tbuckley/cabot-search huggingface dataset:
Maximising opportunities for increased antiretroviral treatment in children in an existing HIV programme in rural South Africa
Authors: R. M. Bland, J. Ndirangu, M.-L. Newell
Journal: BMJ (2013)

Abstract 

The setting is an HIV treatment and care programme in Hlabisa, a rural sub-district of the province of KwaZulu-Natal, South Africa. In 2011, the population of Hlabisa was about 220 000 people, of whom an estimated 37.8% (83 160) were children aged 1 year to ≤15 years and 2.4% (5280) …
Good Intentions Do Pave Road to Safe Harbors, But Taking Contravention Avenues Remains Risky
Authors: Teri Randall
Journal: JAMA (1991)

NEARLY FOUR MONTHS have passed since Richard Kusserow, inspector general for the US Department of Health and Human Services (DHHS), issued safe harbor regulations to help "self-referring" physicians steer clear of federal antikickback investigations. Additional safe harbors, plus interpretive rules, are expected early in 1992. But when these original regulations were issued, few physicians who had invested in health care facilities to which they refer patients found themselves within these safe harbors. Most of them, instead, had to decide whether to restructure, divest, or remain vulnerable to potential criminal and civil sanctions under the 1977 Medicare and Medicaid antikickback statute. <h3>Critical 40%</h3> To fall within safe harbors, no more than 40% of a facility may be owned by those in a position to refer patients to that facility. And referrals from owners should contribute no more than 40% of the facility's business. Under these new regulations, a hospital is also
"War on drugs" continues in United States under new leadership.
Authors: D M Gorman
Journal: BMJ (1993)

Criticism of the "war on drugs" pursued under Republican administrations has grown in the United States. With the election of Bill Clinton many experts expected a shift from law enforcement policies to an approach favouring treatment and prevention. The budget announced in April, however, revealed no such shift in allocation of resources. Although the war on drugs has apparently failed to reduce the supply of cheap heroin and cocaine to the United States, the prevention strategy favoured by its opponents--school based prevention programmes--has not yet been shown to be effective in dealing with the concentration of drug misuse among the socially disadvantaged. In looking for new strategies Clinton must satisfy both liberals and conservatives in Congress, and community policing might therefore prove to be a politically expedient option.
Oral Aztreonam, A Poorly Absorbed Yet Effective Therapy for Bacterial Diarrhea in US Travelers to Mexico
Authors: Herbert L. DuPont
Journal: JAMA (1992)

To evaluate a poorly absorbed antimicrobial with in vitro activity against all major bacterial enteropathogens in oral therapy for bacterial diarrhea.One hundred ninety-one US students with diarrhea acquired in Mexico received 100 mg of aztreonam or matching placebo three times a day for 5 days. Stools were cultured for bacterial enteropathogens before and after therapy.We studied US students who acquired diarrhea in Mexico (travelers' diarrhea) in view of the high frequency of bacterial agents in this setting.We examined time of clinical recovery, treatment failures, adverse experiences, and microbiologic eradication from stool of the etiologic agent in subjects randomized to receive aztreonam or placebo.Aztreonam reduced the average duration of diarrhea compared with the placebo: for all cases, by 40 hours (P much less than .01); for those with enterotoxigenic Escherichia coli diarrhea, by 50 hours (P less than .01); for those with shigellosis, by 90 hours (P, not significant [small sample size]); for all bacterial agents, by 57 hours (P much less than .01). Clinical failures during the 5 days of therapy were seen in six patients (6%) receiving aztreonam and 25 (27%) receiving placebo (P less than .01). Pathogen eradication occurred in 95% of those receiving aztreonam and in 70% of those receiving the placebo (P less than .01). All bacterial enteropathogens were susceptible in vitro to aztreonam. The drug was well tolerated.Oral aztreonam, which is poorly absorbed, was well tolerated and was an effective therapy for bacterial diarrhea in US adults in Mexico.
Leprosy in Chinese Laundries.
Authors: Albert S. Ashmead
Journal: JAMA (1897)

New York City, Sept. 6, 1897. <h3>To the Editor:</h3> —The report of Charles F. Roberts, M.D., Sanitary Superintendent of the Board of Health of New York, to the Hon. Chas. G. Wilson, President, regarding the question of the presence or absence of leprosy in the Chinese laundries of this city, contains statements not consistent with the knowledge of the present day. I have nothing to say about the presence of the disease in the Chinese laundries; I may, however, say I do not believe in its existence. So far he is correct. But I object to his statement that "the authorities of the present day entertain the belief that the disease is due to infection not contagion." I venture to affirm that all able authorities of the whole world, believe in contagiousness, and that it is as contagious in "the four hundred of New York" as in the slums of
Self monitoring of blood pressure at home: Informed self regulation of drug treatment could be next step
Authors: Caroline L Kelham
Journal: BMJ (2005)

Users' guide to detecting misleading claims in researchMisleading claims may be symptom of even more serious flaws Editor-Montori et al justifiably draw attention to misleading claims in published clinical trials. 1 This is a serious and common problem. 2 3 However, I object to their radical proposal that only the methods and results sections should be read, while the remainder of the paper should be ignored.The proposal is inconsistent with the title of their paper, "Users' guide to detecting misleading claims in clinical research reports." 1 How are these misleading claims to be identified if the sections containing them are omitted?Furthermore, anyone capable of critically appraising a trial solely on the basis of the methods and results is unlikely to be fooled by misleading claims in the discussion.But, more importantly, the proposal would deprive the discerning reader of witnessing the conflict between the results and the unwarranted conclusions.If researchers are willing to disseminate misleading claims then their integrity is brought into question.But if so, then all aspects of the trial-including the methods and results sections-are also brought into question.Misleading claims should be identified and broadcast loudly for they signal doubts about the entire study.Large scale randomised trials create the ideal conditions for data manipulation.Yet this is merely one of a multitude of problems stemming from a flawed method. 3 The remedy?When reading a study, ignore everything except the number of patients recruited.If this is large proceed no further as there is little prospect of encountering any data of genuine benefit to patients.
Nicotine substitutes for hospital patients who smoke
Authors: J D G O'Hare
Journal: BMJ (1993)

in his example has now been discarded to cope with the problems of fixed length codes and a single hierarchy.2It is also a mistake to underestimate the challenge of moving from individual terms to the complexity of the contextual information in a medical record:The broader patient centred aims of the information technology strategy are to be welcomed.As with all scientific endeavour, however, it is essential to have a clear vision of the true goal and to have critically appraised the steps required to achieve it.
G3139, an Anti-Bcl-2 Antisense Oligomer That Binds Heparin-Binding Growth Factors and Collagen I, Alters<i>In vitro</i>Endothelial Cell Growth and Tubular Morphogenesis
Authors: C.A. Stein, SiJian Wu, Anatoliy M. Voskresenskiy, Jin-Feng Zhou, Joongho Shin, Paul Miller, Naira Souleimanian, Luba Benimetskaya
Journal: Clinical Cancer Research (2009)

We examined the effects of G3139 on the interaction of heparin-binding proteins [e.g., fibroblast growth factor 2 (FGF2) and collagen I] with endothelial cells. G3139 is an 18-mer phosphorothioate oligonucleotide targeted to the initiation codon region of the Bcl-2 mRNA. A randomized, prospective global phase III trial in advanced melanoma (GM301) has evaluated G3139 in combination with dacarbazine. However, the mechanism of action of G3139 is incompletely understood because it is unlikely that Bcl-2 silencing is the sole mechanism for chemosensitization in melanoma cells.The ability of G3139 to interact with and protect heparin-binding proteins was quantitated. The effects of G3139 on the binding of FGF2 to high-affinity cell surface receptors and the induction of cellular mitogenesis and tubular morphogenesis in HMEC-1 and human umbilical vascular endothelial cells were determined.G3139 binds with picomolar affinity to collagen I. By replacing heparin, the drug can potentiate the binding of FGF2 to FGFR1 IIIc, and it protects FGF from oxidation and proteolysis. G3139 can increase endothelial cell mitogenesis and tubular morphogenesis of HMEC-1 cells in three-dimensional collagen gels, increases the mitogenesis of human umbilical vascular endothelial cells similarly, and induces vessel sprouts in the rat aortic ring model.G3139 dramatically affects the behavior of endothelial cells. There may be a correlation between this observation and the treatment interaction with lactate dehydrogenase observed clinically.
Changes in Weight, Electrolyte and Acid-Base Balance During Prolonged Fasting.
Authors: Abraham Rapoport
Journal: Annals of Internal Medicine (1965)

s1 November 1965Changes in Weight, Electrolyte and Acid-Base Balance During Prolonged Fasting.Abraham Rapoport, M.D., F.A.C.P., G. L. A. From, M.D., H. Husdan, M.D.Abraham Rapoport, M.D., F.A.C.P.Search for more papers by this author, G. L. A. From, M.D.Search for more papers by this author, H. Husdan, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-63-5-915_1 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThirteen obese females were studied during 14 A periods of fasting, lasting 2 to 4 weeks, in which they consumed only noncaloric fluids. The 11 patients who underwent 3 weeks of fasting lost an average of 12.7 lb in the first week, 6.8 lb in the second, and 5.6 lb in the third. The decreasing rate of weight loss with time could be related to decrease in urine output, basal metabolism, and activity of the patients. Urine sodium decreased gradually to an average of 20 mEq/day after 1 week of starvation. During early refeeding, urine sodium almost disappeared regardless of... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Abraham Rapoport, M.D., F.A.C.P.; G. L. A. From, M.D.; H. Husdan, M.D.Affiliations: Toronto, PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 November 1965Volume 63, Issue 5Page: 915-915KeywordsOverweightSodiumStarvationUrineWeight loss ePublished: 1 December 2008 Issue Published: 1 November 1965 PDF downloadLoading ...
CHEMICAL, CLINICAL AND IMMUNOLOGICAL STUDIES ON THE PRODUCTS OF HUMAN PLASMA FRACTIONATION. XXXIII. THE COAGULATION DEFECT IN HEMOPHILIA: THE EFFECT IN VITRO AND IN VIVO ON THE COAGULATION TIME IN HEMOPHILIA OF A PROTHROMBIN AND FIBRINOGEN-FREE NORMAL PLASMA AND ITS DERIVED PROTEIN FRACTIONS 123
Authors: Jessica H. Lewis, J. P. Soulier, F. H. L. Taylor
Journal: Journal of Clinical Investigation (1946)

Patek and Taylor (1) in 1937 demonstrated that the activity of normal plasma in shortening the coagulation time of hemophilic blood could be found almost quantitatively in a derived globulin fraction.In 1939, Lozner, Kark and Taylor (2) showed that Berkefelded normal plasma free from fibrinogen and prothrombin had hemophilic clot- promoting power similar to that of untreated nor- mal plasma.In unpublished investigations (3), they found that a globulin fraction derived from this fibrinogen and prothrombin-free plasma also had antihemophilic activity.Pavlovsky and Si- monetti (4) in 1944, using the technique of Patek and Taylor, demonstrated that globulin substance prepared from the plasma of a patient with con- genital fibrinogenopenia had normal antihemo- philic activity.Investigation in this laboratory of plasma pro- tein fractions prepared by the Harvard Physical Chemistry Department showed marked in vitro (5) antihemophilic activity to be present in Frac- tions I and II + III.Fraction I studied in vivo (6) likewise showed marked power to shorten the coagulation time of hemophilic patient's blood.This investigation was undertaken to study the
Disease Management and the Organization of Physician Practice
Authors: Lawrence P. Casalino
Journal: JAMA (2005)

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
Why Are Today's Medical Students Choosing High-Technology Specialties over Internal Medicine?
Authors: Daniel J. McCarty
Journal: New England Journal of Medicine (1987)

The annual meeting of the Association of Professors of Medicine, an organization of the chairpersons of the departments of medicine of our nation's 125 medical schools, was held last May. Much of the discussion at the meeting was about what has become known among the professors as "Black Tuesday."On Tuesday, March 17, the results of the internship matching program were announced. Nearly all the students graduating from medical schools in the United States have been entered in a computerized matching program with clinical postgraduate training positions every year since 1954. The match represents an opportunity for the various clinical . . .
Occurrence and repetition of hospital admissions for accidents in preschool children.
Authors: C Sellar, J A Ferguson, M J Goldacre
Journal: BMJ (1991)

OBJECTIVES--To examine trends over time in the rates of admission to hospital for accidents of preschool children and to study patterns of repeated admissions for accidents in these children. DESIGN--Analysis of linked, routine abstracts of hospital inpatient records for accidents. SETTING--Six districts in the Oxford Regional Health Authority covered by the Oxford record linkage study. SUBJECTS--Records for 19,427 children aged 5 years and under at the time of first recorded admission to hospital. MAIN OUTCOME MEASURE--Number of admissions to hospital. RESULTS--Records were analysed in three groups: person based annual admission rates were calculated for each calendar year; each child9s first recorded admission in 1976-85 was identified, and the child9s record was followed up by linkage for one year from that admission; each child9s first recorded admission in 1976-81 was identified and followed up for five years. Overall, 19,427 children from an average annual resident population of 163,000 children in 1976-86 had 20,657 admissions for accidents before they were 6 years of age. Of these admissions 13,983 were for injuries, 5717 for poisonings, and 957 for burns. Admission rates declined after 1976 for poisoning, but no substantial changes over time were found in admission rates for injuries or burns. A total of 17,724 children were followed up for one year and 10,889 for five years; 470 (2.6%) of the children who were followed up for one year and 926 (8.5%) of those followed up for five years had at least one further admission for an accident. Of those followed up for one year the 4 and 5 year old children were least likely and those under 1 and 1 year old were most likely to have a further admission for an accident. The number of children who had more than one accident was greater than would be expected if accidents were random occurrences. Those who had a poisoning at first admission were more likely to have another poisoning than an injury or burn; and those who had a burn at first admission were more likely to have another burn. CONCLUSIONS--Hospital admissions for accidents in children are common: on average 1 child in 88 in this population was admitted each year. Multiple admissions are uncommon but none the less occur more often than would be expected by chance.
Long-term Follow-up After Bariatric Surgery
Authors: Nancy Puzziferri, Thomas B. Roshek, Helen G. Mayo, Ryan Gallagher, Steven H. Belle, Edward H. Livingston
Journal: JAMA (2014)

IMPORTANCE Bariatric surgery is an accepted treatment for obesity.Despite extensive literature, few studies report long-term follow-up in cohorts with adequate retention rates.OBJECTIVE To assess the quality of evidence and treatment effectiveness 2 years after bariatric procedures for weight loss, type 2 diabetes, hypertension, and hyperlipidemia in severely obese adults.EVIDENCE REVIEW MEDLINE and Cochrane databases were searched from 1946 through May 15, 2014.Search terms included bariatric surgery, individual bariatric procedures, and obesity.Studies were included if they described outcomes for gastric bypass, gastric band, or sleeve gastrectomy performed on patients with a body mass index of 35 or greater, had more than 2 years of outcome information, and had follow-up measures for at least 80% of the initial cohort.Two investigators reviewed each study and a third resolved study inclusion disagreements.FINDINGS Of 7371 clinical studies reviewed, 29 studies (0.4%, 7971 patients) met inclusion criteria.All gastric bypass studies (6 prospective cohorts, 5 retrospective cohorts) and sleeve gastrectomy studies (2 retrospective cohorts) had 95% confidence intervals for the reported mean, median, or both exceeding 50% excess weight loss.This amount of excess weight loss occurred in 31% of gastric band studies (9 prospective cohorts, 5 retrospective cohorts).The mean sample-size-weighted percentage of excess weight loss for gastric bypass was 65.7% (n = 3544) vs 45.0% (n = 4109) for gastric band.Nine studies measured comorbidity improvement.For type 2 diabetes (glycated hemoglobin <6.5% without medication), sample-size-weighted remission rates were 66.7% for gastric bypass (n = 428) and 28.6% for gastric band (n = 96).For hypertension (blood pressure <140/90 mm Hg without medication), remission rates were 38.2% for gastric bypass ( n = 808) and 17.4% for gastric band (n = 247).For hyperlipidemia (cholesterol <200 mg/dL, high-density lipoprotein >40 mg/dL, low-density lipoprotein <160 mg/dL, and triglycerides <200 mg/dL), remission rates were 60.4% for gastric bypass (n = 477) and 22.7% for gastric band (n = 97).CONCLUSIONS AND RELEVANCE Very few bariatric surgery studies report long-term results with sufficient patient follow-up to minimize biased results.Gastric bypass has better outcomes than gastric band procedures for long-term weight loss, type 2 diabetes control and remission, hypertension, and hyperlipidemia.Insufficient evidence exists regarding long-term outcomes for gastric sleeve resections.
The Effects of Mitral Regurgitation on the Pattern of Instantaneous Aortic Blood Flow Clinical and Experimental Observations
Authors: RONALD C. ELKINS, ANDREW G. MORROW, JOHN S. VASKO, EUGENE BRAUNWALD
Journal: Circulation (1967)

Instantaneous ascending aortic blood flow was recorded at operation in five patients with severe, pure mitral regurgitation, and in nine dogs in which mitral regurgitation was produced experimentally under controlled conditions. In both the patients and the experimental animals, the pattern of aortic flow was abnormal during mitral regurgitation: peak flow occurred early, the percentage of total forward flow was abnormally high during the first half of the ejection period and abnormally low during the last quarter. When stroke volume, heart rate, and aortic pressure were maintained constant, mitral regurgitation also resulted in increases in peak flow, mean ejection rate, and maximum acceleration of flow. These abnormalities of the aortic flow patterns are attributable to inability of the ventricle to sustain forward ejection during late systole in the presence of severe regurgitant flow through the mitral valve.
Refeeding hypophosphataemia in anorexia nervosa and alcoholism.
Authors: A D Cumming, J R Farquhar, I A Bouchier
Journal: BMJ (1987)

Phosphate is important for cellular metabolism.' Body phosphate stores may become depleted during inadequate nutrition, and severe hypophosphataemia may ensue when metabolic deman'd for phosphate is subsequently increased acutely; this condition is termed the nutritional recovery syndrome.2We describe two such cases associated with anorexia nervosa and with severe alcoholism.Marrow suppression, anaemia, thrombocytopenia, neuroencephal- opathy, convulsions, and cardiac effects occurred associated with acute hypophosphataemia. Case 1An 18 year old man with anorexia nervosa was admitted, having collapsed after alcohol ingestion.He weighed 29 kg.Pulse rate was 40/min, and blood pressure 100/70 mm Hg.Plasma glucose concentration was <1 mmol/l (normal 3 6-5-8), plasma phosphate concentration 1-34 mmol/l (normal 0-8-1-4), haemoglobin concentration 124 g/l, white cell count 15 4x I09/I, and platelet count 316x 109/1.He responded to intravenous dextrose, and a ward diet was instituted.After two days the plasma phosphate concentration fell to 0 45 mmol/l and after four days to 0-20 mmol/l.Haemoglobin concentration fell to 98 g/l, white cell count to 2-8 x 109/1, and platelet count to 41 x 109/1.Bone marrow was severely hypoplastic.No cause for the marrow suppression was found other than hypophosphataemia.Over two weeks of normal diet the plasma phosphate value rose to 0-64 mmol/l and full blood count returned to normal with a 5-7% reticulocytosis.Three months later the patient relapsed and was readmitted weighing 27 kg.He was given a normal diet and gained 4 kg.After 10 days grand mal convulsions began, recurring over three days despite anticonvulsants.There were no focal neurological signs; conscious level remained depressed