tbuckley/cabot-search huggingface dataset:
Estimating diagnostic accuracy of tests for latent tuberculosis infection without a gold standard among healthcare workers
Authors: E Girardi, C Angeletti, V Puro, R Sorrentino, N Magnavita, D Vincenti, S Carrara, O Butera, A M Ciufoli, S Squarcione, G Ippolito, D Goletti
Journal: Eurosurveillance (2009)

The evaluation of diagnostic accuracy of new in vitro diagnostic assays for tuberculosis infection has been hampered by the lack of a standard reference test. The aim of this study was to compare sensitivity and specificity of interferon gamma assays for latent tuberculosis infection by assessing the association of test results with tuberculosis occupational exposure and by using latent class analysis. We analysed data from 115 healthcare workers on whom tuberculin skin test (TST) and the following in vitro tests were performed: in-house ELISPOT for RD1 proteins, T.SPOT-TB and Quantiferon-TB Gold. Results of all tests were associated with increased occupational risk of exposure to Mycobacterium tuberculosis, but only TST was associated with Bacillus Calmette-Guerin (BCG) vaccination. Sensitivity/specificity (95% confidence intervals) estimated by a latent class model were: 99.9%/64.2% (53.0-74.1) for TST, 95.3% (61.8-99.6)/87.5% (78.0-93.2) for in-house ELISPOT, 96.7% (69.3-99.7)/85.6%(75.3-92.0) for T.SPOT-TB, and 76.3% (55.9-89.1)/93.6% (85.4-97.3) for Quantiferon. The estimated specificity of in vitro assays was higher than that of TST also among individuals who were not BCG-vaccinated. In conclusion, when used in healthcare workers, in vitro assays may provide a significant increase of specificity for tuberculosis infection compared to TST, even among non vaccinated individuals, at the cost of some sensitivity.
Hypokalaemia: Bartter's Syndrome or Pseudo-Bartter's Syndrome?
Authors: J D Robb, M A Delargy, Marie Nolan, G H Tomkin
Journal: Journal of the Royal Society of Medicine (1984)

The difficulties in the diagnosis of hypokalaemia are often considerable. This paper reports three patients who presented with hypokalaemia. Investigations are described which may help to distinguish Bartter's syndrome from pseudo-Bartter's syndrome.
Prostate Cancer Diagnosis Using MR/Ultrasound–Fusion Guided Biopsy
Authors: Bertrand F. Tombal, Sandy Van Nieuwenhove, Frederic E. Lecouvet
Journal: JAMA Oncology (2015)

This commentary argues that the greater effectiveness of targeted magnetic resonance/ultrasound fusion prostate biopsy will eventually result in its replacing the simple ultrasound procedure, but owing to its greater complexity and level of difficulty, the change will take some time.
The concentration of inflammatory cytokines in exhaled breath condensate in children with inflammatory bowel diseases
Authors: Katarzyna Krenke, Joanna Peradzynska, Joanna Lange, Katarzyna Grzela, Aleksandra Banaszkiewicz, Izabela Lazowska, Marek Kulus
Journal: European Respiratory Journal (2011)

Introduction:  Nowadays, Crohn9s disease (CD) and ulcerative colitis (UC) are regarded as a systemic disorders and extraintestinal sites of inflammation have been found in various organs, including respiratory system. Chronic inflammation involving a wide variety of cytokines plays an important role in the pathogenesis of inflammatory bowel diseases (IBD).   Aim of the study:  The aim of the study was to evaluate the concentration of several inflammatory cytokines in exhaled breath condensate (EBC) in children with IBD.   Material:  47 children with IBD (24 boys and 23 girls, mean age 13.8±3.3) and 37 healthy volunteers (20 boys, 17 girls, mean age 13.9±3.6) were enrolled into the study.   Methods:  EBC was collected during 10 minutes of tidal breathing. IL1β, IL6, IL8 and TNFα were measured with ELISA.   Results:  The concentration of inflammatory cytokines in study group was as follow: TNFα- mean 0.8 pg/ml, SD 0.4, IL1β - mean 0.3 pg/ml, SD 0.3, IL 6 - mean 0,1 pg/ml, SD 0.1, IL 8 - mean 0.2 pg/ml, SD 0.3. Control group - TNFα - 0.6 pg/ml, SD 0.3 IL1β - 0.0 pg/ml, SD 0.1, IL 6 - 0.0 pg/ml, SD 0.0, IL 8 - 0.0 pg/ml, SD 0.0. The levels of all cytokines were significantly higher in the study group (p   Conclusion:  The elevated concentration of inflammatory cytokines in EBC in children with IBD can suggest that inflammation, which plays the key role in pathogenesis of IBD, may be also present in respiratory tract.
The Role of the Microsomal Triglygeride Transfer Protein in Abetalipoproteinemia
Authors: N. Berriot-Varoqueaux, L. P. Aggerbeck, M.-E. Samson-Bouma, J. R. Wetterau
Journal: Annual Review of Nutrition (2000)

The microsomal triglyceride transfer protein (MTP) is a dimeric lipid transfer protein consisting of protein disulfide isomerase and a unique 97-kDa subunit. In vitro, MTP accelerates the transport of triglyceride, cholesteryl ester, and phospholipid between membranes. It was recently demonstrated that abetalipoproteinemia, a hereditary disease characterized as an inability to produce chylomicrons and very low-density lipoproteins in the intestine and liver, respectively, results from mutations in the gene encoding the 97-kDa subunit of the microsomal triglyceride transfer protein. Downstream effects resulting from this defect include malnutrition, very low plasma cholesterol and triglyceride levels, altered lipid and protein compositions of membranes and lipoprotein particles, and vitamin deficiencies. Unless treated, abetalipoproteinemic subjects develop gastrointestinal, neurological, ophthalmological, and hematological abnormalities.
Persistent effects of early infant diet and associated microbiota on the juvenile immune system
Authors: Nicole R Narayan, Gema Méndez-Lagares, Amir Ardeshir, Ding Lu, Koen K A Van Rompay, Dennis J Hartigan-O'Connor
Journal: Gut Microbes (2015)

Early infant diet has significant impacts on the gut microbiota and developing immune system. We previously showed that breast-fed and formula-fed rhesus macaques develop significantly different gut microbial communities, which in turn are associated with different immune systems in infancy. Breast-fed animals manifested greater T cell activation and proliferation and harbored robust pools of T helper 17 (TH17) cells. These differences were sustained throughout the first year of life. Here we examine groups of juvenile macaques (approximately 3 to 5 y old), which were breast-fed or formula-fed in infancy. We demonstrate that juveniles breast-fed in infancy maintain immunologic differences into the fifth year of life, principally in CD8+ memory T cell activation. Additionally, long-term correlation networks show that breast-fed animals maintain persistent relationships between immune subsets that are not seen in formula-fed animals. These findings demonstrate that infant feeding practices have continued influence on immunity for up to 3 to 5 y after birth and also reveal mechanisms for microbial modulation of the immune system.
Carcinoma of unknown primary site: treatment with 1-hour paclitaxel, carboplatin, and extended-schedule etoposide.
Authors: J D Hainsworth, J B Erland, L A Kalman, M T Schreeder, F A Greco
Journal: Journal of Clinical Oncology (1997)

PURPOSE To evaluate the efficacy and toxicity of a novel chemotherapy combination that includes paclitaxel, carboplatin, and extended-schedule etoposide in the treatment of patients with carcinoma of unknown primary tumor site. PATIENTS AND METHODS Fifty-five patients with carcinoma of unknown primary tumor site were treated with the following regimen, administered every 21 days: paclitaxel 200 mg/m2 by 1-hour intravenous (I.V.) infusion on day 1, carboplatin at an estimated area under the concentration-time curve (AUC) of 6.0 on day 1, and etoposide 50 mg alternated with 100 mg orally on days 1 through 10. Responding patients received a total of four courses of treatment. The following histologies were included: adenocarcinoma, 30 patients; poorly differentiated carcinoma (PDC) or poorly differentiated adenocarcinoma (PDA), 21; poorly differentiated neuroendocrine carcinoma, three; and squamous carcinoma, one. RESULTS Twenty-five of 53 assessable patients (47%; 95% confidence interval [CI], 33% to 61%) had major objective responses to treatment (seven complete responses). Response rates were similar in patients with adenocarcinoma versus PDC (45% and 48%, respectively). The actuarial median survival time for the entire group was 13.4 months. The regimen was well tolerated, with only seven hospitalizations for treatment of neutropenia and fever (4% of courses) and no treatment-related deaths. CONCLUSION The combination of paclitaxel, carboplatin, and extended-schedule etoposide is highly active and well tolerated in patients with carcinoma of unknown primary tumor site. Response rates and survival in this multicenter community-based trial compare favorably with all previously studied empiric regimens. In addition, this regimen is substantially less toxic and easier to administer than the cisplatin-based regimens previously used in this setting. If this level of efficacy is confirmed, this treatment should be considered standard first-line therapy in patients with carcinoma of unknown primary tumor site.
Effectiveness of Amantadine in Reducing Relapses in Multiple Sclerosis
Authors: G S Plaut
Journal: Journal of the Royal Society of Medicine (1987)

Fifty-three patients with multiple sclerosis were assessed in a double-blind multicentre study for the effect of amantadine. The patients were observed in general practices for up to four years. Relapses occurred in 5 of the 24 patients treated with amantadine and in 14 of the 29 placebo-treated patients. Neurological deterioration was not significantly different in the two groups.
Selection bias in participation in a smoking prevention program among teenagers
Authors: Linnea Hedman, Martin Andersson, Caroline Stridsman, Eva Rönmark
Journal: European Respiratory Journal (2014)

Background:  Reducing smoking in teenagers is an important public health intervention. Many prevention efforts are voluntary and participation may be affected by selection bias.   Aim:  to compare participants and non-participants in a voluntary smoking prevention program in teenagers.   Method:  Within the Obstructive Lung Disease in Northern Sweden (OLIN) studies, a population-based study of asthma and allergic diseases in schoolchildren started in 2006. In 2010, a questionnaire about asthma, allergic diseases and potential risk factors was completed at age 11-12y (n=2612, 95% of invited). A voluntary smoking prevention program in the study area invited a sample of the OLIN cohort (n=466) and 229 (49%) chose to participate.   Results:  Among the non-participants, the prevalence of boys (59% vs. 43%, p   Conclusion:  A selection bias was found as those in most need of smoking prevention, i.e. children having smoking parents and a lower SES, did not participate in the program.
Transthoracic echocardiography and pulmonary artery pressure assessment in patients with COPD exacerbation
Authors: Szymon Skoczynski, Katarzyna Mizia-Stec, Grzegorz Brozek, Ewa Sozanska, Zbigniew Gasior, Wladyslaw Pierzchala
Journal: European Respiratory Journal (2011)

Background: Transtchoracic echocardiography (TTE) is accepted as screening tool for pulmonary hypertension (PAH), nerveless it is rarely performed in COPD patients due to possible difficulties caused by hyperinflated lungs.

Aims and objectives: The aim of our study was to find out whether it would be possible to predict if TTE is capable to assess pulmonary artery pressure (PAP) in patients with COPD exacerbation.

Methods: 40 consecutive patients with COPD exacerbation were enrolled. TTE directed for diagnosis of PAP, pulmonary function tests, blood gases, six minute walking test and BORG scale were performed at baseline and after successful treatment.

Results: It was possible to perform TTE in 17 (42,5%) subjects on admition and in 26 (65%) at discharge. PAH was present in 88,2% pre-treatment, and in 80,8% post-treatment (PAP mean≥25 mmHg), and in 35,3% pre-treatment and in 52,9% post-treatment (RVSP>35 mmHg). It was possible to measure PAPmean in 94,1% patients pre-treatment, and in 96,2% post-treatment, whereas it was possible to measure RVSP in 58,8% patients pre-treatment before, and 65,4% post-treatment. Simple as well as multivariable analysis did not find predictive value (p>0,05) of the following parameters: FEV1, FVC, IC, RV%TLC, TLC, ITGV, TLCO/VA, pO2, pCO2, 6MWT distance, BORG scale, COPD stage (GOLD), BMI, pack-years, sputum purulence to prognose possibility of obtaining accurate TTE results.

Conclusions: TTE may be used as noninvasive tool in assessment of PAPmean and in much smaller extent in assessment of RVSP in patients with COPD exacerbation, but it still seems impossible to predict in which patients it would be possible to perform accurate TTE.
Usefulness of antimicrobial susceptibility in the eradication of Helicobacter pylori
Authors: A. Cosme, M. Montes, M. Martos, I. Gil, U. Mendarte, Y. Salicio, L. Piñeiro, M.T. Recasens, B. Ibarra, C. Sarasqueta, L. Bujanda
Journal: Clinical Microbiology and Infection (2012)
Abstract 21483: In vivo and in vitro Cardiac Responses to Beta-adrenergic Stimulation in Volume-Overload Heart Failure
Authors: Anuradha Guggilam, Kirk R Hutchinson, Mary J Cismowski, Amy P Gearica, Pamela A Lucchesi
Journal: Circulation (2010)

Volume overloaded hearts undergo progressive left ventricular (LV) failure and decreased β-adrenergic responsiveness; however little is known regarding the mechanisms involved. In the present study we evaluated contractile function and the response of adult rat LV myocytes (ARLVMs) to β-adrenergic agonists.   Objective:  We hypothesize that defective cell to cell communication  in vivo  contributes to β-adrenergic unresponsiveness in VO hearts.   Methods and results:  Aorto-caval fistula (ACF) or sham surgery was performed on 200g male rats. All studies were performed 21-weeks post surgery. Echocardiography analyses showed increased LV systolic and diastolic diameter (LVSD and LVDD, respectively), decreased fractional shortening (%FS) and increased Tei index in ACF compared to sham rats.  In vivo  treatment with a β-adrenergic agonist (dobutamine) caused typical inotropic and chronotropic responses in sham rats while ACF rats were unresponsive to adrenergic stimulation. ARLVM contractility was evaluated at 1–2Hz ± isoproterenol (ISO, β-adrenergic agonist; 10–100 nM). Video edge detection and fura-2 fluorescence microscopy were used to measure single cell contractility and [Ca 2+ ] i , respectively. Interestingly, we observed that  in vitro  treatment of ACF ARLVMs with ISO exhibited a similar response to β-adrenergic stimulation as sham ARLVMs (comparable %PS). These changes in ACF myocytes were associated with increased tau and decreased SERCA-2 expression. Moreover, connexin-43, a major LV gap junction protein, was significantly downregulated while the tight junction protein, N-cadherin was unchanged in VO hearts.   Conclusion:  These results demonstrate that  in vivo  unresponsiveness to β-adrenergic agonists in VO heart failure may involve impaired gap junction communication.
CHOP chemotherapy is better than non-doxorubicin based therapy in patients with HTLV-1 adult T-cell leukemia-lymphoma (ATLL)
Authors: I. Shapira, J. Feldman, W. Solomon
Journal: Journal of Clinical Oncology (2005)

6681 Introduction: ATLL is a common disease in areas endemic for HTLV-I, such as southwest Japan and the Caribbean Basin. In Brooklyn, NY ATLL is more prevalent than in other areas of the US due to immigrant population from the Caribbean. There is no standard therapy for ATLL. Patients and Methods: We conducted a retrospective analysis of 36 consecutive patients diagnosed with HTLV-1 adult T-cell leukemia lymphoma (ATLL) treated at our institution between 1995 and 2004. All these patients were positive for HTLV-I by ELISA & Western Blot. Results: Mean age at diagnosis was 51.5 years, 22 patients were female and 14 were male. Most patients presented with lymphadenopathy and hypercalcemia (n=18) some patients presented with lymphadenopathy but without hypercalcemia (n=12) and 6 patients presented with leukemia and rash. The patients were stratified according to the treatment in two subgroups those that received conventional CHOP chemotherapy as initial therapy versus non-CHOP chemotherapy, this included patients who received AZT & interferon (n=3), CVP (n=6) or no therapy (n=3). The mean survival for the entire group of patients was 24.7 weeks. The median survival was 18 weeks (range from 1 to 75 weeks). Patients who presented initially without hypercalcemia had a mean survival that was significantly higher than the patients with hypercalcemia 34.9 weeks versus 18.1 weeks, p<0.01. Treatment with CHOP chemotherapy significantly improved survival mean 32.5±4.4 weeks versus 9.0±2.2 weeks, p<0.01. Treatment with CHOP consistently improved survival consistently in the patients without hypercalcemia 39.8± 6.6 weeks versus no CHOP therapy 5.5 + 4.5 and in those with hypercalcemia 25.2± 5.2 weeks versus 9.7± 2.5 weeks. In multivariate analysis the presence of hypercalcemia was no longer significant after the therapy with CHOP. Conclusions: CHOP chemotherapy helped both groups of patients those who presented with hypercalcemia and those who presented without hypercalcemia. Besides the well known IPI risk stratification system in patients with ATLL hypercalcemia should be considered a poor prognostic factor. CHOP chemotherapy was better in our experience than CVP or AZT and interferon therapy. No significant financial relationships to disclose.
Prevalence of anxiety and depression in 196 patients with chronic obstructive pulmonary disease (COPD)
Authors: Karen Heslop, Usman Butt, Alan Anderson, Chris Stenton, Julia Newton, Debbie Carrick-Sen, Christine Baker, Graham Burns, Anthony De Soyza
Journal: European Respiratory Journal (2012)

Introduction

Anxiety and depression are common co-morbidities associated with COPD. A systematic review and meta-analysis reported prevalence 36% for anxiety and 40% for depression (1).

Aims and Objectives

This prospective study aimed to identify the prevalence of anxiety and depression symptoms in COPD patients attending out-patient respiratory clinics within a UK NHS Trust.

Methods

Patients with COPD were screened in Clinic in 2011 by completing the Hospital Anxiety & Depression Scale (HADS) (2). Data from 196 patients were analysed.

Results

The mean age was 65.3 years (range 31 - 97) and 88 (45%) male. Using NICE 2010 airflow severity criteria 28 had mild obstruction; 69 moderate; 59 severe and 42 very severe. Significant rates of anxiety were seen: 78% of patients had HADS-anxiety (HADS-A) scores 8 or over and 55% of patients had HADS-depression (HADS-D) scores 8 or over. Both the HADS anxiety & depression scores decreased with increasing age (t=2.8, p0.01 for HADS-A; t=2.9, p0.01 for HADS- D).

View this table:

Mean HADS Results





Conclusion

The prevalence of anxiety and depression is higher in this population than in prior studies. Symptoms of anxiety and depression appear commoner in younger patients and are unrelated to COPD airflow severity. There were no significant associations with COPD NICE severity stage or gender. It is important to screen for both in COPD patients and consider appropriate treatment.

References

1. Yohannes A. Age Ageing. 2006; 35: 457 - 459.

2. Zigmond A. & Snaith RP. 1983; 67, 361-370.
Pain relief in children
Authors: M. Zacharias, D. Watts
Journal: BMJ (1998)

Paediatric pain management has undergone significant change during the past decade, more so than many other areas of medical practice. Development has grown out of improved understanding of the physiological and psychological effects of unrelieved pain in children, greater insight into the benefits and risks of an aggressive approach to pain management, and greater knowledge of the clinical pharmacology of analgesic drugs in children. The trend towards specialised paediatric units staffed by professionals with training and experience in managing children's diseases has accelerated progress towards optimal pain management, whether for acute, chronic, or cancer pain. Unfortunately current practice still falls short of the ideal of safe and effective pain relief for all children.

A longstanding problem in paediatric pain management has been the difficulty of objectively assessing pain. Assessment in infants before they can speak is particularly challenging and may have been responsible for perpetuating the myth …
Robust prediction of later asthma in symptomatic toddlers: A novel approach
Authors: Anina Pescatore, Ben Spycher, Lutz Duembgen, Marie-Pierre Strippoli, Cristian Dogaru, Michael Silverman, Claudia Kuehni
Journal: European Respiratory Journal (2011)

Aim:  Many children have asthma-like symptoms in early life, but few develop asthma. Several models for predicting later asthma in symptomatic toddlers have been built, but some included factors that are difficult to assess, and methods used were prone to overfitting, leading to selection or exaggeration of irrelevant factors. We aimed to identify predictors for later asthma avoiding previous limitations.   Methods:  In a population-based cohort, we selected 1-3 year-olds with respiratory symptoms (current wheeze or recurrent cough) and related healthcare visits. Asthma (current wheeze and treatment) was assessed 5 years (N=1226) and 8 years (N=866) later.  The included factors are easy to assess in clinical practice: family history, symptoms at baseline, demographic and perinatal data. We used lasso penalized logistic regression to select predictors. This minimizes the number of included predictors while maximizing area under ROC curve (AUC).   Results:  Main predictors selected in the model for asthma 5 yrs later (AUC=0.76) were ≥4 wheezing attacks in the past 12mo (OR=1.65), wheeze causing breathlessness (3.1) and activity disturbance (2.4), eczema (1.5) and male sex (1.5). Other predictors (OR   Conclusion:  Among factors easy to assess in symptomatic toddlers, wheeze severity, eczema and male sex are main predictors of asthma in mid-childhood. Because our approach for variable selection avoids overfitting, the resulting prediction models should perform well with new data. However, external validation is needed.  Funding: SNF PDFMP3-123162.
Protection against atopic diseases through farm exposure is partially mediated by regulatory T cells
Authors: Anna Lluis, Martin Depner, Philippe Saas, Beatrice Gaugler, Jing Liu, Isolde Schleich, Vincent Kaulek, Jean-Charles Dalphin, Dominique Vuitton, Erika von Mutius, Bianca Schaub
Journal: European Respiratory Journal (2011)

Background:  Our previous studies suggested a protection against allergic diseases through farm exposure. The underlying mechanisms may involve immune regulation through T cell subsets already present early in childhood.   Objective:  To assess whether T regulatory cells (Tregs) are involved in the allergy-protective effect of farm exposure in childhood and which specific exposures are relevant.   Methods:  457 pregnant women were recruited before delivery and followed until the age of 4.5 years in Germany (n=254) and France (n=203) as part of a European birth cohort study (PASTURE/EFRAIM). Children of families living on livestock farms were compared to children of families from this region, but not living on farms. Detailed questionnaires assessed farming exposures over time. Tregs (CD4 + CD25 high FOXP3 +  expression) in peripheral blood mononuclear cells (PBMC) were assessed at 4.5 years before and following stimulation (lipopolysaccharide (LPS), PMA/Ionomycin (PI)) by flow cytometry.   Results:  At 4.5 years of age, farm-exposed children showed increased Tregs following stimulation (LPS, PI), p   Conclusions:  Farm exposure, and particularly farm milk intake in early childhood, was associated with an increase of Tregs in early childhood upon specific stimulation. Specific contents of farm milk may modulate the immune system towards a regulatory profile potentially leading to a protective effect for the development of childhood allergic diseases.