tbuckley/cabot-search huggingface dataset:
Hassle Hypertension: A Risk of Managed Care
Authors: William R. Phillips
Journal: JAMA (1995)

To the Editor.  —The role of psychological stress in the cause of hypertension has long been debated.1,2A patient's blood pressure rises in response to the stress of having his or her blood pressure checked by a physician.3Dubbed white coat hypertension, this effect has become an important consideration in the diagnosis of hypertension. A new effect on blood pressure—  care hypertension—may pose a threat to physicians and other health care professionals.  A 44-year-old primary care physician complained of feeling stressed by telephone calls to managed care plans to request authorization for services needed by his patients. He noted tachycardia, feeling flushed, and the need to suppress frustration and anger. These telephone calls often required interruptions of patient care lasting 10 to 20 minutes in the midst of busy days in the office. To assess the effect of this stress, his nurse recorded his blood pressure regularly
Variations in S-100 protein expression in naevocellular naevi may be related to metabolic activity
Authors: E. PAUL, D.-R. WEN, A.J. COCHRAN
Journal: British Journal of Dermatology (1987)

Significant amounts of S‐100 protein were demonstrated in naevus cells by an immunoperoxidase technique. Distribution of S‐100 protein was similar in the various types of naevi tested. In most lesions, the superficial A‐type naevus cells stained most heavily, while staining was weaker in the deeper B‐ and C‐type naevus cells. The intensity of staining was not, however, homogeneous in the cells of the various layers of the naevus. S‐100 protein was especially abundant in giant naevus cells which occurred in the vicinity of sub‐epidermal A‐type naevocytes. Cells from neurocutaneous melanosis contained extremely large amounts of S‐100 protein. Normal melanocytes in the epidermis over dermal naevi contained variable amounts of S‐100 protein, but mainly showed weak staining. However, in the basal epidermis of traumatized naevi there were many unusually large and partly dendritic melanocytes. In this part of the epidermis, S‐100 protein‐positive cells lay close together, and many stained strongly. In earlier work, large amounts of metabolic enzymes were found at the same sites in traumatized naevi and giant cells. These results suggest that a high degree of expression of S‐100 protein is due to metabolic activity shown, for example, by giant naevus cells and basal melanocytes of the regenerating epidermis over traumatized naevi.
Association of variant alleles of mannose binding lectin with severity of pulmonary disease in cystic fibrosis: cohort study
Authors: M Gabolde, M Guilloud-Bataille, J Feingold, C Besmond
Journal: BMJ (1999)

Prognosis of cystic fibrosis is conditioned by the severity of pulmonary damage, which is related to infectious complications. The group of partial ∂F508 homozygous patients with cystic fibrosis shows a substantial variability in clinical expression of the severity of lung disease, which could be explained by the influence of modulating genes1 that are probably related to the efficiency of host immune factors in fighting against infection in patients' lungs.

Mannose binding lectin, a protein of the innate immune system, is involved in opsonisation and phagocytosis of micro-organisms. The mannose binding lectin gene shows three major allelic variants that are responsible for a decrease of the protein plasma concentration, an opsonic defect, and a common immunodeficiency.2

We investigated the possible modulating role of mannose binding lectin because studies have shown (a) that homozygosity or compound heterozygosity for mannose binding lectin variant alleles predisposes to recurrent infections including lung infections and (b) that Staphyloccus …
Akalosis during Sulfadiazine Therapy for Pneumococcal Meningitis
Authors: Frank Giunta, Russel O. Bowman
Journal: New England Journal of Medicine (1945)

MENINGITIS due to a pneumococcus has a high mortality.1 When complicated by diabetes and poor kidney function, it becomes a problem in therapy, as illustrated by the following case.A 61-year-old, Italian housewife entered the Rhode Island Hospital on March 13, 1944, in a comatose state with a 4-day history of headache, backache, epigastric pain and vomiting. She had become drowsy 12 hours before admission and had gradually lapsed into coma.Physical examination revealed a comatose woman breathing noisily and heavily through the mouth. The skin was clear. The eyes deviated to the left. The pupils were equal. The ears . . .
Indications for the Use of Allopurinol in the Treatment of Gout and Hyperuricemia.
Authors: James R. Klinenberg
Journal: Annals of Internal Medicine (1967)

s1 May 1967Indications for the Use of Allopurinol in the Treatment of Gout and Hyperuricemia.James R. Klinenberg, M.D., Basil B. Clyman, M.D., Carl M. Pearson, M.D., F.A.C.P.James R. Klinenberg, M.D.Search for more papers by this author, Basil B. Clyman, M.D.Search for more papers by this author, Carl M. Pearson, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-1059_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe recent general availability of the xanthine oxidase inhibitor, allopurinol, has resulted in some confusion as to its role in the treatment of gout and other conditions associated with hyperuricemia. General experience from the past suggests that the majority of patients with hyperuricemia respond satisfactorily to treatment with uricosuric agents. Despite the fact that there have been few adverse reactions to allopurinol reported to date, there is still the potential danger of xanthine deposition in the urinary tract after prolonged allopurinol administration. Therefore, specific indications for the use of allopurinol should be defined. Data are presented to support the following... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Los Angeles, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1967Volume 66, Issue 5Page: 1059-1060KeywordsAdverse reactionsAllopurinolGout Issue Published: 1 May 1967 PDF DownloadLoading ...
Health Care, Medical Practice, and Medical Ethics in Russia Today
Authors: Barrie R. Cassileth
Journal: JAMA (1995)

FOR DECADES Russian leaders sacrificed health care to the financial and human resource needs of military and space efforts. Centralized and government controlled in every respect, Soviet health care became disjointed, inequitable, and inadequate.<sup>1</sup>Presumably egalitarian, the health care system was in fact strictly hierarchical. Bribery to obtain better quality care was common. Physicians had access only to Soviet medical literature. The government concealed information about scientific and clinical advances produced outside of the Soviet Union from most physicians and the general public. Limited information was available, but only in restricted areas of selected central libraries in Moscow and Leningrad (now St Petersburg). Concurrent environmental pollution, alcoholism,<sup>2</sup>tobacco addiction, and poor nutrition led to public health crises of major proportions.<sup>3</sup> For editorial comment see p 1622. Soviet leaders withheld internationally accepted standards of medical ethics, human rights, and patient protection. Thus, Soviet medical ethics did not protect
Mesenchymal stem cells attenuate ischemic acute kidney injury by inducing regulatory T cells through splenocyte interactions
Authors: Jie Hu, Li Zhang, Nan Wang, Rui Ding, Shaoyuan Cui, Fei Zhu, Yuansheng Xie, Xuefeng Sun, Di Wu, Quan Hong, Qinggang Li, Suozhu Shi, Xiaoluan Liu, Xiangmei Chen
Journal: Kidney International (2013)

The mechanism of mesenchymal stem cell therapy in acute kidney injury remains uncertain. Previous studies indicated that mesenchymal stem cells could attenuate inflammation-related organ injury by induction of regulatory T cells. Whether regulatory T-cell induction is a potential mechanism of mesenchymal stem cell therapy in ischemic acute kidney injury and how these induced regulatory T cells orchestrate local inflammation are unknown. Here we found that mesenchymal stem cells decrease serum creatinine and urea nitrogen levels, improve tubular injury, and downregulate IFN-γ production of T cells in the ischemic kidney. In addition to the lung, mesenchymal stem cells persisted mostly in the spleen. Mesenchymal stem cells increased the percentage of regulatory T cells in the spleen and the ischemic kidney. Antibody-dependent depletion of regulatory T cells blunted the therapeutic effect of mesenchymal stem cells, while coculture of splenocytes with mesenchymal stem cells caused an increase in the percentage of regulatory T cells. Splenectomy abrogated attenuation of ischemic injury, and downregulated IFN-γ production and the induction of regulatory T cells by mesenchymal stem cells. Thus, mesenchymal stem cells ameliorate ischemic acute kidney injury by inducing regulatory T cells through interactions with splenocytes. Accumulated regulatory T cells in ischemic kidney might be involved in the downregulation of IFN-γ production.
Intermediary metabolism of the lung.
Authors: A B Fisher
Journal: Environmental Health Perspectives (1984)

The lung is a metabolically active organ that is engaged in secretion, clearance and other maintenance functions that require reducing potential, energy and substrates for biosynthesis. These metabolic requirements are met in part through uptake and catabolism of glucose which represents the major fuel utilized by lung tissues. Gluconeogenesis does not occur, and glycogen stores are limited so that the lung depends on the circulation for its glucose requirement. Other substrates can be metabolized by lung and contribute to the metabolic pool although their role has been less thoroughly studied. Glucose is catabolized in the lung by cytoplasmic and mitochondrial pathways that are responsive to regulatory mechanisms as in other tissues. Activity of the pentose cycle pathway of glucose catabolism is relatively high and generates the NADPH required for biosynthesis of lipid, detoxification reactions, and protection against oxidant stress. The ATP content of the lung is maintained by oxidative metabolism at levels comparable to other metabolically active organs. Alterations in lung intermediary metabolism may depress amine clearance, alter lung permeability, and influence the lung response to oxidant stress.
Angiotensin IV stimulates plasminogen activator inhibitor-1 expression in proximal tubular epithelial cells
Authors: Loreto Gesualdo, Elena Ranieri, Raffaella Monno, Maria Rosaria Rossiello, Mario Colucci, Nicola Semeraro, Giuseppe Grandaliano, Francesco Paolo Schena, Giuseppina Cerullo
Journal: Kidney International (1999)
Gene Inactivation of Proprotein Convertase Subtilisin/Kexin Type 9 Reduces Atherosclerosis in Mice
Authors: Maxime Denis, Jadwiga Marcinkiewicz, Ahmed Zaid, Dany Gauthier, Steve Poirier, Claude Lazure, Nabil G. Seidah, Annik Prat
Journal: Circulation (2012)

Background— The proprotein convertase subtilisin/kexin type 9 (PCSK9) promotes independently of its enzymatic activity the degradation of the low-density lipoprotein (LDL) receptor. PCSK9 gain of function in humans leads to autosomal dominant hypercholesterolemia, whereas the absence of functional PCSK9 results in ≈7-fold lower levels of LDL cholesterol. This suggests that lowering PCSK9 may protect against atherosclerosis. Methods and Results— We investigated the role of PCSK9 in atherosclerosis in C57BL/6 wild-type (WT), apolipoprotein E–deficient, and LDL receptor–deficient mouse models. Circulating cholesterol levels, fast protein liquid chromatography profiles, aortic cholesteryl esters (CE), and plaque sizes were determined. Intima-media thicknesses were measured by ultrasound biomicroscopy. First, mice expressing null (knockout [KO]), normal (WT), or high (transgenic [Tg]) levels of PCSK9 were fed a 12-month Western diet. KO mice accumulated 4-fold less aortic CE than WT mice, whereas Tg mice exhibited high CE and severe aortic lesions. Next we generated apolipoprotein E–deficient mice, known to spontaneously develop lesions, that expressed null (KO/e), normal (WT/e), or high (Tg/e) levels of PCSK9. After a 6-month regular diet, KO/e mice showed a 39% reduction compared with WT/e mice in aortic CE accumulation, whereas Tg/e mice showed a 137% increase. Finally, LDL receptor–deficient mice expressing no (KO/L), normal (WT/L), or high (Tg/L) levels of PCSK9 were fed a Western diet for 3 months. KO/L and Tg/L mice exhibited levels of plasma cholesterol and CE accumulation similar to those of WT/L mice, suggesting that PCSK9 modulates atherosclerosis mainly via the LDL receptor. Conclusions— Altogether, our results show a direct relationship between PCSK9 and atherosclerosis. PCSK9 overexpression is proatherogenic, whereas its absence is protective.
Lipid compositional differences of small, dense low-density lipoprotein particle influence its oxidative susceptibility: Possible implication of increased risk of coronary artery disease in subjects with phenotype B
Authors: Hirotoshi Ohmura, Hiroshi Mokuno, Masato Sawano, Chie Hatsumi, Yasushi Mitsugi, Yoshiro Watanabe, Hiroyuki Daida, Hiroshi Yamaguchi
Journal: Metabolism (2002)
Increase in Testicular Cancer Incidence in Six European Countries: a Birth Cohort Phenomenon
Authors: Reinhold Bergström, Hans-Olov Adami, Matthias Möhner, Witold Zatonski, Hans Storm, Anders Ekbom, Steinar Tretli, Lyly Teppo, Olof Akre, Timo Hakulinen
Journal: JNCI Journal of the National Cancer Institute (1996)

Background:For unknown reasons, the age-standardized incidence of testicular cancer has shown a rapid increase in virtually all countries (mostly Western) studied. For populations with a sufficiently long period of cancer registration, this development can be traced back to the first half of this century.
Polymorphisms in extracellular signal-regulated kinase family influence genetic susceptibility to asthma
Authors: Ramesh Chandra Pandey, Sven Michel, Maximilian Schieck, Aristea Binia, Liming Liang, Norman Klopp, Andre Franke, Andrea von Berg, Albrecht Bufe, Ernst Rietschel, Andrea Heinzmann, Otto Laub, Burkhard Simma, Thomas Frischer, Jon Genuneit, Thomas Illig, Michael Kabesch
Journal: Journal of Allergy and Clinical Immunology (2013)
A treatment for severe nodular acne: a randomized investigator-blinded, controlled, noninferiority trial comparing fixed-dose adapalene/benzoyl peroxide plus doxycycline vs. oral isotretinoin
Authors: J. Tan, S. Humphrey, R. Vender, B. Barankin, M. Gooderham, N. Kerrouche, F. Audibert, C. Lynde
Journal: British Journal of Dermatology (2014)

Oral isotretinoin (ISO) is the gold standard for severe nodular acne. However, as some patients are unwilling or unable to take, or are intolerant to, ISO, other options are needed.To compare efficacy and safety of oral ISO vs. doxycycline 200 mg plus adapalene 0·1%/benzoyl peroxide 2·5% gel (D+A/BPO) in severe nodular acne over 20 weeks.This was a multicentre, randomized, controlled, noninferiority investigator-blinded study involving 266 subjects.D+A/BPO showed a significantly earlier onset of action in reducing nodules, papules/pustules and total lesions at week 2. ISO was superior in reducing nodules (95·6% vs. 88·7%), papules/pustules (95·2% vs. 79·6%) and total lesions (92·9% vs. 78·2%; all P < 0·01) at week 20. Half as many subjects for D+A/BPO compared with ISO had treatment-related, medically relevant adverse events (33 events in 18·0% of subjects vs. 73 in 33·8% of subjects, respectively). D+A/BPO was noninferior to ISO in the intent-to-treat population [95% confidence interval (CI) -2·7 to 20·8 (P = 0·13); 63·9% vs. 54·9% of subjects, respectively] and per-protocol population [95% CI 3·9-28·6 (P = 0·01); 74·3% vs. 58% of subjects, respectively), based on the composite efficacy/safety end point.D+A/BPO showed a favourable composite efficacy/safety profile compared with ISO. This combination is an alternative to ISO in patients intolerant to, or unable or unwilling to take, oral ISO, and is an option for treatment of severe nodular acne.
Proton secretion by the sodium/hydrogen ion antiporter in the human neutrophil.
Authors: J Wright, J H Schwartz, R Olson, J M Kosowsky, A I Tauber
Journal: Journal of Clinical Investigation (1986)

The reducing equivalents used by the human neutrophil respiratory burst oxidase are derived from NADPH generated by the hexose monophosphate shunt. The CO2 generated by the HMP shunt is spontaneously hydrated and the protons (H+) are secreted upon the dissociation of carbonic acid. The mechanism and significance of H+ secretion by the resting and stimulated neutrophil was investigated. A basal rate of H+ secretion by resting neutrophils observed in a choline buffer was augmented with the addition of sodium (Na+) (Km for Na+ was 3.22 +/- 0.32 mM). Amiloride, a Na+/H+ antiporter inhibitor, reduced H+ secretion in Na+-containing buffers with a Ki = 1.02 microM. This Na+/H+ exchange mechanism was also operative in cells stimulated with a variety of agonists, and an increased H+ flux, relative to resting cells, was observed at higher Na+ concentrations. Cytoplasts incorporating acridine orange were also used to assess Na+-H+ flux. Cytoplasts were used to avoid alteration of the fluorescent pH probe by HOCl formed in intact neutrophils. Alkalinization of the cytoplasm was dependent on extracellular Na+ in concentrations similar to that found to augment H+ secretion in intact cells. Also, amiloride competitively inhibited H+ secretion by the cytoplasts. Both superoxide (O2-) production and lysozyme release in cells stimulated with opsonized zymosan or concanavalin A was significantly inhibited in the absence of Na+, restored to normal with the addition of Na+ in low concentrations, and inhibited again in the presence of amiloride. A Na+/H+ antiporter similar to that found in other cell types is present in the human neutrophil and appears linked to activation of the respiratory burst and degranulation.
Cost effective strategies for reducing coronary risk in primary care
Authors: P. Winocour
Journal: BMJ (1995)

coagulant treatment may have differed in some (perhaps complex) way.The protective effect of hospital 6 did not relate to any single factor.While thromboembolic prophylaxis is no panacea, our results suggest that it is associated with reduced deaths from pulmonary embolism.Complacent reliance on anticoagulant treatment-or, for that matter, any drug or procedure-should be avoided.Hospital 6, which among other things routinely used pharmacological anticoagulant prophylaxis (although 14% of this hospital's patients did not receive it), had a much lower 90 day mortality.No single variable (including prophylaxis) explained this, and our audit generated rather than tested hypotheses.We trust that hypotheses generated by the correspondents will be put to the test so that mortality can be reduced and patients' care improved.Clearly, something can be learnt from the package of care at hospital 6. Readers should focus on why differences in mortality occurred among centres and not be distracted by the issue of thromboembolic prophylaxis, a disputed subject that our study was not designed to address.We agree that more detailed and larger scale studies of both prophylaxis and outcome after hip fracture are needed.
Does screening reduce preterm births?
Authors: Anna Alanen
Journal: BMJ (2004)

Preterm birth is one of the most important problems in modern obstetrics. As the connection between ascending infection and preterm birth is undisputed, much research has focused on finding infectious risk factors suitable for screening. In the study by Kiss et al, asymptomatic pregnant women were screened and randomised to treatment during the second trimester for bacterial vaginosis, Candida , and trichomoniasis.1 Bacterial vaginosis has proved to be associated with an increased risk of preterm birth. Unfortunately, in several trials, intervention with antenatal antibiotic treatment—vaginal or systemic—has mostly failed to reduce the rate of preterm births, in spite of successful eradication of bacterial …
Gastro-oesophageal candidiasis.
Authors: B B Scott, D Jenkins
Journal: Gut (1982)

A prospective search for gastro-oesophageal candidiasis was made by histological examination of all the biopsies taken from 465 patients endoscoped consecutively during a 12 month period. The criterion for diagnosis was the demonstration of infiltration of tissue or ulcer slough by yeasts and hyphae. Nineteen cases of candidiasis were found giving an overall incidence of 4%. There were 12 cases with oesophageal candidiasis, two with both oesophageal and gastric candidiasis, and five with gastric candidiasis. In none of the patients was candidiasis suspected before endoscopy. Symptoms referable to the candidiasis were uncommon and radiology was not helpful in diagnosis. There was associated local pathology (particularly peptic ulceration and carcinoma of the stomach or oesophagus) in all except two patients, which suggests that the candidiasis is usually secondary to mucosal damage. In the series, candidiasis was present in 27% of patients with oesophageal cancer, 20% of patients with gastric cancer, 16% of patients with benign gastric ulcers, and 15% of patients with oesophagitis.
Early-Life Soy Exposure and Gender-Role Play Behavior in Children
Authors: Margaret A. Adgent, Julie L. Daniels, Lloyd J. Edwards, Anna Maria Siega-Riz, Walter J. Rogan
Journal: Environmental Health Perspectives (2011)

Soy-based infant formula contains high levels of isoflavones. These estrogen-like compounds have been shown to induce changes in sexually dimorphic behaviors in animals exposed in early development.We examined gender-role play behavior in relation to soy-based and non-soy-based infant feeding methods among children in the Avon Longitudinal Study of Parents and Children.We studied 3,664 boys and 3,412 girls. Four exposure categories were created using data from questionnaires administered at 6 and 15 months postpartum: primarily breast, early formula (referent), early soy, and late soy. Gender-role play behavior was assessed using the Pre-School Activities Inventory (PSAI). Associations between infant feeding and PSAI scores at 42 months of age were assessed using linear regression. Post hoc analyses of PSAI scores at 30 and 57 months were also conducted.Early-infancy soy use was reported for approximately 2% of participants. Mean [95% confidence interval (CI)] PSAI scores at 42 months were 62.3 (62.0, 62.6) and 36.9 (36.6, 37.2) for boys and girls, respectively. After adjustment, early soy (vs. early formula) feeding was associated with higher (less feminine) PSAI scores in girls (β = 2.66; 95% CI: 0.19, 5.12) but was not significantly associated with PSAI scores in boys. The association between soy exposure and PSAI scores in girls was substantially attenuated at 30 and 57 months.Although not consistent throughout childhood, early-life soy exposure was associated with less female-typical play behavior in girls at 42 months of age. Soy exposure was not significantly associated with play behavior in boys.