tbuckley/cabot-search huggingface dataset:
Fundamental Considerations of the Design and Function of Intranasal Antrostomies
Authors: Valerie J Lund
Journal: Journal of the Royal Society of Medicine (1986)

The natural history of intranasal antrostomy is poorly understood despite the popularity of the procedure. Researches have been conducted to examine this and in particular to establish factors which might be responsible for closure. A complete appraisal of the anatomy of the inferior meatus has been undertaken to determine factors which limit the dimensions of an antrostomy. Retrospective and prospective studies have been performed on patients undergoing the operation to assess patency and size. The results of these studies demonstrate that initial size is important in determining long-term patency in adults, and if an antrostomy is open at one year it usually remains open in the long-term unless infection supervenes; in children, however, antrostomies appear to close more rapidly.
CD56 Expression in Acute Promyelocytic Leukemia: A Possible Indicator of Poor Treatment Outcome?
Authors: Clinton K. Murray, Elihu Estey, Elisabeth Paietta, Robin S. Howard, William J. Edenfield, Sherry Pierce, Karen P. Mann, Charles Bolan, John C. Byrd
Journal: Journal of Clinical Oncology (1999)

Blast expression of CD56 is frequent in patients with t(8;21)(q22;q22) acute myeloid leukemia and is associated with an inferior outcome. The expression of CD56 has rarely been reported in acute promyelocytic leukemia (APL) and has not been clinically characterized. Therefore, we examined the prognostic significance of CD56 expression in APL.We identified all reported cases of CD56+ APL in the medical literature and collected clinical, biologic, and therapeutic details.Data were obtained for 12 patients with CD56+ APL (> 20% blast expression of CD56), including four cases from a single institution with a total of 42 APL patients. All of the CD56+ APL patients had documented cytogenetic presence of t(15;17), and of the nine reported isotypes, eight (89%) were S-isoform. Only six CD56+ patients (50%) attained complete remission (CR); the other six individuals died within 35 days of presentation. Of the six patients who attained a CR, three (50%) relapsed at 111, 121, and 155 weeks, whereas three remained in continuous CR at 19, 90, and 109 weeks. Comparison of the control CD56- to CD56+ APL patients demonstrated that the latter group had a significantly lower fibrinogen level (P = .007), and among patients for whom data were available, there was a higher frequency of the S-isoform (P = .006). Additionally, the CR rate (50% v 84%, P = .025) and overall median survival (5 v 232 weeks; P = .019) were significantly inferior for CD56+ APL patients.CD56+ acute promyelocytic leukemia is infrequent, seems to occur more frequently with the S-isoform subtype, and may be associated with a lower CR rate and inferior overall survival.
Resveratrol attenuates hypoxic pulmonary vascular remodeling in simulated high altitude-exposed rats: potential role of Hif-1α/NOX4/ROS inhibition
Authors: Tao Wang, Ling-Li Guo, Guang-Ming He, Feng Luo, Fu-Qiang Wen
Journal: European Respiratory Journal (2012)

Objectives:  Chronic high altitude hypoxia induces pulmonary vascular remodeling with medial hypertrophy and luminal narrowing leading to the development PAH. Pulmonary oxidative stress has been implicated in hypoxic PAH. This study aimed to investigate the effects of resveratrol, an anti-oxidant polyphenol, on hypoxic pulmonary vascular remodeling in rats.   Methods:  Rats were exposed to simulated high altitude of 6000 m in a hyperbaric chamber for 8 h/d, for up to 28 days. Resveratrol (10 mg/kg, ip) was daily administered 0.5 h before hypoxia exposure. Rat primary pulmonary arterial smooth muscle cells (PASMCs) were incubated under hypoxia (2% O 2 ) in the presence of 10, 25, or 50 μM resveratrol. Pathophysiological changes and signal transduction were examined using histochemistry, fluorescence probing, Western blotting and RT-PCR.   Results:  Resveratrol administration significantly reduced hypoxia-induced elevation in mPAP (23.6±2.4 mmHg  vs.  30.3±1.9 mmHg;  P   vs.  22.7±2.4 %;  P  2 O 2  levels as indicators of oxidative stress in hypoxic PAH rats. In vitro studies show that resveratrol dose-dependently inhibited hypoxia-induced rat PASMC proliferation and cellular ROS accumulation. Moreover, resveratrol reduced hypoxia-increased Hif-1α and NOX4 (a ROS contributor) expression both in vitro and in vivo.   Conclusions:  Resveratrol attenuates hypoxic pulmonary vascular remodeling in rats exposed to intermittent simulated high altitude, possibly through its inhibition on Hif-1α/NOX4/ROS-generated oxidative stress under hypoxia.
Early Start of Adjuvant Chemotherapy May Improve Treatment Outcome for Premenopausal Breast Cancer Patients With Tumors not Expressing Estrogen Receptors
Authors: Marco Colleoni, Marco Bonetti, Alan S. Coates, Monica Castiglione-Gertsch, Richard D. Gelber, Karen Price, Carl-Magnus Rudenstam, Jurij Lindtner, John Collins, Beat Thürlimann, Stig Holmberg, Andrea Veronesi, Giovanni Marini, Aron Goldhirsch
Journal: Journal of Clinical Oncology (2000)

PURPOSE: The proper time to commence adjuvant chemotherapy after primary surgery for breast cancer is unknown. An analysis of the International (Ludwig) Breast Cancer Study Group (IBCSG) Trial V at a median follow-up of 11 years suggested that early initiation of adjuvant chemotherapy might improve outcome for premenopausal, node-positive patients whose tumors did not express any estrogen receptor (ER). PATIENTS AND METHODS: We investigated the relationship between early initiation of adjuvant chemotherapy, ER status, and prognosis in 1,788 premenopausal, node-positive patients treated on IBCSG trials I, II, and VI. The disease-free survival for 599 patients (84 with ER-absent tumors) who commenced adjuvant chemotherapy within 20 days (early initiation) was compared with the disease-free survival for 1,189 patients (142 with ER-absent tumors) who started chemotherapy 21 to 86 days after surgery (conventional initiation). The median follow-up was 7.7 years. RESULTS: Among patients with ER-absent tumors, the 10-year disease-free survival was 60% for the early initiation group compared with 34% for the conventional initiation group (226 patients; hazard ratio [HR], 0.49; 95% confidence interval [CI], 0.33 to 0.72; P = .0003). This difference remained statistically significant in a Cox multiple regression analysis controlling for study group, number of positive nodes, tumor size, age, vessel invasion, and institution (HR, 0.60; 95% CI, 0.39 to 0.92; P = .019). Conversely, early initiation of chemotherapy did not significantly improve disease-free survival for patients with tumors expressing ER (1,562 patients; multiple regression HR, 0.93; 95% CI, 0.79 to 1.10; P = .40). CONCLUSION: In premenopausal patients with ER-absent tumors, early initiation of systemic chemotherapy after primary surgery might improve outcome. Further confirmatory studies are required before any widespread modification of current clinical practice. In premenopausal patients with tumors expressing some ER, gains from early initiation are unlikely to be clinically significant.
Elevated Expression of the C-Type Lectin CD93 in the Glioblastoma Vasculature Regulates Cytoskeletal Rearrangements That Enhance Vessel Function and Reduce Host Survival
Authors: Elise Langenkamp, Lei Zhang, Roberta Lugano, Hua Huang, Tamador Elsir Abu Elhassan, Maria Georganaki, Wesam Bazzar, Johan Lööf, George Trendelenburg, Magnus Essand, Fredrik Pontén, Anja Smits, Anna Dimberg
Journal: Cancer Research (2015)

Glioblastoma is an aggressive brain tumor characterized by an abnormal blood vasculature that is hyperpermeable. Here, we report a novel role for CD93 in regulating angiogenesis in this setting by modulating cell-cell and cell-matrix adhesion of endothelial cells. Tissue microarray analysis demonstrated that vascular expression of CD93 was correlated with poor survival in a clinical cohort of patients with high-grade astrocytic glioma. Similarly, intracranial growth in the GL261 mouse model of glioma was delayed significantly in CD93(-/-) hosts, resulting in improved survival compared with wild-type mice. This effect was associated with increased vascular permeability and decreased vascular perfusion of tumors, indicating reduced vessel functionality in the absence of CD93. RNAi-mediated attenuation of CD93 in endothelial cells diminished VEGF-induced tube formation in a three-dimensional collagen gel. CD93 was required for efficient endothelial cell migration and proper cell polarization in vitro. Further, in endothelial cells where CD93 was attenuated, decreased cell spreading led to a severe reduction in cell adhesion, a lack of proper cell contacts, a loss of VE-cadherin, and aberrant actin stress fiber formation. Our results identify CD93 as a key regulator of glioma angiogenesis and vascular function, acting via cytoskeletal rearrangements required for cell-cell and cell-matrix adhesion.
Myocardial injuries in patients with chronic obstructive pulmonary disease
Authors: Mikhail Kiniakin, Galina Sukhanova, Olga Kuraspediani
Journal: European Respiratory Journal (2012)

The purpose of this study is to determine a value of computer electrocardiotopography (CECTG) in myocardial injuries revealing in patients with obstructive pulmonary disease (COPD) and to determine hypoxemia role in its developing.  Materials and methods. We examined 62 male patients with COPD (15 – moderate, 28 – severe, 19 – very severe stages). CECTG method has been used in addition to common physical examination. This technique allows to evaluate condition of all heart9s portions using multielectrode belt consisted of 65 unipolar leads, which should be consecutively applied to the frontal and right side of the chest, abdomen and the backside of the chest. Therefore, amount of monopolar leads increases to 260 electrocardiosignals. That allows estimating panoramic view of electrical field of the heart. 10 myocardial regions were detected with estimating terminal part of QRS complex. Patients have been devided into 2 groups by PaO2 level: first group (n=29) with PaO2>80 mmHg, second group (n=33) had PaO2  Results. CECTG method revealed significant generalization of the myocardial injuries in right ventricle as well as in the left one in patients with COPD (79.8%). Myocardial injuries were detected mostly in rite ventricle area and posterodiafragmatic area of left ventricle. In compare with standard ECG CECTG revealed myocardial injuries in 1,6 times often. Myocardial injuries in patients with hypoxemia has been detected significant more often (p  Conclusion. CECTG method revealed myocardial injuries in right and left ventricle in 79.8% patients with COPD. Hypoxemia takes a definite role in injuries forming.
Predictors of high symptom severity in caregivers of underserved minority cancer patients.
Authors: G. R. Palos, T. R. Mendoza, K. E. Liao, A. Garcia-Gonzalez, K. Hahn, L. A. Nazario, G. R. Lynch, K. O. Anderson, X. S. Wang, C. S. Cleeland
Journal: Journal of Clinical Oncology (2010)

9097 Background: The burden of caring for a patient with advanced cancer is worse for those who are minority and underserved. We examined patterns of physical and psychological symptom severity in caregivers and patients over the treatment trajectory. Methods: The sample included 85 dyads of African-American, Latino, and Caucasian caregivers and patients starting chemotherapy for advanced solid-tumor cancer. Data were collected from dyads 3 times during the chemotherapy regimen. The primary outcome, symptom burden, was measured using severity and interference scores from the M. D. Anderson Symptom Inventory. Longitudinal cluster analysis identified groups of caregivers and patients with high vs. low symptom severity across the study period. Group membership was based on the average of the most severe symptoms for each cluster. Results: The most severe symptoms differed between caregiver and patient groups. Sadness and distress were the most severe symptoms reported by caregivers, while patients reported greater severity for fatigue and disturbed sleep. The caregiver group with high symptom severity (40%) remained highly symptomatic over the treatment course (slope= −0.60; p<0.000). The overall mean severity for the low-symptom caregiver group (60%) decreased over the treatment period. In patients, symptom severity remained stable for both high- and low-symptom groups. Family caregivers were five times more likely than nonfamily caregivers to have high symptom severity (OR 5.6; 95% CL 1.1, 29.5). Patients with high symptom severity were more likely than less-symptomatic patients to have caregivers with high symptom severity (OR 3.8; 95% CL 1.4, 10.4). Conclusions: High symptom severity in caregivers appears related to caring for a patient who is highly symptomatic and to being a family member. Caregivers with high-severity symptoms are also more likely to report high levels of interference in their daily activities. The combination of high symptom severity and interference raises a caregiver's risk for increased symptom burden. Interventions to identify and support at-risk caregivers may contribute to better health outcomes, not only for the caregivers themselves, but for the underserved cancer patients as well. No significant financial relationships to disclose.
Expression of Vasoactive Intestinal Polypeptide and Amylase in a Human Parotid Gland Adenocarcinoma Cell Line in Culture&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Y Hayashi, T Yanagawa, H Yoshida, M Azuma, T Nishida, Y Yura, M Sato
Journal: JNCI Journal of the National Cancer Institute (1987)

A neoplastic epithelial cell line initially established in culture from a human parotid gland adenocarcinoma grown in athymic nude mice with a BALB/c genetic background, which has an ultrastructure similar to that of the intercalated duct cell of the salivary glands, was examined for the expression of amylase and vasoactive intestinal polypeptide (VIP). The cultured cells were found by the peroxidase-antiperoxidase (PAP) method to express amylase and ultrastructurally to have secretory granules showing positive immunoreaction with anti-amylase serum. In addition, the cells were found to secrete amylase into the culture medium. The expression of VIP in the cultured cells was observed by the PAP method, immunofluorescent staining method, or immunoelectron microscopy. Moreover, the presence of the polypeptide reactive to antibodies directed against VIP in the cultured cells was confirmed by immunoblotting and radioimmunoassay. These findings indicate that the cells proliferating in culture express both amylase and VIP.
How much missing data is too much? A single study exploration
Authors: A. Dueck, P. Atherton, A. Tan, J. Sloan
Journal: Journal of Clinical Oncology (2006)

6116 Background: Analyses of patient-reported outcomes rely on the dependability of patients to complete and submit assessments in a timely manner – not all data is obtained. In recent work focusing on quality of life (QOL) data and imputation, it has been found that most methods do not alter study results. But how much data can be missing before study results are affected? Methods: Missing data was investigated using a 2-arm study (109 patients) who completed Linear Analogue Self Assessments at 4 intervals. Patients (11%) had missing data at the second interval. Existing data was analysed for differences in scores between arms, then cases were randomly deleted to create increasing percentages (12%-20%) of missing data. Ten simulations were conducted per percent. Imputation methods applied were carrying forward the last value (LVCF), average value (AVCF), and maximum value (MVCF). Student’s t-tests were performed between arms for each simulation. Results: Imputation did not alter results of our study data which was statistically significant (SS) between arms for overall QOL (p=0.036) and spiritual well-being (SWB) (p=0.006), and not statistically significant (NS) for mental well-being (MWB) (p=0.174). After data deletion and t-test calculations, AVCF did not impact results. For overall QOL, data deletion changed the p-value to NS in 1 of 10 simulations starting at 12% missing data and 5 of 10 simulations starting at 16% missing data. No matter what percentage of missing data, imputation produced a SS p-value over 80% of the time. Data deletion and subsequent imputation did not affect the study decision for SWB. For MWB, all differences between arms were NS prior to imputation. After imputation, there was at most a 7% disagreement in conclusions. LVCF and MVCF performed equally in all simulations. Conclusions: For this particular study, when p-values are close to the study-defined alpha, the increase in missing data can change the study results and imputation methods are more likely to determine SS differences. The further the p-values are from the study alpha, there is little effect from increasing missing data or applying imputation. These results are for one particular study and further research is needed. No significant financial relationships to disclose.
A Pilot Study of the Effect upon Multiple Sclerosis of the Menopause, Hormone Replacement Therapy and the Menstrual Cycle
Authors: R Smith, J W W Studd
Journal: Journal of the Royal Society of Medicine (1992)

A questionnaire enquiring about changes in severity of symptoms of multiple sclerosis with the menstrual cycle, menopause and use of hormone replacement therapy was answered retrospectively by 11 premenopausal and 19 postmenopausal women. Eighty-two per cent of menopausal women reported an increase in severity premenstrually. Of the postmenopausal women 54% reported a worsening of symptoms with the menopause, and 75% of those who had tried hormone replacement therapy reported an improvement. The results of this pilot study indicate the need for further research to clarify the effects of the menopause and hormone replacement therapy upon multiple sclerosis.
Severity-related microbiome changes in COPD
Authors: Marian Garcia-Nuñez, Laura Millares, Vicente Perez-Brocal, Rafaella Ferrari, Miguel Gallego, Conchita Monton, Javier Pomares, Mateu Espasa, Alex Mira, Andres Moya, Eduard Monso
Journal: European Respiratory Journal (2013)

BACKGROUND  .   Bronchial secretion cultures have shown that bronchial colonization is a common finding in COPD, but have the disadvantage that depend on the recovery of bacteria in selective cultures. Culture-independent techniques allow the examination of the whole range of the bronchial flora.   OBJECTIVE:  Analysis and comparison of the bronchial microbiome in moderate and severe COPD patients, in order to identify changes in the COPD microbiome related to disease progression.   METHODS   DNA sputum samples were obtained from 4 stable moderate and 9 severe COPD patients. Microbiome diversity was determined by 454 pyrosequencing of PCR-amplified 16S rDNA. Sequences were filtered and analysed using QIIME software.   RESULTS   Moderate COPD patients showed higher microbial diversity than severe COPD subjects (Shannon Index, p=0.02; Simpson inverse Index, p=0.005) and the PCA analysis revealed one cluster of bacterial community composed by the severe COPD patients. The vast majority of the sequences were assigned to 5 bacterial phyla ( Firmicutes, Proteobacteria, Bacteroidetes, Actinobacteria , and  Fusobacteria, representing the 99% ). The relative abundance of commensal phyla was significantly lower in severe COPD patients ( Bacteroidetes  [p=0.005],  Fusobacteria  [p=0.005] and SR1 [p=0.02]). Moderate COPD patients showed higher relative abundance of 19 genera representing 48% and 2% of relative abundance.   CONCLUSIONS:  In COPD severe disease is associated with a significant decrease in microbiome diversity with a loss of commensal flora, without significant change in the potentially pathogenic microbiota.  Funded by Fundacio Tauli, SOCAP, FUCAP I Menarini.
Some Prognostic and Epidemiologic Factors in Canine Osteosarcoma
Authors: W. Misdorp, A. A. M. Hart
Journal: JNCI Journal of the National Cancer Institute (1979)

Naturally occurring skeletal osteosarcomas in a series of 144 untreated dogs were found especially to involve the ends of the long bones of the forelimbs and affected predominantly older male dogs of giant and large breeds. Most tumors were large and partially necrotic and had extended into soft tissues. Of 12 host and tumor characteristics tested in the first part of the study, tumor diameter and volume were significantly associated with the presence of pulmonary metastases at autopsy. The second part of the study revealed that extension of the tumor into the soft tissues and localization of the tumor in the hind legs were associated with a poor prognosis, whereas the fibrosarcomatous type of tumor was associated, as in man, with a favorable prognosis. An association between the 12 characteristics tested was found in 11 of 78 combinations at the 5% level and in 5 combinations at the 1% level. Affected giant dogs were generally younger than affected small and medium-sized dogs. Especially in giant dogs, the osteosarcomas involved the long bones and were of relatively large diameters. The sarcomas in female dogs were larger in volume than those in males. Pure osteoblastic osteosarcomas were generally smaller than combined (chondroblastic and fibroblastic) osteosarcomas. Peritumorous lymphocytes and plasma cells were present in 50% of the dogs, especially in small and young dogs. When compared with a reference population, great Danes, rottweilers, German shepherds, and boxers were found to be overrepresented in the osteosarcoma group.
Elevated growth differentiation factor 15 levels predict outcome in patients undergoing transcatheter aortic valve implantation
Authors: Nora‐Christina Krau, Nina‐Sophie Lünstedt, Sandra Freitag‐Wolf, Doreen Brehm, Rainer Petzina, Georg Lutter, Peter Bramlage, Astrid Dempfle, Norbert Frey, Derk Frank
Journal: European Journal of Heart Failure (2015)
Leadership in clinical medicine from respiratory perspective
Authors: M. Amin Afridi, Sajid Khan
Journal: European Respiratory Journal (2013)

Objective:   Leadership is an integral part of clinical medicine but as junior doctors, we do not realise how many times we use our unacknowledged leadership skills to perform certain actions. As part of ‘Leadership in clinical medicine’ module that I undertook, I carried out a service improvement project to bring a positive change in the organisation. Reflecting on the project as a respiratory registrar, I realise the importance of the need of incorporating the sense of developing leadership skills right from the start.   Methods :  Attending study days comprising of lectures on history, qualitative and quantitative research methods, ethics, team dynamic, leadership styles, setting up services etc, I combined quantitative (previous audit data) and qualitative data (observational and informal interviews) to improve the care for the patients with pleural effusions and measures were taken to implement the outcome.   Discussion:   As a registrar it was a challenge to bring change to already setup running department in the multi professional environment. In healthcare organisations with current financial constraints and the evolving complex multidisciplinary clinical care that we provide as set out in Darzi’s report (Darzi 2008, Department of Health, UK), as a primary healthcare deliverer we must be aware of the fact that good clinical leaders achieve high quality care and bigger savings. With expertise in the healthcare needs, challenges and delivery at all levels, subjecting junior medical doctors to such educational modules will definitely provide insight into the importance of developing leadership skills to set up vision for people and I feel these modules may become part of the junior training schemes across the board.