tbuckley/cabot-search huggingface dataset:
Cost effectiveness of adalimumab in the treatment of patients with moderate to severe rheumatoid arthritis in Sweden
Authors: N J Bansback
Journal: Annals of the Rheumatic Diseases (2004)

<b>Background:</b> Societal decision makers increasingly emphasise their need for evidence based economic analyses to make reimbursement decisions. <b>Objective:</b> To analyse the cost utility of adalimumab, on both incremental cost and incremental quality adjusted life years (QALYs), versus traditional disease modifying antirheumatic drugs and the other tumour necrosis factor (TNF) antagonists suitable for submission to the Swedish LFN (Pharmaceutical Benefit Board). <b>Methods:</b> Swedish unit costs and treatment guidelines from a lifetime perspective were implemented. A mathematical model, incorporating data from seven trials, simulated the experiences of 10 000 hypothetical patients with moderate to severe rheumatoid arthritis (RA). The primary outcome measure—QALYs—was derived from utility values calculated from a relationship between the Health Assessment Questionnaire (HAQ) Disability Index (DI) and Health Utility Index-III (HUI-3) from adalimumab trial results. The model followed the progression of HAQ-DI through a number of treatments in a sequence accounting for mortality, drug and monitoring costs, and other direct costs. <b>Results:</b> When using ACR50 as a response threshold for determining successful treatment, adalimumab plus methotrexate showed the greatest number of QALYs gained (2.3 from one study and 2.1 from the pooled results of two trials). The etanercept plus methotrexate strategy yielded QALY gains similar to the pooled adalimumab results. Except for the infliximab strategy, the costs results were between €35 000 and €42 000, a range normally considered cost effective in other European countries. <b>Conclusion:</b> Adalimumab appears to be cost effective for the treatment of moderate to severe RA. The results suggest that adalimumab is at least as cost effective as other TNF antagonists.
WHO denounces health benefits of alcohol
Authors: N Craft
Journal: BMJ (1994)

WHO denounces health benefits of alcoholAlcohol is not good for health, the World Health Organisation (WHO) declared last week, in response to reports that drinking small amounts of alcohol may prolong life."We are seeking to demystify advertising that says that alcohol is good for your health, and to debunk the idea that to have a drink a day will keep the doctor away," said Dr Mario Argondona, chief of the treatment unit of the Programme on Substance Abuse at the WHO.The programme's director, Mr Hans Emblad, warned, "There is no minimum threshold below which alcohol can be con- sumed without any risk.Alcohol can be blamed for some of the world's most serious health problems.The less you drink, the bet- ter."Mr Emblad disputed the significance of the research published by Professor Richard Doll in the BMJ about the cardioprotective effects of a moderate intake of alcohol (8 October, p 91 1)."There are other ways of reducing the risk of cardiovascular disease: avoid smoking, engage in physical activity, eat less fat," he said.This view is disputed by Professor Brian Pentecost, medical director of the British Heart Foundation, who said, "There is a very substantial body of evidence now which sug- gests that moderate consumption of alcohol is associated with a reduction of not only cardio- vascular deaths but all causes of death."The WHO is concerned that the publicity given to this evidence may have influenced some people to start drinking.In its criticism of Professor Doll's paper the WHO claims that there is no indication that drinking more than one drink every other day reduces the risk of cardiovascular disease in comparison with total abstinence.The WHO's stance has raised questions over the recommended safe levels of alcohol intake."We are not preaching abstinence or teetotal- ism," reassured Dr Argondona.But he said, "We should be aware that alcohol is a risky, addictive and toxic substance, and that the safe threshold for drinking is culture dependent."In its statement, the WHO said that "the recommended level of drinking does not take into account body weight and individual vul- nerability, the pattern and spacing of drinking or the drinking context."A spokesperson for the Medical Council on Alcoholism said, "Responsible citizens are bound to ask how much they can drink before they risk harming their health and it is not helpful to refuse to give them any guidelines.
Analysis of Gastric Carcinoma Growth by Endoscopic Ultrasonography
Authors: T. Okai, O. Yamakawa, N. Matsuda, H. Kawakami, H. Watanabe, Y. Satomura, H. Ohta, Y. Motoo, N. Sawabu, A. Ooi, M. Mai
Journal: Endoscopy (1991)

Endoscopic ultrasonography (EUS) was performed preoperatively in 82 patients with gastric carcinoma (40 with early and 42 advanced malignancy). Measurements of wall thickness were performed in each case and showed good correlation with histological findings. Wall thickening was found to consist of both tumorous and accompanying ulcerous tissue. Thus, increasing wall thickness, as demonstrated by EUS, may not necessarily mean progressive tumor growth. The EUS features of gastric carcinoma were analyzed and four distinct growth patterns found: predominantly intramural (IM) or intraluminal (IL) growth with preservation (Type 1) or destruction (Type 2) of the submucosal echo-rich layer. All early carcinomas displayed the IL-type growth pattern on EUS (98% IL1-type) and 81% of advanced tumors showed IM-type features. EUS was able to differentiate between early and advanced carcinoma in 98% of cases. The EUS pattern of submucosal destruction (type IM2 or IL2) corresponded to the expanding type tumor according to Ming's histopathological classification. On the other hand, 24 of 26 infiltrative tumors according to Ming were found on EUS to have an intramural growth pattern with preservation of the submucosa (type IM1). It is concluded that EUS is highly sensitive in predicting the tumor growth pattern in gastric carcinoma, providing important additional information to the currently used TNM staging system. Measurements of wall thickness are reliable but differentiation between tumorous growth and peritumorous changes is not possible.
Functional recoveries of sciatic nerve regeneration by combining chitosan-coated conduit and neurosphere cells induced from adipose-derived stem cells
Authors: Yuan-Yu Hsueh, Ya-Ju Chang, Tzu-Chieh Huang, Shih-Chen Fan, Duo-Hsiang Wang, Jia-Jin Jason Chen, Chia-Ching Wu, Sheng-Che Lin
Journal: Biomaterials (2013)
Palliative Management of Fatigue at the Close of Life: “It Feels Like My Body Is Just Worn Out”
Authors: Amy J. Markowitz, Michael W. Rabow
Journal: JAMA (2007)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Incidental Accumulation of Technetium-99m Pertechnetate in Pediatric Burkittʼs Lymphoma With Tumor-Induced Intussusception
Authors: Shiou-Chi Cherng, Yu-Ming Fan, Chih-Yung Yu, Chih-Chun Chu, Shin-Nan Cheng
Journal: Clinical Nuclear Medicine (2004)

A 4-year-old boy was hospitalized for anemia. Because he had dark stool after admission, technetium-99m pertechnetate scintigraphy was performed to screen for ectopic gastric mucosa. Incidental accumulation of Tc-99m pertechnetate in the transverse colon was noticed, and it was seen early and then faded, which indicated lesions with increased blood pool but without taking up Tc-99m pertechnetate. The literature has suggested several causes for such a finding, including intussusception, arteriovenous malformations, and tumors. Small intestine x-rays demonstrated an ileocolic intussusception with terminal ileum invagination into the transverse colon and a tumor mass approximately 4 cm in diameter as the leading point. Exploratory laparotomy and excision biopsy confirmed the diagnosis of Burkitt's lymphoma with tumor-induced intussusception.
Reactivation of human herpesvirus (HHV) family members other than HHV-6 in drug-induced hypersensitivity syndrome
Authors: M. Seishima, S. Yamanaka, T. Fujisawa, M. Tohyama, K. Hashimoto
Journal: British Journal of Dermatology (2006)

Drug-induced hypersensitivity syndrome (DIHS) is characterized by a severe multiorgan hypersensitivity reaction that usually appears after a 3-6-week exposure to certain drugs, including anticonvulsants. There are some reports showing that serum IgG levels often decrease at the early stage of DIHS. Reactivation of human herpesvirus (HHV)-6 has been reported in patients with DIHS, and some other DIHS patients showed reactivation of cytomegalovirus (CMV) or Epstein-Barr virus (EBV).To determine whether reactivation of HHV-6, HHV-7, CMV and/or EBV occurs in patients with DIHS.Titres of IgG and IgM antibodies to HHV-6 and HHV-7 were determined using an indirect immunofluorescence antibody assay on admission and at various times after admission. Anti-CMV IgG and IgM antibody titres and anti-EBV capsid antigen IgG, IgA, IgM, and EBV nuclear antigen and EBV early antigen IgG titres were determined by enzyme immunoassay. Polymerase chain reaction (PCR) procedures for HHV-6, HHV-7, CMV and EBV DNAs were performed using serum samples. IgG antibody titres to HHV-6, HHV-7, CMV and EBV were increased after the onset in seven, six, seven and two of seven patients, respectively. IgG antibody titres to HHV-6 and HHV-7 were elevated simultaneously 21-38 days after the onset.IgG antibody titres to CMV and EBV were elevated 10-21 days after the elevation of HHV-6 and HHV-7 antibody titres. PCR showed that HHV-6, HHV-7, CMV and EBV DNAs became positive in six, five, seven and two of seven patients, respectively. HHV-6 and HHV-7 DNAs were detected 21-35 days after the onset, and CMV DNA was detected 10-21 days after detection of HHV-6 and HHV-7 DNAs.The present study suggests that in addition to HHV-6 reactivation, reactivation of HHV-7, CMV and/or EBV may also occur following drug eruption in some patients with DIHS.
Prognostic value of insulinlike growth factor I and its binding protein in patients with alcohol-induced liver disease
Authors: S Moller, U Becker, A Juul, N E Skakkebaek, E Christensen
Journal: Hepatology (1996)

Insulinlike growth factor I (IGF-I) is a single-polypeptide chain with important anabolic and endocrine activities. The liver is the major source of IGF-I and its binding protein, IGFBP-3. Circulating concentrations of IGF-I and IGFBP-3 are decreased in patients with chronic liver disease and correlate with the severity. The aim of this study was to assess the additional prognostic value of IGF-I and IGFBP-3 in patients entered in a large multicenter study (EMALD). Three hundred thirty-seven patients with alcohol-induced liver disease were studied in a randomized placebo-controlled trial of malotilate with a mean follow-up period of 569 days (range, 7-1,544). A multivariate Cox regression analysis of pertinent clinical and biochemical variables showed a significant independent prognostic value of years of alcohol intake, coagulation factors 2, 7, and 10, alkaline phosphatases, serum creatinine, and immunoglobulin (Ig) M. When IGF-I or IGFBP-3 were added into this model, a Cox regression analysis showed that either had a significant independent prognostic value. Because IGF-I and IGFBP-3 were closely correlated, they contained almost the same prognostic information. Inclusion of IGF-I gave these results: IGF-I ( P &lt; .03), alcohol intake ( P &lt; .02), coagulation factors 2, 7, and 10 ( P &lt; .01), creatinine ( P &lt; .001), and IgM ( P &lt; .01) contained independent prognostic information. Inclusion of IGFBP-3 gave these results: IGFBP-3 ( P &lt; .02), alcohol intake ( P &lt; .05), coagulation factors 2, 7, 10 ( P &lt; .01), creatinine ( P &lt; .001), and IgM ( P &lt; .02) were independent predictors of survival. In conclusion, IGF-I or IGFBP-3 provide important additional information on survival in patients with alcohol-induced liver disease.
"Foreign Medical Training for Recent Graduates."
Authors: Philip Arnold
Journal: JAMA (1898)

Elizabeth, Ill., Jan. 18, 1898. <h3>To the Editor:</h3> —In an article written on the above subject by W. S. Caldwell, M.D., from Vienna, the writer would like to take a few exceptions. Quoting from Dr. Caldwell's article in theJournalof Jan. 15, 1898: "Not because the subject is better understood or more skilfully taught than by our best teachers, but because the clinical material is much more abundant here and can be much better utilized for clinical purposes, and the number of those to be taught are much fewer in proportion to material available." Also: "There may be just as good courses as these at home, but I have not been able to avail myself of them for<i>I have not been able to find them</i>." I simply wish to say that I for one<i>have</i>found "just as good courses as these at home," and though I have
Unilateral Leg Edema-Reply
Authors: Katherine A. Hawkins
Journal: JAMA (1981)

<h3>In Reply.—</h3> We agree with Dr Kurz that extensive testing is not a substitute for a good history and physical examination. The article stresses the occurrence of lymphoma as a sometimes-overlooked cause of unilateral leg edema. The good clinical judgment of modern house officers, we hope, will make Dr Kurz' fears that it will lead to extensive unnecessary work-ups unfounded.
Life-Years Gained From Defibrillator Implantation
Authors: Tushar V. Salukhe, Konstantinos Dimopoulos, Richard Sutton, Andrew J. Coats, Massimo Piepoli, Darrel P. Francis
Journal: Circulation (2004)

Although treatment benefit in randomized controlled trials of defibrillators is often summarized by the numbers of lives saved (absolute risk difference), this may not be a good representation of what matters most to patients, namely, the amount of life they should expect to gain from implantation. The estimate of gain in life-years may depend on duration of follow-up. In this study, we examine this dependency.We estimated, from published data of 8 landmark defibrillator trials, the cumulative benefit in life-years gained at time points from 3 months to 3 years. Because the trial populations, clinical status, and prognosis varied widely between studies, we expressed for each study the benefit at each time point as the proportion of benefit at 3 years. The average dependency of the benefit on duration of follow-up was then calculated. We found that the number of life-years gained from 1 device implantation increases with length of follow-up considered. Importantly, this increase is markedly nonlinear. Within the 3-year span addressable, the benefit rises with the square of time (gain infinity t(1.94), R2=0.998, P<0.001).Measurable benefit from a defibrillator to patients' life spans (life-years gained) is dramatically dependent on the time window over which the benefit is assessed. Because the effort of implantation is front loaded, yet benefit grows with time, the choice of an early time point artificially reduces apparent benefit and artificially increases the apparent number needed to treat to prevent an event. These are useful considerations for the formulation of treatment policy (and even for planning of the follow-up phase of clinical trials).
Income, health, and the National Lottery
Authors: A. Rodgers
Journal: BMJ (2001)

Most people in the United Kingdom have taken part in one of the world's largest trials of one of the most important determinants of health. Unfortunately, neither the participants nor the organisers know about the trial and no one has collected follow up data.

Each month, more than £150m is randomly redistributed among 60% of the adult population in the National Lottery.1 Over £16bn has been redistributed since the lottery began in 1994. Changing the redistribution of a small fraction of this money could create a randomised trial that reliably assessed the speed and extent to which increases in income improve health. The basic study design would be simple. Instead of lump sums, winners would receive regular, income-like payments (such as £40, £80, or £160 a month for a decade). Follow up of these winners, and a large random selection of non-winners, would assess effects on outcomes such as diet, smoking, admission to hospital and broader …
Aplastic Anemia Secondary to Gold-Salt Therapy
Authors: Daniel J. McCarty
Journal: JAMA (1962)

RECENTLY WE ADMINISTERED gold salts to a patient with rheumatoid arthritis who subsequently died from aplastic anemia during treatment. As only 20 well-documented cases of aplastic or "hypoplastic," anemia secondary to gold therapy have been recorded in 30 years, and since none has been reported in the past decade, it seemed worth while to add this case. Gold salts have been frequently employed in the treatment of rheumatoid arthritis since Forestier 's report in 1929, and their use has produced severe toxic effects in about 4.5% of cases. These effects include pruritus, dermatitis, stomatitis, nephritis, hepatitis, and bone marrow depression. Judging by the frequency of reported cases, one may infer that platelet production is most often affected; increasing toxicity may impair leukocytic formation also, while the severest toxicity may result in aplasia of all 3 marrow elements. The previously reported cases of aplastic anemia coinciding with gold-salt therapy have been
Fulminant Hepatitis and Liver Transplantation
Authors: ANGEL LOPEZ
Journal: Annals of Internal Medicine (1988)

Letters and Corrections1 May 1988Fulminant Hepatitis and Liver TransplantationANGEL LOPEZ, M.D., VICENTE JEREZ, M.D., JESUS REBOLLO, M.D., ANA G. LOMBARDO, M.D., JOSE A. JULIA, M.D.ANGEL LOPEZ, M.D.Search for more papers by this author, VICENTE JEREZ, M.D.Search for more papers by this author, JESUS REBOLLO, M.D.Search for more papers by this author, ANA G. LOMBARDO, M.D.Search for more papers by this author, JOSE A. JULIA, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-108-5-769_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We read with interest the article by Bismuth and colleagues (1), in which they report that "in all 17 patients, coma was present and factor V was below 20% of normal." Recently, we treated a 20-year-old patient with fulminant hepatitis associated with Amanita phalloïdes ingestion.After charcoal hemoperfusion during the first 12 hours, the patient was treated with fresh plasma, penicillin G, thioctic acid, and parenteral nutrition (2). After 5 days, the patient was in good cardiorespiratory condition, with encephalopathy grade 2(3) and rectal bleeding. The prothrombin time (164 seconds; control, 14 seconds; 0% activity) and the...References1. BISMUTHSAMUELGUGENHEIMCASTAINGBERNAURUEFFBENHAMOU HDJDJBJ. Emergency liver transplantation for fulminant hepatitis. Ann Intern Med. 1987;107:337-41. LinkGoogle Scholar2. GOULDPRATTER BM. Mushroom poisoning. In: RIPPE JM, IRWIN RS, ALPERT JS, DALEN JE, eds. Intensive Care Medicine. Boston/Toronto: Little, Brown & Co; 1985:962-5. Google Scholar3. CONRILEEVYVLAHCEVIC HCZ. Comparison of lactulose and neomycin in the treatment of chronic portal-systemic encephalopathy. Gastroenterology. 1977;72:573. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Hospital Infanta Cristina Instituto Nacional de la Salud Badajoz Spain PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByToxic Mushroom IngestionsLiver Transplantation in Mushroom PoisoningTreatment of Amatoxin Poisoning: 20-Year Retrospective AnalysisManagement of Liver Failure Secondary to Mushroom Poisoning in ChildrenMushroomsLiver Transplantation After Severe Poisoning Due to Amatoxin-Containing Lepiota -Report of Three CasesLiver transplantation for severe Lepiota helveola poisoning 1 May 1988Volume 108, Issue 5Page: 769-769KeywordsComaHemoperfusionHemorrhageHepatitisHepatitis AIngestionLiver transplantationNutritionPenicillinProthrombin time Issue Published: 1 May 1988 PDF DownloadLoading ...
Interaction of process partitions in phylogenetic analysis: an example from the swallowtail butterfly genus Papilio
Authors: R. D. Reed, F. A. Sperling
Journal: Molecular Biology and Evolution (1999)

In this study, we explored how the concept of the process partition may be applied to phylogenetic analysis. Sequence data were gathered from 23 species and subspecies of the swallowtail butterfly genus Papilio, as well as from two outgroup species from the genera Eurytides and Pachliopta. Sequence data consisted of 1,010 bp of the nuclear protein-coding gene elongation factor-1 alpha (EF-1 alpha) as well as the entire sequences (a total of 2,211 bp) of the mitochondrial protein-coding genes cytochrome oxidase I and cytochrome oxidase II (COI and COII). In order to examine the interaction between the nuclear and mitochondrial partitions in a combined analysis, we used a method of visualizing branch support as a function of partition weight ratios. We demonstrated how this method may be used to diagnose error at different levels of a tree in a combined maximum-parsimony analysis. Further, we assessed patterns of evolution within and between subsets of the data by implementing a multipartition maximum-likelihood model to estimate evolutionary parameters for various putative process partitions. COI third positions have an estimated average substitution rate more than 15 times that of EF-1 alpha, while COII third positions have an estimated average substitution rate more than 22 times that of EF-1 alpha. Ultimately, we found that although the mitochondrial and nuclear data were not significantly incongruent, homoplasy in the fast-evolving mitochondrial data confounded the resolution of basal relationships in the combined unweighted parsimony analysis despite the fact that there was relatively strong support for the relationships in the nuclear data. We conclude that there may be shortcomings to the methods of "total evidence" and "conditional combination" because they may fail to detect or accommodate the type of confounding bias we found in our data.