tbuckley/cabot-search huggingface dataset:
Protein Intake and Treatment of Parkinson's Disease with Levodopa
Authors: Ismael Mena, George C. Cotzias
Journal: New England Journal of Medicine (1975)

We studied the influence of protein ingestion on the therapeutic efficacy and metabolic effects of levodopa in Parkinson's disease. Among eight patients, differing in symptomatic control, neurologic scores (normal 0, maximal 100) on 2 g of protein per kilogram of body weight were, at 8 a.m., 27.8 ± 2.1 (mean ± S.E.M.)and at 3 p.m., 46.7 ± 2.6(p < 0.001). On 10 g of protein per day scores were 24.6 ± 2.1 at 8 a.m. and 24.1 ± 2.7 at 3 p.m. In seven patients maintained on 0.5 g of protein per kilogram of body weight per day for two months to one year, levodopa requirements diminished progressively. Measurement of growth hormone in five patients off levodopa showed low constant levels without the normal fluctuations. Near normal patterns were found in six patients on levodopa, but tended to flatten out in six patients also taking a high protein diet. Although growth hormone affects calcium metabolism, hormone levelsand total body calcium showed no correlation in 15 patients taking levodopa. Ourfindings suggest that a low protein diet benefits patients with Parkinson's disease and with moderate neurologic instability.(N Engl J Med 292:181–184,1975)
A case of life threatening postpartum haemorrhage
Authors: S Macdonald, K Brown, M Wyatt
Journal: BMJ (2008)

A 34 year old pregnant woman (para 4+0, gravida 4) presented because of intrauterine death at 30 weeks after a viral illness. Antepartum haemorrhage occurred during a trial of labour and emergency caesarean section was performed. The patient then had a massive postpartum haemorrhage, which did not respond to intrauterine balloon tamponade. Hysterectomy was performed but bleeding continued. She developed disseminated intravascular coagulation and needed more than 90 units of blood. Haemostasis was achieved after transcatheter embolisation.



### Short answers

### Long answers

The World Health Organization’s definition of primary postpartum haemorrhage is the loss …
Factitious Mitral Insufficiency
Authors: S. Serge Barold, Roger P. Javier, Joseph W. Linhart
Journal: New England Journal of Medicine (1968)

RETROGRADE catheterization of the left side of the heart is commonly used for the postoperative hemodynamic and angiographic evaluation of patients who have undergone mitral-valve replacement.1 2 3 4 Mitral prosthetic valves, by projecting into the left ventricular outflow tract, present a wide space between the struts into which a catheter, manipulated from the aorta to the left ventricle, may pass. This occurrence, which may not be recognized fluoroscopically, as demonstrated in Figures 1 and 2, which show normal entry of a retrograde catheter into the left ventricle, may prevent the proper seating of the ball or disk of the prosthetic valve and cause acute . . .
Case 27-1994: The Numb Chin Syndrome
Authors: Alexander Lossos, Tali Siegal
Journal: New England Journal of Medicine (1994)

To the Editor: With regard to Dr. Lynch's discussion (July 14 issue)1 of the case of a 41-year-old woman with a lytic jaw mass, lymphadenopathy, splenomegaly, and a multifocal neurologic disorder, the patient's reports of numbness and impaired sensation on the right side of the chin is typical of mental neuropathy, also known as the numb chin syndrome. This clinical presentation, combined with the finding of a lytic jaw lesion, suggests that the chin numbness resulted from local involvement of the inferior alveolar nerve or the mental nerve. This uncommon cranial neuropathy is mostly associated with neoplastic disorders.2 Its appearance . . .
Danazol for paroxysmal nocturnal hemoglobinuria
Authors: William J. Harrington, Luciano Kolodny, Lawrence L. Horstman, Wenche Jy, Yeon S. Ahn
Journal: American Journal of Hematology (1997)

Paroxysmal nocturnal hemoglobinuria (PNH) is a rare clonal stem-cell disorder in which blood cells lack complement inhibiting membrane proteins, and become susceptible to complement-mediated injury, leading to chronic intravascular hemolysis and pancytopenia. Glucocorticoids have been a mainstay of therapy. For patients refractory to glucocorticoids and requiring blood transfusions, an alternative therapy is needed. We studied danazol therapy in 5 patients refractory to other treatments. Four of the 5 benefited, showing rise in hematocrit and eventual cessation of transfusion requirements. Remissions lasted ≥2 years in 3 and 10 years in 1 patient. Danazol was well-tolerated without serious side effects. Danazol appears to be a good alternative treatment in PNH. Am. J. Hematol. 54:149–154, 1997 © 1997 Wiley-Liss, Inc.
Obliterative Bronchiolitis Following Lung Transplantation Diagnostic Utility of Aerosol Ventilation Lung Scanning and High Resolution CT
Authors: ROBERT A. HALVORSEN, REN?? P. DuCRET, CHRISTOPHER C. KUNI, MARIA TERESA OUVARI, ULF TYLEN, MARSHALL I. HERTZ
Journal: Clinical Nuclear Medicine (1991)

A serious and often fatal complication of heart-lung transplantation is the development of obliterative bronchiolitis (OB). Currently the screening for OB is based on symptoms, pulmonary function tests, and transbronchial biopsies. The chest radiographs are often normal with OB. Obliterative bronchiolitis produces luminal narrowing of both bronchioles and bronchi resulting in areas of peripheral consolidation and occasional bronchiectasis. We report a patient in whom a chest film was normal, an aerosol ventilation lung scan was abnormal while a perfusion study was mildly abnormal. Simultaneously, routine CT was essentially normal while high resolution CT with 1 mm thick sections was clearly abnormal and demonstrated areas of consolidation. These imaging modalities detected clear-cut abnormalities at a time when the patient was symptomatic but prior to the development of demonstrable abnormality on chest radiograph.
Diagnosis of Diabetes Mellitus-Reply
Authors: Roger W. Turkington
Journal: JAMA (1979)

We are grateful for the opportunity to supply additional information from our study in response to the questions from Drs Soeldner and Christlieb. A study of this size generates a large amount of data, and we have attempted in our report to reduce these to the most central correlates. It must be clear from the design of our analysis that we do not advocate the use of insulin levels "in absolute terms" to establish the diagnosis of diabetes mellitus. We recommend that, given a person with hyperglycemia or glucose intolerance, further studies be carried out to determine whether the hyperglycemia results from insulin deficiency or whether it relates to another cause. If the glucose disposal is normal, then the secretion of insulin may be presumed to be physiologically appropriate, regardless of the absolute levels of insulin secretion. We do not consider any of the subjects in this study
From wheels to feet: a dramatic response of severe chronic psoriatic arthritis to etanercept
Authors: O. ELKAYAM
Journal: Annals of the Rheumatic Diseases (2000)

A 47 year old man presented with seven years of severe psoriatic polyarticular arthritis of progressive, symmetrical, and additive course, affecting the shoulders, elbows, wrists, metacarpophalangeal joints, proximal interphalangeal joints, distal interphalangeal joints, hips, knees, and feet. Also, his skin and nails were completely affected with severe erythroderma. The patient was treated with methotrexate, chrysotherapy, antimalarial drugs, salazopyrine, azathioprine, cyclosporin, minocycline, and intra-articular and systemic corticosteroids. All these treatments consecutively and in …
Distinguishing Pseudoprogression From Progression in High-Grade Gliomas
Authors: Matthew J. Oborski, Charles M. Laymon, Frank S. Lieberman, James M. Mountz
Journal: Clinical Nuclear Medicine (2013)

We report a case in which 18F-FDG PET was able to discriminate pseudoprogression from progression observed on contrast-enhanced (CE) MRI (CE-MRI). A 56-year-old male patient with anaplastic oligodendroglioma demonstrated markedly increased tumor enhancement on CE-MRI 1 month after completing radiation therapy (RT), suggesting radiological progression. However, the patient was clinically improved and therefore received an early-therapy response assessment PET to assess for pseudoprogression. PET showed low tumor uptake indicating stable disease. Follow-up CE-MRI at 3 and 4 months post-RT confirmed stable disease. This case emphasizes the value of 18F-FDG PET when pseudoprogression is clinically suspected.
Upregulation of β <sub>3</sub> -Adrenoceptors and Altered Contractile Response to Inotropic Amines in Human Failing Myocardium
Authors: Stéphane Moniotte, Lester Kobzik, Olivier Feron, Jean-Noël Trochu, Chantal Gauthier, Jean-Luc Balligand
Journal: Circulation (2001)

Background —Contrary to β 1 - and β 2 -adrenoceptors, β 3 -adrenoceptors mediate a negative inotropic effect in human ventricular muscle. To assess their functional role in heart failure, our purpose was to compare the expression and contractile effect of β 3 -adrenoceptors in nonfailing and failing human hearts. Methods and Results —We analyzed left ventricular samples from 29 failing (16 ischemic and 13 dilated cardiomyopathic) hearts (ejection fraction 18.6±2%) and 25 nonfailing (including 12 innervated) explanted hearts (ejection fraction 64.2±3%). β 3 -Adrenoceptor proteins were identified by immunohistochemistry in ventricular cardiomyocytes from nonfailing and failing hearts. Contrary to β 1 -adrenoceptor mRNA, Western blot analysis of β 3 -adrenoceptor proteins showed a 2- to 3-fold increase in failing compared with nonfailing hearts. A similar increase was observed for Gα i-2 proteins that couple β 3 -adrenoceptors to their negative inotropic effect. Contractile tension was measured in electrically stimulated myocardial samples ex vivo. In failing hearts, the positive inotropic effect of the nonspecific amine isoprenaline was reduced by 75% compared with that observed in nonfailing hearts. By contrast, the negative inotropic effect of β 3 -preferential agonists was only mildly reduced. Conclusions —Opposite changes occur in β 1 - and β 3 -adrenoceptor abundance in the failing left ventricle, with an imbalance between their inotropic influences that may underlie the functional degradation of the human failing heart.
ON SPRAINS AND THEIR CONSEQUENCES, MAINLY IN RELATION TO TREATMENT
Authors: W. Bennett
Journal: BMJ (1906)

SCHOOL OF CLINICAL 31kDICINE, ETC.THE commonly-reckoned "little things " of surgery are, it must be admitted, not popular with surgeons generally at the present time, when the great achievements of operative work are apt to overshadow so completely the treat- ment of minor ailments, that they are frequently relegated to the category of cases too uninteresting to call for inuch attention at the hands of those who are mostly concerned in dealing with matters which are apparently more important.Unless, therefore, I had been asked to do so, I should not have presumed to con- tribute to the BRITISH MEDICAL JOURNAL an article upon such a trivial subject as sprains.It is, nevertheless, probable that the neglect or indifferent treatment of some of these minor matters result in more disability amongst the community generally, especially the wage.earning classes, than would arise from a considerable percentage of the cases which are considered to require operation if they were left alone; and, further, it is undeniable that, if the minor things were always adequately treated at their commencement or when they threatened, operations would be less frequently necessary. DEFINITION AND CLASSIFICATION OF SPRAINS.A reference to the latest textbooks will give but scanty information on these points; indeed, excepting sprains of joints, little mention is made of them.A few years ago the definition of a sprain was " awrench or strain resulting in stretching or laceration of the soft parts, without external wound."Academically this defini- tion may still be regarded as sound, but for working purposes it has been conclusively shown by the x rays that sprains commonly so called are in quite a large proportion of cases complicated by slight fractures, a very important point in relation to treatment.In fact, under the usual nomenclature a good percentage of sprains should be classified as fractures.The fracture, however, in these cases is of subordinate importance in a pathological sense, because the sprain of the soft parts is the predominating feature.A fracture can hardly occur with- out a sprain at the same time, but a sprain may of course, and frequently does, occur without a fracture.For my own convenience I am in the habit of classifying sprains as follows:
Neuronal death in glaucoma
Authors: Harry A Quigley
Journal: Progress in Retinal and Eye Research (1999)

Glaucoma is recognized to have its major detrimental effect upon the eye by killing retinal ganglion cells. The process of cell death appears to be initiated at the optic nerve head, though other sites of injury are possible but unsubstantiated. At present the injury at the nerve head seems related to the level of the eye pressure, but its detailed mechanism is as yet unexplained. There is a greater loss of ganglion cells from some areas of the eye, and this feature of glaucoma seems related to the regional structure of the supporting connective tissues of the optic nerve head. Larger retinal ganglion cells have been consistently shown to have somewhat greater susceptibility to injury in glaucoma, though all cells are injured, even early in the process. Ganglion cells die by apoptosis in human and experimental glaucoma, opening several potential areas for future therapies to protect them from dying. Neurotrophin deprivation is one possible cause of cell death and replacement therapy is a potential approach to treatment.
Complications of deep vein thrombosis are halved with compression stockings
Authors: Z. Kmietowicz
Journal: BMJ (1997)

Wearing compression stockings soon after being given a diagnosis of deep vein thrombosis reduces the risk of long term complications by half, says a report from the Netherlands.

A group of 194 patients who had a first episode of deep vein thrombosis were randomly assigned either to wear “sized to fit” compression stockings within two to three weeks of diagnosis for at least two years or to a control group that wore no stockings …
P1-092: Predictive value of fluorodeoxyglucose uptake by positron emission tomography and in refractory non-small-cell lung cancer treated with erlotinib: preliminary results
Authors: Hector J. Soto Parra, Massimo Ippolito, Stefano Cordio, Sebastiano Cosentino, Sibilino Coppolino, Sara Baldari, Enrico Potenza, Maurizio Vallastro, Roberto Bordonaro
Journal: Journal of Thoracic Oncology (2007)
Diagnosing secondary syphilis.
Authors: M A Waugh
Journal: BMJ (1972)

Vaccination 5 4 4 0c2 °2 ----Treatment O 2 3 4 Time (weeks)cantly (t = 4. 185, P < 0001) lower than in controls.The finding that co-trimoxazole in dosages commonly used for curing bacterial in- fections in man partially suppresses antibody response warrants more detailed investiga- tion.Whether the effect is due to the com- bined drug or trimethoprim alone also remains to be investigated.-Weare, etc.,
Coronary neovascularity and fistula formation: a sign of mural thrombus.
Authors: R L Soulen, J H Grollman, D Paglia, T Kreulen
Journal: Circulation (1977)

Fifteen patients have shown neovascularity in the left heart during selective coronary arteriography, with associated fistulous communication to a cardiac chamber in ten. In nine the abnormalities were adjacent to and within ventricular mural thrombi, associated with ventricular aneurysms in seven and congestive cardiomyopathy in two. In six patients with mitral stenosis and atrial fibrillation the angiographic changes related to left atrial thrombi. Histologic study of two atrial thrombi showed revascularization patterns in keeping both with the angiographic findings and with an intermediate stage in the evolution of mural thrombus. Though myxomas can produce a similar appearance, clinical and additional angiographic features should permit differentiation in most instances between this infrequent tumor and the far more common mural thrombus.
Abstract P6-10-06: Metachronous Contralateral Breast Cancer (CBC) Has More Aggressive Biology and Clinical Characteristics Compared to Synchronous Bilateral Breast Cancer (BBC)
Authors: NF Pistamaltzian, C Papadimitriou, C Panopoulos, G Koumakis, S Demiri, N Tsoukalas, D Yannoukakos, N Apostolikas, E Panagopoulos, A. Efremidis
Journal: Cancer Research (2010)

Abstract Purpose: Bilateral breast cancer is an uncommon clinical entity. There is no specific treatment strategy and controversial issues concerning diagnostic criteria, management and classification exist. Method: In order to address some of these issues, a prospective analysis (data recorded upon patients first presentation) of an electronic breast cancer database at a tertiary cancer centre was performed. Patients’ epidemiologic characteristics, clinical profile, genomic analysis information and the tumours’ histopathology were analyzed. Results: Out of 900 patients treated for breast cancer between 2006 and 2009, 44 diagnosed with bilateral disease (5% of total)having a median age of 53 years(range 32-73). 16 of them (36%)suffered from synchronous disease and 28 (64%)from metachronous { &amp;gt;3 months apart between the initial diagnosis and subsequent contralateral breast tumour). Genetic analysis revealed 3 patients with inherited breast cancer syndromes (2 with BRCA1 and one with CDH-1 mutation). Among those with synchronous BBC 63% (10/16)were postmenopausal, 50% (8/16)had a positive family history for breast cancer and upon initial diagnosis 80% (13/16)of them presented with early stage disease (stages I,II).Contralateral disease was diagnosed incidentally. In contrast to these patients with synchronous BBC,57% of the patients (16/28)with metachronous CBC were premenopausal and 68% (19/28)had advanced disease (stages III,IV) upon the second diagnosis. Etrogens’ use didn't differ among the two groups, obesity was more common in patients with metachronous CBC, and smoking in the synchronous BBC patients. Of the 88 tumours, 81(92%) were invasive, with ductal adenoCa being the more common (53% of specimens). Of synchronous BBC tumours 12/16 (75%)were HR+ positive and 80%(13/16) expressed the same biologic features bilaterally. Of the metachronous tumours, upon initial diagnosis,26% were triple negative and only 7% were found with HER2 amplification, compared with 41% and 26% respectively in the second diagnosis. Conclusions: Synchronous BBC is less prevalent than Metachronous CBC, has more favourable characteristics (earlier stage at diagnosis, hormonal receptor positivity), and occurs mainly among postmenopausal women with positive family history. Metachronous CBC is more common in premenopausal women and has a tendency to change its biological and clinical characteristics to a more aggressive phenotype (triple negative, HER2 amplification) between initial and latter diagnosis. If this phenomenon is a result of previously given chemo/radio-therapy or it reperesents the natural evolution to a second primary, remains a challenging question to be answered. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-10-06.
Radiolabeled Nanoparticles for Multimodality Tumor Imaging
Authors: Yan Xing, Jinhua Zhao, Peter S. Conti, Kai Chen
Journal: Theranostics (2014)

Each imaging modality has its own unique strengths. Multimodality imaging, taking advantages of strengths from two or more imaging modalities, can provide overall structural, functional, and molecular information, offering the prospect of improved diagnostic and therapeutic monitoring abilities. The devices of molecular imaging with multimodality and multifunction are of great value for cancer diagnosis and treatment, and greatly accelerate the development of radionuclide-based multimodal molecular imaging. Radiolabeled nanoparticles bearing intrinsic properties have gained great interest in multimodality tumor imaging over the past decade. Significant breakthrough has been made toward the development of various radiolabeled nanoparticles, which can be used as novel cancer diagnostic tools in multimodality imaging systems. It is expected that quantitative multimodality imaging with multifunctional radiolabeled nanoparticles will afford accurate and precise assessment of biological signatures in cancer in a real-time manner and thus, pave the path towards personalized cancer medicine. This review addresses advantages and challenges in developing multimodality imaging probes by using different types of nanoparticles, and summarizes the recent advances in the applications of radiolabeled nanoparticles for multimodal imaging of tumor. The key issues involved in the translation of radiolabeled nanoparticles to the clinic are also discussed.
The Hartford Disaster Exercise
Authors: Leonard F. Menczer
Journal: New England Journal of Medicine (1968)

DISASTERS of one type or another occur almost daily in the United States. Many communities unfortunately have accepted disasters as inevitable and either have become overconfident in their ability to handle these events or are so uninterested as to ignore the necessary training and skills needed to manage them.A disaster may be defined as anything from a traffic fatality to a holocaust involving thousands of individuals. For sound community planning, disaster training should be related to the natural events that may involve large numbers of casualties such as floods, tornadoes and hurricanes, or from manrelated disasters including fires, explosions . . .
South African army is brought in to defend hospitals
Authors: P. Sidley
Journal: BMJ (2010)

South African troops have been deployed to 37 hospitals around the country as healthcare workers continue their increasingly bitter strike over pay. 

Defence forces and outside medical teams have been sent in to help keep emergency services open and defend staff and patients in a dispute that has seen police shoot rubber bullets at striking staff. Protestors have blockaded hospitals, preventing patients and those doctors and nurses still working from entering.

More than 1.3 million civil servants have been striking for nearly two weeks, with healthcare workers and teachers making up the bulk of the strikers. Doctors are not officially on strike. Public sector unions are united in their anger at what they see as the government’s continuing neglect of their work. 

The strike has seen a virtual shutdown of services at …
WBC COUNT AT DISCHARGE IS A STRONG PREDICTOR OF ALL-CAUSE MORTALITY IN PATIENTS WITH ACUTE CORONARY SYNDROME THAT UNDERWENT PERCUTANEOUS CORONARY INTERVENTION
Authors: Michael Lipinski, Rebecca Torguson, Fang Chen, Lowell Satler, William Suddath, Augusto Pichard, Ron Waksman
Journal: Journal of the American College of Cardiology (2014)
Practical Epigram of the Apgar Score
Authors: Joseph Butterfield
Journal: JAMA (1962)

To the Editor:—  As concern about neonatal mortality increases, it becomes apparent that techniques for the objective and uniform recording of pertinent data are necessary. 1 The Apgar Score, a method of evaluating the newborn infant, 2,3 has gained widespread recognition, 4-6 as it has been shown to reflect the immediate status 7 as well as the prognosis 3,8 of the newborn infant.  Despite the value of the scoring system, experience has shown that it may be difficult to memorize the categories that make up the score and that many medical personnel are not familiar with it. The purpose of this communication is to describe an epigram (see figure) which embodies the basic components of the scoring system and implements its application.    The epigram has not altered the essence of the Apgar scoring system, and it does afford a means of remembering it easily. This has been an effective adjunct