tbuckley/cabot-search huggingface dataset:
Sentinel lymph node biopsy in Merkel cell carcinoma: a 15-year institutional experience and statistical analysis of 721 reported cases
Authors: D.A. Gunaratne, J.R. Howle, M.J. Veness
Journal: British Journal of Dermatology (2015)

Merkel cell carcinoma (MCC) is a rare aggressive cutaneous neuroendocrine malignancy that frequently metastasizes to the regional lymphatic basin. Pathological assessment of regional lymph nodes with sentinel lymph node biopsy (SLNB) in patients without clinical involvement has permitted more accurate staging and more appropriate management. Nonetheless, concerns have been raised regarding the accuracy of this technique and its prognostic implications. We conducted a review of previously published data analysing the positive and false negative rates of SLNB in MCC. A search of the Medline and Embase databases to April 2015 identified 36 published studies between 1997 and 2015 comprising 692 patients. With the addition of 29 patients treated at our own institution, we conducted an analysis of 721 patients. Among this cumulative cohort, SLNBs were performed from 736 regional sites with 29·6% recorded as positive. Regional metastasis occurred in 45 cases following a negative SLNB, for a false negative rate of 17·1%. Adjuvant regional radiotherapy in the setting of a negative SLNB did not affect regional recurrence (P = 0·31), providing credence to emerging evidence that regional therapy can be safely omitted in the setting of a negative SLNB. Distant relapse was noted far more frequently following a positive rather than negative SLNB (17·6% vs. 7·3%, P < 0·001).
Breast Cancer Among Women Given X-Ray Therapy for Acute Postpartum Mastitis2
Authors: Roy E. Shore, Nancy Hildreth, Elizabeth Woodard, Philip Dvoretsky, Louis Hempelmann, Bernard Pasternack
Journal: JNCI Journal of the National Cancer Institute (1986)

Journal Article Breast Cancer Among Women Given X-Ray Therapy for Acute Postpartum Mastitis Get access Roy E. Shore, Roy E. Shore Search for other works by this author on: Oxford Academic PubMed Google Scholar Nancy Hildreth, Nancy Hildreth Search for other works by this author on: Oxford Academic PubMed Google Scholar Elizabeth Woodard, Elizabeth Woodard Search for other works by this author on: Oxford Academic PubMed Google Scholar Philip Dvoretsky, Philip Dvoretsky Search for other works by this author on: Oxford Academic PubMed Google Scholar Louis Hempelmann, Louis Hempelmann Search for other works by this author on: Oxford Academic PubMed Google Scholar Bernard Pasternack Bernard Pasternack Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 77, Issue 3, September 1986, Pages 689–696, https://doi.org/10.1093/jnci/77.3.689 Published: 01 September 1986 Article history Received: 06 November 1985 Accepted: 23 April 1986 Published: 01 September 1986
Upregulation of myeloid derived suppressor cells (MDSCs) in chronic obstructive pulmonary disease and its relationship with disease severity
Authors: Simonetta Baraldo, Laura Pinton, Andrea Ballarin, Susanna Mandruzzato, Erica Bazzan, Erika Falisi, Graziella Turato, Kim Lokar Oliani, Manuel Cosio, Paola Zanovello, Marina Saetta
Journal: European Respiratory Journal (2012)

MDSCs have received growing interest as suppressors of immune responses in cancer, induced in the attempt to escape immune surveillance. MDSCs have been recently implicated in immune modulation in chronic inflammatory diseases, particularly autoimmune. Since we proposed an autoimmune component in COPD, we examined the induction of MDSCs in peripheral blood of smokers with COPD with or without lung cancer. In particular, we evaluated the α chain of the IL-4 receptor (IL4Rα, which has been proposed as a marker for MDSCs) in patients with COPD (n=32, 8 with concomitant cancer) compared to subjects with a similar smoking history who did not develop COPD (n=8) and non-smokers (n=10). The expression of IL-4Rα was increased in monocytes from smokers with COPD (17±2%) compared to smokers without COPD (10±1%) and non-smokers (9±1%; p  Funded by Padua University.
Inpatient inspiratory muscle training after upper abdominal surgery
Authors: Seher Özyürek, Mehtap Malkoç, Ali Günerli, Ugur Koca, Tufan Egeli
Journal: European Respiratory Journal (2014)

Background and aim:  It is known that upper abdominal surgery causes postoperative respiratory muscle dysfunction; however, there is limited research on the role of inspiratory muscle training (IMT) after postoperative period. The aim of this study was to investigate the efficiency of inpatient IMT on respiratory muscle strength, peripheral muscle strength and respiratory functions in patients undergoing upper abdominal surgery.   Methods:  Thirty-one patients undergoing upper abdominal surgery were randomly divided into study group (SG, n=15) and control group (CG, n=16), median ages of groups were 59.0 and 54.5 years and APACHE II scores were 23.0 and 22.5, respectively. Respiratory muscle strength (maximum inspiratory pressure=MIP and maximum expiratory pressure=MEP), peripheral muscle strength (handgrip strength) and respiratory functions (spirometric measurements) were assessed on the extubation day in intensive care unit and the day of hospital discharge. The SG received routine physiotherapy program and IMT while the CG received only a routine physiotherapy program from the extubation day to the hospital discharge.   Results:  All recorded outcomes (except for FEV 1 /FVC) showed significant improvements in both groups (p 0.05). However, the increase of MIP (SG=34.0 cmH 2 O, CG=24.5 cmH 2 O), MEP (SG=32.0 cmH 2 O, CG=19.0 cmH 2 O) and handgrip strength (SG=12 kg, CG=9 kg) were significantly higher in SG (p   Conclusion:  IMT results in faster improvement of respiratory and peripheral muscle strength. It can be suggested that IMT should be used as a part of inpatient rehabilitation program after upper abdominal surgery.
Pathways for aberrant angiogenesis in pancreatic cancer.
Authors: M Korc
Journal: Molecular Cancer (2003)

Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease. Althoughthe specific mechanisms that dictate its biological aggressiveness are notclearly established, it is characterized by a variety of molecularalterations as well as by the overexpression of mitogenic and angiogenicgrowth factors and their receptors. PDACs also express high levels ofvascular endothelial growth factor (VEGF). Recent studies indicate thatsuppression of VEGF expression attenuates pancreatic cancer celltumorigenicity in a nude mouse model, and that VEGF can exert directmitogenic effects on some pancreatic cancer cells. These findings suggestthat cancer cell derived VEGF promotes pancreatic cancer growth in vivo viaa paracrine angiogenic pathway and an autocrine mitogenic pathway, andprovide novel opportunities for therapeutic intervention in this deadlydisease.
The proANP increase during exercise may predict the PAP increase in connective tissue disease patients at risk of PAH
Authors: Maria Tscherner, Gabor Kovacs, Friedrich Fruhwald, Robert Maier, Barbara Obermayer-Pietsch, Alexander Avian, Vasile Foris, Horst Olschewski
Journal: European Respiratory Journal (2012)

Background:  Natriuretic peptides (brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP)) are produced in cardiomyocytes of different myocardial regions. In case of dilation of the heart, BNP and ANP are excessivly released into the circulation. BNP is used as a biomarker in patients with chronic heart failure and pulmonary hypertension (PH). ANP is a marker of acute cardiac stress and may reflect actual hemodynamic changes during exercise. In connective tissue disease (CTD) an excessive increase of pulmonary pressure may represent an early stage of pulmonary vascular disease and may be clinically relevant.  Patients and Methods:  We investigated plasma levels of proANP and NTproBNP during right heart catheterization at rest and exercise in patients with CTD without PH. The levels at rest and during exercise were compared by Wilcoxon signed rank test. The correlations between the changes of meanPAP and NTproBNP as well as meanPAP and proANP were calculated by Spearman9s test.  Results:  N=47 patients (resting meanPAP: 16±3 mmHg, meanPAP at maximal exercise: 37±8 mmHg) were included. NTproBNP and proANP significantly increased from rest to exercise (NTproBNP rest: 91±102 pg/mL, max. exercise: 96±96 pg/mL, p  Conclusion: Our results suggest that the exercise induced increase of proANP in patients with connective tissue disease may indicate the exercise-induced increase in PAP.
Discoordination of tongue muscles in obstructive sleep apnoea
Authors: Yaniv Dotan, Giora Pillar, Arie Oliven
Journal: European Respiratory Journal (2013)

Rationale: OSA is characterized by pharyngeal obstructions during sleep. We have recently demonstrated that during mild anaesthesia, dilator muscles EMG increases during apnoeas and hypopnoeas, but fails to improve airflow. The present study evaluates the hypothesis that failure of intense activation of tongue protrusors may be associated with sleep-induced changes in tongue muscle coordination.

Methods: Esophageal pressure (Pes), airflow, and intramuscular EMG of the genioglossus (GG) and tongue retractors (TR) were recorded in 10 OSA patients. While awake, EMG/Pes was assessed while patients breathed through a variable resistor, to estimate the EMG required to prevent pharyngeal collapse. During sleep, EMG/Pes was evaluated during flow limitation. Pre-arousal peak inspiratory EMG was compared to peak EMG at the same Pes during wakefulness.

Results: Patients were 46.1±11.1 years old, with AHI of 59.5±17.3/hr. During wakefulness, both GG and TR were activated similarly. During sleep, the maximal levels of GG-EMG before arousal were significantly larger than those observed during wakefulness at equal Pes (262.5±180.7%, p=0.019). Maximal TR-EMG, however, were significantly lower than those recorded during wakefulness (68.7±37.7, p=0.027).

Conclusions: Augmentation of GG-EMG during obstructed breathing fails to improve airflow. GG-EMG increase to levels higher than those required to prevent pharyngeal collapse during wakefulness. Differently from the similar pattern of activation of GG and TR during wakefulness, co-activation of TRs is deficient during sleep. This alteration in the pattern of tongue muscle activation may be involved in the pathogenesis of pharyngeal obstruction during sleep.
Children's Psychological Health Status–the Impact of Liver Transplantation: A Review
Authors: R Bradford
Journal: Journal of the Royal Society of Medicine (1991)

Medical audit needs to encompass physical, psychological and social aspects to patient functioning. The aim of this paper is to review the psychosocial impact of liver transplantation on children and their families. Evidence suggests that end stage liver diseases are associated with developmental delays. Emotional and behavioural problems are common and have been found to relate to the child's developmental status, physical appearance as well as family functioning. Post transplant, children and families often experience an exacerbation of preexisting emotional problems. One year post transplant, children typically show continuing developmental delays. Longer term assessments of quality of life suggest that children may experience fewer hospital contacts and that over time psychological difficulties reduce. Many families continue to experience problems in normalizing their interactions within and outside the family. The findings demonstrate the importance of including psychosocial outcomes in auditing the efficacy of medical interventions.
SRRM4 Expression and the Loss of REST Activity May Promote the Emergence of the Neuroendocrine Phenotype in Castration-Resistant Prostate Cancer
Authors: Xiaotun Zhang, Ilsa M. Coleman, Lisha G. Brown, Lawrence D. True, Lori Kollath, Jared M. Lucas, Hung-Ming Lam, Ruth Dumpit, Eva Corey, Lisly Chéry, Bryce Lakely, Celestia S. Higano, Bruce Montgomery, Martine Roudier, Paul H. Lange, Peter S. Nelson, Robert L. Vessella, Colm Morrissey
Journal: Clinical Cancer Research (2015)

The neuroendocrine phenotype is associated with the development of metastatic castration-resistant prostate cancer (CRPC). Our objective was to characterize the molecular features of the neuroendocrine phenotype in CRPC.Expression of chromogranin A (CHGA), synaptophysin (SYP), androgen receptor (AR), and prostate-specific antigen (PSA) was analyzed by IHC in 155 CRPC metastases from 50 patients and in 24 LuCaP prostate cancer patient-derived xenografts (PDX). Seventy-one of 155 metastases and the 24 LuCaP xenograft lines were analyzed by whole-genome microarrays. REST splicing was verified by PCR.Coexpression of CHGA and SYP in >30% of cells was observed in 22 of 155 metastases (9 patients); 11 of the 22 metastases were AR(+)/PSA(+) (6 patients), 11/22 were AR-/PSA- (4 patients), and 4/24 LuCaP PDXs were AR(-)/PSA(-). By IHC, of the 71 metastases analyzed by whole-genome microarrays, 5 metastases were CHGA(+)/SYP(+)/AR(-), and 5 were CHGA(+)/SYP(+)/AR(+). Only CHGA(+)/SYP(+) metastases had a neuroendocrine transcript signature. The neuronal transcriptional regulator SRRM4 transcript was associated with the neuroendocrine signature in CHGA(+)/SYP(+) metastases and all CHGA(+)/SYP(+) LuCaP xenografts. In addition, expression of SRRM4 in LuCaP neuroendocrine xenografts correlated with a splice variant of REST that lacks the transcriptional repressor domain.(i) Metastatic neuroendocrine status can be heterogeneous in the same patient, (ii) the CRPC neuroendocrine molecular phenotype can be defined by CHGA(+)/SYP(+) dual positivity, (iii) the neuroendocrine phenotype is not necessarily associated with the loss of AR activity, and (iv) the splicing of REST by SRRM4 could promote the neuroendocrine phenotype in CRPC.
Hyperhomocysteinemia and the risk for vascular disease in hemodialysis patients.
Authors: J Bachmann, M Tepel, H Raidt, R Riezler, U Graefe, K Langer, W Zidek
Journal: Journal of the American Society of Nephrology (1995)

The objective of this study was to examine if hyperhomocysteinemia is associated with occlusive vascular disease in hemodialysis patients. The study design included risk factor analysis and determination of serum homocysteine in hemodialysis patients. Fifty chronic uremic patients on regular hemodialysis treatment were studied. Twenty-four patients had coronary, cerebral, or peripheral signs of occlusive vascular disease. Cerebral vascular disease was diagnosed by computed tomography, arterial angiography, or Doppler sonography of the carotid and vertebral arteries. Coronary vascular disease was diagnosed by documented history of myocardial infarction or by coronary angiography. The diagnosis of peripheral vascular disease was established by angiography of the lower limb arteries. In all control patients, Doppler sonography of the carotid, vertebral, and lower limb arteries and thallium-201 exercise imaging were without pathologic results. Measurements included blood pressure, body mass index, smoking behavior, serum homocysteine (measured by gas chromatography/mass spectrometry), serum total, low-density lipoprotein, and high-density lipoprotein cholesterol, lipoprotein (a), triglycerides, and plasma fibrinogen. In a stepwise multiple logistic regression analysis, high serum homocysteine was significantly associated with occlusive arterial disease (R = 0.23; P = 0.031). Furthermore, hypertension (R = 0.18; P = 0.058), but not serum total, low-density lipoprotein, and high-density lipoprotein cholesterol, lipoprotein (a), triglycerides, diabetes mellitus, body mass index, plasma fibrinogen, and smoking behavior, was significantly associated with atherosclerosis. Our results support the hypothesis that hyperhomocysteinemia is an independent risk factor for vascular disease in hemodialysis patients.
Morphoea is neither associated with features of Borrelia burgdorferi infection, nor is this agent detectable in lesional skin by polymerase chain reaction
Authors: B. Weide, B. Schittek, T. Klyscz, K. Schüz, M. Stark, G. Rassner, B. Wilske, C. Garbe
Journal: British Journal of Dermatology (2000)

The aetiology of morphoea is still unknown. Borrelia burgdorferi as a causative agent of morphoea has been discussed since 1985, but the relationship remains uncertain.We aimed to find evidence for infection with B. burgdorferi by combined evaluation of different clinical and laboratory data in a group of 54 patients with morphoea.In each patient, an evaluation of the case history was performed with regard to infection with B. burgdorferi, using a standardized questionnaire. Questions focused on previous tick bites and skin changes suspicious for erythema migrans (EM). The case history data of 52 patients were compared with those of 104 matched control subjects and of 25 patients with acrodermatitis chronica atrophicans (ACA). Serological examinations were performed in 53 patients with morphoea. Furthermore, lesional skin was examined for borrelial DNA in 33 patients, using nested polymerase chain reaction (PCR) for the ospA and the borrelial rRNA gene.Results of the questionnaire showed no differences between patients with morphoea and matched controls. In contrast, patients with ACA showed a much higher prevalence of tick bites and skin changes suspicious for EM as compared with patients with morphoea. Serological examination was positive in only one patient with morphoea alone and in two additional patients with coexistent ACA. No borrelial DNA was detected by PCR in lesional skin of 33 patients with morphoea.No evidence was found for B. burgdorferi infection in patients with morphoea.
Reactive perforating collagenosis associated with underlying malignancy
Authors: J.L. Bong, C.J. Fleming, D. Kemmett
Journal: British Journal of Dermatology (2000)

S ir, We were interested in the recent report by Chae et al. of a patient with reactive perforating collagenosis (RPC) and periampullary carcinoma. 1 The authors suggest RPC should be considered a paraneoplastic condition. We report a further case of RPC associated with underlying malignancy. A 75‐year‐old lady presented with a 6‐month history of nausea, anorexia, 10 kg weight loss and an itchy rash on her back. There was a history of hysterectomy and bilateral salpingo‐oophorectomy for endometrial carcinoma 20 years previously and also a 20‐year history of non‐insulin‐dependent diabetes. Her medications consisted of metformin, isosorbide mononitrate, atenolol, bendrofluazide and nifedipine. On examination there were multiple dome‐shaped papules with saucer‐like rims and distinctive central dark brown crusts on her back ( Fig. 1a). Several crusts were attached to the underlying lesions through a fine pedicle (Fig. 1b). She also had ichthyosis on her abdomen and back. Systemic examination revealed a tender, palpable liver edge.
Comparison of clinical characteristics between healthcare-associated pneumonia and community-acquired pneumonia in patients admitted to secondary hospitals
Authors: Jong Hoo Lee, Yee Hyung Kim
Journal: European Respiratory Journal (2012)

Background: Since healthcare-associated pneumonia (HCAP) is heterogeneous, clinical characteristics and outcomes are different from region to region. There can also be differences between HCAP patients hospitalized in secondary or tertiary hospitals. This study aimed to evaluate the clinical characteristics of HCAP patients admitted into secondary community hospitals. Methods: This was a retrospective study conducted in patients with HCAP or communityacquired pneumonia (CAP) hospitalized in two secondary hospitals between March 2009 and January 2011. Results: Of a total of 303 patients, 96 (31.7%) had HCAP. 42 patients (43.7%) resided in a nursing home or long-term care facility, 36 (37.5%) were hospitalized in an acute care hospital for ≥ 2 days within 90 days, ten received outpatient intravenous therapy, and eight attended a hospital clinic or dialysis center. HCAP patients were older. The rates of patients with CURB65 scores of 3 or more (22.9% vs. 9.1%; p = 0.001) and PSI class IV or more (82.2% vs. 34.7%; p < 0.001) were higher in the HCAP group. Drug-resistant pathogens were more frequently detected in the HCAP group (23.9% vs. 0.4%; p < 0.001). However, Streptococcus pneumoniae was the most common pathogen in both groups. The rates of antibiotic change, use of inappropriate antibiotics, and failure of initial antibiotic therapy in the HCAP group were significantly higher. Although the overall survival rate of the HCAP group was significantly lower (82.3% vs. 96.8%; p < 0.001), multivariate analyses failed to show that HCAP itself was a prognostic factor for mortality (p = 0.826). Only PSI class IV or more was associated with increased mortality (p = 0.005).
Benefits obtained following a 12 week pulmonary rehabilitation programme
Authors: Anabel Sciriha, David Bilocca, Claudia Fsadni, Peter Fsadni, Eleanor Gerada, Caroline Gouder, Stephen Montefort, Christopher Zammit
Journal: European Respiratory Journal (2013)

Introduction: Pulmonary Rehabilitation (PR) is a recommended standard of care in Chronic Obstructive Pulmonary Disease, but to date, there is no consensus of opinion regarding the optimal duration of the interventions.  Method: 60 subjects suffering from COPD were recruited after being screened by medical doctors and physiotherapists. A multidisciplinary programme was delivered which consisted of two classes per week for 12weeks. All participants were reviewed again after 4, 8 and at the end of the 12weeks. Exercise capacity using the 6 Minute Walk test was measured and the oxygen saturation was measured before, during and after the test. Dyspnoea scores were taken using the Borg Category Ratio Scale. The St George’s respiratory questionnaire (SGRQ) and Hospital Anxiety and Depression scale (HAD) were administered to the participants. The subjects were then enrolled into a one hour of exercise training and was then followed up by one hour of educational talks.  Results This study shows that a multidisciplinary programme increases the walking distance reaching statistical significance by the 8 th week of rehabilitation p th week p th  week) improves anxiety and depression scores p   Conclusion In the present study it has been shown that pulmonary rehabiltiation can help in the amelioration of exercise tolerance and improvement in health related quality of life measures.