tbuckley/cabot-search huggingface dataset:
P91 Can healthcare professionals in a respiratory unit correctly set an oxygen flow rate on a standard oxylitre medical regulator?
Authors: S. J. Billington, C. Mordaunt, R. M. Angus, L. G. Spencer
Journal: Thorax (2010)

<h3>Background</h3> It is known that prescribing practice in UK hospitals for oxygen is often suboptimal. In our Trust we are already working towards improving oxygen prescription practice. However, if we improve prescribing but do not ensure administration is also robust then patient safety will not be achieved. There is potential for serious harm and even death if oxygen management is incorrect (National Patient Safety Agency 2009/RRR006). We investigated how accurate our oxygen administration practice is. <h3>Method</h3> Between January and March 2010 we randomly approached 100 healthcare professionals working on our respiratory wards. They were asked (1) to demonstrate where they would position the ball on a standard oxylitre medical regulator to set a flow rate of 2 l of oxygen per minute, (2) whether they had received training in the use of oxygen flow metres and (3) if they had completed the Trusts self-assessment competency form for the use of oxygen flow metres. <h3>Results</h3> Of the 100 staff approached 49 were nurses (various grades), 25 doctors (various grades), six physiotherapists, 19 nursing and one medical student. 65 staff set the flow rate correctly, with 33 setting it too high, that is, above the appropriate line and two too low, that is, below the line. 24 (24%) staff had received either formal (medical or nursing school) or informal (from a colleague) training in the use of flow metres. Only seven of the staff had completed the Trusts self-assessment competency form; they all set the flow correctly. <h3>Discussion</h3> The NPSA report 2009 identified a national problem regarding the inappropriate administration and management of oxygen. Our study indicates deficiencies in our practice in this specialist unit. There is a lack of clinical training and a low uptake of the self-assessment competency form. With these observations we are moving to make training and competency assessment mandatory for all clinical staff across the Trust. Also with the confusion we observed in correctly setting our hospitals traditional regulators we are considering switching to calibrated flow metres with a ‘dial’ to select flow which would reduce room for error and make oxygen administration safer.
Changes in acetylcholinesterase, Na+,K+-ATPase, and Mg2+-ATPase activities in the frontal cortex and the hippocampus of hyper- and hypothyroid adult rats
Authors: Haris Carageorgiou, Constantinos Pantos, Apostolos Zarros, Vasileios Stolakis, Iordanis Mourouzis, Dennis Cokkinos, Stylianos Tsakiris
Journal: Metabolism (2007)
Models of brachial to finger pulse wave distortion and pressure decrement
Authors: P GIZDULICH, A PRENTZA, K WESSELING
Journal: Cardiovascular Research (1997)

Objective: To model the pulse wave distortion and pressure decrement occurring between brachial and finger arteries. Distortion reversion and decrement correction were also our aims. Methods: Brachial artery pressure was recorded intra-arterially and finger pressure was recorded non-invasively by the Finapres technique in 53 adult human subjects. Mean pressure was subtracted from each pressure waveform and Fourier analysis applied to the pulsations. A distortion model was estimated for each subject and averaged over the group. The average inverse model was applied to the full finger pressure waveform. The pressure decrement was modelled by multiple regression on finger systolic and diastolic levels. Results: Waveform distortion could be described by a general, frequency dependent model having a resonance at 7.3 Hz. The general inverse model has an anti-resonance at this frequency. It converts finger to brachial pulsations thereby reducing average waveform distortion from 9.7 (s.d. 3.2) mmHg per sample for the finger pulse to 3.7 (1.7) mmHg for the converted pulse. Systolic and diastolic level differences between finger and brachial arterial pressures changed from −4 (15) and −8 (11) to +8 (14) and +8 (12) mmHg, respectively, after inverse modelling, with pulse pressures correct on average. The pressure decrement model reduced both the mean and the standard deviation of systolic and diastolic level differences to 0 (13) and 0 (8) mmHg. Diastolic differences were thus reduced most. Conclusion: Brachial to finger pulse wave distortion due to wave reflection in arteries is almost identical in all subjects and can be modelled by a single resonance. The pressure decrement due to flow in arteries is greatest for high pulse pressures superimposed on low means.
Systematic review of comparative efficacy and tolerability of calcipotriol in treating chronic plaque psoriasis
Authors: D. M Ashcroft
Journal: BMJ (2000)

<h3>Abstract</h3> <b>Objectives:</b> To evaluate the comparative efficacy and tolerability of topical calcipotriol in the treatment of mild to moderate chronic plaque psoriasis. <b>Design:</b> Quantitative systematic review of randomised controlled trials. <b>Subjects:</b> 6038 patients with plaque psoriasis reported in 37 trials. <b>Main outcome measures:</b> Mean difference in percentage change in scores on psoriasis area and severity index, and response rate ratios for both patients9 and investigators9 overall assessments of marked improvement or better. Adverse effects were estimated with the rate ratio, rate difference, and number needed to treat. <b>Results:</b> Calcipotriol was at least as effective as potent topical corticosteroids, calcitriol, short contact dithranol, tacalcitol, coal tar, and combined coal tar 5%, allantoin 2%, and hydrocortisone 0.5%. Calcipotriol caused significantly more skin irritation than potent topical corticosteroids (number needed to treat to harm for irritation 10, 95% confidence interval 6 to 34). Calcipotriol monotherapy also caused more irritation than calcipotriol combined with a potent topical corticosteroid (6, 4 to 8). However, the number needed to treat for dithranol to produce lesional or perilesional irritation was 4 (3 to 5). On average, treating 23 patients with short contact dithranol led to one more patient dropping out of treatment owing to adverse effects than if they were treated with calcipotriol. <b>Conclusions:</b> Calcipotriol is an effective treatment for mild to moderate chronic plaque psoriasis, more so than calcitriol, tacalcitol, coal tar, and short contact dithranol. Only potent topical corticosteroids seem to have comparable efficacy at eight weeks. Although calcipotriol caused more skin irritation than topical corticosteroids this has to be balanced against the potential long term effects of corticosteroids. Skin irritation rarely led to withdrawal of calcipotriol treatment. Longer term comparative trials of calcipotriol versus dithranol and topical corticosteroids are needed to see whether these short term benefits are mirrored by long term outcomes such as duration of remission and improvement in quality of life.
Quinone-responsive multiple respiratory-chain dysfunction due to widespread coenzyme Q10 deficiency
Authors: Agnés Rötig, Eeva-Liisa Appelkvist, Vanna Geromel, Dominique Chretien, Noman Kadhom, Patrick Edery, Marc Lebideau, Gustav Dallner, Arnold Munnich, Lars Ernster, Pierre Rustin
Journal: The Lancet (2000)
Hemodynamic and Functional Assessment of Patients with Sickle Cell Disease and Pulmonary Hypertension
Authors: Anastasia Anthi, Roberto F. Machado, Maria L. Jison, Angelo M. Taveira-DaSilva, Lewis J. Rubin, Lori Hunter, Christian J. Hunter, Wynona Coles, James Nichols, Nilo A. Avila, Vandana Sachdev, Clara C. Chen, Mark T. Gladwin
Journal: American Journal of Respiratory and Critical Care Medicine (2007)

Although pulmonary hypertension (PH) is a common complication of sickle cell disease (SCD) associated with high mortality, there exist few data characterizing hemodynamics and cardiopulmonary function in this population.To characterize hemodynamics and cardiopulmonary function in patients with SCD with and without PH.Patients with SCD with PH (n = 26) were compared with control subjects with SCD but without PH (n = 17), matched for age, hemoglobin levels, and fetal hemoglobin levels.Upon catheterization, 54% of the patients with PH had pulmonary arterial hypertension, and 46% had pulmonary venous hypertension. When compared with control subjects, patients with PH exhibited lower six-minute-walk distance (435 +/- 31 vs. 320 +/- 20 m, p = 0.002) and oxygen consumption (50 +/- 3% vs. 41 +/- 2% of predicted, p = 0.02), and also had mild restrictive lung disease and more perfusion abnormalities on radionuclide lung scans. The six-minute-walk distance in this population inversely correlated with tricuspid regurgitant jet velocity (r = -0.55, p < 0.001), and mean pulmonary artery pressure (r = -0.57, p < 0.001), and directly correlated with maximal oxygen consumption (r = 0.49, p = 0.004), even after adjustment for hemoglobin, supporting an independent contribution of increasing pulmonary artery pressures to loss of exercise capacity.Patients with SCD-associated PH have both pulmonary arterial and venous PH associated with severe limitations in exercise capacity, likely compounded by interstitial lung fibrosis and severe anemia. These data support the use of the six-minute-walk distance as an index of PH and cardiopulmonary function in patients with SCD.
Endothelial cell marker expression in dysplastic lesions of the liver: an immunohistochemical study
Authors: Sophie Frachon, Géraldine Gouysse, Jérôme Dumortier, Anne Couvelard, Mimoun Nejjari, François Mion, Françoise Berger, Pierre Paliard, Olivier Boillot, Jean-Yves Scoazec
Journal: Journal of Hepatology (2001)
The effect of the NK2 tachykinin receptor antagonist SR 48968 (saredutant) on neurokinin A-induced bronchoconstriction in asthmatics
Authors: J Van Schoor, GF Joos, BL Chasson, RJ Brouard, RA Pauwels
Journal: European Respiratory Journal (1998)

Inhalation of neurokinin (NK) A causes bronchoconstriction in patients with asthma. The NKA-induced bronchoconstriction in isolated human airways is mediated via the NK2 receptor and inhibited by SR 48968, a potent and specific nonpeptide tachykinin NK2 receptor antagonist. In the present study, the effect of orally administered SR 48968 on NKA-induced bronchoconstriction was examined in 12 mild asthmatics. On the screening day and during the study periods, increasing concentrations of NKA (3.3 x 10(-9) to 1.0 x 10(-6) mol x mL(-1)) were inhaled, until the forced expiratory volume in one second (FEV1) and specific airway conductance (sGaw) decreased by at least 20 and 50%, respectively. During the study periods, 100 mg SR 48968 or matched placebo was ingested in a double-blind, randomized, crossover fashion and NKA provocation was performed at 1.5 and 24 h after dosing. At 1.5 h, the mean (SEM) log10 provocative concentration of NKA causing a 20% fall in FEV1 (PC20 FEV1) was -6.25 (0.20) after SR 48968 and -6.75 (0.17) after placebo (p=0.05); the mean log10 provocative concentration of NKA causing a 35% fall in sGaw (PC35 sGaw) was -7.02 (0.28) after SR 48968 and -7.64 (0.19) after placebo (p=0.05). At 24 h, the mean log10 PC20 FEV1 was -6.21 (0.17) after SR 48968 and -6.65 (0.11) after placebo (p=0.05); the mean log10 PC35 sGaw was -6.85 (0.23) after SR 48968 and -7.17 (0.15) after placebo (nonsignificant). As PC20 FEV1 and/or PC35 sGaw were not reached in up to 4 patients per SR 48968 group, the differences between SR 48968 and placebo were underestimated. In conclusion, oral treatment with 100 mg SR 48968 caused a significant inhibition of neurokinin A-induced bronchoconstriction in asthmatics. This finding constitutes the first evidence of inhibition of sensory neuropeptide-induced bronchoconstriction by a selective tachykinin receptor antagonist in humans.
Nicotine Transdermal Patch and Atypical Antipsychotic Medications for Smoking Cessation in Schizophrenia
Authors: Tony P. George, Douglas M. Ziedonis, Alan Feingold, W. Thomas Pepper, Cheryl A. Satterburg, Justin Winkel, Bruce J. Rounsaville, Thomas R. Kosten
Journal: American Journal of Psychiatry (2000)

OBJECTIVE: Schizophrenic patients have high rates of cigarette smoking. The authors compared the outcomes of two group psychotherapy programs for smoking cessation in patients with schizophrenia or schizoaffective disorder who were also treated with the nicotine transdermal patch and with either atypical or typical antipsychotic medications. METHOD: Forty-five subjects were randomly assigned to 1) the group therapy program of the American Lung Association (N=17) or 2) a specialized group therapy program for smokers with schizophrenia (N=28) that emphasized motivational enhancement, relapse prevention, social skills training, and psychoeducation. All subjects participated in 10 weeks of treatment with the nicotine transdermal patch (21 mg/day) and 10 weekly group therapy sessions and continued to receive their prestudy atypical (N=18) or typical (N=27) antipsychotic medications. Outcome variables included treatment retention, rate of smoking abstinence, and expired-breath carbon monoxide level. RESULTS: Smoking abstinence rates did not differ in the two group therapy programs. However, atypical antipsychotic agents, in combination with the nicotine transdermal patch, significantly enhanced the rate of smoking cessation (55.6% in the atypical agent group versus 22.2% in the typical group), which was reflected by a significant effect of atypical versus typical agents on carbon monoxide levels. Risperidone and olanzapine were associated with the highest quit rates. CONCLUSIONS: The results suggest that 1) smoking cessation rates with the nicotine transdermal patch are modest in schizophrenia, 2) specialized group therapy for schizophrenic patients is not significantly different from American Lung Association group therapy in its effect on smoking cessation, and 3) atypical agents may be superior to typical agents in combination with the nicotine transdermal patch for smoking cessation in schizophrenia.
Regenerative and Proinflammatory Effects of Thrombin on Human Proximal Tubular Cells
Authors: GIUSEPPE GRANDALIANO, RAFFAELLA MONNO, ELENA RANIERI, LORETO GESUALDO, FRANCESCO P. SCHENA, CARMELA MARTINO, MICHELE URSI
Journal: Journal of the American Society of Nephrology (2000)

Interstitial fibrin deposition is a common histologic feature of tubulointerstitial diseases, which suggests that the coagulation system is activated. Thrombin, generated during the activation of the coagulation cascade, is a powerful activating factor for different cell types. Although proximal tubular cells are potential targets for this coagulation factor, no information is available on the effect of thrombin on these cells. Thus, the expression of protease-activated receptor-1 (PAR-1), the main thrombin receptor, was investigated in human proximal tubular cells (hPTC) in vivo and in vitro. A diffuse expression of PAR-1 was observed by immunohistochemistry along the basolateral membrane of PTC in normal human kidney. This observation was confirmed in vitro in cultured hPTC. Because tubular damage and monocyte infiltration are two hallmarks of tubulointerstitial injury, the effect of thrombin on DNA synthesis and monocyte chemotactic peptide-1 (MCP-1) gene and protein expression was evaluated in cultured hPTC. Thrombin induced a significant and dose-dependent increase in thymidine uptake and a striking upregulation of MCP-1 mRNA expression and protein release into the supernatant. Although PAR-1 is a G protein-coupled receptor, its activation in hPTC, as in other cell systems, resulted in a transient increase in cellular levels of tyrosine-phosphorylated proteins. An increased level of tyrosine-phosphorylated c-src suggested the activation of this cytoplasmic tyrosine kinase in response to thrombin and its potential role in thrombin-induced protein-tyrosine phosphorylation. Interestingly, thrombin-induced DNA synthesis and MCP-1 gene expression were completely blocked by genistein, a specific tyrosine kinase inhibitor, but not by its inactive analogue daidzein, demonstrating a central role for tyrosine kinase activation in the thrombin effects on hPTC. Moreover, the specific src inhibitor PP1 abolished the thrombin effect on DNA synthesis. In conclusion, thrombin might represent a powerful regenerative and proinflammatory stimulus for hPTC in acute and chronic tubulointerstitial diseases.
Allergen‐containing immune complexes used for immunotherapy of allergic asthma
Authors: L. K. Poulsen, L. Lunddberg, I. Søndergaard, B. Weeke
Journal: Allergy (1989)

Guinea pigs inbred for their ability to develop respiratory anaphylaxis to experimental antigens have been used for comparison of different forms of immunotherapy (IT). Passive, active and combined (immune complexes between antigen and specific IgG) IT were compared with placebo. The bronchial reactivity of the animals to the antigen was monitored regularly before, during (35 weeks) and after IT (20 weeks). Animals treated with passive IT did not improve clinically. Active and combined IT abolished most symptoms within 7 weeks of treatment. During the post‐treatment period, animals from both groups surprisingly recovered their original sensitivity to inhalation of the antigen.
Increased Early Mortality in Women Undergoing Cardiac Transplantation
Authors: Mindy E. Wechsler, Elsa-Grace V. Giardina, Robert R. Sciacca, Eric A. Rose, Mark L. Barr
Journal: Circulation (1995)

Background To evaluate factors that explain sex differences affecting mortality after cardiac transplantation, a retrospective analysis of adult patients undergoing orthotopic cardiac transplantation was undertaken at the Columbia-Presbyterian Medical Center. Methods and Results The study population consisted of 379 patients (75 women, 304 men) ≥18 years of age who survived for ≥48 hours after undergoing orthotopic cardiac transplantation between March 1985 and March 1992. The following were analyzed: incidence of death and treated rejection episodes, donor and recipient cytomegalovirus (CMV) matches, use of OKT3 induction therapy, and donor and recipient HLA mismatches. Women 49±12 years old and men 47±12 years old were characterized by differences in race and diagnosis. Women were more likely to be nonwhite ( P &lt;.01) and have idiopathic cardiomyopathy than were men ( P &lt;.01). A trend toward an increase in first-year rejection frequency was seen in women compared with men ( P =.08). Overall actuarial survival was significantly reduced in women after transplantation ( P &lt;.05). At 36 months, female actuarial survival was 64±7% versus 76±3% for men ( P &lt;.05). The majority of patients in this study did not receive CMV prophylaxis. Univariate analysis revealed that only CMV(+) donor status and the use of OKT3 induction therapy affected survival in women. Multivariate analysis revealed a marked reduction in survival in female recipients of CMV(+) donors given OKT3 induction therapy. At 36 months, only 25% of women were still alive compared with 86% of women with neither risk factor ( P &lt;.001). Even without OKT3 induction there was markedly reduced survival in women with mismatched CMV status, ie, CMV(−) recipients of CMV(+) donors; 17% survival after 36 months versus 86% in women who were CMV(+) recipients ( P &lt;.05). Although at this institution during the study time period, CMV prophylaxis was not routinely employed and OKT3 induction was selectively used in higher-risk patients, conclusions regarding differences in outcome that are sex dependent are valid. Conclusions (1) Women are at risk for reduced actuarial survival up to 3 years after cardiac transplantation. (2) Univariate analysis shows that women are selectively at risk for death when receiving hearts from CMV(+) donors and after receiving OKT3 induction therapy. (3) Multivariate analysis reveals that women are at even greater risk for death when receiving hearts from CMV(+) donors in conjunction with OKT3 induction therapy. (4) In the absence of OKT3 use, the greatest risk of death occurs in CMV(−) women transplanted with CMV(+) donor hearts. (5) When female to male survival curves are compared, factors that influenced survival in women did not appear to be problematic in men.
A Novel Conditionally Replicative Adenovirus Vector Targeting Telomerase-Positive Tumor Cells
Authors: Qian Huang, Xiuwu Zhang, He Wang, Bin Yan, John Kirkpatrick, Mark W. Dewhrist, Chuan-Yuan Li
Journal: Clinical Cancer Research (2004)

Abstract Purpose: To develop a novel conditionally replicative adenovirus vector that targets telomerase-positive cancer cells. Experimental Design: A telomerase gene-derived promoter was used to control the expression of the E1a gene so that the E1a gene is only expressed in telomerase-positive tumor cells. In addition, a reporter gene was also engineered into the vector so that its infection and replication can be monitored easily. Results: A novel recombinant adenovirus vector that could selectively replicate in telomerase-positive cancer cells was made successfully. This vector showed active replication in a panel of cancer cells and minimal replication in normal human fibroblast or epithelial cells. The recombinant vector could effectively lyse various cultured tumor cells even at very low multiplicity of infection. The replication efficiency in tumor cells is over 103-fold more than normal fibroblast and epithelial cells. In s.c. tumor models, the newly developed telomerase-selective adenovirus vectors exhibited significantly more virus replication and reporter gene expression. Conclusions: The telomerase-targeted adenovirus vector has significant potential as an oncolytic virus as well as a tumor-specific therapeutic gene delivery vehicle.
A study to compare the diagnostic efficacy of closed pleural biopsy with that of the thoracoscopic guided pleural biopsy in patients of pleural effusion
Authors: S.K. Verma
Journal: European Respiratory Journal (2014)

BACKGROUND: The diagnostic approach to exudative pleural effusion remains an underappreciated aspect of modern thoracic medicine. 15-20% of the pleural effusions remain undiagnosed. The most efficient approach to pleural exudates remains uncertain and controversial particularly if acquisition of pleural tissue is required. The clinician needs to consider various factors when confronted with the choice between closed pleural biopsy (CPB) and thoracoscopy. Hence this study was planned to compare the diagnostic efficacy of CPB and Thoracoscopic pleural biopsy (TPB).  MATERIAL & METHODS: This was a prospective interventional study in patients of exudative pleural effusion. CPB was performed by Cope9s biopsy needle. Then inspection of the pleural cavity was performed by single port rigid thoracoscope (KARL, STORZ TELECAM DX II 20 2330 20) with viewing angle of zero (0) degrees and biopsy taken from the diseased or unhealthy parietal pleura. Accordingly we compared the results of CPB and TPB.  RESULTS: 46 Patients underwent this study. In all 46 patients both CPB and TPB were performed.TPB was diagnostic in 36 cases(78.2%) while CPB was diagnostic only in 10 cases i.e.21.7%. 10 (21,7%) cases remained undiagnosed. On thoracoscopic examination 30 patients were having nodularity, 25(54.3%) were having adhesions and 20(43.5%) were having hyperemia.79.3% of the patients with nodularity turned out to be malignant and 71.4% of patients with adhesions and hyperemia tubercular.  CONCLUSIONS: TPB has much greater diagnostic efficacy than CPB .