tbuckley/cabot-search huggingface dataset:
Can body mass index (BMI) predict the likelihood of nocturnal non-invasive home mechanical ventilation (HMV) re-admission rate in chronic hypercapnic chronic obstructive pulmonary disease (CHCOPD)?
Authors: Maria Nuila, Matthew Burman, Emmanuel Selvaraj, David Simcock, Simon Lloyd-Owen
Journal: European Respiratory Journal (2013)

There is increasing evidence HMV improves outcome in CHCOPD, including the avoidance of hospital admission. However, the determinants of readmission rate are yet to be identified.  Methods: Retrospective cohort analysis of CHCOPD patients established on HMV between January 2010 and December 2011, comparing readmission rates due to acute hypercapnic respiratory failure (AHRF) against BMI over the course of one year. Indications for HMV were: symptomatic hypercapnia (arterial carbon dioxide (pCO2) >7–8 kPa), failure to wean after AHRF episode and/or 2 or more AHRF episodes over a 2 year period. Inspiratory pressures were titrated to achieve early morning pCO2  90% for at least 90% of the night. BMI was defined as normal-weight 20-24.9 kg/m2 and overweight/obese (> 25.0 kg/m2).  Results: 26 patients (male= 8, mean age= 66) with HCCOPD (mean FEV1/FVC 41.41 (SD +/- 13.10), mean FEV1 30.53% (SD 14.42), mean pCO2 and bicarbonate 7.51kPa (SD +/- 0.95) and 31.65mmols/l (SD +/- 3.07) respectively) were established on HMV during the study period. 35 % had mean BMI 22.73 kg/m2 (SD +/- 0.95) and 65% were overweight/obese (mean 36.49kgm2, SD +/- 9.38). The 1-year readmission rate was 6 admission/year in the normal-weight group and 0.35 (SD +/- 0.58) admissions/year in the overweight/obesity group (p   Conclusion: BMI could be a determinant factor in the readmission rate in patients with CHCOPD initiated on HMV. Those with a higher BMI appear to have a lower chance of readmission.
Promising results of a pilot trial of a GD<sub>2</sub> directed anti-idiotypic antibody as a vaccine for high risk neuroblastoma
Authors: A. Batova, A. L. Yu, D. Strother, P. Angelini, A. Eskenazi
Journal: Journal of Clinical Oncology (2004)

8511 Background: High risk neuroblastoma has a dismal outcome despite intensive therapy including stem cell transplant. We conducted the first pediatric trial of mAb1A7, an anti-id antibody directed against anti-GD2, 14G2a, as a vaccine for high risk neuroblastoma. Methods: Thirty one patients with high risk neuroblastoma (26 stage 4, 5 stage 3) who achieved first or subsequent complete response (16 in CR1, 7 in CR2) or very good partial response (3 in VGPR1, 5 in VGPR2) were entered into this trial. Patients received SQ injection of mAb1A7 (Titan Pharmaceutical Inc.) + QS-21 (Aquila Pharmaceutical Inc.) q2 weeks × 4, q m × 11. Results: The treatment was well tolerated with only transient local reactions, transient fever and chills in 4 patients and serum sickness in 1. There was no neuropathic pain which is often seen with infusion of anti-GD2. Despite prior intensive treatment including stem cell transplantation in all but 4 patients, all 31 patients generated anti-mAb1A7. The mean peak anti-mAb1A7 was 665 ± 390 ng /ml (83–1467). Anti-mAb1A7 inhibited the binding of mAb1A7 (Ab2) to 14G2A (Ab1) in 31/31. The peak inhibition was observed between weeks 22 and 62, at which time, immune sera from 14/31 patients inhibited binding of Ab2 to Ab1 by > 90% at a 160- fold dilution. Immunoaffinity purified Ab3 from 5/5 patients bound purified GD2 and was predominantly IgG. More importantly, immune sera from 9/13 patients tested after 37 weeks of treatment, displayed CDC activity. Furthermore, purified Ab3 from 6/8 patients mediated ADCC against neuroblastoma. To date, 17 of 20 patients who enrolled during first remission have no evidence of disease progression at 32+ to 52+ months (median + 47 m) from study entry, while only 1 of 11 patients who enrolled during 2nd remission remains progression free. Conclusions: mAb1A7 + QS21 is safe and effective in inducing biologically active anti-GD2 in heavily pre-treated neuroblastoma patients and may be useful in controlling minimal residual disease. No significant financial relationships to disclose.
Improvement of predictive models of risk of disease progression in chronic hepatitis C by incorporating longitudinal data
Authors: Monica A. Konerman, Yiwei Zhang, Ji Zhu, Peter D.R. Higgins, Anna S.F. Lok, Akbar K. Waljee
Journal: Hepatology (2015)

Existing predictive models of risk of disease progression in chronic hepatitis C have limited accuracy. The aim of this study was to improve upon existing models by applying novel statistical methods that incorporate longitudinal data. Patients in the Hepatitis C Antiviral Long-term Treatment Against Cirrhosis trial were analyzed. Outcomes of interest were (1) fibrosis progression (increase of two or more Ishak stages) and (2) liver-related clinical outcomes (liver-related death, hepatic decompensation, hepatocellular carcinoma, liver transplant, or increase in Child-Turcotte-Pugh score to ≥7). Predictors included longitudinal clinical, laboratory, and histologic data. Models were constructed using logistic regression and two machine learning methods (random forest and boosting) to predict an outcome in the next 12 months. The control arm was used as the training data set (n = 349 clinical, n = 184 fibrosis) and the interferon arm, for internal validation. The area under the receiver operating characteristic curve for longitudinal models of fibrosis progression was 0.78 (95% confidence interval [CI] 0.74-0.83) using logistic regression, 0.79 (95% CI 0.77-0.81) using random forest, and 0.79 (95% CI 0.77-0.82) using boosting. The area under the receiver operating characteristic curve for longitudinal models of clinical progression was 0.79 (95% CI 0.77-0.82) using logistic regression, 0.86 (95% CI 0.85-0.87) using random forest, and 0.84 (95% CI 0.82-0.86) using boosting. Longitudinal models outperformed baseline models for both outcomes (P < 0.0001). Longitudinal machine learning models had negative predictive values of 94% for both outcomes.Prediction models that incorporate longitudinal data can capture nonlinear disease progression in chronic hepatitis C and thus outperform baseline models. Machine learning methods can capture complex relationships between predictors and outcomes, yielding more accurate predictions; our models can help target costly therapies to patients with the most urgent need, guide the intensity of clinical monitoring required, and provide prognostic information to patients.
Practical pulse oximetry
Authors: P M Robbins, M D Brunner
Journal: BMJ (1995)

EDITOR,--We agree with C D Hanning and J M Alexander-Williams that pulse oximetry has a place in the management of hypoxic patients with respiratory failure and that hypercarbia is less damaging physiologically than hypoxaemia.1 It is important to point out, however, that arterial carbon dioxide tension can become dangerously high while oxygen saturation remains normal, and this is a limitation …
Incidence of asthma and wheeze during adolescence – The impact of study design
Authors: Linnea Hedman, Anders Bjerg, Sigrid Sundberg, Eva Rönmark
Journal: European Respiratory Journal (2011)

Aim: To study the impact of study design on the incidence rates of asthma and wheeze during the teen ages.

Method: In a longitudinal study about asthma and allergic diseases within the OLIN studies in northern Sweden, a cohort of school children (n=3,430) was followed annually from age 7-8yrs by completion of an extended ISAAC questionnaire. In the endpoint survey (age 19yrs) 2,861 (83% of original responders) participated. Incident cases of asthma and wheeze from age 12 to 19yrs were identified by two methods: the annual questionnaire surveys and the endpoint survey only, respectively.

Results: The incidence was consistently higher when the incidence was based on annual surveys compared to the endpoint survey only. Based on the endpoint survey, the average annual incidence of current asthma, physician-diagnosed asthma and ever asthma was 0.7-1.4/100/y and current wheeze was 1.5/100/y. Based on the annual surveys, the incidence of asthma was 0.9-2.7/100/y and current wheeze 3.6-5.3/100/y. In both study designs, the incidence of asthma and wheeze was higher among girls than boys (p-values<0.01). At the onset, the additional cases of current asthma identified by the annual surveys had slightly less severe asthma than those identified only in the endpoint survey (p<0.06).

Conclusion: The incidence of asthma and wheeze was affected by study design. The incidence was underestimated when only baseline and endpoint data was used. Study design and follow-up time is important to consider for comparisons of the incidence of asthma and wheeze between studies.
Pharmacokinetics of an intravenous-oral versus intravenous-mesna regimen in lung cancer patients receiving ifosfamide.
Authors: M P Goren, L B Anthony, K R Hande, D H Johnson, W P Brade, M W Frazier, D A Bush, J T Li
Journal: Journal of Clinical Oncology (1998)

PURPOSE To compare the pharmacokinetics of the approved I.V. (intravenous) mesna regimen and an investigational I.V.-oral regimen that could be used in outpatients who receive ifosfamide. PATIENTS AND METHODS The I.V. regimen consisted of three I.V. mesna doses given at 0, 4, and 8 hours after ifosfamide administration. The investigational regimen included an I.V. mesna dose given concurrently with ifosfamide, followed 2 and 8 hours later by oral administration of mesna tablets. I.V. and oral mesna doses equaled 20% and 40%, respectively, of the ifosfamide dose. The study subjects were 12 lung cancer patients who received ifosfamide 1.2 g/m2 daily for 5 days. The patients were randomized to receive either the I.V.-oral or I.V. mesna regimen on day 1, followed by crossover to the other regimen on days 2 through 5 of ifosfamide treatment. The urinary profiles of mesna and dimesna excretion were determined on days 1, 2, and 5; pharmacokinetic parameters for blood samples were determined only on day 5. RESULTS During the first 12 hours after ifosfamide administration, the amount of mesna excreted and the profile of urinary mesna excretion was similar for both regimens; however, the I.V.-oral regimen showed less fluctuation in the excretion rate and higher trough values. During hours 12 to 24, about eightfold more mesna was excreted by patients given the I.V.-oral than the I.V. regimen. CONCLUSION These pharmacokinetic data show that the I.V.-oral regimen should be at least as uroprotective as the I.V. mesna regimen. Patients may also benefit from the I.V.-oral regimen because of the higher trough values during hours 0 through 12 and the sustained urinary mesna excretion during hours 12 through 24.
Metabolic modification as a potential therapeutics approach in lung cancer
Authors: Maya Ilouze, Tali Feinberg, Ronen Shavit, Nir Peled
Journal: European Respiratory Journal (2013)

Background:  It is well established that cancer cells can activate their glycolysis pathway in order to survive in hypoxia micro-environment. Tumors cells show a high rate of glycolysis and lactate production, even in the presence of oxygen. Importantly, some cancer cells demonstrate impaired mitochondria respiration and high glycolysis, namely  Warburg effect .   Objective : Our overall goal is to target Warburg phenomenon as a treatment approach for lung cancer and to reverse the metabolic activity towards its normal glycolysis/mitochondrial ratio.   Methods:  We used adenocarcinoma cell lines (A549, H1650, H1563, and H2030), large cell tumor (H1299) and small cell lung cancer (SCLC, SHP77). We quantified the lactic acid production using a colorimetric assay. Dichloacetate (DCA) was used to induce mitochondrial activity and 2-deoxyglucose (2-DG) was used to inhibit the glycolysis pathway. Western blot analyses were performed to determine the protein expression level of glycolysis markers, GAPDH and PKM2, and an oxidative phosphorylation marker ATP5B.   Results:  We demonstrated that Warburg Effect (aerobic glycolysis) occurs only in A549 and H2030 lung cancer cells. A549 and H2030 cells produce high quantity of lactic acid and were sensitive to glycolysis inhibition. H1650, which represents a higher mitochondrial activity, was more sensitive to DCA, an enhancer of oxidative phosphorylation.   Impact:  Glycolysis shut-down and mitochondrial activation induce cell death in lung cancer cell lines. This research is a proof of concept for the feasibility of metabolic modification as an anti cancer therapy in lung cancer.
Berlin questionnaire performance for detecting sleep apnea in the general population
Authors: Raphael Heinzer, Daniela Andries, Francois Bastardot, Nadia Tobback, Peter Vollenweider, Mehdi Tafti, Jose Haba-Rubio
Journal: European Respiratory Journal (2011)

Introduction:  Berlin questionnaire (BQ) has been proposed as a screening tool for identifying patients at risk for obstructive sleep apnea (OSA). The aim of our study is to evaluate the performance of this questionnaire for detecting OSA in a large sample of middle-aged general population.   Methods:  469 subjects (46.4% women, 50.6±7.4 years old, BMI 25.1±4.9 kg/m 2 ) participating in an ongoing population-based cohort study (HypnoLaus, Lausanne, Switzerland) underwent a complete polysomnographic recording at home and an extensive clinical workup including BQ. This instrument includes 3 categories: 1) witnessed apnea and snoring 2) daytime sleepiness and 3) obesity or hypertension. A positive score in 2 or more categories was considered suggestive of OSA.   Results:  Mean AHI was 6.3±10.6/h. Mean 4%ODI was 5.8±10.0. Prevalence of OSA defined as an AHI >5/h, >15/h and >30/h was 33.3%, 10.3% and 3.8%, respectively in our population. Prevalence of positive BQ score was 24.4% (29.2 in men, 18.81 in women). BQ sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) to detect OSA were 36.1%, 82.4%, 51.8% and 72.9% respectively for an AHI >5/h; 52.1%, 78.8%, 21.9% and 93.5% for an AHI>15; and 72.2%, 77.6%, 11.4% and 98.6% for an AHI>30/h. Positive BQ was associated with higher 4% ODI (10.8/h vs 4.2/h p   Conclusion:  BQ questionnaire performance for identifying OSA is lower in a middle-aged general population than previously reported in a clinical population. Our results do not support its use as a screening tool for OSA in an unselected population.
Advances in Surgery for Otosclerosis
Authors: A H DUBBER, G P MCNICOL, A S DOUGLAS
Journal: BMJ (1965)

must be expected in many cases.There is a possibility of serious cardiovascular reactions in patients with spinal-cord lesions at and above D5 segment, especially in cervical lesions.'Moreover, a neurogenic bladder, whether automatic or auto- nomous, represents a multitude of complex functional prob- lems, and electrical control of part of the intermittent function of the bladder is unlikely to give both efficient emptying and continence.This also applies to the method suggested by K. P. S. Caldwell9 of implanting radio-controlled electrodes into the external urethral sphincter.Possibly this method may give a degree of continence to patients suffering from incontinence-especially female patients, for whom there is still no effective urinal available-but at present it remains a research technique.
Abstract 3648: Clinical Cardiovascular Disease in Women is Associated With Increased Epicardial, but Not Subcutaneous Fat Thickness
Authors: Noriko Oyama, Philimon Gona, Michael L Chuang, Rahul R Jhaveri, Carol J Salton, Susan J Blease, Daniel Levy, Anya R Manning, Christopher J O’Donnell, Warren J Manning
Journal: Circulation (2007)

INTRODUCTION: Visceral adipose tissue, such as epicardial fat, is metabolically active, and may portend increased risk for cardiovascular disease (CVD) compared to subcutaneous fat. Cardiovascular magnetic resonance (CMR) can accurately delineate fat, but data are sparse regarding the relationship of epicardial and subcutaneous fat burden to CVD in community-living adult women. METHODS: 957 women (aged 64± 8 years) in the Framingham Heart Study Offspring cohort, followed by serial examinations since 1974, underwent CMR on a 1.5-T Philips system using an ECG-gated cine SSFP sequence. Epicardial fat thickness (EFT) over the midlevel right ventricle was measured from a 4-chamber view. Suprasternal subcutaneous fat thickness (SFT) was measured at the main pulmonary artery level. We compared EFT and SFT between women with clinical CVD, documented by a physician endpoint committee (+CVD), vs. those without (noCVD) based on Cycle 7 (1998 –2002) clinical data. Differences were assessed by two-sample T-test; ANOVA was used to adjust for age, diabetes, hypertension and menopausal status. RESULTS: The +CVD group comprised 74 (8%) women who were older and more likely to be postmenopausal, diabetic and hypertensive than noCVD women (Table ). EFT was greater in +CVD (10.5 ± 5.1mm) vs. noCVD (8.6 ± 5.2mm) groups, p&lt;0.003. This difference remained significant after adjusting for age, diabetes, hypertension and menopausal status (Table ). No difference in SFT or body mass index was observed between groups (p=NS). CONCLUSIONS: Women with history of clinical CVD have greater EFT than women without CVD, and this difference persists after adjustment for common cardiovascular risk factors. However, subcutaneous fat, as assessed by chest wall adiposity, did not differ between groups. EFT may be a useful marker for cardiovascular risk, and prospective investigation of the relationship between EFT and future risk for CVD is warranted.
Alcohol Consumption and Risk of Atrial Fibrillation
Authors: Satoru Kodama, Kazumi Saito, Shiro Tanaka, Chika Horikawa, Aki Saito, Yoriko Heianza, Yui Anasako, Yukako Nishigaki, Yoko Yachi, Kaoruko Tada Iida, Yasuo Ohashi, Nobuhiro Yamada, Hirohito Sone
Journal: Journal of the American College of Cardiology (2011)
Influence of gender in obstructive sleep apnea characteristics and treatment
Authors: Filipa Soares Pires, Marta Drummond, Inês Neves, Cláudia Pinto, Anabela Marinho, Maria Sucena, João Almeida, João Winck
Journal: European Respiratory Journal (2012)

INTRODUCTION: Obstructive sleep apnea (OSA) was initially recognized as a disease of men. However, prevalence of OSA in women is not as low as historically thought. Little is known about the influence of gender in OSA.  Aim: To assess gender differences in demographics, clinical presentation, sleep study findings and treatment parameters in OSA patients.  METHODS: A transversal study was performed, including patients newly diagnosed with OSA, that initiated APAP treatment 6 months before.  RESULTS: 187 patients were included, 128 male and 59 female. Women were older than men (60.5±7.9 vs. 54.4±13.0), their Body Mass Index (BMI) was higher (35.8±7.2 vs. 32.0±4.7) and neck circumference was lower (39.9±3.8 vs. 44.0±3.7). Comorbidities were more frequent in women, including hypertension. Women self-reported more frequently initial insomnia, awakenings, restless legs symptoms, gasping, nightmares, subjective poor sleep quality, depression and daytime sleepiness, but no difference was found in Epworth Sleepiness Scale. Self-reported snoring was similar in both genders. Apnea/hypopnea index (AHI) was higher in men (43.1±19.1 vs. 35.7±21.8), even after adjusting for age and BMI. Apnea/hypopnea duration was also higher in men (22.8±6.7 vs. 19.8±4.9 seconds). The 95 th  percentile of pressure (P95) at 6 months of APAP was superior in women (12.0±2.5 vs. 10.7±2.9).  CONCLUSION:  Gender differences need to be aware when assessing women for OSA. Women report more symptoms and poor sleep quality at a lower AHI and have more significant comorbidities. Despite a higher BMI, OSA severity was lower in females.
Side effects of light therapy in seasonal affective disorder
Authors: A J Levitt, R T Joffe, D E Moul, R W Lam, M H Teicher, B Lebegue, M G Murray, D A Oren, P Schwartz, A Buchanan
Journal: American Journal of Psychiatry (1993)

The authors report the frequency of side effects of light therapy in 105 patients with seasonal affective disorder treated with three intensities of light. Common symptoms to emerge during treatment were headache (19%), eyestrain (17%), and feeling "wired" (14%). There was no relationship between side effects and intensity of light used.
Abstract 4503: A small molecule glycomimetic antagonist of E-selectin (GMI-1271) prevents pancreatic tumor metastasis and offers a novel treatment for improved efficacy of chemotherapy
Authors: Maria M. Steele, Prakash Radhakrishnan, John L. Magnani, Michael A. Hollingsworth
Journal: Cancer Research (2014)

Abstract The processes of intra- and extravasation of tumor cells into and out of the blood and lymphatic systems are crucial steps during metastasis to distant organ sites. These processes are tightly regulated by the initial binding of sialyl Lewis A and sialyl Lewis X (sialyl Le A/X) carbohydrate moeities found on tumor cells to the adhesion protein E-selectin expressed on the activated endothelium. GMI-1271 is a small molecule glycomimetic rationally designed based on the bioactive conformation of sialyl Lea/x and is a potent and specific antagonist of E-selectin. In vitro treatment of human lymphatic endothelial cells with GMI-1271 resulted in a decrease in the number of sialyl Lewis A-expressing pancreatic cancer cells (S2.013 and BxPC-3) binding to the endothelium in a dose-dependent manner. GMI-1271 treatment also inhibited the transendothelial migration of S2.013 and BxPC-3 cells through a lymphatic cell monolayer. We evaluated the in vivo efficacy of GMI-1271 following orthotopic implantation of pancreatic tumor cell line S2.013, which expresses high levels of sialyl Lewis A (CA19-9), into nude mice. Following 2 weeks of tumor growth, mice were treated by intraperitoneal injections for 4 weeks with either PBS once daily, once daily with 40mg/kg GMI-1271 (low dose), twice daily with 40mg/kg GMI-1271 (high dose), twice a week with 60mg/kg gemcitabine injections, combination low dose GMI-1271 and gemcitabine injections, or combination high dose GMI-1271 and gemcitabine injections. Co-treatment of either low or high dose GMI-1271 with gemcitabine resulted in a significant decrease in the number of metastasis to the lymph nodes (p=0.02 low dose; p=0.04 high dose). In addition, compared with gemcitabine alone, low dose GMI-1271 plus gemcitabine was found to be effective at reducing the number of metastatic lesions (per histological section) in the liver (p=0.001), lung (p=0.026) and diaphragm (p=0.01). Based on the significant effects of combination therapy on tumor metastasis, the small molecule glycomimetic antagonist to E-selectin, GMI-1271, offers great promise in preventing pancreatic tumor cell entry into the blood and lymphatic systems and offers a novel treatment for the improved efficacy of standard chemotherapy. Citation Format: Maria M. Steele, Prakash Radhakrishnan, John L. Magnani, Michael A. Hollingsworth. A small molecule glycomimetic antagonist of E-selectin (GMI-1271) prevents pancreatic tumor metastasis and offers a novel treatment for improved efficacy of chemotherapy. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4503. doi:10.1158/1538-7445.AM2014-4503
A Comparison of Patients Discharged Against Medical Advice with a Matched Control Group
Authors: NANCY SCHEER, GAIL M. BARTON
Journal: American Journal of Psychiatry (1974)

This study examines prospective admission and follow-up variables by comparing 21 psychiatric patients leaving an institutional facility against medical advice (AMA) with 21 control patients. The authors conclude that leaving AMA is not necessarily detrimental to patients three or six months after discharge, that the patient may actually be running toward health rather than away from treatment, that the AMA patients have a different relationship with the staff than non-AMA patients, and that effort might be spent in educating the staff and milieu that an AMA discharge may be beneficial therapeutically rather than a negative occurrence.