tbuckley/cabot-search huggingface dataset:
Patients' Choices and the Medical Commons
Authors: Peter J. Jederlinic
Journal: Annals of Internal Medicine (1993)

Letters15 July 1993Patients' Choices and the Medical CommonsPeter J. Jederlinic, MD and Jessica C. Rockwell, MDPeter J. Jederlinic, MDSearch for more papers by this author and Jessica C. Rockwell, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-2-199307150-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The recent perspective by Mann and colleagues [1] describing the critical care of a Jehovah's Witness suggests that the patient's preference resulted in an excessive intensive care unit stay and cost. The authors failed to mention the price tag of this exercise in the application of alternative, less effective technology. The normal length of stay for a similar patient is 8 days with a reimbursement of $6879, according to the 1992 DRG Handbook. The complication of Pseudomonas aeruginosa pneumonia increases the length of stay to 13 days and the reimbursement to $14 429. Outlier status is achieved ...REFERENCE1. Mann MC, Votto J, Kambe J, McNamee MJ. Management of the severely anemic patient who refuses transfusion: lessons learned during the care of a Jehovah's Witness. Ann Intern Med. 1992; 117: 1042-8. Google Scholar Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 July 1993Volume 119, Issue 2Page: 170-171KeywordsCritical careDiagnosis related groupsExerciseIntensive care unitsLength of stayPneumoniaPseudomonas aeruginosaVentilators Issue Published: 15 July 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Improved Short-term Survival of AIDS Patients Initially Diagnosed With Pneumocystis carinii Pneumonia, 1984 Through 1987
Authors: Jeffrey E. Harris
Journal: JAMA (1990)

I analyzed trends in the survival of 36,847 adults who were diagnosed with acquired immunodeficiency syndrome between January 1984 and September 1987 under the pre-1987 surveillance definition of acquired immunodeficiency syndrome. For patients in whom Pneumocystis carinii pneumonia was among the first manifestations of acquired immunodeficiency syndrome, the estimated 1-year survival increased from 42.7% for those diagnosed in 1984 and 1985 (95% confidence interval, 41.5% to 44.3%) to 54.5% for those diagnosed in 1986 and 1987 (95% confidence interval, 53.7% to 55.7%). The gain in survival was observed in homosexual men and intravenous drug users of both sexes, in all age and racial groups, in all geographic regions, and in patients with and without coexisting initial diagnosis. Reduced mortality in the 3-month period immediately following the initial diagnosis of acquired immunodeficiency syndrome contributed little to the overall gain in survival. No gain in survival was seen for patients in whom P carinii pneumonia was not an initial manifestation of acquired immunodeficiency syndrome. It is unlikely that the observed improvements in survival resulted solely from errors in death reporting. Better diagnosis and treatment, particularly the introduction of zidovudine in 1986, may have contributed to the decline in mortality.
Proteinuria and Hypothyroidism
Authors: Thomas J. Roess, Richard P. Levy
Journal: New England Journal of Medicine (1956)

SINCE both hypothyroidism and renal disease may have in common the findings of periorbital edema, lassitude, weakness and anemia, it is of some interest to know whether albuminuria is also encountered in both disorders. Although current textbooks of medicine seem unanimous in stating that albuminuria may often be found in hypothyroidism1 2 3 4 5 a careful review of the literature does not definitely substantiate this.The description of hypothyroidism by Sir William Gull in 1873 reported the urine as normal in the 2 cases described.6 In Murray's review of the life history of the first myxedematous patient treated with thyroid, as quoted by . . .
Cancer of the Breast
Authors: I. Craig Henderson, George P. Canellos
Journal: New England Journal of Medicine (1980)

TWELVE years ago in the Journal, Dr. F. D. Moore and his colleagues evaluated the various forms of therapy then current for the treatment of both primary and metastatic breast carcinoma.1 In 1967 most patients with breast cancer were treated initially with mastectomy, and at the time of relapse one of various endocrine treatments was employed. This is still true in the United States.2 , 3 However, there has been a plateau in the survival curves of breast-cancer patients since about 1955.4 As a result, therapeutic approaches based on new concepts of the disease, some of these approaches merely mentioned in . . .
THE ARTIFICIAL PRODUCTION IN MAMMALIAN PLASMA OF SUBSTANCES INHIBITORY TO THE GROWTH OF CELLS
Authors: Albert J. Walton
Journal: The Journal of Experimental Medicine (1915)

Active immunity to the growth of tissue may be obtained by intraperitoneal injections of tissue emulsions. This immunity is of short duration and is followed by an anti-immunity. The immunity varies for individual tissues both in extent and in the time of onset. The immunity is not specific in so far that it is not more marked to the tissue similar to that forming the emulsion.
Trying Times at the FDA — The Challenge of Ensuring the Safety of Imported Pharmaceuticals
Authors: Stuart O. Schweitzer
Journal: New England Journal of Medicine (2008)

In recent years, the FDA has faced serious challenges to its ability to ensure the safety of the country's medical devices and drugs. What can be done? Stuart Schweitzer writes that one approach is to attempt to boost the FDA's efficiency. Stuart Schweitzer discusses challenges and recent crises at the FDA and the scope of the agency's responsibilities. Dr. Schweitzer is a professor of health services at the UCLA School of Public Health, Los Angeles.
Obese patients are being denied surgery because of commissioning failures
Authors: Z. Kmietowicz
Journal: BMJ (2014)

Patients across England are being denied access to bariatric surgery because GPs in some parts of the country are not commissioning intensive weight loss programmes, a prerequisite to surgery, surgeons have warned.

Since April 2013 NHS England, which is responsible for commissioning bariatric surgery, has said that patients should be operated on only after they have been through intensive “tier 3” weight management services before surgery. These can last up to two years and can also help patients control their diet after surgery.

Guidance from NHS England states that it is the responsibility of clinical commissioning groups (CCGs) to commission and fund these services.1

But the delivery of tier 3 programmes is fragmented and is putting patients’ lives at risk, doctors have told the Royal College of Surgeons.

Sean Woodcock, a surgeon in northern England, told the BMJ that only …
Employment Status of Physicians Completing Training-Reply
Authors: Rebecca S. Miller
Journal: JAMA (1996)

<h3>In Reply.</h3> —We thank Dr Pendergrass for his supportive comments about our study and agree with the call for continued workforce assessment, data collection, and dissemination. We also thank Drs Sunshine and Burkhardt for their comments and constructive suggestions for improving our survey work. We are currently in the process of collecting information from program directors about the experiences of residents who completed training in 1995 and have just begun surveying individual residents completing training in 1996. The suggestions to collect data about the planned increases in program size, as well as the planned decreases, have been incorporated in the current survey to program directors. We have also included a question to determine those working part-time and those working in a specialty or subspecialty other than their specific area of training. The purpose of our study was to determine the unemployment rate of those eligible to enter the workforce; therefore, from the
PKCθ is required for alloreactivity and GVHD but not for immune responses toward leukemia and infection in mice
Authors: Javier O. Valenzuela, Cristina Iclozan, Mohammad S. Hossain, Martin Prlic, Emily Hopewell, Crystina C. Bronk, Junmei Wang, Esteban Celis, Robert W. Engelman, Bruce R. Blazar, Michael J. Bevan, Edmund K. Waller, Xue-Zhong Yu, Amer A. Beg
Journal: Journal of Clinical Investigation (2009)

When used as therapy for hematopoietic malignancies, allogeneic BM transplantation (BMT) relies on the graft-versus-leukemia (GVL) effect to eradicate residual tumor cells through immunologic mechanisms. However, graft-versus-host disease (GVHD), which is initiated by alloreactive donor T cells that recognize mismatched major and/or minor histocompatibility antigens and cause severe damage to hematopoietic and epithelial tissues, is a potentially lethal complication of allogeneic BMT. To enhance the therapeutic potential of BMT, we sought to find therapeutic targets that could inhibit GVHD while preserving GVL and immune responses to infectious agents. We show here that T cell responses triggered in mice by either Listeria monocytogenes or administration of antigen and adjuvant were relatively well preserved in the absence of PKC isoform θ (PKCθ), a key regulator of TCR signaling. In contrast, PKCθ was required for alloreactivity and GVHD induction. Furthermore, absence of PKCθ raised the threshold for T cell activation, which selectively affected alloresponses. Most importantly, PKCθ-deficient T cells retained the ability to respond to virus infection and to induce GVL effect after BMT. These findings suggest PKCθ is a potentially unique therapeutic target required for GVHD induction but not for GVL or protective responses to infectious agents.
Criteria for the Evaluation of Large Cohort Studies: An Application to the Nurses’ Health Study
Authors: Graham A. Colditz, Deborah M. Winn
Journal: JNCI Journal of the National Cancer Institute (2008)

Evaluating the success of major funding programs from the National Institutes of Health (NIH) remains a vexing challenge. We propose a set of criteria to evaluate epidemiological studies that fit within the discovery, development, and delivery paradigm introduced by the NIH. We apply these criteria to the Nurses' Health Study (NHS), a large epidemiological cohort study initiated in the 1970s to evaluate the associations between oral contraceptives and risk of breast cancer and between diet and other lifestyle factors and risk of cancer overall. Our evaluation suggests that the NHS has led to important changes in health practice, and it underscores the need to develop metrics that are suitable to the evaluation of large epidemiological cohort studies.
Erythromycin effects on gastric emptying, antral motility and plasma motilin and pancreatic polypeptide concentrations in anorexia nervosa.
Authors: G Stacher, T L Peeters, H Bergmann, S Wiesnagrotzki, C Schneider, G V Granser-Vacariu, G Gaupmann, A Kugi
Journal: Gut (1993)

In primary anorexia nervosa, gastric motility is often impaired and ensuing symptoms further discourage eating. Prokinetic agents have been shown to accelerate gastric emptying in affected patients. This study investigated whether emptying of a radiolabelled semisolid 1168 kJ meal and antral contractility were enhanced by intravenous erythromycin. Eight women and two men with anorexia nervosa (21-46 years, 50-75% of ideal body weight) received 200 mg erythromycin or placebo under crossover double blind conditions. Gastric emptying and antral contractility were recorded scintigraphically for 90 minutes. In addition, plasma motilin and pancreatic polypeptide concentrations were determined. With placebo, antral contractions were of regular 3 cycles/minute frequency. With erythromycin, less frequent and partly arrhythmic long duration contractions set in and emptying was accelerated: after 90 minutes, the activity remaining in the stomach was markedly less than with placebo in all patients (Sign test, p &lt; 0.002). Basal motilin and pancreatic polypeptide concentrations were normal and showed a normal response to the meal in all patients. Motilin concentrations decreased slightly more and pancreatic polypeptide concentrations increased markedly more with erythromycin than with placebo, possibly because the meal reached the intestine earlier. In conclusion, erythromycin accelerated emptying markedly and in most patients induced an antral motor activity characterised by long duration contractions occurring at often irregular intervals.
Transplacental passage of ampicillin.
Authors: T. E. Blecher, W. M. Edgar, H. A. Melville, K. R. Peel
Journal: BMJ (1966)

Hypertension-7ohnson et al.MEIlSH 7 appeared equally effective in controlling blood-pressure.In this series the fall of pressure in the supine position was no more pronounced with one drug than with the other.A higher proportion of patients were free from side-effects on methykdopa than on guanethidine.It is concluded that methyldopa, though far from ideal, is as potent in reducing blood-pressure as previous drugs, and has the advantage of less frequent and less troublesome side-effects.Our thanks are due to Dr. N. L. Stokoe, who has carried out ophthalmoscopic examinations of all patients in this series.We are also grateful to Dr. C.
Regulation of Hepatic Transport Systems Involved in Bile Secretion During Liver Regeneration in Rats
Authors: Thera A. Vos, Jenny E. Ros, Rick Havinga, Han Moshage, Folkert Kuipers, Peter L. Jansen, Michael Müller
Journal: Hepatology (1999)

We investigated the expression of hepatic transport systems involved in bile secretion during liver regeneration after partial hepatectomy (PH) in rats. Initial studies showed maximal BrdU incorporation 24 hours after PH. Therefore, transporter expression and bile secretion were analyzed in detail at this time. The mRNA levels of the multidrug resistance genes mdr1a and mrp1 slightly increased, whereas mdr1b mRNA levels showed an extensive increase after PH. The mRNA levels of the conjugate transporter, mrp2, decreased slightly, whereas mrp2 protein levels did not change. Bilirubin secretion did not change, but the biliary glutathione secretion markedly decreased and the hepatic GSH content increased. The messenger RNA levels of the bile salt uptake transporters ntcp, oatp1, and oatp2 and the bile salt exporter, bsep/spgp, all decreased with ntcp showing the most prominent decrease. Protein levels of ntcp dramatically decreased whereas oatp2 only slightly decreased. Oatp1 protein expression slightly increased and bsep/spgp protein levels did not change. Decreased levels of bile salt uptake systems were associated with a 10–fold increase in the plasma bile salt concentration, yet, bile flow and bile salt secretion were increased when expressed per gram liver and unaffected when expressed on the basis of body weight. In conclusion, during the initial phase of rat liver regeneration ntcp is down–regulated whereas other transporter proteins involved in bile secretion are only slightly affected. Despite increased serum bile salt levels the remnant liver is not cholestatic: bile flow is maintained by uptake of bile salts probably via oatp isoforms and their secretion via bsep/spgp.
Abstract 14875: Cytoglobin but not Myoglobin Senses Hypoxia and Regulates NO Consumption Rate in the Vascular Wall
Authors: Xiaoping Liu, Jianjing Tong, Joseph R Zweier, Douglas Follmer, Craig Hemann, Jay L Zweier
Journal: Circulation (2012)

The endogenous vasodilator nitric oxide (NO) is metabolized in tissues in an O2-dependent manner. This O2-dependent NO consumption acts as an O2 sensor changing NO diffusion distance, thus regulating vascular tone. However, the molecular mechanism for this O2 sensor is unknown. Cytoglobin (Cygb) was discovered 10 years ago, and its main physiological function remains uncertain although several have been proposed. We have recently demonstrated that, in the low [O2] range (0-50 μM), Cygb with cellular reductants efficiently regulated the NO consumption rate in response to changes in O2 concentration. In this study, we compared the rate of NO metabolism by Cygb with myoglobin (Mb) and studied their reaction kinetics using electrode techniques and UV/VIS spectroscopic methods. It was observed that the initial rate of Cygb(Fe3+) reduction by ascorbate (Asc) was 410-fold greater than that of Mb(Fe3+). The reduction of Mb(Fe3+) by Asc is irreversible; however, the reduction of Cygb(Fe3+) by Asc follows a reversi...
Who Should Give Primary Care?
Authors: David E. Rogers
Journal: New England Journal of Medicine (1981)

Elsewhere in this issue of the Journal, Drs. Fishbane and Starfield offer us some new data comparing the care of children given by general practitioners and by pediatricians in a number of ways.1 Their article is important because of its timeliness.The harsh economic realities of the 1980s are forcing Americans to take a searching look at how much we spend, and whom we spend it on, in many areas of social need. It is going to be a tough, belt-tightening time.2 Because medical care is gobbling up so many precious dollars, much of what we doctors do is . . .
Demonstration of myocardial reperfusion injury in humans: Results of a pilot study utilizing acute coronary angioplasty with perfluorochemical in anterior myocardial infarction
Authors: Mervyn B. Forman, James M. Perry, B.Hadley Wilson, Mario S. Verani, Peter R. Kaplan, Fayaz A. Shawl, Gottlieb C. Friesinger
Journal: Journal of the American College of Cardiology (1991)
Puncture the skin before inserting a needle
Authors: D B Rittoo, D. Rittoo
Journal: BMJ (1991)

Rates of registration of gastric cancer (per 100000) by sex for 1962-5' and 1978-824 in Denmark, Finland, Norway, Sweden, West Midlands region, and Scotland, standardised to world standard population (all ages) and to truncated world standard population (ages 35-64 only) Men Women
Molecular analyses of TT virus in paired serum and tissue samples from 150 patients with either hepatic or non-hepatic disease
Authors: Teresa Pollicino, Giuseppina Raffa, Giovanni Squadrito, Irene Cacciola, Santa Brancatelli, Concetta Alafaci, Maria Gioffre' Florio, Giovanni Raimondo
Journal: Journal of Hepatology (2002)
Smoke Carcinogen Affects Fetus
Authors: Rebecca Voelker
Journal: JAMA (1998)

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
Transmission of Mycobacterium tuberculosis by a Fiberoptic Bronchoscope
Authors: Theresa M. Michele
Journal: JAMA (1997)

<h3>Context.</h3> —An ongoing restriction fragment length polymorphism (RFLP) study of<i>Mycobacterium tuberculosis</i>isolates from tuberculosis (TB) cases revealed an identical 10-banded IS6110RFLP pattern unique to 2 patients diagnosed as having TB 6 months apart. Their only identifiable link was care at the same hospital. <h3>Objective.</h3> —To determine if nosocomial transmission had occurred. <h3>Design.</h3> —Traditional and molecular epidemiologic investigation. <h3>Measurements.</h3> —We reviewed medical charts and bronchoscopic records, examined hospital locations visited by both patients, evaluated hospital ventilation systems, and observed cleaning and disinfection of bronchoscopes. <h3>Results.</h3> —A patient with cough, hoarseness, and fever underwent bronchoscopy and was diagnosed as having TB. A second patient with a mediastinal mass underwent bronchoscopy 2 days later and was diagnosed as having small cell carcinoma. Following 6 months of chemotherapy and radiation therapy, the second patient developed fever and an infiltrate of the right upper lobe of the lung. Bronchoscopic washings revealed acid-fast bacilli and were culture positive for<i>M tuberculosis</i>. Both patients had undergone bronchoscopy with the same instrument in the same operating room with no intervening bronchoscopies. Bronchoscope cleaning and disinfection procedures were inconsistent with national guidelines. <h3>Conclusions.</h3> —A contaminated bronchoscope was the most likely source of<i>M tuberculosis</i>transmission between these 2 patients. The RFLP analysis of<i>M tuberculosis</i>isolates was responsible for detecting this nosocomial source of transmission and led to the implementation of public health measures to prevent further spread of infection and disease. This study emphasizes the need for continued vigilance in endoscope cleaning techniques.
Limb and kidney defects in Lmx1b mutant mice suggest an involvement of LMX1B in human nail patella syndrome
Authors: Haixu Chen, Yi Lun, Dmitry Ovchinnikov, Hiroki Kokubo, Kerby C. Oberg, Carmen V. Pepicelli, Lin Can, Brendan Lee, Randy L. Johnson
Journal: Nature Genetics (1998)
Polycythaemia with Leucoerythroblastosis
Authors: F. G. Marson, M. J. Meynell
Journal: BMJ (1949)

Few cases of leucoerythroblastic anaemia following on polycythaemia have been described in this country (Stone and Woodman, 1938 ; Vaughan and Harrison, 1939). The term  leucoerythroblastic anaemia, or, better, leuco erythroblastosis (as there may be no anaemia), is used to describe a condition characterized by the presence of immature red and white cells in the peripheral blood, and is due to or associated with replacement of the bone marrow by some other tissue. It is usually classified as follows.
Editorial: Arthroplasty Outcomes Are Improving, but Why Isn't My Patient With Rheumatoid Arthritis Doing as Well?
Authors: Jasvinder A. Singh
Journal: Arthritis & Rheumatology (2013)

This issue of the Arthritis and Rheumatism has two new studies of outcomes after arthroplasty by Ravi et al. (ref Ravi) and Lalmahomed et al. (ref Lalmahomed). Findings from these epidemiological studies can help us better understand the evolving trends in arthroplasty outcomes and the associated risk factors in patients undergoing total knee or hip arthroplasty (TKA or THA).
Preoperative Diagnosis of Splenosis by 99mTc-Sulfur Colloid Scanning
Authors: P M FITZER
Journal: Clinical Nuclear Medicine (1977)

Post-traumatic autotransplantation of splenic tissue in the pleural or peritoneal cavities may be diagnosed by 99mTc-sulfur colloid scanning. This may be useful in the evaluation of abdominal pain or pleural mass in patients after splenectomy performed for trauma.