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James G. Dobbins

Bio: James G. Dobbins is an academic researcher from Centers for Disease Control and Prevention. The author has contributed to research in topics: Chronic fatigue syndrome & Population. The author has an hindex of 19, co-authored 29 publications receiving 5453 citations. Previous affiliations of James G. Dobbins include Analysis Group & Pan American Health Organization.

Papers
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Journal ArticleDOI
TL;DR: A conceptual framework and a set of research guidelines for use in studies of the chronic fatigue syndrome are developed that cover the clinical and laboratory evaluation of persons with unexplained fatigue; the identification of underlying conditions that may explain the presence of chronic fatigue; revised criteria for defining cases of the Chronic fatigue syndrome; and a strategy for dividing the chronic Fatigue syndrome and other unexplained cases of Chronic fatigue into subgroups.
Abstract: The complexities of the chronic fatigue syndrome and the methodologic problems associated with its study indicate the need for a comprehensive, systematic, and integrated approach to the evaluation, classification, and study of persons with this condition and other fatiguing illnesses. We propose a conceptual framework and a set of guidelines that provide such an approach. Our guidelines include recommendations for the clinical evaluation of fatigued persons, a revised case definition of the chronic fatigue syndrome, and a strategy for subgrouping fatigued persons in formal investigations.

4,621 citations

Journal ArticleDOI
TL;DR: Conditions associated with unexplained CF occur in all sociodemographic groups but appear to be most prevalent among women, persons with lower income, and some racial minorities.

189 citations

Journal ArticleDOI
TL;DR: Compared with 1990 birth statistics in the United States, mothers of infants with congenital CMV disease were younger, and a greater percentage of these mothers were black, which may reflect different modes of transmission and suggest target populations for future CMV vaccine initiatives.
Abstract: A national surveillance program for congenital cytomegalovirus (CMV) disease was initiated in 1990. In 4 years 285 cases were reported without seasonal patterns. Mean birth statistics were as follows: gestational age, 36 weeks; weight, 2,224 g; length, 45 cm; and head circumference, 30 cm. Of the infants 68% had CNS involvement, which was significantly (P or = 3 mg/dL, petechiae, an alanine aminotransferase level of > 100 U/L, a platelet count of < or = 75,000/mm3, hepatomegaly, and splenomegaly (P < .05). Maternal demographics revealed that the mean age was 23 years (range, 13-38 years), 59% were white, 33% were black, 47% had low incomes (receiving Medicaid), and 45% were primiparous. Compared with 1990 birth statistics in the United States, mothers of infants with congenital CMV disease were younger, and a greater percentage of these mothers were black. Two distinct maternal groups were identified on the basis of age, socioeconomic status, and parity. This finding may reflect different modes of transmission and suggest target populations for future CMV vaccine initiatives.

187 citations

Journal ArticleDOI
TL;DR: No differences were found in white blood cell numbers; immune complex, complement, or serum immunoglobulin levels; delayed type hypersensitivity and allergic responses; NK cell function; and proliferative responses to mitogens and antigens.
Abstract: An exploratory case-control study was conducted to assess whether the many reported differences in the immune function of chronic fatigue syndrome (CFS) patients are detectable in rigorously defined cases of CFS. Although many studies have reported differences between cases and controls in various measures of immune function, none of these differences were found in all studies. In this study, no differences were found in white blood cell numbers; immune complex, complement, or serum immunoglobulin levels; delayed type hypersensitivity and allergic responses; NK cell function; and proliferative responses to mitogens and antigens. Marginal differences were detected in cytokine responses and in cell surface markers in the total CFS population. However, when the patients were subgrouped by type of disease onset (gradual or sudden) or by how well they were feeling on the day of testing, more pronounced differences were seen.

103 citations

Journal ArticleDOI
TL;DR: Significantly elevated risk for brain cancer was also found among male workers in the trucking industry and there was a linear relationship between the probability of exposure to EM fields and brain cancer.
Abstract: The relationship between various occupational exposures and brain cancer was investigated in a case-control study using mortality data from 202 males who died in East Texas from gliomas in 1969-1978 and 238 male controls randomly selected from all deaths in East Texas in 1969-1978. Using the occupational classification scheme of the U.S. Bureau of the Census, the risk for brain cancer was significantly increased for male workers employed in the transportation, communication, and utilities industries [odds ratio (OR) = 2.26, confidence intervals (CI) = 1.18-4.32]. Further examination of this finding showed that male workers employed in occupations associated with electricity or electromagnetic (EM) fields had an elevated risk for brain cancer (OR = 3.94, CI = 1.52-10.20). In addition, there was a linear relationship between the probability of exposure to EM fields and brain cancer. Significantly elevated risk for brain cancer was also found among male workers in the trucking industry.

88 citations


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Book
01 Jan 2001
TL;DR: Without a way of critically appraising the information they receive, clinicians are relatively helpless in deciding what new information to learn and decide how to modify their practice.
Abstract: Medical practice is constantly changing. The rate of change is accelerating, and physicians can be forgiven if they often find it dizzying. How can physicians learn about new information and innovations, and decide how (if at all) they should modify their practice? Possible sources include summaries from the medical literature (review articles, practice guidelines, consensus statements, editorials, and summary articles in "throwaway" journals); consultation with colleagues who have special expertise; lectures; seminars; advertisements in medical journals; conversations with representatives from pharmaceutical companies; and original articles in journals and journal supplements. Each of these sources of information might be valuable, though each is subject to its own particular biases. 1,2 Problems arise when, as is often the case, these sources of information provide different suggestions about patient care. See also p 2093. Without a way of critically appraising the information they receive, clinicians are relatively helpless in deciding what new information

3,305 citations

Journal ArticleDOI
TL;DR: The history of clinical diagnostic criteria demonstrates the evolution from rather tentative classifications of restricted value to the more elaborate 1983 scheme which incorporates some laboratory procedures under the rubric paraclinical tests as well as a new category based on the presence of specific abnormalities of the cerebrospinal fluid (CSF).

1,902 citations

Journal ArticleDOI
TL;DR: Despite high seroprevalences in some populations, a substantial percentage of women of reproductive age are CMV seronegative and thus at risk of primary CMV infection during pregnancy, and future vaccine or educational campaigns to prevent primary infection in pregnant women may need to be tailored to suit the needs of different populations.
Abstract: Cytomegalovirus establishes a lifelong latent infection following primary infection that can periodically reactivate with shedding of infectious virus. Primary infection, reactivation and reinfection during pregnancy can all lead to in utero transmission to the developing fetus. Congenital CMV infections are a major cause of permanent hearing loss and neurological impairment. In this literature review, we found that CMV infection was relatively common among women of reproductive age, with seroprevalence ranging from 45 to 100%. CMV seroprevalence tended to be highest in South America, Africa and Asia and lowest in Western Europe and United States. Within the United States, CMV seroprevalence showed substantial geographic variation as well, differing by as much as 30 percentage points between states, though differences might be explained by variation in the types of populations sampled. Worldwide, seroprevalence among non-whites tended to be 20-30 percentage points higher than that of whites (summary prevalence ratio (PR) = 1.59, 95% confidence interval (CI) = 1.57-1.61). Females generally had higher seroprevalences than males, although in most studies the differences were small (summary PR = 1.13, 95% CI = 1.11-1.14). Persons of lower socioeconomic status were more likely to be CMV seropositive (summary PR = 1.33, 95% CI = 1.32-1.35). Despite high seroprevalences in some populations, a substantial percentage of women of reproductive age are CMV seronegative and thus at risk of primary CMV infection during pregnancy. Future vaccine or educational campaigns to prevent primary infection in pregnant women may need to be tailored to suit the needs of different populations.

1,207 citations

Journal ArticleDOI
TL;DR: A state of pre-existing relative hypocortisolaemia might sensitise the hypothalamic-pituitary-adrenal axis to development of persistent central fatigue after stress.

1,046 citations

Book
01 Jan 1992
TL;DR: In this paper, the induced and contact current limits of IEEE C95.1-1991 are modified in this edition, and field strengths below which induced and current do not have to be measured are specified, spatial averaging and measurement distance requirements are clarified, and more precise definitions for averaging volume and radiated power are provided.
Abstract: IEEE C95.1-1991 gives recommendations to prevent harmful effects in human beings exposed to electromagnetic fields in the frequency range from 3 kHz to 300 GHz. The recommendations are intended to apply to exposures in controlled, as well as uncontrolled, environments. They are not intended to apply to the purposeful exposure of patients under the direction of practitioners of the healing arts. The induced and contact current limits of IEEE C95.1-1991 are modified in this edition. In addition, field strengths below which induced and contact currents do not have to be measured are specified, spatial averaging and measurement distance requirements are clarified, and more precise definitions for averaging volume and radiated power are provided.

928 citations