tbuckley/cabot-search huggingface dataset:
New legislation transforms Spain's health system from universal access to one based on employment
Authors: A. Garcia Rada
Journal: BMJ (2012)

Spain’s public health service is to shift from one that provides universal coverage through general taxation to a system funded through social security contributions, after the conservative People’s Party government of Mariano Rajoy passed new legislation.

Although the new law represents a major change to the General Health Act that established Spain’s national health service in 1986, the legal mechanism chosen by the government was a royal decree, which does not require parliamentary debate.

The so called “royal decree on urgent measures to ensure the sustainability of the national health system and improve the quality and safety of its services” includes decisions previously taken by the Inter-territorial Council on 18 April and on 20 April by the cabinet.1 Among other things, these measures extended drug copayments and limited illegal immigrants’ access to healthcare.

However, the full extent of the changes being imposed on the …
Polymyalgia Rheumatica: Biopsy Studies
Authors: I. Gordon, A. M. Rennie, A. W. Branwood
Journal: Annals of the Rheumatic Diseases (1964)

Polymyalgia rheumatica is a clinical syndrome affecting middle-aged and elderly persons and is characterized by periarthritic and muscular pain and stiffness particularly in the shoulder and hip girdles.Systemic symptoms are present, the erythrocyte sedimentation rate (E.S.R.) is greatly elevated, and the Waaler-Rose test is almost invariably negative.Suppression of symptoms with corticosteroid therapy is striking.The disease appears to run a benign course and in cases not treated with cortico- steroids muscular and periarthritic pains disappear spontaneously and completely in 2 to 4 years (Gordon, 1960).The cause of the syndrome is not known.Some recent authors have suggested that the myalgia is a manifestation of giant cell arteritis.The myalgia and the less common arthralgia sometimes asso- ciated with giant cell arteritis certainly may resemble polymyalgia rheumatica and diagnosis may be difficult in the early stages.Significant differences, however, exist.Giant cell arteritis is now regarded as a widespread arterial disease which may spare, at least for a time, the commonly involved temporal, occipital, and retinal arteries.Rheumatic symptoms may precede, accompany, or follow the phase of temporal artery involvement and present as pain in the muscles of the limb girdles and trunk and as arthralgia of the larger joints.As in polymyalgia rheumatica, the disease occurs in the elderly, the erythrocyte sedimentation rate is considerably elevated, and the symptoms rapidly respond to corticosteroid therapy.In polymyalgia rheumatica, however, the pain in the shoulder and hip girdles is overshadowed by the stiffness of the shoulders with gross limitation of movement in the average case.Stiffness of the shoulder joints is not a prominent feature of giant cell arteritis.Severe pain and tenderness in the muscles of the limb girdles and trunk may occur in giant cell arteritis and, in cases of long duration, these symptoms are associated with weakness and wasting of muscles, the latter being out of all proportion to the clinical and radiological involvement of the joints (Russell, 1959).Such wasting and weakness do not occur in polymyalgia rheumatica.In reviewing 175 cases oftemporal arteritis from the Mayo Clinic, Hollenhorst, Brown, Wagener, and Shick (1960) described diffuse aching in the muscles 447 copyright.
Integrin-Mediated Collagen Matrix Reorganization by Cultured Human Vascular Smooth Muscle Cells
Authors: Richard T. Lee, Fedor Berditchevski, George C. Cheng, Martin E. Hemler
Journal: Circulation Research (1995)

Vascular smooth muscle cells perform the important function of modulation of vascular extracellular matrix. Because integrins mediate many cell-matrix interactions, the role of integrins in reorganization of collagen by cultured human vascular smooth muscle cells was studied. Immunoprecipitation demonstrated that human vascular smooth muscle cells express multiple beta 1 integrins. Monoclonal antibody A2-IIE10 (a blocking anti-alpha 2 antibody) inhibited adhesion of smooth muscle cells to collagen by 31%. The blocking anti-alpha 1 antibody 1B3.1 inhibited adhesion by 40%, whereas a blocking anti-alpha 3 antibody had no effect on adhesion. When 1B3.1 and A2-IIE10 were both used, a 79% reduction in adhesion was observed, indicating that active alpha 1 and alpha 2 integrins cooperatively mediate adhesion. The blocking anti-beta 1 antibody Mab13 abolished smooth muscle cell-mediated gel contraction, and the alpha 2-blocking antibody A2-IIE10 had a dose-dependent partial inhibitory effect (37%). In contrast, blocking antibodies to alpha 1 and alpha 3 had no effect. When anti-alpha 1 (1B3.1) and anti-alpha 2 (A2-IIE10) monoclonal antibodies were combined, no synergistic effect on inhibition of gel contraction was observed. Surprisingly, collagen gel contraction was inhibited by 46% by an anti-beta 1 antibody (TS2/16) known for its stimulatory effect on cell adhesion. Thus, whereas alpha 1 beta 1 and alpha 2 beta 1 integrins both participate in adhesion of vascular smooth muscle cells to collagen, only alpha 2 beta 1 integrins mediate collagen reorganization. In addition, collagen reorganization appears to be a dynamic process, adversely affected by excessive adhesion strengthening.
α <sub>2</sub> (VIII) Collagen Substrata Enhance Endothelial Cell Retention Under Acute Shear Stress Flow via an α <sub>2</sub> β <sub>1</sub> Integrin–Dependent Mechanism
Authors: Neill J. Turner, Michael O. Murphy, Cay M. Kielty, C. Adrian Shuttleworth, Richard A. Black, Martin J. Humphries, Michael G. Walker, Ann E. Canfield
Journal: Circulation (2006)

Background— Essential to tissue-engineered vascular grafts is the formation of a functional endothelial monolayer capable of resisting the forces of blood flow. This study targeted α 2 (VIII) collagen, a major component of the subendothelial matrix, and examined the ability of and mechanisms by which endothelial cells attach to this collagen under static and dynamic conditions both in vitro and in vivo. Methods and Results— Attachment of human endothelial cells to recombinant α 2 (VIII) collagen was assessed in vitro under static and shear conditions of up to 100 dyne/cm 2 . α 2 (VIII) collagen supported endothelial cell attachment in a dose-dependent manner, with an 18-fold higher affinity for endothelial cells compared with fibronectin. Cell attachment was significantly inhibited by function-blocking anti-α 2 (56%) and -β 1 (98%) integrin antibodies but was not RGD dependent. Under flow, endothelial cells were retained at significantly higher levels on α 2 (VIII) collagen (53% and 51%) than either fibronectin (23% and 16%) or glass substrata (7% and 1%) at shear rates of 30 and 60 dyne/cm 2 , respectively. In vivo studies, using endothelialized polyurethane grafts, demonstrated significantly higher cell retention rates to α 2 (VIII) collagen-coated than to fibronectin-coated prostheses in the midgraft area ( P &lt;0.05) after 24 hours’ implantation in the caprine carotid artery. Conclusions— These studies demonstrate that α 2 (VIII) collagen has the potential to improve both initial cell attachment and retention of endothelial cells on vascular grafts in vivo, which opens new avenues of research into the development of single-stage endothelialized prostheses and the next generation of tissue-engineered vascular grafts.
The Complete Nucleotide Sequences of the 5 Genetically Distinct Plastid Genomes of Oenothera, Subsection Oenothera: II. A Microevolutionary View Using Bioinformatics and Formal Genetic Data
Authors: S. Greiner, X. Wang, R. G. Herrmann, U. Rauwolf, K. Mayer, G. Haberer, J. Meurer
Journal: Molecular Biology and Evolution (2008)

A unique combination of genetic features and a rich stock of information make the flowering plant genus Oenothera an appealing model to explore the molecular basis of speciation processes including nucleus–organelle coevolution. From representative species, we have recently reported complete nucleotide sequences of the 5 basic and genetically distinguishable plastid chromosomes of subsection Oenothera (I–V). In nature, Oenothera plastid genomes are associated with 6 distinct, either homozygous or heterozygous, diploid nuclear genotypes of the 3 basic genomes A, B, or C. Artificially produced plastome–genome combinations that do not occur naturally often display interspecific plastome–genome incompatibility (PGI). In this study, we compare formal genetic data available from all 30 plastome–genome combinations with sequence differences between the plastomes to uncover potential determinants for interspecific PGI. Consistent with an active role in speciation, a remarkable number of genes have high Ka/Ks ratios. Different from the Solanacean cybrid model Atropa/tobacco, RNA editing seems not to be relevant for PGIs in Oenothera. However, predominantly sequence polymorphisms in intergenic segments are proposed as possible sources for PGI. A single locus, the bidirectional promoter region between psbB and clpP, is suggested to contribute to compartmental PGI in the interspecific AB hybrid containing plastome I (AB-I), consistent with its perturbed photosystem II activity.
Urine <i>TMPRSS2:ERG</i> Fusion Transcript Stratifies Prostate Cancer Risk in Men with Elevated Serum PSA
Authors: Scott A. Tomlins, Sheila M. J. Aubin, Javed Siddiqui, Robert J. Lonigro, Laurie Sefton-Miller, Siobhan Miick, Sarah Williamsen, Petrea Hodge, Jessica Meinke, Amy Blase, Yvonne Penabella, John R. Day, Radhika Varambally, Bo Han, David Wood, Lei Wang, Martin G. Sanda, Mark A. Rubin, Daniel R. Rhodes, Brent Hollenbeck, Kyoko Sakamoto, Jonathan L. Silberstein, Yves Fradet, James B. Amberson, Stephanie Meyers, Nallasivam Palanisamy, Harry Rittenhouse, John T. Wei, Jack Groskopf, Arul M. Chinnaiyan
Journal: Science Translational Medicine (2011)

Urine TMPRSS2:ERG gene fusion could be used for stratification of patients at higher risk for prostate cancer.
Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis
Authors: Yih-Sharng Chen, Jou-Wei Lin, Hsi-Yu Yu, Wen-Je Ko, Jih-Shuin Jerng, Wei-Tien Chang, Wen-Jone Chen, Shu-Chien Huang, Nai-Hsin Chi, Chih-Hsien Wang, Li-Chin Chen, Pi-Ru Tsai, Sheoi-Shen Wang, Juey-Jen Hwang, Fang-Yue Lin
Journal: The Lancet (2008)
Pulsed monoclonal antibody treatment and autoimmune thyroid disease in multiple sclerosis
Authors: Alasdair J Coles, Mark Wing, Sheila Smith, Francesca Coraddu, Sandra Greer, Craig Taylor, Anthony Weetman, Geoff Hale, V Krishna Chatterjee, Herman Waldmann, Alastair Compston
Journal: The Lancet (1999)
Strenuous endurance exercise improves life expectancy: it's in our genes: Table 1
Authors: Jonatan R Ruiz, Maria Morán, Joaquín Arenas, Alejandro Lucia
Journal: British Journal of Sports Medicine (2010)

The effect of strenuous, competitive exercise on the human heart and life expectancy has long been a subject of debate. For centuries, the general belief was that vigorous, competitive exercise was harmful and decreased life expectancy. However, a number of studies of the early 20th century, together with more recent data in elite athletes, strongly support the notion that participation in competitive sports is associated with normal or increased life expectancy, with a special beneficial effect of aerobic type of activities. In terms of genetics, current humans are citizens of the Paleolithic era living in the 21st century, so that those who better match with an active lifestyle will likely have a longer life expectancy and a reduced risk of chronic diseases. Endurance athletes might be such an example.

The effect of strenuous, competitive exercise on human life expectancy has long been a subject of debate. Since the classical antiquity, the prevailing belief has been that vigorous, competitive exercise is harmful. Hippocrates wrote about athletes that ‘…the truth is, however, that no one is in a more risky state of health than they….’1 Similar was the opinion of the Greek physician–philosopher Galen. Galen's beliefs were that ‘Athletes live a life quite contrary to the precepts of hygiene…when they give up their profession, they fall into a dangerous condition; as a fact, some die shortly afterwards, others live for some little time but do not arrive at old age..’2 The belief that vigorous exercise was harmful remained for centuries. In 1968, Moorstein3 stated that all members of the 1948 Harvard rowing crew had died early from ‘various cardiac diseases.’ A number of studies of the early 20th century and thereafter, however, showed that participation in endurance competitive sports increased life expectancy (table 1).

View this table:

Table 1 
Summary of the main …
Effects of Sevelamer Hydrochloride and Calcium Carbonate on Renal Osteodystrophy in Hemodialysis Patients
Authors: Aníbal Ferreira, João Miguel Frazão, Marie Claude Monier-Faugere, Célia Gil, José Galvao, Carlos Oliveira, Jorge Baldaia, Ilidio Rodrigues, Carla Santos, Silvia Ribeiro, Regula Mueller Hoenger, Ajay Duggal, Hartmut H. Malluche
Journal: Journal of the American Society of Nephrology (2008)

Disturbances in mineral metabolism play a central role in the development of renal bone disease. In a 54-wk, randomized, open-label study, 119 hemodialysis patients were enrolled to compare the effects of sevelamer hydrochloride and calcium carbonate on bone. Biopsy-proven adynamic bone disease was the most frequent bone abnormality at baseline (59%). Serum phosphorus, calcium, and intact parathyroid hormone were well controlled in both groups, although calcium was consistently lower and intact parathyroid hormone higher among patients who were randomly assigned to sevelamer. Compared with baseline values, there were no changes in mineralization lag time or measures of bone turnover (<i>e.g.</i>, activation frequency) after 1 yr in either group. Osteoid thickness significantly increased in both groups, but there was no significant difference between them. Bone formation rate per bone surface, however, significantly increased from baseline only in the sevelamer group (<i>P</i> = 0.019). In addition, of those with abnormal microarchitecture at baseline (<i>i.e.</i>, trabecular separation), seven of 10 in the sevelamer group normalized after 1 yr compared with zero of three in the calcium group. In summary, sevelamer resulted in no statistically significant changes in bone turnover or mineralization compared with calcium carbonate, but bone formation increased and trabecular architecture improved with sevelamer. Further studies are required to assess whether these changes affect clinical outcomes, such as rates of fracture.
Mandatory Reporting of Loss of Consciousness or Confusion Due to Alcohol
Authors: Franklin Drucker
Journal: JAMA (1995)

To the Editor.  —In his excellent article, Dr Kitchens 1 suggests using the Michigan Alcoholism Screening Test (MAST) and the Alcohol Use Disorders Identification Test (AUDIT) to screen patients. Unfortunately, these are hazardous for both the patient and the doctor.  On the MAST, item 2 inquires, Have you ever awakened the morning after some drinking the night before and found that you could not remember a part of the evening before? At item 8, the AUDIT asks, How often during the last year have you been unable to remember what happened the night before because you had been drinking?  Some states, notably California, mandate a physician to report when any person older than 14 years, whether or not a driver, has experienced one or more occasions during the preceding 3 years of a disorder characterized by lapse of consciousness (including momentary lapses) or an episode of marked confusion caused by
Paradigm Shift in the Surgical Management of Multigland Parathyroid Hyperplasia
Authors: Amir H. Lebastchi, Patricia I. Donovan, Robert Udelsman
Journal: JAMA Surgery (2014)

Locoregional anesthesia, conscious sedation, and exploration via a limited incision have become a well-accepted approach for the treatment of patients with primary hyperparathyroidism with image-localized, presumed single-gland disease. However, to our knowledge, this minimally invasive technique has never been investigated in patients with multigland disease.To extrapolate the technique of locoregional anesthesia, conscious sedation, and exploration via a limited incision to perform minimally invasive bilateral exploration in patients who have multigland hyperplasia.Retrospective analysis at a tertiary academic referral center of 100 consecutive patients undergoing parathyroidectomy for primary hyperparathyroidism due to parathyroid hyperplasia between January 19, 2010, and July 30, 2013, who were included in a prospective database.All patients underwent subtotal parathyroidectomy using either conventional treatment (bilateral neck exploration under general anesthesia) or extended minimally invasive parathyroidectomy (ex-MIP; locoregional anesthesia, conscious sedation, and exploration via a limited incision). Patients in the ex-MIP group who required conversion to general anesthesia were analyzed in the ex-MIP group on an intent-to-treat basis.Patient cure and complication rates, length of stay, and total hospital charges.Of the 100 consecutive patients with parathyroid hyperplasia, 29 received conventional treatment and 71 underwent ex-MIP. In the ex-MIP group, 11 of 71 patients (15.5%) required conversion to general anesthesia. There were no differences between the ex-MIP and conventional treatment groups in age (mean [SD], 62.2 [12.2] vs 57.7 [15.2] years; P = .12), sex (59 [83.1%] vs 23 [79.3%] female; P = .78), preoperative serum calcium level (mean [SD], 11.1 [0.9] vs 10.8 [0.8] mg/dL; to convert to millimoles per liter, multiply by 0.25; P = .15), preoperative serum parathyroid hormone level (mean [SD], 114.5 [56.8] vs 137.8 [83.4] pg/mL; to convert to nanograms per liter, multiply by 1; P = .10), complications (4 vs 0 complications; P = .32), or cure rates (98.6% vs 96.6%; P = .50). Importantly, the ex-MIP group had a significant reduction in length of stay compared with the conventional treatment group (mean [SD], 1.01 [0.02] vs 1.35 [0.24] days; P = .04). They also had lower total hospital charges, but the difference was not statistically significant (mean, $23,199 vs $27,312; P = .17).Parathyroidectomy with bilateral neck exploration under general anesthesia has been the standard of care for the treatment of parathyroid hyperplasia. We demonstrate that ex-MIP can provide equivalent cure and complication rates with a shorter hospital stay and a mean hospital charge reduction of more than $4000 per case.
Are we studying the correct state of the stellate cell to elucidate mechanisms of chronic pancreatitis?
Authors: S J Pandol
Journal: Gut (2005)

<h3>OBJECTIVES</h3> The present study examines the utility of three measures of premorbid intellectual functioning in closed head injury, the National adult reading test (NART), the Cambridge contextual reading test (CCRT), and the spot the word test (STW). <h3>METHODS</h3> In the first experiment, a group of 25 patients with closed head injury were compared with 50 healthy controls and 20 orthopaedic trauma controls. In the second experiment, the strength of correlation between the premorbid measures and current intellectual level were assessed in 114 healthy adults. <h3>RESULTS</h3> The head injured group performed significantly more poorly than both control groups on measures of current intellectual ability. However, no significant differences emerged between the groups on any of the premorbid measures. In the large control sample, both the NART and the CCRT accounted for about 50% of the variance in current verbal intelligence. However, by contrast, the STW only accounted for 29% of the variability in verbal intelligence. Adding demographic variables to the prediction of current intellectual level increased the amount of variance explained to 60% for the NART, 62% for the CCRT, but only 41% for the STW. <h3>CONCLUSION</h3> The results provide supportive evidence for the use of the CCRT and NART in estimating premorbid intellectual functioning in patients who have sustained closed head injuries, but suggest caution when employing the STW.
Maintenance Azithromycin Therapy for Bronchiolitis Obliterans Syndrome
Authors: Susan G. Gerhardt, John F. McDyer, Reda E. Girgis, John V. Conte, Stephen C. Yang, Jonathan B. Orens
Journal: American Journal of Respiratory and Critical Care Medicine (2003)

Bronchiolitis obliterans syndrome remains the leading cause of morbidity and mortality in the pulmonary transplant population. Previous studies show that macrolide antibiotics may be efficacious in the treatment of panbronchiolitis and cystic fibrosis. In the latter, azithromycin decreases the number of respiratory exacerbations, improves FEV1, and improves quality of life. We hypothesized that oral azithromycin therapy may improve lung function in patients with bronchiolitis obliterans syndrome. To test this hypothesis, we conducted an open-label pilot trial using maintenance azithromycin therapy in six lung transplant recipients (250 mg orally three times per week for a mean of 13.7 weeks). In this study, five of these six individuals demonstrated significant improvement in pulmonary function, as assessed by FEV1, as compared with their baseline values at the start of azithromycin therapy. The mean increase in the percentage of predicted FEV1 values in these individuals was 17.1% (p </= 0.05). In addition, the absolute FEV1 increased by 0.50 L (range -0.18 to 1.36 L). These data suggest a potential role for maintenance macrolide therapy in the treatment of bronchiolitis obliterans syndrome in lung transplant recipients.
Short-duration therapy with terbinafine for dermatophyteonychomycosis: A multicentre trial
Authors: M.J.D. GOODFIELD
Journal: British Journal of Dermatology (1992)

Journal Article Short‐duration therapy with terbinafine for dermatophyteonychomycosis: A multicentre trial Get access M.J.D. GOODFIELD M.J.D. GOODFIELD Department of Dermatology, Leeds General Infirmary, Leeds, UK Dr Mark J.D.Goodfield, Department of Dermatology, Leeds General Infirmary, Great George Street, Leeds LS1 3EX, UK. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 126, Issue s39, 1 February 1992, Pages 33–35, https://doi.org/10.1111/j.1365-2133.1992.tb00007.x Published: 01 February 1992