tbuckley/cabot-search huggingface dataset:
The Recommendations of the Physician Payment Review Commission
Authors: John K. Iglehart
Journal: New England Journal of Medicine (1989)

THE relations between Medicare and practicing physicians, increasingly conflicted by the economic imperatives of payer and provider, will continue to evolve this year on two related but separate fronts. One involves the government's continuing struggle to reduce the massive federal deficit. A second more fundamental development centers on proposed new policies, some sought by organized medicine and others strongly opposed by it, that would seek to rationalize Medicare payment levels through a physicians' fee schedule, enact further limits on balance billing, impose an expenditure target on physicians' services for the first time, and accelerate the development of guidelines for medical . . .
HUMAN ALBUMIN INFUSIONS AND HOMOLOGOUS SERUM JAUNDICE
Authors: Richmond S. Paine
Journal: JAMA (1952)

It is the general impression of most observers who have had contact with large groups of patients given human albumin intravenously that homologous serum jaundice has not been seen following the use of this preparation. Experimental work by Gellis<sup>1a</sup>and his co-workers, who gave mixtures of albumin and known infected pooled plasma to human volunteers, seems to indicate that the heating for 10 hours at 60 C normally carried out in the process of albumin preparation is sufficient to inactivate the virus. In control studies using the same mixtures without heating, hepatitis was produced in three out of five volunteers, indicating that there is no antiviral activity in the albumin itself. Because of the unsolved problem of homologous serum jaundice following use of dried and even irradiated plasma and other blood derivatives, more study of patients receiving human albumin intravenously seems indicated. An effort was made to determine the
Minimally invasive reoperative valve surgery
Authors: Ram Sharony, Eugene A. Grossi, Aubrey C. Galloway, Paul Saunders, Charles Schwartz, Greg H. Ribakove, Patricia Ursomanno, Julie Delianides, F.Gregory Baumann, Marc S. Kanchuger, Stephen B. Colvin
Journal: Journal of the American College of Cardiology (2003)
Case 50-1976
Authors: Richard C. Cabot, Robert E. Scully, James J. Galdabini, Betty U. McNeely, Zareh N. Demirjian, G. Richard Dickersin
Journal: New England Journal of Medicine (1976)

Presentation of CaseA 22-year-old graduate student was admitted to the hospital because of a pericardial effusion.He was well until three months previously, when, during a visit to his home in southern California, he became fatigued, with a low-grade fever. Six weeks later a nonproductive cough developed, accompanied by wheezing on exertion and frequent headaches. During the next three weeks he had pain in the chest and both shoulders after ingesting small amounts of alcohol. Three weeks before admission night sweats and exertional dyspnea appeared, and the wheezing worsened.Two weeks before admission he entered the university infirmary, where . . .
How Physicians Use Laboratory Tests
Authors: Laurence P. Skendzel
Journal: JAMA (1978)

The aim of our study was to measure the ways in which a physician perceives and reacts to a laboratory result. After reviewing a series of brief clinical problems, physicians were asked to indicate the change in test results that would alter the diagnosis or treatment. Although there were wide differences in attitudes, the pattern of responses from 125 internists offered estimates of what is a clinically important change. In selected clinical settings, the change in successive measurements chosen with the greatest frequency as indicators of a clinically important change in level were glucose, 35 mg/dl; BUN, 6 mg/dl; serum sodium, 4 to 6 mEq/liter; serum potassium, 4 to 6 mEq/liter; uric acid, 8 mg/dl; creatinine, 0.4 mg/dl; serum calcium, 4 to 5 mg/dl; triglycerides, 20 mg/dl; hemoglobin, 1 g/dl; and serum osmolality, 11 mOsm/kg. The responses were compared with estimates of laboratory precision drawn from a national quality control program. The quality of laboratory testing was rated as satisfactory for clinical use in four of five clinical settings. The study points out the need to correlate the activities in the clinical laboratory with the application of test results in the care of patients.
Toxic Reactions to Low Doses of Ambenonium Chloride
Authors: David B. Sachar
Journal: New England Journal of Medicine (1964)

AMBENONIUM chloride (Mytelase), a potent anticholinesterase introduced in 1955 for the treatment of myasthenia gravis,1 has also been used in the prophylaxis and treatment of various types of bowel and bladder dysfunction.2 3 4 Although cholinergic crises commonly occur when low doses of ambenonium are given to patients with myasthenia gravis5 there have been no reports of acute cholinergic crisis in patients without myasthenia occurring as a toxic reaction to the usual dose of ambenonium alone. The following cases are therefore reported to call attention to the possibility of toxic reactions occurring at even low doses of this drug.Case Reports . . .
Characterization of Plaque Prolapse After Drug-Eluting Stent Implantation in Diabetic Patients
Authors: Hideki Futamatsu, Manel Sabaté, Dominick J. Angiolillo, Pilar Jimenez-Quevedo, Cecilia Corros, Kino Morikawa-Futamatsu, Fernando Alfonso, Julie Jiang, Pavel Cervinka, Rosana Hernandez-Antolin, Carlos Macaya, Theodore A. Bass, Marco A. Costa
Journal: Journal of the American College of Cardiology (2006)
Multiple Deficiency State Associated with Isoniazid Therapy
Authors: D. L. Aspinall
Journal: BMJ (1964)

Clostridium welchii-Price and Shooter BRirisHI 1177 (1960) that there is no more need to isolate a patient with gas gangrene than there is to isolate a patient because he hat clostridia in his faeces. SummaryTwo hundred strains of Cl. welchii isolated from the faeces of surgical patients were tested for the production of a-toxin.The majority of strains produced concentrations of toxin from 0.02 to 0.5 unit/ml., with a range of less than 0.005 unit/mi.up to 2 units/ml.Eleven strains isolated from the lesions of patients with gas gangrene were found to produce toxin within a range of 0.01 to 0.75 unit/ml.It is suggested that these results are compatible with the view that the infecting organism in gas gangrene is often derived from the patient, and that they do not support the opinion that the reason why gas gangrene is rare in surgical practice is because faecal strains of Cl. welchii produce relatively little toxin.We would like to acknowledge the help we have had from Dr. G. Harriet
Response of the interatrial septum to transatrial pressure gradients and its potential for predicting pulmonary capillary wedge pressure: An intraoperative study using transesophageal echocardiography in patients during mechanical ventilation
Authors: Fred M. Kusumoto, Isobel A. Muhiudeen, Helmut F. Kuecherer, Michael K. Cahalan, Nelson B. Schiller
Journal: Journal of the American College of Cardiology (1993)
The Muscular Dystrophies
Authors: Wayne S. Zundel, Frank H. Tyler
Journal: New England Journal of Medicine (1965)

ABIOTROPHY of skeletal muscle — that is, degeneration and atrophy after a latent period of apparently normal development and function — is the most obvious common denominator in the group of disorders called the muscular dystrophies. It should be realized, however, that systems other than skeletal muscle are frequently involved in these diseases. Striking examples of this are the cataract, frontal baldness, skeletal anomalies, gonadal atrophy and personality change seen in myotonic dystrophy. The relation between the changes in skeletal muscle and those in other tissues is uncertain except that they behave as single mendelian traits genetically.Although the several . . .
Autoantibody to factor VIII that has less reactivity to factor Vlll/von Willebrand Factor Complex
Authors: Kagehiro Amano, Morio Arai, Kimihito Koshihara, Takashi Suzuki, Kazuhiko Kagawa, Yasuharu Nishida, Katsuyuki Fukutake
Journal: American Journal of Hematology (1995)

Abstract To determine the difference in reactivity of factor Vlll (FVIII) inhibitor to FVlll/von Willebrand Factor (vWF) complex and FVlll free of vWF, an autoantibody to FVlll light chain was tested. A patient (1‐3) suffered from autoimmune hemolytic anemia with autoantibody to FVIII. Epitope specificity of the patient's IgG (1‐3 IgG) was shown to be the C2 domain of FVlll light chain (2170‐2332) by Western blotting using recombinant FVlll deletions expressed in Escherichia coli. The inhibitory effect on FVlll procoagulant activity (VIII :C) of 1‐3 lgG was tested against a conventional FVlll concentrate; Haemate P, a monoclonal antibody‐purified FVlll concentrate; Hemofil M, and a recombinant FVlll (rFVIII); Kogenate. 1‐3 lgG showed only 1.3 BU/mgIgG for Haemate P, in contrast to 20 BU/mglgG for both Hemofil M and Kogenate. The ratio of VIII:C/vWF:Ag in Haemate P and Hemofil M was 1/3.43 and 1/0.01, respectively, while Kogenate did not contain vWF. The inhibitory effect of the 1‐3 IgG was then compared with Kogenate and its complex with vWF. The inhibitory effect was decreased against the rFVlll by forming a complex with vWF. from 22 BU/mglgG to o.5 BU/mgIgG. Fab from the 1‐3 IgG had the same effect. In addition, vWF showed a protective effect on FVlll inactivation by the 1‐3 IgG in a dose dependent manner. Fifty‐nine percent of residual VIII:C was retained in the presence of 8 U/ml of vWF after 1 hr incubation with 1‐3 lgG. These results suggested that vWF could compete with the 1‐3 IgG for binding to FVIII. © 1995 Wiley‐Liss, Inc.
Successful Ventricular Defibrillation by the Selective Sodium-Hydrogen Exchanger Isoform-1 Inhibitor Cariporide
Authors: Raúl J. Gazmuri, Iyad M. Ayoub, Elizabeth Hoffner, Julieta D. Kolarova
Journal: Circulation (2001)

Background — Sodium-hydrogen exchanger isoform-1 (NHE-1) activation worsens functional myocardial abnormalities associated with ischemia and reperfusion. We hypothesize that these abnormalities may limit cardiac resuscitation from ventricular fibrillation (VF) and investigated whether NHE-1 inhibition with the benzoylguanidine derivative cariporide could improve resuscitability, postresuscitation myocardial function, and short-term survival in isolated heart and intact rat models of VF. Methods and Results — In the isolated rat heart, VF was induced for 25 minutes. Perfusion was interrupted for the initial 10 minutes and restarted at 10% of baseline flow for the remaining 15 minutes (simulating chest compression). Cariporide ameliorated ischemic contracture, prevented postresuscitation diastolic dysfunction, and favored earlier return of contractile function. In the intact rat, cariporide, injected into the right atrium before chest compression was started (after 6 minutes of untreated VF), prompted spontaneous defibrillation between minutes 7 and 9 of chest compression in 6 of 8 rats. In contrast, electrical defibrillation was required in each of 8 control rats after completion of a predetermined 16-minute interval of VF. After resuscitation, cariporide-treated rats had less ventricular ectopic activity and normalized their hemodynamic function faster. Electrical defibrillation was then timed in control rats to match the time when spontaneous defibrillation occurred in cariporide-treated rats. With comparable VF duration, postresuscitation hemodynamic dysfunction was ameliorated by cariporide, but only when more severe ischemia was modeled by prolongation of the interval of untreated VF from 6 to 10 minutes. Conclusion — NHE-1 inhibition may represent a novel and remarkably effective intervention for resuscitation from VF.
Skin permeation and cutaneous hypersensitivity as a basis for making risk assessments of chromium as a soil contaminant.
Authors: R E Bagdon, R E Hazen
Journal: Environmental Health Perspectives (1991)

A literature review of experimental and human exposure studies of skin permeation and cutaneous hypersensitivity reactions evoked by chromium was carried out to provide a basis for making a risk assessment of chromium as a soil contaminant. In vitro and in vivo studies demonstrated that 1 to 4% of the applied dose of hexavalent and trivalent chromium to guinea pig skin penetrated skin within 5 to 24 hr after application. Ultrastructural investigations showed that hexavalent chromium localized intracellularly and extracellularly in the upper layers of guinea pig epidermis. Only minute quantities of hexavalent chromium are required to elicit a positive hypersensitivity reaction in susceptible individuals; using a patch dose of 20 micrograms, only 2 micrograms were required to evoke a positive skin reaction in hypersensitive subjects. The potential of hexavalent chromium to produce a skin sensitization reaction is readily demonstrated using animal models. The incidence and characteristics of chromium-induced skin hypersensitivity as a clinical entity are described. A health effects survey of populations exposed to chromium slag in soil in Tokyo, Japan extending over 8 years indicated a tendency toward symptoms characterized as headache, chronic fatigue, and gastrointestinal complaints, positive occult blood tests, minute hematuria and albuminuria suggestive of incipient renal disease, and a tendency toward an increase in contact dermatitis that was seasonally related. Multicenter patch test titration studies in human subjects using an incidence of positive patch tests of 10% or less showed that the threshold for skin hypersensitivity reactions to hexavalent chromium was determined to be of the order 0.001%, equivalent to 10 ppm or 10 mg/kg or 10 mg/L.(ABSTRACT TRUNCATED AT 250 WORDS)
Effective Prevention Remains Elusive for Cognitive Decline and Dementia
Authors: Rebecca Voelker
Journal: JAMA (2010)

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
Induction of Immune Tolerance in Patients with Hemophilia and Antibodies to Factor VIII by Combined Treatment with Intravenous IgG, Cyclophosphamide, and Factor VIII
Authors: Inga Marie Nilsson, Erik Berntorp, Olle Zettervall
Journal: New England Journal of Medicine (1988)

The development of antibodies to factor VIII is a serious complication of the treatment of patients with hemophilia A. We successfully induced immune tolerance in patients with such antibodies with a new treatment protocol, which combined factor VIII, cyclophosphamide, and high-dose intravenous IgG, followed by regular prophylactic treatment with factor VIII. This protocol has now been used in 11 patients with hemophilia A, of whom 9 had a strong antibody response. When the initial concentration of antibodies exceeded 3 Malmö inhibitor units (corresponding to about 10 Bethesda units) per milliliter, treatment was preceded by adsorption of antibody to protein A. After two to three weeks of the combined treatment, factor VIII coagulant antibodies had disappeared in 9 of the 11 patients; in 8 of these 9 patients the half-life of infused factor VIII had normalized. The tolerant state appears to be stable after a median of 30 months. Two patients did not respond to the treatment. Because earlier treatment with factor VIII and cyclophosphamide or with factor VIII and IgG had been ineffective in these patients, our experience suggests that all three components of the protocol are required for the successful induction of tolerance to factor VIII. (N Engl J Med 1988; 318:947–50.)
Discrimination against gay and lesbian doctors goes against GMC's guidance
Authors: S. Bewley, D. Harvey
Journal: BMJ (1998)

EDITOR—As co-chairs of the Gay and Lesbian Association of Doctors and Dentists (GLADD) we were concerned about an anonymous letter published in Career Focus several months ago.1 It was by a gay doctor in a training post and raises several important issues.

Firstly, as the writer pointed out, gay and lesbian doctors in …
Lack of association between early childhood immunizations and beta-cell autoimmunity.
Authors: P M Graves, K J Barriga, J M Norris, M R Hoffman, L Yu, G S Eisenbarth, M Rewers
Journal: Diabetes Care (1999)

OBJECTIVE: To determine whether early childhood immunization history affects the risk of developing the beta-cell autoimmunity that precedes type 1 diabetes. RESEARCH DESIGN AND METHODS: This article describes a case-control study whose participants were 317 children aged &amp;lt; or = 12 years who have a first-degree relative with type 1 diabetes. The children were enrolled in a prospective cohort study of the etiology of beta-cell autoimmunity, the Diabetes Autoimmunity Study in the Young, in Denver, Colorado. The main outcome measure was beta-cell autoimmunity as determined by persistent autoantibodies against insulin, GAD, or islet cell antibody (IA-2) 512. The number of cases with beta-cell autoimmunity was 25, and the number of control subjects (the remainder of the cohort) was 292. RESULTS: There was no difference between cases and control subjects in the proportion receiving hepatitis B (HBV), Haemophilus influenzae b (Hib), polio, or diphtheria tetanus pertussis (DTP) vaccines before 9 months of age; in the proportion receiving HBV at birth rather than later; or in the median age at first HBV, Hib, polio, or DTP vaccination. CONCLUSIONS: The results suggest that changing the early childhood immunization schedule would not affect the risk of developing beta-cell autoimmunity or type 1 diabetes.
Damage to the endothelium in Sjogren's syndrome: lack of correlation with antinuclear antibody titre and presence of antibodies to SSA or SSB autoantigens.
Authors: A D Blann, A C Wainwright, P Emery
Journal: Annals of the Rheumatic Diseases (1992)

Serum levels of von Willebrand factor antigen (as an index of damage to the endothelium) and tissue antinuclear antibodies and antibodies to SSA (Ro) (which have been associated with vasculitis) and SSB (La) autoantigens were measured in patients with Sjögren's syndrome. Although high levels of all indices were recorded, there were no intercorrelations. This provides evidence that although tissue autoantibodies may be useful in confirming a diagnosis, they have no place in the pathological course of the disease and so may be an epiphenomenon.
Effects of Imipramine on Individuals Varying in Level of Depression
Authors: ALBERTO DIMASCIO, ROGER E. MEYER, LAWRENCE STIFLER
Journal: American Journal of Psychiatry (1968)

In the belief that studies with normal subjects are relevant to the assessment of psychotropic drugs for clinical use, the authors examined the antidepressant and anti-anxiety effects of imipramine in a group of nonhospitalized, asymptomatic subjects selected to differ in level of (nonclinical) depression. Although some of the results might be termed paradoxical, it was demonstrated that the antidepressant property of the drug, for which it is clinically utilized, is also evident in normal subjects.
Reduced levels of the TGFb family member GDF15 in spondyloarthritis versus other rheumatic diseases
Authors: S. Lambrecht, J. Coudenys, F. De Keyser, G. Verbruggen, D. Deforce, D. Elewaut
Journal: Annals of the Rheumatic Diseases (2011)

<h3>Introduction</h3> The transforming growth factor (TGF)-β superfamily consists of a number of molecules that regulate a variety of cellular processes such as growth, differentiation and oncogenesis. Growth differentiation factor 15 is a distant member of this TGF-β family. GDF15 was previously shown to be elevated in serum of rheumatoid arthritis (RA)-patients compared to healthy controls. This study aims to compare GDF15 serum and synovial fluid levels in several inflammatory rheumatic diseases. <h3>Methods</h3> GDF15 levels were determined by ELISA in two different cohorts. A first group included serum samples from patients with an indication for an arthroscopic procedure for diagnostic purposes. A total of 37 RA patients, 63 spondyloarthritis (SpA) patients and 17 osteoarthritis patients was analysed. Synovial fluid levels in RA and SpA patients from this cohort were determined as well. A second confirmatory cohort constituted of a consecutive cohort of 555 patients visiting the outpatient clinic of the department of Rheumatology at Ghent University Hospital. <h3>Results</h3> SpA samples show a significant lower serum concentration of GDF15 compared to RA patients. When SpA patients were stratified according to the subdiagnosis (USpA, AS or PsA) no statistically significant differences could be observed between the groups. Interestingly, SpA patients, but not RA-patients, show a significant higher concentration of GDF15 in the synovial fluid compared to serum (serum=516.38 pg/ml ± 71.09 vs syn fluid 803.2167 pg/ml ± 99.14; paired sample t-test, p&lt;0.001), pointing to a local production of GDF15 in the synovial joint. No significant correlations were observed between GDF15 concentration and routine biochemical (C-reactive protein, erythrocyte sedimentation rate) or clinical markers (number of swollen joints, DAS28), indicating that GDF15 serum levels might be indicative for a distinct underlying disease process. Analysis the second group consisting of a consecutive cohort of 555 patients confirmed the lower concentration of GDF15 in serum samples of SpA patients compared to RA patients. To estimate the diagnostic potential to discriminate SpA from RA patients, a ROC curve analysis was performed, characterised by a AUC of 0.76. In addition, it was demonstrated that GDF15 levels might have an added value to anti-CCP and rheumatoid factor to discriminate RA and SpA patients. <h3>Conclusion</h3> GDF15 serum concentrations are significantly lower in SpA patients compared to other inflammatory joint diseases. The serum levels are not directly correlated to inflammatory or known diagnostic parameters and thus may serve as an additional marker for diagnostic purposes in inflammatory joint diseases.
Royal Commission on Health Services, 1964. Vol I
Authors: Amasa B. Ford
Journal: JAMA (1964)

A major document in the social and political history of Canada, this report is the first public statement of a commission appointed three years ago to inquire into existing facilities and future needs for health services, and to recommend appropriate measures to ensure the best possible health care for all Canadians. The inquiry has been thorough, including public hearings in 14 cities, and the preparation of 26 special studies. The evidence is carefully marshalled and lucidly presented, and each of the 200 specific recommendations is supported with recent data. The Commissioners recommend that Canada adopt "a comprehensive, universal Health Services Programme, based upon the freedom of choice, and upon free and self-governing professions and institutions, and financed through prepayment arrangements." They discern an "enormous gap between our scientific knowledge and skills on the one hand and our organizational and financial arrangements to apply them to the needs of men, on