tbuckley/cabot-search huggingface dataset:
Costs and cost effectiveness of different strategies for chlamydia screening and partner notification: an economic and mathematical modelling study
Authors: K. Turner, E. Adams, A. Grant, J. Macleod, G. Bell, J. Clarke, P. Horner
Journal: BMJ (2011)

<b>Objectives</b> To compare the cost, cost effectiveness, and sex equity of different intervention strategies within the English National Chlamydia Screening Programme. To develop a tool for calculating cost effectiveness of chlamydia control programmes at a local, national, or international level. <b>Design</b> An economic and mathematical modelling study with cost effectiveness analysis. Costs were restricted to those of screening and partner notification from the perspective of the NHS and excluded patient costs, the costs of reinfection, and costs of complications arising from initial infection. <b>Setting</b> England. <b>Population</b> Individuals eligible for the National Chlamydia Screening Programme. <b>Main outcome measures</b> Cost effectiveness of National Chlamydia Screening Programme in 2008–9 (as cost per individual tested, cost per positive diagnosis, total cost of screening, number screened, number infected, sex ratio of those tested and treated). Comparison of baseline programme with two different interventions—(i) increased coverage of primary screening in men and (ii) increased efficacy of partner notification. <b>Results</b> In 2008–9 screening was estimated to cost about £46.3m in total and £506 per infection treated. Provision for partner notification within the screening programme cost between £9 and £27 per index case, excluding treatment and testing. The model results suggest that increasing male screening coverage from 8% (baseline value) to 24% (to match female coverage) would cost an extra £22.9m and increase the cost per infection treated to £528. In contrast, increasing partner notification efficacy from 0.4 (baseline value) to 0.8 partners per index case would cost an extra £3.3m and would reduce the cost per infection diagnosed to £449. Increasing screening coverage to 24% in men would cost over six times as much as increasing partner notification to 0.8 but only treat twice as many additional infections. <b>Conclusions</b> In the English National Chlamydia Screening Programme increasing the effectiveness of partner notification is likely to cost less than increasing male coverage but also improve the ratio of women to men diagnosed. Further evaluation of the cost effectiveness of partner notification and screening is urgently needed. The spreadsheet tool developed in this study can be easily modified for use in other settings to evaluate chlamydia control programmes.
Genetic and epigenetic profiling of CLL disease progression reveals limited somatic evolution and suggests a relationship to memory-cell development
Authors: E N Smith, E M Ghia, C M DeBoever, L Z Rassenti, K Jepsen, K-A Yoon, H Matsui, S Rozenzhak, H Alakus, P J Shepard, Y Dai, M Khosroheidari, M Bina, K L Gunderson, K Messer, L Muthuswamy, T J Hudson, O Harismendy, C L Barrett, C H M Jamieson, D A Carson, T J Kipps, K A Frazer
Journal: Blood Cancer Journal (2015)

Abstract We examined genetic and epigenetic changes that occur during disease progression from indolent to aggressive forms of chronic lymphocytic leukemia (CLL) using serial samples from 27 patients. Analysis of DNA mutations grouped the leukemia cases into three categories: evolving (26%), expanding (26%) and static (47%). Thus, approximately three-quarters of the CLL cases had little to no genetic subclonal evolution. However, we identified significant recurrent DNA methylation changes during progression at 4752 CpGs enriched for regions near Polycomb 2 repressive complex (PRC2) targets. Progression-associated CpGs near the PRC2 targets undergo methylation changes in the same direction during disease progression as during normal development from naive to memory B cells. Our study shows that CLL progression does not typically occur via subclonal evolution, but that certain CpG sites undergo recurrent methylation changes. Our results suggest CLL progression may involve developmental processes shared in common with the generation of normal memory B cells.
Mutations of IDH1 and IDH2 genes in early and accelerated phases of myelodysplastic syndromes and MDS/myeloproliferative neoplasms
Authors: O Kosmider, V Gelsi-Boyer, L Slama, F Dreyfus, O Beyne-Rauzy, B Quesnel, M Hunault-Berger, B Slama, N Vey, C Lacombe, E Solary, D Birnbaum, O A Bernard, M Fontenay
Journal: Leukemia (2010)
New law requires doctors to learn care of the dying
Authors: Fred Charatan
Journal: BMJ (2001)

California's governor, Gray Davis, last month signed the first law in the United States requiring doctors to take courses in pain management and in care of people at the end of life. The measure was drafted by assembly woman Dion Aroner, a Berkeley Democrat.

The new law resulted from the case of William Bergman, an 85 year old man admitted in February 1998 to Eden Medical Center in Castro Valley, northern California. Mr Bergman was an inpatient for five days, with …
Screening for Coronary Heart Disease With Electrocardiography: U.S. Preventive Services Task Force Recommendation Statement
Authors: Virginia A. Moyer
Journal: Annals of Internal Medicine (2012)

Chinese translation Description: Update of the 2004 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for coronary heart disease (CHD). Methods: The USPSTF reviewed new evidence on the benefits of screening with electrocardiography (ECG) in asymptomatic adults to reduce the risk for CHD events versus not screening, the effect of identifying high-risk persons on treatment to reduce risk, the accuracy of stratifying individuals into risk categories, and the harms of screening. Recommendations: The USPSTF recommends against screening with resting or exercise ECG for the prediction of CHD events in asymptomatic adults at low risk for CHD events (D recommendation). The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening with resting or exercise ECG for the prediction of CHD events in asymptomatic adults at intermediate or high risk for CHD events (I statement).
Disability, Health, and Minimal Risk Thresholds
Authors: Christopher A. Riddle
Journal: The American Journal of Bioethics (2014)

"Disability, Health, and Minimal Risk Thresholds." The American Journal of Bioethics, 14(9), pp. 25–26 Notes1 . For example, an otherwise healthy child might live in unsafe housing, thereby exposing her to additional and possibly greater risks.2 . The idea of fetishism as applied here is inspired by Sen's critique of Rawlsian primary goods. For more see Sen (Citation1995, 325–326).3 . For Nussbaum's list of capabilities, see Nussbaum (Citation2000, 78–80; 2006, 76–78; 2011, 33–34).4 . I have made a similar argument previously in Riddle (Citation2014, 85–86) concerning Venkatapuram (Citation2011) and World Health Organization (Citation1946).
Firearm Legislation and Gun-Related Fatalities
Authors: Anupam B. Jena, Eric C. Sun, Vinay Prasad
Journal: JAMA Internal Medicine (2013)

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 Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Journals 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 2024 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 Internal Medicine journal
Septicemia in Galactosemia
Authors: Sally Kelly
Journal: JAMA (1971)

To the Editor.—  Two newborns with clinical signs of galactosemia and deficiencies of galactose 1-phosphate uridyl transferase, patients of Drs. David Tuman and Melvin Rosh, respectively, had concomitant septicemias from Escherichia coli (C. A. McNicol, MD, and M. Rosh, MD, personal communications). The family of Rosh's patient included two older siblings who had died in infancy with sepsis. The history of a 7-year-old girl with galactosemia, a patient of Dr. Gerald Machinski, included an Aerobacter aerogenes septicemia in infancy. A fourth infant with clinical signs and the enzyme defect of galactosemia at 5 weeks of age, a patient of Dr. Alice Pita, had Klebsiella meningitis. At least three other infants with transferase deficiencies detected in the newborn screening programs of three states have had concomitant E coli septicemias; one of them had a family history of infant deaths from E coli septicemias (H. Levy, MD, and W. Ullman, MD,
Pfizer launches virtual clinical trial
Authors: B. Roehr
Journal: BMJ (2011)

The giant drug company Pfizer is conducting a “virtual” clinical trial that relies solely on electronic rather than face to face encounters between researchers and participants. It announced the trial on 7 June at a conference on clinical trials held on the Bethesda, Maryland, campus of the US National Institutes of Health.

Freda Lewis-Hall, Pfizer’s chief medical officer, said that the company is trying to reduce barriers to participation in clinical trials; to offer a consistently strong experience that does not vary by location; and potentially to save money in conducting trials in the future, if the concept proves viable.

Surveys of patients show that the …
Mental Retardation and Comprehensive Training in Psychiatry
Authors: FRANK J. MENOLASCINO
Journal: American Journal of Psychiatry (1967)

The psychiatric resident can profit from guided experiences in mental retardation as part of the basic curriculum in his preparation for future practice. The symptomatic nature of mental retardation presents some of the most complex and challenging problems in medicine, affords unique opportunities for collaborative efforts with a variety of medical and paramedical diagnostic and treatment specialists, and provides an excellent introduction to comprehensive treatment planning for handicapped and chronically ill individuals in general.
Familial D/D Translocation Associated With Trisomy 21
Authors: Robert K. Brown
Journal: JAMA (1967)

Trisomy 21 mongolism and D/D translocation occurred in the same individual. To our knowledge, this is the second case of this phenomenon. Three additional members of this patient's family were found to be D/D translocation carriers. Four additional instances in which these two abnormalities are associated within a single family are found in the literature. It is suggested that this association may well be significant and is worthy of further study.
Criminal vs. Civil Commitment of Psychotic Offenders: A Seven-Year Follow-Up
Authors: A. LOUIS MCGARRY, RICHARD H. BENDT
Journal: American Journal of Psychiatry (1969)

Evidence is presented to support the hypothesis that pretrial commitment in a criminal status of mentally ill persons charged with a crime is antitherapeutic compared to the alternative of civil commitment. A seven-year follow-up of 29 persons showed few subsequent criminal offenses by those discharged from civil commitment. The authors propose a more active role for psychiatrists in negotiating with the courts in behalf of patients committed in a criminal status as well as psychiatrist? involvement in other activities designed to modify antitherapeutic legal practices.
Extensive Transmission of<i>Mycobacterium tuberculosis</i>from a Child
Authors: Amy B. Curtis, Renée Ridzon, Ruth Vogel, Stephen McDonough, James Hargreaves, Julie Ferry, Sarah Valway, Ida M. Onorato
Journal: New England Journal of Medicine (1999)

Young children rarely transmit tuberculosis. In July 1998, infectious tuberculosis was identified in a nine-year-old boy in North Dakota who was screened because extrapulmonary tuberculosis had been diagnosed in his female guardian. The child, who had come from the Republic of the Marshall Islands in 1996, had bilateral cavitary tuberculosis. Because he was the only known possible source for his female guardian's tuberculosis, an investigation of the child's contacts was undertaken. We identified family, school, day-care, and other social contacts and notified these people of their exposure. We asked the contacts to complete a questionnaire and performed tuberculin skin tests.
What's really important: Parental review
Authors: S. Saxena
Journal: BMJ (1999)

be accepted that they produce different disability weightings.Four subjects felt that they were led "to some extent" to answer in a particular way, and two subjects felt they were led "to a great extent."In spite of their reported view that the two questions ask about different things, participants at the workshop eventually accepted the requirement of consistency.Some explained that they felt they were participating in a game of little practical consequence.Others reported that rather than making person trade-off judgments, they picked disability weightings that "looked reasonable" and then selected corresponding person trade-off numbers.Perhaps some also accepted the authority of the facilitators and assumed that they were right in what they were demanding, or tried to avoid unpleasantness.
Palmar Dermatoglyphics in Heart Disease
Authors: Tsunekazu Takashina
Journal: JAMA (1966)

Palmar dermatoglyphic patterns on 44 patients with congenital heart disease were compared with patterns on 362 patients with acquired heart disease. Distal displacement (t" or multiple axial triradii) of the palmar axial triradii occurred with significantly greater frequency in the patients with congenital heart disease (64%), than in the patients with acquired heart disease (17%). Studies of the probability of the occurrence of these differences in palmar dermatoglyphics on a chance basis alone gave a value of less than 0.0000000001 for Japanese. This compares with a probability value of 0.0000634 for whites, and 0.0164 for Negroes. Dermatoglyphics is emerging as a clinical instrument and genetic tool of significance.
Lowered Glutathione‐Peroxidase Activity in Asthmatic Patients with Food and Aspirin Intolerance
Authors: R. Malmgren, G. Unge, O. Zetterströ, H. Theorell, K. de Wahl
Journal: Allergy (1986)

In analogy with findings from animal experiments, people with low glutathione‐peroxidase (GSH‐Px) activity could be expected to have altered sensitivities to effects of drugs, chemicals and possibly food. We have investigated GSH‐Px activity in 12 patients with intrinsic asthma and food and aspirin intolerance. Ten of the 12 patients had very low or low GSH‐Px activity and the frequency of low GSH‐Px activity in this group was statistically significant ( P &lt; 0.001) compared with the control material of age‐ and sex‐matched healthy individuals. Our finding of lowered GSH‐Px activity in patients with aspirin intolerance may indicate the involvement of hitherto unknown mechanisms in the pathogenesis of asthmatic disorders.
A case of airway compromise
Authors: N. Hussain, N. Ahmed, S. Ramjug
Journal: BMJ (2010)

A 75 year old white man presented to the accident and emergency department because of sudden onset neck swelling of one hour’s duration, with difficulty in speaking and swallowing. He had no history of recent fever or antibiotic use.

His medical history included ischaemic heart disease with impaired left ventricular function. His drugs had remained unchanged for the past year and included atorvastatin, bisoprolol, bendroflumethiazide, lisinopril, and aspirin. He had no known allergies and was an ex-smoker.

On examination he was haemodynamically stable with a respiratory rate of 25 breaths/min and saturations of 100% on high flow oxygen. Initially he had no urticaria or wheeze, but direct observation of the throat showed a swollen uvula and soft palate. Fibreoptic nasolaryngoscopy by the ear, nose, and throat surgeons showed oedema of the vallecula and arytenoid, partially covering the airway. Later his eyes and lips became swollen.

We started emergency management and admitted him to hospital. Concentrations of mast cell tryptase, total IgE, and C1 esterase were normal.



### 1 What was the cause of our patient’s presentation?

#### Short answer

Angio-oedema secondary to use of an angiotensin converting enzyme (ACE) inhibitor (lisinopril).

#### Long answer

Angio-oedema is a self limiting localised swelling that affects mucosal tissues of the face, larynx, and bowel, as well as the skin and extremities. It is characterised by non-pitting asymmetric swelling, which is not pruritic. Angio-oedema develops over minutes …
Physician Reporting of Sexual Abuse of Children
Authors: Jennifer James
Journal: JAMA (1978)

SEXUAL abuse of children is a growing concern nationally. Whereas incest, rape, and molestation of children were considered almost nonexistent a decade ago, current public alarm has resulted in communities throughout the country developing hot lines, treatment programs, and educational programs for victims and their families. In response to the existence of these services and improved laws, numerous sexual abuse cases are beginning to surface. Sgroi 1 states that the number of reported cases in Connecticut doubled between 1973 and 1974 to a total of 172. Similarly, in Santa Clara, Calif, the number of treatment cases has grown from 36 in 1971 to 180 in 1974. 2 From 1974 to 1976, the number of child sexual abuse cases seen annually at the Sexual Assault Center in Seattle has almost doubled and has increased in proportion from 41% to 53% of their total clientele.  The reports from the two treatment units
Association of Definition of Acute Kidney Injury by Cystatin C Rise With Biomarkers and Clinical Outcomes in Children Undergoing Cardiac Surgery
Authors: Michael Zappitelli, Jason H. Greenberg, Steven G. Coca, Catherine D. Krawczeski, Simon Li, Heather R. Thiessen-Philbrook, Michael R. Bennett, Prasad Devarajan, Chirag R. Parikh
Journal: JAMA Pediatrics (2015)

Research has identified improved biomarkers of acute kidney injury (AKI). Cystatin C (CysC) is a better glomerular filtration rate marker than serum creatinine (SCr) and may improve AKI definition.To determine if defining clinical AKI by increases in CysC vs SCr alters associations with biomarkers and clinical outcomes.Three-center prospective cohort study of intensive care units in New Haven, Connecticut, Cincinnati, Ohio, and Montreal, Quebec, Canada. Participants were 287 patients 18 years or younger without preoperative AKI or end-stage renal disease who were undergoing cardiac surgery. The study dates were July 1, 2007, through December 31, 2009.For biomarker vs clinical AKI associations, the exposures were first postoperative (0-6 hours after surgery) urine interleukin 18, neutrophil gelatinase-associated lipocalin, kidney injury molecule 1, and liver fatty acid-binding protein. For clinical AKI outcome associations, the exposure was Kidney Disease: Improving Global Outcomes AKI definition (based on SCr or CysC).Clinical AKI, length of stay, and length of mechanical ventilation. We determined areas under the receiver operating characteristic curve and odds ratios for first postoperative biomarkers to predict AKI.The SCr-defined vs CysC-defined AKI incidence differed substantially (43.6% vs 20.6%). Percentage agreement was 71% (κ = 0.38); stage 2 or worse AKI percentage agreement was 95%. Interleukin 18 and kidney injury molecule 1 discriminated for CysC-defined AKI better than for SCr-defined AKI. For interleukin 18 and kidney injury molecule 1, the areas under the receiver operating characteristic curve were 0.74 and 0.65, respectively, for CysC-defined AKI, and 0.66 and 0.58, respectively, for SCr-defined AKI. Fifth (vs first) quintile concentrations of both biomarkers were more strongly associated with CysC-defined AKI. For interleukin 18 and kidney injury molecule 1, the odds ratios were 16.19 (95% CI, 3.55-73.93) and 6.93 (95% CI, 1.88-25.59), respectively, for CysC-defined AKI vs 6.60 (95% CI, 2.76-15.76) and 2.04 (95% CI, 0.94-4.38), respectively, for SCr-defined AKI. Neutrophil gelatinase-associated lipocalin and liver fatty acid-binding protein associations with both definitions were similar. The CysC definitions and SCr definitions were similarly associated with clinical outcomes of resource use.Compared with the SCr-based definition, the CysC-based definition is more strongly associated with urine interleukin 18 and kidney injury molecule 1 in children undergoing cardiac surgery. Consideration should be made for defining AKI based on CysC in clinical care and future studies.
Hemochromatosis-Associated Mortality in the United States from 1979 to 1992: An Analysis of Multiple-Cause Mortality Data
Authors: Quanhe Yang
Journal: Annals of Internal Medicine (1998)

Background: Hemochromatosis, which can lead to serious chronic diseases resulting from iron overload, has an estimated prevalence of 50 to 80 cases per 10 000 persons. However, little population-based information is available on the impact of hemochromatosis on morbidity and mortality. Objective: To evaluate trends over 14 years in deaths and medical conditions associated with hemochromatosis in the United States. Design: We searched Multiple-Cause Mortality Files compiled by the National Center for Health Statistics for the years 1979 to 1992 for all records listing hemochromatosis. We used these data to calculate age-adjusted and age-specific mortality rates, identify medical conditions associated with a known diagnosis of hemochromatosis at death, and calculate proportionate mortality ratios for these medical conditions. Results: The listing of hemochromatosis on death certificates increased 60% from 1979 to 1992. Decedents with hemochromatosis were 23, 13, and 5 times more likely to have liver neoplasms, liver disease, and cardiomyopathy, respectively, than were decedents without hemochromatosis. Conversely, decedents with liver neoplasms, liver disease, and cardiomyopathy were 26, 14, and 5 times more likely, respectively, to have hemochromatosis than were decedents without these conditions. Hemochromatosis was 82 times more likely in persons with the combination of liver neoplasms and diabetes and 43 times more likely in those with the combination of liver disease and diabetes than in those without these conditions. Conclusions: Comparison of the reported prevalence of hemochromatosis among decedents with estimates of prevalence in the general U.S. population suggests that either the penetrance or the recognition of hemochromatosis, or both, is low. Nevertheless, substantial mortality resulting from liver disease, liver neoplasms, cardiomyopathy, and a combination of liver disease and diabetes in patients with hemochromatosis argues for the improved diagnosis and treatment of hemochromatosis in persons with these conditions.