tbuckley/cabot-search huggingface dataset:
Domiciliary visits to the old and the mentally ill: How valuable?
Authors: Peter Crome, Alison Malham, Dereth Baker, Allison E Smith, Roger Bloor
Journal: Journal of the Royal Society of Medicine (2000)

Summary In the early days of the British National Health Service, domiciliary visits were a continuation of the tradition whereby general practitioners (GPs) met consultants in the patient's home. The nature of domiciliary visits, which still attract a special fee, has since changed. We analysed the effectiveness of all domiciliary visits undertaken in a NHS trust providing primary care, mental health and elderly care services to a population of 470 000. Data were obtained from domiciliary visit claim forms and from questionnaires completed by the consultant, the referring GP and consultant peer reviewers. The largest number of visits (total 234) was in geriatric medicine 48.9%, followed by old-age psychiatry 44.9%. Geriatric medicine was more likely than psychiatry to admit patients to hospital (19%) after a visit. All domiciliary visits in old-age psychiatry were done during the day (9 am to 5 pm). Only 2% of GPs stated that they attended any of the domiciliary visits; almost all thought that the outcome of domiciliary visits was of value. Old-age-psychiatry peer reviewers believed that all visits in that specialty were appropriate; in geriatric medicine this figure was 77% and in other psychiatric specialties 65%. The findings indicate that domiciliary visits were not being used routinely as a pathway to hospital admission, though they were often used to expedite admission or gain a quick consultant opinion; the visits were valued by GPs. The practice of domiciliary visits differs greatly from the definition in NHS terms and conditions of service. One or other should be altered.
Accurate monitoring of pulmonary air leak closure during endobronchial valve placement
Authors: Christophe Dooms, Paul De Leyn, Jonas Yserbyt, Herbert Decaluwe, Dirk Van Raemdonck, Vincent Ninane
Journal: European Respiratory Journal (2012)

Introduction. 

Endobronchial valves may be effective for the treatment of a prolonged pulmonary air leak (PAL). A traditional chest drainage system relying on a subjective and instantaneous assessment of expiratory bubble formation in the water-seal column lacks accuracy to aid assessments during and after valve placement.

Patients and methods. 

Three patients with a postoperative PAL measuring at least 1000 ml air leakage per minute (ml/min) were evaluated. We attempted air leak closure using endobronchial valves relying on a digital air leak measurement system displaying and recording the expiratory pulmonary air leak in ml/min. The number of valves used was set by either leak cessation or residual leak of <100 ml/min.

Results. 

In all patients, the effect of every single valve placed was accurately assessed in ml/min during the procedure. In 1 patient the air leak stopped after lobar exclusion, while in 2 patients the air leak decreased to <100 ml/min after lobar exclusion. The continuous post-intervention assessment accurately indicated air leak cessation in these two patients within 48 hours after valve placement. Chest drain removal was successful after air leak cessation. None of the patients developed respiratory insufficiency requiring subacute endobronchial valve removal. As planned, all valves were removed 3-4 weeks after their placement.

Conclusion. 

Digital objective air leak assessment guides endobronchial valve placement, indicates the exact timing of air leak cassation, and allows a safe fast-tracking policy of chest tube removal.
Tyrosine phosphorylation of focal adhesion kinase (p125FAK)
Authors: D A Troyer, A Bouton, R Bedolla, R Padilla
Journal: Journal of the American Society of Nephrology (1996)

Stress fibers, composed of actin filaments, converge upon and associate with a number of proteins, including focal adhesion kinase (p125FAK), and integrin receptors to form areas of close contact between cells and the extracellular matrix referred to as focal adhesions. Treatment of mesangial cells with cAMP-elevating agents causes a loss of focal adhesions, fragmentation of stress fibers, and decreased tyrosine phosphorylation of p125FAK. Thrombin reverses these effects of cAMP, and this model can be used to address some of the cellular mechanisms involved in regulating the loss and formation of focal adhesions. This study reports the effects of cAMP and thrombin on mesangial cell shape, distribution of actin, formation of stress fibers, and tyrosine phosphorylation of p125FAK. cAMP-treated cells display a condensed cell body with slender processes that traverse the area formerly covered by the cell. Addition of thrombin to these cells restores actin filaments (stress fibers) and increases tyrosine phosphorylation of p125FAK, and the cells resume a flattened morphology, even in the continued presence of cAMP-elevating agents. Peptides that mimic the tethered ligand portion of the thrombin receptor have the same effects on cell morphology and stress fiber formation as thrombin. In selected experiments, agents that disrupt either stress fibers (cytochalasin D) or microtubules (nocodazole; Sigma Chemical, St. Louis, MO) were used to examine the role of these cytoskeletal elements in thrombin-induced restoration of focal adhesions. Cytochalasin D blocked the ability of thrombin to restore focal adhesions and phosphorylate p125FAK. The effects of nocodazole, an agent that destabilizes microtubules (but which has no known receptor), are very similar to those of thrombin. The findings discussed in this study indicate that thrombin can modulate the formation of focal adhesions. The organization of stress fibers and microtubules is apparently intimately related to the phosphorylation of p125FAK and can be modulated by soluble receptor agonists such as thrombin or via altered polymerization of microtubules.
Cytogenetic, Cytophotometric, and Ultrastructural Study of Large Cerebriform Cells of the Sézary Syndrome and Description of a Small-Cell Variant23
Authors: M. A. Lutzner, I. Emerit, R. Durepaire, G. Flandrin, Ch. Grupper, M. Prunieras
Journal: JNCI Journal of the National Cancer Institute (1973)

Ultrastrudural, cytophotometric, and cytogenetic studies were performed on 4 patients with Sézary syndrome. The diagnosis of Sézary syndrome was based on the association of skin manifestations with the presence in the blood of an abnormal cell exhibiting a high nucleocytoplasmic ratio, a grooved and folded nucleus, and peroxidase and nonspecific esterase negativity. Twelve patients were used as controls: 1 with monocytic leukemia, 6 with chronic lymphocytic leukemia (CLL), 2 healthy donors, and 3 patients with other skin diseases. Two types of abnormal cells were recognized: 1) a large-cell type with a serpentine and cerebriform nucleus, near-tetraploid DNA values, and near-tetraploid chromosome counts and 2) a small-cell variant with indented nucleus, diploid DNA values,and pseudodiploid or hyperdiploid chromosome counts. Among others, A and B as well as Gq— markers were found. It was concluded that chromosomal abnormalities represent an additional criterion for the characterization of the Sézary cell, the nature of which appears to be lymphocytic because of itsresponse in culture to phytohemagglutinin. In addition, preliminary immunologic studies indicated that the Sézary cell is not a B-lymphocyte. It was hypothesized that Sézary syndrome is an uncommon thymus-derived form of CLL.
Endobronchial interventions used in the management of large airway malignancies and their associated complications: An audit
Authors: Clara Pugmire, Brendan Madden
Journal: European Respiratory Journal (2012)

Introduction: Endobronchial intervention is an expanding specialty involving a Multi- Disciplinary Team, which diagnoses and treats a diverse group of patients with large airway pathology. It is usually well tolerated and rarely contraindicated even for patients with advanced malignant disease.  Aims: To identify the different endobronchial interventions used in the treatment of airway malignancies at St. George9s Hospital, and document associated complications.  Methods: Data relating to endobronchial stenting, laser ablation and forceps debulking, and any short-term complications, were collected from the St. George9s Hospital patient database for 49 consecutive patients with airway malignancy.  Results: 36 (73%) patients had stent deployment, 7 (14%) had laser ablation and 3 (6%) had tumours debulked using forceps. Complications occurred in 9 (18.4%) patients and were granulation tissue formation (3), mucus retention (3), stent migration (2) and bleeding (1). All complications were effectively treated.  Conclusions: Stenting is the endobronchial intervention of choice for the treatment of large airway malignancies at St. George9s Hospital. Although it has the greatest associated complications, they are usually effectively treated. Furthermore, it is safe, well tolerated and achieves good symptomatic relief.
Differences in pulmonary function tests between acute respiratory distress syndrome of pulmonary and extrapulmonary etiology
Authors: Beatriz Llorente Ruiz, Esther Alonso Peces, María Vázquez Mezquita, Olga Navarrete Isidoro, Consuelo Pintado Delgado, Alicia Ferreira Moreno, Julio Flores Segovia, Felipe Canseco González
Journal: European Respiratory Journal (2011)

Introduction:  Treatment of Acute Respiratory Distress Syndrome (ARDS) with low volume tidal ventilation has shown improvement in survival rates as compared with high tidal volume therapy, but survivors present physical, psychological and respiratory sequelae, including impaired pulmonary function. The aim of this study was to determine the differences in pulmonary tests in survivors of pulmonary (ARDSp) and extrapulmonary (ADRSexp) distress syndrome, after treatment with that ventilation4 strategy.   Methods:  A total of 39 patients without comorbidity and more than 2-year survival after an ADRS episode were identified between 2000 and 2006. Twenty-seven patients finally participated in this study (13 ADRSp and 14 ADRSexp). Pulmonary function tests were performed in our laboratory using standard procedures. Spirometry, static volumes by pletismography and diffusing capacity form carbon monoxide by single-breath were measured.   Results:  There were no statistical differences neither in demographic and clinical variables analyzed, except for the number of days of low volume tidal ventilation treatment (25,38±17,85 vs. 12,71±10,00; p 0,037), nor in the lung function test values, except for diffusion data (DLCO: 66,82±16,95 vs. 81,88±10,05, p 0,02, KCO: 82,81±14,98 vs. 98,54±20,27, p 0,03).   Conclusions:  A high percentage of previously healthy patients that survived an ARDS, presented changes in the lung function tests, even after 2 years of the clinical episode. There were no differences in long-term respiratory outcomes between ARDSp an ARDSexp, except for DLCO and KCO, with lower values in ARDSp group.
Role of respiratory pathogens in infants hospitalized for a first episode of wheezing and their impact on recurrences
Authors: S. Bosis, S. Esposito, H.G.M. Niesters, G.V. Zuccotti, G. Marseglia, M. Lanari, G. Zuin, C. Pelucchi, A.D.M.E. Osterhaus, N. Principi
Journal: Clinical Microbiology and Infection (2008)
Effect of the 6-week rehabilitation programme in patients with ILD
Authors: Jakub Zatloukal, Katerina Neumannova, Vladimira Lostakova, Vitezslav Kolek
Journal: European Respiratory Journal (2013)

Introduction  Rehabilitation programme (RP) is recommended in all patients with chronic respiratory diseases suffering from dyspnoea, decreased exercise capacity and quality of life. However, the evidence of a RP effect is weak in patients with interstitial lung diseases (ILD).  Aim  To evaluate an effect of a 6-week RP on health status and health-related quality of life (HRQL) in patients with ILD.  Methods  Fourteen ILD patients (53±12 years, DLCO 61%, FVC 87%) with pulmonary sarcoidosis (PS; n=7) or idiopathic pulmonary fibrosis (IPF; n=7) were recruited to the 6-week RP. The assessment included lung function tests (LFT), maximal inspiratory (MIP) and expiratory (MEP) mouth pressures, chest expansion (CE), 6-minute walk test (6MWT) and HRQL using the St. George’s Respiratory Questionnaire (SGRQ). The RP consisted of respiratory physiotherapy, soft-tissue techniques, ventilatory muscle training and exercise training. Data were analysed to evaluate the treatment effect and differences in patients according to the present disease.  Results  Baseline data showed significantly lower DLCO (p  Conclusion  Although the 6-week RP increased physical performance, CE and MIP similarly in both PS and IPF patients, it should be promoted to last longer as no improvement has been achieved in self-reported HRQL.  Supported by grant of the Palacky University: FTK_2012:023.
Is smoking recorded accurately on death certificates? A study of patients who died from chronic obstructive pulmonary disease (COPD) and lung cancer in a tertiary referral centre
Authors: Clara Addison, Toni Jordan
Journal: European Respiratory Journal (2012)

Introduction  Death certification provides an important source of mortality data. This data is used to monitor the health of the population and to plan health services accordingly. It is also used in research into the health effects of exposure to various risk factors. 1 Since 1992 doctors in the UK were permitted to cite smoking as a cause of death without referral to the coroner. 1 However, a recent study suggests that smoking is rarely recorded on death certificates despite smoking being attributed to 18% of all deaths in England. 2 We sought to determine whether or not smoking was being recorded accurately on death certificates in patients who died from COPD and lung cancer at one hospital.  Methods and Results  Notes were reviewed for all the patients who died from COPD and lung cancer between January-November 2011 (N=183). Smoking history was recorded for 127 (69%) patients; 117 (92%) had smoked. Of these 117 patients, cause of death was certified as COPD [N=81 (69%)] and lung cancer [N=44 (38%)]. In all cases, smoking was not recorded on any part of the death certificate.  Conclusions  Smoking is not recorded appropriately on death certificates in patients who died from COPD and lung cancer. This limits death certificates as a potential useful source of epidemiological data on smoking.  References  1. http://www.gro.gov.uk/images/medcert_July_2010.pdf  2. Proctor, I et al. Does smoking kill? A study of death certification and smoking. J Clin Pathol. 2012. 65(2): 129-32.
Randomized phase III trial of edatrexate versus methotrexate in patients with metastatic and/or recurrent squamous cell carcinoma of the head and neck: a European Organization for Research and Treatment of Cancer Head and Neck Cancer Cooperative Group study.
Authors: J H Schornagel, J Verweij, P H de Mulder, F Cognetti, J B Vermorken, P Cappelaere, J P Armand, J Wildiers, A de Graeff, M Clavel
Journal: Journal of Clinical Oncology (1995)

To compared the response rates and the toxicity of the new antifolate edatrexate (EDX) with that of methotrexate (MTX) in a randomized trial in patients with metastatic or recurrent squamous cell cancer of the head and neck (SCC) and to compare the durations of response and survival.Two hundred seventy-three patients with SCC were randomized to receive either EDX or MTX as a weekly intravenous (IV) bolus injection. Doses of EDX were initially 80 mg/m2/wk, but because of the toxicity, this was later reduced to 70 mg/m2/wk. MTX was administered at a dose of 40 mg/m2/wk throughout. In both arms, two dose increments of 10% were scheduled in case of no toxicity.Of 264 eligible patients, 131 were treated with EDX and 133 with MTX. There were five treatment-related deaths: four on EDX and one on MTX. Overall, toxicity was similar in both arms; however, stomatitis, skin toxicity, and hair loss were more pronounced on the EDX arm. The overall response rate was 21% (six complete responses [CRs] and 21 partial responses [PRs]) for EDX and 16% (nine CRs and 12 PRs) for MTX (P = .392). Responses were mainly seen in patients with locoregional disease. Tumors that originated from the hypopharynx responded poorly in comparison to tumors from other sites. The median duration of response was 6.1 months for EDX and 6.4 months for MTX (log-rank P = .262). There was no difference in overall or progression-free survival. The median survival duration was 6 months on both treatment groups.Both EDX and MTX are moderately active against SCC. In this large phase III study, response rates, time to treatment failure, and overall survival appeared to be similar for both antifolates. However, EDX had more side effects than MTX and therefore cannot be recommended for routine palliative treatment of patients with SCC.
Continuous infusion bleomycin in AIDS-related Kaposi's sarcoma.
Authors: S C Remick, M Reddy, D Herman, C Grace, G Harper, K Willis, B Candon, J Horton, J C Ruckdeschel
Journal: Journal of Clinical Oncology (1994)

To determine the toxicity, response, and survival rate of 72-hour continuous infusion bleomycin administered to patients with AIDS-related Kaposi's sarcoma.Seventeen patients with biopsy-proven and measurable-disease AIDS-related Kaposi's sarcoma were treated with a continuous infusion of bleomycin at a dose of 20 mg/m2/d for 3 days every 3 weeks. All patients were evaluated for toxicity, response, and survival using the National Cancer Institute common toxicity criteria, and both the Eastern Cooperative Oncology Group (ECOG) and AIDS Clinical Trials Group (ACTG) response criteria. Fourteen of 17 patients (82%) enrolled had at least two on-study poor-risk factors by ACTG staging criteria.A total of 59 cycles of therapy were administered. Only one cycle (2%) was complicated by an absolute neutrophil count less than 500, and there were no episodes of febrile neutropenia. Fifty-four percent of cycles were associated with fever during the infusion, and five cycles (8%) were complicated by grade 3 rash. There were no other clinically significant (> or = grade 3) toxicities. There were seven partial remissions (41%) by ECOG criteria (95% confidence interval, 18% to 64%) and 11 partial remissions (65%) by ACTG criteria (95% confidence interval, 42% to 88%). Three of five (60%) previously treated patients had a partial remission with this schedule of bleomycin. The median survival duration was 7 months, with a range of 2.5 to 25 months.This continuous infusion schedule of bleomycin is active in patients with advanced-stage AIDS-related Kaposi's sarcoma and has acceptable toxicity. This regimen should be further evaluated in patients with earlier stage Kaposi's sarcoma and as salvage therapy.
References values for forced spirometry. Group of the European Community Respiratory Health Survey
Authors: J Roca, F Burgos, J Sunyer, M Saez, S Chinn, JM Anto, R Rodriguez-Roisin, PH Quanjer, D Nowak, P Burney
Journal: European Respiratory Journal (1998)

The European Coal and Steel Community (ECSC) prediction equations exemplify a significant effort carried out approximately 15 yrs ago to provide uniform standards for lung function testing, but this set of equations has not been properly validated as yet. The present study evaluates the ECSC reference values and four other sets of prediction equations, using spirometric data collected in 12,900 nonasthmatic subjects (43% lifetime nonsmokers and 36% active smokers) aged 20-44 yrs from the European Community Respiratory Health Survey (ECRHS). Standardized spirometric measurements were obtained using a common protocol in 34 centres in 14 countries. For each prediction equation, the prediction deviations (i.e. observed minus predicted value) for forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) were examined for the whole study population and for each centre. For the age range included, the errors about the ECSC equations showed the most prominent underestimation of both predicted FVC (+355 and +360 mL on average in males and females, respectively) and predicted FEV1 (+211 and +200 mL, respectively) among the five studies examined. As expected, FVC and FEV1 in active smokers from the ECRHS were significantly lower than in lifetime nonsmokers (each p&lt;0.01). We conclude that the present European recommendations on lung function reference values should be reconsidered, but further data for nonsymptomatic subjects above the age of 44 yrs are needed.
Skin differences based on age and chronicity of ultraviolet exposure: results from a gene expression profiling study
Authors: J.A. McGrath, M.K. Robinson, R.L. Binder
Journal: British Journal of Dermatology (2012)

Background Skin ageing represents an inevitable physiological consequence of getting older but the impact on personal health and wellbeing can be significant, and therefore considerable efforts have been made to understand the biology and pathophysiology of skin ageing to try to identify new targets that might offer therapeutic intervention and prevention. Objectives This study was designed to identify differences at the gene expression level between young and old, sun-exposed and sun-protected skin. Methods We generated transcriptomic data from young and old skin from sun-exposed and sun-protected sites (10 samples of each) using HG-U133 Plus 2.0 Affymetrix GeneChips. The data were analysed using hierarchical clustering, theme analysis and interaction mapping to identify regulated pathways, processes and potential targets for therapy. Results With 54 613 probe sets on the GeneChip, 2731 significant differences would be expected by chance (at P = 0·05), but we noted that 13 640 probe sets were significantly different comparing young arm skin vs. older arm skin (photoageing), and 7215 probe sets were significant for the young buttock vs. older buttock comparison (intrinsic ageing). In both types of ageing there was reduced expression of many genes implicated in lipid biosynthesis and epidermal differentiation with functional relevance to skin barrier integrity and maintenance. Increased expression of genes contributing to oxidative stress and decreased expression of antioxidant defences were also common to both types of ageing. Differences between intrinsic ageing and photoageing were mainly noted in extracellular matrix gene expression with reduced expression of interstitial collagen genes in intrinsic ageing and increased expression of elastic tissue genes in photoageing. Conclusions Collectively, the data identified new biomarkers of aged skin, particularly involving abnormalities of proteases, matrix proteins and inflammation. These findings offer the prospect of new and more specific targets for therapeutic development based on an improved understanding of the biology of skin ageing.
Human Erythropoietin Induces a Pro-Angiogenic Phenotype in Cultured Endothelial Cells and Stimulates Neovascularization In Vivo
Authors: Domenico Ribatti, Marco Presta, Angelo Vacca, Roberto Ria, Roberta Giuliani, Patrizia Dell’Era, Beatrice Nico, Luisa Roncali, Franco Dammacco
Journal: Blood (1999)