tbuckley/cabot-search huggingface dataset:
Costs and Benefits of Hepatitis Prophylaxis-Reply
Authors: John D. Hamilton
Journal: JAMA (1984)

In Reply.—  Drs Egilman and Lichty presumably reflect the views of the National Institute for Occupational Safety and Health (NIOSH). Unfortunately, in their zeal to detect violators of OHSA regulations they have failed to understand some vital points.  First, there is no mention in my article that it is necessary to assess costs prior to implementing a hepatitis B virus (HBV) control program with vaccine. Of course, if you wish to do a cost analysis, you must assess costs.  Second, no mention is made of trying to get out of doing the right (and legal) thing by invoking excessive costs as an excuse. After all, the analysis led to a hospital decision to proceed with one of the largest and most successful immunization programs among health care personnel in this country, at hospital expense. Furthermore, our program, which officially began in September 1982, has been accompanied by a reduction in
Evaluation of Direct Medical Costs Related to Cancer
Authors: Martin L. Brown, Bruce Fireman
Journal: JNCI Journal of the National Cancer Institute (1995)

Journal Article Evaluation of Direct Medical Costs Related to Cancer Get access Martin L. Brown, Martin L. Brown Search for other works by this author on: Oxford Academic PubMed Google Scholar Bruce Fireman Bruce Fireman Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 87, Issue 6, 15 March 1995, Pages 399–400, https://doi.org/10.1093/jnci/87.6.399 Published: 15 March 1995 Article history Received: 06 February 1995 Accepted: 07 February 1995 Published: 15 March 1995
The Cost-Effectiveness of Preexposure Prophylaxis for HIV Prevention in the United States in Men Who Have Sex With Men
Authors: Jessie L. Juusola, Margaret L. Brandeau, Douglas K. Owens, Eran Bendavid
Journal: Annals of Internal Medicine (2012)

Background: A recent randomized, controlled trial showed that daily oral preexposure chemoprophylaxis (PrEP) was effective for HIV prevention in men who have sex with men (MSM). The Centers for Disease Control and Prevention recently provided interim guidance for PrEP in MSM at high risk for HIV. Previous studies did not reach a consistent estimate of its cost-effectiveness. Objective: To estimate the effectiveness and cost-effectiveness of PrEP in MSM in the United States. Design: Dynamic model of HIV transmission and progression combined with a detailed economic analysis. Data Sources: Published literature. Target Population: MSM aged 13 to 64 years in the United States. Time Horizon: Lifetime. Perspective: Societal. Intervention: PrEP was evaluated in both the general MSM population and in high-risk MSM and was assumed to reduce infection risk by 44% on the basis of clinical trial results. Outcome Measures: New HIV infections, discounted quality-adjusted life-years (QALYs) and costs, and incremental cost-effectiveness ratios. Results of Base-Case Analysis: Initiating PrEP in 20% of MSM in the United States would reduce new HIV infections by an estimated 13% and result in a gain of 550 166 QALYs over 20 years at a cost of $172 091 per QALY gained. Initiating PrEP in a larger proportion of MSM would prevent more infections but at an increasing cost per QALY gained (up to $216 480 if all MSM receive PrEP). Preexposure chemoprophylaxis in only high-risk MSM can improve cost-effectiveness. For MSM with an average of 5 partners per year, PrEP costs approximately $50 000 per QALY gained. Providing PrEP to all high-risk MSM for 20 years would cost $75 billion more in health care–related costs than the status quo and $600 000 per HIV infection prevented, compared with incremental costs of $95 billion and $2 million per infection prevented for 20% coverage of all MSM. Results of Sensitivity Analysis: PrEP in the general MSM population would cost less than $100 000 per QALY gained if the daily cost of antiretroviral drugs for PrEP was less than $15 or if PrEP efficacy was greater than 75%. Limitation: When examining PrEP in high-risk MSM, the investigators did not model a mix of low- and high-risk MSM because of lack of data on mixing patterns. Conclusion: PrEP in the general MSM population could prevent a substantial number of HIV infections, but it is expensive. Use in high-risk MSM compares favorably with other interventions that are considered cost-effective but could result in annual PrEP expenditures of more than $4 billion. Primary Funding Source: National Institute on Drug Abuse, Department of Veterans Affairs, and National Institute of Allergy and Infectious Diseases.
Presidential Disability and the Twenty-fifth Amendment
Authors: Arthur S. Link
Journal: JAMA (1994)

THE AMERICAN presidency is the most powerful office in the world, yet this has not always been true. The emergence of the United States to global power during the two world wars catapulted the United States into financial and military dominance, which increased exponentially during the Cold War. The US president, because of his position as commander in chief of the military and of the nuclear weapons storehouse, is perhaps the world's dominant person. Furthermore, the president is the leader of his political party and the chief administrator of a vast and sprawling bureaucracy that enjoys great and direct control over the lives and activities of millions of people. See also pp 1689, 1698, and 1699. None of these potentialities was considered possible when the Constitutional Convention assembled in Philadelphia, Pa, in May 1787 to construct a framework for government of the new United States of America. Despite their genius
David John Dyson Perrins
Authors: P B James
Journal: BMJ (2006)

​FormerFormer Medical Research Council research fellow Churchill Hospital, Oxford (b 1924; q Cambridge/London 1949; MD, FRCS), d 2 November 2005.



Figure 1



David rowed for Cambridge in the 1946 university boat race. After a house job at St Thomas' and national service he trained in plastic surgery, gaining experience in the use of hyperbaric oxygen treatment. His seminal publications on the use of this in a variety of conditions are still widely quoted. David completed his MD thesis on hyperbaric oxygen and wound healing and spent 10 years at the Churchill Hospital in Oxford studying the use of oxygen as a radiosensitiser. He moved to Stockholm, studying the use of hyperbaric oxygen treatment to avoid amputation in patients with diabetic peripheral vascular disease. On returning to the United Kingdom, he studied the benefit of hyperbaric oxygen treatment in slowing the progression of multiple sclerosis.
FURTHER OBSERVATIONS ON THE SIGNIFICANCE OF A/EQUINE-2/63 ANTIBODIES IN MAN
Authors: F. M. Davenport, A. V. Hennessy, Elva Minuse
Journal: The Journal of Experimental Medicine (1967)

The antibody pattern of equine-2/63 viruses has been more sharply defined using a large number of human sera collected in 1964. The birth dates of persons exhibiting the richest experience with equine-2/63-like viruses delineate a period of past prevalence in man of equine-2/63-like viruses. The period is believed to have begun in the mid-1870's and to have terminated in 1889-1890 at the time of the first Asian pandemic. The equine-2/63 antibodies found in human sera react specifically in the photometric test of Drescher. The equine-2/63 antibody pattern advances along the age scale in exact concordance with the passage of time. The homologous antibody response of the older subjects to equine-2/63 vaccine is more vigorous, reflecting the conditioning effects of prior exposures to equine-2/63 antigens. A "one-way cross" between equine-2/63 virus and A(2) and A(1) strains has been demonstrated. The antigenic ties between strains of influenza A isolated from humans, swine, horses, and birds is recognized and discussed. It is apparent that horses do not constitute an active reservoir for strains of human involvement. The epidemiologic significance of the antigenic linkages between strains isolated from different species remains obscure.
Polyglutamine-containing aggregates in neuronal intranuclear inclusion disease
Authors: Andrew P Lieberman, Yves Robitaille, John Q Trojanowski, Dennis W Dickson, Kenneth H Fischbeck
Journal: The Lancet (1998)

The trinucleotide repeat disorders are a heterogeneous group of neurological diseases characterised by a similar genetic mutation. Eight disorders have been previously identified with expansion of a CAG repeat in the protein coding sequence of the disease gene, resulting in pathological expansion of a glutamine tract in the mutated protein. The presence of this common mutation suggests that a similar mechanism may underlie neurodegeneration. Studies 1 Lunkes A Mandel J-L Folyglutamines, nuclear inclusions and neurodegeneration. Nat Med. 1997; 3: 1201-1202 Crossref PubMed Scopus (53) Google Scholar have shown that mutated protein accumulates in the nuclei of neurons from patients with Machado-Joseph disease, Huntington's disease, and spinocerebellar ataxia type 1, and in transgenic mice expressing mutated ataxin-1 or an amino-terminal fragment of mutated huntingtin. These ubiquitinated intranuclear inclusions contain fibrillar aggregates which form amyloid-like structures in model systems. Large intranuclear aggregates have been observed in neurons and glia in another rare multisystem neurodegenerative disease known as neuronal intranuclear inclusion disease (NIID). 2 Haltia M Somer H Palo J Johnson WG Neuronal intranuclear inclusion disease in identical twins. Ann Neurol. 1984; 15: 316-321 Crossref PubMed Scopus (70) Google Scholar , 3 Munoz-Garcia D Ludwin SK Adult-onset neuronal intranuclear hyaline inclusion disease. Neurology. 1986; 36: 785-790 Crossref PubMed Google Scholar , 4 Schuffler MD Bird TD Sumi SM Cook A A familial neuronal disease presenting as intestinal pseudoobstrution. Gastroenterology. 1978; 75: 889-898 PubMed Scopus (169) Google Scholar This disorder usually affects the young with death by the third decade. Both sporadic and familial cases have been described, and the mode of inheritance is unclear. Patients often present with extrapyramidal signs, lower motor neuron abnormalities, and cognitive or behavioural dysfunction. Neurons of the central, peripheral, and autonomic nervous systems show eosinophilic, ubiquitinated intranuclear inclusions. The similarities between this disease and the CAG repeat disorders prompted us to examine whether expanded polyglutamine tracts could be identified in NIID.
Electrophysiological effects of verapamil
Authors: I. YAMAGUCHI, K. OBAYASHI, W. J. MANDEL
Journal: Cardiovascular Research (1978)

Previous studies have demonstrated that verapamil possess potent anti-arrhythmic effects. The present study has been designed to define the cardiovascular effects of this drug. Isolated tissue studies performed in rabbit right atrium demonstrated that prompt and prominent slowing of the sinus rate even at a dose of 1 × 10−7 mol·litre−1. This dose produced significant decrease in action potential amplitude and phase 4 slope, shifted the ‘threshold potential’ to a less negative value, prolonged action potential duration but did not change maximum diastolic potential. At this dose of verapamil, sinoatrial conduction time prolonged significantly (control: 40.0± 4.8 ms; 1 × 10−7mollitre−1 verapamil: 50.0± 6.4 ms). Purkinje fibre studies demonstrated decreases in dV/dt, resting potential, total amplitude, action potential duration at 75, 95% of recovery and effective refractory period only after exposure to >1 × 10−5 mol·litre−1 verapamil. Electrophysiological studies in conscious dogs demonstrated, after bolus administration of verapamil, progressive increases in the A–H interval and heart rate, but no changes in H–V and QRS intervals. Anaesthetised dog studies showed the lack of significant effect on A–H and H–V intervals or QRS duration regardless of the bolus dose of verapamil. However, verapamil produced statistically significant increases in heart rate after 0.025 mg·kg−1. Verapamil administration did not produce a statistically significant change in escape pacemaker rate in vagal stimulation experiments or with spontaneously beating isolated Purkinje fibres. Finally, the effect of increasing intravenous bolus doses of verapamil on ischaemic arrhythmias was studied in five conscious dogs 24 h following LAD ligation. Only one dog with ventricular tachycardia and another dog with junctional escape rhythm were converted to sinus rhythm after the 0.05 mg·kg−1 and 0.2 mg·kg−1 doses, respectively. In conclusion, these studies demonstrated that administration of verapamil specifically depresses tissue with electrophysiological dependence on slow channel current. Therefore, sinus and A–V nodal events would be suppressed and slow-channel mediated events in ischaemic ventricle also would be inhibited. Clinically, acute administration of verapamil would lead to depression of sinus and A–V nodal function as well as potentially eliminate slow current mechanisms in ischaemic arrhythmias.
RED CELL, PLASMA AND BLOOD VOLUME IN HEALTHY MEN MEASURED BY RADIOCHROMIUM (Cr51) CELL TAGGING AND HEMATOCRIT: INFLUENCE OF AGE, SOMATOTYPE AND HABITS OF PHYSICAL ACTIVITY ON THE VARIANCE AFTER REGRESSION OF VOLUMES TO HEIGHT AND WEIGHT COMBINED*
Authors: R. Wennesland, Ellen Brown, J. Hopper, J. L. Hodges, O. E. Guttentag, K. G. Scott, I. N. Tucker, B. Bradley
Journal: Journal of Clinical Investigation (1959)

Age Height Weight II or III En Me Ec Hematocritt Vrbct Years cm.Kg. % L. F. Bi. 29 178 73.5 II 3 4' 3' 43.0 2.02 W. Ru. 25 * (C) Chinese, (F) Filipino, (I
The Blurred Intersection of Beneficence, Competence, and Autonomy
Authors: Arthur S. Harrow
Journal: Annals of Internal Medicine (1993)

Letters1 October 1993The Blurred Intersection of Beneficence, Competence, and AutonomyArthur S. Harrow, MDArthur S. Harrow, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-7_Part_1-199310010-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I read with interest and then concern Dr. Wrenn's article [1]. Having worked as housestaff, attending physician, and emergency room physician, I can vouch for the agony of the retrospectoscope and the self-doubt regarding whether the proper decision was made. However, something was even more disturbing about Dr. Wrenn's account.Dr. Wrenn described a disheveled patient who did not wish treatment. When this patient attempted to leave the emergency room, he was tackled by security guards and given haloperidol in order to control him. The patient was then admitted to the hospital against his will and eventually ...REFERENCE1. Wrenn K. Lethal cascade. Ann Intern Med. 1993; 118:562-3. Google Scholar Author, Article, and Disclosure InformationAuthors: Arthur S. Harrow, MDAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1993Volume 119, Issue 7_Part_1Page: 637-638KeywordsDrugsEmergency departmentPatientsPerception ePublished: 15 August 2000 Issue Published: 1 October 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Landmark articles. Nov 13 and Dec 4, 1909, (JAMA 1909. The transmission of acute poliomyelitis to monkeys. By Simon Flexner, M.D., and Paul A. Lewis, M.D
Authors: S. Flexner
Journal: JAMA (1983)

Poliomyelitis or infantile paralysis prevailed in epidemic form along the Atlantic seaboard in the summer of 1907. About that time it appeared in Austria and Germany. In the summer of 1909 the disease reappeared as a focalized epidemic in Greater New York and had, by that time, spread widely throughout the United States and Europe. The cause and mode of dissemination of the disease are unknown; and hence there exists no intelligent means of prevention. While the severity and fatality of the disease fluctuate widely, its effects are always so disastrous as to make it of the highest medical and social importance. In spite of many thorough studies of the spontaneous disease in man, our knowledge of causation and prevention has not been advanced; it may be hoped that it will be advanced by the opportunity for fundamental study opened up by the successful transmission of the disease to lower
Skin lesions associated with circulating lupus anticoagulant
Authors: V.A. ALEGRE, D.A. GASTINEAU, R.K. WINKELMANN
Journal: British Journal of Dermatology (1989)

This retrospective study of 295 patients extends the earlier findings of an association between lupus anticoagulation and thrombosis by demonstrating the occurrence of cutaneous lesions related to the coagulation defect in 70 patients. The most frequent cutaneous associations were thrombophlebitis, skin ulcer, gangrene, haemorrhage, and cutaneous necrosis. Of the patients with skin lesions, 41% had the skin lesion as the first sign of the disease. It is important to recognize this association because nearly 40% of the patients with skin lesions have multisystem thrombotic phenomena in the course of the disease.
Multifactorial assessment and targeted intervention for preventing falls and injuries among older people in community and emergency care settings: systematic review and meta-analysis
Authors: S Gates, J D Fisher, M W Cooke, Y H Carter, S E Lamb
Journal: BMJ (2007)

<b>Objective</b> To evaluate the effectiveness of multifactorial assessment and intervention programmes to prevent falls and injuries among older adults recruited to trials in primary care, community, or emergency care settings. <b>Design</b> Systematic review of randomised and quasi-randomised controlled trials, and meta-analysis. <b>Data sources</b> Six electronic databases (Medline, Embase, CENTRAL, CINAHL, PsycINFO, Social Science Citation Index) to 22 March 2007, reference lists of included studies, and previous reviews. <b>Review methods</b> Eligible studies were randomised or quasi-randomised trials that evaluated interventions to prevent falls that were based in emergency departments, primary care, or the community that assessed multiple risk factors for falling and provided or arranged for treatments to address these risk factors. <b>Data extraction</b> Outcomes were number of fallers, fall related injuries, fall rate, death, admission to hospital, contacts with health services, move to institutional care, physical activity, and quality of life. Methodological quality assessment included allocation concealment, blinding, losses and exclusions, intention to treat analysis, and reliability of outcome measurement. <b>Results</b> 19 studies, of variable methodological quality, were included. The combined risk ratio for the number of fallers during follow-up among 18 trials was 0.91 (95% confidence interval 0.82 to 1.02) and for fall related injuries (eight trials) was 0.90 (0.68 to 1.20). No differences were found in admissions to hospital, emergency department attendance, death, or move to institutional care. Subgroup analyses found no evidence of different effects between interventions in different locations, populations selected for high risk of falls or unselected, and multidisciplinary teams including a doctor, but interventions that actively provide treatments may be more effective than those that provide only knowledge and referral. <b>Conclusions</b> Evidence that multifactorial fall prevention programmes in primary care, community, or emergency care settings are effective in reducing the number of fallers or fall related injuries is limited. Data were insufficient to assess fall and injury rates.
Whooping cough and pertussis vaccination
Authors: N. W Preston
Journal: BMJ (1983)

have appeared recently, however, including our own.1A 25 year old nulliparous woman presented with generalised peritonitis and watery diarrhoea.She had had a copper 7 (Gravigard) device inserted two weeks previously.There was no gynaecological history and no vaginal discharge.The intrauterine contraceptive device was removed, and a high vaginal swab was taken.The pelvic organs could not be assessed because of tenderness.At laparotomy thin pus was found throughout the abdomen, but no source could be identified.Streptococcus pneumoniae was cultured from both the peritoneal fluid and the high vaginal swab.The patient made an uncomplicated recovery after drainage and a course of antibiotics.Although this case ended satisfactorily, delay in treatment might have been fatal.The presence of an intrauterine contraceptive
Convalescent Carriers of<i>Vibrio cholerae</i>
Authors: NATHANIEL F. PIERCE
Journal: Annals of Internal Medicine (1970)

Eighty-one convalescent cholera patients were examined by magnesium sulfate purging and duodenal intubation to detect prolonged Vibrio cholerae infection. Three carriers were identified. The carrier state lasted 50 to 331 days. Carriers were more frequently persons over age 50 and persons not receiving effective antibacterial treatment. Cholera vibrios were frequently isolated from duodenal fluid of carriers and consistently increased in numbers after gall bladder evacuation, indicating vibrios were harbored in the gall bladder. After early convalescence stool from carriers rarely yielded cholera vibrios, but purged stool induced by magnesium sulfate was frequently positive. Rough forms of V. cholerae became the predominate type isolated from carriers after 15 to 29 days of convalescence. In carriers the titers of agglutinating, vibriocidal, and exotoxin neutralizing antibodies rose and fell in a pattern similar to convalescent, non-carrier patients. Convalescent carriers may be an interepidemic reservoir of V. cholerae.
Effect of Sabin Type 1 Poliomyelitis Vaccine Administered by Mouth to Newborn Infants
Authors: Martha Lipson Lepow, Robert J. Warren, Nigel Gray, Virginia G. Ingram, Frederick C. Robbins
Journal: New England Journal of Medicine (1961)

IT is the purpose of this report to describe the response of newborn infants to the feeding of Type 1 attenuated poliovirus vaccine (Sabin LSc-2 ab). For comparison, observations were also made upon infants fed the same vaccine at three months of age.This study was undertaken because there appear to be certain practical advantages in beginning immunization during the first few days of life. Active immunity might be achieved while the infant was still protected by antibody passively acquired from the mother, and thus there would be no interval when the child would be susceptible to paralytic disease. If . . .
Massive intravascular haemolysis due to mitral Bjork-Shiley paraprosthetic regurgitation.
Authors: A S Soorae
Journal: Thorax (1979)

A mild degree of haemolysis after insertion of intra- cardiac prostheses and other foreign material is not uncommon, but massive, life-threatening haemolysis necessitating reoperation is, fortunately, rare. Case reportA 68-year-old man, who had undergone closed valv- otomy for mitral stenosis in 1966, was admitted with restenosis of the mitral valve, which was confirmed by cardiac catheterisation.On 15 December 1975 a densely calcified mitral valve was excised and replaced by a 27 mm Bjork-Shiley prosthesis, which was fixed in place with inter- rupted Ethiflex sutures.The calcification extended into the mitral ring near the lateral commissure, and the sutures in this area were reinforced by three rectan- gular pledgets of Teflon.Immediately after the operation the patient passed adequate amounts of clear urine, but 10 hours later he produced dark, burgundy-coloured urine.On the next day he was jaundiced, and a mitral systolic murmur could be heard.