tbuckley/cabot-search huggingface dataset:
Risk Factors for Pediatric Asthma
Authors: C. ANDREW ALIGNE, PEGGY AUINGER, ROBERT S. BYRD, MICHAEL WEITZMAN
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

The Child Health Supplement to the 1988 National Health Interview Survey was used to examine parent-reported current asthma among a nationally representative sample of 17,110 children zero to 17 yr of age. Numerous demographic variables were analyzed for independent associations with asthma using modified stepwise logistic regression, with models including specific combinations of risk factors. Black children had higher rates of asthma than did white children in unadjusted analyses, but after controlling for multiple factors, black race was not a significant correlate of asthma (adjusted odds ratio = 0.87, 95% CI = 0.63 to 1.21). Compared with nonurban white children, urban children, both black and white, were at significantly increased risk of asthma: urban and black (adjusted OR = 1.45, 95% CI = 1.14 to 1.86), urban and white (adjusted OR = 1.22, 95% CI = 1.01 to 1.48), whereas nonurban black children were not: nonurban and black (adjusted OR = 1.15, 95% CI = 0.83 to 1.61). Similarly, compared with nonurban, nonpoor children, urban and poor (adjusted OR = 1.44, 95% CI = 1.05 to 1.95), urban and nonpoor (adjusted OR = 1.22, 95% CI = 1.004 to 1.48), urban children, both poor and nonpoor, were at significantly increased risk of asthma, whereas nonurban poor children were not: nonurban and poor (adjusted OR = 1.03, 95% CI = 0.72 to 1.48). These results suggest that the higher prevalence of asthma among black children is not due to race or to low income per se, and that all children living in an urban setting are at increased risk for asthma.
Role of thoracoscore (thoracic surgery scoring system) in clinical practice
Authors: Balamugesh Thangakunam, Kanwar Pannu, Kim Wilkins, Basharet Ibrahim, Bernard Yung, Dipak Mukherjee, Doug Aitchison, Johnson Samuel
Journal: European Respiratory Journal (2011)

Introduction:  Thoracic surgery scoring system (Thoracoscore) a multivariate score with 9 parameters, may predict mortality after thoracic surgery (Lim E. et al. Thorax 2010;65:iii1-iii27). Its role to assess patient fitness for surgery is not clear. Cardiopulmonary exercise test (CPEX) is recommended by ERS to assess fitness for radical therapy in lung cancer patients (Brunelli A. et al. Eur Respir J 2009;34:17-41)   Objective:  To evaluate role of thoracoscore in patients considered for thoracic surgery.   Methods:  Retrospective data analysis of patients investigated for thoracic surgery.   Results:  Over a 2 period, 22 patients with borderline lung function had CPEX to assess for lung resection. Based on CPEX, 15 (68%) were fit and had surgery, 7 (32%) were high risk and turned down. Mean predicted death rate based on thoracoscore in patients who had surgery and those who didn9t was 3.5% and 3.4% respectively (p=0.95).  Interestingly, mean FEV1 in those who had surgery and those who didn9t was 59% and 66% respectively (p=0.5). The mean peak VO 2  (peak oxygen uptake during CPEX as ml/kg/min) among those who had surgery and those who didn9t was 14.2 and 10.1 respectively, with statistically significant difference (p=0.01). There was no post-surgical mortality. Duration of hospital stay did not correlate with peak VO 2  or thoracoscore.   Conclusion:  Thoracoscore has poor correlation with FEV1 and peak VO 2  and hence is not reliable to triage patients for thoracic surgery.
Few people will change their drinking habits in London
Authors: N. Kessaris, L. A Greasley, D. R M Horner, S. Mathur, R. A S Mukherzee
Journal: BMJ (1996)

LETT'ERSWorldwide decline in semen quality might be due to smoking EDrroR,-While there has been much concem recently about the potential effect of environmental oestrogens on male reproduction, studies of the association between cigarette smoking and sperm concentration, as well as patterns of cigarette consumption, support the notion that cigarette smoking may have contributed considerably to the worldwide decline in semen quality.Carlsen et al systematically reviewed 61 studies of semen quality conducted over 50 years and found that mean sperm concentration worldwide fell by half from 113x1O6/ml in 1940 to 66xI06/ml in 1990.' Giwercman et al concluded that the decline in semen quality was probably due to environmental rather than genetic factors, suggesting that in utero exposure to environmental oestrogens, pollution, and lifestyle exposures (including cigarette smoking) were possible causes.2Recent studies confirm an association between smoking and semen quality.Vine et al, in a meta- analysis of studies published between 1981 and 1992, showed that smokers' sperm concentration was on average about 15% lower than that of non-smokers.3Among studies of only healthy men (that is, studies of men from infertility clinics were excluded) smokers' sperm concentration was 24% lower than that ofnon-smokers.Brake and Krause,4 among others, reanalysed the data from Carlsen et ars study,' noting that the fall in sperm concentration was unlikely to have been linear over the entire 50 year period.Among the 48 studies conducted between 1970 and 1990 We receive more letters than we can publish: we can currently accept only about one third.We prefer short letters that relate to articles published within the past four weeks.
Development and validation of a non-bouts moderate-to-vigorous intense physical activity (MVPA) target in healthy subjects and COPD
Authors: Hans Van Remoortel, Carlos Augusto Camillo, Daniel Langer, Miek Hornikx, Heleen Demeyer, Chris Burtin, Marc Decramer, Rik Gosselink, Wim Janssens, Thierry Troosters
Journal: European Respiratory Journal (2013)

Thirty minutes of MVPA in bouts of at least 10 minutes is a commonly-used target to distinguish active from inactive subjects. Since MVPA data are frequently analyzed without bouts, we aimed to propose a MVPA non-bout target equivalent to 30 min. (bouts) and to validate this target in subjects with and without COPD.  Hundred-thirteen subjects with (62±6 yrs, FEV 1  65±27%) and 110 without COPD (62±5 yrs, FEV 1  111±18%) wore an activity monitor for 7 days. MVPA was defined as the time spent >3 METs. We randomly divided our healthy population into a calibration sample (CS, n=73) and a cross-validation sample (CV-S, n=37). Receiver operating characteristic (ROC) curve analyses were used to determine a MVPA non-bout target (CS) and to (cross-)validate this target by comparing sensitivity and specificity in subjects with and without (CV-S) COPD.  Using the criterion of 30 minutes MVPA per day (bouts), a daily target of 80 min. MVPA provided the best combination of sensitivity (83(58 to 96)%) and specificity (85(73 to 93)%) with an area under the ROC curve of 0.89 (0.81 to 0.98). This target revealed a high balance of sensitivity and specificity in both the healthy CV-S sample (n=37) and patients with COPD (n=113).  Accelerometry measured MVPA (non-bouts) of 80 min. per day corresponds to 30 min. of MVPA per day in bouts and is valid to discriminate active from inactive subjects.
A randomized phase III trial of magic mouthwash and sucralfate versus benzydamine hydrochloride for prophylaxis of radiation-induced oral mucositis in head and neck cancer.
Authors: J. S. Kuk, S. Parpia, S. M. Sagar, T. Tsakiridis, D. Kim, D. I. Hodson, C. Zywine, J. R. Wright
Journal: Journal of Clinical Oncology (2011)

5521 Background: This study evaluated the relative efficacy of magic mouthwash (diphenhydramine, dexamethasone and nystatin) plus sucralfate compared to benzydamine hydrochloride in reducing the severity of patient-reported symptoms of mucositis. Methods: Patients receiving primary or post-operative radiotherapy (RT) for squamous cell carcinoma of the head and neck were stratified according to the use of concurrent cisplatin chemotherapy, and then randomized to receive either magic mouthwash followed by sucralfate (MM+S) or 0.15% benzydamine hydrochloride. Mouthwash regimens were used 4 times daily, from day 1 of RT until 2 weeks post-completion of RT. The prescribed RT dose was 60-70Gy delivered over 6-7 weeks. The primary endpoint was mean change in the Oral Mucositis Weekly Questionnaire - Head and Neck (OMWQ-HN) score from baseline to 6 weeks. Results: Sixty-seven patients were enrolled between May 2009 – May 2010, and randomly assigned to receive MM+S (n=32) or benzydamine (n=35). There were no statistically significant differences in outcomes between the two treatment arms. The mean change in OMWQ-HN score was 15.7 [standard deviation (SD) = 17.5] with MM+S, and 21.2 (SD = 13.8) with benzydamine [absolute difference of -5.5; 95% Confidence Interval (CI), -13.4 to 2.4; P = .16]. The incidence of WHO grade 3 or 4 oral mucositis after 4 weeks of RT was 3.2% with MM+S and 17.6% with benzydamine (P = .11). Time to opioid initiation or increase was not statistically different between the two arms (17 events with MM+S vs. 9 events with benzydamine; hazard ratio 2.2; 95% CI, 0.96 to 4.84; P = .06). Conclusions: The combination of magic mouthwash and sucralfate was not superior to single-agent benzydamine hydrochloride for the prophylactic treatment of radiation-induced oral mucositis.
Monitoring Pharmacologically Induced Immunosuppression by Immune Repertoire Sequencing to Detect Acute Allograft Rejection in Heart Transplant Patients: A Proof-of-Concept Diagnostic Accuracy Study
Authors: Christopher Vollmers, Iwijn De Vlaminck, Hannah A. Valantine, Lolita Penland, Helen Luikart, Calvin Strehl, Garrett Cohen, Kiran K. Khush, Stephen R. Quake
Journal: PLoS Medicine (2015)

Background It remains difficult to predict and to measure the efficacy of pharmacological immunosuppression. We hypothesized that measuring the B-cell repertoire would enable assessment of the overall level of immunosuppression after heart transplantation. Methods and Findings In this proof-of-concept study, we implemented a molecular-barcode-based immune repertoire sequencing assay that sensitively and accurately measures the isotype and clonal composition of the circulating B cell repertoire. We used this assay to measure the temporal response of the B cell repertoire to immunosuppression after heart transplantation. We selected a subset of 12 participants from a larger prospective cohort study (ClinicalTrials.gov NCT01985412) that is ongoing at Stanford Medical Center and for which enrollment started in March 2010. This subset of 12 participants was selected to represent post-heart-transplant events, with and without acute rejection (six participants with moderate-to-severe rejection and six without). We analyzed 130 samples from these patients, with an average follow-up period of 15 mo. Immune repertoire sequencing enables the measurement of a patient's net state of immunosuppression (correlation with tacrolimus level, r = −0.867, 95% CI −0.968 to −0.523, p = 0.0014), as well as the diagnosis of acute allograft rejection, which is preceded by increased immune activity with a sensitivity of 71.4% (95% CI 30.3% to 94.9%) and a specificity of 82.0% (95% CI 72.1% to 89.1%) (cell-free donor-derived DNA as noninvasive gold standard). To illustrate the potential of immune repertoire sequencing to monitor atypical post-transplant trajectories, we analyzed two more patients, one with chronic infections and one with amyloidosis. A larger, prospective study will be needed to validate the power of immune repertoire sequencing to predict rejection events, as this proof-of-concept study is limited to a small number of patients who were selected based on several criteria including the availability of a large number of samples and the absence or presence of rejection events. Conclusions If confirmed in larger, prospective studies, the method described here has potential applications in the tailored management of post-transplant immunosuppression and, more broadly, as a method for assessing the overall activity of the immune system.
Bone marrow infiltration patterns and their prognostic significance in chronic lymphocytic leukemia: correlations with clinical, immunologic, phenotypic, and cytogenetic data.
Authors: T Han, M Barcos, L Emrich, H Ozer, R Gajera, G A Gomez, P A Reese, J Minowada, M L Bloom, N Sadamori
Journal: Journal of Clinical Oncology (1984)

Bone marrow biopsies were prospectively performed on 75 patients with chronic lymphocytic leukemia (CLL). There was a highly significant relationship (p less than 0.002) between clinical stages and bone marrow infiltration patterns. Ten (50%) of 20 patients with diffuse patterns died; the estimated median survival time for these patients was 87 months. In contrast, only six (11%) of 55 patients with nondiffuse patterns died; the estimated median survival time for these patients could not be computed. When both clinical stage and infiltration pattern were evaluated for survival, a highly significant association between clinical stage and survival time was still observed (p less than 0.003) whereas bone marrow infiltration pattern was no longer significant. A significant association was also observed between bone marrow infiltration patterns and absolute lymphocyte counts (p less than 0.0005), Fc-receptor-positive cells (p less than 0.002), 3H-thymidine uptake of leukocytes (p less than 0.01), serum alkaline phosphatase levels (p less than 0.05), monoclonal urinary-free light chain status (p less than 0.05), and cytogenetics of leukemic cells (p less than 0.05). These observations lead to the conclusion that in an overall prognostic evaluation of patients with CLL, although bone marrow histopathology may have no additional value over a well-established clinical staging system, as a whole, it may be of clinically predictive value in disease progression of patients with stage I and II.
EBUS TBNA with rigid bronchoscopy, jet ventilation and general anesthesia – A review of procedural, anesthesia & post recovery times
Authors: Filiz Oezkan, Amir Khan, Lutz Freitag, Kaid Darwiche
Journal: European Respiratory Journal (2014)

Introduction: Flexible bronchoscopy (FB) with moderate sedation (MS) is the optimal technique for airway evaluation. Convex probe endobronchial ultrasound transbronchial needle aspiration (CP-EBUS TBNA) with above is preferred in most of the centers. It is argued, EBUS with FB and MS provide adequate biopsy, lower costs and quick recovery times.

Aims & Objectives: We report our experience of rigid bronchoscopy (RB) with jet ventilation (JV) and IV general anesthesia (GA) as an alternative to FB and MS.

Methods & Material: A retrospective review of prospectively collected data of 105 cases of CP-EBUS TBNA with RB and GA performed in the interventional pulmonology suite of our institution. Post recovery times were calculated in holding area. Rigid intubation with JV and IV sedation (propofol, mivacurium/cisatracurium and remifentanyl) was used.All data was collected by anesthesia staff.

Results: Of the total 105 cases, 71 men and 34 women had an average age of 68.2 years. The average total GA anesthesia time was 46 mts:52 secs, average total EBUS procedural time was 31 mts:17 secs. Average total no. of lymph node biopsied were 3.2. The average total recovery time was 90 mts. In addition we performed 50 forceps biopsies, 37 brush biopsies, 4 cryo biopsies and 22 catheter biopsies. No post-procedural complications were recorded.

Conclusion: We conclude that EBUS TBNA can be performed efficiently and safely with RB, JV and IV GA. Advantage of performing additional therapeutic and diagnostic procedures with a secured airway during bronchoscopy is given.
A phase II trial of docetaxel and samarium in patients with bone metastases from castration-refractory prostate cancer (CRPC) and a response or stabilization after induction docetaxel-estramustine
Authors: A. Laplanche, P. Beuzeboc, J. Lumbroso, M. Di Palma, C. Theodore, D. Prapotnich, B. Escudier, J. Bouzy, V. Haddad, K. Fizazi
Journal: Journal of Clinical Oncology (2006)

4608 Background: Most patients (pts) with disseminated CRPC have bone metastases. Samarium is a radio-isotope with a high affinity to bone. Docetaxel is currently the standard of care in CRPC. We assess the efficacy of combining docetaxel and samarium as consolidation treatment after docetaxel-estramustine in pts with CRPC. Methods: This is a prospective, bi-center phase II trial. Pts with bone metastases from CRPC received docetaxel 70 mg/m 2 day 2 + estramustine 10 mg/Kg/day, day 1–5 (1 cycle every 3 weeks). Pts with a response or stabilization after 4 cycles were given consolidation therapy: docetaxel 20 mg/m 2 /week x 6 weeks + samarium 1 injection during week 1 (37 MBq/Kg). Zoledronic acid was routinely used and was stopped 1 month before samarium infusion. This study used a Simon two-step design with a final target of 39 pts receiving the consolidation treatment. Biological responses were defined according to the working group criteria (Bubley, J Clin Oncol 1999). The primary endpoint was progression-free survival (PFS). Results: From 01/2004 to 12/2005, 43 pts were included in the trial and the accrual is over. Of the 39 pts currently fully evaluable after induction treatment, 28 (72%), 10 (26%) and 1 (3%) achieved a PSA response, stabilization, and progression, respectively. Of 30 pts currently evaluable after consolidation treatment, 20 (65%), 5 (16%) and 5 (16%) achieved a PSA response, stabilization, and progression, respectively. A pain response (defined as a decrease in pain intensity by at least 2/10 on a pain analog visual scale in pts with a baseline pain level ≥ 2/10) was achieved in 89% (16/18) after consolidation treatment. The consolidation docetaxel-samarium regimen was feasible with most pts experiencing a mild (grade 1–2) and rapidly reversible thrombocytopenia at week 5. Data on PFS and overall survival are pending. Conclusions: Combining docetaxel and samarium is feasible and well-tolerated. It yields a high PSA response rate and a major pain improvement in pts with bone metastases from CRPC. [Table: see text]
Prevalence of obstructive sleep apnea in men and women with stable angiographically-confirmed coronary artery disease. Is Berlin questionnaire the appropriate screening tool?
Authors: Stylianos Steiropoulos, Evangelia Nena, Maria Saroglou, Maria Xanthoudaki, Stavros Tryfon, Theodore C. Constantinidis, Demosthenes Bouros, Paschalis Steiropoulos
Journal: European Respiratory Journal (2014)

Introduction: Obstructive sleep apnea (OSA) is associated with Coronary Artery Disease (CAD). Berlin Questionnaire (BQ) is a simple screening tool for OSA in the general population.  Aim of the study was to assess, using BQ, the estimated OSA prevalence in men and women with CAD.  Material and Methods: BQ was answered by 170 consecutive angiographically-confirmed, stable CAD patients (102 males/68 females, age 71.8±12.5 years, BMI 31.6±4.5 Kg/m 2 ). Those who responded positively at 2 out of the 3 categories in BQ, were considered at high risk for OSA.  Results: Based on BQ, 110 patients (79 males/ 31 females) were considered at high risk for OSA. Their age was 71.9±11.6 years, BMI was 31.4±4.1 Kg/m 2  and ESS was 9.96±4.85. In 74 patients (67.3%), ESS score was >10.  No difference between males and females in terms of age (73.2±12.1 vs. 68.6±9.8; p = 0.063) or BMI (30.9±3.9 vs. 32.6±4.3; p = 0.053) was observed.  There was a significant difference in gender proportion among patients at high risk for OSA. More specifically, 77.5% of men and 45.6 % of women of the initial group were at high risk (chi-squared =18.138, p   Conclusions: Among CAD patients, OSA prevalence, according to BQ, is significantly higher in men than women of comparable age and BMI. A possible explanation is that questions included in BQ respond better to a male lifestyle. Polysomnographic confirmation is necessary in order to interpret this discrepancy in OSA prevalence.
Adenosine-guided pulmonary vein isolation for the treatment of paroxysmal atrial fibrillation: an international, multicentre, randomised superiority trial
Authors: Laurent Macle, Paul Khairy, Rukshen Weerasooriya, Paul Novak, Atul Verma, Stephan Willems, Thomas Arentz, Isabel Deisenhofer, George Veenhuyzen, Christophe Scavée, Pierre Jaïs, Helmut Puererfellner, Sylvie Levesque, Jason G Andrade, Lena Rivard, Peter G Guerra, Marc Dubuc, Bernard Thibault, Mario Talajic, Denis Roy, Stanley Nattel
Journal: The Lancet (2015)
A 2 year follow up randomized pilot study of a care on demand system in COPD patients
Authors: Farida Berkhof, Anne Hesselink, Steven Uil, Huib Kerstjens, Jan Willem van den Berg
Journal: European Respiratory Journal (2013)

Introduction Traditionally, outpatient visits for chronic pulmonary disease (COPD) are fixed appointments pre-planned by the pulmonologist. This pilot study determined the effect of an on-demand-system, patient initiated outpatient visits, on health status and COPD-related health care resource use (HCRU).  Methods 100 patients were randomized between on-demand or usual care. To assess health status during 2 years the Clinical COPD Questionnaire (CCQ), the St. George’s Respiratory Questionnaire (SGRQ) and Short Form-36 (SF-36) were used. To evaluate HCRU, visits to general practitioners (GP), pulmonologists, and pulmonary nurse practitioners (PNP) and exacerbations were counted.  Results Baseline characteristics were similar in both groups. COPD-specific health status (CCQ, primary outcome) deteriorated in both groups, slightly but not significantly less in the on-demand-group. The CCQ symptom domain did show a significant and clinically relevant difference in favour of the on-demand group, -0.4±0.21, CI95% -0.87;-0.02, p=0.04. A similar tendency was found for SGRQ. Results for SF-36 were inconsistent and not significant. Patients in the on-demand-group visited the GP significantly less (p=0.01), but the PNP significantly more frequently, p=0.003. Visits to pulmonologists and exacerbations were equally frequent in both groups.  Conclusion This pilot study found that the results of the on-demand-system were comparable with usual care and can be instituted with confidence in the COPD outpatient care setting.
Increased risk of secondary acute nonlymphocytic leukemia after extended-field radiation therapy combined with MOPP chemotherapy for Hodgkin's disease.
Authors: J M Andrieu, N Ifrah, C Payen, J Fermanian, Y Coscas, G Flandrin
Journal: Journal of Clinical Oncology (1990)

The purpose of this study was to evaluate the influence of the number of mechlorethamine, vincristine, procarbazine, and prednisolone (MOPP) cycles and the extent of irradiation on the risk of secondary acute nonlymphocytic leukemia (SANLL) after a single combined treatment for Hodgkin's disease (HD). Between April 1972 and May 1980, 462 patients with HD clinical stage (CS) I, II, and III were prospectively treated with three or six cycles of MOPP and supra- and/or infradiaphragmatic irradiation (40 Gy). Four hundred forty-one patients achieved complete remission (CR). By January 1988, 237 patients had been followed-up in first CR for at least 10 years. Ten patients developed SANLL between the 34th and 123rd month of CR. The 15-year SANLL risk is 3.5% +/- 2.7%. Cox's stepwise regression analysis performed with all initial and treatment covariates (sex, age, histology, splenectomy, MOPP chemotherapy, and irradiation extent) showed that the only significant explanatory variable of SANLL risk was the irradiation extent (P less than .002). Using the log-rank test, SANLL risk ranged from 2.2% for supradiaphragmatic irradiation alone to 9.1% for subtotal (STNI) or total nodal irradiation (TNI) (P less than .001). These results strongly suggest that extended high-dose irradiation and MOPP chemotherapy should not be combined for the treatment of HD.