tbuckley/cabot-search huggingface dataset:
Impact of pneumonia on mortality and length of stay in patients hospitalized with acute COPD exacerbations
Authors: Siw Lillevik Andreassen, Erik Dyb Liaaen, Nikolai Stenfors, Anne Hildur Henriksen
Journal: European Respiratory Journal (2011)

Background and aims:  Community acquired pneumonia (CAP) is common among patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease (COPD).  The aims were to study the impact of (CAP) on the length of hospital stay (LOS), the in-hospital mortality, and the use of non-invasive ventilation (NIV) regardless of COPD severity in patients hospitalized because of COPD exacerbations.   Methods:  Retrospectively all COPD hospitalizations in the Departments of Internal and Respiratory Medicine in one Swedish and two Norwegian hospitals were registered. A total of 1144 admissions (731 patients) were identified from patient administrative systems. CAP was defined as pneumonic infiltrates on x-ray and CRP values over or equal to 40 mg/L, and 237 admissions followed these criteria. Non-CAP was defined as no pneumonic infiltrates on x-ray and CRP lower than 40.   Results:  Patients with CAP had higher usage of NIV (18.1% versus 12.5%, p=0.04) and increased LOS (median 9 days versus 5 days, p   Conclusions:  In conclusion, the in-hospital mortality was not increased among COPD patients with CAP compared to the non-CAP group. This may in part be explained by the more frequent treatment with antibiotics and NIV among the COPD patients with CAP and partly because a higher proportion of those with CAP had mild to moderate COPD compared to the non-CAP group.
Association of Asthma Control with Health Care Utilization
Authors: WILLIAM M. VOLLMER, LEONA E. MARKSON, ELIZABETH O'CONNOR, E. ANN FRAZIER, MARC BERGER, A. SONIA BUIST
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Population-based disease management should be enhanced by good risk assessment models and instruments. We prospectively evaluated the ability of a simple measure of short-term asthma control (scored 0 to 4) to predict asthma 12-mo health care utilization (HCU). A total of 5,172 adult asthma patients completed a brief questionnaire in fall 1997 to assess current level of asthma control. We then evaluated HCU for calendar year 1998. Ninety-three percent had health plan eligibility in 1998 and were included in this analysis. Both acute and routine asthma utilization increased with increasing numbers of asthma control problems. Rates of acute care episodes were 3.5 (95% confidence interval [CI] = 2.9, 4.3) times more likely for those with 3 to 4 control problems versus those with no control problems. Lesser, but statistically significant, increases were seen for those with two (relative risk [RR] = 1.7, 95% CI = 1.4, 2.2) or one (RR = 1.4, 95% CI = 1.1, 1.8) control problems. These patterns were similar for men and women, and diminished with increasing age. The asthma control index contributed significantly to prospective prediction models even after adjusting for administrative data such as medication use and prior HCU. These data reinforce the usefulness of measures of short-term asthma control both for the individual clinician and for those interested in population-based asthma management.
Population structure analyses of Staphylococcus aureus at Tygerberg Hospital, South Africa, reveals a diverse population, a high prevalence of Panton–Valentine leukocidin genes, and unique local methicillin-resistant S. aureus clones
Authors: W.F. Oosthuysen, H. Orth, C.J. Lombard, B. Sinha, E. Wasserman
Journal: Clinical Microbiology and Infection (2013)
Transcervical versus transsternal approach of bronchial stump following pneumonectomy – Two methods in an open competition
Authors: Adrian Istrate, Cristian Paleru, Olga Danaila, Ciprian Lovin, Dan Ulmeanu, Ciprian Nicolae Bolca, Andrei Cristian Bobocea, Radu Serban Matache, Ioan Cordos
Journal: European Respiratory Journal (2011)

Introduction and objectives:  Bronchial stump dehiscence after pneumonectomy was classically treated trough transsternal transpericardic approach, method developed in the 609s. In 1996, Azorin, performed first bronchial transcervical approach.   Methods:  Between March 2001 and February 2010 in our Clinic, we performed 15 cases of transsternal transpericardial approach (6 cases of left primitive bronchial fistula) and 2 cases of transcervical approach of the left bronchial stump fistula.   Results:  In transsternal transpericardial approach: M:F = 12:3, 11 neoplastic (73,57%)/4 TB empyema, 4 cases early (   Conclusions:  Even that transsternal approach of the bronchial fistula remain a major option, the new transcervical approach offer in selected cases an non-traumatic, non-shocking alternative, with very good result. Good experience in mediastinoscopy is required.
Metallo-β-lactamases among Enterobacteriaceae from routine samples in an Italian tertiary-care hospital and long-term care facilities during 2008
Authors: R. Aschbacher, L. Pagani, M. Doumith, R. Pike, N. Woodford, G. Spoladore, C. Larcher, D.M. Livermore
Journal: Clinical Microbiology and Infection (2010)
Malignant Pleural Effusion
Authors: Georgios T. Stathopoulos, Ioannis Kalomenidis
Journal: American Journal of Respiratory and Critical Care Medicine (2012)

Malignant pleural effusion (MPE) poses a significant clinical problem. Current nonetiologic management is suboptimal in terms of efficacy and safety. In light of recent research progress, we propose herein a new view of MPE development, which may rapidly translate into meaningful changes in therapeutics. In addition to tumor-induced impairment of pleural fluid drainage, pertinent findings point toward another pathway to MPE formation: a vicious loop of interactions between pleural-based tumor cells and the host vasculature and immune system that results in increased net fluid production via enhanced plasma extravasation into the pleural space. The ability of tumor cells to trigger this cascade likely rests on a specific and distinct transcriptional repertoire, which results in important vasoactive events in the pleural space. Although the characterization of tumor-derived factors responsible for MPE development is in the making, an additional, indirect path to MPE was recently demonstrated: tumor cells recruit and co-opt host cells and mediators, which, in turn, amplify tumor cell-primed fluid leakage and impact tumor cell functions. Importantly, recent evidence suggests that the biologic events that culminate in clinical MPE are likely amenable to therapeutic inhibition and even prevention. In this perspective, the scientific basis for an update of current concepts of MPE formation is highlighted. Key questions for future research are posed. Finally, a vision for novel, effective, safe, and convenient treatment modalities that can be offered to outpatients with MPE is set forth.
Outcome Of CNS Disease At Diagnosis in Disseminated Small Noncleaved-Cell Lymphoma and B-Cell Leukemia: A Children’s Cancer Group Study
Authors: Sridharan Gururangan, Richard Sposto, Mitchell S. Cairo, Anna T. Meadows, Jonathan L. Finlay
Journal: Journal of Clinical Oncology (2000)

PURPOSE: To examine the impact of initial CNS involvement on outcome and patterns of failure in patients with disseminated small noncleaved-cell lymphoma and B-cell leukemia who were treated in four successive Children’s Cancer Group trials. PATIENTS AND METHODS: Of 462 patients with disseminated disease, 49 (10.6%) had CNS disease at diagnosis (CNS+). CNS disease included meningeal disease or CNS parenchymal masses with or without cranial neuropathies (CSF+/Mass; CNPs) in 36 patients and isolated CNPs in 13. Of the CNS+ patients, 28 had M2 (5% to 25% blasts) or M3 (&gt; 25% blasts) bone marrow involvement. All patients received protocol-based systemic and intrathecal chemotherapy. Thirty-six patients also received CNS irradiation. RESULTS: Relapses occurred in 21 (43%) of 49 patients, predominantly in the CNS (71%) and bone marrow (52%). The 3-year event-free survival ± SE for all patients with CNS+ disease was 45% ± 7%. Patients with CSF+/Mass had a nominally higher treatment failure rate compared with patients with CNS− after adjusting for marrow status and lactate dehydrogenase (LDH) diagnosis, with a relative failure rate (RFR) of 1.52 (95% confidence interval [CI], 0.88 to 2.6; P = .15). In comparison, the RFRs for patients with M2 or M3 marrow and for those with LDH levels greater than 500 IU/L after adjusting for CNS disease were 1.4 (95% CI, 0.96 to 2.0; P = .029) and 2.2 (95% CI, 1.5 to 3.0; P &lt; .001), respectively. The RFR for patients with isolated CNPs was 0.87 (95% CI, 0.36 to 2.1; P = .76). CONCLUSION: We conclude that, with the treatments used during the period covered by these studies, the presence of CSF+/Mass CNS disease at diagnosis was associated with a nominally worse outcome independent of initial bone marrow status and LDH level, but the effect was not statistically significant.
High prevalence of Pneumocystis jirovecii pneumonia among Mozambican children &lt;5 years of age admitted to hospital with clinical severe pneumonia
Authors: M. Lanaspa, C. O'Callaghan-Gordo, S. Machevo, L. Madrid, T. Nhampossa, S. Acácio, C. de la Horra, V. Friaza, E. Campano, P.L. Alonso, E.J. Calderón, A. Roca, Q. Bassat
Journal: Clinical Microbiology and Infection (2015)
Prognostic factors in adenocarcinoma of the gastric cardia: pathologic stage analysis and multivariate regression analysis.
Authors: Y Kajiyama, M Tsurumaru, H Udagawa, K Tsutsumi, Y Kinoshita, M Ueno, H Akiyama
Journal: Journal of Clinical Oncology (1997)

To clarify the pathologic stages of adenocarcinoma of the gastric cardia in which the prognosis is worse than in adenocarcinoma of the middle or distal part of the stomach, and to determine prognostic factors in these stages by multivariate analysis.We analyzed 2,536 cases of surgically resected gastric adenocarcinoma of all pathologic stages. Four hundred seventy-two cases of gastric carcinoma, in which cumulative survival of gastric cardia was poor, were subjected to Cox regression analysis for prognostic factors, and to logistic regression analysis for factors influencing venous or lymphatic invasion.The prognosis of adenocarcinoma of the gastric cardia was inferior when compared with similarly staged carcinomas of the middle or lower part of the stomach when there was invasion of proper muscle layer or subserosal layer, with no lymph node metastasis or with only adjacent (group 1) lymph nodes metastases (T2N0 or T2N1, according to the Japanese classification). In these stages, the prognostic factors were age, histologic type, venous invasion, and location of the tumor in the upper part of the stomach. Tumor location in the upper stomach was also a predictor for the presence of venous invasion.The prognosis of adenocarcinoma of the gastric cardia is poor in patients with T2 tumors with no or few lymph node metastases. Additional treatment after surgery may be necessary to improve the survival of this population.
Aspirin-induced asthma is strongly associated with obesity: Large population study on prevalence and risk factors
Authors: Jonas Eriksson, Linda Ekerljung, Apostolos Bossios, Eva Rönmark, Jan Lötvall, Bo Lundbäck
Journal: European Respiratory Journal (2011)

Background: Population-based studies on aspirin-induced asthma are few and no comprehensive risk factor analysis for the condition has been published. We sought to investigate the prevalence and risk factors of aspirin-induced asthma in the general population.

Methods: A questionnaire on respiratory health was mailed to 30 000 randomly selected subjects aged 16-75 years in West Sweden, 29 218 could be traced and 18 087 (62%) responded. The questionnaire included questions on aspirin-induced dyspnea, asthma, respiratory symptoms and possible determinants.

Results: The prevalence of aspirin-induced asthma was 0.5%, 0.3% in men and 0.6% in women (p=0.014). The prevalence increased with increasing body mass index (BMI 35: 2.2%, p<0.001).

![Figure][1] 



Obesity was a strong risk factor for aspirin-induced asthma (BMI>35: OR 8.15; 95% CI 1.67-39.76). Obesity, occupational exposure to dust gases or fumes and visible mold at home were stronger risk factors for aspirin-induced asthma than for aspirin-tolerant asthma. Current smoking was a risk factor unique for aspirin-induced asthma (OR 2.70; 95% CI 1.52-4.81).

Conclusion: Aspirin-induced asthma was common in the population. Increasing body mass index increased the risk of aspirin-induced asthma in a dose-response manner. A number of risk factors including obesity were considerably stronger for aspirin-induced asthma than for aspirin-tolerant asthma.

 [1]: pending:yes
Antimicrobial susceptibility testing of Clostridium difficile using EUCAST epidemiological cut-off values and disk diffusion correlates
Authors: L.T. Erikstrup, T.K.L. Danielsen, V. Hall, K.E.P. Olsen, B. Kristensen, G. Kahlmeter, K. Fuursted, U.S. Justesen
Journal: Clinical Microbiology and Infection (2012)
High expression of tenascin-C extra domains, markers of angiogenesis, in human lung cancer
Authors: S. Hillinger, M. Silacci, S. Arni, S. Brack, W. Weder, D. Neri
Journal: Journal of Clinical Oncology (2006)

20051 Background: Tumor-associated extracellular matrix molecules are isoforms of proteins with a wide distribution in normal adult tissues, such as fibronectin and tenascin. Large Tenascin-C isoforms are present in almost all normal adult tissues but are upregulated in fetal, regenerating, and neoplastic tissues. In this study we investigated the expression of three tenascin isoforms in tumor tissue samples from lung cancer patients to evaluate the diagnostic and therapeutic value for clinical applications. Methods: In total, 35 corresponding tissue samples (tumor and normal lung tissue of the same patient) have been analyzed by immunohistochemistry using three different human monoclonal antibodies to domains A1 (F16), C (G11) and D (P12). All tumor specimens have been non-small cell lung cancer types. Results: Three isoforms G11, F16 and P12 have exhibited a very intense staining of all types of lung cancer. Almost all samples of squamous cell carcinomas, adenocarcinomas as well as large cell carcinomas have been positively stained. In contrast, none of the corresponding normal lung tissue specimens showed an expression of either tenascin domains. Conclusions: The results show that tenascin-C isoforms are highly expressed around the neovasculature and in the stroma of the majority of non-small cell lung cancers but is undetectable in the normal lung tissue. Therefore these isoforms could represent valuable candidates for the development of antibody based biopharmaceuticals for the treatment of lung cancer. No significant financial relationships to disclose.
Effects of high dose N-acetylcysteine in COPD patients
Authors: Wilfried De Backer, Cedric Van Holsbeke, Anna Sadowska, Jan De Backer, Rita Claes, Wim Vos
Journal: European Respiratory Journal (2012)

Aim 

Studies suggest that NAC can reduce inflammation and hyperinflation in COPD patients, but little data is published about effects of high dose NAC (3x600mg daily) on airway remodeling. Since hdNAC may induce high levels of GSH, this study focuses on the effect of hdNAC on airway structure/function in relation to GSH.

Method 

A double blind randomized placebo-controlled 2way crossover pilot study in 12 GOLDII patients was performed. Patients were treated twice for 3m with either hdNAC or placebo (provided by Zambon S.p.A.) on top of their usual medication according to GOLD guidelines. Respiratory functional imaging (RFI) was used to assess airway volume (iVaw) and resistance (iRaw) (De Backer et al. Radiol. 2010;257(3):854-862). Data was collected at baseline and after both treatment periods.

Result 

A clear drop in iRaw is seen in patients with a higher anti-oxidant reserve (i.e. low baseline GPx) despite lack of overall improvement in the entire population. This drop in iRaw is observed in patients that were already treated according to GOLD criteria.

![Figure][1] 



Conclusion 

For the first time reduction in iRaw caused by anti-oxidant mucolytic drug is shown using highly sensitive RFI methods. It would be interesting to study in a larger population whether this indicates recovery of the β-receptor sensitivity subject to oxidative impairment. The results demonstrate the potential of using RFI to assess anti-inflammatory characteristics of existing and newly developed compounds.

 [1]: pending:yes
Autologous bone marrow transplantation in B-cell non-Hodgkin's lymphoma: very low treatment-related mortality in 100 patients in sensitive relapse.
Authors: A S Freedman, T Takvorian, K C Anderson, P Mauch, S N Rabinowe, K Blake, B Yeap, R Soiffer, F Coral, L Heflin
Journal: Journal of Clinical Oncology (1990)

One hundred patients with B-cell non-Hodgkin's lymphoma (NHL) in sensitive relapse or incomplete first remission underwent high-dose chemoradiotherapy and anti-B-cell monoclonal antibody (MAb)-treated autologous bone marrow transplantation (ABMT). These patients demonstrated good performance status with a Karnofsky score of 80% or greater. The majority of these patients had one or more adverse prognostic features including a failure to achieve a complete remission (CR) with conventional combination chemotherapy (37 patients), bone marrow infiltration (69 patients), a history of extranodal disease other than bone marrow infiltration (42 patients), and histologic conversion (18 patients). At the time of ABMT, only 52 patients were in CR; however, all patients achieved a minimal disease state following conventional intensive therapy. Moreover, at the time of marrow harvest, 37 of these patients had histologic evidence of lymphoma cells infiltrating the marrow. Following high-dose ablative therapy, two acute in-hospital treatment-related deaths were observed. Two late deaths were observed, not due to recurrent lymphoma. Of the remaining 96 patients, 61 are in unmaintained CR with a median follow-up of 13 months. Kaplan-Meier actuarial analysis predicts 50% probability of disease-free survival (DFS) at 37.8 months. This very low treatment-related mortality provides the rationale to apply high-dose therapy and ABMT as consolidative therapy for patients in first remission who are at high risk for relapse following conventional therapy.
Optical biopsy utilising elastic scattering spectroscopy for intra-operative diagnosis of sentinel lymph node metastases
Authors: D. W. Chicken, K. S. Johnson, M. R. Falzon, A. C. Lee, G. Briggs, D. Pickard, I. J. Bigio, S. G. Bown, M. R. S. Keshtgar
Journal: Journal of Clinical Oncology (2004)

841 Background: Sentinel lymph node biopsy (SLNB) enables accurate lymphatic staging while avoiding the morbidity of axillary lymph node dissection(ALND) for node negative patients. Accurate intraoperative detection of sentinel lymph node metastases enables an immediate decision to proceed to ALND, thereby avoiding a second operation. Existing techniques for intraoperative detection of metastases are highly operator dependant and time consuming. Elastic scattering spectroscopy is an optical technique that has the potential for an instant objective diagnosis. We present updated results of the accuracy of our optical biopsy system (OBS) in detecting sentinel node metastases, using algorithms developed for enhanced specificity. Methods: SLNB performed by combination technique. Lymph nodes bivalved and after calibration, multiple optical spectral readings taken from the cut surface using the OBS. Known chromophores subtracted and spectra normalised. Linear discriminant analysis performed using randomly selected two thirds of nodes as training set, and discriminant algorithm tested on remaining one third of nodes. Accuracy calculated on per spectrum and per node basis. Receiver operator curves for per node analysis determined by varying the proportion of positive spectra required for a positive node diagnosis*. Results: 139 axillary nodes from 68 patients sampled. 53 nodes contained metastases. Accuracy of Detection of Metastases Conclusion: The optical biopsy system has the ability to instantly determine the histological status of sentinel node with an accuracy which is operator independent and approaching that of existing methods of intraoperative diagnosis. Further improvement in accuracy likely with larger training sets. Author Disclosure Employment or Leadership Consultant or Advisory Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration US Army Breast Cancer Research Program
Evidence base of clinical diagnosis: Designing studies to ensure that estimates of test accuracy are transferable
Authors: L. Irwig
Journal: BMJ (2002)

There is merit in studies with heterogeneous study populations. They allow exploration of the extent to which the performance of a diagnostic test depends on prespecified predictors, and how much residual variation exists. The more variation there is in study populations, the greater the potential to know how the test will perform in various settings.
Diffuse Ventricular Fibrosis in Atrial Fibrillation
Authors: Liang-han Ling, Peter M. Kistler, Andris H. Ellims, Leah M. Iles, Geraldine Lee, Gerard L. Hughes, Jonathan M. Kalman, David M. Kaye, Andrew J. Taylor
Journal: Journal of the American College of Cardiology (2012)
A COURSE IN PSYCHOLOGICAL FIRST AID AND PREVENTION
Authors: DANIEL BLAIN, PAUL HOCH, V. G. RYAN
Journal: American Journal of Psychiatry (1945)

A method and concrete plan of attack on the rising tide of maladjustment on one of its many fronts is presented. This plan assumes an aggressive rather than a passive, waiting approach. It emphasizes prevention, and the management of mild conditions, and is applicable—in theory, at least—to all individuals. The program is planned for the personnel of the Merchant Marine, but due to the basic similarities of the needs of all members of the human family, it must meet the test of general usefulness in war and in peace. It is important that the general approach and subject matter receive careful consideration from the medical profession. Hence this plan is put forward as a tentative suggestion, subject to review, experiment and change. The subject matter is in terms of general principles. From there application to specific groups can be made. In teaching, clinical illustrations should come from the special problems of the group.
5-Lipoxygenase and Leukotrienes
Authors: COLIN D. FUNK, XIN-SHENG CHEN
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

A decade has passed since the molecular cloning of the 5-lipoxygenase gene and nearly twenty years since the discovery of leukotrienes. In our laboratory, we have strived to make advances in the realm of basic biology and understanding of the 5-lipoxygenase/leukotriene pathway by the use of knockout mice and other cell biology techniques. The aim of this article is to survey the studies conducted with these mice and to present novel information about the nuclear localization of 5-lipoxygenase.
Rituximab Maintenance Treatment for a Maximum of 5 Years In Follicular Lymphoma: Safety Analysis of the Randomized Phase III Trial SAKK 35/03
Authors: Christian J. Taverna, Simona Bassi, Felicitas Hitz, Walter Mingrone, Thomas Pabst, Lidija Cevreska, Auro del Giglio, Daniel A. Vorobiof, Mathew Simcock, Michele Ghielmini
Journal: Blood (2010)