tbuckley/cabot-search huggingface dataset:
Competition and Hospital Costs
Authors: Bernard Friedman
Journal: JAMA (1989)

<h3>To the Editor.—</h3> Drs Melnick and Zwanziger<sup>1</sup>report lower costs and costs per discharge since 1983 for California hospitals in "high-competition markets" because of legislation that promotes price-based selective contracting. We suggest that their results be interpreted cautiously. Increasing enrollment in health maintenance organizations (HMOs) (or competition from ambulatory-care providers) unrelated to bidding among hospitals can foster strategies that maintain net revenue by restraining costs. Hospitals also can respond to declines in demand by well-insured patients through greater selectivity of services and patients. Discharges declined more rapidly in the high-competition hospitals both before and after 1983,<sup>1(p2674)</sup>possibly an effect of expanding enrollment in HMOs. According to Friedman and Shortell,<sup>2</sup>the HMO market share was inversely associated with cost in 1985. The hospitals in the high-competition subsample of Drs Melnick and Zwanziger may have tended not to bid successfully for Medicaid patients, resulting in a less expensive, more
Postmortem tissue digoxin concentrations in infants and children.
Authors: P W Kim, R W Krasula, L F Soyka, A R Hastreiter
Journal: Circulation (1975)

The concentrations of digoxin in tissues of premature infants, full-term infants and older children obtained at autopsy were determined by a radioimmunoassay procedure. Infants were found to have much higher concentrations in the right and left ventricle (about 190 ng/g) than older children (about 70 ng/g) and adults as reported in the literature. Renal concentrations were lower in the premature group which may be related to their limited excretory capacity for digoxin. The relatively high myocardial concentrations of digoxin found in this study suggest that the usually recommended doses for infants may be excessive.
Gastric epithelial cell turnover, mucus production, and healing of gastric ulcers with carbenoxolone.
Authors: W Domschke, S Domschke, J Hagel, L Demling, D N Croft
Journal: Gut (1977)

Nineteen healthy subjects were studied and 17 patients with gastric ulcer before and after ulcer healing with carbenoxolone. Gastric deoxytibonucleic acid (DNA) loss was measured as an index of epithelial cell turnover, and N-acetylneuraminic acid (NANA) content of gastric juice as an index of mucus secretion. In normal subjects there was a negative correlation (p less that 0-025) between gastric DNA loss and NANA secretion; the lower the cell turnover the higher the NANA production. In gastric ulcer patients DNA loss or turnover was significantly (p less than 0-01) higher than normal, and fell significantly (p less than 0-01) after four weeks' treatment with carbenoxolone when 16 of the 17 ulcers had healed. At the same time NANA output increased significantly (p less than 0-01). It is suggested that patients with gastric ulcer lose cells at a high rate, a state of affairs which is returned towards normal by carbenoxolone, thus allowing the epithelial cells to mature within the mucosa and produce more mucus.
Identification and Diameter Assessment of Gastric Submucosal Vessels using Infrared Electronic Endoscopy
Authors: N. Hayashi, S. Kawano, S. Tsuji, M. Tsujii, Y. Takai, K. Nagano, H. Fusamoto, N. Sato, T. Kamada
Journal: Endoscopy (1994)

In this study, an electronic endoscope was applied for observation of gastric submucosal vessels, with infrared illumination, in anesthetized dogs. An in-vivo spectrophotometry showed that infrared light at 620-820 nm penetrates the abdominal and gastric wall. During the endoscopy performed in dogs, the infrared radiation penetrated the abdominal wall and gastric wall from the outside, and was detected by the endoscope's charge-coupled device. A television monitor displayed a network of gastric vasculature, which was identified as veins in the gastric wall by injecting saline or indocyanine green into the vein. Using this system, it was possible to measure venous diameters of more than 0.2 mm by comparison with a reference wire. The diameter obtained by the image analysis correlated lineally to that of a vascular template prepared from the same stomach. Thus, it may become possible to assess gastric submucosal hemodynamics using infrared endoscopy, a new application in electronic endoscopy.
The renin-angiotensin system and volume overload-induced cardiac hypertrophy in rats. Effects of angiotensin converting enzyme inhibitor versus angiotensin II receptor blocker.
Authors: M Ruzicka, B Yuan, E Harmsen, F H Leenen
Journal: Circulation (1993)

The degree of cardiac hypertrophy is not only load dependent: Among other factors, the renin-angiotensin system may play a role in the regulation of cardiac myocyte growth.To evaluate the role of the renin-angiotensin system in volume overload-induced cardiac hypertrophy, we assessed: 1) the time course of changes in cardiac hemodynamics, cardiac anatomy, and plasma and cardiac renin activity in response to volume overload induced by two sizes of abdominal aortocaval shunt and 2) the effects of chronic treatment with an angiotensin converting enzyme inhibitor (ACEI) versus an angiotensin II receptor blocker on hemodynamics and cardiac hypertrophy. Drug treatment started 3 days before shunt surgery. An increase in left ventricular end-diastolic pressure (LVEDP) and the development of right ventricular (RV) and left ventricular (LV) eccentric hypertrophy in response to volume overload occurred within the first week after induction of the shunt. Plasma renin activity (PRA) and cardiac renin activity peaked shortly after induction of the shunt. During the chronic phase, LVEDP and PRA decreased somewhat but remained significantly elevated up to 7 weeks after shunt surgery. Cardiac renin activity returned toward normal within 4 weeks after surgery. Treatment with the ACEI enalapril caused only a modest decrease in LV internal diameter but did not affect increases in LV and RV weights in response to volume overload despite a major decrease in LVEDP after chronic treatment. In contrast, treatment with the angiotensin II receptor blocker losartan, which had similar effects on cardiac and peripheral hemodynamics, prevented dilation of the LV after 7 days and attenuated the dilation of the LV after 28 days. Moreover, increases in LV and RV weights were significantly attenuated by losartan.The development of volume overload-induced cardiac hypertrophy is associated with significant increases in PRA and cardiac renin activity shortly after induction of an aortocaval shunt. Whereas the two blockers of the renin-angiotensin system decreased LVEDP to a similar extent, only the angiotensin II receptor blocker blunted the hypertrophic response of the heart to volume overload, which is indicative for other than hemodynamic determinants of the cardiac hypertrophic response. One trophic factor may be cardiac angiotensin II generated via an angiotensin II-forming enzyme resistant to ACEI and possibly activated by cardiac volume overload.
Dynamic Anal Endosonography May Challenge Defecography for Assessing Dynamic Anorectal Disorders: Results of a Prospective Pilot Study
Authors: M. Barthet, F. Portier, L. Heyries, P. Orsoni, M. Bouvier, D. Houtin, N. Barriere, P. Mambrini, J. Salducci, J. C. Grimaud
Journal: Endoscopy (2000)

Background and Study Aims: The diagnosis of anorectal dynamic disorders and perineal insufficiency has been mainly based up to now on the use of defecography. Here, we performed a prospective blinded study to evaluate the accuracy of a new procedure, dynamic anorectal endosonography (DAE), by comparing it with defecography.
Nomograms for Relative Humidity
Authors: G. H. Bell, J. B. d. V. Weir
Journal: BMJ (1947)

NOMOGRAMS FOR RELATIVE HUMIDITY MERITISHIt is considered that the optimum dosage for combining these drugs is 1i gr.(0.1 g.) of epanutin to 3/4 gr.(0.5 mg.) of pheno- barbitone.
The Value of the Preoperative Visit by an Anesthetist
Authors: Lawrence D. Egbert, George E. Battit, Herman Turndorf, Henry K. Beecher
Journal: JAMA (1963)

The psychologic effect of the preoperative visit by an anesthetist has been compared with the effect of pentabarbital for preanesthetic medication. Patients receiving pentobarbital 1 hour before an operation became drowsy but it could not be shown that they became calm. Patients who had received a visit by an anesthetist before operation (informing them about the events which were to occur on the day of the operation and about the anesthetic to be administered) were not drowsy but were more likely to be calm on the day of the operation. The importance of the preoperative visit probably explains, in part, the difficulties previous investigators have had in showing sedative effects from barbiturates and narcotics before operation. The tremendous emotional significance to a patient of illness or an operation may explain why physicians are able to exert such influence upon their patients.
The Physician as a Witness Against Himself
Authors: —Howard Newcomb Morse
Journal: JAMA (1966)

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
Tics Following Methylphenidate Administration
Authors: Martha Bridge Denckla
Journal: JAMA (1976)

Among children receiving methylphenidate hydrochloride, tics developed in 14, and in six children with pre-existing tics, the tics became worse. The clinical diagnosis in 19 cases was minimal brain dysfunction (MBD), and in one case, Gilles de la Tourette syndrome. Duration and dose of medication showed no particular pattern. In only one case did tics persist unchanged after methylphenidate treatment was discontinued. Tics related to methylphenidate administration appear to be rare (20 of 1,520 cases, or 1.3%) and may point to a specific susceptibility possibly related to personality profile (obsessive, perseverative, withdrawn). (<i>JAMA</i>235:1349-1351, 1976)
Relevance of CD34+ Cells as a Reservoir for JC Virus in Patients With Multiple Sclerosis
Authors: Clemens Warnke, Ortwin Adams, Bernd Kieseier
Journal: JAMA Neurology (2014)

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 Neurology HomeNew OnlineCurrent IssueFor Authors Podcast 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) 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 Neurology journal
A do-it-yourself medical centre.
Authors: C Lockie, A N Ganner
Journal: BMJ (1980)

account for perhaps no more than 5(\, of an accident and emergency department's cases this approach could be applic able to other types of injury. In the long run self-supporting sports clinics, on the lines of the one that opened recently in Cambridge,6 could provide a good solution. But, as with industrial rehabilitation, in a good accident service or even accident and emergency department the onus should surely be on the NHS to provide some kind of help when the ideal special services are not available.
Extravasation of sclerosant after injection of N-butyl-2-cyanoacrylate for a bleeding gastric Dieulafoy lesion
Authors: M.-S. Soon, Y.-Y. Chen, H.-H. Yen
Journal: Endoscopy (2008)

A 79-year-old woman was admitted because she had been passing tarry stools for 2 days. Emergency endoscopy revealed an actively spurting Dieulafoy lesion in the gastric fundus ([Fig. 1]). Because of the technical difficulty of applying hemoclips in this case we performed rubber-band ligation, which resulted in immediate hemostasis ([Fig. 2]). Twelve hours later, fresh blood reappeared in the nasogastric aspirate. A repeat endoscopy showed active oozing from the base of the ligated area ([Fig. 3]). Despite the injection of 12 mL of diluted epinephrine, the bleeding persisted. After discussing the situation with the patient she agreed to receive a sclerosant injection, and the bleeding stopped after an injection of a mixture of 0.5 mL of N-butyl-2-cyanoacrylate and lipiodol. The patient complained of dull epigastric pain after the injection, and a chest radiograph showed radiopaque material along the left diaphragm ([Fig. 4]). Abdominal computed tomography confirmed that there was extravasation of sclerosant along the left subphrenic area ([Fig. 5]). The patient was free of any signs of infection and was discharged on day 6 of her hospital day. She remained well over the following 2 years.
Adverse Health Effects of Chronic Exposure to Low-Level Cadmium in Foodstuffs and Cigarette Smoke
Authors: Soisungwan Satarug, Michael R. Moore
Journal: Environmental Health Perspectives (2004)

Cadmium is a cumulative nephrotoxicant that is absorbed into the body from dietary sources and cigarette smoking. The levels of Cd in organs such as liver and kidney cortex increase with age because of the lack of an active biochemical process for its elimination coupled with renal reabsorption. Recent research has provided evidence linking Cd-related kidney dysfunction and decreases in bone mineral density in nonoccupationally exposed populations who showed no signs of nutritional deficiency. This challenges the previous view that the concurrent kidney and bone damage seen in Japanese itai-itai disease patients was the result of Cd toxicity in combination with nutritional deficiencies, notably, of zinc and calcium. Further, such Cd-linked bone and kidney toxicities were observed in people whose dietary Cd intakes were well within the provisional tolerable weekly intake (PTWI) set by the Joint Food and Agriculture Organization/World Health Organization Expert Committee on Food Additives of 1 microg/kg body weight/day or 70 microg/day. This evidence points to the much-needed revision of the current PTWI for Cd. Also, evidence for the carcinogenic risk of chronic Cd exposure is accumulating and Cd effects on reproductive outcomes have begun to emerge.
Sickle-Cell Trait as a Risk Factor for Sudden Death in Physical Training
Authors: John A. Kark, David M. Posey, Harold R. Schumacher, Charles J. Ruehle
Journal: New England Journal of Medicine (1987)

Case reports of sudden death during exertion have not established an association between the sickle-cell trait (hemoglobin AS) and exercise-related death. To test this association, all deaths occurring among 2 million enlisted recruits during basic training in the U.S. Armed Forces in 1977 to 1981 were classified from autopsy and clinical records as non-sudden deaths or as sudden deaths explained or unexplained by preexisting disease. On the basis of known numbers of entering recruits (according to race, age, and sex) and published prevalence rates for hemoglobin AS (8 percent for black and 0.08 percent for nonblack recruits), death rates (per 100,000) were 32.2 for sudden unexplained deaths, 2.7 for sudden explained deaths, and 0 for non-sudden deaths among black recruits with hemoglobin AS, as compared with 1.2, 1.2, and 0.7 among black recruits without hemoglobin S and 0.7, 0.5, and 1.1 among nonblack recruits without hemoglobin S. Among black recruits the relative risk of sudden unexplained death (hemoglobin AS vs. non-hemoglobin S) was 27.6 (95 percent confidence interval, 9 to 100; P less than 0.001), whereas among all recruits this risk was 39.8 (95 percent confidence interval, 17 to 90; P less than 0.001). The relative risk of sudden unexplained death among all recruits increased with age (P less than 0.04), from 13 (ages 17 to 18) to 95 (ages 26 to 30). We conclude that recruits in basic training with the sickle-cell trait have a substantially increased, age-dependent risk of exercise-related sudden death unexplained by any known preexisting cause.
From the Office of the General Counsel. Economic considerations in treatment decisions and the standard of care in medical malpractice litigation
Authors: E. B. Hirshfeld
Journal: JAMA (1990)

Writing under the auspices of the American Medical Association's Office of the General Counsel, Hirshfeld discusses the possible ramifications for malpractice litigation of economic pressures on physicians to withhold unnecessary treatment from patients. Liability is determined by comparing an individual physician's actions to the prevailing standard of care, which incorporates both objective evaluations of medical science and normative societal values. Many commentators are debating whether the standard of care will become less patient-oriented in order to accommodate society's need to control costs. Hirshfeld describes the role that physicians can play in the debate by exercising their influence to preserve the tradition of providing high-quality, patient-centered care. They can best do this by clearly defining the benefits of specific medical services and articulating where medical science ends and economic considerations begin in treatment decisions.
Immediate functional recovery and avoidance of reperfusion injury with surgical revascularization of short-term coronary occlusion.
Authors: J Vinten-Johansen, T A Edgerton, H R Howe, P A Gayheart, S A Mills, G Howard, A R Cordell
Journal: Circulation (1985)

Functional recovery with surgical revascularization of acutely ischemic myocardium has not been compared with its nonsurgical counterpart in experimental preparations of coronary occlusion. This study compares the functional and metabolic recovery of ischemic (1 hr coronary occlusion) segments revascularized either by restoration of coronary patency (simulating nonsurgical recanalization, e.g., angioplasty) or by surgical revascularization with multidose hypothermic potassium blood cardioplegic solution. Twenty-two anesthetized open-chest dogs were instrumented with Millar micromanometer-tip catheters to measure left ventricular and aortic pressures. Piezoelectric ultrasonic dimension gauges were implanted in the subendocardium supplied by the left anterior descending coronary artery to measure segmental contractile function. In five dogs, only biopsy samples were obtained for control measurements of ATP, creatine phosphate, and tissue water content. In the remaining 17 dogs, the left anterior descending artery and collaterals were ligated for 1 hr. The ligatures were removed in eight dogs and coronary perfusion continued for 2 hr, simulating nonsurgical reperfusion. The remaining nine dogs were placed on cardiopulmonary bypass and the hearts were arrested for 1 hr with multidose (every 20 min) blood cardioplegic solution enhanced with glutamate and aspartate, simulating surgical revascularization (coronary artery bypass grafting). The coronary ligatures were not released until the second cardioplegic infusion, simulating graft placement. One hour of coronary occlusion placed 39.4 +/- 2.5% of the left ventricle at risk, and converted active systolic shortening to persistent paradoxical bulging (25.2 +/- 2.2% to -5.8 +/- 1.2% systolic shortening).(ABSTRACT TRUNCATED AT 250 WORDS)
Leukotriene D4 and methacholine bronchial provocation tests for identifying leukotriene-responsiveness subtypes
Authors: Weijie Guan, Jinping Zheng, Yi Gao, Caiyu Jiang, Yanqing Xie, Jiaying An, Xinxin Yu, Wenting Liu, Nanshan Zhong
Journal: Journal of Allergy and Clinical Immunology (2012)
The <i>microRNA-342-5p</i> Fosters Inflammatory Macrophage Activation Through an Akt1- and <i>microRNA-155</i> –Dependent Pathway During Atherosclerosis
Authors: Yuanyuan Wei, Maliheh Nazari-Jahantigh, Lily Chan, Mengyu Zhu, Kathrin Heyll, Judit Corbalán-Campos, Petra Hartmann, Anna Thiemann, Christian Weber, Andreas Schober
Journal: Circulation (2013)

Background— Atherosclerosis is a chronic inflammatory vascular disease driven by the subendothelial accumulation of macrophages. The mechanism regulating the inflammatory response in macrophages during atherogenesis remains unclear. Because microRNAs (miRNAs) play a crucial role in cellular signaling by posttranscriptional regulation of gene expression, we studied the miRNA expression profiles during the progression of atherosclerosis. Methods and Results— Using an miRNA real-time polymerase chain reaction array, we found that macrophage-derived miR-342-5p and miR-155 are selectively upregulated in early atherosclerotic lesions in Apoe −/− mice. miR-342-5p directly targets Akt1 through its 3′-untranslated region. Akt1 suppression by miR-342-5p induces proinflammatory mediators such as Nos2 and II6 in macrophages via the upregulation of miR-155 . The local application of an miR-342-5p antagomir inhibits the development of atherosclerosis in partially ligated carotid arteries. In atherosclerotic lesions, the miR-342-5p antagomir upregulated Akt1 expression and suppressed the expression of miR-155 and Nos2 . This reduced Nos2 expression was associated with a diminished generation of nitrotyrosine in the plaques. Furthermore, systemic treatment with an inhibitor of miR-342-5p reduced the progression of atherosclerosis in the aorta of Apoe −/− mice. Conclusions— Macrophage-derived miR-342-5p promotes atherosclerosis and enhances the inflammatory stimulation of macrophages by suppressing the Akt1 -mediated inhibition of miR-155 expression. Therefore, targeting miR-342-5p may offer a promising strategy to treat atherosclerotic vascular disease.
CLOPIDOGREL PHARMACOKINETICS AND PHARMACODYNAMICS VARY WIDELY, INDEPENDENT OF CYP2C19 POLYMORPHISMS, DIET, SMOKING, PROTON PUMP INHIBITORS AND OTHER CO-MEDICATIONS
Authors: Andrew L. Frelinger, Deepak L. Bhatt, Ronald D. Lee, Darcy J. Mulford, Jingtao Wu, Alan D. Michelson
Journal: Journal of the American College of Cardiology (2011)