tbuckley/cabot-search huggingface dataset:
Pulmonary Infarction and Atrophy of the Spleen Associated with Sickle-Cell Hemoglobin C Disease
Authors: Francis Y. K. Lau
Journal: New England Journal of Medicine (1959)

ALTHOUGH sickle-cell disease has been associated with vascular thrombosis and tissue infarction1 sickle states have only recently been associated with similar phenomena. Splenic infarctions,2 3 4 5 pulmonary infarctions,7 cerebral thrombosis,8 maternal deaths,6 bony changes9 and hematuria10 , 11 are some of the phenomena occurring with sickle states. The purpose of this paper is to recognize the potential dangers associated with sickle states and to report the occurrence of an atrophied, siderofibrotic spleen in sickle-cell hemoglobin C disease.Case ReportA 34-year-old Negro laborer was admitted to the Oakland Veterans Administration Hospital with pulmonary complaints on 5 different occasions after November 22, 1948. The only . . .
Surgery in Polycythemia Vera
Authors: Louis R. Wasserman, Harriet S. Gilbert
Journal: New England Journal of Medicine (1963)

THE course of polycythemia vera is complicated by hemorrhagic and thromboembolic phenomena of varying severity occurring in about a third of the cases. These complications have been ascribed to the hypervolemia and increased red-cell mass, with resultant sluggish blood flow, capillary distention with poor retractability, thrombocytosis and a complex hemostatic defect manifested by ineffective clot formation despite the presence of normal or increased cellular and plasma coagulation factors.Surgical procedures for coincidental or complicating diseases appear to be accompanied by an excessively high morbidity and mortality. Although the dangers of surgery in polycythemia vera have been noted1 2 3 4 5 6 7 8 there is little . . .
Carbapenem-resistant isolates of Acinetobacter baumannii in a municipal wastewater treatment plant, Croatia, 2014
Authors: Jasna Hrenovic, Ivana Goic-Barisic, Snjezana Kazazic, Ana Kovacic, Marin Ganjto, Marija Tonkic
Journal: Eurosurveillance (2016)

Acinetobacter baumannii is an emerging hospital pathogen. Whereas A. baumannii isolated from patients or hospitals has been reported, there are few data regarding propagation of viable A. baumannii in the natural environment. This study investigates the occurrence and antimicrobial susceptibility of viable A. baumannii in municipal wastewater and its persistence through the wastewater treatment process. A total of 21 A. baumannii isolates were recovered at a secondary type of municipal wastewater treatment plant in Zagreb, Croatia: 15 from raw influent wastewater and six from final effluent. All isolates were carbapenem- and multidrug-resistant. Among 14 isolates tested for bla OXA genes, all harboured the constitutive bla OXA-51-like gene, while the acquired bla OXA-23-like and bla OXA-40-like genes were found in 10 and three isolates respectively. Six A. baumannii isolates recovered from effluent wastewater multiplied and survived in sterilised effluent wastewater up to 50 days. These findings support the idea that multidrug-resistant A. baumannii can occur and have the ability to survive in the environment.
Meta-Analyses of Human Cell-Based Cardiac Regeneration Therapies
Authors: Mariann Gyöngyösi, Wojciech Wojakowski, Eliano P. Navarese, Lemuel À. Moye
Journal: Circulation Research (2016)

In contrast to multiple publication-based meta-analyses involving clinical cardiac regeneration therapy in patients with recent myocardial infarction, a recently published meta-analysis based on individual patient data reported no effect of cell therapy on left ventricular function or clinical outcome. A comprehensive review of the data collection, statistics, and the overall principles of meta-analyses provides further clarification and explanation for this controversy. The advantages and pitfalls of different types of meta-analyses are reviewed here. Each meta-analysis approach has a place when pivotal clinical trials are lacking and sheds light on the magnitude of the treatment in a complex healthcare field.
A Prospective Analysis of Meat Mutagens and Colorectal Cancer in the Nurses’ Health Study and Health Professionals Follow-up Study
Authors: Ngoan Tran Le, Fernanda Alessandra Silva Michels, Mingyang Song, Xuehong Zhang, Adam M. Bernstein, Edward L. Giovannucci, Charles S. Fuchs, Shuji Ogino, Andrew T. Chan, Rashmi Sinha, Walter C. Willett, Kana Wu
Journal: Environmental Health Perspectives (2016)

Heterocyclic amines (HCAs) in cooked meats may play a role in colorectal cancer (CRC) development.We aimed to prospectively examine the association between estimated intakes of HCAs and meat-derived mutagenicity (MDM) in two cohorts of health professionals, the Health Professionals Follow-up Study (HPFS) and the Nurses' Health Study (NHS).In 29,615 men and 65,875 women, intake of the HCAs 2-amino-3,8-dimethylimidazo(4,5-j)quinoxaline (MeIQx), 2-amino-1-methyl-6-phenylimidazo(4,5-b)pyridine (PhIP), 2-amino-3,4,8-trimethylimidazo(4,5-f)quinoxaline (DiMeIQx), and MDM was estimated using a 1996 cooking questionnaire, the 1994 food frequency questionnaire, and an online database. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) and to adjust for potential confounders. Estimates for both cohorts were pooled using random-effects meta-analysis.Between 1996 and 2010, 418 male and 790 female CRC cases were identified. Meat mutagen intake was not statistically significantly associated with risk of CRC [highest vs. lowest quintile, pooled HR (95% CI) for MeIQx: 1.12 (0.93, 1.34), p for trend 0.23; PhIP: 1.10 (0.90, 1.33), p for trend 0.35; MDM: 1.03 (0.86, 1.24), p for trend 0.75] or subtypes of CRC defined by tumor location (proximal or distal colon, or rectum). When analyzed by source of meat, PhIP from red but not from white meat was nonsignificantly positively associated with CRC and significantly positively associated with proximal cancers [HR (95% CI) per standard deviation increase of log-transformed intake: PhIP red meat: CRC: 1.06 (0.99, 1.12), proximal: 1.11 (1.02, 1.21); PhIP white meat: CRC: 0.99 (0.94, 1.04), proximal: 1.00 (0.93, 1.09)].Estimated intakes of meat mutagens were not significantly associated with CRC risk over 14 years of follow-up in the NHS and HPFS cohorts. Results for PhIP from red but not from white meat warrant further investigation.Le NT, Michels FA, Song M, Zhang X, Bernstein AM, Giovannucci EL, Fuchs CS, Ogino S, Chan AT, Sinha R, Willett WC, Wu K. 2016. A prospective analysis of meat mutagens and colorectal cancer in the Nurses' Health Study and Health Professionals Follow-up Study. Environ Health Perspect 124:1529-1536; http://dx.doi.org/10.1289/EHP238.
Calcium Carbimide in the Treatment of Primary Hyperoxaluria
Authors: C. C. Solomons, S. I. Goodman, C. M. Riley
Journal: New England Journal of Medicine (1967)

A DEFECT in the transamination of glyoxalate has been suggested as the metabolic abnormality responsible for the increased rate of oxalate synthesis in patients with primary hyperoxaluria (Fig. 1).1 Some of this excess oxalate combines with calcium to form insoluble deposits in a variety of tissues, resulting, in the kidney, in extensive scarring and progressive renal failure. In a recent review article2 no specific therapy for this disease was proposed. From a consideration of Figure 1 it is evident that, regardless of the site of the metabolic block, any agent that depresses the rate of oxalate formation may be expected to be . . .
Same-day breast core biopsy result: Effect on ER/PR and HER-2 scores
Authors: S. Al-Sam, S. Al-Ramadhani, S. Jader, J. Singer, A. Aylwin
Journal: Journal of Clinical Oncology (2009)

e11585 Background: The peloris rapid tissue processor promises same-day biopsy results. It uses a unique ActivFlo system achieving fast processing by rapid even heating and reagent exchange. The effect on ER/PR, Her2 scores and morphology of tumour cells are assessed Methods: 80 breast core biopsies were so far included in this study. For each case, one of three core biopsies was processed by the Peloris and the other two by the Leica histology processor for next day reporting. Each core biopsy was fixed in formalin for at least 3 - 6 hours before being processed by both systems.Immunohistochemistry for ER, PR and Her2 was carried out as well as FISH for borderline Her2 cases scoring 2+. Microscopical features were compared by the same histopathologist and tumour grade and type were recorded Results: On comparing cases processed by Peloris and Leica, 47 out of 68 biopsies (69%) scored exactly the same for ER and PR. 16 biopsies (23.5%) had minor scoring differences but did not affect the overall hormone receptor status. In total, 63 out of 68 biopsies (94%) scored similar receptor status. 4 cases (6%) had differing ER/PR status. 56 cases had Her2 tested, 51 (91%) had similar scores and 5 (9%) had different scores. 14 borderline cases had FISH tests and no different results were seen between Peloris and Leica processed tissue. Morphologically there were differences in size of nuclei and nuclear chromatin appearances. We have started the second part of the study in which biopsies for the Peloris are loaded immediately on receipt giving about 30 minutes of formalin fixation. Of the 9 biopsies so far processed, there have been no noticeable differences between the fixed tissue on the Leica processor and the fresh tissue on Peloris with regards to ER, PR and Her2. Conclusions: In conclusion, immunohistochemistry for ER/PR and Her2 is similar in 93% and 91% cases respectively. Results for FISH test were similar in all 14 cases. However, morphological differences were noted and the effect on tumour grade was discussed. Further evaluation and comparison of tissue using both processors on morphological architecture need to be carried out and any differences reported. No significant financial relationships to disclose.
Coronary Arteriovenous Fistula on Coronary Angiography
Authors: K Fujise, W Sherman
Journal: New England Journal of Medicine (1994)

Figure 1. Coronary Arteriovenous Fistula on Coronary Angiography. A large coronary arteriovenous fistula can be seen originating in the left coronary artery, coursing over the lateral and posterior walls of the left ventricle, and eventually emptying into the right atrium. The solid arrow indicates the origin of the fistula (not well visualized), and the open arrow indicates a normal-sized left anterior descending coronary artery, which is of much smaller caliber than the greatly dilated fistula. Patients with such fistulas often have loud continuous cardiac murmurs and may have congestive heart failure, myocardial ischemia (due to a coronary-artery ”steal” phenomenon), and . . .
Randomized Phase II Study of Cpt-11 Vs Ptx; +/- S1 in Advanced Gastric Cancer Refractory to S1 or S1 + Platinum(Ogsg0701)
Authors: Naotoshi Sugimoto, Hiroshi Imamura, Masahiro Goto, Yutaka Kimura, Shugo Ueda, Yukinori Kurokawa, Daisuke Sakai, Toshio Shimokawa, Toshimasa Tsujinaka, Hiroshi Furukawa
Journal: Annals of Oncology (2014)
Restenosis after Angioplasty
Authors: Richard O Cannon
Journal: New England Journal of Medicine (2002)

Over the past two decades, percutaneous coronary intervention has revolutionized the treatment of symptomatic coronary artery disease, sparing countless patients the need for surgical revascularization. This year, up to a million procedures are likely to be performed in North America alone.The success of percutaneous coronary intervention has been due largely to an explosion in technology development, with the introduction of a broad array of balloon catheters, atherectomy devices, lasers, and stents. The impetus for the development of such devices has been the occurrence — noted soon after the introduction of balloon angioplasty — of intimal tears, arterial recoil, and . . .
QOL-07DESCRIPTION OF CLINICAL AND PATIENT REPORTED OUTCOMES ASSESSMENTS FROM A PHASE 3, MULTICENTER, RANDOMIZED TRIAL EVALUATING NIVOLUMAB MONOTHERAPY VERSUS BEVACIZUMAB IN RECURRENT GLIOBLASTOMA: CHECKMATE-143
Authors: Lakshmi Nayak, Alba Brandes, Antonio Omuro, Johannes Rieger, Antje Wick, Surasak Phuphanich, Ashley Sumrall, Solmaz Sahebjam, Manmeet Ahluwalia, Paul de Souza, Juan Manuel Sepulveda, Michele Maio, Oliver Grauer, Gordana Vlahovic, Joachim Baehring, Homa Dastani, Robert Latek, Vlad Coric, David Reardon
Journal: Neuro-Oncology (2015)

Advances in therapy for glioblastoma (GBM) have provided limited survival and health-related quality of life (HRQoL) benefit. Symptom management and maintaining HRQoL are important metrics for assessing treatment benefit. To inform on these metrics, both clinician- and patient-reported outcome measures to evaluate HRQoL and neurocognitive impairment were included as exploratory endpoints in the randomized cohort 2 of CHECKMATE-143, evaluating nivolumab monotherapy versus bevacizumab in adult patients with recurrent GBM. Clinician assessment of neurologic function will be done using the Neurologic Assessment in Neuro-Oncology (NANO) scale, which includes nine major domains (gait, strength, ataxia, sensation, visual field, facial strength, language, level of consciousness, and behaviour). The Cogstate assessment, consisting of a computerized battery of neurocognitive tests of approximately 15 minutes in duration, was used to evaluate neurocognitive functioning, cognitive deficits and/or executive functioning at baseline, and on day 1 of weeks 13, 21, 45, and 69, and at the time of treatment discontinuation. Patient-reported HRQoL was determined using the EORTC QLQ-C30, an assessment commonly used in oncology studies and comprising six functional scales (physical functioning, cognitive functioning, emotional functioning, social functioning, role functioning, and global QoL) as well as nine symptom scales (fatigue, pain, nausea/vomiting, dyspnea, insomnia, appetite loss, constipation, diarrhea, and financial difficulties), and the QLQ-BN20, a brain tumor-specific instrument evaluating four domains (future uncertainty, visual disorder, communication deficit, and motor dysfunction). The standardized EuroQoL-5D will be used for self-assessment of general health status across five dimensions (mobility, self-care, usual activities, pain/discomfort, and anxiety) and includes a visual analog rating scale. Scoring by using the NANO scale and assessment with the EORTC QLQ-C30, QLQ-BN20 and EQ5D will be done at baseline, weeks 7, 13, and every 8 weeks thereafter until treatment discontinuation. Methodology and baseline information regarding the use of these patient and clinician scales will be reported.
Challenges for Medicare at 50
Authors: Paul B. Ginsburg, Alice M. Rivlin
Journal: New England Journal of Medicine (2015)

Interview with Dr. Paul Ginsburg on how Medicare can improve care delivery and control spending going forward. (09:42)Download By accelerating adoption of provider-payment reforms in the traditional program and increasing competition under Medicare Advantage, Medicare could achieve better results and move the health care system toward higher quality and sustainable costs.
Soundings: Spend, spend, spend
Authors: Liam Farrell
Journal: BMJ (2006)

Like every family doctor I have many patients on long waiting lists, some with major pain and disability that could be rectified by prompt intervention. Even if we don't like it we can understand why this situation exists.

We know that the health service can't do everything—the sick will always be with us, people are living longer than ever before, new and expensive diagnostic tests and treatments are constantly coming on stream, the costs go ever upwards, and funding will never be enough. Just to take orthopaedic services, for example, there isn't enough funding to support more services; there have to be priorities, and when resources are being rationed elderly people needing replacement hips are well down the list.

Northern Ireland is supported by a huge subvention from Britain. The country has very little private industry, and over 60% of workers are directly or indirectly employed by the government. Essentially British taxpayers pay us to govern ourselves, however inadequately we do it. The receipt of such generosity might imply we have an even greater obligation to allocate our resources as frugally and judiciously as possible.

And then.

This morning I received a letter from the Northern Ireland Department of Health, inviting me to a major conference on complementary medicine in the health service. The theme, apparently, is how to integrate the likes of homoeopathy into the health service (even a smidgin of real evidence that it actually works would be a nice start). And also, I surmise, how to confer bogus respectability on the exploitation of the vulnerable and the gullible.

The letter also informs us that locum expenses will be paid—an almost unprecedented offer. No matter how grave the subject, I can't remember any other conference invitation being accompanied by such seductive largesse, which underlines even further the importance our impecunious health department confers on superstition and voodoo and treatments that don't work.

I do wonder how much this conference will cost, how many replacement hips the money would buy, and how many of our elderly patients could then be freed from pain and disability. But, as usual, the British will be ultimately picking up the tab, so why worry?
Evidence of a Selective Increase in Cardiac Sympathetic Activity in Patients with Sustained Ventricular Arrhythmias
Authors: I T Meredith, A Broughton, G L Jennings, M D Esler
Journal: New England Journal of Medicine (1991)

Although enhanced efferent cardiac sympathetic nervous activity has been proposed as an important factor in the genesis of ventricular arrhythmias and sudden cardiac death, direct clinical evidence has been lacking.
Effect of Acute Disease and ACTH on Serum Zinc Proteins
Authors: Kenneth H. Falchuk, J. M. Mathews, C. Doloff
Journal: New England Journal of Medicine (1977)

The effect of acute disease and ACTH infusion on serum zinc proteins was studied in serums from 156 healthy and diseased subjects. The mean (+/-2 S.D.) zinc content of 20 normal serums was 96 +/- 20 microng per 100 ml. In 87 serums from acutely ill patients the zinc ranged from 92 to 40 microng per 100 ml. The mean values for nearly all categories of disease studied were lower than normal (P is less than 0.001). Chromatography of normal serum on Sephadex G-100 separates two protein fractions, I and II, containing 37.8+/-8.8 and 76+/-10 microng of zinc per 100 ml, respectively. In serum from diseased patients the zinc in fraction I is unaltered whereas that in fraction II decreases to 29.8+/-7.5 microng per 100 ml (P is less than 0.001). ACTH administration reduces secrum zinc from 10 to 60 microng per 100 ml, the decrements being due to changes in the zinc content of fraction II. Thus, ACTH may have an important role in the reduction of zinc content associated with pathologic states.
CHOP compared to THP-COP regimen: Long-term outcome in Chinese non-Hodgkin lymphoma (NHL) patients
Authors: L. Zhai, C. Cheng, S. Niraula, Y. Huang, Z. M. Li, S. S. Wang, H. Q. Huang, T. Y. Lin
Journal: Journal of Clinical Oncology (2007)

8081 Background: THP-ADM (Pirarubicin) has potential to replace conventional ADM (Adriamycin) because of less severe toxicities. However, only a few studies have compared the long-term outcome between patients receiving the two drugs. A Japanese trial (JGTLE) shows the CR rate of THP-COP group was greater than CHOP group in elderly T-cell Non-Hodgkin's Lymphoma (NHL) patients. The current study was aimed at comparing the long-term outcome and toxicities between NHL patients receiving CHOP and THP-COP regimens within similar age-groups and pathological sub-types. Methods: 505 previously untreated NHL patients receiving either standard CHOP or THP-COP regimen (cyclophosphamide 750 mg/m 2 , doxorubicin or pirarubicin 50 mg/m 2 , vincristine 1.4 mg/m 2 and prednisone 40 mg/m 2 for 5 days) were enrolled. Results: Patients’ characteristics between CHOP group(n=279) and THP-COP (n=228) group were well balanced. There were no differences in CR rate (54.8% vs. 54.0%, p=0.85) and response rate (82.1% vs. 84.1%, p=0.55). With a median follow-up of 59.7months, survival rate was similar (5-year OS: 56.7% vs. 55.8%, 5-year PFS: 43.5% vs. 47.3%, 5-year DFS: 54.0% vs. 54.7%). The incidence of cardiotoxicity(myocardial dysfunction and arrhythmia)was almost the same (10.0% vs10.2 %; P=0.958). Less Alopecia (39.1% vs. 28.8%, p= 0.015)and gastrointestinal toxicities(63.1% vs. 50.0%, p=0.003) were observed in THP-COP group. No differences between the two groups were observed within different pathological subtypes (B-cell subtype: CR rate 58.2% vs. 56.7%, 5-year OS 59.2% vs. 60.0%; T-cell subtype: CR rate 47.0% vs. 45.5%, 5-year OS 50.5% vs. 43.4%) and age-groups (&lt;60 years group: CR rate 51.6% vs. 53.7%, p= 0.684; 5y OS 58.9% vs.61.1%, p= 0.570; =60 years group: CR rate 67.9% vs. 54.8 %, p= 0.148; 5y OS 48.0% vs. 42.1 %, p= 0.314). In the 33 elderly patients of T-cell subtype, CR rates were almost the same. (73.7% vs. 42.9%, p=0.073). Conclusions: The long-term outcome of NHL patients receiving THP-COP is similar to those receiving CHOP within similar age groups and pathologic subtypes. Cardiotoxicity occurs at a similar rate in both groups, while a lower incidence of alopecia and gastrointestinal toxicities was observed in THP-COP group. No significant financial relationships to disclose.
Caveolin-1 regulates TCR signal strength and regulatory T-cell differentiation into alloreactive T cells
Authors: Anne Schönle, Frederike A. Hartl, Jan Mentzel, Theresa Nöltner, Katharina S. Rauch, Alessandro Prestipino, Sebastian A. Wohlfeil, Petya Apostolova, Anne-Kathrin Hechinger, Wolfgang Melchinger, Kerstin Fehrenbach, Marta C. Guadamillas, Marie Follo, Gabriele Prinz, Ann-Katrin Ruess, Dietmar Pfeifer, Miguel Angel del Pozo, Annette Schmitt-Graeff, Justus Duyster, Keli I. Hippen, Bruce R. Blazar, Kristina Schachtrup, Susana Minguet, Robert Zeiser
Journal: Blood (2016)
Melanoma, Version 2.2016, NCCN Clinical Practice Guidelines in Oncology
Authors: Daniel G. Coit, John A. Thompson, Alain Algazi, Robert Andtbacka, Christopher K. Bichakjian, William E. Carson, Gregory A. Daniels, Dominick DiMaio, Marc Ernstoff, Ryan C. Fields, Martin D. Fleming, Rene Gonzalez, Valerie Guild, Allan C. Halpern, F. Stephen Hodi, Richard W. Joseph, Julie R. Lange, Mary C. Martini, Miguel A. Materin, Anthony J. Olszanski, Merrick I. Ross, April K. Salama, Joseph Skitzki, Jeff Sosman, Susan M. Swetter, Kenneth K. Tanabe, Javier F. Torres-Roca, Vijay Trisal, Marshall M. Urist, Nicole McMillian, Anita Engh
Journal: Journal of the National Comprehensive Cancer Network (2016)

This selection from the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Melanoma focuses on adjuvant therapy and treatment of in-transit disease, because substantial changes were made to the recommendations for the 2016 update. Depending on the stage of the disease, options for adjuvant therapy now include biochemotherapy and high-dose ipilimumab. Treatment options for in-transit disease now include intralesional injection with talimogene laherparepvec (T-VEC), a new immunotherapy. These additions prompted re-assessment of the data supporting older recommended treatment options for adjuvant therapy and in-transit disease, resulting in extensive revisions to the supporting discussion sections.