tbuckley/cabot-search huggingface dataset:
Should the respiratory physician be familiar with endomyocardial biopsy
Authors: Jenny Louise Bacon, Praveen Kumar Molanguri, Francois J. Raphael, Brendan Madden
Journal: European Respiratory Journal (2014)

Background   We are the UK national centre for non-transplant endomyocardial (EM) biopsy. Cardiac involvement has important clinical, therapeutic and prognostic implications for patients with multisystem diseases and is often associated with significant morbidity and mortality.   Aim   To review patients with associated respiratory illness undergoing EM biopsy.   Method   Retrospective analysis of all EM biopsies performed over 20 months. Procedure indications, histopathology results and complications were reviewed. All patients with associated respiratory complaints were identified. EM biopsies were taken from the right ventricular septum via the right internal jugular vein under strict asepsis and 2D echocardiographic guidance.   Results   40 EM biopsies were performed in 32 males aged 23-82 years. The most common indication was cardiac amyloidosis investigation (25 patients, 14(56%) positive histology). 5 patients with respiratory disease had EM biopsy to assess for associated cardiac involvement. 1 patient originally presented with eosinophilic pleural effusions and cardiac failure. EM biopsy later confirmed eosinophilic myocarditis. 4 patients had EM biopsy confirming cardiac sarcoid (3(75%) positive). The median procedure time was 25 minutes. The only complication was ventricular tachycardia in one patient which was successfully cardioverted.   Discussion   In this study cohort 5 patients undergoing EM biopsy(13%) had associated respiratory disease and the biopsy provided a diagnosis in 4 patients. The respiratory physician should be aware of the diagnostic option for right ventricular biopsy under local anaesthetic and the safety of performing EM biopsy in experienced hands.
Predicting etoposide toxicity: relationship to organ function and protein binding.
Authors: S P Joel, R Shah, P I Clark, M L Slevin
Journal: Journal of Clinical Oncology (1996)

To investigate the effect of organ function on total and free etoposide pharmacokinetics and hematologic toxicity.Seventy-two patients who received single-agent intravenous (i.v.) etoposide over 5 or 8 days (total dose, 500 mg/m2) were studied. Pharmacokinetic parameters were derived after analysis of total plasma etoposide by high-performance liquid chromatography (HPLC) with ultraviolet (UV) detection, and etoposide protein binding by ultrafiltration of an etoposide-spiked, pretreatment serum sample, followed by HPLC analysis. Free etoposide area under the concentration-time curve (AUC) was derived from the total AUC and protein binding.Patients with renal impairment (serum creatinine level > 130 mumol/L) had a lower plasma etoposide clearance (13.6 v 18.5 mL/min/m2; P = .016), resulting in an increased total-drug and free-drug AUC (total etoposide AUC 615 v 452 micrograms/mL.hr; P = .016; free etoposide AUC 26.0 v 17.6 micrograms/mL.hr; P = .026) and increased hematologic toxicity (nadir neutrophil count 0.3 v 1.9 x 10(9)/L; P = .005). Patients with albumin levels less than 35 g/L had no change in total etoposide kinetics but had an increase in unbound etoposide (5.2% v 4.1%; P = .01), resulting in an increase in free etoposide AUC (27.5 v 16.5 micrograms/mL.hr; P = .003) and more profound toxicity (nadir neutrophil count 0.6 v 1.9 x 10(9)/L; P = .004). In patients with normal albumin and creatinine, increased toxicity in those older than 65 years was associated with a reduced drug clearance, and in those with increased liver enzymes by a trend toward an increase in free etoposide AUC.Increased hematologic toxicity after etoposide in patients with abnormal organ function is mediated by an increase in free etoposide AUC. A reduction in dose is clearly indicated in such patients.
Effects of thromboxane A2 receptor blockade on oliguric ischemic acute renal failure in conscious rats.
Authors: H J Kramer, M G Mohaupt, F Pinoli, A Bäcker, H Meyer-Lehnert, H Schlebusch
Journal: Journal of the American Society of Nephrology (1993)

To investigate the potential pathogenetic and therapeutic roles of thromboxane A2 (TXA2) and its receptor blockade, respectively, in the early phase of ischemic acute renal failure (ARF), renal function, TXB2 excretion, and the effects of the specific TXA2 receptor antagonist sulotroban (SU) in a model of unilateral renal artery occlusion in conscious female Sprague-Dawley rats were studied. Occlusion of the left renal artery for 1 h in untreated (i.e., vehicle-treated) rats (N = 8) resulted in oliguric ARF. In SU-treated rats (N = 8), the drug was given as an i.v. bolus of 5 mg/kg body wt, followed by a continuous infusion of 0.5 mg/min.kg body wt from 1 h before and during ischemia and for 6 h after reflow. After 1 h of ischemia, urine volume of left ischemic kidneys from untreated rats had decreased from 13.2 +/- 2.8 to 1.0 +/- 0.3 and 0.5 +/- 0.2 microL/min.100 g at 2 and 6 h of reflow, respectively, and GFR had decreased from 0.32 +/- 0.04 mL/min.100 g body wt to undetectable values. At 6 h of reflow, medullary Na-K-ATPase was slightly (P < 0.05) reduced in left ischemic kidneys, whereas medullary and papillary enzyme activities were compensatorily increased (P < 0.01) in right intact kidneys. The ADP/O ratio of cortical mitochondria was 41% (P < 0.05) and ATP synthesis was 77% (P < 0.01) lower than in right intact kidneys.(ABSTRACT TRUNCATED AT 250 WORDS)
Epidemiology and predictive factors for early and late mortality in Candida bloodstream infections: a population-based surveillance in Spain
Authors: M. Puig-Asensio, B. Padilla, J. Garnacho-Montero, O. Zaragoza, J.M. Aguado, R. Zaragoza, M. Montejo, P. Muñoz, I. Ruiz-Camps, M. Cuenca-Estrella, B. Almirante
Journal: Clinical Microbiology and Infection (2013)
Pregnancy course in patients with interstitial lung diseases
Authors: Lubov Novikova, Yulia Ilkovich, Dali Dzadzua, Natalia Korzina
Journal: European Respiratory Journal (2014)

It is known that pregnancy may have a positive influence on the course of sarcoidosis, and, on the contrary, it may worsen the course of lymphangioleiomyomatosis. There is few information concerning influence of pregnancy on other interstitial lung diseases (ILD).  We observed pregnancy in 11 women with ILD. 4 of them had nonspecific interstitial pneumonia (NsIP), 5 - langerhans cell histiocytosis (LCH), and 2 - hypersensitive pneumonitis (HP). The mean age of patients was 29,9±6,8 years (19-41 years). 6 women continued glucocorticosteroid intake during pregnancy (2,5-10 mg of prednisolonum per day); 3 patients stopped cytostatic intake.  2 women had physiologic delivery, 6 - cesarean section, 3 patients (2 with NsIP, 1 with LCH) had medical abortion due to progressing respiratory failure. Seven of eight newborns were healthy, one had congenital heart valve defect (mother with LCH). In all NsIP patients disease progressing after pregnancy was observed. In one woman with HP exacerbation of the disease was observed soon after delivery. Another patient with HP had favorable course of disease after pregnancy. 2 of 5 LCH patients had quite favorable course of pregnancy and birth, one had spontaneous pheumothorax on 38th week of pregnancy, and in 2 cases disease progression after delivery was observed.  Conclusion: pregnancy in ILD is associated with increased risk of adverse events and leads to disease progression in most cases.
Utilization of Care for Mental Disorders Under the Blue Cross and Blue Shield Plan for Federal Employees, 1972
Authors: LOUIS S. REED
Journal: American Journal of Psychiatry (1974)

The author examines in detail the utilization experience under the Blue Cross and Blue Shield plan for federal employees, especially its high option program, which provides virtually equal benefits for mental as for other conditions. Under this option total benefits paid for the care of mental conditions in 1972 amounted to $11.92 per person covered, which was 7.3 percent of the total benefits for all conditions. Comparison with previous years shows that utilization of care for mental conditions is increasing absolutely and in relation to utilization for all conditions, a trend manifest since the beginning of the program. Some explanations of this trend are offered.
The effect of lung hyperinflation on respiratory muscle strength in COPD patients
Authors: Kevin De Soomer, Hilde Vaerenberg, Lutje Claus, Wilfried De Backer, Ellie Oostveen
Journal: European Respiratory Journal (2012)

Introduction   Many COPD patients exhibit hyperinflation, due to premature closure of the airways and loss of lung elastic recoil, which impairs the respiratory muscle function.   Aim   To assess the relationship between the degree of lung hyperinflation and respiratory muscle strength.   Methods   46 consecutive male COPD patients referred to the hospital9s pulmonary rehabilitation program underwent lung function testing and assessment of respiratory muscle strength at baseline.   Results   We observed a significant negative relationship between MIP and MEP  vs  the degree of hyperinflation.  The slope characterizing the MEP-TLC relationship was less steep than the slope characterizing the MIP-RV relationship (see figure), suggesting that, secondary to lung hyperinflation, the extension of the expiratory muscles is less detrimental to muscle force than shortening of the inspiratory muscles.   Conclusion   Both inspiratory and expiratory muscle strength were negatively associated with the degree of lung hyperinflation. Therefore, when interpreting MIP and MEP values in COPD patients, the degree of hyperinflation should be taken into account.
Modulation of Cell-Mediated Alloimmunity by BCG. II. Induction of Specific, Nonadherent, Non-T -Killer Cells by BCG and Alloantigen&lt;xref ref-type="fn" rid="fn2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="fn3"&gt;3&lt;/xref&gt;
Authors: R I Murahata, M S Mitchell
Journal: JNCI Journal of the National Cancer Institute (1982)

The cellular basis of the augmentation of cell-mediated immunity (CMI) by systemically administered BCG was investigated in C57BL/6 mice. BCG pretreatment potentiated the CMI to alloantigens as measured by a 48-hour microcytotoxicity assay (MCA) against P815Y tumor cells. The effector cell was not a T-cell, as demonstrated by its lack of sensitivity to antithymocyte serum and complement and its failure to kill in a short-term 51Cr release assay. The effector cell also was not a classical macrophage, because it was not depleted by treatment with silica. CMI as measured by the MCA was consistently depleted by magnetic separation after incubation with carbonyl iron. The active cell(s) showed variable adherence properties. The augmentation of alloimmunity was alloantigen-specific. The specificity appeared to be due to the interaction between effector cells without inherent specificity and sensitized T-cells.
Diet and Colon Cancer
Authors: Ernest L. Wynder.
Journal: CA A Cancer Journal for Clinicians (1973)

In 1973, an estimated 37,000 people in the United States wilidie of colon cancer.I understand you and your colleagues at the A men can Health Foundation are currently in s'estigating factors which relate to the etiology of colon cancerâ€"studies which will hopefully lead to the prevention of this disease.-
Host genetic variation impacts microbiome composition across human body sites
Authors: Ran Blekhman, Julia K. Goodrich, Katherine Huang, Qi Sun, Robert Bukowski, Jordana T. Bell, Timothy D. Spector, Alon Keinan, Ruth E. Ley, Dirk Gevers, Andrew G. Clark
Journal: Genome biology (2015)

The composition of bacteria in and on the human body varies widely across human individuals, and has been associated with multiple health conditions. While microbial communities are influenced by environmental factors, some degree of genetic influence of the host on the microbiome is also expected. This study is part of an expanding effort to comprehensively profile the interactions between human genetic variation and the composition of this microbial ecosystem on a genome- and microbiome-wide scale.
Undergraduate Training for Communication in Medical Practice
Authors: A H Crisp
Journal: Journal of the Royal Society of Medicine (1986)

Communication is a major aspect of medical practice in such areas as the consultation, counselling, team work, management duties, health education and teaching. Many communication skills essential to the clinical consultation are different from those used in everyday life. They require an understanding of the doctor/patient relationship and of the self as well as of others. They also require a subserving repertoire of specific behavioural skills. The present paper sets out to emphasize this pervasive importance of communication skills in medical practice and to suggest some educational goals and objectives for those skills of particular relevance to the consultation. It describes one attempt to pursue these within the author's own school despite the piecemeal nature of such teaching. In Britain great emphasis is placed on the importance of clinical skills and this is reflected in the priority given to them in the final professional examination, and yet their communication aspects are rarely well defined within the curriculum or directly assessed. The author advocates the teaching and assessment of communication skills as a continuous process throughout undergraduate and postgraduate medical education for clinical practice.
The association between bacterial colonization and inflammatory pattern in Chinese chronic rhinosinusitis patients with nasal polyps
Authors: L. Ba, N. Zhang, J. Meng, J. Zhang, P. Lin, P. Zhou, S. Liu, C. Bachert
Journal: Allergy (2011)

Chronic rhinosinusitis with nasal polyps (CRSwNP) can be subdivided according to the mucosal inflammatory patterns. In mainland China, apart from interleukin (IL)-5-positive and IL-17-positive polyps, a large group of patients with IL-5/IL-17/interferon-gamma (IFNγ)-negative nasal polyps (referred to as key cytokine-negative (KCN) polyps) can be found.To further study the KCN polyps and evaluate the associations between bacterial colonization and mucosal inflammatory pattern in KCN vs IL-5-positive nasal polyps.Nasal polyp or nasal turbinate tissue was obtained from 89 Chinese CRSwNP patients and 36 nonatopic control subjects during surgery. Samples without and after SEB exposure were processed for the assessment of pro-inflammatory cytokines and mediators by immunoassay. Prior to surgery, nasal swabs were taken from each patient for microbiological evaluation.Overall, 80% polyp tissue did not express IL-5, with about 70% (49/71) of these being KCN. Key cytokine-negative nasal polyps were characterized by the synthesis of mediators promoting neutrophilic inflammation (myeloperoxidase (MPO), IL-1β, IL-6 and IL-8), whereas IL-5-positive nasal polyps were characterized by the synthesis of mediators promoting eosinophilic inflammation (IL-5, ECP, total IgE and SE-IgE). Key cytokine-negative nasal polyps were associated with greater Gram-negative bacterial load compared with controls, while IL-5-positive nasal polyps were associated with greater Gram-positive bacterial colonization vs controls and KCN polyps.Our findings suggest that the bacteria colonizing nasal polyps of CRSwNP patients may impact on or be determined by the presence/absence of IL-5.
Multiple Myeloma Among Atomic Bornb Survivors in Hiroshima and Nagasaki, 1950–76: Relationship to Radiation Dose Absorbed by Marrow&lt;xref ref-type="fn" rid="fn2"&gt;2&lt;/xref&gt;
Authors: M Ichimaru, T Ishimaru, M Mikami, M Matsunaga
Journal: JNCI Journal of the National Cancer Institute (1982)

The relationship between atomic bomb exposure and the incidence of multiple myeloma has been examined in a fixed cohort of atomic bomb survivors and controls in the life-span study sample for Hiroshima and Nagasaki. From October 1950 to December 1976, 29 cases of multiple myeloma were confirmed in this sample. Our analysis shows that the standardized relative risk (RR) adjusted for city, sex, and age at the time of bombings (ATB) increased with marrow-absorbed radiation dose. The increased RR does not appear to differ between cities or sexes and is demonstrable only for those survivors whose age ATB was between 20 and 59 years. The estimated risk in these individuals is approximately 0.48 cases/million person-years/rad for bone marrow total dose. This excess risk did not become apparent in individuals receiving 50 rad or more in marrow total dose until 20 years or more after exposure.
A phase II trial of bortezomib plus lenalidomide for relapsed/refractory mantle cell lymphoma (MCL) (CALGB 50501): Results of a planned interim analysis.
Authors: V. A. Morrison, J. L. Johnson, S. Jung, J. P. Leonard, B. D. Cheson
Journal: Journal of Clinical Oncology (2010)

8106 Background: Despite high response rates to initial therapy for MCL, patients (pts) typically relapse and novel approaches are needed. Although treatments including stem cell transplantation (SCT) are available, they are not curative and many are not candidates due to age and comorbidities. Both thalidomide and bortezomib are active single agents in MCL. Methods: CALGB 50501 examines bortezomib plus lenalidomide for relapsed/refractory MCL. Eligibility includes: histologically documented MCL (CD5+, CD 23-, cyclin D1+); measurable disease; prior therapy with ≥1 regimen including autologous, but not allogeneic, SCT; no prior radioimmunotherapy; performance status 0-2; no ≥grade (gr) 3 peripheral neuropathy. Induction therapy: lenalidomide (20 mg po qd, D1-14) plus bortezomib (1.3 mg/m2 IV, D1,4,8,11), every 21D for 8 cycles. Responding patients (CR, PR) at 6 mos go onto maintenance therapy: lenalidomide (15 mg po qd, D1-14) and bortezomib (1.3 mg/m2 IV, D1,8), continued until disease progression. Primary endpoint is overall response rate; secondary endpoints are time to progression; disease-free/overall survival; correlating changes in activated NK/T-cells and plasma cytokines with response. Accrual goal is 54 pts. The study was activated in 11/07; a planned interim analysis occurred after 19 patients, with ≥10 responses required to reopen the study, which was met. As of 12/2/09, 38 pts are accrued, with interim toxicity data available for 31. Therapy has been well-tolerated, with %gr 3/%gr 4 toxicities as follows: anemia (3/0), leukopenia (3/0), thrombocytopenia (19/13), fatigue/aesthenia (19/0), dyspnea (16/0), infection (6/0), motor neuropathy (13/0), sensory neuropathy (3/0; gr 2 39%), hypotension (13/0). In 9/09, the protocol was modified to have separate dose reduction schedules for each agent (e.g., myelosuppression, decrease lenalidomide; neuropathy, decrease bortezomib). These interim data suggest that a lenalidomide/bortezomib combination has acceptable toxicity in MCL, and efficacy data have met the threshold for completing accrual (anticipated, 8/2010). Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Celgene
The characteristics of pneumonia in a stricken area after the great East Japan earthquake
Authors: Satoshi Ubukata, Takehiro Yajima, Daisuke Jingu, Makoto Shoji, Hiroshi Watanabe, Hiroshi Takahashi
Journal: European Respiratory Journal (2013)

Background:  There is no accurate data of the characteristics of pneumonia after the catastrophic disaster, because the investigation and examination cannot be performed sufficiently. Although the Shiogama-Tagajo area was severely struck by the 3.11 earthquake, we were able to perform bacterial and other tests continuously at a near-normal level.   Objectives:  The aim was to ascertain the clinical picture of pneumonia during the early period after the 3.11 earthquake.   Methods:  We conducted a retrospective study of adult patients with pneumonia visited to our institutions during the first 3 weeks after the earthquake (from 12 March to 1 April). The patients visited during the 10-week period (from 1 January to 11 March 2011) were defined as a control group.   Results:  A total of 173 patients (before: n=90, after: n=83) were evaluated. The number of patients increased 3 times per week and peaked in the 2nd week after the earthquake. There was no obvious change in patient characteristics before and after the earthquake (mean age: 73.5±17.1 vs. 75.9±14.6 years, p=0.32; the number of performance status 3-4, 24 (26.7%) vs. 22 (26.5%), p=0.98; mortality, 7.8% vs. 9.6%, p=0.66). In microbiology data, the rate of purulent sputum samples rose from 48.9% to 60.2%. The isolation frequency of  Haemophilus influenzae  (14.4% vs. 32.5%, p Moraxella catarrhalis  (4.4% vs. 31.3%, p Streptococcus pneumoniae  and other pathogens did not increase.   Conclusions:  There was no difference in patient characteristics before and after the earthquake, but as bacteriological profile,  H.influenzae  and  M.catarrhalis  increased significantly in the Shiogama-Tagajo area.
Chronic recurrent multifocal osteomyelitis is a differential diagnosis of juvenile idiopathic arthritis
Authors: L P Robertson, P Hickling
Journal: Annals of the Rheumatic Diseases (2001)

A 5 year old girl was referred to the paediatric rheumatology clinic in June 1999 for assessment of possible juvenile idiopathic arthritis (JIA). She had been well until seven months previously, when she began to limp and developed a swollen left ankle. At this time she appeared generally unwell and irritable but had no history of fever or rashes. There was no previous past medical history of note. She lived with her parents and twin brother, who were all well. A distant relative was believed to have rheumatoid arthritis. A full blood count was normal, C reactive protein and blood cultures were negative. A radiograph of the left ankle showed a lucency at the distal tibia with associated periosteal reaction (fig 1). A technetium-99m MDP bone scan showed increased uptake in the lower end of the left tibia (fig 2A) as well as the body of L5 and the left sternoclavicular joint (fig 2B). A biopsy of the lower end of the left tibia showed evidence of necrosis and new bone formation with much inflammation and fibrosis, but little suppuration (fig 3). No organisms were identified and culture of the biopsy was negative.



Figure 1 
An x ray picture of the left ankle. Adjacent to the tibial epiphysial plate of the left ankle, there is an area of osteolysis of the tibial metaphysis (black arrows). This is associated with a periosteal reaction (white arrowhead).





Figure 2 
(A) Three phase 99mTc MDP bone scan, static view shows increased uptake in the distal end of the left tibia (arrow). (B) Three phase 99mTc MDP bone scan, static view also shows a small focus of increased uptake at the right aspect of L5 (arrow) and the left sternoclavicular joint.





Figure 3 
Biopsy of left tibial lesion showing an area of dead bone (large arrow), an …