tbuckley/cabot-search huggingface dataset:
Oral Disodium Cromoglycate in the Treatment of Systemic Mastocytosis
Authors: Nicholas A. Soter, K. Frank Austen, Stephen I. Wasserman
Journal: New England Journal of Medicine (1979)

A double-blind crossover study of the efficacy of disodium cromoglycate given by mouth to control the cutaneous, gastrointestinal and central-nervous-system manifestations of systemic mastocytosis was carried out in five patients for periods of eight to 32 months. In 15 of 18 trials, disodium cromoglycate produced marked amelioration of the clinical manifestations of pruritus, whealing, flushing, diarrhea, abdominal pain and disorders of cognitive function. By contrast, in all 19 trials with placebo, there was no improvement in these symptoms and signs. Histaminuria and peripheral-blood eosinophilia were unrelated to disease activity and were unaffected by drug therapy. Although it is poorly absorbed after administration by mouth, disodium cromoglycate is of clinical benefit to patients with systemic mastocytosis.
Case 7-1992
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, I. Kuter, N.L. Harris
Journal: New England Journal of Medicine (1992)

Presentation of CaseA 57-year-old man was admitted to the hospital because of hypotension and tightness in the chest.There was a 20-year history of episodic headache, flushing, lacrimation, and hypotension, with syncope on several occasions. Fifteen years before admission the patient was first seen at this hospital, where an extensive clinical and laboratory evaluation showed no evidence of a carcinoid tumor, pheochromocytoma, or insulinoma. Since that time his episodes occurred approximately once yearly until seven years before entry, when they ceased.The patient was then well until one day before admission, when he awoke from sleep with a stuffy . . .
Case 4-1962
Authors: John G. Freymann
Journal: New England Journal of Medicine (1962)

Presentation of CaseA fifty-four-year-old construction worker entered the hospital because of shortness of breath and abdominal swelling.Gradually increasing nervousness and diaphoresis began approximately ten weeks previously. On one occasion the patient had difficulty in stopping bleeding from a small laceration caused by shaving. A physician found a hematocrit of 71 per cent and withdrew 450 ml. of blood on each of two successive days. Physical examination in the Out-Patient Department seven weeks before admission revealed a generalized, ruddy cyanosis, dilated retinal veins and suffused conjunctivas. The edge of the liver, which was firm and nontender, was palpable 4 . . .
Evidence That Hepatitis B Virus Has a Role in Liver-Cell Carcinoma in Alcoholic Liver Disease
Authors: Christian Bréchot, Bertrand Nalpas, Anne-Marie Couroucé, Gilles Duhamel, Patrice Callard, Françoise Carnot, Pierre Tiollais, Pierre Berthelot
Journal: New England Journal of Medicine (1982)

We compared the presence of serologic markers of hepatitis B virus (HBV) infection with the presence of the viral DNA in the livers of patients with alcoholic liver disease with or without hepatocellular carcinoma. Among 51 patients with various kinds of alcoholic liver disease but without hepatocellular cancer, 19 had one or more serologic markers of HBV, but only three had viral surface antigen in their serum. These three patients, as well as three others who had HBV antibodies but no viral antigen in their serum and two others who had no serologic markers of any kind, had HBV DNA in their liver cells. In at least five of the eight patients with viral DNA in the liver, the DNA was integrated into the genome. Among 20 patients with alcoholic cirrhosis and hepatocellular carcinoma, nine of the 16 tested had serologic markers of HBV infection, but all 20 had HBV DNA integrated into the genome of the neoplastic liver cells. These data suggest that HBV plays a part in the pathogenesis of primary liver-cell cancer in alcoholics.
HPV vaccine: effective but underused in the US
Authors: Douglas Kamerow
Journal: BMJ (2016)

In most young women and men the human papillomavirus (HPV) is an innocuous sexually transmitted infection, asymptomatic, and eventually cleared without consequences. In some people, however, HPV infection becomes chronic and leads to cancer (mainly cervical, but also anal, penile, oral, and throat cancers) or genital warts. The HPV types 16 and 18 together cause 70% of cervical cancers. Vaccines to prevent HPV were licensed in the United States and recommended for all adolescent girls in 2006. Recommendations to vaccinate boys started in 2011. The good news, recently confirmed in a US study of females aged 14-34, is that HPV vaccine can prevent HPV infection; the bad news is that we’re not doing a good job of getting the vaccine into our children. The US Advisory Committee on Immunization Practices and other authorities recommend a three dose regimen of HPV vaccine for girls and boys aged 11-12. A 2014 study, however, found that only 37.6% of girls and 13.9% of boys aged 13-17 had received the full, three dose course of HPV vaccine in 2013. This compares poorly with other vaccines administered at that age—most notably, diphtheria-tetanus-pertussis vaccine (Tdap), which reaches over 80% of US teenagers. Dreadful coverage rate
Decrease in Serum Potassium Concentrations and Appearance of Cardiac Arrhythmias during Infusion of Potassium with Glucose in Potassium-Depleted Patients
Authors: Arthur S. Kunin, Borys Surawicz, Ethan A. H. Sims
Journal: New England Journal of Medicine (1962)

THE intravenous administration of potassium chloride with glucose is a common therapeutic measure in cases of potassium depletion. This study was prompted by the appearance of serious ventricular arrhythmias in 2 hypopotassemic patients during the intravenous infusion of a solution of potassium chloride with glucose. It was suspected that the cellular uptake of glucose stimulated cellular uptake of potassium in excess of that administered. This critically altered the potassium gradient across myocardial cell membranes, precipitating grave manifestations of cardiotoxicity. In both cases the serum potassium concentration at the time of appearance of the arrhythmias might have been lower than the . . .
Neoadjuvant chemotherapy with gemcitabine and carboplatin followed by concurrent chemoradiotherapy in locally advanced carcinoma of urinary bladder
Authors: T. N. Ansari
Journal: Journal of Clinical Oncology (2004)

4715 Background: In locally advanced carcinoma of urinary bladder radiation therapy, either alone, or in combination with chemotherapy is the treatment of choice for patients whose disease is not amenable to surgery. This study was carried out to evaluate the efficacy and toxicity of Neoadjuvant chemotherapy with Gemcitabine and Carboplatin followed by concurrent chemoradiotherapy in locally advanced carcinoma urinary bladder. Patients and Methods: 22 patients were enrolled. All patients initially received 4 cycles of Gemcitabine and Carboplatin, after which response evaluation was done with CT scanning and ultrasonography. Patients with complete response (CR) and partial response (PR) received 2 more cycles followed by radical radiotherapy with weekly Gemcitabine as radiation sensitizer. Those who had stable disease (SD) or progressive disease (PD) were given concurrent chemoradiotherapy after four cycles. Results: Twenty patients were males and two were females. The median age was 52 years (range 35–70 years). All patients had histopathological subtype of transitional cell carcinoma. Eleven (50%) patients had T3 lesion, 7(31.81%) had T4 and 4(18.18%) cases had T2 lesion. Out of 22, 6(27.27%) patients showed CR, and PR was seen in 9(40.90%) patients. Four (18.18%) patients had SD whereas 3 patients showed progression of the disease. Two cases out of four having stable disease showed regression of tumor after concurrent chemoradiotherapy. No grade III/IV toxicity was seen. Common toxicities observed were Neutrogena, fatigue, loss of appetite and myalgias. Conclusion: Neoadjuvant chemotherapy with gemcitabine-carboplatin followed by concurrent chemoradiotherapy is a well tolerable and effective treatment modality to achieve significant tumor response in locally advanced bladder carcinoma. No significant financial relationships to disclose.
Case 16-2011
Authors: Matthew R. Smith, Anthony L. Zietman, Joel S. Finkelstein, Chin-Lee Wu
Journal: New England Journal of Medicine (2011)

A 67-year-old man was seen at this hospital because of an elevated serum level of prostate-specific antigen 18 months after radical prostatectomy and external-beam radiation therapy for prostate cancer. A management decision was made.
144P: Oligometastatic non-small-cell lung cancer (NSCLC) and unresectable primary tumor: Updated retrospective analysis of safety and efficacy of the radical treatment for the primary tumor and the metastases
Authors: S. Marin, J. Garde, C. Salvador Coloma, O. Juan, L. Arribas, J. García Sánchez, C. Escoin Pérez, J. Hidalgo Coloma, R.A. Albino Perez, A. Llombar Cussac
Journal: Journal of Thoracic Oncology (2016)
Who can benefit from chemotherapy holidays after first-line therapy for advanced colorectal cancer? A GERCOR study
Authors: N. Perez-Staub, B. Chibaudel, A. Figer, A. Cervantes, G. Lledo, A. K. Larsen, F. Maindrault-Goebel, C. Louvet, C. Tournigand, A. de Gramont
Journal: Journal of Clinical Oncology (2008)

4037 Background: Chemotherapy free-intervals (CFI) in patients with advanced colorectal cancer who benefit from improved therapy are frequently done. However, early CFI after 6 cycles of first-line FOLFOX could negatively affect overall survival (Optimox 2 study, ASCO 2007, abs 4013). The ongoing study was performed to determine the best time to stop therapy and the predictive factors for a prolonged CFI. Methods: All patients who had a 3-months CFI in the two optimox studies (N=822) were studied according to the time to CFI. Patients who had R0 or R1 metastase resection after 3 months of CFI were censored at time of surgery, patients who had surgery before 3 months of CFI or with progressive disease at time of CFI were excluded. Additionally, patients were individually matched with patients who did not stop chemotherapy, had a PFS at least 3 months longer than time to CFI, and similar baseline features (PS, LDH, ALP, number of metastatic sites, adjuvant chemotherapy, primary and age). Results: 31% of the potentially eligible patients (163/525) had a CFI of more than 3 months. Median OS were 24 months in 65 patients who stopped chemotherapy (CT) before 3 months, 42 months when CT was stopped between 3 and 9 months (48 pts) and 44 months when CT was stopped after 9 months (50 pts), p<0.0002. Prognostic factors in a multivariate analysis were baseline ALP and number of sites. There was no correlation between time to CFI and CFI duration. There was no difference in survival from CFI according to time to CFI. OS of all patients who had a 3-month CFI and of the matched patients were 37.5 and 21.2 months, respectively (p<0.0001). Conclusions: These results demonstrate that a significant number of patients can benefit from chemotherapy holidays. Baseline characteristics do not allow to select these patients and additional studies are needed to solve this important issue. No significant financial relationships to disclose.
M15 Use of E-Cigarettes in patients accessing secondary care in Croydon
Authors: R Siva
Journal: Thorax (2015)

<h3>Background</h3> The introduction of electronic cigarettes on the market as a cheaper and allegedly healthier alternative to cigarettes, has led many people to use them. The aim of this study is to give us a better understanding of the increase in useage of electronic cigarettes as an aid to quitting smoking for people accessing stop smoking services in secondary care in Croydon. <h3>Method</h3> Questionnaires were given to participants who were willing to take part. 50 participants were recruited during their hospital visit through the Croydon Respiratory Team (CRT) and the hospital based stop smoking service. Patient demographics were recorded and participants reported their behavioural changes, impact on health, reason for use, and intention of when to stop using e-cigarettes. <h3>Results</h3> Participants were both male and female with the age range of 23–82 years. 17 participants (35%) reported a diagnosis of COPD (Chronic Obstructive Pulmonary Disease). 34 participants were single users (only used e-cigarettes) and 16 were dual users (use e-cigarettes and other NRT products). Results revealed that e-cigarettes are popular, well tolerated and various brands used. The most popular brand was Vapour Zone cigarettes with 14 users followed by V2 Cig with 8 users. The findings also showed that some patients are using 2 types of e-cigarettes: 2 participants in this study were using more than one brand at the same time. Duration of using e-cigarettes was from one week to over 18 months with 50% of patients having used e cigarettes for at least 3 months. 26 patients (52%) reported improvement in breathing and 9 patients (18%) reported a reduction in sputum. 21 patients (42%) had reduced their cigarette use and 19 (38%) had quit smoking. Out of these 25 patients who were using e-cigarettes for at least 3 months; 12 had quit smoking. 22 participants reported hearing about e-cigarettes through the media, 14 through friends, 3 from health professionals, 3 from relatives and 3 through media and friends. It was interesting to note that despite all participants wanting to stop smoking, 33 participants were not sure when they intended to stop using e-cigarettes. <h3>Conclusions</h3> The use of e-cigarettes is common in patients accessing secondary care in Croydon. Many patients either quit or reduced smoking and many reported improvement in symptoms. Duration of use of e-cigarettes is variable but half of patients surveyed had used them for at least 3 months. Whilst this study provides some local data, further research is required to help shape future respiratory and smoking cessation services and policies.
Risk score application in patients older than age 70 with newly diagnosed non-Hodgkin lymphoma (NHL): A single-institution experience in midwestern Ireland.
Authors: K. I. Quintyne, B. Woulfe, R. K. Gupta
Journal: Journal of Clinical Oncology (2011)

e19508 Background: Cytotoxic therapy in elderly patients with cancer is historically controversial; this is often compounded by a lack of robust prospective data. The elderly account for a significant proportion of NHL diagnosed, and determining the appropriateness and level of intervention is best established on an individual basis. To reduce negative bias to potential treatment tolerance, stratification reliant on reproducible risk scores, such as age-adjusted International Prognostic Index (aaIPI), augments clinical assessment. We herein report our retrospective experience of newly diagnosed patients over 70-years and risk score application. Methods: Study period: 01/01/2001 – 31/12/2010. Data obtained from (1) Mid-Western Cancer Centre (MWCC) Oncology Database (2) MWRH pathology records (3) MWRH patient-files. Data was collated and entered into an Access database and exported into Predictive Analytics Software (PASW) for analysis. Results: Forty patients identified. M:F = 19:21. Mean age: 78 years (Range: 70 – 92 years). Median follow: 11.5 months (Range: 1 – 86 months). aaIPI groupings, low-risk, 45% (18/40), intermediate-risk 17.5% (7/40) and high-risk 17.5% (7/40); mean survival for low-risk, intermediate-risk and high-risk was 62.1 months, 40.1 months and 14.7 months (p = 0.044). For our cohort, a MWCC risk score was devised, by assigning score of 1 for patients with anaemia and extra-nodal involvement; this was added to aaIPI score. Patients were then grouped by MWCC risk score, good-risk, 15.6%, moderate-risk, 53.1% and poor-risk, 31.3%; mean survival for, moderate-risk and poor-risk respectively was 53.4 months, and 15.4 months (p = 0.014); no deaths seen in good-risk grouping, hence no mean survival available. Conclusions: Risk score tools are helpful in evaluating and predicting possible outcome. aaIPI certainly correlated well with outcome for patients. MWCC risk score also correlated well but needs validation and multivariate analysis with a larger dataset; further work is needed before this could be adopted. Such models and scoring systems are useful, when applied correctly, but are not an alternative to good clinical judgement.
Inadvertent Transmission of a Donor's Acute Myeloid Leukemia in Bone Marrow Transplantation for Chronic Myelocytic Leukemia
Authors: Dietger W. Niederwieser, Frederick R. Appelbaum, Günther Gastl, Elisabeth Gersdorf, Bernhard Meister, Dietmar Geissler, Jeannie A. Tratkiewicz, Josef Thaler, Christoph Huber
Journal: New England Journal of Medicine (1990)

A PATIENT with Philadelphia chromosome-positive chronic myelocytic leukemia in a phase of accelerated growth received a bone marrow transplant from her HLA-identical brother, whose cells were not reactive in the mixed leukocyte culture. Although routine examination of the donor's peripheral blood before transplantation revealed no abnormalities, the bone marrow graft showed acute myeloid leukemia, with 38 percent leukemic blasts. The infusion of this leukemic bone marrow resulted in normal engraftment, with complete chimerism two months after transplantation. The specific cytogenetic abnormalities of both the donor and the host leukemias disappeared one month after transplantation and remained undetectable for four more . . .
Health workers sent to indigenous Canadian community beset by attempted suicides
Authors: Owen Dyer
Journal: BMJ (2016)

Health workers have arrived at the indigenous reservation of Attawapiskat First Nation in Canada’s James Bay after 11 people attempted suicide on 9 April. Local leaders of the community of 2000 people had already declared a state of emergency after 100 suicide attempts were made this winter.

Chief Bruce Shisheesh and his councillors called for outside help after the latest suicide attempts. The Nishnawbe Aski Nation, the organisation representing the First Nations of northern Ontario, responded first with two mental health counsellors. The federal government sent five mental health workers, while the province dispatched four psychological health workers and up to five nurses.

The Nishnawbe Aski Nation sent two doctors, a traditional healer, and nurses from a hospital in Moose Factory, a small community to the south. Three of the four …
Adolescent Overweight and Coronary Heart Disease
Authors: Simon Capewell, Julia A Critchley
Journal: New England Journal of Medicine (2008)

To the Editor: The Centers for Disease Control and Prevention (CDC) recommends using the body-mass index (BMI) for age as a marker in assessing patients between the ages of 2 and 20 years for obesity.1 In the article by Bibbins-Domingo et al. (Dec. 6 issue),2 weight alone was used as a marker for obesity in adolescents, which may not reflect the true underlying value. Was this approach justified? Furthermore, the assumption that a high BMI does not directly increase the risk of coronary heart disease (CHD) may be unwarranted, since there is enough evidence to the contrary.3
Effect of eltrombopag on proliferation of solid and hematologic tumor cell lines in vitro
Authors: C. L. Erickson-Miller, V. Sambandam, J. E. Harwell, P. L. Payne, R. D. May, A. Chadderton, M. J. Roberts
Journal: Journal of Clinical Oncology (2008)

14628 Background: Eltrombopag is an oral platelet growth factor in clinical studies to treat thrombocytopenia. It increases platelet production by interacting with the transmembrane domain of the receptor, thereby inducing proliferation and differentiation of cells in the megakaryocytic lineage. TPOR is expressed on the surface of some leukemia and stem cells. The following experiments were conducted to evaluate the effects of eltrombopag on the proliferation of tumor cell lines in vitro. Methods: 10 solid tumor cell lines were examined: non-small cell lung carcinoma (NSCLC) cell lines (A549, EKVX, HOP-62, HOP-92, NCI-H226, NCI-H23, NCI-H322M, NCI-H460, NCI-H522) and the hepatocellular carcinoma cell line, HepG2. 13 cells lines from various AML, CML, and lymphoblastic leukemias included: U937, ML-2, OCI- AML2, OCI-AML3, RPMI-8226, HEL 92.1.7, HL-60, K562, SR, CCRF-CEM, MOLT-4, NOMO-1, OCI-M1. Proliferation was measured by 3H-thymidine incorporation and CellTiter-Glo in the hematologic and solid tumors, respectively. Doxorubicin (Dox) was used as + control in the solid tumors. Myeloid differentiation was assayed by flow cytometry and apoptosis by Annexin V. TPOR mRNA expression was determined by Taqman in 7 cell lines. Results: All solid tumor lines demonstrated decreased proliferation after 72-hour culture w/eltrombopag (IC50=5.7 to 14 ug/mL). However, 3 NSCLC lines were less-responsive to both Dox and eltrombopag. Eltrombopag did not increase proliferation of any of the hematologic cell lines and decreased the proliferation of 11 of the 13 hematologic cell lines, (IC50=5.6 to 15.4 ug/mL). Two cell lines, NOMO-1 and OCI-M1, demonstrated an IC50 >40 ug/mL. Further examination of K562, U937 and OCI-AML3 demonstrated a decrease in total cell number as well as decreased proliferation. Annexin V staining suggests that the cells die by a method other than apoptosis. No change in differentiation was observed after eltrombopag treatment. In the cell lines examined, no relationship between the expression of TPOR mRNA and proliferation IC50 was observed. Conclusion: Eltrombopag did not increase proliferation or differentiation of hematologic tumor cell lines. Eltrombopag caused a dose-dependent decrease in proliferation in most of the 23 solid and hematologic tumor cell lines tested. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration GlaxoSmithKline GlaxoSmithKline GlaxoSmithKline
The Infant or Young Child with Developmental Delay
Authors: Lewis R. First, Judith S. Palfrey
Journal: New England Journal of Medicine (1994)

Despite the 10 percent prevalence of developmental delay,1 the early identification of such problems remains difficult. Although severe disorders can be recognized in infancy, it is unusual to diagnose speech impairments, hyperactivity, or emotional disorders before the age of three or four years, and learning disabilities are rarely identified before children start school2. Despite the difficulty of diagnosing developmental delay, governmental efforts have recently been made (as in the 1986 amendments to the Education of the Handicapped Act) to promote early identification and intervention and thus to reduce long-term disability3. In this article, we shall review the available . . .
Polymorphic Microsatellite Markers for the Diagnosis of Graft-versus-Host Disease
Authors: Li Wang, Takeo Juji, Katsushi Tokunaga, Koki Takahashi, Shoji Kuwata, Shigeharu Uchida, Kenji Tadokoro, Katsuji Takai
Journal: New England Journal of Medicine (1994)

Post-transfusion graft-versus-host disease (GVHD) is generally thought to result from the engraftment of lymphocytes in blood products1,2. If circumstances permit, the donor's T lymphocytes mount an immune attack against the recipient's tissues. The clinical manifestations of the disorder are fever, rash, hepatitis, diarrhea, bone marrow aplasia, pancytopenia, and infection3. Post-transfusion GVHD can usually be diagnosed clinically during its florid stage. However, in its early stage, it is not easily differentiated from toxic shock syndrome, drug reactions, or viral infections. Early diagnosis may allow more effective treatment of the disease. Post-transfusion GVHD occurs when the blood donor is . . .