tbuckley/cabot-search huggingface dataset:
Longevity and Medicare Expenditures
Authors: James Lubitz, James Beebe, Colin Baker
Journal: New England Journal of Medicine (1995)

In the United States, the elderly account for over one third of health care spending. The total population over the age of 65 is projected to increase, as is life expectancy beyond the age of 65. We studied current patterns of Medicare expenses according to age at death and the possible effect of future demographic changes on Medicare spending.We used data from the Medicare program to estimate lifetime Medicare expenses for a sample of 129,166 beneficiaries, 65 or older, who died in 1989 and 1990, according to age at death. Spending for nursing home care not covered by Medicare was excluded. (Nursing home costs represent about 20 percent of total health care spending for the elderly and increase with age.) Through simulation, we assessed the lifetime payments by Medicare for enrollees who turned 65 in 1990 and those who will do so in 2020.Estimated lifetime Medicare payments (in 1990 dollars) ranged from $13,044 for persons who died at 65 years of age, to $56,094 for those who died at 80, to $65,633 for those who died at 101 or older. The payments associated with an additional year of life and the average annual payments over an enrolle's lifetime both decreased as the age at death increased. The estimated 7.9 percent increase in life expectancy beyond 65 years that will have taken place between 1990 and 2020 (19.1 years past the age of 65 in 2020, as compared with 17.7 years in 1990) was associated with an estimated increase of 2.0 percent in lifetime Medicare payments. Of the estimated $98 billion increase in total lifetime payments (in 1990 dollars) from the 1990 group to the 2020 group, 74.3 percent was due to the larger size of the original birth cohort who will reach the age of 65 in 2020, 22.5 percent to an increase in the proportion of that birth cohort projected to survive to 65 years of age, and 3.2 percent to improved life expectancy beyond 65.The effect on Medicare spending of increased longevity beyond the age of 65 may not be great. Total Medicare payments will be more substantially affected by the expected increase in the absolute number of elderly people.
Characterization and reconstruction of historical London, England, acidic aerosol concentrations.
Authors: K Ito, G D Thurston
Journal: Environmental Health Perspectives (1989)

Several past studies of the historical London air pollution record have reported an association between daily mortality and British Smoke levels. However, this pollution index does not give direct information on particulate mass or its chemical composition. A more specific particulate matter index, aerosol acidity, was measured at a site in central London, and daily data are available for the period 1963-1972. British Smoke and SO2 were also measured at the same site. Also, meteorological parameters were routinely measured at a nearby British Meteorological Office. Thus, daily fluctuation of the acidic aerosols was characterized in terms of other environmental parameters. Each of the other parameters analyzed seems necessary, but not sufficient to explain a high level of acidic aerosol. Overall, about half of the variance of log-transformed daily fluctuations of acidic aerosols can be explained by a combination of parameters including SO2 and British Smoke concentrations, temperature, ventilation by wind, and humidity. The rest of the variance cannot be explained by the parameters included in this analysis. Potential factors responsible for this unique variance would be variations in the availability of basic gases to cause neutralization and variation in the availability of catalytic metal salts. Because the acidic aerosol has a unique component of variation, it may be possible to distinguish health effects due to this specific pollutant from other available pollution indices or environmental factors.
Pictorial Handbook of Fracture Treatment.
Authors: Edward Lyon Compere, Sam Wallace Banks
Journal: JAMA (1952)

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
Preoperative predictive risk model for mortality in patients with acute type A aortic dissection undergoing surgery: Lessons from the International Registry of Acute Aortic Dissertion (IRAD)
Authors: Santi Trimarchi, Christoph A. Nienaber, Vincenzo Rampoldi, Rajendra H. Mehta, Eduardo Bossone, Jeanna V. Cooper, Dean E. Smith, Jae K. Oh, Eric M. Isselbacher, Toru Suzuki, Kim A. Eagle
Journal: Journal of the American College of Cardiology (2003)
Cardiovascular Magnetic Resonance, Fibrosis, and Prognosis in Dilated Cardiomyopathy
Authors: Ravi G. Assomull, Sanjay K. Prasad, Jonathan Lyne, Gillian Smith, Elizabeth D. Burman, Mohammed Khan, Mary N. Sheppard, Philip A. Poole-Wilson, Dudley J. Pennell
Journal: Journal of the American College of Cardiology (2006)
Determination of left ventricular mass by magnetic resonance imaging in hearts deformed by acute infarction.
Authors: E P Shapiro, W J Rogers, R Beyar, R L Soulen, E A Zerhouni, J A Lima, J L Weiss
Journal: Circulation (1989)

Measurement of left ventricular (LV) mass by magnetic resonance imaging (MRI) is accurate in normal hearts. Because determination of mass by MRI does not require assumptions about ventricular shape, this method may be well suited for evaluating hearts distorted by infarction. To test this hypothesis, gated MRI was performed in 15 dogs before and after acute myocardial infarction. The LV mass of each dog was calculated from five short-axis images acquired at end systole, when shape distortion is greatest, at end diastole, and also from slices at varying phases of the cycle with a multiphase mode that required only one acquisition. Correlation was excellent between actual mass and end-systolic mass before infarction (p less than 0.001, r = 0.98, and SEE = 5.1 g) and after infarction (p less than 0.001, r = 0.97, and SEE = 6.6 g). Likewise, values correlated closely at end diastole before (p less than 0.001, r = 0.96, and SEE = 6.7 g) and after infarction (p less than 0.001, r = 0.94, and SEE = 8.7 g). Surprisingly, measurements of mass by a multiphase mode were also very accurate before (p less than 0.001, r = 0.98, and SEE = 5.1 g) and after (p less than 0.001, r = 0.95, and SEE = 6.49 g) infarction. Therefore, at the same phase and at multiphases of the cardiac cycle, MRI permits accurate determination of LV mass in distorted hearts.
Detection of <i>COL1A1</i> -<i>PDGFB</i> fusion transcripts and platelet-derived growth factor α and β receptors in giant cell fibroblastoma of the postsacrococcygeal region
Authors: A. Kashima, A. Yamashita, S. Moriguchi, K. Marutsuka, S. Tsumori, K. Yoshizato, A. Ishihara, M. Setoyama, Y. Asada
Journal: British Journal of Dermatology (2006)

We describe a 2‐year‐old girl with recurrent giant cell fibroblastoma (GCF) of the postsacrococcygeal region. Both the initial and recurrent tumours contained solid and angiectoid areas. The former was composed of loosely arranged wavy spindle cells and giant cells with a well‐vascularized myxoid to collagenous stroma. The angiectoid spaces were often lined by multinucleated giant cells. Immunohistochemically, the tumour cells and small vessels in the tumour tissue were positive for platelet‐derived growth factor (PDGF) α and β receptors. Molecular analysis revealed fusion of collagen type Iα1 exon 26 with PDGF‐B chain exon 2 that induced unscheduled production of PDGF‐BB. These findings suggest that PDGF and its receptors significantly contribute to the development of GCF in both an autocrine and a paracrine manner.
New US institute for comparative effectiveness starts work
Authors: B. Roehr
Journal: BMJ (2010)

The United States ratcheted up its commitment to research on comparative effectiveness in health care when the Patient-Centered Outcomes Research Institute officially began operations on 1 October. 

The journal Health Affairs used the occasion to publish a focus issue on comparative effectiveness (http://content.healthaffairs.org/content/vol29/issue10/), which it unveiled at a 5 October briefing in Washington, DC.

The institute differs significantly from the United Kingdom’s National Institute for Health and Clinical Excellence in that it doesn’t have the authority to approve or set prices for interventions in the very fragmented US healthcare system. Criticisms by Republicans that such an institute would lead to the establishment of “death panels” ensured that the final legislation barred Medicare from using the institute’s work in deciding whether and how much …
Patients keep out
Authors: James Owen Drife
Journal: BMJ (2007)

The board is aware that despite our best efforts some patients are still managing to reach the hospital and see doctors. This is in flagrant contravention of trust policy, outlined below. Staff are reminded that caring for unauthorised patients may result in disciplinary action

Referrals: All letters must be directed to the NHS Referral Gateway, where they will be screened by a qualified individual within three working days before being returned to the GP as falling outside our …
The Death of Old Man Rice: A True Story of Criminal Justice in America
Authors: Cyril H. Wecht
Journal: JAMA (1995)

"One of the most remarkable trials in all history... a gripping tale of murder and intrigue... the influence of the popular press, the purchase of expert witnesses... the issue of the death penalty, and the advantage of wealth." The O. J. Simpson case, right? Wrong! <i>The Death of Old Man Rice: A True Story of Criminal Justice in America</i>(book jacket remarks above), by Martin L. Friedland, professor of law at the University of Toronto, relates the controversial circumstances surrounding the death in New York City of William Marsh Rice. The founder of Rice University, he was reputed to be "the wealthiest Texan in the United States" at the time he was found dead in his Berkshire building apartment by his valet on September 23,1900. His personal physician attributed the death of his 84-year-old patient to "Old age and weak heart; immediate cause, indigestion followed by collicqotue [sic] diarrhea with
Severe Graft-versus-Host Disease in a Liver-Transplant Recipient
Authors: James F. Burdick, Georgia B. Vogelsang, William J. Smith, Evan R. Farmer, Wilma B. Bias, Scott H. Kaufmann, Janet Horn, Paul M. Colombani, Henry A. Pitt, Bruce A. Perler, William T. Merritt, G. Melville Williams, John K. Boitnott, H. Franklin Herlong
Journal: New England Journal of Medicine (1988)

CLINICALLY evident generalized graft-versus-host disease is not thought to occur as a consequence of transplantation of most solid organs. The requisite large inoculum of donor lymphoid cells and inability of the recipient to destroy these passenger cells1 are apparently rarely produced by solid-organ transplantation. However, there is a high risk of graft-versus-host disease when normal spleens are included in vascularized pancreas-transplants.2 3 4 5 We report on a case of severe generalized acute graft-versus-host disease in a recipient of a liver transplant, involving documented transient chimerism of donor origin. This life-threatening complication was treated successfully with increases in the corticosteroid dosage and the . . .
A dominant function for interleukin 27 in generating interleukin 10–producing anti-inflammatory T cells
Authors: Amit Awasthi, Yijun Carrier, Jean P S Peron, Estelle Bettelli, Masahito Kamanaka, Richard A Flavell, Vijay K Kuchroo, Mohamed Oukka, Howard L Weiner
Journal: Nature Immunology (2007)
Influence of Smoking on Insulin Requirement and Metbolic Status in Diabetes Mellitus
Authors: S Madsbad, P McNair, M S Christensen, C Christiansen, O K Faber, C Binder, I Transbøl
Journal: Diabetes Care (1980)

This study was performed in order to examine the influence of tobacco smoking on carbohydrate and lipid metabolism and microangiopathy in diabetic patients with normal serum creatinine. Among 163 adult insulin-treated patients 114 smoked daily (smokers). Compared with nonsmokers, smokers had on the average a 15–20% higher insulin requirement (P &amp;lt; 0.001) and serum triglyceride concentration (P &amp;lt; 0.05), increasing to a 30% rise in heavy smokers (P &amp;lt; 0.01). The degree of retinopathy was equal in the two groups, as was the average creatinine clearance [99 ± 2 (mean ± 1 SEM) versus 101 ± 4 ml/min in smokers compared with nonsmokers]. Smokers and nonsmokers were comparable regarding sex ratio, age at diabetic onset, duration of diabetes, residual beta-cell function, fasting hyperglycemia, and glycosuria. Evidently, tobacco smoking represents a strain on both carbohydrate and lipid metabolism in insulin-treated diabetes mellitus.
A Criticism of Pneumonia Mortality Statistics.
Authors: Charles Denison
Journal: JAMA (1903)

Denver, Jan. 28, 1903. <h3>To the Editor:</h3> —Your editorial of January 24, on Dr. Reynolds' announcement of the increased mortality from pneumonia (Bulletin of Chicago's Health Department, January 17), being under discussion, permit me to add a word. I would not seem to detract from the just conclusion that we are evolving a better resistance to and curative management of tuberculosis, as shown by the lessening mortality from consumption during the past forty years. However, it is but right we should recognize any coincident facts in the history of these two diseases, consumption and pneumonia, which might explain the remarkable changes in their reported mortality results. You mention influenza infection as a contributing cause of this increased pneumonia mortality, and we all know that it not only enters into the etiology, but also gravely influences the prognosis of pneumonia. In this discussion it is unfortunate, yet perhaps not to be
Abstract 1081: Rapamycin is a chemopreventive and chemotherapeutic agent for ras-driven epidermal squamous cell carcinoma: evidence from mouse models.
Authors: Hiroshi Kitagawa, Christophe Cataisson, Alessandra Handisurya, Patricia M. Day, Stuart H. Yuspa, Phillip A. Dennis
Journal: Cancer Research (2013)

Abstract Braf inhibitors are clinically important agents for the treatment of advanced melanoma however secondary cutaneous tumors are a common side effect; non-melanoma skin cancers (NMSCs) arise in 15-30% of patients on Braf inhibitor therapy and 60% of these harbor ras mutations. NMSC also occurs in 40% of organ transplant patients receiving immunosuppressive therapy, and switching from a calcineurin inhibitor-containing regimen to rapamycin reduces the incidence. To examine the effect of rapamycin on ras-driven epidermal squamous cell tumors, we treated mutant K-RasLA2 mice with rapamycin or vehicle by intraperitoneal injection and found that rapamycin prevented the development of squamous skin tumors (0/21 vs 6/24; p=0.04), and also rapidly reduced the tumor size. To explore this effect we employed a syngeneic orthotopic grafting model using H-Ras mutant primary murine keratinocytes to determine if rapamycin could hamper the ability of a Braf inhibitor to enhance squamous skin tumor growth. Similar to results in the K-RasLA2 model, rapamycin alone diminished the growth of tumors (size difference; 334.5 vs 22.3mm3; p=0.03), and decreased the volume even more in the presence of a Braf inhibitor (size difference; 699.6 vs 17.6 mm3; p=0.02). Treatment of established tumors with rapamycin resulted in significant tumor shrinkage even in the continuous presence of a Braf inhibitor. Size reduction was 78.7% and 66.7% in Braf inhibitor untreated and treated groups respectively. In vitro, Braf inhibition enhanced mutant H-Ras-induced activation of the Raf-ERK and mTOR pathways in keratinocytes, while rapamycin addition blocked the activation of signaling pathways and decreased cell proliferation. Taken together, rapamycin prevents murine skin tumor development arising from oncogenic mutations in two distinct types of ras gene alleles, and reduced the tumor size by inhibiting downstream oncogenic pathways. Rapamycin may have clinical application as a chemopreventive and therapeutic agent for patients at high risk to develop ras-driven NMSC, including those receiving Braf inhibitors. Citation Format: Hiroshi Kitagawa, Christophe Cataisson, Alessandra Handisurya, Patricia M. Day, Stuart H. Yuspa, Phillip A. Dennis. Rapamycin is a chemopreventive and chemotherapeutic agent for ras-driven epidermal squamous cell carcinoma: evidence from mouse models. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1081. doi:10.1158/1538-7445.AM2013-1081
Addison's Disease in North American Blastomycosis
Authors: Robert S. Abernathy, James C. Melby
Journal: New England Journal of Medicine (1962)

INVOLVEMENT of the adrenal glands in patients with North American blastomycosis has usually been recognized only at autopsy in persons dying of disseminated disease. Apparently, such involvement rarely produces adrenal insufficiency since only 2 cases of North American blastomycosis associated with Addison's disease have been reported.1 , 2 In both patients symptoms of adrenal insufficiency developed some years after the onset of blastomycosis, one at eleven and a half years and the other at five years. The latter patient responded well to maintenance therapy with adrenocorticosteroids, but little details were given concerning the other patient.This report presents an additional case in . . .
Many unbalanced translocations show duplication of a translocation participant. Clinical and cytogenetic implications in myeloid hematologic malignancies
Authors: Bent Pedersen, Jan M. Nørgaard, Bjarne Bach Pedersen, Niels Clausen, Inge Helleberg Rasmussen, Karen Thorling
Journal: American Journal of Hematology (2000)

If a translocation is followed by loss of one of the two derivative chromosomes, the result is an unbalanced translocation, showing monosomy for the segments making up the lost derivative. We have found that in most unbalanced translocations, a third event takes place: a morphologically normal copy of one of the two translocation participants is added to the karyotype. This creates a complex abnormal karyotype with monosomy, disomy, and trisomy for different segments of the translocation participants. We have examined 82 unbalanced translocations from 77 patients, 73 of whom had a myeloid hemopoietic malignancy. Acquisition of a normal copy of a translocation participant was found in 49 translocations. Twenty-five of these showed trisomy for 1q. In 16 of the 25 1q-trisomic cases the translocation was t(1;7)(q10;p10) (trisomy for 1q and monosomy for 7q). Patients with trisomy for 1q were younger than the remaining patients. Whereas those with t(1;7))(q10;p10) showed brief survivals, those with trisomy 1q but monosomy for regions other than 7q survived longer than the remaining patients. We conclude that most unbalanced translocations involve a partial trisomy, that 1q is trisomic far more frequently than any other segment, and that partial trisomy is associated with patient age and survival. Am. J. Hematol. 64:161–169, 2000. © 2000 Wiley-Liss, Inc.
Cerebrovascular events in sickle cell‐beta thalassemia treated with hydroxyurea: A single center prospective survey in adult Italians
Authors: Paolo Rigano, Alice Pecoraro, Giuseppina Calvaruso, Martin H. Steinberg, Sonia Iannello, Aurelio Maggio
Journal: American Journal of Hematology (2013)

Stroke is a common cause of morbidity and mortality in sickle cell disease (SCD) and silent cerebral infarction is the most common form of neurologic injury. The frequency and risk factors for new silent cerebral infarction are incompletely understood. Moreover, no recommended treatment has been established. Although hydroxyurea (HU) is recommended for SCD, concerns remain regarding its role in the prevention of cerebrovascular events, including silent cerebral infarction. A single center population of 104 Italian patients with HbS-ß thalassemia treated with HU has been followed for a mean of 11 years. Clinical evaluation and brain imaging by Magnetic Resonance Imaging were done before and during HU treatment. During follow-up, the number of sickle cell crises (86%, 7.8 ± 6.9 vs. 1.2 ± 0.5 per year, P < 0.0001), hospitalizations (2.5 ± 2.9 vs. 0.3 ± 1.5 per year, P < 0.0001), and days in the hospital (22.4 ± 21.9 vs. 0.3±1.5 per year, P < 0.0001) decreased significantly and HbF increased from a mean of 8-20.8%. Cerebral infarcts occurred in 37.5% of patients. Among these, 6.7% had overt strokes, while 30% had new or progressive silent cerebral infarction. Stroke and silent cerebral infarction were not related to clinical hematologic or HbF response to HU. These findings suggest that in adults, HU treatment does not prevent new cerebrovascular events or the progression of existent silent cerebral infarcts in HbS-β thalassemia. A major benefit of HU is the increase in HbF; the association of high HbF and reduced cerebrovascular disease has been weak. New treatment strategies should be developed for the prevention of sickle cerebrovascular disease.
Peritoneal Carcinomatosis in Patients With Ovarian Cancer
Authors: Hae Won Kim, Kyoung Sook Won, Seok Kil Zeon, Byeong-Cheol Ahn, Isis W. Gayed
Journal: Clinical Nuclear Medicine (2013)

The study aimed to evaluate the efficacy of PET/CT in detecting peritoneal carcinomatosis in patients with ovarian cancer and to compare the diagnostic accuracy of FDG PET/CT with that of enhanced abdominal CT.The medical records of 46 consecutive patients with ovarian cancer were reviewed, and the presence of peritoneal tumor on (18)F-FDG PET/CT and enhanced abdominal CT scans was also assessed. Imaging results were compared with the pathologic findings obtained by surgery.Pathologic results were positive for peritoneal carcinomatosis in 26 patients and negative in 20 patients. PET/CT correctly detected 25 of 26 patients with peritoneal carcinomatosis and enhanced abdominal CT correctly detected 23 of 26 patients. Sensitivity and specificity for the diagnosis of peritoneal carcinomatosis were 96.2% and 90%, respectively, for PET/CT and 88.5% and 65%, respectively, for enhanced abdominal CT. The accuracy of PET/CT was statistically higher than that of enhanced abdominal CT (93.5% vs 78.3%, P = 0.039). Four distinctly abnormal PET/CT findings of single nodular, multiple nodular, diffuse, and mixed FDG uptakes were identified and corresponded to pathologic findings.(18)F-FDG PET/CT imaging is efficient in the diagnosis of peritoneal carcinomatosis and its performance is superior to that of enhanced abdominal CT.