tbuckley/cabot-search huggingface dataset:
Physician Referrals in a Competitive Environment
Authors: Lawrence M. Markman
Journal: JAMA (1988)

<h3>To the Editor.</h3> —Glenn et al<sup>1</sup>have recently written about physician referrals in a competitive environment. In their useful article on a seldom-discussed aspect of medical practice, the authors reminded us of the important economic aspects of physician referrals, which "have a cumulative economic impact on many components of the broader medical care system."<sup>1</sup> Primary care physicians account for as many as two thirds of all referrals, according to the authors. We agree with them that "historical prerogatives among physicians are being altered in our medical care system, which is undergoing rapid structural and economic change." One such prerogative is how often and where to refer. <h3>Study.</h3> —We recently examined the referral patterns of family physicians to see whether the incidence of their referrals differed for prepaid patients from managed health care plans vs fee-for-service patients. Fifteen members of the Delaware Academy of Family Physicians, selected to represent
Evidence of patient benefit must be "at the heart" of NHS efficiency plans, warn doctors
Authors: Z. Kmietowicz
Journal: BMJ (2010)

The public must be prepared for certain facilities in local hospitals to close and to have to travel further to specialist centres for treatment if the NHS is to survive the level of cuts that have to take place under the next government, warns a group of eminent clinicians and academics.

There is a “wealth of clinical evidence” that shutting certain departments in local hospitals, such as stroke, trauma, and heart surgery, and concentrating these services in fewer centres with the latest equipment and expert clinicians improves patient safety …
Interleukin-1 Receptor Antagonist Gene Polymorphism and Coronary Artery Disease
Authors: Sheila E. Francis, Nicola J. Camp, Rachael M. Dewberry, Julian Gunn, Petros Syrris, Nicholas D. Carter, Stephen Jeffery, Juan Carlos Kaski, David C. Cumberland, Gordon W. Duff, David C. Crossman
Journal: Circulation (1999)

Background —Cytokine gene variations are contributory factors in inflammatory pathology. Allele frequencies of interleukin (IL)-1 cluster genes [IL-1A(-889), IL-1B(-511), IL-1B(+3953), IL-1RN Intron 2 VNTR] and tissue necrosis factor (TNF)-α gene [TNFA(-308)] were measured in healthy blood donors (healthy control subjects), patients with angiographically normal coronary arteries (patient control subjects), single-vessel coronary disease (SVD), and those with multivessel coronary disease (MVD). Methods and Results —Five hundred fifty-six patients attending for coronary angiography in Sheffield were studied: 130 patient control subjects, 98 SVD, and 328 MVD. Significant associations were tested in an independent population (London) of 350: 57 SVD, 191 MVD, and 102 control subjects. IL-1RN*2 frequency in Sheffield patient control subjects was the same as in 827 healthy control subjects. IL-1RN*2 was significantly overrepresented in Sheffield SVD patients (34% vs 23% in patient control subjects); IL-1RN*2 homozygotes in the SVD population (χ 2 carriage=8.490, 1 df , P =0.0036). This effect was present though not quite significant in the London population ( P =0.0603). A summary trend test of the IL-1RN SVD genotype data for Sheffield and London showed a significant association with *2 ( P =0.0024). No significant effect of genotype at IL-1RN was observed in the Sheffield or London MVD populations. Genotype distribution analysis comparing the SVD and MVD populations at IL-1RN showed a highly significant trend ( P =0.0007) with the use of pooled data. No significant associations were seen for the other polymorphisms. Conclusions —IL-1RN*2 was significantly associated with SVD. A difference in genetic association between SVD and MVD was also apparent.
REPORT OF A PATIENT EXHIBITING THREE INFECTIONS WITH SYPHILIS
Authors: Charles R. L. Halley
Journal: JAMA (1928)

Instances of second infection with syphilis are still sufficiently infrequent to be published in detail when observed. Examples of patients exhibiting a third infection with syphilis are exceedingly rare, so much so that each case should be reported fully. In collaboration with Dr. Harry Wassermann, I have recently reviewed, with especial reference to the time of treatment of the first infection, all the instances (about 700) of second syphilitic infection ("reinfection," "superinfection") reported in the literature since the introduction of arsphenamine, in 1910. This study, which is now being prepared for publication, discloses, among other facts, that there have thus far been published only eight satisfactory reports of patients who have acquired a third infection with syphilis. The present case report is, so far as I am aware, the first satisfactory instance in the American and English literature. This patient's record is briefly mentioned in the
Peers defeat government plan to withdraw benefits from sick and disabled people after a year
Authors: I. Torjesen
Journal: BMJ (2012)

The House of Lords has rejected a government proposal to limit payment of the Employment Support Allowance to sick, disabled, and dying people to one year and then use means testing to determine who is entitled to keep receiving it.

The allowance is meant to replace the earnings of people whose health problems or disabilities pose a barrier to work. It is paid to people who have previously worked and made national insurance contributions and to young people who have never been able to work or not paid enough contributions, such as people born with disabilities or teenagers with cancer.

The government’s Welfare Reform Bill was seeking to limit to 12 months the period that anyone could claim the allowance without being means tested. The proposed bill would also have completely excluded young people who had not paid enough contributions because of disability or illness if they had other means of support, such as from parents, savings, or inheritance.

The House of …
Inherited human cPLA2α deficiency is associated with impaired eicosanoid biosynthesis, small intestinal ulceration, and platelet dysfunction
Authors: David H. Adler, Joy D. Cogan, John A. Phillips, Nathalie Schnetz-Boutaud, Ginger L. Milne, Tina Iverson, Jeffrey A. Stein, David A. Brenner, Jason D. Morrow, Olivier Boutaud, John A. Oates
Journal: Journal of Clinical Investigation (2008)

Cytosolic phospholipase A2alpha (cPLA2alpha) hydrolyzes arachidonic acid from cellular membrane phospholipids, thereby providing enzymatic substrates for the synthesis of eicosanoids, such as prostaglandins and leukotrienes. Considerable understanding of cPLA2alpha function has been derived from investigations of the enzyme and from cPLA2alpha-null mice, but knowledge of discrete roles for this enzyme in humans is limited. We investigated a patient hypothesized to have an inherited prostanoid biosynthesis deficiency due to his multiple, complicated small intestinal ulcers despite no use of cyclooxygenase inhibitors. Levels of thromboxane B2 and 12-hydroxyeicosatetraenoic acid produced by platelets and leukotriene B4 released from calcium ionophore-activated blood were markedly reduced, indicating defective enzymatic release of the arachidonic acid substrate for the corresponding cyclooxygenase and lipoxygenases. Platelet aggregation and degranulation induced by adenosine diphosphate or collagen were diminished but were normal in response to arachidonic acid. Two heterozygous single base pair mutations and a known SNP were found in the coding regions of the patient's cPLA2alpha genes (p.[Ser111Pro]+[Arg485His; Lys651Arg]). The total PLA2 activity in sonicated platelets was diminished, and the urinary metabolites of prostacyclin, prostaglandin E2, prostaglandin D2, and thromboxane A2 were also reduced. These findings characterize what we believe is a novel inherited deficiency of cPLA2.
Involvement of neutrophilic granulocytes in the uptake of biodegradable non-stealth and stealth nanoparticles in guinea pig
Authors: Marie-France Zambaux, Béatrice Faivre-Fiorina, François Bonneaux, Sophie Marchal, Jean-Louis Merlin, Edith Dellacherie, P Labrude, Claude Vigneron
Journal: Biomaterials (2000)
Identification of Physician Impairment
Authors: Julius Cuong Pham, Peter J. Pronovost, Gregory E. Skipper
Journal: JAMA (2013)

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
Inhibition of β -Adrenergic Desensitization by K<sub>Ca</sub> Channels in Human Trachealis
Authors: HIROAKI KUME, KENZO TAKAGI
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

We examined the reduced responsiveness to β -adrenergic receptor agonists ( β -agonists) after exposure to β -agonists, and the mechanisms underlying this phenomenon in isolated human tracheal smooth muscle, using isometric tension records to test the hypothesis that repeated inhalation of β -agonists leads to reduced responsiveness to β -agonists. The inhibitory effects of isoproterenol (ISO) on contraction by spasmogens participating in asthma attacks diminished markedly after continuous exposure to ISO (0.0003 to 3 μ M) for 45 min; moreover, when ISO was repeatedly applied for 10 min to tissues precontracted by methacholine every 30 min, the relaxant effects of ISO gradually attenuated after these repeated applications. In contrast, reduced β -adrenergic relaxation after continuous and repeated exposure to agonists did not occur when tissues were preincubated with 2 μ g/ ml cholera toxin (CTX), which irreversibly activates guanosine triphosphate (GTP)-binding protein (Gs) coupled with β -adrenergic receptors, for 6 h. However, the CTX inhibition disappeared in the presence of iberiotoxin, a selective inhibitor of large conductance Ca2 +-activated K+ (KCa) channels. Our results demonstrate that continuous and repeated exposure to β -agonists leads to β -adrenergic desensitization, and that activation of KCa channels by Gs prevents this desensitization.
Mutation in the promoter region of the hepatic lipase gene correlates with dyslipidemia in type 2 diabetes
Authors: Raj K. Mattu, Edward W. Needham, Jasper Trevelyan, Dimitri J. Richter, Maria A. Adiseshiah, Mauro Lencioni, Shane Gleowarsingh, D.John Betteridge
Journal: Journal of the American College of Cardiology (2002)
Increased Adiposity at Diagnosis in Younger Children With Type 1 Diabetes Does Not Persist
Authors: Giuseppe d’Annunzio, Valentina Emmanuele, Angela Pistorio, Vera Morsellino, Renata Lorini
Journal: Diabetes Care (2007)

The report by Clarke et al. (1) showed that in pediatric type 1 diabetes, younger age at diagnosis was associated with higher BMI SD scores (SDSs); however, BMI SDSs did not change from 1976 to 2004. In patients longitudinally evaluated and grouped according to age at diagnosis, BMI SDSs were higher in the youngest age-group, while, 5 years later, anthropometric parameters were similar across the three groups.

We report our results regarding BMI SDSs of 174 patients, 106 (60.9%) male and 68 (39.1%) female, insulin treated since diagnosis and followed between 1990 and …
Massive Osteolysis of the Right Clavicle Developing After Radiation Therapy
Authors: William L. Skinner, Aman U. Buzdar, Herman I. Libshitz
Journal: JAMA (1988)

<h3>History</h3> A 52-year-old woman had a right modified radical mastectomy in February 1980 for a stage II, Tl (2-cm mass), N1 (three of 13 lymph nodes positive), MO, estrogen receptor-positive breast cancer. She received postoperative irradiation with 40 Gy delivered by opposing tangential fields to the chest wall and by a single anterior field to the supraclavicular and internal mammary areas; 10 Gy of additional radiation was also given to the posterior axilla. Adjuvant combination chemotherapy was given with six courses of fluorouracil, doxorubicin (Adriamycin), cyclophosphamide (Cytoxan), vincristine, and prednisone. The total doxorubicin dose was 300 mg/m<sup>2</sup>.2. After completion of adjuvant combination chemotherapy, 10 mg of tamoxifen twice a day was given for six months concomitantly with three months of methotrexate therapy followed by three months of vinblastine therapy. The patient sustained a fall in February 1981 and suffered a fracture of the medial aspect of her right
More Midwives in Developing Countries Could Save Millions of Lives
Authors: M. J. Friedrich
Journal: JAMA (2014)

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
The Evolution of Pharmacy in Britain
Authors: Lester S. King
Journal: JAMA (1966)

The history of pharmacy has not received nearly the attention it deserves. Relatively few scholars concern themselves with this topic, and much of the extant literature is not readily available. Historians will be grateful, therefore, for this new publication, which represents the proceedings of the Fourth British Congress on the History of Medicine and Pharmacy, held in September 1963. The title, perhaps, is not quite precise, for the book contains a series of studies rather disconnected one from the other. Even in the aggregate, the contributions do not provide a unified picture of an evolutionary trend. The individual papers present a quite varied fare, some parts far more nutritious and substantial than others. The 18th and 19th centuries are considered in greatest detail, while earlier periods receive variable amounts of attention. The subjects covered include a discussion of pharmacy schools, relationships of pharmacy and hospitals, the actual production of drugs
The Individual Communion Cup.
Authors: Howard S. Anders
Journal: JAMA (1900)

Philadelphia, Nov. 9, 1900. <h3>To the Editor:</h3> —InThe Journalfor November 3, a brief reference is made (p. 1150) to a "Sanitary Substitute for the Individual Communion Cup," which the<i>Lancet</i>suggests, namely, "intinction," or "the ancient custom of dipping the bread in the wine." With regard to the ecclesiastical or sanitary reasons for the revival of this method of celebrating the Lord's supper I have nothing to say here, pro or con. But the reason for advocating the change that the<i>Lancet</i>gives, namely, that individual communion cups are not practicable, is valid or not, according to the point of view; that is, whether from the dogmatic and ecclesiastical, or from the purely sanitary. If the<i>Lancet</i>means that according to the doctrine and ritual of the Church of England (presumably, because the state church), individual communion cups are impracticable, then I have nothing to say; the advocates
Benign Paroxysmal Positional Vertigo
Authors: Katherine D Heidenreich
Journal: New England Journal of Medicine (2010)

A patient with benign paroxysmal positional vertigo can be diagnosed with the Dix–Hallpike maneuver. A positive Dix–Hallpike test is manifested as upbeating torsional nystagmus with a fast component that rotates toward the undermost ear.
Pelvic varicosities due to thrombophlebitis. Report of a case following occlusion of the iliac veins and inferior vena cava
Authors: I. Steinberg
Journal: JAMA (1967)

Venography through the common femoral veins demonstrated that dyspareunia following recurrent pelvic, groin, and lower-extremity thrombophlebitis was caused by pelvic varicosities resulting from occlusion of the common iliac veins and inferior vena cava. An adequate collateral circulation via ascending lumbar, vertebral, gonadal (vaginal, uterine, and ovarian), and caval (azygos system)
Interferon emerging as hormone-like substance
Authors: Sandra Panem
Journal: JAMA (1982)

The First Annual International Congress for Interferon Research, held in Washington, DC, during the fall of 1980, left the impression that interferon as an anticancer drug was intriguing but unproved (<i>JAMA</i>[MEDICAL NEWS] 1981;245:109-116). The second congress, held recently in San Francisco and, like the first congress, well attended by scientists, the business community, and the press, left much the same impression. However, some new questions, for example, those concerning interferon's possible role in disease induction, came to light. At the time of the first congress, the results of the American Cancer Society-sponsored phase I trials of interferon in cancer patients were known. They were highly variable—reported tumor regression ranged from 0% to 40%—and raised several questions, such as these: Was the variability of response due to the kind of interferon used for treatment (there are three major groups of interferons that include a minimum of 20 distinct entities)? Was
WHO in 2002: Why does the world still need WHO?
Authors: G. Yamey
Journal: BMJ (2002)

The landscape of global health is changing. New donor money, disease control initiatives, and trade laws have all had an impact on international health cooperation. WHO is being forced to rethink what its functions should be 

WHO used to dominate international health. But in the 1990s, the World Bank took its place as the premier global health agency,1 and a wide array of health initiatives were launched, bringing new money and fresh ideas to tackle disease. Globalisation is presenting new challenges to an increasingly fragmented global health landscape.2 What are the implications for WHO of these changes?

### Summary points

The World Bank, Gates Foundation, and Global Fund have become major financiers of global health activities

WHO has little influence over the spending of these new health funds

The poorest countries need WHO's support in applying for funds and rolling out new global health initiatives

As international health cooperation fragments, WHO's role in setting global standards has become crucial

WHO's integrity in setting standards remains open to undue influence

The World Bank has become the largest external financier of health activities in low income and middle income countries.1 In the 1990s its health loans far exceeded WHO's total budget (fig 1), and its health sector activities have continued to grow. Its new Multi-Country AIDS Programme alone provides $500m over three years to Africa—where the prevalence of HIV in adults is now 8.6%—to scale up existing HIV/AIDS interventions.3



Fig 1 
The growing role of the World Bank in health1



The Gates Foundation, the largest charitable donor of the 20th century,4 is often called the new “800 pound gorilla” in global health. By September 2002, it had granted $2.8bn in health funding.5 Its biggest donation was $750m over five years as a start up grant to the Global Alliance for …
SYPHILITIC JOINT DISEASE SIMULATING TUBERCULOSIS
Authors: PERCY WILLARD ROBERTS
Journal: JAMA (1918)

Until recently, the diagnosis of tuberculous joint disease was considered one of the simplest and most definite problems with which the orthopedic surgeon is confronted. It is evident, however, from the gradual elimination from this classification of such conditions as Perthes' disease, hemorrhagic osteomyelitis (Barrie) and other benign lesions, and also from studies of congenital syphilis pursued by me during the past two years, that this simplicity is merely apparent. We have, indeed, enjoyed a sense of diagnostic security entirely unwarranted by the facts. Heretofore it has been the custom to consider as probably tuberculous those cases of articular disease characterized by a gradual onset of symptoms, the presence of spasm on passive movement, limitation of motion in all directions, atrophy and limp, if a weight bearing joint was involved, or alteration of attitude when the lesion was vertebral. This method of diagnosis has been practiced for many decades, and
INTUBATION OF THE LARYNX.
Authors: CHAS. J. WHALEN
Journal: JAMA (1900)

Intubation of the larynx, which has been employed in many thousand cases in this country and abroad, has now taken its place with tracheotomy as a well-recognized procedure in the treatment of obstructive dyspnea. Before taking up the technique of the operation, I will briefly consider its history and the indications for the employment. The passing of a tube, as for instance a catheter, for the relief of laryngeal obstruction is of ancient origin, but it was not until 1858 that Bouchet, of Paris, devised special instruments for this purpose. Unfortunately for Bouchet, owing partly to the defective condition of the instruments, the profession of Paris, led especially by the great authority, Troussseau, not only condemned but ridiculed the new method. Criticism coming from such an authority as Trousseau caused the treatment to meet with so little favor that it was soon entirely abandoned. While catheterism of the larynx has
Potentiation of Insulin Action in Normal Subjects by a Pituitary Polypeptide
Authors: J. Bornstein, J. McD. Armstrong, F. M. Ng, H. P. Taft
Journal: BMJ (1969)

A pituitary polypeptide, acceleratory polypeptide-growth hormone (ACG), has been found to increase the sensitivity of fasting normal people to intravenous insulin. It is suggested that diminished activity of this polypeptide-or increased activity of another polypeptide, inhibitory polypeptide-growth hormone (ING)-may have a role in the genesis of diabetes mellitus.