tbuckley/cabot-search huggingface dataset:
Effects of a Birth Hospital’s Neonatal Intensive Care Unit Level and Annual Volume of Very Low-Birth-Weight Infant Deliveries on Morbidity and Mortality
Authors: Erik A. Jensen, Scott A. Lorch
Journal: JAMA Pediatrics (2015)

The annual volume of deliveries of very low-birth-weight (VLBW) infants has a greater effect on mortality risk than does neonatal intensive care unit (NICU) level.The differential effect of these hospital factors on morbidity among VLBW infants is uncertain.OBJECTIVE To assess the independent effects of a birth hospital's annual volume of VLBW infant deliveries and NICU level on the risk of several neonatal morbidities and morbidity-mortality composite outcomes that are predictive of future neurocognitive development.DESIGN, SETTING, AND PARTICIPANTS Retrospective, population-based cohort study (performed in 2014) of all VLBW infants without severe congenital anomalies delivered in all hospitals in California, Missouri, and Pennsylvania between January 1, 1999, and December 31, 2009 (N = 72 431).Risk-adjusted odds ratios and risk-adjusted probabilities were determined by logistic regression. MAIN OUTCOMES AND MEASURESThe primary study outcomes were the individual composites of death or bronchopulmonary dysplasia, necrotizing enterocolitis, retinopathy of prematurity, and severe intraventricular hemorrhage.RESULTS Among the 72 431 VLBW infants in the present study, birth at a hospital with 10 or less deliveries of VLBW infants per year was associated with the highest risk-adjusted probability of death (15.3% [95% CI, 14.4%-16.3%]),death or severe intraventricular hemorrhage (17.5% [95% CI, 16.5%-18.6%]),and death or necrotizing enterocolitis (19.3% [95% CI, 18.1%-20.4%]).These complications were also more common among infants born at hospitals with a level I or II NICU compared with infants delivered at hospitals with a level IIIB/C NICU.The risk-adjusted probability of death or retinopathy of prematurity was highest among infants born at hospitals with a level IIIB/C NICU and lowest among infants born at hospitals with a level IIIA NICU.When the effects of NICU level and annual volume of VLBW infant deliveries were evaluated simultaneously, the annual volume of deliveries was the stronger contributor to the risk of death, death or severe intraventricular hemorrhage, and death or necrotizing enterocolitis. CONCLUSIONS AND RELEVANCEThe risk of death or severe intraventricular hemorrhage and death or necrotizing enterocolitis was lowest among infants born in hospitals that had both a high volume of VLBW infant deliveries and a high-level NICU.Antenatal transfer of high-risk pregnancies to these hospitals may reduce mortality and improve outcomes.
Management of Adrenocortical Carcinoma
Authors: Jonathan R. Strosberg, Gary D. Hammer, Gerard M. Doherty
Journal: Journal of the National Comprehensive Cancer Network (2009)

Adrenocortical carcinomas (ACCs) are rare tumors that arise from the cortex of the adrenal gland with an incidence 1 to 2 per million. The rarity of this tumor translates into a paucity of experience in managing patients in most medical centers. Because clinical series are small and prospective evaluation of treatment strategies is limited, the current state of knowledge is strongly influenced by expert consensus opinion from a few medical centers specializing in ACCs. This article describes the basic diagnostic and prognostic issues in adrenal cancer management, and presents detailed rationales for therapeutic management.
IL-33 has a nuclear distribution and is not increased in peripheral lung of COPD patients
Authors: Gaetano Caramori, Paolo Casolari, Anna Padovani, Elvira Garofano, Marco Contoli, Kian Fan Chung, Ian M. Adcock, Alberto Papi
Journal: European Respiratory Journal (2011)

Interleukin-33 (IL-33), a member of the IL-1 cytokine family, is crucial for induction of Th2-type immune responses but is also involved in the induction of non-Th2-type inflammation as a pro-inflammatory cytokine, similar to IL-1 and IL-18. The aim of our study was to investigate by immunohistochemistry (IHC), RT-qPCR, ELISA and Western blotting (WB) the expression and the amount of IL-33 in peripheral lung, and bronchoalveolar lavage (BAL) from 15 age- and smoking history-matched smokers with normal lung function and 15 smokers with mild to moderate stable COPD not treated with ICS and/or theophylline. The IHC staining was mainly confined to the nuclei of endothelial cells and small airway epithelial cells. The number of IL-33 positive cells and the level of mRNA expression was not significantly different in patients with COPD compared to controls. IL-33 was under detection limits using ELISA (BAL) and WB (peripheral lung). These data suggest that an IL-33-mediated immune response, may not be critical in COPD and its nuclear role is uncertain.
Abstract 2835: Waveform Characteristics of Ventricular Fibrillation Are Altered in Post-Myocardial Infarction Swine
Authors: Julia H Indik, Richard L Donnerstein, Justin Feigelman, Ronald W Hilwig, Mathias Zuercher, Karl B Kern, Marc D Berg, Robert A Berg
Journal: Circulation (2007)

Background: In ventricular fibrillation (VF) of short duration chest compressions do not improve survival prior to defibrillation. We have previously shown that in an acute myocardial infarction (MI), frequency characteristics are markedly depressed and are poor surrogates for VF duration. We hypothesized that the VF waveform further evolves post-MI, after a myocardial scar has formed. Methods: Acute myocardial infarction was induced in nine swine by occlusion of the mid left anterior descending artery. After a two week recovery period, VF was induced and compared to VF in 16 control swine over the first five minutes. VF waveforms were analyzed for frequency content (mean, median, dominant and bandwidth), slope (the median of the absolute value of the difference in voltage every 5 ms), and AMSA (the summed product of amplitude and frequency). Results: Myocardial scar was confirmed in all MI swine postmortem. All frequency characteristics were significantly altered in post-MI swine (p&lt;0.01). At 4 minutes, VF mean frequency in controls was 10.3 ± 0.5Hz compared to 9.1± 0.5Hz in post-MI swine (mean ±SEM, p=0.007), with similar differences for median and dominant frequencies. Bandwidth was markedly decreased and at 4 minutes was 3.2 ± 0.2Hz in controls compared to 2.1 ± 0.2Hz in post MI swine (p&lt;0.001). However, slope and AMSA were similar in both groups. Conclusions: Frequency content of VF remains altered post MI compared to control swine, with reductions in mean, median and dominant frequencies and larger reductions in bandwidth. Amplitude based measures such as AMSA and slope, however, are not significantly altered and may serve as better predictors of time in VF.
Are the benefits of pulmonary rehabilitation sustained after 6 months
Authors: Lily Zainudin, Paul Albert, Verity Ford, Peter Calverley
Journal: European Respiratory Journal (2011)

While Pulmonary Rehabilitation (PR) improves health status and exercise capacity in the short term, there is a lack of consistent evidence that daily physical activity increases after PR and if this is sustained.  17 stable COPD patients (mean (sd) age 67.7 (9.6)yrs, FEV 1  1.1 (0.4)l, 47 (16)% pred) were assessed before and after 8 weeks9 PR and 6 mths later. St George9s Respiratory Questionnaire (SGRQ), hospital anxiety and depression (HADa, HADd), London Chest ADL (LCADL), quadriceps force (QF), endurance shuttle walk (ESWT) and physical activity (DynaPort accelerometer) were measured.  Paired analysis showed significant improvements in QF, ESWT, HADd,% time moving and walking after PR. Most of these benefits were lost 6 months later, with significant declines in SGRQ, LCADL,% time weightbearing and moving, although ESWT was reasonably well maintained.  While PR leads to an increase in daily physical activity, this subsequently declines along with health status, depression score and functional status. The preservation of exercise capacity suggests that patients retain the ability to carry out increased activity, but do not actually do so. More effective, possibly behavioural, interventions are needed to maximise and sustain the immediate benefits seen immediately after active PR.
Breakthrough invasive pulmonary aspergillosis (IPA) in patients receiving posaconazole prophylaxis (PPxis)
Authors: Maxime Patout, Chloé Fercocq, Alexandre Alanio, Sophie Touratier, Emmanuel Raffoux, Francis Derouin, Jean-Michel Molina, Stéphane Bretagne, Patricia Ribaud, Anne Bergeron
Journal: European Respiratory Journal (2014)

Introduction:   PPxis is used to prevent IPA in patients with high-risk haematological malignancies. The aim of this study was to assess the incidence and to describe the clinical presentation of IPA under PPxis.   Methods:  6-year retrospective monocentric study (2007-2013).   Results:   40 (7.8%) patients (pts) among 514 with PPxis developed IPA. IPA was proven (n=2), probable (n=21) or possible (n=17) using the EORTC/MSG 2008 criteria. Underlying diseases were acute myeloid leukaemia (n=27), other myeloid malignancies (n=10), non-Hodgkin lymphoma (n=3). 10 pts were allogeneic transplant recipients (median time from transplant to IPA: 146 days [IQR: 116-316]). Median duration of PPxis courses was 16 days [10–34]. Plasma posaconazole concentration (Cmin) was below 0.5mg/l in 13 of the 25 assessed pts. 33 pts had neutropenia, with a median duration of 20 days [13–44] before IPA diagnosis. 39 pts had a CT-scan at IPA diagnosis, showing nodules (n= 35) with a halo sign (n=28). Serum galactomannan(GM) was positive in 16/40 pts. Bronchoscopy was performed in 22 pts:  Aspergillus  was recovered in 6 cases ( A.  fumigatus  n=5) and BAL GM was positive in 9/20 cases. Antifungal initial salvage treatment consisted in voriconazole (n=20), voriconazole and caspofungin (n=7), liposomal amphotericin B (n=9) and caspofungin (n=4). The overall complete and partial responses rate was 70% and 30-day mortality was 12.5%. However, median survival after IPA diagnosis was only 128 days [24-415].   Conclusion:   This study suggests that breakthrough IPA in pts receiving PPxis is not such a rare event in high-risk pts. Although a favorable response to salvage antifungal therapy can occur, overall survival appears poor.
Coronary function and adenosine receptor-mediated responses in ischemic-reperfused mouse heart
Authors: A Flood
Journal: Cardiovascular Research (2002)

Objectives: To assess the impact of ischemia-reperfusion (I/R) on coronary function, and the role of endogenous adenosine in modifying post-ischemic vascular function in asanguinous hearts. Methods: Vascular function was studied in Langendorff perfused mouse hearts subjected to 20–25-min ischemia and 30-min reperfusion. Results: Ischemia altered the dependence of flow on work-rate observed in normoxic hearts, and inhibited reflow by mechanisms additional to diastolic compression. Coronary responses were selectively reduced: 2-chloroadenosine and ADP dilated with pEC50s of 8.4±0.1 and 7.4±0.1 in non-ischemic hearts versus 7.7±0.1 and 7.1±0.1 after 20-min ischemia (P<0.05). Sensitivity was further reduced after 25-min ischemia. Responses to nitroprusside were unaltered. NO-synthase antagonism (50 μM nitro-l-arginine methylester) reduced sensitivities to 2-chloroadenosine and ADP up to 10-fold, and eliminated inhibitory effects of I/R. KATP blockade with 5 μM glibenclamide impaired sensitivity pre- and post-ischemia, not eliminating the inhibitory effects of I/R. A1 adenosine receptor antagonism with 100 nM 8-cyclopentyl-1,3-dipropylxanthine worsened effects of ischemia on sensitivity. A2A adenosine receptor antagonism with 100 nM 8-(3-chlorostyryl)caffeine reduced post-ischemic flow by 50%, yet paradoxically enhanced post-ischemic contractile recovery. Conclusions: Ischemia modifies vascular control and impairs NO- versus KATP-dependent coronary dilation in an asanguinous model. Endogenous adenosine protects against vascular dysfunction via A1 receptors, and determines coronary reflow via A2A receptors. However, intrinsic A2A activation apparently worsens contractile dysfunction.
Socioeconomic position and use of drugs in chronic obstructive pulmonary disease (COPD): A population-based cohort study in Rome, Italy
Authors: Nera Agabiti, Valeria Belleudi, Ursula Kirchmayer, Lisa Bauleo, Luigi Pinnarelli, Massimo Arcà, Marina Davoli
Journal: European Respiratory Journal (2011)

Introduction:  Little is known about “real-life” use of evidence-based recommended drugs in COPD. We tested the hypothesis that drug prescription vary according to socioeconomic position.   Methods:  All people (35-64 years old) discharged in 2006-07 with a diagnosis of COPD exacerbation, resident in Rome (2.700.000 inhabitants) were selected from Hospital Information System (standardized ICD-9-CM coding). Drugs were retrieved from the regional drug prescription registry based on ATC codes (12-months follow-up after discharge). An area-based (census block) socioeconomic position (SEP) index was used for each patient (quintiles: I well off, V disadvantaged). Logistic regression was performed to take into account gender, age and comorbidities.   Results:  779 individuals were studied (mean age 58.1, 58% men). 55% were in the lower SEP levels. Disadvantaged people were more likely to have respiratory failure, diabetes, ischemic heart disease and heart failure. Proportions of people with at least two prescriptions during 12 months after discharge were: long-acting inhalants 70%, short-term inhalants 45%, xanthines 23%. No statistically difference was observed across SEP groups for long-acting (OR= 1.20, 95% IC=0.67-2.16) or short-acting inhalants (OR=1.55, 95% IC= 0.90-2.68), while xanthines were more frequently prescribed for low SEP people (SEP-V vs. SEP-I OR=2.17, 95% IC=1.03-4.57;  p  trend    Conclusions:  Disadvantaged COPD patients seem more exposed to xanthines whose effectiveness is less clear in comparison to inhalant drugs. We highlight the need for improving outpatient care programmes to reduce disparity in health.
Maximal exercise in obese patients with COPD. The role of the fat free mass
Authors: Marina Aiello, Elisabetta Teopompi, Panagiota Tzani, Sara Ramponi, Maria Rosaria Gioia, Emilio Marangio, Alfredo Chetta
Journal: European Respiratory Journal (2014)

BACKGROUND: Obese patients (OB) with COPD may better tolerate exercise as compared to normal weight (NW) COPD patients,even if the reason of this fact is not completely understood. We investigated the interactions between obesity, lung hyperinflation, fat-free mass (FMM) and exercise capacity in COPD. METHODS: Forty-four patients (16 females; age 65 ± 8 yrs) were assessed by resting lung function, symptom-limited cardiopulmonary exercise test, and body composition to measure FFM. RESULTS: OB (n = 22) and NW (n = 22) patients did not differ in age, gender and airflow obstruction degree, but not in FFM (p l 0.05).OB patients showed significantly higher values in peak workload (p l 0.05) and in peak oxygen uptake (VO 2 ), when expressed as absolute value (p l 0.05), but not when corrected by FFM. OB also showed significantly higher values in inspiratory capacity/total lung capacity ratio (IC/TLC) at rest (pl 0.01), but not at peak of exercise and experienced lower leg fatigue (pl0.05), but similar dyspnea degree on exertion. The regression equation by stepwise multiple regression analysis for the peak workload included FFM and IC/TLC at rest, as independent variables (r 2  = 0.43). CONCLUSIONS: OB with COPD, as compared to NW patients matched for age, gender and airflow obstruction, had greater FMM and less resting lung hyperinflation and showed a greater exercise capacity in terms of peak workload, when performing a maximal exercise test. FFM and resting lung hyperinflation were determinants of the peak workload in all patients.
Splenic versus hepatic artery infusion of interleukin-2 in patients with liver metastases.
Authors: G M Mavligit, A A Zukiwski, J U Gutterman, P Salem, C Charnsangavej, S Wallace
Journal: Journal of Clinical Oncology (1990)

In an attempt to improve the therapeutic index of recombinant interleukin-2 (rIL-2) by generating or activating lymphokine-activated killer (LAK) cells and tumor-infiltrating lymphocytes (TIL) regionally and/or in situ, we randomly assigned 28 patients with liver metastases to receive rIL-2 by continuous infusion for 5 days via either the splenic artery or the hepatic artery. Clinically significant and lasting tumor regression was observed only in two of 28 patients (7%), one in each of the two treatment arms. The maximum-tolerated daily dosage of rIL-2 was 3 x 10(6) U/m2; beyond this dosage, toxicity was excessive. Peripheral LAK cell activity measured in vitro and clinical tumor regression did not correlate. This observation, coupled with the equal distribution of regressions between the two treatment arms, raises the possibility that tumor regression, rare though it may be in response to rIL-2 administration, is largely mediated by TIL activation and not by LAK cell generation.
Neutrophilic granule proteins in the occupational pulmonary diseases
Authors: Galina Orlova, Elena Surkova
Journal: European Respiratory Journal (2013)

Aim: to study the neutrophil inflammatory products in bronchoalveolar lavage fluid (BALF) in dust-induced pulmonary diseases.  Methods. 20 pneumoconiosis (PC) patients, 21 occupational COPD patients were investigated. Mean duration of exposition to fibrogenic dust was 20,7±1,8 yrs. in PC and 21,4±7,8 yrs. in COPD. The bronchoalveolar lavage fluid (BALF) cell profile, levels of myeloperoxidase (MPO), lactoferrin, elastase activity in BALF were studied. Control group consisted of 10 healthy persons.  Results. PC was characterized by BALF lymphocytosis (11,4±1,5%, comparatively to control group (p  Conclusion. Significantly increased BALF MPO levels and elastase activity resulted in marked emphysema in occupational COPD, while in PC pneumofibrosis is associated with irregular emphysema.
Etoposide in relapsed or refractory Wilms' tumor: a phase II study by the French Society of Pediatric Oncology and the United Kingdom Children's Cancer Study Group.
Authors: F Pein, R Pinkerton, M F Tournade, M Brunat-Mentigny, G Levitt, G Margueritte, H Rubie, D Sommelet, A Thyss, J M Zücker
Journal: Journal of Clinical Oncology (1993)

PURPOSE Despite a high cure rate of approximately 85% in Wilms' tumor by multimodality therapy, to date only four drugs are known to be active against such tumors. There is a clear need for new active drugs. PATIENTS AND METHODS Thirty-one patients with relapsed or refractory Wilms' tumor from three British and 14 French centers were treated with intravenous (IV) etoposide 200 mg/m2 daily for 5 days. Original stage was I (n = 3), II (n = 7), III (n = 9), IV (n = 10), and V (n = 2). Prior chemotherapy, administered initially or at relapse, included vincristine and dactinomycin in all cases, doxorubicin or epirubicin in 30, and ifosfamide in 20. Sites of relapse or resistant disease were lung in 13, abdomen or pelvis in six, liver in one, and multiple in 11. When entered onto the study, 12 patients were in first relapse, 10 in second relapse, and four in third or more relapse. Five had never obtained a complete remission. All but two (progressing) patients received two courses of etoposide, the second course being administered at day 21. RESULTS A complete response (CR) was documented in two patients, partial response (PR) in 11, stable disease in 10, and progressive disease (PD) in eight. The duration of response could not be evaluated, because all responding patients were subsequently treated with multimodality therapy. The major toxicities observed were neutropenia and thrombocytopenia, but most patients had been heavily pretreated. No toxic death clearly associated with etoposide was noted. CONCLUSION It is concluded that etoposide in this schedule is an active agent in Wilms' tumor and should be considered for inclusion in regimens for high-risk patients, such as those with metastatic disease at diagnosis and those who relapse after multiagent chemotherapy.
Mutations With Loss of Heterozygosity of p53 Are Common in Therapy-Related Myelodysplasia and Acute Myeloid Leukemia After Exposure to Alkylating Agents and Significantly Associated With Deletion or Loss of 5q, a Complex Karyotype, and a Poor Prognosis
Authors: Debes H. Christiansen, Mette K. Andersen, Jens Pedersen-Bjergaard
Journal: Journal of Clinical Oncology (2001)

PURPOSE: To study mutations and loss of heterozygosity (LOH) of p53 in therapy-related myelodysplasia (t-MDS) and acute myeloid leukemia (t-AML). PATIENTS AND METHODS: Fifty-two unselected patients with t-MDS and 25 patients with t-AML were studied by polymerase chain reaction (PCR)–single-strand conformational polymorphism (SSCP) at the DNA level and by reverse transcriptase (RT)-PCR–SSCP at the mRNA level, and cases with aberrant SSCP patterns were sequenced. RESULTS: Somatically acquired mutations of p53 were observed in 21 of 77 cases of t-MDS or t-AML, and 19 of these 21 patients had received alkylating agents. Single-base substitutions at A:T pairs were more common in t-MDS and t-AML, whereas single-base substitutions at G:C pairs are most common in MDS and AML de novo and in solid tumors. Six patients demonstrated a cytogenetic loss of 17p13, and these six and an additional nine patients with p53 mutations demonstrated LOH of p53 at the DNA or mRNA level. This suggests a cytogenetic loss of the normal p53 allele in these nine cases combined with duplication of the homologous chromosome 17 carrying the mutated p53 allele. Mutations of p53 were significantly associated with deletion or loss of 5q (P &lt; .0001) and a complex karyotype (P = .0001), but surprisingly were not associated with deletion or loss of 7q (P = .73), and were infrequent in patients with balanced chromosome translocations (P = .03). Mutations of p53 were more common in older patients (P = .036) and were associated with an extremely poor prognosis (P = .014), apparently restricted to the 15 cases with LOH of p53 ( P = .046). CONCLUSION: Mutations with loss of function of p53 are significantly associated with deletion or loss of 5q in t-MDS and t-AML after previous treatment with alkylating agents and are associated with genetic instability.
A Morphologic Classification of Brain Tumors Found in Several Strains of Mice2
Authors: Kevin T. Morgan, Charles H. Frith, James A. Swenberg, John T. McGrath, K. J. Zulch, Daniel M. Crowder
Journal: JNCI Journal of the National Cancer Institute (1984)

Journal Article A Morphologic Classification of Brain Tumors Found in Several Strains of Mice Get access Kevin T. Morgan, Kevin T. Morgan Search for other works by this author on: Oxford Academic PubMed Google Scholar Charles H. Frith, Charles H. Frith Search for other works by this author on: Oxford Academic PubMed Google Scholar James A. Swenberg, James A. Swenberg Search for other works by this author on: Oxford Academic PubMed Google Scholar John T. McGrath, John T. McGrath Search for other works by this author on: Oxford Academic PubMed Google Scholar K. J. Zulch, K. J. Zulch Search for other works by this author on: Oxford Academic PubMed Google Scholar Daniel M. Crowder Daniel M. Crowder Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 72, Issue 1, January 1984, Pages 151–160, https://doi.org/10.1093/jnci/72.1.151 Published: 01 January 1984 Article history Received: 29 March 1983 Accepted: 01 September 1983 Published: 01 January 1984