tbuckley/cabot-search huggingface dataset:
Effect of Cytotoxic Drugs in Frequently Relapsing Nephrotic Syndrome with and without Steroid Dependence
Journal: New England Journal of Medicine (1982)

In a prospective, controlled study, 50 children with frequently relapsing nephrotic syndrome who had steroid toxicity were treated for eight weeks with either cyclophosphamide (2 mg per kilogram of body weight per day) or chlorambucil (0.15 mg per kilogram per day), in combination with prednisone in tapering doses. Of the 34 children whose relapses had tended to occur after the prednisone dosage had been reduced or immediately after the drug was discontinued (the steroid-dependent group), 22 also had early relapses after cytotoxic-drug treatment. In contrast, cytotoxic drug treatment produced long-lasting remissions in 12 of the 16 children whose relapses usually occurred after prednisone treatment had been interrupted for more than 14 days (the non-steroid-dependent group). The difference in response between the two groups was highly significant (P<0.001). We conclude that patients with frequent relapses without steroid dependence can be treated successfully with an eight-week course of cytotoxic drugs, whereas those with steroid-dependent nephrotic syndrome do not profit from cytotoxic drugs in the low doses used. (N Engl J Med. 1982; 306:451–4.)
A Simple, Objective Test for Arteriosclerosis Obliterans
Authors: Jay D. Coffman, John A. Mannick
Journal: New England Journal of Medicine (1965)

A TEST to demonstrate the deficit in muscle blood flow during exercise in patients with intermittent claudication is necessary for objective diagnosis and evaluation of treatment. In arteriosclerosis obliterans the symptoms and deficit in blood flow are usually present only during exercise. Diagnostic tests in current use either do not indicate the amount of blood flow (arteriography) or cannot be used to measure blood flow during exercise (plethysmography). Therefore, the diagnosis of occlusive vascular disease is most often based on subjective symptoms and physical findings that may sometimes be secondary to other conditions. Dependence on subjective symptoms and tests which . . .
Increased Plasma Levels of a Rapid Inhibitor of Tissue Plasminogen Activator in Young Survivors of Myocardial Infarction
Authors: Anders Hamsten, Björn Wiman, Ulf de Faire, Margareta Blombäck
Journal: New England Journal of Medicine (1985)

Certain risk factors for myocardial infarction have been linked with disturbances in fibrinolytic activity. The recent development in our laboratory of new sensitive and specific methods for determination of tissue plasminogen activator (t-PA) activity and antigen, as well as the discovery of a new rapid inhibitor of this enzyme, enabled us to study fibrinolytic function in detail in a representative population of postinfarction patients. Seventy-one patients (62 men and 9 women) who had survived a myocardial infarction before the age of 45 were compared with 50 healthy subjects of similar age, three years after the infarction. Low t-PA activity after venous occlusion, mostly explained by high plasma levels of the t-PA inhibitor and to some extent by impaired release of t-PA from the vessel wall, was a frequent finding in the patients. The level of t-PA inhibitor was positively and significantly correlated with levels of serum triglycerides. Our data suggest that reduced fibrinolytic capacity due to increased plasma levels of a rapid inhibitor of t-PA may have pathogenetic importance in myocardial infarction, particularly in patients with hypertriglyceridemia.
Rethinking the military family syndrome
Authors: J Morrison
Journal: American Journal of Psychiatry (1981)

The author presents prospective data on 140 child and adolescent military dependents and 234 nonmilitary subjects to assess the validity of the "military family syndrome." The only significant diagnostic difference was that military dependents had a lesser prevalence of schizophrenia and schizophreniform psychosis; the few environmental differences did not consistently favor either group. The author concludes that if the military family syndrome exists at all, its effects are more subtle and its causes are less obvious than has been previously stated.
Review of Methods in “Breast Augmentation: A Risk Factor for Breast Cancer?”
Authors: Heather Bryant, Penny M.A. Brasher, Johan H. van de Sande, Jean-Michel Turc
Journal: New England Journal of Medicine (1994)

To the Editor: We are writing to follow up on the article by Berkel et al. concerning breast implants and the risk of cancer (June 18, 1992, issue).1 The study was a population-based, noncurrent cohort-linkage study, which was performed under the auspices of the Alberta Cancer Board. Essentially, the study was designed to identify women who had undergone cosmetic breast augmentation between 1973 and 1986 and to link this cohort of women with the Alberta Cancer Registry to determine which women with implants subsequently had breast cancer. The actual breast-cancer rates were compared with the expected rates, which were calculated . . .
Pulmonary Complications of Cardiospasm
Authors: Arnold S. Breakey, Charles T. Dotter, Israel Steinberg
Journal: New England Journal of Medicine (1951)

THE association of cardiospasm and respiratory symptoms has been recognized since the beginning of the nineteenth century. Not until relatively recent years, however, has attention been directed to the relation between cardiospasm and a variety of pulmonary diseases ranging from lung abscess to pulmonary fibrosis. Massive or repeated aspiration of the contents of a dilated, food-filled esophagus frequently causes significant pulmonary complications. It is the purpose of the present report to emphasize this relation and to stress the value of prompt recognition and treatment of the underlying cardiospasm in order to prevent serious pulmonary disease. To date 46 case reports . . .
Intravenous Urea Treatment of the Painful Crisis of Sickle-Cell Disease
Authors: Paul R. McCurdy, Laviza Mahmood
Journal: New England Journal of Medicine (1971)

Because it may break the hydrophobic bonds responsible for the sickling phenomenon, urea (40–320 g in 10 per cent invert sugar) was given 24 times to 14 patients for treatment of painful sickle-cell crisis. Seventeen crises were terminated, and the patients became free of pain. The major side effect was massive diuresis. Eight patients responded to 40 g of urea with a plasma urea nitrogen of 40 to 80 mg per 100 ml. Nine required more and attained plasma levels of 60 to 120 mg per 100 ml. The levels were similar in the patients who responded and those who did not. These results suggest that urea therapy has a beneficial effect on the painful crises of sickle-cell disease, but the method is still experimental.
Early T-cell precursor acute lymphoblastic leukemia/lymphoma (ETP-ALL/LBL) in adolescents and adults: a high-risk subtype
Authors: Nitin Jain, Audrey V. Lamb, Susan O’Brien, Farhad Ravandi, Marina Konopleva, Elias Jabbour, Zhuang Zuo, Jeffrey Jorgensen, Pei Lin, Sherry Pierce, Deborah Thomas, Michael Rytting, Gautam Borthakur, Tapan Kadia, Jorge Cortes, Hagop M. Kantarjian, Joseph D. Khoury
Journal: Blood (2016)
Associations of Insulin and IGFBP-3 with Lung Cancer Susceptibility in Current Smokers
Authors: Gloria Y. F. Ho, Siqun L. Zheng, Mary Cushman, Roman Perez-Soler, Mimi Kim, Xiaonan Xue, Tao Wang, Nicolas F. Schlecht, Lesley Tinker, Thomas E. Rohan, Sylvia Wassertheil-Smoller, Robert Wallace, Chu Chen, Jianfeng Xu, Herbert Yu
Journal: JNCI Journal of the National Cancer Institute (2016)

The epidermal growth factor receptor (EGFR) signaling network is involved in lung carcinogenesis. This study examined whether ligands that activate or suppress the EGFR signaling network were associated with lung cancer risk in ever smokers. A nested case-control study within the Women's Health Initiative assessed baseline plasma levels of insulin, insulin-like growth factor (IGF)-1, insulin-like growth factor binding protein (IGFBP)-3, interleukin (IL)-6, hepatocyte growth factor (HGF), and nerve growth factor (NGF) in 1143 ever-smoking lung cancer cases and 1143 controls. Leptin was measured as an adiposity biomarker. Conditional logistic regression was used in data analyses. Leptin was inversely associated with lung cancer risk (odds ratio [OR continuous ] per Ln [pg/mL] = 0.85, 95% confidence interval [CI] = 0.74 to 0.98). After adjusting for adiposity and other risk factors, null associations were found for IL-6, HGF, and NGF. In current smokers, but not former smokers, high insulin levels were associated with increased lung cancer risk (OR for 4th quartile vs others [OR q4 ] = 2.06, 95% CI = 1.30 to 3.26) whereas IGFBP-3 had a linear inverse association (OR continuous per μg/mL = 0.64, 95% CI = 0.41 to 0.98). The insulin association was consistent across subgroups defined by body mass index and histological type, but the IGFBP-3 association was specific to small cell lung cancer. There was a modest positive association between IGF-1 and lung cancer risk in current smokers (OR q4 = 1.44, 95% CI = 0.90 to 2.29). Independent of obesity, high insulin levels but reduced levels of IGFBP-3 were associated with increased lung cancer risk in current smokers.
Long-Term Evaluation of Decontamination of Inhalation-Therapy Equipment and the Occurrence of Necrotizing Pneumonia
Authors: Alan K. Pierce, Jay P. Sanford, Grace D. Thomas, J. S. Leonard
Journal: New England Journal of Medicine (1970)

Inhalation-therapy equipment incorporating reservoir nebulization was sampled for bacterial contamination during a four-year period after the introduction of routine daily decontamination with 0.25 per cent acetic acid. The incidence of contamination was found to be less than 10 per cent during the last three study years, as compared to 84 per cent before the use of the acetic acid regimen. Residual contamination was related to personnel error or corrosion of nebulizer jets. During the "preacetic acid era" the prevalence of necrotizing pneumonia due to gram-negative bacilli at autopsy was 7.9 per cent, whereas in the last two years studied, the incidence was 2.2 and 2.1 per cent. This prevalence is similar to that found before the use of reservoir nebulizers. These data indicate that daily decontamination of reservoir nebulizer equipment with 0.25 per cent acetic acid is effective and practical in routine hospital use.
Computer/Online-Mediated Social Support for Cancer-Related Fatigue
Authors: Nina Wagner-Johnston
Journal: Journal of the National Comprehensive Cancer Network (2013)

Fatigue is a pervasive symptom in individuals with cancer that is often underrecognized and undertreated by health care providers. Contrasted with the sparse data in support of pharmacologic interventions for the management of cancer-related fatigue, the literature for nonpharmacologic interventions is vast. In particular, support groups have proven beneficial. Limited access, transportation issues, and unwillingness to share in a public forum represent just a few of the barriers to more widespread participation in face-to-face support groups. Millions of people with cancer rely on the Internet to gain information regarding their diagnosis and to validate their cancer experience. Tapping into this wealth of online information is an obvious avenue for patients with cancer-related fatigue to seek support. This article explores online- and computer-mediated support groups for fatigue.
registHER: A prospective, longitudinal cohort study of women with HER2 positive metastatic breast cancer
Authors: E. Tanchiu, P. A. Kaufman, S. Paik, M. Ulcickas-Yood, M. Mayer, D. Tripathy, H. Rugo, A. Brufsky
Journal: Journal of Clinical Oncology (2005)

670 Background: Human Epidermal Receptor 2 (HER2) is gene amplified in approx 25% of patients with breast cancer and is an unfavorable prognostic factor for survival. Both NCCN and ASCO recommend that all breast tumor samples be tested for HER2 status by either immunohistochemistry (ICH) or fluorescent in situ hybridization (FISH). Methods: RegistHER is a prospective, longitudinal cohort study of HER2 positive MBC designed to understand treatment practice and outcomes. Eligible patients are HER2 + with MBC diagnosed within 6 months and receive treatments according to standard of care. HER2 testing data collection includes tissue source (primary vs metastatic tumor) and test Method: All treatment information is collected from the time of initial diagnosis to study discontinuation or death. Study endpoints include time to treatment failure, time to progression, tumor response, cardiac safety and survival. All data are obtained through an internet-based data collection system. Results: 273 of 291 eligible patients have been enrolled over 11 months, of a planned n=1,000. Patient characteristics: median age 54 yrs (range 22 - 91), race (white 83%), PS 0–1 64%, DFI 20 mos (range 0 - 263 mos). Tumor characteristics: ER and/or PR + 46%, ductal histology 86%. HER2 testing results were available in 264 patients. The tissue source for HER2 testing was primary tissue samples only (67%), metastatic tissue only (13%) or both 17%. Positive HER2 results were considered to be either IHC 3+ or FISH positive in >90% of patients. In those with results from both primary and metastatic tissue sources (n=46), HER2 results were confirmed by the same testing method in 23/46 (50%). IHC results were confirmed by FISH in 11/46 (24%). Discordant HER2 results (discrepant IHC-IHC or IHC- FISH results) between primary and metastatic tissue samples were reported in 7/46 (15%). Conclusion: The pace of enrollment suggests that this study design represents a feasible approach in HER2+ MBC. The predominant HER2 test reported was IHC performed on primary tissue samples. The number of patients with confirmatory metastatic biopsy findings and discrepant HER2 results was higher than anticipated and highlight the importance of accurate HER2 testing practices. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Genentech Genentech Genentech
Serum Concentrations of Colistin in Patients with Normal and Impaired Renal Function
Authors: Donald N. MacKay, Donald Kaye
Journal: New England Journal of Medicine (1964)

A MARKED increase in the incidence of systemic infections due to gram-negative enteric bacilli has been observed in hospitalized patients since the advent of antibiotic therapy.1 , 2 Many of these micro-organisms are relatively insensitive or resistant in vitro to the action of commonly used antibiotics.3 , 4 However, most strains of escherichia, klebsiella-aerobacter and pseudomonas species are susceptible in vitro to colistin,3 , 4 which has been shown to be effective in therapy of infections caused by these micro-organisms.4 5 6 7 To achieve therapeutic serum levels of colistin, intramuscular administration of colistimethate sodium§ must be employed.8 Colistin is excreted in the urine,9 , 10 and excessively high serum concentrations . . .
Fortnightly Review: Treating myopia with the excimer laser: the present position
Authors: D. S Gartry
Journal: BMJ (1995)

<h3>Summary points</h3> Excimer laser photorefractive keratectomy is the latest in a long line of surgical treatments for myopia (short sightedness) Around 50 centres (including three research centres) in the United Kingdom offer this treatment and tens of thousands of patients have been treated worldwide Considerable individual variation in corneal wound healing exists following photorefractive keratectomy, and this limits the predictability of the procedure Predictability of refractive outcome is much better for lower amounts of myopia (up to around - 6.00 dioptres) Important side effects exist which are all more common in people with higher myopia (regression, corneal haze, loss of best corrected visual acuity) Overall patient satisfaction is high and around 85% of patients are pleased with the outcome even if this is a partial correction only Careful patient selection and counselling are vitally important, and all patients must be fully informed of possible side effects
Ditching our simplistic systems for categorising mental health problems
Authors: Keith E Dudleston
Journal: BMJ (2016)

Mutations in the TANK-binding kinase (<i>TBK1</i>) gene have been shown to cause frontotemporal dementia (FTLD) and amyotrophic lateral sclerosis (ALS). The phenotype is highly variable and has been associated with behavioural variant FTD, primary progressive aphasia and pure amyotrophic lateral sclerosis. We describe the clinical, anatomical and pathological features of a patient with onset of a corticobasal syndrome (CBS)/primary progressive aphasia overlap aged 59. The patient presented with progressive speech difficulties and later developed an asymmetric akinetic-rigid syndrome. Neuroimaging showed asymmetrical frontal atrophy, predominantly affecting the right side. There was a strong family history of neurodegenerative disease with 4/7 siblings developing either dementia or ALS in their 50’s-60’s. Following death at age 71, post mortem examination revealed FTLD TDP-43 type A pathology. Genetic screening did not reveal a mutation in the progranulin, microtubule-associated protein tau or <i>C9orf72</i> genes. However exome sequencing revealed a novel E703X mutation in the <i>TBK1</i> gene. Although segregation data was not available, this loss of function mutation is highly likely to be pathogenic. In conclusion, we show that TBK1 can be a cause of an atypical parkinsonian syndrome and screening for <i>TBK1</i> should be considered in CBS patients with a family history of dementia, ALS or CBS.
Cyclophosphamide Therapy in Childhood Neuroblastoma
Authors: W. G. Thurman, D. J. Fernbach, M. P. Sullivan
Journal: New England Journal of Medicine (1964)

THE role of chemotherapy in the management of the child with neuroblastoma remains to be defined. Until recently, conventional therapy has consisted of a combination of surgery and radiotherapy, whereas chemotherapy has usually been reserved for palliation of children with advanced metastatic disease. This approach can be attributed to the fact that no specific agent has been of consistent value in the treatment of this neoplasm. Since the introduction of cyclophosphamide to clinical investigation in this country in 1958 reports from various investigators1 2 3 have indicated a more consistent pattern of response with this drug, especially in advanced disease, than has . . .
The Popliteal-Artery Entrapment Syndrome in a Patient Using Anabolic Steroids
Authors: Mattia Lepori, Andreas Perren, Augusto Gallino
Journal: New England Journal of Medicine (2002)

To the Editor: The popliteal-artery entrapment syndrome is a potentially serious but rare cause of ischemia of the legs.1 It occurs predominantly in young persons and is due to an abnormal anatomic...
Intermittent Cyclical Etidronate Treatment of Postmenopausal Osteoporosis
Authors: Nelson B. Watts, Steven T. Harris, Harry K. Genant, Richard D. Wasnich, Paul D. Miller, Rebecca D. Jackson, Angelo A. Licata, Philip Ross, Grattan C. Woodson, Melissa J. Yanover, W.Jerry Mysiw, Larry Kohse, M. Bhaskar Rao, Peter Steiger, Bradford Richmond, Charles H. Chesnut
Journal: New England Journal of Medicine (1990)

To determine the effects of etidronate (a bisphosphonate that inhibits osteoclast-mediated bone resorption) in the treatment of postmenopausal osteoporosis, we conducted a prospective, two-year, double-blind, placebo-controlled, multicenter study in 429 women who had one to four vertebral compression fractures plus radiographic evidence of osteopenia.
18F-FDG PET/CT Imaging of Bilateral Renal Metastasis of Breast Adenoid Cystic Carcinoma
Authors: Hani Hassoun, Yazan Z. Alabed, Shawn Karls, Stephan Probst, Jerome Laufer
Journal: Clinical Nuclear Medicine (2015)

We report the case of a 65-year-old woman with a history of adenoid cystic carcinoma (ACC) of the breast. Fifteen years after mastectomy, the patient underwent a right upper lobectomy for a lung mass, and biopsy indicated ACC metastasis. Ten years after lobectomy, an F-FDG PET/CT was performed for restaging to rule out further metastases. We observed intense FDG uptake in enlarged polylobulated kidneys, which was biopsy proven as ACC metastasis.
Motor-Neuron Disease in Natives of New Guinea
Authors: D. Carleton Gajdusek
Journal: New England Journal of Medicine (1963)

WITH the focuses of high incidence of motor-neuron disease now known in the Chamorro and Carolinian populations in the Mariana Islands of Micronesia1 2 3 and on the Kii Peninsula of Japan,4 it has for several years been my interest to determine whether such diseases can be found among Melanesian populations in the South Pacific. This report deals with the identification of a disease similar to amyotrophic lateral sclerosis in several areas of New Guinea, with the discovery of a large focus of unusually high incidence of motor-neuron disease clinically akin to amyotrophic lateral sclerosis, but running a very slowly progressive, prolonged . . .
Safety and efficacy of capecitabine (C) plus bevacizumab (B) as first-line in metastatic breast cancer
Authors: G. Sledge, K. Miller, C. Moisa, W. Gradishar
Journal: Journal of Clinical Oncology (2007)

1013 Background: C alone has good activity and tolerability in metastatic breast cancer (MBC) and when combined with docetaxel improves response and survival. C combined with B in heavily pretreated MBC improved the response rate but not PFS. In untreated MBC, the addition of B to chemotherapy significantly improves progression-free survival (PFS) which suggests that B, is most effective in early disease. Methods: Primary objective of this single-arm, 2-phase study, is to evaluate PFS in MBC patients receiving first-line treatment with C 1,000 mg/m 2 twice daily on days 1–15 (28 doses) and B 15 mg/kg on day 1. Treatment was repeated every 21 days until progression. Eligibility criteria included HER2-negative MBC previously untreated for metastatic disease; ECOG performance status =1; no prior anti-angiogenic or oral fluoropyrimidine therapy. A sample size of 109 patients (including dropouts) was required to give 90% power to test an improvement from 4 months median PFS to 5.6 months with the two-sided test (a 5%) Results: At data cut-off, 103 patients had received study medication. Present results are based on 103 patients (ITT population), except tumor response which is based on 91 patients who had response evaluation. The average # of cycles received in first phase is 6.8. 84 pts.are alive at this time. 38.5% (35/91) pts. have had a response: complete response 5.5%; partial response 33.0%. Stable disease is 42.9% with 81.4% clinical benefit. Planned dose received is 77.7 % for C and 99.0 % for B. The majority of adverse events (AEs) were mild or moderate. The most common grade 3 AEs were hand-foot syndrome (13%) and pain (10%); grade 4 pulmonary embolism occurred in 2% in the first phase of the study. Conclusions: Updated results with longer follow-up including toxicity, TTP and PFS will be presented at the meeting. It appears that in first-line C+B is active for MBC and is well tolerated, with few grade 3/4 toxicities. [Table: see text]
Intrathecal Methylprednisolone for Intractable Postherpetic Neuralgia
Authors: Naoki Kotani, Tetsuya Kushikata, Hiroshi Hashimoto, Futoshi Kimura, Masatoshi Muraoka, Misako Yodono, Mizue Asai, Akitomo Matsuki
Journal: New England Journal of Medicine (2000)

There is no effective treatment for intractable postherpetic neuralgia. Because there is evidence that postherpetic neuralgia has an inflammatory component, we assessed treatment with intrathecally administered methylprednisolone to reduce pain in patients with this disorder.