Abstract：
:We sought to evaluate the economic impact and diagnostic utility of magnetic resonance imaging (MRI) in the management of patients with headache and nonfocal physical examinations. Computerized medical records were retrospectively reviewed of 1,233 patients presenting for MRI of headache at our institution over a 3-year period (1992-1995). Patients with focal findings at physical examination, prior brain surgery, head trauma, or immunocompromise were excluded. A model was developed to assess the cost associated with the MR test results, and actual average institutional costs of performing an examination applied. Correlative statistical analysis of referring specialties and positive tests was also performed. Three hundred twenty-eight patients who met the above criteria were retained in the sample. One hundred sixty-three patients (50%) had negative MR test results. Of the 50% of patients with positive studies, only 5 (1.5%) had clinically significant MR results. The average cost of an MR examination was 517 dollars (1998 dollars). The cost per clinically significant managed case detected was 34,535 dollars. No statistically significant difference was found among referring specialties and clinically significant MR results. Our results indicate that MRI of nonfocal headache yields a low percentage of positive clinically significant results and has limited cost-effectiveness. Referring specialty had no significant bearing on these outcomes, regardless of specialist experience.
journal_name
J Natl Med Assocjournal_title
Journal of the National Medical Associationauthors
Jordan JE,Ramirez GF,Bradley WG,Chen DY,Lightfoote JB,Song Akeywords:
subject
Has Abstractpub_date
2000-12-01 00:00:00pages
573-8issue
12eissn
0027-9684issn
1943-4693journal_volume
92pub_type
杂志文章abstract：OBJECTIVE:To examine factors within the patient-provider relationship that influence which role African American men aged 40-70 years prefer when making health care decisions. METHODS:We recruited 40 African American men from barbershops in the Richmond, Virginia, metropolitan area to participate in semistructured int...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/s0027-9684(15)30176-0
更新日期：2012-07-01 00:00:00
abstract：:While the author recognizes the positive impact community psychiatry has had on postpsychotic patients by the uses of medical management and environmental manipulation, he demonstrates that there is a deficiency in the treatment of lower socioeconomic patients with neurotic illnesses. Specifically, neurotic patients t...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1979-04-01 00:00:00
abstract：:A case of sickle cell disease with 63 documented episodes of priapism that were managed medically is presented. The case is very unusual because of the fact that despite so many episodes of priapism, he did not lose sexual potency. On the contrary, over a period of time, his penis hypertrophied. To the best of our kno...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1993-06-01 00:00:00
abstract：:Attributes of age, tobacco use, and alcohol consumption were studied in order to elucidate their roles in the increased risks of blacks for selected neoplasms. Black cancer patients with and without liver cirrhosis were compared by cancer sites, age, tobacco usage, and alcohol consumption. Subsequently, non-cirrhotic ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1978-08-01 00:00:00
abstract：:The surgeon who is faced with the management of a neonate with a prenatally ruptured omphalocele or a gastroschisis has a challenging problem. These anomalles are some of the most serious, lifethreatening neonatal surgical emergencies. ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1982-07-01 00:00:00
abstract：:A comparative clinical trial of short-course and long-course ampicillin prophylaxis in cesarean section was completed at Ife University Teaching Hospitals Complex. The results demonstrate a decided advantage in using the short-course regimen in the various parameters measured. The study constitutes a significant advan...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1979-01-01 00:00:00
abstract：:The number of minority physician graduates depends upon both the recruitment and retention of physician manpower. Numbers cannot be increased until the problems of recruiting and retaining minority students are minimized. This paper describes the process by which one medical school initiated changes to overcome barrie...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1978-11-01 00:00:00
abstract：:Over 600 Howard University medical alumni of seven representative classes graduating from 1955 to 1975 were surveyed by questionnaire in 1975 and 1976. Replies of the 252 black respondents confirm that these graduates are providing substantial care to blacks, the economically disadvantaged, and residents of the inner ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1982-02-01 00:00:00
abstract：:The purpose of this survey of 528 black men in Miami and Fort Lauderdale, FL, was to assess prostate cancer knowledge among African-American, English-speaking Caribbean, Haitian-American, and African men in America. Knowledge levels were assessed by education, ethnicity, age, income, family history of prostate cancer,...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2004-05-01 00:00:00
abstract：ISSUES:Tobacco Control remains one of the greatest determinants for reducing the morbidity and mortality of African Americans. OBJECTIVE:To examine the scope and consequences of tobacco use among African Americans and characterize its implications for the National Medical Association physician membership and their pat...
journal_title：Journal of the National Medical Association
pub_type： 共识发展会议,杂志文章,评审
doi：
更新日期：2002-02-01 00:00:00
abstract：PURPOSE:This article highlights issues of misdiagnosis in an African-American, adult clinical population by doing point prevalence, record review study within a comprehensive community mental health center. METHOD:Psychiatric evaluations of 330 patients were reviewed and clinically identifiable variables of: a) childh...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/S0027-9684(15)30048-1
更新日期：2015-03-01 00:00:00
abstract：PURPOSE:The purpose of this study was to explore the experiences of medical students who are underrepresented in medicine (UIM) from two urban medical centers with an interest in pursuing academic pediatrics. METHODS:Focus groups were conducted at Children's National Hospital (CN) at three different times with UIM med...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/j.jnma.2020.07.014
更新日期：2020-08-05 00:00:00
abstract：BACKGROUND:Although several studies have outlined the need for and benefits of diversity in academia, the number of underrepresented minority (URM) faculty in academic health centers remains low, and minority faculty are primarily concentrated at the rank of assistant professor. In order to increase the diversity of th...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2006-09-01 00:00:00
abstract：:Chondroectodermal dysplasia is a rare autosomal recessive disorder characterized by short extremities, short stature, polydactyly, and nail hypoplasia. Dental abnormalities, congenital heart defects, and thoracic abnormalities impending respiration are seen in many patients. Virtually all previous reports of the class...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1980-06-01 00:00:00
abstract：BACKGROUND AND STUDY AIMS:Barrett's Esophagus (BE) is a well-recognized pre-malignant condition. Previous data indicate histologically confirmed BE frequency varies by ethnicity in the United States. However, clinical factor assessment to explain this has only occurred in a veteran population to date. The study aim was...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/j.jnma.2018.09.008
更新日期：2019-04-01 00:00:00
abstract：:Multiple Myeloma (MM) is a neoplastic disorder derived from the malignant proliferation of monoclonal plasma cells. It is characterized by the overproduction of immunoglobulins (Ig). We report a rare case in which bulbar palsy was the initial manifestation of IgG-MM. A 66-year-old woman initially presented with progre...
journal_title：Journal of the National Medical Association
pub_type：
doi：10.1016/j.jnma.2020.12.007
更新日期：2021-01-18 00:00:00
abstract：BACKGROUND:Hypertension is associated with left ventricular diastolic function abnormalities. There have been few studies evaluating left ventricular diastolic function in an African populace. MATERIALS AND METHODS:Ninety-eight hypertensives (52 females, 46 males) and 99 normal controls (49 females, 50 males) were rec...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2005-01-01 00:00:00
abstract：:We describe an unusual case of Wegener's granulomatosis, which initially caused fulminant palsies affecting cranial nerves II, V, VI, VII, and VIII during a brief episode of the disease. The patient was successfully treated with immunosuppressive therapy. Wegener's granulomatosis should be suspected when multiple cran...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章,评审
doi：
更新日期：2000-09-01 00:00:00
abstract：:In April 1986, magnetic resonance imaging (MRI) of the thorax and shoulder girdle was presented to the 99th Annual Meeting of the American Association of Anatomists. These images were the authors' first attempt to correlate the magnetic resonance display of the muscles and soft tissues of the chest in the coronal plan...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1989-06-01 00:00:00
abstract：:Delirium is a transient global disorder of cognition. Almost any medical illness or medication can cause delirium. Here, we report a 71-year-old male who presented to the emergency department with a sudden change in mental status, which later resolved. An electrocardiogram was consistent with acute myocardial infarcti...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2006-04-01 00:00:00
abstract：:Transitional cloacogenic carcinoma of the anus is one of the rarest tumors of the alimentary tract. It represents less than two percent of all anorectal cancers. Three cases are presented from the surgical files of George W. Hubbard Hospital, Meharry Medical College, which were collected during a period of 15 years. ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1979-05-01 00:00:00
abstract：:Testing of 722 black hospital patients in Baltimore for the Duffy antigens found in whites demonstrated that 36.28 percent of the patients possessed these blood proteins. This group is the largest cluster of black individuals so examined in the United States. The results may provide a genetic benchmark for the Baltimo...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1984-04-01 00:00:00
abstract：:This study explores the effects of abuse on the risk-taking behaviors of 2973 black and white adolescent males, 412 of whom were sexually or physically abused. Surveys on mental and physical health, risk-taking behaviors and attitudes, and family living were administered to 9th and 12th graders in an urban midwestern ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1993-08-01 00:00:00
abstract：:Painful palmar and plantar erythema is an uncommon systemic complication of chemotherapy and has been reported in association with methotrexate, cystosine arabinoside, doxorubicin, and 5-fluorouracil. The authors report a case in which the syndrome was precipitated by hepatic artery infusion of 5-FUdR. The previous re...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1987-06-01 00:00:00
abstract：:Primary lymphoma of the central nervous system (CNS) is difficult to diagnose because of the difficulty in differentiating it from multiple sclerosis, sarcoidosis, metastatic disease, chronic granulomatous disease, and cerebral cysticercosis. With the patient presented in this report, no abnormalities were found after...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1987-02-01 00:00:00
abstract：:An account of primary malignant bone tumors in Africans is presented in this series. The study analyzes 170 Nigerians with bone neoplasms diagnosed over the 17-year period 1960-1976. It accounted for 1.28 percent of tumors registered in the Cancer Registry of the University College Hospital, Ibadan. There were 119 mal...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1982-01-01 00:00:00
abstract：BACKGROUND:Dental caries is a big public health problem which is prevalent in the highest degree worldwide, especially in lower socioeconomic levels. This study aims to investigate the anti-caries effects of Curcumin in Turmeric on the caries model of enamel under laboratory conditions. METHODS:In order to make a reli...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：10.1016/j.jnma.2017.12.005
更新日期：2018-10-01 00:00:00
abstract：:A retrospective review was conducted to determine if there were identifiable racial markers in patients who were explored and misdiagnosed as having appendicitis. Between May 1983 and May 1987, 100 patients were explored for appendicitis. There were 65 whites and 35 blacks with a male predominance in each group. The a...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1989-03-01 00:00:00
abstract：OBJECTIVE:While African-American women tend to have greater bone mineral density (BMD) than caucasian women, they are still at risk of developing osteoporosis later in life. Clinical decision rules (i.e., algorithms) have been developed to assist clinicians identify women at greatest risk of low BMD. However, such tool...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：2004-03-01 00:00:00
abstract：:Even though Lyme disease probably existed in Oklahoma prior to 1975 when the disease was first reported in Connecticut and even though ecological conditions favor a high prevalence, an unexpectedly low rate was evidenced in both a serological survey and the number of cases reported to the Oklahoma State Department of ...
journal_title：Journal of the National Medical Association
pub_type： 杂志文章
doi：
更新日期：1992-09-01 00:00:00
