tbuckley/cabot-search huggingface dataset:
Postsplenectomy Erythrocytosis in Hemoglobin Köln Disease
Authors: Ernest L. Egan, Virgil F. Fairbanks
Journal: New England Journal of Medicine (1973)

In a family with hemoglobin Köln disease, which is characterized by mild hemolytic anemia, erythrocytosis developed in the index patient after splenectomy for massive splenomegaly. The erythrocytosis may represent a compensatory response to the high oxygen affinity of hemoglobin Köln. This compensatory response may not have been possible before splenectomy because of the rapid sequestration and destruction of erythrocytes in the spleen. (N Engl J Med 288:929–931, 1973)
Home Hemodialysis: Six Years' Experience
Authors: C. R. Blagg, R. O. Hickman, J. W. Eschbach, B. H. Scribner
Journal: New England Journal of Medicine (1970)

Fifty-two patients trained for unattended overnight home hemodialysis were followed for six to 64 months. The overall mortality was 31 per cent. Deaths and morbidity were associated mainly with complications only indirectly related to uremia and in many cases related to the dialysis treatment. More than 80 per cent of the patients were rehabilitated and returned to their previous occupations. Psychologic problems were appreciable in 19 per cent of patients and moderate in 16 per cent, but 65 per cent adjusted well to home hemodialysis. Many of the difficulties that these patients experienced were related to anticoagulation, cannulas and equipment malfunctions. Home hemodialysis has medical, psychologic, financial and logistical advantages over center dialysis. Future improvements required include portable anticoagulant-free equipment, an alternative to overnight dialysis for some patients, better circulatory access, improvement in equipment reliability and service, better physician education, and development of regional dialysis and transplant programs for patients with end-stage renal disease.
Galeterone in 4 Patient Populations of Men with Crpc: Results from Armor2
Authors: M. Taplin, K.N. Chi, F. Chu, J. Cochran, W.J. Edenfield, M. Eisenberger, U. Emmenegger, E.I. Heath, A. Hussain, A. Koletsky, D. Lipsitz, L. Nordquist, R. Pili, M. Rettig, O. Sartor, N.D. Shore, R. Dhillon, J. Roberts, B. Montgomery
Journal: Annals of Oncology (2014)
Multiple Localized Pleural Effusions as a Manifestation of Congestive Heart Failure
Authors: Michael DiMaio
Journal: New England Journal of Medicine (1948)

EFFUSION into the general pleural cavity is a frequent manifestation of congestive heart failure. On the other hand, pleural effusion localized in an interlobar space is not a common finding, since only 15 cases have been recorded in the literature.1 2 3 4 5 6 7 8 9 10 11 Multiple, localized pleural effusions associated with heart failure are apparently even more unusual since no record of this phenomenon has been found in a careful review of the available literature.Although the case reported below is quite similar, in most respects, to those already reported with a single pleural effusion localized in an interlobar space in congestive heart failure, the . . .
How<i>Not</i>to Reform Medicare
Authors: Henry J. Aaron
Journal: New England Journal of Medicine (2011)

Medicare reform has become a hot political issue. The program is wildly popular but expensive. It is the principal source of projected increases in budget deficits. With deficits increasingly seen as a mortal economic threat, many believe that now is the time for Medicare reform.The reform flavor of the day is “premium support.” What is it? What are its strengths and weaknesses?The idea dates from the mid-1990s, when traditional Medicare provided nearly all beneficiaries “defined benefit” health insurance coverage — payment for most of the cost of whatever covered services enrollees and their health care providers deemed medically . . .
Abnormal Calcium Homeostasis in Sarcoidosis
Authors: Frederick R. Singer, John S. Adams
Journal: New England Journal of Medicine (1986)

Sarcoidosis is a fascinating multifocal disorder of unknown origin,1 which first attracted the attention of endocrinologists in 1939, when Harrell and Fisher2 reported hypercalcemia as a complication in 8 of 11 cases. Since then, it has been observed that mild to severe hypercalcemia may appear, often transiently, in approximately 10 percent of patients and that hypercalciuria is considerably more common.3 In the early 1950s, the efficacy of glucocorticoids in reversing the hypercalcemia and hypercalciuria of sarcoidosis was established.4 , 5 O'Leary and colleagues remind us in this issue of the Journal that chloroquine is also effective in the management of sarcoidosis with . . .
Human induced pluripotent stem cell–derived cardiomyocytes recapitulate the predilection of breast cancer patients to doxorubicin-induced cardiotoxicity
Authors: Paul W Burridge, Yong Fuga Li, Elena Matsa, Haodi Wu, Sang-Ging Ong, Arun Sharma, Alexandra Holmström, Alex C Chang, Michael J Coronado, Antje D Ebert, Joshua W Knowles, Melinda L Telli, Ronald M Witteles, Helen M Blau, Daniel Bernstein, Russ B Altman, Joseph C Wu
Journal: Nature Medicine (2016)
P245 “… No cleaning, no stairs, no sex…everything just stops”: Understanding living with severe asthma to inform effective self-management
Authors: LD Apps, S Hewitt, R Green, P Bradding, A Murphy, N Martin, SJ Singh, SJ Singh, N Hudson, R Evans
Journal: Thorax (2015)

<h3>Introduction and objectives</h3> Despite the large socioeconomic burden of severe asthma, few studies have focused specifically on the patient experience of living with and managing severe asthma. Patient-related factors including behavioural, psychological and social factors complicate the management of the condition. This study aimed to explore these experiences in individuals with severe asthma to understand how to support effective self-management. <h3>Method</h3> Semi-structured interviews were conducted with participants recruited from a difficult asthma service at Step 4–5 of the BTS/SIGN guidelines. Recruitment occurred until theoretical saturation was achieved. Interviews were transcribed verbatim and coded, supported by NVivo software (Version 10). Thematic analysis was performed.<sup>1</sup> <h3>Results</h3> 29 interviews were completed (44% male, mean age 49.45 (13.64) years, BMI 31.65 (5.48) kg/m<sup>2</sup>, 4 smokers). Five themes describe the experience of living with and managing severe asthma: <b>Impact of asthma.</b> Debilitating breathlessness was described impacting on many areas of participants lives, including relationships, work and family life. <b>Day to day management of asthma.</b> Self-regulatory behaviours were described such as monitoring peak flow and pacing. However, these behaviours and the implied restrictions could induce distress and dissatisfaction. This limited self-management behaviours in-between the acute phases of illness. <b>Confidence to manage symptoms. </b>Participants reported confidence to manage acute events, but the unpredictability of symptoms and fear of inducing symptoms appeared to undermine their confidence to manage symptoms. <b>Challenges to effective self-management. </b>There were further multiple challenges to effective self-management, such as: understanding of disease; perceptions of asthma by others; reluctance to accept hospitalisation and the unpredictability of symptoms. <b>Beliefs about medication. </b>There was conflict around long term oral steroids. Most participants resolved this by balancing the necessity of the medication versus the concerns they held about the long term effects of maintenance. There was little comment regarding inhaled medications. <h3>Conclusion</h3> Strategies are needed to enhance acceptance and confidence to engage in self-management behaviours. This should encompass all aspects of the disease, not solely the acute phases, to minimise daily distress and increase effective self-management to improve the health status for this severe population. <h3>Reference</h3> 1 Braun V. Using thematic analysis in psychology.<i> Qualitative Research in Psychology</i>. 2006;<b>3</b>:77–101
Prevalence, Nature and Identification of Leukocyte Antibodies
Authors: James L. Tullis
Journal: New England Journal of Medicine (1958)

INCREASING awareness of the role of autoimmune mechanisms in the production of certain types of idiopathic hemolytic anemia1 2 3 and thrombopenic purpura4 , 5 has stimulated work on the possible relation of idiopathic leukopenia to autoantibody formation. Certain features of the clinical syndromes have points of similarity. Moreover, animal experiments have suggested the existence of leukocyte antibodies and antigenicity since the early work of Bordet. More recently, Doan6 (1926) presented evidence that leukocyte incompatibility was sometimes responsible for febrile and urticarial transfusion reactions. He named the antileukocyte factor leukotoxin.‡The first reports on the possible role of such substances in the development of . . .
A phase II trial of 10-Ethyl-10-deaza-aminopterin, a novel antifolate, in patients with advanced and/or recurrent squamous cell carcinoma of the head and neck
Authors: J H Schornagel, J Verweij, P H de Mulder, F Cognetti, J B Vermorken, P Cappelaere, J P Armand, J Wildiers, M Clavel, A Kirkpatrick
Journal: Annals of Oncology (1992)
Reduction in the Rate of Early Restenosis after Coronary Angioplasty by a Diet Supplemented with n–3 Fatty Acids
Authors: G J Dehmer, J J Popma, E K van den Berg, E J Eichhorn, J B Prewitt, W B Campbell, L Jennings, J T Willerson, J M Schmitz
Journal: New England Journal of Medicine (1988)

To determine the safety and benefit of n-3 fatty acid therapy in the prevention of early restenosis after coronary angioplasty, we conducted a randomized, unblinded study comparing a conventional antiplatelet regimen (325 mg of aspirin and 225 mg of dipyridamole per day; control group) with a similar regimen supplemented with 3.2 g of eicosapentaenoic acid per day (treatment group). Treatment began seven days before angioplasty and continued for six months afterward. All angiographic analyses were blinded and performed by a method that was validated by comparison with quantitative coronary angiography. In 82 male patients, 103 coronary lesions were dilated. Both groups had similar base-line clinical and angiographic characteristics. The incidence of early vessel restenosis, as determined on a second angiogram three to four months after angioplasty, was 36 percent in the control group and 16 percent in the treatment group (P = 0.026). The incidence of restenosis per patient was also significantly lower in the treatment group (46 vs. 19 percent). Both multiple logistic regression and Mantel-Haenszel statistical analyses demonstrated a significant independent benefit of treatment with n-3 fatty acids. No important bleeding complications developed in the treated patients. These results, in a male population at relatively high risk for restenosis, suggest that a dietary supplement of n-3 fatty acids, administered for one week before and for six months after coronary angioplasty, is safe and reduces the occurrence of early restenosis after that procedure. Whether this beneficial effect also applies to other populations is unknown.
Dupuytren's Contracture
Authors: Radford C. Tanzer
Journal: New England Journal of Medicine (1952)

SPONTANEOUS contraction of the palmar fascia was first described by Plater in 1610, and its surgical correction by subcutaneous fasciotomy was mentioned by Sir Astley Cooper in 1818, but the observations of Baron Dupuytren1 in 1831 concerning the true nature of the disease have rightfully led to its association with his name. Since then a similar but less frequent involvement of the plantar fascia has been described, and an occasional association with progressive contraction of the penis (Peyronie's disease) has been noted.2 IncidenceDupuytren's contracture is essentially a hereditary disease of adults, occurring nine times as frequently in males as . . .
Profound Acidosis Resulting from Excessive Ammonium Chloride in Previously Healthy Subjects
Authors: Arnold S. Relman, Palmer F. Shelburne, Armistead Talman
Journal: New England Journal of Medicine (1961)

AMMONIUM chloride has been widely used as a therapeutic agent ever since its introduction by Keith, Barrier and Whelan1 in 1925. Given intermittently for a few days at a time, it has a slight diuretic effect that is sometimes useful in the treatment of relatively mild degrees of fluid retention. More potent diuretics for oral use have recently become available,2 but ammonium chloride is still in general use, not only as a diuretic agent but also as an acidifying agent that appears to potentiate the action of mercurials and may be used to prevent or treat mercurial-induced hypochloremic alkalosis. It . . .
Photofluorographic Detection of Cardiovascular Disease in a General Hospital
Authors: Harold D. Batt, John M. Allen, Frederick H. Treder, Robert Shapiro
Journal: New England Journal of Medicine (1954)

THE importance of the survey chest photofluorogram in the discovery of tuberculosis and other pulmonary lesions is well recognized. Recently, this method has also been used to detect cardiovascular disease. The literature contains a number of reports on the detection of heart disease in adults selected at random,1 2 3 4 as well as in special groups such as high-school5 and college students,6 pregnant females7 and others.8 The purpose of this paper is to record our experience in detecting cardiovascular disease in routine admissions to a general hospital.A study of this type has several inherent limitations. In the first place cardiac patients . . .
Thrombolytic Therapy for Thrombosis of an Aortic Bioprosthetic Valve
Authors: Michaela Diamant, Wybren Jaarsma, Wim J. Morshuis
Journal: New England Journal of Medicine (1994)

To the Editor: Acute thrombotic obstruction of an aortic bioprosthetic valve is an uncommon yet life-threatening condition1–3. A 72-year-old man came to our hospital because of four days of chest pain and dyspnea. Seven months earlier, he had undergone an aortic-valve replacement with a 27-mm Medtronic Intact porcine bioprosthesis. The results of cardiac auscultation were compatible with a diagnosis of aortic stenosis. The patient had mild thrombocytopenia (139,000 platelets per cubic millimeter) and an increased lactate dehydrogenase level (571 U per liter). Echocardiography revealed reduced motion of the prosthetic-valve leaflets and an obstructing mass between the struts ( . . .
Significance of Selective Vasculitis and the Bone-Marrow Syndrome in Pseudomonas Septicemia
Authors: William Margaretten, Hisayo Nakai, Benjamin H. Landing
Journal: New England Journal of Medicine (1961)

INFECTION of the respiratory tract of children with fibrocystic disease by Pseudomonas aeruginosa apparently rarely leads to septicemia.1 However, the transformation of this organism from a harmless inhabitant of the intestinal tract to a dangerous systemic invader is not uncommon in children with leukemia.2 Selective vasculitis, a lesion highly characteristic of pseudomonas septicemia, is frequently recognized in patients with leukemia who have been treated with steroids or antimetabolites or both, but this has not been observed in children with fibrocystic disease and pseudomonas infection of the respiratory tract. An evaluation of the etiologic factors predisposing to initial infection with Ps. . . .
Case 30-1993
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Irving Waxman, Carolyn C. Compton
Journal: New England Journal of Medicine (1993)

Presentation of CaseA 59-year-old woman was admitted to the hospital because of left-sided abdominal pain.She had been well until two hours after dinner on the evening before entry, when she experienced the onset of intermittent crampy abdominal pain that was more severe in the left upper quadrant than in the left lower quadrant. She was referred to the hospital early the next morning.The patient was a housewife. There was a history of asthma, which was managed with an albuterol inhaler, and of spondyloarthropathy, which involved the lumbar spine and knees and was treated with nonsteroidal antiinflammatory drugs. . . .
Case 1-1991
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Norman L. Letvin, Nancy L. Harris, Jean-Paul Vonsattel
Journal: New England Journal of Medicine (1991)

Presentation of CaseA 45-year-old man was admitted to the hospital because of cervical pain and an epidural mass.There was a history of pulmonary tuberculosis 11 years earlier that was treated with isoniazid, pyridoxine, and rifampin for 18 months. Two years before admission the patient began to experience occasional cervical pain and "stiffness." Twenty-one months before entry a left testicular mass was found. An ultrasonographic examination showed that the left testis and epididymis were enlarged and diffusely heterogeneous; the right testis appeared normal. A radical left orchiectomy was performed. Microscopical examination of the excised specimen revealed a seminoma confined . . .
Hypertrophied Frenuli, Oligophrenia, Familial Trembling and Anomalies of the Hand
Authors: Robert J. Gorlin, V. Elving Anderson, C. Ronald Scott
Journal: New England Journal of Medicine (1961)

IN 1954 Papillon-Léage and Psaume1 , 2 collected from the literature and from their own files a group of 8 patients having similar malformations. This symptom complex was described as affecting only females and inherited as an incomplete recessive. It consisted of abnormally developed frenuli that, by extension, cleft the jaws and tongue. These clefts were situated in the lateral incisor-canine regions. Malposition of maxillary canine teeth, frequent infraocclusion and absence of mandibular lateral incisors were commonly observed. Frequently associated with these oral anomalies were the following: hypoplasia of the base of the skull and extension of the cranial vault, with increased . . .
Natural history and outcome of light chain deposition disease
Authors: Rabya H. Sayed, Ashutosh D. Wechalekar, Janet A. Gilbertson, Paul Bass, Shameem Mahmood, Sajitha Sachchithanantham, Marianna Fontana, Ketna Patel, Carol J. Whelan, Helen J. Lachmann, Philip N. Hawkins, Julian D. Gillmore
Journal: Blood (2015)
Microarray analysis of apoptosis resistance mediated by dexamethasone in ovarian cancer
Authors: I. B. Runnebaum, L. Walz, E. Stickeler, V. J. Möbus, A. Brüning
Journal: Journal of Clinical Oncology (2004)

5037 Background: Dexamethasone is widely used as a supportive drug to reduce side-effects of chemotherapy in ovarian cancer. This study identified apoptosis-inhibiting genes responsible for the anti-apoptotic effect of dexamethasone in ovarian cancer. Methods: Microarray analysis was performed using chips comprising 8,000 human genes. RT-PCR and Western Blot analysis were utilized for confirmation. Samples from solid tumors and from ascites of ovarian cancer patients have been used to establish tissue culture. Dexamethasone was used at serum-equivalent doses of 10 to 100 nM. After induction of apoptosis, activition of caspase 3 and PARP cleavage were analyzed. Results: Thirty genes were identified to be upregulated by more than 4-fold following dexamethasone treatment. Major anti-apoptotic genes were upregulated: 7fold upregulation of MIHC (major inhibitor of human caspases), 4.5fold upregulation of bcl-XL and 5.4fold upregulation of bcl-2. Activity of apoptosis-executing caspase 3 was reduced by 40% after dexamethasone treatment. Conclusion: Administration of dexamethasone in ovarian cancer patients could reduce the therapeutic efficacy of systemic cancer therapies by upregulation of anti-apoptotic genes. No significant financial relationships to disclose.
Clinical translation pathway to Precision Medicine in GBM through simulation and repurposing.
Authors: Sandeep C. Pingle, Pengfei Jiang, Rajesh Mukthavaram, Natsuko Nomura, Prashant Nair, Ansu Kumar, Neeraj Singh, Taher Abbasi, Shireen Vali, Santosh Kesari
Journal: Journal of Clinical Oncology (2015)

e13041 Background: We have previously developed and validated an in silico predictive model to create simulation avatars for tumors based on genomic profiles. This model can be refined to personalize therapeutics for cancer. An important step in clinical translation of this model is the ability to predict combinations of targeted agents for cancer. Methods: Our predictive simulation-based approach for glioblastoma (GBM) incorporates comprehensive representation of disease pathophysiology. Here, we employ this model to design rational drug combinations for GBM. To create simulation avatars of patient-derived GBM tumors, we used copy number, expression, and mutation data (OncoScan, Human Transcriptome Array - Affymetrix). Next, based on molecular signatures of these tumors, we predicted rational combinations of FDA-approved targeted agents,. Following simulations, we validated these responses ex vivo. Results: Our simulation predicted combinations of targeted drugs personalized to specific patient genomics signatures. All 3 patient tumors tested demonstrated different molecular characteristics; simulation predicted varied combinations of targeted drugs for each. For example, based on the molecular features of GBM tumor from patient 1, our simulation predicted inhibitors of PI3K and mTOR pathways to be effective against this tumor. Similarly, simulations predicted effective combinations for each tumor. Following predictions, we tested each tumor in vitro for cell proliferation and cell death, and in vivo for tumor growth in patient-derived xenograft (PDX) models. Conclusions: Data from ex vivo testing validates our in silico predictions. We believe that this simulation-driven approach to precision medicine addresses the requirements for clinical translation. The advantages of our approach are incorporation of “actionable” genomics data for real-time generation of personalized therapies, and the ability to repurpose combinations of FDA-approved agents. Predicting rational combinations a priori will facilitate precision medicine not only for GBM but also for other cancers.
Pulmonary Hazards of Smoking Marijuana as Compared with Tobacco
Authors: T C Wu, D P Tashkin, B Djahed, J E Rose
Journal: New England Journal of Medicine (1988)

To compare the pulmonary hazards of smoking marijuana and tobacco, we quantified the relative burden to the lung of insoluble particulates (tar) and carbon monoxide from the smoke of similar quantities of marijuana and tobacco. The 15 subjects, all men, had smoked both marijuana and tobacco habitually for at least five years. We measured each subject's blood carboxyhemoglobin level before and after smoking and the amount of tar inhaled and deposited in the respiratory tract from the smoke of single filter-tipped tobacco cigarettes (900 to 1200 mg) and marijuana cigarettes (741 to 985 mg) containing 0.004 percent or 1.24 percent Δ9-tetrahydrocannabinol. As compared with smoking tobacco, smoking marijuana was associated with a nearly fivefold greater increment in the blood carboxyhemoglobin level, an approximately threefold increase in the amount of tar inhaled, and retention in the respiratory tract of one third more inhaled tar (P<0.001). Significant differences were also noted in the dynamics of smoking marijuana and tobacco, among them an approximately two-thirds larger puff volume, a one-third greater depth of inhalation, and a fourfold longer breath-holding time with marijuana than with tobacco (P<0.01). Smoking dynamics and the delivery of tar during marijuana smoking were only slightly influenced by the percentage of tetrahydrocannabinol. We conclude that smoking marijuana, regardless of tetrahydrocannabinol content, results in a substantially greater respiratory burden of carbon monoxide and tar than smoking a similar quantity of tobacco. (N Engl J Med 1988;318:347–51.)