tbuckley/cabot-search huggingface dataset:
Randomized Trial of Apneic Oxygenation during Endotracheal Intubation of the Critically Ill
Authors: Matthew W. Semler, David R. Janz, Robert J. Lentz, Daniel T. Matthews, Brett C. Norman, Tufik R. Assad, Raj D. Keriwala, Benjamin A. Ferrell, Michael J. Noto, Andrew C. McKown, Emily G. Kocurek, Melissa A. Warren, Luis E. Huerta, Todd W. Rice
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Hypoxemia is common during endotracheal intubation of critically ill patients and may predispose to cardiac arrest and death. Administration of supplemental oxygen during laryngoscopy (apneic oxygenation) may prevent hypoxemia.To determine if apneic oxygenation increases the lowest arterial oxygen saturation experienced by patients undergoing endotracheal intubation in the intensive care unit.This was a randomized, open-label, pragmatic trial in which 150 adults undergoing endotracheal intubation in a medical intensive care unit were randomized to receive 15 L/min of 100% oxygen via high-flow nasal cannula during laryngoscopy (apneic oxygenation) or no supplemental oxygen during laryngoscopy (usual care). The primary outcome was lowest arterial oxygen saturation between induction and 2 minutes after completion of endotracheal intubation.Median lowest arterial oxygen saturation was 92% with apneic oxygenation versus 90% with usual care (95% confidence interval for the difference, -1.6 to 7.4%; P = 0.16). There was no difference between apneic oxygenation and usual care in incidence of oxygen saturation less than 90% (44.7 vs. 47.2%; P = 0.87), oxygen saturation less than 80% (15.8 vs. 25.0%; P = 0.22), or decrease in oxygen saturation greater than 3% (53.9 vs. 55.6%; P = 0.87). Duration of mechanical ventilation, intensive care unit length of stay, and in-hospital mortality were similar between study groups.Apneic oxygenation does not seem to increase lowest arterial oxygen saturation during endotracheal intubation of critically ill patients compared with usual care. These findings do not support routine use of apneic oxygenation during endotracheal intubation of critically ill adults. Clinical trial registered with www.clinicaltrials.gov (NCT 02051816).
Serum TIMP-1, TIMP-2, and MMP-1 in patients with systemic sclerosis, primary Raynaud's phenomenon, and in normal controls
Authors: S A Young-Min, C Beeton, R Laughton, T Plumpton, S Bartram, G Murphy, C Black, T E Cawston
Journal: Annals of the Rheumatic Diseases (2001)

Excess tissue matrix accumulates in systemic sclerosis (SSc), accounting for both visceral and dermal fibrosis. It is suggested that decreased serum levels of matrix metalloproteinases (MMPs) or increased levels of tissue inhibitors of matrix metalloproteinases (TIMPs) may account for this matrix accumulation.To measure serum levels of tissue inhibitors of metalloproteinases, TIMP-1, TIMP-2, and collagenase-1 (MMP-1), in patients with diffuse cutaneous systemic sclerosis (dcSSc), limited cutaneous systemic sclerosis (lcSSc), primary Raynaud's phenomenon (RP), and in normal controls.Serum samples from patients with dcSSc (n=83), lcSSc (n=87), RP (n=80), and normal controls (n=98) were analysed using enzyme linked immunosorbent assays (ELISAs) for total TIMP-1, TIMP-2, and MMP-1. Results from each assay were analysed by the Kruskal-Wallis test. Dunn's multiple comparison post-test was then applied between groups.TIMP-1 levels were significantly raised in dcSSc and lcSSc groups compared with the RP group and normal controls (p<0.01 to p<0.001). In the dcSSc group, TIMP-1 levels were significantly higher in early disease (<2 years) than in late stage disease (>4 years) (p<0.05). This was not found for the lcSSc group. Serum TIMP-2 and MMP-1 levels in dcSSc and lcSSc did not differ significantly from those in normal controls. Increased levels of TIMPs were not convincingly associated with organ disease. No assay result correlated with autoantibody status (anti-topoisomerase 1 (anti-Scl-70), anticentromere antibody, or anti-RNA polymerase). No significant differences in serum TIMP-1, TIMP-2, or MMP-1 levels were shown in the RP group compared with normal controls.Raised TIMP-1 levels in the SSc groups support the hypothesis that matrix accumulation occurs in SSc at least in part owing to decreased degradation. Moreover, the variation in TIMP-1 levels between the early and late disease stages of dcSSc seems to reflect the early progressive course of dermal fibrosis seen clinically. The expected reduction in serum MMP-1 levels in the SSc groups was not found. This suggests that tissue matrix accumulation is due to increased inhibitors rather than to decreased MMPs.
Hickman Catheter–Related Infections in Neutropenic Patients: Insertion in the Operating Theater Versus Insertion in the Radiology Suite
Authors: Jan L. Nouwen, Jenne J. Wielenga, Hans van Overhagen, J. S. Laméris, Jan A.J.W. Kluytmans, Myra D. Behrendt, Wim C.J. Hop, Henri A. Verbrugh, Simon de Marie
Journal: Journal of Clinical Oncology (1999)

PURPOSE: To determine the influence of microbial air quality during Hickman catheter insertion in the operating theater versus insertion in the radiology suite on the incidence of catheter-related infections (CRIs). PATIENTS AND METHODS: Hemato-oncologic patients with prolonged neutropenia on antimicrobial prophylaxis were entered onto the study. Catheters were inserted by experienced radiologists under sonographic and fluoroscopic guidance. RESULTS: Forty-eight Hickman catheters in 39 patients were inserted (23 in the operating theater, 25 in the radiology suite). CRIs were seen in 16 catheters (33%; six per 1,000 catheter days; eight in each group). Local infections were found in nine catheters (22%; six in the operating theater v three in the radiology suite; not significant [NS]), catheter-related bacteremia was found in 10 (29%; three in the operating theater v seven in the radiology suite; NS). Coagulase-negative staphylococci (CoNS) caused all CRIs. Despite early vancomycin therapy, 11 (69%; four in the operating room group v seven in the radiology suite group; NS) of the catheters with CRIs had to be removed prematurely. At 90 days after insertion, catheter survival was 78% and 60% (NS) for the operating room and radiology suite, respectively. Multivariate analysis showed that neutropenia increased the CRI risk 20-fold (P = .004) and was strongly related to premature catheter removal owing to infection (relative risk = 11.9; P = .009). Neutropenia on the day of insertion was also significantly correlated with CRI (P = .04) and premature catheter removal owing to infection (P = .03). Serial cultures of blood, exit site, and catheter hub did not predict the development of CRI. CONCLUSION: The high incidence of Hickman CRI caused by CoNS was not associated with insertion location (operating theater v radiology suite). Neutropenia, including neutropenia on the day of insertion, was a significant risk factor for CRI and infection-related catheter removal.
Patients' views have been surveyed
Authors: P A Mallinder, S M Bonner, K M Lawler, C S. Clair, C Dodds
Journal: BMJ (1995)

was called a "trivial if easily explicable error," but it calls into question the competence of the operator.If not, we should have to say to female patients not only "during anaesthesia you will be given a suppository which will help numb the pain
Improvements in survival and clinical benefit with gemcitabine as first-line therapy for patients with advanced pancreas cancer: a randomized trial.
Authors: H A Burris, M J Moore, J Andersen, M R Green, M L Rothenberg, M R Modiano, M C Cripps, R K Portenoy, A M Storniolo, P Tarassoff, R Nelson, F A Dorr, C D Stephens, D D Von Hoff
Journal: Journal of Clinical Oncology (1997)

PURPOSE Most patients with advanced pancreas cancer experience pain and must limit their daily activities because of tumor-related symptoms. To date, no treatment has had a significant impact on the disease. In early studies with gemcitabine, patients with pancreas cancer experienced an improvement in disease-related symptoms. Based on those findings, a definitive trial was performed to assess the effectiveness of gemcitabine in patients with newly diagnosed advanced pancreas cancer. PATIENTS AND METHODS One hundred twenty-six patients with advanced symptomatic pancreas cancer completed a lead-in period to characterize and stabilize pain and were randomized to receive either gemcitabine 1,000 mg/m2 weekly x 7 followed by 1 week of rest, then weekly x 3 every 4 weeks thereafter (63 patients), or to fluorouracil (5-FU) 600 mg/m2 once weekly (63 patients). The primary efficacy measure was clinical benefit response, which was a composite of measurements of pain (analgesic consumption and pain intensity), Karnofsky performance status, and weight. Clinical benefit required a sustained (&gt; or = 4 weeks) improvement in at least one parameter without worsening in any others. Other measures of efficacy included response rate, time to progressive disease, and survival. RESULTS Clinical benefit response was experienced by 23.8% of gemcitabine-treated patients compared with 4.8% of 5-FU-treated patients (P = .0022). The median survival durations were 5.65 and 4.41 months for gemcitabine-treated and 5-FU-treated patients, respectively (P = .0025). The survival rate at 12 months was 18% for gemcitabine patients and 2% for 5-FU patients. Treatment was well tolerated. CONCLUSION This study demonstrates that gemcitabine is more effective than 5-FU in alleviation of some disease-related symptoms in patients with advanced, symptomatic pancreas cancer. Gemcitabine also confers a modest survival advantage over treatment with 5-FU.
Persistent parvovirus B19 infections with different clinical outcomes in renal transplant recipients: diagnostic relevance of polymerase chain reaction (PCR) and of quantification of B19 DNA in sera
Authors: Alberta Axzi, Krystyna Zakrxewskal, Elisabetta Bertoni, Stefno Guidi, Maurixio Salvadori
Journal: Clinical Microbiology and Infection (1996)
Laser Trabeculoplasty and Decay Effects in Glaucoma Patients
Authors: Austin I Fink, Alan J Jordan
Journal: Journal of the Royal Society of Medicine (1984)

Forty patients (47 eyes) with open-angle glaucoma who had been treated by laser trabeculoplasty to help reduce intraocular pressure were reviewed. The majority of patients had been followed for at least one year. Eighty-nine percent responded satisfactorily, with an average pressure decrease of 5 mmHg. There was no evidence of decay (pressure reversal) after one year. Seventy-six percent of patients who had been on carbonic anhydrase inhibitor medication were able to discontinue this therapy after laser treatment. Blacks, aphakic and diabetic patients responded satisfactorily, but hypertensive patients and those with narrow-angle glaucoma less so. Re-lasering was successful in only one of 6 patients.
Transplantation and Cell-Free Transmission of a Reticulum-Cell Sarcoma in BALB/c Mice&lt;xref ref-type="fn" rid="fn1"&gt;2&lt;/xref&gt;,&lt;xref ref-type="fn" rid="fn2"&gt;3&lt;/xref&gt;
Authors: P. G. Stansly, H. D. Soule
Journal: JNCI Journal of the National Cancer Institute (1962)

A neoplastic disease resembling “reticulum-cell neoplasm, type B (Hodgkin's-like lesion)” developed in 2 of 11 BALB/c mice inoculated with cell-free extracts derived from the Ehrlich ascites tumor. Thereafter, the disease was serially propagated either by transplantation or with cell-free extracts. While reticulum-cell sarcoma (RCS) was the major neoplastic disease generated, a lymphocytic neoplasm (or a disease with characteristics of both neoplasms) was also encountered during the cell-free passage of RCS and could be distinguished from RCS in various ways, particularly in its behavior on transplantation. Cell-free induced reticulum-cell sarcoma is characterized by a prolonged stage of splenic hyperplasia preceding the onset of neoplasia. Such hyperplastic tissue was nonetheless infective. Induction of neoplastic disease occurred with filtered extracts and a fluorocarbon-treated extract. Although strain specificity was evident, it was not absolute. The incidence of cell-free transmission was dependent on age of host at time of inoculation. The agent survived storage at −70° C, and repeated freeze-thawing. Evidence is cited for the probable replication of the neoplastic agent(s) in tissue culture.
Early Detection of Type III Procollagen Peptide in Acute Lung Injury
Authors: ASHA N. CHESNUTT, MICHAEL A. MATTHAY, FRED A. TIBAYAN, JOAN G. CLARK
Journal: American Journal of Respiratory and Critical Care Medicine (1997)

The fibroproliferative reaction to acute lung injury may limit restoration of normal lung function and increase mortality in patients with acute lung injury. A biologic marker of collagen synthesis in the lung may be useful for studying the pathogenesis of acute lung injury and for identifying patients with acute lung injury who are at high risk for death and might benefit from new therapeutic modalities. Using an immunoassay, type III procollagen NH2 terminal peptide was measured in the pulmonary edema fluid of 44 patients with either acute lung injury or hydrostatic pulmonary edema (control group) within the first 24 h after endotracheal intubation for acute respiratory failure. Patients with acute lung injury (n = 33) or hydrostatic edema (n = 11) had the same degree of lung dysfunction as measured by the severity of oxygenation defect, the level of positive end-expiratory pressure, the decrease in static lung compliance, and the extent of infiltrates on the chest radiograph. However, the median procollagen III level was 5-fold higher in the pulmonary edema fluid of patients with acute lung injury than in the patients with hydrostatic pulmonary edema (p = 0.0001). Of the 33 patients with acute lung injury, 21 patients died and 12 lived. Nonsurvivors had significantly higher procollagen III levels than did survivors (p = 0.05). The positive and negative predictive values for nonsurvival for a procollagen III level ⩾ 1.75 U/ml were 74 and 83%, respectively. The relative risk of dying in the presence of a procollagen III value ⩾ 1.75 U/ml was 4.5 (95% CI, 0.7 to 27). Collagen synthesis in the lung, as reflected by elevated levels of procollagen III in pulmonary edema fluid, begins within the first 24 h of acute lung injury concurrent with the acute phase of increased endothelial and epithelial permeability to protein. This evidence suggests that fibrosing alveolitis begins much earlier in the course of clinical acute lung injury than has previously been appreciated. In addition, the presence of an elevated level of procollagen III is an early predictor of poor outcome. Thus, elevation of procollagen III in pulmonary edema fluid may have both pathogenetic and prognostic significance in patients with acute lung injury.
Impact of rapid microbial identification directly from positive blood cultures using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry on patient management
Authors: D. Martiny, F. Debaugnies, D. Gateff, M. Gérard, M. Aoun, C. Martin, D. Konopnicki, A. Loizidou, A. Georgala, M. Hainaut, M. Chantrenne, A. Dediste, O. Vandenberg, S. Van Praet
Journal: Clinical Microbiology and Infection (2013)
MUSIC: Efficacy and safety of macitentan in idiopathic pulmonary fibrosis (IPF)
Authors: Juergen Behr, Rachel Million-Rousseau, Adele Morganti, Loïc Perchenet, Ganesh Raghu
Journal: European Respiratory Journal (2012)

Endothelin-1 may contribute to IPF pathophysiology. The prospective double-blind Macitentan USe in an IPF Clinical (MUSIC) trial (NCT00903331) investigated the endothelin receptor antagonist macitentan in adults with IPF of   Mean (range) exposure to macitentan was 14.3 (0.0–24.6) months and to placebo was 15.4 (6.3–24.3) months. Median (95% confidence limit) change in FVC was −0.20 L (−0.29 to −0.16) for macitentan and −0.20 L (−0.28 to −0.13) for placebo; ie. no treatment effect on FVC was observed. No difference in time to IPF worsening or death was observed. Adverse events in ≥10% of macitentan-treated patients with a ≥5% difference versus placebo comprised peripheral oedema, anaemia (both favoured placebo), cough (favoured macitentan). Hepatic aminotransferase elevations >3× upper limit of normal occurred in 3.4% of macitentan recipients and 5.1% of placebo recipients. In summary, the primary objective was not met. Long-term macitentan exposure was well tolerated with rates of elevated hepatic aminotransferases comparable to placebo.
Consequences of poor compliance in chronic respiratory diseases
Authors: NM Siafakas, D Bouros
Journal: European Respiratory Journal (1992)

In this short report, we reviewed the literature on the consequences of poor compliance in chronic respiratory diseases. Unquestionably, poor compliance is a very significant medical issue in the management of tuberculosis. Poor compliance could cause serious personal and public health problems and is probably the major obstacle to the elimination of tuberculosis. Similarly, important consequences have been attributed to poor compliance with prescribed treatment in bronchial asthma. Those consequences could vary from impairment of daily life to life threatening attacks and death. However, it is difficult to apply methods to produce solid evidence that such consequences are the result of poor compliance. In conclusion a greater number of well designed studies are needed to investigate the various consequences of poor compliance in chronic respiratory diseases; a major issue that undoubtedly affects the outcome of treatment.
Saliva as a source of anti-Toxoplasma gondii IgG for enzyme immunoassay in human samples
Authors: B.F.C. Sampaio, M.S. Macre, L.R. Meireles, H.F. Andrade
Journal: Clinical Microbiology and Infection (2013)

Toxoplasmosis, a highly prevalent disease, is mainly diagnosed by serology. Incidence studies could be feasible in children, but ethical concerns restrict blood sampling in this group. Saliva contains small amounts of crevicular fluid IgG. Dot-ELISA and a protein A IgG capture immunoassay were standardized for anti-Toxoplasma gondii IgG in paired saliva and serum samples from 20 adult volunteers. A frequency of toxoplasmosis of 19% (95% CI 12-28) was found in 100 saliva samples from university graduates using both assays. Toxoplasmosis immunoassays using saliva IgG are a promising tool for the investigation of the epidemiology of this disease in children and other vulnerable groups.
Test/retest study of the European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire.
Authors: M J Hjermstad, S D Fossa, K Bjordal, S Kaasa
Journal: Journal of Clinical Oncology (1995)

The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) is a well-validated instrument that assesses health-related quality of life (HRQOL) in cancer patients. It is used in cancer clinical trials in Europe, Canada, and the United States, and has demonstrated high reliability and validity in different groups of cancer patients. Despite thorough testing of reliability and validity, we have not identified any reports on its test/retest reliability; thus, a test/retest study was performed at the Norwegian Radium Hospital (NRH).Cancer patients from the outpatient clinic who were off treatment for > or = 3 months were eligible for the study. The EORTC QLQ-C30 was given to the patients when they presented for their visit. The second questionnaire was received by the patients 4 days later. Of 291 eligible patients, 270 (93%) agreed to participate and 190 (73%) completed both questionnaires.The test/retest reliability measured by Pearson's correlation coefficient was high for all functional scales, with a range from .82 for cognitive and role function to .91 for physical function. The r value for global HRQOL was .85. For the symptom scales--nausea/vomiting, fatigue, and pain--the coefficients were .63, .83, and .86, respectively. The single-item coefficients ranged from .72 for diarrhea to .84 for financial impact. The Spearman rank correlation was in the same range for all dimensions.The EORTC QLQ-C30 seems to yield high test/retest reliability in patients with various cancer diagnoses whose condition is not expected to change during the time of measurement.
Randomized Comparison of Surveillance Intervals in Familial Colorectal Cancer
Authors: Simone D. Hennink, Andrea E. van der Meulen-de Jong, Ron Wolterbeek, A. Stijn L.P. Crobach, Marco C.J.M. Becx, Wiet F.S.J. Crobach, Michiel van Haastert, W. Rogier ten Hove, Jan H. Kleibeuker, Maarten A.C. Meijssen, Fokko M. Nagengast, Marno C.M. Rijk, Jan M.J.I. Salemans, Arnold Stronkhorst, Hans A.R.E. Tuynman, Juda Vecht, Marie-Louise Verhulst, Wouter H. de Vos tot Nederveen Cappel, Herman Walinga, Olaf K. Weinhardt, Dik Westerveld, Anne M.C. Witte, Hugo J. Wolters, Annemieke Cats, Roeland A. Veenendaal, Hans Morreau, Hans F.A. Vasen
Journal: Journal of Clinical Oncology (2015)

Colonoscopic surveillance is recommended for individuals with familial colorectal cancer (CRC). However, the appropriate screening interval has not yet been determined. The aim of this randomized trial was to compare a 3-year with a 6-year screening interval.Individuals between ages 45 and 65 years with one first-degree relative with CRC age < 50 years or two first-degree relatives with CRC were selected. Patients with zero to two adenomas at baseline were randomly assigned to one of two groups: group A (colonoscopy at 6 years) or group B (colonoscopy at 3 and 6 years). The primary outcome measure was advanced adenomatous polyps (AAPs). Risk factors studied included sex, age, type of family history, and baseline endoscopic findings.A total of 528 patients were randomly assigned (group A, n = 262; group B, n = 266). Intention-to-treat analysis showed no significant difference in the proportion of patients with AAPs at the first follow-up examination at 6 years in group A (6.9%) versus 3 years in group B (3.5%). Also, the proportion of patients with AAPs at the final follow-up examination at 6 years in group A (6.9%) versus 6 years in group B (3.4%) was not significantly different. Only AAPs at baseline was a significant predictor for the presence of AAPs at first follow-up. After correction for the difference in AAPs at baseline, differences between the groups in the rate of AAPs at first follow-up and at the final examination were statistically significant.In view of the relatively low rate of AAPs at 6 years and the absence of CRC in group A, we consider a 6-year surveillance interval appropriate. A surveillance interval of 3 years might be considered in patients with AAPs and patients with ≥ three adenomas.