tbuckley/cabot-search huggingface dataset:
Longitudinal course of suicidal ideation in patients with newly diagnosed thoracic cancers
Authors: W. F. Pirl, J. Solis, J. S. Temel, S. Admane, R. Rosovsky, H. G. Prigerson, J. Greer
Journal: Journal of Clinical Oncology (2009)

9606 Background: While cancer itself is associated with elevated suicide rates, thoracic cancers have the highest rates. Previous studies of suicidal ideation (SI) in cancer patients have all been cross-sectional. This study investigates the longitudinal course of SI in newly diagnosed thoracic cancer patients. Methods: Between 8/7/07–9/16/08, a prospective cohort was recruited from consecutive new patients at a thoracic oncology clinic in an academic cancer center. At initial visit and approximately every two months afterward, participants completed the Patient Health Questionnaire depression and anxiety modules, which include one item measuring SI over the prior two weeks. Participants were assessed at points of care; those not returning within follow up periods were not assessed. Factors bivariately associated with SI at initial visit were entered into multiple logistic regression models to identify independent predictors. Linear mixed effects models investigated change in SI level over time within individuals. Results: 373 participants enrolled. At initial visit, 254 (68.1%) had known lung cancers, 38 (10.2%) had esophageal cancer. 127 (34.1%) had advanced cancer. Mean age was 63.71 (11.50) and 200 (53.6%) were women. 368 completed initial assessment. At initial visit, 21 (5.7%) expressed SI and 111 (30.16%) met criteria for depressive or anxiety disorders. While ECOG performance status was associated with SI in bivariate analyses, only depression and anxiety remained independent predictors, both p=.01. Cancer type and stage were not significantly associated. Controlling for performance status, SI was more likely in those with any depressive or anxiety disorders (OR=7.14, 95% CI 2.48–20.55). Levels of SI within individuals decreased over time (p=.02). Only 2.2% (3/135) had SI at two months and none at four and six months. One participant (4.8%) with SI at initial visit had a known suicide attempt during the study period. Conclusions: Newly diagnosed thoracic cancer patients had a 6% SI rate at initial visit, slightly lower than other reports with mixed cancers. SI appears to decrease over time, with highest risk early after diagnosis. Given previous data that suicide rates are highest with thoracic cancers, our findings may suggest greater likelihood to act on SI. [Table: see text]
Larva therapy in wound management
Authors: M Courtenay, J C T Church, T J Ryan
Journal: Journal of the Royal Society of Medicine (2000)

The use of maggots for wound debridement has a long history and has lately gained ground in several countries. We collected prospective data to examine the current use of larva therapy (LT) in the UK. Quantitative information was collected on 70 patients treated in nine hospitals. LT is used primarily to treat leg ulcers and generally involves three applications of larvae at two to three day intervals. This method is judged effective in wound debridement and promotes the growth of granulation tissue. Wound exudate, odour, infection and pain are all reduced by the treatment. Adverse reactions are infrequent but include pain, bleeding, pyrexia and influenza-like symptoms. Prevention of hospital admission and surgery, reduced need for antibiotics and reduced hospital stay are all identified as outcomes of LT. The nurse practitioners who used LT believed it to have an important role in wound management. A randomized clinical trial, comparing LT with other debriding agents, is required for evaluation of cost effectiveness.
Outcome of acidotic COPD-patients on hospital admission
Authors: Sylvia Hartl, Mike Roberts, Jose Luis Lopez-Campos
Journal: European Respiratory Journal (2012)

Background: Acidosis is a marker of acute respiratory failure in COPD.Non invasive ventilation (NIV) is the first choice of ventilation for such patients to avoid intubated mechanical ventilation (IMV) and associated complications. The ERS COPD Audit evaluated the clinical practice of treatment standards in acute exacerbation of COPD(AECOPD) in 422 hospitals of 13 European countries.We present the analysis of treatment standards for acidotic AECOPD patients and associated outcomes.  Methods: Data collection of clinical treatment of all hospital admitted AECOPD for 8 weeks and follow up until 90 days after discharge.  Results: Of 12893 patients 18,8% (2429/ 66%male) presented with respiratory acidosis on admission(14,8%(n=1902) with moderate acidosis: ph 7,35≥7,25, 4,1%(n=526) with severe acidosis: ph ≤7,25).Acidotic patients were significantly sicker than non acidotic.  Outcomes were related to severity of acidosis.  43% of the acidotic patients received NIV and 5 % IMV. 89,6% of hospitals offered NIV in their unit but only 66,7% always had the capacity for all eligible patients.  Summary: Our data revealed a severe comorbid condition of acidotic COPD patients,a subgroup of AECOPD- patients with worse outcome.A high proportion received NIV, units accepting these patients should offer NIV.
Resilience: The role of accurate appraisal, thresholds, and socioenvironmental factors
Authors: Steven M. Southwick, Robert H. Pietrzak, Dennis S. Charney, John H. Krystal
Journal: Behavioral and Brain Sciences (2015)

Abstract Adding to the resilience model of Kalisch and colleagues, we suggest that resilience is associated with accurate rather than excessively positive or negative appraisal or reappraisal styles; that complex systems do not always change in linear fashion; that linkages of individuals, families, and communities markedly affect individual resilience; and that resilience research focus on specific factors or mechanisms as well as more global ones.
Late-breaking abstract: Prevalence of influenza A H1N1 virus infection in patients with asthmatic crisis of the National Institute of Respiratory Diseases (in Mexico City)
Authors: Olivia Sánchez Cabral, Jair Rodríguez Barragán, Manuel de Jesús Castillejos Lόpez
Journal: European Respiratory Journal (2011)

Introduction:  Among the key precipitating factors of these crises are respiratory infections, mainly viral. In April of 2009, Mexico experienced a new influenza A H1N1 epidemic.   Objective:  Determine the prevalence of influenza A H1N1 infection in patients with secondary asthmatic crisis.  Research methods. A transversal research on 5-75 year-old patients was developed between September 1, 2009 and May 17, 2010. Research subjects were admitted to the emergency room with a probable diagnosis of influenza A H1N1 infection and asthmatic crisis. Real-time polymerase chain reaction technique was used to confirm influenza A H1N1.   Findings:  We found a global prevalence of 3.6% (19/526) of influenza A H1N1 among the patients that were admitted to the emergency room due to asthmatic crisis. From reviewing medical files we found 124 cases of asthmatic crisis among those patients with a clinical suspicion of influenza A H1N1. The prevalence of the A H1N1 virus among patients with asthmatic crisis was 13.7%. The average age of patients in the study was 35.8 years (mean 14.0 years). 71.8% of the patients were women. The average stay in the hospital was 6.9 days, 91% (104/124) of the crises ranged from acute to almost fatal.   Conclusion:  Prevalence is relatively high. They can expect an aggravation of the crisis and a longer stay in the hospital.
Is it normal for terminally ill patients to desire death?
Authors: James H. Brown, Paul Henteleff, Samia Barakat, Cheryl J. Rowe
Journal: American Journal of Psychiatry (1986)

Among 44 terminally ill patients, the majority (N = 34) had never wished death to come early. Of the remainder, three were or had been suicidal and seven more had desired early death. All 10 patients who had desired death were found to be suffering from clinical depressive illness. The methodologic difficulties encountered by the authors were the lack of a brief, efficient interview schedule suitable for debilitated patients and criteria for depressive disorder that do not depend on suicidal thoughts or on symptoms that can also be caused by physical disease.
Survival and risk factors of mortality among defaulters from treatment of pulmonary tuberculosis
Authors: Alan Altraja, Piret Viiklepp, Lea Pehme
Journal: European Respiratory Journal (2012)

Defaulters from treatment of pulmonary tuberculosis (PTB) convey a significant transmission risk that is particularly dangerous during increasing prevalence of MDR-TB and TB/HIV co-infection.  We estimated 1- and 5-year survival, assessed infectiousness and identified risk factors of mortality of PTB patients after treatment default.  We observed all patients with PTB registered in the Estonian Tuberculosis Registry as defaulters during 2004-2006 (n=160) in a cohort study until 12.12.2011 and used multivariate Cox regression analysis to identify risk factors of mortality.  Median follow-up time was 5.94 (IQR 3.21-6.68) years after default. One-year and 5-year survivals were 90.5% and 68.8%, respectively. Among the 50 patients (31.3%) who died, median survival time was 1.86 (IQR 0.88-3.04) years; 24 deaths (48.0%) occurred due to TB and 26 (52.0%) due to other reasons. At 1 and 5 years after default, 22.8% and 12.2% of surviving patients, respectively, were smear/culture positive.  Smear-positivity (HR 2.86, 95% CI 1.05–7.80), previous TB (HR 2.99 95% CI 1.27–7.04) and ofloxacin resistance (HR 5.77, 95% CI 1.74–19.18) increased risk of TB-related mortality. Disabled (HR 7.97, 95% CI 1.01–62.63), retired (HR 17.10, 95% CI 1.71–171.41), homeless (HR 2.36, 95% CI 1.61–4.78) and imprisoned people (HR 34.01, 95% CI 2.92–398.11) were at increased risk of all-cause mortality, whereas targeted case detection by medical personnel lowered this risk (HR 0.19, 95% CI 0.56–0.61).  Among defaulters, TB-related mortality is not associated with demographic factors, which influence all-cause mortality instead. Infectiousness of defaulters remains high, though decreases with time.  Funded by ESF grant No. 8188.
The use of non-invasive ventilation in paediatric lung transplantation
Authors: Surendran Thavagnanam, Hartmut Grasemann, Melinda Solomon, Indra Narang
Journal: European Respiratory Journal (2012)

Introduction: Progressive deterioration in paediatric patients (pts) with end-stage lung disease may result in diurnal hypoventilation. There are paucity of data describing polysomnography (PSG) & the benefits of Bilevel Positive Airway Pressure (BiPAP) therapy in these children.

Aim: To evaluate cardiorespiratory data & gas exchange using PSG in children awaiting lung transplantation (LTx) prior to & after BIPAP therapy.

Methods: Retrospective review of PSGs on these patients between 2005 & 2012 was performed. Change in cardiorespiratory parameters during PSG following BiPAP initiation was assessed & analysed using a paired t-test.

Results: Of the 31 pts identified, 24 underwent LTx & 7 were on a wait list (WL). 13 were male pts with mean age of 12 years (9 to 15). 9 LTX and 3 WL pts had PSGs & 10 pts were on supplemental oxygen. 9 pts had cystic fibrosis, 2 had interstitial lung disease & 1 had pulmonary venous occlusive disease (PVOD).

10 pts had evidence of nocturnal hypoventilation in the absence of obstructive or central apneas & were initiated on BIPAP. After titration of BiPAP to optimal settings, there was a significant increase in mean SaO2 [91% (SD 2.4) to 96% (SD 0.9),p=0.0001], decrease in heart rate [111 (SD 18.3) to 96 (SD 15) beats per minute, p=0.02], respiratory rate [35 (SD 5) to 28 (SD 6) breaths per minute, p=0.003] and transcutaneous carbon dioxide recordings [74 (SD17) to 67 (SD 14) mmHg, p=0.006] from baseline.

Conclusion: All pts had significant nocturnal hypoventilation with improved clinical parameters & gas exchange abnormalities following BiPAP. Further research is needed to assess the role of PSG & BIPAP therapy as a bridge to transplant in children with severe chronic lung disease.
EVIDENCE THAT ASCHOFF BODIES OF RHEUMATIC MYOCARDITIS DEVELOP FROM INJURED MYOFIBERS
Authors: George E. Murphy
Journal: The Journal of Experimental Medicine (1952)

Comparative studies on the histopathogenesis of experimentally induced lesions of myocardial Aschoff body type in rabbits and of many myocardial Aschoff bodies from several active rheumatic fever patients have revealed the following: Almost invariably these experimental lesions and very frequently the myocardial Aschoff bodies studied in their early stages have been shown to originate in and evolve from lesions of heart muscle fibers. The mono-, multi-, and non-nuciested cell masses, most characteristic of myocardial disease of the rheumatic type, appear to be damaged muscle fibers their fragments, and syncytial cell masses of probable muscular origin that proliferate from beneath the sarcolemma and in the tracks of damaged muscle fibers in reaction to that damage. In addition to destructive changes in cardiac muscle fibers an attempt at myofiber regeneration may occur in some myocardial Aschoff bodies. The most distinguishing histologic feature of the myocardial Aschoff bodies in rheumatic heart disease are the peculiar lesions of muscle fibers. Therefore, it is proposed that they be designated as myofiber Aschoff bodies in order to indicate their origin more accurately. The results of these investigations contrast with the widely accepted theory that all myocardial Aschoff bodies originate as injured interstitial collagen, and that, as they evolve, they consist of damaged interstitial collagen intermingled with cells of non-myogenic derivation that proliferated in response to that collagen injury. These studies, furthermore, provide evidence that experimental homologues of rheumatic myocardial Aschoff bodies have been induced in a very few among many rabbits subjected to reposted focal infections with group A streptococci of different serological types. Hence, they support the concept that the myocardial Aschoff bodies of rheumatic fever are induced by repeated infections with group A streptococci of several different serological types; even though only a certain few among the many patients so infected develop these lesions.
Activists welcome Delhi government's ban on "unscientific" two finger test for rape
Authors: S. Bagcchi
Journal: BMJ (2015)

The Delhi government has revoked a circular it issued on 31 May, which suggested that hospitals in Delhi should perform the archaic two finger test on women who have been raped.

The Times of India newspaper said that the government sent hospitals a circular stating that per vaginal examination, also known as the two finger test, could be conducted on such women “with their consent.” It said that doctors “cannot be made to function under the constraint of a complete ban of this …
Etoposide kinetics in patients with obstructive jaundice.
Authors: K R Hande, S N Wolff, F A Greco, J D Hainsworth, G Reed, D H Johnson
Journal: Journal of Clinical Oncology (1990)

The kinetics and urinary excretion of etoposide and etoposide glucuronide were determined in 11 patients with obstructive jaundice (bilirubin greater than 2.0 mg/dL) and in 23 patients with normal renal and hepatic function. Mean (+/- SE) measurements of clearance (24.5 +/- 2.06 v 26.5 +/- 2.05 mL/min/m2), half-life (5.7 +/- 0.5 v 6.4 +/- 0.5 hours), and volume of distribution (12.4 +/- 1.1 v 13.7 +/- 1.6 L/m2) were not significantly different in patients with jaundice when compared with controls. Similarly, etoposide kinetics in three patients determined during a period of hyperbilirubinemia were not different from measurements made in the same patients following resolution of their obstructive jaundice. In patients with jaundice, 46% of an administered etoposide dose was excreted in the urine as etoposide compared with 35% in controls (P = .15). Urinary excretion of etoposide glucuronide accounted for 29% of an administered etoposide dose in control patients and 15% in those with hepatic obstruction (P = .03). Biliary etoposide excretion measured in four patients with T-tubes was insignificant (less than 2.0% of an administered dose). The calculated renal clearance of etoposide was 11.5 mL/min/m2 in patients with jaundice and 10.4 mL/min/m2 in controls (P = .53). Respective metabolic clearance was 4.9 and 6.9 mL/min/m2 in these two study groups (P = .13). Although hepatic metabolism of etoposide may be slightly decreased in patients with obstructive jaundice, a modest increase in renal etoposide excretion appears to compensate for this change, so that total clearance is similar in the patients with jaundice when compared with controls. No etoposide dose reductions appear to be needed in treating patients with obstructive jaundice who have normal renal function.
Multicenter Comparison of Lung and Oral Microbiomes of HIV-infected and HIV-uninfected Individuals
Authors: James M. Beck, Patrick D. Schloss, Arvind Venkataraman, Homer Twigg, Kathleen A. Jablonski, Frederic D. Bushman, Thomas B. Campbell, Emily S. Charlson, Ronald G. Collman, Kristina Crothers, Jeffrey L. Curtis, Kimberly L. Drews, Sonia C. Flores, Andrew P. Fontenot, Mary A. Foulkes, Ian Frank, Elodie Ghedin, Laurence Huang, Susan V. Lynch, Alison Morris, Brent E. Palmer, Thomas M. Schmidt, Erica Sodergren, George M. Weinstock, Vincent B. Young
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Improved understanding of the lung microbiome in HIV-infected individuals could lead to better strategies for diagnosis, therapy, and prophylaxis of HIV-associated pneumonias. Differences in the oral and lung microbiomes in HIV-infected and HIV-uninfected individuals are not well defined. Whether highly active antiretroviral therapy influences these microbiomes is unclear.We determined whether oral and lung microbiomes differed in clinically healthy groups of HIV-infected and HIV-uninfected subjects.Participating sites in the Lung HIV Microbiome Project contributed bacterial 16S rRNA sequencing data from oral washes and bronchoalveolar lavages (BALs) obtained from HIV-uninfected individuals (n = 86), HIV-infected individuals who were treatment naive (n = 18), and HIV-infected individuals receiving antiretroviral therapy (n = 38).Microbial populations differed in the oral washes among the subject groups (Streptococcus, Actinomyces, Rothia, and Atopobium), but there were no individual taxa that differed among the BALs. Comparison of oral washes and BALs demonstrated similar patterns from HIV-uninfected individuals and HIV-infected individuals receiving antiretroviral therapy, with multiple taxa differing in abundance. The pattern observed from HIV-infected individuals who were treatment naive differed from the other two groups, with differences limited to Veillonella, Rothia, and Granulicatella. CD4 cell counts did not influence the oral or BAL microbiome in these relatively healthy, HIV-infected subjects.The overall similarity of the microbiomes in participants with and without HIV infection was unexpected, because HIV-infected individuals with relatively preserved CD4 cell counts are at higher risk for lower respiratory tract infections, indicating impaired local immune function.
Increased Expression of NAPDH Oxidase 4 in Systemic Sclerosis Dermal Fibroblasts: Regulation by Transforming Growth Factor β
Authors: Sonsoles Piera‐Velazquez, Alma Makul, Sergio A. Jiménez
Journal: Arthritis & Rheumatology (2015)

Objective Systemic sclerosis (SSc) is characterized by severe and often progressive fibrosis of the skin and multiple internal organs. The mechanisms responsible for these alterations remain obscure, although excessive reactive oxygen species (ROS)–mediated oxidative stress has been implicated. NOX‐4 is 1 of 7 isoforms of NADPH oxidase responsible for the generation of ROS. The purpose of this study was to examine NOX‐4 expression in skin and cultured dermal fibroblasts from SSc patients and to examine its regulation by transforming growth factor β1 (TGFβ1). Methods NOX‐4 was assessed in normal and SSc skin by immunohistologic analysis and in normal and SSc cultured dermal fibroblasts by quantitative polymerase chain reaction analysis, fluorescence microscopy, and Western blotting. ROS levels were assessed by fluorescence measurement of H 2 O 2 production. Specific kinase inhibitors were used to study the TGFβ1 signaling involved in NOX‐4 stimulation. NOX‐4 inhibition/down‐regulation was induced with a selective NOX‐4 small‐molecule inhibitor and NOX‐4 small interfering RNA (siRNA). Results In contrast with normal skin fibroblasts, those from SSc skin showed intense NOX‐4 staining. Cultured SSc fibroblasts displayed increased NOX‐4 expression. TGFβ1 caused potent NOX‐4 protein and messenger RNA stimulation in normal and SSc fibroblasts, which was mediated by the protein kinase Cδ (PKCδ) and Smad2/3 pathways. NOX‐4 knockdown in SSc fibroblasts reduced the production of ROS and lowered the expression of type I collagen. Conclusion NOX‐4 expression and production were found to be constitutively elevated in SSc skin and cultured SSc dermal fibroblasts. TGFβ1 stimulated NOX‐4 expression in normal and SSc fibroblasts through PKCδ and Smad2/3 signaling pathways. A small‐molecule NOX‐4 inhibitor decreased collagen and fibronectin production by normal and SSc fibroblasts, and NOX‐4 siRNA knockdown reduced ROS and collagen production by SSc fibroblasts. These results demonstrate the involvement of NOX‐4 in SSc‐associated fibrosis and indicate NOX‐4 inhibitors as novel therapeutic approaches for SSc.
Comparison of current therapies against endothelin-induced growth in pulmonary smooth arterial muscle cells (PASMCs) derived from patients with pulmonary arterial hypertension
Authors: Jigisha Patel, David Abraham, Andrew Nelson, Adam Silverstein, Lucie Clapp
Journal: European Respiratory Journal (2014)

Pulmonary arterial hypertension (PAH) is a highly proliferative, vascular remodelling disease leading to heart failure and death. Endothelin-1 (ET-1) levels are raised and correlate with a poor outcome in PAH. Agents targeting the prostacyclin, ET-1 and cyclic GMP pathway are widely used to treat PAH but no direct comparison of multiple agents from all three pathways exists in vitro. Aim: To compare effects of prostacyclin mimetics (iloprost, treprostinil and MRE-269), tadalafil (PDE5 inhibitor), riociguat (guanylyl cyclase activator) and ET-1 receptor antagonists (ETRAs), bosentan and macitentan on cell proliferation in PASMCs derived from PAH patients (n=5). Methods: PASMCs were incubated in serum ± ET-1 (0.001-300nM). Drugs were evaluated in cells treated with 3nM ET-1 and serum. Cell proliferation was assessed using an MTS assay. Results: ET-1 modestly increased proliferation (1.5 fold at 100nM), but when combined with serum, the magnitude and potency of ET-1 was enhanced 3 and 10 fold, respectively. All drugs reduced proliferation with a rank order of the lowest (0.1nM-1000nM) dose to significantly (P riociguat≥MRE-269≥tadalafil=iloprost>>macitentan≥bosentan. ETRAs decreased (≥3 fold) while cGMP elevating agents increased (≥10 fold) the potency of treprostinil when combined. Conclusion: The efficacy of the different PAH therapies to inhibit ET-1 induced growth in PASMCs derived from PAH patients varied 10,000 fold. Prostacyclins and cGMP elevating agents, especially when combined, appear more effective antiproliferative agents than ETRAs.