tbuckley/cabot-search huggingface dataset:
Low oxygen saturation and mortality in an adult population
Authors: Monica Linea Vold, Ulf Aasebø, Tom Wilsgaard, Hasse Melbye
Journal: European Respiratory Journal (2013)

Background:  Low oxygen saturation measured by pulse oximetry(SpO2) has been shown to predict mortality in emergency care, and in patients with lung diseases.  Aims and objectives:  We wanted to see whether low SpO2 values are associated with mortality in a general adult population.  Methods:  Pulse oximetry was carried out in 5152 participants in a cross-sectional survey in Tromso, Norway, in 2001/2002. Follow-up for all-cause mortality until 31.12.2010 were linked to the National Population Register. The SpO2 categories ≤92% and 93-95% were assessed as predictors of mortality in Cox Proportional Hazard regression models correcting for age, sex, smoking and self-reported cardiovascular disease(CVD). Further analysis also included body mass index(BMI), C-reactive protein(CRP) and forced expiratory volume in 1 s(FEV1)% predicted.  Results:  Mean age was 65.8 years, 56% were women, SpO2≤92% and 93-95% were recorded in 53(1.0%) and 537(10.4%) individuals, respectively. During follow-up, 910(17.7%) died. The adjusted Hazard Ratio(HR) was 1.31(p 95%). By adding BMI, CRP and FEV1% predicted as covariates in the model HR for 93-95% was 1.14(p=0.17) and for ≤92% 1.56(p  Conclusion:  We found that low oxygen saturation is associated with mortality. When including FEV1% predicted in the analysis the strength of the association weakens and is only statistically significant for SpO2≤92%.
Abstract 5688: HMGB1 is a Novel Substrate of Dypeptidyl Peptidase IV
Authors: Carlo Marchetti, Raimondo De Cristofaro, David Mocini, Fabiola Olivieri, Maurizio Marra, Anna Rita Bonfigli, Federica Limana, Maurizio C. Capogrossi, Antonia Germani
Journal: Circulation (2009)

Introduction: High Mobility Group Box 1 (HMGB1) is a cytokine with a key role in tissue regeneration and angiogenesis. HMGB1 levels are reduced in diabetic skin and topical application of HMGB1 to skin wounds of diabetic mice enhanced vessel density and accelerated wound healing, suggesting that diabetes may affect endogenous HMGB1 functions. CD26 is a protease which selectively removes the N-terminal X-Pro or X-Ala containing motifs from a number of chemokines modulating their activity. High levels of CD26 have been detected in plasma of type II diabetic patients and its inhibition has proved effective in the treatment of diabetes. Since HMGB1 contains potential CD26 cleavage sites we determined whether HMGB1 may be a substrates for CD26 and, eventually, whether CD26-mediated cleavage may alter its biologic activity. Methods and results: Recombinant HMGB1 (5 uM) was incubated overnight with CD26 (2.2 uM). RP-HPLC analysis on Aquapore C18 column yielded a peptide with a molecular weigh lower than 2000 kDa. The CD26-mediated deletion of the N-terminal region of HMGB1 was confirmed by western blot analysis: time-dependent disappearance of the molecular weigh band corresponding to HMGB1 was detected with an anti-HMGB1 antibody which recognizes its first 16 N-terminal amino-acids of HMGB1. It was previously found that HMGB1 promoted endothelial cell migration through the activation of c-Jun N-terminal kinase (JNK) and extracellular regulated kinase (ERK) signaling pathways. To evaluate whether CD26 altered HMGB1 functions, endothelial cells were induced to migrate in presence of HMGB1 and CD26. HMGB1-mediated chemotactic activity was reduced by CD26 in a dose-dependent manner. Similarly, CD26 abolished HMGB1-induced JNK and ERK activation. Since diabetes is associated with the increased CD26 activity, both CD26 activity and HMGB1 levels were measured in serum of diabetic patients. Although HMGB1 serum levels did not significantly differ between diabetic and normoglycemic patients, increased N-terminal deleted HMGB1 was detected in serum from diabetic patients. Conclusions: CD26 cleaves HMGB1 and, via this mechanism, it inhibits its functions. These findings suggest that CD26 may account for the inhibition of HMGB1 effects found in diabetes.
Losartan and renal sodium handling Reply
Authors: R JALAN
Journal: Gut (2000)

Editor,—We read with great interest the paper by Girgrah et al ((2000) Gut 46:114–120; [OpenUrl][1][CrossRef][2][PubMed][3]) . Their report suggests that the subtle sodium retention that is characteristic of preascitic cirrhosis is improved by administration of low dose losartan. This is despite the paradoxical observation of an angiotensin concentration that is significantly lower in patients compared with healthy volunteers (mean (SEM) patients 6 (2); controls 40 (10) pmol/l). Our results of angiotensin II measurements are at variance with those published by Girgrah et al and are summarised in fig 1.1 ,2 Our studies suggest that there is a progressive increase in angiotensin II concentrations with increasing severity of sodium retention. In fact, this increase in angiotensin II is evident before any measurable derangement in systemic haemodynamic characteristics.3 The values measured in healthy volunteers are also significantly higher than those reported in the literature.4 We are not sure if these differences in measured values are the result of different patient populations, differences in the method of collection of the sample (Girgrah et al —EDTA and aprotinin; Newby et al and Helmy et al —0.5 ml of 0.45% … [1]: {openurl}?query=rft.jtitle%253DGut%26rft_id%253Dinfo%253Adoi%252F10.1016%252FS0008-6363%252898%252900008-X%26rft_id%253Dinfo%253Apmid%252F9683925%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1016/S0008-6363(98)00008-X&link_type=DOI [3]: /lookup/external-ref?access_num=9683925&link_type=MED&atom=%2Fgutjnl%2F47%2F4%2F596.2.atom
Metabolic and cardiopulmonary responses to the incremental shuttle walk test vs. six-minute walk test in healthy older adults
Authors: Victor Dourado, Ricardo Guerra, Suzana Tanni, Letícia Antunes, Irma Godoy
Journal: European Respiratory Journal (2011)

Whether the incremental shuttle walk test (ISWT) induces a higher physiological stress compared to six-minute walk test (6MWT) in patients remains controversial. However, previous studies did not include healthy subjects. We compared physiological responses to the ISWT and 6MWT in healthy adults (38 men, aged 60±10). Secondarily, peak oxygen uptake (VO 2 ) in these tests were compared to predict values of a maximal cycle-ergometer test. In a randomized order and alternate days, 80 participants completed three 6MWTs and three ISWTs. VO 2 , CO 2  output (VCO 2 ), minute ventilation (VE), and heart rate (HR) were monitored by a portable telemetric system during each third test. Physiological responses were linear during ISWT and exponential during 6MWT. We could calculate deficit-O 2  (1072±622 mL) and VO 2  time constant –tauVO 2 – (56±19 s) in all participants by exponential fittings (R 2 =0.905±0.065). During the 6MWT, VO 2  (1627±441 mL/min), VCO 2  (1443±439 mL/min), VE (46±16 L/min), and HR (129±24 bpm) were not significantly different compared to ISWT (respectively 1714±544 mL/min; 1591±582mL/min; 51±19 L/min; and 132±21bpm). The distance covered correlated with peak VO 2  for ISWT (r=0.738; p 2  (1541±422mL/min) was not significantly different from measured peak VO 2  obtained during ISWT and 6MWT. Although being considered to be closer to a maximal exercise test than 6MWT, ISWT does not induce a greater physiological responses in healthy adults. Larger studies should be performed in patients for better physiological comparisons between these walking tests.
Pain and Dysphagia in Patients with Squamous Carcinomas of the Head and Neck: The Role of Perineural Spread
Authors: R L Carter, M R Pittam, N S B Tanner
Journal: Journal of the Royal Society of Medicine (1982)

Clinical and pathological features of perineural spread have been investigated in patients with squamous carcinomas at several sites in the head and neck. In 100 surgical cases, the clinical and pathological findings were congruent in 76%. Combined clinical and histological evidence of perineural invasion was recorded in 33% and the overall incidence of nerve involvement detected morphologically was 44%. Perineural infiltration was demonstrated histologically in 51% of major excisions from the buccal cavity and in 34% of resections from the oropharynx, hypopharynx and cervical oesophagus. The neurological findings were dominated by hypoaesthesia, dysaesthesia and referred pain - mainly in the territories of cranial nerves V and IX. Multiple and/or sequential nerve involvement was occasionally seen. No correlation was established between nerve invasion and metastasis to regional lymph nodes. Long-distance infiltration of nerve trunks, and multiple involvement, are grave prognostic features.In 17 terminal patients submitted to autopsy, 65% had combined clinical and pathological evidence of perineural spread and the overall incidence of nerve involvement detected morphologically was 88%. Sensory changes again predominated. Multiple nerve involvement was observed in 35%. An apparently new `dysphagia syndrome' is described in 4 patients with oropharyngeal carcinomas in whom gross mechanical obstruction was simulated by a combination of perineural spread of tumour into the ipsilateral vagal trunk, sometimes accompanied by segmental infarction, variable invasion of the sympathetic chain, and `splinting' of the pharynx by local fibrosis and tumour in the soft tissues of the neck. Short-term palliation was achieved in these patients with high-dose steroids.
Association of Polymorphisms in the Microrna Target Sites and Survival of Patients in Early-Stage Non-Small-Cell Lung Cancer
Authors: S.Y. Lee, J.E. Choi, H.S. Jeon, M.J. Hong, Y.Y. Choi, S.S. Yoo, E.B. Lee, W.K. Lee, Y.T. Kim, S. Jheon, J.W. Son, J.Y. Park
Journal: Annals of Oncology (2014)
Lipids in the lung: Respiratory inflammation in COPD
Authors: Andrew Higham, Simon Lea, Karen Simpson, Dave Singh
Journal: European Respiratory Journal (2012)

Background   There is strong association between COPD and metabolic co-morbidities involving lipids. Abnormalities of lipid metabolism are associated with increased inflammatory responses. The aim of this study was to identify abnormalities of lipid content in the lungs of COPD patients, focusing on lung macrophages.   Methods   Resected lung tissue from patients undergoing surgery for cancer was used; isolated macrophages and macrophages within formalin fixed paraffin embedded (FFPE) tissue were examined. Comparisons were made between 5 subject groups, never smokers (NS), current smokers with normal lung function (S), ex-smokers with normal lung function (E), COPD current smokers (COPDS) and COPD ex-smokers (COPDE). The presence of lipid laden macrophages was identified using oil red o stain (ORO) where positive staining is expressed as % mean (SD).   Results   The number of ORO positive macrophages was increased in COPD patients and controls who were current smokers (COPDS and S) compared to the other groups of ex- or never smokers, in both isolated macrophages and FFPE tissue.   Discussion   We have shown an increase in lipid laden macrophages in the lungs of S and COPDS. Current smoking appears to cause dysfunctional lipid metabolism within lung macrophages that may contribute to respiratory inflammation. Smoking cessation may have benefits in returning lipid metabolism to normal in these cells.
Pneumocystis jirovecii colonisation in patients with interstitial lung disease
Authors: S. Vidal, C. de la Horra, J. Martín, M.A. Montes-Cano, E. Rodríguez, N. Respaldiza, F. Rodríguez, J.M. Varela, F.J. Medrano, E.J. Calderón
Journal: Clinical Microbiology and Infection (2006)
Current Issues in Vaccines for Adult Patients With Hematologic Malignancies
Authors: Nicolas C. Issa, Lindsey R. Baden
Journal: Journal of the National Comprehensive Cancer Network (2012)

Vaccination is an important strategy for preventing infections in patients with hematologic malignancies. Hematopoietic cell transplant (HCT) recipients have diminished immunity against vaccine-preventable diseases after transplantation. Optimal timing for initiating immunization in the context of hematologic malignancies and after HCT, however, is not well defined, and data on the magnitude and duration of immune response to vaccines in this population are lacking. Factors such as degree of immunosuppression, administration of monoclonal antibodies, time after HCT, and presence or absence of chronic graft-versus-host disease may influence the immune response to vaccines and may pose safety concerns for certain vaccines, such as live-attenuated immunogens. Patients who received certain monoclonal antibodies (eg, rituximab, alemtuzumab) less than 6 months before vaccination have poorer immune responses to vaccines. New advancements in vaccine development are warranted to improve safety and immunogenicity of vaccination in immunocompromised patients.
Abstract 3596: The Effect of Chiral Isolates of Digoxin on Systemic Vascular Resistance
Authors: John Somberg, Akshay Gupta, Christian Spies, Dana Glock, Trudie Somberg, Darshan Nagesh, Jocelyn Spoon, Vasant Ranade, Congrong Lin, Jeff Snell
Journal: Circulation (2006)
Outcomes in embolisations of pulmonary arterio-venous malformations
Authors: Logan Thirugnanasothy, Sasiharan Sithamparanathan, Leslie Mitchell, Andrew Fisher, James Lordan, Paul Corris
Journal: European Respiratory Journal (2014)

Introduction   Pulmonary arterio-venous malformation (AVM) development is an important clinical problem due to the risk of paradoxical embolism and cerebral abscess. To reduce these risks, coil embolisation is recommended.   Aims   To establish following embolisation:  The degree of improvement in oxygenation  The complication rate  The incidence of further paradoxical embolism   Methods   Patients having had an embolisation of pulmonary AVMs from 2002 were identified from our Radiology and lung function databases.   Results   Since 2002, a total of 57 embolisations were done in 42 patients. The mean increase in oxygen saturations was 3.8% ± 4.5%. Of those who had a shunt calculation done before and after embolisation (27/56), the mean reduction in the shunt was 9.2% ± 8.4%. Only one patient in our cohort had a significant complication, the migration of a coil into the left ventricle which was successfully removed surgically. Prior to embolisation, eight patients had experienced a paradoxical event, including stroke (four), cerebral abscess (four) and an ST-elevation Myocardial Infarction (one); one patient had both a previous stroke and cerebral abscess. Following embolisation, only one patient had a further episode of paradoxical embolism; they had not attended clinic following the preceding embolisation.   Conclusion   Our centre has demonstrated that over the last 12 years, embolisation of pulmonary AVMs has led to a significant reduction in further episodes of paradoxical embolism and only one complication had occurred. The reduction in shunt fraction was similar to previously reported 1 .   References   1. Haitjema et al.Embolisation of pulmonary arterio-venous malformations: results and follow up in 32 patients. Thorax 1995 July; 50(7): 719-723.
Efficacy and safety of aclidinium bromide vs placebo and tiotropium in COPD: A phase IIIb study
Authors: Jutta Beier, Anne-Marie Kirsten, Robert Mróz, Rosa Segarra, Ferran Chuecos, Cynthia Caracta, Esther Garcia Gil
Journal: European Respiratory Journal (2013)

Background: Maintaining significant bronchodilation throughout the entire day is important to improve COPD outcomes.

Aim: To evaluate the 24-hour bronchodilatory efficacy and safety of aclidinium bromide vs tiotropium and placebo.

Methods: In this randomized, double-blind study, 414 patients with COPD (FEV1 1.6 L; 56% predicted) received aclidinium bromide 400 µg BID (metered dose; equivalent to aclidinium 322 µg delivered dose) via Genuair®a, tiotropium 18 µg QD via HandiHaler® or placebo for 6 weeks. Endpoints included change from baseline in normalized FEV1 AUC0-24 (primary) and FEV1 AUC12-24 at Week 6, inhaler preference and safety.

Results: Spirometry findings are summarized (Table). Genuair was preferred over HandiHaler (80% vs 11%; p<0.001). Patients were more willing to continue using Genuair than HandiHaler (89 vs 45; p<0.001 [0=not willing; 100=definitely willing]). AE incidence (28%, overall) was similar across groups. Few anticholinergic AEs (<2%) or SAEs (<3%) occurred in any group.

View this table:

Change from baseline (difference from placebo), mL





Conclusions: Aclidinium provided significant 24-hour bronchodilation vs placebo. Aclidinium and tiotropium had comparable efficacy after 6 weeks.

aRegistered trademark of Almirall S.A., Barcelona, Spain, for use within the EU, Iceland and Norway as Genuair®, and within the USA as PressairTM.
Acute respiratory distress syndrome in patients admitted for community-acquired pneumonia
Authors: Jorge Moisés, Joan Ramón Badia, Miquel Ferrer, Albert Gabarrus, Catia Cilloniz, Eva Polverino, Jacobo Sellares, Rosanel Amaro, Antoni Torres
Journal: European Respiratory Journal (2014)

Background:  Community-acquired pneumonia (CAP) is a known risk factor for respiratory distress syndrome (ARDS).    Aim:  To assess the characteristics and outcomes of CAP patients developing ARDS.   Methods:  We have prospectively collected in a large systematic database all hospital admissions for CAP from 1997 to 2012. In this population, those who met the Berlin 2012 ARDS definition were identified. Risk factors, and differences between patients with and without ARDS were studied.   Results:  4831 hospital admission during the study period were included. 139 patients met ARDS definition criteria (2.9%). Severe ARDS in 12.2% of the cases and moderate ARDS in 42.9%.They also had significantly more elevated C-reactive protein (CRP) (22±12vs.18±11 mg/dL pl 0.001) and PSI severity index was higher. and all met ATS criteria for severe CAP.  The microbiological diagnosis was higher in patients with ARDS (59 vs 41%, pl0.001) but no differences were found regarding aetiology as  S.pneumoniae  was the most common isolation. Among ARDS patients 73% required mechanical ventilation and 26% non-invasive ventilation and mortality at 30 days was significantly higher 40/139(29 %)vs.243/4831 (5%), p l0.001. A multivariate analysis disclosed dyspnea at admission (OR 2.44,CI :2,2 -6, 1,p = 0.009) and a CRP ≥ 12 mg /dL (OR 2,59, 1.5 - 4.6 , p = 0.001) as independent factors associated with the development of ARDS. The presence of ARDS increased risk of mortality (OR: 5.9 , CI :3,4 -10,2, p l 0.001)   Conclusions:  Less than 3% of patients with CAP met the current ARDS definition. This complication is more common in pneumonia with higher severity index and increased CRP. CAP patients had a 6-fold increase in mortality.
50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study
Authors: Renate B Schnabel, Xiaoyan Yin, Philimon Gona, Martin G Larson, Alexa S Beiser, David D McManus, Christopher Newton-Cheh, Steven A Lubitz, Jared W Magnani, Patrick T Ellinor, Sudha Seshadri, Philip A Wolf, Ramachandran S Vasan, Emelia J Benjamin, Daniel Levy
Journal: The Lancet (2015)
Immune monitoring technology primer: flow and mass cytometry
Authors: Holden T. Maecker, Alexandre Harari
Journal: Journal for ImmunoTherapy of Cancer (2015)

Flow cytometry traditionally uses fluorochrome-labeled probes, such as antibodies, to identify cells expressing the targets of those probes. A sample stream carries single cells in suspension past a laser, exciting the fluorochromes, with quantitation of the emitted fluorescent signals from each
A preliminary study of the prevalence of hypoxaemia, hyperoxaemia, hypercapnia and acidosis in hospital blood gas specimens
Authors: Ronan O'Driscoll, Aram Rudenski, Peter Turkington, Luke Howard
Journal: European Respiratory Journal (2011)

Over or under treatment of hypoxaemia can be dangerous. We studied 3524 blood gas specimens at a university hospital. 362 samples (10.2%) were hypoxaemic with oxygen saturation below 90% and 2.7% were severely hypoxaemic with saturation below 80%. 1074 samples (30%) were hyperoxaemic with PO2 >15.0 kPa.  This study suggests that severe uncorrected hypoxaemia is relatively uncommon in hospital practice and is usually associated with respiratory rather than metabolic acidosis. Hyperoxaemia (30% of samples), hypercapnia (27% of samples) and respiratory acidosis (21% of samples) were relatively common.This suggests that oxygen needs to be used with more caution in hospitals in the light of recent studies showing increased mortality associated with hyperoxaemia in a range of common clinical conditions.
A proposal for the addition of hyperthermia to treatment regimens for acute and chronic leukemia.
Authors: H I Robins, W H Dennis, R A Steeves, P M Sondel
Journal: Journal of Clinical Oncology (1984)

The application of hyperthermia to the treatment of neoplastic disease has focused on solid tumors. Human leukemias, both acute and chronic, may represent a unique category of diseases for which hyperthermia should be used in combination with other modalities with curative intent. Three clinical approaches to include hyperthermia are proposed. These are hyperthermia in combination with therapeutic low-dose whole-body irradiation, ablative high-dose total body irradiation, and bone marrow transplantation with the in vitro use of hyperthermia to purge remission bone marrow of abnormal cells. Current preclinical research further supporting these clinical applications of hyperthermia to leukemia therapy is presented.
Incorporation of Tritiated Uridine Into DNA of Ehrlich Ascites Tumor Cells
Authors: Betty K. Yost, Marvin J. Rosenberg, David J. Nishioka
Journal: JNCI Journal of the National Cancer Institute (1976)

Ehrlich ascites tumor cells were labeled with [5,6-3H]uridine in vivo during the exponential growth phase of the tumor in the mouse. Hydroxyapatite column chromatography of the total cell nucleic acid revealed a level of activity in the DNA approaching 50% of the incorporated activity of the RNA after 24 hours. After perchloric acid hydrolysis, the constituent bases of the DNA, separated by paper chromatography, contained more than 90% of the tritium radioactivity in the cytosine and thymine, at a ratio of approximately 2:1. Prior to digestion of the polymer, the level of label in the DNA was not sensitive to RNase, alkaline, or heat denaturation. Equilibrium density gradient centrifugation produced a single peak, coincidental for radioactivity and optical density at 260 nm. Our results indicate that tumor cells under replicative stress incorporated more than one-third of the tritium radioactivity of uridine into the DNA, whereas those at a growth plateau had less than 10% of the label in the DNA. This exogenous uridine radioactivity observed in the DNA represented neither a DNA-RNA hybrid, RNA primer pieces in DNA synthesis, nor any other RNase-sensitive species, but was apparently the consequence of amination and methylation of the tritium-labeled uracil moiety to satisfy the metabolic needs of the replicating cells for cytosine and thymine bases.
Narcotic Poisoning: A Review of the Literature
Authors: WILLIAM E. THORNTON, BONNIE PRAY THORNTON
Journal: American Journal of Psychiatry (1974)

Varied adverse physical reactions to narcotic drugs are being reported increasingly in the medical literature. The findings indicate a morbid physical prognosis for the habitual narcotic user. The author reviews the literature on such complications and emphasizes the need for increased prevention and treatment interventions by the medical and nursing professions.