tbuckley/cabot-search huggingface dataset:
Second hospital courts partnership deal with private sector company
Authors: I. Torjesen
Journal: BMJ (2012)

The George Eliot Hospital NHS Trust is on the hunt for a private or NHS partner to help secure its future as a provider of NHS services.

If a private sector organisation is chosen, the hospital will become only the second in England to be run by a private sector organisation. Hinchingbrooke Health Care NHS Trust in Huntingdonshire, which has debts of £40m (€48m; $63m), was the first ( BMJ 2011;343:d7341, doi:10.1136/bmj.d7341). It agreed in November last year to enter into a 10 year £7m contract with Circle from February 2012. After the announcement health minister Simon Burns insisted that Hinchingbrooke was a unique case. “This is not a blueprint or model to be used by other hospitals,” he said ( BMJ 2011;343:d7692, doi:10.1136/bmj.d7692).

The …
Definition of the Chronic Fatigue Syndrome
Authors: Dale A. Matthews
Journal: Annals of Internal Medicine (1988)

Letters and Corrections15 September 1988Definition of the Chronic Fatigue SyndromeDale A. Matthews, MD, Thomas J. Lane, MD, Peter Manu, MDDale A. Matthews, MDSearch for more papers by this author, Thomas J. Lane, MDSearch for more papers by this author, Peter Manu, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-109-6-511 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:We read with interest the recent consensus statement about the chronic fatigue syndrome (1). This important effort lends coherence and clarity to current discussion of this syndrome, and uniformity of case definition for future studies. However, the authors do not present quantitative evidence to support their decisions about the number and type of criteria needed for the case definition. For example, why are eight minor criteria necessary? Should physical criteria be weighted the same as symptoms? Such questions are best answered using data (which might be assembled from the previous work of the investigators on the consensus...References1. HolmesKaplanGantz GJN. Chronic fatigue syndrome: a working case definition. Ann Intern Med. 1988;108:387-9. LinkGoogle Scholar2. Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Washington: American Psychiatric Association: 1987. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: Dale A. Matthews, MD; Thomas J. Lane, MD; Peter Manu, MDAffiliations: University of Connecticut Health Center Farmington, CT. 06032 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMüdigkeit und Chronic-Fatigue-SyndromGesamtliteraturverzeichnisInfections, Vaccinations, and Chronic Fatigue SyndromeSymptom MüdigkeitExamining case definition criteria for chronic fatigue syndrome and myalgic encephalomyelitisThe adoption of chronic fatigue syndrome/myalgic encephalomyelitis case definitions to assess prevalence: a systematic reviewThe Common Immunogenic Etiology of Chronic Fatigue Syndrome: From Infections to Vaccines via Adjuvants to the ASIA SyndromeDefinitionen des „Chronic Fatigue Syndrome” (CFS)Development of the 1994 Chronic Fatigue Syndrome Case Definition and Clinical Evaluation GuidelinesThe Chronic Fatigue Syndrome 15 September 1988Volume 109, Issue 6Page: 511-512KeywordsChronic fatigue syndromeForecasting ePublished: 1 December 2008 Issue Published: 15 September 1988 PDF downloadLoading ...
The Last 100 Years of Sepsis
Authors: Jean-Louis Vincent, Edward Abraham
Journal: American Journal of Respiratory and Critical Care Medicine (2005)

Over the last 100 years, huge advances have been made in the field of sepsis in terms of pathophysiology, epidemiology, diagnosis, monitoring, and therapeutics. Here, we offer our perspective of the key changes and current situation in each of these areas. Despite these changes, mortality rates remain unacceptably high and continued progress, particularly in early diagnosis and therapy, is urgently needed.
Suicide Among Women Physicians
Authors: Katherine Finseth
Journal: JAMA (1977)

To the Editor.—  The authors of Preventing Physician Suicide (237:143-145) address a very real problem for the medical community. They allude only in passing, however, to the sex of the physician as a possible influence on likelihood of suicide and on presentation of barriers to suicide prevention.  It is fruitful to consider men and women physicians who commit suicide separately. The psychosocial dynamics of their problems may well differ; certainly, their personal characteristics do. Women physicians have a higher suicide rate than men physicians and a much higher rate when each group is compared with the general population (228:323, 1974).1In general, women physicians who commit suicide are younger than men physicians who commit suicide, thus resulting in a relatively greater loss of professional working years as well as total life years.  Family social dynamics are almost certain to differ for married men and women physicians. Female physicians who
Creating a new drug service in Edinburgh
Authors: A. A Fraser, C. Cahill
Journal: BMJ (1990)

phenomenon.' Thev refer, however, to onlyr one study, and although this studv showed an improvement in finger cutaneous blood flow, it showed no change in either the number or the severity of Raynaud's attacks.Subjective benefit has been claimed in other studies of captopril both in patients with primary Raynaud's phenomenon and in those with secondary disease, but these studies were either uncontrolled or confined to case reports.By contrast, the double blind placebo controlled studv of Madsen and Hvidt did not support these claims."Furthermore, our results of a double blind placebo controlled study of enalapril showed no evidence ofeither objective or subjective improvement during treatment for one month.rWe believe that at present there is insufficient evidence to support the use of angiotensin con- verting enzyme inhibitors in patients with Raynaud's phenomenon.Nevertheless, further controlled studies are required to determine whether there is a dose dependent response to these inhibitors and to resolve the disparity between the subjective and objective effects seen in some studies.
PROGNOSTIC IMPACT OF DISCORDANT VERSUS CONCORDANT LEFT BUNDLE BRANCH BLOCK IN HEART FAILURE PATIENTS UNDERGOING CARDIAC RESYNCHRONIZATION THERAPY
Authors: Michele Emdin, Alessandro Valleggi, Laura Perrotta, Giuseppe Mascia, Giuseppe Ricciardi, Paolo Pieragnoli, Giuseppe Vergaro, Claudio Passino, Giosuè Mascioli, Luigi Padeletti
Journal: Journal of the American College of Cardiology (2013)
Microalbuminuria, cardiovascular autonomic dysfunction, and insulin resistance in patients with type 2 diabetes mellitus
Authors: Naohiko Takahashi, Futoshi Anan, Mikiko Nakagawa, Kunio Yufu, Tatsuhiko Ooie, Tomoko Nawata, Sakuji Shigematsu, Masahide Hara, Tetsunori Saikawa, Hironobu Yoshimatsu
Journal: Metabolism (2004)
Poisoning by a Malathion-Xylene Mixture
Authors: Simon Gitelson
Journal: JAMA (1966)

DIAGNOSTIC difficulties may arise in cases of severe poisoning when the nature of the poison is unknown and the information available about the circumstances of the poisoning inadequate or even misleading. An illustrative case of malathion-xylene poisoning masquerading as chlordane-kerosene intoxication follows. <h3>Report of a Case</h3> An unconscious 17-year-old boy was brought to the hospital at midnight from a nearby settlement with an accompanying note from a physician stating that the boy had drunk an insecticide (a 2% solution of chlordane in kerosene [Flit]). On admission he was deeply comatose. Muscular rigidity and opisthotonos alternating with generalized clonic convulsions were seen at intervals. Some foamy secretion was present at the mouth, but there was no sweating or lacrimation, and no fasciculations were observed. Respiration was labored, and wheezing was heard over the chest. His gaze wandered, and the pupils were pinpoint. The pulse rate was 100 beats per minute, and
REMARKS ON THE TREATMENT OF SYPHILIS BY HYPODERMATIC INJECTIONS OF CORROSIVE SUBLIMATE.
Authors: JOHN V. SHOEMAKER
Journal: JAMA (1884)

Read in the International Medical Congress, Section on Syphilis, August, 1884. The hypodermatic injections of mercuric chloride for the treatment of syphilis have been received with great caution in the United States of America, notwithstanding that Dr. Lewin's book on the subject had been there translated and republished. I was one of the first to take up that treatment there, and reëncouraged by my success with it, read a paper on the subject before the meeting of the American Medical Association at St. Paul, Minn., in 1882. I analyzed there a number of cases treated in this manner by me at the Philadelphia hospital for skin diseases. I have since then practiced it freely and with even greater success than before. Syphiloderma of all descriptions were made to yield under this treatment and no disadvantages of any consequence were experienced in its course. While I have experimented with the various
SUPPURATION OF THE SHOULDER JOINT: REPORT OF TWO CASES
Authors: Benjamin S. Barnes
Journal: JAMA (1926)

The two cases of abscess of the shoulder joint here reported are of interest in that one case illustrates the results of neglecting to operate until destruction of joint structures has occurred, while the other shows the effects of comparatively early treatment. <h3>REPORT OF CASES</h3><h3>Case 1.</h3> —A boy, aged 16, seen, Jan. 18, 1924, had injured his right shoulder severely in a football game during October, 1923. A roentgen-ray examination at the time disclosed no fracture. The shoulder continued to be very painful, and during December, two months after the injury, a marked swelling of the part developed. This received no treatment except by a chiropractor, until I saw the patient four weeks later. Examination at this time showed a considerably emaciated boy, with a marked swelling of the right shoulder, especially prominent on the anterior aspect, giving a sensation of fluctuation. The leukocyte count was 7,500, and there
Fc epsilon receptor, a specific differentiation marker transiently expressed on mature B cells before isotype switching.
Authors: H Kikutani, M Suemura, H Owaki, H Nakamura, R Sato, K Yamasaki, E L Barsumian, R R Hardy, T Kishimoto
Journal: The Journal of Experimental Medicine (1986)

The expression of Fc epsilon R on human lymphocytes was studied with the anti-Fc epsilon R mAbs. Fc epsilon R was expressed on most mu+,delta+ circulating B cells, whereas T cells did not express Fc epsilon R even in patients with hyper-IgE syndrome. B cells with gamma, alpha, or epsilon phenotype did not express Fc epsilon R, moreover its expression could not be induced, suggesting that the Fc epsilon R expression was correlated with isotype switching. mu+delta+ B cells in bone marrow did not express Fc epsilon R, but PHA-sup (supernatant from PHA-stimulated cell cultures) could induce its expression, and the addition of IgE augmented this induction. Recombinant IL-2, IL-1, IFN-gamma or -beta, or purified B cell differentiation factor (BSF-2 B cell-stimulatory factor 2) could not induce Fc epsilon R expression in bone marrow B cells. IFN-gamma inhibited the Fc epsilon R expression induced by PHA-sup, suggesting that the human counterpart of BSF-1 may be responsible for Fc epsilon R expression in bone marrow B cells. B cells from patients with common variable immunodeficiency and ataxia telangiectasia did not express Fc epsilon R, but PHA-sup could induce its expression, indicating that circulating B cells of these patients are at a differentiation stage similar to B cells in bone marrow. The study showed that Fc epsilon R is a B cell-specific differentiation marker, the expression of which is restricted to a defined stage of B cell differentiation.
Use of an Artificial Neural Network for the Diagnosis of Myocardial Infarction
Authors: William G. Baxt
Journal: Annals of Internal Medicine (1991)

To validate prospectively the use of an artificial neural network to identify myocardial infarction in patients presenting to an emergency department with anterior chest pain.Prospective, blinded testing.Tertiary university teaching center.A total of 331 consecutive adult patients presenting with anterior chest pain.Diagnostic sensitivity and specificity with regard to the diagnosis of acute myocardial infarction.An artificial neural network was trained on clinical pattern sets retrospectively derived from the cases of 351 patients hospitalized with a high likelihood of having myocardial infarction. It was prospectively tested on 331 consecutive patients presenting to an emergency department with anterior chest pain. The ability of the network to distinguish patients with from those without acute myocardial infarction was compared with that of physicians caring for the same patients. The physicians had a diagnostic sensitivity of 77.7% (95% CI, 77.0% to 82.9%) and a diagnostic specificity of 84.7% (CI, 84.0% to 86.4%). The artificial neural network had a sensitivity of 97.2% (CI, 97.2% to 97.5%; P = 0.033) and a specificity of 96.2% (CI, 96.2% to 96.4%; P less than 0.001).An artificial neural network trained to identify myocardial infarction in adult patients presenting to an emergency department may be a valuable aid to the clinical diagnosis of myocardial infarction; however, this possibility must be confirmed through prospective testing on a larger patient sample.
The Evolution of Dermatology Grand Rounds
Authors: Jeffrey M. Cohen, Susan Burgin
Journal: JAMA Dermatology (2015)

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 Dermatology HomeNew OnlineCurrent IssueFor Authors Podcast 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 Dermatology journal
Management of chronic disease by practitioners and patients: are we teaching the wrong things?
Authors: N. M Clark
Journal: BMJ (2000)

<b>Objective:</b> To evaluate the occurrence, treatment, and outcome of hydrocephalus complicating community-acquired bacterial meningitis in adults. <b>Methods:</b> Case series from a prospective nationwide cohort study from Dutch hospitals from 2006 to 2009. <b>Results:</b> Hydrocephalus was diagnosed in 26 of 577 episodes (5%) and was classified as communicating hydrocephalus in all but 1 patient. The majority of patients (69%) presented with hydrocephalus on admission. Most common causative bacteria were <i>Streptococcus pneumoniae</i> (in 14 patients, 54%) and <i>Listeria monocytogenes</i> (in 4 patients, 15%). Thirteen patients died (50%) and 18 had an unfavorable outcome (69%). Hydrocephalus was an independent predictor of death in a multivariate analysis (odds ratio 7.81, 95% confidence interval 2.91–20.8). Six patients underwent an intervention: 2 patients (8%) had serial lumbar punctures; 4 patients (15%) underwent external ventricular CSF catheter placement. Median time from diagnosis of hydrocephalus to CSF shunting was 12 hours (range 0–4 days). All patients who underwent CSF shunting died or had a poor outcome. <b>Conclusions:</b> Hydrocephalus complicates community-acquired bacterial meningitis in 5% of adult cases and is associated with high fatality rates. A minority of patients underwent neurosurgery and outcome was uniformly poor in these patients.
Pathophysiology of Beta Cell Failure After Prolonged Remission of Insulin-dependent Diabetes Mellitus (IDDM)
Authors: Daniel Drucker, Bernard Zinman
Journal: Diabetes Care (1984)

The pathophysiology of beta cell failure in IDDM has not been well documented. Islet cell responsiveness (C-peptide and glucagon) to oral glucose (OGTT), intravenous glucose (IVGTT), and arginine infusion was studied sequentially in a 24-yr-old nonobese patient with IDDM in prolonged remission interrupted by an episode of diabetic ketoacidosis and followed by a second transient (6 mo) partial recovery of beta cell function. The earliest abnormality in glucose tolerance was demonstrated with the IVGTT (K = 0.77) although OGTT (F, 101: ½ h, 177; 7 h, 211; 1 ½ h, 144; and 2 h, 111 mg/dl) and glucagon responses to glucose and arginine were normal. With the development of abnormal OGTT, glucagon failed to suppress with hyperglycemia although basal levels were not elevated. With the development of frank clinical diabetes, C-peptide did not respond to oral or i.v. glucose although stimulation in response to arginine infusion was still possible. Basal glucagon concentrations were now elevated. Thus, the failing beta cell shows a progressive deterioration in its responsiveness to various secretagogues in a sequential manner (i.v. glucose followed by oral glucose and then i.v. arginine). Abnormalities in glucagon secretion can be demonstrated early in the development of abnormal oral glucose tolerance. With more precise elucidation of the etiology of diabetes, it may be possible to intervene therapeutically in diabetic individuals who experience a remission in order to prevent further deterioration in beta cell function.
Routine Data Sources Challenge International Diabetes Federation Extrapolations of National Diabetes Prevalence in Switzerland
Authors: Matthias Bopp, Ueli Zellweger, David Faeh
Journal: Diabetes Care (2011)

Information on diabetes prevalence in the general population is scarce and often based on extrapolations. We evaluated whether prevalence could be estimated from routine data sources.The sources were 1) hospital discharges (2008, n = 828,171), 2) death registry (2007/2008, n = 118,659), and 3) Swiss Health Survey (SHS; 2007, n = 18,665). Persons without diabetes as underlying cause of death (death registry) or principal diagnosis (hospital discharges) were regarded as surrogate for a general population random sample.In those aged 20-84 years, 4.5% of men and 3% of women were expected to have diabetes. By source, estimations were 4.4 and 2.8% (hospital discharges), 3.8 and 3.1% (death registry), and 4.9 and 3.7% (SHS) for men and women, respectively. Among sources, age-sex patterns were similar.In countries with adequate data quality, combination of routine data may provide valid and reliable estimations of diabetes prevalence. Our figures suggest that International Diabetes Federation extrapolations substantially overestimate diabetes prevalence in Switzerland.
OBSERVATIONS ON THE TREATMENT OF WOUNDS IN WAR
Authors: J. Tissot
Journal: BMJ (1915)

Private K. AVWounded November 6th, 1914, in the anterior aspect of the right tlhigh.Femur fracture(l.December 5th, on a(dmissioni, there was a smail depressed sinus in mid(lle of thiglh dischargilng foul pus.On December 9th the silnus was ,opened thro'ugh wounid in fronit of thigh, anld a couniter .openingmade.In thirty-six hours the thigh was much swollen and there was a discharge of thick serous fluid, wvhich colntained a large lnumber of sporilng -bacilli and bubbles of gas.The wound-wvas freely opeie(l.anid the muscles in the centre of the sinus were found blackenied and semi-digested.A portioii of this tissue was examined microscopicallv.The individual muscle bundles were burst, semi- digested, and large niumbers of spore-forming organisms were seen tightiy packed between the muscle bundles, and actually passing into and invading the muscle fibres themselves.Surroundinig the larger collections of bacteria, the tissue was transparent and hardly took up the stain at all.Practically no pus cells were seen.The slporinig organiisms were isolated in pure culture ani(d identified as the bacillus of malignant oedema.An organismi of the proteuis type was the only other organiism isolated, althouglh a few capssulated Gram-positive organisms 'were observed in the original films.Within three davs of the operation the patient's haemoglobin had fallen to 40 per cent., and he was acutely ill, but finally made an excellent recovery.The wounds were treated throughout with hydrogeni peroxidle, covered by a thin layer of gauze soaked with peroxi(le, and ,oxygen colnstantly passed into the woundls.The limb was ultimately useful, though somewhat shortenied.In this case -tle bacillus of malignant oedeina had apparently lain dormant for nearly five weeks, but was activated by the incision to provide adequate drainage.'Bacteriologically this case suggests symibiotic activity ,betweeu the bacillus of malignant oederma and the B. proteuts or B. perfrinqens.Anotlher type of case, such, for instance, as Case Iv aud possibly Case v, owes its peculiar features to a process analogous to anaphylaxis; the tissues, lhaving originally .beensubjected to constant doses of bacterial poison, are, after an interval, subjected to an anaphylactic dose of the original poison.
Cooperative study of hospital frequency and character of transient ischemic attacks
Authors: R. A. Gotshall
Journal: JAMA (1978)

Information was collected among six participating medical centers on the frequency of performance and the percentage of abnormality of 30 tests performed on patients with complaints suggesting transient ischemic attacks (TIAs). A number of these were commonly performed and commonly exhibited abnormalities. Although the diagnosis of TIA is made by history and physical examination, these tests were of value in aiding the physician to determine possible causes of TIA, to detect risk factors of associated conditions, to rule out alternative diagnoses, and to assess the patient's ability to tolerate different types of therapy. (<i>JAMA</i>239:2001-2003, 1978)
Experimental lead nitrate poisoning: microscopic and ultrastructural study of the gills of tench (Tinca tinca, L.).
Authors: V Roncero, J A Vincente, E Redondo, A Gãzquez, E Duran
Journal: Environmental Health Perspectives (1990)

A microscopic, ultrastructural, and morphometric study was made of the gills of tench (Tinca tinca, L.) subjected to acute experimental lead nitrate poisoning. Twenty-one adult tench were subjected to poisoning and a further 22 were used as controls. Lesions were characterized by the appearance of edema and epithelial hyperplasia and necrosis, both in cells forming part of the filtration barrier and in those in the interlamellar space. These processes developed in the course of the experiment, leading to the death of tench after 12 to 15 days of exposure to 75 ppm lead nitrate, at which point the concentrations of lead in the gills had reached their maximum.
Cardiac hypertrophy is enhanced in PPAR -/- mice in response to chronic pressure overload
Authors: P. J.H. Smeets, B. E.J. Teunissen, P. H.M. Willemsen, F. A. van Nieuwenhoven, A. E. Brouns, B. J.A. Janssen, J. P.M. Cleutjens, B. Staels, G. J. van der Vusse, M. van Bilsen
Journal: Cardiovascular Research (2008)

AimsPeroxisome proliferator-activated receptor-α (PPARα) is a nuclear receptor regulating cardiac metabolism that also has anti-inflammatory properties. Since the activation of inflammatory signalling pathways is considered to be important in cardiac hypertrophy and fibrosis, it is anticipated that PPARα modulates cardiac remodelling. Accordingly, in this study the hypothesis was tested that the absence of PPARα aggravates the cardiac hypertrophic response to pressure overload.