tbuckley/cabot-search huggingface dataset:
Circulating Monoclonal B Lymphocytes in Non-Hodgkin's Lymphoma
Authors: Brian R. Smith, David S. Weinberg, Nicholas J. Robert, Murray Towle, Edgar Luther, Geraldine S. Pinkus, Kenneth A. Ault
Journal: New England Journal of Medicine (1984)

Using a sensitive flow cytometric method ("kappa–lambda analysis"), we have found monoclonal B lymphocytes in the blood of 71 of 91 patients with non-Hodgkin's lymphoma. The presence of the B lymphocytes was independent of the histologic subclassification of the patient's disease. When we performed simultaneous analysis of the surface light-chain type in tumor tissue obtained by biopsy, the apparent light-chain type of the blood monoclonal cells corresponded with that of the tumor in 21 of 23 patients (P = 0.03). There was no correlation of the presence of these cells in the blood with morphologic evidence of bone-marrow involvement by lymphoma, but there was a strong correlation with clinical staging. Studies performed during prolonged clinical remission showed that whereas 16 of 25 patients with nodular non-Hodgkin's lymphoma had persistence of monoclonal lymphocytes, none of the 14 patients with diffuse histiocytic lymphoma in remission had these findings (P<0.005). Our analysis for B-cell clonal excess demonstrates the persistence of circulating monoclonal lymphocytes during complete remission in patients with forms of lymphoma that have a high probability of relapse, but we did not find these cells in patients in remission from categories of lymphoma in which prolonged remission is associated with cure. It is possible that the circulating monoclonal lymphocytes in patients with lymphoma are malignant cells, and their disappearance or persistence after remission may have prognostic importance. (N Engl J Med 1984; 311: 1476–81.)
Endocarditis Due to<i>Escherichia coli</i>
Authors: Albert G. Smith
Journal: New England Journal of Medicine (1950)

SUBACUTE bacterial endocarditis and various acute forms of endocarditis are usually considered to arise on valves that have been previously damaged. It would be remarkable if endocarditis due to Escherichia coli should prove to be an exception, since the colon bacillus is usually an organism of low virulence and one that generally invades only in cases of extensive tissue damage. The explanation for this discrepancy is thought to be due to an increased virulence assumed by Esch. coli. 1 A case of this disease is reported below because of the rarity of well documented cases. This case and the seeming incongruity . . .
European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopy
Authors: J. Dumonceau, A. Riphaus, J. Aparicio, U. Beilenhoff, J. Knape, M. Ortmann, G. Paspatis, C. Ponsioen, I. Racz, F. Schreiber, P. Vilmann, T. Wehrmann, C. Wientjes, B. Walder
Journal: Endoscopy (2010)

See also: Retraction of endorsement: European Society of Gastrointestinal Endoscopy, European Society of Gastroenterology and Endoscopy Nurses and Associates, and the European Society of Anaesthesiology Guideline: Non-anesthesiologist administration of propofol for GI endoscopyEndoscopy 2012; 44(03): 302-302DOI: 10.1055/s-0031-1291648 See also: Reply to PelosiEndoscopy 2012; 44(03): 302-302DOI: 10.1055/s-0031-1291649
Abstract 73: Tea Polyphenols Improve the Outcome of CPR in an Asphyxial Rat Model
Authors: Feng-Qing Song, Dong-Ming Fang, Meng-Hua Chen, Lu Xie, Xue-Li Qu, Xiao-Fen Tian
Journal: Circulation (2010)

Introduction: Cerebral ischemia/reperfusion injury following cardiac arrest and cardiopulmonary resuscitation (CPR) has been demonstrated. Oxidant injury plays a critical role in the process. Since...
Brain Glucose Uptake and Unawareness of Hypoglycemia in Patients with Insulin-Dependent Diabetes Mellitus
Authors: Patrick J. Boyle, Scott F. Kempers, Anne M. O'Connor, Roger J. Nagy
Journal: New England Journal of Medicine (1995)

In patients with insulin-dependent diabetes mellitus (IDDM) whose treatment results in nearly normal mean plasma glucose concentrations, an unawareness of hypoglycemia can develop, and such patients are at increased risk for seizures and coma. We tested the hypothesis that during hypoglycemia, these patients would have normal glucose uptake in the brain and that consequently no sympathoadrenal activation would begin, resulting in an unawareness of hypoglycemia.
Managing cutaneous side effects with K1 vitamine creme reduces cutaneous toxicities induced by cetuximab
Authors: J. Ocvirk, M. Rebersek
Journal: Journal of Clinical Oncology (2008)

20750 Background: Cetuximab is a chimeric IgG1 monoclonal antibody against the epidermal growth factor receptor, approved in the treatment of patients (pts) with metastatic colorectal cancer and head and neck squamous cell carcinoma. More than 80% of pts develop cutaneous reactions, mainly as acne-like rash or less frequently as pruritus, dry skin, desquamation, hypertrichosis or nail disorders. It is important to continue the therapy despite toxicity because delaying treatment and lowering doses typically reduce response rates. Methods: From September 2006 to August 2007, 30 pts with metastatic colorectal cancer were treated with cetuximab in combination with chemotherapy. They all suffered from acne-like rash. They were followed for at least 3 months, once per week. Skin care with topical use of creme containing urea and 0.1% K1 vitamin (Reconval K1) was started after the first documented cutaneous toxicity evaluated according to NCI CTCAE, ver.3. Results: Of 30 pts, 6 had grade 3 rush, 18 pts grade 2 and 6 pts grade 1. Reconval K1 was used twice daily. In all pts, cutaneous toxicity was gradually decreasing. The median time to improvement was 8 days and 18 days to observe down-staging in rash by at least 1 grade. In only 3 of 6 pts with grade 3 toxicity, reduction of cetuximab dose was needed, whereas in historical controls, in all pts with grade 3 skin toxicity, reduction of cetuximab dose was recommended and also performed. No dose reduction or delay of treatment was needed in the group of pts with grade 1 and 2 cutaneous toxicity. We didn’t observe any toxicity of topical use of Reconval K1. Conclusions: To our knowledge, this is the first documented effect of topical use of K1 vitamin creme for reducing cetuximab-induced cutaneous toxicity. Reconval K1 is useful in skin care of pts treated with cetuximab. Further studies are needed to evaluate the impact on response rate of cetuximab and quality of life. No significant financial relationships to disclose.
Tumor-specific targeting of intravenous <sup>131</sup>I-chlorotoxin (<sup>131</sup>I-TM-601) in patients with metastatic melanoma
Authors: J. B. Fiveash, R. M. Conry, S. Shen
Journal: Journal of Clinical Oncology (2008)

20003 Background: Previous clinical trials of 131I-chlorotoxin in patients with recurrent glioblastoma multiforme administered this targeted peptide locally into a tumor resection cavity. In this trial the distribution of intravenous (IV) 131I-chlorotoxin was examined to determine if the IV route of administration would be feasible and show intratumoral uptake in patients with metastatic melanoma including metastases to the CNS. Materials and Methods: Seven patients with metastatic melanoma were enrolled in a prospective clinical trial of IV 131I-chlorotoxin that also included patients with other advanced solid tumors. The melanoma patients are the subject of this report. All patients received a test dose of 10 mCi (0.2 mg peptide) 131I-chlorotoxin IV. Five, sequential, whole body gamma camera images were acquired immediately, 3 hours, 24 hours, 48–72 hours, and 168 hours post 131I -chlorotoxin injection for tumor localization and dosimetry analysis. Patients showing tumor localization by gamma camera or SPECT imaging received a second therapeutic dose of 30 mCi (0.6 mg peptide) 131I-chlorotoxin one week later. Patients not showing uptake were re-treated a week later with 20 mCi (0.4 mg peptide) 131I-chlorotoxin to determine possible localization at a higher dose. Results: Six of the seven enrolled patients with melanoma demonstrated tumor specific localization on follow-up gamma camera or SPECT imaging after IV administration of 131I-chlorotoxin. Tumor localization was observed in the CNS and at extracranial sites. The remaining patient did not complete the imaging assessment and was not considered evaluable. Dose limiting toxicity was not observed. Full dosimetric analysis is available on three patients treated at UAB. The mean radiation dose was 0.24 cGy/mCi (ranged 0.21–0.27 cGy/mCi) to total body and 2.56 cGy/mCi (ranged 1.36- 4.43 cGy/mCi) to tumor with a calculated therapeutic ratio of approximately 10 (tumor/body). Conclusion: 131I-chlorotoxin administered IV will cross the blood brain barrier and produces at high rate of tumor specific targeting. Future clinical trials will evaluate the safety and efficacy of higher doses of IV 131I-chlorotoxin in a variety of tumor types. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Transmolecular, Inc. Transmolecular, Inc.
EPID-25GERMLINE POLYMORPHISMS IN MGMT INCREASE ABILITY TO MODEL TEMOZOLOMIDE (TMZ)-RELATED MYELOTOXICITY RISK IN PATIENTS WITH GLIOBLASTOMA (GBM) TREATED ON NRG ONCOLOGY/RTOG 0825
Authors: Michael E. Scheurer, Renke Zhou, Mark R. Gilbert, Melissa L. Bondy, Erik P. Sulman, Ying Yuan, Yanhong Liu, Elizabeth Vera-Bolanos, Merideth M. Wendland, David G. Brachman, Volker W. Stieber, Ritsuko R. Komaki, John C. Flickinger, Lawrence C. Kenyon, H. Ian Robins, Grant K. Hunter, Ian R. Crocker, Samuel T. Chao, Philip J. Stella, Stephanie L. Pugh, Terri Armstrong
Journal: Neuro-Oncology (2015)

BACKGROUND: Even though TMZ is well tolerated by most GBM patients, some experience severe myelotoxicity, resulting in treatment delay or cessation. Our ultimate goal is to develop robust risk prediction models for toxicity, which incorporate both clinical and genetic variables. Predicting risk of toxicity would allow for treatment optimization: lower dosing for at-risk patients; full dose for low-risk patients. METHODS: Logistic regression with backward variable selection (p ≤ 0.05) was used to select the best fitting clinical model. A genome-wide analysis of genetic variation associated with myelotoxicity in glioblastoma patients from RTOG 0825 was then conducted. The top hits were then incorporated into the risk modeling strategy to increase our ability to predict toxicity. Tagging variants were selected and examined individually and jointly (by summing the number of adverse genotypes). RESULTS: Clinical and genotype data from 367 cases were included. The final clinical model included the following variables: treatment arm, gender, Karnofsky performance status (KPS), anticonvulsant use, and body surface area (BSA). The area under the curve (AUC) for the clinical model was 0.69. The genome scan revealed ten polymorphisms in MGMT that were significantly associated with myelotoxicity (p < 10−8). The most significant variant in the genome scan resulted in the best model (AUC = 0.80) for an individual SNP. Individuals with the risk allele in this SNP exhibited a 5.3-fold increase in risk of myelotoxicity compared to those with the non-risk allele (p < 0.0001, 95%CI: 3.2-8.7) after adjusting for the clinical variables and independent of survival. The final model with genetic dose performed equally as well as the model with the single MGMT SNP. CONCLUSIONS: TMZ myelotoxicity is a significant clinical issue. The addition of genetic variants in MGMT greatly improved the performance of our clinical risk model. Future work will continue to improve prediction by examining other genetic variants and potential interactions between variants.
Gut Microbiota Drive Autoimmune Arthritis by Promoting Differentiation and Migration of Peyer’s Patch T Follicular Helper Cells
Authors: Fei Teng, Christina N. Klinger, Krysta M. Felix, C. Pierce Bradley, Eric Wu, Nhan L. Tran, Yoshinori Umesaki, Hsin-Jung Joyce Wu
Journal: Immunity (2016)
Temozolomide/capecitabine therapy for metastatic neuroendocrine tumors of the pancreas. A retrospective review
Authors: W. H. Isacoff, R. A. Moss, A. L. Pecora, R. L. Fine
Journal: Journal of Clinical Oncology (2006)

14023 Background: Our laboratory studies suggest additive to synergistic cytotoxicity when neuroendocrine (NET) cells were given continuous exposure to 5 fluorouracil (5-FU) which preceded exposure to temozolomide (T). Based on this in vitro efficacy, salvage treatment with capecitabine (C), an orally-available fluoropyrimidine that is metabolized to 5-FU, and T was initiated in 17 patients (pts) with advanced NET of the pancreas. Methods: A retrospective review was conducted of the 17 pts who received C 1000mg bid on days # 1–14 and T 150–200mg/m2 on days #10–14 of a 28-day cycle, beginning in October, 2002. Pts had imaging performed after every 2 cycles, and serum tumor markers (TM), when present, were measured at every cycle. Median Age 54 (range 33–70). There were 9 men and 8 women. All of the pts had failed first-line treatment with escalating doses of sandostatin LAR. 11 pts had failed multiagent chemotherapy (range 1–5 regimens). Pathology: 10 pts had NET, 3 had non-secretory carcinoid, 1 had secretory carcinoid, one had a glucagonoma; 2 had non-secretory beta cell tumors and one pt had Multiple Endocrine Neoplasia Type I. Results: 13 of the pts are still alive and 12 remain on therapy with SD or PR. One pt did not complete cycle #1 and is not evaluable for response, but is included in an intent-to-treat (ITT) analysis. Grade 3 toxicity was thrombocytopenia in 2 pts, 1 of whom had splenectomy with resolution, and hand-foot syndrome in 1 pt who resumed therapy at reduced dose of C. Of 17 pts with unidimensionally measurable disease, 1 (6%) achieved a complete pathological response. 9 pts (53%) achieved a partial response by RECIST criteria, with a median duration of PR of 284 days (range 85–364 days). Of the 7 pts with evaluable TM, 6 (86%) had a greater than 50% decline. Median overall survival by ITT analysis in the 4 pts now deceased was 268 days (range 111–613 days). Median time to treatment failure was 340 days (range 111–470 days) in 5 pts. Conclusion: The results of this retrospective review suggest that a combination of T + C is active, well tolerated and may prolong survival and palliate symptoms in pts with NET. [Table: see text]
Case 23-1976
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, Julie R. Ingelfinger, Robert T. McCluskey
Journal: New England Journal of Medicine (1976)

Presentation of CaseA 15-year-old girl was admitted to the hospital because of proteinuria.She was well until nine months previously, when a routine medical examination at her school disclosed +++ proteinuria, 1 to 4 white cells and 3 to 10 red cells per high-power field; a culture yielded a growth of lactobacilli. There were no urinary-tract symptoms. A physician prescribed a sulfonamide; the pyuria cleared, but proteinuria persisted. Seven months before admission she entered another hospital, where physical examination was negative. Proteinuria and microscopic hematuria were again noted; no casts were seen. The erythrocyte sedimentation rate was 32 mm . . .
The Treatment of Chronic Human Amebiasis with Aureomycin
Authors: Wendell H. Hall
Journal: New England Journal of Medicine (1951)

AS a part of a survey of intestinal parasites among veterans of World War II, every patient admitted to the Minneapolis Veterans Administration Hospital on the Medical Service during the first ten months of 1949 was asked to collect 3 random stool specimens to be examined for ova and parasites. In March, 1949, a young packing-plant employee, hospitalized for treatment of acute brucellosis with bacteremia due to Brucella abortus, was found to have trophozoites and cysts of Endamoeba histolytica in 3 successive stool specimens, although he at first denied any past symptoms of amebiasis. He was treated with oral administration . . .
Interferon Alfa-2a Therapy for Life-Threatening Hemangiomas of Infancy
Authors: R. Alan B. Ezekowitz, John B. Mulliken, Judah Folkman
Journal: New England Journal of Medicine (1992)

Most hemangiomas are small, harmless birthmarks that appear soon after birth, proliferate for 8 to 18 months, and then slowly regress over the next 5 to 8 years, leaving normal or slightly blemished skin. In rare cases, hemangiomas can endanger vital structures, with a mortality of up to 60 percent. About a third of these life-threatening hemangiomas respond to treatment with corticosteroids, but for the others there is no safe and effective treatment. We evaluated the effects of daily subcutaneous injections of interferon alfa-2a (up to 3 million units per square meter of body-surface area) in 20 neonates and infants with life-threatening or vision-threatening hemangiomas that failed to respond to corticosteroid therapy.
Antisense-Oligonucleotide Therapy
Authors: F K Askari, W M McDonnell
Journal: New England Journal of Medicine (1996)

Many pharmacologic advances involve creating compounds that bind and disable proteins. Such compounds include propranolol, which blocks the β-adrenergic receptor; cimetidine, which blocks the H2 receptor; calcium-channel blockers; angiotensin-converting–enzyme inhibitors; and inhibitors of the H+/K+–ATPase pump. A new way to block protein function is to prevent the translation of messenger RNA (mRNA) into protein.If the nucleic acid sequence encoding a protein is known, molecules can be designed to bind the corresponding mRNA, thereby inhibiting the production of the protein (Figure 1). The nucleotide sequence of DNA or RNA that contains the information for the amino acid sequence of . . .
Case 37-1999
Authors: Johnathan L. Halperin, Stefanie J. Fry, Stuart L. Houser
Journal: New England Journal of Medicine (1999)

Presentation of CaseA 72-year-old, right-handed woman was admitted to the hospital because of slurred speech and agitation.The patient had a long history of hypothyroidism, hyperlipidemia, and angina pectoris. Five years before admission, a St. Jude Medical prosthetic valve had been inserted to replace a stenotic aortic valve; a double coronary-artery bypass graft was also performed because of severe, symptomatic coronary artery disease. Warfarin therapy was begun.Several months before admission, the patient began to eat less and lost a considerable amount of weight. She continued her warfarin therapy. During the three months before admission, she had headaches and . . .
Seizures in Chronic Subdural Hematoma
Authors: M. Cole, E. Spatz
Journal: New England Journal of Medicine (1961)

MANY of the basic works in neurology comment on the rarity of seizures in chronic subdural hematoma.1 2 3 Indeed, it is almost a maxim in many neurologic centers that the two are only rarely associated. Recently, at the Boston City Hospital, several cases of chronic subdural hematoma have been seen in which seizures were a prominent part of the clinical picture. The seizures occurred as the initial symptom or the presenting complaint or after admission to the hospital. The present review was undertaken to elucidate the relation between chronic subdural hematoma and convulsive seizures in the cases at the Boston City . . .
Case 42-1981
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, Betty U. McNeely, Barry W. Levine, Eugene J. Mark
Journal: New England Journal of Medicine (1981)

Presentation of Case First admission. An 82-year old man was admitted to the hospital because of a right pleural effusion.He was well until seven weeks earlier, when fever developed, with a cough productive of small amounts of sputum. Physical examination showed dullness at the base of the right lung. A Grade 3 systolic ejection murmur radiated to both carotid arteries. An x-ray film of the chest revealed blunting of the right costophrenic sulcus; the heart was not enlarged; calcifications were visible within the annulus of the mitral valve; the lungs appeared clear; osteoporosis and ankylosis of the dorsal . . .
Statin Use Is Associated With Fewer High-Risk Plaques on Coronary CT Angiography
Authors: Sumbal A. Janjua, Amit Pursnani, Thomas Mayrhofer, Stefan B. Puchner, Ting Liu, Michael T. Lu, Pal Maurovich-Horvat, Pamela K. Woodard, Eric Chou, Jerome L. Fleg, Quynh A. Truong, Maros Ferencik, Udo Hoffmann
Journal: JACC. Cardiovascular imaging (2016)
Dexamethasone, etoposide and cisplatin (DEP) as second line chemotherapy in patients with diffuse large B cell lymphoma (DLBCL)
Authors: P. Sobrevilla-Calvo, L. Vargas-Hernandez, D. Cortes-Padilla, J. R. Labardini-Mendez, L. F. Oñate-Ocaña
Journal: Journal of Clinical Oncology (2005)

6723 Background: : DLBCL represents the most common lymphoma subtype. The great majority of patients are diagnosed at advanced states of disease, therefore, in spite of high response rate to chemotherapy, only a minority can reach long disease free survival. As second line chemotherapy, the overall response rate is between 40–68% with a short median survival time. We present our experience with DEP as second line to DLBCL. Methods: Between 1999 to 2001 we included 27 patient treated with DEP (Cisplatin 100 mg/m2 in day 1, Etoposide 300 mg/m2 in days 2–3 and Dexamethasone 40 mg in days 1–4); every 21 days to a maximun of four cycles, after failure or relapsed to CHOP. Results: The median follow-up was 26 months. Median age was 51 years (range 30–78), with stage III-IV: 77.7% (according to Working Formulation) and bulky disease: 60%. Total dosis was completed in 60% of patients. The overall response rate was 40.7% with complete response (CR): 18.5%. In patients with CR, the median time to progression was 5 months. The median survival time was 20 months (range: 14.9–26.8) and after DEP was 7 months (range:0.32–14). The poor response characteristics in multivariated analysis were: > 55 years and B immunophenotype (HR:15.9, 95% CI: 1.09–234.2, P=0.043). Grade 3–4 toxicities (according to NCI): neutropenia: 66.7%, anemia: 18.5%, thrombocitopenia:29.6%, mucositis: 10%, nausea and vomiting:28%, renal toxicity: 3.7%. There was 2 deaths associated to toxicity (sepsis: 1 and renal toxicity:1). Conclusions: DEP appears a reasonable option for patients with CLBCL, however we plan to improve the DEP regimen with G-CSF support and the addition of Rituximab. No significant financial relationships to disclose.