tbuckley/cabot-search huggingface dataset:
Evaluating lung function in patients being considered for resectional surgery
Authors: Stefan Wesolowski, Piotr Boros, Tadeusz Orlowski, Philip Quanjer
Journal: European Respiratory Journal (2013)

Objectives: Pulmonary function tests are important in assessing eligibility for lung resection surgery. The aim of the study was to assess the prevalence and type of pulmonary dysfunction in patients referred for lung resection. We also studied how the limit of normal (80%predicted versus lower limit of normal (LLN) as -1.645SD) affected the incidence of functional disorders. Methods and material: Retrospective analysis of lung function tests, spirometry, lung volumes, transfer factor for CO (TL,CO) in 493 consecutive patients referred for resectional surgery. Results: Spirometry was within the normal range in 255 (51.7%) patients. Airway obstruction was diagnosed in 210 (42.6%), and a restrictive pattern in 28 (5.7%) patients. FEV1 <LLN occurred in 154 (31%), and FEV1<80%pred. in 223 (45%) patients. In 275 (56.6%) cases TL,CO was <LLN, and in 350 (72%) patients <80%pred. In 151 (31%) cases with FEV1 within the normal range TL,CO was reduced. FEV1 or TL,CO was <LLN in 302 (62%) patients, and <80%pred. in 371 (76%) patients, (p<0.0001). Conclusions: Lung functional disorders are common in candidates for lung resection. Using the true LLN diminishes the incidence of disorders by 14% comparing to a lower limit at 80% of predicted; this reduces the number of additional diagnostic tests, the duration and the cost of hospitalization.
Prevalence of tobacco use among inpatients in a partial smoke-free hospital- A cross-sectional study in a Portuguese hospital
Authors: Ana Lucas, J.M. Calheiros, S.B. Ravara
Journal: European Respiratory Journal (2014)

Background : Smoke-free hospitals are a window of opportunity towards smoking cessation. However, partial bans may hinder this goal.  Setting : A medium-sized partial smoke-free Hospital in Portugal. Smoking rooms are allowed in mental health department.  Aim : To access prevalence of smokers among adult inpatients (≥18 years) and factors associated.  Methods : Cross-sectional study in 2012. Structured interviews were carried out among inpatients. Expired air carbon monoxide (CO) levels of all patients reporting being smokers were measured. Descriptive analysis and logistic regression was performed.  Results : Of the 289 inpatients, 151 were interviewed. Smoking status was accessed by clinical files on other 5 inpatients. Participation rate (54.0%) was hindered by factors related with patients9 disease severity, consciousness level and cognitive skills and barriers rose by healthcare providers. Of the participants, 51% were males; mean age was 68.4±15.3 years (median 73; range: 21-94). Smoking prevalence was 16.7% (95%CI: 10.85-22.55); 59.6% were never-smokers and 23.7% ex-smokers. Of the interviewed inpatients, 21 were smokers. Of those, 13 reported smoking in hospital premises (10 in the psychiatric smoking room) CO levels were ≥7 in 7 patients. Being a smoker was predicted by age (OR:11.88; 95%CI:3.89-36.27, p
Tamoxifen flare in advanced endometrial carcinoma.
Authors: B J Brooks, M E Lippman
Journal: Journal of Clinical Oncology (1985)

Tamoxifen citrate has recently been shown to be effective palliative therapy in advanced endometrial carcinoma. Flare reactions from tamoxifen are well known in treatment of metastatic breast carcinoma and are not an indication for stopping therapy. We report a patient being treated with tamoxifen for advanced endometrial cancer who developed acute abdominal pain as a manifestation of a flare reaction and the significance of this observation.
Light to moderate intake of alcohol, drinking patterns, and risk of cancer: results from two prospective US cohort studies
Authors: Yin Cao, Walter C Willett, Eric B Rimm, Meir J Stampfer, Edward L Giovannucci
Journal: BMJ (2015)

<b>Objectives</b> To quantify risk of overall cancer across all levels of alcohol consumption among women and men separately, with a focus on light to moderate drinking and never smokers; and assess the influence of drinking patterns on overall cancer risk. <b>Design</b> Two prospective cohort studies. <b>Setting</b> Health professionals in the United States. <b>Participants</b> 88 084 women and 47 881 men participating in the Nurses’ Health Study (from 1980) and Health Professionals Follow-up Study (from 1986), followed until 2010. <b>Main outcomes and measures</b> Relative risks of cancer. <b>Results</b> 19 269 and 7571 (excluding non-advanced prostate cancers) incident cancers were documented among women and men, respectively, over 3 144 853 person years. Compared with non-drinkers, light to moderate drinkers had relative risks of total cancer of 1.02 (95% confidence interval 0.98 to 1.06) and 1.04 (1.00 to 1.09; P<sub>trend</sub>=0.12) for alcohol intake of 0.1-4.9 and 5-14.9 g/day among women, respectively. Corresponding values for men were 1.03 (0.96 to 1.11), 1.05 (0.97 to 1.12), and 1.06 (0.98 to 1.15; P<sub>trend</sub>=0.31) for alcohol intake of 0.1-4.9, 5-14.9, and 15-29.9 g/day, respectively. Associations for light to moderate drinking and total cancer were similar among ever or never smokers, although alcohol consumption above moderate levels (in particular ≥30 g/day) was more strongly associated with risk of total cancer among ever smokers than never smokers. For a priori defined alcohol related cancers in men, risk was not appreciably increased for light and moderate drinkers who never smoked (P<sub>trend</sub>=0.18). However, for women, even an alcohol consumption of 5-14.9 g/day was associated with increased risk of alcohol related cancer (relative risk 1.13 (95% confidence interval 1.06 to 1.20)), driven by breast cancer. More frequent and heavy episodic drinking was not further associated with risk of total cancer after adjusting for total alcohol intake. <b>Conclusion</b> Light to moderate drinking is associated with minimally increased risk of overall cancer. For men who have never smoked, risk of alcohol related cancers is not appreciably increased for light and moderate drinking (up to two drinks per day). However, for women who have never smoked, risk of alcohol related cancers (mainly breast cancer) increases even within the range of up to one alcoholic drink a day.
Late-breaking abstract: Role of IL-13-producing BLT1-positive CD8 T cells in asthmatic airway obstruction
Authors: Azzeddine Dakhama, Maureen L. Collins, Donald Y.M. Leung, Elena Goleva, Rafeul Alam, E. Rand Sutherland, Richard J. Martin, Erwin W. Gelfand
Journal: European Respiratory Journal (2011)

Background: Asthma is characterized by reversible airflow obstruction, persistent inflammation and airway hyperresponsiveness. Recent animal studies identified a subset of CD8 T cells expressing BLT1, the high affinity receptor for leukotriene B4. These cells accumulate in the lungs and alter airway function via interleukin-13 (IL-13) production (Nat Med 2004, 10:865-9).

Aims: To determine if a similar subset of CD8 T cells are present in asthmatic human airways and if their presence is associated with evidence for asthmatic airway obstruction.

Methods: BAL cells from asthmatics (n=39) and healthy controls (n= 28) were stimulated in culture and immuno-stained for CD8, BLT1 and IL-13. The data were correlated to lung function, serum IgE and airway basement membrane (BM) thickness.

Results: Compared to controls, asthmatics showed higher proportion of CD8-positive lymphocytes in BAL fluid (p < 0.001). A significant proportion of these CD8 T cells expressed BLT1 in both groups. Most importantly, the proportion of BLT1-positive CD8 T cells expressing IL-13 was significantly higher in asthmatic airways compared to controls (p < 0.001). Furthermore, the proportion of IL-13-producing BLT1-positive CD8 T cells negatively correlated with FEV1 (% predicted) values and FEF[25-75] values (p < 0.001). Interestingly, a positive correlation was detected between the proportion of these cells and serum IgE levels as well as with BM thickness (p < 0.01).

Conclusions: IL-13-producing BLT1-positive CD8 T cells are present in the airways of asthmatics, and their accumulation correlates with airway obstruction, serum IgE levels and BM thickness, suggesting a pathogenic role for these cells in human asthma.
Medical Student Burnout and Professionalism
Authors: James Bateman
Journal: JAMA (2011)

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
Improvement of thromboprophylaxis by attaching printed thrombosis risk assessment tool and recommendations to patient's hospital charts
Authors: Mohammad Hossein Rahimi-Rad, SeidSoma Seidsalehi, Shabnam SeidSalehi
Journal: European Respiratory Journal (2011)

Evidence suggests that venous thromboembolism prophylaxis (VTEP) is still significantly underused. Studies showed that computerized reminders have resulted in increased rates of VTEP  (Kucher N, N Engl J Med 2005) . However, this system is not available in most hospitals especially in developing countries. We hypothesized that attaching written guidelines to patients hospital charts during admission would act as reminder and would increase VTEP.   Methods:  This pre and post-interventional study included three phases: 1. Baseline survey of VTEP using Caprini thrombosis risk assessment tool and recommendation (CTRT)  (Caprini JA. Dis Mon 2005)  phase 2. Over the following nine months we attached a printed CTRT to patients hospital chart. 3. We reevaluated VTEP similar to phase 1 during next 3 months. Setting: surgery wards in teaching hospital, Urmia, Iran.   Result:  Any type prophylaxis was 20.0% before and 37.6% after intervention (p value    Conclusion:  A simple intervention can improve VTEP rate in setting that electronic alert is not available. VTEP is underused despite improvement still there is high gap between evidence and practice.   Acknowledgements:  We would like to thank JA. Caprini (j-caprini2@aol.com) for giving permission to use Risk Assessment Tool.
The availibility of copd assessment test (CAT) in determination of risk of early hospitalization in chronic obstructive pulmonary disease patients and its correlation with pulmonary function tests, dyspnea measurement scales and St George respiratory questionnaire
Authors: Mustafa Dinç, Emin Maden, Kursat Uzun
Journal: European Respiratory Journal (2014)

COPD is an airway flow restriction that is not responded or partially responded to bronchodilators. In this study, we compared the newly defined COPD assessment test (CAT) with other tests defined for the same purpose.  COPD patients presented to outpatient and inpatient clinic of Pulmonary Department were enrolled to the study. Age, file numbers, phone numbers, disease period, COPD stage, smoking and environmental biomass exposure, COPD exacerbation and hospitalization history in the past 1 year period and 3 months period after the test and co-morbidities of the patients were recorded. After these test, face to face m MRC, SGRQ and CAT were done  Forty eight male (92,3%) and 4 female (7,7%) patients were enrolled to the study. When we evaluate the CAT score of the patients; the score of inpatient cases were significantly higher than cases of outpatient clinic (29,73±8,37 versus 17,2± 6,80 and pl0,01). When we compared the mean CAT scores of the patients and other dyspnea scales, significant difference was found with mMRC stage 4 and stage 5. In SGRQ total score significant difference was observed between cases took a score under 60 and a score above 60. Positive significant correlation was found between CAT score, SGRQ division and total scores and with Borg and mMRC scale (pl0,01).  CAT is a easy, short, understandable test to show the characteristic and complex structure of COPD in every stage and will provide optimum evaluation by providing the communication between the clinician and patient in daily practice.
Detection of bone metastases in breast cancer by 18FDG PET: differing metabolic activity in osteoblastic and osteolytic lesions.
Authors: G J Cook, S Houston, R Rubens, M N Maisey, I Fogelman
Journal: Journal of Clinical Oncology (1998)

PURPOSE 99mTechnetium methylene diphosphonate (99mTc MDP) bone scintigraphy is currently the method of choice for the detection of bone metastases, but 18F-fluoro-deoxy-D-glucose positron emission tomography (18FDG PET) offers superior spatial resolution and improved sensitivity. We have compared 18FDG PET with 99mTc MDP bone scintigraphy in patients with skeletal metastases from breast cancer and have analyzed the data in subgroups based on radiographic characteristics of lesions. PATIENTS AND METHODS Twenty-three women with breast cancer and confirmed bone metastases were studied with both 99mTC MDP bone scintigraphy and 18FDG PET, and the number of lesions detected and the quantitation of uptake (standardized uptake values [SUVs]) of 18FDG in osteolytic and osteoblastic metastases were compared. Survival was compared for both lytic and blastic bone metastases and for patients with high and low accumulation of 18FDG. RESULTS 18FDG PET detected more lesions than 99mTc MDP scintigraphy (mean, 14.1 and 7.8 lesions, respectively; P &lt; .01). However, 18FDG detected fewer bone metastases compared with 99mTc MDP scintigraphy in a subgroup of patients with osteoblastic disease (P &lt; .05). Higher SUVs were observed for osteolytic than osteoblastic disease (mean, 6.77 and 0.95, respectively; P &lt; .01). Survival was lower in patients with osteolytic disease compared with the remainder (P=.01). A difference in survival was not found for those patients with high SUVs (&gt; 3.6; P=.4). CONCLUSION 18FDG PET is superior to bone scintigraphy in the detection of osteolytic breast cancer metastases, which led to a poorer prognosis. In contrast, osteoblastic metastases show lower metabolic activity and are frequently undetectable by PET. The biologic explanation for this observation remains to be elucidated.
Vehicle exhaust levels outside home and exhaled NO - Results from the Swedish GA2LEN study
Authors: Bertil Forsberg, David Olsson, Anders Bjerg, Alexandra Ek, Linda Ekerljung, Andrei Malinovschi, Roelinde Middelveld, Christer Janson
Journal: European Respiratory Journal (2012)

Fraction of NO in exhaled air (FeNO) is a common method to assess airway inflammation. FeNO has been used to study effects of air pollution, especially short-term exposure. Our aim was to study if living in areas with high levels of vehicle exhaust results in chronically increased levels of FeNO.  We study subjects with asthma (n=473), sinusitis (n=109), asthma and sinusitis (n=130), symptoms suggestive of asthma (n=383), and a random control group (n=222), aged 17-76 years (median 45 years) from the Swedish GA 2 LEN Study.  Exhaust exposure at the home address was modelled as the annual mean concentration of nitrogen oxides (NOx) in 50 m grids from a dispersion model using traffic counts and emission factors (NOx/km). We used log-transformed FeNO (50mL/s) from the clinical examination. The fully adjusted regression models included NOx at home, age, sex, current smoking, height and atopy, and in the combined model diagnosis category.  Overall there was a very weak positive, non-significant coefficient for the effect of NOx on FeNO. For the asthma group and the group with some asthma-like symptom, this increase was 4% per 10 µg/m3 increase in NOx. The geometric mean FeNO levels were 19.3 for the asthmatics and 15.7 for the control group. Subjects with chronic high pollution exposure in terms of tobacco smoke had reduced FeNO also in our study.  In conclusion, we see no significant association between modelled annual level of vehicle exhaust outside home and FeNO in any of the studied groups. A few other studies have observed such an association. We have not yet adjusted for a possible short-term effect of air pollution levels on FeNO.
Abstract 4280: Combination of Doxycycline and Losartan is an Effective Secondary Prevention Treatment for the Thoracic Aortic Aneurysm in Marfan Syndrome
Authors: Hh C Yang, Cornelis van Breemen, Ada Chung
Journal: Circulation (2008)

Losartan, an antihypertensive drug, has been shown to prevent thoracic aortic aneurysm (TAA) in Marfan syndrome (MFS) through the inhibition of transforming growth factor (TGF)-β. Recently we have suggested doxycycline, a non-specific inhibitor of matrix metalloproteinases (MMPs), suppressed aneurysm and normalized vasomotor function in TA. We hypothesized that a combination of doxycycline and losartan could be effective in the secondary prevention to ameliorate TAA in MFS. A well-defined mouse model of Marfan syndrome (Fbn1 C1039G/+ ) were untreated (n=20), given doxycycline (0.24g/L, n=15), losartan (0.6g/L, n=15), or doxycycline+losartan (0.12g/L+0.3g/L, respectively, n=15) from drinking water at the age of 4 months. The littermate Fbn1 +/+ mice served as control (n=20). Ascending thoracic aortae from each group at 9 months were studied. Mortality (2%) and TAA (increase in diameter by &gt;35%) were observed in the untreated group. Mild aneurysm (diameter of aorta was increased by 15% compared with controls) was evident in either losartan-or doxycycline-groups, but TAA was prevented by the combined treatment. From the aortic media of untreated, losartan- and doxcycline-groups, elastic fiber degeneration shown on Movat’s histology was pronounced, which accompanied with increased aortic stiffness. Combined treatment attenuated elastic fiber degradation and normalized the aortic elasticity to the control levels. The impairment of smooth muscle contraction and endothelial-dependent relaxation in the untreated group were also completely normalized by the combined treatment. Either losartan- or doxcycline-groups improved aortic contractility by 75% compared with the untreated, but was not effective in improving endothelium-dependent relaxation. Combined treatment reduced activities of MMP-2 and -9 in the aortic media by 60 – 80%, and activation of TGF-β by 70%. Delayed treatment reduced effectiveness of both losartan and doxycycline in the prevention of TAA. Combination of doxycycline and losartan is effective in the secondary prevention to preserve elastic fiber integrity and normalize vasomotor function, indicating that both MMP and TGF-β are crucial mediators in TAA formation in MFS.
Effects of oral dual ERA therapy on pulmonary function testing and 6MWT in patients with idiopathic pulmonary fibrosis and pulmonary hypertension
Authors: Assunta Micco, Emanuela Carpentieri, Ginevra Del Giudice, Antonio Russo, Angelo Romano, Gaetano Beatrice, Mario Del Donno
Journal: European Respiratory Journal (2012)

PH can be present in 37% to 59% of patients with IPF and is a predictor of mortality, which appears to be the cause of additional burden of exercise capacity. The aim of study was to investigate the role of oral dual ERA therapy in 2 groups of patients with PH associate to IPF with or without Bosentan therapy during 24 months. The primary endpoint was the change of exercise capacity up to month 24, measured by a modified 6MWT.We evaluated retrospectively 16 patients: 8 pts (6 M; mean age of 72 yrs old) with moderate-severe PH and IPF (mPAP measured by RCH estimated as a mean value of 38 ± 4.8 mmHg), treated with Bosentan (PH-IPF ERA group); 8 pts (5 M; mean age of 70 yrs old) with moderate PH and IPF not treated with Bosentan (PH-IPF control group).At baseline, there were differences about hemodynamic and pulmonary functional test profile between two groups of pts. At T 24, the 6MWT increased in PH-IPF ERA group showing a mean increase of +150 mt, while in the PH-IPF control group we observed a reduction of 41% compared to the 6MWT values baseline ( p 0,0003 ).In PH-PID group treated with ERA, FVC% and DLCO% were reduced of 8% and 32%, respectively, while in PH-IPF control group were reduced of 6,6% and 22% compared to the baseline ( p 0,009 ).The NYHA functional class was decreased in group treated with ERA (3,5 vs 2;  p 0,009 ) and improved in control group (2,12 vs 3,25;  p 0,007 ). In patients with moderate-severe PH and idiophatic pulmonary fibrosis, treated by Bosentan, there was a clinical improvement, measured by a six minute-walk test and a change in NYHA functional class, without affecting pulmonary functional test.
Use of the Muscle Relaxant Atracurium in Anephric Patients: Preliminary Communication
Authors: J M Hunter, R S Jones, J E Utting
Journal: Journal of the Royal Society of Medicine (1982)

Atracurium is a new, non-depolarizing muscle relaxant which rapidly breaks down in vivo and appears to require neither renal nor hepatic function for its elimination. As the commonly used non-depolarizing muscle relaxants carry the risk of prolonged effect when used in anephric patients, atracurium appears to have special promise in this situation. A preliminary account of the successful use of the relaxant in 20 anephric patients is recorded and evidence presented that atracurium is, indeed, a suitable agent for use in patients with renal failure.
Expression of fibrogenic cytokines in desmoplastic malignant melanoma
Authors: None Kubo, None Kikuchi, None Nashiro, None Kakinuma, None Hayashi, None Nanko, None Tamaki
Journal: British Journal of Dermatology (1998)

Desmoplastic malignant melanoma (DMM) consists of amelanotic spindle-shaped melanoma cells and is accompanied by desmoplasia with fibrous stromata. It has a strong tendency for local infiltrative growth and recurrence and a propensity for neurotropism. It is not yet known which cytokine is responsible for the desmoplasia in DMM. In the present study, we investigated the roles of several fibrogenic cytokines and cytokine receptors in DMM: basic fibroblast growth factor (bFGF), connective tissue growth factor (CTGF), transforming growth factor-beta, platelet-derived growth factor (PDGF) and PDGF receptors. Immunostaining and in situ hybridization were conducted in four cases of DMM and four cases of amelanotic malignant melanoma (AMM) as negative controls for desmoplasia. PDGF-beta receptor, bFGF and CTGF were intensely expressed in the DMM specimens in comparison with the AMM specimens. The reaction of PDGF-B ligand and CTGF to PDGF-beta receptor, in addition to the expression of bFGF, may contribute to the desmoplasia in DMM.
Ex Vivo Generation of Human Anti–Pre-B Leukemia-Specific Autologous Cytolytic T Cells
Authors: Angelo A. Cardoso, Mark J. Seamon, Hernani M. Afonso, Paolo Ghia, Vassiliki A. Boussiotis, Gordon J. Freeman, John G. Gribben, Stephen E. Sallan, Lee M. Nadler
Journal: Blood (1997)