whose characteristics correspond to either parenchimal destructive ( A , n=130) or airway obstructive ( B , n=189) phenotype ( Pistolesi M, et al. Respir Med 2008 ).

Groups were similar for age, sex, body mass, smoking habit and gas exchange. Age-unadjusted Charlson comorbidity score was higher in group B than in A (1.33±1.43 and 0.98±1.17, respectively p=0.031). Comparisons of pre-to-post absolute values and changes (Δ) in exercise tolerance (6MWT), Borg dyspnea (D), fatigue (F) and SatO2 nadir (N) on effort, perceived breathlessness (MRC), and quality-of-life (SGRQ) were made. Patients of both groups significantly (p<0.05) improved their 6MWT, D, F, and MRC level after rehabilitation, whereas SGRQ score improved in group A only (p<0.01). Δ-D only was different in group B than in A (-1.33±1.91 and -0.41±1.61 pt respectively, p<0.001).

This study confirms that COPD patients with or without emphysema phenotype may similarly benefit from pulmonary rehabilitation, although the former individuals are less likely to gain in perceived dyspnea on exertion.
Abstract 2907: Everolimus enhances the cytotoxic action of the immunotoxin, HA22, directed to CD22 on B-cell malignancies
Authors: Antonella Antignani, Matteo Pasetto, Chris Choo, Evan Angelus, Lesley Mathews, Rajarshi Guha, Paul Shinn, Marc Ferrer, Craig J. Thomas, Ira Pastan, David J. Fitzgerald
Journal: Cancer Research (2014)

Abstract Recombinant immunotoxins, antibody-toxin fusion proteins, are therapeutic proteins designed as targeted anti-cancer agents. Clinical trials of immunotoxins directed to surface CD22 or mesothelin are ongoing with a 50% complete response rate in patients with refractory Hairy Cell Leukemia as well as dramatic responses in some patients with advanced mesothelioma. To identify agents that could improve clinical efficacy further, a screen of 500 approved or near-approved compounds (MIPE-4) was conducted, revealing everolimus as a potential enhancer of Pseudomonas exotoxin-based recombinant immunotoxins. When the immunotoxin HA22 (moxetumomab pasudotox), which targets CD22, was added to various B-cell lines, everolimus enhanced cytotoxicity by 2-10-fold. Kinetic analyses indicated that combinations of HA22 and everolimus (0.25 uM) accelerated the cessation of protein synthesis in Nalm-6 and CA46 cells compared to either agent alone. Likewise, in CellTiterGlo assays of cell viability, combinations of HA22 and everolimus resulted in a greater loss of ATP from cells. Western blot analysis of key survival proteins indicated an early loss of Mcl-1 in combination treatments. Additional experiments are ongoing to extend these observations with the goal of uncovering insights in the mechanism of synergy seen with these two compounds. Citation Format: Antonella Antignani, Matteo Pasetto, Chris Choo, Evan Angelus, Lesley Mathews, Rajarshi Guha, Paul Shinn, Marc Ferrer, Craig J. Thomas, Ira Pastan, David J. Fitzgerald. Everolimus enhances the cytotoxic action of the immunotoxin, HA22, directed to CD22 on B-cell malignancies. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2907. doi:10.1158/1538-7445.AM2014-2907
Responses to salvage chemotherapy in ovarian cancer: a critical need for precise definitions of the treated population.
Authors: M Markman, W Hoskins
Journal: Journal of Clinical Oncology (1992)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1992.10.4.513 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 1548513 Responses to salvage chemotherapy in ovarian cancer: a critical need for precise definitions of the treated population. M MarkmanxM MarkmanSearch for articles by this author , W HoskinsxW HoskinsSearch for articles by this author https://doi.org/10.1200/JCO.1992.10.4.513 PDF "Responses to salvage chemotherapy in ovarian cancer: a critical need for precise definitions of the treated population.." Journal of Clinical Oncology, 10(4), pp. 513–514© 1992 by American Society of Clinical Oncology
Differential diagnosis in silicosis and the importance of an accurate occupational history
Authors: Alexandre Franco Amaral, Anna Miethke-Morais, Gustavo Faibischew Prado, Mario Terra-Filho, Ubiratan de Paula Santos
Journal: European Respiratory Journal (2014)

Background: Silicosis is a common condition worldwide, and its diagnosis relies upon a thorough occupational history. Nevertheless, there are situations in which images are critical for the diagnosis, such as pulmonary masses, due to lung cancer and tuberculosis risks.

Objective: To report cases of misleading diagnosis in patients with pulmonary masses and occupational exposure to silica.

Methods: We reviewed data on patients with a diagnosis of silicosis in a tertiary hospital, who presented with pulmonary masses and were either submitted to unnecessary procedures, due to lack of information on occupational exposition, or had to be further investigated because of atypical presentations of the disease.

Results: Two patients presented silicosis with compatible exposure and radiological findings, but had pulmonary masses of unusual locations, which turned out to be lung adenocarcinomas. Three other patients with pulmonary masses and silicosis radiological findings had been submitted to lung resections, including a pneumonectomy, due to the absence of an occupational history. The remaining four had known exposure to silica but, owing to lack of other typical findings of the disease on chest CT, were submitted to biopsies (transthoracic), all of which turned out to be silicosis, and evolved with typical radiological findings.

Conclusions: Silicosis is yet a frequent disease and it should be included in the differential diagnosis of pulmonary masses. The importance of an occupational history and the possibility of a differential diagnosis must be taken into account while evaluating these patients. Pulmonary medical training programs should be aware of this not so rare condition.
Overexpression of inhibitor of DNA-binding proteins and angiogenic markers have higher impact on survival of non small cell lung cancer patients
Authors: Roberta Sales, Thayla Tuma, Milena Acencio, Ricardo Terra, Edwin Parra, Vera Capelozzi, Leila Antonangelo
Journal: European Respiratory Journal (2012)

Background:  The inhibitor of DNA binding (Id) proteins have been implicated in oncogenic transformation, progression and in tumor angiogenesis, the last one by regulation of vascular endothelial growth factor (VEGF) expression. Notwithstanding, these mechanisms have not been fully understood. The aim of this study was to evaluate the Ids 1,2,3 and VEGF expression and angiogenesis amount in non small cell lung cancer (NSCLC) and their role on patients9 prognosis.   Methods:  Immunohistochemistry and morphometry were used to evaluate Ids, VEGF expression and microvessel density (CD34+) in neoplastic and stromal cells from 85 patients with surgically excised NSCLC. The impact of these markers was tested on follow-up until death from recurrence lung cancer.   Results:  The Kaplan-Meier survival curve analysis showed that expression of Id-1, CD34 and VEGF were associated with poor prognosis (Log Rank Test, p   Conclusion:  In resected NSCLC, Id1, Id3, VGF and vascular density were strongly associated with prognosis. Therefore, Id1 and Id3 seem to contribute on tumor progression and should be considered as prognostic markers in NSCLC.
Phase II randomized study of biomarker-directed treatment for non-small cell lung cancer (NSCLC): The BATTLE (Biomarker-Integrated Approaches of Targeted Therapy for Lung Cancer Elimination) clinical trial program
Authors: E. S. Kim, R. S. Herbst, J. J. Lee, G. Blumenschein, A. Tsao, I. Wistuba, C. Alden, S. Gupta, D. Stewart, W. K. Hong
Journal: Journal of Clinical Oncology (2009)

8024 Background: Treatment for patients (pts) with recurrent NSCLC has limited efficacy despite the use of new targeted agents. Identifying biomarkers to predict tumor response will help personalize therapy for individuals. Methods: Eligible pts had prior chemotherapy, ECOG PS 0–2, and when enrolled, required 2 fresh core needle biopsy specimens to test 11 biomarkers related to 4 molecular pathways in NSCLC: EGFR, Kras, and Braf gene mutation (PCR-based sequencing), EGFR and Cyclin D1 copy number analyses (FISH), and 6 proteins via IHC (VEGF/R and RXR receptors/Cyclin D1). Based on eligibility and tumor biomarker analyses, pts were randomized into 1 of 4 treatments: erlotinib (E) 150 mg qd; sorafenib 400 mg bid, vandetanib 300 mg qd; E 150 mg + bexarotene 400 mg/m2 qd. The primary endpoint is 8-week progression-free status. The first 97 pts were equally randomized, with subsequent pts adaptively randomized under a Bayesian framework. Results: Since 11/2006, 227 pts have been enrolled and 171 randomized and treated (median age 62 yrs, 89 males, 137 Caucasians, 11 Asians, 107 former and 38 never smokers). Accrual has proceeded well (average 9 pts per month). 112 of the biopsied lesions were lung, with a pneumothorax rate of 12.1% (15 of 124 pts; grade 1–2 only; lung, mediastinal and pleural sites). 168 pts (74%) have complete biomarker profiles and 7 (3%) have partial. Histology: adenocarcinoma (75%), squamous (11%), large cell (13%). Mutation frequency was 19% EGFR, 15.4% Kras, and 2.9% Braf. 2 tumors contained both EGFR and Kras mutations, and 2 cases had both Kras and Braf mutations. EGFR polysomy by FISH was 36.4%, and gene amplification 21%. Cyclin D1 amplification was 16.3%. Treatment-related adverse events (grade 3 or more) were 6.5%. Conclusions: We have demonstrated that biopsies are safe and feasible for biomarker-directed studies. The study continues enrollment to 200 evaluable pts at which point the results will be unblinded. BATTLE is one of the first studies in advanced lung cancer to prospectively utilize biomarker analysis of fresh biopsies to direct pt treatment, and is a step towards personalizing therapy in NSCLC. Supported by grant DoD W81XWH-6–1-0303. No significant financial relationships to disclose.
Observation cohort study of cause of death in patients with Duchenne muscular dystrophy (DMD)
Authors: Emily Ballard, Natalie Grey, Heinz Jungbluth, Elizabeth Wraige, Stam Kapetanakis, Craig Davidson, Nicholas Hart
Journal: European Respiratory Journal (2012)

Prior to the introduction of home mechanical ventilation (HMV), the major cause of death in patients with Duchenne muscular dystrophy (DMD) was respiratory failure. We performed an observational mortality cohort study of our DMD population over a 6 year period. As a large specialist centre we have a current population of 117 adult patients with DMD and 12.7% of our total patient population died in the 6 year period.  Out of a total of 17 deaths in a six year period, only 35.2% died of respiratory failure with a mean age of 22.7 years, despite 76.5% of the patients being dependent on NIV. The major cause of death in this cohort was cardiac failure, with 58.8% of patients dying from cardiac complications at a mean age of 19.1 years. Cardiac death was only anticipated in one of the 10 cases, and this patient died in the home environment. These data support the need for early regular cardiac surveillance. In addition to the standard electrocardiographic and echocardiographic measurements, the use of extended electrocardiographic measurements may be required. This is supported by the current UK guidelines endorsing yearly screening for patients with DMD once over the age of 10 years.   This project has been supported by the Guy9s & St Thomas9 Charity(Project Code: G080109) .
Specifications for equipment used for infant pulmonary function testing
Authors: U. Frey, J. Stocks, A Coates, P Sly, J Bates, None on behalf of the Ers/ats Task Force on Standards for Infant Respiratory Function Testing
Journal: European Respiratory Journal (2000)

The aim of this position paper is to define minimal performance criteria for the separate items comprising equipment used to measure respiratory function in infants together with overall performance criteria for the assembled pieces of such equipment. These guidelines cover numerous aspects including: 1) safety, 2) documentation and maintenance of equipment, 3) physical characteristics of mechanical parts and signal transducers, and 4) data acquisition. Further, validation procedures for individual components as well as for the integrated equipment are recommended. Adherence to these guidelines should ensure that infant lung function measurements can be performed with an acceptable degree of safety, precision and reproducibility. They will also facilitate multicentre collection of data and performance of clinical investigations. Manufacturers of infant respiratory function equipment should make every effort to comply with these guidelines, which represent the current standards of paediatric health professionals in this field.
ELECTROENCEPHALOGRAPHY IN THE PSYCHOSES
Authors: MORTON A. RUBIN
Journal: American Journal of Psychiatry (1940)

The bilateral distribution of the amount of alpha-wave activity (per cent time alpha) from the cerebrum of 14 schizophrenics, two manic-depressives and one case of traumatic psychosis was determined. From differences in the distribution of per cent time alpha over the two cerebral hemispheres, it was found possible to localize cerebral atrophy. The electroencephalographic diagnoses were confirmed pneumoencephalographically in eight of the nine schizophrenics and in both manic-depressive patients. Air injections have not yet been done on the other five schizophrenics. In two of the schizophrenics with cerebral atrophy delta-wave discharges were occasionally observed. Epileptiform discharges were recorded from the forehead of one of the manic-depressive patients. The patient with traumatic psychosis had no detectable alpha rhythm, so that it was not possible to localize the extensive, marked cerebral atrophy, both deep and superficial, which were subsequently found pneumoencephalographically. However, potential changes typical of normal sleep were obtained while this patient was asleep.
Severe lower limb cellulitis is best diagnosed by dermatologists and managed with shared care between primary and secondary care
Authors: N.J. Levell, C.G. Wingfield, J.J. Garioch
Journal: British Journal of Dermatology (2011)

Background Cellulitis is responsible for over 400 000 bed days per year in the English National Health Service (NHS) at the cost of £96 million. Objectives An audit following transfer of care of lower limb cellulitis managed in secondary care from general physicians to dermatologists. Methods Review of patient details and work diaries from the first 40 months of implementation of the new model of care. Results Of 635 patients referred with lower limb cellulitis 33% had other diagnoses which did not require admission. Four hundred and seven of 425 patients with cellulitis were managed entirely as outpatients, many at home. Twenty-eight per cent of patients with cellulitis had an underlying skin disease identified and treated, which is likely to have reduced the risk of recurrent cellulitis, leg ulceration and lymphoedema. Only 18 of 635 patients referred with lower limb cellulitis required hospital admission for conventional treatment. Conclusions This new way of managing suspected lower limb cellulitis offered substantial savings for the NHS, and benefits of early and accurate diagnosis with correct home treatment for patients.
Follow-up of intracranial aneurysms in autosomal dominant polycystic kidney disease by magnetic resonance angiography.
Authors: J Huston, V E Torres, D O Wiebers, W I Schievink
Journal: Journal of the American Society of Nephrology (1996)

The purpose of this study was to assess the value of magnetic resonance angiography (MRA) in the follow-up of patients with autosomal dominant polycystic kidney disease (ADPKD) and saccular intracranial aneurysms (ICA), the risk of MRA-defined growth of asymptomatic incidental ICA, and the rate of development of MRA-defined de novo ICA in these patients. Between 1989 and 1995, 15 asymptomatic incidental ICA measuring 1.5 to 6.5 mm in diameter, three symptomatic aneurysms, and one asymptomatic concurrent aneurysm were detected by MRA in this study in 18 patients from 15 families. Four-vessel cerebral angiography in the three patients with symptomatic ICA and autopsy in one patient with an asymptomatic incidental ICA did not reveal additional aneurysms undetected by MRA. Thirty MRA studies were obtained in 10 of the 15 patients with incidental ICA during a cumulative clinical follow-up of 500 months (mean, 33.3; range, 0 to 65 months). The cumulative interval between the initial and the last MRA was 306 months (mean, 30.6; range, 14 to 51 months). No change in aneurysmal size or development of de novo aneurysms was detected. Eight MRA studies were obtained in the three patients with symptomatic ICA during a cumulative clinical follow-up of 130 months (mean, 43.3; range, 23 to 64 months). The cumulative interval between the first and the last MRA was 95 months (mean, 31.7; range, 15 to 49 months). Development of de novo aneurysms was not detected. These results indicate that MRA is an appropriate technique to follow small asymptomatic incidental ICA in patients with ADPKD and that the risk for rapid growth of these aneurysms is low. Although the results of this study should be viewed as preliminary, they do not suggest a higher rate of development of de novo aneurysms or a higher frequency of multiple aneurysms in patients with ADPKD and ICA as compared with patients with sporadic ICA in the general population.