tbuckley/cabot-search huggingface dataset:
Private sector benefits the most from efforts to market NHS skills abroad
Authors: G. Iacobucci
Journal: BMJ (2014)

BACKGROUND: In the United Kingdom little is known about general practitioners9 attitudes to and behaviour concerning clinical guidelines. AIM: A study was performed to investigate these two under-researched areas. METHOD: In 1994 a postal questionnaire on clinical guidelines was sent to all 326 general practitioner principals on the list of Lincolnshire Family Health Services Authority. The questionnaire consisted of 20 attitude statements and an open question on clinical guidelines, as well as surveying characteristics and behaviour of respondents. RESULTS: Of the 326 general practitioners sent questionnaires, 213 (65%) replied. Most respondents (78%) reported having been involved in writing inhouse guidelines. An even greater proportion (92%) reported having participated in clinical audit. Respondents were generally in favour of clinical guidelines, with mean response scores indicating a positive attitude to guidelines in 15 of the 20 statements, a negative attitude in four and equivocation in one. The majority of respondents felt that guidelines were effective in improving patient care (69%). Members (or fellows) of the Royal College of General Practitioners had a more positive attitude than non-members towards guidelines. They were also significantly more likely than non-members to have written inhouse guidelines, as were those who had participated in audit compared with those who had not participated in audit. A substantial minority (over a quarter) of general practitioners were concerned that guidelines may be used for setting performance-related pay, or that they may lead to 9cookbook9 medicine, reduce clinical freedom or stifle innovation. There was also concern that guidelines should be scientifically valid. CONCLUSION: This study suggests that many general practitioners in the Lincolnshire Family Health Services Authority area have produced written inhouse guidelines. This is largely sustained by positive attitudes about the effectiveness and benefits of clinical guidelines. The positive attitude of RCGP members supports it in its continuing role in developing, implementing and evaluating guidelines in primary care. The question of whether incorporation of guidelines into clinical audit is an effective means to disseminate systematic research-based guidelines warrants further study.
The growing burden of cancer in India: epidemiology and social context
Authors: Mohandas K Mallath, David G Taylor, Rajendra A Badwe, Goura K Rath, V Shanta, C S Pramesh, Raghunadharao Digumarti, Paul Sebastian, Bibhuti B Borthakur, Ashok Kalwar, Sanjay Kapoor, Shaleen Kumar, Jennifer L Gill, Moni A Kuriakose, Hemant Malhotra, Suresh C Sharma, Shilin Shukla, Lokesh Viswanath, Raju T Chacko, Jeremy L Pautu, Kenipakapatnam S Reddy, Kailash S Sharma, Arnie D Purushotham, Richard Sullivan
Journal: The Lancet Oncology (2014)
[628] USE OF LOW-DOSE PEGINTERFERON a-2a (40 kD) (PEGASYS®) TO TREAT HEPATITIS C-INFECTED END-STAGE RENAL DISEASE PATIENTS UNDERGOING HAEMODIALYSIS: INTERIM RESULTS FROM A RANDOMISED STUDY
Authors: M. Peck-Radosavljevic, J. Boletis, F. Besisik, M. Lucia Ferra, L. Alric, D. Samuel, D. Messinger, H. Junker, H. Cheinquer
Journal: Journal of Hepatology (2007)
Short stature and risk for mortality and cardiovascular disease events. The Framingham Heart Study.
Authors: J P Kannam, D Levy, M Larson, P W Wilson
Journal: Circulation (1994)

BACKGROUND Several studies have observed an inverse association between height and risk for coronary disease, but it is unclear whether other traditional coronary disease risk factors may have confounded this association. We examined the original Framingham Heart Study cohort to determine whether short stature is associated with all-cause mortality, cardiovascular disease mortality, and myocardial infarction after adjusting for age and other traditional coronary heart disease risk factors. METHODS AND RESULTS A total of 2019 men and 2585 women were followed up to 35.6 years. Subjects were stratified by sex and divided into quartiles according to height. Risk ratios were calculated from proportional hazards analyses comparing the first, second, and third quartiles of height to the tallest quartile before and after adjusting for age, hypertension, smoking, serum cholesterol, diabetes, relative weight, and alcohol intake. In both sexes, there were significant differences in the unadjusted event rates between the shortest and the tallest quartile for all-cause mortality, cardiovascular mortality, and myocardial infarction. Once the analyses were age adjusted, differences among height quartiles persisted only for risk of myocardial infarction in women. Further adjustment for other clinical variables had little additional impact on the results. CONCLUSIONS After considering age and other coronary disease risk factors, short stature was not associated with increased risk for all-cause or cardiovascular mortality in either sex. It was associated with increased risk for myocardial infarction in women but not in men.
The presence of latex can induce false‐positive skin tests in subjects tested with penicillin determinants
Authors: S. Terrados, M. Blanca, J. L. Justicia, F. Moreno, C. Mayorga
Journal: Allergy (1997)

Latex allergens are ubiquitous, and exposure may occur from different sources in the medical environment and in daily life. The observation that subjects with latex allergy were skin test positive lo major and minor to explain these findings. A group of 20 subjects with a history of allergy to latex and with positive skin tests for, but good tolerance of, penicillins was studied. The presence of latex contaminants was studied by RAST and RAST inhibition. Sixteen of the subjects were positive lo at least one of the penicillin determinants used, and 14 (87%) of these were positive to at least two determinants. Repetition of skin tests using the container without a stopper changed the skin test results lo negative in almost all cases, indicating that some trace contaminants had still been present RAST‐inhibition studies showed that in all penicillin determinants there were trace amounts of latex allergens varying between 3 and 0.03 μg/ml. These results indicate that skin tests with penicillin in subjects allergic to latex may give false‐positive results and lead to such patients being falsely diagnosed as allergic to betalactams when penicillins are stored in containers with rubber stoppers.
THE LACK OF DETECTABLE IMMUNE COMPLEXES IN RAT ANAPHYLAXIS
Authors: L. FéSüS, M. KAVAI
Journal: Allergy (1976)

Attempts were made to detect soluble immune complexes (IC) in sera of rats submitted to anaphylactic shock 12 days following BPV plus antigen treatment, and their in vitro formation following the addition of specific antigens to sera or heparinized platelet rich plasma of sensitized rats. We failed to detect ICs or IC formation by studying Hageman factor activation and platelet aggregation or by using a very sensitive radio-assay of ICs. It is established that the anaphylactic activation of Hageman factor as well as the aggregation of platelets are not mediated by immune complexes, therefore, other explanations must be found.
ANATOMICAL VARIATION AFFECTS THE PROCEDURAL ACHIEVEMENT OF THE TRANSRADIAL CARDIAC CATHETERIZATION
Authors: Yohei Numasawa, Shun Kohsaka, Satoshi Mogi, Masashi Takahashi, Ayaka Endo, Takahide Arai, Yohei Ohno, Shinsuke Yuasa, Akira Furuta, Yuichiro Maekawa, Akio Kawamura, Keiichi Fukuda
Journal: Journal of the American College of Cardiology (2011)
Frontiers of Physical Medicine and Rehabilitation
Authors: Lewis A. Leavitt
Journal: JAMA (1960)

Since the advent of sulfonamides and antibiotics the physician finds his time taken up less by infectious diseases and more by the chronic diseases of an aging population. It is important that restorative services be available and that physicians know about rehabilitative agencies available within their communities. For amputees, new types of protheses are being developed for both lower and upper extremities; the fitting of a prosthesis and training of the patient to use it are essential steps in his rehabilitation. The physiatrist functions as a diagnostician, a physician, and a director of broad rehabilitative programs. It can be shown that the economic gain from a good program of rehabilitation far exceeds its cost.
Proceedings of 11th Congress of the International Society of Blood Transfusion, Sydney, 1966
Authors: Frances K. Widmann
Journal: JAMA (1969)

The science of blood transfusion has progressed beyond its earlier, necessary preoccupation with the safest means to pair donor blood with specific recipient. Increasingly selective compatibility testing revealed the existence of myriad red blood cell antigens and, in the years from the mid 1940's to the early 1960's, genetic and serologic investigations produced a dazzling array of systematized antigenic categories. <i>The Proceedings of 11th Congress of the International Society of Blood Transfusion</i>reveal that emphasis has shifted from the red blood cell to the serum elements of blood, to white blood cells and platelets, and to histocompatibility antigens. For the front-bench blood banker, most of the news in these proceedings concerns automation and red blood cell preservation. The delay in publication has rendered this material less new, but it is still far from widespread practical application. The sections on hemolytic disease of the newborn and fetal-maternal incompatibility show how basic
Identification of Hypometabolic Areas in the Brain Using Brain Imaging and Hyperbaric Oxygen
Authors: RICHARD A. NEUBAUER, SHELDON F. GOTTLIEB, AUGUST MIALE
Journal: Clinical Nuclear Medicine (1992)

Current neurologic assessments consider idling neurons and ischemic penumbras to be metabolically lethargic and electrically nonfunctional or nonviable. Diagnosis, prognosis, and therapeutics of central nervous system dysfunctions require differentiation between viable and nonviable neurons. It is necessary to develop and document efficacious and safe techniques for reactivating idling neurons. The authors present a case study of a near drowning 12 years earlier. Areas of cortical hypometabo-lism were identified by using SPECT imaging in conjunction with hyperbaric oxygen therapy (HBOT). Delayed imaging after HBOT (1 hour, 1.5 atm abs) suggested viable but metabolically lethargic neurons. After HBOT (801 -hour treatments, monoplace chamber, 1.5 atm abs), marked improvements in cognitive and motor functioning were demonstrated. The data support the hypothesis that idling neurons and ischemic penumbras, when given sufficient oxygen, are capable of reactivation. Thus, changes in tracer distribution after a single exposure to HBOT may be a good prognostic indicator of viable neurons. HBOT may be valuable not only in recovery from anoxic encephalopathy but also from other traumatic and nontraumatic dysfunctions of the central nervous system, including stroke. HBOT in conjunction with physical and rehabilitative therapy may help reactivated idling neurons to remain permanently active.
Tuning the non-equilibrium state of a drug-encapsulated poly(ethylene glycol) hydrogel for stem and progenitor cell mobilization
Authors: Youyun Liang, Tor W. Jensen, Edward J. Roy, Chaenyung Cha, Ross J. DeVolder, Richie E. Kohman, Bao Zhong Zhang, Kyle B. Textor, Lauretta A. Rund, Lawrence B. Schook, Yen Wah Tong, Hyunjoon Kong
Journal: Biomaterials (2010)
THU0338 Does Age at Onset of SjöGren’s Syndrome Influence the Course and Severity of the Disease?
Authors: J. C. Sarmiento-Monroy, J. Amaya-Amaya, N. Molano-Gonzalez, R.-D. Mantilla, A. Rojas-Villarraga, J.-M. Anaya
Journal: Annals of the Rheumatic Diseases (2013)

<h3>Background</h3> Age at onset of disease (AOD) refers to the time period at which a patient experiences the first symptom(s). AOD varies among autoimmune diseases (ADs) and has been related to prognosis in some of them. Genetic, environmental and immunological factors may influence the AOD. Sjögren's syndrome (SS) is considered an AD affecting mostly older women. However, information about how does AOD influence the course of SS is scarce. <h3>Objectives</h3> To evaluate the factors associated with AOD in SS. <h3>Methods</h3> This was a two-phase study. First, a cross sectional analytical study was undertaken in 294 consecutive adult patients with SS (by <i>AECG</i> criteria) with a mean duration of disease of 6.4 years. Clinical, laboratory and sociodemographic variables were investigated through a structured medical record review. AOD was categorized in early (17-35 years) and late (&gt;35 years) according to the 25th percentile of AOD in our cohort. Odds Ratios (ORs) with their 95% confidence intervals were calculated, and p-values &lt;0.003 were considered as significant, after Bonferroni correction. Second, a systematic literature review in adult SS, following the PRISMA guidelines, was performed in PubMed and EMBASE databases to address the state of the art about this topic. <h3>Results</h3> Significant differences were not observed between early-AOD (73/294) and late-AOD (221/294) groups, except for the presence of cutaneous vasculitis (OR= 0.15, 95% CI: 0.07-0.39, p&lt;0.0005). Out of a total of 2,512 articles retrieved, 11 were selected for final analyses. Some of them showed differences in serological abnormalities and disease manifestations with a lack of statistical significance in most of them. Just one article found AOD as a prognostic factor (i.e., Lymphoma). <h3>Conclusions</h3> In contrast with other ADs, AOD has not a critical effect on disease expression and autoimmune response in patients with SS. Late-onset traits are more sensitive to environmental variation rather than genetic influence. Therefore, these results, together with the fact that SS has a similar clinical and immunological presentation worldwide, may serve to design better strategies aimed to discover the etiological factors of disease. <h3>References</h3> Amador-Patarroyo MJ, et al. <i>Autoimmune Dis</i>. 2012;1-7. Botsios C, et al. <i>Joint Bone Spine</i>. 2011;78:171-4. Haga HJ, et al. <i>Scand J Rheumatol</i>. 1999;28:227-32. Ramos-Casals M, et al. <i>Lupus</i>. 1998;7;202-6. <h3>Disclosure of Interest</h3> None Declared
A pH-sensitive fusogenic peptide facilitates endosomal escape and greatly enhances the gene silencing of siRNA-containing nanoparticles in vitro and in vivo
Authors: Hiroto Hatakeyama, Erika Ito, Hidetaka Akita, Motoi Oishi, Yukio Nagasaki, Shiroh Futaki, Hideyoshi Harashima
Journal: Journal of Controlled Release (2009)
Trends in survival of patients with hepatocellular carcinoma between 1977 and 1996 in the United States
Authors: Hashem B. El-Serag, Andrew C. Mason, Charles Key
Journal: Hepatology (2001)

The recent increase in the incidence of hepatocellular cancer in the United States is thought to underlie the rising mortality of this malignancy. However, it remains unknown whether survival of patients with hepatocellular carcinoma (HCC) has changed during the same time period. Using the SEER database (Surveillance, Epidemiology, and End Results) of the National Cancer Institute, we examined the temporal changes and determinants of survival among patients with histologically proven HCC over a 20–year period. Between 1977 and 1996, 7,389 patients diagnosed with HCC were followed in the survival database of SEER. The overall 1–year relative survival rate increased from 14% (95% confidence intervals (CI): 12–16) during 1977–1981 to 23% (95% CI: 21–24) during 1992 to 1996. Between the same two time periods, less improvement was seen in the 5–year survival rates, which increased from 2% (95% CI: 1–3) to only 5% (95% CI: 4–7). The median survival increased slightly from 0.57 years during 1977 to 1981 to 0.64 years during 1992 to 1996. In general, there were no significant differences in survival between men and women or between ethnic groups. During 1987 to 1991, a small fraction (0.8%) of patients underwent radical surgery; these patients had 1–year survival of 59% (95% CI: 35–83%), and 5–year survival of 35% (95% CI: 12–58%). Similar rates were seen during 1992–1996. In conclusion, a small improvement in survival of patients with HCC was seen between 1977 and 1996. Most of this apparent benefit is restricted to the first year following cancer diagnosis, raising the possibility of lead–time bias. There were no significant differences related to gender or ethnicity.
The Accuracy of Dermatology Network Physician Directories Posted by Medicare Advantage Health Plans in an Era of Narrow Networks
Authors: Jack S. Resneck, Aaron Quiggle, Michael Liu, David W. Brewster
Journal: JAMA Dermatology (2014)

IMPORTANCE Insurers are increasingly deploying “narrow networks” with fewer contracted physicians both in health plans offered in new state exchanges under the Affordable Care Act and in Medicare Advantage (MA) plans, which are commercial alternatives offered to Medicare beneficiaries. Patients choosing health plans rely on the accuracy of network directories posted by insurers. The MA plans must meet network adequacy requirements,and inaccurate directories of participating physicians might prejudice those determinations.OBJECTIVE To determine the accuracy of MA plan directories of participating dermatologists,and the appointment availability of listed physicians.DESIGN, SETTING, AND PARTICIPANTS Scripted telephone calls were placed to every dermatologist listed in directories for the largest MA plans in 12 US metropolitan areas. The caller sought an appointment on behalf of his fictitious father who had severe itch for several months, asked whether the dermatologist accepted the relevant plan, and asked for the next available appointment date.MAIN OUTCOMES AND MEASURES Appointment availability and wait time.RESULTS Among 4754 total physician listings, 45.5%represented duplicates in the same plan directory. Among the remaining unique listings, 48.9% of physicians were reachable,accepted the listed plan, and offered an appointment for our fictitious patient. Many of the dermatologists listed had incorrect contact information, were deceased, retired, or had moved, were not accepting new patients, did not accept the insurance plan, or were subspecialized. The mean (range) wait time for appointments among the remaining listings was 45.5 (1-414) days. Both the accuracy of network directories and the appointment wait times varied substantially by health plan and metropolitan area. For 1 plan, our caller was unable to obtain an appointment with any listed dermatologist. CONCLUSIONS AND RELEVANCE Medicare Advantage physician directories for dermatology in many areas substantially overestimate the number of in-network physicians available to treat patients with medical skin conditions. These inaccuracies occurred in areas with long appointment wait times and where plans are terminating selected physician contracts. This suggests a lack of capacity that would be exacerbated by further network narrowing.Accurate physician directories are essential for proper oversight of network adequacy, and for patients who rely on these listings to evaluate health plan options during open enrollment.
Idiopathic Pulmonary Hypertension, Hemophilia A, and Infection with Human Immunodeficiency Virus (HIV)
Authors: Gordon L. Bray
Journal: Annals of Internal Medicine (1989)

Letters and Corrections15 October 1989Idiopathic Pulmonary Hypertension, Hemophilia A, and Infection with Human Immunodeficiency Virus (HIV)Gordon L. Bray, MD, Gerard R. Martin, MD, Roma Chandra, MDGordon L. Bray, MD, Gerard R. Martin, MD, Roma Chandra, MDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-8-689_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:We read with interest the article by Goldsmith and colleagues (1) that described five adult patients with classic hemophilia and primary pulmonary hypertension. We describe the first child with moderate hemophilia A complicated by the occurrence of this disorder. An 11-year-old black boy (born in September 1978) was diagnosed with moderate hemophilia A at 2 years of age. Between 1981 and 1988, he received a total of 55 000 units of factor VIII concentrate for the treatment of bleeding. There was no evidence of cardiac or pulmonary disease at physical examination during his first 7 years of...Reference1. GoldsmithBailyBrettler GRD. Primary pulmonary hypertension in patients with classic hemophilia. Ann Intern Med. 1988;108:797-9. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Gordon L. Bray, MD; Gerard R. Martin, MD; Roma Chandra, MDAffiliations: Children's National Medical Center Washington, D.C. 20010 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Patient With the Human Immunodeficiency Virus-1 in the Cardiovascular Operative SettingPathobiology and Treatment of Pulmonary Hypertension in HIV DiseaseHIV and pulmonary arterial hypertension: a systematic reviewPrimary Pulmonary Hypertension in HIV Patients: A Systematic ReviewHIV-Related Pulmonary HypertensionHematological DisordersRole of Human Immunodeficiency Virus in Primary Pulmonary HypertensionHuman Immunodeficiency Virus Infection and Pulmonary Hypertension: Two New Cases and a Review of 86 Reported CasesRespiratory Distress in a Former Drug AbuserPulmonary hypertension in patients with human immunodeficiency virus infection. Comparison with primary pulmonary hypertension.Marked Pulmonary Function Abnormalities in a Case of HIV-Associated Pulmonary HypertensionAIDS and primary pulmonary hypertensionPrimary pulmonary hypertension and human immunodeficiency virus infection in a non-hemophiliac manPrimary Pulmonary Hypertension in HIV Infection 15 October 1989Volume 111, Issue 8Page: 689-690KeywordsHIVHeart diseasesHemophilia AHemorrhagePulmonary diseasesPulmonary hypertension ePublished: 1 December 2008 Issue Published: 15 October 1989 PDF downloadLoading ...
Autoradiographic investigations on the cell kinetics of epidermis and periderm of limb buds from mouse embryos in vitro*
Authors: R. HERKEN, U. SCHULTZ-EHRENBURG
Journal: British Journal of Dermatology (1981)

Upper limb buds of mouse embryos (day 11 + 3 h of development) were cultured for 6 days. During this time the epidermis develops from a two‐layered stage, consisting of a basal cell layer and a periderm cell layer, to a multilayered squamous epithelium with a stratum granulosum and a stratum corneum. To investigate the cell kinetics of epidermis and periderm during epidermogenesis the limb buds were labelled with 3H‐thymidine at different stages of development. The migration of labelled cells was studied on day 3 in vitro. In the first period of development, before a stratum granulosum has differentiated, each individual cell layer of the epidermis has a cell cycle of its own, i.e. once it has developed each cell layer grows independent of the other. The switching from horizontal to vertical proliferation starts on day 4 of culture with the appearance of the stratum granulosum and is completed on day 5 when a corneal layer begins to develop. With the appearance of the stratum corneum the limb bud shows the typical proliferation of the adult epidermis, which is regenerating only from the basal layer. The labelling behaviour of periderm cells also shows that these cells have a cell cycle of their own and are not formed by cells migrating from the epidermis in an upward direction.