tbuckley/cabot-search huggingface dataset:
Physical activity is associated with lower risk of death and rehospitalization in COPD
Authors: Huong Nguyen, Adam Sharp, Erin Hahn, Amy Liu, Janet Lee, Michael Gould
Journal: European Respiratory Journal (2014)

Background: We recently found that patients with COPD who reported any level of moderate to vigorous physical activity (MVPA) during routine clinical care had a 34% lower risk of 30-day all-cause readmission. In this paper, we examined whether physical activity also predicted risk of first re-hospitalization or death over 12 months of follow-up.  Methods: Patients from an integrated health care system were included in this retrospective cohort study if they were hospitalized for COPD and discharged between 1/1-12/31/2011, age 40+, on at least a bronchodilator or steroid inhaler, alive at discharge, and continuously enrolled in the health plan 12 months prior to the index admission and at least 12 months post discharge or died within the follow-up window. Physical activity (PA) was routinely assessed at the time of all outpatient visits and expressed as total minutes of MVPA. Multivariate Poisson regression models were used.  Results: The sample included 2,499 patients with a mean age of 73±11 (55% females). There were 493 deaths (20%) and 55% of patients were re-hospitalized over 12 months of follow-up. Multivariate adjusted analyses showed that compared to inactive patients, those reporting any level of MVPA had a significantly lower risk of death (1-149 mins/wk of MVPA, Risk Ratio, RR: 0.75, 95%CI 0.56-1.0; ≥150 minutes/week of MVPA, RR: 0.55, 95%CI 0.36-0.86) and rehospitalization, (1-149 mins/wk of MVPA, RR: 0.84, 95%CI 0.71-0.98; ≥150 minutes/week of MVPA, RR: 0.79, 95%CI 0.65-0.98).  Conclusions: Our findings add to the growing evidence base on the prognostic significance of PA in COPD. Prospective studies are needed to determine if increasing PA in high risk patients improves outcomes.
Effects of age on severity of disease in an obstructive sleep apnea population
Authors: Diana Pocora, Florin Dumitru Mihaltan, Florina Prunescu, Ruxandra Ulmeanu, Oana Claudia Deleanu
Journal: European Respiratory Journal (2013)

Background:  There is little information focused on difference between elderly and young patients with obstructive sleep apnea (OSA),especially regarding polysomnography(PGS) findings.   Aim:  To analyze age-related peculiarities in an OSA population who underwent PSG and polygraphy (PG).   Methods:  We studied retrospectively 131 consecutively OSA patients comparing 2 age groups: 22-40 years old (78.62%) versus >65 years old (21.37%),using SPSS 17.   Results:  The young group included less women compared to the elderly (p 2 (  69.9±13.9% vs 77.2±9.7%,p=0.006),without any difference regarding duration of respiratory event.Age is not correlated with AHI (r=-0.009, p=0.91), DI (r= -0.15, p=0.1),minimum SpO 2 (r=0.31, p=0.32) or Epworth score (r= -0.1, p=0.22).There were no significant differences between age groups regarding titration failure and CPAP pressure.   Conclusion:  Although age was not correlated with AHI, the severity of OSA appears to be greater in younger patients.Even though the elderly are sometimes considered to be a different phenotype of OSA, these peculiarities appear to be due to normal ageing process.
Grape seed proanthocyanidin extract attenuates airway inflammation and hyperresponsiveness in a murine model of asthma: Downregulating inducible nitric oxide synthase
Authors: Qian Zhang, Guo-Zhen Wei, Dan-Yang Zhou, Qiang Du, Mao Huang
Journal: European Respiratory Journal (2011)

Background: Allergic asthma is characterized by hyperresponsiveness and inflammation of the airway with increased expression of inducible nitric oxide synthase (iNOS) and overproduction of nitric oxide (NO). Grape seed proanthocyanidin extract (GSPE) has been proved to have antioxidant, anti-inflammatory and other pharmacological effects.

Aims and objectives: The purpose of this study was to examine the role of GSPE on airway inflammation and hyperresponsiveness in a mouse model of allergic asthma.

Methods: BALB/c mice, sensitized and challenged with OVA, were intraperitoneally injected with GSPE. HE staining and PAS staining were used to observe airway inflammation in lung tissue and airway mucus secretion, respectively. Quantification of cytokines in bronchoalveolar lavage fluid (BALF) and total serum immunoglobulin E (IgE) were detected by ELISA. The protein expression of iNOS was evaluated by immunohistochemistry and Western Blot analysis.

Results: GSPE remarkably suppressed airway resistance, and reduced the total inflammatory cell and eosinophil counts in BALF. Treatment with GSPE significantly enhanced interferon (IFN)-γ level and decreased interleukin (IL)-4 and IL-13 levels in BALF and total IgE levels in serum. GSPE attenuated allergen-induced lung eosinophilic inflammation and mucus-producing goblet cells in the airway. The elevated iNOS expression observed in the OVA mice was significantly inhibited by GSPE.

Conclusions: GSPE decreases the progression of airway inflammation and hyperresponsiveness by downregulating the iNOS expression, promising to be a potential in the treatment of allergic asthma.
Epirubicin Plus Tamoxifen Versus Tamoxifen Alone in Node-Positive Postmenopausal Patients With Breast Cancer: A Randomized Trial of the International Collaborative Cancer Group
Authors: J.A. Wils, J.M. Bliss, M. Marty, G. Coombes, C. Fontaine, F. Morvan, T. Olmos, F.R. Pérez-López, P. Vassilopoulos, E. Woods, R.C. Coombes
Journal: Journal of Clinical Oncology (1999)

PURPOSE: To assess whether the addition of epirubicin (EPI) therapy to prolonged treatment with tamoxifen (TAM) improves relapse-free and overall survival in postmenopausal women with node-positive primary breast cancer. PATIENTS AND METHODS: Six hundred four patients entered onto a randomized clinical trial were allocated to receive TAM 20 mg/d for 4 years or TAM 20 mg/d for 4 years plus EPI 50 mg/m 2 intravenously on days 1 and 8 every 4 weeks for six cycles. Analysis was performed according to allocated treatment, with all randomized patients included (intention to treat), irrespective of eligibility status. RESULTS: After a median follow-up period of 5.7 years, an improvement in relapse-free survival (RFS) was observed for the TAM and EPI–treated patients, compared with those who received TAM alone. The unadjusted hazard ratio was 0.72 (95% confidence interval, 0.54 to 0.96), with a corresponding reduction in the odds of recurrence of 27.9% (SD, 12.3), which was statistically significant (P = .023). Adjustment for prognostic and/or predictive factors did not materially affect the hazard ratio. No difference was observed in terms of overall survival (reduction in odds of death, 11.9% [SD, 16.3]; P = .46). Combined chemohormonal treatment was associated with a higher incidence of acute side effects but without a clear increase in long-term cardiotoxicity. Twelve nonbreast second malignancies, including five hematologic malignancies (two of which were cases of acute myelogenous leukemia), were observed. CONCLUSION: The data show that combined chemohormonal treatment reduces the risk of relapse in postmenopausal patients with node-positive breast cancer. No evidence was found, however, for an improvement in overall survival. The size of benefit observed for both outcomes was consistent with that reported in the Early Breast Cancer Trialists' Collaborative Group overview. The trial presented here, however, provides the first report of an improvement in RFS associated with the provision of a single cytotoxic drug in addition to prolonged TAM.
Statistical analyses in Swedish randomised trials on mammography screening and in other randomised trials on cancer screening: a systematic review
Authors: Philippe Autier, Mathieu Boniol, Michel Smans, Richard Sullivan, Peter Boyle
Journal: Journal of the Royal Society of Medicine (2015)

Objectives We compared calculations of relative risks of cancer death in Swedish mammography trials and in other cancer screening trials. Participants Men and women from 30 to 74 years of age. Setting Randomised trials on cancer screening. Design For each trial, we identified the intervention period, when screening was offered to screening groups and not to control groups, and the post-intervention period, when screening (or absence of screening) was the same in screening and control groups. We then examined which cancer deaths had been used for the computation of relative risk of cancer death. Main outcome measures Relative risk of cancer death. Results In 17 non-breast screening trials, deaths due to cancers diagnosed during the intervention and post-intervention periods were used for relative risk calculations. In the five Swedish trials, relative risk calculations used deaths due to breast cancers found during intervention periods, but deaths due to breast cancer found at first screening of control groups were added to these groups. After reallocation of the added breast cancer deaths to post-intervention periods of control groups, relative risks of 0.86 (0.76; 0.97) were obtained for cancers found during intervention periods and 0.83 (0.71; 0.97) for cancers found during post-intervention periods, indicating constant reduction in the risk of breast cancer death during follow-up, irrespective of screening. Conclusions The use of unconventional statistical methods in Swedish trials has led to overestimation of risk reduction in breast cancer death attributable to mammography screening. The constant risk reduction observed in screening groups was probably due to the trial design that optimised awareness and medical management of women allocated to screening groups.
The 2015 World Health Organization Classification of Tumors of the Thymus: Continuity and Changes
Authors: Alexander Marx, John K.C. Chan, Jean-Michel Coindre, Frank Detterbeck, Nicolas Girard, Nancy L. Harris, Elaine S. Jaffe, Michael O. Kurrer, Edith M. Marom, Andre L. Moreira, Kiyoshi Mukai, Attilio Orazi, Philipp Ströbel
Journal: Journal of Thoracic Oncology (2015)
The relationship between pulmonary function tests and gender among smokers with no respiratory symptoms
Authors: Sermin Börekçi, Berna Duman, Umut Sema, Müsellim Benan
Journal: European Respiratory Journal (2012)

Aim: In some studies, it is shown that, there is declines in pulmonary function test due to cigarette consumption. In this study we aimed to investigate the relationship between respiratory function test, cigarette consumption (packet-year) and gender among smokers with no respiratory symptoms.

Method: Total of 197 files of patients who admit to smoking cessation clinic were evaluated between March 2011-January 2012. 86 cases who have no respiratory complaints were enrolled in this study. Statistical analysis were done by using SPSS 15.0 statistical program. The mean cigarette consumption and pulmonary function test values [FVC(L), FEV1(L/1.sn), FEV1/FVC%, PEF (L/sn), MEF 25-75 ] of male and female sex were compared.

Results: 22 patients (% 25.6) were female, 64 patients (%74.4) were male. Mean age of female was 38.5±9.7, male was 38.3±11.4. The mean cigarette consumption; 26±17 packet-year for men, 19±16 packet-year for female. There was no statistical difference betwen female and male acording to cigarette consumption and age (P>0.05). The mean values of respiratory function test of male patients were; FVC=4702 ml(%102), FEV1=3650 mL/1.sn (%95), FEV1/FVC% =77, PEF=8508 mL/sn(%.93), MEF 25-75=3330 (%74). The mean values of respiratory function test of female patients were; FVC=3286 mL(%103), FEV1=2607 mL/1.sn (%94), FEV1/FVC%=79, PEF=6175 mL/sn (%93), MEF 25-75=2650 (%69). The relationship between pulmonary function test values and gender was not statistically meaningful (p>0.05). Among female, the mean % values of MEF 25-75 were lower than the normal range that shows effected small airways.

Conclusion: Damage to small airways due to smoking begins earlier periods among women.
Respiratory sound analysis for the non-invasive diagnosis of paradoxical vocal cord dysfunction in children
Authors: Nicki Barker, Ravi Thevasagayam, Laurie Smith, Kelechi Ugonna, Mark Everard
Journal: European Respiratory Journal (2014)

Background   Paradoxical vocal cord dysfunction (pVCD) is diagnosed in children using nasendoscopy. Nasendoscopy, however, is invasive and difficult for children to tolerate. An alternative, non-invasive, technique is required to improve the diagnosis of this under-recognised condition.   Aim   The aim of this study was to determine whether respiratory sound analysis (RSA) can be used to identify pVCD in children with nasendoscopically proven pVCD.   Methods   43 children (11 with suspected pVCD, 11 with thoracic dysfunctional breathing (T-DB) and 21 with no respiratory problems) aged 8-16 years performed a treadmill based exercise test, to provoke symptoms of pVCD, whilst undergoing RSA using the PulmoTrack TM  system. Children with suspected pVCD underwent pre and post exercise test nasendoscopy to confirm the presence of the condition.   Results   RSA was well tolerated by the children with 100% of recordings completed. Using audio and visual data, abnormal respiratory sounds were identified in each of the three participant groups. The proportion of children with confirmed pVCD who were positive for abnormal sounds was twice that of either those with T-DB or healthy controls (67% v 29% and 24%). The PulmoTrack automated sound analysis software did not, however, reflect these differences with no apparent difference seen between groups for abnormal sounds on either inspiration, expiration or as a combined total of inspiration and expiration.   Conclusion   Data from this study supports the possibility of using respiratory sound analysis as a non-invasive means of diagnosing pVCD. However, objective analysis of abnormal sounds is not currently possible using the technology available.
Streptococcal vertebral osteomyelitis: multiple faces of the same disease
Authors: O. Murillo, A. Roset, B. Sobrino, J. Lora-Tamayo, R. Verdaguer, E. Jiménez-Mejias, J.M. Nolla, J.D. de Colmenero, J. Ariza
Journal: Clinical Microbiology and Infection (2013)
Promoting Effects of Polychlorinated Biphenyls (Aroclor 1254) and Polychlorinated Dibenzofuran-Free Aroclor 1254 on Diethylnitrosamine-Induced Tumorigenesis in the Rat&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: Bradley D. Preston, John P. van Miller, Robert W. Moore, James R. Allen
Journal: JNCI Journal of the National Cancer Institute (1981)

The hepatic tumor-promoting activity of a commercial polychlorinated biphenyl mixture, Aroclor 1254 (AR 1254), with and without its intrinsic polychlorinated dibenzofuran (PCDF) impurities, was investigated. Male Sprague-Dawley non-inbred albino rats were treated with 66 microgram diethylnitrosamine (DENA)/ml drinking water for 5 weeks and subsequently given a control diet or a diet supplemented (100 ppm for 18 wk) with either AR 1254 or AR 1254 from which the PCDF moieties were removed (AR 1254-PCDF). Of those animals receiving DENA alone, 16% exhibited hepatocellular carcinomas. Of those rats treated with DENA followed by administration of AR 1254 or AR 1254-PCDF, 64 or 84%, respectively, developed hepatocellular carcinomas. Thus promotion with either AR 1254 or AR 1254-PCDF significantly (P less than 0.05) increased the incidence of DENA-initiated hepatocellular carcinomas. Administration of AR 1254 or AR 1254-PCDF alone did not induce hepatic tumors. Therefore, PCDF impurities were not necessary for the promoting activity of AR 1254.
Safety and efficacy of pleurodesis with thoracoscopic doxycycline poudrage in malignant pleural effusion
Authors: Mohamed Elnady, Amr Sakr
Journal: European Respiratory Journal (2011)

Objective:  To assess the safety and efficacy of thoracoscopic doxycycline poudrage (TDP) for pleurodesis in malignant effusions.   Design:  Retrospective.   Methods:  Twenty seven patients were included in this study. Thoracoscopy was performed for diagnosis and subsequent doxycycline pleurodesis. At the end of thoracoscopy, a new method for Doxycycline delivery to the pleura was used through pneumatic atomizer insufflations where about 500-1000 mg of doxycycline were taken & prepared as a powder from the oral preparation (vibramycin 100 mg/capsule).   Results:  74.1% had a successful pleurodesis, 18.5% had partial reponse and 7.4% had failed pleurodesis at one month. Adverse effects included pain (48.1%), fever (3.7%) and pain & fever (22.2%). The mean drainage time for intercostals tube was about 1.52 days.   Conclusions:  TDP is an inexpensive, well tolerated, reasonably effective, comparatively simple, safe, and capable of alleviating respiratory symptoms.
Association between Glucose Metabolism and Sleep-disordered Breathing during REM Sleep
Authors: Hassan A. Chami, Daniel J. Gottlieb, Susan Redline, Naresh M. Punjabi
Journal: American Journal of Respiratory and Critical Care Medicine (2015)

Sleep-disordered breathing (SDB) has been associated with impaired glucose metabolism. It is possible that the association between SDB and glucose metabolism is distinct for non-REM versus REM sleep because of differences in sleep-state-dependent sympathetic activation and/or degree of hypoxemia.To characterize the association between REM-related SDB, glucose intolerance, and insulin resistance in a community-based sample.A cross-sectional analysis that included 3,310 participants from the Sleep Heart Health Study was undertaken (53% female; mean age, 66.1 yr). Full montage home-polysomnography and fasting glucose were available on all participants. SDB severity during REM and non-REM sleep was quantified using the apnea-hypopnea index in REM (AHIREM) and non-REM sleep (AHINREM), respectively. Fasting and 2-hour post-challenge glucose levels were assessed during a glucose tolerance test (n = 2,264). The homeostatic model assessment index for insulin resistance (HOMA-IR) was calculated (n = 1,543). Linear regression was used to assess the associations of AHIREM and AHINREM with fasting and post-prandial glucose levels and HOMA-IR.AHIREM and AHINREM were associated with fasting glycemia, post-prandial glucose levels, and HOMA-IR in models that adjusted for age, sex, race, and site. However, with additional adjustment for body mass index, waist circumference, and sleep duration, AHIREM was only associated with HOMA-IR (β = 0.04; 95% CI, 0.1-0.07; P = 0.01), whereas AHINREM was only associated with fasting (β = 0.93; 95% CI, 0.14-1.72; P = 0.02) and post-prandial glucose levels (β = 3.0; 95% CI, 0.5-5.5; P = 0.02).AHIREM is associated with insulin resistance but not with fasting glycemia or glucose intolerance.
Airways hyperresponsiveness, bronchodilator response, allergy and smoking predict improvement in FEV1 during long-term inhaled corticosteroid treatment. Dutch CNSLD Study Group
Authors: HA Kerstjens, SE Overbeek, JP Schouten, PL Brand, DS Postma
Journal: European Respiratory Journal (1993)

Although most patients with obstructive airways disease show some amelioration with long-term inhaled corticosteroid therapy, the extent of improvement may vary considerably between patients. Patients with mild to moderately severe obstructive airways disease (asthma and COPD) were selected if provocative concentration producing a 20% fall in forced expiratory volume in one second (PC20) < or = 8 mg.ml-1, and forced expiratory volume in one second (FEV1) < 95% confidence intervals (CI) of predicted normal. The independent influences of baseline PC20FEV1, inspiratory vital capacity (IVC), bronchodilator response, smoking habits, and allergy both on the "immediate" (within 3 months) response in FEV1 and the change in long-term (from 3 months onwards) slope of FEV1 with inhaled corticosteroids were analysed. Patients had a larger "immediate" improvement in their FEV1 with inhaled corticosteroids with each doubling doses lower PC20, with each ten-fold higher immunoglobulin E (IgE), and if they did not smoke. Total IgE proved a better independent predictor of "immediate" response than specific IgE for house dust mite, skin tests, or blood eosinophils. A more favourable long-term slope of FEV1 was predicted by a larger baseline bronchodilator response, but not by smoking. In conclusion, PC20, total IgE, and smoking habits are independent predictors of immediate treatment response to inhaled corticosteroids. Bronchodilator response is the single independent predictor of changes in long-term slope of FEV1 with corticosteroid treatment.
Effect of inhaled steroids on cholinergic transmission in human isolated bronchi
Authors: J Ricny, KD Hohle, K Racke, I Wessler
Journal: European Respiratory Journal (1995)

Steroids have been found to facilitate cholinergic transmission in skeletal muscle, but possible effects in airways smooth muscles have not been studied. Therefore, choline acetyltransferase (CAT) activity, tissue content of stored acetylcholine and release of newly-synthesized [3H]acetylcholine were were measured in freshly-dissected human bronchi. All lung tissue was obtained from patients with lung cancer at thoracotomy. Group I bronchi were obtained from patients who also suffered from chronic obstructive bronchitis and had been treated for at least 6 weeks before surgery with daily doses of four puffs of flusinolid. Group II bronchi were obtained from patients who did not suffer from chronic obstructive airways disease and had not been treated with steroids. Neither CAT activity (3.1 nmol.h-1.mg protein-1) nor acetylcholine tissue content (260 pmol.100 mg-1), or electrically evoked [3H]acetylcholine release (about 2,000 dpm.100 mg-1) differed in the two groups. This cross sectional study indicates that inhaled steroids do not change cholinergic transmission beyond the level observed in the airways obtained from patients with lung cancer who do not suffer from chronic airways disease and have not been treated with inhaled steroids. This suggests that inhaled steroids can be given chronically without the induction of a facilitatory side-effect on cholinergic transmission within the airways.
Periodic Pattern of Genetic and Fitness Diversity during Evolution of an Artificial Cell-Like System
Authors: Norikazu Ichihashi, Takuyo Aita, Daisuke Motooka, Shota Nakamura, Tetsuya Yomo
Journal: Molecular Biology and Evolution (2015)

Genetic and phenotypic diversity are the basis of evolution. Despite their importance, however, little is known about how they change over the course of evolution. In this study, we analyzed the dynamics of the adaptive evolution of a simple evolvable artificial cell-like system using single-molecule real-time sequencing technology that reads an entire single artificial genome. We found that the genomic RNA population increases in fitness intermittently, correlating with a periodic pattern of genetic and fitness diversity produced by repeated diversification and domination. In the diversification phase, a genomic RNA population spreads within a genetic space by accumulating mutations until mutants with higher fitness are generated, resulting in an increase in fitness diversity. In the domination phase, the mutants with higher fitness dominate, decreasing both the fitness and genetic diversity. This study reveals the dynamic nature of genetic and fitness diversity during adaptive evolution and demonstrates the utility of a simplified artificial cell-like system to study evolution at an unprecedented resolution.