tbuckley/cabot-search huggingface dataset:
Radiation therapy, cigarette smoking, and lung cancer risk among breast cancer patients in Connecticut
Authors: Judith S. Jacobson, Elizabeth Kaufman, Alfred I. Neugut, Manisha Desai
Journal: Cancer Research (2005)

Proc Amer Assoc Cancer Res, Volume 46, 2005

1663 

As cancer survival improves, patients face the long-term consequences of the disease, its causes, and its treatment. The purpose of this study was to investigate the relationships between radiation therapy (RT) for breast cancer, cigarette smoking, and second primary lung cancer. We conducted a population-based nested case-control study of women listed in the Connecticut Tumor Registry as having a first primary breast cancer diagnosed after 1964. Cases were women who developed a second primary cancer of the lung at least ten years after the first primary breast cancer diagnosis. Controls, matched to the cases on age at and year of breast cancer diagnosis, had survived at least as long as their case without being diagnosed with a second cancer. Medical records were abstracted for information on history of cigarette smoking and breast cancer therapy, including radiation therapy, chemotherapy and surgery. Analyses focused on the independent and joint effects of cigarette smoking and RT on the risk of lung cancer. Our sample included 119 cases and 380 controls; 43% of cases and 37% of controls received RT for their breast cancer. At the time of breast cancer diagnosis, 68% of case patients had ever smoked cigarettes (48% were current smokers and 20% were former smokers), compared with 26% of control patients (18% current smokers, 8% former smokers). Smoking status was not available from the medical records of 25% of subjects. Radiation therapy alone did not significantly increase the risk of lung cancer. Smoking prior to the breast cancer diagnosis increased the risk of developing lung cancer. Smoking was a highly statistically significant modifier of the effect of radiation therapy on lung cancer risk. The results of our logistic regression analysis appear in the table below. The risk of lung cancer among cigarette smokers is high regardless of their breast cancer history. During the period covered by this study, the technology of RT advanced, reducing radiation exposure of normal tissue. However, given the striking interaction we observed between RT and smoking, radiation oncologists may want to ascertain the smoking status of their breast cancer patients and to discuss the potential risks with smokers prior to treatment.
Clinical and Metabolic Effects of Prednisone, Prednisolone and Cortisone in a Patient with Acrodermatitis Continua (Hallopeau)
Authors: Evan Calkins, Leon Reznick, Walter Bauer
Journal: New England Journal of Medicine (1957)

THE introduction of prednisone and prednisolone has provided steroids with markedly enhanced anti-inflammatory effectiveness in comparison with their 1, hydrogenated analogues, cortisone and hydrocortisone. This has been demonstrated in patients with rheumatoid arthritis,1 2 3 acute disseminated lupus erythematosus,4 pemphigus,5 bronchial asthma6 and other diseases. The extent to which this enhanced potency is accompanied by an increase in the adverse metabolic consequences of corticoid therapy is still under debate. Because patients with rheumatoid arthritis and other debilitating diseases show less than normal tendency to display losses of nitrogen, phosphorus and calcium during acute stressful situations or massive corticoid therapy, it was thought . . .
Detecting colorectal cancer based on presence of methylated septin 9 DNA in plasma.
Authors: K. Muralidharan, M. S. Tint, A. K. Chadha, P. P. Chou, V. M. Pratt
Journal: Journal of Clinical Oncology (2010)

e14071 Background: The improved prognosis for early-detected colorectal cancer (CRC) has supported the value of CRC screening. However, compliance is very low, partly due to the inconvenience and unpleasant nature of colonoscopy and fecal sampling. The availability of a blood-based test for CRC detection might improve compliance and enable early detection of more cancers. Detection of methylated septin 9 DNA in plasma has been associated with CRC in prior studies. We report herein the development and validation of a clinical test for methylated septin 9 DNA in plasma. Methods: Total nucleic acids were extracted from plasma using the Chemagen MSM platform. Bisulfite conversion and purification of DNA was performed using the Zymo Research DNA Direct kit. Methylated septin 9 DNA was detected using methylation-specific real-time PCR. We evaluated sensitivity, specificity, and clinical performance using plasma samples from colonoscopy-negative individuals and CRC patients at varying stages. Results: The PCR was specific for methylated DNA in the range of 0.0005–50 ng DNA/reaction. No septin 9 PCR products were detected at the same concentrations of unmethylated DNA. Five of 46 (11%) colonoscopy-negative individuals tested positive for methylated septin 9 DNA. The detection rate among CRC patients was 12/18 (67%) stage I, 8/18 (44%) stage II, 7/10 (70%) stage III, and 5/5 (100%) stage IV cases. The overall clinical sensitivity was 63%, and the specificity was 89%. Conclusions: This methylated septin 9 DNA PCR test is highly sensitive and specific for detection of the analyte. In patient samples, the assay has a clinical sensitivity and specificity comparable to fecal occult blood (FOBT) and immunochemical tests. Thus, the assay may prove to be useful for identifying patients at risk of colorectal cancer. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Quest Diagnostics Quest Diagnostics
<i>Capnocytophaga canimorsus</i>Sepsis
Authors: L Alberio, B Lämmle
Journal: New England Journal of Medicine (1998)

Figure 1. A 41-year-old man had a two-day history of constant upper-abdominal pain, diarrhea, and fever (temperature as high as 40°C). The blood pressure was 139/59 mm Hg, and the pulse rate was 100 beats per minute. Physical examination revealed abdominal distention, diffuse tenderness, decreased bowel sounds, and poor dentition but was otherwise unremarkable. The hemoglobin level was 9.4 g per deciliter, with a white-cell count of 11,700 per cubic millimeter and a platelet count of 1000 per cubic millimeter. The peripheral-blood smear revealed abundant fusiform rods that were about 2 to 4 μm in length (arrows) and were frequently . . .
A Case of Lung Squamous Cell Carcinoma With Duodenal Metastasis on FDG PET/CT
Authors: Gang Cheng
Journal: Clinical Nuclear Medicine (2016)

Non–small cell lung cancer (NSCLC) tends to have distant metastasis. However, metastasis from NSCLC to the small bowel is uncommon, and duodenal metastasis from NSCLC is extremely rare. FDG PET/CT findings of duodenal metastasis from NSCLC have not been reported in the literature. In this case, we report FDG PET/CT findings in a 61-year-old NSCLC patient with biopsy-proven metastasis in the transverse duodenum.
Hydroxy Acid Excretion in Steatorrhea of Pancreatic and Nonpancreatic Origin
Authors: Young S. Kim, Norton Spritz
Journal: New England Journal of Medicine (1968)

Although fecal hydroxy fatty acids are known to be increased in steatorrhea, we found this increase to be inconstant in different types of steatorrhea. In eight normal subjects, hydroxy acids were undetectable in three and in no case exceeded 1.2 per cent of total fecal fatty acids. In 15 patients with steatorrhea from causes other than pancreatic insufficiency, hydroxy acid excretion per day ranged from 0.2 to 11.4 gm, representing from 5.1 to 20.9 per cent of their total fecal fat loss. In five patients with comparable steatorrhea caused by pancreatic disease, hydroxy acids were undetectable in two, were below 1 per cent of fecal fat loss in two and in the fifth amounted to 2.2 per cent of this loss. The significant difference in excretion of hydroxy acids between patients with pancreatic disease and those with other types of steatorrhea may prove diagnostically useful and suggests that only nonesterified fatty acids serve as substrate for hydroxylation by intestinal bacteria.
Bowel and bladder toxicity patterns in patients with prostate cancer treated with proton beam versus intensity-modulated radiation therapy.
Authors: Phillip J. Gray, Jonathan J. Paly, Martin G. Sanda, Howard Mark Sandler, Jeff M. Michalski, James Austin Talcott, John Coen, William U. Shipley, Anthony L. Zietman, Justin E. Bekelman, Jason Alexander Efstathiou
Journal: Journal of Clinical Oncology (2012)

22 Background: Limited data exist comparing contemporary technologies in the treatment of prostate cancer. Proton beam therapy (PBT) and intensity-modulated radiation therapy (IMRT) are both accepted ways of delivering high-dose radiation. We evaluated patient-reported quality of life (QOL) outcomes from two modern prospective cohorts treated with either PBT or IMRT. Methods: QOL data for 153 patients treated with IMRT and collected by the PROST-QA consortium using the Expanded Prostate Cancer Index Composite instrument were compared to data for 95 patients treated on protocol between 2004 and 2008 at the Massachusetts General Hospital with PBT using the Prostate Cancer Symptoms Index instrument. Mean score changes from baseline were compared using the Satterthwaite t-test. Clinically meaningful decline was defined as a score drop exceeding half the standard deviation of the baseline value. Results: Both cohorts had a similar distribution of Gleason score and baseline PSA though the IMRT cohort was older (median age 69 vs. 64, p&lt;.0001). Treatment dose range was 75.6-79.2 Gy for IMRT and 74-82 CGE for PBT. Neither group received hormonal therapy. By 3 months after treatment there was a significant worsening in the bowel domain for the IMRT but not PBT cohort (15.9 point reduction vs. 1.5, p&lt;.0001) which normalized by 12 months. Post-treatment scores were also lower in the urinary irritation domain (13.8 point reduction vs. 5.5, p&lt;.0001) and in the urinary incontinence domain (7.3 point reduction vs. 1.5, p=.002) for IMRT but were similar by 24 months. All immediate post-treatment score changes in the IMRT but not PBT cohort were clinically meaningful. A steady decline in the sexual function domain was seen in both groups but the difference was not significant. Conclusions: In this non-randomized comparison using two validated QOL instruments measuring similar domains, PBT appears to be associated with lower gastrointestinal and urinary toxicity early after treatment with similar late outcomes. While subject to selection bias, these preliminary data suggest transient differences in toxicity patterns underscoring the rationale for a randomized controlled trial.
Latent Papillomavirus and Recurring Genital Warts
Authors: Alex Ferenczy, Masaru Mitao, Nobutaka Nagai, Saul J. Silverstein, Christopher P. Crum
Journal: New England Journal of Medicine (1985)

After anogenital condylomata and intraepithelial neoplasms are removed, they frequently recur. Since these lesions are related to papillomaviruses, it has been suggested that latent papillomavirus infection is responsible for recurrence. We studied 20 cases of anogenital lesions that were treated by laser therapy and analyzed biopsy specimens of margins of normal skin adjacent to the lesions for papillomavirus sequences by Southern blot hybridization. In nine cases (45 per cent), papillomavirus sequences were detected in the normal skin margin; lesions recurred in 6 of the 9 patients (67 per cent), in contrast to only 1 of 11 patients (9 per cent) whose margins were negative for the presence of papillomavirus sequences. All but one recurrence developed within 15 mm of the treatment area. Our results demonstrate that clinically and histologically latent papillomavirus exists beyond the treatment area and that its presence influences subsequent recurrences.
Superoxide Dismutase 2 (Sod2) Expression Is Highly Decreased In Chronic Myeloid Leukemia (CML): Contribution To Genetic Instability In Bcr-Abl-Expressing Leukemic Cells
Authors: Sandrine Girerd, Lucie Tosca, Olivier Herault, Christine Vignon, Denis Biard, Fatima Dkhissi, Clémentine Bouneau, Djamel Aggoune, Angelina Bertrand, Marie Laure Bonnet, Nathalie Sorel, Gerard Tachdjian, François Guilhot, Joelle Guilhot, Jean-Claude Chomel, Ali G Turhan
Journal: Blood (2013)
Ongoing outbreak of aseptic meningitis in south-eastern Latvia, June – August 2010
Authors: J Perevoščikovs, A Brila, L Firstova, T Komarova, I Lucenko, J Osmjana, L Savrasova, I Singarjova, J Storozenko, N Voloscuka, N Zamjatina
Journal: Eurosurveillance (2010)

An outbreak of aseptic meningitis has been ongoing in several areas of Latgale region, in the south-eastern part of Latvia since the end of June 2010. By 9 August 2010, 114 cases had been notified. Most of the cases were registered in the city and amalgamated municipality of Daugavpils and neighbouring territories. According to current evidence, two types of enteroviruses, coxsackie A-9 virus and echovirus 30, are the causative agents of the outbreak.
The Prognostic Value of Serum Troponin T in Unstable Angina
Authors: Christian W. Hamm, Jan Ravkilde, Willie Gerhardt, Poul Jørgensen, Edgar Peheim, Lars Ljungdahl, Britta Goldmann, Hugo A. Katus
Journal: New England Journal of Medicine (1992)

Cardiac troponin T is a regulatory contractile protein not normally found in blood. Its detection in the circulation has been shown to be a sensitive and specific marker for myocardial cell damage. We used a newly developed enzyme immunoassay for troponin T to determine whether its presence in the serum of patients with unstable angina was a prognostic indicator.
Polymorphisms in estrogen receptor beta, interleukin-8, and interleukin-8 receptor associated with clinical outcome in metastatic colorectal cancer (mCRC) patients treated with 5-fluorouracil/oxaliplatin
Authors: R. D. Ladner, M. A. Gordon, W. Zhang, D. Yang, F. Nagashima, H. Chang, G. Lurje, E. Borucka, H. Lenz
Journal: Journal of Clinical Oncology (2007)

4130 Background: Many factors contribute to the progression of colorectal cancer and to chemoresistance. Two factors that have recently gained attention are angiogenesis and sex hormones. Interleukin-8 and its receptors play a critical role in angiogenesis, and polymorphisms in these genes have previously been reported to predict clinical outcome and resistance to therapy in a variety of cancer types. In addition, gender and the subsequent varied levels of sex hormones between males and females may also have an impact on colorectal cancer progression. Sex hormones such as estrogen exert their effects on the cell by binding to steroid receptors such as estrogen receptor beta (ER-β). It is known that ER-β is predominantly expressed in the colon, and that differential expression of this gene is predictive of clinical outcome. Therefore, functional polymorphisms within ER-β, IL-8, and the IL-8 receptors may prove to be molecular markers for predicting clinical outcome in colorectal cancer patients. Methods: 173 patients were enrolled in this phase II study. 152 patients were evaluable for genotyping and statistical analysis. There were 74 females and 78 males, and median age was 60 (range 25–87). The dose of oxaliplatin was 130mg/m 2 every 3 weeks and 5-FU was 200mg/m 2 /day CI for 10 weeks followed by 2 weeks rest. Polymorphisms in estrogen receptor beta, IL-8, and CXCR2 (IL-8 receptor) were tested by PCR. Results: Median follow-up was 18.6 months, response rate 19%, median time to tumor progression 4.2 months and median survival 10.3 months. IL-8 T251A polymorphism was predictive of time to tumor progression (p=0.04, log-rank test). ER-β CA repeat polymorphism was predictive of tumor response as well as time to tumor progression (p=0.015, p=0.012, respectively). ER-β A730G SNP was also predictive of time to tumor progression (p=0.03). Polymorphism in CXCR2 was predictive of tumor response (p=0.034). Conclusions: Our results suggest that polymorphisms within IL-8, CXCR2, and ER-β may affect the progression of colorectal cancer and subsequent clinical outcome. These results highlight the importance of angiogenesis and hormone levels in colorectal cancer. No significant financial relationships to disclose.
Immunocytochemical and Serologic Observations in Primary Biliary Cirrhosis
Authors: Fiorenzo Paronetto, Fenton Schaffner, Hans Popper
Journal: New England Journal of Medicine (1964)

CONVENTIONAL microscopical studies in primary biliary cirrhosis carried out in this laboratory have suggested a specific injury of the intrahepatic bile ducts,1 in agreement with previous reports.2 , 3 The early lesion is characterized by immunocytes — namely, lymphocytes and plasma cells — in the walls of and around bile ducts and by proliferation of apparently immunocytic mesenchymal cells in the lining of the sinusoids. These features suggest an immunologic reaction in this disease, whose etiology is unknown. In the later stages the specific histologic changes become noncharacteristic. A role of an immune reaction in the pathogenesis of this disorder has been . . .
Case 25-2012
Authors: Garrett C. Zella, Michael S. Gee, Kamran Badizadegan
Journal: New England Journal of Medicine (2012)

A 15-year-old boy had intermittent abdominal pain and diarrhea for 8 months. The abdomen was mildly tender. There was iron deficiency and occult blood in the stool. A diagnostic test was performed.
Unusual Dermatoglyphics Associated with Major Congenital Malformations
Authors: Ruth Achs, Rita G. Harper, N. J. Harrick
Journal: New England Journal of Medicine (1966)

UNUSUAL and unexpected distortions of dermal patterns were first observed in chromosome aberrations.12 These reports stimulated our interest to look for other correlations. In our random screening of abnormal infants we soon became impressed with the high incidence of unusual dermatoglyphies in children with all types of major congenital malformations. Four findings appeared to occur with increased frequency in abnormal infants: simian lines; bilateral distal axial triradii; radial loops on other than the second digit; and a single flexion crease on a digit. These unusual findings occur in normal persons but are relatively rare in the general population.'3 A dermatoglyphic . . .
Positive and Negative Gravitational Forces and Herniated-Disk Sciatic Pain
Authors: Daniel S.J. Choy
Journal: New England Journal of Medicine (1997)

To the Editor: I recently encountered a stunt pilot with an L4–5 herniated disk, documented by magnetic resonance imaging (MRI), who had sciatic pain and experienced exacerbation of symptoms when pulling out of a sharp dive, at which point his body was subjected to up to 5 g's. The pilot empirically found he could alleviate this pain by climbing to 10,000 ft and performing an outside loop, experiencing as much as -3 g's. These experiences were repetitively duplicated in the course of his profession, which was performing aerobatics in high-performance fighter planes at military and civilian air shows. The physiology . . .
Necrotic Lesions of the Leg in Arteriosclerosis
Authors: Edward A. Edwards
Journal: New England Journal of Medicine (1948)

IT IS commonly known that necrosis can occur in the toes or feet in the presence of arteriosclerosis. It is the purpose of this paper to indicate that necrosis may likewise start more proximally, in the leg, and that the lesion is of grave import and deserves painstaking treatment. The disorder may arise spontaneously as an infarction of the skin and subcutaneous tissue. In other cases the necrosis follows local trauma or infection.Clinical Varieties Infarction of the Skin In this category may be placed cases in which there is the sudden appearance of a blue-red area on the leg, . . .
Case 30-2000
Authors: Jonathan P. Arm, Eugene J. Mark
Journal: New England Journal of Medicine (2000)

Presentation of CaseA 25-year-old man was admitted to the hospital because of asthma, cardiac failure, diarrhea, and weakness of the right hand.He had been well until two years earlier, when asthma developed. It was managed with bronchodilator medications and intermittent pulsed doses of corticosteroids, including prednisone. Seven months before admission, treatment with montelukast sodium was begun. The wheezing worsened, and repeated doses of corticosteroids were administered. Four months before admission, laboratory tests were performed (Table 1 and Table 2). Several weeks before admission, the dose of prednisone was tapered, but information on the specific regimen was not available.One month . . .
Radiation risks to lymphoma patients undergoing 18F-FDG studies
Authors: L. V. Hardin, J. Ravenel, L. Gordon, W. Huda, E. Mah
Journal: Journal of Clinical Oncology (2009)

e22024 Background: To investigate radiation risks to patients undergoing 18F-FDG studies that take into account patient age, sex, and weight. Methods: We obtained patient demographics and weights of 54 consecutive patients with lymphoma who each underwent a18F-FDG PET study. The administered activity was converted into an effective dose using the patient size dependent dosimetry data provided in ICRP Publication 80. Patient effective doses were converted into estimates of the lifetime attributable risk of cancer incidence and cancer mortality using age and sex dependent risk factors provided in BEIR VII. Results: The average patient age/weight in this study was 43 years/68 kg for males and 33 years/61 kg for females. Patient effective dose are proportional to patient weight (-0.784) (r 2 &gt;0.99). The average administered activity was 410 MBq, which resulted in an average effective dose of 8.5 mSv for males and 8.9 mSv for females. The average cancer incidence was 0.71/1,000 cases for males, and 1.27/1,000 cases for females, with cancer mortality being about half the incidence. Cancer rates for the youngest patients were an order of magnitude higher than those for the oldest patients. Conclusions: Average lifetime attributable cancer risks to lymphoma patients from a single FDG-PET study is approximately 1 per 1,000, but are strongly influenced by patient age, gender and weight. Cancer risk in younger patients is a magnitude of order greater. No significant financial relationships to disclose.
Post-Transfusion Purpura
Authors: Francis S. Morrison, P. L. Mollison
Journal: New England Journal of Medicine (1966)

SHULMAN et al.1 described 2 patients in whom severe purpura developed six or seven days after transfusion; in both cases a potent platelet isoantibody was present in the plasma. The specificity of the 2 antibodies was shown to be identical with that of an antibody previously described by van Loghem and his co-workers2 that was at first called anti-Zw and later anti-Zwa (after the discovery of the allele Zwb).3 Shulman and his co-workers1 suggested that it might be better to name- the various platelet antigen systems as PlA, P1B and so forth, and that anti-Zwa should be . . .
Herpes Zoster Involving the Urinary Bladder
Authors: Robert Meyer, Hathorn P. Brown, J. Hartwell Harrison
Journal: New England Journal of Medicine (1959)

HERPES zoster has been recognized as a clinical entity since the time of Celsus; it was referred to as "zona" by the Greeks and "holy fire" by the Romans.1 Mehlis, in 1818, pointed out its association to peripheral nerves, but it was Bärensprung,1 in 1861, who first described its relation to the dorsal-root ganglions. The etiologic agent appears to be a filtrable virus that may be related to the virus of chicken pox. Histologically, it produces a severe inflammatory reaction in the dorsal root and ganglions, as described by Head and Campbell.2 This reaction may extend peripherally or centrally, or . . .