tbuckley/cabot-search huggingface dataset:
Hypernatremia in Hospitalized Patients
Authors: Paul M. Palevsky
Journal: Annals of Internal Medicine (1996)

To determine the incidence, clinical characteristics, and outcome for general medical-surgical hospital patients with hypernatremia.A prospective cohort study.A 942-bed urban university hospital.All patients who developed a serum sodium concentration of 150 mmol/L or greater during a 3-month observation period.Daily fluid balance, mental status, and serum and urine electrolytes and osmolality.103 patients were identified. Eighteen patients were hypernatremic on hospital admission, and 85 developed hypernatremia during hospitalization. Patients who developed hypernatremia during hospitalization were younger than patients who developed hypernatremia before hospital admission (mean age +/- SD, 58.9 +/- 19.2 years compared with 76.6 +/- 16.6 years; P < 0.01) but did not differ in age from the patients of the general hospitalized population. Eighty-nine percent of patients who developed hypernatremia during hospitalization had urine concentrating defects, primarily as the result of the use of diuretics or of solute diuresis, whereas only 50% of patients who were hypernatremic on admission could be shown to have concentrating defects (P < 0.01). Fifty-five percent of all hypernatremic patients had increased insensible water losses, and 35% had increased enteral water losses. Eighty-six percent of patients with hospital-acquired hypernatremia lacked free access to water, 74% had enteral water intake of less than 1 L/d, and 94% received less than 1 L of intravenous electrolyte-free water per day during the development of hypernatremia. No supplemental electrolyte-free water was prescribed during the first 24 hours of hypernatremia in 49% of patients. The duration of hypernatremia was shorter in patients who were hypernatremic on admission (median duration, 3 days) than in patients with hospital-acquired hypernatremia (median duration, 5 days; P < 0.05). Mortality was 41% for all patients, but hypernatremia was judged to have contributed to mortality in only 16% of patients.Although the development of hypernatremia before hospital admission occurs primarily in geriatric patients, hospital-acquired hypernatremia was more common in our cohort and had an age distribution similar to that of the general hospitalized population. Hospital-acquired hypernatremia was primarily iatrogenic, resulting from inadequate and inappropriate prescription of fluids to patients with predictably increased water losses and impaired thirst or restricted free water intake or both. Treatment of hypernatremia is often inadequate or delayed. Efforts to manage hypernatremia better and altogether avoid hospital-acquired hypernatremia should focus on both physician education and the development of hospital systems to prevent errors in fluid prescription.
Treatment of Obese Non-Diabetic Patients with Phenformin. A Double-Blind Cross-Over Trial
Authors: A. Hart, H. Cohen
Journal: BMJ (1970)

The effect of 50 mg. of sustained release phenformin capsules administered twice daily was compared with a placebo as an aid to weight reduction in obese non-diabetic patients. Phenformin and placebo were administered alternately in two three-month periods. Weight loss on a 1,200-calorie diet was greater in the first three months than in the second three months regardless of treatment. There was no difference in weight loss between the phenformin and placebo groups in either the first or second three-month period. Serum cholesterol levels tended to fall in association with weight loss, but not apparently in relation to the size of the weight loss or to the treatment.
SOME DEFORMITIES OF THE CHEST IN THE LIGHT OF ITS ANCESTRY AND GROWTH.
Authors: WOODS HUTCHINSON
Journal: JAMA (1897)

I can invite your attention to only a limited portion of the most interesting field of deformities of the chest; and even here my presentation can not claim to be exhaustive, but simply suggestive of certain lines for future work and discussion. The deformities I have chosen are the common and important ones of (so-called) flat chest, "pigeon-breast," "guttered" sternum, Harrison's groove and "funnel chest" ("Trichter Brust"). These may be, at first sight, divided into two apparently distinct classes, those in which the transverse diameter is increased at the expense of the anteroposterior, which for the sake of brevity in our future discussion we will call the transverse or "bellows" form of chest, and those in which the increase appears to be the antero-posterior diameter and the contraction in the transverse, which again, for the sake of brevity, we will call the antero-posterior or "keeled" type of chest. It is
Outcome of pregnancy in diabetic women in northeast England and in Norway, 1994-7
Authors: G Hawthorne
Journal: BMJ (2000)

In northeast England, perinatal mortality is five times higher and congenital malformation is four times higher for pregnancies in diabetic women than for those in women who do not have diabetes.1 The same is true in other regions in the United Kingdom, 2 3 but this is not the case in Norway.4 Why is the outcome of pregnancy in diabetic women better in Norway? Does Norway use the same definitions and record the same outcome data as the United Kingdom? If the data are standardised will these differences disappear? If not, what is causing the difference in the outcome of pregnancy in diabetic women?

The methodology for data collection needs to be standardised between the two countries to determine whether differences in outcome are real before looking for explanations in the healthcare systems of the two countries. We compare the …
Antibody Response to Burkholderia cepacia in Patients with Cystic Fibrosis Colonized with Burkholderia cepacia and Pseudomonas aeruginosa
Authors: J. Hendry, S. Butler, J.S. Elborn, J.R.W. Govan, J. Nelson, D.J. Shale, A.K. Webb
Journal: Journal of Infection (2000)
Corticosteroid Treatment for Acute Meningoencephalitis: a Retrospective Study of 346 Cases
Authors: J. Boe, C. O. Solberg, T. Saeter
Journal: BMJ (1965)

<h3>ABSTRACT</h3> <h3>Background</h3> As of 26 March 2021, the Africa CDC had reported 4,159,055 cases of COVID-19 and 111,357 deaths among the 55 African Union Member States; however, no country has published a nationally representative serosurvey as of May 2021. Such data are vital for understanding the pandemic’s progression on the continent, evaluating containment measures, and policy planning. <h3>Methods</h3> We conducted a cross-sectional, nationally representative, age-stratified serosurvey in Sierra Leone in March 2021 by randomly selecting 120 Enumeration Areas throughout the country and 10 randomly selected households in each of these. One to two persons per selected household were interviewed to collect information on socio-demographics, symptoms suggestive of COVID-19, exposure history to laboratory-confirmed COVID-19 cases, and history of COVID-19 illness. Capillary blood was collected by fingerstick, and blood samples were tested using the Hangzhou Biotest Biotech RightSign COVID-19 IgG/IgM Rapid Test Cassette. Total seroprevalence was was estimated after applying sampling weights. <h3>Findings</h3> The overall weighted seroprevalence was 2.6% (95% CI 1.9-3.4). This is 43 times higher than the reported number of cases. Rural seropositivity was 1.8% (95% CI 1.0-2.5), and urban seropositivity was 4.2% (95% CI 2.6-5.7). <h3>Interpretation</h3> Although overall seroprevalence was low compared to countries in Europe and the Americas (suggesting relatively successful containment in Sierra Leone), our findings indicate enormous underreporting of active cases. This has ramifications for the country’s third wave (which started in June 2021), where the average number of daily reported cases was 87 by the end of the month—this could potentially be on the order of 3,700 actual infections, calling for stronger containment measures in a country with only 0.2% of people fully vaccinated. It may also reflect significant underreporting of incidence and mortality across the continent. <h3>Funding</h3> This study was supported by NIAID K08 AI139361, the Sierra Leone Ministry of Health and Sanitation, and the Africa CDC.
Textiloma on 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography: A Wolf in a Sheep's Clothing?
Authors: David Petermann, Michel Christodoulou, Igor Letovanec, Carole Gengler, Francesco Doenz, Victoria Orcurto, Hans-Beat Ris, John O. Prior
Journal: Journal of Thoracic Oncology (2010)
Treatment of classic Kaposi's sarcoma with liposomal encapsulated doxorubicin
Authors: Jacob J Gottlieb, Ken Washenik, Abraham Chachoua, Alvin Friedman-Kien
Journal: The Lancet (1997)

Stealth liposomal encapsulated doxorubicin (Doxil) is an approved effective systemic therapy for AIDS-associated Kaposi's sarcoma. 1 Bogner JR Liposomal doxorubicin in the treatment of advanced AIDS-related Kaposi sarcoma. J Acq Immune Def Syndr. 1994; 7: 463-468 PubMed Google Scholar , 2 Wagner D Kern WV Kern P Liposomal doxorubicin in AIDS-related Kaposi's sarcoma: long-term experiences. Clin Invest. 1994; 72: 417-423 PubMed Google Scholar We report successful use of liposomal doxorubicin in the treatment of classic Kaposi's sarcoma.
Is Incretin-Based Therapy Ready for the Care of Hospitalized Patients With Type 2 Diabetes?
Authors: Stanley Schwartz, Ralph A. DeFronzo
Journal: Diabetes Care (2013)

Significant data suggest that overt hyperglycemia, either observed with or without a prior diagnosis of diabetes, contributes to an increase in mortality and morbidity in hospitalized patients. In this regard, goal-directed insulin therapy has remained as the standard of care for achieving and maintaining glycemic control in hospitalized patients with critical and noncritical illness. As such, protocols to assist in the management of hyperglycemia in the inpatient setting have become commonplace in hospital settings. Clearly, insulin is a known entity, has been in clinical use for almost a century, and is effective. However, there are limitations to its use. Based on the observed mechanisms of action and efficacy, there has been a great interest in using incretin-based therapy with glucagon-like peptide-1 (GLP-1) receptor agonists instead of, or complementary to, an insulin-based approach to improve glycemic control in hospitalized, severely ill diabetic patients. To provide an understanding of both sides of the argument, we provide a discussion of this topic as part of this two-part point-counterpoint narrative. In this point narrative as presented below, Drs. Schwartz and DeFronzo provide an opinion that now is the time to consider GLP-1 receptor agonists as a logical consideration for inpatient glycemic control. It is important to note the recommendations they propose under “incretin-based approach” with these agents represent their opinion for use and, as they point out, well-designed prospective studies comparing these agents with insulin will be required to establish their efficacy and safety. In the counterpoint narrative following Drs. Schwartz and DeFronzo’s contribution, Drs. Umpierrez and Korytkowski provide a defense of insulin in the inpatient setting as the unquestioned gold standard for glycemic management in hospitalized settings. —William T. Cefalu Editor in Chief, Diabetes Care
Regression of Optociliary Shunt Vessels
Authors: Adrienne Ruth, Nancy J Newman
Journal: New England Journal of Medicine (2006)

A previously healthy 53-year-old man presented with headache, blurred vision, and pulsatile tinnitus. A lumbar puncture demonstrated meningitis with increased intracranial pressure (opening pressure, 37 cm H2O), with a white-cell count of 154 per cubic millimeter, a protein level of 68 mg per deciliter (0.68 g per liter), and a glucose level of 75 mg per deciliter (4 mmol per liter). A serum sample was positive for West Nile virus–specific IgG antibody. Results of brain magnetic resonance imaging and magnetic resonance angiography were normal. Initial ocular examination revealed a visual acuity of 20/25 in the right eye and . . .
Coronary Collateral Circulation and Myocardial Blood Flow Reserve
Authors: SUZANNE B. KNOEBEL, PAUL L. MCHENRY, JOHN F. PHILLIPS, FEBREL J. PAULETTO
Journal: Circulation (1972)

This study was undertaken to assess the effect of collateral circulation on myocardial blood flow (MBF) reserve (ability to increase myocardial blood flow with a stress that increases myocardial oxygen requirements). One hundred patients had MBF measured at rest and after isoproterenol. After classification by anatomic severity of coronary artery disease (CAI), the groups were further compared by presence or absence of collateral vessels, and whether the collaterals were intercoronary or bridge collaterals. Forty patients (group A) had no coronary artery disease demonstrated by cineangiography. The increase in MBF with isoproterenol for this group was 87% ( P &lt; 0.001). Fifteen patients (group B) had CAI of 175 or greater. These patients increased MBF 73% on infusion of isoproterenol, an insignificant difference from group A. Forty-five patients (group C) had CAI of 175 or less when an index of 300 represents no occlusive disease. Those with intercoronary collateral vessels (group C 1, 2 ) were unable to increase MBF to the same extent as patients in groups A and B did. There was no difference between this group and those without collateral vessels and the same severity of disease. Fifteen patients with CAI of 175 or less (group C 3, 4 ) had bridge collaterals and were able to increase MBF to a greater extent than those with no collaterals or with intercoronary collateral vessels. This same group of patients, in a parallel observation, showed less S-T-segment depression on treadmill exercise than patients with intercoronary collateral vessels. The data suggest that intercoronary collateral vessels contribute insignificantly, statistically, to myocardial blood flow reserve. Bridge collaterals, however, do seem to contribute in selected patients.
Removal of the Astragalus in an Adult, in a Case of Congenital Talipes
Authors: E. Lund
Journal: BMJ (1878)

HAVIN-G had the honour on a previous occasion, so long ago as the year 1872, when our Association met at Birmingham, to lay before the Surgical Section an account of a very interesting case of congenital talipes, in which I had removed the astragalus from each foot in a boy at that time seven years of age, I have now the opportunity of relating to the meeting a case of a similar nature in an adult.It is that of a man named Abraham Taylor, a factory operative, aged 29, who from birth had been the subject of talipes equino-varus of the right foot, for which, according to his statement, no attempt had been made at any time to remedy the deformity, but he had been able up to very recently to walk about with that peculiar stumping gait which is observed in such cases.About two years ago, having previously suffered considerably from the formation of corns and tender spots on the external border of the foot, it appeared that these had become so troublesome that at last ulceration of the skin set in, and for nearly twelve months before his admission into the Manchester Royal Infirmary in March 1878, he had been entirely prevented from 'following his work,
Is hypokalaemia the cause of paralysis in barium poisoning?
Authors: D M Phelan, S R Hagley, M D Guerin
Journal: BMJ (1984)

warming can be successful.We concur with Althaus that below 270C life is difficult to detect and the diagnosis obscured,3 and with Coniam that resuscitation should not be abandoned in a case of hypothermia until the patient has been adequately rewarmed.4Disturbing patients with hypothermia may precipitate ventricular fibrillation (as intubation did in this patient).These patients should, therefore, be handled gently and not intubated unless ventilation is inadequate or protective reflexes absent as they were in this case.
907-104 Endothelial Injury at a Transiently Occluded Coronary Artery Increases Myocardial Leukocyte Content and Necrosis. Effect of Aspirin
Authors: José A. Barrabés, David García-Dorado, Juan Oliveras, Miguel A. González, Marisol Ruiz-Meana, Julia Solares, Amparo García, Joan Castell, Ricard Ballester, J. Soler-Soler
Journal: Journal of the American College of Cardiology (1995)
TB or not TB, That Is the Question-Reply
Authors: Neil M. H. Graham
Journal: JAMA (1992)

<h3>In Reply.</h3> —Drs Jolson and Behrman raise the question whether differential enrollment of HIV-seropositive and HIV-seronegative patients could explain the differences in tuberculin positivity we observed in our study.<sup>1</sup>In particular, they wondered if more rigorous screening or higher previous TB rates in the HIV-seropositive patients might explain the difference. To determine if this occurred, we reanalyzed data from those patients who were not tested (n=52). We observed no relationship between HIV serostatus and not being tested (<i>P</i>=.53). Thirty-seven of these patients were not tested because they had previous positive tuberculin tests (HIV seronegative, 19 patients; HIV seropositive, 15 patients) or a history of TB (HIV seronegative, one patient; HIV seropositive, two patients). Clearly these cases are equally distributed between groups and could not have influenced our results. Jolson and Behrman also suggest combining past history and current test results. This approach does give additional information about prior
Hair Follicle–Derived Blood Vessels Vascularize Tumors in Skin and Are Inhibited by Doxorubicin
Authors: Yasuyuki Amoh, Lingna Li, Meng Yang, Ping Jiang, Abdool R. Moossa, Kensei Katsuoka, Robert M. Hoffman
Journal: Cancer Research (2005)

Abstract We have recently shown that the neural-stem cell marker nestin is expressed in hair follicle stem cells and the blood vessel network interconnecting hair follicles in the skin of transgenic mice with nestin regulatory element–driven green fluorescent protein (ND-GFP). The hair follicles were shown to give rise to the nestin-expressing blood vessels in the skin. In the present study, we visualized tumor angiogenesis by dual-color fluorescence imaging in ND-GFP transgenic mice after transplantation of the murine melanoma cell line B16F10 expressing red fluorescent protein. ND-GFP was highly expressed in proliferating endothelial cells and nascent blood vessels in the growing tumor. Results of immunohistochemical staining showed that the blood vessel–specific antigen CD31 was expressed in ND-GFP–expressing nascent blood vessels. ND-GFP expression was diminished in the vessels with increased blood flow. Progressive angiogenesis during tumor growth was readily visualized during tumor growth by GFP expression. Doxorubicin inhibited the nascent tumor angiogenesis as well as tumor growth in the ND-GFP mice transplanted with B16F10-RFP. This model is useful for direct visualization of tumor angiogenesis and evaluation of angiogenic inhibitors.
Desipramine Isn't When It's Disopyramide
Authors: Carol W. Garvey
Journal: JAMA (1989)

To the Editor.—  Pitfalls in medication dispensing are demonstrated by the following case.  Report of a Case.—  A 33-year-old businesswoman had been taking tricyclic medication since 1980 for treatment of chronic fatigue and slow morning wakening. She was doing well while taking desipramine, 200  daily, when seen in December 1987. She returned 3 1/2 months later, however, complaining of severe sleep disturbance reminiscent of her symptoms before using tricyclics. She also complained of depression and unusual weight gains and losses. Laboratory evaluation revealed a normal blood cell count and chemistry values, but her desipramine level was zero.  When informed of this, the patient looked at her desipramine bottle and noted that it was labeled  100 mg (disopyramide). Because she had received both Norpramin (desipramine, Merrell Dow) and Pertofrane (desipramine, Rorer) on her generically written prescriptions in the past, she assumed that Norpace was another generic form of desipramine.
Prediction of fractures in perimenopausal women: a comparison of dual energy x ray absorptiometry and broadband ultrasound attenuation.
Authors: A Stewart, D J Torgerson, D M Reid
Journal: Annals of the Rheumatic Diseases (1996)

OBJECTIVE: To consider whether bone mineral density (BMD) measurements can predict traumatic fractures occurring in perimenopausal women. METHODS: One thousand perimenopausal women called up for screening underwent both dual energy x ray absorptiometry (DXA) of the spine and hip, and broadband ultrasound attenuation (BUA) of the heel. Two years later, they were sent a questionnaire to discover those who had since had a fracture, and compare them with those who had not. RESULTS: About 2% of the women had sustained a fracture in the two years since attendance for screening. Fractures in this age group can be predicted weakly, but significantly, by bone mass measurements using DXA and BUA (odds ratios from 1.4 to 2.1). The lumbar spine appeared to be one of the best predictive sites (odds ratio for 1 SD reduction in BMD 2.1 (95% confidence interval 1.2 to 3.8)), but no significant differences were found between the areas under the curve in receiver operator characteristic (ROC) analysis. CONCLUSION: In this preliminary study it appeared that bone mass measurements are predictive of perimenopausal traumatic fractures in addition to postmenopausal fractures related to osteoporosis. DXA of the lumbar spine did not perform significantly better than BUA. The number of fractures occurring was low, however, and further long term follow up is required to confirm the finding.
Idiopathic chronic pancreatitis in India: looking for a name! Futile or fruitful exercise?
Authors: D. K. Bhasin, S. S. Rana, K. Singh
Journal: Gut (2011)

We read with interest the article by Midha et al 1 and correspondence by various authors on the interesting and challenging topic of idiopathic chronic pancreatitis (ICP) in India. At the outset we would like to congratulate the authors of this good study. We had earlier published a study, which somehow escaped the attention of the authors in their initial study and also later in correspondence, where we had shown that the clinical profile of ICP in North India differs from that of classical tropical pancreatitis (TP) with a higher frequency of pain and a lower frequency of diabetes, pancreatic calcification and intraductal calculi.2

In our study of 155 patients with chronic pancreatitis (CP), ICP was the most common form of CP (41.3%).2 When …
Hereditary Bleeding Diseases
Authors: Armand J. Quick
Journal: JAMA (1961)

THE HEREDITARY BLEEDING DISEASES constitute a veritable storehouse of valuable, potential, untapped information for unravelling many problems of human genetics and for probing the intricate coagulation mechanism of the blood and of hemostasis. More than 12 different hemorrhagic diseases are now known to be congenital in origin. Laboratory tests have become available for characterizing each of these entities with a relatively high degree of precision and for exploring their basic defect. the sex-linked recessive type. Von Willebrand's disease, known also as pseudohemophilia A, and telangiectasia or Rendu-Osler's disease represent the autosomal dominant type. Most of the remaining bleeding diseases are inherited as autosomal recessives as shown in the table. In this group are congenital thrombocytopenia, hypofibrinogenemia, hypoprothrombinemia, and deficiencies of <h3>Type and Incidence of Inheritance</h3>