tbuckley/cabot-search huggingface dataset:
Leading by Example—Health Systems Improving the Care of Employees
Authors: Lindsay E. Jubelt, Dave A. Chokshi
Journal: JAMA (2015)

Payment reform is expanding the focus of health systems beyond care for individual patients to improving the health outcomes of populations. Improving population health is a daunting new task for health systems, requiring novel approaches and partnerships. Yet many health systems have an opportunity to make early and meaningful improvements in the health of one particular population—their own employees. Health systems employ approximately 10% of the US workforce (http://bit.ly /1CgTfxi). Despite health care being their primary focus, health care workers, at least those in US hospitals, generally have poorer health status and higher costs than those in other industries (http://bit.ly /1Jg1zxG). For the many health systems that are self-insured, organizations are at full risk for their employees’ health care expenditures. As employers, health systems are also motivated to improve worker satisfaction and well-being as a means of increasing productivity and retention and reducing sick days. Several features set health systems apart fromother industries in the pursuit of employee health. Health systemsmay providemedical care for a large portion of their workforce, a relationship that facilitates health systems’ addressing their workers’ health. For example, biometric screening programs, common in many workplaces, may identifyemployeeswithcertain risk factors (such as elevated blood pressure or a high bodymass index). In health systems, however, once a screening program has identified a risk factor, the individual can be directly connected with appropriate follow-up—often with a clinician whom the employee already trusts. Furthermore, employees in a health system are a “captive” patient audience. Health systems can craft healthful environments through more nutritious meal options, exercise programs, and workplace redesign, thereby promoting sustained behavior change that is otherwise difficult to achieve within traditional medical settings and relationships. Across the United States, a number of health systems are leveraging these advantagestodeveloppromisinginnovationsinemployee health. For example, the employee health management program at the UniversityofPittsburghMedicalCenter(UPMC)uses financial incentivessuchasreducedannualdeductiblestoencouragehealthybehaviors.The programtargetsannualcompletionofahealth risk assessment, blood lipid and glucose screening every 5 years, and participation in a comprehensiveprogramthat integrates an incentiveplatform,healthcoaching,andaweb portal for tracking progress and accessing health education tools. An evaluation of the UPMC program found that it improved risk factorprofiles, increasedtheuseofpreventiveandchronicdiseasemanagement services, and reducedabsence from work (http://1.usa.gov/1xz9f8y). The UPMC health plan also experienced reducedgrowthincostsafterthe inceptionof the employee health initiative, although a causal inference cannot be made about this finding (http://bit.ly/1AOwooE).
Apolipoprotein B-100 deficiency. Intestinal steatosis despite apolipoprotein B-48 synthesis.
Authors: P N Herbert, J S Hyams, D N Bernier, M M Berman, A L Saritelli, K M Lynch, A V Nichols, T M Forte
Journal: Journal of Clinical Investigation (1985)

We describe a child, the issue of phenotypically normal parents, who had fat malabsorption, both intestinal and hepatic steatosis, and serum cholesterol and triglyceride concentrations of 38 and 63 mg/dl, respectively. Lipoprotein electrophoresis, Ouchterlony double diffusion, and electron microscopy demonstrated that normal low density lipoproteins (LDL: 1.006 less than rho less than 1.063 g/ml) were absent. Lipoprotein particles in the rho less than 1.006-g/ml fraction were triglyceride rich, very large (93.2 +/- 35.1 nm), and contained the B-48 but not the B-100 apoprotein; both species of apolipoprotein (apo) B were found in the parents' lipoproteins. These chylomicrons and chylomicron remnants were present even in the patient's fasting plasma, which suggested prolonged dietary fat absorption. Plasma levels of high density lipoprotein lipids and proteins were low, and the phosphatidylcholine/sphingomyelin ratio was reduced as in typical abetalipoproteinemia. The monosialylated form of apo C-III was not identified on polyacrylamide gel electrophoresis, which suggested that this protein was elaborated only with very low density lipoproteins (VLDL). A radioimmunoassay for apo B employing a polyclonal antisera to plasma LDL gave apparent plasma apo B levels of 0.6, 66, and 57 mg/dl in the patient and his father and mother, respectively. The displacement curve generated by the parents' VLDL and LDL did not did not differ from control lipoproteins. The patient's chylomicron-chylomicron remnant fraction displaced normal LDL over the entire radioimmunoassay range, but the efficiency of displacement was strikingly less than with B-100 containing lipoproteins. If the patient's B-48 protein is not qualitatively abnormal, these results confirm very limited immunochemical cross-reactivity between at least one major epitope on B-100 and the epitopes expressed on B-48. The apo B defect in this patient appears to be recessive. It abolishes B-100 production and may additionally limit the formation of B-48.
Fingolimod and Sphingosine-1-Phosphate — Modifiers of Lymphocyte Migration
Authors: Steffen Massberg, Ulrich H. von Andrian
Journal: New England Journal of Medicine (2006)

Multiple sclerosis is considered an autoimmune disease in which CD4+ T cells and macrophages destroy oligodendrocytes, which synthesize and maintain axonal myelin sheaths in the central nervous system (CNS). This misguided attack results in progressive focal demyelination that can cause severe neurologic disability. In this issue of the Journal, Kappos et al. (pages 1124–1140) report that the immunosuppressant fingolimod (also called FTY720 or 2-amino-2-(2-[4-octylphenyl]ethyl)-1,3-propanediol hydrochloride) exerted considerable therapeutic effects in a small, placebo-controlled clinical trial involving patients with relapsing multiple sclerosis. Patients who received oral fingolimod once daily had a rapid reduction in disease activity, reflected in significant reductions in . . .
Medical Oncology: Basic Principles and Clinical Management of Cancer
Authors: Richard L. Meyer
Journal: JAMA (1994)

<i>Medical Oncology</i>is designed to be a "single comprehensive source of information for the practitioner and trainee and to serve as a platform on which to build new information," say the editors in their preface. For the most part they have achieved their goal, for this is a well-organized, well-written text on medical oncology. The editors have assembled a group of contributors who are well known in their fields of endeavor and have written their assignments in a cogent, clear, and succinct manner. The text has three main parts: "Basic Principles," "Specific Neoplasms," and "Supportive Care." "Basic Principles" is the platform one needs to be conversant with in order to build new information. This major area is subdivided into sections on the biology, etiology, and systemic effects of cancer and principles of patient management and clinical evaluation of new cancer therapies. These sections are excellent but by their nature difficult
Perforation of the intestine due to muscular violence.
Authors: J. B. Galloway, H. McKirdy
Journal: BMJ (1966)

xDIsALHJOURNAL additional barrier in the form of the visceral pleura, which has to be penetrated by pieces of intrapleural calcium before they can reach the bronchi.Coughing produces a steep rise in intrapleural pressure.It may even reach 200 mm.Hg (Bell et at., 1965).Any loose pieces of intrapleural calcium with jagged edges may penetrate the visceral pleura as a result of this sudden increase of intra- pleural pressure.In this patient the cough accompanying pulmonary tuberculosis may have been the precipitating factor in the production of broncholithiasis.I am grateful to Dr. N. K. G. Mendis, thoracic surgeon, Ratnapura, Ceylon,
SPONTANEOUS MENINGEAL HEMORRHAGE
Authors: JOSEPHINE B. NEAL
Journal: JAMA (1926)

While the French have developed an extensive literature on spontaneous or medical meningeal hemorrhage, comparatively little has been written on the subject by the physicians of other nations. Aside from an article by Leopold,<sup>1</sup>a chapter that I<sup>2</sup>contributed to Tice's Practice of Medicine and a case reported by Dawson,<sup>3</sup>there are but brief references to the subject in English. In Sweden, two comprehensive articles have been published by Ehrenberg<sup>4</sup>and Forsheim,<sup>5</sup>respectively. Only a few articles have been written on the subject in Germany. No attempt will be made to review the literature, the principal references<sup>6</sup>only being given. During the fifteen years that the members of the meningitis division of the Health Department of New York City have been studying acute conditions of the central nervous system, especially meningitis, poliomyelitis and epidemic encephalitis, we have seen over thirty cases, occurring for the
Acute Renal Failure Complicating a Reticulosis
Authors: H. Duncan, W. Elliott, M. Hall, D. N. S. Kerr, A. J. Wort
Journal: BMJ (1963)

MYELOMABDyJN L ~~~~~~~~~MEDICAL JOUTRNAL functional impairment prior to the onset of anuria need only be slight.This encourages one to use more vigorous therapy-for example, dialysis with the artificial kidney-than has been the custom in these cases, in the hope that the anuria may be a reversible state.A further indication for vigorous therapy may be obtained by renal biopsy.If casts are infrequent the secondary obstructive element will be absent and a successful outcome might be more reasonably expected.However, as it is not possible to assess either the importance of the obstructive factor or the reversibility of cast formation, all cases should at present be given every chance for survival, provided that other disabilities from the multiple myeloma are not great.The usual precautions with renal biopsy should of course be taken, bearing in mind the frequency of a bleeding tendency in multiple myeloma.
SULFAPYRIDINE THERAPY IN LOBAR PNEUMONIA ASSOCIATED WITH LEUKOPENIA
Authors: CHARLES K. FRIEDBERG
Journal: JAMA (1941)

When lobar pneumonia is associated with leukopenia instead of the usual leukocytosis, a therapeutic problem is presented as to the propriety of administering sulfapyridine. On the one hand it is known that sulfapyridine itself is capable of producing serious or even fatal leukopenia and neutropenia. Thus there would seem to be a justifiable hesitation in using this drug, lest it further depress the low leukocyte count to a dangerous degree. On the other hand, sulfapyridine is probably the most valuable single agent in the treatment of lobar pneumonia. Its use appears particularly indicated in cases of lobar pneumonia with leukopenia because these cases usually represent severe infections and present the worst prognosis. Middleton and Gibbon<sup>1</sup>noted that all their patients with leukopenia of less than 5,000 leukocytes per cubic millimeter died. Even those patients with relative leukopenia (5,000 to 10,000 leukocytes per cubic millimeter) had a much higher mortality
Genetics and Heterogeneity of Common Gastrointestinal Disorders
Authors: Bertram Fleshler
Journal: JAMA (1981)

This book presents the edited manuscripts of presentations made during an international workshop held in March 1980. Investigators attempted to assess current knowledge of genetics in gastrointestinal disease with the fostering of future research as a major goal. The presentations were of several kinds. One set related to genetics per se, with titles such as "Approaches to the Genetics of Common Diseases," "The Analysis of Pedigree Information," and "Twins and Twin Methods as Genetic Epidemiologic Tools." Another presented clinical information about various gastrointestinal diseases. Thus, there were brief discussions of peptic ulcer, gallstones, and inflammatory bowel disease. The sections on genetics presumably were designed for nongeneticists in the audience and the clinical discussions for nonclinicians. Finally, some presentations reviewed data concerning genetic associations with these disorders. The major problem in reviewing the book is to try to gauge its audience. For those not knowledgeable in genetics, it is not a
Role of computed tomography in diagnosis of bronchiectasis.
Authors: J C Cooke, D C Currie, A D Morgan, I H Kerr, D Delany, B Strickland, P J Cole
Journal: Thorax (1987)

Bronchograms and computed tomograms were performed in 27 patients who presented consecutively for bronchography with chronic sputum production. The films were reported separately by three consultant radiologists, who had been asked to give a diagnostic interpretation of the films for each bronchopulmonary segment. The reporting of bronchiectasis on computed tomograms was compared with that on bronchograms. The sensitivity and specificity of computed tomography at segmental level compared with bronchography was 66% and 92%, respectively. We conclude that computed tomography alone is not yet suitable for accurate characterisation and localisation of disease in patients in whom surgery is contemplated. Computed tomography may be useful in patients in whom bronchography is contraindicated and for monitoring progression of disease after initial combined computed tomography and bronchography.
States organise joint non-profit prescription plan to cut drug costs
Authors: F. Charatan
Journal: BMJ (2003)

Nine states and the District of Columbia have banded together to create a joint non-profit operation to manage their prescription drug plans.

Their goal is to put a brake on spending on drugs for millions of state government employees and Medicaid beneficiaries (the joint federal and state programme for poor people).

The new prescription drug management plan comes at a time when a survey by the Kaiser Family Foundation found that two thirds of states are cutting Medicaid benefits, …
Follicular Hyperplasia: A Potential False-Positive Finding on PET/CT Imaging in the Evaluation of Lymphoma
Authors: Ashok Muthukrishnan, Judith M. Joyce, Mohammed Islam
Journal: Clinical Nuclear Medicine (2006)

PET/CT is a widely accepted imaging modality in the diagnosis and staging of lymphoma because of the increased FDG uptake commonly detected in malignant lesions. However, various causes of false-positive FDG localization have been described, including in nonmalignant lymph nodes. We report a patient with a history of Hodgkin lymphoma who presented with bilateral axillary lymphadenopathy, which was intensely FDG-avid on PET/CT imaging. Biopsy of lymph nodes from both axillae revealed benign follicular hyperplasia. Follicular hyperplasia is a potential false-positive finding on PET/CT imaging, and obtaining pathologic confirmation of malignancy should be considered before treatment.
Exogenous stimuli and circadian peak expiratory flow variation in allergic asthmatic children.
Authors: G G Meijer, D S Postma, S van der Heide, D M de Reus, R J Roorda, G H Koëter, W M van Aalderen
Journal: American Journal of Respiratory and Critical Care Medicine (1996)

The influence of exogenous factors in the home on the circadian variation of airway obstruction has not been fully assessed in children with asthma. The aim of the present study was to investigate the contribution of exogenous stimuli to the degree of peak expiratory flow (PEF) variability during 24 h. Fifty-five children (33 boys and 22 girls; mean age, 9.3 +/- 1.7 yr) with symptoms of asthma, increased bronchial responsiveness, and a solitary allergy to house dust mite (HDM) participated. Their asthma symptoms were well-controlled for at least 4 mo with daily inhaled corticosteroids (ICS) and beta 2-adrenergic drugs if needed. Symptoms, peripheral blood eosinophils, total IgE, and specific IgE to HDM were assessed. Spirometry and PC20 histamine were performed. PEF amplitudes during 24 h (highest minus lowest as a percentage of the day's mean value) were obtained at home during and 6 d after withdrawal of ICS. Dust samples were collected from the total area of the living rooms, bedrooms, mattresses (n = 25), and classrooms to obtain the HDM allergen (HDMA) exposure to Der p I and Der p II. Family smoking habits, presence of pets, and types of floor-covering were recorded on a checklist. Mean PEF amplitude did not increase after withdrawal of ICS, but absolute PEF values were significantly lower (p = 0.05) at midnight and 4:00 A.M. Twenty-six children (47%) were exposed to environmental tobacco smoke (ETS), and 23 (42%) kept pets. Mattresses contained significantly higher amounts of HDMA compared with other locations. PEF amplitude after withdrawal of ICS was significantly higher in children exposed to ETS, a pet, or a high HDMA level in their mattress than in children who were not exposed (ETS: 29.7% [3.9 to 56.6] versus 19.4% [0.0 to 56.6], p < 0.05; pets: 31.4% [9.7 to 52.5] versus 21.9% [0.0 to 56.6], p < 0.05; high HDMA level in the mattress: 35.5% [10.2 to 56.6] versus 21.4% [3.9 to 56.6], p < 0.05). These factors combined with age and PC20 histamine and its interaction with ETS, especially in mild to moderate asthma, explained 48.4% of the variance of the PEF amplitude after withdrawal of ICS. Exogenous stimuli such as exposure to ETS, pets, and high HDMA levels in mattresses contribute to an increased circadian PEF amplitude after withdrawal of ICS and therefore to nocturnal worsening of asthma in HDM-allergic asthmatic children. Moreover, ETS exposure seems to especially worsen PEF variability in children with mild to moderately severe bronchial responsiveness.
Targeted radiotherapy with tumor vascular homing trimeric GEBP11 peptide evaluated by multimodality imaging for gastric cancer
Authors: Jing Zhang, Hao Hu, Shuhui Liang, Jipeng Yin, Xiaoli Hui, Sijun Hu, Minglei He, Jing Wang, Biaoluo Wang, Yongzhan Nie, Kaichun Wu, Jie Ding
Journal: Journal of Controlled Release (2013)
Identification of allergens in fruits and vegetables: IgE cross-reactivities with the important birch pollen allergens Bet v 1 and Bet v 2 (birch profilin)
Authors: C EBNER, R HIRSCHWEHR, L BAUER, H BREITENEDER, R VALENTA, H EBNER, D KRAFT, O SCHEINER
Journal: Journal of Allergy and Clinical Immunology (1995)
A Novel Mitochondrial K <sub>ATP</sub> Channel Assay
Authors: Andrew P. Wojtovich, David M. Williams, Marcin K. Karcz, Coeli M.B. Lopes, Daniel A. Gray, Keith W. Nehrke, Paul S. Brookes
Journal: Circulation Research (2010)

The mitochondrial ATP sensitive potassium channel (mK(ATP)) is implicated in cardioprotection by ischemic preconditioning (IPC), but the molecular identity of the channel remains controversial. The validity of current methods to assay mK(ATP) activity is disputed.We sought to develop novel methods to assay mK(ATP) activity and its regulation.Using a thallium (Tl(+))-sensitive fluorophore, we developed a novel Tl(+) flux based assay for mK(ATP) activity, and used this assay probe several aspects of mK(ATP) function. The following key observations were made. (1) Time-dependent run down of mK(ATP) activity was reversed by phosphatidylinositol-4,5-bisphosphate (PIP(2)). (2) Dose responses of mK(ATP) to nucleotides revealed a UDP EC(50) of approximately 20 micromol/L and an ATP IC(50) of approximately 5 micromol/L. (3) The antidepressant fluoxetine (Prozac) inhibited mK(ATP) (IC(50)=2.4 micromol/L). Fluoxetine also blocked cardioprotection triggered by IPC, but did not block protection triggered by a mK(ATP)-independent stimulus. The related antidepressant zimelidine was without effect on either mK(ATP) or IPC.The Tl(+) flux mK(ATP) assay was validated by correlation with a classical mK(ATP) channel osmotic swelling assay (R(2)=0.855). The pharmacological profile of mK(ATP) (response to ATP, UDP, PIP(2), and fluoxetine) is consistent with that of an inward rectifying K(+) channel (K(IR)) and is somewhat closer to that of the K(IR)6.2 than the K(IR)6.1 isoform. The effect of fluoxetine on mK(ATP)-dependent cardioprotection has implications for the growing use of antidepressants in patients who may benefit from preconditioning.
Controlled-release of epidermal growth factor from cationized gelatin hydrogel enhances corneal epithelial wound healing
Authors: Kuniko Hori, Chie Sotozono, Junji Hamuro, Kenta Yamasaki, Yu Kimura, Makoto Ozeki, Yasuhiko Tabata, Shigeru Kinoshita
Journal: Journal of Controlled Release (2006)
Genesis of the austin flint murmur: Relation to mitral inflow aortic regurgitant flow dynamics
Authors: Shigefumi Emi, Nobuo Fukuda, Takashi Oki, Arata Iuchi, Tomotsugu Tabata, Koichi Kiyoshige, Takashi Fujimoto, Kazuyo Manabe, Susumu Ito
Journal: Journal of the American College of Cardiology (1993)
Robin Cook warns of threat to aid from war against terrorism
Authors: Lynn Eaton
Journal: BMJ (2004)

One of the UK government's leading opponents of the war in Iraq, former foreign secretary Robin Cook, has warned that Britain's reputation on overseas aid is under threat from the war against terrorism.

Mr Cook, who resigned from his government post in March 2003 in protest at Prime Minister Tony Blair's plans to support President George Bush in the war in Iraq, argues that the aid effort is being undermined by the cost of the ongoing war.

“I find it particularly depressing that any of our aid effort should be diverted to fund the occupation of Iraq,” he said, …
Dietary Calcium Supplementation and Blood Pressure-Reply
Authors: Heiner C. Bucher
Journal: JAMA (1996)

In Reply.  —Dr Cappuccio's aggressive attack on our work is particularly unfortunate because he has either not read or not understood our article. Cappuccio seems to think we suggested our findings have public health implications. In fact, we stated that [i]t is unlikely that there are important underlying effects of calcium supplementation in reducing blood pressure in those with adequate calcium intake.  Cappuccio criticizes our handling of the question of underlying hypertension. We pointed out in our article that the issue is not what investigators arbitrarily decide is high blood pressure, but the degree of overlap of blood pressure in putatively  and  patients. Mean blood pressure in populations labeled  vs those labeled  demonstrated a huge overlap, with many hypertensive populations showing lower mean blood pressures than many of the normotensive populations. The informal regression analysis we reported showed no relationship between mean blood pressure and the magnitude of
Renal Artery Occlusion From Migration of Stainless Steel Coils
Authors: LeRoy S. Wirthlin
Journal: JAMA (1980)

RENAL artery embolization is a useful preoperative adjunct in the treatment of patients with vascular neoplasms of the kidney. A variety of percutaneous methods have been developed that result in occlusion of renal artery circulation before nephrectomy. A current method of occlusion described by Wallace and co-workers' involves selective placement of stainless steel coils into the renal artery 12 to 24 hours before nephrectomy to decrease operative blood loss. Migration of occlusive material at the time of insertion has been described; however, to our knowledge, embolization of the occlusive material during subsequent surgery has not been reported. The following report documents migration of occlusive stainless steel coils during nephrectomy resulting in contralateral renal artery occlusion. <h3>Report of a Case</h3> A 47-year-old man was admitted with left-sided flank pain and hematuria. His BUN level was 17 mg/dL, and his serum creatinine level was 1.4 mg/dL. The left kidney could not be
Hepatitis C virus–related cryoglobulinemic glomerulonephritis: Long-term remission after antiviral therapy
Authors: Paolo Rossi, Tullio Bertani, Piero Baio, Roberta Caldara, Patrizia Luliri, Francesca Tengattini, Piermario Bellavita, Gianna Mazzucco, Rocco Misiani
Journal: Kidney International (2003)