tbuckley/cabot-search huggingface dataset:
Evaluation of QuantiFERON-TB Gold Assay in detecting latent and active infection with mycobacterium tuberculosis in group of Egyptian children
Authors: Maha Ghanem, Nefesa Refaat, Heba Rashed
Journal: European Respiratory Journal (2011)

Background:  QuantiFERON-TB Gold In-Tube [QFG-IT] showed good diagnostic accuracy for active and latent TB in adults; limited studies have been performed in children, none in  Egypt .   Methods:  In a hospital-based prospective study, diagnostic accuracy of the tuberculin skin testing (TST) and QFG-IT were assessed in a cohort of 112 children (mean age 6.98±4.44, range 0.7-16); control not exposed (n=20), latent tuberculosis (n=42), active tuberculosis (n=50).   Results:  In confirmed active TB, TST was positive in 24 out of 26 cases (92.31%), compared to 37 out of 50 cases (74%) for QFG-IT. None of the 2 tests performed significantly better than the other (p=0.109).  In latent TB infection (LTBI), TST was positive in 24 out of 26 cases (92.31%), compared to 37 out of 50 cases (74%) for QFG-IT. Despite that QFG-IT performed better than TST; this was not statisticaly significanct (p=0.062).  Significantly higher number of positive QFG-IT and TST were seen in children older than 5 years compared to younger children (p=0.009, and 0.007, consecutively). The 2 tests did not show significant differences between those who had confirmed pulmonary and extra-pulmonary TB (p>0.05).  The overall agreement between the 2 tests was good (84.21%, κ 0.677).   Conclusions:  QTG-IT did not show higher diagnostic value in confirmed active childhood TB. Both QFG-IT and TST perform better in children older than 5 years than in younger population. Positive QFG-IT supports the diagnosis of TB in TST positive children. Negative QFG-IT does not exclude active TB. If used for diagnosis of LTBI, QFG-IT could significantly reduce the numbers of children receiving chemoprophylaxis.
Effects of a lifestyle intervention in obese obstructive sleep apnoea patients treated with CPAP
Authors: James Moss, Garry A. Tew, Robert J. Copeland, John M. Saxton, Edward M. Winter, Stephen M. Bianchi
Journal: European Respiratory Journal (2012)

Obstructive sleep apnoea (OSA) is a common condition characterised by repetitive closures of the upper airway during sleep. CPAP is the primary treatment and lifestyle changes are recommended, but there is no agreed structured intervention.  This RCT assessed responses to a lifestyle intervention that incorporated exercise, dietary advice and behaviour change counselling. We hypothesised that the intervention would have a positive effect on anthropometry, functional capacity, cardiovascular risk and quality of life.  Sixty OSA patients were recruited either into an intervention (n=30) or control group (n=30). Assessments occurred at week 0, week 13 and week 26. The intervention involved supervised exercise sessions, dietary advice and behaviour change counselling between weeks 0 and 13. Changes in body  habitus  and walking capacity (ISWD) between week 0, 13 and 26 were assessed using a mixed-design factorial ANOVA and 95% confidence intervals (CIs) of the net change in groups over time.  At 13 weeks, the intervention group improved body mass (-1.7kg;  P =0.001) and body fat percentage (-1.1 %;  P  =0.001) relative to the control group, although CIs between groups over time indicate changes were not clinically important. Changes in resting heart rate (-6 [-9, -2] beats⋅min -1 ;  P =0.002) and ISWD (+91 [52, 130] m;  P  -1 ;  P =0.250) although ISWD was probably beneficial (+110 [71, 149] m;  P   These data suggest that a change towards exercise behaviour has occurred. Interventions have potential as part of the holistic management of obese OSA patients compliant with CPAP.
The innate immune response in the airways and in blood is altered by training in horses
Authors: Linda Frellstedt, Philippe Gosset, Christophe Desmet, Dimitri Pirottin, Fabrice Bureau, Ingrid Waldschmidt, Marie-Capucine Dupuis-Tricaud, Pierre Lekeux, Tatiana Art
Journal: European Respiratory Journal (2013)

Lower airway diseases are common problems in sports and racing horses. In humans, exercise has been associated with upper respiratory tract infections due to down-regulated expression of Toll-like receptors (TLRs), costimulatory and antigen-presenting molecules on monocytes. The objectives of this study were 1) to examine the expression of TLRs in equine bronchial epithelial cells (EBEC) and blood monocytes in untrained and trained horses; 2) to stimulate EBEC and monocytes in vitro with TLR ligands, in order to mimic bacterial/viral infections; 3) to compare the cytokine production of EBEC and monocytes in untrained and trained horses. Bronchial biopsies were taken from 8 horses during lower airway endoscopy at rest and 24 hours after a standardized exercise test (SET). Bronchial epithelial cells were grown in vitro and activated with TLR ligands. Blood monocytes were collected at rest and after the SET. TLR1-TLR9 expression was evaluated via real-time PCR and cytokine production was measured via ELISA. TLR3 and TLR4 expression was modified by training. The expression of TLR2, TLR7 and TLR8 was modified only by strenuous exercise in trained horses. Training had local immuno-suppressive effects shown by a decreased production of TNF-alpha and IFN-beta in EBEC in response to TLR2 and TLR3 ligands. Training also caused a systemic pro-inflammatory response evidenced by increased production of TNF-alpha in monocytes in response to TLR2 and TLR4 ligands. These findings suggest that training and strenuous exercise in trained subjects may result in an increased susceptibility of the lower airway to infections associated with systemic inflammation.
A comparison of the antiemetic efficacy of prochlorperazine and metoclopramide for the treatment of cisplatin-induced emesis: a prospective, randomized, double-blind study.
Authors: B I Carr, M Bertrand, S Browning, J H Doroshow, C Presant, B Pulone, L R Hill
Journal: Journal of Clinical Oncology (1985)

This study compared high-dose metoclopramide and prochlorperazine for their antiemetic activities in the treatment of patients with solid tumors receiving cisplatin-based cancer chemotherapy, in a prospective, double-blind fashion. Sixty patients were entered in the study, and 28 patients on each regimen were evaluable. For regimen 1, metoclopramide was given intravenously (IV) over 15 minutes at a dose of 2 mg/kg 30 minutes before, 30 minutes after, and three hours after treatment with cisplatin. In regimen 2, prochlorperazine was given IV 30 minutes before and three hours after the cisplatin; a placebo was administered at 30 minutes after cisplatin. There was no statistically significant difference between the two regimens in their antiemetic efficacies during the first three hours. For emesis that occurred from three to 24 hours after administration of cisplatin, prochlorperazine was marginally superior. The median number of emeses in the metoclopramide regimen was 2.5 (range, 0 to 10+) compared to 1.0 (range, 0 to 10+) in the prochlorperazine regimen. This is not a significant difference. The overall incidence of adverse reactions was greater in the metoclopramide regimen, with drowsiness being the most common toxicity for both antiemetic programs. Thus, IV high-dose metoclopramide and prochlorperazine are similar and effective in the management of cisplatin-induced emesis. IV prochlorperazine at 20-mg dosage is surprisingly effective.
Worsening disability in older people: a trigger for palliative care
Authors: K. J. Boyd, S. A. Murray
Journal: BMJ (2015)

We must identify and respond to a trajectory of functional decline in our older patients

In a linked paper reporting a 15 year observational study, Gill and colleagues (doi:10.1136/bmj.h2361) highlight a strong association between admission to hospital and worsening disability in older adults.1 The authors suggest that hospital admission itself may be an important risk factor for increasing dependency in four activities of daily living (bathing, dressing, walking, and transferring) and adverse outcomes. About half of their study cohort had persistent or progressive disability and substantial care needs. These people also had a higher risk of dying than others in the cohort, especially when their functional ability declined rapidly. The authors’ main recommendation is important: that older people admitted to hospital with substantial disability should be considered for palliative care for control of symptoms, care planning, and increased support with personal care needs. How can this be done consistently?

It is known that older people are increasingly likely to have unplanned hospital admissions as their health deteriorates in the last year of life and that this happens for complex reasons, including age, socioeconomic deprivation, and …
Melanoma: summary of NICE guidance
Authors: Fergus Macbeth, Julia Newton-Bishop, Susan O’Connell, James E Hawkins
Journal: BMJ (2015)

This is one of a series of BMJ summaries of new guidelines based on the best available evidence; they highlight important recommendations for clinical practice, especially where uncertainty or controversy exists.Melanoma is the fifth most common cancer in the United Kingdom, with more than 13 000 cases diagnosed in 2011 and its incidence is rising rapidly. 1 Clinical practice seems to vary in the UK, especially with regard to the use of dermoscopy and photography, access to sentinel lymph node biopsy, vitamin D measurement and advice, follow-up policies, and the use of routine follow-up imaging.Patient groups have reported inadequate information on management options.This article summarises the most important recent recommendations from the National Institute for Health and Care Excellence (NICE) on the diagnosis and care of people with melanoma.
Review of the Role of Opioids in Cancer Pain
Authors: Andrea M. Trescot
Journal: Journal of the National Comprehensive Cancer Network (2010)

Cancer pain is unfortunately very prevalent, with opioids the mainstay of treatment. Knowledge of the types of pain caused by cancer and the effects of various opioids would be expected to improve pain therapy. This article addresses the use, side effects, formulations, and metabolism of the most commonly used opioids in cancer pain management, including morphine, codeine, hydrocodone, hydromorphone, fentanyl, and methadone. The role of opioid conversion and equipotent dosing when changing from one opioid to another is also described.
Correlation Between Serum Levels of Cardiac Troponin-T and the Severity of the Chronic Cardiomyopathy Induced by Doxorubicin
Authors: Eugene H. Herman, Jun Zhang, Steven E. Lipshultz, Nader Rifai, Douglas Chadwick, Kazuyo Takeda, Zu-Xi Yu, Victor J. Ferrans
Journal: Journal of Clinical Oncology (1999)

PURPOSE: To investigate, over a wide range of cumulative doxorubicin doses, the feasibility of using serum concentrations of cardiac troponin-T (cTnT) as a biomarker for doxorubicin-induced myocardial damage. MATERIALS AND METHODS: Groups of spontaneously hypertensive rats (SHR) were given 1 mg/kg doxorubicin weekly for 2 to 12 weeks. Cardiomyopathy scores were assessed according to the method of Billingham and serum levels of cTnT were quantified by a noncompetitive immunoassay. Myocardial localization of cTnT was studied by immunohistochemical staining and confocal microscopy. RESULTS: Increases in serum levels of cTnT (0.03 to 0.05 ng/mL) and myocardial lesions (cardiomyopathy scores of 1 or 1.5) were found in one out of five and two out of five SHR given 2 and 4 mg/kg doxorubicin, respectively. All animals given 6 mg/kg or more of doxorubicin had increases in serum cTnT and myocardial lesions. The average cTnT levels and the cardiomyopathy scores correlated with the cumulative dose of doxorubicin (0.13 v 0.4 ng/mL cTnT and scores of 1.4 v 3.0 in SHR given 6 and 12 mg/kg doxorubicin, respectively). Decreased staining for cTnT was observed in cardiac tissue from SHR receiving cumulative doses that caused only minimal histologic alterations (scores of 1 to 1.5). Staining for cTnT decreased simultaneously with increases in the severity of the cardiomyopathy scores. CONCLUSION: cTnT is released from doxorubicin-damaged myocytes. Measurements of serum levels of this protein seem to provide a sensitive means for assessing the early cardiotoxicity of doxorubicin.
Indications for Radiotherapy and Chemotherapy After Complete Resection in Rhabdomyosarcoma: A Report From the Intergroup Rhabdomyosarcoma Studies I to III
Authors: Suzanne L. Wolden, James R. Anderson, William M. Crist, John C. Breneman, Moody D. Wharam, Jr, Eugene S. Wiener, Stephen J. Qualman, Sarah S. Donaldson
Journal: Journal of Clinical Oncology (1999)

PURPOSE: To evaluate the outcome of patients with rhabdomyosarcoma (RMS) treated with complete surgical resection and multiagent chemotherapy, with or without local radiotherapy (RT). PATIENTS AND METHODS: Four hundred thirty-nine patients with completely resected (ie, group I) RMS were further treated with chemotherapy (vincristine and actinomycin D ± cyclophosphamide, doxorubicin, and cisplatin) on Intergroup Rhabdomyosarcoma Studies (IRS) I to III between 1972 and 1991. Eighty-three patients (19%) also received local RT as a component of initial treatment. RESULTS: Eighty-six patients relapsed (10-year failure-free survival [FFS] 79%, overall survival 89%). Six percent of failure sites were local, 6% were regional, and 7% were distant. Poor prognostic factors were tumor size greater than 5 cm, alveolar or undifferentiated histology, primary tumor sites other than genitourinary, and treatment on IRS-I or II. For patients with embryonal RMS who were treated with RT, there was a trend for improved FFS but no difference in overall survival. On IRS-I and II, patients with alveolar or undifferentiated sarcoma who received RT compared with those who did not receive RT had greater 10-year FFS rates (73% v 44%, respectively; P = .03) and overall survival rates (82% v 52%, respectively; (P = .02). Such patients who received RT on IRS III also benefited more than those who did not receive RT (10-year FFS, 95% v 69%; P = .01; overall survival, 95% v 86%; P = .23). CONCLUSION: Patients with group I embryonal RMS have an excellent prognosis when treated with adjuvant multiagent chemotherapy without RT. Patients with alveolar RMS or undifferentiated sarcoma fare worse; however, FFS and overall survival are substantially improved when RT is added to multiagent chemotherapy (IRS-I and II). The best outcome occurred in IRS-III, when RT was used in conjunction with intensified chemotherapy.
Role of highly reactive aldehydes in cigarette smoke induced airway inflammation
Authors: Agnieszka Troszok, Marco van der Toorn, Delaram Rezayat, Renee Gras, Harold de Bruin, Dirk-Jan Slebos, Antoon van Oosterhout
Journal: European Respiratory Journal (2011)

Cigarette smoke (CS) is the most important cause of COPD, which is associated with chronic neutrophilic airway inflammation. We hypothesize, that the presence of highly reactive α,β-unsaturated aldehydes in CS is a crucial factor for neutrophilic airway inflammation.  BALB/c mice were exposed to CS, water filtered CS (WF-CS) or air. Levels of CO and aldehydes were measured in CS and WF-CS. Six hrs after the last CS exposure, cell differentials and cytokine levels were measured in lung tissue and bronchoalveolar lavage fluid (BALF). Beas-2b cells (epithelial cell line) were exposed to cigarette smoke extract (CSE) or water filtered cigarette smoke extract (WF-CSE) with and without acrolein. The neutrophil chemoattractant IL-8 was measured after 24 hrs.  CO levels were not different between CS and WF-CS but aldehyde levels were strongly decreased in WF-CS compared to CS. The numbers of neutrophils in BALF (p
Accuracy of chest high-resolution computed tomography in diagnosing diffuse cystic lung diseases
Authors: Nishant Gupta, Riffat Meraj, Daniel Tanase, Laura E. James, Kuniaki Seyama, David A. Lynch, Masanori Akira, Cristopher A. Meyer, Stephen J. Ruoss, Charles D. Burger, Lisa R. Young, Khalid F. Almoosa, Srihari Veeraraghavan, Alan F. Barker, Augustine S. Lee, Daniel F. Dilling, Yoshikazu Inoue, Corey J. Cudzilo, Muhammad A. Zafar, Francis X. McCormack
Journal: European Respiratory Journal (2015)

The diffuse cystic lung diseases (DCLDs) are a group of pathophysiologically heterogeneous processes characterised by the presence of multiple, thin-walled, air-filled spaces within the pulmonary parenchyma [1]. The differential diagnosis of DCLDs includes lymphangioleiomyomatosis (LAM), follicular bronchiolitis (FB), lymphocytic interstitial pneumonia (LIP), Birt–Hogg–Dubé syndrome (BHD), pulmonary Langerhans cell histiocytosis (PLCH), amyloidosis, light chain deposition disease, cystic metastases, infectious entities such as Pneumocystis , and other aetiologies [2]. Bronchiectasis and bullous changes seen in chronic obstructive pulmonary disease can also produce high-resolution computed tomography (HRCT) patterns that mimic the DCLDs. Correct diagnosis of diffuse cystic lung diseases is established in most cases by critical review of HRCT features <http://ow.ly/NvrCc>
Metabolic syndrome, systemic inflammation and Framingham risk score are independent risk factors for reduced lung function in healthy Korean adults
Authors: Seong Yong Lim, Si Young Lim, Jae-Uk Song, Ki-Suck Jung
Journal: European Respiratory Journal (2013)

Background: We aimed to investigate the association of lung function with systemic inflammation as assessed by high-sensitivity C-reactive protein (hs-CRP), 10-year cardiovascular event risk by Framingham risk score (FRS), and metabolic syndrome (MetS) simultaneously in a large number of healthy Korean subjects. Method: We recruited 9761 (mean age 46 years) apparently healthy adults from medical check-up programme at Kangbuk Samsung Hospital. FRS was calculated and the presence of MetS was defined according to AHA/NHLBI criteria. We analyzed the patients according to the quartiles of FVC or FEV1 (% of pred) as well as ventilatory patterns. Restrictive pattern (RP) was defined as FVC  0.05). When subjects were divided into quartiles of FVC or FEV1 (% pred), prevalence of MetS, hs-CRP concentration, and FRS event risk >10% significantly increased as the FVC or FEV1 (% pred) decreased to the lowest quartile. The presence of abdominal obesity, MetS, FRS event risk >10%, hs-CRP were the independent predictors for RP or the lowest FVC (% pred) quartile, while FRS event risk >10% and hs-CRP were independent predictor for OP or the lowest FEV1 (% pred) quartile even after adjustment for confounders. Conclusion: These results indicate that MetS including abdominal obesity, systemic inflammation, and FRS are important risk factors for reduced lung function in Korean adults.
Abstract 77: Distinct Profiles of Transient Receptor Potential Canonical (TRPC) Channel Expression in Biventricular Failure
Authors: Kevin J Morine, Vikram Paruchuri, Xiaoying Qiao, Duc T Pham, Gordon S Huggins, David DeNofrio, Michael S Kiernan, Lixia Yue, Richard H Karas, Navin K Kapur
Journal: Circulation Research (2014)

Heart failure is a major cause of morbidity and mortality. The transient receptor potential canonical (TRPC) family of channels mediate pathologic cardiac remodeling. In particular, TRPC6 participates in a self-propagating circuit that amplifies cardiac hypertrophy and fibrosis. The objective of this study was to explore biventricular expression of TRPCs in advanced heart failure. Methods: Viable left (LV) and right (RV) ventricular free wall tissue was obtained from human subjects with end-stage heart failure (n=12) referred for transplantation or biventricular assist devices. Control LV and RV tissue was obtained from the National Disease Research Interchange (n=3/group). To explore TRPC expression in a murine model, adult male C57BL/6 mice underwent thoracic aortic constriction (TAC) for 10 weeks (n=6/group). Biventricular tissue was analyzed by real-time polymerase chain reaction. Results: Compared to normal LV and RV, levels of TRPC 1, 3, 4 and 6 were increased in failing LV and RV samples, respectively. Levels of TRPC1 and TRPC6 were greater in failing RV than failing LV samples. TRPC 5 and 7 expression were not consistently detected in normal or failing tissue samples. Compared to sham LV, levels of TPRC 1, 4 and 6 increased in the LV after TAC. Compared to sham RV, levels of TRPC 3, 4, and 6 increased in the RV after TAC. Levels of TRPC3 were greater in the RV than LV after TAC. Conclusions: Our results identify distinct profiles of TRPC expression in the RV versus LV in both human tissue and in a murine model of advanced biventricular failure. Levels of select TRPCs are higher in the failing RV compared to LV, suggesting a potentially important role for TRPCs in RV remodeling.
Pulmonary Nontuberculous Mycobacterial Disease Prevalence and Clinical Features
Authors: Kevin L. Winthrop, Erin McNelley, Brian Kendall, Allison Marshall-Olson, Christy Morris, Maureen Cassidy, Ashlen Saulson, Katrina Hedberg
Journal: American Journal of Respiratory and Critical Care Medicine (2010)

Rationale: Respiratory specimens with nontuberculous mycobacteria (NTM) are increasingly common; however, pulmonary disease prevalence is unknown.Objectives: To determine the disease prevalence, clinical features, and risk factors for NTM disease, and to examine the predictive value of the microbiologic criteria of the American Thoracic Society (ATS)/Infectious Diseases Society of America (IDSA) pulmonary NTM case definition for true NTM disease.Methods: We identified all Oregon residents during 2005–2006 with at least one respiratory mycobacterial isolate. From a population-based subset of these patients, we collected clinical and radiologic information and used the ATS/IDSA pulmonary NTM disease criteria to define disease.Measurements and Main Results: In the 2-year time period, 807 Oregonians had one or more respiratory NTM isolates. Four hundred and seven (50%) resided within the Portland metropolitan region, among which 283 (70%) had evaluable clinical records. For those with records, 134 (47%) met ATS/IDSA pulmonary NTM disease criteria for a minimum overall 2-year period prevalence of 8.6/100,000 persons, and 20.4/100,000 in those at least 50 years of age within the Portland region. Case subjects were 66 years of age (median; range, 12–92 yr), frequently female (59%), and most with disease caused by Mycobacterium avium complex (88%). Cavitation (24.5%), bronchiectasis (16%), chronic obstructive pulmonary disease (28%), and immunosuppressive therapy (25.5%) were common. Eighty-six percent of patients meeting the ATS/IDSA microbiologic criteria for disease also met the full ATS/IDSA disease criteria.Conclusions: Respiratory NTM isolates frequently represent disease. Pulmonary NTM disease is not uncommon, particularly among elderly females. The ATS/IDSA microbiologic criteria are highly predictive of disease and could be useful for laboratory-based NTM disease surveillance.
The challenge of developing useful blood-based biomarkers in melanoma
Authors: R. Sullivan
Journal: British Journal of Dermatology (2012)

Journal Article The challenge of developing useful blood‐based biomarkers in melanoma Get access R. Sullivan R. Sullivan Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114, U.S.A. E‐mail: rsullivan7@partners.org Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 168, Issue 1, 1 January 2013, Page 3, https://doi.org/10.1111/bjd.12088 Published: 01 January 2013