tbuckley/cabot-search huggingface dataset:
Staffordshire CCGs to outsource cancer services as private sector expands in NHS
Authors: I. Torjesen
Journal: BMJ (2014)

Cancer care and treatment services across Staffordshire are being put out to tender in what is believed to be the biggest outsourcing deal in NHS history.

Four of Staffordshire’s clinical commissioning groups (Stafford and Surrounds, Cannock Chase, North Staffordshire, and Stoke-on-Trent) have come together to tender contracts for cancer care and end of life services across the county, jointly worth £1.22bn (€1.5bn; $2.1bn). The commissioning groups are working with the charity Macmillan Cancer Support on the initiative.

This week the health policy think tank the Nuffield Trust released a briefing showing how the private sector’s slice of NHS services was growing.1 The analysis, extracted from In the Red , the trust’s comprehensive analysis of the finances of the NHS since 2010 (due to be published on 10 July), shows that spending on independent sector provision of community and mental health services was still rising but that growth in provision of hospital services by the private sector had stalled.

The briefing examined primary care trusts’ spending from 2010-11 to 2012-13. It showed that the proportion of community services provided by …
Counterpulsation for Intraoperative Cardiogenic Shock
Authors: Leland B. Housman
Journal: JAMA (1973)

Intra-aortic balloon counterpulsation has been used successfully in the treatment of cardiogenic shock following cessation of cardiopulmonary bypass in four patients, three of whom had an aortocoronary bypass and one, an aortic valve replacement. In each patient, systolic blood pressure could not be maintained above 60 mm Hg after an extensive trial of vasopressor therapy. The balloon catheter was inserted through a graft sewn onto the femoral artery and the effect of heparin sodium was reversed with protamine sulfate; no further anticoagulation was carried out. The hemodynamic status improved immediately in all four patients and counterpulsation was discontinued in two to five days. All four patients survived and were discharged from the hospital.
A New Disease?—Perhaps Dengue.
Authors: B. K. CORLEY
Journal: JAMA (1907)

Anino, Durango, Mex., Oct. 17, 1907. <h3>To the Editor:</h3> —Permit me to reply to Dr. W. E. Clark of Frederick, S. D., page 1295,The JournalA. M. A., October 12: Although I have never heard of the disease occurring so far north, the doctor describes dengue or breakbone fever (see Flint's "Practice" under eruptive fevers). While the disease was first supposed to be an infectious eruptive fever, the eruption is by no means pathognomonic, and in my opinion is wanting in a large percentage of cases. There is at present an epidemic of dengue in parts of Mexico and Texas.
Anesthesia Technique and Outcomes After Hip Fracture Surgery
Authors: Derek Dillane, James Green
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
Shock news for the gut
Authors: T D WARNER, S A McCARTNEY
Journal: Gut (1998)

See article on page 696 

In a variety of pathological states, notably ischaemia–reperfusion injury, organ infarction, and shock, there are substantial increases in the normally low circulating concentrations of endothelin-1 (ET-1).1 2 This is more than just a symptom. ET-1 seems to be an active participant in these disorders as antibodies directed against ET-1 and endothelin receptor antagonists are protective.1 2 Interestingly, although studies in isolated cells suggest that the production of ET-1 can only be up-regulated over the course of hours, increases in vivo can be recorded within much shorter periods. For example, intravenous injection of a high dose of endotoxin to anaesthetised rats causes within 5–10 minutes both a dramatic fall in blood pressure and a notable increase in haematocrit. Both of these effects are greatly reduced by treatment with endothelin …
150-kD von Willebrand factor binding protein extracted from human vascular subendothelium is type VI collagen.
Authors: J H Rand, N D Patel, E Schwartz, S L Zhou, B J Potter
Journal: Journal of Clinical Investigation (1991)

We have previously shown that von Willebrand factor (vWF), a glycoprotein which plays a critical role in the adhesion of platelets to injured blood vessels, is present within vascular subendothelium. We investigated the identity of the subendothelial binding site(s) for vWF by examining vWF binding to subendothelial constituents and solubilized a 150-kD protein with SDS-urea that bound vWF. This protein had an amino-acid composition similar to that of the type VI collagen alpha-1/alpha-2 chains, was recognized by specific polyclonal antibodies against type VI collagen, and had a similar acidic isoelectric point. Furthermore, we found that purified type VI collagen also bound vWF. Thus, we have identified the extracted 150-kD protein as type VI collagen. This protein may play a significant role in the binding of vWF to vascular subendothelium in vivo.
Reduction of the nosocomial meticillin-resistant Staphylococcus aureus incidence density by a region-wide search and follow-strategy in forty German hospitals of the EUREGIO, 2009 to 2011
Authors: A Jurke, R Köck, K Becker, S Thole, R Hendrix, J Rossen, I Daniels-Haardt, A W Friedrich
Journal: Eurosurveillance (2013)

Meticillin-resistant Staphylococcus aureus (MRSA) disseminates between hospitals serving one patient catchment area. Successful prevention and control requires concerted efforts and regional surveillance. Forty hospitals located in the German EUREGIO have established a network for combating MRSA. In 2007 they agreed upon a synchronised strategy for screening of risk patients and a standard for transmission-based precautions (search and follow). The same year, the hospitals started synchronised MRSA prevention and annually reporting MRSA-data to the public health authorities. The median rate of screening cultures per 100 patients admitted increased from 4.38 in 2007 to 34.4 in 2011 (p&lt;0.0001). Between 2007 and 2011, the overall incidence density of MRSA (0.87 MRSA cases/1,000 patient days vs 1.54; p&lt;0.0001) increased significantly. In contrast, both the incidence density of nosocomial MRSA cases (0.13 nosocomial MRSA cases/1,000 patient days in 2009 vs 0.08 in 2011; p=0.0084) and the MRSA-days-associated nosocomial MRSA rate (5.51 nosocomial MRSA cases/1,000 MRSA days in 2009 vs 3.80 in 2011; p=0.0437) decreased significantly after the second year of the project. We documented adherence to the regional screening strategy resulting in improved detection of MRSA carriers at admission. Subsequently, after two years the nosocomial MRSA-incidence density was reduced. Regional surveillance data, annually provided as benchmarking to the regional hospitals and public health authorities, indicated successful prevention.
Nurse–Patient Ratios as a Patient Safety Strategy
Authors: Paul G. Shekelle
Journal: Annals of Internal Medicine (2013)

A small percentage of patients die during hospitalization or shortly thereafter, and it is widely believed that more or better nursing care could prevent some of these deaths. The author systematically reviewed the evidence about nurse staffing ratios and in-hospital death through September 2012. From 550 titles, 87 articles were reviewed and 15 new studies that augmented the 2 existing reviews were selected. The strongest evidence supporting a causal relationship between higher nurse staffing levels and decreased inpatient mortality comes from a longitudinal study in a single hospital that carefully accounted for nurse staffing and patient comorbid conditions and a meta-analysis that found a "dose–response relationship" in observational studies of nurse staffing and death. No studies reported any serious harms associated with an increase in nurse staffing. Limiting any stronger conclusions is the lack of an evaluation of an intervention to increase nurse staffing ratios. The formal costs of increasing the nurse–patient ratio cannot be calculated because there has been no evaluation of an intentional change in nurse staffing to improve patient outcomes.
Quantitation of Valvular Regurgitation from Multiple Indicator-Dilution Curves
Authors: RAMON L. LANGE, HANS H. HECHT
Journal: Circulation (1958)

Dye-dilution curves obtained simultaneously from the pulmonary artery and from the femoral artery following an intravenous injection of T 1824 or Indocyanine Green in normal subjects and in patients with nonregurgitant heart disease yielded a similar contour. This suggested that in the absence of regurgitation the parameters of the distal (arterial) curve can be predicted from the proximal (pulmonary artery) curve. The distortion of the arterial curve by regurgitation can therefore be compared with the undistorted pulmonary artery curve. To the extent that 2 identifiable and measurable flow rates exist between the sites of sampling, a theoretical basis for quantitation of the degree of valvular regurgitation may be derived.
Medical Models for Understanding Alcoholism
Authors: Frederick Lemere
Journal: JAMA (1973)

To the Editor.—  The increasing trend to treat alcoholism as a disease, rather than a crime, is obligating physicians to deal directly with this major health problem. Many physicians, however, find it difficult to accept the concept of alcoholism as a disease. This is especially true in the context of their daily practice.  Alcoholism, however, has many similarities to other medical conditions and, if viewed from the standpoint of these, can be more readily understood. Diabetes, for example, like alcoholism, has a definite tendency to run in certain families. A wide range of damage to various organs and bodily systems occurs in both diseases. Polyneuritis and neurogenic impotency, for example, is common to both diseases. Especially analogous is the primary intolerance to sugar on the one hand and to alcohol on the other hand. Whereas these intolerances are medically understandable, the temptation to eat sugar or drink alcohol, when one
Estimation of the Fractional Catabolic Rate Constants for the Elimination of Cytosolic Liver Enzymes From Plasma
Authors: Henny G. Peltenburg, Wim T. Hermens, George M. Willems, Guus J. Flendrig, Ellen Schmidt
Journal: Hepatology (1989)

Pathological elevations of the plasma activities of liver enzymes are not simply related to the quantitative release of such enzymes from the liver. Several enzymatic indices, such as the well–known de Ritis quotient, may be determined by differences in the time course of hepatic enzyme release, rather than reflecting true differences in the released quantities of various enzymes. A more quantitative use of enzymatic data is hampered by the fact that the fractional catabolic rate constants for the elimination of enzyme activities from plasma are unknown. In the present study, three of these constants are estimated by comparison of the time–activity curves in plasma with the corresponding curve of a simultaneously released, more slowly eliminated reference enzyme. This method can be applied in patients with an acute short period of hepatic enzyme release. Values obtained for the cytosolic isoforms of lactate dehydrogenase, AST and ALT are: fractional catabolic rate constant (lactate dehydrogenase isoenzyme 5) = 0.13 ± 0.01 hr -1 , fractional catabolic rate constant (cytosolic AST) = 0.088 ± 0.016 hr -1 and fractional catabolic rate constant (cytosolic ALT) = 0.034 ± 0.004 hr -1 (mean ± S.E., n = 10). These values are much higher than the apparent disappearance rate constants, because of extravascular return of activity and tailing release of enzymes during the major part of the elimination phase. It is shown that these results are consistent with earlier published data on the disappearance rates from plasma of lactate dehydrogenase, AST and ALT after acute liver injury. Cumulative release of various cytosolic enzymes occurred in proportion to the corresponding activities in human control livers.
Influence of cholesterol on survival after stroke: retrospective study
Authors: A. G Dyker, C. J Weir, K. R Lees
Journal: BMJ (1997)

To investigate the association between serum cholesterol concentration and cerebrovascular disease.Retrospective study.Acute stroke unit of inner city general hospital.977 patients with acute stroke.Serum total cholesterol concentration, type of stroke investigated by computed tomography or magnetic resonance imaging, three month outcome (good (alive at home) or bad (dead or in care)), long term mortality.After adjustment for known prognostic factors, higher serum cholesterol concentrations were associated with reduced long term mortality after stroke (relative hazard 0.91 (95% confidence interval 0.84 to 0.98) per mmol/l increase in cholesterol) independently of stroke type, vascular territory and extent, age, and hyperglycaemia. Three month outcome was also influenced independently by serum cholesterol (P = 0.024).Our data suggest an association between poor stroke outcome and lower serum cholesterol concentration. Until a prospective controlled study has confirmed the benefits of lowering cholesterol concentration in elderly subjects, the application of cholesterol lowering guidelines cannot be justified as secondary prevention of acute stroke.
Multiple potential mechanisms of graft action is not a new idea
Authors: Stephen B. Dunnett
Journal: Behavioral and Brain Sciences (1995)

Abstract It is well established that neural grafts can exert functional effects on the host animal by a multiplicity of different mechanisms – by diffuse release of trophic molecules, neurohormones, and deficient neurotransmitters, as well as by growth and reformation of neural circuits. Our challenge is to understand how these different mechanisms complement each other.
India tops world table for number of babies who die on day of birth
Authors: S. Bhaumik
Journal: BMJ (2013)

More babies die in India on the day that they are born than in any other country in the world, says the 14th annual State of the World’s Mothers report from the charity Save the Children.1

The report found that 29% of babies who died on the day of their birth were born in India and that the next highest numbers were in Nigeria, Pakistan, and China.

The annual report assesses the health status of women and newborns and children’s life chances in 176 countries by looking at five indicators: lifetime risk of maternal death, death rate in the under 5s, expected years of formal schooling, gross national income per capita, and participation of …
Arousing the LTP and learning debate
Authors: Stephen Maren
Journal: Behavioral and Brain Sciences (1997)

Shors &amp; Matzel provide compelling arguments against a role for hippocampal long-term potentiation (LTP) in mammalian learning and memory. As an alternative, they suggest that LTP is an arousal mechanism. I will argue that this view is not a satisfactory alternative to current conceptions of LTP function.
Beth Levine receives the 2014 ASCI/Stanley J. Korsmeyer Award
Authors: Sarah Jackson
Journal: Journal of Clinical Investigation (2014)

Autophagy is an evolutionarily conserved process that degrades large cellular components and plays a critical role in maintaining cellular homeostasis. This year, the ASCI recognizes seminal work in the field by Beth Levine (Figure ​(Figure1)1) of the University of Texas Southwestern Medical Center with its annual Stanley J. Korsmeyer Award. The prize honors Levine for her groundbreaking studies that first elucidated the genetic control of autophagy in mammalian systems and subsequent work that has implicated the autophagy pathway in the pathogenesis of a wide spectrum of diseases, including cancer, aging, neurodegeneration, infectious diseases, and diabetes. Levine recently talked with the JCI to discuss her extraordinary path in research.
Suicide in Male and Female Physicians
Authors: Robert C. Steppacher
Journal: JAMA (1974)

The frequency of suicide among physicians in the United States over the 5 1/2-year period March 1965 to August 1970 was studied. Suicides and possible suicides were identified through the obituary listings in<i>JAMA</i>. Confirmation of suicide was attempted for equivocal cases where possible. Within this time period, 530 deaths by suicide were identified, 489 in men and 41 in women. Analysis indicated that the rate in male physicians was approximately 1.15 times that of the overall male population, whereas for female physicians the rate was fully three times that expected on the basis of population values. For physicians 45 years of age and over, suicide rates were somewhat higher for men. Below that age, there was a marked excess among the women. Twelve of the 41 women were in training. The findings are consistent with reports of high rates of suicide among females in other professions. (<i>JAMA</i>228:323-328, 1974)
OC-063 Pharyngeal Electrical Stimulation (pes) In Dysphagia Post-acute Stroke: A Double-blind, Randomised Trial
Authors: DH Vasant, E Michou, P Tyrrell, V Jayasekeran, S Mistry, N O’Leary, A Vail, S Anwar, E Gamble, S Hamdy
Journal: Gut (2014)

<h3>Introduction</h3> Pharyngeal Electrical Stimulation (PES) is known to activate pharyngeal motor pathways. It has shown promise in acute stroke pilot studies, having improved swallowing function at 2-weeks.<sup>1,2</sup> <h3>Methods</h3> We aimed to recruit 100 hospitalised patients with new-onset dysphagia within 6 weeks of stroke at three Greater Manchester centres. Participants were randomised to either Active or Sham PES. Both interventions were delivered via an intraluminal pharyngeal catheter, left <i>in situ</i> for 10 min, once-daily for 3 days. Active intervention was delivered at optimal parameters (5Hz, at 75% maximum-tolerated intensity). The primary outcome measure was intended to be penetration-aspiration scores on videofluoroscopic assessment at 2-weeks. Owing to logistic difficulties with videofluoroscopy, prior to unblinding and analysis of data, we upgraded the dichotomised Dysphagia Severity Rating (DSR) scale,<sup>2</sup> assessed by independent, blinded speech therapists, to be the primary outcome: mild/no dysphagia (scores 0–3) or moderate-severe dysphagia (scores 4–12). We analysed under the intention to treat principle using logistic regression with an odds ratio (OR)/ Hazards ratio (HR) &gt;1 indicating a favourable outcome for the active group. <h3>Results</h3> We recruited 36 participants: median age 71y; 61% male, 92% moderate-severe dysphagia; 58% with enteral feeding tubes in-situ. At 2-weeks, 11/18 (61%) in the active group had DSR &lt;4 compared with 9/18 (50%) in the sham group: OR (95% CI) = 2.53 (0.52 to 14.56). Patients in the active group also had shorter times to hospital discharge (39 vs. 52 days, HR (95% CI) of 1.19 (0.55, 2.57)) and removal of nasogastric feeding tubes (8 vs.14 days, HR (95% CI) of 2.01 (0.51, 7.93)). By 3 months, all but 3 patients in each group had DSR &lt;4: OR (95% CI) = 1.0 (0.13 to 7.02). <h3>Conclusion</h3> The observed differences are consistent with the hypothesised effect of PES in accelerating recovery of swallowing over the first 2-weeks following treatment. Lower than desired recruitment prevents definitive answers from this study but study design experience and outcome data reported here are essential to inform a definitive, multi-centre randomised trial. <h3>References</h3> 1 Fraser, <i>et al</i>. 2002 2 Jayasekeran, <i>et al</i>. 2010 <h3>Disclosure of Interest</h3> None Declared.
Radon may account for one in 20 cases of lung cancer
Authors: J. Wise
Journal: BMJ (1998)

For the first time, researchers have found direct evidence that the occurrence of radon in people's homes may account for one in 20 cases of lung cancer in the UK.

Radon is a radioactive gas that occurs naturally in the earth's crust as part of the decay chain of uranium-238. It percolates through the earth's surface, and although concentrations of radon remain low in outdoor air, they can build up inside houses. The whole of Devon and Cornwall, and parts of Somerset, Derbyshire, and Northamptonshire are the worst affected areas of the UK. It has been known for some time that high …
Thiopurine methyltransferase levels should be measured before commening patients on azathioprine
Authors: A.P. Jackson, A.G. Hall, J. McLelland
Journal: British Journal of Dermatology (1997)

Journal Article Thiopurine methyltransferase levels should be measured before commening patients on azathioprine Get access A.P. Jackson, A.P. Jackson Department of Dermatology. Royal Victoria Infirmary. Queen Victoria Road. Newcastle upon Tyne. U.K. Search for other works by this author on: Oxford Academic Google Scholar A.G. Hall, A.G. Hall Cancer Research Unit. The Medical School. University of Newcastle. Newcastle upon Tyne, U.K. Search for other works by this author on: Oxford Academic Google Scholar J. McLelland J. McLelland Department of Dermatology. Royal Victoria Infirmary. Queen Victoria Road. Newcastle upon Tyne. U.K. Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 136, Issue 1, 1 January 1997, Pages 133–134, https://doi.org/10.1111/j.1365-2133.1997.tb08765.x Published: 01 January 1997
Diminished agonist-stimulated inositol trisphosphate generation blocks stimulus-secretion coupling in mouse pancreatic acini during diet-induced experimental pancreatitis.
Authors: R E Powers, A K Saluja, M J Houlihan, M L Steer
Journal: Journal of Clinical Investigation (1986)

Young female mice fed a choline-deficient, ethionine-supplemented (CDE) diet rapidly develop acute hemorrhagic pancreatitis. We have observed that pancreatic acini prepared from these mice are unable to secrete amylase in response to addition of the cholinergic agonist carbachol, although they retain the ability to secrete amylase in response to the Ca2+ ionophore A23187. The CDE diet does not alter the binding characteristics (Kd or the maximal number of binding sites) for muscarinic cholinergic receptors as tested using the antagonist [3H]N-methylscopolamine nor the competition for this binding by carbachol. Addition of carbachol to acini prepared from mice fed the CDE diet does not result in as marked an increase in cytosolic free Ca2+ levels as that noted in control samples (evaluated using quin2 fluorescence). These observations indicate that the CDE diet interferes with stimulus-secretion coupling in mouse pancreatic acini at a step subsequent to hormone-receptor binding and prior to Ca2+ release. This conclusion is confirmed by our finding that the hormone-stimulated generation of [3H]inositol phosphates (inositol trisphosphate, inositol bisphosphate, and inositol monophosphate) from acini labeled with [3H]myoinositol is markedly reduced in acini prepared from mice fed the CDE diet. This reduction is not due to a decrease in phosphatidylinositol-4,5-bisphosphate. This communication represents the first report of a system in which a blockade of inositol phosphate generation can be related to a physiologic defect and pathologic lesion.