tbuckley/cabot-search huggingface dataset:
Exploring the immune status of sepsis patients through Tim-3 expressed on monocytes and IL-12
Authors: Jia Li, Yan Xiao, Longxiang Su, Huijuan Wang, Kun Xiao, Gencheng Han, Lixin Xie
Journal: European Respiratory Journal (2014)

Purpose: Sepsis is a severe infection disease that leads to immune dysfunction. The expression of T cell Ig and mucin domain protein-3(Tim-3) on monocytes has been suggested to be an important immune regulator during infection as it was shown to regulate the production of IL-12 both in vitro and in vivo. The expression of Tim-3 on monocytes and its relationship to IL-12 expression in sepsis patients remain unclear.   Methods:  Our study included 36 patients with differing severities of sepsis (12 patients with sepsis, 16 patients with severe sepsis, 8 patients with septic shock) and 11 normal controls. The expression of Tim-3 on monocytes was evaluated by flow cytometry. IL-12 mRNA in peripheralbloodcells was assayed using real-time PCR (RT-PCR).   Results: The expression of Tim-3 on monocytes and IL-12 mRNA were significantly elevated in sepsis and severe sepsis patients in comparison with normal controls. However, Tim-3 and IL-12 levels were significantly decreased in patients with septic shock compared to patients with severe sepsis. The relevant risk factors for death and Tim-3 were evaluated using logistic regression analysis; the odds ratio (OR) for Tim-3 was 1.218 (p   Conclusion:  Our findings indicate that Tim-3 is involved in regulating the function of monocytes in sepsis patients and that low expression of Tim-3 is associated with the immune suppression of monocytes during the early stage of septic shock. Tim-3 may potentially act as an indicator for the prognosis of septic shock and guide future developments of immunotherapy approaches.
Sleep monitoring with portable devices in ICU patients
Authors: Shihoko Namba, Yoshito Ujike, Tetsunori Ikegami, Ichiro Shimoyama, Paul A. Easton
Journal: European Respiratory Journal (2011)

Introduction: Sleep disruption and deprivation is a continuing problem in the Intensive Care Unit, but measures to improve sleep cannot utilize traditional polysomnography. Practical, non-intrusive diagnostic monitoring of sleep is required.

Aim: To: 1) test two new portable ambulatory sleep diagnostic devices to monitor sleep in ICU and 2) compare sleep data generated by the different devices.

Methods: The devices were a) WatchPAT 200 (Itamar Medical), wrist watch-style, employing peripheral arterial tone and actigraphy to evaluate sleep time and sleep stage by an automatic algorithm (PAT device) and b) ALICE PDx (Respironics Philips), miniature polysomnographic device utilizing EEG and EMG recordings, with technician scoring (Mini-PSG device). Both include oximetry and position sensors. Seven ICU patients provided informed consent (mean age 68 years) and were recorded wearing both devices, from 2100 to 0600.

Results: Both devices successfully monitored sleep in ICU patients. The PAT device was less intrusive with size and attachments. Saturation and heart rate oximetry data were identical from the devices: Both devices calculated total sleep time (TST), and detected changing sleep stage. There were significant differences in reported values. Mean TST reported was 365 and 507 min., for Mini-PSG and PAT device, respectively, difference 28%. Similarly, REM sleep time was 7.9 and 16.1%TST for the devices, difference 51%. There was large inter-patient variance; some patients showed similar results from both devices.

Conclusions: Portable sleep diagnostic devices can successfully monitor sleep in ICU patients. Devices based on different sensor recordings may generate different calculations of sleep time and stage.
Abstract 1719: A Potential Mechanism for the Reduced Efficacy of Aspirin in Individuals with Diabetes
Authors: Ramzi Ajjan, Kristina F Standeven, Salihah Mughal, Fladia A Phoenix, Robert A Ariens, Peter J Grant
Journal: Circulation (2008)

The protective effects of aspirin are reduced in individuals with diabetes by mechanisms that remain unclear. Diabetes is associated with changes in clot structure making it more resistant to lysis, which may be due to increased glycation of the fibrinogen molecule. In contrast, we have recently found that acetylation of fibrinogen enhances fibrinolysis of the fibrin clot. The aim of this study was to assess whether the reduced efficacy of aspirin in diabetes is due to an interaction between acetylation and glycation in fibrinogen and clotting factors.Type 1 diabetes subjects with poor diabetes control (n = 18) were recruited and insulin treatment was intensified. Blood samples were obtained before and after improving glycaemic control over a period of 7.3 months (CI 5.5, 9.2). Plasma samples were incubated with 0, 1, 10 and 100 mg L-1 aspirin for 5 h at 37°C, subsequently treated with thrombin and tissue plasminogen activator, and time to 50% lysis was assessed using turbidity measurements. Electron microscopy was used to study the structure of clots made from plasma-purified fibrinoge.HbA1c was reduced significantly post-intervention [10.52% (9.56, 11.48) vs . 9.23% (8.31, 10.15)]. In the absence of aspirin, improvement in glycaemic control significantly reduced lysis time [357 (312, 402) and 323 (278, 368) seconds at baseline and after intervention respectively; p &lt; 0.05]. Low dose aspirin (1 mg L −1 and 10 mg L −1 ) had an adverse effect on lysis time in the presence of poor diabetes control [367 (323, 413) and 385 (332, 437) seconds respectively, p &lt; 0.05], whereas high dose aspirin (100 mg L −1 ) had a beneficial effect on lysis time only in individuals with improved glycaemic control [299 (264, 333) seconds, p &lt; 0.05]. Experiments on plasma-purified fibrinogen showed the formation of thicker fibres and bigger pores with improved glycaemic control and after treatment with high dose aspirin. This study has shown that improvement in glycaemic control has a beneficial effect on fibrinolysis. Our work has also demonstrated that aspirin treatment can adversely affects lysis time in the presence of poor glycaemic control, which may explain the reduced efficacy of this agent in individuals with diabetes.
No effect of oral high frequency oscillation combined with forced expiration manoeuvres on tracheobronchial clearance in chronic bronchitis
Authors: M van Hengstum, J Festen, C Beurskens, M Hankel, W van den Broek, F Corstens
Journal: European Respiratory Journal (1990)

This study compared the effect of oral high frequency oscillation (OHFO) with the effect of the forced expiration technique (FET) on tracheobronchial clearance. Eight patients with chronic bronchitis were investigated (mean age 60 +/- 10 yrs, mean forced expiratory volume in one second (FEV1) 68 +/- 27% predicted, mean sputum production 33 +/- 9 g.day-1). OHFO was applied at the respiratory system resonant frequency of each patient (range 9.2-25 Hz) and combined with huffing. FET included breathing exercises, huffing and postural drainage. Duration of both OHFO and FET was 30 minutes. Tracheobronchial clearance was measured by means of a radio-aerosol technique. At 60 mins after start of the treatment mean tracheobronchial retention was 70 +/- 26% after OHFO, 54 +/- 26% after FET and 76 +/- 18% in the control run, which included huffing only. OHFO was not significantly different from control. FET was significantly different (p less than 0.02) from both OHFO and control. It is concluded that OHFO has no effect on tracheobronchial clearance in chronic bronchitis.
Effect of Lifestyle-Focused Text Messaging on Risk Factor Modification in Patients With Coronary Heart Disease
Authors: Clara K. Chow, Julie Redfern, Graham S. Hillis, Jay Thakkar, Karla Santo, Maree L. Hackett, Stephen Jan, Nicholas Graves, Laura de Keizer, Tony Barry, Severine Bompoint, Sandrine Stepien, Robyn Whittaker, Anthony Rodgers, Aravinda Thiagalingam
Journal: JAMA (2015)

IMPORTANCE Cardiovascular disease prevention, including lifestyle modification, is important but underutilized.Mobile health strategies could address this gap but lack evidence of therapeutic benefit.OBJECTIVE To examine the effect of a lifestyle-focused semipersonalized support program delivered by mobile phone text message on cardiovascular risk factors. DESIGN AND SETTINGThe Tobacco, Exercise and Diet Messages (TEXT ME) trial was a parallel-group, single-blind, randomized clinical trial that recruited 710 patients (mean age, 58 [SD, 9.2] years; 82% men; 53% current smokers) with proven coronary heart disease (prior myocardial infarction or proven angiographically) between September 2011 and November 2013 from a large tertiary hospital in Sydney, Australia.INTERVENTIONS Patients in the intervention group (n = 352) received 4 text messages per week for 6 months in addition to usual care.Text messages provided advice, motivational reminders, and support to change lifestyle behaviors.Patients in the control group (n=358) received usual care.Messages for each participant were selected from a bank of messages according to baseline characteristics (eg, smoking) and delivered via an automated computerized message management system.The program was not interactive. MAIN OUTCOMES AND MEASURESThe primary end point was low-density lipoprotein cholesterol (LDL-C) level at 6 months.Secondary end points included systolic blood pressure, body mass index (BMI), physical activity, and smoking status.RESULTS At 6 months, levels of LDL-C were significantly lower in intervention participants, with concurrent reductions in systolic blood pressure and BMI, significant increases in physical activity, and a significant reduction in smoking.The majority reported the text messages to be useful (91%), easy to understand (97%), and appropriate in frequency (86%).Parameter Mean (95% CI) Mean Difference (95% CI) P Value Intervention Control LDL-C, mg/dL 79 (76 to 82) 84 (81 to 87) -5 (-9 to 0) .04Systolic blood pressure, mm Hg 128.2 (126.7 to 129.8) 135.8 (134.3 to 137.3) -7.6 (-9.8 to -5.4) <.001 BMI 29.0 (28.8 to 29.3) 30.3 (30.1 to 30.5) -1.3 (-1.6 to -0.9) <.001 Physical activity, MET min/wk 932 (825 to 1039) 587 (482 to 692) 345 (195 to 495) <.001 Smoking, No./total (%) 88/339 (26.0) 152/354 (42.9)RR, 0.61 (0.48 to 0.76) <.001CONCLUSIONS AND RELEVANCE Among patients with coronary heart disease, the use of a lifestyle-focused text messaging service compared with usual care resulted in a modest improvement in LDL-C level and greater improvement in other cardiovascular disease risk factors.The duration of these effects and hence whether they result in improved clinical outcomes remain to be determined.
Quality of spirometry in the elderly
Authors: Malgorzata Czajkowska-Malinowska, Waldemar Tomalak, Jakub Radlinski
Journal: European Respiratory Journal (2011)

Assessment of lung function in aged subjects became quite frequent. We have attempted to evaluate quality of spirometric examination in people aged ≥65 years.  We have analyzed data from all the patients admitted to the Center of COPD and Respiratory Failure Regional Hospital of Pulmonology in Bydgoszcz in the period June-December 2010. Spirometry was performed by 3 experienced technicians using Jaeger9s MasterLab calibrated prior to the measurements. There were 500 patients analysed (age range: 65-90; median: 72; mean ±SD: 73.1±5.7).We used quality error codes assigned by spirometer (according to ERS/ATS 2005 recommendations for spirometry).  Following errors are recognized: 1) less than 3 trials; 2) lack of reproducibility of FEV1 and 4) FVC; 10) cough or variable cooperation; 100) FET  Out of 500 patients 32 were not able to perform spirometry (due to error 1 – 28 and 10 – 4). Out of the remaining 468 patients 195 (41,2%) performed spirometry without any errors. In the rest – software indicated (by frequency of occurrence) error 100; error 4; error 4000; error 2 and error 1000. In 232 patients 1 error was encountered, in 35 - 2; in 5 - 3 and in 1 – 4.  All examined patients reached FET>6s. If the error 100 (lack of plateau) would be ommited, the percentage of good spirometries rise to 91,2%.  We conclude that 6.4% of aged persons were not able to cooperate during spirometry. Those who cooperated - had problem with reaching the plateau at end expiration. Such the analysis of errors; repeated from time to time might be very useful in giving feedback to technicians - to make them much more careful in observing end expiration in aged persons performing spirometry.
Can Diet Prevent Breast Cancer?
Authors: Mitchell H. Katz
Journal: JAMA Internal Medicine (2015)

Estefanía Toledo, MD, MPH, PhD; Jordi Salas-Salvadó, MD, PhD; Carolina Donat-Vargas, PharmD; Pilar Buil-Cosiales, MD, PhD; Ramón Estruch, MD, PhD; Emilio Ros, MD, PhD; Dolores Corella, DPharm, PhD; Montserrat Fitó, PhD; Frank B. Hu, MD, PhD; Fernando Arós, MD, PhD; Enrique Gómez-Gracia, MD, PhD; Dora Romaguera, MSc, PhD; Manuel Ortega-Calvo, MD; Lluís Serra-Majem, MD, PhD; Xavier Pintó, MD, PhD; Helmut Schröder, PhD; Josep Basora, MD, PhD; José Vicente Sorlí, MD, PhD; Mònica Bulló, BSc, PhD; Merce Serra-Mir, RD; Miguel A. Martínez-González, MD
The association between high-dose cytarabine neurotoxicity and renal insufficiency.
Authors: L E Damon, R Mass, C A Linker
Journal: Journal of Clinical Oncology (1989)

We reviewed the medical records of 110 consecutive patients at our institution who had acute leukemia and received high-dose cytarabine (Ara-C; HDAC) in order to analyze risk factors associated with HDAC neurotoxicity (NT). There were adequate records on 101 patients who received 147 courses of HDAC. Twenty-six treatment courses (18%) were complicated by NT. The median time of NT onset was 5 days (range, 1 to 10 days), and NT was reversible in 16 of 21 survivors (76%). Patients with severe NT (grades 3 to 4) were less likely to have complete reversal of their neurological deficit than those with mild NT (P less than .1). In our patients, there was no significant association between previously described risk factors (age over 49 years, male gender, CNS disorder, and cumulative HDAC dose greater than 48 g/m2) and incidence of NT. However, treatment courses involving HDAC given during renal insufficiency (serum creatinine greater than or equal to 1.5 mg/dL or an increase in serum creatinine greater than 0.5 mg/dL) were much more likely to be complicated by any degree of NT during administration of HDAC (62%) and severe NT (42%) than those given during normal renal function (8% and 3%, respectively; P less than .001). Of the treatment courses involving patients with estimated creatinine clearances less than 60 mL/min, 76% were complicated by NT compared with 8% of treatment courses involving patients with clearances greater than 60 mL/min (P less than .001). HDAC courses with neurotoxic patients had higher serum creatinines (2.1 +/- 1.4 v 1.1 +/- 0.6 mg/dL), greater increases in serum creatinine (+ 0.5 +/- 0.8 v + 0.07 +/- 0.3 mg/dL), and lower estimated creatinine clearances (61 +/- 35 v 91 +/- 29 mL/min) than those courses with nonneurotoxic patients (P less than .001, all parameters). Patients receiving HDAC during renal insufficiency are at high risk for developing NT. Dose reduction of HDAC should be considered for patients with renal insufficiency.
Hybrid SPECT/CT Evaluation of Marine-Lenhart Syndrome
Authors: Chidambaram Natrajan Balasubramanian Harisankar, Govindababu Rajalakshmi Preethi, Biju Baby Chungath
Journal: Clinical Nuclear Medicine (2013)

Marine-Lenhart syndrome has been described as a variant of Graves disease with the following criteria: (1) the thyroid scan shows an enlarged gland and 1 or 2 poorly functioning nodules; (2) the nodule is TSH dependent and the paranodular tissue is TSH independent; (3) after endogenous or exogenous TSH stimulation, the return of function in the nodule can be demonstrated; and (4) the nodule is histologically benign. We report a 57-year-old woman with Marine-Lenhart syndrome evaluated with technetium scanning and hybrid SPECT/CT.
Vena cava filter in patients With pulmoner embolism: Long-term results
Authors: Savas Ozsu, Neslihan Ozcelik, M. Halil Ozturk, Tevfik Ozlu
Journal: European Respiratory Journal (2013)

Pulmonary thromboembolism(PTE) is a significant cause of morbidity and mortality. Although anticoagulation remains the primary therapy for venous thromboembolism, vena caval filters are an important alternative when anticoagulants are contraindicated. In these condition, vena caval filters(VCF) have been considered an effective alternative form of therapy for PTE. We retrospectively analyzed the records of all patientswith PTE who were diagnosed between 2008 and 2012. Spiral chest computed tomography pulmonary angiography was confirmed diagnosis of acute PTE.  The average age of the patients was 65.4± 15.7 years, and 15 (60%) were females.  Risk factors for the development PE of were;various causes of immobilization (60% ), malignancy (24%) and hereditary thrombophilia (16%). As a result, VCF was placement in 25(4%) of 624 patients with the diagnosis of pulmonary embolism. Indications for filter respectively; 56% the development of bleeding under treatment, 24% although effective treatment the development of recurrent deep vein thrombosis and / or pulmonary embolism, 16% re-embolism (no under treatment), 4% trombocytopenia was occurred under treatment. The average time after installing vena cava filter was 820±707 days. With polyclinic visits and telephone follow-up was determined that 7 (28%) patients were died (3 patient malignancy, 2 patients cardiac failure, 1 patients COPD and 1 patient PTE). The treatment continued with warfarin in 3 patient and molecular weight heparin in 6 patients with VCF. There were no re-embolism and complications in these patients who followed up with VCF. Only one patient was removed filter.Coclusion,we found that long-term safety and efficacy of filters.
Breast Cancer Screening Guidelines in the United States
Authors: Jill Jin
Journal: JAMA (2015)

Kevin C. Oeffinger, MD; Elizabeth T. H. Fontham, MPH, DrPH; Ruth Etzioni, PhD; Abbe Herzig, PhD; James S. Michaelson, PhD; Ya-Chen Tina Shih, PhD; Louise C. Walter, MD; Timothy R. Church, PhD; Christopher R. Flowers, MD, MS; Samuel J. LaMonte, MD; Andrew M. D. Wolf, MD; Carol DeSantis, MPH; Joannie Lortet-Tieulent, MSc; Kimberly Andrews; Deana Manassaram-Baptiste, PhD; Debbie Saslow, PhD; Robert A. Smith, PhD; Otis W. Brawley, MD; Richard Wender, MD
Abstract 230: Comparing Manual and Mechanical Chest Compression Quality Parameters in 30:2 Mode with Use of a Novel Approach
Authors: Pär Lindblad, Annika Åström Victorén, Christer Axelsson, Bjarne Madsen Härdig
Journal: Circulation (2011)

This study aimed at analyzing the possibility of evaluating the logistic differences between manual chest compressions (M-CC) and mechanical chest compressions (LUCAS TM 2, (L-CC)) performed by 17 paramedics. CPR in 30:2 was performed with both techniques on a modified Leardal manikin. The modification consisted of two cords placed at a depth of 4.5 cm inside the manikin. These cords were connected to the electrodes on the manikin and then connected to the defibrillation leads of a Life-Pack 12 defibrillator enabling registration of impedance measurements in CODE-STAT. Thus only compressions reaching the set depth (4.5 cm) were recorded as a correct compression. Two scenarios were tested with both M-CC and L-CC; the first was a stationary scenario of 10 min CPR on the floor, the second scenario explored CPR during; two min on the floor, 2 min on the stretcher and during 2 min in the ambulance. Parameters compared were number and length of pauses, frequency and chest compression ratio (correct chest compressions alone in % of time). The first scenario revealed, significant differences regarding pauses that occurred significant more often 32 (26-33) compared to 29 (28-29) (Median (Min-Max)) and lasted longer time (s): 129 (105-155) compared to 110 (104-122) for the M-CC group compared to the L-CC group resulting in a chest compressions ratio, lower in the M-CC group: 79 % (65-87%) compared to L-CC group: 84% (33-89%). This result was due to a significant higher frequency of chest compression in the M-CC group 116 (92-133) compared to 99 (98-110). In the two minutes scenario on the floor no significant differences were found, except regarding frequency, but in the M-CC group significantly fewer chest compressions reached 4.5 cm on the stretcher and due to loading in the ambulance. In conclusion: With only small changes done to a manikin we were able to mimic impedance measurements, including depth, using CODE-STAT. An increased frequency during 30:2 CPR also increases the number of pauses and L-CC gives stricter and fewer pauses during CPR in 30:2 resulting better chest compression ratio.
Healthcare-associated infective endocarditis: an undesirable effect of healthcare universalization
Authors: J.M. Lomas, F.J. Martínez-Marcos, A. Plata, R. Ivanova, J. Gálvez, J. Ruiz, J.M. Reguera, M. Noureddine, J. de la Torre, A. de Alarcón
Journal: Clinical Microbiology and Infection (2010)
Case-ascertained study of household transmission of seasonal influenza — South Africa, 2013
Authors: Preetha Iyengar, Claire von Mollendorf, Stefano Tempia, Alexandra Moerdyk, Ziyaad Valley-Omar, Orienka Hellferscee, Neil Martinson, Meera Chhagan, Meredith McMorrow, Manoj Gambhir, Simon Cauchemez, Ebrahim Variava, Katlego Masonoke, Adam L. Cohen, Cheryl Cohen
Journal: Journal of Infection (2015)
Association between particulate air pollution and hospital admissions, mortality and acute exacerbations for chronic obstructive pulmonary disease in Beijing, China
Authors: Ya Chen, Rui Zhu, Fu Deng, Wan Yao
Journal: European Respiratory Journal (2012)

Background: Numerous studies with varying associations between particulate air pollution and chronic obstructive pulmonary disease (COPD) have been reported.

Objective: To determine the association between air pollutants and hospital admissions, mortality and acute exacerbations for COPD in Beijing and identify which pollutants contributed most to this effect.

Methods: Data of patients with COPD and air pollutants in Beijing were obtained from Peking University Third Hospital and Haidian District Environment Protection Bureau. We analyzed monthly hospital admissions, mortality and acute exacerbations for COPD and air pollutants data using Poisson regression in generalized additive models, adjust for the mean temperature, pressure and relative humidity.

Results: In the single-pollutant model, an interquartile range (IQR) change of PM10 was associated with a 29.7% (7.9% to 55.9%) increase in hospital admissions for COPD. An IQR change of SO2 and NO2 were associated with a 64.5% (14.1% to 137.1%) increase and a 35.3% (-54.3% to -8.2%) decrease in COPD mortality respectively. While in the multiple-pollutant model, an IQR change of PM10 and NO2 were associated with a 46.4% (11.4% to 92.3%) increase and a 52.9% (-68.7% to -29.1%) decrease in COPD mortality. And SO2 and NO2 were associated with a 125.0% (61.3% to 214.0%) increase and a 61.5% (-66.0% to -32.8%) decrease in COPD mortality.

Conclusion: Ambient concentrations of pollutants have an adverse effect on hospital admissions and mortality for COPD in Beijing.

Grant: National Natural Science Foundation of China (No.81170012).