tbuckley/cabot-search huggingface dataset:
Opportunities for Quality Measurement to Improve the Value of Care for Patients With Multiple Chronic Conditions
Authors: Arjun K. Venkatesh, Kate Goodrich, Patrick H. Conway
Journal: Annals of Internal Medicine (2014)

Quality measurement efforts have not historically focused on patients with multiple chronic conditions (MCCs), despite them comprising one quarter of the population and two thirds of health care spending. The Patient Protection and Affordable Care Act (ACA) creates several mechanisms for the Centers for Medicare & Medicaid Services (CMS) to transform quality measurement into an organized enterprise designed to support clinicians caring for this vulnerable population. This article highlights 3 emerging policy opportunities for CMS to guide public and private quality measurement efforts for patients with MCCs. First, it discusses infusing an MCC framework into measure development to promote patient-centered, as opposed to single-disease-specific, performance measurement. Second, it describes the importance of using common performance measures for individual clinicians, hospitals, and communities to accelerate meaningful improvement in the prevention and management of chronic conditions across local populations. Finally, the need for longitudinal measurement as a foundation for sustained quality improvement is presented. The ACA's expansion of insurance access and portability necessitates collaborative alignment of chronic condition quality measurement efforts between public and private programs to develop a high-value lifelong health system.
Long-Term Follow-Up After Radiofrequency Modification of the Atrioventricular Node in Patients With Atrial Fibrillation
Authors: Fred Morady, Carol Hasse, S.Adam Strickberger, K.Ching Man, Emile Daoud, Frank Bogun, Rajiva Goyal, Mark Harvey, Bradley P Knight, Raul Weiss, Marwan Bahu
Journal: Journal of the American College of Cardiology (1997)
Universal Screening and Drug Treatment of Dyslipidemia in Children and Adolescents
Authors: Bruce M. Psaty, Frederick P. Rivara
Journal: JAMA (2011)

VER THE LAST FEW DECADES, THE THEORY THAT adultdiseasesbegininchildhoodhasbeenwidely discussed.Smoking,themostcommonunderlyingcauseofdeathforadultsintheUnitedStates, beginsbeforetheageof18yearsinthemajorityofadultsmokers. Obesity has become the largest health problem in the United States, and the difficulty of long-term weight loss for obesechildrenandadolescentsmeansthatmanyofthemwill beoverweightasadults.Therationaleforconsideringcardiovascular disease prevention efforts in childhood is compelling. Not only do risk factors track from childhood into adult life, but the development and progression of atherosclerosis, whichoftenstartsinchildhood,arealsodirectlyrelatedtothe number of risk factors and their severity. The recent report of the National Heart, Lung, and Blood Institute(NHLBI)ExpertPanelonIntegratedGuidelinesfor CardiovascularHealthandRiskReductioninChildrenandAdolescents 1 reviewsallthemajorcardiovasculardiseaseriskfactors and makes recommendations about their management. There is good evidence for the recommendations on screening for tobacco use and hypertension during childhood and adolescencetopreventlatercardiovasculardisease.Themost controversialrecommendationislikelytobeuniversalscreeningforlipidlevelsinchildrenat9to11yearsofageandagain at17to21yearsofage.InthenewNHLBIguidelines,highlevelsoflipidsinchildrenarelinkedtorecommendationsabout bothbehavioralanddrugtherapies.Therobustevidencethat high levels of low-density lipoprotein (LDL) cholesterol are a cause of atherosclerosis and clinical events is not matched bysimilarlevelsofevidencethatlong-term,perhapslifelong, drug treatment in young children is effective and safe. In adults, the health benefits of statins are well demonstrated. In a meta-analysis of 10 primary prevention clinical trials, statin use was associated with a 30% reduction (95% CI, 19%-39%) in coronary events and a 12% reduction (95% CI, 4%-19%) in total mortality. 2 Recent trials, meta-analyses, andlipidtreatmentguidelinessupportnotonlymoreaggressivestatintherapyinhigh-riskindividualsbutalsotheexpan
Treatment of Tobacco Addiction: Experiences in Tobacco Withdrawal Clinics.
Authors: Borje Ejrup
Journal: Annals of Internal Medicine (1964)

s1 April 1964Treatment of Tobacco Addiction: Experiences in Tobacco Withdrawal Clinics.Borje Ejrup, M.D.Borje Ejrup, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-60-4-736_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo support clinically patients with cardiovascular diseases in their efforts to stop smoking, a series of studies was undertaken at the Karolinska Hospital in Stockholm, Sweden, in November, 1955. An astonishingly large group of smokers with miscellaneous symptoms brought about by their smoking habits applied for the treatment. Therefore, a special outpatient clinic was started in February of 1956.Results of systematic testing focused the program more on the mind than on the soma. Smoking appeared to be mostly psychological addiction. Needed was a treatment that was reliable, capable of being adapted to the particular needs of the individual patient,... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMethods for Stopping Cigarette SmokingHEALTH AND PUBLIC POLICY COMMITTEESmoking-Withdrawal Clinics 1 April 1964Volume 60, Issue 4Page: 736-736KeywordsCardiovascular diseasesOutpatient clinicsSmoking habits Issue Published: 1 April 1964 PDF downloadLoading ...
Pretherapeutic Dosimetry in Patients Affected by Metastatic Thyroid Cancer Using 124I PET/CT Sequential Scans for 131I Treatment Planning
Authors: Cinzia Pettinato, Emiliano Spezi, Cristina Nanni, Gaia Grassetto, Fabio Monari, Vincenzo Allegri, Simona Civollani, Simona Cima, Paolo Zagni, Renzo Mazzarotto, Patrick M. Colletti, Domenico Rubello, Stefano Fanti
Journal: Clinical Nuclear Medicine (2014)

Purpose This study evaluates the use of sequential 124I PET/CT for predicting absorbed doses to metastatic lesions in patients with differentiated thyroid cancer undergoing 131I therapy. Methods From July 2011 until July 2013, 30 patients with metastatic differentiated thyroid cancer were enrolled. Each participant underwent PET/CT at 4, 24, 48, and 72 hours with 74 MBq of 124I. Blood samples and whole-body exposure measurements were obtained to calculate blood and red marrow doses. Activity concentrations and lesion volumes obtained from PET/CT were used to evaluate tumor doses with medical internal radiation dose formalism and spheres modeling. Mean administered 131I therapeutic dose was 5994 MBq (range, 1953–11,455 MBq). Results 124I PET/CT demonstrated all lesions detected by posttherapy 131I whole-body scans. Mean dose rates for blood, red marrow, and lesions were as follows: 0.07 ± 0.02 mGy/MBq, 0.05 ± 0.02 mGy/MBq, and 46.5 ± 117 mGy/MBq, respectively. Despite the high level of thyroid-stimulating hormone and CT detectable lesions, 15 of 30 patients did not show any abnormal 124I uptake. Conclusions The quantitative value of 124I PET/CT allows simple and accurate evaluation of lesion dosimetry following medical internal radiation dose formalism. Negative 124I PET/CT predicts absence of iodine avidity, potentially allowing avoidance of therapeutically ineffective 131I administration.
Pharmaceutical Houses and the Doctor
Authors: S. J. Hartfall
Journal: BMJ (1958)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Pharmaceutical Houses and the Doctor Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Doctors on the dole
Authors: D. Spence
Journal: BMJ (2010)

The effects of several enological practices on ochratoxin A (OTA) concentration in wines were evaluated. Analysis of OTA was performed by reverse-phase high-performance liquid chromatography (HPLC) after immunoaffinity cleanup. Higher toxin levels were found in red wines (0.017 to 0.050 μg/L) than white wines (0.006 to 0.022 μg/L). Intensive pressing of pomace, prolonged drying of grapes, and storage in partially empty tanks increased OTA contamination of wines. Poor winery sanitation practice was the primary source of OTA contamination, as wines from contaminated wineries had the highest OTA values (0.130 to 1.300 μg/L). Filtration through a 10-μm membrane and heating on hot plates at 55°C did not cause a significant decrease in the toxin level. An 80% decrease of OTA was observed after wine filtration through a 0.45-μm membrane (<i>p</i> &lt; 0.05). Eleven enological fining agents were tested to study their ability to remove OTA from wine. Enological decolorizing carbon removed (at 30 g/hL) up to 72% of OTA. The Freundlich isotherm was used to model OTA adsorption on carbon. Results showed that carbon had selective adsorption (K<sub>F</sub> = 3.172 (mg/g)/(mg/L)<sup>0.8474</sup>), but it did not affect polyphenol content and color of red wine. Nevertheless, a decrease of key sensory odorants of wine, such as 3-methylbutyl acetate, ethyl hexanoate, ethyl octanoate, and geraniol, was observed.
False-Negative Cryptococcal Antigen Test
Authors: Alan M. Stamm
Journal: JAMA (1980)

THE LATEX slide agglutination (LA) test for cryptococcal antigen in the CSF is more sensitive than the India ink preparation for diagnosing cryptococcal meningitis<sup>1,2</sup>and is the most widely used immunologic test for this disease. We describe here a previously unreported cause of negative LA test results in CSF in a patient with cryptococcal meningitis. <h3>Report of a Case</h3> A 64-year-old man with rheumatoid arthritis receiving 15 mg of prednisone daily had a fever, headache, confusion, and vertigo of three weeks' duration. Initial physical examination demonstrated delirium and meningismus. Lumbar puncture showed an opening pressure of 360 mm of CSF; glucose level, 49 mL/dL; protein level, 105 mg/dL; and WBC count, 40/cu mm. India ink preparation showed many budding yeast with thick capsules. The LA test results for cryptococcal antigen in CSF were initially reported as negative. The CSF cultures subsequently grew tan colonies of budding yeast that were
RESULTS OF BONE PLASTIC AND GRAFT OPERATIONS ON THE SPINE FOR THE CURE OF POTT'S DISEASE
Authors: JOHN JOSEPH NUTT
Journal: JAMA (1913)

In assuming the position of surgeon to Sea Breeze Hospital in November, 1912, I received under my care ten patients who had been operated on for tuberculous disease of the spine. Five other patients who had been operated on and discharged have been examined by me, some of them several times. Thus I have had the opportunity to study the results in fifteen cases. Fully realizing the importance of correctly interpreting these results, on account of the influence this report may possibly have in either deterring others from or encouraging them to adopt these operations, I have attempted a tabulation of all the factors which are of value in reaching a conclusion in each case and present copies of the tracings of the kyphoses taken from the history sheets. After a study of the temperature charts, it did not seem worth while to reproduce them. The rise and fall for months
O9.04 * HIGH GRADE GLIOMAS AND CAREGIVERS' PSYCHOLOGICAL BURDEN
Authors: A. Petruzzi, C. Y. Finocchiaro, G. Vistalli, A. Botturi, I. Milanesi, A. Silvani, E. Lamperti
Journal: Neuro-Oncology (2014)

The diagnosis of a brain tumor is particularly stressful both for patients and their caregivers because the prognosis is poor and life expectancy is short. This is especially true when caregivers deal with high-grade gliomas (HGG). Despite treatment advances, median survival remains low, ranging from 1 to 5 years. Focal neurological deficits, epilepsy, cognitive dysfunction and symptoms of increased intracranial pressure are prominent symptoms in HHG and they may arise in any stage of the disease. Moreover, fatigue, mood disturbance, and anxiety are often reported. All these factors negatively affect patients' and caregivers' overall quality of life. Few studies have investigated, to date, the quality of life of the caregivers who take care of HGG patients. Thus, we sought to evaluate their quality of life and their specific reactions to caregiving. We recruited 91 caregivers of HGG patients. We used the following questionnaires in order to detect quality of life, anxiety, depression and specific reactions to patients' disease: 36-Item Short-Form Health Survey (SF-36), Hospital Anxiety and Depression Scale (HADS), Caregiver Reaction Assessment Scale (CRA). These psychological questionnaires were administered in the form of an interview by a psychologist. The present study shows that caregivers experience higher levels of anxiety (t (90) = 11.3, p < .01) and depression (t (90) = 9.26, p < .01) than the normative sample. Also caregivers' mental health (“Vitality”, “Social Functioning”, “Role-Emotional”, “Mental Health”) appeared to be compromised as compared to the normative sample. As specific reactions to caregiving our caregivers presented “loss of physical strength” and “financial problems”. Caregiving experience did not negatively influence “caregivers' self-esteem”, “lack of family support” and “disrupted schedule”. Although a highly positive perception of the caregivers' self-esteem is reported, the impact of HGG diagnosis seems to be indeed profound. Such diagnosis affected caregivers' psychological well-being and their ability and energy to provide care and financial strain. Therefore, this study underlines the necessity to take into account caregivers' emotional unease in order to support them during the various stages of patients' disease trajectory.
Blood bank officials hope donor altruism will pass new (anti-HCV) test
Authors: M. F. Goldsmith
Journal: JAMA (1990)

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
Oleogranuloma of the rectum produced by Lasonil ointment.
Authors: M G Greaney, P R Jackson
Journal: BMJ (1977)

three patients with ulcers and sutures.In only one patient did the ulcer heal, but it recurred three months later without a visible suture.Sutures were removed from 18 patients without ulcers.In 17 symptoms improved initially, but in 13 symptoms had recurred within three months.Six of these patients were later selected for bile-diversion surgery.One year after this operation five of these patients were cured of their dyspepsia or vomiting, although four still had sutures visible at endoscopy.Peak acid output (mmol/hour) in 24 patients matched in three groups; those with ulcers with sutures, ulcers alone, and sutures alone PAO after pentagastrin (6 ,ugjkg) Operation Suture and ulcer Ulcer alone Suture aloneVagotomy and pyloroplasty 14 7 36 1 5.1Vagotomy and pyloroplasty 18-0 28-6 2 1Vagotomy and pyloroplasty 22 2 20 7 2-6 Vagotomy and pyloroplasty 26 3 23.0
Poliovirus tropism and attenuation are determined after internal ribosome entry
Authors: Steven E. Kauder, Vincent R. Racaniello
Journal: Journal of Clinical Investigation (2004)

Poliovirus replication is limited to a few organs, including the brain and spinal cord. This restricted tropism may be a consequence of organ-specific differences in translation initiation by the poliovirus internal ribosome entry site (IRES). A C-to-U mutation at base 472 in the IRES of the Sabin type 3 poliovirus vaccine strain, known to attenuate neurovirulence, may further restrict tropism by eliminating viral replication in the CNS. To determine the relationship between IRES-mediated translation and poliovirus tropism, recombinant human adenoviruses were used to express bicistronic mRNAs in murine organs. The IRESs of poliovirus, the cardiotropic coxsackievirus B3 (CVB3), and the hepatotropic hepatitis C virus (HCV) mediate translation in many organs, including those that do not support viral replication. A translation defect associated with the Sabin type 3 IRES was observed in all organs examined. Poliovirus type 1 and recombinant polioviruses dependent on the IRES of CVB3 or HCV replicate in the CNS of mice and cause paralysis. Although the type 3 Sabin strain is an effective vaccine, polioviruses with a U at base 472 of the IRES cause paralysis in newborn mice. Tropism of wild-type and vaccine strains of poliovirus is therefore determined after internal ribosome entry.
Pulmonary-Flow (Swan-Ganz) Catheter in a Coronary Care Unit
Authors: ARI ZIMRAN
Journal: Annals of Internal Medicine (1986)

Letters and Corrections1 February 1986Pulmonary-Flow (Swan-Ganz) Catheter in a Coronary Care UnitARI ZIMRAN, MADY S. MORIEL, NERI WEISBERG, MONTY M. ZIONARI ZIMRANSearch for more papers by this author, MADY S. MORIELSearch for more papers by this author, NERI WEISBERGSearch for more papers by this author, MONTY M. ZIONSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-104-2-284_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: We found the article by Robin (1) on the overuse and abuse of pulmonary flow catheters interesting and would agree that knowledge of risk-benefit ratios is sadly lacking. However, as noted by the author, the originators of the catheter have expressed doubt as to the practicability of randomized trials to prove the effectiveness of, or to provide guidelines for, usage of the catheter (2).Much of Robin's criticism is based on the use of the catheter in critically ill patients in general intensive care units. He has not indicated that the risks of the procedure might differ...References1. ROBIN E. The cult of the Swan-Ganz catheter: overuse and abuse of pulmonary flow catheters. Ann Intern Med. 1985;103:445-9. LinkGoogle Scholar2. SWANGANZ HL. Hemodynamic measurements in clinical practice: a decade in review. J Am Coll Cardiol. 1983;1:103-13. CrossrefMedlineGoogle Scholar3. SPRUNGJACOBSCARALISKARPF CLPM. Ventricular arrhythmias during Swan-Ganz catheterisation of the critically ill. Chest. 1981;79:413-5. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Shaare Zedek Medical Center Jerusalem, Israel PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Swan-Ganz Catheter: A decade of hemodynamic monitoring 1 February 1986Volume 104, Issue 2Page: 284-284KeywordsCardiac care unitCathetersIntensive care unitsRandomized trials Issue Published: 1 February 1986 PDF downloadLoading ...
Cyclin D1 overexpression promotes cardiomyocyte DNA synthesis and multinucleation in transgenic mice.
Authors: M H Soonpaa, G Y Koh, L Pajak, S Jing, H Wang, M T Franklin, K K Kim, L J Field
Journal: Journal of Clinical Investigation (1997)

D-type cyclin/cyclin-dependent kinase (CDK) complexes regulate transit through the restriction point of the cell cycle, and thus are required for the initiation of DNA synthesis. Transgenic mice which overexpress cyclin D1 in the heart were produced to determine if D-type cyclin deregulation would alter myocardial development. Cyclin D1 overexpression resulted in a concomitant increase in CDK4 levels in the adult myocardium, as well as modest increases in proliferating cell nuclear antigen and CDK2 levels. Flow cytometric and morphologic analyses of dispersed cell preparations indicated that the adult transgenic cardiomyocytes had abnormal patterns of multinucleation. Histochemical analyses confirmed a marked increase in number of cardiomyocyte nuclei in sections prepared from the transgenic mice as compared with those from control animals. Tritiated thymidine incorporation analyses revealed sustained cardiomyocyte DNA synthesis in adult transgenic hearts.
Complement activation within the coeliac small intestine is localised to Brunner's glands.
Authors: R B Gallagher, C P Kelly, S Neville, O Sheils, D G Weir, C F Feighery
Journal: Gut (1989)

Complement activation may play an important role in the pathogenesis of coeliac disease. In the present study immunohistochemical localisation of C3 and of a neoantigen exposed only on the terminal C5b-9 complement complex has been performed on small intestinal biopsy sections from newly diagnosed untreated coeliac patients, from coeliac patients on long-term gluten-free diet and from disease controls. Levels of C3 were markedly increased in treated coeliac patients compared with controls. Staining of C3 was concentrated subepithelially and within the centre of the lamina propria. No staining was detected at these sites using antibody to the neoantigen, however, strongly suggesting that the increased levels of C3 seen in the coeliac patients was the result of increased extravasation of serum proteins rather than complement activation. Surprisingly, complement activation was detected within the glands of Brunner. Positive staining using anti-C5b-9 neoantigen was found in all coeliac patients, both treated and untreated. Three of the 13 disease controls also showed reactivity with this antibody. This novel finding suggests that Brunner9s glands, hitherto largely neglected structures, may play an important role in the development of coeliac disease.
Demonstration That C-Reactive Protein Decreases eNOS Expression and Bioactivity in Human Aortic Endothelial Cells
Authors: Senthil Kumar Venugopal, Sridevi Devaraj, Ivan Yuhanna, Philip Shaul, Ishwarlal Jialal
Journal: Circulation (2002)

C-reactive protein (CRP), the prototypic marker of inflammation, has been shown to be an independent predictor of cardiovascular events. Endothelial nitric oxide synthase (eNOS) deficiency is a pivotal event in atherogenesis.We tested the effect of CRP on eNOS expression and bioactivity in cultured human aortic endothelial cells (HAECs). CRP decreased eNOS mRNA, protein abundance, and enzyme activity in HAECs. Furthermore, eNOS bioactivity assayed by cyclic GMP levels was significantly reduced by CRP. Preincubation of cells with CRP also significantly increased the adhesion of monocytes to HAECs.CRP causes a direct reduction in eNOS expression and bioactivity in HAECs, further supporting its role in atherogenesis.