tbuckley/cabot-search huggingface dataset:
Tuberculosis risk from exposure to solid fuel smoke: A systematic review and meta-analysis
Authors: Om Kurmi, Charandeep Sadhra, Jon Ayres, Steven Sadhra
Journal: European Respiratory Journal (2013)

Background:  Studies, particularly from low and middle income countries suggest that exposure to smoke from household air pollution (HAP) is a risk factor to tuberculosis. The primary aim of this study is to quantify the risk to tuberculosis from exposure to smoke arising from different solid fuel types, to explore the publication bias and identify the cause for heterogeneity in reported effect sizes.   Methods:  We conducted a systematic review and meta-analysis of primary studies published in peer reviewed journals reporting effects size and confidence intervals following a pre-defined inclusion criteria. 16 studies were identified and results from these studies were used to conduct sub-group analysis and to calculate a pooled effect estimate.   Results:  The random pooled effect estimate (OR, 95% CI) was significantly higher among those exposed to biomass smoke (1.65, 1.16 – 2.36) compared to kerosene only (0.70, 0.13 – 3.87) and combined use of biomass and kerosene (1.30, 0.20 – 8.63). Analysis of data showed no publication bias (p=0.435) for studies conducted among never smokers and those which had adjusted for smoking. Significant heterogeneity was observed in diagnosis criteria for tuberculosis (coeff. = 0.397, p=0.029).   Conclusion: The result suggests significant heterogeneity in risk estimates depending largely upon fuel types with significant risk obtained from exposure to biomass smoke. Most of the studies were small and with limited information on parameters and methods for assessing HAP. Future studies require improved methods for objective assessment of exposure as well as factors which modify exposure. Very few studies have provided reliable estimates of cumulative exposure to HAP.
Late-breaking abstract: Health-related quality of life of patients with idiopathic pulmonary fibrosis
Authors: Susan Yount, Jennifer Beaumont, Karen Kaiser, Katy Wortman, Shih-Yin Chen, David Van Brunt, David Cella
Journal: European Respiratory Journal (2014)

Background: Idiopathic pulmonary fibrosis (IPF) is a debilitating condition, yet health-related quality of life (HRQOL) data are limited. The primary objective was to evaluate HRQOL in IPF using measures from the Patient Reported Outcomes Measurement Information System (PROMIS). The secondary objective was to examine the association between key symptoms and HRQOL.  Methods: Individuals with IPF were recruited via patient advocacy organizations to complete an online survey consisting of PROMIS-29 health profile, PROMIS-Dyspnea, dyspnea measured by Modified Medical Research Council Dyspnea Scale (MMRC), self-reported cough, and cough subscale of the ATAQ (A Tool to Assess Quality of life)-IPF. PROMIS-29 scores have mean=50, SD=10 in the US general population; PROMIS-Dyspnea scores are referenced to a COPD sample.  Results: The 275 survey participants showed worse mean PROMIS-29 scores than the general population.  Dyspnea severity was associated with worse mean PROMIS-29 scores. PROMIS-Dyspnea (mean=58.7) and Functional Limitations Due to Dyspnea (mean=58.4) scores were worse than the COPD reference population. Cough severity was associated with worse HRQOL measured by ATAQ-IPF.  Conclusions: Patients with IPF report substantial deficits in HRQOL, particularly with respect to physical function, anxiety, pain, depression and fatigue. Patients suffering from dyspnea and cough had poorer HRQOL.
COPD on anti-GERD therapy remains at higher risk for severe exacerbation
Authors: Daiana Stolz, Francesco Blasi, Joachim Aerts, Renaud Louis, Branislava Milenkovic, Kostantinos Kostikas, Tobias Welte, Antoni Torres, Gernot Rohde, Alicia Lacoma, Lucas Boeck, Janko Rakic, Andreas Scherr, Wim Boersma, Michael Tamm
Journal: European Respiratory Journal (2014)

BACKGROUND:  Gastroesophageal reflux is associated with a higher risk of exacerbation, predicting the “frequent exacerbator” phenotype in COPD. We hypothesize that treatment with a proton pump inhibitor normalizes the risk of exacerbation in stable COPD.   METHODS:  We prospectively evaluated 638 patients with stable COPD for ≥ 6 weeks, > 10 PY and GOLD II-IV seeking care in pulmonary tertiary hospitals in 8 European countries and included in the PROMISE cohort. Comorbidities including associated medical therapy were assessed at baseline, at exacerbation and at biannual visits. The primary outcome of the study was exacerbation and/or death. Median observation time was 24 months.   RESULTS:  85 (13.3%) of the patients with stable COPD were on anti-GERD therapy. This patient group had higher annual exacerbation and severe exacerbation rates (p=0.009 and p=0.002), decreased QoL (SF-36: activity score p=0.004, SGRQ: physical functioning p=0.013, social functioning p=0.007), higher BODE-index (p=0.033) and MMRC scores (p=0.002), shorter 6 MWD (p=0.0004) and higher adjusted Charlson score (p 1 % pred (HR 1.912 95% CI 1.259-2.905); adjusted Charlson score, BODE index and MMRC (HR 1.623 95% CI 1.038-2.538); as well as adjusted Charlson score, FEV 1 % pred and 9 classes of medication for comorbidities (HR 1.625 95% CI 10.43-2.531) in 3 multivariable cox-regression models.   CONCLUSION:  Patient on anti-GERD therapy remain at higher risk for severe exacerbation of COPD.
Poorly differentiated carcinoma and poorly differentiated adenocarcinoma of unknown origin: favorable subsets of patients with unknown-primary carcinoma?
Authors: R Lenzi, K R Hess, M C Abbruzzese, M N Raber, N G Ordoñez, J L Abbruzzese
Journal: Journal of Clinical Oncology (1997)

PURPOSE The objectives of this study were to assess clinical outcomes and prognostic factors in unselected, consecutive patients with poorly differentiated carcinoma (PDC) or poorly differentiated adenocarcinoma (PDA). PATIENTS AND METHODS The 1,400 patients analyzed were referred to our unknown-primary tumor (UPT) clinic from January 1, 1987 through July 31, 1994. Clinical data from these patients were entered into a computerized data base for storage, retrieval, and analysis. Survival was measured from the time of diagnosis; survival distribution was estimated using the product-limit method. Multivariate survival analyses were performed using proportional hazards regression and by recursive partitioning. RESULTS Nine hundred seventy-seven patients were diagnosed with unknown-primary carcinoma (UPC) and 337 of these patients had PDC or PDA. No clinical differences were identified among patients with PDC, PDA, or UPC patients with other carcinoma or adenocarcinoma subtypes. PDC patients enjoyed better survival than PDA patients. Poor cellular differentiation was not an important prognostic variable. Variables predictive of survival included lymph node metastases, sex, number of metastatic sites, histology (PDC v PDA), and age. Although chemotherapy did not appear to influence survival for the entire group of PDC or PDA patients, a subset of patients with good prognostic features experienced median survival durations of up to 40 months. CONCLUSION The long median survival and chemotherapy responsiveness of UPC patients with PDC and PDA could not be confirmed. However, subpopulations with prolonged median survival durations could be defined, and the value of chemotherapy in this group remains to be determined. Identification and exclusion of treatable or slow-growing malignancies may account for the poor survival of the PDC and PDA patients reported in this study.
Severe pulmonary hypertension in chronic lung disease. Long term effects on gas exchange of endothelin receptor antagonists or PDE5 inhibitors
Authors: Anna Stanziola, Emanuela Carpentieri, Michele D'Alto, Paola Argiento, Carolina Vitale, Emanuele Romeo, Manuela Pitassi, Antonio Molino, Mauro Mormile, Matteo Sofia
Journal: European Respiratory Journal (2011)

Drug therapy for pulmonary hypertension associated to chronic lung disease is currently discouraged for the negative effects on gas exchange.We retrospectively evaluated blood gases and 6MWT in patients with severe PH associated with IPF or COPD during 12 months of treatment with Bosentan or Sildenafil. 22 pts with diagnosis of severe pre-capillary PH at right heart catheterization were evaluated including 10 IPF and 12 pts with COPD. Haemodynamical and long term respiratory function data were available in 20 pts: 5 pts with COPD treated with Bosentan, 5pts COPD with Sildenafil, 5 pts IPF treated with ERA and 5 pts with PDE5-inh. Blood gases measuring paO2 and paCO2, PFTs and 6MWT were analyzed at baseline, T6 and T12 months. A-aO2 gradient was calculated using alveolar gas equation. Baseline there were not any difference between haemodinamics and gas exchange profile between IPF and COPD (PAPm = 40mmHg vs 47mmHg), PaO2 58 vs 56 mm Hg, PaCO2 36 vs 37 mm Hg. In 5 IPF pts treated with ETRA A-aO2 gradient increased by 28% and 30% at T6 and T12; in 5 IPF pts exposed to PDE5-inib by 4% and by 6% at the same time points. The distance at 6MWT decreased in IPF-ERA group (- 41 mt T12) and it increased (+90 mt T12) in IPF- PDE5-inhib. In 5 COPD treated with ERA A-aO2 gradient increased by 13% and 22% at T6 and T12 respectively while in 5 COPD pts exposed to PDE5-inib did non significantly change. At T12 the distance at 6MWT increased + 36 mt and + 88 mt in COPD-ERA treated and in COPD-PDE5inib treated respectively.Long term treatment with sildenafil is not associated to detrimental effect on gas exchange both in IPF or in COPD with severe PH.
Correlation of gene expression analysis of tumor-infiltrating CD4+ cells with immune function and survival according to different breast cancer (BC) molecular subtypes
Authors: C. Sotiriou, C. Equeter, F. El Ouriaghli, B. Haibe-Kains, V. Durbecq, D. Larsimont, M. Ignatiadis, C. Desmedt, K. Willard-Gallo, M. Piccart
Journal: Journal of Clinical Oncology (2008)

11022 Background: Several studies have demonstrated the role of the adaptive immune response in controlling growth and recurrence of human tumors. However, its role in BC remains largely unknown. Here, we aim to gain further insight into the functional defects characterizing breast tumor-infiltrating T cells and to assess their relationship with BC subtypes and clinical outcome. Methods: CD4+ T cells were purified from 10 primary invasive ductal breast carcinomas and a whole genome gene expression profiling analysis was performed using Affymetrix Human GeneChip Arrays. A tumor-infiltrating CD4+ signature, reflecting immune response, was computed, and its association with BC subtypes and clinical outcome was assessed using several external publicly available datasets, including more than 2500 untreated and systemically treated BC patients. Results: A gene expression analysis of purified CD4+ cells revealed several differences in immune response according to the BC subtypes from which they derived. Interestingly, CD4+ signature levels were higher in ER-/PR-/HER2- (“triple-negative”) and HER2+ tumors compared to ER+/HER2- (“luminal”) tumors, suggesting several functional differences in immune response of CD4+ T cells according to BC subtypes. Higher levels of CD4+ signature were statistically associated with better survival only within the ER-/PR-/HER2- (HR=0.733; 95%CI: {0.620 to 0.867}; p<0.0001) and the HER2+ subtypes (HR0.790; 95%CI: {0.635 to 0.982}; p=0.033), but not in the ER+ (“luminal”) subgroup. This positive association with survival was even stronger when adjuvant chemotherapy was administered. Of interest, the CD4+ signature was the only prognostic signature, compared to several others, showing a statistically significant prognostic value in the already high-risk “triple-negative” subgroup. Conclusions: This study is the first to demonstrate differences in the immune function of tumor-infiltrating CD4+ cells according to BC molecular subtypes. Our results suggest that only the already high-risk “triple-negative” and HER2+ tumors may be suitable candidates for adjuvant immunotherapy strategies. No significant financial relationships to disclose.
Asthma Education: More Reading or More Viewing?
Authors: M R Partridge
Journal: Journal of the Royal Society of Medicine (1986)

An audit of a hospital asthma clinic has revealed deficiencies in its educational activities. A significant minority of attending patients failed to understand the rationale behind their therapy and would take potentially inappropriate action when symptoms worsen. Many of those taking oral theophylline therapy were shown to be at risk of self-induced toxicity. Watching a videotape about the disease in the waiting room was found to be more popular than leaflets and books as a source of information.
Mid-Region Pro-Hormone Markers for Diagnosis and Prognosis in Acute Dyspnea
Authors: Alan Maisel, Christian Mueller, Richard Nowak, W. Frank Peacock, Judd W. Landsberg, Piotr Ponikowski, Martin Mockel, Christopher Hogan, Alan H.B. Wu, Mark Richards, Paul Clopton, Gerasimos S. Filippatos, Salvatore Di Somma, Inder Anand, Leong Ng, Lori B. Daniels, Sean-Xavier Neath, Robert Christenson, Mihael Potocki, James McCord, Garret Terracciano, Dimitrios Kremastinos, Oliver Hartmann, Stephan von Haehling, Andreas Bergmann, Nils G. Morgenthaler, Stefan D. Anker
Journal: Journal of the American College of Cardiology (2010)
Utility of sleep studies in Pierre Robin sequence: A 10-year study
Authors: Marie Wright, Felicity Mehendale, Don Urquhart
Journal: European Respiratory Journal (2014)

Aim  Children with Pierre Robin Sequence (PRS) are at risk of early upper airway obstruction (UAO) and have increased prevalence of childhood obstructive sleep apnoea (OSA). Polysomnography is gold standard for OSA diagnosis and is used to objectively evaluate treatment modalities. This study defines its utility in PRS.  Methods  We retrospective reviewed case-notes and sleep study (SS) reports of 84 children with PRS (born 2004-2013). Sleep studies were performed as limited-channel cardiorespiratory studies with measurement of airflow (allowing confident detection of apnoea) and effort (allowing delineation of central versus obstructive events) in addition to SpO 2 . Scoring was in accordance with AASM standards.  Results  Management of UAO included prone positioning (36%), nasopharyngeal airway (51%), tongue-lip adhesion (4%) and tracheostomy (4%).  60% children (n=50) underwent SS (1-8 studies/child, mean 2.1), of whom 82% had abnormal studies. Syndromic PRS was highly predictive of abnormal SS (100% vs 76% in isolated PRS).  48% underwent SS aged l1 year (median 9d), of whom 98% had an abnormal study; 80% showed OSA and 18% central apnoeas alone. 23% underwent SS aged 1-6 years and 47% had an abnormal study (64% OSA, 36% central apnoeas).  SS results guided the following interventions: NPA insertion/removal (n=16), caffeine therapy (n=2), home oxygen (n=2), overnight CPAP (n=3), adenotonsillectomy (n=2).  Conclusions  SS play an important role in PRS management, guiding decisions about airway support and timing of surgery, identifying OSA in older children, and demonstrating central apnoeas alone in a subset of patients. All of the above suggest that sleep diagnostics be considered an essential component of cleft services.
Diagnosis of DSM-III-R personality disorders by two structured interviews: patterns of comorbidity
Authors: J M Oldham, A E Skodol, H D Kellman, S E Hyler, L Rosnick, M Davies
Journal: American Journal of Psychiatry (1992)

The purpose of this study was to examine patterns of co-occurrence of axis II disorders in a group of consecutive patients evaluated with two contrasting structured interviews.One hundred of 106 consecutive applicants for long-term, inpatient treatment of severe personality psychopathology were assessed, face-to-face, by psychiatrists using the Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II) and the Personality Disorder Examination (PDE). The percent of co-occurrence of pairs of disorders diagnosed by each structured interview separately was calculated, and significance levels were determined by using chi-square tests of independence. Finally, odds ratios were computed for the odds of each pair of disorders occurring together compared with the odds for the occurrence of each disorder alone.The two interview methods revealed different comorbidity patterns. Significant covariation was found for 29 pairs of disorders diagnosed with the PDE, compared with 12 pairs diagnosed with the SCID-II. Six pairs of disorders covaried significantly and were associated with odds ratios greater than 4: histrionic with borderline, histrionic with narcissistic, narcissistic with antisocial, narcissistic with passive-aggressive, avoidant with schizotypal, and avoidant with dependent.Substantial overlap occurred among personality disorders. In this group of patients, consistent patterns of comorbidity involving narcissistic, avoidant, and histrionic personality disorders suggest that categorical distinctions between them and certain other DSM-III-R personality disorders may be illusory. The question of which of two overlapping disorders is more valid, however, is left unanswered. For clinical purposes, a two-level diagnostic convention is proposed.
Gene Methylation in Myelodysplastic Syndrome – a Comparative Study Between Bone Marrow and Peripheral Blood
Authors: J.M. Jorge, E. Cortesão, A.C. Gonçalves, A. Pires, R. Alves, C. Moucho, L. Rito, E. Magalhães, J. Carda, C. Geraldes, A.I. Espadana, M.A. Pereira, M.D.A.R.F. Dourado, L. Ribeiro, J.M. Nascimento-Costa, A.B. Sarmento-Ribeiro
Journal: Annals of Oncology (2014)
The modern approach to the problem of symptomatic erythrocytosis in smokers with COPD
Authors: Elena Privalova, Natalia Kuzubova, Olga Titova
Journal: European Respiratory Journal (2012)

The aim of was the comparative study of erythrocyte parameters, indicators of total hemoglobin and hemoglobin within erythrocytes at smokers patients with COPD. Findings of 64 habitual smokers patients with COPD, 24 smokers with normal spirometry and 20 nonsmokers healthy individuals similar age and sex. The following laboratory parameters have been analyzed: number of erythrocytes (RBC), hemoglobin (HGB), hematocrit (HCT), mean erythrocyte volume (MCV), average content of hemoglobin (MCH), mean hemoglobin concentration (MCHC), anisocytosis (RDW-SD), number leukocytes, monocytes, lymphocytes, eosinophils, neutrophils of peripheral blood. The blood study was carried hematological analyzer “Sysmex XT–2000i”. The symptomatic erythrocytosis marked in 42% of patients with COPD (p
A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study Of The Efficacy and Safety Of Siltuximab, An Anti-Interleukin-6 Monoclonal Antibody, In Patients With Multicentric Castleman’s Disease
Authors: Raymond S Wong, Corey Casper, Nikhil Munshi, Xiaoyan Ke, Alexander Fosså, David Simpson, Marcelo Capra, Ting Liu, Ruey Kuen Hsieh, Yeow Tee Goh, Jun Zhu, Seok-Goo Cho, Hanyun Ren, James Cavet, Rajesh Bandekar, Margaret Rothman, Thomas A Puchalski, Shalini Chaturvedi, Helgi van de Velde, Jessica Vermeulen, Frits van Rhee
Journal: Blood (2013)
Esomeprazole, versus esomeprazole and domperidone in treatment of gastroesophageal reflux in children with difficult-to-treat asthma
Authors: Mohammed Al-Biltagi, Adel Salah Bediwy, Salem Deraz, Hesham Galal Amer, Nermin K. Saeed
Journal: European Respiratory Journal (2013)

Background and Objectives: Gastroesophageal reflux (GER) is a common finding in asthmatic children and has been identified as a potential trigger for asthma. The aim of this study was to investigate the efficacy of combined use of both esomeprazole and antidopaminergic prokinetic domperidone versus the sole use of esomeprazole in improving asthma severity in children with difficult to treat asthma. Patients and Methods: Our study included 89 children with difficult-to-treat asthma. GER was assessed using upper GIT endoscopy. Those who had GER were randomly blindly divided into 2 equal subgroups the first subgroups was treated with esomeprazole and domperidone for 12 weeks while the other subgroup was treated with esomeprazole. Childhood-Asthma Control Test (C-ACT), Forced Expiratory Volume in 1 second (% of predicted) [FEV1], Peak Expiratory Flow (PEF) variability, induced sputum substance P (SP) and endoscopic reflux score (ERS) were recorded before and after the treatment. Results: The (C-ACT) showed significant improvement, the induced sputum SP and ERS showed significant reduction wile FEV1% and PEF variability showed no significant changes in the subgroup treated with both esomeprazole and domperidone than the subgroup treated with esomeprazole only. Conclusions: Gastro-esophageal reflux (GER) was observed in about 45% of children with difficult-to-treat asthma. Combination of domperidone and esomeprazole was more effective in improving the endoscopic reflux score, childhood asthma control test (C-ACT) and FEV1 (% of predicted) and significantly reduced the sputum SP than the use of esomeprazole only in children with difficult-to-treat asthma.
New study supports MHRA advice on combined oral contraceptives
Authors: Mira Harrison-Woolrych, Jane Woolley
Journal: BMJ (2015)

The association between combined oral contraceptives and venous thromboembolism (VTE) is not new, and Vinogradova and colleagues’ study confirms the UK regulatory position,1 supporting decisions on safe prescribing.

The authors’ conclusions are consistent with the findings of a regulatory Europe-wide review of …
Preliminary report: Outbreak of Legionnaires’ disease in a hotel in Calp, Spain, update on 22 February 2012
Authors: H Vanaclocha, S Guiral, V Morera, M A Calatayud, M Castellanos, V Moya, G Jerez, F González
Journal: Eurosurveillance (2012)

Research is ongoing on eighteen cases of Legionellosis, including four deaths, identified among tourists and employees in a hotel in Calp, Spain. Cases occurred during a period of two months, indicating the possibility of a point-source transmission at the hotel. An environmental investigation identified several positive samples in the hotel, which as a precautionary measure, was closed until requested improvements were made. Surveillance measures currently remain active.
Phase I Study of Topotecan Plus Cranial Radiation for Glioblastoma Multiforme: Results of Radiation Therapy Oncology Group Trial 9507
Authors: Barbara J. Fisher, C. Scott, D. R. Macdonald, C. Coughlin, W. J. Curran
Journal: Journal of Clinical Oncology (2001)

PURPOSE: A phase I trial was conducted by the Radiation Therapy Oncology Group (RTOG) to determine the maximum-tolerated dose of topotecan that could be safely combined with standard cranial radiation for glioblastoma multiforme. A secondary objective was to document the acute and late toxicities of this combination of chemotherapy and radiation. PATIENTS AND METHODS: Forty-seven patients with histologically confirmed glioblastoma multiforme were entered onto this phase I trial. Three cycles of topotecan were administered at 21-day intervals commencing at day 1 of cranial radiotherapy (60 Gy/30 fractions). Each cycle consisted of daily 30-minute intravenous (IV) infusions for 5 days. The dose of topotecan was escalated in three-dose increments from 0.5 mg/m 2 /d to 1.0 mg/m 2 /d to 1.5 mg/m 2 /d in different patient groups. RESULTS: The majority of patients were over age 50. Three dose levels of topotecan were tested. Fifteen patients accrued to level 1 (topotecan dose 0.5 mg/m 2 /d). No grade 4 toxicities were seen. Sixteen patients accrued to level 2 (topotecan dose 1.0 mg/m 2 /d), five of whom had brief episodes of grade 4 neutropenia. Seventeen patients accrued to level 3 (1.5 mg/m 2 /d). Six of these patients had brief episodes of grade 4 neutropenia and four developed grade 3 thrombocytopenia. No serious nonhematologic or late toxicities were seen. Median survival for all patients was 9.7 months. There was no apparent difference in survival by topotecan dose schedule. CONCLUSION: Toxicity was acceptable at an IV topotecan dose of 1.5 mg/m 2 /d administered daily for 5 days every 21 days for three cycles. A phase II trial has been performed using this dose of topotecan.