tbuckley/cabot-search huggingface dataset:
Case 4-1990
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Juan J. Canoso, H. Randolph Byers
Journal: New England Journal of Medicine (1990)

Presentation of CaseA 53-year-old woman was admitted to the clinic because of extensive cutaneous swelling, thickening, and pain, with peripheral eosinophilia.The patient was in a stable state of health until five months earlier, when swelling developed in both legs, with purplish discoloration and generalized pruritus. During the following month the patient gradually became aware that the skin was becoming progressively leathery. At about the same time she began to experience a burning sensation in both legs, accompanied by tingling and numbness that became constant; sharp pains appeared, like "bolts of electricity," that shot up from the ankles to . . .
Effects of Somatostatin on Plasma Glucose and Glucagon Levels in Human Diabetes Mellitus
Authors: John E. Gerich, Mara Lorenzi, Victor Schneider, John H. Karam, Jean Rivier, Roger Guillemin, Peter H. Forsham
Journal: New England Journal of Medicine (1974)

To evaluate the role of pancreatic alpha-cell dysfunction in human diabetes mellitus, somatostatin, an inhibitor of glucagon secretion, was infused (1 mg over two hours) in 10 insulin-dependent diabetic subjects. Fasting plasma glucagon fell from 150 ± 15 (mean ± S.E.M.) to 77 ± 10 pg per milliliter (p<0.001), and plasma glucose from 260 ± 20 to 191 ± 21 mg per 100 ml (p<0.001). Similar responses occurred in a hypophysectomized diabetic patient, indicating that these effects of somatostatin were independent of suppression of growth hormone secretion. Somatostatin (4 mg subcutaneously) was active transiently. In additional studies, somatostatin infusion combined with insulin completely abolished post-meal hyperglycemia in four diabetic patients and was more effective than insulin alone. These results indicate that excessive glucagon secretion accounts for about 25 per cent of the fasting plasmaglucose levels in such patients. Furthermore, somatostatin may be a useful adjunct to insulin in treating diabetes mellitus. (N Engl J Med 291:544–547, 1974)
Value of Early Ambulation in Patients with and without Complications after Acute Myocardial Infarction
Authors: Abraham S. Abraham, Yitzhak Sever, Moshe Weinstein, Marcel Dollberg, Jacob Menczel
Journal: New England Journal of Medicine (1975)

A prospective, controlled, randomized study was done to compare the effect of early and late ambulation in hospitalized patients with acute myocardial infarction. All patients surviving longer than the first five days were studied; 64 patients were mobilized on day six and discharged on day 12, and 65 were mobilized on day 13 and discharged on day 19. Follow-up observation lasted from six to 52 weeks. Of patients without complications until day six, eight out of 32 in the early and 16 of 35 in the late groups manifested complications during the follow-up period (p < 0.05). Of those who had complications before day six, seven of 32 and 26 of 30 still had or acquired new complications until last seen (p < 0.0001). The number of serious complications in the two groups was eight and 24 respectively (p < 0.001). We conclude that early ambulation is beneficial irrespective of complications on admission. (N Engl J Med 292:719–722, 1975)
57O Efficacy, safety and tolerability of MEDI4736 (durvalumab [D]), a human IgG1 anti-programmed cell death-ligand-1 (PD-L1) antibody, combined with gefitinib (G): A phase I expansion in TKI-naïve patients (pts) with EGFR mutant NSCLC
Authors: D.L. Gibbons, L.Q. Chow, D.-W. Kim, S.-W. Kim, T. Yeh, X. Song, H. Jiang, R. Taylor, J. Karakunnel, B. Creelan
Journal: Journal of Thoracic Oncology (2016)
DDEL-08OVERALL SAFETY AND EFFICACY IN SUBJECTS WITH RECURRENT HGG TREATED ACROSS 2 TOCAGEN STUDIES - PROGNOSTIC FACTORS ASSOCIATED WITH SURVIVAL
Authors: Joseph Landolfi, Timothy Cloughesy, Michael A. Vogelbaum, Santosh Kesari, David E. Piccioni, Steven N. Kalkanis, Jana Portnow, Tom Mikkelsen, J. Bradley Elder, David Baskin, Alice Chu, Andreas Niethammer, Harry Gruber, Charles Cobbs, Greg Foltz, George Kaptain, Manish Aghi
Journal: Neuro-Oncology (2015)

High grade glioma (HGG) remains resistant to standard therapies with survival ranging from 7.2-8.1 months. Two Phase 1 clinical studies using a retroviral replicating vector (RRV), Toca 511, in combination with oral Toca FC (extended-release 5-FC) are ongoing to evaluate intracranial delivery of Toca 511 in patients with recurrent HGG. Patients were treated either by administering Toca 511 via intratumoral injection by biopsy needle or convection-enhanced delivery (CED) (NCT01156584), or by injection into the resection cavity wall (NCT01470794). The total safety population included 82 patients. The safety profile was favorable with only 3.7% patients experiencing a treatment related SAE and 1 patient discontinuing treatment due to toxicity (rash). A total of 59 patients who were efficacy evaluable (received Toca 511 and at least one dose of Toca FC) and excluding patients with non-biopsy needle delivery had a mOS of 13.8 months (95% CI 10.8,16.9). Cox-regression was used to examine factors associated with survival outcome. Baseline factors included for univariate analysis were tumor grade (III vs IV), number of recurrences (≤2 vs >2), gender, age (≤55 vs >55), longest diameter of cancerous lesion (continuous), daily dose of Toca FC (≥170 mg/kg vs  80), time between Toca 511 and Toca FC (weeks), and respective study participation (NCT01156568 vs NCT01470794). Of these, tumor grade, number of recurrences, gender and lesion diameter were included for multivariate analysis based on a p value  2 recurrences, the observed median overall survival (mOS) is 14 months (95% CI 11.15, 23.36), comparing favorably to historical benchmarks. 60% and 24.7% of patients were alive after 12 and 24 months, respectively.
The Efficacy and Safety of Clazakizumab, an Anti–Interleukin‐6 Monoclonal Antibody, in a Phase IIb Study of Adults With Active Psoriatic Arthritis
Authors: Philip J. Mease, Alice B. Gottlieb, Alberto Berman, Edit Drescher, Jun Xing, Robert Wong, Subhashis Banerjee
Journal: Arthritis & Rheumatology (2016)

To evaluate the efficacy of clazakizumab, a monoclonal antibody with high affinity and specificity for the interleukin-6 (IL-6) cytokine, in psoriatic arthritis (PsA).In this randomized, double-blind, placebo-controlled, dose-ranging study (ClinicalTrials. gov identifier: NCT01490450), patients with active PsA and an inadequate response to nonsteroidal antiinflammatory drugs were randomized (1:1:1:1) to receive subcutaneous placebo or clazakizumab 25 mg, 100 mg, or 200 mg every 4 weeks, with or without methotrexate. The primary end point was the response rate according to the American College of Rheumatology 20% criteria for improvement (ACR20) at week 16, with secondary efficacy end points at weeks 16 and 24.A total of 165 patients were randomized. At week 16, the ACR20 response rate was significantly higher with clazakizumab 100 mg versus placebo (52.4% versus 29.3%; P = 0.039). ACR20 response rates at week 16 were 46.3% with clazakizumab 25 mg (P = 0.101 versus placebo) and 39.0% with clazakizumab 200 mg (P = 0.178 versus placebo). ACR50/ACR70 response rates were numerically higher with clazakizumab versus placebo at weeks 16 and 24. Compared with placebo, clazakizumab treatment significantly improved musculoskeletal manifestations (joint signs and symptoms, enthesitis, and dactylitis), with minimal improvements in skin disease, without clear evidence of a dose response. Clazakizumab was well tolerated.This is the first clinical trial of an IL-6-targeted therapy in PsA. Clazakizumab may be an effective treatment option for musculoskeletal aspects of PsA, but because of the lack of a dose response in this study, further studies are required to confirm the appropriate dose. The safety profile is consistent with the pharmacology of IL-6 blockade and prior clinical experience with this antibody in rheumatoid arthritis.
Case 13-1993
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Julian L. Seifter, John L. Niles, Robert T. McCluskey
Journal: New England Journal of Medicine (1993)

Presentation of CaseA 74-year-old woman was admitted to the hospital because of progressive renal failure.The patient had had a subendocardial infarct and congestive heart failure 14 months before admission. Nine months before entry she was treated as an inpatient for congestive heart failure. An echocardiographic study revealed appreciable mitral regurgitation. Six months before admission she underwent sigmoidoscopic examination, which showed diverticulosis and a colonic polyp, which was removed. The urea nitrogen was 18 mg per deciliter (2.9 mmol per liter), and the creatinine was 1.1 mg per deciliter (97.2 μmol per liter).Thereafter, the patient was in stable . . .
Sodium Diuresis from Amphenone Given to Patients with Cirrhosis and Ascites
Authors: Stanley J. Wolfe, Bernhard Fast, James M. Stormont, Charles S. Davidson
Journal: New England Journal of Medicine (1957)

AMPHENONE1 (1,2-bis [p-aminophenyl]-2-methyl propanone-1-dihydrochloride)∥ affects both thyroid and adrenocortical activity in animals and man.4 5 6 7 8 9 The adrenal effect is reflected in reduction of plasma hydrocortisone and corticosterone concentrations and in reduced urinary excretion of their metabolites. Studies by Peterson, Hertz and Lubs10 indicate that amphenone acts through inhibition of adrenocortical-hormone synthesis. Renold et al.11 reported that amphenone administration resulted in decreased levels of urinary aldosterone and definite sodium diuresis in a majority of 17 patients. Depressed sodium excretion in sweat, saliva and feces,12 , 13 as well as in urine of patients with hepatic cirrhosis and ascites, who also are known to excrete . . .
FLT PET/CT in a Case of Demyelinating Disease
Authors: Alexandra Nikaki, Vasilios Prassopoulos, Roxani Efthimiadou, Ioannis Tsougos, Panagiotis Georgoulias
Journal: Clinical Nuclear Medicine (2016)

A 32-year-old woman, with spare previous medical history, presented with neurological symptoms of numbness and diplopia. The patient underwent brain MRI, which revealed a lesion of abnormal signal in the midbrain that could be attributed to subacute stroke; however, consecutive MRIs revealed multiple lesions of abnormal signal pointing to demyelinating disease. During symptoms investigation and MRI findings assessment, the patient underwent a FLT PET/CT examination, which revealed lesions of increased FLT uptake, probably indicating active disease and blood-brain barrier disruption.
Screening for Lung Cancer
Authors: Edward F. Patz, Philip C. Goodman, Gerold Bepler
Journal: New England Journal of Medicine (2000)

Lung cancer is the leading cause of death from cancer among men and women in the United States. More people die each year of lung cancer than of colon, breast, and prostate cancer combined. Despite new diagnostic techniques, the overall five-year survival rates remain about 14 percent, and most patients still present with advanced disease.1 There has long been interest in screening to detect lung cancers when they are smaller and presumably at earlier and more curable stages, as witnessed by the support for previous screening trials using chest radiography and cytologic examination of sputum. Unfortunately, these studies failed to . . .
<i>Strongyloides stercoralis</i> Infestation
Authors: J Brenneck, A Mattia
Journal: New England Journal of Medicine (1996)

Figure 1. Strongyloides stercoralis infection occurs when filariform larvae from the soil penetrate the skin, pass through the circulation to the lungs, enter the airways, and are then swallowed. In the small-intestinal mucosa, the larvae mature into adults (Panel A, long arrow) and deposit eggs that release first-stage rhabdoid larvae (Panel A, short arrow; hematoxylin and eosin, ×105). These larvae are the usual diagnostic feature in the stool specimen (Panel B; iodine stain, ×505) and are identified by their short buccal cavity (long arrow) and prominent genital primordium (short arrow).
164P Does patient selection according to RAS/PIK3CA/BRAF mutational status enrich the efficacy of adjuvant chemotherapy for Stage IV CRC after R0 resection?
Authors: I. Nakayama, E. Shinozaki, T. Azuma, T. Wakatsuki, M. Ogura, T. Ichimura, M. Ozaka, D. Takahari, K. Chin, N. Mizunuma
Journal: Annals of Oncology (2015)
Family-Based Approaches to Cardiovascular Health Promotion
Authors: Rajesh Vedanthan, Sameer Bansilal, Ana Victoria Soto, Jason C. Kovacic, Jacqueline Latina, Risa Jaslow, Maribel Santana, Elio Gorga, Andrew Kasarskis, Roger Hajjar, Eric E. Schadt, Johan L. Björkegren, Zahi A. Fayad, Valentin Fuster
Journal: Journal of the American College of Cardiology (2016)
Does Adjuvant Bisphosphonate in Early Breast Cancer Modify the Natural Course of the Disease? A Meta-Analysis of Randomized Controlled Trials
Authors: Davide Mauri, Antonis Valachis, Nikolaos P. Polyzos, Lamprini Tsali, Dimitris Mavroudis, Vassilis Georgoulias, Giovanni Casazza
Journal: Journal of the National Comprehensive Cancer Network (2010)

To address whether the use of bisphosphonates in the adjuvant setting of breast cancer might have any effect on the natural course of the disease, a meta-analysis was conducted of published and unpublished randomized controlled trials found in PubMed, the Cochrane Central Register of Controlled Trials, the ISI Web of Knowledge, and abstracts of major international conferences up to January 2009. All trials that randomized patients with primary breast cancer to undergo adjuvant treatment with any bisphosphonate versus non-use were considered eligible. Analysis included data from 13 eligible trials involving 6886 patients randomized to treatment with bisphosphonates (n = 3414) or either placebo or no treatment (n = 3472). Compared with no use, adjuvant breast cancer treatment with bisphosphonates did not reduce the overall number of deaths (odds ratio [OR], 0.708; 95% CI, 0.482–1.041; P = .079), bone metastases (OR, 0.925; 95% CI, 0.768–1.114; P = .413), overall disease recurrences (OR, 0.843; 95% CI, 0.602–1.181; P = .321), distant relapse (OR, 0.896; 95% CI, 0.674–1.192; P = .453), visceral recurrences (OR, 1.051; 95% CI, 0.686–1.609; P = .820), or local relapses (OR, 1.056; 95% CI, 0.750–1.487; P = .756). No significant heterogeneity was observed among the trials except for estimates of deaths and disease recurrences ( P = .034 and P = .016, respectively). In subgroup analyses, use of zoledronic acid was associated with a statistically significant lower risk for disease recurrence (OR, 0.675; 95% CI, 0.479–0.952; P = .025). However, these results should be interpreted with caution because the statistical significance for this association was weak and might be attributed to chance from multi-test analyses. Use of zoledronic acid was not associated with any significant difference in death (OR, 0.642; 95% CI, 0.388–1.063) and bone metastasis rates (OR, 0.661; 95% CI, 0.379–1.151). Currently available evidence does not support the hypothesis that use of bisphosphonates in adjuvant treatment of early breast cancer will alter the natural course of the disease. Nonetheless, a nonsignificant trend seems to exist for better outcomes in patients undergoing bisphosphonate treatment. Until further evidence from new clinical trials becomes available, adjuvant bisphosphonates should not be recommended routinely.
D-type cyclin expression and localization in prostate cell xenografts and carcinomas
Authors: Clay E. S. Comstock, Patricia M. Revelo-Penafiel, Shan Lu, Karen E. Knudsen
Journal: Cancer Research (2006)

Proc Amer Assoc Cancer Res, Volume 47, 2006

4919 

Prostate cancer is a major health concern worldwide, especially within the industrialized nations, and the second leading cause of cancer-related deaths in men in the United States. For patients not cured by primary therapy, androgen-deprivation is initially successful in causing cancer regression. However, relapse often arises within 2-3 years wherein the androgen receptor has circumvented deprivation therapy thus, transforming the disease to an androgen-independent status, for which there is no effective treatment. The D-type cyclins are critical components of the mitogenic response to androgen, through its ability to activate cyclin-dependent protein kinases. Similarly, we have previously shown that cyclin D1 plays an important role in regulating androgen dependent proliferation in prostate cancer cells thru direct modulation of the androgen receptor. While few somatic mutations of cyclin D1 have been reported in any tumor type, aberrations in cyclin D1 localization can dramatically alter its function and protein stability. Therefore, we sought to elucidate the contributions of expression and localization of the D-type cyclins using in vivo cell xenografts under various treatments and in a subset of human prostate carcinoma samples. Preliminary results suggest that D-type cyclins have a role to play in prostate cancer progression.
Chemotherapeutic Management of Invasive Bladder Carcinoma
Authors: Cora N. Sternberg, Alan Yagoda, Howard I. Scher, Robin C. Watson, Harry W. Herr, Micharl J. Morse, Pramod Sogani, E. Darracott Vaughan, Neil Bander, Nancy Geller, William R. Fair, Willet F. Whitmore
Journal: European Urology (1988)
Case 16-2004
Authors: Anthony A. Amato, Anne Louise Oaklander
Journal: New England Journal of Medicine (2004)

A 76-year-old woman was referred to the neurology clinic because of numbness and pain in her feet and legs. The symptoms began six years earlier. Imaging studies of the spine were unrevealing, and electrodiagnostic tests were normal. The differential diagnosis of painful sensory neuropathy is reviewed, and new diagnostic testing and treatment options are discussed.
Prognostic Value of a Treadmill Exercise Score in Outpatients with Suspected Coronary Artery Disease
Authors: Daniel B. Mark, Linda Shaw, Frank E. Harrell, Mark A. Hlatky, Kerry L. Lee, James R. Bengtson, Charles B. McCants, Robert M. Califf, David B. Pryor
Journal: New England Journal of Medicine (1991)

The treadmill exercise test identifies patients with different degrees of risk of death from cardiovascular events. We devised a prognostic score, based on the results of treadmill exercise testing, that accurately predicts outcome among inpatients referred for cardiac catheterization. This study was designed to determine whether this score could also accurately predict prognosis in unselected outpatients.
SAT0461 A Retrospective Study of 88 Cases with Idiopathic Inflammatory Myositis (IIM)
Authors: K. Akashi, D. Sugiyama, Y. Kogata, G. Kageyama, J. Saegusa, S. Kumagai, A. Morinobu
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Prognostic factors and long-term outcome including functional impairment of idiopathic inflammatory myositis (IIM) vary widely. In addition, the efficacy of immunosuppressive agents on clinical course of IIM, have not been well established. <h3>Objectives</h3> To evaluate clinical course including relapse, functional impairment and mortality rate, and the efficacy of immunosuppressive agents in polymyositis (PM), dermatomyositis (DM), and amyopathic dermatomyositis (ADM). <h3>Methods</h3> Clinical data of 88 IIM patients (33 with PM, 40 with DM, and 10 with ADM) who received induction therapy from April 2002 to July 2013 in Kobe University Hospital were collected from the medical charts. Survival rate were modeled Kaplan-Meier estimation. Functional impairment was evaluated with Health Assessment Questionnaire Disability Index (HAQ-DI). <h3>Results</h3> Interstitial lung disease (ILD) was diagnosed in 63.1% of PM, 82.5% of DM, and all the ADM patients. Rapidly progressive ILD (RP-ILD) were found none of PM, 6% of DM, and 70% of ADM patients. Ten-year survival rate estimates of PM and DM were 79.3% and 76.2%, respectively. Half of ADM patients had a fatal clinical course of RP-ILD within 4 months after onset. Ten-year survival rate estimates without relapse were 74.5% for PM and 54.6% for DM. Immunosuppressive agents were used for 68.4% of PM, 61.5% of DM, and 90% of ADM patients. Predictors of poor outcome were male sex (analysis by Cox proportional hazards model, Hazard ratio (HR) 3.38, 95% confidence interval (CI) 1.20 to 9.48), ADM (HR 9.72, 95%CI 2.28 to 41.44), pneumomediastinum (HR 3.11, 95%CI 1.02 to 9.42), dysphagia (HR 3.27, 95%CI 1.12 to 9.50), and RP-ILD (HR 12.31, 95%CI 3.54 to 42.33). Patients positive for anti-Jo-1 antibody had a higher rate of recurrence (HR 3.52, 95%CI 1.33 to 9.36). Patients treated with immunosuppressive agents tended to have lower relapse rate than those without immunosuppressive agents (log-rank test, <i>P</i>=0.053). Patients with ILD associated with favorable physical function (multiple logistic regression analysis, Odds Ratio (OR) 12.07, 95%CI 1.91 to 126.54). Higher age patients had statistically high HAQ-DI (OR 0.19, 95%CI 0.04 to 0.75). <h3>Conclusions</h3> Male sex, ADM, RP-ILD, pneumomediastinum and dysphagia predict the poor outcome, and anti-Jo-1 antibody-positive patients had a high relapse rate in IIM patients. Early administration of immunosuppressive agents may reduce the risk of relapse of IIM. <h3>Disclosure of Interest</h3> None declared
Autoimmune Protein S Deficiency in a Boy with Severe Thromboembolic Disease
Authors: Armando D'Angelo, Patrizia Della Valle, Luciano Crippa, Elisabetta Pattarini, Luigi Grimaldi, Silvana Vigano D'Angelo
Journal: New England Journal of Medicine (1993)

Protein S is a vitamin K-dependent plasma protein involved in the regulation of the protein C anticoagulant pathway,1 the system responsible for the inactivation of factors Va and VIIIa2. Protein S functions as a cofactor for activated protein C by increasing its affinity for the cell surface3 and by blocking the capacity of factor Xa to protect factor Va from inactivation by activated protein C4; it also enhances the profibrinolytic effects of activated protein C5–7. The congenital deficiency of protein S is associated with an increased risk of recurrent juvenile venous and arterial thromboembolism8–10. . . .
Collagenolytic Activity of Synovium in Rheumatoid Arthritis
Authors: Gerald S. Lazarus, John L. Decker, Cap H. Oliver, John R. Daniels, Carter V. Multz, Harold M. Fullmer
Journal: New England Journal of Medicine (1968)

Synovial specimens from 24 patients with rheumatoid arthritis and eight patients with noninflammatory synovial conditions were studied for enzymatic activity capable of degrading collagen in vitro. On culture of the specimens, a collagenase was found that was operative at physiologic pH and cleaved the collagen molecule at a single site, a property of other vertebrate collagenases. This collagenase was not detected in the media of noninflammatory control synovial cultures but was produced by 20 of the 24 rheumatoid synovia. The amount of collagenolytic activity measured in the rheumatoid synovial cultures was directly related to both local and systemic disease activity.
Recurrent Pulmonary Infiltration and Pleural Effusion Due to Nitrofurantoin Sensitivity
Authors: Harold L. Israel, Paul Diamond
Journal: New England Journal of Medicine (1962)

PULMONARY disease with eosinophilia, either transient or chronic, has been observed in patients with and without asthma, often as the result of drug allergy or of parasites.A patient recently encountered is of interest because of several features: there was no history of prior allergic reactions, the lesions recurred in the same pulmonary segments over a five-week period, the clinical and radiologic changes simulated pulmonary embolism, marked eosinophilia was not manifested until the third episode and the cause of the recurrent pneumonias was shown to be nitrofurantoin.‡ Severe reactions to this drug have been reported,1 but it has not previously . . .