tbuckley/cabot-search huggingface dataset:
Persistent lung perfusion defect is a risk factor for recurrent venous thromboembolism after pulmonary embolism
Authors: Alexis Ferré, Benjamin Planquette, Amandine Vial, Antoine Roux, Joseph Emmerich, Guy Meyer, Olivier Sanchez
Journal: European Respiratory Journal (2012)

Introduction.  Up to 50% of patients with pulmonary embolism (PE) still have lung perfusion defects after 6 months of anticoagulant treatment, but little is known about the risk of recurrence in patients with persistent perfusion defect after an acute PE.   Aim of the study.  To assess the risk of recurrent venous thromboembolism (VTE) in patients with persistent lung perfusion defects after a first episode of PE.   Patients and methods.  Consecutive patients given at least 3 months of anticoagulant for an objectively proven first episode of acute PE were included. Ventilation/perfusion (V/Q) lung scan was performed 6 to 12 months after the diagnosis of PE. Objectively proven recurrent deep vein thrombosis (DVT) and PE were registered during follow-up. Persistent perfusion defects were defined as a pulmonary vascular obstruction > 10% on the V/Q lung scan.   Results.  318 patients (mean age 58 ± 19 years) with an acute PE were included. 63 (19.8%, 95% CI, 15.4-24.2%) had persistent perfusion defects. During follow-up (median duration: 51 months [25 th  75 th  percentiles: 27 - 73 months]), 71 patients (22%) had a recurrent episode of VTE. In multivariate analysis, persistent defect (HR 2.22; 95% CI, 1.3-3.75; p =0.0048), unprovoked PE (HR 3.48; 95% CI, 1.96-6.19; p   Conclusion.  Persistent perfusion defect is an independent risk factor for recurrent VTE after a first episode of PE.
The forced oscillation technique in intubated, mechanically-ventilated patients
Authors: KP Van de Woestijne
Journal: European Respiratory Journal (1993)

In a recent discussion concerning the use of the forced oscillation technique (FOT), PRIDE [ 1] stated that, although anaesthesia and intensive care are among the obvious ar­ eas of application of the method, there is very little in­ formation on these applications. The paper by PEsuN et al. [2] in the present issue of the Journal describes one of the first attempts to apply the FOT to mechanically­ ventilated patients. FOT, first described by DuBozs et al. [3] in 1956, is a technique in which externally produced pressure oscilla­ tions are applied to the respiratory system. The resulting oscillations in airflow, related to the corresponding pres­ sure oscillations, allow a direct measurement of the im­ pedance, i.e. the pressure-flow relationships of the system. Generally, the oscillations are produced by a loudspeaker, and are applied at the mouth of the subject The imped­ ance is calculated from the signals of a pressure trans­ ducer and a pneumotachograph placed close to the subject's mouth. Because of the complex mechanical prop­ erties of the respiratory system, consisting of various structures with capacitive (compliant), resistive and inertive properties, pressure and flow signals are not in phase (except at given frequencies, called resonant fre­ quencies): recorded in X-Y coordinates, the pressure-flow relationships describe a loop. Therefore, the impedance is characterized by a modulus, IZI, the ratio of pressure ver­ sus airflow, and a phase, <p, expressing the shift in time of these two variables. Another, more usual, way of deal­ ing with this time shift is to divide the impedance into a real part or resistance (R), and an imaginary part or re­ actance (X), in which R is IZI cos <p, and X is lZI sin <p. In a simple circuit, consisting of a capacity, a resistance and an inertance, coiUlected in series, R corresponds to the actual resistance of the circuit and X to a combina­ tion of capacity and inertance. Generally, in a complex system, Rand X vary with oscillatory frequency. There­ fore, to define the mechanical properties of the respira­ tory system, R and X are measured at various frequencies. In the original device of DuBms et al. [3], the response of the respiratory system was investigated by applying a succession of oscillations varying in frequency, during voluntary apnoea. This took time, and made the techni­ que very impractical. This is why the FOT did not gain widespread acceptance, until it was modified so that sev
Late intensification in small-cell lung cancer: a phase I study of high doses of cyclophosphamide and etoposide with autologous bone marrow transplantation.
Authors: J P Sculier, J Klastersky, P Stryckmans
Journal: Journal of Clinical Oncology (1985)

We conducted a late dose intensification pilot study of small-cell lung cancer (SCLC) treated with high doses of cyclophosphamide (200 mg/kg) and etoposide (1.0 to 3.5 g/m2), administered during a period of 48 hours, as well as autologous bone marrow infusion. We have been able to administer safely 3 g/m2 of etoposide with the autologous bone marrow infusion and 1.5 g/m2 without it. Limiting extrahematopoietic toxicity appeared to take the form of irreversible cardiac failure. Complete responses have been obtained with our regimen for late dose intensification, but the duration of the responses and the survival rates of the patients were poor. This suggests that late dose intensification in incomplete responders is not superior to the usually reported results obtained with standard regimens for the treatment of SCLC.
Inaccuracy of built-in ventilator softwares (BIVS) in monitoring apnea-hypopnea index (AHI) in patients treated by home non invasive ventilation (NIV)
Authors: Julie Teulade, Frédéric Damagnez, Ha Trang
Journal: European Respiratory Journal (2012)

Home ventilators are often equipped with BIVS able of recording various parameters over many months. AHI is one of the parameter most frequently used by clinicians to monitor efficiency of ventilation applied to patients with Obstructive Sleep Apneas (OSA). However, the reliability of algorithms used by BIVS to detect apnea (A) or hypopnea (H) has yet to be determined.

Patients & Methods. We studied 5 patients with severe OSA (4M, 1F, 10.5 years, range 2.5-15 years) and treated by NIV (4 CPAP,1 BiPAP). An overnight respiratory polygraphy (RP) was performed while the patient was on NIV at home. All RP were analyzed as usually recommended by one of us (J.T) blinded to BIVS data. We compared A and H detected by BIVS versus those detected by RP.

Results. BIVS detected 169 A-H that were related to movements in 56% and no visible event using RP in 25% of cases.

View this table:

Table 1





Among the 88 A-H detected by RP, only 35% were recognized by BIVS.

View this table:

Table 2





Conclusion. The majority of A-H detected by BIVS was related to patient movements, whereas BIVS was unable to detect A-H seen in RP. These preliminary data support that AHI provided by BIVS is largely inaccurate in patients during NIV and should not be used to adjust NIV. Polysomnographies are required to monitor efficiency of NIV.
Airway centered interstitial fibrosis – An under-recognized type of idiopathic interstitial pneumonia
Authors: Edith Silbernagel, Alicia Morresi-Hauff, Wolfgang Gesierich, Michael Lindner, Juergen Behr, Frank Reichenberger
Journal: European Respiratory Journal (2014)

Background: Airway centered interstitial fibrosis (ACIF) is a rare subtype of idiopathic interstitial pneumonia with variable outcome. The origin of the disease is unknown.  We describe the clinical features and follow up in a case series of 12 patients (7 female, men age 52 (min 27- max 64) years) with ACIF over a time period of 20 years. The diagnosis was based on clinical presentation and radiological imaging. Histologies were obtained by surgical lung biopsy.  In 4 patients an exogenous agents could be detected (1 pt mould, 2 pts wood dust, 1 pt hide exposure). Two patients had a rheumatoid arthritis, and 1 patient each suffered from recurrent aspiration and asbestos exposure, respectively. In 3 patients no associated condition has been found. Three patients were current smokers. At presentation patient were restrictive and had a significant impairment in diffusion capacity (VC 68%, TLC 78%, DLCO 37%).  All patients were started on immunosuppressive therapy with steroids and additional azathioprine if necessary.  Mean time of follow up was 6 (0.5-19) years. One patient with idiopathic ACIF showed a rapid deterioration despite immunosuppression and required urgent lung transplantation. The patients with ACIF due to exogenous agents or associated with RA were stable on immunosuppressive therapy.  Conclusion: In our case series, ACIF frequently showed an association with exogenous agents and rheumatoid arthritis with a favorable long-term outcome on immunosuppressive therapy.
Contemporary Mortality Risk Prediction for Percutaneous Coronary Intervention
Authors: Eric D. Peterson, David Dai, Elizabeth R. DeLong, J. Matthew Brennan, Mandeep Singh, Sunil V. Rao, Richard E. Shaw, Matthew T. Roe, Kalon K.L. Ho, Lloyd W. Klein, Ronald J. Krone, William S. Weintraub, Ralph G. Brindis, John S. Rumsfeld, John A. Spertus
Journal: Journal of the American College of Cardiology (2010)
Increased Vascular Endothelial Growth Factor and Receptors
Authors: Bryce N. Feltis, Dharshini Wignarajah, Ling Zheng, Chris Ward, David Reid, Richard Harding, E. Haydn Walters
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Rationale: Increased vascularity is a feature of airway remodeling in asthma with the potential to contribute to a number of functional abnormalities in this chronic disease. Although various growth factors have been implicated in modulating vascularity, the important contributors in vivo are still being elucidated. The most likely candidate is vascular endothelial growth factor (VEGF).Objectives: We have examined VEGF and its receptors, VEGFR1 and VEGFR2, and angiopoietin-1 (Ang1) in the airways of subjects with asthma and contrasted these results with findings in normal control subjects. We aimed to explore whether these powerful angiogenic factors were expressed at elevated levels in asthmatic airways.Methods: We obtained biopsy and bronchoalveolar lavage samples from 35 subjects with mild to moderate asthma and from 22 normal control subjects.Measurements: We performed immunohistochemistry and image analysis to obtain quantitative measures of VEGF, VEGFR1, VEGFR2, and Ang1 staining in airway biopsies, and ELISA to assess VEGF concentration in the bronchoalveolar lavage fluid.Results: VEGF staining and VEGF levels in bronchoalveolar lavage fluid were elevated in the airways of subjects with asthma and were related to the number of vessels; Ang1 staining was similarly increased. VEGFR1 was slightly higher in subjects with asthma and the VEGFR1:VEGFR2 ratio was significantly higher in subjects with asthma. We observed angiogenic sprouts (i.e., early-forming vascular structures) that were increased in number in subjects with asthma.Conclusions: Our findings suggest that VEGF, its receptors, and Ang1 are likely to be important in vascular changes in the airways of patients with asthma. Further, there are observable structures in the vessel walls of asthmatic airways that could present ongoing evidence of increased angiogenic activity.
Medical thoracoscopy in the diagnosis and treatment of lung/pleural disease: Sharing an experience of 1125 cases
Authors: Georgia Hardavella, Dimitrios Zachilas, Georgia Doga, Maria Dassiou, Stavros Malagaris, Gerasimos Papavasileiou, Nikolaos Anastasiou
Journal: European Respiratory Journal (2013)

Introduction: MT has substantially thrived over the last decade and has been a useful technique in the hands of experienced chest physicians.   Objective: To assess our 12-year experience(2000-2012)of our first 1125 MT cases in terms of clinical efficacy/patient outcome.   Materials and methods: Retrospective review of 1125 MT patients&clinical follow up at 1, 6 and 12 months post procedure.We assessed diagnostic efficacy,sensitivity,complications,recurrences,survival,clinical effectiveness(SPSS v12.0).   Results: Patients were 757 males and 368 females(mean age 69.7 years). 137/1125 had high risk comorbidities steming them from more invasive procedures.All MTs were performed in the endoscopy suite under conscious sedation(midazolam, fentanyl)and intercostal block(ropivacain)to diagnose+/-treat lung/pleural diseases.Mean hospital stay: 2.1 days(range 0-4) for diagnostic and 3.4 days(range 1-15) for therapeutic MT.The procedures were pleural biopsy 276/1125,talc pleurodesis 383/1125,pleural biopsy&talc pleurodesis 125/1125,lung biopsy(stappler device) 52/1125,empyema 264/1125, haemothorax 25/1125.Diagnosis was obtained in 95% patients, palliation in 65%, clinical effictiveness with no recurrency at 12 months in 84%. Sensitivity:88% for pleural and 99% for lung biopsies.Mortality:0.088%.No intraoperative or postoperative complications were recorded.   Conclusions: The assessment of our first 1125 MT showed increased sensitivity,diagnostic and clinical efficacy with minimal hospital stay and morbidity.MT has been also safe and efficient in patients unable to undergo more invasive procedures.MT can be a useful tool in the hands of a skilled thoracic team ensuring optimal patient outcome.
Randomized Trial of Bone Marrow Versus Lenograstim-Primed Blood Cell Allogeneic Transplantation in Patients With Early-Stage Leukemia: A Report From the Société Française de Greffe de Moelle
Authors: Didier Blaise, Mathieu Kuentz, Cecile Fortanier, Jean Henri Bourhis, Noël Milpied, Laurent Sutton, Jean-Pierre Jouet, Michel Attal, Pierre Bordigoni, Jean-Yves Cahn, Jean-Michel Boiron, Marie-Pascale Schuller, Jean-Paul Moatti, Mauricette Michallet
Journal: Journal of Clinical Oncology (2000)

To compare hematologic recovery in patients receiving allogeneic blood cell transplantation (BCT) with those receiving allogeneic bone marrow transplantation (BMT).One hundred eleven patients with leukemia in the early stages and with HLA-matched sibling donors were randomized in this study. One hundred one underwent transplantation. Standard procedures for collection and transplantation were used. Patients did not receive prophylactic granulocyte colony-stimulating factor after undergoing transplantation. In addition to clinical end points being established, a prospective and comparative economic evaluation of the first 6 months after transplantation was performed.Groups were balanced for patient, donor, and transplant characteristics. Blood cell collection led to the collection of a higher number of CD34(+) and CD3(+) cells than did bone marrow collection (P < 10(-6)) without reported side effects for the donor. Patients in the BCT group reached platelet counts of 25 and 50 x 10(9) platelets/L 8 and 11 days earlier than did the BMT group (P < 10(-4) and P < 10(-5)), respectively. This resulted in fewer platelet transfusions during the first 180 days after transplantation (P =.002) for the former group. The time to reach neutrophil counts of 0.5 and 1 x 10(9) neutrophils/L was 6 and 7 days shorter, respectively, in the BCT group than in the BMT group (P < 10(-5)). This quicker hematologic recovery was associated with a shorter length of hospitalization and a decrease in total cost of procedure during the first 6 months.This study establishes that allogeneic BCT results in quicker hematologic recovery but is associated with a higher occurrence of chronic graft-versus-host disease.
Transplantation of a Murine Chondrosarcoma in Mice of Different Inbred Strains
Authors: Richard L. Swarm
Journal: JNCI Journal of the National Cancer Institute (1963)

A transplantable chondrosarcoma survived and grew when homotransplanted to different inbred strains of mice. Previous studies demonstrated the survival of normal cartilage homo-grafts in several species. Intercellular matrix surrounded the chondrocytes in this tumor. Homotransplants of the tumor incorporated S35-labeled sulfate into the matrix. It has been previously suggested that the chondrocytes in normal cartilage grafts may be protected by the matrix. The matrix in this chondrosarcoma may have protected the tumor chondrocytes from the host homograft response. The tumor also grew in hypophysectomized animals and in animals from which previous tumor transplants had been surgically removed. Some other attempts to transplant cartilage and neo-plastic cartilage are reviewed.
Hyperbaric Oxygen, Whole-Body X Irradiation, and Cyclophosphamide Combination Therapy in Mouse Leukemia L1210&lt;xref ref-type="fn" rid="FN1"&gt;1&lt;/xref&gt;
Authors: Fredrik I. Lottsfeldt, Samuel Schwartz, William Krivit
Journal: JNCI Journal of the National Cancer Institute (1966)

Survival of B6D2F1/J mice with L1210 leukemia after treatment with whole-body X irradiation, hyperbaric oxygen, or cyclophosphamide was studied. Response was determined to irradiation and cyclophosphamide administered individually, in combination, and with and without hyperbaric oxygen. Average survival was increased by only 2 or 3 days after 525 to 1300 r irradiation and by 8.7 days with cyclophosphamide alone. No additive effect could be demonstrated with any two-way combination of the three variables under study. Average increased survival of mice (16.2 days) following treatment with hyperbaric oxygen, 525 r wholebody irradiation, and cyclophosphamide was approximately double that of mice receiving cyclophosphamide alone. The effect was associated with the decreased proportion of mice dying rapidly with relatively normal spleens. It is suggested that hyperbaric oxygen protected the leukemic mice from the toxic effect of radiation and cyclophosphamide.
Morbidity of pneumonectomy in the age of neoadjuvant therapy for lung cancer
Authors: A. N. Patel, J. D. Luketich, H. C. Fernando, N. A. Christie, P. Ferson, R. J. Landreneau
Journal: Journal of Clinical Oncology (2004)

7176 Background: Recent literature suggests there is a significant difference in morbidity following right pneumonectomy compared to left for lung cancer in the setting of neoadjuvant therapy. The objective of this study was evaluate the morbidity and effects of neoadjuvant therapy in right vs left pneumonectomy for non small cell lung cancer (NSCLC). Methods: A review of all patients who underwent a pneumonectomy for NSCLC at a single institution (1990–2002). Evaluation of outcomes for right vs left pneumonectomy was performed. Statiscal analysis: Chi Square and Fisher Exact. Results: There were 115 patients (65 left: 50 right) who underwent pneumonectomy for NSCLC. Histology was similar between the two groups. Fifty-two of 115 (45%)patients underwent neoadjuvant therapy (right n=25 (50%), left n=27 (42%). The median length of hospital stay was 5 days for both groups. There was no significant difference in the broncho-pleural fistula rate whether neoadjuvant therapy was given or not (right with-4, without-3; left with-1, without-1). Supraventricular arrhythmias were more common in patients with neoadjuvant therapy prior to their pneumonectomy (left 16 of 19, right 3 of 5),p=0.0004. Conclusions: There was no significant difference between right and left pneumonectomies with regard to 30 day mortality and overall median survival. Patients with left pneumonectomies were more likely to have post operative arrhythmias. Patients with right pneumonectomies had more BPFs. Right pneumonectomy is a risk factor for development of BPFs, but neoadjuvant therapy is not. Neoadjuvant therapy is associated with an increase in the risk of supraventricular arrhythmias following pneumonectomy No significant financial relationships to disclose.
Paclitaxel by 1-hour infusion: an active drug in metastatic non-small-cell lung cancer.
Authors: J D Hainsworth, D S Thompson, F A Greco
Journal: Journal of Clinical Oncology (1995)

PURPOSE Paclitaxel is an active single agent when administered as a 24-hour continuous infusion in the treatment of stage IV non-small-cell lung cancer. We evaluated the efficacy and toxicity of paclitaxel administered by 1-hour infusion in the outpatient setting to patients with stage IV or relapsed non-small-cell lung cancer. PATIENTS AND METHODS Fifty-nine patients with stage IV or relapsed non-small-cell lung cancer were treated with 1-hour infusions of paclitaxel. The first 17 patients received a dose of 135 mg/m2 and the remaining 42 patients received 200 mg/m2. By random assignment, 31 patients received a single-day, 1-hour infusion of paclitaxel, and 28 patients received a 3-day, divided-dose schedule, with each dose administered by 1-hour infusion. Both regimens were repeated every 21 days. All patients received premedication with dexamethasone, diphenhydramine, and cimetidine. Cytokines were not routinely used. RESULTS Thirteen of 53 assessable patients (25%) had partial responses to treatment. An additional five patients had minor responses. The median survival duration of the entire group was 8 months and the actuarial 1-year survival rate was 33%. Patients who received 200 mg/m2 of paclitaxel had a higher response rate than those who received 135 mg/m2 (31% v 12%, respectively). Six of 16 patients (38%) previously treated with cisplatin-based regimens responded to 200 mg/m2 of paclitaxel. No significant differences in activity were seen when the 1-day and 3-day paclitaxel schedules were compared. Paclitaxel was well tolerated at both doses and schedules, and no severe hypersensitivity reactions occurred. Only 18 of 154 courses (12%) given at 200 mg/m2 resulted in grade 3 or 4 leukopenia. CONCLUSION Paclitaxel administered by 1-hour infusion is an active and well-tolerated new agent in the treatment of metastatic non-small-cell lung cancer. These results suggest that a paclitaxel dose of 200 mg/m2 is more effective than 135 mg/m2 and can produce responses in patients previously treated with cisplatin-based regimens. Incorporation into combination regimens is indicated.
A Tumor-Associated Organ-Specific Antigen Characteristic of Spontaneously Metastatic .Rat Mammary Carcinomas&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: S K Ghosh, A L Grossberg, U Kim, D Pressman
Journal: JNCI Journal of the National Cancer Institute (1979)

An organ-specific tumor-associated antigen (TAA) was present in several metastatic and nonmetastatic mammary carcinomas induced in WF female rats by 3-methylcholanthrene. The level of TAA was high in 2 metastatic carcinomas tested (TMT-081 and SMT-2A) and much lower--by a factor of 50--200--in 2 nonmetastatic mammary carcinomas (MT-100 and MT-W9B). The TAA in the 2 metastatic tumors was identical, as demonstrated by immunodiffusion and supported by cross-reactivity with antibody against TAA from TMT-081 in a binding inhibition radioimmunoassay. The TAA was shed in relatively large amounts by the metastatic tumors maintained in short-term organ culture. The high level and shedding of TAA thus appeared to be characteristics of the metastatic tumors but not of the nonmetastatic ones. This suggests that TAA on the cell membrane or in the circulation may be involved in the metastatic process as a factor blocking potentially cytotoxic cells or in other ways leading to suppression of the immune response against the tumor.