tbuckley/cabot-search huggingface dataset:
Indoor Particles Affect Vascular Function in the Aged
Authors: Elvira Vaclavik Bräuner, Lykke Forchhammer, Peter Møller, Lars Barregard, Lars Gunnarsen, Alireza Afshari, Peter Wåhlin, Marianne Glasius, Lars Ove Dragsted, Samar Basu, Ole Raaschou-Nielsen, Steffen Loft
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Rationale: Exposure to particulate matter is associated with risk of cardiovascular events, possibly through endothelial dysfunction, and indoor air may be most important.Objectives: We investigated effects of controlled exposure to indoor air particles on microvascular function (MVF) as the primary endpoint and biomarkers of inflammation and oxidative stress as secondary endpoints in a healthy elderly population.Methods: A total of 21 nonsmoking couples participated in a randomized, double-blind, crossover study with two consecutive 48-hour exposures to either particle-filtered or nonfiltered air (2,533–4,058 and 7,718–12,988 particles/cm3, respectively) in their homes.Measurements and Main Results: MVF was assessed noninvasively by measuring digital peripheral artery tone after arm ischemia. Secondary endpoints included hemoglobin, red blood cells, platelet count, coagulation factors, P-selectin, plasma amyloid A, C-reactive protein, fibrinogen, IL-6, tumor necrosis factor-α, protein oxidation measured as 2-aminoadipic semialdehyde in plasma, urinary 8-iso-prostaglandin F2α, and blood pressure. Indoor air filtration significantly improved MVF by 8.1% (95% confidence interval, 0.4–16.3%), and the particulate matter (diameter < 2.5 μm) mass of the indoor particles was more important than the total number concentration (10–700 nm) for these effects. MVF was significantly associated with personal exposure to iron, potassium, copper, zinc, arsenic, and lead in the fine fraction. After Bonferroni correction, none of the secondary biomarkers changed significantly.Conclusions: Reduction of particle exposure by filtration of recirculated indoor air for only 48 hours improved MVF in healthy elderly citizens, suggesting that this may be a feasible way of reducing the risk of cardiovascular disease.
Improved effects of formoterol-budesonide combination on residual eosinophilic inflammation in asthmatic peripheral airway
Authors: Hiroyuki Ohbayashi, Mitsuru Adachi
Journal: European Respiratory Journal (2013)

Aims: To evaluate the inhibitory effect of formoterol-budesonide combination (FBC) on residual eosinophilic inflammation in the peripheral airways of well-controlled asthmatic patients compared with salmeterol-fluticasone propionate combination (SFC). Methods: Forty one outpatients (57.5+/-19.9yrs) with well-controlled moderate asthma who had used SFC for more than 3 months were the subjects. Evidence of eosinophilic cationic protein (ECP) and surfactant protein D (SP-D) in 10% hypertonic saline-induced sputum was assessed, together with pulmonary function testing, impulse oscillometry system (IOS), exhaled nitric oxide (FeNO), and the Asthma-related Quality of Life Questionnaire (AQLQ). Results: Eosinophilic inflammation was detected in the peripheral airway of 17 patients (41.5%) and they were switched to FBC. As higher levels of sputum SP-D were obtained from the nearer peripheral airway area, significantly higher ECP levels in late-phase sputum may indicate residual asthmatic inflammation in the peripheral airway. The ECP levels in late-phase sputum, 218.1+/-256.6ug/1 at study entry, significantly decreased to 49.4+/- 42.3 (p=0.031) and 48.1+/- 45.3 (p=0.035) at 4 and 8 weeks, respectively, after switching to treatment with the FBC. The FeNo levels (61.2+/-59.7 ppb at study entry) also significantly decreased 26.7+/-16.8(p=0.023) at 8 weeks. The R5-R20 and AX values of IOS parameters and both symptom and emotional function domains of the AQLQ also significantly improved after 8 weeks. Conclusion: This suggests that the FBC may give better control of residual eosinophilic inflammation in the peripheral airway compared to SFC therapy.
Added Sugar Intake and Public Health
Authors: Natalia Linos, Mary T. Bassett
Journal: JAMA (2015)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Sympathomimetics in acute severe asthma: inhaled or parenteral, nebulizer or spacer?
Authors: A Noseda, JC Yernault
Journal: European Respiratory Journal (1989)

It is accepted today that all patients with acute asthma should be treated with a sympathomimetic, irrespective of previous therapy. This short review addresses the question of the optimal mode of administration of these drugs in acute severe asthma. Inhaled sympathomimetics are as effective as subcutaneous adrenaline, or intravenous salbutamol or terbutaline, and, as they produce fewer side-effects, are recommended as the best mode of administration. However, self-medication with a ready to use subcutaneous preparation may be indicated in those patients prone to very abrupt attacks. The conventional mode of inhalation therapy in acute asthma is nebulization, but equally effective bronchodilatation may be obtained with metered-dose inhalers combined with valved spacers. Tachypnoeic patients unable to perform a conventional inhalation manoeuvre can use one-way valve inhalation devices with repeated tidal breaths. Finally, sequential or even continuous inhalation techniques have recently been advocated, particularly in patients with impending respiratory failure.
Overview of safety and efficacy of CT guided biopsy for the diagnosis of lung cancer in a district general hospital (DGH)
Authors: Axel Sylvan, Yin Liu, Tom Houghton, Choong Poon, Ram Sundar, Imran Aziz
Journal: European Respiratory Journal (2012)

Background : Obtaining conclusive histology to diagnose lung cancer is an important part of the management of potential lung cancer patients. The 2 main methods used to get tissue diagnosis are bronchoscopy with biopsy and CT guided biopsy. Due to recent advancement in the techniques CT guided biopsy is becoming increasingly important in obtaining histology samples. The main complications of the procedure are bleeding and pneumothorax. We describe our experience of numbers and complications of CT guided biopsy over 4 years in a DGH in Northwest England.   Results : We collected samples over 4 years (2008-2011) of CT guided biopsy booked in our hospital. 314 procedures were planned in 313 patients. 292 procedures were carried out. The main reason for not carrying out the procedure was shrinkage of the mass seen on the day of the procedure.  Post procedure pneumothorax was observed in 82 (28.1%), out of which 6/82 (7%) lead >10% lung collapse (visual estimate). 102 (34.9%) procedures resulted in parenchymal haemorrhage, out of which 8/102 (7.8%) were visually classed as substantial.  None of the patients required insertion of chest drain or transfusion, although 6 patients were kept in the hospital for observation (maximum stay 4 days).   Conclusion : We have shown that CT guided biopsy is a safe procedure and can be carried out without major complications in a DGH. In our sample the complication rate (usually described as 2% patients requiring chest drain insertion) was very low. We are at present in the process of re-writing hospital guidelines regarding post procedure observation and patient guidelines.
Upper airways resistance and snoring in anaesthetized dogs
Authors: JG Widdicombe, A Davies
Journal: European Respiratory Journal (1988)

We have measured upper airways resistance from the trachea and from the pharynx to the atmosphere, EMG of genioglossus muscle, and the sound of snoring, in anaesthetized greyhounds breathing spontaneously through the upper airways. Using extra-corporeally produced continuous flow we determined flow/pressure curves for the upper airways in an expiratory direction and analysed them in terms of resistances from the trachea and from the pharynx. Resistances and other variables were determined with the nose open and the nostrils blocked. About one-third of the dogs snored spontaneously and most of the remainder did so when the nose was blocked. During snoring with nasal blockage the upper airways resistance increased considerably, and the sound of snoring and genioglossus EMG were also enhanced. The results show that the anaesthetized greyhound is a suitable model for studying snoring with simultaneous measurements of upper airways resistance and the activity of pharyngeal dilator muscles.
Effect of cold stimulation over face on 6 minute walk distance (6MWD), oxygen saturation and dyspnea scores in patients with COPD
Authors: Shweta Rasam, Devashree Salvi, Yogesh Thorat, Sandeep Salvi, Rahul Kodgule
Journal: European Respiratory Journal (2014)

Background: Earlier studies have shown that blowing cold air over the face reduces dyspnea in patients with COPD presumably by stimulation of cold receptors over face. We aimed to study the effect of cold stimulation over face by ice application on 6MWD and dyspnea perception in patients with COPD. Methods: In this cross-over study, 33 patients with COPD were treated with application of ice pack and normal water pack over face in randomized sequence during six-minute walk test. The distance walked in six minutes (6MWD) and Borg dyspnea score, oxygen saturation (SpO2), heart rate and respiratory rate at 6 minutes were compared between the two treatments after adjusting for the baseline values. Results: 6MWD was similar with both treatments (Ice=409±12 m, water=398±12 m, p=0.541). SpO2 after 6 minute-walk was significantly higher with ice treatment (95.93±0.45) compared to water (94.43±0.45, p=0.022). Borg's dsypnea score was similar with both treatments (5.46±0.43 with ice vs. 5.57±0.43 with ice, p=0.85).There were no differences between treatments for rest of the parameters

View this table:

Comparison of post 6-minute walk values between ice and water treatments





. Conclusion: Cold stimulation over face reduces exercise induced hypoxia but does not impact perception of breathlessness or 6MWD in patients with COPD.
Building Bridges Between Physicians and Patients: Results of a Pilot Study Examining New Tools for Collaborative Decision Making in Breast Cancer
Authors: Karen R. Sepucha, Jeffrey K. Belkora, Debasish Tripathy, Laura J. Esserman
Journal: Journal of Clinical Oncology (2000)

To present the results of a pilot study testing an intervention designed to improve the quality of medical consultations between breast cancer patients and physicians and, in particular, to report the effects of the intervention on the quality of treatment decisions, the quality of communication, and the satisfaction of patients and physicians.We enrolled 24 predominantly white, well-educated, early-stage breast cancer patients who were facing local or systemic treatment decisions in a sequential, controlled trial. All patients received a visit preparation session before the consultation in which a trained researcher helped patients organize their questions and concerns. In the control, a researcher observed the consultation. In the intervention, a researcher helped create an agenda, facilitated the discussion, and created a record of the consultation in real time. Valid and reliable surveys measured the quality of treatment decisions and satisfaction with the consultation.Patients in the intervention achieved significantly higher final decision quality scores compared with control patients (median score, 14 v 10, respectively; P =.008) and a significantly higher level of intersubjective agreement with their physicians about decision quality (Cohen's kappa, 0.49 v 0.285, respectively; P <.0001). Consultation recording methods did not affect the length of time required for the consultation.Consultation recording methods provide a promising innovation for medical consultations. Further studies are warranted to broaden the findings, assess impacts on the quality of decisions, cost, and health, and develop practical ways to integrate consultation recording methods into clinics.
Teniposide for brain metastases of small-cell lung cancer: a phase II study. European Organization for Research and Treatment of Cancer Lung Cancer Cooperative Group.
Authors: P E Postmus, E F Smit, H Haaxma-Reiche, N van Zandwijk, A Ardizzoni, E Quoix, A Kirkpatrick, T Sahmoud, G Giaccone
Journal: Journal of Clinical Oncology (1995)

PURPOSE Here we report the results of a phase II study of teniposide, one of the most active drugs against small-cell lung cancer (SCLC), in patients with brain metastases. PATIENTS AND METHODS Patients with SCLC who presented with brain metastases at diagnosis (n = 11) or during follow-up evaluation after treatment (n = 69) were treated with teniposide at a dose of 150 mg/m2 intravenously on days 1, 3, and 5 at 3-week intervals in an outpatient setting. Response in the brain was evaluated by brain computed tomography (CT) after two, six, and 12 courses. RESULTS In 26 of 80 assessable patients, an intracranial response was seen, with a response rate of 33% (95% confidence interval, 22% to 44%). The median response duration was 5.4 months for patients with a complete response (CR) and 4.2 months for patients with a partial response (PR). Patients who required corticosteroids for peritumoral edema had a significantly lower response rate than patients who did not receive corticosteroids. Neurologic function at the start of treatment had a significant influence (neurologic function 1 better than 2, respectively, better than 3 and 4; P &lt; .001), as did the number of cycles of previous chemotherapy (0 better than 1 to 5 cycles, respectively, better than &gt; 5 cycles; P = .043). Grade 3/4 leukocytopenia and thrombocytopenia were seen in 3% and 39%, respectively, of 80 patients. Toxicity-related death was seen in eight patients, seven of whom were previously treated with chemotherapy. CONCLUSION Teniposide is active against brain metastases of SCLC. It is a suitable drug for palliation, especially of patients without extensive pretreatment and with a good neurologic function and performance status. Patients previously treated with cranial radiotherapy are also candidates for this therapy. If systemic chemotherapy is considered for tumor progression outside the brain, radiotherapy of brain metastases might be omitted or delayed pending the effect of chemotherapy. The use of corticosteroids in patients with brain metastases treated with chemotherapy might influence the efficacy of the chemotherapy.
Extracellular proteasomes are cAMP-dependent released by alveolar epithelial cells type II
Authors: Stephan J. Schließmann, Kerstin Höhne, Timur Anlasik, Matthias Schmidt, Martin J. Hug, Andreas Kirschbaum, Joachim Müller-Quernheim, Gernot Zissel, Stephan U. Sixt
Journal: European Respiratory Journal (2013)

The repair mechanism resulting in alveolar protein degradation is largely unknown.  In the alveolar space the presence of extracellular, biologically active proteasomes are recently reported [1,2]. The proteasome is involved in protein degradation and is able to degrade proteins at a high rate, possibly to minimize oncotic pressure [1].  We tested proteasome release by alveolar epithelial cells type II (AEC-II).  AEC-II were isolated from 24 macroscopically tumour-free lung tissues as described previously [3].  Cells were stimulated with dibutyryl cAMP; for second part of the study after levelling with 1 µM indomethacin and 10 nM PGE2. Unstimulated AEC-II and primary isolated PBMC served as control. Extracellular proteasome concentration was measured by an established ELISA targeting the proteasome in supernatant. For statistical evaluation the Wilcoxon signed rank test was applied.  Our study demonstrates for the first time that human non-tumourous AEC-II do release proteasomes. Stimulated with db-cAMP, the extracellular proteasome concentration (median unstim. 700 ng/mL) results in a wide insignificant range (median stim. 600 ng/ml). Indeed after levelling with indomethacin and PGE2 (median unstim. 400 ng/ml) the stimulation with db-cAMP. increases proteasome release highly significantly (stim. 460 ng/ml).  Unchanged proteasome concentration in the alveolar fluid showed no artificial elution of the proteasomes by the pre-smoking lavage.  In conclusion, AEC-II release proteasomes cAMP-dependent into the alveolar space.  [1] Sixt, S.U. et al. Am J Physiol Lung Cell Mol Physiol 2007; 292:L1280-8  [2] Sixt, S.U. et al. Am J Respir Crit Care Med 2009; 179:1098-106.  [3] Hoehne, K. et al. PLoS One 2012; 7:e38369.
Sarcoidosis associated pulmonary hypertension (SAPH) in the Netherlands
Authors: Eva Bots, Marlies Wijsenbeek, Leon van den Toorn, Henk Hoogsteden, Bernt van den Blink
Journal: European Respiratory Journal (2012)

Background:

The development of pulmonary hypertension (PH) is an important risk factor for early mortality in sarcoidosis. The prevalence is of SAPH in Europe is largely unknown.

Aim:

To investigate the prevalence of and clinical parameters associated with SAPH in the Netherlands.

Methods:

We analyzed clinical data and transthoracic echocardiograms (TTEs), made routinely at our PH/Interstitial Lung Disease clinic, from consecutive patients. Sarcoidosis patients with reliable echocardiography, without left heart dysfunction, were included. An estimated systolic pulmonary artery pressure (sPAP) > 50 mmHg was considered PH. Possible PH was defined as sPAP 37-50 mmHg or sPAP ≤ 36 mmHg with signs of right ventricular dysfunction.

Results:

From 139 sarcoidosis patients, 130 were included with stage 0 (11), I (46), II (39), III (7), IV (16). 5 patients (3,8%) had PH and 6 (4,6%) possible PH. Patients with PH were all women, predominantly black (4 out of 5) with stage IV disease (4 out of 5). 4 out of 6 patients with possible PH (3 white, 3 Asian) had stage I disease.

TLCO % pred was lower in PH compared to no PH (median: 46,0 (18- 47) vs 78,50 (29,0- 119) p < 0,01). FEV1 % pred was decreased in PH compared to no PH (median: 48,0 (36,0- 96,0) vs 82,0 (30,0- 131,0) p< 0,05). TLC was decreased in PH (median: 61,0 (51,0- 91,0) vs 82,50 (46,0- 116)), but not significantly different. In possible PH pulmonary function showed no significant difference versus no PH.

Conclusions:

SAPH is uncommon in the Netherlands and mainly found in black women with stage IV disease and associated with decreased lung function. Unexpectedly, suspicion of PH was found in some patients with stage I disease, warranting further investigation.
Vitamin D level predicts clinical outcome in community-acquired pneumonia
Authors: Hilde Remmelts, Ewoudt van de Garde, Sabine Meijvis, Evelyn Peelen, Jan Damoiseaux, Jan Grutters, Douwe Biesma, Willem Jan Bos, Ger Rijkers
Journal: European Respiratory Journal (2012)

Rationale: Vitamin D plays a role in host defense against infection. Vitamin D deficiency is common. The prognostic value of vitamin D in pneumonia is unknown.  Objective: To examine the impact of vitamin D status on outcome in community-acquired pneumonia (CAP).  Methods: Subanalysis of a prospective study in 272 adults presenting to the emergency department with CAP. 25-hydroxyvitamin D, leukocytes, C-reactive protein, total cortisol, the Pneumonia Severity Index (PSI) score and the CURB-65 score were measured. Intensive care unit (ICU) admission during hospitalization and 30-day mortality were assessed.  Results: 143/272 patients (53%) were vitamin D deficient (≤50 nmol/L), of which 65 patients were severe deficient (  Conclusion: The vitamin D level is an independent predictor of 30-day mortality, and adds prognostic value to the PSI score.
Endobronchial ultrasound-guided transbronchial needle aspiration in mediastinal staging of extrathoracic neoplasm
Authors: Vanessa Santos, Maria Sucena, Adriana Magalhães, Gabriela Fernandes
Journal: European Respiratory Journal (2014)

Introduction   The presence of mediastinal lymph node metastasis (MLNM) in patients with extrathoracic malignancy (ETM) has prognostic and therapeutic consequences, implying pathological confirmation of malignancy. Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) can be useful in this setting.   Objectives:  Evaluate the utility of EBUS-TBNA in the diagnosis of MLNM in patients with ETM.   Methods:  Retrospective analysis of patients with ETM with enlarged intrathoracic lymph nodes (LN), referenced to perform EBUS-TBNA between 2009 and 2012.   Results:  189 patients underwent EBUS-TBNA to investigate mediastinal LN. 14.8% (28) had clinical suspicion of ETM9s metastasis. 60.7% male, mean age of 58.2±16.3years. 19 had history of malignancy: colorectal (8), kidney (5), breast (3), oesophagus (3), ovarian (2), skin (2), thyroid (1), prostate (1), testicular (1) and metastasis of unknown tumor (2). Histological diagnosis of ETM was under investigation in 9 patients. Results were: metastasis of ETM (10), reactive LN (13), nodal involvement of lung tumor(1), granulomatous disease (2) and non-representative sample (2). Among 13 patients with reactive LN and 2 non-representative samples, 2 MLNM were confirmed by another EBUS-TBNA procedure/clinical surveillance (false negatives), 11 patients were confirmed by clinical/radiological surveillance (true negatives) and in 2 the diagnosis wasn9t confirmed. Sensitivity, negative predictive value and diagnostic accuracy in the diagnosis of MLNM were 83.3, 87.5 and 85.7%, respectively.   Conclusion   EBUS-TBNA is an effective procedure in the diagnosis of MLNM in patients with ETM and should be included in their evaluation.
Humoral Antibody Response and Tumor Transplantation Resistance Elicited by Fetal Tissues in Mice
Authors: Chou-Chik Ting, John P. Grant
Journal: JNCI Journal of the National Cancer Institute (1976)

Immune responses to fetal antigen immunization were studied in C57BLJ6 (B6), C3HJHeN (C3H), and BALBJc (BALB) mice. In tests by the isotopic antiglobulin technique, the mice could be grouped in three classes according to their antibody responses: good responders (86), poor responders (C3H), and nonresponders (BALB). In tumor transplantation experiments, protection against syngeneic tumor cell challenge, after fetal tissue immunization, was observed only with B6 mice. In addition, experiments on 86 mice showed that resistance to tumor challenge after fetal tissue immunization depended on the quantitative expression of fetal antigens by the tumor cells. Our results indicated that, in addition to other well-known factors, the effectiveness of fetal tissue immunization in tumor challenge resistance depended on both host reo sponsiveness and the amount of fetal antigen expressed by the tumor cells.
Resistance of Salmonella and Shigella in Turkey
Authors: Ayse Willke, Dilek Arman, Fügen Çokça, Bülent Sümerkan, Güner Söyletir, Mehmet Bakir, Fatma Sirmatel, Hakan Leblebicioğlu, Sirn Kiliç
Journal: Clinical Microbiology and Infection (1999)