tbuckley/cabot-search huggingface dataset:
Effects of Medicare and Title XIX on House-Staff Training Programs
Authors: Woodbury Perkins
Journal: JAMA (1967)

The amended Social Security Act of 1965, or Public Law 89-97, includes Title XVIII, the Medicare bill; and Title XIX, the Medical Assistance Program. Title XVIII (Medicare) went into effect in all states on July 1, 1966. On the other hand, the effective date of Title XIX (the Medical Assistance Program) is an individual matter for each state legislature to decide sometime before 1975. To date, approximately 19 states, including California, have put Title XIX into effect. The Medical Assistance Program became effective in California on March 1, 1966, and thus California has had as much experience with both Titles XVIII and XIX as any other state. However early, it is not premature to report the effects of this legislation on intern-resident training programs, and to outline some of the problems which have resulted. It is assumed that the basic purposes and rules of Title XVIII are understood, but this
High mobility group box 1 in the inflammatory pathogenesis of epilepsy: profiling circulating levels after experimental and clinical seizures
Authors: Lauren Walker, Karen Tse, Emanuele Ricci, Thimmasettappa Thippeswamy, Graeme J Sills, Steve H White, Daniel J Antoine, Anthony Marson, Munir Pirmohamed
Journal: The Lancet (2014)
B Lymphocytes Induce the Formation of Follicular Dendritic Cell Clusters in a Lymphotoxin α–dependent Fashion
Authors: Yang-Xin Fu, Guangming Huang, Yang Wang, David D. Chaplin
Journal: The Journal of Experimental Medicine (1998)

Lymphotoxin (LT)α is expressed by activated T cells, especially CD4+ T helper type 1 cells, and by activated B and natural killer cells, but the functions of this molecule in vivo are incompletely defined. We have previously shown that follicular dendritic cell (FDC) clusters and germinal centers (GCs) are absent from the peripheral lymphoid tissues of LTα-deficient (LTα−/−) mice. LTα−/− mice produce high levels of antigen-specific immunoglobulin (Ig)M, but very low levels of IgG after immunization with sheep red blood cells. We show here that LTα-expressing B cells are essential for the recovery of primary, secondary, and memory humoral immune responses in LTα−/− mice. It is not necessary for T cells to express LTα to support these immune functions. Importantly, LTα-expressing B cells alone are essential and sufficient for the formation of FDC clusters. Once these clusters are formed by LTα-expressing B cells, then LTα-deficient T cells can interact with B cells to generate GCs and productive class-switched antibody responses. Thus, B cells themselves provide an essential signal that induces and maintains the lymphoid microenvironment essential for GC formation and class-switched Ig responses.
Randomised, controlled walking trials in postmenopausal women: the minimum dose to improve aerobic fitness?
Authors: T-M Asikainen, S Miilunpalo, P Oja, M Rinne, M Pasanen, K Uusi-Rasi, I Vuori
Journal: British Journal of Sports Medicine (2002)

The American College of Sports Medicine recommends 20-60 minutes of aerobic exercise three to five days a week at an intensity of 40/50-85% of maximal aerobic power (VO(2)MAX) reserve, expending a total of 700-2000 kcal (2.93-8.36 MJ) a week to improve aerobic power and body composition.To ascertain the minimum effective dose of exercise.Voluntary, healthy, non-obese, sedentary, postmenopausal women (n = 121), 48-63 years of age, were randomised to four low dose walking groups or a control group; 116 subjects completed the study. The exercise groups walked five days a week for 24 weeks with the following intensity (% of VO(2)MAX) and energy expenditure (kcal/week): group W1, 55%/1500 kcal; group W2, 45%/1500 kcal; group W3, 55%/1000 kcal; group W4, 45%/1000 kcal. VO(2)MAX was measured in a direct maximal treadmill test. Submaximal aerobic fitness was estimated as heart rates at submaximal work levels corresponding to 65% and 75% of the baseline VO(2)MAX. The body mass index (BMI) was calculated and percentage of body fat (F%) estimated from skinfolds.The net change (the differences between changes in each exercise group and the control group) in VO(2)MAX was 2.9 ml/min/kg (95% confidence interval (CI) 1.5 to 4.2) in group W1, 2.6 ml/min/kg (95% CI 1.3 to 4.0) in group W2, 2.4 ml/min/kg (95% CI 0.9 to 3.8) in group W3, and 2.2 ml/min/kg (95% CI 0.8 to 3.5) in group W4. The heart rates in standard submaximal work decreased 4 to 8 beats/min in all the groups. There was no change in BMI, but the F% decreased by about 1% unit in all the groups.Walking (for 24 weeks) at moderate intensity 45% to 55% of VO(2)MAX, with a total weekly energy expenditure of 1000-1500 kcal, improves VO(2)MAX and body composition of previously sedentary, non-obese, postmenopausal women. This dose of exercise apparently approaches the minimum effective dose.
Medical Ophthalmology: Ophthalmologic Manifestations of Systemic Diseases
Authors: Henry J. L. Van Dyk
Journal: JAMA (1967)

Something new has been added. This slender volume is neither an atlas nor a textbook but a richly illustrated survey of medical ophthalmology. It presents more than 270 color prints in its 64 pages and spans the whole of ophthalmic manifestations of systemic disease, from albinism to zoster. There is but a modest amount of text, and it is all lean meat; yet, amplified by good photographs and drawings, a remarkable breadth of coverage has been attained. Of the eight chapters that comprise the book, six present surveys covering medical and pediatric ophthalmology, external eye disease, eye injuries, and neuro-ophthalmology. Two chapters, those on hypertension, arteriosclerosis, and the retina and on glaucoma, are done in greater depth. Everywhere, the emphasis is on diagnosis and recognition. This is not a book that requires concentrated, diligent study, but like some of our news weeklies that specialize in illustrations, it can be read
Randomised controlled trial comparing effectiveness and acceptability of an early discharge, hospital at home scheme with acute hospital care
Authors: S. H Richards, J. Coast, D. J Gunnell, T. J Peters, J. Pounsford, M.-A. Darlow
Journal: BMJ (1998)

<h3>Abstract</h3> <b>Objective:</b> To compare effectiveness and acceptability of early discharge to a hospital at home scheme with that of routine discharge from acute hospital. <b>Design:</b> Pragmatic randomised controlled trial. <b>Setting:</b> Acute hospital wards and community in north of Bristol, with a catchment population of about 224 000 people. <b>Subjects:</b> 241 hospitalised but medically stable elderly patients who fulfilled criteria for early discharge to hospital at home scheme and who consented to participate. <b>Interventions:</b> Patients9 received hospital at home care or routine hospital care. <b>Main outcome measures:</b> Patients9 quality of life, satisfaction, and physical functioning assessed at 4 weeks and 3 months after randomisation to treatment; length of stay in hospital and in hospital at home scheme after randomisation; mortality at 3 months. <b>Results:</b> There were no significant differences in patient mortality, quality of life, and physical functioning between the two arms of the trial at 4 weeks or 3 months. Only one of 11 measures of patient satisfaction was significantly different: hospital at home patients perceived higher levels of involvement in decisions. Length of stay for those receiving routine hospital care was 62% (95% confidence interval 51% to 75%) of length of stay in hospital at home scheme. <b>Conclusions:</b> The early discharge hospital at home scheme was similar to routine hospital discharge in terms of effectiveness and acceptability. Increased length of stay associated with the scheme must be interpreted with caution because of different organisational characteristics of the services. <h3>Key messages</h3> Pressure on hospital beds, the increasing age of the population, and high costs associated with acute hospital care have fuelled the search for alternatives to inpatient hospital care There were no significant differences between early discharge to hospital at home scheme and routine hospital care in terms of patient quality of life, physical functioning, and most measures of patient satisfaction Length of stay for hospital patients was significantly shorter than that of hospital at home patients, but, owing to qualitative differences between the two interventions, this does not necessarily mean differences in effectiveness Early discharge to hospital at home provides an acceptable alternative to routine hospital care in terms of effectiveness and patient acceptability
Transport of Bacteria by the Dalkon Shield Tail
Authors: Howard J. Tatum
Journal: JAMA (1976)

<h3>To the Editor.—</h3> In reference to the letter of Dr Katayama (233:950,1975) concerning the "<i>Escherichia coli</i>Transport by Dalkon Shield String," I was glad to see supportive evidence for our in vitro experiments. However, I assume that at the time his letter was written, Dr Katayama was not aware of our subsequent in vivo study in which the terminal segments (proximal end of the tail beyond the double knot at the base of the Dalkon Shield and normally located inside the uterus) of Dalkon Shield tails removed from patients were examined.<sup>1</sup> In this investigation, the terminal ends of the tails from 35 Dalkon Shields were examined either by phase contrast microscopy or by transmission electron microscopy. The duration of intrauterine device use ranged from five months to four years for these 35 patients. The Dalkon Shields with their attached tails were placed in electron microscopy fixative immediately after their
Medical ethics and law as a core subject in medical education
Authors: L. Doyal, R. Gillon
Journal: BMJ (1998)

In Tomorrow's Doctors Britain's General Medical Council initiated a radical and needed reform of medical education. One of the less noticed, yet revolutionary, aspects of this reform is that medical ethics and law have become a core component of the curriculum. Thus all medical students, states the council, must acquire knowledge and understanding of ethical and legal issues relevant to the practice of medicine and be able “to understand and analyse ethical problems so as to enable patients, their families, society, and the doctor to have proper regard to such problems in reaching decisions.”1

Seeking to pool their expertise, most of the academics currently teaching medical ethics and law in UK medical schools—mostly cliniciansphilosophers, lawyers, and theologians—hammered out a consensus statement about what should constitute the core academic content necessary to produce “doctors who will engage in good ethically and legally informed practice.” They also agreed some minimal organisational requirements for the subject to be taught successfully.

The consensus statement sees the teaching of medical ethics and law as contributing to the overall objective of medical education—“the creation of good doctors who will enhance and promote the health and medical welfare of the people they serve in ways which fairly and …
Demographic Characteristics of US Medical School Admission Committees
Authors: Douglas G. Kondo
Journal: JAMA (2000)

ContextAlthough concerns continue to be raised about the diversity of the US physician workforce, there has never been a nationwide survey of both the sex and underrepresented minority (URM) composition of medical school admission committees.ObjectiveTo document US medical school admission committee membership in several demographic domains, including sex and URM (African American, Mexican American, mainland Puerto Rican, Native American, Native Hawaiian, and Native Alaskan) status.DesignMailed survey.Setting and ParticipantsDeans or directors of admission at 85 US medical schools that were members of the Association of American Medical Colleges (response rate, 70%).Main Outcome MeasuresPrevalence of 1999-2000 school-year committee members in demographic categories, such as sex, URM status, physician or medical student status; compensation status.ResultsThe overall ratio of men to women on admission committees was 1.77 to 1. On average, 16% of committee members were from URM groups. Physicians with URM status comprised 8% of committee membership; 51% of committees had 1 or 0 URM physicians. Seventy-four percent of committees had at least 1 medical student; medical students comprised 15% of total membership. Ninety-one percent of committees operated on a volunteer basis.ConclusionAlthough representation of women and persons with URM status on medical school admission committees has improved since 1972, URM membership, in particular, remains low.
Abstract 2: IGF-1 attenuates antiestrogen- and antiprogestin-induced apoptosis in ER + breast cancer cells by MEK1 regulation of the BH3-only pro-apoptotic protein Bim
Authors: Suchreet Takhar, Sudharsan Periyasamy-Thandavan, William Hutch Jackson, Shuang Huang, Patricia Schoenlein
Journal: Cancer Research (2011)

Abstract In an effort to understand the underlying mechanisms of inherent antiestrogen resistance in estrogen receptor positive (ER+) breast cancer cells, we have been studying the pro-survival role of insulin-like growth factor 1 (IGF-1) in protecting breast cancer cells from death induced by hormonal therapy. In past studies, we demonstrated that IGF-1, at physiologically relevant doses binds the insulin like growth factor receptor (IGF-IR), blocks antiestrogen- and antiprogestin- induced apoptosis in ER+ MCF-7 breast cancer cells. We further showed that the mechanism of protection was dependent on the action of the dual specificity protein kinase MEK1 (Abstract #4846, Proc Am Assoc Cancer Res, 51, 2010, p1178-79); however we did not elucidate the specific death effector pathway being blocked by MEK1/MAPK signaling. For this study, we sought to identify the specific death pathway blocked by the IGF-IR/MEK1/MAPK prosurvival signaling. We now present strong data identifying the pro-apoptotic BH3 family member Bim as a critical death effector activated by MEK1 blockade in ER+ breast cancer cells. We utilized Bim siRNA, which effectively down-regulated Bim intracellular protein expression by five-to ten-fold. Bim downregulation significantly attenuated the pro-apoptotic action(s) of U0126, as well as that of the antiestrogen 4-hydroxytamoxifen (4-OHT) and/or the antiprogestin mifepristone (MIF). Bim knockdown reduced the generation of ROS that results from treatment with 4-OHT, MIF, and U0126 (whether used as monotherapies or in combination) and is required for MCF-7 apoptotic cell death under these treatment conditions. We are currently elucidating how Bim action induces cell death in breast cancer cells with compromised MEK1 action. These studies support the targeting of MEK1 to activate a Bim-dependent apoptotic pathway during hormonal therapy of early-stage breast cancer, particularly in patients with high circulating levels of IGF-1. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2. doi:10.1158/1538-7445.AM2011-2
HLA class II alleles in isocyanate-induced asthma.
Authors: J S Bignon, Y Aron, L Y Ju, M C Kopferschmitt, R Garnier, C Mapp, L M Fabbri, G Pauli, A Lockhart, D Charron
Journal: American Journal of Respiratory and Critical Care Medicine (1994)

Studying genetic factors that control human immune responsiveness may further our understanding of specific types of asthma in which the role of immune factors is uncertain to date. HLA Class II gene products are involved in the control of immune responses. Therefore, we investigated whether HLA Class II genetic markers contribute to susceptibility or resistance to isocyanate-induced asthma (IAA) in exposed workers. We collected venous blood samples from two groups of unrelated white adults: (1) patients with isocyanate-induced asthma documented by a positive inhalation challenge; and (2) exposed individuals with no history of IAA. The second exon of DQA1, DQB1, DPB1, and DRB genes was selectively amplified by the polymerase chain reaction (PCR) method. HLA typing was carried out by the PCR-RFLP method, which allowed discrimination of most HLA DQA1, DQB1, DPB1, and DRB alleles. No significant difference was found in the distribution of DPB1 alleles between patients and control subjects. Allele DQB1*0503 and allelic combination DQB1*0201/0301 were associated with susceptibility to the disease. Conversely, allele DQB1*0501 and the DQA1*0101-DQB1*0501-DR1 haplotype conferred significant protection to exposed healthy control subjects. Our results are consistent with the hypothesis that immune mechanisms are involved in isocyanate-induced asthma and that specific genetic factors may increase or decrease the risk of developing IAA in exposed workers.
A platform technique for growth factor delivery with novel mode of action
Authors: Nam Hee Kim, Yong Hoon Cha, Hyun Sil Kim, Soo Eon Lee, Jong-Ki Huh, Jung Kook Kim, Jeong Moon Kim, Joo Kyung Ryu, Hee-Jin Kim, Yoonmi Lee, Su Yeon Lee, Insup Noh, Xiao-Yan Li, Stephen J. Weiss, Tae-Ahn Jahng, Jong In Yook
Journal: Biomaterials (2014)
Estrogen Replacement Therapy and Risk of Breast Cancer
Authors: Joan B. Vatz
Journal: JAMA (1991)

<h3>To the Editor.—</h3> Colditz et al<sup>1</sup>categorized estrogen exposure into three groups: never users, current users, and past users. Past users are further stratified on duration of use and years since last use, and current users on duration of use. Based on these measures of estrogen exposure, the investigators note that "the past users of replacement estrogen were not at an increased risk [of breast cancer]..., including even those with more than 10 years of use (relative risk [RR] after adjustment for established risk factors, 0.70; 95% confidence interval [CI], 0.45 to 1.10)." This adjusted RR of 0.70 for past users with 10 or more years of use, however, appears to be inconsistent with data presented in Table 3 of the article by Colditz et al, in which the 0.70 RR refers to the adjusted RR for past users who stopped using estrogen 10 or more years ago. The
The Effects of Dysthymic Disorder on Health-Related Quality of Life and Disability Days in Persons with Comorbid Medical Conditions in the General Population
Authors: Bernhard T. Baune, Riccardo N. Caniato, Volker Arolt, Klaus Berger
Journal: Psychotherapy and Psychosomatics (2009)

&lt;i&gt;Background:&lt;/i&gt; We aimed to investigate in medical disorders the effects of comorbid dysthymic disorder as compared to major depressive disorder (MDD) on health-related quality of life (HR-QoL) and disability days in the general population. &lt;i&gt;Methods:&lt;/i&gt; In a population-based study 4,181 individuals were assessed for the presence of dysthymic disorder and depression, utilizing the Composite International Diagnostic Interview. Each participant received a thorough medical examination to assess the presence of comorbid somatic conditions. HR-QoL was evaluated using the Medical Outcomes Survey Short-Form 36 (SF-36) and disability days were provided by self-report. Descriptive statistics, analysis of variance and multivariable logistic regression were used. &lt;i&gt;Results:&lt;/i&gt; Comorbidity with illnesses from a maximum of 6 somatic disease groups was more prevalent in persons with dysthymic disorder (78.7%) than in those with MDD (70.4%). Persons with dysthymic disorder had a significantly lower mental health summary score in the SF-36 and more disability days than those with MDD. The physical health summary scores were not significantly different between participants with dysthymic disorder and MDD (after Bonferroni correction), suggesting that limitations in physical functioning due to comorbid medical conditions were similar in both affective disorder groups. &lt;i&gt;Conclusions:&lt;/i&gt; These results show that affective disorders comorbid with medical, somatic illnesses have a major impact on HR-QoL and disability with more pronounced effects in dysthymic disorder than in MDD. Differences in the time course of both conditions might contribute to this finding. Our results support the need for an improved identification and treatment of affective disorders in patients with somatic illnesses.
A Method of Treating Inversion of the Limb Subsequent to the Cure of Equino-Varus
Authors: R. L. Swan
Journal: BMJ (1895)

INVERSION OF THE LIMB AFTER CURE OR± EQUINO-VARUS.[TDuBLTOJN 1317 position, however unnatural, does harm, provided the in- dulgence in it be occasional and not continuous.Of the various factors which by their continuous application give rise to deformities, none are so potent and yet prove so un- suspected as clothing.Especially is this the case amongst girls.From a hygienic standpoint, 90 per cent. of modern clothing is faulty and even harmful.Nowadays people object to belts and garters, and the ob- jection when made to such articles tightly applied is rational.But the result of the sensible objection to tight belts and garters has been a recoil to the other extreme, a discarding altogether of belts and garters, with'the result that modern clothing is suspended entirely from the shoulders, and not only from the shoulders, which is bad enough, but from the extreme acromial ends, which makes matters worse.The hips, not the shoulders, should support
Hyperproliferation, cancer, and inflammation in mice expressing a Δ133p53-like isoform
Authors: Tania L. Slatter, Noelyn Hung, Hamish Campbell, Carina Rubio, Reena Mehta, Prudence Renshaw, Gail Williams, Michelle Wilson, Afra Engelmann, Aaron Jeffs, Janice A. Royds, Margaret A. Baird, Antony W. Braithwaite
Journal: Blood (2011)

The p53 protein is a pivotal tumor suppressor that is frequently mutated in many human cancers, although precisely how p53 prevents tumors is still unclear. To add to its complexity, several isoforms of human p53 have now been reported. The Δ133p53 isoform is generated from an alternative transcription initiation site in intron 4 of the p53 gene (Tp53) and lacks the N-terminus. Elevated levels of Δ133p53 have been observed in a variety of tumors. To explore the functions of Δ133p53, we created a mouse expressing an N-terminal deletion mutant of p53 (Δ122p53) that corresponds to Δ133p53. Δ122p53 mice show decreased survival and a different and more aggressive tumor spectrum compared with p53 null mice, implying that Δ122p53 is a dominant oncogene. Consistent with this, Δ122p53 also confers a marked proliferative advantage on cells and reduced apoptosis. In addition to tumor development, Δ122p53 mice show a profound proinflammatory phenotype having increased serum concentrations of interleukin-6 and other proinflammatory cytokines and lymphocyte aggregates in the lung and liver as well as other pathologies. Based on these observations, we propose that human Δ133p53 also functions to promote cell proliferation and inflammation, one or both of which contribute to tumor development.
ADAMTS13 activity and inhibitor
Authors: Adriana Doldan‐Silvero, Carlos Acevedo‐Gadea, Clandine Habib, Jonathan Freeman, Vandita Johari
Journal: American Journal of Hematology (2008)

Thrombotic thrombocytopenic purpura (TTP) is often associated with acquired or congenital deficiency of the von Willebrand factor-cleaving metalloprotease, ADMATS13 (Lammle B et al., J Thromb Haemost 2005;3:1663-1675; Schneppenheim et al., Blood 2003;101:1845-1850). Although undetectable levels of enzyme activity (<10%) are diagnostic of inherited or acquired TTP in the correct clinical setting (absence is specific), not all patients diagnosed with TTP have severe protease deficiency, and it is therefore not recommended as an initial test for diagnosis (Copelovitch and Kaplan, Pediatr Nephrol, in press). Many prospective and retrospective studies have demonstrated that patients with severe protease deficiency have a higher likelihood of relapse, making it helpful as an indicator of recurrence. The short-term prognostic usefulness of ADAMTS13 testing during acute TTP warrants further investigation because of limited prospective studies (Ferrari S et al., Blood 2007;109:2815-2822; Peyvandi et al., Haematologica 2008;93:232-239).