tbuckley/cabot-search huggingface dataset:
Splenic Reticuloendothelial Function after Splenectomy, Spleen Repair, and Spleen Autotransplantation
Authors: A Traub, G S Giebink, C Smith, C C Kuni, M L Brekke, D Edlund, J F Perry
Journal: New England Journal of Medicine (1987)

Overwhelming infection after splenectomy remains a problem despite the introduction of vaccine and antimicrobial prophylaxis. To evaluate prospectively various procedures proposed for salvage of the spleen, we measured reticuloendothelial function for two to five years in 51 patients who had initially presented with abdominal trauma and suspected splenic rupture. The mean percentage of pocked erythrocytes and the clearance of antibody-coated autologous erythrocytes in 8 patients who had splenic repair and in 6 who had partial splenectomy were the same as in 11 controls with intraabdominal injury that did not involve the spleen. The mean percentage of pocked erythrocytes remained significantly elevated in 19 patients who had undergone total splenectomy without autotransplantation of splenic tissue. One of seven patients who underwent splenic autotransplantation had a normal level of pocked erythrocytes 18 months after surgery, and a second patient had only a slight elevation at 24 months. The mean (±SEM) half-time clearance of labeled erythrocytes was significantly longer in the group that had total splenectomy without autotransplantation (421.1±74.5 hours) than in the autotransplantation group (91.6±20.0) or in the controls (5.4±2.0). We conclude that reticuloendothelial function was better preserved after partial splenectomy and splenic repair than after splenic autotransplantation, but that autotransplantation was superior to total splenectomy and appeared to be safe. Splenic autotransplantation deserves further study in patients who have had splenic trauma when other surgical maneuvers to save the spleen are not possible. (N Engl J Med 1987; 317:1559–64.)
Nefopam for Severe Hiccups
Authors: Federico Bilotta, Giovanni Rosa
Journal: New England Journal of Medicine (2000)

To the Editor: Rapid pharmacologic control of severe hiccups is a difficult problem.1 The preferred drugs for treating hiccups are dopaminergic blockers or antagonists. Nefopam (3,4,5,6-tetrahydro-5-methyl-1-phenyl-1H-2,5-benzoxazocine hydrochloride) is a centrally acting nonopioid analgesic agent with antishivering effects2 that is structurally related to antihistamines and antiparkinsonian drugs.3 We report the use of intravenous nefopam in three patients with incapacitating hiccups. A 32-year-old woman with lymphoblastic leukemia was hospitalized because she had had intense, nearly continuous hiccups for 48 hours. Vagal maneuvers, chlorpromazine (10 mg intravenously three times a day for 24 hours), and lidocaine (a loading dose of 1 . . .
The Relation between the Nasal-Staphylococcal-Carrier State and the Incidence of Postoperative Complications
Authors: Haskell J. Weinstein
Journal: New England Journal of Medicine (1959)

INFECTIONS caused by hemolytic, coagulase-positive Staphylococcus aureus have become an increasingly serious and prevalent problem. In many hospitals such infectious complications have assumed prime significance in the etiology of the morbidity and mortality of postoperative patients.1 2 3 4 5 Of the many studies of possible cause- and-effect relations that have been reported, of particular interest have been those dealing with the nasal-carrier state of hospital personnel, the general-hospital patient and the general population in the community.6 7 8 9 The high nasal-carrier state often found among hospital personnel has been suggested as an important factor in the transmission of infections due to the hemolytic staphylococcus, as . . .
Diarrheal Disease during Operation Desert Shield
Authors: Kenneth C. Hyams, August L. Bourgeois, Bruce R. Merrell, Patrick Rozmajzl, Joel Escamilla, Scott A. Thornton, Glenn M. Wasserman, Arlene Burke, Peter Echeverria, Kim Y. Green, Albert Z. Kapikian, James N. Woody
Journal: New England Journal of Medicine (1991)

Under combat conditions infectious disease can become a major threat to military forces. During Operation Desert Shield, there were numerous outbreaks of diarrhea among the U.S. forces. To evaluate the causes of and risk factors for diarrheal disease, we collected clinical and epidemiologic data from U.S. troops stationed in northeastern Saudi Arabia.
Effect of Corynebacterium parvum , Methanol-Extraction Residue of BCG, and Levamisole on Macrophage Random Migration, Chemotaxis, and Pinocytosis
Authors: Neal A. Sher, David G. Poplack, R. Michael Blaese, Teresa M. Brown, Sotiros D. Chaparas
Journal: JNCI Journal of the National Cancer Institute (1977)

Three parameters of macrophage function: random migration, chemotaxis, and pinocytosis, were studied in the guinea pig after administration of Corynebacterium parvum, methanol-extraction residue of BCG, and levamisole (LMS), a synthetic anthelmintic. Macrophage migration studies were performed with a modified Boyden chamber. Pinocytosis was assessed by the uptake of colloidal 198Au. After ip administration, each of the three immunostimulators induced an increase in macrophage chemotactic responsiveness and, to a lesser extent and duration, in random motility. Kinetic, dose-response, and time course data for the effect of each agent on macrophage movement were explored. LMS was the most effective stimulator of macrophage activation, which occurred earlier and persisted longer than it did with the other agents. Macrophages from animals receiving each of the agents showed enhanced pinocytosis. Measurement of macrophage random migration, chemotaxis, and pinocytosis appeared to provide a rapid and quantitative assessment of several parameters of macrophage function and, when studied with other immunologic parameters, may provide useful tools for the evaluation of potential immunoadjuvants.
American Society of Clinical Oncology Statement: Human Papillomavirus Vaccination for Cancer Prevention
Authors: Howard H. Bailey, Linus T. Chuang, Nefertiti C. duPont, Cathy Eng, Lewis E. Foxhall, Janette K. Merrill, Dana S. Wollins, Charles D. Blanke
Journal: Journal of Clinical Oncology (2016)

American Society of Clinical Oncology (ASCO), the leading medical professional oncology society, is committed to lessening the burden of cancer and as such will promote underused interventions that have the potential to save millions of lives through cancer prevention. As the main providers of cancer care worldwide, our patients, their families, and our communities look to us for guidance regarding all things cancer related, including cancer prevention. Through this statement and accompanying recommendations, ASCO hopes to increase awareness of the tremendous global impact of human papillomavirus (HPV) -caused cancers, refocus the discussion of HPV vaccination on its likely ability to prevent millions of cancer deaths, and increase HPV vaccination uptake via greater involvement of oncology professionals in ensuring accurate public discourse about HPV vaccination and calling for the implementation of concrete strategies to address barriers to vaccine access and acceptance.
HER2/neu overexpression and survival in African-American women with breast cancer.
Authors: Keith A. Dookeran, Karen Ferrer, Marin Sekosan, Xuezhi Gao, Elona Sciupokiene, Yu Wang, Rocio De La Torre, Lorena Diaz de Leon, Barbara Lukaszczyk, Songlin Zhang, Shiwen Song, Howard A. Zaren
Journal: Cancer Research (2005)

489   Purpose: It has been suggested that outcome disparities for African-American (AA) women with breast cancer, including late stage presentation and poorer survival, may in part be due to biological variation, including more aggressive features. We hypothesized that survival for AA women with HER2/neu positive breast tumors would be decreased. Methods: 311 consecutive AA patients were evaluated for HER2/neu status with immunohistochemistry (IHC) using polyclonal rabbit anti HER2/neu antibody (DAKO) on paraffin embedded tissue, at the Stroger Hospital of Cook County, Minority-Based Community Clinical Oncology Program (MBCCOP), which serves the medically-indigent in Chicago. HER2/neu IHC score of 3+ was considered positive for overexpression and IHC results from reference laboratories were validated with repeat in-house staining, which demonstrated no significant differences between methods (McNemar test p=0.648). Correlations were evaluated for disease-free (DFS), distant-disease-free (DDFS) and overall survival (OS). Results: The mean follow-up was 48 months and high AJCC stage, high tumor grade and negative hormone receptor (HR) status, were all significantly correlated with poorer survival. A total of 56 cases (18.1%) were HER2/neu positive and there was no correlation with DFS, DDFS, and OS. For DFS, 78 events occurred, Hazard Ratio (HR)=0.77, 95% Confidence Interval (95% CI)=0.41-1.47, p=0.43; for DDFS, 55 events occurred, HR=0.79, 95% CI=0.38-1.69, p=0.55; and for OS, 40 events occurred, HR=1.01, 95% CI=0.45-2.31, p=0.96. Negative HR status was the only significant predictor of HER2/neu positive tumor status (Odds Ratio=0.46, 95% CI=0.24-0.87, p=0.018). Conclusions: This study demonstrates that there was no difference in survival between AA women with HER2/neu positive and HER2/neu negative breast tumors. These results may be limited by the small sample size, short follow-up period and treatment variables, and further study is required.
Remarks on Angina Pectoris
Authors: JOHN WARREN
Journal: New England Journal of Medicine (1962)

IN our inquiries into any particular subject of Medicine, our labours will generally be shortened and directed to their proper objects, by a knowledge of preceding discoveries.When Dr. Heberden, in the London Medical Transactions, first described a disease under the name of Angina Pectoris, so little had it attracted the attention of physicians, that much surprise was excited by the communication. From the most striking and distressing symptoms, with which it was attended, pain and stricture about the breast, it received from him its denomination; and he soon after published farther remarks on this subject, with the history of . . .
Variable Plasma Propranolol Levels in Thyrotoxicosis
Authors: Sheldon Rubenfeld, Victor E. Silverman, K. M. A. Welch, Lawrence E. Mallette, Peter O. Kohler
Journal: New England Journal of Medicine (1979)

PROPRANOLOL has been widely used in the preparation of thyrotoxic patients for operation,1 2 3 in the treatment of thyroid storm,4 5 and as adjunct6 or sole7 therapy in the symptomatic management of hyperthyroid subjects. Several observers, however, have noted that the degree of relief of hyperthyroid symptoms provided by propranolol alone is not sufficient in many patients.8 9 10 Furthermore, propranolol in conventional doses does not necessarily prevent thyroid storm.11 Since plasma propranolol concentrations were not determined in any of these studies, the apparent therapeutic failures may have been the result of inadequate drug levels. We therefore investigated propranolol pharmacokinetics in thyrotoxic subjects. We . . .
S122 The effect of body mass index on patient outcome in chronic obstructive pulmonary disease: a retrospective cohort study using the Hampshire Health Record
Authors: C Perry, L Josephs, M Johnson, D Gulliford, M Thomas
Journal: Thorax (2015)

<h3>Introduction and objectives</h3> Chronic obstructive pulmonary disease (COPD) is a systemic disease characterised by persistent airflow obstruction but also has significant extra-pulmonary manifestations, including effects on body mass index (BMI). Nutritional status has been implicated as a predictor of outcome. We aimed to investigate the relationship between BMI and outcomes in a representative sample of UK COPD patients. <h3>Method</h3> Patients with a coded GP diagnosis of COPD on or before 31/12/2010 and full data for 3 years or until death were identified from the Hampshire Health Record Analytical database, which collects anonymised routine clinical care data from GP and hospital computer records. Subjects were categorised as underweight, normal, overweight, obese or very obese by WHO standards. Outcomes measured were all-cause death and respiratory-cause hospitalisation and emergency department attendance rate in the following 3 years. Multivariate cox regression modelling was used to estimate hazard ratio (HR) and confidence intervals (CI) adjusted for age, gender, smoking status and FEV<sub>1</sub>%predicted. <h3>Results</h3> 10,813 patients were identified (55% male, mean (SD) age 71.07 (±10.48), FEV<sub>1</sub>%predicted 59.96% (±19.98%). 1677 deaths (15.5%) occurred during the follow-up period. Compared with individuals with a normal BMI, underweight subjects had a higher mortality risk in adjusted analysis (HR = 1.58, 95% CI = 1.31–1.88). The lowest mortality rates were in overweight subjects (HR = 0.72, 95% CI = 0.64–0.81) and very obese subjects had no significant difference (HR = 0.83, 95% CI = 0.68–1.02, p = 0.08). The relationship between hospitalisation rate and BMI was ‘U’ shaped. Admission rates were highest in the underweight category where 13.3% of subjects had ≥2 admissions compared to 6.2% and 5.3% of overweight and obese subjects respectively. A similar relationship was observed between BMI and respiratory-cause emergency department attendance. 13.9% of underweight subjects had ≥2 emergency department attendances. The lowest attendance rates were observed in overweight and obese subjects where 6.5% and 5.6% of subjects had ≥2 attendances. <h3>Conclusions</h3> Underweight COPD patients have the highest death and hospitalisation rates, whilst being overweight or obese appears to have protective effects. There is potential for nutritional supplementation interventions in underweight COPD patients to improve outcomes, and further research into the protective effects of obesity is required.
Local Effect of Serotonin Released during Coronary Angioplasty
Authors: Paolo Golino, Federico Piscione, Claude R. Benedict, H. Vernon Anderson, Maurizio Cappelli-Bigazzi, Ciro Indolfi, Mario Condorelli, Massimo Chiariello, James T. Willerson
Journal: New England Journal of Medicine (1994)

Serotonin is released after the aggregation of platelets, a phenomenon that may occur after coronary angioplasty. We sought to determine whether serotonin is released into the coronary circulation during coronary angioplasty and to assess whether serotonin can affect coronary-artery tone during angioplasty.
Sorafenib therapy and CNS hemangioblastomas in individuals with Von Hippel Lindau syndrome
Authors: N. Panakis, C. Offiah, A. Azizan, A. Roy, P. N. Plowman
Journal: Journal of Clinical Oncology (2008)

2065 Background: Germline mutation of the tumor suppressor gene (3p25-p26) in the familial Von Hippel Lindau (VHL) syndrome predisposes to tumor induction and progression. Loss of VHL expression results in upregulation of HIFα resulting in the overproduction of factors such as VEGF, TGFβ, PDGF GLUT-1 and EPO promoting angiogenesis, differentiation, migration and proliferation. VHL Type 1 disease is characterised by loss of VHL expression predisposing individuals to hemangioblastomas and clear cell Renal Cell Carcinoma (RCC). Sorafenib is small molecular multi-targeted kinase inhibitor with proven efficacy in treating advanced RCC. Proliferation and angiogenesis are decreased through upstream inhibition of receptor tyrosine kinase KIT, FLT-3, VEGFR, PDGFR as well as downstream inhibition of serine/threonine kinases in the RAF/MEK/ERK pathway. VEGF is regarded as a key mediator in the pathogenesis of RCC. It is posited that the mechanisms of tumor induction, survival and progression for hemangioblastoma share the same common pathway with RCC and might similarly prove responsive to sorafenib. Methods: We observed the effects of oral sorafenib (400mg bd) for up to six months on 16 CNS hemangioblastomas, 12 in the brain and 4 in the spinal cord, in 4 patients with VHL syndrome having therapy for advanced RCC. Assessment was by serial MRI scans. Results: One partial response in RCC was observed. No responses were observed in the brain or spinal hemangioblastomas and in one individual there was progression in the brain and spinal cord with stable extracranial disease. Treatment was well tolerated with Grade 1–2 toxicity including, rash, headache and hypertension. Grade 3 toxicity necessitated a 50% dose reduction at 2 months for Grade 3 palmar-plantar erythema and one individual experienced total alopecia. Conclusions: We conclude that over a 6 month period of sorafenib, at the standard dosage used in RCC, there was no response effect demonstrable in CNS hemangioblastomas in this patient population. No significant financial relationships to disclose.
Frequency and presentation of neuroleptic malignant syndrome in a large psychiatric hospital
Authors: H G Pope, P E Keck, S L McElroy
Journal: American Journal of Psychiatry (1986)

Neuroleptic malignant syndrome, a dangerous but little-known complication of antipsychotic drugs, is often assumed to be rare. To assess the frequency of the syndrome in a large psychiatric hospital, the authors first reviewed the literature and developed operational diagnostic criteria. Using these criteria to survey nearly 500 neuroleptic-treated patients admitted during a 1-year period, they found that seven (1.4%) had experienced definite or probable neuroleptic malignant syndrome. In several cases, including one fatal case, the diagnosis of neuroleptic malignant syndrome was not immediately considered. The authors conclude that neuroleptic malignant syndrome may be more common than previously thought and may be underdiagnosed.
QOL-22THE IMPACT OF PREGNANCY ON GLIOMA PATIENTS
Authors: Jacqueline Stone, Jerome Graber, Thomas Kaley, Lisa DeAngelis
Journal: Neuro-Oncology (2015)

OBJECTIVE: To describe outcomes of glioma patients who become pregnant. BACKGROUND: Few data exist regarding the effect of pregnancy on gliomas, making it challenging to counsel glioma patients of reproductive age regarding potential risks. Individual case reports and small series report increased rates of tumor progression with pregnancy. METHODS: This was an IRB-approved retrospective study of women with gliomas who became pregnant during their disease course or were diagnosed with gliomas during the peripartum period defined as during pregnancy or the 12 months following delivery. Outcomes analyzed included radiographic and clinical signs of disease progression. RESULTS: We identified 82 patients: 38 with known gliomas who became pregnant, 27 diagnosed with gliomas during pregnancy, and 17 diagnosed with gliomas in the postpartum period. Histologies included astrocytoma(33%), oligodendroglioma(33%), mixed oligoastrocytoma(21%), and other gliomas(5%); pathology was unavailable for 7 patients. The majority of patients had WHO II tumors(56%), followed by WHO III(30%), WHO I(2%), and WHO IV(2%). The most common presenting symptom of glioma was seizure(55%). Four patients underwent surgical resection during pregnancy. No patient received radiation or temozolomide during pregnancy. There were 85 pregnancies examined. There were 20 known Cesarean sections and 4 elective terminations. Of the 36 patients with known gliomas who carried a pregnancy to delivery, 10 had radiographic progression during the peripartum period. Ten patients experienced recurrent neurological symptoms during pregnancy including seizures, headache, and hemorrhage into a pituitary adenoma. All babies were healthy. CONCLUSIONS: A noticeable number of women harboring a glioma were diagnosed in the peripartum period suggesting that pregnancy is a potential stimulant of tumor growth. For women with known gliomas, 28% developed radiographic progression during pregnancy. Women of reproductive age with gliomas should be counseled on the potential impact of pregnancy on tumor growth, however, the majority of pregnancies in glioma patients were uncomplicated.
The<i>Medical Repository</i>— The First U.S. Medical Journal (1797–1824)
Authors: Richard J. Kahn, Patricia G. Kahn
Journal: New England Journal of Medicine (1997)

July 1997 marked the 200th anniversary of the founding of the Medical Repository, the first medical journal indigenous to the United States (Figure 1). It was printed by T. & J. Swords, Printers to the Faculty of Physic of Columbia College in New York City.15 The journal, originally edited by Samuel Latham Mitchill, Elihu Hubbard Smith, and Edward Miller, was published quarterly from 1797 to 1824. Why was the Medical Repository founded, who was responsible, and what was the proposed subject matter?6,7 Finally, who read it, and why did publication cease in 1824?The British blockade during the . . .
Postinfectious Brachial Neuritis
Authors: C Lidor, E Goichman
Journal: New England Journal of Medicine (1998)

Figure 1 A nine-year-old boy presented with a two-day history of extreme pain in his right shoulder girdle after an upper respiratory tract infection that was accompanied by fever (temperature, 39.5°C). Physical examination revealed paresthesia of the lateral aspect of the arm, atrophy (arrow in Panel A), weakness of the deltoid muscle (4/5) during abduction of the shoulder, and weakness of the serratus anterior muscle, with scapular winging (Panel B). Symptomatic therapy with acetaminophen was administered. The patient recovered uneventfully within four months. Figure 1 A nine-year-old boy presented with a two-day history of extreme pain in his right shoulder girdle after an upper respiratory tract infection that was accompanied by fever (temperature, 39.5°C). Physical examination revealed paresthesia of the lateral aspect of the arm, atrophy (arrow in Panel A), weakness of the deltoid muscle (4/5) during abduction of the shoulder, and weakness of the serratus anterior muscle, with scapular winging (Panel B). Symptomatic therapy with acetaminophen was administered. The patient recovered uneventfully within four months. Cobi Lidor, M.D., Ph.D.Ella Goichman, M.D.Kupat-Holim Meuchedet, Herzeliya 46782, Israel
&lt;italic&gt;Herpesvirus saimiri.&lt;/italic&gt; V. Further Evidence to Consider This Virus as the Etiological Agent of a Lethal Disease in Primates Which Resembles a Malignant Lymphoma&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: L. V. Meléndez, M. D. Daniel, R. D. Hunt, C. E. O. Fraser, F. G. Garciá, N. W. King, M. E. Williamson
Journal: JNCI Journal of the National Cancer Institute (1970)

Herpesvirus saimiri, a new herpesvirus indigenous to the squirrel monkey (Saimiri sciureus), with the ability to induce malignant lymphoma in nonhuman primates has been reisolated from kidney tissue cultures prepared from the affected animals at the terminal stage of disease. The purity of the reisolated H. saimiri was determined by filtration, reinoculation in susceptible animals, and by electron microscopy. These studies indicate that H. saimiri fulfills Koch's postulates for the experimentally induced lethal disease characterized histologically as a type of malignant lymphoma in nonhuman primates.