tbuckley/cabot-search huggingface dataset:
Changes in Salivary Enzymes in Patients with Sarcoidosis
Authors: K. D. Bhoola, M. W. McNicol, S. Oliver, John Foran
Journal: New England Journal of Medicine (1969)

Assessment of salivary-gland function in 40 patients with sarcoidosis showed that whereas only one had clinical evidence of involvement of the salivary glands, both secretion volume (19 patients) and enzyme content of amylase (below 50 per cent of normal in 27 patients) and of kallikrein (below 50 per cent of normal in 18 patients) were clearly reduced in many patients. Although the fall in kallikrein activity in general paralleled that of amylase, the reduction in both enzyme activities did not correlate with volume change. Since the fall in enzyme activity was not associated with any clinically apparent involvement of the salivary glands, these findings raise the possibility of more frequent and widespread impairment of function in these and other glandular structures than has hitherto been realized.
Acute Renal Failure Due to Nephrotoxins
Authors: Norman K. Hollenberg, Douglass F. Adams, Donald E. Oken, Herbert L. Abrams, John P. Merrill
Journal: New England Journal of Medicine (1970)

Seven patients with nephrotoxin-induced acute renal failure had characteristic renal hemodynamic and angiographic abnormalities identical to those found in patients with acute renal failure due to shock and hemolysis. The abnormalities include the absence of recognizable cortical arterial vessels and the cortical nephrogram, delayed transit of contrast medium through the kidney and disappearance of the rapid — or cortical — flow component of xenon washout from the kidney. These observations suggest a persistent homogeneous reduction in renal cortical perfusion sufficient to induce the cessation of glomerular filtration and thus account for the failure of renal function. The similarity of the hemodynamic pattern in patients with acute renal failure of widely different etiology suggests a pathogenetic final common pathway involving undefined mediators that induce severe, sustained preglomerular vasoconstriction.
Electroencephalographic Abnormalities in Endocrine Disease
Authors: Joseph V. Condon, Dorothy R. Becka, Frederic A. Gibbs
Journal: New England Journal of Medicine (1954)

THE intimate metabolic processes of the brain are closely related to the general metabolism of the body, and the electric activity of the brain varies with certain endocrine functions. Lindsley and Rubenstein1 showed a correlation between the alpha frequency and the metabolic rate. Gibbs and Gibbs2 demonstrated changes in the cortical frequency spectrum with the level of thyroid function. Ross and Schwab3 report that when the alpha rhythm is taken during a "basal state" (with the patient fasting and resting for half an hour) the correlation is not so good as when the patient is well fed, satisfied and relaxed. . . .
Urban or Rural Residence and Histologic Type Distribution in 21,000 Childhood Leukemia Deaths in the United States, 1950–59
Authors: Charles R. Stark, Arthur Oleinick
Journal: JNCI Journal of the National Cancer Institute (1966)

Type-, age-, sex-, race-, year of death-, and urban-rural-specific leukemia mortality rates for 20,711 leukemia deaths in the entire United States for the years 1950–59 were compared with previous studies of childhood leukemia by histologic type and urban-rural residence. Among white children, urban rates exceeded rural rates, but among nonwhite children the reverse was true. Except for myelocytic leukemia, urban rates in whites appear to be increasing with the passage of time, but rural rates are declining. Data from the present study and from the studies reviewed suggest lymphocytic and myelocytic forms of the disease are distinct. A comparison of white and nonwhite mortality rates indicates that myelocytic leukemia has a common etiology in whites and nonwhites, but nonwhites are either not exposed to, or are protected against, agents causing lymphocytic leukemia.
Granulocyte-Macrophage Progenitors (GMPs) Express Low Adhesive Potential and High CXCR-4 Levels
Authors: Valentina Giai, Christian Scharenberg, Robert Wallin, Florian Salomons, Olaf Bergmann, Simona Conte, Dario Ferrero, Mario Boccadoro, Eva Hellström-Lindberg
Journal: Blood (2013)
Soundings: The past is another country
Authors: Kevin Barraclough
Journal: BMJ (2005)

Recently I went to a conference at my old university. I was put in a college room that, a quarter of a century before, had belonged to a friend of mine. The room was as large and uncomfortable as I remembered it, and somewhat bleak without my friend's obligatory Che Guevara and Raquel Welch posters. Through the high monastic windows you could see the gothic roofs against a grey sky. An ensuite bathroom had been jammed awkwardly into the medieval architecture, but the plumbing didn't work. I don't recall it being there before, but then I don't recall my friend washing either.

The experience was slightly unsettling. I found myself idly wondering whether I should have done something else with my life. It was one of those moments when you suddenly find yourself approaching 50 and wonder how on earth you got there. You turn over in the uncomfortable bed and suddenly half your life has gone. Where did it go? What happened to all those lives you were going to live and haven't?

We had champagne before the conference dinner in Hall and I definitely remember making some startlingly funny comments. Unfortunately, when I got back to my uncomfortable bed it was rolling in a slight but definite swell. I lay for a while in the half light from the high window, but the ghosts of those worlds that might have been were lying in wait behind the wardrobe, lurking under the lining of the empty drawers with the stale rich tea biscuits. Eventually I gave up the struggle and walked around the moonlit place.

The oddest thing about revisiting your childhood from middle age, especially in moonlight, is the feeling that you are seeing someone else's memories. You look through the eyes of someone who had no children, no wife, no patients, no career, and was worried about spots.

So there it is. I was wandering alone through this moonlit college with a suspicion that the ghosts were laughing at me. I think they were laughing at a middle aged man who apparently still retained the delusional belief that you can plan your life. As Yogi Berra said, obliquely: “You've got to be careful if you don't know where you're going because you might not get there.” For me the moral is clear: drink less at conferences.
Platelet Function in Renal Failure
Authors: G. Eknoyan, Stanley J. Wacksman, Helen I. Glueck, John J. Will
Journal: New England Journal of Medicine (1969)

Study of the bleeding tendency in uremia in 26 subjects, 10 of whom were bleeding, showed platelet counts and plasma coagulation factors to be normal. There was a significant inverse correlation between the level of serum urea nitrogen and creatinine, and the adhesiveness of the platelets. Platelet adhesiveness was significantly lower in bleeding subjects than in those without bleeding. A prolonged bleeding time was more frequent in the group with bleeding. Abnormal prothrombin consumption was found only in bleeding subjects despite normal numbers of platelets and plasma coagulation factors. The ingestion of urea in 10 normal volunteers prolonged the bleeding time in five and decreased the platelet adhesiveness, which fell to pathologic levels, in eight. These observations suggest a direct effect of urea or one of its metabolites on platelet function and help define the bleeding defect of uremia.
BMA Annual Representative Meeting, Belfast, 26 June to 29 June: Conference attacks referral centres
Authors: Zosia Kmietowicz
Journal: BMJ (2006)

Doctors have criticised referral management centres for sending patients for inappropriate treatment to independent sector treatment centres far from their home. At their annual conference in Belfast, BMA representatives backed motions that condemned the use of referral management centres, saying they made a nonsense of patient choice, and called for a restoration of GPs' right to refer patients to a named specialist.

Charlie Daniels, a GP in Torquay, said that patients who are referred for whatever reason are in a vulnerable position, because they are worried about what will happen to them. Yet patients in his area are being put under pressure by a referral management centre to switch from being seen at the local district general hospital recommended by their GP to a treatment centre 60 km away in Plymouth.

He recounted the case of a late middle aged woman whom he referred for an arthroscopy at the local hospital. She returned to the surgery seeking advice after the local referral management centre told her that she was scheduled to have a total knee replacement operation in Plymouth. “In that case my GP colleague re-referred the patient back to the district general hospital [for the minor procedure],” said Dr Daniels. “She [the patient] was clearly distressed, and it would have been negligent for a woman of her age to have a knee replacement.”

The independent treatment centre in Plymouth, to which the woman was being referred, is one of an estimated 30 to 40 such independent centres in England.

Independent treatment centres are working well below their capacity, said the BMA's chairman, James Johnson, but they are paid for the number of operations they have been commissioned to perform whether they do them or not.

“At the same time the NHS has very severe problems—laying off staff in large numbers because they cannot afford to keep them. We can understand why doctors are getting angry,” he said.
Ultrasonographic evaluation in psoriatic arthritis is of major importance in evaluating disease activity
Authors: Brigitte Michelsen, Andreas P Diamantopoulos, Hilde B Hammer, Dag M Soldal, Arthur Kavanaugh, Glenn Haugeberg
Journal: Annals of the Rheumatic Diseases (2016)

To investigate the association between clinical and ultrasonographic (US) evidence of inflammation in psoriatic arthritis (PsA), as well as to compare clinical and US remission criteria.In this cross-sectional study 141 PsA outpatients were included. Minimal disease activity (MDA), 28-joint Disease Activity Score (DAS28), Disease Activity Index for PSoriatic Arthritis (DAPSA) and modified versions of Composite Psoriatic Disease Activity Index (CPDAI) and Psoriatic ArthritiS Disease Activity Score (PASDAS) were assessed. Remission criteria were explored. US evaluation was performed on 34 joints, in addition to joints being tender/swollen by 66/68 joint count, 30 tendons, 10 entheses and additionally entheses found to be tender by clinical examination of 19 other entheses. Power Doppler (PD) and grey scale global scores on joints, entheses and tendons were assessed. US remission was defined as no PD activity in joints, entheses and tendons.DAPSA and DAS28, but not CPDAI and PASDAS, were associated with PD activity. MDA was fulfilled in 22.7% and the clinical remission criteria in 5.7%-9.9% of the patients. US remission was found in 49.6% of the patients. The prevalence of PD activity at joints, entheses and tendons was similar for patients fulfilling versus not fulfilling MDA/clinical remission criteria. MDA (OR 2.3, p=0.048), DAPSA ≤3.3 (OR 4.2, p=0.025) and Boolean's (OR=7.8, p=0.033) definitions of remission were found to predict US remission.We found major discrepancies between US and clinical findings. DAPSA and DAS28 reflected US findings better than CPDAI and PASDAS. MDA, DAPSA and Boolean's remission criteria predicted US remission.
Magnesium and infection risk after kidney transplantation: An observational cohort study
Authors: Steven Van Laecke, Pieter Vermeiren, Evi V. Nagler, Rogier Caluwe, Maarten De Wilde, Marc Van der Vennet, Patrick Peeters, Caren Randon, Frank Vermassen, Raymond Vanholder, Wim Van Biesen
Journal: Journal of Infection (2016)
209P: SMO mutation is a strong negative prognostic factor in malignant pleural mesothelioma
Authors: D. Signorelli, C. Proto, M. Ganzinelli, G. Lo Russo, L. Botta, A. Trama, G. Pasello, M. Tiseo, G. Pelosi, M. Garassino
Journal: Journal of Thoracic Oncology (2016)
Depressed Monoamine Catabolite Levels in Cerebrospinal Fluid of Patients with Parkinsonism Dementia of Guam
Authors: Jacob A. Brody, Thomas N. Chase, Edna K. Gordon
Journal: New England Journal of Medicine (1970)

Depressed levels of homovanillic acid, the principal catabolite of dopamine, and 5-hydroxyindoleacetic acid, the major product of serotonin degradation in brain, were found in the cerebrospinal fluid of seven Guamanian patients with Parkinsonism dementia. Homovanillic acid concentrations in spinal fluid of six Guamanians with amyotrophic lateral sclerosis were also significantly lower than those observed in six Guamanian control subjects, although higher than those found in the patients with Parkinsonism dementia. Monoamine catabolite levels in patients with Parkinsonism dementia and amyotrophic lateral sclerosis on Guam were similar to those found in Americans with idiopathic Parkinsonism or classic amyotrophic lateral sclerosis, respectively. An alteration in cerebral monoamines similar to that previously found in classic Parkinson's disease may thus attend the Parkinsonism-dementia syndrome of Guam.
Prognostic assessment in COPD without lung function: the B-AE-D indices
Authors: Lucas Boeck, Joan B. Soriano, Marjolein Brusse-Keizer, Francesco Blasi, Konstantinos Kostikas, Wim Boersma, Branislava Milenkovic, Renaud Louis, Alicia Lacoma, Remco Djamin, Joachim Aerts, Antoni Torres, Gernot Rohde, Tobias Welte, Pablo Martinez-Camblor, Janko Rakic, Andreas Scherr, Michael Koller, Job van der Palen, Jose M. Marin, Inmaculada Alfageme, Pere Almagro, Ciro Casanova, Cristobal Esteban, Juan J. Soler-Cataluña, Juan P. de-Torres, Marc Miravitlles, Bartolome R. Celli, Michael Tamm, Daiana Stolz
Journal: European Respiratory Journal (2016)

Several composite markers have been proposed for risk assessment in chronic obstructive pulmonary disease (COPD). However, choice of parameters and score complexity restrict clinical applicability. Our aim was to provide and validate a simplified COPD risk index independent of lung function.The PROMISE study (n=530) was used to develop a novel prognostic index. Index performance was assessed regarding 2-year COPD-related mortality and all-cause mortality. External validity was tested in stable and exacerbated COPD patients in the ProCOLD, COCOMICS and COMIC cohorts (total n=2988).Using a mixed clinical and statistical approach, body mass index (B), severe acute exacerbations of COPD frequency (AE), modified Medical Research Council dyspnoea severity (D) and copeptin (C) were identified as the most suitable simplified marker combination. 0, 1 or 2 points were assigned to each parameter and totalled to B-AE-D or B-AE-D-C. It was observed that B-AE-D and B-AE-D-C were at least as good as BODE (body mass index, airflow obstruction, dyspnoea, exercise capacity), ADO (age, dyspnoea, airflow obstruction) and DOSE (dyspnoea, obstruction, smoking, exacerbation) indices for predicting 2-year all-cause mortality (c-statistic: 0.74, 0.77, 0.69, 0.72 and 0.63, respectively; Hosmer-Lemeshow test all p>0.05). Both indices were COPD specific (c-statistic for predicting COPD-related 2-year mortality: 0.87 and 0.89, respectively). External validation of B-AE-D was performed in COCOMICS and COMIC (c-statistic for 1-year all-cause mortality: 0.68 and 0.74; c-statistic for 2-year all-cause mortality: 0.65 and 0.67; Hosmer-Lemeshow test all p>0.05).The B-AE-D index, plus copeptin if available, allows a simple and accurate assessment of COPD-related risk.
NIMG-39A CASE REPORT OF RAPID RECURRENCE OF CERVICAL SCHWANNOMA IN A PEDIATRIC PATIENT
Authors: Gurcharanjeet Kaur, Lauren Cameron, Tejwant Bindra, Agnieszka Kowalska
Journal: Neuro-Oncology (2015)

OBJECTIVE: To describe a unique clinical presentation and rapid recurrence of cervical Schwannoma. BACKGROUND: Schwannomas are known to be benign peripheral nerve tumors, 25% of the cases occur in the head and neck region and are frequently ( 18%) associated with NF -2 with recurrence rates (5%) after subtotal resection. CASE DESCRIPTION: 16 year-old right-handed female presented to the ED for right arm and leg weakness, right foot drop, patchy paresthesias after a fall five months prior to the presentation. Physical exam revealed absence of neurocutaneous markers, subtle right arm and leg weakness, hand apraxia, hyperreflexia, high steppage gait with right-sided ataxia. Outpatient Brain and Lumbar MRI prior to presentation were reported normal. Patient underwent cervical MRI with and without contrast in ED, which revealed a dumbbell lesion, expanding the right neural foramina at C6-C7 and severe central spinal stenosis with cord compression. She received IV dexamethasone and subsequently underwent subtotal resection of a right C7 schwannoma with posterior cervicothoracic instrumentation. Genetics consultation suggested NF-2, given family history of cervical schwannoma in paternal uncle. RESULTS: Surgical pathology revealed WHO grade I schwannoma. Patient was discharged home with short interval follow-up showing resolution of her right upper extremity weakness. MRI c-spine, 6 weeks post-op, revealed regrowth of the schwannoma through the neural foramen at C6-7. NF-2 work-up pending. DISCUSSION: Schwannomas may present in an acute setting in a variety of ways despite an absence of cutaneous findings. Imaging of the total spine should be performed in a timely manner, preferentially MRI with and without contrast, in suspected cases. Surgical resection is preferred to spare permanent neurologic impairment. Gross total resections have been associated with better outcomes. Short interval follow up is suggested for patients with subtotal resection.
Lemierre's Syndrome
Authors: Clinton Lai, Dharshan R Vummidi
Journal: New England Journal of Medicine (2004)

Cannock Chase Hospital Cannock WS11 2XY, United Kingdom 35-year-old woman presented with a three-day history of sore throat, painful swelling of the neck, fever, rigor, hemoptysis, and dyspnea. Examination revealed pustular exudates on the right tonsil and thrombophlebitis of the right external jugular vein (Panel A, arrows). Computed tomographic imaging of the chest revealed bilateral pleural effusion and multiple areas of consolidation with cavitation (Panel B, arrows). Doppler ultrasonography confirmed thrombosis of both the external and the internal jugular veins. Lemierre’s syndrome is characterized by disseminated abscesses and thrombophlebitis of the internal jugular vein after infection of the oropharynx. The predominant pathogen is a gram-negative anaerobic bacillus, Fusobacterium necrophorum; in this case, the bacillus was isolated from blood culture after two days. The patient had a rapid response to therapy with metronidazole, clindamycin, and enoxaparin. She had recovered completely by three weeks after discharge.
Successful Valve Replacement in an Infant with Congenital Mitral Stenosis
Authors: Dennison Young, George Robinson
Journal: New England Journal of Medicine (1964)

CONGENITAL mitral stenosis, sufficiently severe to cause recurrent heart failure and syncopal episodes in infancy, is rarely compatible with life beyond two years of age.1 Except for 1 reported case of recovery following "blind" finger fracture of a stenotic valve in a three-month-old baby,2 all patients in the infant age group have failed to survive attempts at surgical correction. Of 15 patients with this isolated anomaly for whom surgery was attempted, the 4 other survivors were six years of age or older. The present case is reported because it demonstrates the feasibility of prolonged extracorporeal circulatory bypass in a small . . .
Case 11-1966
Authors: Richard Schatzki, Benjamin Castleman
Journal: New England Journal of Medicine (1966)

Presentation of CaseA nineteen-year-old girl was admitted to the hospital because of pain in the abdomen.Persistent, aching pain developed in both lower quadrants of the abdomen two days previously and abruptly became severe on the day of admission. A menstrual period terminated on the day before admission. She had last experienced sexual intercourse two weeks earlier. There was no history of chills or fever, nausea, vomiting, vaginal discharge, dysuria or pyuria.The patient had had tuberculosis during her childhood in Hungary; annual x-ray examination of the chest thereafter had been negative. One year before admission she had swallowed . . .
Some Observations on Cretinism and Its Treatment
Authors: Daniel Federman, Jacob Robbins, J. E. Rall
Journal: New England Journal of Medicine (1958)

THE present paper is a report of findings in a group of cretins who have been under observation at the National Institute of Arthritis and Metabolic Diseases. The patients, gathered within the course of a year, suggest that the condition is far from disappearing, and their histories reaffirm that tardy recognition remains a major problem of the syndrome.The studies reported include those related to bone growth, cerebral activity and thyroid function. Seven of the 12 patients have been treated with L-tri-iodothyronine, and the results are reported below.Clinical FindingsThe patients studied, 5 males and 7 females, ranged in . . .
Dynamics of the Enterohepatic Circulation of Bile Acids
Authors: Nicholas F. LaRusso, Melvyn G. Korman, Neville E. Hoffman, Alan F. Hofmann
Journal: New England Journal of Medicine (1974)

Abstract The effect of three liquid meals on the serum level of conjugates of cholic acid was determined by radioimmunoassay. In eight healthy subjects, these bile acids peaked 90 to 120 minutes after each meal, and returned to base line by four hours. This pattern was meal related because the values remained at base line in four subjects undergoing a 22-hour fast. In five patients with cholecystectomy, conjugates of cholic acid increased to lower maxima after the first meal, and then remained elevated throughout the day, returning to base line 14 hours after the evening meal. In six patients with bile acid malabsorption (after ileal resection), the postprandial increase after the first meal was smaller than in health; an increase was barely detectable after the mid-day meal and occurred after the evening meal. In subjects with normal liver function, postprandial conjugates of cholic acid appear to indicate the dynamics of the enterohepatic circulation of bile acids; the level depends in part on intestina...
Herpesvirus-Induced Antigens in Squamous-Cell Carcinoma in Situ of the Vulva
Authors: Raymond H. Kaufman, Gordon R. Dreesman, Joyce Burek, Matti O. Korhonen, David O. Matson, Joseph L. Melnick, Kenneth L. Powell, Dorothy J. M. Purifoy, Richard J. Courtney, Ervin Adam
Journal: New England Journal of Medicine (1981)

Antigens induced by herpes simplex virus Type 2 (HSV2) were found to be associated with squamous-cell carcinoma in situ of the vulva in nine of 10 patients. The HSV2-induced antigens are DNA-binding proteins that are normally present in the nuclei of infected cells, but in the cells of the carcinomas in situ they were found in the cytoplasm. Whole-virion structural antigens were not present, although there was serologic evidence of previous HSV2 infection in patients tested for the presence of antibodies. The observations reported here and the recent parallel rise in the prevalence of both HSV2 infections and vulvar carcinoma in situ, particularly in women under 40 years of age, suggest an association of HSV2 infection with this type of neoplasia, the nature of which remains to be determined. (N Engl J Med. 1981; 305:483–8.)
Concomitant and adjuvant temozolomide (TMZ) and radiotherapy (RT) for newly diagnosed glioblastoma multiforme (GBM). Conclusive results of a randomized phase III trial by the EORTC Brain &amp; RT Groups and NCIC Clinical Trials Group
Authors: R. Stupp, W. P. Mason, M. J. Van Den Bent, M. Weller, B. Fisher, M. Taphoorn, A. A. Brandes, G. Cairncross, D. Lacombe, R. O. Mirimanoff
Journal: Journal of Clinical Oncology (2004)

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