tbuckley/cabot-search huggingface dataset:
The 'Medicaidization' of AIDS. Trends in the financing of HIV-related medical care
Authors: J. Green
Journal: JAMA (1990)

Among patients with the acquired immunodeficiency syndrome (AIDS) who were hospitalized in New York City, San Francisco, Calif, and Los Angeles, Calif, from 1983 through 1988, we observed a marked shift in the payer distribution toward Medicaid and away from private insurance. This trend, which we refer to as the "Medicaidization" of AIDS, occurred among whites as well as blacks and Hispanics and increased the burden on public hospitals and emergency rooms. "Medicaidization" jeopardizes access to office-based primary care because of very low reimbursement rates that are paid to physicians by Medicaid relative to private insurance. Policies designed to prevent the loss of employment-based private insurance would slow or reverse the trend to public financing. Increasing Medicaid reimbursement will improve access to care.Hospitalization rates for AIDS and HIV-related conditions in New York City, Los Angeles, and San Francisco from 1983 through 1988 were studied to determine trends in the funding of AIDS-related care. The authors noted that increasingly care has been financed through Medicaid rather than through private health insurers, and that this trend has occurred among white, black, and Hispanic patients. Study data also confirmed that the "Medicaidization" of AIDS affected access to care. Patients whose treatment was financed by Medicaid were more likely to enter public rather than private hospitals, and to be admitted via an emergency room rather than by a private physician. Green and Arno are concerned that "Medicaidization," which jeopardizes access to office-based primary care because of low physician reimbursement rates, will deny new life-prolonging therapies to many AIDS patients. They propose policies that would improve access to care by strengthening AIDS financing.
Psoriasis treated with clobetasol propionate and photochemotherapy
Authors: P. W. GOULD, LYN WILSON
Journal: British Journal of Dermatology (1978)

Comparable lesions in 16 patients with chronic plaque psoriasis were treated with clobetasol propionate or placebo ointments for 1 week before beginning photochemotherapy. The greater improvement of the steroid treated lesions was maintained after the ointment was withdrawn and there was a mean period of 31 days before those treated with placebo showed a comparable response to photochemotherapy. By the end of the study 8 patients were completely free of psoriasis, healing being achieved after a mean of 7.2 photochemotherapy treatments on the steroid treated lesions compared with 13.5 where a placebo ointment was used. No patient had any adverse reaction to treatment.
Looking for Adverse Reproductive Outcomes in 'Atomic Veterans': Are Such Studies Feasible?
Authors: Robert W. Miller
Journal: JAMA (1995)

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
Effects of a cholecystokinin receptor antagonist on intestinal phase of pancreatic and biliary responses in man.
Authors: P Hildebrand, C Beglinger, K Gyr, J B Jansen, L C Rovati, M Zuercher, C B Lamers, I Setnikar, G A Stalder
Journal: Journal of Clinical Investigation (1990)

The present study was designed (a) to characterize the activity of loxiglumide as a peripheral cholecystokinin (CCK) antagonist in healthy human subjects, and (b) to determine whether CCK is a physiologic regulator of the intestinal phase of meal-stimulated exocrine pancreatic and biliary secretions in man. Intravenous loxiglumide (22 mumol/kg per h) was highly potent in antagonizing CCK8-induced pancreatic enzyme and bile acid secretion as well as pancreatic polypeptide release. The potency and selectivity of loxiglumide as an antagonist of CCK provides the tool for evaluating the role of CCK as a physiological mediator of meal-induced pancreatic and biliary responses in humans. Infusion of a liquid test meal into the duodenum evoked an immediate response of pancreatic enzyme and bilirubin outputs, respectively. Intravenous loxiglumide significantly inhibited the meal-induced pancreatic amylase output by 63% (P less than 0.05), lipase output by 43% (P less than 0.05), and bilirubin output by 59% (P less than 0.05). These data suggest that CCK is a physiological mediator of the intestinal phase of meal-stimulated pancreatic and biliary responses.
Superoxide dismutase plus catalase improve contractile function in the canine model of the "stunned myocardium".
Authors: K Przyklenk, R A Kloner
Journal: Circulation Research (1986)

Fifteen minutes of coronary occlusion followed by reperfusion does not result in myocardial necrosis; however, the contractile function and high energy phosphate content of the previously ischemic myocardium remains depressed or "stunned" for several hours to days after reperfusion. Oxygen-derived free radicals have been implicated in ischemia and reperfusion-induced injury in a variety of tissues. We wished to determine whether administration of free radical scavengers superoxide dismutase plus catalase before and during occlusion, and throughout reperfusion, could attenuate the "stunning" produced by 15 minutes of left anterior descending coronary artery occlusion in anesthetized, open-chest dogs. Segment shortening in the previously ischemic zone recovered to within only +/- 10% of preinfusion values in the control group during 3 hours of reperfusion, while, in the treated dogs, segment shortening returned to a maximum of 56 +/- 16% of preinfusion at 1 1/2 hours post-reperfusion (P less than 0.0003 compared to controls). Similarly, superoxide dismutase + catalase-treated dogs exhibited improved wall thickening during reperfusion (+30% to +70% of preinfusion values), compared to controls (0% to +10%). However, this improvement in contractile function in the treated group was not accompanied by increased adenosine triphosphate stores in the previously ischemic zone (31.8 +/- 0.8 vs. 28.2 +/- 2.2 nmol/mg protein for control vs. treated groups). Infusion of superoxide dismutase + catalase did not influence blood flow during occlusion or reperfusion. However, the treated group did exhibit a significant decrease in blood pressure during reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS)
Glycosylated haemoglobin concentrations in newly diagnosed diabetics before and during treatment.
Authors: D M Fraser, A F Smith, R S Gray, D Q Borsey, M E Sinclair, B F Clarke, L J Duncan
Journal: BMJ (1979)

Concentrations of total glycosylated haemoglobins (Hb A1) were measured in 40 diabetics at diagnosis and at monthly intervals after treatment with chlorpropamide, insulin, or diet alone was begun. The mean Hb A1 concentration at presentation in 16 patients treated with chlorpropamide was significantly higher than that in 12 patients treated with insulin, and the duration of glycaemic symptoms was much longer in the chlorpropamide-treated group. In contrast, the mean plasma glucose concentration was similar in both groups. The mean concentrations of Hb A1 and plasma glucose at diagnosis in the 12 patients treated by diet alone were lower than those in the other two groups, and most of these patients were free of symptoms. Treatment quickly relieved symptoms and lowered plasma glucose in all patients. The Hb A1 concentration fell significantly with treatment such that after two months there was no significant difference between the three groups, although results remained above the normal range. These findings support the theory that the Hb A1 concentration reflects the blood glucose control over the previous one to two months and suggest that the duration of hyperglycaemia may be important in determining the Hb A1 concentration as well as the absolute blood glucose concentration.
Occupancy of dipeptidyl peptidase IV activates an associated tyrosine kinase and triggers an apoptotic signal in human hepatocarcinoma cells
Authors: Lucia Gaetaniello, Michele Fiore, Sergio de Filippo, Nicola Pozzi, Sonia Tamasi, Claudio Pignata
Journal: Hepatology (1998)

Dipeptidyl peptidase IV (CD26/DPP-IV) is an ectoenzyme expressed on different cell types. Signaling properties and functional consequences of the CD26 triggering have been elucidated mostly on T cells, where the molecule delivers a costimulatory signal that potentiates T-cell activation through the T-cell receptor. We conducted studies in the human hepatocarcinoma-derived PLC/PRF/5 cell line to examine the signal transduction through CD26 and its functional properties in the absence of other T-cell-specific membrane molecules. Engagement of CD26 in PLC/PRF/5 cells through a specific antibody induces tyrosine phosphorylation of several proteins with maximal intensity 15 minutes after the stimulation. This effect was under the negative regulatory control of CD45 tyrosine phosphatase, in that the addition of orthovanadate clearly enhanced the phosphorylation events. Using in vitro kinase assays with CD26 immunoprecipitates, we observed that a protein or proteins with kinase activity are coprecipitated with the CD26 molecule. In addition, unlike Jurkat T cells, in which CD26 expression exerts a protective effect against apoptosis, in PLC/PRF/5 cells CD26 occupancy delivers a potent apoptotic signal. This effect was also observed in HepG2 cells, thus indicating that it represents a more general phenomenon occurring in different liver neoplastic cell lines.
A Multicenter Study of Physicians' Knowledge of the Pulmonary Artery Catheter
Authors: Thomas J. Iberti, Ellen P. Fischer, Andrew B. Leibowitz, Edward A. Panacek, Jeffrey H. Silverstein, Timothy E. Albertson
Journal: JAMA (1990)

We administered a 31-question multiple-choice examination to 496 physicians practicing in 13 medical facilities in the United States and Canada to assess their knowledge and understanding of the use of the pulmonary artery catheter and interpretation of data derived from it. The mean test score was 20.7 (67% correct), with an SD of 5.4 and a range of 6 to 31 (19% to 100%). Mean scores varied independently by training, frequency of use of pulmonary artery catheter data in patient treatment, frequency of inserting a pulmonary artery catheter, and whether the respondent's hospital was a primary medical school affiliate. Given the variability in physician understanding of the pulmonary artery catheter, we believe that credentialing policies should be reevaluated and that consideration should be given to restricting its use to individuals with documented competency. (<i>JAMA</i>. 1990;264:2928-2932)
Brain Scans, Genes Provide Addiction Clues
Authors: Bridget M. Kuehn
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 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
Acquired pulmonary stenosis due to compression by a bronchiogenic cyst
Authors: M. Harris, M. O. Woo-Ming, C. G. Miller
Journal: Thorax (1973)

A case of pulmonary stenosis due to extrinsic compression of the pulmonary artery and right ventricular infundibulum is reported. It is believed that this is the first such case recorded in the English literature where the cause of the compression was a bronchiogenic cyst.
Parvovirus B19 infection induces apoptosis of erythroid cells in vitro and in vivo
Authors: Nobuo Yaegashi, Takenari Niinuma, Hiroshi Chisaka, Shigeki Uehara, Stanley Moffatt, Kohtaro Tada, Mitsunari Iwabuchi, Yasuko Matsunaga, Masahiro Nakayama, Chikao Yutani, Yoshiyuki Osamura, Emi Hirayama, Kunihiro Okamura, Kazuo Sugamura, Akira Yajima
Journal: Journal of Infection (1999)
The Switch Process in Manic-Depressive Psychosis
Authors: WILLIAM E. BUNNEY
Journal: Annals of Internal Medicine (1977)

Bipolar manic-depressive illness is a chronic disease in which patients experience recurrent episodes of mania and depression. Patients often change from a nonverbal, retarded depression of many months' duration to a hyperactive, psychotic, manic condition during the switch. The time required for the switch from depression into mania varies from 5 minutes to a couple of days. Just before it happens, patients experience marked insomnia and decreased rapid eye movement sleep. It is hypothesized that specific changes in brain monoamine metabolism precede the switch. Alterations in neurotransmitter metabolites, as measured in urine and cerebrospinal fluid, may precede and accompany it. The switch into mania can be precipitated by environmental stresses or by drugs that act by increasing functional brain monoamines. Drugs that reverse the manic state all share the common property of affecting biogenic amines. The switch into mania is viewed in the context of a longitudinal cyclic process and may be further studied with specific pharmacologic agents that block drug-induced maniclike states in man.
Circulating Anticoagulants Against Factors IX and XI in Systemic Lupus Erythematosus
Authors: OSWALDO CASTRO
Journal: Annals of Internal Medicine (1972)

In four patients with systemic lupus erythematosus and unusual circulating anticoagulants the partial thromboplastin time of normal plasma was prolonged by the patient's plasma, but the prothrombin time was normal. Low plasma levels of factor IX in one case and of factor XI in two cases were the only coagulation abnormalities, suggesting that the anticoagulant was directed against these factors. In the fourth patient, assay values of factors V, VIII, IX, and X were not low enough to explain the prolonged partial thromboplastin time. Adequate contact product was found, but the patient's plasma had anticoagulant activity against her own and normal contact product. This interfered with assays of factors XI and XII; we believe that in this patient the anticoagulant was directed against activated factor XI. In two cases there was significant bleeding. Treatment with prednisone and immunosuppressive agents resulted in disappearance of the clotting abnormalities.
Climate Cycles and Forecasts of Cutaneous Leishmaniasis, a Nonstationary Vector-Borne Disease
Authors: Luis Fernando Chaves, Mercedes Pascual
Journal: PLoS Medicine (2006)

Background Cutaneous leishmaniasis (CL) is one of the main emergent diseases in the Americas. As in other vector-transmitted diseases, its transmission is sensitive to the physical environment, but no study has addressed the nonstationary nature of such relationships or the interannual patterns of cycling of the disease. Methods and Findings We studied monthly data, spanning from 1991 to 2001, of CL incidence in Costa Rica using several approaches for nonstationary time series analysis in order to ensure robustness in the description of CL's cycles. Interannual cycles of the disease and the association of these cycles to climate variables were described using frequency and time-frequency techniques for time series analysis. We fitted linear models to the data using climatic predictors, and tested forecasting accuracy for several intervals of time. Forecasts were evaluated using "out of fit" data (i.e., data not used to fit the models). We showed that CL has cycles of approximately 3 y that are coherent with those of temperature and El Niño Southern Oscillation indices (Sea Surface Temperature 4 and Multivariate ENSO Index). Conclusions Linear models using temperature and MEI can predict satisfactorily CL incidence dynamics up to 12 mo ahead, with an accuracy that varies from 72% to 77% depending on prediction time. They clearly outperform simpler models with no climate predictors, a finding that further supports a dynamical link between the disease and climate.
Prognostic factors in Sezary syndrome: a study of 28 patients
Authors: P. Foulc, J.M. N'Guyen, B. Dreno
Journal: British Journal of Dermatology (2003)

The new European Organization for Research and Treatment of Cancer classification considers Sézary syndrome (SS) among the aggressive epidermotropic cutaneous T-cell lymphomas (ECTLs). Recent technological advances have facilitated the diagnosis of this disease, but it remains practically incurable, with a median survival of about 2.5-5 years. Deaths are due in part to the iatrogenic effects of treatments, which suggests that the management of SS could be improved.Retrospectively to study the prognostic criteria related to disease progression.Thirty patients with SS were followed up in the Dermatology Department of the University Hospital in Nantes, France, between January 1989 and May 2000. The diagnosis of SS was based on at least three of the following criteria: erythroderma, histological evidence of ECTL, a level of 20% or more circulating Sézary cells, and loss of My7 antigen expression by basal cells of the epidermis. Two patients not seen again after the initial diagnosis were excluded from the statistical study.The median disease-specific survival of the 28 patients was 64.55 +/- 10.11 months. The prognostic factors found in univariate analysis were age at diagnosis (P = 0.0109), interval before diagnosis (P = 0.0566), lactate dehydrogenase (LDH) level (P = 0.042) and presence of the Epstein-Barr virus (EBV) genome (BHLF in in situ hybridization) in skin (P = 0.0079). The prognostic factors found in multivariate analysis were age, interval before diagnosis and presence of the EBV genome in keratinocytes. A decreased number of Langerhans cells in the epidermis did not appear to be a prognostic factor.Our study confirms the prognostic value of age and LDH level, and for the first time demonstrates the prognostic value of the identification of the EBV genome in the skin. This seems consistent with a marked immune deficit during severe forms of SS.
Chronic HIV Infection
Authors: Benjamin Jacobs, David M. Aboulafia
Journal: Annals of Internal Medicine (2003)

Letters4 March 2003Chronic HIV InfectionBenjamin Jacobs and David M. Aboulafia, MDBenjamin JacobsVirginia Mason Medical Center; Seattle, WA 98111 (Jacobs, Aboulafia)Search for more papers by this author and David M. Aboulafia, MDVirginia Mason Medical Center; Seattle, WA 98111 (Jacobs, Aboulafia)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-138-5-200303040-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Highly active antiretroviral therapy (HAART) has had a profound influence on the natural history of HIV infection but does not lead to HIV eradication (1). More conservative approaches to treatment have been suggested because of the complex nature of the regimens, the high cost of therapy, and lifestyle issues (2). Furthermore, with continued exposure to HAART, patients have begun to experience myriad unexpected adverse events, including redistribution of body fat, lipid and bone disorders, cardiovascular complications, and lactic acidosis (3). Without near-perfect adherence, patients may also incur therapy-associated mutations that may compromise long-term viral suppression.We initiated ...References1. Palella FJ, Delaney KM, Moorman AC, Loveless MO, Fuhrer J, Satten GA, . Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection. HIV Outpatient Study Investigators. N Engl J Med. 1998;338:853-60. [PMID: 9516219] CrossrefMedlineGoogle Scholar2. Yeni PG, Hammer SM, Carpenter CC, Cooper DA, Fischl MA, Gatell JM, . Antiretroviral treatment for adult HIV infection in 2002: updated recommendations of the International AIDS Society-USA Panel. JAMA. 2002;288:222-35. [PMID: 12095387] CrossrefMedlineGoogle Scholar3. Carr A, Cooper DA. Adverse effects of antiretroviral therapy. Lancet. 2000;356:1423-30. [PMID: 11052597] CrossrefMedlineGoogle Scholar4. Kane B. Chronic HIV infection: can anyone afford a drug holiday? Ann Intern Med. 2002;137:301-4. [PMID: 12186535] LinkGoogle Scholar5. Tebas P, Henry K, Mondy K, Deeks S, Valdez H, Cohen C, . Effect of prolonged discontinuation of successful antiretroviral therapy on CD4+ T cell decline in human immunodeficiency virus-infected patients: implications for intermittent therapeutic strategies. J Infect Dis. 2002;186:851-4. [PMID: 12198623] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Virginia Mason Medical Center; Seattle, WA 98111 (Jacobs, Aboulafia) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoChronic HIV Infection: Can Anyone Afford a Drug Holiday? Brigid Kane Metrics 4 March 2003Volume 138, Issue 5Page: 437-438KeywordsAdverse eventsBoneHIVHIV infectionsHighly active antiretroviral therapyLactic acidosisLipidsMutationProspective studiesViral load ePublished: 4 March 2003 Issue Published: 4 March 2003 CopyrightCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Noninvasive assessment of atrioventricular pressure half-time by Doppler ultrasound.
Authors: L Hatle, B Angelsen, A Tromsdal
Journal: Circulation (1979)

The mean pressure drop across the mitral valve and atrioventricular pressure half-time were measured noninvasively by Doppler ultrasound in 40 normal subjects, in 17 patients with mitral regurgitation, 32 patients with mitral stenosis and 12 with combined stenosis and regurgitation. In normal subjects pressure half-times were 20--60 msec, in patients with isolated mitral regurgitation 35--80 msec and in patients with mitral stenosis 90--383 msec. There was no significant change in pressure half-time with exercise or on repeat examinations, indicating relative independence of mitral flow. In 25 patients with mitral stenosis and seven with combined stenosis and regurgitation, pressure half-time was related to mitral valve area calculated from catheterization data. Increasing pressure half-times occurred with decreasing mitral valve area, and this relationship was not influenced by additional mitral regurgitation. Noninvasive measurement of pressure half-time together with mean pressure drop was useful for evaluating patients with mitral valve disease.