tbuckley/cabot-search huggingface dataset:
How to Achieve a High-Performance Health Care System in the United States
Authors: Richard L. Cruess, Sylvia R. Cruess
Journal: Annals of Internal Medicine (2008)

Letters6 May 2008How to Achieve a High-Performance Health Care System in the United StatesRichard L. Cruess, MD and Sylvia R. Cruess, MDRichard L. Cruess, MDFrom the Center for Medical Education, McGill University, Montréal, Québec H3A T25, Canada.Search for more papers by this author and Sylvia R. Cruess, MDFrom the Center for Medical Education, McGill University, Montréal, Québec H3A T25, Canada.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-148-9-200805060-00018 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:When comparing the health care system in the United States with the national health plans in other countries, we can learn many lessons about health outcomes and health economics. With no national health plan and an emphasis on market forces, the United States is unprepared for negotiations between government and physicians.In a national health program, individuals and organizations representing both physicians and patients sit around a negotiating table and hammer out the terms of medical practice. In the United Kingdom, which has a highly centralized system, representatives of the Department of Health—representing society—sit at the table ...Reference1. Stevens RA. Public roles for the medical profession in the United States: beyond theories of decline and fall. Milbank Q. 2001;79:327-53, III. [PMID: 11565160] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From the Center for Medical Education, McGill University, Montréal, Québec H3A T25, Canada.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoAchieving a High-Performance Health Care System with Universal Access: What the United States Can Learn from Other CountriesHow to Achieve a High-Performance Health Care System in the United States Thomas James III How to Achieve a High-Performance Health Care System in the United States Harvey S. Zarren How to Achieve a High-Performance Health Care System in the United States Jack A. Ginsburg , Robert B. Doherty , and J. Fred Ralston Jr. How to Achieve a High-Performance Health Care System in the United States S. Ward Casscells and MG Elder Granger How to Achieve a High-Performance Health Care System in the United States Arvind R. Cavale How to Achieve a High-Performance Health Care System in the United States Richard S. Leff Metrics 6 May 2008Volume 148, Issue 9Page: 710-711KeywordsAttentionConflicts of interestHealth careHealth economicsHealth insuranceSub-specialty care ePublished: 6 May 2008 Issue Published: 6 May 2008 CopyrightCopyright © 2008 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Rupture of Aneurysm on Branch of Left Renal Artery, Complicating Pregnancy
Authors: A. E. Chisholm
Journal: BMJ (1926)

T 41 Bm 9 discharged to a convalescent home in March.Four weeks later a small abscess in the scar was opened in the casualty department.He was readmitted in July with an abscess below Poupart's ligament, flexed hip, pain on walking, and a mass in the right iliac fossa.The diagnosis of actinomycosis was made, and con- firmed by the recovery of the organism from the pus.He was treated by x rays, large doses of potassium iodide, by vaccines (both stock and autogenous), and later by collosol iodine given by the mouth and injected into the sinuses.His progress was, however, steadily downward.In December he was bedridden and apparently moribund.The whole peritoneum seemed to consist of one huge abscess, which extended down the thighs almost to the knees.No doubt a very mixed infection was present.About this time our pharmacist, Mr. A. L. Taylor, expressed the opinion that collosol iodine contained little if any iodine m a colloidal state, and suggested that tincture of iodine freshly added to milk would give a more truly colloidal solution.The patient was therefore given this preparation by the mouth.Within a week the sinuses had all closed, and he was out of bed greatly improved in his general condition.Unfortunately, in April a fresh abscess, containing staphylococci and other organisms, re-formed in the abdomen, and he died on April 29th, 1924.
The Farm Family Exposure Study: Acquavella et al. Respond
Authors: John Acquavella, Bruce Alexander, Jack Mandel, Christophe Gustin
Journal: Environmental Health Perspectives (2006)

We thank Mage for his comments. In our article on glyphosate in the Farm Family Exposure Study (FFES) (Acquavella et al. 2004), we used 24-hr urinary creatinine to assess the completeness of daily samples over 5 days for the 48 participating farmers. We erred by summarizing the results as micrograms per deciliter instead of micrograms per day. Using an expected daily excretion of 566 μg/day as the lower end of the normal range (Bingham et al. 1988; Forman 2003), only four 24-hr urine samples over 5 days were below that lower limit. Therefore, the completeness of urine collection for the applicators was exceptional. Further details of the urine collection and our assessment of completeness can be found in a related article (Baker et al. 2005).

Mage criticizes us for not subtracting preapplication urine values in our assessment of systemic dose related to on-study applications. Indeed, seven of the applicators had detectable glyphosate in their urine on the day before their on-study application (Acquavella et al. 2004). Values were 1.1, 2.6, 3.9, 5.3, 8.3, 9.8, and 15.4 ppb. We intentionally did not correct for these initial values for two reasons. First, from an epidemiologic and public health standpoint, it is instructive to know the total dose for farmers during and after an application, which, for example, could then be compared to levels of toxicologic significance. Second, the overestimate caused by this practice is trivial for glyphosate in both an absolute and relative sense. Consider that glyphosate has a U.S. Environmental Protection Agency (EPA) reference dose of 2 mg/kg/day (U.S. EPA 1999), and the highest systemic dose we estimated in our study was 0.004 mg/kg/day. The requested corrections would be to the ten thousandths of a milligram per kilogram per day or less.

Last, Mage calls the fact that we only evaluated one application per farm family a limitation that may vitiate our study. That is a strong indictment for a study that comprehensively assessed exposure for farm families related to a single application of three pesticides to an extent not seen before. We agree that characterizing intraperson variation in absorbed pesticide dose over several seasons would provide valuable information, but that was not the objective of the FFES. Nevertheless, Mage’s claim that we cannot reject the possibility that all 47 applicators have the same exposure distribution is refuted by our observations that absorbed dose was related to specific practices (e.g., not wearing gloves) and by similar findings in the literature that practices dictate absorbed dose (e.g., Arbuckle et al. 2002).
Hepatoma and HAA
Authors: BURTON D. TEPFER
Journal: Annals of Internal Medicine (1972)

Letters, Comments, and Corrections1 January 1972Hepatoma and HAABURTON D. TEPFER, M.D.BURTON D. TEPFER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-76-1-145_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In the March 1971 issue Denison, Peters, and Reynolds reported on a family with hepatoma, one member of which had a hepatitis-associated antigen (HAA) present. I should like to report another (third) brother of those previously described, who also died of hepatoma at age 33 and who also was found to have a positive HAA.D.B. a 33-year-old black man, was admitted to San Francisco General Hospital on 18 May 1970 complaining of right flank pain of 3 months' duration, with weight loss, increasing abdominal girth, and loss of taste for cigarettes. The patient denied jaundice, dark...References1. VYAS G and SHULMAN N: Hemagglutination assay for antigen and antibody associated with viral hepatitis. Science 170:332-333, 1970 CrossrefMedlineGoogle Scholar2. SUTNICK A, LONDON W, and BLUMBERG B: Australia antigen: a genetic basis for chronic liver disease and hepatoma? Ann Intern Med 74:442-444, 1971 LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: BURTON D. TEPFER, M.D.Affiliations: University of California San Francisco Medical Center San Francisco, Calif. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFamilial clustering of hepatocellular carcinoma in HBsAg-positive patients in the United StatesClustering of hepatocellular carcinoma in Alaska Native familiesHepatitis B Virus and Hepatocellular CarcinomaMaternal transmission of hepatocellular carcinomaHepatitis B virus and primary hepatocellular carcinoma: Family studies in KoreaEvidence for clustering of hepatitis B virus infection in families of patients with primary hepatocellular carcinoma 1 January 1972Volume 76, Issue 1Page: 145-146KeywordsAbdominal painAntigensHepatocellular carcinomaTasteWeight loss ePublished: 1 December 2008 Issue Published: 1 January 1972 PDF downloadLoading ...
Abstract 1451: DAB2IP, a novel tumor suppressor protein modulates prostate cancer cell death in response to the combined treatment of ionizing radiation and a DNA-PKcs inhibitor NU7441
Authors: Lan Yu, Feng-Ming Hsu, Jer-Tsong Hsieh, Debabrata Saha
Journal: Cancer Research (2012)

Abstract Introduction: Prostate cancer (PCa) is the most common malignancy (25%) and the second leading cause of cancer-related death (10%) in U.S. men. Radiation treatment, which is noninvasive and well tolerated, is one of the front line therapeutic interventions in the management of localized PCa. However, significant proportions of high-risk patients fail therapy and develop metastatic disease. DAB2IP, which is a novel member of the Ras GTPase-activating protein family and a regulator of PI3K/Akt activity, is often downregulated and associated with aggressive prostate cancer (PCa). The purpose of this study is to investigate the radio-sensitizing property of a novel DNA-PKcs inhibitor, NU7441, in DAB2IP- deficient human PCa cells. Methods: We have developed DAB2IP deficient and proficient PCa cell lines (C4-2, PC3) for this study. We performed clonogenic surviving fraction analysis, DNA double strand break repair kinetics, cell cycle analysis, TUNEL assays, immunofluorescence, immunoblot, apoptosis and autophagy assays to investigate the mechanism of radiosensitization of NU7441 in these PCa cells. Results: Clonogenic surviving fraction analysis indicates a strong radiosensitizing ability of NU7441 in PCa cells deficient in DAB2IP. This is primarily due to robust G2-M block and persistent DNA double strand break in response to the combined treatment of radiation and NU7441. We clearly demonstrate that the presence of DAB2IP modulates prostate cancer cell death when treated with radiation and NU7441. Apoptotic cell death was prominent in PCa cells proficient in DAB2IP whereas, robust autophagic cell death was noticed in DAB2IP deficient PCa cells. Conclusion: Our study clearly shows that NU7441, a novel DNA-PKcs inhibitor, is a potent radiosensitizer in aggressive PCa cells. Furthermore, our study indicates that DAB2IP may act as an important factor in PCa cell death after combined treatment Nu7441 and radiation. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1451. doi:1538-7445.AM2012-1451
The Identification of Pentobarbital by Paper Chromatography in a Medicolegal Death
Authors: Elvera J. Algeri, Arthur J. McBay
Journal: New England Journal of Medicine (1953)

THE results of an investigation of the application of paper chromatography to the identification of the common barbiturates were recently reported by this laboratory.1 If a barbiturate is found to be responsible for a medicolegal death, the investigator is compelled to engage in as complete and detailed a study as biologic material available allows so that the results can be fully evaluated and the drug identified. Important factors in the final appraisal are the metabolic fate and distribution of the barbiturates in the human body.It is here that the advantages of paper chromatography may be realized, for this simple . . .
Variable Impact of State Legislative Advocacy on Registry Participation and Regional Systems of Care Implementation
Authors: Ivan C. Rokos, Lee H. Schwamm, Madeleine Konig, Mary-Beth Malcarney, Katie B. Horton, Jeffrey Ranous, A. Gray Ellrodt, Steven A. Farmer, Michael R. Frankel, T. Bruce Ferguson, David C. Goff, Loren Hiratzka, Alice K. Jacobs
Journal: Circulation (2013)
PHYSICIANS AS SPEAKERS.
Authors: WILLIAM WHITFORD
Journal: JAMA (1900)

<h3>Introductory Remarks.</h3> — The communication of thoughts by means of spoken language is an art that can not be acquired to any great degree of perfection except by long and continued practice. Some physicians are more highly gifted than others with facility of expression, and they are naturally endowed with the power of eloquence; but to none is it at all times an easy process to embody, in exact and appropriate language, the various trains of ideas that are passing through the mind. However distinct may be a physician's voice, however vivid his conceptions, he is often conscious that the phraseology at his command, particularly in public speaking, is inadequate to do them justice. He seeks in vain the words he needs, and strives ineffectually to devise forms of expression which shall faithfully portray his thoughts. He employs words and phrases either too general or too limited, too strong or
Effect of inhaled formyl-methionyl-leucyl-phenylalanine on airway function.
Authors: N Berend, M J Peters, C L Armour, J L Black, H E Ward
Journal: Thorax (1988)

Formyl-methionyl-leucyl-phenylalanine (FMLP), a synthetic, acylated tripeptide analogous to bacterial chemotactic factors, has been shown to cause bronchoconstriction in guinea pig, rabbit, and human airways in vitro. To determine whether FMLP causes bronchoconstriction in man in vivo, a preliminary study was undertaken in which five non-smokers (mean age 35 years, FEV1 94% (SEM 5%) predicted) and five smokers (mean age 34 years, FEV1 93% (6%) predicted) inhaled aerosols of FMLP. None of the subjects showed airway hyperresponsiveness to histamine (the provocative concentrations of histamine causing a fall of greater than or equal to 20% in FEV1 (PC20) were over 8 mg/ml). FMLP dissolved in 50% dimethylsulphoxide and 50% saline in concentrations of 0, 0.06, 0.12, 0.25, 0.5, 1.0, 2.0, and 4.0 mg/ml was administered to the subjects by means of a French-Rosenthal dosimeter, FEV1 being recorded after inhalation of each concentration. Dose dependent falls in FEV1 occurred in five non-smokers (geometric mean 1.76, 95% confidence limits 0.87-3.53 mg/ml) and three smokers (0.23, 0.07-0.78 mg/ml), with two smokers not responding by 20% to the highest concentration of FMLP. On a separate day the FMLP dose-response curves were repeated after nebulisation of 500 micrograms of ipratropium bromide. The PC20 FMLP in the responders more than doubled. In six additional normal subjects a histamine inhalation test was performed before and four and 24 hours after inhalation of FMLP. All subjects remained unresponsive to histamine. These results show that FMLP is a potent bronchoconstrictor in some non-asthmatic individuals in vivo and this may be important in bronchoconstriction related to infection in patients with chronic obstructive lung disease.
Mental Health and Environment
Authors: Samuel H. Kraines
Journal: JAMA (1964)

The setting for this social study was the planned outward movement of large numbers of postwar Londoners. Contrasted with the Majority who remained behind were those who moved to "out-county" housing estates, with good living accommodations but poor social planning; and others who moved to eight new towns around London, each with a socially planned community. Taylor and Chave wanted to learn whether removal to these new areas affected mental health; whether by building good communities, people could be prevented from becoming mentally ill; whether mental illness resulted from genetic and deepseated personal causes or from the immediate environment. The reader senses that these social investigators were disappointed in their findings, and would probably have had them otherwise, but the results are nevertheless intriguing. The authors discovered that about one third (30% to 35%) of each of the three groups, despite the marked differences in their living conditions, have what
Climate Change. A Global Threat to Cardiopulmonary Health
Authors: Mary B. Rice, George D. Thurston, John R. Balmes, Kent E. Pinkerton
Journal: American Journal of Respiratory and Critical Care Medicine (2014)

Section:ChooseTop of pageAbstract <<Environmental Air Polluti...Aeroallergen (Pollen) and...Extreme WeatherClimate Change SolutionsConclusionsReferencesCITING ARTICLES
Editorial: The need for unified medical management of interictal personality changes
Authors: V. H. Mark
Journal: JAMA (1976)

Increasing specialization in medicine may bring hazards as well as benefits to the patient whose complaints do not fall into the typical pattern of medical disease. He or she may be called a "crock," sent to a psychiatrist for management, and then suffer the results of little or no communication between the referring physician and the psychiatrist. Nowhere is this practice more unfortunate than when it occurs in an emotionally disturbed patient who also has symptoms of structural or functional brain disease. Waxman and Geschwind illustrate this clearly in their article in the recent issue of<i>Archives of General Psychiatry</i>(32:1580-1586, 1975). They point out that some patients with temporal lobe epilepsy, especially when it involves the limbic system, may have changes in their behavior that occur between obvious seizures. They describe hyperreligiosity, punctuated by religious conversions; hypergraphia, characterized by strikingly voluminous writings of an unusually compulsive nature; and occasional
THE EFFECT OF TUBERCLE BACILLI ON THE POLYMORPHONUCLEAR LEUCOCYTES OF NORMAL ANIMALS
Authors: Samuel P. Martin, Cynthia H. Pierce, Gardner Middlebrook, René J. Dubos
Journal: The Journal of Experimental Medicine (1950)

A description is given of a slide cell whereby the rate of migration of very small amounts of leucocytes can be followed and measured. The migration of polymorphonuclear leucocytes was found to be inhibited by virulent tubercle bacilli pathogenic for the class of animal (mammal or bird) from which the leucocytes were obtained; it was not affected by the avirulent variants of these microorganisms, or by bacilli pathogenic for animals of the other class. Tests failed to disclose that the inhibition of leucocytic migration resulted from any gross damage caused by the bacilli to the leucocytes.
Diabetic Retinopathy in 2011: Further Insights From New Epidemiological Studies and Clinical Trials
Authors: Ecosse L. Lamoureux, Tien Y. Wong
Journal: Diabetes Care (2011)

Diabetic retinopathy (DR) is a common and specific microvascular complication of diabetes and one of the leading global causes of preventable blindness. Population-based studies suggest that about one-third of the diabetic population have signs of DR and approximately one-tenth have vision-threatening stages of retinopathy, such as diabetic macular edema and proliferative retinopathy (1,2). Notwithstanding its effects on vision, DR is costly (3), substantially impacts on the patient's quality of life (4), and is linked with a greater risk of life-threatening systemic vascular complications (5).

Because blindness from DR is preventable from both public health screening and clinical management perspectives, it is important to precisely identify persons at risk for developing DR and those most likely to progress to severe vision-threatening stages. In this issue of Diabetes Care , Zavrelova et al. (6) present a fascinating and informative article that discusses people with diabetes having distinct developmental patterns of DR and that there may be specific risk factors associated with different patterns of progression. From a large group of patients with type 2 diabetes ( N = 3,343), the authors identified five clusters of developmental patterns of DR. The largest (cluster A) included patients who did not develop any form of DR over a 6-year period (“persistent no retinopathy”). Cluster B included patients with a high probability of a mild form of DR, which disappeared over time and thus are not at risk for vision loss. Two progressive clusters (C and D) were identified and differed from each other in severity and in speed of developing retinopathy. Finally, a fifth cluster (E) consisted of patients who had persistent proliferative DR, including previous laser treatment.

Perhaps the most important finding was that almost 90% of this population (cluster A) were …
Attenuation of the negative chronotropic effect of myelinated fibers by nonmyelinated fibers in the vagus nerve of the rabbit.
Authors: K J de Neef, J R Jansen, A Versprille
Journal: Circulation Research (1983)

In the adult rabbit, both myelinated and nonmyelinated efferent fibers travel from the cervical vagus nerve to the sinoauricular node. The myelinated fibers convey the negative chronotropic effect. The influence of the nonmyelinated fibers was studied. Stimulation (4/sec) of the myelinated fibers, while the compound action potential was monitored continuously, caused a slowing of the heart rate. Subsequent activation of the non-myelinated fibers attenuated this negative chronotropic effect. Stimulation of adrenergic fibers was excluded, based on data from histochemical studies and the effects of blockade of beta- and muscarinic receptors. The lengthening of the RR interval during activation of the myelinated fibers alone was about 3.5 times larger than during activation of all fiber groups. When the conduction of the myelinated fibers was blocked (anodal block), activation of the nonmyelinated fibers did not show any effect on heart rate. It was concluded that the negative chronotropic effect is conducted via small myelinated fibers and that the nonmyelinated fibers modulate the effect of these cardiomotor fibers, without having an effect on heart rate on their own. This modulation is effected either via a presynaptic mechanism on preganglionic fibers or via an interaction with postganglionic neurons. The nonmyelinated fibers constitute a novel peripheral system to modulate heart rate.
OBSERVATIONS ON THREE CASES OF SCURVY
Authors: VILHJÁLMUR STEFÁNSSON
Journal: JAMA (1918)

The winter of 1916-1917 was passed in Melville Island by seventeen members of the Canadian Arctic Expedition. The expedition vessel, the<i>Polar Bear</i>, had failed to reach the island and we expected to live the winter entirely on fresh or dried musk-ox, reindeer, seal and bear meat. During the darkness of winter, however, our sleds got their steel shoeing worn out through a traveling party getting lost among some rocky hills where the sleds had to be dragged scores of miles, mainly over rock. This necessitated my sending a party in midwinter to Winter Harbor on the same island (where in the past several vessels have wintered) to see if they could find abandoned iron or steel and shoe the sleds for the spring work. Some of our people made another trip to the same place during the winter for a different purpose. At Winter Harbor our men found, besides