tbuckley/cabot-search huggingface dataset:
Bacterial infections and colonization in patients with tracheobronchial stenting
Authors: Milena Encheva, Encho Savov, Kosta Kostov, Vassil Shishkov, Plamen Titorenkov
Journal: European Respiratory Journal (2013)

Traheobronchial stenting (TBS) is a major therapeutic interventional procedure in obstructive lesions of central airways. Among the most common complications of TBS are retention of secretions (RS) and infections, but few studies pay attention to the microbiological constellations associated with stenting.  Patients and methods: In this prospective clinical observation we examine the microbiological samples of tracheal/traheobronchial lavage (T/TBL) before and 4 weeks after placement of silicone stents in 14 patients with benign traheobronchial stenosis. The pathogenetic role of the isolated bacteria was determined by correlation of culture results and clinical signs of infection.  Results: T/TBL are associated with presence and degree of RS. In five of 14 patients colonization of airways is present before TBS; in three of them we identified potentially pathogenic microorganisms. After TBS, bacterial colonization was observed in 11 (7 of them without prior colonization) of 14 patients. In 6 of them we have established one or more potentially pathogenic bacteria (Pseudomonas aeruginosa [4], Staphylococcus aureus [3], Streptococcus pneumoniae [1], Klebsiella spp. [1]). Although TBS is likely related to the RS, no statistical significance has been established (Fisher test, p = 0.06).  Discussion: We assume that TBS is a prerequisite for bacterial colonization and RS, caused by potentially pathogenic microorganisms. This is confirmed with absence of airway colonization before TBS in most patients in the study group. In our observation, however, bacterial colonization is not manifested by clinical signs of infection. Colonization is associated with RS in stent wall.
Airway eosinophilia in response to allergen is augmented by diesel exhaust
Authors: Chris Carlsten, Mandy Pui, Thomas Sandstrom, Anders Blomberg
Journal: European Respiratory Journal (2013)

Rationale: Mechanisms of association between traffic-related air pollution and asthma remain unclear. Specifically, there is limited evidence in animal models and human nasal models that diesel exhaust (DE) augments the response to allergen, but this has not been shown in vivo in the human lung.  Methods: We recruited 10 volunteers and determined their specific sensitization by skin prick testing. Each subject participated in a blinded crossover experiment between two conditions (filtered air (FA) and 300µg PM2.5/m3 of DE), randomized and counter-balanced to order (Fig.1). Each subject was exposed to each condition, with a 4-week washout period between exposures. One hour following exposure, diluent-controlled segmental allergen challenge was performed using 5mL of saline and allergen extract (in a concentration 10-fold lower than the lowest concentration producing a positive (≥3mm) wheal to skin prick) in the lingular and right middle lobe segments. Two days post-exposure initiation, bronchoalveolar lavages (BAL) is collected in both the allergen-affected and control regions.  BAL eosinophils were assessed by differential cell counts on cytospins. Eosinophilic cationic protein (ECP) was assessed by ELISA. Pairwise t-tests were performed to compare effects of contrasting conditions (DES = diesel exhaust + saline; DEA = diesel exhaust + allergen; FAA = filtered air + allergen).  Results: BAL eosinophilia was significantly higher in DEA vs FAA (p = 0.007) and DEA vs DES (p= 0.01 [n = 8]). BAL ECP was higher in DEA vs DES (p = 0.001; n = 10).  Conclusions: DE has a synergistic effect on airway eosinophilia in response to allergen in previously-sensitized individuals.
Authors should have stated how drug was given
Authors: A. Herxheimer
Journal: BMJ (1996)

Single dose of oral dexamethasone for outpatient croupFailure to follow up all patients is a concern EDrTOR,-G C Geelhoed and colleagues con- clude from their study that oral dexamethasone at a dose of 0.15 mg/kg is effective in reducing return to medical care in children with mild croup.'The sample size seems adequate, though on the borderline for detecting a 90% reduction,
Brain metastases in patients with renal cell carcinoma: prognosis and treatment.
Authors: D A Decker, V L Decker, A Herskovic, G D Cummings
Journal: Journal of Clinical Oncology (1984)

Thirty-four patients with renal cell carcinoma and brain metastases were reviewed to define important prognostic factors and treatment results. The following covariates were analyzed to determine their influence on survival: disease-free interval, serum calcium, number of central nervous system (CNS) metastases, weight loss, performance score, age, radiation therapy, surgery, and surgery plus radiation. The mean survival for all patients was 7.0 months (range, seven days to 32 months). The patients with a good performance score of 0-2 survived significantly longer (mean survival, 10.2 months) than those with a poor performance score of 3-4 (mean survival, 2.8 months; p = 0.0019). Surgery was associated with significantly improved survival (mean survival, 13.8 months versus mean survival, 4.2 months; p = 0.014). However, all the surgical patients were from the good performance score group, suggesting patient selection. Radiation was associated with an improved mean survival of 8.6 months versus 3.2 months. Performance score is a significant prognostic factor. Furthermore, the data support treatment with radiation therapy for patients with multiple CNS metastases and surgery followed by postoperative radiation therapy for patients with single CNS metastases.
Reid warns food industry over labelling
Authors: Caroline White
Journal: BMJ (2005)

Health secretary John Reid has warned the food industry that if it does not voluntarily introduce clear nutritional labelling on its products, the government will enlist the help of the European Commission to force it to comply. Dr Reid was speaking to the parliamentary health committee last week, to explain the feasibility and effectiveness of the proposals in the public health white paper, Choosing Health , published last November ( BMJ 2004;329:1201, 20 Nov). Public health minister Melanie Johnson and deputy chief medical officer Fiona Adshead also attended.

His remarks came amid …
CHLORPROMAZINE HEPATITIS TREATED WITH CORTISONE
Authors: M CUTTS
Journal: Annals of Internal Medicine (1957)

Case Reports1 June 1957CHLORPROMAZINE HEPATITIS TREATED WITH CORTISONEMORGAN CUTTS, M.D., F.A.C.P.MORGAN CUTTS, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-46-6-1160 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe occurrence of jaundice following chlorpromazine therapy has been repeatedly noted, but the exact mechanism of its production remains in doubt.1, 2 Some authors suggest a drug sensitivity, others an increased viscosity of the bile produced by the medication. Recently, benefit from treatment with cortisone in one case has been reported.1 Following is a report of another such case.CASE REPORTA 45 year old woman was admitted to the hospital because of increasing anorexia, nausea, weakness and epigastric distress for 10 days. For one week she had noted increasingly dark urine and severe generalized pruritus. She had taken 25...Bibliography1. SteinWright AAAW: Hepatic pathology in jaundice due to chlorpromazine, J. A. M. A. 161: 508 (June 9) 1956. CrossrefMedlineGoogle Scholar2. JohnsonDoenges HCJP: Intrahepatic obstructive jaundice, Ann. Int. Med. 44: 589 (Apr.) 1956. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Providence, Rhode Island*Received for publication September 17, 1956.Requests for reprints should be addressed to Morgan Cutts, M.D., 154 Waterman Street, Providence 6, Rhode Island. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byPhenobarbital-Induced Hepatic DysfunctionThe-Effect of Cortisone on Cholangitis Induced by α-Naphthyl-Isothiocyanate in RatsPhenothiazine und Azaphenothiazine als HeilmittelXanthomatous biliary cirrhosis following chlorpromazine 1 June 1957Volume 46, Issue 6Page: 1160-1161KeywordsBileChlorpromazineDrug therapyHepatitisNauseaPruritusUrine ePublished: 1 December 2008 Issue Published: 1 June 1957 PDF downloadLoading ...
Genome‐Wide DNA Methylation Study Identifies Significant Epigenomic Changes in Osteoarthritic Cartilage
Authors: Matlock A. Jeffries, Madison Donica, Lyle W. Baker, Michael E. Stevenson, Anand C. Annan, Mary Beth Humphrey, Judith A. James, Amr H. Sawalha
Journal: Arthritis & Rheumatology (2014)

To perform a genome-wide DNA methylation study to identify DNA methylation changes in osteoarthritic (OA) cartilage tissue.The contribution of differentially methylated genes to OA pathogenesis was assessed by bioinformatic analysis, gene expression analysis, and histopathologic severity correlation. Genome-wide DNA methylation profiling of >485,000 methylation sites was performed on eroded and intact cartilage from within the same joint of 24 patients undergoing hip arthroplasty for OA. Genes with differentially methylated CpG sites were analyzed to identify overrepresented gene ontologies, pathways, and upstream regulators. The messenger RNA expression of a subset of differentially methylated genes was analyzed by reverse transcription-polymerase chain reaction. Histopathology was graded by modified Mankin score and correlated with DNA methylation.We identified 550 differentially methylated sites in OA. Most (69%) were hypomethylated and enriched among gene enhancers. We found differential methylation in genes with prior links to OA, including RUNX1, RUNX2, DLX5, FURIN, HTRA1, FGFR2, NFATC1, SNCAIP, and COL11A2. Among these, RUNX1, HTRA1, FGFR2, and COL11A2 were also differentially expressed. Furthermore, we found differential methylation in approximately one-third of known OA susceptibility genes. Among differentially methylated genes, upstream regulator analysis showed enrichment of TGFB1 (P = 4.40 × 10(-5) ) and several microRNAs including miR-128 (P = 4.48 × 10(-13) ), miR-27a (P = 4.15 × 10(-12) ), and miR-9 (P = 9.20 × 10(-10) ). Finally, we identified strong correlations between 20 CpG sites and the histologic Mankin score in OA.Our data implicate epigenetic dysregulation of a host of genes and pathways in OA, including a number of OA susceptibility genes. Furthermore, we identified correlations between CpG methylation and histologic severity in OA.
Building evidence to improve maternal and child health
Authors: David Olds
Journal: The Lancet (2015)

Giving children the best possible start in life is crucial to reduce health disparities.1 One of the UK Government's efforts to support young children has been to adapt and assess the Family Nurse Partnership (FNP), a programme of prenatal and early childhood home visiting for vulnerable first-time mothers and their children. In The Lancet, Michael Robling and colleagues2 report on Building Blocks, a multisite trial of the FNP in England. My colleagues and I3,4 have developed and tested this programme previously in three randomised trials in the USA.
Environmental factors associated with wheezing illness in pre-schoolers
Authors: Doxa Kotzia, Apostolis Giotas, Christine Kottaridi, Eleni Kletsiou, Constantinos Douros, Petros Karakitsos, Vasiliki Matziou, Konstantinos N. Priftis
Journal: European Respiratory Journal (2014)

Aim: Previous studies showed that various environmental factors may contribute in the development of the wheezing illness in early childhood. The aim was to assess the impact of environmental factors (climate, air pollution, passive exposure to second-hand smoking, viral infections) in the development of wheezing symptoms in preschoolers attending nursery, during the period December 2010-June 2011 in Greece.

Methods: The study population consisted of 233 preschool aged children, attending nursery: 120 children living in a rural area with low air-pollution (Viotia) and 113 in a metropolitan city (Athens). Urine cotinine was measured in the beginning of the study and 2 months later. The mean value was considered as a reliable index of tobacco smoke exposure. Nasal-pharyngeal swabs (NPS) were collected for 4 consecutive time periods during the school year December 2010-June 2011 and examined with RT-PCR for Adenovirus, Bocavirus, Coronavirus, Enteroviruses, Influenza (A, B, C) viruses, Metapneumovirus, Parainfluenza (1, 2, 3, 4) viruses, Rhinovirus, and RSV (A, B). Children were generally well during the sampling period. For the analysis of the results multivariate analysis was employed.

Results : Eighteen children had at least one episode of wheeze during study period. The existence of wheeze during this period was related with cotinine levels (p=0.032) and living in urban area (p=0.023). Sensitization to aeroallergens, parental education, or virus' detection when asymptomatic were not associated with presence of wheeze.

Conclusion: Preschool children leaving in urban areas and whose parents tend to smoke are more prone to develop wheezing episodes compared to those leaving in non-smoking or rural environment.
Infective Endocarditis in a District General Hospital
Authors: M Manford, J Matharu, K Farrington
Journal: Journal of the Royal Society of Medicine (1992)

Thirty-three cases of infective endocarditis presenting during a 6.5 year period to a district general hospital were analysed retrospectively. The annual incidence was 22 cases per million population. Twenty-two cases had pre-existing cardiac disease, mainly valvular disease — Usually rheumatic (nine cases) and prosthetic valves (10 cases). Recognizable precipitants such as recent surgery were uncommon. Two cases presented after deliberate drug overdose possibly due to depression exacerbated by systemic disease. Symptoms were usually non-specific. All but two cases had murmurs and most were pyrexial. Splinter haemorrhages and clubbing were seen in about 20% of cases. Viridans-type streptococci were the commonest infecting organisms (14 cases). Staphylococcal infection (six cases) was confined to intravenous drug abusers and patients with prosthetic valves. Five cases were culture negative. Cerdiac failure was present in 13 cases at presentation and developed in seven others during treatient. Acute valve replacement was necessary in eight cases, and late replacement in three. Renal impairment (plasma urea &gt; 8 mmol/l and/or plasma creatinine &gt; 120 μmol/l) occurred in 19 cases during the course of their illness. Embolic phenomena occurred in 12 patients and mostly involved the central nervous system. In the 8 fatal cases, the cause of death was cardiac failure in six, cerebrovascular accident in one, and myocardial infarction in one. Four of the six patients who subsequently died of cardiac failure had been referred for surgery. Both those who were not referred had coexisting medical problems. Factors associated with increased mortality were age, male sex, cardiac failure (P&lt;0.01), renal impairment (P&lt;0.05), and embolic phenomena (P&lt; 0.01). These outcome figures are similar to those reported from regional centres, and support the management of infective endocarditis in district general hospitals, particularly those with adequate access to echocardiography, with transfer for surgery when necessary.
Abstract 4401: Anticoagulant Treatment Before Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction: A Propensity Score Adjusted Comparison Between No Pre-treatment, Unfractionated Heparin, Enoxaparin and Fondaparinux
Authors: Francois Schiele, Nicolas Meneveau, Marie-France Seronde, Vincent Descotes-Genon, Joanna Dutheil, Romain Chopard, Fiona Ecarnot, Jean-Pierre Bassand
Journal: Circulation (2009)
Paradoxical Effects of Clofibrate on Liver and Muscle Metabolism in Rats
Authors: Harbhajan S. Paul, Siamak A. Adibi
Journal: Journal of Clinical Investigation (1979)

Chronic clofibrate intake, on occasion, results in a muscular syndrome in man. We have investigated the effects of chronic clofibrate administration in rats on the electrical activity of a skeletal muscle (gastrocnemius), its composition, and its oxidation of palmitate and glucose. These effects have been compared with those in the liver. Clofibrate administration altered electromyographic pattern of gastrocnemius muscle (characteristic of myotonia), decreased its protein content, and impaired its oxidation of palmitate and glucose. These effects were quite different in the liver, because clofibrate intake increased the liver protein content and oxidation of palmitate without affecting the oxidation of glucose by this tissue. Whereas chronic clofibrate administration markedly increased the concentration of carnitine as well as the activity of mitochondrial carnitine palmitoyl-transferase in the liver, it decreased the activity of this enzyme in the gastrocnemius muscle without a significant effect on carnitine concentration in this tissue. Greater in vivo fatty acid oxidation by clofibratefed than by control rats was evidenced (a) by greater rate of production of 14CO2 in the expired air after injection of a tracer dose of [14C]palmitate and (b) by greater plasma and tissue concentrations of ketone bodies. We conclude that (a) paradoxical effects of clofibrate on fatty acid oxidation by the liver and skeletal muscle are related to changes in the activity of carnitine acyltransferase, (b) an increase in hepatic fatty acid oxidation may contribute to hypolipidemic effect of clofibrate, and (c) impairment of fatty acid and glucose oxidation by the muscle may be a factor in the development of muscular syndrome in patients receiving clofibrate treatment.
Should bronchoscopy be performed in all patients with haemoptysis and a normal CT chest
Authors: Maryam Ahmed, Muhammad Badar Ganaie, Mohammed Haris, Imran Hussain
Journal: European Respiratory Journal (2014)

Background: Haemoptysis is a common symptom that requires urgent assessment to exclude serious lung pathology. The diagnostic pathway includes an urgent plain chest radiograph (CXR), chest computed tomography (CT) and bronchoscopic evaluation. We reviewed the investigations performed in patients presenting with haemoptysis over 12 months.

Methods: Retrospective analysis of consecutive patients referred to our lung cancer clinic with new onset haemoptysis from January to December 2013.

Results: 116 patients were referred with haemoptysis, 80 (69%) male; mean age 63 years; 51 (44%) current smokers. CXR was performed in 102 (75 reported normal). 89 (77%) had CT chest; 30 (33.7%) were reported abnormal (suspicious for malignancy or other pathology causing haemoptysis). Of the 59 patients with normal CT, bronchoscopy was performed in 51 (86%); 1 did not tolerate the procedure. 50 had no endobronchial abnormality. Of the 30 with abnormal CT, 21 had bronchoscopy. 12 had endobronchial abnormality confirmed to be malignant. 1 patient with normal endobronchial findings was diagnosed with malignancy on EBUS. Table 1 shows final diagnoses in patients that had an abnormal CT

View this table:

Final diagnoses in patients with abnormal CT chest





. Sensitivity, specificity and negative predictive value for CT in patients presenting with haemoptysis was 100% (CI 73-100%), 76.62% (CI 65-85%) and 100% (94-100%) respectively.

Conclusion: Our practice shows that CT chest is the best modality to pick up malignancy in patients with haemoptysis. Bronchoscopy should be used after CT to direct tissue sampling.
The effects of mispair and nonpair correction in hybrid DNA on base ratios (G + C content) and total amounts of DNA.
Authors: B C Lamb
Journal: Molecular Biology and Evolution (1985)

Base ratios and total DNA amounts can vary substantially between and within higher taxa and genera, and even within species. Gene conversion is one of several mechanisms that could cause such changes. For base substitutions, disparity in conversion direction is accompanied by an equivalent disparity in base ratio at the heterozygous site. Disparity in the direction of gene conversion at meiosis is common and can be extreme. For transitions (which give purine [R]/pyrimidine [Y] mispairs) and for transversions giving unlike R/R and Y/Y mispairs in hybrid DNA, this disparity could give slow but systematic changes in G + C percentage. For transversions giving like R/R and Y/Y mispairs, it could change AT/TA and CG/GC ratios. From the extent of correction direction disparity, one can deduce properties of repair enzymes, such as the ability (1) to excise preferentially the purine from one mispair and the pyrimidine from the other for two different R/Y mispairs from a single heterozygous site and (2) to excise one base preferentially from unlike R/R or Y/Y mispairs. Frame-shifts usually show strong disparity in conversion direction, with preferential cutting of the nonlooped or the looped-out strand of the nonpair in heterozygous h-DNA. The opposite directions of disparity for frame-shifts and their intragenic suppressors as Ascobolus suggest that repair enzymes have a strong, systematic bias as to which strand is cut. The conversion spectra of mutations induced with different mutagens suggest that the nonlooped strand is preferentially cut, so that base additions generally convert to mutant and deletions generally convert to wild-type forms. Especially in nonfunctional or noncoding DNA, this could cause a general increase in DNA amounts. Conversion disparity, selection, mutation, and other processes interact, affecting rates of change in base ratios and total DNA.
Incidence of chronic bronchitis: A prospective study in a large general population
Authors: Mathias Holm, Kjell Torén, Eva Andersson
Journal: European Respiratory Journal (2013)

Background: There are few studies on incidence of chronic bronchitis (CB) in general populations.  Aims and objectives: The present prospective study in a large general population sample aimed to investigate the incidence rate of chronic bronchitis (CB) in relation to age, atopy, gender and smoking.  Methods: A random sample of individuals living in a county in Western Sweden participated in a study 1993 and answered a short questionnaire. They were mailed a new respiratory questionnaire in 2003. 11,463 (72%) answered the questionnaire, which also comprised an item about age when symptoms of CB started. CB was defined as chronic productive cough of at least 3 months a year for 2 consecutive years. Cox regression analyses were performed with incident CB as an event and person-years under observation as the dependent variable. Mutual adjustments were made for age, atopy, gender and smoking. Hazard ratios were calculated for the explanatory variables.  Results: The 11,463 subjects were born 1943-1973 and 98 of them developed CB during the study period (1993-2003). The incidence rate was 0.9/1,000 person-years, and was increased in relation to smoking (HR 2.2, 95% CI (1.5-3.3)) and atopy (HR 1.6 95% CI (1.0-2.5)).The incidence rate of CB did not differ significantly between women and men or between different age groups.  Conclusions: An incidence rate of 0.9/1,000 person-years for CB was found in this large prospective general population-based study. Smoking and atopy were both associated with an increased risk of CB.
Abstract 10837: Mean Platelet Volume and Neutrophil-to-Lymphocyte Ratio on Admission as a Predictor of Impaired Reperfusion in Patients Presenting with ST-Segment Elevation Myocardial Infarction
Authors: Paolo P Gabriel, Vikas Aggarwal, Seshasayee Narasimhan, Nassim Krim, V. S Srinivas, James Scheuer
Journal: Circulation (2011)