tbuckley/cabot-search huggingface dataset:
Laboratory Distinction between Essential and Secondary Hypertension by Measurement of Erythrocyte Cation Fluxes
Authors: Ricardo P. Garay, Jean-Luc Elghozi, Georges Dagher, Philippe Meyer
Journal: New England Journal of Medicine (1980)

An abnormally low sodium-potassium net flux ratio in erythrocytes was recently described in human essential hypertension. We have confirmed this finding in 65 patients with essential hypertension who were compared with 33 normotensive controls born of normotensive parents. In 23 other subjects with documented secondary hypertension and normotensive parents, the sodium-potassium net flux ratio was found to be similar to that in the controls. The erythrocyte test thus appears to be of interest in distinguishing between essential and secondary hypertension. Severe renal failure itself reduces the flux ratio and would therefore distort the results of this test.
Group 2 Innate Lymphoid Cells and IL-9 Receptor Are Increased in Active Eosinophilic Esophagitis
Authors: Ashmi Doshi, Rachel Baum, Paulo Holanda, Kellen Cavagnero, Braxton Bell, Lucas Dohil, Robert Newbury, Melissa Aquino, Richard Kurten, Taylor Doherty, Seema Sharma Aceves
Journal: Journal of Allergy and Clinical Immunology (2016)
Case 20-1966
Authors: Allan I. Sandler, Austin L. Vickery
Journal: New England Journal of Medicine (1966)

Presentation of Case First admission. A sixty-two-year-old woman was admitted to the hospital because of leukopenia.Rheumatoid arthritis had developed thirty-one years previously; large subcutaneous nodules over the elbows were observed on examination six years later. Twelve years before admission examination in another hospital disclosed that the white-cell count ranged between 1050 and 2100, with a hemoglobin level of 12.4 gm. per 100 ml. A bone-marrow examination was reported to show erythroid hyperplasia and granulocytopenia. During the two years before entry she experienced very little pain and took only occasional doses of salicylates. Four months before admission, after prolonged exposure . . .
Case 10-1990
Authors: Richard C. Cabot, Robert E. Scully, Eugene J. Mark, William F. McNeely, Betty U. McNeely, Allen M. Goorin, Andrew E. Rosenberg
Journal: New England Journal of Medicine (1990)

Presentation of CaseA 15-year-old girl was admitted to the hospital because of pain in the right wrist and multiple radiolucent bony defects.The patient was in apparent good health except for scoliosis, for which she was seen in periodic orthopedic follow-up examinations. Three days before admission, on a routine visit to her orthopedist, she mentioned pain in the right wrist of approximately one year's duration, with worsening on vigorous use of the right upper extremity. Physical examination revealed no swelling or tenderness of the wrist. X-ray films of the right wrist (Fig. 1) showed a well-circumscribed osteolytic lesion, 5 . . .
Risk factors for Clostridium difficile infection in hospitalized patients with community-acquired pneumonia
Authors: James D. Chalmers, Ahsan R. Akram, Aran Singanayagam, Mark H. Wilcox, Adam T. Hill
Journal: Journal of Infection (2016)

Clostridium difficile infection (CDI) is strongly associated with anti-biotic treatment, and community-acquired pneumonia (CAP) is the leading indication for anti-biotic prescription in hospitals. This study assessed the incidence of and risk factors for CDI in a cohort of patients hospitalized with CAP.We analysed data from a prospective, observational cohort of patients with CAP in Edinburgh, UK. Patients with diarrhoea were systematically screened for CDI, and risk factors were determined through time-dependent survival analysis.Overall, 1883 patients with CAP were included, 365 developed diarrhoea and 61 had laboratory-confirmed CDI. The risk factors for CDI were: age (hazard ratio [HR], 1.06 per year; 95% confidence interval [CI], 1.03-1.08), total number of antibiotic classes received (HR, 3.01 per class; 95% CI, 2.32-3.91), duration of antibiotic therapy (HR, 1.09 per day; 95% CI, 1.00-1.19 and hospitalization status (HR, 13.1; 95% CI, 6.0-28.7). Antibiotic class was not an independent predictor of CDI when adjusted for these risk factors (P > 0.05 by interaction testing).These data suggest that reducing the overall antibiotic burden, duration of antibiotic treatment and duration of hospital stay may reduce the incidence of CDI in patients with CAP.
Alevaire as a Mucolytic Agent
Authors: Maurice L. Tainter, Frederick C. Nachod, Joseph G. Bird
Journal: New England Journal of Medicine (1955)

THE use of detergents in the liquefaction of thick mucoid and purulent exudates in the alveoli and bronchial tree was not practical until recent years, owing to the fact that no surfactant with appropriate properties was known. Agents that lower surface tension had long been used in suppurating wounds and body cavities. Their value in cleansing and in aiding the penetration of infected tissues by chemotherapeutic agents is well established. The application of this action to infections and other conditions of the lower respiratory tract has now become quite extensive through the use of the new detergent superinone in a . . .
CBIO-17EXPRESSION AND FUNCTIONAL ANALYSIS OF AN ONCOANTIGEN, DEPDC1, IN MALIGNANT GLIOMA
Authors: Ryogo Kikuchi, Masahiro Toda, Oltea Sampetrean, Hideyuki Saya, Kazunari Yoshida
Journal: Neuro-Oncology (2015)

DEP domain containing 1 (DEPDC1) is a novel oncoantigen that is specically expressed protein in cancer cells and also have oncogenic activity and high immunogenicity. We demonstrated an overexpression of DEPDC1 in glioma tissues and are performing a clinical trial of vaccine therapy for recurrent malignant glioma using peptides of VEGF receptors and four oncoantigens of which DEPDC1 is a target molecule. In this study, we analyzed the expression and function of DEPDC1 in malignant glioma. mRNA and protein expression of DEPDC1 was shown to be increased in glioma cells and tumor tissues. Furthermore, we found an overexpression of DEPDC1 in human and mouse glioma stem cells. DEPDC1 was located in nucleus in glioma cells. Suppression of DEPDC1 by siRNA inhibited glioma cell proliferation and also interfered translocation of phosphorylated NFkB to nucleus. These results suggest that DEPDC1 may inhibit the apoptosis of glioma cells through NFkB signaling pathway and a possibility of molecular target therapy of DEPDC1 for the treatment of glioma.
The Mango–Poison Ivy Connection
Authors: M O Tucker, C R Swan
Journal: New England Journal of Medicine (1998)

Figure 1. A 27-year-old man had had a pruritic and eczematous rash for three days. One week earlier, he had peeled a mango, become distracted by a telephone call, and rested his left hand on his right leg. Three days later, contact dermatitis became apparent. When much younger, the patient had been sensitized to poison oak and poison ivy; the sap of the mango rind contains oleoresins that cross-react with the oleoresins of poison ivy. The rash resolved after one week of treatment with topical corticosteroids.
P44 Chronic obstructive pulmonary disease exacerbation and respiratory acidosis: patient outcomes at 6 months
Authors: S Jackson, TM McKeever, G Hearson, G Housley, C Reynolds, W Kinnear, TW Harrison, AM Kelly, DE Shaw
Journal: Thorax (2015)

<h3>Introduction</h3> Recognition of hypercapnic respiratory failure is a vital part of the assessment and management of the patient with an acute exacerbation of chronic obstructive pulmonary disease (COPD). Several studies have demonstrated that respiratory acidosis in the context of an acute exacerbation is associated with worse inpatient outcomes. Our study compares the outcomes of patients admitted with an acute exacerbation, between those with respiratory acidosis and those who had a normal pH and PaCO<sub>2</sub> on arterial blood gas (ABG) analysis. <h3>Methods</h3> Patients requiring hospital treatment for an acute exacerbation of COPD had an ABG taken on admission. Patients were subsequently assessed for the following outcomes: inpatient mortality, outpatient mortality up to six months after discharge and hospital re-admission rates in the six months post discharge. Chi-squared test was applied to assess the relationship between respiratory acidosis and our outcomes. <h3>Results</h3> 234 patients had an admission ABG and were subsequently followed up to the point of death or six months post discharge. Patients with a PaCO<sub>2</sub> of &gt;6 Kpa were 2.33 times (95% CI 1.11 to 4.96) more likely to die in hospital as compared to those patients with a normal value. Patients with a lower arterial pH (&lt;7.35) were 2.32 times (95% CI 1.07 to 4.96) more likely to die in hospital as compared to those with a pH of &gt;7.35. The increased risk in mortality was only seen for in-hospital mortality and there was no association with death in the 6 months following discharge, hospital re-admission or re-admission for a respiratory problem. <h3>Conclusion</h3> This data supports previous studies that suggest hypercapnia and respiratory acidosis are associated with increased inpatient mortality, therefore further demonstrating the usefulness of pH and PaCO<sub>2</sub> as prognostic markers for inpatient outcomes. However our study does suggest that patients with respiratory acidosis on admission, who survive until discharge from hospital, do not have an increased risk of six month mortality or readmission compared to those with a normal admission ABG.
Methotrexate in Resistant Juvenile Rheumatoid Arthritis
Authors: Edward H. Giannini, Earl J. Brewer, Nina Kuzmina, Alexander Shaikov, Alexei Maximov, Igor Vorontsov, Chester W. Fink, Arthur J. Newman, James T. Cassidy, Lawrence S. Zemel
Journal: New England Journal of Medicine (1992)

The antimetabolite methotrexate has been shown in placebo-controlled trials to be effective in adults with rheumatoid arthritis. Methotrexate may also be effective in children with resistant juvenile rheumatoid arthritis, but the supporting data are from uncontrolled trials.
Hematopoietic stem cell transplant (HSCT) versus intensive chemotherapy in infant acute lymphoblastic leukemia (ALL)
Authors: Z. E. Dreyer, P. Dinndorf, H. Sather, J. M. Hilden, M. Devidas, N. A. Heerema, F. O. Smith, W. Carroll, G. Reaman, B. M. Camitta
Journal: Journal of Clinical Oncology (2007)

9514 Background: Infants (&lt;366 days) with ALL and an MLL rearrangement (MLL-R), have a dismal prognosis. Early relapse is common and event free survival (EFS) is poor. The Children's Oncology Group (COG) parallel pilot trials, 1953 and 9407, were designed to prospectively compare early HSCT to intensified chemotherapy in infants with MLL-R ALL. This is the largest prospective trial investigating the role of HSCT in such patients (pts) in first remission (CR-1). Methods: From 1997–2000, 186 pts were registered (132 MLL-R). Both trials were identical through Induction, Induction Intensification and Re-Induction (Re-I), then diverged. Pts with MLL-R ALL with matched/one antigen mismatched - related/unrelated donors were to undergo HSCT (mandated on 1953/optional on 9407) at completion of Re-I. The HSCT regimen was ara-c, cyclophosphamide, steroid and total body irradiation; graft vs. host prophylaxis was cyclosporine. Results: Compliance with protocol mandated conditioning for HSCT was poor and 28/53 HSCT pts received non-protocol preparative regimens. By life table comparisons, the 5 year HSCT EFS was 50.9% (SE=9.9%, RHR 1.13) vs. 48.7% (SE=10.1%) p=0.68 in 47 control pts (chemotherapy-treated, MLL-R), who survived 143 days (median time to HSCT = 143 days). By statistical regression analysis the RHR for HSCT was 1.454 (90% CI 0.911, 2.318), p-value = 0.19, showing a trend in favor of chemotherapy alone. Neither donor source nor preparative regimen affected HSCT outcome. Chemotherapy outcomes were similar on 1953 and 9407. Events for HSCT pts were most common in the first 6 months: 20 events (11 HSCT related deaths/9 relapses). In the control group, 7/9 events in this time period were due to relapse. Conclusion: These results show no advantage for HSCT in CR1 in infants with MLL-R ALL. These data do not support the routine use of HSCT in CR1 in MLL-R infants. No significant financial relationships to disclose.
Case 1-2006
Authors: Robert H. Rubin, Matthew D. Gilman, Richard L. Kradin
Journal: New England Journal of Medicine (2006)

A 64-year-old man who had received a double-lung allograft because of emphysema six months previously was admitted to the hospital with cough, hemoptysis, and abdominal pain of three days' duration. He had a history of smoking, chronic obstructive pulmonary disease, and lung cancer. Since the transplantation, he had had an episode of rejection and had recently had thrombophlebitis of the leg. A chest radiograph revealed a new right upper-lobe infiltrate, and a cytomegalovirus antigenemia test was positive at 185 cells per two slides. A diagnostic procedure was performed.
Case 37-2010
Authors: William D. Binder, Avram Z. Traum, Robert S. Makar, Robert B. Colvin
Journal: New England Journal of Medicine (2010)

A 16-year-old girl with a history of lupus nephritis was seen in the emergency department because of altered mental status. She was somnolent and agitated and had no focal neurologic signs. Brain CT revealed no abnormalities. Laboratory studies revealed anemia and thrombocytopenia.
Giant-Cell Aortitis Causing an Aneurysm of the Ascending Aorta and Aortic Regurgitation
Authors: W. Gerald Austen, J. B. Blennerhassett
Journal: New England Journal of Medicine (1965)

ANEURYSMS of the thoracic aorta may be of diverse etiology. Atherosclerosis, syphilis, medial degeneration, trauma and occasionally sepsis have been implicated.1 2 3 4 The present case represents a notable exception in that an aneurysm of the ascending aorta resulted from a nonspecific giant-cell aortitis.Case ReportA.L. (M.G.H. 1283255), a 30-year-old Negro mother of 7, entered the Massachusetts General Hospital because of increasingly severe dyspnea. There was no history of rheumatic fever, arthritis, venereal disease, tuberculosis or temporal headache. Five years previously she had noted the sudden onset of pain and weakness in the left arm; this difficulty cleared shortly, but . . .
Hyperuricemia in Diabetic Ketoacidosis
Authors: James Padova, Gordon Bendersky
Journal: New England Journal of Medicine (1962)

THERE is considerable clinical1 2 3 4 5 6 7 and biochemical8 , 9 evidence suggesting but not firmly establishing a relation of uric acid with carbohydrate and lipid metabolism. Uric acid resembles alloxan in its chemical configuration, and there have been preliminary observations provoking the concept of "uric acid diabetes."8 , 9 Although the diabetogenic effects of uric acid have not been proved to exist in man there is at least some statistical evidence of a high incidence of diabetes with hyperuricemia or gout or both.3 , 7 Other observations include the influence of insulin on precipitating acute gout,10 the coincidence of hypercholesterolemia,3 hyperuricemia and hyperglycemia11 and the effects of starvation, . . .
Oral Prednisolone in the Treatment of Acute Gout
Authors: Timothy Hudson Rainer, Chi Hung Cheng, Hein J.E.M. Janssens, Chi Yin Man, Lai Shan Tam, Yu Fai Choi, Wah Hon Yau, Ka Hing Lee, Colin Alexander Graham
Journal: Annals of Internal Medicine (2016)

Two recent double-blind, randomized, controlled trials (RCTs) showed that oral steroids and nonsteroidal anti-inflammatory drugs have similar analgesic effectiveness for management of gout, but the trials had small sample sizes and other methodological limitations.To compare the effectiveness and safety of oral prednisolone versus oral indomethacin in patients presenting to emergency departments (EDs) with acute gout.Multicenter, double-blind, randomized equivalence trial. Patients were randomly assigned (1:1 ratio) to receive either indomethacin or prednisolone. (ISRCTN registry number: ISRCTN45724113).Four EDs in Hong Kong.416 patients aged 18 years or older.Analgesic effectiveness was defined as changes in pain (at rest or with activity) greater than 13 mm on a 100-mm visual analogue scale. Outcomes were measured during the first 2 hours in the ED and from days 1 to 14.376 patients completed the study. Equivalent and clinically significant within-group reductions in mean pain score were observed with indomethacin and prednisolone in the ED (approximately 10 mm [rest] and 20 mm [activity]) and from days 1 to 14 (approximately 25 mm [rest] and 45 mm [activity]). No major adverse events occurred during the study. During the ED phase, patients in the indomethacin group had more minor adverse events than those in the prednisolone group (19% vs. 6%; P < 0.001). During days 1 to 14, 37% of patients in each group had minor adverse events.Diagnosis of gout was usually based on clinical criteria rather than examination of joint fluid.Oral prednisolone and indomethacin had similar analgesic effectiveness among patients with acute gout. Prednisolone is a safe, effective first-line option for treatment of acute gout.Health and Health Services Research Grant Committee of the Hong Kong Government.
Sex and the single transplanted kidney
Authors: Sanjeev Noel, Niraj M. Desai, Abdel Rahim A. Hamad, Hamid Rabb
Journal: Journal of Clinical Investigation (2016)

Substantial ischemia-reperfusion injury (IRI) to the transplanted kidney occurs in 30% to 50% of transplantation patients who receive the organ from a deceased donor. IRI usually manifests as delayed graft function (DGF) and, in severe cases, results in primary nonfunction. Previous studies, primarily experimental, have demonstrated sex-specific susceptibility to IRI in kidney and other organs. In this issue of the JCI, Aufhauser Jr., Wang, and colleagues further demonstrate the importance of donor and recipient sex in IRI and elucidate the role of estrogen receptors in a murine model. Furthermore, analysis of data from 46,691 renal transplant patients in the United Network for Organ Sharing (UNOS) database revealed that sex affects DGF outcomes in humans. Manipulation of sex-driven molecular pathways offers a fertile opportunity to increase the number of organs available for transplantation and to reduce IRI in kidney and, likely, other organs.
A phase I dose expansion trial of avelumab (MSB0010718C), an anti-PD-L1 antibody, in Japanese patients with advanced gastric cancer.
Authors: Yasuhide Yamada, Tomohiro Nishina, Satoru Iwasa, Kohei Shitara, Kei Muro, Taito Esaki, Shuichi Hironaka, Kensei Yamaguchi, Nozomu Machida, Taroh Satoh, Anja von Heydebreck, Hiroyuki Achiwa, Toshihiko Doi
Journal: Journal of Clinical Oncology (2015)

4047 Background: The programmed death-1 receptor (PD-1) and its ligand (PD-L1) are key therapeutic targets in the reactivation of the immune response against multiple cancers. Avelumab* (MSB0010718C) is a fully human anti-PD-L1 IgG1 antibody currently being investigated in clinical trials. Here we present preliminary results from a phase Ib dose expansion study (NCT01943461) evaluating safety and clinical activity in a cohort of Japanese patients (pts) with advanced gastric cancer (GC). Methods: Pts with previously treated progressive GC, ECOG PS 0-1, received avelumab at 10 mg/kg, Q2W. Responses were assessed according to RECIST 1.1 and modified immune-related RECIST (irRECIST). Adverse events (AEs) were evaluated by CTCAE v4.0. Initial data from a prespecified analysis are reported here. A total of 20 pts in this expansion cohort were enrolled. Results: As of Oct 8, 2014, 11 pts were treated with avelumab. Pts were followed-up for at least 3 weeks (wks) and the median treatment duration was 9.9 wks (range 4-12). Median age was 69 years (range 38–76) and all pts had an ECOG-PS of 0 or 1, with a median of 3 prior lines (range 1–4) of therapy. Drug-related treatment-emergent AEs (TEAEs; all grades) occurred in 10/11 pts (90.9%). The most frequently observed treatment-related TEAEs ( > 1 case; all grade 1 or 2) were infusion-related reactions (IRRs) (3 pts, 27.3%), hyperthyroidism, and pruritus (2 pts each, 18.2%). There were no treatment discontinuations from AEs. One pt had grade 3 anemia; it was assessed as not drug-related. At data cutoff, 2 pts (18.2%) have come off study due to disease progression. Nine patients were still on treatment. To date, partial responses according to RECIST have been observed in 3 pts. Conclusions: Avelumab at 10 mg/kg Q2W can be safely administered in Japanese pts with heavily pretreated, metastatic GC. Additional studies to evaluate the efficacy of avelumab in Japanese pts with GC are planned and biomarkers from tumor tissue and blood samples including PD-L1 expression and soluble factors related to immune response will be evaluated. *Proposed INN. Clinical trial information: NCT01943461.
Hereditary Multiple Exostoses
Authors: Joseph Rose, Paul D. Doolan
Journal: New England Journal of Medicine (1949)

HEREDITARY multiple exostoses are a distinct clinical entity more frequently encountered than is generally appreciated.We have recently had the opportunity of studying 4 members of a Negro family who had the condition. Few cases occurring in Negroes are reported in the American literature.1 2 3 To our knowledge this is the first Negro family studied and reported.The cases were typical in both the clinical and roentgenologic aspects, varying, of course, in degree. It was our intention originally to include total protein, dextrose tolerance, calcium, phosphorus and other hormonal excretion studies in the investigation. Owing to circumstances beyond our control it . . .
Impact of Ambulatory-Health-Care Services on the Demand for Hospital Beds
Authors: Seymour S. Bellin, H. J. Geiger, Count D. Gibson
Journal: New England Journal of Medicine (1969)

ONE of the more dramatic developments in the health-care field during the past five years has been the widespread diffusion of neighborhood health centers around the nation, under varying auspices, and funded by the Federal Office of Economic Opportunity as part of the war on poverty. Although the concept of the neighborhood health center as a system for delivering ambulatory health care is applicable to any community, it was conceived as a particularly effective way of overcoming the barriers to optimum health among the poor.The Columbia Point Neighborhood Health Center in Boston, sponsored by Tufts University School of Medicine, . . .
Incidence of dementia in UK men is lower than previously estimated
Authors: Anne Gulland
Journal: BMJ (2016)

New figures have shown the number of cases of dementia to be 40 000 fewer each year in the United Kingdom than previously estimated, with the shortfall mainly in men.

A study in Nature Communications has shown that there are just under 210 000 new cases of dementia every year—74 000 in men and 135 000 in women—whereas the previous estimate was 250 000 new cases a year.1

In the first Medical Research Council funded Cognitive Function and Ageing Study, which took place between 1989 and 1994, researchers interviewed 7500 people aged 65 or over in Cambridgeshire, Newcastle, and Nottingham, with repeat interviews at two years to estimate incidence.

Two decades later (2008-2011) a new sample of the same number of people at the same localities was interviewed, again with a …
Dermatologic Etymology
Authors: Vidhi V. Shah, Stephanie Mlacker, Adam S. Aldahan, Keyvan Nouri
Journal: JAMA Dermatology (2016)

A cutaneous (Latin. cutaneous&lt;cutis, skin) disease (French. des, from + aise, ease) can be classified according to its color (Latin. color, hue, appearance).1,2 The color of skin disease may be described as: