tbuckley/cabot-search huggingface dataset:
Video-assisted thoracoscopic surgery (VATS) and percutaneous drain insertion (PDI) in childhood empyema
Authors: Iris De Schutter, Susanne van Steijn, Elke De Wachter, Jan Lamote, Dirk Smets, Patrick Haentjens, Anne Malfroot
Journal: European Respiratory Journal (2012)

Introduction:

Pediatric parapneumonic effusion (PPE) incidence increases.

Aims:

To compare different treatment options in children with PPE.

Methods:

Retrospective analysis of children with PPE, admitted from 01/01/2007-30/11/2011. PPE definition: ≥1cm fluid on US or CT, and/or an opacity on chest X-ray of ≥50% of the hemithorax. Exclusion criteria: age <6m., trauma, thoracotomy.

PDI and VATS were performed on clinical indication. VATS was reserved for patients (pts) with insufficient clinical improvement.

Pts were treated as follows: Group A: no PDI/VATS. Group B: PDI. Group C: VATS. Group D: PDI followed by VATS.

Results:

49 pts were included, F/M=23/26, median age 3.3y (range 0.8-14.8y); 15, 12, 11, and 11, in group A, B, C, and D, resp. Age, sex ratio and inflammatory parameters were similar in all groups.

Total length of stay (LOS) was similar for groups B, C and D, but shorter for group A (22 vs 18d, p=.023) Oxygen need was also shorter in group A compared to the others (4 vs 12d, p<.001). PDI was performed earlier than VATS (4 vs 9d, p=.011). Oxygen need and fever resolved earlier after intervention in group C than in group B (3 vs 8d, p=.009 and 1 vs 6d, p=.04, resp). Time to drain removal, LOS and duration of antibiotic treatment after intervention (3 vs 6d, p=.001; 11 vs 18d, p=.004; and 10 vs 18d, p=.001) were shorter in group C than in group B. ICU stay after intervention was similar in the 3 groups.

Conclusions:

VATS is a good treatment option for PDI in children with PPE. Clinical improvement was faster with VATS than with PDI, indicating that early performed VATS might shorten LOS and duration of antibiotic treatment.
LSC 2013 abstract - Coagulation factor IX deficiency does not afford protection from bleomycin-induced pulmonary fibrosis in mice
Authors: Keren Borensztajn, Lin Cong, Bruno Crestani, Olivier Christophe, Arnold Spek
Journal: European Respiratory Journal (2013)

Introduction:  Evidence from animal and human studies show the role of the coagulation cascade in acute and chronic lung injury. We hypothesized that the absence of coagulation Factor(F)IX, which is essential for the initiation, amplification and propagation phases of the coagulation cascade would reduce fibrosis development and progression.   Methods:  We used the murine model of bleomycin-induced pulmonary fibrosis in wild-type (WT; n=14) and FIX deficient mice (FIX ko; n=13). After 14 days, we assessed the markers of tissue fibrosis, inflammatory cell influx in the bronchoalveolar lavage fluid (BALF), and cytokines levels in the BALF, blood and lung homogenate of the animals.   Results:  Mortality during the experiment was higher in the FIX ko compared to WT mice (23% versus 7%). The remaining FIX ko (n=10) developed pulmonary fibrosis to a degree similar to WT mice (n=13). There was no significant difference in the Ashcroft score between WT and FIX ko mice (4.011±0.4 versus 4.2±0.4), in the alpha-actin score (0.94±0.09 versus 0.70±0.07) and in the inflammatory cell number. In contrast, we observed a higher pulmonary hemorrhage score in the FIX ko mice, as well as significant elevations in levels of cytokines IL-10, IFNγ, 12 and IL-6 in their plasma.   Conclusions:  our results suggest that FIX deficiency is detrimental in pulmonary fibrosis. In line with the results of Noth et al, our results suggest to proceed with caution when using anticoagulation as a treatment for IPF.  Noth et al Am J Respir Crit Care Med. 2012 Jul 1;186(1):88-95.
Immunologic Identification of Epstein-Barr Virus Early Antigen in a P3HR-1 Cell Extract2
Authors: Robert W. Veltri, William H. Wainwright, Philip M. Sprinkles
Journal: JNCI Journal of the National Cancer Institute (1976)

We extracted the Epstein-Barr soluble antigen (EBSA) from the P3HR-1 human lymphoid cell line, which carries the Epstein-Barr virus (EBV), after P3HR-1 cells were activated with 5-iodo-2′-deoxyurldine. EBSA was identified as the early antigen (EA) complex by immunodiffusion and blocking immunofluorescence tests with hlgh-titered human antiserum to EA. The identity of the EA complex was confirmed with antiserum to EA prepared in rabbits and adsorbed to assure its immunologic specificity. The EA was partially purified on Sephadex G-200. Further characterization by immunoelectrophoresis showed that the EBSA moved rapidly toward the anode. This indicated a highly negative charge. EBSA appeared to be distinct from the previously described complement-fixing S-antigen. It was demonstrable only in EA-producer lymphoid cell lines and reacted specifically with human antiserum to EA, whereas the S-antigen was found in all EBV-carrying lymphoid cell lines and reacted with all EBV antibody-positive human antisera.
Implementing systems medicine within healthcare
Authors: Marc Kirschner, Angela Bauch, Alvar Agusti, Sebastian Hilke, Sibylle Merk, Christophe Pison, Jim Roldan, Bernard Seidenath, Michael Wilken, Emiel F. Wouters, Hans-Werner Mewes, Klaus Heumann, Dieter Maier
Journal: Genome Medicine (2015)

The cause of a complex disease cannot be pinpointed to a single origin; rather, a highly complex network of many factors that interact on different levels over time and space is disturbed. This complexity requires novel approaches to diagnosis, treatment, and prevention. To foster the necessary shift to a pro-active systems medicine, proof-of-concept studies are needed. Here, we highlight several systems approaches that have been shown to work within the field of respiratory medicine, and we propose the next steps for broader implementation.
Clinical Research Saves Money: Reflections on High-Dose Therapy of Breast Cancer
Authors: George P. Canellos
Journal: Journal of Clinical Oncology (1999)

Article Tools EDITORIAL Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1999.17.7.1965 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 10561244 Clinical Research Saves Money: Reflections on High-Dose Therapy of Breast Cancer George P. CanellosxGeorge P. CanellosSearch for articles by this author https://doi.org/10.1200/JCO.1999.17.7.1965 Full Text PDF Figures and Tables "Clinical Research Saves Money: Reflections on High-Dose Therapy of Breast Cancer." Journal of Clinical Oncology, 17(7), p. 1965© 1999 by American Society of Clinical Oncology
Key Role of Suppressor of Cytokine Signaling 3 in Regulating gp130 Cytokine–Induced Signaling and Limiting Chondrocyte Responses During Murine Inflammatory Arthritis
Authors: Xiao Liu, Ben A. Croker, Ian K. Campbell, Stephanie J. Gauci, Warren S. Alexander, Brett A. Tonkin, Nicole C. Walsh, Edmond M. Linossi, Sandra E. Nicholson, Kate E. Lawlor, Ian P. Wicks
Journal: Arthritis & Rheumatology (2014)

Objective To examine the impact of the gp130 cytokine family on murine articular cartilage and to explore a potential regulatory role of suppressor of cytokine signaling 3 (SOCS‐3) in murine chondrocytes. Methods In wild‐type (WT) mouse chondrocytes, baseline receptor expression levels and gp130 cytokine–induced JAK/STAT signaling were determined by flow cytometry, and expression of SOCS‐3 was assessed by quantitative polymerase chain reaction. The role of endogenous SOCS‐3 was examined in cartilage explants and chondrocytes from mice with conditional deletion of Socs3 driven by the Col2a1 promoter in vitro ( Socs3 Δ/Δcol2 ) and from mice during CD4+ T cell–dependent inflammatory monarthritis. Bone erosions in the murine joints were analyzed by micro–computed tomography. Results On chondrocytes from WT mice, gp130 and the oncostatin M (OSM) receptor were strongly expressed, whereas the transmembrane interleukin‐6 (IL‐6) receptor was expressed at much lower levels. Compared to other gp130 cytokines, OSM was the most potent activator of the JAK/STAT pathway and of SOCS‐3 induction. Treatment of Socs3 Δ/Δcol2 mouse cartilage explants and chondrocytes with gp130 cytokines prolonged JAK/STAT signaling, enhanced cartilage degradation, increased the expression of Adamts4, Adamts5 , and RANKL, and elevated the production of IL‐6, granulocyte colony‐stimulating factor, CXCL1, and CCL2. Socs3 Δ/Δcol2 mice developed exacerbated inflammation and joint damage in response to gp130 cytokine injections, and these histopathologic features were also observed in mice with inflammatory monarthritis. Conclusion The results of this study highlight a key role for SOCS‐3 in regulating chondrocyte responses during inflammatory arthritis. Within the gp130 cytokine family, OSM is a potent stimulus of chondrocyte responses, while IL‐6 probably signals via trans ‐signaling. The gp130 cytokine–driven production of RANKL in chondrocytes may link chondrocyte activation and bone remodeling during inflammatory arthritis. Thus, these findings suggest that the inhibition of OSM might reduce the development and severity of structural joint damage during inflammatory arthritis.
Small airway dysfunction by impulse oscillometry system (IOS) in asthma. Relationship with spirometry, bronchodilator response and disease control
Authors: Roberta Pisi, Panagiota Tzani, Marina Aiello, Enrico Martinelli, Emilio Marangio, Dario Olivieri, Alfredo Chetta
Journal: European Respiratory Journal (2012)

Rationale  : Small airways are relevant to the pathophysiology of asthma    Objective  : We investigated the relationship between small airway function, as assessed by IOS and spirometry, bronchodilator response, disease control and fractional exhaled nitric oxide (FeNO) values, in asthmatic patients.    Methods:   We studied 38 patients with asthma (24 F, age range 16-70 yr). The fall in resistance from 5 to 20 Hz (R5–R20) and reactance at 5 Hz (X5) in kPa s l 1  by IOS and spirometry at baseline and after 400 mcg of salbutamol were measured. Asthma Control Test (ACT) and FeNO (in ppb) were also recorded.    Results:   R5-R20 and X5 were significantly related to spirometry, with FEF 25-75  being the parameter stronger related. By the ROC curve method, the FEF 25-75  cut-off point, which better identified patients with an increase in R5-R20 was ≤ 38% of pred (0.95 sensitivity and 0.78 specificity). When the bronchodilator responses were considered, only the post-bronchodilator FEV 1  percent changes correlated to the corresponding R5-R20 values ( p ). ACT score, but not FeNO values was related to R5-R20 ( p ) and X5 ( p ) values. Logistic regression analysis showed that increased R5-R20 was independently associated with poor controlled asthma ( p ).    Conclusions:   We found that R5-R20 and X5 were related to FEF 25-75 , as baseline values but not as percent change after bronchodilator. The increase in peripheral airway resistance was associated with a poor asthma control, but not with FeNO values. These results further confirm the value of IOS as investigative tool in asthma.
A Clinical and Immunological Study of Allergy to Hen's Egg White
Authors: Tor Langeland
Journal: Allergy (1982)

Allergens in hen's egg white were studied in crossed radio‐immunoelectrophoresis (CRIE). Specific IgE‐antibodies against different proteins in the egg white were examined in sera from 70 atopic patients with clinical hypersensitivity, and RAST ≥2 to egg white. Ovalbumin, ovomucoid and an unidentified protein, antigen 22, were classified as major allergens. Specific IgE‐antibodies against 10 more proteins in hen's egg white were detected. IgE‐antibodies against lysozyme could not be detected.
Endothelin in a model of acute ischemic renal dysfunction
Authors: E K Sandok, A Lerman, A J Stingo, M A Perrella, P Gloviczki, J C Burnett
Journal: Journal of the American Society of Nephrology (1992)

This study was undertaken to investigate circulating endothelin (ET) and associated renal hemodynamics in the acute ischemic renal dysfunction associated with suprarenal aortic cross-clamping (ACC) in the presence and absence of prostaglandin inhibition in the anesthetized dog. Second, the modulating action of exogenous atrial natriuretic factor (ANF) was also investigated. In Group I (ACC; N = 6), ACC was performed in the absence of prostaglandin inhibition. No change in mean arterial pressure, GFR, RBF, renal vascular resistance, or ET was noted 2 h after reperfusion when compared with baseline values. In the presence of prostaglandin inhibition with indomethacin (10 mg/kg iv) (Group II, ACC + INDO; N = 10), an increase in plasma ET was first noted to be elevated above baseline ET in Group I as well as during and 2 h after ACC in association with a reduction in GFR, marked renal vasoconstriction, and a sustained increase in arterial pressure. To evaluate the role of the kidney in this increase in ET, another group (Group III, ACC + INDO + NEPH; N = 6) was investigated in the presence of prostaglandin inhibition, and bilateral renal artery clamping was performed 30 min before ACC and maintained throughout the protocol to simulate nephrectomy. In this group, plasma ET concentrations did not increase during ACC. Because ANF may antagonize the renal actions of ET in vivo and may suppress ET release in vitro, the action of ANF upon GFR and plasma ET was evaluated in Group IV (ACC + INDO + ANF; N = 6).(ABSTRACT TRUNCATED AT 250 WORDS)
A family outbreak of haemolytic uraemic syndrome and haemorrhagic colitis caused by verocytotoxigenic Escherichia coli O157 from unpasteurised cow's milk in Slovakia
Authors: A. Liptakova, L. Siegfried, J. Rosocha, L. Podracka, E. Bogyiova, D. Kotulova
Journal: Clinical Microbiology and Infection (2004)
Cutaneous B‐cell lymphomas: 2015 update on diagnosis, risk‐stratification, and management
Authors: Ryan A. Wilcox
Journal: American Journal of Hematology (2014)

Approximately one-fourth of cutaneous lymphomas are B-cell derived and are generally classified into three distinct subgroups: primary cutaneous follicle center lymphoma (PCFCL), primary cutaneous marginal zone lymphoma (PCMZL), and primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT).DIAGNOSIS and disease classification is based on histologic review and immunohistochemical staining of an appropriate skin biopsy. Pathologic review and an appropriate staging evaluation are necessary to distinguish primary cutaneous B-cell lymphomas from systemic B-cell lymphomas with secondary skin involvement. Risk-stratification: Disease histology remains the most important prognostic determinant. Both PCFCL and PCMZL are indolent lymphomas that infrequently disseminate to extracutaneous sites and are associated with 5-year survival rates that exceed 95%. In contrast, PCDLBCL, LT is an aggressive lymphoma with an inferior prognosis.PCFCL and PCMZL patients with solitary or relatively few skin lesions may be affectively managed with local radiation therapy. While single-agent rituximab may be employed for patients with more widespread skin involvement, multiagent chemotherapy is rarely appropriate. In contrast, management of patients with PCDLBCL, LT is comparable to the management of patients with systemic DLBCL.
Evaluation of cardio-respiratory parameters during the stair climbing test and the six minutes walking test
Authors: Estelle Villiot-Danger, Jean Christophe Villiot-Danger, Gregory Reychler, Hassan Razzouk
Journal: European Respiratory Journal (2014)

Background: The stair climbing test (SCT) could be used as an alternative to the six minutes walking test (6MWT) to assess exercise tolerance in COPD patients.

Objective: To compare the relationship between evolution of dyspnoea, oxygen saturation and heart rate during the stair climbing test and the 6MWT.

Material and method: A self-paced 2-minutes SCT and a 6MWT were performed on a separate day in 36 stable COPD patients (Age = 65.1 ± 12.7 y.o.; FEV1 = 54 ± 17.5 % pred.val.; BMI = 25.3 ± 4.3kg.m-2) without encouragement. Arterial oxygen saturation (SpO2), heart rate (HR), and dyspnoea (VAS) were measured before, during and immediately after both tests. Climbed and walked distances were measured at the end of the tests.

Results: Delta HR and maximum HR measured during exercise were significantly different for each test (38 ±17 bpm and 109 ±11 bpm vs 25 ±12 bpm and 104 ±16 bpm, p<0.001 and p=0.01 for SCT and 6MWT respectively).

Difference between pre- and post-exercise saturation tended to be different between both tests (3 ±3% and 4 ±2% for SCT and 6MWT respectively, p=0.056).

Difference between pre- and post-exercise dyspnoea was significantly greater with SCT than with 6MWT (6 ±2 vs 4 ±2, p<0.001).

There was a significant correlation between FEV1 and climbed distance (r=0.44, p<0.01) and walked distance (r=0.34, p<0.05).

Conclusion: These results highlight that HR and dyspnoea increase to a greater extent during the SCT compared to the 6MWT despite similar changes in SpO2.
Expansion of alveolar-lymphoid interfaces in lungs of patients with COPD
Authors: Michiko Mori, Cecilia Andersson, Kaj A. Svedberg, Anders Bergqvist, Medya Shikhagaie, Claes-Göran Löfdahl, Jonas S. Erjefält
Journal: European Respiratory Journal (2012)

Rationale:  Although adaptive immune responses are critical for combating distal airway infections in COPD lungs, the structural basis for alveolar antigen uptake has remained poorly investigated. This study investigates the interface between alveolar lumen and the adaptive immune system at different severities of COPD.   Methods:  Lung resections (n=31) from mild (GOLD I), moderate-severe (GOLD II-III), and very severe (GOLD IV) COPD were subjected to detailed histological assessment of components of the adaptive immune system in distal lung. Never-smokers and non-COPD smokers served as controls (n=15).   Results:  In COPD, both numbers and mean size of lymphoid aggregates were increased in small airways, pulmonary vessels and the alveolar parenchyma. Irrespective of anatomical localization, the vast majority (88%) of the aggregates had direct contact with alveolar luminal spaces (37% of the aggregate perimeter). In advanced COPD, the epithelium at alveolar-lymphoid interfaces had transformed into a significantly higher columnar phenotype (p=0.02) that, apart from expressing immune-regulatory molecules, contained increased numbers of langerin-positive dendritic cells (p=0.02). Also, the total alveolar-lymphoid interface and interface-associated dendritic cells were increased (p=0.02 and p=0.002, respectively).   Conclusions:  The progression of COPD is linked with an expansion and remodeling of alveolar lumen-lymphoid interfaces. These alterations, which predict an increased capacity to respond to alveolar antigens, correlated with lung function parameters and may thus contribute to the aggravated inflammation in COPD lungs.
Tuberculosis Infection in the United States
Authors: Kamran Khan, Jun Wang, Wei Hu, Arlene Bierman, Yukit Li, Michael Gardam
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

In 1989, the United States embarked upon an ambitious path to eliminate tuberculosis (TB) nationwide. Although incidence rates of TB disease in the United States are declining, these cases represent only a tiny fraction of all TB infections. Understanding national trends in TB infection may be important in anticipating future trends in TB disease.Describe the epidemiology of Mycobacterium tuberculosis infection in the United States in 1971-1972 and 1999-2000.We studied nationally representative cohorts of the U.S. noninstitutionalized civilian population participating in the 1971-1972 and 1999-2000 National Health and Nutrition Examination Surveys. Participants were tuberculin skin tested and the epidemiology of TB infection was compared across surveys. Logistic regression was used to identify associations between participant and household characteristics and TB infection.In 1999-2000, 4.2% (95% confidence interval [CI], 3.3-5.2%) of the U.S. population aged 1 year or older displayed evidence of TB infection. Among persons aged 25-74, the prevalence of infection decreased from 14.4% in 1971-1972 (95% CI, 11.6-17.7%) to 5.6% in 1999-2000 (95% CI, 4.4-7.1%). Declines in the relative burden of infection among persons aged 25-74 were greater in the United States-born population (12.6 to 2.5%) compared with the nation's foreign-born population (35.9 to 21.3%).The United States has experienced a substantial decline in the burden of TB infection since the early 1970s. Despite this, the prevalence of infection among the nation's foreign-born population is over eight times greater than that observed in the United States-born population.
Phase I study of topotecan and cisplatin in patients with advanced solid tumors: a cancer and leukemia group B study.
Authors: A A Miller, J B Hargis, R C Lilenbaum, S Z Fields, G L Rosner, R L Schilsky
Journal: Journal of Clinical Oncology (1994)

PURPOSE The objectives of this phase I trial were to determine the dose-limiting toxicities (DLTs) of the novel topoisomerase I inhibitor topotecan combined with cisplatin, to define the maximum-tolerated doses (MTDs) of the combination without and with the use of filgrastim, and to define recommended doses for phase II trials. PATIENTS AND METHODS Patients with advanced solid tumors were eligible if they had normal bone marrow, renal, and hepatic function and had not previously been treated with platinum compounds. Topotecan was administered intravenously on days 1 through 5 and cisplatin was administered intravenously on day 1 of a 21-day cycle. The topotecan dose was fixed at 1.0 mg/m2/d on the first four dose levels, and cisplatin was escalated in 25-mg/m2 increments from 25 to 100 mg/m2 without filgrastim. After encountering DLT, the dose of cisplatin was decreased by one level and topotecan dose escalation was attempted. After defining the MTD without growth factor, the study proceeded with escalating cisplatin doses to define the MTD with filgrastim 5 micrograms/kg subcutaneously (SC) daily starting on day 6 of treatment. Priming with filgrastim 5 micrograms/kg SC on days -6 to -2 before the first course was explored last. RESULTS Of 38 patients entered, 37 were eligible, 35 assessable for toxicity in the first course, and 28 assessable for response. The principal toxicity was grade 4 neutropenia, which had to last more than 7 days to be considered dose-limiting. No DLT was observed at the starting cisplatin dose of 25 mg/m2 (dose level 1). On level 2 (cisplatin 50 mg/m2, one patient had dose-limiting neutropenia and one patient had grade 3 renal toxicity. On level 3 (cisplatin 75 mg/m2), two patients had dose-limiting neutropenia. Therefore, cisplatin dose escalation was stopped. On dose level 5 (cisplatin 50 mg/m2 and topotecan 1.25 mg/m2/d), one patient had grade 4 neutropenia that lasted more than 7 days and one patient died of neutropenic sepsis. The remaining dose levels used topotecan 1.0 mg/m2/d plus cisplatin 75 mg/m2 (level 6) and 100 mg/m2 (levels 7 and 8) with filgrastim. No DLT was observed on level 6. On level 7, two patients had dose-limiting neutropenia and one patient had grade 3 hyperbilirubinemia. Priming with filgrastim on level 8 demonstrated no obvious advantage over level 7, and one patient had grade 4 thrombocytopenia that lasted more than 7 days. Three patients with non-small-cell lung cancer achieved a partial response and one patient with breast cancer had a complete response. CONCLUSION Topotecan and cisplatin in combination cause more neutropenia than expected from either drug given alone at the same dosage. The recommended phase II doses are topotecan 1.0 mg/m2/d for 5 days in combination with cisplatin 50 mg/m2 on day 1 without filgrastim or cisplatin 75 mg/m2 on day 1 with filgrastim support.