tbuckley/cabot-search huggingface dataset:
How frequent are unusual types of ventilatory impairment (mixed and nonspecific)? Analysis of over 10,000 patients data
Authors: Piotr Boros, Magdalena Martusewicz-Boros, Stefan Wesolowski
Journal: European Respiratory Journal (2013)

Objective: To determine the frequency of mixed and nonspecific ventilatory disturbances in the large population of patients with different lung diseases.

Material: 24,151 tests (spirometry and pletysmography performed at the same time) in 10,130 subjects (49.98% females), aged 18-87 years, referred for PFT evaluation from National TB & Lung Diseases Institute, Warsaw, Poland.

Methods: Predicted FEV1, FVC, FEV1/VC, TLC and lower limits of normal (LLN) using ECSC 1993 equations were applied. Mutually exclusive types of ventilatory disturbances were defined as follows: obstruction as FEV1/VC<LLN with normal TLC, a restrictive pattern as TLC<LLN without obstruction, “mixed” abnormality as TLC<LLN and FEV1/VC<LLN and “nonspecific” pattern as VC<LLN with no obstruction and no restriction.

Results: “Nonspecific” and “mixed” disturbances were detected in 424 (4.2%) and 229 (2.3%) patients, while obstruction and restriction in 3058 (30.2%) and 2511 (24.8%) respectively (some subjects had different types at different time). Patients presenting mixed pattern were males in majority (74.2%), have lower BMI and presented the most advanced ventilatory impairment (mean FEV1%pred. 50.0±10.9) comparing to others and had variety of diagnosis with the most prevalent sarcoidosis and lung fibrosis. Patients with nonspecific pattern were younger with BMI similar to others and were diagnosed also as interstitial lung diseases (sarcoidosis, lung fibrosis, hypersensitivity pneumonitis, connective tissue diseases) in majority.

Conclusion: Mixed and nonspecific ventilatory disturbances are rare conditions associated with various interstitial lung diseases.
Abstract 1945: Levels Of Circulating Progenitor Cells In Patients With Chronic Heart Failure Predict Outcomes
Authors: Roberto Latini, Ralph Lehmann, Birgit Assmus, Giovanna Balconi, Stefanie Dimmeler, Patrizio Sarto, Emanuele Carbonieri, Alessandra Gualco, Fondazione S Maugeri, Carlo Campana, IRCCS S Matteo, Fabio Fiordaliso, Laura Angelici, Elisabetta Dejana, Andreas M Zeiher
Journal: Circulation (2007)

Background: A low level of circulating endothelial progenitor cells (EPCs), a marker of reduced vascular regeneration, is related to worse outcome in patients with coronary heart disease, but little is known on pts with heart failure (HF). The aim was to assess the prognostic value of circulating EPCs in patients with HF. Methods: In 68 pts enrolled to GISSI-HF trial by 5 Italian Centers and 45 pts from Frankfurt, mononuclear cells from peripheral blood were isolated and plated; after 4 days, adherent cells were incubated with DiI-labeled acetylated LDL, stained with FITC-labeled Ulex europaeus agglutinin I (lectin), and counted as double positive at confocal microscopy. 66 patients had ischemic etiology, 12 were females, 26 had NYHA class &gt;II, median age 64 y (Q1–Q3 56–70y). Cutoffs for EPCs were assessed by ROC. Results: Mean EPCs in pts with HF 34 ± 7 EPCs/mm 2 , 2–3 fold lower than in age-matched controls. Over a median of 2.5 years, 12 CV deaths and 47 first hospitalizations for CV reasons were recorded. Levels of EPCs were unrelated to severity of HF, age or sex. After adjustment for clinical variables, creatinine and BNP, EPCs &lt;30/mm 2 were associated with a 2-fold higher risk of CV death and hospitalization, as shown by K-M curves (figure ) and by Cox multivariate regression. Pts with HF of ischemic etiology gave identical results. Conclusions : The level of circulating EPCs is an independent predictor of CV death and hospitalization in pts with chronic HF. The assay of this cellular marker of risk can be performed in blood samples collected in a multicenter setting under controlled conditions, and may offer an accessible tool to assess the role of vascular regeneration in the treatment of HF.
Epidemiology of Renal Cell Carcinoma in Connecticut, 1935–1973 2
Authors: Arlene L. Finger Kantor, J. Wister Meigs, Jean F. Heston, John T. Flannery
Journal: JNCI Journal of the National Cancer Institute (1976)

Data on over 3,700 patients with renal cell carcinoma, reported to the Connecticut Tumor Registry from 1935 through 1973, were used to assess incidence, survival, and associations of risk with demographic characteristics. Incidence increased over time among men, but not among women; a birth cohort effect suggesting increasing incidence rate over time was demonstrated for men. A comparison of male and female agespecific incidence rates indicated that, in the 15- to 39-year-old age group, men were three times more likely than women to develop the disease; after age 40, renal cell carcinoma was diagnosed in men twice as often as in women. Survival probability has increased from 1940 to the present time. A high density of persons per square mile was associated with a higher-than-expected incidence. No trends in incidence according to socioeconomic status were observed.
An examination of psycho-social factors among adult patients with asthma
Authors: Junko Yamanaka, Satoshi Ogino, Hiroshi Fijiwara, Chiko Okada, Setsuko Yamamoto, Naoko Ochiai, Seijiro Minamoto
Journal: European Respiratory Journal (2012)

Introduction: Nursing staff provide support for patients with asthma to facilitate effective self-management, which, in turn, will contribute to achieving the ultimate goal of asthma care: improving the Quality of life(QoL) of the patients. However, psycho-social factors, in particular, personality traits, have a significant impact on the delivery and effectiveness of self-management support, and are considered as a factor that impairs the control of symptoms.Objective: The purpose of this study was to examine personality traits of adult patients with asthma and associated factors.Methods: We conducted a questionnaire survey involving 291 patients with asthma under outpatient treatment at respiratory care facilities in Osaka Prefecture. We quantified and scored personality traits to be said to be easy to feel stress. These scores and associated factors were analyzed statistically.Results: A comparison of those with high and low scores for personality trait items showed that the high group engaged in self-management activities mostly in a passive manner, with significantly low scores for stress-coping items.An analysis of the QoL using the Asthma Health Questionnaire-33 Japan (AHQ-33J) showed that those with high scores for emotional experiences, aggravating factors, and the restriction of social activity, as well as those with high overall scores had a significantly impaired QoL. Conclusions: The findings suggest that personality traits exert an influence on patients9 self-management behavior and QoL. Due consideration should be given to the contributing factor when providing self-management support.
Lung Inflammation and Fibrosis
Authors: Herbert Y. Reynolds
Journal: American Journal of Respiratory and Critical Care Medicine (2004)

The alveolar inflammatory reaction, important for amplifying host defenses in the lungs, is in part under the cellular control of the pulmonary alveolar macrophage, which can initiate and modulate the reaction. A chronic, poorly regulated reaction can cause tissue dysfunction including fibrosis. This historical perspective will review the efferent function of alveolar macrophages that elicits inflammation through secretion of several chemokines, examining how some of these were identified from normal macrophages, and later investigated in lung fibrosis, particularly idiopathic pulmonary fibrosis (IPF). The focus is on two chemokines: interleukin-8 (IL-8) and leukotriene B4 (LTB4).
Pulmonary immune cells in health and disease: lymphocytes
Authors: C Agostini, M Chilosi, R Zambello, L Trentin, G Semenzato
Journal: European Respiratory Journal (1993)

Immunological defence mechanisms of the lung are provided by several different types of immunocompetent cell. Among these, the most important are lymphocytes, alveolar macrophages and neutrophils. This review focuses mainly on the pattern of physiological activities of pulmonary lymphocytes in the local host defences. The article provides an overview of the events leading to the recruitment, homing and activity of lymphocytes in the lower respiratory tract. The pathways through which the pulmonary lymphoid system recognizes, destroys and contributes to removing potentially harmful inhaled antigenic materials are also briefly discussed. The final section of the article highlights the pathogenetic role envisaged for lymphoid cells in disease states, in the context of the known biology of these cells.
Systemic inflammation and vascular dysfunction in patients with OSA
Authors: Felipe Villar-Άvarez, María Fernanda Troncoso-Acevedo, Germán Peces-Barba, María Soledad Lucero, Ivonne Cabrejos-Salinas, Zahdia Saavedra-Moreno, Nicolás González-Mangado
Journal: European Respiratory Journal (2011)

Introduction: Our hypothesis is that systemic inflammation and endothelial vascular dysfunction in OSA patients are associated. Therefore our primary objective was to be able to establish the etiological association between them.

Materials and methods: Observational case control study in OSA patients and healthy individuals. All of them were tested for serum and urinary markers. Peripheral arterial tonometry by oscillometric sphygmomanometer (ENDO-PAT 2000) was used to measure endothelial dysfunction and arterial stiffness values (Reactive Hyperemia Index-RHI and Augmentation Index-AI).

Results: This study involved 42 participants (30 with OSA and 12 healthy controls). Mean age: OSA 61,7, controls 50,4 (p =0,02). Mean BMI: OSA 31,8, controls 26,1 (p= 0,01). The OSA severity rate was severe in 54%, low-moderate in 11, 9% and low in 11, 9% of them. The results for the serum and urinary markers (Mann-Whitney test) comparison with median and quartiles were the following: CRP (OSA 0,5 controls 0,3, p=0,15), leucocytes (OSA 7500, controls 6700, p= 0,18), D-dimer (OSA 339, controls 252, p= 0,18), fibrinogen (OSA 401, controls 318, p= 0,0007) and microalbuminuria (OSA 7,6, controls 4,7, p= 0,12). No statistically significant differences in arterial stiffness (IA, OSA 19, controls 13,5 p= 0,3) neither in vascular endothelial dysfunction (IRH, OSA 1,50 control 1,72 p= 0,2) were found, although its value was lower than what is considered significant for endothelial dysfunction (<1,67).

Conclusions: An association between OSA and cardiovascular risk can be established by measuring the inflammatory marker fibrinogen, and by taking into consideration the data that suggest that endothelial dysfunction may be present.
Influence of antisecretory drugs on Helicobacter pylori eradication rates
Authors: M Pellegrini, R Urso, G Giorgi, D Cerretani
Journal: Gut (2004)

We read with great interest the article by Sherwood and colleagues ( Gut 2002; 51 :490–5) evaluating the role of acid secretion and gastric luminal pH on the gastric transfer rate of amoxycillin, clarithromycin, and metronidazole. The study showed that metronidazole and clarithromycin but not amoxicillin transfer was increased by acid secretion. Gastric acid suppression, induced by the use of omeprazole, produced the fall in clarithromycin and metronidazole transfer.

These data may help to clarify preliminary results of our study on Helicobacter pylori eradication in a population of 120 H pylori infected dyspeptic patients (63 males and 57 females; mean age 53.2 (12.31) years).1 None of the patients received prior antibiotic treatment with nitroimidazoles or macrolides, or H pylori eradication therapy, nor was there a history of gastrointestinal surgery, alcohol use, or smoking.

Our population was divided in two groups of 60 patients who underwent two different 14 day triple eradicating regimens based on …
Management of the unstable shoulder
Authors: T. Thangarajah, S. Lambert
Journal: BMJ (2015)

The flavin-containing monooxygenase (FMO) family of enzymes oxygenates nucleophilic xenobiotics and endogenous substances. Human FMO3 and FMO5 are the predominant FMO forms in adult liver. These enzymes are naturally membrane-bound, and recombinant proteins are commercially available as microsomal preparations from insect cells (i.e., Supersome FMO). As an alternative, FMO3 has previously been expressed as a soluble protein, through use of an N-terminal maltose-binding protein (MBP) fusion. In the current study, MBP fusions of both human FMO3 and FMO5 were prepared to &gt;90% purity in the presence of detergent and characterized for biochemical and kinetic parameters, and the parameters were compared with those of Supersome FMO samples. Although MBP-FMO enzymes afforded lower rates of turnover than the corresponding Supersome FMOs, both types of FMO showed identical substrate dependencies and similar responses to changes in assay conditions. Of interest, the FMO3 enzymes showed a 2-fold activation of <i>k</i><sub>cat</sub>/<i>K</i><sub>m</sub> in the presence of Triton X-100. Oligomeric analysis of MBP-FMO3 also showed disassociation from a high-order oligomeric form to a monomeric status in the presence of Triton X-100. This report serves as the first direct comparison between Supersome FMOs and the corresponding MBP fusions and the first report of a detergent-based activation of <i>k</i><sub>cat</sub>/<i>K</i><sub>m</sub> that corresponds to changes in oligomerization.
XVI. International Union of Pharmacology Recommendations for the Nomenclature of Neuropeptide Y, Peptide YY, and Pancreatic Polypeptide Receptors
Authors: Martin C. Michel, Annette Beck-Sickinger, Helen Cox, Henri N. Doods, Herbert Herzog, Dan Larhammar, Remi Quirion, Thue Schwartz, Thomas Westfall
Journal: Pharmacological Reviews (1998)

Based on structural and evolutionary criteria, neuropeptide Y (NPY)b, peptide YY (PYY) and pancreatic polypetide (PP) are closely related polypeptides ([Larhammar, 1996a][1]). They are composed of 36 amino acids each and share considerable amino acid homology, amidated C-terminal ends, and the
Subjective sleep quality in adults with cystic fibrosis
Authors: Odette Erskine, John Wheatley, Peter Middleton
Journal: European Respiratory Journal (2014)

Introduction 

In patients with varying degrees of severity of cystic fibrosis (CF) lung disease, disturbances of sleep may impact on sleep quality. There are currently limited studies evaluating objective sleep measures (using polysomnography (PSG)), together with subjective sleep quality (using questionnaires).

Aim 

The aim of this study was to evaluate sleep abnormalities and their impact in subjects with mild to severe CF lung disease.

Methods 

In-laboratory PSG and spirometry were recorded for CF subjects during a period of clinical stability. All PSGs were analysed and scored according to standard criteria (AASM). Questionnaires administered at the time of PSG included the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI).

Results 

Twenty subjects with CF were recruited (male=7;age=30.7±8.2 (mean±SD) years; and body mass index (BMI):22.0±3.7 kg.m2). Baseline percent predicted FEV1 (%predicted FEV1) was 47.7±13.5 (range 21–73%). Although, ESS was normal at 5.1±3.4 arbitrary units, the mean PSQI was 6.7±3.1 with 60% of subjects rating themselves “poor sleepers” i.e. PSQI>5. There was no significant correlation between %predicted FEV1 and PSQI across all the disease severity types. The sleep efficiency was normal at 83.8±9.9%. Arousal index (AI) was normal at 16.7±8.0 (mean±IQR) events per hour. Respiratory disturbance index (RDI) was mildly elevated at 7.3±4.2 (mean±IQR) events per hour.

Conclusions 

In these CF subjects, objective sleep efficiency and the AI were within normal limits. In addition, the RDI was mildly elevated indicating mild sleep disordered breathing, which may be a cause of reduced sleep quality. CF subjects were not excessively sleepy but reported reduced subjective sleep quality.
Abstract P355: Variable associations of dehydroepiandrosterone with cardiovascular risk factors in the Boston Puerto Rican Health Study
Authors: Monik C Jimenez, Kathrine Tucker, Fatima Rodriguez, James B Meigs, Lenny Lopez
Journal: Circulation (2014)

Introduction: Low blood levels of dehydroepiandrosterone sulfate (DHEAS) have been shown to have strong positive associations with diabetes, cardiovascular disease (CVD) mortality and stroke. However, the underlying pathways remain unclear, given limited data to systematically examine associations of DHEAS with CVD risk. In exploratory analyses we tested the association between CVD risk factors and DHEAS levels in a large population of Latinos. Methods: Among 1,450 participants in the Boston Puerto Rican Health Study between the ages of 45-75 years at baseline, socio-demographic, behavior, medical history, anthropometric and blood pressure data were collected at in-home interviews conducted by trained staff. A certified phlebotomist collected fasting blood samples. All samples were assayed for DHEAS, lipids, and C-reactive protein (CRP), HbA1c, insulin and glucose (GL). Spearman correlations were estimated between DHEAS and continuous CVD risk factors (lipids, systolic blood pressure [SBP] and diastolic blood pressure [DBP], CRP, GL, HbA1c, insulin, body mass index [BMI], waist circumference, physical activity and alcohol consumptions). We used robust multivariable linear regression models adjusted for potential confounders and intermediates with α=0.05 to estimate the association selected CVD risk factors and DHEAS levels. CVD risk factors were identified from a set of potential candidate predictors (age, female gender, history of heart disease, diabetes status, SBP, DBP, total and high density cholesterol [TC, HDL], triglycerides [TG], GL, CRP) using stepwise linear regression with an entry criterion of α=0.20 and exit criterion of α=0.10. Results: The mean DHEAS concentration among women was 70.7 μg/dL (s.d. 53.9; median=70.7) and among men was 119 μg/dL (s.d. 87.7; median=100). In age and sex adjusted Spearman correlations, TC, low density lipoprotein cholesterol, physical activity and alcohol were positively significantly correlated with DHEAS, while BMI and waist circumference were inversely correlated. In robust multivariable linear regression adjusted for potential confounders, age (-8.3; 95%CI:-10.0,-6.5; per 5 yrs), sex (β=-32.5; 95%CI:-38.4,-26.6) and TG (β=-0.5; 95%CI:-0.7,-0.2; per 10 mg/dl) were significantly inversely associated with DHEAS concentration, while TC (β=0.9; 95%CI:0.2,1.6;per 10 mg/dL) and GL (β=0.7; 95%CI:0.2, 1.2;per 10 mg/dL) were positively associated, albeit non-statistically significant. Adjustment for history of CVD, diabetes and BMI, only marginally attenuated these associations. Conclusions: Our data provide support for a significant association between TG levels and DHEAS concentrations even after adjustment for potential confounders and intermediates, which has been previously untested. These results suggest that DHEAS may work through lipid pathways.
Mesothelioma in Sunderland U.K 1998 -2011: Chemotherapy usage and impact on survival
Authors: Joanne Anderson, Susan Pollock, Gemma Probert, Stephen Murphy, Ian Taylor, Kishore Sridharan, Howell Clague
Journal: European Respiratory Journal (2012)

Background. UK and European guidelines on treatment of mesothelioma recommend combination chemotherapy with Cisplatin/Pemetrexed (CP) in patients with good performance status. In Sunderland CP chemotherapy has been the standard treatment for mesothelioma in selected patients since 2006. The aim of this study was to ascertain the usage of CP for mesothelioma and impact on survival.  Method Study conducted at Sunderland Royal Hospital. Patients diagnosed with malignant mesothelioma between 1998-2011 were included. Data collected: demographics, performance status, comorbidity, histology, treatment. Patients were stratified by date of diagnosis: 1998-2005 and 2006-2011. Factors affecting survival were assessed by Cox9s regression analysis.  Results. N=209, median (IQ range) age 69 (63-77) years, male 81.8 %. Histology: Epithelioid 48%; Sarcomatoid 12.6%, Mixed 5.2%, Unspecified 34.2%. Proportion treated with chemotherapy 1998-2005 29.3%, 2006-2011 60.2%; OR 3.65 (2.03-6.5). Median (IQR) survival: 1998-2005 8.2 (3.7-19.3) months; 2006-2011 all patients 9.8 (3.7-15.8) months, patients given CP chemotherapy 12.7 (9.8-22.7) months p > 0.05. On regression analysis treatment with CP appeared to confer a survival benefit HR (95% CI) 0.30 (0.21-0.43). But overall survival was unchanged between 1998-2005 and 2006-2011 HR 0.98 (0.72-1.3).  Conclusion Most patients with malignant mesothelioma are now treated with carboplatin/pemetrexed combination chemotherapy. However overall survival has not improved significantly and the apparent benefit of treatment may be due to patient selection.
Heterogeneity within chronic lung allograft dysfunction: A BAL analysis
Authors: Stijn Verleden, David Ruttens, Elly Vandermeulen, Dirk Van Raemdonck, Robin Vos, Bart Vanaudenaerde, Geert Verleden
Journal: European Respiratory Journal (2013)

It became clear that patients suffering from irreversible Chronic Lung Allograft Dysfunction (CLAD) after lung transplantation (LTx) can be subdivided in at least two phenotypes based on pulmonary function (Restrictive Allograft Syndrome, RAS vs. Bronchiolitis Obliterans Syndrome, BOS). Underlying mechanisms remain elusive  A retrospective analysis of our LTx cohort (2003-2012) was performed (n=380) to identify all patients with an irreversible FEV1 decline. They were further classified as BOS or RAS patients according to the classical definitions. BAL was performed with 2x50 cc saline at the moment (±1 months) of CLAD diagnosis. Classical BAL cellular analysis was done and IL-6 and IL-8 levels were measured using ELISA (Invitrogen). C-reactive protein was measured in serum (Tina-quant CRP latex assay).  25 RAS patients were identified, of whom 20 BAL samples at diagnosis were included and compared with 52 BAL samples of 79 BOS patients. We could identify significant differences in % BAL neutrophils (p=0.035), macrophages (p=0.0010), eosinophils (p=0.025), total cell count (p=0.031) and IL-6 (p=0.0092) (table 1). Serum CRP was higher in RAS compared to BOS (p=0.0013). More RAS patients (15/20) were already under active azithromycin before diagnosis of CLAD compared to BOS (22/52) (p=0.013). There was no difference in immunosuppression.  Significant differences in the BAL cellular profile were detected, which may point to different mechanisms.
Deaths from cardiovascular disease are four times higher in eastern Europe than western Europe
Authors: Ingrid Torjesen
Journal: BMJ (2015)

Stark differences exist in death rates from cardiovascular disease (CVD) across Europe, as rates in western Europe are far lower than those in the former Eastern bloc states, data published in the European Heart Journal show.1

Deaths from CVD have been declining, but over four million deaths a year still occur in Europe (45% of all deaths). Among women, eight countries—France, Israel, Spain, Denmark, the Netherlands, Norway, Switzerland, and the United Kingdom—have cardiovascular death rates lower than 250 per 100 000 women …