tbuckley/cabot-search huggingface dataset:
Outsourcing favours private companies and is unsustainable, says report
Authors: Z. Kmietowicz
Journal: BMJ (2012)

Social enterprises and charities are being squeezed out of the market to provide public services by a small number of private companies that dominate the sector and have “become too big and too complex to fail,” says a new report.1

The situation has serious consequences for Britain’s economy and communities, says the report from Social Enterprise UK.

The report says that changes such as the Health and Social Care Act have led to an acceleration of outsourcing of public services. Currently a quarter of the total spend on public services in the United Kingdom is outsourced, worth £82bn (€101bn; $132bn). But this is predicted to rise to £140bn by 2014. Since the act was passed the estimated value of NHS contracts is £20bn, says the report. One company, …
POLYSACCHARIDE IN DELAYED HYPERSENSITIVITY
Authors: Robert J. Gerety, Rodolfo W. Ferraresi, Sidney Raffel
Journal: The Journal of Experimental Medicine (1970)

A highly purified pneumococcal polysaccharide (Type II SSS) is a very efficient inducer of delayed hypersensitivity in random-bred guinea pigs. The cellular reactivity induced by this polysaccharide administered subcutaneously in complete Freund's adjuvant is of "tuberculin type"; it increases in intensity with time after the sensitizing injection, as judged by skin tests, the macrophage inhibition reaction and transfer of reactivity by peritoneal exudate cells. By contrast, the cellular reactivity induced by this immunogen in the absence of mycobacterial adjuvant has the characteristics of "Jones-Mote" reactivity. It is best seen at about 1 wk after sensitization; the reactions are characteristically little indurated and show histologic differences from tuberculin type responses; and the reactive state begins to disappear by 2–3 wk, with the accession of Arthus reactivity. This type of delayed reactivity may be related to an early phase of antibody synthesis.
First Experience DaTSCAN Imaging Using Cadmium-Zinc-Telluride Gamma Camera SPECT
Authors: Karim Farid, Mathieu Queneau, Mohamed Guernou, David Lussato, Xavier Poullias, Slavomir Petras, Nadine Caillat-Vigneron, Bernard Songy
Journal: Clinical Nuclear Medicine (2012)

We report our first experience of brain DaTSCAN SPECT imaging using cadmium-zinc-telluride gamma camera (CZT-GC) in 2 cases: a 64-year-old patient suffering from essential tremor and a 73-year-old patient presenting with atypical bilateral extrapyramidal syndrome. In both cases, 2 different acquisitions were performed and compared, using a double-head Anger-GC, followed immediately by a second acquisition on CZT-GC. There were no significant visual differences between images generated by different GC. Our first result suggests that DaTSCAN SPECT is feasible on CZT-GC, allowing both injected dose and acquisition time reductions without compromising image quality. This experience needs to be evaluated in larger series.
Corticosteroid‐responsive pure red cell aplasia in chronic lymphatic leukemia
Authors: P. Vashi, B. Patel, P. Musson, J. Fahrner, R. Rosenbaum
Journal: American Journal of Hematology (1987)

Abstract Acquired pure red cell aplasia characterized by selective failure of erythropoiesis was seen in a 37‐yr‐old female patient with a diagnosis of chronic lymphatic leukemia (CLL). Though different immunosuppressive therapies have been tried in the past with variable response, there has been no case report of such favorable response to corticosteroids alone. We report this rare and unusual case of PRCA associated with CLL who responded to steroid therapy.
US hospital incident reporting systems do not capture most adverse events
Authors: B. Roehr
Journal: BMJ (2012)

US hospitals are capturing and reporting only 14% of adverse events experienced by patients covered by the Medicare government health insurance programme, an analysis has found.

The report, by the inspector general of the Department of Health and Human Services, laid most of the blame on uncertainty as to what should be reported. It recommends a series of actions to educate healthcare providers, administrators, and agencies that evaluate their operations.

The analysis was based upon a random sample of 780 patients from the nearly one million Medicare beneficiaries discharged from acute care hospitals in October 2008. It involved a detailed …
Preconception genetic testing should be more widely available, says UK commission
Authors: S. Mayor
Journal: BMJ (2011)

Preconception genetic testing for mutations that can cause genetic conditions should be made available in screening programmes to people who may benefit, the UK government’s advisory body on human genetics recommended in a report published on 6 April.

The Human Genetics Commission initiated the report in response to a request from the UK National Screening Committee for guidance on the social, ethical, and legal implications of making preconception genetic screening available across a whole population.

The two groups set up a collaborative expert working group, including representatives from the NHS sickle cell and thalassaemia screening programme and the PHG Foundation (Foundation for Genomics and Population Health), to review the issue.

“Having considered the issues associated with preconception genetic testing, in …
A 42-Year-Old Man With Hypertension, 1 Year Later
Authors: Thomas L. Delbanco
Journal: JAMA (1998)

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
Non Alcoholic Steatohepatitis is Associated with Subclinical Impairment in Left Ventricular Function Measured by Speckle Tracking Echocardiography
Authors: Ahmet Oğuz Baktır, Bahadir Sarli, Emre Refik Altekin, Huseyin Arinc, Hayrettin Saglam, Yasemin Dogan
Journal: Journal of the American College of Cardiology (2013)
Hemorrhagic cystitis after allogeneic hematopoietic stem cell transplantation: donor type matters
Authors: Maha El-Zimaity, Rima Saliba, Kawah Chan, Munir Shahjahan, Antonio Carrasco, Ola Khorshid, Humberto Caldera, Daniel Couriel, Sergio Giralt, Issa Khouri, Cindy Ippoliti, Richard Champlin, Marcos de Lima
Journal: Blood (2004)
A Placebo-Controlled Evaluation of Adjunctive Modafinil in the Treatment of Bipolar Depression
Authors: Mark A. Frye, Heinz Grunze, Trisha Suppes, Susan L. McElroy, Paul E. Keck, Jorge Walden, Gabriele S. Leverich, Lori L. Altshuler, Shoshanna Nakelsky, Sun Hwang, Jim Mintz, Robert M. Post
Journal: American Journal of Psychiatry (2007)

Objective: Modafinil is approved by the U.S. Food and Drug Administration for improving wakefulness in patients with excessive sleepiness associated with narcolepsy, obstructive sleep apnea, and shift-work sleep disorder. This study was conducted to evaluate the efficacy and safety of adjunctive modafinil in bipolar depression, which is often characterized by excessive sleepiness and fatigue. Method: Eighty-five patients with bipolar depression that was inadequately responsive to a mood stabilizer with or without concomitant antidepressant therapy were randomly assigned to receive adjunctive modafinil (N=41) or placebo (N=44) for 6 weeks. The primary outcome measure was baseline-to-endpoint change in score on the Inventory of Depressive Symptoms—Clinician Rated (IDS). Results: The baseline-to-endpoint change in IDS score was significantly greater in the modafinil group (mean dose, 177 mg/day) compared with the placebo group. Improvement in depressive symptoms was significantly greater in the modafinil group by week 2, and this greater improvement was maintained at weeks 4, 5, and 6. Both the response and remission rates were significantly higher in the modafinil group (44% and 39%) compared with the placebo group (23% and 18%). During the 6-week study period, there was no difference between groups in treatment-emergent hypomania or mania (six patients in the modafinil group and five in the placebo group) or hospitalization for mania (one in each group). Conclusions: These data suggest that adjunctive modafinil at doses of 100–200 mg a day may improve depressive symptoms in patients with bipolar disorder.
Senators call for action on obesity as study quantifies link to heart failure
Authors: J. H. Tanne
Journal: BMJ (2002)

A large US study has quantified the greatly increased risk of heart failure caused by obesity and overweight.

Nearly two thirds (61%) of adults and 13% of children in the United States are overweight or obese, according to the report, and its authors and three senators have called for programmes to promote optimal body weight.

Nearly five million Americans a year have heart failure. Previous studies showed that only extreme obesity, not lesser degrees of obesity and overweight, was a risk factor. The new study, published in the New England Journal of Medicine …
A novel model for training in ERCP with double-balloon enteroscopy after abdominal surgery
Authors: J. Maiss, H. Diebel, A. Naegel, B. Müller, J. Hochberger, E. Hahn, M. Raithel
Journal: Endoscopy (2007)

Since the first presentation of the compactEASIE in 1997, this training model has become established for nearly all interventional techniques in upper gastrointestinal endoscopy including ERCP. So far, training using double-balloon enteroscopy (DBE) for ERCP has not become established.This paper presents a special organ preparation for the compactEASIE model which for the first time allows simulation of ERCP in patients who have had prior abdominal surgery. Two abdominal organ packages from freshly slaughtered pigs were used to create a postsurgical anatomic situation.A life-like training model was established for ERCP training in a postsurgical anatomic situation. A Roux-en-Y anastomosis was created such that the papilla was located around 100 cm beyond the pylorus. The duodenum was closed shortly above the pig papilla at the level of the pylorus. The papilla was successfully reached by DBE after 40 minutes. The papilla was cannulated and regular contrasting of the biliary system using fluoroscopy was achieved. Sphincterotomy, stent placement and exchange, and needle-knife sphincterotomy over a 7-Fr stent were conducted successfully.Modified organ preparations allow the simulation of and training in ERCP in postsurgical anatomic situations in training models using animal parts.
The longest weekend
Authors: Nigel E Drury
Journal: BMJ (2004)

It was late February, and I was working at a busy seaport hospital that often accepts patients from docking ships. A man in his early 30s was one such arrival, admitted to the infectious diseases unit with suspected chickenpox. In basic English, he complained of a rash over his face, trunk, and thighs, with pain on swallowing preventing him from eating or drinking.

On examination, he was feverish with generalised lymphadenopathy and widespread crusting papulopustular lesions. He also had …
Injuries of the trachea and bronchi
Authors: S. Bertelsen, P. Howitz
Journal: Thorax (1972)

Traumatic rupture of the trachea or the bronchi is reported with increasing frequency. Such rupture may follow penetrating wounds, but the common cause is blunt trauma of the throat or thorax. When the proximal trachea is damaged other cervical structures are usually involved. By contrast the distal trachea or bronchi are not infrequently the only thoracic structures damaged. In particular there may be no rib fractures, or obvious fractures may be uncomplicated and insignificant. Thoracic rupture usually occurs in the vicinity of the carina. Central rupture generally presents with emphysema of the mediastinum and neck. Diagnosis can usually be confirmed by tracheobronchoscopy. Rupture of the peripheral bronchi generally presents with pneumothorax and atelectasis. Central rupture should be treated by primary suture. Lobectomy is often necessary when small bronchi are ruptured.
Robots in operating theatres
Authors: R A Buckingham, R O Buckingham
Journal: BMJ (1995)

Robots designed for surgery have three main advantages over humans.They have greater three dimensional spatial accuracy, are more reliable, and can achieve much greater precision.Although few surgical robots are yet in clinical trials one or two have advanced to the stage of seeking approval from the UK's Medical Devices Agency and the US Federal Drug Administration.Safety is a key concern.A robotic device can be designed in an intrinsically safe way by restricting its range of movement to an area where it can do no damage.Furthermore, safety can be increased by making it passive, guided at all times by a surgeon.Neverthe- less, some of the most promising developments may come from robots that are active (monitored rather than controlled by the surgeon) and not limited to intrinsically safe motion.Research into the use ofrobotic technology in operating theatres has reached a critical stage in the United Kingdom and around the world.Many systems that can be described as "robotic" are now working in laboratories, and some are undergoing trials in operat- ing theatres.Although the United States leads in this work, Europe is well placed since the litigious nature of American society makes full clinical use a risky venture.Robots designed for surgery have three main advantages over humans.Firstly, they have greater three dimensional spatial accuracy, especially when linked to scanning technology.Secondly, systems can be designed to be more reliable and produce more repeatable outcomes, and, finally, robots can achieve a precision at least an order of magnitude greater than that achievable by humans.This article explains some of the background to the development of surgical robotics and illustrates the current state of the technology by describing some of the leading developments from around the world.
THE NEUTRALIZATION OF ANTIPNEUMOCOCCUS IMMUNE BODIES BY INFECTED EXUDATES AND SERA
Authors: Rufus Cole
Journal: The Journal of Experimental Medicine (1917)

1. In empyema fluids resulting from infection with pneumococci there are present large amounts of soluble substances which have the property of neutralizing pneumococcus antibodies. 2. Similar substances are found in the blood of infected rabbits. 3. When immune serum is injected into infected rabbits the immune substances disappear very quickly, and therefore are prevented from activity in overcoming the infection. 4. When immune serum is administered to patients severely infected with pneumococci, the immune bodies may also disappear very rapidly, and this disappearance is probably associated with the presence of such soluble substances in the blood. 5. The serum only becomes effective when these substances are neutralized. 6. The study of agglutination curves is of value in showing why in certain instances favorable results have not followed the use of immune serum. 7. It is important that in severely injected patients the serum be administered early in the disease and that the initial dosage be large.
Treatment of aortoiliac occlusive or dilatative disease concomitant with kidney transplantation: how and when?
Authors: Matteo Tozzi, Marco Franchin, Gabriele Soldini, Giuseppe Ietto, Corrado Chiappa, Beatrice Molteni, Francesco Amico, Giulio Carcano, Renzo Dionigi
Journal: International Journal of Surgery (2013)
Prophylaxis of surgical wound sepsis: cardiac pacemakers.
Authors: N P Silverton
Journal: BMJ (1980)

The paper by Giacchino and his colleagues,7 on which your recommendations for manage- ment are so clearly based, was criticised in the subsequent discussion for its conclusions that colonoscopy should not be performed and it is surprising that you should perpetuate this erroneous conclusion.There is clearly much evidence to support a co-ordinated approach to the problem of massive bleeding from the large bowel, involving the gastroenterologist, endoscopist, radiologist, and surgeon in a joint and flexible approach to investigation and management rather than adherence to the more rigid flow chart suggested.
LUMBAR NEPHROPEXY WITHOUT SUTURING, WITH REPORT OF CASE.
Authors: EMANUEL J. SENN
Journal: JAMA (1899)

Since N. Senn devised and described this method of treatment for movable kidney a year ago, the operation has been performed frequently by different surgeons, and it will undoubtedly soon assume its proper place in operative surgery, that is, it will supplant an irrational technic. The old method of fixing a movable kidney in its normal location by passing sutures through the glandular structure of such a delicate, as well as vital organ as the kidney, should be emphatically condemned. Sutures which are tied sufficiently firm to suspend a kidney must, through subsequent cicatricial contraction, destroy a considerable amount of kidney tissue. If such sutures remained<i>in situ</i>, it would be far better than what actually takes place in the great majority of such cases, that is, cutting through of the sutures. This was well illustrated<i>in vivo</i>in a case upon which I recently did a nephrotomy. I passed
Effect of Digoxin on A-V Conduction
Authors: R. A. J. Spurrell, A. M. Harris, M. R. Howard
Journal: BMJ (1971)

The effect of digoxin on A-V conduction in 19 patients with known disease of their conduction tissue was studied while a demand pacing system was in position. Fifteen had transient complete heart block after myocardial infarction and four had chronic intermittent complete heart block. The patients were studied on return to sinus rhythm.In no instance was a return to either second- or third-degree heart block precipitated in these patients despite therapeutic levels and, in some cases, high serum level of digoxin for a period of seven days.The duration of complete heart block after myocardial infarction was 4.3 days in those taking digoxin while in heart block and 3.3 days in those who started digoxin only after return to sinus rhythm.
The Effect of Vitamin E Supplementation on Cardiovascular Risk in Diabetic Individuals With Different Haptoglobin Phenotypes
Authors: Andrew P. Levy, Hertzel C. Gerstein, Rachel Miller-Lotan, Robert Ratner, Matthew McQueen, Eva Lonn, Janice Pogue
Journal: Diabetes Care (2004)

Several clinical trials (1) have demonstrated that vitamin E does not reduce future major cardiovascular (CV) events. However, these trials could not rule out the potential benefit for high-risk subgroups. Diabetic individuals who are homozygous for the haptoglobin 2 allele (Hp 2-2) are at high risk for CV events (2–4); moreover, the Hp 2-2 protein product is an inferior antioxidant compared with …
Corneal Damage due to Eye Contact With Chlorhexidine Gluconate
Authors: Edward Tabor
Journal: JAMA (1989)

To the Editor.—  Use of chlorhexidine gluconate for preparing a patient's facial skin prior to surgical incision has resulted in irreversible corneal damage in at least four patients. Cases 1 and 2 were reported to the Food and Drug Administration; cases 3 and 4 were reported by Hamed et al. 1   Report of Cases.—  Case1.—A 60-year-old woman was treated with chlorhexidine gluconate on the face prior to transantral ethmoidectomy. Chlorhexidine gluconate got into her eyes, where it remained for one hour. She developed bilateral eye redness, pain, and diminished vision (20/200), due to severe corneal damage. A corneal transplant was performed two months later.  Case 2.—  A 45-year-old woman was treated with chlorhexidine gluconate for presurgical preparation of the face. The length of time the drug remained in the eyes is not known. Corneal injuries resulted in both eyes and remained present at three months' follow-up. Vision in one
Only a fifth of 1.7bn NHS underspend will be carried into next year's budget
Authors: N. Hawkes
Journal: BMJ (2012)

The NHS in England underspent its budget by £1.7bn (€2.1bn; $2.6bn) in 2011-12, and most of the money saved can’t be carried over to 2012-13 but must be returned to the Treasury. Only £0.3bn (18%) of the underspend was surrendered through “budget exchange,” the mechanism that allows money to be carried through to the next financial year.

The NHS underspend was the largest in cash terms across Whitehall departments, which collectively spent £5.3bn less than had been budgeted a year ago. A further £1.4bn was saved because the Treasury did not have to distribute funding held in reserve. As a result, while the budgets set a year ago envisaged a fall in public spending of 3.5% in real terms, the outcome was a fall of 5.2%.

The figures, published in Public Spending Statistics on 6 July,1 suggest that departments decided to anticipate the …
Multidrug Treatment of Type 2 Diabetes
Authors: Roberto Miccoli, Giuseppe Penno, Stefano Del Prato
Journal: Diabetes Care (2011)

Type 2 diabetes is a chronic and progressive condition associated with the risk of invalidating micro- and macrovascular complications. Hyperglycemia is the hallmark of the condition and, despite much discussion, glycemic control remains a main goal of treatment in the attempt to prevent chronic complications.

A beneficial effect of glycemic control was initially supported by the UK Diabetes Prospective Study showing that intensive treatment, compared with conventional therapy, resulted in an average HbA1c level of 7% and was associated with a 24% relative risk reduction of any diabetes-related end point and a 37% reduction in the risk of microvascular disease. Moreover, a nonsignificant 16% reduction ( P = 0.052) in the risk of acute myocardial infarction was reported (1). Similar results were confirmed in the Kumamoto study (2), whereas the results of more recent intervention trials remain questionable. In the Action in Diabetes and Vascular Disease: Preterax and Diamicron Modified Release Controlled Evaluation (ADVANCE) study (3), a lower mean HbA1c level was achieved in the intensive-control group than in the standard-control group (6.6 vs. 7.3%). Intensive control reduced the incidence of combined major macro- and microvascular events (hazard ratio [HR] 0.90; 95% CI 0.82–0.98; P = 0.01), as well as that of major microvascular events (HR 0.86; 0.77–0.97; P = 0.01). However, there was no significant effect of glucose control on major macrovascular events, death from cardiovascular causes, or death from any cause. In the Veteran Administration Diabetes Trial (VADT) (4), median HbA1c levels were 8.4% in the standard therapy group and 6.9% in the intensive therapy group. There was no significant difference between the two groups in the rate of cardiovascular events or in the rate of death from any cause (HR 1.07; 0.81–1.42; P = 0.62). No differences between the two groups were observed for microvascular …
Use of aldosterone receptor blockers in chronic heart failure before the results of RALES Study. Data from the Italian Network on Congestive Heart Failure (IN‐CHF)
Authors: P. Faggiano, G. Cacciatore, M. Gorini, G. Marangoni, A. Gualeni, F. Morandi, A.M. Paci, R. Sebastiani, A.P. Maggioni
Journal: European Journal of Heart Failure (2000)