tbuckley/cabot-search huggingface dataset:
Health state utility and toxicities in metastatic lung cancer: A qualitative study
Authors: B. Nafees, M. Stafford, S. Bhalla, J. Watkins
Journal: Journal of Clinical Oncology (2006)

16017 Background: In metastatic lung cancer, it is expected that quality of life is impacted both by the efficacy and toxicity of therapy. Previous research has reported health states either based on response to therapy or on toxicity, but not in combination. Using methodology applied in breast cancer (Narewska 2005), we developed health state descriptions for advanced non-small cell lung cancer (NSCLC) for use in cost-utility analyses. Methods: An interview discussion and content validation guide was produced based on literature review and clinical input. Response to therapy was described as responding disease, stable disease, or progressive disease. The most common toxicities were selected based on randomized clinical trials. Descriptions of health states were reviewed by clinical specialists. Final health states will be piloted and then used in a societal-based valuation study using standard gamble technique. The contributory effect of disease state and toxicity will be estimated using a mixed model analysis and compared with the data from the previous breast cancer utility study. Results: Eight toxicities were identified: alopecia and grade 3/4 neutropenia, febrile neutropenia, hand-foot syndrome, gastrointestinal (diarrhea/vomiting), rash, stomatitis and fatigue. These were combined with response to therapy to yield 19 health states: 9 responding disease (one with each toxicity plus one with no toxicity), 9 stable disease (one with each toxicity plus one with no toxicity) and one progressive disease (toxicity not included). These health states were reviewed by 6 pulmonary oncologists and 3 specialist nurses. Conclusions: Development of health states that combine both efficacy and toxicity will be useful in evaluating the relative value of therapies for advanced NSCLC and comparison with other diseases. Input by clinical experts has provided validation for the proposed health states. Evaluation of these health states by members of society will provide appropriate perspective for economic evaluations. [Table: see text]
P118 Factors affecting concordance with continuous positive airway pressure (CPAP) in obstructive sleep apnoea syndrome (OSAS)
Authors: N Shilliday, A Bishopp, B Chakraborty, M Daniels, R Mukherjee
Journal: Thorax (2015)

<h3>Introduction and objectives</h3> The benefits of continuous positive airways pressure in the treatment of obstructive sleep apnoea syndrome have been well established. Despite this, CPAP adherence remains a significant issue resulting in many patients not receiving adequate treatment. A number of variables have been suggested as contributing to non-concordance, however study results have been inconsistent. Studies assessing long term concordance, suggest severity of OSAS and sleepiness to be good predictors of this. This scientific survey looked at the influence of co-morbidity and the severity of OSAS as represented by apnoea hypopnoea index (AHI) at diagnosis on the usage and concordance with CPAP. <h3>Methods</h3> Data from 230 patients completing annual follow up after initiation of CPAP by 31<sup>st</sup> December 2014 was collected retrospectively. The presence and severity of co-morbidity was assessed by the Adult Co-morbidity Evaluation- 27 (ACE-27) score. CPAP usage per day was averaged over the preceding year. The association between usage and initial AHI (data available for 207 patients) was analysed by linear regression. The association between usage and ACE-27 score was analysed by ANOVA. <h3>Results</h3> The regression coefficient for initial AHI against CPAP usage shows a statistically significant effect ([p = 0.00126] fitted equation: concordance = 4.161 + 0.024 × AHI). There was no significant difference in CPAP usage between different ACE-27 groups. Further analysis of individual co-morbidities revealed significance in four categories; cardiac arrhythmia (p = 0.031), coronary artery disease (p = 0.006), congestive heart failure (p = 0.045) and malignancy (p = 0.001). <h3>Conclusion</h3> AHI at diagnosis remains a strong determinant of CPAP concordance at 1 year. Severity of co-morbidity cannot be conclusively demonstrated to influence usage however further studies into overall and specific co-morbidities are warranted.
Bone Marrow Necrosis and the Lambert–Eaton Syndrome Associated with Interferon Alfa Treatment
Authors: Shunichi Kumakura, Hiroto Ishikura, Shotai Kobayashi
Journal: New England Journal of Medicine (1998)

To the Editor: The chronic phase of chronic myeloid leukemia was diagnosed in a 41-year-old man and treated with interferon alfa and hydroxyurea. After four months of treatment, there was a sudden onset of high fever, severe bone pain in multiple sites, and muscle weakness. Proximal weakness was more severe in the legs than the arms. Tendon reflexes were absent bilaterally. There were no cranial-nerve dysfunctions or autonomic symptoms. Bone marrow specimens showed the characteristic features of necrosis without any sign of blast crisis (Figure 1A). At the same time, we found a high level of tumor necrosis factor α . . .
Postarsenical Encephalopathy in the Treatment of Syphilis in Women
Authors: S. Charles Kasdon, Morris W. Shapiro
Journal: New England Journal of Medicine (1948)

AT LEAST 60 per cent of adults receiving arsenical antisyphilitic therapy who develop postarsenical encephalopathy are pregnant women. The mortality in this most serious complication in the treatment of syphilis approaches 70 per cent. Postarsenical encephalopathy, the term considered most apt, has also been described under the following titles: cerebral purpura, serous apoplexy, hemorrhagic encephalitis, pericapillary encephalorrhagia, medullary perivascular necrosis and toxic encephalitis.There is a widespread lack of familiarity with this cause of death in 1.3 per cent of the total number of patients treated by the massive five-day arsenical course.1 Postarsenical encephalopathy was the cause of 9.5 per . . .
The Present Status of ACTH, Cortisone and Related Steroids in Clinical Medicine
Authors: William McK. Jefferies
Journal: New England Journal of Medicine (1955)

SINCE the report of Hench and his associates1 in 1949 pointing out that cortisone and ACTH produced remarkable improvement in patients with rheumatoid arthritis, the attention of the medical profession has been focused on the effects of these substances in a host of diseases. Dramatic descriptions of results in various apparently unrelated illnesses have appeared with such frequency that it has been practically impossible for physicians to evaluate them critically. At the same time, reports of undesirable and sometimes alarming side effects have been disturbing. As a result many physicians have become confused about their actual value and dangers. Hence, . . .
Cross-Reactivity Among Cereal Grains
Authors: Juliana Guimarães Mendonça, Roberta Almeida Castro, Pablo Torres Cordova, Paula Rezende Meireles, Daniele Danella Figo, Keity Souza Santos, Jorge Kalil, Fabio Fernandes Morato Castro, Ariana C. Yang
Journal: Journal of Allergy and Clinical Immunology (2016)
Genetic variation in the toll-like receptor gene family and chronic rhinosinusitis: a GA2LEN pilot study
Authors: Daniel Nilsson, Claus Bachert, Wytske Fokkens, Peter Hellings, Marek Kowalski, Joaquim Mullol, Heidi Olze, Peter Tomassen, Elina Toskala, Christer Halldén, Lars-Olaf Cardell
Journal: Allergy (2011)
DSM-III disorders in a large sample of psychiatric patients: frequency and specificity of diagnoses
Authors: J E Mezzich, H Fabrega, G A Coffman, R Haley
Journal: American Journal of Psychiatry (1989)

This study examined certain nosological features of DSM-III axis I diagnostic categories and subcategories as applied to 11,292 general psychiatric patients presenting for care, using a semistructured assessment procedure. The most frequently used major categories were affective, substance use, childhood-onset, and adjustment disorders. Secondary diagnoses were given to 26% of the patients. Male patients predominated in the categories of impulse-control, psychosexual, and substance use disorders, and female patients predominated in the categories of anxiety, affective, and somatoform disorders. Of the 329 five-digit subcategories available in DSM-III, 296 (90%) were actually used. Sixteen percent of the patients were given unspecific primary diagnoses.
Phase II trial of sunitinib in medullary thyroid cancer (MTC).
Authors: J. A. De Souza, N. Busaidy, A. Zimrin, T. Y. Seiwert, V. M. Villaflor, K. B. Poluru, P. L. Reddy, J. Nam, E. E. Vokes, E. E. Cohen
Journal: Journal of Clinical Oncology (2010)

5504 Background: There is no standard treatment for MTC not amenable to surgery or radiotherapy. Sunitinib is an oral multikinase inhibitor against RET, VEGFR2, PDGFR, and c-KIT. We conducted an open-label multicenter phase II trial to determine the efficacy of sunitinib in patients (pts) with MTC and whether RET mutations can predict response. Methods: Pts with MTC who had evidence of disease progression within the prior 6 months and were not amenable to surgery or radiotherapy were treated with sunitinib 50 mg at a 4/2 week schedule. Responses were monitored by RECIST and serum calcitonin measurements every 12 weeks. Results: 25 pts were enrolled from 11/2006 to 08/2009; one pt was deemed ineligible and never received drug. Median follow-up was 11 months (range, 1-34); median age was 51 years (23-74); 12 pts (50%) were male. 23 pts were evaluable for response. To date, RET activating mutations were found in 11 (85%) of 13 analyzed tumors (8 somatic and 3 germline). Partial response (PR) was achieved in 8 (35%) pts with a median duration of response of 37 weeks (22-106+). 13 (57%) had stable disease (SD) with a median duration of 32 weeks (12-147+). Among those who progressed, the median time-to-progression was 28 weeks. 13 pts remain on study. The most common treatment-related adverse events were fatigue, lymphopenia, neutropenia, nausea, diarrhea, mucositis and palmar-plantar erythema (PPE). Two pts died during the trial due to non-related toxicities. There was one case of grade 4 neutropenia. Grade 3 events were: lymphopenia, 6 pts (25%); neutropenia, 5 pts (21%); PPE, 4 pts (17%); and mucositis, 3 pts (13%). One pt discontinued on day 15 due to grade 3 fatigue. 10 pts showed a decrease in calcitonin levels greater than 30%. Further genotyping for RET mutations is in progress and to date, in the pts with an activating RET mutation, the 1-year probability of progression free survival was 88% (95% CI, 43-98%). Evidence of PR or SD greater than 24 weeks was observed in 7 of 9 MTC pts with a M918T RET mutation. Conclusions: Sunitinib has activity in MTC, with an overall response rate of 35% and clinical benefit rate (PR + SD) of 91%. Evidence of clinical benefit has been observed in pts with and without RET mutations and the M918T RET mutation may be associated with a durable response. No significant financial relationships to disclose.
The Treatment of Hysteric Amnesia by Purely Pharmacologic Means
Authors: Abraham Myerson
Journal: New England Journal of Medicine (1947)

PERHAPS no condition is fundamentally so psychologic and without any obvious organic background as hysteric, or functional, amnesia. This condition usually arises abruptly and may disappear as suddenly. It is difficult to conceive of an organic or physiologic basis for a memory loss in which the whole or a large part of the past, often including personal identity, so far as the consciousness of the patient is concerned, is lost for long periods and without the slightest evidence of any neurologic disturbance.Several kinds of treatment have been instituted for this condition. One is, simply, by the stimulation of the . . .
Absence of Association between Insurance Copayments and Delays in Seeking Emergency Care among Patients with Myocardial Infarction
Authors: David J. Magid, Thomas D. Koepsell, Nathan R. Every, Jenny S. Martin, David S. Siscovick, Edward H. Wagner, W. Douglas Weaver
Journal: New England Journal of Medicine (1997)

The requirement of copayments for emergency care is thought to control costs by reducing "inappropriate" visits to the emergency department. However, requiring copayments may lead to adverse outcomes if patients delay seeking care for emergency conditions. To determine whether such requirements are associated with delays in seeking care, we examined the length of time from the onset of symptoms to arrival at the hospital among patients with myocardial infarction who did or did not have required insurance copayments.
Association of Changes in Air Quality With Bronchitic Symptoms in Children in California, 1993-2012
Authors: Kiros Berhane, Chih-Chieh Chang, Rob McConnell, W. James Gauderman, Edward Avol, Ed Rapapport, Robert Urman, Fred Lurmann, Frank Gilliland
Journal: JAMA (2016)

<h3>Importance</h3> Childhood bronchitic symptoms are significant public and clinical health problems that produce a substantial burden of disease. Ambient air pollutants are important determinants of bronchitis occurrence. <h3>Objective</h3> To determine whether improvements in ambient air quality in Southern California were associated with reductions in bronchitic symptoms in children. <h3>Design, Setting, and Participants</h3> A longitudinal study involving 4602 children (age range, 5-18 years) from 3 cohorts was conducted during the 1993-2001, 1996-2004, and 2003-2012 years in 8 Southern California communities. A multilevel logistic model was used to estimate the association of changes in pollution levels with bronchitic symptoms. <h3>Exposures</h3> Average concentrations of nitrogen dioxide, ozone, particulate matter with an aerodynamic diameter of less than 10 µm (PM<sub>10</sub>) and less than 2.5 µm (PM<sub>2.5</sub>). <h3>Main Outcomes and Measures</h3> Annual age-specific prevalence of bronchitic symptoms during the previous 12 months based on the parent’s or child’s report of a daily cough for 3 months in a row, congestion or phlegm other than when accompanied by a cold, or bronchitis. <h3>Results</h3> The 3 cohorts included a total of 4602 children (mean age at baseline, 8.0 years; 2268 girls [49.3%]; 2081 Hispanic white [45.2%] ) who had data from 2 or more annual questionnaires. Among these children, 892 (19.4%) had asthma at age 10 years. For nitrogen dioxide, the odds ratio (OR) for bronchitic symptoms among children with asthma at age 10 years was 0.79 (95% CI, 0.67-0.94) for a median reduction of 4.9 ppb, with absolute decrease in prevalence of 10.1%. For ozone, the OR was 0.66 (95% CI, 0.50-0.86) for a median reduction of 3.6 ppb, with an absolute decrease in prevalence of 16.3%. For PM<sub>10</sub>, the OR was 0.61 (95% CI, 0.48-0.78) for a median reduction of 5.8 µg/m<sup>3</sup>, with an absolute decrease in prevalence of 18.7%. For PM<sub>2.5</sub>, the OR was 0.68 (95% CI, 0.53-0.86) for a median reduction of 6.8 µg/m<sup>3</sup>, with absolute decrease in prevalence of 15.4%. Among children without asthma (n = 3710), the ORs were 0.84 (95% CI, 0.76-0.92) for nitrogen dioxide; 0.85 (95% CI, 0.74-0.97) for ozone, 0.80 (95% CI, 0.70-0.92) for PM<sub>10</sub>, and 0.79 (95% CI, 0.69-0.91) for PM<sub>2.5</sub>; with absolute decrease in prevalence of 1.8% for nitrogen dioxide, 1.7% for ozone, 2.2% for PM<sub>10</sub>, and 2.3% for PM<sub>2.5</sub>. The associations were similar or slightly stronger at age 15 years. <h3>Conclusions and Relevance</h3> Decreases in ambient pollution levels were associated with statistically significant decreases in bronchitic symptoms in children. Although the study design does not establish causality, the findings support potential benefit of air pollution reduction on asthma control.
Performance and Validation of the U.S. NCDR Acute Kidney Injury Prediction Model in Japan
Authors: Taku Inohara, Shun Kohsaka, Hiroaki Miyata, Ikuko Ueda, Yuichiro Maekawa, Keiichi Fukuda, David J. Cohen, Kevin F. Kennedy, John S. Rumsfeld, John A. Spertus
Journal: Journal of the American College of Cardiology (2016)
Beyond comparisons of means: understanding changes in gene expression at the single-cell level
Authors: Catalina A. Vallejos, Sylvia Richardson, John C. Marioni
Journal: Genome biology (2016)

Traditional differential expression tools are limited to detecting changes in overall expression, and fail to uncover the rich information provided by single-cell level data sets. We present a Bayesian hierarchical model that builds upon BASiCS to study changes that lie beyond comparisons of means, incorporating built-in normalization and quantifying technical artifacts by borrowing information from spike-in genes. Using a probabilistic approach, we highlight genes undergoing changes in cell-to-cell heterogeneity but whose overall expression remains unchanged. Control experiments validate our method’s performance and a case study suggests that novel biological insights can be revealed. Our method is implemented in R and available at https://github.com/catavallejos/BASiCS .
Case 17-1990
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, M.C. Pike, A.H. Gorn
Journal: New England Journal of Medicine (1990)

Presentation of CaseA 16-year-old boy was admitted to the hospital because of painful swelling of the left leg.He was well until two weeks earlier, when a sore throat developed. One week before admission he stayed out of school for one day because of a low-grade fever, with headache, malaise, and a productive cough. Three days before entry he experienced "cramping" of the left hamstrings and was unable to extend his knee for about five minutes. On the following day he noticed pain and swelling in the left calf, although he was able to play tennis; both symptoms worsened . . .
Too Close to Call
Authors: Gregory D. Curfman, Jeffrey M. Drazen
Journal: New England Journal of Medicine (2001)

More than 20 physicians and scientists are involved in making editorial decisions about accepting or rejecting manuscripts for publication in the Journal. We recently summarized this process and the contributions made by each member of the editorial staff.1 Many of our editors and consultants are also actively involved in their own research; indeed, it is the fact that they are closely connected with the research community that makes them so valuable as members of the editorial staff. Sometimes an associate editor, deputy editor, or consultant may wish to submit his or her own work for consideration for publication in . . .
Mitochondrial DNA and Disease
Authors: Donald R. Johns
Journal: New England Journal of Medicine (1995)

The mitochondrial encephalomyopathies are a diverse group of disorders that result from the structural, biochemical, or genetic derangement of mitochondria.1 Since mitochondrial dysfunction can affect virtually all organ systems (Figure 1), physicians in many specialties see patients with mitochondrial diseases. Despite a bewildering array of clinical manifestations (Table 1 and Table 2) and variations in the mode of onset, course, and progression of disease, many mitochondrial disorders share prominent systemic effects (Table 2) that contribute to their morbidity.Our understanding of the role of mitochondrial DNA in certain diseases has evolved rapidly since 1988, when the first mutations in mitochondrial DNA were . . .
PWE-038 Adalimumab therapy for infliximab failures in Crohn's disease. A single-centre UK experience
Authors: M B Sprakes, A C Ford, L Warren, D Greer, C F Donnellan, J S R Jennings, S M Everett, P J Hamlin
Journal: Gut (2010)

<h3>Introduction</h3> Adalimumab (ADA) is efficacious in Crohn9s disease (CD) patients who have lost response to infliximab (IFX).1 However, there are little data detailing the long-term follow-up of IFX failures who are receiving ADA. Our aim was to prospectively analyse long-term outcomes of CD patients treated with ADA as a second line anti-TNF agent in Leeds. <h3>Methods</h3> CD patient data include demographics, previous IFX regime, reason for IFX discontinuation, disease site, immunomodulator and steroid use, Harvey-Bradshaw indices (HBI), BMI and adverse events. <h3>Results</h3> Since 2007, 36 CD patients (previously treated with IFX) received ADA in Leeds. 27 females (75%). Mean age 36. 21 had luminal disease (58%), 15 had fistulating disease (42%) 88% of these having perianal fistulae. 16 previously received IFX in a scheduled manner (44%), 11 episodically (31%), with nine switched to scheduled IFX to try and improve response, and nine had three dose induction of IFX only (25%). 22 patients received induction ADA dosing of 80 mg/40 mg (61%), 14 received 160 mg/80 mg (39%). Response was assessed following four injections. 27 patients initially responded (75%) with sustained response in 22 (58%), median follow-up of 12 months. Eight patients were primary non-responders (NR) to ADA, four of whom were primary NR to IFX. One discontinued during ADA induction due to a reaction. Other reasons for discontinuation were: 3 secondary NR, 1 further reaction, 1 patient in remission. The outcomes for patients who discontinued therapy were as follows: 10 patients had surgery (71%), 4 were observed (29%). 20 patients were on steroids prior to ADA therapy (55%), 10 were on steroids at follow-up (28%) with seven patients able to decrease the steroid dose. The mean HBI on commencing ADA was 10.7 and 7.1 after four injections. In 23 responders (four excluded as stoma) the HBI was 10 pre ADA and 5.5 after four injections, with 12 (52%) having HBI of &lt;4 (defined as remission). In primary NR the HBI was 14.2 pre ADA and 12.4 on discontinuation. There were seven reactions attributed to ADA, two requiring cessation of therapy. Three were localised skin reactions at the injection site, and two diffuse skin rashes. There was one opportunistic infection (HSV). <h3>Conclusion</h3> ADA is a safe and effective therapy in CD patients who have been exposed to IFX. Our data demonstrate a good initial response to ADA and a sustained response out to 12 months of therapy. Steroid sparing was achieved in 50% of patients and few adverse events have been documented. These data confirm the efficacy of ADA use in IFX failures in a single centre UK experience.
Proximal-Muscle Weakness Induced by Herbs
Authors: David J. Capobianco, Paul W. Brazis, Thomas P. Fox
Journal: New England Journal of Medicine (1993)

To the Editor: We report a case of muscle weakness induced by herbs that is associated with the boom in unconventional therapy. A 69-year-old man had an eight-month history of painless, nonfluctuating weakness, primarily of the lower extremities, without other associated neurologic or constitutional symptoms. The results of magnetic resonance imaging of the head, electromyography including nerve-conduction study with repetitive stimulation, and blood tests were normal. The patient had paroxysmal supraventricular tachycardia, as well as chronic obstructive pulmonary disease. When seen initially (April 1992), the man was taking theophylline, verapamil, digoxin, and quinidine gluconate. He was cachectic, with numerous ecchymoses . . .
Case 35-1994
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Walter H. Dzik, Lyn M. Duncan
Journal: New England Journal of Medicine (1994)

Presentation of CaseA 55-year-old woman with idiopathic thrombocytopenic purpura was admitted to the hospital because of left hemiparesis.The patient had been well until 3 1/2 years earlier, when easy bruising developed and a diagnosis of idiopathic thrombocytopenic purpura was made; she had a poor response to prednisone therapy. Six months later she was first seen at this hospital. Physical examination showed petechiae and ecchymoses. Hematologic studies were performed (Table 1). Prednisone (80 mg daily) was begun, and one week later the platelet count was 41,000 per cubic millimeter. A splenectomy was performed one month later at a foreign . . .