tbuckley/cabot-search huggingface dataset:
The latest forecast. Managed care collides with physician supply
Authors: S. A. Schroeder
Journal: JAMA (1994)

The confluence of two important trends—the dramatic growth of managed care and the impending oversupply of physician specialists—is examined by Weiner<sup>1</sup>in this issue ofThe JOURNAL. Enrollment in managed care plans has increased from 12.5 million persons in 1983 to 45 million in 1993.<sup>2,3</sup>This growth will almost certainly continue whether or not the Clinton Health Security Act—or some variant—is enacted, because both the business sector and most state governments believe managed care is less expensive than traditional feefor-service medicine. See also p 222. Though "managed care" is now a familiar term, it embraces a widely diverse set of organizational and financing arrangements, including such tightly run group practice health maintenance organizations (HMOs) as Kaiser Permanente, looser affiliations of physicians and hospitals that are linked by marketing and payment formulas, and traditional forms of practice that are "managed" by a corporate third party that attempts to restrain
Regulation of Abortion Services — For Better or Worse?
Authors: Willard Cates, Julian Gold, Richard M. Selik
Journal: New England Journal of Medicine (1979)

Legal abortions are being limited in the United States by restricting public funds and regulating the conditions for performing an abortion. These regulations require a woman's informed consent to a major surgical operation, a detailed description of anatomic and physiologic fetal characteristics, a 24-hour waiting period after the counseling, parental notification if the woman is under 18 years old, restriction of hypertonic saline or hypersmolar urea agents, and hospitalization for an obortion after 12 weeks gestation. These regulations, however, may create more psychologic reactions to terminating the pregnancy by describing fetal morphology; delays may increase the risk of morbidity and mortality; and requiring hospitalization after 12 weeks of gestation increases costs and unnecessarily uses hospital beds. In addition, complications from illegal abortions may increase if the regulations lead women to seek abortions from persons other than physicians. These regulations in affect in some areas tend to bias continuation of an unwanted pregnancy and may ultimately endanger rather than protect women seeking an abortion.
Olympic site polyclinic "will be most tangible health legacy" of games, says medical chief
Authors: I. Torjesen
Journal: BMJ (2012)

Heme oxygenase (HO) catalyzes the rate-limiting enzymatic step of heme degradation and regulates the cellular heme content. The gene expression of the inducible isoform of HO, HO-1, is up-regulated in response to various agents causing oxidative stress. To investigate the regulatory role of protein phosphatases in the hepatic regulation of HO-1 gene expression, primary cultures of rat hepatocytes were treated with okadaic acid (OA), which specifically inhibits the serine threonine protein phosphatases 1 and 2A. Both protein synthesis and mRNA expression of HO-1 were induced by OA in cultured hepatocytes, but not in cultured tissue macrophages of rat liver. The HO-1 mRNA induction by OA occurred in a time- and concentration-dependent manner. Simultaneous treatment with OA plus dibutyryl cAMP caused a synergistic up-regulation of steady-state levels of HO-1 mRNA, and the specific protein kinase A inhibitor KT5720 markedly reduced the OA-dependent HO-1 mRNA induction. In contrast, the dibutyryl cAMP-dependent induction of the phosphoenolpyruvate carboxykinase mRNA expression and enzyme activity was inhibited by simultaneous treatment with OA in hepatocytes. The induction of the HO-1 gene expression by OA was transcriptional as determined by studies with actinomycin D, nuclear run-off assay, and measurement of the half-life of HO-1 mRNA. Luciferase reporter constructs containing DNA sequences of the rat HO-1 promoter 5′-flanking region were up-regulated by OA in transiently transfected hepatocytes. Mutation of the cAMP response element/activator protein-1 (−665/−654) site obliterated the OA-dependent induction, suggesting that this element is involved in the transcriptional induction of the rat HO-1 gene by OA.
Response to Scientific journals are ‘faith based’: is there a science behind peer review?
Authors: Sara Schroter
Journal: Journal of the Royal Society of Medicine (2007)

Linkov et al.1 criticize the lack of scientific rigour in peer review research by writing a non-evidence-based piece themselves. A literature search would have identified an increasing body of scientific research on evaluating peer review and the publication process.2,3 Since 1989 there have been five international congresses on peer review and biomedical publication, organized by Drummond Rennie at JAMA, where some research in this area is presented.4 Admittedly, it is surprising that progress has been slow in this important research area, but these authors should not be so quick to dismiss this valuable body of work. They misquote the review by Jefferson et al.5 by saying that they only found 19 scientifically sound studies on peer review. That review did focus on 19 papers, but it only included studies looking at the effectiveness of peer review. There are many more scientifically sound studies on the subject of peer review. So the use of scientific method is not ‘almost non-existent’ in the publication process, but I agree more rigorous research is needed. Randomized controlled trials have been done and I hope they will continue. However, peer review research should not be limited to randomized controlled trials. More extensive rigorous qualitative research is needed to unpack some of the more complex issues which are not suitable for study by randomized controlled trials. We also need to agree on the objectives of peer review and develop appropriate validated tools that can measure its effects. The BMJ Publishing Group now has an extensive programme of research into evaluating the publishing process both in-house and in collaboration with external researchers (www.bmjresearch.com).6 More research funds are needed to help support researchers and journals wanting to conduct research with the aim of improving the publishing process.
Abstract LB-169: Sulfasalazine sensitizes glioblastoma cells to radiation treatment
Authors: Linda Sleire, Jian Wang, Jan Heggdal, Paal-Henning Pedersen, Per Øyvind Enger
Journal: Cancer Research (2010)

Abstract Glioblastomas (GBMs) are lethal cancers with a limited response to ionizing radiation. Recent studies suggest that Sulfasalazine (SAS), a drug used to treat inflammatory bowel disease, inhibits the xCT antiporter system in glioma cells, thereby blocking their uptake of cystine. Since the availability of cystine is a rate limiting step in intracellular antioxidant production, we wanted to investigate whether sulfasalazine sensitizes glioma cells to radiation. SAS effect on glioma cell growth was investigated using a electric cell substrate impedance sensing (ECIS) instrument. All cell lines showed altered growth curves in response to SAS treatment. Further, U251 glioma cells were treated with escalating doses of SAS, alone or in combination with radiation (8 Gy). Immunocytochemistry for the apoptotic marker Annexin V as well as DAPI staining to assess nuclear integrity were conducted to estimate cell death following treatment. All treatment groups exhibited increased rates of cell death compared to untreated controls. However, a combination of SAS and radiation resulted in higher levels of cell death, than radiation or SAS administered alone. In order to assess whether this can be exploited therapeutically, we are currently preparing to treat nude rats harbouring gliblastoma biopsy xenografts with SAS, alone or in combination with radiation. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr LB-169.
Effect of Gastric Bypass Surgery on the Absorption and Bioavailability of Metformin
Authors: Raj S. Padwal, Raniah Q. Gabr, Arya M. Sharma, Lee-Ann Langkaas, Dan W. Birch, Shahzeer Karmali, Dion R. Brocks
Journal: Diabetes Care (2011)

OBJECTIVE Use of gastric bypass surgery is common and increasing. Over 40% of patients in diabetes remission after gastric bypass surgery may redevelop diabetes within 5 years. Metformin, the first-line drug for diabetes, has low bioavailability and slow, incomplete gastrointestinal absorption. We hypothesized that gastric bypass would further reduce the absorption and bioavailability of metformin. RESEARCH DESIGN AND METHODS In a nonblinded, single-dose pharmacokinetic study, 16 nondiabetic post–gastric bypass patients and 16 sex- and BMI-matched control subjects (mean age 40 years and BMI 39.2 kg/m2) were administered two 500-mg metformin tablets. Plasma metformin levels were sampled at 0.5, 1, 1.5, 2, 3, 4, 6, 8, and 24 h. Metformin absorption, estimated by the area under the curve (AUC) of the plasma drug concentrations from time 0 to infinity (AUC0-∞), was the primary outcome, and metformin bioavailability, assessed by measuring 24-h urine metformin levels, was a secondary outcome. RESULTS Compared with control subjects, metformin AUC0–∞ was increased in gastric bypass subjects by 21% (13.7 vs. 11.4 μg/mL/h; mean difference 2.3 [95% CI −1.3 to 5.9]) and bioavailability was increased by 50% (41.8 vs. 27.8%; 14.0 [4.1–23.9]). Gastric bypass patients had significantly lower AUC glucose levels over 8 h compared with control subjects (35.8 vs. 41.7 μg/mL/h; 5.9 [3.1–8.8]), but this was likely a result of differences in baseline fasting glucose and not metformin absorption. CONCLUSIONS Metformin absorption and bioavailability seem to be higher after gastric bypass, and this may have implications on dosing and toxicity risk. Studies are needed to confirm these findings and delineate potential mechanisms.
Effects of In Vivo Nitroglycerin Treatment on Activity and Expression of the Guanylyl Cyclase and cGMP-Dependent Protein Kinase and Their Downstream Target Vasodilator-Stimulated Phosphoprotein in Aorta
Authors: Alexander Mülsch, Matthias Oelze, Stefan Klöss, Hanke Mollnau, Andrea Töpfer, Albert Smolenski, Ulrich Walter, Johannes-Peter Stasch, Ascan Warnholtz, Ulrich Hink, Thomas Meinertz, Thomas Münzel
Journal: Circulation (2001)

Background —Chronic in vivo treatment with nitroglycerin (NTG) induces tolerance to nitrates and cross-tolerance to nitrovasodilators and endothelium-derived nitric oxide (NO). We previously identified increased vascular superoxide formation and reduced NO bioavailability as one causal mechanism. It is still controversial whether intracellular downstream signaling to nitrovasodilator-derived NO is affected as well. Methods and Results —We therefore studied the effects of 3-day NTG treatment of rats and rabbits on activity and expression of the immediate NO target soluble guanylyl cyclase (sGC) and on the cGMP-activated protein kinase I (cGK-I). Tolerance was induced either by chronic NTG infusion via osmotic minipumps (rats) or by NTG patches (rabbits). Western blot analysis, semiquantitative reverse transcription–polymerase chain reaction, and Northern blot analysis revealed significant and comparable increases in the expression of sGC α 1 and β 1 subunit protein and mRNA. Studies with the oxidative fluorescent dye hydroethidine revealed an increase in superoxide in the endothelium and smooth muscle. Stimulation with NADH increased superoxide signals in both layers. Although cGK-I expression in response to low-dose NTG was not changed, a strong reduction in vasodilator-stimulated phosphoprotein (VASP) serine239 phosphorylation (specific substrate of cGK-I) was observed in tolerant tissue from rats and rabbits. Concomitant in vivo and in vitro treatment with vitamin C improved tolerance, reduced oxidative stress, and improved P-VASP. Conclusions —We therefore conclude that increased expression of sGC in the setting of tolerance reflects a chronic inhibition rather than an induction of the sGC–cGK-I pathway and may be mediated at least in part by increased vascular superoxide.
USE OF POULTON'S OXYGEN TENT IN BRONCHOPNEUMONIA COMPLICATING WHOOPING-COUGH
Authors: A. Joe, J. S. Westwater
Journal: BMJ (1935)

IIOSPITALBronchopneumonia as a complication of whooping-cough invariably carries a grave prognosis, and any method of treatment which can improve the outlook is to be wel- comed.The following case therefore seems worthy of record, as it indicates that the oxygen tent can increase the expectation of recovery.It also illustrates the suc- cessful use of the tent in a young patient suffering from an illness which itself is liable to present many nursing difficulties.Case Record A well-nourished boy of 16 months was admitted to the North-Western Hospital on February 27th, 1935, suffering from whooping-cough.Six weeks previously he had had his first illness, an attack of bronchitis, for which he had been under treatment in a general hospital; in con- valescence he developed a spasmodic cough, and was heard to whoop for the first time on February 26th.On admission the child was found to have a few crepitations at the base of each lung, indicative of some bronchitis, but there was no fever, dyspnoea, or cyanosis.Typical spasms of coughing were occurring about eight to twelve times in the day, followed by a whoop and occasionally terminating in vomiting.On March 4th, five days after admission, the onset of a bronchopneumonia was heralded by a sharp evening rise of temperature to 1030 F. and of respirations to 78.The next day there were numerous fine crepitations at both bases, and signs of partial consolidation over the lower lobe of the lett lung.Thereafter the child continued acutely ill, with a swinging temperature, but with a tendency to lysis
Maternal Occupational Exposure to Polycyclic Aromatic Hydrocarbons: Effects on Gastroschisis among Offspring in the National Birth Defects Prevention Study
Authors: Philip J. Lupo, Peter H. Langlois, Jennita Reefhuis, Christina C. Lawson, Elaine Symanski, Tania A. Desrosiers, Zeina G. Khodr, A.J. Agopian, Martha A. Waters, Kara N. Duwe, Richard H. Finnell, Laura E. Mitchell, Cynthia A. Moore, Paul A. Romitti, Gary M. Shaw
Journal: Environmental Health Perspectives (2012)

Exposure to polycyclic aromatic hydrocarbons (PAHs) occurs in many occupational settings. There is evidence in animal models that maternal exposure to PAHs during pregnancy is associated with gastroschisis in offspring; however, to our knowledge, no human studies examining this association have been conducted.Our goal was to conduct a case-control study assessing the association between estimated maternal occupational exposure to PAHs and gastroschisis in offspring.Data from gastroschisis cases and control infants were obtained from the population-based National Birth Defects Prevention Study for the period 1997-2002. Exposure to PAHs was assigned by industrial hygienist consensus, based on self-reported maternal occupational histories from 1 month before conception through the third month of pregnancy. Logistic regression was used to determine the association between estimated occupational PAH exposure and gastroschisis among children whose mothers were employed for at least 1 month during the month before conception through the third month of pregnancy.The prevalence of estimated occupational PAH exposure was 9.0% in case mothers (27 of 299) and 3.6% in control mothers (107 of 2,993). Logistic regression analyses indicated a significant association between occupational PAHs and gastroschisis among mothers ≥ 20 years of age [odds ratio (OR) = 2.53; 95% confidence interval (CI): 1.27, 5.04] after adjusting for maternal body mass index, education, gestational diabetes, and smoking. This association was not seen in mothers < 20 years (OR = 1.14; 95% CI: 0.55, 2.33), which is notable because although young maternal age is the strongest known risk factor for gastroschisis, most cases are born to mothers ≥ 20 years.Our findings indicate an association between occupational exposure to PAHs among mothers who are ≥ 20 years and gastroschisis. These results contribute to a body of evidence that PAHs may be teratogenic.
Effect of changes in circulating blood volume on cardiac output and arterial and ventricular blood pressure in the stage 18, 24, and 29 chick embryo.
Authors: A J Wagman, N Hu, E B Clark
Journal: Circulation Research (1990)

We studied the hemodynamic effects of changing volume loading in the chick embryo, before autonomic innervation, to test the hypothesis that the Frank-Starling mechanism functions in the embryonic myocardium. Dorsal aortic blood velocity was measured by pulsed Doppler. Heart rate and aortic diameter were also measured to calculate cardiac output and stroke volume index. Vitelline arterial and ventricular pressures were measured with a servo-null micropressure system in stage 24 embryos. Infusing isotonic solution intravenously resulted in linear increases in stroke volume index for stages 18 (y = 388x + 6.89), 24 (y = 466x + 7.86), and 29 (y = 549x + 4.96). The slopes and intercepts were statistically the same for all three stages. Similar volume loading in stage 24 embryos initially increased mean arterial pressure linearly, but at higher loading conditions, the rate of rise lessens. Thus, volume loading resulted in a decrease in vascular resistance. Withdrawing blood from stage 24 embryos resulted in a decrease in ventricular peak systolic and end-diastolic pressures. With reinfusion of the blood, systolic and end-diastolic pressures initially rose above baseline levels and later returned to normal. We conclude that a length-tension relation is present in the preinnervated embryonic heart and that vascular resistance changes inversely with loading conditions. We speculate that these mechanisms are the primary hemodynamic control mechanism in the early chick embryo.
Ibuprofen and Antihypertensive Drugs
Authors: LUCINDA G. MILLER
Journal: Annals of Internal Medicine (1988)

Letters and Corrections1 March 1988Ibuprofen and Antihypertensive DrugsLUCINDA G. MILLER, PHARM.D.LUCINDA G. MILLER, PHARM.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-108-3-485_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I read with interest the article by Radack and associates (1) on the interaction of Ibuprofen and antihypertensive drugs. Although the dosage studied was that normally used via prescription, the article alerts the practitioner to this potential interaction in over-the-counter use as well. The authors' data is in contrast to a similar study where Ibuprofen in a dose of 2400 mg/d produced no hypertensive effects in healthy women (2). Taking these two reports into consideration, it would appear that Ibuprofen affects blood pressure control in hypertensive patients and does not adversely affect normotensive patients.Whether the adverse...References1. RADACK K, DECK C, and BLOOMFIELD S. Ibuprofen interferes with the efficacy of antihypertensive drugs: a randomized, double-blind, placebo-controlled trial of Ibuprofen compared with acetaminophen. Ann Intern Med. 1987;107:628-35. LinkGoogle Scholar2. MCKENNEY J, WRIGHT J, and GOODMAN R. Effect of high-dose Ibuprofen on 24-hour blood pressure in healthy women. Drug Intell Clin Pharm. 1987;21:517-21. CrossrefMedlineGoogle Scholar3. PUDDEY I, BEILIN L, and VANDONGEN R. Differential effects of sulindac and indomethacin on blood pressure in treated essential hypertensive subjects. Clin Sci. 1985;69:327-36. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: LUCINDA G. MILLER, PHARM.D. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byStock price reactivity to earnings announcements: the role of the Cammer/Krogman factorsCurrent Issues in NSAID Therapy 1 March 1988Volume 108, Issue 3Page: 485-485KeywordsBlood pressureDrug interactionsDrugsIbuprofen ePublished: 1 December 2008 Issue Published: 1 March 1988 PDF downloadLoading ...
Renal Transplantation in Type 1 Glycogenosis
Authors: Michael Emmett
Journal: JAMA (1978)

In glycogenosis type 1 (GT1), glucose synthesis is deficient due to absence of glucose-6-phosphatase. Development of renal failure in such a patient provided the opportunity to test whether or not this metabolic defect could be reversed by a renal allograft, which contains the missing enzyme and has potential for glucose synthesis. Despite normalization of renal function and both glucocorticoid therapy and the infusion of amino-acid precursors of glucose, fasting hypoglycemia persisted unabated. We conclude that a functioning renal allograft is incapable of meeting the metabolic demands of a patient with glucose-6-phosphatase deficiency. (<i>JAMA</i>239:1642-1644, 1978)
Effect of a High-Monounsaturated Fat Diet Enriched With Avocado in NIDDM Patients
Authors: Israel Lerman-Garber, Sagrario Ichazo-Cerro, José Zamora-González, Guillermo Cardoso-Saldaña, Carlos Posadas-Romero
Journal: Diabetes Care (1994)

OBJECTIVE To assess the effects of two controlled diets, one rich in oleic acid obtained from avocado and olive oil and the other rich in complex carbohydrates, on fasting and postprandial serum lipids and glycemic control in 12 women with NIDDM. RESEARCH DESIGN AND METHODS A randomized crossover study was designed. During a 4-week baseline period, all patients received the isocaloric diets recommended by the American Diabetes Association. After this period the patients were randomly assigned to receive the two study diets alternately during two 4-week periods. One diet was high in monounsaturated fatty acids (HMUFA) and the other was high in complex carbohydrates (high-CHO). There also was a 4-week washout period in between the two 4-week periods during which the patients followed the American Diabetes Association's isocaloric diet. Blood samples were obtained before and after each dietary period. RESULTS Both diets had a minor hypocholesterolemic effect with no major changes in high-density lipoprotein cholesterol. The HMUFA diet was associated with a greater decrement in plasma triglycerides (20 vs. 7% in the high-CHO diet). Glycemic control was similar with both diets. CONCLUSIONS Partial replacement of complex digestible carbohydrates with monounsaturated fatty acids (avocado as one of its main sources) in the diet of patients with non-insulin-dependent diabetes mellitus improves the lipid profile favorably, mantains an adequate glycemic control, and offers a good management alternative.
Assembled Microcapsules by Doxorubicin and Polysaccharide as High Effective Anticancer Drug Carriers
Authors: Cuiling Du, Jie Zhao, Jinbo Fei, Yue Cui, Junbai Li
Journal: Advanced Healthcare Materials (2013)

Abstract Doxorubicin, together with the modified polysaccharide (alginate dialdehyde), was used as a wall material to fabricate microcapsules through self‐cross‐linking by a template method. The microcapsules as‐prepared are pH‐responsive. Relevant scanning electronic microscopy, atom force microscopy and confocal laser scanning microscopy confirm the morphology of the uniform microcapsules. The spectroscopic results show that the microcapsules are assembled through electrostatic interaction and Schiff's base covalent bonding. Doxorubicin can be released sustainably from the capsules in buffer solution at a lower pH value. The cellular uptake of the microcapsules and drug release induced by acidic microenvironment are time‐dependent processes. The cell cytotoxicity experiments in vitro demonstrate that the doxorubicin‐based microcapsules have high efficiency to kill the cancer cells.