tbuckley/cabot-search huggingface dataset:
Effects of pay-for-performance system on tuberculosis default cases control and treatment in Taiwan
Authors: Wen-Chen Tsai, Pei-Tseng Kung, Mahmud Khan, Claudia Campbell, Wen-Ta Yang, Tsuey-Fong Lee, Ya-Hsin Li
Journal: Journal of Infection (2010)

In order to make tuberculosis (TB) treatment more effective and to lower the default rate of the disease, the Bureau of National Health Insurance (BNHI) in Taiwan implemented the "pay-for-performance on Tuberculosis" program (P4P on TB) in 2004. The purpose of this study is to investigate the effectiveness of the P4P system in terms of default rate.This is a retrospective study. National Health Insurance Research Datasets in Taiwan from 2002 to 2005 has been used for the study. The study compared the differences of TB default rate before and after the implementation of P4P program, between participating and non-participating hospitals, and between P4P hospitals with and without case managers. Furthermore, logistic regression analysis was conducted to explore the related factors influencing TB patients default treatment after TB detected.The treatment default rate after "P4P on TB" was 11.37% compared with the 15.56% before "P4P on TB" implementation. The treatment default rate in P4P hospitals was 10.67% compared to 12.7% in non-P4P hospitals. In addition, the default rate was 10.4% in hospitals with case managers compared with 12.68% in hospitals without case managers.The results of the study showed that "P4P on TB" program improved the treatment default rate for TB patients. In addition, case managers improved the treatment outcome in controlling patients' default rate.
Localization of Pheochromocytoma by Computed Tomography
Authors: Bruce H. Stewart, Emmanuel L. Bravo, John Haaga, Thomas F. Meaney, Robert Tarazi
Journal: New England Journal of Medicine (1978)

TUMOR localization is an integral part of the surgical management of pheochromocytoma. Although the diagnosis may be suspected from the history and physical findings and confirmed by various pharmacologic studies, it is important for the surgeon to know the precise location and extent of the tumor when he is planning its safe and expeditious removal.1 2 3 Intravenous pyelography, even with laminagraphic views, has often failed to demonstrate these tumors.4 Selective arteriography has accurately demonstrated the blood supply and extent of most pheochromocytomas, but is an invasive technic with serious potential complications, including hypertensive crises.5 6 7 Adrenal-vein and vena-cava sampling of blood for . . .
Modern Hospital: International Planning Practices
Authors: John Weinman
Journal: JAMA (1980)

The architect who specializes in hospitals participates in the planning and construction of the most complex of building types, in which stringent technical and humane design criteria often seem to vie for exclusive attention. Added to this intrinsic difficulty is the problem of clarifying and translating the often vaguely defined, sometimes contradictory needs of the various departments and staff. To arrive at effective design solutions, the architect or planner should have as good a background in the technical workings of a hospital as possible. Glancing at the ambitious table of contents, it would appear that<i>Modern Hospital: International Planning Practices</i>provides the architect with a valuable technical reference; the author himself is an architect. Chapters deal with specific areas and departments within the hospital and with more explicit architectural topics. Especially in the chapters on clinical laboratory and radiology services, the book is an interesting primer on functions, procedures, equipment,
Notch signals are required for in vitro but not in vivo maintenance of human hematopoietic stem cells and delay the appearance of multipotent progenitors
Authors: Patricia Benveniste, Pablo Serra, Dzana Dervovic, Elaine Herer, Gisele Knowles, Mahmood Mohtashami, Juan Carlos Zúñiga-Pflücker
Journal: Blood (2013)
The Membrane Skeleton Controls Diffusion Dynamics and Signaling through the B Cell Receptor
Authors: Bebhinn Treanor, David Depoil, Aitor Gonzalez-Granja, Patricia Barral, Michele Weber, Omer Dushek, Andreas Bruckbauer, Facundo D. Batista
Journal: Immunity (2010)

Early events of B cell activation after B cell receptor (BCR) triggering have been well characterized. However, little is known about the steady state of the BCR on the cell surface. Here, we simultaneously visualize single BCR particles and components of the membrane skeleton. We show that an ezrin- and actin-defined network influenced steady-state BCR diffusion by creating boundaries that restrict BCR diffusion. We identified the intracellular domain of Igbeta as important in mediating this restriction in diffusion. Importantly, alteration of this network was sufficient to induce robust intracellular signaling and concomitant increase in BCR mobility. Moreover, by using B cells deficient in key signaling molecules, we show that this signaling was most probably initiated by the BCR. Thus, our results suggest the membrane skeleton plays a crucial function in controlling BCR dynamics and thereby signaling, in a way that could be important for understanding tonic signaling necessary for B cell development and survival.
Predeposited Autologous Blood for Elective Surgery
Authors: Pearl T.G.V. Toy, Ronald G. Strauss, Linda C. Stehling, Rita Sears, Thomas H. Price, Ennio C. Rossi, Myra L. Collins, James P. Crowley, Richard S. Eisenstaedt, L. Tim Goodnough, Tibor J. Greenwalt, Marilyn F.M. Johnston, Melanie S. Kennedy, Bruce A. Lenes, Jeanne M. Lusher, Paul D. Mintz, Ethel D. Patten, Toby L. Simon, Robert G. Westphal
Journal: New England Journal of Medicine (1987)

To determine the extent to which autologous blood that has been donated in advance ("predeposited") is used in patients undergoing elective surgery and to assess whether predonation decreases the use of homologous blood and the demand on the blood supply, we studied 4996 patients undergoing elective surgery at 18 tertiary care hospitals. Cross-matched blood was ordered for 1287 patients (26 percent), and of these, 590 (46 percent) were considered eligible for predepositing blood. Only 5 percent (32) of the eligible patients actually predeposited blood, indicating that predonation is not widely used. Of those who predeposited, only 13 percent (4 of 32) subsequently received homologous blood, as compared with 36 percent (199 of 558) of those who did not predeposit (P less than 0.01). Among the 199 patients who did not predeposit but required transfusion, we estimate that predonation could have avoided homologous transfusion in as many as 68 percent. If all eligible patients had predeposited autologous blood, they could have supplied as much as 72 percent of their own transfused red cells. The blood for as much as 10 percent of all red-cell transfusions could have been predonated by and transfused into the patients undergoing elective surgery. Greater use of predonation would not only reduce the demand on the blood supply by decreasing the need for homologous transfusion, but would probably also reduce the risk of hepatitis and other transfusion-associated illnesses.
PHYSIOLOGICAL CONDITIONS EXISTING IN CONNECTIVE TISSUE
Authors: Philip D. McMaster, Robert J. Parsons
Journal: The Journal of Experimental Medicine (1939)

The interstitial movement of several dyes of widely different chemical constitution and diffusibility, in the connective tissues of the mouse ear, has been observed at high magnification. Dye extension seems to be conditioned by the form and structure of the connective tissue fibers. After escaping from the lymphatics of the ears of living mice, each dye appeared first in the tissues as bristly projections of color. These bent and twisted when pressed upon by a micro probe but sprang back into place when the pressure was removed. The present work and the preceding have shown that the lines of color are formed by dye along or between connective tissue fibers. Intermittent external pressure applied to the tissue, squeezes and bends the fibers together and greatly increases the spread of dye along them. The connective tissue fibers assume an important role in the spread of substances through tissues subjected to pressure changes. The experiments have given evidence of the existence of a tissue matrix in the organ but none of the presence of free interstitial fluid. In tissue subjected to irritant stimuli and in frankly edematous tissue, free fluid is readily demonstrated. When it is present the method of extension of dye is completely changed. Dye appears in the tissues as a diffusely colored cloud which can be freely moved by pressure with a micro probe. The bearing of this evidence upon the condition of interstitial fluid and the nature of the interstitial spaces is discussed.
THE BIOASSAY OF ADRENAL CORTICOIDS IN THE URINE OF PATIENTS WITH CONGESTIVE HEART FAILURE
Authors: Alvin E. Parrish
Journal: Journal of Clinical Investigation (1949)

Futcher and Schroeder (1) and Warren and Stead (2) suggested that changes in endocrine activity might be present in congestive heart fail- ure and might explain some of the symptoms such as edema and sodium retention.Merrill, Morrison, and Brannon (3) found an increased concentration of renin in the renal venous blood.No other reports of endocrine changes in con- gestive heart failure appear in the literature.Since sodium and water retention are known to occur following administration of adrenal cortical hormones, especially desoxycorticosterone, stud- ies were undertaken to determine if the urine of patients in congestive heart failure contained in- creased amounts of corticoid substances. METHODSTen male patients with congestive heart failure were selected at random from the Gallinger Municipal Hos- pital.These represented four cases of hypertensive heart disease, one of rheumatic heart disease, four of arterio- sclerotic heart disease, and one of chronic cor pulmonale associated with asthma.Their ages ranged from 28 to 70 years, and all but two were negroes.The study was restricted to males to eliminate any possible interference due to changes in the menstrual cycle.Six medical stu- dents, none of whom had any evidence of heart disease, were used as control subjects.Twenty-four hour sam- ples of urine were collected without preservatives.In the case of the heart failure patients these were col- lected as soon after admission as possible, usually within the first 48 hours.The first stage of extraction was car- ried through in all instances within 12 hours after the collection was made.Urinary corticoids were extracted by the method of Venning, Kazmin, and Bell (4); and the extracted mate- rial was stored in the refrigerator until used.Before use this material was taken up in 6 cc. of 10 per cent ethanol so that each cubic centimeter of the resulting solution represented a four-hour excretion of corticoids.This material was assayed on young male rats of the Sprague-Dawley strain, using the survival time of ad- renalectomized rats as one method of assay (57).The animals ranged in weight from 70 to 120 gm.Imme- diately after adrenalectomy these rats were placed on a diet of dog biscuit with 1 per cent sodium chloride and
Malpractice Prevention through the Sharing of Uncertainty
Authors: Thomas G. Gutheil, Harold Bursztajn, Archie Brodsky
Journal: New England Journal of Medicine (1984)

Uncertainty presents a commonly acknowledged threat to the doctor–patient alliance1; anxious patients seeking doctors also seek the reassurance of medical certainty. Hut anxiety about undiscovered causes and undetermined outcomes sets doctor and patient apart if both react defensively; even worse, anxiety over uncertainty may evoke feelings of helplessness, hopelessness, and worthlessness.Increasingly, patients and families who experience tragic disappointments in their expectations of medicine attempt to assuage their grief, helplessness, and despair by suing — that is, blaming — the physician. In doing so, they often fail to discriminate among errors of negligence, other errors, natural variations, and acts . . .
Of Mugs and Marketing: The Robin Hood Solution
Authors: Donald O. Kollisch
Journal: JAMA (1992)

To the Editor.  —I've recently moved from a rural private practice to academia, and Dr Goldstein's Commentary 1 on the largess of pharmaceutical companies has helped me to understand better a phenomenon I've found perplexing. While in practice, my partner and I refused to let drug company representatives in the door. We saw the ethical downside as being too great, and although we knew that we couldn't truly purify ourselves, we felt compelled to attempt integrity. We were sorely tempted by the appeal of free samples for our many poor patients but realized that accepting them would put us at the top of a slippery slope. Therefore, we prescribed inexpensive antibiotics and older, generic medications for chronic illnesses whenever possible. There were times, I must admit, when quality care demanded our prescribing an expensive new medicine—when we regretted not having a full sample closet—but we got by.  My new job,
Sorafenib, a multikinase inhibitor, is effective in vitro against non‐hodgkin lymphoma and synergizes with the mTOR inhibitor rapamycin
Authors: Vijay Ramakrishnan, Michael Timm, Jessica L. Haug, Teresa K. Kimlinger, Timothy Halling, Linda E. Wellik, Thomas E. Witzig, S. Vincent Rajkumar, Alex A. Adjei, Shaji Kumar
Journal: American Journal of Hematology (2011)

Non-Hodgkin lymphoma (NHL) represents a heterogenous group of neoplasias originating from lymphoid cells. Increased angiogenesis and expression of Vascular Endothelial Growth Factor (VEGF) and its receptors (VEGFR) have been found to be associated with NHL disease progression. Increase in VEGF and other cytokines stimulate signaling cascades, including the Ras/Raf/Mek/Erk pathway, resulting in increased proliferation and decreased apoptosis. Here, we report the in vitro antilymphoma activity of sorafenib, an inhibitor of VEGFR and Raf kinase. Sorafenib induced potent cytotoxicity in NHL cell lines and patient samples. This induction of cytotoxicity was associated with a corresponding increase in apoptotic cell death. Mechanism of action of sorafenib was investigated in follicular (DoHH2) and Burkitt lymphoma (Raji) cell lines. pStat3, pAkt, Mcl1, and Xiap were downregulated in both cell lines, whereas pErk decreased in Raji but not in DoHH2 cells following sorafenib treatment. IL6 was unable to prevent sorafenib induced repression of pStat3, pAkt, Mcl1, and Bcl-Xl. Sorafenib in combination with an mTORC1 inhibitor rapamycin demonstrated synergy in inducing cytotoxicity in NHL cells. Sorafenib/rapamycin combination resulted in downregulation of pAkt, pmTOR, p-p70S6K, p4EBP1, pGSK3β, Mcl1, and Bcl-Xl. On the basis of our results, a clinical trial is underway using sorafenib with everolimus in NHL patients.
Expression of functional lung resistance–related protein predicts poor outcome in adult T-cell leukemia
Authors: Nobuhito Ohno, Ayako Tani, Kimiharu Uozumi, Shuichi Hanada, Tatsuhiko Furukawa, Suminori Akiba, Tomoyuki Sumizawa, Atae Utsunomiya, Terukatsu Arima, Shin-ichi Akiyama
Journal: Blood (2001)
Hemoglobin inhibits endothelium-dependent relaxation to acetylcholine in human coronary arteries in vivo.
Authors: P Collins, J Burman, H I Chung, K Fox
Journal: Circulation (1993)

The endothelium can regulate vascular tone by releasing both endothelium-derived relaxing factor (EDRF or nitric oxide) and contracting factors. To date, there has only been circumstantial evidence to indicate EDRF activity in vivo in human coronary arteries. Using human hemoglobin as a specific inhibitor, the hypothesis that acetylcholine-induced coronary vasodilation is due to EDRF release was tested.We studied the response of normal coronary arteries to acetylcholine (an endothelium-dependent vasodilator) and isosorbide dinitrate (an endothelium-independent vasodilator) in seven patients. The specificity of any vasodilator response was assessed by the infusion of reduced free human hemoglobin. Hemoglobin 10(-5) M infusion alone had no effect on coronary artery diameter. Drugs were infused into the coronary artery, and the diameter changes were assessed by quantitative angiography. Acetylcholine 10(-7) M increased left anterior descending coronary artery diameter from control: 2.30 +/- 0.12 mm to 2.79 +/- 0.20 mm (mean +/- SEM, n = 7, p < 0.01). Hemoglobin both in a concentration of 10(-6) M and 10(-5) M reversed this vasodilator effect, causing constriction to 2.11 +/- 0.18 mm (p < 0.001 compared with acetylcholine 10(-7) M) and 2.29 +/- 0.14 mm (p < 0.05 compared with acetylcholine 10(-7) M). Isosorbide dinitrate in the presence of hemoglobin caused dilatation of the coronary artery in all cases to 3.04 +/- 0.24 mm (p < 0.001 compared with acetylcholine 10(-7) M and hemoglobin 10(-6) M).Using a specific inhibitor of nitric oxide, reduced free hemoglobin, we have demonstrated that basal EDRF release does not appear to play an important role in the maintenance of human epicardial coronary artery diameter in vivo but is responsible for the acetylcholine-induced dilatation.
Evidence of an immediate hypersensitivity mechanism in systemic lupus erythematosus.
Authors: J Egido, M Sanchez Crespo, C Lahoz, R Garcia, M Lopez-Trascasa, L Hernando
Journal: Annals of the Rheumatic Diseases (1980)

In 30 patients with systemic lupus erythematosus the number of a circulating basophils was countered in different stages of activity. An inverse correlation was found between the absolute basophils count and anti-DNA antibodies and presumptive circulating immune complexes (as judged by polyethylene glycol precipitation of serum). A positive correlation was found between the absolute basophil count and C3 or C4 levels. IgE on the basophil surface was determined by radioimmunoassay in 7 patients. All of them showed a significantly higher surface IgE number. When the count of circulating basophils was roughly normal, 5 out of the 6 patients showed a positive basophil degranulation test with native DNA. These results suggest the existence of an anti-DNA specific IgE in lupus patients. Depression of the circulating basophil count may be a useful index of lupus activity.
Pituitary adenylate cyclase-activating polypeptide: Effects on pancreatic-adrenal hormone secretion and glucose-lipid metabolism in normal conscious dogs
Authors: Koichi Kawai, Chizuko Yokota, Shinichi Ohashi, Kazumasa Isobe, Seiji Suzuki, Toshiaki Nakai, Kamejiro Yamashita
Journal: Metabolism (1994)
Sex differences in the developmental antecedents of aggression
Authors: Joseph M. Boden
Journal: Behavioral and Brain Sciences (2009)

Abstract Archer examines sex differences in aggression, and argues that these differences may be better explained by sexual selection theory than by social role theory. This commentary examines sex differences in the developmental antecedents of aggression and violence, and presents a preliminary framework for examining whether the observed sex differences amongst these developmental antecedents can also be accounted for by sexual selection theory.
Early Signs of Atherosclerosis in Obstructive Sleep Apnea
Authors: Luciano F. Drager, Luiz A. Bortolotto, Maria Cecília Lorenzi, Adelaide C. Figueiredo, Eduardo M. Krieger, Geraldo Lorenzi-Filho
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Obstructive sleep apnea (OSA) is associated with several cardiovascular diseases. However, the mechanisms are not completely understood. Recent studies have shown that OSA is associated with multiple markers of endothelial damage. We hypothesized that OSA affects functional and structural properties of large arteries, contributing to atherosclerosis progression.Twelve healthy volunteers, 15 patients with mild to moderate OSA, and 15 with severe OSA matched for age, sex, and body mass index were studied by using (1) full standard overnight polysomnography; (2) carotid-femoral pulse wave velocity with a noninvasive automatic device; and (3) a high-definition echo-tracking device to measure intima-media thickness, diameter, and distensibility. All participants were free of hypertension, diabetes, and smoking, and were not on any medications. Patients with OSA were naive to treatment.Significant differences existed between control subjects and patients with mild to moderate and severe OSA (apnea-hypopnea index, 3.1 +/- 0.3, 16.2 +/- 1.7, and 55.7 +/- 5.9 events/hour, respectively) in pulse wave velocity (8.7 +/- 0.2, 9.2 +/- 0.2, and 10.3 +/- 0.2 m/second; p < 0.0001), intima-media thickness (604.4 +/- 25.2, 580.2 +/- 29.0, and 722.2 +/- 35.2 microm; p = 0.004), and carotid diameter (6,607.8 +/- 126.7, 7,152.3 +/- 114.4, and 7,539.9 +/- 161.2 microm; p < 0.0001). Multivariate analyses showed that the apnea-hypopnea index correlated independently with pulse wave velocity and intima-media thickness variability (r = 0.61, p < 0.0001, and r = 0.44, p = 0.004, respectively), whereas minimal oxygen saturation correlated with the carotid diameter (r = -0.60, p < 0.0001).Middle-aged patients with OSA who are free of overt cardiovascular diseases have early signs of atherosclerosis. All vascular abnormalities correlated significantly with the severity of the OSA, which further supports the hypothesis that OSA plays an independent role in atherosclerosis progression.
Directions of resident activity
Authors: S. J. Dresnick
Journal: JAMA (1980)

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
Alpha-fetoprotein in antenatal diagnosis of neural tube defects.
Authors: N Wald, H Cuckle, P E Polani
Journal: BMJ (1978)

Mr. R. Carachi (19 November p. 1357) would like to know the false-positive rate associated with the use of amniotic fluid x-fetoprotein (AFP) measurement in the antenatal diagnosis of open spina bifida.  The results of individual studies indicate that this is much less than 1% if levels equal to or exceeding 5 standard deviations above the mean are considered positive.  Provided the procedure is carried out on women with a sufficiently high risk of having a fetus with open spina bifida (say 5% or greater) the number of normal pregnancies with raised amniotic fluid AFP levels is likely to be small in comparison with the number of affected ones with raised levels.  The UK Collaborative AFP Study Group is currently undertaking a study designed to obtain a more precise estimate of the amniotic fluid AFP false-positive rate than has so far been possible from smaller individual studies.  So far results on more than 9000 singleton pregnancies without neural tube defects and more than 100 cases of open spina bifida have been collected.  Information on pregnancies with conditions such as exomphalos which may cause raised amniotic fluid AFP levels in the absence of neural tube defects is also being collected. (FULL TEXT)