tbuckley/cabot-search huggingface dataset:
Abstract 13694: Greater Contribution of Endothelium-Derived Hyperpolarizing Factor to Exercise-Induced Vasodilation in African Americans Compared to Whites.
Authors: Muhiddin Ozkor, Ayaz Rahman, Jonathan Murrow, Nino Kavtaradze, Ji Lin, Amita Manatunga, Arshed Quyyumi
Journal: Circulation (2010)

Whether impaired endothelial function in African Americans (AA) compared to Whites is due to alterations in either nitric oxide (NO) or endothelium-derived hyperpolarizing factor (EDHF) activity is...
Efficacy and safety of bacterial lysates in patients with chronic obstructive pulmonary disease and exacerbation
Authors: Hao Tang, Zheng Fang, Qingyu Xiu
Journal: European Respiratory Journal (2011)

Objective:  This study was a double-blind, placebo-controlled, randomized clinical trial to evaluate the preventive effect of bacterial lysates (Broncho-Vaxom, OM-85 BV) on acute exacerbation in patients with COPD or chronic bronchitis in China.   Methods:  428 patients recruited from 13 centers were randomly allocated into BV or placebo. 384 patients completed the study (192 in OM-85 BV group and 192 in the placebo group). Patients received medications for 10 days per month during 3 months with a 10-week follow-up.   Results:  This study revealed that the proportion of patients with recurrent exacerbation in OM-85 BV group was significantly lower than that in placebo group within 12-week treatment period (23.4% vs. 33.3%, p 0.05).   Conclusions:  OM-85 BV significantly reduced the rate of recurrent exacerbations in patients with chronic bronchitis or COPD in therapy period. It also significantly reduced the frequency of exacerbations in individual patients in active therapy period and decreased the usage of antibiotics, with a good safety profile.
Gender differences in sleep pattern in a cohort of patients with obstructive sleep apnea syndrome
Authors: Sebastian Canisius, Thomas Ploch, Sandra Apelt, Jörg Heitmann, Werner Cassel, Karl Kesper, Andreas Jerrentrup
Journal: European Respiratory Journal (2011)

Introduction:  Besides sleep related breathing disorders, other factors influence sleep pattern and polysomnographic parameters. Especially gender differences have been described that must be considered when making therapeutic decisions. Using data from a cohort of patients with OSAS, we will present gender related differences derived from a polysomnographic (PSG) examination prior to any therapeutic intervention.   Methods:  Patients with OSAS who were referred to our sleep disorders centre with suspected sleep disordered breathing were monitored during the diagnostic visit and filled in the Epworth Sleepiness Scale. PSG recordings were visually analysed and parameters essential for sleep pattern rating were collected.   Results:  Data from 938 patients were collected, consisting of 790 male (age 54.6±12.3 years) and 148 female (age 58.5±12.8 years) subjects. Sleepiness among genders was not different (males: 380 ESS 2  p=0.15). However, females had less breathing disorders (AHI 25.7±24.9/h) than males (AHI 33.0±26.9/h; p   Conclusion:  We could show significant differences in light sleep and deep sleep proportions and arousal indices between male and female OSA patients. In contrast, the proportion of sleepy patients was not significantly different. These results may help to understand gender related differences in reported daytime symptoms and facilitate therapeutic decisions.
Pregnancy in Women With a Mechanical Heart Valve
Authors: Iris M. van Hagen, Jolien W. Roos-Hesselink, Titia P.E. Ruys, Waltraut M. Merz, Sorel Goland, Harald Gabriel, Malgorzata Lelonek, Olga Trojnarska, Wael Abdulrahman Al Mahmeed, Hajnalka Olga Balint, Zeinab Ashour, Helmut Baumgartner, Eric Boersma, Mark R. Johnson, Roger Hall
Journal: Circulation (2015)

Background— Pregnant women with a mechanical heart valve (MHV) are at a heightened risk of a thrombotic event, and their absolute need for adequate anticoagulation puts them at considerable risk of bleeding and, with some anticoagulants, fetotoxicity. Methods and Results— Within the prospective, observational, contemporary, worldwide Registry of Pregnancy and Cardiac disease (ROPAC), we describe the pregnancy outcome of 212 patients with an MHV. We compare them with 134 patients with a tissue heart valve and 2620 other patients without a prosthetic valve. Maternal mortality occurred in 1.4% of the patients with an MHV, in 1.5% of patients with a tissue heart valve ( P =1.000), and in 0.2% of patients without a prosthetic valve ( P =0.025). Mechanical valve thrombosis complicated pregnancy in 10 patients with an MHV (4.7%). In 5 of these patients, the valve thrombosis occurred in the first trimester, and all 5 patients had been switched to some form of heparin. Hemorrhagic events occurred in 23.1% of patients with an MHV, in 5.1% of patients with a tissue heart valve ( P &lt;0.001), and in 4.9% of patients without a prosthetic valve ( P &lt;0.001). Only 58% of the patients with an MHV had a pregnancy free of serious adverse events compared with 79% of patients with a tissue heart valve ( P &lt;0.001) and 78% of patients without a prosthetic valve ( P &lt;0.001). Vitamin K antagonist use in the first trimester compared with heparin was associated with a higher rate of miscarriage (28.6% versus 9.2%; P &lt;0.001) and late fetal death (7.1% versus 0.7%; P =0.016). Conclusions— Women with an MHV have only a 58% chance of experiencing an uncomplicated pregnancy with a live birth. The markedly increased mortality and morbidity warrant extensive prepregnancy counseling and centralization of care.
A single institution, retrospective chart review of relapse patterns in stage 1 non-seminomatous germ cell tumours (NSGCT)
Authors: D. B. Thomson, M. Burge, E. T. Walpole
Journal: Journal of Clinical Oncology (2004)

4731 Background: The optimal active watch policy for stage I is unknown. Our policy for all patients includes clinical evaluation, markers and CXR monthly for 6 months, then 6 weekly for 6 months, then 3 monthly for 1 year and then 6 monthly until 5 years with yearly visits thereafter. Abdominal/pelvic CT scans were obtained every alternate visit until at least 2 years. Methods: We assessed the policy validity by reviewing charts of all stage I NSGCT patients on active watch from 1983–2002. We analysed relapse rates related to vascular invasion (VI), presence of embryonal histology and pre-op marker levels. Mode of relapse was correlated with time of relapse (months 1–6, 7–12 or >13). Results: There were 87 patients. 38 (44%) relapsed, of these 84% by 1 yr, 97% by 2 years (range 45–1245 days). Median relapse time was 159 days. Relapse rates with and without VI were 65% and 38%, and with and without embryonal carcinoma were 48% and 21% respectively. 25/60 of pre-op marker positive and 13/26 marker negative patients relapsed. 17/25 pre-op marker positive patients and 6/13 pre-op marker negative patients relapsed with positive markers. Of 38 relapses, 8 (21%) were found by markers alone, 16 (42%) by radiology alone and 14 (37%) by both. Of 30 relapses with radiological abnormalities, 23 (77%) were below the diaphragm, 7 (23%) above, 5 of which were picked up by CXR alone. Relapses months 1–6: 26% marker only, 37 % radiology only (of these 71% CT, 29% CXR), 37% both; months 7–12 8% marker only, 38% radiology only (of these 80% CT, 20% CXR), 54% both; months 13+ 33% marker only 66% radiology only (of these 50% CT, 50% CXR). All relapses achieved a sustained complete remission after platinum based regimens. Conclusions: VI and embryonal histology correlate with higher relapse rate. Pre-op markers do not correlate with relapse risk or positivity at relapse. Time of relapse did not correlate with mode of relapse. Markers and CXR are valuable tools in relapse detection. CT scans should be continued to 2 years minimum follow up. We would not change our intensive surveillance policy based on this data. No significant financial relationships to disclose.
Phase I/II trial and pharmacokinetics of intrathecal diaziquone in refractory meningeal malignancies.
Authors: S L Berg, F M Balis, S Zimm, R F Murphy, J Holcenberg, J Sato, G Reaman, P Steinherz, A Gillespie, K Doherty
Journal: Journal of Clinical Oncology (1992)

PURPOSE Because there is a compelling need to develop new agents for intrathecal use, we investigated the safety, efficacy, and CSF pharmacokinetics of diaziquone (AZQ) following intrathecal administration in patients with refractory meningeal malignancies. PATIENTS AND METHODS Thirty-nine patients received 45 courses of intrathecal AZQ. Two schedules were studied; twice-weekly administration of a 1- or 2-mg dose and "concentration times time" (C x T) administration of 0.5 mg every 6 hours for three doses, administered once weekly. RESULTS Dose-limiting toxicity consisting of headache, nausea, or vomiting occurred in only three patients and only at the 2-mg, twice weekly dose. The schedules of 1 mg twice-weekly and 0.5 mg every 6 hours for three doses were well tolerated. Thirty-seven courses were assessable for response. The overall response rate was 62%. Complete responses (CRs) occurred in 14 of 37 courses (38%) and partial responses (PRs) occurred in nine of 37 courses (24%). Among patients with meningeal leukemia, CRs were observed in 11 of 26 courses (42%) and PRs in nine of 26 courses (35%). There was no difference in response rate related to dose or schedule. The pharmacokinetic behavior of intrathecally administered AZQ was characterized by biexponential disappearance from ventricular CSF, with mean half-lives of 18.2 and 78.6 minutes. The mean clearance rate was 0.37 mL/min. CONCLUSION Intrathecal AZQ is safe, well tolerated, and highly active against refractory meningeal malignancies.
New Zealand priority criteria project
Authors: A. Mordue, D. W Parkin, J. Elliott, M. Doogue, I. Crozier, D. Smyth, A M. Richards, M G. Nicholls, H. Ikram
Journal: BMJ (1997)

CONSORT statement on the reporting standards of clinical trials Recommendations are inappropriate for trial reportsEditor-In his editorial on the CONSORT statement Douglas G Altman states that since "only randomised trials have the potential directly to affect patient care ... it is ... reasonable to require higher standards for papers reporting randomised trials than those describing other types of study." 1 But although randomised trials are usually the preferred approach for the unbiased evaluation of treatments, non-randomised observational studies also influence treatment.Because the correct interpretation of observational studies is much more difficult, largely due to uncontrollable biases, their description and analysis call for at least as much care as do randomised trials.Sometimes, of course, randomised comparisons are unnecessary-for example, to determine the value of fetoprotein screening for neural tube defects.CONSORT is the product of deliberations conducted almost entirely through North American journals. 2Journal editors and statisticians are well represented among those involved, but clinicians and others with experience in actually conducting trials less so.Experience of the procedures recommended seems to be limited and not wholly positive.The authors of one trial report who had been persuaded to rewrite it 3 in the structured format expressed mixed feelings: the paper was rendered less readable with "ideas that are logically linked together (such as point estimates with 95% confidence intervals) torn asunder." 4 Inflexibility and a lengthier manuscript were other reported disadvantages.The editor stated that a journal "should change the way it structures articles only when there is good agreement on the new format in the communities we serve" 4 ; this includes writers and readers of trial reports as well as editors.Feedback from the test case 3 or from other commentators does not seem to have materially altered the final version of CONSORT.By announcing its decision, less than a fortnight after publication of CONSORT, the BMJ pre-empted input from many with experience of planning, conducting, and reporting trials.Few will dispute the need for improvements in the reporting of all studies with implications for patient care, whatever their design.But without appropriate consultation, the BMJ seems to have made its decision on CONSORT prematurely.The requirement that randomised trials report the numbers of patients excluded is generally pointless, 5 and making authors indicate where a large number of checklist items are dealt with would be unduly prescriptive.The CONSORT recommendations should not be imposed unilaterally.Others with experience of trial conduct should be consulted on the nature of any guidelines for the reporting of randomised trials and, more importantly, of observational studies of treatments.
Significant Improvement Of Outcome In Adolescents and Young adults (AYAs) Aged 15-35 Years With Acute Lymphoblastic Leukemia (ALL) With a Pediatric Derived Adult ALL Protocol; Results Of 1529 AYAs In 2 Consecutive Trials Of The German Multicenter Study Group For Adult ALL (GMALL)
Authors: Nicola Gökbuget, Joachim Beck, Kalina Brandt, Monika Brüggemann, Thomas Burmeister, Helmut Diedrich, Christoph Faul, Andreas Hüttmann, Mustafa Kondakci, Doris M Kraemer, Oliver G. Ottmann, Stefan Schwartz, Hubert Serve, Michael Starck, Matthias Stelljes, Reingard Stuhlmann, Andreas Viardot, Ralph M. Waesch, Knut Wendelin, Dietrich Beelen, Renate Arnold, Dieter Hoelzer
Journal: Blood (2013)
When to use fibrinolytics in empyema- are there clear recommendations?
Authors: Jan Plutinsky, Zuzana Taligova, Stanislava Szaboova, Ingrid Libakova, Karol Bitter
Journal: European Respiratory Journal (2013)

Parapneumonic pleural effusion (or empyema-EMP) is a common complication of pneumonia, and other diseases in pneumological practice. Chest drainage (CHD) is the best treatment choice for pneumologists. A typical complication is multiloculated and/or encapsulated EMP. CHD is then extended (as well as hospitalisation) and treatment becomes more expensive. Fibrinolysis (FBIS) may be considered a suitable solution. We would like to share our experience with when and why to use FBIS.  The aims: benefits of FBIS in EMP treatment.  The methods: 48 pts with CHD and FBIS were analysed (A). This cohort was compared with 68 pts with CHD for empyema without FBIS (B). The CHD was performed by a pneumologist after examination by ultrasonography and/or CT. 16 F drain, which was used in all cases. When CHD was ineffective after 24 hrs, then 250,000 IU of Streptokinase was inserted into the pleural space with flushing 100 mL of normal saline. The drain was closed for 4 hours. Production of EMP was recorded. Kruskall-Wallis test was used for statistical analysis.  The results: A group: 48 pts, age 55.12±13.95 (32 M), B group: 68 pts (54 M), age 54.61±16.95 (SN). Time of CHD A/B: 8.95±4.54 days /15.94±11.28 (p  Conclusions: FBIS resulted in shorter CHD time. We prefer to use it in pts with ineffective CHD during the first 24 hrs and in healthier pts. It is better to use FBIS in smaller encapsulated empyema. Pts from group A were sent to surgery in an effort to solve complicated empyema. Pts deaths in B group were probably the result of poor health.
label is unhelpful
Authors: J. H Verbeek
Journal: BMJ (2003)

How useful is it to label a set of complaints as failed back surgery syndrome or post-discotomy syndrome? My view is that, far from improving a patient's condition, such a label may even play a part in its deterioration. Even the authors of articles who use these diagnostic terms admit that they are better avoided since they do not help to identify a cause or a treatment. After all, the only characteristics that these patients share are that they have been operated on for back pain and that non-specific back related complaints returned at some point after the operation.1–3 I prefer the term non-specific back pain because this provides us with …
Putting patients at the heart of healthcare: Respiratory allergy care in 18 European countries
Authors: Erkka Valovirta, Felice Addeo, Daniela Finizio, Joanna Bottema, Antje-H. Fink-Wagner
Journal: European Respiratory Journal (2012)

Aim. To evaluate, from the patients' perspective, how Europe cares for patients with respiratory allergies (RAs; allergic rhinitis and asthma) in order to identify national gaps and patients' needs. The survey was part of the 4-year Allergy Awareness Project of the European Federation of Allergy and Airways Disease Patients Associations (EFA).

Methods. Data were collected via an online 3-part questionnaire: 1) Basic facts: epidemiology, disease definitions, prevalence and costs; 2) Access to care: diagnosis, management, role of healthcare professionals in patient management and follow-up; 3) Quality of care: national policies and best practices. EFA member associations (n. 38) received the questionnaire. Data were also obtained from governmental sources and the scientific literature.

Results. Associations from 18 countries returned the questionnaire. RAs affect 20%-30% of the European population. But RAs, and particularly allergic rhinitis, are not considered serious diseases, and thus often remain underdiagnosed and undertreated despite the heavy burden they place on patients and society (in all 18 countries, direct RA costs reach millions of euros). In most countries, patients have difficulty in seeing specialists, and coordination among physicians is lacking. However, countries that implement national programs (Finland, Czech Republic) have seen reduced costs and better quality of care.

Conclusions. Awareness of RAs and their social burden is low. There is a need for better prevention and coordination among healthcare professionals. Patients' associations can help increase public awareness, and must be actively involved in devising and implementing RA management and education programs.
Pulmonary function changes during treatment with rituximab in patients with rheumatoid arthritis
Authors: Daniel Franzen, Christian F. Clarenbach, Diego Kyburz, Tsogyal D. Latshang, Adrian Ciurea, Erich W. Russi, Malcolm Kohler
Journal: European Respiratory Journal (2014)

Background:  Rituximab (RTX) has been reported to cause pulmonary toxicity, though mainly during polychemotherapy (R-CHOP) of malignant lymphoma. Data about RTX-induced pulmonary complications in other conditions are scarce. Data from a prospective study on RTX in patients with rheumatoid arthritis (RA) and its potential effect on lung function have not been published so far.   Methods:  Serial spirometries and DLCO measurements in patients with RA before and at 2, 4, 8, and 24 weeks after treatment with RTX were performed.   Results:  20 patients (5 men, mean age 59.8±12.9 years, 65% smoker) were included. Mean±SD FVC predicted and DLCO predicted at baseline were 110±16% and 85±19%, respectively. Mean FVC predicted did not significantly change between baseline and follow-up. A reduction of FVC ≥10% was seen in 3 patients after 2 weeks and in 2 patients after 8 weeks. DLCO decreased time-dependent after 2 weeks (-3.4±6.3%, p=0.031), and after 24 weeks (-5.5±8.9%, p=0.047) (figure 1). DLCO decline ≥15% was observed in 2 patients after 8 weeks, and in 4 at 24 weeks. None of the patients reported increased dyspnoea at any time point.   Conclusion:  Although no symptomatic pulmonary toxicity was observed in patients with RA treated with RTX, a subclinical decline of DLCO was measurable in 26.7% of patients 24 weeks after administration of the drug.
Dysfunctional breathing patterns: A literature review and proposal for classification
Authors: Richard Boulding, Robert Niven, Stephen Fowler
Journal: European Respiratory Journal (2014)

Introduction : Dysfunctional breathing (DB) is a term describing breathing disorders where changes in breathing pattern result in dyspnoea and sometimes associated non-respiratory symptoms without organic respiratory disease. Descriptions in the literature aren't standardised and there is no agreed classification facilitating clinical description or research into causes and treatment. Literature was reviewed in attempt to categorise abnormal breathing patterns.

Methods : We searched PUBMED and EMBASE using the terms 'Dysfunctional breathing, hyperventilation, Nijmegen and thoracoabdominal asynchrony' returning 115 papers of which 59 were relevant.

Results : Many DB patterns were described; review of symptoms and physiology enabled us to classify each into the following proposed categories;

1. Hyperventilation syndrome - symptoms related to respiratory alkalosis and those independent of hypocapnia. Sub-categories include:

a. Exercise-induced – symptoms occurring during exercise without bronchospasm.

b. Postural - associated with change from supine to standing.

2. Periodic Deep Sighing - excessive sighing and erratic breathing pattern.

3. Thoracic dominant breathing- - physiologically excessive use of thoracic muscles.

4. Forced abdominal expiration - inappropriate and excessive abdominal muscle contraction in aid of expiration.

5. Thoracoabdominal asynchrony - delay between rib cage and abdominal contraction resulting in ineffective breathing.

Conclusion : Here we attempt to categorize breathing patterns in patients with DB. Our review aims to highlight common abnormalities, diagnostic methods and therapeutic implications and hopefully provides a platform for future research in this difficult diagnostic area.
Abstract 227: Activation of Angiotensin II Type 2 Receptor Suppresses TNFα-induced ICAM-1 via NF-κB: Possible Role of ACE2
Authors: Liping Zhu, Oscar A Carretero, Jiang Xu, Pamela Harding, Xiao-Ping Yang
Journal: Circulation Research (2014)

Activation of the renin-angiotensin system (RAS) is a major factor contributing to the pathophysiology of cardiovascular disease (CVD). Blockade of the RAS with angiotensin receptor blockers (ARBs) has been a standard treatment for CVD. Activation of angiotensin II type 2 receptor (AT2) and angiotensin I-converting enzyme 2 (ACE2) contribute to the cardioprotective effects of ARBs. Both AT2 and ACE2 counteract the vasoconstrictor and pro-inflammatory effects of angiotensin II. However, the possible interaction between AT2 and ACE2 has never been established. Tumor necrosis factor (TNFα) is a cytokine involved in angiotensin II signaling and promotes the inflammatory response via NF-κB. We hypothesized that activation of AT2 increases ACE2, thereby preventing TNFα-stimulated intercellular adhesion molecule-1 (ICAM-1) expression via inhibition of NF-κB. Human coronary artery endothelial cells were pretreated with AT2 antagonist PD123319 or ACE2 inhibitor DX-600, and then stimulated with TNFα in the presence or absence of AT2 agonist CGP42112A. ACE2 mRNA was measured by real-time RT-PCR. ACE2 activity was measured using a Fluorimetric Kit. ICAM-1 and phospho-inhibitory κB (p-IκB) were measured by Western Blot. Activation of AT2 with CGP42112A increased ACE2 mRNA by 1.82 ± 0.09 fold (p&lt;0.01) and ACE2 activity from 0.61 ± 0.05 to 0.95 ± 0.03 (pg/μl/h/μg protein) (p&lt;0.01). This effect was diminished by inhibition of AT2 or ACE2. ICAM-1 expression was almost undetectable in untreated cells but greatly increased by TNFα. Activation of AT2 reduced TNFα-induced ICAM-1 expression by 47% (from control value of 1 to 0.53 units) ± 5% (p&lt;0.01), which was diminished by AT2 antagonist or ACE2 inhibitor. We also found that TNFα increased p-IκB by 7.46 ± 0.51 fold (p&lt;0.01) compared to untreated cells and this effect was diminished by AT2 activation. Furthermore, ACE2 inhibitor blunted the effects of AT2 on TNFα-induced p-IκB expression. Our findings suggest that stimulation of AT2 reduces TNFα-induced ICAM-1 expression, which is partly through ACE2-mediated inhibition of NF-κB. Perspective: understanding the mechanisms underlying AT2-mediated anti-inflammatory effects could lead to new therapeutic strategies such as specific activation of AT2 and/or ACE2.