tbuckley/cabot-search huggingface dataset:
Single-Dose Therapy of Gonococcal Ophthalmia Neonatorum with Ceftriaxone
Authors: Marie Laga, Warren Naamara, Robert C. Brunham, Lourdes J. D'Costa, Herbert Nsanze, Peter Piot, Dennis Kunimoto, J.O. Ndinya-Achola, Leslie Slaney, Allan R. Ronald, Francis A. Plummer
Journal: New England Journal of Medicine (1986)

We conducted a randomized clinical trial comparing a single intramuscular dose of 125 mg of ceftriaxone with a single intramuscular dose of 75 mg of kanamycin followed by topical gentamicin for seven days, and with a single intramuscular dose of 75 mg of kanamycin followed by topical tetracycline for seven days, in the treatment of gonococcal ophthalmia neonatorum in Nairobi, Kenya. Of 122 newborns with culture-proved gonococcal ophthalmia neonatorum, 105 returned for follow-up. Sixty-one infants (54 percent) received ceftriaxone, 32 received kanamycin plus topical gentamicin, and 29 received kanamycin plus topical tetracycline. Sixty-six (54 percent) of the Neisseria gonorrhoeae isolates were penicillinase producing. All 55 newborns who received ceftriaxone and returned for follow-up were clinically and microbiologically cured. One of 26 returning newborns who received kanamycin plus tetracycline and 2 of 24 returning newborns who received kanamycin plus gentamicin had persistent or recurrent gonococcal conjunctivitis. Ceftriaxone also eradicated oropharyngeal gonococcal infection in 18 newborns, whereas oropharyngeal infection persisted in 2 of 8 newborns who had received kanamycin (P not significant). We conclude that 125 mg of ceftriaxone as a single intramuscular dose is very effective therapy for gonococcal ophthalmia neonatorum, with marked efficacy against extraocular infection and without the need for concomitant topical antimicrobial therapy.
Identification and targeting of a TACE-dependent autocrine loop which predicts poor prognosis in breast cancer
Authors: Paraic A. Kenny, Mina J. Bissell
Journal: Journal of Clinical Investigation (2005)

The ability to proliferate independently of signals from other cell types is a fundamental characteristic of tumor cells. Using a 3D culture model of human breast cancer progression, we have delineated a protease-dependent autocrine loop which provides an oncogenic stimulus in the absence of proto-oncogene mutation. Inhibition of this protease, TACE/ADAM17, reverts the malignant phenotype by preventing mobilization of two crucial growth factors, Amphiregulin and TGF{alpha}. We show further that the efficacy of EGFR inhibitors is overcome by physiological levels of growth factors and that successful EGFR inhibition is dependent on reducing ligand bioavailability. Using existing patient outcome data, we demonstrate a strong correlation between TACE and TGF{alpha} expression in human breast cancers that is predictive of poor prognosis.
Failure of Children to Receive Penicillin by Mouth
Authors: Abraham B. Bergman, Richard J. Werner
Journal: New England Journal of Medicine (1963)

A TEN-DAY blood level of penicillin is necessary to eradicate Group A beta-hemolytic streptococci from the pharynx.1 , 2 For implementation of this objective the American Heart Association recommends either a single injection of benzathine penicillin G, injections of procaine penicillin with aluminum monostearate every third day for three doses or penicillin, 200,000 to 250,000 units, given three times daily by mouth for a full ten days, even if the patient becomes afebrile and asymptomatic.3 The question always arises when medication is given by mouth whether it actually reaches the patient's stomach, particularly in the amount and for the duration prescribed. . . .
Abstract 109: Interleukin 17 A, Coronary Artery Disease And Gender of The Patients
Authors: Dinaldo C Oliveira, Elayne Heide, Moacyr Rego, Danielle A Oliveira, Felipi W Sarinho, Viviane R Gomes, Maira G Pita
Journal: Circulation Research (2014)

Introduction: The effects of interleukins during development of coronary artery disease (CAD) have been studied by researchers and it may help to understand better this disease. The aim of this study was to evaluate if there are differences of concentrations of the IL 17 A between men and women with stable CAD. Hypothesis: There are no differences of concentrations of the IL 17 A according to gender of the patients. Methods: This is a cross-sectional, prospective, analytical study, conducted from August to December 2012. We included 40 patients (24 men (MP) and 16 women (WP) with stable CAD, CCS III or IV, ischemic myocardial scintigraphy, who had not been subjected to any kind of myocardial revascularization and with coronary stenosis ≥ 50% according to current coronary angiography. There were 20 healthy volunteers (12 men (MC) and 8 women (WC), to take up comparison of concentrations of interleukins (IL). Interleukins were evaluated in serum of patients and after 48 hours of cells in culture with and without stimulus. IL concentrations were expressed in pg / ml. Statistical analysis was performed using the Mann-Whitney or Student t test. P ≤ 0,05 was considered statistically significant. Results: The comparison between the groups showed: IL 17 A: Serum: MP = 3.91 (3.91 - 3.91) vs MC = 3.91 (3.91 - 9.28), p = 0.31; culture 48 hours without stimulus: MP = 3.91 (3.91 - 3.91) vs MC = 3.91 (3.91 - 3.91), p = 0.45; culture 48 hours with stimulus: MP = 451.67 (99.02 - 892.58) vs MC = 135 (3.91 -- 285), p = 0.04. IL 17 A: Serum: WP = 3.91 (3.91 - 3.91) vs WC = 3.91 (3.91 -- 6.25), p = 0.90; culture 48 hours without stimulus: WP = 3.91 (3.91 - 3.91) vs WC = 3.91 (3.91 -- 3.91), p = 0.20; culture 48 hours with stimulus: WP = 131.21 (3.91 - 231.97) vs WC = 173.78 (3.91 - 642), p = 0.24. IL 17 A: Serum: MP = 3.91 (3.91 - 3.91) vs WP = 3.91 (3.91 - 3.91), p = 0.17; culture 48 hours without stimulus: MP = 3.91 (3.91 - 3.91) vs WP = 3.91 (3.91 - 3.91), p = 0.47; culture 48 hours with stimulus: MP = 451.67 (99.02 -- 892.58) vs WP = 131.21 (3.91 - 231.97), p = 0.02. Conclusions: There were no differences of concentrations of the IL 17 A between WP and WC. However, MP had higher concentrations of the IL 17 A than MC and WP. Therefore, it is possible that the IL 17 A take part in a pathway which determines different patterns of CAD according to gender.
HCP-12IMPROVING THE EFFICIENCY OF MOLECULAR TESTING FOR EXPEDITED BRAIN TUMOR PATIENT MANAGEMENT AND CLINICAL TRIAL ENROLLMENT
Authors: Justin T. Jordan, Julie Batten, Jochen Lennerz, Matthew Froch, A. John Iafrate, Tracy T. Batchelor
Journal: Neuro-Oncology (2015)

BACKGROUND: O6-methylguanine methyltransferase (MGMT) methylation status is prognostic in glioblastoma. It is a critical datum in optimizing care in elderly glioblastoma patients. Further, MGMT methylation status is increasingly required for clinical trial enrollment (e.g. NCT02336165, NCT02287428). As such, maximizing efficiency of molecular tumor testing is critical in order to provide the best care for glioblastoma patients. METHODS: Using the longitudinal electronic medical record and pathology sample tracking systems, we determined the turn around time (TAT) from tumor resection to MGMT methylation status reporting, along with various intermediate steps along the way. We performed interdepartmental process mapping to identify opportunities for process change, followed by 2 process interventions with follow-up tracking of TAT with statistical process control testing. RESULTS: The baseline average interval from craniotomy to MGMT methylation result was 25.1 days for the 30 weeks prior to intervention, which included ∼5 days from craniotomy to pathological diagnosis, and ∼18 days from pathological diagnosis to MGMT result. Two tests of change were implemented, including a switch from batched to daily DNA extraction and MGMT methylation testing, and implementation of a new procedure for pathology sample inventory within the molecular pathology laboratory. The median time from craniotomy to MGMT methylation status reporting was reduced to from 25.1 days to 17 days after the first intervention, and to 15 days after the second intervention, with significant TAT reduction. CONCLUSIONS: Through clinical process improvement strategies and interdepartmental collaboration, we significantly reduced the TAT from craniotomy to MGMT methylation status reporting by an average of 10 days (40%). This allows for improved patient care by accelerating the delivery of potentially treatment-altering information as well as supplying earlier eligibility information for clinical trial enrollment. We continue to study additional opportunities for intervention, as this work highlights the possibility for neuro-oncology care improvement through process improvement strategies.
The Clinical Significance of Extracellular Material (ECM) in L.E.-Cell Preparations
Authors: Mary Betty Stevens, Helen Abbey, Lawrence E. Shulman
Journal: New England Journal of Medicine (1963)

AS the initial event in L.E.-cell formation an abnormal serum gamma globulin (the L.E.-cell factor) reacts with leukocyte nuclei, causing them to swell, to lose their lobulation and chromatin pattern and thus to become amorphous, homogeneous globules (Fig. 1). Secondarily, these globular bodies of altered nuclear material may be phagocytized by intact leukocytes to form typical L.E. cells (Fig. 1).Nonphagocytized nuclear bodies (hereafter designated extracellular material, or ECM), histologically identical to the L.E.-cell inclusion, are found in the absence of L.E. cells, as well as in positive L.E.-cell preparations. Although great diagnostic importance has been attached to the finding . . .
GENO-17AN 8-microRNA SIGNATURE PREDICTS RESPONSE TO BEVACIZUMAB IN GLIOBLASTOMA
Authors: Josie Hayes, Pim French, Martin Van Den Bent, Walter Gregory, David Westhead, Sean Lawler, Susan Short
Journal: Neuro-Oncology (2015)

Following the trials of bevacizumab for the treatment of glioblastoma multiforme, there has been considerable discussion over whether this drug should be recommended as a standard treatment for this disease. Trial data suggests prolongation of progression-free survival, but no effect on overall survival. Despite these results, tails of Kaplan Meier curves and observations on a case-by-case basis suggest bevacizumab improves overall survival in certain patient subsets. We used TCGA microRNA expression data from tumors resected at first diagnosis of glioblastoma in patients treated with bevacizumab and randomly separated these into training (n = 50) and test (n = 37) groups. Using a cross-validated penalized regression model we identified 8 microRNAs as potential predictors of overall survival in the training set. We created a response score using the total expression of these microRNAs, weighted by regression coefficient. This was dichotomized based on the most prognostic minimum of a density plot of the response scores (Log-rank HR = 0.16, p = 1.2e-5). This was then validated in the test cohort (one-sided log-rank HR = 0.34, p = 0.026). Analysis of the signature using all samples in the TCGA, regardless of treatment received, (n = 562) showed that the response prediction was much less powerful (HR = 0.73, p = 1.6e-3) in this cohort suggesting the signature is specific to bevacizumab. The definition of a bevacizumab responding group was validated using expression of microRNAs from RNA-seq data from patients treated with bevacizumab or CCNU at recurrence in the BELOB trial. This showed that ‘responders’ defined by the microRNA signature survived significantly longer than ‘non-responders’ after treatment with bevacizumab (n= 20, HR = 0.23, p = 0.020) but not after treatment with CCNU (n= 22, HR = 0.35, p = 0.052). In conclusion, we have identified an 8-microRNA signature that predicts overall survival in patients with glioblastoma treated with bevacizumab. This may be useful for identifying patients who are likely to benefit from this agent.
Malignant Cells in Peripheral Blood
Authors: J. C. Pruitt, A. W. Hilberg, R. F. Kaiser
Journal: New England Journal of Medicine (1958)

THE fact that malignant tumor cells are sometimes found in the circulating peripheral blood has been demonstrated by several investigators,1 2 3 but the presence of these cells has been thought to be extremely rare. Recent reports, however, indicate that many patients with known cancer have recognizable tumor cells in circulating blood. Engell4 describes definite tumor cells in the peripheral blood of 9.7 per cent of the patients he examined, and "atypical tumor-like cells" in 8.5 per cent. Sandberg and Moore5 report the findings of tumor cells in the peripheral blood of 38 per cent of patients with advanced adenocarcinoma. Both groups . . .
Prognostic Significance of Reverse Transcriptase Polymerase Chain Reaction for Prostate-Specific Antigen in Men With Hormone-Refractory Prostate Cancer
Authors: Philip W. Kantoff, Susan Halabi, Deborah A. Farmer, Daniel F. Hayes, Nicholas A. Vogelzang, Eric J. Small
Journal: Journal of Clinical Oncology (2001)

PURPOSE: To evaluate the prognostic significance of reverse transcriptase polymerase chain reaction (RT-PCR) detection of prostate-specific antigen (PSA) mRNA in the blood of men with hormone-refractory prostate cancer (HRPC). PATIENTS AND METHODS: Peripheral blood was obtained from 193 men enrolled on Cancer and Leukemia Group B Study 9480, a prospective randomized comparison of three doses of suramin. RNA was isolated from the samples and assayed for the presence of PSA transcripts by RT-PCR. RESULTS: RNA could be isolated in 156 (83%) of samples. PSA transcripts as measured by RT-PCR were detectable in 75 (48%) of the 156 patients. The median survival for those patients in whom no transcripts were detectable was 18 months (95% confidence interval [CI], 14 to 22 months) compared with 13 months (95% CI, 11 to 15 months) (P = .004) for those in whom transcripts were detectable. In a multivariate analysis in which other factors predictive of survival were used, RT-PCR for PSA provided independent prognostic information. CONCLUSION: RT-PCR for PSA predicts survival duration in a population of men with HRPC.
Modeling Diamond Blackfan Anemia in Vivo Using Human Induced Pluripotent Stem Cells
Authors: Sergei Doulatov, Linda T Vo, Elizabeth R Macari, Stephanie S Chou, Manav Gupta, Michelle Godfrey, Katherine McGrath, Thorsten M Schlaeger, Leonard I. Zon, George Q. Daley
Journal: Blood (2014)
Effects of Theophylline on Erythropoietin Production in Normal Subjects and in Patients with Erythrocytosis after Renal Transplantation
Authors: George L. Bakris, Edward R. Sauter, John L. Hussey, James W. Fisher, A. Osama Gaber, Rebecca Winsett
Journal: New England Journal of Medicine (1990)

Erythrocytosis occurs in 10 to 15 percent of renal-transplant recipients, and there is in vitro evidence that the production of erythropoietin is modulated by adenosine.
Intestinal Obstruction of the Newborn Infant
Authors: E. Elian, H. Shwaghman, W. H. Hendren
Journal: New England Journal of Medicine (1961)

INTESTINAL obstruction of the newborn infant is a surgical emergency, and an effort should be made to determine the cause before surgical exploration. The accuracy of preoperative diagnosis varies. Gross1 believes that with the aid of all available information, including a history, family history, physical examination and x-ray studies, a correct diagnosis may be made preoperatively in 70 to 80 per cent of such cases. Of special interest are the few cases diagnosed as ileal atresia treated successfully by surgery, in whom the typical picture of cystic fibrosis of the pancreas develops later in life. We have seen 3 such . . .
Case 39-1994
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Michael B. Raizman, Max L. Goodman, Eugene J. Mark
Journal: New England Journal of Medicine (1994)

Presentation of CaseA 69-year-old woman was admitted to the hospital because of a right orbital mass with chronic conjunctivitis.One month before admission she had noticed that her right eye was bloodshot. An ophthalmologist found a mass beneath the lateral aspect of the right lower lid with overlying conjunctival injection. Dexamethasone eye drops were prescribed. A computed tomographic (CT) scan of the orbits (Figure 1 and Figure 2) showed a slightly ill-defined, enhanced mass in the inferior and lateral anterior right orbit, without calcification or cavitation; there was no bone destruction, paranasal sinus disease, or evidence of an intraocular malignant tumor. . . .
Intraperitoneal chemotherapy: Who, what, when, and how in diverse academic settings.
Authors: L. R. Boyd, A. Novetsky, T. L. Pua, B. Pothuri, J. P. Curtin, R. C. Wallach, S. V. Blank
Journal: Journal of Clinical Oncology (2010)

5114 Background: When GOG 172 showed a benefit to intraperitoneal (IP) chemotherapy as frontline treatment for advanced ovarian cancer, our division adopted IP as the preferred treatment at both a public and a private hospital setting. We evaluated decision-making for IP port placement and use for patients (pts) with advanced ovarian cancers. Methods: A chart review was undertaken from January 2005 to May 2009. All pts with a diagnosis of advanced (stage III or IV) epithelial ovarian, fallopian tube or primary peritoneal cancer were included. Operative reports and chemotherapy records were reviewed. Statistical analysis was performed using chi-square analyses. Results: A total of 108 pts were identified for inclusion in the study. Of these, 90/108 (83%) were optimally debulked and were evaluated for IP port placement. 37% of pts received an IP port at the time of cytoreductive surgery. An additional 16% of patients received an interval IP port via laparoscopic insertion, for a total of 53% of eligible patients receiving IP ports. Pts aged ≤ 60 were more likely to have an IP port placed (p < 0.04) than pts over age 60. Hospital type (public or private) did not affect the rate of IP port placement, although pts at the public hospital were less likely to undergo optimal cytoreduction (p = 0.04). Race/ethnicity and ASA class were not associated with likelihood of IP port placement. The rate of IP port placement increased over time, with more ports placed in the latter years of our series (p = 0.003). 26/40 (65%) of pts with IP ports received ≥ 4 cycles of chemotherapy, while 5/40 (13%) received no IP chemotherapy. The most common reasons for failed completion include: grade 3 toxicity; patients' fear of toxicity; and port malfunction. Conclusions: Despite a concerted institution-wide effort to implement IP therapy as standard treatment for patients with optimally debulked ovarian cancer, a substantial percentage of pts do not receive IP ports. This percentage is improving over time. The rate of IP port placement was similar in both a public and private hospital setting. Although placement will likely increase with surgeons' comfort, refinements are needed to decrease the toxicities associated with the 172 regimen, while maintaining its successful outcome. No significant financial relationships to disclose.
Angle Closure Phenotypes in Siblings of Patients at Different Stages of Angle Closure
Authors: Nazlee Zebardast, Srinivasan Kavitha, Krishnamurthy Palaniswamy, Sabyasachi Sengupta, Mohideen Abdul Kader, Ganesh Raman, Sharmila Reddy, Pradeep Y. Ramulu, Rengaraj Venkatesh
Journal: Ophthalmology (2016)
Domino Hepatic Transplantation in Maple Syrup Urine Disease
Authors: Bruce A. Barshop, Ajai Khanna
Journal: New England Journal of Medicine (2005)

To the Editor: Orthotopic liver transplantation has been performed in at least 10 patients who have maple syrup urine disease (MSUD).1–4 In the first patients, transplantation was for nonmetabolic ...
Pathology of Cricoarytenoid Arthritis
Authors: William W. Montgomery
Journal: New England Journal of Medicine (1959)

A PREVIOUS publication1 discussed the etiology, the signs, the symptoms and the laryngeal picture of cricoarytenoid arthritis. Since the publication of this paper, which was based on 4 cases, 13 additional cases have been observed, and now the autopsy and microscopical findings of the larynges of 2 patients who had suffered with arthritis of the larynx are available.As reported in the previous paper, the cricoarytenoid joint is arthrodial in type (presence of a joint cavity), with a capsule of fibrous and synovial stratums attached to the edges of the joint surfaces, and is reinforced by the cricoarytenoid posterior ligament . . .
Consensus Plans Emerge to Tackle Long-term Care Costs
Authors: Stuart M. Butler
Journal: JAMA (2016)

Promotion, whose division led the development of the guidelines, said their data review showed that current intake of added sugars was much higher than ideal based on food-pattern modeling for healthy diets."Today in American adults, about 13.4% of their calories come from added sugars, and for children and adolescents, it's 17%," Olson said.According to their findings, about 70% of people in the United States consume added sugar above the recommended 10% limit.To help individuals reduce added sugar intake, the guidelines were crafted to give concrete goals instead of just suggestions, he said."Ten percent is basically a target to move the population down to added sugar amounts that fit in a healthy diet: it's not a magic number," he added.In the typical US diet, 31% of calories from added sugars come from snacks and sweets, and 47% come from added sugars in beverages (not including milk or 100% fruit juices).One-quarter of added sugars come from drinking sweetened soda.However, despite the fact that sweetened soda is the greatest source of added sugars in the US diet, the guideline authors made no specific recommendations for limiting its consumption, an omission that has garnered criticism.In a recent forum on cancer and diet, presented in collaboration with the Huffington Post and in association with Harvard Health Publications by the Harvard T. H.
Cancer-Causing Substances in Food, Drugs, and Cosmetics
Journal: New England Journal of Medicine (1989)

EVERY calling, every profession, every common activity of people develops its maxims, its short-hand messages, imparting to later generations the hard-earned lessons of the past. These maxims are often designed to save time that would be wasted, or to avoid risks or dangers that our elders underwent to their peril. Legal systems, filled as they are with historical documentation and adherence to precedent, are replete with pithy maxims that every new law student learns by rote. One of the most frequently cited maxims of the ancient common law is the de minimis rule, which is used to avoid the pointless . . .
Genetic Mapping of the 21-Hydroxylase-Deficiency Gene within the HLA Linkage Group
Authors: Lenore S. Levine, Milo Zachmann, Maria I. New, Andrea Prader, Marilyn S. Pollack, Geoffrey J. O'Neill, Soo Y. Yang, Sharon E. Oberfield, Bo Dupont
Journal: New England Journal of Medicine (1978)

To document further the proposed genetic linkage between congenital adrenal hyperplasia due to 21-hydroxylase deficiency and HLA, 34 unrelated families from New York and Zurich, with a total of 48 patients, 48 siblings and their parents, were studied. All patients were HLA genotypically different from the healthy sibs; when two or more children were affected in the same sibship they were always HLA-B identical. The gene for 21-hydroxylase deficiency was separated by genetic recombination from the HLA-A locus and from the locus for glyoxalase I-polymorphism. No HLA-A, HLA-B or HLA-C antigen was selectively increased among the 34 unrelated patients. Lod-score analysis for HLA-B:21-hydroxylase deficiency gave a peak for theta approximately 0.00 at 5.20 for females and 4.30 for males, giving a total peak lod score of 9.5 at theta approximately 0.00 when male and female lod scores were combined. Close genetic linkage between HLA-B and 21-hydroxylase deficiency was thus established.