tbuckley/cabot-search huggingface dataset:
Hereditary diffuse gastric cancer in the developing world: A Jordanian family.
Authors: I. Aldoss, W. Petro, J. F. Lynch, D. Huntsman, H. T. Lynch
Journal: Journal of Clinical Oncology (2010)

e12021 Background: Of the world population of 6.7 billion, 5.5 billion (82%) live in developing countries (Population Reference Bureau, 2008), where there is low ability to diagnose hereditary cancer syndromes and provide genetic counseling. In some developing countries, clinical translation of genetic knowledge may be markedly curtailed by cultural and religious beliefs, and by lack of funds. For example, in Jordan, it is believed that cancer is a fatalistic disease and cannot be modified, and that thinking about cancer can cause it. Thus, not to think about it is safer than screening for it. Consanguinity is also high. Methods: A healthcare professional in Amman, Jordan, who recognized the significance of multiple gastric cancer deaths in 3 generations of her family, contacted us at the Creighton Hereditary Cancer Center. We collected detailed genealogy, medical, and pathology information on her family. Our pathologist/molecular genetic colleague (DH) then tested 2 gastric cancer clinically affecteds and 2 asymptomatic relatives, all 4 of whom were CDH1 mutation positive. An experienced cancer genetic clinician, a senior medical resident fluent in Arabic, and a nurse from our Creighton team visited Amman, where we offered a family information service, which was attended by 40 members of the family. Attendees were educated about the CDH1 mutation's significance with its 70%-80% penetrance, HDGC's natural history, its inadequate screening, and the potential benefit of prophylactic total gastrectomy in mutation carriers. Saliva for DNA was collected from at-risk consenting family members. Results: CDH1 mutations have been identified in 4 of 11 additional family members tested to date, for a total of 8 mutation positives among the 15 tested; 3 additional samples are being tested. Conclusions: Creighton volunteers, at moderate expense, helped this family with diffuse gastric cancer by successfully diagnosing HDGC clinically and through CDH1 mutation identification, even though their country has limited funds and lacks up-to-date clinical genetic services. Mutation carriers will be provided further genetic counseling regarding the option of prophylactic gastrectomy. Cancer genetic services should be extended to the developing world. No significant financial relationships to disclose.
Phase II study of temozolomide and thalidomide in patients with unresectable or metastatic leiomyosarcoma
Authors: M. Boyar, M. L. Keohan, M. Hesdorffer, R. Taub
Journal: Journal of Clinical Oncology (2005)

9029 Background: Our previous phase II study of temozolomide in sarcoma suggested temozolomide has modest activity in patients with leiomyosarcoma (Cancer 2003;9:1942). The combination of temozolomide and the anti-angiogenic agent thalidomide is reported to show promising activity in other tumors. The objective of this study was to assess the efficacy of temozolomide and thalidomide in leiomyosarcoma patients with unresectable or metastatic disease. Methods: Patients with histologically-confirmed advanced-stage leiomyosarcoma were enrolled on this single-institution Phase II trial. Prior systemic chemotherapy (0–3 regimens) was allowed. Temozolomide (150mg/m2/day for 7 days every other week) was administered with concomitant thalidomide (200mg/day). Treatment was continued until unacceptable toxicity or disease progression occurred. Results: Twenty-three eligible patients (median age 60) were enrolled. Nineteen (83%) had received prior systemic chemotherapy. There was one partial response (PR), no complete responses and 5 patients had stable disease (SD) that lasted for more than 4 months. The average time to progression for the PR and SD patients was 9.3 months. One patient had a PR lasting 23 months. The median time to progression for non-responders was 6 weeks. Ten of 21 patients required dose reduction or discontinuation of thalidomide, including 4 of the 6 patients with either PR or SD. There were no treatment related deaths or National Cancer Institute Grade 4 toxicities. Grade 3 toxicities included neutropenia, anemia, emesis, fatigue (4% each), pain (10%), and neurologic toxicity (13%). Conclusion: This combination of temozolomide and thalidomide provided disease stabilization in a subset of patients with metastatic leiomyosarcoma. In this study, thalidomide was poorly tolerated and may have contributed to the toxicity of the regimen. We hypothesize that temozolomide is the active agent in this regimen. Further studies of temozolomide as first or second-line treatment in advanced leiomyosarcoma are warranted. No significant financial relationships to disclose.
The Mechanism of Hypoproteinemia Associated with Giant Hypertrophy of the Gastric Mucosa
Authors: Yale Citrin, Kenneth Sterling, James A. Halsted
Journal: New England Journal of Medicine (1957)

GIANT hypertrophy of the gastric mucosa has been known under many synonyms, which include Menetrier's disease, polyadénome en nappe, polyadénome polypeux, giant hypertrophic gastritis, tumor-simulating gastritis and giant hypertrophy of the gastric rugae. It is a relatively uncommon lesion of the stomach. Hypoproteinemia has been described in some cases of this disease. In the present report, the mechanism of hypoproteinemia in a patient was investigated with I131-labeled albumin. This patient was subsequently examined at autopsy.Review of the LiteratureThe clinical aspects of giant hypertrophy of the gastric mucosa are described in several recent studies.1 2 3 4 In reviewing 47 cases . . .
Shock and Multiple-Organ Dysfunction after Self-Administration of Salmonella Endotoxin
Authors: Angelo M. Taveira da Silva, Helen C. Kaulbach, Francis S. Chuidian, David R. Lambert, Anthony F. Suffredini, Robert L. Danner
Journal: New England Journal of Medicine (1993)

Endotoxin, a lipopolysaccharide component of the outer membrane of gram-negative bacteria, is involved in the pathogenesis of septic shock, but it is unclear whether endotoxin alone is capable of causing all the manifestations of the septic shock syndrome. In animals, endotoxin causes many of the clinical features1 but produces a low-cardiac-output form of shock that is unlike the hyperdynamic cardiovascular profile of septic shock in humans2,3. In humans, the administration of endotoxin (4 ng per kilogram of body weight) triggers the release of cytokines,4 activates the coagulation and fibrinolytic systems,5,6 and causes a decrease in systemic vascular . . .
The community meeting: a comparative study
Authors: R S Rubin
Journal: American Journal of Psychiatry (1979)

In this study of two identical open wards, the author found that in ward 1's highly structured meetings a higher proportion of patients participated, and they distributed their participation in more direct proportion to the relative numbers of each present than in the open meetings on ward 2, where patients directed their participation disproportionately to staff. Staff on both wards disproportionately directed their participation to patients, but less so in the structured meetings. The implications of these observations are discussed in terms of the executive ego deficits of the patients involved and their need for structure in the external milieu in order to compensate for these deficits.
Case 27-1996
Authors: Ashby C. Moncure, G. Petur Nielsen
Journal: New England Journal of Medicine (1996)

Presentation of CaseA 31-year-old woman was admitted to the hospital because of pain in the left lumbar region and the left lower quadrant of the abdomen.The patient had been well until 19 months before admission, when increasing pain developed in the left lower abdominal quadrant, with fever. Examination at this hospital showed that the blood pressure was 130/80 mm Hg. An ultrasonographic examination of the pelvis revealed bilateral complex ovarian cysts with fluid in the cul-de-sac. Cefotetan, doxycycline, and gentamicin were administered intravenously. A laparoscopic examination showed torsion of the left fallopian tube and most of the left . . .
Chronic Intravascular Coagulation Syndrome
Authors: Michael W. Mosesson, Robert W. Colman, Sol Sherry
Journal: New England Journal of Medicine (1968)

In a patient with a chronic intravascular coagulation syndrome characterized by depletion of fibrinogen and platelets, participation of other clotting factors or secondary fibrinolysis were not demonstrable. Heparin was effective in controlling the syndrome, which was evident 10 months before discovery of a primary ovarian carcinoma. Warfarin did not prevent thrombotic complications. A plasma cryoprecipitate ("cryofibrinogen") was constantly present. Physicochemical studies demonstrated, in addition to fibrinogen, a β1 globulin amounting to approximately 50 per cent of the total protein. The β1 globulin, presumably an "incomplete cryoglobulin," formed a reversible, cold-precipitable complex with the fibrinogen and was immunochemically related to a normal serum protein. The reason for the association of the cryoprecipitate with the intravascular coagulation process was not determined, but its presence helped to establish the diagnosis and reflected the intensity of intravascular coagulation during heparin and other therapy.
Pyridoxine-Deficiency Neuropathy Due to Hydralazine
Authors: Neil H. Raskin, Robert A. Fishman
Journal: New England Journal of Medicine (1965)

PARESTHESIA has been noted in 81 to 152 per cent of patients receiving the antihypertensive drug hydralazine (Apresoline); these symptoms of neuropathy persist and become more bothersome if the dose is not reduced. The possible role of pyridoxine (vitamin B6) deficiency in the pathogenesis of this problem is suggested by the fact that the hydrazine (—NHNH2) group in the structure of the drug (Fig. 1) relates hydralazine to a family of compounds, the hydrazines and hydrazides (—CONHNH2), that have been shown to produce pyridoxine-responsive convulsions in laboratory animals3; one hydrazide, isoniazid (Fig. 1), . . .
Subaortic Obstruction after Sildenafil in a Patient with Hypertrophic Cardiomyopathy
Authors: Jean-Christophe Stauffer, Vincent Ruiz, Jean-Daniel Morard
Journal: New England Journal of Medicine (1999)

To the Editor: Recently, the American College of Cardiology and the American Heart Association released an expert consensus document on the use of sildenafil (Viagra) in patients with cardiovascula...
Origin of Elevated Serum Enzyme Activities after Direct-Current Countershock
Authors: Aarne Konttinen, Veikko Hupli, Antti Louhija, Gottfried Härtel
Journal: New England Journal of Medicine (1969)

Abstract Serum creatine kinase (CPK) activity was abnormally elevated on eight of 37 occasions in patients treated with direct-current electroshock. Serum total LDH rose on five and GOT on three occasions. The myocardium was excluded as the enzyme-releasing tissue, since the serum LDH1 isoenzyme decreased after the shock whereas the LDH5 isoenzyme increased in all the cases in which serum CPK activity was elevated. Liver damage was excluded on the basis of normal serum ornithine carbamoyltransferase, γ-glutamyltranspeptidase, alanine aminotransferase and guanase determinations. Measurement of LDH3 and LDH2 isoenzymes did not indicate injury of lung parenchyma. Thus, skeletal muscles appear to be the origin of the enzyme elevations after electroconversion.
Case 40-1992
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, P.F. Weller, G.R. Dickersin
Journal: New England Journal of Medicine (1992)

Case Records of the Massachusetts General Hospital from The New England Journal of Medicine — Case 40-1992 — A 43-Year-Old Cambodian Man with Several Years of Recurrent Bouts of Fever and Abdominal Pain
Legalized Physician-Assisted Suicide in Oregon, 1998–2000
Authors: Amy D. Sullivan, Katrina Hedberg, David Hopkins
Journal: New England Journal of Medicine (2001)

To the Editor: In 1997, Oregon legalized physician-assisted suicide.1 In a follow-up to our previous reports,2,3 we assessed whether the numbers and characteristics of patients who died after the ingestion of legally prescribed lethal medications in 2000 differed from those of patients who did so in 1998 and 1999.4 Patients who chose physician-assisted suicide were identified through required physician reporting of legally prescribed lethal medications. Data were obtained from these reports, interviews with physicians, and death certificates. We also compared patients who chose physician-assisted suicide in 2000 with a cohort assembled from 1999 death certificates of state residents who . . .
Anaerobic Infection of the Paranasal Sinuses
Authors: Joseph Frederick, Abraham I. Braude
Journal: New England Journal of Medicine (1974)

Abstract Heavy growth of anaerobic bacteria in pure culture was obtained from 23 of 83 specimens aseptically removed from chronically infected paranasal sinuses during external frontoethmodectomy or radical antrotomy via the canine fossa. Since these procedures avoid nasal contamination, the data indicate that anaerobic bacteria are an important cause of chronic sinusitis. (N Engl J Med 290:135–137, 1974)
Abstract OT1-03-02: Evaluation of the use of oral care to prevent oral mucositis in estrogen receptor positive metastatic breast cancer patients treated with everolimus: Phase III randomized control trial
Authors: N Niikura, Y Ohta, N Hayashi, M Naito, K Kashiwabara, K Watanabe, T Yamashita, H Mukai, M Umeda
Journal: Cancer Research (2016)

Abstract Background: In patients with estrogen receptor (ER)-positive advanced breast cancer, everolimus plus exemestane prolongs progression-free survival compared to exemestane monotherapy. However, as an adverse event from everolimus, oral mucositis (all grades) has been reported in 58% of all patients and 81% of Asian patients. Although no established prevention method is available, a previous study reported that professional oral care might prevent oral mucositis, and dentists have hypothesized that such care can reduce the occurrence of oral mucositis induced by everolimus. To evaluate this hypothesis, we compare the incidence of oral mucositis with and without professional oral care. Method: This is a randomized, multi-center, open-label, phase III study to evaluate the efficacy of professional oral care in preventing oral mucositis induced by everolimus in postmenopausal ER-positive metastatic breast cancer (MBC). Patients will be randomized into professional oral care and control groups (1:1 ratio). All patients will receive everolimus (10 mg daily) with exemestane (25 mg daily) and will continue everolimus until disease progression. Before the initiation of everolimus, instruction on a professional brushing method will be provided to both groups by specialists. In the professional oral care group, patients will receive teeth surface cleaning, scaling, and tongue cleaning before starting everolimus, and will continue to receive professional oral care weekly from oral surgeons throughout the 8 week treatment. In the control group, patients will brush their own teeth and gargle with 0.9% sodium chloride solution or water. The primary endpoint is the incidence of all grades of oral mucositis. The secondary endpoints are the incidence of over grade 2 and over 3 oral mucositis as determined by an oncologist and oral surgeons. The endpoints include onset and duration of oral mucositis. Major eligibility criteria include: 1) Postmenopausal women with ER positive MBC, and 2) No more than one prior chemotherapy treatment for MBC. Target accrual is 200 patients with a two-sided type I error rate of 5% and 80% power to detect 25% risk reduction. This study has just begun, and 5 of a planned 200 patients have been enrolled. (This study was registered with the UMIN 000016109). Citation Format: Niikura N, Ohta Y, Hayashi N, Naito M, Kashiwabara K, Watanabe K, Yamashita T, Mukai H, Umeda M. Evaluation of the use of oral care to prevent oral mucositis in estrogen receptor positive metastatic breast cancer patients treated with everolimus: Phase III randomized control trial. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr OT1-03-02.
Blood Ammonia Levels in Advanced Cirrhosis during Therapeutic Elevation of the Insulin:glucagon Ratio
Authors: Charles Walker, Walter Peterson, Roger Unger
Journal: New England Journal of Medicine (1974)

Plasma insulin, glucagon and blood ammonia were measured at frequent intervals in four separate nine-hour studies in five patients with advanced cirrhosis who had consistent basal hyperammonemia while on a diet containing 40 to 60 g of protein. In two of the four studies the diet was supplemented hourly with 20 g of glucose orally. Without supplementation mean blood ammonia rose 20 μg per 100 ml, insulin averaged >50 μU per milliliter, and glucagon averaged >160 pg per milliliter. Mean molar insulin:glucagon ratio rose to a peak of 12.3 but was usually below 5. With glucose supplementation, mean insulin rose to 201 μU per milliliter, glucagon fell below basal values, and the insulin: glucagon ratio rose to a peak of 39.2, significantly above the control at all points. In this hormonal setting, blood ammonia did not rise, but declined slightly, a difference that was significant at all six points of comparison after the first hour of the experiment. The improved protein tolerance could reflect reduced ammonia generation from hepatic ureagenesis and from amino acids secondary to the increased mean molar insulin: glucagon ratio. (N Engl J Med 291:168–171, 1974)
Effect of Treatment on the Evolution of Renal Abnormalities in Lupus Nephritis
Authors: James E. Balow, Howard A. Austin, Larry R. Muenz, Kathleen M. Joyce, Tatiana T. Antonovych, John H. Klippel, Alfred D. Steinberg, Paul H. Plotz, John L. Decker
Journal: New England Journal of Medicine (1984)

We retrospectively studied the evolution of histopathologic features in successive renal biopsies in patients with lupus nephritis, to evaluate the effects of various treatment regimens. Repeat renal biopsies had been performed in 62 patients after more than 18 months of observation (median interval, 44 months) in randomized therapeutic trials comparing prednisone with cytotoxic drugs. Renal histopathologic features were graded individually, and a composite score reflecting the number and severity of irreversible lesions was defined as a chronicity index. The chronicity index for patients treated with conventional high-dose prednisone increased linearly with the interval between biopsies, whereas the index in the group receiving cytotoxic-drug treatments did not increase over time. After statistical adjustment for important prognostic factors (age and initial chronicity index) identified by multiple linear regression, the difference in the slopes between the group receiving prednisone and the group receiving cytotoxic drugs was significant (P<0.0001). We conclude that cytotoxic-drug treatment reduces the likelihood of progressive renal scarring in lupus nephritis. (N Engl J Med 1984; 311:491–5.)
Ki67 and PIM1 expression in aggressively treated mantle cell lymphoma (MCL): A Cancer and Leukemia Group B (CALGB) 59909 correlative science study
Authors: E. Hsi, S. Jung, R. Lai, J. Johnson, J. Cook, D. Jones, S. DeVos, B. D. Cheson, L. E. Damon, J. Said
Journal: Journal of Clinical Oncology (2008)

8560 Background: Gene expression profiling has suggested that the proliferation signature is an important predictor of outcome in MCL. Retrospective studies have suggested that the proliferative index, measured by mitoses or Ki67, is an important prognostic indicator. This has not been validated in a US cooperative group setting or in the context of aggressive therapy. We assessed Ki67 and PIM1 (a cell cycle-related gene upregulated in blastoid MCL) expression in a prospective phase 2 cooperative group study. Methods: CALGB 59909 examined the efficacy of aggressive chemotherapy followed by autologous stem cell transplantation (ASCT) in untreated MCL patients less than 70 years of age. Cases with available material were studied for Ki67 and PIM1 expression by immunohistochemistry. Ki67 was quantitated by image analysis (IA Ki67) and manually as # positive cells/1000x hpf (Ki67-count). PIM1 staining was scored semi-quantitatively (0–3+). Progression-free survival (PFS) and disease-free survival (DFS) were the clinical endpoints. 52 cases had evaluable IA Ki67 data, 49 cases had Ki67-count data, and 50 had data for PIM1. All patients received ASCT. The IA cases form the basis for this study. Results: For the 52 IA Ki67 cases, the median age was 56 (range 37–68 yrs.) and male:female ratio was 3.7. The median IA Ki67 was 27.7% (0.01–84.0). Ki67-count correlated with IA Ki67 (R=0.79, P<.0001). As a continuous variable, IA Ki67 was associated with shorter PFS (P=.013) and DFS (P=.007). PIM1 was expressed in 72% of cases. PIM1 greater than 1+ was marginally associated with PFS (P=.033) and DFS (P=.043). Bivariate Cox models showed IA Ki67 and PIM1 to be independent of clinical factors such as age, stage and international prognostic index. Conclusions: CALGB 59909 met its primary endpoint, suggesting ASCT may be a reasonable first-line treatment in MCL. In this prospective, aggressively treated study group, proliferation remained a prognostic factor. PIM1 expression may also predict poor outcome. These data support routine measurement of Ki67 as a practical marker for risk stratification in MCL, and provide rationale for study of PIM1 in MCL. No significant financial relationships to disclose.
Abstract P291: Adipocytokines, Lipoproteins &amp; Obesity Among Black &amp; White Postmenopausal Women from the Women’s Health Initiative
Authors: Rachel H Mackey, Kathleen M McTigue, Emma Barinas-Mitchell, Rhobert W Evans, Lesley F Tinker, JoAnn E Manson, Simin Liu, Barbara V Howard, Jennifer G Robinson, Marcia L Stefanick, Lawrence S Phillips, Matthew A Allison, Milagros C Rosal, Shirley Beresford, Lewis H Kuller
Journal: Circulation (2013)

Background: Despite the prevalence of severe obesity, particularly among women and African-American women, there is little data on CV risk factor differences across the BMI spectrum including extreme obesity. Methods: Participants were 1200 black and white postmenopausal women sampled from the Women’s Health Initiative Observational Study according to BMI categories and waist circumference tertiles: 300 black and 300 white women with BMI 40-65 kg/m 2 and 75 black and 75 white women in BMI categories 8.5-&lt;25, 25-&lt;30, 30-&lt;35 and 35-&lt;40 kg/m 2 . Using stored baseline serum, total and high molecular-weight (HMW) adiponectin, leptin, ghrelin and insulin were measured by immunoassay; plasma lipoproteins and subclasses were measured by NMR spectroscopy. Race-ethnicity differences were tested in linear regression models adjusted for age, diabetes, BMI, waist, hip, hormone therapy and lipid-lowering medication. Results: Compared with white women, black women had lower levels of total and HMW adiponectin and ghrelin, and higher levels of insulin and leptin. Despite similar levels of total LDL particles (LDL-P), black women had lower levels of small LDL-P and higher levels of large LDL-P and larger mean LDL size. Levels of large HDL particles (HDL-P) and small HDL-P were also similar for black and white women, but black women had lower levels of total and medium HDL-P and larger mean HDL particle size. Black women also had lower levels of total, large, medium and small VLDL particles (VLDL-P) which increased little across BMI category, such that mean levels of total or large VLDL-P among black women with BMI≥ 40 kg/m 2 were lower than white women of normal BMI (&lt;25 kg/m 2 ) (Figure). Among white, but not black women, total LDL-P was higher and total HDL-P was lower with higher BMI category (Figure). Conclusions: Among postmenopausal women of similar BMI and waist circumference, black women have lower levels of ghrelin and total and HMW adiponectin, but better lipoprotein levels that are less related to obesity compared with white women.