tbuckley/cabot-search huggingface dataset:
Prediction of the duration of hospitilization in acute COPD exacerbations: The AECOPD-F score
Authors: Filia Diamantea, Konstantinos Kostikas, Konstantinos Bartziokas, Foteini Karakontaki, Stamatoula Tsikrika, Sofia Pouriki, Vlasis Polychronopoulos, Napoleon Karagiannidis, Aikaterini Chaniotou, Andriana Papaioannou
Journal: European Respiratory Journal (2014)

Background:  Hospital admissions for COPD exacerbations account for 70% of total costs of COPD treatment whereas the length of hospital stay (LOS) is directly related to this cost.   Objectives:  The aim of the present study was to investigate possible associations of demographic, clinical, laboratory and functional parameters with LOS of patients admitted for an acute exacerbation of COPD (AECOPD) and to provide a score for the prediction of prolonged LOS   Methods:  We included 164 consecutive patients admitted to two tertiary hospitals for AECOPD and we evaluated parameters possibly related to the duration of hospital stay.   Results:  Seven parameters evaluated on patient9 admission ( A ntonisen type of exacerbation, Number of  E xacerbations in the previous year,  C harlson index of comorbidities,  O xygenation, Partial Pressure of  Pa CO 2  in arterial blood gases,  D yspnea according to the Borg dyspnea scale and history of Chronic Respiratory  F ailure, were able to predict LOS and were included in a simple score named AECOPD-F Score. The AUC of the score for the prediction of prolonged hospital stay is 0.960, and a cut-off point ≥3 predicts prolonged length of stay with a sensitivity 84.5% and specificity 92.5%, 95% CI 0.917-0.984. The AECOPD-F score was validated in a second group of 88 patients admitted for AECOPD. In the validation group patients with AECOPD-F score ≥3 required prolonged LOS compared to those with a scorel3, [8.0 (6.0, 10.0) vs 6.5 (4.0, 9.0), p=0.007], respectively.   Conclusion:  The AECOPD-F Score could accurately predict LOS in hospitalized COPD patients. The implementation of this score in clinical practice could be useful in the discharge planning of such patients.
Enhanced cytotoxic function of NK and NKT-like cells associated with decreased CD94 (Kp43) in the airway in COPD
Authors: Greg Hodge, Violet Mukaro, Mark Holmes, Paul Reynolds, Sandra Hodge
Journal: European Respiratory Journal (2012)

NK and NKT-like cells represent a small but important proportion of effector lymphocytes that we have previously shown to be a major source of pro-inflammatory cytokines and granzymes 1 . We hypothesized that NK and NKT-like cells would be increased in the airway in COPD and that this would be accompanied by a reduction in expression of the inhibitory receptor CD94 (Kp43) and increased expression of the cytotoxic mediators granzyme B and perforin.  We measured NK and NK-like T-cells and their expression of CD94 in the blood of patients with COPD (n=61), smokers (16) and healthy controls (25) and BAL from a cohort of subjects. We further assessed activation by expression of CD69 and cytotoxic potential by production of granzymes A and B and using a cytotoxicity assay.  In  blood  from COPD subjects, there were no significant changes in NK or NKT-like cell numbers or expression of granzyme A or cytotoxic potential vs controls. There was however, increased expression of granzyme B and decreased expression of CD94 by both cell types vs controls.  In the  airway  in COPD, NK and NKT-like numbers were increased, associated with increased NK cytotoxicity, increased expression of granzyme B and decreased expression of the inhibitory receptor CD94.  Treatment strategies that target NK and NKT-like cells, their cytotoxicity and production of inflammatory mediators in the airway may improve COPD morbidity.
Radiographic chest assessment of lung injury following hemithorax irradiation for pleural mesothelioma
Authors: P Maasilta, L Kivisaari, L R Holsti, L Tammilehto, K Mattson
Journal: European Respiratory Journal (1991)

To characterize the nature, extent and time-course of radiation-induced lung injury, and to evaluate the usefulness of serial chest radiographs in this assessment, we studied 253 chest radiographs of 46 patients with pleural mesothelioma given hemithorax irradiation according to one of four different regimens: I 20 Gy; II 55 Gy; III hyperfractionation 70 Gy; IV hyperfractionation 35 Gy followed by local hypofractionation 36 Gy. Lung injury on the chest radiograph was graded from 0 (none) to V (maximal) based on the degree of loss of aerated lung tissue. Grade I changes were present 1-2 mths after radiotherapy in regimens II-IV. Grade V injury had developed in all but 3 out of 4 patients of the 20 Gy group by 6-12 months after irradiation. The extent and time-course of radiation-induced lung injury could be defined by serial chest radiographs alone. However, the documentation of tumour status and/or infections needed additional imaging or laboratory investigation, especially when grade IV-V lung injury was present. For research protocols evaluating radiation-induced lung injury serial chest X-rays are recommended at the following time-points: before treatment and 2, 6 and 12 mths after treatment, with additional computerized tomographic (CT) scans as required for differential diagnosis.
t(5;14)/HOX11L2-positive T-cell acute lymphoblastic leukemia. A collaborative study of the Groupe Français de Cytogénétique Hématologique (GFCH)
Authors: R Berger, N Dastugue, M Busson, J van den Akker, C Pérot, P Ballerini, A Hagemeijer, L Michaux, C Charrin, M P Pages, F Mugneret, J Andrieux, P Talmant, C Hélias, L Mauvieux, M Lafage-Pochitaloff, M-J Mozziconacci, P Cornillet-Lefebvre, I Radford, V Asnafi, C Bilhou-Nabera, F Nguyen Khac, C Léonard, F Speleman, B Poppe, C Bastard, S Taviaux, B Quilichini, C Herens, M-J Grégoire, H Cavé, O A Bernard
Journal: Leukemia (2003)
Abstract 20514: Improved Left Ventricular Synchrony with Parahisian and Mid-Septal Pacing Sites: Insights from Color Tissue Doppler Imaging
Authors: Rahel Zubairi, Himesh V Vyas, Jeffrey Gossett, Volkan Tuzcu
Journal: Circulation (2010)

Background: Long term RV apical pacing may result in altered LV hemodynamics and a higher incidence of CHF and early death. Alternate site RV pacing may promote more physiologic ventricular depolar...
Differential actions of the endogenous docosahexaenoic acid (DHA) electrophilic derivative 17-oxo-DHA in macrophages and bronchial epithelial cells
Authors: Chiara Cipollina, Stefania Gerbino, Serena Di Vincenzo, Liboria Siena, Mark Gjomarkaj, Bruce A. Freeman, Francisco J. Schopfer, Elisabetta Pace
Journal: European Respiratory Journal (2013)

17-oxo-DHA is an endogenous electrophilic derivative of the omega-3 fatty acid DHA, which is generated in activated macrophages by the action of cyclooxygenase-2. In murine macrophages 17-oxo-DHA exerts dual anti-inflammatory and anti-oxidant actions. This makes 17-oxo-DHA attractive for the development of new treatments for chronic diseases characterized by persistent inflammation and oxidative stress such as chronic obstructive pulmonary disease (COPD). In the airways of COPD patients, combined activation of bronchial epithelial cells and alveolar macrophages produces a state of chronic inflammation which is further enhanced by cigarette smoke. Currently there is no therapy able to revert disease progression and the search for new drugs is highly active.  In the present work, the actions of 17-oxo-DHA were evaluated in human macrophages and bronchial epithelial cells (HBE) stimulated with cigarette smoke extract (CSE) and lipopolysaccharide (LPS). We report that despite increasing intracellular glutathione and promoting Nrf2 nuclear translocation and heme oxygenase-1 expression in both cell types, 17-oxo-DHA protected macrophages from CSE-induced oxidative stress but enhanced ROS formation in CSE-stimulated HBE cells without causing cell toxicity. In macrophages, 17-oxo-DHA displayed anti-inflammatory actions by suppressing LPS-induced TNFalpha production at transcriptional level and reducing total and surface expression of Toll-like receptor 4.  Overall, the present results support a differential role of 17-oxo-DHA in immune and structural cells which should be taken into account when considering this compound for drug development.
COPD screening and risk factor frequency identification study
Authors: Saadia Ashraf, Mukhtiar Zaman
Journal: European Respiratory Journal (2013)

Background: In Pakistan, Chronic Obstructive Pulmonary Disease(COPD)is still underdiagnosed.We conducted this study to see utility of GOLD screening questionnaire for quick identification of COPD patients and to identify the risk factors frequency for COPD.  Methodology: Global obstructive lung disease(GOLD) copd screening questionnaire was used to screen patients in COPD camp at Khyber Teaching Hospital, Peshawar, followed by spirometry for confirmation & their demographics, risk factors& treatment details were entered on a structured questionnaire.   Results  :  Total of 500 patients were screened on 5 item COPD screening questionnaire.270 patients screened of having suspicion of COPD were further worked up.Among them,73% and 27% were males and females with mean age 42± 17yrs.Tobacco was consumed by 50% & out of these 27% used niswar.Other risk factors such as exposure to logfire and passive smoking were found in 42 and 41% of the study participants. Risk factors for COPD at workplace such as exposure to visible dust, smoke, irritating chemicals and fumes were found in 67,47,24 and 10% of the respondents respectively. Past history of Tuberculosis & asthma were present in 10 & 25% of patients.Mean FEV1,FVCand PEFR of the study population was 2.4± 0.97 L(73%predicted),2.9 ± 1.1 L(74% predicted)& 415 ± 140 L/min(86% predicted) respectively.Almost 50% were either asthmatic or at risk of having COPD due to exposure to risk factors.   Conclusion:  GOLD COPD screening questionnaire is helpful in identifying patients and even those with normal spirometry have risk factors for COPD like tobacco use, exposure to log fire, passive smoking and workplace exposure to visible dust, smoke, irritating chemicals and fumes.
Women worldwide are subjected to abuse in labour, study finds
Authors: Anne Gulland
Journal: BMJ (2015)

Women across the world experience mistreatment in labour, including physical and verbal abuse, a lack of supportive care, neglect, discrimination and denial of autonomy, a systematic review has found.1

The study, published in PLoS Medicine , identified 65 studies undertaken in 34 countries detailing mistreatment by doctors, nurses, and other healthcare providers.

Being hit or slapped with the hand or an instrument was the most commonly reported physical abuse. Women also reported being pinched, …
Topical vitamin D3 analogues induce thymic stromal lymphopoietin and cathelicidin in psoriatic skin lesions
Authors: E. Sato-Deguchi, S. Imafuku, B. Chou, K. Ishii, K. Hiromatsu, J. Nakayama
Journal: British Journal of Dermatology (2012)

Psoriasis is a chronic inflammatory skin disease of unknown aetiology, and an active form of vitamin D(3) (1α,25-dihydroxyvitamin D(3)) and its analogues (VD3As) are widely used topical reagents for psoriasis treatment. Besides their well-known calcium homeostasis functions, VD3As have been shown to have various immune-modulating effects including the induction of thymic stromal lymphopoietin (TSLP), a master cytokine for inducing Th2 inflammation, in mouse models, but not yet in human psoriasis. VD3As also have been shown to induce cathelicidin, an antimicrobial peptide and strong inducer of innate immunity. Cathelicidin is overexpressed in psoriatic skin lesions; however, its role in this disease seems as yet inconclusive.To clarify whether topical VD3As induce TSLP and cathelicidin, and to examine the modulation of expression patterns of related cytokines in human psoriatic lesions.Skin biopsy samples from psoriatic lesions with or without VD3A treatment were subjected to immunohistochemical staining and quantitative reverse transcription-polymerase chain reaction analyses to measure the expression levels of various cytokines.Significantly higher levels of TSLP, thymus and activation-related chemokine and CCR4 expression were observed in VD3A+ skin samples than in VD3A- samples. In contrast, significantly lower levels of interleukin (IL)-12/23 p40, IL-1α, IL-1β and tumour necrosis factor (TNF)-α expression were observed in the VD3A+ samples than in the VD3A- samples. Expression of cathelicidin was elevated in VD3A+ samples.Topical VD3As induce TSLP and cathelicidin in psoriatic lesions, resulting in suppression of IL-12/23 p40, IL-1α, IL-1β and TNF-α, thereby ameliorating psoriatic plaques.
Pulmonary non-tuberculous mycobacterial infection (pNTM) with multiple species
Authors: Steven Cowman, Charlotte Goward, Diana Bilton, Robert Wilson, Michael Loebinger
Journal: European Respiratory Journal (2013)

Background:  The incidence and relevance of pNTM with >1 species is unknown.   Aims:  To describe a cohort with respiratory isolates of >1 NTM species.   Methods:  pNTM cases were identified and recruited from clinic to undergo clinical assessment and lung function testing.   Results:  Of 57 recruited cases, 44% had >1 NTM species (1 to 6 additional species, table 1). In 11 cases, the isolation of additional species preceded isolation of what would become the predominant organism.  Subjects with >1 species were more likely to be female (84% v 50% p=0.01). Isolation of >1 species was not related to disease severity as measured by lung function, SGRQ, smear positivity or decision to treat. Median duration of disease was not significantly greater in those with >1 species (2.8 v 2.0 years p=0.35), but the median number of samples sent was higher (24 v 13 p=0.02).   Conclusion:  The first isolated species of NTM may not be indicative of the predominant infecting organism, and the isolation of multiple species may make management decisions challenging. A subgroup of patients has an unexplained propensity towards isolation of NTM; further study of this group may lead to insights into disease pathogenesis.
CXCR1 is dispensable for allergy-driven airway leukocyte recruitment in vivo
Authors: Melanie Carevic, Martina Bakele, Sandra Beer-Hammer, Lauren Mays, Dominik Bloes, Peter Gierschik, Stella Autenrieth, Michael Kormann, Barbara Moepps, Dominik Hartl
Journal: European Respiratory Journal (2013)

Chemokines recruit inflammatory cells to sites of inflammation. Human CXCL8 (Interleukin 8) represents the prototypical chemokine for neutrophil migration by binding to the G-protein coupled chemokine receptors CXCR1 (IL-8RA, CD181) and CXCR2 (IL-8RB, CD182). While the role of CXCR2 has been investigated in detail by genetic deletion or pharmacologic inhibition, the distinct contribution of CXCR1 remains incompletely understood. The murine homologue of human CXCR1 has recently been identified. Here we studied the role of CXCR1 in leukocyte recruitment by using recently generated CXCR1 knock-out mice and in vivo models of airway inflammation (ovalbumin and house dust mite models of allergic asthma), infection-triggered cell recruitment and chemotaxis. In contrast to human CXCR1, murine CXCR1 was dispensable for the recruitment of neutrophils, monocytes, dendritic cells or T cells in models of allergic or bacterial inflammation. These studies demonstrate that CXCR1 is dispensable for allergy-driven airway leukocyte recruitment and inflammatory cell migration in vivo. The functional role of murine CXCR1 in cell recruitment and pulmonary inflammation remains to be solved in future studies.
Richard Wellesley Spencer
Authors: S. Spencer
Journal: BMJ (2015)

Richard Wellesley Spencer had a distinguished student record and acquired a distinction in surgery. Although he never had any great aspirations to become a surgeon, within a year or so of qualifying and while serving in wartime as a surgeon lieutenant in the Royal Navy (an FY2, in today’s terminology), he performed an appendicectomy on a sick rating. The anaesthetist was a sick bay orderly with an ether rag. In the days before widespread antibiotics and intravenous crystalloids, let alone airlifting, and still several days’ sailing from an allied port he felt he had no choice but to …
Art: The Spark of Life
Authors: John Quin
Journal: BMJ (2001)

The Spark of Life by Christine Borland. Lisson Gallery, Bell Street, London NW1, until 5 May 2001

No, no, no, a little more humanity please. That's what much of contemporary British art wants to say to 21st century medicine, and it's the message to be gleaned from Christine Borland's sparkling new show. Allied to the Hirst generation, and just as fascinated by death as the man with the shark, Borland concentrates on genetics, on the beginnings of life, an interest strengthened by an association with Glasgow University's Department of Genetics.

This is displayed to stunning effect in the new show, the centrepieces of which occupy two adjacent and contrasting rooms. Ecbolic Garden, Winter (2001) features 50 glass womb shaped containers suspended from the ceiling that hold the bleached “skeletons” of plants preserved in alcohol that were once used as abortifacients. These plants—larkspur, juniper and the like—were found to be part of a 16th century garden close to the original university in Glasgow, and Borland speculates on the potential use of these by the medical school. In effect, a kind of ghost garden is created, denuded of colour and life.

The adjoining room contains the opposite in intent. A Treasury of Human Inheritance, Huntington's disease, Entres' Case (2001) is a giant mobile constructed of different brilliantly coloured slices of agate suspended by silver and steel which represents the family tree published by the Galton Institute of Eugenics in the 1930s. Here, in three dimensions, Borland takes the lessons from the dead and shows how they teach the living, and in doing so she transforms them into objects of real beauty. The intense lividity and colour of the room contrast markedly with the spooky and sterile pallor of the neighbouring ecbolic garden.

Elsewhere, Endless Walk (2000) features two small screens in opposite parts of a room. They appear blank for a while and then a simple animation appears in one based on the engraving of an eight year old boy by Duchenne of muscular dystrophy fame. He lifts his feet with his hands in order to walk and leaves the first screen only to reappear in the second in the time it would take him to cross the perimeter of the room. And thus a work of art can inform the clinician of the true nature of the effect this condition may have. Other works on show include drawings based on fetal skulls, glass bronchial trees, and video works, all illustrating the fragility of human biology. 

This show challenges without being didactic, and fascinates in its ambiguities as well as delighting the eye, and Borland emerges, like her suspended glittering objects, as a true star.
Lung function decline in a modern cystic fibrosis cohort
Authors: Liam Welsh, Louise King, Philip Robinson, Colin Robertson, Sarath Ranganathan
Journal: European Respiratory Journal (2012)

Introduction: Though the starting point for lung function measured by spirometry in children with cystic fibrosis (CF) has improved, the annual rate of decline has not changed significantly during the critical period of adolescence. The aim of this study was to describe factors associated with longitudinal decline in lung function in a contemporary cohort of children with CF.

Methods: Best annual lung function data from children attending the CF service of the Royal Children's Hospital Melbourne were reviewed to determine rate of decline in FEV1 up until time of transfer to an adult centre. Mixed multi-level modeling was used to determine the influence of age, sex, genotype (homozygous F508del), CF related diabetes mellitus (CFRD), Pseudomonas aeruginosa (PsA) infection, and body mass index (BMI) on lung function decline.

Results: Longitudinal lung function data (range 5–20 years) were obtained for 98 patients with CF (55 male) on a median 12 (range 3–16) occasions. Overall, FEV1 declined by a mean of -0.12 z-score each year (p<0.001). Homozygous F508del genotype (-0.10, p<0.01), CFRD (-0.15, p<0.01) and mucoid PsA infection (-0.09, p<0.01) were all independently associated with an increased rate of decline in FEV1 z-score. Taken together, these three factors resulted in a cumulative reduction of -0.25 FEV1 z-score (p<0.001).

Conclusion: Genotype, CFRD and PsA infection are all associated with an increased rate of decline in lung function during adolescence. How these findings relate to underlying lung structural changes, and whether PsA eradication success can influence rate of decline in future cohorts, warrants further investigation.
Abstract 2111: Independent Prognostic Value of Ventricular Gradient for Risk Stratification of Post-Myocardial Infarction Patients: a Prospective Study
Authors: Georgios Giannopoulos, Polychronis Dilaveris, Velislav Batchvarov, Andreas Synetos, Katerina Hnatkova, Marek Malik, Christodoulos Stefanadis
Journal: Circulation (2006)

BACKGROUND: Ventricular gradient (VG) quantifies the angle between the ventricular depolarization and repolarization vectors, representing repolarization heterogeneity and potentially arrhythmic ri...
Pain affects patient satisfaction with quality of life in advanced cancer: A longitudinal analysis
Authors: J. J. Stark, K. Campbell, L. Cain, K. Gilbert, C. G. Lis, T. C. Birdsall, J. F. Grutsch, S. Williams, D. Gupta
Journal: Journal of Clinical Oncology (2008)

20702 Background: Pain is one of the most common and disabling symptoms experienced by cancer patients. We prospectively quantified the relationship between pain and patient satisfaction with quality of life (QoL) in advanced cancer. Methods: 295 cancer patients treated at Cancer Treatment Centers of America between 10/03 and 10/05 for a minimum period of 3 months and who completed 2 QoL questionnaires at both baseline and 3 months. Pain was measured using the EORTC QLQ-C30 pain subscale. Scores ranged from 0 - 100, higher scores indicating more pain. Patient satisfaction with QoL was measured using Ferrans & Powers Quality of Life Index (QLI). Scores ranged from 0 - 30, higher scores indicating better QoL. The mean pain scores were compared using paired-samples t test across the 2 time periods at baseline and 3 months. Results: Of 295 patients, 140 were males and 155 females. 73 had breast cancer, 65 lung, 39 prostate, 33 colorectal, 12 pancreas and 73 had other cancers. 150 were newly diagnosed and 145 had received prior treatment elsewhere. The mean pain scores at baseline and 3 months were 33.9 (more pain) and 27.8 (less pain) respectively (p=0.002). Similarly, the mean QLI health scores at baseline and 3 months were 17 (low QoL) and 18.3 (better QoL) respectively (p=0.002). At baseline, after controlling for age, gender, prior treatment history, and tumor stage at diagnosis, every 10-unit increase in pain was significantly associated with 1.2 (p < 0.001), 0.26 (p = 0.001), 0.35 (p = 0.002), and 0.65 (p < 0.001) unit decrease in QLI health, social, psychological and overall QoL respectively. At 3 months, every 10-unit increase in pain was significantly associated with 1.1 (p < 0.001), 0.41 (p < 0.001), 0.42 (p = 0.004), 0.36 (p = 0.002) and 0.66 (p < 0.001) unit decrease in QLI health, social, psychological, family and overall QoL. Conclusions: We found that pain is a strong correlate of QoL independent of age, gender, prior treatment history and tumor stage at diagnosis during the first 3 months of treatment. Despite receiving aggressive cancer therapy, patients treated at our integrative cancer center reported statistically significant improvements in pain and overall QoL. No significant financial relationships to disclose.