tbuckley/cabot-search huggingface dataset:
The Effect on Children of Curtailing Medicaid Spending
Authors: Paul W. Newacheck
Journal: JAMA (1995)

FEDERAL policymakers are considering a number of major changes for Medicaid and other social welfare programs serving children from low-income families. In this article we discuss the proposed spending reductions and programmatic changes for the Medicaid program because it is the single most important health program for low-income families with children. We present a description of the proposed changes, describe Medicaid's role in financing medical care to children, and assess the likely effects of the current proposals for reducing future growth in Medicaid expenditures on access to medical services and covered benefits. See also pp 1429 and 1472. Medicaid is an insurancelike program for financing medical, mental health, and dental services, as well as long-term care for low-income people. It is funded and administered jointly by federal and state governments. Medicaid is expected to serve 36 million people during 1995, up from 22 million in 1988.<sup>1,2</sup>Although Medicaid has
Melanocytic Nevi as Biomarkers of Breast Cancer Risk
Authors: Barbara Fuhrman, Victor Cardenas
Journal: PLoS Medicine (2014)

report on their number of moles using qualitative categories as follows: ‘‘none,’’ ‘‘a few,’’ ‘‘many,’’ or ‘‘very many.’’ The cohort was followed through 2008; a total of 5,956 incident breast cancer cases were ascertained over nearly 1.4 million personyears. In age-adjusted models, women reporting the most nevi were observed to have 13% higher breast cancer risk than their counterparts without nevi (p for trend=0.04). This association was attenuated and the trend no longer significant when investigators adjusted for benign breast disease or family history of breast cancer. A non-statistically significant increase in breast cancer risk of 8% was observed after adjusting for established breast cancer risk factors and measures of ultraviolet radiation exposure. While their findings are broadly consistent, subgroup findings in the two studies were different. Kvaskoff and colleagues found no significant association in postmenopausal women, but observed that, among premenopausal women, those who had reported ‘‘very many’’ nevi were 34% more likely to be diagnosed with breast cancer compared to counterparts who reported ‘‘none’’ even after adjustment for all potential confounders (p for trend=0.03, p for heterogeneity=0.04). In contrast, Han and colleagues found no significant modification of the risk association by menopausal status. The association between nevi and breast cancer risk is unlikely to be causal. Both melanocytic nevi and melanoma are derived from melanin-producing cells in dermal or epidermal tissues [5]; in contrast, most breast cancers are thought to arise from epithelial cells of ductal or lobular origin [6]. Given their
Effect of Aspirin on Brachial Artery Occlusion following Brachial Arteriotomy for Coronary Arteriography
Authors: KIERAN M. HYNES, GERALD T. GAU, BARRY D. RUTHERFORD, FRANCIS J. KAZMIER, ROBERT L. FRYE
Journal: Circulation (1973)

The effect of oral aspirin in doses known to influence in vitro platelet aggregation was evaluated in patients undergoing brachial artery catheterization. Neither arterial thrombus formation nor pulse reduction was affected in patients given aspirin when compared to controls. Aspirin in small doses does not decrease the incidence of vascular occlusion after brachial artery catheterization.
Hippocrates: timeless still
Authors: Eleni Tsiompanou, Spyros G Marketos
Journal: Journal of the Royal Society of Medicine (2013)

. . . I wish I had known of these views of Hippocrates before I had published, for they seem almost identical with mine merely a change of terms and an application of them to classes of facts necessarily unknown to the old philosopher. The whole case is a good illustration of how rarely anything is new. . . .Hippocrates has taken the wind out of my sails, but I care very little about being forestalled. I advance the views merely as a provisional hypothesis, but with the secret expectation that sooner or later some such view will have to be admitted. . . . I do not expect the reviewers will be so learned as you otherwise, no doubt, I shall be accused of wilfully stealing Pangenesis from Hippocrates, for this is the spirit some reviewers delight to show.
THE POSSIBILITIES OF DOMICILIARY TREATMENT IN PHTHISIS
Authors: G. Jessel
Journal: BMJ (1914)

lhave previously suppurated, give real diffictulty wlhen in close contact witlh inerves or large vessels.We use blunt:pointed scissors curved on tlle flat, a stronig tissue separator, and special ring-slhaped gland forceps witlh a spritng catcli and long handles, whlich enable an assistailt to assist tlle operator.Drainage slhould be euployed in extensive alid doubtful cases.But we do not favour drainage ttubes for aseptic cases; a narrow gauze wick suffices.Tlhe laslimir sawv- dust pads are useful as outside dressings, and, with a well- applied knitted baud(lage of loose mieshi, the head is com- fortably fixed almost as if splinted.We remove the drain usually after twenty-four hiours, and tllen do not dress aseptic cases till the ninth day, wlhen tlle stitchles are remioved.For ligatures we use locally prepared iodine- clhronmic gut, and tor sutures local silk thlread.So far as I can judge, tlle end results are very satisfac- tory.I lhave not scen pulmlonary plltllisis as a later com- plication, nor tuberculous peritonitis.Tllere is an increase of pulmonary tubercle in Kashmir, but nio apparent increase in glanidular disease.The clim-iate is favourable, and it is proposed slhortly to start a State sanatoriumu, which is likely to attract tuberculous patients from the plains of Northi India.
The Diagnosis and Treatment of Medicare
Authors: Prentiss Taylor
Journal: JAMA (2007)

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 Journals 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 2024 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
The Role of Ischemic Mitral Regurgitation in the Pathogenesis of Acute Pulmonary Edema
Authors: Luc A. Piérard, Patrizio Lancellotti
Journal: New England Journal of Medicine (2004)

Acute mitral regurgitation may cause pulmonary edema, but the pathogenetic role of chronic ischemic mitral regurgitation, a dynamic condition, has not yet been characterized.We prospectively studied 28 patients (mean [+/-SD] age, 65+/-11 years) with acute pulmonary edema and left ventricular systolic dysfunction and 46 patients without a history of acute pulmonary edema. The two groups were matched for all baseline characteristics. Patients underwent quantitative Doppler echocardiography during exercise. Exercise-induced changes in the left ventricular volume, the ejection fraction, the mitral regurgitant volume, the effective regurgitant orifice area, and the transtricuspid pressure gradient were compared in patients with and without acute pulmonary edema.The two groups had similar clinical and baseline echocardiographic characteristics. They also had similar exercise-induced changes in heart rate, systolic blood pressure, and left ventricular volumes. In the univariate analysis, patients with recent pulmonary edema had a much higher increase than did the patients without pulmonary edema in mitral regurgitant volume (26+/-14 ml vs. 5+/-14 ml, P<0.001), the effective regurgitant orifice area (16+/-10 mm2 vs. 2+/-9 mm2, P<0.001), and the transtricuspid pressure gradient (29+/-10 mm Hg vs. 13+/-11 mm Hg, P<0.001). In the multivariate analysis, exercise-induced changes in the effective regurgitant orifice area (P<0.001), in the transtricuspid pressure gradient (P=0.001), and in the left ventricular ejection fraction (P=0.02) were independently associated with a history of recent pulmonary edema.In patients with left ventricular systolic dysfunction, acute pulmonary edema is associated with the dynamic changes in ischemic mitral regurgitation and the resulting increase in pulmonary vascular pressure.
SUPERIOR ACCESSORY THYROIDS.
Authors: JOHN B. MURPHY
Journal: JAMA (1905)

Some writers call the accessory thyroids, "lingual goiter." The term "goiter" given to such affections is an improper one, since the histo-pathology shows that not all aberrant or accessory thyroids have the structure of a goiter, which implies a pathologic thyroid. In several instances the histology of the accessory gland was exactly the same as that of the normal thyroid. Perhaps, even the term "accessory" is not proper, since in some cases, as will be seen later, the so-called accessory thyroid was the only one of the individual. Aberrant thyroids would be the most satisfactory term, indicating a thyroid situated outside of the normal area. For the sake of convenience, however, I will respect the term "accessory" generally used in the description of these tumors. While anatomists, and even pathologists, are more or less familiar with the accessory thyroid, the clinician has rarely an opportunity to meet such tumors. On
TCT-2 Comparative Effectiveness of Prasugrel vs. Clopidogrel Among Acute Myocardial Infarction Patients Treated With Percutaneous Coronary Intervention: 30-Day Outcomes from the TRANSLATE-ACS Observational Study
Authors: Tracy Y. Wang, Marjorie Zettler, Mark B. Effron, Lisa McCoy, Kevin Anstrom, Gregg C. Fonarow, John C. Messenger, Gregg Stone, David Cohen, Timothy D. Henry, Eric Peterson
Journal: Journal of the American College of Cardiology (2013)
Dentists, dental nurses, and brain tumours.
Authors: A Ahlbom, S Norell, Y Rodvall, M Nylander
Journal: BMJ (1986)

CommentThis case indicates that synergism may occur between lithium and spironolactone, which might be clinically useful in patients resistant to lithium or in whom low dose lithium is advisable.Moreover, this case also indicates that spironolactone alone may maintain a manic patient in remission.Further research is needed to assess the mode of action of spironolactone alone or in combination with lithium in the treatment of mania.1
Commission reviews six cases of parents convicted of killing their children
Authors: Clare Dyer
Journal: BMJ (2004)

Only six cases of parents convicted of killing their children by courts in England and Wales are under consideration by the Criminal Cases Review Commission for possible referral to the Court of Appeal as a result of concerns over medical evidence.

The cases come from an 11 month review of nearly 300 cases by the attorney general, Lord Goldsmith, in the wake of an appeal court ruling a year ago quashing Angela Cannings' conviction for murdering her two baby sons ( BMJ 2004;328:183).

Lord Goldsmith instituted the review after the …
MEMBERSHIP IN THE NEBRASKA STATE MEDICAL SOCIETY.
Authors: A. S. v. Mansfelde
Journal: JAMA (1884)

Ashland, Neb., Sept. 3, 1884. N. S. Davis, M.D., Editor. <h3>Dear Doctor:</h3> —You will oblige me very much if you will insert these lines into your next issue of the Journal, as well as the subjoint resolution, adopted by the Nebraska State Medical Society at its last session, May 14 and 15. <h3>MINIMAL QUALIFICATIONS FOR MEMBERSHIP IN THE NEBRASKA STATE MEDICAL SOCIETY.</h3> No applicant for membership in the Nebraska State Medical Society shall be received, who is not a graduate of a school the requirements of which embody the following conditions: 1. Creditable certificate of good moral character. 2. Diploma of graduation from a good literary and scientific college or high school; or, lacking this, 3. A thorough examination in the branches of a good English education, including mathematics, English composition and elementary physics or natural philosophy. 4. Branches of medical science to be included in the course of instruction:
Acquired Blue Nevi in Older Individuals
Authors: Erik S. Cabral, Frank W. Chen, Barbara M. Egbert, Susan M. Swetter
Journal: JAMA Dermatology (2014)

Apart from the atypical mole phenotype, development of new melanocytic nevi in older individuals is uncommon and considered worrisome for melanoma. We performed a retrospective case series in a Veterans Affairs population from 1991 to 2013 to characterize blue nevi (BN) by patient age at biopsy, location, self-reported duration, and relation to prior or subsequent development of cutaneous melanoma.A total of 204 BN were identified in 194 predominantly male patients (90.7%) who had a mean (SD) age of 62.8 (14.4) years. Clinical duration of 10 years or less was reported by 90.3% of patients with available data (32.0%). Histopathologic examination classified 74.0% of BN as common, 1.5% as cellular, and 24.5% as combined type. No malignant BN were identified; however, 18 primary melanomas were diagnosed, most (72.2%) prior to blue nevus biopsy, including 38.9% in situ and 61.1% with mean (SD) Breslow thickness of 1.02 (0.99) mm.The later patient-reported onset of BN suggests a potential alternative mechanism of nevogenesis compared with common acquired nevi and differs from prior reports of BN development in younger adults. The lack of association with melanoma in older individuals suggests that most benign-appearing BN may be safely observed, even in a cohort at higher risk for skin cancer.
Mechanisms underlying γδ T-cell subset perturbations in SIV-infected Asian rhesus macaques
Authors: Levelle D. Harris, Nichole R. Klatt, Carol Vinton, Judith A. Briant, Brian Tabb, Kristin Ladell, Jeffrey Lifson, Jacob D. Estes, David A. Price, Vanessa M. Hirsch, Jason M. Brenchley
Journal: Blood (2010)
Sanitary Flood Survey
Authors: Frank W. Foxworthy
Journal: JAMA (1913)

<h3>To the Editor:</h3> —The first sanitary flood survey of the Ohio and Wabash rivers was made during the week of April 7, 1913, and is a good example of emergency sanitation. The United States government is better fitted than any of the states to initiate emergency sanitation, and on this account on April 7 the Indiana State Health Commissioner, Dr. Hurty, was notified that a boat survey expedition would start from Louisville, Ky., April 8, and that the government wished representatives of the states of Indiana, Kentucky and Illinois to accompany this expedition. Major James A. Logan, Jr., of the Quartermaster's Department of the U. S. Army chartered a steam packet, the<i>Ed Myer</i>, on which were placed several car-loads of lime in 40-pound sacks, this size being the easiest handled, a large quantity of potassium permanganate in 1-pound cans, several thousand units of typhoid vaccine, several thousand small-pox vaccine
Lead exposure and intelligence in 7-year-old children: the Yugoslavia Prospective Study.
Authors: G A Wasserman, X Liu, N J Lolacono, P Factor-Litvak, J K Kline, D Popovac, N Morina, A Musabegovic, N Vrenezi, S Capuni-Paracka, V Lekic, E Preteni-Redjepi, S Hadzialjevic, V Slavkovich, J H Graziano
Journal: Environmental Health Perspectives (1997)

For a prospective study of lead exposure and early development, we recruited pregnant women from a lead smelter town and from an unexposed town in Yugoslavia and followed their children through 7 years of age. In this paper we consider associations between lifetime lead exposure, estimated by the area under the blood lead (BPb) versus time curve (AUC7), and intelligence, with particular concern for identifying lead's behavioral signature. The Wechsler Intelligence Scales for Children-Version III (WISC-III) was administered to 309 7-year-old children, 261 of whom had complete data on intelligence, blood lead, and relevant sociodemographic covariates (i.e., Home Observation for the Measurement of the Environment (HOME), birth weight, gender, sibship size, and maternal age, ethnicity, intelligence, and education). These showed anticipated associations with 7-year intelligence, explaining 41-4% of the variance in Full Scale, Performance, and Verbal IQ. Before covariate adjustment, AUC7 was unrelated to intelligence; after adjustment, AUC7 explained a significant 2.8%-4.2% of the variance in IQ. After adjustment, a change in lifetime BPb from 10 to 30 micro/dl related to an estimated decrease of 4.3 Full Scale IQ points; estimated decreases for Verbal and Performance IQ were 3.4 and 4.5 points, respectively. AUC7 was significantly and negatively related to three WISC-III factor scores: Freedom from Distractibility, Perceptual Organization, and Verbal Comprehension; the association with Perceptual Organization was the strongest. Consistent with previous studies, the IQ/lead association is small relative to more powerful social factors. Findings offer support for lead's behavioral signature; perceptual-motor skills are significantly more sensitive to lead exposure than are the language-related aspects of intelligence.
Periprocedural and Late Consequences of Overlapping Cypher Sirolimus-Eluting Stents
Authors: Dean J. Kereiakes, Hong Wang, Jeffrey J. Popma, Richard E. Kuntz, Dennis J. Donohoe, Joachim Schofer, Erick Schampaert, Bernhard Meier, Martin B. Leon, Jeffrey W. Moses
Journal: Journal of the American College of Cardiology (2006)
Pediatric Psychology: An Introduction for Pediatricians and Psychologists
Authors: Stuart McIntyre Finch
Journal: JAMA (1982)

While the main thrust of this book is to define the role of the psychologist working in a pediatric setting, it should be of interest to any professional who deals with children in or out of the area of emotionally or physically ill children and adolescents. The chapter on the major theories, namely, cognitive, psychoanalytic, and behavioral, is well done and, as with all sections, the references are extensive and thorough. The cognitive theory as originated by Piaget postulates various stages through which the thinking proceeds. The theory is replete with its own terms, but once these are mastered it contributes substantially to our understanding of the development of cognitive function. The psychoanalytic theory of which Freud was the founder stresses the various stages of psychosexual development. Its main focus is on the cause and treatment of emotional problems, including those that are unconscious. The behaviorist theory is based primarily
Regulation of Secretion of Cortical Hormones
Authors: M. Vogt
Journal: BMJ (1950)

PROTEIN STRUCTURE AND CLINICAL PROBLEMS MEDICALJOURNAL body, and moreover rebuilt to precisely the same struc- ture, one cannot help but speculate about the controlling mechanism.It is rather a terrifying thought that the whole of the protein in the human body is replaced in toughly 160 days, and at the present time we can only speculate on the mechanism controlling this elaborate resynthesis, where even a single amino-acid must not be out of place if the hormone is to have its activity or the antibody its potency.It might well be that, when the mechanism of perhaps the most complex problem in human biochemistry is under- stood, we shall find the answer to many problems, possibly even the mechanisms of senescence and of cancer.
Evaluation of the Acute Kidney Injury Network criteria in hospitalized patients with cirrhosis and ascites
Authors: Salvatore Piano, Silvia Rosi, Giulio Maresio, Silvano Fasolato, Marta Cavallin, Antonietta Romano, Filippo Morando, Elisabetta Gola, Anna Chiara Frigo, Angelo Gatta, Paolo Angeli
Journal: Journal of Hepatology (2013)
Prazepam and Lorazepam, Two New Benzodiazepines
Authors: Jan Koch-Weser, David J. Greenblatt, Richard I. Shader
Journal: New England Journal of Medicine (1978)

THE neuropharmacologic properties of the many benzodiazepine derivatives available for clinical use are qualitatively similar if not identical.1 , 2 Nonetheless, new benzodiazepines continue to be marketed and promoted as "unique" agents for the treatment of anxiety or insomnia.3 Thus, there is a need for critical comparative assessment of new benzodiazepine derivatives as they are introduced to clinical use. This article assesses the properties and apparent clinical value of prazepam and lorazepam (Fig. 1), two new benzodiazepine "anxiolytics" marketed in the United States in 1977.PrazepamPharmacokinetic PropertiesEarly studies of the kinetics of Radio-labeled prazepam suggested that the drug had a . . .
Glycemic Control With Diet, Sulfonylurea, Metformin, or Insulin in Patients With Type 2 Diabetes Mellitus&lt;SUBTITLE&gt;Progressive Requirement for Multiple Therapies (UKPDS 49)&lt;/SUBTITLE&gt;
Authors: Robert C. Turner
Journal: JAMA (1999)

ContextTreatment with diet alone, insulin, sulfonylurea, or metformin is known to improve glycemia in patients with type 2 diabetes mellitus, but which treatment most frequently attains target fasting plasma glucose (FPG) concentration of less than 7.8 mmol/L (140 mg/dL) or glycosylated hemoglobin A1c(HbA1c) below 7% is unknown.ObjectiveTo assess how often each therapy can achieve the glycemic control target levels set by the American Diabetes Association.DesignRandomized controlled trial conducted between 1977 and 1997. Patients were recruited between 1977 and 1991 and were followed up every 3 months for 3, 6, and 9 years after enrollment.SettingOutpatient diabetes clinics in 15 UK hospitals.PatientsA total of 4075 patients newly diagnosed as having type 2 diabetes ranged in age between 25 and 65 years and had a median (interquartile range) FPG concentration of 11.5 (9.0-14.4) mmol/L [207 (162-259) mg/dL], HbA1c levels of 9.1% (7.5%-10.7%), and a mean (SD) body mass index of 29 (6) kg/m2.InterventionsAfter 3 months on a low-fat, high-carbohydrate, high-fiber diet, patients were randomized to therapy with diet alone, insulin, sulfonylurea, or metformin.Main Outcome MeasuresFasting plasma glucose and HbA1c levels, and the proportion of patients who achieved target levels below 7% HbA1c or less than 7.8 mmol/L (140 mg/dL) FPG at 3, 6, or 9 years following diagnosis.ResultsThe proportion of patients who maintained target glycemic levels declined markedly over 9 years of follow-up. After 9 years of monotherapy with diet, insulin, or sulfonylurea, 8%, 42%, and 24%, respectively, achieved FPG levels of less than 7.8 mmol/L (140 mg/dL) and 9%, 28%, and 24% achieved HbA1c levels below 7%. In obese patients randomized to metformin, 18% attained FPG levels of less than 7.8 mmol/L (140 mg/dL) and 13% attained HbA1c levels below 7%. Patients less likely to achieve target levels were younger, more obese, or more hyperglycemic than other patients.ConclusionsEach therapeutic agent, as monotherapy, increased 2- to 3-fold the proportion of patients who attained HbA1c below 7% compared with diet alone. However, the progressive deterioration of diabetes control was such that after 3 years approximately 50% of patients could attain this goal with monotherapy, and by 9 years this declined to approximately 25%. The majority of patients need multiple therapies to attain these glycemic target levels in the longer term.