tbuckley/cabot-search huggingface dataset:
The Impact of Alternative Payment Models on Oncology Innovation and Patient Care
Authors: Amy M. Miller, Gilbert S. Omenn, Marcia A. Kean
Journal: Clinical Cancer Research (2016)

Abstract Oncology care is in a time of major transformation. Scientific discovery is driving breakthroughs in prevention, diagnostics, and treatment, resulting in tremendous gains for patients as the number of cancer survivors continues to grow on an annual basis. At the same time, there is mounting pressure across the healthcare system to contain costs while improving the quality of cancer care. In response to this pressure, private and government payers are increasingly turning to tools such as alternative payment models (APM) and clinical pathways to improve the efficiency of care, inform coverage decisions, and support shared decision-making. As APMs, clinical pathways and other tools are utilized more broadly, it will be critical that these models support the evidence-based use of innovative biomedical advances, including personalized medicine, and deliver patient-centered, high-value care. Clin Cancer Res; 22(10); 2335–41. ©2016 AACR.
Conus Medullaris Syndrome after Meningococcal Meningitis
Authors: Robert A. Gotshall
Journal: New England Journal of Medicine (1972)

ONE characteristic of meningococcal meningitis in the antibiotic era appears to be the fact that among survivors of the disease definite residual neurologic dysfunction is uncommon.1 , 2 The majority of neurologic complications involve the sixth, seventh or eighth cranial nerves. Other rarely observed neurologic complications have included involvement of other cranial nerves, hydrocephalus and focal cerebral deficits.3 4 5 The following case, in which the neurologic complication was localized to the conus medullaris, represents a distinctive postmeningitic syndrome.Case ReportA 20-year-old U.S. Coast Cuardsman was admitted to the U. S. Public Health Service Hospital on October 19, 1970. He had been well . . .
Plasma Organochlorine Levels and the Risk of Breast Cancer
Authors: David J. Hunter, Susan E. Hankinson, Francine Laden, Graham A. Colditz, JoAnn E. Manson, Walter C. Willett, Frank E. Speizer, Mary S. Wolff
Journal: New England Journal of Medicine (1997)

Exposure to "environmental estrogens" such as organochlorines in pesticides and industrial chemicals has been proposed as a cause of increasing rates of breast cancer. Several studies have reported higher blood levels of 1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene (DDE) and polychlorinated biphenyls (PCBs) in patients with breast cancer than in controls.
Difference in Acid-Base State between Venous and Arterial Blood during Cardiopulmonary Resuscitation
Authors: Max Harry Weil, Eric C. Rackow, Robert Trevino, William Grundler, Jay L. Falk, Martin I. Griffel
Journal: New England Journal of Medicine (1986)

We investigated the acid-base condition of arterial and mixed venous blood during cardiopulmonary resuscitation in 16 critically ill patients who had arterial and pulmonary arterial catheters in place at the time of cardiac arrest. During cardiopulmonary resuscitation, the arterial blood pH averaged 7.41, whereas the average mixed venous blood pH was 7.15 (P<0.001). The mean arterial partial pressure of carbon dioxide (PCO2) was 32 mm Hg, whereas the mixed venous PCO2 was 74 mm Hg (P<0.001). In a subgroup of 13 patients in whom blood gases were measured before, as well as during, cardiac arrest, arterial pH, PCO2, and bicarbonate were not significantly changed during arrest. However, mixed venous blood demonstrated striking decreases in pH (P<0.001) and increases in PCO2 (P<0.004). We conclude that mixed venous blood most accurately reflects the acid-base state during cardiopulmonary resuscitation, especially the rapid increase in PCO2. Arterial blood does not reflect the marked reduction in mixed venous (and therefore tissue) pH, and thus arterial blood gases may fail as appropriate guides for acid-base management in this emergency. (N Engl J Med 1986; 315:153–6.)
A memorable patient: Legacies
Authors: Anthony S Oberman
Journal: BMJ (2006)

She was my first patient of the afternoon in the kibbutz clinic. An elderly woman with a Hungarian accent—in truth, every patient had a different accent since Israel has provided a safe haven for all Jewish refugees. As I placed my stethoscope on the back of her chest, she asked me if I knew who the last doctor who had examined her was. At first I assumed it was her last GP, but a shiver went down my spine when she told me that it had been Dr Mengele in the “Arbeitlager” (concentration camp).

At the time, I thought this was an isolated incident, but since then I have found the Holocaust a constant presence. Whether it is the senior banker who rolls up his sleeve to have his blood pressure taken, exposing the tattooed concentration camp number on his forearm, the grandmother who cries to me every year before the Jewish festivals because this is when she especially misses her family members who were killed in the camps, or the woman who comes to me for her statins and takes her prescription with her partially amputated fingers caused by a blow from a gun butt. Even my salary includes a small allowance for treating people persecuted by the Nazis.

Sixty years on, I—who was born 10 years after the end of the second world war and who lives and works in the Middle East—still see the results of the Holocaust on a daily basis.
GMC relaxes length of time sanctions will appear on doctors’ records
Authors: Clare Dyer
Journal: BMJ (2016)

Doctors who are struck off or suspended from the UK medical register will no longer have the sanction permanently on their online record, under a package of reforms aimed at making the system more proportionate.1

From early 2017 information about decisions to strike a doctor off will be removed from the General Medical Council’s (GMC) online register after 10 years. The 10 year period will also apply to conditions placed on a doctor’s registration and to suspensions …
Relation of the Lower Esophageal Ring to the Esophagogastric Junction
Authors: Lauran D. Harris, J. Edward Kelly, Philip Kramer
Journal: New England Journal of Medicine (1960)

ALTHOUGH a ringlike indentation encircling the lower esophagus had been described by radiologists for several years1 , 2 it was not recognized as a cause of dysphagia until 1953.3 , 4 Since that time there has been considerable discussion in the literature about the nature of the lower esophageal ring. Most of the recent literature has emphasized the opinion that this structure represents the esophagogastric junction and, in fact, may well represent the only valid radiologic indication of this junction.5 , 6 Published histologic data appear to strengthen this point of view, in that esophageal mucosa is usually found proximal and gastric mucosa distal to the . . .
Encephalomyelitis Due to Infection with<i>Herpesvirus simiae</i>(Herpes B Virus)
Authors: Klaus Hummeler, Wallace L. Davidson, Werner Henle, Alfred C. LaBoccetta, Hilda G. Ruch
Journal: New England Journal of Medicine (1959)

HERPESVIRUS simiae, or herpes B virus, may apparently cause similar clinical manifestations in monkeys as Herpesvirus hominis, or the virus of herpes simplex, in man. Both viruses are closely related morphologically, biologically and antigenically. Rarely do these agents cause severe clinical illnesses in their respective natural hosts. The usual clinical disease, as a result of primary infection, is a stomatitis, and oral-carrier states are frequently encountered. Accidental inoculation of H. simiae into man, on the other hand, may lead to severe encephalomyelitis, usually with fatal consequences. Prevention of the disease in man depends upon a comprehensive safety program. Any institution . . .
Case 5-1998
Authors: Gerard B. Hayes, Eugene J. Mark
Journal: New England Journal of Medicine (1998)

Presentation of CaseA 51-year-old man with refractory anemia and excess blasts in transformation was admitted to the hospital because of fever, dyspnea, and a pulmonary infiltrate.The patient had been well until 21 months earlier, when unexplained bruising developed. Nine months before admission, mild thrombocytopenia was discovered on evaluation for arthroscopic surgery. Laboratory tests were performed (Table 1). Microscopical examination of a bone marrow–biopsy specimen revealed normocellular marrow with dyserythropoiesis and dysmegakaryocytopoiesis. The patient received no treatment. Five and a half months before admission, laboratory tests were performed (Table 1). Two months later, the patient returned to the hospital . . .
Specific Therapy for Salicylism
Authors: George E. Schreiner, Leonard B. Berman, John Griffin, Jean Feys
Journal: New England Journal of Medicine (1955)

SALICYLATES account for 4 per cent of all the fatal poisonings in the United States1 due to solids and liquids. Mortality statistics include all forms of the drug since the toxic effects depend on the salicylate radical. Although fatal cases have been reported in adults with as little as 2 gm. of aspirin2 the more usual lethal dose is in excess of 10 gm.3 Deaths from 0.3 gm.4 may be dismissed from the present discussion as hypersensitivity phenomena usually occurring in asthmatic patients.The major clinical manifestations of salicylate poisoning have been well described,5 as have many of the complications. . . .
FOLFOXIRI or FOLFOXIRI plus bevacizumab as first-line treatment of metastatic colorectal cancer: a propensity score-adjusted analysis from two randomized clinical trials
Authors: C. Cremolini, F. Loupakis, G. Masi, S. Lonardi, C. Granetto, M.L. Mancini, S. Chiara, R. Moretto, D. Rossini, S. Vitello, G. Allegrini, G. Tonini, F. Bergamo, G. Tomasello, M. Ronzoni, A. Buonadonna, S. Bustreo, C. Barbara, L. Boni, A. Falcone
Journal: Annals of Oncology (2016)
Reply from Authors re: Adri C. Voogd, Rob H.A. Verhoeven. Treatment of the Primary Tumour in the Presence of Metastases: Lessons from Breast Cancer. Eur Urol 2016;69:797–9Reply from Authors re: Alfred I. Neugut, Edward P. Gelmann. Treatment of the Prostate in the Presence of Metastases: Lessons from Other Solid Tumors. Eur Urol 2016;69:795–6
Authors: Prasanna Sooriakumaran, Markus Graefen, Peter Wiklund
Journal: European Urology (2015)
Somatostatin in Human Cerebrospinal Fluid
Authors: Yogesh C. Patel, Krishna Rao, Seymour Reichlin
Journal: New England Journal of Medicine (1977)

To determine whether somatostatin is found in the hypothalamus and extrahypothalamic brain, we studied autopsy brain tissue by specific immunoassay. The hypothalamus contained the highest concentration (16.7 +/- 2.4 S.D. pg per microgram of protein), with small amounts in brainstem, cerebral cortex, cerebellum, pineal gland and spinal cord. Cerebrospinal fluid of seven neurologically normal persons also contained somatostatin in concentrations ranging from 15 to 55 pg per milliliter. To determine whether brain disease leads to abnormal cerebrospinal-fluid somatostatin, we examined 30 patients with neurologic disease, of whom 20 of 24 with cord or cerebral disease had concentrations above the highest normal level. The wide variety of diseases with somatostatin elevation suggests nonspecific leakage from damaged brain tissue. Cerebrospinal-fluid somatostatin may provide a good index of brain damage. Although correlated statistically with cerebrospinal-fluid protein, somatostatin concentration in five of 24 cases exceeded the upper limit of normal by 3 S.D. while protein was normal.
Neutrophils Suppress Intraluminal NK Cell–Mediated Tumor Cell Clearance and Enhance Extravasation of Disseminated Carcinoma Cells
Authors: Asaf Spiegel, Mary W. Brooks, Samin Houshyar, Ferenc Reinhardt, Michele Ardolino, Evelyn Fessler, Michelle B. Chen, Jordan A. Krall, Jasmine DeCock, Ioannis K. Zervantonakis, Alexandre Iannello, Yoshiko Iwamoto, Virna Cortez-Retamozo, Roger D. Kamm, Mikael J. Pittet, David H. Raulet, Robert A. Weinberg
Journal: Cancer Discovery (2016)

Abstract Immune cells promote the initial metastatic dissemination of carcinoma cells from primary tumors. In contrast to their well-studied functions in the initial stages of metastasis, the specific roles of immunocytes in facilitating progression through the critical later steps of the invasion–metastasis cascade remain poorly understood. Here, we define novel functions of neutrophils in promoting intraluminal survival and extravasation at sites of metastatic dissemination. We show that CD11b+/Ly6G+ neutrophils enhance metastasis formation via two distinct mechanisms. First, neutrophils inhibit natural killer cell function, which leads to a significant increase in the intraluminal survival time of tumor cells. Thereafter, neutrophils operate to facilitate extravasation of tumor cells through the secretion of IL1β and matrix metalloproteinases. These results identify neutrophils as key regulators of intraluminal survival and extravasation through their cross-talk with host cells and disseminating carcinoma cells. Significance: This study provides important insights into the systemic contributions of neutrophils to cancer metastasis by identifying how neutrophils facilitate intermediate steps of the invasion–metastasis cascade. We demonstrate that neutrophils suppress natural killer cell activity and increase extravasation of tumor cells. Cancer Discov; 6(6); 630–49. ©2016 AACR. This article is highlighted in the In This Issue feature, p. 561
Subphrenic Abscess Related to the Ingestion of a Toothpick
Authors: José L. Zambrana, Juan A. García-Gutiérrez, Felipe Díez
Journal: New England Journal of Medicine (1998)

To the Editor: The development of intraabdominal abscesses secondary to the ingestion of foreign bodies is a known but infrequent phenomenon.1 We describe a patient with a right subphrenic abscess that developed after the accidental ingestion of a toothpick 15 months earlier. Images obtained through abdominal ultrasonography were helpful in making a preoperative diagnosis. A 52-year-old man was referred to the hospital because of progressive weight loss of 10 kg during the preceding six months, despite the presence of a good appetite. There was no history of fever, chills, vomiting, or abdominal pain. There was a history of non-insulin-dependent diabetes . . .
P83 Remote pulmonary function testing – computer gaming in the respiratory world
Authors: C Sharp, V Soleimani, S Hannuna, M Camplani, D Damen, J Viner, M Mirmehdi, J Dodd
Journal: Thorax (2015)

<h3>Introduction</h3> Lung function testing by spirometry has remained unchanged for over 50 years, despite limitations including patient technique, discomfort, cost and training. Non-invasive, remote lung volume measurement is an alternative approach. This has been explored in the past using structured light, accelerometers and impedance pneumography, but these have often been costly and of limited validity. We use a novel approach to remote assessment (~2 metres) using a 3D time-of-flight depth camera – similar to those found in many home gaming consoles. This pilot developmental data was generated from patients in a clinical setting. <h3>Methods</h3> Patients were recruited from a general respiratory physiology laboratory. Spirometry was performed according to ATS/ERS standards using an unmodified pneumotachograph (nSpire Health, Longmont, CO, USA). A Kinect V2 time-of-flight depth sensor (Microsoft, Redmond, WA, USA) was used to reconstruct 3D models of the subject’s thorax to estimate volume-time and flow-time curves for both Forced and Slow Vital Capacity and their associated measurements (Figure 1, technical details in<sup>1</sup>). These results were correlated with simultaneous recordings from the pneumotachograph, and error values calculated to assess the accuracy of the technique. <h3>Results</h3> Data were available from 53 patients, with 40 having usable data. Mean age 62.8 yrs (SD 16.2), BMI of 26.8 (SD 5.5). 41.5% male. 54.7% of patients had obstructive lung diseases, and 28.4% fibrotic lung disease. Mean FVC was 91.3% predicted (SD 26.4%), Mean FEV1 83.1% (SD 28.9%). The model estimates were highly correlated with spirometric values for FVC (λ = 0.999), FEV1 (λ = 0.947), VC (λ = 0.999), IC (λ = 0.997) and TV (λ = 0.962). Univariate analysis demonstrated no patient characteristics predictive of discrepancy from spirometric values for FVC or VC. <h3>Conclusions</h3> We describe a pilot data from the initial development of a new technique for non-invasively assessing lung volume and pulmonary function measurements. It correlates to within 30 ml for FVC and 10 ml for VC. This has a wide range of potential applications, including screening, home monitoring of respiratory disease, assessment of lung function in those unable to complete pneumotachygraphy and gating controls for radiological imaging techniques. <h3>Reference</h3> 1 Soleimani V, Mirmehdi M, Damen D, <i>et al</i>. Remote pulmonary function testing using a depth sensor. Biocas 2015
A Controlled Trial of Aerosolized Pentamidine or Trimethoprim–Sulfamethoxazole as Primary Prophylaxis against<i>Pneumocystis carinii</i>Pneumonia in Patients with Human Immunodeficiency Virus Infection
Authors: Margriet M.E. Schneider, Andy I.M. Hoepelman, Jan Karel M. Eeftinck Schattenkerk, Thyge L. Nielsen, Yolanda van der Graaf, Jos P.H.J. Frissen, Ineke M.E. van der Ende, Ad F.P. Kolsters, Jan C.C. Borleffs
Journal: New England Journal of Medicine (1992)

Primary prophylaxis against Pneumocystis carinii pneumonia (PCP) is recommended for patients with human immunodeficiency virus (HIV) infection if their CD4 cell counts are below 200 per cubic millimeter (0.2×109 per liter). Either aerosolized pentamidine or trimethoprim–sulfamethoxazole (co-trimoxazole) is commonly prescribed for prophylaxis, but the relative efficacy and toxicity of these agents are unknown.
Impact of Tumor Microenvironment on the Expression of Vascular Endothelial Growth Factor Receptor 2 in Glioblastoma Multiforme
Authors: M. Saretok, A. Adamson, T. Jogi, M. Joonsalu, M. Kase, A. Minajeva, J. Lukjanova, T. Metsaots, M. Vardja, T. Asser, J. Jaal
Journal: Annals of Oncology (2014)
The Prevalence of Antibodies against Desmoglein 1 in Endemic Pemphigus Foliaceus in Brazil
Authors: Simon J.P. Warren, Mong-Shang Lin, George J. Giudice, Raymond G. Hoffmann, Gunter Hans-Filho, Valeria Aoki, Evandro A. Rivitti, Vandir dos Santos, Luis A. Diaz
Journal: New England Journal of Medicine (2000)

Pemphigus foliaceus is an autoimmune skin disease mediated by autoantibodies against desmoglein 1. The endemic form is thought to have an environmental cause. The Terena reservation of Limão Verde in Mato Grosso do Sul, Brazil, is a recently identified focus of the disease, with a prevalence of 3.4 percent in the population. We tested the hypothesis that normal subjects living in an endemic area have antibodies against desmoglein 1.
Coronary Revascularization for Recurrent Pulmonary Edema in Elderly Patients with Ischemic Heart Disease and Preserved Ventricular Function
Authors: Richard Kunis, Henry Greenberg, Chin Bor Yeoh, Oscar B. Garfein, Anthony J. Pepe, Bruce H. Pinkernell, Mark V. Sherrid, Edward M. Dwyer
Journal: New England Journal of Medicine (1985)

PULMONARY congestion in a patient with acute myocardial infarction is a poor prognostic sign,1 2 3 even if left ventricular ejection fraction measured at least six days after the acute event is normal or nearly so.3 , 4 Acute pulmonary edema accompanying myocardial infarction may be associated with a 25 to 30 per cent mortality rate and a 50 per cent incidence of recurrent ischemic events at 6 to 12 months, even if the ejection fraction is normal before discharge.4 This lack of correlation between the ejection fraction during recovery and the ultimate prognosis presumably reflects the presence of a large or critical amount . . .
Phase I study of intraperitoneal MHC unrestricted adoptive cell therapy with TALL-104 cells in patients with peritoneal carcinosis
Authors: C. Bengala, V. Rasini, R. Sternieri, M. Dominici, A. Andreotti, R. Gelmini, L. Cafarelli, P. Bevini, A. Berti, P. Conte
Journal: Journal of Clinical Oncology (2007)

3054 Background: TALL-104 is an irradiated human leukemic T cell line (CD3+, CD4- CD8+, CD56+, CD16-) grown in IL-2- containing medium, that has the ability to kill tumor cells in preclinical models in a MHC unrestricted way. A phase I trial in metastatic breast cancer patients, has shown that multiple i.v. infusions (infs) of TALL-104 cells can be given safely. In order to optimise the tumor:effector cell ratio, we have designed a phase I study of intraperitoneal infs of γ-irradiated TALL-104 cells. Methods: Patients (pts) with peritoneal carcinosis from ovarian or gastrointestinal tumors not responding to at least 2 lines of chemotherapy were eligible for study entry. The treatment included 5 i.p. infs (day 1, 3, 5, 15, 30) and the study aimed to test three cell dose levels: 1 x 10 8 , 5 x 10 8 , 2.5 x 10 9 . End points of the study were: safety, kinetic of TALL-104 cells on ascites (if present) and peripheral blood (PB) by PCR, levels of cytokines (TGF-β, GM-CSF, IL-2, IL-4, IL-10, IFN-γ, TNF-a and -β, HGF, sIL-2R, sICAM-1) on ascites and serum, and cytotoxicity of autologous PB mononuclear cells (MNC) against K562 cells. Results: So far 10 pts have been treated: 6 with GI and 4 with ovarian cancer; 7 patients had ascites. Five pts have been treated at the 1st and 5 pts at the 2nd dose level. No treatment-related adverse events were observed. TALL-104 cells were detected in ascites (100 % of the pts) and PB (43 % of the pts) up to 48 hrs after the infs. Cytotoxicity of MNC showed a mean 5-fold increase at day 3 through 7 and it was still evident at day 30 in both dose levels. Cytokine levels are available for the first 5 pts. In one pt 18-fold increase of TNF-a was observed in ascites after the first infusion with a peak of 40-fold at day 15. sIL-2R and sICAM-1 showed both a mean 1.2-fold and 1.5-fold increase in serum in ascites respectively up to day 45. TGF-β1 level increased in average 3.3-fold in serum and 1.5-fold in ascites during the same observation period. HGF showed a mean 1.2-fold increase both in serum and ascites. Conclusions: These preliminary results show that the i.p. infusion of TALL-104 is safe. Moreover, the increased autologous cell-mediated cytotoxicity and the levels of soluble cytokines after i.p. infs indicate that TALL-104 cells may elicit potential antitumor activity. No significant financial relationships to disclose.
NOTCH1 Transcriptionally Activates Deptor and Promotes AKT Activation in Acute T-Cell Lymphoblastic Leukemia
Authors: Hudan Liu, Yufeng Hu, Hexiu Su, Qi Ye, Zhaojing Wang, Liang Huang, Qian Wang, Suning Chen, Jianfeng Zhou, Shuangyou Liu, Guoliang Qing
Journal: Blood (2014)
Cost Effectiveness of Thrombolytic Therapy with Streptokinase in Elderly Patients with Suspected Acute Myocardial Infarction
Authors: Harlan M. Krumholz, Richard C. Pasternak, Milton C. Weinstein, Gottlieb C. Friesinger, Paul M. Ridker, Anna N.A. Tosteson, Lee Goldman
Journal: New England Journal of Medicine (1992)

There is a lack of consensus among cardiologists about the potential benefit of thrombolytic therapy for suspected acute myocardial infarction in older patients. To investigate this issue, we constructed a decision-analytic model for patients 75 years of age or older who present with ST-segment elevation within six hours of the onset of symptoms suggesting acute myocardial infarction.