tbuckley/cabot-search huggingface dataset:
Medicine and books: General Practice Under the National Health Service, 1948-1997
Authors: Roland Petchey
Journal: BMJ (1998)

Irvine Loudon, John Horder 

Oxford University Press, £45, pp 329 

ISBN 0 198206 755 

The path travelled by general practice since 1948 is dotted with milestones: the foundation of the (Royal) College of General Practitioners (1952), the creation of the first Chair of General Practice in Edinburgh (1963), the Family Doctors’ Charter (1966), mandatory vocational training (1975), etc. Along the way, the service has been almost totally transformed. The professionally isolated, single handed general practitioner of the early years has evolved into the multipartner practice. The inadequate premises, facilities, and support staff that Collings described in 1950 have given way to the purpose built health centre and the multidisciplinary primary care team. Other indications of the increasing maturity of general practice as a clinical discipline are also evident. In both teaching and research it has asserted its right to equal status with hospital based specialties. Finally, after 50 years of waiting in the wings, the ugly duckling of national health policy has taken centre stage. 

These are just some of the events and themes that are recalled and analysed in this book. It is the third volume in a series that tells the story of general practice from 1750 to the present. It is destined (rightly) to become a standard reference for the history of general practice in the NHS, and it should be read by anyone wishing to understand how general practice has become what it is. The list of contributors reads like a Who’s Who of 50 years of general practice research; their lives are often intimately bound up with the developments that they recount. This intertwining of autobiography and history not only mirrors one of the core features of general practice itself but also adds immeasurably to the pleasure of reading these accounts. 

The book also faithfully reflects two other characteristics of contemporary general practice—its ambivalence towards the concept of primary care and its suspicion of closer incorporation into the NHS. The relation between general practice and primary care is largely unexplored; indeed, the two terms are generally treated as interchangeable. Bevan once described the NHS as “a great collective experiment ... through the agency of a profession which abounds in individualism.” Undoubtedly he was referring to the medical profession generally, but he might have had general practitioners and their wish to retain their independent contractor status specifically in mind. They now face a further round of collectivisation in the shape of primary care groups. It will be fascinating to observe how these reluctant collectivists of the NHS fare over the next half century.
PWE-414 A designated eras nurse consistently achieves eras goals with significant cost reductions for the nhs
Authors: A Johnston, C McCutcheon, A Renwick, S Moug
Journal: Gut (2015)

<h3>Introduction</h3> Enhanced recovery after surgery (ERAS) optimises patient outcomes after elective surgery. The role of designated ERAS nurse has rarely been assessed with limited information on any potential cost savings. <h3>Method</h3> 3 separate time periods were compared: n = 36, group 1 (ERAS established, no designated nurse, 3 months duration); n = 64, group 2 (5 month introductory period for ERAS Nurse) and group 3, n = 204 (12 months following introductory period) Total numbers of patients; length of hospital stay (LOS); re-admission rates were calculated with daily patient costs estimated using £541 / surgical ward. <h3>Results</h3> LOS reduced in group 2 and further reduced in group 3: 9 (3–36) vs. 8 (3–15) vs. 7 (3–68) [Groups 1, 2 and 3 respectively]. The re-admission rate reduced: 8% vs. 4.7% vs. 5.4%; length of re-admission stay shorter: 4.5 days vs. 1.7 vs. 1.7. The two day LOS reduction saved 408 bed days: potential cost reduction of £1082/patient/ hospital stay or alternatively, allowed extra 58 patients to have surgery. <h3>Conclusion</h3> A designated ERAS Nurse has substantially increased the number of patients undergoing surgery, with further reductions in hospital stay and re-admission rates; a designated ERAS Nurse has vital and cost-effective role in current surgical practice. <h3>Disclosure of interest</h3> None Declared.
AB0586 Persistent Rather Than Fluctuating Serum Cryoglobulins are Associated with Cryoglobulinemic Vasculitis in Primary SjÖgren's Syndrome, and Related to the Risk of Lymphoma
Authors: L. Quartuccio, L. Corazza, S. Gandolfo, S. De Vita
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> CrCryoglobulinemia is a known risk factor lymphoma in primary Sjögren9s syndrome (pSS) and it is an hallmark of a more aggressive systemic disease. Whether this is related to the sole presence of serum cryoglobulins (SC) or also to an associated cryoglobulinemic vasculitis (CV) is unknown, since criteria for the classification of the latter were developed and validated only very recently (1,2). <h3>Objectives</h3> The aim of this study is to describe the characteristics of cryoglobulinemia in the course of pSS and to evaluate the association with CV, classified according to the validated criteria (1,2), and with B-cell lymphoma. <h3>Methods</h3> 144 consecutive patients with pSS were repeatedly evaluated for SC according to the standard methods (3). The 2011 classification criteria for CV and the presence of lymphoma were investigated in positive cases. <h3>Results</h3> SC were repeatedly present in 28/144 patients (19.4%), with a median of three determinations (range 2-33) per patient. In 14/28 cases (50%), the presence of SC was fluctuating, while in 14/28 cases (50%) SC were persistently positive in all the tests performed. SC were type II in 11/28 (39.3%) patients (8/11 persistently positive, 3/11 fluctuating), and type III in 7/28 patients (2/7 persistently positive, 5/7 fluctuating); in 10/28 cases, SC typing was not performed for the insufficient cryocrit (4/10 persistent, 6/10 fluctuating). Patients with positive SC fulfilled the CV classification criteria in 16/28 cases (57.1%). CV was more frequent in pSS with persistent SC (11/14, 78,6%) than pSS with fluctuating SC (5/14, 35,7%) (p=0,02, Pearson). Lymphoma was observed in 4/12 (33.3%) pSS patients with SC without CV, and in 6/16 (54.5%) pSS patients with CV. <h3>Conclusions</h3> Persistently detectable, rather than fluctuating SC, are more associated with CV and with malignant lymphoma in pSS. The repetition of SC testing is then recommended in pSS. <h3>References</h3> De Vita S, et al. Preliminary classification criteria for the cryoglobulinaemic vasculitis. Ann Rheum Dis. 2011;70(7):1183-90. Quartuccio L, et al. Validation of the classification criteria for cryoglobulinaemic vasculitis. Rheumatology (Oxford). 2014;53(12):2209-13. Brouet JC, et al. Biologic and clinical significance of cryoglobulins. A report of 86 cases. Am J Med 1974;57:775-88. <h3>Disclosure of Interest</h3> None declared
Monoclonal antibodies directed against the Epstein-Barr virus-encoded nuclear antigen 1 (EBNA1): immunohistologic detection of EBNA1 in the malignant cells of Hodgkin's disease
Authors: FA Grasser, PG Murray, E Kremmer, K Klein, K Remberger, W Feiden, G Reynolds, G Niedobitek, LS Young, N Mueller-Lantzsch
Journal: Blood (1994)
Web-based questionnaires – a tool used in a campylobacter outbreak investigation in Stockholm, Sweden, October 2007
Authors: B de Jong, C Ancker
Journal: Eurosurveillance (2008)

Campylobacteriosis is the most common reported bacterial gastrointestinal disease in Sweden. Food-borne outbreaks of campylobacteriosis in Sweden are rather rare except for, usually rather small, family outbreaks. Water-borne outbreaks of campylobacteriosis, however, have affected several thousand persons in the past.
NMSC in Organ Transplant Recipients and Other High-Risk Groups
Authors: Brent E. Pennington, Thomas Stasko
Journal: Journal of the National Comprehensive Cancer Network (2004)

Non-melanoma skin cancers (NMSCs) are the most commonly occurring malignancies in the United States, with over 1 million cases annually. Several subsets of patients within the general population are particularly susceptible to the development of basal cell carcinomas and squamous cell carcinomas. These groups include patients with xeroderma pigmentosum, basal cell nevus syndrome, epidermodysplasia verruciformis, and chronic lymphocytic leukemia as well as organ transplant recipients. Organ transplant recipients are the largest and best characterized of these subsets of patients. Review of the available data regarding the epidemiology, etiology, and clinical features of NMSC in organ transplant patients provides insight into the care of other high-risk patients.
Patient-Therapist Sexual Contact
Authors: Roberta J. Apfel, Bennett Simon
Journal: Psychotherapy and Psychosomatics (1985)

We use the catalogue of negative effects of sexual contact with the therapist (part I) to discuss the problems of subsequent therapy. Patient issues center around problems of trust, and anxiety and guilt around eventually exploring characterological issues involved in the sexual contact. From the therapist side (either as consultant or long-term therapist) problems include that of finding the best way of evaluating and understanding the patient's story (including its credibility); how to avoid repeating, in some new and disguised form, the previous therapist's counter-transference problems, and finally, the questions of if, when, and how is it therapeutic for the patient to report and press charges against the previous therapist. We recommend an ongoing role for the initial consultant in instances where such charges are to be pressed.
High-dose chemotherapy of breast cancer: is the question answered?
Authors: M J Kennedy
Journal: Journal of Clinical Oncology (1995)

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.1995.13.10.2477 Journal of Clinical Oncology - published online before print September 21, 2016 PMID: 7595695 High-dose chemotherapy of breast cancer: is the question answered? M J KennedyxM J KennedySearch for articles by this author https://doi.org/10.1200/JCO.1995.13.10.2477 First Page PDF © 1995 by American Society of Clinical Oncology
Malignant melanoma in the elderly.
Authors: C D Taylor
Journal: Journal of Clinical Oncology (1987)

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.1987.5.11.1853 Journal of Clinical Oncology - published online before print September 22, 2016 PMID: 3681372 Malignant melanoma in the elderly. C D TaylorxC D TaylorSearch for articles by this author https://doi.org/10.1200/JCO.1987.5.11.1853 PDF "Malignant melanoma in the elderly.." Journal of Clinical Oncology, 5(11), p. 1853© 1987 by American Society of Clinical Oncology
Identification of Fibroblastoid Cell Type in Human Melanoma Cultures&lt;xref ref-type="fn" rid="FN1"&gt;1&lt;/xref&gt;&lt;xref ref-type="fn" rid="FN2"&gt;2&lt;/xref&gt;
Authors: Marion Delcroix, Anita Libert, Ferdy Lejeune
 6
Journal: JNCI Journal of the National Cancer Institute (1986)

Identification of Fibroblastoid Cell Type in Human Melanoma Cultures Get access Marion Delcroix, Marion Delcroix Laboratory of Oncology and Experimental Surgery J. Bordet Institute Université Libre de Bruxelles, Rue Héger-Bordet 1 B-1000 Brussels, Belgium Search for other works by this author on: Oxford Academic PubMed Google Scholar Anita Libert, Anita Libert Laboratory of Oncology and Experimental Surgery J. Bordet Institute Université Libre de Bruxelles, Rue Héger-Bordet 1 B-1000 Brussels, Belgium Search for other works by this author on: Oxford Academic PubMed Google Scholar Ferdy Lejeune Ferdy Lejeune 6 Laboratory of Oncology and Experimental Surgery J. Bordet Institute Université Libre de Bruxelles, Rue Héger-Bordet 1 B-1000 Brussels, Belgium 6Address reprint requests to Dr. Lejeune. Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 77, Issue 5, November 1986, Page 1171, https://doi.org/10.1093/jnci/77.5.1171 Published: 01 November 1986
Cutaneous Loxoscelism
Authors: Lourdes Garza Ocañas, Roque Masaharu Mifuji
Journal: New England Journal of Medicine (2013)

A 10-year-old healthy girl from a rural area in northeast Mexico was bitten on the right thigh by a spider resembling a brown recluse spider (Loxosceles reclusa). Five days later, a necrotic lesion and perilesional edema developed in the area of the bite, accompanied by fever.
Endoscopy in the Diagnosis of Gastritis
Authors: T. Sauerbruch, M.A. Schreiber, P. Schüssler, W. Permanetter
Journal: Endoscopy (1984)

Endoscopy of the stomach was performed in 152 consecutive patients alternately by two endoscopists, such that the non-examining endoscopist always followed the procedure via a teaching attachment. A fiberscope with a close-focusing optical system for magnification of the mucosa was used. The interobserver reliability of eleven predefined macroscopic criteria was analysed and these criteria were compared with the histological diagnosis for each gastric region (body, transitional zone, antrum). The percentage of agreement between the two observers ranged between 80 % and 97 % for all criteria except mucosal erythema (74, 68, 62 %) and mucus covering (53, 61, 87 %).
Acute Pancreatitis
Authors: A. V. Pollock
Journal: BMJ (1959)

representatives even for preliminary discussions with the executors of Alfred Nobel's will until it was evident that the will would become legally recognized.Leading conservative politicians in Sweden declared the will as an infringement of the-legal rights of Nobel's heirs.Meanwhile some of Nobel's heirs in Sweden had brought an action against the executors, claiming that the will should be declared invalid.The executors of the will appointed by Nobel, Mr. Ragnar Sohlman and Civ.eng.Rudolf Lilljequist, would have met an almost insurmountable resistance from the authorities and the heirs had not the nephew of Alfred Nobel, Ludwig's son Emanuel Nobel, in February, 1898, declared that he, although the death of Alfred Nobel had heavily shaken the financial ground of the naphtha enterprises in Russia, was willing to do his best to see that his uncle's will should be respected.The action of Emanuel Nobel on this occasion deserves to be remembered.Such a disregard of what was considered the rights of the heirs as Alfred Nobel had shown was in fact unheard of.Because of the extraordinarily good relations which had always prevailed within the family, Emanuel felt convinced that deeper motives had induced his uncle's decision.He therefore, when the highest representative of the State claimed that Alfred Nobel had been "influenced by peace fanatics and particularly by women and advised him to act in favour of the heirs' rights, responded: "Your Majesty !It is not my intention to take any action through which members of my family in the future could be blamed by the most highly deserving scientists of the time for having deprived them of something which duly ought to be theirs."Emanuel Nobel called the executors "solicitors of the soul."He participated in the preliminary discussions between them and the representatives of the Swedish Academy and the Karolinska Institutet.A proposal was made on June 5, 1898, according to which the heirs should be allotted one and a half years' income to the estate, provided they recognized the will and waived any further claims upon the estate.
Report on the measles situation in Portugal
Authors: M Gíria, H Rebelo-de-Andrade, T Fernandes, S Pedro, G Freitas
Journal: Eurosurveillance (2008)

A measles case, imported from the United Kingdom (UK), was reported in Portugal in late August 2008. Previously, measles cases imported from Romania, and import-related cases, were reported in 2005. There was no transmission to the autochthonous Portuguese population.
Effectiveness of physical therapy treatment of clearly defined subacromial pain: a systematic review of randomised controlled trials
Authors: M N Haik, F Alburquerque-Sendín, R F C Moreira, E D Pires, P R Camargo
Journal: British Journal of Sports Medicine (2016)

Aim To summarise the current evidence regarding the effectiveness of physical therapy on pain, function and range of motion in individuals with subacromial pain syndrome (SAPS). Design Systematic review. Data sources PubMed, Web of Science, CINAHL, Cochrane, Embase, Lilacs, Ibecs and Scielo databases. Eligibility criteria for selecting studies Randomised controlled trials (RCTs) investigating physical therapy modalities for SAPS on pain, function/disability or range of motion were included. Results 64 high-quality RCTs were included. Exercise therapy provided high evidence of being as effective as surgery intervention and better than no treatment or placebo treatment to improve pain, function and range of motion in the short, mid and long terms. The combination of mobilisation and exercises provided high evidence to decrease pain and improve function in the short term. There is limited evidence for improvements on the outcomes with the isolated application of manual therapy. High level of evidence was synthesised regarding the lack of beneficial effects of physical resources such as low-level laser, ultrasound and pulsed electromagnetic field (PEMF) on pain, function or range of motion in the treatment of SAPS. There is limited evidence for microwave diathermy and transcutaneous electrical nerve stimulation. There is moderate evidence to no benefits with taping in the short term. Effects of diacutaneous fibrolysis and acupuncture are not well established yet. Conclusions Exercise therapy should be the first-line treatment to improve pain, function and range of motion. The addition of mobilisations to exercises may accelerate reduction of pain in the short term. Low-level laser therapy, PEMF and taping should not be recommended.
Silence–Winter
Authors: Jeanette M. Smith
Journal: JAMA (2013)

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
OC-044 Introduction of an inflammatory bowel disease smart phone ‘app’: a qualitative study
Authors: AJM Watson, L Patience, U Pisano, D Heaney
Journal: Gut (2015)

<h3>Introduction</h3> A smart phone application (app) for patients with inflammatory bowel Disease (IBD), was introduced in April 2013 for IBD patients. Patients were requested to record symptoms daily on the app which were then sent behind the NHS firewall and were then available, via a dashboard system. The aim of this study was to perform qualitative analysis of patient focus groups formed for the study. <h3>Method</h3> Two focus groups were arranged after the app had been in use for three months. One of the focus groups was with participating clinicians in the unit, and one with a sample of participating patients. Both were conducted by an external qualitative researcher (DH). Interviews were recorded with participants’ permission, coded and analysed in Nvivo using a framework approach. 40 patients were recruited, and of these a purposive sample of 10 consented to participate in the focus group. <h3>Results</h3> A framework analysis of the recordings revealed distinct themes. <b><i>Technical features of the app</i></b>– Patients felt the app easy to use despite some teething issues around connectivity. There were issues depending on the type of phone the patient was using. All patients had experienced some issues, but accepted this at this stage because the app was being tested, Some patients reported that they liked the fact they were all collecting the same information. Patients expressed few, if any, concerns about the security of information being recorded. <b><i>Use of the app</i></b>– All patients reported using the app every day with only some minor exceptions. This was because the data they were collecting was of real importance to them. There was genuine enthusiasm and support for this innovation. Patients felt self monitoring had begun to transform subsequent clinical encounters. Patients felt reassured that their symptoms were monitored by a specialist Nurse. <b><i>Features of success</i></b>– The ability of patients to transmit data directly to the clinical team was seen as critical by patients. The integration of the application into the healthcare delivery is another key feature. Patients who had not collected structured information about themselves before, reported that they were better able to think about their disease. <h3>Conclusion</h3> Whilst it is still too early to ascertain whether this innovation is sustained and becomes normalised into everyday practice, the results from this study suggest it will. The ability for patients to send data directly to clinicians was seen as a key attribute of this development. Patients who had had a clinic visit since using the app felt it had made a significant impact on the consultation. This app fitted into patients lives and was tailored to their needs, and was a successful first step in releasing the potential that technology provides for this patient group. <h3>Disclosure of interest</h3> None Declared.
Website of the week: NHS performance indicators
Authors: Douglas Carnall
Journal: BMJ (2000)

This week, the second ever set of health indicators for the NHS is published, and naturally there is a website that incorporates data from all 99 health authorities and some 275 trusts in England (www.doh.gov.uk/nhsperformanceindicators/index.htm). As a way into the data, start with the “media briefing pack” (www.doh.gov.uk/nhsperformanceindicators/hlpi2000/mediabrief.html), which launches immediately into a discussion of the variation in “performance” between health authorities. Valuing a healthcare intervention against action on the wider determinants of health can be difficult, and the department does not attempt this. Indeed, it argues that standards “should be applied equally to all patients irrespective of their socioeconomic status . . . which may explain but not necessarily justify variation” (www.doh.gov.uk/nhsperformanceindicators/hlpi2000/graphs.html).
The out-of-body experience: a phenomenological typology based on questionnaire responses
Authors: S W Twemlow, G O Gabbard, F C Jones
Journal: American Journal of Psychiatry (1982)

The authors review the few surveys that have been made of the incidence of out-of-body experiences. They then present data on 339 respondents to questionnaires who reported having had out-of-body experiences and 81 who had not. They analyze these data according to the conditions existing at the time of the experience, phenomenological features, and the long- and short-term impact of the experience. Finally, they raise questions about the etiology of out-of-body phenomena and their meaning to individuals who have such experiences.