tbuckley/cabot-search huggingface dataset:
Endobronchial Ultrasound Skills and Tasks Assessment Tool
Authors: Mohsen Davoudi, Henri G. Colt, Kathryn E. Osann, Carla R. Lamb, John J. Mullon
Journal: American Journal of Respiratory and Critical Care Medicine (2012)

Rationale: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is becoming standard of care for the sampling of mediastinal adenopathy. The need for a safe, effective, accurate procedure makes EBUS-TBNA ideal for mastery training and testing.Objectives: The Endobronchial Ultrasound Skills and Tasks Assessment Tool (EBUS-STAT) was created as an objective competency-oriented assessment tool of EBUS-TBNA skills and knowledge. This study demonstrates the reliability and validity evidence of this tool.Methods: The EBUS-STAT objectively scores the EBUS-TBNA operator's skills, including atraumatic airway introduction and navigation, ultrasound image acquisition and optimization, identification of mediastinal nodal and vascular structures, EBUS-TBNA sampling, and recognition of EBUS/computed tomography images of mediastinal structures. It can be administered at the bedside or using combination of low- and high-fidelity simulation platforms. Two independent testers administered the EBUS-STAT to 24 operators at three levels of EBUS-TBNA experience (8 beginners, 8 intermediates, and 8 experienced) at three institutions; operators were also asked to self-assess their skills. Scores were analyzed for intertester reliability, correlation with prior EBUS-TBNA experience, and association with self-assessments.Measurements and Main Results: Intertester reliability between testers was very high (r = 0.9991, P < 0.00005). Mean EBUS-STAT scores for beginner, intermediate, and experienced groups, respectively, were 31.1, 74.9, and 93.6 out of 100 (F2,21 = 118.6, P < 0.0001). Groups were nonoverlapping: post hoc tests showed each group differed significantly from the others (P < 0.001). Self-assessments corresponded closely to actual EBUS-STAT scores (r2 = 0.81, P < 0.001).Conclusions: The EBUS-STAT can be used to reliably and objectively score and classify EBUS-TBNA operators from novice to expert. Its use to assess and document the acquisition of knowledge and skill is a step toward the goal of mastery training in EBUS-TBNA.
The Effects of Fluticasone with or without Salmeterol on Systemic Biomarkers of Inflammation in Chronic Obstructive Pulmonary Disease
Authors: Don D. Sin, S. F. Paul Man, Darcy D. Marciniuk, Gordon Ford, Mark FitzGerald, Eric Wong, Ernest York, Rajesh R. Mainra, Warren Ramesh, Lyle S. Melenka, Eric Wilde, Robert L. Cowie, Dave Williams, Wen Q. Gan, Roxanne Rousseau
Journal: American Journal of Respiratory and Critical Care Medicine (2008)

Small studies have suggested that inhaled corticosteroids can suppress systemic inflammation in chronic obstructive pulmonary disease (COPD).To determine the effect of inhaled corticosteroids with or without long-acting beta(2)-adrenergic agonist on systemic biomarkers of inflammation.We conducted a double-blind randomized placebo-controlled trial across 11 centers (n = 289 patients with FEV(1) of 47.8 +/- 16.2% of predicted) to compare the effects of inhaled fluticasone alone or in combination with salmeterol against placebo on circulating biomarkers of systemic inflammation over 4 weeks. The primary endpoint was C-reactive protein (CRP) level. Secondary molecules of interest were IL-6 and surfactant protein D (SP-D).Neither fluticasone nor the combination of fluticasone/salmeterol had a significant effect on CRP or IL-6 levels. There was, however, a significant reduction in SP-D levels with fluticasone and fluticasone/salmeterol compared with placebo (P = 0.002). Health status also improved significantly in both the fluticasone and fluticasone/salmeterol groups compared with placebo, driven mostly by improvements in the symptom scores. Changes in the circulating SP-D levels were related to changes in health status scores. FEV(1) improved significantly only in the fluticasone/salmeterol group compared with placebo.ICS in conjunction with long-acting beta(2)-adrenergic agonist do not reduce CRP or IL-6 levels in serum of patients with COPD over 4 weeks. They do, however, significantly reduce serum SP-D levels. These data suggest that these drugs reduce lung-specific but not generalized biomarkers of systemic inflammation in COPD.
Extradigestive manifestations of Helicobacter pylori gastric infection
Authors: A Gasbarrini, F Franceschi, A Armuzzi, V Ojetti, M Candelli, E S. Torre, A De Lorenzo, M Anti, S Pretolani, G Gasbarrini
Journal: Gut (1999)

In the past year, several studies have been carried out on the association between Helicobacter pylori infection and a miscellany of extradigestive diseases, such as cardiovascular, immunological, and various other pathologies.In particular, a higher prevalence of H pylori infection in patients aVected by ischaemic heart disease has been described and there is growing evidence for an association between H pylori and some autoimmune diseases.Moreover, recent studies have shown that various helicobacter species have been detected in human bile; if confirmed, this finding could revise the diagnostic and therapeutic approach to diseases of the biliary tract.
Generation of biliary lesions after transfer of human lymphocytes into severe combined immunodeficient (SCID) mice.
Authors: S M Krams, K Dorshkind, M E Gershwin
Journal: The Journal of Experimental Medicine (1989)

Human PBL have been reported to reconstitute B and T cells as well as human serum Ig in mice with severe combined immunodeficiency disease (SCID). To confirm these observations and attempt the transfer of an autoimmune disease to the immunodeficient animals, groups of SCID mice received an injection of PBL from patients with primary biliary cirrhosis (PBC) or from normal volunteers. By 8 wk after the injection of 10-42 x 10(6) PBL into the mice, human lymphoid cells were detected in the spleen of approximately half of the animals and all had detectable serum levels of human IgG. Moreover, the sera of SCID mice that received cells from patients with PBC contained human antimitochondrial antibodies (AMA) to dihydrolipoamide acetyltransferase, the major mitochondrial autoantigen of PBC. Histologically, a human mononuclear cell infiltrate was present around the portal areas of the liver and inflammation, bile duct atypica, and necrosis of bile duct cells were observed. While the biliary lesions in the SCID recipients of PBC cells were more severe, a mononuclear infiltrate was clearly evident in mice that received cells from normal donors, suggesting the presence of a graft-vs.-host-like disease. While these data are the first to describe an animal model with both the humoral and cellular characteristics of PBC, they also raise an interesting question regarding the preferential localization of lymphoid cells to the biliary system.
Malignant atrophic papulosis in an infant
Authors: A. Torrelo, J. Sevilla, I.G. Mediero, D. Candelas, A. Zambrano
Journal: British Journal of Dermatology (2002)

Summary We report a 7‐month‐old girl with malignant atrophic papulosis (Degos' disease). She also showed spontaneous aggregation of platelets. A good clinical response was obtained by treatment with aspirin and dipyridamole.
Signal Transduction in Drosophila Photoreceptors
Authors: R Ranganathan, D M Malicki, C S Zuker
Journal: Annual Review of Neuroscience (1995)

The brain's default mode network consists of discrete, bilateral and symmetrical cortical areas, in the medial and lateral parietal, medial prefrontal, and medial and lateral temporal cortices of the human, nonhuman primate, cat, and rodent brains. Its ...Read More
Overnight closed loop insulin delivery (artificial pancreas) in adults with type 1 diabetes: crossover randomised controlled studies
Authors: R. Hovorka, K. Kumareswaran, J. Harris, J. M. Allen, D. Elleri, D. Xing, C. Kollman, M. Nodale, H. R. Murphy, D. B. Dunger, S. A. Amiel, S. R. Heller, M. E. Wilinska, M. L. Evans
Journal: BMJ (2011)

<b>Objective</b> To compare the safety and efficacy of overnight closed loop delivery of insulin (artificial pancreas) with conventional insulin pump therapy in adults with type 1 diabetes. <b>Design</b> Two sequential, open label, randomised controlled crossover, single centre studies. <b>Setting</b> Clinical research facility. <b>Participants</b> 24 adults (10 men, 14 women) with type 1 diabetes, aged 18-65, who had used insulin pump therapy for at least three months: 12 were tested after consuming a medium sized meal and the other 12 after consuming a larger meal accompanied by alcohol. <b>Intervention</b> During overnight closed loop delivery, sensor measurements of glucose were fed into a computer algorithm, which advised on insulin pump infusion rates at 15 minute intervals. During control nights, conventional insulin pump settings were applied. One study compared closed loop delivery of insulin with conventional pump therapy after a medium sized evening meal (60 g of carbohydrates) at 1900, depicting the scenario of "eating in." The other study was carried out after a later large evening meal (100 g of carbohydrates) at 2030, accompanied by white wine (0.75 g/kg ethanol) and depicted the scenario of "eating out." <b>Main outcome measures</b> The primary outcome was the time plasma glucose levels were in target (3.91-8.0 mmol/L) during closed loop delivery and a comparable control period. Secondary outcomes included pooled data analysis and time plasma glucose levels were below target (≤3.9 mmol/L). <b>Results</b> For the eating in scenario, overnight closed loop delivery of insulin increased the time plasma glucose levels were in target by a median 15% (interquartile range 3-35%), P=0.002. For the eating out scenario, closed loop delivery increased the time plasma glucose levels were in target by a median 28% (2-39%), P=0.01. Analysis of pooled data showed that the overall time plasma glucose was in target increased by a median 22% (3-37%) with closed loop delivery (P&lt;0.001). Closed loop delivery reduced overnight time spent hypoglycaemic (plasma glucose ≤3.9 mmol/L) by a median 3% (0-20%), P=0.04, and eliminated plasma glucose concentrations below 3.0 mmol/L after midnight. <b>Conclusion</b> These two small crossover trials suggest that closed loop delivery of insulin may improve overnight control of glucose levels and reduce the risk of nocturnal hypoglycaemia in adults with type 1 diabetes. <b>Trial registration</b> ClinicalTrials.gov NCT00910767 and NCT00944619.
Occurrence of autoimmune diseases and autoantibodies in multicase rheumatoid arthritis families.
Authors: D.J Walker, M Griffiths, I.D Griffiths
Journal: Annals of the Rheumatic Diseases (1986)

The presence of autoimmune diseases and autoantibodies has been studied in 237 individuals from 17 families with two or more members affected by rheumatoid arthritis (RA). Hyperthyroidism occurred significantly more frequently than in a local control population (p less than 0.05), but if the RA cases were excluded this significance was lost. Thyroid cytoplasmic and microsomal antibodies were significantly more common (p less than 0.001), and this remained true if RA sufferers were excluded (p less than 0.01). The prevalence of both clinical thyroid disease and circulating thyroid autoantibodies was similar in the families where RA was associated with HLA-DR4 and in those where no DR4 association was observed. RA and immune thyroid disease may, therefore, share a common inherited factor, but this is unlikely to be at the HLA-DR locus. Antinuclear factor (ANF) was found in association with RA and with HLA-DR3 within the RA group (p less than 0.02). Relatives of RA sufferers did not show any excess of ANF positivity. The prevalence of pernicious anaemia (PA) and gastric parietal cell antibody did not differ from the expected.
Promise of New Vascular-Disrupting Agents Balanced With Cardiac Toxicity: Is It Time for Oncologists to Get to Know Their Cardiologists?
Authors: Willem J. van Heeckeren, Shyam Bhakta, Jose Ortiz, Jeff Duerk, Matthew M. Cooney, Afshin Dowlati, Keith McCrae, Scot C. Remick
Journal: Journal of Clinical Oncology (2006)

Willem J. van Heeckeren, Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH Shyam Bhakta and Jose Ortiz, Division of Cardiology, Department of Medicine, CASE School of Medicine, Cleveland, OH Jeff Duerk, Departments of Radiology and Biomedical Engineering, CASE School of Medicine, Cleveland, OH Matthew M. Cooney, Afshin Dowlati, Keith McCrae, and Scot C. Remick, Division of Hematology/Oncology, Department of Medicine, Case Western Reserve University School of Medicine, Developmental Therapeutics Program, CASE Comprehensive Cancer Center, University Hospitals of Cleveland, Cleveland, OH
Letter Regarding Article by Markus et al, “Dual Antiplatelet Therapy With Clopidogrel and Aspirin in Symptomatic Cardiac Stenosis Evaluated Using Doppler Embolic Signal Detection: The Clopidogrel and Aspirin for Reducton of Emboli in Symptomatic Carotid Stenosis (CARESS) Trial”
Authors: Christopher H.E. Imray, Daniel J. Higman, Colette Marshall
Journal: Circulation (2005)
Interplay Between Heart and Skeletal Muscle Disease in Heart Failure
Authors: Elizabeth M. McNally, Jeffery A. Goldstein
Journal: Circulation Research (2012)

The study of single gene disorders often provides insight for more complex human disease. Mutations in the genes encoding the dystrophin protein complex cause muscular dystrophy and cardiomyopathy by destabilizing the plasma membrane of skeletal myofibers and cardiomyocytes. In these diseases, progressive skeletal muscle degeneration and weakness contribute to cardiac dysfunction. Moreover, the pace and pattern of muscle weakness, along with onset of cardiomyopathy, is highly variable even when associated with the same identical mutation. Using a mouse model of muscular dystrophy and cardiomyopathy, we identified genetic loci that modify muscle pathology and cardiac fibrosis. Distinct genetic modifiers were identified for diaphragm and abdominal musculature, and these genetic intervals differ from those that regulate pathology in the skeletal muscle of the limbs and the heart. One modifier gene was identified and highlights the importance of the transforming growth factor-β pathway in the pathogenesis of muscular dystrophy and cardiomyopathy. We determined that canonical transforming growth factor-β signaling contributes to heart and muscle dysfunction using a Drosophila model. Together, these studies demonstrate the value of using a genetically sensitized model to uncover pathways that regulate heart failure and muscle weakness.
Measurement of sniff nasal and diaphragm twitch mouth pressure in patients.
Authors: P D Hughes, M I Polkey, D Kyroussis, C H Hamnegard, J Moxham, M Green
Journal: Thorax (1998)

BACKGROUND: Inspiratory muscle weakness is a recognised cause of unexplained dyspnoea. It may be suggested by the finding of a low static inspiratory mouth pressure (MIP), but MIP is a difficult test to perform, with a wide normal range; a low MIP may also occur if the patient has not properly performed the manoeuvre. Further investigation conventionally requires balloon catheters to obtain oesophageal (Poes) and transdiaphragmatic pressure (Pdi) during sniffs or phrenic nerve stimulation. Two non-invasive tests of inspiratory muscle strength have recently been described--nasal pressure during a maximal sniff (Sn Pnas) and mouth pressure during magnetic stimulation of the phrenic nerves (Tw Pmo). The use of these two tests in combination might identify patients without inspiratory muscle weakness who are unable to produce a satisfactory MIP&lt; therefore avoiding the need for investigation with balloon catheters. METHODS: Thirty consecutive patients with clinically suspected inspiratory muscle weakness and a low MIP underwent both conventional (Sn Poes and Tw Pdi) and non-invasive testing (Sn Pnas and Tw Pmo). Weakness was considered to be excluded by a Sn Poes of &gt; or = 80 cm H20 or a Tw Pdi of &gt; or = 20 cm H20. The limit values used to test the hypothesis were Sn Pnas &gt; or = 70 cm H20 or Tw Pmo &gt; or = 12 cm H20. RESULTS: Inspiratory muscle weakness was excluded in 17 of the 30 patients. Fifteen of these would have been identified using Sn Pnas and Tw Pmo, with better results when the two tests were combined. The cut off values selected for Sn Pnas and Tw Pmo were shown by ROC plots to indicate normal strength conservatively, avoiding failure to detect mild degrees of weakness. No patient with global weakness was considered normal by Sn Pnas or Tw Pmo. CONCLUSIONS: In most patients with normal inspiratory strength and a low MIP, Tw Pmo and Sn Pnas used in combination can reliably exclude global inspiratory muscle weakness, reducing the number of patients who need testing with balloon catheters.
Isolated idiopathic bile ductular hyperplasia in patients with persistently abnormal liver function tests
Authors: Aurelio Sonzogni, Guido Colloredo, Luca Fabris, Massimiliano Cadamuro, Bruno Paris, Luigi Roffi, Massimo Pozzi, Giorgio Bovo, Paolo Del Poggio, Bernard C Portmann, Mario Strazzabosco
Journal: Journal of Hepatology (2004)
Neutral endopeptidase (EC 3.4.24.11) in cirrhotic liver: A new target to treat portal hypertension?
Authors: Giovanni Sansoè, Manuela Aragno, Raffaella Mastrocola, Francesca Restivo, Giulio Mengozzi, Antonina Smedile, Floriano Rosina, Oliviero Danni, Maurizio Parola, Mario Rizzetto
Journal: Journal of Hepatology (2005)
Sarcoidosis presenting as recurrent left laryngeal nerve palsy.
Authors: F A el-Kassimi, M Ashour, R Vijayaraghavan
Journal: Thorax (1990)

<h3>Objective:</h3> NA <h3>Background:</h3> Parsonage-Turner Syndrome (PTS), also known as neuralgic amyotrophy, is an inflammatory peripheral nerve disorder, classically presenting with severe pain followed by weakness in one or more nerve territories, often including the anterior interosseous nerve (AIN). PTS is often associated with an antecedent event such as infection, surgery, vaccination, or medication. Surgical and high resolution nerve ultrasound (HRUS) studies have demonstrated focal, hourglass-like constriction in some cases. To our knowledge, this is the first report of PTS occurring in association with nivolumab, as well as the first report of hourglass-like HRUS findings in chemotherapy-associated PTS. <h3>Design/Methods:</h3> NA <h3>Results:</h3> <h3>Case Report:</h3> A 71-year-old male with lung adenocarcinoma presented one week following cycle 2 of nivolumab therapy with severe acute bilateral proximal upper extremity pain with subsequent recognition of hand weakness and numbness. The patient’s pain improved over 1 week, but he was left with residual weakness of the right hand, including marked difficulty grasping objects between his index finger and thumb. Physical exam revealed 1/5 strength of the right flexor pollicis longus and right flexor digitorum profundus, localizing to the right AIN. MRI of brachial plexus was unremarkable. Ultrasound of the right median nerve demonstrated an enlarged hypoechoic fascicle branching off the median nerve at the antecubital fossa consistent with an enlarged AIN. In addition to segmental enlargement, an area of focal constriction was seen in long-axis views, consistent with an hourglass-like constriction. EMG studies were consistent with an anterior interosseous mononeuropathy. <h3>Conclusions:</h3> The authors report the first known case of neuralgic amyotrophy due to nivolumab therapy, although this phenomenon is seen in the setting of other neurotoxic chemotherapeutic agents. This case is also notable for the ultrasonographic appearance of an hourglass-like constriction, a finding increasingly reported in neuralgic amyotrophy, particularly involving the AIN, although as of yet not in this clinical setting. <b>Disclosure:</b> Dr. Porambo has nothing to disclose. Dr. Sedarsky has nothing to disclose. Dr. Elliott has nothing to disclose. Dr. Theeler has nothing to disclose. Dr. Smith has nothing to disclose.
Attitudes of patients towards a hospital-based rehabilitation service for obesity hypoventilation syndrome
Authors: K E Jordan, M Ali, J M Shneerson
Journal: Thorax (2009)

Obesity hypoventilation syndrome (OHS) is characterised by a body mass index of >30 kg/m2, with either diurnal or nocturnal hypoventilation in the absence of any other explanation for this.1 If left untreated, OHS can be associated with significant morbidity and mortality. Currently, the mainstay of treatment for OHS is non-invasive ventilation. Pulmonary rehabilitation (PR) is an established form of treatment for patients with chronic obstructive pulmonary disease (COPD).2 PR is increasingly offered to patients with various other chronic respiratory diseases, and a similar programme with particular emphasis on obesity can reasonably be expected to benefit patients with OHS.

At Papworth hospital, we …
Independent prognostic value of BCR-ABL1-like signature and IKZF1 deletion, but not high CRLF2 expression, in children with B-cell precursor ALL
Authors: Arian van der Veer, Esmé Waanders, Rob Pieters, Marieke E. Willemse, Simon V. Van Reijmersdal, Lisa J. Russell, Christine J. Harrison, William E. Evans, Vincent H. J. van der Velden, Peter M. Hoogerbrugge, Frank Van Leeuwen, Gabriele Escherich, Martin A. Horstmann, Leila Mohammadi Khankahdani, Dimitris Rizopoulos, Hester A. De Groot-Kruseman, Edwin Sonneveld, Roland P. Kuiper, Monique L. Den Boer
Journal: Blood (2013)
Regulation of leucocyte homeostasis in the circulation
Authors: Christoph Scheiermann, Paul S. Frenette, Andrés Hidalgo
Journal: Cardiovascular Research (2015)

The functions of blood cells extend well beyond the immune functions of leucocytes or the respiratory and hemostatic functions of erythrocytes and platelets. Seen as a whole, the bloodstream is in charge of nurturing and protecting all organs by carrying a mixture of cell populations in transit from one organ to another. To optimize these functions, evolution has provided blood and the vascular system that carries it with various mechanisms that ensure the appropriate influx and egress of cells into and from the circulation where and when needed. How this homeostatic control of blood is achieved has been the object of study for over a century, and although the major mechanisms that govern it are now fairly well understood, several new concepts and mediators have recently emerged that emphasize the dynamism of this liquid tissue. Here we review old and new concepts that relate to the maintenance and regulation of leucocyte homeostasis in blood and briefly discuss the mechanisms for platelets and red blood cells.
Safety of long-acting β agonists for the treatment of asthma: clearing the air
Authors: Gustavo J Rodrigo, José A Castro-Rodríguez
Journal: Thorax (2011)

Concerns about the safety of long-acting β2-agonist (LABA) therapy, has led to the appearance of multiple publications and recommendations. This review critically examines the available clinical evidence and safety requirements for LABA use. On the basis of nearly 20 systematic reviews and databases, the authors conclude that LABA monotherapy significantly increases the risk of asthma-related adverse effects. We also conclude that the use of LABAs concomitantly with inhaled corticosteroids (ICS) significantly reduces asthma hospitalisations and is not associated with life-threatening events and asthma-related deaths, especially when concurrent use of LABAs and ICS can be reasonably assured (use of a single inhaler device). An appropriate clinical study would require an extremely large sample, making it impractical. Finally, some of the new US Food and Drug Administration (FDA) recommendations have caused confusion and do not appear to be fully evidence based. Although limited by low statistical power, the evidence supports the use of LABAs plus ICS in a single inhaler device (to increase adherence and reduce the potential use of LABA monotherapy) for all patients (not only children) with moderate to severe asthma.