tbuckley/cabot-search huggingface dataset:
Four countries' experiences of universal health coverage implementation: lessons for the future
Authors: J Rosenberg, R Weintraub
Journal: The Lancet Global Health (2015)

BackgroundThe WHO defines universal health coverage (UHC) as access for all people to the health services they need (prevention, promotion, treatment, and rehabilitation) without financial hardship. But UHC implementation is a daunting undertaking for many countries. To commit to UHC, countries and their leaders must address questions such as: can the country afford it? What services should be provided and who should have access to them? Who should be responsible for managing insurance? And how can providers project demand and ensure adequate supply of services? Health ministers, who often serve only short terms, must address these questions about UHC, while also managing policy and services for many other health issues. We undertook case studies of four countries' experiences in implementing UHC—Thailand, Ghana, Vietnam, and Rwanda to help inform health ministers from countries still working towards the goal of UHC.MethodsWe used published information and conducted interviews with leaders from Thailand, Ghana, Vietnam, and Rwanda. We asked questions about how UHC was funded (including the package of services and population covered, with attention to the values informing these choices); the political process accompanying implementation; the sustainability of the programme; and the outcomes achieved so far in terms of measurable health benefits. We compiled each country's experience in case studies and exhibits.FindingsTeaching cases were used for a Ministerial Leadership in Health forum held at the Harvard School of Public Health and will be published as part of an open-access case collection in global health delivery. Although each country offers a unique experience and approach, there were some responses common to all countries, the most important of which was the generation of political will and accountability. Other key tactics in the successful implementation of UHC were provision of incentives for expansion of care for the most vulnerable, and adaptation and monitoring of the programme over time.InterpretationTeaching cases that document country experiences of UHC implementation and approaches to other complex health issues will contribute to an understanding of how we can improve health care for populations around the world.FundingThis research received funding from the Rockefeller Foundation and Harvard School of Public Health.
F-18 FDG Positron Emission Tomography and Benign Fractures
Authors: IVAN HO SHON, IGNAC FOGELMAN
Journal: Clinical Nuclear Medicine (2003)

Purpose F-18 2-fluoro-2-deoxy-D-glucose (FDG) positron emission tomography (PET) has been used extensively in the imaging of cancer, including metastatic skeletal disease. Although uptake into benign osseous disease has been reported, there is very limited information regarding uptake into benign fractures. This report provides additional information regarding the appearance of benign fractures on FDG-PET images. Materials and Methods Four case reports of FDG-PET scanning are presented in patients with proved benign fractures. Results In three of these cases, FDG uptake was noted in fractures when images were obtained 17 days to 8 weeks after injury, with the most avid uptake observed when FDG-PET imaging was performed 17 days after fracture. In the patient in whom imaging was performed 8 weeks after fracture, no uptake of FDG was seen in a benign fracture. Conclusions Fractures may accumulate FDG to varying degrees, and false-positive findings may occur when FDG-PET imaging is performed to assess for metastases, although the different pattern of uptake and clinical correlation usually allows accurate differentiation of fracture from skeletal metastases.
Ga-67 Imaging in Primary and Secondary Psoas Abscess
Authors: GILLES LEBOUTHILLIER, JEAN LETTE, JACQUES MORAIS, BENOÎT AUBIN, MICHEL PICARD
Journal: Clinical Nuclear Medicine (1993)

Primary and secondary psoas abscesses are uncommon and frequently misdiagnosed. Two cases of pyogenic psoas abscess are presented to Illustrate the usefulness of Ga-67 scintigraphy in determining the presence and the extent of the infectious process.
Culinary curiosities-resemblances between common skin disorders and food
Authors: William F Tucker, Fiona Lewis
Journal: Journal of the American Academy of Dermatology (2004)

Many dermatological disorders are described in terms of their similarity to different types of food eg. the honey crusts in impetigo and the Victoria plum lesions seen in Sweet's disease. Often patients will liken their skin problem to food items and these may be graphic. We show examples of well known and many newer descriptions of dermatological disease in terms of food.
Important role of the hepatic vagus nerve in glucose uptake and production by the liver
Authors: Munehide Matsuhisa, Yoshimitsu Yamasaki, Yuichi Shiba, Itsuro Nakahara, Akio Kuroda, Tadahiro Tomita, Motoyuki Iida, Masahiko Ikeda, Yoshitaka Kajimoto, Minoru Kubota, Masatsugo Hori
Journal: Metabolism (2000)
Use of the Low-Molecular-Weight Heparin Reviparin to Prevent Deep-Vein Thrombosis after Leg Injury Requiring Immobilization
Authors: Michael R. Lassen, Lars C. Borris, Roumen L. Nakov
Journal: New England Journal of Medicine (2002)

Deep-vein thrombosis is a well-recognized complication after trauma to the legs and subsequent immobilization, but there are no generally accepted approaches to preventing this complication.
Role of Sulfonylurea Receptor Type 1 Subunits of ATP-Sensitive Potassium Channels in Myocardial Ischemia/Reperfusion Injury
Authors: John W. Elrod, Maddison Harrell, Thomas P. Flagg, Susheel Gundewar, Mark A. Magnuson, Colin G. Nichols, William A. Coetzee, David J. Lefer
Journal: Circulation (2008)

Background— Opening of cardiac ATP-sensitive potassium channels (K ATP channels) is a well-characterized protective mechanism against ischemia and reperfusion injury. Evidence exists for an involvement of both sarcolemmal and mitochondrial K ATP channels in such protection. Classically, cardiac sarcolemmal K ATP channels are thought to be composed of Kir6.2 (inward-rectifier potassium channel 6.2) and SUR2A (sulfonylurea receptor type 2A) subunits; however, the evidence is strong that SUR1 (sulfonylurea receptor type 1) subunits are also expressed in the heart and that they may have a functional role. The aim of this study, therefore, was to examine the role of SUR1 in myocardial infarction. Methods and Results— We subjected mice lacking SUR1 subunits to in vivo myocardial ischemia/reperfusion injury. Interestingly, the SUR1-null mice were markedly protected against the ischemic insult, displaying a reduced infarct size and preservation of left ventricular function, which suggests a role for this K ATP channel subunit in cardiovascular function during conditions of stress. Conclusions— SUR1 subunits have a high sensitivity toward many sulfonylureas and certain K ATP channel–opening drugs. Their potential role during ischemic events should therefore be considered both in the interpretation of experimental data with pharmacological agents and in the clinical arena when the cardiovascular outcome of patients treated with antidiabetic sulfonylureas is being considered.
Perfusion Versus Function: The Ischemic Cascade in Demand Ischemia
Authors: Howard Leong-Poi, Se-Joong Rim, D. Elizabeth Le, Nick G. Fisher, Kevin Wei, Sanjiv Kaul
Journal: Circulation (2002)

Background — We hypothesized that during demand ischemia, abnormal perfusion will precede abnormal function, the spatial extent of perfusion abnormality will be greater than that of functional abnormality, and the spatiotemporal disparity between abnormal perfusion and abnormal function will be more marked in the presence of single-vessel stenosis (SVS) versus multivessel stenosis (MVS). Methods and Results — Nine dogs each underwent either SVS or MVS placement. These noncritical stenoses were classified as mild, moderate, or severe on the basis of the transstenotic pressure gradient (10 to 14, 15 to 20, or &gt;20 mm Hg). Dobutamine was infused starting at 10 and reaching 40 μg/kg −1 · min −1 . Wall thickening (WT) and myocardial perfusion (myocardial contrast echocardiography) were assessed at each stage. Resting perfusion and function were normal in all dogs. In SVS, abnormal perfusion (delayed rate of microbubble replenishment) was seen at the lowest dose of dobutamine irrespective of the stenosis severity, whereas WT abnormality was seen only at high doses of dobutamine and was influenced by the stenosis severity. The spatial extent of abnormal perfusion exceeded that of WT abnormality at all but the highest dobutamine dose. This spatiotemporal discordance between abnormal perfusion and function was significantly less in MVS, where it was possible to identify separate regions with abnormal function at lower doses of dobutamine. Conclusions — These data support the occurrence of the ischemic cascade during demand ischemia. They also explain the higher sensitivity of abnormal perfusion compared with abnormal function for the detection of coronary stenosis as well as the higher sensitivity of dobutamine echocardiography for MVS compared with SVS.
Long-Term Treatment With Oral Sildenafil Is Safe and Improves Functional Capacity and Hemodynamics in Patients With Pulmonary Arterial Hypertension
Authors: Evangelos D. Michelakis, Wayne Tymchak, Michelle Noga, Linda Webster, Xi-Chen Wu, Dale Lien, Shao-Hua Wang, Dennis Modry, Stephen L. Archer
Journal: Circulation (2003)

The prognosis and functional capacity of patients with pulmonary arterial hypertension (PAH) is poor, and there is a need for safe, effective, inexpensive oral treatments. A single dose of sildenafil, an oral phosphodiesterase type-5 (PD-5) inhibitor, is an effective and selective pulmonary vasodilator in PAH. However, the long-term effects of PD-5 inhibition and its mechanism of action in human pulmonary arteries (PAs) are unknown.We hypothesized that 3 months of sildenafil (50 mg orally every 8 hours) added to standard treatment would be safe and improve functional capacity and hemodynamics in PAH patients. We studied 5 consecutive patients (4 with primary pulmonary hypertension, 1 with Eisenmenger's syndrome; New York Heart Association class II to III). Functional class improved by > or =1 class in all patients. Pretreatment versus posttreatment values (mean+/-SEM) were as follows: 6-minute walk, 376+/-30 versus 504+/-27 m, P<0.0001; mean PA pressure, 70+/-3 versus 52+/-3 mm Hg, P<0.007; pulmonary vascular resistance index 1702+/-151 versus 996+/-92 dyne x s x cm(-5) x m(-2), P<0.006. The systemic arterial pressure was unchanged, and no adverse effects occurred. Sildenafil also reduced right ventricular mass measured by MRI. In 7 human PAs (6 cardiac transplant donors and 1 patient with PAH on autopsy), we showed that PD-5 is present in PA smooth muscle cells and that sildenafil causes relaxation by activating large-conductance, calcium-activated potassium channels.This small pilot study suggests that long-term sildenafil therapy might be a safe and effective treatment for PAH. At a monthly cost of 492 dollars Canadian, sildenafil is more affordable than most approved PAH therapies. A large multicenter trial is indicated to directly compare sildenafil with existing PAH treatments.
Asthma in the Emergency Room
Authors: William Franklin
Journal: New England Journal of Medicine (1981)

Bronchial asthma is an inflammatory process of the airway that is characterized functionally by highly reversible obstruction of both the large and the small airways. Subjectively, there may be a sense of irritation and a great deal of coughing, even when there is little or no obstruction.1 The amount of discomfort or dyspnea that a patient perceives varies greatly and sometimes correlates poorly with objective measures of airway obstruction. Wheezing may be present when obstruction and even discomfort are minimal, and may be absent when obstruction is severe. Hyperinflation occurs in an attempt to keep the airways open. Marked inspiratory . . .
Dissolution of cholesterol gallstones by perfusion: A solution for the matrix?
Authors: Jay W. Marks
Journal: Hepatology (1988)

The goal of this study was to identify the structural and compositional features of human gallstones that influence in vitro gallstone dissolution in the cholesterol solvent monooctanoin. Gallstones were obtained from 86 consecutive patients who had at least three morphologically similar stones. One stone from each patient was dissolved in ethanol/ether to determine cholesterol and matrix composition. The remaining two matched stones were dissolved in either monoctanoin plus ethanol (n = 86) or monooctanoin plus 2-mercaptoethanol (n = 86). The thiol reducing agent 2-mercaptoethanol has been previously shown to solubilize the isolated gallstone matrix and to accelerate the dissolution of intact, small cholesterol stones. Stone matrix content and initial diameter had the most significant predictive value for stone dissolution (p &lt; 0.0001 for each), whereas cholesterol content had no predictive value (p = 0.558). Stones incubated in monooctanoin containing 2-mercaptoethanol dissolved more rapidly than those incubated in monooctanoin plus ethanol (16.7% of initial weight per day vs. 13.8% of initial weight per day, p &lt; 0.0001). Matrix content correlated significantly with the difference in dissolution rate between stones dissolved in monooctanoin plus ethanol or monooctanoin plus 2-mercaptoethanol (p &lt; 0.0001). These data indicate that the matrix content of human cholesterol gallstones significantly inhibits in vitro stone dissolution in the cholesterol solvent monooctanoin. This finding may be relevant to the clinical dissolution of gallstones.
Results of surgery for bronchial carcinoma in patients aged 70 and over
Authors: M. Bates
Journal: Thorax (1970)

The number of elderly patients who are developing carcinoma of the bronchus and who are also fit for surgical treatment is increasing. One hundred patients are reviewed who had operations for this condition. The histological distribution of growths in this age group is the same as in younger patients, and the rate of growth can be just as rapid. The importance of a high resectability rate and a low mortality rate in this age group is stressed. Pneumonectomy should be performed only for the strictest of reasons, as the mortality rate is too high, but the mortality rate for lobectomy is acceptable, and this is the operation of choice.
The Control of Fertility
Authors: Robert W. Kistner
Journal: JAMA (1966)

The author, world renowned for his monumental research which preceded the development of the original contraceptive agent, makes readily available the basic facts relative to fertility control in higher animals. He also delineates clearly the inadequacies of certain investigative aspects, proposes questions to which answers are not presently available, and pinpoints precise areas needing immediate and exhaustive study. Following a short introductory background, the basic principles of the reproductive processes in male and female mammals are considered. Since much of the data presented derives from experimental work of the last decade, the reader would do well to review this material carefully, for it may conflict with ancient medical school teaching. The next major section, "Animal Studies," presents pertinent facets of the following subjects: (1) spermatogenesis and characteristics of seminal fluid, (2) ovulation, (3) fertilization, (4) ova development, (5) blastocyst development and implantation, and (6) biological activities of steroidal compounds on
AB1004 Inter-Rater Reliability of the US-7 Score in A Population of Volunteers: is A Post-Hoc Analysis of Still Images Comparable to the Dynamic Analysis? Results from the “Rheuma-Truck” Cohort
Authors: P. Sewerin, S. Vordenbäumen, R. Brinks, A. Liedmann, S. Ohrndorf, M. Backhaus, O. Sander, M. Kümmel, M. Schneider, B. Ostendorf
Journal: Annals of the Rheumatic Diseases (2014)

<h3>Objectives</h3> To investigate the value of a follow-up analysis of ultrasonographic still images versus dynamic investigation using the US-7 ultrasound score. <h3>Methods</h3> “Rheuma-Truck” was a mobile rheumatology office located in different city center of North Rhine Westphalia offering a screening for rheumatic diseases including Rheuma-Check questionnaire, lab-tests (MCV capillary test), imaging (US, capillaroscopy), and if positive a consultation with a rheumatologist to everybody free of charge. Ultrasound (MyLab 25 Gold, Esaote linear scanner, 15, Typ LA435) of the dominant hand of 605 volunteers was performed. Moreover in 236 of these volunteers the foot was obtained by ultrasound. Thus a total of 3497 joints were examined by ultrasound. Live images were analyzed according to the US-7 scoring system dynamically on site by a trained rater. Still images were stored in a standardized manner in section planes according to US7. These images were assessed by 3 additional experts blinded to the dynamic scoring. The agreement upon all four raters is assessed in two measures a(0) and a(1). These are the percentages of study subjects who are rated equally (a(0)) or equally up to ±1 score point (a(1)) by all four raters. <h3>Results</h3> The mean age of the investigated cohort was 52.72 years (min. 10, max. 89 years). Sex distribution shows 72.2% females and 27.8% males. 181 (29.9%) volunteers displayed any inflammatory sign according to US-7 scoring. Using a(0) (all raters rated all subject equal) dorsal wrist showed an accordance between all 4 raters of 62%, the palmar wrist of 98%, the ulnar wrist of 87%, MCP-2 of 77%, MCP-3 85%, PIP-2 70%, PIP-3 81%, MTP -2 72% and MTP-5 96%. Using a(1) (up to ±1) we obtained accordance9s of the dorsal wrist of 87%, palmar wrist 100%, ulnar wrist 94%, MCP-2 94%, MCP-3 94%, PIP-2 91%, PIP-3 91%, MTP-2 89% and MTP-5 98%. The accordance between still images and dynamic assessment according to a(1) was 100% for the palmar wrist, 100% for the ulnar wrist, 100% for MCP-2, 100% for MCP-3, 97% for PIP-2, 100% for PIP-3, 100% for MTP -2, and 100% for MTP-5 using the US-7 scoring system. <h3>Conclusions</h3> Inter-rater reliability (between all 4 raters) was good with an average of 93.1%. The accordance between still images and dynamic interpretation by using the US-7 scoring system was excellent with 99.6% consensus. Post-hoc evaluation of still images is a valid and reliable tool for the evaluation and interpretation of the US-7 scoring system as shown here in a population of volunteers. <h3>Disclosure of Interest</h3> None declared <h3>DOI</h3> 10.1136/annrheumdis-2014-eular.3636
Effect of prostacyclin on vascular capacity in the dog.
Authors: T G Fulghum, J P DiMarco, E W Supple, I Nash, J Gendlerman, D F Eton, J B Newell, R M Zusman, W J Powell
Journal: Journal of Clinical Investigation (1985)

Since the discovery of prostacyclin (PGI2) in 1976, there has been great interest in its vascular effects and potential clinical applications. High infusion rates of PGI2 markedly depress arterial blood pressure both in animal studies and in clinical trials. This fall in pressure may result entirely from a decrease in arterial resistance. However, it is possible that the administration of PGI2 may decrease ventricular filling due to an increase in vascular capacity. To investigate whether or not PGI2 affects vascular capacity, we infused PGI2 intraarterially at both 10 and 25 micrograms/min into 15 dogs on total cardiopulmonary bypass. These infusions were associated with a 25 +/- 3 mmHg decrease in arterial pressure and an increase in vascular capacity of 155 +/- 29 ml (SE, P less than 0.005). This increase in capacity was greater (P less than 0.02) than the increase of 23 +/- 42 ml resulting from infusions of nitroglycerin into eight dogs at 2 mg/min, which produced a decrease in arterial pressure of 23 +/- 4 mmHg, which was the maximal effect that could be achieved. Neither bilateral cervical vagotomy nor beta adrenergic blockade with propranolol significantly diminished the increase in vascular capacity associated with infusions of PGI2. The results from studies in four eviscerated dogs indicated that PGI2 acts on both splanchnic and extrasplanchnic capacity vasculature. To compare the direct effects of PGI2 with those of nitroglycerin and nitroprusside on venous tone, we used an isolated canine spleen preparation. Infusions of PGI2 (100 mcg/min) increased spleen weight in this preparation by 9.0 +/- 2.4% (n = 10, P less than 0.001); this increase was significantly greater than increases of 3.6 +/- 2.2% (P less than 0.001) and 3.5 +/- 2.3% (P less than 0.001) caused by high dose infusions of nitroglycerin (1 mg/min) and nitroprusside (400 micrograms/min), respectively. Thus, PGI2 substantially increases vascular capacity by a mechanism that appears to involve a direct action on vascular smooth muscle. Furthermore, these results suggest that PGI2 might be useful in clinical conditions in which an increase in vascular capacity is indicated.
Effects of the QUADDS-QP2 drug-eluting stent extend beyond the targeted area into adjacent nonstented zones: results of the SCORE trial
Authors: Alexandra J. Lansky, Nicholas Reifart, Jean Fajadet, Germano DiSciascio, Carlo DiMario, Karl Hauptmann, Antonio Colombo, Roland Bach, Sigmund Silber, Eberhard Grube
Journal: Journal of the American College of Cardiology (2002)
Indian doctors condemn move to fund treatments abroad for civil servants
Authors: S. Bhaumik
Journal: BMJ (2013)

An announcement by the Indian government that civil service officers will be reimbursed for approved medical treatments they receive outside India has led to calls of hypocrisy from doctors.

A circular from the Department of Personnel and Training earlier this month extends the benefit of medical treatment outside India to staff in the Indian Administrative Service (IAS), the Indian Police Service (IPS), and the Indian Forest Service (IFoS) as well as …
Deep vein thrombosis in patients with superficial thrombophlebitis of the leg.
Authors: D Bergqvist, H Jaroszewski
Journal: BMJ (1986)

Sur 56 malades atteints de thrombophlebite superficielle du membre inferieur, 9 presentent une thrombose profonde, dont 6 dans la partie inferieure. Les malades presentant a la fois des thrombophlebites superficielles et profondes doivent etre surveilles etroitement etant donne la frequence des maladies malignes a l'origine de cette pathologie
Functional correction in mouse models of muscular dystrophy using exon-skipping tricyclo-DNA oligomers
Authors: Aurélie Goyenvalle, Graziella Griffith, Arran Babbs, Samir El Andaloussi, Kariem Ezzat, Aurélie Avril, Branislav Dugovic, Rémi Chaussenot, Arnaud Ferry, Thomas Voit, Helge Amthor, Claudia Bühr, Stefan Schürch, Matthew J A Wood, Kay E Davies, Cyrille Vaillend, Christian Leumann, Luis Garcia
Journal: Nature Medicine (2015)