tbuckley/cabot-search huggingface dataset:
Diagnostic-Related Groups-Reply
Authors: David W. Young
Journal: JAMA (1982)

<h3>In Reply.—</h3> While we can appreciate Mr Vladeck's concerns about our article, we find his arguments in support of the present New Jersey system (which as Assistant Commissioner of Public Health he helped implement) to be unconvincing. As we stressed in our analysis, DRGs have been and, even as revised, remain an inadequate basis on which to design an appropriate hospital management control system. The DRG system presently in place in New Jersey still seeks to control hospital costs without incorporating the most important cost-influencing actor—the attending physician—into the hospital's formal management control structure. More importantly, because it mandates reimbursement to the hospital of a fixed fee per case type, the DRG-based system does in fact establish de facto medical treatment standards for attending physicians' hospital practices. Since physician decisions are incorporated into a package that includes price and efficiency factors, however, it is not possible to distinguish among these
NERVOUS AND MENTAL DISEASES FOLLOWING PELVIC OPERATIONS.
Authors: HAROLD N. MOYER
Journal: JAMA (1898)

The topic assigned to me is a narrow one, namely, the nervous and mental diseases or changes which follow pelvic operations in women. The purpose of the inquiry is to show if there is any difference in the nervous and mental effects which follow operations upon the pelvic organs from operations done on other parts of the body or surgical operations in general. It would be easy to discuss this subject from one's individual experience, but it would be exceedingly narrow. The observations that come to any one man are certainly few as compared with those that come to a large number of operators, so that I shall not relate individual cases, but will draw conclusions so far as I can, from the literature which is accessible to me and the material which I have collected. The literature is disappointingly deficient in many respects. Reported cases of the nervous and
Informing the Public — With Facts and Folk Tales
Authors: Arnold S. Relman
Journal: New England Journal of Medicine (1981)

Everyone agrees that we need the understanding and participation of a well-informed public if we are to continue to improve the nation's health and our health-care system. The public's interest in medicine appears insatiable, and popular books on this subject are being published in seemingly infinite number and variety. Two examples that have recently come to hand illustrate the diversity of material now being offered to the general reader. The contrast between these books may help to explain why the burgeoning of popular literature on health does not necessarily lead to more public enlightenment.The first is called The Harvard . . .
Use of Bone Scintigraphy in the Management of Slipped Capital Femoral Epiphysis
Authors: ELEANOR M. SMERGEL, H THEODORE HARCKE, PETER D. PIZZUTILLO, RANDAL R. BETZ
Journal: Clinical Nuclear Medicine (1987)

Fourteen patients with slipped capital femoral epiphysis (SCFE) who had high-resolution and magnification bone scintigraphy during treatment were studied. By demonstrating the vascular status of the femoral head and physiologic condition of the growth plate, scintigraphy was found to assist the clinician in the management of patients with this disorder.
Bile Leakage Over the Hepatic Surface Detected by Hepatobiliary Imaging
Authors: KENICHI NAKAJIMA, NORIHISA TONAMI, KINICHI HISADA, HIROMI FUNAKI, MAKOTO UOGISHI, MASAYUKI SUZUKI
Journal: Clinical Nuclear Medicine (1986)

A bile leakage over the hepatic surface mimicking the shape of the liver was demonstrated by the hepatobiliary imaging with Tc-99m diethyl IDA. Without delayed imaging, it might have been misinterpreted, as the retained activity caused by the obstruction of common hepatic duct. Delayed imaging and careful observation were important for detecting bite leakage.
P08.09 * RADIOSURGERY FOR BRAIN METASTASES: PROSPECTIVE VALIDATION OF THE BSBM PROGNOSTIC SCORE
Authors: D. Devriendt
Journal: Neuro-Oncology (2014)

PURPOSE: To prospectively validate our basic score for brain metastases (BSBM) classification in patients treated by Gamma Knife radiosurgery (GKRS) for brain metastases (BM) METHODS AND MATERIALS: Between January 2003 and December 2007, we treated more than 1000 BM in 283 patients by RS. We followed these patients prospectively since January 2003 using the BSBM classification, which is based on 3 prognostic factors: no extracranial metastatic disease (ECMD), KPS ≥80, primary tumor controlled. A score of 0 to 1 point was attributed to each factors, with a total from 0 to 3 points; the patients had a BSBM score 0, 1, 2 and 3 in 2.5%, 13%, 60% and 24%, respectively. RESULTS: The median survival (MS) was 12 months (95% CI, 10-14 months); the 2-years and 5-years survival were respectively 27 and 10 %. The MS was 2.5, 6, 12 and 20.5 months respectively for the BSBM scores 0, 1, 2 and 3 (p < 0.001); the MS was respectively 13 and 11 months with an ECMD absent or present (p < 0.001), 4 and 13 months according a KPS <80 or ≥80 (p < 0.001) and finally, 13 and 7 months with a primary tumor controlled or not (p < 0.001). All 3 prognostic factors used in the BSBM classification were found statistically significant in univariate and multivariate analysis. CONCLUSIONS: We have validated prospectively our BSBM prognostic model which we developed retrospectively in 2004. The strenghts of our classification is the ease to use as we consider only 3 prognostic factors.
874-4 Hypertensive stress enhances repolarization heterogeneity
Authors: Bart Hooft van Huysduynen, Cees A Swenne, Henk J Ritsema van Eck, Anna L Schoneveld, Hedde van de Vooren, Jan A Kors, Piet Schiereck, Martin J Schalij, Ernst E der Wall
Journal: Journal of the American College of Cardiology (2004)
Propofol enhances ischemic tolerance of middle-aged rat hearts: effects on 15-F2t-isoprostane formation and tissue antioxidant capacity
Authors: Z Xia
Journal: Cardiovascular Research (2003)

Experimental study has shown that myocardial ischemic tolerance is reduced during middle-age. We investigated the effect of propofol on ischemic tolerance of middle-aged rat hearts.Hearts of young adult (10 weeks old, Y) and middle-aged rats (20 weeks old, M) were assigned to propofol (P-Y, P-M) and control (C-Y, C-M) groups (n=6 each). Hearts were perfused using a Langendorff preparation with Krebs-Henseleit solution (KH) at constant flow rates. We applied propofol (P-Y, P-M) for 10 min at 12 microg/ml before inducing 40 min global ischemia. During ischemia, saline (C-Y, C-M) or propofol (P-Y, P-M) in saline was perfused through the aorta at 60 microl/min. Propofol in KH was perfused at 12 microg/ml for the first 15 min of reperfusion and subsequently reduced to 5 microg/ml in propofol treatment groups. Coronary effluent was assayed for 15-F(2t)-isoprostane after equilibration, during ischemia (T(1)) and at 0.5 (T(2)) and 5 (T(3)) min of reperfusion. After 90 min of reperfusion (T(4)), hearts were harvested to assess tissue antioxidant capacity.In P-Y, we observed an increased latency to ischemic-contracture and a significantly reduced contracture after 35 min ischemia compared to control groups. No ischemic contracture was observed in P-M. There were significantly lower 15-F(2t)-isoprostane levels in P-M and P-Y than in C-M and C-Y at T(1). At T(4), the recovery of left ventricular developed pressure in P-M was greater than in P-Y (P<0.05); both were greater than in C-M and C-Y.Propofol enhanced ischemic tolerance of middle-aged hearts, primarily by inhibiting lipid peroxidation.
Cost-Effectiveness of Statin Therapy for Primary Prevention in a Low-Cost Statin Era
Authors: Lawrence D. Lazar, Mark J. Pletcher, Pamela G. Coxson, Kirsten Bibbins-Domingo, Lee Goldman
Journal: Circulation (2011)

With wide availability of low-cost generics, primary prevention with statins has become less expensive. We projected the cost-effectiveness of expanded statin prescribing strategies using low-cost generics and identified conditions under which aggressive prescribing ceases to be cost-effective.We simulated expanded statin prescribing strategies with the coronary heart disease policy model, a Markov model of the US population >35 years of age. If statins cost $4/mo, treatment thresholds of low-density lipoprotein cholesterol >160 mg/dL for low-risk persons (0 to 1 risk factor), >130 mg/dL for moderate-risk persons (≥2 risk factors and 10-year risk <10%), and >100 mg/dL for moderately high-risk persons (≥2 risk factors and 10-year risk >10%) would reduce annual healthcare costs by $430 million compared with Adult Treatment Panel III guidelines. Lowering thresholds to >130 mg/dL for persons with 0 risk factors and >100 mg/dL for persons with 1 risk factor and treating all moderate- and moderately high-risk persons regardless of low-density lipoprotein cholesterol would provide additional health benefits for $9900 per quality-adjusted life-year. These findings are insensitive to most adverse effect assumptions (including statin-associated diabetes mellitus and severe hypothetical effects) but are sensitive to large reductions in the efficacy of statins or to a long-term disutility burden for which a patient would trade 30 to 80 days of life to avoid 30 years of statins.Low-cost statins are cost-effective for most persons with even modestly elevated cholesterol or any coronary heart disease risk factors if they do not mind taking a pill daily. Adverse effects are unlikely to outweigh benefits in any subgroup in which statins are found to be efficacious.
Exposure Assessment for Atmospheric Ultrafine Particles (UFPs) and Implications in Epidemiologic Research
Authors: Constantinos Sioutas, Ralph J. Delfino, Manisha Singh
Journal: Environmental Health Perspectives (2005)

Epidemiologic research has shown increases in adverse cardiovascular and respiratory outcomes in relation to mass concentrations of particulate matter (PM) ≤2.5 or ≤10 μm in diameter (PM2.5, PM10, respectively). In a companion article [Delfino RJ, Sioutas C, Malik S. 2005. Environ Health Perspect 113(8):934–946]), we discuss epidemiologic evidence pointing to underlying components linked to fossil fuel combustion. The causal components driving the PM associations remain to be identified, but emerging evidence on particle size and chemistry has led to some clues. There is sufficient reason to believe that ultrafine particles &lt; 0.1 μm (UFPs) are important because when compared with larger particles, they have order of magnitudes higher particle number concentration and surface area, and larger concentrations of adsorbed or condensed toxic air pollutants (oxidant gases, organic compounds, transition metals) per unit mass. This is supported by evidence of significantly higher in vitro redox activity by UFPs than by larger PM. Although epidemiologic research is needed, exposure assessment issues for UFPs are complex and need to be considered before undertaking investigations of UFP health effects. These issues include high spatial variability, indoor sources, variable infiltration of UFPs from a variety of outside sources, and meteorologic factors leading to high seasonal variability in concentration and composition, including volatility. To address these issues, investigators need to develop as well as validate the analytic technologies required to characterize the physical/chemical nature of UFPs in various environments. In the present review, we provide a detailed discussion of key characteristics of UFPs, their sources and formation mechanisms, and methodologic approaches to assessing population exposures.
Peroral direct cholangioscopy for recurrent bile duct stones, using an ultrathin upper endoscope
Authors: D. Agrawal, A. Chak
Journal: Endoscopy (2010)

Multiple recurrences of bile duct stones are rare, and occur when there is bile stasis and a nidus for stone conglomeration [1] [2]. Endoscopic examination of the bile duct has traditionally been difficult and is not routinely performed. We report the first case of management of recurrent bile duct stones using an ultrathin upper endoscope.
A Contract sought to be avoided on the Ground of Insanity
Authors: I. RAY
Journal: American Journal of Psychiatry (1848)

At a session of the Supreme Judicial Court of Massachusetts, holden at Northampton Aug. 22d, 1848, by Judge Dewey, was tried the case of Allis by guardian vs. Billings and others. Counsel for plaintiffs, Chapman of Springfield, and Baker of Northampton; for defendants, Rufus Choate of Boston, and Huntingdon of Nofthampton.
Making Insurance Coverage for New Technologies Reasonable and Accountable
Authors: James E. Sabin
Journal: JAMA (1998)

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
[508] IN HEPATITIS B PATIENTS TREATED WITH EITHER ADEFOVIR OR TELBIVUDINE, MAXIMAL EARLY HBV SUPPRESSION AT 24 WEEKS PREDICTS OPTIMAL ONE-YEAR EFFICACY
Authors: P. Marcellin, H.L.Y. Chan, C.-L. Lai, M. Clio, I. Heathcote, Y.-M. Moon, Y.-C. Chao, R. Myers, G. Harb, N.A. Brown
Journal: Journal of Hepatology (2007)
Cancer and beyond: the formation of BACUP.
Authors: V Clement-Jones
Journal: BMJ (1985)

This article describes my experiences as a doctor with cancer and how this has led to the formation of a new cancer organisation in Britain, BACUP (British Association of Cancer United Patients? and their families and friends). BACUP is being launched on 31 October 1985. It will provide a national cancer information service for patients, their relatives, doctors, and other health professionals. The enclosure with this issue of the BMJ details its services, background, and aims.
Aeromonas hydrophilia Sepsis in a Previously Healthy Man
Authors: Catherine M. Russell
Journal: JAMA (1978)

<h3>To the Editor.—</h3> The article by Ramsay et al (239:128-129, 1978) recorded another instance of<i>Aeromonas hydrophila</i>sepsis in an immunosuppressed host. The article cited the single known reported instance of<i>A hydrophila</i>sepsis in an otherwise healthy adult. While at the University of Virginia Hospital in Charlottesville in 1969, we were witness to an overwhelming hemorrhagic pneumonia terminating fatally and caused by<i>A hydrophila</i>in a previously healthy 29-year-old man. The patient was in good health until he awoke with severe right pleuritic chest pain 15 hours before death. Chest x-ray examination showed an early right middle lobe infiltrate and a questionable right pleural effusion. He received 50 mg of meperidine and 1.2 million units of penicillin G procaine intramuscularly. He returned to the emergency room six hours antemortem with increasingly severe right pleuritic chest pain and dyspnea. He coughed up approximately 20 ml of bright red blood for
A Comparison of the Properties of Chlorothiazide, Spironolactone and a Combination of Both as Diuretic Agents
Authors: David A. Ogden, Lawrence Scherr, Norton Spritz, Albert L. Rubin
Journal: New England Journal of Medicine (1961)

CHLOROTHIAZIDE is an effective diuretic agent in fluid-retention states.1 2 3 4 5 Hypokalemia due to excessive urinary potassium loss is a frequent and sometimes life-threatening complication of therapy with this agent and its derivatives.2 , 5 6 7 8 Its therapeutic value is further limited by its ineffectiveness in many patients.6 Steroidal 17-spironolactones specifically block the action of aldosterone on the renal-tubule cell9 , 10 and produce increased sodium and water and decreased potassium excretion in normal subjects.10 , 11 It has been suggested that these actions of spironolactones should augment the diuretic potency of chlorothiazide while diminishing the potassium loss produced by this agent.11 This study was undertaken to determine the . . .
Lymphocyte subsets in patients with aplastic anemia
Authors: G. J. Ruiz‐Argüelles, J. A. Katzmann, P. R. Greipp, A. Marín‐López, J. González‐Llaven, R. Cano‐Castellanos
Journal: American Journal of Hematology (1984)

Abstract Lymphocyte subsets were enumerated in a group of 31 patients with aplastic anemia. Abnormal numbers of immunoregulatory T‐cells were found in some patients: 26% of them showed a reversed helper/suppressor ratio. Seven of 18 patients showed significantly decreased proliferation in response to PWM; this hyporesponsiveness was present in 75% of patients with a reversed helper/suppressor ratio and in 10% of those with a normal helper/suppressor ratio (R = 0.66, P = 0.008). Eight of 18 patients showed suppressor activity over PWM‐induced allogeneic cell proliferation. This suppressive activity did not correlate with T‐cell phenotype. Of the patients with a low number of T‐cells, 73% had responded to treatment, whereas of those patients with a normal number of T‐cells, 26% had responded (P = 0.016). The results are consistent with abnormal immune response in selected patients with aplastic anemia, and suggest a possible influence of T‐cells on disease process.
Fc receptor-mediated inhibition of murine B-lymphocyte activation.
Authors: J L Ryan, P A Henkart
Journal: The Journal of Experimental Medicine (1976)

Immobilized antigen-antibody complexes are able to inhibit the mitogenic response of murine spleen cells to the B-cell mitogen 8-bromo-3',5'-cyclic guanosine monophosphoric acid. This this inhibition is dependent on intact Fc fragments in the immobilized complexes. Soluble complexes do not mediate this inhibition. When lipopolysaccharide (lps) activation of B cells was studied, it was found that the mitogenic response was inhibited at all times tested between 2 and 7 days of culture. Also, the LPS-induced mitogenesis of nude spleen cells was inhibited by immobilized complexes, indicating that suppressor T cells probably play no significant role in the inhibition. Immobilized complexes inhibit polyclonal antibody responses in a serum-free system and in the presence of normal mouse serum, but are unable to inhibit in the presence of fetal calf serum (FCS). If nu/nu spleen cells are used, however, the FCS does not block the ability of the complexes to inhibit the polyclonal response. It is suggested that that antigen-antibody complexes under appropriate conditions may bind to B lymphocytes via their Fc receptors and trigger a central "off" signal which blocks proliferation and consequently antibody production.
Person-to-Person Transmission of Hantavirus?
Authors: Joan Stephenson
Journal: JAMA (1997)

An outbreak of hantavirus pulmonary syndrome (HPS) in southern Argentina last fall that killed 11 of the 20 people infected may have featured the first known cases of person-to-person transmission of the disease. Although many hantavirus species have been identified and found to cause illness in humans, extensive epidemiologic studies had failed to turn up any clear-cut evidence of transmission between infected people. Experts previously believed that the primary means by which humans contracted hantavirus infections, which are known to attack the lungs or kidneys, was inhalation of tiny particles of the fecal droppings of infected rodents. Now, however, a team of Argentine and US researchers investigating the 1996 Argentine outbreak has found epidemiologic evidence that "strongly suggests" person-to-person transmission (<i>Emerg Infect Dis.</i>1997;3:171-174). The outbreak, which began last September among residents or visitors of 3 towns in southern Argentina, later involved individuals who'd had contact with infected patients but
Circumscribed myxoedema of lichen myxoedematosus as a sign of faulty formation of the proteoglycan macromolecule
Authors: HIDEFUMI MAEDA, HIDEKAZU ISHIKAWA, SHIGEO OHTA
Journal: British Journal of Dermatology (1981)

Using a new method devised by our laboratory, the ultrastructure of dermal glycosaminoglycan in an involved area of lichen myxoedematosus was examined. Although histochemical and biochemical studies have indicated simply an accumulated deposition of hyaluronic acid in the lesion, the glycosaminoglycan ultrastructure within it was distinctly different from that in normal skin. The glycosaminoglycan structure of normal skin was similar to the proteoglycan aggregate model described by Rosenberg (1975). As confirmed by the enzymatic digestion procedure, it represents the ultrastructure of hyaluronic acid bound to glycosaminoglycans such as dermatan sulphate or chondroitin sulphate. In contrast, hyaluronic acid filaments observed in lesions of lichen myxoedematosus contained no glycosaminoglycan subunits.
Letter: Aetiology of anencephaly and spina bifida.
Authors: J H Elwood
Journal: BMJ (1976)

<h3>ABSTRACT</h3> The microorganisms that inhabit human skin, collectively termed the skin microbiome, must overcome numerous challenges that typically impede microbial growth, including low pH, osmotic pressure, and low nutrient availability. Yet, the skin microbiota thrive on the skin and have adapted to these stressful conditions. Limited skin nutrients are available for microbial use in this unique niche, including those from host-derived sweat, sebum, and corneocytes. Here, we have developed physiologically-relevant, skin-like growth media that is composed of compounds present in human sweat and sebum. We find that skin-associated bacterial species exhibit unique growth profiles in different concentrations of sweat and sebum. The majority of strains evaluated demonstrate a preference for high sweat concentrations, while sebum preference is highly variable, suggesting that the capacity for sebum utilization may be an important driver of skin microbial community structure. Furthermore, these findings provide experimental rationale for why different skin microenvironments harbor distinct microbiome communities. In all, our study further emphasizes the importance of studying microorganisms in an ecologically-relevant context, which is critical for our understanding of their physiology, ecology, and function on the skin.
MedPics Series: An Image Library for Medical Education: Histology and Pathology
Authors: Michael J. Kornstein
Journal: JAMA (1995)

This software is described on the package insert as an interactive multimedia program using high quality digital images, descriptive text, and on-screen graphics for lessons on normal and abnormal organ structure and function. It was developed by the University of California, San Diego, School of Medicine, Office of Learning Resources and distributed by Micron Biosystems. No author is listed on the accompanying brochure or on the disc. The software can be run on either a Macintosh (II series or better) or IBM compatible (386SX 33 MHz or better) system.  The program is provided on a CD-ROM and consists of two modules: histology and pathology. A third module on hematology is under development. This reviewer concentrated on the pathology section.  The pathology module consists of approximately 400 images generally divided into organ systems. For each image, the screen is divided into four sections. About one third of the screen contains the