tbuckley/cabot-search huggingface dataset:
Prognostic significance of peritumoral lymphatic and blood vessel invasion in node-negative carcinoma of the breast.
Authors: A K Lee, R A DeLellis, M L Silverman, G J Heatley, H J Wolfe
Journal: Journal of Clinical Oncology (1990)

The prognostic significance of intramammary lymphatic and blood vessel invasion was evaluated in a retrospective series of 221 patients with node-negative carcinoma of the breast treated with modified radical mastectomy. To facilitate identification of lymphatic and blood vessel invasion, the tumors were studied with an immunohistochemical technique using antibodies to endothelial markers. Peritumoral lymphatic and blood vessel invasion (PLBI) (encompassing both lymphatic and blood vessel invasion) was an adverse prognostic indicator independent of menopausal status, tumor size, and other histologic variables. Recurrence of disease and death resulting from carcinoma were significantly higher for patients with PLBI-present (+) tumors compared with patients with PLBI-absent (-) tumors (P less than .0001). The risk of recurrence for patients with PLBI+ tumors was 4.7 times that for their PLBI- counterparts. The presence of intratumoral lymphatic and blood vessel invasion (ILBI) is less important because few examples were found without concomitant PLBI. When PLBI was separated into lymphatic invasion and blood vessel invasion individually, the prognostic significance was retained in both groups. The immunohistochemical approach reduced both false-negative and false-positive observations and identified about 40% of PLBI that would have been missed by routine histologic examination alone. The presence of PLBI appears to be a potentially useful discriminant in predicting the outcome of patients with node-negative carcinoma of the breast.
Results of a Prospective Randomized Trial Comparing Neoadjuvant Chemotherapy Plus Radiotherapy With Radiotherapy Alone in Patients With Locoregionally Advanced Nasopharyngeal Carcinoma
Authors: Jun Ma, Hai-Qiang Mai, Ming-Huang Hong, Hua-Qing Min, Zhi-Da Mao, Nian-Ji Cui, Tai-Xiang Lu, Hao-Yuan Mo
Journal: Journal of Clinical Oncology (2001)

PURPOSE: A prospective randomized trial was performed to evaluate the contribution of neoadjuvant chemotherapy in patients with locoregionally advanced nasopharyngeal carcinoma. PATIENTS AND METHODS: Patients with locoregionally advanced nasopharyngeal carcinoma were treated either with radiotherapy alone (RT group) or neoadjuvant chemotherapy plus radiotherapy (CT/RT group). Neoadjuvant chemotherapy consisting of two to three cycles of cisplatin (100 mg/m 2 , day 1), bleomycin (10 mg/m 2 , days 1 and 5), and fluorouracil (5-FU; 800 mg/m 2 , days 1 through 5, continuous infusion) followed by radiotherapy was given to the CT/RT group. All patients were treated in a uniform fashion by definitive-intent radiation therapy in both groups. RESULTS: Between July 1993 and July 1994, 456 patients were entered onto the study, with 228 patients randomized to each treatment arm, and 449 patients (225 in the RT group and 224 in the CT/RT group) were assessable. All 456 patients were included in survival analysis according to the intent-to-treat principle. The 5-year overall survival (OS) rates were 63% for the CT/RT group and 56% for the RT group (P = .11). The median relapse-free survival (RFS) time was 50 months for the RT group and not reached for the CT/RT group. The 5-year RFS rate was 49% for the RT group versus 59% for the CT/RT group (P = .05). The 5-year freedom from local recurrence rate was 82% for the CT/RT group and 74% for the RT group (P = .04). There was no significant difference in freedom from distant metastasis between the two treatment groups (CT/RT group, 79%; RT group, 75%; P = .40). CONCLUSION: This randomized study failed to demonstrate any significant survival benefit with the addition of neoadjuvant chemotherapy for patients with locoregionally advanced nasopharyngeal carcinoma. Therefore, neoadjuvant chemotherapy for nasopharyngeal carcinoma should not be used outside of the context of a clinical trial.
Irreversible airway obstruction is present in adulthood after infantile bronchiolitis: Evidence from a 30-year prospective follow-up study
Authors: Katri Backman, Eija Piippo-Savolainen, Hertta Ollikainen, Heikki Koskela, Matti Korppi
Journal: European Respiratory Journal (2013)

Background: Lung function deficits and increased risk of COPD after lower respiratory infection in infancy may be present in adulthood.  Aim: To evaluate lung function, with a special focus on irreversible airway obstruction, thirty years after bronchiolitis or pneumonia in infancy.  Methods: In 1981-82, 83 children under 2 years of age were hospitalized for bronchiolitis and 44 for pneumonia at Kuopio University Hospital, Finland. In 2010, 47 former bronchiolitis patients and 22 former pneumonia patients, and 138 matched controls attended the clinical study, including flow volume spirometry before (pre-BD) and after bronchodilatation (post-BD). The measured parameters were forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FVC/FEV1-ratio and FEV% (FVC/FEV1-ratio % of predicted). Irreversible airway obstruction was defined as two ways: post-BD FEV1/FVC-ratio   Results: Former bronchiolitis patients had lower post-BD FEV1/FVC-ratio (mean 0.78, 95%CI 0.76-0.81 vs. controls 0.83, 0.82-0.84, p  Conclusion: Irreversible airway obstruction is present 30 years after bronchiolitis in infancy suggesting permanent, structural changes in airways.
Abstract 17471: The Obese Zsf1 Rat as a New Model of Heart Failure with Preserved Ejection Fraction Accompanying the Metabolic Syndrome
Authors: André P LourenÇo, Inês Falcão-Pires, Rui Cerqueira, Dulce Fontoura, Daniela Miranda, Nazha Hamdani, Walter Paulus, Adelino F Leite-Moreira
Journal: Circulation (2012)

Diastolic dysfunction, characterized by relaxation abnormalities and increased myocardial stiffness, and heart failure with preserved ejection fraction (HFpEF) are increasingly prevalent in Western...
Safety and tolerability of pirfenidone (PFD) in patients with idiopathic pulmonary fibrosis (IPF) receiving commonly used concomitant medications
Authors: Carlo Albera, Williamson Bradford, Ulrich Costabel, Talmadge King, Paul Noble, Steven Sahn, Dominique Valeyre, Roland du Bois
Journal: European Respiratory Journal (2012)

Introduction: The CAPACITY Program (CAP) included two Phase 3 trials of PFD in 779 patients with IPF. Analyses were conducted to assess the safety of PFD in patients receiving commonly used concomitant medications. Objective: Examine the safety/tolerability of PFD in IPF patients receiving commonly used concomitant medications. Methods: Pooled data from the CAP trials were analyzed. Commonly used concomitant medications were defined as those used by ≥25% of patients in any treatment group between the first and last dose of study drug. The percentage of patients with selected treatment emergent adverse events (TEAEs) while on or within 28 d of cessation of commonly used concomitant medications was assessed. Patients in the PFD 2403 mg/d group were evaluated using a composite safety endpoint that included any Grade 3 or 4 TEAE, discontinuation of PFD, interruption/dose reduction of PFD, or any TE serious AE. Results: Commonly used concomitant medications and vaccines included: acetylsalicylic acid, azithromycin, influenza vaccine, multivitamins, omeprazole, paracetamol, salbutamol, and simvastatin. No evidence of a clinical pattern of TEAEs was observed with the use of PFD and these commonly used medications or vaccines. Patients receiving these agents were no more likely to meet the composite safety endpoint than those not receiving a commonly used concomitant agent. Conclusions: These data suggest that PFD is safe and generally well tolerated in patients with IPF when used with a spectrum of common medications. More long-term data will be collected in RECAP, an open-label extension trial evaluating PFD in patients with IPF.
Prevalence of pulmonary hypertension among outpatients with sarcoidosis: An echocardiographic and pulmonary catheterization study
Authors: Agostinho Hermes Medeiros-Neto, Fabiola Gomes Rodrigues, Jean Mike Tsutsui, Rogério Souza, Carlos Roberto Ribeiro Carvalho, Ronaldo Adib Kairalla
Journal: European Respiratory Journal (2012)

BACKGROUND: Pulmonary hypertension (PH) has negative impact in sarcoidosis prognosis. Prevalence of pulmonary hypertension (PH) among patients with sarcoidosis has not been investigated by screening studies confirmed by hemodynamic evaluation. OBJECTIVES: (1) to determine the prevalence of PH among outpatients with sarcoidosis in a tertiary center and (2) compare the presence of systolic pulmonary artery pressure estimated by echocardiogram (SPAP) ≥ 40 mmHg to the diagnostic gold standard for PH (mean pulmonary artery pressure mPAP ≥ 25 mmHg) measured by pulmonary artery catheterization, in patients with tricuspid reflux velocity (TRV) ≥ 2.5 m/s. METHODS: Seventy-two consecutives patients of 163, from our outpatient sarcoidosis clinic (ATS/ERS criteria), underwent echocardiographic evaluation to assess TRV and to estimate SPAP. Patients with TRV ≥ 2.5 m/s (possible PH) underwent pulmonary artery catheterization. Lung function testing and high-resolution CT (HRCT) also were performed in all patients in all patients. RESULTS: Nineteen patients had TRV ≥ 2.5 m/s; 18 underwent hemodynamic evaluation (one patient died before the procedure). PH (mPAP ≥ 25 mmHg) was diagnosed in 4 patients and its prevalence was 5.6% (IC95% 0.2-10.8%). Five patients (6.9%), had SPAP ≥ 40 mmHg, estimated by echocardiography, but only two of them had PH (mPAP ≥ 25 mmHg); on the other hand, two patients with SPAP ≤ 40 mmHg, estimated by echocardiography, had PH in hemodynamic study. CONCLUSION: PH prevalence in outpatients with sarcoidosis was 5.6%. SPAP > 40 mmHg estimated by echocardiogram was not accurate to diagnose PH (3 false positive and 2 false negative).
Do patients sleep under noninvasive ventilation (NIV) in the intensive care unit (ICU)
Authors: Ana Cordoba Izquierdo, Xavier Drouot, Arnaud W. Thille, Fabrice Galia, Laurent Brochard
Journal: European Respiratory Journal (2011)

Rationale:  Whether patients receiving NIV are really sleeping in the ICU, and whether sleep occurs during the NIV sessions is unknown. In addition the ventilator used may influence patient-ventilator synchronizarion (1) and cause sleep disruption (2).   Objectives:  1. To analyze sleep quality and quantity in ICU patients receiving NIV for acute hypercapnic respiratory failure (AHRF). 2. To compare sleep between two different types of ventilators (these results are not yet available).   Material and methods:  Prospective study on consecutive ICU patients treated by NIV for AHRF. On the 2nd to 4th day of admission patients were randomized to receive NIV with their current ICU ventilator or with a specific NIV ventilator (Respironics V60) and a polysomnographic study was conducted during a 17 hour-period (3pm to 8am).   Results:  14 patients included, 7 in each group, age 73±9, pH 7.28±0.07, PCO2 77±18 mmHg. Previous respiratory disease: COPD 39%, obesity hypoventilation/sleep apnea syndrome 43%. Time under NIV previous to inclusion 18±11hours. Time under NIV during the study period 7.5±1 hours in 2 or 3 sessions.  During the study period patients slept 5.9±2 hours (42±2% stages 1+ 2, 38±2% stage 3, 12±6% REM) with a fragmentation index of 29±13 arousals and awakenings per hour of sleep. 76% of the total sleep time (4.5±1.3 hours) happened during the night period (11pm to 8am), and 80% took place under NIV.   Conclusions:  In patients treated for AHRF in the ICU, sleep architecture is relatively preserved, with most of the sleep time occurring at night. NIV seems to favour sleep during the night period.  1. Carteaux G. Intensive Care Medicine 2009;35: S22  4. Fanfulla F. Am J Respir Crit Care Med 2005;172:619.
Rheumatology, third edition
Authors: H Schulze-Koops
Journal: Annals of the Rheumatic Diseases (2004)

Eds M C Hochberg, A J Silman, J S Smolen, M E Weinblatt, M H Weisman (pp 2282, £255) Mosby, 2003. ISBN 0-3230-24041.

It is a particular challenge to present a new edition of a textbook that has been praised as the “model for other textbooks” and “a departure from everything that has preceded it”. The new international team of editors of Rheumatology has accepted this task and has succeeded brilliantly. The third edition of Rheumatology is an admirable Reference that brings together comprehensive, up to date coverage, more than 1600 full colour photographs, tables and charts, and practical clinical guidance for the practising and academic rheumatologist and arthritis related healthcare professional in a well organised, highly visual format. It is …
An MRI Study of Neurological Injury Before and After Congenital Heart Surgery
Authors: William T. Mahle, Federica Tavani, Robert A. Zimmerman, Susan C. Nicolson, Kristin K. Galli, J. William Gaynor, Robert R. Clancy, Lisa M. Montenegro, Thomas L. Spray, Rosetta M. Chiavacci, Gil Wernovsky, C. Dean Kurth
Journal: Circulation (2002)

Neurological deficits are observed in patients with congenital heart disease (CHD) before and after neonatal surgery, the etiology being multifactorial. To understand the impact of preoperative events and to characterize the evaluation of neurological injury, we performed serial magnetic resonance imaging (MRI) studies of the brain in a cohort of neonates undergoing open-heart surgery.Twenty-four term neonates with CHD were studied prospectively with brain MRI: before surgery, within 2 weeks of surgery, and several months after surgery. Preoperative MRI examinations showed periventricular leukomalacia (PVL) in 4 patients (16%) and infarct in 2 subjects (8%). MR spectroscopy was performed in 19 subjects preoperatively and revealed elevated brain lactate in 53%. An early postoperative MRI (n=21) identified new PVL in 48%, new infarct in 19%, and new parenchymal hemorrhage in 33%. New lesions or worsening of preoperative lesions occurred in 67% of subjects. No patient- or procedure-related factors for the development of early postoperative lesions were identified. A late postoperative MRI (n=17) demonstrated resolution of early lesions in 8 and mild cerebral atrophy in 2.Mild ischemic lesions, primarily in the form of PVL, occur in a number of neonates with CHD before surgery and >50% of patients postoperatively. Resolution of these lesions is common 4 to 6 months after surgery. Longer-term follow-up is needed to determine the significance of perioperative ischemic lesions on functional outcome.
Pepsin, a Biomarker of Gastric Aspiration in Lung Allografts
Authors: Rachel Stovold, Ian A. Forrest, Paul A. Corris, Desmond M. Murphy, Jaclyn A. Smith, Sam Decalmer, Gail E. Johnson, John H. Dark, Jeffrey P. Pearson, Chris Ward
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Human lung transplantation is a therapeutic option for selected patients with advanced cardiopulmonary disease, but long-term survival is limited by chronic rejection. Persistent acute rejection and gastric aspiration have been implicated as risk factors but there is little or no evidence to date that they are associated.We have tested the hypothesis that pepsin, a marker of gastric aspiration, is present in lung transplant recipients, and that high levels are associated with biopsy-diagnosed acute rejection and/or bronchiolitis obliterans syndrome.Levels of bronchoalveolar lavage (BAL) pepsin were measured by ELISA in 36 lung transplant recipients, 4 normal volunteers, and 17 subjects with unexplained chronic cough.Our primary finding was that, compared with control subjects, BAL pepsin levels were elevated in stable lung transplant recipients, subjects with acute rejection, and subjects with bronchiolitis obliterans syndrome. Our secondary finding was that the highest levels were found in recipients with acute vascular rejection grade > or = A2 (median, 11.2; range, 5.4 - 51.7 ng/ml; normal median, 1.1; range, 0-2.3 ng/ml; p = 0.004).We have shown that elevated levels of pepsin, a biomarker of gastric aspiration, are consistently identified in the BAL of lung allografts. The highest levels were seen in patients with > or = grade A2 acute rejection. This provides further evidence supporting the possible role of aspiration in the development of overall allograft injury.
Inflammatory cytokine levels in serum and bronchoalveolar lavage fluid and gene polymorphism in young adult patients with bronchiectasis
Authors: Gulhan Ayhan, Dilaver Tas, Oguzhan Okutan, Ismail Yilmaz, Ersin Demirer, Omer Ayten, Zafer Kartaloglu
Journal: European Respiratory Journal (2013)

Aim:  Chronic infection and inflammation plays an important role in pathonegesis of bronchiectasis. In this study inflammatory cytokine levels, cytokine gene polymorphisms and genetic predisposition in patients with bronchiectasis was investigated.   Methods:  Forty cases with bronchiectasis (23.04±4.62 years) and 20 controls (23.04±2.62 years) were included to the study. Serum and bronchoalveolar lavage fluid (BALF) cytokine levels (IL-6, IL-8, IL-10, TNF-α) were analyzed. Automatic sequence analysis was used to determine DNA IL-6, IL-8, IL-10, TNF-α cytokine genes polymorphism and frequencies.   Results:  Serum and BALF IL-8 levels were significantly higher while IL-10 levels were lower in the patient group (p   Conclusion:  Serum and BALF IL-8 levels were significantly higher while IL-10 levels were lower in patients with bronchiectasis. Significant association was observed in IL-8 and IL-10 gene polymorphism in the patient group. Risk of bronchiectasis were significantly higher in patients with high IL-8 and low IL-10 group.
Effect of periodized aerobic training on power and autonomic modulation in COPD patients
Authors: Marceli Leite, Ercy M.C. Ramos, Ana Paula Freire, Bruna S. Silva, Juliana Nicolino, Rafaella F. Xavier, Giovana N. Bertolini, Paula Pestana, Rafaela C. Cuissi, Renata David, Iara Buriola, Marcelo Papoti, Celso R.F. Carvalho, Luiz C.M. Vanderlei, Dionei Ramos
Journal: European Respiratory Journal (2014)

Background:  The most effective method of aerobic training in COPD is continuing under investigation. In healthy individuals, periodized aerobic training has been considered superior than traditional methods; however, its effect on COPD patients has not yet been elucidated.  Aim:  To evaluate the effect of periodized aerobic training on aerobic power and autonomic modulation in COPD patients.  Methods : 16 COPD patients were included in the study and randomized to either periodized training (PTG; N=10) or control group (CG; N=6). Aerobic power (cardiopulmonary exercise testing) and autonomic function (heart rate variability) were assessed at baseline and after 12 weeks of training. Linear periodized aerobic training was conducted in 3 mesocycles with a 4 weeks duration each. Comparison between baseline and 12 weeks was performed using paired Student9s t test or the Wilcoxon test, in case of non-normally distributed data.  Results:  After 12 weeks of periodized training, PTG presented a huge increase in peak oxygen consumption in either total (0.72±0.39 to 1.9±1L/min; P=0.01) or relative values (VO 2peak , 9.4±4 to 27.2±16.8 ml/kg/min; P=0.01) and it was also observed an increase in the parasympathetic response (HF index, 62.3±46.8 to 113.2±62.1 ms;  P =0.04). In addition, after training it was observed an increase in maximal speed reached during peakVO 2  (5.5±1.2 to 6.3±1.3 km/h; P=0.006) in PTG. No significant difference for any outcome was observed in CG (P>0.05).  Conclusion:  Periodized aerobic training promoted enormous benefits on the aerobic capacity and autonomic modulation in patients with COPD.
A novel way of heliox administration in patients with COPD exacerbation
Authors: Roman Zazula, Karel Roubik, Tomas Tyll, Martin Müller, Vladimir Zabrodsky, Jan Chlumsky, Adela Strnadova, Antonin Spaleny, Petr Stastny
Journal: European Respiratory Journal (2011)

Introduction:  Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. The purpose of heliox (helium and oxygen mixture) administration in patients with severe COPD exacerbation is to avoid invasive ventilation which is recognized as an adverse prognostic factor.   Aims:  The aim of the study is to test suitability of a modified semi-closed anesthetic circuit with CO 2  absorber for heliox administration. The circuit may offer a safe way of heliox administration to spontaneously breathing patients at significantly reduced costs.   Methods:  The semi-closed circuit was evaluated by work of breathing (WOB) measurement in healthy volunteers (N=9) who signed the informed consent. An esophageal balloon catheter was used for esophageal pressure measurement. The resistive component of WOB and pressure-time product (PTP) were calculated; O 2  consumption and end-tidal CO 2  were evaluated. These parameters were compared with the corresponding parameters obtained during spontaneous ventilation on air.   Results:  WOB was increased by 15% and PTP was increased by 12% during the spontaneous ventilation with heliox using the semi-closed circuit compared to the ventilation on air.   Conclusion:  The study showed that administration of heliox using the semi-closed circuit increases WOB and PTP for a patient due to the intrinsic resistance of the circuit. Nevertheless, as resistance of the airways and WOB are increased significantly in patients with COPD exacerbation, the heliox administration using the semi-closed circuit does not represent a significant workload for patients with COPD exacerbation.  Supported by grant IGA MHCR NS10087-4/2008, MSM grant 6840770012 and grant GACR 102/08/H018.
Carboplatin (C) and Paclitaxel (P) Combination (Cp) in Triple-Negative Metastatic Breast Cancer (Tnmbc) Treatment: Long-Term Survival
Authors: A. Storozhakova, L. Vladimirova, Y. Prgedetsky, I. Popova, N.A. Abramova, V.S. Myagkova, A. Lyanova, N. Samaneva
Journal: Annals of Oncology (2014)
Chemoradiation, surgery and adjuvant chemotherapy versus induction chemotherapy followed by chemoradiation and surgery: long-term results of the Spanish GCR-3 phase II randomized trial
Authors: C. Fernandez-Martos, X. Garcia-Albeniz, C. Pericay, J. Maurel, J. Aparicio, C. Montagut, M.J. Safont, A. Salud, R. Vera, B. Massuti, P. Escudero, V. Alonso, C. Bosch, M. Martin, B.D. Minsky
Journal: Annals of Oncology (2015)