tbuckley/cabot-search huggingface dataset:
Aspergillus skin hypersensitivity in patients of COPD
Authors: Vishal Chopra, Parul Mrigpuri, Don Gregory Mascerehnas
Journal: European Respiratory Journal (2014)

Allergic bronchopulmonary aspergillosis is caused by hypersensitivity to the antigens of the Aspergillus. A. fumigatus causes more than 80% of cases of ABPA. There have been case reports on ABPA in COPD. The aim was to evaluate the rate of Aspergillus skin hypersensitivity to various Aspergillus antigens in patients of COPD. 100 patients with COPD and 100 healthy controls were included. Intradermal Aspergillus skin test using 0.02 ml of Aspergillus antigens (fumigatus, niger, flavus, versicolor and tamari). Aspergillus hypersensitivity (AH) was defined as the presence of immediate cutaneous hyperreactivity to the Aspergillus antigen. All statistical tests were two-sided and performed at a significance level of =.05.All analyses were conducted using SPSS for Windows . The 100 COPD patients consisted of 95 males and 5 females with a mean (95% CI) age 51.34years(49.19-53.59). 95% were smokers.  15% of the COPD patients were positive to at least one of the five Aspergillus antigens tested of which 86.7% were males and 13.3% were females. None of the members in the control population demonstrated hypersensitivity to any of the tested Aspergillus antigens. On univariate analysis there was no relationship of Aspergillus hypersensitivity in COPD patients with age, gender and absolute eosinophil count. There have always been a overlap in COPD and asthma. Even in the scarcity of studies showing direct evidence of aspergillus skin hypersensitivity in patients of COPD there are enough studies in the literature pointing towards the possibility. This study is just a step forwards to explore this possibility and differentiate patients of COPD with element of aspergillus skin hypersensitivity so that they can be treated in a better way.
Localized mucosal involvement and severe pulmonary involvement in a young patient with paraneoplastic pemphigus associated with Castleman's tumour
Authors: None Kim, None Chang, None Lee, None Park, None Jeong, None Lee, None Ahn, None Anhalt
Journal: British Journal of Dermatology (1998)

We describe a 19-year-old female patient who developed recurrent ulcerations limited to the orogenital mucosa for the last 3 years. She also developed dyspnoea 5 months after the onset of the orogenital lesions. Castleman's tumour of the retroperitoneum was found incidentally during routine physical examination. The diagnosis of paraneoplastic pemphigus (PNP) was made by pathological and immunological studies. The orogenital ulceration responded well to corticosteroid therapy, but severe bronchiolitis obliterans progressed despite intensive care. The patient eventually died from respiratory failure. This case demonstrates the diversity of clinical features of paraneoplastic pemphigus.
Bias in randomised controlled trials: comparison of crossover group and parallel group designs
Authors: Philip Sedgwick
Journal: BMJ (2015)

The efficacy and side effects of the synthetic cannabinoid nabilone were compared with those of the weak opioid dihydrocodeine in the treatment of chronic neuropathic pain. A randomised, double blind, crossover trial study design was used. Participants received a maximum daily dose of 2 mg nabilone or 240 mg dihydrocodeine. The trial lasted for 14 weeks and comprised two treatment periods, each of six weeks’ duration, separated by a two week washout period. Participants were patients with chronic neuropathic pain aged 23-84 years, who were recruited using convenience sampling from outpatient units at three hospitals in the United Kingdom. The sample comprised 96 patients, who were randomised to nabilone (n=48) and dihydrocodeine (n=48) in the first treatment period.1

The main outcome was pain as measured on a visual analogue scale over the final two weeks of each treatment period. Side effects were measured by a questionnaire. The researchers reported that dihydrocodeine provided better pain relief than nabilone and had slightly fewer side effects, although no major adverse events occurred for either drug.

Which of the following statements, if any, are true?

Statements a , b , c , d , and e are all true.

The aim of the trial was to compare the efficacy and side effects of nabilone with dihydrocodeine in the treatment of chronic neuropathic pain. A randomised double blind crossover trial was conducted. Participants received both treatments in succession, …
Assessment of fissure integrity for decision-making in valve treatment of emphysema: Preliminary results
Authors: Hugo Oliveira, Rafael Rambo, Silvia Oliveira, Enio Valle, Amarilio Macedo-Neto
Journal: European Respiratory Journal (2012)

Objective. To investigate if fissure integrity can determine collateral ventilation and guide endobronchial valve (EBV) treatment of emphysema.

Method. The study is underway. We employ the Apollo software (VIDA Diagnostics) for treatment planning, and developed a visual fissure integrity score using a sagittal view through pre-treatment CT scans, to determine which % of the fissure was visible:  90% (complete). Before treatment, collateral ventilation is measured with Chartis (Pulmonx Inc., a balloon catheter inserted into the airway + console showing airflow, pressure, and resistance).

Preliminary results:

View this table:

Two cases showing correlation between fissure integrity and collateral ventilation





Case 1 was successfully treated based on fissure completeness.

![Figure][1] 



Case 2 received an additional valve in a neighboring segment after detection of collateral ventilation.

Conclusion. Fissure integrity could be a reliable indicator of collateral ventilation and support EBV treatment of homogeneous emphysema.

 [1]: pending:yes
Skin lesions and an intrathoracic mass
Authors: WL Vasmel, JC van Mourik, MN Jiwa, PE Postmus
Journal: European Respiratory Journal (1994)

We describe a case of thoracic actinomycosis in a previously healthy man. The clinical features were a paramediastinal mass with skin lesions due to haematogenic dissemination. After parasternal mediastomy, the diagnosis was made. After treatment with penicillin, there was complete recovery.
F alpha-1 antitrypsin polymerization activates endoplasmic reticulum overload response
Authors: Samuel Alam, Ravi Mahadeva
Journal: European Respiratory Journal (2014)

Severe deficiency of the major anti-elastase α 1 -antitrypsin (AT) due to Z (Glu342Lys) variant (Z-AT) (polymerizes within hepatocyte endoplasmic reticulum (ER)) is the commonest genetic reason for the development of COPD. F variant (Arg223Cys) of AT (F-AT) is linked with mild plasma deficiency. FZ heterozygote is linked to emphysema and cirrhosis. We assessed properties of F-AT in a cell-model. Human F-AT gene was transfected into lung epithelial (A549) cells and assessed supernatants, lysates or inclusion bodies at 24h and compared to normal non-polymerizing M-AT by ELISA/immunoblot. F-AT secretion was slightly lower, but comparable to M-AT secretion(1535±150pg/ml vs.1785±112, P=0.59). Secreted F-AT had reduced elastase inhibitory capacity (EIC) (0.5±0.1(OD@405nm) vs.1.2±0.1, P
Compliance (<i>COM</i>municate <i>PL</i>ease w<i>I</i>th Less <i>A</i>bbreviations, <i>N</i>oun <i>C</i>lusters, and <i>E</i>xclusiveness)
Authors: Martin J. Tobin
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Keywords: AGA = appropriate for gestational age; AR = arousal; BLM = bleomycin; CTL = control; CTL = cytotoxic T lymphocytes; CR = complete response; DH = dynamic hyperinflation; DH = diaphragmatic hernia; DZ = dizygotic; EIF = electrically induced fatigue; ETX = endotoxin; FLAP = 5-LO-actvating protein; GGEMG/Pepi = genioglossus electromyography/epiglottic pressure; HASM = human airway smooth muscle cells; IRL = inspiratory resistive load; ITGV = intrathoracic gas volume; JEM = job exposure matrix; KO = knockout; LAM = lymphangioleiomyomatosis; LB = lymphocytic bronchiolitis; MAP = mean arterial pressure; MAP = mitogen-activated protein; MAP = multivariate apnea prediction; MIP = macrophage inflammatory protein; MIP = maximum inspiratory pressure; MPP = microorganisms with potential pathogenicity; NTHi = non-typeable Haemophilus influenzae; OI = orthostatic intolerance; OI = oxygenation index; OT = operating theater; PATC = pulmonary antibiotic tissue concentration; QWB = quality of well being; ROFA = residual oily fly ash; SLB = surgical lung biopsy; TWG = total water gradient; TST = tuberculin skin test; TST = total sleep time; UC = usual care; UIP = usual interstitial pneumonia; UIP = upper inflection point; Vuip1 = volume of UIP; UPPP = uvulopalatopharyngoplasty; WG = weight gain; Xrs5 = reactance at 5 Hz with impulse oscillation technique; Yr6 = age 6 years; Zds = impedance of compressible gas
Reduction of Central Venous Catheter Use in Medical Inpatients Through Regular Physician Audits Using an Online Tool
Authors: Emily G. McDonald, Todd C. Lee
Journal: JAMA Internal Medicine (2015)

unintended consequences due to these in-office payment reduction policies through shifting the performance of these procedures to the hospital environment, with the associated hospital outpatient department payment formula, at a substantial increase in cost to the CMS.White and Wu 2 have examined Medicare hospital cost reports for the period 1996-2009 and concluded that Medicare price cuts yield revenue reductions that are even larger than the Medicare payment reductions-in other words, other payers also reduce payments and affect downstream revenues.In addition, Wu and Shen 3 have demonstrated that drastic reductions in Medicare payments can potentially have an adverse effect on quality of patient care.Lindrooth and colleagues 4 studied 30-day mortality from Medicare databases for the years 1997, 2001, and 2005 and have reported an inverse relationship between changes in profitability and mortality across 21 service lines.Many would view that it is speculative to suggest that reducing payments will lead to an adverse effect on quality of care, but the analyses of Wu et al and Lindrooth et al at least beg the question of whether better strategies for imaging cost containment could be implemented by the CMS.The current health care delivery challenges and resultant changes to the practice landscape demand creative and workable solutions to meet the needs of new practice models as well as help current private practitioners maintain viability while simultaneously promoting high value in health care delivery.These changes include a renewed focus on new payment models, education around evolving models of care, developing and using quality tools to ensure evidence-based care, and promoting the appropriate use of stretched resources.In particular, addressing the problem of overuse of unnecessary tests and procedures by implementing payment models that encourage appropriate testing while discouraging inappropriate testing is a more rational approach for controlling Medicare costs than across-the-board decreases in reimbursement.Physicians will need to assume leadership in new delivery systems and health care policy to encourage all specialties to practice cost-effective medicine.We agree with Fuchs and Milstein 5 : "There is not much that physicians can do directly to change the behavior of insurance companies, employers, or other stakeholders, but physicians are the most influential element in health care.The public's trust in them makes physicians the only plausible catalyst of policies to accelerate diffusion of costeffective care."
A proposal in small cell lung cancer staging according to TNM system
Authors: Kostas Zarogoulidis, Dimitris Latsioe, Kostas Porpodis, Paul Zarogoulidis, Nick Antoniou, Ellada Elephteriadou, Efimia Boutsikou, Theodore Kontakiotis, Jan-Paul Sculier
Journal: European Respiratory Journal (2012)

Background: Many pts with limited disease [LD] behave similarly to those with extensive disease [ED] from the prognostic point of view. On the other hand, a proportion of pts with ED SCLC behave similarly to those with LD. Moreover, the 7th (IASLC) TNM classification has not been evaluated with recent, large scale studies in SCLC.  Patients and Methods: In this retrospective analysis 764 pts with proven SCLC were included managed with the same therapeutic protocols based on platinum analogues. Of these pts, 278 (36.4%) had LD, while 486 (63.6%) had ED. This classification was based on the following investigations: chest radiography, computed tomography of chest, abdomen and brain, fiberoptic bronchoscopy, isotope bone scan, sputum cytology and haemotological and biochemical profile. We also grouped the pts according to new TNM classification (seventh edition).  Results: A statistically significant difference was found in survival among the LD SCLC pts with (IA + IB), (IIA + IIB + IIIA) and IIIB stage (p  Conclusions: A new classification of SCLC can be proposed which includes four stages based on TNM classification of NSCLC. [(Stage IA+IB), (Stage IIA+IIB+IIIA), (Stage IIIB) and (Stage IV)].
Survival in Hereditary Breast Cancer Associated With Germline Mutations of <i>BRCA2</i>
Authors: L. C. Verhoog, C.T.M. Brekelmans, C. Seynaeve, G. Dahmen, A. N. van Geel, C.C.M. Bartels, M.M.A. Tilanus-Linthorst, A. Wagner, P. Devilee, D.J.J. Halley, A.M.W. van den Ouweland, E. J. Meijers-Heijboer, J.G.M. Klijn
Journal: Journal of Clinical Oncology (1999)

PURPOSE: Breast cancer in BRCA1 and BRCA2 gene-mutation carriers may differ from so-called sporadic breast cancer in clinical features and behavior. These potential differences may be of importance for the prevention, screening, and, ultimately, treatment of breast cancer in women with such germline mutations. Thus far, there have been very few studies on the survival of BRCA2-associated breast cancer patients. PATIENTS AND METHODS: We determined the disease-free and overall survival of 28 breast cancer patients from 14 consecutive families with eight different BRCA2 germline mutations. These patients' survival and tumor characteristics were compared with those of a control group of 112 sporadic breast cancer patients matched to them by age and year of diagnosis. RESULTS: The 5-year disease-free survival was 52% for each group (P = .91); the overall survival was 74% for BRCA2 carriers and 75% for sporadic cases (P = .50). At the time of diagnosis, tumors from the BRCA2 carriers were borderline significantly larger in comparison to the tumors in sporadic cases (P = .05), but axillary nodal status was not significantly different in the two groups (node-negativity, 63% v 52.8%, respectively; P = .34). With respect to steroid receptor status, BRCA2-associated tumors were more likely to be steroid receptor-positive, especially regarding progesterone receptor status (100% v 76.7% positive, respectively; P = .06). Stage-adjusted recurrence and death rates were nonsignificantly better for BRCA2 cases (hazard ratios of 0.84 and 0.59 [P = .61 and P = .19], respectively). In contrast, after 5 years, the rate of metachronous contralateral breast cancer in BRCA2 patients was 12% (v 2% in controls; P = .02). CONCLUSION: Patients with hereditary breast cancer due to BRCA2 have a similar prognosis when compared with age-matched sporadic breast cancer patients. Contrary to our previous observation regarding BRCA1-associated breast cancer, BRCA2 tumors tended to be steroid receptor-positive, instead of steroid receptor-negative.
Interaction between high glucose and TGF-beta in cell cycle protein regulations in MDCK cells.
Authors: Y L Yang, J Y Guh, M L Yang, Y H Lai, J H Tsai, W C Hung, C C Chang, L Y Chuang
Journal: Journal of the American Society of Nephrology (1998)

Transforming growth factor-beta (TGF-beta) may mediate high glucose effects in renal cells. Thus, Madin-Darby canine kidney cells were studied for the modulation of cell cycle regulatory proteins by high glucose (27.5 mM) and TGF-beta1. We showed that unlike other renal cells, TGF-beta1 mRNA and its bioactivity were not induced by high-glucose culture. Furthermore, high glucose per se increased cellular proliferation without alterations in cell size. High glucose also increased the percentage of cells in the G2/M phase while decreasing cells in the G0/G1 phase of the cell cycle. In contrast, TGF-beta1 dose dependently (1 to 4 ng/ml) decreased cellular mitogenesis while increasing hypertrophy in the cells, especially in the presence of high glucose. TGF-beta1 also increased the percentage of cells arrested in the G0/G1 phase while decreasing cells in the G2/M phase of the cell cycle. Regarding two of the cell cycle regulatory proteins, high glucose increased cdc2 kinase activity and retinoblastoma protein (pRb) phosphorylation. In contrast, TGF-beta1 decreased cdc2 kinase activity and pRb phosphorylation, especially in the presence of high glucose. Additionally, glucose dose dependently (5.5, 16.5, 27.5, and 38.5 mM) increased type I and II TGF-beta receptor protein expression. In conclusion, changes in cdc2 kinase activity and pRb phosphorylation were correlated with high glucose and TGF-beta1-induced growth effects in a cell cycle-dependent manner in the Madin-Darby canine kidney cells. Furthermore, high glucose may potentiate TGF-beta1-induced effects by enhancing TGF-beta receptor protein expression.
Abstract 16: Diabetes, Pre-diabetes, and Progression of Subclinical Myocardial Damage
Authors: Elizabeth Selvin, Mariana Lazo, Lu Shen, Jonathan Rubin, John William (Bill) McEvoy, Ron C Hoogeveen, Christie M Ballantyne, Josef Coresh
Journal: Circulation (2014)

Background: Persons with hyperglycemia even below the threshold for the diagnosis of diabetes are at increased risk for cardiovascular events. The relationships of pre-diabetes and undiagnosed diabetes with progression of subclinical myocardial damage are relatively uncharacterized. Objective: To characterize the associations of diabetes and pre-diabetes with 6-year progression of subclinical myocardial injury, as assessed by a novel highly sensitive assay for cardiac troponin T (hs-cTnT). Methods: We conducted a prospective analysis of hs-cTnT measured at two time points, 6 years apart, in 8446 participants of the community-based ARIC Study with hs-cTnT &lt;14 ng/L and without a history of heart disease, stroke or heart failure at baseline (1990-92). We examined the associations of pre-diabetes and diabetes defined by HbA1c or fasting glucose with 6-year change in hs-cTnT after adjustment for traditional cardiovascular risk factors. Diagnosed diabetes was defined as self-reported physician diagnosis or medication use for diabetes. We used Poisson regression to evaluate the risk of progression of hs-cTnT from non-elevated (&lt;14 ng/L) to elevated (≥14 ng/L) (“incident elevated hs-cTnT”) at 6 years of follow-up. Results: Baseline prevalence of elevated concentrations of hs-cTnT among persons with no diabetes (HbA1c&lt;5.7%), prediabetes (HbA1c 5.7-6.4%), undiagnosed diabetes (≥6.5%), and diagnosed diabetes were 1.8%, 3.3%, 6.3% and 10.3%, respectively. Diagnosed diabetes, undiagnosed diabetes, and pre-diabetes were significantly associated with incident elevated hs-cTnT (Table). The associations of undiagnosed diabetes and pre-diabetes defined by diagnostic categories of HbA1c showed somewhat stronger associations compared to those clinical categories defined by fasting glucose. Conclusions: These results provide evidence for a progressive, deleterious effect of hyperglycemia on the myocardium, even below the threshold for a diagnosis of diabetes.
Features of pneumonia diagnostics in burn trauma patients
Authors: Tetiana Khomazyuk, Sergei Slesarenko, Lyudmila Novozhenina
Journal: European Respiratory Journal (2014)

Pneumonia diagnostics in patients with burn trauma is an actual problem as lesion of respiratory organs in the general structure of polyorgan insufficiency makes 88,9%.  Purpose: studying features of pneumonia course and informative criteria of early diagnostics in patients with burn trauma depending on age, area, depth of defeat, airways burn (AB).  Methods: retrospective analysis of medical records of 749 patients and 40 autopsies in age groups from 18 to 60 and over 60 with burns of 2% to 95% of body surface.  Results: in patients aged before 60 with superficial burns of more than 40% of body surface, pneumonia developed in 38,1% of cases, with deep burns of more than 20% - in 43,9%, and in the senior age group - in 53,6% of cases in case of smaller area of burns (more than 20% and 5% respectively). Physical symptoms of pneumonia were stated only in 34,5% of cases. In AB pneumonia developed more often by 1,37 times. Autopsy analysis showed that in the first days in deep burns pneumonia foci were detected in 83,3%, in 22,2% - with areas of micro-abscesses, and 46,43% cases were not diagnosed during lifetime.  Conclusions: standard clinical and laboratory diagnostic criteria of pneumonia are leveled as a rule, by manifestations of burn disease. The X-ray research of the thorax in 2 projections is obligatory on day 2-3 in patients over 60 years even in a mild burn trauma without AB and in all patients in AB presence, despite absence of physical data in the lungs. Correction of antibiotic treatment should be carried out by monitoring microbic landscape of sputum, wound surface, serological diagnostics and local resistance of microflora.
Cutaneous adverse drug reactions reported in children: a national register-based study
Authors: L. Aagaard, E.H. Hansen
Journal: British Journal of Dermatology (2012)

Journal Article Cutaneous adverse drug reactions reported in children: a national register‐based study Get access L. Aagaard, L. Aagaard Research Unit of Clinical Pharmacology, Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, JB Winsløws Vej 19, 2, 5000 Odense C, DK‐ DenmarkDanish Pharmacovigilance Research Project (DANPREP), Copenhagen, Denmark Search for other works by this author on: Oxford Academic Google Scholar E.H. Hansen E.H. Hansen Danish Pharmacovigilance Research Project (DANPREP), Copenhagen, Denmark Section for Clinical and Social Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark E‐mail: laagaard@health.sdu.dk Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 168, Issue 2, 1 February 2013, Pages 434–437, https://doi.org/10.1111/j.1365-2133.2012.11133.x Published: 01 February 2013