tbuckley/cabot-search huggingface dataset:
Malignant hypertension with irreversible renal failure due to oral contraceptives.
Authors: P Zech, G Rifle, A Lindner, J Sassard, N Blanc-Brunat, J Traeger
Journal: BMJ (1975)

The case report of a 27-year-old woman who had been normotensive before her 1st pregnancy 6 years earlier is presented. At 2 months postdelivery she began taking estro-progesterone. She was given Enidrel R (norethynodrel 4.925 mg, mestranol .075 mg) for 18 months and then Ovariostat (lynestrenol 2.5 mg, mestranol .075 mg). Her blood pressure was not recorded until 2 years later when it was 180 mm Hg systolic. Contraceptive therapy was then stopped. A month later pregnancy occurred. At that time her blood pressure was 120 mm Hg. The delivery was normal. 4 months later she began taking Ovariostat again. Headaches soon developed and her blood pressure was found to be 270/150 mm Hg. On admission to the hospital 3 weeks later her blood pressure was 250/100 mm Hg. Renal failure was present. Creatinine clearance was 12 ml/minute. No cause for this hypertension was found. 1 month later hypertension was 210/160 mm Ha. Retinal hemorrhaging had lessened but azotemia persisted. Heart failure and oliguria followed. Dialysis was done weekly. A bilateral nephrectomy was done. Microscopic study of renal tissue showed malignant nephroangiosclerosis. After 10 days her blood pressure was 150/100 mm Hg. Her general condition improved. A salt-free diet was prescribed. Blood pressure subsided to 140/80 mm Hg before dialysis. A renal graft was done and 10 months later blood pressure was normal. These hypertensions are usually benign and subside when the contraceptive therapy is discontinued. When estrogen-progesterones are prescribed, blood pressures should be recorded frequently and therapy stopped if hypertension arises.
Extracellular matrix modulates epidermal growth factor receptor activation in rat glomerular epithelial cells.
Authors: A V Cybulsky, A J McTavish, M D Cyr
Journal: Journal of Clinical Investigation (1994)

To understand how glomerular epithelial cell (GEC) proliferation may be regulated in health and disease, we studied the effects of type I collagen extracellular matrices (ECM) on EGF receptor (EGF-R) activation in cultured rat GEC. EGF stimulated proliferation of GEC adherent to ECM, but not of GEC on a plastic substratum. Significant and prolonged EGF-R tyrosine autophosphorylation (which reflects receptor kinase activation) was induced by EGF in GEC adherent to collagen, but EGF did not stimulate EGF-R autophosphorylation in GEC on plastic (at 37 degrees C). However, EGF-R autophosphorylation increased significantly in plastic-adherent GEC that were stimulated with EGF at 4 degrees C or in the presence of vanadate, an inhibitor of phosphotyrosine phosphatases. Furthermore, dephosphorylation of EGF-R was enhanced in GEC on plastic as compared with collagen. At 4 degrees C, [125I]EGF binding was not different between substrata, and there was negligible accumulation of intracellular [125I]EGF (which reflects EGF-R internalization). At 37 degrees C, EGF-R internalization was reduced significantly in collagen-adherent GEC as compared with GEC on plastic. Thus, contact with ECM facilitates proliferation and EGF-R activation in GEC. The enhanced activity of EGF-R tyrosine kinase may be due to ECM-induced reduction in EGF-R internalization and dephosphorylation by phosphotyrosine phosphatase(s). Signals from ECM to growth factor receptors may regulate cell turnover in the glomerulus under normal conditions and during immune glomerular injury.
Sex Education in Schools— A Polemic
Authors: Patrick J. Buttarazzi
Journal: JAMA (1969)

<h3>To the Editor:—</h3> I believe that you should make it clear to the public that this editorial represents the views of the editors ofThe Journal, not all the members of the American Medical Association. To characterize the opponents of the program as either extreme right wingers or uninformed people is a slur not befitting the AMA. As a physician and father who has spent a great deal of time in researching the so-called sex education programs; I am at a loss to explain their value to either the individual or society. Let me assure you that my feelings are shared by a great number of responsible physicians who are neither uninformed nor members of the extreme right wing. I am looking forward to a clarification of your editorial position.
Elevated Morbidity and Health Care Use in Children with Obstructive Sleep Apnea Syndrome
Authors: Ariel Tarasiuk, Sari Greenberg-Dotan, Tzahit Simon-Tuval, Bruria Freidman, Aviv D. Goldbart, Asher Tal, Haim Reuveni
Journal: American Journal of Respiratory and Critical Care Medicine (2006)

Health care use, a reliable measure of morbidity, is noticeably higher 1 yr before obstructive sleep apnea syndrome (OSAS) diagnosis in preschool children. It is not clear at what age OSAS-related morbidity becomes expressed.To explore morbidity and health care use among children with OSAS starting from first year of life.Case-control study, starting from the first year of life to date of OSAS diagnosis, among 156 patients (age range, 3-5 yr) and their pair-matched healthy control subjects, by age, sex, primary care physician, and geographic location.Patients with OSAS underwent nocturnal polysomnography studies. Medical records during hospital visits were reviewed for diagnosis. Variables of health care use were obtained from computerized databases of Clalit Health Care Services, the largest health maintenance organization in Israel.From the first year of life to date of OSAS diagnosis, children with OSAS had 40% more (p = 0.048) hospital visits, 20% more repeated (two or more) visits (p < 0.0001), and higher consumption of antiinfective and respiratory system drugs (p < 0.0001). Referrals of children with OSAS to otolaryngology surgeons and pediatric pulmonologists were higher from Year 1 (p < 0.0001) to date of OSAS diagnosis, especially in Year 4 (odds ratio, 9.4; 95% confidence interval, 4.2-21.1). The 215% elevation (p < 0.0001) in health care use of the OSAS group was due mainly to higher occurrence of respiratory tract morbidity (p < 0.0001).Practitioners should be aware that starting in Year 1 until date of diagnosis, children with OSAS have higher health care use, mostly related to respiratory diseases.
UK needs more cancer specialists
Authors: L. Beecham
Journal: BMJ (1997)

Over 450 extra consultants could be needed to staff the network of cancer units and specialist cancer centres proposed by the Calman/Hine report.

In 1995 the Expert Advisory Group on Cancer, which reported to the chief medical officers of England and Wales, published A Policy Framework for Commissioning Cancer Services . This proposed a network of 150 cancer units linked to 40 specialist cancer centres.

The cancer collaboration study produced by the …
Accuracy of Rubella History
Authors: STEPHEN J. LERMAN
Journal: Annals of Internal Medicine (1971)

The availability of rubella vaccine makes it important to identify the 20% of women in the childbearing age who are susceptible and at risk for rubella during pregnancy. A study of 275 women 15 to 56 years of age (median, 20 years) was undertaken to determine the correlation between history of rubella and presence of antibody. A history of rubella was accompanied by a significant level of antibody in 92% of the subjects, however, over 50% with "no history" of rubella and 85% who were "not sure" had antibody. History was also not a specific indicator of immunity; 7 of 38 susceptible subjects reported past rubella, a false-positive response of 18%. Determination of circulating antibody is the only reliable method for deciding which adult women should receive rubella vaccine.
Turning a blind eye:Authors' reply
Authors: Dean Fergusson, Kathleen Cranley Glass, Duff Waring, Stan Shapiro
Journal: BMJ (2004)

EDITOR—Altman et al and Senn correctly note that a strong relation is likely between patients' improvement, real or perceived, and a subsequent guess by patients, investigators, or outcome assessors that active treatment had been assigned. Admittedly, assessing blinding by simply examining the proportion of correct “guesses” is …
No Insurance, No Admission
Authors: Keith Wrenn
Journal: New England Journal of Medicine (1985)

I would like to address what seems to me to be a very disturbing trend from my vantage point as a primary care internist in a relatively isolated rural area approximately two hours in any direction from a referral center. To illustrate my problem, I report the following two cases.In May 1983 a mildly intoxicated 26-year-old man was in an automobile accident, sustaining a bump on his head without loss of consciousness. He was brought to the emergency room as a precaution and was initially lucid and in no distress. While waiting to be seen, he began to have . . .
Kussmaul's Paradoxical Pulse
Authors: Edward Shapiro
Journal: JAMA (1964)

<h3>To the Editor:—</h3> I appreciate the biographical sketches inThe Journaland find the one on Kussmaul in the July 6 issue (<b>189</b>:58, 1964) particularly interesting. Having recently translated the paper, "On Adhesive Mediastino-Pericarditis and the Paradoxical Pulse," and realizing that much confusion exists about the nature of the paradox in the "paradoxical pulse," I would like to offer a clarification of the translation quoted on page 59, specifically the part which reads "... this is expected during normal heart action." The paradox in Kussmaul's mind was that the heart beat regularly while the arterial pulsations at the wrist and elsewhere faded away or disappeared during inspiration. In normal persons the arterial pressure during inspiration falls a few millimeters, giving rise to a physiologically normal decrease in pulse action, but not to the extent that the pulse is absent or seems irregular.
Nuclear bodies in rheumatoid synovium.
Authors: T Neumark, K Farkas
Journal: Annals of the Rheumatic Diseases (1970)

Ba 679 BR [7(S)-(1 alpha, 2 beta, 4 beta, 5 alpha, 7 beta)-7-[(hydroxydi(2-thienyl) acetyl)oxy]-9,9-dimethyl-3-oxa-9-azoniatricyclo[3.3.1.0(2,4)]nonan e bromide] is a new long-acting muscarinic antagonist developed as a bronchodilator drug. In this study, we have evaluated its affinity, its selectively, and the distribution of its binding sites in human lung. [3H]Ba 679 BR binds to a homogeneous population of muscarinic receptors in human lung membranes, with affinities in the subnanomolar concentration range. Like ipratropium bromide, Ba 679 BR showed no selectivity in its interactions with rat cerebrocortical M1 receptors (labeled with [3H]telenzepine) or heart M2 and salivary gland M3 receptors [labeled with [N-methyl-3H]scopolamine ([3H)]. Ba 679 BR displayed 6-20-fold higher affinity, compared with ipratropium bromide. We also studied the rate of Ba 679 BR and ipratropium bromide dissociation from human lung muscarinic receptors, by monitoring [3H]NMS association. Unlike ipratropium bromide (100 nM), which dissociated so quickly that there was little difference in the [3H]NMS association, compared with vehicle-treated membranes, Ba 679 BR (1 nM) had a strong protective effect against [3H]NMS binding ( &gt; 70%) that lasted for 90 min. Kinetic experiments conducted with [3H]Ba 679 BR confirmed the slow dissociation profile of this compound. The dissociation rate constant (k-1) for [3H]Ba 679 BR was 3.29 +/- 0.18 x 10(-3) min-1, corresponding to a half-life of the complex of 212 +/- 11 min. Autoradiographic studies revealed that [3H]Ba 679 BR binding sites were densely distributed in alveolar walls and submucosal glands. These results suggest that the slow dissociation profile of Ba 679 BR from human lung muscarinic receptors might be the underlying mechanism by which this drug achieves its long duration of action observed in functional tests.
European Backgrounds of American Medical Education (1600-1900)
Authors: Richard H. Shryock
Journal: JAMA (1965)

There was no formal medical education in the American Colonies for more than 150 years. A like interval, traced back from the present, would land us in the presidency of James Madison; in other words, it was a long time to carry on without well-trained physicians. Only near the end of the Colonial period, moreover, did a few Americans go abroad for professional education. There are no statistics but it has been estimated that even a decade after the first native school was founded in 1765, 95% of American practitioners held no medical degrees whatever.<sup>1</sup> Throughout the Colonial era, nevertheless, wellinformed persons realized that European governments provided by law for formal medical training and licensing. Why then were there no demands that English colonists be protected in a similar way? We usually ascribe this seeming neglect to a lack of population and wealth, or say that early Americans were
Rift Valley Fever Caused the Fifth Plague of Egypt and That of 1977
Authors: A. Shimshony
Journal: JAMA (1986)

<h3>To the Editor.—</h3> Gombert et al<sup>1</sup>suggested that the Fifth Plague of Egypt (Exodus 9:3-6) was caused by babesiosis. Subsequently, Jacoby<sup>2</sup>mentioned more likely candidates for the plague, namely, epidemic viral diseases such as foot and mouth disease and rinderpest. It should, however, be emphasized that the Bible mentions a wide spectrum of animal species that were severely affected and died due to the "very grievous murrain," namely, "cattle which is in the field, horses, asses, camels, oxen and sheep" (Exodus 9:3). The two viral diseases suggested by Jacoby do not affect the complete range of the mentioned species. Both viruses are not pathogenic for horses and asses; rinderpest does not affect camels. More likely candidates are anthrax, as suggested by Shoshan,<sup>3</sup>and Rift Valley fever (RVF), as suggested by me.<sup>4</sup>There are some factors supporting the candidacy of RVF, an insect-borne zoonosis confined to the
Brief Psychotherapy in an Outpatient Clinic: Evolution and Evaluation
Authors: MANUEL STRAKER
Journal: American Journal of Psychiatry (1968)

Following a critical evaluation of the treatment philosophy and services provided at the psychiatric outpatient clinic of a university hospital, a reorganization was undertaken, shifting the emphasis from reconstructive to brief psychotherapy. The results included a decline in the previously high dropout rate and the elimination of clinic congestion and discouraging waiting lists. A subsequent two-year follow-up of clinic intake during a three-month period revealed a remission rate of 84 percent among those patients selected for brief psychotherapy.
Endothelial Dysfunction in Chronic Myocardial Infarction Despite Increased Vascular Endothelial Nitric Oxide Synthase and Soluble Guanylate Cyclase Expression
Authors: Johann Bauersachs, Anne Bouloumié, Daniela Fraccarollo, Kai Hu, Rudi Busse, Georg Ertl
Journal: Circulation (1999)

Endothelial dysfunction of the peripheral vasculature is a well-known phenomenon in congestive heart failure that contributes to the elevated peripheral resistance; however, the underlying mechanisms have not yet been clarified.Dilator responses, the expression of protein and mRNA of the endothelial nitric oxide synthase (eNOS), inducible NOS (iNOS), and soluble guanylate cyclase (sGC), and superoxide anion (O(2)(-)) and peroxynitrite production were determined in aortic rings from Wistar rats 8 weeks after myocardial infarction and compared with those in sham-operated animals. In rats with heart failure, the concentration-response curve of the endothelium-dependent vasodilator acetylcholine (after preconstriction with phenylephrine) was significantly shifted to the right, and the maximum relaxation was attenuated. Determination of expression levels of the 2 key enzymes for NO-mediated dilations, eNOS and sGC, revealed a marked upregulation of both enzymes in aortas from rats with heart failure, whereas iNOS expression was not changed. Pretreatment with exogenous superoxide dismutase partially restored the acetylcholine-induced relaxation in aortas from rats with heart failure. Aortic basal and NADH-stimulated O(2)(-) production assessed by use of lucigenin-enhanced chemiluminescence was significantly elevated in rats with chronic myocardial infarction. Peroxynitrite-mediated nitration of protein tyrosine residues was not different between the 2 groups of rats.These results demonstrate that endothelial dysfunction in ischemic heart failure occurs despite an enhanced vascular eNOS and sGC expression and can be attributed to an increase in vascular O(2)(-) production by an NADH-dependent oxidase. By inactivation of NO, O(2)(-) production appears to be an essential mechanism for the endothelial dysfunction observed in heart failure.
Insurance Loss Threatens Medical Gain
Authors: Paul Cotton
Journal: JAMA (1991)

YESTERDAY'S medical miracles are running headlong into today's health insurance morass. Advances in repair and treatment of congenital heart defects over the last few decades are allowing hundreds of thousands of those who would have died as children to thrive now as young adults. New, long-term follow-up data show that their morbidity and mortality rates are often little or no different from those of the general population. Yet these healthy and productive people are increasingly unable to get what health care they do need due to the metastasis of severe medical underwriting practices by health insurance companies. Those with congenital heart defects logged in their medical records are either excluded from coverage altogether, or from coverage for any cardiac-related care, regardless of their current health needs or prognosis. <h3>Part of Daily Practice</h3> Norman S. Talner, MD, professor of pediatrics and diagnostic imaging at Yale University School of Medicine, New Haven,
Is it time to revisit orphan drug policies?
Authors: C. McCabe, T. Stafinski, D. Menon
Journal: BMJ (2010)

Yes, for equity’s sake

The number of new treatments for rare disorders—so called orphan drugs—has increased over the past decade. This is a testament to the success of the Orphan Drug Act in the United States and the Orphan Drugs Regulation in Europe.1 2 The large number of treatments in late stage development indicates that this success is likely to be sustained.3 However, this poses a substantial challenge for healthcare systems because the prices charged for these drugs make it impossible for them to meet conventional measures of good value.4 Increasingly, access to orphan drugs is likely to be restricted, causing political problems for governments and reducing the return to manufacturers from their research investment.

To date, many healthcare payers have exempted orphan drugs from formal value assessment, arguing that society values equal opportunity for people with rare and common conditions enough to justify the high costs. Until now this has been assumed, rather than being based on robust evidence.5

In the linked survey (doi:10.1136/bmj.c4715), Desser and colleagues asked a representative sample of the Norwegian general population whether society should pay more to treat rare diseases than it does …
Regulating Specific Growth Factor Signaling Using Immobilized Branched Ligands
Authors: Michael W. Toepke, Nicholas A. Impellitteri, Sheeny K. Lan Levengood, Derek S. Boeldt, Ian M. Bird, William L. Murphy
Journal: Advanced Healthcare Materials (2012)

VEGF-binding peptide ligands are incorporated into hydrogel microspheres and reduce the amount of growth factor in solution. VEGF binding affinity is enhanced by creating ligands with a dimer structure. The spheres are able to knock down VEGF-mediated HUVEC growth and reduce calcium signaling. The binding interaction is reversible, allowing the spheres to be used as a VEGF delivery vehicle. Detailed facts of importance to specialist readers are published as "Supporting Information". Such documents are peer-reviewed, but not copy-edited or typeset. They are made available as submitted by the authors. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
Allergy to Tetanus Toxoid
Authors: Paul E. Klein
Journal: JAMA (1967)

To the Editor:—  In your question and answer section ( 198 :493, 1966) there appears a query about reactions to tetanus toxoid. My answer to the question would differ completely from that of Dr. Dull.  In my experience, local allergic reactions to tetanus toxoid are fairly common and generalized reactions are not rare. This patient would be strongly advised never to have tetanus toxoid under any circumstances. He would be urged to stay out of the service, as he would be unlikely to be able to avoid tetanus toxoid there. He would be urged to obtain a Medic Alert and to carry with him a note describing the problem.
Detection of myxovirus resistance protein A in lichen planus lesions and its relationship to hepatitis C virus
Authors: O.G. Shaker, N. Hantar, S. El-Tahlawi, A. El-Tawdi, H. El-Hadidi, S. Hantar, A. El-Refai, R. William
Journal: British Journal of Dermatology (2009)

Background Lichen planus (LP) is an inflammatory disease of the skin and oral mucosa. Studies suggested that type I interferons (IFNs) could play an important role in the cytotoxic inflammation in LP. Type I IFNs stimulate the production of several IFN-induced proteins including myxovirus resistance protein A (MxA protein). The association of LP and chronic hepatitis C is well established, with variable prevalence rates among different populations. Many authors have considered hepatitis C virus (HCV) as a possible antigen for inducing cytotoxic immune response in LP. Objectives To investigate the role of type I IFNs in LP through the detection of MxA protein, and to compare the expression of MxA protein between HCV-positive and HCV-negative patients with LP in an attempt to clarify the role of HCV in the pathogenesis of LP. Methods The study included 33 skin biopsies from patients with LP and 10 control biopsies. MxA mRNA was detected by reverse transcription-polymerase chain reaction. HCV-specific antibodies were detected in patient sera by enzyme-linked immunosorbent assay. Results Our analysis revealed a significantly higher level of MxA protein in all the LP skin biopsies compared with controls. The expression was significantly higher in HCV-positive patients than in HCV-negative patients. Conclusions Type I IFNs play a role in the pathogenesis of LP, and HCV could induce LP through increasing the production of type I IFNs.