tbuckley/cabot-search huggingface dataset:
In Retrospect and Prospect
Authors: THOMAS M. DURANT
Journal: Annals of Internal Medicine (1965)

Medical History1 December 1965In Retrospect and ProspectTHOMAS M. DURANT, M.D., F.A.C.P.THOMAS M. DURANT, M.D., F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-63-6-1106 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptSince we celebrate at this meeting the fiftieth anniversay of the founding of the American College of Physicians, it seems appropriate to discuss briefly the accomplishments of the College during that half century and to attempt a forward look to what some of its future accomplishments may or should be, keeping in mind what we believe to be the major deficiencies and needs of medicine as they exist today. It has been my lot as your President this year to do historical research for this occasion, and I have found the task an extremely pleasant and stimulating experience. Much of...References1. DURANT TM: The Days of Our Years: A Short History of Medicine and The American College of Physicians 1915-1965. Available through Wyeth & Co., Radnor, Pa. Google Scholar2. PIERSOL GM: Gateway of Honor: The American College of Physicians, 1915-1959. Lancaster Press, Lancaster, Pa., 1962. Google Scholar3. CHESNEY A: The Johns Hopkins Hospital and the Johns Hopkins University School of Medicine. Johns Hopkins University Press, Baltimore, 1943. Google Scholar4. REHN L: Die pericardialen verwachswigen in kindersalter. Arch. Kinderheilk 68: 179, 1920. Google Scholar5. MIDDLETON WS: Doctor Walter L. Bierring and the American Board of Internal Medicine. Lancet 83: 466, 1963. Google Scholar6. GOODLARD JI: Changing curriculum of America's schools. Sat. Rev. p. 65, Nov. 16, 1963. Google Scholar7. WOOD WB: Calling Mephistopheles. Arch. Intern. Med. (Chicago) 112: 643, 1963. CrossrefMedlineGoogle Scholar8. SZENT-GYORGYI A: Teaching and expanding knowledge. Science 146: 1278, 1964. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Philadelphia, PennsylvaniaFrom the Department of Medicine, Temple University Medical Center, Philadelphia, Pa.This paper was presented at the Golden Anniversary Session of the American College of Physicians, March 22, 1965, Chicago, Ill.Requests for reprints should be addressed to Thomas M. Durant, M.D., Chairman, Department of Medicine, Temple University Medical Center, Broad and Ontario Sts., Philadelphia, Pa. 19140. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByGoals for Our Next Fifty Years 1 December 1965Volume 63, Issue 6Page: 1106-1116KeywordsForecasting Issue Published: 1 December 1965 PDF DownloadLoading ...
New Scottish CMO criticises training reforms Non-principal GPs will have their own committee BMA warns of growing inequalities in healthcare New pay system agreed for Medical Research Council staff Changes agreed to PLAB test Do performance indicators have a role in health promotion?
Authors: L. Beecham
Journal: BMJ (1996)

# New Scottish CMO criticises training reforms {#article-title-2}

Sir David Carter, who becomes the Scottish chief medical officer next month, says that some of the changes proposed in the Calman report on specialist training could leave some doctors unprepared to work as consultants.

At present professor of clinical surgery at the University of Edinburgh, Sir David was speaking at the BMA's clinical meeting in Istanbul. He said that doctors would spend five years in training compared with eight in the past and this would be exacerbated by the reduction in hours of work. The result would be that they would have, on average, a total of 12 880 hours experience when appointed a consultant at the average age of 33, compared with the 25 760 hours of their predecessors, who were appointed at about the age of 40.

Sir David said that the quality of training under the new arrangements was better but that doctors would be forced to follow the American practice of seeking fellowships to acquire additional experience before they were ready to take up a consultant post.

The deputy chairman of the BMA's representative body and a vascular surgeon in Nottingham, Professor Brian Hopkinson, told the meeting, “The pendulum has swung too far and patient care will deteriorate.” He believed that the next generation of junior doctors were used to more time off and would not want to take part in a continuing commitment to their patients.

# Non-principal GPs will have their own committee {#article-title-3}

The General Medical Services …
TWO INTERESTING CASES OF FORCED RESPIRATION.Read in the Section of Practice of Medicine and Physiology, at the Forty-second Annual Meeting of the American Medical Association, held at Washington, D. C., May 5-8, 1891.
Authors: GEORGE E. FELL
Journal: JAMA (1891)

Sunday morning, March I, at 3:20 a.m., I was called to the residence of Dr, Harrington, on Franklin St., and there found a young lady who had taken a large dose of morphine. At 3 A.m., Mr. Harrington, Sr., had noticed stertorous breathing. He arose, looked at the patient, but concluded that it was nothing more than a very deep slumber. The condition continuing, however, he called Dr. Harrington, who examined the patient, finding her in a comatose condition, cyanotic; pupils markedly contracted; and a bottle of morphia upon the table. She had written two or three letters which clearly indicated the cause of the trouble. I immediately proceeded to forced respiration with the face-mask, which resulted in overcoming the cyanosis and producing an improvement in the heart action. We continued forced respiration with the face-mask until 6:30 a.m., when it was observed that the cyanosis was again increasing, and
America worries about contagion.
Authors: T Delamothe
Journal: BMJ (1991)

essential, but the equipment can be as simple as a standard gastroscope and an injection needle.If skill is not available locally then transferring high risk cases should be considered.Controlling bleeding endoscopically will be technically impossible in a few patients, but the savings in morbidity, mortality, and cost justify strenuous efforts to make such a service widely available.A recent review by a surgeon concluded that "conventional surgery for bleeding from peptic ulcers may become a rarity in the near future."3In an increasing number of hospitals this is already the case.
Glucocorticoid-Induced Osteoporosis: Pathogenesis and Management
Authors: Barbara P. Lukert
Journal: Annals of Internal Medicine (1990)

Purpose: To review the clinical picture, pathogenesis, and management of glucocorticoid-induced osteoporosis. Data Identification: Studies published since 1970 were identified from a MEDLINE search, articles accumulated by the authors, and through bibliographies of identified articles. Study Selection: Information for review was taken from 160 of the more than 200 articles examined. Data Extraction: Pertinent studies were selected; the relative strengths and weaknesses of these studies are discussed. Results of Data Synthesis: Studies in tissue and organ cultures suggest that glucocorticoids have a direct effect on bone, causing inhibition of bone formation and enhancing bone resorption. Glucocorticoids decrease calcium absorption from the intestine and increase renal excretion. Osteoporosis occurs in at least 50% of persons who require long-term glucocorticoid therapy. Long-term trials of therapy for the prevention of glucocorticoid-induced osteoporosis have not been done, but reasonable recommendations include the use of a glucocorticoid with a short half-life in the lowest dose possible, maintenance of physical activity, adequate calcium and vitamin D intake, sodium restriction and use of thiazide diuretics, and gonadal hormone replacement. In refractory cases, the use of calcitonin, bisphosphonates, sodium fluoride, or anabolic steroids should be considered. Conclusions: Osteoporosis is common in patients requiring long-term treatment with glucocorticoids. Careful attention to preventive management may minimize the severity of this serious complication.
Abstract P1-01-08: Lymph Node Ratio as an Alternative to pN Staging in Node Positive Breast Cancer: A report from the Korean Breast Cancer Society
Authors: HJ Kim, KY Gong, KH Jung, S-B Kim, JW Lee, SH. Ahn
Journal: Cancer Research (2010)

Abstract Background: To compare the lymph node ratio(LNR) and pN staging as a prognostic predictor and find out high risk subgroup which can not predict prognosis using pN staging. Patients and Methods: Using information from two large databases, including Korean nationwide registry, we compared the survival using LNR and pN stage parameters by Cox regression analysis. Moreover survival data were analysed according to age subgroups and intrinsic subtypes. Results: In an analysis of 2264 node positive patients from single institution, adjusted cancer specific mortality risks of low (≥0.20), intermediate (&amp;gt;0.20 and ≥0.65) and high risk (&amp;gt;0.65) LNR groups were 1(reference), 1.9 (95%CI, 1.6 to 2.4), 4.6(95%CI, 3.6 to 5.8). The difference of mortality risk between LNR parameters were wider than that of N1, N2 and N3 in DFS, CSS, OS. In contrast to LNR risk categories, survival curve in pN1 and pN2 overlapped in the patients below 35 years old. Survival curve in pN1 and pN2 also overlapped in patients in her2/neu enriched as well as triple negative subtype. These finding were validated by an analysis of nationwide registry data on 15488 node positive patients. The patients who had N1 and LNR2-3 disease showed poor DFS (HR 1.7 95% CI 1.4 to 2.2) and CSS (HR 1.6, 95% CI 1.1 to 2.2) compared with the patients who had N2 and LNR1 disease. Conclusion: LNR define breast cancer prognosis more adequate than the pN categories especially high risk breast cancer like young age, her2/neu enriched and triple negative intrinsic subtype. It is more reasonable that treatment decision like radiotherapy might be depend on the LNR than pN staging. We argue that LNR should be considered as an alternative to pN staging. Figures available in online version. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-01-08.
Internalization of circulating apoptotic cells by splenic marginal zone dendritic cells: dependence on complement receptors and effect on cytokine production
Authors: Adrian E. Morelli, Adriana T. Larregina, William J. Shufesky, Alan F. Zahorchak, Alison J. Logar, Glenn D. Papworth, Zhiliang Wang, Simon C. Watkins, Louis D. Falo, Angus W. Thomson
Journal: Blood (2002)
Becoming a Good Doctor: The Place of Virtue and Character in Medical Ethics
Authors: Joe Sample
Journal: JAMA (1989)

Professor James Drane is trained as a philosopher and theologian and holds a university chair in clinical medical ethics. He tells the reader in his introduction that his purpose is to reintroduce the personal dimension into modern American medical ethics. He criticizes the current state of ethical concerns: "... American medical ethicists practice on only one small section of the ethical turf. Focused mainly on dilemmas and quandaries, American ethicists work at finding rules and procedures for getting out of a bind." He goes on to point out, "Certainly, doctors need help with decision-making in hard cases, but the thousands of other non-conflictual medical acts also have ethical dimensions, and these need to be attended to in medical ethics." Professor Drane would steer us away from the diligent search for rules, regulations, and algorithms to govern ethical behavior and to make ethical decisions. He counsels "a style of life, or a
Still striving for utopia
Authors: Carol Black
Journal: BMJ (2006)

Culture of fearThe flu pandemic of 2007 not only ended Tony Blair's premiership but left a legacy of everyone wanting every possible protection, irrespective of any evidence that the interventions were effective.All employers are now legally obliged to provide a comprehensive occupational health service, including influenza immunisation for all workers.Similarly, the horrendous 2010 measles outbreak resulted in legislation that requires schools and nurseries to have proof that children have been immunised before they are allowed to admit a child.
Effects of Chronic Acidosis on Connective Tissue
Authors: G. Rolland Finlayson, J. Graham Smith, Mordecai J. Moore
Journal: JAMA (1964)

HEMORRHAGIC DIATHESES, poor wound healing, bone alterations, certain characteristic skin changes, and other poorly understood tissue responses occur in chronic acidotic states.<sup>1</sup>Skin changes were studied in 1958 by Olmstead and Lunseth<sup>2</sup>who observed that the skin of chronically acidotic patients was dry, scaly, and atrophic with marked loss of hair. Histologically, they found elastosis (an increase of fibers which take elastic tissue stains) throughout both the upper and lower dermis and postulated that the fibers were elastic tissue formed from degradation products of the collagen. The purpose of this study was to determine the identity of these fibers in chronic acidosis and to correlate the histological findings of the elastosis with the urinary hydroxyproline levels, since urinary hydroxyproline excretion has been demonstrated to be an index of collagen turnover.<sup>3-6</sup>Results of this study suggest that these fibers are, in reality, true elastic tissue and that collagen
Abstract 2731: Cetuximab resistance is associated with increased dependence on lipogenesis
Authors: Yang Lu, Haiquan Lu, Xinqun Li, Zhen Fan
Journal: Cancer Research (2012)

Abstract Sterol regulatory element binding proteins (SREBPs) are key transcriptional regulators of cellular lipid homeostasis. By regulating the maturation of SREBPs through the PI3K/Akt and MEK/Erk signaling pathways, the epidermal growth factor receptor (EGFR) regulates de novo lipogenesis, which is essential for the structural needs of proliferation of cancer cells. The objective of current study is to determine the role of inhibition of lipogenesis by cetuximab, an FDA-approved EGFR-blocking antibody, in cetuximab-induced antiproliferative/antisurvival effects in cancer cells and to identify new combinations of cetuximab with approaches interfering with lipid metabolism for improved therapy. We found that addition of cetuximab into culture medium inhibited the activation of SREBP-1 (appearance of a nuclear form through cleavage of SREBP-1 precursor) in HN5 head and neck cancer cells but not in a cetuximab-resistant subline of HN5 cells (HN5R). Compared with parental HN5 cells, HN5R cells exhibit remarkably increased sensitivity to treatment with two pharmacological lipogenesis inhibitors, C75 (a fatty acid synthase inhibitor) and TOFA (an acetyl-CoA carboxylase inhibitor), suggesting that the cetuximab-resistant cells are more dependent on de novo fatty acid synthesis for survival, and combination of cetuximab with lipogenesis inhibitors may be a novel combination therapy. On the other hand, the increased dependence of cancer cells on lipogenesis suggests that cetuximab-resistant cells might also be sensitive to agents that promote fatty acid α-oxidation. We found treatment of HN5R cells with fenofibrate, an agonist of peroxisome proliferator-activated receptor alpha that transcriptionally activates the genes for inducing fatty acid α-oxidation, disrupted the redox balance in the cetuximab-resistant cells, leading to increased production of ROS and depolarization of the mitochondrial membrane potential that resulted in apoptosis. In summary, our data indicate that the antiproliferative/antisurvival effects of cetuximab in cancer cells depend on effective inhibition of lipogenesis. Pharmacological approaches that forcibly switch cancer cell metabolism from aerobic glycolysis to fatty acid α-oxidation may overcome cetuximab resistance. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 2731. doi:1538-7445.AM2012-2731
Seasonal variations in hospital admission for deep vein thrombosis and pulmonary embolism: analysis of discharge data
Authors: F. Boulay, F. Berthier, G. Schoukroun, C. Raybaut, Y. Gendreike, B. Blaive
Journal: BMJ (2001)

found no difference in the proportion of surgical or nephrology centres that provided skin cancer surveillance, full skin examination, or specific training for clinicians performing surveillance (table), regardless of the size of the unit (data not shown).
Cryosurgery for Benign Cervical Lesions
Authors: J. E. Peck
Journal: BMJ (1974)

Fifty patients with cervical erosions causing symptoms were treated with cryosurgery. Healing was complete in 41 (91%) out of 45 patients who were seen six weeks later, and in 21 patients who were followed up in greater detail the rate of symptomatic relief was high. All the patients who were treated without anaesthesia found the procedure acceptable. Only one patient noted post-operative bleeding, and this was minimal.
Building Bridges to Quality
Authors: Terrence M. Shaneyfelt
Journal: JAMA (2001)

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
A quarter of young children in Iraq are chronically malnourished
Authors: Peter Moszynski
Journal: BMJ (2004)

A new nutritional survey shows that 27% of under 5s in Iraq have chronic malnutrition, despite the widespread distribution of food in the largest relief operation in history.

The Baseline Food Security Assessment, the first ever such survey to be done in Iraq, also found that 6.5 million people (a quarter of the population) remain highly dependent on food aid.

The assessment was …
Hepatitis C: Evaluating the seropositive blood donor
Authors: Paul Martin
Journal: Hepatology (1992)

ABSTRPlCT Objective: To determine the epidemiologic, clinical, serologic, and histologic importance of antibodies to hepatitis C virus (anti–HCV) in blood donors. Design: Cross–sectional identification and prospective evaluation of seropositive donors; retrospective assessment of infectivity; and nested casecontrol study for risk factors. Setting: Liver unit of a referral–based university hospital. Subjects: Of 30 231 consecutive donors, 368 (1.2%) were found to be anti–HCV–reactive by enzyme–linked immunosorbent assay (ELISA). Two hundred and fifty–four of these 368 donors were evaluated for risk factors by comparison with 284 age– and sex–matched controls. Eighty–six spouses of seropositive donors were also evaluated. Measurements and Main Results: Twenty–four percent of the seropositive donors had a history of percutaneous exposure to blood. This rate increased to 45% when only those donors confirmed to be anti–HCV positive by a second–generation recombinant immunoblot assay (RIBA–2) were considered. A family history of liver disease (odds ratio, 2.8; 95% CI, 1.6 to 4.8), previous blood transfusion (odds ratio, 6.1; 95% CI, 3 to 12.5), and a history of tattooing or intravenous drug abuse (odds ratio, 8.4; 95% CI, 2.3 to 31) were associated with anti–HCV seropositivity. An elevated alanine aminotransferase (ALT) level was found in 58% of the seropositive donors. Of the 150 donors tested, 104 (69%; CI, 62% to 77%) were confirmed by RIBA–2 to be anti–HCV positive. Of the 105 donors who had a biopsy, 16% had normal histologic findings, 11% had minimal changes, 21% had chronic persistent hepatitis, 45% had chronic active hepatitis, and 7% had active cirrhosis. All 77 donors with RIBA–2–confirmed seropositivity had histologic abnormalities. Of 43 donors evaluated in an infectivity study, 82% were implicated in previous HCV transmission. Only 2.3% of the spouses were anti–HCV positive. The ELISA, RIBA–2, and ALT results correlated with infectivity and abnormal histologic findings. Conclusions: In our geographic area, almost 70% of donors who are anti–HCV positive by ELISA are confirmed to be positive by RIBA–2; most of these donors appear to be chronic carriers of HCV and have substantial liver disease.
The Effects of Small Concentrations of Carboxyhemoglobin on Gas Exchange and Myocardial Oxygen Consumption.
Authors: Stephen M. Ayres
Journal: Annals of Internal Medicine (1967)

s1 May 1967The Effects of Small Concentrations of Carboxyhemoglobin on Gas Exchange and Myocardial Oxygen Consumption.Stephen M. Ayres, M.D., F.A.C.P., John L. Penny, M.D., Stanley Giannelli Jr., M.D., Ruth G. Armstrong, R.N.Stephen M. Ayres, M.D., F.A.C.P.Search for more papers by this author, John L. Penny, M.D.Search for more papers by this author, Stanley Giannelli Jr., M.D.Search for more papers by this author, Ruth G. Armstrong, R.N.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-66-5-1033_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptCigarette smoking and exposure to urban air pollution may raise carboxyhemoglobin (COHb) saturation to from 10 to 20%. Studies were performed on 20 subjects undergoing diagnostic cardiac catheterization and on 19 dogs to determine the effects of this concentration of COHb on alveolar gas exchange and on myocardial oxygen consumption. Arterial, mixed venous, and coronary sinus blood were sampled and analyzed for PO2, PCO2 and pH by electrochemical techniques. Oxygen and carbon monoxide contents were measured by gas chromatography. Coronary flow was measured by 131I aminopyrine using a modification of the original Kety saturation technique.In contrast to accepted theory,... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New York, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1967Volume 66, Issue 5Page: 1033-1033KeywordsAttentionBloodCarbon monoxideCarboxyhemoglobinCatheterizationChromatographyOxygenOxygen consumptionPartial pressure of carbon dioxidePartial pressure of oxygen Issue Published: 1 May 1967 PDF DownloadLoading ...