tbuckley/cabot-search huggingface dataset:
Case 7-1994
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Paul E. Sax, Anthony R. Mattia
Journal: New England Journal of Medicine (1994)

Presentation of CaseA 55-year-old man was admitted to the hospital because of a persistent urinary tract infection.The patient had had an extensive anterior myocardial infarct 11 years earlier accompanied by ventricular tachycardia, and another myocardial infarction was complicated by complete atrioventricular block one year later. A permanent electronic pacemaker was implanted. Coronary angiographic examination revealed inoperable coronary artery disease, and medical management was provided for congestive heart failure. Six and a half years before entry recurrent bouts of ventricular tachycardia developed, with near syncope. An orthotopic cardiac transplantation was performed nine months later. The patient's postoperative course was . . .
Vinorelbine as radiosensitizer in head and neck and esophageal cancer: A pilot study
Authors: G. Sudarshan, S. Mahadev
Journal: Journal of Clinical Oncology (2004)

5562 Background: Vinorelbine (VRL) is a vinca alkaloid, which acts on microtubule assembly during S-Phase of cell cycle. As radiation acts on M phase, VRL acts synergistically with radiation to bring about good cancer cell kill. Methods: Thirty consecutive cases of squamous cell carcinoma of head & neck and esophagus of stage II and III were recruited into this study. The protocol was (a) Head & Neck cancers: 50 Gy external radiation (ERT) to primary and neck nodes in 5 weeks + 25 Gy boost to primary. VRL (Vinelbine®-Dabur India Ltd) 10 mg was given weekly for 5 weeks and then 1 dose before the boost. The boost in cancers of buccal mucosa or anterior 2/3rd of tongue was given by iridium implant. (b) Esophageal cancer: If Intra Luminal Radiation Therapy (ILRT) was possible, 54 Gy of ERT in 6 weeks along with weekly VRL(10mg) + 10 Gy by ILRT was given. If ILRT was not possible, only 60 Gy as ERT was given along with weekly VRL. Results: The median age of patients was 48 years. Sixteen were cases of Ca.Esophagus (Upper 1/3rd 2, middle 1/3rd 11, lower 1/3rd 3) and the remaining were from larynx,oro & hypopharynx. Follow-up period was 20 months. The initial response rate was 28/30 (93%). One had a partial remission (PR) and one case did not respond. During follow-up, one had local recurrence and 2 cases developed neck node recurrence. At the end of 20 months 25 out of 30 cases (83%) were alive with no evidence of disease. Mucositis (Grade III in 6 cases and grade IV in 1 case) and dysphasia (grade IV in 1 case) were the most troubling toxicities but could be managed symptomatically. No neurotoxicity was observed. None of the esophageal cancers recurred. Conclusions: Vinorelbine 10 mg weekly for 6 weeks along with radiation gives excellent results in cancers of head & neck and esophagus and needs to be explored in larger studies. No significant financial relationships to disclose.
Early appearance of breast cancer (BC) and its patterns of expression for HER-2/NEU and hormonal receptors (HR)
Authors: R. Villalobos, F. Bustamante, A. Castruita, A. Silva, M. Perez, G. Olivares, M. Silva
Journal: Journal of Clinical Oncology (2004)

9728 Background: To evaluate the age of presentation of breast cancer (BC) and its correlation with the expression of HER-2/NEU and hormonal receptors in Mexican women Methods: A descriptive analysis of 101 patients with breast cancer was carried out in the Oncology Hospital ‘Siglo XXI’ during the year 2002–2003.Testing of herceptes and determination of hormonal receptors were correlated with the clinical stage and the patient age. Results: The average patient age was 52 years (range 29–86), the most frequent clinical stage was stage III (58.41%). 26 patients with HER-2/neu positive, 75 patients HER-2/neu negative. 37 patients with RE positive, 62 RE negative, 37 patients with RP positive and 61 with RP negative. A description of the subgroups is detailed in the table below. Undeterminable = 2, non classification = 5 When correlating HER-2/neu with hormonal receptors the following results were established: HER-2/neu positive is associated with RE negative (80.76%) and with RE positive (15.38%); HER-2/neu negative is associated with RP negative (84.61%), and with RP positive (7.69%), with RE negative (54.60%), and with RE positive (44.00%). Conclusions: The age of presentation of breast cancer is at least 10 years earlier than in developed countries, the over-expression of HER-2/neu is similar to that reported in the literature, and in the same way the appearance of positive hormonal receptors is associated with under-expression of HER-2/neu. The RE and RP are expressed in equal percentage in patients with HER-2/neu negative. Environmental and inherent factors need studying in order to investigate the early appearance of breast cancer. No significant financial relationships to disclose.
Breast Cancer Therapy–Related Cardiac Dysfunction in Adult Women Treated in Routine Clinical Practice: A Population-Based Cohort Study
Authors: Paaladinesh Thavendiranathan, Husam Abdel-Qadir, Hadas D. Fischer, Ximena Camacho, Eitan Amir, Peter C. Austin, Douglas S. Lee
Journal: Journal of Clinical Oncology (2016)

Most women diagnosed with breast cancer are younger than 65 years of age. Population-based studies on cancer therapy-related cardiotoxicity have focused on older women. We sought to determine the risk of cardiotoxicity with breast cancer therapy in women with an age distribution representative of routine clinical practice.This was a population-based retrospective cohort study including 14 regional cancer centers in Ontario, Canada. Adult women receiving chemotherapy for stage I to III breast cancer between 2007 and 2012 were included. Cancer treatment was categorized as follows: anthracycline-based chemotherapy without trastuzumab, trastuzumab with nonanthracycline chemotherapy, anthracyclines followed by trastuzumab (sequential therapy), and chemotherapy without anthracycline/trastuzumab (other chemotherapy). The primary outcome was a composite of hospitalization or emergency room visit for congestive heart failure (CHF), outpatient diagnosis of CHF, or cardiovascular death. A sensitivity analysis limited the outcomes to hospital-based CHF events. Cause-specific hazard models were used accounting for the competing risk of noncardiovascular death.Of 18,540 women included (median age, 54 years; interquartile range, 47 to 63 years), 79% were younger than age 65 years. The cumulative incidence of the primary outcome was 3.08% (95% CI, 2.81% to 3.36%) by 3 years of follow-up, whereas in an age-matched sample of Ontario women (n = 92,700) without breast cancer, it was 0.96% (95% CI, 0.89% to 1.04%). Compared with those receiving other chemotherapy, patients receiving trastuzumab with nonanthracycline chemotherapy and sequential therapy were at a higher risk of cardiotoxicity (hazard ratio, 1.76 [95% CI, 1.19 to 2.60] and 3.96 [95% CI, 3.01 to 5.22], respectively). Hospital-based CHF events were only increased with sequential therapy (hazard ratio, 1.86; 95% CI, 1.07 to 3.22).In women with breast cancer and an age distribution representative of routine clinical practice, trastuzumab-based regimens, including those without anthracyclines, were associated with an increased risk of cardiotoxicity. Sequential therapy increased the risk of hospital-based CHF events.
P145 Using Fractional Exhaled Nitric Oxide (FeNO) Suppression and Inhaled Compliance Assessment (INCA) to identify and manage non-adherence in Difficult Asthmatics
Authors: LG Heaney, KJ Hetherington
Journal: Thorax (2015)

<h3>Introduction</h3> The identification of intentional and non-intentional non-adherence in patients with “difficult” asthma and establishing who should respond well to inhaled steroid treatment is essential to prevent the inappropriate escalation of inhaled corticosteroids (ICS) and the initiation of complex biological therapies. One week FeNO suppression testing can identify non-adherence and ascertain which patients who should achieve good asthma control with better adherence to standard treatment. Combining this test with simple remote technology it can be determined whether they are intentionally or non-intentionally non-adherent, and can show technique and timing errors. <h3>Methods</h3> The INCA device was developed by Professor Richard Costello in conjunction with Vitalograph and is designed to work with the Accuhaler inhaler. The INCA device time and date stamps the activation of a microphone and records a sound file of the inhaler being used; these sound files can then be transferred to the computer and uploaded onto a server where they are analysed by an algorithm. Within the Belfast City Hospital 40 patients have carried out the one week FeNO suppression testing, 20 of those in combination with INCA technology. This testing is relatively simple and is part of the Medical Research Council funded Refractory Asthma Stratification Programme and is currently being piloted in five specialist Difficult Asthma Centres in the UK. <h3>Results</h3> Within the 40 patients there were 23 non-suppressors (ie adherent patients) and 17 suppressors (ie non-adherent patients). With the patients using the INCA technology, the server highlighted technique errors; for example, not activating the drug blister or exhaling into the mouthpiece, as well as erratic timing issues. At subsequent follow up appointments these issues were emphasised and addressed by using patient-friendly print outs showing the usage of the inhaler, with the addition of alarm reminders and behavioural cues to encourage adherence. <h3>Conclusion</h3> FeNO Suppression and INCA testing is an effective method of identifying and managing non-adherence with the capability of encouraging improved technique and timing also having the capability to be used as a long term behavioural assistance to adherence to ICS.
Behavioral Treatment for the Anticipatory Nausea and Vomiting Induced by Cancer Chemotherapy
Authors: Gary R. Morrow, Christine Morrell
Journal: New England Journal of Medicine (1982)

The nausea and vomiting experienced by one in four cancer patients in anticipation of chemotherapy is probably a learned response to treatment. To determine whether behavioral approaches for altering learned responses might be useful treatments for these symptoms, we compared the effects of "systematic desensitization" (a behavioral treatment in which relaxation is learned as a response to situations In which patients have had anticipatory nausea and vomiting) with those of counseling and of no treatment. Sixty ambulatory cancer patients with anticipatory nausea and vomiting before their third and fourth chemotherapy treatments were randomized equally to the three groups. Significantly more patients receiving desensitization reported no anticipatory nausea before their fifth and sixth chemotherapy treatments than patients given counseling (P<0.05) or no treatment (P<0.01). Desensitized patients also reported significantly less severe anticipatory nausea (P<0.01) and vomiting (P<0.05) and a shorter duration of anticipatory nausea (P<0.01). We conclude that systematic desensitization appears to have an antiemetic effect in cancer patients who receive chemotherapy, and may be useful in the management of these problems. (N Engl J Med. 1982; 307:1476–80.)
Adjunctive Drug Therapy of Acute Myocardial Infarction — Evidence from Clinical Trials
Authors: Charles H. Hennekens, Christine M. Albert, Susan L. Godfried, J. Michael Gaziano, Julie E. Buring
Journal: New England Journal of Medicine (1996)

Despite improvement in primary prevention1 and treatment,2 acute myocardial infarction remains the chief cause of death in the United States and most developed countries. Almost half of all victims of myocardial infarction die before they reach the hospital.3 Of several hundred thousand patients hospitalized each year with acute myocardial infarction, 7 to 15 percent die during hospitalization and another 7 to 15 percent die during the following year.4 This article reviews the current evidence from published randomized trials (Table 1) and meta-analyses (Table 2) of adjunctive drug therapy with beta-adrenergic antagonists, angiotensin-converting–enzyme (ACE) inhibitors, nitrates, calcium-channel blockers, antiarrhythmic drugs, and . . .
P97 Uptake of the emergency salbutamol inhaler in North East England secondary schools following amendment of the Human Medicines Regulations
Authors: W Funston, SJ Howard
Journal: Thorax (2015)

<h3>Introduction and objectives</h3> As a result of amendments to The Human Medicines Regulations 2012, schools have been permitted since 1<sup>st</sup> October 2014 to purchase salbutamol inhalers to be used by children diagnosed with asthma and prescribed an inhaler, where parents have given written permission for the emergency inhaler to be used. This regulatory change may represent a useful step in facilitating access to emergency asthma treatment in schools. This study provides the first published data on the number of schools that have availed of this new power, through an assessment of uptake of the emergency salbutamol inhaler in secondary schools in North East England. <h3>Methods</h3> We compiled a list of all free-to attend schools within the 12 local authorities in North East England using listings on local authority websites. We limited our study to schools which served 16 year old mainstream pupils in order to aid interpretation of our results. Postal letters were sent to invite the included schools to complete a brief online or postal questionnaire asking if the school had an emergency salbutamol inhaler for use by pupils in an asthma emergency. Data was collected between November 2014 and May 2015. <h3>Results</h3> Of 153 schools included in the study, 103 questionnaire responses were received. We excluded the response of 1 school due to lack of clarity. Of the remaining 102 responses, 45 (44%) indicated that the school had an emergency salbutamol inhaler available, while 57 (56%) indicated that the school did not have such an inhaler. The proportion of schools in which emergency salbutamol inhalers were available varied by local authority from 0% to 71%. <h3>Conclusions</h3> Despite the change in legislation, 56% of schools included in this study did not possess an emergency salbutamol inhaler. More needs to be done to increase the level of uptake of the emergency salbutamol inhaler to enable schools to better respond to asthma emergencies.
Bone-Resorbing Activity in Supernatants from Lymphoid Cell Lines
Authors: Gregory R. Mundy, Richard A. Luben, Lawrence G. Raisz, Joost J. Oppenheim, Donald N. Buell
Journal: New England Journal of Medicine (1974)

To study the pathogenesis of osteolytic lesions and hypercalcemia in neoplastic disease, supernatant fluids of cultured lymphoid cell lines were tested for their ability to stimulate bone resorption in vitro. Lines from patients with myeloma, Burkitt's lymphoma, and malignant lymphoma secreted a potent bone-resorbing material. Four lines from normal subjects or patients with other neoplasms did not have this activity. The lymphoid cell-line agent (or agents) could be distinguished from parathyroid hormone, prostaglandin E2 and vitamin-D-like sterols by dose-response curves, Sephadex G-100 chromatography, heat inactivation, dialysis and ultrafiltration, extraction with lipid solvents and immunoassays, but could not be distinguished from the osteoclast-activating factor secreted by human leukocytes. Osteolytic lesions in patients with lymphocytic neoplasms may be due to excessive secretion of stimulators of osteoclast-mediated bone resorption. (N Engl J Med 290:867–871, 1974)
The value of FACT-G in screening cancer patients for depression
Authors: S. Jang, J. Ackler, L. Braitman, W. Tester
Journal: Journal of Clinical Oncology (2007)

19557 Background: The prevalence of depression in cancer patients varies greatly, reported in the range of 5–50% depending upon the population studied. Several tools have been used to screen for depression, but it remains uncertain which tool is most valuable. The Zung self-rating depression scale (ZSDS) is one of the commonly used screening tools for depression. Using a cutoff value of ≥ 40, one study reported sensitivity of 100% and specificity of 55% in diagnosing depression. This study was designed (1) to investigate the prevalence of major depression in our population of outpatients receiving chemotherapy, (2) to determine the correlation between the ZSDS score and Functional Assessment of Cancer Therapy - General version (FACT-G) score and (3) to examine whether statements from the FACT-G can be used as a screening tool for major depression. Methods: Sixty-two chemotherapy patients completed both ZSDS and FACT-G. Median age was 62 years (range 22–81); 55% were female. Patients with ZSDS scores ≥ 40 were interviewed, using standard DSM-IV criteria to evaluate for major depression. Pearson’s correlation was used to examine the correlation between ZSDS and FACT-G scores. We then analyzed responses to FACT-G statements to evaluate if certain questions from the FACT-G could be used as a screening tool for major depression. Results: Thirty patients had ZSDS score &lt; 40, and were considered to not have major depression. Among the 32 patients with ZSDS score = 40, 30 underwent clinical interviews. Seven of these 30 were diagnosed with major depression. The prevalence of major depression was 7/60, or 12% (95% CI: 5% - 23%). The ZSDS score and FACT-G score had strong correlation (R= -0.75). If the total score (range 0–24) of six statements from FACT-G were ≤12, then these six FACT-G statements had sensitivity of 100% and specificity of 81% in predicting major depression. Conclusions: The prevalence of major depression was 12% in our population of chemotherapy patients. The ZSDS and FACT-G scores showed strong correlation. Patient responses to six selected statements from the FACT-G appear to be useful as a screening tool for depression. A confirmatory study with larger numbers of patients is planned. No significant financial relationships to disclose.
Inhibition of Exercise-Induced Bronchoconstriction by MK-571, a Potent Leukotriene D<sub>4</sub>–Receptor Antagonist
Authors: Patrick J. Manning, Richard M. Watson, Dorothy J. Margolskee, Vanessa C. Williams, Jules I. Schwartz, Paul M. O'Byrne
Journal: New England Journal of Medicine (1990)

Exercise is a common stimulus of bronchoconstriction in subjects with asthma, who also have bronchoconstriction after inhaling the sulfidopeptide leukotriene D4 (LTD4). The purpose of this study was to investigate the importance of LTD4 as a mediator of exercise-induced bronchoconstriction.
Can preoperative antibiotics take the place of postoperative long period antibiotics on the surgical site infection in Japan? – A phase II study by Osaka Gastrointestinal Cancer Chemotherapy Study Group (OGSG) in Japan
Authors: H. Furukawa, H. Imamura, J. Shimizu, S. Iijima, S. Sugihara, T. Tsujinaka
Journal: Journal of Clinical Oncology (2004)

4162 [Background] A prospective randomized controlled study showed that preoperative administration of antibiotics reduced the risk of wound infection after clean-contaminated surgical procedures more effectively than postoperative administration (N Engl J Med 1992;326:281–286) In Japan, large number of patients undergoing the clean-contaminated surgical procedures receive postoperative administration of antibiotics for a few days and the incidence of surgical site infection (SSI) is 5–10%. [Methods] A preoperative antibiotics administration to the patients with gastric cancer was studied on SSI in a multi-institutional phase II study. A one gram of Cefazoline diluted by 100 ml of saline was administered to the patients at the start of anesthesia. When the operation lasted more than 3 hours, an additional perioperative Cefazoline was administered. Eligibility Criteria: (1) histologically proven gastric cancer, (2) undergoing distal gastrectomy, (3) D2 lymphadenectomy, (4) clean-contaminated surgical procedures, (5) written informed consent. Exclusion Criteria: preexisting infection. Surgical Site Infection: For 30 days after operation, the infection control team graded the wound according to CDC guideline. Endpoints: The primary endpoint is the incidence of SSI, and the secondary endpoint is the incidence of distant site infection. [Results] A total of 56 patients have been registered between November 2002 and April 2003. A deep incisional SSI, an organ SSI and urinary tract infection were observed in one, two and one patients, respectively. The SSI rate was 5.4% (3/56). Before this series, the incidence of SSI following 3 days of postoperative antibiotics was 4.8% (3/62). There is no difference between the two groups (p=0.05). [Conclusion] A preoperative low dose antibiotics was feasible and showed the same SSI rate as postoperative high dose antibiotics. A phase III study is necessary to confirm a low incidence of SSI of preoperative antibiotics administration in comparison with that of postoperative antibiotics in Japan. No significant financial relationships to disclose.
Folding of Secretory and Membrane Proteins
Authors: Galina Kuznetsov, Sanjay K. Nigam
Journal: New England Journal of Medicine (1998)

Genetic errors may result in abnormal synthesis of proteins, abnormal folding and processing of proteins after they are synthesized, or changes in the functional properties of proteins. Although the synthesis of proteins begins in the cytoplasm, many are destined to be expressed on the cell surface (e.g., surface-recognition molecules, ion channels, receptors, and adhesion molecules) or secreted (e.g., hormones, growth factors, extracellular matrix proteins, and proteolytic enzymes). Newly synthesized membrane and secretory proteins are transported into the endoplasmic reticulum, the internal membranous network of the cell, in a largely unfolded state. When they leave the endoplasmic reticulum to move through . . .
Olympia, Neo-Olympia and Olympiad: Randomized Phase III Trials of Olaparib in Patients (Pts) with Breast Cancer (Bc) and a Germline Brca1/2 Mutation (Gbrcam)
Authors: A. Tutt, J. Balmana, M. Robson, J. Garber, B. Kaufman, C. Geyer, K. Saini, M. Stuart, H. Mann, P.A. Fasching
Journal: Annals of Oncology (2014)