tbuckley/cabot-search huggingface dataset:
Is a consultant supported community respiratory service an alternative to hospital based specialist care? - Experience of a local service improvement project
Authors: Robert Balfour, Janet McCarlie, Alison Anderson, Hans Hartung
Journal: European Respiratory Journal (2012)

1. Better integration of primary and secondary care services and shifting the balance of care remain a major challenge with only few practical examples in respiratory care.

2. The aim of a local service improvement project is to gain insight into an example of specialist supported, integrated respiratory care closer to the patient's home. The objectives are to provide more flexible access, more patient centred care and develop general practitioners as partners in care.

3. Regular consultant respiratory clinics supported by a general practitioner with a specialist interest were set up in a local surgery. An interactive triage system, E communication, meetings with primary care colleagues and consultant access to primary care patient data and radiology were implemented. Service user satisfaction, general practitioner satisfaction and number of patients seen by the general practitioner with a specialist interest were recorded for a period of 18 months.

4. 77 out of 116 service users completed the questionaire and were all satisfied with the new service and felt well supported to manage their condition. 76 out of 77 found it easy to get a suitable appointment. All 7 general practitioners were highly satisfied. 73 of the 116 respiratory patients were seen by the general practitioner with a specialist interest.

5. Our consultant supported community respiratory service project demonstrates a model of integrated and flexible care in partnership closer to the service user's home which could serve as a possible alternative to hospital centred specialist care.
A Total of 1,007 Percutaneous Coronary Interventions Without Onsite Cardiac Surgery
Authors: Henry H. Ting, Ganesh Raveendran, Ryan J. Lennon, Kirsten Hall Long, Mandeep Singh, Douglas L. Wood, Bernard J. Gersh, Charanjit S. Rihal, David R. Holmes
Journal: Journal of the American College of Cardiology (2006)
Chest physiotherapy for children with pneumonia: A systematic review
Authors: Karla Mendonça, Gabriela Chaves, Ingrid Guerra, Diana Freitas, Thalita Macêdo, Raquel Mendes, Fernando Dias, Cibele Ribeiro, Ricardo Guerra, Verônica Parreira, Guilherme Fregonezi
Journal: European Respiratory Journal (2014)

Background: Chest physiotherapy may contribute as an adjuvant treatment of pneumonia even though its indication remains controversial. Aim: To assess the effectiveness of chest physiotherapy in relation to time until clinical resolution in children (from birth up to 18 years old) of either gender with any type of pneumonia. Methods: This is a Cochrane systematic review (Chaves, G.S.S. et al. Cochrane Database of Systematic Reviews 2013, Issue 9). Trials were searched for in CENTRAL, MEDLINE, EMBASE, CINAHL, LILACS, Web of Science and PEDro. Trial registers were also consulted. The types of studies were randomised controlled trials (RCTs) that compared chest physiotherapy of any type with no chest physiotherapy. Two review authors independently selected the studies, assessed trials quality and extracted data. Results: Three RCTs involving 255 inpatient children are included in the review. Two of the included studies found a significant improvement in respiratory rate and oxygen saturation whereas one study failed to show that chest physiotherapy decreases the time to clinical resolution and the duration of hospital stay. Two included studies had an overall low risk of bias whereas one included study had an overall unclear risk of bias. Due to the different characteristics of the trials data were not able to be pooled by meta-analysis. Conclusions: This review does not provide conclusive evidence to justify the use of chest physiotherapy in children with pneumonia. The number of included studies is small and they differed in their statistical presentation of data.
Age at Menarche and Breast Cancer&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: Jerzy Staszewski
Journal: JNCI Journal of the National Cancer Institute (1971)

The results of a case-control study in the Katowice and Opele Districts of Poland are presented. The proportion of females with “late” menarche (age ≥ 16 years), both cases and controls , was similar to the proportion reported for Tokyo and much higher than in Athens or Boston, where breast cancer incidence is also higher. Females reporting menarche at ages < 6 years had breast cancer risks 1.76 as high as those reporting “late” menarche. This differential in risk was more marked for women up to 44 years of age than for older women. Other sources indicate an increase of the low breast cancer risk in Poland and also a decrease of the proportion of late menarche. A relation between geographic and secular variation in breast cancer occurrence and in menarche pattern is discussed. Age at menarche and breast cancer risk are probably indirectly associated, with nutrition being the possible common factor.
Production of an Oncornavirus by the Continuous Human Cell Line, Detroit-6
Authors: G. G. Miller, V. M. Zhdanov, T. F. Lozinsky, M. Y. Volkova, K. V. Ilyin, D. B. Golubev, I. S. Irlin, A. F. Bykovsky
Journal: JNCI Journal of the National Cancer Institute (1974)

An oncornavirus was discovered in a subllne of the continuous human cell line, Detroit-6. Electron microscope studies of the cells revealed particles of types A and B or theta. The former were found in various parts of the cytoplasm, but the latter were predominantly in the intercellular spaces. Biochemical and biophysical tests were used to study both extracellular and intracellular virus. The virus was immunologically distinct from the mouse mammary tumor virus and shared a common antigen with the virus isolated from HEp-2 cells and with the rhesus monkey mammary carcinoma virus.
Correlation between expression of vascular endothelial growth factor and tumor vascularity, and patient outcome in human gastric carcinoma.
Authors: N Tanigawa, H Amaya, M Matsumura, T Shimomatsuya
Journal: Journal of Clinical Oncology (1997)

PURPOSE The relationship between the expression of vascular endothelial growth factor (VEGF) and its receptor, KDR, in human gastric carcinoma tissues and tumor angiogenesis, as well as patient outcome, were investigated. MATERIALS AND METHODS One hundred sixty-three primary tumor specimens were investigated by immunohistochemical studies with anti-VEGF, anti-KDR, and anti-CD34 antibodies and by monitoring patients for at least 2 years after surgery. RESULTS For intensity of VEGF staining, 48 tumors were graded as 0, 36 as 1+, 63 as 2+, and 16 as 3+. Tumors with strong VEGF staining, assessed as 2+ and 3+, had significantly higher vascularity than those with weak VEGF. Eighty-eight tumors (54%) were positive for KDR. There was no association between KDR expression and tumor vascularity. No close correlation was found between VEGF and KDR expressions. The Cox proportional hazards model identified intratumoral vessel count as the most significant and independent prognostic factor among various clinicopathologic factors. In contrast, overall survival rates for 84 patients with weak VEGF staining tumors and 79 with strong VEGF staining tumors were not significantly different. Patients with tumors of either localized Borrmann types or well-differentiated histologies, which are found more frequently in tumors with strong VEGF staining, survived significantly longer than those with tumors of either infiltrative Borrmann types or poorly differentiated histologies. CONCLUSION We suggest that expression of VEGF is more frequently found in tumors with well-differentiated histology and plays a role in the promotion of angiogenesis in human gastric carcinomas.
Airway responsiveness following wheezy bronchitis in infants
Authors: P Gutkowski
Journal: European Respiratory Journal (1990)

The study was undertaken to assess the airway function and its response to carbachol and salbutamol in infants recovering from wheezy bronchitis. In 82 children aged 3-33 mths, free from wheeze at the time of testing, and in 14 healthy infants, airway resistance (Raw) and thoracic gas volume (TGV) were measured using a body plethysmograph. Specific airway resistance (sRaw = Raw x TGV) was calculated. Increasing doses of nebulized carbachol were applied to challenge the airways. After a positive reaction had been achieved, 0.1 mg of nebulized salbutamol was administered. Raw was monitored during the whole procedure. In 23 of the 82 children the study was repeated after nine months on average. Within this period Raw remained elevated, whereas TGV and sRaw fell considerably (TGV from 37.9 to 28.2 ml.kg-1, p less than 0.01; sRaw from 0.78 to 0.63 kPa.s-1, p less than 0.01). Airway responsiveness also dropped during the observation period (mean log provocation dose producing 50% fall (PD50) 0.026 and 0.358, p less than 0.01). In comparison with controls the study infants responded to lower doses of carbachol (mean log PD50 0.610 and 0.031, respectively, p less than 0.01). Airway responsiveness was not related to baseline airway calibre or to signs of atopy. sRaw returned to baseline 2-5 min following salbutamol. The results suggest that airways of children in a symptom-free period following wheezy bronchitis have reduced patency and reveal hyperresponsiveness to carbachol.
Relationship Between Antigen Density and Immunotherapeutic Response Elicited by Monoclonal Antibodies Against Solid Tumors&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;3&lt;/xref&gt;
Authors: P M Capone, L D Papsidero, T M Chu
Journal: JNCI Journal of the National Cancer Institute (1984)

The relationship between the level of cell surface antigen expression and solid tumor immunotherapy with monoclonal antibody (MoAb) was evaluated. Two MoAb's that were shown effective in the passive therapy of breast carcinomas of human origin, established and growing in female Swiss nude mice, were used for these studies. Several groups of tumors were produced from cell cultures of different passages; each cell culture possessed a distinct target antigen level. Results from immunotherapy experiments demonstrated that the amount of tumor reduction response after MoAb therapy was proportional to the antigen density at the cell surface. Analysis of these data indicated a theoretical improbability of a single MoAb treatment being able to completely eradicate solid tumors and may necessitate the use of multiple MoAb's to circumvent this problem.
Can VE45 & VT30 predict abnormality during cardio-pulmonary exercise testing?
Authors: Elliott Dewsbury, James Stockley, Brendan Cooper
Journal: European Respiratory Journal (2014)

Aims: 1. To validate Cotes9 hypothesis that VE45 (minute ventilation at 1.0L/min VO2) & Vt30 (tidal volume at a ventilation of 30L/min VO2) can identify abnormalities in exercise earlier than V02 peak 2. To distinguish between respiratory & cardiac abnormalities using VE45 & Vt30.  Methods: VE45 & Vt30 were identified in 105 consecutive, routine Cardio Pulmonary Exercise Tests (CPETs). Predictive diagnoses from VE45 & Vt30 were compared to the diagnosis at VO2 peak . ROC analysis was performed to determine the sensitivity/specificity of VE45 & Vt30. VE45 & Vt30 data from healthy subjects was compared to previously published normal ranges by Cotes (1).  Results: A significant correlation was observed between VE45 & VO2 peak in exercise-limited patients, but not in healthy subjects. No correlation was observed between Vt30 & VO2 peak in all subjects. Calculated ranges for VE45 in normal subjects were different from published normal ranges(1). VE45 was highly sensitive and accurately predicted abnormality in the majority of patients with exercise limitation at VO2 peak.  However, it did not accurately predict normality in healthy subjects.  Conclusions: It was not possible to distinguish between respiratory & cardiac abnormality using VE45, but it was possible to distinguish between those with and without limitation. Vt30 did not accurately predict abnormality. Our results differ significantly from previously published normal ranges(1).  1. Cotes, J.E., (1993). Lung Function: Assessment and Application in Medicine, 5th edition. Oxford: Blackwell scientific publishing p429.
&lt;italic&gt;Brief Communication:&lt;/italic&gt; Inhibition of Metastasis in Rats Immunized With Xenogenized Autologous Tumor Cells After Excision of the Primary Tumor&lt;xref ref-type="fn" rid="fn2"&gt;2&lt;/xref&gt;
Authors: H Kobayashi, E Gotohda, M Hosokawa, T Kodama
Journal: JNCI Journal of the National Cancer Institute (1975)

Subcutaneously transplanted 3-methylcholanthrene-induced KMT-17 tumor in WKA rats yielded not only a local solid tumor but also frequent metastases in regional lymph nodes. Neither active immunization with xenogenized identical tumor cells nor surgical excision of the solid tumor prohibited the metastases when each treatment was given 4 days after tumor transplantation. However, immunization combined with surgery significantly decreased the metastases and prolonged survival.
Novel fabrication of fluorescent silk utilized in biotechnological and medical applications
Authors: Dong Wook Kim, Ok Joo Lee, Seong-Wan Kim, Chang Seok Ki, Janet Ren Chao, Hyojong Yoo, Sung-il Yoon, Jeong Eun Lee, Ye Ri Park, HaeYong Kweon, Kwang Gill Lee, David L. Kaplan, Chan Hum Park
Journal: Biomaterials (2015)
Transforming Growth Factor-α Mediates Nuclear Factor κB Activation in Strained Arteries
Authors: Catherine A. Lemarié, Pierre-Louis Tharaux, Bruno Esposito, Alain Tedgui, Stéphanie Lehoux
Journal: Circulation Research (2006)

Mechanical factors regulate both blood vessel growth and the development and progression of vascular disease. Acting on apoptotic and inflammatory signaling, the transcription factor nuclear factor kappaB (NF-kappaB) is a likely mediator of these processes. Nevertheless, pressure-dependent NF-kappaB activation pathways remain mostly unknown. Here we report that high intraluminal pressure induces reactive oxygen species (ROS) in arteries and that inhibition of NADPH oxidase prevents both the generation of ROS and the activation of NF-kappaB associated with high pressure. We also identify the epidermal growth factor receptor (EGFR) as a ROS-dependent signaling intermediate. In arteries from EGFR mutant mice (waved-2), pressure fails to activate NF-kappaB. Moreover, using vessels from EGFR ligand-deficient mice, we show that transforming growth factor (TGF)-alpha, but neither heparin-binding EGF-like growth factor nor epiregulin, transduces NF-kappaB activation by high pressure. Preventing the release of the active form of TGF-alpha also abolishes NF-kappaB induction by strain. The role of TGF-alpha signaling in vascular remodeling is substantiated in vivo; angiotensin II-induced activation of NF-kappaB and associated cell proliferation and wall thickening are much reduced in TGF-alpha-mutant mice compared with wild-type, despite equivalent hypertension in both groups. Conversely, apoptotic cells are detected only in vessels from hypertensive TGF-alpha-mutant mice, outlining the role of NF-kappaB in cell survival. Finally, the NF-kappaB activation pathway contrasts with that of extracellular signal-regulated kinase 1/2, which is activated by stretch through the EGFR but does not implicate TGF-alpha. Hence, our data identify TGF-alpha as a potential specific target to modulate mechanosensitive NF-kappaB activation and associated vascular remodeling.
Preferential activation of alveolar macrophages versus epithelial cells during initiation of ventilator-induced lung injury in mice
Authors: Alicia Waite, Kieran O'Dea, Michael Wilson, Masao Takata
Journal: European Respiratory Journal (2011)

Background: It has been suggested that stretch-induced deformation of alveolar epithelial cells (AEC) plays a role in the initiation of ventilator-induced lung injury (VILI). In vitro stretch of AEC upregulates intracellular mitogen-activated protein kinases (MAPK) leading to mediator release, but this may not reflect the situation in vivo . We have developed a novel method to measure MAPK intermediates within discrete lung cell populations following in vivo VILI.

Methods: Anaesthetised C57BL6 mice were ventilated with high (Vt=40ml/kg) or low stretch (Vt=10ml/kg). At various time points lungs were removed and single cell suspensions were produced by mechanical disruption, with cells immediately fixed and permeabilised. Levels of intracellular phosphorylated (p-) p38 and MK2 in alveolar macrophages (AM, CD11c+ cells), type I (T1α+) and II (Pro-SPC+) AEC were determined by flow cytometry.

Results: p-p38 and p-MK2 expression (mean fluorescence intensity, MFI) increased in AM within 5 minutes of high stretch. In contrast, both type I and II AEC showed little p38 and MK2 phosphorylation, even up to 1 hour.

View this table:

MAPK phosphorylation





Conclusion: Contrary to previous suggestions that stretch-induced activation of AEC is the key initiator of VILI, our results indicate an immediate, direct activation of AM with high stretch, placing AM as potentially more important than AEC in triggering the early inflammatory response during VILI.
Simultaneously transdiaphragmatic approach to liver and lung cysts
Authors: Yener Aydin, Mine Celik, Ali Bilal Ulas, Atilla Eroglu
Journal: European Respiratory Journal (2012)

Background: Hydatid cysts are clinical problem at developing and non developed countries. Liver and lung are the two organs which they often settle. In this study we aimed to present lung and liver hydatid cysts which we underwent transdiaphragmatic surgical approach.

Methods: Consecutive 50 patients with lung and liver hydatit cyst whom underwent surgical treatment by transdiaphragmatical way at our clinic between January 1998 and December 2011 were evaluated retrospectively.

Results: Twenty-four (48%) patients were male and 26 (52%) patients were female. The avarege age of the patients was 34±21 (3-72 years old). All cases have liver cyst and 37 of them also have lung cyst. In 9 of the 37 patients with lung cyst, lung cysts were bilateral. Avarage cyst diameter (In patients whom have multipl cysts the largest cyst diameter has taken) was 9.9±3.5 cm (4-18 cm). Forty-eight of the patients were approached with thoracotomy, one of them is approached with laparatomy and one of them is approached with median sternotomy. In 49 cases it was interneved to liver and in 1 case it was interneved to lung by phrenotomy. Excessive biliary drainage was observed in postoperative 2 case. In one case fistule was observed from drain path which is placed in liver cyst. Plevral effusion was observed in one patient. None of the patients was no hospital mortality. Avarage hospital stay was 9.4 ±3.8 (3-21 days).

Conclusion: Simultaneously transdiaphragmatic approach at lung and liver dome cysts is a safe and effective treatment method.

Keywords: Hydatit cyst, transdiaphragmatic surgery.
Value of bronchoscopic specimens for the diagnosis of sputum smear negative tuberculosis in high burden multidrug resistant tuberculosis setting
Authors: Dumitru Chesov, Ecaterina Stratan, Iurie Semionica, Valeriu Crudu, Victor Botnaru
Journal: European Respiratory Journal (2012)

Background 

Rapid diagnosis of pulmonary tuberculosis (PTB) allows timely treatment and infection control. This has a special relevance in subjects with potential multidrug resistant tuberculosis (MDR TB). Bronchoscopy is an alternative method of collecting sputum samples, with an additional benefit in sputum smear-negative (SSN) patients.

Objectives 

To assess the diagnostic yield of PTB in SSN patients, using the examination of bronchoscopic specimens (BSS) such as - bronchoscopic aspiration (BA), bronchoalveolar lavage (BAL), bronchial washing (BW) and post-bronchoscopy sputum (PBS).

Methods 

A retrospective study of patients, registered in national electronic TB database, with culture confirmed PTB between January 2008 and December 2011. Patients, who were SSN or non-productive of sputum (NPS) before bronchoscopy, were eligible.

Results 

The inclusion criteria were met by 503 subjects. BA was performed in 369 cases, BW - 116 cases, BAL - 18 cases, PBS was available 37 in patients. Microbiological examination of BSS was the exclusive method for the microbiological confirmation of PTB in 344(68,4%) cases. The overall diagnostic rate of BSS for smear positive PTB was 21% (98/466). Higher rate for diagnosis of smear positive PTB were proven for bronchial washing (30,9%) and bronchial aspirate (17,2%) which were superior to PBS (8,5%; p=0,01 and p=0,005, respectively). The overall rate of MDR TB among smear positive cases was 27,6% (27/98).

Conclusions 

Microbiological examinations of BSS give a higher rate of definitive diagnosis of PTB among SSN cases, with an earlier identification of contagious subjects with potential MDR TB.
CURB 65 or CURB (S) 65 for community acquired pneumonia
Authors: Sakine Nazik, Nurdan Köktürk, Ayse Baha, Numan Ekim
Journal: European Respiratory Journal (2012)

The CURB-65 score (confusion, blood urea >42,8 mg/dl, respiratory rate> 30/min, blood pressure   65) is quite a practical method for determining the need for hospitalization in community-acquired pneumonia. On the other hand, it is a known fact that CURB-65 is rather more sensitive for determining patients with severe illness, and lacks sensitivity towards other factors dealing with milder cases. The purpose of this study is to investigate factors that determine the need for hospitalization in patients not requiring hospitalization according to CURB-65.

The study was undertaken on 54 patients diagnosed with pneumonia and were recorded to the TTD pneumonia database between 2010-2012.

Nineteen (35,2%) of the patients were female while 35 (64,8%) were male. The mean age was 67,5. The total treatment time, duration of hospitalization, saturations (SpO2), partial arterial oxygen pressures (PaO2) and mean pneumonia severity index (PSI) values were compared between 15 patients recieving 0-1 CURB-65 points (27.8%) (Group 1) and 39 patients receiving 2 or more CURB-65 points (72.1%) (Group 2). According to the data, the mean PSI score in Group 1 (74,93 ± 30,45) and in Group 2 (106,61± 37,4) were statistically different (p=0,003) even though their SaO2, paO2, hospitalization and treatment time were similar (Group 1 SaO2: 89±8,45, PaO2: 53,0±8,72; Group 2 SaO2: 89,23±5,94, PaO2: 54,61±8,48; p< 0,05).

The study shows that although the PSI are different, low SaO2 levels in both groups show that hypoxemia is the main factor for hospitalization in patients with low CURB indexes. Therefore we propose that the CURB(S) 65 hypothetic index is a better determinant than CURB 65 for hospitalization.