tbuckley/cabot-search huggingface dataset:
Cultural and Organizational Implications of Academic Managed-Care Networks
Authors: Mark C. Rogers, Ralph Snyderman, Elizabeth L. Rogers
Journal: New England Journal of Medicine (1994)

Many academic medical centers are developing complex organizations of physicians and large health networks that provide managed care to large groups of people. Leaders of these centers believe that these organizations and networks will provide the financial resources that have previously been obtained through clinical care provided at the medical center itself. The rationale is that a surplus of revenues from clinical care provided by hospitals and professionals is needed to continue support for research and teaching.13 In the race to develop academic managed-care networks, basic questions about the cultural and organizational implications of entering this competitive business have . . .
Relationships Between Authors of Clinical Practice Guidelines and the Pharmaceutical Industry
Authors: Niteesh K. Choudhry
Journal: JAMA (2002)

Increasing contact has been reported between physicians and the pharmaceutical industry, although no data exist in the literature regarding potential financial conflicts of interest for authors of clinical practice guidelines (CPGs). These interactions may be particularly relevant since CPGs are designed to influence the practice of a large number of physicians.To quantify the extent and nature of interactions between authors of CPGs and the pharmaceutical industry.Cross-sectional survey of 192 authors of 44 CPGs endorsed by North American and European societies on common adult diseases published between 1991 and July 1999. One hundred authors (52%) provided usable responses representing 37 of 44 different CPGs that we identified.Nature and extent of interactions of authors with drug manufacturers; disclosure of relationships in published guidelines; prior discussion among authors regarding relationships; beliefs regarding whether authors' own relationships or those of their colleagues influenced treatment recommendations in guidelines.Eighty-seven percent of authors had some form of interaction with the pharmaceutical industry. Fifty-eight percent had received financial support to perform research and 38% had served as employees or consultants for a pharmaceutical company. On average, CPG authors interacted with 10.5 different companies. Overall, an average of 81% (95% confidence interval, 70%-92%) of authors per CPG had interactions. Similarly, all of the CPGs for 7 of the 10 diseases included in our study had at least 1 author who had some interaction. Fifty-nine percent had relationships with companies whose drugs were considered in the guideline they authored, and of these authors, 96% had relationships that predated the guideline creation process. Fifty-five percent of respondents indicated that the guideline process with which they were involved had no formal process for declaring these relationships. In published versions of the CPGs, specific declarations regarding the personal financial interactions of individual authors with the pharmaceutical industry were made in only 2 cases. Seven percent thought that their own relationships with the pharmaceutical industry influenced the recommendations and 19% thought that their coauthors' recommendations were influenced by their relationships.Although the response rate for this survey was low, there appears to be considerable interaction between CPG authors and the pharmaceutical industry. Our study highlights the need for appropriate disclosure of financial conflicts of interest for authors of CPGs and a formal process for discussing these conflicts prior to CPG development.
Substance Abuse Treatment
Authors: Joan Stephenson
Journal: JAMA (2000)

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
IRS2 takes center stage in the development of type 2 diabetes
Authors: Matthew J. Brady
Journal: Journal of Clinical Investigation (2004)

The etiology of type 2 diabetes is characterized by obesity, insulin and leptin resistance, and compensatory β cell hyperplasia followed by islet degeneration, resulting in the eventual dysregulation of glucose and lipid homeostasis. The recent identification of insulin receptor substrate 2 (IRS2) as a central player in the pathophysiology of many of these processes suggests a potentially unifying molecular link underlying the initiation and progression of type 2 diabetes.
Treatment of Typhoid Fever.
Authors: W. T. Dodge
Journal: JAMA (1895)

Grand Rapids, Mich., Aug. 10, 1895.  To the Editor:  —I have just been reading Dr. Woodbridge's article, read at Baltimore, giving quotations from my letters. I notice one mistake. In one of the aborted cases the types read that four grains of quinin were given in twelve hours. It should have read forty grains. The object I had in mentioning the quinin at all was to show that a large dose had no effect in the fever, and that the medicine did, after the quinin failed to abort the disease.  I have had no typhoid cases this year but have had the druggist put in a stock of Parke, Davis & Co.'s Woodbridge treatments and will try the new formula upon the first suspicious case that presents. Sincerely yours,
Prevalence of hepatitis C virus infection in Hashimoto's thyroiditis
Authors: B. Wagner, H. Vierhapper, H. Hofmann
Journal: BMJ (1996)

EDITOR,—Duclos-Vallee et al have reported that infection with hepatitis C virus may have a role in triggering Hashimoto's thyroiditis.1 Using enzyme linked immunosorbent assay (ELISA), they detected antibodies to hepatitis C virus in 12 of 50 patients, and a second generation recombinant immunoblot assay confirmed the finding in five of the 12 cases.

As we did not see such a high prevalence of hepatitis C in our outpatients we retested 118 consecutive patients with Hashimoto's thyroiditis for possible infection …
Gastrointestinal motility and gastric secretion during intravenous infusions of gastrin II
Authors: J. J. Misiewicz, S. L. Waller, D. J. Holdstock
Journal: Gut (1969)

The effect of intravenous infusion of gastrin II on gastric and colonic motor activity was studied in 12 patients; gastric acid output was also measured. Administration of gastrin at near-maximal dose levels stimulates the motor activity of the antrum but has no measurable effect on the activity of the proximal colon, sigmoid, or rectum. The results suggest that gastrin plays a part in the regulation of gastric motility but that it is not a mediator of the gastro-colic reflex.
Differences in the electrophysiological response of canine ventricular epicardium and endocardium to ischemia. Role of the transient outward current.
Authors: A Lukas, C Antzelevitch
Journal: Circulation (1993)

BACKGROUND Acute ischemia is known to produce more severe electrophysiological disturbances in canine ventricular epicardium than endocardium, although the mechanism for the differential sensitivity is still unresolved. Recent studies have demonstrated the presence of a prominent transient outward current (Ito) in ventricular epicardium but not endocardium. The present study was designed to test the hypothesis that the differential sensitivity of these two tissues to ischemia results, at least in part, from a more prominent Ito in epicardium than in endocardium. METHODS AND RESULTS Isolated canine ventricular epicardial and endocardial tissues and myocytes were studied by standard microelectrode techniques. Simulated ischemia (hyperkalemia, hypoxia, and acidosis) abolished the action potential plateau and caused a 50% to 60% shortening of action potential duration in epicardium but only a 10% to 20% shortening in endocardium. 4-Aminopyridine, an Ito inhibitor, restored the plateau in epicardium and reduced the dispersion of action potential duration between epicardium and endocardium. Stimulation protocols that minimized the contribution of Ito, such as acceleration of the stimulation rate or introduction of early premature beats, produced a paradoxical prolongation of the epicardial response caused by restoration of the action potential dome. Thus, ischemia-induced dispersion of repolarization was greatly diminished at rapid rates and after premature beats. Similar results were obtained in tissues and myocytes obtained from the same myocardial layers, suggesting that the differential sensitivities of epicardium and endocardium to ischemia are largely a result of inherent differences in cellular properties. CONCLUSIONS Our data suggest that the presence of a prominent Ito in epicardium but not endocardium contributes importantly to the selective electrical depression of epicardium by simulated ischemia. The repolarizing influence of Ito serves to amplify the ischemia-induced changes in inward (ICa and INa) and outward (calcium-activated) currents. By facilitating loss of the dome in epicardium, Ito contributes to the development of a marked dispersion of repolarization between normal and ischemic epicardium and between epicardium and endocardium, thereby providing the electrophysiological substrate for the genesis of reentrant arrhythmias.
Intravascular Ultrasound–Guided Percutaneous Fenestration of the Intimal Flap in the Dissected Aorta
Authors: A. Chavan, D. Hausmann, C. Dresler, H. Rosenthal, K. Jaeger, A. Haverich, H. G. Borst, M. Galanski
Journal: Circulation (1997)

Background Aortic dissection with branch obstruction is associated with high morbidity and mortality. Fenestration of the dissection flap to relieve distal vessel ischemia is at present largely performed surgically. The surgical mortality and morbidity are high, because most patients are poor candidates for anesthesia or surgery. Methods and Results Nine percutaneous fenestrations (one with additional stenting of the infrarenal true aortic lumen) were performed under local anesthesia in seven patients with aortic dissection. The presenting symptoms were abdominal angina or claudication. By the transfemoral approach, the intimal flap was initially punctured with a needle-catheter combination through which a guidewire was placed across the dissection flap. The fenestration was carried out with a balloon catheter introduced over the guidewire. The procedure was performed under on-line guidance with intravascular ultrasound imaging. The procedure was performed successfully and without complications in all patients. After intervention, symptoms resolved in all seven patients. Conclusions Intravascular ultrasound–guided percutaneous fenestration of the intimal flap in symptomatic aortic dissections with distal vessel involvement is a technically feasible and safe procedure that can effectively relieve the patient’s symptoms.
TCT-225 The role of collateral pressure index assessing collateral function and coronary hemodynamics in patients with total or nearly total occluded coronary lesions
Authors: Jang Hoon Lee, Myung Hwan Bae, Shung Chull Chae, Yongkeun Cho, Won Suk Choi, Se Yong Jang, Jae-Eun Jun, Kyun Hee Kim, Sun Hee Park, Hun Sik Park, Dong Heon Yang
Journal: Journal of the American College of Cardiology (2012)
Factors Involved in Crystal Formation in Cystinuria
Authors: Bruce L. Fariss
Journal: JAMA (1968)

Six patients with persistent cystine crystalluria were given chlordiazepoxide hydrochloride (Librium) in a daily dose of 5 to 40 mg by mouth. While taking this drug, the patients had a prompt reduction in cystine crystalluria. When administration of the medication was stopped, cystine crystals were again noted but disappeared when the patients again began taking chlordiazepoxide. No other medications were prescribed during this study, and no attempt was made to control food or fluid intake. Also, a patient with cystine crystalluria was observed to have a decrease of cystine crystals in his urine with the development of the nephrotic syndrome during treatment with penicillamine (D-penicillamine). On reduction of his proteinuria, there was a prompt return of cystine crystals without a significant change in total cystine excretion. Possible mechanisms to explain these observations are under investigation.
Pleuroparenchymal fibroelastosis as a late complication of chemotherapy agents
Authors: Caroline Beynat-Mouterde, Guillaume Beltramo, Guillaume Lezmi, Didier Pernet, Clio Camus, Annlyse Fanton, Pascal Foucher, Vincent Cottin, Philippe Bonniaud
Journal: European Respiratory Journal (2014)

Pleuroparenchymal fibroelastosis as a late complication of chemotherapy agentsTo the Editor:We identified six patients with clinical, radiographic and physiological features typical of pleuroparenchymal fibroelastosis (PPFE).In the six cases, PPFE may have been causally related to prior alkylating drugs used to treat malignacy, namely cyclophosphamide in five of the cases and carmustine (BCNU (1,3-bis-(2chloroethyl)-1-nitrosourea)) in one.Based on an extensive review of the literature, we suspect that similar cases may have already been reported in the past 4 decades but have not been recognised either as PPFE or as drug-induced in nature.In 2004, FRANKEL et al.[1] described a then-new clinicopathologic entity, which they termed ''idiopathic PPFE''.The authors identified five patients who had a clinical presentation suggestive of chronic interstitial pneumonitis that did not fit any previously established category of idiopathic interstitial pneumonia.The patients were characterised by significant pleural involvement in the form of pleural thickening, which was more marked in both upper regions.In all five patients, surgical biopsy demonstrated prominent visceral pleural fibrosis with subpleural fibroelastosis and an abrupt transition between the fibrotic area and the near-normal adjoining lung.There was sparing of the underlying lung parenchyma at some depth from the pleural surface, and sparse fibroblast foci were present at the edge of the fibrotic area.Since that seminal report, several cases and small series have been reported that have demonstrated a strikingly similar clinical, radiological and pathological presentation, also characterised by difficult-to-treat pneumothoraces in a sizable fraction of affected patients.
Gonococcal tenosynovitis-dermatitis and septic arthritis
Authors: Sumner E. Thompson, Norman F. Jacobs, Fernando Zacarias, Michael F. Rein, Jonas A. Shulman
Journal: JAMA (1981)

<h3>In Reply.—</h3> Our experience with preoperative irradiation in cases of endometrial carcinoma occurring in patients up to 86 years indicates that advanced age is not a contraindication to external beam therapy of the pelvis in the management of this disease. In fact, the median age of women in our series who received either external pelvic irradiation alone or combined with an intracavitary procedure was slightly greater (60 years vs 59 years) than that of those who received only intracavitary irradiation. The incidence of complications secondary to radiological sequelae was identical in either group, occurring in 4% of patients. It is important to emphasize this observation, since elderly women are more likely to be seen with poorly differentiated or advanced-stage disease,<sup>1</sup>both highly associated with extrauterine spread, including metastases to lateral pelvic lymph nodes. In these patients, external pelvic irradiation preoperatively appears not only to be safe but is likely to
Monitoring fibrillar collagen turnover in hypertensive heart disease
Authors: J Díez, C Laviades
Journal: Cardiovascular Research (1997)

Time for primary review 32 days.

A substantial increase in fibrillar collagen has been observed in the cardiac ventricles of animals [1]and humans [2]with arterial hypertension. Either reactive or reparative hypertensive myocardial fibrosis is the result of both increased collagen types I and III synthesis by fibroblasts and unchanged or decreased extracellular collagen degradation [3]. Hemodynamic and non-hemodynamic factors may be involved in the disequilibrium between collagen synthesis and degradation that occurs in hypertension [4].

As shown experimentally [1]and clinically [5, 6], a rise in collagen content increases myocardial stiffness and promotes abnormalities of cardiac function. In addition, the perivascular accumulation of collagen fibers may impair the vasodilator capacity of intramyocardial coronary arteries and contribute to the decrease in coronary reserve, which is commonly seen in the hypertensive heart [7]. On the other hand, alterations in the electrical activity of the left ventricle in hypertensive patients have been shown to be related to the degree of myocardial fibrosis [6].

Although microscopic examination of cardiac biopsies is the most reliable method for documenting and measuring myocardial fibrosis, the development of non-invasive methods to indicate the presence of myocardial fibrosis in hypertensive patients would be useful. We have therefore applied a biochemical method based on the measurement of serum peptides derived from the tissue formation and degradation of fibrillar collagens to monitor the turnover of these molecules in rats with spontaneous hypertension (SHR) and in patients with essential hypertension.

### 2.1 Fibrillar collagen synthesis

Fibrillar collagen is synthesized in the fibroblasts as procollagen containing an amino-terminal and a carboxy-terminal propeptide (Fig. 1) [8]. After procollagen has been secreted into the extracellular space, the propeptides are removed by specific proteinases, allowing integration of the rigid collagen triple helix into the growing fibril (Fig. 1) [8].



Fig. 1 
Diagrammatic depiction of … 



* Corresponding author. Unidad de Fisiopatologiea Vascular, Facultad de Medicina, C/ Irunlarrea s/n, 31080 Pamplona, Spain. Tel.: +34 (48) 425600; fax: +34 (48) 425649.
COMPARISON OF BIOPROSTHETIC TRICUSPID VALVE DYSFUNCTION BETWEEN PATIENTS WITH AND WITHOUT TRANSVALVULAR LEAD IMPLANTATION
Authors: Wafa Dawood, Azam Shafquat, Bandar S. Al Ghamdi, Bahaa Fadel, Majid Al-Fayyadh, Waleed Manea, Aly Al Sanei
Journal: Journal of the American College of Cardiology (2014)
Parathyroid cyst of the thymus.
Authors: W G McCluggage, C F Russell, P G Toner
Journal: Thorax (1995)

A case is described of primary hyperparathyroidism in a patient with both a parathyroid cyst within the thymus gland and a concomitant parathyroid adenoma. The parathyroid adenoma contained microcystic areas of degeneration, and it is thought that the parathyroid cyst reflected degenerative change in a pre-existing adenoma. Parathyroid cyst should be considered in the differential diagnosis of cystic lesions within the thymus. Fine needle aspiration and parathyroid hormone assay on cyst fluid may provide a preoperative diagnosis.
A multiple dose powderinhaler (Turbuhaler®) compared with a conventional aerosol
Authors: K. Osterman, A.‐M. Norborg, E. Stäuhl
Journal: Allergy (1989)

Nineteen patients with asthma completed an open, randomized, crossover study in which 0.5 mg terbutaline sulphate was administered either via Turbuhaler® or via the metered dose inhaler (MDI) for 2‐week periods. The clinical effect of the two treatment forms was comparable; both provided adequate bronchodilator therapy. Patients also considered Turbuhaler and MDI equally effective, with a small preference for the MDI. Turbuhaler seems to be a valuable alternative to bronchodilator MDI therapy.
Patients' safety must not be sacrificed to financial targets, doctors say
Authors: A. Cole
Journal: BMJ (2009)

The government’s obsession with targets means that tragedies such as the deaths of patients at the Mid-Staffordshire NHS Foundation Trust ( BMJ 2009;338:b1141, doi:10.1136/bmj.b1141) could be repeated in other parts of the country, doctors warned at the BMA’s annual representatives meeting on Monday.

“Mid-Staffs is not an isolated incident,” said one delegate, Mary McCarthy from South Staffordshire local medical committee. “It has the potential to happen in any other area.” She said that the concentration on targets had distorted clinical care at the Mid-Staffordshire trust and that difficulties in the area could grow, because the number of elderly people …
Human parvovirus and aplastic crisis in chronic hemolytic anemias: A study of 24 observations
Authors: Jean‐Jacques Lefrère, Anne‐Marie Couroucé, Yves Bertrand, Robert Girot, Jean‐Pierre Soulier
Journal: American Journal of Hematology (1986)

Abstract From March 1984 through November 1985, 24 children and adults with aplastic crises were admitted in several Parisian hospitals. Twelve patients had known hemolytic anemia. Aplastic crisis revealed hemolytic anemia in the remaining patients. The detection of human parvovirus antigen was performed by counter‐immunoelectrophoresis, and specific IgM antibodies were detected by IgM‐antibody‐capture‐radioimmunoassy, in order to establish the incidence of human parvovirus infection in the genesis of the aplastic crisis. Twenty‐one patients had acute infection with human parvovirus. In the three remaining patients, no marker of human parvovirus infection was found. The features of the human parvovirus linked aplastic crisis are described. We consider that human parvovirus infection, and unknown hemolytic anemia, must be systematically researched in any case of unexplained acute aplastic anemia.
Development of health systems and universal coverage should be evidence based, says WHO
Authors: T. Groves
Journal: BMJ (2012)

The World Health Organization launched the first global strategy on research into health policy and systems last week at the Second Global Symposium on Health Systems Research in Beijing. 

The strategy calls for a more prominent role for such research, as many countries are aiming to strengthen their health systems and develop universal and equitable health coverage.1

The time is ripe to build this evidence base, said WHO, because countries are …
Chance, utility, rationality, strategy, equilibrium
Authors: Anatol Rapoport
Journal: Behavioral and Brain Sciences (2003)

Almost anyone seriously interested in decision theory will name John von Neumann's (1928) Minimax Theorem as its foundation, whereas Utility and Rationality are imagined to be the twin towers on which the theory rests. Yet, experimental results and real-life observations seldom support that expectation. Over two centuries ago, Hume (1739–40/1978) put his finger on the discrepancy. “Reason,” he wrote “is, and ought to be the slave of passions, and can never pretend to any other office than to serve and obey them.” In other words, effective means to reach specific goals can be prescribed, but not the goals. A wide range of experimental results and daily life behavior support this dictum.