tbuckley/cabot-search huggingface dataset:
BMA launches review on UK healthcare spending
Authors: A. Ferriman
Journal: BMJ (2000)

Two major issues emerged at the launch last week of the BMA's review of healthcare funding in the United Kingdom. Participants at a London seminar, held to kick off the debate, wanted a system that protected the most vulnerable populations in society—particularly mentally ill people—and one that was equitable, so that proved treatments available to patients in one area were available to patients everywhere.

But none of the 40 participants could offer a solution to the problem that some patients would always be able to buy the most up to date drugs and procedures before they had been proved to be cost effective, whereas others would not.

The BMA's review, which was announced last year when the NHS was showing particular signs of strain, is expected to last …
Arterial Inflammation in Patients With HIV
Authors: Sharath Subramanian, Ahmed Tawakol, Tricia H. Burdo, Suhny Abbara, Jeffrey Wei, Jayanthi Vijayakumar, Erin Corsini, Amr Abdelbaky, Markella V. Zanni, Udo Hoffmann, Kenneth C. Williams, Janet Lo, Steven K. Grinspoon
Journal: JAMA (2012)

Cardiovascular disease is increased in patients with human immunodeficiency virus (HIV), but the specific mechanisms are unknown.To assess arterial wall inflammation in HIV, using 18fluorine-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET), in relationship to traditional and nontraditional risk markers, including soluble CD163 (sCD163), a marker of monocyte and macrophage activation.A cross-sectional study of 81 participants investigated between November 2009 and July 2011 at the Massachusetts General Hospital. Twenty-seven participants with HIV without known cardiac disease underwent cardiac 18F-FDG-PET for assessment of arterial wall inflammation and coronary computed tomography scanning for coronary artery calcium. The HIV group was compared with 2 separate non-HIV control groups. One control group (n = 27) was matched to the HIV group for age, sex, and Framingham risk score (FRS) and had no known atherosclerotic disease (non-HIV FRS-matched controls). The second control group (n = 27) was matched on sex and selected based on the presence of known atherosclerotic disease (non-HIV atherosclerotic controls).Arterial inflammation was prospectively determined as the ratio of FDG uptake in the arterial wall of the ascending aorta to venous background as the target-to-background ratio (TBR).Participants with HIV demonstrated well-controlled HIV disease (mean [SD] CD4 cell count, 641 [288] cells/μL; median [interquartile range] HIV-RNA level, <48 [<48 to <48] copies/mL). All were receiving antiretroviral therapy (mean [SD] duration, 12.3 [4.3] years). The mean FRS was low in both HIV and non-HIV FRS-matched control participants (6.4; 95% CI, 4.8-8.0 vs 6.6; 95% CI, 4.9-8.2; P = .87). Arterial inflammation in the aorta (aortic TBR) was higher in the HIV group vs the non-HIV FRS-matched control group (2.23; 95% CI, 2.07-2.40 vs 1.89; 95% CI, 1.80-1.97; P < .001), but was similar compared with the non-HIV atherosclerotic control group (2.23; 95% CI, 2.07-2.40 vs 2.13; 95% CI, 2.03-2.23; P = .29). Aortic TBR remained significantly higher in the HIV group vs the non-HIV FRS-matched control group after adjusting for traditional cardiovascular risk factors (P = .002) and in stratified analyses among participants with undetectable viral load, zero calcium, FRS of less than 10, a low-density lipoprotein cholesterol level of less than 100 mg/dL (<2.59 mmol/L), no statin use, and no smoking (all P ≤ .01). Aortic TBR was associated with sCD163 level (P = .04) but not with C-reactive protein (P = .65) or D-dimer (P = .08) among patients with HIV.Participants infected with HIV vs noninfected control participants with similar cardiac risk factors had signs of increased arterial inflammation, which was associated with a circulating marker of monocyte and macrophage activation.
TOXIC EFFECTS OF FUADIN AND ANTIMONY AND POTASSIUM TARTRATE
Authors: F. Gordon Cawston
Journal: JAMA (1942)

<h3>To the Editor:—</h3> In the<i>South African Medical Journal</i>, Nov. 8, 1941, page 440, E. Ross Marshall of New York is reported to have said, in comparing antimony and potassium tartrate with fuadin (<i>J. Nat. M. A.</i><b>33</b>:105 [May] 1941) that "fuadin is the better drug since it is less toxic.... As it is much less toxic, almost no untoward symptoms are noted from its use." Similar statements have been made in regard to the use of antimony in the treatment of leprosy. No thoughtful reader can think that a 6 per cent solution is as "toxic" as a powder containing from 36 to 39 per cent of the same drug, and an equivalent amount of the two solutions reveals that the solution of antimony and potassium tartrate is free of the undesirable effects of the pyrocatechol compounds. Estimates of cure are difficult in instances in which extensive parasitic
Extracorporeal shock wave therapy in the treatment of inferior calcaneal enthesophytosis: outcome by fan-beam dual x ray absorptiometry (DXA)
Authors: R Cosentino
Journal: Annals of the Rheumatic Diseases (2004)

Plantar fasciitis with heel spurs is a common cause of heel pain, and is often not sensitive to conservative treatment, including insole supports, non-steroidal anti-inflammatory drugs, local steroid injection, and physical therapy.1,2 In patients in whom conservative treatment fails, surgical intervention is recommended.3

Recently, extracorporeal shock wave therapy has been introduced for the alleviation of painful heel and other conditions such as tennis elbow, calcifying tendinopathy of the shoulder, and non-union of fractures of the long bones.4–7

The presence and size of the heel spurs do not correlate with the clinical symptoms.4,8

Twenty patients aged between 40 …
Congestive cardiomyopathy in uraemic patients on long term haemodialysis.
Authors: T Drueke, C Le Pailleur, B Meilhac, C Koutoudis, J Zingraff, J Di Matteo, J Crosnier
Journal: BMJ (1977)

Five uraemic patients who developed progressive cardiac failure with clinical evidence of congestive cardiomyopathy at the start or during haemodialysis treatment were studied. The diagnosis of cardiomyopathy, for which there was no apparent cause, was confirmed by angiocardiographic and haemodynamic studies. These showed a significant increase in left ventricular end-diastolic volume over normal values obtained in 12 patients without uraemia. The mean velocity of myocardial fibre shortening was significantly decreased, as was the index of normalised rigidity. Three of the five patients presented the complete picture of the disease. The other two also had considerable ventricular dilatation and a decreased index of normalised rigidity but normal ejection fraction and only moderately decreased myocardial contractility indices. This suggests that there may be primary involvement of normalised heart muscle rigidity followed by secondary changes in myocardial contractility in uraemic patients with congestive cardiomyopathy.
A population study on the prevalence of gallstone disease: The sirmione study
Authors: Luigi Barbara, Claudia Sama, Antonio Maria Morselli Labate, Francesco Taroni, Anna Giulia Rusticali, Davide Festi, Carlo Sapio, Enrico Roda, Claudio Banterle, Armando Puci, Franco Formentini, Silvia Colasanti, Francesco Nardin
Journal: Hepatology (1987)

The prevalence of gallstone disease (cholelithiasis and previous cholecystectomy for gallstones) in the population of the town of Sirmione, Italy, examined by ultrasonography, was 6.7% in men and 14.6% in women, ranging from 18 to 65 yr of age (overall prevalence = 11%). The prevalence of cholelithiasis in the same age span was 6.9% (4.5% in men and 8.9% in women). Prevalence of cholelithiasis increased with age in both sexes. Twenty-two percent of gallstone subjects suffered from biliary pain vs. 2% of subjects without gallstones. No difference was observed in the frequency of nonspecific symptoms between subjects with and without gallstones. Of the 132 gallstone subjects, 108 (82%) were not aware of having gallstones prior to the study. Prevalence of gallstone disease was found to be higher in obese and hypertriglyceridemic subjects and to increase with the number of pregnancies.
Circulating cardiovascular risk factors in obstructive sleep apnoea: data from randomised controlled trials
Authors: G V Robinson
Journal: Thorax (2004)

Obstructive sleep apnoea (OSA) is associated with high cardiovascular morbidity and mortality and is an independent risk factor for hypertension. Novel circulating cardiovascular risk markers enabling a more accurate prediction of cardiovascular risk have been identified. Examination of these markers may clarify the increased risk in OSA and contribute to an analysis of the benefits of treatment.Plasma levels of total cholesterol and triglyceride and activated coagulation factors XIIa and VIIa, factors VII, VIII, XII, fibrinogen, thrombin-antithrombin (TAT), von Willebrand factor antigen (vWFAg), soluble P-selectin (sP-sel), and homocysteine were measured before and after treatment for 1 month with therapeutic or subtherapeutic (control) continuous positive airways pressure (CPAP) in 220 patients with OSA.Levels of activated coagulation factors XIIa, VIIa, TAT and sP-sel were higher in OSA patients at baseline than in unmatched controls, but did not fall with 1 month of therapeutic CPAP treatment. The raised sP-sel levels correlated only with body mass index (p = 0.002). There was a trend towards a significant fall in total cholesterol with therapeutic CPAP (p = 0.06) compared with the control group. In the therapeutic group there was a clinically significant mean fall in total cholesterol of 0.28 mmol/l (95% confidence interval 0.11 to 0.45, p = 0.001) which may reduce cardiovascular risk by about 15%.A number of activated coagulation factors are increased in untreated OSA patients, potentially contributing to vascular risk, but they do not fall with 1 month of CPAP treatment. Nasal CPAP may produce a clinically relevant fall in total cholesterol level, potentially reducing cardiovascular risk, but this needs to be verified in a larger prospective study.
Androgen production in a patient with Klinefelter's syndrome and choriocarcinoma.
Authors: A P Weetman, L K Borysiewicz
Journal: BMJ (1980)

Background/Aim: To explore the effect of palliative care (PC) pathway including home care and end-of-life care beds in the community hospitals supported by a PC unit in the secondary hospital on ER visits and hospitalizations. Patients and Methods: Patients with advanced cancer and no further oncologic therapies who visited the ER of the Hyvinkää hospital before (2009) and after (2015) the establishment of the PC pathway were evaluated. Results: A total of 112 patients visited the ER in both years, but revisits decreased from 59% to 38% (p&lt;0.01). The most common symptoms necessitating the visit were pain (20%) and dyspnoea (14%). The proportion of patients admitted to a secondary hospital were 56% and 45% (p=0.016) and to community hospitals 12% and 28% (p&lt;0.001) in 2009 and 2015, respectively. Conclusion: Organizing a PC pathway for cancer patients together with primary and secondary care decreases revisits to ER and admissions to secondary hospitals.
Secondary sclerosing cholangitis after chemotherapy with bevacizumab and paclitaxel
Authors: G. von Figura, J. Stephani, M. Wagner, M. Wegener, C. Wolf, G. Adler, H. Kulaksiz
Journal: Endoscopy (2009)

A 59-year-old woman was referred to our hospital by her gynaecologist because of progressive jaundice. She had been diagnosed as having left-sided breast cancer 18 months ago. Two months before admission, she had started chemotherapy with intravenous paclitaxel (90 mg/m2) and bevacizumab (10 mg/kg). [Fig. 1] summarizes the patient's treatments and results of the liver function tests (LFTs).
Outcomes After Kidney Donation
Authors: Allan B. Massie, Abimereki D. Muzaale, Dorry L. Segev
Journal: JAMA (2014)

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
Influence of Combined Intravenous and Topical Antibiotic Prophylaxis on the Incidence of Infections, Organ Dysfunctions, and Mortality in Critically Ill Surgical Patients
Authors: Wolfgang A. Krueger, Franz-Peter Lenhart, Gertraud Neeser, Gotthart Ruckdeschel, Heidi Schreckhase, Hans-Joachim Eissner, Helmuth Forst, Joachim Eckart, Klaus Peter, Klaus E. Unertl
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

We prospectively studied the impact of an antibiotic prophylaxis regimen on the incidence of infections, organ dysfunctions, and mortality in a predominantly surgical and trauma intensive care unit (ICU) population. A total of 546 patients were enrolled and stratified according to Acute Physiology and Chronic Health Evaluation (APACHE)-II scores. They were then randomized to receive either 2 × 400 mg of intravenous ciprofloxacin for 4 days, together with a mixture of topical gentamicin and polymyxin applied to the nostrils, mouth, and stomach throughout their ICU stay or to receive intravenous and topical placebo. When receiving prophylaxis, significantly fewer patients acquired infections (p = 0.001, risk ratio [RR], 0.477; 95% confidence interval [CI], 0.367–0.620), especially pneumonias (6 versus 29, p = 0.007), other lower respiratory tract infections (39 versus 70, p = 0.007), bloodstream infections (14 versus 36, p = 0.007), or urinary tract infections (36 versus 60, p = 0.042). Also, significantly fewer patients acquired severe organ dysfunctions (63 versus 96 patients, p = 0.0051; RR, 0.636; 95% CI, 0.463–0.874), especially renal dysfunctions (17 versus 38; p = 0.018). Within 5 days after admission, 24 patients died in each group, whereas 28 patients receiving prophylaxis and 51 receiving placebo died in the ICU thereafter (p = 0.0589; RR, 0.640; 95% CI, 0.402–1.017). The overall ICU mortality was not statistically different (52 versus 75 fatalities), but the mortality was significantly reduced for 237 patients of the midrange stratum with APACHE-II scores of 20–29 on admission (20 versus 38 fatalities, p = 0.0147; RR, 0.508; 95% CI, 0.295–0.875); there was still a favorable trend after 1 year (51 versus 60 fatalities; p = 0.0844; RR, 0.720; 95% CI, 0.496–1.046). Surveillance cultures from tracheobronchial, oropharyngeal, and gastric secretions and from rectal swabs did not show any evidence for the selection of resistant microorganisms in the patients receiving prophylaxis.
Prognostic Factors of 634 HIV-Negative Patients with <i>Mycobacterium avium</i> Complex Lung Disease
Authors: Makoto Hayashi, Noboru Takayanagi, Tetsu Kanauchi, Yousuke Miyahara, Tsutomu Yanagisawa, Yutaka Sugita
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

The prognostic factors of Mycobacterium avium complex lung disease (MAC-LD) are not clearly defined.To assess the prognostic factors of all-cause and MAC-specific mortality in patients with MAC-LD, especially in accordance with radiographic features, first-line treatment, and host predisposition.Medical records of 634 HIV-negative patients with MAC-LD treated at our institution in Saitama, Japan were retrospectively analyzed.Patients' mean age was 68.9 years, and median follow-up period was 4.7 years. Radiographic features included nodular/bronchiectatic (NB) disease: 482 patients (76.0%); fibrocavitary (FC) disease: 105 patients (16.6%); FC+NB disease: 30 patients (4.7%); and other types: 17 patients (3.0%). First-line treatments were observation or one drug: 479 patients (75.6%); 2 to 5 drugs: 131 patients (20.7%); and unknown: 24 patients (3.8%). A multivariate Cox proportional hazard model showed male sex, older age, presence of systemic and/or respiratory comorbidity, non-NB radiographic features, body mass index (BMI) less than 18.5 kg/m(2), anemia, hypoalbuminemia, and erythrocyte sedimentation rate greater than or equal to 50 mm/h to be negative prognostic factors for all-cause mortality, and FC or FC+NB radiographic features, BMI less than 18.5 kg/m(2), anemia, and C-reactive protein greater than or equal to 1.0 mg/dl to be negative prognostic factors for MAC-specific mortality.The first-line treatment regimen was not associated with all-cause mortality. FC or FC+NB disease, BMI less than 18.5 kg/m(2), and anemia were negative prognostic factors for both all-cause and MAC-specific mortality.
Review: Non–calcium-based phosphate binders reduce mortality compared with calcium-based binders in CKD
Authors: Chirag R. Parikh
Journal: Annals of Internal Medicine (2013)

Source Citation Jamal SA, Vandermeer B, Raggi P, et al. Effect of calcium-based versus non-calcium-based phosphate binders on mortality in patients with chronic kidney disease: an updated systematic review and meta-analysis. Lancet. 2013;382:1268-77. 23870817
Melioidosis: an important cause of pneumonia in residents of and travellers returned from endemic regions
Authors: B.J. Currie
Journal: European Respiratory Journal (2003)

Melioidosis is endemic in South East Asia, Asia and northern Australia. Infection usually follows percutaneous inoculation or inhalation of the causative bacterium, Burkholderia pseudomallei, which is present in soil and surface water in the endemic region. While 20-36% of melioidosis cases have no evident predisposing risk factor, the vast majority of fatal cases have an identified risk factor, the most important of which are diabetes, alcoholism and chronic renal disease. Half of all cases present with pneumonia, but there is great clinical diversity, from localised skin ulcers or abscesses without systemic illness to fulminant septic shock with multiple abscesses in the lungs, liver, spleen and kidneys. At least 10% of cases present with a chronic respiratory illness (sick > 2 months) mimicking tuberculosis and often with upper lobe infiltrates and/or cavities on chest radiography. As with tuberculosis, latency with reactivation decades after infection can also occur, although this is rare. Confirmation of diagnosis is by culture of B. pseudomallei from blood, sputum, throat swab or other samples. Microbiology laboratories need to be informed of the possibility of melioidosis, as those not familiar with it can misidentify the organism. Antibiotic therapy is initial intensive therapy with i.v. ceftazidime or meropenem or imipenem +/- cotrimoxazole for > or = 10 days, followed by eradication therapy with cotrimoxazole +/- doxycycline +/- chloramphenicol (first 4 weeks only) for > or = 3 months. Melioidosis has been increasingly recognised in returning travellers in Europe and recently melioidosis and colonisation with B. pseudomallei have been documented in cystic fibrosis patients visiting or resident in endemic areas.
Maintenance of Licensure
Authors: Marc S. Frager
Journal: Annals of Internal Medicine (2013)

Letters5 February 2013Maintenance of LicensureMarc S. Frager, MDMarc S. Frager, MDFrom East Coast Medical Associates, Boca Raton, Florida.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-158-3-201302050-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We read Chaudhry and colleagues' article (1) with great interest. Although MOL sounds acceptable superficially, is it reasonable to implement a costly and highly controversial procedure, such as MOC, that has never been shown to have any value over and above continuing medical education (CME)? Numerous publications point out the real problems with MOC, including cost, time commitment, and that the secure test seems to exist only to provide revenues to the testing organization.Until the MOC procedure has been compared in age-matched physicians with current methods of CME and has been found to positively affect some ...Reference1. Chaudhry HJ, Talmage LA, Alguire PC, Cain FE, Waters S, Rhyne JA. Maintenance of licensure: supporting a physician's commitment to lifelong learning. Ann Intern Med. 2012;157:287-9. [PMID: 22733035] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Marc S. Frager, MDAffiliations: From East Coast Medical Associates, Boca Raton, Florida.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMaintenance of Licensure: Supporting a Physician's Commitment to Lifelong Learning Humayun J. Chaudhry , Lance A. Talmage , Patrick C. Alguire , Frances E. Cain , Sandra Waters , and Janelle A. Rhyne Maintenance of Licensure James J. Glazier Maintenance of Licensure Connie Nugent and Kenneth M. Nugent Maintenance of Licensure Humayun J. Chaudhry , Lance A. Talmage , and Janelle A. Rhyne Maintenance of Licensure Paul Kempen Metrics 5 February 2013Volume 158, Issue 3Page: 219-220KeywordsBehaviorConflicts of interestMedical education ePublished: 5 February 2013 Issue Published: 5 February 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Verbal Hyperplasia
Authors: Ellis Quay
Journal: JAMA (1965)

<b>Verbal hyperplasia</b>is a disease which neither kills nor seriously incapacitates, but it may produce considerable discomfort. Although common —indeed, in its subclinical form extremely wide-spread—it has failed to arouse much interest in either the medical scientist or the practicing physician. Such indifference I find regrettable. The present report may stimulate interest in the condition. <h3>History</h3> The Greeks, after consultation with the Romans, first established the disease as an entity. They called it<i>cacoethes scribendi</i>and distinguished it from another ailment,<i>cacoethes loquendi</i>. Modern research, of course, has indicated the essential similarity of these two conditions and identified both as variants of a single more basic state. The term<i>cacoethes</i>("bad habit") implied that the disease was mental. Whereas physical defects—palpable overgrowths, swellings, tumors and excrescences —were quite obvious and attracted the attention of physicians, the excrescences of the mind, the out-growths of language, seemed of a very different order.
Re: Visualizing Length of Survival in Time-to-Event Studies: A Complement to Kaplan-Meier Plots
Authors: N. Lama, C. Gallo
Journal: JNCI Journal of the National Cancer Institute (2008)

Royston et al. ( 1 ) recently suggested a method of presenting data that was complementary to Kaplan – Meier curves, with the aim to supplement ordinary survival probability plots with a direct and intuitive indication of the variability in survival times among individual patients. They showed how survival time histograms could be obtained by imputing censored survival times with values predicted by a log-normal model. We agree with Royston et al. ( 1 ) that Kaplan – Meier plots tend to conceal survival time variability, thus obscuring the impact of the treatment. We also agree the actual benefi ts of the treatment depend not only on the hazard ratio but also on the