tbuckley/cabot-search huggingface dataset:
Clinical and Neuroradiographic Manifestations of Eastern Equine Encephalitis
Authors: Robert L. Deresiewicz, Scott J. Thaler, Liangge Hsu, Amir A. Zamani
Journal: New England Journal of Medicine (1997)

Eastern equine encephalitis occurs principally along the east and Gulf coasts of the United States. Recognition of the neuroradiographic manifestations of eastern equine encephalitis could hasten the diagnosis of the illness and speed the response to index cases.We reviewed all cases of eastern equine encephalitis reported in the United States between 1988 and 1994. The records of 36 patients were studied, along with 57 computed tomographic (CT) scans and 23 magnetic resonance imaging (MRI) scans from 33 patients.The mortality rate was 36 percent, and 35 percent of the survivors were moderately or severely disabled. Neuroradiographic abnormalities were common and best visualized by MRI. Among the patients for whom MRI scans were available, the results were abnormal for all eight comatose patients as well as for all three noncomatose patients who subsequently became comatose. The CT results were abnormal in 21 of 32 patients with readable scans. The abnormal findings included focal lesions in the basal ganglia (found in 71 percent of patients on MRI, and in 56 percent on CT), thalami (found in 71 percent on MRI and in 25 percent on CT), and brain stem (found in 43 percent on MRI and in 9 percent on CT). Cortical lesions, meningeal enhancement, and periventricular white-matter changes were less common. The presence of large radiographic lesions did not predict a poor outcome, but either high cerebrospinal fluid white-cell counts or severe hyponatremia did.Eastern equine encephalitis produces focal radiographic signs. The characteristic early involvement of the basal ganglia and thalami distinguish this illness from herpes simplex encephalitis. MRI is a sensitive technique to identify the characteristic early radiographic manifestations of this viral encephalitis.
Antibody-Coated Bacteria in the Urine and the Site of Urinary-Tract Infection
Authors: Virginia Thomas, Alexis Shelokov, Marvin Forland
Journal: New England Journal of Medicine (1974)

An immunofluorescence test for the detection of antibody-coated bacteria in urinary sediments of patients with urinary-tract infections was studied for its predictive value in determining the site of infection. Antibody-coated bacteria were observed in urine specimens from 34 of 35 patients with pyelonephritis; they were not observed in urines from 19 of 20 patients with cystitis. Most of the patients (20 of 28) with antibody-coated bacteria in the urine had high serum antibody titers against their own infecting bacteria. These results suggest that the immunofluorescence test can be useful in distinguishing infection of the kidney from infection of the bladder. (N Engl J Med 290:588–590, 1974)
Abstract 3362: Systematic evaluation of immune checkpoint inhibitors
Authors: Sheri Barnes, Paula Miliani de Marval, Jacob Hauser, Tracy Brainard, Daniel Small, Aidan J. Synnott, Robert J. Mullin
Journal: Cancer Research (2015)

Abstract With the increasing success and subsequent interest in tumor immunology, we recognized a growing need for well-characterized preclinical models. While the literature contains many different experimental models, the available data includes a variety of reagents and the side by side comparative evaluation of therapeutics in multiple models is relatively rare. Lechner et al., (J. Immunother. 36:477-489, 2013) addressed this issue and reported on a comparative analysis of a set of six syngeneic models. Our effort looked to expand this paradigm towards a comparative evaluation of the responsiveness of a collection of syngeneic models to antibody based checkpoint inhibitor therapeutics. Specifically, we examined the response of the Colon26, MC38, B16F10, Lewis Lung, Madison109, EMT-6, and 4T1 models to anti-CTLA-4, anti-PD-1 and anti-PDL-1 monotherapies as well as capturing the response to combination therapies of anti-CTLA-4 with anti-PD-1 or anti-PDL-1.. Our results clearly show a differential response across this set of models both in regard to CTLA-4 targeted therapy as well as PD-1/PDL-1 therapy. In an attempt to expand the number of checkpoint inhibitor responsive models, we are performing a second phase of work evaluating the impact of immuno-modulatory radiation therapy upon these baseline responses. In initiating these studies and evaluating the literature, it became clear that there were multiple choices in regard to anti-CTLA-4 preclinical reagents. We have also performed a series of studies evaluating the efficacy of multiple anti-CTLA-4 clones as an extension of previously published work which described the variable ability of anti-CTLA-4 clones to deplete tumor Treg populations (Simpson et al. J. Exp. Med. 210(9) 1695-1710, 2013). Our anti-tumor data correlates well with these cell based observations. This differential allows one to match efficacy with model and expands the reagents available for evaluating combination therapies. Citation Format: Sheri Barnes, Paula Miliani de Marval, Jacob Hauser, Tracy Brainard, Daniel Small, Aidan J. Synnott, Robert J. Mullin. Systematic evaluation of immune checkpoint inhibitors. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3362. doi:10.1158/1538-7445.AM2015-3362
Inhibition of Terminal Axonal Sprouting by Serum from Patients with Amyotrophic Lateral Sclerosis
Authors: Mark E. Gurney, Ardean C. Belton, Neil Cashman, Jack P. Antel
Journal: New England Journal of Medicine (1984)

To investigate the pathogenesis of amyotrophic lateral sclerosis, we compared the effect of serum from patients with this disease on the regenerative sprouting of terminal axons in botulinum-treated mouse gluteus muscle with the effects of serum from controls and from patients with diabetic peripheral neuropathy. Serum from 9 of 19 patients with the sporadic form of amyotrophic lateral sclerosis and from 2 of 6 patients with the familial form caused a reduction in the proportion of sprouting terminal axons, as compared with that found in muscles treated with serum from controls or diabetic patients. Immunoglobulin from patients with amyotrophic lateral sclerosis, when tested on immunoblots, recognized a 56-kilodalton protein secreted by denervated rat diaphragm muscle; rabbit antiserum raised against this protein also suppressed terminal axonal sprouting. Thus, we have detected an antibody in the serum of patients with amyotrophic lateral sclerosis that inhibits sprouting of neurons and subsequent reinnervation of skeletal muscle. Whether this antibody is of primary pathogenic importance or represents a secondary response to neuromuscular destruction is not known. In either case, serum from patients with amyotrophic lateral sclerosis may provide reagents for studies of the trophic communications between muscle and motor neurons.
A Trial of Annual in-Home Comprehensive Geriatric Assessments for Elderly People Living in the Community
Authors: Andreas E. Stuck, Harriet U. Aronow, Andrea Steiner, Cathy A. Alessi, Christophe J. Büla, Marcia N. Gold, Karen E. Yuhas, Rosane Nisenbaum, Laurence Z. Rubenstein, John C. Beck
Journal: New England Journal of Medicine (1995)

The prevention of disability in elderly people poses a challenge for health care and social services. We conducted a three-year, randomized, controlled trial of the effect of annual in-home comprehensive geriatric assessment and follow-up for people living in the community who were 75 years of age or older. The 215 people in the intervention group were seen at home by gerontologic nurse practitioners who, in collaboration with geriatricians, evaluated problems and risk factors for disability, gave specific recommendations, and provided health education. The 199 people in the control group received their regular medical care. The main outcome measures were the prevention of disability, defined as the need for assistance in performing the basic activities of daily living (bathing, dressing, feeding, grooming, transferring from bed to chair, and moving around inside the house) or the instrumental activities of daily living (e.g., cooking, handling finances and medication, housekeeping, and shopping), and the prevention of nursing home admissions.At three years, 20 people in the intervention group (12 percent of 170 surviving participants) and 32 in the control group (22 percent of 147 surviving participants) required assistance in performing the basic activities of daily living (adjusted odds ratio, 0.4; 95 percent confidence interval, 0.2 to 0.8; P = 0.02). The number of persons who were dependent on assistance in performing the instrumental activities of daily living but not the basic activities did not differ significantly between the two groups. Nine people in the intervention group (4 percent) and 20 in the control group (10 percent) were permanently admitted to nursing homes (P = 0.02). Acute care hospital admissions and short-term nursing home admissions did not differ significantly between the two groups. In the second and third years of the study, there were significantly more visits to physicians among the participants in the intervention group than among those in the control group (mean number of visits per month, 1.41 in year 2 and 1.27 in year 3 in the intervention group, as compared with 1.11 and 0.92 visits, respectively, in the control group; P = 0.007 and P = 0.001, respectively). The cost of the intervention for each year of disability-free life gained was about $46,000.A program of in-home comprehensive geriatric assessments can delay the development of disability and reduce permanent nursing home stays among elderly people living at home.
Transiently Reduced Activity of Carbamyl Phosphate Synthetase and Ornithine Transcarbamylase in Liver of Children with Reye's Syndrome
Authors: Ted Brown, George Hug, Lester Lansky, Kevin Bove, Annette Scheve, Mary Ryan, Henry Brown, William K. Schubert, John C. Partin, John Lloyd-Still
Journal: New England Journal of Medicine (1976)

Since Reye's syndrome is associated with hyperammonemia, we measured the urea-cycle enzymes in hepatic tissue of 13 patients. Expressed as nanomoles of citrulline per milligram of hepatic protein per minute, mean activity of carbamyl phosphate synthetase (6.27 +/- 2.45 S.D.) and ornithine transcarbamylase (136.19 +/- 41.83) in Reye's syndrome was reduced significantly (P less than 0.005) when compared with that of 25 "normal" controls (11.54 +/- 4.24 and 307.49 +/- 94.15, respectively). Activity was maximally reduced during the first days of clinical symptoms; it returned toward normal during the following week regardless of whether the disease ended in death or recovery. The activity of the two enzymes was normal in patients with salicylate intoxication or heritable argininosuccinic acid synthetase deficiency. The apparent Km of hepatic ornithine transcarbamylase for ornithine was in the normal range in patients with Reye's syndrome (mean 0.24 mM). These observations indicate that Reye's syndrome is associated with acquired and transient dysfunction of hepatic mitochondrial urea-cycle enzymes.
Case 14-1993
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Michael M. Lewis, John X. O'Connell
Journal: New England Journal of Medicine (1993)

Presentation of CaseA 74-year-old woman was admitted to the hospital because of hypercalcemia and an osteolytic bone lesion.The patient had been in good health until six years earlier, when hypercalcemia was discovered. The alkaline phosphatase was increased, and the parathyroid hormone was six times the upper limit of normal. The calcium rose as high as 13.6 mg per deciliter (3.4 mmol per liter), although the patient denied all symptoms. An ultrasonographic examination of the neck was said to show no definite evidence of a parathyroid adenoma.Thereafter the patient continued to feel well except for intermittent fatigue until . . .
Palate Destruction by Aspergillus
Authors: S Schwartz, E Thiel
Journal: New England Journal of Medicine (1997)

Figure 1. A 24-year-old man was treated with high-dose cytarabine and idarubicin for relapsed acute myeloid leukemia. Ten days after beginning chemotherapy, the patient required nasal tamponade for heavy epistaxis. Three days later, tenderness over the right maxillary sinus and right-sided periorbital swelling developed. Computed tomography (top panel) revealed opacification of the ethmoidal right sinus (black arrow) and thickening of the periorbital soft tissue (white arrows) but no bone destruction. Histologic examination of surgical-debridement specimens showed
Secondary Acute Myeloid Leukemia after Treatment of Acute Monoblastic Leukemia
Authors: Christian Kebelmann-Betzing, Karlheinz Seeger, Andreas Kulozik, Günter Henze, Thomas Liehr, Anita Heller, Andrea Teigler-Schlegel
Journal: New England Journal of Medicine (2000)

To the Editor: Secondary cancer is an important complication of the treatment of childhood cancer. The occurrence of secondary acute myeloid leukemia (AML) after successful treatment of a variety of tumors1–3 generally carries a poor prognosis. We report a case of secondary AML that followed treatment for acute monoblastic leukemia. A 21-year-old woman had been treated when she was 18 years old for acute monoblastic leukemia subtype M5a according to the French–American–British (FAB) classification with cytarabine (cumulative dose, 36.2 g per square meter of body-surface area), etoposide (795 mg per square meter), thioguanine (2.58 g per square meter), doxorubicin . . .
Differential Characteristics of the Electrocardiogram in Early Repolarization and Acute Pericarditis
Authors: David H. Spodick
Journal: New England Journal of Medicine (1976)

Electrocardiographic mimicry necessitates differentiation between acute pericarditis and early repolarization. Among 96 persons, limb-lead RST deviations occurred in all 48 with pericarditis, but only 27 with early repolarization. RS-T vectors (A RS-T) in pericarditis tended to be horizontal (25 patients) and left of the T vector, A T (28 patients); in early repolarization, A RS-T was vertical in 15 subjects and right of A T (20 subjects); P less than or equal to 0.01. RS-T depression in Lead V1 was more common in pericarditis (14 vs. two); isoelectric RS-T in Lead V6 was more common in early repolarization (10 vs. one); P less than or equal to 0.01. PR segment deviations occurred in both limb and precordial leads in pericarditis; in early repolarization they were confined to either lead group. Thus, R-ST deviations in both limb and precordial leads with horizontal A RS-T to left of A T and RS-T depression in Lead V1 favor pericarditis; vertical A RS-T and isoelectric RS-T in Lead V6 favor early repolarization.
Nontuberculous Spinal Epidural Infections
Authors: A. Price Heusner
Journal: New England Journal of Medicine (1948)

NONTUBERCULOUS spinal epidural infections are infrequent disorders that merit periodic reconsideration by the profession at large because of the heavy responsibility accruing to the practitioner who first visits a patient thus afflicted. Final diagnosis and definitive treatment of these infections are now regarded as functions of specialists, but the decisive factor in the outcome of most cases is the celerity with which the first attending physician suspects the probable nature of the ailment and summons expert aid. Thus, early diagnosis leading to prompt surgical intervention is regularly rewarded by total recovery. On the other hand, even brief delay of operation . . .
Defective Polymorphonuclear-Leukocyte Function and Chronic Granulomatous Disease in Two Female Children
Authors: Paul G. Quie, Edward L. Kaplan, Arthur R. Page, Frank L. Gruskay, Stephen E. Malawista
Journal: New England Journal of Medicine (1968)

In vitro studies of polymorphonuclear-leukocyte function in two female patients with clinical and pathological features of chronic granulomatous disease of childhood showed defective bactericidal capacity and abnormalities of metabolic response to phagocytosis. There was no clinical or laboratory evidence of leukocytic abnormalities in the family members of these girls. All patients with this syndrome previously described have been males. The syndrome in males is familial, and its transmission is X linked. The studies of leukocytic function in these girls demonstrate that defective bactericidal function and metabolic abnormalities of polymorphonuclear leukocytes associated with chronic granulomatous disease are not necessarily familial and are not limited to male patients with X-linked hereditary disease.
Abstract A1-14: Discovery of a functional SNP in an estrogen receptor binding site in the IGF1R gene
Authors: Amir Bahreini, Amir Bahreini, Lucas Santanas, Peilu Wang, Panayiotis V. Benos, Adrian V. Lee, Adrian V. Lee, Steffi Oesterreich, Steff Oesterreich
Journal: Cancer Research (2015)

Abstract Estrogen receptor (ER) positive luminal breast cancer represents approx 70% of all newly diagnosed breast cancers. ER is known to drive breast cancer development and progression, and targeting ER has been one of the most successful targeted therapies in oncology. Given the paucity of functional DNA sequence variants (DSVs) within the ER in primary breast tumors, we asked whether DSVs in ER binding sites could contribute to altered hormone response through changes in ER recruitment to DNA. We developed a pipeline to extract DSVs in ER binding sites, and to assess their impact on ER binding in a genome-wide manner, using ChIP-seq data from hormone responsive breast cancer cells. We utilized MACS for peak calling and GATK for calling DSVs including SNVs and short indels. Using 22,143 ER binding sites which overlapped in at least six data sets, we detected 1,409,406 DSVs from 441,855,039 reads. Position weight matrix (PWM) was used to scan the genome for potential ERE motifs, and identified 126 potential DSVs which were predicted to change ER binding. Of those, 29 DSV-containing EREs were in proximity or within estrogen regulated genes. Intriguingly, the top hit was a previously reported SNP within intron 2 of the IGF1R gene (rs62022087), which our data predicted to increase the affinity for ER binding. The ERE lies in a regulatory region characterized by active histone marks such as H3K29ac and H3k4Me1, and recruitment of a number of transcription factors including c-myc, FoxA1, GATA-1, and finally DNase I hypersensitive sites. Further analysis of published ChIP-seq studies on 6 ER+ cell lines and 15 primary tumors revealed that the presence of rs62022087 was associated with the enrichment of reads over the ER binding site, suggesting that the DSV indeed increases binding affinity of ER. Our further in-vitro functional studies confirmed that ER is more preferentially binding to mutant allele vs wild-type allele. In summary, we have shown that our pipeline is capable of predicting potential regulatory DSVs in ER binding sites. Studies are ongoing to understand functional and clinical relevance of rs62022087, especially with respect to crosstalk between estrogen and IGF1 signaling. Citation Format: Amir Bahreini, Amir Bahreini, Lucas Santanas, Peilu Wang, Panayiotis V. Benos, Adrian V. Lee, Adrian V. Lee, Steffi Oesterreich, Steff Oesterreich. Discovery of a functional SNP in an estrogen receptor binding site in the IGF1R gene. [abstract]. In: Proceedings of the AACR Special Conference on Translation of the Cancer Genome; Feb 7-9, 2015; San Francisco, CA. Philadelphia (PA): AACR; Cancer Res 2015;75(22 Suppl 1):Abstract nr A1-14.
New Positive Inotropic Agents in the Treatment of Congestive Heart Failure
Authors: Wilson S. Colucci, Richard F. Wright, Eugene Braunwald
Journal: New England Journal of Medicine (1986)

The treatment of congestive heart failure has traditionally centered on the judicious use of rest, diuretics, cardiac glycosides, and restriction of dietary sodium.1 More recently, manipulation of cardiac preload and afterload with vasodilating drugs has become a widely accepted adjunctive therapy.2 3 4 Despite the vigorous application of all these approaches, many patients with congestive heart failure remain symptomatically compromised, and their prognosis continues to be very poor.5 6 7 8 Since congestive heart failure is usually caused by impaired ventricular systolic function, considerable effort has been devoted to the search for pharmacologic agents capable of augmenting cardiac contractility.9 The only currently available and widely . . .
A phase II study combining tremelimumab and durvalumab (MEDI4736) immunomodulating antibodies in mesothelioma patients: The NIBIT-MESO-1 study
Authors: L. Calabrò, A. Morra, E. Fonsatti, D. Giannarelli, D. Annesi, E. Bertocci, R. Danielli, M. Altomonte, A.M. Di Giacomo, M. Maio
Journal: Annals of Oncology (2015)
Electrocardiography by Do-It-Yourself Radiotelemetry
Authors: Frederick W. Fasgenelli
Journal: New England Journal of Medicine (1965)

RADIOTELEMETRY for biomedical monitoring has become a frequently used research tool; however, its high cost has kept it from being universally accepted. A low-cost radiotelemetry system would probably find wide acceptance for clinical and laboratory use by persons with low research budgets. Unfortunately, most commercially available radiotelemetry systems are highly sophisticated and range in price from $500 to $1,500 per channel.1 The price is high because these systems are FM-FM multiple channel and very complex.2 This paper describes a simple one-channel electrocardiogram radiotelemetry system that can be built by any interested person in four hours for under $15.Materials and . . .
Age as a Criterion for Rationing Health Care
Authors: N G Levinsky
Journal: New England Journal of Medicine (1990)

A widely held view is that medical costs are a problem verging on a crisis. Perhaps on the principle that drastic problems require drastic solutions, for the first time powerful voices have been raised in favor of explicit rationing as a solution — possibly the only solution — to the looming cost crisis. And, in a remarkable reversal of recent history, age has been proposed as a criterion for withholding medical care. This has occurred in a society that less than 30 years ago established Medicare, its first national health plan, specifically to improve the health of the elderly.Although . . .
Radiation Exposure from Medical Imaging Procedures
Authors: Gary Jay Becker, Jennifer Bosma, William Hendee
Journal: New England Journal of Medicine (2009)

To the Editor: In the August 27 issue, the arti­ cle by Fazel et al.1 and the accompanying Perspec­ tive article by Lauer2 create an opportunity for the medical community to learn more about the work of radiation protection professionals: medi­ cal physicists and diagnostic radiologists. Radiol­ ogists are the only physicians who receive sub­ stantive training in radiation biology and safety that is linked to their board certification. Radiolo­ gists are most knowledgeable in managing and minimizing radiation exposures associated with medical imaging, and they can recommend sonog­ raphy and magnetic resonance imaging (MRI) as alternatives to ionizing imaging.3 In a 2009 re­ port,4 the National Council on Radiation Protec­ tion and Measurements, which was chartered by Congress, provided a comprehensive analysis of medical and all other sources of ionizing radia­ tion to which the American public was exposed. The medical community should work together across disciplines to use existing knowledge about radiation protection to ensure that imaging is warranted and optimized. When patients do need imaging, they should ask if the imaging center is accredited, the imaging personnel are creden­ tialed, and the protocols used are weight­based and indication­based, to ensure quality.