tbuckley/cabot-search huggingface dataset:
US doctors are unwilling to pay more to abolish industry funded education
Authors: B. Roehr
Journal: BMJ (2011)

<h3>Abstract</h3> The premise of catch-and-release angling is that most fish survive fisheries interactions. Therefore, it is common for anglers, management agencies, and other organizations to share information on handling practices and other strategies that are believed to improve fish welfare and survival. Recent media coverage has sensationalized the use of carbonated beverages to treat bleeding fish, an intervention that is purported to stop bleeding but has yet to be validated scientifically. We captured Northern Pike (<i>Esox lucius</i>) via hook and line, experimentally injured their gills in a standardized manner, and treated them with either Mountain Dew, Coca Cola, or carbonated lake water and observed the duration and intensity of bleeding, as well as overall blood loss (using gill colour as a proxy) while the fish was held in a lake water bath. As a control, we had a group of experimentally injured fish that did not have liquid poured over their gills before the observation period. All treatments and the control were conducted at two different water temperatures (11-18 °C and 24-27 °C) to determine if the effects of pouring carbonated beverages over injured gills is temperature dependent. When compared to the control, we found that the duration and intensity of bleeding increased regardless of the type of carbonated beverages used in this study, and there was no effect of water temperature. Use of chilled versus ambient temperature beverages similarly had no influence on outcomes. As such, there is no scientific evidence to support the use of carbonated beverages for reducing or stopping blood loss for fish that have had their gills injured during recreational angling based on the context studied here. This study reinforced the need to scientifically test angler anecdotes and theories when it comes to best practices for catch-and-release fishing.
190 IMPACT OF AN EXERCISE PROGRAMME ON QUALITY OF LIFE, EFFORT TOLERANCE AND MUSCLE MASS IN PATIENTS WITH CIRRHOSIS
Authors: G. Soriano, E. Román, M.T. Torrades, G. Cárdenas, J. Córdoba, S. Vidal, M.J. Nadal, C. Villanueva, H. Bascuñana, C. Juárez, C. Guarner
Journal: Journal of Hepatology (2011)
Race and Allocation of Kidneys for Transplantation
Authors: Andrea Hassol
Journal: JAMA (1994)

To the Editor.  —As Gaston et al 1 point out, the hierarchical system favoring HLA matching disadvantages black renal transplant candidates. The impact of mandatory sharing of phenotypically identical kidneys is often underestimated. According to United Network for Organ Sharing (UNOS) policy, all such kidneys must be   with a kidney from the next suitable donor of the same blood type. Thus, not only is a kidney shared for a white patient (more than 90% of shared unmismatched kidneys are used for white patients 2 ), it is being paid back with a kidney also more likely to be used for a white recipient. As the Table demonstrates, the races have markedly different blood-type profiles (kidneys from type O donors are used for type O recipients).  The payback policy focuses on distribution of organs among transplant centers, not among patients. Public Law 99-509 (1986) requires UNOS to acquire and allocate
Hypnosis and will
Authors: Irving Kirsch, Steven Jay Lynn
Journal: Behavioral and Brain Sciences (2004)

Although we are sympathetic to his central thesis about the illusion of will, having previously advanced a similar proposal, Wegner's account of hypnosis is flawed. Hypnotic behavior derives from specific suggestions that are given, rather than from the induction, of trance, and it can be observed in 90% of the population. Thus, it is very pertinent to the illusion of will. However, Wegner exaggerates the loss of subjective will in hypnosis.
Expression of specific chemokines and chemokine receptors in the central nervous system of multiple sclerosis patients
Authors: Torben L. Sørensen, Marie Tani, Jakob Jensen, Virginia Pierce, Claudia Lucchinetti, Virginia A. Folcik, Shixin Qin, Jim Rottman, Finn Sellebjerg, Robert M. Strieter, Jette L. Frederiksen, Richard M. Ransohoff
Journal: Journal of Clinical Investigation (1999)

Chemokines direct tissue invasion by specific leukocyte populations. Thus, chemokines may play a role in multiple sclerosis (MS), an idiopathic disorder in which the central nervous system (CNS) inflammatory reaction is largely restricted to mononuclear phagocytes and T cells. We asked whether specific chemokines were expressed in the CNS during acute demyelinating events by analyzing cerebrospinal fluid (CSF), whose composition reflects the CNS extracellular space. During MS attacks, we found elevated CSF levels of three chemokines that act toward T cells and mononuclear phagocytes: interferon-gamma-inducible protein of 10 kDa (IP-10); monokine induced by interferon-gamma (Mig); and regulated on activation, normal T-cell expressed and secreted (RANTES). We then investigated whether specific chemokine receptors were expressed by infiltrating cells in demyelinating MS brain lesions and in CSF. CXCR3, an IP-10/Mig receptor, was expressed on lymphocytic cells in virtually every perivascular inflammatory infiltrate in active MS lesions. CCR5, a RANTES receptor, was detected on lymphocytic cells, macrophages, and microglia in actively demyelinating MS brain lesions. Compared with circulating T cells, CSF T cells were significantly enriched for cells expressing CXCR3 or CCR5. Our results imply pathogenic roles for specific chemokine-chemokine receptor interactions in MS and suggest new molecular targets for therapeutic intervention.
Transjugular Intrahepatic Portosystemic Shunt (TIPS)
Authors: Robin Miller-Catchpole
Journal: JAMA (1995)

<h3>Objective.</h3> —To provide clinicians with a technology assessment of the safety and effectiveness of the use of a transjugular intrahepatic portosystemic shunt (TIPS) for reducing portal hypertension and its associated complications of esophageal varices and ascites. <h3>Participants.</h3> —A literature review and a Diagnostic and Therapeutic Technology Assessment (DATTA) survey questionnaire were mailed to 72 physicians with expertise in gastrointestinal or abdominal surgery or interventional radiology and a special interest in liver disease or esophageal varices. These panelists had been nominated to the DATTA panel by appropriate specialty societies and medical schools. A total of 54 panelists (75%) responded. <h3>Evidence.</h3> —Assessment was based on the expert opinion of the panelists, as well as on published scientific literature (available as of January 2, 1995). Published studies were identified by a MEDLINE search using the terms<i>transjugular intrahepatic portosystemic shunt, TIPS</i>, and<i>transjugular</i>and by review of the references cited in these primary sources. <h3>Consensus Process.</h3> —The respondents completed a DATTA survey questionnaire; the survey results were tabulated, analyzed, and interpreted by an American Medical Association staff physician. <h3>Conclusions.</h3> —The safety of TIPS was considered to be established in the acute control of bleeding from esophageal varices in patients who had failed sclerotherapy. The safety of TIPS was considered to be promising for long-term control of bleeding from esophageal varices. In patients with end-stage liver disease and esophageal varices who are liver transplant candidates, the use of TIPS was considered to be an established therapy. The effectiveness of TIPS was considered to be (1) established in the acute control of bleeding in patients who failed sclerotherapy; (2) promising for long-term control of bleeding from esophageal varices; and (3) established in patients with end-stage liver disease and esophageal varices who are candidates for liver transplants. (<i>JAMA</i>. 1995;273:1824-1830)
The private finance initiative: The politics of the private finance initiative and the new NHS
Authors: D. Gaffney, A. M Pollock, D. Price, J. Shaoul
Journal: BMJ (1999)

This is the last of four articles on Britain's public-private partnership in health care

We began this series by arguing that the private finance initiative, far from being a new source of funding for NHS infrastructure, is a financing mechanism that greatly increases the cost to the taxpayer of NHS capital development.1 The second paper showed that the justification for the higher costs of the private finance initiative—the transfer of risk to the private sector—was not borne out by the evidence.2 The third paper showed the impact of these higher costs at local level on the revenue budgets of NHS trusts and health authorities, is to distort planning decisions and to reduce planned staffing and service levels.3

All this raises questions about the direction of government policy on the NHS. Recent government commitments to increase clinical staffing levels and reverse the decline in bed capacity sit uneasily with a policy that seems to lead in the opposite direction. The government has consistently argued that the private finance initiative is no more than a procurement policy, with no implications for services other than increased efficiency. However, this ignores the importance of public-private partnerships to the government's overall agenda.

#### Summary points

The private finance initiative does not provide new money for public services as the government claims

The high costs of capital under the private finance initiative translates into service and workforce cuts

The reduction in public provision of long term care, NHS dentistry, optical services, and elective surgical care shows the trajectory for the NHS under the private finance initiative

In the NHS, shrinkage in service provision combined with budget constraints could force primary care trusts to redefine entitlement to NHS care and to seek privately funded solutions for those who can afford to pay, leaving a rump service

The …
EUS-FNA and biomarkers for the staging of non-small cell lung cancer
Authors: M. Al-Haddad, M. Wallace
Journal: Endoscopy (2006)

Non-small cell carcinoma of the lung (NSCLC) is the most common cause of cancer death in the United States [1], with more than 160,000 annual deaths [2]. The American Joint Committee on Cancer TNM system is the current staging system for lung cancer, and its goal is to classify patients into groups based on the extent of disease. This system relies heavily on the pathologic evaluation of the primary tumor (T), regional nodes (N) and distant metastases (M). Lymph nodes in the mediastinum are the most common sites of metastases. Recent advances in molecular diagnostics has great potential to increase the accuracy of detection of both primary tumors and metastatic lymph nodes by enabling detection of very small numbers of cancer cells ("micrometastases") using minimally invasive sampling techniques such as image-guided fine needle aspiration (FNA).
Proceedings: The actions of some anti-inflammatory and antirheumatic drugs on hexosamine biosynthesis.
Authors: P J Winterburn, C F Phelps
Journal: Annals of the Rheumatic Diseases (1975)

The object of the research was to shed light on the factors concerned in the formation of synovial joints, with specific reference to the possible role of movement.The digits of human embryos (8-12 weeks) were maintained in organ culture (Trowell, 1954; Dingle, Fell and Lucy, 1966; Rajan and Hopkins, 1970) in the presence of synthetic medium BGJ (Biggers, Gwatkin, and Heuner, 1961) containing 15 % fetal calf serum (Flow Laboratories) and 150 uigfml ascorbic acid (Reynolds, 1966).In the young fetus, 10 weeks and under, the digits consist of a cartilagenous bar.After 1O days in culture the joint cavity appeared and this was in the absence of movement.There was evidence of material in the joint cavity, which was acid mucopolysaccharide in nature, with occasional cells showing pyknotic nuclei lining the cavity.Under the electron microscope there was single cell necrosis with evidence of loss of glycosaminoglycans, some areas showing aggregation of this material as seen with ruthenium red stained sections.So far 76 explants have been examined and the evidence suggests that the following factors may be responsible in part, if not wholly, in the formation ofjoints: (a) Necrosis ofcells in areas undergoing joint differentiation.(b) Altera- tions in glycosaminoglycans.As the organ cultures are devoid of blood supply, nervous control, and movement, these factors may not be essential to the formation and differentiation of joint cavity.
Fate of the gold and the thiomalate part after intramuscular administration of aurothiomalate to mice.
Authors: E Jellum, E Munthe, G Guldal, J Aaseth
Journal: Annals of the Rheumatic Diseases (1980)

Double isotope-labelled aurothiomalate (195Au-14C-thiomalate) has been administered to mice, and the excretory fate and tissue distribution have been studied. The results show that the gold and the thiomalate separate in vivo resulting in protein-bound gold and release of free thiomalate. About half of this thiol is excreted in the urine during the first day, and the remaining half is bound to tissue membranes and cells. Although thiomalate penetrates cellular membranes slowly in vitro. the compound is found in all organs, mostly in the liver and the kidneys, after administration of aurothiomalate. Separation of the gold moiety from its thiol carrier also takes place in man. This explains the finding of free thiomalate in the urine of patients receiving aurothiomalate intramuscularly. As thiomalate has now been shown to possess penicillamine-like biological activities it is suggested that at least part of the antirheumatic effects of aurothiomalate may be due to the thiol carrier being released in the body.
England launches programme to prevent type 2 diabetes
Authors: J. Wise
Journal: BMJ (2015)

In the first six months of a formal Internal Quality Assessment Scheme operating in the Department of Histopathology, Broadgreen Hospital, Liverpool, 1005 items of data were gathered, relating to 80 cases. The scheme entails a random 2% sample of biopsy specimens being selected, each case being analysed using a structured proforma, and a numerical scoring system being allocated to all aspects of specimen handling. Technical and secretarial performance was good while the quality of clinical information provided by the requesting clinician was poor. There was a wide variation in reporting times, which related partly to the complexity of the specimen, and partly to the degree of supervision required by the reporting pathologist. Month by month analysis of reporting times showed a significant increase in reporting times associated with rotation of junior staff, but not with periods of annual leave. Pathologist performance scores were good, but close examination of components of the overall score for an individual pathologist indicated occasional areas of weakness (such as the adequacy of the macroscopic report). It is concluded that this scheme is worthwhile and its practice will be continued indefinitely. The comprehensive nature of the analysis allows for the formal identification of areas of work which need improvement, and the allocation of a formal numerical score allows improvement in these areas to be monitored. The monthly meetings provide a means whereby performance scores are fed back to the participating pathologists, and they are also of general educational value regarding histological reporting practice. It is intended that the scheme be extended to include the assessment of special stains, frozen sections, and adequacy of the report delivery service. The system is easily adaptable for use within other histopathology departments.
An Analysis of the Incidence of "Fainting" in 5,897 Unselected Blood Donors
Authors: C. L. Greenbury
Journal: BMJ (1942)

ARSENICAL POISONING MEDITIHRNAL 253 lishes a figure of 1 to 3 mg.as usual in acute and chronic poisoning.In the Armstrong case it was only 0.45 mg.probably eight days after the first dose.Two of five cases recorded by Schwartz and Deckert (1936) showed concen- tration for scalp hair at 0.1 and 0.5 mg. in chronic arsenical poisoning from wine.It is of great importance to con- sider the presence or absence of arsenic in normal hair.Althausen and Gunther (1929) record two analyses-0.08 and 0.16 mg. of arsenic per 100 grammes of hair of known history.The locality and previous treatment are of paramount importance in this consideration.Wuhrer (1937) carried out thirty analyses in Berlin on both male and female hair, mainly from barbers' shops: the great majority were at concentrations between 0.015 and 0.038 mg. of arsenic per 100 grammes of hair.Bagchi and Ganguly (1937) found between 0.056 and 0.094 mg. in four normal cases in India.The results of Myers and Cornwall (1925) are much more variable and less con- vincing.No method of analysis is given.Twenty-one
Acute Myocardial Infarction Following Tetraethylammonium Chloride Therapy
Authors: D. J. Livingstone
Journal: BMJ (1950)

ready in the operating theatre.The present case has shown, however, that, despite its dramatic effect, procaine may have no action for about five minutes, during which time severe damage to the brain will occur.Time should therefore not be wasted in awaiting the result of the procaine injection, and cardiac massage should be started at once.Our experience with the above case showed the difficulty of compressing the heart satisfactorily from below the diaphragm, as mentioned by Nicholson (1942).and that the transdiaphragmatic incision carries a risk of injury to,the heart.Unless the abdomen be already open, Lahey and Ruzicka recommend a direct transthoracic approach through the fourth interspace, dividing the fourth and fifth costal cartilages.Lahey and Eversole (1950) suggest that a disconnected needle be passed through the fourth interspace into the ventricle as soon as the pulse becomes imperceptible; if no movement be observable, or begins after the needle prick, the case is one of true cardiac arrest and not momentary inhibition as may occur following accidental pressure on the carotid sinus; the procaine-adrenaline mixture is then injected in two instalments of 5 ml.each, and if ther.e is no response within 30 seconds cardiac massage should be started at once.Lahey and Ruzicka report 46% of complete recoveries in 15 cases ; Hamilton Bailey had only four survivors of 40 cases, though the heart restarted in 13; and Barber and Madden (1945) reported 48 recoveries in 143 cases Summary A case of cardiac arrest is reported in which complete asystole persisted for 45 minutes despite cardiac massage and adrenaline, but normal rhythm was restored after two intra- cardiac injections of procaine, though the patient survived for only four hours.The immediate use of procaine, injected into the heart in preference to or with adrenaline, is suggested, but in view of its delayed action cardiac massage should be per- formed at once so that there is no interruption of the cerebral circulation.
Prevalence of vertebral compression fractures due to osteoporosis in ankylosing spondylitis.
Authors: S H Ralston, G D Urquhart, M Brzeski, R D Sturrock
Journal: BMJ (1990)

To determine the prevalence of vertebral compression fractures due to osteoporosis in patients with ankylosing spondylitis.Prospective study of 111 consecutive patients; patients with vertebral compression fractures were entered into a case-control study.Outpatient clinic at the centre for rheumatic diseases, Glasgow.111 Consecutive patients with ankylosing spondylitis. Patients with compression fractures were matched for age and sex with two controls selected from the rest of the group. Patients with biconcave vertebral fractures were also studied.Assessments of spinal deformity and mobility and analysis of lateral radiographs of spines for presence of syndesmophytes.Fifteen patients with compression fractures and five with biconcave fractures were studied. Compared with the controls the patients with compression fractures had increased formation of syndesmophytes in the lumbar spine, whereas those with biconcave fractures had increased formation throughout the spine. Patients with compression fractures also had a greater degree of spinal deformity (distance from wall to tragus 24.5 cm v 12.7 cm in controls), less spinal mobility (20 v 45.6 degrees of flexion), and reduced chest expansion (2 cm v 3cm).Vertebral compression fractures due to osteoporosis are a common but frequently unrecognised complication of ankylosing spondylitis and may contribute to the pathogenesis of spinal deformity and back pain.
Abstract 1564 3D Magnetic Resonance Imaging of Body Fat Distribution in Obese Twins From the TwinsUK Cohort: A Comparative Study to Current Cardiovascular Risk Assessment and Risk Scores
Authors: Christian H Jansen, Diana Wald, Marcus R Makowski, Ulrike Blume, Andrea J Wiethoff, Hans-Peter Meinzer, Peter Boernert, Tobias Schaefter, Rene M Botnar, Reza M Razavi, Timothy Spector, Gerald F Greil
Journal: Circulation (2009)
Physician-Controlled Utilization Management
Authors: Daniel Temianka
Journal: Annals of Internal Medicine (1996)

Letters1 May 1996Physician-Controlled Utilization ManagementDaniel Temianka, MDDaniel Temianka, MDHealth Care Partners Medical Group; Los Angeles, CA 90015Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-124-9-199605010-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their article on managed care and capitation, Kerr and colleagues [1] overlook the fact that physicians' resource utilization meetings also gather clinicians together in a collegial atmosphere to discuss their patients, thus functioning as a multidisciplinary brain trust. This is neither gatekeeping nor utilization management. We have renamed this group our “Care and Resources Committee,” a term that more accurately reflects the group's purpose and function.Implicit in most criticisms of utilization management is the shaky assumption that doing a requested procedure is, by default, the gold standard. This is the “might as well” mentality, which ...References1. Kerr EA, Mittman BS, Hays RD, Siu AL, Leake B, Brook RH. Managed care and capitation in California: how do physicians at financial risk control their own utilization? Ann Intern Med. 1995; 123:500-4. Google Scholar2. Goldfarb S. Physicians in control of the capitated dollar: do unto others … [Editorial]. Ann Intern Med. 1995; 123:546-7. Google Scholar Author, Article, and Disclosure InformationAffiliations: Health Care Partners Medical Group; Los Angeles, CA 90015 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByManagement of Knowledge in the Modern Health Care Delivery SystemCommentary: Clinical Decision Support for Quality Management 1 May 1996Volume 124, Issue 9Page: 856KeywordsBrainEnd of life careEvidence based medicineLaboratory testsPatientsSurgery Issue Published: 1 May 1996 CopyrightCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...