tbuckley/cabot-search huggingface dataset:
Dual infections with different Legionella strains
Authors: G. Wewalka, D. Schmid, T.G. Harrison, S.A. Uldum, C. Lück
Journal: Clinical Microbiology and Infection (2013)

In 2010 a case of a dual infection with Legionella pneumophila serogroup (sg) 1 and sg 3 was identified by culture of a blood sample collected from a female Austrian patient with septic pneumonia. Subsequently all 35 European National Legionella Reference Laboratories were interviewed regarding the frequency of dual infections in legionellosis. The Reference Laboratories in Denmark, the UK and Germany reported the detection of another 14 cases of dual infections with different Legionella strains between 2002 and 2012. Among the 15 cases, there were four cases with different Legionella species, six cases with different L. pneumophila serogroups, and five cases of dual infections with L. pneumophila sg 1 with different MAb-types. The median age of the 15 cases was 56 years and the male to female ratio 1:1.14. Six of the 15 patients were receiving immunosuppressive treatment following organ transplantation (n = 3) or for underlying haematological and solid malignancies (n = 3). Five of the 15 cases died within 30 days following diagnosis. Efforts to detect dual infections with different Legionella strains will improve our ability to correctly elucidate the causative sources of infection and enhance our understanding of the epidemiology of Legionella infections.
The Menace of Over-population
Authors: E W BARNES
Journal: BMJ (1951)

THE ADOLESCENT DELINQUENT BOY -ME NL teachers before the boys leave school and obtain their first situations, and, if possible, keep in touch with the boys afterwards.23.It is highly desirable that, with the more backward boys, attention should be paid to special placement in industry so that they are not given work which is beyond their capabilities.24. Aftercare committees should be established in con- nexion with all secondary modern schools throughout the country.Pre-marital Guidance 25.Facilities for obtaining pre-marital advice and guidance should be available to all who desire it.The committee strongly supports the view that education, in the widest sense, before marriage is a vital matter.The family doctor, marriage guidance councils, and the Church are channels through which advice can ordinarily be obtained.The committee feels, however, that with regard to marriage guidance councils, and other lay bodies, there is a real need for a greater measure of selection and training of those giving the advice.26.There should be a closer follow-up by the Church of those who are married in church, so that the clergy may be on such terms as to be able to advise and help in marital difficulties.Married Couples 27.Discord in the home should be dealt with' as early as possible, and to this end the conmmittee recommends that those people welcomed in the home, such 'as the doctor, nurse, health visitor, etc., should be fully cognizant of the help which can be given by psychiatric clinics of, the hospitals and child-guidance clinics, by probation officers, or by organizations such as citizens' advice bureaux, the Council of Social Service, marriage guidance councils, family
Myelodysplastic syndrome as a late complication following autologous bone marrow transplantation for non-Hodgkin's lymphoma.
Authors: R M Stone, D Neuberg, R Soiffer, T Takvorian, M Whelan, S N Rabinowe, J C Aster, P Leavitt, P Mauch, A S Freedman
Journal: Journal of Clinical Oncology (1994)

PURPOSE To determine the incidence, natural history, and risk factors associated with myelodysplastic syndrome (MDS) occurring as a late complication following autologous bone marrow transplantation for patients with non-Hodgkin's lymphoma. METHODS We retrospectively reviewed the charts of all 262 patients who underwent autologous bone marrow transplantation for non-Hodgkin's lymphoma at the Dana-Farber Cancer Institute from 1982 through 1991. Although patients received a variety of treatments before they were eligible for transplant, identical myeloablative therapy (cyclophosphamide 60 mg/kg/d for 2 days plus total-body irradiation twice daily for 3 days) was administered in each case. By collecting data on pretransplant and early posttransplant variables, we attempted to identify risk factors for the development of MDS. RESULTS The crude overall incidence of posttransplant MDS or acute myeloid leukemia (AML) was 7.6%. The actuarial risk at 6 years was 18% +/- 9%. The median time of onset was 31 months (range, 10 to 101) after transplant or 69 months (range, 27 to 141) after initial treatment for lymphoma. Pretreatment variables predictive for the development of MDS (univariate analysis) included prolonged interval between initial treatment and the transplant procedure (P = .003), increased duration of exposure to chemotherapy (P = .019) or to alkylating agents (P = .045), and use of radiation therapy (P = .032) or pelvic radiation (P = .003) before transplant. CONCLUSION MDS is a potential complication of autologous bone marrow transplantation for non-Hodgkin's lymphoma; bone marrow stem-cell damage sustained before the transplant may be the most important risk factor.
An extract of cultured A431 cells contains major tissue antigens of autoimmune bullous diseases
Authors: C.W. Lee
Journal: British Journal of Dermatology (2000)

Autoantibodies that are characteristic of autoimmune bullous diseases (AIBDs) can be detected by immunoblot assay using epidermal or dermal extracts. However, none of the substrates obtained by ordinary methods seems to contain a sufficient amount of all of the autoantigens involved in AIBDs, and diagnosis may require the use of several different substrates.To examine the potential of A431 cell extracts as a substrate for immunoblotting.Fourteen sera obtained from patients with major AIBDs (pemphigus vulgaris, pemphigus foliaceus, paraneoplastic pemphigus, bullous pemphigoid and epidermolysis bullosa acquisita) were tested using this substrate.Bands corresponding to desmoglein 1 and 3, desmoplakin 1 and 2, periplakin, BPAG1, BPAG2 and type VII collagen were identified distinctly with these sera.This finding suggests that culture extracts of A431 cells provide an effective substrate for the diagnosis and differential diagnosis of major AIBDs.
Interobserver analysis of assumed optimal positions for transbronchial needle aspiration
Authors: Kjetil Roth, Tomas Eagan, Jon Hardie
Journal: European Respiratory Journal (2012)

Background: Various guidelines have described the optimal positions for transbronchial sampling from lymph node stations. The variability in expert opinion for these positions is unknown.  Objective: To describe the interobserver variability in the assumed optimal position for transbronchial needle aspiration (TBNA) from lymph node station 4,7,10 and 11.  Methods: Four physicians with large experience in TBNA were shown six bronchoscopy pictures and asked to describe the optimal positions for TBNA. The physicians marked an area for the assumed best position for different lymph node stations. A mean diameter was calculated for each area. The mean diameter represented the intraobserver spread for each expert in the lymph node station. The distance to an average X and Y-coordinate defined the interobserver variation.  Results: The mean diameter that represented the average spread was 1.14 cm (95% confidence interval: 0.91-1.38 cm). Lymph node station 11L had an average intraobserver diameter below the 95% confidence interval. The average intraobserver diameter in lymph node station 4R and 10L were above the 95% confidence interval.  The median interobserver distance was 0.64 cm (interquartiles range 0.17-1.04 cm). Lymph node station 7L had a mean interobserver distance smaller than the 25% quartile, lymph node station 10R and 10L had an interobserver distance larger than the 75% quartile.  Conclusions: The intraobserver spread was large in station 4R and 10L, the interobserver variation was large in 10R and 10L compared to the other lymph node stations that were examinated.
Clinical toxicity of interferons in cancer patients: a review.
Authors: J R Quesada, M Talpaz, A Rios, R Kurzrock, J U Gutterman
Journal: Journal of Clinical Oncology (1986)

All major types of human interferons (IFNs) have been purified and clinically administered as antitumor agents. We summarize here experience to date with toxicity of IFNs in cancer patients. The acute syndrome consists of fever, chills, myalgias, arthralgias, and headache, with some variation according to type of IFN, route of administration, schedule, and dose. Fatigue, perhaps reflecting CNS toxicity, is the most prevalent nonacute symptom. At high doses, IFNs are neurotoxic; the abnormalities seen by EEG resemble those in diffuse encephalitis. Hematologic toxicity consists mainly of leukopenia, but anemia and thrombocytopenia occur in some patients. Nausea, vomiting, and diarrhea are the main gastrointestinal symptoms. Elevation of serum transaminases seems to reflect liver toxicity. Renal function is well preserved, except for rare instances of acute renal failure. Cardiac toxicity remains questionable, although heart failure and arrhythmias have been associated with the administration of IFNs. Most, if not all, of these effects are reversible or can be ameliorated. With IFN alpha, the type most widely used in clinical studies, doses of 1 million to 9 million units (MU) are generally well tolerated, but doses greater than or equal to 18 MU yield moderate to severe toxicity. Doses greater than or equal to 36 MU can induce severe toxicity and significantly alter the performance status of the patient.
Stomach Cancer in Japan2
Authors: William Haenszel, Minoru Kurihara, Frances B. Locke, Kiyoshi Shimuzu, Mitsuo Segi
Journal: JNCI Journal of the National Cancer Institute (1976)

A study of 783 patients with stomach cancer and 1,566 hospital controls in Hiroshima and Miyagi prefectures of Japan showed that farmers, representing mostly the lowest socioeconomic class, had higher risk of developing stomach cancer. The usual inverse gradient in risk by social class was in the urban population of Miyagi, but not Hiroshima, prefecture. The study in Japan did not reproduce the association of stomach cancer with consumption of salted/dried fish and salt-pickled vegetables described for the Hawaiian Japanese. salted/dried fish and pickled vegetables were more widely used by farmers than by nonfarmers in Japan or by Japanese migrants to Hawaii. The ability to detect associations for these typical Japanese foods in Hawaii stemmed from the fact that these reduced levels of use were more completely expressed by the Hawaiian-Japanese controls than by patients. The lower risk of developing stomach cancer for lettuce and celery users agreed with the Hawaiian-Japanese findings, and the combined results supported conjectures on possible protective food effects. Lettuce, in particular, warranted attention from this viewpoint, since similar findings have been consistently reported.
Hypertension and the development of complications in patients with non-insulin dependent diabetes mellitus in Japan.
Authors: R Kikkawa, S Araki, M Haneda, N Kajiwara, H Hidaka, Y Shigeta
Journal: Journal of the American Society of Nephrology (1992)

Hypertension is a very frequent condition in individuals with non-insulin dependent diabetes mellitus (NIDDM) in Japan and has affected the occurrence of late diabetic complications, especially stroke and nephropathy. Despite similar characteristics of hypertension among Japanese and white patients, the effect of hypertension on the development of coronary artery disease (CAD) in these two populations is strikingly different. In white NIDDM patients, hypertension is one of the major risk factors for the development of CAD. However, CAD is an infrequent complication in NIDDM patients in Japan, even though they have hypertension, lipid abnormalities, and renal complications.
Microparticles from OSA patients induce hyper-reactivity through up-regulation of pro-inflammatory proteins
Authors: Simon Tual-Chalot, Keita Fatoumata, Pascaline Priou, Wojciech Trzepizur, Cristina Contreras, Dolores Prieto, M. Carmen Martinez, Frédéric Gagnadoux, Ramaroson Andriantsitohaina
Journal: European Respiratory Journal (2011)

Obstructive sleep apnea (OSA) is characterized by repetitive apnea-hypopnea cycles during sleep, which are associated with oxygen desaturation and sleep disruption. It has been shown that level of circulating microparticles (MPs), vesicles released from plasma membrane during cell activation and apoptosis, is altered in OSA patients and contribute to endothelial dysfunction. However, their participation to reactivity in response to vasoconstrictor agonists has not yet been assessed. Two age-matched groups of patients undergoing polysomnography for OSA were compared: 15 patients with an apnea-hypopnea index (AHI)≥5 events/h were included in the OSA group and 17 control subjects with an AHI
Commentary on aAcid reflux into the oesophagus does not influence exercise-induced airway narrowing in bronchial asthmaa
Authors: C C Randolph
Journal: British Journal of Sports Medicine (2008)

This paper describes a well-conducted, well-designed, well-referenced and well-written investigation of the impact of oesophageal reflux on exercise-induced bronchospasm.Reflux on exertion has been documented in exercising individuals (10 in study) particularly in running or weight training (reference …
The need for including pleural procedure sessions in respiratory physicians' job planning in the United Kingdom
Authors: Rahul Mukherjee, Shiva Bikmalla, Vikas Punamiya, Milan Bhattacharya, Richard Steyn
Journal: European Respiratory Journal (2012)

Background:  In 2008, the UK National Patient Safety Agency (NPSA) issued an alert for risks associated with insertion of intercostal chest drains (ICD) and highlighted issues related to insertion by non-specialists and by inadequately trained or supervised junior doctors.   Methods:  In an acute hospital (catchment population about 280000), an education campaign targeted at emergency medicine on-call doctors was started in August 2008 questioning the need for out-of-hours insertion of ICD. Three physician-led elective sessions/week were introduced in November 2008; trainees were directly supervised by experienced physicians (consultants); all unavoidably out-of-hours ICD procedures were reviewed by respiratory consultants.   Results:  Fifty-two patients underwent ICD insertion in 5 months: 18 (34.62%) for pneumothorax; 34 (65.38%) for effusions. Of the 34 with pleural effusions, 31 (91.17%) had radiological imaging pre-procedure. The 3 (8.82%) who had ICDs without prior radiological imaging were due to suspected empyema thoracis in the emergency department. Only 2 ICDs (3.84%) - both for pneumothoraces - were complicated by infection of the pleural space. No other major complications occurred in the remaining 50 patients. Initial ICD was displaced in 8 patients needing further ICD insertions (15.38%), confirming a significant improvement with respect to the local average.   Conclusion:  The successful pilot of consultant-led ICD-insertion sessions led to reduced length of stay, improved outcomes and improved trainee feedback - hence our policy recommendation to include pleural procedure sessions in physician job plans which is currently not undertaken uniformly in the UK.
OSCE as an evaluation method for graduate students in respiratory therapy
Authors: Cibele C.B. Marques da Silva, Adriana C. Lunardi, Felipe A.R. Mendes, Flavia Ferreira, Celso R.F. Carvalho
Journal: European Respiratory Journal (2011)

Objective: The aims of this study were to assess the use of OSCE (objective structured clinical evaluation) as a tool to evaluate the abilities of graduate students in respiratory therapy and to verify the internal consistency of this exam.

Methods: Forty seven students were evaluated by two exams: traditional and OSCE. Each question (traditional) or station (OSCE) ranged from 0.0 to 2.0 and the total score of both exams was 10.0. The exams were prepared by independent educators that were blinded to the final grades. Internal consistency of OSCE stations was assessed by four experienced Respiratory Therapists.

Analysis: Internal consistency was tested by Cronbach's Alpha. The relation between scores obtained in both exams was analyzed by Bland Altman and Pearson's test.

Results: The average score of the students' grades ranged from 4.5 to 9.1. The internal consistency of OSCE stations was considered good (0.7). The agreement between exams was estimated and it was observed that they are not comparable. It was also observed a low agreement between both exams (r=-0.1; p=0.9; Pearson linear correlation).

Conclusions: Our results showed that OSCE and traditional exams are not related. The OSCE exam had good internal consistency and assessed distincts aspects of traditional exam.
Abstract 3538: Periostin Accelerates Degeneration of the Cardiac Valve Complex by Promoting Angiogenesis and Matrix Metalloproteinase Production
Authors: Daihiko Hakuno, Naritaka Kimura, Masatoyo Yoshioka, Tokuhiro Kimura, Yasunori Okada, Ryohei Yozu, Akira Kudo, Takeshi Adachi, Fumitaka Ohsuzu, Satoshi Ogawa, Keiichi Fukuda
Journal: Circulation (2009)

Although we previously reported that an angioinhibitory factor chondromodulin I maintains cardiac valvular function by preventing angiogenesis (Nat Med, 2006), the mechanism underlying the progression of degenerative valvular heart disease (VHD) is poorly understood, and no preventive therapy has been established. Periostin is reported to be a stress-responsive, secreted protein that promotes embryonic cardiac valve development, but its physiological and pathophysiological roles in VHD remain unknown. We investigated the possible involvement of periostin in VHD, and if it is involved, how it affects the progression of VHD.   Methods and Results:   Periostin was specifically expressed in the cardiac valves and annuli from the E10.5 embryo to adulthood rodents.  In human normal cardiac valves (n=12), periostin was localized to the subendothelial superficial layer of the valve, and its expression pattern was mutually exclusive to that of chondromodulin I, but overlapped those of  α -smooth muscle actin and vimentin.  Interestingly, periostin expression was increased 4-fold in the areas of angiogenesis in patients with atherosclerotic and rheumatic VHD (n=17).  A high-fat (HF) diet was administered to wild type (WT) and  Periostin  knockout (KO) mice for 4 months, and the cardiac valve complex was examined by 45-MHz echocardiography, immunohistochemis-try, and Western blot analysis (n=8 each). In WT mice, the HF diet markedly increased aortic valve thickening, angiogenesis and fibrosis of the annuli, and the expression of matrix metalloproteinase (MMP)-2 and MMP-13, in parallel with a 2.5-fold increase in the expression of periostin. However, these changes were strongly attenuated in KO mice.   In vitro  studies using human endothelial cells revealed that periostin significantly promoted tube formation and mobilization, and inhibited apoptosis, thereby indicating its angiogenic activity.  Periostin increased the secretion of MMP-2 and MMP-13 from cultured valvular interstitial cells by 4-and 8-fold, respectively, without affecting their proliferation or apoptosis.   Conclusions:  Periostin is specifically expressed in the cardiac valve complex, and accelerates its degeneration by promoting angiogenesis and MMP production.
Evaluation of high-sensitivity C-reactive protein in acute asthma
Authors: Ebrahim Razi, Hassan Ehteram, Hossein Akbari, Vajihe Chavoshi, Armin Razi
Journal: European Respiratory Journal (2011)

Objective: High sensitivity C reactive protein (Hs-CRP) is an inflammatory marker known to be related to inflammation, infection, and cardiovascular disease. The aim of this study was to evaluate hs-CRP levels in serum of asthmatics and their relationship to pulmonary function tests, serum IgE levels, peripheral blood white blood cells (WBC) counts.

Methods: The study groups were 108 patients with acute asthma and 93 healthy volunteers. The levels of hs-CRP of 108 patients with acute bronchial asthma and 93 non-asthmatic control subjects were measured. Spirometry, serum immunoglobulin-E (IgE) measurement, WBC and counts were done in all the patients and control groups.

Results: Mean serum hs-CRP levels were significantly higher in patients with acute asthma compared with control (5.47±7.33 mg/l versus 1.46±1.89 mg/l, p<0.001). Among asthmatic patients, mean hs-CRP levels did not correlate with indices of pulmonary function (forced expiratory volume in one second/forced vital capacity and forced mid-expiratory flow), serum IgE level, eosinophil count and WBC.

Conclusions: Increase in serum C-reactive protein levels measured by high-sensitivity assays may be associated with airflow obstruction in acute asthma, and may be useful as a sensitive marker and a diagnostic tool for detecting and monitoring airway inflammation in patients with acute asthma. In our study of patients with acute asthma, did not reveal any significant correlation between hsCRP and pulmonary function tests, total serum IgE, and peripheral blood white blood cells counts.
Anxiety and drug taste as predictors of anticipatory nausea in cancer chemotherapy.
Authors: D R Nerenz, H Leventhal, D V Easterling, R R Love
Journal: Journal of Clinical Oncology (1986)

Interview data from 192 patients receiving cytotoxic chemotherapy for the first time were analyzed to identify factors predictive of the development of anticipatory nausea. Posttreatment nausea and vomiting (particularly vomiting), tastes of drugs during injections, and anxiety before injections were all associated with an increased probability of anticipatory nausea. An index consisting of those three variables, plus age, was found to have good predictive power, even when the predictor variables were assessed only at the first chemotherapy administration and the index was used to predict the development of anticipatory nausea at any time during the first six chemotherapy cycles.
Late-breaking abstract: Caregiver smoke and depression/anxiety state promote persistent tobacco smoking (TS) in home oxygen therapy (HOT) patients
Authors: Fabrizio Facchini, Laura De Lozzo, Luigi Marino, Fulvio Braido, Stefano Nardini
Journal: European Respiratory Journal (2014)

Background and aim: There is insufficient knowledge about reasons of persistent smoking in HOT. We looked at care givers smoking habit and depression/anxiety state.  Method: We interviewed 136 HOT. History of TS of patient and care giver was asked to both patient and caregiver. Finally a consultation was carried out for the group of active smokers (AS), ex smokers (ES) and never smokers (NS).  Results: AS were 8,0% (11/136) with high male prevalence 82% (9/11) and slightly younger age. The majority of caregivers were smokers 55% (5/9). Anxiety was expressed in 36.4% of the patients and Depression 54.5%. Main reasons for relapses were nervous tension and lack of pleasure. ES were 51,0% (69/136) with high male prevalence 63% (43/68), mean age 78. In this subgroup of HOT patients, the majority of caregivers were non smokers, 82% (54/68). In this subgroup TS history was higher 56 p/y, ExCO=1,4 ppm; Anxiety was expressed in 27.3% of the patients and Depression 45.5%. NS were 41% (56/136) with high female prevalence 68%, mean age 78. Opposite to AS, a similarly to ES, in this subgroup of HOT patients, the majority of caregivers were non smokers 80% (45/56). Anxiety & Depression was expressed in a minority 33.3% of this subgroup of patients  Conclusion: Caregivers smoking habit and Anxiety/Depression state might promote persistent smoke in HOT patients