tbuckley/cabot-search huggingface dataset:
Childhood diffuse parenchymal lung diseases: Diagnosis, treatment and outcome
Authors: Güzin Cinel, Nural Kiper, Diclehan Orhan, Ebru Yalçin, Deniz Dogru, Ugur Özçelik, Berna Oguz, Mithat Haliloglu, Gülsev Kale
Journal: European Respiratory Journal (2013)

Childhood diffuse parenchymal lung diseases are a group of heterogeneous disorders that have common histological features with a chronic course and associated with high morbidity and mortality.There is not an exact consensus about the terminology, classification, therapy and follow up of this disease because of its rarity and wide clinical spectrum.In this study, clinical features, laboratory, radiological and histopathological findings, therapy and outcome of 130 pediatric DPLDcases who were followed up at our hospital are retrospectively evaluated.We also tried to classify these patients according to the last classification scheme recommended.Our childhood DPLD series is the largest one in the literature that’s reported from a single center.Sixteen distinct disease groups are discussed under the DPLDtitle.Our patients’ mean age at diagnosis was 7,7years.The most frequent symptoms were cough and dyspnea in all disease groups.The diagnosis of patients were delayed between median 5,5months and 3years in all groups; and these patients were treated as if they had pneumonia, tuberculosis and asthma.As the presenting clinical manifestations are non-specific, every child, with a history of normal birth, who has signs and symptoms suggesting DPLD for more than 3months should be investigated in terms of DPLD. A group of patients with idiopathic interstitial pneumonia, idiopathic pulmonary hemosiderosis, pulmonary alveolar microlithiasis and diffuse chondroid malformation of the lung, could not be classified in the last classification scheme recommended by Children’s Interstitial Lung Disease(chILD) Network.These results indicate that a new classification system involving all these patients is required.
Effect of Different Levels of Dietary &lt;italic&gt;Trans&lt;/italic&gt; Fat or Corn Oil on Azoxymethane-Induced Colon Carcinogenesis in F344 Rats&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: B S Reddy, T Tanaka, B Simi
Journal: JNCI Journal of the National Cancer Institute (1985)

The effect of various levels of dietary corn oil or trans fat on azoxymethane (AOM; CAS: 25843-45-2)-induced carcinogenesis was investigated in female F344 rats fed the AIN-76 semipurified diets. Starting at 5 weeks of age, groups of rats were fed the low-fat diet containing 5% corn oil (designated as low-fat control diet). At 7 weeks of age, all animals except the vehicle-treated controls, were given sc injections of AOM (15 mg/kg body wt, once weekly) for 3 weeks. After 1 week, groups of animals were transferred to semipurified diets containing 13.6% corn oil and 23.5% corn oil or high-fat diets containing 5.9% corn oil plus 5.9% trans fat plus 11.8% Oleinate (low trans fat), 5.9% corn oil plus 11.8% trans fat plus 5.9% Oleinate (intermediate trans fat), and 5.9% corn oil plus 17.6% trans fat (high trans fat). Fecal bile acids were measured in vehicle-treated rats. All animals were necropsied 34 weeks after the last AOM injection. The animals fed the 23.5% corn oil diet had a higher incidence of colon tumors than did those in the groups fed the 5 and 13.6% corn oil diets. There was no difference in colon tumor incidence between the 5 and 13.6% corn oil diet groups. The animals fed the high-fat diets containing low trans fat, intermediate trans fat, and high trans fat developed significantly fewer liver and colon tumors and more small intestinal tumors than did the rats fed 23.5% corn oil diet. The excretion of fecal deoxycholic acid, lithocholic acid, and 12-ketolithocholic acid was higher in animals fed the 23.5% corn oil diet compared to the excretion in animals fed the other diets.
Urban-rural differences in health status among patients with chronic obstructive pulmonary disease (COPD)
Authors: David Coultas, FengHsiu Su, Bradford Jackson, Sumihiro Suzuki, Kaming Lo, Karan Singh, Sejong Bae
Journal: European Respiratory Journal (2011)

Background: While geographic variation in health care access and quality may affect health status of patients with chronic diseases little is known about the health status of patients with COPD.

Objectives: The purpose of this analysis was to examine urban-rural differences in health status among patients with COPD.

Methods: This was a cross-sectional analysis of baseline data from patients with COPD enrolled in a self-management clinical trial. Urban-rural residence was determined from zip code. Health status was measured using BODE index (BMI, obstructive impairment, dyspnea severity, exercise capacity), and generic (SF-12) and disease-specific (Chronic Respiratory Questionnaire [CRQ]) quality-of-life instruments. Independent sample t-tests and chi-square tests were used to examine statistical differences.

Results: To date, results from 82 patients are available with mean age of 69 years, 46% female, 51% rural residence, and 98.8% with health insurance. Rural residence was associated with greater impairment (mean [SD] BODE index=4.9 [1.8]) compared to urban residence (3.4 [1.8], p=0.0003). Moreover, 6-minute walk distance was clinically and significantly less among rural (325 m [104]) vs. urban (375 m [90]) (p=0.02) residence. A similar pattern was found for quality-of-life measures with a lower SF-12 physical summary score among rural (28.3 [9.6]) vs. urban (36.1 [10.0], p=0.0006) residence and clinically worse dyspnea (CRQ-dyspnea=4.1 [1.0]) vs. 4.8 [1.3], respectively, p=0.009).

Conclusion: In this population of patients with COPD rural residence was associated with poorer health status for all measures despite similar access to health care as measured by health insurance.
Mycosis fungoides involving the central nervous system.
Authors: D Hallahan, M Griem, S Griem, E Duda, J Baron
Journal: Journal of Clinical Oncology (1986)

The clinical records of nine patients, followed at the University of Chicago, with mycosis fungoides (MF) and neurologic deficits due to direct CNS involvement were reviewed. Lymph node and visceral involvement was present in all patients. Clinical findings included cranial nerve deficits in four patients, altered mental status in eight, gait disturbances in three, and leg weakness in one. Helpful diagnostic studies included lumbar puncture with CSF cytology, computerized tomography (CT) brain scans, brain biopsy, and myelogram. Two patients, who were treated with radiation therapy (RT), survived 14 and 40 weeks, respectively. Survival of less than 4 weeks limited treatment in the other patients. Autopsies were performed on six patients and revealed meningeal infiltration and perivascular infiltration of the brain. In addition, the cerebral parenchyma was infiltrated in one patient and a lymphomatous tumor was found in the brainstem of another. We conclude that the varied clinical and pathologic features of CNS involvement with mycosis fungoides resemble those seen in leukemias and other lymphoproliferative disorders. Better awareness of the clinical features may permit earlier diagnosis and initiation of therapy.
Bone turnover markers and vitamin D status in patients with cystic fibrosis
Authors: Tatjana Jakovska-Maretti, Jasmina Meceska-Jovcevska, Stojka Fustik, Lidija Spirevska
Journal: European Respiratory Journal (2013)

Imbalance between bone formation and degradation in cystic fibrosis(CF)has become an important issue for developing osteopenia.The aim of our study was to assess bone formation and resorption process with bone markers in prepubertal,pubertal and young adult CF patients. Materials and methods: The study included 70 clinically stable CF patients who regularly attended the Cystic fibrosis center at the Pediatric Clinic in Skopje, R.Macedonia .Serum osteocalcin (OC), βcross laps, 25OHD and PTH were determine by ELISA assays in prepubertal CF group (mean age ± SD 8.5±2.4 years), pubertal CF group (mean age ±SD 15±2.4years) and young adults (mean age±SD 25±2.7 years) and in age-match controls. Results: 25OHD in prepubertal groups was(25.56±12.1ng/ml versus 27.75±2.1,p=0.05),osteocalcin(81.06±21.1 ng/ml v. 96.57±11.2, p=0.004)βcrosslaps(1.33±0.3 ng/ml v. 1.57±0.4, p=0.03)and PTH (31.7±12.3 pg/ml v.21.07±11.6,p=0.002).In the pubertal groups laboratory parameters were (25OHD 22.07±10 v. 29.4±8.3, p=0.07; OC 77.035±11.2 v.101.4±10,p=0.004;βcrosslaps 1.419±0.5 v.1.118±0.7,p=0.1;PTH 40.6±11.3 v.35.5±10,p=0.2).In adult groups(25OHD was 20.4±8.4 v. 22.78±7.84, p=0.01; OC 27.66±12.1. v. 17.02±4.98, p=0.05;βcrosslaps 0.58±0.3 v. 0.25±0.06, p=0.3; PTH 65.93±9.6 v. 45±9.4,p=0.2). In prepubertal and adult CF patients bone markers were higher than normal values, but with no significance from the healthy controls.OC in pubertal CF patients correlates significantly with the control, indicate a decreased formation rate whereas resorption rate is normal. This may contribute to impaired bone turnover. Conclusion: Our results suggest that bone remodeling in CF patients can be impaired in puberty and lead to osteopenia.
Association of CAT scores with exacerbations and comorbidity in COPD patients in Greece attended primary care settings
Authors: Ioanna Tsiligianni, Dimitra Sifaki-Pistolla, Anna Dakanali, Nikolaos Siafakas, Nikolaos Tzanakis
Journal: European Respiratory Journal (2012)

Introduction:  Health status measurement with CAT has been proposed for COPD management in the updated GOLD guidelines. We aimed to investigate CAT score correlation with AECOPD and comorbidity in a Greek cohort of COPD patients   Methods:  Data were selected from 544 COPD patients from Greece through a prospective cross-sectional study, attending primary health care units. Demographic data, previous treatment, lung function testing,exacerbations and co-morbidity were recorded. Chi-square test, bivariate Pearson r correlation and binary logistic regression were applied on data regarding the CAT score, FEV 1  (% pred.), FEV 1 /FVC (%) and certain clinical parameters of the disease.   Results : CAT scores classification percentages showed: 38% mild CAT score, medium impact level 46%, severe score 15% and very severe score 1.0%. 56.9% of the patients with exacerbated disease had medium CAT score while the 19.6% of them a high impact score (p   Conclusions : The co-existence of other diseases with COPD increases the probability of presenting a worse health status.
Skin lightening practices: an epidemiological study of South African women of African and Indian ancestries
Authors: N.C. Dlova, S.H. Hamed, J. Tsoka-Gwegweni, A. Grobler
Journal: British Journal of Dermatology (2015)

Cutaneous adverse sequelae of skin lightening creams present with myriad skin complications and affect dermatology practice, particularly in sub‐Saharan Africa where such products are widely used, with a prevalence of 25–67%. To examine the skin lightening practices of both African and Indian women living in South Africa. A cross‐sectional survey was undertaken in the general outpatient departments of two regional university hospitals in Durban, South Africa. All consenting African and Indian women aged 18–70 years were recruited and asked to complete a questionnaire. Six hundred women completed the questionnaire, of whom 32·7% reported using skin lightening products. The main reasons cited were treatment of skin problems (66·7%) and skin lightening (33·3%). Products were purchased from a variety of sources. Twenty‐five percent reported using sunscreen. The use of skin lightening cosmetics is common among darkly pigmented South African women, including those of both African and Indian ancestries. Despite more than 20 years of governmental regulations aimed at prohibiting both the sale of cosmetics containing mercury, hydroquinone and corticosteroids, and the advertising of any kind of skin lightener, they are far from having disappeared. The main motivations for using these products are the desire to treat skin disorders and to achieve a lighter skin colour. Television and magazine advertisements seem to influence womens' choice of these products and, thus, would be efficient channels for raising public awareness about the dangers of using uncontrolled skin lighteners.
T Lymphocyte–Specific Activation of Nrf2 Protects from AKI
Authors: Sanjeev Noel, Maria N. Martina, Samatha Bandapalle, Lorraine C. Racusen, Haranatha R. Potteti, Abdel R.A. Hamad, Sekhar P. Reddy, Hamid Rabb
Journal: Journal of the American Society of Nephrology (2015)

T lymphocytes are established mediators of ischemia reperfusion (IR)-induced AKI, but traditional immune principles do not explain their mechanism of early action in the absence of alloantigen. Nrf2 is a transcription factor that is crucial for cytoprotective gene expression and is generally thought to have a key role in dampening IR-induced AKI through protective effects on epithelial cells. We proposed an alternative hypothesis that augmentation of Nrf2 in T cells is essential to mitigate oxidative stress during IR-induced AKI. We therefore generated mice with genetically amplified levels of Nrf2 specifically in T cells and examined the effect on antioxidant gene expression, T cell activation, cytokine production, and IR-induced AKI. T cell-specific augmentation of Nrf2 significantly increased baseline antioxidant gene expression. These mice had a high frequency of intrarenal CD25(+)Foxp3(+) regulatory T cells and decreased frequencies of CD11b(+)CD11c(+) and F4/80(+) cells. Intracellular levels of TNF-α, IFN-γ, and IL-17 were significantly lower in CD4(+) T cells with high Nrf2 expression. Mice with increased T cell expression of Nrf2 were significantly protected from functional and histologic consequences of AKI. Furthermore, adoptive transfer of high-Nrf2 T cells protected wild-type mice from IR injury and significantly improved their survival. These data demonstrate that T cell-specific activation of Nrf2 protects from IR-induced AKI, revealing a novel mechanism of tissue protection during acute injury responses.
Abstract 2695: A New Doppler Index For Assessment Of Left Ventricular Diastolic Function: Ratio Of Early Diastolic Transmitral Inflow Velocity To Late Diastolic Mitral Annular Tissue Velocity In Patients With Coronary Artery Disease
Authors: Kyung Jin Lee, Sahng Lee, Yu Jeong Choi, Jeong Hee Kim, Kyung Tae Jung, Soon Chang Park
Journal: Circulation (2007)

Background:  Late diastolic period is related with left ventricular stiffness. Our hypothesis was that the combination of both early and late diastolic parameters may predict LV end-diastolic pressure (LVEDP) more accurately than the previous index, the ratio of early diastolic transmitral inflow velocity to early diastolic mitral annular tissue velocity (E/e’) which uses only early diastolic parameters.   Methods:  LVEDP and coronary angiogram (CAG) were obtained within 2-h after standard echocardiography with tissue Doppler imaging without preload change. Medial and lateral mitral annular tissue velocities were obtained and mean value was used for analysis. Patients with normal CAG were excluded.   Results:  A total of 50 patients (30 men; mean ages, 63.2 ± 9.8 years) were enrolled. LV ejection fraction was 68 ± 11 %. E/e’ ratio showed positive correlation with LVEDP (r = 0.406, p = 0.003). The ratio of E velocity to late diastolic mitral annular tissue velocity (E/a’) showed stronger positive correlation with LVEDP (r = 0.502, p   8 was the optimal cut-off value for predicting LVEDP > 15mmHg with a sensitivity of 77% and specificity of 76% (Figure 2).   Conclusion:  In this study, E/a’ ratio which uses both early and late diastolic Doppler parameters, showed better correlation with LVEDP compared to E/e’ ratio in patients with coronary artery disease. E/a’ ratio may be used as an alternative index for the assessment of diastolic function.
Abstract 8844: 10-Year Mortality is Very High, and Warfarin Use Very Low, in Patients with Myocardial Infarction and Atrial Fibrillation
Authors: John P Vavalle, Renato Lopes, Christopher H May, Aijing Z Starr, Linda K Shaw, Rajendra H Mehta, Sana M Al-Khatib, John H Alexander, Christopher B Granger
Journal: Circulation (2011)

Background: Patients hospitalized for myocardial infarction (MI) who have atrial fibrillation (AF) are recommended to use warfarin for stroke prophylaxis if CHADS 2 score ≥ 2. The long-term use of warfarin in these patients and associated outcomes are not well known. Herein, we describe the use of warfarin out to one year after hospitalization and identify predictors of 10-year mortality in this population. Methods: Patients with acute MI (STEMI and NSTEMI) and AF during hospitalization undergoing cardiac catheterization between January 1, 2005 and December 31, 2007 were identified from the Duke Databank for Cardiovascular Disease. Anti-thrombotic medication use at 6 months and 1 year was assessed by mailed and telephone surveys. Multivariable Cox proportional hazards modeling was used to identify predictors of 10-year mortality. Results: A total of 882 patients were identified with a median age of 72 years (64, 79). The use of warfarin was low at discharge (24%), and increased only slightly at 6 months (26%), and one year (27%), despite decreasing clopidogrel use and stable aspirin use over that time ( Figure 1 ). With a higher CHADS 2 score, warfarin use increased (CHADS 2 0, 18%; CHADS 2 1, 21%; CHADS 2 ≥2, 27%; p=0.06). In general, patients who received warfarin at discharge had similar baseline characteristics compared with those who did not. The 10-year mortality rate in this study was high and similar regardless of whether warfarin was (71.0%) or was not (70.7%) used at discharge (p=0.12). The strongest predictors of 10-year mortality in this population were: older age (HR 1.44 per 10 year, 95% CI 1.31-1.59), history of heart failure (HR 1.63, 95% CI 1.35-1.97), and higher Charlson comorbidity index (HR 1.19, 95% CI 1.11-1.27). Conclusions: Patients with MI and AF have high 10-year mortality. The use of warfarin was low, even among patients with high CHADS 2 score, remained low out to one year after discharge, and is not explained by the use of alternative antithrombotic regimens.
Elements of Informed Consent for Hormone Replacement Therapy in Patients With Diagnosed Breast Cancer
Authors: Rowan T. Chlebowski, Anne McTiernan
Journal: Journal of Clinical Oncology (1999)

An approach to providing informed consent to breast cancer survivors considering hormone replacement therapy (HRT) is offered.Current information on HRT, breast cancer, and chronic disease prevention is reviewed in the context of risks faced by women with resected breast cancer.Breast cancer patients, unwilling to trade symptom reduction for even a small increase in recurrence risk, are at substantially increased risk of death from breast cancer relative to other causes. Observational studies suggest that long-term HRT increases breast cancer development. The influence of HRT on the growth of established breast cancer has not been determined; however, estrogen reduction (oophorectomy) significantly reduces recurrence in premenopausal women, and current evidence cannot exclude a risk that HRT increases recurrence to the same degree. The following issues are of particular relevance to breast cancer survivors: HRT reduces mammographic sensitivity, increases thromboembolic events, and increases endometrial cancer risk. Although benefit for HRT is commonly inferred from observational studies, randomized trials of HRT on all-cause mortality have not been completed. For coronary heart disease prevention, an array of strategies independent of HRT are available, with some (tamoxifen, selective estrogen receptor modifiers [SERMs], diet, and exercise) likely to favorably influence breast cancer risk; for osteoporosis prevention, an array of strategies also are available, with some (bisphosphonates, tamoxifen, SERMs, and exercise) likely to favorably influence breast cancer risk.Current data preclude the generation of evidence-based guidelines for HRT use in breast cancer survivors, and clinical trials in this setting should be supported. However, given available therapeutic alternatives for menopausal symptom management and chronic disease prevention, breast cancer survivors should be offered HRT only with caution and with their full participation in the decision-making process.
Clinical significance radadiation sennsitivity of nuclear survivin expression in uterine cervical carcinoma treated with concurrent chemoradiotherapy: prospective analysis (KGROG0501)
Authors: Y. Niibe, J. Watanabe, S. Tsunoda, M. Imai, T. Jobo, M. Arai, T. Arai, M. Kawaguchi, N. Unno, K. Hayakawa
Journal: Journal of Clinical Oncology (2008)

16569 Background: Cytoplasmic survivin expression was reported to be correlated with radiationr-esistance because its inhibition of apoptosis. However, no studies have been performed to evaluate radiation-resistance of survivin expression in a prospective manner. We conducted prospective phaseII study of concurrent chemoradiotherapy for locally advanced uterine cervical carcinoma using nedaplatin, new platinum agent, as KGROG0501. The Interim analysis of KGROG0501 was performed in December 2007. The correlation between survivin expression and radiation-resistance have been studied. Methods: Between June 2005 and April 2007, 20 patients were registered and treated in KGROG0501. Survivin expression was studied using immunohistochemical method (Novus Biologicals, USA) in pre-treatement biopsied specimens. Cytoplasmic survivin expression was evaluated as positive (+) of greater than 50% cytoplasmic positiviety. Nuclear surviving expression was evaluated as positive (+) of greater than 20 % nuclear positivity. Results: Cytoplasmic survivin expression of (+)/(−) were 10/10, respevitvely. Nuclear survivin expression of (+)/(−) were 13/7, respectively. Initial response CR/PR were 16/4, respectively. In CRs, cytoplasmic suvivin (+)/(−) was 9/7, respectively. In PRs, cytoplasmic surviving (+)/(−) 1/3, respectively (p=0.582). In CRs nuclear survivin (+)/(−) was 13/3, respectively. In PRs, nuclear surviving (+)/(−) was 0/4, respectively (p=0.007). These indicated nuclear survivin expression could be correlated significantly with better initial response. Conclusions: In prospective analysis, nuclear survivin expression suggested to be correlated with better sensitivity of chemoradiotherapy for uterine cervical carcinoma. No significant financial relationships to disclose.
Quality of life among sleep apnea patients before and after treatment with continuous positive airway pressure (CPAP) compared to controls from the general population
Authors: Erla Bjornsdottir, Bjorg Eysteinsdottir, Christer Janson, Erna Sif Arnardottir, Allan I. Pack, Bryndis Benediktsdottir, Thorarinn Gislason
Journal: European Respiratory Journal (2013)

The aim of this study was to compare health-related quality of life between patients with obstructive sleep apnea (OSA) and subjects from the general population. Also, the change in quality of life with CPAP treatment was explored.  The OSA subjects (n=822) were untreated newly diagnosed with moderate or severe OSA. The control subjects (n=742) were randomly selected Icelanders ≥40 years old. Quality of life was measured by the Short Form 12 (SF-12) which gives a physical component score (PCS) and mental component score (MCS). Scoring are transformed into a scale ranging from 0 (worst possible health) to 100 (best possible health).The change with CPAP treatment was assessed after two years and 90.1% (n=741) of the OSA subjects finished the follow up.  Untreated OSA patients reported worse quality of life than controls (mean PCS 40.1±10.9 vs. 50.7±8.0 for controls (p  OSA patients report severely impaired quality of life compared to controls. Both physical and mental health improve from baseline to follow up for OSA patients but the improvement is not significantly greater among CPAP users.