tbuckley/cabot-search huggingface dataset:
Consolidation chemoradiotherapy and autologous bone marrow transplantation versus continued chemotherapy for metastatic neuroblastoma: a report of two concurrent Children's Cancer Group studies.
Authors: D O Stram, K K Matthay, M O'Leary, C P Reynolds, G M Haase, J B Atkinson, G M Brodeur, R C Seeger
Journal: Journal of Clinical Oncology (1996)

PURPOSE To compare event-free survival (EFS) for patients with stage IV neuroblastoma who were treated with induction chemotherapy followed by additional courses of the same chemotherapy or by intensive chemoradiotherapy and autologous bone marrow transplantation (ABMT). METHODS Two hundred seven children who were diagnosed with stage IV neuroblastoma after 1 year of age were given five to seven courses of induction chemotherapy consisting of cisplatin, etoposide, doxorubicin, and cyclophosphamide (CCC-321-P2). This chemotherapy was continued for 13 total courses for some patients, whereas intensive chemoradiotherapy with ABMT was given to others (CCG-321-P3). The decision to continue chemotherapy versus to consolidate with chemoradiotherapy was not randomized but was made by parents and physicians. Marrow used for ABMT was purged ex vivo and was free of immunocytologically detectable neuroblastoma cells. RESULTS One hundred fifty-nine of 207 patients (77%) remained event-free during induction therapy. Of these, 67 received chemoradiotherapy/ABMT (CCG-321-P3) and 74 continued chemotherapy (CCG-321-P2). Using Cox regression analysis, the relative risk (RR) of an event after chemoradiotherapy/ABMT was estimated to be 58% of that for patients who continued chemotherapy (P = .01). Similarly, Kaplan-Meier analysis estimated EFS at four years for the chemoradiotherapy/ABMT and chemotherapy groups to be 40% and 19% respectively (P = .019). Subgroups appearing to benefit from chemoradiotherapy/ABMT were those with only a partial tumor response to induction chemotherapy (RR = 0.43; P = .008; EFS, 29% v 6%) and those whose tumors had amplification of the N-myc gene (RR = 0.26; P = .112; EFS, 67% v 0%). CONCLUSION Consolidation with intensive, myeloablative chemoradiotherapy followed by purged ABMT may be more effective than continuing chemotherapy for patients with stage IV neuroblastoma.
Richard Cenric Humphreys
Authors: D. Humphreys
Journal: BMJ (2015)

Born in Wales in 1924, Richard Cenric Humphreys (“Cen”) graduated in Edinburgh in 1946. After service in the Royal Army Medical Corps, spent mainly on troopships in the Middle East and Far East, he embarked on research into weight changes in pregnancy; this resulted in an MD with high commendation in 1953.

Having gone initially on a temporary basis in 1950 he stayed in Crickhowell until he retired in …
Designing a holding chamber mask using anthropometric data and CAD-simulation
Authors: Susanne Merk, Frank Kummer, Kay Behrenbruch, Anna Soderholm Labre
Journal: European Respiratory Journal (2011)

Background: A good seal is regarded as critical factor of face-masks for efficient inhaled drug delivery. Dead space, contour, flexibility and acceptance are also important.

Objectives: Evaluate anthropometric data and CAD-simulation to optimise face-masks for inhalation.

Methods: Basic anthropometric data of faces and heads from 32 children (age 1,1-3,5 yrs) were determined with measuring tape and calliper. Data were compared to existing literature data. Frontal and profile photos were taken with and without a mask prototype. Photogrammetry was used to generate a 3-D CAD-database comprising the anthropometric and mask related information. The complex interactions between face and mask were then simulated and geometric data for optimised mask design determined. In a subsample (n=8) of the study population, fit of the optimised masks was visually controlled.

Results: Basic anthropometric data of the sample population agreed well with literature values, proving the study population to be representative. CAD-simulation identified the 2D-tightness geometry as inappropriate and was changed to a 3D-shape with soft lip seals. Dead space could be minimised yet leaving enough space for the nose to keep the mask comfortable. Design according to the CAD-simulation led to an optimised fit of the face mask. Dimensions went very well with the children's face structures. Enclosure of mouth and nose were both collision-free and space-saving.

Conclusions: Complex interactions between face and mask could be successfully simulated with a CAD-database. This helped to design face masks (PARI SmartTouch ) which now allow for less leakage, more comfortable fit and minimised dead space - supporting efficient aerosol delivery.
Evaluating Risk Factors for Pediatric Post-extubation Upper Airway Obstruction Using a Physiology-based Tool
Authors: Robinder G. Khemani, Justin Hotz, Rica Morzov, Rutger Flink, Asavari Kamerkar, Patrick A. Ross, Christopher J. L. Newth
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Rationale: Subglottic edema is the most common cause of pediatric extubation failure, but few studies have confirmed risk factors or prevention strategies. This may be due to subjective assessment of stridor or inability to differentiate supraglottic from subglottic disease.Objectives: Objective 1 was to assess the utility of calibrated respiratory inductance plethysmography (RIP) and esophageal manometry to identify clinically significant post-extubation upper airway obstruction (UAO) and differentiate subglottic from supraglottic UAO. Objective 2 was to identify risk factors for subglottic UAO, stratified by cuffed versus uncuffed endotracheal tubes (ETTs).Methods: We conducted a single-center prospective study of children receiving mechanical ventilation. UAO was defined by inspiratory flow limitation (measured by RIP and esophageal manometry) and classified as subglottic or supraglottic based on airway maneuver response. Clinicians performed simultaneous blinded clinical UAO assessment at the bedside.Measurements and Main Results: A total of 409 children were included, 98 of whom had post-extubation UAO and 49 (12%) of whom were subglottic. The reintubation rate was 34 (8.3%) of 409, with 14 (41%) of these 34 attributable to subglottic UAO. Five minutes after extubation, RIP and esophageal manometry better identified patients who subsequently received UAO treatment than clinical UAO assessment (P < 0.006). Risk factors independently associated with subglottic UAO included low cuff leak volume or high preextubation leak pressure, poor sedation, and preexisting UAO (P < 0.04) for cuffed ETTs; and age (range, 1 mo to 5 yr) for uncuffed ETTs (P < 0.04). For uncuffed ETTs, the presence or absence of preextubation leak was not associated with subglottic UAO.Conclusions: RIP and esophageal manometry can objectively identify subglottic UAO after extubation. Using this technique, preextubation leak pressures or cuff leak volumes predict subglottic UAO in children, but only if the ETT is cuffed.
Predicting development and progression of COPD
Authors: P H Quanjer, I Steenbruggen, G Ruppel, M P Swanney
Journal: Thorax (2008)

Albers and colleagues1 recently concluded that “Lung function below the normal range and early respiratory signs predict the development and progression of COPD”. We have some concerns about the data. Table 2 in their article lists 151 subjects without baseline abnormalities. In 5 years, forced expiratory volume in 1 s (FEV1) fell by 200 ml and FEV1%/vital capacity (VC) by 5.2%, remarkably large declines for such subjects. We computed predicted values at ages 43 and 48 years according to 28 authors …
Colin Andrew Pinnock
Authors: T. Smith
Journal: BMJ (2015)

Colin Pinnock joined the Bromsgrove District General Hospital in 1986, shortly before its move to the brand new hospital in Redditch. In this way he was instrumental in setting up and developing the anaesthetic service with his three colleagues. Colin’s particular interest was in education, and, after developing the teaching programme for senior house officers, as royal college tutor, Colin set up the first district general anaesthetic registrar rotation in the West Midlands.

Colin trained in anaesthesia at the Royal Free Hospital and Worcester before becoming a clinical lecturer in Leicester, where he wrote the …
Evaluating Discrimination of Risk Prediction Models
Authors: Michael J. Pencina, Ralph B. D’Agostino
Journal: JAMA (2015)

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The role of PEF and Vas score by pain assessment after thoracosurgical interventions
Authors: Adam Rzechonek, Jerzy Kolodziej, Aleksandra Kaminska, Marek Lubicz
Journal: European Respiratory Journal (2011)

The pain after surgical interventions in the thoracopulmonary region is characterized by a longer period of occurrence lasting usually 72 to 96 hours, considerable intensity and potential influence on the incidence of complications. Various clinical parameters were used to determine the pain most precisely. Measurements of the which one parameters the pain is most useful?   Aim:  We looked for the most effective and simple method of pain assessment in postoperative thorax surgery.   Material and method:  80 patients were operated for lung cancer. The clinical parameters of pain were assessed, namely: the visual analog pain scale (VAS), pulse oximetry (SpO2), systolic and diastolic arterial pressure (RRs, RRd), spirometry - vital capacity, forced vital capacity, forced expiratory volume in one second, peak expiratory flow (VC, FVC, FEV1, PEF), measurement of pain intensity during a spirometry test. These parameters were monitored during 96 hours after surgery.  Factor Analysis was applied in order to present the pain status of patients by using one digit (the rotation method, VARIMAX). The common factors (F) were created for various management methods.   Results:  The factor F was created by using the data from the VAS and spirometry. The correlation between F and PEF achieve a value -0,76 and between F and VAS reach 0,97. The greater pain worsens outcome PEF and increases the VAS result.   Conclusions:  In thoracosurgical practice, the interview with subjective assessment of pain (VAS) and the one parameter (PEEF) of spirometry is great importance to measure the intensity of postoperative pain.
The Investigation Of Relationship Between Joint Findings and Serum Angiogenic and Inflammatory Factor Levels In Severe Hemophilia A Patients
Authors: Tuba Hilkay Karapınar, Nihal Karadaş, Gülcihan Özek, Özlem Tüfekçi, Berna Atabay, Meral Türker, Faize Yüksel, Deniz Yılmaz Karapınar, Canan Vergin, Gülersu Irken, Hale Ören
Journal: Blood (2013)
High-intensity training induces airway hyperresponsive through neuron transdifferentiation of adrenal medulla chromaffin cells
Authors: Ruoxi He, Juntao Feng, Qiufen Xun, Qingwu Qin, Chengping Hu
Journal: European Respiratory Journal (2013)

Background: A high prevalence of exercise-induced bronchoconstriction(EIB) can be found in elite athletes, but the underlying mechanisms remain elusive.  Objectives: We hypothesized that high-intensity training was related to the mechanisms of EIB via nerve growth factor(NGF)-induced neuron transdifferentiation of adrenal medulla chromaffin cells(AMCC).  Methods: Airway responsiveness, NGF and EPI levels, and chromaffin cell structure in high/ moderate-intensity training(HiTr/MoTr) rats with or without ovalbumin sensitization and the expression of NGF-associated genes in AMCC was tested.  Results: Both HiTr and OVA intervention significantly increased airway resistance. HiTr significantly increased peribronchial lymphocyte infiltration, whereas OVA significantly increased various inflammatory cells infiltration especially the eosinophil level. Both HiTr- and OVA-intervention up-regulated circulating NGF level and peripherin level in AMCC, but down-regulated phenylethanolamine N-methyl transferase level in AMCC and circulating EPI level. HiTr+OVA and HiTr+ExhEx(exhaustive exercise) interventions significantly enhanced most of the HiTr effects. The elevated NGF level was significantly associated with neuronal conversion of AMCC. The levels of p-Erk1/2, JMJD3 and Mash1 were significantly increased, but the levels of p-p38 and p-JNK were significantly decreased in AMCC in HiTr and OVA rats. Injection of NGF antiserum and MoTr reversed these changes observed in HiTr and/or OVA rats.  Conclusion: Our study suggests that NGF may be important in the pathogenesis of EIB by inducing neuron transdifferentiation of AMCC via MAPK pathways and decreasing circulating EPI.
Evaluation of a Home Visiting and Befriending Scheme for Young Mothers: Newpin
Authors: A D Cox, A Pound, M Mills, C Puckering, A L Owen
Journal: Journal of the Royal Society of Medicine (1991)

Befriending schemes to support families with young children are now widespread in the United Kingdom. One such scheme, Newpin, which aims to prevent child abuse is described. Evaluation compared those recruited to befriend as well as those befriended. Assessments at baseline and 6 months' follow-up comprised interviews with mothers, developmental assessments of the children and observation of mother–child interaction using video tapes. All assessments were conducted in the home and similar measures were applied to a control sample in an area where a Newpin scheme was planned. Newpin recruits, whether befrienders or befriended had high rates of adverse early experiences, but depression was more common amongst those referred for befriending. Approximately a third did not sustain involvement in the scheme, but those that did were more likely to have had training as volunteers and mental health problems of more than 2 years' duration.
Poor standardisation of plethysmographic specific airways resistance measurement despite widespread use
Authors: Paul D. Robinson, Janet Stocks, Francois Marchal, Kim G. Nielsen, Bruce R. Thompson, Waldemar Tomalak, Jane Kirkby
Journal: European Respiratory Journal (2015)

Plethysmographic specific airways resistance (s R aw) has remained the most recognised measure of airway resistance for almost 60 years [1]. Studies in both adults and children (including preschoolers) suggest clinical utility across important obstructive lung diseases [2–5]. Measurement protocols based on rapid panting or tidal breathing exist, and are incorporated into many current commercial plethysmographs. Tidal breathing measurement offers feasibility across a wide age range, and a relatively stable index with which to distinguish effects of disease from those of growth and development [6]. Both adult and paediatric reference data exists [7, 8]; however, the wide variation in methodology existing between centres has recently been highlighted [8], and s R aw remains one of the few lung function measurements without formal standardisation guidelines [9]. Despite the wide availability of plethysmographic equipment in lung function laboratories, its use is frequently confined to lung volume measurements. Although simultaneous measures of airway resistance can easily be recorded at no extra cost, the clinical applications of s R aw remain unclear. As part of ongoing s R aw standardisation work, we sought to describe current international use of s R aw across paediatric and adult respiratory laboratories. s R aw is widely used but results should be interpreted with caution until its recording is better standardised <http://ow.ly/QvJRJ>
Real-time PCR assay-based strategy for differentiation between active Pneumocystis jirovecii pneumonia and colonization in immunocompromised patients
Authors: A. Alanio, G. Desoubeaux, C. Sarfati, S. Hamane, A. Bergeron, E. Azoulay, J.M. Molina, F. Derouin, J. Menotti
Journal: Clinical Microbiology and Infection (2010)
Prospective evaluation of prognostic variables from patient-completed questionnaires. North Central Cancer Treatment Group.
Authors: C L Loprinzi, J A Laurie, H S Wieand, J E Krook, P J Novotny, J W Kugler, J Bartel, M Law, M Bateman, N E Klatt
Journal: Journal of Clinical Oncology (1994)

PURPOSE This study was developed to determine whether descriptive information from a patient-completed questionnaire could provide prognostic information that was independent from that already obtained by the patient's physician. PATIENTS AND METHODS An initial detailed questionnaire was administered to approximately 150 patients with advanced cancer. This questionnaire was subsequently revised and given to a total of 1,115 patients with advanced colorectal or lung cancer. Univariate and multivariate analyses were performed to evaluate the data from these questionnaires. RESULTS A total of 36 variables showed statistically significant prognostic information for survival in univariate analyses, even though many of these variables were associated with only a minimal increase in risk. A multivariate analysis demonstrated that there was a high correlation between many variables. Three major groups of variables became apparent as providing strong prognostic information. These included the following: (1) a physician's assessment of performance status (PS); (2) a patient's assessment of their own PS; and (3) a nutritional factor such as appetite, caloric intake, or overall food intake. CONCLUSION Data generated by a patient-completed questionnaire can provide important prognostic information independent from that obtained by other physician-determined prognostic factors.
Sputum Sol Neutrophil Elastase Activity in Bronchiectasis
Authors: Stanley C. H. Chan, Daisy K. Y. Shum, Mary S. M. Ip
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

The persistently dominant activity of neutrophil elastase in bronchial secretions replete with antielastases is crucial to the pathogenesis of bronchiectasis. We hypothesize that components in the bronchial secretions bind neutrophil elastase and compromise the inhibitory efficiency of prevailing antielastases. Zymographic analysis of sputum sols from patients with bronchiectasis found elastase activity in a polydisperse, alcian blue-stained zone of high molecular mass. This suggested that neutrophil elastase was complexed with polyanionic partners. Western blot analysis found not only the polyanionic partner, heparan sulfate/syndecan-1, but also the physiological antielastases, secretory leukoproteinase inhibitor and α1-antitrypsin, in the complex. Both dissociative density gradient ultracentrifugation and heparin displacement revealed that elastase dissociated from heparan sulfate/syndecan-1 was fully inhibited by the endogenous antielastases. This contrasts with the effects of exogenous antielastases on sputum neutrophil elastase activity—that of α1-antitrypsin was limited, but that of secretory leukoproteinase inhibitor was facilitated. Similarly, complexed elastase on blots of sputum sol zymographs was bound and inhibited by exogenous secretory leukoproteinase inhibitor but not by exogenous α1-antitrypsin. Taken together, the results bring a new focus to heparan sulfate/syndecan-1 complexed with neutrophil elastase in inflamed bronchial secretions as a target for modulating elastase susceptibility to physiological antielastases.
Assessment of oxidative stress in cystic fibrosis using malondialdehyde
Authors: Balazs Antus, Orsolya Drozdovszky, Imre Barta
Journal: European Respiratory Journal (2014)

Background:  We previously demonstrated that malondialdehyde (MDA), an established by-product of lipid peroxidation can be precisely measured in the sputum, and is a useful marker of oxidative stress in patients with chronic obstructive pulmonary disease. In this study MDA was investigated in the airways of patients with cystic fibrosis (CF).   Methods:  Levels of MDA in exhaled breath condensate (EBC) as well as in sputum were measured in 41 clinically stable CF patients (males: 25, age: 25.0±9.1 years, FEV 1 : 54.4±4.0%) and in 19 healthy controls. Measurement was performed by high-performance liquid chromatography (HPLC). Data are presented as mean±SEM.   Results:  MDA levels both in sputum and EBC were significantly increased in patients with CF compared to healthy controls (sputum: 293.4±19.7 vs. 85.9±11.3 nmol/L, p 0.05). By contrast, we found a significant association between sputum MDA levels and CRP values (r=0.434, p=0.012). The intra- and inter-assay repeatability of MDA measurement was similar between EBC and sputum (intra-assay: CV: 9.5±4.0 vs. 7.3±1.6%, p=0.53, Bland-Altman test: -75.8 and 36.1 vs. -72.2 and 58.0; inter-assay: CV: 11.9±3.8 vs. 12.1±4.1%, p=0.77, Bland-Altman test: -144.9 and 76.8 vs. -167.9 and 89.3).   Conclusions:  MDA appears to be a useful marker for assessing oxidative stress within the airways of patients with CF.