tbuckley/cabot-search huggingface dataset:
Abstract IA19: The evolutionary landscape of chronic lymphocytic leukemia.
Authors: Catherine J. Wu
Journal: Clinical Cancer Research (2015)

Abstract Clonal evolution is a key feature of cancer progression and relapse. Recent studies across cancers have demonstrated the extensive degree of intratumoral heterogeneity present within individual cancers. We hypothesized that evolutionary dynamics contribute to the variations in disease tempo and response to therapy that are highly characteristic of chronic lymphocytic leukemia (CLL). We have recently investigated this phenomenon by developing a pipeline that estimates the fraction of cancer cells harboring each somatic mutation within a tumor through integration of whole-exome sequence (WES) and local copy number data (Landau et al., Cell 2013). By applying this analysis approach to 149 CLL cases, we discovered earlier and later cancer drivers, uncovered patterns of clonal evolution in CLL and linked the presence of subclones harboring driver mutations with adverse clinical outcome. Thus, our study, generated from a heterogeneous sample cohort, strongly supports the concept that CLL clonal evolution arises from mass extinction and therapeutic bottlenecks which lead to the emergence of highly fit (and treatment resistant) subclones. We further hypothesize that epigenetic heterogeneity also shapes CLL clonal evolution through interrelation with genetic heterogeneity. Indeed, in recent work, we have uncovered stochastic methylation disorder as the primary cause of methylation changes in CLL and cancer in general, and that this phenomena impacts gene transcription, genetic evolution and clinical outcome. Ongoing studies focus on establishing a framework for understanding the stepwise transformation of B cells, and elucidating the role of the dynamic evolutionary landscape of CLL on its diagnosis, prognosis and treatment. Citation Format: Catherine J. Wu. The evolutionary landscape of chronic lymphocytic leukemia. [abstract]. In: Proceedings of the AACR Special Conference on Hematologic Malignancies: Translating Discoveries to Novel Therapies; Sep 20-23, 2014; Philadelphia, PA. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(17 Suppl):Abstract nr IA19.
Case 37-2004
Authors: Richard T. Penson, Dushyant Sahani, Debra A. Bell
Journal: New England Journal of Medicine (2004)

A 52-year-old woman with postmenopausal bleeding was found to have a 12-cm cystic ovarian mass on imaging studies. The cyst was resected and contained a papillary serous cystadenocarcinoma, grade 2 to 3 of 3, arising as a polypoid intracystic mass in a serous tumor containing benign and borderline areas. The discussants review the diagnosis, grading, and treatment of early-stage ovarian cancer.
Study on four polymorphs of bifendate based on X-ray crystallography
Authors: Jinju Nie, Dezhi Yang, Kun Hu, Yang Lu
Journal: Acta Pharmaceutica Sinica B (2016)

Bifendate, a synthetic anti-hepatitis drug, exhibits polycrystalline mode phenomena with 2 polymorphs reported (forms A and B). Single crystals of the known crystalline form B and 3 new crystallosolvates involving bifendate solvated with tetrahydrofuran (C), dioxane (D), and pyridine (E) in a stoichiometric ratio of 1:1 were obtained and characterized by X-ray crystallography, thermal analysis, and Fourier transform infrared (FT-IR) spectroscopy. The differences in molecular conformation, intermolecular interaction and crystal packing arrangement for the four polymorphs were determined and the basis for the polymorphisms was investigated. The rotation of single bonds resulted in different orientations for the biphenyl, methyl ester and methoxyl groups. All guest solvent molecules interacted with the host molecule via an interesting intercalative mode along the [1 0 0] direction in the channel formed by the host molecules through weak aromatic stacking interactions or non-classical hydrogen bonds, of which the volume and planarity played an important role in the intercalation of the host with the guest. The incorporation of solvent-augmented rotation of the C–C bond of the biphenyl group had a striking effect on the host molecular conformation and contributed to the formation of bifendate polymorphs. Moreover, the simulated powder X-ray diffraction (PXRD) patterns for each form were calculated on the basis of the single-crystal data and proved to be unique. The single-crystal structures of the four crystalline forms are reported in this paper.
The Attitude of Medical Societies to Prepaid Group Practice
Authors: George Baehr
Journal: New England Journal of Medicine (1952)

WHEN people become emotionally disturbed, they often lose the power of logical reasoning. The commonest cause of such emotional disturbances in everyday life is fear of the unknown. These two simple observations explain the unreasonable emotionalism that often moves a large portion of the medical profession, sometimes even a majority, to resist violently and often illogically almost any changes in the organization of medical care and public health.This was the original reaction of many physicians to the establishment of full-time county health departments, to communicable-disease clinics, to full-time professorships at medical schools and teaching hospitals, to the medical provisions . . .
Treatment of Trigeminal Neuralgia
Authors: Howard L. Fields
Journal: New England Journal of Medicine (1996)

Trigeminal neuralgia, or tic douloureux, is a severely painful condition of unknown cause that typically arises in otherwise healthy people in late middle age. The diagnosis can be made with confidence on purely clinical grounds because the symptoms are so characteristic of the disorder. The patient reports brief, stabbing pain or clusters of stabbing pains in the face or mouth that are restricted to one or more divisions of the trigeminal nerve, most often the maxillary division. The pain varies from mild to intense and is often described as having a penetrating, knifelike or jabbing quality. Although brief and followed . . .
Exogenous Reinfection as a Cause of Recurrent Tuberculosis after Curative Treatment
Authors: Annelies van Rie, Robin Warren, Madeleine Richardson, Thomas C. Victor, Robert P. Gie, Donald A. Enarson, Nulda Beyers, Paul D. van Helden
Journal: New England Journal of Medicine (1999)

For decades it has been assumed that postprimary tuberculosis is usually caused by reactivation of endogenous infection rather than by a new, exogenous infection.
Management of Acute Appendicitis, Comparative Effectiveness Research, and the Nuances of Study Design
Authors: Frederick Thurston Drake
Journal: JAMA Surgery (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Surgery HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Surgery journal
A Population-Based Assessment of Invasive Disease Due to Group B Streptococcus in Nonpregnant Adults
Authors: Monica M. Farley, Christopher Harvey, Tina Stull, J. David Smith, Anne Schuchat, Jay D. Wenger, David S. Stephens
Journal: New England Journal of Medicine (1993)

Group B streptococci (Streptococcus agalactiae) are a major cause of meningitis and septicemia in neonates and pregnant women, but the importance of group B streptococcal disease in nonpregnant adults has not been clearly defined.We conducted a prospective surveillance of the pathogens responsible for meningitis for a period of 24 months in 35 hospitals and a referral laboratory in metropolitan Atlanta. We reviewed the clinical and laboratory records of all the nonpregnant adults identified as having invasive group B streptococcal disease during this period.During 1989 and 1990 there were 424 patients with invasive group B streptococcal disease (annual incidence, 9.2 cases per 100,000 population). Of these patients, 46 percent were 1 month of age or younger, 6 percent were older than 1 month but younger than 18 years of age, and 48 percent were 18 or older. Men and nonpregnant women accounted for 68 percent (n = 140) of all cases among adults (annual incidence, 4.4 per 100,000). Clinical and laboratory records were available for 137. In the nonpregnant adult patients (age, 18 to 99 years), the most common clinical diagnoses were skin, soft-tissue, or bone infection (in 36 percent); bacteremia with no identified source (30 percent); urosepsis (14 percent); pneumonia (9 percent); and peritonitis (7 percent). Risk factors included older age (> or = 60 years), the presence of diabetes mellitus, the presence of malignant neoplasms, and infection with the human immunodeficiency virus. The mortality rate in nonpregnant adults was 21 percent, accounting for 67 percent of all deaths related to group B streptococcal infection during the surveillance period.Invasive group B streptococcal infection is a major problem not only in pregnant women and neonates but also in nonpregnant adults, especially those who are elderly and those who have chronic diseases.
BMET-11SURGICAL RESECTION OF CEREBRAL METASTASES LEADS TO FASTER RESOLUTION OF PERI-TUMORAL EDEMA: A QUANTITATIVE ANALYSIS
Authors: Nir Shimony, Ben Shofty, Razi Sitt, Zvi Ram, Rachel Grossman
Journal: Neuro-Oncology (2015)

BACKGROUND: Surgical resection and stereotactic-radiosurgery (SRS) are valid treatment options for selected patients with brain-metastases.The desired rate of resolution of the tumor-associated edema may play a role in the decision making process.However, the dynamics of edema resolution with each modality has not been well characterized.METHODS: Of 646 patients treated at our center for brain metastases between 2010-2014, we retrospectively identified 70 patients (100 metastases) who underwent either surgery or SRS for brain metastasis, and had sufficient clinical data, and radiological follow-up to be included in this study.Individual volumetric measurement of the tumor and edema before, and three months after treatment, was performed.RESULTS: Forty-six surgical cases were compared to 54 cases treated with SRS.As expected, the volume of the tumor and surrounding edema were significantly higher in the surgical group compared to SRS.However, resolution of edema was significantly superior in the surgical group (p , 0.0001).After a matching process based on the propensity of a patient to receive SRS, a nested cohort of 40 patients was analyzed (meanmaximal diameter:21.5mmvs. 18.8mm for surgery and SRS, respectively).At diagnosis, edema volume, but not tumor volume was significantly higher in the surgical group.Three months after treatment, the resolution of edema tended to be much more prominent in the surgical group (74.2% vs.18.8% improvement, p ¼ 0.1).Steroid consumption was significantly higher in the SRS group (p ¼ 0.02).No difference in the incidence of new neurological deficits after treatment was found between the groups.CONCLUSIONS: Resolution of tumor-associated edema in medium sized brain metastases tended to be more prominent after surgical resection compared to SRS.Irradiated patients required a significantly higher dose of steroids.Accordingly, when both treatment options are suitable, surgery appears to induce a faster resolution of edema and perhaps may alleviate edema-induced deficits faster in patients with brain metastases.
Lessons we can learn from organ retention
Authors: G. Derrick
Journal: BMJ (2003)

In 2001 and 2002 I was involved with the Birmingham Children's Hospital's organ retention inquiry. Most of the parents who contacted the hospital were interviewed not by managers or nurses but by clinicians. Half of these clinicians were paediatric anaesthetists who had had no involvement with these families before the inquiry and could provide impartial support, as well as broad knowledge of anatomy, physiology, and surgical techniques when explaining causes of illnesses and death.

I met 40 families, and it was a sobering experience to hear common themes of inadequacy of treatment. They showed a lot of anger, but very little was directed at me. Instead, many parents expressed appreciation for the discussion and explanations. I was privileged to be party to their individual emotions, expressions of love for their children, and dignity in their grief.

> Several parents could not even remember a consent form 

Most of the deaths had occurred many years previously, when information about the causes of illness and …
Active tuberculosis case-finding among drug users and homeless persons: after the outbreak
Authors: Rob van Hest, Gerard de Vries
Journal: European Respiratory Journal (2016)

Tuberculosis (TB) control in high-risk settings and populations is a fascinating challenge, as it also is in the context of the World Health Organization (WHO) End TB strategy [1]; and it is frequently reported in medical journals. We previously described how an outbreak was built up among illicit drug users and homeless persons in Rotterdam, the Netherlands, and successfully controlled by a systematic targeted TB active case-finding programme, using a mobile digital X-ray unit (MDXU) [2, 3]. On the contrast, programmatic implications after an outbreak are rarely reported. This study evaluates the intervention among these urban risk groups by describing trends of TB disease, recent transmission, active case finding and treatment outcome, and by comparing efficiency and yield of screening during outbreak management (May 2002–2005) with post-outbreak screening (2006–2014). Efficiency and yield of an active TB case-finding programme during and after an outbreak can guide scaling down <http://ow.ly/ZT1Me>
PWE-221 Improving the practice of nutrition therapy in the critically ill patient: Abstract PWE-221 Table 1
Authors: A Jukes, E Golding, J Jenkins, O Morgan, G Scholey
Journal: Gut (2015)

<h3>Introduction</h3> In 2013, the University Hospital of Wales (UHW) participated in the fourth International Critical Care Nutrition Survey, a period prevalence survey led by Daren Heyland of the Clinical Nutrition Unit, Canada. This Quality Improvement Project aims to compare nutritional practices within and across countries and to highlight strengths and weaknesses leading to practice improvement. <h3>Method</h3> Critical Care units were eligible to participate in the survey if they had a minimum of 8 beds, and enrolled a minimum of 20 patients within a set time period. Over 100 patients were screened for enrollment criteria - aged ≥ 18 years of age, mechanically ventilated with 48 h of admission and remained for ≥ 72 h in the unit. For each patient a questionnaire was completed. This included patient demographics, diagnosis, co-morbidities, clinical parameters and severity of illness scores, nutritional status, nutritional requirements, feeding route and when nutrition was commenced. Data was subsequently collected for up to 12 days for actual nutrition received from enteral and parenteral sources in addition to insulin and glycaemic control. Patient outcomes included duration of mechanical ventilation, critical care and hospital outcomes. Data was collected by 2 Dietitians and submitted using the web based data collection tool. UHW data was validated for 3 randomly selected patients, and a comprehensive report comparing our patients and practice with Critical Care units in Europe and overall worldwide was provided by the Clinical Nutrition Unit. <h3>Results</h3> 190 Critical Care Units participated in the 2013 International Survey. UHW enrolled 23 of the total 3997 patients and 243 of the 37460 days analysed. The results of UHW–s practice compared with the other units are shown in the Table 1. <h3>Conclusion</h3> UHW was ranked joint 4th in the 2013 International Critical Care Survey and is the highest achievement of any UK hospital to date. The UHW feeding protocol has been further revised as a result of this improvement project and is both evidence based and practical. UHW participated in the 2014 survey and is currently awaiting the results. <h3>Disclosure of interest</h3> None Declared.
Lactic Acidosis as a Cause of Nonketotic Acidosis in Diabetic Patients
Authors: William H. Daughaday, Raymond John Lipicky, Dorothy C. Rasinski
Journal: New England Journal of Medicine (1962)

SEVERE metabolic acidosis, when it occurs in diabetic patients, is generally the result of excessive hepatic production of acetoacetic and beta-hydroxybutyric acid. Exceptional cases of metabolic acidosis in diabetic patients whose urine has failed to give a positive reaction for acetoacetic acid have long been recognized.1 In certain cases increased concentrations of beta-oxybutyric acids have been demonstrated in the plasma. A failure of renal excretion of acetoacetic acid, usually attributed to shock, has been proposed as an explanation of these cases.2 , 3 In other cases examinations of the plasma or tissues for beta-oxybutyric acids by qualitative or quantitative procedures have failed . . .
PTH-342 Are there differences in screening vs. non-screening colonoscopy?
Authors: S Ahmed, DN Naumann, S Karandikar
Journal: Gut (2015)

<h3>Introduction</h3> Colonoscopies undertaken as part of the NHS Bowel Cancer Screening Programme (BCSP) must be of high standard in order to meet the Global Rating Scale (GRS) criteria. The same practitioners usually also provide a non-screening colonoscopy service. We aim to compare colonoscopy techniques and outcomes between screening and non-screening groups, in order to ascertain whether there are any areas for development, education, and service improvement. <h3>Method</h3> Patient details were obtained for all consecutive colonoscopies between 2007 and 2014 performed by a single Consultant Surgeon at our NHS Trust. Data were collected retrospectively from electronic patient records, and screening (BCSP) and non-screening colonoscopies were compared. Data included patient demographics (age, gender), and colonoscopy performance (caecal intubation and neoplasia detection rates). <h3>Results</h3> There were 1961 colonoscopies in this time period (1067 screening and 894 non screening). 1120/1961 (57%) were male. Mean (SD) age for all patients was 64 (±10.4) years. Non-screening patients were younger, had a wider variation in age (62 (±14) versus 66 (±4.8) years; p &lt; 0.001), and were less likely to be male (51.5%<i>vs.</i>61.9%; p &lt; 0.001) than their screening counterparts. Caecal intubation was more successful in screening patients (1027/1067 (96.3%)) than non-screening patients (805/894 (90%)); p &lt; 0.001. There was no difference in neoplasia detection rate between the groups. Polypectomy was more likely (55.5% <i>vs</i>30.2%), and polyp retrieval more successful (97.5% <i>vs.</i>86.7%) in the screening group. <h3>Conclusion</h3> Screening and non-screening colonoscopy patients differ in their performance factors, pathology detection and management, as well as patient demographics. Benchmarking non-screening colonoscopies against the high quality of screening colonoscopy may aid practitioners to optimise their own practice. <h3>Disclosure of interest</h3> None Declared.
PTPS-04LUMBAR SPINAL ATYPICAL TERATOID RHABDOID TUMOR- CASE REPORT
Authors: Aditi Dhir, Tanya Tekautz, Violette Recinos, Erin Murphy, Richard Prayson, Paul Ruggieri, Johannes Wolff
Journal: Neuro-Oncology (2015)

INTRODUCTION: Atypical Teratoid Rhabdoid tumor (AT/RT) is a rare, highly aggressive pediatric tumor of the central nervous system with a dismal prognosis. Although there is sufficient literature on brain AT/RT, spinal AT/RT continues to be a rare entity with lumbar location even less frequently reported. We report a recently diagnosed case of a lumbar spinal AT/RT in an African American child in our institution. CASE REPORT: A 30-month-old African American male child with multiple comorbidities presented with the inability to ambulate, encopresis and urinary dribbling. MRI showed an intradural extramedullary mass extending downwards from L3-4 level. He underwent L3-S2 laminoplasty. The surgically resected mass was marked by sheets of cells with large nuclei and prominent nucleoli. The tumor cells stained with antibodies to synaptophysin and CAM 5.2 and showed an absence of immunoreactivity to INI-1 antibody. A diagnosis of a WHO grade IV AT/RT was rendered. There was no mutation detected in the SMARCB1 gene on comprehensive analysis of blood. Patient is currently being treated according to the Medical University of Vienna ATRT-protocol (MUV-ATRT) with no evidence of tumor recurrence 8 months after surgery. DISCUSSION: Although not observed in all the cases, mutations of hSNF5/INI1, also known as SMARCB1 gene on chromosome 22q11, is pathognomic for AT/RT. Recent studies have suggested that the inactivation of INI1 might be associated with a poor prognosis. It is not known if spinal AT/RTs routinely have the chromosomal 22q abnormality frequently seen with brain AT/RT or if the two entities even have a different prognosis. More cases need to be reviewed to differentiate spinal from brain AT/RT to determine an effective prognostic marker and treatment strategy for patients with this rare tumor.
Delayed Pneumonia and Urticaria Following Bronchography
Authors: H. E. Bass
Journal: New England Journal of Medicine (1949)

PNEUMONIA complicating bronchography has been described.1 2 3 4 Some of the cases previously reported have been attributed to infectious factors, owing to the carrying down of infecting organisms from the upper respiratory tract. Waldbott4 has emphasized the role of iodized oil in producing obstruction of the small bronchi followed by atelectasis of lung tissue and pneumonitis or massive collapse of a lung when a main bronchus is involved. Other authors have reported cases of pneumonia believed to be due to an allergic reaction to the iodide component of lipiodol.2 All the reported cases, whether infectious or allergic, were characterized by a rapid . . .
Clinical Features of Adrenocortical Carcinoma, Prognostic Factors, and the Effect of Mitotane Therapy
Authors: Jean-Pierre Luton, Sonia Cerdas, Line Billaud, Guy Thomas, Brigitte Guilhaume, Xavier Bertagna, Marie-Hélène Laudat, Albert Louvel, Yves Chapuis, Philippe Blondeau, André Bonnin, Henri Bricaire
Journal: New England Journal of Medicine (1990)

Adrenocortical carcinoma is a rare tumor, and only limited information is available about its natural history and the effects of therapy.