tbuckley/cabot-search huggingface dataset:
Medical Expenditures Associated With Diabetes Among Privately Insured U.S. Youth in 2007
Authors: Sundar S. Shrestha, Ping Zhang, Ann Albright, Giuseppina Imperatore
Journal: Diabetes Care (2011)

OBJECTIVE To estimate, among privately insured youth in the U.S., medical expenditures associated with diabetes and the difference in medical expenditures between individuals with insulin-treated diabetes mellitus (ITDM) and with non-ITDM (NITDM). RESEARCH DESIGN AND METHODS Using the 2007 MarketScan commercial claims and encounter database, we analyzed data for 49,356 youth (aged ≤19 years) who were continuously enrolled in fee-for-service health plans. Youth with diabetes (cases) were identified from inpatient, outpatient, and pharmaceutical drug claims. Each case was matched with five controls (without diabetes) by age (±2 years), sex, census region, and urban versus rural residence. We used regression models to estimate medical expenditures in total and by component (inpatient, outpatient, and medication). RESULTS The predicted mean annual total per-person medical expenditures were $9,061 for youth with diabetes and $1,468 for those without, an excess of $7,593 for those with diabetes; of which, 43% was for prescription drugs. The predicted mean annual total expenditures were $9,333 for ITDM youth and $5,683 for NITDM youth, respectively, an excess of $3,650 for those with ITDM diabetes, of which 59% was for prescription drugs. CONCLUSIONS The excess medical expenditures associated with diabetes, ITDM in particular, among youth are substantial. Our estimates of excess expenditures can be used to assess the economic burden of diabetes overall and by diabetes treatment mode. Our estimated excess expenditure for NITDM may be used for evaluating the economic efficiency of interventions aimed at preventing type 2 diabetes in U.S. youth.
Noninvasive Ventilation in Chronic Obstructive Pulmonary Disease
Authors: Mark W. Elliott
Journal: New England Journal of Medicine (1995)

There have been a number of uncontrolled studies in which nasal or face-mask ventilation was used successfully to treat acute exacerbations of chronic obstructive pulmonary disease.18 The concern remains, however, that when this approach is unsuccessful, the delay in intubation and mechanical ventilation may adversely affect the outcome.7 The study by Brochard and coworkers9 in this issue of the Journal firmly establishes a role for noninvasive ventilation in the management of acute exacerbations of chronic obstructive pulmonary disease. This study shows that in most patients with severe abnormalities of arterial-blood gas levels and a high risk of death,10 pressure-support . . .
TV: Dogma in retreat
Authors: S. Wessely
Journal: BMJ (1999)

Talking Cure, BBC2, Tuesdays at 9.50pm, 2 November to 7 December 

The fly on the wall documentary has now developed its own cliches, but when done well it can still grip. Talking Cure , filmed at London's Tavistock Clinic, made compelling viewing.

The Tavistock has been the spiritual home of psychoanalytic practice in this country from its foundation after the first world war—its original patrons being the rather unlikely combination of Field Marshall Haig and Admiral Beatty of Jutland fame. Although it no longer has the influence it once did, it remains the largest NHS psychotherapy clinic.

In six episodes we saw six different aspects of the work of the clinic, based around six patients. Granted the patients were not straightforward: all had responded to advertisements placed by the programme makers and had then got themselves referred to …
Continuing Education in Nursing
Authors: Ruth Perkins Kuehn
Journal: JAMA (1964)

PROGRAMS in continuing nursing education, relatively new in evolvement, are usually carried on in a university setting but may be sponsored by nursing organizations in cooperation with health-oriented groups. The programs, individually varying in scope and focus, nevertheless have a foundation in common nursing principles and practices. Planned to meet the needs of specific nursing groups—hospital head nurses or teachers of nursing, for example—the programs communicate to the nursing profession new concepts resulting from research in many fields. A basic administrative staff is necessary for pre-conference planning and for expediting program needs and evaluating results. Field visits to participating institutions for program appraisal have been found helpful. The staff for the continuing nursing education program is usually assembled from more than one department in the university and often from more than one university. Participants devote full time to the program, exchanging ideas with other nurses who come from a variety
Systematic generation of high-resolution deletion coverage of the Drosophila melanogaster genome
Authors: Annette L Parks, Kevin R Cook, Marcia Belvin, Nicholas A Dompe, Robert Fawcett, Kari Huppert, Lory R Tan, Christopher G Winter, Kevin P Bogart, Jennifer E Deal, Megan E Deal-Herr, Deanna Grant, Marie Marcinko, Wesley Y Miyazaki, Stephanie Robertson, Kenneth J Shaw, Mariano Tabios, Valentina Vysotskaia, Lora Zhao, Rachel S Andrade, Kyle A Edgar, Elizabeth Howie, Keith Killpack, Brett Milash, Amanda Norton, Doua Thao, Kellie Whittaker, Millicent A Winner, Lori Friedman, Jonathan Margolis, Matthew A Singer, Casey Kopczynski, Daniel Curtis, Thomas C Kaufman, Gregory D Plowman, Geoffrey Duyk, Helen L Francis-Lang
Journal: Nature Genetics (2004)
Surfactant Maturation Is Not Delayed in Human Fetuses with Diaphragmatic Hernia
Authors: Olivier Boucherat, Alexandra Benachi, Bernadette Chailley-Heu, Marie-Laure Franco-Montoya, Caroline Elie, Jelena Martinovic, Jacques R Bourbon
Journal: PLoS Medicine (2007)

Background Pulmonary hypoplasia and persistent pulmonary hypertension account for significant mortality and morbidity in neonates with congenital diaphragmatic hernia (CDH). Global lung immaturity and studies in animal models suggest the presence of surfactant deficiency that may further complicate the pathophysiology of CDH. However, data about surfactant status in human fetuses with CDH at birth are contradictory. The lack of a chronological study of surfactant content in late pregnancy has been a significant limitation. The appropriateness of administering surfactant supplements to neonates with CDH is therefore a debated question. Methods and Findings We investigated surfactant content in human fetuses with CDH compared to age-matched fetuses with nonpulmonary diseases used as controls. Concentrations of disaturated phosphatidylcholine and surfactant proteins were found to be similar at a given stage of pregnancy, with both components showing a similar pattern of increase with progressing pregnancy in fetuses with CDH and in control fetuses. Thyroid transcription factor 1, a critical regulator of surfactant protein transcription, similarly displayed no difference in abundance. Finally, we examined the expression of three glucocorticoid-regulated diffusible mediators involved in lung epithelial maturation, namely: keratinocyte growth factor (KGF), leptin, and neuregulin 1 beta 1 (NRG1-β1). KGF expression decreased slightly with time in control fetuses, but remained unchanged in fetuses with CDH. Leptin and NRG1-β1 similarly increased in late pregnancy in control and CDH lungs. These maturation factors were also determined in the sheep fetus with surgical diaphragmatic hernia, in which surfactant deficiency has been reported previously. In contrast to the findings in humans, surgical diaphragmatic hernia in the sheep fetus was associated with decreased KGF and neuregulin expression. Fetoscopic endoluminal tracheal occlusion performed in the sheep model to correct lung hypoplasia increased leptin expression, partially restored KGF expression, and fully restored neuregulin expression. Conclusions Our results indicate that CDH does not impair surfactant storage in human fetuses. CDH lungs exhibited no trend toward a decrease in contents, or a delay in developmental changes for any of the studied surfactant components and surfactant maturation factors. Surfactant amounts are likely to be appropriate to lung size. These findings therefore do not support the use of surfactant therapy for infants with CDH. Moreover, they raise the question of the relevance of CDH animal models to explore lung biochemical maturity.
Entonox as a Psychotherapeutic Aid
Authors: I. J. MacDonald
Journal: BMJ (1970)

therefore, being carried out in many nur- series without physicians being aware of it.There are no data whatsoever to support the present "dim light" conditions present in many nurseries as being the best.Outdoor lighting is used to illuminate many nurseries and "long-term disadvantages" are not ap- parent.I agree that we have much to learn about light and its effect on human infants.The present leading article implies, however, that we know the present highly artifical light conditions are good, so why change?I would suggest that we face our ignorance on this point, examine the currently avail- able evidence without prejudice, and then make a judgement.-Iam, etc.,
IgE Cross-reactivity to Tropomyosins among Patients with Asthma and/or Rhinitis from Brazil: Analysis by Component-based Allergen Microarray
Authors: A.C.S. Santos, G.A. Bardini, K.S. Santos, M.C.R. Barbosa, A.B.R. Santos, L.K. Arruda
Journal: Journal of Allergy and Clinical Immunology (2011)
Hepatic expression of A Disintegrin And Metalloproteinase (ADAM) and ADAMs with thrombospondin motives (ADAM-TS) enzymes in patients with chronic liver diseases
Authors: Lutz Schwettmann, Michael Wehmeier, Dunja Jokovic, Krasimira Aleksandrova, Korbinian Brand, Michael P. Manns, Ralf Lichtinghagen, Matthias J. Bahr
Journal: Journal of Hepatology (2008)
Perinatal Deaths in a Family with Autosomal Dominant Polycystic Kidney Disease and a<i>PKD2</i>Mutation
Authors: Carsten Bergmann, Nadina Ortiz Brüchle, Valeska Frank, Helga Rehder, Klaus Zerres
Journal: New England Journal of Medicine (2008)

The authors report on a four-generation family carrying a mutation in the gene for ADPKD2 (PKD2) with previously undetected polycystic kidney disease. In the present generation, however, perinatal ...
ENCEPHALITIS LETHARGICA AFFECTING THE NUCLEI OF THE MID-BRAIN IN AN UNUSUAL MANNER
Authors: W. Calwell
Journal: BMJ (1922)

ANTISEPTIC PROPERTIES OF CYANINE DYES.was normal.He seemed to me to correspond fairly well with the cases of astasia one met with during the war.He gradually recovered, and was disclharged in June, 1920, for treatment and training at a convalescent camp.There he reImained until one day lhe had a fall, when all his old symptoms reappeared, and in Marce, 1921, he was readmitted to the Soutlh Devon Hospital.His condition then was by no means so severe as when first seen.The rigiditv, however,
Association between Maternal Serum Perfluoroalkyl Substances during Pregnancy and Maternal and Cord Thyroid Hormones: Taiwan Maternal and Infant Cohort Study
Authors: Yan Wang, Walter J. Rogan, Pau-Chung Chen, Guang-Wen Lien, Hsiao-Yen Chen, Ying-Chih Tseng, Matthew P. Longnecker, Shu-Li Wang
Journal: Environmental Health Perspectives (2014)

Perfluoroalkyl substances (PFASs) are synthetic compounds that are widely used in industry and are often detectable in humans. In pregnant rats and their pups, PFASs can interfere with thyroid hormone homeostasis. In humans, maternal thyroid hormones supply the fetus throughout pregnancy, and thyroid hormones play a critical role in fetal growth and neurodevelopment.We investigated the association between maternal PFAS exposure and thyroid hormone status in pregnant women and neonates.In a study of environmental exposure and health in Taiwan, we measured serum concentrations of nine PFASs and four thyroid hormones for 285 pregnant women in their third trimester, and also measured cord serum thyroid hormones for 116 neonates. Associations between maternal PFASs and maternal and cord thyroid hormones were examined in multiple linear regression models.Perfluorohexanesulfonic acid concentrations were positively associated with maternal thyroid-stimulating hormone (TSH) levels. Pregnant women with higher levels of perfluorononanoic acid (PFNA), perfluoroundecanoic acid (PFUnDA), and perfluorododecanoic acid (PFDoDA) had lower free thyroxine (T4) and total T4 levels. For example, we estimated that maternal free T4 levels decreased 0.019 ng/dL (95% CI: -0.028, -0.009) with each nanogram per milliliter increase in maternal PFNA. Finally, maternal PFNA, PFUnDA, and PFDoDA levels were associated with lower cord total triiodothyronine (T3) and total T4 levels, and maternal perfluorodecanoic acid (PFDeA) was associated with lower cord total T3.Our results suggest that exposure to some PFASs during pregnancy may interfere with thyroid hormone homeostasis in pregnant women and fetuses.
Collagen loss in the stunned myocardium.
Authors: R H Charney, S Takahashi, M Zhao, E H Sonnenblick, C Eng
Journal: Circulation (1992)

BACKGROUND This study was performed to biochemically assess and quantify the previously observed ultrastructural alterations in the collagen matrix of stunned myocardium. METHODS AND RESULTS The stunned myocardium was produced in 13 mongrel dogs by a series of 12 coronary artery occlusions of 5 minutes followed by 10-minute reperfusion periods, with a final reperfusion period of 90 minutes. Regional systolic function in the stunned myocardium was 17% of control. Relative end-diastolic length in the stunned region increased up to 8%. There was a nonuniform transmural loss of collagen. Hydroxyproline in the stunned endocardium was not different from control. The stunned midwall and epicardium demonstrated 12.5% (p less than 0.05) and 14.6% (p less than 0.005) decreases, respectively. All transmural layers in the stunned myocardium had significant increases in collagenase activity before procollagenase activation, averaging a 73.6% increase (p less than 0.025). Complete activation of all procollagenase forms with aminophenylmercuric acetate revealed no differences in fully activated collagenase between the stunned and normal regions. The lysosomal enzymes, elastase and cathepsin G, were not different between stunned and normal zone tissue. These results would tend to exclude exogenous sources of protease in the stunned myocardium at the 90-minute final reperfusion time frame. Collagen fibers were isolated from the stunned and normal zone tissue and underwent dansyl chloride reaction. Stunned collagen fibers had 9% greater dansyl labeling, suggesting greater numbers of exposed N-terminal amino acid residues on the fiber and compatible with greater enzymatic cleavage activity on the stunned collagen matrix. Tissue water content was consistently greater in the stunned region compared to the normal: a uniform transmural increase of approximately 1.7%. CONCLUSIONS The stunned myocardium is characterized by both systolic dysfunction and diastolic expansion or dilatation. Endogenous procollagenase is activated by the ischemic process leading to degradation of the extracellular matrix. The underlying mechanisms may be relevant in ischemic enlargement of the heart and cardiomyopathy.
More on pre-mortal provision
Authors: R. Bayliss
Journal: BMJ (2001)

In his article on pre-mortal provision in the BMJ of 2 June, Douglas Black shows his customary wisdom when he points out that, in making a living will, it is not possible to be sure that convictions will remain unchanged.1 How right he is, as I now know to my own satisfaction and happiness.

At noon on January 12 this year I began to experience pain in the right iliac fossa, which quickly crescendoed. I lay on the sofa and applied the 13 questions required for the elucidation of any pain of unclear origin.2 On examination there was tenderness on release. Appendicitis and Meckel's diverticulitis could be excluded because both had been operated on in 1970. The pain …
Group R streptococcal meningitis (Streptococcus suis type II): a new industrial disease?
Authors: C H Twort
Journal: BMJ (1981)

As retinal changes usually precede the development of diabetic nephropathy, in the five patients with proteinuria but without retinopathy (three positive and two negative for chlorpropamide- alcohol flushing) the proteinuria may possibly have been due to other causes.If these cases are excluded the difference between the groups positive and negative for flushing becomes greater (1/191 (0 5 ) v 12/100 (120;).
In Mice Sensitized to Milk, Epicutaneous Immunotherapy Prevents Further Sensitization to Peanut or House Dust Mite
Authors: L. Mondoulet, V. Dioszeghy, E. Puteaux, M. Ligouis, V. Dhelft, C. Dupont, P. Benhamou
Journal: Journal of Allergy and Clinical Immunology (2012)
The origin of quasispecies: cause or consequence of chronic hepatitis C viral infection?
Authors: David G. Bowen, Christopher M. Walker
Journal: Journal of Hepatology (2004)

The hepatitis C virus (HCV) presents a major global health challenge, with an estimated 170 million individuals infected [1]. In some regions seropositivity rates of more than 12% have been demonstrated [2]. While a lack of available data precludes an accurate assessment of the annual global incidence of HCV infection [3], it is estimated that some 38,000 new infections occur annually in the United States alone [4]. HCV persists in some 70% of infected individuals, and is associated with the development of cirrhosis in approximately 20% of patients [5]; up to 2.5% develop hepatocellular carcinoma [6].
Purification and characterization of Pla a 1, a major allergen from <i>Platanus acerifolia</i> pollen
Authors: J. A. Asturias, I. Ibarrola, B. Bartolomé, I. Ojeda, A. Malet, A. Martínez
Journal: Allergy (2002)

Background: Plane trees, as Platanus acerifolia , are an important source of airborne allergens in cities of the United States and Western Europe. Little is known about the relevant allergens of this pollen. The aim of this study was to identify relevant allergens from P. acerifolia pollen and purify and characterize a major allergen of 18 kDa. Methods: P. acerifolia pollen extract was fractionated using ion exchange, gel filtration, and reverse‐phase chromatography. Analyzes were carried out by EAST, SDS‐PAGE, isoelectric focusing, immunoblotting and amino‐acid sequencing. Results: An 18‐kDa protein from the P. acerifolia pollen extract, which we named Pla a 1, was purified. This nonglycosylated protein had an isoelectric point value higher than 9.3 and was recognized by up to 92% of monosensitized Platanus allergic patients and 83% of polyzensitized patients. Sequencing of its N‐terminal yielded an amino acid sequence which showed no homology to the known proteins in the databases. Other relevant allergens detected in monosensitized patients were proteins of 43 and 52 kDa, with immunoglobulin (Ig)E‐binding prevalences of 83 and 42%, respectively. Profilin was an important allergen in polyzensitized patients. Conclusions: The most relevant allergens from the P. acerifolia pollen have been determined. A major allergen, specific of this pollen, and named Pla a 1, has been purified and characterized.
Is the Care of the Chronically Ill a Medical Prerogative?
Authors: Muriel R. Gillick
Journal: New England Journal of Medicine (1984)

"The situation regarding the care of chronic disease in this community is such that certain measures must be taken in the near future to improve the conditions if Boston is to retain its place as a progressive medical center,"1 cautioned an editorial in the Boston Medical and Surgical Journal in 1906. A similar concern, even more dramatically stated, was expressed in a recent issue of the New England Journal of Medicine, the direct descendant of the Boston Medical and Surgical Journal: "Of all the difficult health-care issues facing the nation today, none is more complex or more urgent . . .
Phases of Psychopathology After Assassination
Authors: JOSEPH C. FINNEY, DONALD E. SKEETERS, C. DWIGHT AUVENSHINE, DAVID F. SMITH
Journal: American Journal of Psychiatry (1973)

An Arabic man who assassinated a prominent American politician was tested with the Minnesota Multiphasic Personality Inventory six weeks and five months after the crime. Analysis of both tests by a psychiatric diagnostic computer program revealed a schizo-affective psychosis with paranoid features. The authors recommend the computer method of diagnosis for medicolegal cases in which public opinion has been aroused and the specialist's objectivity may be impaired.
The Effects of Somatic Disability or Progressive Illness on Psychological and Social Well-Being
Authors: Vappu Viemerö
Journal: Psychotherapy and Psychosomatics (1991)

Two different studies are discussed. In the first, 67 subjects with neuromuscular diseases were interviewed to study their mental state and features of their personality as functions of disability. Female subjects had a higher aggression level than male subjects. Aggression in different forms seemed to function as a coping mechanism for the female disabled subjects whereas denial and withdrawal were more typical for the males. Due to unsolved crises, unstated fear of the future and/or death or forlornness and the poor ability to form positive social relationships, the subjects had limited psychological resources to cope with the extremely stressful situation caused by disability and progressive diseases. In the other study, two test groups were formed. One included subjects with a hitherto nonvisible disability (n = 29), the other consisted of persons whose disability had already become visible but who had used wheelchairs for only 2 years or less (n = 40). The aim was to study different ways in which subjects in these two groups experienced crisis and what kind of differences occured in it. Subjects with visible disability went through the crisis significantly better than the subjects in the other group. Most of the subjects had known about their diseases for a long time and the disorder itself did not cause their crisis symptoms. These were created by limitations in mobility, and even more so by fear of other people's attitudes toward disability.