tbuckley/cabot-search huggingface dataset:
Therapy of Parenchymal Brain Cysticercosis with Praziquantel
Authors: Julio Sotelo, Francisco Escobedo, Jesus Rodriguez-Carbajal, Bertha Torres, Francisco Rubio-Donnadieu
Journal: New England Journal of Medicine (1984)

Twenty-six patients with cysticercosis of the brain parenchyma were treated with the antihelmintic agent praziquantel (50 mg per kilogram of body weight daily for 15 days). During treatment a strong inflammatory reaction occurred, as evidenced by increased protein and cells in the cerebrospinal fluid. This finding correlated with headache, exacerbation of neurologic symptoms, and edema and inflammation around cystic lesions. After three months of treatment all patients had improved clinically, and 13 (50 percent) were asymptomatic. The total number of cysts on CT scans had decreased from 152 at the beginning of treatment to 51, and the mean diameter of cysts was reduced by 72 per cent. CT scans showed improvement in 25 of the 26 patients, with total remission of all cysts in nine. Seventeen control patients followed with CT studies for a mean of 9±2 months had no spontaneous remission of lesions, and in many cases the scans showed worsening during the observation period. Our results indicate that praziquantel is effective in cysticercosis of the brain parenchyma. (N Engl J Med 1984; 310:1001–7.)
Surgical Treatment of Papillary-Muscle Rupture Complicating Myocardial Infarction
Authors: W. Gerald Austen, David M. Sokol, Roman W. DeSanctis, Charles A. Sanders
Journal: New England Journal of Medicine (1968)

Mitral-valve replacement was performed in five patients with ruptured papillary muscle secondary to myocardial infarction. In each case severe mitral regurgitation was suggested by the sudden appearance of a systolic murmur followed by progressive congestive heart failure. The diagnosis was confirmed by the presence of giant systolic waves in the pulmonary wedge tracing in four and of severe mitral regurgitation by left ventricular angiography in one. Open-heart surgery was performed at intervals of 14 days to 14 months after the acute infarct; four of the patients survive and are now doing well.
Case 48-1993
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, L. Jack Faling, Eugene J. Mark
Journal: New England Journal of Medicine (1993)

Presentation of CaseA 27-year-old woman was admitted to the hospital because of pulmonary hypertension with increasing right-sided heart failure.The patient had been well and active until nine months earlier, when she first experienced mild dyspnea while riding a bicycle. The dyspnea worsened, and three months before entry medical evaluation elsewhere included radiographs of the chest that showed slight cardiac enlargement and prominent pulmonary-artery shadows. An ultrasonographic examination of the heart revealed marked dilatation of the right ventricle, with moderate tricuspid regurgitation; the estimated pulmonary arterial pressure was over 100 mm Hg. A ventilation-perfusion scan disclosed no evidence of . . .
Mother-to-Child Transmission of the Human Immunodeficiency Virus
Authors: Catherine Peckham, Diana Gibb
Journal: New England Journal of Medicine (1995)

Heterosexual transmission is responsible for most infection with the human immunodeficiency virus (HIV). The increase in pediatric HIV infection has had a substantial impact on childhood mortality, both in industrialized countries, such as the United States,1 and in developing countries.2 In some areas in sub-Saharan Africa, 10 to 30 percent of pregnant women are HIV-infected, and infection is now spreading to parts of Southeast Asia.Reporting of pediatric cases of the acquired immunodeficiency syndrome (AIDS) to public health authorities, registers of HIV-infected children, and unlinked anonymous testing of antenatal and neonatal blood samples make it possible to monitor the prevalence . . .
Case 27-1990
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, P.T. O'Gara, J.F. Southern
Journal: New England Journal of Medicine (1990)

Presentation of CaseA 63-year-old woman was admitted to the hospital because of severe substernal pain.The patient was in a stable state of health until 2 1/2 years earlier, when chest pain developed while she was walking uphill and disappeared after several minutes of rest. A physician prescribed nitroglycerin, but chest pain did not recur until five months before entry, while she was watching television, with radiation to the left arm. She took an antacid without relief and went to sleep; the pain was still present when she awoke the next morning, and she was admitted to the hospital. . . .
Bacteriologic Flora of the Lower Respiratory Tract
Authors: Gustave A. Laurenzi, Robert T. Potter, Edward H. Kass
Journal: New England Journal of Medicine (1961)

THE complex nature of chronic bronchitis makes it difficult to define the relative importance of the many factors that might contribute to its pathogenesis and course.1 , 2 The progressive decline of the patient can generally be related to the number, length and severity of acute exacerbations that he suffers. The role of infection in the decline of the bronchitic patient is indicated by the morphologic findings in the bronchopulmonary tree,3 by the relative success of antibacterial treatment of the acute illness and by the occasional effectiveness of the prophylactic use of selected antibiotics.4 5 6 Much of the difficulty in evaluating the role . . .
Trial of Different Intensities of Anticoagulation in Patients with Prosthetic Heart Valves
Authors: Jalal Najib Saour, Jens Otto Sieck, Layla Abdul Rahim Mamo, Alexander Stephen Gallus
Journal: New England Journal of Medicine (1990)

We compared the efficacy and complications of anticoagulation with warfarin in 258 patients with prosthetic heart valves treated with regimens of "moderate intensity" (prothrombin-time ratio, 1.5; international normalized ratio, 2.65) or "high intensity" (prothrombin-time ratio, 2.5; international normalized ratio, 9) in a prospective, randomized study. The two patient groups were followed up for 421 patient-years and 436 patient-years, respectively. Eleven patients were lost to follow-up.
ATNT-06EVALUATION OF THE SAFETY OF GSK2256098 AND PHARMACOKINETICS OF<sup>11</sup>C-GSK2256098 IN PATIENTS WITH RECURRENT GLIOBLASTOMA BY POSITRON EMISSION TOMOGRAPHY (PET) IMAGING
Authors: Paul Mulholland, Matthew Williams, Hendrik-Tobias Arkenau, Ronald Fleming, Jerry Tolson, Li Yan, Jianping Zhang, Lisa Swartz, Rajendra Singh, Kurt Auger, Laurie Lenox, David Cox, Christophe Plisson, Azeem Saleem, Graham Searle, Sarah Blagden
Journal: Neuro-Oncology (2015)
Hyperinsulinemia as an Independent Risk Factor for Ischemic Heart Disease
Authors: Jean-Pierre Després, Benoît Lamarche, Pascale Mauriège, Bernard Cantin, Gilles R. Dagenais, Sital Moorjani, Paul-J. Lupien
Journal: New England Journal of Medicine (1996)

Prospective studies suggest that hyperinsulinemia may be an important risk factor for ischemic heart disease. However, it has not been determined whether plasma insulin levels are independently related to ischemic heart disease after adjustment for other risk factors, including plasma lipoprotein levels.
Soundings: Handing on the gong
Authors: James Owen Drife
Journal: BMJ (2005)

Tonight there will be a little ceremony at our local medical society. As outgoing president I am required to unfasten my medal of office (a test of dexterity, as the catch tends to creep up under the back of the collar) and hang it round the neck of my successor. What he does with it then is up to him.

Doctors generally have little time for ceremonial or insignias. Most of us happily wore academic dress at graduation but otherwise pomp seems masonic and unnecessary. I rather like it, though. At the annual dinner of a medical royal college, for example, it is fun to ask visiting presidents to explain their traditional regalia. In some cases the tradition goes back all of 20 years.

Doctors also have little time for local medical societies. This is a pity. Medical networking nowadays is limited almost exclusively to people in your own specialty. Each of us relates more to the internet than to colleagues down the road or even down the corridor.

Most medical societies began in the 19th century, initially to discuss difficult cases. Then they began inviting out-of-town lecturers. Recently, as continuing professional development has moved into normal working hours, they have struggled to attract audiences. We tried subjects like genetically modified plants or medical aspects of medieval stained glass. They are fascinating but don't pull in the registrars.

Big names from outside medicine are prohibitively expensive, but distinguished medics are still willing, for expenses only, to fit journeys into fraught schedules and deliver talks that are often works of art. They know they will be addressing a tiny proportion of the local doctors, but that doesn't put them off, thank goodness.

Why bother continuing? Because it is enriching to feel that you are part of a learned profession rather than switching only between specialty silo and non-medical mode. Your colleagues become human beings, not names on a letterhead. And the meeting with the student presentations is truly inspirational.

For me, the scariest responsibility has been looking after the silk-lined box with the 19th century presidential medal. Inside the lid is a rather sentimental oath of office. My successor, a forward-thinking GP, may baulk at that. I'll find out tonight.
This Scabies Pandemic
Authors: Milton Orkin, Howard I. Maibach
Journal: New England Journal of Medicine (1978)

UNCOMMON in the 1950's, scabies has progressed in frequency since 1964 to epidemic proportions worldwide.1 2 3 In the United States scabies constitutes about 2 to 4 per cent of patients seen in dermatologists' offices.4 The socioeconomic characteristics of patients with scabies are representative of the overall population.4 In the current cycle typical scabies is seen less frequently. Special forms, especially minimal scabies in clean persons, are common and more difficult to diagnose.Re-evaluation of the toxicology of gamma benzene hexachloride (lindane) has led to its decreased use in infants and young children, and to altered therapeutic routines.5 BiologyThe adult female . . .
Bone-Marrow Ablation and Allogeneic Marrow Transplantation in Acute Leukemia
Authors: Karl G. Blume, Ernest Beutler, Klaus J. Bross, Ram K. Chillar, Owen B. Ellington, John L. Fahey, Mark J. Farbstein, Stephen J. Forman, Gerhard M. Schmidt, Edward P. Scott, Wayne E. Spruce, M. Ann Turner, Jeffrey L. Wolf
Journal: New England Journal of Medicine (1980)

Thirty-three patients with acute leukemia (15 with lymphoblastic leukemia and 18 with myeloblastic leukemia) were entered into a program of high-dose radiochemotherapy followed by allogeneic bone-marrow transplantation. These patients were in various clinical stages of disease. Of 10 in complete hematologic remission at the time of transplantation, seven were alive without maintenance therapy at the time of evaluation, eight to 35 months after grafting; one was in relapse. Of 11 who received transplants during partial remission, six were in remission without further treatment eight to 33 months after transplantation. In 12 the disease was refractory to chemotherapy when preparation for transplantation was started, and only one of them was alive and free of disease after 10 months. Recurrent leukemia, graft-versus-host disease, viral pneumonia, and early therapy-related toxicity were the major causes of failure. High-dose chemotherapy and total-body irradiation followed by allogeneic marrow transplantation performed during complete or partial remission can produce long-term remission of acute leukemia.
Treatment of the Malignant Carcinoid Syndrome
Authors: Larry K. Kvols, Charles G. Moertel, Michael J. O'Connell, Allan J. Schutt, Joseph Rubin, Richard G. Hahn
Journal: New England Journal of Medicine (1986)

We studied the effects of a long-acting analogue of somatostatin (SMS 201–995, Sandoz) in 25 patients with histologically proved metastatic carcinoid tumors and the carcinoid syndrome. This drug was self-administered by subcutaneous injection at a dose of 150 μg three times daily. Flushing and diarrhea associated with the syndrome were promptly relieved in 22 patients. All 25 patients had an elevated 24-hour urinary excretion of 5-hydroxyindoleacetic acid (5-HIAA) (mean, 265 mg per 24 hours; range, 14 to 1079), which served as an objective indicator of disease activity. Eighteen of the 25 patients (72 percent) had a decrease of 50 percent or more in their urinary 5-HIAA levels, as compared with the pretreatment values. The median duration of this biochemical response was more than 12 months (range, 1 to >18). Since no serious toxicity was observed, we conclude that SMS 201–995 may be appropriate for use as early therapy in patients with symptoms due to the carcinoid syndrome who have not responded to simpler measures. (N Engl J Med 315:663–6.)
Zika Virus and Birth Defects — Reviewing the Evidence for Causality
Authors: Sonja A. Rasmussen, Denise J. Jamieson, Margaret A. Honein, Lyle R. Petersen
Journal: New England Journal of Medicine (2016)

Summary The Zika virus has spread rapidly in the Americas since its first identification in Brazil in early 2015. Prenatal Zika virus infection has been linked to adverse pregnancy and birth outcomes, most notably microcephaly and other serious brain anomalies. To determine whether Zika virus infection during pregnancy causes these adverse outcomes, we evaluated available data using criteria that have been proposed for the assessment of potential teratogens. On the basis of this review, we conclude that a causal relationship exists between prenatal Zika virus infection and microcephaly and other serious brain anomalies. Evidence that was used to support this causal relationship included Zika virus infection at times during prenatal development that were consistent with the defects observed; a specific, rare phenotype involving microcephaly and associated brain anomalies in fetuses or infants with presumed or confirmed congenital Zika virus infection; and data that strongly support biologic plausibility, including the identification of Zika virus in the brain tissue of affected fetuses and infants. Given the recognition of this causal relationship, we need to intensify our efforts toward the prevention of adverse outcomes caused by congenital Zika virus infection. However, many questions that are critical to our prevention efforts remain, including the spectrum of defects caused by prenatal Zika virus infection, the degree of relative and absolute risks of adverse outcomes among fetuses whose mothers were infected at different times during pregnancy, and factors that might affect a woman’s risk of adverse pregnancy or birth outcomes. Addressing these questions will improve our ability to reduce the burden of the effects of Zika virus infection during pregnancy.
Estimation of heterozygosity for single-probe multilocus DNA fingerprints.
Authors: J C Stephens, D A Gilbert, N Yuhki, S J O'Brien
Journal: Molecular Biology and Evolution (1992)

In spite of the increasing application of DNA fingerprinting to natural populations and to the genetic identification of humans, explicit methods for estimation of basic population genetic parameters from DNA fingerprinting data have not been developed. Contributing to this omission is the inability to determine, for multilocus fingerprinting probes, relatively important genetic information, such as the number of loci, the number of alleles, and the distribution of these alleles into specific loci. One of the most useful genetic parameters that could be derived from such data would be the average heterozygosity, which has traditionally been employed to measure the level of genetic variation within populations and to compare genetic variation among different loci. We derive here explicit formulas for both the estimation of average heterozygosity at multiple hypervariable loci and a maximum value for this estimate. These estimates are based upon the DNA restriction-pattern matrices that are typical for fingerprinting studies of humans and natural populations. For several empirical data sets from our laboratory, estimates of average and maximal heterozygosity are shown to be relatively close to each other. Furthermore, variances of these statistics based on simulation studies are relatively small. These observations, as well as consideration of the effect of missing alleles and alternate numbers of loci, suggest that the average heterozygosity can be accurately estimated using phenotypic DNA fingerprint patterns, because this parameter is relatively insensitive to the lack of certain genetic information.
SAT0294 Fracture Risk Assessment of Patients with Inflammatory Joint Disease Receiving Biological Agents Attending a Rheumatology Service in a University Affiliated Teaching Hospital
Authors: O. McDonnell, M.B. O'Connor, U. Bond, M.J. Phelan
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Osteoporosis, characterised by deteriorating bone microarchitecture with a concomitant increase in bone fragility, represents a growing public health concern. From an inflammatory arthropathy perspective, especially RA, it is a well-known extra-articular characteristic of concern. Fracture risk can be examined using the World Health Organization Fracture Risk Assessment Tool (FRAX®) which has been formulated to estimate a 10-year absolute risk of fracture using validated clinical risk factors. <h3>Objectives</h3> The aims of our study were to determine the fracture risk in patients receiving biologic therapies using the FRAX® tool and to determine if a care-gap exists in this cohort. <h3>Methods</h3> A cross-sectional telephone based questionnaire study, employing the FRAX® tool, was conducted on Inflammatory arthropathy patients (RA, PsA, SNA, AS), receiving biological therapies, attending our Rheumatology service. Patients received a letter informing them of the study and pending telephone call one week in advance. Those not contactable within two attempted telephone calls were excluded from the study. Patients were randomly selected from the Departments Biologics database. Following FRAX® assessment, patients were classified as low, intermediate or high fracture risk using The National Osteoporosis Guideline Group (NOGG) analysis. <h3>Results</h3> 182 patients were telephoned with 123 patients being contactable within two attempts. 101 patients partook in the study. 8 (8%) had a prior osteoporosis diagnosis. 93 (92%) were eligible for FRAX® assessment with a mean age was 55.5 years (range: 40-75) and 53% male. Of the untreated group 77% had RA, 14% PsA and 8% AS. FRAX® assessment gave a median 10-year hip osteoporotic fracture probability of 2.1% (mean =3.5%) and major osteoporotic fracture probability of 11% (mean =12.4%). NOGG analysis would advise offering treatment to 25%, DXA imaging to 56% and osteoporosis/fracture risk lifestyle advice to 19% of patients. Thus a potential 81% of untreated patients may require osteoporosis/risk fracture prevention measures. <h3>Conclusions</h3> A large care-gap was identified among this patient group. Results highlight the need to identify and modify fracture risk in patients with inflammatory arthropathies receiving biologic therapies. <h3>Disclosure of Interest</h3> None declared
Reasons That Patients with Acute Myelogenous Leukemia Do Not Undergo Allogeneic Bone Marrow Transplantation
Authors: Ellin Berman, Claudia Little, Timothy Gee, Richard O'Reilly, Bayard Clarkson
Journal: New England Journal of Medicine (1992)

Numerous reports suggest that allogeneic bone marrow transplantation prolongs the survival of adult patients with acute myelogenous leukemia (AML) in first remission. However, it is unclear how many such patients actually undergo this procedure.
Imatinib-Induced Bone Edema: Case Report and Review of Literature
Authors: Lucas Vieira dos Santos, João Paulo Lima, Kathia Cristina Abdalla, Arinilda Campos Bragagnoli, Florinda Almeida Santos, Alexandre dos Anjos Jácome, Fabiano Elias Porto
Journal: Journal of the National Comprehensive Cancer Network (2013)

Imatinib mesylate represents a revolution in the management of patients with metastatic gastrointestinal stromal tumors (GISTs). More recently, postoperative imatinib has been shown to improve both disease-free and overall survivals in patients with a high risk of recurrence. This article presents a well-documented case of a patient with painful and reversible bone edema related to imatinib.
Argentine Hemorrhagic Fever
Authors: María M. E. de Bracco, María T. Rimoldi, Patricío M. Cossio, Adriana Rabinovich, Julio I. Maiztegui, Guadalupe Carballal, Roberto M. Arana
Journal: New England Journal of Medicine (1978)

We investigated immunologic mechanisms and the role of complement in the pathogenesis of Argentine hemorrhagic fever, a disease caused by the Junin virus, a member of the arenavirus group. Total serum complement activity was reduced to 68 per cent of control values in patients with severe or moderate disease (P less than 0.001). C2, C3 and C5 values were also low (12 to 60 per cent) during the early acute period of the disease. However, serum C4 content was increased to 160 per cent of the control values in the same patients. Total complement activity returned to normal with clinical and laboratory recovery, at the time of detection of antibodies against Junin virus. C1q reactive material was found in four of 19 cases and no relation to the evolution of the disease could be established. These results suggest that immune complexes are not important in the pathogenesis of Argentine hemorrhagic fever, but that activation of the complement system has a role.
Toward an Effective Ebola Virus Vaccine
Authors: Rohan Keshwara, Reed F. Johnson, Matthias J. Schnell
Journal: Annual Review of Medicine (2016)

Long-term control of viral outbreaks requires the use of vaccines to impart acquired resistance and ensuing protection. In the wake of an epidemic, established immunity against a particular disease can limit spread and significantly decrease mortality. Creation of a safe and efficacious vaccine against Ebola virus (EBOV) has proven elusive so far, but various inventive strategies are now being employed to counteract the threat of outbreaks caused by EBOV and related filoviruses. Here, we present a current overview of progress in the field of Ebola virus vaccine development.
Dexamethasone, rituximab, and cyclophosphamide as primary treatment of Waldenström macroglobulinemia: final analysis of a phase 2 study
Authors: Efstathios Kastritis, Maria Gavriatopoulou, Marie-Christine Kyrtsonis, Maria Roussou, Evdoxia Hadjiharissi, Argyris Symeonidis, Panagiotis Repoussis, Evridiki Michalis, Sosana Delimpasi, Konstantinos Tsatalas, Panagiotis Tsirigotis, Amalia Vassou, Elina Vervessou, Eirini Katodritou, Dimitra Gika, Evangelos Terpos, Meletios A. Dimopoulos
Journal: Blood (2015)
Improvement of Kidney-Graft Survival with Increased Numbers of Blood Transfusions
Authors: Gerhard Opelz, Paul I. Terasaki
Journal: New England Journal of Medicine (1978)

In a study of 1360 cadaver-donor kidney transplants we found a striking correlation of increased numbers of pretransplant blood transfusions with Improved transplant survival (P<0.0001). Graft survival rate in recipients with >20 transfusions was 71±5 per cent at one year as compared with 42±2 per cent for recipients with no transfusions; at four years the survival rates were 65±5 per cent and 30±3 per cent (P<10-6). Frozen blood was less effective than nonfrozen blood in producing this effect. In contrast to previous reports based on fewer numbers of transplants, a single pretransplant transfusion or transfusions given during transplantation had no statistically significant influence on graft outcome. The beneficial effect of pretransplant transfusions was apparent at transplant centers with high or low overall success rates. Deliberate transfusion trials in prospective transplant recipients should consider this strong dose dependence of graft prolongation by transfusions. (N Engl J Med 299:799–803, 1978)