tbuckley/cabot-search huggingface dataset:
Reorganizing Adult Critical Care Delivery
Authors: Yên-Lan Nguyen, Jeremy M. Kahn, Derek C. Angus
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Variation in the quality of critical care services across hospitals coupled with an emerging workforce crisis necessitates system-level change in the organization of intensive care. In this review, we evaluate three alternative organizational models that may expand access to high-quality critical care: tiered regionalization, intensive care unit telemedicine, and quality improvement through regional outreach. These models share a potential to increase survival and reduce costs. Yet there are also major barriers to implementation, including the lack of a strong evidence base and the need for significant upfront financial investment. Reorganization of intensive care will also require the support of all involved stakeholders: patients and their families, critical care practitioners, administrative and public health professionals, and policy makers. To varying degrees these models require a central authority to implement and regulate the system, as well as specific legislation, investment in information technology, and financial incentives for providers. The existing evidence does not strongly support exclusive use of a particular model, and creation of a hybrid model that integrates the three complementary approaches is a practical option. A potential framework for implementation involves triage guidelines developed by professional societies leading to demonstration projects and national legislation in support of optimal systems. Additional research is needed to determine the comparative effectiveness and cost implications of these approaches, with a goal of best matching high-quality critical care to patients' needs and professional preferences at the hospital, regional, and national level.
Glutamine treatment of paclitaxel-induced myalgias and arthralgias.
Authors: D Savarese, J Boucher, B Corey
Journal: Journal of Clinical Oncology (1998)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1998.16.12.3918 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 9850043 Glutamine treatment of paclitaxel-induced myalgias and arthralgias. D SavaresexD SavareseSearch for articles by this author , J BoucherxJ BoucherSearch for articles by this author , B CoreyxB CoreySearch for articles by this author https://doi.org/10.1200/JCO.1998.16.12.3918 First Page PDF © 1998 by American Society of Clinical Oncology
Anti-inflammatory Intervention in Depression—Reply
Authors: Ole Köhler, Michael Eriksen Benros, Jesper Krogh
Journal: JAMA Psychiatry (2015)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Psychiatry HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Psychiatry journal
Glutamate-Mediated Respiration in Tumors2
Authors: David H. Regan, Beverly B. Lavietes, Martha G. Regan, Harry B. Demopoulos, Harold P. Morris
Journal: JNCI Journal of the National Cancer Institute (1973)

Fluoropyruvate (FP), a pyruvate analog, and vinblastine (VLB), an oncolytîc vinca alkaloid, inhibited oxygen (O2) uptake in sarcoma 180 and 3 Morris hepatoma lines. Glutamate, which inhibits the oncolytic effects of VLB, prevented the effect on O2 uptake when added simultaneously with VLB. Glutamate also mitigated the effects of FP at low concentrations (≤5 mM), concentrations which inhibit pyruvate oxidation and reduction. At higher concentrations where FP also inhibited α-ketogIutarate oxidation, glutamate failed to prevent inhibition of O2 consumption. VLB did not inhibit respiration of normal mouse liver or spleen, and FP inhibition of respiration of mouse liver, spleen, and skeletal muscle was not reversed by glutamate. These data suggest that glutamate may be oxidized in place of pyruvate in the citric acid cycle of these tumors and is vital to their respiration.
Non invasive home ventilation (NIHV) in chronic obstructive pulmonary disease (COPD): Impact on hospital admission rates and length of stay
Authors: Simon Richards, Harman Saman, Marie Packer, Jodie Hunt, Syed Huq, Shyam Madathil
Journal: European Respiratory Journal (2014)

Introduction: There is a lack of sufficient data in the utility of NIHV in patients with COPD and chronic hypercapinic respiratory failure (1). Furthermore, its impact on hospital admission rates and length of stay are unknown.  Methods: An observational single centre, retrospective study of all COPD patients commenced on NIHV between January 2002 and July 2013.  Results: NIHV was started in 42 patients (47% male, 48% current smokers) who had a least one admission with hypercapnic respiratory failure. The mean (range) age was 65 (55-82) years with a mean (SD) FEV1 of 38 (15) % predicted. In the year preceding commencement of NIHV, 74% of patients were admitted at least once, with a mean (range) number of admissions of 1.44 (0-10) and mean (range) duration of stay of 12.7 (3-24) days. In the year following commencement of NIHV, 48% of patients were admitted at least once. The mean (range) number of admissions was reduced to 1.24 (0-10) (p=0.62) and the mean (range) duration of stay to 8.65 (2-24) days (p  Discussion: This study demonstrated a significant reduction in length of stay in our cohort of selected COPD patients following commencement of NIHV. This suggests that NIHV in COPD may have a significant role in reducing the use of precious secondary care resources. Further prospective studies are required to examine the cost effectiveness of NIHV in COPD.  Reference:  1- McEvoy et al. Thorax 2009, Nocturnal non-invasive nasal ventilation in stable hypercapnic COPD: a randomised controlled trial.
Mouse Skin Tumorigenesis and Induction of Aryl Hydrocarbon Hydroxylase by Tobacco Smoke Fractions&lt;xref ref-type="fn" rid="fn2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="fn3"&gt;3&lt;/xref&gt;
Authors: F J Akin, W J Chamberlain, O T Chortyk
Journal: JNCI Journal of the National Cancer Institute (1975)

Ten fractions separated from the neutral portion of cigarette smoke condensate (CSC) were tested on mouse skin for tumor-initiating activity and for their capacity to induce the enzyme aryl hydrocarbon hydroxylase (AHH). Tumor-initiating activity was confined primarily to the fraction containing more than 90% of the polynuclear aromatic hydrocarbons (PAH) in CSC. One other PAH-containing fraction was active. The combined initiating effect of these fractions was comparable to that of a 40-ppm solution of benzo[a]pyrene (BP), which is about 40 times the BP content of CSC. Some of the neutral fractions that have been demonstrated to cause tumor promotion in mice pretreated with 7,12-dimethylbenz-[aA1ANTHRACENE sere inactive as tumor initiators. The fractions that contained aromatic hydrocarbons induced mouse skin AHH levels twofold to sixfold after a single topical application. AHH-inducing activity was not, however, a reliable indicator of the carcinogenic potential of a fraction.
Transparent-Chamber Studies of Vessels, Circulation, and Follicles in Thyroid Grafts in Unanesthetized Mice
Authors: Ruth M. Merwin, Seymour H. Wollman
Journal: JNCI Journal of the National Cancer Institute (1965)

This investigation was made to obtain quantitative measurements of follicles and microcirculation in thyroid tissue in vivo. Grafts of mouse thyroid tissue placed in dorsal skin folds were observed with a microscope through glass windows. During periods of observations lasting several weeks, we detected no changes in the grafts in vascular patterns or in size or shape of the follicles. The average follicle diameter was 59 µ, with a standard deviation of 30 µ. Most follicles were supplied by several capillaries. The blood flow in these capillaries was intermittent and in many was asynchronous because capillaries arose from different arterioles with different vasomotor cycles. The capillary pathway for any one corpuscle from arteriole to venule averaged 155 µ in length, with a standard deviation of 44 µ. Most pathways anastomosed with others or had one or two branches. A typical pathway went by two to four follicles, that is, one or two follicles on each side of the capillary. Blood flow in capillaries in which the red cells passed in single file was recorded by the use of cinemi-crography. The velocity of flow, based on the frequency distribution of velocities during vasomotor cycles, averaged 109 µ per second, with a standard deviation of 47 µ per second. The average transit time for a red cell in a capillary was 1.4 seconds. Analysis of transit times indicates that most radioiodide in the red cell is not available during its passage through the thyroid tissue.
Epidemiology of candidaemia and antifungal susceptibility patterns in an Italian tertiary-care hospital
Authors: A. Bedini, C. Venturelli, C. Mussini, G. Guaraldi, M. Codeluppi, V. Borghi, F. Rumpianesi, F. Barchiesi, R. Esposito
Journal: Clinical Microbiology and Infection (2006)
Echocardiographic abnormalities following cardiac radiation.
Authors: D J Perrault, M Levy, J D Herman, R J Burns, B Z Bar Shlomo, M N Druck, W Q Wu, P R McLaughlin, B W Gilbert
Journal: Journal of Clinical Oncology (1985)

Five years or more after receiving cardiac radiation, 41 patients with Hodgkin's disease and seminoma in remission were subjected to echocardiography. The abnormalities detected included pericardial thickening in 70%, thickening of the aortic and/or mitral valves in 28%, right ventricular dilatation or hypokinesis in 39%, and left ventricular dysfunction in 39%. In the 23 patients treated by an upper mantle technique with shielding, the incidence of right ventricular abnormalities and valvular thickening was significantly lower than in patients treated with modified techniques. Although no symptoms were attributable to the observed abnormalities, longer follow-up time may reveal important functional implications.
Randomized study of recombinant human granulocyte colony-stimulating factor after high-dose chemotherapy and autologous bone marrow transplantation for high-risk lymphoid malignancies.
Authors: R A Stahel, L M Jost, T Cerny, G Pichert, H Honegger, A Tobler, E Jacky, M Fey, E Platzer
Journal: Journal of Clinical Oncology (1994)

PURPOSE The aim of this prospective randomized trial was to examine the efficacy and safety of filgrastim after high-dose chemotherapy and autologous bone marrow transplantation (ABMT). PATIENTS AND METHODS Patients with poor-risk non-Hodgkin's lymphoma or relapsed Hodgkin's disease were treated in a randomized, open-label trial to study the use of filgrastim as an adjunct to high-dose chemotherapy and ABMT. Of 43 assessable patients, 19 were randomized to receive filgrastim by continuous subcutaneous infusion at a dose of 10 micrograms/kg/d, 10 to filgrastim 20 micrograms/kg/d, and 14 to a parallel control group that received no filgrastim after ABMT. RESULTS For all filgrastim-treated patients analyzed together, the median time to neutrophil recovery &gt; or = 0.5 x 10(9)/L after the day of ABMT was significantly accelerated to 10 days compared with 18 days in control patients (P = .0001). The median number of platelet transfusions was identical in both groups. Clinical parameters, including the median number of days with fever (1 v 4, P = .0418) and neutropenic fever (5 v 13.5, P = .0001) were significantly shorter in the filgrastim than in the control group. The number of days on intravenous antibiotics and duration of hospitalization were also shorter in the treated groups; however, the differences did not reach statistical significance. For patients treated with the two different dose levels of filgrastim, the neutrophil recovery and clinical results were similar. Filgrastim-associated toxicity appeared to be minimal, with five adverse events considered at least possibly related to filgrastim: two in the higher-dose group and three in the lower-dose group. All of these were rated moderate, except one case of severe bone pain that did not preclude continued filgrastim treatment at a lower dose. Survival and relapse-free survival were similar for control and filgrastim-treated patients. CONCLUSION Taken together, the results of this first randomized study support the role of filgrastim given as an adjunct to ABMT in accelerating neutrophil recovery, as well as in reducing treatment-related morbidity and overall duration of the treatment procedure.
Non-small cell lung carcinoma-advanced disease (NSCLC-AD): Effectiveness of subsequent therapeutic lines and predictive factors of poor outcome
Authors: Lígia Fernandes, Inês Sanches, Catarina Ferreira, Ana Figueiredo, Fernando Barata
Journal: European Respiratory Journal (2012)

Five years observational study (2006-2010) of a cohort of patients with NSCLC-AD (1st line monotherapy excluded). Epidemiology, histology,  performance status  (PS), therapy, response – disease control (DC) or progression (n-DC), progression free survival (PFS) and overall survival (OS) after each therapy were evaluated. We also tried to assess predictors for DC and OS.   Results:  We included 276 patients, 77.9% men, mean age 63.1 years (±10.9), most of them smokers (36.6%) with PS 1 (89.1%). The most frequent histology was adenocarcinoma (59.8%). Metastasis in 1, 2 or 3 organs was found in 65.2%, 31.2% and 3.6% of the patients. All patients were initially treated with a platinum-based duplet; Pemetrexed or Erlotinib were the most used in 2 nd -line setting (53,9% of the patients) and Erlotinib in 3 rd  (15.6% of the patients). There was a progressive reduction of the DC rate along the 3 lines- 71.7%, 67.1% and 51.2%. The median PFS and OS for each line were: 1st- 4.53M ± 0.22 and 10.12M ± 0.55, 2nd- 4.17M ± 0.21 and 9.1M ± 0.66, 3rd- 4.47M ± 0.68 and 10.42M ± 3.35. Prognostic factors were: smoking status ( HR  1.54,  p-value 0.016 ), the presence of metastasis> 1 organ ( HR  1.50,  p-value  0.003), PS2 ( HR  3.62,  p-value  HR  2.71,  p-value  p-value > 0.05), but the PFS after 1st line correlates with the following PFS ( p-value  0.001).   Conclusions:  There is an increase in OS and PFS in the 3rd line, probably reflecting the influence of new biological treatments. Strong predictors for a poor outcome were PS 2 and n-DC after 1st line.
Investigation of the Relationship Between Breast Cancer and Transient Receptor Potential (Trp) Genes
Authors: Mehmet E. Kalender, Serdar Oztuzcu, Mustafa Ulasli, Ali Suner, Beyhan Cengiz, Esma Ozkara, Yusuf Z. Igci, Ahmet Arslan, Hakan Buyukhatipoglu, Celaletdin Camci
Journal: Annals of Oncology (2014)
The Second Medical Research Council study of prognostic factors in nonseminomatous germ cell tumors. Medical Research Council Testicular Tumour Working Party.
Authors: G M Mead, S P Stenning, M C Parkinson, A Horwich, S D Fossa, P M Wilkinson, S B Kaye, E S Newlands, P A Cook
Journal: Journal of Clinical Oncology (1992)

PURPOSE To assess prognostic factors in a large population of patients with metastatic nonseminomatous germ cell tumors (NSGCT) arising in gonadal or extragonadal sites. PATIENTS AND METHODS Data from 795 patients treated with chemotherapy between 1982 and 1986 in 13 centers were analyzed. Particular emphasis was placed on exact tumor measurements (eg, size of nodal masses, number of lung metastases), and the diagnostic pathology was also reviewed. Cox regression analysis was performed on these data. The patients were treated with a variety of cisplatin-containing chemotherapy regimens, 86% of which included etoposide. RESULTS With median follow-up of 45 months, overall 3-year survival is 85%. The independently adverse features proved to be (1) the presence of liver, bone, or brain metastases; (2) raised marker levels (alpha-fetoprotein [AFP] level greater than 1,000 kU/L or beta subunit of human chorionic gonadotropin [HCG] greater than 10,000 IU/L [corrected]); (3) the presence of a mediastinal mass greater than 5 cm in diameter; (4) the presence of 20 or more lung metastases; (5) increasing age; and (6) absence of undifferentiated teratoma (embryonal carcinoma) or fibrous tissue from the primary tumor. CONCLUSIONS The first four factors were used to define a simple prognostic classification. A good-prognosis group having none of these features comprised 67% of our patient population and had a 3-year survival of 93%. The remaining 33% of patients having at least one of these features had a 3-year survival rate of 68%. These patient groups are currently the subjects of international randomized clinical trials.
Assessment of tracheal tube biofilm translocation during mechanical ventilation and lung injury
Authors: Gianluigi Li Bassi, Laia Fernández-Barat, Joan Daniel Martí, Montserrat Rigol, Lina María Saucedo, Valeria Giunta, Mariano Esperatti, Néstor Luque, Ignasi Roca, Laura Muñoz, Miquel Ferrer, Jordi Vila, Francesco Blasi, Antoni Torres
Journal: European Respiratory Journal (2011)

Introduction:  The role of bacterial biofilm, within the endotracheal tube (ETT), in the pathogenesis of respiratory infections is still under debate   Objectives:  To study effects of length of stay under mechanical ventilation (MV) on bacterial biofilm translocation from within the ETT into health and injured lungs   Methods:  ETTs colonized by biofilm were obtained from an associated study where pigs underwent oropharyngeal bacterial challenge by  Pseudomonas Aeruginosa  (PA) and 72h MV. Those ETTs were used in 8 healthy pigs (32.1±2.5 kg) on MV (V T  8ml/kg, PEEP 0, RR adjusted based on pH, T I /T TOT  0.25). Pigs were randomized into 4 groups (2 pigs/group) to be MV up to 24h (Group1), 48h (Group2), 72h (Group3) and 48h with lung injury caused by oleic acid (OA) (Group4). Upon autopsy, 4 samples from trachea and main bronchi and 7 from segmental bronchi were excised for PA quantification   Results:  In pigs of group 3, 1 hour after OA instillation, PaO 2 /FiO 2  decreased to 189.8±27.7. Upon extubation, ETT PA colonization was 5.7±1.6, 6.4±0.5, 6.7±0.5 and 7.6±0.6 log cfu/cm in groups 1-4, respectively (p=0.21). As depicted in figure 1, the airway tissue/ETT PA colonization ratio of trachea and main bronchi was 0.59±0.37. Colonization of segmental bronchi was infrequent.   Conclusions:  Bacteria from within the ETT PA biofilm rapidly translocate up to the main bronchi, however distal colonization is uncommon even when lung are injured.
Promotional effect of 27-hydroxycholesterol in the release of matrix metalloproteinases by lung fibroblasts
Authors: Takashi Kikuchi, Hisatoshi Sugiura, Tomohiro Ichikawa, Akira Koarai, Masakazu Ichinose
Journal: European Respiratory Journal (2013)

(Rationale) 27-Hydroxycholesterol (27-OHC) has been reported to have inflammatory effects on several types of cells such as endothelial cells and neuronal cells. Recent studies also have demonstrated that 27-OHC was related to the pathogenesis of some degenerative disorders such as Alzheimer’s disease and age-related macular degeneration. Previously, we reported that 27-OHC increased in the airways of chronic obstructive pulmonary disease (COPD) and was involved in airway fibrosis. However, the effect of 27-OHC in the release of matrix metalloproteinases (MMPs) which are key mediators in the pathogenesis of COPD remains unknown. In the current study, we examined the possible role of 27-OHC in the release of MMPs by lung fibroblasts.  (Methods) We treated human fetal lung fibroblasts (HFL-1) with various concentrations of 27-OHC. The release of MMP-2 and MMP-9 were assessed by gelatin zymography. To explore its signal transduction, we evaluated the transforming growth factor (TGF)-β 1  release by ELISA and the translocation of nuclear factor-kappa B (NF-κB) p65 by western blot.  (Results) 27-OHC augmented the release of MMP-2 and MMP-9 through the translocation of NF-κB p65 and subsequent TGF-β 1  up-regulation. Caffeic acid phenethyl ester (CAPE) which is a novel NF-κB inhibitor inhibited the 27-OHC-augmented total TGF-β 1  release and neutralizing anti-TGF-β antibody inhibited the 27-OHC-augmented MMPs release.  (Conclusion) These results suggest that 27-OHC has the promotional effect in the release of matrix metalloproteinases and may be involved in the pathogenesis of COPD in this regard.
Two-year follow up with patients treated with Zephyr valves over 10 years: Focus on safety
Authors: Hugo Oliveira, Rafael Rambo, Silvia Oliveira, Amarilio Macedo-Neto
Journal: European Respiratory Journal (2014)

Background:  Endoscopic lung volume reduction (LVR) has become a therapeutic option for selected patients with advanced emphysema. Nevertheless, little is known about the long-term side effects of this treatment.  Aim:  To describe long-term follow-up of patients treated with Zephyr valves for emphysema and air leak.  Methods:  We retrospectively analyzed 84 treatments performed between June 4, 2002 and February 20, 2012 using Zephyr valves in 63 patients.  Results:  Four patients received valves for prolonged air leak and 59 for end-stage emphysema. In the emphysema group, 6 patients received a second treatment (contralateral) and 8 were treated using a staged approach. Of a total of 198 valves implanted, 26 were removed and 4 extruded in 16 patients. Three patients were retreated for dislodgment (1 twice) and 3 were retreated after valve removal due to infection. Treatment was completely reversed in 5 patients. Treatment was partially reversed due to pneumothorax in 2 patients. By February 20,2014, 43 patients had died (median survival 883 days). Sixteen are alive (median survival 1,286 days). All side effects associated with valve implantation were endoscopically managed. Figure 1 shows a 967 days endoscopic follow-up of a Zephyr valve.   Conclusions:  LVR with Zephyr valves is a safe procedure with reasonable performance at long follow-up. Selection criteria remain as the main challenge for applicability of this method.