tbuckley/cabot-search huggingface dataset:
Predictors of readmission in patients on home mechanical ventilation (HMV)
Authors: Lourdes Cañón Barroso, Jacinto Hernandez Borge, MariCarmen Garcia Garcia, Estefania Molina Ortiz, Pilar Cordero Montero, Amparo Sanz Cabrera, Ignacio Blanco Rodríguez, Fernando Fuentes Otero
Journal: European Respiratory Journal (2012)

OBJECTIVES : There are few studies that examine which factors determine the readmission of patients on HMV. Our objective was to study the variables related to this fact to determine which aspects should be monitored more closely.   METHODS:  Prospective observational study over a period of 10 years. We collected clinical variables during hospitalization and data related to treatment adherence and the date of hospital readmission. Bivariate analysis and a Cox multivariate model were performed   RESULTS:  We included 214 patients (55.6% women, mean age 63.8 years± 13.3). 50% required hospital readmission and the median time to readmission was 170 weeks (144.1 to 195.8). Readmission was not related to the presence of comorbidities, morbid obesity, situation at the start of ventilation (chronic respiratory vs. acute respiratory failure) or main diagnosis that led to the start of HMV. During follow-up readmission was associated with poor adherence to HMV (46.7% vs 29.9%, p = 0.017), previous admissions, previous respiratory failure and a poor quality of life. Predictors of readmission were also worse PaO2 control and PaCO2 control, greater number of previous admissions and poorer lung function. The multivariate model identified as independent predictors of readmission: Poor adherence to HMV (OR 1.7, CI 95% 1.1. -2.6), PaCO2 control (OR: 1.03, 95% CI 1 to 1.06) and the level of dyspnea at follow up(OR:2.3,95%:1,5-3,3).   CONCLUSIONS : 1.-In our experience, a high percentage of patients on HMV required hospital readmission. 2. - Readmissions does not appear to be directly related to comorbidities neither the initial results of HMV and appear related to poor treatment adherence and severity of respiratory failure.
Does self-management support increase the risk of mortality amongst patients with COPD? A systematic review of the evidence
Authors: Rachel Jordan, Saimma Majothi, Nicola Heneghan, Richard Riley, Alice Sitch, Malcolm Price, Elizabeth Bates, Alice Turner, Sue Bayliss, David Moore, Sally Singh, Peymane Adab, David Fitzmaurice, Kate Jolly
Journal: European Respiratory Journal (2014)

Introduction   Self-management support is recommended worldwide for patients with COPD, although interventions are heterogeneous and evidence of their effectiveness is inconsistent. A large RCT was stopped prematurely because of increased mortality among patients in the self-management arm. We undertook a broad, comprehensive systematic review to evaluate whether self-management support increases mortality.   Methods   RCTs were sought to May 2012: population: patients with COPD; intervention: any intervention including self-management components compared with usual care/control; outcome: all-cause mortality; duration: g24 weeks. Pooled estimates of hazard ratios were obtained from random effects meta-analysis.   Results   From 13477 records, 44 RCTs reported 447 deaths among 5522 patients. Trials varied in size (n=26 to n=743), intervention (from single components to integrated care) and generally had few events. Overall there was no clear evidence of a difference in mortality, although the point estimate favoured the self-management interventions (HR 0.90 (95%CI 0.74, 1.09)). Sub-group analyses among trials of patients with more severe disease, prior admissions (HR 0.93 (0.72, 1.19)) or provision of action plans (HR 0.89 (0.70, 1.12)) did not differ. However, interventions with the most scheduled contact with healthcare professionals (HCP) showed reduced mortality (HR 0.72 (0.55, 0.95)). I 2 =0% (no heterogeneity) for all results.   Conclusion   There is no evidence that self-management support increases mortality. Only the most supported interventions (eg disease/case management/home rehabilitation) with substantial scheduled contact with HCP may reduce mortality.
Role of virus in community-acquired pneumonia (CAP)
Authors: Ana Simon, Carolina Panadero, Elisa Minchole, Sergio Fandos, Ana Lasierra, Maria Angeles Ruiz, Elena Forcen, Virginia Moya, Elisabeth Vera, Salvador Bello
Journal: European Respiratory Journal (2012)

INTRODUCTION  It is of increasing interest the role of viruses as etiologic agent of CAP. We tried to assess this subject in our patients.  We conducted a prospective observational study to investigate the viral, bacterial and mixed viral/bacterial etiology of patients admitted to hospital with a diagnosis of CAP. Samples were taken for blood culture and sputum culture, serial serology studies, urinary Legionella and S pneumoniae antigens, and nasopharyngeal aspirate to search virus by immunofluorescence and 2 different multiple polimerase chain reaction (PCR).  RESULTS  Of a total of 262 patients with CAP admitted to our hospital were included, and we found at least one pathogen in 180 (68.7%). Out of the 180 patients with etiological diagnosis, in 70 (38.8%) a bacterial agent, in 64 (35.6%) a viral agent and in 46 (25.6%) had a mixed etiology (virus + bacteria) were found. The bacteria most frequently found was S. pneumoniae, in 67 patients. Rhinovirus was found in 30 patients, and was the most prevalent virus associated with CAP. The most frequent virus/bacteria combination was S. pneumoniae with Rhinovirus, found in 9 patients.  CONCLUSIONS  Prevalence of virus in CAP is important, reaching more than half (62%) of all known etiology. The most common pathogen causing CAP is S. pneumoniae, which was also the most often associated with virus. The study of viruses as pathogens of CAP must be taken into account in future studies of this disease.
Abstract 3662: Flavinoid Effect on Aggregation and Stimulation of Thrombocytes, CRP and Lipids (FEAST-CAL Study)
Authors: Miruais S Hamed, Steven Gambert, Kevin P Bliden, Joseph DiChiara, Oscar Bailon, Anand Singla, Mark J Antonino, Udaya S Tantry, Paul Gurbel
Journal: Circulation (2007)
Acrodermatitis enteropathica-like skin eruption in cystic fibrosis patients
Authors: Guzin Cinel, Selin Yakarisik, Ebru Yalcin, Deniz Dogru, Ugur Ozcelik, Nural Kiper
Journal: European Respiratory Journal (2012)

Dermatitis is an uncommon initial presentation of cystic fibrosis(CF).Here we report 3CF patients diagnosed with severe dermatitis.

Case1: Four-month-old male patient was admitted with diffuse skin eruptions, failure to thrive, edema, hypoalbuminemia and anemia.His sweat test was not diagnostic; but he was suspected to be CF with clinical findings; treated with pancreatic enzyme replacement(PERT), and supportive therapy.His skin lesions resolved within 2 weeks. CF was confirmed with elevated sweat test(96 mEq/L) retested after the resolution of the edema, and mutation analysis that revealed 2183AA-G/-.

Case2: Two-month-old male patient was admitted with diffuse erythemateous and pathcy, exfoliated skin eruptions, anemia, hypoalbuminemia, edema, diarrhea, failure to thrive and bronchiolitis history.He was thought to be CF; treated with PERT and skin lesions resolved within 3 weeks.High sweat test and homozygous DeltaF508 mutation confirmed the diagnosis.

Case3: Two-month-old male patient was admitted with scaling erythematous rash, puffy feet, failure to thrive, diarrhea, hypoalbuminemia, and anemia.We could not perform sweat test because of diffuse edema and rash.He was diagnosed as CF with clinical and laboratory findings.Despite supportive therapies, we lost him becuse of staphilococci sepsis as the skin integrity was impaired.Sequence analysis revealed G576A/R668C compound heterozygous mutation.

Acrodermatitis enteropathica-like skin lesions can be seen in CF because of malabsorbtion and insufficient nutrition that lead to hypoproteinemia, zinc and essential fatty acids deficiencies.In patients with these skin lesions, CF must be kept in mind and sweat test must be repeated after the resolution of edema.
Long-term disease progression in spinocerebellar ataxia types 1, 2, 3, and 6: a longitudinal cohort study
Authors: Heike Jacobi, Sophie Tezenas du Montcel, Peter Bauer, Paola Giunti, Arron Cook, Robyn Labrum, Michael H Parkinson, Alexandra Durr, Alexis Brice, Perrine Charles, Cecilia Marelli, Caterina Mariotti, Lorenzo Nanetti, Marta Panzeri, Maria Rakowicz, Anna Sulek, Anna Sobanska, Tanja Schmitz-Hübsch, Ludger Schöls, Holger Hengel, Laszlo Baliko, Bela Melegh, Alessandro Filla, Antonella Antenora, Jon Infante, José Berciano, Bart P van de Warrenburg, Dagmar Timmann, Sandra Szymanski, Sylvia Boesch, Jun-Suk Kang, Massimo Pandolfo, Jörg B Schulz, Sonia Molho, Alhassane Diallo, Thomas Klockgether
Journal: The Lancet Neurology (2015)
Little difference between minimum inhibitory concentrations of Mycobacterium tuberculosis wild-type organisms determined with BACTEC MGIT 960 and Middlebrook 7H10
Authors: E Sturegård, K A Ängeby, J Werngren, P Juréen, G Kronvall, C G Giske, G Kahlmeter, T Schön
Journal: Clinical Microbiology and Infection (2014)
Language and Thought Content in Acute Psychosis
Authors: FRANK E. REILLY, MARTIN HARROW, GARY J. TUCKER
Journal: American Journal of Psychiatry (1973)

Twenty-three acute schizophrenic inpatients were given a standardized 15-minute free verbalization interview during the acute phase and again during partial recovery. During the acute phase, patients tended to get lost in a vivid, overwhelming flood of details, whereas later they took more distance and were not as overinvolved, even when discussing the same subjects. Over time there was a shift to future concerns and a renewed interest in interpersonal relationships and responsibilities. Patients became more organized and coherent over time.
Implications of Coronary Artery Calcium Testing Among Statin Candidates According to American College of Cardiology/American Heart Association Cholesterol Management Guidelines
Authors: Khurram Nasir, Marcio S. Bittencourt, Michael J. Blaha, Ron Blankstein, Arthur S. Agatson, Juan J. Rivera, Michael D. Miedema, Christopher T. Sibley, Leslee J. Shaw, Roger S. Blumenthal, Matthew J. Budoff, Harlan M. Krumholz
Journal: Journal of the American College of Cardiology (2015)
Pleural mesothelioma: Our experience in 132 cases
Authors: Estibaliz Perez, Marta Inchausti, Larraitz Garcia, Amaia Sagarna, Unai Jimenez, Lorea Martinez, Beatriz Gomez, Sonia Castro, Pedro M. Ansola
Journal: European Respiratory Journal (2014)

INTRODUCTION: 

Pleural mesothelioma is a rare tumor with a poor prognosis. Our aim is to analyze clinical and survival data of our patients diagnosed with mesothelioma.

MATERIAL AND METHODS: 

We reviewed histologically diagnosed mesotheliomas from 1/01/2000 to 31/12/2012, analyzing clinical characteristics, histological types, treatments and survival data.

RESULTS: 

132 cases:108 men (82%) and 24 women (18%). Mean age 67 years

94 cases showed history of occupational exposure, 83% confirmed asbestos exposure.

![Figure][1] 



Clinical features

Overall survival at 1 year 47%; 3 years 18% and 5 years 6.5%; median survival of 11.2 months.

![Figure][1] 



Survival multivariate analysis and Kaplan Meier curves

In 10 cases: neoadjuvant chemotherapy followed by surgery, without postoperative mortality at 90 days and median survival of 33.7 months

CONCLUSIONS: 

1- Increasing incidence in recent years. Confirmed absestos exposure in 83%

2- Poor overall survival (median 11.2 months)

3- Worse prognostic factors: leukocytosis>10000, pleural thickening or pleural mass, non epitheloid histology and symptomatic treatment

4- Surgery after neoadjuvant chemotherapy in selected cases showed larger median survival (33.7 months) without postoperative mortality at 90 days.

 [1]: pending:yes
IL‐34 and macrophage colony‐stimulating factor are overexpressed in hepatitis C virus fibrosis and induce profibrotic macrophages that promote collagen synthesis by hepatic stellate cells
Authors: Laurence Preisser, Charline Miot, Hélène Guillou‐Guillemette, Elodie Beaumont, Etienne D Foucher, Erwan Garo, Simon Blanchard, Isabelle Frémaux, Anne Croué, Isabelle Fouchard, Françoise Lunel‐Fabiani, Jérôme Boursier, Philippe Roingeard, Paul Calès, Yves Delneste, Pascale Jeannin
Journal: Hepatology (2014)

Chronic hepatitis C virus (HCV) infection is characterized by progressive hepatic fibrosis, a process dependent on monocyte recruitment and accumulation into the liver. The mediators expressed in chronically injured liver that control the differentiation of human monocytes into profibrotic macrophages (Mφ) remain poorly defined. We report that chronically HCV-infected patients with high fibrosis stages have higher serum levels of macrophage colony-stimulating factor (M-CSF) and interleukin (IL)-34 than HCV-infected patients with lower fibrosis stages and healthy subjects. Immunohistochemistry reveals an intense expression of IL-34 and M-CSF by hepatocytes around liver lesions. In addition, HCV infection and inflammatory cytokines enhance the in vitro production of IL-34 and M-CSF by hepatocytes. We next analyzed the acquisition of profibrotic properties by Mφ generated with M-CSF (M-CSF-Mφ) or IL-34 (IL-34-Mφ). M-CSF and IL-34 up-regulate the expression, by differentiating monocytes, of chemokine (C-C motif) ligand (CCL)2, CCL4, C-C chemokine receptor (CCR)1, and CCR5, which are involved in monocyte recruitment/Mφ accumulation in liver lesions. M-CSF-Mφ and IL-34-Mφ also express the hepatic stellate cell (HSC) activators, platelet-derived growth factor, transforming growth factor beta, and galectin-3. IL-34-Mφ and M-CSF-Mφ induce type I collagen synthesis by HSCs, the main collagen-producing cells in liver fibrosis. IL-13, whose expression correlates with the fibrosis stage in HCV-infected patients, decreases the expression of the collagenase, matrix metalloproteinase 1, by IL-34-Mφ and M-CSF-Mφ, thereby enhancing collagen synthesis. By inhibiting the production of interferon-gamma (IFN-γ) by activated natural killer cells, IL-34-Mφ and M-CSF-Mφ prevent the IFN-γ-induced killing of HSCs.These results identify M-CSF and IL-34 as potent profibrotic factors in HCV liver fibrosis.
Influence of smoking intensity and smoking quitting on lung function parameters in COPD patients
Authors: Irina Pavlenko, Julia Ilkovich, Nina Shklarevich
Journal: European Respiratory Journal (2011)

Aim: To evaluate dependence of changes in lung function parameters (LFP) from intensity of smoking in patients with moderate and severe COPD.

Materials, methods: 74 patients (63 male, 11 female) with COPD III-IV stages, receiving therapy according to GOLD. The mean smoking status - 36,5 pack years (p/y). The patients were divided into 2 groups: 1. Current smokers (43 pts., 37 male), mean age - 60±13.5 years; smoking status - 39,9 p/y; average 19 cigarettes per day. 2. Ex-smokers (31 pts., 26 male), mean age- 62.19±14,5 years, smoking status - 31±27 p/y. Each group was divided to 2 subgroups: low smoking intensity (0 - 20 cigarettes per day) and high smoking intensity (20 and more cigarettes per day). LFP (FEV1 in liters, FEV1/FVC% of pred., “Lung Age” - LA) were analyzed in groups during one year. LA was estimated according to Morris JF and Temple W (Prev Med 1985;14:655-662).

Results: LFP significantly improved in a year in ex-smokers vs. current smokers (p<0,01). FEV1 and LA significantly improved (p≤0,05) in ex-smokers vs. current smokers in subgroups with low smoking intensity. FEV1 significantly improved in ex-smokers vs. current smokers in subgroups with high intensity of smoking.

Conclusion: Smoking sessation has positive influence on lung function parameters in patients with severe and moderate COPD irrespectively of smoking intensity. FEV1 in litres is the most sensitive indicator reacting on smoking intensity.
Abstract 119: Cardiac Transcription Factor EB Sumoylation Deficiency Exacerbates Age-associated Reduction In Autophagy
Authors: Heng Ma, Le Zhang, Lu Yu, Yan Li
Journal: Circulation Research (2014)

Background: Aging-dependent decline of autophagy contributes to cardiac dysfunction and ischemic intolerance. Transcription factor EB (TFEB) is a master transcriptional regulator of the autophagy-lysosome pathway. The present study aimed to characterize the role of TFEB in the autophagic decrease with aging. Methods and Results: We analyzed age-associated autophagic changes in male C57BL/6 young (4-6 mo) and aged (22-24 mo) mice. The results demonstrated that TFEB expressed predominantly as a SUMOylated form in cardiomyocyte nuclei and this SUMOylation of TFEB declined in aged heart associated with autophagy reduction. Interestingly, SUMOylation of TFEB was unaffected by rapamycin. Rapamycin induced translocation of TFEB into nucleus but lower level of nuclear TFEB in aged hearts than that seen in young hearts (P&lt;0.05). SUMO1 downregulation by adeno-associated-virus-mediated small hairpin RNA (rAAV9-shSUMO1) significantly reduced nuclear TFEB levels (P&lt;0.05), depressed cardiac autophagy and accelerated cardiomyocyte contractile dysfunction with worse hypoxia/reoxygenation (H/R) injury (all P&lt;0.05). Therefore, impaired SUMOylation decreased nuclear TFEB during aging. By contrast, SUMO1 restitution significantly augmented nuclear SUMOylated TFEB with enhanced autophagy and ultimately reduced infarct size in aged heart. However, knockdown of cardiac TFEB blocked the protective effect of upregulation of SUMO1 in aged hearts, resulted in decline of autophagy and worse in vivo I/R injury. Conclusions: The present study newly demonstrates that SUMOylation is a critical post-translational modification that regulates cardiac TFEB. Impaired SUMOylation of TFEB aggravates decline of autophagy in the senescent heart. Targeting SUMO1 may provide a novel therapeutic strategy for the treatment of aging-related loss of cardioprotection.
The role of transvaginal ultrasound in early diagnosis of tamoxifen-related endometrial cancer: An Italian experience
Authors: F. Martella, P. G. Giannessi, L. Coltelli, N. Giuntini, V. Safina, A. Falcone
Journal: Journal of Clinical Oncology (2007)

11021 Background: women treated with tamoxifen for ER-positive early breast cancer are at a two to seven fold increased risk of endometrial cancer. Even though published data fail to support the use of transvaginal ultrasound (TVU) for screening of endometrial cancer, this is still a very common clinical practice in this subset of patients (pts). Methods: we have conducted a retrospective analysis to investigate the value of TVU in early detection of tamoxifen-related endometrial cancer. The screened population consists of pts treated with adjuvant tamoxifen in our institution from January 1999 up to December 2003 receiving a TVU annually or in case of gynaecologic symptoms. Results: 491 evaluated pts performed a total of 1634 TVUs in asymptomatic conditions. FIGO stage I endometrial cancers have been diagnosed in 3 patients (0.32%) who are still alive after total hysterectomy. A vaginal bleeding anticipated the examination in 33 women (3.2%) and represented the first symptom in two cases of tumor. Only one endometrial cancer has been detected with the screening procedure. Median increase of endometrial thickness has been 7.6 mm (range 1–34 mm) and those patients with abnormal images at TVU underwent an hysteroscopy with endometrial biopsies (169) resulting in a benign histology (polyps, cystic atrophy, hyperplasia) in most cases. Conclusions: therefore we have performed more than 1500 transvaginal ultrasound to detect only one asymptomatic cancer so we agree with literature in supporting that women receiving tamoxifen should undergo only an annual gynaecologic examination reserving the TVU to patients with vaginal bleedings or discharges. No significant financial relationships to disclose.
The global burden of liver disease: The major impact of China
Authors: Fu‐Sheng Wang, Jian‐Gao Fan, Zheng Zhang, Bin Gao, Hong‐Yang Wang
Journal: Hepatology (2014)

Liver disease is a major cause of illness and death worldwide. In China alone, liver diseases, primarily viral hepatitis (predominantly hepatitis B virus [HBV]), nonalcoholic fatty liver disease, and alcoholic liver disease, affect approximately 300 million people. The establishment of the Expanded Program on Immunization in 1992 has resulted in a substantial decline in the number of newly HBV-infected patients; however, the number of patients with alcoholic and nonalcoholic fatty liver diseases is rising at an alarming rate. Liver cancer, one of the most deadly cancers, is the second-most common cancer in China. Approximately 383,000 people die from liver cancer every year in China, which accounts for 51% of the deaths from liver cancer worldwide. Over the past 10 years, China has made some significant efforts to shed its "leader in liver diseases" title by investing large amounts of money in funding research, vaccines, and drug development for liver diseases and by recruiting many Western-trained hepatologists and scientists. Over the last two decades, hepatologists and scientists in China have made significant improvements in liver disease prevention, diagnosis, management, and therapy. They have been very active in liver disease research, as shown by the dramatic increase in the number of publications in Hepatology. Nevertheless, many challenges remain that must be tackled collaboratively. In this review, we discuss the epidemiology and characteristics of liver diseases and liver-related research in China. (Hepatology 2014;60:2098–2107)
Spread of Stenotrophomonas maltophilia colonization in a pediatric intensive care unit detected by monitoring tracheal bacterial carriage and molecular typing
Authors: P. Lanotte, S. Cantagrel, L. Mereghetti, S. Marchand, N. Van der Mee, J.M. Besnier, J. Laugier, R. Quentin
Journal: Clinical Microbiology and Infection (2003)
Pulmonary metastases of stage IIB extremity osteosarcoma and subsequent pulmonary metastases.
Authors: W G Ward, K Mikaelian, F Dorey, J M Mirra, A Sassoon, E C Holmes, F R Eilber, J J Eckardt
Journal: Journal of Clinical Oncology (1994)

This study investigated prognostic factors in nonmetastatic high-grade extremity osteosarcoma and the prognosis following resection of subsequent pulmonary metastases, with emphasis on the effect of chemotherapy-induced tumor necrosis.We reviewed 111 consecutive patients with high-grade nonmetastatic extremity osteosarcoma treated with preoperative chemotherapy and surgical resection, with additional review of 36 patients who had subsequent pulmonary metastases resected.The overall 5-year survival rate was 53%. In resected primary tumors, tumor-free resection margin (P < .001) and increasing chemotherapy-induced tumor necrosis (> 90% threshold, P < .003) correlated with increased metastasis-free survival. Relative risk factors for metastases were as follows: tumor-containing resection margin (most likely to metastasize); poor response to preoperative chemotherapy and/or lack of postoperative chemotherapy (next worse prognosis); and excellent response to preoperative chemotherapy (> or = 90% necrosis) combined with postoperative chemotherapy (best prognosis). The 5-year survival rate following pulmonary metastasis resection was 23%, whereas a 0% 4-year survival rate followed development of bony metastases (P < .001). The extent of tumor necrosis in resected pulmonary metastases did not affect prognosis. Survival was best in patients with three or fewer pulmonary nodules (P < .048), four or fewer recurrent pulmonary nodules (P < .047), unilateral pulmonary metastases (P < .037), or longer intervals between primary tumor resection and metastases (P < .082).Intensive preoperative and postoperative chemotherapy combined with complete resection of both primary and metastatic pulmonary osteosarcomas is justified, with a goal of 100% tumor necrosis and excision. Although current treatment regimens allow effective salvage therapy for a few patients with pulmonary metastases, more effective systemic treatment is needed.