tbuckley/cabot-search huggingface dataset:
The Effect of Providing Health Coverage to Poor Uninsured Pregnant Women in Massachusetts
Authors: Jennifer S. Haas
Journal: JAMA (1993)

There has been substantial policy interest in whether the provision of health coverage to poor uninsured pregnant women affects access to prenatal care and birth outcomes. We therefore examined whether the statewide provision of health coverage to uninsured low-income pregnant women affects access to prenatal care and infant birth outcomes.Natural experiment.All in-hospital, single-gestation live births in 1984 (N = 57,257) and 1987 (N = 64,346).In 1985, Massachusetts instituted Healthy Start, a program providing health coverage to uninsured pregnant women with incomes below 185% of the federal poverty level.Rates of satisfactory prenatal care, care initiated before the third trimester, and adverse infant outcome for uninsured women and for two concurrent control groups, women with Medicaid, and women with private insurance. We calculated the difference in rates between the uninsured and each concurrent control. To assess the effect of the program, we examined the change in these interpayer differences in rates between 1984 and 1987.Between 1984 and 1987, the rate of satisfactory prenatal care declined from 96.4% to 93.8% for all women in Massachusetts (P < .001). There was no statewide change in the overall incidence of adverse birth outcome (6.6% in both years). In 1984, uninsured women were less likely than privately insured women to receive satisfactory prenatal care (90.5% and 98.1%, respectively; interpayer difference, -7.6%) and to initiate care before the third trimester (94.2% and 99.1%; interpayer difference, -4.9%), and were more likely to suffer an adverse birth outcome (7.1% and 5.8%; interpayer difference, 1.3%). Between 1984 and 1987, there were no statistically significant changes in the interpayer differences in rates for any of the outcome measures relative to either control group.Our findings suggest that access to prenatal care may have declined for all women in Massachusetts between 1984 and 1987. In the setting of this statewide decline in access, the expansion of health coverage to uninsured low-income pregnant women was not associated with an improvement in access to prenatal care or birth outcomes.
Lower limb injuries.
Authors: N. Roberts
Journal: BMJ (1968)

High-dosage Fluphenaze SIR,-Comment in your correspondence column has drawn attention to side-effects ol phenothiazines,"' and there is current interest in the use of fluphenazine enanthate.4wish to draw attention to the value of highdose oral fluphenazine administration in acute schizophrenic illness.This therapeutic approach to a broad cross-section of psychotic
Primary meningococcal pericarditis. Diagnosis by counter-current immunoelectrophoresis
Authors: H. B. Simon
Journal: JAMA (1976)

PURULENT pericarditis is an uncommon disorder that often escapes clinical detection despite its lifethreatening nature.1Appropriate management requires vigorous antimicrobial therapy and, in most cases, surgical drainage. Identification of the responsible pathogen is of paramount importance. We report a patient with pericardial tamponade who was found to have primary meningococcal pericarditis. The diagnosis was suggested by the Gram stain of the pericardial fluid, but, because the patient had recently been given antibiotics, cultures were negative. A new technique, counter-current immunoelectrophoresis (CIE), was used to confirm the etiologic diagnosis. This is, to our knowledge, the first time CIE has been used successfully in the diagnosis of purulent pericarditis.  Report of a Case  A 49-year-old mother of four was in excellent health until 10:45 AM on Aug 1, 1974, when she experienced an abrupt rigor followed promptly by fever and diffuse myalgia. She remained bedridden for 48 hours, with fever, sweats,
Post-mortem Bacteriology
Authors: A. J. Wort, E. W. Walton
Journal: BMJ (1966)

BRDITALsH 611 treated disks.A collar or traction do not achieve this.The range of extension can be increased by means of a relaxed extension lying on a block under the upper dorsal region.The active extension must be carried out lying supine, and arching up to lie on back of head and buttocks.Carried out in this way ,the spine is not weight-bearing.It must be done as a stretch, not as physical jerks.This treatment has been carried out for a good many years in the hospitals I visit, 'with gratifying results.-Iam, etc.,
Biologic Rhythms in Hyperthyroidism.
Authors: D. H. Mintz
Journal: Annals of Internal Medicine (1963)

s1 April 1963Biologic Rhythms in Hyperthyroidism.D. H. Mintz, M.D., M. M. Martin, M.D., J. J. Canary, M.D., D. Hellman, M.D.D. H. Mintz, M.D.Search for more papers by this author, M. M. Martin, M.D.Search for more papers by this author, J. J. Canary, M.D.Search for more papers by this author, D. Hellman, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-58-4-719_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHyperthyroroism is known to increase 24-hour urinary 17-hydroxycortico-steroid (17OHCS) as well as inorganic phosphate excretion. The observation that forenoon phosphate clearance, in contrast, was reduced in hyperthyroidism prompted a study of the circadian variation in serum and urinary inorganic phosphate, and plasma and urinary 17OHCS.Hyperthyroidism, by accelerating steroid degradation and excretion, lowers plasma free 17OHCS and exaggerates the rhythm in plasma conjugated and total urinary 17OHCS. The lack of significant variation in cortisol half-life and minimal differences in adrenal stimulation by exogenous ACTH at different times throughout 24 hours appear to exclude changes in adrenal responsiveness or peripheral steroid... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 April 1963Volume 58, Issue 4Page: 719-719KeywordsAdrenocorticotropic hormoneBiologicsBlood plasmaCortisolExcretionHalf lifeHyperthyroidismPhosphates Issue Published: 1 April 1963 PDF downloadLoading ...
Phenylpropanolamine in Patients With Autonomic Impairment-Reply
Authors: Italo Biaggioni
Journal: JAMA (1987)

<h3>In Reply.—</h3> Kroenke and colleagues are confusing placebo effects with stress reactions. A placebo classically has a mild blood pressure—lowering effect,<sup>1</sup>possibly by reducing the stress associated with blood pressure measurements. On the other hand, a stress reaction to medical testing, such as the one Kroenke and colleagues so vividly describe, may certainly have a pressor effect in normal subjects, but not in patients with severe autonomic failure. Indeed, one of the criteria for this diagnosis is the failure for blood pressure to increase during stress testing (eg, cold pressor test or mental arithmetic).<sup>2</sup>No significant blood pressure elevations in response to a placebo have ever been demonstrated in patients with severe autonomic failure. In our report, we focused on the cardiovascular effects of phenylpropanolamine. We concluded that phenylpropanolamine was a potent pressor agent in patients with autonomic failure based on the following: every one of the patients
Observations on the Culture Diagnosis of Gonorrhea in Women
Authors: John D. Schmale
Journal: JAMA (1969)

Specimens were cultured from women suspected of having venereal disease to determine at which anatomical site or sites Neisseria gonorrhoeae can be most commonly found. Of the four sites examined (cervix, urethra, vagina, and rectum), the cervical site was the single site most often infected. When the results of two sites were combined, the cervical and rectal cultures gave the greatest frequency of detection. Nevertheless, it is felt that 6% to 8% of females with gonorrhea will have negative cultures from all four sites at any one visit.
Hypersensitivity reactions in the small intestine. 2. Effects of allograft rejection on mucosal architecture and lymphoid cell infiltrate.
Authors: T T MacDonald, A Ferguson
Journal: Gut (1976)

Small intestinal mucosa contains both thymus dependent and thymus independent lymphoid cells and thus has the capacity to act via humoral and cellular mechanisms as a site of local immunity and local hypersensitivity. Allograft rejection of mouse small intestine is a model of a local cell mediated reaction. The effects of this clearly defined, immunologically mediated damage villi, crypts, enterocytes, and lymphoid cell infiltrate have been assessed by comparing the morphology of rejecting allografts with that of isografts and normal small intestine of the same age. In rejection there is infiltration of the lamina propria with lymphocytes, hyperplasia of the crypts of Lieberkuhn, and an eventual sloughing off of the mucosa. Usually, but not always, there is villous atrophy and increased numbers of intraepithelial lymphocytes. However, the morphology of individual enterocytes remains normal throughout rejection and neither plasma cells nor polymorphonuclear leucocytes infiltrate the lamina propria before mucosal ulceration. These results show unequivocally that a local T cell mediated immune response causes villous atrophy and crypt hyperplasia in this animal model, and since there is no evidence of local enterocyte cytotoxicity, a lymphokine may be the link between the activated T cell and the effects on mucosal architecture. We suggest that a local CMI reaction may be the cause of villous atrophy, crypt hyperplasia, and malabsorption in many clinical and experimental conditions, including coeliac disease, food allergy, and intestinal infections.
Deletion of 3 residues from the C-terminus of MCFD2 affects binding to ERGIC-53 and causes combined factor V and factor VIII deficiency
Authors: Beat Nyfeler, Yukiko Kamiya, Françoise Boehlen, Kazuo Yamamoto, Koichi Kato, Philippe de Moerloose, Hans-Peter Hauri, Marguerite Neerman-Arbez
Journal: Blood (2007)
Number of midwives is critically low in many poor countries, study shows
Authors: P. Moszynski
Journal: BMJ (2011)

Up to 3.6 million deaths would be avoided each year if midwifery services in 58 developing countries were upgraded by 2015, says the United Nations Population Fund.

Each year some 358 000 women die in pregnancy or while giving birth, two million newborns die within the first 24 hours, and there are 2.6 million stillbirths because of “inadequate or insufficient healthcare,” says a report launched by the fund at this week’s triennial congress of the International Confederation of Midwives in Durban, South Africa.

Most of these countries were “suffering from a crisis in human resources for health,” the report says. Women in these countries …
Sex differences in whole body skeletal muscle mass measured by magnetic resonance imaging and its distribution in young Japanese adults
Authors: T Abe, C F Kearns, T Fukunaga
Journal: British Journal of Sports Medicine (2003)

Objectives: To determine sex differences in the distribution of regional and total skeletal muscle (SM) using contiguous whole body magnetic resonance imaging (MRI) data, and to examine the relations between fat free mass (FFM) and total and regional SM masses. Methods: A total of 20 Japanese college students (10 women and 10 men) volunteered for the study. FFM was measured by two compartment densitometry. Whole body MRI images were prepared using a 1.5 T scanner. Contiguous transverse images with 1.0 cm slice thickness were obtained from the first cervical vertebra to the ankle joints. All MRI scans were segmented into four components (SM, subcutaneous adipose tissue, bone, and residual tissues). In each slice, the SM tissue cross sectional areas (CSAs) were digitised, and the muscle tissue volume per slice was calculated by multiplying muscle CSA by slice thickness. SM volume units (litres) were converted into mass units (kg) by multiplying the volumes by the assumed constant density (1.041 mg/ml) for SM. Results: The SM distribution pattern (shape of curve) from the contiguous whole body slices was essentially similar for the two sexes, with two large peaks and three smaller peaks (arms excluded). However, the largest peak was observed at the upper portion of the thigh for women and at the level of the shoulder for men. Men had larger (p&lt;0.01) total and regional SM mass than women. All regional SM masses correlated highly ( r = 0.90–0.99, p&lt;0.01) with total SM mass. A strong positive correlation was observed between FFM and total and regional SM masses in both sexes (women, r = 0.95; men, r = 0.90; all p&lt;0.01). As FFM increased, there was a corresponding increase in SM/FFM ratio for all subjects ( r = 0.86, p&lt;0.01). Conclusions: Sex differences in total SM/FFM ratio and regional SM distributions are associated with the degree of absolute FFM accumulation in men and women.
Audit of practice based cervical smear programme: completion of the cycle.
Authors: P. A. Creighton, A. M. Evans
Journal: BMJ (1992)

To determine the effectiveness of a practice based cervical screening programme and the changing pattern of abnormal smear results and to improve the quality of care provided for patients.Audit of practice held data on cervical screening from 1980 to 1990. Changes in the programme were made after analysis of first five years' data.Mixed urban and rural practice of 10,900 patients in Northumberland.Women aged 20-65 who had not had a hysterectomy.2356 (85.1%) of the 2767 targeted women had a test during 1980-5 and 2498 (89.5%) of the 2790 women had a test during 1985-90. Inviting women aged 20-25 to attend for a test increased coverage from 45.8% (146/319) in 1980-5 to 82.5% (282/342) in 1985-90. The proportion of women with abnormalities requiring hospital referral rose in the second half of the study, especially among younger women (from 17/39 (44%) to 45/64 (70%) in women aged 25-34).Practice based cervical screening programmes can be highly effective. Cytological abnormalities affect patients psychologically as well as physically and practices should provide support and explanation for patients with abnormal results. Data from individual practices should be aggregated to allow health authorities to plan secondary care effectively.
Genome-wide association study identifies variants in TMPRSS6 associated with hemoglobin levels
Authors: John C Chambers, Weihua Zhang, Yun Li, Joban Sehmi, Mark N Wass, Delilah Zabaneh, Clive Hoggart, Henry Bayele, Mark I McCarthy, Leena Peltonen, Nelson B Freimer, Surjit K Srai, Patrick H Maxwell, Michael J E Sternberg, Aimo Ruokonen, Gonçalo Abecasis, Marjo-Riitta Jarvelin, James Scott, Paul Elliott, Jaspal S Kooner
Journal: Nature Genetics (2009)
A Critical Analysis of RBRVS
Authors: John D. Rowlett
Journal: JAMA (1992)

<h3>To the Editor.</h3> —As a board-certified pediatrician in a hospital-based practice, I am not, at least currently, affected by the proposed RBRVS or HCFA payment systems. Nonetheless, I found the article by Dr Maloney<sup>1</sup>to be interesting and would like to share a few related thoughts. First, I think it is unfair to use data collected in the 1970s<sup>2</sup>to represent the hours worked by physicians in the 1990s. Cook<sup>3</sup>recently reported a median of 60 hours per week for both surgical and nonsurgical physicians. Further, she found that 46% of all surgical specialists, compared with 36% of all nonsurgical specialists, were practicing below full capacity. This casts doubt on Maloney's conclusion that the difference in salaries is essentially due to a difference in the number of working hours. Second, I question the appropriateness of "weighting" hours worked (1.5 per hour between 40 to 48 and 2.0
Comparison of “Risk-Adjusted” Hospital Outcomes
Authors: David M. Shahian, Sharon-Lise T. Normand
Journal: Circulation (2008)

A frequent challenge in outcomes research is the comparison of rates from different populations. One common example with substantial health policy implications involves the determination and comparison of hospital outcomes. The concept of "risk-adjusted" outcomes is frequently misunderstood, particularly when it is used to justify the direct comparison of performance at 2 specific institutions.Data from 14 Massachusetts hospitals were analyzed for 4393 adults undergoing isolated coronary artery bypass graft surgery in 2003. Mortality estimates were adjusted using clinical data prospectively collected by hospital personnel and submitted to a data coordinating center designated by the state. The primary outcome was hospital-specific, risk-standardized, 30-day all-cause mortality after surgery. Propensity scores were used to assess the comparability of case mix (covariate balance) for each Massachusetts hospital relative to the pool of patients undergoing coronary artery bypass grafting surgery at the remaining hospitals and for selected pairwise comparisons. Using hierarchical logistic regression, we indirectly standardized the mortality rate of each hospital using its expected rate. Predictive cross-validation was used to avoid underidentification of true outlying hospitals. Overall, there was sufficient overlap between the case mix of each hospital and that of all other Massachusetts hospitals to justify comparison of individual hospital performance with that of the remaining hospitals. As expected, some pairwise hospital comparisons indicated lack of comparability. This finding illustrates the fallacy of assuming that risk adjustment per se is sufficient to permit direct side-by-side comparison of healthcare providers. In some instances, such analyses may be facilitated by the use of propensity scores to improve covariate balance between institutions and to justify such comparisons.Risk-adjusted outcomes, commonly the focus of public report cards, have a specific interpretation. Using indirect standardization, these outcomes reflect a provider's performance for its specific case mix relative to the expected performance of an average provider for that same case mix. Unless study design or post hoc adjustments have resulted in reasonable overlap of case-mix distributions, such risk-adjusted outcomes should not be used to directly compare one institution with another.
STUDIES ON THE MECHANISM OF RECOVERY IN PNEUMONIA DUE TO FRIEDLÄNDER'S BACILLUS
Authors: Llewellyn Sale, Mary Ruth Smith, W. Barry Wood
Journal: The Journal of Experimental Medicine (1947)

Sulfonamide chemotherapy was found to cure rats of an otherwise fatal form of experimental Friedländer's bacillus pneumonia when treatment was begun 6 hours after inoculation. Most of the pneumonic lesions cleared completely, but an occasional animal exhibited small residual abscesses in the previously consolidated lung. The recovery process taking place in the lungs was studied histologically at various intervals during therapy. As in the case of pneumococcal pneumonia, the principal action of the sulfonamide was upon the bacteria in the advancing edema zone at the periphery of the pneumonic lesion. The bacteriostatic action of the drug appeared to stop the spread of the pneumonia, and the Friedländer bacilli were ultimately ingested and destroyed by the phagocytic cells in the alveolar exudate. The phagocytosis of bacteria in the lung was shown to be unrelated to the presence of antibody in the blood.
Acute generalized exanthematous pustulosis does not always have a drug-related cause
Authors: A.J. Birnie, S.M. Litlewood
Journal: British Journal of Dermatology (2008)

Journal Article Acute generalized exanthematous pustulosis does not always have a drug‐related cause Get access A.J. Birnie, A.J. Birnie Department of Dermatology, Queen’s Medical Centre, Nottingham NG7 2UH, U.K. E‐mail: birnieandrew@hotmail.com Search for other works by this author on: Oxford Academic Google Scholar S.M. Litlewood S.M. Litlewood Department of Dermatology, Queen’s Medical Centre, Nottingham NG7 2UH, U.K. E‐mail: birnieandrew@hotmail.com Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 159, Issue 2, 1 August 2008, Pages 492–493, https://doi.org/10.1111/j.1365-2133.2008.08638.x Published: 01 August 2008
Nadolol and Papilledema
Authors: SANJIV KAUL
Journal: Annals of Internal Medicine (1982)

Letters and Corrections1 September 1982Nadolol and PapilledemaSANJIV KAUL, M.D., MAYLENE WONG, M.D., BRAMAH N. SINGH, M.D., D. PHIL., ROBERT S. HEPLER, M.D.SANJIV KAUL, M.D.Search for more papers by this author, MAYLENE WONG, M.D.Search for more papers by this author, BRAMAH N. SINGH, M.D., D. PHIL.Search for more papers by this author, ROBERT S. HEPLER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-97-3-454_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Nonspecific visual disturbances have been reported with the use of most beta-adrenergic blocking agents (1, 2). Serious ocular disorders, however, have not been described for any of these compounds except in the case of practolol (3). Nadolol, a long-acting beta-antagonist has been marketed in the United States since January 1980. Visual disturbances have been reported with this drug but objective evidence of serious ocular disturbance has not been documented (4, 5).A 58-year-old white man was started on 40 mg of nadolol a day for hypertension. After the first dose the patient had diplopia while playing tennis....References1. GREENBLATTKOCH-WESER DJ. Adverse reactions to propranolol in hospitalised medical patients: a report from the Boston collaborative drug surveillance program. Am Heart J. 1973;86:478-83. CrossrefMedlineGoogle Scholar2. CONOLLYKERSTINGDOLLERY MFC. The clinical pharmacology of beta-adrenoceptor blocking agents. Prog Cardiovasc Dis. 1976;19:203-34. CrossrefMedlineGoogle Scholar3. WRIGHT P. Untoward effect associated with practolol administration: oculocutaneous syndrome. Br Med J. 1975;1:595-8. CrossrefMedlineGoogle Scholar4. HEELBROGDENPAKESSPEIGHTAVERY RRGTG. Nadolol: a review of its pharmacological properties and therapeutic efficacy in hypertension and angina pectoris. Drugs. 1980;20:1-22. CrossrefMedlineGoogle Scholar5. FRISHMAN W. Nadolol: a new beta-adrenoceptor antagonist. N Engl J Med. 1981;305:678-82. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Wadsworth Medical Center UCLA School of Medicine Jules Stein Eye Institute Los Angeles, CA 90073 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByCardiac, Vascular, and Renal DrugsDrug-induced ocular side effectsDrug-induced ocular side effects 1 September 1982Volume 97, Issue 3Page: 454-454KeywordsDrugsHypertension Issue Published: 1 September 1982 PDF DownloadLoading ...
Deliberate Self-intoxication with Petrol
Authors: W. Oldham
Journal: BMJ (1961)

between these two sets of observations.It has been demonstrated that destruction of erythrocytes in hypo- tonic saline solutions is apparently related to intracellular osmotic activity of the individual cells (Sharpsteen, 1955).If this is the case then our findings would seem to indicate yet another " abnormal haemoglobin " which occurs with appreciable frequency in Western Nigeria.The reduced osmotic fragility of the erythrocytes in a percentage of the local population is not related to an increase in the quantity of alkali-resistant haemoglobin, but current studies by one of us (E.J. W.-W.) indicate that it is in some cases associated with increased haemoglobin A, and other characteristics of thalassaemia.1001..