tbuckley/cabot-search huggingface dataset:
The Cost-effectiveness of Preventing AIDS-Related Opportunistic Infections
Authors: Kenneth A. Freedberg
Journal: JAMA (1998)

Context.-Multiple options are now available for prophylaxis of opportunistic infections related to the acquired immunodeficiency syndrome (AIDS).However, because of differences in incidence rates as well as drug efficacy, toxicity, and costs, the role of different types of prophylaxis remains uncertain.Objective.-Todetermine the clinical impact, cost, and cost-effectiveness of strategies for preventing opportunistic infections in patients with advanced human immunodeficiency virus (HIV) disease.Design.-We developed a Markov simulation model to compare different strategies for prophylaxis of Pneumocystis carinii pneumonia (PCP), toxoplasmosis, Mycobacterium avium complex (MAC) infection, fungal infections, and cytomegalovirus (CMV) disease in HIV-infected patients.Data for the model were derived from the Multicenter AIDS Cohort Study, randomized controlled trials, and the national AIDS Cost and Services Utilization Survey.Main Outcome Measures.-Projectedlife expectancy, quality-adjusted life expectancy, total lifetime direct medical costs, and cost-effectiveness in dollars per quality-adjusted life-year (QALY) saved.Results.-For patients with CD4 cell counts of 0.200 to 0.300ϫ10 9 /L (200-300/ µL) who receive no prophylaxis, we projected a quality-adjusted life expectancy of 39.08 months and average total lifetime costs of $40 288.Prophylaxis for PCP and toxoplasmosis with trimethoprim-sulfamethoxazole for patients with CD4 cell counts of 0.200ϫ10 9 /L (200/µL) or less increased quality-adjusted life expectancy to 42.56 months, implying an incremental cost of $16 000 per QALY saved.Prophylaxis for MAC for patients with CD4 cell counts of 0.050ϫ10 9 /L (50/µL) or less produced smaller gains in quality-adjusted life expectancy; incremental costeffectiveness ratios were $35 000 per QALY saved for azithromycin and $74 000 per QALY saved for rifabutin.Oral ganciclovir for the prevention of CMV infection was the least cost-effective prophylaxis ($314 000 per QALY saved).Results were most sensitive to the risk of developing an opportunistic infection, the impact of opportunistic infection history on long-term survival, and the cost of prophylaxis.Conclusions.-Thecost-effectiveness of prophylaxis against HIV-related opportunistic infections varies widely, but prophylaxis against PCP or toxoplasmosis and against MAC delivers the greatest comparative value.In an era of limited resources, these results can be used to set priorities and explore new alternatives for improving HIV patient care.
Trochanteric Bursitis
Authors: FRED A. CARUSO, MORAKINYO A. O. TONEY
Journal: Clinical Nuclear Medicine (1994)

A 43-year-old woman confined to bed and wheelchair due to multiple sclerosis (MS) presented with complaints of sharp, bilateral hip pain (left greater than right) that radiated to the thighs with point tenderness to trochanteric palpation. She had received several courses of high–dose intravenous corticosteroids for MS. Plain radiographs were normal. Three–phase Tc-99m MDP bone scan demonstrated focal increased tracer activity in the trochanteric regions of the hips on blood pool images only. MRI was performed using T1, fast spin echo T2, and STIR sequences in a 1.5T unit. The T1, fast spin echo T2, and a previous .5T standard spin echo examination all were normal. However, the STIR sequence demonstrated abnormal increased signal in the trochanteric bursae bilaterally. This is the first known report of trochanteric bursitis with plain film, scintigraphic, and MRI correlation.
The Social Phobia Psychotherapy Research Network
Authors: F. Leichsenring, J. Hoyer, M. Beutel, S. Herpertz, W. Hiller, E. Irle, P. Joraschky, H.H. König, T.M. de Liz, B. Nolting, K. Pöhlmann, S. Salzer, H. Schauenburg, U. Stangier, B. Strauss, C. Subic-Wrana, S. Vormfelde, G. Weniger, U. Willutzki, J. Wiltink, E. Leibing
Journal: Psychotherapy and Psychosomatics (2008)

This paper presents the Social Phobia Psychotherapy Research Network. The research program encompasses a coordinated group of studies adopting a standard protocol and an agreed-on set of standardized measures for the assessment and treatment of social phobia (SP). In the central project (study A), a multicenter randomized controlled trial, refined models of manualized cognitive-behavioral therapy and manualized short-term psychodynamic psychotherapy are compared in the treatment of SP. A sample of 512 outpatients will be randomized to either cognitive-behavioral therapy, short-term psychodynamic psychotherapy or waiting list. Assessments will be made at baseline, at the end of treatment and 6 and 12 months after the end of treatment. For quality assurance and treatment integrity, a specific project using highly elaborated measures has been established (project Q). Study A is complemented by 4 interrelated add-on projects focusing on attachment style (study B1), on cost-effectiveness (study B2), on variation in the serotonin transporter gene in SP (study C1) and on structural and functional deviations of the hippocampus and amygdala (study C2). Thus, the Social Phobia Psychotherapy Research Network program enables a highly interdisciplinary research into SP. The unique sample size achieved by the multicenter approach allows for studies of subgroups (e.g. comorbid disorders, isolated vs. generalized SP), of responders and nonresponders of each treatment approach, for generalization of results and for a sufficient power to detect differences between treatments. Psychological and biological parameters will be related to treatment outcome, and variables for differential treatment indication will be gained. Thus, the results provided by the network may have an important impact on the treatment of SP and on the development of treatment guidelines for SP.
ENHANCED IN-VIVO PLATELET RELEASE REACTION, INCREASED THROMBOXANE SYNTHESIS, AND DECREASED PROSTACYCLIN RELEASE AFTER TOURNIQUET ISCHAEMIA
Authors: J. Zahavi, J. Westwick, S.F.A. Al-Hasani, M. Dubiel, A.J. Price, M.F. Scully, A.C. Honey, V.V. Kakkar
Journal: The Lancet (1980)
Ischemic Necrosis Following Treatment of Hip "Dysplasia"
Authors: Robert P. Allen
Journal: JAMA (1962)

ALTHOUGH HIP ABNORMALITIES of infancy are incompletely understood, much progress has been made. Within the general category of congenital hip disease, workable criteria have been advanced both clinically and roentgenologically, for dislocation, preluxation, and adductor tightness. Indication for therapy have become better defined. However, there is still some uncertainty, and an attitude of "if in doubt, treat to be on the safe side" persists. It is the purpose of this report to show that some forms of treatment may be harmful, and that improper diagnosis combined with such therapy may result in making a cripple out of a normal child. The history of efforts to diagnose dislocation before it occurs goes back many years. Palmen has reviewed it in detail. Only a brief recounting will be given here. In 1925 Hilgenreiner suggested the name "dysplasia" to indicate a congenital malformation of the joint and also described a sound made as
Occupational Health Practice
Authors: Harold J. Magnuson
Journal: JAMA (1981)

ABSTRACT Professor Schilling and 21 collaborators designed Occupational Health Practice as a comprehensive introduction to the field for postgraduate students in occupational medicine, nursing, and hygiene at the London School of Hygiene and Tropical Medicine. The authors' task was formidable, considering the diversity of professional preparation. The appearance of this second edition speaks to the authors' success.Most of the book has been rewritten. New chapters have been added on occupational health in developing countries and on migrant workers. Five new chapters on the response of particular organs to toxic agents, the screening of organ systems, and toxicity testing are valuable additions. Nearly every subject pertinent to occupational health practice is discussed, and each chapter includes a bibliography of pertinent articles in the English language. This is particularly useful for the neophyte, since this literature is to be found in medical and scientific journals of many specialties.Although British work and
Improved outcome with pulses of vincristine and corticosteroids in continuation therapy of children with average risk acute lymphoblastic leukemia (ALL) and lymphoblastic non-Hodgkin lymphoma (NHL): report of the EORTC randomized phase 3 trial 58951
Authors: Barbara De Moerloose, Stefan Suciu, Yves Bertrand, Françoise Mazingue, Alain Robert, Anne Uyttebroeck, Karima Yakouben, Alice Ferster, Geneviève Margueritte, Patrick Lutz, Martine Munzer, Nicolas Sirvent, Lucilia Norton, Patrick Boutard, Dominique Plantaz, Frederic Millot, Pierre Philippet, Liliana Baila, Yves Benoit, Jacques Otten
Journal: Blood (2010)
The Healing Process of Experimentally Produced Bleeding Lesions after Hemostatic Electrocoagulation with Simultaneous Instillation of Water
Authors: W. Matek, P. Frühmorgen, B. Kaduk, H.-D. Reidenbach, F. Bodem, L. Demling
Journal: Endoscopy (1980)

Fifty experimentally induced, standardized gastric bleeding lesions were successfully arrested in the dog using electrocoagulation with simultaneous instillation of water (EHT-coagulation). The contact pressure of the coagulating electrode was kept almost constant by means of a spring mechanism. The coagulated lesions healed without secondary enlargement of the coagulation effect and without complication. No secondary perforations were observed. Even when coagulation was carried out at an output power about 30% higher than the mimimum power necessary for reliable hemostatic coagulation, no complications were observed. Only with additional post bleeding arrest coagulation in excess of 10 seconds at this higher output, were two primary performations produced in 2 out of 12 cases. The non-perforated remaining 10 lesions healed without complication. With additional coagulation (at power output setting 6 for 20 seconds - 8 cases; at power setting 7 for 10 seconds - 6 cases), no perforations were observed and healing was without complications. Thus, in animal experiments, the therapeutic range for the arrest of bleeding using the electro-hydro-thermo-electrode is adequately large. The technique should be tested in clinical trials.
Diagnostic Roentgenology: Congenital Lesions of the Heart and Great Vessels: Nephrography
Authors: Richard Schatzki
Journal: New England Journal of Medicine (1947)

A NUMBER of years have passed since the last progress report on diagnostic roentgenology. As had been anticipated, roentgenology proved to be an essential part in the medical routine of the armed forces. Photofluorography, which received its first intensive test in this country, became a routine part of the examination of the chest on entry and at discharge from the service. Even if one considered the inaccuracies and fallacies of any such survey, one was impressed by the comparative rareness of tuberculosis in the armed forces and could not help crediting the survey films with part of this improvement over . . .
A NEW IRRIGATOR PROVIDING REGULATED FLOW AND TEMPERATURE OF CONTENTS
Authors: John Cooke Hirst
Journal: JAMA (1922)

Every physician has felt the need of some improvement in the methods in general use, and in the apparatus employed for irrigation, so that the rate of flow shall be controlled with exactness and the fluid contents of the can be kept at a constant temperature. Such a need is filled by the irrigating apparatus herein described, which has given entire satisfaction in actual practice. The apparatus consists of a reservoir built on the vacuum principle, so that it retains for periods of time the heat of the liquid contents. The outflow is regulated by a dial which is numbered from 10 to 80 and fitted with a handle and an arrow, so that when a continuous irrigation is ordered, the nurse or other attendant, by grasping the handle, moves the arrow to the number on the dial corresponding to the number of drops a minute ordered by the physician,
Age-Specific Exercise Capacity Threshold for Mortality Risk Assessment in Male Veterans
Authors: Peter Kokkinos, Charles Faselis, Jonathan Myers, Xuemei Sui, Jiajia Zhang, Steven N. Blair
Journal: Circulation (2014)

Mortality risk decreases beyond a certain fitness level. However, precise definition of this threshold is elusive and varies with age. Thus, fitness-related mortality risk assessment is difficult.We studied 18 102 male veterans (8305 blacks and 8746 whites). All completed an exercise test between 1986 and 2011 with no evidence of ischemia. We defined the peak metabolic equivalents (METs) level associated with no increase in all-cause mortality risk (hazard ratio, 1.0) for the age categories of <50, 50 to 59, 60 to 69, and ≥70 years. We used this as the threshold group to form additional age-specific fitness categories based on METs achieved below and above it: least-fit (>2 METs below threshold; n=1692), low-fit (2 METs below threshold; n=4884), moderate-fit (2 METs above threshold; n=4646), fit (2.1-4 METs above threshold; n=1874), and high-fit (>4 METs above threshold; n=1301) categories. Multivariable Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality across fitness categories. During follow-up (median=10.8 years), 5102 individuals died. Mortality risk for the cohort and each age category increased for the least-fit and low-fit categories (HR, 1.51; 95% CI, 1.37-1.66; and HR, 1.21; 95% CI, 1.12-1.30, respectively) and decreased for the moderate-fit; fit and high-fit categories (HR, 0.71; 95% CI, 0.65-0.78; HR, 0.63; 95% CI, 0.56-0.78; and HR, 0.49; 95% CI, 0.41-0.58, respectively). The trends were similar for 5- and 10-year mortality risk.We defined age-specific exercise capacity thresholds to guide assessment of mortality risk in individuals undergoing a clinical exercise test.
UK must improve its recruitment rate in clinical trials, report says
Authors: N. Hawkes
Journal: BMJ (2012)

Clinical trials in the United Kingdom cost significantly more than in other European countries, largely because of the need for lengthy negotiations with NHS organisations and poor rates of recruitment, concludes a report produced for the drug company Novartis.1

The number of trial applications in the UK has been falling and could fall further, it warns, unless the system is made more efficient and a “cultural shift” takes place in the NHS.

The report, by Europe Economics, a consultancy that specialises in the application of economics to public policy, says that the average cost of a trial per patient in the UK is now €9758 (£7890; $12 650), higher than in Spain (€7310), Germany (€7232), Italy (€5810), …
Exhumation of Mass Graves in Iraq
Authors: Eric Stover, William D. Haglund, Margaret Samuels
Journal: JAMA (2003)

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
Intrapleural Sulphanilamide for Empyema
Authors: W. F. Nicholson
Journal: BMJ (1938)

MethodsRabbits were used in this work, for it is not difficult to infect them with a human strain of haemolytic streptococcus and pleural puncture is fairly simple in animals of this size.A haemolytic streptococcus isolated from a fatal case of septicaemia occurring in the hospital was passed successively through ten rabbits in order to increase its virulence for them.Equal doses of a broth culture of the organism recovered from the tenth rabbit were injected into the right pleural cavities of a series of rabbits of approximately equal weights.In one case the injection resulted in immediate death from haemorrhage, due to puncture of a blood vessel.The animals of the test series received regular doses of soluble prontosil by direct injec- tion into the right pleural cavity, and an effort was made to remove a volume of fluid from the pleural cavity equal to the volume of prontosil to be injected, so that the intrapleural pressure was disturbed as little as possible.This was not always easy in practice.The drug was the 2.5 per cent.solution of prontosil.Horlein (1935) has demonstrated that rabbits tolerate 50 c.cm. of this solution intra- venously per kilogramme of body weight; but the largest dose used in these investigations was 10 c.cm., and this was found too large, for reasons suggested later.The control animals received the infecting dose of streptococci, but no treatment.Complete necropsies were performed, cultures being taken from the pleural cavity and the presence of prontosil in other organs observed. ResultsThe first ten animals gave the results tabulated in Table 1, which includes one other animal which died on being injected.Note the early deaths in the treated group, com- pared with the controls.In two cases in the test group
Diagnosis of Pericardial Effusion by Ultrasound
Authors: R. B. Pridie, T. A. Turnbull
Journal: BMJ (1968)

A reliable method of determining the presence of a pericardial effusion has been evolved. Ultrasonic waves reflected from the posterior part of the anterior chest wall and from the anterior surface of the anterior myocardium and pericardium produce echoes separated from each other by a bare area. This bare area varies in width and the variation has the same periodicity as the cardiac cycle.
Bites of Venomous Snakes
Authors: Barry S. Gold, Richard C. Dart, Robert A. Barish
Journal: New England Journal of Medicine (2002)

At least 2000 persons are bitten by venomous snakes in the United States each year. This article reviews the diagnosis and management of bites from venomous snakes encountered in North America, but the same principles apply to management of snakebites elsewhere in the world. The review summarizes the complications of envenomation and explains the current recommendations for the use of antivenoms. It explains how to distinguish venomous from nonvenomous snakes.
AEROBIC FITNESS STRONGLY ASSOCIATED WITH THROMBOTIC RISK MARKERS THAN FATNESS IN FIREFIGHTERS
Authors: RADHIKA R. GADESAM, Catherine Skrifvars, Brenda Garrett, Lakshmana Pendyala, Andrew Huang, Kathryn Momary, Stephen C. Frohwein, Melissa Clay, David Dusik, Bill Myers, Steve Rolader, Robert H. Superko
Journal: Journal of the American College of Cardiology (2010)
Systematic Growth Monitoring for the Early Detection of Celiac Disease in Children
Authors: Antti Saari, Samuli Harju, Outi Mäkitie, Marja-Terttu Saha, Leo Dunkel, Ulla Sankilampi
Journal: JAMA Pediatrics (2015)

Growth-monitoring programs in children aim to achieve the early detection of disorders that affect growth. Celiac disease (CD) is underdiagnosed in the pediatric population in which the presenting features often include faltering linear growth, short stature, or poor weight gain.To develop new evidence-based cutoffs for screening for growth disorders and to evaluate the performance of these cutoffs among children with CD measured regularly in a nationwide growth screening program.A longitudinal retrospective study that included longitudinal growth data of healthy children (the reference population) from primary health care and children with CD (the cases) from primary health care and 3 university hospital outpatient clinics in Finland (Kuopio University Hospital, Tampere University Hospital, and Helsinki University Hospital) from January 1, 1994, to April 9, 2009. Children of the reference population were between 0 and 20 years of age and children with CD were between 1 and 16 years of age. In the reference population of 51,332 healthy children, 5 age-specific and sex-specific growth-screening parameters (height standard deviation score and body mass index standard deviation score distance from the population mean, distance from target height, change in height standard deviation score, and change in body mass index standard deviation score) were developed. Performance of these parameters and their combination was evaluated in 177 children with CD by analyzing longitudinal growth data from birth until diagnosis of CD.The screening accuracy for detecting abnormal growth in children with CD, assessed using receiver operating characteristics analysis expressed as the area under the curve.Celiac disease was detected with good accuracy (area under the curve [95% CI] = 0.88 [0.84-0.93] for girls and 0.84 [0.77-0.91] for boys) when screening was performed using the combination of all 5 growth-screening parameters. When the specificity of the screening was set at 90%, growth was already abnormal in 57% of the girls with CD and 48% of the boys with CD 2 years prior to diagnosis.Prior to diagnosis, growth faltered in most children with CD. These children could have been detected several years earlier by a well-established growth-monitoring program. Acceptable screening accuracy can be achieved for CD via the use of several growth-monitoring parameters in combination, preferably using computerized screening algorithms that are integrated into an electronic health record system.
Drug safety: reporting systems for the general public
Authors: J. M. Raine
Journal: BMJ (2012)

WHO’s latest guidance is relevant to developed and developing countries 

Harms from drugs are an important cause of morbidity, mortality, and extra costs to healthcare.1 Such costs are high in developed countries—the average treatment costs of a single adverse drug reaction in Germany were recently estimated to be €2250 (£1766; $2762).2 The costs to healthcare delivery in developing countries could be even greater, because real harm to even a few patients can destroy the credibility and success of an important public health programme. Public concern about adverse effects of drugs can spread rapidly and is difficult to refute in the absence of good data.3 4 The latest guidance on monitoring the safety of drugs from the World Health Organization focuses on planning and implementing adverse drug reaction systems for the general public and will probably make an important contribution to pharmacovigilance strategies.5

Spontaneous reporting systems remain a core element of pharmacovigilance—the science and activities relating to the detection, assessment, understanding, and prevention of adverse effects or any other drug related problem. But is the WHO report relevant to countries with an existing …