tbuckley/cabot-search huggingface dataset:
Comparison of Performance of Traditional Medicare vs Medicare Managed Care
Authors: Bruce E. Landon
Journal: JAMA (2004)

ContextSince 2000, the Centers for Medicare & Medicaid Services (CMS) has been collecting information on beneficiaries' experiences with health care for Medicare managed care (MMC) and traditional fee-for-service (FFS) Medicare.ObjectivesTo compare beneficiary experiences with managed care and FFS arrangements throughout the country and to assess the stability of those differences over time.Design, Setting, and ParticipantsCMS administered managed care and FFS versions of the Consumer Assessment of Health Plans Study (CAHPS) survey to samples of beneficiaries (aged ≥65 years) from Medicare + Choice MMC organizations and from geographic strata within the traditional FFS Medicare program. We analyzed responses collected in 2000 and 2001 from 497 869 respondents: 299 058 beneficiaries enrolled in MMC plans (response rate, 82%) and 198 811 enrolled in FFS Medicare (response rate, 68%). Differences between MMC and FFS within states were assessed after adjustment for case mix and nonresponse. For estimates at the regional and national level, state estimates were combined after weighting by the MMC enrollment in the state.Main Outcome MeasuresFour overall ratings (of the plan, personal physician, care received overall, and care received from specialists), 5 measures summarizing beneficiaries' experiences with care (getting care needed; getting care quickly; communication with clinicians; courtesy and respect of physician's office staff; and paperwork, information, and customer service), and reports of receipt of 3 preventive services (flu shots, pneumococcal vaccinations, and being advised to quit smoking) were assessed.ResultsRespondents in MMC and FFS plans were similar to each other and to the Medicare population as a whole. Nationally, FFS Medicare beneficiaries rated experiences with care measured by the CAHPS survey higher than did MMC beneficiaries; for instance, in ratings of care received overall (scale of 1-10) (8.91 FFS vs 8.86 MMC, P<.001, in 2000; and 8.88 FFS vs 8.78 MMC, P<.001, in 2001). Differences between FFS and MMC varied across states, however. Managed care enrollees reported significantly fewer problems with paperwork, information, and customer service (2.62 FFS vs 2.55 MMC, P<.001, in 2000; and 2.59 FFS vs 2.51 MMC, P<.001, in 2001). Enrollees in MMC were also more likely to report having received immunizations for influenza and pneumococcus (from any source) (in 2000, 77% of MMC vs 63% of FFS respondents; P<.001), and smokers were more likely to report having received counseling to quit smoking.ConclusionsOur data suggest that managed care was better at delivering preventive services, whereas traditional Medicare was better in other aspects of care related to access and beneficiary experiences. These relative strengths should be considered when policy decisions are made that affect the availability of choice or influence beneficiaries to choose one model of care over another.
Behavioral innovation and phylogeography
Authors: Pierre Deleporte
Journal: Behavioral and Brain Sciences (2007)

Abstract Indirect identification of innovations in wild populations involves inferring past, unobserved behavioral events. Such historical inference can make simple use of present distribution patterns of differently behaving individuals, but population genetic studies are a potential source of complementary relevant information. Methodological lessons can be taken from phylogeography, that is, molecular approaches to the history of population spatial distribution patterns and gene flows. Opportunities for such studies in primates should increase with the developing population genetic studies used for management and conservation purposes.
pH-responsive scaffolds generate a pro-healing response
Authors: Jin-Oh You, Marjan Rafat, Dariela Almeda, Natalia Maldonado, Peng Guo, Christoph S. Nabzdyk, Maggie Chun, Frank W. LoGerfo, John W. Hutchinson, Leena K. Pradhan-Nabzdyk, Debra T. Auguste
Journal: Biomaterials (2015)
Cardioselective beta blockers do not cause adverse respiratory effects in mild to moderate reactive airway disease
Authors: E Gamble
Journal: Thorax (2003)

Salpeter SR, Ormiston TM, Salpeter EE. Cardioselective β blockers in patients with reactive airway disease: a meta-analysis. Ann Intern Med2002;137:715–25 [OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] This study examined data from 19 studies of single dose treatment and 10 studies of continued treatment with cardioselective β blockers (atenolol, metoprolol, bisoprolol, practolol, celiprolol, acebutolol and xamoterol) in patients … [1]: {openurl}?query=rft.jtitle%253DAnnals%2Bof%2BInternal%2BMedicine%26rft.stitle%253DANN%2BINTERN%2BMED%26rft.issn%253D0003-4819%26rft.aulast%253DSalpeter%26rft.auinit1%253DS.%2BR.%26rft.volume%253D137%26rft.issue%253D9%26rft.spage%253D715%26rft.epage%253D725%26rft.atitle%253DCardioselective%2B%257Bbeta%257D-Blockers%2Bin%2BPatients%2Bwith%2BReactive%2BAirway%2BDisease%253A%2BA%2BMeta-Analysis%26rft_id%253Dinfo%253Adoi%252F10.7326%252F0003-4819-137-9-200211050-00035%26rft_id%253Dinfo%253Apmid%252F12416945%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.7326/0003-4819-137-9-200211050-00035&link_type=DOI [3]: /lookup/external-ref?access_num=12416945&link_type=MED&atom=%2Fthoraxjnl%2F58%2F2%2F142.atom [4]: /lookup/external-ref?access_num=000179052400002&link_type=ISI
Left ventricular wall stress and sarcoplasmic reticulum Ca-ATPase gene expression in renal hypertensive rats: dose-dependent effects of ACE inhibition and AT-receptor blockade
Authors: W ZIERHUT, R STUDER, D LAURENT, S KASTNER, P ALLEGRINI, S WHITEBREAD, F CUMIN, H BAUM, M DEGASPARO, H DREXLER
Journal: Cardiovascular Research (1996)

Cardiac hypertrophy is associated with altered Ca2+ handling and may predispose to the development of LV dysfunction and cardiac failure. At the cellular level, the re-expression of ANF represents a well-established marker of myocyte hypertrophy while the decreased expression of the sarcoplasmatic reticulum (SR) Ca(2+)-ATPase is thought o play a crucial role in the alterations of Ca2+ handling and LV function. We assessed the dose-dependent effect of chronic ACE inhibition or AT1 receptor blockade on cardiac function in relation to the cardiac expression of the SR Ca(2+)-ATPase and ANF.Renal hypertensive rats (2K-1C) were treated for 12 weeks with three different doses of the ACE inhibitor benazepril, the AT1-receptor antagonist valsartan (each drug 0.3, 3, and 10 mg/kg per day i.p.) or placebo. LV dimensions, hypertrophy and wall stress were determined in vivo by magnetic resonance imaging and the gene expressions of ANF and SR Ca(2+)-ATPase were quantified by Northern blot. Low doses of both drugs did not affect blood pressure, hypertrophy, systolic wall stress and the ANF and SR Ca(2+)-ATPase gene expression. High doses of each drug reduced systolic blood pressure, wall stress, and LV hypertrophy to a similar extent and to values comparable to normotensive, age-matched rats. In addition, high dose treatment reduced LV end-systolic and end-diastolic volume as compared to untreated 2K-1C animals and normalized the mRNA levels of both ANF and SR Ca(2+)-ATPase (as compared to normotensive animals).We conclude that in this model, high doses of ACE inhibition and AT1-receptor blockade are necessary to normalize systolic blood pressure, LV hypertrophy and systolic LV wall stress which, in turn, is associated with restoration of a normal cardiac phenotype with respect to SR Ca(2+)-ATPase and ANF and normalization of cardiac function.
Cell membrane is a major locus for ultraviolet B-induced alterations in accessory cells.
Authors: J Krutmann, I U Khan, R S Wallis, F Zhang, E A Rich, J J Ellner, C A Elmets
Journal: Journal of Clinical Investigation (1990)

In vitro ultraviolet B (UVB) irradiation of human blood monocytes inhibits their accessory cell function for antigen- and mitogen-induced T cell responses. These studies were designed to characterize the nature of the UVB-induced defect in human monocyte accessory cell function. Irradiated monocytes were deficient in their ability to serve as accessory cells for OKT3-induced T cell activation. In vitro exposure of monocytes to 100 J/m2 UVB completely inhibited the T cell proliferative response (51502 cpm, non-UVB-irradiated; 302 cpm, UVB-irradiated). Analysis of the accessory signals altered by UVB indicated that irradiated monocytes were incapable of binding to OKT3 molecules attached to the CD3 antigen on T cells. Provision of an alternative mechanism for binding of OKT3 molecules by attaching anti-mouse IgG to the bottom of microtiter wells completely restored accessory cell function. Further characterization of the defect demonstrated that UVB radiation did not deplete p72 Fc receptors from the surface of irradiated monocytes. However, UVB exposure did produce a dose-dependent decrease in monocyte membrane expression of ICAM-1. It is proposed that UVB radiation leads to changes within the cell membrane that inhibit the ability of monocytes to express selected molecules necessary for binding of T cells.
Upper Limits of Physiological Cardiac Adaptation in Ultramarathon Runners
Authors: Keith P. George, Darren E.R. Warburton, David Oxborough, Jessica M. Scott, Ben T.A. Esch, Karen Williams, Sarah Charlesworth, Heather Foulds, Adele Oxborough, Martin D. Hoffman, Rob Shave
Journal: Journal of the American College of Cardiology (2011)
CD45-null transgenic mice reveal a positive regulatory role for CD45 in early thymocyte development, in the selection of CD4+CD8+ thymocytes, and B cell maturation.
Authors: K F Byth, L A Conroy, S Howlett, A J Smith, J May, D R Alexander, N Holmes
Journal: The Journal of Experimental Medicine (1996)

The CD45 transmembrane glycoprotein has been shown to be a protein phosphotyrosine phosphatase and to be important in signal transduction in T and B lymphocytes. We have employed gene targeting to create a strain of transgenic mice that completely lacks expression of all isoforms of CD45. The spleens from CD45-null mice contain approximately twice the number of B cells and one fifth the number of T cells found in normal controls. The increase in B cell numbers is due to the specific expansion of two B cell subpopulations that express high levels of immunoglobulin (IgM) staining. T cell development is significantly inhibited in CD45-null animals at two distinct stages. The efficiency of the development of CD4-CD8- thymocytes into CD4+ CD8+ thymocytes is reduced by twofold, subsequently the frequency of successful maturation of the double positive population into mature, single positive thymocytes is reduced by a further four- to fivefold. In addition, we demonstrate that CD45-null thymocytes are severely impaired in their apoptotic response to cross-linking signals via T cell receptor (TCR) in fetal thymic organ culture. In contrast, apoptosis can be induced normally in CD45-null thymocytes by non-TCR-mediated signals. Since both positive and negative selection require signals through the TCR complex, these findings suggest that CD45 is an important regulator of signal transduction via the TCR complex at multiple stages of T cell development. CD45 is absolutely required for the transmission of mitogenic signals via IgM and IgD. By contrast, CD45-null B cells proliferate as well as wild-type cells to CD40-mediated signals. The proliferation of B cells in response to CD38 cross-linking is significantly reduced but not abolished by the CD45-null mutation. We conclude that CD45 is not required at any stage during the generation of mature peripheral B cells, however its loss reveals a previously unrecognized role for CD45 in the regulation of certain subpopulations of B cells.
1326 LIVER IMMUNOLOCALIZATION AND TISSUE EXPRESSION OF METALLOPREOTEINASE-9 (MMP-9) IN NONALCOHOLIC FATTY LIVER DISEASE (NAFLD)
Authors: A.C. Teixeira, F.F. Souza, M. Brunaldi, A.L. Jacob-Ferreira, S.C. Ferreira, M. Secaf, M.G. Villanova, S. Zucoloto, J. Elias-Junior, J.E. Tanus-Santos, A.D.L.C. Martinelli
Journal: Journal of Hepatology (2012)
Health service accreditation: report of a pilot programme for community hospitals
Authors: C. D Shaw, C. D Collins
Journal: BMJ (1995)

Voluntary accreditation in the United Kingdom is being used by health care providers to improve and market their services and by commissioners to define and monitor service contracts.In a three year pilot scheme in the south west of England, 43 out of 57 eligible community hospitals volunteered to be surveyed; 37 of them were ultimately accredited for up to two years by the hospital accreditation programme.The main causes for non-accreditation related to safety, clinical records, and medical organisation.Follow up visits in 10 hospitals showed that, overall, 69% of recommendations were imple- mented.An independent survey of participating hospitals showed the perceived benefits to include team building, review of operational policies, improvement of data systems, and the generation of local prestige.Purchasers are increasingly influenced by accreditation status but are mostly unwilling to finance the process directly.None the less, the concept may become an important factor moderating the quality ofservice in the new NHS.
US doctors are not following ethical guidelines
Authors: Jeanne Lenzer
Journal: BMJ (2007)

Many doctors in the United States are failing to conform to professional guidelines. A survey sponsored by the US Institute of Medicine found that doctors often fail to conform to accepted norms in areas of self regulation, managing conflicts of interest, and ordering of unnecessary tests.

Moreover, although most respondents thought they should report colleagues who were not competent, almost a half said that in the past three years they had known of a doctor who was “impaired or incompetent” but had failed to report the doctor to a relevant authority ( Annals of Internal Medicine 2007;147:795-802).

The survey of …
X-rays: Health Effects of Common Exams
Authors: Yolanda T. Adler
Journal: JAMA (1986)

The possibility that the demise of life on earth may be brought about by nuclear radiation has reached the consciousness of many who read about nuclear plant accidents and disarmament talks (or the lack thereof). Convincing the superpowers to give up nuclear arms is proving to be a frustrating task. But focusing the public's fears on something else with the word radiation attached to it, say, medical diagnostic procedures, gives everyone the opportunity to refuse a roentgenogram and feel in control. This book can help people find that type of "solution." The theory that there is no safe threshold and that even minute radiation exposure can induce malignant processes has some convinced defenders and many skeptical detractors. Among other things, it ignores the fact that we are all exposed to unavoidable natural environmental radiation, in some geographic locations in considerably larger doses than from many medical procedures. Regardless of their
Levodopa dosage and ventilatory function in Parkinson's disease.
Authors: D N Bateman, R G Cooper, G J Gibson, E T Peel, I Wandless
Journal: BMJ (1981)

Oldest case of sarcoidosis in the world Acute sarcoidosis in an octogenarian is rare.In this case bone-mnarrow trephine biopsy uncovered an unsuspected diagnosis. Case report examination.Compared to results during standard treatment: *p <0.05; **p <0.02.
Hemodynamic patterns of response during long-term captopril therapy for severe chronic heart failure.
Authors: M Packer, N Medina, M Yushak, J Meller
Journal: Circulation (1983)

To determine the relationship between the early and late hemodynamic effects of captopril in patients with severe heart failure, we performed serial right heart catheterizations in 51 such patients who were treated with the drug for 2 to 8 weeks. Four hemodynamic patterns of response were observed. Nine patients had minimal responses initially (type I); six failed to improve during long-term treatment, but three showed delayed hemodynamic benefits. Twenty-eight patients had initial beneficial drug effects that were sustained after 48 hr and after 2 to 8 weeks (type II). In seven patients, first doses of captopril produced marked beneficial responses, but these became rapidly attenuated after 48 hr; nevertheless, continued therapy for 2 to 8 weeks was accompanied by spontaneous restoration of the hemodynamic effects of first doses of the drug, i.e., triphasic response (type III). In the remaining seven patients, attenuation of initial response was not reversed by prolonged captopril therapy; hemodynamic variables after 2 to 8 weeks had returned to their pretreatment values, i.e., drug tolerance (type IV). Plasma renin activity was lower in patients with minimal responses (0.6 +/- 0.2 ng/ml/hr) and was higher in patients with triphasic responses (9.4 +/- 2.5 ng/ml/hr) than in patients with types II and IV response patterns (4.4 +/- 0.7 and 2.8 +/- 0.5 ng/ml/hr, respectively; both p less than .05). Although first-dose effects of captopril are frequently sustained, the occurrence of delayed, attenuated, and triphasic responses indicates that a complex and variable relationship may exist between the early and late hemodynamic effects of vasodilator drugs in patients with severe heart failure.
Effect of cholesterol-lowering diet on mortality from coronary heart disease and other causes.
Authors: O Turpeinen
Journal: Circulation (1979)

International statistics indicate that there is a close correlation between the consumption of saturated fats (dairy fats and meat fats) and the mortality from coronary heart disease (CHD), and this conception has been confirmed by many epidemiological studies. Such studies alone, however, cannot prove the existence of a cause-and-effect relationship between these two variables; dietary intervention trials are needed. The Finnish Mental Hospital Study was such a trial, conducted in two hospitals near Helsinki in 1959--1971. Practically total replacement of dairy fats by vegetable oils in the diets of these hospitals was followed by a substantial reduction in the mortality of men from CHD. Total mortality also appeared to be reduced. As to the causes of death other than CHD, none was significantly influenced by dietary change. This was also true for malignant neoplasms. To alleviate the burden of CHD on public health, many investigators have recommended important changes in the quantity and quality of dietary fats.
Statistics for the Biological Sciences
Authors: William R. Barclay
Journal: JAMA (1979)

This is a textbook for a formal introductory course on biostatistics. It is obviously intended for instruction of medical students, physicians, and others in the health field, for the illustrative examples are taken from the field of medicine. Each chapter is followed by carefully chosen questions which, if worked by the student, ensure a high degree of comprehension of the material in the chapter. The concepts are carefully developed and made clear, even for readers with a limited background in mathematics. Among the subjects covered are data distributions, probability, inference, hypothesis testing, χ<sup>2</sup>, analysis of variance, correlation and regression, covariance, and nonparametric tests. This could be used either as a text or as a reference source for physicians who wish to understand biostatistics without in-depth knowledge or great practical expertise.
1012-128 The long-term impact of initiating treatment with the angiotensin-converting enzyme inhibitor trandolapril after a myocardial infarction in patients with left ventricular dysfunction: A 10- to 12-year follow-up study
Authors: Pernille Buch, Soren Rasmussen, Steen Zabell Abildstrom, Lars Kober, Jan Carlsen, Christian Torp-Pedersen
Journal: Journal of the American College of Cardiology (2004)
New Medical Education Standards Board will lower standards
Authors: N. W Goodman
Journal: BMJ (2002)

EDITOR—The government's intended reorganisation of postgraduate medical education received little mention in the BMJ until Pereira Gray's editorial,1 which outlined the proposals2 but gave little analysis. By contrast, the analysis in an editorial in the British Journal of General Practice —whose view we agree with—was extremely critical.3

The new Medical Education Standards Board, half of whose 24 members are intended to be lay members, will be the single body overseeing curriculums, standards, and the registration of …
Identification of patients with sick sinus syndrome by use of atrial early potentials: A prospective study
Authors: Takahisa Yamada, Jiyoong Kim, Masatake Fukunami, Tsuyoshi Shimonagata, Kazuaki Kumagai, Yasushi Abe, Shoji Sanada, Noritake Hoki
Journal: Journal of the American College of Cardiology (1996)
Reduction in Size of a Pituitary Tumor by Bromocriptine Therapy
Authors: Alan M. Mcgregor, Maurice F. Scanlon, Keith Hall, David B. Cook, Reginald Hall
Journal: New England Journal of Medicine (1979)

SINCE the development of specific assays for prolactin1 , 2 it has been possible to demonstrate that a large proportion of pituitary tumors secrete prolactin.3 Until the advent of bromocriptine, operation and irradiation had been used as the primary treatments for such tumors.4 The introduction of bromocriptine, an ergot derivative5 and dopamine agonist,6 into therapeutic regimens for pituitary disease is recent and is still being evaluated. It is a potent inhibitor of prolactin secretion. Acting primarily at the level of the pituitary,7 but with a possible hypothalamic effect not yet excluded,8 it lowers prolactin secretion in patients with hyperprolactinemia from any cause, . . .
Current Perspectives in the Use of Molecular Imaging To Target Surgical Treatments for Genitourinary Cancers
Authors: Francesco Greco, Jeffrey A. Cadeddu, Inderbir S. Gill, Jihad H. Kaouk, Mesut Remzi, R. Houston Thompson, Fijs W.B. van Leeuwen, Henk G. van der Poel, Paolo Fornara, Jens Rassweiler
Journal: European Urology (2013)
Trade or Profession?
Authors: W. R. Barclay
Journal: JAMA (1976)

In recent years the Federal government and its agencies repeatedly have attempted to control the practice of medicine. The latest quixotic sortie has been made by the Federal Trade Commission (FTC) against the ethical code of the medical profession. The FTC contends that Madison Avenue hucksterism is the appropriate mechanism for establishing a patient-doctor relationship. The American Medical Association holds that medical need and professional competence should establish this relationship. The code of medical ethics recognizes the rules of decent behavior that for centuries have governed people of good will and intention. This code of ethical principles did not originate through government legislation or from bureaucratic regulation. It evolved simply because these rules, or principles, were right in the very nature of things. The competent physician does not advertise skill; it is self-evident. The compassionate physician does not advertise compassion but practices it. Physicians bring compassion, skill, and knowledge to
The Fallacy of a Low-Fat Diet in Liver Disease
Authors: Roberta H. Crews
Journal: JAMA (1962)

The frequency with which a low-fat diet is routinely prescribed in the treatment of liver disease has stimulated a review of the available evidence dealing with the effect of fat upon human hepatic disease. Restriction of dietary fat has been found to be based upon fallacious assumptions. In many pertinent and well-controlled studies the lack of deleterious effect from a liberal fat intake when offered in a balanced diet has been documented. Diets unrestricted in fat offer many advantages to the patient with liver disease who suffers anorexia. Increased caloric intake, which is associated with the improved palatability and more concentrated calorie content of such diets, results in accelerated recovery and decreased convalescence time in both cirrhosis and hepatitis.