tbuckley/cabot-search huggingface dataset:
Abstract 3202: Gender Differences Among Patients with Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention in the ACC/NCDR PCI Registry
Authors: Nausheen Akhter, Sarah Milford-Beland, Matthew T Roe, Adhir R Shroff
Journal: Circulation (2007)

Background : Cardiovascular disease is the leading cause of death in women. Prior studies have demonstrated gender disparities in the management and outcomes of women with acute coronary syndromes (ACS). Objectives : We sought to explore if gender differences exist in a patient population who present with ACS and have a percutaneous coronary intervention (PCI) during hospitalization in a large, contemporary national PCI registry, the American College of Cardiology National Cardiovascular Data Registry (ACC-NCDR). Methods : We analyzed ACS patients who had a PCI in the ACC-NCDR PCI registry from January 1, 2004 to March 30, 2006. Clinical characteristics, procedural and clinical outcomes, and concomitant medical therapies were compared between men and women according to ACS status: unstable angina (UA)/non-ST elevation MI (NSTEMI) and ST elevation MI (STEMI). Results : Of 199,690 patients with ACS who underwent PCI, women more often presented with unstable angina (57.7% vs. 53.9%), equally with NSTEMI (24.2% vs. 23.6%), and less often with STEMI (18.1% vs. 22.6%) compared with men. In both ACS categories, women were older and had a higher incidence of diabetes (insulin or non-insulin dependent), HTN, PVD, CVA, past and current CHF and renal failure. There was also a higher incidence of cardiogenic shock in women among the STEMI population. The use of drug eluting stents was similar among women and men, but women were less likely to receive aspirin, GP IIb-IIIa inhibitors, and discharge aspirin and statins compared with men. While the adjusted rate of in-hospital mortality was similar among women and men, women had higher rates of peri-procedural complications, including more cardiogenic shock, CHF, bleeding and vascular complications. Rates of subacute stent thrombosis were similar between genders. Conclusions : Women with ACS who underwent PCI were older and more likely to have comorbidities compared with men, and were more likely to have procedural complications. Whether these differences were related to the observed differences in a number of evidence-based medications or clinical characteristics among women vs. men will require further study. Adjusted rate of in-hospital mortality was similar among women and men.
Evaluation of noninvasive positive-pressure ventilation in newborns after anastomosis with esophageal atresia
Authors: Ievgenii Vzhetson, Dmytro Dmytriiev, Konstantin Bertsun, Kosechenko Nataliia
Journal: European Respiratory Journal (2013)

Introduction: The frequency of esophageal atresia (EA) is 1:3000 newborns. Esophageal atresia related surgery treatment within 6-72 hours after birth. The use of two levels of positive pressure ventilation (BPAP), related to the conventional respiratory therapy (CRT) in the postoperative period with EA in infants can reduce pulmonary complications.  Objectives: To evaluate the safety and compliance of preventive application of BPAP associated with EA in postoperative period.  Methods: 20 patients undergoing anastomosis with EA were randomly allocated in one of the groups. Patients of the Control Group (CG) were treated only with conventional respiratory therapy, compared to BPAP group (BG) (in addition to conventional respiratory therapy in postoperative period the patients were subjected to 120 minutes of noninvasive ventilation by two levels (BPAP) once a day). All patients were evaluated for oxygen saturation, heart rate, respiratory frequency, tidal volume, systolic and diastolic blood pressure. Evaluations were performed immediately after extubation 24h and 48h.  Results: In CG 58% of patients had some degree of atelectasias, in comparison to 44% of BG (P=0.691). The vital capacity was higher in the GB postoperatively (P  Conclusion: Anastomosis after EA leads to deterioration of respiratory function postoperatively, and the application of noninvasive positive pressure ventilation (BPAP) in postoperative period may be beneficial to restore lung function more quickly, safely, and well accepted by patients.
Cost effectiveness of the induced sputum technique for the diagnosis of Pneumocystis carinii pneumonia (PCP) in HIV-infected patients
Authors: C. Chouaid, B. Housset, J. L. Poirot, P. Roux, B. Lebeau
Journal: European Respiratory Journal (1993)

The purpose of this study was to assess: 1) the percentage of human immunodeficiency virus (HIV)-infected patients with suspected Pneumocystis carinii pneumonia (PCP) but unable to undergo the induced sputum procedure, together with the reasons involved; 2) the sensitivity and specificity of induced sputum procedure, using conventional stains and an immunofluorescence test; and 3) the cost of introducing induced sputum procedure for the diagnosis of PCP. One hundred and thirty eight HIV-infected patients with suspected PCP underwent induced sputum procedure and bronchoalveolar lavage (BAL). P. carinii was identified in induced sputum and BAL samples using conventional and immunofluorescence staining. The economic analysis took into account the direct costs of the two procedures. The induced sputum procedure was either not feasible or unsuccessful in 29% of the patients. The sensitivity of induced sputum, using conventional and immunofluorescence staining, was 0.27 and 0.56 respectively. The economic analysis showed that the two strategies (systematic BAL versus BAL only after negative induced sputum) are equivalent in cost terms when the induced sputum to BAL cost ratio is equal to the product of the prevalence of PCP by the sensitivity of induced sputum procedure. We conclude that the immunofluorescence test should be the reference technique for induced sputum samples, whilst conventional stains are more clinically relevant for BAL samples. The cost of introducing induced sputum should take into account the sensitivity of induced sputum and the prevalence of PCP in the suspected population.
The effects of extrafine beclomethasone/formoterol on hyperinflation and airway geometry in COPD patients
Authors: Samir Vinchurkar, Wim Vos, Cedric Van Holsbeke, Jan De Backer, Gianluigi Poli, Wilfried De Backer
Journal: European Respiratory Journal (2012)

Aim of this study was to assess the effects of extrafine beclomethasone⁄formoterol treatment on lung hyperinflation and airway geometry in COPD. Data of lobar volume (%pred) and specific lobar airway volumes (siVaw) at FRC and TLC were obtained with functional imaging in 25 COPD patients (GOLD II 14, III 7, IV 4) pre- and 4h post-bronchodilator (post BD) both at baseline and after 6 months of treatment. A post BD drop was observed for both functional residual capacity (FRC) and total lung capacity (TLC) lobar volumes at baseline (FRC:-10%,p<0.01;TLC:-2%,p<0.01) and after 6 months (FRC:-12%,p<0.01;TLC:-2%,p<0.01) as index of reduced hyperinflation. siVaw did increase 4 hours after administration at both time points (+10%,p<0.01, and +8%,p<0.01).

![Figure][1] 



The 4h post-BD drop in hyperinflation at FRC was positively associated with the degree of hyperinflation (r=0.4, p<0.01). A drop in pre-bronchodilation hyperinflation was also observed at TLC after 6 months of treatment (-1%, p<0.01). Extrafine beclomethasone/formoterol decreased hyperinflation and increased airway volume in COPD patients 4h after bronchodilator. Moreover the chronic treatment over 6 months decreased also the pre-bronchodilator hyperinflation at TLC, indicating a progressive reduction of air trapping with treatment.

 [1]: pending:yes
Air liquid interface culture can alter ciliary beat pattern in epithelium from primary ciliary dyskinesia patients
Authors: Claire Jackson, Janice Coles, Patricia Goggin, Amanda Harris, Jane Lucas
Journal: European Respiratory Journal (2012)

Introduction:  Primary Ciliary Dyskinesia (PCD) is a rare inherited heterogeneous disorder of cilia, impairing mucociliary clearance. PCD is diagnosed by low nasal nitric oxide concentration, abnormal airway ciliary function with corresponding ultrastructural defects, excepting atypical cases. PCD may be differentiated from secondary dyskinesia by assessing differentiated ciliated epithelium at air liquid interface (ALI).   Aim:  To evaluate ciliary beat pattern (CBP) on PCD airway epithelium before and after ALI culture.   Method:  Ciliary function of nasal brushing epithelium from 9 PCD patients with ultrastructure defects confirmed by TEM, was analysed (n=10 cell clusters) at 37oC by high-speed video microscopy (100x oil objective). Confluent basal epithelial cells on 0.3 mg/ml Purecol (Nutacon) coated 12 mm transwell inserts were differentiated over 21 days in 1:1 BEGM:DMEM with SingleQuots (Clonetics, Lonza) and 100 nM retinoic acid. Ciliated ALI membranes were excised and cilia and ciliary function re-examined.   Results:  Three ALI cultures (33.3%) retained their CBP compared to the original epithelium: 2/9 completely static cilia; 1/9 static with twitching cilia. Six ALI cultures (66.7%) continued to exhibit abnormal CBP but the phenotype changed following ALI culture: 5/9 static with twitching cilia became completely static on ALI; 1/9 dyskinetic with static cilia became completely static on ALI and additionally dynein arm defects altered from 60 to 98% after culture.   Conclusions:  The diagnosis of PCD remained clear before and after ALI culture, however we observe that ciliary function and percentage defect rate may alter in epithelial cell culture at ALI.
Acute impact of a single e-cigarette smoking on symptoms, vital signs and airway inflammatory response
Authors: Sofia Vakali, Stamatia Tsikrika, Sofia-Antiopi Gennimata, Georgios Kaltsakas, Anatsasios Palamidas, Nikolaos Koulouris, Christina Gratziou
Journal: European Respiratory Journal (2012)

E-cigarette is a battery powered electronic nicotine delivery device. Many smokers use it, because it is marketed as a safer alternative to smoking.  The aim of our study was to evaluate the acute effect of smoking a single e-cigarette for 10 minutes on symptoms, vital signs, exhaled CO, exhaled NO and airway temperature in never smokers and in smokers with and without chronic airway obstruction.  We studied 37 consecutive subjects (17 male), aged:42±14yr (mean±SD). Nine were never smokers, 15 were smokers with normal spirometry and 13 smokers with chronic airway obstruction (7 asthmatics, 6 with COPD). All subjects answered a questionnaire about symptoms (cough, sore throat, eye irritation, dizziness and feeling of satisfaction) immediately after smoking a single e-cigarette for 10 minutes. We also measured oxygen saturation (SpO2), heart rate (HR), exhaled CO, exhaled NO and airways temperature pre and post smoking.  After smoking a single e-cigarette for 10 minutes, our group reported cough (65%), sore throat (68%), irritation in eyes (24%), difference in taste (78%), dizziness (24%) and feeling of satisfaction (51%). In addition, there was a statistically significant: a) increase in HR (from 75±10 to 92±17, p  We conclude that after smoking a single e-cigarette for 10 minutes there was a change in symptoms, vital signs and indices of airway inflammation in a statistically significant manner. Further studies are needed to establish the immediate and long-term effects of e-cigarette smoking.
Restrictive lung disease following treatment for malignant brain tumors: a potential late effect of craniospinal irradiation.
Authors: R I Jakacki, C M Schramm, B R Donahue, F Haas, J C Allen
Journal: Journal of Clinical Oncology (1995)

PURPOSE To examine the effects of lomustine (CCNU), a commonly used nitrosourea, and craniospinal radiation therapy on the subsequent development of restrictive lung disease (RLD) following treatment for malignant brain tumors. PATIENTS AND METHODS Pulmonary function testing with measurement of lung volume, spirometry, and diffusion capacity was performed in 28 patients who had received CCNU and/or radiation therapy as treatment for a malignant brain tumor. The median age at the time of treatment was 11.4 years (range, 3.9 to 36.7) and radiation therapy was completed 6 months to 11.6 years (median, 2.6 years) before testing. Patients were divided into four groups based on prior therapy. Group 1 received involved-field irradiation and a CCNU-containing chemotherapy regimen (n = 7); group 2, craniospinal irradiation with a boost to the primary tumor site and a CCNU-containing chemotherapy regimen (n = 6); group 3, craniospinal irradiation with a boost to the primary tumor site and a non-CCNU-containing chemotherapy regimen (n = 7); and group 4, craniospinal irradiation with a boost to the primary tumor site without chemotherapy (n = 8). RESULTS Fourteen patients (50%) had findings consistent with RLD. One of seven patients (14.3%) who received CCNU without spinal irradiation had RLD, whereas 13 of 21 (61.9%) who received spinal irradiation with or without CCNU had RLD (P = .038), including four of eight patients treated with craniospinal irradiation alone. Logistic regression analysis showed that only spinal irradiation was a significant predictor for RLD. Patients who received spinal irradiation were 4.3 times more likely to have RLD than those who did not receive spinal irradiation. CONCLUSION Spinal irradiation may be a risk factor for the development of RLD.
High-frequency Oscillatory Ventilation
Authors: BRADLEY A. YODER, THERESA SILER-KHODR, VICKI T. WINTER, JACQUELINE J. COALSON
Journal: American Journal of Respiratory and Critical Care Medicine (2000)

Acute lung injury models demonstrate that high-frequency oscillatory ventilation (HFOV) improves lung function, mechanics, and histopathology with reduced inflammatory mediators. Neither human HFOV trials nor premature animal studies have adequately evaluated these factors during prolonged HFOV. The objective of this study was to compare the effect of prolonged HFOV with low tidal volume (Vt) positive pressure ventilation (LV-PPV) in an immature baboon model for neonatal chronic lung disease (CLD). After administration of prenatal steroids, 18 baboons were delivered by cesarean section at 125 d (term = 185 d), treated with exogenous surfactant, then randomized to either HFOV or LV-PPV by 5 min age. Animals were maintained on oxygen on an "as needed" basis and on nutritional support for 1 to 2 mo. Serial pulmonary function testing (PFT) was performed. Tracheal aspirates were analyzed for interleukin-6 (IL-6), IL-8, tumor necrosis factor-alpha (TNF- α ), IL-1 β , and IL-10. Lungs were inflation fixed for morphometric analyses. From 12 h through 10 d age, HFOV animals had consistently lower fraction of inspired oxygen (Fi O2 ) and higher a/ A ratio. Pulmonary mechanics were significantly improved in HFOV animals at nearly every time point analyzed from 12 h to 28 d. There were no consistent differences in tracheal IL-6, TNF- α , IL-1 β , or IL-10 after 24 h age. Higher tracheal IL-8 values and macrophage/monocyte numbers were found in LV-PPV animals after 1 wk and 3 to 4 wk ventilation. Both groups exhibited pulmonary pathologic lesions found in extremely immature humans, including alveolar hypoplasia, variable saccular wall fibrosis, and minimal airway disease. HFOV animals had significantly better lung inflation patterns by panel of standards analysis. Early, prolonged HFOV significantly improved early lung function with sustained improvement in pulmonary mechanics out to 28 d. Immature baboons managed with HFOV had less pulmonary inflammation in the hyaline membrane disease (HMD) recovery phase. Though enhanced alveolization was not observed, HFOV for 1 to 2 mo resulted in consistently more uniform lung inflation than LV-PPV.
Survey of non-invasive ventilation use for acute respiratory failure in respiratory wards in Poland
Authors: Jacek Nasilowski, Marcin Leszczyk, Martyna Bura, Ryszarda Chazan
Journal: European Respiratory Journal (2011)

Introduction:  Non-invasive ventilation (NIV) is one of the most important developments in pulmonology over the last two decades. NIV reduces need to intubation and mortality in acute respiratory failure secondary to several conditions. NIV requires qualified staff and access to appropriate equipment. Aim of the study was to assess use of NIV in respiratory wards (RW) in Poland and to reveal main obstacles and difficulties in its use.   Methods:  Using survey methodology we developed a questionnaire comprising 11 questions about methods, indications and technical aspects of NIV. Survey was send by mail to all hospitals with RW in Poland.   Results:  Prevalence of NIV according to hospital grade is shown in table.  NIV is used in 75% of RW with high dependency unit (HDU) and in 27% without HDU. The main indication to NIV has been acute exacerbation of COPD, 73% of all patients treated with NIV. Majority of RW (71%) treat up to 5 patients per month.  Main obstacles to development of NIV is lack of equipment and adequate structure of the ward.   Conclusions:  Prevalence of NIV availability within RW in Poland is low and strongly depends on the grade of hospital and the presence of HDU.
Autonomic nerve dysfunction in COPD as assessed by the acetylcholine sweat-spot test
Authors: AG Stewart, F Marsh, JC Waterhouse, P Howard
Journal: European Respiratory Journal (1994)

Patients with hypoxic chronic obstructive pulmonary disease (COPD) have evidence of a subclinical parasympathetic autonomic neuropathy, with apparent preservation of sympathetic function. However, these cardiovascular-respiratory tests might have been biased by concomitant chest disease, the acetylcholine sweat-spot test avoids this bias. This sweat-spot test assesses sympathetic nerve function, it relies upon the fact that denervated sweat glands do not produce sweat. 35 patients with hypoxaemic COPD and seven age matched normal subjects were studied. Following intradermal injection of 0.1 of 1% acetylcholine into the dorsum of the feet, the number of sweatglands able to respond in a given surface area was recorded. Cardiovascular autonomic nerve function, arterial oxygen and carbon dioxide tensions, lung function and cigarette consumption were also recorded. The acetylcholine sweat-spot test was highly repeatable in eight COPD patients, no person with normal or frankly abnormal function being wrongly assigned. The age matched control subjects had normal acetylcholine sweat-spot scores and cardiovascular autonomic tests. The acetylcholine sweat-spot test was abnormal in 24 patients, borderline in 8 and normal in 3 patients. The abnormal sweat-spot test group had significant worse FEV1, arterial blood gases and autonomic function. The acetylcholine sweat-spot score correlated with the severity of arterial hypoxaemia (r = 0.78, p < 0.001) and with the parasympathetic cardiovascular tests (r = 0.80, p < 0.001). In conclusion, patients with hypoxaemic COPD have a parasympathetic cardiovascular and a peripheral sympathetic autonomic neuropathy. The acetylcholine sweat-spot test is repeatable, easy to perform and a sensitive indicator for autonomic dysfunction in breathless individuals with COPD.
Intercostal nerve blockage for pain control in blunt thoracic trauma
Authors: H. Volkan Kara, Nuri Tutar, Selma Yesilkaya, Gokhan Ertas, M. Erdem Memetoglu, Kadir Agladioglu, A. Seckin Cetinkaya
Journal: European Respiratory Journal (2011)

Blunt thoracic traumas are common clinical occasions in the emergency rooms. There are several approaches in the medical management of these patients. In this study we evaluated the the safety and efficacy of application of long acting local anesthetic bupivacaine 5% in to the intercostal space.  There were 32 consequative patients in a single city state hospital in Turkey. Median age of the patients was 42,4 (22 min 78 max). There were 27 male and 5 female patients. Admission to the ER were due to blunt trauma caused by falling down or motor vehicle accident. The patients who needed to have chest tube insertion either due to pneumothorax or hemothorax were excluded from the study.  The Visual Analog Pain Scale was asked every patient before starting treatment. Mean value was 7.8 were patients with fractured ribs (n=12) and 7.3 for the patients without fracture in the ribs (n=20). After the intercostal blokage and the analgesic treatment themean values decreased to 4.2 and 4 respectively in the following 24 hour. The patients discharged from the hospital in the following 3.4 days. The injection of bupivacaine 5% was to 1ml to 3 levels. First was to the site having the most severe pain to the palpation plus one level up and down with the well known standardized method. The procedure was repeated every day during the hospitalization period.  Application of 5% bupivacaine into the intercostal space to patients having pain is safe and effective. It decreases the the Visual Analog Pain Scale rapidly, need for non opiod analgesics and decreases the hospitalization period and possible morbidities due to secretion retention. It evidently improve the patients comfort.
Abstract 2513: Assessment of Both Coronary Microvascular Damage and Epicardial Flow Velocity Measurement Immediately after Successful Percutaneous Coronary Intervention for Acute Myocardial Infarction Predicts In-Hospital Complications and Survival
Authors: Atsushi Yamamuro, Takashi Akasaka, Shuichiro Kaji, Koichi Tamita, Minako Katayama, Makoto Kinoshita, Natsuhiko Ehara, Atsushi Kobori, Takeshi Kitai, Takafumi Yamane, Yoshimori An, Kite Kim, Syunsuke Funakoshi, Noriyuki Kimura, Tomoko Tani, Kazuaki Tanabe, Shigefumi Morioka, Yutaka Furukawa
Journal: Circulation (2008)

Quantitative measurement of post-reperfusion epicardial flow velocity by a Doppler guidewire can predict clinical cardiac events in patients with acute myocardial infarction (AMI). It has also been reported that the coronary flow velocity pattern in patients with microvascular dysfunction is characterized by the presence of early systolic retrograde flow and a rapid diastolic deceleration time (DDT). The purpose of this study was to examine the role of assessing both epicardial flow velocity and microvascular damage in the prediction of in-hospital complications and survival after percutaneous coronary intervention (PCI). Two hundred and eleven consecutive patients with first anterior AMI who underwent successful PCI were subjected to coronary flow measurement immediately after successful PCI with a Doppler guidewire. The coronary flow velocity spectrum provided the following parameters: time-averaged peak velocity (cm/s, APV), systolic peak velocity (cm/s) and DDT (ms). We defined the presence of microvascular dysfunction as DDT ≤600 ms and the presence of systolic flow reversal, and slow epicardial flow as resting APV ≤10cm/s. We classified the patients into three categories: without microvascular dysfunction (group 1, n=122), with microvascular dysfunction and normal epicardial flow (group 2, n= 54), with microvascular dysfunction and slow epicardial flow (group 3, n=35). The clinical event rate was compared among the 3 groups. The in-hospital event rates for congestive heart failure, cardiac rupture and death were highest in group 3 and lowest in group 1 (Table ). Assessment of both coronary microvascular damage and epicardial flow velocity can accurately predict in-hospital complications and survival in AMI patients who underwent successful reperfusion of the infarct-related coronary artery, identifying a subset of high risk patients. In-hospital event rates (%)