tbuckley/cabot-search huggingface dataset:
Exercise capacity after video-assisted thoracic surgery (VATS) for lung cancer
Authors: Raquel Sebio, Esther Gimenez, Adriana García, Yolanda Sanesteban, Isabel Yañez
Journal: European Respiratory Journal (2014)

BACKGROUND: Chest physical therapy is routinely given to all patients after video-assisted thoracic surgery (VATS) to re-expand lung tissue, facilitate airway clearance and prevent postoperative pulmonary complications. However, it has not been established yet if exercise training should be incorporated to restore functional and exercise capacity. OBJECTIVES: To asses exercise tolerance in lung cancer patients after lung resection and identify possible determinants. MATERIALS AND METHODS: Observational prospective study to evaluate exercise capacity before and after VATS for lung cancer. Exercise capacity was measured with the 6 Minute Walk Test (6MWT) the day before surgery and at hospital discharge. Sample sized was calculated to detect a minimum difference of 35 meters between the two measures. RESULTS: 19 patients were included:17 were men (87.5%) and median age was 61.73±9.3. 6 patients (31.6%) had Chronic Obstructive Pulmonary Disease (COPD). 6MWT decrease after surgery from 549.73±75,74 to 477.1±116.1 metres (median difference 72.63±63.23, p 2 =0.343). CONCLUSIONS: Despite the introduction of VATS, patients after lung resection experienced a significant decrease in exercise tolerance. Further research is needed to establish if a pulmonary rehabilitation program is requiere in this population.
Economic evaluation of allogeneic bone marrow transplantation: a rudimentary model to generate estimates for the timely formulation of clinical policy.
Authors: R Barr, W Furlong, J Henwood, D Feeny, J Wegener, I Walker, M Brain
Journal: Journal of Clinical Oncology (1996)

PURPOSE To provide an evidence-based approach to the formulation of clinical policy with respect to allogeneic bone marrow transplantation (BMT) that involves perceived trade offs between two major factors: costs and consequences. The report also highlights key informational deficiencies. PATIENTS AND METHODS Adults with acute myeloid leukemia (AML) in second complete remission (2CR) and those with acute lymphoblastic leukemia (ALL) in first complete remission (1CR) were assigned to BMT or control groups solely on the availability of a suitable donor. All hospital-borne costs were estimated, based on services used according to manual chart review, in four categories: diagnostic and therapeutic costs, professional fees, drug costs, and ward costs. Incremental costs and incremental life-years were calculated, and the quotient determined a cost per life-year gained by BMT for AML (2CR) and ALL (1CR). RESULTS The incremental cost (in 1992 Canadian dollars) per life-year gained by BMT (cost-effectiveness) for AML (2CR) was $29,200; and for ALL (1CR) it was minus $29,200. CONCLUSION For AML (2CR), allogeneic BMT creates better outcomes than standard treatment, but is more costly. For ALL (1CR), both the costs and outcomes are similar for BMT and standard therapy. Quality adjustments made to life-years gained did not change these conclusions.
Feasibility of minimising motorised traffic interaction as an air pollution exposure risk management strategy for bicycle commuters
Authors: Thomas Cole-Hunter, Lidia Morawska, Ian Stewart, Rohan Jayaratne, Colin Solomon
Journal: European Respiratory Journal (2012)

Bicycle commuting in an urban environment of poor air quality has been demonstrated as a potential cardiopulmonary health risk for susceptible participants; however, limited studies have assessed the feasibility of risk management strategies. The potential of minimising motorised traffic interaction during bicycle commuting to reduce ultrafine particle (UFP; < 0.1 µm, main particle diameter range) exposure was investigated using air quality measurements and acute health endpoints in healthy individuals. Thirty-five healthy adults (n = 35; mean ± SD age = 39 ± 11 yr; 29% female) rode two return trips of pre-determined minimal (MIN) and maximal (MAX) motorised traffic interaction variations of their typical bicycle commute route. Particle number concentration (PNC) and diameter were collected in-commute, along with ambient air quality data from fixed monitoring sites. Health endpoints including acute respiratory symptoms, lung function and spontaneous sputum were collected immediately pre-commute, and then one and four hours post-commute. MIN facilitated a significant reduction in mean PNC (1.91 x e4 vs 2.95 x e4 ppcc; p = 0.01) compared to MAX. Besides incidence of in-commute offensive odour detection (42.4 vs 55.8 %; p = 0.03) and nasopharyngeal irritation (31.2 v. 40.9 %; p = 0.04), health endpoints were not significantly associated to air quality measures, nor were reduced with MIN compared to MAX. Acute health detriment from in-commute air pollution exposure is not indicated in healthy bicycle commuters; however, susceptible participants may benefit from a significantly reduced PNC associated with minimising motorised traffic proximity.
Prognosis and treatment of lymphoblastic lymphoma in adults: a report on 80 patients.
Authors: P Morel, E Lepage, P Brice, B Dupriez, M F D'Agay, P Fenaux, B Gosselin, F Bauters, C Gisselbrecht
Journal: Journal of Clinical Oncology (1992)

PURPOSE We analyzed prognostic factors in 80 adult patients with lymphoblastic lymphoma (LBL). PATIENTS AND METHODS Twenty-one patients received six monthly courses of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) and maintenance chemotherapy for 12 months. The LNH-84 protocol (30 patients) consisted of four courses of high-dose CHOP followed by consolidation for 4 months. Both FRALLE (22 patients) and LALA (seven patients) protocols were two intensive chemotherapy regimens for acute lymphoblastic leukemia (ALL) that included an induction with daunorubicin, vincristine, cyclophosphamide, prednisolone (and asparaginase for the FRALLE regimen), consolidation, and maintenance chemotherapy that lasted for 2 years. RESULTS Sixty-six patients (82%) achieved a complete remission (CR). The CR duration rate and overall survival rate at 30 months were estimated to be 46% and 51%, respectively, with a median follow-up of 55 months. Only two of 37 relapses occurred after 26 months. Chemotherapy protocol did not influence CR rate, CR duration, and survival. A higher CR rate was associated with an age of less than 40 years, lactic dehydrogenase (LDH) level of less than two times the upper limits of normal, and no or one extranodal site of disease. Short survival was associated with a failure to achieve CR, age older than 40 years, B symptoms, LDH level more than two times the upper limits of normal, and hemoglobin level of less than 100 g/L. Bone marrow involvement had no prognostic value. We could not evaluate precisely the prognostic value of Ann Arbor stage because inclusion criteria differed among treatment groups. CONCLUSION Our findings suggest that age and LDH are two important pretreatment prognostic factors for adult LBL, and that the optimal prognostic staging system remains a controversial issue.
Southwest Oncology Group Study of Paclitaxel and Carboplatin for Advanced Transitional-Cell Carcinoma: The Importance of Survival as a Clinical Trial End Point
Authors: Eric J. Small, Danika Lew, Bruce G. Redman, Daniel P. Petrylak, Neel Hammond, Howard M. Gross, James A. Eastham, E. David Crawford
Journal: Journal of Clinical Oncology (2000)

PURPOSE: The combination of paclitaxel and carboplatin for the treatment of advanced transitional-cell carcinoma (TCC) of the urothelium has promising activity and acceptable toxicity. The purpose of this trial was to evaluate the efficacy of this regimen in a cooperative group setting. PATIENTS AND METHODS: Twenty-nine patients with advanced TCC were treated every 21 days with paclitaxel 200 mg/m 2 , administered as a 3-hour infusion, followed by carboplatin dosed to an area under the curve of 5. Prior systemic adjuvant or neoadjuvant platinum-based therapy was not permitted unless completed at least 1 year before enrollment. Patients were evaluated for response every three cycles, and follow-up was conducted to determine survival. RESULTS: Twenty-nine patients were enrolled and were assessable. Four (14%) had received prior adjuvant or neoadjuvant therapy. Node-only disease was present in 24%, and 76% of patients had extranodal disease. The median number of cycles received was five. Grade 4 toxicity consisted primarily of neutropenia (38% of patients). Neurologic toxicity was noted in 16 patients (grade 1 in four patients, grade 2 in five patients, grade 3 in six patients, and grade 4 in one patient). Six partial responses and no complete responses were noted, for a response proportion of 20.7% (95% confidence interval, 8% to 40%). Median progression-free survival time was 4 months, and overall survival time was 9 months. CONCLUSION: The combination of paclitaxel and carboplatin for the treatment of advanced TCC is reasonably well tolerated. However, a response proportion considerably lower than that previously reported was noted. In addition, the median survival time of 9 months was less than the survival time previously reported for patients treated with the combination of methotrexate, vinblastine, doxorubicin, and cisplatin. Although our results may reflect enrollment of patients with poor prognostic features, they also call into question the utility of this regimen.
Trends in the asthma hospitalization rates among young adults in Spain
Authors: Javier de Miguel Díez, Jorge Chancafe Morgan, Julio Vargas Espinal, Valentin Hernández Barrera, Rodrigo Jiménez Garcia, Luis Puente Maestu, Pilar Carrasco Garrido
Journal: European Respiratory Journal (2013)

Objective: To assess changes in incidence, length of hospital stay (LOS) and costs, of patients hospitalized for acute exacerbations (AE) between 2002 and 2010.

Methods: We included all young adult patients (from 16 to 45 years) hospitalized for AE between 2002 and 2010 (ICD9-CM codes 493.0x-493.9x ). The data were collected from the National Hospital Discharge Database (entire population).We compared the incidence, length of hospital stay (LOS) and costs between two points in the time 2002 and 2010.

Results: We included a total of 2,792 patients. Overall crude incidence decreased from 4.12 to 3.68 AE per 100.000 inhabitants from 2002 to 2010 (p<0.05). There was no difference for sex. The mean LOS was 5.36 (SD 4.02) days in 2001 and progressively decreased to 5.16 (SD 5.39) in 2010 (p<0.05). During the study period, the mean cost per patient decreased from 2183.44 (SD 783.15) to 2564.32 (SD 1933.98) euros (p<0.05).

Conclusions: Our results suggest a decrease in the incidence of hospital admissions for AE among young adults patients with concomitant decrease in LOS. The mean cost per patient also decreased significantly. Better primary care management of disease may explain the improvement in the incidence and outcomes.
Abstract 1719: Down-regulation of IGFBP2 is associated with resistance to IGF1R therapy in rhabdomyosarcoma
Authors: Zhigang Kang, Yunkai Yu, Yuelin J. Zhu, Lee Helman, Paul Meltzer, Liang Cao
Journal: Cancer Research (2014)

Abstract Agents targeting the insulin-like growth factor-1 receptor (IGF1R) are in clinical development, but, despite some initial success of single agents in sarcoma, response rates are low with brief durations. Thus, it is important to identify markers predictive of response, to understand mechanisms of resistance, and to explore combination therapies. In this study, we found that, while associated with PAX3-FKHR translocation, increased IGF1R level is an independent prognostic marker for worse overall survival, particularly in patients with PAX3-FKHR-positive rhabdomyosarcoma (RMS). IGF1R antibody-resistant RMS cells were generated using an in vivo model. Expression analysis indicated that IGFBP2 is both the most affected gene in the IGF signaling pathway and the most significantly down-regulated gene in the resistant lines, indicating that there is a strong selection to repress IGFBP2 expression in tumor cells resistant to IGF1R antibody. IGFBP2 is inhibitory to IGF1R phosphorylation and its signaling. Similar to antibodies to IGF1/2 or IGF2, the addition of exogenous IGFBP2 potentiates the activity of IGF1R antibody against the RMS cells, and it reverses the resistance to IGF1R antibody. In contrast to IGF1R, lower expression of IGFBP2 is associated with poorer overall survival, consistent with its inhibitory activity found in this study. Finally, blocking downstream AKT activation with PI3K- or mTOR-specific inhibitors significantly sensitized the resistant cells to the IGF1R antibody. These findings show that constitutive IGFBP2 down-regulation may represent a novel mechanism for acquired resistance to IGF1R therapeutic antibody in vivo and suggest various drug combinations to enhance antibody activity and to overcome resistance. Citation Format: Zhigang Kang, Yunkai Yu, Yuelin J. Zhu, Lee Helman, Paul Meltzer, Liang Cao. Down-regulation of IGFBP2 is associated with resistance to IGF1R therapy in rhabdomyosarcoma. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 1719. doi:10.1158/1538-7445.AM2014-1719
Pregnancy complications and respiratory outcomes in very preterm infants
Authors: Luigi Gagliardi, Franca Rusconi, Monica Da Frè, Giorgio Mello, Virgilio Carnielli, Domenico Di Lallo, Francesco Macagno, Silvana Miniaci, Carlo Corchia, Marina Cuttini
Journal: European Respiratory Journal (2012)

Very preterm infants have a high mortality and morbidity, due to a combination of immaturity per se, and of the underlying pathology causing preterm birth. The role of prenatal infection on increasing the risk of bronchopulmonary dysplasia (BPD) is still unsettled.  Aim: To test the hypothesis that infection/inflammation disorders (I) (prelabor premature rupture of membranes, spontaneous preterm labor, infection and hemorrage) and hypertensive disorders (H) (maternal hypertension and intrauterine growth restriction) are differently associated to in-hospital mortality and BPD.  Methods: A population-based prospective cohort of 2085 singleton infants 23 to 31 weeks gestational age (GA) born in 6 Italian regions in 2003-2005 (ACTION study), was analyzed.  Infants born of mothers with H (31%) were contrasted with those born after I (63%) with respect to mortality and BPD. Multivariable logistic analyses (generalized estimating equations) were used.  Results: Mortality was 14.3%, with 48.7 % of deaths occurring in the first 5 days of life, largely due to respiratory causes. Infants born after H had more respiratory distress syndrome than the I group (odds ratio (OR)= 1.41, 95% confidence interval (CI): 1.1-1.8, adjusted for GA, sex and antenatal steroids). 12.8 % of neonates had BPD. After adjustment for GA, H disorders had a higher risk of mortality (OR=1.4; 95% CI:1.0, 2.0) and of BPD (OR=2.5; CI: 1.8, 3.6). Further adjustment for maternal age, education, citizenship, and antenatal steroids did not change results.  Conclusions: Our results support the hypothesis that pathogenetic mechanisms involving the regulation of lung/airways size and vessels are more important than I in the development of BPD.
"Intrinsic" positive end-expiratory pressure in stable patients with chronic obstructive pulmonary disease
Authors: L Dal Vecchio, G Polese, R Poggi, A Rossi
Journal: European Respiratory Journal (1990)

We have assessed "intrinsic" positive end-expiratory pressure (PEEPi), during quiet breathing in 18 patients with chronic obstructive pulmonary disease (COPD) in stable condition. Ventilatory flow, lung volume, oesophageal (Poes), gastric (Pga), and transdiaphragmatic pressure (Pdi) were measured. PEEPi was measured as the pressure difference (delta Poes) between the onset of the inspiratory effort, indicated by the start of the Pdi swing, and the point corresponding to zero flow. PEEPi was present in all of the 18 COPD patients, and averaged 2.4 +/- 1.6 cmH2O. The maximum transdiaphragmatic pressure (Pdi,max) was also measured and averaged 81.5 +/- 17.4 cmH2O. Following a randomized sequence, ten patients then inhaled an adrenergic agonist (fenoterol 1.6 mg), and eight patients the corresponding placebo. Fenoterol, but not placebo, caused a significant increase in forced expiratory volume in one second (FEV1) (+34%, on average), associated with a significant decrease in PEEPi (-63%, on average) and a significant improvement in Pdi,max (+19%, on average). We conclude that: 1) intrinsic PEEP can be present in stable COPD patients due to increased airflow resistance; 2) fenoterol improved diaphragmatic strength (Pdi,max) in our COPD patients, possibly due to a decrease in lung volume.
Abstract 2575: Negative Remodeling is Primarily Responsible for Coronary Artery Lumen Loss Early After Cardiac Transplantation: Role of Cytomegalovirus
Authors: Ryota Sakurai, Masao Yamasaki, Luciano Potena, Atsushi Hirohata, Yasuhiro Honda, Paul G Yock, Peter J Fitzgerald, Alan C Yeung, Hannah A Valantine, William F Fearon
Journal: Circulation (2006)

Background: Coronary artery dimensions change significantly early after cardiac transplantation due to intimal thickening and vessel remodeling. However, the degree to which these changes impact co...
Aflibercept, Bevacizumab, or Ranibizumab for Diabetic Macular Edema
Authors: John A Wells, Adam R Glassman, Allison R Ayala, Lee M Jampol, Lloyd Paul Aiello, Andrew N Antoszyk, Bambi Arnold-Bush, Carl W Baker, Neil M Bressler, David J Browning, Michael J Elman, Frederick L Ferris, Scott M Friedman, Michele Melia, Dante J Pieramici, Jennifer K Sun, Roy W Beck
Journal: New England Journal of Medicine (2015)

The relative efficacy and safety of intravitreous aflibercept, bevacizumab, and ranibizumab in the treatment of diabetic macular edema are unknown.
Antimicrobial susceptibilities of amoxycillin-non-susceptible and susceptible isolates among penicillin-non-susceptible Streptococcus pneumoniae
Authors: E. Pérez-Trallero, J.M. Marimón, M. Ercibengoa, M.J. Giménez, P. Coronel, L. Aguilar
Journal: Clinical Microbiology and Infection (2007)
Clinical presentation and evolution of community acquired pneumonia in older patients
Authors: Adamantia Liapikou, Ioanna Malliou, Panagiotis Petras, Maria Kasiola, Andreas Anastasopoulos, Michalis Volonakis, Dimitra Chaimala, Katerina Dimakou
Journal: European Respiratory Journal (2012)

Introduction: Community-acquired pneumonia (CAP) is an important threat to the health of older adults with almost 40% of them requiring hospitalization. CAP in the elderly has a different clinical presentation and evolution than CAP in other age groups.  Aim: Comparing the characteristics, severity and outcomes of CAP in elderly and younger patients (control group).  Methods: An observational, retrospective study of consecutive CAP patients >65 years old was performed during two years in two respiratory clinics. Exclusion criteria were immunosuppression and suspicion of aspiration.  Results: Of 180 cases of CAP, 116 patients were>65 years old, with a mean age 75±10.3 years. Most elderly patients (76%) had comorbid conditions, including cardiac (55%), COPD(42%), diabetes mellitus (27%) and neurologic diseases(17%). Two-thirds (68%) of elderly patients belong to CURB65 III –IV classes comparing to 12% of the controls. An acute altered mental status was established in 30% of elderly patients comparing to 11% of the others and 80.5% requiring oxygen assessment, with 47% having PAFI
Liaison Psychiatry for the 21st Century: A Review
Authors: F Creed
Journal: Journal of the Royal Society of Medicine (1991)

The development of liaison psychiatry services over the last 20 years is briefly reviewed - sophisticated liaison services have been confined to teaching hospitals. Limited manpower and other resources have prevented the development of liaison services in most district general hospitals; further developments are unlikely unless these deficiencies are corrected and psychiatrists take a more active role in developing links with physicians and surgeons. The time is right for such development as physicians are keen to extend our understanding of psychological and social factors in causing non-organic disorders, reduce unnecessary investigations and provide more comprehensive care. Increased collaboration between physicians and psychiatrists will provide a better service for many patients and this should be extended to all district general hospitals.
Smoking is a strong independent risk factor for indeterminate and false negative IGRA results
Authors: Martine G. Aabye, Morten Ruhwald, George PrayGod, Daniel Faurholt-Jepsen, Kidola Jeremiah, Maria Faurholt-Jepsen, Nyagosya Range, Henrik Friis, John Changalucha, Aase B. Andersen, Pernille Ravn
Journal: European Respiratory Journal (2011)

Objectives:  10-40% of IGRA results are indeterminate or false negative. HIV infection, old age and immunosuppressive treatment are known risk factors, but in many cases the reason remains unknown.  The aim of this study was to identify risk factors for indeterminate and false negative TB results.   Materials and methods:  80 HIV-positive and 112 HIV-negative patients with bacteriologically confirmed pulmonary TB were included and tested with the QuantiFERON-TB (QFT-IT) and a Luminex based IP-10 test. By multivariate analysis the following parameters were tested as risk factors for an indeterminate or false negative QFT-IT or IP-10 test result: HIV-infection, age>50 years, smoking and alcohol consumption.   Results:  Smokers (28/192) had a higher risk of an indeterminate or false negative result by both the QFT-IT (OR 7.1, CI: 2.2-23.0) and the IP-10 test (OR 11.2, CI: 3.3-37.8). ORs for HIV-infection was 3.6 (CI: 1.8-7.5) and 5.3 (CI: 2.2-11.8) respectively.  Antigen levels were lower in smokers for both IFN-γ (median 22 vs. 79.5 pg/ml, p  Positivity rate (incl. indeterminate results) was lower for smokers by both the QFT-IT (50 vs. 74%, p=0.03) and the IP-10 test (42 vs. 76, p  Apart from HIV-infection no other parameter tested was identified as a risk factor for a false negative or indeterminate result by either test.   Conclusion:  Smoking increases the risk of having a false negative or indeterminate IGRA results. IGRA test results should be interpreted with care in smokers.