tbuckley/cabot-search huggingface dataset:
Multidisciplinary approach in management of extended and multifocal benign tracheal stenosis: Lessons learned
Authors: Dmitry Bazarov, Kuldash Abdumuradov, Rumia Sharipjanova, Sergei Cherny, Vladimir Parshin, Michail Rusakov, Denis Fedorov
Journal: European Respiratory Journal (2013)

Background. Frequency of benign scar stenoses of trachea after carrying out the emergency care varies from 0,2 to 25%. Treatment of patients with extended or multifocal tracheal stenoses still remain difficult task.  Aims. To study results of multidisciplinary tactics in treatment of extended and multifocal cicatricial stenoses of trachea.  Materials and methods: There were 172 patients with extended and multifocal benign tracheal stenoses. With extended stenoses there were 153 patients (89%), and with multifocal defeat 19 patients (11%). Among them 103 (60%) were men and 69 (40%) were women aged from 9 till 76 years (middle age of 36 years). Postintubation stenosis was in 24(14%) cases and posttracheostomy stenosis was in 126 (73%). Totally 452 airways interventions were performed in 172 patients, including 64 segmental resection of a trachea, 169 tracheoplasty with T-tube, 92 elimination of tracheal defect, 125 endoscopic procedures.  From clinic discharged 169 patients. The lethality was 1,7%.  The complications were in 39 cases (8,6%). Most often complications occured after endoscopic operations 19 (4,2%). Thus the health as good was estimated by 40% of patients, 43% of patients felt well. Unsatisfactorily results of treatment (17%) were connected with preservation of tracheostomy.  Conclusions. In case of extended cicatricial stenoses of a trachea the one-stage extensive resection of a respiratory way with the anastomosis is possible only in 14% of patients. Preliminary elimination of tracheostomy and also formation of the top departments of a respiratory way by means allows to perform segmental resection of chest department of a trachea with good clinical results.
Edmund Augustine Dowling
Authors: S. Dowling
Journal: BMJ (2015)

Edmund Augustine Dowling was born in Waterford, Ireland. After an internship as house surgeon at Burton General Hospital and Nottingham General Hospital in England, he emigrated from Ireland to the US in 1952. Joan O’Connor soon followed him, and they married in 1953. At the invitation of his cousin, Edmund began a residency in pathology at Baptist Hospital in Birmingham, Alabama. In 1968, after a series of …
Abstract 3490: Mechanistic Involvement of Myeloperoxidase in the Pathogenesis of Atrial Fibrillation
Authors: Volker Rudolph, Rene Andrie, Kai Friedrichs, Tanja K Rudolph, Anna Klinke, Denise Lau, Katalin Scoecs, Jan Schrickel, Thorsten Lewalter, Georg Nickenig, Thomas Meinertz, Stephan Willems, Stephan Baldus
Journal: Circulation (2008)

Background: Observational clinical and ex-vivo studies have established a strong association between atrial fibrillation (AF) and inflammation. However, whether inflammation is cause or consequence of AF and which specific inflammatory mediators increase atrial susceptibility to fibrillate remain elusive. Herein, we provide evidence for mechanistic involvement of myeloperoxidase (MPO), a heme enzyme abundantly expressed by neutrophils, in the pathophysiology of AF. Methods and Results: Patients with AF assessed by pacemaker interrogation not only exhibited higher circulating plasma levels of MPO (503.1 [IR:404.6 –880.7] vs. 437.8 [IR:348.9 – 488.0 pmol/l; p=0.03; n=42), they also revealed an increased MPO burden in explanted left atrial tissue as compared to patients devoid of AF. In AF-patients MPO co-localized with markedly increased formation of 3-nitro and 3-chlorotyrosin, protein oxidations known to be catalyzed by MPO. Myeloperoxidase knock-out mice, pretreated with angiotensin II infusion for 2 weeks yielding increased neutrophil activation, revealed strikingly attenuated vulnerability for AF during right atrial electrophysiological stimulation as compared to wild type mice (probability of AF-induction: 3.0 vs. 12.7%; p&lt;0.01). Whereas the electrical homogeneity of the atrial myocytes was not altered between the groups, atria of MPO knock out mice were indicative of significantly reduced atrial fibrosis and markedly reduced formation of 3-chloro- and 3-nitrotyrosine. Conclusion: In conclusion, the current findings not only underscore the significance of neutrophil activation as a critical pathophysiological prerequisite of AF, but reveal that MPO - by oxidatively modifying protein residues and increasing fibrosis of atrial myocytes - is causally linked to the initiation and perpetuation of AF.
Occupational asthma and rhinitis caused by brazing agent
Authors: Bronislava Viest, Jindriska Lebedova
Journal: European Respiratory Journal (2012)

Background: Aluminium potassium fluoride (KAlF4) often used in automotive industry as a brazing agent is not currently classified as an allergen.

Methods: Between 2007 and 2011, eleven patients with suspected occupational asthma (OA) and/or occupational rhinitis (OR) exposed in their workplace to KAlF4 were examined. Diagnostic of OA/OR included: methacholine (MCT), specific bronchoprovocation (SBPC) and/or nasal challenges if necessary. Inhaled corticosteroids (ICS) were withdrawn 6 weeks prior to the evaluation.

Results: Seven of the 11 patients tested positive. According to final diagnosis patients were divided into 2 groups. Group 1: no occupational disease (OD) diagnosed (4 cases); ICS withdrawn in 100%; average age of subjects was 35; mean exposure time was 50.2 months; subjects were examined 6.5 months after leaving the workplace; no allergic disease before exposure; MCT negative in 50%, mild hyperactivity in 50%; IgE: 21 IU/ml, ECP: 16 ng/ml, eosinophils (eo): 5%. Group 2: OD diagnosed in 7 cases (OA in 4, OR in 3 cases), ICS withdrawn in 25%; average age of subjects was 44.3; mean exposure time was 65.5 months; subjects were examined 2.4 months after leaving the workplace; allergic disease before exposure in 42%; MCT negative in 14%, moderate to severe hyperactivity in 86%; IgE: 42 IU/ml, ECP: 38 ng/ml, eo: 10%.

Conclusion: Subjects in group 2 versus patients in group 1 were: a) often tested with ICS b) more likely to be bronchial hyperreactors and atopics c) demonstrated higher levels of eosinophils, IgE and ECP. The small number of patients did not allow proper statistical analysis, however KAlF4 seems to be hazardous and likely to cause allergic occupational diseases.
Improving physical activity in patients with severe COPD with urban walking circuits. A randomised trial
Authors: Eulogio Pleguezuelos, Maria Engracia Pérez, LLuis Guirao, Beatriz Samitier, Maria Costea, Pilar Ortega, Xavi Vila, Margarita Solans, Eva Moreno, Alex Meri, Marc Miravitlles
Journal: European Respiratory Journal (2013)

Patients with COPD are more inactive than healthy subjects of the same age. Even after a rehabilitation program, levels of physical activity progressively decrease unless strategies to encourage activity are implemented. We analyzed the adherence and effects of the implementation of urban walking circuits on levels of physical activity and exercise capacity of patients with severe COPD after a respiratory rehabilitation program.  A total of 83 patients were randomized to either urban circuits (UCG) or usual care (NCG) after completing a 12-week rehabilitation program. Results were evaluated 9 months after completion of the rehabilitation program and were compared with a control group of 54 patients not enrolled in the rehabilitation program.  UCG patients increased their physical activity by a mean of 38 minutes per day compared to 10.8 minutes of NCG (p 0.05). Patients in the control group showed a significant decrease in exercise capacity and physical activity over the follow-up.  The use of urban circuits is an easy, inexpensive strategy, which demonstrated to be useful to stimulate physical activity in our population of severe COPD patients and resulted in increased exercise capacity even 9 months after completion of a rehabilitation program. There was a significant correlation between exercise capacity and physical activity only in patients enrolled in the urban circuits.
Hospital adherence to GOLD guidelines for COPD exacerbation. Results of the European CODP audit
Authors: Jose Luis Lopez-Campos, Michael Roberts, Francisco Pozo-Rodriguez, Sylvia Hartl
Journal: European Respiratory Journal (2013)

Objectives. Understanding how European care of COPD admissions varies against guideline standards provides an opportunity to target appropriate quality improvement interventions. We aimed to analyse health care provided to COPD admissions against GOLD guidelines.

Methods. In 2010-11 an audit of care against the 2010 GOLD standards was performed in 16018 patients from 384 hospitals in 13 countries. Clinicians prospectively identified consecutive COPD admissions over an 8 week period recording clinical care measures on a web based data-tool. Data were analysed comparing adherence to 10 key guideline standards in GOLD 2010.

Results. The subjects comprised 67.8% males, mean age 70.8 (SD 10.8) years, mean FEV1 44.04 (SD 17.4)%. Adherence varied between hospitals and across countries. Average compliance is reflected in the table. Altogether 15.3% fulfilled all 10 recommendations.

View this table:

Guideline recommendation adherence





Conclusions. The European COPD Audit describes adherence to GOLD guideline across Europe. The lack of available spirometry results and variable use of oxygen and NIV are high impact areas identified for improvement.
Access flow measurements in hemodialysis patients
Authors: P J Bosman, F T Boereboom, C J Bakker, W P Mali, B C Eikelboom, P J Blankestijn, H A Koomans
Journal: Journal of the American Society of Nephrology (1996)

In this study, access flow in hemodialysis patients with bridge grafts was measured by a newly developed device. The technique is based on the measurement of changes in the ultrasound characteristics of blood. These changes were initiated by an injection of isotonic saline and measured in the tubes of the extra-corporeal circuit. The access flow rate (mean +/- standard variation) was 880 +/- 440 mL/min (range, 166 to 1740) (N = 46). The mean coefficient of variation was 13.4 +/- 6.8% (median, 13.0%; range 3.5 to 29.4%). Measurements correlated well (r = 0.91, N = 22, P < 0.001) with flow rates determined by magnetic resonance angiography and by a technique based on intra-access flow-pressure curves (r = 0.84, N = 14, P < 0.001). In conclusion, access flow can be measured easily, noninvasively, and reliably by the ultrasound dilution device.
The Distinctive Mutational Spectra of Polyomavirus-Negative Merkel Cell Carcinoma
Authors: Paul William Harms, Pankaj Vats, Monique Elise Verhaegen, Dan R. Robinson, Yi-Mi Wu, Saravana Mohan Dhanasekaran, Nallasivam Palanisamy, Javed Siddiqui, Xuhong Cao, Fengyun Su, Rui Wang, Hong Xiao, Lakshmi P. Kunju, Rohit Mehra, Scott A. Tomlins, Douglas Randall Fullen, Christopher Keram Bichakjian, Timothy M. Johnson, Andrzej Antoni Dlugosz, Arul M. Chinnaiyan
Journal: Cancer Research (2015)

Abstract Merkel cell carcinoma (MCC) is a rare but highly aggressive cutaneous neuroendocrine tumor. Merkel cell polyomavirus (MCPyV) may contribute to tumorigenesis in a subset of tumors via inhibition of tumor suppressors such as retinoblastoma (RB1) by mutated viral T antigens, but the molecular pathogenesis of MCPyV-negative MCC is largely unexplored. Through our MI-ONCOSEQ precision oncology study, we performed integrative sequencing on two cases of MCPyV-negative MCC, as well as a validation cohort of 14 additional MCC cases (n = 16). In addition to previously identified mutations in TP53, RB1, and PIK3CA, we discovered activating mutations of oncogenes, including HRAS and loss-of-function mutations in PRUNE2 and NOTCH family genes in MCPyV-negative MCC. MCPyV-negative tumors also displayed high overall mutation burden (10.09 ± 2.32 mutations/Mb) and were characterized by a prominent UV-signature pattern with C &amp;gt; T transitions comprising 85% of mutations. In contrast, mutation burden was low in MCPyV-positive tumors (0.40 ± 0.09 mutations/Mb) and lacked a UV signature. These findings suggest a potential ontologic dichotomy in MCC, characterized by either viral-dependent or UV-dependent tumorigenic pathways. Cancer Res; 75(18); 3720–7. ©2015 AACR.
Cytologic transformation in cutaneous T cell lymphoma: a clinicopathologic entity associated with poor prognosis.
Authors: E Dmitrovsky, M J Matthews, P A Bunn, G P Schechter, R W Makuch, C F Winkler, J Eddy, E A Sausville, D C Ihde
Journal: Journal of Clinical Oncology (1987)

The clinical course of cutaneous T cell lymphoma (mycosis fungoides and Sezary syndrome) is generally indolent, but in occasional patients becomes fulminant. We found that biopsies from patients with accelerating disease can reveal cytologic transformation from previously observed small, convoluted lymphocytes to large cells that are similar to cells seen in large-cell lymphoma. The cerebriform nuclei characteristic of malignant T cells can only rarely be identified. Of 150 cutaneous T cell lymphoma patients we treated from 1976 to 1984, cytologic transformation was identified in 12 after review of peripheral blood smears and biopsies from skin, lymph nodes, and visceral sites. Patients who developed cytologic transformation were initially characterized by advanced stage (11 of 12), with lymph node effacement (seven of 11) and erythroderma (five of 12). The tumor cell DNA content after transformation was aneuploid (four of four), and the ability to form rosettes with sheep erythrocytes was retained in transformed cells (three of three). The median time from diagnosis of cutaneous T cell lymphoma to cytologic transformation was 21.5 months (range, 4 to 64), and the median survival from transformation was only 2 months (range, 0 to 19+). We conclude that cytologic transformation in cutaneous T cell lymphoma represents a distinct clinicopathologic entity, characterized by an aggressive clinical course.
Impact of frailty on interpretability of spirometry : the Rotterdam study
Authors: Bastiaan Maes, Lies Lahousse, D.W. Loth, V.J.A. Verlinden, G. Ziere, M.C. Zillikens, A. Uitterlinden, F. Rivadeneira, H. Tiemeier, M.A. Ikram, G.F. Joos, A. Hofman, B.H. Stricker, G.G. Brusselle
Journal: European Respiratory Journal (2013)

INTRODUCTION   Chronic obstructive pulmonary disease (COPD) is a common disease in the general population, especially among elderly. For COPD diagnosis, spirometry demonstrating an obstructive syndrome (FEV 1 /FVC   AIMS   We evaluated the association of frailty and the capability of a participant to perform a high-quality spirometry according to ATS/ERS guidelines.   METHODS   This study was part of the Rotterdam Study, a prospective population-based cohort study performed in subjects aged ≥55. Frailty was defined as meeting ≥3 of 5 established criteria for frailty, evaluating nutritional status, physical activity, mobility, strength and energy. Spirometry was classified as not interpretable when ATS/ERS criteria for acceptability/reproducibility were not met.   RESULTS   Of the 2730 subjects evaluated for frailty who visited the research centre for lung function measurement, 2487(91.1%) performed an interpretable spirometry and in 232(8.5%) subjects spirometry was not interpretable. 11(0.4%) subjects could not complete spirometry due to technical problems and were excluded. Compared to non-frail subjects(n=2564), frail elderly(n=155) had an almost threefold increased tendency to perform a spirometry which was not interpretable due to a lack of quality (OR 2.94;95%CI:1.93-4.47;p   CONCLUSIONS   This prospective study in a general elderly population indicates that frail persons have more difficulties in performing a high-quality lung function test. This observation might indicate underdiagnosis of COPD in this group.
Time of Appearance and Histology of Tumors Induced in the Dorsal Skin of C3Hf Mice by Ultraviolet Radiation From a Mercury Are Lamp 2
Authors: J. D. Spikes, M. L. Kripke, R. J. Connor, E. J. Eichwald
Journal: JNCI Journal of the National Cancer Institute (1977)

The time course of skin tumor induction was determined in hair-clipped inbred agouti C3Hf mice irradiated three times per week with a medium-pressure quartz-mercury lamp; 4 different UV doses were used. Although the ears were also exposed to the radiation, in the 3 groups given the highest doses no ear tumors were observed by the time each animal had developed at least 1 tumor on its back. No tumors were found in the animals receiving the lowest UV dose. In the group receiving the highest dose, males developed tumors earlier than did females; this trend continued in the lower dose groups. Many tumors that developed in the back skin were well-differentiated squamous cell carcinomas. Others were less well defined so that the cell of origin was difficult to determine. In the group receiving the highest UV dose, the squamous cell carcinomas were few, whereas at the lower doses they predominated.
Effects on Clinical Outcomes of Adding Dipeptidyl Peptidase-4 Inhibitors Versus Sulfonylureas to Metformin Therapy in Patients With Type 2 Diabetes Mellitus
Authors: Shuo-Ming Ou, Chia-Jen Shih, Pei-Wen Chao, Hsi Chu, Shu-Chen Kuo, Yi-Jung Lee, Shuu-Jiun Wang, Chih-Yu Yang, Chih-Ching Lin, Tzeng-Ji Chen, Der-Cherng Tarng, Szu-Yuan Li, Yung-Tai Chen
Journal: Annals of Internal Medicine (2015)

Background: Recent studies concluded that dipeptidyl peptidase-4 (DPP-4) inhibitors provide glycemic control but also raised concerns about the risk for heart failure in patients with type 2 diabetes mellitus (T2DM). However, large-scale studies of the effects on cardiovascular outcomes of adding DPP-4 inhibitors versus sulfonylureas to metformin therapy remain scarce. Objective: To compare clinical outcomes of adding DPP-4 inhibitors versus sulfonylureas to metformin therapy in patients with T2DM. Design: Nationwide study using Taiwan's National Health Insurance Research Database. Setting: Taiwan. Patients: All patients with T2DM aged 20 years or older between 2009 and 2012. A total of 10 089 propensity score–matched pairs of DPP-4 inhibitor users and sulfonylurea users were examined. Measurements: Cox models with exposure to sulfonylureas and DPP-4 inhibitors included as time-varying covariates were used to compare outcomes. The following outcomes were considered: all-cause mortality, major adverse cardiovascular events (MACEs) (including ischemic stroke and myocardial infarction), hospitalization for heart failure, and hypoglycemia. Patients were followed until death or 31 December 2013. Results: DPP-4 inhibitors were associated with lower risks for all-cause death (hazard ratio [HR], 0.63 [95% CI, 0.55 to 0.72]), MACEs (HR, 0.68 [CI, 0.55 to 0.83]), ischemic stroke (HR, 0.64 [CI, 0.51 to 0.81]), and hypoglycemia (HR, 0.43 [CI, 0.33 to 0.56]) compared with sulfonylureas as add-on therapy to metformin but had no effect on risks for myocardial infarction and hospitalization for heart failure. Limitation: Observational study design. Conclusion: Compared with sulfonylureas, DPP-4 inhibitors were associated with lower risks for all-cause death, MACEs, ischemic stroke, and hypoglycemia when used as add-ons to metformin therapy. Primary Funding Source: None.
Local Immunoglobulin A in Normal and Neoplastic Breast Tissues&lt;xref ref-type="fn" rid="fn2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="fn3"&gt;3&lt;/xref&gt;
Authors: P P Lee, G C Buehring
Journal: JNCI Journal of the National Cancer Institute (1981)

Local IgA levels in 36 normal, 92 nonmalignant atypical, and 47 malignant human breast tissue specimens were analyzed by three methods: direct immunofluorescence, modified radioimmunoassay for IgA in cryostat sections, and the Immuno-Fluor (Bio-Rad Laboratories, Richmond, Calif.) assay for the cell surface IgA in tissue eluates. The proportion of epithelium in each sample was estimated microscopically. For malignant specimens the proportion of epithelial cells was significantly higher than that for nonmalignant specimens. The immunofluorescence test showed no qualitative difference in epithelial IgA content between normal and nonmalignant atypical tissues, but the frequency of positive specimens was markedly lower in malignant tissues. The modified radioimmunoassay and the Immuno-Fluor assay indicated little or no difference in IgA concentration per tissue weight among normal, nonmalignant atypical, and malignant breast tissues. However, when the data were corrected for proportion of glandular epithelium, nonmalignant atypical tissues had less IgA per cell than normal tissues, and malignant mammary carcinomas had significantly less IgA per cell than both normal and nonmalignant atypical tissues.
Tumortropic monocyte-mediated delivery of echogenic polymer bubbles and therapeutic vesicles for chemotherapy of tumor hypoxia
Authors: Wen-Chia Huang, Wen-Hsuan Chiang, Ya-Hui Cheng, Wan-Chi Lin, Ching-Fang Yu, Chia-Yi Yen, Chih-Kuang Yeh, Chorng-Shyan Chern, Chi-Shiun Chiang, Hsin-Cheng Chiu
Journal: Biomaterials (2015)
Treatment of patients with relapsed and resistant non-Hodgkin's lymphoma using total body irradiation, etoposide, and cyclophosphamide and autologous bone marrow transplantation.
Authors: S Gulati, J Yahalom, L Acaba, L Reich, R Motzer, J Crown, M Toia, T Igarashi, R Lemoli, E Hanninen
Journal: Journal of Clinical Oncology (1992)

PURPOSE Patients with non-Hodgkin's lymphoma (NHL) who do not achieve a complete response (CR) after induction chemotherapy or who relapse after achieving a CR are rarely cured of their disease by the usual salvage therapy. Success of high-dose cytotoxic therapy with an autologous bone marrow transplant (AuBMT) is limited. We describe the results of a prospective single-institution study using a new conditioning regimen for patients with relapsed or resistant NHL who underwent AuBMT. PATIENTS AND METHODS Forty-four patients were reinduced with cytotoxic therapy and then evaluated for response. All patients received the conditioning regimen of hyperfractionated total body irradiation (TBI), etoposide (VP-16), and cyclophosphamide (CTX) followed by autologous bone marrow reinfusion. RESULTS The disease-free survival (DFS) rate was 57% with a median follow-up of 42+ months. The only variable significantly associated with DFS was the patient's remission status at AuBMT. Patients who underwent AuBMT in CR had a DFS of 80%, whereas patients who underwent AuBMT in partial response (PR) or with progressive disease (PD) had a DFS of 60% and 11%, respectively (P = .002). The major toxicity was hemorrhage at the site of bulky disease, especially in patients with residual mediastinal and/or pulmonary disease. CONCLUSION Planned reinduction cytotoxic therapy followed by TBI, VP-16, and CTX with AuBMT is an effective treatment for patients with relapsed and resistant NHL.