tbuckley/cabot-search huggingface dataset:
A Critical Evaluation of Thromboangiitis Obliterans
Authors: Stanford Wessler, Si-Chun Ming, Victor Gurewich, David G. Freiman
Journal: New England Journal of Medicine (1960)

IN 1908 Leo Buerger, impressed by the occurrence of gangrene in a small number of young men, delineated in this group certain features that, in his opinion, constituted a distinct clinical and pathological entity.1 This condition, which he termed thromboangiitis obliterans, was readily accepted by his contemporaries and today is so well known to the laity as to be all but synonymous with gangrene of an extremity from any cause.The clinical picture as described by Buerger in his various publications was dominated by symptoms and signs referable to recurrent progressive peripheral arterial insufficiency. The lower extremities were involved more . . .
Medium-Chain Acyl-CoA Dehydrogenase Deficiency
Authors: C A Stanley, D E Hale, P M Coates
Journal: New England Journal of Medicine (1988)

Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency, one of the most common inherited metabolic disorders, is often mistaken for the sudden infant death syndrome or Reye's syndrome. Diagnosing it has been difficult because of a lack of fast and reliable diagnostic methods. We developed a stable-isotope dilution method to measure urinary n-hexanoylglycine, 3-phenylpropionylglycine, and suberylglycine, and we retrospectively tested its accuracy in diagnosing MCAD deficiency. We measured the concentrations of these three acylglycines in 54 urine samples from 21 patients with confirmed MCAD deficiency during the acute and asymptomatic phases of the illness and compared the results with the concentrations in 98 samples from healthy controls and patient controls with various diseases. The levels of urinary hexanoylglycine and phenylpropionylglycine were significantly increased in all samples from the patients with MCAD deficiency, clearly distinguishing them from both groups of controls. Although urinary suberylglycine was increased in the patients, the range of values in the normal controls who were receiving formula containing medium-chain triglycerides was very wide, overlapping somewhat with the values in the patients with asymptomatic MCAD deficiency. These results indicate that the measurement of urinary hexanoylglycine and phenylpropionylglycine by our method is highly specific for the diagnosis of MCAD deficiency. The method is fast and can be applied to random urine specimens, without any pretreatment of patients.
Silent HIV Infections
Authors: Willam A. Haseltine
Journal: New England Journal of Medicine (1989)

The report in this issue by Imagawa et al.1 that infectious human immunodeficiency virus type 1 (HIV-1) was isolated from 31 of 133 people who tested negative for antibodies on conventional enzyme-linked immunosorbent assay (ELISA) and Western blot assay adds another layer of complexity to the understanding of the epidemic of acquired immunodeficiency syndrome. The blood samples tested were from a group of homosexual men who acknowledged their continued high-risk behavior. The men were part of a much larger prospective study in which serum and lymphocytes were obtained and stored every six months.2 Twenty-seven people remained seronegative during the 7-to-36-month . . .
Regional Variation in Out-of-Hospital Cardiac Arrest Survival in the United States
Authors: Saket Girotra, Sean van Diepen, Brahmajee K. Nallamothu, Margaret Carrel, Kimberly Vellano, Monique L. Anderson, Bryan McNally, Benjamin S. Abella, Comilla Sasson, Paul S. Chan
Journal: Circulation (2016)

Although previous studies have shown marked variation in out-of-hospital cardiac arrest survival across US regions, factors underlying this survival variation remain incompletely explained. Using data from the Cardiac Arrest Registry to Enhance Survival, we identified 96 662 adult patients with out-of-hospital cardiac arrest in 132 US counties. We used hierarchical regression models to examine county-level variation in rates of survival and survival with functional recovery (defined as Cerebral Performance Category score of 1 or 2) and examined the contribution of demographics, cardiac arrest characteristics, bystander cardiopulmonary resuscitation, automated external defibrillator use, and county-level sociodemographic factors in survival variation across counties. A total of 9317 (9.6%) patients survived to discharge, and 7176 (7.4%) achieved functional recovery. At a county level, there was marked variation in rates of survival to discharge (range, 3.4%-22.0%; median odds ratio, 1.40; 95% confidence interval, 1.32-1.46) and survival with functional recovery (range, 0.8%-21.0%; median odds ratio, 1.53; 95% confidence interval, 1.43-1.62). County-level rates of bystander cardiopulmonary resuscitation and automated external defibrillator use were positively correlated with both outcomes (P<0.0001 for all). Patient demographic and cardiac arrest characteristics explained 4.8% and 27.7% of the county-level variation in survival, respectively. Additional adjustment of bystander cardiopulmonary resuscitation and automated external defibrillator explained 41% of the survival variation, and this increased to 50.4% after adjustment of county-level sociodemographic factors. Similar findings were noted in analyses of survival with functional recovery. Although out-of-hospital cardiac arrest survival varies significantly across US counties, a substantial proportion of the variation is attributable to differences in bystander response across communities.
P212 Microbiological sampling in community-acquired pneumonia: do we follow the guidelines and does it help our patients?
Authors: SS Sunny, P McDermott, K Tariq, J Hadcroft, J Folb
Journal: Thorax (2015)

<h3>Introduction</h3> Community-acquired pneumonia (CAP) is a common cause for hospital admission and carries a high mortality rate. Choosing the correct antibiotic can be challenging and “atypical” pathogens, such as <i>Mycoplasma pneumoniae</i> and <i>Chlamydophila pneumoniae</i>, are not eliminated by some first-line empirical agents. Identification of the infecting organism through microbiological sampling can help to tailor antibiotic therapy and substantially improve patient outcomes. Guidelines exist (NICE, BTS, trust) that recommend which patients should undergo microbiological sampling. We wished to determine whether these guidelines were followed in our trust in patients admitted with CAP. <h3>Methods</h3> We reviewed the notes of adult patients admitted over a 15-week period (February–May 2014) with a clinical code of pneumonia. Further information was derived from hospital systems, including Telepath (used by the Microbiology department) and from ‘Advancing Quality’ data available for these patients. <h3>Results</h3> 175 patients were identified with CAP. Blood cultures (BCs) were indicated in 89 patients according to trust guidelines (based on Systemic Inflammatory Response Syndrome (SIRS) criteria, CURB-65 score, immunocompromised; data sufficient in 147) and appropriately collected in 55 (61.8%). However, only 4 had positive (clinically significant) BC results. Sputum samples were sent for 31 patients (17.7%, n = 175) and only 19% had significant bacterial growth. All patients transferred to intensive care (ITU; 3.4%) were screened appropriately for urinary pneumococcal antigen (UPA) and urinary legionella antigen (ULA), with 1 positive UPA result. 6 (of 10) UPA and 7 (of 12) ULA samples appeared to be sent inappropriately for non-ITU patients and were rejected by the laboratory. Serum samples were sent for Mycoplasma testing in 7 patients, despite this service being superseded by testing by polymerase chain reaction (PCR)-testing of nose/throat swabs, for which only 1 was sent for the entire cohort. <h3>Conclusion</h3> While BC collection was frequent, compliance with local guidance was less than desired. Sampling to rule out atypical pathogens in CAP appeared to be low and, occasionally, inappropriate. Although positive detection rates were low, further work appears to be indicated to optimise patient outcomes in CAP by increasing awareness amongst clinicians of tests available and ensure appropriate sampling for atypical pathogen screening.
Determinants of Prognosis in Survivors of Myocardial Infarction
Authors: G. Sanz, A. Castañer, A. Betriu, J. Magriña, E. Roig, S. Coll, J. C. Paré, F. Navarro-López
Journal: New England Journal of Medicine (1982)

To identify predictors of late mortality, 259 consecutive men (≤60 years old) who survived acute myocardial infarctions were catheterized one month after admission and were then followed for a mean of 34 months. Nineteen patients (7 per cent) died during the observation period. Of 79 base-line descriptors, 17 proved to be univariate predictors of survival. Cox regression analysis demonstrated that the ejection fraction (P<0.001), the number of diseased vessels (P<0.005), and the occurrence of congestive heart failure in the coronary unit (P<0.01) were the only independent predictors of survival. Risk stratification showed that the probability of survival at four years was highest in patients with normal ejection fractions (96 to 100 per cent, depending on the number of diseased vessels) and lowest in those with ejection fractions below 20 per cent (30 to 75 per cent). The prognosis in patients with ejection fractions between 21 and 49 per cent was significantly worse (78 per cent) than in those with normal ejection fractions only in the group with three-vessel involvement (P<0.01). Since most survivors of myocardial infarction who are likely to have their lives prolonged by coronary-artery bypass surgery are in this group, it is reasonable to limit routine coronary angiography to the 56 per cent of survivors who have ejection fractions between 21 and 49 per cent. (N Engl J Med. 1982; 306:1065–70.)
Thickening and Contraction of the Palmar Fascia (Dupuytren's Contracture) Associated with Alcoholism and Hepatic Cirrhosis
Authors: Stanley J. Wolfe, William H. J. Summerskill, Charles S. Davidson
Journal: New England Journal of Medicine (1956)

BARON Guillaume Dupuytren,1 in 1832, attributed the hand deformity that now bears his name to retraction of the palmar aponeurosis, and an extensive literature has since appeared concerning its etiology, pathogenesis and treatment. In a detailed review, Skoog2 mentioned as possible causes or concomitants of Dupuytren's contracture heredity, trauma, neuropathy, rheumatic diseases, endocrinopathy, epilepsy, developmental abnormalities, contraction of the palmaris-longus muscle, local infection, tuberculosis, chronic intoxication (lead) and others. None have been universally accepted or proved.The deformity is quite common; it is said to occur as frequently in nonmanual workers as in those who labor with their hands,3 and . . .
Role of Complexed PSA in the Early Detection of Prostate Cancer
Authors: Yoshio Naya, Koji Okihara
Journal: Journal of the National Comprehensive Cancer Network (2004)

Prostate cancer is a clinically significant health care problem in the United States. Total prostate specific antigen (tPSA) is widely used to detect prostate cancer with a significant increase in the incidence of organ-confined disease at the time of diagnosis. The limitations of tPSA are low specificity and positive predictive value. Numerous attempts to enhance PSA's performance based on prostate volume, patient age, patient race, and PSA velocity have shown little clinical improvement. Percent free PSA has proven to be somewhat improved but still limited. Recently, the complexed PSA (cPSA) assay was developed and multisite institutional studies have shown that cPSA has improved specificity over tPSA. Complexed PSA can replace tPSA as a first screening test.
Cladribine added to daunorubicin-cytarabine induction prolongs survival of FLT3-ITD+ normal karyotype AML patients
Authors: Marta Libura, Sebastian Giebel, Beata Piatkowska-Jakubas, Marta Pawelczyk, Izabella Florek, Karolina Matiakowska, Bozena Jazwiec, Katarzyna Borg, Iwona Solarska, Magdalena Zawada, Sylwia Czekalska, Jolanta Libura, Malgorzata Jakobczyk, Karolina Karabin, Monika Paluszewska, Malgorzata Calbecka, Justyna Gajkowska-Kulik, Grazyna Gadomska, Marek Kielbinski, Anna Ejduk, Dariusz Kata, Sebastian Grosicki, Agnieszka Wierzbowska, Slawomira Kyrcz-Krzemien, Krzysztof Warzocha, Kazimierz Kuliczkowski, Aleksander Skotnicki, Jerzy Holowiecki, Wieslaw Wiktor Jedrzejczak, Olga Haus
Journal: Blood (2015)
Relation between Pyelonephritis and Bacterial Counts in the Urine
Authors: Richard A. MacDonald, Howard Levitin, G. Kenneth Mallory, Edward H. Kass, Joanne C. Norton
Journal: New England Journal of Medicine (1957)

THE clinical diagnosis of pyelonephritis is frequently overlooked, and the disparity between the clinical and post-mortem findings in this infection has been emphasized repeatedly.1 2 3 4 The failure of clinical diagnosis has been due not so much to failure to recognize the classic symptoms and signs of the disease as to the absence of overt clinical manifestations of pyelonephritis in many patients.Bacterial counts of the urine have been performed in an attempt to add to the objective methods for determining the presence of infection of the urinary tract.3 , 5 6 7 The validity of the quantitative approach is suggested by the following considerations:Urine . . .
The Ets transcription factor Esx regulates expression of metastasis-associated genes in non-small cell lung cancer (NSCLC)
Authors: M. Mitas, A. Graham, A. Khoors, Y. Chen, D. Lewin, P. Davoodi, K. Mikhitarian, A. Montero, D. Cole, M. Wallace
Journal: Journal of Clinical Oncology (2006)

17077 Background: The overall 5-yr survival for the treatment of lung cancer patients is less than 20% due to the inability to control metastatic disease. Methods: To identify genes that promote the development of metastases in NSCLC and other solid tumors, we first performed three separate microarray analyses using Affymetrix U133A chips whereby expression values of a pool of normal lymph nodes was compared to: lung cancer cell lines (n = 4), and metastatic lymph nodes from breast (n = 3) and pancreatic (n = 3) cancer patients. Separate lists of the 35 most highly overexpressed genes for each cancer type were compiled. Results: We observed that each list contained EpCAM, XAG, CK19, and CK8 (p = 1.1E-18). To search for genes that might regulate expression of these four genes, we queried the CGAP NCI60 gene expression database with the 87 genes contained on the three lists and constructed a connectivity map such that the presence of a gene on the map required: 1) high correlation (p &lt; 8.0E-6) with at least two other genes, and 2), direct or indirect contact to EpCAM or XAG. The map contained two gene clusters (XAG cluster = 6 genes; EpCAM/CK19/CK8 cluster = 7 genes) that were connected to, and potentially regulated by, the Ets transcriptional factor Esx. Genes from both clusters, as well as Esx, were highly overexpressed in metastatic mediastianal lymph nodes obtained from NSCLC patients. To investigate whether Esx might regulate expression of one or more genes in the two clusters, we transfected an NSCLC cell line derived from lymph node metastases with siRNA to Esx and observed: 1) a reduction in expression of EpCAM (4-fold), XAG (7-fold), and the orphan nuclear receptor ESRRα (1,000-fold), and 2), an inhibition of cell growth. Conclusions: Based on our ability to simultaneously inhibit cell growth and expression of multiple metastasis-associated genes with a single siRNA, we conclude that Esx is a major regulator of lymph node metastasis. No significant financial relationships to disclose.
EBV‐positive diffuse large B‐cell lymphoma of the elderly: 2016 update on diagnosis, risk‐stratification, and management
Authors: Jorge J. Castillo, Brady E. Beltran, Roberto N. Miranda, Ken H. Young, Julio C. Chavez, Eduardo M. Sotomayor
Journal: American Journal of Hematology (2016)

Epstein–Barr virus (EBV)‐positive diffuse large B‐cell lymphoma (DLBCL) of the elderly is a provisional entity included in the 2008 WHO classification of lymphoid neoplasms. It is a disease typically seen in the elderly and thought to be associated with chronic EBV infection and severe immunosuppression with a component of immunosenescence. Recent research, however, has suggested that EBV‐positive DLBCL can be seen in younger, immunocompetent patients. The diagnosis of EBV‐positive DLBCL of the elderly is made through a careful pathological evaluation. The differential diagnosis includes infectious mononucleosis (specifically in younger patients), lymphomatoid granulomatosis, Hodgkin lymphoma, and gray zone lymphoma, among others. Detection of EBV‐encoded RNA (EBER) is considered standard for diagnosis; however, a clear cutoff for positivity has not been defined. The International Prognostic Index (IPI), and the Oyama score can be used for risk‐stratification. The Oyama score includes age &gt;70 years and presence of B symptoms. The expression of CD30 is emerging as a potential adverse, and targetable, prognostic factor. Patients with EBV‐positive DLBCL should be staged and managed following similar guidelines than patients with EBV‐negative DLBCL. It has been suggested, however, that EBV‐positive patients have a worse prognosis than EBV‐negative counterparts in the era of chemoimmunotherapy. There is an opportunity to study and develop targeted therapy in the management of patients with EBV‐positive DLBCL. Am. J. Hematol. 91:530–537, 2016. © 2016 Wiley Periodicals, Inc.
Djungarian Hamster—A Suitable Tool for Cancer Research and Cytogenetic Studies
Authors: Helen E. Pogosianz
Journal: JNCI Journal of the National Cancer Institute (1975)

The Djungarian hamster, bred under usual laboratory conditions, developed different spontaneous neoplasms, most often mammary and skin cancers. Some mammary tumors were serially transplanted to noninbred animals. This hamster was susceptible to some chemical carcinogens and oncogenic viruses but resistant to others. It had comparatively few chromosomes (2n equal to 28), most of which could be recognized even in conventionally stained preparations. The chromosome-breaking effect of gamma-rays, chemical carcinogens, and viruses was studied with primary cultures of cells. Several transformed cell lines were developed. Karyotype abnormalities were generally not seen in primary and induced neoplasms. This hamster is a new suitable tool for cancer research and cytogenetic studies.
Creutzfeldt-Jakob Disease Infectivity of Growth Hormone Derived from Human Pituitary Glands
Authors: Clarence J. Gibbs, David M. Asher, Paul W. Brown, Judith E. Fradkin, D. Carleton Gajdusek
Journal: New England Journal of Medicine (1993)

To the Editor: As part of a comprehensive evaluation of the risk of Creutzfeldt-Jakob disease in recipients of native human growth hormone (GH), we inoculated nonhuman primates with samples of all 76 lots of GH retained on file at the National Hormone and Pituitary Program distribution center in September 19851. A total of 1 ml from each lot was inoculated by intracerebral, intravenous, and intramuscular routes into three squirrel monkeys, and 25 of the same lots were pooled in different combinations and inoculated into chimpanzees. The protocol called for these animals to be observed for a minimum of five . . .
Case 44-1966
Authors: Warren Point, Richard B. Cohen
Journal: New England Journal of Medicine (1966)

Presentation of CaseA sixty-eight-year-old man entered the hospital because of pain in the neck.He had been well until the previous afternoon, when there was the onset of cervical pain and stiffness that were aggravated by movement. He complained of chilliness and was found to have a temperature of 101°F. His physician prescribed polycillin (Ampicillin) and on the following morning referred him to the hospital.Six years earlier he had sustained a compression fracture of the first lumbar vertebra. During the three weeks before admission he experienced intermittent pain in the right side of the neck and the right . . .
Reply to
Authors: Zhaowei Meng, Xinghua Song
Journal: Clinical Nuclear Medicine (2016)

Department of Nuclear Medicine Tianjin Medical University General Hospital Tianjin, People’s Republic of China [email protected] Department of Nuclear Medicine Tianjin Medical University General Hospital Tianjin and Department of Nuclear Medicine Second Affiliated Hospital of Zhejiang Medical University Hangzhou, People’s Republic of China Conflicts of interest and sources of funding: none declared.
Early Clinical Study of an Intermittent Schedule for Maytansine (NSC-153858): Brief Communication 2
Authors: R. T. Eagan, J. N. Ingle, J. Rubin, S. Frytak, C. G. Moertel
Journal: JNCI Journal of the National Cancer Institute (1978)

Maytansine, an ansa macrolide, was evaluated in an early clinical trial in 40 adult patients with various solid tumors. Severe nausea and vomiting, sometimes associated with watery diarrhea and abdominal cramps, and liver function abnormalities, mainly elevation of serum glutamic--oxaloacetic transaminase levels, together constituted what we considered dose-limiting toxicity. Mild hematologic toxicity (mainly thrombocytopenia), neurotoxicity, and possibly cardiac toxicity were also noted. No antitumor effect was seen. An iv dose of 0.750 mg/m2 on days 1, 3, and 5 (total dose, 2.25 mg/m2) repeated every 4 weeks is recommended for Phase II trials.
The Public and the Gene-Editing Revolution
Authors: Robert J. Blendon, Mary T. Gorski, John M. Benson
Journal: New England Journal of Medicine (2016)

Polls conducted over recent decades give a sense of what the U.S. public thinks about gene therapy and gene editing in adults, children, and human embryos or germline cells, as well as of whether and for what reasons Americans would consider undergoing genetic testing.
Case 6-1990
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Gerald F. Winkler, Jean-Paul Vonsattel
Journal: New England Journal of Medicine (1990)

Presentation of CaseA 78-year-old man was admitted to the hospital because of confusion, impaired memory, and a gait disturbance.The patient was well and active in business until three months earlier, when he consulted a physician because of a headache and nausea, with increasing confusion, but no explanation was found. Isosorbide, which the patient took because of coronary artery disease, was discontinued, with only transient relief. The patient was referred to a neurologist. A cranial computed tomographic (CT) scan was reported to show only mild cerebral atrophy. The headaches persisted, and vomiting developed, with a loss of 11.4 kg . . .
Pheochromocytoma and Neurofibromatosis
Authors: Frank H. Healey, C. J. Mekelatos
Journal: New England Journal of Medicine (1958)

THE association of pheochromocytoma and the neurocutaneous syndromes is widely recognized. It is estimated that neurofibromatosis is present with approximately 5 per cent of pheochromocytomas. Glushien, Mansuy and Littman,1 in 1953, summarized the literature to that time and reported a total of 18 cases, including 1 of their own, in which these entities appeared together. Knox and Slessor2 added a similar case in 1955. The case reported below is believed to be the twentieth such case reported.Case ReportA 25-year-old man was admitted to Salem Hospital complaining of severe generalized headache and sharp epigastric pain radiating into the left . . .