tbuckley/cabot-search huggingface dataset:
Slope of serial glomerular filtration rate and the progression of diabetic glomerular disease.
Authors: S M Austin, J S Lieberman, L D Newton, M Mejia, W A Peters, B D Myers
Journal: Journal of the American Society of Nephrology (1993)

Glomerular function was evaluated longitudinally over a 24- to 48-month period in 18 patients with diabetic glomerular disease (DGD) manifested by proteinuria. GFR was determined by iothalamate clearance at 4-month intervals. The patients were divided into two groups: Group 1 (N = 9) had subnephrotic proteinuria and an initially normal GFR of 91 +/- 8 mL/min. Group 2 (N = 9) had nephrotic-range proteinuria, and initial GFR was reduced to 53 +/- 5 mL/min. Serial GFR fluctuated over time in Group 1, but no trend towards hypofiltration was evident. In contrast, GFR declined linearly in Group 2 at 1.1 +/- 0.3 mL/min per month. The transglomerular sieving of uncharged dextrans of graded size was analyzed and initially revealed a uniform reduction in glomerular pore density and an enhancement of shuntlike pores. Pore density was initially reduced by 80% and declined further after 24 months in nephrotic Group 2; corresponding pore density in subnephrotic Group 1 was reduced by half but remained constant. Renal biopsy of four members of Group 1 revealed a 22% prevalence of global glomerulosclerosis. Remaining open glomeruli exhibited hypertrophy, excessive extracellular matrix, and deformation of epithelial podocytes. The latter abnormality appeared to be the predominant determinant of lowered ultrafiltration capacity. It was inferred that trials of therapy to attenuate the progression of DGD should be initiated at a functional level similar to that in subnephrotic Group 1. Because GFR is unlikely to decline over a 2- to 4-yr period, it is suggested that such trials be extended for longer periods. Alternatively, morphometric analysis of serial renal biopsies may shorten the time needed to demonstrate effective renoprotection in DGD.
Antigenic Specificity of Benzo[a]pyrene-Induced Sarcomas2
Authors: Amiela Globerson, Michael Feldman
Journal: JNCI Journal of the National Cancer Institute (1964)

Tumors induced in C3H and C57BL mice by benzopyrene elicited isograft immune reactions to tumor-specific antigens. The antigenicity of primary tumors was higher than that of the same sarcomas after a series of transfers through isologous hosts. Apparently the progressive growth of transplants of primary tumors is determined by the antigenicity of the tumors. Sarcomas that did not take in normal hosts—such as grafts of early transplant generations—grew progressively when transplanted to animals exposed to total-body X irradiation, i.e., in immunologically suppressed animals. The decrease in antigenicity was not associated with a complete loss of the tumor antigens. Tumors that could no longer immunize animals were still susceptible to the immune response elicited by immunogenic grafts of earlier transplant generations. Each of the 2 sarcomas produced in a single animal by 2 simultaneous applications of the carcinogen had distinct antigenic specificity. Tumors produced in a single animal may differ from each other in (a) transplantability, (b) immunogenicity, and (c) antigenic specificity. The exposure of preimmunized animals to X irradiation, followed by test grafting, was most useful for the analysis of antigenic specificity of non-transplantable tumors. Experiments in which sarcomas, originating in C3H, were tested for antigenicity in (C3H × C57BL)F1 hybrids demonstrated that the lack of manifested immunological reactivity to certain tumors is due to the properties of the tumor cells themselves and not to the recipient animals.
The effect of almitrine on the steady-state ventilatory response to carbon dioxide at rest and during exercise in man
Authors: AR Cummin, MS Jacobi, CP Patil, RJ Telford, CN Morgan, KB Saunders
Journal: European Respiratory Journal (1990)

Almitrine has potential as a tool for testing the physiological role of the peripheral chemoreceptor. The effects of almitrine on CO2 chemosensitivity were studied at rest and during light exercise using a constant inflow technique that avoids the hyperoxia of rebreathing methods. The steady-state ventilatory response to CO2 was measured in two groups of six normal men before and 150 min after 100 mg oral almitrine bismesylate or placebo. One group was studied at rest, the other while pedalling at 50 W. The resting group showed a significant increase in CO2 response slope after almitrine when compared with placebo but there was no significant change in the response intercept. During exercise the individual results were very variable and after almitrine no significant change was seen in either the response slope or intercept. Control ventilation was not affected by almitrine in either group. Even in the absence of marked hyperoxia the effect of almitrine on CO2 sensitivity at rest in small. The lack of effect at 50 W is against any important role for the peripheral chemoreceptor during light exercise but other interpretations are possible.
Reported health related headlines are often unhelpful
Authors: Kit Byatt
Journal: BMJ (2015)

I agree that we need to scrutinise healthcare performance and variations across trusts, regions, and countries.1 Reflection on personal, institutional, and national data is the only way to learn and improve. However, simplistic reporting of headline data is dispiriting at best, and alarming or downright misleading at worst.

As Gigerenzer points out, survival rates depend on …
Assessment of severity of intensive care unit-acquired pneumonia and association with aetiology
Authors: Marta Di Pasquale, Miquel Ferrer, Mariano Esperatti, Ernesto Crisafulli, Valeria Giunta, Gianluigi Li Bassi, Francesco Blasi, Michael S. Niederman, Antoni Torres
Journal: European Respiratory Journal (2013)

Background : Studies on nosocomial pneumonia define severity only related to mortality or mortality scores. The current 2005 guidelines, with limited accuracy to predict multi-drug resistant (MDR) microorganisms, do not take into account severity in choosing empiric antibiotics. We evaluated the association between severity and microbial aetiology of ICU-acquired pneumonia (ICUAP), to define if severity should be used to guide empiric antibiotics.   Methods : We prospectively assessed characteristics, microbiology, systemic inflammatory response and outcomes of 343 consecutive patients with ICUAP clustered according to the presence or not of MDR pathogens.   Results : 208 (61%) patients had ventilator-associated pneumonia (VAP). We determined etiology in 217 (63%) patients. The most frequent pathogens were  P. aeruginosa, Enterobacteriaceae , methicillin-sensitive (MSSA) and methicillin-resistant (MRSA)  S. aureus.  58 (17%) patients had a MDR patthogen. Except for a longer ICU stay in the MDR group, no differences were found in clinical and inflammatory characteristics, severity criteria and outcomes between patients with or without MDR pathogens, even after adjusting for potential confounders. Patients with higher severity scores and septic shock had significantly lower survival and higher systemic inflammatory response. The results were similar when only patients with microbial diagnosis were considered.   Conclusions : In patients with ICUAP severity of illness seems not to affect aetiology. Risk factors for MDR, but not severity, should be taken into account in selecting empiric antimicrobial treatment.   Supported : IDIBAPS, CibeRes (CB06/06/0028)-ISCiii, 2009 SGR 911, ERS Fellowship.
Breathing pattern during sleep disruptive snoring
Authors: KE Bloch, Y Li, MA Sackner, EW Russi
Journal: European Respiratory Journal (1997)

Breathing disturbances during snoring have been quantified by face mask pneumotachography and oesophageal catheters. In order to nonobtrusively investigate respiratory mechanics during nonapnoeic snoring in relation to sleep disturbances, we employed calibrated respiratory inductive plethysmography (RIP). In 10 snorers, RIP recordings were studied during nonapnoeic snoring without arousals in non-rapid eye movement (NREM) sleep, nonapnoeic snoring with repetitive arousals in NREM sleep and wakefulness. Results were compared to RIP recordings in undisturbed NREM sleep and wakefulness in seven healthy nonsnorers. Compared to wakefulness and undisturbed NREM sleep in nonsnorers, snoring was associated with predominant thoracic breathing, ribcage/abdominal asynchrony, and increased fractional inspiratory time. Preceding arousals during snoring, inspiratory flattening of time-derivatives of RIP volume signals, and marked ribcage/abdominal asynchrony indicated pronounced flow limitation. Low variation coefficients of respiratory cycle time (<10%) and tidal volume (<20%) discriminated snoring periods without arousals from snoring periods with arousals and from wakefulness periods, with a sensitivity of 100% and a specificity of 99%. Snoring periods with arousals were identified by the presence of snoring combined with high coefficients of variation of cycle time (> or =10%) and tidal volume (> or =20%), with a sensitivity of 96% and a specificity of 100%. Thus, characteristic patterns of ribcage/abdominal motion recorded by respiratory inductive plethysmography differentiated breathing in sleep disruptive snoring from simple snoring.
Overexpression of Her-2 in Patients With Poorly Differentiated Carcinoma or Poorly Differentiated Adenocarcinoma of Unknown Primary Site
Authors: John D. Hainsworth, Wayne J. Lennington, F. Anthony Greco
Journal: Journal of Clinical Oncology (2000)

PURPOSE: To determine the frequency of Her-2 overexpression in patients with poorly differentiated carcinoma or poorly differentiated adenocarcinoma of unknown primary site. PATIENTS AND METHODS: Tumor specimens from 100 patients with poorly differentiated carcinoma or poorly differentiated adenocarcinoma were stained for the Her-2 protein using the Dako immunohistochemical method. Clinical and pathologic characteristics of patients with and without Her-2 overexpression were compared. RESULTS: Staining for Her-2 overexpression was successful in 94 of 100 patients. Ten (11%) of 94 tumor specimens overexpressed Her-2. Eight of 10 overexpressors had poorly differentiated adenocarcinoma, and all overexpressors had predominant tumor location above the diaphragm, usually in the mediastinum or lungs. CONCLUSION: Her-2 overexpression occurs in a minority of patients with poorly differentiated carcinoma/adenocarcinoma of unknown primary site. Because most overexpressors had poorly differentiated adenocarcinoma, further evaluation of patients with adenocarcinoma of unknown primary site is necessary to determine the frequency of Her-2 overexpression in this common subgroup. Evaluation of the efficacy of trastuzumab in Her-2 overexpressors with carcinoma of unknown primary site is indicated.
Randomized clinical study on smoking cessation in young adults
Authors: Anna Hamari, Tuula Toljamo, Merita Salmela, Pentti Nieminen
Journal: European Respiratory Journal (2013)

Many young smokers want to quit smoking: in a recent Finnish survey study, a majority (60.2%) of the daily young smokers had made unsuccesfull quit attempts. Still, only a small number of studies have been published on smoking cessation in young adult smokers. Our aim was to further study the effectiveness of different smoking cessation aids in young adults e.g motivational interview method and drugs (NRT) vs. placebo.  Our study design is a blinded, randomized and plasebo controlled clinical study. The study population consists of 18 to 26-year-old subjects. Our target sample size is 300 daily smokers, of whom 150 are men and 150 women. We include also a group of 50 nonsmoking men and 50 nonsmoking women. The estimated sample size has been made on the basis of our earlier study with military draftees. About 48% of these male young adults were daily smokers. We postulate that if 30% of the smokers quit in a study group with NRT patch would be clinically important. A reduction of this size with a two-tailed p-value of 0.05 and power of 0.80 requires a sample size of 150 young adults in each group (study group and control group). Total required minimum number of cases is 300. So, our goal is to recruit 350 young smokers knowing that some of the smokers drop out from the follow up. The preliminary results of the study will be presented in ERS 2013.  Toljamo T, Hamari A, Nieminen P, Kinnula VL. Young male daily smokers are nicotine dependent and experience several unsuccessful quit attempts. Scandinavian Journal of Primary Health Care. 2012 Sep;  30(3):183-188.
An exercise challenge for epidemiological studies of childhood asthma: validity and repeatability
Authors: M M Haby, J K Peat, C M Mellis, S D Anderson, A J Woolcock
Journal: European Respiratory Journal (1995)

We assessed the validity, repeatability and practicality of a standardized exercise challenge protocol for measuring airway responsiveness in epidemiological studies of asthma in children aged 8-11 yrs. The construct validity of the exercise challenge was assessed by comparing response to exercise with other measures of asthma, i.e. wheeze frequency, diagnosed asthma, asthma medication use, atopy and urgent doctor visits (n = 802), and by comparison with response to histamine challenge (n = 201). Repeatability was assessed by comparison of responsiveness to two exercise challenges within 3 days (n = 113), and practicality was assessed by measurement of consent, compliance and throughput rates (n = 802). There was a significant relationship between frequency of wheeze attacks and % fall in forced expiratory volume in one second (FEV1) to exercise. The correlation (r) between % fall in FEV1 to exercise challenge and dose-response ratio to histamine challenge was 0.59. The repeatability of the exercise challenge was +/- 12% fall in FEV1. Consent and compliance rates for exercise challenge were 78 and 99%, respectively, and the mean throughput rate was 45 children per school day for a team of seven researchers. In conclusion, this exercise challenge was found to have good validity and to be reliable and practical. Thus, this challenge could be used as a standardized epidemiological tool to investigate the prevalence, aetiology and mechanisms of asthma.
Respiratory viral infections in adult asthma exacerbation:one year survey at a Japanese university hospital for characterization of hospitalized or not hospitalized patients
Authors: Takeshi Saraya, Daisuke Kurai, Hiroyuki Tsukagoshi, Haruyuki Ishii, Hirokazu Kimura, Hajime Goto, Hajime Takizawa
Journal: European Respiratory Journal (2014)

Introduction: Among asthmatic patients with exacerbative status, the discrimination is difficult whether those patients have virus respiratory infection (VRI) or not.  Aims: To investigate the prevalence of VRI in exacerbation of adult asthma both in hospitalized or not-hospitalized patients, and characterized clinical findings in the perspective of the presence of VRI.  Methods: Prospective observational cohort study was conducted at Kyorin University Hospital, Tokyo, Japan from August 2012 to August 2013. All patients with exacerbative asthma were included, and respiratory samples were obtained and applied for multiplex polymerase chain reaction method for common respiratory viruses,  Mycoplasma pneumoniae , and  Chlamydophila pneumoniae .  Results: The 44 patients were enrolled, who are consisted of hospitalized (n=15) or not-hospitalized patients (n=29), respectively. No patients had isolation of  Mycoplasma pneumoniae  and  Chlamydophila pneumoniae.  The incidence of VRI was significantly higher in former group (46.7%, n=7) than that of latter group (6.9%, n=2).  In hospitalized patients, human rhinovirus (n=5), human metapneumovirus (n=1), and respiratory syncytial virus (n=1) were identified. On admission, virus positive group (n=7) had significant lower value of SpO 2  (81.4±3.9%) than that of virus negative group (n=8, SpO 2 :91.8±1.3%, p ), and the frequency of hypercapnia (PaCO 2≥ 45 Torr) was significantly higher in virus positive group (66.7%, n=4) than that of virus negative group (0%) ( p=0.014 ), respectively.  Conclusion: VRI was associated with hospitalized patients who had more severe respiratory failure.
Latent tri-lineage potential of adult hippocampal neural stem cells revealed by Nf1 inactivation
Authors: Gerald J Sun, Yi Zhou, Shiori Ito, Michael A Bonaguidi, Genevieve Stein-O'Brien, Nicholas K Kawasaki, Nikhil Modak, Yuan Zhu, Guo-li Ming, Hongjun Song
Journal: Nature Neuroscience (2015)
Treatment of Metastatic Testicular Tumours with Bleomycin, Etoposide, Cisplatin and Vincristine (BEPV)
Authors: B A Price, N H Peters
Journal: Journal of the Royal Society of Medicine (1992)

Between August 1983 and December 1988, 47 patients with metastatic testicular tumours (44 non-seminomatous, three seminomas) were treated with two to six courses of bleomycin, etoposide, cisplatin and vincristine (BEPV). Five stage I tumours were included, three because of raised tumour markers following orchidectomy, one with vascular invasion of spermatic cord vessels and the other with both these features. Forty-four patients (93.6%) are alive and disease free 12–75 months (median 39 months) after completion of BEPV. Further treatment was necessary in 12 of the survivors. Eight had residual disease excised, one of whom received radiotherapy, one additional chemotherapy and one both radiotherapy and chemotherapy. Of the remaining four, two had radiotherapy and two second line chemotherapy. Thirty-one non-seminomatous and the three seminoma patients had small volume disease and all are in complete remission. Ten of the 13 patients with bulky disease are alive. It is concluded that BEPV is a well-tolerated, effective, first line therapy for patients with metastatic testicular tumour.
Overall Survival in Small Cell Lung Cancer Detected with Epithelial, Mesenchymal and Stem Cell Biomarkers
Authors: T.J. Hiltermann, M.M. Pore, J. Meijer, W. Timens, G.H. De Bock, H.J.M. Groen, F.A.E. Kruijt
Journal: Annals of Oncology (2014)
Knowledge, attitudes and practices concerning Middle East respiratory syndrome among Umrah and Hajj pilgrims in Samsun, Turkey, 2015
Authors: Mustafa Kursat Sahin, Servet Aker, Ebru Kaynar Tuncel
Journal: Eurosurveillance (2015)

We performed a questionnaire study to determine knowledge, attitudes and practices concerning Middle East respiratory syndrome (MERS) among people intending to participate in the Hajj or Umrah Muslim pilgrimages. Of the 381 respondents aged between 17 and 85 years, 55% had never heard of MERS, while only one in three knew that it is a respiratory disease. Approximately half were insufficiently informed about protective measures. Prospective pilgrims do not seem prepared to take such precautions.
The in vitro effect of vitamin D on peripheral blood mononuclear cell cytokine expression in COPD
Authors: Niall Stewart, Richard Wood-Baker
Journal: European Respiratory Journal (2012)

Background   Vitamin D is recognised as a powerful modulator of immune responses. It promotes T helper 2 (Th2) immunity and the anti-inflammatory cytokine Interleukin-10 (IL-10). However, little is known about the effects of vitamin D on the immune response in COPD, a Th1 mediated disease.   Aims and objectives   We hypothesised that in COPD vitamin D would push a Th2 response, with increased levels of the Th2 cytokine Interleukin-4 (IL-4) and the suppressive cytokine IL-10. Such a shift could be beneficial in COPD.   Methods   We recruited 10 COPD subjects from whom we isolated peripheral blood mononuclear cells (PBMC) and measured serum 25(OH)D. PBMC were stimulated with antibodies to the T cell receptor either with or without added vitamin D.   Results   For both IL-4 and IL-10, we observed a biphasic effect of vitamin D supplementation. For those with low ( 80nmol/L) serum 25(OH)D, added vitamin D suppressed IL-4 and IL-10 (Figure 1,2). Between these two levels, vitamin D increased expression.   Conclusions   Serum 25(OH)D levels may be an important determinant of the usefulness of vitamin D in beneficially modifying the immune response in COPD.
Abstract 16370: Real-World Risk of Thromboembolism or Bleeding with Warfarin or Dabigatran Therapy in Patients with Atrial Fibrillation
Authors: Scott L Charland, Daniel C Malone, Barnabie C Agatep, Vivian Herrera, Gosia S Hawk, Bruce J Schrader, Eric J Stanek
Journal: Circulation (2012)
Lung Cancer Screening
Authors: Peter B. Bach
Journal: Journal of the National Comprehensive Cancer Network (2008)

Because lung cancer frequently presents in an advanced stage when it is incurable, there has been a sustained search for an early diagnosis approach that could detect lung cancer when curable, while having few secondary consequences. Decades of research have evaluated various approaches to lung screening, including routine chest radiograph, sputum cytology, and, most recently, computed tomography (CT) scanning. No study has suggested that any of these approaches will identify life-threatening lung cancers at an earlier disease stage and allow alteration of their natural history. Therefore, no recommending body or professional society recommends using any of these approaches to screen for lung cancer. This general recommendation could change if randomized trials examining CT screening suggest that its benefits outweigh its harms.
Serum omentin levels in patients with obstructive sleep apnea syndrome
Authors: Ozlem Kar Kurt, Mehmet Tosun, Aytekin Alcelik, Beyhan Yilmaz, Fahrettin Talay
Journal: European Respiratory Journal (2013)

Background: Obstructive sleep apnea syndrome (OSAS) is associated with increased rates of cardiovascular diseases (CVD). The basic mechanisms involved in the increased cardiovascular risk of OSAS remain unclear. Recent discoveries of fat-secreted substances which serve endocrine roles, improve our understanding of the relationship between OSAS, CVD, and the metabolic syndrome. In this study, we aimed to examine associations between omentin levels and OSAS.

Methods: 46 newly diagnosed OSAS patients and 35 age-matched nonapneic controls were enrolled in this study. Polysomnography (PSG) was performed in all patients.

Results: The mean age was 48.1±12.5 (24-74) years in OSAS group and 42.8±14.1 (21-69) in control group. 46 (34 males and 12 females) of the 81 patients were classified as having OSAS, and 35 patients (20 males and 15 females) as control. Plasma levels of omentin were found to be markedly higher in OSAS patients (570.8 ng/ml) than in the control group (432.0 ng/ml; p<0.001). In addition, plasma levels of omentin were found to be high in all OSAS subgroups than in controls. The plasma omentin levels were negatively correlated with sex, smoking and positively correlated with age, BMI, AHI, Epworth sleepiness scale.

View this table:

Spearman correlation coefficients between age, sex, BMI, smoking, Epworth sleepiness scale, AHI, minimum SpO2 and Omentin levels in OSAS groups.





Conclusions: We conclude that circulating omentin levels are elevated in OSAS patients. To the best of our knowledge, this is the first clinical study that demonstrated the association between omentin and OSAS.
Impact of psm-mec in the mobile genetic element on the clinical characteristics and outcome of SCCmec-II methicillin-resistant Staphylococcus aureus bacteraemia in Japan
Authors: T. Aoyagi, C. Kaito, K. Sekimizu, Y. Omae, Y. Saito, H. Mao, S. Inomata, M. Hatta, S. Endo, H. Kanamori, Y. Gu, K. Tokuda, H. Yano, M. Kitagawa, M. Kaku
Journal: Clinical Microbiology and Infection (2014)