tbuckley/cabot-search huggingface dataset:
Clinical experience with a new self-expandable metal stent, SILMET, in tracheo-bronchial stenosis
Authors: Roberto Marchese, Giuseppe Paglino, Giovanni Di Giacomo, Vincenzo Argano
Journal: European Respiratory Journal (2012)

Introduction : The Implantation of Tracheo bronchial stents is a recognised treatment option in the management of airway disease. However, stent related side effects and complications are still an unresolved issue and are object of intense investigation. Research is currently focusing on the delivery mechanism and on biomaterials.   Aims : We evaluate the clinical result and effectiveness of the Silmet stent for treatment of benign or malignant bronchial disease.   Methods : Clinical data were collected retrospectively from 21 consecutive patients. Each patient implanted were underwent to clinical monitoring, according to our protocol, consisting in endoscopic and microbiological testing at 1 day, 1 month, 3 months and 6 months after the procedure. For the evaluation of mucus plugging we used our 4 points endoscopic scoring: 0 = no secretions; 1 = moderate amount of secretions easily removable by suction; 2 = severe amount of secretions removable using a biopsy forceps, mucolytic agents instillations or other devices in addition to the suction; 3 = complete stent obstruction or deposit of thick and non-removable secretions.   Results : at the end of follow-up we recorded a single death which was not respiratory related. In one patient under chemiotherapy we observed dislocation of the stent after significant tumor mass regression. No patient developed airways stenosis or trauma, airway wall damage or major complications. Nineteen patients had endoscopic score 0 and two patients score 1 in the last visit. One patient had a mild not obstructing granuloma.   Conclusions : these new Silmet stent have proved effective and free of severe complications in the treatment of tracheo-bronchial stenosis.
BACTEC versus Lowenstein-Jensen media for isolation of mycobacterium tuberculosis
Authors: Rana El-Helbawy, Osama Fahim, Amal Abd-Elaziz, Emad Eed, Marwa Abd-Elazeem
Journal: European Respiratory Journal (2013)

Background : The BACTEC medium has consistently demonstrated faster and increased recovery of Mycobacterium tuberculosis from respiratory specimens of patients with pulmonary tuberculosis than conventional culture methods.  Objective:  to assess the efficacy of the BACTEC medium in supporting growth of Mycobacterium tuberculosis, to determine the incubation time required for detection of growth in both culture media in relation to inoculums size and to compare cost benefits of the BACTEC system with the conventional LJ culture.  Methods:  case-control study was done on 50 PTB patients admitted to Chest Department, Menoufiya University Hospital (Egypt) from January to December 2012. All the clinical respiratory specimens received were subjected to direct smear microscopy by Ziehl-Neelsen (ZN) staining method, as well as inoculated into the BACTEC and LJ medium.  Result:  The overall recovery rate was 68% by BACTEC and 56% using Lowenstein-Jensen (LJ) medium. The combination use of both media produced positive mycobacterial culture yield (84%). for smear negative specimens an average detection time for Bactec media was found to be 13.3 days and 15.3 days as against 31.2 days and 35.3 days by LJ method for respiratory specimens (BAL and sputum) respectively. The BACTEC culture was more expensive and required more medical technologists9 time.  Conclusions:  The BACTEC medium is a good for the diagnosis of smear negative tuberculosis. It demonstrated faster and increased recovery of Mycobacterium tuberculosis of patients with pulmonary tuberculosis than conventional culture methods. The combined use of BACTEC and LJ gives better positive culture yield.
A study of suspected pulmonary embolism (PE) in pregnancy management and a survey of guideline awareness
Authors: Imogen Felton, Katie Wimble, Paul Murray
Journal: European Respiratory Journal (2012)

Introduction: A recent report showed PE as a major cause of maternal death in the UK (CMACE,BJOG 2011;118(Suppl.1):1-203); delays in diagnostic tests, treatment and poor knowledge of radiological safety are contributing factors. The Royal College of Obstetricians & Gynaecologists provides a protocol for suspected PE (Greer, I.A.et al.RCOG Green-top Guideline No.28 Feb 2007).

Aims:To gauge the level of guideline-awareness in medical trainees and evaluate the management of suspected PE in pregnancy in a UK District Hospital.

Methods: A survey of medical trainee knowledge of investigative pathways, radiation-exposure risks and guideline awareness. We also analysed management of pregnant women with suspected PE between 2009-11.

Results: 76% of medical trainees and 58% of Respiratory SpRs were unaware of guidelines and had poor knowledge of radiation risks.

View this table:

Table 1





41 women had symptoms of PE and were investigated as shown.

![Figure][1] 



3 patients had PE confirmed(7.3%). Only 15% of women were investigated as per RCOG guidelines.

Conclusion: Our study revealed poor guideline-awareness for PE in pregnancy highlighting the need for better dissemination of these guidelines to medical trainees.

 [1]: pending:yes
Black widow spider toxin, alpha-latrotoxin, contracts large and small airways in different species
Authors: Chantal Donovan, Alen Faiz, Brian G. Oliver, Judith L. Black, Brent E. McParland, Janette K. Burgess, Jane E. Bourke
Journal: European Respiratory Journal (2013)

Introduction: Airway hyperresponsiveness (AHR) in asthma is characterised by airways contracting too easily and too much. We recently identified increased expression of latrophilin 1 (LPHN1) in human primary airway smooth muscle (ASM) cells from asthmatic donors that may influence contractile function. In this study we characterised the responses to the LPHN1 agonist, α-latrotoxin (α-LTX), toxin produced by the black widow spider, in various size airways from different species.  Methods: Changes in force were measured in guinea pig trachea, mouse trachea and bronchi under isotonic conditions (n=8). Changes in small airway lumen diameter were visualized in mouse lung slices (150μm thick, n=2) using phase-contrast image analysis. Responses to α-LTX (10nM) were compared in the absence and presence of the muscarinic antagonist, atropine (3μM) and compared to the maximal airway contraction to acetylcholine (ACh 1mM).  Results: α-LTX caused biphasic contractions in guinea pig trachea, characterised by a transient oscillating contraction and a secondary increase in tone (∼65% of ACh max) that was also not sustained. Single atropine-sensitive contractions were observed for mouse trachea and bronchi, with oscillations evident in bronchi only. In small airways in mouse lung slices, α-LTX induced small oscillations without a significant change in airway lumen area.  Conclusion: α-LTX elicited contraction in all airways tested, however the profile of contraction differed between species and airway size. Contractile responses can be attributed to ACh release from nerve terminals innervating ASM. It remains to be determined whether direct activation of LPHN1 on ASM contributes to AHR observed in asthma.
Race and overall survival in acute myeloid leukemia.
Authors: J. M. Bierenbaum, Y. Ning, M. Tidwell, I. Gojo, M. R. Baer
Journal: Journal of Clinical Oncology (2010)

6570 Background: Racial differences in outcomes have been identified in a number of malignancies, but have not been extensively studied in the adult acute myeloid leukemia (AML) population. Our goal was to determine if overall survival (OS) in AML differs by race. Methods: Patients with AML evaluated at the University of Maryland Greenebaum Cancer Center from 2000 through 2009 were reviewed for age, sex, race, karyotype and FLT3 status. Cytogenetic data were categorized by Southwest Oncology Group risk criteria. OS was evaluated by the method of Kaplan and Meier. Results: 548 AML patients were identified. Racial distribution was 72% white, 20% black, and 8% other. Cytogenetic data were available for 93% and FLT3 data for 32%. Cytogenetic and molecular findings and OS (months) were compared in black and white patients (see Table). While blacks had a higher incidence of complex karyotypes (27% vs. 13%, p=0.002) and a lower incidence of normal karyotypes (30% vs. 45%, p=0.04), OS did not differ (15 vs. 14 months; p NS) and did not differ within cytogenetic subsets. OS of black males was longer than that of white males (21 vs. 12 months, p=0.02), likely attributable to a younger median age (53 vs. 63 years, p<0.001) and a trend toward a higher incidence of t(15;17) (13% vs. 6%, p=0.09) in black males. Females did not differ by race in median age or OS but there was a much higher incidence of complex karyotypes in black females (30% vs. 12%, p=0.003) and also a trend toward more total unfavorable karyotypes (45% vs. 28%, p=0.06). Additionally, in intermediate karyotype patients, wild type FLT3 status more strongly predicted OS in blacks (NR vs. 7 months; p=0.03) than in whites (18 vs. 13 months, p=0.07). Conclusions: While there are biologic differences in AML between black and white patients, OS does not differ. White Black p n (%) median OS n (%) median OS All patients 368 14 99 15 0.21 t (15;17) 24 (7) * 9 (9) 55 0.31 Favorable 23 (6) 42 9 (9) * 0.31 Normal 165 (45) 20 30 (30) 15 0.30 All intermediate 208 (57) 15 43 (43) 16 0.26 Wild-type FLT3 45 18 6 * 0.03 Mutated FLT3 32 10 7 7 0.17 Complex 49 (13) 7 27 (27) 8 0.48 All unfavorable 113 (31) 7 38 (38) 8 0.81 * Not reached. No significant financial relationships to disclose.
Serologically Defined, Unique Surface Antigen on a Mouse Mammary Adenocarcinoma2
Authors: Noboru Kuzumaki, George Klein
Journal: JNCI Journal of the National Cancer Institute (1979)

Journal Article Serologically Defined, Unique Surface Antigen on a Mouse Mammary Adenocarcinoma Get access Noboru Kuzumaki, Noboru Kuzumaki 3Department of Tumor Biology, Karolinska Instituter, S-104 01 Stockholm 60, Sweden. 4Recipient of a fellowship from the Cancer Research Institute, Inc. Search for other works by this author on: Oxford Academic PubMed Google Scholar George Klein George Klein 3Department of Tumor Biology, Karolinska Instituter, S-104 01 Stockholm 60, Sweden. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 62, Issue 3, March 1979, Pages 619–622, https://doi.org/10.1093/jnci/62.3.619 Published: 01 March 1979 Article history Received: 08 June 1978 Accepted: 13 September 1978 Published: 01 March 1979
Leukaemia cutis and leukaemic vasculitis
Authors: S. Paydas¸, S. Zorludemir
Journal: British Journal of Dermatology (2000)

Leukaemia cutis (LC) and leukaemic vasculitis (LV) are uncommon but important features of haematological malignancy.We aimed to evaluate clinicopathological features of a series of such cases.Thirty-four patients with LC were studied. Nineteen had acute myeloblastic leukaemia, six had acute lymphoblastic leukaemia, three had myelodysplastic syndrome-refractory anaemia with excess blast in transformation, three had non-Hodgkin's lymphoma in leukaemic phase, two had chronic lymphocytic leukaemia and one had multiple myeloma.Cutaneous lesions were widely dispersed in 15 patients, but were restricted to the extremities in eight patients. In other patients lesions were localized on the face, hands and feet. Cutaneous lesions were generally erythematous, maculopapular, squamous, nodular, haemorrhagic or necrotic. Two localizations were very interesting: in one case, lesions were confined to the site of previous varicella zoster virus infection; in the other case, leukaemic infiltration occurred within a lesion of cutaneous leishmaniasis. All of the patients had high white blood cell count and/or other findings of high tumour burden. Vasculitis with leukaemic cell infiltration (LV) was detected in 24 patients, and was high-grade LV in 16 patients. Patients with high-grade LV tended to have a higher white blood cell count and other findings associated with an aggressive clinical course compared with patients not having LV. Thirteen patients with LV died within 1 month but five patients lived more than 1 year.LC, and especially LV, is generally an indicator of poor prognosis. Its pathogenesis must be evaluated further with additional studies, including adhesion molecules, angiogenic factors and other biological parameters.
Present state of the controversy about regular inhaled beta-agonists in asthma
Authors: CG Giuntini, PL Paggiaro
Journal: European Respiratory Journal (1995)

A possible association between the use of β-agonists and mortality from asthma was postulated for the first time during the so-called epidemic of asthma deaths, which was observed in England and Wales in the 1960s [1]. With reference to this epidemic, INMAN and ADELSTEIN [2] reported a rise and fall of asthma mortality paralleling an increase and decrease, respectively, in the use of pressurized aerosols. However, SPEIZER et al. [1], the authors of the first report, pointed out that Accounts of the excess use of aerosols have been obtained in some cases, but decisive evidence to incriminate them is lacking. Other studies based on the same approach have yielded different results. In New Zealand, from 1979 to 1987, asthma mortality showed a trend to decline, whereas fenoterol and salbutamol use had a further increase [3]. In Sweden, asthma mortality remained quite stable from the beginning of the 1960s, whereas there was a marked increase in the use of inhaled β-agonists [4]. In the UK, prescription of β-agonists increased threefold during the 1980s, without any appreciable change of asthma mortality in this decade [4]. In Italy, no correlation was apparent between asthma mortality in three age classes (5–34, 35–54, and more than 55 yrs) and the number of β-agonist canisters sold in the period 1980– 1989, since against an increase in the sale of metereddose inhalers there was a trend for asthma mortality firstly to level-off and then to decline [5]. Ecological studies of this type, which are based on correlations, at a regional level, between rates of asthma death and sales of inhaled β-agonist bronchodilators, may be used only to generate or support cause-effect hypotheses, which then require other methodological approaches to be tested [6]. Case-control studies
Psychologic functioning, quality of life, and behavioral compliance in patients beginning hemodialysis.
Authors: P L Kimmel, R A Peterson, K L Weihs, S J Simmens, D H Boyle, W O Umana, J A Kovac, S Alleyne, I Cruz, J H Veis
Journal: Journal of the American Society of Nephrology (1996)

Psychologic and demographic characteristics have been shown to correlate with behavioral compliance in studies of prevalent hemodialysis (HD) patients. Few data, however, exist on the psychologic characteristics or their relationship to compliance in patients initiating HD treatment, or incident patients. Our previous work with prevalent HD patients showed an interrelationship among social support, perception of the effects of illness, and depression measured by a standardized depression index and a cognitive depression index deleting somatic symptoms. To compare psychosocial and behavioral compliance parameters in incident and prevalent patients, 99 incident HD patients undergoing dialysis for less than 6 months were assessed by using a variety of questionnaires. The patients' mean standardized depression index score was in the range of mild depression. There was no difference in mean age, Karnofsky functional status, perception of effects of illness or standardized or cognitive depression scores between incident patients and 149 prevalent patients treated with HD for 6 to 246 months. Satisfaction with life scores and perception of sexual adjustment were better, but Kt/V (quantitative measure of the amount of dialysis provided) and protein catabolic rate were lower in incident than in prevalent patients. Social support and perception of illness scores correlated with depression measures in incident patients, findings that were similar to prevalent patients. Incident (as did prevalent) patients showed striking bivariate correlations between the psychosocial and depression variables, but fewer correlations between psychologic and compliance measures. Both standard compliance parameters, such as mean predialysis serum phosphorus and potassium concentration, and behavioral compliance were better in incident than in prevalent patients. Worsened sexual adjustment, functional status, and increased severity of illness were correlated with improved behavioral compliance in incident patients. Behavioral compliance styles correlated with different social support and severity of medical illness variables in incident and prevalent patients, when assessed by multiple linear regression analysis. These different patterns suggest the existence of different mechanisms of adaptation in the groups. Measures focused on increasing delivery of dialysis and enhancing social support in urban African-American patients starting HD therapy may be useful in improving compliance with the dialysis prescription, and indirectly improving survival.
Frequent exacerbators – A distinct phenotype of severe asthma
Authors: Maciej Kupczyk, Shushila Haque, Roelinde Middelveld, Sven-Erik Dahlen
Journal: European Respiratory Journal (2011)

In order to analyse exacerbations, 93 patients with severe asthma (SA) and 76 with mild-to-moderate asthma (MA) were screened and followed up for 1 year in the BIOAIR European multicentre study. Severe asthma has been defined by use of high doses of inhaled corticosteroids (≥1600 μg of budesonide or equivalent) and despite this treatment at least 1 exacerbation in the year preceding the start of the study. Risk factors for frequent exacerbations (FE) (defined as either ≥2 or ≥3 events/year) were evaluated.  In total, 122 exacerbations were recorded, including 104 events in 52 SA patients (55.9% of SA cohort) and 18 events in 16 MA (22.2% of MA cohort). The average rate of exacerbations was 1.1 events per patient per year in SA and 0.2 events in MA. Significant decrease in PEF values, FEV 1 , increase in rescue medication use, day and night symptoms during exacerbations were recorded (p 1 ≤70% were associated with the development of exacerbations in FE defined as ≥2 events/year (odds ratios OR: 5.06, 4.38, 3.48, 2.48, 2.34, respectively, p 25, quality of life, smoking and Juniper ACQ score were risk factors for exacerbations in FE defined as ≥3 events/year (odds ratios OR: 8.07, 6.7, 4.25, 4.14, respectively, p  Frequent exacerbators represent a distinct phenotype of severe asthma group. Identification of factors associated with a higher risk of exacerbations enables us to improve the standards of every day care in this subgroup of patients.  Supported by EU (QLG1-CT-2000-01185), national funding bodies and the Osher Initiative for Severe Asthma Research at KI.
Regression of Rat Primary Mammary Tumors Following Dietary &lt;italic&gt;d&lt;/italic&gt;-Limonene&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: J. Abiodun Elegbede, Charles E. Elson, Martin A. Tanner, Asaf Qureshi, Michael N. Gould
Journal: JNCI Journal of the National Cancer Institute (1986)

The effects of d-limonene on rat mammary tumors were investigated. Following the appearance of mammary tumors induced by 7,12-dimethylbenz[a]anthracene in female (W/Fu X F344)F2 rats, animals were assigned to pairs in which 1 rat was fed a diet containing 10% d-limonene and the other was pair fed an isocaloric diet containing 10% cellulose. There was a highly significant increase in the regression of the first tumors in the rats fed d-limonene. In addition, d-limonene given at this time inhibited the formation of subsequent multiple tumors in these rats.
Successful treatment using clarithromycin for a cutaneous lesion caused by Mycobacterium szulgai
Authors: T. Shimizu, K. Kodama, H. Kobayashi, A. Ohkawara, K. Ogawa, S. Taniguchi
Journal: British Journal of Dermatology (2000)

Journal Article Successful treatment using clarithromycin for a cutaneous lesion caused by Mycobacterium szulgai Get access T. Shimizu, T. Shimizu Departments of Dermatology and *Internal Medicine II, Hokkaido University School of Medicine, Kita‐ku, Sapporo 060‐8638, Japan E‐mail: michiki@med.hokudai.ac.jp Search for other works by this author on: Oxford Academic Google Scholar K. Kodama, K. Kodama Departments of Dermatology and *Internal Medicine II, Hokkaido University School of Medicine, Kita‐ku, Sapporo 060‐8638, Japan E‐mail: michiki@med.hokudai.ac.jp Search for other works by this author on: Oxford Academic Google Scholar H. Kobayashi, H. Kobayashi Departments of Dermatology and *Internal Medicine II, Hokkaido University School of Medicine, Kita‐ku, Sapporo 060‐8638, Japan E‐mail: michiki@med.hokudai.ac.jp Search for other works by this author on: Oxford Academic Google Scholar A. Ohkawara, A. Ohkawara Departments of Dermatology and *Internal Medicine II, Hokkaido University School of Medicine, Kita‐ku, Sapporo 060‐8638, Japan E‐mail: michiki@med.hokudai.ac.jp Search for other works by this author on: Oxford Academic Google Scholar K. Ogawa, K. Ogawa Departments of Dermatology and *Internal Medicine II, Hokkaido University School of Medicine, Kita‐ku, Sapporo 060‐8638, Japan E‐mail: michiki@med.hokudai.ac.jp Search for other works by this author on: Oxford Academic Google Scholar S. Taniguchi S. Taniguchi Departments of Dermatology and *Internal Medicine II, Hokkaido University School of Medicine, Kita‐ku, Sapporo 060‐8638, Japan E‐mail: michiki@med.hokudai.ac.jp Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 142, Issue 4, 1 April 2000, Pages 838–840, https://doi.org/10.1046/j.1365-2133.2000.03452.x Published: 01 April 2000
Abstract 12217: Clinical Impact of Late Gadolinium Enhancement to Differentiate End-Stage Phase of Hypertrophic Cardiomyopathy from Dilated Cardiomyopathy
Authors: Emi Tateishi, Teruo Noguchi, Yoichi Goto, Naoaki Yamada
Journal: Circulation (2011)

Background: Differentiating between end-stage phase of hypertrophic cardiomyopathy (Es-HCM) and idiopathic dilated cardiomyopathy (DCM) is a diagnostic dilemma. Few studies have examined the morpho...
Gaps in paediatric rotas mean that GPs must do more in community, says royal college
Authors: Abi Rimmer
Journal: BMJ (2015)

Gaps in paediatric rotas mean that general practitioners need to deliver more child health services in the community, the Royal College of Paediatrics and Child Health (RCPCH) has said.

The RCPCH’s Rota Vacancies and Compliance Survey1 was sent to the 214 clinical directors and clinical leads responsible for all UK units that provide general paediatric inpatient and neonatal services. It received 157 responses, a response rate of 73%.

The …
Two-surgeon approach to thoracic outlet syndrome: long-term outcome
Authors: D Sharan, A Moulton, G H Greatrex, S K Das, A M Whiteley, V M Ms Srivastava
Journal: Journal of the Royal Society of Medicine (1999)

An orthopaedic surgeon and a vascular surgeon jointly conducted 30 operations for thoracic outlet syndrome in 27 patients, having done the preoperative assessments in conjunction with a neurologist. Anterior scalenectomy was performed by the supraclavicular route except in one case where the infraclavicular route was used. The further surgical procedure was tailored to the abnormalities identified--i.e. resection of cervical rib or band, or medial scalenectomy. The first rib was spared. At median follow-up of 37 months (range 3-228) results were judged excellent or good on 26/30 sides (87%); on the three occasions when scalenectomy alone was performed, the results were only fair or poor. There were no major complications and no patient required reoperation. The long-term outcome in this series suggests that, with multidisciplinary assessment and two-surgeon operative treatment, good results can be obtained by the supraclavicular route without resection of the first rib.