tbuckley/cabot-search huggingface dataset:
Differentiation of Hyperparathyroidism and the Milk-Alkali (Burnett) Syndrome
Authors: Laurence H. Kyle
Journal: New England Journal of Medicine (1954)

THE most recent addition to the list of hypercalcemic disorders that may stimulate hyperparathyroidism is the syndrome of excessive intake of milk and absorbable alkali. This interesting condition, first clearly delineated by Burnett and his associates1 in 1949, is characterized especially by hypercalcemia without hypercalciuria, although several other features aid in its identification. In the five years since the original report 10 additional cases have been described, and the nature of the findings in these patients has substantiated the specific identity of the syndrome.2 3 4 5 6 7 Recently, Carpenter and Pautler8 described a patient who demonstrated most of the features outlined by Burnett . . .
Systemic<i>Candida tropicalis</i>Infection Treated with Amphotericin
Authors: David B. Shurtleff, Wilbur Peterson, John C. Sherris
Journal: New England Journal of Medicine (1963)

THIS report describes the clinical course and laboratory studies of a case of systemic Candida tropicalis infection successfully treated with amphotericin.Case ReportAn 18-month-old girl contracted proved Haemophilus influenzae meningitis, which responded to treatment with chloramphenicol, tetracycline, penicillin and streptomycin. The convalescent course was satisfactory until the 6th day, when shock developed, responding to intravenous infusion of fluids, epinephrine and steroids. Yeast was identified in the urine, and nystatin (Mycostatin) was initiated by mouth. On the 8th day malaise, vomiting and fever developed. No subdural-fluid collection was detected, and cerebrospinal-fluid examinations on the 5th and 7th days showed decreasing . . .
Adjuvant mitotane therapy for adreno-cortical carcinoma
Authors: A. Berruti, P. Sperone, F. Daffara, R. Rossetto, P. Loli, B. Ambrosi, A. Angeli, M. Mannelli, F. Mantero, L. Dogliotti
Journal: Journal of Clinical Oncology (2005)

4570 Surgery is the mainstay of therapy for adrenocortical carcinoma (ACC) but the majority of patients undergoing radical resection are destined to relapse. The role of adjuvant mitotane is controversial. This is a retrospective study on 102 patients consecutively recruited in 8 referral Italian institutions (7 endocrinological and 1 oncological) between 1985 and 2003. All patients had undergone radical surgery. Forty-seven were treated with adjuvant mitotane. Fifty-five patients underwent radical surgery only and served as control group. According to the Mc Farlane Sullivan system, 3 patients (6.4%) in the adjuvant group had stage I, 22 (46.8%) stage II, 11 (23.4%) stage III and 11 (23.4%) stage IV of disease; the corresponding figures in the control group were: 4 (7.3%) stage I, 32 (58.2%) stage II, 14 (25.4%) stage III and 5 (9.1%) stage IV, respectively. Adjuvant mitotane (Lysodren, Bristol Myers) was administered at low dose (1–3 g/daily) in 27 patients and high dose (3–5 g/daily) in the remaining 20. The median duration of treatment was 29 months (range, 3–162 months). Neurological WHO grade III toxicity was observed in 4/20 patients on high-dose regimen and 0/27 patients on low-dose regimen. Gastroenterological WHO grade III toxicity was observed in 3/20 patients on high-dose regimen and 0/27 patients on low-dose regimen. Twenty-four out of 47 (51.0%) patients in the adjuvant group and 50 of 55 (90.0%) in the control group have relapsed, 12 (25.0%) and 30 (54.0%) died. Median disease free survival (range) was 30 months (4–164+) in adjuvant patients and 10 months (1–109) in control patients (p=0.0001); the corresponding median survival (range) was 47 months (6–164+) and 39 months (3–161), respectively (p=0.01). This relative large non randomized comparison of patients followed in the same time period suggests that mitotane is effective as adjuvant treatment in adrenocortical cancer patients. Mitotane could be safely administered for many months with manageable toxicity. Low dose mitotane is better tolerated than high dose. No significant financial relationships to disclose.
Case 38-2006
Authors: Verne S. Caviness, Pallavi Sagar, Esther J. Israel, Bonnie T. Mackool, Eric F. Grabowski, Matthew P. Frosch
Journal: New England Journal of Medicine (2006)

A 5-year-old boy was admitted to the hospital because of headaches, abdominal pain, increasing abdominal girth, and a rash. Five months earlier, intermittent severe headaches and abdominal pain had developed, and papilledema was found. MRI disclosed bilateral subdural hygromas, which required placement of a subdural–peritoneal shunt, at which time ascites was noted. Headaches, abdominal pain, and ascites gradually worsened, and a rash developed. Diagnostic procedures were performed.
Etoposide and cisplatin adjuvant therapy for patients with pathologic stage II germ cell tumors.
Authors: R J Motzer, J Sheinfeld, M Mazumdar, D F Bajorin, G J Bosl, H Herr, P Lyn, V Vlamis
Journal: Journal of Clinical Oncology (1995)

PURPOSE Two options cure nearly all patients with pathologic stage II nonseminomatous germ cell tumors (NSGCTs): two cycles of adjuvant chemotherapy with cisplatin, vinblastine, and bleomycin (PVB) or cisplatin, vinblastine, bleomycin, cyclophosphamide, and dactinomycin (VAB-6); or close observation with full treatment at relapse. Two cycles of etoposide plus cisplatin (EP) were given to selected patients with pathologic stage II NSGCT and high-volume nodal metastases. PATIENTS AND METHODS All patients had pathologic stage II NSGCT with one or more of the following features found at retroperitoneal lymph node dissection (RPLND), suggesting a greater than 50% likelihood of relapse after observation alone: (1) any lymph node involved by tumor greater than 2 cm (stage N2b); (2) &gt; or = six nodes involved with tumor (stage N2b); and (3) extranodal extension (stage N3). Two cycles of therapy were given at 21-day intervals; each cycle consisted of etoposide 100 mg/m2 plus cisplatin 20 mg/m2 per day given on days 1 to 5. RESULTS Fifty patients were treated with two cycles of EP. Treatment was well tolerated; five patients (10%) were admitted for nadir fever and none had grade II or greater neurologic, renal, or pulmonary toxicity. All 50 patients are alive and relapse-free at a median follow-up time of 35 months (range, 12 to 72). The follow-up duration has been &gt; or = 2 years for 42 patients. CONCLUSION A treatment program that consists of two cycles of EP is effective in preventing relapses in patients with completely resected pathologic stage N2b and N3 NSGCT. The likelihood of relapse without adjuvant cisplatin-containing chemotherapy in this group has been shown to be greater than 50%. As has been demonstrated in patients with disseminated germ cell tumor (GCT), EP can be considered a therapeutic option in the adjuvant setting for completely resected N2b and N3 NSGCT.
Inhibition of DNA Synthesis by 1,2-Dimethylhydrazine and Methylazoxymethanol Acetate in Rabbit Colon Mucosa in Organ Culture&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: K. M. Mak
 5, W. W. Chang
Journal: JNCI Journal of the National Cancer Institute (1978)

When maintained in organ culture, colon mucosa from male New Zealand White rabbits showed a near-normal mucosal morphology and linear incorporation of [3H]thymidine into mucosal DNA up to 36 hours of incubation. Explants from the descending colon had a higher DNA synthetic activity than did other segments of the large bowel. Inhibition of DNA synthesis in colon explants by 1,2-dimethylhydrazine (DMH) and methylazoxymethanol (MAM) acetate was dose-dependent. When DNA synthesis was determined after an 18-hour incubation, MAM acetate inhibited DNA synthesis at concentrations of 50, 100, 150, and 200 μg/ml. With the same concentrations of DMH, little or no inhibition was observed. At the concentration of 200 μg/ml, both carcinogens significantly inhibited DNA synthesis after 3 and 6 hours of incubation. With longer incubation, the inhibitory effect of DMH appeared to be reversible, whereas DNA synthesis was continuously inhibited by MAM acetate up to 18 hours of incubation. No altered uptake of [3H]thymidine by colon explants incubated in the presence of DMH or MAM acetate for 18 hours was observed. No morphologic changes were seen in colon explants treated with 200 μg MAM acetate/ml for 18 hours. Physostigmine sulfate had no influence on MAM acetate-induced inhibition of DNA synthesis in colon explants. These in vitro observations reflected a direct action of DMH and MAM acetate on the colon mucosa and supported the possibility that colon epithelial cells contain enzymes capable of activating DMH and MAM acetate to their alkylating carcinogens.
Retroperitoneal Hemorrhage Complicating Pregnancy
Authors: Cornelius T. O'Connor, Joseph J. Bradley
Journal: New England Journal of Medicine (1946)

IN 1918 Potocki1 reported a case of retroperitoneal hemorrhage complicating pregnancy in which the patient, two and a half months' pregnant, experienced pain in the lower abdomen after intercourse. The pain extended gradually to the left side, with some degree of shock. Shortly after admission to the hospital the pain became severer and the shock deeper. The diagnosis was ruptured tubal pregnancy or pregnancy with an ovarian cyst with a twisted pedicle. Laparotomy performed immediately revealed an extensive retroperitoneal hemorrhage that did not involve the true pelvis but filled the mesocolon and the retroperitoneal areas in the region of the . . .
Hypokalemic Myopathy Induced by Giardia lamblia
Authors: A Cervelló, A Alfaro, M J Chumillas
Journal: New England Journal of Medicine (1994)

To the Editor: Giardiasis is the leading cause of waterborne outbreaks of diarrhea in the United States,1 yet its role as a potential cause of malabsorption in elderly patients may be underestimate...
The Epidemic of Cardiovascular Disease in Eastern Europe
Authors: Emil Ginter
Journal: New England Journal of Medicine (1997)

To the Editor: The failure of the study by Adkinson et al. (Jan.30 issue) 1 to demonstrate a significant benefit of immunotherapy with a few allergens to a particular group of children with asthma does not negate the positive benefit demonstrated in numerous other studies.The meta-analysis by Abramson et al. 2 suggests that 33 negative studies would be necessary to overturn the results that demonstrated significant odds of symptomatic improvement, decreased medication use, reduction in bronchial hyperreactivity, and improvement in forced expiratory volume in one second with immunotherapy.Some of the patients may have been sensitive to allergens not included in treatment (or presumably in testing).These might include cockroach, other molds, and other tree and fall-weed pollens.Most allergist-immunologists are familiar with the wide variety of pollens at different seasons in their areas, and they test and treat with all the major pollens that have positive results on skin-prick testing.They would not expect improvement if they treated with only one type of allergen for the season.Adkinson et al. chose to limit the number of allergens in order to reach very high doses and perhaps threw out the baby with the bath water.The authors themselves suggest caution in interpreting their results.The patients received maintenance treatment with free medications with close follow-up, and any participating children who did not comply were dropped from the study.I concur that allergy shots may be more useful in patients in the real world who tend to have lower levels of compliance with pharmacotherapy.
The big toe
Authors: Don Sarll
Journal: BMJ (2004)

Background/Aim: Pancreatic cancer (PC) is currently the fourth leading cause of cancer-related mortality worldwide. Peripheral blood mononuclear cells (PBMCs) is a subpopulation of accessible and functional immune cells. Comparative analysis of the proteome of PBMCs can help us elucidate the mechanism of disease and find potential biomarkers for diagnosis. Materials and Methods: PBMCs were collected from healthy individuals, patients with benign diseases, and pancreatic cancer. iTRAQ-2DLC-MS/MS and SWATH methodologies were applied to make a comparative proteomics analysis of PBMCs. Results: A total of 3,357 proteins with a false discovery rate (FDR) &lt;1% were identified, of which 114 proteins were found dysregulated in the PC group. An extensive SWATH library was constructed which showed a potential application for large scale clinical sample analysis. Conclusion: A PBMCs proteome with extensive protein representation was achieved, which will potentially allow the identification of novel biomarkers for PC.
S41 Interstitial Lung Disease MDT presentations post VATS lung biopsy changes the original histological diagnosis in 30%
Authors: GA Burge, L Okiror, S Trotter, G Langman, S Payyappilly, P Naidoo, J Reynolds, M Djearman, S Hussain, E Hoey, R Steyn, P Rajesh, E Bishay, B Naidu, M Kalkat, D Petkova, S Ghani, PS Burge
Journal: Thorax (2015)

<h3>Introduction</h3> NICE recommends MDT presentation of all patients with suspected ILD. Any benefit of representation post VATS biopsy is unknown. <h3>Methods</h3> Our hospital (BHH) provides a regional service for thoracic surgery. All VATS lung biopsies for interstitial lung diseases carried out in 2013 were identified. They were presented post surgery at the ILD MDT where their history, physiology, immunology, original CTs and pathology were reviewed by a fully constituted MDT team including ILD specialist histopathologists, radiologists, clinicians and CNS’. The MDT diagnosis was compared with the original specialist pulmonary histopathology report. <h3>Results</h3> 71 patients had qualifying VATS biopsies in 2013. In 21 patients (30%) the MDT diagnosis differed significantly from the original histology report. In a further 12 patients the MDT altered a probable to a definite diagnosis. In 3 patients the MDT reduced the confidence of the histological diagnosis. Hypersensitivity pneumonitis was diagnosed much more confidently by the MDT than the histologist alone. The interpretation of necrotising granuloma was a particular problem from the histology alone; the MDT confirming diagnoses of rheumatoid lung, sarcoidosis or no ILD. It was also possible to achieve specific diagnoses in 5 patients whose biopsies were reported as non-specific fibrosis; NSIP (2), UIP (2), HP (1), and in 2 in whom the original report was resolving pneumonia (both HP). In 10/21 patients there was sufficient evidence to classify the UIP as IPF (7), collagen vascular disease UIP (1), chronic HP UIP (1), and drug induced UIP (1). There was often insufficient exposure and immunological data for the MDT to further characterise UIP and NSIP. <h3>Conclusions</h3> The post biopsy MDT changed the diagnosis in 30% compared with the histology report alone. An ILD MDT review with the combination of radiology and pathology and an expert team provided significant extra benefit in terms of a precise diagnosis in patients biopsied with interstitial lung disease in whom the referring physician thought that a diagnosis was not possible without a biopsy. This is not surprising as the histologist is limited by sampling, the radiologist by resolution, and both by the lack of physiology, exposure history and immunology.
Serum Lipids in Infection
Authors: John I. Gallin, Donald Kaye, William M. O'Leary
Journal: New England Journal of Medicine (1969)

Abstract Striking elevations in concentrations of total serum lipids were observed in patients with infection caused by gram-negative bacilli. The elevated levels of total lipid in these patients were due mainly to marked increases in serum concentrations of triglycerides or free fatty acids or both. In contrast, patients with severe infection caused by gram-positive cocci had normal concentrations of total serum lipids. Those with fever but no infection and those with influenza had normal concentrations of total serum lipids and normal levels of the major lipid classes. Patients with infectious or serum hepatitis demonstrated a moderate hyperlipidemia, which resulted from increased concentrations of serum triglycerides and free cholesterol. Lipoprotein electrophoresis demonstrated that the hyperlipidemia in patients with severe infection caused by gram-negative bacilli was related to increased levels of pre-beta-lipoproteins. In patients with hepatitis there were increased levels of pre-beta-lipoproteins...
Exposure-response of sunitinib in metastatic renal cell carcinoma (mRCC): A population pharmacokinetic/pharmacodynamic (PKPD) approach
Authors: B. E. Houk, C. L. Bello, M. D. Michaelson, R. M. Bukowski, B. G. Redman, G. R. Hudes, G. Wilding, R. J. Motzer
Journal: Journal of Clinical Oncology (2007)

5027 Background: Sunitinib malate (SU) is an oral, multitargeted tyrosine kinase inhibitor of VEGFRs and PDGFRs, and has shown substantial antitumor activity in mRCC (Motzer et al, JAMA 2006 and ASCO 2006). This analysis describes SU, and total drug (TD; SU+SU12662 [active metabolite]) exposure-response relationships in mRCC using a population PKPD approach. Methods: PK and efficacy data from 3 studies (phase II and III) of SU (25–62.5 mg/day; 4 wks dosing followed by 2 wks off) in treatment-naïve (N=44) and cytokine-refractory mRCC pts (N=148) were analyzed. SU and SU12662 concentrations were fitted to a population PK model (a 2- compartment model for both parent and metabolite). Estimates of pt PK were used to calculate steady-state Area Under the Curve (AUCss) for SU, SU12662 and TD, which were used as the exposure measure in a PKPD analysis of partial response (PR) rates, time to tumor progression (TTP), overall survival (OS), and tumor volume changes. Results: The probability of a PR for cytokine-refractory pts increased with increasing AUCss for SU and TD. The odds-ratio suggested a 2.6-fold increase in PR frequency for each unit increase in AUCss. Longer TTP and OS were also noted in pts with high SU and TD AUCss. In treatment-naïve pts on SU, there was very little observed tumor progression or death (only 5 pts progressed and only 1 death) limiting the ability to analyze exposure-response. A tumor growth dynamics model (developed to describe changes in tumor volume [by CT or MRI] in response to treatment, as a function of AUCss) provided a good description of tumor volume changes with SU for both treatment-naïve and cytokine-refractory pts. Efficacy was not related to baseline tumor volume, gender, or race. Based on this model, clinical trial simulations assuming perfect pt compliance predict that 62% of pts would achieve a PR with SU 50 mg/day. Conclusions: SU and TD AUCss correlated significantly with the probability of a PR in cytokine- refractory pts, and longer TTP and OS. Limited data were available for treatment-naïve pts. The tumor growth dynamics model provided a good description of tumor volume changes with SU for both populations. This exposure-response analysis indicates that increased exposure to SU is associated with clinical benefit. [Table: see text]
Case 9-1970
Authors: Richard C. Cabot, Benjamin Castleman, Betty U. McNeely, Newton E. Hyslop, John B. Blennerhassett
Journal: New England Journal of Medicine (1970)

Presentation of CaseA sixty-two-year-old man was admitted to the hospital because of dyspnea, wheezing and hemoptysis.Five years previously a diagnosis of Friedländer's pneumonia had been made; subsequently, x-ray films showed complete resolution of the pneumonia. He remained well until one year before entry, when a left lingular pneumonia developed; a loud friction rub was heard over the involved area. He was afebrile, and there was no pleural effusion. Ampicillin therapy was instituted. The friction rub disappeared, and an x-ray film of the chest taken several weeks later disclosed partial resolution of the pulmonary infiltrate. Ten months before admission . . .
Development of homoharringtonine.
Authors: C R Smith, R G Powell, M Suffness
Journal: Journal of Clinical Oncology (1986)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1986.4.8.1283 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 3525773 Development of homoharringtonine. C R SmithxC R SmithSearch for articles by this author , R G PowellxR G PowellSearch for articles by this author , M SuffnessxM SuffnessSearch for articles by this author https://doi.org/10.1200/JCO.1986.4.8.1283 PDF "Development of homoharringtonine.." Journal of Clinical Oncology, 4(8), p. 1283© 1986 by American Society of Clinical Oncology
Gaining patients' consent
Authors: I Callanan, J M Pegum
Journal: BMJ (1996)

more, one could argue that it is unethical to con- duct research in a biased (that is, self selected) group if one cannot define the population to which the results should be applied.Quoting guidelines of 1996 developed in a different con- text is hardly constructive.With regard to her next point, is Goodare insinuating that, simply because of the structure of husband and wife or sibling teams, their work is suspect and they should be disbanded?We are also unclear why the approach taken by the self help group invalidates the results obtained by the nurse.Furthermore, contrary to what she states, all patients were provided with contact numbers for national voluntary organisations.Derek Lowe suggests that, in this study, patients in voluntary organisation groups fared worse.It would be inappropriate, however, to dismiss all approaches ofvoluntary organisations as ineffective.Space precluded comment on the patients lost to follow up.There is some evidence that psychological morbidity is higher in those who fail to attend, and therefore psychological morbidity in the control group may have been even higher and the effect of the nurse even greater.
A phase II study of triapine in combination with gemcitabine in advanced pancreatic carcinoma: A Princess Margaret Hospital Phase II Consortium Trial
Authors: M. J. Mackenzie, M. J. Moore, D. Saltman, K. M. Zbuk, E. Vandesompele, S. Lovell, P. Degendorfer, C. Johnson, L. Siu, J. Low
Journal: Journal of Clinical Oncology (2005)

4093 Background: Triapine (3-aminopyridine-2-carboxaldehyde thiosemicarbazone, 3-AP) is an inhibitor of ribonucleotide reductase. Inhibition of ribonucleotide reductase lowers cellular deoxyribonucleotide triphosphates which can enhance the effect of cytidine analogs given subsequently. Phase I studies demonstrated the MTD to be 105 mg/m2 of Triapine infused over 2–4 hours followed by gemcitabine 1000 mg/m2 given weekly. The dose limiting toxicity was hypoxia, dyspnea, hypotension, and prolongation of the QT interval. This phase II trial was undertaken to evaluate the combination of triapine and gemcitabine in advanced pancreatic cancer. Methods: Patients had advanced pancreatic adenocarcinoma, no prior chemotherapy and at least one site of measurable disease. Patients with G6PD deficiency were excluded due to risk of methemoglobinemia with Triapine. Triapine 105 mg/m2 was given as a 2 hour infusion on days 1, 8, and 15 of a 28 day cycle; gemcitabine 1000 mg/m2 was given over 30 minutes, 4 hours after Triapine was completed. The primary endpoint for this trial is tumor control defined as objective response + stable disease ≥ 4 months. If more than 7/22 meet this criteria in stage I then the trial will proceed to stage II. Results: Seventeen patients have been enrolled since March 2004; median age is 63; ECOG 0:1:2 7:8:2. Grade 3 hematological toxicity was neutropenia [3], thrombocytopenia [1]; no febrile neutropenia. Four patients experienced grade 3 hyperglycemia. The most frequent non-hematologic toxicity were fatigue, fever, hyperglycemia and transient hypoxemia. Eight patients are presently evaluable for response. Three patients had prolonged stable disease and remain on therapy; 4 had PD after 2 cycles; 1 had PD at 4 cycles; 9 are inevaluable [too early]. Accrual is ongoing. No significant financial relationships to disclose.