tbuckley/cabot-search huggingface dataset:
How private finance is moving primary care into corporate ownership
Authors: A. M Pollock
Journal: BMJ (2001)

A central aim in establishing the NHS was to integrate primary care and health and social services in health centres.But this aim was compromised by the absence of public capital and the reluctance of the Treasury to buy out practice premises owned by general practitioners.Although there was some grant funding for health and local authority owned health centres, by 1974 only 15% of general practitioners operated out of these. 1 General practitioner owned practice premises remained the dominant model from 1966 until 1989, financed by government loans and funded from NHS revenue under the rental reimbursement schemes.The privatisation of the government loan body in 1989 saw a switch to private finance and the entry of commercial companies and for-profit corporations.The amount of capital that can be raised by the private sector for new investment in the NHS is unrestricted.However, these debts have to be repaid through NHS funds or user charges.The renewed impetus for integrated services in the 1997 white paper, The New NHS, 2 means that more sophisticated buildings are required to accommodate advanced clinical technology and information systems.The complex financing and funding arrangements, combined with demographic factors, makes it likely that as general practitioners opt for a salaried service, the trend to for-profit corporations owning and buying out practice premises will accelerate.Currently, primary care services are provided by 29 987 general practitioners in 9000 main surgeries and 2500 branch surgeries. 3The most recent survey of ownership carried out by the NHS Executive's valuation office in 1995-6 showed that 63% of practice premises were owned by general practitioners, 16% were owned by the NHS, and 21% were rented from the private sector. 4 In its first capital investment strategy for the NHS, the Department of Health proposed a "national target of improving 1000 GP premises over the next 3 years [by] replicating the success of big hospitals in non-acute settings and to explore the scope for PFI [Private Finance Initiative] type solutions in primary care." 5 Recent estimates suggest that about £10bn needs to be invested in primary care over the next decade. 6Investment has started and is accelerating under the government's public-private partnerships initiative.Although loans for practice premises are now increasingly from the commercial sector
THE EFFECTS OF OBSTRUCTIVE LESIONS OF THE COMMON DUCT OF THE LIVER
Authors: E. STARR JUDD
Journal: JAMA (1927)

While the accepted tests of hepatic function in obstructive jaundice such as the dye retention test and the van den Bergh test yield valuable information concerning the clinical condition of the patient, they do not afford an accurate indication of the amount of temporary or permanent hepatic injury caused by bile stasis and infection. Mann and Bollman<sup>1</sup>in their recent survey of the subject have made this point clear. It would seem that no short-cut laboratory methods can yet replace careful gross and microscopic examination of all material obtained at operation or at necropsy, as a basis for the treatment of future cases. There is a tendency for the surgeon to neglect the rather unknown intrahepatic portion of the biliary tract in considering the effects of the local lesion, even though a thorough knowledge of its condition might modify his technic or alter his prognosis. This, in itself, is
Clonal genetic and hematopoietic heterogeneity among human-induced pluripotent stem cell lines
Authors: Jason A. Mills, Kai Wang, Prasuna Paluru, Lei Ying, Lin Lu, Aline M. Galvão, Dongbin Xu, Yu Yao, Spencer K. Sullivan, Lisa M. Sullivan, Helen Mac, Amel Omari, Jyh-Chang Jean, Steve Shen, Adam Gower, Avi Spira, Gustavo Mostoslavsky, Darrell N. Kotton, Deborah L. French, Mitchell J. Weiss, Paul Gadue
Journal: Blood (2013)
Doctors urge Syrian government to allow them access to patients
Authors: A. Gulland
Journal: BMJ (2013)

Doctors and aid agencies are urging the Syrian government to allow medical and other aid relief into the country to alleviate the worsening humanitarian crisis.

Zaher Sahloul, president of the Syrian American Medical Society and a critical care specialist in Chicago, told a debate on the health crisis in Syria that he welcomed the renewed diplomatic and international focus on the warring country since the chemical attack on Damascus in August. But he said that the country’s deteriorating humanitarian situation had to be a priority.

Sahloul said, “It is morally repulsive that we are talking about creating safe passage for chemical weapons inspectors but we are not allowing safe passage for humanitarian organisations.”

During the debate, organised by the Global Health Policy Center in Washington, DC, and held at its headquarters, Sahloul …
The relation between the prevalence of HEV in three dinstinct region of Turkey and age, gender, education and abortions
Authors: Dilek Olcay, Can Polat Eyigun, Sukru Volkan Ozguven, Ismail Yasar Avci, Bulent Ahmet Besirbellioglu, Selma Yegane Tosun, Alaaddin Pahsa
Journal: Journal of Hepatology (2002)
Risk of Developing Adenomas and Carcinomas in the Ileal Pouch in Patients With Familial Adenomatous Polyposis
Authors: Pieter Friederich, Andrea E. de Jong, Lisbeth M. Mathus–Vliegen, Eveline Dekker, Han H. Krieken, Jan Dees, Fokko M. Nagengast, Hans F.A. Vasen
Journal: Clinical Gastroenterology and Hepatology (2008)
Abstract 3636: Systems biology approach links genetic, epigenetic, and transcriptomic features to tamoxifen sensitivity.
Authors: Eric R. Gamazon, Liming Weng, Hae Kyung Im, Xiaotong Zhang, Dana M. Ziliak, R. Stephanie Huang
Journal: Cancer Research (2013)

Abstract Utilizing existing genome-wide genotype, transcriptome and microRNA (miRNA) datasets, we developed an integrative approach to evaluate the role of genetic-epigenetic regulatory networks in human complex traits. In this study, we focused on cellular sensitivity to tamoxifen, a commonly prescribed breast cancer medication as a phenotype of interest. A sequential multi-dimensional model was constructed to first identify genes/miRNAs whose expression levels are correlated with tamoxifen sensitivity. This in turn facilitated the identification of SNPs associated with potential functionally relevant genomic features. Finally, associations between these selected SNPs and cellular sensitivity to tamoxifen were evaluated. A permutation-based false discovery rate (FDR) procedure showed that association findings from our approach have much lower FDRs when compared to those obtained through a traditional single-step genome-wide association study (GWAS) between SNP and drug sensitivity. Our model identified 50 unique SNPs associated with 30 miRNAs and 34 gene expression levels, all of which associated with cellular sensitivity to tamoxifen phenotypes in HapMap YRI samples. Among them, several miRNAs and genes have been previously implicated to play a role in tamoxifen sensitivity; most are novel. Functional studies on select miRNAs/genes are currently underway in both the HapMap samples and breast cancer cell lines. Citation Format: Eric R. Gamazon, Liming Weng, Hae Kyung Im, Xiaotong Zhang, Dana M. Ziliak, R. Stephanie Huang. Systems biology approach links genetic, epigenetic, and transcriptomic features to tamoxifen sensitivity. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3636. doi:10.1158/1538-7445.AM2013-3636
Effects of Atrial Pacing on Left Ventricular Performance in Patients with Heart Disease
Authors: RICHARD F. LEIGHTON, STEPHEN J. ZARON, JOHN L. ROBINSON, ARNOLD M. WEISSLER
Journal: Circulation (1969)

Hemodynamic data and systolic time intervals were obtained at resting heart rate and during atrial pacing in 10 patients with heart disease, eight with left ventricular dysfunction, and two with mitral stenosis. The mean increase in heart rate was 44 beats/min. During atrial pacing there was no significant alteration in cardiac output, minute work, left atrial or pulmonary wedge mean pressure, or duration of left ventricular pre-ejection period. When the pressure events which determine the duration of the isovolumic time and the left ventricular pre-ejection period were examined, aortic diastolic pressure rose while left ventricular end-diastolic pressure fell. The rate of pressure rise (dp/dt) determined from high-fidelity left ventricular pressure pulses in three patients increased out of proportion to the increased pressure developed throughout isovolumic contraction. The augmentation in dp/dt from lower end-diastolic pressure indicates improved mechanical performance of the left ventricle, which is not necessarily translated into hemodynamic improvement.
Rebuilding of Afghanistan is hampered by the Taliban
Authors: Peter Moszynski
Journal: BMJ (2006)

A five year plan to restore security, combat opium cultivation, and help development in Afghanistan was launched at a conference on reconstruction in the country in London last week.

The World Food Programme told the conference that “over 50% of children are malnourished,” and it reminded donors “that humanitarian assistance to poor and hungry Afghans—often living in troubled areas—is an important part of achieving peace.”

The World Bank warned that reconstruction “will be severely affected unless pervasive gender gaps are addressed.” It pointed out: “Afghanistan's …
II. Medicine and Motherhood
Authors: Marilyn Heins
Journal: JAMA (1983)

IN THE preceding COMMENTARY, Dr Dimond makes two cogent points: (1) that discrimination directed against women entering medical education has ended and (2) that a major task before women physicians is to solve career-family conflicts. He suggests that women should learn how to delegate tasks in a "professional household." Most women physicians will agree with him. Dr Dimond is correct when he says that the major battle has been won. The system has responded, perhaps as rapidly as any system in history. Not only are women entering medical school in unprecedented numbers, but complaints of sexism have greatly diminished. Although many schools have women's support groups, the sheer numbers of women make it possible for women not only to<i>be</i>in medical school, but to feel comfortable there. Women are beginning to be accepted even in those residency programs once thought to be "for men only." There is also slow
Interaction between heat shock and interleukin 6 stimulation in the acute-phase response of human hepatoma (HepG2) cells
Authors: Jens O. Karlsson, Martin L. Yarmush, Mehmet Toner
Journal: Hepatology (1998)

Two characteristic elements of the acute-phase response are an altered pattern of circulating hepatic proteins and fever. Whereas a fever-induced heat shock response could affect expression of acute-phase proteins in the liver, the effects of a modest temperature increase on protein secretion in interleukin-6 (IL-6)-stimulated HepG2 cells were investigated. The response of HepG2 cells to IL-6 stimulation was significantly affected by heat treatment at 40 degreesC. Albumin secretion rates, which were reduced by a factor of 2 in response to either heat shock or IL-6 stimulation alone, were down-regulated by a factor of 4 when IL-6 was administered simultaneously with a continuous 40 degrees C heat shock. IL-6-induced fibrinogen up-regulation was significantly reduced by heat treatment (P < .01), and secretion rates were indistinguishable from control levels after 2 days (P > .10). Unexpectedly, heat shock at 40 degrees C induced a fivefold up-regulation of haptoglobin production in the absence of IL-6. Simultaneous heat shock and IL-6 stimulation caused a synergistic enhancement of haptoglobin expression, with secretion rates increasing up to 30-fold compared with unstimulated control cells. For all three proteins, the interaction between temperature and IL-6 concentration was statistically significant (P < .001). Heat treatment resulted in significant alterations of both the kinetics and sensitivity of IL-6-induced protein synthesis, suggesting a major modification of the mechanism of acute-phase protein regulation at 40 degreesC. In summary, the data show that heat shock can significantly modulate the pattern of acute-phase protein expression and that fever may be an important regulatory factor in the acute-phase response.
Strep and OCD, Tourette
Authors: Joan Stephenson
Journal: JAMA (2009)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Seroprevalence Rates of Human Immunodeficiency Virus Infection at Sentinel Hospitals in the United States
Authors: Michael E. St. Louis, Kathryn J. Rauch, Lyle R. Petersen, John E. Anderson, Charles A. Schable, Timothy J. Dondero
Journal: New England Journal of Medicine (1990)

To evaluate the epidemiology of infection with human immunodeficiency virus type 1 (HIV-1) in selected urban communities in the United States, we instituted active surveillance at sentinel hospitals by anonymous testing of samples of blood specimens for HIV-1 antibody. To reflect better the rates of HIV-1 seroprevalence in the communities served by the sentinel hospitals, we excluded specimens from all patients with diagnoses that are often associated with HIV infection.From January 1988 to June 1989, 89,547 specimens were tested at 26 hospitals in 21 cities. The overall rate of HIV-1 seroprevalence was 1.3 percent, but it ranged from 0.1 to 7.8 percent according to hospital (median, 0.7 percent). The age distribution of persons seropositive for HIV-1 was similar across hospitals and closely paralleled that of persons with the acquired immunodeficiency syndrome (AIDS). In areas of low seroprevalence, HIV-1 infections were highly concentrated among men. However, the male-to-female ratio (median, 7.0) decreased steadily with an increasing overall rate of seroprevalence (P less than 0.001); at the five hospitals with the highest rates of seroprevalence, the median male-to-female ratio was only 2.9. The median black-to-white ratio of HIV-1 seroprevalence was 1.8, but at hospitals with low rates of seroprevalence the rates in blacks and whites were nearly equal. At two hospitals in the communities with the highest prevalence of AIDS, 1.1 to 3.8 percent of adolescents 15 to 19 years old and 18 to 22 percent of all men 25 to 44 years old were seropositive for HIV-1.In these sentinel, urban populations there is tremendous variation in the rate of HIV-1 infection (over 70-fold). The very high seroprevalence at some sentinel hospitals indicates the need for routine screening for HIV-1 infection among some groups of patients, regardless of clinical presentation.
Comparative toxicity of PCBs and related compounds in various species of animals.
Authors: E E McConnell
Journal: Environmental Health Perspectives (1985)

There are several basic principles that apply to the clinicopathologic syndrome produced by polychlorinated biphenyls (PCBs). They are as follows: The degree of halogenation and position of the halogen atoms determine the potency of PCB, PBB, CDD, CDF and CN; in a given species of animals, the clinicopathologic syndrome induced by PCB is comparable to that induced by polybrominated biphenyls (PBB), chlorinated dibenzo-p-dioxins (CDD), chlorinated dibenzofurans (CDF), and chlorinated naphthalenes (CN) when an equitoxic dose is achieved; The clinicopathologic syndrome is different in each species of animals; Different species of animals vary in their susceptibility to intoxication; intoxication is more readily effected in young animals that in adults; at lethal doses the time between exposure and death is prolonged (greater than 2 weeks).
High Density of Long Dinucleotide Microsatellites in Drosophila subobscura
Authors: Marta Pascual, Malcolm D. Schug, Charles F. Aquadro
Journal: Molecular Biology and Evolution (2000)

We isolated 96 dinucleotide repeats with five or more tandemly repeated units from a subgenomic Drosophila subobscura library. The mean repeat unit length of microsatellite clones in D. subobscura is 15, higher than that observed in other Drosophila species. Population variation was assayed in 32–40 chromosomes from Barcelona, Spain, using 18 randomly chosen microsatellite loci. Positive correlation between measures of variation and perfect repeat length measures (mean size, most common, and longest allele) is consistent with a higher mutation rate in loci with longer repeat units. Levels of microsatellite variation measured as variance in repeat number and heterozygosity in D. subobscura were similar to those of Drosophila pseudoobscura and higher than those of Drosophila melanogaster and Drosophila simulans. Our data suggest that higher levels of microsatellite variation, and possibly density, in D. subobscura compared with D. melanogaster are due to both a higher average effective population and a higher intrinsic slippage rate in the former species.
A CASE OF PRIMARY RETROPERITONEAL SARCOMA.
Authors: RICHARD R. SMITH
Journal: JAMA (1901)

The following case of retroperitoneal sarcoma is reported because of its rarity. The extremely softened condition of the tissues was unusual, perhaps unique. In Steele's<sup>1</sup>summary of the literature of the subject he found 22 cases, or 35 per cent. of the total number of cases reported were cystic, and in 15 of the 22 the degeneration a hemorrhagic one, the center of the softened growth being filled with a dark brown fluid or semi-fluid material. This softening was so extreme in the case here reported as to make it impossible to name its exact origin. That it started in the upper retroperitoneal space was apparent. The case also presented many of the objective symptoms of a pancreatic cyst, which makes the case of interest in considering that affection. T. A. D., male, aged 27, farmer, gave no history of syphilis or gonorrhea. He had good health until the
The impact of outcome reporting bias in randomised controlled trials on a cohort of systematic reviews
Authors: J. J Kirkham, K. M Dwan, D. G Altman, C. Gamble, S. Dodd, R. Smyth, P. R Williamson
Journal: BMJ (2010)

To examine the prevalence of outcome reporting bias-the selection for publication of a subset of the original recorded outcome variables on the basis of the results-and its impact on Cochrane reviews.A nine point classification system for missing outcome data in randomised trials was developed and applied to the trials assessed in a large, unselected cohort of Cochrane systematic reviews. Researchers who conducted the trials were contacted and the reason sought for the non-reporting of data. A sensitivity analysis was undertaken to assess the impact of outcome reporting bias on reviews that included a single meta-analysis of the review primary outcome.More than half (157/283 (55%)) the reviews did not include full data for the review primary outcome of interest from all eligible trials. The median amount of review outcome data missing for any reason was 10%, whereas 50% or more of the potential data were missing in 70 (25%) reviews. It was clear from the publications for 155 (6%) of the 2486 assessable trials that the researchers had measured and analysed the review primary outcome but did not report or only partially reported the results. For reports that did not mention the review primary outcome, our classification regarding the presence of outcome reporting bias was shown to have a sensitivity of 88% (95% CI 65% to 100%) and specificity of 80% (95% CI 69% to 90%) on the basis of responses from 62 trialists. A third of Cochrane reviews (96/283 (34%)) contained at least one trial with high suspicion of outcome reporting bias for the review primary outcome. In a sensitivity analysis undertaken for 81 reviews with a single meta-analysis of the primary outcome of interest, the treatment effect estimate was reduced by 20% or more in 19 (23%). Of the 42 meta-analyses with a statistically significant result only, eight (19%) became non-significant after adjustment for outcome reporting bias and 11 (26%) would have overestimated the treatment effect by 20% or more.Outcome reporting bias is an under-recognised problem that affects the conclusions in a substantial proportion of Cochrane reviews. Individuals conducting systematic reviews need to address explicitly the issue of missing outcome data for their review to be considered a reliable source of evidence. Extra care is required during data extraction, reviewers should identify when a trial reports that an outcome was measured but no results were reported or events observed, and contact with trialists should be encouraged.
Reporting of eligibility criteria of randomised trials: cohort study comparing trial protocols with subsequent articles
Authors: A. Blumle, J. J. Meerpohl, G. Rucker, G. Antes, M. Schumacher, E. von Elm
Journal: BMJ (2011)

<b>Objective</b> To determine whether and how eligibility criteria of participants prespecified in protocols of randomised trials are reported in subsequent articles. <b>Design</b> Cohort study. <b>Setting</b> Protocols submitted to the ethics committee of a German medical faculty. <b>Data sources</b> 52 trial protocols and 78 subsequent publications published between 2000 and 2006. <b>Main outcome measure</b> Proportion of matching, missing, modified, or newly added eligibility criteria between trial protocols and subsequent publications. <b>Results</b> Differences were found between protocols and subsequent publications for all 52 trials. Information on eligibility criteria was missing in the publications for all 52 trials (100%, 95% confidence interval 93% to 100%), modified for 44 (85%, 72% to 93%), and newly added for 21 (41%, 27% to 55%). The mean number of eligibility criteria for each trial was 25 (range 7-43) and the mean proportion of matching eligibility criteria per trial was 50% (95% confidence interval 44% to 55%, range 13-93). Of 1248 eligibility criteria prespecified in the protocols, 606 (49%, 46% to 51%) were matching in subsequent publications, 479 (38%, 36% to 41%) were missing, and 163 (13%, 11% to 15%) were modified. 51 eligibility criteria were added to publications. Most prespecified eligibility criteria were about comorbidity (42%, 39% to 45%), treatment (20%, 18% to 22%), or type or severity of illness (17%, 15% to 19%). Most of the missing eligibility criteria (96%, 94% to 97%) and modified eligibility criteria (54%, 46% to 62%) suggested broader study populations and most of the added eligibility criteria (86%, 74% to 94%) suggested narrower study populations. <b>Conclusions</b> Many users of trial information rely on published journal articles. These articles generally do not reflect the exact definition of the study population as prespecified in the protocol. Incomplete or inadequate reporting of eligibility criteria hampers a proper assessment of the applicability of trial results.