tbuckley/cabot-search huggingface dataset:
Comparing the 2007 and 2011 GOLD classifications as predictors of all-cause mortality and morbidity in COPD
Authors: Maurits Klatte, Maaike Zuur-Telgen, Paul Van der Valk, Job Van der Palen, Marjolein Brusse-Keizer
Journal: European Respiratory Journal (2014)

Aims

The 2007 GOLD classification identifies COPD patients based on lung function. Because lung function correlates poorly with clinically relevant outcomes, in 2011 risk and burden of disease were added to the model. Main objective of our study was to investigate whether the 2011 COPD GOLD model is a better predictor of mortality and morbidity than the 2007 classification. Furthermore, the predictive power of the GOLD 2011 classification with the modified medical research council scale (mMRC) versus Clinical COPD Questionnaire (CCQ) was compared.

Methods

This study was performed in 645 COPD patients from the COMIC study of whom all data for both classification models were known. Cox-regression models with C-statistic were calculated to compare the predictive power of all models.

Results (see figure 1)

Overall, C-statistics were higher in the 2011 models compared to the 2007 model in predicting all cause mortality. Using the CCQ with a cut-off of 1.5 showed higher C-statistics and better discrimination between the four categories (ABCD) than the cut-off of 1.0 and the mMRC. Similar results are observed for hospitalisations and pneumonias in COPD.

Conclusion

In COPD patients, the 2011 COPD GOLD classification is improved in predicting mortality, hospitalizations for COPD exacerbations and pneumoniaswhen compared to the 2007 classification and performs best when the CCQ with cut off of 1.5 is used.

![Figure][1]  [1]: pending:yes
Expert Consensus on the Management of Adverse Events from EGFR Tyrosine Kinase Inhibitors in the UK
Authors: R. Califano, N. Tariq, S. Compton, D. A. Fitzgerald, C. A. Harwood, R. Lal, J. Lester, J. McPhelim, C. Mulatero, S. Subramanian, A. Thomas, N. Thatcher, M. Nicolson
Journal: Drugs (2015)

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) such as gefitinib, erlotinib, and afatinib are standard-of-care for first-line treatment of EGFR-mutant advanced non-small cell lung cancer (NSCLC). These drugs have a proven benefit in terms of higher response rate, delaying progression and improvement of quality of life over palliative platinum-based chemotherapy. The most common adverse events (AEs) are gastrointestinal (GI) (diarrhoea and stomatitis/mucositis) and cutaneous (rash, dry skin and paronychia). These are usually mild, but if they become moderate or severe, they can have a negative impact on the patient's quality of life (QOL) and lead to dose modifications or drug discontinuation. Appropriate management of AEs, including prophylactic measures, supportive medications, treatment delays and dose reductions, is essential. A consensus meeting of a UK-based multidisciplinary panel composed of medical and clinical oncologists with a special interest in lung cancer, dermatologists, gastroenterologists, lung cancer nurse specialists and oncology pharmacists was held to develop guidelines on prevention and management of cutaneous (rash, dry skin and paronychia) and GI (diarrhoea, stomatitis and mucositis) AEs associated with the administration of EGFR-TKIs. These guidelines detail supportive measures, treatment delays and dose reductions for EGFR-TKIs. Although the focus of the guidelines is to support healthcare professionals in UK clinical practice, it is anticipated that the management strategies proposed will also be applicable in non-UK settings.
Pneumocystis carinii pneumonia in HIV-infected patients: diagnostic yield of induced sputum and immunofluorescent stain with monoclonal antibodies
Authors: J Fortún, E Navas, P Martí-Belda, P Montilla, J M Hermida, M J Pérez-Elías, L Buzón, A Guerrero
Journal: European Respiratory Journal (1992)

The purpose of this study was to evaluate the diagnostic yield of induced sputum (IS), assessing the reliability of indirect immunofluorescent stain with monoclonal antibodies (IFMoAb) and methenamine silver (Met-Ag) and analysing factors likely to influence the sensitivity of these techniques. An analysis was prospectively carried out on IS specimens collected from 61 human immunodeficiency virus (HIV)-infected patients during 69 episodes of suspected Pneumocystis carinii pneumonia. Ultrasonic nebulizers with hypertonic 2% saline were used. IFMoAb to P. carinii and Met-Ag were performed after cytocentrifugation of the specimen. Results were compared with those of bronchoalveolar lavage (BAL) with/without transbronchial biopsy (TBB), performed not more than seven days after induction of sputum. P. carinii pneumonia was confirmed in 32 episodes, of which IS was diagnostic in 23. The sensitivity of the staining procedures was 69% for IFMoAb, and 28% for Met-Ag. The three episodes of P. carinii pneumonia in patients on oral chemoprophylaxis yielded negative IS results; in contrast, IS was negative in only 6 of the 29 cases not receiving chemoprophylaxis. IS is a non-aggressive procedure that diagnosed P. carinii pneumonia in 72% of our cases. The yield increased significantly when IFMoAb was used in patients not receiving oral chemoprophylaxis.
Validation of the UCLA Integrated Staging System for Patients With Renal Cell Carcinoma
Authors: Amnon Zisman, Allan J. Pantuck, Robert A. Figlin, Arie S. Belldegrun
Journal: Journal of Clinical Oncology (2001)

Article Tools SPECIAL DEPARTMENTS Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.2001.19.17.3792 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 11533107 Validation of the UCLA Integrated Staging System for Patients With Renal Cell Carcinoma Amnon ZismanxAmnon ZismanSearch for articles by this author , Allan J. PantuckxAllan J. PantuckSearch for articles by this author , Robert A. FiglinxRobert A. FiglinSearch for articles by this author , Arie S. BelldegrunxArie S. BelldegrunSearch for articles by this author Show More UCLA School of Medicine, Los Angeles, CA https://doi.org/10.1200/JCO.2001.19.17.3792 First Page Full Text PDF Figures and Tables © 2001 by American Society of Clinical Oncology
Nonimmune and Immune Surveillance. II. Effect of Recipient's Age, Tumor Immunogenicity, and Neonatal Thymectomy on Tumor Growth Inhibition
Authors: Svetlana N. Zinzar, George J. Svet-Moldavsky, Natalia V. Karmanova
Journal: JNCI Journal of the National Cancer Institute (1978)

After a suspension of tumor pieces was grafted into newborn and adult (CBA X C57BL/6J)F1 and BALB/c mice, the growth of Lewis lung adenocarcinoma and mammary gland adenocarcinoma was inhibited in newborn mice, whereas sarcoma of the rectum (SR-1-75) grew at the same rate in newborn and adult recipients. Neonatal thymectomy stimulated the growth of hepatoma (H-2-73) in newborns. The degree of tumor growth inhibition was age-dependent: The maximum inhibition was observed in 1- to 6-day-old recipients, but later it gradually decreased. The hepatoma (H-2-73) and ovarian carcinoma (OC-1-75) with inhibited growth in newborns and the tumor (SR-1-75) with uninhibited growth had equally low immunogenicity. The data suggested that newborns possess factors that inhibit tumor growth but these factors disappear with increased age of recipients.
Inhibition of Cell-Mediated Cytotoxicity Against Tumor-Associated Antigens by Suppressor Cells From Tumor-Bearing Mice
Authors: Moshe Glaser, Holger Kirchner, Howard T. Holden, Ronald B. Herberman
Journal: JNCI Journal of the National Cancer Institute (1976)

Spleen cells from mice bearing primary tumors induced by Moloney strain of murine sarcoma virus (M-MuSV) strongly inhibited the in vitro generation of specific secondary cell-mediated cytotoxic response of spleen cells from M-MuSV regressor mice. These suppressor cells were resistant to treatment with anti-theta serum and complement or to X-irradiation. It appeared that suppressor cells may have had a role in limiting the host's immune response against tumor growth.
Tumors and Immunological Response in Rhesus Monkeys Born After &lt;italic&gt;In Utero&lt;/italic&gt; Inoculation With Rous Sarcoma Virus
Authors: L. D. Berman, P. Mary Cotes, P. J. Simons
Journal: JNCI Journal of the National Cancer Institute (1967)

Fetal (66–114 days gestation), young (22–34 days), and adult rhesus monkeys were inoculated with Schmidt-Ruppin strain of Rous sarcoma virus. Fetuses can survive inoculation, and 7 of 12 treated fetuses were born as live babies. In treated monkeys tumors developed in 6 of 12 fetuses, in 2 of 3 young, but not in 2 adults. Prenatally and postnatally induced tumors regressed spontaneously, although partial excision was carried out to control growth in one animal. Tumor incidence appeared greater with larger doses of virus. The complement fixation avian leukosis (COFAL) antibody, demonstrable by complement fixation and immunodiffusion, appeared 3 weeks after birth in 1 monkey born with a tumor and at the time of tumor development in a young monkey treated with virus after birth. Antibody was not present in serum collected soon after birth from 6 treated monkeys, 3 born with and 3 without tumors. Virus-neutralizing antibody was present in serum from 1 of 2 monkeys born with tumors and tested soon after birth; it appeared at the time of tumor development in another monkey treated with virus after birth, but it was not detected in serum from 2 treated fetuses born without tumors. Its appearance preceded the demonstration of COFAL antibody. Two monkeys with tumors did not show complement-fixing or virus-neutralizing antibody; in these animals possible immunological tolerance to the group specific (GS) and type specific (TS) leukosis antigens cannot be excluded. Eventual tumor regression in all animals indicated unimpairment of the cellular homograft rejection mechanism.
Behavioural counselling in general practice about risk of CHD
Authors: F D R. Hobbs, G. Frost, C. Dore, G. Davey Smith, S. Ebrahim, R. Bennett, A. Steptoe, E. Rink, S. Kerry, T. Kendrick, S. Hilton
Journal: BMJ (2000)

Attempts to modify the risk of cardiovascular disease through individually based health education activities have proved disappointing. The report of the apparently successful trial of behavioural counselling seems to provide just what is needed to improve the efficacy of health promotion.
Effectiveness of dexmedetomidine in agitated patients receiving non-invasive ventilation for acute hypoxemic respiratory failure – A pilot study
Authors: Vera Baturova, Dmitry Levikov
Journal: European Respiratory Journal (2014)

Acute hypoxemia can be accompanied by patient's agitation, which may lead to non-invasive ventilation (NIV) failure.

The aim of our study was to estimate the effectiveness and safety of dexmedetomidine in comparison to haloperidol sedation in agitated patients requiring NIV.

We enrolled 31 patients admitted to the intensive care unit due to acute hypoxemic respiratory failure in whom NIV was difficult because of agitation and prescribed dexmedetomidine to facilitate NIV in the treatment group (n=16) vs. haloperidol sedative therapy (n=15).

Patients who were sedated with dexmedetomidine (n=16) and haloperidol (n=15) were cooperative enough for full-face mask NIV. Richmond Agitation-Sedation Scale scores were maintained at 2.3±0.4 in both groups. In haloperidol group 5/15 patients deteriorated their oxygenation status, which resulted in endotracheal intubation. Patients who received dexmedetomidine required less intubations (2/16 vs. 5/15) and 14/16 were successfully weaned from NIV. Dexmedetomidine sedation was associated with better survival rate by Kaplan-Meier test (p<0.05). Dexmedetomidine patients presented with systemic hypotension more often than haloperidol patients (7/16 vs. 4/15). The demand of vasopressor support in dexmedetomidine and haloperidol groups was 8/16 and 4/15 respectively. However, circulatory distress was neutralized in all patients.

In agitated patients requiring NIV dexmedetomidine shows a sedative effect that is non-inferior to haloperidol and has better outcomes in secondary intubation and survival rates. Dexmedetomidine appears to cause overt hypotension more often, though this effect seems to be treatable.
Referral of Dr Peter Mansfield to the GMC
Authors: R. Whitmore, M. Alexander, K D Bardhan, A. Manning, G. Gardner
Journal: BMJ (2001)

Medical Council is flawed as he assumes that Worcestershire Health Authority has power in managing its responsibility for a successful public health immunisation campaign. 1It is precisely because the authority is impotent as a public statutory public body that it asked the GMC to intervene.The continuing debate about measles, mumps, and rubella vaccine dents the confidence of many public and professional people, not least because of the assumption that there is no smoke without fire.Majeed's third reference indicates his anxiety despite his initial position statement on the safety of the vaccine.Patients and the media take heed of these different emphases.Maintaining a high level of vaccination cover against diseases that are seen rarely or not at all poses serious difficulties.Majeed's role as an educationalist-a position of power and responsibility-could provide a forum where these difficulties are debated.The role of medical journals and the media should not be ignored in that debate.Their keenness for headlines containing bad news, however misguided or ill informed, while
Brentuximab Vedotin in Patients With Relapsed HIV-Related Lymphoma
Authors: Mitul Gandhi, Adam Petrich
Journal: Journal of the National Comprehensive Cancer Network (2014)

Lymphoma is a well-recognized complication in patients infected with HIV. Although its incidence has declined since the advent of antiretroviral therapy, it remains higher than seen in the general population. Several recent studies have noted improvement in clinical outcomes with the use of modern chemoimmunotherapy regimens. In patients who experience relapse, however, fewer data are available on the role of immunotherapy and its impact on outcomes. This case report presents 2 patients with relapsed HIV-associated lymphoma who experienced a second complete remission after treatment with the immunotherapy agent brentuximab vedotin.
Abstract 1319: Plasma Levels of Fatty Acid Binding Proteins 4 and 5 are Markers of Adiposity and the Metabolic Syndrome but are not Independent Predictors of Subclinical Atherosclerosis in Type 2 Diabetes
Authors: Roshanak Bagheri, Michael Lehrke, Shiv Kapoor, Megan Wolfe, Karen Terembula, Daniella Barou, Nayyar Iqbal, Daniel Rader, Muredach P Reilly
Journal: Circulation (2007)

Objectives: Adipocyte-fatty acid binding protein (aP2) or FABP4 is expressed predominantly in adipose and macrophages. Its less abundant family member, FABP5 (Mal1), is more diffusely expressed but also found in adipocytes and macrophages. Gene deletion studies in rodents suggest that FABP4, to a greater extent than FABP5, modulates obesity and atherosclerosis. Preliminary clinical studies support a relationship of circulating FABP4 with obesity and the metabolic syndrome (MetSyn). However, there are no studies of circulating FABPs and atherosclerosis in humans. Methods: We evaluated the association of FABP4 and 5 (ELISA, Biovender) with cardiovascular risk factors, NCEP-defined MetSyn and Coronary Artery Calcification (CAC) in 846 asymptomatic, type 2 DM subjects (62.5% Caucasian, 32.5% African-American; 60% male; aged 58.6±9.2) recruited to the Penn Diabetes Heart Study. Findings : Levels [(median (IQ range)] of FABP4 [37.1 (23.0–55.2) vs 20.9 (14.0–31.0) ng/mL; p&lt;0.001] and FABP5 [1.5 (1.2–1.9) vs 1.4 (1.1–1.8) ng/mL; p&lt;0.01] were higher in women than men. FABP4 was significantly correlated with waist circumference (r=0.4, p&lt;0.001), levels of leptin (r=0.5, p&lt;0.001), insulin (r=0.21, p&lt;0.001), hsCRP (r=0.23, p&lt;0.001), triglycerides (r=0.25, p&lt;0.001) and inversely with HDL cholesterol (women r=−0.23, p&lt;0.001; men r=−0.11, p&lt;0.05). Plasma FABP5 had similar, but weaker biomarker correlations. Both were strongly associated with MetSyn (FABP4 χ 2 =29.8, p&lt;0.0001; FABP5 χ 2 =36.2, p&lt;0.0001). Notably, FABP4 [22.7 (15.0–35.9) vs 34.4 (22.9–55.0), p&lt;0.001], but not FABP5 (p&lt;0.89), levels were lower in subjects on thiazolidinedione therapy. In tobit regression, FABP4, but not FABP5, levels above the median were associated with CAC scores after adjustment for age, gender and ethnicity [1.68 (1.05–2.66), Ratio (CI), p&lt;0.03] but this was attenuated after further adjusting for BMI and established risk factors [1.52 (0.49–2.48), Ratio (CI), p&lt;0.09]. Conclusion: Both FABP 4 and 5 are biomarkers of adiposity and MetSyn. In the first study of its kind, plasma FABP4, but not FABP5, was associated with CAC in type 2 DM, but neither were independent predictors of this subclinical atherosclerosis measure.
Spontaneous Sternal Fracture — A Misnomer
Authors: R C Bowyer, V L R Touquet
Journal: Journal of the Royal Society of Medicine (1986)

Spontaneous sternal fractures, although rare, may present to the Accident and Emergency Department as a severe central chest pain of sudden onset. These may be confused with myocardial infarction 1 or pulmonary embolism 2 . Treatment in the uncomplicated case may be symptomatic with analgesics, but this fracture may require sternal wiring if paradoxical sternal movement embarrasses respiration. Spontaneous fracture of the sternum appears in the majority of cases to be due either to secondary metastatic infiltration, myelomatosis or extreme osteoporosis 3 . We report a case which emphasizes the importance of investigating these patients.
Impact of smoking on physical activity level and functional status of hospitalized patients: A bicentric study
Authors: Adriana Lunardi, Daniel Souza, Fernando Wegner, Luciana Chiavegato
Journal: European Respiratory Journal (2013)

Smoking potentiates the deleterious effects of sedentary lifestyle. Low physical activity level and low functional status are predictors of complications during hospitalization. Therefore, the aim of this study was to compare the impact of smoking on physical activity level and functionality of hospitalized patients in two cities. This bicentric and controlled study involved 60 patients from two hospitals (one in southeast region and one in northeast region) in Brazil, due to clinical or surgical reasons. Smokers (n=30; 52.8±19.9yrs; 27.1±6.3Kg/m2) and Nonsmokers (n=30; 46.7±18.5yrs; 28.3±9.6Kg/m2) matched for age and body mass index, and without severe musculoskeletal impairments, and who have signed the consent form, were selected and evaluated until 24 hours after admission. The IPAQ-version 6 questionnaire, Barthel index (score 0-100) and Human Profile Activity (HPA) questionnaire (score 0-94) were applied to all patients. One way ANOVA, chi-quare test and linear regression were used. Significance level was set at 5%. The prevalence of physical inactive into smoker was higher than into nonsmoker inpatients (46% vs. 22%; p
The effect of changes in quality of life in patients with lung cancer in the observation period (European Organization for Research and treatment of Cancer) EORTC QLQ-C 30 results of the evaluation and follow-up (AKAYAK-1 project)
Authors: Aysen Öz, Pinar Çelik, Tuncay Göksel, Ahmet Emin Erbaycu, Erhan Eser, Burcu Basarik, Kader Kiyar Gürsul, Ebru Çakir Ediz, Osman Hatipoglu, Bedriye Atay Yayla, Sevin Baser, Hakan Baydur
Journal: European Respiratory Journal (2013)

Aim:  We aimed to assess the quality of life in lung cancer patients, the effect of changes in the observation period with the results of the EORTC-C30 scale and follow-up evaluation determine the relationship between patient and cancer response.   Materials and Methods:  Turkish Thoracic Society, Lung - pleural Malignancies Study Group and Association of Health and Quality of Life carried out jointly Lung Cancer Quality of Life Quality of Life Project (Akayak-1) in the framework of a prospective cohort study. Stage IIIB-IV patients with primary lung cancer were monitored. Analysis of the effect of changes in quality of life STATA 12.0.   Findings:  Total 224 patients, mean age 61.4, the most frequently squamous cell carcinoma, adenocarcinoma was the most common in women.  Average survival time was 444.9 days. Age, gender, type, stage of tumor was not significantly associated with survival. Increase of ECOG one step risk of death increased 2.3 times. Deterioration in the quality of life was found to be independent prognostic factor. Deterioration in general well-being, physical, emotional, clutch function impairment, fatigue, nausea, vomiting, pain, dyspnea, insomnia, loss of appetite, constipation, negative impact on survival. Increase in financial difficulties had negative impact on the survival. Only the social function, diarrhea were not associated with survival.   Conclusion:  In this study, performance status, quality of life was independent, strong prognostic factors for survival. Life time improving quality of life for these patients is extremely important.
Assessment the dependence between nutritional status and functional damage of the lungs as well as prognosis in BODE index in COPD patients
Authors: Barbara Kuznar-Kaminska, Marcin Grabicki, Beata Brajer-Luftmann, Halina Batura-Gabryel
Journal: European Respiratory Journal (2013)

Cachexia is systemic manifestation of COPD, that can influence on disease outcome and patients prognosis. Aim of study was assessment the dependence between nutritional status and functional damage of lungs 2.Evaluation the connection between cachexia parameters and disease prognosis in BODE index. 114 patients – 60,5% males and 39,5% females, mean age 65,6 +/- 9,3 in different stages of stable COPD participated in the study. Nutritional status was evaluated by BMI, FMI, FFMI, MMI using bioimpedance method. Functional tests – spirometry, bodypletysmografy and diffusion test were performed in order to measurment of FEV1, RV, ITGV, RV/TLC, DLCO. Each participant was assessed in BODE index. Malnutrition assessed with BMI, FFMI was found in 7,02% and 16,66 % of COPD patients, respectively. In most patients 52,63% very severe stage of obstruction was found. It was observed dependence between parameters of nutritional status and stage of the obstruction in subgroup of patients with cachexia BMI, FFMI, MMI & FEV1 (r=0,51, 0,36, 0,42, respectively). BMI and FMI inversely correlated with indicators of lung hyperinflation in subgroup of malnourished patients BMI & RV, ITGV, RV/TLC (r = -0,65; -0,72; -0,48 respectively), but not for other parameters of cachexia: FFMI, MMI. It was confirmed inversely correlation between BMI and MMI with prognosis in BODE index, better found in group of patients with malnutrition BMI, MMI & BODE (r = -0,67 -0,60), respectively.  1. Presence of cachexia is an important parameter affecting functional worsening of lung parameters. 2. Malnutrition is negative prognostic factor measured in BODE index in group of COPD patients.