tbuckley/cabot-search huggingface dataset:
Liver Metastases from Lung Cancer
Authors: M Baron, V Lewis
Journal: New England Journal of Medicine (2001)

Figure 1. A 72-year-old woman had a six-month history of upper abdominal swelling, pain in the right upper quadrant, weight loss of 13.6 kg (30 lb), anorexia, and generalized weakness. Laboratory analysis revealed an alkaline phosphatase level of 259 U per liter, a lactate dehydrogenase level of 559 U per liter, an aspartate aminotransferase level of 129 U per liter, and a bilirubin level of 1.4 mg per deciliter (24 μmol per liter). A computed tomographic (CT) scan of the abdomen showed multiple hepatic metastases (arrows). Until eight months before presentation, she had smoked an average of 1 1/2 packs . . .
Fever and Anemia in Renal Cancer
Authors: B. G. Clarke, W. J. Goade
Journal: New England Journal of Medicine (1956)

A SURVEY of 36 proved cases of renal cancer has been made to determine the importance of fever and anemia as diagnostic signs in this disease. All patients underwent operations: nephrectomy in 35 and exploration and biopsy in 1. The histologic diagnosis, in every case, was consistent with cancer of the tubular epithelium. Various names have been applied to this neoplasm, including Grawitz's tumor, hypernephroma, clear-cell carcinoma and renal-cell or renal-tubular carcinoma.ResultsOur findings are summarized in Tables 1 to 7. Two of the 36 patients presented otherwise unexplained fever as a chief complaint (Table 2). Eight others had fever as . . .
A phase Ib study to assess the safety of lexatumumab, a human monoclonal antibody that activates TRAIL-R2, in combination with gemcitabine, pemetrexed, doxorubicin or FOLFIRI
Authors: B. I. Sikic, H. A. Wakelee, M. von Mehren, N. Lewis, A. H. Calvert, E. R. Plummer, N. L. Fox, T. Howard, S. F. Jones, H. A. Burris
Journal: Journal of Clinical Oncology (2007)

14006 Background: Lexatumumab (HGS-ETR2) is a fully-human agonistic monoclonal antibody that targets and activates the Tumor Necrosis Factor-Related Apoptosis-Inducing Ligand Receptor 2 (TRAIL-R2). TRAIL-R2 is a member of the Tumor Necrosis Factor Receptor (TNFR) superfamily that, when activated, induces apoptosis via the extrinsic pathway. Lexatumumab shows promising anti-tumor activity in preclinical models, particularly in combination with chemotherapeutic agents. Single-agent lexatumumab was well-tolerated in phase I trials. This is the first study of the safety of a TRAIL-R2 agonist in combination with chemotherapy. Methods: Patients for whom gemcitabine, pemetrexed, doxorubicin or FOLFIRI was considered an appropriate treatment received one of the full-dose chemotherapy regimens plus lexatumumab every 2 weeks (for gemcitabine and FOLFIRI) or 3 weeks (for pemetrexed and doxorubicin). Four to 6 patients were treated with 5 mg/kg lexatumumab in each chemotherapy cohort prior to dose escalation to 10 mg/kg. Results: To date, 41 patients with a wide range of cancer types have received 164 courses of lexatumumab over the 2 dose levels. The majority (33/41) received at least 2 courses (range 1 to 19). Lexatumumab was well-tolerated; no dose reductions of lexatumumab were required. Severe adverse events considered at least possibly related to lexatumumab included anemia, fatigue and dehydration. Tumor shrinkage has been observed, including confirmed partial responses (PRs) in the FOLFIRI and doxorubicin arms. Eight patients continue on study. Conclusions: Lexatumumab can be safely administered in combination with a wide range of chemotherapeutic agents. Evaluation of the efficacy of lexatumumab in combination with chemotherapy in Phase 2 trials is warranted. [Table: see text]
Wasted Paper in Pharmaceutical Samples
Authors: Martin T. Donohoe, Harmony Matthews
Journal: New England Journal of Medicine (1999)

To the Editor: In their article on mutations of the cystic fibrosis gene in patients with chronic pancreatitis, Sharer et al. (Sept.3 issue) 1 concluded that the frequency of carriers of the 5T allele was significantly higher in these patients than in the general population.However, we believe that this conclusion may be incorrect.The authors did not use for comparison the control group of 600 unrelated partners of persons with a family history of cystic fibrosis in the northwest of England. 2 Rather, they used the series studied by Kiesewetter et al., 3 which included persons from the United States, Northern Ireland, Italy, and Greece.The control group should represent the population from which the case patients were selected.Moreover, the carrier rate of 10.4 percent for the 5T allele found among 134 patients with chronic pancreatitis was compared with a 5 percent prevalence among 224 normal chromosomes (143 from the parents of patients with cystic fibrosis and 81 from the general population). 3 The comparison of the carrier prevalence rate with the allele prevalence rate is inappropriate because the former is approximately two times as high, since a person has two homologous chromosomes.Thus, their conclusion that the frequency of the 5T allele among patients with chronic pancreatitis is "twice as high as expected" is incorrect.To date, there is no evi-dence that the 5T allele confers susceptibility to chronic pancreatitis.
Histological Osteomalacia Due to Dietary Calcium Deficiency in Children
Authors: Pierre J. Marie, John M. Pettifor, F. Patrick Ross, Francis H. Glorieux
Journal: New England Journal of Medicine (1982)

We performed a histomorphometric study of trabecular-bone formation and resorption in undecalcified sections of iliac crest from three children presenting with clinical, radiologic, and biochemical evidence of rickets associated with dietary calcium deficiency. All three children had severe osteomalacia documented by hyperosteoidosis and reduced static and dynamic indicators of bone mineralization. There was a reduction of the calcified bone volume associated with a decreased bone formation rate and features of increased bone resorption. Correction of dietary calcium intake in two of the patients led to normal serum and urinary calcium levels and reduced alkaline phosphatase levels. After calcium therapy, the calcified bone volume was normal and indicators of bone mineralization returned to normal. We conclude that low calcium intake in children may be associated with a histologic picture of severe osteomalacia. Our finding that adequate amounts of calcium rapidly improved bone mineralization demonstrates that calcium deficiency can cause osteomalacia in children. (N Engl J Med. 1982;307:584–8.)
A Stressful Interaction
Authors: Daniel S. Pine, Lawrence Tierney
Journal: New England Journal of Medicine (1996)

A 52-year-old man was brought to the hospital because of lethargy and headache. He had a history of mild, intermittent headaches and heartburn but had had worse-than-usual occipital and left retro-orbital pain for the past one or two days. There was no trauma, photophobia, nausea, or vomiting, and his only medications were pseudoephedrine and aspirin, which he had taken that morning. He also described several recent bouts of heartburn in his left chest and shoulder that were independent of exertion, position, and ingestion of food and that had resolved spontaneously after 5 to 10 minutes. He had no current . . .
Inheritance Pattern and Clinical Response to Splenectomy as a Reflection of Erythrocyte Spectrin Deficiency in Hereditary Spherocytosis
Authors: Peter Agre, Andrew Asimos, James F. Casella, Campbell McMillan
Journal: New England Journal of Medicine (1986)

To determine how various inheritance patterns and responses to splenectomy relate to erythrocyte spectrin deficiencies in hereditary spherocytosis, we measured the spectrin content of erythrocytes by radioimmunoassay in 33 patients with this disease. Patients with the dominant form of hereditary spherocytosis generally had mild anemia, with spectrin at 63 to 81 percent of normal levels. Patients with the nondominant form of the disease had anemia ranging from severe to mild, with corresponding spectrin levels of 30 to 74 percent; their siblings were affected similarly. Distantly related homozygotes had different clinical severities with correspondingly different spectrin levels. The parents and offspring of patients with the nondominant form were clinically normal but consistently had subtle erythrocyte abnormalities. Spectrin levels in all patients were inversely related to osmotic fragility (P less than 0.0001), and they were also correlated with the clinical response to splenectomy: patients with spectrin levels above 70 percent achieved normal blood counts, those with levels of 40 to 70 percent had compensated hemolysis, and those with levels below 40 percent improved but remained anemic (P less than 0.0001). We conclude that the inheritance pattern and response to splenectomy in hereditary spherocytosis reflect erythrocyte spectrin deficiencies as determined by radioimmunoassay.
171P: Carboplatin–paclitaxel bevacizumab followed by the addition of erlotinib to bevacizumab beyond progression in patients with advanced NSCLC
Authors: H. Van Groningen, A. Timmer-Bonte, D. Van den Hurk, M. Dohmen, C. Smits-Van der Graaf, M. Van der Drift
Journal: Journal of Thoracic Oncology (2016)
Case 37-2011
Authors: T. Bernard Kinane, Randheer Shailam, Eugene J. Mark
Journal: New England Journal of Medicine (2011)

A 9-month-old boy had had recurrent episodes of tachypnea and respiratory distress since he was 5.5 months of age, with expiratory wheezing and fine crackles on auscultation, hyperinflation on chest radiography, and bilateral ground-glass opacities on CT.
Case 17-1991
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely
Journal: New England Journal of Medicine (1991)

Presentation of Case A 68-year-old man was admitted to the hospital because of a dry cough, progressive dyspnea, and abnormal pulmonary findings on radiologic examination. There was a history of bilateral cataracts that were extracted, with the insertion of intraocular lenses. The right cornea was injured by the implanted lens, and a corneal opacification developed. Twelve weeks before admission a right corneal transplant procedure was performed, with removal of the intraocular lens. Prednisone was begun in a dose of 40 mg daily. At about the same time the patient began to experience hoarseness, dyspnea, chest pain, and a dry cough. . . .
Case 29-2013
Authors: Gerald H. Friedland, Pumersha Naidoo, Bilal Abdool-Gafoor, Mahomed-Yunus S. Moosa, Pratistadevi K. Ramdial, Rajesh T. Gandhi
Journal: New England Journal of Medicine (2013)

A 32-year-old man with HIV infection was admitted to a hospital in South Africa because of progressively worsening skin lesions, dyspnea, and cough. A CD4+ T-cell count was 268 per cubic millimeter. Diagnostic procedures were performed.
<i>Serratia liquefaciens</i>Bloodstream Infections from Contamination of Epoetin Alfa at a Hemodialysis Center
Authors: Lisa A. Grohskopf, Virginia R. Roth, Daniel R. Feikin, Matthew J. Arduino, Loretta A. Carson, Jerome I. Tokars, Stacey C. Holt, Bette J. Jensen, Richard E. Hoffman, William R. Jarvis
Journal: New England Journal of Medicine (2001)

In a one month period, 10 Serratia liquefaciens bloodstream infections and 6 pyrogenic reactions occurred in outpatients at a hemodialysis center.We performed a cohort study of all hemodialysis sessions on days that staff members reported S. liquefaciens bloodstream infections or pyrogenic reactions. We reviewed procedures and cultured samples of water, medications, soaps, and hand lotions and swabs from the hands of personnel.We analyzed 208 sessions involving 48 patients. In 12 sessions, patients had S. liquefaciens bloodstream infections, and in 8, patients had pyrogenic reactions without bloodstream infection. Sessions with infections or reactions were associated with higher median doses of epoetin alfa than the 188 other sessions (6500 vs. 4000 U, P=0.03) and were more common during afternoon or evening shifts than morning shifts (P=0.03). Sessions with infections or reactions were associated with doses of epoetin alfa of more than 4000 U (multivariate odds ratio, 4.0; 95 percent confidence interval, 1.3 to 12.3). A review of procedures revealed that preservative-free, single-use vials of epoetin alfa were punctured multiple times, and residual epoetin alfa from multiple vials was pooled and administered to patients. S. liquefaciens was isolated from pooled epoetin alfa, empty vials of epoetin alfa that had been pooled, antibacterial soap, and hand lotion. All the isolates were identical by pulsed-field gel electrophoresis. After the practice of pooling epoetin alfa was discontinued and the contaminated soap and lotion were replaced, no further S. liquefaciens bloodstream infections or pyrogenic reactions occurred at this hemodialysis facility.Puncturing single-use vials multiple times and pooling preservative-free epoetin alfa caused this outbreak of bloodstream infections in a hemodialysis unit. To prevent similar outbreaks, medical personnel should follow the manufacturer's guidelines for the use of preservative-free medications.
Human DNA Polymorphism
Authors: David Housman
Journal: New England Journal of Medicine (1995)

One of the most important tools underlying the revolution in medical genetics is the ability to visualize sequence differences directly in DNA. When studied in the context of a population, these differences in DNA sequences are called polymorphisms; they may occur in coding regions (exons) or noncoding regions of genes. The ability to visualize thousands of DNA polymorphisms has made possible family studies for tracking genes of medical importance. This technique has located and identified genes for many disorders with a clear pattern of mendelian inheritance, such as cystic fibrosis, the inherited muscular dystrophies, and neurodegenerative disorders such as Huntington's . . .
Relations between Serum Gastrin Levels and Rates of Gastric Hydrochloric Acid Secretion
Authors: Walter L. Trudeau, James E. McGuigan
Journal: New England Journal of Medicine (1971)

Fasting venous serum gastrin concentrations and both unstimulated and maximum-stimulated gastric hydrochloric acid secretory rates were determined in 168 subjects. The patients included 55 with duodenal peptic-ulcer disease, nine with gastric ulcers and 69 with assorted gastrointestinal abnormalities, and 35 control subjects without recognized gastrointestinal diseases. Fasting serum gastrin concentrations were measured by radioimmunoassay and compared for groups of patients with differing rates of basal and stimulated gastric acid secretion. There was, in general, an inverse relation between fasting serum gastrin concentrations and rates of gastric hydrochloric acid secretion. Fasting serum gastrin concentrations in patients with duodenal-ulcer disease were not found to be significantly greater than those of the control subjects. However, mean serum gastrin concentrations in the patients with gastric-ulcer disease were found to be significantly greater than those of both the control subjects and the patients with duodenal-ulcer disease.
Sarcoidosis, Another Disease Associated with Serologic Evidence for Herpes-like Virus Infection
Authors: Yashar Hirshaut, Philip Glade, Luiz Octavio B.D. Vieira, Eugene Ainbender, Bozena Dvorak, Louis E. Siltzbach
Journal: New England Journal of Medicine (1970)

The herpes-like virus (HLV, and also EBV), first detected in lymphoid cell cultures derived from Burkitt tumor, has been suggested as the etiologic agent of infectious mononucleosis, and has been suspected of playing a part in the pathogenesis of African Burkitt lymphoma and carcinoma of the posterior nasal space. Most of the evidence for these associations between virus and disease has come from seroepidemiologic data. Our study of serums from 131 patients with sarcoidosis indicates that all have antibody to HLV and in 79 per cent the titers were 1:640 or higher. This contrasts with a 76 per cent prevalence of antibody in a control group with considerably lower titers. Sarcoidosis, therefore, is the fourth disease to be linked serologically with HLV infection. Since four diseases have now been associated with infection by the same virus, any conclusions regarding the pathogenic role of HLV in any given condition must be made cautiously.
TMOD-10EVALUATION OF GROWTH DYNAMICS OF UNTREATED GLIOBLASTOMA MULTIFORME AND CORRELATION WITH EPIDEMIOLOGICAL AND TUMOR RELATED PARAMETERS
Authors: Daniel Ruess, Lea Flitsch, Tobias Blau, Chistoph Wipplinger, Alexandra Hellerbach, Harald Treuer, Maximilian I. Ruge
Journal: Neuro-Oncology (2015)

TMOD-10. EVALUATION OF GROWTH DYNAMICS OF UNTREATED GLIOBLASTOMA MULTIFORME AND CORRELATION WITH EPIDEMIOLOGICAL AND TUMOR RELATED PARAMETERS Daniel Ruess1, Lea Flitsch1, Tobias Blau2, Chistoph Wipplinger1, Alexandra Hellerbach1, Harald Treuer1, and Maximilian I. Ruge1; Departement of Stereotaxie and functional Neurosurgery, University of Cologne, Cologne, Germany; Institute of Neuropathology, University of Cologne, Cologne, Germany BACKGROUND: To conduct stereotactic biopsy with highest precision and safetya MRI for planning is routinelyobtained close before the procedure, especially in fast growing tumours. Thus, usually two MR series are available (one leading to suspected diagnosis followed by one serving stereotactic planning). Aim of the presented study was to evaluate the growth dynamic in patients with glioblastoma multiforme (GBM) and to correlate with epidemiological and tumor related features. METHODS: For this single-centre retrospective evaluation (2010-2013) all patients with histologically confirmed diagnosis of GBM by stereotactic biopsy and with two pre-operative MR series were identified. Contrast enhancing tumour was outlined on T1w MR using Osirix Dicom Viewerw independently by two investigators and tumor volume was calculated by integrating area-thickness products. Tumor growth rate (TGR) was assessed as the percentage of volume change per day (Dvol%/d) and correlated with age, volume of contrast enhancing tumor and O6-Methylguanin-DNA-Methyltransferase (MGMT) status by using Mann-Whitney-U test. RESULTS: 52 patients (f:m 1⁄4 22:30, median age 62 (range 37-82) were included. Median time span between MR imaging was 7 days (range 1-42). Median tumor growth rate was 3.4 Dvol%/d (range 0.1-17.6). There was no significant correlation between tumor growth rate and initial tumor size, gender and age. However there was a trend to slower growth in patients .70 years (p 1⁄4 0.066) and tumors .20 ml (p 1⁄4 0.058). Furthermore, MGMT status did not correlate with TGR. CONCLUSION: These data show heterogeneous but substantial TGR in untreated GBM. There might be an influence of older age and larger tumour size while molecular features (MGMT/IDH) do not show any influence in this cohort. In how far these influences sustain in a larger patient population is still under investigation. Neuro-Oncology 17:v226–v229, 2015. doi:10.1093/neuonc/nov237.10 Published by Oxford University Press on behalf of the Society for Neuro-Oncology 2015.
Case 8-2013
Authors: Monica Morrow, Jonathan M. Winograd, Phoebe E. Freer, John H. Eichhorn
Journal: New England Journal of Medicine (2013)

A 48-year-old woman presented after routine tomosynthesis had revealed a lesion in the left breast. Core-biopsy and lumpectomy specimens showed ductal carcinoma in situ, with positive margins. Management decisions were made.
Reaping the Benefits of Recent Advances for Adults With Acute Lymphoblastic Leukemia
Authors: Patrick A Brown, Joseph C Alvarnas
Journal: Journal of the National Comprehensive Cancer Network (2012)

In adults, acute lymphoblastic leukemia (ALL) is a rare cancer, even among hematologic malignancies, and is generally associated with long-term survival rates of approximately 40%. Conversely, ALL is the most common cancer in children and, with steady advances fueled by systematic randomized clinical trials over the decades, is now curable in more than 80% of cases.

One of the most important reasons for the worse outcomes among adult patients with ALL is intrinsic disease biology. Poor-risk genetic features occur with higher frequency, and favorable-risk genetic features occur with lower frequency in adults compared with children. A striking example of this is Philadelphia chromosome–positive (Ph+) ALL, which occurs in 25% of adult patients with ALL but in fewer than 5% of childhood patients. Importantly, the addition of BCR-ABL tyrosine kinase inhibitors (TKIs) to chemotherapy for Ph+ ALL appears to markedly improve responses. Notwithstanding these clear differences in disease biology in adults compared with children, evidence is emerging that adopting a pediatric-inspired treatment approach for adolescents and younger adults (AYAs) with ALL results in improved survival.

The impetus for developing the first NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for ALL (in this issue) arose from our desire for every adult diagnosed with ALL in 2012 and beyond to reap the benefits of 2 major recent advances that have redefined “standard of care” for adult ALL: 1) recognition that pediatric-inspired treatment regimens are both feasible and associated with improved survival in younger adult patients compared with traditional “older adult” regimens, and 2) recognition that including TKIs in the treatment of Ph+ ALL is associated with improved response and survival.
The Late Results of Femoral Thrombophlebitis and Their Treatment
Authors: John Homans
Journal: New England Journal of Medicine (1946)

THERE is probably an advantage, in these recent days when thrombosis in the veins of the lower limbs is receiving active treatment by surgical procedures as well as by anticoagulants, in visualizing the usual end stage of the disease untouched by such methods. It is as yet too soon to learn how much or how little they alter its natural course, even supposing that in any considerable proportion of cases their use is attempted, for when one considers that venous thromboses occur in association with injuries, operations, childbirth and serious cardiac and other diseases, as well as spontaneously in everyday . . .
Neuroendocrine abnormalities in bulimia
Authors: H E Gwirtsman, P Roy-Byrne, J Yager, R H Gerner
Journal: American Journal of Psychiatry (1983)

The authors examined the relationship of clinical variables, family history, and neuroendocrine function in 18 bulimic patients. Twelve of 18 patients (67%) showed abnormalities of cortisol suppression, and 8 of 10 (80%) showed blunted thyrotropin-releasing hormone (TRH) tests. These findings suggest that neuroendocrine abnormalities identified previously in anorexia nervosa are not solely an artifact of low weight and, further, that eating disorders and affective disorders may share neurochemical similarities.