tbuckley/cabot-search huggingface dataset:
Association of High-Volume Hospitals With Greater Likelihood of Discharge to Home Following Colorectal Surgery
Authors: Courtney J. Balentine, Aanand D. Naik, Celia N. Robinson, Nancy J. Petersen, G. John Chen, David H. Berger, Daniel A. Anaya
Journal: JAMA Surgery (2014)

Discharge disposition is a patient-centered quality metric that reflects differences in quality of life and recovery following surgery. The effect of hospital volume on quality of recovery measured by rates of successful discharge to home remains unclear.To test the hypothesis that patients having colorectal surgery at high-volume hospitals would more likely be discharged to home rather than discharged to skilled rehabilitation facilities to complete recovery.Longitudinal analysis of 2008 hospital inpatient data to identify patients undergoing colorectal surgery who survived to discharge. The setting was the Nationwide Inpatient Sample, the largest all-payer inpatient care database, containing data from more than 1000 hospitals. Participants were 280,644 patients (≥ 18 years) who underwent colorectal resections for benign or malignant disease and survived to discharge.The primary end point was discharge to home (with or without home health care) vs discharge to skilled facilities (skilled nursing, short-term recovery, or rehabilitation hospitals or other institutions). The secondary end point was discharge to home with home health care rather than to a skilled facility for patients with postdischarge care needs. Multiple logistic regression using robust standard errors was used to compute the odds ratios of each outcome based on hospital volume, while adjusting for other important variables.The odds of discharge to home vs discharge to skilled facilities were significantly greater in high-volume hospitals compared with low-volume hospitals (odds ratio, 2.09; 95% CI, 1.70-2.56), with an absolute increase of 9%. For patients with postdischarge care needs, high-volume hospitals were less likely than low-volume hospitals to use skilled facilities rather than home health care (odds ratio, 0.35; 95% CI, 0.27-0.45), with an absolute difference of 10%.Patients having colorectal surgery at high-volume hospitals are significantly more likely to recover and return home after surgery than individuals having operations at low-volume hospitals. This study is the first step in a process of identifying which features of high-volume hospitals contribute toward desirable outcomes. Efforts to identify the reasons for improved recovery at high-volume hospitals can help lower-volume hospitals adopt beneficial practices.
Indian Health Service: 30 years of progress
Authors: K. Glasbrenner
Journal: JAMA (1985)

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
The treatment of constipation in mental hospitals
Authors: L. R. C. Haward, H. E. Hughes-Roberts
Journal: Gut (1962)

This study investigates the incidence of constipation in two representative mental institutions, and the effect, in one of the hospitals, of restricting the use of laxatives to only one drug, namely, standardized senna (Senokot). The remarkable potentiality of Senokot for long-term re-educative programmes is reflected in the reduction from 44% of 210 patients receiving various laxatives regularly at the start of the trial to 8% after three months9 treatment. The special studies showed that chronic psychotics could be freed from enemas and a substantial number (17 out of 24) cured of constipation; 31 patients on insulin therapy required maintenance doses during treatment but all were subsequently cured; of 25 patients with various neurological lesions, 21 were freed of laxative treatment with four only remaining on sub-laxative doses.
Complication During Anesthesia and Laparoscopy
Authors: Barry G. Smiler
Journal: JAMA (1973)

<h3>To the Editor.—</h3> We present the following case report because it demonstrates a not-so-well-known mechanism leading to a marked complication of laparoscopy for tubal ligation. <h3>Report of a Case.—</h3> The patient was a 32-year-old white woman, ASA Status I. The patient was premedicated, then brought to the operating room for laparoscopic tubal ligation. Blood pressure, electrocardiograph, and blockade monitoring were established. Prior to induction, her blood pressure was 130/80, pulse 90 beats per minute. The patient was given 3 mg tubocurarine chloride; and anesthesia was induced with 375 mg of thiamylal sodium; succinylcholine chloride, 100 mg, was given intravenously, and the patient was then intubated with a 7-0 oral endotracheal tube with ease. Breath sounds were equal and full bilaterally postintubation. Anesthesia was maintained with 70% nitrous oxide in oxygen. The patient's breathing was aided with a mechanical ventilator with a tidal volume of 550 ml at a respiration rate
Cost-Effectiveness of Screening for Colorectal Cancer
Authors: Amnon Sonnenberg
Journal: Annals of Internal Medicine (2001)

Letters7 August 2001Cost-Effectiveness of Screening for Colorectal CancerAmnon Sonnenberg, MD, MScAmnon Sonnenberg, MD, MScDepartment of Veterans Affairs Medical Center; Albuquerque, NM 87108 (Sonnenberg)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-3-200108070-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Some of the problems associated with models of screening for colorectal cancer are related to the multitude of factors and their interactions, which can potentially influence the outcome. Dr. Chelmowski is correct in suggesting that a markedly reduced cost of flexible sigmoidoscopy could render this procedure more cost-effective. Assuming perfect adherence and a sigmoidoscopy cost of less than $162, the incremental cost-effectiveness ratio of flexible sigmoidoscopy (compared with no screening) falls below that of the fecal occult blood test or colonoscopy. Assuming adherence rates of 75% for both repeated sigmoidoscopy every 5 years and colonoscopy after positive results ... Author, Article, and Disclosure InformationAuthors: Amnon Sonnenberg, MD, MScAffiliations: Department of Veterans Affairs Medical Center; Albuquerque, NM 87108 (Sonnenberg) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Colonoscopy in Screening for Colorectal Cancer Amnon Sonnenberg , Fabiola Delcò , and John M. Inadomi Cost-Effectiveness of Screening for Colorectal Cancer Mark K. Chelmowski Cost-Effectiveness of Screening for Colorectal Cancer Ananya Das Cost-Effectiveness of Screening for Colorectal Cancer Brian Budenholzer and H. Gilbert Welch Metrics 7 August 2001Volume 135, Issue 3Page: 219KeywordsCancer preventionCancer screeningColonoscopyColorectal cancerFallsFlexible sigmoidoscopyHematologic testsPolypectomiesQuality of lifeSurgery ePublished: 7 August 2001 Issue Published: 7 August 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
WHO accused of watering down tobacco treaty
Authors: F. Fleck
Journal: BMJ (2003)

Health activists urged the World Health Organization not to cave in to industry pressure as the final round of talks to conclude a landmark global treaty to reduce tobacco consumption got under way on 17 February.

The Framework Convention on Tobacco Control seeks to restrict advertising and marketing, make health warnings larger on cigarette packets, reduce passive smoking, increase awareness about the risks of smoking, and establish disclosure requirements for tobacco firms.

The final text, which …
Respiratory Syncytial Virus Infection in Adults
Authors: WILLIAM J. HALL
Journal: Annals of Internal Medicine (1978)

We prospectively studied 10 previously healthy adults who developed an acute respiratory illness while working in an infants' ward during a community outbreak of respiratory syncytial virus infection. In addition to clinical and viral evaluation, total respiratory resistance before and after carbachol aerosol inhalation was measured. All 10 subjects had respiratory syncytial virus infection documented by viral isolation, and all developed pronounced cough, nasal congestion, and fever. Eight subjects missed work for an average of 6 days. In all 10 patients, the total respiratory resistance was significantly elevated through 8 weeks. Altered airway reactivity, characterized by exaggerated responses of pulmonary resistance to carbachol challenge, was also observed through the first 8 weeks of evaluation. In this group, respiratory syncytial virus produced a protracted illness associated with appreciable morbidity. The pathophysiologic mechanism of this illness in part appeared to arise from altered airway reactivity.
Dantrolene Improves Survival After Ventricular Fibrillation by Mitigating Impaired Calcium Handling in Animal Models
Authors: Nima Zamiri, Stéphane Massé, Andrew Ramadeen, Marjan Kusha, Xudong Hu, Mohammed Ali Azam, Jie Liu, Patrick F. H. Lai, Edward J. Vigmond, Patrick M. Boyle, Elham Behradfar, Abdul Al-Hesayen, Menashe B. Waxman, Peter Backx, Paul Dorian, Kumaraswamy Nanthakumar
Journal: Circulation (2014)

Resistant ventricular fibrillation, refibrillation. and diminished myocardial contractility are important factors leading to poor survival after cardiac arrest. We hypothesized that dantrolene improves survival after ventricular fibrillation (VF) by rectifying the calcium dysregulation caused by VF.VF was induced in 26 Yorkshire pigs for 4 minutes. Cardiopulmonary resuscitation was then commenced for 3 minutes, and dantrolene or isotonic saline was infused at the onset of cardiopulmonary resuscitation. Animals were defibrillated and observed for 30 minutes. To study the effect of VF on calcium handling and its modulation by dantrolene, hearts from 14 New Zealand rabbits were Langendorff-perfused. The inducibility of VF after dantrolene administration was documented. Optical mapping was performed to evaluate diastolic spontaneous calcium elevations as a measure of cytosolic calcium leak. The sustained return of spontaneous circulation (systolic blood pressure ≥60 mm Hg) was achieved in 85% of the dantrolene group in comparison with 39% of controls (P=0.02). return of spontaneous circulation was achieved earlier in dantrolene-treated pigs after successful defibrillation (21 ± 6 s versus 181 ± 57 s in controls, P=0.005). The median number of refibrillation episodes was lower in the dantrolene group (0 versus 1, P=0.04). In isolated rabbit hearts, the successful induction of VF was achieved in 83% of attempts in controls versus 41% in dantrolene-treated hearts (P=0.007). VF caused diastolic calcium leaks in the form of spontaneous calcium elevations. Administration of 20 μmol/L dantrolene significantly decreased spontaneous calcium elevation amplitude versus controls. (0.024 ± 0.013 versus 0.12 ± 0.02 arbitrary unit [200-ms cycle length], P=0.001).Dantrolene infusion during cardiopulmonary resuscitation facilitates successful defibrillation, improves hemodynamics postdefibrillation, decreases refibrillation, and thus improves survival after cardiac arrest. The effects are mediated through normalizing VF-induced dysfunctional calcium cycling.
404-5 Vascular endothelial growth factor (VEGF) plays a central role in the development of diabetic cardiomyopathy and gene transfer of VEGF improves heart failure in long-standing streptozotocin-induced diabetic rat
Authors: Young-Sup Yoon, Shigeki Uchida, Jong-Seon Park, Cynthia Curry, Jeffrey M Isner, Douglas W Losordo
Journal: Journal of the American College of Cardiology (2004)
Inducible Silencing of KILLER/DR5 <b> <i>In vivo</i> </b> Promotes Bioluminescent Colon Tumor Xenograft Growth and Confers Resistance to Chemotherapeutic Agent 5-Fluorouracil
Authors: Shulin Wang, Wafik S. El-Deiry
Journal: Cancer Research (2004)

Abstract The candidate tumor suppressor KILLER/DR5 is a DNA damage-inducible p53-regulated death receptor for the tumor necrosis factor-related apoptosis-inducing ligand (TRAIL), a promising agent for cancer therapy. The majority of studies on KILLER/DR5 have been focused on its role in TRAIL-induced apoptosis. However, its contribution to the inhibition of tumor growth and its role as a determinant of chemosensitivity are poorly understood. In the present study, we have generated stable human colon cancer cell lines, in which the function of KILLER/DR5 was ablated using inducible RNA interference. Inducible silencing of KILLER/DR5 in vivo by exposure of mice to doxycycline led to accelerated growth of bioluminescent tumor xenografts and conferred resistance to the chemotherapeutic agent 5-fluorouracil. Our results suggest that KILLER/DR5 may be a critical determinant for tumorigenicity and chemosensitivity.
Repeated chemoembolisation (CHE) with systemic chemotherapy for hepatocellular carcinoma (HCC)
Authors: M. Baur, R. Walter, A. Gebauer, Ch. Dittrich, D. Tscholakoff, H. Lochs, F. Mühlbacher, A. Fritsch, A. Gangl, P. Ferenci
Journal: Journal of Hepatology (1991)
Doctors' financial interests should be declared to avoid any impression of impropriety
Authors: Gee Yen Shin, Rohini Manuel
Journal: BMJ (2015)

We are concerned by the General Medical Council’s laissez faire approach to reports of undeclared financial conflicts of interest in the form of financial inducements that may have influenced the referral patterns of UK doctors.1 We are glad that the editorial prompted a response to these serious allegations from the GMC.2

We agree that doctors should make conflicts of interest declarations if these conflicts could affect prescribing and clinical …
Lack of increase in heterozygous α1-antitrypsin deficiency phenotypes among patients with hepatocellular and bile duct carcinoma
Authors: Mordechai Rabinovitz, Judith S. Gavaler, Robert H. Kelly, Martin Prieto, David H. Van Thiel
Journal: Hepatology (1992)

Homozygous alpha 1-antitrypsin deficiency (PiZZ phenotype) is known to be associated with increased risk of cirrhosis and primary liver cancer. Although a relationship between heterozygous alpha 1-antitrypsin deficiency and chronic liver disease was suggested recently, it is still a matter of controversy whether such patients are at increased risk of liver cancer. The goal of this study was to determine the prevalence of heterozygous alpha 1-antitrypsin deficiency of different phenotypes among patients with primary hepatobiliary cancers. We studied 82 patients with primary hepatobiliary cancer; 59 had hepatocellular carcinoma and 23 had bile duct carcinoma. alpha 1-Antitrypsin quantitation and phenotyping were performed in each patient using standard methods. The distribution of the various Pi phenotypes was compared with that found in a normal population and reported elsewhere. Odds-ratio and chi 2 tests were used to measure the relative risk and the significance of association, respectively, between primary hepatobiliary cancers and heterozygous alpha 1-antitrypsin deficiency. Four patients in each of the cancer groups were heterozygous. Among the hepatocellular carcinoma patients, three had the PiMS phenotype and one had the PiMZ phenotype. Of these four heterozygous patients, only two had cirrhosis; one had cryptogenic cirrhosis and the other had hepatitis B virus-related cirrhosis. One noncirrhotic patient with a PiMZ phenotype had a fibrolamellar carcinoma. Of the four patients with bile duct carcinoma, three had the PiMS phenotype and one had the PiMZ phenotype. Of the four heterozygous patients, two had primary sclerosing cholangitis without associated inflammatory bowel disease and one patient had had previous biliary operations.(ABSTRACT TRUNCATED AT 250 WORDS)
Southern Africa is good place to research role of fetal malnutrition in chronic diseases
Authors: A R P Walker, K E Charlton
Journal: BMJ (1998)

Outcome of pregnancy in women with insulin dependent diabetes Centralisation of care leads to better outcomeEditor-The finding of a persistently poor outcome of pregnancy in women with insulin dependent diabetes in two (northern) English regions is an important statement of the problem. 1 2 Both studies provide figures and show outcomes that are no different from those widely reported in the past.Unfortunately, neither give evidence of any degree of centralisation of obstetric or diabetic care, with on-site neonatal intensive care, although this is a proved means of improving the outcome of pregnancy for diabetic mothers. 3 The St Vincent declaration guidelines on the outcome of pregnancy, referred to in the accompanying editorial (p 263), are based on the Scandinavian reports held up as examples of good practice and state that "an interdisciplinary team should provide centralized diabetic pregnancy care in a hospital treating at least 20-30 cases a year.Pregnant diabetic
Independent Factors Associated With Outcomes of Parachute Mitral Valve in 84 Patients
Authors: Mark V. Schaverien, Robert M. Freedom, Brian W. McCrindle
Journal: Circulation (2004)

Parachute mitral valve (PMV) is defined as a unifocal attachment of the mitral valve chordae to a single or dominant papillary muscle and may cause subvalvar obstruction. We sought to determine factors associated with outcomes.Patients (n=84; 64% male) who presented between 1977 and 2001 at a median age of 3 days (range, birth to 5.4 years) were assessed with PMV (without atrioventricular septal defect). Associated cardiac anomalies in 99% included aortic coarctation in 68%, atrial septal defect in 54%, ventricular septal defect in 46%, aortic valve stenosis in 32%, subaortic stenosis in 20%, and left ventricular hypoplasia in 19%, with complex anomalies in 14%. Noncardiac anomalies were noted in 32%. Survival (n=18 deaths) was 82% at 1 year and 79% at 10 years, with independent risk factors including left ventricular hypoplasia (P<0.001) and atrial septal defect (P<0.003). Freedom from surgical mitral valvotomy (n=11 patients) was 95% at age 6 months and 80% at 10 years, with independent risk factors including the absence of aortic coarctation (P<0.02) and the presence of subaortic stenosis (P<0.04). There was no significant increase in mean gradient of the PMV over time, but higher gradient was independently associated with the presence of supravalvar mitral stenosis (P<0.001), absence of atrial septal defect (P<0.04), presence of ventricular septal defect (P<0.02), and subsequent mitral valvotomy (P<0.01).Outcomes for patients with PMV are dependent on the spectrum of associated cardiac lesions. The degree of mitral valve obstruction remains stable, and the majority will not require valvotomy.
Origin of the third heart sound.
Authors: K. Reid
Journal: BMJ (1969)

BRITJsH 597 seven days and then reduce the dose to 45 mg.daily.Eleven days later she was readmitted with an acute psychotic illness characterized by paranoid delusions.She was febrile and her pulse rate varied between 110 and 145.Clinically she was considered to be euthyroid and the serum P.B.I. was 4-3 ltg.1100 ml.Serum urea, electrolytes, full blood count, electrocardiogram, chest x-ray, and urine culture were normal.Three days later her temperature was normal and she was transferred to a psychiatric hospital (Dr.J. G. Henderson).She was treated with chlorpromazine and benztropine and continued on carbi- mazole 20 mg.daily.Two months later she was mentally normal and during her illness she re- mained clinically and biochemically euthyroid.Subtotal thyroidectomy was carried out two months after her discharge (Mr. W. Michie), and at her most recent review, 10 months after operation, she was euthyroid and normal in all other respects.At the time of her first admission this patient was considered to have severe hyper- thyroidism, and the treatment rapidly altered her thyroid state towards normal.There was no evidence of hypothyroidism at any time during her illness.It is suggested that her psychiatric disturbance may have been due to either the acute change in her metabolic state, induced by the antithyroid drug, or to the drug itself.Similar findings have been reported previously.'-We are, etc.,
Role of the inward rectifier IK1 in the myocardial response to hypoxia
Authors: E. Ruiz-Petrich, F. d. Lorenzi, D. Chartier
Journal: Cardiovascular Research (1991)

Study objective – The aim was to assess the contribution of the inward rectifier IK1 to the electrical responses of the myocardium to hypoxia: action potential shortening, maintenance of resting potential, and myocardial K loss. Design – Hypoxia induced changes of gK1 were inferred from the effects of 40 μm Ba2+ on action potential duration, resting potential, and cellular K content of normoxic and hypoxic rabbit hearts paced at 2.5 Hz and perfused at 33°C and constant coronary flow of 20 ml·min−1. The components (diffusion generated and Na pump related) of the resting potential (Vr) were separated by exposure to 10−4 M ouabain. The effects of varying the extracellular K concentration (Ko were also examined. Experimental material – New Zealand rabbits were heparinised and anaesthetised and the hearts rapidly excised and perfused in the Langendorff manner. Measurements and main results – The membrane potential was measured with standard glass microelectrodes and the cellular content of K and Na estimated from determinations of total electrolyte and water content and volume of the inulin space of the tissue. In normoxia, Ba2+ caused a slight depolarisation at Ko below 10 mM and lengthened the action potential duration at 95% repolarisation (APD95) without altering the plateau duration. In hypoxia, Ba2+ caused further depolarisation and markedly reduced the APD95 shortening at normal Ko. The Vrv Ko relationship was considerably flattened and the diffusion component of Vr became insensitive to changes in Ko between 1.5 and 10 mM. Concomitantly, the Na pump related fraction of Vr increased under Ba2+. Barium also attenuated myocardial K loss induced by hypoxia. Conclusion – Our data suggest that an increase in the IK1 current underlies the maintenance of Vr in hypoxia despite the decrease in the transmembrane K gradient and contributes to the action potential shortening, speeding up the late repolarisation. The inwardly rectifying K channels would also be involved in the increased efflux of K+. In contrast, the decrease in plateau duration is probably caused by another K current system, less sensitive to Ba2. Finally, the contribution of electrogenic Na pumping to Vr becomes critical for the maintenance of the resting potential under conditions of decreased resting permeability.