tbuckley/cabot-search huggingface dataset:
Occurrence of Defective Hexosephosphate Isomerization in Human Erythrocytes and Leukocytes
Authors: Donald E. Paglia, Phillip Holland, Marjorie A. Baughan, William N. Valentine
Journal: New England Journal of Medicine (1969)

Deficient activity of erythrocyte and leukocyte glucosephosphate isomerase was found in three siblings with hereditary hemolytic anemia who were unrelated to the single patient previously described. Anemia was more severe in these subjects but was ameliorated by splenectomy. Activities of glucose phosphate isomerase in proband red cells were 14 to 30 per cent of normal mean values despite brisk reticulocytosis, and leukocyte activities were as low as 5 per cent. Cells from both parents, both grandmothers and four siblings, all clinically unaffected, contained approximately half the usual isomerase levels. Enzyme inhibitors were not demonstrable, and glucosephosphate-isomerase reaction kinetics appeared normal. Starch-gel electrophoresis of proband hemolysates demonstrated distinct isozyme patterns unlike any previously noted, including those of the other deficient kindred. Genealogic patterns conformed with autosomal recessive transmission of the genetic defect.
Asymptomatic Urinary-Tract Infection with Shigella Sonnei in a Chronic Fecal Carrier
Authors: Rodolfo L. Jao, George Gee Jackson
Journal: New England Journal of Medicine (1963)

SHIGELLA dysentery is an infection in which the micro-organisms are usually localized to the alimentary tract and regional lymph nodes.1 The literature reveals, however, that infection of the urinary tract2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 and bacteremia20 21 22 23 24 25 26 27 with the shigella species have been documented. Asymptomatic fecal carriers have also been recognized, but they usually follow acute bacillary dysentery. The case reported below is unusual in that it is the first noted case of asymptomatic urinary-tract infection caused by Shigella sonnei, and the infection occurred in a patient who was a fecal carrier without a history of dysentery.Case HistoryR.O., a 61-year-old Mexican housekeeper, was . . .
The Diastolic Murmur of Mitral Stenosis
Authors: Patrick A. Ongley, Howard B. Sprague, Maurice B. Rappaport
Journal: New England Journal of Medicine (1955)

BECAUSE of the great interest currently demonstrated in the surgical correction of mitral stenosis, it has become essential for the clinician to be able to diagnose this condition with the greatest possible accuracy and also to estimate the degree of disability caused by it. A thorough knowledge of the murmurs of mitral stenosis and of the variations in these murmurs under different physiologic and pathologic conditions should be of assistance in diagnosis. It is our purpose to present in this paper a brief history of the murmurs of mitral stenosis and various factors affecting these murmurs, as well as brief . . .
Histocompatibility (HL-A) Antigens Associated with Psoriasis
Authors: Thomas J. Russell, Lorain M. Schultes, Donald J. Kuban
Journal: New England Journal of Medicine (1972)

HL-A phenotypes were determined in 44 unrelated and 22 related psoriatic patients to establish frequency of HL-A. HL-A13 was present in 12 of 44 unrelated patients, and in three of 89 controls (a difference significant at p less than 0.0001). W17 (Te57) was also present in 10 of 44 unrelated patients and in 17 family members with psoriasis examined of a dominant pedigree with psoriasis over four generations. Two members of the family not having W17, siblings 42 and 46 years old, did not have psoriasis. These findings suggest that HL-A phenotypes may be of value in studies regarding the etiology of psoriasis.
Case 31-1978
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, Ronald P. McCaffrey, John C Long
Journal: New England Journal of Medicine (1978)

Presentation of CaseA 14-year-old boy was admitted to the hospital because of dyspnea.He was well until four months earlier, when he began to experience fatigue and exertional dyspnea. He gradually gave up sports. A hacking, nonproductive cough appeared, with a low-grade fever that subsided promptly. Three days before admission fever recurred, with increased cough and severe dyspnea.The boy was born in the Dominican Republic. In early infancy a draining sinus was observed in the right side of the neck, but it soon healed. He was brought to this country at the age of 10 years. Physical examination, . . .
Outcomes of Two Trials of Oxygen-Saturation Targets in Preterm Infants
Journal: New England Journal of Medicine (2016)

The safest ranges of oxygen saturation in preterm infants have been the subject of debate.In two trials, conducted in Australia and the United Kingdom, infants born before 28 weeks' gestation were randomly assigned to either a lower (85 to 89%) or a higher (91 to 95%) oxygen-saturation range. During enrollment, the oximeters were revised to correct a calibration-algorithm artifact. The primary outcome was death or disability at a corrected gestational age of 2 years; this outcome was evaluated among infants whose oxygen saturation was measured with any study oximeter in the Australian trial and those whose oxygen saturation was measured with a revised oximeter in the U.K. trial.After 1135 infants in Australia and 973 infants in the United Kingdom had been enrolled in the trial, an interim analysis showed increased mortality at a corrected gestational age of 36 weeks, and enrollment was stopped. Death or disability in the Australian trial (with all oximeters included) occurred in 247 of 549 infants (45.0%) in the lower-target group versus 217 of 545 infants (39.8%) in the higher-target group (adjusted relative risk, 1.12; 95% confidence interval [CI], 0.98 to 1.27; P=0.10); death or disability in the U.K. trial (with only revised oximeters included) occurred in 185 of 366 infants (50.5%) in the lower-target group versus 164 of 357 infants (45.9%) in the higher-target group (adjusted relative risk, 1.10; 95% CI, 0.97 to 1.24; P=0.15). In post hoc combined, unadjusted analyses that included all oximeters, death or disability occurred in 492 of 1022 infants (48.1%) in the lower-target group versus 437 of 1013 infants (43.1%) in the higher-target group (relative risk, 1.11; 95% CI, 1.01 to 1.23; P=0.02), and death occurred in 222 of 1045 infants (21.2%) in the lower-target group versus 185 of 1045 infants (17.7%) in the higher-target group (relative risk, 1.20; 95% CI, 1.01 to 1.43; P=0.04). In the group in which revised oximeters were used, death or disability occurred in 287 of 580 infants (49.5%) in the lower-target group versus 248 of 563 infants (44.0%) in the higher-target group (relative risk, 1.12; 95% CI, 0.99 to 1.27; P=0.07), and death occurred in 144 of 587 infants (24.5%) versus 99 of 586 infants (16.9%) (relative risk, 1.45; 95% CI, 1.16 to 1.82; P=0.001).Use of an oxygen-saturation target range of 85 to 89% versus 91 to 95% resulted in nonsignificantly higher rates of death or disability at 2 years in each trial but in significantly increased risks of this combined outcome and of death alone in post hoc combined analyses. (Funded by the Australian National Health and Medical Research Council and others; BOOST-II Current Controlled Trials number, ISRCTN00842661, and Australian New Zealand Clinical Trials Registry number, ACTRN12605000055606.).
Case 9-2003
Authors: Alison M. Friedmann, Esther Oliva, Anthony L. Zietman, Suzanne L. Aquino
Journal: New England Journal of Medicine (2003)

Presentation of CaseAn 18-year-old man was admitted to the hospital because of back and leg pain and a nondiagnostic biopsy specimen from a paravertebral mass.The patient had been well until eight months earlier, when the back pain began. Despite the use of ibuprofen and local application of ice, the pain increased, and three months before admission, pain developed in the right lower leg. A chiropractor obtained a radiograph of the spine, which revealed a compression fracture at the L3 vertebra. About one month before admission, a computed tomographic (CT) scan of the lumbosacral spine, obtained at another facility, . . .
Experience with a Tubeless Method of Gastric Analysis
Authors: Monte Malach, Benjamin M. Banks
Journal: New England Journal of Medicine (1952)

THE recent availability of cation-exchange indicator compounds has suggested their use in determining the presence or absence of free hydrochloric acid in gastric contents without the need for intubation of the stomach.1 , 2 The purpose of this preliminary report is to present our experiences with this test in comparison with the conventional tube method of gastric analysis, and to outline the indications and limitations of the tubeless technic.RationaleThe cation-exchange indicator compound Diagnex§ is prepared by replacing the hydrogen cation of a carboxylic acid group, present in the exchange resin, with a quininium cation. As demonstrated by in vitro and . . .
Management of Pyogenic Cutaneous Infections
Authors: Joseph W. Burnett
Journal: New England Journal of Medicine (1962)

PYOGENIC cutaneous infections are commonly seen in the practice of medicine. Often, these conditions are localized to the skin and are not accompanied by constitutional symptoms. One of their identifying characteristics is a yellow crust or exudate on the skin. This double-blind study was designed to select patients with such yellow, crusted exudates to determine the effects of antibiotic therapy and the local application of wet dressings upon the duration of this type of disease. Several laboratory procedures were performed in an attempt to discover a simple test to separate infected from noninfected cases.MethodEighty-nine outpatients with yellowish, crusted . . .
Cooking Coal Use and All-Cause and Cause-Specific Mortality in a Prospective Cohort Study of Women in Shanghai, China
Authors: Christopher Kim, Wei Jie Seow, Xiao-Ou Shu, Bryan A. Bassig, Nathaniel Rothman, Bingshu E. Chen, Yong-Bing Xiang, H. Dean Hosgood, Bu-Tian Ji, Wei Hu, Cuiju Wen, Wong-Ho Chow, Qiuyin Cai, Gong Yang, Yu-Tang Gao, Wei Zheng, Qing Lan
Journal: Environmental Health Perspectives (2016)

Nearly 4.3 million deaths worldwide were attributable to exposure to household air pollution in 2012. However, household coal use remains widespread.We investigated the association of cooking coal and all-cause and cause-specific mortality in a prospective cohort of primarily never-smoking women in Shanghai, China.A cohort of 74,941 women were followed from 1996 through 2009 with annual linkage to the Shanghai vital statistics database. Cause-specific mortality was identified through 2009. Use of household coal for cooking was assessed through a residential history questionnaire. Cox proportional hazards models estimated the risk of mortality associated with household coal use.In this cohort, 63% of the women ever used coal (n = 46,287). Compared with never coal use, ever use of coal was associated with mortality from all causes [hazard ratio (HR) = 1.12; 95% confidence interval (CI): 1.05, 1.21], cancer (HR = 1.14; 95% CI: 1.03, 1.27), and ischemic heart disease (overall HR = 1.61; 95% CI: 1.14, 2.27; HR for myocardial infarction specifically = 1.80; 95% CI: 1.16, 2.79). The risk of cardiovascular mortality increased with increasing duration of coal use, compared with the risk in never users. The association between coal use and ischemic heart disease mortality diminished with increasing years since cessation of coal use.Evidence from this study suggests that past use of coal among women in Shanghai is associated with excess all-cause mortality, and from cardiovascular diseases in particular. The decreasing association with cardiovascular mortality as the time since last use of coal increased emphasizes the importance of reducing use of household coal where use is still widespread.Kim C, Seow WJ, Shu XO, Bassig BA, Rothman N, Chen BE, Xiang YB, Hosgood HD III, Ji BT, Hu W, Wen C, Chow WH, Cai Q, Yang G, Gao YT, Zheng W, Lan Q. 2016. Cooking coal use and all-cause and cause-specific mortality in a prospective cohort study of women in Shanghai, China. Environ Health Perspect 124:1384-1389; http://dx.doi.org/10.1289/EHP236.
Cell-Mediated Immunity to Mouse Mammary Tumor Virus Antigens by Patients With Hyperplastic Benign Breast Disease&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN3"&gt;3&lt;/xref&gt;
Authors: G B Cannon, S H Barsky, T C Alford, L F Jerome, V Tinley, J L McCoy, J H Dean
Journal: JNCI Journal of the National Cancer Institute (1982)

Peripheral blood leukocytes of patients with preoperative breast cancer, benign breast disease, and benign gynecologic disorders and normal healthy females were tested, as blind coded specimens, with murine mammary tumor virus (MuMTV) antigens in the direct and indirect leukocyte migration inhibition (LMI) assays. The incidence of reactivity by patients with breast cancer was low. (From 5 to 35% breast cancer patients reacted, depending on which group of control individuals they were compared to and what antigen was used.) Nonparametric analyses showed no differences between control groups (normal donors and patients with gynecologic disorders) and breast cancer patients with either assay. However, there was a significant difference between benign breast disease patients with hyperplasia and 1) benign breast disease patients without hyperplasia (P less than 0.03) and 2) patients with gynecologic disorders (P less than 0.04) in the direct assay when it was performed blindly with the gp52 antigen. Patients with hyperplasia (benign breast disease as well as breast cancer) had a higher incidence of enhanced migration in the indirect test than breast disease patients without hyperplasia. The enhanced migration to the MuMTV was correlated to enhanced migration to a 3-M KCI extract of the breast cancer cell line MCF-7 in simultaneous tests. Thus the LMI assays with MuMTV antigens do not appear valuable in breast cancer diagnosis, but they may help to identify a small group of benign breast disease patients whose breast pathology is thought to be associated with a high risk for developing breast cancer.
Editorial Review: Peerless Pronouncements
Authors: Ian Douglas-Wilson
Journal: New England Journal of Medicine (1977)

Years of working and dozing in an editorial office persuaded me that the outside experts who advise editors are a saintly band who give unstinted help with no thought (and never a chance) of proper recognition. No general journal that publishes original work could function reasonably without being able to call on their aid. But how often should this help be invoked?I am a convinced opponent of routine peer review of articles. The experts' pronouncements tend toward cautious conservatism; they are not invariably beyond misplacing the big with the bogus; and they are apt to be swayed by the . . .
Postoperative Psychosis in Cardiotomy Patients
Authors: Ottis L. Layne, Stuart C. Yudofsky
Journal: New England Journal of Medicine (1971)

Fifty-eight cardiotomy patients and 20 patients undergoing major vascular surgery were studied to assess the roles of organic factors, sleep and sensory deprivation and psychiatric factors in the development of postoperative psychosis. Two thirds of the cardiac patients were psychologically evaluated before operation, extensively interviewed and encouraged to discuss the emotional aspects of their surgery. The findings include a 14 per cent overall prevalence of postoperative psychosis in cardiotomy patients, with increased percentages in males, older patients, patients undergoing aortic-valve replacement, those with neurologic and other organic abnormalities and those expressing minimal preoperative anxiety. The preoperative psychiatric interview was associated with a reduction of postoperative psychosis by 50 per cent.
Serum Lipoproteins and Coronary Heart Disease in a Population Study of Hawaii Japanese Men
Authors: George G. Rhoads, Christian L. Gulbrandsen, Abraham Kagan
Journal: New England Journal of Medicine (1976)

To ascertain the frequency of defined hyperlipoproteinemia and to investigate the relation between lipoprotein fractions and coronary heart disease, we measured serum lipoprotein cholesterol levels in a population-based sample of Hawaii Japanese men 50 to 72 years old. Type II hyperlipoproteinemia was present in 3 per cent of 1859 men, and Type IV in 26 per cent. Relative risks for coronary heart disease, based on 264 prevalence cases, were found to be 1.8, 1.8 and 0.46, between the upper and lower quartiles of total, beta, and alpha cholesterol, respectively. We found no significant relation between triglyceride and coronary heart disease. The inverse relation of alpha cholesterol of prevalence of coronary heart disease was independent of beta cholesterol, obesity, and other factors. The data suggest the need for further evaluation of the protective effect of the alpha lipoprotein fraction on the development of coronary heart disease.
Picking a Research Problem -- The Critical Decision
Authors: C. Ronald Kahn
Journal: New England Journal of Medicine (1994)

There is probably no question that plagues investigators, especially young investigators, more than how to pick a research project. This decision is not one that must be faced only once in a lifetime; rather, it must be continually revisited. Although it is easy to assume that success in research is just the difference between good and bad luck (and indeed there is a certain amount of luck in research), most highly regarded investigators will have many successful research experiences during their careers.For the new investigator and junior faculty member just starting his or her career, the decision about a . . .
Development of Laser-Driven Proton Beam Therapy
Authors: U. Masood, M. Bussmann, T.E. Cowan, W. Enghardt, M. Kaluza, T. Herrmannsdoerfer, M. Krause, J. Pawelke, R. Sauerbrey, U. Schramm, M. Baumann
Journal: Annals of Oncology (2014)
PWE-236 The palatability of a savoury electrolyte drink for short bowel syndrome patients with a jejunostomy: Abstract PWE-236 Table 1
Authors: P Turner, E Richman
Journal: Gut (2015)

<h3>Introduction</h3> The jejunal mucosa is permeable to sodium and consumption of low sodium fluids by patients with short bowel syndrome and jejunostomy can lead to high stoma output, sodium depletion and dehydration. The optimum solution for absorption in the jejunum contains &gt;100 mmol/l sodium and glucose as there is coupled absorption of water sodium and glucose.<sup>1,2</sup>For this reason patients are encouraged to sip around 1000 ml/day of a glucose saline solution and restrict all other fluids to &lt;500 m/day.<sup>3</sup>Two preparations are commonly used: St Marks Solution (SMS) (2.5g sodium bicarbonate, 20g glucose and 3.5g sodium chloride per 1000ml water + flavour) and double strength Dioralyte (DSD) (10 sachets per 1000 mls). Patients often find these unpalatable and compliance is low often resulting in dehydration and the need for IV fluids with associated complications. Many patients also report a preference for hot drinks. Meat extracts such as Bovril contain &gt; 100mmol/l sodium when made up as per manufacturer’s instructions and the addition of glucose to these has the potential to make a savoury electrolyte solution that can be made up in small quantities and sipped while warm. <h3>Method</h3> 1000ml of DSD and SMS were made up. Two separate 1000ml portions of Bovril were made up by adding 60g Bovril concentrate to each 1000ml hot water giving a sodium content of 100mmol/l. 20g glucose powder was added to one portion and 20g glucose polymer added to the other. The drinks were coded A-D. 8 healthy volunteers were provided with 50ml samples and asked to sip each drink. They were asked to score them out of ten for palatability, with ten being the most palatable and 0 being the least palatable. <h3>Results</h3> <h3>Conclusion</h3> The two savoury drinks scored highest for palatability and could therefore provide an alternative to the existing solutions. They could also be used in combination with these to give more variety and a choice of hot and cold drinks. Glucose polymer is rapidly broken down to glucose and has a theoretical advantage over glucose through being less sweet although this was not demonstrated in this small study. Further investigation of savoury electrolyte drinks in jejunostomy patients is warranted. <h3>Disclosure of interest</h3> None Declared. <h3>References</h3> Nightingale JMD, <i>et al</i>. Oral salt supplements to compensate for jejunostomy losses: comparison of sodium chloride capsules, glucose electrolyte solution, and glucose polymer electrolyte solution. Gut, 1992;33:759–761. Fordtran JS, <i>et al</i>. The mechanism of sodium absorption in the human small intestine. J Clin Invest 1968;47:884. Nifghtingale J, Woodward JM; On behalf of the Small Bowel Nutrition Group of the BSG. Guidelines for the management of patients with a short bowel. http://www.gut.bmjjournals.com, 2006.
Treatment of Benign Prostatic Hyperplasia
Authors: Patrick C. Walsh
Journal: New England Journal of Medicine (1996)

Medications to treat benign prostatic hyperplasia fall into two main categories: α1-adrenergic–antagonist drugs, which relax smooth muscle in the prostate, and drugs that inhibit 5α-reductase, which shrink the prostate by blocking the formation of the chief intracellular androgen, dihydrotestosterone.1 The main question is, Which drug is better, or would a combination of the two work best? In this issue of the Journal, Lepor et al. report the results of a landmark study by the Veterans Affairs Cooperative Studies Benign Prostatic Hyperplasia Study Group that attempts to answer this question.2 The authors found that treatment with terazosin, an α . . .
Acute Pulmonary Edema in falciparum Malaria
Authors: Marion H. Brooks, Frank W. Kiel, Thomas W. Sheehy, Kevin G. Barry
Journal: New England Journal of Medicine (1968)

Clinical and autopsy findings correlated in five patients with pulmonary edema due to acute falciparum malaria disclosed that the clinical illness was characterized by progressive deterioration, severe cerebral dysfunction, overt intravascular hemolysis and marked parasitemia. In all cases rapidly lethal pulmonary edema, unresponsive to vigorous therapy, occurred in the absence of detectable cardiac decompensation or fluid retention. This study suggests that abnormalities of the pulmonary microcirculation have a central role in the pathogenesis of pulmonary edema in malaria.
Retention crisis in general practice must be tackled, says think tank
Authors: Gareth Iacobucci
Journal: BMJ (2016)

A new international analysis of attitudes of primary care doctors has identified “a clear correlation” between stress levels among GPs in the United Kingdom and their desire to leave their job.

The UK health policy charity the Health Foundation analysed findings from a survey by the US think tank the Commonwealth Fund that compared attitudes among 11 500 primary care doctors from 11 industrialised nations, including 1001 GPs in the UK.

Some 29% of the UK GPs surveyed said that they planned to leave general practice within five years, with 82% of those planning to leave medicine for a different career saying that their current role was extremely or very stressful. In contrast, only 48% of UK …