tbuckley/cabot-search huggingface dataset:
Association between sleep apnea and tuberculosis – A nationwide population-based study
Authors: TaiHuang Lee, Ming-Ju Tsai, Yu-Chieh Chung, Hung-Ling Huang, Wei-An Chang, Inn-Wen Chong, Ming-Shyan Huang
Journal: European Respiratory Journal (2014)

Rationale   Patients with sleep apnea (SA) have various co-morbidities, particularly metabolic disorders, cardiovascular and cerebrovascular diseases. A recent study showed SA was associated with higher mortality in septic patients, suggesting its possible effect on immune response. However, no study to date had discussed theassociation between SA and tuberculosis (TB). We therefore conducted a nationwide population-based study using Taiwan National Health Insurance (NHI) database.   Methods   The dataset used for this study is a cohort of 1 million subjects randomly sampled from individuals enrolled in the Taiwan NHI system in 2005. We enrolled adult patients with a diagnosis of SA in the dataset. Patients with a diagnosis of TB prior to SA were excluded. The date of the first SA diagnosis was defined as the index date for each patient. Each SA patient was matched to 30 randomly-selected, age- and sex-matched control subjects without any diagnosis of SA. The control subjects were assigned index dates as their corresponding SA patients without diagnosis of TB before. The incidences of TB in both groups were compared.   Results   A total of 6135 SA patients and 184050 control subjects were identified. Significantly lower TB incidence was noted in SA patients than control subjects (0.33% v.s. 0.56%, p=0.0167). The cumulative incidence of TB was also lower in SA patients (p =0.0165). After adjusting for age, sex and comorbidities, SA remained a significant protective factor for TB (hazard ratio = 0.509 [95% confidence incidence: 0.327 – 0.793], p = 0.0028).   Conclusions   Our study revealed significantly lower TB incidence in SA patients than in control subjects. The underlying mechanisms deserve further study.
Final results of the EORTC Intergroup randomized phase III study 40983 [EPOC] evaluating the benefit of peri-operative FOLFOX4 chemotherapy for patients with potentially resectable colorectal cancer liver metastases
Authors: B. Nordlinger, H. Sorbye, L. Collette, B. Glimelius, G. J. Poston, P. M. Schlag, P. Rougier, W. Bechstein, E. Walpole, T. Gruenberger
Journal: Journal of Clinical Oncology (2007)

LBA5 Background: The 5-year survival after resection of colorectal cancer liver metastases is 30% but recurrence is common. This study evaluates the benefit of combining peri-operative chemotherapy and surgery for patients with initially resectable liver only metastases from colorectal cancer (LM). Methods: Between September 2000 and July 2004, 364 pts with up to 4 LM were randomized between peri-operative FOLFOX4 (oxaliplatin 85mg/m 2 and LV5FU2), 6 cycles before and 6 cycles after surgery, (CT), and surgery alone (S). The primary endpoint was progression free survival (PFS) with the goal to increase median PFS by 40% (HR=0.71). Safety was a secondary endpoint (already reported at ASCO 2005). PFS results are reported at the 2-sided 0.0434 significance level (adjusting for one interim analysis). Results: Baseline characteristics were similar in both arms. Eleven of 182 pts were ineligible in each arm, mostly for more advanced disease. In the CT arm, a median of 6 pre-op cycles were delivered and 151 patients were resected. 115 pts (63%) received post-op CT, with a median number of 6 cycles and a relative dose intensity of 79% to 86%. In the S arm, 152 pts were resected. Due to the nature of the trial, evaluation of resectability (relevant for eligibility) was based on pre-op imaging, but 31/182 pts (CT arm) and 30/182 pt (S arm) could not undergo resection. There were 2 (S arm) and 1 (CT arm) deaths after surgery. At a median follow-up of 3.9 years, 254 PFS events were reported (240 in eligible pts) and the results are as shown in the table . Conclusions: Peri-operative FOLFOX4 chemotherapy improved PFS over surgery alone in patients whose metastases were actually resected. The benefit was slightly diluted when also pts considered resectable on imaging but eventually not resected were taken into account. FOLFOX4 given peri-operatively is safe and does not prevent the pts from undergoing surgery. [Table: see text] [Table: see text]
Klf4 Expression in Conventional Dendritic Cells Is Required for T Helper 2 Cell Responses
Authors: Roxane Tussiwand, Bart Everts, Gary E. Grajales-Reyes, Nicole M. Kretzer, Arifumi Iwata, Juhi Bagaitkar, Xiaodi Wu, Rachel Wong, David A. Anderson, Theresa L. Murphy, Edward J. Pearce, Kenneth M. Murphy
Journal: Immunity (2015)
Concurrent combination of high dose imatinib and dose-intensive chemotherapy for patients with newly diagnosed Philadelphia-positive acute lymphoblastic leukemia: Promising preliminary results of JALSG Ph+ALL202 study
Authors: N. Usui, M. Towatari, M. Yanada, J. Takeuchi, F. Yagasaki, A. Takeshita, I. Sugiura, M. Takeuchi, R. Ohno
Journal: Journal of Clinical Oncology (2004)

6538 Background: Adult patients with Ph+ALL have an extremely poor outcome. In order to improve outcome of patients with Ph+ALL, a phase II trial of high-dose imatinib and dose-intensive chemotherapy was conducted in newly diagnosed Ph+ALL. Methods: In induction therapy, oral imatinib 600 mg/day was given from day 8 for 8 weeks (day 63) with dose-intensive chemotherapy consisting of cyclophosphamide (day 1:i.v. 1200 mg/M2), daunorubicin (days 1–3:i.v. 60 mg/M2), vincristine(days 1,8,15,22: i.v.1.3 mg/M2), prednisolone(days 1–21:p.o. 60 mg/M2). As consolidation therapy, alternating chemotherapy course [high dose chemotherapy with methotrexate(MTX) (day 1: i.v.1 g/M2) and cytarabine (Ara-C)(days 2 and 3:i.v. 2 g/M2 /q12h)] and single administration of oral imatinib (600 mg/day for 4 weeks) were repeated in a total of 8 courses. Risk-adapted intrathecal prophylaxis (MTX+ Ara-C+ dexamethasone) was given. Patients having either related or unrelated HLA-identical donor were permitted to receive allogeneic stem cell transplantation (SCT). Results: To date, 23 patients with newly diagnosed Ph+ALL have been treated with this protocol from September 2002 to October 2003. Median age was 40 years (range15–59) and 48 % were male. Twenty-two out of 23 patients (96%) quickly attained CR and one patient died of pulmonary bleeding on day 9. The prospective monitoring of the minimal residual disease by quantitative (real-time) RT-PCR on Day 28 and Day 63 indicated that 16 out of 20 patients (80%) examined entered molecular remission (defined as BCR-ABL/GAPDH ratio being < 10–5). Allogeneic SCT was performed for 8 patients in CR. Toxicity profile was similar to that seen with chemotherapy alone. All CR patients were alive even though 2 patients relapsed during consolidation therapy. Therefore, failure free and overall survival rates at 6 months were 87% and 96%, respectively. Conclusions: Combination treatment of high-dose imatinib with intensive chemotherapy might increase not only the rate of CR but also the quality of CR in patients with Ph+ ALL. No significant financial relationships to disclose.
Predictors of PTSD in injured trauma survivors: a prospective study
Authors: A Y Shalev, T Peri, L Canetti, S Schreiber
Journal: American Journal of Psychiatry (1996)

The aim of this study was to prospectively examine the relationship between immediate and short-term responses to a trauma and the subsequent development of posttraumatic stress disorder (PTSD).All patients consecutively admitted to a general hospital were screened for the presence of physical injury due to a traumatic event. Fifty-one eligible subjects were assessed 1 week and 6 months after the trauma. The initial assessment included measures of event severity, peritraumatic dissociation, and symptoms of intrusion, avoidance, depression, and anxiety. The follow-up assessments added the PTSD module of the Structured Clinical Interview for DSM-III-R--Non-Patient Version and the civilian trauma version of the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder.Thirteen subjects (25.5%) met PTSD diagnostic criteria at follow-up. Subjects who developed PTSD had higher levels of peritraumatic dissociation and more severe depression, anxiety, and intrusive symptoms at the 1-week assessment. Peritraumatic dissociation predicted a diagnosis of PTSD after 6 months over and above the contribution of other variables and explained 29.4% of the variance of PTSD symptom intensity. Initial scores on the Impact of Event Scale predicted PTSD status with 92.3% sensitivity and 34.2% specificity. Symptoms of avoidance that were initially very mild intensified in the subjects who developed PTSD.Peritraumatic dissociation is strongly associated with the later development of PTSD. Early dissociation and PTSD symptoms can help the clinician identify subjects at higher risk for developing PTSD.
A prognostic cytogenetic scoring system to guide the adjuvant management of patients with atypical meningioma
Authors: Ayal A. Aizer, Malak Abedalthagafi, Wenya Linda Bi, Margaret C. Horvath, Nils D. Arvold, Ossama Al-Mefty, Eudocia Q. Lee, Lakshmi Nayak, Mikael L. Rinne, Andrew D. Norden, David A. Reardon, Patrick Y. Wen, Keith L. Ligon, Azra H. Ligon, Rameen Beroukhim, Ian F. Dunn, Sandro Santagata, Brian M. Alexander
Journal: Neuro-Oncology (2015)

The appropriate use of adjuvant therapy in patients with gross totally resected atypical meningioma requires an accurate assessment of recurrence risk. We sought to determine whether cytogenetic/genetic characterization may facilitate better estimation of the probability of recurrence. We first analyzed our clinical database, including high-resolution DNA copy number data, to identify 11 common copy number aberrations in a pilot cohort of meningiomas of all grades. We summed these aberrations to devise a cytogenetic abnormality score (CAS) and determined the CAS from archived tissue of a separate cohort of 32 patients with gross totally resected atypical meningioma managed with surgery alone. Propensity score adjusted Cox regression was used to determine whether the CAS was predictive of recurrence. An association between higher CAS and higher grade was noted in our pilot cohort with heterogeneity among atypical tumors. Among the 32 patients who underwent gross total resection of an atypical meningioma, the CAS was not significantly associated with age, gender, performance status, or tumor size/location but was associated with the risk of recurrence on univariable analysis (hazard ratio per aberration = 1.52; 95% CI = 1.08–2.14; P = .02). After adjustment, the impact of the dichotomized number of copy aberrations remained significantly associated with recurrence risk (hazard ratio = 4.47; 95% CI = 1.01–19.87; P = .05). The number of copy number aberrations is strongly associated with recurrence risk in patients with atypical meningioma following gross total resection and may inform the appropriate use of adjuvant radiation therapy in these patients or be useful for stratification in clinical trials.
Role of the lung volume measurement in the diagnosis of obstructive diseases in patients with restrictive ventilatory impairment
Authors: Won Jun Song, Duk Hyun Ryu, Boksoon Chang, Hye Yun Park
Journal: European Respiratory Journal (2014)

To evaluate the usefulness of the lung volume measurement and the forced expiratory flow between 25% and 75% of vital capacity (FEF 25-75 ) in the diagnosis the obstructive lung disease in patients with restrictive ventilatory impairment.  A retrospective study was conducted in 13,555 subjects with lung function tests including spirometry and lung volume measurement on the same date between April 2008 and December 2010 at Samsung Medical Center, Seoul, Korea. 2,175 patients with normal FEV 1 /FVC and low FVC showed restrictive ventilator impairment. When interpreting the obstructive pattern among them, total lung capacity (TLC) criteria was defined as TLC ≥ 80% predicted, and FEF 25-75  criteria as FEF 25-75  25-75  criteria. Of the 857 patients with an obstructive pattern through TLC criteria, 210 (25%) patients were obstructive disease by clinical diagnosis. Of the 1,018 patients with an obstructive pattern through FEF 25-75  criteria, 206 (20%) patients were obstructive disease by clinical diagnosis. The agreement between the clinical diagnosis and TLC criteria was poor, with concordance in 1,338/2,175 (53%) (k = 0.111, 95% CI: 0.074-0.148, p  25-75  criteria also poor, with concordance in 1,169/2,175 (54%) (k = 0.036, 95% CI: 0.003-0.069, p = 0.037).  Lung volume measurement might not be useful to diagnose the obstructive disease in patients with restrictive ventilatory impairment.
Ministers must halt "surreal obsession" with seven day opening, GP leader says
Authors: A. Rimmer
Journal: BMJ (2015)

The UK government faces a “catastrophe” in the GP workforce, with a third of GPs set to retire in the next five years at a time when the profession is struggling to recruit new GPs, the chair of the BMA’s General Practitioners Committee has warned.

Speaking at the BMA’s conference of local medical committees, Chaand Nagpaul called on the government to act now to save general practice. …
Non-invasive method for investigation of inhaled carbon monoxide (CO) distribution between intra- and extravascular compartments
Authors: Evgeny Babarskov, Evgeny Stepanov, Yury Shulagin, Alexander Cherniak, Zaurbek Aisanov, Alexander Chuchalin
Journal: European Respiratory Journal (2011)

Background:  Therapeutic potential of inhaled CO at low concentration was demonstrated in the treatment of some human diseases [Ryter S. at al. Am J Respir Cell Mol Biol 2009; 41: 251-260]. Basic parameters of CO-dosing were: CO concentration in inhaled air, time of administration and carboxyhemoglobin (COHb) concentration in blood. However therapeutic effect of CO is defined mainly by interaction with intracellular enzymes in extravascular tissues.   Aim:  To develop method for determination of CO contents in extravascular compartment.   Methods:  Balance equation of total CO mass administrated into body (MCOt, mkmol) used for calculation of CO contents in extravascular compartment (MCOex, mkmol). COHb concentration (Ccohb,%) was defined by measuring of equilibrium CO concentration (Ceq, ppm) in exhaled air using high selective laser spectrophotometer. Total Hb mass (MHb,g) detected by preliminary administration of calculated CO amount (ΔMco, mkmol) as a result of single breath diffusion capacity test (Master Lab, Erich Jaeger) in 19 healthy volunteers (12 males and 7 females).   Results:  ΔMco (a part of MCOt) varied from about 100 to 600 mkmol and Ceq deviations from baseline values (ΔCeq) were 2/8ppm. Following formula was found: MHb=8.95*ΔMco/ΔCeq. MHb was approximatly proportional to body weight (Mbody, kg). The ratio R=MHb/Mbody was equal about 9.8 for males and 8.0 for females. After additonal CO adminstration intravascular CO contents (MCOin, mkmol) is defined by formula: MCOin=0.11*ΔCeq*MHb, consequently MCOex=MCOt-MCOin.   Conclusion: Investigation of administrated CO distribution between compartments allow to optimize dosing regime and total CO dose value.
Helios Enhances Treg Cell Function in Cooperation With FoxP3
Authors: Hiroaki Takatori, Hirotoshi Kawashima, Ayako Matsuki, Kazuyuki Meguro, Shigeru Tanaka, Taro Iwamoto, Yoshie Sanayama, Natsuko Nishikawa, Tomohiro Tamachi, Kei Ikeda, Akira Suto, Kotaro Suzuki, Shin‐ichiro Kagami, Koichi Hirose, Masato Kubo, Shohei Hori, Hiroshi Nakajima
Journal: Arthritis & Rheumatology (2015)

Helios+FoxP3+CD4+ (Helios+) Treg cells are believed to be involved in the regulation of various autoimmune diseases; however, the regulatory mechanisms underlying the development of Helios+ Treg cells remain uncertain. This study was undertaken to elucidate the regulatory mechanisms of Helios expression in CD4+ T cells and its roles in transforming growth factor β (TGFβ)-induced Treg cell function.We examined the expression of Helios in CD4+ T cells in patients with rheumatoid arthritis by DNA microarray analysis before and after treatment with biologic agents. We also examined the effect of interleukin-6 (IL-6) and TGFβ on Helios expression in CD4+ T cells in humans and mice. The effect of forced expression of Helios on murine induced Treg cell function was also examined. The role of FoxP3 in the induction and function of Helios was assessed by using CD4+ T cells from FoxP3-deficient scurfy mice.Tocilizumab, but not tumor necrosis factor (TNF) inhibitors or abatacept, increased Helios expression in CD4+ T cells in patients with a good response. IL-6 inhibited the TGFβ-induced development of Helios+ induced Treg cells in both humans and mice. Both cell-intrinsic FoxP3 expression and TGFβ signaling were required for Helios induction in murine induced Treg cells. The forced expression of Helios enhanced the expression of various Treg cell-related molecules and the suppressive function in murine induced Treg cells. Helios-mediated enhancement of the suppressive function of induced Treg cells was obvious in FoxP3-sufficient CD4+ T cells but not in FoxP3-deficient CD4+ T cells.Our findings indicate that Helios enhances induced Treg cell function in cooperation with FoxP3.
Development of persistent late onset asthma following treatment with captopril
Authors: BJ Lipworth, JJ McMurray, RA Clark, AD Struthers
Journal: European Respiratory Journal (1989)

We describe the first case of de novo asthma following treatment with the angiotensin converting enzyme (ACE) inhibitor captopril. Despite drug withdrawal there was evidence of persistent airways obstruction and bronchial hyperreactivity. This suggests the possibility that ACE inhibitors may uncover an asthmatic tendency in patients with pre-existing bronchial hyperreactivity.
Abstract 5115: Purified Human Muscle-Derived Pericytes Support Formation of Vascular Structures and Promote Angiogenesis After Myocardial Infarction
Authors: Chien-Wen Chen, Kimimasa Tobita, Bruno Peault, Johnny Huard
Journal: Circulation (2009)

We have recently shown that perivascular cells isolated from multiple human tissues represent stem cells endowed with mesodermal lineage potentials, and the injection of multipotent muscle-derived pericytes repair damaged skeletal muscle in vivo . Our current study further demonstrated that transplantation of human muscle-derived pericytes (3.0×10 5 cells/heart) into the ischemic myocardium of NOD/SCID mice sustains the cardiac function of the infarcted hearts. Here, we tested the hypothesis that purified CD34 − /45 − /56 − /146 high pericytes support formation of structures of blood vessels and promote angiogenesis post infarction. To illustrate the potential vessel-forming properties of purified pericytes, pericytes and endothelial cells were co-cultured in Matrigel in vitro, and co-formation of capillary-like structures was observed. To evaluate the angiogenic effect of pericytes in vivo , histological examination was performed two weeks after transplantation. Capillary density was measured by anti-CD31 staining on tissue sections. Capillary density within peri-infarct areas was 43% higher in the pericyte-injected group than in the saline-injected group ( P &lt;0.05). Myocardial fibrosis estimated by Masson’s trichrome staining revealed a 38% reduction of the scar area in pericyte-injected hearts when compared to saline-injected hearts. These findings indicated that transplantation of pericytes sustains the cardiac function of the infarcted left ventricle presumably through enhancement of angiogenesis and reduction of myocardial fibrosis. We further examined potential mediators of pericyte-induced cardiac repair in the ischemic micro-environment by culturing pericytes under hypoxic conditions (2.5% oxygen) in vitro for 24 hours. Real-time quantitative PCR analysis showed that vascular endothelial growth factor (VEGF)-related genes, including VEGF 165 and VEGF receptor 1 and 2, were significantly up-regulated in the pericyte population. Overall, the data suggested a role of VEGF-regulated angiogenesis on pericyte-mediated cardiac repair. Experiments are being performed to elucidate the potential of pericytes to differentiate into cardiac cell lineages and explore the regulatory mechanisms involved in vivo .
New Population‐Based Reference Values for Spinal Mobility Measures Based on the 2009–2010 National Health and Nutrition Examination Survey
Authors: Shervin Assassi, Michael H. Weisman, MinJae Lee, Laurie Savage, Laura Diekman, Tiffany A. Graham, Mohammad H. Rahbar, Joan I. Schall, Lianne S. Gensler, Atul A. Deodhar, Daniel O. Clegg, Robert A. Colbert, John D. Reveille
Journal: Arthritis & Rheumatology (2014)

Objective To report population‐based percentile reference values for selected spinal mobility measures in a nationally representative sample of 5,001 US adults ages 20–69 years who were examined in the 2009–2010 US National Health and Nutrition Examination Survey (NHANES). Methods Occiput‐to‐wall distance (OWD), thoracic expansion (TE), and anterior lumbar flexion (ALF; by modified Schober test) were measured by trained examiners in a standardized manner. TE was measured at the xiphisternal level, while the lower reference point for ALF was a line marked at the level of the superior margin of the lateral iliac crests. We report reference values based on the 95th percentile for the OWD and the 5th percentile for TE and ALF, as well as other summary statistics for these measures, in the study population. Results An OWD of &gt;0 was present in 3.8% of the participants, while 8.8% of them had out‐of‐range values for TE based on the commonly used threshold of 2.5 cm. The 95th percentile of the OWD measurement was 0, while the 5th percentile for TE and ALF were 1.9 cm and 2 cm, respectively. The spinal measures were significantly associated with sex, age, ethnicity, height, and body mass index (BMI). Exclusion of individuals with severe obesity (BMI &gt;35 kg/m 2 ) changed the proposed reference values for TE and ALF to 2.2 cm and 1.9 cm, respectively. Conclusion We verified a reference value of 0 for the OWD in the general population. Using the reported population‐based percentile values, new reference values for TE and ALF can be derived.
Incidence, etiology and prevention strategies in early and late onset ventilator associated pneumonia in a tertiary care intensive care unit
Authors: Vikas Maurya, Puneet Khanna, Vipin Kauts, Rajesh Pande, Sharmila Sengupta, Tulsi Chugh
Journal: European Respiratory Journal (2012)

Introduction:  Ventilator associated pneumonia (VAP) is associated with increased morbidity and mortality. VAP has been characterized into early (E-VAP) and late onset (L-VAP) depending upon the duration of mechanical ventilation.   Objectives:  To ascertain the incidence of VAP and its common causative pathogens and compliance to VAP prevention strategies in an intensive care unit (ICU).   Methods:  Prospective cohort surveillance of VAP was conducted by applying the definitions of the US Centers for Disease Control and Prevention National Nosocomial Infections Surveillance System (CDC-NNIS). Data on microbial isolates and antimicrobial resistance were also collected along with documentation of measures to prevent VAP.   Result:  Between January 2010 to December 2011, 2756 patients who were hospitalized in the ICU, for an aggregate 10,948 patient days acquired 66 VAP infections. The ventilator days were 4190 and this amounts to overall VAP rate of 15.75 infections per 1000 ventilator days. The incidence of E-VAP and L-VAP was 24.2% & 75.8% respectively. The most common pathogens identified were  Acinetobacter baumanii ,  Pseudomonas aeruginosa  and  Klebseila spp . Most of these were multidrug resisitant. There was low compliance to hand hygiene, head of bed elevation, daily sedation interruption and oral care.   Conclusion:  VAP was the commonest nosocomial infection in the ICU. Most of the VAP was late in onset (L-VAP) and was caused by multidrug resistant pathogens. There is a need to maximize compliance to VAP prevention measures as part of the routine management of patients on mechanical ventilation.