tbuckley/cabot-search huggingface dataset:
Prospective Payment: Implications for Medical Technology
Authors: JOHN R. BALL
Journal: Annals of Internal Medicine (1984)

Editorials1 April 1984Prospective Payment: Implications for Medical TechnologyJOHN R. BALL, M.D., J.D.JOHN R. BALL, M.D., J.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-100-4-606 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe article by Vladeck (1) in this issue is as lucid an overview of the theory and practice of prospective payment as can be found. As Vladeck suggests, per-case payment based on diagnosis-related groups (DRGs) will have profound and wide-ranging implications for the practice of medicine and for the interrelations of all components of the health care system, especially physicians and hospitals. One of the most intriguing sets of implications is how medical technology of all sorts, from hardware to drugs to procedures, will be developed and applied. A most commendable discussion of the issues involved is the Congressional Office...References1. VLADECK B. Medicare hospital payment by diagnosis-related groups: a review article. Ann Intern Med. 1984;100:576-91. LinkGoogle Scholar2. Diagnosis Related Groups (DRGs) and the Medicare Program: Implications for Medical Technology. Washington DC: U. S. Congress, Office of Technology; 1983. (Available for sale from the Superintendent of Documents, U.S. Government Printing Office; Washington, DC 20402.) Google Scholar3. SCHWARTZBALLMOSER JJR. Safety, efficacy, and effectiveness of clinical practices: a new initiative [Editorial]. Ann Intern Med. 1982;96:246-7. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBalloon tamponade vs. endoscopic sclerotherapy in the management of active variceal hemorrhageMedical Uncertainty, Diagnostic Testing, and Legal LiabilityLegal and Ethical Implications of Health Care Reimbursement by Diagnosis Related Groups 1 April 1984Volume 100, Issue 4Page: 606-607KeywordsDiagnosis related groupsDrugsHealth careHospital medicine ePublished: 1 December 2008 Issue Published: 1 April 1984 PDF downloadLoading ...
Wilms' tumor protein (—KTS) modulates renin gene transcription
Authors: Andreas Steege, Michael Fähling, Alexander Paliege, Anja Bondke, Karin M. Kirschner, Peter Martinka, Charlotte Kaps, Andreas Patzak, Pontus B. Persson, Bernd J. Thiele, Holger Scholz, Ralf Mrowka
Journal: Kidney International (2008)
D. N. KULUND (Ed.) "The Injured Athlete"
Authors: B. Helal
Journal: British Journal of Sports Medicine (1983)

Let there be no doubt, the days of the pseudo-expert in the field of Sports Science are numbered.Properly trained and qualified personnel are taking an interest in the training, performance and the ills and injuries of the athlete.Daniel Kulund, the Editor of this book, and his fellow contributors have produced a work of high standard which is matched in quality by the illustrations, format and printing, and the publishers, Lippincott, must take their due share of the credit The title is misleading for only 50% of content is directly concerned with injury.There are sections on medical assessment, nutrition, drugs, the handicapped athlete, training techniques, preparation, rehabilitation, the special problems of children and women, medico-legal aspects, and there is a systematic survey of injuries and sports-related injuries and their treatment.
International variations in asthma treatment compliance The results of the European Community Respiratory Health Survey (ECRHS)
Authors: I Cerveri, F Locatelli, M.c Zoia, A Corsico, S Accordini, R de Marco, None , on behalf of the Ecrhs
Journal: European Respiratory Journal (1999)

Noncompliance to medication is a major barrier to effective asthma management. Its real extent and geographical variation throughout the world are not yet known. The data on compliance, collected in the framework of the European Community Respiratory Health Survey (ECRHS) on 1771 subjects (aged 20-44 yrs) with current asthma identified in 14 countries, offer a unique opportunity to assess the extent of noncompliance and its variation across countries. The median percentage of current asthmatics who had received a medical prescription at least once was 95%. The compliance of those patients who had received a medical prescription was found to be low in all countries (median 67%) but with wide variations, the rate ranging from 40% (USA) to 78% (Iceland). During exacerbations patients' rate of compliance increased to 72%. Age was the only variable which influenced compliance to treatment. A significant, although weak, negative correlation was found between patients' compliance and rate of hospital casualty department or emergency room admissions. This study documents that compliance to the treatment of asthma is poor worldwide and that there are large variations between countries. These results emphasize the necessity for further efforts to improve patients' education and to promulgate the international guidelines.
Defusing adverse effects of anticancer drugs
Authors: Beverly Merz
Journal: JAMA (1983)

Doxorubicin hydrochloride and daunorubicin hydrochloride, two of the most potent drugs in the anticancer arsenal, share, in addition to bone marrow suppression, another serious—sometimes fatal—adverse effect: cardiotoxicity. Recently, however, research at several institutions has begun to yield ways to eliminate this drawback and, in some cases, increase the drugs' potencies in the process. Researchers at SRI International, Menlo Park, Calif, and Adria Laboratories, Inc, Dublin, Ohio, have developed a doxorubicin derivative that appears to be orders of magnitude more potent than the parent molecule yet free of its main side effect. The newly synthesized molecule, 3′-deamino-3′-(3-cyano-4-morpholinyl) doxorubicin, called "A-489," has been tested against two forms of leukemia and a solid tumor in mice, as well as in DNA/RNA synthesis inhibition trials in cultured tumor cells. The studies indicate that the optimum dose of A-489 is 600 times lower than that of doxorubicin. Results are the same whether the substance is
Pigmented penile papules with carcinoma in situ changes
Authors: HARRY IRVING KATZ, ZOLTAN POSALAKY, DENNIS McGINLEY
Journal: British Journal of Dermatology (1978)

Benign appearing, multifocal, pigmented penile papules were found in three patients, showing the histopathological and electron microscopic changes of carcinoma in situ. Their clinical appearance, relation to other carcinoma in situ lesions, as well as possible pathogenesis are discussed.
Genetic Damage From Diagnostic Radiation
Authors: L. V. Gould
Journal: JAMA (1977)

<h3>To the Editor.—</h3> The article entitled "Genetic Damage From Diagnostic Radiation" (237:2399-2401, 1977) makes interesting reading. The authors (Bross and Natarajan) attack "a dogma that is often cited by radiologists who claim that diagnostic radiation is harmless" and imply that an attitude of "out of sight, out of mind" is a radiological precept. I for one was not taught that diagnostic radiation is harmless and have not taught it myself. Most of my radiologic colleagues and many of our predecessors would make the same claim. As long ago as 1928, the second International Congress of Radiology at Stockholm adopted recommendations made by the British x-ray and radium protection committee (<i>Acta Radiol</i>, suppl 3, part 1, 1928, pp 62-73). "The suggestions are now to form the basis by which doctors and engineers will be guided in making their departments safe for patients and staff."<sup>1</sup>Note that it is not staff
Effects of Propafenone Plus Digoxin on Ventricular Rate During Atrial Fibrillation: A Randomized Study
Authors: Alessandro Capucci, Giuseppe Boriani, Gianluca Botto, Silvia Pernpruner, Camillo Falcone, Andrea Rimondini, Salvatore De Paola, Leonardo Spedicato, Mauro Bifti, Davide Agnelli, Walter Bonini, Bruno Magnani
Journal: Journal of the American College of Cardiology (1995)
P81Changes on right ventricle induced by a high caloric diet and a left ventricle model of pressure overload
Authors: N Goncalves, E Correia, AF Silva, CM Moura, R Roncon Albuquerque, I Falcao Pires, AF Leite Moreira
Journal: Cardiovascular Research (2014)

Purpose: Two major cardiovascular risk factors are hypertension and metabolic syndrome. This study aimed to evaluate the influence of a high-caloric diet, left ventricle (LV) chronic pressure overload, and their combination on right ventricle (RV) structure and function. Methods: Wistar rats (60-80g) were subjected to ascending aorta constriction (Ba) or sham procedure (Sh). After 2 weeks the animals were randomly divided and fed with a regular diet (Rd,2.9kcal) or with a western-type diet rich in carbohydrates, fat and salt(Hd,5.4kcal), resulting in 4 groups: Sh+Rd, Sh+Hd, Ba+Rd, Ba+Hd. After 8weeks of protocol RV function was assessed by pressure-volume catheters and samples obtained for morpho-histological and molecular analysis. Data presented as mean ±SEM. α vs. Sh+Rd, β vs. Ba+Rd, δ vs. Sh+Hd. p<0.05. Results: The administration of a western-type diet resulted in increased fat depots, visceral adipocyte hypertrophy, cardiomyocyte cross sectional area (CSA) and collagen III overexpression, in both Hd groups (Img1). These structural changes reflected in RV function by increased Pmax, dP/dtmax as well as impaired relaxation seen by the constant t. Constriction of ascending aorta for 8weeks resulted in increased heart/tibial length (TL) ratio, RV Pmax as well as RV cardiomyocyte hypertrophy together with BNP overexpression (Ba+Rd).The concomitant presence of these two cardiovascular risk factors in Ba+Hd animals led to a significant heart and RV cardiomyocyte hypertrophy as well as collagen I overexpression. Conclusions: This study demonstrates that both Western diet consumption and LV chronic pressure overload induce RV structural and functional changes and that the combination of these factors further promotes hypertrophy and extracellular matrix changes in the non-overloaded ventricle. Open in new tabDownload slide
A proposed approach to study the toxicology of complex mixtures of petroleum products: the integrated use of QSAR, lumping analysis and PBPK/PD modeling.
Authors: H J Verhaar, J R Morroni, K F Reardon, S M Hays, D P Gaver, R L Carpenter, R S Yang
Journal: Environmental Health Perspectives (1997)

Mixture toxicity is a topic that has become a matter of concern during the last two decades. One of the major problems with assessing the toxicity of mixtures and the associated human and environmental risk is the large number of possible mixtures, as well as the fact that the actual mixture effect for a given set of constituents might strongly depend on the actual composition of the mixture, i.e., the ratios of the constituent, as well as their nature. This paper presents a possible approach to describe and thereby better understand the pharmacokinetics and dynamics of complex mixtures by combining quantitative structure-activity relationships to predict needed parameters, lumping to reduce the complexity of the problem, and physiologically based pharmacokinetic/pharmacodynamic modeling to integrate all this information into a complete toxicological description of the mixture. It is our hope that by presenting this conceptual approach we might be able to stimulate some criticisms and discussions in the toxicology community regarding this complex and yet very important area of research.
MEDICAL EDUCATION AND THE HOSPITAL
Authors: ARTHUR DEAN BEVAN
Journal: JAMA (1913)

true amniotic cellular tissue has been taken up by the raw surface.Thus far the conditions treated have not held closely In any one group but have included varicose ulcers, burns, scalds and denudations of traumatic origin.Ulcers.-These were generally varicose ulcers of the leg of all singes of infection and depth of erosion, and in nearly every instance if was necessary to "clean up" before grafting could be thought of.loilin or strong solutions of potassium permanganate followed with a wet dressing of mercuric chlorid solution 1:2,000 left on two days generally sufficed lo subdue the odor and encourage a more healthy appearing surface.After this procedure it is often found useful lo stimulate by rub¬ bing briskly with dry gauze, thus removing all sluggish granulations and detritus.The application of the graft and wax with a thick and smoothly applied outer dress¬ ing was usually done as described, bul occasionally t.he wax covering was extended over the entire leg below Ihe knee for the heller maintenance of the circulation.While the results were much belter than anything seen in our experience with other methods, there was not: the diffuse even lake over the ulcerated surface which occurred in other cases.There were numerous spots or islands of skin and edges which were healthy ami grew in rapidly.Burns anil Scalds.-.When all bits of dead skin and all foreign matter bad been Carefully removed and the tissue applied and left on two days, there was almost; without exception an even and diffuse adaptation of the graft,.In Ibis group, however, there were only eleven cases-, t lies,, included all degrees, but none more exten¬ sive in area than !> square inches, approximately, and mine siliiated on the face.Traumatic Denudation.-»-One case was treated with so satisfactory a result as lo justify a more complete description, in this instance the left hand of a laundry worker was caught in a machine ami then quickly pulled oui.denuding the palmar aspect of the ring and middle lingers throughout the length of the I wo terminal phalanges.The raw surfaces were grafted bul once and after two days were found diffusely and entirely covered With healthy skin so ihai no fiiiiher treatment was necessary other than a dry protective dressing, the skin being yet delicate.This case demons', rales ihe aclioii of this mode of treatment at its best advantage, there being no unhealthy condition of the Underlying tissue.
Association Between Cigarette Smoking and Acute Respiratory Tract Illness in Young Adults
Authors: Mark D. Aronson
Journal: JAMA (1982)

The association of cigarette smoking with the occurrence and severity of an acute respiratory tract illness (ARTI) was studied. Clinical data were obtained prospectively on 867 men and women with an ARTI and on a control group of 289 women. Three hundred seven (57%) of the 534 women in the ARTI group were smokers, compared with 97 (34%) of the 289 women in the control group, a highly significant difference. Of the 867 men and women with ARTIs, 506 were smokers. Smokers had a statistically significant greater likelihood of having a lower respiratory tract illness (57% v 45%), a longer duration of cough (8.9 v 6.8 days), and a greater frequency of abnormal auscultatory findings (31% v 20%) than did the 361 nonsmokers. Cigarette smoking may thus contribute to the substantial morbidity and lost productivity resulting from ARTI.
Identification of mutations in the putative ATP-binding domain of the adrenoleukodystrophy gene.
Authors: P Fanen, S Guidoux, C O Sarde, J L Mandel, M Goossens, P Aubourg
Journal: Journal of Clinical Investigation (1994)

The recently identified adrenoleukodystrophy (ALD) gene is predicted to encode a peroxisomal protein of 745 amino acids that includes one domain for ATP-binding, termed nucleotide-binding fold (NBF). To determine whether mutations occur in the putative NBF of ALD protein, we analyzed by denaturing gradient gel electrophoresis (DGGE) exon 6 and 8 that encode most part of this domain in 50 ALD patients. Four amino acid substitutions, three frameshift mutations leading to premature termination signal, and a splicing mutation were identified. These amino acid substitutions occurred at residues highly conserved in other ATP-binding cassette (ABC) proteins. In addition, a nonsense mutation was detected in exon 4.
Human development—cradle to mid-years
Authors: Marsha F. Goldsmith
Journal: JAMA (1984)

"When the National Institute of Child Health and Human Development [NICHD] contained the aging branch as well, they called us the cradle-to-the-grave institute. Now we're just sort of cradle to menopause," says Deputy Director Duane Alexander, MD. This pretty well sums up the purview of the institute that administers a multidisciplinary program of research, training, and public information on maternal, child, and family health, and on population. "One of the two major challenges facing this institute at the present time is the problem of low birth weight," states NICHD Director Mortimer B. Lipsett, MD, an expert in developmental endocrinology who has been head of the institute since July 1982. Before that, he directed the NIH Clinical Center. <h3>Its studies focus... on "human development across the spectrum"</h3> Unlike the Clinical Center or some other agencies in the NIH, the NICHD is noncategorical, or nondisease-oriented. Instead, its studies have a broad focus,
Cholesterol Screening of Children-Reply
Authors: Thomas B. Newman
Journal: JAMA (1991)

<h3>In Reply. —</h3> We agree with Kashani and Nader that the emphasis of pediatric preventive cardiology should be on the adoption of a healthy life-style, including exercise and no smoking. But we disagree that dietary treatment to decrease blood cholesterol levels is known to be safe. The clinical trial evidence that cholesterol level reduction increases noncardiovascular mortality<sup>1,2</sup>and the observational evidence that low cholesterol levels are associated with persistent increases in cancer incidence and mortality<sup>3</sup>suggest that lowering children's cholesterol levels could increase their death rate. Such an increase would be likely to go undetected unless it occurred within a large clinical trial.<sup>4</sup> Stuhldreher et al believe that identification of children with familial hypercholesterolemia is justification enough for screening and that labeling will be no more of a problem for children with high cholesterol levels than it is for children with weight problems. However, labeling is a
Divergence between refractoriness of His-Purkinje system and ventricular muscle with abrupt changes in cycle length.
Authors: S Denker, M H Lehmann, R Mahmud, C Gilbert, M Akhtar
Journal: Circulation (1983)

The concept that refractoriness of the His-Purkinje system (HPS) and ventricular muscle both vary directly with cycle length is based on observations during the use of constant cycle length. During abrupt changes in ventricular cycle length, refractoriness of the ventricular muscle is known to reflect the cumulative durations of preceding cycle lengths. The effect of such changes on retrograde refractoriness of the HPS is not known. In this study refractoriness of ventricular muscle and of the HPS was evaluated in 30 patients with normal intraventricular conduction by the ventricular extrastimulus (V2) technique during constant cycle length (method I) and during abrupt cycle length changes (method II). During method II the cycle length immediately before V2 was identical to the constant cycle length of method I and therefore was designated as the reference cycle length (CLR); however, the cycle length preceding (CLP) CLR was either longer than CLR (method IIA) by 100 to 300 msec in 11 patients or shorter than CLR (method IIB) by 100 to 300 msec in 30 patients. Results showed that compared with method I, method IIA shortened the relative refractory period (RRP) of the HPS from 350 +/- 29 to 344 +/- 29 msec (p less than .04), whereas the effective refractory period (ERP) of the ventricular muscle increased from 225 +/- 21 to 233 +/- 20 msec (p less than .0001). In contrast, compared with method I, method IIB lengthened the RRP of the HPS from 335 +/- 30 to 351 +/- 35 msec (p less than .0001), whereas ERP of the ventricular muscle decreased from 223 +/- 23 to 213 +/- 22 msec (p less than .0001). Similar to the inverse relationship between CLP and RRP of the HPS, ERP of the HPS was prolonged with short CLP (method IIB) compared with long CLP (method IIA). The results indicate a marked divergence between refractoriness of the HPS and of ventricular muscle during abrupt cycle length changes; these results were not previously anticipated. Whereas ventricular muscle responded to cumulative effects of preceding cycle lengths and varied directly with CLP, the HPS appeared to respond to directional and/or dynamic changes in cycle length and varied inversely with CLP. Moreover, in contrast to ventricular muscle, the HPS appeared to be responsive to rate of change in cycle length whereby short-to-long change in cycle length had a greater effect than long-to-short change in cycle length.
Mifepristone (RU 486) in the United States -- What Does the Future Hold?
Authors: Allan Rosenfield
Journal: New England Journal of Medicine (1993)

RU-486 or mifepristone developed by Roussel-UCLAF was approved in France in September 1988. Mifepristone coupled with a prostaglandin and administered within 49 days of the last menstrual period produces a complete abortion in about 95% of cases. A new regimen involves supplementing mifepristone with an oral prostaglandin, misoprostol. Mifepristone has been also reported to be effective as a postcoital agent, and it is being evaluated in the treatment of meningioma, recurrent breast cancer, Cushing's syndrome, and glaucoma. Despite these potentially important medical uses, the drug is not available in the US, although its popularity is demonstrated by the large number of women in France who have chosen it over 1st trimester surgical curettage. Many American women prefer a medical abortifacient to be taken privately because of harassment of patients outside abortion facilities; 83% of US countries do not have an abortion facility; a diminishing number of physicians are willing to provide abortion because of the violent protests by antiabortion groups (e.g., the recent murder of Dr. David Gunn); and few residency programs in obstetrics and gynecology routinely offer training in abortion procedures. The manufacturer has restricted the distribution of mifepristone, thus it is available only in France, the UK, and Sweden. The Clinton administration has a pro-choice position, hence Roussel had agreed to grant a license to the Population Council and to provide the Food and Drug Administration with toxicologic and chemical data on mifepristone. Approval will likely take place within 2-3 years. The drug should be used by obstetrician-gynecologists and perhaps by family practitioners and nurse-midwives. Physicians should provide counseling about the side effects and potential complications of abortion. Misoprostol is marketed in the US under the trade name Cytotec, thus its review for use with mifepristone should be simple.