tbuckley/cabot-search huggingface dataset:
Limited Impact on Health and Access to Care for 19- to 25-Year-Olds Following the Patient Protection and Affordable Care Act
Authors: Meera Kotagal, Adam C. Carle, Larry G. Kessler, David R. Flum
Journal: JAMA Pediatrics (2014)

The Patient Protection and Affordable Care Act (PPACA) allowed young adults to remain on their parents' insurance until 26 years of age. Reports indicate that this has expanded health coverage.To evaluate coverage, access to care, and health care use among 19- to 25-year-olds compared with 26- to 34-year-olds following PPACA implementation.Data from the Behavior Risk Factor Surveillance System and the National Health Interview Survey, which provide nationally representative measures of coverage, access to care, and health care use, were used to conduct the study among participants aged 19 to 25 years (young adults) and 26 to 34 years (adults) in 2009 and 2012.Self-reported health insurance coverage.Health status, presence of a usual source of care, and ability to afford medications, dental care, or physician visits.Health coverage increased between 2009 and 2012 for 19- to 25-year-olds (68.3% to 71.7%). Using a difference-in-differences (DID) approach, after adjustment, the likelihood of having a usual source of care decreased in both groups but more significantly for 26- to 34-year-olds (DID, 2.8%; 95% CI, 0.45 to 5.15). There was no significant change in health status for 19- to 25-year-olds compared with 26- to 34-year-olds (DID, -0.5%; 95% CI, -1.87 to 0.87). There was no significant change for 19- to 25-year-olds compared with 26- to 34-year-olds in the percentage who reported receiving a routine checkup in the past year (DID, 0.3%; 95% CI, -2.25 to 2.85) or in the ability to afford prescription medications (DID, -0.4%; 95% CI, -2.93 to 1.93), dental care (DID, -2.6%; 95% CI, -5.61 to 0.61), or physician visits (DID, -1.7%; 95% CI, -3.66 to 0.26). There was also no change in the percentage who reported receiving a flu shot (DID, 1.9; 95% CI, -1.93 to 4.93). Insured individuals were more likely to report having a usual source of care and a recent routine checkup and were more likely to be able to afford health care than uninsured individuals.Implementation of the PPACA was associated with increased health insurance coverage for 19- to 25-year-olds without significant changes in perceived health care affordability or health status. Although the likelihood of having a usual source of care declined between 2009 and 2012 for all, this decrease was smaller among 19- to 25-year-olds, and younger adults were more likely than 26- to 34-year-olds to have a usual source of care.
Hepatobiliary Imaging in Choledocholithiasis
Authors: PATRICK M. COLLETTI, PHILIP W. RALLS, STEWART A. LAPIN, MICHAEL E. SIEGEL, JAMES M. HALLS
Journal: Clinical Nuclear Medicine (1986)

A retrospective analysis of preoperative biliary imaging and ultrasound in 22 patients with surgically proven choledocholithiasis was performed. Ultrasound detected dilated ducts greater than 7 mm in 11 of 14 jaundiced patients (79%). Hepatobiliary imaging was able to detect either absent or delayed bowel visualization or prominent bile ducts in 13 of 14 jaundiced patients (93%). Of eight nonjaundiced patients, ultrasound showed dilated ducts in three (38%). Hepatobiliary imaging showed either absent bowel activity or prominent ducts in six of eight nonjaundiced patients (75%). Twenty of 22 patients had stones in the gallbladder that were detected by ultrasound, although only one patient had actual visualization of the common duct stone. Hepatobiliary imaging may show abnormalities in choledocholithiasis with normal ultrasound studies.
The Forward Plan (or Wish?) for Health
Authors: Daniel S. Greenberg
Journal: New England Journal of Medicine (1976)

The Forward Plan (or Wish?) for HealthApart from its literary opacity, the difficulty with the government's annual Forward Plan for Health is that it confuses wishing with planning.The mixup is understandable, since the Forward Plan, which recently made its third appearance, is a product of the Department of Health, Education, and Welfare, whose function is to intervene in American life under an administration that purports to be antiinterventionist.Doubt not what HEW's health planners would do if they could acquire control over the nation's healthcare industry, for their intentions have been clearly delineated in these plans, each . . .
Gastro-intestinal Ulceration and Non-ulcerative Dyspepsia in an Urban General Practice
Authors: S. Lipetz
Journal: BMJ (1955)

PEPTIC ULCERB JOURNAL on re-examination by Qvigstad and Romcke (1946) became 22% and 10% after a further five years.Ogilvie (1952), in comparing the results of surgical and medical treatment of 660 cases, found 34% satisfactory after medical treatment and 70% satisfactory after surgical treatment after 5-10 years.
Efficacy of NS-018, a potent and selective JAK2/Src inhibitor, in primary cells and mouse models of myeloproliferative neoplasms
Authors: Y Nakaya, K Shide, T Niwa, J Homan, S Sugahara, T Horio, K Kuramoto, T Kotera, H Shibayama, K Hori, H Naito, K Shimoda
Journal: Blood Cancer Journal (2011)

Aberrant activation of Janus kinase 2 (JAK2) caused by somatic mutation of JAK2 (JAK2V617F) or the thrombopoietin receptor (MPLW515L) plays an essential role in the pathogenesis of myeloproliferative neoplasms (MPNs), suggesting that inhibition of aberrant JAK2 activation would have a therapeutic benefit. Our novel JAK2 inhibitor, NS-018, was highly active against JAK2 with a 50% inhibition (IC(50)) of <1 n, and had 30-50-fold greater selectivity for JAK2 over other JAK-family kinases, such as JAK1, JAK3 and tyrosine kinase 2. In addition to JAK2, NS-018 inhibited Src-family kinases. NS-018 showed potent antiproliferative activity against cell lines expressing a constitutively activated JAK2 (the JAK2V617F or MPLW515L mutations or the TEL-JAK2 fusion gene; IC(50)=11-120 n), but showed only minimal cytotoxicity against most other hematopoietic cell lines without a constitutively activated JAK2. Furthermore, NS-018 preferentially suppressed in vitro erythropoietin-independent endogenous colony formation from polycythemia vera patients. NS-018 also markedly reduced splenomegaly and prolonged the survival of mice inoculated with Ba/F3 cells harboring JAK2V617F. In addition, NS-018 significantly reduced leukocytosis, hepatosplenomegaly and extramedullary hematopoiesis, improved nutritional status, and prolonged survival in JAK2V617F transgenic mice. These results suggest that NS-018 will be a promising candidate for the treatment of MPNs.
Radiotracer Visualization Within a Saline Breast Implant Due to Inadvertent Needle Penetration During Lymphoscintigraphy
Authors: Frank I. Lin, Cameron C. Foster, David K. Shelton
Journal: Clinical Nuclear Medicine (2011)

A 36-year-old woman with biopsy-proven infiltrating ductal carcinoma of the left breast is referred for lymphoscintigraphy prior to left mastectomy with reconstruction and sentinel lymph node biopsy. The patient had a history of bilateral subpectoral saline breast augmentation performed 8 years prior using a periareolar surgical approach. Injection of Tc-99m filtered sulfur colloid was performed peritumorally under real-time ultrasound guidance. Immediate static images demonstrate good tracer deployment with 2 left axillary lymph nodes identified. However, an additional circular area of increased tracer activity was observed underlying the injection sites that likely represents inadvertent tracer injection into the saline breast implant.
Hepatic Imaging in Diffuse Liver Disease
Authors: WALTER E. DRANE, MICHAEL M. VanNESS
Journal: Clinical Nuclear Medicine (1988)

An analysis of hepatic imaging (liver-spleen scintigraphy, ultrasonography, and computed tomography) was performed in 91 patients prospectively referred for percutaneous liver biopsy for suspected chronic liver disease. Hepatic imaging was performed in 51 of 91 patients (56%). Of these 51 patients, 42 (82%) underwent radionuclide imaging, whereas only seven (14%) underwent ultrasonography and only two (4%) underwent computed tomography performed. Scintigraphy revealed evidence of diffuse liver disease in 40 of 42 patients (95%) vs 0 of 7 patients (0%) for ultrasonography (P less than 0.0001). The frequency of imaging varied significantly by prebiopsy presumptive diagnosis, but this pattern was primarily a reflection of patient age. Imaging was performed in 76% of patients over 50 years of age vs 37% of patients below this age (P less than 0.001). In the hospital, scintigraphy is still prominently used as a screening tool before referral for percutaneous liver biopsy. Justification of this use involves multiple reasons beyond simply a diagnosis.
Hallux-to-Hand Transfer During Ankle Disarticulation for Multiple Limb Anomalies
Authors: Roy A. Meals
Journal: JAMA (1983)

FOR TRAUMATIC loss of the thumb, the techniques and results of hallux transfer for hand reconstruction are well established. In addition, there are several reports of toe-to-hand transfer for reconstruction of the congenitally deficient hand. Most of these cases involved transfer of a normal toe from a normal foot<sup>1</sup>; in several cases, abnormal toes from cleft feet were transferred.<sup>2,3</sup>This case report highlights the treatment of a child who was born with four anomalous limbs. He required an ankle disarticulation because of a severely unstable ankle. During the preoperative planning of amputation, the usefulness of the amputated foot tissues for hand reconstruction was discussed, and a microsurgical hallux-to-hand transfer was performed at the time of ankle disarticulation. <h3>Report of a Case</h3> The patient had four anomalous limbs at birth. No specific etiologic factor could be identified. The left upper limb had syndactylous ring and little fingers; the thumb,
Sterilisation of mentally handicapped woman.
Authors: C Dyer
Journal: BMJ (1987)

Dyer reports on a case that has provoked widespread media comment in Great Britain. In In re B (A Minor), the Court of Appeal authorized an operation to sterilize a 17-year-old girl with a mental age of 5 or 6. If the case goes to the House of Lords, as requested by the Official Solicitor, a quick ruling will be necessary if the operation is to be carried out before the girl's 18th birthday, when she will no longer be a ward of court. The point of law involved, according to the Solicitor, is whether it is an abuse of wardship jurisdiction to authorize the sterilization of a girl within two months of her 18th birthday when, if she were not mentally handicapped, the court would not act. A gap in the law leaves no one in a position to consent to sterilization or to abortion involving a mentally handicapped adult, though a physician can act without consent in an emergency.
THE TRANSPLANTATION OF SPLENIC TISSUE INTO THE SUBCUTANEOUS FASCIA OF THE ABDOMEN IN RABBITS
Authors: O. T. Manley, David Marine
Journal: The Journal of Experimental Medicine (1917)

We have not found in the literature a report of an instance of permanent homoio or autotransplantation of the spleen, or of the probably closely related spleno and hemolymph glands. Spleen autotransplants with considerable difficulty as compared with thyroid, parathyroid, ovary, or adrenal cortex. This may be due to its complex anatomical structure. An instance of a permanent autotransplant has been observed. None of our attempts to homoiotransplant it were successful beyond the usual taking and persistence for 2 or 3 weeks, common to all homoiografts. The successful permanent subcutaneous autotransplantation had all the morphological characteristics of a fully differentiated and functionally active spleen. This method of transplantation would seem to offer a means of learning more of the normal development, regeneration, and function of this complex tissue.
A Comparative Mitogenomic Analysis of the Potential Adaptive Value of Arctic Charr mtDNA Introgression in Brook Charr Populations (Salvelinus fontinalis Mitchill)
Authors: Sarah Doiron, Louis Bernatchez, Pierre U. Blier
Journal: Molecular Biology and Evolution (2002)

Wild brook charr populations (Salvelinus fontinalis) completely introgressed with the mitochondrial genome (mtDNA) of arctic charr (Salvelinus alpinus) are found in several lakes of northeastern Québec, Canada. Mitochondrial respiratory enzymes of these populations are thus encoded by their own nuclear DNA and by arctic charr mtDNA. In the present study we performed a comparative sequence analysis of the whole mitochondrial genome of both brook and arctic charr to identify the distribution of mutational differences across these two genomes. This analysis revealed 47 amino acid replacements, 45 of which were confined to subunits of the NADH dehydrogenase complex (Complex I), one in the cox3 gene (Complex IV), and one in the atp8 gene (Complex V). A cladistic approach performed with brook charr, arctic charr, and two other salmonid fishes (rainbow trout [Oncorhynchus mykiss] and Atlantic salmon [Salmo salar]) revealed that only five amino acid replacements were specific to the charr comparison and not shared with the other two salmonids. In addition, five amino acid substitutions localized in the nad2 and nad5 genes denoted negative scores according to the functional properties of amino acids and, therefore, could possibly have an impact on the structure and functional properties of these mitochondrial peptides. The comparison of both brook and arctic charr mtDNA with that of rainbow trout also revealed a relatively constant mutation rate for each specific gene among species, whereas the rate was quite different among genes. This pattern held for both synonymous and nonsynonymous nucleotide positions. These results, therefore, support the hypothesis of selective constraints acting on synonymous codon usage.
Adult-Onset Hirschsprung's Disease
Authors: Paul B. Lesser
Journal: JAMA (1979)

THE MAJORITY of reported cases of Hirschsprung's disease (aganglionic megacolon) or its variant, hypoganglionosis, have been in newborns and infants. Little attention has been paid to the late manifestation of this disease. We report a case of a 53-year-old man who showed symptoms of aganglionic megacolon late in life, perhaps made clinically apparent as a result of the use of antipsychotic medication. <h3>Report of a Case</h3> A 53-year-old man was admitted to the hospital complaining of abdominal distension, anorexia, and two weeks of watery diarrhea. His medical history indicated a lack of gastrointestinal symptoms, as he previously had two well-formed bowel movements per day. At the age of 51 years, he was seen for some neuropsychiatric symptoms, and a treatment of phenothiazine and anticholinergic medication was started. Since first taking these medications, the patient began complaining of constipation consisting of one bowel movement every three to four days. On admission
Both ETA and ETB receptors mediate contraction to endothelin-1 in human blood vessels.
Authors: B Seo, B S Oemar, R Siebenmann, L von Segesser, T F Lüscher
Journal: Circulation (1994)

Endothelin (ET)-1 has potent vascular effects. Two endothelin receptors have been cloned, namely, the ETA receptor, which preferentially binds ET-1, and the ETB receptor, which equally binds ET-1 and ET-3 and preferentially sarafotoxin S6c. We characterized endothelin receptor subtypes on vascular smooth muscle and endothelium of isolated human internal mammary artery (IMA) and vein (IMV) and porcine coronary artery (PCA) using the ETA antagonists FR139317 and BQ-123, the ETB ligand sarafotoxin S6c, and the ETA/ETB antagonist Ro 47-0203 (bosentan).In endothelium-denuded IMA and PCA and less so in IMV, FR139317 and BQ-123 (in PCA only) shifted the concentration-contraction curves to ET-1 parallel to the right. However, even at 10(-5) mol/L, FR139317 did not inhibit a high-sensitivity portion of the concentration-contraction curve. Moreover, the ETB receptor agonist sarafotoxin S6c induced contraction in vessels preincubated with FR139317. IMV was significantly more sensitive to the contractile effect of ET-1 and sarafotoxin S6c than was IMA (P < .05). Prolonged incubation with sarafotoxin S6c (to downregulate ETB receptors) and FR139317 eliminated the contraction resistant to FR139317. The ETA/ETB receptor antagonist bosentan caused a parallel shift of the concentration-contraction curve to the right at all concentrations of endothelin. ETB receptor mRNA was detected by Northern blot analysis in IMA and aortic smooth muscle cells. In precontracted IMA and PCA with endothelium, sarafotoxin S6c did not cause endothelium-dependent relaxations, whereas transient responses occurred in IMV.Vascular smooth muscle cells of human IMA, IMV, and PCA contain both ETA and ETB receptors, whereas the endothelium of IMA and PCA does not express functional ETB receptors linked to nitric oxide and/or prostacyclin production. Hence, inhibition of endothelin-induced contraction in patients requires the use of combined ETA/ETB antagonists.
Tc-99m PMT Hepatobiliary Scintigraphy in the Differential Diagnosis of Extrahepatic Metastases and Hepatocellular Carcinoma
Authors: TERUHITO MOCHIZUKI, TAKAHARU TSUDA, YOSHIFUMI SUGAWARA, HIROAKI TANAKA, TAKANORI KIKUCHI, MASAO MIYAGAWA, KENJI SHIMIZU, KENYA MURASE, HEDEHITO IUCHI, MORIKAZU ONJI, JUNPEI IKEZOE
Journal: Clinical Nuclear Medicine (2000)

The authors evaluated the utility of hepatobiliary scintigraphy for tissue characterization of extrahepatic metastases from hepatocellular carcinoma (HCC) using Tc-99m N-pyrydoxyl-5-methyltriptophane (Tc-99m PMT).We examined 13 patients with HCC (29 extrahepatic metastases and 3 benign bone lesions) and 5 patients with other cancers (15 extrahepatic metastases). Thirty minutes to 6 hours after intravenous administration of Tc-99m PMT, planar (all 47 lesions) and SPECT (42 lesions) images were obtained. Accumulation of Tc-99m PMT in the lesion was evaluated visually by comparing bone scintigraphy, computed tomography, magnetic resonance imaging, or all of these.Findings were positive in 12 of 13 patients with HCC and extrahepatic metastases (16 of 29 on planar imaging and 21 of 26 on SPECT). Findings in all three benign bone lesions and 15 metastatic lesions from non-HCC primary lesions were negative (0 of 18 on planar imaging, 0 of 16 on SPECT). There were no false-positive findings in these lesions. Lesion-by-lesion sensitivity, specificity, accuracy, and positive and negative predictive values were 55%, 100%, 72%, 100%, and 58% by planar imaging and 81%, 100%, 88%, 100%, and 76% by SPECT, respectively.Because of the high specificity and reasonable sensitivity, Tc-99m PMT appears to be useful for the differential diagnosis of extrahepatic metastases from HCC. SPECT improves the detectability of small or faint accumulation in metastases from HCC.
Wife abuse. The diagnosis and its implications
Authors: J. A. Petro
Journal: JAMA (1978)

Wife abuse is receiving widespread attention in the lay press, but its discussion in the medical literature has been rare. Identifying a victim of wife abuse is complicated, since these women will seldom volunteer that information. There are no economic, educational, or class predictors of wife abuse. Suspicion of abuse should be aroused if there is (1) a substantial delay between time of injury and presentation for treatment, (2) evidence of repeated injuries to the face and neck, or (3) a previous history of abuse. Social agencies for the care and counseling of these victims exist and should be used. (<i>JAMA</i>240:240-241, 1978)
A Pill for Impotence
Authors: Robert D. Utiger
Journal: New England Journal of Medicine (1998)

Impotence — the preferred term is now erectile dysfunction — is a common problem, especially among older men,1 and if it is not caused by psychological problems it certainly can cause them. Among the components of sexual function and satisfaction in men — desire, erectile function, orgasmic function, ejaculation, and fertility — decreased erectile function is not only the most common but also the most distressing and threatening. It can destroy a man's ego and threaten happy relationships.In this issue of the Journal, Goldstein et al. describe the efficacy of oral sildenafil in men with erectile dysfunction.2 This is . . .
Disparities in Evaluation of Patients With Rectal Bleeding 40 Years and Older
Authors: Helen M. Shields, Elena M. Stoffel, Daniel C. Chung, Thomas D. Sequist, Justin W. Li, Stephen R. Pelletier, Justin Spencer, Jean M. Silk, Bonita L. Austin, Susan Diguette, Jean E. Furbish, Ruth Lederman, Saul N. Weingart
Journal: Clinical Gastroenterology and Hepatology (2013)
Concentration of organochlorines in human brain, liver, and adipose tissue autopsy samples from Greenland.
Authors: E Dewailly, G Mulvad, H S Pedersen, P Ayotte, A Demers, J P Weber, J C Hansen
Journal: Environmental Health Perspectives (1999)

Organochlorines are persistent lipophilic compounds that accumulate in Inuit people living in circumpolar countries. Organochlorines accumulate as a result of the Inuits' large consumption of sea mammal fat; however, available data are limited to blood lipids, milk fat, and adipose tissue. We report results of organochlorine determination in liver, brain, omental fat, and subcutaneous abdominal fat samples collected from deceased Greenlanders between 1992 and 1994. Eleven chlorinated pesticides and 14 polychlorinated biphenyl congeners were measured in tissue lipid extracts by high-resolution gas chromatography with electron capture detection. Mean concentrations of polychlorinated biphenyls, 2, 2'-bis(4-chlorophenyl)-1,1-dichloroethylene, ss-hexachlorocyclohexane, hexachlorobenzene, mirex, trans-nonachlor, and oxychlordane in adipose tissue samples from Greenlanders were 3-34-fold higher than those measured using the same analytical method in samples from Canadians in Quebec City, Quebec. Brain lipids contained lower concentrations of all organochlorines than lipids extracted from other tissues. Organochlorine residue levels in lipid extracts from liver, omental fat, and subcutaneous abdominal fat samples were similar, with the exception of ss-hexachlorocyclohexane, which reached a greater concentration in liver lipids than in lipids from both adipose tissues (4-fold; p < 0. 05). Comparisons with available international data on adipose tissue levels reveal that the organochlorine body burden in the Inuit population of Greenland is presently among the highest resulting from environmental exposure.
The Clinical Pharmacist
Authors: George D. Lundberg
Journal: JAMA (1983)

In the early 1960s, pharmacy as a profession had come upon hard times. Pharmacists were being trained excessively to do what they spent most of their time doing, namely, counting tablets and typing labels (typing wasn't even part of the curriculum). Similarly, although problems with drugs were rife through our civilization, pharmacists were not trained fully enough to be particularly helpful in this area. Recognizing these inadequacies, groups of forward-thinking educators, especially at the University of California, San Francisco, the University of the Pacific at Stockton, Calif, and the University of Southern California, had the notion that such things as the counting of tablets and typing of labels could be done by pharmacy technicians. Also, they reasoned that the large gaps that existed between ideal use of drugs and what was actually happening might be filled in part by the creation of a new breed of professional, the clinical pharmacist.
Three Demonstrations ON MALFORMATIONS OF THE HIND END OF THE BODY: Given at the Royal College of Surgeons, England
Authors: A. Keith
Journal: BMJ (1908)

THE specimens for to-day's demonstration illustrate a subject in which Hunter's knowledge was a, hundred years and more ahead of his time.On the table' are his celebrated' preparations of the sexual organs of "free martins," of the foal-ass, of the sheep from the West Indies, and others described in his writings.The anomalous condition seen in these and similar prepara- tions he ascribed to an absence of the "stimulus of