tbuckley/cabot-search huggingface dataset:
Generic Prescriptions: Can the Consumer Benefit?
Authors: Ashok K. Gumbhir, Christopher A. Rodowskas
Journal: Annals of Internal Medicine (1975)

Editorials1 May 1975Generic Prescriptions: Can the Consumer Benefit?ASHOK K. GUMBHIR, PH.D., CHRISTOPHER A. RODOWSKAS JR., PH.D.ASHOK K. GUMBHIR, PH.D.Search for more papers by this author, CHRISTOPHER A. RODOWSKAS JR., PH.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-82-5-711 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThree centuries ago, the term "an apothecaries charge" was commonly used in England as a synonym for an unreasonably high price for any commodity or service. Even today, because patients do not wish to have to buy drugs, and because the prescribers make the decision for them, there is a great deal of resentment over drug prices. Drugs are probably the only tangible commodity that the patient receives from the medical care system. Therefore, to many persons drug prices symbolize the high cost of health care in this nation. No wonder, then, that several governmental attempts have been made in...References1. Patents on 117 of the top 200 Rx items to lapse by '84. Am Druggist Merchandising 167:19, 1973 Google Scholar2. GUMBHIRRODOWSKAS AC: Consumer price differentials between generic and brand name prescriptions. Am J Public Health 64:977-982, 1974 CrossrefMedlineGoogle Scholar3. HAMMELMCCORMICK RW: Some economic considerations in generic and brand prescribing. Med Market Media 5:7-16, 1970 Google Scholar4. Drug Bioequivalence Study Panel Report. Office of Technology Assessment, Congress of the United States, July 1974, pp. 1-3 Google Scholar5. TURENNE W: The Lilly Digest 1974. Indianapolis, Eli Lilly and Company, 1974, p. 7 Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAn Exploration into Elderly Consumers' Responses to Direct Marketing Appeals of Health CareGeneric Drugs: Consumer, Pharmacist and Physician Perceptions of the IssuesPrescription Prices Under the New York Generic Substitution LawIGOR FRANCETIĆ, M.D., LOUIS LASAGNA, M.D., MICHAEL WEINTRAUB, M.D., FRED E. KARCH, M.D.Physician and pharmacist perceptions of generic drugsRetail Cost of Antiglaucoma Drugs in Two Cities 1 May 1975Volume 82, Issue 5Page: 711-712KeywordsDrug pricesDrugsHealth care Issue Published: 1 May 1975 PDF downloadLoading ...
An initiation: Unequal encounter
Authors: H. Tunstall-Pedoe
Journal: BMJ (1998)

Just down from Cambridge in October 1961, I was bottom of the clinical hierarchy at Guy's Hospital. Put straight on a surgical ward as ward clerk I was responsible for clerking admissions and was junior to the senior dressers, some of whom lorded it over us. I had been shaken on my first day, holding open a door for two pinstriped gentlemen, to have them sweep past as if I was invisible.

Woe betide the ward clerk who did not know his patients. Two weeks after starting, the student gauleiter allocated me a young Bermondsey woman with a renal cyst. The senior registrar said that I was to present her case next Saturday morning to a distinguished visitor, Sir Clement Price-Thomas, who had operated on King George VI and who had …
Carrier detection in childhood: a need for policy reform
Authors: Lainie Ross
Journal: Genome Medicine (2010)

Current policy statements discourage identification of disease carrier status in minors on the grounds that carrier information is of mainly reproductive significance. Such policies fail to consider that the carrier state may have important health implications for minors. They also fail to consider that carrier status of newborns is routinely discovered as an incidental finding in newborn screening programs. Finally, such policies fail to take into account that it may not be parents but adolescents who are seeking out this information and that adolescence may be a valid time to learn about one's reproductive risks. Here, I consider the issues that need to be addressed in revising current policies about the carrier detection of minors.
Magnesium relaxes arterial smooth muscle by decreasing intracellular Ca2+ without changing intracellular Mg2+.
Authors: E K D'Angelo, H A Singer, C M Rembold
Journal: Journal of Clinical Investigation (1992)

Elevations in extracellular [Mg2+] ([Mg2+]o) relax vascular smooth muscle. We tested the hypothesis that elevated [Mg2+]o induces relaxation through reductions in myoplasmic [Ca2+] and myosin light chain phosphorylation without changing intracellular [Mg2+] ([Mg2+]i). Histamine stimulation of endothelium-free swine carotid medial tissues was associated with increases in both Fura 2- and aequorin-estimated myoplasmic [Ca2+], myosin phosphorylation, and force. Elevated [Mg2+]o decreased myoplasmic [Ca2+] and force to near resting values. However, elevated [Mg2+]o only transiently decreased myosin phosphorylation values: sustained [Mg2+]o-induced decreases in myoplasmic [Ca2+] and force were associated with inappropriately high myosin phosphorylation values. The elevated myosin phosphorylation during [Mg2+]o-induced relaxation was entirely on serine 19, the Ca2+/calmodulin-dependent myosin light chain kinase substrate. Myoplasmic [Mg2+] (estimated with Mag-Fura 2) did not significantly increase with elevated [Mg2+]o. These results are consistent with the hypothesis that increased [Mg2+]o induces relaxation by decreasing myoplasmic [Ca2+] without changing [Mg2+]i. These data also demonstrate dissociation of myosin phosphorylation from myoplasmic [Ca2+] and force during Mg(2+)-induced relaxation. This finding suggests the presence of a phosphorylation-independent (yet potentially Ca(2+)-dependent) mechanism for regulation of force in vascular smooth muscle.
Hereditary Renal-Retinal Dysplasia
Authors: R. NEIL SCHIMKE
Journal: Annals of Internal Medicine (1969)

Two cousins with vasopressin-resistant diabetes insipidus, progressive azotemia, and retinitis pigmentosa are presented. These patients were found in a survey of a consanguineous religious isolate, and autosomal recessive inheritance of this disorder, termed hereditary renal-retinal dysplasia, seems likely. Comparison with other similar cases from the literature suggests that this entity is distinct. Although there are superficial resemblances between hereditary renal-retinal dysplasia and two other disorders, juvenile nephronophthisis and medullary cystic disease, the fact that despite pathologic similarity all three diseases are unique when viewed from a clinicogenetic perspective is substantiated. Study of these entities suggests that reliance solely on the pathologic picture for classification of various hereditary renal disorders may lead to diagnostic confusion. The presence of extrarenal manifestations of the defective genes may be of paramount importance in the differential diagnosis of two functionally and histologically similar renal disorders.
ETIOLOGY, DIAGNOSIS, PROGNOSIS AND TREATMENT OF SPHENOPALATINE GANGLION NEURALGIA
Authors: GREENFIELD SLUDER
Journal: JAMA (1913)

severe cases of toxemia following the use of cocain, nmyl nitrite acts quite well. 1 believe that not more than one out of twenty caseB of suspected cocain poisoning are really true cases of cocain poisoning, especially if one considers the small amount of cocain used in Sehleieh's method of infiltration (1.5 grains to 100 c.c. of water) and that of this solution but a small portion is used, and that a still smaller portion enters the circulation, for the greater por- tion of that injected is held between the mucous membrane and the cartilage or bone.I take exception to what Dr. Ballenger said regarding adhesions, because there are some real adhesions which result in cases of fracture.If one will reason out the pathology of the condition that results from fractures, he will find that a proliferative inflammation fol- lows a new formation of tissue, and with it come the adhesions.On account of the small amount of cocain used, I do not often find it necessary to operate with the patient in the prone position, although I do operate on patients in this position when it is necessary.With the sitting position the operator sees quite well and can do the operation better no doubt than if the patient is in the recumbent position.If the patient manifests any symptoms of cocain toxemia, he should at once be placed in the prone position until the symptoms have passed.I do not like to cut off a dog's tail by inches, but I find that formerly, when we used this com- bination method, wo have a greater degree of reaction and more frequent infections than we have now by the method advocated in my paper.I believe that the tonsils and adenoids should be removed in advance of the septal operation; I think that infection is prone to occur after a septum operation from infected adenoids and tonsils.It is surprising what a large number of patients, adults included, have adenoids or, at least, some thickening of the posterior phnryngeal wall.Some patients whose ade- noids are not particularly large develop an acute inflamma- tion of the adenoids when the nose is packed, infection which had been present, but laten!, lias been awakened and becomes active and from this source the infection spreads to nn accidentally made wound of the septum.
Morbidity in Schistosomiasis Japonica in Relation to Intensity of Infection
Authors: Kenneth S. Warren, Su De-long, Xu Zhao-yue, Yuan Hong-chang, Pierre A. Peters, Joseph A. Cook, Kenneth E. Mott, Harold B. Houser
Journal: New England Journal of Medicine (1983)

Schistosomiasis japonica remains endemic in several provinces south of the Yangtze River in China because of relatively sparse populations of human beings and dense populations of snails. We studied two brigades in a rural commune in Gui-chi County, Anhui Province, to determine the prevalence, intensity, and morbidity associated with this infection before concerted control efforts were instituted. Quantitative fecal examinations, histories, and physical examinations relevant to schistosomiasis japonica were performed in 96 per cent of the available population 2 to 65 years of age. The prevalence was 26.3 per cent in Brigade A (778 persons) and 14.4 per cent in Brigade B (1532 persons). Clinical symptoms and signs were compared among uninfected persons and persons at three levels of infection as determined by fecal egg output. Some increased weakness was seen only at the heaviest levels of infection; abdominal pain was not an important symptom. Hepatomegaly was somewhat more frequent in moderate and heavy infections, but splenomegaly was rare and unrelated to intensity of infection. Neither stool consistency nor occult blood was related to the presence or intensity of infection. Approximately 50 per cent of the population had been treated for schistosomiasis japonica, 25 per cent repeatedly.
Acute liver injury by vinyl chloride: involvement of endoplasmic reticulum in phenobarbital-pretreated rats.
Authors: E S Reynolds, R J Jaeger, S D Murphy
Journal: Environmental Health Perspectives (1975)

A single 6-hr exposure to vinyl chloride monomer (5%) produces extensive vacuolization of centrolobular liver parenchyma and focal midzonal necrosis in the hepatic lobuole in phenobarbital-pretreated rats. Ultrastructurally, vacuolization consists of dilation of cysternae of rough endoplasmic reticulum and in the same cells smooth endoplasmic reticulum coalesces into discreet aggregates resembling denatured membranes. The findings support the hypothesis that vinyl chloride is hepatotoxic because it is converted into a toxic metabolite by components of the mixed function oxidase system of liver endoplasmic reticulum.
Managing hypertension in elderly patients.
Authors: F. J. de Looze, P. Whincup
Journal: BMJ (1992)

although opioids have their own clinically relevant adverse effects.'There is much current interest in the use of non-steroidal anti-inflammatory drugs as adjuvant agents with other analgesics after surgery.Several studies have shown that combining non-steroidal anti-inflammatory drugs with opioids provides superior analgesia with less total opioid required and possibly a reduction in side effects mediated by opioids, such as respiratorv depression and sedation.Furthermore, there is good reason to believe that giving non-steroidal anti-inflammatory drugs before surgery may result in a pre-emptive analgesic effect with a subsequent reduction in postoperative analgesic requirements and the associated adverse effects.'The results of controlled trials to substantiate this effect in humans are awaited.We suggest, therefore, that until there is stronger evidence for clinically significant impairment of wound healing, non- steroidal anti-inflammatory drugs should continue to be used for surgical patients without other contraindications as they have a useful role in the management of postoperative pain.
Next of kin
Authors: M. Kamath
Journal: BMJ (2013)

Early in my medical career, I was caring for a middle aged man with a disabling chronic disease that had left him bedbound. While he could barely open his mouth to eat, he could open it enough to drink, as evidenced by his multiple admissions with acute alcohol withdrawal. On this occasion, he had been admitted with an exacerbation of his underlying illness, accompanied by alcohol withdrawal and aspiration pneumonia. This time he did not seem his usual self. He had lost a lot of weight and had the …
Linear IgA disease of adults: association with lymphoproliferative malignancy and possible role of other triggering factors
Authors: K. GODFREY, FENELLA WOJNAROWSKA, J. LEONARD
Journal: British Journal of Dermatology (2006)

Seventy patients with linear IgA disease of adults were followed up for a mean of 8.5 years and all malignant diseases in this group were ascertained. There were three cases of lymphoproliferative malignancy, which constituted a significant excess over the 0.2 cases that would be expected by comparison with an age- and sex-matched population using National Cancer Registry statistics. In contrast, the non-lymphoid malignancy rate of 13% is almost identical to the expected 14%. A subgroup of 35 of the adult linear IgA disease patients were assessed with respect to the possible precipitating illnesses or drugs, as well as co-existing medical conditions. Almost one-third of patients described an event that was felt could possibly have triggered the linear IgA disease, the most frequent being non-steroidal anti-inflammatory or antibiotic drug therapy, trauma/burns and upper respiratory tract infections. However, it is difficult to determine how often the preceding event is coincidental, and how often, if at all, it is causal.
Greater vigilance needed to tackle domestic abuse, says BMA
Authors: Zosia Kmietowicz
Journal: BMJ (2007)

UK NEWS Scientists plead for right to create interspecies embryos, p1238 World NEWS US gro�p highlights symptoms of early o�arian cancer, p 12�� US gro�p highlights symptoms of early o�arian cancer, p 12�� bmj.com �itamin d from s�n e�pos�re may protect against solid cancers �itamin d from s�n e�pos�re may protect against solid cancers
Chloramphenicol Today-Reply
Authors: William Kitto
Journal: JAMA (1975)

<h3>In Reply.—</h3> I am in basic agreement with the comments of Dr Keeney. I do not advocate the use of tetracycline as routine therapy for<i>H influenzae</i>respiratory illness in children who are in an age group that may develop tooth staining. However, that risk should not rule it out where one is forced with a choice of risks. Tetracycline-induced benign intracranial hypertension is innocuous without the concomitant presence of a diagnostic zealot. I will take issue with his recommendation for combined therapy with penicillin V or G with a sulfonamide and, to a lesser degree, with the combination of erythromycin with sulfonamides. The probability of having a significantly ampicillin-resistant<i>H influenzae</i>organism that is, at the same time, sensitive to one of the other penicillins is remote, leaving only the sulfonamide as effective therapy (which, if properly chosen, it would be) in the use recommended. My original version of
Is It Time to Pull the Pulmonary Artery Catheter?
Authors: James E. Dalen
Journal: JAMA (1996)

Pulmonary artery (PA) catheterization is performed daily in hospitals around the world. The hemodynamic data derived from PA catheterization are used to determine, monitor, and modify therapy in critically ill and/or hemodynamically unstable patients, including those with acute myocardial infarction (MI), congestive heart failure (CHF), and multiorgan failure, and they are frequently used to monitor patients with heart disease who undergo cardiac or noncardiac surgery. More than 1 million PA catheters are sold in the United States each year, and the annual costs associated with the use of PA catheters exceed $2 billion a year. Despite the widespread use of this procedure and its attendant costs, there is no evidence that it benefits patients. Its use has not been shown to decrease patient morbidity or mortality. To the contrary, there is evidence that it may increase morbidity and mortality. <h3>How Did We Get Here?</h3> Pulmonary artery catheterization was first performed
Renal dysfunction in allogeneic hematopoietic cell transplantation
Authors: Chirag R. Parikh, Peter A. McSweeney, Didem Korular, Tevfik Ecder, Aicha Merouani, Jeremy Taylor, Vicki Slat-Vasquez, Elizabeth J. Shpall, Roy B. Jones, Scott I. Bearman, Robert W. Schrier
Journal: Kidney International (2002)
PTU-126 MR assessment of Crohn's related strictures correlates well with endoscopic findings facilitating safe and effective fluoroscopic dilatation
Authors: N Mohammed, F Majeed, D Tolan, R Hyland, J Hamlin
Journal: Gut (2012)

<h3>Introduction</h3> Intestinal strictures are a known complication of Crohn9s disease (CD) and may be inflammatory (in part), fibrostenotic or post-operative (anastomotic). Treatment options include a combination of medical, endoscopic or surgical interventions. We performed a retrospective analysis of our radiological assessment and endoscopic management of CD related strictures. <h3>Methods</h3> A retrospective review of adult patients who underwent balloon dilatation of CD related strictures by a single endoscopist at our institution. All patients underwent MR enterography prior to endoscopic assessment. Where necessary strictures were dilated under fluoroscopic screening. Endoscopic success was defined as the ability to traverse the stricture endoscopically after dilatation. Clinical success was defined as improvement in patients symptoms at follow-up. Complications, need for escalation of medical therapy, further dilatation or surgical intervention were recorded. <h3>Results</h3> A total of 56 dilatations were performed in 30 patients (range 1–5). Mean age was 47.5 years. 16 were females. Mean duration of disease was 209 months (range 14–444). Mean follow-up was 29.5 months (range 1–135). 27/30 (90%) had at least one previous CD surgical resection (range 0–6, mean 1.96 per patient). The site of the strictures were ileo-colonic in 21/30 (70%), colonic 3/30 (10%), gastro-duodenal 3/30 (10%), ileo-rectal 2/30 (7%) and ileal pouch stricture in 1/30 (3%). Stricture lengths at MRE were 6 cm, a length deemed significant as this is the length of the colonoscopic balloons. At MRE 17 (57%) of strictures were deemed to have an inflammatory component and 13 (43%) fibrostenotic. There was correlation between MRE and endoscopic findings of the nature of the stricturing (inflammatory vs fibrostenotic) in 26/30 (87%) of cases. Fluoroscopic screening was used in 21/30 (70%) of cases. Dilatation endoscopically successful in 27/30 (90%) cases and clinically successful in 26/30 (87%) of cases. No dilatation was performed in one case due to technical difficulties and this patient ultimately required surgical resection. Fourteen patients (47%) required repeated dilatations for symptom recurrence (range 2–5 dilatations). 17 patients (57%) had an escalation of their medical therapy after dilatation. A total of 5/30 (17%) ultimately required elective surgery for symptom recurrence. <h3>Conclusion</h3> MRE enterographic assessment of CD related strictures correlates well with endoscopic findings. Fluoroscopic screening facilitates safe and effective dilatation of CD related strictures which, together with optimising medical therapy, can reduce the need for surgical intervention. <h3>Competing interests</h3> None declared.
Is hepatobiliary scintigraphy indeed insensitive for the diagnosis of sphincter of Oddi dysfunction?
Authors: J Toouli
Journal: Gut (2003)

I was very pleased to read the letter by Dr Madacsy in response to our article “Scintigraphy versus manometry in patients with suspected sphincter of Oddi dysfunction” ( Gut2003;52:352–7 [OpenUrl][1][Abstract/FREE Full Text][2] ). The major criticism of our study refers to the change from the original study of Sostre and colleagues1 that we made with regards to administration of … [1]: {openurl}?query=rft.jtitle%253DGut%26rft.stitle%253DGut%26rft.issn%253D0017-5749%26rft.aulast%253DCraig%26rft.auinit1%253DA%2BG%26rft.volume%253D52%26rft.issue%253D3%26rft.spage%253D352%26rft.epage%253D357%26rft.atitle%253DScintigraphy%2Bversus%2Bmanometry%2Bin%2Bpatients%2Bwith%2Bsuspected%2Bbiliary%2Bsphincter%2Bof%2BOddi%2Bdysfunction%26rft_id%253Dinfo%253Adoi%252F10.1136%252Fgut.52.3.352%26rft_id%253Dinfo%253Apmid%252F12584215%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=ABST&journalCode=gutjnl&resid=52/3/352&atom=%2Fgutjnl%2F52%2F9%2F1385.2.atom
Renin Profiling for Diagnosis and Treatment of Hypertension
Authors: John H. Laragh
Journal: JAMA (1979)

Recent research shows that the renin-angiotensin-aldosterone axis either maintains or causes some or all of the high blood pressure of most patients and demonstrates anew that renin-sodium profiling defines this involvement. Performed with a serum potassium measurement, this now reliable test is useful for primary screening and then, in conjunction with renal vein renin studies or an aldosterone profile, for diagnosis or exclusion of surgically curable renovascular or adrenocortical hypertensions. For the remaining majority with essential hypertension, renin profiling exposes the relative participation of either vasoconstriction or volume factors, thereby guiding simpler, more specific, and predictably effective antirenin or antivolume treatments. Renin profiling identifies those in whom treatment should begin with a beta-blocker as opposed to a diuretic while not infrequently also providing baseline information about severity and prognosis in individual patients.
Anaesthesia and Colles' fractures.
Authors: P Armstrong, M Payne, M Brockway
Journal: BMJ (1990)

cussions" such as case conferences and second opinions.I suspect that abandoning lengthy dis- charge summaries that endlessly repeat patients' background details would paradoxically lead to savings in secretarial time, reduced boredom on the part of general practitioners, and increased clarity of thought among trainee psychiatrists.