tbuckley/cabot-search huggingface dataset:
Personal paper: how to get the best health outcome for a given amount of money
Authors: M. Sutton
Journal: BMJ (1997)

Increasingly, healthcare programmes are evaluated in terms of both their costs and outcomes. However, existing evaluation designs, in which equal numbers of participants are compared, remain a hangover from the time when outcomes were the sole concern. Outcome maximisation studies, in which costs are equalised, are an alternative way of comparing the costs and consequences of health interventions. They may be feasible in some instances and are attractive because they highlight two of the main messages of health economics.

Firstly, economists emphasise that their concern for the costs of interventions is due to the implications of opportunity costs—that is, resources used for one intervention should be compared with the potential benefits achievable by the next best option that is forgone because the resources for health care are finite.1 2 3 In an outcome maximisation design the opportunity costs of high cost interventions would be highlighted more clearly in the study results.

Secondly, the marginal costs of implementing programmes do not necessarily equal average costs, in which marginal costs are the change in costs resulting from a small change in the level of provision.4 By evaluating alternative technologies at comparable levels of expenditure, outcome maximisation studies would take account of the fact that programme costs often do not rise proportionally with the number of patients treated.

#### Summary points

Health care evaluations used to focus solely on outcomes, but increasingly they have compared the costs of competing interventions

Popular study designs in which equal numbers of people are subjected to each regimen at different levels of total cost do not reflect this innovation

An outcome maximisation design, in which the costs allocated to each programme are equal, might be appropriate

This design has two main advantages: ( a ) the opportunity costs (or next best use) of more resource intensive treatments are readily expressed …
ON THE ACTION OF TARTRATE OF ANTIMONY IN INTRAVENOUS INJECTIONS: The "Permeability" of Bilharzia Ova and some Protozoal Organisms
Authors: J. B. Christopherson
Journal: BMJ (1920)

ACTION OF ANTIMONY TARTRATE INTRAVENOUSLY. t?zSam=nGram-positive diplococcus in one.In every instance the diagnosis of infective endocarditis was made witlhout the aid of the bacteriological report.It was based upon signs of gross valvular disease-aortic regurgitation or mitral stenosis associated with pallor, enlargement of the spleen, petechiae, and in many clubbing of the filnger-tips.There may have been no fever at the timer of the examination, peteclhiae may not have been found, and the bacteriological examination of tlle blood was often negative.The dia- gnosis was correct, as the post-morten findings proved in 22 cases.Of the 55 cases, 44 are known to hlave died with an average duration of symptoms of fourteen months; no information could be obtained from 8 after discliarge from hospital; three of these had no signs of venous stasis and one was a doubtful case.The cause of death in 26 was gradually increasing lheart failure, acute heart failure in 5, the sudden onset of auricular fibrillation and death in a few hours in one; 3 died following a hemiplegia, one from pulmonary embolism, and one from a streptococcus pneumonia.ITe pathological changes revealed at-autopsy were typical in every instanoe of subacute infective endocarditis.There were reeent vegetations, and these were usually engrafted on an old valvular lesion with extension in many with mitral disease on to the po'sterior wall of the left auricle, and on to the septal wall of the left ventricle in those with aortio disease.Sometimes myocardial -degeneration was easily recognized.The spleen was en.Jarged in all, witlh old or recent inifarcts in many.In others they were absent, and the organ was congested and swollen as in typhoid fever.Neplhritis was always noted wlhen sections of the kidney were made; usually of the parenchymatous type, but in all the glomeruli were more or le'ss replaced by fibrous tissue.Infarcts were found in the kidneys of many.The other pathological changes were those found after death-from-cardiac failure.Conclt8ions.
Anaphylaxis From Alphazurine 2 G During Lymphography
Authors: William L. Kopp
Journal: JAMA (1966)

ALPHAZURINE 2G, a blue triphenylmethane dye, has recently been used for two clinical purposes. Radiologists have injected it subcutaneously into patients to identify lymphatic vessels for lymphography.<sup>1</sup>Since the dye stains only viable tissues, surgeons have injected it intravenously into patients with severe burns to guide debridement.<sup>2,3</sup> To date, only one adverse reaction to alphazurine 2G has been reported.<sup>4</sup>A burned patient who received 6 ml of a 10% solution of alphazurine 2G intravenously suffered immediate sneezing, respiratory distress, shock, convulsions, and temporary cardiac arrest. He died five days later. On the other hand, recent reviews<sup>5,6</sup>of experiences with lymphography have not mentioned adverse reactions from the dye, which was used to identify lymphatic vessels. The present paper describes the occurrence of nonfatal, anaphylactic reactions to alphazurine 2G in two patients during lymphography. <h3>Report of Cases</h3><h3>CASE 1.—</h3> A 56-year-old cheese maker was well until early
Robot-assisted Laparoscopic Adrenalectomy: Step-by-Step Technique and Comparative Outcomes
Authors: Luis Felipe Brandao, Riccardo Autorino, Homayoun Zargar, Jayram Krishnan, Humberto Laydner, Oktay Akca, Maria Carmen Mir, Dinesh Samarasekera, Robert Stein, Jihad Kaouk
Journal: European Urology (2014)
Elements of Danger — The Case of Medical Imaging
Authors: Michael S. Lauer
Journal: New England Journal of Medicine (2009)

According to the Book of Exodus, a man who assaults another must pay a physician to heal the wounds. A careful examination of the Hebrew text reveals that the word "heal" appears twice; the literal reading is "and heal he shall be healed." The 13th-century medieval physician and philosopher Nachmanides interprets this redundant phrase to mean that physicians require permission to heal, for "without the warrant to treat, physicians might hesitate to treat patients . . . `in that there is an element of danger in every medical procedure; that which heals one may kill another.'" This 800-year-old warning seems self-evident, yet . . .
THE ROLE OF PLASMA CO2 TENSION AND CARBONIC ANHYDRASE ACTIVITY IN THE RENAL REABSORPTION OF BICARBONATE*
Authors: Floyd C. Rector, Donald W. Seldin, Albert D. Roberts, Jerry S. Smith
Journal: Journal of Clinical Investigation (1960)

The reabsorption of bicarbonate by the kidneys under normal circumstances appears to be a linear function of the plasma CO, tension (1-3).Previ- Otis studies from this laboratory (4) (lemonstratel that when carbonic anhydrase was inhibited by acetazolamide the linear relationship between plasma CO2 tension and HCO,reabsorption still obtained.It was therefore proposed that the un- catalyzed, as well as the catalyzed, hydration of CO2 was an important source of the H' involved in the reabsorption of HCO-.The present investigations were undertaken in an attempt to characterize more precisely the catalyzed and uncatalyzed reactions.By varying plasma CO2 tension, carbonic anhydrase activity, and filtered HCO3-, three aspects of HCO-reab- sorption were examined: 1) the maximal reab-
David Elliot Rogers, MD
Authors: Bruce B. Dan
Journal: JAMA (1995)

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
Stress fracture of the sacrum in a child
Authors: K S LAM, A MOULTON
Journal: Annals of the Rheumatic Diseases (2001)

CoVee or decaV?This potentially valuable information about a relation between coVee consumption and the presence of rheumatoid factor 1 is difficult to evaluate because of a lack of clarity in definitions.What is meant by "coVee"?Is coffee, caVeinated or decaVeinated?This is an obvious distinction that readers need when considering these findings.It would have been interesting, also, to have had information about other beverage consumption, such as colas or teas, or both.This might or might not have aVected or clarified the results, which, currently, have no theoretical underpinnings.However, the information is an exciting start towards understanding factors that contribute to this disabling and prevalent illness.
Dyspepsia results may not apply in primary care
Authors: B. C Delaney
Journal: BMJ (2003)

EDITOR—Manes et al reported their trial of Helicobacter pylori test and treat v initial proton pump inhibitors.1 Their results in secondary care are encouraging in that eradication treatment for H pylori reduced the relapse of symptoms by 33% compared with a short course of treatment to suppress acid. However, we doubt whether their findings have any relevance …
Abstract 3600: Comparison of estrogen receptor expression in breast cancer cells by immunohistochemistry using the monoclonal antibodies SP1 and 1D5
Authors: Klesia P. Madeira, Renata Daltoe, Gabriela Sirtoli, Lucas Rezende, Ian Silva, Alex Carvalho, Leticia Rangel
Journal: Cancer Research (2012)

Abstract Background: Accurate pathological analysis of biopsies is crucial for conclusive and precise disease diagnosis, prognosis and therapeutic guidelines. Evaluation of estrogen receptor (ER) expression in breast cancer (BC) is imperative in determining the disease prognosis, and patients' eligibility for hormonotherapy. Herein, ERα status was evaluated in 61 BC cases using two different anti-ERα monoclonal antibodies, Sp1 (rabbit) and 1D5 (mouse). Methods: Primary BC cases registered in two reference hospitals, with correspondent written informed consent, were used to generate in house tissue microarray platforms. ERα expression was accessed by immunohistochemistry using the monoclonal antibodies anti-ERα, SP1 and 1D5. Staining scoring followed the Allred method (PS, proportion score or percentage of stained cells; IS, intensity score). Concordance and correlation parameters were calculated using Kappa factor; Pearson, Spearman's, or intraclass correlation coefficient (CF). Staining patterns were compared by paired T-Test and Wilcoxon test. Findings: SP1 and 1D5 provided equivalent results (Concordance rate, 96.7%; Kappa factor, 0.921), whereas SP1 was more prone for positive results than 1D5 (2 samples diverged). Total concordance of PS was obtained (Pearson and intraclass CF, 0.7351 and 0.6193, respectively); however, concordance between the antibodies seems more accurate in higher PS values. Excellent SI correlation between antibodies was observed throughout the population (Spearman's CF, α=0.9150). Following the Allred score, 17 out of 42 positive BC samples diverged; always pointing 1D5 to weaker staining than SP1. When calculating Spearman's CF of Total Score (TS) within the population, excellent correlation between both the antibodies (α=0.9238) was noted; nonetheless, results were less concordant result among the BC positive cases (α=0.7743). Indeed, 20 samples were differentially classified using the antibodies (only 3 had higher TS with 1D5). Considering the mean TS of all samples, or of invasive ductal carcinoma, SP1 provided higher scores than 1D5 (p&amp;lt;0.05). Interpretation: Despite the equivalence between the anti-ERα monoclonal antibodies, SP1 and 1D5, the former has proven superior to the latter with respect to the IS and TS. Therefore, we suggest the clinical use of SP1 while diagnosing BC, due to its higher accuracy in examining ER status; thus, enabling more accurate therapeutic decisions to treat the disease. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 3600. doi:1538-7445.AM2012-3600
NEOINTIMAL APPEARANCE OF LATE RESTENOSIS AFTER SIROLIMUS-ELUTING STENT IMPLANTATION: AN OPTICAL COHERENCE TOMOGRAPHY STUDY
Authors: Yasushi Ino, Kunihiro Shimamura, Yasutsugu Shiono, Kenichi Komukai, Kohei Ishibashi, Keisuke Satogami, Makoto Orii, Takashi Tanimoto, Hironori Kitabata, Tomizou Masuno, Keizo Kimura, Hiroko Nakanishi, Kumiko Hirata, Takashi Kubo, Atsushi Tanaka, Masato Mizukoshi, Toshio Imanishi, Takashi Akasaka
Journal: Journal of the American College of Cardiology (2011)
Fas ligand- mediated killing by intestinal intraepithelial lymphocytes. Participation in intestinal graft-versus-host disease.
Authors: T Lin, T Brunner, B Tietz, J Madsen, E Bonfoco, M Reaves, M Huflejt, D R Green
Journal: Journal of Clinical Investigation (1998)

In vitro studies have demonstrated that intestinal intraepithelial lymphocytes (IEL) are constitutively cytotoxic; however, the mechanism and target of their cytotoxicity are unknown. Apoptosis of intestinal epithelial cells (IEC) and an increase in IEL numbers are classical signs of intestinal graft-versus-host disease (GVHD), although whether IEL can mediate IEC apoptosis directly in GVHD is unclear. Recent evidence suggests that target epithelial organ injury observed in GVHD is predominantly Fas-mediated; therefore, we investigated the possibility that IEL induce apoptosis of IEC through a Fas-mediated mechanism. Here, we demonstrate that the IEL isolated from normal mice readily display potent Fas ligand (FasL)-mediated killing activity after CD3 stimulation, and that IEC express Fas, suggesting that IEC are potential targets for FasL-mediated killing by IEL. In vitro, IEL isolated from GVHD mice have markedly increased FasL-mediated killing potential and are spontaneously cytolytic toward host-derived tumor cells predominantly through a Fas-mediated pathway. In vivo transfer of IEL isolated from GVHD mice induced significantly more IEC apoptosis in F1 wild-type mice than in Fas-defective F1lpr mice. Thus, these results demonstrate that FasL-mediated death of IEC by IEL is a major mechanism of IEC apoptosis seen in GVHD.
Activation mechanisms of STAT5 by oncogenic Flt3-ITD
Authors: Chunaram Choudhary, Christian Brandts, Joachim Schwable, Lara Tickenbrock, Bülent Sargin, Andrea Ueker, Frank-D. Böhmer, Wolfgang E. Berdel, Carsten Müller-Tidow, Hubert Serve
Journal: Blood (2007)
"AN OVARIAN HORMONE"
Authors: Robert T. Frank
Journal: JAMA (1923)

<h3>To the Editor:</h3> —InThe Journal, September 8, appears an article by Allen and Doisy on "An Ovarian Hormone," in which the authors show that the follicle fluid of the pig ovary, when injected into castrated or into immature mice and rats, produces typical estrual hyperemia, growth and hypersecretion in the genital tract and growth in the mammary glands. They mention that I (Frank, R. T.: The Ovary and the Endocrinologist,The Journal, Jan. 21, 1922, p. 181) produced "uterine hyperemia" in two normal virgin rabbits by the injection of liquor folliculi—but "one cannot be quite sure that the changes described were not caused by the activity of the ovaries." The authors, however, misquote me. My statement reads that "well marked hyperplasia" resulted, which signifies that estrual changes had been produced by the injections. In order to avoid the unnecessary amount of labor involved in spaying large series of animals,
Immunological aspects of the anemia of rheumatoid arthritis
Authors: Masakuni Sugimoto, Yoshihisa Wakabayashi, Shun‐Ichi Hirose, Fumimaro Takaku
Journal: American Journal of Hematology (1987)

Abstract In order to investigate the cause of the anemia concomitant with rheumatoid arthritis (RA), we examined, using the erythroid colony assay of human bone marrow colonyforming units‐erythroid (CFU‐e) and burst‐forming units‐erythroid (BFU‐e), the effects of the patients' serum and peripheral blood T lymphocytes on the CFU‐e‐derived colonies. The counts of erythroid colonies of RA patients were markedly lower than those of human control subjects [CFU‐e: control 152.9 ± 30.6 (n = 19), RA 51.1 ± 13.6 (n = 7), t = 7.66567, p &lt; 0.01; BFU‐e: control 25.2 ± 5.9 (n = 5), RA 12.6 ± 2.6 (n = 7), t = 4.574, p &lt; 0.01]. The serum from two out of seven RA patients slightly inhibited the formation of CFU‐e‐derived colonies of human control subjects (t = 2.31, 0.05 &lt; p &lt; 0.1); however, the serum from the other five RA patients did not significantly inhibit human control erythroid colony formation as compared with human control serum (t = 0.981, 0.3 &lt; p &lt; 0.4). On the other hand, peripheral blood T lymphocytes of the patients markedly inhibited the formation of CFU‐e‐derived colonies of the control subjects (t = 4.24, p &gt; 0.01). The above‐mentioned results suggest that the peripheral blood T lymphocytes of RA patients might play a role as one of the causes of the concomitant anemia of RA patients.
Toxic Megacolon Associated With Loperamide Therapy
Authors: James W. Brown
Journal: JAMA (1979)

TOXIC megacolon is a well-known serious complication of fulminant ulcerative colitis and has been reported to occur in granulomatous colitis, typhoid fever, amebic colitis, malignant lymphoma, pseudomembranous enterocolitis, bacillary dysentery, and cholera.<sup>1-4</sup>The following report is of the occurrence of toxic megacolon complicating ulcerative colitis attributed to loperamide therapy. <h3>Report of a Case</h3> A 24-year-old missionary was first admitted to Central Washington Deaconess Hospital on July 6, 1977, because of ulcerative colitis. While he was in Europe in June 1976, rectal bleeding, low abdominal cramping pain, and diarrhea developed. A diagnosis of ulcerative colitis was made sigmoidoscopically. He responded to steroid enema treatment. In June 1977, he noted increasing diarrhea, fatigue, and weakness. Findings from his physical examination were unremarkable except for pallor and tachycardia. A proctosigmoidoscopy was diagnostic of ulcerative colitis. The patient was treated with oral prednisone, vitamins, iron, and a psyllium hydrophilic bulking agent. A barium
Comparative anatomy, physiology, and function of the upper respiratory tract.
Authors: G K Reznik
Journal: Environmental Health Perspectives (1990)

The anatomical characteristics of the upper respiratory tract of various experimental animals and man are described. There are a number of differences and similarities macroscopically and microscopically between the species. Perhaps one of the most obvious examples of anatomical differences is in the structure of the turbinates. Some of the differences could affect deposition and clearance of particles in the nasal cavities. Effects of compounds in the nasal cavity, larynx, and trachea can differ depending on the cellular composition of the mucosa.
Synergism between rhinovirus infection and oxidant pollutant exposure enhances airway epithelial cell cytokine production.
Authors: E William Spannhake, Sekhar P M Reddy, David B Jacoby, Xiao-Ying Yu, Bahman Saatian, Jingyan Tian
Journal: Environmental Health Perspectives (2002)

Of the several factors believed to exacerbate asthmatic symptoms, air pollution and viral infections are considered to be particularly important. Although evidence indicates that each of these respiratory insults individually can increase asthma severity in susceptible individuals, we know little about the extent to which exposure to environmental oxidant pollutants can influence the course of respiratory viral infection and its associated inflammation. To investigate the interaction of these two stimuli within their common epithelial cell targets in the upper and lower respiratory tracks, we infected primary human nasal epithelial cells and cells of the BEAS-2B line grown at the air-liquid interface with human rhinovirus type 16 (RV16) and exposed them to NO2 (2.0 ppm) or O3 (0.2 ppm) for 3 hr. Independently, RV16, NO2, and O3 rapidly increased release of the inflammatory cytokine interleukin-8 through oxidant-dependent mechanisms. The combined effect of RV16 and oxidant ranged from 42% to 250% greater than additive for NO2 and from 41% to 67% for O3. We abrogated these effects by treating the cells with the antioxidant N-acetylcysteine. Surface expression of intercellular adhesion molecule 1 (ICAM-1) underwent additive enhancement in response to combined stimulation. These data indicate that oxidant pollutants can amplify the generation of proinflammatory cytokines by RV16-infected cells and suggest that virus-induced inflammation in upper and lower airways may be exacerbated by concurrent exposure to ambient levels of oxidants commonly encountered the indoor and outdoor environments.