tbuckley/cabot-search huggingface dataset:
Correcting Static Intrinsic Positive End-expiratory Pressure for Expiratory Muscle Contraction
Authors: SPYROS G. ZAKYNTHINOS, THEODOROS VASSILAKOPOULOS, EPAMINONDAS ZAKYNTHINOS, CHARIS ROUSSOS, GEORGE E. TZELEPIS
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

We have recently shown (Eur. Respir. J. 1997;10:522–529) that in spontaneously breathing and actively expiring patients, static intrinsic positive end-expiratory pressure (PEEPi,st) can be corrected for expiratory muscle contraction by subtracting the average expiratory rise in gastric pressure (Pga,exp rise), calculated from three breaths just prior to an airway occlusion, from the end-expiratory airway pressure (Paw) of the first occluded inspiratory effort (PEEPi,st avg). However, since in some patients there is substantial variability in the intensity of expiratory muscle activity and hence in Pga,exp rise, this method may be inaccurate because the Pga,exp rise of breaths preceding airway occlusion may differ from that of the first postocclusion breath. In the present study, we introduced a new method consisting of synchronous subtraction of Pga,exp rise from Paw, both occurring during airway occlusion (PEEPi,st sub). PEEPi,st sub and PEEPi,st avg were each compared with the reference PEEPi,st (PEEPi,st ref), which was obtained during muscular paralysis and simulation of the spontaneous breathing pattern by the ventilator. We found that, in 25 critically ill patients, PEEPi,st sub (mean ± SD, 5.3 ± 2.6 cm H2O) was nearly identical to PEEPi,st ref (5.4 ± 2.4 cm H2O). Their mean difference was − 0.06 cm H2O with limits of agreement − 0.96 to 0.84 cm H2O, indicating a strong agreement between these methods. In contrast, mean difference of PEEPi,st avg and PEEPi,st ref was 0.73 cm H2O with limits of agreement − 3.97 to 5.43 cm H2O, indicating lack of agreement. Coefficient of variation of Pga,exp rise was 14.3 ± 7.2% (range, 5.2 to 28.3%). There was a good correlation between the coefficient of variation of Pga,exp rise and the difference between PEEPi,st avg and PEEPi,st ref (r = 0.909; p < 0.001). We conclude that PEEPi,st can be accurately measured in spontaneously breathing patients by synchronous subtraction of Pga,exp rise from Paw during airway occlusion.
NARCOSYNTHESIS IMMEDIATELY FOLLOWING INSULIN SHOCK
Authors: SOL LEVY
Journal: American Journal of Psychiatry (1952)

The same favorable results as reported for the original group of 11 patients were obtained in the second larger group justifying the conclusion that narcosynthesis immediately following insulin coma appears to deserve its place in the treatment of mental disease, and especially seems worth while in patients who have previously not responded either to insulin coma therapy alone, or to the prognostic pre-insulin sodium amytal interview. This type of treatment on the basis of this study not only seems to hasten considerably the recovery of the patients and lessen appreciably their hospital stay, but also seems to produce a more prolonged and well-sustained recovery. In fact, 10 out of 11 patients of the preliminary group have adjusted satisfactorily outside the hospital for periods of over 5 years, and 26 of the 30 patients of the second group have also made satisfactory extra-institutional adjustment for periods of 3 to 5 years without recurrence of symptoms of mental illness.
Risk-adapted management of stage I seminoma: Results of the third Spanish Germ Cell Cancer Group study.
Authors: J. Aparicio, L. Robert, X. Garcia del Muro, J. Guma, A. Sanchez, M. Margeli, M. Domenech, R. Bastus, J. P. Maroto, J. R. Germa-Lluch
Journal: Journal of Clinical Oncology (2010)

4532 Background: Stage I seminoma is the most common clinical scenario among testicular germ cell tumors. We performed a multicenter, nationwide study to evaluate the efficacy of a risk-adapted treatment policy. Methods: Between 2004 and 2008, 227 consecutive patients were prospectively included after orchiectomy. Of them, 37% did not present any risk criteria, 19% had tumors larger than 4 cm, 11% had rete testis invasion, and 33% presented both risk factors. Only the latter group received 2 courses of adjuvant carboplatin, whereas the rest were managed with active surveillance. Results: Median patient age was 33 years (range, 21-59), serum preorchiectomy BHCG was elevated in 15%, median tumor size was 41 mm (3- 120), and vascular invasion was present in 25% cases. pT stages were T1 (71%), T2 (26%) and T3 (3%). There was no significant chemotherapy toxicity. After a median follow-up time of 32 months (range, 12-62), 15 (6.6%) relapses have been documented (Table). All of them occurred in retroperitoneal lymph nodes, except for 1 case in pelvis nodes. They were detected by means of CT scans (73%) or raised serum BHCG levels (27%). Median node size was 25 mm (range, 5-90) and median time to recurrence was 14 months (range, 3-31). All patients were rendered disease-free after chemotherapy (etoposide plus cisplatin). Actuarial overall patient survival is 100%. Conclusions: We confirm that a risk- adapted approach is safe and effective for stage I seminoma. Two courses of carboplatin are adequate for patients with two risk criteria, as is active surveillance for those with 0-1 risk factors. However, the percentage of recurrences among patients with rete testis invasion may also justify the consideration of adjuvant treatment. Risk criteria Treatment Relapses (%) None Active surveillance 4/84 (4.8) Tumor size > 4 cm Active surveillance 6/44 (13.6) Rete testis invasion Active surveillance 5/25 (20) Both criteria Chemotherapy 0/74 (0) Total 15/227 (6.6) No significant financial relationships to disclose.
Preliminary investigations into surface molecularly imprinted nanoparticles for Helicobacter pylori eradication
Authors: Jiaying Han, Yinjing Sun, Jiapeng Hou, Yuyan Wang, Yu Liu, Cao Xie, Weiyue Lu, Jun Pan
Journal: Acta Pharmaceutica Sinica B (2015)

This paper reports investigations into the preparation and characterization of surface molecularly imprinted nanoparticles (SMINs) designed to adhere to Helicobacter pylori (H. pylori). Imprinted nanoparticles were prepared by the inverse microemulsion polymerization method. A fraction of Lpp20, an outer membrane protein of H. pylori known as NQA, was chosen as template and modified with myristic acid to facilitate its localization on the surface of the nanoparticles. The interaction between these SMINs with the template NQA were evaluated using surface plasmon resonance (SPR), change in zeta potential and fluorescence polarization (FP). The results were highly consistent in demonstrating a preferential recognition of the template NQA for SMINs compared with the control nanoparticles. In vitro experiments also indicate that such SMINs are able to adhere to H. pylori and may be useful for H. pylori eradication.
Abstract 4309: Ventricular Elastic Support Therapy (VEST) Reduces Transmural Pressure and Myocardial Strain
Authors: Paul W Fedak, Cheryl Meek, Rozsa Sas, Israel Belenkie, John V Tyberg
Journal: Circulation (2008)

Background: Transmural pressure (TMP) determines myocardial strain and chamber dimensions. Epicardial ventricular support may improve mechanical function and promote reverse remodeling by reducing TMP. HeartNet (Paracor Medical Inc) is an elastic intra-pericardial ventricular support device currently evaluated in the PEERLESS-HF clinical trial. To explore the mechanism of action of VEST, we directly measured the in vivo effects of HeartNet on regional hemodynamics and myocardial strain. Methods: We instrumented open-chest anesthetized dogs (n=6) with flat silastic-balloon epicardial pressure transducers, intravascular pressure catheters, aortic flow probes, and sonomicronometry crystals. The pericardium was re-approximated. We obtained pericardial, epicardial, LV, and aortic pressures. We measured epicardial segment length (end-diastolic myocardial strain) and LV dimensions throughout the cardiac cycle. Loading conditions were altered by volume infusion, caval occlusion, and LAD ligation to induce regional ischemia / dysfunction. Parameters were obtained in every animal with and without the HeartNet in situ (applied at 45% baseline stretch) and compared. Results: HeartNet epicardial support was 2.8±0.2 mmHg (mean at end-diastole) and was maintained throughout the cardiac cycle and over a wide range of physiologic filling conditions (LVEDP 0 –15 mmHg) indicating that the device is compliant, elastic, and self-adjusting. TMP and end-diastolic strain were significantly reduced (P&lt;0.01) supporting a mechanism of action for the device. After LAD ligation, HeartNet also reduced TMP (−38±8%, P&lt;0.0001) and end-diastolic strain over the anterior wall. Negative regional stroke work was also lowered (−56±2%, P&lt;0.001) suggesting improved overall ventricular mechanical efficiency. Aortic pressure and LV stroke volume (20±2 vs 22 ±3 mL, P=0.20) was maintained. Conclusions: These are the first in vivo data to demonstrate that ventricular elastic support therapy improves regional myocardial mechanics throughout the cardiac cycle by reducing transmural pressure and end-diastolic strain. Elastic support therapy may provide significant benefits on acute hemodynamics and chronic remodeling in the failing heart.
Differences in asthma control and management in Europe
Authors: Monica Fletcher, David Price, Thys van der Molen
Journal: European Respiratory Journal (2013)

Introduction: We report on differences in asthma control, and patient attitudes to asthma and its management across 9 countries in the largest, most recent survey of asthma in Europe.

Methods: Online surveys were conducted with 8000 patients with asthma (aged 18–50 years, ≥2 prescriptions in the past 2 years) from 11 countries (Austria, Belgium, Finland, France, Germany, Italy, Netherlands, Norway, Spain, Sweden, UK), recruited via validated consumer panels. Countries with <400 respondents were excluded (Belgium and Norway; N=7457).

Results: GINA-defined asthma control was low, ranging from 15% (Germany) to 28% (Austria). Adherence to therapy was also low (respondents who used their preventer inhaler every day: 25% [Spain] to 61% [Germany]). Overall, 44% of respondents reported that they required oral steroids for asthma in the past 12 months; this proportion was highest in Italy (60%). The incidence of AE this may reflect differences in primary and out-of-hours care. GPs were the main healthcare professionals (HCPs) managing asthma in all countries (54% [Sweden] to 69% [France]) except Austria (43%). The UK had the highest proportion of respondents identifying nurses as the main HCP (26% vs 0% [France] to 11% [Sweden]). Respondents were confident in managing their asthma (fairly/very confident 88–96%); confidence was strongest in the Netherlands, Sweden and the UK (very confident 45%, 42% and 41%, respectively, vs 15% [Italy] to 31% [Finland]).

Conclusions: Asthma control remains poor across Europe, despite different national programmes to improve management. HCPs and healthcare systems should adapt and share best practice to improve outcomes.
FOLFOX-4 vs. FOLFIRI vs. IROX as first line chemotherapy for metastatic colon cancer: efficacy and toxicity
Authors: D. L. Stanculeanu, R. Matache, L. Minea, A. Cringeanu, R. Anghel
Journal: Journal of Clinical Oncology (2006)

13541 Background: The combination of OXA or IRI with 5FU-LV are accepted as standard treatment for metastatic colorectal cancer. However, the right sequence in first or second line is still under debate. We developed a non-randomised prospective study in first line metastatic colorectal cancer comparing the efficacy and the toxicity of three different chemotherapy regimens - FOLFOX-4 vs. FOLFIRI vs. IROX. Methods: From January 2004 to January 2005 we included in the study 57 patients with metastatic non-resectable colon cancer - 22 in FOLFOX arm, 18 in FOLFIRI arm and 17 in IROX arm. In the FOLFOX arm patients received OXA 85 mg/m 2 d1, LV 200 mg/m 2 d1,2, 5FU 400 mg/m 2 bolus d1,2, 5FU 600 mg/m 2 as 22 hours CI d1,2 q15d; in the FOLFIRI arm - IRI 180 mg/m 2 , LV 400 mg/m 2 , 5FU 400 mg/m 2 bolus and 5FU 2400 mg/m 2 as 46 hours CI, q15d; in the IROX arm - IRI 300 mg/m 2 d1, OXA 85 mg/m 2 d2, q3w. The main patients characteristics were: median age 60 vs 62 vs 59; number of metastatic sites ≥ 2: 41% vs 33.33% vs 35.3%; performance status ECOG 0–1: 86.3% vs 83.3% vs 88.2%. The primary end-point was the objective response rate (CR + PR) and the secondary end-points was the toxicity. The objective response was evaluated every 3 months; at disease progression patients were offered to switch to a comparator regimen. Results: The objective response was 63.6% in FOLFOX arm (with a CR of 9%), 44% in FOLFIRI arm (CR - 5.5%) and 53% in IROX arm (CR - 11,7%); the stable disease rate - 27.3% in FOLFOX arm, 44.4% in FOLFIRI arm, 35.3% in IROX arm and the disease control rate - 91% in FOLFOX arm, 88.8% in FOLFIRI arm and 88.2% in IROX arm. The main grade 3–4 toxicities were: neutropenia - 22.7% vs 16.66% vs 29.4%; febrile neutropenia - 4.5% vs 5.5% vs 11.76%; diarrhea - 9% vs 22.2% vs 23.5%; nausea/vomiting - 4.5% vs 5.5% vs. 11.76%; neuropathy - 18.18% vs 0% vs 17.6%. No patients stoped the treatment because of side effects. Conclusions: All three regimens were well tolerated, with comparable results - with a slightly better disease control rate in the FOLFOX arm and a tendance of a better complete response rate in the IROX arm. The FOLFOX regimen had lower rates of nausea, vomiting, diarrhea; sensitive neuropathy and neutropenia were more common with regimens containing oxaliplatine. The IROX regimen had a higer incidence of adverse effects. No significant financial relationships to disclose.
Abstract 3706: Functional Mutation in ABCG1 Predicts Risk of Ischemic Heart Disease in the General Population
Authors: Jesper Schou, Ruth Frikke-Schmidt, Borge G Nordestgaard, Dimitris Kardassis, Efstathia Thymiakou, Gorm Jensen, Peer Grande, Anne Tybjaerg-Hansen
Journal: Circulation (2008)
Is the e-mail useful in a smoking cessation cllinic??
Authors: Jose Andres García Romero de Tejada, Verónica Pérez González, Cristina López-Riolobos, Emma Vázquez Espinosa, Olga Rajas Naranjo, Julio Ancochea Bermúdez
Journal: European Respiratory Journal (2013)

Tobacco is the most important preventable cause of premature death worldwide. Only about 4%-7% of people are able to quit smoking on any given attempt without medicines. Smoking cessation clinics have been shown to improve smoking cessation rates. New technologies might be useful for improving cessation rates.  AIM:  To study if provide an email to the patients, 7 days per week, can be useful for improving abstinence quit rate.  Material and Methods: From November 2010 to October 2012, 422 consecutive smokers were included. Demographic data, comorbilities, smoking history, nicotine dependence, motivation to quit, treatment and success in quitting smoking were recorded. An email was provided to the patients recruited in the last year.The statistical software SPSS.19 was used for analysis.  Results: Our population had a mean age of 51.44 years, with 56.5% of them being women. The mean age at smoking initation was 17.11 years. Pack-years index was 40.37 and the score in Fagerstrom test was 6.11. There were no statistical differences between men and women. In 223 of our patients (52.2%), an email address were provided. Six-month continuous abstinence quit rate was 40.3% without differences between the patients who received the email and the ones who didn9t. 134 smokers left the program after the first visit, with no differences if they had an email or not. Six-month quit rate was 58.82% without one-visit patients. Varenicline was the most effective treatment.  Conclusions:  1. Provide an email, 7 days per week, did not improve the 6-month continuos abstinence quit rate.  2. There was not statistical differences in abstinence quit rate between men and women.  3. The use of an email did nor improve the adherence to medical treatment.
Integration of HBV-DNA may not be a prerequisite for the maintenance of the state of malignant transformation
Authors: M.J.F. Fowler, C. Greenfield, C.-M. Chu, P. Karayiannis, A. Dunk, A.S.F. Lok, C.L. Lai, E.K. Yeoh, J.P. Monjardino, B.M. Wankya, H.C. Thomas
Journal: Journal of Hepatology (1986)
Prevalence and prognosis of critically ill patients with COPD between 1998 and 2008
Authors: Georg-Christian Funk, Peter Bauer, Otto Chris Burghuber, Andreas Fazekas, Sylvia Hartl, Barbara Metnitz, Philip Metnitz
Journal: European Respiratory Journal (2011)

Background:  Little is known about the prevalance and outcome of patients with COPD treated in ICUs. Such information is valuable for the planning of resources e.g. respiratory care units and weaning facilities.   Aims and objectives:  We speculated that COPD would be an increasing problem in critically ill patients and would be associated with increased morbidity and mortality.   Methods:  We analysed prospectively collected data of 194,453 adults treated in 87 Austrian ICUs over a period of 11 years (1998-2008).   Results:  COPD was present in 9% of all ICU patients. The risk-adjusted mortality of patients with COPD was higher compared to patients without COPD (observed to expected mortality ratio with 95% CI 0.91 (0.90 – 0.92) vs 1.14 (1.12 – 1.16), respectively). The presence of COPD was an independent risk factor for increased mortality in multivariable regression. Prolonged mechanical ventilation occurred more common in patients with COPD (24%) compared to those without (13%), p   Conclusions:  Acute respiratory failure due to COPD is an increasingly common condition in critically ill patients. The presence of COPD is associated with increased mortality and morbidity. The improvement of risk-adjusted mortality over time may be attributable to the beneficial effects of non-invasive ventilation.
Drugs Which Inhibit Prostaglandin Biosynthesis
Authors: Roderick J. Flower
Journal: Pharmacological Reviews (1974)

Three classes of compounds inhibit prostaglandin synthetase. The first group consists of the substrate analogues. The specificity of these analogues is unknown but many possess good inhibitory potency which makes them useful tools to demonstrate the involvement of the synthetase enzyme. However, although they are active in some organised tissue preparations, their use in vivo has not been widespread. The absorption, excretion and distribution of these fatty acids is not yet fully understood and this tends to detract from their usefulness in whole animal work. Apart from the substrate analogues a number of other fatty acids also inhibit the synthetase but probably in a non-specific manner and only in high concentrations.

The second class of inhibitors consists of the aspirin-like drugs. Although these may not be as specific as the substrate analogues, they have several advantages; they are readily available, easily administered and in many species abolish prostaglandin synthesis almost completely in therapeutic doses. In addition, a considerable amount is known concerning their absorption, distribution and excretion. The final group of inhibitors which inhibit the synthetase includes such diverse agents as metal ions, anti-oxidants and nucleotides. The concentrations necessary to achieve inhibition are often high and no degree of specificity can be claimed. Thus, these agents are not likely to be of value for in vivo work, although in vitro studies with different cofactors and ions may contribute to our understanding of how the synthetase system is regulated.

Concerning the inhibition of the dehydrogenase, the situation is far less clear. Certain substrate analogues appear to be good inhibitors of the purified enzyme, although they have not been tested in vivo. Some of the aspirin-like drugs are also active in this respect, but the concentrations are again rather high. Polyphloretin phosphate inhibits PGDH and on this basis it may be worth investigating other prostaglandin blocking agents or agonists as inhibitors of PGDH.

In conclusion, the participation of prostaglandins in complex biological events may be investigated with the aid of substrate analogues or with pharmacological agents which block prostaglandin biosynthesis both in vitro and in vivo. At the time of writing no convenient technique for producing the complementary effect, by inhibition of metabolism, is available.
Eradication regime of methicillin resistant staphylococcus aureus lung infection in cystic fibrosis
Authors: Stojka Fustik, Tatjana Jakovska, Lidija Spirevska
Journal: European Respiratory Journal (2013)

Background: The impact of Methicillin resistant Staphylococcus aureus (MRSA) infection on cystic fibrosis (CF) progression and the optimal treatment regimen are still unclear.  Aims and objectives: To assess the efficacy of therapeutic measures taken for eradication of MRSA and the influence of developed chronic MRSA colonization on lung function.  Methods: All microbiological results from 110 patients who were followed at our CF centre from 2007 to 2012 were analysed, focusing on the detection of MRSA. MRSA eradication was attempted with two oral antibiotics (4 weeks) and nebulised Vancomycin (2 weeks). If the patient had clinical signs of infection, i.v. treatment for 2 weeks was given as before. Chronic infection was defined as persistently or ≥ 3 consecutive MRSA-positive respiratory cultures during at least 6 months follow-up period. FVC and FEV1 values, prior and two years after the establishment of chronic MRSA infection were analysed. Results: Thirty-seven patients (33.6%) were identified as having respiratory cultures positive for MRSA. 14 patients developed chronic infection. The % predicted FVC and FEV1 prior and two years after MRSA colonization in this group were, respectively 91.9±21.1.. 92.3±20.6 and 89.7±24.2.. 82.8±23.2. The difference was not significant. Patients with more severe lung disease and poor clinical condition had harder worsening.  Conclusions: Successful eradication of MRSA lung infection was achieved in 62% of patients. It is important to start eradication therapy as soon as MRSA grows from respiratory cultures. High prevalence of MRSA infection in our center indicate the needs for enhanced segregation, infection control policy and eradication treatment.
University of Toronto clears antivaccine course but will discontinue it
Authors: Owen Dyer
Journal: BMJ (2015)

A University of Toronto internal review has cleared a health studies course taught by a homeopath that required students to watch antivaccine videos on the internet. The course had drawn complaints from academic staff and sharp criticism from several newspapers.

The course material included a two hour internet video of an interview with Andrew Wakefield, author of the discredited and withdrawn Lancet study that posited a link between autism and the measles, mumps, and rubella vaccine. The study led to a fall in uptake of the vaccine in the United Kingdom, and Wakefield was later struck off for numerous ethical breaches.

The course outline also suggested that …
Mutation of Human Cells by Kerosene Soot&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: T R Skopek, H L Liber, D A Kaden, R A Hites, W G Thilly
Journal: JNCI Journal of the National Cancer Institute (1979)

The polycyclic aromatic hydrocarbon fraction of a kerosene soot induced forward mutation in human diploid lymphoblasts when coincubated with Sprague-Dawley rat liver postmitochondrial supernatant. Two components of the kerosene soot extract, benzo[a]pyrene (BP) and cyclopenta[cd]pyrene (CP), were also tested. TP was not mutagenic at the concentration found in the soot extract, although it was active at higher concentrations. The amount of CP present could account for approximately 8% of the total mutation observed with the soot. The results were compared to data obtained previously in a similar mutation assay in Salmonella typhimurium. The protocol described permits the facile assay of mutation at the hgprt locus in human lymphoblasts; such mutation is induced by compounds of complex mixtures requiring mixed-function oxygenase activity for metabolism to genetically active derivatives.