tbuckley/cabot-search huggingface dataset:
Depressive Symptoms and Plan Switching Under Managed Care
Authors: Benjamin Druss, Mark Schlesinger, Tracey Thomas, Harris Allen
Journal: American Journal of Psychiatry (1999)

OBJECTIVE: A central assumption underlying managed care is that plan switching is a viable option for enrollees when they are dissatisfied. The authors used a national employee survey to test the hypothesis that this mechanism is less effective for enrollees with high levels of depressive symptoms than for the remainder of the population. METHOD: The study used data from the Employee Health Care Value Survey, a 1993 survey of 20,283 employees of three major corporations. The authors used the Medical Outcomes Study 36-Item Short-Form Health Survey to identify individuals with the highest decile of depressive and physical symptoms. They examined the relationship between symptoms and dissatisfaction and, for dissatisfied individuals, how symptoms predicted plan switching. Multivariate models were used to control for potential demographic, health, and health coverage confounders. RESULTS: Depressive and physical symptoms were both associated with dissatisfaction with care. Unlike physical symptoms, depressive symptoms were associated with a significantly lower likelihood of actually disenrolling among people who were dissatisfied or who intended to disenroll. This effect was most pronounced for satisfaction with administrative aspects of care (e.g., gatekeeping, utilization review). CONCLUSIONS: People with high levels of depressive symptoms appeared to be less willing or able to act on their dissatisfaction by switching plans. In particular, they were willing to tolerate higher rates of dissatisfaction with the administrative aspects of their health coverage without disenrolling. Plan switching is an essential mechanism underpinning a health care system predicated on competition; it may be less effective for people with depressive disorders.
Lessons learned from apnoe in cough down regulation
Authors: Zuzana Biringerova, Mariana Brozmanova, Silvia Gavliakova, Eva Hanuskova, Jana Plevkova
Journal: European Respiratory Journal (2013)

Afferents from the nose do not trigger cough, but the reflex is sensitized by experimental rhinitis. Most published data suggest that nasal sensory nerves are involved in up-regulation of cough, little evidence is available to support down-regulation of it from nose. Based on the data published recently about suppression of cough during water induced apnoe (Poussel et al., 2012), we decided to conduct a study on the model of irritant induced nasal apnea.  Dunkin Hartley guinea pigs (n=8) were anaesthetized and tracheotomized. Trachea was lengthwise open at the proximal end and superfused with oxygenated saline. Cough was induced after nasal allylisothiocyanate AITC (TRPA1 agonist) by application of citric acid (CA) to the tracheal surface in ascending concentrations (0.001 - 2 M). Cough was also induced in conscious animals (n=22) by inhaling 0.4M CA for 10 min after nasal AITC. Cough response was estimated from the airflow traces and cough sound analysis.  In anaesthesia, nasal AITC induced drop of respiratory rate (RR) p   While suppression of cough in anaesthetized model could be attributed to apnoe/hypopnoea, explanation of the results in conscious animals needs complex approach. There are important issues of the consciousness (C-fiber signalling), mucus overproduction and central coordination of cough and sneeze.
Molecular epidemiology of severe respiratory disease by human rhinoviruses and enteroviruses at a tertiary paediatric hospital in Barcelona, Spain
Authors: C. Launes, G. Armero, A. Anton, L. Hernandez, L. Gimferrer, C. Cisneros, I. Jordan, C. Muñoz-Almagro
Journal: Clinical Microbiology and Infection (2015)
Cough, active smoking ever, smoking history of >10 packyears and wheezing/chest tightness should prompt COPD suspicion in cardiac patients who remain symptomatic despite adequate management
Authors: Marta Kolacinska-Flont, Jaroslaw Drozdz, Marzenna Zielinska, Piotr Kuna
Journal: European Respiratory Journal (2012)

Background: Coronary heart disease (CHD) and chronic obstructive pulmonary disease (COPD) share common risk factors and often coexist. Dyspnea, effort intolerance and chest tightness in CHD patients are readily attributed to cardiac disorder while COPD passes unnoticed. Proper COPD management optimizes patient9s outcome.  Aim: The aim of our study was to determine key features from history and physical examination that should raise COPD suspicion in persistently symptomatic cardiac patients.  Material and methods: Patients were recruited with respect to the following inclusion criteria: angiographically confirmed CHD, adequate cardiac management, ability to visit study site, expressed informed consent for study participation. Subjects were evaluated for: demography, smoking, respiratory complaints (modified ECRHS questionnaire), airflow limitation (spirometry accompanied by reversibility test if applicable). COPD diagnosis was based on clinical presentation, history and post-bronchodilator FEV1/FVC  Results: Among 206 subjects eligible for the study 33 (16%) were found to have COPD. COPD vs. non-COPD subjects did not differ in age, sex, BMI, waist circumference and tobacco exposure in general. Active smoking ever (OR 5.45, 95%CI 1.24-23.9), >10 packyears (OR 4.28, 95% CI 1.57-11.7), cough (OR 8.65 95%CI 3.16-23.6) and wheezing/chest tightness (OR 3.38 95%CI 1.51-7.58) significantly increased COPD risk.  Conclusions: Longstanding history of active smoking ever, cough and wheezing/chest tightness in persistently symptomatic cardiac patients should raise the suspicion of concomitant COPD.
Brain Metastases in Male Germ Cell Tumors (Gct): a Large Retrospective Analysis on Behalf of the Swenoteca and the G3 Consortium
Authors: J. Beyer, A. Lorch, T. Powles, A. Kramar, L. van Alstine, P. Giannatempo, T. Sava, C. Albany, L. Einhorn, A. Flechon, J. Aparicio, P. Chung, R.A. Huddart, C. Bokemeyer, A. Tryakin, E. Winquist, C. Sweeney, M. Hentrich, K. Margolin, D.R. Feldman
Journal: Annals of Oncology (2014)
Omalizumab and voriconazole in allergic broncopulmonary aspergillosis (A case series)
Authors: Anna Agnese Stanziola, Emanuela Carpentieri, Carolina Vitale, Manuela Pitassi, Nunzia Sorrentino, Matteo Sofia
Journal: European Respiratory Journal (2011)

Allergic bronchopulmonary aspergillosis (ABPA) in immunocompetent patients may represent a cause of severe, difficult to control asthma associated with recurrent exacerbations and dependence to systemic steroid.We describe of 5 F patients, age mean 62.6 y (range 50 - 74) with ABPA who were treated with combined anti-IgE omalizumab and Voriconazole.They have skin prick test positive to different pollens (Parietaria, grass) and perennial allergens such as mites and Aspergillus fumigatus, but also high levels of total (732±228 UI/mL) and specific IgE towards Aspergillus f. (>25 Ku/L) in the absence of invasive aspergillosis. Their treatment consisted of ICS and LABA daily and orally steroids during exacerbations (about 6-7/y).  All of the patients have CT- rhinosinusitis and 1of 5 pts has radiological signs of bronchiectasis. The PFR showed obstructive ventilatory pattern with FEV1% th = 66±6; FVC% th = 77±11 and ACT score was 17.Voriconazole 200mg bid was admistrated for two months before treatment with biological therapy with Omalizumab even if the serum levels of galactomannan were negative. 3 months later treatment with voriconazole, the specific Aspergillus f. IgE levels returned normal.  After 1 year of treatment with Omalizumab, the exacerbations rate (8 vs 3) and the ACT score were reduced (21 vs 17); FEV1% th 75 improved and total IgE levels were lower (363±173 UI/mL). Second year of treatment: the specific aspergillus IgE levels returned to be high but no exacerbation was registred and ACT remained stable.In APBA patients with severe allergic asthma the combined therapy with omalizumab and voriconazole in burst might offer a longer and safer approach in this setting.
Earlier presentation and application of curative treatments in hepatocellular carcinoma
Authors: Susanna V. Ulahannan, Austin G. Duffy, Timothy S. McNeel, Jonathan K. Kish, Lois A. Dickie, Osama E. Rahma, Katherine A. McGlynn, Tim F. Greten, Sean F. Altekruse
Journal: Hepatology (2014)

The purpose of the study was to assess the use of curative therapies for hepatocellular carcinoma (HCC) in the population. HCC treatment patterns were examined in Surveillance, Epidemiology, and End Results (SEER) 18 registries (28% of U.S.). Joinpoint regression analyses were performed to assess 2000-2010 incidence trends by tumor size, count, and receipt of potentially curative treatments (transplantation, resection, and ablation). SEER-Medicare data enabled evaluation of treatment patterns including receipt of sorafenib or transarterial chemoembolization (TACE) by HCC-associated comorbidities. Diagnoses of tumors≤5.0 cm in diameter significantly increased during 2000-2010, surpassing diagnosis of larger tumors. Overall, 23% of cases received potentially curative treatment. Joinpoint models indicated incidence rates of treatment with curative intent increased 17.6% per year during 2000-2005, then declined by -2.9% per year during 2005-2010 (P<0.001). Among HCC cases with a single tumor≤5.0 cm and no extension beyond the liver, use of ablative therapy significantly increased during 2000-2010. Use of invasive surgery for single tumors, regardless of size, significantly increased during the initial years of the decade, then plateaued. The group most likely to receive curative treatment in the SEER-Medicare cases was patients with one, small tumor confined to the liver (657 of 1,597 cases, 41%), with no difference in treatment by hepatic comorbidity status (P=0.24). A higher proportion of cases with reported liver-associated comorbidities were, however, diagnosed with tumors≤5.0 cm in diameter (1,745 0f 2,464, 71%) compared to patients with no reported comorbidities (996 of 2,596, 38%, P<0.001). Although more HCC patients were diagnosed with early disease over time, the use of curative treatments in this patient group has recently plateaued. Efforts to identify and treat more eligible candidates for curative therapy could be beneficial.
Mobility of the Young Adult Physically Handicapped Patient following Lower Limb Surgery in Childhood
Authors: J D Spencer
Journal: Journal of the Royal Society of Medicine (1990)

Fifty-six cases seen consecutively in a young adult physically handicapped clinic were assessed with regard to their mobility. In addition an attempt was made to review the long term outcome of lower limb orthopaedic operations in these patients with physical handicap. The patients were subdivided into four groups and it was found that in three of the groups, patients who could only walk with a walking aid or who were wheelchair bound had had more surgical procedures than those who walked independently in adulthood. As problems in the young adult physically handicapped patients are defined so further work will be required to determine the best way they should be treated.
High-dose N-acetylcysteine (NAC) in fibrotic interstitial lung diseases, a retrospective analysis
Authors: Saher B. Shaker, Niels Seersholm, Marianne Hestad, Svenja Andersen, Asger Dirksen
Journal: European Respiratory Journal (2013)

Background: NAC is prescribed to patients with fibrotic interstitial lung diseases (f-ILD) due to its antioxidant effects and based on a single clinical trial in patients with idiopathic pulmonary fibrosis (IPF).

Objective: to characterize the practice of prescribing NAC for f-ILD in our institution and to study the effect of NAC treatment on mortality and lung function decline in patients with IPF and other f-ILD.

Methods: data from all patients treated with high-dose NAC for f-ILD in our hospital were retrospectively collected from patients’ records including lung function measurements and mortality data.

Results: during the period 2004-2012, a total of 84 patients received high-dose NAC for IPF (n=52) or other f-ILD (n=32) including fibrotic NSIP, CTD-ILD and unclassified fibrosis. During follow-up period, 25 patients (48%) with IPF and 8 patients (25%) with other f-ILD died (p<0.036). The annual decline in FVC was 162 ml (±69) and 13 ml (±51) in patients with IPF and other f-ILD, respectively. The annual decline in DLco was 0.23 mm/kPa/min (±0.10) and 0.06 mm/kPa/min (±0.06) in patients with IPF and other f-ILD, respectively.

Conclusion: As expected, among patients treated with NAC, mortality and decline in lung function were higher in patients with IPF than patients with other f-ILD; nevertheless, the figures in IPF were similar to those from placebo arms in randomized clinical trials.
<i>CHIA</i> confers susceptibility to childhood eczema
Authors: T.F. Leung, K.W. Ching, H.Y. Sy, A.P.S. Kong, L.Y. Tse, S.S. Wang, C.W.K. Lam, J.C.N. Chan, G.W.K. Wong, K.L. Hon
Journal: British Journal of Dermatology (2010)
Exacerbation frequency is related to PEF self-similarity in COPD
Authors: Gavin Donaldson, Terence Seemungal, John Hurst, Jadwiga Wedzicha
Journal: European Respiratory Journal (2011)

Introduction: Self-similarity in Peak Expiratory Flow (PEF) can predict the frequency of asthmatic events but it is unknown whether in COPD there is a relationship with exacerbation frequency.

Methods: We examined data from the London COPD cohort on 308 COPD patients who recorded worsening of respiratory symptoms and PEF on daily diary cards. Exacerbations were identified as previously described (Seemungal. AJRCCM 157:1418-1422; 1998) from which an annual rate was calculated. Detrended fluctuation analysis was used to calculate α which is a measure of decay in self-correlation over time (Frey et al Nature. 438: 667-70, 2005). PEF time series when the patient was clinically stable were also analyzed by excluding data collected 7 day before to 7 day after each exacerbation, and splicing the series together.

Results: The 308 COPD patients (195M; mean age (SD) 68.3 (8.4) years; FEV1 1.12 (0.46) l, FEV1% predicted 44.5 (16.4), PEF% predicted 54.7 (18.6). The cohort recorded diary card data for a median 1077 days and experienced 2621 exacerbations with a median frequency of 2.04 per year (IQR 0.9 – 3.3). The patients had an α of 0.944 (SD 0.19) over the initial 365 days which was positively related to exacerbation frequency (negative binomial regression, P=0.009). No difference was seen if exacerbation PEF data were excluded, α = 0.935 (SD 0.21; P=0.139) and there was also a relationship with exacerbation frequency (P=0.001).

Conclusion: In COPD patients, long-term correlations (self-similarity) exist in PEF, which are related to exacerbation frequency. The exponent α may prove a useful marker of exacerbation frequency and as normally distributed lead to a reduction in the number of patients required for clinical trials.
Identification of a Three-Biomarker Panel in Urine for Early Detection of Pancreatic Adenocarcinoma
Authors: Tomasz P. Radon, Nathalie J. Massat, Richard Jones, Wasfi Alrawashdeh, Laurent Dumartin, Darren Ennis, Stephen W. Duffy, Hemant M. Kocher, Stephen P. Pereira, Luisa Guarner (posthumous), Cristiane Murta-Nascimento, Francisco X. Real, Núria Malats, John Neoptolemos, Eithne Costello, William Greenhalf, Nick R. Lemoine, Tatjana Crnogorac-Jurcevic
Journal: Clinical Cancer Research (2015)

Abstract Purpose: Noninvasive biomarkers for early detection of pancreatic ductal adenocarcinoma (PDAC) are currently not available. Here, we aimed to identify a set of urine proteins able to distinguish patients with early-stage PDAC from healthy individuals. Experimental design: Proteomes of 18 urine samples from healthy controls, chronic pancreatitis, and patients with PDAC (six/group) were assayed using GeLC/MS/MS analysis. The selected biomarkers were subsequently validated with ELISA assays using multiple logistic regression applied to a training dataset in a multicenter cohort comprising 488 urine samples. Results: LYVE-1, REG1A, and TFF1 were selected as candidate biomarkers. When comparing PDAC (n = 192) with healthy (n = 87) urine specimens, the resulting areas under the receiver-operating characteristic curves (AUC) of the panel were 0.89 [95% confidence interval (CI), 0.84–0.94] in the training (70% of the data) and 0.92 (95% CI, 0.86–0.98) in the validation (30% of the data) datasets. When comparing PDAC stage I–II (n = 71) with healthy urine specimens, the panel achieved AUCs of 0.90 (95% CI, 0.84–0.96) and 0.93 (95% CI, 0.84–1.00) in the training and validation datasets, respectively. In PDAC stage I–II and healthy samples with matching plasma CA19.9, the panel achieved a higher AUC of 0.97 (95% CI, 0.94–0.99) than CA19.9 (AUC = 0.88; 95% CI, 0.81–0.95, P = 0.005). Adding plasma CA19.9 to the panel increased the AUC from 0.97 (95% CI, 0.94–0.99) to 0.99 (95% CI, 0.97–1.00, P = 0.04), but did not improve the comparison of stage I–IIA PDAC (n = 17) with healthy urine. Conclusions: We have established a novel, three-protein biomarker panel that is able to detect patients with early-stage pancreatic cancer in urine specimens. Clin Cancer Res; 21(15); 3512–21. ©2015 AACR.
Evaluation of respiratory problems in children with profound intellectual and multiple disabilities (PIMD)
Authors: Marijke Proesmans, Myriam Vreys, Elke Huenaerts, E. Haest, S. Coremans, H. Feys
Journal: European Respiratory Journal (2013)

PIMD is a profound cognitive disability combined with severe sensory and motor impairments. Children with PIMD often present with recurrent or chronic respiratory problems. The aim of this study was to evaluate the incidence of respiratory problems in children with PIMD and investigate possible risk factors.  In 10 institutions, specialized in the care of PIMD, children were assessed for respiratory and motor function according to a standardized protocol. Addition information was obtained from medical records and interviews with the caregivers/physiotherapists.  RESULTS: 107 children aged 2-21 years (median age 12 years; 59 male, 48 female) were tested. All had a developmental age   20°).  Only 15 (14%) children were chronically on respiratory medication. Median number of lower airway infections in the previous year was 3: almost 50% of children experienced 4 airway infections over the previous year while 25% of the group had experienced none. 75% of these children had not been hospitalized for respiratory problems/infection over the last 5 years; around 10% of children were hospitalized 3 times or more in this period.  Risk factors for respiratory morbidity are analyzed.  Conclusion: The overall respiratory morbidity in our sample of children with PIMD was lower than anticipated. A subgroup of children are prone to recurrent severe airway problems while in the majority of children in this group there were no important/frequent airway infections. Risk factors will be discussed.
microRNAs are deregulated in pulmonary arteries from COPD patients
Authors: Melina M. Musri, Victor I. Peinado, Nuria Coll, Jorge Altirriba, Jessica Garcia, David Dominguez-Fandos, Borja Lobo, Raquel Puig-Pey, Joan A. Barberà
Journal: European Respiratory Journal (2012)

Pulmonary vessel remodelling in chronic obstructive pulmonary disease (COPD) is associated with changes in smooth muscle cell (SMC) phenotype. MicroRNAs (miRNAs) regulate the expression of many genes controlling cell growth and differentiation. The aim of the study was to evaluate miRNAs expression in pulmonary arteries (PA) from COPD and control patients. We studied 29 PA from COPD (n=12), smokers (S) with normal lung function (n=10) and nonsmokers (NS) patients (n=7) who underwent lung resection. MiRNAs expression was assessed after RNA isolation by RT-PCR using taqman low-density arrays card A Set v3.0 (Applied Biosystems). MiRNAs expression was additionally evaluated by Northern Blot (NB) in primary human pulmonary artery endothelial (HPAE) and in human pulmonary artery smooth muscle cells (HPASMC) (Lonza) with both proliferative and contractile phenotype. MiRNAs were also studied in PA-derived SMC from patients. Expression of markers was assessed by Real Time PCR. The results showed a significant upregulation of miR-146 and miR-139, whereas miR-204, miR-149, miR-197, miR-487b and miR-485 were downregulated in PA from COPD respect to NS (p  Supported by grants FIS 09/00536 and 10/02175, SEPAR-2009 and 2010. MMM is recipient of a Sara Borrell grant from ISC III, Spain.
An Immunotoxin Composed of Monoclonal Anti-Thy 1.1 Antibody and a Ribosome-Inactivating Protein From &lt;italic&gt;Saponaria officinalis:&lt;/italic&gt; Potent Antitumor Effects In Vitro and In Vivo
Authors: Philip E. Thorpe, Alex N. F. Brown, John A. G. Bremner, Brian M. J. Foxwell, Fiorenzo Stirpe
Journal: JNCI Journal of the National Cancer Institute (1985)

The ribosome-inactivating protein saporin, from Saponaria officinalis, was coupled by a disulfide bond to monoclonal anti-Thy 1.1 antibody (OX7) and to its F(ab')2 fragment. The immunotoxins were at least as toxic as the plant toxin ricin to the Thy 1.1-expressing cell lines AKR-A and BW5147 in tissue culture. They reduced the rate at which the cells incorporated [3H]leucine into protein by 50% at cell concentrations of 1.5-3 X 10(-11) and 3 X 10(-12) M, respectively. The toxic effect was specific. No toxicity was seen when the immunotoxins were applied to Thy 1.2-expressing EL 4 lymphoma cells at 3 X 10(-8) M, and a control immunotoxin made from an antibody (R10) of irrelevant specificity was without effect on AKA-A cells. Further, the treatment of spleen cells from AKR mice with OX7-saporin at 10(-8) M abolished their response to the T-lymphocyte mitogen concanavalin A, without impairing their response to the B-lymphocyte mitogen lipopolysaccharide. A single iv injection of OX7-saporin into nu/nu randombred mice bearing peritoneal AKR-A lymphoma cells prolonged the survival time of the animals by an extent corresponding to that expected if 99.999% of the tumor cells had been eradicated by the immunotoxin. None of the control materials (unconjugated OX7, unconjugated saporin, OX7 plus saporin, or R10-saporin) delayed tumor growth. The OX7 F(ab')2-saporin conjugate was also highly effective as an antitumor agent, although significantly less so than the conjugate made with intact OX7. Unexpectedly, the acute toxicity of saporin to mice (median lethal dose = 6.8 mg/kg) was elevated eightfold to sixteenfold by conjugation to OX7, R10, or OX7 F(ab')2. Histologic examination of recipients of the immunotoxin revealed gross damage to hepatic parenchymal cells and to the white pulp of the spleen, neither of which was caused by unconjugated saporin. Ricin A-chain coupled to OX7 antibody was one hundredfold to one thousandfold less effective than OX7-saporin as an antitumor agent in vivo, although the two immunotoxins were equally cytotoxic to AKR-A cells in vitro.