tbuckley/cabot-search huggingface dataset:
Abstract 1539: Benefits of Chronic Exercise Training on Aerobic Capacity and NT-proBNP Plasma Levels in Patients With Ventricular Assist Devices
Authors: Ioannis D Laoutaris, Athanasios Dritsas, Stamatis Adamopoulos, Athanassios Manginas, Aggeliki Gouziouta, Maria Koulopoulou, Petros Sfirakis, Vassilis Voudris, Dennis V Cokkinos, Peter A Alivizatos
Journal: Circulation (2009)

Introduction: Patients supported with ventricular assist devices are increasing and tend to stay longer on mechanical support. Studies show a maximal benefit on aerobic capacity 12 weeks post-impla...
How does obesity correlate with severe asthma
Authors: David Gibeon, Winston Banya, Hofmann Markus, Regan Suzanne, Pankaj Bhavsar, Kian Fan Chung, Andrew Menzies-Gow
Journal: European Respiratory Journal (2011)

Introduction:  10% of asthmatics have refractory disease. Cluster analysis has identified that BMI is a factor in defining phenotypes of severe asthma [1]. Obesity antedates asthma diagnosis [2], suggesting that obesity has a pathophysiological role.  Last year we reported the outcome of 115 patients with severe, treatment refractory asthma (ATS, 2000). This study looks at data from 374 patients from 4 UK centres, collected as part of the National Registry for dedicated UK Difficult Asthma Services.   Methods:  Patients were divided into three groups by BMI: 18.5 to 24.99, 25 to 29.99 (overweight), and ≥30 (obese).   Results:  The table below highlights demographic data, lung function, steroid use and bone density between groups.   Conclusion:  Severe asthmatics are more likely to be female although this does not appear to correlate to BMI. Raised BMI is associated with more GORD, greater use of PPI9s, increased KCO, but a reduction in aspirin sensitivity, and appears to be protective against osteoporosis at the neck of femur.   References:   1Moore W, et al. Identification of asthma phenotypes using cluster analysis in the severe asthma research program. AJCCM 2009 epub ahead of print.  2Shore SA. Obesity and asthma: cause for concern. Current Opinion in Pharmacology 2006;6:230-236.
MIF/CD74 contributes to the endothelial pro-inflammatory phenotype in pulmonary arterial hypertension
Authors: Ly Tu, Morane Le Hiress, Nicolas Ricard, Carole Phan, Andrei Seferian, Barbara Girerd, Elie Fadel, Frances de Man, Gael Jalce, David Montani, Gerald Simonneau, Marc Humbert, Alice Huertas, Christophe Guignabert
Journal: European Respiratory Journal (2013)

Rationale:   Inflammation and endothelial dysfunction are considered two primary instigators of pulmonary arterial hypertension (PAH). CD74 is a receptor for the cytokine macrophage migration-inhibitory factor (MIF). This ligand/receptor complex initiates survival pathways and cell proliferation, triggers the synthesis/secretion of major pro-inflammatory factors and cell adhesion molecules.   Objectives:   We hypothesized that MIF and endothelial-CD74 are over-expressed and over-activated in PAH and contributes to pulmonary endothelial cells (P-ECs) pro-inflammatory phenotype.   Results:   Circulating MIF levels is increased in serum of idiopathic PAH (iPAH) patients as compared to controls and T-cells lymphocytes represent a cause of this overabundance. In addition, CD74 is highly expressed in the endothelium of muscularized distal pulmonary arteries as well as in cultured P-ECs from iPAH and contributes to an exaggerated recruitment of PBMC to P-EC in iPAH. Over-activation of CD74 by MIF induces production of interleukin (IL)-6 and monocyte chemoattractant protein (MCP)-1 and causes an increase in intercellular adhesion molecule (ICAM)-1 protein level. These effects are partially abolishes in presence of the selective MIF antagonist ISO-1. Finally, we found that daily treatment of rats with ISO-1 for 2 weeks started 2 weeks after a subcutaneous monocrotaline injection partially reverses development of pulmonary hypertension and this is associated with decreased of IL-6, MCP-1 and inflammatory cell infiltration.   Conclusions:   We report here that CD74 and MIF are markedly increased and activated from iPAH patients and contribute to the abnormal pro-inflammatory phenotype of P-EC in PAH.
Increased Thrombin Activity after Allergen Challenge
Authors: Masaki Terada, Elizabeth A. B. Kelly, Nizar N. Jarjour
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

In addition to its central role in hemostasis, thrombin may play a role in inflammation and remodeling. To investigate the contribution of thrombin to allergic airway inflammation in asthma, we used an enzymatic assay to determine thrombin activity in bronchoalveolar lavage fluid obtained from 19 subjects with atopic asthma before (Day 0) and 48 hours after (Day 2) segmental bronchoprovocation with antigen. Thrombin activity increased from 0 (0, 2.9) on Day 1 to 41.1 (0.3, 75.6) U x 10(-3)/ml on Day 2 (p = 0.002) and correlated with total protein levels in lavage fluid on Day 2 (r = 0.885, p < 0.001). After antigen challenge, thrombin activity also showed significant correlations with interleukin-5 (r = 0.66, p = 0.002), transforming growth factor beta1 (r = 0.70, p < 0.001), fibronectin (r = 0.85, p < 0.001) and tissue factor (r = 0.55, p = 0.03) levels in lavage fluid. Furthermore, Day 2, but not Day 0 lavage fluid, induced proliferation of human airway fibroblasts. This mitogenic effect was significantly reduced with hirudin, a specific thrombin inhibitor. Taken together, our findings suggest that allergen-driven airway inflammation in asthma is associated with enhanced potential for fibroblast proliferation that is related, at least in part, to increased thrombin activity. We propose that enhanced thrombin activity provides a potential link between allergic inflammation and initiation of airway remodeling.
The effect of treatment duration by inhaled glucocorticosteroids, on "cough variant asthma" in children
Authors: Mehdi Alizadeh, Leila Ghasemi
Journal: European Respiratory Journal (2013)

National Asthma Education and Prevention Program has recommended that: “CVA (cough variant asthma) treatment should follow the stepwise approach to long-term management of asthma.” This leads us to deal with CVA, as same as the asthma, and any patient enter to this approach, must use at least 3 months ICS (inhaled glucocorticosteroids). The aim is to examine, is there any significant changes in the outcome of CVA by changing duration of treatment with ICS. Based on inclusion criteria (children 2-12 years with chronic cough as the only symptom and sign of asthma) and exclusion criteria (any signs and symptoms of other diseases that can cause chronic cough other than asthma) 250 children entered in the study and followed for 1 year. Patients randomly allocated in 2 groups (one group treated for 1 month and the other for 3 months). 212 children (130 male and 82 female) completed the study and there was no significant difference in mean age and sex ratio between 2 groups. Patients who received 1 month treatment (113 patients), cough control ratio was 69.7 % and mean time to next episode of chronic cough was 168.8 days. Patients who received 3 months treatment (99 patients) cough control ratio was 78.8 % and mean time to next episode was 180.6 days. There were no significant difference in Cough control ratio (P value = 0.09) and cough free time until next episode of chronic cough (P value = 0.4) between 2 groups. Developing wheezy asthma after 1 year were 6.3% between patients who treated for 1 month and 9% in other group (P value=0.8). Increasing CVA treatment time from 1 month to 3 months, with low dose ICS does not alter the cough control ratio and cough free time.
High bone density increases risk of breast cancer
Authors: Scott Gottlieb
Journal: BMJ (2001)

Older women with high bone density are about twice as likely to develop breast cancer, a new study has found.

These results add to existing evidence that suggests that older women who have low bone mass have a decreased risk of breast cancer and, conversely, that higher bone density is associated with increased risk of breast cancer.

Bone mineral density can be an accurate marker of the body's response to oestrogen, in that women with higher bone density are thought to be physiologically more sensitive to the hormone's effects than women with lower bone density.

Because oestrogens have also been …
The Epworth sleepiness score should not be used to screen out patients with suspected sleep-breathing disorders
Authors: Sara Neale, Adrian H. Kendrick
Journal: European Respiratory Journal (2012)

The Epworth Sleepiness Score (ESS) is used to assess the level of daytime sleepiness as perceived by the patient. In some centres and in primary care, the ESS is used to reduce the number of referrals for suspected sleep-breathing disorders (SBD), where an ESS is within normal range (≤10).   Aim : To determine the limitations of using ESS to screen patients with suspected SBD.   Methods : 150 consecutively referred patients were given an ESS and had 2 nights of oximetry at home (Minolta 300i). The oximetry data was analysed using Download 2001 (Stowood Scientific,UK) for 4% dips/hr and an Δindex cut-off of >0.6. Data is given as median (range). The highest dips/hr and Δindex was used in the analysis from either night.   Results : 130 patients had usable data; 39F and 91M, aged 50 yrs (19-79), ESS - 11.5 (1–23), 4% dips/hr - 4.8 (0.3-119) and 6.2 (0.1-118), and Δindex - 0.57 (0.2-5.6) and 0.63 (0.2-10.9) on the 2 nights respectively. There was no correlation between ESS and oximetry indices.  25/130 (19%) had a normal 4% dips/hr and 20/130 (15%) had a normal Δindex in with a normal ESS of ≤10. 27/130 (21%) had a normal 4% dips/hr with an ESS>10.   Conclusion : The ESS, within limitations, is a guide as to whether daytime sleepiness is present. It should not be used to reduce referrals for assessment of suspected SBD, but as part of a screening assessment using oximetry and a good clinical history. The reasons why patients have a high ESS in the absence of a significant SBD requires further investigation.
Outcomes after use of two standard ablative regimens in patients with refractory acute myeloid leukaemia: a retrospective, multicentre, registry analysis
Authors: Arnon Nagler, Bipin N Savani, Myriam Labopin, Emmanuelle Polge, Jakob Passweg, Jürgen Finke, Slawomira Kyrcz-Krzemien, Liisa Volin, Achilles Anagnostopoulos, Mahmoud Aljurf, Dietrich W Beelen, Stephane Vigouroux, Noel Milpied, Felipe Suarez, Mohamad Mohty
Journal: The Lancet Haematology (2015)
Extended continuous infusion low-dose recombinant interleukin-2 in advanced cancer: prolonged immunomodulation without significant toxicity.
Authors: M A Caligiuri, C Murray, R J Soiffer, T R Klumpp, M Seiden, K Cochran, C Cameron, C Ish, L Buchanan, D Perillo
Journal: Journal of Clinical Oncology (1991)

In previous clinical trials, recombinant interleukin-2 (rIL-2) has been infused at high doses over short periods of time to generate lymphokine-activated killer (LAK) cells in vivo. These trials have been limited by severe toxicities, and the immunologic effects of rIL-2 have been transient. The present study was designed to assess the toxicity and immunologic effects of prolonged administration of low doses of rIL-2. In this phase I study, patients with advanced cancer were scheduled to receive intravenous (IV) infusion of rIL-2 without interruption for 3 months in an outpatient setting. Twenty-one patients received rIL-2 at doses ranging from 0.5 x 10(5) to 6.0 x 10(5) U/m2/d. Treatment was extremely well tolerated, and no patient experienced grade 3 or grade 4 toxicity. The lowest dose level (0.5 x 10(5) U/m2/d) did not have demonstrable immunologic activity. At doses of 1.5 x 10(5) and 4.5 x 10(5) U/m2/d, rIL-2 infusion resulted in the specific expansion of natural-killer (NK) cells (sixfold and ninefold increases, respectively, at these two dose levels) without any changes in B cells, T cells, neutrophils, or monocytes. Grade 2 toxicity was observed at the dose of 6.0 x 10(5) U/m2/d, as three patients required interruption of therapy and two patients who completed therapy developed transient hypothyroidism. In patients with increased NK cells, enhancement of non-major histocompatibility complex (MHC)-restricted cytotoxicity and increased generation of LAK cells in vitro were also demonstrated. Therapy with low-dose rIL-2 can be given safely in an uninterrupted fashion for prolonged periods of time in an outpatient setting. This results in selective expansion of NK cells in vivo with minimal toxicity. Further investigation of this schedule for immunomodulation in vivo should be pursued in phase II studies of both malignant and immunodeficient disease states.
The future of rehabilitation
Authors: L. McLellan
Journal: BMJ (2002)

Editor—Greenwood's editorial on the future of rehabilitation is a welcome sign that British neurologists have accepted restorative neurology as part of their discipline.1 But it suggests that their grasp of what rehabilitation is, and their understanding of the range of objectives that rehabilitation medicine seeks to achieve, are still uncertain.

For disabled people whose impairments cannot be reversed, rehabilitation involves processes that are clearly distinct from biological recovery, including learning, the acquisition of new skills, and the changing of behaviour. This is the case for the many non-neurological causes of impairment as well as the neurological ones.

Greenwood suggests that neurologists are far more disposed to accept published evidence that rehabilitation works now that they are able to view physical changes in the brain that might be taking place concurrently with it. If this is true they are seriously confusing two kinds of evidence.

Scientific study of the acquisition of skills and of the processes that enhance or obstruct it is potentially valuable in increasing our understanding of the processes involved and predicting how we might best promote them. But the demonstration of brain mechanisms at work is not proof that rehabilitation has been achieved. Other and different scientific approaches are necessary for that. Furthermore, Greenwood makes no mention of the influence that changes in a person's environment (especially the behaviour of others) can have on the overall outcome of rehabilitation—the wellbeing and social participation of the subject, not simply the eradication of biological impairments.

Finally, Greenwood's carping at rehabilitation medicine as a discipline is surely unjustified. He seems to think that four months' training in rehabilitation medicine is ample to enable neurologists to practise it on their patients but that one year's training in neurology is not nearly enough to allow specialists in rehabilitation medicine to promote rehabilitation in those with neurological disorders.

The future of rehabilitation would look brighter if health professionals saw it as a scientific challenge in its own right to be met by interdisciplinary collaboration rather than as an opportunity for them to annexe clinical territory from others as soon as bits started to look interesting to them. Perhaps more neurologists could be prevailed on to attend meetings of the multidisciplinary Society for Research in Rehabilitation. There they could meet colleagues from the other disciplines already expert in this area, expand the old fashioned concepts of rehabilitation rehearsed in the editorial, and make a contribution to much needed progress in this important field.
Applicability of the global lung function initiative (GLI) reference ranges to spirometry data from children in Nepal
Authors: Delan Devakumar, Jane Kirkby, Dharma Manandhar, David Osrin, Bhim Shrestha, Shiva Shanker Chaube, Janet Stocks
Journal: European Respiratory Journal (2013)

Background  As lung function differs by ethnic group, the GLI recently produced all-age, multi-ethnic reference equations (Quanjer, ERJ 2012), but no specific equations exist yet for South Asian groups.  Aim  To ascertain whether any of the current ethnic-specific GLI equations are appropriate for use in children from southern Nepal.  Method  Spirometry was performed according to ATS/ERS standards, adjusted for children (Kirkby Ped pulm 2008) in 7-9yr olds participating in a follow-up of antenatal micronutrients. Results were interpreted using each of the GLI ethnic-specific equations, to ascertain best fit, based on the fact that mean(SD) spirometry z-scores in a healthy population should approximate 0(1).  Results  Spirometry was obtained from 841 children. Data were excluded due to acute illness (n=8), chronic illness (n=121) and poor technique (n=48), leaving data from 678 ‘healthy’ children (mean age 8.5yr; 51% boys). While use of the ‘Black’ GLI equation provided the best fit for FEV1 [mean(SD) 0.09(0.86) z score], the SE Asia equation was slightly better for FVC (Figure 1). The NE Asia and ‘Other’ equations were also assessed but were inappropriate. FEV1/FVC was interpreted appropriately using any of the ethnic specific equations, except SE Asia.  Conclusion  Until ethnic-specific GLI coefficients can be developed, use of the GLI-Black equations appear the most appropriate for Nepalese children.
Radiocurability of microscopic disease in childhood rhabdomyosarcoma with radiation doses less than 4,000 cGy.
Authors: L Mandell, F Ghavimi, T Peretz, M LaQuaglia, P Exelby
Journal: Journal of Clinical Oncology (1990)

In an attempt to evaluate the radiocurability of microscopic disease in childhood rhabdomyosarcoma (RMS) with total tumor doses of less than 4,000 cGy, we performed a retrospective analysis of all patients with microscopic residual RMS who were treated at the Memorial Sloan-Kettering Cancer Center (MSKCC) during the years 1970 to 1987. There were 32 patients ranging in age from 3 months to 22 years (median, 6 years) with microscopic residual of either (1) a localized primary tumor (MSKCC, stage IB; Intergroup Rhabdomyosarcoma Study [IRS] group IIA), 19 patients; or (2) an involved lymph node region with the primary tumor completely resected (MSKCC stage III; IRS group IIC), 13 patients. Twenty-nine of the 32 patients presented with embryonal histology. All patients were treated with combination chemotherapy (CT) and megavoltage external beam radiotherapy (RT). The RT was delivered in either conventional fractionation of 180 to 200 cGy daily (30 patients) or hyperfractionation of 150 cGy twice daily (two patients). Fifteen patients received RT doses of less than 4,000 cGy with a range of 3,000 to 3,600 cGy and a median value of 3,100 cGy; 17 patients received 4,000 cGy or more with a range of 4,000 to 6,000 cGy and a median value of 4,600 cGy. With a median follow-up of 11 years, the relapse-free survival was 25 of 32 patients (less than 4,000 cGy, 12 of 15; greater than or equal to 4,000 cGy, 13 of 17). The RT local control rate was 30 of 32 (less than 4,000 cGy, 14 of 15; greater than or equal to 4,000 cGy, 16 of 17 [P = .94]). Our results suggest that radiation doses of below 4,000 cGy, when combined with effective multiagent CT, may be sufficient for local control of microscopic disease in childhood embryonal RMS.
Abstract 1243: Impact of Glycemic Control on Cardiovascular Outcome in Diabetic Patients Undergoing Coronary Revascularization.
Authors: Natsuhiko Ehara, Takeshi Morimoto, Yutaka Furukawa, Satoshi Shizuta, Toshihiro Tamura, Makoto Kinoshita, Shigefumi Morioka, Yukikatsu Okada, Michihiro Nasu, Ryoji Taniguchi, Naoko Okamoto, Asuka Saeki, Satoshi Teramukai, Masanori Fukushima, Toru Kita, Takeshi Kimura, CREDO-Kyoto Investigators
Journal: Circulation (2008)
Insulin-induced hypoglycemia and panic attacks
Authors: E Schweizer, A Winokur, K Rickels
Journal: American Journal of Psychiatry (1986)

To investigate whether hypoglycemia might trigger panic attacks, the authors administered intravenous insulin to 10 patients with panic disorder. All subjects developed hypoglycemia but no panic anxiety. They reported symptoms of adrenergic hyperactivity but differentiated them from spontaneous panic attacks.
Effect of regional and systemic fluorinated pyrimidine chemotherapy on quality of life in colorectal liver metastasis patients.
Authors: S Earlam, C Glover, M Davies, C Fordy, T G Allen-Mersh
Journal: Journal of Clinical Oncology (1997)

PURPOSE Since systemic and regional (HAI) fluorinated pyrimidine chemotherapies offer similar survival benefit in treatment of colorectal liver metastases (CLM), we sought to identify their impact on quality of life (QoL), which might be a useful indicator of treatment preference. METHODS We compared QoL in 135 CLM patients managed by symptom control (n = 49 patients), systemic fluorouracil (5FU)/folinic acid (n = 35), or hepatic arterial floxuridine (FUDR) (n = 51). Full blood count and liver function tests, World Health Organization (WHO) toxicity criteria, and QoL (Rotterdam Symptom Checklist [RSC], the Sickness Impact Profile [SIP], and the Hospital Anxiety and Depression scale [HAD]) were measured monthly in all patients. RESULTS The HAD anxiety score was significantly increased in symptom control compared with chemotherapy patients 1 month after randomization. There was a significant increase in RSC physical score (repeated measures, P = .05), and in scores for sore mouth (P &lt; .01), dry mouth (P &lt; .01), and tingling hands and feet (P &lt; .01) in systemic chemotherapy compared with symptom control patients. Significant QoL differences (repeated measures and Mann-Whitney U [MWU]) between HAI and symptom control patients were not detected. Systemic chemotherapy patients lived for significantly longer (log-rank test, P &lt; or = .0001) with abnormal HAD anxiety, RSC psychosocial, or RSC sore mouth scores compared with HAI patients, but there were no overall survival differences. CONCLUSION Randomization to symptom control only was associated with increased anxiety. QoL with systemic chemotherapy was impaired by side effects. HAI was associated with similar survival to systemic chemotherapy but with better sustained QoL.
Drug-resistant tuberculosis.
Authors: R Long
Journal: BMJ (1981)

Globally the proportion of tuberculosis cases caused by drug-resistant strains is increasing. Interruptions in the drug supply, improper drug prescription and nonadherence to treatment protocols promote drug resistance through mechanisms that are now well understood. The treatment of tuberculosis must take into account the possibility of drug resistance and include at least 2 drugs, preferably 3, to which the isolate is proven or anticipated to be susceptible.