tbuckley/cabot-search huggingface dataset:
Economic Considerations in Emergency Care
Authors: Arnold S. Relman
Journal: New England Journal of Medicine (1985)

Two items in this issue have some lessons to teach us about the social responsibilities of hospitals in a health care system now obsessed with cost control and increasingly influenced by economic competition. The first article is a Sounding Board contribution from Dr. Keith Wrenn, a primary care internist in rural North Carolina, who recounts his difficulty in getting an uninsured patient with an acute traumatic neurosurgical problem admitted to a tertiary care referral center. The article is printed virtually unedited, because it so vividly describes the author's distress as he vainly tries to persuade a staff neurosurgeon at a . . .
Transbronchial Lung Biopsy for the Diagnosis of Sarcoidosis
Authors: Spencer K. Koerner, Arthur J. Sakowitz, Robert I. Appelman, Norwin H. Becker, Stephan W. Schoenbaum
Journal: New England Journal of Medicine (1975)

To evaluate the efficacy of transbronchial lung biopsy in the diagnosis of sarcoidosis, 26 consecutive patients with clinical features of sarcoidosis underwent this procedure during fiberoptic bronchoscopy. In 21, the biopsy revealed noncaseating granuloma and, in the remaining five, normal lung parenchyma. Subsequently, two of these five patients were found to have tuberculosis, one was confirmed as having sarcoidosis, and the fifth has not had further evaluation. Transbronchial lung biopsy was therefore successful in the histologic confirmation of sarcoidosis in 21 of 23 patients. The only complication was one 20 per cent pneumothorax, which resolved spontaneously. Because of its low morbidity rate, high diagnostic yield and specificity transbronchial lung biopsy is recommended as one of the initial procedures for obtaining histologic confirmation in patients with suspected sarcoidosis.
Rehabilitating Bodies: Health, History, and the American Civil War
Authors: N. Cervetti
Journal: JAMA (2004)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
Asthma Induced by a Thermal Printer
Authors: Silvia Sánchez-Garcia, Mar Fernández-Nieto, Joaquín Sastre
Journal: New England Journal of Medicine (2009)

To the Editor: Point-of-sale terminals are devices used worldwide for credit-card or debit-card transactions or to print a variety of coupons. These machines print receipts on thermal paper covered with N-propyl-acrylamide and acrylate tints. We report on a nonsmoking 62-year-old woman without atopy in whom asthma symptoms developed after she had worked for 20 years selling lottery tickets inside a 4-m3 kiosk. For the past 3 years, she had been using a point-of-sale terminal to print lottery tickets. She had a 2.5-year history of rhinoconjunctivitis, facial edema, cough, shortness of breath, and wheezing. These symptoms occurred within 30 to 60 . . .
The Pill, John Rock, and the Church: The Biography of a Revolution
Authors: Alex S. Tulsky
Journal: JAMA (1983)

For those of us who still remember our early years of practice making our own intrauterine devices (IUDs) of silkworm gut and stainless steel wire, and for those of us who watched the unfolding of gynecologic endocrinology with its evolution from Hitschman and Adler, to Allen and Doisy, George Corner, Hisaw and Greep, Butenandt, and a host of others who made possible the development of the Pill, I laud the author of this timely book for a well-written, well-constructed, and most informative work. McLaughlin may be a science writer, but her perceptions of John Rock as a human being and a physician, of the origin of the pill, and of the Church in coming to theological grips with a concept and its progenitor is an expression of the synthesis of science and humanism at its best. The book is evidently intended for the general public, but the author demonstrates an
Surgical management of bronchial carcinoma invading the chest wall.
Authors: M P Jamieson, P R Walbaum, R J McCormack
Journal: Thorax (1979)

In a 20-year period (1958-77) 43 patients underwent combined pulmonary and chest wall resection for bronchial carcinoma with local invasion of the thoracic wall. The clinical data, symptoms, surgical procedures, pathology, and results are reviewed. Pain was the usual presenting symptom. The operative mortality was 16%, respiratory complications causing most of the postoperative morbidity and mortality. These complications were less common after pneumonectomy. Long-term survival was achieved in only three cases with a corrected three-year survival rate of 10%. The survivors had certain pathological and operative features in common that may have prognostic significance. Recurrent carcinoma was responsible for most late deaths. Despite the poor overall prognosis, surgical management provided reasonable palliation and occasionally resulted in prolonged disease-free survival.
Epidemiological and clinical features of Budd-Chiari syndrome in Japan
Authors: Hiroaki Okuda, Hideharu Yamagata, Hiroshi Obata, Hirotoshi Iwata, Ryuichiro Sasaki, Fukashi Imai, Masahiko Okudaira, Makoto Ohbu, Kunio Okuda
Journal: Journal of Hepatology (1995)
Developing a Bidirectional Academic–Community Partnership with an Appalachian-American Community for Environmental Health Research and Risk Communication
Authors: Erin N. Haynes, Caroline Beidler, Richard Wittberg, Lisa Meloncon, Megan Parin, Elizabeth J. Kopras, Paul Succop, Kim N. Dietrich
Journal: Environmental Health Perspectives (2011)

Marietta, Ohio, is an Appalachian-American community whose residents have long struggled with understanding their exposure to airborne manganese (Mn). Although community engagement in research is strongly endorsed by the National Institutes of Health and the National Institute of Environmental Health Sciences in particular, little has been documented demonstrating how an academic-community partnership that implements the community-based participatory research (CBPR) principles can be created and mobilized for research.We created a bidirectional, academic-community partnership with an Appalachian-American community to a) identify the community's thoughts and perceptions about local air quality, its effect on health, and the perception of risk communication sources and b) jointly develop and conduct environmental health research.We formed a community advisory board (CAB), jointly conducted pilot research studies, and used the results to develop a community-driven research agenda.Persons in the community were "very concerned" to "concerned" about local air quality (91%) and perceived the air quality to have a direct impact on their health and on their children's health (93% and 94%, respectively). The CAB identified the primary research question: "Does Mn affect the cognition and behavior of children?" Although the community members perceived research scientists as the most trusted and knowledgeable regarding risks from industrial emissions, they received very little risk information from research scientists.Engaging a community in environmental health research from its onset enhanced the quality and relevance of the research investigation. The CBPR principles were a useful framework in building a strong academic-community partnership. Because of the current disconnect between communities and research scientists, academic researchers should consider working collaboratively with community-based risk communication sources.
Phase II trial of recombinant interferon alfa‐2 in the treatment of primary systemic amyloidosis
Authors: Morie A. Gertz, Robert A. Kyle
Journal: American Journal of Hematology (1993)

Abstract Primary systemic amyloidosis (AL) is a rare disorder characterized by production of an aberrant monoclonal light chain. This insoluble light chain, or a fragment thereof, deposits in tissues as amyloid and results in disruption of organ function and, ultimately, death. Although melphalan and prednisone were reported to benefit subsets of patients with the disease, many patients showed no benefit; the median survival with the disease is ∼2 years. There is a need to develop new agents for patients who fail to respond to a trial of cytotoxic chemotherapy. A study was undertaken of interferon alfa‐2 in the treatment of 15 patients with AL because of its reported benefits in the induction and maintenance therapy for patients with multiple myeloma, a disease that has many characteristics in common with AL. None of the patients showed any objective regression of their disease; the median survival of the entire group was 26.3 months. This survival is not superior to that reported with other agents used for this disease. We conclude that interferon alpha‐2 is not a valuable agent in the treatment of AL. © 1993 Wiley‐Liss, Inc.
Acute Versenate Nephrosis
Authors: Melvin D. Reuber
Journal: JAMA (1960)

A 1-year-old girl with acute lead poisoning developed anuria and uremia five days after treatment with calcium versenate (125 mg. per kilogram of body weight daily for three days). Her clinical course was complicated by pneumonia, pericarditis, and bleeding from the gastrointestinal tract. Despite artificial dialysis she died after remaining anuric for 13 days. At autopsy the kidneys showed acute tubular necrosis, which was attributed to the calcium versenate therapy. It is recommended that the dosage of calcium versenate should not exceed 75 mg. per kilogram of body weight.
Recurrent Adult Wilms Tumor With Extensive Metastases on FDG PET-CT
Authors: Linh Ho, Vicki Quan, Susan Park, John Seto
Journal: Clinical Nuclear Medicine (2008)

We report the PET-CT appearance of recurrent Wilms tumor in the surgical bed with multiple metastatic sites in a 30-year-old man. He was initially diagnosed with Wilms tumor in the right kidney with involvement of the right adrenal gland and right renal vein into the inferior vena cava, for which he underwent a right nephrectomy, right adrenalectomy, and retroperitoneal lymph node dissection. Three months later, a restaging PET-CT study demonstrated multiple hypermetabolic lesions in the surgical bed region, the left adrenal gland, liver, thoracolumbar spine, retroperitoneal lymph nodes, and peritoneum.
GLOBAL 2D STRAIN AS NEW INDEX OF LEFT VENTRICULAR FUNCTION IN OBESITY BEFORE AND AFTER BARIATRIC SURGERY
Authors: Vito Di Bello, Cristina Giannini, Maria Grazia Delle Donne, Francesco De Sanctis, Paolo Spontoni, Cuono Cucco, Chrysanthos Grigoratos, Anca Irina Corciu, Fei Lu, Valeria Santonato, Ferruccio Santini, Alberto Balbarini
Journal: Journal of the American College of Cardiology (2011)
A Case Against Justified Non-Voluntary Active Euthanasia (The Groningen Protocol)
Authors: Alan Jotkowitz, S. Glick, B. Gesundheit
Journal: The American Journal of Bioethics (2008)

The Groningen Protocol allows active euthanasia of severely ill newborns with unbearable suffering. Defenders of the protocol insist that the protocol refers to terminally ill infants and that quality of life should not be a factor in the decision to euthanize an infant. They also argue that there should be no ethical difference between active and passive euthanasia of these infants. However, nowhere in the protocol does it refer to terminally ill infants; on the contrary, the developers of the protocol take into account the future quality of life of the infant. We also note how the Nazi Euthanasie Programm started with the premise that there is some life not worthy of living. Therefore, in our opinion, the protocol violates the traditional ethical codes of physicians and the moral values of the overwhelming majority of the citizens of the world.
Heart block in patients with sleep apnoea
Authors: H F Becker, U Koehler, A Stammnitz, J H Peter
Journal: Thorax (1998)

Prevalence of bradycardic arrhythmias in sleep apnoeaIn the early days of sleep research it was thought that heart block (second and third degree atrioventricular block), sinus arrest, or sinoatrial block were frequent findings in patients with sleep apnoea.Tilkian and co-workers 1 reported that more than 50% of patients with sleep apnoea develop episodes of heart block during sleep.In 400 patients studied by Guilleminault et al 2 bradycardic arrhythmias were reported in almost 18% of the patients and later studies found heart block in 9-13% of patients with sleep apnoea. 3 4Due to ventricular asystoles of up to 13 seconds in duration it was hypothesised that heart block might lead to an increased mortality risk in these patients. 2A recent publication challenged previous results in that no increased prevalence of bradycardic arrhythmias was seen in patients with sleep apnoea compared with those without sleep apnoea. 5o examine these seemingly discrepant results further we performed Holter monitoring in 239 consecutive patients diagnosed as having sleep apnoea (apnoea/hypopnoea index >10/h) using a validated ambulatory recording device based on the measurement of heart rate, SaO 2 , snoring sound, and body position.Episodes of second and third degree atrioventricular (AV) block and/or sinus arrest of more than two seconds in duration occurred in 17 of the 239 patients. 6There was no significant difference in age between patients with and without heart block (mean (SD) 50.7 (12.8) versus 52.1 (9.8) years), but those with heart block were significantly more obese (38.7 (7.3) versus 30.7 (4.6)).Twelve of the 17 patients (70.6%) had arterial hypertension, seven (41.1%) suVered from heart failure (NYHA II-III), and four (23.5%) had pulmonary hypertension.None of the patients reported a myocardial infarction in their medical history, and in only one (5.9%)exercise testing showed signs of coronary heart disease.Ten of the 17 patients received no medication at all.Treatment with digoxin in two patients and with a blocker in one patient was discontinued one week prior to the study.Diuretic therapy in four patients and ACE inhibitors in two patients were continued unchanged.Standard polysomnography and a repeat 24 hour Holter monitoring were then performed.Severe sleep apnoea (mean (SD) AHI 90 (36)/h, range 59.6-158) was found in the 17 patients and in all of them episodes of heart block during sleep could again be demonstrated.In two of these patients clusters of sinus arrest and second degree AV block could be demonstrated during the daytime as well.
Postmenopausal Estrogen Therapy and the Risk for Developing Systemic Lupus Erythematosus
Authors: Jorge Sanchez-Guerrero
Journal: Annals of Internal Medicine (1995)

Objective: To examine the relation between postmenopausal hormone use and development of systemic lupus erythematosus. Design: Prospective cohort study. Setting: Nurses' Health Study. Patients: 69 435 women aged 30 to 55 years in 1976 who reported that they had completed menopause and did not have systemic lupus erythematosus or any connective tissue disease were followed every 2 years from 1976 to 1990. These women were classified as never-or ever-(current and past) users of postmenopausal hormones. Measurements: Incidence rates of systemic lupus erythematosus and classification criteria from the American College of Rheumatology that were confirmed by chart review. Results: With never-users of postmenopausal hormones as the reference group, age-adjusted relative risks for systemic lupus erythematosus (n = 45 women) were 2.1 (95% CI, 1.1 to 4.0) for ever-users, 2.5 (CI, 1.2 to 5.0) for current users, and 1.8 (CI, 0.8 to 4.1) for past users. A proportional increase in the risk for systemic lupus erythematosus was observed that was related to the duration of use of postmenopausal hormones (test for trend, P = 0.011). Conclusions: Postmenopausal hormone therapy is associated with an increased risk for developing systemic lupus erythematosus.
Comment on: Rizzo et al. Reduction of Oxidative Stress and Inflammation by Blunting Daily Acute Glucose Fluctuations in Patients With Type 2 Diabetes: Role of Dipeptidyl Peptidase-IV Inhibition. Diabetes Care 2012;35:2076–2082
Authors: Antoine Makdissi, Ajay Chaudhuri, Nitesh Kuhadiya, Manav Batra, Paresh Dandona
Journal: Diabetes Care (2013)

In their interesting study on the concomitant reduction in inflammatory and oxidative stress and mean amplitude of glycemic excursions (MAGE) following treatment with dipeptidyl peptidase-IV (DPP-4) inhibitors, sitagliptin and vildagliptin, in patients with type 2 diabetes, Rizzo et al. (1) propose that the reduction in MAGE leads to the reduction in indices of oxidative and inflammatory stress. However, the recent demonstration that sitagliptin exerts a rapid and potent …
On Medical Reform and the Remodelling the Profession
Authors: J. Macartney
Journal: BMJ (1841)

Neither wislhintg to lengthen these observations urine- cessarilv, nor desirous of enterinig too deeply into a ques- tion whlichi requires a more comprehensive view than I feel myself capable of taking, I propose to offer onily a few more remarks on the present subject; wlich, however, I oiler withi somile confi(lence, because 1 know thiem to be in accordance with the views of several members of the pro- fession, whlio, though among the war-mest advocates for Medical Refornm, are most desirous of respecting, existing institutions to the utmost possible extent compatible witlh the alterations essentially requisite.Thle most prominient and most general object of the advocates of Medical Reform appears to be a uiiifo)rmity of qualification, to be tested by a public examiniation, in all the candidates for a license to practise medicine.The desire of this unliformity has naturally resulted ftom the consideratiotn of the fact, that scarcely two of the ninsierous existing, boards of examination exact tire same kind or the same degree of qualificationl; and that each medical school determines, indepenidenitly of all the rest, the character and the period of its annual courses of professionall study, whether ini the form of lectures or cliniical observation.But it is here fair to state, that in almost every instance these annual courses are, with reference both to character and lengtl, sufficient for the due instruction of the pupils the average anniual period of study being from six to eight months; the ainnual averag,e number of lectures being from 110 to 140.It is also fair to state, that althouglh not half the sanme number of professionial lectulres could be delivered in Oxford, consistently with the existiing system of that university, and it miiay be presumed that no onie would be (lesirouis of unnecessarily disturbing that system, yet, as every candidate for even the eatliest of the two degrees in medicine must first have resided four years in the univer- sity, for the puirpose of studying the classics, &c., and must af.erwards have passed three uhole years in an accredited school of medicine, London being usually that school, Oxford may be considered as virtually uponi a par with the other medical schlools of this kingdonr: and what has been aflirrmed of Oxford may, in every essential poiint, be applied to Camblridge.It cal halrdly be denied tlrat a change is desirable in that part of the existinig system above described, which re- feirs to the inequality of the starndard of qualification ex- pected by the difk.+rentboards of exanmination for license to
Pollution and people: need for selective monitoring.
Authors: J E Davies, R S Levine, M Fordyce
Journal: BMJ (1981)

less than 16 units being indicative of fat malabsorp- tion (where units=O dose/mmol CO2 x body weight in kg x 10-2).On the basis of faecal fat excretion two patients had steatorrhoea with values of 32 3 and 57 mmol/ 24 hours.The patient, however, with the highest faecal fat output (57 mmol/24 hours) had a normal 4CO2 excretion at 16 2 units.Furthermore, of the five patients with normal faecal fat excretion, three yielded maximum G4CO2 excretion results sugges- tive of fat malabsorption (4 4, 12 3, and 6-7 units).Thus in this group of seven patients with liver disease three false-positive results and one false-negative result were obtained when the '4CO2-GTP test was compared with faecal fat excretion.These results therefore suggest that the '4CO2-GTP breath test does not provide a reliable alternative to faecal-fat analysis in the detection of steatorrhoea in patients with liver disease, who may have disordered metabolism of tripalmitate.
The World Bank and world health: Under fire
Authors: K. Abbasi
Journal: BMJ (1999)

This is the third in a series of six articles examining the World Bank's role in international health The World Bank is accustomed to criticism, and since the second world war few organisations have generated as much outcry. Most analysts, however, accept that the bank has conducted a successful campaign to improve its image over the past decade. Indeed, I was surprised during my meetings with health workers outside the bank that it attracted far less criticism than I had expected. None the less, reservations remain about the bank's approach, and this article discusses some of the most controversial aspects of the bank's policies. #### Summary points Critics of the World Bank argue that structural adjustment loans are a mechanism of forcing free market economics on countries through coercion. Countries with a debt crisis, whatever their other characteristics, agree to the bank's package of legal and economic reforms, and the bank agrees to lend them money. Argentina, Ecuador, and India have all either weakened their labour legislation or amended their land laws to qualify for an adjustment loan. India is reported to have changed 20 pieces of major legislation.1 #### Common criticisms of the World Bank