tbuckley/cabot-search huggingface dataset:
Reduced intravascular infection by antibiotic bonding
Authors: Neil A. Solomon
Journal: JAMA (1991)

<h3>To the Editor.</h3> —Kamal et al<sup>1</sup>state that their "data suggest that antibiotic bonding of catheters would be highly cost-effective," but the technique of cost-effectiveness analysis is never used. Furthermore, the researchers have failed to demonstrate clinically relevant and quantifiable gains in outcome by the intervention group and have not considered direct and indirect costs of the two competing strategies. The article also raises the issue of conflict of interest in cost-effectiveness analysis. Health economists have recently begun to question the practice of conducting cost-effectiveness analyses that are sponsored by third parties who have a vested interest in the outcome, and they have suggested guidelines to maintain high standards.<sup>2</sup>Because Kamal et al promoted a single catheter type and prominently displayed the brand name in the accompanying photograph, the potential for financial gain to the manufacturer cannot be ignored. As questions about medical resource allocation grow in importance,
Effect of halothane on neuromuscular transmission
Authors: A. J. Gissen
Journal: JAMA (1966)

The patient with impaired muscle function presents a special problem to the anesthesiologist. At the end of general anesthesia, muscular relaxation must be reversed as quickly and as completely as possible, and for this reason halothane has been a frequent choice as the inhalational anesthetic. Two recent studies<sup>1,2</sup>would seem to support this choice since in these experiments the neurally evoked muscle twitch showed no depression during halothane anesthesia. However, in the report by Watland<sup>1</sup>it is apparent that the intensity and duration of block by tubocurarine was increased in the presence of halothane anesthesia. Since normal neuromuscular transmission has a reserve safety factor several times that necessary for transmission, a moderate neuromuscular blocking action of halothane might be undetected in twitch tension experiments. This degree of block might be of little consequence under ordinary circumstances, but a moderate blocking action of halothane could be of clinical significance
Reply
Authors: R H Holloway, J Dent, F Narielvala, A M Mackinnon
Journal: Gut (1996)

THIS ARTICLE REVIEWS THE CURRENT STATE AND FUTURE PROSPECTS of the health care system in the United States. The 1990s were a decade of reform and change in US medical care, with the debate over the Clinton plan for universal insurance and, after its defeat, the spread of managed care. In particular, managed care had a profound impact on the delivery of medical services, transforming traditional insurance arrangements. However, after all of the changes, the United States appears to be no closer to solving the problems that have characterized its health care system for the past 3 decades. Over 40 million Americans lack health insurance, universal coverage is nowhere in sight, and medical care costs are rising again after a period of moderation. It is doubtful that incremental health reforms will significantly ameliorate these problems.
Alterations in guanine nucleotide regulatory protein expression and activity in human hepatocellular carcinoma
Authors: C Schmidt
Journal: Hepatology (1997)

Alterations in the expression and activity of guanine nucleotide regulatory proteins (G proteins) have been linked to the growth of several human tumors. We hypothesized that the expression and activity of G proteins are altered in human hepatocellular carcinoma (HCC). The expression of Gi and Gs proteins was determined in six human tumors and six normal controls (adjacent nonneoplastic liver) by Western blotting using specific antisera raised against the α subunit of G proteins Gi1, Gi1-2, Gi3, and Gs. Differences in G-protein expression were quantified by densitometry and expressed as percentage change from normal controls. The expression of Gi α1 was significantly increased in 80% of tumors (Gi α1, 284% ± 77%; P < .05 percent of normal tissue), whereas Gi α1-2 and Gi α3 expression was increased in 67% of tumors (Gi α1-2, 218% ± 21%; Gi α3, 154% ± 6%; P < .05 percent of normal tissue). The functional activity of Giα proteins as determined by pertussis toxin-catalyzed adenosine diphosphate (ADP)-ribosylation was also significantly increased in these tumors. In contrast, Gs α-protein expression was significantly reduced in all tumors examined (74% ± 8% of normal tissue, P < .05). The functional activity of Gs α, as determined by adenylyl cyclase (AC) activity, was significantly decreased in tumor as compared to normal liver under both basal and agonist stimulated (guanosine triphosphate gamma S and forskolin) conditions. In summary, these data show for the first time a significant alteration in G-protein expression and functional activity in human HCC tissue. These alterations indicate a down-regulation of the AC-linked enzyme effector system in HCC that may be of critical importance to the formation and progression of human hepatocellular carcinoma.
Adherence to surviving sepsis campaign 3-hour bundles improves survival in non-critically ill patients with cirrhosis and sepsis
Authors: Salvatore Piano, Leopoldo Torresan, Simone Incicco, Marta Tonon, Carmine Gabriele Gambino, Silvano Fasolato, Umberto Cillo, Patrizia Burra, Paolo Angeli
Journal: Journal of Hepatology (2020)
Effect of student loan indebtedness and repayment on resident physicians' cash flow. An analytic model
Authors: J. Hernried
Journal: JAMA (1990)

Cumulative figures of "average medical student indebtedness," although meaningful, do not convey the effect of loan repayments on residents' cash flow, effect on a resident's value system and residency performance, and effect on trends in health care manpower allocation. Using a computer-based cash flow model, a "typical" house officer with $20 000 in undergraduate indebtedness who is training in a less expensive city will realize a $2390 deficit during internship and negative cash flow throughout a 5-year residency. House officers with extreme indebtedness (&gt;$80 000) who are training in an expensive metropolitan area would accumulate an overall deficit approaching $75 000 or more,<i>in excess of their undergraduate indebtedness</i>, during a 5-year residency program. Effects of these findings on residency education and health care manpower issues, along with potential solutions for alleviating residents' cash flow problems, are discussed. (<i>JAMA</i>. 1990;263:1102-1105)
Khat abuse fuels Somali conflict, drains economy
Authors: T. Randall
Journal: JAMA (1993)

AN AMPHETAMINE-LIKE compound commonly used in East African societies for hundreds if not thousands of years is stoking the flames of Somalia's civil conflict, draining that nation's economy and, until recently, thwarting international relief efforts in the region. Somalis commonly chew the leaves of the khat shrub for its stimulating effects. Khat's active component, cathinone, closely resembles ephedrine and amphetamine in chemical structure (see figure). Its users report euphoria and increased alertness, although their concentration and judgment are objectively impaired (<i>Psychol Med</i>. 1989;19:657-668). Chewing khat is as socially acceptable in Somali culture as is drinking espresso in Western culture. Both men and women chew khat in congenial social gatherings in which family and guests discuss topics of interest or listen to poetry or music. Somali homes often include rooms called<i>muffraj</i>, designed specifically for these gatherings. Khat chewers normally chew 100 to 200 g of leaves and stems over 3
Neoplastic disease in fertile age: Psychological support during the course of the mother-child experience
Authors: R. Biamonte, A. Piattello, S. Pignata, B. Costantini, G. Conte, D. Barberio, S. Palazzo, F. De Falco, G. Scambia
Journal: Journal of Clinical Oncology (2004)

8235 Background: Because of the progressive rise in the mean age of the first delivery and the progressive lowering in the age of onset of tumors, the continuous increas in the number of patients with children in infancy or adolescence is clear. Methods: In the months of July-August 2002,the research Institute ISI Research, carried out an analysis of the needs of women with oncological pathology by filling out a form given to 80 Oncologists and 20 Haematologists. 1186 Italian oncological patients were assessed (917 women affected by solid tumours and 269 by haematological neoplasia) as a representative sample of the different national geographic areas. Because of the progressive rise in the mean age of the first delivery and the progressive lowering in the age of onset of tumours, the continuous increase in the number of patients with children in infancy or adolescence is clear. Results: 69.5% of the women interviewed are of fertile age including 95.2% with children and 37.1% of them referring to notable problems in the management of the situation during the course of oncological treatment. Conclusions: The realization of the project "Neoplastic pathology in fertile age: psychological support during the course of the mother-child experience" provides for: 1)the involvement of a series of Italian Oncological Centres in which suitable living environments will be set up suitable to the needs of mother-children and woman-family and to the entertainment of the children during the course of oncological treatment; 2)specialized work carried out, after an initial assessment of the overall needs both of the mother and of the child, using a methodology set up by a group of expert Psychoncologists. Individual and group actions are provided for patients: psychological support, relaxation techniques, psycho-educational provision, psycho-emotional support. Actions by means of "baby-observation" techniques and other assessment methodologies of the emotional state of the child are provided for the children. The results achieved should constitute the basis of the guidelines. No significant financial relationships to disclose.
Effects of lower surgical fees on the use of physician services under Medicare
Authors: J. J. Escarce
Journal: JAMA (1993)

<h3>Background and Objective.</h3> —The changes in physician fees that will occur under the resource-based Medicare Fee Schedule (MFS) are similar to those that took place under the Omnibus Budget Reconciliation Act of 1987 (OBRA 87), when Medicare fees for selected "overpriced" procedures and diagnostic tests were reduced. To gain insight regarding the changes in utilization that may occur under the MFS, this study examines the effects of the OBRA 87 fee reductions on the use of physician services by Medicare patients. <h3>Data and Methods.</h3> —The five specialties that were most affected by the OBRA 87 fee reductions were studied: ophthalmology, thoracic surgery, urology, orthopedic surgery, and gastroenterology. Medicare physician claims files for 1987 and 1989 were used to obtain data on utilization and fees. Multivariate regression analysis was used to assess the effect of changes in fees on changes in utilization. <h3>Results.</h3> —The best estimate of the effect of the OBRA 87 fee reductions on overall physician-services utilization, obtained by pooling the five study specialties, was that every 1% decrease in fees led to a 0.09% decrease in the volume and complexity of services (95% confidence interval, 0.49% decrease to 0.31% increase). This result was not sensitive to minor changes in the covariates included in the regression model. <h3>Conclusion.</h3> —To calculate payment levels during the transition to the MFS, the Health Care Financing Administration assumed that physicians whose Medicare revenue declines under the MFS will increase service volume and complexity enough to make up one half of the lost revenue. The findings of this study suggest that the Health Care Financing Administration's assumption was, at best, extreme. (<i>JAMA</i>. 1993;269:2513-2518)
Predicting Hospital-Associated Mortality for Medicare Patients
Authors: Jennifer Daley
Journal: JAMA (1988)

We created a microcomputer-based system that uses characteristics of the patient at admission to predict death within 30 days of hospital admission for Medicare patients with stroke, pneumonia, myocardial infarction, and congestive heart failure. These conditions account for 13% of discharges and 31% of 30-day mortality for Medicare patients over 64 years of age. The system was calibrated on a stratified, random sample of 5888 discharges (about 1470 for each condition) from seven states, with stratification by hospital type to make the sample nationally representative. The predictors must be specially abstracted from the medical record. The cross-validated<i>R</i><sup>2</sup>for predictions is 0.14 to 0.25, which is better than the values for other systems for which we have data. Risk-adjusted predicted group mortality rates may be useful in interpreting information on unadjusted mortality rates, and patient-specific predictions may be useful in identifying unexpected deaths for clinical review. (<i>JAMA</i>1988;260:3617-3624)
FINGER-PRINT IDENTIFICATION
Journal: JAMA (2012)

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 Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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) 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
Fertility patterns after appendicectomy: historical cohort study
Journal: BMJ (1999)

Objective To examine fertility patterns in women who had their appendix removed in childhood.Design Historical cohort study with computerised data and fertility data for this cohort and for an age matched cohort of women from the Swedish general population.The cohorts were followed to 1994.Setting General population.Participants 9840 women who were under 15 years when they underwent appendicectomy between 1964 and 1983; 47 590 control women.Main outcome measures Diagnoses at discharge.Distributions of age at birth of first child among women with perforated and non-perforated appendix and women who underwent appendicectomy but were found to have a normal appendix compared with control women by using survival analysis methods.Parity distributions at the latest update of the registry were also examined.Results Women with a history of perforated appendix had a similar rate of first birth as the control women (adjusted hazard ratio 0.95; 95% confidence interval 0.88 to 1.04) and had a similar distribution of parity at the end of follow up.Women who had had a normal appendix removed had an increased rate of first births (1.48; 1.42 to 1.54) and on average had their first child at an earlier age and reached a higher parity than control women.Conclusion A history of perforated appendix in childhood does not seem to have long term negative consequences on female fertility.This may have important implications for the management of young women with suspected appendicitis as the liberal attitude to surgical explorations with a subsequently high rate of removal of a normal appendix is often justified by a perceived increased risk of infertility after perforation.Women whose appendix was found to be normal at appendicectomy in childhood seem to belong to a subgroup with a higher fertility than the general population.
Imerge: A Study to Evaluate Imetelstat (GRN163L) in Transfusion-Dependent Subjects with IPSS Low or Intermediate-1 Risk Myelodysplastic Syndromes (MDS) That Is Relapsed/Refractory to Erythropoiesis-Stimulating Agent (ESA) Treatment
Authors: Uwe Platzbecker, David P. Steensma, Koen Van Eygen, Azra Raza, Valeria Santini, Ulrich Germing, Patricia Font, María Díez-Campelo, Sylvain Thepot, Edo Vellenga, Mrinal M Patnaik, Jun Ho Jang, Laurie Sherman, Souria Dougherty, Faye Feller, Libo Sun, Ying Wan, Fei Huang, Aleksandra Rizo, Pierre Fenaux
Journal: Blood (2019)
Angiosarcoma.
Authors: R H Vonderheide, M D Fleming, G Carter, S Singer, G Demetri
Journal: Journal of Clinical Oncology (1997)

Article Tools Article Tools OPTIONS & TOOLS Export Citation Track Citation Add To Favorites Rights & Permissions COMPANION ARTICLES No companion articles ARTICLE CITATION DOI: 10.1200/JCO.1997.15.4.1708 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 9193372 Angiosarcoma. R H VonderheidexR H VonderheideSearch for articles by this author , M D FlemingxM D FlemingSearch for articles by this author , G CarterxG CarterSearch for articles by this author , S SingerxS SingerSearch for articles by this author , G DemetrixG DemetriSearch for articles by this author Show More Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. https://doi.org/10.1200/JCO.1997.15.4.1708 PDF "Angiosarcoma.." Journal of Clinical Oncology, 15(4), pp. 1708–1709© 1997 by American Society of Clinical Oncology
Computer Searching: Finding Information the Easy Way.
Journal: Annals of Internal Medicine (1987)

curriculum), 29 p. (teaching guide).$49.00.End-user searching presents librarians with the problem of how best to teach the basics of searching in an efficient, cost-effective manner.The content and complexity of their teaching depend upon the needs of the group, the structure of the database, and the user-friendliness of the vendor software.Because of its value to clinicians and researchers, MEDLINE is one of the databases most frequently accessed by end users in the health sciences.This two-part set, Computer Searching: Finding Information the Easy Way, presents a framework upon which instructors can build a course in MED- LINE searching with the BRS Colleague system.In their prefatory comments the authors state that the purpose of this material is "to provide a struc- ture for your teaching."The book includes a course syllabus, class notes, and exercises.The purchase price covers photocopy rights.The format of these materials will be familiar to those who attended search training sessions spon- sored by NLM.The student materials come in a three-ring binder, divided alphabetically.Section A begins with the most basic skills (logging in, search terminology, system commands).It then explains simple searches by author, journal title, language of publication, and year.Basic use of Boolean logic is unobtrusively introduced.Section B introduces MeSH, tree structures, explosions, and major/minor concepts, and it describes Boo- lean searching in greater detail.The last two sec- tions address advanced search techniques (subheadings, free-text searching, stop words, and broadening/narrowing techniques) and full-text searching.The brief full-text section may be mis- leading; it shows the difference between biblio- graphic and full-text retrieval techniques only superficially.It might have been better to delete that section from the outlined curriculum and to create a separate full-text curriculum instead.
Vioxx Controversy
Authors: Joan Stephenson
Journal: JAMA (2004)

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
Aggressive treatment of endothelial dysfunction in geriatric patients: The Simvastatin, Ascorbate, and Vitamin E in seniors (SAVES) study James H. Stein, Cynthia M. Carlsson, Kristi Papcke-Benson, Susan E. Aeschlimann, Molly L. Carnes, Patrick E. McBride. University of Wisconsin Medical School, Madison, WI
Journal: Journal of the American College of Cardiology (2001)
Organophosphate Poisoning
Authors: J. D. Khandekar
Journal: JAMA (1971)

<h3>To the Editor.—</h3> I was rather surprised to find nothing mentioned about "delayed deaths" in Milby's article on "Prevention and Management of Organophosphate Poisoning" (<b>216</b>:2131, 1971). In some cases of intoxication with organophosphorus compounds, the condition of a patient initially improves, then suddenly deteriorates, culminating in death.<sup>1</sup> In our studies on 35 patients<sup>2</sup>who ingested malathion for suicidal purposes, 37% showed electrocardiographic abnormalities, such as dysrhythmia, right axis deviation, and ST-T changes. The myocardium of five of these patients who died exhibited fatty metamorphosis, interstitial edema, and infiltration by mononuclear cells. Limaye<sup>3</sup>observed similar histopathologic abnormalities (interpreted as toxic myocarditis) among 76 cases of organophosphorus compound poisoning. Alterations in the myocardium can cause delayed death and, hence, this question warrants further study. However, our own investigations clearly indicate that organophosphorus poisoning should be treated in intensive care units with ECG monitoring. Continuous vigil is recommended, even
Impact of a rural high blood pressure control program on hypertension control and cardiovascular disease mortality
Authors: J. M. Kotchen
Journal: JAMA (1986)

Kentucky is a predominantly rural state with relatively high death rates from hypertension and cardiovascular disease. We report the results of a community-based high blood pressure control educational program undertaken in two rural counties of southeastern Kentucky. In the intervention counties, systolic and diastolic blood pressures of both men and women decreased despite the five-year increase in age; moreover, hypertension was better controlled after the program, and substantial decreases in deaths due to cardiovascular disease were seen. These differences were greater among men in the two regions than among women. The results of this program suggest that, in sparsely populated rural areas, existing resources and programs can be successfully utilized in a communitywide cardiovascular disease risk reduction educational program. (<i>JAMA</i>1986;255:2177-2182)