tbuckley/cabot-search huggingface dataset:
Pectus excavatum, small lungs or small chest cavity?
Authors: Mark Gaides, C. Gauci, Sergei Bogomazov
Journal: European Respiratory Journal (2012)

INTRODUCTION . It is accepted that a pectus it is primary deformation of the chest. An alternative explanation is that the lung is underdeveloped and the small lung retracts the chest wall. According to this hypothesis, the small lung to chest volume ratio augment the negative intrapleural pressure thereby deforming the chest wall.  With surgical correction of the supposed chest deformity the chest cavity volume is increased and these small lungs are stretched even more than they were stretched. This traumatizes the lungs, further impairs their function.   Patient9s studied : 27 patients with Pectus Excavatum without surgical correction and 5 patients after surgical correction of the chest.   Methods : Body-plethysmography, Cardio-Pulmonary Exercise test, mathematical modeling.   Results.    Discussion . The preoperative TLC and VC were almost normal, but FRC and RV was significantly increased in the 27 patients. Central hemodynamic parameters were also within normal limits. Hence, the chest deformity is a secondary effect caused by this Little Lung Syndrome.  After surgery, all lung volumes and hemodynamic functions decreased.   Conclusion . It is probable that we need to change the surgical technique to not only correct the chest wall defect but also to reduce the intra-thoracic volume, so as not to stretch the lungs.
Study on mouth occlusion pressure in normal subjects and patients with obstructive or restrictive lung diseases
Authors: HongLyeol Lee, HaeSung Nam, JaeHwa Cho, JeongSeon Ryu
Journal: European Respiratory Journal (2012)

Mouth occlusion pressure (P 0.1 ) is the mouth pressure developed against a complete occlusion at 0.1 second after beginning of inspiration from FRC. Consciousness, autogenous reflexes and various lung mechanics do not affect it. We did this study in sequence of arterial blood gas examination, flow-volume curve, body plethysmography, diffusion capacity and measurement of P 0.1 . We divided the subjects into 4 groups such as normal control groups below 35 and above 50 years old, and the patient groups of obstructive and restrictive lung diseases. We measured P 0.1  during breathing of the ambient air and, again during 6% CO 2 -rebreathing with simultaneous measurement of ventilatory parameters such as MV (minute ventilatory volume)/P 0.1 , T i /T t  (inspiratory time/total respiratory time), TV/T i , and P 0.1 /TV/T i .  During breathing of the ambient air, P 0.1 , MV/P 0.1  and P 0.1 /TV/T i  showed a significant difference between the control groups and patient groups, and between the patient groups of obstructive and restrictive diseases. During CO 2 -rebreathing, P 0.1  and P 0.1 /TV/T i  showed a significant difference between the control groups and patient groups. P 0.1  and P 0.1 /TV/T i  correlated significantly. We did not find any difference between the patients with normal PaO 2  and those with hypoxemia. However, during CO 2 -rebreathing, there was a characteristic change of P 0.1  in the hypercapnic patient group compared with the normocapnic patient group. As a result, P 0.1  and P 0.1 /V T /T i  are the valid indices of central inspiratory neuromuscular drive and effectiveness of respiratory muscles contraction. They are useful in the diagnosis of advanced chronic lung diseases that accompany CO 2  retention.
GERIATRIC WARD PSYCHIATRY
Authors: RAPHAEL GINZBERG
Journal: American Journal of Psychiatry (1953)

1. Mental and intellectual deterioration are typical for psychoses in advanced life. Thus, an approach based on logical argumentation fails to facilitate contact with the elderly psychotic. 2. The emotional sphere is often not so much affected as the intellectual. Therefore, any therapeutic technique in treatment and psychological management of elderly psychotics has to be based primarily on the utilization of preserved emotional faculties, among them the preserved or only partly impaired ability for group identification. 3. Psychological management and treatment based on these principles is divided into the following 4 phases: Group occupational therapy; group and individual psychotherapy; training in self-care both inside, and in case of release, outside the hospital; adjustment of the elderly psychotic to the environment and adjustment of the immediate environment to the elderly person. 4. This program, which is already in action, takes care of the reversible psychological symptoms but not of the irreversible pathophysiological ones. 5. Although still in an experimental stage, the program opens the way for a more satisfactory management of elderly psychotics. The use of the methods described has therefore been advocated.
Natural history of IgE sensitisation to food allergens in a cohort of adults
Authors: Antonios Patelis, Christer Janson, Andrei Malinovschi, Maria Gunnbjörnsdottir, Torarinn Gislason, Kjell Torén, Betril Forsberg
Journal: European Respiratory Journal (2012)

Background: The prevalence of sensitisation to aeroallergens is reported to be unchanged or to decrease in adults in longitudinal studies. No longitudinal studies exist on the natural history of sensitisation to food allergens.  Methods: A subgroup of participants from the European Community Respiratory Health Survey (ECRHS) in Iceland and Sweden (n = 806) performed allergy tests (aeroallergens and food allergens) in ECRHS I (1990-1991), and ECRHS II (1999-2000) within the frame of EuroPrevall. IgE-sensitisation was measured against mite, cat (referred as perennial), timothy (referred as grass pollen) and egg white, milk, fish/cod, wheat, peanut, and soy (referred as food allergens).  Results: Food sensitisation decreased by 56% (from 5% to 2.2%). Peanut IgE-sensitisation was the most common food allergen sensitisation and its prevalence decreased by 67% (from 2.7% to 0.9%). Perennial allergen sensitisation decreased by 9% (from 18.5% to 16.8%) and grass pollen sensitisation decreased by 15% (from 17.5% to 14.8%) (all p-values  Conclusion  Prevalence of allergic sensitisation to food decreased in adults during a 9-year-period and this is likely to be due to aging. Persistence of IgE to food allergens was related to higher baseline levels of total IgE.
Hypodiploidy with less than 45 chromosomes confers adverse risk in childhood acute lymphoblastic leukemia : A report from the children's cancer group
Authors: Nyla A. Heerema, James B. Nachman, Harland N. Sather, Martha G. Sensel, Mei K. Lee, Raymond Hutchinson, Beverly J. Lange, Peter G. Steinherz, Bruce Bostrom, Paul S. Gaynon, Fatih Uckun
Journal: Blood (1999)
Streptococcus pneumoniae: proteomics of surface proteins for vaccine development
Authors: C. Morsczeck, T. Prokhorova, J. Sigh, M. Pfeiffer, M. Bille-Nielsen, J. Petersen, A. Boysen, T. Kofoed, N. Frimodt-Møller, P. Nyborg-Nielsen, P. Schrotz-King
Journal: Clinical Microbiology and Infection (2007)
Chordoma of the mobile spine: A retrospective analysis on 146 patients from two reference centers
Authors: S. Stacchiotti, S. Lo Vullo, M. Mercuri, L. Mariani, M. Alberghini, S. Pilotti, S. Ferrari, P. G. Casali, A. Gronchi, P. Picci
Journal: Journal of Clinical Oncology (2009)

10517 Background: The natural history of chordoma is still poorly known. Methods: We reviewed a large series of patients (pts) from two major reference centers for chordoma. All pts presenting at Istituto Ortopedico Rizzoli, Bologna, and Istituto Nazionale Tumori, Milan, Italy, over 25 years, were reviewed. Clinical and pathologic characteristics were recorded. Local recurrence, distant metastasis, and overall survival (OS) were analyzed both from time of diagnosis and from time of local recurrence/distant metastasis. A multivariable analysis to identify independent prognostic factors was carried out. PDGFR and brachyury expression analysis is ongoing. Results: One hundred forty-six consecutive pts were identified (sacrum 79%, lumbar spine 15%, cervical-dorsal spine 6%; extension at diagnosis: localized 90%, locally-advanced 5%, metastatic 5%; median size 10 cm, IQ range: 6–14). Median follow-up was 140 months (IQ range: 80–205). The 5/10-year OS, local relapse-free survival (LRFS) and distant relapse-free survival (DRFS) were respectively: 76/52%, 51/32%, 86/72%. For pts with primary disease, size independently predicted OS (p-value: 0.004), LRFS (p-value: 0.006) and DRFS (p-value: 0.02), while surgical margins independently predicted only LRFS (p-value: 0.0001) with a trend for OS (p-value 0.1007). Radiotherapy performed in 44 pts did not influence LRFS nor OS, but only 9 pts received &gt;60 Gy. The 5/10-year OS, LRFS, DRFS after the first local relapse were 54/24%, 50/45%, 64/61%. Size of the recurrence and quality of surgical margins did not influence post-relapse OS. The 5/10-year OS after the second local relapse were 20/0%. The overall incidence of metastases was 32% (commonest site: lung). The 5/10-year post-metastases OS was 35/0% (median 3 years). Results on PDGFR and brachyury expression will be provided. Conclusions: Tumor size and surgical margins affected outcome only on initial presentation. Incidence of distant metastases was higher than expected, although with a more indolent course than generally supposed. In spite of its indolent behavior, long-term prognosis was poor, with 26% of pts being continuously disease-free at 10 years. This series may provide an external control for studies on novel targeted agents, which are proving effective in such a rare tumor. No significant financial relationships to disclose.
Transcription factor p63 regulates differentiation- and repair-related genes in primary human bronchial epithelial cells: Implications for airway remodeling in asthma
Authors: Stephanie Warner, Tillie-Louise Hackett, Furquan Shaheen, Darryl Knight
Journal: European Respiratory Journal (2011)

Rationale: We have previously shown increased expression of the transcription factor p63 in the asthmatic epithelium, both in vivo and in vitro (Hackett et al. AJRCCM 2009 180(2):122-33). p63 is a crucial regulator of development and maintenance of a stratified epithelium in tissues such as the skin and kidney. Whether p63 has a similar role in regulating genes involved in airway epithelial barrier function, and could thus contribute to the airway remodeling seen in asthma, is unknown.

Objective: To determine the role of p63 in regulating expression of genes involved in airway epithelial adhesion, differentiation, structural integrity and cell cycle progression.

Methods: Monolayer cultures of primary human bronchial epithelial cells (n=5) were treated with 50nM custom Stealth siRNA (Invitrogen) targeting various p63 isoforms. RNA was collected at 48h and real-time qPCR for 21 epithelial genes was performed (SA Biosciences, USA). Results were normalized to GAPDH expression. One-way ANOVA with Dunnett's post-test were employed to assess statistical significance.

Results: Loss of p63 expression was found to significantly (p<0.05) decrease expression of several genes, most notably the differentiation-associated genes β-catenin and Jagged 1, the proliferation and repair-related gene Epidermal Growth Factor Receptor (EGFR) and the extracellular matrix component Lamininγ2.

Conclusions: In primary human airway epithelial cells, p63 loss results in decreased expression of key genes involved in epithelial differentiation and repair. This may have an impact on the phenotype observed in the asthmatic epithelium.
Screening for Obesity in Adults: Recommendations and Rationale
Journal: Annals of Internal Medicine (2003)

This statement summarizes the U.S. Preventive Services Task Force (USPSTF) recommendations on screening for obesity in adults based on the USPSTF's examination of evidence specific to obesity and overweight in adults and updates the 1996 recommendations on this topic. The complete USPSTF recommendation and rationale statement on this topic, which includes a brief review of the supporting evidence, is available through the USPSTF Web site (www.preventiveservices.ahrq.gov), the National Guideline Clearinghouse (www.guideline.gov), and in print through the Agency for Healthcare Research and Quality Publications Clearinghouse (telephone, 800-358-9295; e-mail, ahrqpubs@ahrq.gov). The complete information on which this statement is based, including evidence tables and references, is available in the accompanying article in this issue and in the summary of the evidence and systematic evidence review on the Web sites already mentioned. The summary of the evidence is also available in print through the Agency for Healthcare Research and Quality Publications Clearinghouse. *For a list of the members of the U.S. Preventive Services Task Force, see the Appendix.
Hospital and Physician Volume or Specialization and Outcomes in Cancer Treatment: Importance in Quality of Cancer Care
Authors: Bruce E. Hillner, Thomas J. Smith, Christopher E. Desch
Journal: Journal of Clinical Oncology (2000)

PURPOSE: To conduct a comprehensive review of the health services literature to search for evidence that hospital or physician volume or specialty affects the outcome of cancer care. METHODS: We reviewed the 1988 to 1999 MEDLINE literature that considered the hypothesis that higher volume or specialization equals better outcome in processes or outcomes of cancer treatments. RESULTS: An extensive, consistent literature that supported a volume-outcome relationship was found for cancers treated with technologically complex surgical procedures, eg, most intra-abdominal and lung cancers. These studies predominantly measured in-hospital or 30-day mortality and used the hospital as the unit of analysis. For cancer primarily treated with low-risk surgery, there were fewer studies. An association with hospital and surgeon volume in colon cancer varied with the volume threshold. For breast cancer, British studies found that physician specialty and volume were associated with improved long-term outcomes, and the single American report showed an association between hospital volume of initial surgery and better 5-year survival. Studies of nonsurgical cancers, principally lymphomas and testicular cancer, were few but consistently showed better long-term outcomes associated with larger hospital volume or specialty focus. Studies in recurrent or metastatic cancer were absent. Across studies, the absolute benefit from care at high-volume centers exceeds the benefit from break-through treatments. CONCLUSION: Although these reports are all retrospective, rely on registries with dated data, rarely have predefined hypotheses, and may have publication and self-interest biases, most support a positive volume-outcome relationship in initial cancer treatment. Given the public fear of cancer, its well-defined first identification, and the tumor-node-metastasis taxonomy, actual cancer care should and can be prospectively measured, assessed, and benchmarked. The literature suggests that, for all forms of cancer, efforts to concentrate its initial care would be appropriate.
Transposable element LINE1 is activated after exposure to cigarette smoke in primary human lung fibroblasts
Authors: N. Miglino, M. Tamm, P. Borger
Journal: European Respiratory Journal (2014)

Cigarette smoking causes cell proliferation disorders, including lung cancers and emphysema. Although about 40% of lung cancers is associated with p53 mutations, the major part (60%) is of unknown etiology. Integration of transposable elements (TE) in or nearby cell cycle control genes may disrupt the cell cycle and lead to uncontrolled proliferation. This may lead to loss of lung tissue, as seen in emphysema, or to hyperplasia and the development of tumors.  To assess the effect of cigarette smoke extract (CSE) on the expression and transposition of LINE1 (L1), a human TE present in primary human lung fibroblast. The L1 open reading frame (ORF)-2 protein was detected in immunoblotting (Westerns). The applied CSE was used as a 1:10 dilution from a stock solution containing the smoke equivalent of 1 cigarette/25 ml.  Primary fibroblast cell lines (n=8) were cultured in RMPI without and with CSE for 10, 30, 60, 90 and 120 minutes. Resting cells did not express detectable levels of L1-ORF2. CSE induced a biphasic L1-ORF2 expression pattern: an immediate early maximum at 10-30 minutes and a second maximum after 120 minutes. This coincided with a complete inhibition on fibroproliferation.  We conclude that CSE induced the expression of L1-ORF2, a marker for transposable elements activity. The increased expression of L1-ORF2 implies an overall increased activity of TE, since the L1-transposition machinery is also used by other mobile elements. Uncontrolled transposition of TE may cause genetic changes and lead to genomic damage. Their involvement in smoking-induced proliferation-disorders should be envisaged to understand the heterogeneity observed in lung cancers and emphysema.
Shifting Patterns of Prescription Opioid and Heroin Abuse in the United States
Authors: Theodore J Cicero, Matthew S Ellis, Jessie Harney
Journal: New England Journal of Medicine (2015)

This analysis of data from surveys of patients with opioid dependence who were entering treatment programs in the United States showed that exclusive abuse of prescription opioids declined between 2010 and 2014 and concurrent abuse of heroin and opioids increased.
Late-breaking abstract: Clinical epidemiology of lung cancer in China: A retrospective study of 4205 patients
Authors: Lei Li, Weimin Li, Li Zhang, Dan Liu
Journal: European Respiratory Journal (2014)

Introduction:The prevalence of lung adenocarcinoma keeps increasing. However, no large-scale survey has been done incorporating the epidemiologic and clinical characteristics with adenocarcinoma.  Objectives: To determine the association between population-based distribution, clinical characteristics and histologic subtypes of lung cancer.  Methods: 4205 hospitalized patients with lung cancer in China were enrolled in this study. Histologic subtypes were categorized as squamous carcinoma, adenocarcinoma, adenosquamous carcinoma, large cell carcinoma, small cell carcinoma and others. The prevalence of lung cancer subtypes within age and gender were examined, and their association with primary site, lymph node status, TNM stage, histologic grade and metastasis at diagnosis were determined.  Results: 1). Adenocarcinoma was the most common type (52.2%), most of the patients were with IV stage tumors (60.1%), low histologic grade (64.9%) and lymph node metastasis (60.7%) at diagnosis. The most common metastatic organs were bone (19.9%), brain (9.9%), and liver (9.1%). 2).The adenocarcinoma was more prevalent among women>45 years old (76.3%) than those  45 years old (40.5%) and men  Conclusions: Women>45 years old were more easily to have adenocarcinoma, while men were more easily to have squamous carcinoma.
Identification of <i>IL12RB1</i> as a Novel Systemic Sclerosis Susceptibility Locus
Authors: Elena López‐Isac, Lara Bossini‐Castillo, Sandra G. Guerra, Christopher Denton, Carmen Fonseca, Shervin Assassi, Xiaodong Zhou, Maureen D. Mayes, Carmen Pilar Simeón, Norberto Ortego‐Centeno, Iván Castellví, Patricia Carreira, Olga Gorlova, Lorenzo Beretta, Alessandro Santaniello, Claudio Lunardi, Roger Hesselstrand, Annika Nordin, Gabriela Riemekasten, Torsten Witte, Nicolas Hunzelmann, Alexander Kreuter, Jörg H. W. Distler, Alexandre E. Voskuyl, Jeska de Vries‐Bouwstra, Bobby P. Koeleman, Ariane Herrick, Jane Worthington, Timothy R. D. J. Radstake, Javier Martin
Journal: Arthritis & Rheumatology (2014)

ObjectiveLumbar spinal stenosis is one of the most commonly diagnosed spinal disorders in older adults. Although the pathophysiology of the clinical syndrome is not well understood, a narrow central canal or intervertebral foramen is an essential or defining feature. The aim of the present study was to estimate the magnitude of genetic versus environmental influences on central lumbar spinal stenosis and to investigate disc degeneration and stature or bone development as possible genetic pathways. MethodsA classic twin study with multivariate analyses considering lumbar level and other covariates was conducted. The study sample comprised 598 male twins (147 monozygotic and 152 dizygotic pairs), 35-70 years of age, from the population-based Finnish Twin Cohort. The primary phenotypes were central lumbar stenosis as assessed qualitatively on magnetic resonance imaging (MRI) and quantitatively measured dural sac cross-sectional area. Additional phenotypes (to examine possible genetic pathways) included disc bulging and standing height, as an indicator of overall skeletal size or development. ResultsThe heritability estimate (h(2)) for qualitatively assessed central lumbar spinal stenosis on MRI was 66.9% (95% confidence interval [95% CI] 56.8, 74.5). The broad-sense heritability estimate for dural sac cross-sectional area was 81.2% (95% CI 74.5, 86.1), with a similar magnitude of genetic influences across lumbar levels (h(2) = 72.4-75.6). The additive genetic correlation of quantitatively assessed stenosis and disc bulging was extremely high. There was no indication of shared genetic influences between stenosis and stature. ConclusionCentral lumbar spinal stenosis and associated dural sac dimensions are highly genetic, and disc degeneration (bulging) appears to be one pathway through which genes influence spinal stenosis. (Less)
Vascular access
Authors: P Y Fan, S J Schwab
Journal: Journal of the American Society of Nephrology (1992)

Modern hemodialysis requires repeated reliable access to blood vessels capable of providing rapid extracorporeal blood flow. This necessity for reliable access to the circulation is the Achilles' heel of modern hemodialysis. Native and synthetic arteriovenous fistulas remain the preferred method of maintaining long-term hemodialysis access. Vascular access dysfunctions (thrombosis and infection) are the most common complications encountered in the care of end-stage renal disease patients. This article focuses on the mechanisms by which permanent vascular access for hemodialysis is obtained and deals with the common complications that result. This review will evaluate these common complications and outline new methods for improving vascular access patency. New concepts focusing on the prospective detection and correction of venous stenoses as well as on the prevention of other factors that predispose to access failure are explored.