tbuckley/cabot-search huggingface dataset:
Active surveillance of antibiotic resistance prevalence in urinary tract and skin infections in the outpatient setting
Authors: A. Kronenberg, S. Koenig, S. Droz, K. Mühlemann
Journal: Clinical Microbiology and Infection (2011)

The aim of the study was to evaluate the need for active surveillance of antibiotic resistance in ambulatory infections. We measured the prevalence of antibiotic resistance in urinary tract infections (UTIs) (n = 1018) and skin infections (n = 213) diagnosed in outpatients between September 2008 and February 2009 in the Canton of Bern, Switzerland. Samples were stratified into 'solicited' (diagnostic work-up for study purpose only) and 'routine' (diagnostic work-up as part of standard care). Susceptibility patterns were compared for 463 Escherichia coli isolates from UTIs (231 solicited; 232 routine) and 87 Staphylococcus aureus isolates from skin infections (35 solicited; 52 routine). Overall, E. coli showed higher susceptibility to ampicillin, amoxicillin–clavulanic acid and norfloxacin in solicited than in routine samples. Among 15–45-year-old patients, susceptibility rates were comparable between solicited and routine samples for all antibiotics except for amoxicillin–clavulanic acid. However, among patients >45 years old, isolates from routine samples showed lower susceptibility to all β-lactams tested and quinolones than those from solicited samples. Extended-spectrum β-lactamase (ESBL)-producing E. coli isolates were rare (solicited, 0.4%; routine, 1.7%; p 0.4). Susceptibility patterns of S. aureus were comparable between solicited and routine samples. Therefore, in the outpatient setting, susceptibility rates for E. coli isolates differ by indication for urinary culture and age. Surveillance based on samples taken during standard care may underestimate susceptibility rates for uncomplicated infections, especially among the elderly. Reports of resistance data should include age stratification.
Early Detection of Airway Involvement in Obliterative Bronchiolitis after Lung Transplantation
Authors: MARTINE REYNAUD-GAUBERT, PASCAL THOMAS, MONIQUE BADIER, PIERRE CAU, ROGER GIUDICELLI, PIERRE FUENTES
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

As defined by the International Society for Heart and Lung Transplantation, the diagnosis of posttransplant obliterative bronchiolitis (OB) is based on histopathologic features and/or spirometric staging criteria, using FEV(1) to determine the extent of disease. However, this last parameter reflects an advanced bronchiolar process. The present study investigated whether physiologic parameters reflecting smaller airways dysfunction on one hand, and neutrophils in bronchoalveolar lavage fluid (BALF) on the other hand, could be useful for the earlier detection of bronchiolitis obliterans syndrome (BOS). We analyzed data obtained both from 765 pulmonary function test results and from 467 BALF specimens from 45 patients who survived at least 1 yr after surgery (n = 47, including two retransplantations). Of the transplant procedures, 22 were associated with BOS and 25 were not. The mean delay from transplantation to the diagnosis of BOS was 578 d (range: 122 to 2,619 d). The threshold values of the following parameters were studied: decline in the forced expiratory flow rate at 25% to 75% of FVC (FEF(25-75)) to </= 70% of the predicted value and of baseline values, increase in the slope of the nitrogen washout curve (DeltaN(2)) > 3%, and alveolar neutrophilia >/= 20% of the total BALF cell count. Agreement on the diagnosis of BOS (using the decline in FEV(1)) was equally good for each of the four markers (kappa coefficient > 0.65, p < 10(-)(5)). In the OB group, mean delays after the threshold was reached for each of these parameters were 110 d (p = 0.09), 173 d (p = 0.03), 150 d (p = 0.003), and 131 d (p = 0.1), respectively, before the FEV(1) criteria were fulfilled. At the chosen threshold values, the decline in FEF(25-75), increase in DeltaN(2), and development of a substantial alveolar neutrophilia all occurred significantly before a decline in FEV(1) in posttransplant OB.
Portable oxygen therapy: use and benefit in hypoxaemic COPD patients on long-term oxygen therapy
Authors: J Vergeret, C Brambilla, L Mounier
Journal: European Respiratory Journal (1989)

In 159 chronic obstructive pulmonary disease (COPD) patients (139 males, mean age 62 +/- 8 yrs, arterial oxygen tension (PaO2) 7.2 +/- 0.9 kPa), on long-term oxygen therapy (LTOT), we evaluated the effects of portable oxygen therapy both on the daily duration of oxygen therapy and on daily activities. They were given two types of LTOT at random: group A (n = 75), oxygen concentrators only (OC); group B (n = 84), either small oxygen cylinders plus OC (B1 = 51) or liquid oxygen (B2 = 33). The patients were followed-up for one year by means of: a) medical examination every three months; b) monthly home interviews concerning the daily duration of oxygen therapy, the utilization of the devices and the daily activities of the patients; c) a measurement of the daily oxygen usage. The results show that: 1) there are no significant clinical and functional differences between groups A and B at the onset of and throughout the study; 2) in group B the daily use of oxygen therapy is significantly longer than in group A (17 +/- 3.5 h.day-1 vs 14 +/- 3 h.day-1, p less than 0.01) without any difference between groups B1 and B2; 3) outdoor walking activities are different between groups A and B, at least in those patients using oxygen more than 18 h.day-1. Only 60% of patients in group B (55% of B1; 67% of B2) use their portable devices outdoors and for walking. No strict predictive criterion of this use is found in our study.(ABSTRACT TRUNCATED AT 250 WORDS)
Detection on four continents of dengue fever cases related to an ongoing outbreak in Luanda, Angola, March to May 2013
Authors: E Schwartz, E Meltzer, M Mendelson, A Tooke, F Steiner, P Gautret, B Friedrich-Jaenicke, M Libman, H Bin, A Wilder-Smith, D J Gubler, D O Freedman, P Parola
Journal: Eurosurveillance (2013)

In April 2013, ten cases of dengue fever in travellers returning from Luanda, Angola, to five countries on four continents, were reported to the globally distributed GeoSentinel Surveillance network. Dengue virus serotype 1 was identified in two cases. The findings indicate that a major dengue outbreak is currently ongoing in Luanda. This report illustrates how cases from an emerging arboviral epidemic focus can spread internationally and highlights the risk of dissemination of a vector-borne disease into receptive areas
Stress tolerance evaluation in obese children
Authors: Laura Fidalgo-Marron, Maria Jesus Garcia-Mazario, Nerea Lopez-Andres, Ignacio Adrados-Razola, Ana Lopez-Dueñas, Estela Insfran-Marron
Journal: European Respiratory Journal (2011)

Aims:  To evaluate stress tolerance in obese children using a sub-maximal intensity field test and an ergospirometry with maximal stress on a treadmill and study the correlation between the principle variables of both tests.   Methods:  It is a descriptive transversal study carried out amongst obese children from 6 to 14 years old with a control group of normal-weight children. A 6MWT and an ergospirometry on a treadmill with an incremental maximal stress protocol according to the ERS/ATS recommendations were carried out on the obese children. On the control group, the 6MWT was carried out.   Results:  A total of 28 obese children (17 male,61%) were studied, with an average age of 10.90years old (±2.43) and a BMI of 27.61kg/m 2  (±3.46). The average 6MWD was 539.4metres (±44.60), which makes up 92.94% (±11.27) of the theoretical. The Hrmax in the 6MWT was 70.10% (±7.24) of the maximum and the perceived effort scale (PE) was 6.8 (±1.6). The VO 2 peak was 35.64ml/kg/min (±5.86), placing itself at 83.21% (±5.86) of the theoretical. The Hrmax was 192.43bpm (±10.10) which makes up 92.05% (±5.17) of the maximum. The RER was 1.15 (±0.13) and the PE was 9.40 (± 0.84). The correlation between the 6MWD and the VO 2 peak was not significant (p>0.05). In the group of normal-weight children, the 6MWD was 95.5% (±7.56) of the theoretical, the Hrmax% was 60.75% (±7.96) and the average on the PE was 5.1 (±3.2). Significant differences (p≤0.05) were found between the PE and the Hrmax% reached between the group of normal-weight and the obese children.   Conclusions:  The obese children are able to maintain the distance walked in the sub-maximal stress test at the expense of a greater maximal heart rate and a greater stress perception than the normal-weight children.
Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma, Version 1.2015
Authors: Andrew D. Zelenetz, Leo I. Gordon, William G. Wierda, Jeremy S. Abramson, Ranjana H. Advani, C. Babis Andreadis, Nancy Bartlett, John C. Byrd, Myron S. Czuczman, Luis E. Fayad, Richard I. Fisher, Martha J. Glenn, Thomas M. Habermann, Nancy Lee Harris, Richard T. Hoppe, Steven M. Horwitz, Christopher R. Kelsey, Youn H. Kim, Susan Krivacic, Ann S. LaCasce, Auayporn Nademanee, Pierluigi Porcu, Oliver Press, Rachel Rabinovitch, Nishitha Reddy, Erin Reid, Ayman A. Saad, Lubomir Sokol, Lode J. Swinnen, Christina Tsien, Julie M. Vose, Lynn Wilson, Joachim Yahalom, Nadeem Zafar, Mary Dwyer, Hema Sundar
Journal: Journal of the National Comprehensive Cancer Network (2015)

Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are different manifestations of the same disease, which are managed in the same way. The advent of novel monoclonal antibodies (ofatumumab and obinutuzumab) led to the development of effective chemoimmunotherapy regimens. The recently approved small molecule kinase inhibitors (ibrutinib and idelalisib) are effective treatment options for CLL in elderly patients with decreased tolerance for aggressive regimens and in patients with poor prognostic features who do not benefit from conventional chemoimmunotherapy regimens. This portion of the NCCN Guidelines for Non-Hodgkin's Lymphomas describes the recent specific to the incorporation of recently approved targeted therapies for the management of patients with newly diagnosed and relapsed or refractory CLL/SLL.
Mantle irradiation alone for selected patients with laparotomy-staged IA to IIA Hodgkin's disease: preliminary results of a prospective trial.
Authors: P M Mauch, G P Canellos, L N Shulman, B Silver, N J Tarbell, S Come, M S Rabin, C N Coleman
Journal: Journal of Clinical Oncology (1995)

PURPOSE To determine the feasibility of omitting prophylactic paraaortic irradiation in selected patients with laparotomy-staged (pathologically staged [PS]) IA to IIA Hodgkin's disease. PATIENTS AND METHODS We initiated a prospective single-arm trial in October 1988 to study the role of mantle irradiation alone in selected PS IA to IIA patients with Hodgkin's disease. A total of 37 patients have been entered onto this trial. Entrance criteria included nodular sclerosis (NS) or lymphocyte predominance (LP) histology, absence of B symptoms, disease limited above the carina, and a negative laparotomy. Results of treatment of 23 patients in the prospective trial, monitored off treatment for &gt; or = 1 year, are presented. Twenty-three additional PS IA to IIA patients, treated with mantle irradiation alone from 1970 to 1987, were analyzed as a comparison group. The median follow-up durations were 32 and 113 months, respectively, for the two groups. RESULTS The 4-year actuarial rates of freedom from relapse and overall survival are 83% and 100%, respectively, for the prospective trial. The 10-year actuarial rates of freedom from relapse and overall survival are 83% and 89%, respectively, for retrospectively studied patients. There have been five recurrences among 46 patients who received mantle irradiation alone, all with a component of relapse below the diaphragm. CONCLUSION These early results support the use of mantle irradiation alone in selected PS IA to IIA patients with NS or LP histology. Relapses, although rare, have occurred predominantly below the diaphragm. This suggests the need for continued long-term surveillance of abdominal and pelvic nodes in this group of treated patients.
Experimental model of atelectasis in newborn pigs
Authors: Talitha Comaru, Renato Fiori, Humberto Fiori
Journal: European Respiratory Journal (2012)

Background: there are few studies using animal models in chest physiotherapy, moreover, there are no models to assess these effects in newborns.  Aims: the objective of this study was to develop a model of atelectasis by bronchial obstruction in newborn pigs for the study of neonatal physiotherapy.  Methods: newborn pigs resulting from a cross-breeding between Large White and Landrace, properly sedated, anesthetized, tracheostomized, paralyzed and mechanically ventilated were used. The animals received artificial mucus infusion through an infusion pump, underwent radiological assessment of the lungs and blood gas analysis was performed to confirm the production of atelectasis.  Results: the model showed consistent results between parameters of oxygenation and radiological analysis. The atelectasis model was successfully developed in over 70% of cases, surpassing 90% of attempts in the final phase of the study.  Conclusions: this model of atelectasis showed results consistent enough to be used in studies of chest physiotherapy techniques in newborn pigs.
Prognostic significance of magnetic resonance imaging in patients with asymptomatic multiple myeloma.
Authors: L A Moulopoulos, M A Dimopoulos, T L Smith, D M Weber, K B Delasalle, H I Libshitz, R Alexanian
Journal: Journal of Clinical Oncology (1995)

To assess the prognostic significance of magnetic resonance (MR) imaging in patients with newly diagnosed asymptomatic multiple myeloma.Thirty-eight consecutive patients with asymptomatic myeloma of low tumor mass and negative skeletal surveys underwent MR imaging of the thoracic and lumbosacral spine. The presence and patterns of marrow involvement were correlated with standard laboratory parameters and time to disease progression.Nineteen patients (50%) had evidence of marrow involvement at spinal MR imaging. MR patterns of marrow involvement were classified as diffuse (five patients), variegated (nine), and focal (five). Patients with abnormal MR imaging studies required therapy after a median of 16 months, versus 43 months for those with normal MR studies (P < .01).Abnormal marrow patterns were present in half of patients with asymptomatic myeloma. An abnormal MR study of the spine identified asymptomatic patients who were likely to require treatment earlier than those with a normal MR study. A normal MR pattern provided additional justification to defer institution of chemotherapy. However, MR imaging remains an investigational tool to stage patients with multiple myeloma until more data are accumulated.
Pregnancy and pulmonary hypertension: Experience of a reference center in Brazil
Authors: Eloara V.M. Ferreira, Regina B. Tibana, Rudolf K. de Oliveira, Carolina M.S. Messina, Erika C. Treptow, Roberta P. Ramos, Jaquelina S.O. Arakaki
Journal: European Respiratory Journal (2013)

Pulmonary hypertension (PH) is a rare disease that can affect women of childbearing age. Pregnancy is associated with high-risk mortality and, therefore, even in the modern treatment era it is contraindicated for these patients. The aims of this study were to describe the courses of pregnancies and to identify the maternal mortality rate at a reference center in Brazil where prostacyclin is not available. We retrospectively analysed the database between 2002-2012. Results: 12 pregnancies (2 from the same patient) occurred in this period, including 2 abortions and one pregnancy still in course. Mean age was 29±7 years and gestational age of delivery was 32-41weeks. Eight patients had prior diagnosis and 3 discovered PH during the course of pregnancy: 07 PAH, 3 CTEPH and 1 multifactorial PH. All patients used subcutaneous anticoagulation. After 2009, all patients were treated with sildenafil during pregnancy. Except for one patient in NYHA III, all the others remained stable in NYHA II during pregnancy. Cesarean section was the main route of delivery and epidural anesthesia was done in 7/9. No stillbirths were reported. Period of maternal hospitalization was 5-30days after labor. Two patients died within the first week post-partum (right heart failure) and one died after 2 years (pulmonary embolism). Other 5 patients experienced worsening of symptoms after labor, needed to upgrade therapy (just oral drugs available) and took more than 6 months to return to baseline status. In conclusion, pregnancy continues to be associated with a high-risk of clinical deterioration (78%) and mortality (22% in our center) even in mildly symptomatic PH patients (NYHA II), especially after delivery.
A New Framework for Baccalaureate Careers in the Human Services
Authors: ROBERT M. VIDAVER, JAMES E. CARSON
Journal: American Journal of Psychiatry (1973)

An articulated human service career lattice, utilizing three two-year modules, has been developed in Maryland, extending from community college mental health associate programs through baccalaureate and master's degree modules. Graduates of the several curricula work in a variety of community mental health, institutional, and family service roles linked with appropriate civil service classifications. Completion of an educational component qualifies the graduate for the next higher employment role, and, similarly, promotion becomes the ticket of admission to the next academic rung.
Maintenance chemotherapy prolongs remission duration in adult acute nonlymphocytic leukemia.
Authors: P A Cassileth, D P Harrington, J D Hines, M M Oken, J J Mazza, P McGlave, J M Bennett, M J O'Connell
Journal: Journal of Clinical Oncology (1988)

The value of maintenance therapy after the achievement of complete remission in adult acute nonlymphocytic leukemia (ANLL) has never been clearly established. A randomized Eastern Cooperative Oncology Group (ECOG) study of postremission therapy compared outcomes in patients who received no further therapy to those administered long-term maintenance chemotherapy. Adverse results in the group administered no further therapy led to early termination of this trial after only 51 patients were randomized. Patients receiving no postremission therapy experienced significantly inferior remission durations (P = .002) compared with patients receiving maintenance therapy. All 26 patients in the group administered no postremission therapy have relapsed, with a median duration of remission of 4.1 months. In contrast, four of 25 patients (16%) who received maintenance therapy remain disease free, with a median duration of remission of 8.1 months.
First repeated bone scan in the observation of patients with operable breast cancer.
Authors: A Pedrazzini, R Gelber, M Isley, M Castiglione, A Goldhirsch
Journal: Journal of Clinical Oncology (1986)

Data on 1,601 patients with node-positive operable breast cancer who were randomized in four different prospective adjuvant therapy trials were analyzed to evaluate the role of routine bone scans and the alkaline phosphatase value at regular intervals in screening for bone involvement. Bone scan was a prerequisite for randomization and was repeated within the first 12 months in 90% (1,441) of the patients. Abnormal or doubtful scan findings had to be verified by x-ray examination. The repeated scan results were normal in 1,263 (87.8%) patients, doubtful but with no radiologic evidence of bone metastasis in 161 (11%), and abnormal (radiologically confirmed) in 17 (1.2%). After a median observation of 4 years bone metastases as the first relapse developed in 136 (8.5%) patients. This occurred in 87 of 1,263 (6.9%) of the patients with normal repeated scan results and in 18 of 161 (11.2%) of those with doubtful repeated scan findings. Based on the results of the first repeated scan, early detection of a first recurrence in bone might have been possible for 2.4% of the population. Serum alkaline phosphatase levels were also without clinical use. Bone scan in the observation of patients with operable breast cancer should be performed only as dictated by the clinical situation.
A comparison of fast homoarginine-sensitive alkaline phosphatase and carcinoembryonic antigen as markers in colon carcinoma.
Authors: F C Larson, L Kahan, D C Tormey, T E Davis
Journal: Journal of Clinical Oncology (1984)

The diagnostic value of a recently described cancer marker, fast homoarginine-sensitive alkaline phosphatase ( FHAP ), was compared with the established marker, carcinoembryonic antigen (CEA), in the diagnosis of colon cancer. Comparisons were made with respect to sensitivity, specificity, predictive value of a positive result, and efficiency. An upper limit of normal of 2.1 units/L was assumed for FHAP , based on earlier studies. Two values for the upper limit of normal for CEA were tested: 2.5 ng/mL and 5.0 ng/mL. When 2.5 ng/mL was used as the upper limit of normal for CEA, FHAP was less sensitive, more specific, and had a higher predictive value. The diagnostic efficiency was not significantly different. When the upper limit of normal for CEA was set at 5.0 ng/mL, the two tests were roughly equal in sensitivity, specificity, predictive value, and diagnostic efficiency.
Are muti-disciplinary teams helpful in managing respiratory referrals?
Authors: Sam Weaver, Vicky Campbell, Jo Riley, Toni Jordan, Martin Allen
Journal: European Respiratory Journal (2014)

Introduction   Respiratory conditions, including COPD, are a common problem which generates many outpatient referrals from primary care to hospital. We have introduced a community respiratory team supported by consultants undertaking clinics in the community underpinned by a multidisciplinary team meeting (MDT). At the MDT all referrals from general practitioners are received on a specific proforma where spirometry, old clinical notes / letters and chest x-rays are reviewed. Patients are triaged into different care pathways from this weekly MDT. We have audited our output from this.   Results    Over a 3 year period 2011 to 2013, 1534 patients referred from one primary care trust serving a population of 193.000 patients were discussed. The outcomes from the MDT are tabulated below.   Conclusion   Over a 3 year period there has been a consistent ability to ensure referrals are placed in the community setting with few patients who would have previously attended hospital now doing so (14%) This represents a considerable cost that may be saved by directing patients from hospital to a community clinic where there is on-going support of nurses, parking is easier and fulfils the desire for care closer to home.
Genomic Profiling of Cancers of Unknown Primary Site
Authors: Anna M. Varghese, Leonard B. Saltz
Journal: JAMA Oncology (2015)

Jeffrey S. Ross, MD; Kai Wang, MD, PhD; Laurie Gay, PhD; Geoff A. Otto, PhD; Emily White, BS; Kiel Iwanik, BS; Gary Palmer, MD; Roman Yelensky, PhD; Doron M. Lipson, PhD; Juliann Chmielecki, PhD; Rachel L. Erlich, PhD; Andrew N. Rankin, PhD; Siraj M. Ali, MD, PhD; Julia A. Elvin, MD, PhD; Deborah Morosini, MD; Vincent A. Miller, MD; Philip J. Stephens, PhD