tbuckley/cabot-search huggingface dataset:
A Population Analysis of Aortic Aneurysm Repair—Better Than Randomized Clinical Trials?
Authors: Jamie E. Anderson, James W. Holcroft
Journal: JAMA Surgery (2015)

6. Malas M, Arhuidese I, Qazi U, Black J, Perler B, Freischlag JA. Perioperative mortality following repair of abdominal aortic aneurysms: application of a randomized clinical trial to real-world practice using a validated nationwide data set. JAMA Surg. 2014;149(12):1260-1265. 7. Greenhalgh RM, Brown LC, Kwong GP, Powell JT, Thompson SG; EVAR Trial Participants. Comparison of endovascular aneurysm repair with open repair in patients with abdominal aortic aneurysm (EVAR Trial 1), 30-day operative mortality results: randomised controlled trial. Lancet. 2004;364 (9437):843-848.
Impact of smoking in patients with and without history of asthma
Authors: Ileana Palma, Pablo Fescina, Raquel Aguirre, Maria Rolando, Daniel Antuni, Ricardo Gene
Journal: European Respiratory Journal (2011)

Patients with a history of asthma who smoke develop an accelerated decline in lung function and greater mortality. More complex studies are needed to distinguish asthma from COPD in this population.

Objectives: Evaluate the characteristics of a COPD population with and without history of asthma.

Methods: We invited people ≥ 40 y/o. who smoked at least 10 years (current or ex-smokers), during one week on Nov 2005, 2007and 2009. A questionnaire on respiratory symptoms, demographics and spirometry were done. COPD was defined by a FEV1/FVC <70, the presence of symptoms and smoking history. Population was divided into 2 groups: COPD with history of previous asthma (AS) and COPD (NAS).

Results: 1626 patients were surveyed; 61 were excluded (< 40 y/o or non-obstructive lung disease). Mean age was 58.4±10.4 y/o, 54% were men. 89 patients had previous diagnosis of asthma. 329 of 1565 (21%) patients were diagnosed with COPD, 42% of AS vs 19% of NAS (p=0,001). The pack/years index in AS was 19±10 vs. 34±23 in NAS (p = 0.001). FEV1% and FEV1/FVC were comparable in both groups (67% and 57 vs 59). No differences in symptoms was found.(p= NS) AS had more emergency visits (39.5% vs 24.4%, p = 0.047), higher previous spirometric tests (73.7% vs 54.6%, p = 0.026) on the last year, and higher use of bronchodilators and ICS.

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Table 1





Conclusions: Patients with history of asthma develop COPD more often, with lower smoking load, and have higher use of medical resources in spite of more use of effective treatment.
Significance and long-term outcome of nonspecific pleuritis after medical thoracoscopy
Authors: Xanthi Tsiafaki, Maria Chorti, Niki Maounis, Maria Kokolaki, Constantinos Mantzouranis, Vasiliki Filaditaki
Journal: European Respiratory Journal (2012)

Introduction: A specific diagnosis of an exudative pleural effusion (EPE) often poses a clinical challenge for the pulmonary physician. Although medical thoracoscopy (MTH) remains the gold standard technique in the work up of patients with EPE a definite histological diagnosis will not be established in a significant number of the cases and will therefore be, characterized as non specific pleuritis (NSP). Objective: To study the outcome of patients with NSP in a group of patients with long term follow up. Method: A retrospective analysis was performed on 110 patients who underwent thoracoscopy for EPE, over a 7 year period, at our Institution. In 47(42,7%) cases, that were histologically diagnosed as NSP, long-term follow up (a minimum of 24 months) was available. MTH was performed by a respiratory physician, experienced in the procedure, under local anesthesia and IV/IM sedation.  Results: A definite histological diagnosis was established in 63 patients. In the remaining 47 (42.7%), 35 men and 12 women with mean age of 64.5 years, the diagnosis of NSP was rendered. Four of the latter (8.5%) were subsequently diagnosed with malignancy after an interval of 3-5 months (2 mesotheliomas, 2 adenocarcinoma). A probable cause was established on clinical grounds in 13(27.6%) cases. Finally, in 30 (63.8%) patients, the underlying etiology for NSP was not discovered and was therefore, described as “idiopathic pleuritis”.  Conclusions: In our series 3.6% proved to be false negative, after a mean follow up of 4 months. Furthermore, in 27.3% of our undiagnosed EPE cases, a definite diagnosis could not be determined and was characterized as “idiopathic pleuritis”.
Approaches to the diagnosis of viral pneumonias in the immunocompromised host: the importance of assaying cytopathogenic viral effects in bronchoalveolar lavage cells
Authors: P Chanez, P Aubas, M Segondy, G Barneon, M Cluzel, Y Maria, J Mandin, FB Michel, P Godard
Journal: European Respiratory Journal (1988)

Pneumonopathic conditions in the immunocompromised host (IH) are frequent and often serious. Rapid diagnosis is essential and is made possible by bronchoalveolar lavage (BAL). Sixty-two pneumonopathic episodes in 53 immunocompromised patients were examined by BAL, for viral cytopathogenic effects (CPE) in isolated cells, with appropriate viral culture techniques. Viral culture was positive in seventeen of the eighteen episodes in renal allograft recipients and AIDS patients as against eight of the fourty-four episodes in other causes of IH (p less than 0.001). CPE was found thirteen times; in seven cases it was characteristic of cytomegalovirus. Positive viral culture and CPE were shown simultaneously during thirteen episodes in eleven patients. Ten patients died (autopsies performed in three cases confirmed viral presence). Positive viral culture with absence of CPE was observed in twelve cases. There were only four fatalities in this group (the autopsies performed in three cases did not establish the presence of a virus in the pulmonary parenchyma). The percentage of lymphocytes was high in both groups of patients (18.6 +/- 2.8%). CPE is a simple and rapid examination for the diagnosis of viral pneumonopathology in the IH. Prognosis at present is gloomy; more complex examinations such as viral cultures and/or identification of the virus by immunofluorescence will be indicated only when effective antiviral agents become available.
Novel Rheumatoid Arthritis Susceptibility Locus at 22q12 Identified in an Extended UK Genome-Wide Association Study
Authors: Gisela Orozco, Sebastien Viatte, John Bowes, Paul Martin, Anthony G. Wilson, Ann W. Morgan, Sophia Steer, Paul Wordsworth, Lynne J. Hocking, Anne Barton, Jane Worthington, Stephen Eyre
Journal: Arthritis & Rheumatology (2013)

The number of confirmed rheumatoid arthritis (RA) loci currently stands at 32, but many lines of evidence indicate that expansion of existing genome-wide association studies (GWAS) enhances the power to detect additional loci. This study was undertaken to extend our previous RA GWAS in a UK cohort, adding more independent RA cases and healthy controls, with the aim of detecting novel association signals for susceptibility to RA in a homogeneous UK cohort.A total of 3,223 UK RA cases and 5,272 UK controls were available for association analyses, with the extension adding 1,361 cases and 2,334 controls to the original GWAS data set. The genotype data for all RA cases were imputed using the Impute program version 2. After stringent quality control thresholds were applied, 3,034 cases and 5,271 controls (1,831,729 single-nucleotide polymorphisms [SNPs]) were available for analysis. Association testing was performed using Plink software.The analyses indicated a suggestive association with susceptibility to RA (P < 0.0001) for 6 novel RA loci that have been previously found to be associated with other autoimmune diseases; these 6 SNPs were genotyped in independent samples. Two of the associated loci were validated, one of which was associated with RA at genome-wide levels of significance in the combined analysis, identifying a novel RA locus at 22q12 (P = 6.9 × 10(-9) ). In addition, most of the previously known RA susceptibility loci were confirmed to be associated with RA, and for 16 of the loci, the strength of the association was increased.This study identified a new RA locus mapping to 22q12. These results support the notion that increasing the power of GWAS enhances novel gene discovery.
The difference in upper airway morphology between supine and upright posture
Authors: Cedric Van Holsbeke, Wim Vos, Samir Vinchurkar, Jan De Backer, Oswald Peters, Nasser Nadjmi, Wilfried De Backer
Journal: European Respiratory Journal (2012)

Introduction   The effect of upper airway (UA) morphology and especially the effect of the minimal cross sectional area (CSA) on lung deposition of inhaled medication (IM) is significant. However since IM is used when a patient is upright, conventional computed tomography (CT) data may not provide accurate information on the influence of the UA on lung deposition. The objective of this study is to evaluate variability in UA morphology for supine posture using CT vs. upright posture using cone beam CT (CBCT).   Materials and Methods   A total of 20 normal subjects were included. 15 valid CBCT scans could be included as the rotating gantry of the CBCT touched the shoulders of the broad-shouldered subjects, causing motion artifacts. The UA CT scans were performed using the GE VCT LightSpeed scanner and the CBCT scans were performed using the ISI i-CAT scanner.   Results   It is found that the CT scans were characterized by lower CSAs as compared to CBCT (Minimal CSA, p = 0.036, Average CSA, p = 0.006). The minimal CSA in the CT scan could accurately predict the difference in minimal CSA between CT and CBCT as indicated in the figure.   Conclusions   It can be concluded that the UA morphology is different between upright and supine position. From the supine CT image, it can be predicted how large the minimal CSA will be when the subject is in an upright position. This function can be used to generate a correction factor for assessing lung deposition of IM.
Abstract 2563: Off Label Use Of Sirolimus Eluting Stent Increases The Rate Of Death And Stent Thrombosis Without Jeopardizing The Efficacy: Result Of The Evastent Matched Corhort Registry
Authors: Aude Boignard, Alison Foote, Jean Louis Quesada, Mohamed Sahnoun, Nicolas Danchin, Jacques Machecourt
Journal: Circulation (2007)

In everyday practice the off label use of DES is widespread, but are SES as effective in reducing the need for revascularisation when used on-label and do certain types of off-label use raise greater safety concerns? The EVASTENT nationwide matched cohort registry was designed to assess the efficacy and safety of the SES in diabetic patients with single or multiple vessel disease (SVD and MVD) compared to non-diabetic patients. 1731 pts were included (844 diabetic and 730 MVD patients). Although on-label use of SES was required patients presenting with various categories of off-label lesions were included. 428 (24% ) patients included and 514/ 2730 lesions (19%) treated were off-label: bifurcation lesions (n=182), lesions with thrombus (n=139), highly calcified lesions (n=134), ostial lesions (n=102), very long (&gt;30 mm) lesions (n=15), left-main stenosis n=11), EF&lt;0.30 (n=7). In 73 cases the lesion was off-label for more than one reason. Complete interim one year follow-up data are available for 98% of the patients and in October 2007 most patients will have been followed for 3 years. All MACES (cardiac death, non-fatal myocardial infarction and Stent thrombosis ST) have been evaluated by an independent critical events committee and cases of ST have been classified according to the ARC criteria. Results: off-label use was not more frequent in diabetic patients but occurred more often in MVD patients. Table 1 shows the one-year comparison between on and off-label use. Subgroup analysis suggests that highly calcified, bifurcation and ostial lesions are particularly at risk for ST. In multivariate analysis off-label use remained an independent predictor of death and the occurrence of MACEs. Conclusion: Off-label use of SES does not reduce the efficacy of the SES, but increases the risk of death and ST. This safety concern must be taken into consideration when designing studies to evaluate new indications for these DES. On and Off-Label comparison
Multigene mutation analysis of mediastinal and hilar lymph nodes sampled by endobronchial unltrasound-guided needle aspiration
Authors: Thomas Vandemoortele, Isabelle Nanni-Metellus, Elise Kaspi, Véronique Secq, Sophie Laroumagne, Patrice Roll, Elisa Roca, Hervé Dutau, Philippe Astoul, Andrée Robaglia
Journal: European Respiratory Journal (2013)

Background: The presence of an Epidermal Growth Factor Receptor (EGFR) activating mutation guide treatment selection in advanced Non-Small Cell Lung Cancer (NSCLC), whereas (BRAF) mutations play a role in metastatic melanoma. We aimed to determine the feasibility of routine multigene mutation analysis for EGFR, KRAS, BRAF and PI3KCA in EndoBronchial UltraSound-guided (EBUS) TransBronchial Needle Aspiration (TBNA) in patients with NSCLC and melanoma.

Methods: Data was prospectively collected from patients undergoing EBUS-TBNA from March 2011 until September 2012. Smears were studied after using Papanicolaou and May-Grunwald Giemsa stains. Genetic mutations were analyzed in metastatic lymph nodes diagnosed by EBUS TBNA in 40 patients with NSCLC and 1 melanoma patient. PCR and direct sequencing of EGFR exons 18 to 21, KRAS exon 2, BRAF exon 15 and PI3KCA exons 9 and 20 were performed.

Results : Multigene mutation analysis was completed for samples from 40 patients (97,6%). Mutations were detected in 11 patients (26,8%) : 3 (7,3%) EGFR exon 19 deletion, 6 (14,6%) KRAS mutation, 1 (2,4%) BRAF, and 1 (2,4%) PI3KCA mutation. Only one sample could not be processed for the detection of KRAS mutation. All the samples were adequate for the other mutations detection. Molecular biology analyses were performed both on cytological samples and biopsy samples in 7 patients (17,1%), with a perfect correlation between these.

Conclusions: Mutations of the EGFR, KRAS, BRAF and PI3KCA genes can be detected in cytological samples routinely obtained with EBUS TBNA.
Lymphoid Leukosis in Chickens Chemically Bursectomized and Subsequently Inoculated with Bursa Cells 2
Authors: H. Graham Purchase, Douglas G. Gilmour
Journal: JNCI Journal of the National Cancer Institute (1975)

Lymphoid leukosis (LL). a neoplasm of the bursa-dependent lymphoid cells of the chicken. was induced by Rous-associated virus-1 in susceptible chickens. Cyclophosphamide (CY), which destroyed the lymphoid elements of the bursa of Fabricius and abrogated humoral immunity, prevented LL. Concomitantly, osteopetorosis and other neoplasms increased. Transfer of bursa cells from chickens into CY-treated hatchmates restored immune competence. Birds whose B-cell functions were reconstituted died of LL and were less likely to die of osteopetrosis and other neoplasms than were CY-treated chicks. These results suggested that the bursa cell transferred into the CY-treated chicks were the target cells for lymphoid leukosis transformation.
Relaxation and memory training in 39 elderly patients
Authors: Jerome A. Yesavage
Journal: American Journal of Psychiatry (1984)

A group of 39 elderly subjects whose mean age was 76 years were taught a standard mnemonic technique to improve face and name recall. About half of the subjects (the experimental group) received relaxation training before learning the mnemonic, and the remainder (the control group) were taught a nonspecific method to improve attitudes. Final performance on name and face recall improved significantly more in the experimental group, and this improvement was significantly correlated with decreased state anxiety scores. These results indicate that relaxation training may enhance the ability of elderly individuals to benefit from memory and similar training programs.
Lack of antimicrobial activity of sodium heparin for treating experimental catheter-related infection due to Staphylococcus aureus using the antibiotic-lock technique
Authors: J.A. Capdevila, J. Gavaldà, J. Fortea, P. López, M.T. Martin, X. Gomis, A. Pahissa
Journal: Clinical Microbiology and Infection (2001)
Role of Sentinel Lymph Node Biopsy in Patients with Thin Melanoma
Authors: Robert H. I. Andtbacka, Jeffrey E. Gershenwald
Journal: Journal of the National Comprehensive Cancer Network (2009)

Sentinel lymph node (SLN) biopsy has emerged over the past 2 decades as a rational approach for staging regional lymph nodes in patients with clinically node-negative melanoma (stage I and II disease). Large multi-institutional studies have confirmed that when performed by experienced surgeons, it is an accurate, reliable technique for identifying occult regional nodal disease, and that SLN status is the most important prognostic factor in patients with stage I and II melanoma. However, the incidence of occult regional nodal metastasis in patients with thin melanoma (<or= 1.0 mm; approximately 70% of patients with newly diagnosed melanoma) is low, and whether to perform SLN biopsy in these patients remains controversial. Several predictors of SLN metastasis in patients with thin melanoma have been suggested, but none widely accepted. This article reviews current literature on these predictors in patients with thin melanoma. Although the ability to draw conclusions was limited by the size and design of the available studies, the authors tentatively conclude that SLN biopsy can be considered for patients with melanomas 0.75 mm or larger, those with T1b melanomas (i.e., <or= 1.0 mm; Clark level IV/V and/or ulcerated), and those with thin melanomas with an increased tumor mitotic rate (especially >or= 1 mitosis/mm2). Including younger age (e.g., <or= 40 years) in the decision also seems reasonable, particularly if the primary tumor is associated with a high tumor mitotic rate. Tumor regression does not seem to be associated with an increased risk for SLN metastasis. Firm conclusions on the predictive value of vertical growth phase, absence of tumor-infiltrating lymphocytes, or male gender were not possible, particularly if used as a sole criterion for offering this procedure. SLN biopsy should be discussed with all patients with newly diagnosed thin melanoma.
Factors associated with subsequent nontuberculous mycobacterial lung disease in patients with a single sputum isolate on initial examination
Authors: M.-R. Lee, C.-Y. Yang, C.-C. Shu, C.-K. Lin, Y.-F. Wen, S.-W. Lee, J.-C. Ko, J.-Y. Wang, L.-N. Lee, C.-J. Yu
Journal: Clinical Microbiology and Infection (2014)
Prophylactic and therapeutic implications of toll‐like receptor ligands
Authors: Mona Hedayat, Kiyoshi Takeda, Nima Rezaei
Journal: Medicinal Research Reviews (2010)

Abstract The evolutionary conserved Toll‐like receptors (TLRs) are the first identified and best characterized pattern recognition receptors (PRRs) which discriminate self from nonself, providing an early and effective immune response against invading pathogens. The ever expanding knowledge of TLR signaling network make it one of the most promising therapeutic strategies to modulate the immune response in various human diseases. Immune modulating strategies based on TLR‐specific agonists elicit a potent immune response to adjuvant vaccine immunotherapy, cancers, allergic diseases, and chronic viral infections while minimizing the risk of uncontrolled provocation of systemic inflammatory response. Moreover, the contribution of TLR signaling in the pathogenesis of chronic noninfectious inflammatory and autoimmune diseases provides the rationale for the development and clinical implementation of TLR‐specific antagonists. At present, a few TLR‐specific agonists have been approved for both prophylactic and therapeutic applications, while the ongoing preclinical and clinical studies show promising results on various novel therapeutic molecules as an adjunctive to conventional pharmacotherapy or stand‐alone therapeutic strategy. © 2010 Wiley Periodicals, Inc. Med Res Rev
Quantifying peripheral and central lung response to bronchodilator in asthma with hyperpolarised gas MRI
Authors: John Kenworthy, Helen Marshall, Steven Thomas, Juan Parra-Robles, Xiaojun Xu, General Leung, Salman Siddiqui, Christopher Brightling, James M. Wild
Journal: European Respiratory Journal (2013)

Background: Hyperpolarised gas MRI is sensitive to regional ventilation changes, which can be quantified as a percentage of total lung volume.  Objective: To quantify lung ventilation response to bronchodilator in patients with asthma on a global and regional basis.  Methodology: 24 asthmatic patients were scanned using synchronous hyperpolarised  3 He and  1 H lung MRI before and after bronchodilator use.  1 H images were used to measure lung volume (LV) using a seed growing algorithm (Slicer 3D, Harvard). Ventilation volumes (VV) were calculated using manual thresholding on  3 He images. Whole lung percentage ventilated volumes (%VV) were calculated by VV÷LV. The peel (peripheral 1/3 of the lung) and core (inner 2/3 of the lung) %VV were automatically segmented.  Results: Significant increase in %VV was measured (Wilcoxon rank) following bronchodilator when calculated globally (p=0.001) and for core (p=0.007) and peel (p=0.004). Ventilation improvement was greater in the peel than the core (Parametric t-test p=0.024).  Conclusions: Hyperpolarised gas MRI measured increased ventilation following bronchodilator in a cohort of 24 asthmatics, with a greater response in the lung periphery than the central core suggesting a biasing towards small airway involvement both in the underlying asthma pathology and its response to bronchodilator.  Research funded by Novartis and EU FP7 programmes: Airprom and PInet.
Molecular characterization of VIM-producing Klebsiella pneumoniae from Scandinavia reveals genetic relatedness with international clonal complexes encoding transferable multidrug resistance
Authors: Ø. Samuelsen, M.A. Toleman, V. Hasseltvedt, K. Fuursted, T.M. Leegaard, T.R. Walsh, A. Sundsfjord, C.G. Giske
Journal: Clinical Microbiology and Infection (2011)
The effect of salmeterol/fluticasone on markers of airway inflammation in patients with uncontrolled asthma
Authors: Dmitry Tikhanov, Galina Sergeeva, Alexander Emelyanov
Journal: European Respiratory Journal (2012)

Aim: to assess changes of markers of airway and systemic inflammation in patients with uncontrolled asthma treated with salmeterol/fluticasone.  Materials and methods: Thirteen nonsmoking patients (62% males) aged 35-61 yrs (mean 47.4 yrs) with uncontrolled asthma (ACQ-5 >1.5) despite of previous monotherapy with ICS (medium dose 910.7±49.77 mcg BDP) for >30 days were included in this study. Patients were treated with salmeterol/fluticasone (Seretide Discus) 50/250 mcg twice daily during 12 weeks. Spirometry, methacholin challenge test (dry spirometer 2120 Vitalograph, UK), exhaled nitic oxide (FeNO) (Logan 4100 analyser), differential cell count in induced sputum and serum C reactive protein (CRP) were measured at baseline and in 12 weeks.  Results. There was a significant reduction of exhaled FeNO (14.9 vs 10.8 ppb, p=0.003) and increase of PC20 to methacholine(0.072 vs 0.203 mg, p=0.005) that was associated with impove asthma contol during the treatment with salmetrol/fluticasone. However, eosinophil counts in induced sputum (13.2 vs 8.9%, p>0.05) and serum CRP level (5.5 vs 4.5 mg/l, p>0.05) did not decrease compared to baseline level.  We conclude that FeNO and airway hyperesponsiveness to methacholine change faster and may reflect asthma control in steroid-treated patient with asthma. Eosinophil count in induced sputum and serum CRP level may use for to assess the duration of treatment with ICS/LABA.