tbuckley/cabot-search huggingface dataset:
Risk Factors for Hospitalization and Surgery in Patients with Rheumatoid Arthritis: Implications for Capitated Medical Payment
Authors: MICHAEL C. NEVITT
Journal: Annals of Internal Medicine (1986)

Risk factors for hospitalization in patients with rheumatoid arthritis were analyzed to determine if factors proposed for use in adjusting Medicare capitation payments to prepaid health plans are, in fact, associated with use of costly medical care for this illness. Participating physicians from a random sample of half the rheumatologists in northern California provided us with the names of all patients with rheumatoid arthritis presenting during a 1-month period. We surveyed 754 (89%) of these patients in both 1982-83 and 1984 to obtain information about health care use in the previous 12 months. We found that baseline functional status and prior-year admissions (proposed Medicare adjustment factors), as well as disease-specific severity measures, predicted subsequent admissions. The association of prior with subsequent admissions was independent of disease severity and physician characteristics. Adjusting capitation payments for both health status and prior use will increase incentives for prepaid health plans to enroll patients with rheumatoid arthritis who have high expected medical costs.
Issues in research on short-term dynamic psychotherapy
Authors: Jacques P Barber, Carol Foltz
Journal: Clinical Psychology Review (1999)

In this article, we review the development of short-term dynamic psychotherapy (STDP) and introduce some of the important questions to be addressed in studying STDP. We begin by surveying some of the areas not covered in this special edition (e.g., the efficacy of STDP, recent developments in dynamic formulation) because they were recently reviewed elsewhere. We then introduce the four articles included in this special mini-series. We conclude by looking at which questions could benefit from further study and recommend that more data be gathered regarding (a) the differences between the many different forms of STDP; (b) the efficacy of these forms of therapies for specific disorders, including personality disorders; (c) the essential theoretically relevant processes occurring in those treatments; (d) matching patients to different therapies; (e) the interrelations between different therapeutic processes; and (f) the different strategies for teaching STDP.
The role of helmets in skiing and snowboarding
Authors: P McCrory
Journal: British Journal of Sports Medicine (2002)

Helmets need to be developed using injury data and suitable standards

Haid was the first to raise the issue of helmet use in skiing when, in 1955, he published a study of fatal ski injuries treated in Innsbruck in Austria and suggested that head injury might be less severe if a helmet was worn.1 Since then the main proponent of helmet use in all aspects of skiing has been the Swiss neurosurgeon, Sooyoung Oh, although the evidence presented for his recommendations is anecdotal.2,3

The issue of sport specific helmet design becomes more important. Because at the present point in time we have only limited data on precise injury mechanisms in skiing and snowboarding, which suggests that there is no common mechanism to the occurrence of concussive injuries or skull fractures in these sports.4,5 This would mean that any helmet would have to be designed differently for these two sports. Injuries occurring in ski racing occur at far higher impact velocities than recreational skiing and furthermore usually occur …
Homosexuality, Confidentiality, and the Military
Authors: Richard J. Forde
Journal: JAMA (1987)

To the Editor.—  The idea that military personnel—either enlisted personnel or officers—are no more likely than civilians to lie to their personal physicians is an odd one. Although Redfield et al 1 apparently have no direct evidence that the military personnel in their study were ever punished for any illegal activities, one must consider certain facts of military life. The military physician is, in addition to being a physician, an agent of the state. There is no confidentiality regarding medical matters in the armed services; disclosure of misconduct to a military physician carries with it the possibility of punishment and/or discharge. Under the prevailing instructions, separation from the US Navy on the basis of homosexuality carries with it the stigma of by reason of Misconduct (SECNAV instruction 1900-9D, March 12, 1981, p 2). Having worked on the human immunodeficiency virus (HIV) antibody screening ward at a large West Coast navy
Blair says patients will have to travel further for specialist care
Authors: Zosia Kmietowicz
Journal: BMJ (2006)

Prime Minister Tony Blair warned this week that patients in England would have to get used to travelling beyond their local emergency department for the specialist care they need. 

Speaking at the launch of the Primary Care Trust Network, a membership organisation for the 152 primary care trusts in England, he referred to two reports published this week that call for further changes to the health service—this time to emergency heart and stroke services. 

George Alberti, the national clinical director for emergency care, and Roger Boyle, national clinical director for heart disease and stroke, argue in their reports that traditional emergency departments are not the only option in life and death situations. Mr …
Thyroid Function and Plasma Concentrations of Polyhalogenated Compounds in Inuit Adults
Authors: Renée Dallaire, Éric Dewailly, Daria Pereg, Serge Dery, Pierre Ayotte
Journal: Environmental Health Perspectives (2009)

BackgroundSeveral ubiquitous polyhalogenated compounds (PHCs) have been shown to alter thyroid function in animal and in vitro studies. So far, epidemiologic studies have focused on the potential effect of a small number of them, namely, polychlorinated biphenyls (PCBs) and some organochlorines (OCs), without paying attention to other important PHCs.ObjectivesWe investigated the relationship between exposure to several PHCs and thyroid hormone homeostasis in Inuit adults from Nunavik.MethodsWe measured thyroid parameters [thyroid-stimulating-hormone (TSH), free thyroxine (fT4), total triiodothyronine (tT3), and thyroxine-binding globulin (TBG)] and concentrations of 41 contaminants, including PCBs and their metabolites, organochlorine pesticides (OCPs), polybrominated diphenyl ethers (PBDEs), perfluorooctanesulfonate (PFOS), and a measure of dioxin-like compounds, detected in plasma samples from Inuit adults (n = 623).ResultsWe found negative associations between tT3 concentrations and levels of 14 PCBs, 7 hydroxylated PCBs (HO-PCBs), all methylsulfonyl metabolites of PCBs (MeSO2-PCBs), and 2 OCPs. Moreover, we found negative associations between fT4 levels and hexachlorobenzene Concentrations. TBG concentrations were inversely related to 8 PCBs, 5 HO-PCBs, and 3 OCPs. Exposure to BDE-47 was positively related to tT 3, whereas PFOS concentrations were negatively associated with TSH, tT3, and TBG and positively with fT4 concentrations.ConclusionExposure to several PHCs was associated with modifications of the thyroid parameters in adult Inuit, mainly by reducing tT3 and TBG circulating concentrations. The effects of PFOS and BDE-47 on thyroid homeostasis require further investigation because other human populations display similar or higher concentrations of these chemicals.
Melanoma awareness and self-examination practices: Results of a United States survey
Authors: Donald R Miller, Alan C Geller, Stephen W Wyatt, Allan Halpern, J.B Howell, Clay Cockerell, Barbara A Reilley, Barbara A Bewerse, Darrell Rigel, Lawrence Rosenthal, Rex Amonette, Ting Sun, Ted Grossbart, Robert A Lew, Howard K Koh
Journal: Journal of the American Academy of Dermatology (1996)

Skin cancers are common and there has been a dramatic increase in their incidence, particularly melanoma. However, little is known about awareness of melanoma and early detection practices in the general U.S. population.In 1995, the American Academy of Dermatology increased their efforts to promote awareness of melanoma. This study was conducted to document current knowledge of melanoma and self-examination practices.In February 1995, a telephone survey was conducted in a nationally representative sample of 1001 persons at least 18 years of age (3% margin of error) that included questions on knowledge, attitudes, and practices regarding early detection of melanoma.Almost 42% of those surveyed were unaware of melanoma, and only 26% of those who were aware could identify its specific signs. Most recognized at least one common risk factor for melanoma (e.g., sun exposure, fair skin). However, many did not distinguish melanoma from other skin cancers in terms of risk factors, signs of early disease, and body site distribution. The lowest measures of melanoma knowledge and attitudes were found among those who are male, nonwhite, and parents, and those with the lowest level of education and income. More than half (54%) did not conduct a self-examination. This practice was most frequently reported by women, white persons, and the elderly, as well as those with a greater knowledge of melanoma.Our research documents deficiencies in knowledge and practices related to early detection of melanoma in the general U.S. population and supports the need for public education about melanoma.
A morphometric and morphological study of the lungs of rabbits after unilateral pneumonectomy
Authors: E. S. Boatman
Journal: Thorax (1977)

<b>Boatman, E. S. (1977).</b><i>Thorax</i>, <b>32,</b> 406-417. <b>A morphometric and morphological study of the lungs of rabbits after unilateral pneumonectomy.</b> A study was made to determine the changes occurring in the contralateral lung of adult rabbits as a result of left pneumonectomy. Stereological procedures for light microscopy and for electron microscopy were used to quantitate the changes. Lungs from control rabbits, ranging in body weight from 1·0 to 9·0 kg, were also analysed. Resin corrosion casts of left and right lungs were prepared. Left pneumonectomy causes the volume of the right lung to increase to the total paired lung volume in about four weeks. Total surface area, while increasing directly with lung volume in control rabbits, increased as two-thirds of the lung volume after pneumonectomy. In some right lungs there appeared to be an increase in the number of alveoli. Mean linear intercepts for control lungs were fairly constant, but the volume density of alveolar ducts increased with age. In pneumonectomised animals, mean air-space diameter of the right lung increased by about 25% and the volume density of alveolar ducts by 22-33%. The volume density of alveolar wall tissue decreased by about 30%. The average number of alveoli/cm<sup>3</sup> for whole lungs was 2·31±0·46×10<sup>6</sup>, whereas for right lungs eight weeks or more after pneumonectomy it was significantly less (1·70±0·38×10<sup>6</sup>). Morphometry by electron microscopy revealed slight changes in the components of the alveolar septum and a reduction in the thickness of the air-blood barrier. The overall effect of left pneumonectomy was mainly one of a compensatory increase in the volume of the right lung with dilatation of alveoli and of alveolar ducts.
Homing Phenotypes of Tumor-Specific CD8 T Cells Are Predetermined at the Tumor Site by Crosspresenting APCs
Authors: Thomas Calzascia, Frédérick Masson, Wilma Di Berardino-Besson, Emmanuel Contassot, Rick Wilmotte, Michel Aurrand-Lions, Curzio Rüegg, Pierre-Yves Dietrich, Paul R. Walker
Journal: Immunity (2005)
Mucous membrane of respiratory epithelium.
Authors: L M Reid, R Jones
Journal: Environmental Health Perspectives (1980)

Of the eight epithelial cell types of the airway surface epithelium three are secretory, the mucous, serous and Clara cells: the first two are also found in the submucosal glands. Organ culture results indicate that the pattern of control of the surface cells is different from that of the glands. Our recent studies show that in the surface epithelium Clara and serous cells can quickly convert to mucous as do nonsecretory undifferentiated cells. The balance between the various cell types changes with airway level. The type of glycoprotein within the secretory granules is neutral or acid, sialylated or sulfated, and also shows a regional pattern. Homeostasis is maintained in the normal but the equilibrium is quickly upset by a variety of irritants, infection of drugs. Change in pattern of glycoprotein synthesis depends largely on change of granules. The granules at the cell apex change first. The nature and distribution of the various receptor binding sites is significant in patterns of control. This lability occurs in an intact epithelium and whether or not mitotic activity is increased. With irritation tolerance to stimulus develops. Antiinflammatory agents can protect against some of these cellular and intracellular events. Our organ culture studies and biochemical analysis of secretion complement the tissue studies. Recent studies show that isoproterenol and salbutamol (a nonselective beta agonist and a selective beta 2, respectively) alter the normal mix of cell types and quickly, but that they have different regional specificity.
Prevention of blindness by screening for diabetic retinopathy: a quantitative assessment.
Authors: T. E. Rohan, C. D. Frost, N. J. Wald
Journal: BMJ (1989)

Diabetic retinopathy is an important cause of blindness in the Western World. A review of the randomised trials of laser photocoagulation of the retina as a method of preventing blindness from this disorder showed that this treatment is very effective, reducing the risk of blindness by 61% in a treated eye. As only one eye is needed for sight the reduction in blindness in a population will be greater than 61% because the effect of treatment in one eye is not always identical with the effect in the other eye. For analysis this reduction was taken as 73%, representing the average of the minimum and maximum estimates (61% and 85%). The effectiveness of this treatment suggests that there is the potential for a national screening programme to bring about a major reduction in blindness from this cause. A quantitative assessment of the effect of screening indicated that a programme in which patients with diabetes mellitus are systematically referred to ophthalmic opticians for a retinal examination could detect 88% of all diabetics with serious retinopathy and that 87% of these cases would be treatable. Screening and early treatment of retinopathy would prevent deterioration of visual acuity and could reduce the risk of blindness due to diabetic retinopathy by an estimated 56% (0.73 X 0.88 X 0.87). The findings suggest that an effectively managed community based screening programme encompassing detection, referral, treatment, and follow up would prevent about 260 new cases of blindness in diabetics under the age of 70 each year in England and Wales. This would represent over 10% of all cases of blindness in adults in this age group.
The Unwelcome Intruder: Freud's Struggle With Cancer
Authors: Elliott B. Oppenheim
Journal: JAMA (1985)

This is not only a scholarly treatise about Freud's 16-year struggle with oropharyngeal cancer, but a valuable addition to the literature on doctors as patients. Sharon Romm has commingled her expertise as a plastic surgeon with her skill as an analytic biographer and historical scientist. When Sigmund Freud was 66 years old, he discovered a lesion he knew his personal physician Felix Deutsch "would not like"—a fungating carcinoma of the glossopalatine fold, the hard palate, and the mucosa of the cheek. Who did Freud select to operate? Freud was in his most productive years and world famous. He chose a surgeon whose academic prowess, unfortunately, outshone his technical expertise. Marcus Hajek, according to Romm, "performed an incomplete operation in his private clinic." The postoperative care was also inferior. Freud had a hemorrhage and almost died but was saved, paradoxically, by an imbecilic deaf-mute dwarf roommate. Hajek's care was "in the
A Statewide Approach to Diethylstilbestrol — The New York Program
Authors: Donna M. Glebatis, Dwight T. Janerich
Journal: New England Journal of Medicine (1981)

In August 1978, the New York State Legislature passed a bill to develop a program that would deal with the health problems associated with exposure to diethylstilbestrol (DES). The law, enacted as Chapter 715 of the New York Public Health Law, was a response to the mounting public concern about DES-induced cancer and the need for action on a statewide level.BackgroundDES, the synthetic nonsteroidal estrogen first produced in London in 1938 by Dodds and his colleagues, 1 was used extensively during the late 1940s and early 1950s after publication of reports on the efficacy of its use during pregnancy . . .
Airborne particles are a risk factor for hospital admissions for heart and lung disease.
Authors: A Zanobetti, J Schwartz, D W Dockery
Journal: Environmental Health Perspectives (2000)

We examined the association between particulate matter [less than/equal to] 10 microm; (PM(10)) and hospital admission for heart and lung disease in ten U.S. cities. Our three goals were to determine whether there was an association, to estimate how the association was distributed across various lags between exposure and response, and to examine socioeconomic factors and copollutants as effect modifiers and confounders. We fit a Poisson regression model in each city to allow for city-specific differences and then combined the city-specific results. We examined potential confounding by a meta-regression of the city-specific results. Using a model that considered simultaneously the effects of PM(10) up to lags of 5 days, we found a 2.5% [95% confidence interval (CI), 1.8-3. 3] increase in chronic obstructive pulmonary disease, a 1.95% (CI, 1. 5-2.4) increase in pneumonia, and a 1.27% increase (CI, 1-1.5) in CVD for a 10 microg/m(3) increase in PM(10). We found similar effect estimates using the mean of PM(10) on the same and previous day, but lower estimates using only PM(10) for a single day. When using only days with PM(10) < 50 mg/m(3), the effect size increased by [greater/equal to] 20% for all three outcomes. These effects are not modified by poverty rates or minority status. The results were stable when controlling for confounding by sulfur dioxide, ozone, and carbon monoxide. These results are consistent with previous epidemiology and recent mechanistic studies in animals and humans.
Glucuronidation of bile acids by their high-dose infusion into rats
Authors: Hajime Takikawa, Tohru Narita, Naoyo Sano, Masami Yamanaka
Journal: Hepatology (1991)

We previously reported that high-dose infusion of ursodeoxycholate into rats caused its extensive glucuronidation. In this study, the glucuronidation of various bile acids after high-dose infusion into rats was examined and the effects of coinfusion of bile acids on the glucuronidation of a trace dose of [14C]deoxycholate were also studied. Sixty minutes after infusion of 14C-bile acids at a rate of 1 mumol/min/100 gm, the glucuronidation of the labeled bile acid in the bile was 31%, 15%, 8% and 3% for deoxycholate, ursodeoxycholate, chenodeoxycholate and cholate, respectively. The infusion of a trace dose of [14C] deoxycholate resulted in only 2% glucuronidation, and coinfusion of taurochenodeoxycholate or tauroursodeoxycholate at a rate of 1 mumol/min/100 gm did not change the percentage of glucuronidation of [14C]deoxycholate. However, coinfusion of chenodeoxycholate, ursodeoxycholate or cholate at the same rate markedly increased the percentage of the [14C]deoxycholate-glycuronide in the bile (35%, 18% and 36%, respectively). Thus glucuronidation of bile acids by high-dose infusion into rats occurs predominantly with deoxycholate and is not specific for ursodeoxycholate, and glucuronidation depends on the unconjugated bile acid load, which might be regulated by the capacity of amidation by the liver.
Serious Acid-Base Disorders
Authors: Jerome P. Kassirer
Journal: New England Journal of Medicine (1974)

MAINTENANCE of the pH of body fluids within a narrow normal range is accomplished by an elaborate system involving the action of body buffers, alterations in the rate and volume of ventilation, and adjustments in renal bicarbonate reabsorption and acid excretion. A large variety of diverse clinical derangements alter the acid–base composition of body fluids, and the resulting acid–base disturbances may impair the function of vital organs such as the heart and brain, particularly when the pH change is severe—i.e., values less than 7.1 or greater than 7.6. The emergency measures in management necessitated by acid–base disorders with serious potential . . .
Comparative study of NOTES alone vs. EUS-guided NOTES procedures
Authors: A. Fritscher-Ravens, A. Ghanbari, T. Cuming, E. Kahle, H. Niemann, P. Koehler, K. Patel
Journal: Endoscopy (2008)

See also: Commentaire de travail de A. Fritscher-Ravens et al., pp. 925Endoscopy 2008; 40(11): 1059-1059DOI: 10.1055/s-0032-1306889
Long-Term Facilitation of Ventilation in Humans with Chronic Spinal Cord Injury
Authors: Nicole J. Tester, David D. Fuller, Jason S. Fromm, Martina R. Spiess, Andrea L. Behrman, Jason H. Mateika
Journal: American Journal of Respiratory and Critical Care Medicine (2013)

Rationale: Intermittent stimulation of the respiratory system with hypoxia causes persistent increases in respiratory motor output (i.e., long-term facilitation) in animals with spinal cord injury. This paradigm, therefore, has been touted as a potential respiratory rehabilitation strategy.Objectives: To determine whether acute (daily) exposure to intermittent hypoxia can also evoke long-term facilitation of ventilation after chronic spinal cord injury in humans, and whether repeated daily exposure to intermittent hypoxia enhances the magnitude of this response.Methods: Eight individuals with incomplete spinal cord injury (>1 yr; cervical [n = 6], thoracic [n = 2]) were exposed to intermittent hypoxia (eight 2-min intervals of 8% oxygen) for 10 days. During all exposures, end-tidal carbon dioxide levels were maintained, on average, 2 mm Hg above resting values. Minute ventilation, tidal volume, and breathing frequency were measured before (baseline), during, and 30 minutes after intermittent hypoxia. Sham protocols consisted of exposure to room air and were administered to a subset of the participants (n = 4).Measurements and Main Results: Minute ventilation increased significantly for 30 minutes after acute exposure to intermittent hypoxia (P < 0.001), but not after sham exposure. However, the magnitude of ventilatory long-term facilitation was not enhanced over 10 days of intermittent hypoxia exposures.Conclusions: Ventilatory long-term facilitation can be evoked by brief periods of hypoxia in humans with chronic spinal cord injury. Thus, intermittent hypoxia may represent a strategy for inducing respiratory neuroplasticity after declines in respiratory function that are related to neurological impairment.Clinical trial registered with www.clinicaltrials.gov (NCT01272011).
Focus: Washington: A fragile compromise on embryo research?
Authors: J Roberts
Journal: BMJ (1994)

Last week the National Institutes of Health took its first step towards ending a 15 year ban on funding research on human embryos. Supporters say it will eventually decrease birth defects. Opponents say it is murder.

A 19 member ad hoc committee of the NIH has spent over a year reviewing the arguments. Although its members - scientists, doctors, ethicists, and others - came from all points of the philosophical spectrum, they reached a consensus on difficult issues. For example, the committee says that while a human embryo “possesses qualities requiring moral respect” it “does not have the same moral status as infants and children.”

For 15 years, under Presidents Reagan and Bush, the NIH would not fund human embryo research because the Republicans were worried that antiabortion activists would threaten their fragile political coalition. Private …