tbuckley/cabot-search huggingface dataset:
Expression of Bcl-x in Erythroid Precursors from Patients with Polycythemia Vera
Authors: Maite Silva, Carlos Richard, Adalberto Benito, Cristina Sanz, Ignacio Olalla, José Luis Fernández-Luna
Journal: New England Journal of Medicine (1998)

Deregulating the expression of Bcl-xL, an inhibitor of apoptosis, in an erythropoietin-dependent erythroblast cell line averts apoptosis induced by the withdrawal of erythropoietin. Since in polycythemia vera an abnormal clone of erythroid progenitors is independent of erythropoietin, we investigated whether the endogenous expression of Bcl-xL was deregulated in these cells.
Chromosome Studies on Testicular Tissue Cultures and Blood Leukocytes of a Male Previously Reported to Have No Y Chromosome
Authors: Irene L. Solomon, Charles W. Hamm, Orville C. Green
Journal: New England Journal of Medicine (1964)

IN 1961 Oikawa and Blizzard1 described an eleven-year-old phenotypic male with bilateral undescended testes, clinical features of Turner's syndrome, a positive buccal smear and absence of a Y chromosome in bone-marrow cells. There was no apparent explanation of the failure of this patient to conform to the theory that the Y chromosome carries male-determining genes.Testicular tissue in the absence of a demonstrable Y chromosome has been reported in true hermaphrodites. Rosenberg et al.2 and Solomon and Green3 proposed that the usual finding of an XX chromosome pattern in true hermaphrodites suggests a genetic disturbance in these cases. It is . . .
Withdrawal of LHRH therapy in selected prostate cancer patients
Authors: R. Raphael, S. Zoya, R. Ana, S. Katty, L. Michelle, K. Shoshana, G. Eliahu, S. Mariana
Journal: Journal of Clinical Oncology (2005)

4763 Background: LHRH agonists therapy was discontinued after achieving complete response in 61 selected prostate cancer patients. Patients were then followed clinically and serum PSA level was obtained periodically. Treatment was restarted if disease activity was evident and considered significant by doctor or patient. Methods: In a retrospective analysis the withdrawal period was correlated with clinical disease parameters. Results: The median patient’s age was 77 years (55–92). All patients had non metastatic prostate cancer, 67% had Gleason =< 6, 22% Gleason 7 and 11% Gleason 8–10 disease. 72% had hormonal therapy as their first treatment and 28% failed after radical prostatectomy or radiotherapy. They had LHRH agonists therapy for 7–86 months (median 23) and the median serum PSA level was 0.04 ng/ml (0.01–2.61) when treatment was withdrawn. The median length of the withdrawal period was 28 months (7–72+).It correlated with LHRH agonists therapy period being 21 months (7–72) in patients treated for less than two years and 28 months (9–66+) in patients treated more than two years. Patients with Gleason score =< 6 disease had longer withdrawal period, (median 28 months, 7–72+) than those with Gleason score 7–10, (median 21 months, 5–66). No correlation was found between the length of withdrawal period and patient’s age. LHRH agonists treatment was restarted in 34 patients after median withdrawal of 16 months (7–57) at a median PSA level of 6.4 ng/ml (0.65–20.8). All patients responded to the secondary hormonal manipulation with secondary serum PSA level decrease. Conclusions: We concluded that LHRH agonists therapy withdrawal in prostate cancer patients in complete response is possible and safe. Patients with prolonged therapy (> two years) and Gleason score =< 6 are more likely to benefit from longer withdrawal period. No significant financial relationships to disclose.
Sodium Diuresis Produced by Dopamine in Patients with Congestive Heart Failure
Authors: Leon I. Goldberg, Robert H. McDonald, Alfred M. Zimmerman
Journal: New England Journal of Medicine (1963)

A NUMBER of sympathomimetic amines have been found to increase heart contractile force of laboratory animals1 2 3 and man.4 Because of this positive inotropic effect5 several investigators have suggested that these agents may be of value in the treatment of congestive heart failure.6 7 8 9 Unfortunately, recent attempts to use sympathomimetic amines for such therapy have not been successful. Frye, Kahler and Braunwald8 reported that administration of mephentermine (Wyamine) to patients with congestive heart failure was without beneficial effect, and Sandier, Dodge and Murdaugh9 observed that intravenous administration of isoproterenol did not significantly increase sodium excretion or glomerular filtration rate in 11 patients . . .
Abstract 17636: Potential Warfarin-supplement Interactions in the Anticoagulation Clinic - Insights From the Michigan Anticoagulation Quality Improvement Initiative (MAQI2)
Authors: Steven T Heidt, Constantina Alexandris-Souphis, Eva Kline-Rogers, Geoffrey D Barnes, Brian Haymart, Eric D Puroll, Stephanie Watts, Renee Kozlowski, Jay Kozlowski, James B Froehlich
Journal: Circulation (2013)

Background: Warfarin interacts with many dietary supplements, potentially leading to dangerous bleeding or clotting events. Since 1994, supplement use in the US has grown substantially, particularl...
Cryptosporidiosis in Immunocompetent Patients
Authors: John S. Wolfson, James M. Richter, Mary Ann Waldron, David J. Weber, Deborah M. McCarthy, Cyrus C. Hopkins
Journal: New England Journal of Medicine (1985)

The intestinal protozoan cryptosporidium is known to cause diarrhea in immunocompromised patients, but few cases have been reported in detail in immunocompetent persons. During a 12-month period, we identified cryptosporidium in the stools of 43 immunocompetent patients. The numbers of cases were increased in those under 4 years old and in those from 30 to 39 years old. Of 30 index cases, 23 (77 per cent) were diagnosed in the late summer or the fall. Fifteen of the 43 patients (35 per cent) had other gastrointestinal pathogens, of which only Giardia lamblia was statistically associated with cryptosporidium. In the 28 patients in whom other gastrointestinal pathogens were not identified, the clinical manifestations were predominantly watery, nonbloody diarrhea and, less commonly, abdominal discomfort, anorexia, fever, nausea, and weight loss. The infection was self-limited in all 43 patients. Clustering of cases occurred in a day-care center and in two families. These clinical observations confirm worldwide findings and suggest that cryptosporidium is a relatively common nonviral cause of self-limited diarrhea in immunocompetent persons in the northeastern United States.
Hepatitis C virus infection in HIV-infected men who have sex with men: sustained rising incidence in Antwerp, Belgium, 2001–2009
Authors: E Bottieau, L Apers, M Van Esbroeck, M Vandenbruaene, E Florence
Journal: Eurosurveillance (2010)

During the last decade, outbreaks of acute hepatitis C virus (HCV) infection have been reported among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) in several European countries. To study this emerging infection in MSM in Antwerp, Belgium, we reviewed all cases of newly acquired HCV infection in HIV-positive MSM followed from 2001 to 2009 at the HIV/sexually transmitted infection (STI) reference clinic of the Institute of Tropical Medicine in Antwerp. Newly acquired HCV infection was considered as certain or probable according to local definitions. During the study period, 69 episodes of newly acquired HCV infection (40 certain and 29 probable) were diagnosed in 67 HIV-infected MSM. In only 10 episodes (14%) were the patients symptomatic. The annual incidence of HCV infection in our population of HIV-infected MSM rose steadily from 0.2% in 2001 to 1.51% in 2008, and then peaked to 2.9% in 2009. For 60 episodes (87%), another STI (mainly syphilis and lymphogranuloma venereum) had been diagnosed within the six months before the diagnosis of HCV infection. All but one patient with available genotyping (n=54) were found to be infected with the difficult-to-treat HCV genotypes 1 or 4. Our results therefore demonstrate the rising incidence of HCV infection in HIV-positive MSM in Antwerp, since 2001, which reached an alarming level in 2009. Targeted awareness campaigns and routine screening are urgently needed to limit further HCV spread and its expected long-term consequences.
Malaria Probably Locally Acquired in New Jersey
Authors: John H. Brook, Carol A. Genese, Peter B. Bloland, Jane R. Zucker, Kenneth C. Spitalny
Journal: New England Journal of Medicine (1994)

In September 1991, the New Jersey Department of Health received two case reports of Plasmodium vivax malaria presumed to have been locally acquired in New Jersey. Both patients reported no known exposure to malaria, including travel to areas of endemic disease. Case Reports Patient 1 Patient 1 was a 29-year-old woman who presented to her physician on September 9, 1991, with a four-day history of fevers (temperature, up to 39.9 °C [103.8 °F]), chills, headache, and a petechial rash on her legs. A blood smear, obtained four days earlier as part of a workup for hemochromatosis and just hours before . . .
RTRB-12A NOVEL PET INDEX,<sup>11</sup>C-METHIONINE/<sup>18</sup>F-FDG UPTAKE DECOUPLING SCORE, IN MALIGNANT GLIOMA: EVALUATION OF ITS GEOMETRICAL FEATURES FOR PLANNING RADIATION THERAPY
Authors: Takero Hirata, Manabu Kinoshita, Hideyuki Arita, Osamu Suzuki, Naoya Hashimoto, Jun Hatazawa, Teruki Teshima, Toshiki Yoshimine, Kazuhiko Ogawa
Journal: Neuro-Oncology (2015)

For radiotherapy (RT) of malignant glioma (MG), it is important to define the target volume correctly and precisely. 11C-methionine (MET) positron emission tomography (PET) holds promise for detecting areas of glioma cell infiltration: our previous research showed that the magnitude of disruption of MET and 18F-fluorodeoxyglucose (FDG) uptake correlation (decoupling score; DS) precisely reflects glioma cell invasion. Here, we analyzed the volumetric and geometrical properties of RT target delineation based on DS and compared them with those based on magnetic resonance imaging (MRI). We compared three target volumes, which include core lesions from gadolinium-enhanced lesions identified with contrast-enhanced T1 weighted images, lesions for high intensity regions on T2 weighted images, and regions showing high DS (> 3). Their geometrical differences were assessed by calculating the probability of overlap, and the probability that one could encompass the other. Our analysis indicated that microscopic invasion of glioma cells often extends more than 2.0 cm beyond a gadolinium-enhanced core lesion. We also demonstrated that a 1.0 cm margin from a target volume, delineated by MRI, is required to cover the entire high DS region, while the volume increases accordingly. In addition, our morphological estimation showed that lesions with T2 high intensity and high DS around the core lesion have different configurations. Taken together, our findings indicate that MRI is probably insufficient for target delineation of RT for MG, and that MET/FDG PET-DS is a more promising modality.
Abstract 4346: Prognostic gene signature for intermediate risk prostate cancer
Authors: Brian Li, Robin Hallet, Ying Wu, Greg Pong, John Hassell, Sebastien Hotte, Mark Levine, Himansu Lukka, Anita Bane
Journal: Cancer Research (2015)

Abstract The over treatment of prostate cancer patients is a significant concern, as recent clinical trials suggest that many patients are over treated which can lead to significant patient morbidity. Although the Gleason score is a powerful predictor of lethal or indolent disease, a significant proportion (∼40%) of men present with early stage Gleason score (GS) 7 tumors, for whom prognosis is variable. The goal of this study is to develop and optimize a robust prognostic gene signature that can be utilized on formalin fixed paraffin embedded (FFPE) core biopsy tumor material to better classify patients with intermediate risk, GS 7 tumors into good and poor outcome groups. Three gene signatures were derived from publicly available gene expression profiles of the Swedish Watchful Waiting cohort. The Genomic Grade Index consisted of the top 25 molecular signatures discriminating between high (8, 9 &amp; 10) and low (≤ 6) GS tumors. The Lethal Gene Score consisted of the top 25 molecular signatures discriminating between lethal and indolent disease within GS 7 tumors only. A network-based gene signature consisted of 88 genes which accurately stratified GS 7 patients into high risk and low risk groups, resembling the survival curves of high GS and low GS patients. The prognostic capacity of the combined gene signature was tested in silico on the gene expression profiles of the Mayo cohort. Results demonstrated the gene signature's highly robust capacity for differentiating low risk and high risk patients within GS 7 patients. The NanoString nCounter System will be used to quantify mRNA from prostate FFPE blocks to assess the expression of the 138 prognostic genes. 156 archived prostate tumor blocks will be collected from intermediate risk, GS 7 patients enrolled in the 2005 PR5 prostate trial, which also collected 12 years of clinical follow-up information. Results will be correlated with biochemical (PSA) failure rates and overall survival. In short, our findings provide proof-of-principle that through the use of gene signatures it is possible to separate prostate cancer patients of intermediate risk into good and poor outcome groups. Furthermore, they also identify multiple gene candidates whose expression could likely be formulated into a clinically applicable assay, the implementation of which could serve to stratify prostate cancer patients with tumors of intermediate risk into more accurate high and low risk groups. Citation Format: Brian Li, Robin Hallet, Ying Wu, Greg Pong, John Hassell, Sebastien Hotte, Mark Levine, Himansu Lukka, Anita Bane. Prognostic gene signature for intermediate risk prostate cancer. [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 4346. doi:10.1158/1538-7445.AM2015-4346
Epidemiologic, Clinical and Laboratory Aspects of Wound Botulism
Authors: Michael H. Merson, V. R. Dowell
Journal: New England Journal of Medicine (1973)

An analysis of the clinical, epidemiologic and laboratory aspects of nine patients with wound botulism showed that all had characteristic clinical findings, including respiratory paralysis. Five cases were reported between April, 1971, and November, 1972. Laboratory confirmation was obtained in six cases by demonstration of botulinal toxin in serum or isolation of Clostridium botulinum from a wound or both; all were Type A. Although four of the nine patients died, only one of the six most recent cases was fatal. Electromyography was helpful in confirming the diagnosis in three cases. A diagnosis of wound botulism should be considered when characteristic neurologic abnormalities are present and no food item can be implicated epidemiologically. Use of proper laboratory methods for detection of botulinal toxin and identification of clostridial isolates is imperative. (N Engl J Med 289:1005–1010, 1973)
Soundings: How to party
Authors: James Owen Drife
Journal: BMJ (2000)

At an academic dinner recently two professors remarked that their grown up children had advised them to get a life. This advice had been given in all seriousness and, in one case, had been reinforced by a postcard saying, “WORK is for people who don't know how to party.” “It's true,” the professor added sadly, “I really don't.”

Such ignorance is new. Older professors always used the word “fun” in their retirement speeches, usually when referring to the second world war or academic life in the 1960s. Sooner or later medical schools will realise that those bon viveurs were actually more productive than their workaholic successors.

When this happens, partying will come back into fashion. Indeed, it will become compulsory. We shall have a national RAE (Revelry Assessment Exercise) involving detailed questionnaires on party quality and quantity. We shall agonise about how many parties to declare.

We shall need published guidelines. At present there is no basis for evidence based partying. What follows is a draft for consultation.

The invitation: Email is boring. Have your invitation sung by a stripping lab technician or encoded on a genetic fingerprint.

The venue: Be original. Choose somewhere that will be stimulatingly unfamiliar to academics—the outpatient clinic, for example. Inexpensive decorations can be made from bunches of used airline tickets.

Games: Academics love to see themselves as Machiavellian plotters. Get things going with a box of rubber daggers. Everyone has to stab everyone else in the back and when stabbed has to writhe in agony on the floor. (Keep an eye on the stilettos to make sure that nobody slips in a real one.)

The food: Bring back memories of your days as a junior. Install a hospital vending machine with sinister looking pasties. And why not retune the microwave to sound like a mobile phone? 

The music: Hip disc jockeys with strange names and huge loudspeakers can be easily hired. Most are medical students but a few are ear, nose, and throat surgeons drumming up trade.

The drugs: Having trouble recruiting volunteers for your latest phase III trial? Make sure your doormen have a good supply of consent forms.

Remember, these are only guidelines. Enjoy.
Risk of Breast Cancer to Relatives of Young Breast Cancer Patients&lt;xref ref-type="fn" rid="FN1"&gt;2&lt;/xref&gt;
Authors: A G Schwartz, M C King, S H Belle, W A Satariano, G M Swanson
Journal: JNCI Journal of the National Cancer Institute (1985)

Breast cancer risk among sisters and mothers of a population-based series of 1,137 breast cancer patients diagnosed in Metropolitan Detroit before the age of 55 years was compared with risk to the same relatives of 1,001 age-matched, population-based controls. After adjusting for age of the relative, for age of the case or control, and for race, the odds ratio for breast cancer for women with affected sisters was 2.2; for women with affected daughters, 3.2; and for women with affected mothers and sisters, 9.9. Breast cancer in aunts had no independent influence on risk. Among white women, cumulative risk of breast cancer before the age of 50 years was approximately 1% for relatives of controls, 3% for sisters of older cases, but about 17% for women either with sisters diagnosed before the age of 40 years or with affected sisters and mothers. Sisters of the older patients had a 13% risk of breast cancer by 70 years of age, compared to 5% for sisters of controls. White women with affected mothers and sisters were at 50% risk by 65 years of age. This study identifies the criteria for women who could receive particular benefit from screening for breast cancer.
Adult T-Cell Leukemia–Lymphoma during Pregnancy
Authors: Amar Safdar, Natalie Johnson, Francisco Gonzalez, John D. Busowski
Journal: New England Journal of Medicine (2002)

To the Editor: Human T-cell lymphotrophic virus type I (HTLV-I) infection is uncommon in the United States. During the period from 1991 to 1996, the incidence of seropositivity for HTLV-I or human T-cell lymphotrophic virus type II (HTLV-II) in U.S. blood donors was 1.59 per 100,000 person-years.1 This virus causes adult T-cell leukemia–lymphoma.2 We report a case of adult T-cell leukemia–lymphoma during pregnancy. A 23-year-old woman was admitted to a hospital in South Carolina because of a 7-day history of sore throat, fever, and fatigue during the 26th week of gestation. There was no history of intravenous drug use, foreign . . .
Chronic Hypocalcemia in a Patient with Parathyroid Clear-Cell Hyperplasia
Authors: Boy Frame, Martin Fruchtman, Richmond W. Smith
Journal: New England Journal of Medicine (1962)

THE etiology of hypocalcemia is usually not difficult to define. In most cases it is due to one of the following: postoperative, idiopathic or pseudohypoparathyroidism; rickets and osteomalacia; chronic renal disease with azotemia; renal tubular acidosis; hypoalbuminemia; or malabsorption syndrome.The present report concerns a patient with long standing hypocalcemia not readily explained by any of the known causes. Parathyroid exploration demonstrated gross enlargement of the glands, which, on histologic study, revealed clear-cell hyperplasia. A partial defect in synthesis of parathyroid hormone resulting in compensatory hyperplasia, an end-organ (bone) refractoriness to the effect of parathyroid hormone and a hypersecretion of . . .
Observational Evidence of For-Profit Delivery and Inferior Nursing Home Care: When Is There Enough Evidence for Policy Change?
Authors: Lisa A. Ronald, Margaret J. McGregor, Charlene Harrington, Allyson Pollock, Joel Lexchin
Journal: PLoS Medicine (2016)

Points• Nursing home residents are a highly vulnerable population, and nursing home care quality has been a persistent focus of public concern.• There is considerable evidence from observational studies that public funding of care delivered in for-profit facilities is inferior to care delivered in public or nonprofit facilities.• The past decade has seen many industrialized countries increasing governmental payment for care of frail seniors in for-profit nursing homes, leading to questions about whether this leads to inferior care.• Many of Bradford Hill's guidelines for causation can be found in published studies supporting a causal link between for-profit ownership and inferior care.• The precautionary principle should be applied when developing policy for this frail and vulnerable population.
A Prospective Study of Diarrhea and HIV-1 Infection among 429 Zairian Infants
Authors: Donald M. Thea, Michael E. St. Louis, Uvoya Atido, Kakanda Kanjinga, Biyela Kembo, Mbala Matondo, Tshimpaka Tshiamala, Claude Kamenga, Farzin Davachi, Christopher Brown, William M. Rand, Gerald T. Keusch
Journal: New England Journal of Medicine (1993)

Persistent diarrhea is a prominent feature of the acquired immunodeficiency syndrome in adults, but its cause and its effect on children with human immunodeficiency virus (HIV) infection are largely unknown, particularly in Africa.We studied a birth cohort of 429 infants born to HIV-positive or HIV-negative mothers in Zaire to determine the incidence of acute, recurrent (> or = 2 episodes), and persistent (> or = 14 days) diarrhea; outcome; and risk factors.Of the 238 infants whose mothers were HIV-positive, 53 were infected, 139 were uninfected, and the HIV status of 46 could not be determined. As compared with uninfected infants, infected infants had higher incidence rates for acute diarrhea (170 vs. 100 episodes per 100 child-years, P = 0.003), recurrent diarrhea (21 vs. 11, P = 0.12), and persistent diarrhea (19 vs. 4, P < 0.003). Persistent diarrhea developed in 11 HIV-infected infants; all but 1 died. It also developed in 19 uninfected infants; all but 1 survived. The prevalence of stool pathogens was similar in the two groups. In a multivariate model, persistent diarrhea in an infant was independently associated with symptomatic HIV type 1 infection in the mother (relative hazard, 1.5; P = 0.08). The incidence of persistent diarrhea in the uninfected infants of seropositive mothers was nearly double that in the uninfected infants of seronegative mothers (4.9 vs. 2.7 episodes per 100 child-years), and the risk increased if the mother died (relative hazard, 10.4). Significant growth impairment and severe immunosuppression occurred in the six to eight weeks before the onset of persistent diarrhea.In Zaire, infants with HIV infection have an 11-fold increased risk of death from diarrhea, largely persistent diarrhea, which is often preceded by recurrent episodes of acute diarrhea, malnutrition, or immunosuppression. Illness and death of the mother increase that risk, even among her uninfected infants.