tbuckley/cabot-search huggingface dataset:
PWE-226 Enteral feeding in non-surgical oncology- it–s not just head and neck and upper GI cancers: Abstract PWE-226 Table 1
Authors: R White, S Freemantle, R Bracegirdle, S Chowdhury, M Roy, O Kegey, M Siemicka
Journal: Gut (2015)

<h3>Introduction</h3> A significant amount of head and neck (H&amp;N) and upper gastrointestinal (UGI) cancer patients require enteral nutrition (EN) at home. At our centre in 2014 alone we established 156 H&amp;N patients and 52 UGI patients on home EN. However, a significant proportion of cancer patients with other tumours may also require EN. ESPEN guidelines recommend EN should be considered if under-nutrition exists, oral intake is &lt; 60% of requirements and prognosis exceeds 2–3 months.<sup>1</sup>Our aim was to determine the extent of EN use in non-surgical oncology patients (excluding H&amp;N and UGI patients) and to compare its use against ESPEN guidelines. <h3>Method</h3> We undertook a retrospective review of dietetic records between January 2013 and December 2014 for all patients who required home EN. Data was analysed descriptively. <h3>Results</h3> 17 patients were initiated on EN during the data collection period. 16 patients were fed via naso-gastric tube (NGT) and 1 via percutaneous endoscopic gastrostomy (PEG), with 2 of the NGT’s later converted to gastrostomies. Table 1shows the number of patients with EN by tumour site and stage of cancer pathway. The main indication for EN was dysphagia secondary to disease (76%), oesophagitis secondary to radiotherapy (12%), inadequate oral intake (6%) and tracheal-oesophageal fistula (6%). 12 patients were nil by mouth due to aspiration risk and 5 were managing &lt; 60% of estimated nutritional requirements. Only 3 (18%) patients were given a predicted prognosis of &lt;3 months but all were fed following MDT discussion with the aim of improving quality of life (QOL). <h3>Conclusion</h3> A small but significant proportion of oncology patients require home EN outside of H&amp;N and UGI cancers. In particular lung cancer patients may have a need for EN due to swallowing difficulties where the cause can be multifactorial.<sup>2</sup>Our practice appears compliant with ESPEN guidelines with all patients managing less than 60% of requirements on initiation of feeding and prognosis was &gt; 3 months in all but 3 patients. However, the effectiveness of EN is rarely recorded and greater consideration should be given to validated outcome measures both in terms of anthropometry and QOL. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Arends J, <i>et al</i>. ESPEN Guidelines on Enteral Nutrition: Non surgical oncology. Clin Nutr. 2006;25:245–259. Camidge D. The causes of dysphagia in carcinoma of the lung. J Roy Soc Med. 2001;94:567–572.
Multiple Myeloma and Acute Myelomonocytic Leukemia
Authors: Robert A. Kyle, Robert V. Pierre, Edwin D. Bayrd
Journal: New England Journal of Medicine (1970)

A rapidly progressive acute myelomonocytic leukemia developed in four patients who had received prolonged courses of melphalan, ranging from 30 to 57 months. Three patients were being treated for typical multiple myeloma (anemia, elevated sedimentation rate, monoclonal serum peak, Bence-Jones protein in the urine, lytic bone lesions and increased numbers of myeloma cells in the marrow), and one for a plasma-cell dyscrasia, with systemic amyloidosis of five years' duration. Because of the remote likelihood of chance association of acute leukemia and multiple myeloma, the known effect of alkylating agents on deoxyribonucleic acid, the fact that the leukemia was myelomonocytic, and the long period of treatment with melphalan, a possible etiologic role of melphalan therapy in the development of acute leukemia is suggested.
Relation between Skin Cancer and HLA Antigens in Renal-Transplant Recipients
Authors: Jan N. Bouwes Bavinck, Bert J. Vermeer, Fokko J. van der Woude, Jan P. Vandenbroucke, Geziena M. Th. Schreuder, Jane Thorogood, Guido G. Persijn, Frans H.J. Claas
Journal: New England Journal of Medicine (1991)

Recipients of renal allografts are at an increased risk for skin cancer. It Is also known that recipients who are homozygous for HLA antigens are at an increased risk for certain cancers, as are those who are mismatched with their donors for these antigens. In a case–control study we assessed the relation between skin cancer in renal-transplant recipients and HLA homozygosity and mismatching.
Progressive Multifocal Leukoencephalopathy
Authors: Edward P. Richardson
Journal: New England Journal of Medicine (1961)

IN the course of the regular post-mortem examination of the brains of patients coming to autopsy at the Massachusetts General Hospital, my attention has been called in recent years to an unusual disorder of the cerebral white matter with distinctive features unfamiliar to me and my colleagues from our own experience or that of others. We reported 3 such cases in 19581 and called the condition "progressive multifocal leukoencephalopathy" to emphasize the outstanding clinicopathological features. Since these 3 cases, and 3 of the 5 others previously reported, were associated either with lymphatic leukemia or with Hodgkin's disease, we considered the . . .
Case 33-2008
Authors: Charles M. Wiener, Victorine V. Muse, Eugene J. Mark
Journal: New England Journal of Medicine (2008)

A 63-year-old woman was admitted to the hospital because of a 3-week history of dyspnea on exertion, associated left subscapular burning pain, and a mild dry cough. She had a history of ulcerative colitis, which was most recently treated with azathioprine and infliximab. On examination, there were inspiratory wheezes and rales, without expiratory wheezes. Chest imaging showed ground-glass opacities in both lower lobes. A diagnostic procedure was performed.
The effects of body mass index on curative radiation therapy in cervical carcinoma: An analysis of complications and survival
Authors: P. H. Thaker, F. Gao, I. Zighelboim, M. A. Powell, J. S. Rader, D. G. Mutch, N. Kizer
Journal: Journal of Clinical Oncology (2009)

e16520 Background: Recently, the rates of obese and overweight patients have increased dramatically. However, the effect of body mass index (BMI) have not been evaluated in treatment outcomes for patients with advanced stage cervical cancer receiving definitive chemotherapy and radiation therapy, and is the purpose of this study. Methods: After obtaining approval from the Washington University Human Studies Protection Office, a retrospective cohort study (n = 321) was performed on all cervical cancer patients with stage IB 1 with positive lymph nodes or ≥ stage IB 2 from January 1998 to January 2008. The median duration of follow up was 60 months. BMI was calculated using the National Institute of Health online BMI calculator. Main outcomes were overall survival, disease free survival, and radiation complications such as radiation enteritis/cystitis, bowel obstruction, and fistula formation. Univariate and multivariate analyses were performed, and Kaplan-Meier curves were generated. Results: Underweight patients (BMI&lt;18.5 kg/m 2 ) compared to normal weight (BMI = 18.5–25 kg/m 2 ) and overweight/obese (&gt;25 kg/m 2 ) have a higher actuarial complication rate (p = 0.0137). Regardless of weight there is no difference in disease free survival. However, underweight patients have a significantly poorer overall survival than those patients with a higher BMI (&gt;18.5 kg/m 2 ) (p &lt; 0.001). Conclusions: Underweight patients have a diminished overall survival compared to normal or obese cervical cancer patients. This is of clinical relevance when counseling underweight cervical cancer patients who will be cured of the disease with chemotherapy and radiation therapy, but have a significant risk of suffering potentially fatal complications from treatment. Further study needs to be done to elucidate this relationship further. No significant financial relationships to disclose.
Prozac or Prilosec for Gastric Ulcer?
Authors: John M. Costable, Matthew J. McKinley
Journal: New England Journal of Medicine (1996)

To the Editor: Six years ago, Fine et al. reported two instances in which Lasix (furosemide) was confused with Losec, the trade name for omeprazole at that time.1 Later that year, Merck Sharp & Doh...
Distinct subpopulations of FOXD1 stroma-derived cells regulate renal erythropoietin
Authors: Hanako Kobayashi, Qingdu Liu, Thomas C. Binns, Andres A. Urrutia, Olena Davidoff, Pinelopi P. Kapitsinou, Andrew S. Pfaff, Hannes Olauson, Annika Wernerson, Agnes B. Fogo, Guo-Hua Fong, Kenneth W. Gross, Volker H. Haase
Journal: Journal of Clinical Investigation (2016)

Renal peritubular interstitial fibroblast-like cells are critical for adult erythropoiesis, as they are the main source of erythropoietin (EPO). Hypoxia-inducible factor 2 (HIF-2) controls EPO synthesis in the kidney and liver and is regulated by prolyl-4-hydroxylase domain (PHD) dioxygenases PHD1, PHD2, and PHD3, which function as cellular oxygen sensors. Renal interstitial cells with EPO-producing capacity are poorly characterized, and the role of the PHD/HIF-2 axis in renal EPO-producing cell (REPC) plasticity is unclear. Here we targeted the PHD/HIF-2/EPO axis in FOXD1 stroma-derived renal interstitial cells and examined the role of individual PHDs in REPC pool size regulation and renal EPO output. Renal interstitial cells with EPO-producing capacity were entirely derived from FOXD1-expressing stroma, and Phd2 inactivation alone induced renal Epo in a limited number of renal interstitial cells. EPO induction was submaximal, as hypoxia or pharmacologic PHD inhibition further increased the REPC fraction among Phd2–/– renal interstitial cells. Moreover, Phd1 and Phd3 were differentially expressed in renal interstitium, and heterozygous deficiency for Phd1 and Phd3 increased REPC numbers in Phd2–/– mice. We propose that FOXD1 lineage renal interstitial cells consist of distinct subpopulations that differ in their responsiveness to Phd2 inactivation and thus regulation of HIF-2 activity and EPO production under hypoxia or conditions of pharmacologic or genetic PHD inactivation.
Hospitalization and rehabilitation service through an oncological support PROJECT S.O.R.R.I.S.O (Service of Hospital and Rehabilitation through Integrated Network Supportfor Cancer)
Authors: F. Laudato, R. Manzo, G. Petrillo, A. Massa, F. Andreozzi, F. Caputo, A. Di Sarno, T. Garofano, L. Leo, M.L. Lentini Graziano, G. Massaro, R. Guida, N. Silvestro, G. Pignataro, E. Simeone, M. Tamburrino, N. Ambrosino, V. Montesarchio
Journal: Annals of Oncology (2015)
Androgen receptor independent acquired mechanisms of resistance to enzalutamide in castration-resistant prostate cancer.
Authors: Russell Zelig Szmulewitz, Steve Kregel, Masis Isikbay, Yi Cai, James Lin Chen, Donald J Vander Griend
Journal: Journal of Clinical Oncology (2014)

129 Background: Enzalutamide (MDV3100) is a second generation androgen receptor (AR) antagonist with potent activity in the treatment of castration resistant prostate cancer (CRPC). However, most patients develop resistance and progression of disease; thus there is a critical need to identify novel targetable pathways mechanistically linked to this resistance. Methods: A panel of four prostate cancer cell lines (LAPC-4, LNCaP, VCaP, and CWRR1) was created each with a different AR status that are resistant to MDV3100 by culturing cells long-term less than 6 months in the drug at pharmacologic levels. The MDV3100 resistant (MDV-R) lines were assayed for proliferation, viability, resistance to docetaxel, and tumor take of subcutaneous xenografts. AR expression and ligand binding domain (LBD) DNA sequences were analyzed. Gene expression microarray comparison of resistant and non-resistant parental cell lines was performed. Prostate-specific antigen (PSA) and testosterone levels were analyzed from conditioned media. Results: Cell lines demonstrated heterogeneous growth characteristics.In vivo studies depicted increased or unaltered tumor take and growth in castrate athymic mice. In some cell lines growth was increased in vitro when drug was withdrawn; yet this growth was inhibited by physiological testosterone levels, both in vitro and in vivo. MDV-R cells remained sensitive to docetaxel in vitro and had increased levels of ARmRNA. However, total AR protein levels were lower or unchanged than the parental lines, with evidence for increased truncated forms of AR. The AR LBD acquired no new mutations. Secreted PSA was lower in all but one MDV-R line. Gene expression analyses demonstrated strong upregulation of IGFBP3 in all MDV-R cells. Pathway analysis implicated increased IGF and JAK/STAT signaling whereas mammalian target of rapamycin (mTOR) signaling was decreased. Conclusions: Although AR-mediated pathways contribute to enzalutamide resistance, a broader approach across several cell lines suggests that there may be even a greater contribution from pleiotropic, non-AR mediated mechanisms. Such mechanisms may include IGF signaling, JAK/STAT signaling and modulation of mTOR.
Sex-Specific Associations Between Coronary Artery Plaque Extent and Risk of Major Adverse Cardiovascular Events
Authors: Joshua Schulman-Marcus, Bríain ó Hartaigh, Heidi Gransar, Fay Lin, Valentina Valenti, Iksung Cho, Daniel Berman, Tracy Callister, Augustin DeLago, Martin Hadamitzky, Joerg Hausleiter, Mouaz Al-Mallah, Matthew Budoff, Philipp Kaufmann, Stephan Achenbach, Gilbert Raff, Kavitha Chinnaiyan, Filippo Cademartiri, Erica Maffei, Todd Villines, Yong-Jin Kim, Jonathon Leipsic, Gudrun Feuchtner, Ronen Rubinshtein, Gianluca Pontone, Daniele Andreini, Hugo Marques, Leslee Shaw, James K. Min
Journal: JACC. Cardiovascular imaging (2016)
Case 46-1994
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Melvin D. Burton, Eugene J. Mark
Journal: New England Journal of Medicine (1994)

Presentation of CaseA 35-year-old man was admitted to the hospital because of increasing exertional dyspnea, recent arthralgia and digital clubbing, and a questionable fungus ball in the right lung.The patient had been well until five years earlier, when he began to have increasing exertional dyspnea. Four months before admission arthralgia developed, and his mother, who had pulmonary emphysema, observed that he had digital clubbing. Two months later he consulted a physician. Radiographs of the chest (Figure 1) showed hyperinflated lungs and bilateral upper-lobe bullae; there was a lobulated soft-tissue mass with an air-fluid level within a large bulla . . .
New Technic for Detection of Bacterial Contamination in a Blood Bank Using Plastic Equipment
Authors: Carl W. Walter, Ruth B. Kundsin, Lawrence N. Button
Journal: New England Journal of Medicine (1957)

GROWTH of bacteria in blood during refrigerated storage is a problem in blood banks. Reports of reactions ranging from mild to fatal clinical manifestations after transfusion of contaminated blood have been published,1 2 3 4 5 6 with the consistent observation that transfusion is a potential hazard. Of all the complications of transfusion — incompatibility, allergic manifestation, air embolism or homologous serum jaundice — bacterial contamination is the most insidious and dangerous. Contamination is difficult to detect because the very procedure of sampling a container of blood for culture before transfusion creates the opportunity for contamination. Conventional glass bottles may paradoxically yield a negative culture . . .
Development of Diabetic Vascular Lesions in Normal Kidneys Transplanted into Patients with Diabetes Mellitus
Authors: S. Michael Mauer, Jose Barbosa, Robert L. Vernier, Carl M. Kjellstrand, Theodore J. Buselmeier, Richard L. Simmons, John S. Najarian, Frederick C. Goetz
Journal: New England Journal of Medicine (1976)

We examined renal-transplant tissue from 12 diabetic and 28 nondiabetic patients who had had a renal graft for at least two years. In 10 diabetic patients arteriolar hyalinosis lesions developed in the graft. In six these lesions involved both afferent and efferent limbs of glomerular arterioles - a pathological finding virtually diagnostic of diabetes mellitus. In all cases these lesions were present within five years of transplantation. Only three of the 28 nondiabetic patients had hyaline vascular changes (P less than 0.001), which occurred only in rare vessels, did not appear within the first five years after transplantation and did not involve both afferent and efferent arterioles, One diabetic patient had nodular glomerulosclerosis. Thus, the first clearly distinguishable lesion of diabetes to occur with frequency in normal kidneys transplanted into diabetic patients is arteriolar hyalinosis.
Case 35-2002
Authors: R. Michael Scott, E. Tessa Hedley-Whyte
Journal: New England Journal of Medicine (2002)

Presentation of CaseA nine-year-old right-handed girl was admitted to the hospital because of a suprasellar mass.The girl had been well, with normal development, until about six months earlier, when her mother observed that she reported “feeling cold” with increasing frequency. During the four months before admission, she reported having impaired vision. Several optometric and ophthalmologic examinations failed to reveal a cause, in great part because the girl was frightened and unable to cooperate fully. At about the same time, her performance at school began to deteriorate dramatically; she reported having severe fatigue and was noted to sleep for . . .
Petrosal Sinus Sampling with and without Corticotropin-Releasing Hormone for the Differential Diagnosis of Cushing's Syndrome
Authors: Edward H. Oldfield, John L. Doppman, Lynnette K. Nieman, George P. Chrousos, Donald L Miller, David A. Katz, Gordon B. Cutler, D. Lynn Loriaux
Journal: New England Journal of Medicine (1991)

Measurement of adrenocorticotropin levels in plasma from the inferior petrosal sinuses of patients with Cushing's syndrome can distinguish adrenocorticotropin-secreting pituitary tumors (Cushing's disease) from other causes of the syndrome, principally ectopic adrenocorticotropin secretion from an occult tumor. However, it is unknown whether such measurement consistently identifies patients with Cushing's disease and whether testing with corticotropin-releasing hormone (CRH) enhances the value of the procedure.
More on Ganciclovir-Induced “Psychosis”
Authors: Harold B. Schiff
Journal: New England Journal of Medicine (1997)

With respect to your editorial on the medicinal use of marijuana (Jan.30 issue), 1 I made it a priority, as the first director of the National Institute on Drug Abuse (1973 to 1978), to investigate the health effects of smoking marijuana and to report on them regularly to the Congress and the public.Particular chemical constituents of smoked marijuana may have medical benefits, but it is unthinkable that in the closing decade of the 20th century, American medicine would return to prescribing smoked leaves for any condition.The history of the past hundred years in medicine has been to identify chemicals that offer benefits for specific problems and then to make those chemicals available in stable, known doses.The proper mechanism for sorting out claims of safety and efficacy was established by the Pure Food and Drug Act in 1906. . . .
EGFR expression is associated with increased cell turnover and poor histologic grade in human colon carcinomas
Authors: R. L. Rego, T. C. Smyrk, N. R. Foster, D. J. Sargent, B. F. Kabat, A. J. French, S. N. Thibodeau, M. J. O'Connell, H. Windschitl, F. A. Sinicrope
Journal: Journal of Clinical Oncology (2007)

21046 Background: The Epidermal Growth Factor Receptor (EGFR) is a transmembrane receptor tyrosine kinase that is important for colon cancer cell growth and represents a therapeutic target. We studied EGFR expression in relation to rates of apoptosis and cell proliferation. Methods: TNM stage II and III colon carcinomas (n= 361) from patients treated in a 5-FU-based adjuvant trial were studied. EGFR expression (EGFR pharmDx™) and extent were analyzed and their relationship to rates of cell turnover, histologic grade, mismatch repair (MMR) status (defective if instability at BAT 26 locus plus loss of hMLH1, hMSH2 or hMSH6 proteins) and clinical outcome were determined. Results: EGFR plasma membrane staining was detected in 214 (59.3 %) colon carcinomas. Increased EGFR intensity (2+, 3+) was associated with a higher number of caspase-3- (p= 0.02) and Ki-67- (p&lt; 0.001)positive tumor cells. Increased EGFR intensity (p= 0.02) and extent (p= 0.03) were associated with poor differentiation, and did not depend upon MMR status (Breslow-Day test p ≥ 0.46). Diffuse (vs. focal) EGFR extent was increased in tumors with defective MMR [22 of 32 (69%)] compared to those with intact MMR [136 of 271 (50%)] (p= 0.047). EGFR intensity was unrelated to MMR status. Neither EGFR intensity nor extent was significantly associated with patient survival. Conclusions: Stage II and III colon cancers with EGFR overexpression show adverse prognostic variables, i.e., increased rates of cell turnover and poor histologic grade, suggesting that EGFR may be an important target for adjuvant therapy. * Chi-square test for categorical data, Wilcoxin rank-sum test for continuous data [Table: see text] No significant financial relationships to disclose.
Case 1-1998
Authors: James J. Riviello, Kathryn L. Ruoff
Journal: New England Journal of Medicine (1998)

Presentation of CaseAn 11-year-old right-handed boy was admitted to the hospital because of a seizure.The child had been well until the day of admission, when he stood up and fell, striking his head on a desk. He became unconscious, with arms extended and pronated, and had a right focal motor seizure that became generalized and lasted 20 minutes. There was no contusion, rash, or lymphadenopathy. Emergency medical technicians found him confused, combative, and unresponsive to verbal stimuli. He was brought to this hospital.The boy's mother stated that he had developed normally without any serious illnesses. An adult . . .
Congenital Nystagmus and Hypothyroidism
Authors: Joseph D. Schulman, John D. Crawford
Journal: New England Journal of Medicine (1969)

AN association between congenital nystagmus and hypothyroidism has not to our knowledge been suggested in the medical literature. Four patients have been seen at the Massachusetts General Hospital in whom both these disorders were present and probably dated from birth. Since all four enjoyed reasonably good vision the nystagmus was not of the sensory-defect type.1 This coincidence of two relatively rare abnormalities suggests that their association is pathogenetically meaningful.Case SummariesCase 1. In S.K. (M.G.H. 107–46–63), a girl, now 14 years of age, the diagnosis of hypothyroidism was made at 8 weeks of life, and she has since received . . .
Treatment of Symptomatic Hemolytic Anemia with Prednisone
Authors: Herbert C. Lichtman, S. Fred Rabiner, George S. Shields, Nathan Plotkin, Richard Levere
Journal: New England Journal of Medicine (1957)

THE complication of hemolytic anemia occurring in association with a variety of diseases has been described by numerous observers.1 2 3 4 5 6 The pathogenesis of this process has not been elucidated, although an autoimmune mechanism has been found in some patients.1 , 2 , 4 This increased rate of erythrocytic destruction is known to accompany diseases such as leukemia, especially the chronic lymphocytic type, the malignant lymphomas, carcinoma and collagen diseases. In addition to specific therapeutic measures directed at the underlying disorders, control of the hemolytic component has been effected by the use of ACTH, the adrenal corticoids and splenectomy.7 8 9 10 11 12 In the past year, 9 patients with . . .