tbuckley/cabot-search huggingface dataset:
Frequency of undiagnosed hypoxia in admitted patients in Nishtar Hospital Multan,using pulse oximeter
Authors: Muhammad Wajahat Tariq, Shahid Pervaiz, Tahir Khan, Nida Akram, Nida Khalid, Syed Sarmad Ali Naqvi, Muhammad Atiq ul mannan, Muhammad Zubair Shaheen
Journal: European Respiratory Journal (2014)

Background :Hypoxia may be the indicator of serious medical illness, if not corrected can have its impacts on mortality and morbidity.Diagnosing hypoxemia using pulse oximeter is a routine in well resourced clinical settings but in limited resourced settings,it is a rarity.   Objective :To find the frequency of undiagnosed hypoxia in admitted patients due to any illness.   Materials and Methods :This cross sectional study is conducted in Nishtar Hospital Multan, a tertiary care hospital.We included patients by simple random probability,from various wards.Oxygen saturation (SpO2) was checked with a handheld pulse oximeter.Hypoxia was diagnosed when resting room air SpO2 was less than 90%.  Results:296 patients were enrolled. 46 children (less than 15 years) and 250 were adults (15 years or older).Hypoxia was found in 25 patients (8.44%) in total,7 children (15.21%) and 18 adults (7.2%).In children,Pneumonia was most common while nephrotic syndrome and meningitis were other common illnesses found.In adults,hypoxia was more frequently noticed in post-operative cases of general surgery.Other hypoxic adults had respiratory ailments,IHD,CNS infections and CVA.None was previously diagnosed to have respiratory failure and none was on supplemental oxygen therapy at the time of diagnosis.Hypoxia was an incidental finding.Pulse oximetry enabled us to diagnose undiagnosed hypoxia and changed management leading to application of oxygen and further diagnostic testing.   Conclusion :Undiagnosed hypoxia was found in significant number of admitted patients.This supports that oxygen saturation checking with pulse oximeter should be the part of vitals monitoring of all admitted patients as their 5 th vital sign.
Microvascular Abnormalities in Adjuvant‐Induced Arthritis: Relationship to Macrovascular Endothelial Function and Markers of Endothelial Activation
Authors: Perle Totoson, Katy Maguin‐Gaté, Maude Nappey, Clément Prati, Daniel Wendling, Céline Demougeot
Journal: Arthritis & Rheumatology (2015)

To determine the time course of microvascular abnormalities and the link with macrovascular endothelial function and circulating markers of endothelial activation in adjuvant-induced arthritis (AIA) in rats.Microvascular function/structure and mechanics were studied in third-order mesenteric arteries subjected to flow and/or pressure on day 4 (preclinical arthritis), day 11 (very early arthritis), day 33 (severe disease), and day 90 (when inflammation has resolved) after AIA induction. Macrovascular function was studied in aortic rings, and blood pressure, plasma levels of C-reactive protein (CRP), intercellular adhesion molecule 1 (ICAM-1), and vascular cell adhesion molecule 1 (VCAM-1) were measured at each time point.Mesenteric flow-mediated vasodilation was significantly reduced from very early arthritis to chronic disease, whereas increased microvascular arterial stiffness was evident only on day 33. Macrovascular endothelial dysfunction was observed only on day 33. Thus, on day 90, whereas rats with AIA recovered normal macrovascular endothelial function, microvascular endothelial function remained impaired. No correlation was found between micro- and macrovascular endothelial function throughout the course of arthritis (r = 0.180, P = 0.229). Furthermore, no correlation was found between CRP levels, ICAM-1 levels, and endothelial function whatever the vascular bed. AIA was not associated with change in blood pressure or VCAM levels.Our findings indicate that microvascular endothelial dysfunction occurs earlier than macrovascular endothelial dysfunction and microvascular arterial stiffness during arthritis, suggesting that microvascular endothelial function would be a valuable tool for the early assessment of cardiovascular risk in RA. Neither the ICAM-1 level nor the CRP level is a good marker of micro- or macrovascular endothelial dysfunction.
In the Spotlight: Health Information Systems
Authors: Niilo Saranummi
Journal: IEEE Reviews in Biomedical Engineering (2011)

What is mHealth? If we look at the use of information technology in healthcare, we'll notice two intertwined development trends: connectivity and intelligent applications. The over arching goal has been to support and enable the delivery of health services and as a part of this to create a life-long electronic health record for patients. The emergence of local area networks and later internet provided new means for connectivity and enabled telemedicine and remote patient monitoring applications.
Ten-year results of a randomized trial evaluating prolonged low-dose adjuvant chemotherapy in node-positive breast cancer: a joint European Organization for Research and Treatment of Cancer-Dutch Breast Cancer Working Party Study. Cooperating Investigators.
Authors: P C Clahsen, C J van de Velde, K Welvaart, O J van Driel, R J Sylvester
Journal: Journal of Clinical Oncology (1995)

PURPOSE To investigate whether treatment with prolonged low-dose adjuvant chemotherapy could improve survival of patients with axillary node-positive breast cancer. PATIENTS AND METHODS Four hundred fifty-two patients with axillary node-positive breast cancer who received postoperative irradiation were prospectively randomized in a trial (European Organization for Research and Treatment of Cancer [EORTC] 09771) that compared surgery followed by prolonged low-dose chemotherapy versus surgery alone. Chemotherapy was given for a period of 2 years and consisted of monthly courses of cyclophosphamide 50 mg/m2 orally on days 1 to 14, methotrexate 15 mg/m2 intravenously on days 1 and 8, and fluorouracil 350 mg/m2 intravenously on days 1 and 8 (CMF). RESULTS At a median follow-up time of 10 years, the overall survival duration was significantly prolonged in the chemotherapy arm (hazards ratio, 0.75; 95% confidence interval, 0.56 to 0.99; P = .04). Ten-year overall survival rates (+/- SE) were 59% (+/- 3.6%) for the chemotherapy arm and 50% (+/- 3.7%) for the control arm. Time to local relapse was significantly prolonged in the chemotherapy arm (hazards ratio, 0.63; 95% confidence interval, 0.42 to 0.94; P = .02). Patients with one to three positive axillary nodes and patients with estrogen receptor-negative tumors especially benefited from chemotherapy. Toxicity was observed in 93% of patients. CONCLUSION We conclude that prolonged low-dose adjuvant CMF can significantly prolong overall survival in patients with node-positive breast cancer. However, considering the fact that toxicity was still considerable despite reducing the dose of chemotherapy by 50%, we believe that conventionally dosed short-term regimens are preferable in the treatment of node-positive breast cancer.
Abstract 3098: Left Ventricular Delayed Hyper-enhancement Further Risk Stratifies Patients with Severe Systolic Dysfunction Regardless of the Presence of Coronary Artery Disease: A Cardiac MRI Study
Authors: Deborah H Kwon, Carmel Halley, Tom Carrigan, Randolph Setser, Paul Schoenhagen, Randall Starling, Scott Flamm, Milind Desai
Journal: Circulation (2007)

Background: Patients with severe systolic left ventricular (LV) dysfunction have poor survival. Delayed hyperenhancement magnetic resonance imaging (DHE-MRI) accurately measures myocardial scar. In patients with severe systolic LV dysfunction, it is unclear if presence of scar further impacts survival. We sought to determine if presence of LV scar further risk-stratifies patients with severe LV dysfunction. Methods: We studied 199 consecutive patients with LV systolic dysfunction who underwent DHE-MRI (Siemens 1.5 T scanner, Erlangen, Germany) from 2005– 6. The percentage of myocardial scar was determined semi-quantitatively on DHE-MR images, in a standard 17-segment model using custom software (Siemens Research), and defined as intensity &gt;2 standard deviation above viable myocardium. Transmurality score was recorded in all segments as follows: 0 = no scar, 1 = 1–25% scar, 2 = 26 –50 %, 3 = 51–75% and 4 = &gt; 75%. Global LV scar burden was calculated as total transmurality score for all segments/17. LV ejection fraction (EF) and end-diastolic diameter (EDD) were recorded from echocardiography. Presence of coronary artery disease (CAD) and all-cause mortality were recorded. Results: In a median follow up of 1.6 years [1, 1.9], 26 (13 %) patients died. Characteristics of survivors vs. non-survivors are detailed in Table . Survival in patients with any amount of LV scar had significantly worse 1-year survival compared to those without (log-rank p = 0.03). Median global LV scar burden was 1.8 [1, 2.5]. On receiver operating characteristic curve analysis, global scar burden &gt; 1.8 was predictive of death (area under curve 0.61, p = 0.05). Patients with scar burden &gt; 1.8 also had significantly worse 1-year survival compared to those with scar burden ≤ 1.8 (log rank p = 0.03). Conclusions: In patients with severe systolic LV dysfunction, higher LV myocardial scar burden, detected on DHE-MRI is associated with worse survival, despite similar LVEF, LVEDD, and prevalence of CAD. Table
The role of second line chemotherapy in small cell lung cancer: A retrospective analysis
Authors: Efimia Boutsikou, Paul Zarogoulidis, Kostas Porpodis, Dimitris Latsios, Maria Kipourou, Kostas Zarogoulidis
Journal: European Respiratory Journal (2013)

PURPOSE: To evaluate the benefit of second line chemotherapy with platinum based treatment in patients with recurrent small cell lung cancer (SCLC).  PATIENTS AND METHODS: 764 patients first diagnosed with SCLC received first-line platinum based chemotherapy for a maximum of six cycles. 535 patients continued with follow up or best supportive care (BSC) if needed and 229 patients who progressed after the completion of first line chemotherapy were treated with second line chemotherapy at the time of progression: 103/229 patients received paclitaxel 190mg/m2 and carboplatin 5.5AUC(PC) while 126/229 patients received etoposide 200 mg/m2 and carboplatin 5.5 AUC(EC) every 28 days.  RESULTS: Patients administered second-line chemotherapy lived significantly longer with median survival 422 days compared to 228 days in patients with BSC only (P  CONCLUSION: Patients administered new generation second-line chemotherapy had significantly longer survival than patients administered BSC. Continuation with carboplatin/paclitaxel or carboplatin/etoposide as second line chemotherapy has no significant survival impact and did not improve responses rates. Sensitivity to front line treatment is a prognostic factor to OS in SCLC patients.
EFFECT OF THE LESION DUE TO INFLUENZA VIRUS ON THE RESISTANCE OF MICE TO INHALED PNEUMOCOCCI
Authors: Carl G. Harford, Virginia Leidler, Mary Hara
Journal: The Journal of Experimental Medicine (1949)

1. The normal lung of the mouse possesses the power of reducing markedly its content of Type I pneumococci within 3 hours after inhalation of the organisms in the form of fine droplets. 2. Lungs with fully developed influenza viral pneumonia not only fail to reduce the pulmonary content of pneumococci administered in this manner but, on the contrary, support their growth. 3. After intrabronchial inoculation into mice, influenza virus multiplies rapidly in the lung within 24 hours. 4. Criteria have been established for distinction between true viral lesions of the lung and changes due to the inoculation of diluents as vehicles for the virus. 5. 24 hours after inoculation of virus, there are no macroscopic lesions in the lung and the microscopic changes are due to the diluent. 6. Presence and multiplication of the virus in the lung 24 hours after inoculation have no apparent effect on the power of the lung to reduce rapidly its content of inhaled pneumococci. 7. The effect of the virus in lowering resistance to secondary bacterial infection appears to be due to the presence of the lesion produced by the virus.
Randomized trial of hepatic arterial floxuridine, mitomycin, and carmustine versus floxuridine alone in previously treated patients with liver metastases from colorectal cancer.
Authors: N Kemeny, A Cohen, K Seiter, J A Conti, E R Sigurdson, Y Tao, D Niedzwiecki, J Botet, A Budd
Journal: Journal of Clinical Oncology (1993)

PURPOSE This study was designed to determine if hepatic arterial therapy with floxuridine (F), mitomycin, and carmustine (BCNU) (FMB) is superior to hepatic arterial therapy with F alone in previously treated patients with hepatic metastases from colorectal cancer. PATIENTS AND METHODS Ninety-five patients were randomized to intrahepatic FMB versus intrahepatic F. All patients had tumor progression after systemic chemotherapy (either therapeutic or adjuvant). RESULTS There was no significant difference in response rate (47% FMB v 33% F; P = .17). Median survival was similar in the two groups, 19.1 months for the FMB group compared with 14.0 months for the F group (P = .23). The overall median survival was 16.8 months. In patients who received prior adjuvant therapy, there was no difference between the two groups, but response rate was high in both (50% FMB v 62% F). The response rate for all patients who had received only prior adjuvant therapy versus all those who had received prior therapy for metastatic disease was 57% and 35%, respectively (P = .066). In the subset of patients whose disease had progressed with prior systemic chemotherapy, the response rate to FMB was greater than that to F (47% v 23%; P = .035). CONCLUSION The overall partial response rate of 39% and the overall survival of 16.8 months from initiation of intrahepatitis therapy show that hepatic arterial therapy is a reasonable treatment option for patients whose tumor does not respond to systemic therapy or whose disease progresses after adjuvant therapy for colorectal cancer.
The Mildly Abnormal Cervical Smear: Patient Anxiety and Choice of Management
Authors: M H Jones, A Singer, D Jenkins
Journal: Journal of the Royal Society of Medicine (1996)

Argument continues over the best management of women with a first mildly dyskaryotic cervical smear: should they be referred for prompt colposcopy, or should they be kept under cytological review, with recourse to colposcopy if the abnormality persists? One consideration is the amount of anxiety generated. We measured anxiety, retrospectively, in two groups of women who had been managed by one or other method. Colposcopy caused more anxiety than cytological surveillance. When told that their smear was mildly abnormal, 47% of the immediate-colposcopy group (n = 182), compared with 33% of the surveillance group (n = 163), thought they had cancer. None the less, there was a general preference for immediate colposcopy. Whatever the relative merits of these two strategies for clinical management, it is clear that both forms of screening, and especially colposcopy, demand better information for patients.
Exhaled nitric oxide and lung function in winter sports elite athletes
Authors: Samira Gasymova, Alexandr Ulianov, Lydia Nikitina, Fedor Petrovskiy
Journal: European Respiratory Journal (2011)

Background:  Little is known about the role of nitric oxide (NO) in pathogenesis of exercise-induced bronchoconstriction and its association with lung function in athletes.   Aim:  The aim of the study was to investigate whether airway NO is associated with lung function in elite athletes of winter sports.   Methods:  A total of 86 elite athletes (biathlon, ski, ice hockey, snowboard) aged 14–35 were included in the study. FEV1, FVC, PEF (MasterScreen Pneumo, Viasys) were analyzed at the baseline and 1, 5, and 10 minutes after the exercise challenge test. NO was measured in the exhaled air (fractional exhaled NO (FeNO)) pre and between 1 and 5 min after the exercise using CLD 88 apparatus (EcoMedics). All tests were performed according to ATS/ERS recommendations before the competition phase.   Results:  21% of athletes had a post exercise decrease in FEV1 of ≥ 10%. Baseline and post exercise FeNO levels were 15.1 ppb and 14.5 ppb, respectively. Most athletes had a post exercise decrease in FeNO (63.6% in males and 72.7% females). In athletes with the decreased post exercise FeNO level, the mean change was -26.8% from the baseline, in contrast to +70% increase in those who had a post exercise FeNO level unchanged or increased (p   Conclusion:  The present data suggest a role of airway NO in lung function and in exercise induced bronchoconstriction in elite athletes.
POU2F2-oriented network promotes human gastric cancer metastasis
Authors: Si-Meng Wang, Jun Tie, Wen-Lan Wang, Si-Jun Hu, Ji-Peng Yin, Xiao-Fang Yi, Zu-Hong Tian, Xiang-Yuan Zhang, Meng-Bin Li, Zeng-Shan Li, Yong-Zhan Nie, Kai-Chun Wu, Dai-Ming Fan
Journal: Gut (2015)

Aberrant upregulation of POU2F2 expression has been discovered in metastatic gastric cancer (GC). However, the mechanisms underlying the aberrant upregulation and the potential functions of POU2F2 remain uncertain.The role and mechanism of POU2F2 in GC metastasis were investigated in gastric epithelial cells, GC cell lines and an experimental metastasis animal model by gain of function and loss of function. Upstream and downstream targets of POU2F2 were selected by bioinformatics and identified by luciferase reporter assay, electrophoretic mobility shift assay and chromatin immunoprecipitation PCR. The influence of miR-218 on its putative target genes (POU2F2, ROBO1 and IKK-β) and GC metastasis was further explored via in vitro and in vivo approaches.Increased POU2F2 expression was detected in metastatic GC cell lines and patient samples. POU2F2 was induced by the activation of nuclear factor (NF)-κB and, in turn, regulated ROBO1 transcription, thus functionally contributing to GC metastasis. Finally, miR-218 was found to suppress GC metastasis by simultaneously mediating multiple molecules in the POU2F2-oriented network.This study demonstrated that NF-κB and the SLIT2/ROBO1 interaction network with POU2F2 as the central part may exert critical effects on tumour metastasis. Blocking the activation of the POU2F2-oriented metastasis network using miR-218 precursors exemplified a promising approach that sheds light on new strategies for GC treatment.
Mutation in the V2 vasopressin receptor gene, AVPR2, causes nephrogenic syndrome of inappropriate diuresis
Authors: László S. Erdélyi, W. Alexander Mann, Deborah J. Morris-Rosendahl, Ute Groß, Mato Nagel, Péter Várnai, András Balla, László Hunyady
Journal: Kidney International (2015)

Nephrogenic syndrome of inappropriate antidiuresis (NSIAD) is a recently discovered rare disease caused by gain-of-function mutations of the V2 vasopressin receptor gene, AVPR2. To date, mutations of Phe229 and Arg137 have been identified as gain-of-function in the V2 vasopressin receptor (V2R). These receptor mutations lead to hyponatremia, which may lead to clinical symptoms in infants. Here we present a newly identified I130N substitution in exon 2 of the V2R gene in a family, causing NSIAD. This I130N mutation resulted in constitutive activity of the V2R with constitutive cyclic adenosine monophosphate (cAMP) generation in HEK293 cells. This basal activity could be blocked by the inverse agonist tolvaptan and arginine-vasopressin stimulation enhanced the cAMP production of I130N-V2R. The mutation causes a biased receptor conformation as the basal cAMP generation activity of I130N does not lead to interaction with β-arrestin. The constitutive activity of the mutant receptor caused constitutive dynamin-dependent and β-arrestin-independent internalization. The inhibition of basal internalization using dominant-negative dynamin resulted in an increased cell surface expression. In contrast to the constitutive internalization, agonist-induced endocytosis was β-arrestin dependent. Thus, tolvaptan could be used for treatment of hyponatremia in patients with NSIAD who carry the I130N-V2R mutation.
The effect of SLIT on asthma symptoms at different pediatric age ranges
Authors: Francesca Occasi, Giovanna De Castro, Gisele Castagna, Taulant Melengu, Annalisa di Coste, Paola Pansa, Marzia Duse
Journal: European Respiratory Journal (2013)

Background: Sublingual Specific Immunotherapy (SLIT) is considered a disease-modifying treatment for allergic asthma.  Objective: to compare the effect of SLIT in children of different age ranges on asthmic symptoms.  Method: Fifty children (29 boys;58%), aged between 6 and 14 years, with a clinical history of allergic asthma underwent SLIT for 3 years: 23(46%) for House Dust Mite and 27(54%) for Grass Mix. Sensitizations were assessed by Skin Prick Tests and serum specific IgE. We divided children into two age groups: 27 patients (54%) aged ≤10 years and 23 (46%) aged >10 years of life. Severity and frequency of bronchial symptoms were evaluated at the baseline (T0) and at the end (T3) of the treatment by an Asthma Symptom Score (ASS): a score of 1 was assigned to mild symptoms, 2 to moderate and 3 to severe. For each children the difference between the ASS at T0 and at T3 was considered as Δ asthma score (ΔAS).  Results: A decrease of ASS for both the age ranges was observed since the first year of treatment. Among different age ranges although its reduction over time did not show any statistically significant difference (p>0.05), there was a significant difference in ΔAS which was higher in children aged >10 years than the younger ones (children aged years >10 mean= 3.85; children aged ≤10 years mean=2.11; p  Conclusion: SLIT is effective in determining a significant reduction of bronchial symptoms in pediatric patients at different age ranges. The reduction of symptoms seems to be more in children aged >10 years.
Neutrophil elastase gene polymorphisms as therapy modulators in childhood bronchiectasis
Authors: Katarina Milosevic, Srdjan Boskovic, Mila Ljujic, Branimir Nestorovic, Aleksandra Nikolic
Journal: European Respiratory Journal (2013)

Bronchiectasis is a chronic pulmonary disease characterized by irreversibly dilated bronchi, bacterial colonization and inflammation dominated by neutrophils. Neutrophil elastase (NE) contributes significantly to the pathogenesis of the disease and may affect response to therapy due to interaction with commonly used agents, macrolide antibiotics and corticosteroids. The aim of this study was to investigate NE gene promoter polymorphisms as potential modulators of therapeutical response in children with idiopathic bronchiectasis. The study has encompassed 48 children (19 boys and 29 girls) aged between 5 and 17 years, diagnosed with idiopathic bronchiectasis based on clinical findings and high-resolution computed tomography (HRCT). In all patients therapy included administration of antibiotics, anti-inflammatory drugs, expectorants and postural drainage. The choice of therapy was based on clinical and microbiology findings, while response to therapy was evaluated based on change in exhaled NO levels after therapy administration. The NE gene promoter was analyzed by PCR combined with direct DNA sequencing. According to the predicted NE activity based on the polymorphisms present, patients were classified in two groups: high (−903TT/−741GG) which included 30 patients, and low/intermediate (−903TG, −903TT/−741AG and −903TT/−741AA), which included 18 patients. The main finding of this study was that children with high NE activity genotype responded better to therapy than children with low/intermediate activity genotypes (r=0.350; p=0,015). In spite of relatively small study sample, this finding deserves further investigation in a larger cohort of patients and in other pulmonary diseases.
The UK Standardisation of Breast Radiotherapy (START) Trial B of radiotherapy hypofractionation for treatment of early breast cancer: a randomised trial
Authors: Bentzen Sm, Agrawal Rk, Aird Eg, Barrett Jm, Barrett-Lee Pj, Bliss Jm, Brown J, Dewar Ja, Dobbs Hj, Haviland Js, Hoskin Pj, Hopwood P, Lawton Pa, Magee Bj, Mills J, Morgan Da, Owen, Simmons S, Sumo G, Sydenham Ma, Venables K, Yarnold
Journal: The Lancet (2008)