tbuckley/cabot-search huggingface dataset:
Coexisting subdural and intercostal haemangiomata
Authors: R Aguilo, C Montesinos, M Llobera
Journal: European Respiratory Journal (1994)

Haemangioma in the chest wall is a very rare entity, seldom described in the literature. We report the case of a 23 year old woman presenting with independent, cervical subdural and intercostal haemangiomata. She suffered several episodes of recurrent, self-limiting subdural haemorrhage before diagnosis was made by magnetic nuclear resonance, aortography and selective intercostal angiography. Surgical excision was performed in both locations with excellent results.
Abstract 18398: Malignant Ventricular Arrhythmias in Lamin A/C Cardiomyopathies: Prevalence, Clinical Course and Outcome
Authors: Sip Wijchers, Ferdi Akca, Kadir Caliskan, Alina Constantinescu, Olivier Manintveld, Tamas Szili-Torok
Journal: Circulation (2014)

Introduction: Genetic mutations in the Lamin A/C (LMNA) genes have been recognized as a possible cause of familial cardiomyopathies (CMP). Ventricular Tachycardias (VT) are frequently associated with LMNA cardiomyopathy, but data is limited on time of occurrence, prevalence of and used treatment options and their efficacy of these VTs. The aim of this study is to describe ventricular arrhythmias in LMNA cardiomyopathy Methods: This was a retrospective cohort study including data from all patients diagnosed with LMNA CMP within the Erasmus MC department of cardiology, a tertiary referral centre. Follow up continued until the patient either got a heart transplantation (HTX) or died. Results: Twenty patients were identified with LMNA CMP. The follow up time ranged between 14 and 208 months with a median of 67. Malignant VTs were documented in 14 out of 20 (70%) patients. Five patients (25%) had documented non sustained (NS) VT before a diagnosis was made using genetic testing, whereas the remaining VTs occurred 45 ± 54 months during follow up. All patients with documented VT or frequent premature ventricular complexes showed at least 2 or more morphologies with variable coupling intervals. Pharmacological therapy was beta blockade for 80 % of the cohort. Amiodarone was used in 45% of the patients and was discontinued in another 20%. An ICD was implanted in 95% of the patients. Twelve of the 19 (63%) received appropriate therapy. Three patients (15%) underwent radio frequent catheter ablation (RFCA) for a recurrent VT. Two of whom had multiple morphologies. All three patients had VT recurrence showing different and multiple morphologies after 0, 2 and 33 months. Two of these patients died of electrical storm at 0 and 27 months after RFCA and the third received a HTX after 98 months. All patients of the total cohort that showed VT during monitoring had documented recurrences despite different treatment strategies. Five patients (25%) died after a mean of 9 ± 7 years. Three patients (15%) received a HTX. Conclusions: Patients with LMNA CMP have an increased risk for malignant VT with very limited treatment options. Both medical regimes as well as the few ablations had 100% recurrences. Because the VTs are multiform in nature we would advise taking a reticent stand towards RFCA
Role of procalcitonin (PCT) as a marker of severity of community acquired bacterial pneumonia (CABP) compared to PSI, CRB65 abd CURB65
Authors: Lalita Fernandes, Anthony Mesquita, Akash Arora
Journal: European Respiratory Journal (2013)

Background: Community Acquired Pneumonia (CAP) can present as mild to often fatal illness (mortality 3.3% to 11%). One of the most important decisions for the treating physician is whether to hospitalize or not.This decision has great impact on patient outcome and cost of treatment.Hence accurate assessment of severity at presentation is vital to treatment strategy. PSI, CURB65 and CRB65 scores are available to assess severity, however not all physicians use these scores1.  Aim: PCT, a marker of sepsis is easy to measure and hence we aim to assess the prediction value of PCT for severity of CABP.  Methods: We enrolled patients≥15yrs meeting IDSA definition for CABP. Exclusion criteria was prior antibiotic use or immunosuppressive therapy. PSI,CURB65 and CRB65 scores were calculated at admission and baseline PCT levels were also measured semi-quantitatively. Patients were treated as per hospital protocol and were followed for 30 days for mortality.The sensitivity,specificity, negative and positive predictive value was calculated for PCT using each of the scores as gold standard.  Results:  Conclusions: PCT level at admission predicts patients at low risk for mortality. PCT when combined with CRB65 improves sensitivity and Negative Predictive Value for morality to 100.  Reference:  1. Lindstrom et al. Respirology, July 2007.
Does diabetes mellitus influence the prognosis of patients with lung cancer
Authors: Nagore Blanco Cid, Isaura Parente Lamelas, Jose Abal Arca, Pedro Marcos Velázquez
Journal: European Respiratory Journal (2013)

INTRODUCTION  Studies investigating the influence of diabetes mellitus (DM) in the prognosis of lung cancer (LC) have been recently published. Our objective was to analyze the clinical features of patients with LC and DM and assess the impact of DM in survival.  MATERIAL AND METHODS  An observational, retrospective study in patients diagnosed with LC between 2003-2011 at the Complexo Hospitalario Universitario of Ourense. All cases were diagnosed by cytohistology. The Student9s T-test was used for comparison of means and the Chi-square for comparison of proportions. Survival was estimated by the Kaplan-Meier method. The statistical software used was SPSS 15.0.  RESULTS  1,504 patients were diagnosed with LC, 16% were diabetic. 88% of them were men and 12% women; the mean age was 70.43±9.4 years. 85.8% were smokers, with a mean consumption of 61.27±29.15 packs/year. Their clinical histories included HT (46%), COPD (39.7%) and heart disease (31.8%). The diagnosis was small-cell carcinoma in 19.7% and non-small cell carcinoma in 80.3%. 19.3% were diagnosed in early stage (I,II), 35.6% in localized regional stage, and 45.1% in advanced stage. 13.8% received surgery, 57.7% chemotherapy, 29.3% radiation therapy, and 26.4% palliative treatment. A comparative analysis was performed vs patients without DM and significant differences were only seen for age, DM patients being older (p=0.001). End of study survival was 11.9%, with no significant differences seen between the 2 groups (p=0.092).  CONCLUSIONS  -Survival at the end of the study of patients with LC and DM was 11.9%, with no significant differences vs non-diabetic patients.  -Patients with LC and DM were older, and no other differences were seen between the 2 groups.
Reply to Steven MacLennan, Paula R. Williamson, and Thomas B. Lam's Letter to the Editor re: Neil E. Martin, Laura Massey, Caleb Stowell, et al. Defining a Standard Set of Patient-centered Outcomes for Men with Localized Prostate Cancer. Eur Urol 2015;67:460–7
Authors: Neil E. Martin, Caleb Stowell, Hartwig Huland
Journal: European Urology (2015)
Occult foreign bodies mimicking lung cancer: A rare entity
Authors: Kalliopi Athanassiadi, Athanasia Makrygianni, Ilias Samiotis, Maria Chantziara, Theodore Argyrakos, Vassiliki Karameri, Stamatios Kakaris
Journal: European Respiratory Journal (2014)

OBJECTIVE: Occult pulmonary foreign bodies are infrequently seen in adults. Patients present with cough, dyspnea and recurrent hemoptysis mimicking asthma, chronic bronchitis and lung cancer and usually reach the thoracic surgeon for diagnosis.  MATERIAL: During the last 10 years 6 patients, 5 male and one female, ranging in age from 36 to 74 years, were admitted to our departments with the suspicion of lung cancer. None of our patients had a history of aspiration or psychiatric disease. All patients had recurrent pneumonitis for more than 4 years, additionally, 3 of them presented with hemoptysis and chronic cough. All of them were submitted to repeated bronchoscopies that did not turn out to be diagnostic. Also FNA under CT guidance did not solve the problem of preoperative diagnosis.  RESULTS: All patients after a detailed staging were led to the operating room and were submitted to thoracotomy. The intraoperative histological diagnosis revealed fibrotic and necrotic tissue in the majority of cases without excluding the possibility of lung cancer and the pathologists demanded the whole lesion for definite diagnosis. The resection of the lesion was technically possible only with lobectomy in 8 cases, while in the rest atypical resection was performed. Different foreign bodies were found such as suture migrating from the abdomen, cloth, needle etc. The postoperative course was uneventful.  CONCLUSIONS: Retained foreign bodies in the lung are a rare clinical entity undetectable preoperatively in the majority of cases. They can be asymptomatic for years and might mimick lung cancer. The differential diagnosis is very difficult and only the final histological diagnosis can be definitive.
Chromosome abnormalities in leukemia.
Authors: J D Rowley
Journal: Journal of Clinical Oncology (1988)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1988.6.2.194 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 3422259 Chromosome abnormalities in leukemia. J D RowleyxJ D RowleySearch for articles by this author Show More Department of Medicine, University of Chicago, IL 60637. https://doi.org/10.1200/JCO.1988.6.2.194 First Page PDF © 1988 by American Society of Clinical Oncology
Hypoxic Gene Expression of Donor Bronchi Linked to Airway Complications after Lung Transplantation
Authors: Bryan D. Kraft, Hagir B. Suliman, Eli C. Colman, Kamran Mahmood, Matthew G. Hartwig, Claude A. Piantadosi, Scott L. Shofer
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Central airway stenosis (CAS) after lung transplantation has been attributed in part to chronic airway ischemia; however, little is known about the time course or significance of large airway hypoxia early after transplantation.To evaluate large airway oxygenation and hypoxic gene expression during the first month after lung transplantation and their relation to airway complications.Subjects who underwent lung transplantation underwent endobronchial tissue oximetry of native and donor bronchi at 0, 3, and 30 days after transplantation (n = 11) and/or endobronchial biopsies (n = 14) at 30 days for real-time polymerase chain reaction of hypoxia-inducible genes. Patients were monitored for 6 months for the development of transplant-related complications.Compared with native endobronchial tissues, donor tissue oxygen saturations (Sto2) were reduced in the upper lobes (74.1 ± 1.8% vs. 68.8 ± 1.7%; P < 0.05) and lower lobes (75.6 ± 1.6% vs. 71.5 ± 1.8%; P = 0.065) at 30 days post-transplantation. Donor upper lobe and subcarina Sto2 levels were also lower than the main carina (difference of -3.9 ± 1.5 and -4.8 ± 2.1, respectively; P < 0.05) at 30 days. Up-regulation of hypoxia-inducible genes VEGFA, FLT1, VEGFC, HMOX1, and TIE2 was significant in donor airways relative to native airways (all P < 0.05). VEGFA, KDR, and HMOX1 were associated with prolonged respiratory failure, prolonged hospitalization, extensive airway necrosis, and CAS (P < 0.05).These findings implicate donor bronchial hypoxia as a driving factor for post-transplantation airway complications. Strategies to improve airway oxygenation, such as bronchial artery re-anastomosis and hyperbaric oxygen therapy merit clinical investigation.
IL33 expression and release from airway epithelium
Authors: Nicola Green, Monika Suwara, Lee Borthwick, Derek Mann, Andew Fisher
Journal: European Respiratory Journal (2012)

Background   IL33 has been highlighted as a potential key player in several chronic respiratory diseases with a fibrotic aietiology. IL33 expression is thought to be predominantly in lining cellsi.e airway epithelia, suggesting this may be a primary source of IL33; as an alarmin in response to epithelial insult.   Aim   To evaluate expression of IL33 and release in response to airway epithelial damage.   Methods   BAL was prospectively collected from post lung transplant patients (n=230) levels of IL33(ELISA) and relationship to Broncholitis Obliteran Syndrome (BOS) evaluated. Explant lung tissue from patients with IPF(n=3),COPD(n=3), Bronchiectasis(n=3) and CF(n=3) was identified and expression of IL-33 evaluated (immunohistochemistry). Epithelial damage was induced in Primary Bronchial Epithelial Cells and A549 cells by oxidative stress (H2O2) and freeze/thaw and release of IL33 evaluated(ELISA and Western Blot).   Results   IL33 conc. in post-lung transplant BAL trended towards an increase following diagnosis of BOS but did not reach statistical significance. However, elevated levels of IL-33 were associated with positive microbial culture (mean 178.197pg/ml± 42.89vs 71.31pg/ml±20.12 p=0.007). IL33 was strongly expressed in airway epithelia with a predominant nuclear location.IL33 was not detected in response to epithelial cell damage.   Conclusion   IL33 is strongly expressed in the airway epithelium of chronic respiratory conditions but does not appear to be released as an alarmin in response to airway epithelial cell damage. Elevated IL33 associated with infection in the post transplant population may contribute towards allograft dysfunction but further work is required to evaluate the cellular mechanistic pathways.
Abstract P316: Prehypertension and Incident Acute Coronary Heart Disease in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study
Authors: Stephen P Glasser, Yulia Khodneva, Daniel Lackland, Ronald Prineas, Monika Safford
Journal: Circulation (2013)

Objective: The independent prognostic value of prehypertension (preHTN) for incident coronary heart disease (CHD) remains unsettled. Using the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort study, we examined associations between preHTN and incident acute CHD and CVD death. Methods: REGARDS includes 30,239 black and white community-dwelling adults age 45 and older at baseline. Recruitment occurred from 2003-7, with baseline interviews and in-home data collection for physiologic measures. Follow-up is conducted by telephone every 6 months to detect events and deaths, which are adjudicated by experts. Systolic BP was categorized into &lt;120 mmHg (n=4385), 120-129 mmHg (n=4000), 130-139 (n=2066), and hypertension was categorized into controlled (&lt;140/90 mmHg on treatment) (n=8378), and uncontrolled (&gt;140/90 mmHg) (n=5364). Incident acute CHD was defined as definite or probable myocardial infarction (MI) or acute CHD death. CVD death was defined as acute CHD, stroke, heart failure or other cardiovascular disease related. Cox proportional hazards models estimated the hazard ratios (HR) for incident CHD by BP categories, adjusting for sociodemographics and CHD risk factors. Results: The 23,393 participants free of CHD at baseline were followed for a median of 4.4 years. Mean age was 64.1, 58% were women and 42% were black. There was a significant interaction between sex and BP categories, therefore analyses were stratified by sex. There were 252 non-fatal and fatal acute CHD events among women and 407 among men. Among women, compared with SBP&lt;120 mmHg, BP categories above SBP 120 mmHg were associated with incident CHD (adjusted HR for SBP120-129 mmHg=1.94 {95% CI 1.04-3.62]; SBP 130-139 mmHg=1.92 {0.95-3.87}; controlled HTN=2.16 {1.25-3.75}; uncontrolled HTN=3.25 {1.87-5.65}) in fully adjusted models. Among men, only uncontrolled HTN was associated with incident CHD (HR=1.55 {1.11-2.17}). Conclusion: In this sample, preHTN may be associated with incident CHD among women but not men.
NIV: Is it useful to assess patient-perceived quality of ventilation?
Authors: Marjolaine Georges, Claudio Rabec, Claire-Marie Monnet, Frank Kabeya, Philippe Camus
Journal: European Respiratory Journal (2013)

Background: Noninvasive ventilation (NIV) aims to correct daytime and nocturnal hypoventilation, to improve symptoms and to preserve quality of sleep. The goal of our study was to compare patient-perceived quality of ventilation (QV) with objective assessment of NIV efficacy.

Methods: NIV efficacy was evaluated in 98 patients. They underwent an oxi-capnography (SpO2-TcPCO2) under NIV and arterial blood gases (ABG) in the morning. Unintentional leaks were continuously recorded with a ventilator-coupled monitoring system (VPAP3-ResLinkTM, ResMed). All subjects completed an eight-item visual analogic scale (VAS) to evaluate patient-perceived QV in 3 domains: synchrony, effectiveness and leakage then a questionnaire to assess subjective quality of sleep.

Results: Table 1 show global comparison between NIV results as assessed by different tools and patient-perceived QV. Objective NIV evaluation do not show any significant correlation neither with VAS score (rho value: mean SaO2, -0.09; mean TcPCO2, 0.21; PaCO2, 0.15) nor with perceived quality of sleep.

View this table:

Subjective versus objective evaluationof NIV efficacy





Conclusion: Our study shows that patients' perception of QV is not significantly related to outcomes obtained from objective NIV evaluation.
Effect of cholera toxin and cyclic adenosine monophosphate on fluid-phase endocytosis, distribution, and trafficking of endosomes in rat liver
Authors: Rebecca W. Van Dyke
Journal: Hepatology (2000)

In prior studies, we showed that cholera (CTX) and pertussis toxins (PTX) increase rat liver endosome acidification. This study was performed to characterize the effects of these toxins and cyclic adenosine monophosphate (cAMP) on endosome ion transport, fluid-phase endocytosis (FPE), and endosome trafficking in liver. In control liver, more mature populations of endosomes acidified progressively more slowly, but both toxins and cAMP caused retention of an early endosome acidification profile in maturing endosomes. CTX caused a density shift in endosomes, and all agents increased net FPE at time points from 5 to 60 minutes. By confocal microscopy, fluorescent dextrans first appeared in small vesicles at the hepatocyte sinusoidal membrane and trafficked rapidly to the pericanalicular area, near lysosomes and the trans-Golgi network (TGN). Prolonged exposure to these agents caused redistribution of many labeled vesicles to the perinuclear region, colocalized with markers of both early (EEA1 and transferrin receptor) and late (LAMP1) endosomes. We conclude that cAMP is the common agent that disrupted normal maturation and trafficking of endosomes and increased net FPE, in part via decreased diacytosis.
C1 inhibitor function using contact‐phase proteases as target: evaluation of an innovative assay
Authors: A. Ghannam, P. Sellier, F. Defendi, B. Favier, D. Charignon, A. López‐Lera, M. López‐Trascasa, D. Ponard, C. Drouet
Journal: Allergy (2015)

Controlling prekallikrein activation by C1 inhibitor (C1Inh) represents the most essential mechanism for angioedema patient protection. C1Inh function in the plasma is usually measured based on the residual activity of the C1s protease not involved in the pathological process. We have hereby proposed an alternative enzymatic measurement of C1Inh function based on contact-phase activation and correlation with angioedema diagnostic requirements.The contact phase was reconstituted using the purified components, with C1Inh standard or plasma sample. The kinetics of the amidase activity were monitored using Pro-Phe-Arg-pNA, independently of alpha2-macroglobulin. We prevented any interference from a possible high plasma kininogenase activity by preincubating the samples with protease inhibitor. Receiver operating characteristics (ROC) were used to calculate the assay's diagnostic performance.The calibration curve was built using C1Inh standard (threshold limit 0.10 × 10(-3) U, i.e., 0.2 pmol), and C1Inh function was quantified in the sample, with a reference interval established based on healthy individuals (n = 281; men: 0.61-1.10 U/ml, median: 0.85 U/ml; women: 0.42-1.08 U/ml, median: 0.74 U/ml). The median values of female donors were lower than those of the others due to estrogen, yet C1Inh function remained within the reference interval. The ROC curve calculation provided the following optimum diagnostic cutoff values: women 0.36 U/ml (area under curve [AUC]: 0.99; sensitivity: 93.48%; specificity: 99.37%); and men 0.61 U/ml (AUC: 1; sensitivity: 100.0%; specificity: 100.0%).The performance outcome provided features suitable for angioedema diagnostic or follow-up. Established by means of the kinin formation process, this assay should be preferred over the method based on a C1s protease target.
Promotion of Hypercoagulability in Antineutrophil Cytoplasmic Antibody–Associated Vasculitis by C5a‐Induced Tissue Factor–Expressing Microparticles and Neutrophil Extracellular Traps
Authors: Yi‐Min Huang, Huan Wang, Chen Wang, Min Chen, Ming‐Hui Zhao
Journal: Arthritis & Rheumatology (2015)

Patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) have a high frequency of venous thromboembolic events and a hypercoagulable state. As C5a-primed neutrophils play an important role in the development of AAV, we investigated whether C5a-induced neutrophil tissue factor (TF)-expressing microparticles (MPs) and neutrophil extracellular traps (NETs) might promote hypercoagulability in AAV.TF-expressing MPs were measured by flow cytometry. TF-expressing NETs were assessed by confocal microscopy. Levels of thrombin-antithrombin complexes were determined by enzyme-linked immunosorbent assay. The effect of C5a in sera from AAV patients was evaluated by treating neutrophils with C5a receptor antagonist before incubation with sera from AAV patients with active disease.Treatment of C5a-primed neutrophils with antineutrophil cytoplasmic antibody (ANCA)-positive IgG resulted in the release of TF-bearing MPs and NETs. Neutrophils from healthy donors treated with sera from patients with active AAV released TF-bearing MPs and NETs, which were abolished by treatment with C5a receptor antagonist. Involvement of TF in MP- or NET-dependent thrombin generation was indicated by the findings of antibody neutralization studies. NETs with thrombin-generating capacity were demonstrated by DNase I treatment.C5a-primed neutrophils produce TF-expressing MPs and NETs after stimulation with ANCAs, indicating a mechanism for hypercoagulability in AAV that was not previously recognized.
Complex Blood Flow Disturbance and Reduced Mean Wall Shear Stress contribute to the Aortic Disease of Marfan Syndrome: Insights from Time-Resolved, 3D Phase-Contrast Magnetic Resonance Imaging
Authors: Alex Pitcher, Anisha Ramessur, Tom Cassar, Edward Blair, Paul Wordsworth, Paul Leeson, Jane M Francis, Bock Jelena, Lorenz Ramona, Alexander Barker, Forfar Colin, Michael Markl, Steffen E Peteresen, Stefan Neubauer
Journal: Circulation (2011)

Background: Marfan syndrome (MFS) predisposes to progressive aortic dilation and dissection. Complex flow disturbance and low wall shear stress (WSS) are increasingly recognised as potentially impo...