tbuckley/cabot-search huggingface dataset:
Cardiopulmonary and gas-exchange responses during the 6-minute walk test in patients with chronic obstructive pulmonary disease
Authors: Arnoldus van Gestel, Florent Baty, Anne-Kathrin Rausch-Osthoff, Martin Brutsche
Journal: European Respiratory Journal (2014)

Background : There is limited information about the cardiopulmonary- and gas exchange responses to the 6-minute walk test (6MWT) in patients with Chronic Obstructive Pulmonary Disease (COPD)   Objectives : To analyze the breath-by-breath cardiopulmonary- and gas exchange responses of patients with COPD during the 6MWT. In addition, we have investigated the extent to which parameters reflecting cardiopulmonary- and gas exchange function are associated with exercise capacity.   Methods : Oxygen uptake (VO 2 ) kinetics of patients were obtained using mobile telemetric cardiopulmonary monitoring (MOB) during a 6MWT. A new mean response time (MRT) index (wMRT) was developed to quantify VO 2  on-kinetics by correcting MRT for work rate. Linear multivariate regression analysis was performed to assess the association between variables reflecting cardiopulmonary- and gas exchange function and exercise capacity (6-minute walking distance, 6MWD and oxygen uptake at steady state, VO 2SS ).   Results : In 72 patients with COPD (29 females) with a mean (SD) age 65 (10) years, FEV 1  44 (14) %predicted exercise capacity as assessed by VO 2SS  (p=0.003) was significantly reduced across the stages of COPD. 82% of the patients reached criteria for maximal effort during the 6MWT. After adjustment for covariates, wMRT was independently associated with 6MWD (p=9.7x10-5) and VO 2SS  (p=5.5x10-10)   Conclusions : As wMRT mostly depends on the rate of increase of pulmonary blood flow, the results of the present study underline the fact that cardiocirculatory function may play a significant role in exercise tolerance in patients with COPD.
Endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of lymphoproliferative disorders
Authors: Vanessa Santos, Maria Sucena, Adriana Magalhães, Gabriela Fernandes
Journal: European Respiratory Journal (2014)

Introduction   The utility of Endobronchial Ultrasound-guided Transbronchial Needle Aspiration (EBUS-TBNA) in the diagnosis of lymphoproliferative disorders (LPD) is not well established. This is a minimally invasive technique that allows obtaining samples of mediastinal lymph nodes (MLN) for pathologic and flow citometry analysis, useful for the diagnosis of LPD.   Objective:  Evaluate the utility of EBUS-TBNA in the diagnosis of LPD in patients with lymph nodes/mediastinal masses and clinical suspicion of LPD.   Methods:  Retrospective analysis of patients with MLN and suspected LPD that performed EBUS-TBNA between 2009 and 2012.   Results:  189 patients underwent EBUS-TBNA to investigate MLN. 6.9% (13) had clinical suspicion of LPD. 61.5% male, mean age 58.4±15.9 years. Results were: LPD (3), granulomatous disease (2), reactive lymph node (4) and inadequate sample (4). Among patients with inconclusive results (8), in 25% (2) LPD was confirmed by other methods (thoracotomy or EBUS-TBNA repetition). The diagnosis of reactive lymph node was confirmed in three patients with clinical and radiological monitoring, and in three patients MLN were not investigated by other method. One patient of the last group had the diagnosis of LPD by peripheral lymph node biopsy.  In the study, the diagnosis of LPD has been established in five. The sensitivity, negative predictive value and diagnostic accuracy of EBUS-TBNA in the diagnosis of LPD were 60, 71.4 and 61.5%, respectively.   Conclusion   EBUS-TBNA is a useful method for the investigation of patients with MLN with suspected LPD that can reduce the need for more invasive exams. Thus, it may be considered in the initial evaluation of these patients.
Composition and development of oral bacterial communities
Authors: Robert J. Palmer Jr
Journal: Periodontology 2000 (2013)

Abstract The oral bacterial microbiome encompasses approximately 700 commonly occurring phylotypes, approximately half of which can be present at any time in any individual. These bacteria are largely indigenous to the oral cavity; this limited habitat range suggests that interactions between the various phylotypes, and between the phylotypes and their environment, are crucial for their existence. Molecular cataloging has confirmed many basic observations on the composition of the oral microbiome that were formulated well before ribosomal RNA‐based systematics, but the power and the scope of molecular taxonomy have resulted in the discovery of new phylotypes and, more importantly, have made possible a level of bacterial community analysis that was unachievable with classical methods. Bacterial community structure varies with location within the mouth, and changes in community structure are related to disease initiation and disease progression. Factors that influence the formation and the evolution of communities include selective adherence to epithelial or tooth surfaces, specific cell‐to‐cell binding as a driver of early community composition, and interorganismal interaction leading to alteration of the local environment, which represents the first step on the road to oral disease. A comprehensive understanding of how these factors interact to drive changes in the composition of the oral microbial community can lead to new strategies for the inhibition of periodontal diseases and dental caries.
EGFR: The Paradigm of an Oncogene-Driven Lung Cancer
Authors: Gregory J. Riely, Helena A. Yu
Journal: Clinical Cancer Research (2015)

Abstract Somatic, activating mutations in EGFR identify a significant minority of patients with non–small cell lung cancer (NSCLC). Although these mutations are associated with an approximately 70% response rate to some EGFR tyrosine kinase inhibitors (gefitinib, erlotinib, and afatinib), patients develop resistance (i.e., “acquired resistance”) after a median of 9 to 12 months. In patients with clinical acquired resistance, repeat biopsy of tumors has identified a number of relevant mechanisms of resistance, but by far the most frequent event is the acquisition of EGFR T790M, a mutation in the “gatekeeper” residue that confers resistance to gefitinib, erlotinib, and afatinib. This emphasizes the critical dependence upon EGFR signaling for some tumors, a property that has been exploited therapeutically. Dual EGFR blockade using afatinib and cetuximab led to a 29% radiographic response rate. More recently, drugs that target EGFR T790M (e.g., rociletinib, AZD9291, and others) have entered clinical trials, with impressive results observed in phase I clinical trials. The development of these newer drugs, with efficacy after resistance to first-line EGFR tyrosine kinase inhibitor, has led to exploration of these strategies in multiple disease settings: at resistance, in the first line, and in adjuvant treatment of those with completely resected early-stage disease who would otherwise die of recurrent/metastatic disease. This example of translational research that identifies mechanisms of resistance to first-generation drugs, and then targets those mechanisms yielding clinical benefit, is a paradigm for how targeted therapies can be developed. Clin Cancer Res; 21(10); 2221–6. ©2015 AACR. See all articles in this CCR Focus section, “Progress in Lung Cancer.”
Prognostic factors in adult chronic myelomonocytic leukemia: an analysis of 107 cases.
Authors: P Fenaux, R Beuscart, J L Lai, J P Jouet, F Bauters
Journal: Journal of Clinical Oncology (1988)

Adult chronic myelomonocytic leukemia (CMML), as defined by the French-American-British (FAB) group, is associated with a variable survival, ranging from a few weeks to several years. From 1971 to 1986, we made the diagnosis of CMML in 107 cases, according to FAB criteria (except for patients with 20% to 30% bone marrow [BM] blasts who were also included). Median survival was 30 months (range 1 to 81 months) and life expectancy did not seem to be influenced by treatment modalities other than supportive care. Eighteen patients (17%) progressed to acute nonlymphoblastic leukemia (ANLL). In a Cox regression model, main factors associated with short survival were: an excess of marrow blasts (P = 10(-6], anemia (P = .17 x 10(-5], high peripheral blood (PB) monocytosis (P = .26 x 10(-5], presence of PB blasts (P = .49 x 10(-4], and to a lesser extent hyperleukocytosis (P = .001), presence of PB immature granulocytes, thrombopenia, and splenomegaly. Survival (less than 1 year v greater than 1 year) could be predicted at diagnosis in a multivariate stepwise discriminant analysis using two parameters only (percentage of BM blasts and hemoglobin level), with 82% accuracy. Among patients surviving greater than 1 year, initial PB leukocyte count was higher in patients with intermediate survival (12 to 42 months) than in long survivors (greater than 42 months) and was the only discriminating factor between these two subgroups in multivariate analysis. Abnormal cytogenetic findings and increased lysozymuria were also poor prognostic factors, but could not be analyzed in the multivariate models, as they were determined in a minority of patients. Parameters associated with subsequent progression to ANLL included younger age at diagnosis, thrombopenia, increased BM blasts, and splenomegaly. Our study allows for the identification of subgroups with different prognoses in CMML, on the basis of a small number of hematologic parameters, particularly initial percentage of BM blasts, hemoglobin level, and leukocytosis. These subgroups probably require different therapeutic approaches.
Increased circulating fibrocytes and their capacity of proliferation and differentiation in clinically unstable patients with chronic obstructive pulmonary disease
Authors: Chun-Hua Wang, Tzu-Ting Huang, Han-Pin Kuo
Journal: European Respiratory Journal (2013)

Background:  Airway inflammation occurs around small airways in COPD, contributing to irreversible airflow obstruction. Circulating fibrocytes have home to the airways in response to local inflammation and able to be transformed into myofibrobalsts for airway remodeling.   Objectives:  To compare the proportion, proliferation, and differentiation of circulating fibrocytes between clinically unstable and stable COPD patients.   Methods:  60 ml peripheral blood were collected from 10 COPD patients with at least 2 episodes of hospitalization (Unstable COPD) and 9 COPD without any episode of hospitalization (Stable COPD) over previous one year, then separating as non-adherent non-T cells (NANT). NANT cells were cultured for 14 days and variable treatment. The fibrocyte markers CD34, CD45RO, collagen I and EGFR were identified by flowcytometry. Serum level of IL-8 was measured.   Results:  A higher percentage of circulating fibrocytes (12.3±2.4%, n=10) in NANT cells was found in Unstable COPD when compared with Stable COPD (2.9±0.7%, n=9, p   Conclusions:  Circulating fibrocytes are increased and associated with higher proliferative capacity in clinically unstable COPD patients. Fibrocytes may contribute to airway obstruction in COPD.
Further Immunological Studies of Chemical Carcinogenesis<xref ref-type="fn" rid="FN2">2</xref>
Authors: Jan Stjernswärd
Journal: JNCI Journal of the National Cancer Institute (1967)

The effect of the carcinogenic hydrocarbon 3-methylcholanthrene (MCA) on the immune status of the exposed host was studied at the cellular level. A hemolytic agar-plaque technique, measuring single plaque-forming spleen cells (PFC) toward the test antigen, sheep red blood cells (SRBC), was used. 1) Kinetic studies of PFC numbers following a single exposure to MCA showed that the previously observed, long-lasting immunodepression, which corresponded to the latency period before antigenic MCA-induced sarcomas appeared, was real and not due only to a delay of the immune response. 2) An early stage in the process leading to PFC, possibly related to the uptake of the antigen, was specifically sensitive to the effect of MCA. Once the process was started, MCA had a much smaller effect. 3) Dose-effect relationship studies of MCA dose versus PFC depression showed that the PFC number dropped sharply when the dose was increased from 0.1–1.0 mg MCA. Further increase up to 5.0 mg had little effect. 4) Repeated exposure to small doses of the carcinogen led to a cumulative immunodepressive effect comparable to the total dose. 5) Cutaneous application of MCA and of croton oil depressed the PFC. Combined with earlier findings, the results suggest a possible correlation between immunodepression and antigenicity of the tumors arising after exposure.
Relationship of chronic pelvic pain to psychiatric diagnoses and childhood sexual abuse
Authors: Elizabeth Walker, Wayne Katon, J. Harrop-Griffiths, L. Holm, J. Russo, L. R. Hickok
Journal: American Journal of Psychiatry (1988)

Structured psychiatric and sexual abuse interviews were administered to 25 women with chronic pelvic pain and a comparison group of 30 women with specific gynecological conditions. All 55 patients underwent diagnostic laparoscopy, and the results of the fiberoptic pelvic examination were objectively classified by the study gynecologist, who was blind to the psychiatric diagnoses. The patients with chronic pelvic pain showed a significantly higher prevalence of major depression, substance abuse, adult sexual dysfunction, somatization, and history of childhood and adult sexual abuse than the comparison group. There were no significant differences between the groups in severity or type of pelvic pathology.
Cardiopulmonary assessment in overweight/obesity children with asthma
Authors: Ilaria Ernesti, Giancarlo Tancredi, Flaminia Bardanzellu, Gisele Castagna, Valentina De Vittori, Maria Palma Carbone, Marzia Duse
Journal: European Respiratory Journal (2013)

Introduction: Overweight/obesity has been suggested as a risk factor for developing asthma since they are often associated with a reduced lung function.  Aims and objectives: to assess the influence of Body Mass Index (BMI) and asthma on cardiopulmonary function in a cohort of children.  Methods: we selected 435 subjects (73.3% boys, means age 12.5 ± 2.5). All subject underwent a cardiopulmonary exercise test to measure maximal oxygen uptake (VO2max).  BMI was calculated as body weight (Kg) /height (m2). BMI percentile for age and sex was determined according to the national cross-sectional growth charts. According to BMI percentiles children were classified as underweight if  95th percentile. Underweight patients were excluded from the study.  Results: overall 415 patients were included in the study. Asthma was reported in 197(47.5%) children: 133 (67.5%)with normal weight, 37(18.8%) were overweight and 27(13.7%) were obese. Non asthmatic children were 218(52.5%): 172(78.9%) N, 26(11.9%) OV, 20(9.2%)OB. We found that the prevalence of overweight and obesity was higher in asthmatic children (18.8% vs 11.9% in OV group; 13.7% vs 9.2% in OB; p  Conclusions:  We found an association between high BMI and childhood asthma. Overweight/obese children had lower VO2max respect the normal weight group.
Acute vasodilator response in different forms of pre-capillary pulmonary hypertension
Authors: Maria Coronel, Isabel Blanco, Veronica Amado, Roberto Del Pozo, Nuria Gonzalez, Gemma Argemi, Joan Albert Barberà
Journal: European Respiratory Journal (2013)

Background: acute vasodilator testing (AVT) is well established in idiopathic pulmonary arterial hypertension (IPAH). Few data exist about its use in other forms of pulmonary arterial hypertension (PAH) or chronic thromboembolic pulmonary hypertension (CTEPH). Objetives: Analyze results of AVT in non-IPAH and CTEPH; and its predictive value on patient status over 1yr of calcium channel blockers (CCB), compared with IPAH. Methods: clinical and haemodynamic parameters were reviewed in 232 consecutive patients with pre-capillary PH (53±16 yrs; 66% female; mPAP 46±12 mmHg; CI 2.53±0.86 l.min.m²; PVR 829±473 din.s.cm). Patients were classified in IPAH (n=58, 25%), PAH associated with connective tissue disease (PAH-CTD) (n=40, 17.2%), HIV (PAH-HIV) (n=31, 13.4%), portal hypertension (PoPH) (n=53, 22.8%), congenital heart disease (PAH-CHD) (n=10, 4.3%) and CTEPH (n=40, 17.2%). Venice criteria defined a positive response. Long-term responders to CCB (LTR-CCB) were defined as achieving functional class I-II, 6 min walk distance ≥450m and no addition of targeted therapy. Results: shown in table.  Conclusion: As in IPAH, a proportion of patients with PAH-CTD, PoPH and CTEPH show positive AVT. Whereas at least 50% of acute responders with PoPH and CTEPH show long-term response, no patient with PAH-CTD present long-term response. AVT and vasodilator treatment is justified in PoPH and CTEPH, although with close clinical control.
Abstract 8457: Early Neurodevelopmental Outcome in Hypoplastic Left Heart Syndrome and Related Anomalies: The Single Ventricle Reconstruction Trial
Authors: Jane W Newburger, Lynn A Sleeper, David C Bellinger, Caren S Goldberg, Sarah Tabbutt, Minmin Lu, Kathleen A Mussatto, Ismee A Williams, Kathryn E Gustafson, Seema Mital, Nancy Pike, Erica Sood, William T Mahle, David S Cooper, Carolyn Dunbar-Masterson, Catherine Dent Krawczeski, Allan Lewis, Shaji Menon, Victoria L Pemberton, Chitra Ravishankar, Theresa W Atz, Richard G Ohye, J. W Gaynor
Journal: Circulation (2011)

Background: Children with HLHS and related anomalies who survive the Norwood procedure are at risk for neurodevelopmental (ND) impairment. We evaluated the relationship of ND outcome with type of Norwood shunt, patient factors, management practices, and medical course. Methods: In the Single Ventricle Reconstruction trial of the Norwood procedure with modified Blalock-Taussig shunt vs. right-ventricle-to-pulmonary-artery shunt, 14-month ND outcome was assessed using the Psychomotor Development Index (PDI) and Mental Development Index (MDI) of the Bayley Scales of Infant Development®-II. We used stepwise multivariable regression to identify risk factors for adverse ND outcome. Results: Among 373 transplant-free survivors, 321 (86%) returned for ND testing at age 14.3±1.1 (mean±SD) months. Mean PDI (74±19) and MDI (89±18) scores were lower than normative means (P&lt;.001). Independent predictors of lower PDI score (R 2 = 26%) were center (P=.003), birth weight&lt;2.5 kg (P=.023), longer Norwood hospitalization (P&lt;.001), and more complications between Norwood procedure discharge and age 12 months (P&lt;.001). Independent risk factors for lower MDI score (R 2 = 34%) included center (P&lt;.001), birth weight&lt;2.5 kg (P=.04), genetic syndrome/anomalies (P=.036), lower maternal education (P=.045), longer mechanical ventilation after the Norwood operation (P&lt;.001), and greater number of complications after Norwood discharge to age 12 months (P&lt;.001). We found no significant relationship of PDI or MDI score to type of Norwood shunt, perfusion type (i.e., deep hypothermic circulatory arrest, regional cerebral perfusion), other aspects of vital organ support (e.g., hematocrit, pH strategy); or cardiac anatomy including ascending aorta diameter. The relationship of predictors to ND outcome was similar in pre-specified subgroups of birth weight, preterm status, pre-Norwood head circumference, or genetic syndrome/other anomalies. Conclusion: ND impairment in Norwood survivors is more highly associated with innate patient factors and overall morbidity in the first year than with intraoperative management strategies. Improvement in ND outcome in this vulnerable population is thus likely to require interventions that occur outside the operating room.
Pulsed-field gel electrophoresis (PFGE) pattern of genomic DNA of penicillin-resistant pneumococci in Korea, where the resistance rate is very high
Authors: Yunsop Chong, Kyungwon Lee, Xue-Song Xu, Oh Hun Kwon, Jue-Myung Kim, Jørgen Henrichsen
Journal: Clinical Microbiology and Infection (1997)
STUDIES UPON EXPERIMENTAL MEASLES
Authors: Charles W. Duval, Rigney D'Aunoy
Journal: The Journal of Experimental Medicine (1922)

1. There is present as a causal agent in the nasopharyngeal secretions of measles cases a filter-passing virus. 2. The rabbit and the guinea pig react specifically to the intratracheal and intracirculatory injections of filtered nasopharyngeal secretions secured from cases of human measles. 3. Enanthem, exanthem, and pyrexial disturbances characterize this specific reaction in the rabbit; in the guinea pig the reaction manifests itself by pyrexia, marked leucopenia, and grave nephritis in the fatal cases.
Responsiveness of dyspnea through the pulmonary function status and dyspnea questionnaire - Modified version (PFSDQ-M) post different training programs in patients with COPD
Authors: Eloisa Regueiro, Renata Basso-Vanelli, Ivana Labadessa, Dirceu Costa, Valéria Pires Di Lorenzo
Journal: European Respiratory Journal (2013)

Background : Patients with COPD experience shortness of breath affecting exercise tolerance and activities of daily living (ADL) performance. Physical training and inspiratory muscle training (IMT) improves it, which could be expressed by scales and questionnaires.  Aims : To evaluate the responsiveness of dyspnea during the ADL set by Borg scale (BS) and change in activity levels, dyspnea and fatigue by the PFSDQ-M at baseline, after general physical training (GPT) and GPT+IMT. Additionally, to verify the effect of IMT on symptoms.  Methods : 28 COPD patients were enrolled into two groups: 13 at GPT (67±7yrs; FEV143±4%pred), which performed aerobic training (AT), lower limbs (LL) resistive exercise and respiratory exercise; and 15 at GPT+IMT (67±11yrs; FEV1 51±3%pred) (AT, resistive exercise of LL and IMT). The ADL set, the reported BS and PFSDQ-M were done at baseline and after 48 sessions.  Results : There was a significant fell (p Conclusion : The instruments assessed were reliable to detect changes in functional status and dyspnea in both groups after 4 month-rehabilitation. Moreover, the IMT showed higher improvement of PImax when compared to a conventional training. However, it did not result in further benefits on symptoms and in the ADL set.