tbuckley/cabot-search huggingface dataset:
Association between control of rhinitis and control of asthma as assessed by validated questionnaires
Authors: Silviya Novakova, Nonka Mateva, Vasil Dimitrov, Todor Popov
Journal: European Respiratory Journal (2014)

Background.  The connection and interplay between upper and lower airways have long been established and have served as basis for the “Allergy Rhinitis and its Impact on Asthma” /ARIA/ global guideline. Control is considered the most important indicator of adequate management of both diseases and questionnaires have been developed as simple tools to assess it.   The aim  of our study was to explore the concordance between asthma control and rhinitis control in a random population of patients with both asthma and rhinitis by means of internationally recognized questionnaires for control validated in Bulgarian language.   Methods.  35 patients, [mean age 33, range 12 - 63 years], with rhinitis and asthma were recruited for the study. The level of asthma control was assessed by the Asthma Control Questionnaire (ACQ) and that of rhinitis control by theRhinitis Control Assessment Test (RCAT) recently validated in Bulgarian language.   Results.  Out of the 25 patients with controlled asthma. 21 (84, 0%) were with controlled rhinitis, while out of the 10 uncontrolled asthmatics 9 (90, 0%) were with uncontrolled rhinitis. The discordant results were 4 patients with uncontrolled rhinitis in the controlled asthma group and 1 patient with controlled rhinitis in the uncontrolled asthma group. There was a highly significant inverse correlation between the ACQ and RCAT 1: R=-0.64, P   Conclusion.  Control of asthma and control of rhinitis were highly concordant in a random population of patients with both diseases. The relatively higher number of discordant cases of uncontrolled rhinitis among controlled asthmatics reemphasizes the need to actively seek and treat nasal symptoms in asthma patients.
Predictors of Plaque Rupture Within Nonculprit Fibroatheromas in Patients With Acute Coronary Syndromes
Authors: Bo Zheng, Gary S. Mintz, John A. McPherson, Bernard De Bruyne, Naim Z. Farhat, Steven P. Marso, Patrick W. Serruys, Gregg W. Stone, Akiko Maehara
Journal: JACC. Cardiovascular imaging (2015)
Abstract 4532: Benefits of Strength Training and Supervised Treadmill Exercise on Walking Performance for Persons with Peripheral Arterial Disease with and without Intermittent Claudication Symptoms
Authors: Mary M McDermott, Alan Dyer, Kiang Liu, Jack M Guralnik, Philip Ades, Luigi Ferrucci, Miriam Nelson, Donald Llyod-Jones, William H Pearce, Linda Van Horn, Michael H Criqui
Journal: Circulation (2008)

Most men and women with lower extremity peripheral arterial disease (PAD) do not have classic symptoms of intermittent claudication (IC). We assessed the ability of supervised treadmill walking exercise and lower extremity resistance training to improve walking performance, quality of life, and brachial arterial flow-mediated dilation (FMD) in PAD persons with and without symptoms of IC. The study design was a randomized controlled clinical trial. One-hundred fifty participants with ankle brachial index (ABI) &lt; 0.95 were randomized to one of three arms for 6 months: a) supervised treadmill exercise; b) supervised lower extremity resistance training; c) control condition. Outcomes were six-month change in the six-minute walk test, maximal treadmill walking performance, brachial arterial FMD, and the quality-of-life outcome measures of the Walking Impairment Questionnaire (WIQ) scores and the Short-Form 36 Physical Functioning score. The average age of study participants was 70.6 + 10.3, the average ABI was 0.60 + 0.20, and 52% were women. One hundred thirty-six (91%) participants completed follow-up. Results are shown in the Table . Findings were similar when analyses were restricted to participants without IC. This study demonstrates, for the first time, that both aerobic and resistance exercise interventions improve treadmill walking performance and WIQ scores in PAD persons with and without classic symptoms of IC. Supervised treadmill exercise additionally improves six-minute walk performance and brachial arterial FMD in PAD participants with and without IC. TABLE. Change in outcomes at six month follow-up by group assignment.
Abstract IA11: Using genomics to study preexisting resistance
Authors: Elaine R. Mardis
Journal: Clinical Cancer Research (2015)

Abstract High depth sequencing with next-generation technology permits the examination of tumor-derived DNA for evidence of pre-existing, therapy resistance-conferring alterations. Several technical challenges must be addressed to overcome the inherent limitations of assays from pre-treatment biopsies. Specific computational tools are required for accurate assessment of therapy-related alterations and changes in tumor heterogeneity. Approaches that address the assay-related difficulties and the computational analyses required for these analyses will be illustrated by several examples from our studies. Citation Format: Elaine R. Mardis. Using genomics to study preexisting resistance. [abstract]. In: Proceedings of the AACR Precision Medicine Series: Drug Sensitivity and Resistance: Improving Cancer Therapy; Jun 18-21, 2014; Orlando, FL. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(4 Suppl): Abstract nr IA11.
The treatment of acne fulminans: a review of 25 cases
Authors: None Seukeran, None Cunliffe
Journal: British Journal of Dermatology (1999)

The treatment of acne fulminans has been difficult. It is difficult to perform a controlled treatment trial due to the rarity of the complication. However, it is possible to compare four different therapeutic regimens which have evolved with time in the management of 25 patients over a period of 25 years. Oral antibiotics produced a slow response in the resolution of acne and systemic symptoms. The addition of a systemic steroid produced a quick resolution of systemic features, but the time until resolution of the acne was longer than when it was used in combination with oral isotretinoin. The protocols which used a combination of prednisolone and isotretinoin led to faster control of systemic features as well as clearance of acne when compared with other protocols. This was particularly so if the oral steroid was used sooner rather than later. We conclude that the preferred treatment of acne fulminans is oral prednisolone 0.5-1 mg/kg daily for 4-6 weeks (thereafter slowly reduced to zero) with oral isotretinoin being added to the regimen at the fourth week, initially at 0.5 mg/kg daily and gradually increased to achieve complete clearance.
A frequent hypofunctional IRAK2 variant is associated with reduced spontaneous hepatitis C virus clearance
Authors: Hui Wang, Souhayla El Maadidi, Janett Fischer, Elena Grabski, Sabine Dickhöfer, Sascha Klimosch, Sinead M. Flannery, Angela Filomena, Olaf‐Oliver Wolz, Nicole Schneiderhan‐Marra, Markus W. Löffler, Manfred Wiese, Tica Pichulik, Beat Müllhaupt, David Semela, Jean‐François Dufour, Pierre‐Yves Bochud, Andrew G. Bowie, Ulrich Kalinke, Thomas Berg, Alexander N.R. Weber
Journal: Hepatology (2015)

Patients carrying very rare loss‐of‐function mutations in interleukin‐1 receptor–associated kinase 4 ( IRAK4 ), a critical signaling mediator in Toll‐like receptor signaling, are severely immunodeficient, highlighting the paramount role of IRAK kinases in innate immunity. We discovered a comparatively frequent coding variant of the enigmatic human IRAK2 , L392V (rs3844283), which is found homozygously in ∼15% of Caucasians, to be associated with a reduced ability to induce interferon‐alpha in primary human plasmacytoid dendritic cells in response to hepatitis C virus (HCV). Cytokine production in response to purified Toll‐like receptor agonists was also impaired. Additionally, rs3844283 was epidemiologically associated with a chronic course of HCV infection in two independent HCV cohorts and emerged as an independent predictor of chronic HCV disease. Mechanistically, IRAK2 L392V showed intact binding to, but impaired ubiquitination of, tumor necrosis factor receptor–associated factor 6, a vital step in signal transduction. Conclusion : Our study highlights IRAK2 and its genetic variants as critical factors and potentially novel biomarkers for human antiviral innate immunity. (H epatology 2015;62:1375–1387)
Abstract P397: Circulating Species of Matrix Gla Protein and the Risk of Vascular Calcification in Healthy Women
Authors: Gerdien Dalmeijer, Yvonne van der Schouw, Elke Magdeleyns, Cees Vermeer, Birgitta Velthuis, Pim de Jong, Joline Beulens
Journal: Circulation (2013)

Background: Matrix Gla protein (MGP) is an inhibitor of vascular calcification that requires vitamin K for its carboxylation. Circulating MGP occurs as various species with different conformations depending on carboxylation and phosphorylation. Total uncarboxylated MGP (t-ucMGP) is the sum of non-phosphorylated and phosphorylated uncarboxylated MGP (dp-ucMGP and p[[Unable to Display Character: &amp;#8209;]]ucMGP) and mainly consists of p-ucMGP. Due to its phosphorylated group p-ucMGP has a strong calcium-binding capacity irrespective of the Gla content. In high risk populations, high levels of t[[Unable to Display Character: &amp;#8209;]]ucMGP were associated with decreased calcification, while high levels dp-ucMGP were associated with low vitamin K status and increased vascular calcification. These relations have never been investigated in a healthy population. Objective: This prospective study investigates the association between circulating matrix Gla protein species and vascular calcifications among postmenopausal women. Design: In a prospective cohort of 571 healthy women, MGP levels were measured by ELISA techniques at baseline. Vitamin K intake was estimated from a validated food frequency questionnaire. Calcification was measured in the coronary arteries, aortic valve, mitral valve, and aortic arch by multi-detector computed tomography after 8.5 years follow-up. Coronary artery calcification (CAC) was defined present if Agatston score was ≥10 and the calcification score was calculated as the sum of the calcified areas. Multivariate adjusted relative risks (RR) and odds ratios (OR) were estimated using modified Poisson regression and multinomial logistic regression per standard deviation of MGP species and the no calcification group was used as reference. Results: Of the women, 24% had no calcification while 5% had calcification in all areas. High dp-ucMGP levels, reflecting poor vitamin K status, were (p=0.08) associated with more CAC (RR SD 1.07;95%CI 0.99-1.15) and calcification areas (OR (4 areas vs no calcification) 1.49; 95%CI 0.95-2.35, p=0.09). High t-ucMGP levels were associated with less calcification (OR (4 areas vs no calcification) 0.63; 95%CI 0.36-1.10, p=0.10). Desphospho-carboxylated MGP was not associated with calcification. High phylloquinone intake was not associated with the number of calcified areas OR (4 areas vs no calcification) 1.14 (95%CI: 0.72-1.81, p=0.57). In contrast, higher menaquinones intake was associated with less calcification areas (OR (4 areas vs no calcification) 0.39; 95%CI: 0.21-0.74, p=0.004). Conclusion: High dp-ucMGP levels, reflecting a poor vitamin K status, may be associated with more calcification, also in a healthy population. High menaquinones intake was associated with less calcification. Consistent with high-risk populations, high t-ucMGP levels seem to associated with fewer calcification areas.
On Insight and Psychosis: Discussion Paper
Authors: Anthony S David
Journal: Journal of the Royal Society of Medicine (1990)

The concept of insight into psychosis has received scant attention in the psychiatric literature. Various types of insight are described after drawing on such sources as phenomenology, clinical observation and experimental psychology. It is proposed that insight is far from an all or none phenomenon but comprises three overlapping dimensions, namely, the recognition that one has a mental illness, compliance with treatment and the ability to re-label unusual mental events (delusions and hallucinations) as pathological.
High dose fluticasone propionate, 1 mg daily, versus fluticasone propionate, 2 mg daily, or budesonide, 1.6 mg daily, in patients with chronic severe asthma. International Study Group
Authors: JG Ayres, ED Bateman, B Lundback, TA Harris
Journal: European Respiratory Journal (1995)

Airway inflammation is now regarded as fundamental in the pathogenesis of asthma and treatment with inhaled corticosteroids has proved effective. There is a need for drugs in this category with higher topical potency but fewer side-effects than those presently available. A double-blind, parallel group study was conducted in 671 patients with severe asthma (already taking between 0.8-2.0 mg of inhaled corticosteroid daily) to compare the safety and efficacy of 6 weeks of treatment with inhaled fluticasone propionate (FP), 1 mg daily, to fluticasone propionate, 2 mg daily, and budesonide (BUD), 1.6 mg daily, delivered via a metered-dose inhaler. Peak expiratory flow (PEF), asthma symptoms, and usage of rescue medication were recorded daily by the patient. At each clinic visit (-2, 0, 3 and 6 weeks) morning serum cortisol levels, bone markers and spirometry were assessed. The changes in mean morning PEF from baseline (weeks 1-6) were: FP 2 mg daily +24 l.min-1; FP 1 mg daily +21 l.min-1; BUD 1.6 mg daily +13 l.min-1. A similar rank order for the three treatments was seen for evening PEF, clinic spirometry, reduction of diurnal PEF variation, symptom scores, and requirement for rescue bronchodilators. The mean serum cortisol levels remained well within the normal range in all three groups. Analysis of the geometric mean cortisol ratio (treatment/baseline ratio after 6 weeks treatment) showed a changed rank order, the values being: FP 1 mg daily 1.04; BUD 1.6 mg daily 0.97; FP 2 mg daily 0.88.(ABSTRACT TRUNCATED AT 250 WORDS)
Outpatient management of primary spontaneous pneumothorax using small-bore catheter: A prospective study
Authors: Massongo Massongo, Bachar Chahine, Charles Hugo Marquette, Arnaud Scherpereel
Journal: European Respiratory Journal (2011)

The various guidelines published about the management of primary spontaneous pneumothorax (PSP), have raised up discrepancies regarding indications and methods of air-removal.  We aimed to assess the feasibility of a single system small-bore drain based management. Primary end-point was 1-week success rate, secondary ones were the part of full outpatient management, the 1-year recurrence rate, the length of hospitalization stay, the cost and the side-effects.  All patients aged ≥ 16 years with 1st episode of PSP, were managed in the emergency room (ER) by observation alone or insertion of an 8.5 F “pigtail” drain, according to PSP volume and clinical tolerance. The drain was connected to a one-way Heimlich valve. Patients were re-assessed at the 4th hour for potential admission or discharge. Patients still having air leak at day-4 were referred for video-assisted thoracoscopy (VATS).  On the 60 patients recruited, 80% underwent drainage and 60% were discharged after 4 hours. Success rate was 83% at day-7, the 17% left underwent a VATS. Fifty per cent of the patients benefited from strict outpatient management and 2 procedure-related complications occurred. The mean length of hospitalization was 2.3±3.1 days, the 1-year recurrence rate was 17%. The financial gain of this PSP management was 1,791 to 3,940 Euros/patient/episode, compared with manual aspiration (MA) or conventional chest tube drainage (CTD).  This one-system management offers good efficacy, safety, comfort and aesthetics; it is time and cost-effective. Our results suggest its use in a larger population, but a randomised controlled study comparing it with MA and/or CTD is needed for validation.
On relationship between local and systemic chronic inflammation and between level of hypoxia and bronchial obstruction in COPD pts
Authors: Bogdana Basina, Tetyana Pertseva, Lyudmyla Konopkina
Journal: European Respiratory Journal (2013)

In the literature, there are conflicting data on the relationship between local and systemic chronic inflammation and between level of hypoxia and bronchial obstruction in COPD pts.   Aim : to establish the relationship between markers of local and systemic chronic inflammation, as the level of hypoxia and bronchial obstruction in COPD pts.   Materials and methods . We studied 15 COPD pts (II-III st.) in stable phase (age–64.2±3,7yrs). Measurements included clinical status, spirometry (post-dose of salbutamol), SaO 2 , nitric oxide in exhaled air (NO ex ), plasma level of matrix metalloproteinases (MMP)-2 and 9.   Results  are presented in the Table.   Conclusion : FEV 1  levels didn’t correlate with the level of NO ex , which characterizes the severity of local inflammation in the respiratory tract.  COPD pts due to SaO 2  not differ from each other.  MMP-2 had an inverse correlation (average power) with FEV 1  level. MMP-9 did not correlate with the level of bronchial obstruction.  Level of NO ex  had relatively well correlated with SaO 2 , didn’t correlate with MMP-2 and very strong correlated with plasma level of MMP-9.   Conclusion : 1) the degree of bronchial obstruction does not reflect processes of oxygen tension; 2) the degree of local inflammation is an independent characteristic of COPD and can be used for verification of the phenotypes of the disease (with severe chronic local inflammation or without chronic local inflammation); 3) some markers of systemic inflammation may reflect a certain degree of local inflammation (in particular MMP-9).
William Menzies Clow
Authors: M. E. C. D. J. C. J. A. K. D. M. R. Howells
Journal: BMJ (2015)

<h3>Background</h3> Mutations in <i>TRPV4</i>, a gene that encodes a Ca<sup>2+</sup> permeable non-selective cation channel, have recently been found in a spectrum of skeletal dysplasias that includes brachyolmia, spondylometaphyseal dysplasia, Kozlowski type (SMDK) and metatropic dysplasia (MD). Only a total of seven missense mutations were detected, however. The full spectrum of <i>TRPV4</i> mutations and their phenotypes remained unclear. <h3>Objectives and methods</h3> To examine <i>TRPV4</i> mutation spectrum and phenotype−genotype association, we searched for <i>TRPV4</i> mutations by PCR-direct sequencing from genomic DNA in 22 MD and 20 SMDK probands. <h3>Results</h3> <i>TRPV4</i> mutations were found in all but one MD subject. In total, 19 different heterozygous mutations were identified in 41 subjects; two were recurrent and 17 were novel. In MD, a recurrent P799L mutation was identified in nine subjects, as well as 10 novel mutations including F471del, the first deletion mutation of <i>TRPV4</i>. In SMDK, a recurrent R594H mutation was identified in 12 subjects and seven novel mutations. An association between the position of mutations and the disease phenotype was also observed. Thus, P799 in exon 15 is a hot codon for MD mutations, as four different amino acid substitutions have been observed at this codon; while R594 in exon 11 is a hotspot for SMDK mutations. <h3>Conclusion</h3> The <i>TRPV4</i> mutation spectrum in MD and SMDK, which showed genotype−phenotype correlation and potential functional significance of mutations that are non-randomly distributed over the gene, was presented in this study. The results would help diagnostic laboratories establish efficient screening strategies for genetic diagnosis of the <i>TRPV4</i> dysplasia family diseases.
Cardiovascular mortality following short-term androgen deprivation in clinically localized prostate cancer: An analysis of RTOG 94-08.
Authors: Jason Alexander Efstathiou, Rebecca Paulus, Matthew R. Smith, Christopher U. Jones, Mark H. Leibenhaut, Siraj M. Husain, Marvin Rotman, Luis Souhami, Howard Mark Sandler, William U. Shipley
Journal: Journal of Clinical Oncology (2012)

18 Background: Androgen deprivation therapy (ADT) is associated with greater risk of diabetes and coronary heart disease in men with prostate cancer but there is significant controversy surrounding its potential impact on cardiovascular mortality especially among men with lower rates of cancer-specific death. We assessed the relationship between ADT and mortality in a large randomized trial of men treated with or without short-course ADT and radiation therapy (RT) for clinically-localized prostate cancer. Methods: Between 1994-2001, 1979 eligible men (median age 71) with clinically-localized (T1-2, PSA&lt;20) prostate cancer were enrolled on a phase III trial (RTOG 94-08) and randomized to RT and 4 months of neoadjuvant/concurrent ADT or RT alone. Fine-Gray proportional hazards model was used to evaluate the relationship between treatment arm and mortality (disease-specific and cardiovascular). Covariates included PSA, Gleason score, T-stage, age, race, weight, prevalent cardiovascular disease (CVD), diabetes (DM), and hypertension. Results: After a median follow-up of 8.2 years, use of ADT improved overall and disease-specific survival but there was no ADT-related increase in cardiovascular mortality or non-prostate cancer death. There were a total of 191 cardiovascular-related deaths. At 10-years, cardiovascular mortality for men treated with RT+ADT was 9.8% vs 10.7% for men treated with RT alone. In multivariate analyses, treatment arm was not significantly associated with an increased risk of cardiovascular mortality [adjusted hazard ratio (HR)=0.93, 95% confidence interval (CI) 0.69-1.26, p=0.64]. Traditional cardiac risk factors, including prevalent CVD and DM, were significantly associated with greater cardiovascular mortality. Results were similar when limiting analyses to patient subsets at high risk for cardiovascular mortality and at low risk for disease-specific mortality. Conclusions: Use of short-course ADT improves overall and disease-specific survival but does not appear to increase cardiovascular mortality in men with clinically-localized prostate cancer. Supported by RTOG grant U10 CA21661 and CCOP grant U10 CA37422 from NCI.
Diagnosis of abdominal tuberculosis * Authors' reply
Authors: M. Petrou, V. Vassiliou, S Rai, W M Thomas
Journal: Journal of the Royal Society of Medicine (2004)

We agree with the argument presented by Mr Rai and Mr Thomas (December 2003 JRSM1) for earlier use of diagnostic laparoscopy in suspected abdominal tuberculosis (TB). However, even in the hands of experienced operators the risk is not negligible (though under 1%). The complications, apart from those of general anaesthesia, include damage to blood vessels, bowel and bladder. In Rai and Thomas's series, seemingly, a polymerase chain reaction (PCR) test was not used on the 11 ascitic fluids when acid-fast bacilli were not found. A positive result might have avoided the need for laparoscopy;2,3 furthermore, PCR can help to distinguish Mycobacterium tuberculosis from M. avium in immunocompromised patients.3

In addition, although in 9 of 28 patients ultrasound showed evidence of TB, it seems that fine needle aspiration was not attempted in those with lymph node abnormalities, or colonoscopy in those with an ileocaecal mass. An ultrasound-guided biopsy4 or colonoscopy5 is indicated in the presence of lymphadenopathy, abscess or a focal lesion in the viscera. Finally, Rai and Thomas refer to low haemoglobin and raised C-reactive protein as a consistent feature but say nothing about Ca-125, which can be high in abdominal tuberculosis.6

In our opinion, diagnostic laparoscopy should be used only when less invasive investigations yield no positive results.