tbuckley/cabot-search huggingface dataset:
Thoracic determination of Behçet's disease
Authors: Wiam Elkhattabi, Abdelaziz Aichane, Hasna Jabri, Regis Bopaka, Hicham Afif, Zoubida Bouayad
Journal: European Respiratory Journal (2013)

Bechet9s disease is a multisystemic vascularitis of unknown etiology. Thoracic lesions are dominated by venous and arterial diseases.We analyzed all cases of Behcet9s disease with thoracic lesions identified between January 1997 and June 2012.The study included 21 patients. The average age was 34 years with a male predominance (86%). Six patients were followed for Behcet9s disease previously.Hemoptysis and superior vena cava syndrome were the most common signs. Chest CT has confirmed thrombosis of the superior vena cava in 15 patients, and pulmonary artery aneurisms in 6 patients, three of them were complicated by thrombosis. Patients followed for thrombosis of the superior vena cava received anticoagulant therapy, corticosteroid and / or immunosuppressive therapy.The combination of corticosteroids, colchicine and / or immunosuppressive drugs were prescribed in patients with pulmonary aneurysms before surgical treatment. The main cause of death was massive hemoptysis, two patients has died immediately after diagnosis.Thoracic lesions of Behcet’s disease are not rare in Mediterranean countries, diagnosis is easy with CT, but there’s a lake in treatment. In these cases, prognosis is conditioned by thoracic lesions.
Career destinations, job satisfaction and views of the UK medical qualifiers of 1977
Authors: Kathryn Taylor, Trevor Lambert, Michael Goldacre
Journal: Journal of the Royal Society of Medicine (2008)

Summary Objective To study the career destinations, job satisfaction and views of UK-trained senior doctors. Design Postal questionnaire. Setting All doctors who qualified from all UK medical schools in 1977; and Department of Health employment data. Main outcome measures Career destinations of medical qualifiers from 1977. Results 72% responded to the questionnaire. Using all available evidence, including that on non-responders, 76% of the cohort, comprising 77% of the men and 74% of the women, were working in the NHS 27 years after qualification. Approximately 18% were in medical jobs either overseas or outside the NHS. Of respondents in the NHS, 89% of men and 51% of women had full-time contracts. NHS doctors rated their job satisfaction highly, with a median score of 19.5 on a scale from 5 (very low satisfaction) to 25 (very high satisfaction). Satisfaction with time off for leisure was much lower, with a median score of 4.6 on a scale from 1 (low) to 10 (high). Of those in the NHS, 67% agreed that they worked longer hours than they thought they should; and 40% agreed that their working conditions were satisfactory. Conclusions 27 years after qualification, the percentage of women who were working in the NHS was similar to that of men. Although these senior doctors had high levels of satisfaction with the content of their jobs, they were not so satisfied with their working hours and working conditions. Our results can be used as benchmarks, against which the career pathways and satisfaction levels of more recently qualified doctors can be compared.
The Respira project: Difference in levels of indoor biological pollutants in schools and homes in Southern Sicily and Malta
Authors: Valeria Longo, David Bilocca, Chris Zammit, Martin Balzan, Fabio Cibella, Steve Montefort, Giovanni Viegi, Paolo Colombo
Journal: European Respiratory Journal (2014)

Guidelines in asthma and allergic disease highlighted the importance of indoor levels of allergens and LPS evaluation, to identify the “threshold value” in sensitization and symptom onset. The RESPIRA Project has provided a monitoring study of LPS and four allergens (Derp1, Feld1, Alta1 and Phlp5) in Sicily and Malta.

Methods: Dust samples were collected by vacuum sampling from schools (12 in Sicily and 6 in Malta – 3 classrooms per each school). From a population sample of 2,047 schoolchildren (11-14 years) a subsample of subjects with and without symptoms of allergic diseases was selected and their houses evaluated (74 in Sicily and 81 in Malta). LPS evaluation was determined by chromogenic LAL assay and allergen quantization was performed by Elisa assays.

Results: In Sicily (Health District of Gela), data show a higher level of LPS in schools than in houses (p<0.0001); 70% of houses have a concentration of Der p 1 above the threshold value of sensitization (≥1 µg allergen/g dust) and, in any case, higher in dwellings than in schools (p<0.0001). In Malta no statistical difference in LPS concentration was recorded between houses and schools; on the other hand Der p 1 and Fel d 1 allergens are present in higher amount in Maltese dwelling. No differences were reported for Alt a 1 and Phl p 5. Finally, the comparison between LPS and allergens distribution between Sicily and Malta shows i) a significant higher LPS concentration in Italian schools (p<0.0001); ii) higher Fel d 1 concentration in Maltese schools; iii) higher Der p 1 concentration in Italian houses. Funded by Operational Programme Italia-Malta 2007-2013, RESPIRA Project #A.1.2.3-72.
A comparison of three measures of the response to inhaled methacholine
Authors: AJ Knox, HE Coleman, None Britton, AE Tattersfield
Journal: European Respiratory Journal (1989)

In studies of asthma prevalence bronchial responsiveness has usually been measured as the provocative dose of bronchoconstrictor causing a 20% fall in FEV1 (PD20FEV1). This is relatively insensitive and only 10-20% of subjects in a general population sample will show such a response. Attempts to increase sensitivity, such as the use of the provocative dose causing a 10% fall in FEV1 (PD10FEV1), have not demonstrated any overall advantage, due to poorer repeatability. It has been suggested that measurement of bronchial reactivity using flow at low lung volumes measured from a partial flow volume curve is a more sensitive index of bronchoconstriction than PD20FEV1. If equally repeatable, it would have advantages in epidemiological practice. In 20 subjects with asthma, we compared the sensitivity and repeatability of PD10FEV1, PD20FEV1, and the provocative dose causing a 40% fall in flow at 30% of vital capacity (PD40V30P) following methacholine challenge. PD40V30P was more sensitive than both PD20FEV1 and PD10FEV1 by 1.48 and 0.35 doubling doses (DD) of methacholine, respectively. PD20FEV1 and PD40V30P showed equal repeatability, the 95% range for a single estimate of both being 2.02 DD. PD10FEV1 was less repeatable, with a 95% range of 2.35 DD. Values for the intraclass correlation co-efficient, which measures the ability of a test to discriminate between subjects, were 0.63, 0.79 and 0.69 for PD10FEV1, PD20FEV1, and PD40V30P, respectively. The increased sensitivity and comparable repeatability of measurement of bronchial reactivity for PD40V30P suggest that this method may be useful for studies of asthma prevalence.
Increase in Cancer of the Corpus Uteri in the San Francisco-Oakland Standard Metropolitan Statistical Area, 1960–75&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: D F Austin, K M Roe
Journal: JNCI Journal of the National Cancer Institute (1979)

A significant rise in the incidence of carcinoma of the corpus uteri in women of the San Francisco-Oakland standard metropolitan statistical area (SMSA) was reported by the Resource for Cancer Epidemiology. The incidence among white females increased by over 50% in the 6 years between 1969 and 1975. The increase was limited to the groups over 50 years old and to invasive cancers of the endometrial lining. The increase occurred in all five of the SMSA counties and, in white women in Alameda County, the average annual incidence for the 50- to 74-year age group tripled in 15 years. The rise was greatest in the areas of most affluence. Possible spurious causes of increase, such as changing diagnostic criteria, better case finding, or better reporting were examined and ruled out. The data suggested that the increase was due to the recent introduction of a potent endometrial carcinogen to the population group affected.
Spontaneous changes in the rate of decline in reciprocal serum creatinine
Authors: B V Shah, A S Levey
Journal: Journal of the American Society of Nephrology (1992)

The slope of reciprocal serum creatinine (1/Pcr) versus time has been used to measure the rate of progression of chronic renal disease, predict the interval until onset of end-stage renal disease, and assess the effect of therapy. In order to determine the errors that might result from extrapolating the slope of 1/Pcr versus time beyond the interval of observation, we applied a method of linear regression analysis to search for spontaneous changes in slope in 21 patients from New England Medical Center and 56 patients in three published studies in whom the decline in 1/Pcr appeared constant (r greater than or equal to 0.84 for the correlation of 1/Pcr versus time). Significant changes in the slope (breakpoints) were identified in one third to one half of the 77 patients and appeared to be spontaneous. The second slope was less steep in 49 patients (6.1%); the mean value for serum creatinine at the time of the breakpoint was 5.3 mg/dL; the mean change in slope (absolute value) was 0.005 dL/mg/month (adults) and 0.017 dL/mg/month (children); and the mean error in prediction of the interval until the final value for serum creatinine was 27% of the actual interval. We conclude that spontaneous breakpoints in the slope of 1/Pcr versus time are very frequent, even among patients with an apparent constant rate of decline. Breakpoints may cause errors in extrapolating the slope to predict the interval until the onset of end-stage renal disease and to assess the effect of therapy.(ABSTRACT TRUNCATED AT 250 WORDS)
Pathogenesis of Radiation-Induced Thymic Lymphoma in Mice&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Richard Siegler, Wilhelmina Harrell, Marvin A. Rich
Journal: JNCI Journal of the National Cancer Institute (1966)

Previous observations on the pathogenesis of thymic lymphoma in mice indicate that the two thymic masses on either side of the trachea behave independently during leukemogenesis and should be considered as separate organs—the right and left thymuses. After each of 4 weekly doses of radiation, both thymuses showed lymphocyte depletion, followed by lymphocyte regeneration. The rate and degree of the depletion and subsequent regeneration, quantitated by individual thymus weights, were identical. This synchronous thymic response to the direct effect of the radiation was in contrast to the later, nonsynchronous, independent thymic lymphoma response, which in this study was always unilateral. Changes in Hassall's corpuscles were noted in the period preceding the development of the thymic lymphoma. The pathogenesis of radiation-induced lymphoma was similar to that of virus-induced lymphoma.
Confidence and aptitude of hospital personnel at demonstrating inhaler technique- A pilot study
Authors: Peter Gallacher, Ramamurthy Sathyamurthy
Journal: European Respiratory Journal (2013)

Background   The majority of therapies for obstructive airways diseases are delivered through Metered Dose Inhalers (MDI) to manage symptoms and reduce exacerbations. Delivery of the drug is dependent on an accurate inhaler technique. Medical (M) and Nursing (N) staff play a crucial role in teaching and reiteration of the technique to patients.   Aim   The aim of the study was to determine if M and N were confident at teaching patients how to use MDIs and to evaluate the proficiency of staff at demonstrating MDI technique.   Method   Staff were individually interviewed and assessed on their ability to demonstrate MDI technique using a validated MDI scoring system 1 . N were based on an acute admissions ward. M were final year students and doctors in training.   Results   Thirty staff [N=14 (46.7%), M= 16 (53.3%)] were interviewed. Seventeen [N=50%, M=69%, p=0.984] were confident at teaching MDI technique. Only 4 N and M (13.3%) accurately demonstrated all steps of MDI technique being evaluated. The average score for the cohort was 72.9%, with a mean score for N of 66.3% and a mean score for M of 78.6% (p=0.04). Ninety percent of staff felt they would benefit from more training on inhaler technique.   Discussion   The proficiency of staff at demonstrating the correct technique was inadequate and many lack the confidence at teaching inhaler technique. Adequate staff training is essential for them to confidently display and teach patients who have been prescribed inhaled therapies. Incorporation of inhaler technique modules to N and M training is recommended.  1. O9Donnell J, Birkinshaw R, Burke V, Driscoll PA. The Ability of AE14:163-164.
Retrospective analysis of oxygen therapy in persistent nocturnal hypoxia despite CPAP in obstructive sleep apnoea syndrome (OSAS)
Authors: Maria Nuila, Rachel Moll, Emuobonuvie Emoghware, David Simcock, Simon Lloyd-Owen
Journal: European Respiratory Journal (2014)

A subset of obese patients experience persistent nocturnal hypoxia despite continuous positive airway pressure (CPAP) for OSAS. Bi-level ventilation (BIPAP) has been used as second line therapy despite little evidence of its benefits.  Aim: To evaluate the role of additional oxygen therapy in nocturnal hypoxia in obese patients with OSAS on CPAP.  Methods: Retrospective analysis of electronic records, sleep polygraphy, oximetry, blood gases and lung function of OSA patients with nocturnal hypoxia despite CPAP.  Results: Sixty-two patients (male = 35), mean age 62 ± 11, mean Body Mass Index (BMI) 43.8 ± 13 with OSAS (mean Apnoea Hypopnoea Index 42 events/hour) and nocturnal hypoxia (pre-CPAP time spent with saturations   Conclusion: In our experience, the majority of obese OSAS patients with persistent nocturnal hypoxia despite CPAP can be managed by additional nocturnal oxygen without causing hypercapnia. Further studies are required to identify this subset of patients.
Complete and Partial Remission as Surrogate End Points in Membranous Nephropathy
Authors: Aliza Thompson, Daniel C. Cattran, Melanie Blank, Patrick H. Nachman
Journal: Journal of the American Society of Nephrology (2015)

Absent a remission of proteinuria, primary membranous nephropathy (MN) can lead to ESRD over many years. Therefore, use of an earlier end point could facilitate the conduct of clinical trials. This manuscript evaluates complete remission (CR) and partial remission (PR) of proteinuria as surrogate end points for a treatment effect on ESRD in patients with primary MN with heavy proteinuria. CR is associated with a low relapse rate and excellent long-term renal survival, and it plausibly reflects remission of the disease process that leads to ESRD. Patients who achieve PR have better renal outcomes than those who do not but may have elevated relapse rates. How long PR must be maintained to yield a benefit on renal outcomes is also unknown. Hence, available data suggest that CR could be used as a surrogate end point in primary MN, whereas PR seems reasonably likely to predict clinical benefit. In the United States, surrogate end points that are reasonably likely to predict clinical benefit can be used as a basis for accelerated approval; treatments approved under this program must verify the clinical benefit in postmarketing trials. Additional analyses of the relationship between treatment effects on CR and PR and subsequent renal outcomes would inform the design of future clinical trials in primary MN.
Late-breaking abstract: Are small specimens" big enough" as therapeutic indicators in non-small cell lung cancer?
Authors: Cláudia Matos, Maria Teresa Almodovar, Filipa Santos, Susana Esteves, Fernando Cunha, José Duro da Costa
Journal: European Respiratory Journal (2014)

New targeted therapies for non-small cell lung cancer (NSCLC) have increased the demand for accurate diagnosis rendered by histology or cytology. We evaluated small specimens value in NSCLC diagnosis against surgical pathology.  Methods  Our database was searched for all resected NSCLCs between 2008-2011 with pre-resection cytology and/or biopsy. Small specimens9 sensitivity was determined taking surgical pathology as gold-standard. Pre-resection diagnoses for type of procedure: bronchoscopic (FB) or transthoracic (TT); size; pathology; distance from thoracic wall were correlated with resection pathological diagnosis. SPSS for windows was used to analyze Wilson method estimated 95% confidence intervals, agreement between results by Cohen9s Kappa; factors associated with sensitivity and agreement by uni and multivariate regression.  Results  131 (69%) patients had known preoperative diagnosis (171 FB, 85 TT);. Pre-resection pathologic subtypes: adenocarcinoma 105 (55%), squamous 48 (25%), adenosquamous 9 (5%); others 27 (15%). Tumor size: median (min-max) 27 mm (4-110). Distance from thoracic wall median (min-max) 7 mm (0-50).  Sensitivity: all 69%, TT 57%, FB 55%. Agreement: all k=0,54, TT k=0,69, FB k=0,69. Tumor size by additional mm, in TT ODD 5% (p=0,001), in BF ODD 3% (p=0, 004) was associated with diagnosis sensitivity in multivariated analysis. Size of tumor in TT was associated with agreement in multivariated analysis.  Conclusion  Results from our study confirm that tumour size is an influencial predictor for diagnosis accuracy. Distance from chest wall is a relevant additional issue to be considered. Overall small specimens may accurately be used to diagnose NSCLC subtypes.
Mechanisms of clonal evolution in childhood acute lymphoblastic leukemia
Authors: Srividya Swaminathan, Lars Klemm, Eugene Park, Elli Papaemmanuil, Anthony Ford, Soo-Mi Kweon, Daniel Trageser, Brian Hasselfeld, Nadine Henke, Jana Mooster, Huimin Geng, Klaus Schwarz, Scott C Kogan, Rafael Casellas, David G Schatz, Michael R Lieber, Mel F Greaves, Markus Müschen
Journal: Nature Immunology (2015)
Mammalian Chromosomes &lt;italic&gt;In Vitro&lt;/italic&gt;. XVII. Idiogram of the Chinese Hamster&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: T. C. Hsu, Maria T. Zenzes
Journal: JNCI Journal of the National Cancer Institute (1964)

From 67 diploid male Chinese hamster cells in vitro, an idiogram was constructed. The chromosomes can be classified into 4 natural groups: group I, 2 pairs of large submetacentrics (1 and 2); group II, 3 pairs of mediumsized submetacentrics (the sex pair, 4 and 5); group III, 3 pairs of mediumsized subtelocentrics (6, 7, and 8); group IV, 3 pairs of small metacentrics (9, 10, and 11). A system of subdividing each chromosome into regions is also suggested.
Studies on the Mechanism of lsoantigenlc Variant Formation in Heterozygous Mouse Tumors. V. Quantitative Studies of Residual H-2 Antigens in lsoantigenic Variant Sublines Isolated From a Mouse Lymphoma of F<sub>1</sub> Hybrid Origin<xref ref-type="fn" rid="FN1">2</xref>
Authors: K. E. Hellström, B. Bjaring
Journal: JNCI Journal of the National Cancer Institute (1966)

A cytotoxic assay, involving labeling of lymphoma cells with 51Cr and treatment with specific antibodies and complement, was used for calculation of the amount of absorbing H-2 antigens on cells from the LNSF lymphoma of (A × A.SW)F1 hybrid origin, and variants selected from it, for compatibility with the A or A.SW parental strain. Parental strain variants contained nearly double the amount of H-2 antigens of the strain of variant selection compared to that of the unselected LNSF line and were therefore phenotypically similar to homozygous cells.
Chromosomes of Tumor Cells. IV. Cell Population Changes in Thymus, Spleen, and Bone Marrow During X-Ray-lnduced Leukemogenesis in C57BL/6J Mice2
Authors: M. G. Joneja, H. F. Stich
Journal: JNCI Journal of the National Cancer Institute (1965)

The incidence of chromosome aberrations and of cells with abnormal chromosome complements was estimated in the thymus, spleen, and bone marrow of preleukemic, leukemic, and nonleukemic C57BL/6J mice that received repeated total-body irradiations. In early stages of leukemogenesis the normal cell populations of the thymus, spleen, and bone marrow, consisting predominantly of diploid cells, changed into genetically heterogeneous ones, consisting of cells with abnormal chromosome numbers, marker chromosomes, or both. At 7 weeks after irradiation the incidence of chromosomally abnormal cells in the spleen and bone marrow was greatly reduced, whereas clones of chromosomally abnormal cells became established in the thymus of most irradiated mice. All 10 thymic lymphosarcomas examined consisted of cells with abnormal chromosome complements. The presence of particular marker chromosomes in most leukemic cells of a mouse suggests that they originate from one parent cell. Clones of chromosomally abnormal cells were also observed in the spleen and bone marrow of 2 of 5 irradiated but apparently nonleukemic mice 9 months after irradiation. The particular behavior of the cell population of the thymus, the significance of a genetically heterogeneous cell population in preleukemic mice, and the possible role of environment conditions in tissue are discussed.
Paediatric origins of adult lung diseases bullet 5: Adult outcome of congenital lower respiratory tract malformations
Authors: M S Zach
Journal: Thorax (2001)

Congenital malformations of the lower respiratory tract are usually diagnosed and managed in the newborn period, in infancy, or in childhood. To what extent should the adult pulmonologist be experienced in this predominantly paediatric field?

There are three ways in which an adult physician may be confronted with this spectrum of disorders. The most frequent type of encounter will be a former paediatric patient, now reaching adulthood, with the history of a surgically treated respiratory malformation; in some of these patients the early loss of lung tissue raises questions of residual damage and compensatory growth. Secondly, there is an increasing number of children in whom paediatric pulmonologists treat respiratory malformations expectantly; these patients eventually become adults with their malformation still in place. Thirdly, there is a small group of patients in whom the malformation goes unrecognised throughout childhood; in these a late complication or the coincidental discovery of a radiographic anomaly may demand a late diagnosis and management in adulthood.

All three of these adult presentations will require some expertise on the part of the managing physician. The subsequent text reviews the most common “classical” congenital malformations of the lower respiratory tract from the above three perspectives.

### PAEDIATRIC PRESENTATION

TOF usually occurs in association with oesophageal atresia; thus, the outcome is invariably fatal unless the anomaly is surgically repaired in the first days of life. The rare “H type” TOF without oesophageal atresia is an exception to this rule and may persist into later childhood or even adulthood before the diagnosis is established.1 The malformation is explained by the defective progression of a complex system of folds that separate the foregut into trachea and oesophagus.2 Approximately 50% of infants with TOF have associated anomalies, most often involving the urinary, gastrointestinal, and cardiac systems.3 4 

The first successful repair of …
New EU rules might hinder research
Authors: Rory Watson
Journal: BMJ (2001)

Legislators for the European Union are trying to reassure medical researchers that recently agreed rules on clinical trials will not hinder their efforts to develop new drugs to help adult patients incapacitated with diseases such as Alzheimer's disease.

The new legislation was adopted by the 15 EU governments and the European parliament shortly before Christmas (13 January, p 68). It stipulates that medicinal products for trial may be administered to individuals incapable of giving their consent only when foreseeable risks and inconveniences have been weighed against the anticipated benefit for the individual trial subject and society. Consent to the subject's participation must be given by …