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Biomedical subjects

J Perlmutter

Publications and source records attributed to J Perlmutter.

12 recordsLinked to original sources
PubMed2026

Surgical Management of Young Women with High-Risk Breast Cancer Receiving Neoadjuvant Systemic Therapy on the I-SPY2 Trial.

BACKGROUND: Mastectomy rates in women with breast cancer are higher in younger women than in older women. The impact of this more extensive surgery on overall survival (OS) and locoregional recurrence in younger women is unknown, especially after neoadjuvant systemic therapy (NST). This study evaluated surgical management and outcomes of patients aged &#x2264; 45 versus > 45 years enrolled in multicenter NST clinical trial, I-SPY2.0 (NCT01042379, PMID 37325931). METHODS: We conducted a secondary data analysis comparing locoregional treatment in patients aged &#x2264; 45 versus > 45 years with clinical or molecular high-risk clinical stage II-III breast cancer treated from April 2010 to June 2022. Multivariate Cox proportional hazards models were used to evaluate associations between type of breast surgery with OS and locoregional recurrence-free interval by age group and tumor receptor subtype. RESULTS: Of 1737 patients, 698 (40.2%) were aged &#x2264; 45 years. There were no significant differences in patient or tumor characteristics or residual cancer burden distribution between age groups. Although breast-conserving surgery was significantly less common in younger women (36.8% vs 48.5%, p < 0.001), surgery type was not associated with OS or locoregional recurrence-free interval for patients aged &#x2264; 45 years. CONCLUSIONS: Greater extent of breast surgery was not associated with improved outcomes in women aged &#x2264; 45 years. Choice of surgical procedure in the management of breast cancer is multifactorial, but young age alone&#xa0;does not warrant mastectomy following NST.

Breast cancer↗
PubMed1993

Loss of residual renal function in patients on peritoneal dialysis.

We performed a retrospective chart review of 32 patients on peritoneal dialysis (PD) for longer than 5 months (range 5-64 months) in an attempt to identify risk factors influencing the preservation of renal function. Residual renal function (RRF) was evaluated by measurement of creatinine clearance (Ccr) from 24-hour urine collections. Risk factors examined included age and Ccr at start of PD, presence of diabetes, mean arterial pressure (MAP), diastolic blood pressure (DBP), and peritonitis rate. Multiple regression analysis was performed to determine the correlation of these factors to the rate of decline of Ccr. Loss of RRF in all patients was 0.3 mL/min/month (median 0.2, range 0.04-1.7). The contribution of RRF to total Ccr was 39% (range 12%-72.5%). Patient age, presence of diabetes, MAP, DBP, peritonitis rate, and Ccr at the start of PD had no influence on the rate of RRF loss. Nine patients in the study (28%) had been on PD longer than 2 years and still had significant renal function (mean Ccr 3.3 mL/min), which was 40% of their total weekly Ccr. These results show that PD patients can maintain RRF for extended periods and that RRF contributes substantially to their weekly Ccr. The risk factors evaluated did not influence the rate of renal function loss.

Adult↗
PubMed1993

Correlation of normalized protein catabolic rate to weekly creatinine clearance and KT/V in patients on peritoneal dialysis.

We collected data on 43 stable peritoneal dialysis patients (60 values), all of whom had residual renal function, to determine the dependency of normalized protein catabolic rate (PCRN) on residual renal function as well as dialysis adequacy. All patients were on a stable peritoneal dialysis regimen for at least 4 months (median 8 months, range 4-64 months) and were without peritonitis or other serious infections for at least 6 months prior to data collection. Dialysate creatinine clearance (Ccr) was obtained from 24-hour collections of dialysate. Residual renal function was calculated from the average of the urea and the creatinine clearance from 24-hour urine collections. The normalized protein catabolic rate was calculated using the Randerson method. Using linear regression analysis, PCRN correlated with total weekly Ccr (r = 0.7, p < 0.0005), KT/V urea (r = 0.5, p < 0.0005), and residual renal function (r = 0.6, p < 0.0005). All patients with residual renal function more than 40 L/week had a PCRN greater than 1.0 g/kg/day. To assure a PCRN of 1.0 g/kg/day in all patients, a weekly KT/V urea of 1.9 and/or a total weekly Ccr of 79 L was required. These results confirm the important role of residual renal function in dialysis adequacy and elucidates its contribution to the maintenance of the patient's protein intake.

Creatinine↗
PubMed1986

The application of positron emission tomography to the study of panic disorder.

Positron emission tomography was used to study eight patients with panic disorder who were vulnerable to lactate-induced panic, eight patients with panic disorder who were not vulnerable to lactate-induced panic, and 25 normal control subjects. Patients who were vulnerable to lactate-induced panic had several abnormalities in the resting, nonpanic state: an abnormal hemispheric asymmetry of parahippocampal blood flow, blood volume, and oxygen metabolism; abnormally high whole brain metabolism; and abnormal susceptibility to episodic hyperventilation. A hypothetical model for the neurobiology of panic disorder, involving the abnormal parahippocampal region and its afferent and efferent connections, is proposed.

Adult↗
PubMed1981

One-hour intraocular pressure response to timolol. Lack of correlation with long-term response.

The initial topical administration of 1 drop of 0.25% timolol maleate in 25 nontreated ocular hypertensive patients resulted in a significant reduction of mean intraocular pressure one hour later, from a baseline of 28.1 +/- 5.3 (mean +/- SD) mm Hg to 18.5 +/- 4.5 mm Hg. Two patients (8%) failed to show at least a 10% decreases in IOP one hour after the initial administration. After three to four weeks of twice a day unilateral therapy with 0.25% timolol, mean IOP increased to 21.1 +/- 4.2 mm Hg. At this time seven patients (28%) failed to obtain a 10% decrease in IOP from topical timolol administration. Changing to 0.5% timolol for three to four weeks did not cause an additional significant lowering of IOP (20.4 +/- 3.5 mm Hg). At this time five patients (20%) had less than a 10% reduction in IOP. The one-hour response failed to predict future IOP nonresponsiveness.

Administration, Topical↗