tbuckley/cabot-search huggingface dataset:
Serum vitamin D levels are associated with markers of hypoxia in obstructive sleep apnea patients
Authors: Evangelia Nena, Kostas Archontogeorgis, Maria Xanthoudaki, Panagiotis Boglou, Andreas Koulelidis, Theodore Constantinidis, Marios Froudarakis, Athanassios Zisimopoulos, Demosthenes Bouros, Paschalis Steiropoulos
Journal: European Respiratory Journal (2013)

Background: Vitamin D (Vit. D) insufficiency has been associated with metabolic syndrome, diabetes and cardiovascular disease, conditions also related with obstructive sleep apnea syndrome (OSAS).  Aim of the study was to examine serum levels of Vit. D in otherwise healthy OSAS patients and to explore associations between these levels and patients9 sleep and anthropometric characteristics.  Methods: Patients with polysomnographically confirmed OSAS (AHI>15/h) were included. To all of them blood was drawn in order to examine Vit. D levels with radioimmunoassay (RIA). Additionally, PFTs and ABGs analysis were conducted.  Results: Totally, 136 patients (94 males) with mean AHI 59.1/h, minimum SpO 2  67.8±11.4%, and average SpO 2  89±3.5% were included. PFTs and ABGs results were within normal range.  Mean levels of Vit. D were 19.5±10.9 ng/ml. These levels were positively correlated with Total Sleep Time (p=0.003), Sleep Efficiency (p=0.008), S2%TST (p=0.006), and negatively with S1%TST (p=0.010). Additionally, a negative association was revealed with AHI (p=0.039), maximum apnea duration (p=0.001), and t 2  (p=0.001) and minSpO 2  (p=0.004) during sleep and PaO 2  (p=0.003). No association was found with age or BMI.  OSAS patients with hypovitaminosis D ( 2  (p=0.022) and PaO 2  (p=0.010) levels, and higher maximum apnea duration (p=0.025) and t 20ng/ml.  Conclusions: Vit. D levels are negatively affected by OSAS. This association could be considered in interpreting the pathogenesis of cardiovascular and metabolic disorders in OSAS.
Ethical dilemma: Competency, consent, and the duty of care Best of motives, worst of consequences Let the courts decide The only failure was the outcome
Authors: A C Inwald, J. Hippisley-Cox, S. Hippisley-Cox, I. Hill-Smith
Journal: BMJ (1998)

Doctors have a legal duty to ensure that their patients have sufficient information and understanding to make informed choices about proposed treatment. But what can and should they do if a patient whose competence to make such a decision is in doubt refuses much needed treatment? Here a general practitioner describes a tragic situation that arose with a schizophrenic patient, and a lecturer in general practice, a Church of England ordinand, and a general practitioner make their observations. # Best of motives, worst of consequences {#article-title-2} My patient was a 62 year man who was looked after by his mother. He was a “burnt out” schizophrenic of low intelligence and used to spend most of his time on long walks on his own. He was always hyperactive and communicated with staccato speech, but he was always pleasant and reasonably well presented. My patient's mother died two years ago, and he had become increasingly dirty and unkempt. He walked the streets daily and found it difficult to keep still. He continued to come to the surgery regularly for his medication, and we noticed that the chair he sat on in the waiting room was faecally soiled and he began to smell. We alerted social services to the change. They visited the man at home, where he now lived on his own. His home was in an appalling state, with faeces everywhere, and he was overtly faecally incontinent. He consented to a physical examination and was found to have a severe rectal prolapse. He did not seem overly concerned about his incontinence and his general state. The patient was referred to a consultant surgeon and was told he needed an operation to correct the prolapse. He refused to proceed—he would not accept that there was a problem. The situation deteriorated and his home became uninhabitable. Social services arranged for it … Correspondence to: Dr Julia Hippisley-Cox
INFLUENZA AND SCHIZOPHRENIA
Authors: Karl A. Menninger
Journal: American Journal of Psychiatry (1926)

Of the psychoses appearing in close conjunction with influenza, as observed during the 1918 epidemic, the schizophrenic syndrome was by far the most frequent. The previous epidemics of influenza occurred prior to Kraepelin's formulation of "dementia precox," hence 1918 was the first opportunity afforded for the determination of the relationship of these two widespread afflictions as presently conceived. Because of the almost unequalled neurotoxicity of influenza, it should prove to be a critical test of the pathological basis of schizophrenia. The facts are that of about two hundred acute post-influenzal psychoses at the Boston Psychopathic Hospital, one-third looked like and were labeled "dementia precox"; and follow-up inquiries made one to five years later reveal that of about fifty of these that could be traced, two-thirds had apparently completely recovered, and certainly only ten living cases showed no improvement. This would seem to indicate the need of new diagnostic criteria or new prognostic conceptions (in re reversibility) for the acute schizophrenic syndrome.
2-step community screening strategy for OSA
Authors: Michiel Eijsvogel, Job van der Palen, Winfried Randerath, Johan Verbraecken
Journal: European Respiratory Journal (2013)

Introduction: Philips-Netherlands has intended to screen its Dutch employees (13.000) for OSA. For screening is a high specificity needed.  Objectives: due to the large number of employees and the small amount of studies on screening for OSA, a screening strategy had to be developed in a pilot study.  Methods: 1861 Philips employees where invited by e-mail. Sleep Questionnaires (Q), type IV portable monitoring (PM), and a standard home-polysomnography were done. Uni-variate analysis and logistic regression analysis was performed to determine the optimal screening strategy. OSA was defined as AHI>15, or AHI>5 with symptoms but without overt insomnia.  Results: 249 Persons gave informed consent, 235 returned all Q, 190 did both sleep studies and from 176 (9,5%) all data were available. The StopQ, StopBangQ, BerlinQ, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, and Athens Insomnia Scale were positive in 45%, 57%, 36%, 9%, 34%, and 7%, respectively. Using PM a RDI>15 was found in 61 persons (35%). Finally, OSA was diagnosed in 65 persons (37%). Age, presence of heart failure or arrhythmias, absence of insomnia, BerlinQ- Question 5 (breathing stops), and 3-way scoring of the BerlinQ and StopBang Q predicted OSA. Step 1 of the screening strategy is based on the mentioned predictor variables, resulting in subjects with a low, intermediate and high probability of OSA. In step 2 the intermediate group is split into low and high probability for OSA, based on PM with a RDI cutoff of 15. This 2- step strategy has a sensitivity of 66%, and specificity of 89%. For an estimated prevalence of 9%, the pos. and neg. predictive values will be 38% and 96%, respectively.  Conclusion: Screening for OSA in an employees population is feasible.
Transient cerebral dysfunction secondary to high-dose methotrexate.
Authors: R W Walker, J C Allen, G Rosen, B Caparros
Journal: Journal of Clinical Oncology (1986)

A transient acute neurologic syndrome occurred in 22 patients receiving high-dose methotrexate (HDMTX) (8 to 9 g/m2) for a variety of malignancies. The neurologic signs were similar in all cases. The syndrome occurred an average of six days after the second or third weekly treatment. Common findings included behavioral abnormalities, focal sensorimotor signs, and abnormal reflexes. Signs often alternated from one side to the other. Evaluations including computed tomography (CT) scan, lumbar puncture, hemogram, and blood chemistry were normal. The EEG revealed some slowing in all cases. The cause of this syndrome is unknown. It is transient and usually does not recur. Its appearance does not preclude further treatment with HDMTX.
On-line survey of a 7 steps patient passport for COPD
Authors: Stephen Gaduzo, Mark Pilling, June Roberts, Preeti Sud, John Williams
Journal: European Respiratory Journal (2013)

INTRODUCTION  Little is known about patient engagement with national and international quality standards for COPD care.  AIMS  We previously reported results of patient opinion at a “Listening event”, and development of a simple patient-held passport condensing recommended standards into 7 care steps. (PCRJ vol21/21_2_A1_A35) We have now conducted a pilot survey of patients to find out how frequently the 7 steps were met.  METHOD  The survey was posted on the British Lung Foundation website9s community forum for 12 weeks. Participants were asked to state if the 7 standards on the passport were being met, and to post positive or negative comments about their care.  RESULTS  The BLF on-line community has 2129 members, 306 (15%) contributed, results are summarised below:  CONCLUSIONS  Results show variation in the delivery of basic standards of care to COPD patients completing the survey, demonstrating significant room for improvement. Responders may be commenting on primary or secondary care providers and may be a self-selecting group.  However, the high number of responses in a relatively short time suggests that patient websites are useful mechanisms for patient engagement.  We propose wider use of the 7 Steps Patient Passport and a more extensive survey as a way of enabling patient-driven improvement in standards of care.
Enhancing Effect on &lt;italic&gt;N&lt;/italic&gt;-Nitrosodimethylamine-Induced Tumorigenesis by Unilateral Hydronephrosis
Authors: T Ohmori
Journal: JNCI Journal of the National Cancer Institute (1984)

The effect of unilateral hydronephrosis (U-HN) on chemical tumorigenesis by two im injections of N-nitrosodimethylamine (DMN; CAS: 62-75-9) with the use of inbred female W rats was studied. Of the rats in the U-HN group, 70.0% developed kidney tumors, 25.0% developed mammary tumors, 20.0% developed hepatomas, and 20.0% developed other tumors. Almost all kidney tumors in the U-HN group (96.0%) were induced in the compensatory (contralateral) kidney. In contrast, of the rats in the unilateral nephrectomy (U-NR) group, 29.4% developed kidney tumors, 11.8% developed mammary tumors, 23.5% developed hepatomas, and 11.8% developed other tumors. Rats in the sham-operated group developed 1 small kidney tumor (7.7% of the rats) but no tumors in other organs. Thus, under these conditions, U-NR and especially U-HN strongly increased tumor induction in DMN tumorigenesis not only in the compensatory kidney but also in extrarenal organs.
Prevalence, Predictors, and Outcomes of Pulmonary Hypertension in CKD
Authors: Sankar D. Navaneethan, Jason Roy, Kelvin Tao, Carolyn S. Brecklin, Jing Chen, Rajat Deo, John M. Flack, Akinlolu O. Ojo, Theodore J Plappert, Dominic S. Raj, Ghulam Saydain, James H. Sondheimer, Ruchi Sood, Susan P. Steigerwalt, Raymond R. Townsend, Raed A. Dweik, Mahboob Rahman
Journal: Journal of the American Society of Nephrology (2015)

Pulmonary hypertension (PH) is associated with poor outcomes in the dialysis and general populations, but its effect in CKD is unclear. We evaluated the prevalence and predictors of PH measures and their associations with long–term clinical outcomes in patients with nondialysis-dependent CKD. Chronic Renal Insufficiency Cohort (CRIC) Study participants who had Doppler echocardiography performed were considered for inclusion. PH was defined as the presence of estimated pulmonary artery systolic pressure (PASP) >35 mmHg and/or tricuspid regurgitant velocity (TRV) >2.5 m/s. Associations between PH, PASP, and TRV and cardiovascular events, renal events, and all-cause mortality were examined using Cox proportional hazards models. Of 2959 eligible participants, 21% (n=625) had PH, with higher rates among those with lower levels of kidney function. In the multivariate model, older age, anemia, lower left ventricular ejection fraction, and presence of left ventricular hypertrophy were associated with greater odds of having PH. After adjusting for relevant confounding variables, PH was independently associated with higher risk for death (hazard ratio, 1.38; 95% confidence interval, 1.10 to 1.72) and cardiovascular events (hazard ratio, 1.23; 95% confidence interval, 1.00 to 1.52) but not renal events. Similarly, TRV and PASP were associated with death and cardiovascular events but not renal events. In this study of patients with CKD and preserved left ventricular systolic function, we report a high prevalence of PH. PH and higher TRV and PASP (echocardiographic measures of PH) are associated with adverse outcomes in CKD. Future studies may explain the mechanisms that underlie these findings.
Photodynamic therapy for actinic keratoses: time to re-evaluate?
Authors: C.A. Morton
Journal: British Journal of Dermatology (2010)

Conflicts of interest C.A.M. has received honoraria for speaking, organized educational events and conducted research for Galderma, PhotoCure and Phototherapeutics Ltd. Heard about the therapy reporting 99% lesion and 96% patient complete clearance rates for actinic keratoses (AKs)? Perhaps not, unless you have already read the BJD epub accepted articles section. These are the clearance rates achieved for immunocompetent patients with four to eight mild to moderate AK lesions on the face/scalp recruited to a randomized, multicentre, double‐blind, placebo‐controlled study of topical photodynamic therapy (PDT) published in this month’s BJD.1 A new, stable nanoemulsion formulation of 10% aminolaevulinic acid (ALA) was combined with illumination by one of two light sources, and the impressive clearance rates were achieved by only one of the sources, a narrowband red light‐emitting diode (LED) source. The protocol did permit a second treatment after 12 weeks and clearance rates are based on clinical assessment, only 12 weeks after last treatment. Nevertheless, these are impressive results and will stimulate fresh enthusiasm into re‐evaluating PDT for AK.
Maternal abstention from cow milk and egg in allergy risk pregnancies
Authors: K. Fälth‐Magnusson, H. ÖMan, N‐I. M. Kjellman
Journal: Allergy (1987)

To study the possibility of intrauterine sensitization, 212 women were enrolled on a voluntary basis into a prospective, randomized study, comparing the effects of an elimination diet and normal food during late pregnancy. The diet group took no cow milk and no egg from week 28 to delivery, and extra calcium and casein hydrolysate (Nutramigen ®) supplement was given to fill the nutritional needs of mother and child. The control group took normal food, including approximately 1/2 liter of milk/day and 3–5 eggs/week. All families had a history of allergy in mother, father, or sibling. Maternal weight gain during pregnancy was significantly lower in the diet group. Birth weights showed no significant difference between the two main groups, but smokers in the elimination diet group had significantly smaller babies. IgE antibodies to cow milk and egg were significantly higher in atopic than in non‐atopic women before the trial. The diet caused a significant fall in IgG‐antibodies to cow milk and egg in both atopic and non‐atopic subjects. Cord blood IgE determination revealed no significant difference between the groups. No IgE antibodies to cow milk or egg were detected in any of the cord sera. The participating babies are being followed up until 18 months of age.
Predictors of clinical and microbiological treatment failure in patients with methicillin-resistant Staphylococcus aureus (MRSA) bacteraemia: a retrospective cohort study in a region with low MRSA prevalence
Authors: C. Forstner, C. Dungl, S. Tobudic, D. Mitteregger, H. Lagler, H. Burgmann
Journal: Clinical Microbiology and Infection (2013)
Systemic effect of intrathecal methotrexate during the initial phase of treatment of childhood acute lymphoblastic leukemia. The European Organization for Research and Treatment of Cancer Children's Leukemia Cooperative Group.
Authors: A Thyss, S Suciu, Y Bertrand, F Mazingue, A Robert, E Vilmer, F Mechinaud, Y Benoit, P Brock, A Ferster, P Lutz, P Boutard, G Marguerite, E Plouvier, G Michel, D Plantaz, M Munzer, X Rialland, J M Chantraine, L Norton, G Solbu, N Philippe, J Otten
Journal: Journal of Clinical Oncology (1997)

PURPOSE The in vivo response to prephase corticosteroid therapy for 1 week has been described as a major prognostic factor in childhood acute lymphoblastic leukemia (ALL). Patients with less than 1,000 blasts/microL at day 8 are considered responders and have a better prognosis. This prephase therapy is usually considered as an evaluation of glucocorticoid sensitivity. In fact, it also includes one intrathecal (IT) injection of methotrexate (MTX). In this study, we try to clarify the influence of this injection of IT MTX on the response to the prephase therapy. PATIENTS AND METHODS This retrospective study analyzed the response to prephase therapy in 1,044 children with ALL entered onto the European Organization for Research and Treatment of Cancer (EORTC) trial 58881 of the Children's Leukemia Cooperative Group (CLCG). Analysis was restricted to 732 cases with an initial blast count greater than 1,000/microL. The following variables were tested to analyze response to prephase therapy: age, sex, evaluated risk factor (RF), blast count on day 0, actual dose of prednisolone administered, immunophenotype (T v non-T), and day of IT MTX. For statistical analysis, the variable day of IT MTX (D) was stratified into three groups: group 1 if D less than 2, group 2 if D &gt; or = 2 but &lt; or = 6, and group 3 if D greater than 6. RESULTS All variables tested had a significant influence on response to the prephase therapy. This was especially true for IT MTX: 90.4% responders in group 1, 76.9% in group 2, and 70% in group 3 (P &lt; .001). Immunophenotype was also a major predictor of response to the prephase: 88% responders in B-lineage ALL versus 56.2% in T-lineage ALL. IT MTX had a significant influence in B-lineage ALL (96% responders in group 1, 90% in group 2, and 79% in group 3; P &lt; .001), whereas the influence could not be detected in T-lineage ALL. CONCLUSION These results clearly demonstrate a therapeutic systemic effect of low doses of IT MTX in childhood ALL, and response to prephase therapy should not be considered as an in vivo test for cortico-sensitivity only. Earlier use of IT MTX leads to a higher percentage of responders.
Use of RAST Technique in Wasp Sting Hypersensitivity
Authors: U. Müller, A. Roth, L. Yman, R. Patrizzi
Journal: Allergy (1978)

Clinical hypersensitivity to wasp stings was found to be fairly well correlated with the presence of serum IgE‐antibodies against yellow jacket venom as detected by the RAST technique. Such antibodies were never found in a control group of non‐allergic blood donors, but they were detected in a surprisingly large proportion of patients with bee sting allergy without known allergic reactions to wasps. Studies using RAST inhibition technique failed to prove cross‐reactions between bee and wasp venoms. Considerably better results were obtained when venom antigens instead of whole body antigens were used in the RAST, RAST inhibition studies suggested that IgE‐antibodies detected with RAST using whole body antigen are directed against bee venom constituents in the whole body extract.
Productivity losses in COPD – A population-based survey
Authors: Marta Erdal, Ane Johannessen, Jan Erik Askildsen, Tomas Eagan, Amund Gulsvik, Rune Grønseth
Journal: European Respiratory Journal (2014)

Background and aims: Treatment-related costs are well known in COPD, but the incremental productivity losses (sick leave and disability) of spirometry-defined COPD in population-based samples are unknown.  Methods: We performed 4 quarterly telephone interviews of 53 and 107 population-based COPD patients and controls, as well as 102 hospital-recruited COPD patients. Information was gathered regarding annual productivity loss, exacerbations of respiratory symptoms, and comorbidities. Incremental productivity losses were estimated by multivariate quantile median regression according to the human capital approach, adjusting for sex, age, smoking habits, education and lung function.  Results: 55%, 87% and 31% of population based COPD cases, controls and hospital patients had a paid job at baseline. The unadjusted annual mean (SD) number of lost days was 120 (158), 39 (87) and 242 (159) among population based COPD patients, controls and hospital patients, respectively. 38%, 41% and 8% reported zero days of productivity loss. The incremental productivity losses were 5.8 (95% CI 1.5 to 10.0) days and 335.0 (95% CI 332.4 to 337.5) days, comparing population-recruited and hospital-recruited COPD patients to controls, respectively. There were significantly higher productivity losses associated with female sex and less education. Comorbidities and exacerbations explained all productivity losses associated with moderate disease, as well as 24% of the productivity losses in very severe disease.  Conclusion: The annual productivity losses associated with COPD were considerable, but nevertheless smaller in population-recruited patients. Comorbidities and respiratory symptom exacerbations were associated with a large fraction of these losses.
FK506 and cyclosporin A inhibit granulocyte/macrophage colony-stimulating factor production by mononuclear cells in asthma
Authors: T Sano, Y Nakamura, Y Matsunaga, T Takahashi, M Azuma, Y Okano, E Shimizu, F Ogushi, S Sone, T Ogura
Journal: European Respiratory Journal (1995)

Bronchial asthma is associated with eosinophilic inflammation and expression of T-cell-derived cytokines, which influence eosinophilic function. FK506, a newly established immunosuppressive agent, may have potential as a therapeutic instrument for asthma because of its suppressive effect on T-cell activation. To assess this, we compared the inhibitory effects of FK506 and cyclosporin A on production of granulocyte/macrophage colony-stimulating factor and interleukin-5 by interleukin-2- or Dermatophagoides farinae-stimulated mononuclear cells from patients with asthma, and their contribution to proliferation and survival of eosinophils in vitro. FK506 inhibited granulocyte/macrophage colony-stimulating factor production by stimulated mononuclear cells from asthma patients at lower concentrations than cyclosporin A. Both drugs inhibited eosinophil proliferation and survival activity from mononuclear cells at comparable concentrations. Interleukin-5 production by stimulated mononuclear cells was also inhibited both by FK506 and cyclosporin A. We conclude that both FK506 and cyclosporin A have potential for therapy of bronchial asthma.
Future Research Directions in Acute Lung Injury
Authors: Michael A. Matthay, Guy A. Zimmerman, Charles Esmon, Jahar Bhattacharya, Barry Coller, Claire M. Doerschuk, Joanna Floros, Michael A. Gimbrone, Eric Hoffman, Rolf D. Hubmayr, Mark Leppert, Sadis Matalon, Robert Munford, Polly Parsons, Arthur S. Slutsky, Kevin J. Tracey, Peter Ward, Dorothy B. Gail, Andrea L. Harabin
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Section:ChooseTop of pageAbstract <<OVERVIEW OF ALI/ARDSSYSTEMIC MANIFESTATIONS O...CURRENT UNDERSTANDING AND...FUNCTIONAL GENOMICS, PROT...GENETICS OF ALI/ARDSHETEROGENEITY OF PHENOTYP...CLINICAL AND BIOCHEMICAL ...ANIMAL MODELS OF LUNG INJ...CONCLUSIONS AND RECOMMEND...ReferencesCITING ARTICLES