tbuckley/cabot-search huggingface dataset:
Physician need. An alternative projection from a study of large, prepaid group practices
Authors: R. Mulhausen
Journal: JAMA (1989)

To model a base level of physician demand in a managed health care system, we examined in 1983 the ratios by specialty of full-time equivalent physicians to health maintenance organization members in seven large, closed-panel health maintenance organizations, each with more than 100 000 members. The medical director of each plan was surveyed by mailed questionnaire and telephone interview to determine the plan's number of full-time equivalent physicians by specialty and members served. Out-of-plan physicians contracted by the group were included within the specialty distribution wherever possible. We compared our findings (4779.4 full-time equivalent physicians serving 4 297 790 members) with Graduate Medical Education National Advisory Committee and others' projections of physician need and supply. Based on this model and unknowns that might affect utilization, our study suggests that at least 111 physicians per 100 000 population would be necessary in a system that emphasized reduced utilization of services and that more primary care physicians would be needed than the Graduate Medical Education National Advisory Committee predicted would be available. (<i>JAMA</i>. 1989;261:1930-1934)
The Treatment of Type II Diabetes in Texas: Current issues for managed care and employers
Authors: Jaime A Davidson
Journal: Diabetes Care (1997)

In 1995, a forum was held in Dallas, Texas, to discuss the current state of treatment for type II diabetes and the issues facing managed care organizations (MCOs) and employers. Attendees included representatives from the American Diabetes Association (ADA), diabetologists, medical directors from leading MCOs in the area, benefits managers and employee representatives from large corporations in the region, diabetes educators, and a range of health care personnel directly involved in the care and treatment of patients with type II diabetes. The objectives of the forum were to discuss the state of diabetes treatment from the perspectives of MCOs and employers, to create a better understanding of the issues in treating diabetic patients, and to reach a consensus on the standards of care and the treatment guidelines for managed care patients with diabetes. Several needs were agreed on and identified by the attendees, including the need to develop minimum standards of care for the management of diabetes care, to improve patient and physician education programs and the communication between MCOs and employers, to acquire more sophisticated outcomes data, to pursue aggressive treatment of hyperglycemia, to increase emphasis on managing care to achieve long-term cost savings, and to stress greater patient responsibility for their own care.
Double dipping: the new challenge for health and safety
Authors: Fred Kavalier
Journal: BMJ (2008)

The pervasive influence of evidence based medicine is about to invade tapas bars and cocktail parties.

Scientists from Clemson University in South Carolina have discovered that double dipping, the practice of dipping a single tortilla chip into the guacamole more than once, is a good way to transfer bacteria from one person to another.

Double dipping first came to prominence in the 1990s in the US television series Seinfeld . A character in the series is confronted with …
Follow-up of Wheezing in Preschool Children from São Paulo and Maceió, Brazil: International Study of Wheezing in Infants - phase 2
Authors: A.C.C. Dela Bianca, M.L. Medeiros, G.F. Wandalsen, F.J. Soares, J. Mallol, D. Sole
Journal: Journal of Allergy and Clinical Immunology (2012)
TCTAP A-140 Manual Vacuum Thrombextraction (MVT) Combined with Endovascular Angioplasty of the Infarct-related Coronary Artery (IRA) for the Management of STEMI Patients After Pre-hospital Systemic Thrombolytic Therapy (TLT)
Authors: David G. Iosseliani, Anton Koledinsky, Ilya Kovalchuk, Dmitry Kurtasov, Mohammed Matini, Pavel Vasiliev
Journal: Journal of the American College of Cardiology (2014)
PI3-K/AKT/FKHR and MAPK signaling cascades are redundantly stimulated by a variety of cytokines and contribute independently to proliferation and survival of multiple myeloma cells
Authors: S Lentzsch, M Chatterjee, M Gries, K Bommert, H Gollasch, B Dörken, R C Bargou
Journal: Leukemia (2004)
"TREATMENT OF MIGRAINE WITH PEPTONE"
Authors: J. Arthur Buchanan
Journal: JAMA (1923)

<h3>To the Editor:</h3> —The article by Miller and Raulston on the "Treatment of Migraine with Peptone" (The Journal, June 30, p. 1894) interested me very much. The note of warning by the Council on Pharmacy and Chemistry is of vast importance. Miller and Raulston say, "Migraine... is distinctly hereditary." Surely a physician must have a high regard for medication and a low regard for fundamental biologic processes as expressed in hereditary characters when he suggests that a hereditary character can be removed by a few intravenous injections of a preparation of peptone. The phenomena of migraine do the bearer no permanent harm. In fact, it is absurd to recommend treatments for hereditary characters. Migraine is hereditary, and is transmitted between generations in exact compliance with the two laws of Mendel. Heredity is a subdivision of physiology and not a subdivision of pathology. A person who receives from his ancestors an
Endosonographic Evaluation of the Patient with Achalasia: Appearance of the Esophagus using the Echoendoscope
Authors: J. Van Dam, G. W. Falk, M. V. Sivak, Jr., E. Achkar, T. W. Rice
Journal: Endoscopy (1995)

Endoscopic ultrasonography (EUS) provides high-resolution images of the esophageal wall and adjacent structures. The purpose of this study was to evaluate the usefulness of EUS using the echoendoscope in the evaluation of patients with achalasia.Seventeen patients with achalasia underwent esophagogastroduodenoscopy (EGD), esophageal manometery, and EUS. The esophageal wall thickness was measured endosonographically in four quadrants at the gastroesophageal junction (GEJ) and at 1 cm intervals proximally. Of the 17 patients evaluated, five had a tortuous esophagus (Group A) and 12 had a relatively straight esophagus (Group B). Six patients without esophageal symptoms served as controls (Group C).There was no significant difference in the mean esophageal wall thickness measured at the GEJ between the groups (4.0 mm, 3.3 mm, and 2.9 mm for Groups A, B, and C, respectively). Esophageal wall thickness was significantly greater in Group A than Group C when measured 2, 3, and 4 cm above the GEJ (4.2 mm vs. 2.8 mm; 4.1 mm vs. 2.4 mm; 4.0 mm vs. 2.4 mm, respectively) (p < .05). When measured 2 cm above the GEJ, the esophageal wall in Group A patients was significantly thicker (4.2 mm) than in patients in either Group B (3.2 mm) or Group C (2.8 mm) (p < 0.05).The appearance of esophageal wall thickening was common in patients with achalasia. Positioning of the echoendoscope in some patients with an irregularly-shaped, tortuous esophagus may result in tangential imaging and the production of artifacts simulating submucosal lesions. The production of such imaging artifacts suggests that caution must be exercise when EUS with the echoendoscope is used to evaluate patients with achalasia and a tortuous esophagus. Based on the present level of knowledge, EUS is not recommended in the routine evaluation of patients with achalasia.
The Occult Sciences in the Renaissance: A Study in Intellectual Patterns
Authors: Lester S. King
Journal: JAMA (1973)

A present-day physician, practicing "modern" scientific medicine, works within a rather specific intellectual framework. He may not realize that many quite different intellectual patterns have, at various times, exerted profound influence on thought and action generally and on medicine in particular. The occult sciences, for example, have shaped men's thoughts into patterns quite at variance with modern science. In the history of ideas, the occult occupies an important place and is not without presentday influence. Professor Shumaker has provided an interesting study of intellectual patterns in the Renaissance, the era when occult sciences were, perhaps, at their peak. With great scholarship he traces the doctrines and conflicts in five specific areas—astrology, witchcraft, white magic, alchemy, and the so-called Hermetic writings. He brings to his task vast learning and extensive reading in the primary sources. In his presentation he takes up the principal authors and many minor ones, and gives summaries,
HMO Market Penetration and Hospital Cost Inflation in California
Authors: James C. Robinson
Journal: JAMA (1991)

<h3>Objective.</h3> —Health maintenance organizations (HMOs) have stimulated price competition in California hospital markets since 1983, when the state legislature eliminated barriers to selective contracting by conventional health insurance plans. This study measures the impact of HMO-induced price competition on the rate of inflation in average cost per admission for 298 private, non-HMO hospitals between 1982 and 1988. <h3>Data.</h3> —HMO market penetration was calculated using discharge abstract data on insurance coverage, ZIP code of residence, and hospital of choice for 3.35 million patients in 1983 and 3.41 million patients in 1988. Data on hospital characteristics were obtained from the American Hospital Association and other sources. <h3>Results.</h3> —HMO coverage grew from an average of 8.3% of all admissions in local hospital markets in 1983 to 17.0% of all admissions in 1988. The average rate of growth in costs per admission between 1982 and 1988 was 9.4% lower in markets with relatively high HMO penetration compared with markets with relatively low HMO penetration (95% confidence interval, 5.2 to 13.8). Cost savings for these 298 hospitals are estimated at $1.04 billion for 1988. <h3>Conclusion.</h3> —Price competition between HMOs and conventional health insurers can significantly reduce hospital cost inflation if legislative barriers to selective contracting are removed. The impact of competition in California was modest, however, when evaluated in terms of the 74.5% average rate of California hospital cost inflation during these years. (<i>JAMA</i>. 1991;266:2719-2723)
Family Crisis and Psychosomatic Illness
Authors: Ida Cermak
Journal: Psychotherapy and Psychosomatics (1973)

Experiences of the past decades have shown us that, especially with psychosomatic illnesses classified as 'somatic neuroses', it is not enough to treat merely one member of the family through combined organic and psychiatric therapy, coupled with exercises in relaxation. If a patient who has been brought back to health is sent home to an unchanged pathological family situation, either the patient suffers a relapse or another member of the family becomes ill. The family presents its 'sick one' as a standard-bearer for a disturbed family structure in which very often a somatically healthy family member acts as the real psychotoxin. The attention of psychosomatic research has recently been highly concentrated on the relationship between the condition of the family circle and the psychosomatic illness of a member of that family and, therefore, on family therapy.
Student admits sending email with incorrect details about new journal
Authors: Z. Kmietowicz
Journal: BMJ (2009)

A student has claimed responsibility for the confusion surrounding a new medical journal that listed among its editorial board people who had never heard of the publication.

Devesh Oberoi, a former student of Kasturba Medical College in Mangalore, India, who describes himself as an “independent researcher,” has admitted that he sent an email that wrongly listed the BMJ ’s former editor Richard Smith among those on the editorial board of the journal Scientific Medicine .

Dr Oberoi was selected to be a student representative for Scientific Medicine and takes up the position from 1 March 2009. He said that he inadvertently copied a list of his mentor’s contacts into an email he sent to friends to publicise the journal, saying that they were members of the editorial board.

The list included the names of …
Alterations in carbohydrate composition of serum IgG from patients with rheumatoid arthritis and from pregnant women.
Authors: J M Pekelharing, E Hepp, J P Kamerling, G J Gerwig, B Leijnse
Journal: Annals of the Rheumatic Diseases (1988)

The carbohydrate composition of IgG purified from serum of patients with rheumatoid arthritis (RA), pregnant women, and blood donors has been determined by gas-liquid chromatography. Comparison of the results indicates that IgG from patients with RA contains significantly less galactose but more N-acetylglucosamine than normal IgG, whereas the fucose and sialic acid contents are not changed. The carbohydrate content of IgG in RA is reduced. IgG in pregnancy contains more galactose and more sialic acid than normal IgG, whereas fucose, N-acetylglucosamine, and the total carbohydrate content are not changed. These data suggest a temporal compensation of the RA associated undergalactosylation of IgG in female patients with RA during pregnancy, a period during which remission of the disease is often observed.
Contact Lens-related Deep Stromal intracorneal Hemorrhage
Authors: Eric D. Donnenfeld, Herbert Ingraham, Henry D. Perry, Marc Imundo, Leslie P. Goldberg
Journal: Ophthalmology (1991)

Deep corneal neovascularization is a recently described complication of contact lens wear.Visual loss associated with deep corneal neovascularization has been associated with stromal lipid leakage.Deep intracorneal hemorrhage is rare and has been documented infrequently with the use of contact lenses.The authors present five cases of deep stromal hemorrhage associated with contact lens-related deep corneal neovascularization.These patients had no other discernible cause for their vascularization and subsequent hemorrhage.One patient required a penetrating keratoplasty for visual rehabilitation.Contact lenses of all types may cause neovascularization.The deep stromal neovascularization develops insidiously and may progress in the absence of acute symptoms.The presence of deep stromal neovascularization must be watched carefully and managed as a potentially vision-threatening complication of contact lens use.
Coregulator Function: A Key to Understanding Tissue Specificity of Selective Receptor Modulators
Authors: Carolyn L. Smith, Bert W. O’Malley
Journal: Endocrine Reviews (2004)

Ligands for the nuclear receptor superfamily control many aspects of biology, including development, reproduction, and homeostasis, through regulation of the transcriptional activity of their cognate receptors. Selective receptor modulators (SRMs) are receptor ligands that exhibit agonistic or antagonistic biocharacter in a cell- and tissue context-dependent manner. The prototypical SRM is tamoxifen, which as a selective estrogen receptor modulator, can activate or inhibit estrogen receptor action. SRM-induced alterations in the conformation of the ligand-binding domains of nuclear receptors influence their abilities to interact with other proteins, such as coactivators and corepressors. It has been postulated, therefore, that the relative balance of coactivator and corepressor expression within a given target cell determines the relative agonist vs. antagonist activity of SRMs. However, recent evidence reveals that the cellular environment also plays a critical role in determining SRM biocharacter. Cellular signaling influences the activity and subcellular localization of coactivators and corepressors as well as nuclear receptors, and this contributes to gene-, cell-, and tissue-specific responses to SRM ligands. Increased understanding of the effect of cellular environment on nuclear receptors and their coregulators has the potential to open the field of SRM discovery and research to many members of the nuclear receptor superfamily.
A Comet-Tail Imaging Artifact Due to a "Hot" Point Source and Faulty Electronics
Authors: HEE-MYUNG PARK, AMY HUNT-REIMANN, C ROBERT APPLEDORN, ASLAM SIDDIQUI
Journal: Clinical Nuclear Medicine (1993)

Reported are two patient studies with very rare image artifacts associated with a “hot” point source in the injection site and faulty camera electronics. One was a Tc-99m MDP bone scan in a patient with a suspected bone tumor. The “hot” point source (infiltrated dose in his arm) caused an unusual linear artifact mimicking a comet-tail. When the “hot“ source was moved away, the artifact disappeared. Another was a lymphangiogram in a patient with unilateral leg edema. The “hot” point sources (Tc-99m sulfur colloid in the web spaces) in the feet caused similar artifacts. The artifact was unique for this particular manufacturer's camera (Raytheon Spectrum 150 DT, Hitachi, Japan) and was found to be from its faulty electronic signal positioning circuit and not from a defective collimator.
Podocyte injury underlies the progression of focal segmental glomerulosclerosis in the fa/fa Zucker rat
Authors: Nikolaus Gassler, Marlies Elger, Bettina Kränzlin, Wilhelm Kriz, Norbert Gretz, Brunhilde Hähnel, Hiltraud Hosser, Inge Hartmann
Journal: Kidney International (2001)
Malnutrition of the Medical Soul
Authors: John T. Laing
Journal: New England Journal of Medicine (1958)

"PROFESSOR Gemmill's† recent article on the British Health Service was an objective report by a person whose principal interest is economics. It seems fair, however, for the medical reader to know what the medical life of the service doctor is like, from one who has actually experienced it. Having worked for eight years as a general practitioner in the "free" health service of Mr. Aneurin Bevan, who vowed he would take the money out of medicine, I feel qualified to offer a supplement to Professor Gemmill's observations. This article considers patient and doctor alike.The "free" health service was part . . .
In Search of a Better HIV Vaccine — The Heat Is On
Authors: Elizabeth G. Phimister
Journal: New England Journal of Medicine (2003)

Pathogens employ a variety of methods to evade the immune response, and human immunodeficiency virus type 1 (HIV-1) is exceptionally capable in this regard. A recent study demonstrates why antibodies generated against the commonly exposed HIV-1 glycoprotein 120 are usually unable to prevent infection and, in so doing, uncovers a new means of viral evasion. The surface of glycoprotein 120 is remarkably flexible, making it difficult for antibodies to get a grip. This finding has implications for the development of an effective HIV-1 vaccine.
Increased incidence of cardiovascular disease in patients with rheumatoid arthritis: results from a community based study
Authors: C Turesson
Journal: Annals of the Rheumatic Diseases (2004)

<b>Objective:</b> To investigate the first-ever incidence of acute myocardial infarction and stroke in a community based RA cohort compared with the general population. <b>Methods:</b> The RA cohort consisted of all patients in a local RA register in Malmö, Sweden (n = 1022). The patients were recruited from private and hospital based rheumatology practices, and made up the absolute majority of patients with RA in the city. The general population of Malmö, aged 16 and above, served as controls. From the Swedish National Hospital Discharge Register and the national Swedish Causes of Death Register, information about all first-ever myocardial infarctions and strokes in Malmö residents between July 1997 and December 1999 was retrieved. The age and sex adjusted standardised morbidity ratio (SMR) of the two cohorts was calculated. <b>Results:</b> Fifty four patients with RA had first-ever myocardial infarctions or stroke during the study period, compared with 3862 subjects in the general population. The age and sex adjusted SMR was 161 (95% confidence interval (CI) 121 to 210). The first-ever incidence of cardiovascular disease was increased among female and male patients when studied separately. The increase of cardiovascular events in the RA cohort was mainly due to an excess of myocardial infarctions (n = 36; SMR = 176 (95% CI 123 to 244). <b>Conclusion:</b> Patients with RA in Malmö had an increased first-ever incidence of myocardial infarction or stroke compared with the general population. This confirms that cardiovascular comorbidity is of major importance in RA.
Reducing Door-to-Needle Time for tPA Use Remains an Elusive Goal in Stroke Care
Authors: Mike Mitka
Journal: JAMA (2011)

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
Perioperative and Long-term Results With Mapping-Guided Subendocardial Resection and Left Ventricular Endoaneurysmorrhaphy
Authors: Hassan Rastegar, Mark S. Link, Caroline B. Foote, Paul J. Wang, Antonis S. Manolis, N.A. Mark Estes
Journal: Circulation (1996)

Surgical ablation of the arrhythmogenic focus in patients with life-threatening ventricular tachyarrhythmias can be curative. However, the surgical techniques have been plagued by a high perioperative mortality rate (averaging approximately 12%). Reconstruction of the left ventricle may reduce mortality.Reconstruction of the left ventricle with a pericardial patch, or endoaneurysmorrhaphy, was performed with mapping-guided subendocardial resection for recurrent ventricular tachycardia in 25 patients over a 5-year period. Postoperatively, electrophysiological studies were conducted to assess the results of surgery, which were further evaluated during long-term follow-up with survival analyses. The study included 25 patients, 60 +/- 9 years of age, with coronary artery disease, discrete left ventricle aneurysms, and malignant ventricular tacharrhythmias. Left ventricular ejection fraction was 24 +/- 6% preoperatively. Left ventricular endocardial mapping, endocardial resection, and endoaneurysmorrhaphy were performed in all patients. There was no operative or postoperative (30-day) mortality. Postoperative ventricular tachycardia was induced in 2 of the 25 patients (8%); left ventricular function increased to 32 +/- 9% (range, 19% to 52%). At a mean follow-up of 37 +/- 16 months (range, 6 to 65 months), there had been 6 deaths, including 1 sudden cardiac death, 2 congestive heart failure deaths, and 3 noncardiac deaths. Analysis of multiple variables failed to identify predictors of postoperative inducibility, sudden cardiac death, cardiac death, or total mortality.Endoaneurysmorrhaphy with a pericardial patch combined with mapping-guided subendocardial resection frequently cures recurrent ventricular tachycardia with low operative mortality and improvement of ventricular function. Long-term follow-up demonstrates low sudden cardiac death rates.