tbuckley/cabot-search huggingface dataset:
Antenatal Diagnosis of Renal Tract Anomalies: Has it Increased the Sum of Human Happiness?
Authors: P S J Malone
Journal: Journal of the Royal Society of Medicine (1996)

When used as a screening procedure, ultrasound examination of the fetal urinary tract seldom leads to beneficial interventions. There is also a cost in terms of parental anxiety and unnecessary investigation and treatment. A formal screening programme would therefore be unjustified. However, screening of women for obstetric purposes will continue to reveal fetal abnormalities, and a strategy for dealing with these is needed. Antenatal treatments remain experimental; for most of the common conditions postnatal treatment has no urgency; and, in cases of minor abnormality detected by ultrasound, the best course may be to do nothing.
Autoimmune Encephalitis in Postpartum Psychosis
Authors: Veerle Bergink, Thaís Armangue, Maarten J. Titulaer, Sander Markx, Josep Dalmau, Steven A. Kushner
Journal: American Journal of Psychiatry (2015)

Significant immunological alterations have been observed in women with first-onset affective psychosis during the postpartum period. Recent studies have highlighted the possibility that a subset of patients with first-onset severe psychiatric episodes might suffer from undiagnosed autoimmune encephalitis. Therefore, the authors performed a three-step immunohistochemistry-based screening for CNS autoantibodies in a large cohort of patients with postpartum psychosis and matched postpartum comparison subjects.Ninety-six consecutive patients with postpartum psychosis and 64 healthy postpartum women were included. Screening for antibodies in patient serum was performed using immunohistochemistry. Samples showing any staining were further examined by immunocytochemistry using live hippocampal neurons and cell-based assays to test for anti-N-methyl-d-aspartate (NMDA) receptor antibodies. Cell-based assays for all other known CNS antigens were performed in those samples with immunocytochemistry labeling but negative for NMDA receptor antibodies.Four patients (4%) with neuropil labeling suggestive for extracellular antigen reactivity were identified. Serum samples from all four patients showed clear extracellular labeling of live hippocampal neurons. Two women had the specific staining pattern characteristic for anti-NMDA receptor antibody positivity, which was confirmed by cell-based assays. Neither patient with anti-NMDA receptor antibody positivity had evidence of an ovarian teratoma. The other two patients tested negative by cell-based assays for all known CNS antigens. None of the matched postpartum comparison subjects had confirmed neuronal surface antibodies. The two patients with anti-NMDA receptor antibodies both showed extrapyramidal symptoms following initiation of treatment with low-dose haloperidol.In patients with acute psychosis during the postpartum period, systematic screening for anti-NMDA receptor autoantibodies should be considered. The acute onset of severe atypical psychiatric symptoms in young female patients should raise the index of suspicion for anti-NMDA receptor encephalitis, particularly in the setting of neurological symptoms, including extrapyramidal side effects of antipsychotic treatment.
Patient-physician communication and physical challenges resulting from morning symptoms of COPD
Authors: Philip O'Hagan, Beyza Oezel, Niels Chavannes
Journal: European Respiratory Journal (2014)

Introduction   The treatment of COPD centres on relieving symptoms but there is scant information concerning the extent to which physicians provide guidance and advice on how treatment may help to improve patients9 ability to carry out everyday activities. The survey assessed the impact of morning symptoms of COPD on patients9 ability to perform activities in the morning and the rest of the day and the level of 9communication9 with their physicians.   Methods   Approximately 100 patients in each of eight countries completed a 20 minute on-line survey that thus had sufficient statistical power to reveal country differences. Patients were recruited from a panel of consumers who had previously expressed an interest in participating in healthcare research.   Results   Although a third of patients stated that 9improvement in ability to carry out morning activities9 was a key goal of treatment, physicians were much less likely to identify it as a goal. Physicians were far more likely to concentrate on discussing medications and general health than on providing advice on how treatment could help improve patients9 ability to perform daily activities. And although the majority of patients considered their medications to be effective in controlling symptoms, they considered them much less effective in helping to improve their ability to perform activities.   Conclusions   Many patients believed they had not received the advice and support they desired with regard to their goal of improved ability to carry out morning activities.
The effect of lung volume on transdiaphragmatic pressure
Authors: CH Hamnegard, S Wragg, G Mills, D Kyroussis, J Road, G Daskos, B Bake, J Moxham, M Green
Journal: European Respiratory Journal (1995)

Diaphragm strength can be assessed by measurement of transdiaphragmatic pressure (Pdi) in response to stimulation of the phrenic nerves. The length-tension relationship of the diaphragm can be studied by measuring twitch Pdi over the range of lung volume. Previous studies of the relationship between lung volume and diaphragm strength have used the technique of electrical stimulation of the phrenic nerves. In these studies, the phenomenon of twitch potentiation has not been taken into account. It has previously been shown that prior contraction of the diaphragm can greatly enhance the twitch response, thus affecting the measurements. The aim of this study was to investigate the relationship between unpotentiated twitch Pdi and lung volume for volumes ranging from residual volume (RV) to total lung capacity (TLC) in normal subjects. Great care was taken to avoid muscle potentiation. For this purpose, we stimulated the phrenic nerves with a magnetic stimulator. In addition, we used positive pressure to inflate the lungs to high lung volumes. The impact of twitch potentiation on the length-tension relationship was investigated by subjects making maximum inspiratory efforts prior to phrenic nerve stimulation. The unpotentiated twitch Pdi decreased in a linear fashion with increasing lung volume over the full range of vital capacity by 0.54 kPa.L-1. Potentiation increased twitch Pdi by 40% at FRC and the effect was similar, in absolute terms, at all lung volumes. In relative terms, the effect of potentiation became greater as lung volume increased, and more than doubled twitch Pdi at TLC. With increasing lung volume, there is a linear fall in unpotentiated twitch Pdi with a slope that is less steep, over the same range of absolute lung volume, than previously reported. When assessing diaphragm strength by the twitch technique, it is essential to control for lung volume and equally important to control for twitch potentiation.
Reasons of intensive care unit admission in COPD patients
Authors: Huriye Berk Takir, Feyza Kargin, Cuneyt Salturk, Merih Kalamanoglu Balci, Ozlem Yazicioglu Mocin, Gokay Gungor, Nalan Adiguzel, Zuhal Karakurt
Journal: European Respiratory Journal (2013)

Aim:Determining reasons of intensive care unit(ICU) admission in COPD patients and managing earliertreatmentto decrease ICU admissions.

Method:Observational retrospective cohort study.All ICU patients between 2008-2011 who haveradiologic and physical examination findings compatible with COPD and previously diagnosed as COPD were included. Demographics,body mass index(BMI), ICUseverity score(APACHEII), comorbidities were recorded. ICU admission reasons were grouped as airway infections, pneumonia, pulmonary embolism, respiratory failure(pH<7.35, hypoxia(PaO2/FiO2<300), hypercapnia(pCO2 greater than 45 mmHg), length of ICUand hospitalization stay(LOS), and number of hospitalizations in last 1 year were recorded. Results were summarized as descriptive statistics.

Results:1264 COPD patients(954,male) were included. Median and interquartileratio(IQR) of age, BMI, APACHEII score were 70(63-77),24(22-28),19(15-23) respectively. Most frequent ICU admission reasons were hypercapnia(72,6%,918), airway infection(46,6%,589), pneumonia(19,5%,246), hypoxia(4,6%,58), pulmonary embolism(4%,52), pneumothorax(1,4%,18).423(33%) of patients had no hospitalization in last one year, 445(35%)had one, 164(12%)had two, 108(8%)had three, 55(4%) had four hospitalization. Comorbidities were hypertension(%33.1 n:418), diabetes(%16,5 n:209), arytmia(%12 n:152), coronary artery disease (%11,2 n:141), depression(%4,5 n:57). LOS in ICU and ward were 7(4-10) and 12(7-18) respectively.

Conclusion: Most frequent reasons for ICU admission in COPD patients were respiratory failure and infection.We believe that long term efective NIMV and rational antibiotherapy decrease number of ICU admission in COPD patients.
Studies on a Transplantable Mastocytoma in Mice. I. Origin and General Morphology&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: R. Rask-Nielsen, H. E. Christensen
Journal: JNCI Journal of the National Cancer Institute (1963)

The origin and general morphology of a transplantable murine mast cell neoplasm are described. The primary tumor arose in a 26-month-old female (CBA × DBA/2)F1 mouse that at the age of 4 months had been inoculated sub-cutaneously with leukemic tissue from a transplantable plasma cell leukemia. There was no visible growth of the inoculated material. Macroscopically, the original neoplasms appeared as numerous, 2 to 3 mm, white, opaque nodules in the mesentery. Microscopically, the primary and the transplanted tumors consisted of mast cells with many metachromatic and orthochromatic granules. Groups of mast cells were also in the liver, spleen, lymph nodes, and in many other organs. Various histochemical stainings indicated the presence of an acid mucopolysaccharide in the metachromatic granules. No attempts to demonstrate histamine or serotonin were made. Subcutaneous inoculation of tumor tissue resulted in local tumors with exceedingly slow growth rates in all mice of the first and second passage. Heavy amyloidosis was seen in most organs of the mouse with the primary tumor; varying degrees of amyloid development were observed in the mice with transplanted tumors. These mice were killed during early stages of the disease. The etiology of the mastocytoma and its possible relation to amyloid formation are discussed.—J Nat Cancer Inst 30: 743–761, 1963.
Does antihypertensive treatment prevent progression of microalbuminuria to overt proteinuria in insulin-dependent diabetic patients?
Authors: P Passa
Journal: Journal of the American Society of Nephrology (1992)

Prospective studies in insulin-dependent diabetic patients have shown that microalbuminuria is a strong predictor of clinical nephropathy. Because this syndrome is associated with a dramatic excess in mortality, different types of intervention have been proposed for insulin-dependent diabetic patients with microalbuminuria to prevent or postpone clinical nephropathy. The effects of antihypertensive treatment are being extensively investigated. Beta-blockers, calcium antagonists, and angiotensin-converting enzyme inhibitors have proved effective in reducing albumin excretion and postponing overt proteinuria in hypertensive and normotensive insulin-dependent diabetic patients with microalbuminuria. However, many problems remain to be solved. A decrease in albumin excretion may not be an adequate endpoint for intervention trials, because it has been shown that patients with normal albumin excretion can develop diabetic nephropathy lesions, whereas patients with microalbuminuria alone may have little or no pathology. The patients included in these trials all had incipient diabetic nephropathy but exhibited different functional, and probably morphological, forms of the disease. For insulin-dependent diabetic patients with microalbuminuria, the real aim of antihypertensive treatment is not to reduce urinary albumin excretion or to prevent its progression but to preserve renal function and to reduce the incidence of premature cardiovascular deaths. To achieve this, we have to improve our knowledge of the natural history of the early pathology of diabetic nephropathy and of the mechanisms of action of antihypertensive treatment. New large-scale intervention trials will have to be designed in which the patients will have to be carefully characterized on the basis of functional and morphological data.(ABSTRACT TRUNCATED AT 250 WORDS)
Diffuse aspiration bronchiolitis diagnosed on transbronchial lung biopsy in a case of thymoma with dysphagia
Authors: Vikas Mittal, Nevin Kishore, Andleeb Abrari, Amit Kumar
Journal: European Respiratory Journal (2012)

Background: Diffuse aspiration bronchiolitis (DAB) is a form of aspiration related lung disease and has unique clinico-radio-pathologic features. It has heretofore been reported on autopsy or surgical biopsies. We report a case of DAB diagnosed on trans-bronchial lung biopsy (TBLB).

Case: A 72 year old previously healthy male, smoker (150 pack-years) presented with hoarseness of voice and vertigo for 4 months, dysphagia and swelling in the neck for 1 month. Examination revealed a firm, non tender swelling in the right side of the neck and signs of Horner's syndrome. PET-scan showed a FDG avid mass in the right side of the neck, extending into the superior mediastinum, encasing the trachea, abutting and displacing the esophagus to the left and normal lung parenchyma. A CT-guided transthoracic percutaneous biopsy of the mass revealed an immature lymphocyte rich thymoma. Patient developed sudden breathlessness, after 3 weeks from the start of radiotherapy. A CT-pulmonary angiography was negative for pulmonary embolism. HRCT showed bilateral disseminated centrilobular nodules with 'tree-in-bud' appearance suggestive of diffuse bronchiolitis. A TBLB revealed necrotising alveolitis with foreign body giant cells containing refractile material, suggestive of aspiration. A final diagnosis of DAB/aspiration alveolitis secondary to occult chronic aspiration was made. Patient improved on nasogastric feed and treatment with clidamycin. A repeat CT-thorax after 2 months showed normal lung parenchyma.

Conclusion: DAB is an underrecognised, yet an important differential diagnosis, which should be considered in any patient having risk of aspiration and a HRCT showing diffuse bronchiolitis.
Retarded Growth of Lymphoma in Immunodepressed Mice2
Authors: Ronald W. Gillette, David A. Wunderlich
Journal: JNCI Journal of the National Cancer Institute (1977)

Lymphoma cells were inoculated iv into normal and immunodepressed mice. In most instances the immunodepressed animals survived longer than their normal counterparts. This was true both with athymic and thymectomized animals that had been lethally irradiated and reconstituted with syngeneic bone marrow. The route of administration was critical, since increased survival of immunodeficient animals was not observed when the lymphoma cells were injected ip.
Desmosomes and Extradesmosomal Adhesive Signaling Contacts in Pemphigus
Authors: Jens Waschke, Volker Spindler
Journal: Medicinal Research Reviews (2014)

Abstract Desmosomes are adhering junctions present in all cells of simple and complex epithelia. They are most abundant in cells of tissues subjected to extensive mechanical stress such as keratinocytes and cardiomyocytes. The core of desmosomes is built up of desmosomal cadherins, cadherin‐type adhesion molecules that are tethered to intermediate filaments via adaptor proteins of the armadillo and the plakin family. In addition, desmosomal cadherins are present outside of desmosomes. Recent investigations indicate that these molecules are involved in adhesion‐dependent and adhesion‐independent signaling and thus have functions different from the adhesive properties of their counterparts within desmosomes. Impaired adhesion of desmosomal cadherins both within and outside of desmosomes is the cause of the blistering skin disease pemphigus. Autoantibodies interfere with the binding of desmosomal cadherins and alter intracellular signaling pathways, the latter of which is necessary for loss of cell adhesion. Among the plethora of signaling molecules reported, altered activities of p38MAPK, protein kinase C, and epidermal growth factor receptor (EGFR) are most relevant. This review highlights the recent data on signaling by desmosomal cadherins and the mechanisms involved in pemphigus skin blistering.
In-vivo microscopy of the effect of surfactant on alveolar morphology
Authors: Caterina Salito, Andrea Aliverti, Enrico Mazzuca, Ilaria Rivolta, Giuseppe Miserocchi
Journal: European Respiratory Journal (2012)

Changes in alveolar morphology induced by intra-tracheal delivery of CUROSURF (CS, Chiesi) were evaluated after opening a pleural window allowing in-vivo microscopic imaging (x300) of sub-pleural alveoli (fig 1a) revealing in physiological, non surfactant deprived conditions, a remarkable degree of geometrical inhomogeneity.

Data were collected in 7 male anesthetized, tracheotomized and mechanically ventilated rabbits (0,75-1 Kg) who received intra-tracheal instillation of 300 μl, corresponding to 16 mg/Kg, of CS.

Images were acquired up to 20 minutes after instillation. Each acquisition (10 images/second) was triggered during the expiratory phase. After defining a ROI (Region Of Interest), alveolar morphology was analized through an image processing program (ImageJ).

Surfactant instillation, on average, caused an increase in alveolar area (fig 1b, closed circles), peaking at about 10% after 10 minutes and returning towards baseline after 20 minutes. The large standard deviation reflects the variability in caliber following CS instillation as shown for individual alveoli in one representative animal (fig 1c, closed symbols). No changes in alveolar geometry were observed in animals not receiving CS (open circles).

Data suggest that CS instillation favors gas diffusion by increasing alveolar surface area, despite a large inhomogeneity in alveolar distension, likely reflecting local differences in surfactant distribution and/or alveolar compliance.

![Figure][1]  [1]: pending:yes
Pre-procedure antibiotics and effect on microbiological yield from broncho-alveolar lavage fluid in children with cystic fibrosis
Authors: Sonal Kansra, Alan Smyth, Carol Bertenshaw, Amanda Ward, Matthew Hurley, Jayesh Bhatt
Journal: European Respiratory Journal (2011)

Bronchoscopy and broncho-alveolar lavage (BAL) is widely used in children with cystic fibrosis (CF) to obtain reliable lower airway specimens for microbiological analysis.This is done under general anaesthetic (GA) or sedation.GA could lead to a significant decline in pulmonary function tests.It is recommended that preparation for surgery should involve physiotherapy and judicious use of antibiotics to treat any evidence of infection.However if antibiotics are given pre-procedure,the microbiological yield from BAL could potentially be lower.   Methods:  We reviewed the records of children with CF undergoing bronchoscopy and BAL at our centre to see if there was a difference in rates of microbiological isolation if children with CF had antibiotics pre-procedure.BAL was collected in line with ERS task force 2000 recommendations.   Results:  36 of the 86 bronchoscopies done between 2005 and 2010 were in children with CF. BAL results from 2 children were not available.BAL showed bacterial growth in 21 (62%) of cases and atypical mycobacteria in 1 child.Children who did not have pre-procedure antibiotics were more likely to have bacterial isolates from BAL fluid as compared to children who had antibiotics pre-procedure (p=0.017) as shown in the table.   Conclusions:  Athough there may be a bias because of its retrospective nature, this study indicates that pre-procedure antibiotics in children with CF undergoing bronchoscopy for getting a gold standard microbiological sample leads to a significantly lower microbiological yield.
Supportive Cancer Care In-Patient Unit: a Three Years Experience
Authors: K. Legeay, M. Kfoury, P. Leroy, C. Gervais, S. Hans, C. Aubaret, C. Sauvajot, L. Tripault, A. Guillou, D. Brasnu, S. Oudard, C. Herve, F. Scotte
Journal: Annals of Oncology (2014)
Diminished acetylcholine-induced vasodilation in renal microvessels of cyclosporine-treated rats.
Authors: T Takenaka, Y Hashimoto, M Epstein
Journal: Journal of the American Society of Nephrology (1992)

The mechanisms mediating cyclosporin A (CsA)-induced nephrotoxicity have not been established, but damage to endothelial cells by CsA has been proposed as an important factor. In the study presented here, whether endothelial cell function is impaired in the renal vasculature of CsA-treated rats is investigated. The vasodilatory effects of acetylcholine (ACH) on norepinephrine (NE)-induced microvascular constriction in isolated perfused hydronephrotic rat kidneys pretreated with CsA were therefore examined. Hydronephrosis was established to permit direct visualization of renal microvessels. Nephrotoxicity was induced by s.c. injection of CsA (60 mg/kg/day for 5 days). NE (0.3 microM)-induced afferent arteriolar (AA) constriction was exaggerated in CsA rats as compared with that in vehicle (olive oil)-treated control rats. (reduction in diameter of -34 +/- 3 (SE) versus -26 +/- 2%; P less than 0.05). Similarly, efferent arteriolar (EA) constriction by NE in CsA rats exceeded that of controls (-34 +/- 2 versus -22 +/- 3%; P less than 0.01). The vasodilatory responses evoked by ACH were blunted in CsA rats. The AA response to ACH in CsA rats was significantly decreased (P less than 0.005) at ACH concentrations from 1 nM to 1 microM. Similarly, ACH (1 nM to 100 nM) induced less EA vasodilation in CsA rats (P less than 0.025). In control and CsA rats, the addition of nitro-L-arginine abolished AA and EA vasodilation induced by ACH, suggesting that the sustained vasodilatory responses of AA and EA to ACH are mainly dependent on nitric oxide synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)
miR-126; link between angiogenesis and exercise intolerance in pulmonary arterial hypertension
Authors: Francois Potus, Simon Malenfant, Sandra Breuils-Bonnet, Sébastien Bonnet, Steeve Provencher
Journal: European Respiratory Journal (2014)

INTRODUCTION: Pulmonary arterial hypertension (PAH) is characterized by a significant exercise intolerance which does not correlates with the cardiac output at rest and during exercise. Thus intrinsic skeletal muscle dysfunctions may contribute to exercise intolerance in PAH. Several studies have shown a close relationship between muscle circulation, exercise capacity and miR-126, an endothelial specific pro-angiogenic miRNA. We hypothesized that miR-126 is downregulated in peripheral muscles of PAH patients, decreasing microcirculation and contributing to exercise intolerance. METHODS/RESULTS: Compared to control patients matched by both age and sex, PAH patients displayed dramatic decrease in exercise tolerance. This decrease correlates with a significant diminution in quadriceps microcirculation measured by CD31 immunofluorescence. At the cellular level, the decrease in microcirculation was associated with a significant downregulation of miR-126 expression Interestingly microcirculation and miR-126 expression are also decreased in intercostal muscle of PAH patient compared to control. In vitro, using freshly isolated CD31+ cells from human quadriceps biopsies; we demonstrated that the downregulation of miR-126 triggered the activation of SPRED-1 leading to VEGF/ERK pathway effector downregulation in PAH impairing the angiogenic response. All these abnormalities were reversed by treating the cells with miR126 mimic; while inhibition of miR126 in healthy CD31+ cells fully mimic the PAH phenotype. CONCLUSION: We demonstrated for the first time that exercise intolerance in PAH is associated with the decrease of skeletal muscle angiogenesis secondary to the downregulation of miR-126.