tbuckley/cabot-search huggingface dataset:
Physiotherapy indication and accomplishment at ICU
Authors: Leda Silveira, Mauro Péz, Priscila Nogueira, Sofia Furlan, Alexandra Colombo
Journal: European Respiratory Journal (2013)

Background: Attention has been given to the prevention of physical deconditioning developed at Intensive Care Unit (ICU) and its complications. Physiotherapy is one of the available tools.  Objectives: To describe the indications for musculoskeletal physiotherapy (MP) and respiratory physiotherapy (RP) presented by ICU patients and also to verify if those patients received physiotherapy care when indicated.  Methods: For an eight week period, ICU physiotherapists of a secondary hospital in Brazil were questioned about patients’ indications for MP and RP and if they were executed.  Results: 80 patients were admitted in ICU during the data collection period, resulting in a total of 351 cases. Patient’s mean age (years) was 59.59±13.56; 47 (58.75%) were male; mean SAPS III was 55.45±14.11. Main causes of admission were: post operative, 25 (31.25%); shock, 15 (18.75%); acute myocardial infarction or arrhythmia, 10 (12.50%). Duration of invasive mechanical ventilation (MV) was 4.00 (2.00-9.00) days and ICU length of stay was 8.00 (4.00-16.00) days.  MP was indicated in 274 (79.41%) cases. Main indication was ICU immobility: 271 cases (72.46%). In 83 (33.60%) cases patients did not receive MP care although it was indicated.  RP was indicated in 280 (79.77%) cases. Main indications were: invasive MV: 140 (39.89%); respiratory complication prevention for patients at risk (obese, bedridden, thoracic surgery): 87 (24.79%); lung mucus hypersecretion: 80 (22.79%); decreased lung volume: 73 (20.80%) and non-invasive MV: 56 (15.95%). In 36 (12.86%) cases patients did not receive the indicated MP.  Conclusion: MP was not performed in a significant part of patients. Invasive MV was the main RP indication. There may be a discrepancy regarding MP and RP.
Breast milk fatty acid composition has a long-term effect on the risk of asthma, eczema, and sensitization
Authors: T. M. van Elten, L. van Rossem, A. H. Wijga, B. Brunekreef, J. C. de Jongste, G. H. Koppelman, H. A. Smit
Journal: Allergy (2015)

Levels of n-3 polyunsaturated fatty acids (PUFAs) and n-6 PUFAs in breast milk are associated with the development of allergic diseases up to school age. However, it is unknown whether this relationship persists when the child becomes older. We therefore studied the association between levels of n-3 PUFAs and n-6 PUFAs in breast milk of allergic- and nonallergic mothers and asthma, eczema and sensitization up to the age of 14 years.The study was nested in the ongoing PIAMA birth cohort. At the child's age of 3 months, 276 mothers provided a breast milk sample. Asthma (N total = 269) and eczema (N total = 274) were self-reported up to the child's age of 14 years. Specific serum IgE levels were measured at the ages of 4, 8 and 12 years (N total = 216). Generalized estimating equations analyses were used to take account of repeated observations.Asthma up to the age of 14 years is less prevalent in children of allergic mothers receiving breast milk with higher levels of n-3 long chain polyunsaturated (LCP) fatty acids (OR 0.50; 95% CI 0.31-0.79), and more prevalent in children of nonallergic mothers receiving breast milk with higher levels of n-6LCP (OR 1.86; 95% CI 1.14-3.03). Weaker associations in similar direction were observed for eczema and sensitization. Direction of associations were consistent and of similar magnitude throughout childhood.The association between breast milk fatty acid composition and asthma, eczema and sensitization persists up to the age of 14 years in children of both allergic and nonallergic mothers.
Active case finding among contacts of sputum smear positive tuberculosis patients in rural and urban Sindh Pakistan
Authors: Shahina Qayyum, Saifullah Baig, Riaz Akhtar, Sharaf Ali Shah
Journal: European Respiratory Journal (2013)

Introduction:  Household contacts sputum smear positive tuberculosis patients have much higher rates of active TB. In Pakistan it is done passively.; patients to bring their contacts to the diagnostic facility   Objective:  This study was done to see the yield of Active case finding among household contacts of sputum-smear positive (SS+) TB cases   Methods:  In 07 urban and 15 rural public facilities lay workers were provided an incentive to counsel new SS+ TB cases about household contacts screening. Household members were verbally screened. TB suspects were escorted to TB center for sputum examination. Diagnosed SS+ TB recieved monthly food baskets, reminders SMS and home visits.   Results:  3608 SS+ new TB patients registered in 2011. The results are summarized in table 1  Out of 490 SS+ females and males were 242 and 248. 16% index cases had one SS+ household contact  Overall 393 were cured, 87 completed treatment, 5 died and 6 were treatment failure, with no difference between the urban and rural setting   Conclusion  Active contact tracing of SS+ve index cases have high yields in Sindh, Pakistan. The intervention has resulted in improved compliance.
Leukemia: management of relapse after allogeneic bone marrow transplantation.
Authors: L Kumar
Journal: Journal of Clinical Oncology (1994)

PURPOSE To review the current state of knowledge regarding the management of leukemic relapse after allogeneic bone marrow transplantation (BMT). PATIENTS AND METHODS The literature was analyzed using MEDLINE (National Library of Medicine, Bethesda, MD) and reports were identified through review of report bibliographies. Pertinent studies were selected and data synthesized into a review format. RESULTS Leukemic relapse after allogeneic BMT is an important cause of treatment failure. The risk of leukemic relapse varies from 20% to 60% depending on the diagnosis and phase of disease. Reinduction chemotherapy (CT), second BMT, interferon (IFN) alfa, and donor leukocyte infusions are various options, but none of the approaches is clearly optimal. Approximately 50% of acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL) patients achieve remission after standard induction CT. However, most patients finally relapse and die of uncontrolled leukemia. Second BMT is successful in 20% to 25% patients and is a reasonable option in patients who relapse more than 6 months after the initial transplant. Young patients with a good performance status and those in remission from initial transplant relapse have a better outcome after second BMT. Venocclusive disease (VOD), interstitial pneumonitis (IP), and acute graft-versus-host disease (GVHD) are the main complications. Therapy with IFN alfa results in cytogenetic complete remission (CR) in 10% to 25% patients with chronic myeloid leukemia (CML). The initial results of leukocyte infusions from the original donor are promising. However, acute GVHD and bone marrow aplasia are associated complications. The correct dose and schedule of donor leukocyte infusions need to be determined in future studies to minimize GVHD while maintaining the graft-versus-leukemia (GVL) effect. CONCLUSION Identification of patients at increased risk for relapse and use of biologic response modifiers post-transplant to augment the GVL effect in such patients are possible areas of improvement for future studies.
A multinational, randomized phase III study of bevacizumab (Bev) with FOLFOX4 or XELOX versus FOLFOX4 alone as adjuvant treatment for colon cancer (CC): Subgroup analyses from the AVANT trial.
Authors: T. Andre, E. Van Cutsem, H. Schmoll, J. Tabernero, S. Clarke, M. J. Moore, D. Cunningham, T. H. Cartwright, J. R. Hecht, F. Rivera, S. Im, G. Bodoky, R. Salazar, F. Maindrault-Goebel, E. Shmueli, E. Bajetta, M. Makrutzki, A. Shang, A. De Gramont, P. M. Hoff
Journal: Journal of Clinical Oncology (2011)

3509 Background: The therapeutic impact of Bev plus either FOLFOX4 or XELOX in the adjuvant setting was evaluated in the AVANT trial. First efficacy findings were presented at ASCO GI 2011. Here we present results of subgroup analyses. Methods: Eligible pts underwent resection for resected high-risk stage II or stage III CC. Pts were randomly assigned to 1 of 3 treatment groups and stratified by geographic region and tumor stage: Arm A: FOLFOX4 w1–24; Arm B: FOLFOX4 + Bev w1–24, then Bev alone w25–48; Arm C: XELOX + Bev w1–24, then Bev alone w25–48. The primary endpoint was disease-free survival (DFS) for stage III CC; secondary endpoints included overall survival (OS) and safety. DFS/OS follow-up assessments were performed every 6m after randomization for 4y, then annually until recurrence/death. Results: 3,451 (2,867 stage III CC) pts were enrolled between Dec 2004 and Jun 2007; median age was 58–59y. Median duration of follow-up was 48m (range 0–66). Adding Bev did not prolong DFS with FOLFOX4 (HR 1.17; 95% CI 0.98–1.39) or XELOX (HR 1.07; 95% CI 0.90–1.28); the chemotherapy alone arm was favored numerically. Key subgroup findings for DFS in stage III pts are presented below (Table). Conclusions: Subgroup analysis results for DFS were consistent with those seen in the overall stage III CC population. Follow-up is ongoing for OS analysis. Subgroups FOLFOX4 n=955 FOLFOX4 + Bev n=960 XELOX + Bev n=952 n n HR (95% CI) n HR (95% CI) Gender Male Female 530 425 487 1.07 (0.85–1.35) 473 1.32 (1.01–1.71) 520 1.04 (0.83–1.31) 432 1.11 (0.84–1.47) Age, y <65 ≥65 <70 ≥70 680 275 833 122 699 1.14 (0.93–1.40) 261 1.26 (0.92–1.73) 848 1.17 (0.97–1.41) 112 1.19 (0.72–1.96) 656 1.00 (0.80–1.24) 296 1.24 (0.91–1.69) 819 1.04 (0.86–1.26) 133 1.28 (0.80–2.06) Race Asian Black White Other 139 6 791 18 115 2.18 (1.29–3.67) 13 0.48 (0.08–2.89) 813 1.09 (0.90–1.32) 18 0.97 (0.31–3.02) 123 1.52 (0.88–2.63) 14 0.27 (0.04–1.97) 795 1.04 (0.86–1.26) 20 1.24 (0.40–3.84) No. of lymph nodes analyzed <12 ≥12 269 684 261 1.26 (0.91–1.75) 695 1.13 (0.92–1.39) 275 1.06 (0.76–1.49) 675 1.08 (0.88–1.34) N stage N1 N2 585 370 590 1.37 (1.07–1.76) 370 0.99 (0.78–1.26) 572 1.14 (0.87–1.48) 380 0.99 (0.78–1.26)
Review: In AF or VTE, direct oral anticoagulants reduce fatal bleeding compared with vitamin K antagonists
Authors: Alejandro Lazo-Langner
Journal: Annals of Internal Medicine (2015)

Source Citation Caldeira D, Rodrigues FB, Barra M, et al.Non-vitamin K antagonist oral anticoagulants and major bleeding-related fatality in patients with atrial fibrillation and venous thromboembolism: a systematic review and meta-analysis. Heart. 2015;101:1204-11. 26037103
Precision cancer mouse models through genome editing with CRISPR-Cas9
Authors: Haiwei Mou, Zachary Kennedy, Daniel G. Anderson, Hao Yin, Wen Xue
Journal: Genome Medicine (2015)

Abstract The cancer genome is highly complex, with hundreds of point mutations, translocations, and chromosome gains and losses per tumor. To understand the effects of these alterations, precise models are needed. Traditional approaches to the construction of mouse models are time-consuming and laborious, requiring manipulation of embryonic stem cells and multiple steps. The recent development of the clustered regularly interspersed short palindromic repeats (CRISPR)-Cas9 system, a powerful genome-editing tool for efficient and precise genome engineering in cultured mammalian cells and animals, is transforming mouse-model generation. Here, we review how CRISPR-Cas9 has been used to create germline and somatic mouse models with point mutations, deletions and complex chromosomal rearrangements. We highlight the progress and challenges of such approaches, and how these models can be used to understand the evolution and progression of individual tumors and identify new strategies for cancer treatment. The generation of precision cancer mouse models through genome editing will provide a rapid avenue for functional cancer genomics and pave the way for precision cancer medicine.
Extracorporeal CO2 removal in patients with severe COPD exacerbation failing non invasive ventilation
Authors: Lara Pisani, Luca Fasano, Lorenzo Del Sorbo, Vito Fanelli, Marco Vito Ranieri, Stefano Nava
Journal: European Respiratory Journal (2013)

BACKGROUND. Noninvasive ventilation (NIV) has a success rate of about 75% during an episode of severe hypercapnic respiratory failure in COPD patients. Recently, a new minimally invasive CO 2  extracorporeal removal device (ECCO2-R, Decap; Hemodec, Salerno, Italy) consisting of a pump-driven veno-venous hemofiltration system has been developed. The main features of this system are a low extracorporeal blood flow (  METHODS. 15 COPD patients with severe hypercapnic respiratory failure failing NIV after a trial of 2-4 hrs and meeting the criteria for intubation (i.e.pH   35 b/min, moderate to severe dyspnea) were enrolled.  The average duration of treatment with Decap was 18-24 hours. Intubation was required in 2/15 (13%) patients, and other 2 had procedure related complications (i.e bleeding and obstruction of hemofiltration circuit), but did not require intubation.  RESULTS. Decap improved gas exchange vs baseline (pH 7.28±0.06, PaCO 2  81±16 mmHg PaO 2 /FiO 2  184±79, RR 29±8 b/min baseline; pH 7.34±0.07,PaCO 2  70±19, PaO 2 /FiO 2  169±60, RR 22±6 b/min at 1 hour; pH 7.37±0.07, PaCO 2  64±16, PaO 2 /FiO 2  210±85 RR 21±6 b/min after 12 hours).  CONCLUSIONS: This study shows that extracorporeal CO2 removal may be applied safely with veno-venous technique needing low blood flow and therefore can be used to avoid intubation in those patients failing a NIV attempt.
Vascular endothelial growth factor and basic fibroblast growth factor in melanoma
Authors: F. Weber, N. Sepp, P. Fritsch
Journal: British Journal of Dermatology (2000)

Journal Article Vascular endothelial growth factor and basic fibroblast growth factor in melanoma Get access F. Weber, F. Weber Department of Dermatology and Venereology, University of Innsbruck, Anichstrasse 35, A‐6020 Innsbruck, Austria E‐mail: florian.weber@uibk.ac.at Search for other works by this author on: Oxford Academic Google Scholar N. Sepp, N. Sepp Department of Dermatology and Venereology, University of Innsbruck, Anichstrasse 35, A‐6020 Innsbruck, Austria E‐mail: florian.weber@uibk.ac.at Search for other works by this author on: Oxford Academic Google Scholar P. Fritsch P. Fritsch Department of Dermatology and Venereology, University of Innsbruck, Anichstrasse 35, A‐6020 Innsbruck, Austria E‐mail: florian.weber@uibk.ac.at Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 142, Issue 2, 1 February 2000, Pages 392–393, https://doi.org/10.1046/j.1365-2133.2000.03327.x Published: 01 February 2000
DNA replication stress underlies renal phenotypes in CEP290-associated Joubert syndrome
Authors: Gisela G. Slaats, Joshua C. Saldivar, Julien Bacal, Michelle K. Zeman, Andrew C. Kile, Ann Marie Hynes, Shalabh Srivastava, Jekaterina Nazmutdinova, Krista den Ouden, Miriam S. Zagers, Veronica Foletto, Marianne C. Verhaar, Colin Miles, John A. Sayer, Karlene A. Cimprich, Rachel H. Giles
Journal: Journal of Clinical Investigation (2015)

Juvenile ciliopathy syndromes that are associated with renal cysts and premature renal failure are commonly the result of mutations in the gene encoding centrosomal protein CEP290. In addition to centrosomes and the transition zone at the base of the primary cilium, CEP290 also localizes to the nucleus; however, the nuclear function of CEP290 is unknown. Here, we demonstrate that reduction of cellular CEP290 in primary human and mouse kidney cells as well as in zebrafish embryos leads to enhanced DNA damage signaling and accumulation of DNA breaks ex vivo and in vivo. Compared with those from WT mice, primary kidney cells from Cep290-deficient mice exhibited supernumerary centrioles, decreased replication fork velocity, fork asymmetry, and increased levels of cyclin-dependent kinases (CDKs). Treatment of Cep290-deficient cells with CDK inhibitors rescued DNA damage and centriole number. Moreover, the loss of primary cilia that results from CEP290 dysfunction was rescued in 3D cell culture spheroids of primary murine kidney cells after exposure to CDK inhibitors. Together, our results provide a link between CEP290 and DNA replication stress and suggest CDK inhibition as a potential treatment strategy for a wide range of ciliopathy syndromes.
Principles of Health Economics for Developing Countries
Authors: Matthew Jowett
Journal: BMJ (2000)

William Jack 

World Bank Institute Development Studies, £20, pp 305 ISBN 0821345710

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Health and economics have always been uneasy bedfellows, and both are currently in crisis. Britain's NHS, for example, is a poisoned chalice for politicians, whatever their affiliation. A recent article in the Economist suggested that economics as a discipline lacks pragmatism, with its obsessional search for general laws and overreliance on human rationality and mathematics.

William Jack's book adopts the orthodox economics approach, and is not for the uninitiated. Jack is clearly …

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Attenuation of platelet-activating factor induced bronchoconstriction by nedocromil sodium
Authors: JP Hayes, KF Chung, PJ Barnes
Journal: European Respiratory Journal (1992)

We assessed the effect of nedocromil sodium on bronchoconstriction and airway responsiveness induced by platelet-activating factor (PAF) in eight normal subjects, in a double-blind, placebo-controlled cross-over study. Subjects inhaled PAF by a dosimeter method in 5 doses of 18 micrograms each, separated by an interval of 15 min, (total dose of 90 micrograms). Airway calibre was measured by partial expiratory flow at 30% of vital capacity (Vp30) before and at 1, 3, 5, 10 and 15 min after each dose of PAF. The bronchoconstrictor response was assessed by measuring the area under the curve of the percentage fall in Vp30 over time. There was a significant reduction in PAF-induced bronchoconstriction after nedocromil sodium (1,225 +/- 392 arbitrary units; mean +/- SEM) compared to placebo (2,395 +/- 598; p < 0.01). There was no significant difference in the fall in peripheral neutrophil count measured at 5 min after PAF with nedocromil sodium (48.5 +/- 9.5%) compared to placebo (43.3 +/- 6.8%). In conclusion, nedocromil sodium significantly attenuates PAF-induced bronchoconstriction but not the peripheral neutropenia in normal subjects. Since PAF is not a direct constrictor of human airway smooth muscle, this effect of nedocromil sodium may indicate inhibition of release of bronchoconstrictor mediators.
The effect of teaching method for mechanical ventilation in respiratory therapy education
Authors: Lynda Goodfellow, Bandar Almasoudi
Journal: European Respiratory Journal (2014)

BACKGROUND : The Problem-based learning (PBL) approach is a common teaching technique in medical education, but its use in the field of respiratory therapy is somewhat controversial. Therefore, it is important to determine if this teaching model makes any difference in learning outcomes when compared to traditional teaching approaches. This study compared the cognitive abilities of students in mechanical ventilation in PBL and lecture-based programs.  METHODS : Two universities with BS programs in respiratory therapy were chosen—one used PBL (15 participants) and one used a lecture-based method (24 participants). All 39 participants were given pre and post-tests containing 10 multiple-choice questions related to mechanical ventilation derived from the NBRC RRT written exam forms (C & D).  RESULTS : The dependent t-test showed a significant difference between the pre and post-test of both the lecture-based and PBL groups, with p values of 0.006 and 0.025, respectively. The independent t-test showed a significant difference on the pre-test, favoring the lecture-based group (p = 0.039). However, the independent t-test showed no significant difference in the post-test (p=0.085).  CONCLUSIONS : PBL is increasing in popularity despite the fact that studies of its efficacy have been thus far inconclusive. This study has shown PBL to be effective, but not significantly more effective than traditional lecture-based methods in improving student outcomes as measured by objective test scores.
Expression of Oct-4 and lack of gap junctional intercellular communication as “hallmarks” for human adult stem cells and cancer cells
Authors: James E. Trosko, Mei-Hui Tai, Chia-Cheng Chang, Lawrence K. Olson, Tsai-Ming Lin, B. V. Madhukar
Journal: Cancer Research (2004)

Proc Amer Assoc Cancer Res, Volume 45, 2004

2787 

The stem cell theory has been one of the oldest concepts in the genesis of cancers. This study presents evidence that adult human stem cells are target cells for initiating the carcinogenesis process. In addition, the inhibition of gap junctional intercellular communication (GJIC) by chemicals or oncogenes plays an important role in the promotion/progression phases of carcinogenesis, while the prevention of this inhibition in pre-malignant cells is correlated with chemoprevention and the reversal of inhibited GJIC is correlated with chemotherapy. Adult human stem cells, that have been isolated from the kidney, breast, pancreas, liver and the adipose (mesencyhmal) tissues, were characterized for two markers found in these cells (absence of GJIC function and the expression of Oct-4 gene). The role of GJIC in the carcinogenic process has been previously measured in normal cells [GJIC+], tumor promoter-treated cells [GJIC-], in cells treated with both tumor promoters and chemopreventive agents [GJIC+], in oncogene-activated cells [GJIC-] and in oncogene-chemotherapeutic agent-treated cells [GJIC+]. Normal human adult stem cells from these tissues showed no GJIC and expressed the Oct-4 transcription factor gene, whereas the normal derivative, differentiated cells showed functional GJIC and no expression of Oct-4. In addition, immortalized but non-tumorigenic cells, as well as the tumorigenic cells derived from breast epithelial stem cells in vitro, showed Oct-4 expression, with or without expressed connexin genes but with no functional GJIC. Oct-4 expression was not seen in histological sections of normal tissues, while Oct-4 was expressed in all the tumor cells examined. It has been indicated in the literature that most, if not all tumor cells, have been found to be defective in either homologous or heterologous GJIC. The absence of functional GJIC, either due to no expressed connexins or expressed connexins that are non-functional, and the expression of Oct-4 appear to be common markers for adult human stem cells and tumor cells. The results are consistent with the “stem cell theory” of carcinogenesis. Research supported by a gift from Dr. Barnett Rosenberg to JET and a grant, Michigan Life Science Corridor Fund # GR178, to LKO.