tbuckley/cabot-search huggingface dataset:
Medicaid Managed Care and High Quality
Authors: Arnold M. Epstein
Journal: JAMA (1997)

MEDICAID HAS EMBARKED on a major transition. Accelerating cost pressures in recent years have prompted states to initiate large-scale conversion of their Medicaid programs from traditional fee-for-service coverage to managed care. As a result, the number of Medicaid enrollees cared for in managed care has increased from approximately 2.5 million in 1991 to more than 13 million in June 1996.<sup>1</sup>Most of the enrollees have been from the nondisabled, nonelderly, Aid for Dependent Children/Temporary Assistance for Needy Families population.<sup>2</sup>The fastest growth has been in fully capitated plans, which now care for approximately 70% of the Medicaid managed care market.<sup>3</sup> Growth of managed care for those who are privately insured has led to substantial controversy because of the financial disincentives for managed care organizations to provide sufficient medical services when these lead to increased costs. The potential impact of these disincentives on quality of care is arguably
Transient retinal ischaemia induced by nifedipine.
Authors: S Pitlik, R S Manor, I Lipshitz, G Perry, J Rosenfeld
Journal: BMJ (1983)

Transient retinal ischaemia induced by nifedipineRare ischaemic complications have been reported after oral nifedipine, but none of these affected the retinal circulation.We report on a patient who developed repeated transient unilateral retinal ischaemia after administration of nifedipine. Case reportSeven years after suffering an anteroseptal myocardial infarction a 67 year old man presented with angina of one year's duration that did not respond on 18 July 2023 by guest.
The Bronchospastic Component in Patients With Chronic Bronchitis and Emphysema
Authors: John K. Curtis
Journal: JAMA (1966)

The bronchospastic component in 100 patients with moderate to severe chronic bronchitis and emphysema was investigated by determination of serial, timed vital capacity (FEV<sub>1</sub>) before and after isoproterenol hydrochloride inhalation. Four hundred twenty-five studies over a one- to five-year period showed that the FEV<sub>1</sub>decreases with progression of disease; however, the degree of bronchospasm did not change significantly, indicating a tendency for bronchospasm to persist in many patients in spite of the use of bronchodilators (95 patients), daily intermittent positive pressure breathing (51 patients), and steroids (21 patients). A paradoxical response to isoproterenol was encountered in nine patients. Eighty-four patients showed definite improvement in FEV<sub>1</sub>in one or more tests after isoproterenol administration. It is concluded that a bronchospastic component exists in most patients with chronic bronchitis and emphysema, whether or not a history of asthma is elicited.
THREE–YEAR RESULTS OF THE PLATINUM RANDOMIZED TRIAL COMPARING PLATINUM CHROMIUM PROMUS ELEMENT AND COBALT CHROMIUM PROMUS/XIENCE v EVEROLIMUS–ELUTING STENTS
Authors: Gregg W. Stone, Paul Teirstein, Ian Meredith, Robert Stoler, Abram Rabinowitz, Vincent Pompili, Ameer Kabour, Thomas Stuckey, Nick Curzen, Shigeru Saito, Andrejs Erglis, Dominic J. Allocco, Keith D. Dawkins
Journal: Journal of the American College of Cardiology (2013)
Leukotriene D<sub>4</sub>-Induced Activation of Smooth-Muscle Cells From Human Bronchi Is Partly Ca<sup>2 +</sup>-Independent
Authors: MARIA ROSA ACCOMAZZO, GIAN ENRICO ROVATI, TERESA VIGANÒ, ALICIA HERNANDEZ, ALBINO BONAZZI, MANLIO BOLLA, FRANCESCA FUMAGALLI, SERENA VIAPPIANI, ELISABETTA GALBIATI, SAULA RAVASI, CHIARA ALBERTONI, MONICA DI LUCA, ANTONIO CAPUTI, PIERO ZANNINI, GIUSEPPE CHIESA, ANNA MARIA VILLA, SILVIA MARIA DOGLIA, GIANCARLO FOLCO, SIMONETTA NICOSIA
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

Cysteine-containing leukotrienes (cysteinyl-LTs) are potent bronchoconstrictors and play a key role in asthma. We found that histamine and LTD4 markedly constrict strips of human bronchi (HB) with similar efficacy. However, in human airway smooth-muscle (HASM) cells, LTD4, at variance with histamine, elicited only a small, transient change in intracellular calcium ion concentration. HASM cells express both Ca2 +-dependent and -independent isoforms of protein kinase C (PKC) (i.e., PKC- α and PKC- α ). Western blot analysis showed that PKC- α is activated by histamine and, to a lesser extent, by LTD4, whereas only LTD4 translocates PKC- α . This translocation was specifically inhibited by the LTD4 antagonist pobilukast. Phorbol-dibutyrate ester (PDBu) (a PKC activator) contracted HB strips to the same extent in the presence as in the absence of extra- and intracellular Ca2 +. In the absence of Ca2 +, LTD4 contracted HB strips to the same extent as did PDBu, suggesting the involvement of a Ca2 +-independent PKC in LTD4-mediated signal transduction. PDBu-induced desensitization and the PKC inhibitor H7 abolished the slow and sustained LTD4-triggered contraction of HB strips in the absence of Ca2 +, although H7 did not greatly affect the response in the presence of the ion. Thus, in human airways, we identified a novel LTD4 transduction mechanism linked to bronchial smooth-muscle contraction, which is partly independent of Ca2 + and involves the activation of PKC- α .
A Reevaluation of the Duration of Survival after the Onset of Dementia
Authors: C Wolfson, D B Wolfson, M Asgharian, C E M'Lan, T Ostbye, K Rockwood, D B Hogan
Journal: New England Journal of Medicine (2001)

Dementia shortens life expectancy; estimates of median survival after the onset of dementia have ranged from 5 to 9.3 years. Previous studies of people with existing dementia, however, may have underestimated the deleterious effects of dementia on survival by failing to consider persons with rapidly progressive illness who died before they could be included in a study (referred to as length bias).
Serotonin and Myoclonic Seizures
Authors: Theodore L. Munsat
Journal: New England Journal of Medicine (1977)

Myoclonus is a descriptive term for involuntary, brief, jerking movements of a muscle, limb or combination of limbs. It may be symmetrical or focal, rhythmical or irregular and commonly involves the head, face and upper extremities. It characteristically disappears during sleep. Although myoclonus may occur at rest, it is usually precipitated or intensified by movement and emotional or sensory stimuli. It is quite clear that myoclonus occurs in the setting of many dissimilar pathologic states. In the newborn it may be a reflection of severe perinatal brain damage from any cause. In infancy massive myoclonic seizures are often associated with . . .
Loss of protein kinase Cβ function protects mice against diet-induced obesity and development of hepatic steatosis and insulin resistance
Authors: Wei Huang, Rishipal Bansode, Madhu Mehta, Kamal D. Mehta
Journal: Hepatology (2008)

Abstract Obesity is an energy balance disorder in which intake is greater than expenditure, with most excess calories stored as triglyceride (TG). We previously reported that mice lacking the β-isoform of protein kinase C (PKCβ), a diacylglycerol- and phospholipid-dependent kinase, exhibit marked reduction in the whole body TG content, including white adipose tissue (WAT) mass. To investigate the role of this signaling kinase in metabolic adaptations to severe dietary stress, we studied the impact of a high-fat diet (HFD) on PKCβ expression and the effect of PKCβ deficiency on profound weight gain. We report herein that HFD selectively increased PKCβ expression in obesity-prone C57BL/6J mice, specifically in WAT; the expression levels were little or unchanged in the liver, muscle, kidney, and heart. Basal PKCβ expression was also found to be elevated in WAT of obese ob/ob mice. Remarkably, mice lacking PKCβ were resistant to HFD-induced obesity, showing significantly reduced WAT and slightly higher core body temperatures. Unlike lean lipodystrophic mouse models, these mice did not have fatty livers, nor did they exhibit insulin resistance. Moreover, PKCβ −/− mice exhibited changes in lipid metabolism gene expression, and such alterations were accompanied by significant changes in serum adipokines. These observations suggest that PKCβdeficiency induced a unique metabolic state congruous with obesity resistance, thus raising the possibility that dysregulation of PKCβ expression could contribute to dietary fat–induced obesity and related disorders. (Hepatology 2009.)
QUALITY OF LIFE AND PHYSICAL ACTIVITY IN PATIENTS WITH CHRONIC HEART FAILURE
Authors: Francisco Saavedra, José Alves, Liliana Oliveira, Nuno Garrido, Nélson Sousa, Victor Reis
Journal: British Journal of Sports Medicine (2013)

Background Chronic heart failure is a complex syndrome manifested by hemodynamic disturbances, exercise intolerance, increased mortality and reduced quality of life (Heidenreich et al ., 2006). Besides impaired cardiac function, a variety of changes in peripheral skeletal muscles may contribute to the major and debilitating symptoms of chronic heart failure, dyspnea and fatigue (Coats et al ., 1994). The aim of this study was to evaluate the perception of quality of life and physical performance in patients with heart failure. Methods A total of 47 patients, of both genders, with chronic heart failure, were recruited (55,5±12,3 years), and divided into two groups. One group (n=28) clinical and another group (n=19) surgical. Fifty five percent of the patients had NYHA class III and forty five percent NYHA class III. Quality of life was assessed, in both groups, with the Minnesota Living with Heart Failure Questionnaire (Rector et al; 1992). The physical activity level was measured by an accelerometer (number of steps) during seven consecutive days. Results For the quality of life, were found significant differences (p ≤0.05), in the physical dimensions of chronic heart failure patients. The surgical group showed a better quality of life. Considering the physical activity, the clinical group appear with better performance (p≤0,01). In the daily activities, there weren't observed vigorous or very vigorous intensity activities. Conclusions These results indicate that chronic heart failure patients differ in their daily physical activity, especially in high-impact activities, due to age, gender, and disease progression (Rector, 2005). Further investigation should be directed towards the impact of the different components of the rehabilitation process upon quality of live improvement in patients with chronic heart failure.
Diabetes Prevalence and Hospital and Pharmacy Use in the Veterans Health Administration (1994): Use of an ambulatory care pharmacy-derived database
Authors: Leonard M Pogach, Gerald Hawley, Ruth Weinstock, Clark Sawin, Harlan Schiebe, Franklin Cutler, Franklin Zieve, Mary Bates, Denis Repke
Journal: Diabetes Care (1998)

OBJECTIVE To develop a diabetes registry from an outpatient pharmacy database to systematically analyze the prevalence of diabetes, patterns of glycemic medication and glucose monitoring, pharmacy costs, and hospital use related to diabetes care in the Veterans Health Administration (VHA) in fiscal year (FY) 1994. RESEARCH DESIGN AND METHODS Veterans with diabetes were identified using a software program that extracted the social security number (SSN) of patients receiving insulin, sulfonylurea agents, or glucose-monitoring supplies. The cumulative FY94 cost for a drug was calculated by multiplying the units dispensed times the unit cost for each fill, using the actual drug cost that was in effect at the time of dispensing. Admission data were obtained by crossmatching the SSN registry with the VHA Austin Mainframe Patient Treatment Files to retrieve associated diagnosis-related groups (DRG), Physicians' Current Procedural Terminology (CPT), and International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes. RESULTS From among 1,180,260 unique patients, 139,646 veterans with diabetes receiving insulin, oral agents, or glucose-monitoring strips were identified, accounting for a prevalence of 11.83% from 62 Veterans Administration medical centers. There were 63,078 individuals (52%) who received oral agents, of whom 26.3% also received blood glucose-monitoring supplies; 46,664 individuals (39%) received insulin, of whom 53.2% received blood glucose-monitoring supplies; and 9,440 individuals (8%) received both oral agents and insulin during FY94, with 64.4% receiving blood glucose-monitoring supplies. Only 1,482 (1.2%) individuals received monitoring supplies alone, and 129 patients (0.1%) were provided with an insulin pump. Using an adjusted data set, 12% of veterans accounted for 24% of all outpatient pharmacy costs, with an average expenditure of $622 for veterans with diabetes compared with $276 for veterans without diabetes. There was $454 (73%) for non-diabetes-specific prescriptions and $168 (27%) for prescriptions related to glycemic control. Of pharmacy expenditures for glycemic control, $101 (60.1%) was attributed to insulin, oral agents, and supplies, while $67 (39.9%) was attributable to glucose monitoring. Veterans with diabetes were admitted 1.6 times as frequently as veterans without diabetes. CONCLUSIONS This study demonstrates the feasibility of using a pharmacy-based electronic diabetes database in a payor system that can track both claims and individual classes of medication based on a unique identifier number. While the prevalence of diabetes in the VHA is high relative to other health care systems and the general population, patterns of medication usage, pharmacy costs, and relative admission frequency are comparable to results from the private sector.
Possible roles of nonparenchymal cells in hepatocyte proliferation induced by lead nitrate and by tumor necrosis factor ?
Authors: H Shinozuka, T Ohmura, S L Katyal, A I Zedda, G M Ledda-Columbano, A Columbano
Journal: Hepatology (1996)

A single intravenous injection of lead nitrate (LN) to rats induces liver cell proliferation without causing cell necrosis (direct hyperplasia). We suggested that liver cell proliferation in this model may be triggered by the induction of liver tumor necrosis factor α (TNF–α). Because administration of TNF–α in vivo has been shown to induce proliferation of both parenchymal and nonparenchymal cells of the liver, we analyzed the temporal sequences of DNA synthesis in both cell populations following LN and recombinant TNF–α treatment by 5– bromo–2–deoxyuridine (BrdU) immunohistochemistry. The patterns of cell proliferation induced by these agents were further compared with those induced by a single dose of nafenopin (NAF), a direct mitogen which does not induce liver TNF–α messenger RNA (mRNA). In male Wistar rats given a single dose of LN (100 μmol/kg), BrdU incorporation of hepatocytes and nonparenchymal cells (Kupffer cells, endothelial cells and periportal nondescript cells) became evident 12 hours after the treatment. The labeling of all cell types reached a peak after 36 hours and declined thereafter. Rats given a single intravenous injection of human recombinant TNF–α (46 μg/rat) showed an increase of BrdU labeling in nonparenchymal cells after 24 hours, whereas the labeling of hepatocytes became evident at 36 hours. A single intragastric administration of NAF resulted in a rapid increase in the number of labeled hepatocytes with no substantial labeling of nonparenchymal cells. These results add further support to the notion that LN–induced liver cell proliferation is mediated by TNF–α, and suggest that different cell populations are involved in the initial proliferative response of the liver to mitogens, depending on the capacity of the mitogens to stimulate TNF–α production.
Donepezil benefits patients with moderate to severe Alzheimer's disease
Authors: G. Watts
Journal: BMJ (2012)

A study of 295 patients with Alzheimer’s disease has shown that the drug donepezil and memantine, already used in the mild to moderate stage of the illness, are also beneficial in its moderate to severe stage.

“Overall this is an important study,” said Clive Ballard, one of the study’s coauthors and director of research at the Alzheimer’s Society. “It’s informed an issue where previously there wasn’t any evidence, and it’s allowed us to think about the drug treatment of Alzheimer’s disease in a smarter way.”

The new findings, reported in the New England Journal of Medicine (2012;136:893-903), are the outcome of the DOMINO trial funded by the Medical Research Council and the Alzheimer’s Society. This …
The Prevalence of Clinically Meaningful Overactive Bladder: Bother and Quality of Life Results from the Population-Based FINNO Study
Authors: Camille P. Vaughan, Theodore M. Johnson, Mika A. Ala-Lipasti, Rufus Cartwright, Teuvo L.J. Tammela, Kimmo Taari, Anssi Auvinen, Kari A.O. Tikkinen
Journal: European Urology (2011)
Network Television News
Authors: William A. Gardner
Journal: JAMA (1982)

THE ALMOST ubiquitous television monitors and playback facilities in classrooms and conference rooms attest to the widespread use of television as an instructional medium.<sup>1</sup>A less widely acknowledged instructional approach but one that has been shown to be effective, especially in the social sciences, is the incorporation of news reports into the classroom.<sup>2,3</sup>This communication describes the use of network television news coverage of health-related events as a supplemental audiovisual resource in medical education. <h3>Resource</h3> "Clearly, an improved awareness of what sources are open to the academic user is almost as important as insuring that future sources are even more complete and easily acceptable."<sup>4</sup> In August 1968, Vanderbilt University, Nashville, Tenn, began videotaping weekday evening network news programs. This project has continued and expanded to produce one of the largest archival resources in the United States. The collection includes the evening news broadcasts of the three major
Diabetes and ST Elevation Myocardial Infarction
Authors: Michael N. Zairis, Stamatis S. Makrygiannis, Olga A. Papadaki, Anastassios G. Lyras, John P. Kouzanidis, Olga S. Ampartzidou, Stelios M. Handanis, Spyros M. Argyrakis, Stefanos G. Foussas
Journal: Diabetes Care (2002)

Early resolution of ST-segment elevation is associated with enhanced clinical outcome following ST elevation myocardial infarction (STEMI). According to previous studies, the incidence of successful reperfusion following STEMI treated with thrombolytic regimen is similar for type 2 diabetic subjects and nondiabetic subjects as assessed by “snapshot” electrocardiographic or angiographic criteria (1). Nevertheless, type 2 diabetic subjects thrombolysed because of STEMI still seem to fare worse, manifesting impaired left ventricular function or long-term prognosis (2).

The aim of this prospective study was to test the hypothesis that type 2 diabetic subjects may have a protracted …
Combination of rituximab, bortezomib, doxorubicin, dexamethasone and chlorambucil (RiPAD+C) as first-line therapy for elderly mantle cell lymphoma patients: results of a phase II trial from the GOELAMS
Authors: R. Houot, S. Le Gouill, M. Ojeda Uribe, C. Mounier, S. Courby, C. Dartigeas, K. Bouabdallah, M. Alexis Vigier, M.P. Moles, O. Tournilhac, N. Arakelyan, P. Rodon, A. El Yamani, L. Sutton, L. Fornecker, D. Assouline, J.L. Harousseau, H. Maisonneuve, S. Caulet-Maugendre, R. Gressin
Journal: Annals of Oncology (2011)
The TPA Controversy and the Drug Approval Process
Authors: Peter R. Kowey, Lloyd Fisher, Elsa-Grace Giardina, Carl V. Leier, David T. Lowenthal, Franz H. Messerli, Craig M. Pratt
Journal: JAMA (1988)

SEVERAL months ago, our panel considered two applications submitted to the Food and Drug Administration (FDA) for the approval of thrombolytic agents for treatment of patients with acute myocardial infarction. One of these was intravenous (IV) streptokinase and the other was IV recombinant tissue plasminogen activator (rt-PA). We recommended approval of IV streptokinase and postponement of approval of IV rt-PA. There followed considerable public debate in which we were accused of "deciding to sacrifice thousands of American lives on an altar of pedantry" (<i>The Wall Street Journal</i>, June 2,1987). In essence, many observers opined that we had elected to debate picayune, unsolvable issues rather than make an important and lifesaving therapy available to the American public. Editorialists demanded that FDA Commissioner Frank Young repudiate the panel's suggestion and grant immediate approval of rt-PA. In response to one of the editorials in the lay press, we attempted to explain the issues
Preseasonal local allergoid immunotherapy to grass pollen in children: a double‐blind, placebo‐controlled, randomized trial
Authors: C. Caffarelli, L. G. Sensi, F. Marcucci, G. Cavagni
Journal: Allergy (2000)

Background: We assessed the efficacy of preseasonal local allergoid immunotherapy in a group of children with asthma and/or rhinitis and/or rhinoconjunctivitis due to grass pollen. Methods: We randomly assigned 24 children allergic to grass pollen to receivelocal allergoid immunotherapy for 3 months before the pollen season and 24 such patients to receive identically appearing placebo. The immunotherapy consisted of tablets of monomeric allergoid grass pollen allergens held in the mouth until they dissolved and then swallowed. The study was double‐blind. Symptoms and medications were scored on diary cards during the pollen season. Nasal eosinophil cationic protein levels were measured by the monoclonal antibodies EG1 and EG2 outside the pollen season and at low and at high pollen concentration during the pollen season. Results: The active‐treatment group had a statistically significant reduction of total symptoms ( P &lt;0.05), especially bronchial symptoms ( P &lt;0.05), in comparison with the placebo group. Immunotherapy was well tolerated and compliance was good. Nasal levels of EG2 and EG1 increased significantly during the pollen season, but there was no difference between groups. EG2/EG1 increased significantly only in the placebo group during natural allergen exposure ( P &lt;0.01). Conclusions: Our results suggest that this immunotherapy is effective for the treatment of asthma due to grass pollen in children.
The cognitive path through kinship
Authors: Fadwa El Guindi
Journal: Behavioral and Brain Sciences (2010)

Abstract Integral to the discipline of anthropology are both science and holism. The application of Optimality Theory to two partial kin terminologies narrows analysis to descriptive value, fragments phenomena, and constrains data selection, which precludes significant knowledge. Embedded in this critique is a call to move analysis from fragment to whole and from descriptive features to deeper levels of knowledge underlying kin terms, thereby leading to a cognitive path for holistic understanding of human phenomena.
Facts about Minority Students at Harvard Medical School
Authors: Robert H. Ebert
Journal: New England Journal of Medicine (1976)

The article by Dr. Davis, entitled "Academic Standards in Medical Schools" (N Engl J Med 294:1118–1119, 1976), was an attack on the Harvard Medical School and its policy of recruiting minority students. I make that categorical charge, since the body of the article was originally written by Dr. Davis as an internal document for presentation to the Faculty Council on January 13, 1976. It was modified with a few editorial flourishes to make it appear that it was a more general article, but I doubt if many readers were misled. In it he used privileged information without asking for clearance . . .