tbuckley/cabot-search huggingface dataset:
Surgeons postpone work as insurer goes broke
Authors: C. Zinn
Journal: BMJ (2002)

Australian health services were in confusion and crisis this week, with surgeons postponing operations and doctors fearing that they were uninsured after the largest medical defence organisation said it would go into liquidation.

United Medical Protection, which has faced financial problems for some time, said it will appoint a provisional liquidator next week, and the Australian Medical Association said many doctors and surgeons were considering it too risky to work.

The federal government defended its short term guarantee to cover medical insurance claims up to 30 June and said that it might introduce legislation …
A BENIGN FORM OF OSTEOMYELITIS OF THE SPINE
Authors: ALAN DeFOREST SMITH
Journal: JAMA (1933)

Although osteomyelitis of the vertebral column generally is considered to be relatively uncommon, numerous case reports and descriptions of the condition have been published. With very few exceptions they have dealt with the very acute form associated with high temperature, marked prostration, frequent paralysis from involvement of the spinal cord, and with a high mortality. The impression is had from reading the textbooks and most of the articles on the subject that this is the generally accepted picture of the disease. Steindler<sup>1</sup>describes a milder form of infection, and Kidner<sup>2</sup>has reported three cases which ran a relatively benign course. From August, 1924, to December, 1932. sixteen cases of osteomyelitis of the spine have been collected from the records of the New York Orthopaedic Dispensary and Hospital and one other was seen in consultation. They indicate the occurrence of a milder form of the disease which, in this
Trade and health: dealing in death
Authors: Woody Caan
Journal: The Lancet (2009)

Thanks for your Comment on the global scale and gravity of the health consequences from unjust trade "rigged against the poorest countries" (Jan 24, p 273).1MacDonald R Horton R Trade and health: time for the health sector to get involved.Lancet. 2009; 373: 273-274Summary Full Text Full Text PDF PubMed Scopus (17) Google Scholar The international trade described in The Lancet is largely done by corporations with identified board members, annual general meetings, and financial reports. The massive untaxed, unrecorded, and undercover trade in illicit drugs bleeds that global economy, widens local social inequalities, and directly undermines individual health. It is impossible to get an accurate value of the economic cost of locally produced and consumed drugs (such as various amfetamines) but cocaine and heroin cross many borders and currency zones. The International Monetary Fund estimates that, in 2007, the necessary money laundering involved constituted 3–5% of the gross domestic product of the entire world—ie, between US$2·17 and 3·61 trillion.2Bureau of International Narcotics and Law Enforcement AffairsInternational narcotics control strategy report.http://www.state.gov/p/inl/rls/nrcrpt/2008/vol2/html/100800.htmDate: 2008Google Scholar A key dimension of the dependence syndrome is the salience of drug-seeking behaviour relative to other important priorities.3Caan W The nature of heroin and cocaine dependence.in: Caan W de Belleroche J Drink, drugs and dependence: from science to clinical practice. Routledge, London2002: 171-195Crossref Google Scholar Corrupted governments, gang violence, family breakdown, and a climate of fear across whole, plundered communities spread the population health effect. Who has planned seriously for the coming effect on productivity and economic development of viral hepatitis infections arising now from networks of young injectors? In rich countries, one can look down at the "undeserving poor" who presume to make claims on public resources such as employment support.4Caan W London M The most undeserving poor?.Br J Psychiatry. 2008; 193: 510Crossref PubMed Scopus (2) Google Scholar But it is in poor countries that populations have suffered most from global dealing in cocaine and heroin.5Boddiger D Battling addiction.Lancet. 2004; 364: 923-924Summary Full Text Full Text PDF PubMed Scopus (2) Google Scholar I recall one addiction specialist, near the epicentre of the trillion-dollar cocaine trade, worrying that if one of the bombs planted in her clinic eventually killed her she would never know which of the many vested interests had planted it. I declare that I have no conflict of interest.
Appointment Availability after Increases in Medicaid Payments for Primary Care
Authors: Daniel Polsky, Michael Richards, Simon Basseyn, Douglas Wissoker, Genevieve M. Kenney, Stephen Zuckerman, Karin V. Rhodes
Journal: New England Journal of Medicine (2015)

Providing increases in Medicaid reimbursements for primary care, a key provision of the Affordable Care Act (ACA), raised Medicaid payments to Medicare levels in 2013 and 2014 for selected services and providers. The federally funded increase in reimbursements was aimed at expanding access to primary care for the growing number of Medicaid enrollees. The reimbursement increase expired at the end of 2014 in most states before policymakers had much empirical evidence about its effects.
Appendicitis: The Seven Anomalies
Authors: John H. Wulsin
Journal: JAMA (1971)

This genteel volume has the appeal and flavor of a well-preserved period house, complete in the decor and bric-a-brac of a once notable era and now open for leisurely visitation on Sundays. The main furnishings of the book consist of skilled clinical observations and histories derived from the author's long and dedicated experience with appendicitis. In truth he records a lost art. As in a gracious home, where the arrangement of contents is determined more by the individual taste of the owner than the rational expectations of the guests, the chapters offer a succession of personal descriptions cast in the phraseology of the master clinicians of an earlier time when the surgical literature dwelt on "squirting borborygami," "clean tongues," and treatments such as sea voyages and olive oil by mouth, because so little else merited conscientious discussion. And so the generous reader of today cannot be overly troubled if the
Osteocyte and osteoblast apoptosis and excessive bone deposition accompany failure of collagenase cleavage of collagen
Authors: Weiguang Zhao, Michael H. Byrne, Yingmin Wang, Stephen M. Krane
Journal: Journal of Clinical Investigation (2000)

Mice carrying a targeted mutation (r) in Col1a1, encoding a collagenase-resistant form of type I collagen, have altered skeletal remodeling. In hematoxylin and eosin–stained paraffin sections, we detect empty lacunae in osteocytes in calvariae from Col1a1r/r mice at age 2 weeks, increasing through age 10–12 months. Empty lacunae appear to result from osteocyte apoptosis, since staining of osteocytes/periosteal osteoblasts with terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling is increased in Col1a1r/r relative to wild-type bones. Osteocyte perilacunar matrices stained with Ab that recognizes collagenase collagen α1(I) chain cleavage ends in wild-type but not Col1a1r/r calvariae. Increased calvarial periosteal and tibial/femoral endosteal bone deposition was found in Col1a1r/r mice from ages 3–12 months. Calcein labeling of calvarial surfaces was increased in Col1a1r/r relative to wild-type mice. Daily injections of synthetic parathyroid hormone for 30 days increased calcein-surface labeling in wild-type but caused no further increase in the already high calcein staining of Col1a1r/r bones. Thus, failure of collagenase cleavage of type I collagen in Col1a1r/r mice is associated with osteocyte/osteoblast death but increases bone deposition in a manner that mimics the parathyroid hormone–induced bone surface activation seen in wild-type mice.
Cancer risks from arsenic in drinking water.
Authors: A H Smith, C Hopenhayn-Rich, M N Bates, H M Goeden, I Hertz-Picciotto, H M Duggan, R Wood, M J Kosnett, M T Smith
Journal: Environmental Health Perspectives (1992)

Ingestion of arsenic, both from water supplies and medicinal preparations, is known to cause skin cancer. The evidence assessed here indicates that arsenic can also cause liver, lung, kidney, and bladder cancer and that the population cancer risks due to arsenic in U.S. water supplies may be comparable to those from environmental tobacco smoke and radon in homes. Large population studies in an area of Taiwan with high arsenic levels in well water (170-800 micrograms/L) were used to establish dose-response relationships between cancer risks and the concentration of inorganic arsenic naturally present in water supplies. It was estimated that at the current EPA standard of 50 micrograms/L, the lifetime risk of dying from cancer of the liver, lung, kidney, or bladder from drinking 1 L/day of water could be as high as 13 per 1000 persons. It has been estimated that more than 350,000 people in the United States may be supplied with water containing more than 50 micrograms/L arsenic, and more than 2.5 million people may be supplied with water with levels above 25 micrograms/L. For average arsenic levels and water consumption patterns in the United States, the risk estimate was around 1/1000. Although further research is needed to validate these findings, measures to reduce arsenic levels in water supplies should be considered.
TUBERCULAR DISEASE OF THE KNEE-JOINT AND HIP-JOINT IN CHILDREN. DIAGNOSIS AND TREATMENT.
Authors: EDWARD A. TRACY
Journal: JAMA (1901)

The importance to the practitioner of a practical knowledge of joint diseases in children is becoming generally recognized. A sign-post of the times is the making of the orthopedic course obligatory to the medical students of Harvard University. The majority of orthopedic cases, and the most important ones, are met with in children. In recent years it is rare to see incurable cases that formerly were common, the cases that exemplify the terrible pathologic conditions that can be produced by tubercular joints, untreated or badly treated. And this is so because these diseases are recognized in their incipiency, and in every large city there are ways and means established that bring the proper treatment of such cases within the reach of the poor. This general leavening of the profession, as it may be termed, with orthopedic knowledge, is the work, in our country, of Henry G. Davis, Lewis A. Sayre,
Limitation of the Lymphocyte Cytotoxicity Crossmatch Test in Recipients of Kidney Transplants Having Preformed Antileukocyte Antibodies
Authors: Ramon Patel, William A. Briggs
Journal: New England Journal of Medicine (1971)

KIDNEY transplantation in recipients with donor-specific anti-HL-A antibodies is associated with hyperacute rejection of the transplant.1 These high-risk patients can be identified on the basis of a positive cytotoxic crossmatch test of the recipient's serum and donor's lymphocytes.2 In 15 per cent of cases, however, a graft may still be rapidly rejected even though the crossmatch is negative.3 A possible explanation for this discrepancy is suggested by the course of a 26-year-old man who received a kidney transplant from his mother. Immediate diuresis was followed by anuria 24 to 36 hours later. A biopsy showed hyperacute rejection.4 The transplanted kidney . . .
Rewriting
Authors: Charles G. Roland
Journal: JAMA (1967)

Most authors, particularly those with little experience, use too many words. And most factual writing gains clarity by being shortened. This shortening becomes a large part of the much neglected task of revision, a task which seems necessary to produce truly skillful, effective writing.  Garland 1 has suggested—at least partly seriously —that ... one reason why ancient writings are to the point is that it took a vast labor to scratch them out in wet clay with a stylus and then bake the clay, or to chisel them into the everlasting rock, or to mess around with papyrus and a paint brush. In those days rewriting would have been technologically undesirable.  Today no writer has a comparable excuse for failing to revise his work. Every primer, every lecturer, every article about writing urges the writer to revise often, and most better-than-average writers join this chorus. However, exceptions exist; the noted historian,
Electroanatomic Substrate and Ablation Outcome for Suspected Epicardial Ventricular Tachycardia in Left Ventricular Nonischemic Cardiomyopathy
Authors: Oscar Cano, Mathew Hutchinson, David Lin, Fermin Garcia, Erica Zado, Rupa Bala, Michael Riley, Joshua Cooper, Sanjay Dixit, Edward Gerstenfeld, David Callans, Francis E. Marchlinski
Journal: Journal of the American College of Cardiology (2009)
Correlative Clinicopathological Studies of Patients Following Acute Renal Failure.
Authors: Robert C. Muehrcke
Journal: Annals of Internal Medicine (1964)

s1 April 1964Correlative Clinicopathological Studies of Patients Following Acute Renal Failure.Robert C. Muehrcke, M.D., F.A.C.P., Robert M. Kark, M.D., F.A.C.P., Conrad L. Pirani, M.D., F.A.C.P., Seymour Rosen, M.D.Robert C. Muehrcke, M.D., F.A.C.P.Search for more papers by this author, Robert M. Kark, M.D., F.A.C.P.Search for more papers by this author, Conrad L. Pirani, M.D., F.A.C.P.Search for more papers by this author, Seymour Rosen, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-4-736_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptCorrelative clinicopathological studies were made of renal biopsies from five patients with acute oliguric renal failure resulting from apparent tubular necrosis. The acute tubular necrosis followed shock in three patients, CCL4poisoning in one, and arsine toxicity in one. In four patients, renal biopsies were done after the patients made a recovery from acute renal failure. Serial renal biopsies were performed on one patient with arsine toxicity during each of the following periods: (1) complete anuria, (2) early diuretic phase, (3) height of diuresis, and (4) 6 months after recovery from acute renal failure. These serial biopsies were studied by... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Robert C. Muehrcke, M.D., F.A.C.P.; Robert M. Kark, M.D., F.A.C.P.; Conrad L. Pirani, M.D., F.A.C.P.; Seymour Rosen, M.D.Affiliations: Chicago, Illinois PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1964Volume 60, Issue 4Page: 736-736KeywordsAcute renal failureBiopsyDiureticsNecrosisRenal failureShockToxicity ePublished: 1 December 2008 Issue Published: 1 April 1964 PDF downloadLoading ...
Downregulation of the antigen presenting cell function(s) of pulmonary dendritic cells in vivo by resident alveolar macrophages.
Authors: P G Holt, J Oliver, N Bilyk, C McMenamin, P G McMenamin, G Kraal, T Thepen
Journal: The Journal of Experimental Medicine (1993)

Class II major histocompatibility complex (Ia)-bearing dendritic cells (DC) from airway epithelium and lung parenchyma express low-moderate antigen presenting cell (APC) activity when freshly isolated. However, this function is markedly upregulated during overnight culture in a manner analogous to epidermal Langerhans cells. The in vitro "maturation" process is inhibited by coculture with pulmonary alveolar macrophages (PAM) across a semipermeable membrane, and the degree of inhibition achieved can be markedly increased by the presence of tumor necrosis factor alpha. In addition, PAM-mediated suppression of DC function is abrogated via inhibition of the nitric oxide synthetase pathway. Functional maturation of the DC is accompanied by increased expression of surface Ia, which is also inhibited in the presence of PAM. Prior elimination of PAM from DC donors via intratracheal administration of the cytotoxic drug dichloromethylene diphosphonate in liposomes, 24-72 h before lung DC preparation, achieves a comparable upregulation of APC activity, suggesting that (consistent with the in vitro data) the resident PAM population actively suppresses the APC function of lung DC in situ. In support of the feasibility of such a regulatory mechanism, electron microscopic examination of normal lung fixed by intravascular perfusion in the inflated state (which optimally preserves PAM in situ), revealed that the majority are preferentially localized in recesses at the alveolar septal junctions. In this position, the PAM are in intimate association with the alveolar epithelial surface, and are effectively separated by as little as 0.2 microns from underlying interstitial spaces which contain the peripheral lung DC population. A similar juxtaposition of airway intraepithelial DC is demonstrated with underlying submucosal tissue macrophages, where the separation between the two cell populations is effectively the width of the basal lamina.
Hemolytic Anemia Following Prosthetic Valve Replacement
Authors: BRADLEY M. RODGERS, DAVID C. SABISTON
Journal: Circulation (1969)

Ten patients with marked hemolytic anemia secondary to prosthetic cardiac valve replacement are presented. Although the etiology of this disorder is not understood, available evidence supports the concept of blood destruction secondary to turbulence around valves as the primary factor. These studies illustrate the technical difficulties associated with reoperation and the disappointing results which often follow. Emphasis is placed on the role of iron replacement and folic acid therapy in association with moderate reduction in exercise. This regimen has produced gratifying results in the management of these patients.
Is there a link between iritis and diabetic autonomic neuropathy?
Authors: C N Martyn, R J Young, D J Ewing
Journal: BMJ (1986)

promoted as being less allergenic than animal insulins, nevertheless carry a risk of allergic reactions.To my knowledge, this is the first reported case of a generalised allergic reaction to human insulin in which reactions to highly purified monocomponent bovine and porcine insulins did not also occur.I thank Dr S Haider for permission to report this case, Dr J S Kristenson (Novo
Diesel exhaust particles induce local IgE production in vivo and alter the pattern of IgE messenger RNA isoforms.
Authors: D Diaz-Sanchez, A R Dotson, H Takenaka, A Saxon
Journal: Journal of Clinical Investigation (1994)

Diesel exhaust particles (DEP) have been implicated in the increased incidence of allergic airway disorders. We investigated the effects of DEP on localized immunoglobulin production by performing nasal challenges with varying doses of DEP and analyzing the local immune response in nasal lavages obtained before and after. A significant rise in nasal IgE but not IgG, IgA, IgM, or albumin was observed in subjects 4 d after challenge with 0.30 mg DEP, equivalent to exposure on an average Los Angeles day. Direct evidence for DEP-enhanced local production of IgE was that challenge increased the number of IgE-secreting cells in lavage fluid from < 1 in 2,000,000 to > 1 in 100,000 but did not alter the number of IgA-secreting cells. There was a concomitant increase in epsilon mRNA production in the lavage cells. Additionally, DEP altered the relative amounts of five different epsilon mRNAs generated by alternative splicing, mRNAs that code for different IgE proteins. These results show that DEP exposure in vivo causes both quantitative and qualitative changes in local IgE production. The implication is that natural exposure to DEP may result in increased expression of respiratory allergic disease.
The perioperative complication rate of orthopedic surgery in sickle cell disease: Report of the national sickle cell surgery study group
Authors: Elliott P. Vichinsky, Lynne D. Neumayr, Charles Haberkern, Ann N. Earles, James Eckman, Mabel Koshy, Dennis M. Black
Journal: American Journal of Hematology (1999)

Orthopedic disease affects the majority of sickle cell anemia patients of which aseptic necrosis of the hip is the most common, occurring in up to 50% of patients. We conducted a multicentered study to determine the perioperative complications among sickle cell patients assigned to different transfusion regimens prior to orthopedic procedures: 118 patients underwent 138 surgeries. The overall serious complication rate was 67%. The most common of these were excessive intraoperative blood loss, defined as in excess of 10% of blood volume. The next most common complication was sickle cell-related events (acute chest syndrome or vaso-occlusive crisis), which occurred in 17% of cases. While preoperative transfusion group assignment did not predict overall complication rates, higher risk procedures were associated with significantly higher rates of overall complications. Transfusion complications were experienced by 12% of the patients. Two patients died following surgery. Both deaths were associated with an acute pulmonary event. The 52 patients undergoing hip replacements experienced the highest rate of complications with excessive intraoperative blood loss occurring in the majority of patients. Sickle cell-related events occurred in 19% of patients, and surgical complications occurred after 15% of hip replacements and included postoperative hemorrhage, dislocated prosthesis, wound abscess, and rupture of the femoral prosthesis. There were twenty-two hip coring procedures. Acute chest syndrome occurred in 14% of the patients. Overall, decompression coring was a safer, shorter operation. A randomized prospective trial to determine the perioperative and long-term efficacy of core decompression for avascular necrosis of the hip in sickle cell disease is needed. In conclusion, this study demonstrates a high rate of perioperative complications despite compliance with sickle cell perioperative care guidelines. Pulmonary complications and transfusion reactions were common. This study supports the results previously published by the National Preoperative Transfusion in Sickle Cell Disease Group. These results stated that a conservative preoperative transfusion regimen to bring hemoglobin concentration to between 9 and 11 g/dl was as effective as an aggressive transfusion regimen in which the hemoglobin S level was lowered to 30%. Am. J. Hematol. 62:129–138, 1999. © 1999 Wiley-Liss, Inc.
Emergency Airway—A Plan of Action
Authors: Theodore H. Nicholas
Journal: JAMA (1960)

An orderly plan of action for correcting the occasional critical airway obstruction is essential; otherwise irreversible brain damage and even death may occur before effective action is taken. A safe, simple, and effective plan has been developed for restoring ventilation in critical airway emergencies. The four basic steps are: recognition of obstruction; nonsurgical maneuvers to relieve obstruction; mouth-to-mouth breathing to overcome obstruction or to diagnose persistent obstruction; and establishment of emergency surgical airway. Cricothyroid membrane puncture is the safest and simplest method for establishing a satisfactory airway under adverse and serious conditions.
The compulsive habit of cars
Authors: Yavor Yalachkov, Marcus J Naumer, Anna Plyushteva
Journal: Trends in Cognitive Sciences (2014)

The car dependence of people living in contemporary cities is a major concern for policy makers, who often find it difficult to persuade people into more sustainable transport modes. By contrast, recent insights from neuroscience have shown that a broad spectrum of behaviors can become habitual and, thus, resistant to change. Here, we outline the potential of collaboration between neuroscience and human geography aiming at a better understanding of habits that determine everyday commuting routines.