tbuckley/cabot-search huggingface dataset:
Risk Factors for HIV Infection Overlooked in Routine Antenatal Care
Authors: Jennifer Hawken, T Chard, Kate Costeloe, D J Jeffries, C N Hudson
Journal: Journal of the Royal Society of Medicine (1995)

We have ascertained the extent to which risk factors for HIV infection may escape detection by standard history-taking procedures in an antenatal clinic. This study was based on 1264 women from a multi-ethnic population in an inner London health district (City and Hackney). All had agreed to undergo attributable HIV testing and a detailed personal interview. Thirty-nine per cent (494 of 1264 women) reported risk factors contributed personally or by a partner. Most of these risk factors had not been earlier disclosed by routine history taking. In most cases the risk was residence and risk activity in a World Health Organization (WHO) Pattern 2 country. [HIV spread WHO categories: Pattern 1—principally homosexual/bisexual males and i.v. drug use (areas=North America, Western Europe, Australasia, parts of South America) with male to female ratio 10/1; Pattern 2—Heterosexual (areas=Sub Saharan Africa, Caribbean and part South America) with male to female 1/1.] Thirty-one subjects (2.4%) were aware that their partners had participated in bisexual activity. Only six subjects perceived themselves at risk through their own or partner's drug injecting activity. The frequency of risk factors was substantially greater than that ascertained by the routine history. The findings highlight the potential risk of heterosexual spread resulting from travel to or residence in high prevalence territories. The contribution by male partners is significant and is particularly difficult to detect during a routine interview. These data support the recommendation that voluntary HIV serum testing should be universal rather than a selective offer based on risk factors determined at a routine history.
Night Sedation and Arthritic Pain
Authors: P G Hardo, T D Kennedy
Journal: Journal of the Royal Society of Medicine (1991)

This pilot study highlights the problems of benzodiazepine (BDP) usage in patients attending a rheumatology clinic. Of 127 consecutive patients attending the rheumatology clinic a total of 29% (37) had been taking night sedation for mean duration of 4.1 years. The majority of BDP users (92%) were women. In 78% night sedation was taken for insomnia associated with night pain. We recommend that if BDP is to be prescribed it should be only in selected cases for a short time.
A Novel Bioavailable BH3 Mimetic Efficiently Inhibits Colon Cancer via Cascade Effects of Mitochondria
Authors: Xuefeng Wang, Chen Zhang, Xiangming Yan, Bin Lan, Jianyong Wang, Chongyang Wei, Xingxin Cao, Renxiao Wang, Jianhua Yao, Tao Zhou, Mi Zhou, Qiaoling Liu, Biao Jiang, Pengfei Jiang, Santosh Kesari, Xinjian Lin, Fang Guo
Journal: Clinical Cancer Research (2015)

Gossypol and its analogs, through their ability to bind to and inactivate BH3 domain-containing antiapoptotic proteins, have been shown to inhibit the growth of various human cancer cells in culture and xenograft models. Here, we evaluated the antitumor efficacy of a novel gossypol derivative and BH3 mimetic ch282-5 (2-aminoethanesulfonic acid sodium-gossypolone) in colon cancer models. Several innovative combination strategies were also explored and elaborated.Ch282-5 was synthesized by modifying the active aldehyde groups and R groups of gossypol according to a computer-aided drug design program. The stability of ch282-5 was examined by high-performance liquid chromatography, and cytotoxic effects of ch282-5 on colon cancer cells were assessed by MTS assay. Activation of mitochondrial apoptotic pathway by ch282-5 was evidenced with a series of molecular biology techniques. In vivo antitumor activity of ch282-5 and its combination with chloroquine, rapamycin, oxaliplatin, and ABT-263 was also evaluated in colon cancer xenograft models and experimental liver metastasis models.Ch282-5 showed antiproliferative and pro-cell death activity against colon cancer cells both in vitro and in vivo, and the response to the drug correlated with inhibition of antiapoptotic Bcl-2 proteins, induction of mitochondria-dependent apoptotic pathway, and disruption of mitophagy and mTOR pathway. Ch282-5 also suppressed liver metastasis produced by intrasplenic injection of colon cancer cells. Furthermore, ch282-5 could potentiate the effectiveness of oxaliplatin and rescue ABT-263 efficacy by downregulation of Mcl-1 and elevation of platelet number.These findings provide a rational basis for clinical investigation of this highly promising BH3 mimetic in colon cancer.
The influence of right ventricular diastolic functions and pulmonary hypertension on exercise limitation and their relationship with serum NT-proBNP levels in COPD
Authors: Tugce Sahin Ozdemirel, Begum Yetis, Nilufer Bayraktar, Serife Savas Bozbas, Emir Karacaglar, Gaye Ulubay
Journal: European Respiratory Journal (2011)

Introduction:  During the course of the chronic obstructive pulmonary disease (COPD); pulmonary hypertension (PHT), right heart failure, exercise limitation develop due to elevated right ventricle afterload.   Method:  In this study, 31 moderate-severe COPD patients, 20 healthy controls were included.Right ventricular diastolic parameters, serum NT-proBNP levels were studied. Exercise capacity was evaluated by cardiopulmonary exercise testing (CPET).   Results:  Echocardiography revealed PHT in 13 of the COPD patients. NT-proBNP levels were found to be higher in the COPD group than in the control group,the difference between was statistically significant (p 0.05). COPD patients demonstrated statistically lower values than the control group with regard to anaerobic threshold oxygen consumption (ATVO 2 ) and carbondioxide production (ATVCO 2 ), and peak oxygen consumption (PVO 2 ) and peak carbondioxide production (PVCO 2 ) (p 2  values determined by CPET.There was a difference between the COPD and control groups with regard to tricuspid annular plane systolic excursion (TAPSE) value,an echocardiographic parameter (p   Conclusion:  Our study demonstrates that NT-proBNP levels show a correlation with PAP and are raised in COPD patients.COPD may have a tendency for right ventricular diastolic dysfunction and that exercise limitation might be predicted by right ventricular functions and NT-proBNP levels.
Ciliated epithelial cell nipples are a common feature of primary ciliary dyskinesia (PCD)
Authors: Andrew Rutman, Robert Hirst, Gwyneth Williams, Chris O'Callaghan
Journal: European Respiratory Journal (2013)

Background: Laboratory based PCD diagnosis relies on a battery of complex tests. Common epithelial features of PCD include abnormal ciliary beat pattern after high speed video analysis and, in most cases, abnormalities of the ciliary axoneme seen after transmission electron microscopy (TEM). Phenotyping of PCD could be further enhanced by discovery of common features of the epithelium specific to PCD. We noted ciliated cells in PCD biopsies that project from the epithelium and these are referred to as ciliated epithelial cell nipples.  Aims: To test the hypothesis that ciliated epithelial cell nipples are a common feature of PCD.  Methods: Nasal brush biopsies were taken from 40 PCD and 18 non-PCD patients. The strips of ciliated epithelium were visualised by a light microscope and a high speed video recording made. The epithelium was fixed for TEM analysis. Re-growth of cilia from the biopsy was performed using cultures at an air-liquid interface. Light microscopy and TEM analysis was repeated on the cultured cilia.  Results: Ciliated epithelial cell nipples were found in 72.5% of the PCD positive samples tested. There were no nipples present in non PCD biopsies. After re-growth of the PCD cilia in culture the nipples were present in 15% of the cultures. Data to show PCD phenotype breakdown of this feature and ciliary functional analysis data will be presented.  Conclusion: Ciliated epithelial cell nipples are a common feature of PCD. The physiological significance of the ciliated nipples in PCD remains to be determined.
Randomized Phase II Study of BR96-Doxorubicin Conjugate in Patients With Metastatic Breast Cancer
Authors: Anthony W. Tolcher, Steven Sugarman, Karen A. Gelmon, Roger Cohen, Mansoor Saleh, Claudine Isaacs, Leslie Young, Diane Healey, Nicole Onetto, William Slichenmyer
Journal: Journal of Clinical Oncology (1999)

PURPOSE: BMS-182248-1 (BR96-doxorubicin immunoconjugate) is a chimeric human/mouse monoclonal antibody linked to approximately eight doxorubicin molecules. The antibody is directed against the Lewis-Y antigen, which is expressed on 75% of all breast cancers but is limited in expression on normal tissues. Preclinical xenograft models demonstrated significant antitumor activity, including cures. A randomized phase II design was chosen to estimate the activity of the BR96-doxorubicin conjugate in metastatic breast cancer in a study population with confirmed sensitivity to single-agent doxorubicin. PATIENTS AND METHODS: Patients with measurable metastatic breast cancer and immunohistochemical evidence of Lewis-Y expression on their tumor received either BR96-doxorubicin conjugate 700 mg/m 2 IV over 24 hours or doxorubicin 60 mg/m 2 every 3 weeks. Patients were stratified on the basis of prior doxorubicin exposure, visceral disease, and institution. Cross-over to the opposite treatment arm was allowed with progressive or persistently stable disease. RESULTS: Twenty-three patients who had received a median of one prior chemotherapy regimen were assessable. There was one partial response (7%) in 14 patients receiving the BR96-doxorubicin conjugate and one complete response and three partial responses (44%) in nine assessable patients receiving doxorubicin. No patient experienced a clinically significant hypersensitivity reaction. The toxicities were significantly different between the two treatment groups, with the BR96-doxorubicin conjugate group having limited hematologic toxicity, whereas gastrointestinal toxicities, including marked serum amylase and lipase elevations, nausea, and vomiting with gastritis, were prominent. CONCLUSION: The BR96-doxorubicin immunoconjugate has limited clinical antitumor activity in metastatic breast cancer. The gastrointestinal toxicities likely represent binding of the agent to normal tissues expressing the target antigen and may have compromised the delivery of the immunoconjugate to the tumor sites.
Expiratory flow limitation during sleep in heavy snorers and obstructive sleep apnoea patients
Authors: D Stanescu, S Kostianev, A Sanna, G Liistro, C Veriter
Journal: European Respiratory Journal (1996)

Inspiratory flow limitation (FL) during sleep has previously been reported both in obstructive sleep apnoea (OSA) patients and heavy snorers (HS). Recent results from this laboratory have shown the occurrence both of inspiratory and expiratory flow limitation during muscular relaxation in awake healthy subjects and OSA patients. In this study, we have investigated whether expiratory flow limitation occurs during sleep in heavy snorers and in patients with OSA. We studied four nonapnoeic, heavy snorers and five OSA patients. Airflow was measured with a pneumotachograph attached to a tight-fitting mask, and supraglottic pressure with a catheter placed at the supraglottic level. Scoring for flow limitation was achieved by visual inspection of 200 breaths recorded during sleep. About 20% of the respiratory cycles presented isolated inspiratory flow limitation. Approximately the same percentage was observed in heavy snorers and OSA patients. Isolated expiratory flow limitation was less frequently recorded. Coupled inspiratory and expiratory flow limitations were more numerous, especially in heavy snorers. We conclude that both in heavy snorers and obstructive sleep apnoea patients, inspiratory flow limitation is associated with expiratory flow limitation. This suggests that upper airway obstruction during sleep is both an inspiratory and expiratory event.
Structural Changes and Antibody Enrichment in the Lungs Are Early Features of Anti–Citrullinated Protein Antibody–Positive Rheumatoid Arthritis
Authors: Gudrun Reynisdottir, Reza Karimi, Vijay Joshua, Helga Olsen, Aase Haj Hensvold, Anders Harju, Marianne Engström, Johan Grunewald, Sven Nyren, Anders Eklund, Lars Klareskog, Carl Magnus Sköld, Anca Irinel Catrina
Journal: Arthritis & Rheumatology (2013)

It has been suggested that immunologic events in the lungs may be involved in triggering immunity, in particular production of anti-citrullinated protein antibodies (ACPAs) during early phases of rheumatoid arthritis (RA). The aim of this study was to investigate the structural and immunologic features of the lungs in incident cases of early RA in relation to ACPA presence and smoking status.High-resolution computed tomography (HRCT) was used to examine the lungs of 105 patients with early, untreated RA (70 with ACPA-positive RA and 35 with ACPA-negative RA) and 43 healthy individuals. Bronchoscopy with collection of bronchoalveolar lavage (BAL) fluid and mucosal bronchial biopsy specimens was performed in 23 RA patients. The presence of citrullinated proteins in the bronchial tissue was detected by immunohistochemical staining. ACPAs (detected with an anti-cyclic citrullinated peptide 2 test) and total Ig levels were determined in the sera and BAL fluid of RA patients.HRCT imaging revealed that 63% of ACPA-positive RA patients had parenchymal lung abnormalities, compared with only 37% of ACPA-negative RA patients and 30% of healthy controls (each P < 0.05). These significant differences remained after adjustment for smoking status. Airway changes detected by HRCT were more frequent in RA patients than in healthy controls (66% versus 42%; P < 0.05), but there was no difference between ACPA-positive and ACPA-negative RA patients. Immunohistochemical studies of the bronchial tissue showed increased staining for citrullinated proteins in ACPA-positive RA patients compared with ACPA-negative RA patients (P < 0.05). ACPA levels were relatively higher in the BAL fluid as compared with the sera of ACPA-positive RA patients, suggesting that there is local production of ACPAs in the lungs of these patients.The presence of ACPAs is associated with parenchymal lung abnormalities, site-specific citrullination, and antibody enrichment in the lungs early in the development of ACPA-positive RA.
The role of epithelial-mesenchymal transition in the possibility of chronic process in the lungs during influenza pneumonia, caused by the virus AH1N1
Authors: Nadiya Monogarova, Inna Vasilenko, Olena Semendyayeva, Bella Bruk, Natalia Surgay
Journal: European Respiratory Journal (2012)

Despite numerous influenza pandemics and morphological studies of influenza pneumonia, the question of the possible mechanisms of chronisity of the process has not been studied. It is known that in the process of chronic inflammation and sclerosis of various organs plays an important role of epithelial-mesenchymal transition. The aim of our study - to test this hypothesis in the lungs. Studied 30 sectional cases of influenza pneumonia using immunohistochemistry studies: evaluated the expression of cytokeratin and AE1/AE3 pantcytokeratina 18, vimentin, alpha-smooth muscle actin (monoclonal antibody, imaging system En Vision, Daco). The material was divided in 2 groups based on dominant lokalization. First group included 20 cases with significant damage of alveolar epithelium (necrosis, apoptosis, desquamation) and intaalveolar exudate (fibrinous, hemorrhagic, suppurative and often mixed). The second group included 10 cases with predominant changes of interalveolar septae (thickening due to edema, infiltration by inflammatory cells, stromal proliferation with transition fibrosis into myofibroblasts, accumulation of intercelular matrix. In only half of the cases in first group showed features of proliferation of alveolar epithelium in the form of small groups and sometimes numerous type 2 pneumocytes, which are more resistent to damaging factors, capable to division and differentiation toward type 1 pneumocytes and producing surfactant. All cases of the second group were found significant hyperplasia of type 2 pneumocytes. The results of our study allow to suggest that this mechanism may underlie the chronic influenza pneumonia.
Obstructive airway disease in pulmonary tuberculosis cases in relation to smoking
Authors: Shiv Sagar Gupta, Nishith Kumar
Journal: European Respiratory Journal (2012)

Introduction: Tuberculosis (TB) is a long-standing & expanding threat to public health. People with treated pulmonary tuberculosis (PTB) are left with significant changes in lung anatomy & are at higher risk of pulmonary sequelae. Smoking is the major risk factor for airflow obstruction. Recent & early studies suggest association of prior TB with development of COPD. But whether smoking modifies this relationship is unclear. Aims: 1) To study the effect of smoking & prior PTB on airflow obstruction 2) To assess the severity of obstructive abnormality in smoker versus non smoker patients of prior PTB. Settings: Tertiary care Institute in Lucknow, India. Period: From Jan 2011 to Jan 2012. Material & Method: 100 patients who visited OPD with history of prior PTB were divided into different categories on the basis of sex, smoking history, age etc. All patients were subjected to spirometry, sputum examination for acid fast bacilli, chest X-ray & their history were also evaluated. Diagnosis of COPD was based on GOLD criteria. Results: Out of total 100 patients 53 were smokers and 47 were non smokers. Out of 53 smokers 38 (71.69 %) had obstructive abnormality while out of 47 Non smokers 23 (48.93 %) had obstructive abnormality (p
“Why am I sleepy?”
Authors: NEIL J. DOUGLAS
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

Correspondence and requests for reprints should be addressed to Correspondence and requests for reprints should be addressed to Neil J. Douglas, M.D., FRCPE, Professor of Respiratory & Sleep Medicine, The University of Edinburgh, Respiratory Medicine Unit, Department of Medicine, Royal Infirmary, Edinburgh EH3 9YW, Scotland, UK. Email: n.j.douglas@ed.ac.uk “Why am I sleepy?” Sorting the Somnolent
Cream PUVA therapy for scleredema adultorum
Authors: M. Grundmann-Kollmann, F. Ochsendorf, T.M. Zollner, K. Spieth, R. Kaufmann, M. Podda
Journal: British Journal of Dermatology (2000)

Journal Article Cream PUVA therapy for scleredema adultorum Get access M. Grundmann‐Kollmann, M. Grundmann‐Kollmann Department of Dermatology, Johann Wolfgang Goethe University, Theodor‐Stern‐Kai 7, 60590 Frankfurt, Germany Search for other works by this author on: Oxford Academic Google Scholar F. Ochsendorf, F. Ochsendorf Department of Dermatology, Johann Wolfgang Goethe University, Theodor‐Stern‐Kai 7, 60590 Frankfurt, Germany Search for other works by this author on: Oxford Academic Google Scholar T.M. Zollner, T.M. Zollner Department of Dermatology, Johann Wolfgang Goethe University, Theodor‐Stern‐Kai 7, 60590 Frankfurt, Germany Search for other works by this author on: Oxford Academic Google Scholar K. Spieth, K. Spieth Department of Dermatology, Johann Wolfgang Goethe University, Theodor‐Stern‐Kai 7, 60590 Frankfurt, Germany Search for other works by this author on: Oxford Academic Google Scholar R. Kaufmann, R. Kaufmann Department of Dermatology, Johann Wolfgang Goethe University, Theodor‐Stern‐Kai 7, 60590 Frankfurt, Germany Search for other works by this author on: Oxford Academic Google Scholar M. Podda M. Podda Department of Dermatology, Johann Wolfgang Goethe University, Theodor‐Stern‐Kai 7, 60590 Frankfurt, Germany Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 142, Issue 5, 1 May 2000, Pages 1058–1059, https://doi.org/10.1046/j.1365-2133.2000.03504.x Published: 01 May 2000
Intestinal obstruction due to malrotation * Authors' response
Authors: R. D Spicer, A. K Awan, R. I Hall
Journal: Journal of the Royal Society of Medicine (2004)

Mr Awan and his colleagues (July 2004 JRSM1) report a case of malrotation in an adult. As they point out, this condition is much more often encountered in childhood. Paediatric surgeons would not agree that the operation done in this case, with an attempt to restore normal anatomy, was the correct one. The standard operative procedure is based on that described by Ladd 70 years ago—detorsion of the volvulus, division of adhesions, broadening of the small-bowel mesentery and positioning of the duodenum down the right side of the abdomen and the caecum into the left iliac fossa. There was a brief vogue in the 1960s for stabilization, as performed by Awan and colleagues, but this was never accepted by the paediatric surgical community; indeed a study by Shier et al.2 in 1987 confirmed that it has a higher morbidity than the Ladd procedure.
Phase II study of irinotecan in the treatment of advanced colorectal cancer in chemotherapy-naive patients and patients pretreated with fluorouracil-based chemotherapy.
Authors: P Rougier, R Bugat, J Y Douillard, S Culine, E Suc, P Brunet, Y Becouarn, M Ychou, M Marty, J M Extra, J Bonneterre, A Adenis, J F Seitz, G Ganem, M Namer, T Conroy, S Negrier, Y Merrouche, F Burki, M Mousseau, P Herait, M Mahjoubi
Journal: Journal of Clinical Oncology (1997)

PURPOSE To assess the efficacy of irinotecan (CPT-11) in the treatment of advanced colorectal cancer in both chemotherapy-naive and pretreated patients. PATIENTS AND METHODS Two hundred thirteen patients (aged 18 to 75 years) with metastatic colorectal cancer, World Health Organization (WHO) performance status &lt; or = 2, and life expectancy &gt; or = 3 months were treated with CPT-11 350 mg/m2 every 3 weeks. All 178 patients eligible for efficacy analysis had not received more than one prior fluorouracil (5-FU)-based chemotherapy regimen (adjuvant or palliative) and had adequate hematologic, renal, and hepatic function. RESULTS Primary tumor sites were the colon (71%) and rectum (28%). Sixty-six percent of the patients had &gt; or = two metastatic sites. Ninety-eight percent of the patients had undergone previous surgery, and 77.5% had received prior chemotherapy. Thirty-two of 178 eligible patients achieved on objective response (four complete responses [CRs] and 28 partial responses [PRs]; response rate, 18%; 95% confidence interval, 12.6% to 24.4%), 65 were stable, and 59 progressed. The response rate was 17.7% in the pretreated group and 18.8% in the chemotherapy-naive group. Within the former subgroup, response rates of 16.1% were reported in patients who were progressive on prior 5-FU chemotherapy and 19.1% in patients who were progressive off such treatment. The median duration of objective response (9.1 months) and median time to achievement of a response (9.3 weeks) did not differ between chemotherapy-naive and pretreated patients. The most frequent adverse events were neutropenia, which developed in 80% of the patients, delayed diarrhea (87%), alopecia (88%), fatigue (81%), and nausea/vomiting (77%). All these adverse events were manageable. Severe (WHO grade 3 or 4) neutropenia was only observed in 18% of the cycles, leukopenia in 11%, delayed diarrhea in 11%, and nausea and vomiting in 3%. Development of simultaneous grade 3 or 4 neutropenia and delayed diarrhea during 4% of the cycles was the safety issue of greatest concern. CONCLUSION CPT-11 has definite activity in the treatment of advanced metastatic colorectal cancer both in chemotherapy-naive and in pretreated patients who experienced disease progression on 5-FU, which suggests a lack of cross-resistance between CPT-11 and 5-FU. Diarrhea and neutropenia, the major toxicities of CPT-11, contribute to the risk to develop febrile neutropenic sepsis.