tbuckley/cabot-search huggingface dataset:
Regulation of immune response plasticity - A path to success in pulmonary diseases management
Authors: Svetlana Lyamina, Sergey Kalish, Igor Malyshev
Journal: European Respiratory Journal (2012)

Disorder of the immune response plasticity is the basis of pathogenesis of pulmonary diseases with inflammatory component.  Objective.  to assess the possibility of immune response plasticity management in pulmonary diseases with inflammatory component by means of microenvironment components of alveolar macrophages (AM).  Methods. AM of patients with chronic obstructive pulmonary disease (n=18), bronchial asthma (n=17), sarcoidosis (n=23) were cultured with various concentrations of standard serum FBS containing TGF-β and surfactant protein D (SP-D)–serum model of reprogramming. Quality of macrophages bioprogramming was measured by morphological characteristic (light microscopy), cytokine production and surface macrophages markers expression (flow cytometry, Beckman Coulter FC500).  Results.  Changing of macrophages microenvironment with FBS concentration and the level of TGF-β and SP-D, respectively, purposefully programmed macrophages phenotype on M1 proinflammatory, or M2 antiinflammatory, shifting the immune response to Th1 or Th2, respectively. Decreasing FBS concentration to 0% programmed macrophages to M1 phenotype which was confirmed by morphologic characteristic, cytokine production and macrophages markers expression. The consecutive increasing of FBS concentration from 20 % to 40 % led to bioprogramming of macrophages on M2 phenotype and Th2 response development with close relationship to concentration.  Conclusions . Serum model of reprogramming was effective in regulation of immune response plasticity in pulmonary diseases and can be used as the new approach in pathogenetic therapy of pulmonary diseases with inflammatory component.
Psychological co-morbidities in patients with COPD: Which changes can be observed during inpatient pulmonary rehabilitation (PR)?
Authors: Birgit Schwaighofer, Danijel Jelusic, Michael Wittmann, Michael Schuler, Konrad Schultz
Journal: European Respiratory Journal (2014)

Introduction: Anxiety and affective disorders are frequent co-morbidities in patients with COPD as well as negative prognostic predictors.This is why rehabilitation guidelines postulate systematic assessments to screen for major depression (MD) and anxiety symptoms (AS). Scientific sources highlight positive effects in reduction of symptoms for 6 weeks and longer lasting rehabilitations.  Objectives: The aim of this research was to find out how many of COPD patients show a MD or AS and whether a PR of 3 weeks can reduce symptoms.  Methods: From Feb 13 - Jan 14 356 patients with COPD were systematically screened by PHQ-9 and GAD-7 in terms of MD and AS at admission (T0) and dismissal (T1). Differences were analysed using crosstables and McNemar-test.  Results: At T0 31,2% of all patients showed criteria of a MD (PHQ9≥10) and 26,2% met the criteria of relevant AS (GAD7≥10). 69 patients (19,4%) revealed clinical relevant symptoms for MD and AS. At dismissal percentages shortened of MD to 17,7% and for clinical relevant AS to 14,1%. In patients with MD as well as AS the part of affected patients dropped to 10,1% (n=36). All reductions of scores in comparison from T0 to T1 were significant.  Conclusions: The results of this research suggest that even in 3 weeks PR a relevant reduction of anxiety and depression symptoms can be determined.
Does SpO2 correlate with SaO2 in stable COPD patients
Authors: Rajesh Kumar Yadavilli, Vinay Shanker Sreeguru Lakshman, Paul Stockton, Simon Twite, Sanjeev Agarwal
Journal: European Respiratory Journal (2012)

Background:   Pulse oximetry is commonly used to measure oxygen saturations (SpO 2 ) in assessment of patients with stable COPD. This is considered to be equivalent to oxygen saturations measured on a blood gas analyser (SaO 2 ). The ATS, ERS and GOLD guidelines for COPD define suitability for long term oxygen therapy with PaO 2  less than 7.3kPa or SaO 2  of less than 88%.   Aim:   To confirm if SpO 2  correlates to SaO 2  in stable COPD patients.   Methods:   Retrospective study of patients with stable COPD attending oxygen clinics in an acute teaching hospital.   Results:   N=73, Male 29 %, Mean Age70 (range 53 - 93), Mean FEV1 0.89 L, current smokers 29%, 26% on oxygen, mean MRC grade 4, mean BORG score at rest 2 and mean hematocrit (HCT) 0.41.  On9t9 paired testing in all patients, no statistically significant difference was noted between SpO 2  and SaO 2  (p value: 0.972), the mean SpO 2 - SaO 2  is -0.012% (95% CI of -0.71 to 0.69).  However, in current smokers subgroup (N=21) high variation between these values was noted, with the mean SpO 2 - SaO 2  1.067%. There was a tendency for SpO 2  to be higher than SaO 2  (95% CI of -1.038 to 3.171).  There is no statistically significant relationship between SpO 2  and SaO 2  in COPD patients in relation to sex, age, severity of COPD, smoking status, MRC grade, BORG score, and HCT levels.   Conclusions:   As the difference between SpO 2  and SaO 2  is high in current smokers, SpO 2  reading using pulse oximetry might not be reliable. Further studies with larger sample size are needed to evaluate this further.
Respiratory muscle endurance training in cystic fibrosis
Authors: Christian Bieli, Summermatter Selina, Inci Demet, Jung Andreas, Moeller Alexander
Journal: European Respiratory Journal (2014)

Background 

Respiratory muscle endurance training (RMET) has been shown to increase endurance performance in trained and untrained healthy subjects and patients with chronic obstructive pulmonary disease COPD). Two studies have been performed in adult patients with cystic fibrosis (CF), however with conflicting study design and results.

Aims 

The aim of the study is to investigate the effects of an eight week RMET with the SpiroTiger® device in children and adolescents with CF on respiratory endurance (RE), exercise endurance (EE), quality of life (QoL), lung function and clinical score.

Methods 

16 children (8-18 years, FEV187.0 ± 25.8%pred [mean ± SD]) were included. All children underwent an incremental exercise test and a first RMET using the SpiroTiger® device. Three weeks later patients were randomly assigned either group A or B. Group A performed eight weeks RMET followed by eight weeks standard chest physiotherapy whereas group B absolved the program in reverse order. Primary outcome measures consisted in a respiratory endurance test using the SpiroTiger® device, a constant workload cycling test and CFQ, and secondary outcomes were clinical score and lung function.

Results 

Respiratory endurance increased significantly from 3.7 ± 2.1to 16.8± 10.2 min (mean± SD); p < 0.001), whereas exercise endurance increased from 7.9 [8.1] to 10.25.8] min (median [IQR]; p= 0.008), respectively. All other outcomes including CFQ scores, clinical score, FEV1 (L) and FVC (L) did not change significantly after RMET.

Conclusions 

The RMET leads to a significant increase in respiratory endurance and exercise endurance. However, other clinical relevant outcomes such as lung function, quality of life and clinical score were unaffected by RMET.
Fluticasone/formoterol combined in a single aerosol inhaler vs budesonide/formoterol for the treatment of asthma: A non-inferiority trial
Authors: Anna Bodzenta-Lukaszyk, Roland Buhl, Beatrix Bálint, Mark Lomax, Kay Spooner
Journal: European Respiratory Journal (2011)

Background:  Fluticasone (FLUT) and formoterol (FORM) are widely prescribed for asthmatics. A combination of FLUT/FORM in a single aerosol inhaler ( flutiform ®) has now been developed. This trial aimed to determine if FLUT/FORM is non-inferior to budesonide/formoterol (BUD/FORM; single inhaler) with regards to efficacy, and to assess safety, in adolescents and adults with moderate-to-severe persistent reversible asthma.   Methods:  Eligible patients had an FEV 1  of ≥50% to ≥80% for predicted normal values and a ≥15% reversibility in FEV 1  following salbutamol (up to 400μg). 279 patients were randomised to FLUT/FORM 250/10μg b.i.d. (n=140) or BUD/FORM 400/12μg b.i.d. (n=139) in this 12 week, double-blind, 2-arm, parallel-group trial. The primary efficacy measure was change in morning pre-dose FEV 1  from baseline to Week 12.   Results:  261 patients completed (FLUT/FORM; n=133; BUD/FORM; n=128). Both treatment groups showed improvements in morning pre-dose FEV 1  from baseline to Week 12. FLUT/FORM was shown to be non-inferior to BUD/FORM because the lower limit of the 95% CI of the treatment difference (FLUT/FORM – BUD/FORM) was greater than the pre-defined threshold value of -0.2L (95% CI: -0.130, 0.043L). One patient on FLUT/FORM discontinued due to AEs (asthma exacerbation: not related) vs 3 patients on BUD/FORM (asthma exacerbation, acute sinusitis: not related; asthma exacerbation: possibly related).   Conclusions:  Fluticasone/formoterol combination improved morning pre-dose FEV 1  over 12 weeks of treatment; demonstrated comparable efficacy to BUD/FORM with regards to this key lung function measure of asthma control and had a similar safety profile.
Human Skin Aryl Hydrocarbon Hydroxylase
Authors: David R. Bickers, Attallah Kappas
Journal: Journal of Clinical Investigation (1978)

Coal tar products, which are widely used in treating dermatologic disease, contain numerous polycyclic aromatic hydrocarbons, including 3,4-benzo[a]pyrene (BP). BP is among the most potent environmental chemical carcinogens and is known to evoke tumors in the skin of experimental animals and perhaps also of man. In this study the effect of cutaneous application of coal tar solution (U. S. Pharmacopeia) on aryl hydrocarbon hydroxylase (AHH) activity in the skin of patients usually treated with this drug was investigated. AHH, a cytochrome P-450 dependent carcinogen-metabolizing enzyme appears to play an important role in the activation of polycyclic hydrocarbons into reactive moieties that can bind to DNA and that may directly induce cancer. Application of coal tar solution to human skin caused a two to five-fold induction of cutaneous AHH in nine subjects. In further studies, the incubation of human skin with coal tar solution in vitro also caused variable induction of cutaneous AHH. Maximum responses in both systems occurred after 24 h and enzyme activity in vitro was time- and tissue- and substrate-concentration dependent. Studies in experimental animals showed that topical application of coal tar solution caused induction of AHH in skin and, after percutaneous absorption, in liver as well. Assay of several defined constituents of coal tar for AHH induction showed that BP was the most potent inducer of AHH tested. These studies indicate that topical application of coal tar solution in doses ordinarily used in treating dermatologic disease causes induction of AHH in human skin and suggest that such induced enzymatic activity could relate to carcinogenic responses to this agent in skin or, after percutaneous absorption, in other tissues as well.
Markets, politicians, and the NHS
Authors: R. Klein
Journal: BMJ (1999)

In 1985 Alain Enthoven, a visiting American professor, published a monograph that introduced the idea of “an internal market model” for the National Health Service,1 a phrase that was to resonate over the coming years. He has now returned to report on what has happened to the idea, drawing on 120 interviews with people working in the NHS. In the 1999 Rock Carling lecture, commissioned and published last week by the Nuffield Trust,2 he gives his conclusions. The result is a scholarly analysis of the implementation of the 1991 NHS reforms. On the one hand, it helps to make sense of the past: the reasons why the 1991 reforms disappointed both the hopes of their advocates and the prophecies of their critics. On the other, its arguments and insights feed into the continuing debate about the NHS's future.

One myth, however, first requires exploding. This is the view that the 1991 reforms represented a systematic attempt to translate an “internal market model” into practice. They did not. The …
Deficits in short-term memory in posttraumatic stress disorder
Authors: J D Bremner, T M Scott, R C Delaney, S M Southwick, J W Mason, D R Johnson, R B Innis, G McCarthy, D S Charney
Journal: American Journal of Psychiatry (1993)

The purpose of this study was to compare the memory function of patients with posttraumatic stress disorder (PTSD) to that of matched comparison subjects.Vietnam veterans with combat-related PTSD (N = 26) were compared to physically healthy comparison subjects (N = 15) matched for age, race, sex, years of education, handedness, socioeconomic status, and alcohol abuse. Memory and intelligence were assessed with a battery of neuropsychological tests, including the Russell revision of the Wechsler Memory Scale, the Selective Reminding Test, and subtests of the Wechsler Adult Intelligence Scale-Revised (WAIS-R).The PTSD patients scored significantly lower than the comparison subjects on the Wechsler Memory Scale logical memory measures for immediate recall (mean = 11.6, SD = 3.3 versus mean = 20.9, SD = 6.6) and delayed recall (mean = 8.0, SD = 3.3 versus mean = 17.8, SD = 6.4). The PTSD patients also scored significantly lower on the total recall, long-term storage, long-term retrieval, and delayed recall measures for the verbal component of the Selective Reminding Test and on the recall, long-term storage, long-term retrieval, and continuous long-term retrieval measures for the visual component of the Selective Reminding Test. There was no significant difference between the PTSD patients and comparison subjects in prorated full-scale IQ as measured by the WAIS-R.Patients with PTSD may have deficits in short-term memory. Counseling and rehabilitation that address these deficits may be of value for PTSD patients.
Comorbidities at time of COPD diagnosis
Authors: David Price, David Halpin, Robert Winter, Susan Hill, Eric Bateman, Daryl Freeman, Dermot Ryan, Matthew Kearney, Kevin Holton, Annie Burden, Julie von Ziegenweidt, Laurence Mascarenhas, Alison Chisholm, Rupert Jones
Journal: European Respiratory Journal (2011)

Rationale:  Comorbidities can potentiate the morbidity of chronic obstructive pulmonary disease (COPD), and vice versa. Patients with COPD often die as a result of comorbidities.   Objectives:  Evaluate prevalence of comorbidities at COPD diagnosis in real-world patients over a 10-yr period.   Methods:  Retrospective study using data from the United Kingdom9s General Practice and Optimum Patient Care research databases. Eligible patients were: ≥40 yrs; received first COPD diagnostic code between 1990–2009; prescribed ≥2 COPD therapies in the year following diagnosis, had ≥2 yrs clinical data prior to diagnosis. Prevalence of asthma, ischaemic heart disease (IHD), gastroesophageal reflux disease (GERD) and diabetes mellitis (DM) were evaluated using diagnostic codes and (for GERD and DM) prescribing records before COPD diagnosis.   Results:  38,859 eligible patients: 52.6% male, diagnosed with COPD at median (IQR) age 68 (60–75)yrs. Over the period, asthma was recorded in 53.3% of patients, falling from 71.1% in 1990 to 29.7% by 2008. In the 2 yrs prior to their COPD diagnosis, 7.7% of patients consulted for IHD and 18.5% consulted, or received prescriptions, for GERD and 9.6% for DM. The percentage of patients consulting for comorbidities prior to COPD diagnosis increased over the study period: IHD from 6.5% in 1990 to 11.5% in 2009; GERD from 1.5–8.4% and DM from 4.4–12.5%.   Conclusions:  These data confirm the presence of comorbidities in a substantial proportion of the UK COPD population. Trends over the study period suggest better differentiation of asthma and COPD diagnoses in recent years. The increasing prevalence of comorbidities may indicate increased awareness of comorbidities or improved diagnosis of COPD in patients treated for comorbidities.
Abstract 18238: Is the Impairment of Diastolic Function in Metabolic Syndrome Simply a Consequence of Hypertension?
Authors: Joao L Cavalcante, Balaji K Tamarappoo, Deborah H Kwon, M. Chadi Alraies, Sandra Halliburton, Damini Dey, Daniel S Berman, Thomas H Marwick
Journal: Circulation (2011)

Purpose: Metabolic syndrome (MS) is associated with diastolic dysfunction (DD). However, hypertension (HTN) is a constituent of MS, which may itself be sufficient to explain this association. Hypothesis: We sought to establish the balance between HTN and visceral adipose (measured as epicardial fat volume, EFV) in DD. Methods: Pts were eligible if cardiac CT and echo were obtained within 6 months, as long as there was no history of myocardial infarction, revascularization), &gt;2+ valvular regurgitation, valvular stenosis or systolic dysfunction. MS was defined by ≥3 of: fasting blood sugar ≥ 100 mg/dl or diagnosis of DM, body mass index &gt;30 kg/m 2 , HTN, triglycerides ≥150 mg/dl or HDL &lt;40 mg/dl. HTN was defined by either use of antihypertensive medication(s) and/or blood pressure ≥ 130/85 mmHg. DD was defined as per ASE guidelines. EFV was measured using previously validated CT software by 2 independent cardiologists blinded to the echo data. Results: Of 110 pts (age 55±13 years, 65% men, body mass index 28±5 kg/m²) HTN, MS and DM were present in 42%, 40% and 12%, respectively. Systolic function (LVEF=58±4%) and mean E/e’ (8±3) were generally normal, but left atrial volume index (25±9 cm³/m²) and diastolic parameters (E/A=1.2±0.5, mean e’ 10±4 cm/s) were variable. Pts were divided into 3 groups: A) MS with HTN; B) MS without HTN; C) No MS but with HTN. Markers of DD are shown in the Table 1. In a univariate analysis, there were no significant differences among the 3 groups in any of the parameters. In contrast, higher EFV was strongly correlated with presence of MS (102±7 vs 80±6 cm 3 , p=0.02) and diastolic dysfunction (107±8 vs 80±6 cm 3 , p=0.005). In a multivariate logistic regression analysis (R 2 =0.39), only age (p&lt;0.001) and EFV (p=0.0008) were independent predictors of DD (decreased mean e'velocities) whereas MS and HTN were not (p=0.7). Conclusions: In conclusion, despite the usual association of DD with HTN, its link with MS seems to involve EFV.
Psoriasis and sleep disorders: A systematic review
Authors: Madhulika A. Gupta, Fiona C. Simpson, Aditya K. Gupta
Journal: Sleep Medicine Reviews (2015)

Psoriasis is an immune-mediated chronic inflammatory disorder which manifests as dermatologic lesions, and psoriatic arthritis (PsA) in about 30% of cases. Psoriasis is associated with multiple comorbidities including metabolic syndrome, hypertension, diabetes, cardiovascular events, obesity and psychiatric disorders, which can all affect the course of sleep disorders. A systematic review of the literature on the relationship between psoriasis, PsA, and formal sleep disorders identified 33 studies. There is an increased prevalence of obstructive sleep apnea (OSA) with 36%–81.8% prevalence in psoriasis versus 2%–4% in the general population. There was also an increase in the prevalence of restless legs syndrome of 15.1%–18% in psoriasis versus 5%–10% in European and North American samples. The wide variety of insomnia criteria used in studies resulted in an insomnia prevalence of 5.9%–44.8% in psoriasis, which is insufficient to show an elevated prevalence when the general population has a 10% prevalence of chronic insomnia and 30–35% prevalence of transient insomnia. There is evidence that symptoms of insomnia in psoriasis are directly mediated by pruritus and pain. Treatments that decrease the cutaneous symptoms in psoriasis were successful in mitigating insomnia, but did not show improvements in OSA where the relationship with psoriasis is multifactorial.
The impact of the CB2-63 polymorphism on the histological presentation of chronic hepatitis B
Authors: N. Coppola, R. Zampino, G. Bellini, M. Stanzione, N. Capoluongo, A. Marrone, M. Macera, G. Pasquale, A. Boemio, S. Maione, L.E. Adinolfi, E. Miraglia Del Giudice, E. Sagnelli, F. Rossi
Journal: Clinical Microbiology and Infection (2015)
Comparisons between different polychemotherapy regimens for early breast cancer: meta-analyses of long-term outcome among 100 000 women in 123 randomised trials
Authors: R Peto, C Davies, J Godwin, R Gray, H C Pan, M Clarke, D Cutter, S Darby, P McGale, C Taylor, Y C Wang, J Bergh, A Di Leo, K Albain, S Swain, M Piccart, K Pritchard
Journal: The Lancet (2012)
Leaving the Hospital Against Medical Advice
Authors: D O'Hara, W Hart, I McDonald
Journal: JAMA (1980)

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Report on the Consensus Workshop on Formaldehyde
Authors: M. Gough, R. Hart, B.W. Karrh, A. Koestner, R. Neal, D. Parkinson, F. Perera, K.E. Powell, S. Rosenkranz
Journal: Environmental Health Perspectives (1984)

The Consensus Workshop on Formaldehyde consisted of bringing together scientists from academia, government, industry and public interest groups to address some important toxicological questions concerning the health effects of formaldehyde.The participants in the workshop, the Executive Panel which coordinated the meeting, and the questions posed, all were chosen through a broadly based nomination process in order to achieve as comprehensive a consensus as possible.The subcommittees considered the toxicological problems associated with formaldehyde in the areas of exposure, epidemiology, carcinogenicity/histology/genotoxicity, immunology/sensitization/irritation, structure activity/biochemis- try/metabolism, reproduction/teratology, behavior/neurotoxicity/psychology and risk estimation.Some questions considered included the possible human carcinogenicity of formaldehyde, as well as other human health effects, and the interpretation of pathology induced by formaldehyde.These reports, plus introductory material on the procedures used in setting up the Consensus Workshop are presented here.Additionally, there is included a listing of the data base that was made available to the panel chairmen prior to the meeting and was readily accessible to the participants during their deliberations in the meeting.This data base, since it was computerized, was also capable of being searched for important terms.These materials were supplemented by information brought by the panelists.The workshop has defined the consensus concerning a number of major points in formaldehyde toxicology and has identified a number of major deficits in understanding which are important guides to future research.
Dual PI3K/Akt/mTOR Pathway Inhibitor Potentiate Cytarabine Cytotoxicity For Acute Myeloid Leukemia
Authors: Eun Kyung Kim, Hyoung Jin Kang, Hyung Joon Kim, Ji Won Lee, Hyery Kim, Kyung Duk Park, Hee Young Shin, Hyo Seop Ahn
Journal: Blood (2013)