tbuckley/cabot-search huggingface dataset:
P15 A pilot study of a dedicated ballooned intercostal drain
Authors: S Ross, H Ali, L Allsop, NJ Ali, SV Kemp
Journal: Thorax (2016)

<h3>Introduction</h3> Intercostal tube drainage of pleural air or fluid is an essential tool in the management of respiratory patients. A common complication of drain insertion is accidental removal of the drain, usually as a result of inadequate securing techniques, with rates of up to 21% quoted in the literature.<sup>1,2</sup> This often results in the need for further pleural procedures (including drain re-siting), with associated additional risk to the patient and an increase in health care costs. One suggested method to reduce premature drain removal is to use intercostal drains with ballooned tips. These would provide a relatively atraumatic physical obstruction to the thoracostomy site, whilst being easy to use as stitching or extensive taping may not be required. <h3>Methods</h3> We conducted a pilot study of a dedicated 16F ballooned intercostal drain (Rocket Medical; Figure 1) to assess its safety and feasibility, and to give an indication as to whether a reduction in accidental early drain removal could be achieved. Drains were inserted under ultrasound guidance using the Seldinger technique and secured with dedicated dressings. Skin sutures were not applied. Pain scores were collected from a subset of 11 patients using a visual analogue scale (VAS) from 0 (no pain) to 10 (worst pain imaginable) at insertion, 24h post-insertion, and drain removal to ensure pleural irritation was not prohibitive. <h3>Results</h3> Twenty patients requiring intercostal tube drainage as an in-patient for pleural effusion were recruited from a single hospital site. Of the drains inserted, 1/20 (5%) was prematurely dislodged., comparing favourably with the literature. Inspection of the device showed that the balloon had become partially unglued from the drain, hence deflation. The patient did not require further pleural procedures. No other drain-related adverse events were recorded. The drains were generally well tolerated, with median(range) pain scores at insertion, 24 hours, and removal of 1 (0–7), 3 (0–8), and 2 (0–7). <h3>Conclusion</h3> The use of a dedicated ballooned intercostal drain is safe and feasible, and may reduce the need for drain re-siting. A larger randomised trial is planned. <h3>References</h3> Corcoran JP, <i>et al</i>. Pleural procedural complications: prevention and management. <i>J Thorac Dis</i> 2015;<b>7</b>(6):1058–67. Horsley A, <i>et al</i>. Efficacy and complications of small-bore, wire-guided chest drains. <i>Chest</i> 2006;<b>130</b>:1857–63.
PUB053 Panel Based Hybrid Capture Sequencing Assay to Correlate Mutational Load with Response to Immunotherapy
Authors: Roopika Menon, Erika Mariotti, Judith Mueller, Sotirios Lakis, Naomi Walsch, John Crown, Johannes Heuckmann, Frank Griesinger, Lukas Heukamp
Journal: Journal of Thoracic Oncology (2017)
P1.05-047 Early Mortality in Patients with Non-Small Cell Lung Cancer Undergoing Adjuvant Chemotherapy
Authors: Daniel Morgensztern, Pamela Samson, Saiama Waqar, Lingling Du, Siddhartha Devarakonda, Ashiq Masood, Cliff Robinson, Varun Puri, Ramaswamy Govindan
Journal: Journal of Thoracic Oncology (2017)
P213 Positive drivers and potential barriers to implementation of hospital at home selected by low risk decaf score
Authors: L Dismore, C Echevarria, A Van-Wersch, AJ Simpson, GJ Gibson, SC Bourke
Journal: Thorax (2016)

<h3>Background</h3> Despite endorsement in guidelines, many hospitals do not offer hospital at home (HAH) for COPD exacerbation (AECOPD), partly reflecting the previous lack of a robust prognostic score to guide selection. The DECAF score addresses this concern, and should be routinely scored on admission.<sup>1</sup> In a RCT we have shown that HAH selected by DECAF score 0–1 is safe and effective. Up to 50% of admitted patients are suitable. Our population included patients with higher medical dependency than earlier trials and HAH was supported by 24/7 specialist on-call. In an embedded qualitative study, we identified positive drivers for, and potential barriers to, use of HAH to inform service implementation. <h3>Methods</h3> Patients, carers, clinicians and managers were purposely selected to ensure diversity. Semi-structured interviews were conducted and Thematic-Construct Analysis employed.<sup>2</sup> <h3>Results</h3> 44 patients (HAH/inpatient care/declined randomisation), 15 carers, 14 consultants, 11 specialist nurses and 4 managers were interviewed. ‘<i>Positive drivers’ </i>were divided into two sub-constructs: <i>‘Feeling more at ease and comfortable in own home environment’; </i>and <i>‘Feeling safe, reassured and appreciated through continuity of hospital care’. </i>Positive influences on independence, perceived rate of recovery, sleep quality, mood and contact with friends and family were noted. At 14 days post-presentation, 90% of patients stated they would prefer HAH over inpatient care for subsequent exacerbations of similar severity. Counter-intuitively, carers reported greater convenience rather than increased burden. <i>‘Potential Barriers’ </i>were grouped into two sub-constructs: <i>‘Personal preferences’; </i>and <i>‘Resistance to change’. </i>Some patients highlighted fear of being alone at night and dislike of strangers visiting their home; nurses cited higher workload and greater responsibility (with experience, viewed positively); whilst operational concerns included keeping medical records in a patient’s home and inability to capture activity within current payment systems. <h3>Conclusions</h3> HAH selected by DECAF allows the inclusion of more patients than existing models, and is preferred to inpatient care by most patients and their families. During the trial few barriers to implementation were identified, and were effectively overcome. Hospitals planning to implement HAH selected by DECAF should pre-emptively address these issues. <h3>References</h3> National COPD Audit Report, 2015. Dismore. <i>J Health psychol,</i> 2016.
Unstable angina - Clinical manifestations and prognosis of 74 medically-treated patients.
Authors: Toshio Yaginuma, Masao Tsuchiya, Toshitaka Noda, Tomoya Iino, Saichi Hosoda
Journal: Circulation (1983)

Seventy-four patients with unstable angina are reviewed. A rather high incidence (65%) of a changing pattern syndrome was observed in the study group. A history of prior myocardial infarction was obtained in 22 patients (30%). Fifty-seven patients (77%) were investigated using coronary angiography : 15 did not have any significant occlusive disease but are included in this study ; single vessel disease was present in 20, double in 8 and triple in 14. Ten patients (13.5%) had myocardial infarcts which had occurred between 48 hours and 3 months after admission, and no patients died during this period. Patients who on admission had resting angina of new onset were more likely to have a worse short-term prognosis. Four patients underwent coronary bypass surgery in the first year of the follow-up period because of unsuccessful medical treatment. Six patients died within the first 4 years. Of the 6 deaths, 5 had triple vessel disease and one did not have any significant coronary stenosis. Mortality rate at 2 years was 2.7% and at 4 years 10.3%. This low mortality is probably attributable to a low incidence of 2- or 3-vessel disease.
M18 Enhanced training for medical registrars learning chest drains and thoracocentesis. understanding total competency level in the work force
Authors: AL Chapman, M Gingell, E Clissold
Journal: Thorax (2016)

Performing a chest drain procedure with a safe technique is a core skill for a medical registrar and arguably the highest risk procedure they are expected to perform at junior level. The competency level of a cohort of registrars who typically rotate every six months is often not known. Little regard is given to this when drawing up on call rotas and training needs are often missed. In this initiative we aimed to address these failings. <h3>Methods</h3> By way of induction for the general medical registrars beginning a six month post in our hospitals we arranged a short verbal introduction to the group about local processes of how chest procedures within our hospital are performed eg. location of equipment in centralised packs, standardised equipment lists, check lists and use of bedside US and patient information/consent. Over the first two weeks of the run we arranged “one on one” teaching with a Consultant chest physician who taught each registrar according to their needs on realistic mannequins. Three techniques taught: thoracocentesis with an 8 F drainage pack; a small bore 12 F seldinger drain and a surgical 28 F drain drain according to need. Teaching of 32 registrars was completed within a two week time frame in the space of four PA/clinic sessions. Competency was judged at the end of the session and electronic DOPS and feedback from the registrars was obtained. We encouraged further discussion with educational supervisors with regard to ongoing training requirements for individuals. <h3>Results and evaluation</h3> Attendance was 31/32. 59% had 12 months or less experience as a registrar. 66% were able to perform thoracocentesis and 63% seldinger drain independently. Most others were competent enough to perform with a colleague supervising. Additionally 38% and 25% of registrars were deemed to be able to teach other thoracocentesis and seldinger drains respectively. Learner feedback was extremely positive and self-rated confidence and safety improved from 5–7.6 and 5.2 to 7.7 out of 10 respectively. Responses highly valued the fact this was delivered by a Consultant and identified a need for further bedside chest US training.
P267 Dlco predicts disease severity and mortality in bronchiectasis
Authors: MJ McDonnell, M O’Mahony, D Breen, JJ Gilmartin, A O’Regan, RM Rutherford
Journal: Thorax (2016)

<h3>Background</h3> Few studies have assessed the role of lung diffusing capacity (DLCO%) in bronchiectasis. We sought to examine the relationship between DLCO% and clinical and radiological variables in a well-defined population of bronchiectasis patients to determine its potential prognostic significance and compare with FEV<sub>1</sub>%. <h3>Methods</h3> Of 312 consecutive bronchiectasis patients attending our institution over a 3-year period, 204 patients were suitable for study inclusion. Exclusion criteria consisted of patients with cystic fibrosis or traction bronchiectasis, patients with missing data and patients with absent radiological evidence of bronchiectasis on independent expert thoracic radiologist review. Univariate analyses was performed using Pearson’s correlation. Backwards stepwise logistic regression analysis was subsequently performed to determine independent associations of DLCO% and FEV1%. <h3>Results</h3> DLCO% strongly correlated with all measured lung function parameters FEV<sub>1</sub>%, FVC%, FEF 25–75% and FEV<sub>1</sub>/FVC ratio (all p &lt; 0.001). Negative correlations were noted with age at diagnosis (p = 0.047), body mass index (p &lt; 0.001) and number of comorbidities (p = 0.002). Significant symptom associations included SOB (p = 0.001) and fatigue (p &lt; 0.001). Reduced DLCO% was associated with higher MRCD scores (p &lt; 0.001), higher number of hospitalisations on follow up (p = 0.015), higher BSI scores (p &lt; 0.001) and increased mortality (p = 0.028). No correlations were noted with gender, smoking history, aetiology or bacterial colonisation of any form. Reduced DLCO% was associated with increased number of lobes (p = 0.004), and higher total Reiff and modified Bhalla HRCT scores (p = 0.001 and p &lt; 0.001 respectively). The modified Bhalla was excluded from stepwise regression as unavailable in most clinical settings. Backwards elimination showed DLCO% to be significant in predicting BSI (p &lt; 0.001), number of lobes (0.017) and mortality (p = 0.028). Comparatively, backwards stepwise regression of FEV<sub>1</sub>% showed significance in predicting BSI (p &lt; 0.001), number of hospitalisations on follow up (p = 0.008), and mortality (p = 0.024). Separate regression models of DLCO% and FEV<sub>1</sub>% using modified Bhalla components as cofactors showed DLCO% to be associated with disease extent (p = 0.002), bronchial wall thickness (p &lt; 0.001), bronchial wall dilatation (p &lt; 0.001) and reduced parenchymal attenuation (p = 0.015); FEV<sub>1</sub>% was associated with bronchial wall dilatation only (p &lt; 0.001). <h3>Conclusion</h3> DLCO% predicts radiological disease, disease severity and mortality in bronchiectasis, independently of aetiology, and may identify patients with advanced disease who could benefit from intensive management.
Aspirin enhances TRAIL-induced apoptosis of colon cancer cells
Authors: Mathilde Jalving, Ineke A. Sloots, Jan H. Kleibeuker, Elisabeth G E De Vries, Steven De Jong
Journal: Cancer Research (2006)

755  Background: TNF-related apoptosis inducing ligand (TRAIL) is a novel anti-cancer drug, which can induce apoptosis in human colorectal adenoma and carcinoma cell lines. However, not all colon cancer cell lines are sensitive to TRAIL and resistance to TRAIL can be aquired. Aspirin has a chemopreventive effect in colorectal cancer and may be able to enhance TRAIL-induced apoptosis. The aim of this study was to investigate whether aspirin sensitises colon cancer cells to TRAIL-induced apoptosis and to investigate the mechanisms involved. Methods: Three human colon cancer cell lines with varying senstivities to rhTRAIL, as well as a cell line with acquired TRAIL resistance, and a cell line in which dominant negative (dn) expression of T-cell factor (TCF) can be induced by doxycyclin were used. The cell lines were exposed to aspirin (0-10mM) and/or rhTRAIL (0-1 ug/ml). Apoptosis and caspase activation were evaluated using immunocytochemistry for cleaved cytokeratin 18, fluorescence microscopy, fluorometric caspase assays and Western blotting. Cell membrane expression levels of the TRAIL receptors were measured using flow-cytometric analysis. Expression levels of caspase 8 and c-FLIP were evaluated using Western blotting. Results: Aspirin sensitised all cell lines to rhTRAIL-induced apoptosis and this effect was dose dependent. Addition of 10 mM aspirin led to a two to nine fold increase in rhTRAIL-induced apoptosis measured using fluorescence microscopy. These results were confirmed using immunocytochemistry. Increased apoptosis was accompanied by caspase-3 and caspase-8 activation and PARP cleavage. Aspirin induced increased levels of procaspase-8 and marginally reduced c-FLIP protein expression. Aspirin, however, had no effect on rhTRAIL-induced apoptosis when dnTCF was expressed. Conclusion: Aspirin sensitises colon cell lines with intrinsic TRAIL resistance, as well as those with aquired TRAIL resistance to rhTRAIL-induced apoptosis. This effect is mediated through the TCF transcription factor and is accompanied by a change in caspase 8-FLIP ratios. Supported by the Dutch Cancer Society grant 2005-3361.
Identification of a Novel Auto-Antibody Highly Prevalent in Patients with Hepatitis-Associated and Idiopathic Aplastic Anemia.
Authors: Hiroyuki Takamatsu, Zhirong Qi, Tomoyuki Sakurai, Luis Espinoza, Naomi Sugimori, Hirohito Yamazaki, Katsuya Okawa, Shinji Nakao
Journal: Blood (2009)
Aetiology of febrile pharyngitis in children: Potential of myxovirus resistance protein A (MxA) as a biomarker of viral infection
Authors: Lauri Ivaska, Jussi Niemelä, Johanna Lempainen, Riikka Österback, Matti Waris, Tytti Vuorinen, Jukka Hytönen, Kaisu Rantakokko-Jalava, Ville Peltola
Journal: Journal of Infection (2017)

Besides group A streptococcus (GAS), microbial causes of pharyngitis in children are not well known. We aimed to document the viral and bacterial aetiology of pharyngitis and to assess the pathogenic role of viruses by determining the myxovirus resistance protein A (MxA) in the blood as a marker of interferon response.In this prospective observational study, throat swabs and blood samples were collected from children (age 1-16 years) presenting to the emergency department with febrile pharyngitis. Microbial cause was sought by bacterial culture, polymerase chain reaction, and serology. Blood MxA level was determined.A potential pathogen was detected in 88% of 83 patients: GAS alone in 10%, GAS and viruses in 13%, group C or G streptococci alone in 2% and together with viruses in 3%, and viruses alone in 59% of cases. Enteroviruses, rhinoviruses, and adenoviruses were the most frequently detected viruses. Blood MxA levels were higher in children with viral (880 [245-1250] μg/L; median [IQR]) or concomitant GAS-viral (340 [150-710] μg/L) than in those with sole GAS (105 [80-160] μg/L) infections.Detection of respiratory viruses simultaneously with elevated blood MxA levels supports the causative role of viruses in the majority of children with pharyngitis.
P2.03b-053 Role of KRAS Mutation Status in NSCLC Patients Treated on SWOG S0819, a Phase III Trial of Chemotherapy with or without Cetuximab
Authors: Philipp Mack, James Moon, Roy Herbst, Edward Kim, Thomas Semrad, Mary Redman, Rebekah Tsai, Leslie Solis, Jeffrey Gregg, Sandra Hatcher, Marileila Varella-Garcia, Fred R. Hirsch, Charles Blanke, Karen Kelly, David R. Gandara
Journal: Journal of Thoracic Oncology (2017)
P200 Large scale implementation of copd discharge bundle
Authors: J Congleton, JP Crofton-Biwer, T D’Auvergne, J Bott
Journal: Thorax (2016)

<h3>Introduction</h3> COPD Discharge Bundles have been associated with reduction in 30 day re-admission rates.<sup>1 </sup>Kent, Surrey, Sussex Respiratory Programme aims to improve respiratory care by spreading good practice and reducing variation. We monitor outcomes via our regional COPD Dashboard. In 2014 we decided to start a project to support acute hospital trusts to deliver a COPD discharge bundle <h3>Methods</h3> We held twice yearly collaborative meetings with respiratory clinicians establishing region wide support for implementation of the bundle. By consensus working the teams agreed wording for a KSS bundle, based on the BTS bundle. A data dictionary and a data collection tool were created to standardise collection of data. Results are fed back to teams monthly via a bespoke reporting tool. Educational sessions on improving quality and delivery of the bundles are part of the collaborative meetings, e.g. ‘train the trainers’ inhaler technique. <h3>Results</h3> 10 of 11 acute trusts in the region now deliver the COPD discharge bundle. 8 of those submit data to the regional reporting tool. Prior to the project only one trust in the region was systematically delivering the COPD discharge bundle. At the start of the programme in October 2014, for the trusts reporting data, 222 patients per month (45% of HES recorded COPD admissions) were receiving at least some elements of the tool. By October 2015 the number had increased to 330 (66% of HES recorded COPD admissions). The percentage of recorded patients documented as receiving each element of the bundle in KSS is shown in Table 1. By October 2015, the percentage of AECOPD patients recorded as receiving every element of the discharge bundle had increased from a baseline of 4% to 25%. We aim to assess impact of bundle compliance on outcome measures. Data to Q4 2015/16 show a regional reducing 30 day readmission rate trend compared to prior to the project . <h3>Conclusion</h3> With strong clinical networks and collaborative working it is possible to implement a more unified approach to delivery across a large geographical area. <h3>Reference</h3> Hopkinson NS, <i>et al</i>. Designing and implementing a COPD care bundle. <i>Thorax</i> 2012;<b>67</b>(1):90–2.
Pomp and Pestilence: Infectious Disease, Its Origins and Conquest.
Journal: Annals of Internal Medicine (1956)

surgery in heart disease.As such it covers the great majority of common conditions in which emergencies occur.Mention is not made, but would seem useful, of shock other than in myocardial infarction and of cardiovascular com- plications of pregnancy and labor.The presentation of details of drug administration and other therapy is succinct and current.This is noteworthy in digitalis intoxication, arrhythmias -and myocardial infarction.Short case histories enliven the presentations of results of therapy and the brief comments on the pathologic physiology and clinical patterns give reason for the therapy presented for various conditions.
P3.05-007 Prospective Evaluation for Combination Antiemetic Therapy on CINV in NSCLC Receiving Carboplatin-Based Chemotherapy of MEC
Authors: Mototsugu Shimokawa, Fumihiko Hirai, Kaname Nosaki, Takashi Seto, Toshinobu Hayashi, Reiko Matsui, Koichi Takayama, Yoichi Nakanishi, Keisuke Aiba, Kazuo Tamura, Koichi Goto
Journal: Journal of Thoracic Oncology (2017)
NK and T-Cell Status as Well as Their Perforin Expression Is Related to Clinical Severity and Outcome in Difuse Large Cell Lymphoma.
Authors: Antonio Gutierrez, Jose Rodriguez, Jordi Martinez, Carmen Ballester, Catalina Crespi, Maria Dolores Bea, Juan Carlos Amat, Roberto Villavicencio, Miguel Morey, Maria Antonia Duran, Cristina Linares, Julio Rifa, Antonia Bautista, Oliver Voegler, Regina Alemany, Antonia Sampol, Joan Besalduch
Journal: Blood (2007)
Comparative Study on the Fatty Acid Composition of Lipids in Thoracic Duct Lymph, Serum and Diet of the Rat and Rabbit
Authors: Kanji Seiki, Akira Yamashita, Akiyoshi Takashima, Fumio Rai, Masahiko Kotani
Journal: Circulation (1964)

Comparative study was carried out on the fatty acid composition of the lipids of thoracic duct lymph, aortic blood serum and diet of the rat and rabbit. Analysis of the fatty acid was made by gas-liquid chromatography. Major acids in lymph and serum of rats were palmitic, stearic, oleic, linoleic and arachidonic acids. In rabbits, the arachidonic acid level was, however, very low both in lymph and serum. On the other hand, a great quantity of linolenic acid was contained in both lymph and serum of rabbits in contrast to rats. Particularly interesting was the presence of fatty acids with 15 and 17 carbon atoms in lymph and serum of all examined rats and rabbits whereas the percentage composition of these acids was very low. Small amounts of lauric, myristic and palmitoleic acids were also present in lymph and serum of both animals. In addition to this, there was a possility of appearance of 13:1 or branched 14 :0, 14:1, 15:1 or branched 16:0, 16:2 or branched 18 :0, 20:1 and 20:3 acids. An unknown acid which followed arachidonic acid was noted in lymph and serum of rats while the nature of this acid has not yet been determined. Major fatty acids found in lymph were all observed in diet. The same odd carbon fatty acids in lymph was also identified in diet. The percentages of most of the components in lymph run roughly parallel to those in diet in each animal. The stearic and arachidonic acids were, however, the exceptions in rats. The level of stearic and arachidonic acids was greatly higher in lymph and serum than in diet. In rabbits, stearic acid showed the same relationship as in rats, but arachidonic acid was contained in a small quantity both in lymph and diet. The linoleic acid was the largest component in lymph and diet of both animals. A great difference in the percentage composition of linolenic acid in lymph and serum between the rat and rabbit might be obtained from the difference of the content of this acid in diets.
P3.03-021 When RON MET TAM in Mesothelioma: All Druggable for One, and One Drug for All?
Authors: Anne-Marie Baird, David Easty, Monika Jarzabek, Liam Shiels, Alex Soltermann, Stéphane Raeppel, Lauren Mcdonagh, Chengguang Wu, Chandra Goparju, Bryan Stanfill, Martin Barr, Daisuke Nonaka, Bruno Murer, Dean Fennell, Dearbhaile O’Donnell, Luciano Mutti, Stephen Finn, Sinead Cuffe, Harvey Pass, Isabelle Schmitt-Opitz, Annette Byrne, Kenneth O’Byrne, Steven Gray
Journal: Journal of Thoracic Oncology (2017)