tbuckley/cabot-search huggingface dataset:
Performance of VITEK-2 Compact and overnight MicroScan panels for direct identification and susceptibility testing of Gram-negative bacilli from positive FAN BacT/ALERT blood culture bottles
Authors: M.D. Quesada, M. Giménez, S. Molinos, G. Fernández, M.D. Sánchez, R. Rivelo, A. Ramírez, G. Banqué, V. Ausina
Journal: Clinical Microbiology and Infection (2009)
The health-related quality of life of asthmatic patients according to the illness severity
Authors: Juliana Maria De S Pinto, Ana María M. Nogueras, Jacinto R. González, José Ignacio C. Arenillas
Journal: European Respiratory Journal (2011)

Aim: To evaluate the differences in the Health Related Quality of Life (HRQoL) of Asthmatic patients according to the illness severity using the Saint George Respiratory Questionnaire (SGRQ), an specific instrument for respiratory diseases.

Methods: A cross-sectional, descriptive and observational study with 103 outpatients with Asthma (65 women and 38 men) with mean age of 58.48 years (SD 18.30 years) recruited from the Respiratory Service of the University Hospital of Salamanca, Spain from January to July 2010. Socio-demographic and spirometric data (American Thoracic Society criteria) were collected. The HRQoL was evaluated by the SGRQ. Descriptive analysis, one-way analysis of variance and the t-student test were applied using SPSS.

Results: It was found that 30.1% had Intermittent (I), 35% had Mild Persistent (MP), 25.2% had Moderate Persistent (MOP) and 9.7% had Severe Persistent (SP) asthma according to the Global Initiative Asthma. The mean of the domains were: Symptoms 39.93 scores (SD 21.83 scores), Activity 43.50 scores (SD 28.10 scores), Impact 24.61 scores (SD 17.81 scores) and the Total 32.84 scores (SD 19.07 scores). There were significant differences (ANOVA) between the groups of severity and the forced expiratory volume in 1s (FEV1), the Vital Capacity (VC) and all domains and the Total SGRQ. There were no signification in the FEV1 and the VC between I and MP groups (t-student tests). Also there was no signification between the three contrasts between the MP, MOP and MS groups in all domains and in the total SGRQ.

Conclusions: The HRQoL is related to the asthma severity in this studied sample due to higher differences between the Intermittent Asthma and the other groups.
A <scp>P</scp>hase 2 study of <scp>L</scp>‐asparaginase encapsulated in erythrocytes in elderly patients with <scp>P</scp>hiladelphia chromosome negative acute lymphoblastic leukemia: The <scp>GRASPALL/GRAALL‐SA</scp>2‐2008 study
Authors: Mathilde Hunault‐Berger, Thibaut Leguay, Françoise Huguet, Stéphane Leprêtre, Eric Deconinck, Mario Ojeda-Uribe, Caroline Bonmati, Martine Escoffre‐Barbe, Pierre Bories, Chantal Himberlin, Patrice Chevallier, Philippe Rousselot, Oumedaly Reman, Marie‐Laure Boulland, Severine Lissandre, Pascal Turlure, Didier Bouscary, Laurence Sanhes, Ollivier Legrand, Marina Lafage‐Pochitaloff, Marie C Béné, David Liens, Yann Godfrin, Norbert Ifrah, Hervé Dombret
Journal: American Journal of Hematology (2015)

The GRASPALL/GRAALL-SA2-2008 Phase II trial evaluated the safety and efficacy of L-asparaginase encapsulated within erythrocytes (GRASPA®) in patients ≥ 55 years with Philadelphia chromosome-negative acute lymphoblastic leukemia.Thirty patients received escalating doses of GRASPA® on Day 3 and 6 of induction Phases 1 and 2. The primary efficacy endpoint was asparagine depletion < 2 µmol/L for at least 7 days. This was reached in 85 and 71% of patients with 100 and 150 IU/kg respectively but not with 50 IU/kg. Grade 3/4 infection, hypertransaminasemia, hyperbilirubinemia and deep vein thrombosis occurred in 77, 20, 7, and 7% of patients, respectively. No allergic reaction or clinical pancreatitis was observed despite 17% of Grade 3/4 lipase elevation. Anti-asparaginase antibodies were detected in 50% of patients and related to a reduction in the duration of asparagine depletion during induction Phase 2 without decrease of encapsulated L-asparaginase activity. Complete remission rate was 70%. With a median follow-up of 42 months, median overall survival was 15.8 and 9.7 months, in the 100 and 150 IU/kg cohorts respectively.The addition of GRASPA®, especially at the 100 IU/kg dose level, is feasible in elderly patients without excessive toxicity and associated with durable asparagine depletion. (clinicaltrials.gov identifier NCT01523782).
Endoscopic ultrasound-guided choledochoduodenostomy vs. transpapillary stenting for distal biliary obstruction
Authors: Kazumichi Kawakubo, Hiroshi Kawakami, Masaki Kuwatani, Yoshimasa Kubota, Shuhei Kawahata, Kimitoshi Kubo, Naoya Sakamoto
Journal: Endoscopy (2015)

Endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) has gained popularity as an alternative to percutaneous biliary drainage for patients in whom endoscopic retrograde cholangiopancreatography has failed. There are no previous studies comparing EUS-CDS with endoscopic transpapillary stenting (ETS) as first-line treatment for distal malignant obstruction. The aim of this study was to compare the clinical efficacy and safety of EUS-CDS and ETS as first-line treatment in patients with distal malignant biliary obstruction.A total of 82 patients with distal malignant biliary obstruction underwent initial biliary drainage using self-expandable metal stents at a tertiary care university hospital. ETS was performed between June 2009 and May 2012, and EUS-CDS was performed between May 2012 and March 2014. Clinical success rates, adverse event rates, and reintervention rates were retrospectively evaluated for EUS-CDS and ETS.A total of 26 patients underwent EUS-CDS and 56 underwent ETS. Clinical success rates were equivalent between the groups (EUS-CDS 96.2 %, ETS 98.2 %; P = 0.54). The mean procedure time was significantly shorter with EUS-CDS than with ETS (19.7 vs. 30.2 minutes; P < 0.01). The rate of overall adverse events was not significantly different between the groups (EUS-CDS 26.9 %, ETS 35.7 %; P = 0.46). Post-procedural pancreatitis was only observed in the ETS group (0 % vs. 16.1 %; P = 0.03). The reintervention rate at 1 year was 16.6 % and 13.6 % for EUS-CDS and ETS, respectively (P = 0.50).EUS-CDS performed by expert endoscopists was associated with a short procedure time and no risk of pancreatitis, and would therefore be feasible as a first-line treatment for patients with distal malignant biliary obstruction.
microRNA-155 negatively regulates Apaf-1 and enhance sensitivity of A549 to cisplatin
Authors: Yuan-Sheng Zang, Qing-Yu Xiu, Zheng Fang, Bing Li, Jing An
Journal: European Respiratory Journal (2012)

MicroRNA-155(miR-155) overexpression is often found in malignancies including lung cancer. The objective of this study is to verify the hypothesis that miR-155 is involved in development and progress of lung cancer by modulating cell apoptosis and DNA damage through regulation on Apaf-1, which is postulated according to the bioinformatics analysis. Firstly, the expression of miR-155 and Apaf-1 protein in the lung cancer tissues were measured. The results showed that expression of miR-155 is significantly higher in lung cancer tissues compared with the paracancerous tissues and normal tissues, while Apaf-1 protein expression level decreased in lung cancer tissues. Then the miR-155 silenced and Apaf-1 overexpressed A549 cell models were established through transfection with pMAGic2.0-BIC-siRNA and pcDNA3.1-Apaf-1, respectively. The cell apoptosis and DNA damage of different cell models under treatment with cisplatin were assessed, and the untranfected A549 cells were used as negative control. The results showed that silence of miR-155 resulted in elevated expression of Apaf-1 protein, but the Apaf-1 mRNA level had no significant difference compared with the control group. Both miR-155 silencing and Apaf-1 overexpression in A549 cells seemed greatly increase the cellular sensitivity to cisplatin treatment as evidenced by elevated apoptosis rate and DNA damage. Further, dual-transfection with both miR-155 siRNA and Apaf-1 siRNA in A549 cells resulted in attenuation and alleviation of cell apoptosis and DNA damage. In conclusion, inhibition of miR-155 can enhance the sensitivity of A549 cells to cisplatin treatment by regulation on cell apoptosis and DNA damage through Apaf-1 mediated pathway.
Treatment and Outcome of Thrombolysis-Related Hemorrhage
Authors: Shadi Yaghi, Amelia K. Boehme, Jamil Dibu, Christopher R. Leon Guerrero, Syed Ali, Sheryl Martin-Schild, Kara A. Sands, Ali Reza Noorian, Christina A. Blum, Shuchi Chaudhary, Lee H. Schwamm, David S. Liebeskind, Randolph S. Marshall, Joshua Z. Willey
Journal: JAMA Neurology (2015)

IMPORTANCETreatments for symptomatic intracerebral hemorrhage (sICH) are based on expert opinion, with limited data available on efficacy.OBJECTIVE To better understand the natural history of thrombolysis-related sICH, with a focus on the efficacy of various treatments used.
The histological confirmation rate of lung cancer in the UK using the NLCA database
Authors: Aamir Khakwani, Anna Rich, Richard Hubbard
Journal: European Respiratory Journal (2012)

Background  The optimal histological confirmation rate (HCR) for lung cancer is unknown. However, in the UK, an arbitrary figure of 75% has been recommended by the National Lung Cancer Audit (NLCA) as a benchmark. The aim of this study was to quantify the effect of patient features on the likelihood of having a histological diagnosis of lung cancer.  Methods  Individuals with a diagnosis of lung cancer were selected from the NLCA database from between 01/01/2004 and 31/12/2010. Percentage and odd ratios with 95% confidence interval were calculated to assess the proportion of patients having histology.  Results  Our study included a total of 127,099 individuals with NSCLC. HCR for NSCLC in the NLCA was found to be 66.8%. This however was increasing from 62.2% in 2007 to 72.3% in 2010. The histology in patients aged  75 years and CI of 0 and PS of 4. Increasing age and worsening PS were also associated with a reduced odds ratio, whilst stage and CI had little effect on the likelihood of having proven histology. Individuals from least affluent areas were 23% less likely (adj OR 0.77, 95% CI 0.74 to 0.81, p  Conclusion  HCR is crucial in determining the appropriate treatment plan for every patient, especially with the advent of targeted therapies. Our results also show that there is a difference in the histological rate in the sub groups of patients. Therefore achieving 75% HCR in the total population is unreasonable and it should focus on different attainable HCR in sub group of patients.
Risk Factors for H. pylori Antimicrobial Resistance Partnership (SHARP) Study, 1993–1999
Authors: Joette M. Meyer
Journal: Annals of Internal Medicine (2002)

Background: Pretreatment antimicrobial resistance has an important impact on the efficacy of many Helicobacter pylori treatment regimens. Objective: To estimate the prevalence of H. pylori resistance to antimicrobials in the United States, to characterize risk factors associated with H. pylori antimicrobial resistance, and to explore the association between drug utilization and antimicrobial resistance patterns over time. Design: Meta-analysis using patient-level data. Setting: 20 nationwide trials of H. pylori eradication. Patients: 3624 men and women, each of whom contributed one isolate. Measurements: Rates of H. pylori resistance to clarithromycin, metronidazole, and amoxicillin, according to geographic region, age, sex, study year, ethnicity, ulcer status, test method, and study. Results: Overall resistance to clarithromycin, metronidazole, and amoxicillin was 10.1% (95% CI, 9.1% to 11.1% [360 of 3571 patients]), 36.9% (CI, 35.1% to 38.7% [1063 of 2883 patients]), and 1.4% (CI, 1.0% to 1.8% [48 of 3486 patients]), respectively. In multivariable analyses, multiple risk factors were associated with resistance to individual agents. Clarithromycin resistance was significantly associated with geographic region (P = 0.050), older age (P < 0.001), female sex (P < 0.001), inactive ulcer disease (P < 0.001), and study (P = 0.010). Metronidazole resistance was significantly associated with female sex (P < 0.001), earlier year of study enrollment (P = 0.036), Asian ethnicity (P < 0.001), use of an epsilometer test (P = 0.002), and study (P < 0.001). Amoxicillin resistance was low and was not significantly associated with any risk factor. In the 1990s, when rates for use of oral macrolides and metronidazole were relatively stable, clarithromycin resistance rates were stable and metronidazole resistance rates varied. Conclusions: Clinicians should consider risk factors for antimicrobial resistance when deciding which patients should have susceptibility testing and when choosing appropriate H. pylori treatments in the empirical setting.
Pulmonary Rehabilitation and Physical Activity in Patients with Chronic Obstructive Pulmonary Disease
Authors: Martijn A. Spruit, Fabio Pitta, Edward McAuley, Richard L. ZuWallack, Linda Nici
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Physical inactivity is common in patients with chronic obstructive pulmonary disease (COPD) compared with age-matched healthy individuals or patients with other chronic diseases. Physical inactivity independently predicts poor outcomes across several aspects of this disease, but it is (at least in principle) treatable in patients with COPD. Pulmonary rehabilitation has arguably the greatest positive effect of any current therapy on exercise capacity in COPD; as such, gains in this area should facilitate increases in physical activity. Furthermore, because pulmonary rehabilitation also emphasizes behavior change through collaborative self-management, it may aid in the translation of increased exercise capacity to greater participation in activities involving physical activity. Both increased exercise capacity and adaptive behavior change are necessary to achieve significant and lasting increases in physical activity in patients with COPD. Unfortunately, it is readily assumed that this translation occurs naturally. This concise clinical review will focus on the effects of a comprehensive pulmonary rehabilitation program on physical activity in patients with COPD. Changing physical activity behavior in patients with COPD needs an interdisciplinary approach, bringing together respiratory medicine, rehabilitation sciences, social sciences, and behavioral sciences.
India is urged to make stents essential medicines to help control price
Authors: S. Bagcchi
Journal: BMJ (2015)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following India is urged to make stents essential medicines to help control price Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
A regional nurse study day using small group tutorials- A successful novel approach to publicising pulmonary hypertension
Authors: Jenny Louise Bacon, Ernest Wong, Brendan Patrick Madden
Journal: European Respiratory Journal (2013)

Introduction: Diagnosing pulmonary hypertension (PH) early in the disease process is paramount. Many health professionals encounter patients with PH without considering the diagnosis and these delays have a significant impact on patient prognosis. Efforts to increase awareness have centred on doctors education.

Objective: A regional UK nurse study day was arranged to investigate whether specialist nurses would benefit from PH education using small group learning.

Methods: Regional specialist cardiology and respiratory nurses were invited to attend a PH study day. Five rotating small group tutorials were run simultaneously by specialist physicians. Case based learning (CBL) in small groups was then delivered. An optional, anonymous feedback form was given to attendees.

Results: From 42 interested nurses all 25 invited attended (14 cardiology (56%), 10 respiratory (40%) and 1 paediatric nurse (4%)) from 8 centres. 22 (88%) feedback forms were completed. All adult nurses (21/21) reported ‘yes’ they felt more confident in identifying appropriate patients for referral to PH centres. Five rotating sessions scored mean 4.5-4.7/5 for satisfaction and CBL scored 4.7/5. All nurses (21/21) answered yes they benefited more from small group tutorials instead of lecture based materials. 16 nurses added positive comments on course structure in additional comments.

Conclusions: Specialist nurses are interested in and have benefited from PH education. A small group learning approach was favoured. The results suggest new focus should be given to also educating nurses on PH and small group learning should be considered for training other health professionals on PH.
The reproducibility and responsiveness of the lung clearance index in bronchiectasis
Authors: Lizzie Grillo, Samantha Irving, David M. Hansell, Arjun Nair, Bertrand Annan, Simon Ward, Diana Bilton, Eleanor Main, Jane Davies, Andrew Bush, Robert Wilson, Michael R. Loebinger
Journal: European Respiratory Journal (2015)

Lung clearance index (LCI) is a potential clinical outcome marker in bronchiectasis. Its responsiveness to therapeutic intervention has not been determined. This study evaluates its responsiveness to a session of physiotherapy and intravenous antibiotic treatment of an exacerbation.32 stable and 32 exacerbating bronchiectasis patients and 26 healthy controls were recruited. Patients had LCI and lung function performed before and after physiotherapy on two separate occasions in the stable patients and at the beginning and end of an intravenous antibiotic course in the exacerbating patients.LCI was reproducible between visits in 25 stable patients, with an intraclass correlation of 0.978 (0.948, 0.991; p<0.001). There was no significant difference in LCI (mean±sd) between stable 11.91±3.39 and exacerbating patients 12.76±3.47, but LCI was significantly higher in both bronchiectasis groups compared with healthy controls (7.36±0.99) (p<0.001). Forced expiratory volume in 1 s improved after physiotherapy, as did alveolar volume after intravenous antibiotics, but LCI did not change significantly.LCI is reproducible in stable bronchiectasis but unlike conventional lung function tests, is unresponsive to two short-term interventions and hence is unlikely to be a useful clinical tool for short-term acute assessment in these patients. Further evaluation is required to establish its role in milder disease and in the evaluation of long-term interventions.
AXL receptor tyrosine kinase controls epithelial differentiation of human lung progenitor cells
Authors: Naoya Fujino, Hiroshi Kubo, Rose Maciewicz
Journal: European Respiratory Journal (2013)

Understanding the molecular mechanisms controlling differentiation of lung stem/progenitor cells may offer therapeutic opportunities for lung diseases. Studies of human lung progenitor cells indicated that inhibition of epithelial-to-mesenchymal transition (EMT) was important for differentiation towards alveolar epithelial type II cells (Fujino N, et al. Respir Investig 2012;50:110). However, it is not known what signalling pathway(s) controls the EMT and provokes the differentiation. The aim of this study was to identify molecular targets and pathways regulating differentiation from the progenitors towards alveolar epithelial cells. We conducted a phenotypic screen using human lung progenitor cells (Fujino N, et.al. Lab Invest 2011;91:363) and 220 known modulators for stem cell phenotypes. Immunofluorescence staining for pro surfactant protein-C (SP-C), to detect alveolar type II cell-differentiation, was quantified by ArrayScan. 41 out of the 220 compounds increased SP-C expression. These hit compounds included a variety of kinase inhibitors, e.g. AXL kinase, GSK3β, IκB kinase and PI3 kinase. However, only one of them, which had the inhibitory effect on AXL kinase, changed the shape of the progenitor cells to the epithelial-like morphology. Inhibition of AXL kinase also increased expression of other proteins for alveolar type II and type I cells, including surfactant protein-A, aquaporin 5 and T1α, and decreased expression of EMT-inducing transcription factors, e.g. Zeb1. These data indicate that the AXL kinase pathway may be important in controlling lung progenitor differentiation to alveolar epithelial type II and type I cells via suppression of the EMT.
Plasma Biomarker Profiling In Langerhans Cell Histiocytosis: Risk-Stratifying The Inflammatory Storm
Authors: Miguel Dario Cantu, Tricia L Peters, Karen Phaik-Har Lim, Albert Shih, Rikhia Chakraborty, Harshal Abhyankar, Maria Angelica Cantu, Kenneth McClain, Tsz-Kwong Chris Man, Carl E. Allen
Journal: Blood (2013)
Huge bilaterally cavitary and nodulary lung lesions: Pulmonary lenfomatoid granulomatosis
Authors: Ismail Hanta, Melek Ergin, Sedat Kuleci
Journal: European Respiratory Journal (2013)

Pulmonary lenfomatoid granulomatosis (PLG) is a very rare disorders, characterized by multiple nodular lesions. PLG is considered to be a variant of B-cell lymphoma, associated with Epstein-Barr virus. In this report, we present a case of PLG characterized by multiple large both cavitary, and nodular lesions.  Twenty two years old, male patient has admitted to our out-patient clinic with the symptoms of cough, within the last month, and progressive dyspnea, within the last week. Physical and laboratory examination revealed no apparent abnormal findings. There were bilateral multiple great cavities and nodulary lesions in computerized tomography of the thorax. ANCA was negative. Fiberoptic bronchoscopy and transthoracic fine needle biopsy were negative. Finally, at thoracoscopic biopsy, lenfomatoid granulomatosis was diagnosed pathologically. It is thought that PLG should be also considered in the differential diagnosis of multiple cavitary and nodulary lesions of the lung.
T spot TB – Changing trends and resource implications for trusts
Authors: Mehul Patel, Adrian Morris, Bandipalyam Prathibha
Journal: European Respiratory Journal (2011)

Introduction: The diagnosis of TB has been revolutionised by Gamma interferon testing with the advantage of being more specific and sensitive in detecting both active and latent TB. East Kent Hospitals NHS Trust ia a lage trust serving a population of 700,000. This study outlines our experience and in particular focuses on the resource implications as usage of biological agents increases.

Methods: All samples assayed over a twelve month period were included in the study. Data, including the demographics of the patients, indication for the test and the result, was collated. The data was analysed.

Results: A total of 491 samples were sent for analysis within the study period. There was an equal gender distribution (M:F – 221:270) and the median age was 53.02.

View this table:

Table 1. Reason for requesting T spot T





View this table:

Table 2. Result of T spot T by indication





Conclusion: T spot TB provides a highly sensitive and specific way of detecting active or latent TB. Almost a third of the requests are to assess TB status prior to the introduction of biological agents. This will have a major impact on resources with the increased usage of biologics, something that needs to be borne in mind whilst developing this service.