tbuckley/cabot-search huggingface dataset:
What's a good doctor and how do you make one?
Authors: C. A Rizo
Journal: BMJ (2002)

Editor—Imagine waking tomorrow to find a magic lamp by your bed, and the genie tells you that there is only one wish left. You decide to devote it to making good doctors. What kind of people would these good doctors be?


We ask this question often among ourselves—a doctor embarking on his career, an active researcher approaching his peak, and a retired clinician needing geriatric care. We sometimes ask other people too. Despite the disparate vantage points, the wish lists are amazingly similar. We all want doctors who will: 








Respect people, healthy or ill, regardless of who they are


Support patients and their loved ones when and where they are needed


Promote health as well as treat disease


Embrace the power of information and communication technologies to support people with the best available information, while respecting their individual values and preferences


Always ask courteous questions, let people talk, and listen to them carefully


Give unbiased advice, let people participate actively in all decisions related to their health and health care, assess each situation carefully, and help whatever the situation


Use evidence as a tool, not as a determinant of practice; humbly accept death as an important part of life; and help people make the best possible arrangements when death is close


Work cooperatively with other members of the healthcare team


Be proactive advocates for their patients, mentors for other health professionals, and ready to learn from others, regardless of their age, role, or status




Finally, we want doctors to have a balanced life and to care for themselves and their families as well as for others. In sum, we want doctors to be happy and healthy, caring and competent, and good travel companions for people through the journey we call life.

Unfortunately, we do not have a magic lamp, and there is no genie. We must use our own skills and endeavours to make the good doctors we want and need. It is an awesome responsibility.
Metronidazole
Authors: Jan Koch-Weser, Peter Goldman
Journal: New England Journal of Medicine (1980)

METRONIDAZOLE provided the first effective cure for trichomoniasis, a disease that until 20 years ago was said to cause more suffering than cancer.1 The drug was placed under a cloud, however, when, after nearly 15 years of widespread use, attention was called to observations indicating that metronidazole was a mutagen of bacteria and an oncogen in animals.2 In this situation proved clinical benefits had to be reconciled with laboratory evidence that suggested human risk. The search for such a reconciliation cannot be avoided. Alternative therapies are either ineffective or use drugs with similar structures and similar laboratory properties.In judgments . . .
Further Evidence of Indirect Induction by X-radiation of Lymphocytic Neoplasms in Mice
Authors: L. W. Law, Michael Potter
Journal: JNCI Journal of the National Cancer Institute (1958)

Further Evidence of Indirect Induction by X-radiation of Lymphocytic Neoplasms in Mice Get access L. W. Law, L. W. Law Leukemia Studies Section, National Cancer Institute,2Bethesda, Maryland Search for other works by this author on: Oxford Academic PubMed Google Scholar Michael Potter Michael Potter Leukemia Studies Section, National Cancer Institute,2Bethesda, Maryland Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 20, Issue 3, March 1958, Pages 489–493, https://doi.org/10.1093/jnci/20.3.489 Published: 01 March 1958 Article history Received: 20 June 1957 Published: 01 March 1958
Abstract 3860: Arrhythmia Vulnerability of Aged Haploinsufficient Cx43 Mice is Determined by Heterogeneous Downregulation of Cx43 Combined with Increased Fibrosis
Authors: John A Jansen, Toon A van Veen, Astrid A Bosch, Roel van der Nagel, Marc A Vos, Jacques M de Bakker, Harold V van Rijen
Journal: Circulation (2008)

Background: Reduced gap junction expression and increased collagen deposition are commonly found in ventricles of electrically remodeled diseased hearts. Their interactive contribution to slow conduction and increased arrhythmogeneity is, however, unclear. In this study, we investigated the effect of increased fibrosis with normal or reduced levels of the ventricular gap junction protein Cx43 on impulse propagation and arrhythmogeneity. Methods: 11 Cx43fl/fl (Control) and 13 Cx43CreER(T)/fl mice (expressing only 50% of Cx43 protein compared to control; Cx43HZ) were aged to 20 months. Epicardial activation mapping (208 electrode terminals) of right (RV) and left (LV) ventricle was performed on Langendorff perfused hearts. Effective refractory period (ERP) was determined by premature stimulation and arrhythmia inducibility was tested by 1–3 premature stimuli and burst pacing. Epicardial conduction velocity longitudinal (CVL) and transverse (CVT) to fiber orientation and inhomogeneity of conduction was determined during S1S1 pacing (150 ms). Cx43, N-cadherin expression, and tissue collagen content was determined by (immuno)histology and Western blotting. Results: Sustained ventricular arrhythmias were induced in 0/11 control and 8/13 Cx43HZ mice (p&lt;0.01). CVL and CVT were unchanged, except for CVT in RV, which was decreased from 48.2±2 to 39.3±1.8 cm/s (Control vs Cx43HZ, p&lt;0.05). In RV, ERP was decreased from 78.2±6.0 to 53.1±3.3 ms (Control vs Cx43HZ, p&lt;0.05). In both RV and LV, inhomogeneity of conduction was significantly higher in Cx43HZ mice with arrhythmias (VT+), compared to both Control and Cx43HZ mice without arrhythmias (VT−). Cx43 expression levels were comparable between VT+ and VT- Cx43HZ mice, though strongly reduced compared to Control. However, Cx43 distribution was very heterogeneous in VT+ mice with large areas devoid of Cx43 while N-cadherin was unaffected, indicating the presence of intact intercalated disks. Compared to Control interstitial fibrosis was increased in Cx43HZ mice, but more pronounced in VT+ Cx43HZ mice when compared to Cx43HZ VT- mice. Conclusions: Combined heterogeneous reduction of Cx43 and increased fibrosis strongly enhance arrhythmogenic vulnerability in aged haploinsufficient Cx43 mice.
Abstract 1197: A Selective ACAT1 Inhibitor, K-604, Stabilizes Atherosclerotic Lesion Versus Pactimibe in Apolipoprotein E-Knockout Mice
Authors: Hideyuki Kobayashi, Yasunobu Yoshinaka, Mami Ikenoya, Kimiyuki Shibuya, Hiroki Kuriyama, Fumiyasu Sato, Kimio Sawanobori
Journal: Circulation (2006)
Abstract 16205: Prevalence and Prognosis of Unrecognized Myocardial Infarction by Cardiac Magnetic Resonance versus ECG in the ICELANDMI Study
Authors: Erik B Schelbert, Jie J Cao, Sigurdur Sigurdsson, Thor Aspelund, Peter Kellman, Anthony H Aletras, Christopher Dyke, Gudmundur Thorgeirsson, Gudny Eiriksdottir, Lenore J Launer, Vilmundur Gudnason, Tamara B Harris, Andrew E Arai
Journal: Circulation (2011)

Background: We compared the ability of late gadolinium enhancement cardiac magnetic resonance (CMR) and electrocardiography (ECG) to diagnose unrecognized myocardial infarction (UMI) and to predict...
Experiences from the Shiga toxin-producing Escherichia coli O104:H4 outbreak in Germany and research needs in the field, Berlin, 28–29 November 2011
Authors: Klaus Stark, Rolf Bauerfeind, Helen Bernard, Tim Eckmanns, Steen Ethelberg, Antje Flieger, J. Giesecke, M. Greiner, Helge Karch, Gérard Krause, Martin Mielke, S. J. O'Brien, M. Pulz, F. Scheutz, Anika Schielke, R. A. Stahl, J. Takkinen, Phillip I. Tarr, R. V. Tauxe, Dirk Werber
Journal: Eurosurveillance (2012)

This report presents the main findings from an international workshop on Shiga toxin-producing Escherichia coli (STEC), held on 28-29 November 2011, organized by the Robert Koch Institute [1]. The workshop assembled over 100 experts in clinical medicine, epidemiology, public health, microbiology, food safety, and environmental science from various countries
Usefulness of Maalox for Detection of the Precise Bleeding Points and Confirmation of Hemostasis on Gastrointestinal Hemorrhage
Authors: M Fujishiro, H Ono, T Gotoda, H Yamaguchi, H Kondo, D Saito
Journal: Endoscopy (2001)

For endoscopists, gastrointestinal hemorrhage is one of the major occurrences encountered in general practice as a life-threatening emergency. The first goal is to stop the bleeding endoscopically without surgical treatment [1], because hypovolemic hypotension and delay in hemostasis increase the surgical risk and adversely affect the patient9s survival [2].
Acute pancreatitis
Authors: J. K Torrens, P H M McWhinney, G. Suntharalingam, R. Keays, N. Soni, L. H Breimer
Journal: BMJ (1998)

# Normal serum amylase does not exclude severe acute pancreatitis {#article-title-2} EDITOR—Mergener and Baillie highlight the problem of diagnosing acute pancreatitis if too much reliance is placed on the serum amylase level, drawing attention to the relatively low specificity of the test.1 They also state that amylase is rapidly cleared from the kidneys, and this, along with other factors, may lead to a normal serum amylase level even in the presence of necrotising pancreatitis.2 We have recently seen two patients with severe necrotising pancreatitis and normal serum amylase levels (one of whom also had a normal result on abdominal ultrasonography), which led to a delay in establishing the correct diagnosis. Computed tomography showed pancreatic necrosis in both cases, and both patients required management in intensive care; one died subsequently from sepsis and multiorgan failure. Clinicians need to be aware not only of alternative causes of raised serum amylase but also of the fact that a normal serum amylase does not exclude severe forms of acute pancreatitis, which are associated with a high morbidity and mortality. 1. 1.↵1. Mergener K, 2. Baillie J . Acute pancreatitis. BMJ 1998;316:44-48. (3 January.) [OpenUrl][1][FREE Full Text][2] 2. 2.↵1. Misiewicz JJ, 2. Pounder RE, 3. Venables CW In: Misiewicz JJ, Pounder RE, Venables CW, eds. Diseases of the gut and pancreas., Oxford: Blackwell Scientific, 1994. # Major haemorrhage may be a late complication {#article-title-4} EDITOR—In their clinical review of acute pancreatitis Mergener and Baillie point out that patients often get worse before they get better … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DMergener%26rft.auinit1%253DK.%26rft.volume%253D316%26rft.issue%253D7124%26rft.spage%253D44%26rft.epage%253D48%26rft.atitle%253DFortnightly%2Breview%2B%253A%2BAcute%2Bpancreatitis%26rft_id%253Dinfo%253Apmid%252F9451268%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=FULL&journalCode=bmj&resid=316/7124/44&atom=%2Fbmj%2F316%2F7149%2F1982.3.atom
Treatment of gall stones
Authors: A G Lim, R P Jazrawi
Journal: BMJ (1995)

and a shortened lifespan of the catheter, but none was found.Recent studies have shown benefit from in- fusional chemotherapy,5 and its use is likely to increase.There could be a strong argument for rationalising use of the percutaneous technique of inserting central venous catheters: occasional operators are more likely to encounter difficuties, so specialist centres that insert over 200 a year are desirable and should incorporate a comprehensive education programme for both patients and staff.The background of the operator is not critical provided that he or she has been trained and is capable of treating complications, monitoring patients, and recovering them safely.The anaes- thetists at the Royal Marsden Hospitals provide this service and endeavour to refine the subtleties of the technique.
Abstract 2567: Paclitaxel Eluting Stents are associated with a high rate of Stent Thrombosis compared to Bare Metal Stents in an Underserved Hispanic Population Presenting with Acute ST Segment Myocardial Infarction
Authors: Atman P Shah, David M Shavelle, Kathleen Swenson, Sandra Jaquez, Michelle Martinez, Jae Choi, William J French
Journal: Circulation (2007)

Background: Paclitaxel-eluting stents (PES) are shown to reduce restenosis and target lesion revascularization (TLR). The effectiveness of PES in Hispanic patients who present with acute myocardial infarction with ST segment elevation (STEMI) is not well established. Methods: A non-randomized, retrospective analysis was performed on 236 Hispanic patients presenting with STEMI between 8/2002 and 4/2006 at an academic tertiary care hospital serving a primarily indigent population. 150 patients received a PES and 86 received an uncoated stent (BMS). The incidence of cardiac death, myocardial infarction (MI), TLR, subacute thrombosis (SAT), and a composite of these major adverse cardiac events (MACE) was assessed at 1 year. Results: Baseline clinical characteristics in both groups revealed no statistically significant differences. All patients had clinical follow up at one year. There were statistically significant reductions in MI [2.0% (n=3 PES) vs. 10.5% (n=9 BMS), p=0.037] and TLR [6.0% (9) vs. 18.6% (16), p=0.04]. There was no difference in death [0.7% (1) vs. 1.1% (1), p=0.99]. SAT was increased in the PES group (6.0%, n=9) compared to the BMS group (1.1%, n=1, p=0.03). MACE was 14.7% in the PES group and 31.2% in the BMS group (p=0.017). Premature clopidogrel discontinuation (&lt;6 months) was the etiology of SAT in 8 of the 9 patients. Conclusions: Use of DES is associated with lower rates of MI and TLR in Hispanics presenting with STEMI. There is an increased incidence of SAT in this population primarily due to premature clopidogrel discontinuation. The role of socioeconomic factors in premature antiplatelet discontinuation and its effects on SAT need further evaluation.
Abstract 5796: Unique Atrial Fibrillation Subpopulations: Thromboembolic Destination Predicts Recurrence Rates and Survival
Authors: Izabela Gosk-Bierska, Robert McBane, Thomas G McLeod, Waldemar E Wysokinski
Journal: Circulation (2009)

Aim. Thromboembolic presentation (stroke, mesenteric or limb ischemia) in non-valvular atrial fibrillation may occur randomly or may identify unique subpopulations of patients with this dysrhythmia. The aim of this study was to determine whether future major adverse cardiovascular event rates (myocardial infarction, stroke, peripheral arterial embolism, death) differ between patients with peripheral embolism (AFPE) compared to those suffering stroke (AFS). Methods. An inception cohort (1995–2005) with AFPE (n=216) were compared to randomly selected AFS patients (n=241). Results. Patients with AFPE were older than AFS patients (79±10 vs 73±13 years; p&lt;0.001) with a greater percentage of women (71% vs 45%; p&lt;0.001). The most common presentation of AFPE patients was limb ischemia (90%). Except for prior stroke, all CHADS-2 variables were more prevalent in AFPE (Table ). During 3.3±3.6 years of follow up, survival was lower in AFPE compared to either AFS (p&lt;0.001) or age/gender matched controls (p&lt;0.001; Figure ). AFPE patients had lower survival free from recurrent embolization compared to AFS (82% vs 100%; p=0.005). Recurrence free survival for MI and stroke were similar. Conclusions. Patients with peripheral embolization represent a unique subset of non-valvular atrial fibrillation with an increased risk of recurrence and high mortality rates compared to those suffering stroke. Comparison of clinical and echocardiographic characteristics
The Sialomucin CD164 (MGC-24v) Is an Adhesive Glycoprotein Expressed by Human Hematopoietic Progenitors and Bone Marrow Stromal Cells That Serves as a Potent Negative Regulator of Hematopoiesis
Authors: Andrew C.W. Zannettino, Hans-Jörg Bühring, Silvana Niutta, Suzanne M. Watt, M. Ann Benton, Paul J. Simmons
Journal: Blood (1998)
Abstract 20281: Friend of GATA-2 (FOG-2) Regulates FOXM1 Expression and Cardiomyocyte Proliferation
Authors: Sarah Greytak, Pamela C Yelick, Gordon S Huggins
Journal: Circulation (2010)

Embryos deficient in FOG-2 or carrying a mutation that renders GATA-4 independent of FOG-2 have left ventricular hypoplasia, suggesting an important role for these transcription factors as regulato...
Lifetime prevalence of panic states
Authors: D A Katerndahl, J P Realini
Journal: American Journal of Psychiatry (1993)

Little is known about the prevalence of panic symptoms that do not meet criteria for panic disorder. This study was conducted to determine the prevalence of panic disorder, panic attacks, and limited-symptom attacks in the general population.The authors identified a community-based sample of 1,683 randomly selected adults in 18 census tracts in San Antonio, Tex.; 1,306 of these subjects agreed to be interviewed with the Structured Clinical Interview for DSM-III. Subjects were classified as having panic disorder if they met DSM-III-R criteria, as having panic attacks if they had attacks of four or more panic symptoms but did not have panic disorder, and as having limited-symptom attacks if they had attacks of fewer than four symptoms but no full-blown panic attacks.The crude lifetime prevalence rates were 3.8% for panic disorder, 5.6% for panic attacks, and 2.2% for limited symptom attacks. Women had higher rates of panic disorder and panic attacks than men, but the difference between men and women was not statistically significant for limited-symptom attacks. No statistically significant differences in rates between Hispanic and either non-Hispanic white or black subjects were found. Non-Hispanic white subjects had higher rates of limited-symptom attacks than black subjects.The prevalence of limited-symptom attacks in this community-based study was 2.2%; black subjects had lower rates than non-Hispanic white subjects. Panic attacks appear to be at least as common as DSM-III-R panic disorder and, like panic disorder, are more common among women.
Abstract 16281: Mild “Stiff Left Atrial Syndrome” Commonly Presents as Persistent Cough Following Atrial Fibrillation Ablation
Authors: Gourg Atteya, Marianne Cosentino, Neil Brysiewicz, Leslie Perrelli, Neil Connery, Mark Marieb, Joseph Akar
Journal: Circulation (2013)

Introduction: We observed an unusual persistent, dry non-productive cough commonly occurring immediately following catheter ablation (CA) for atrial fibrillation (AF). The cough worsens with speech...
Abstract 2833: Low Erythropoietin Serum Levels Are Associated With Angiographic No-reflow After Primary Intervention For Acute Myocardial Infarction
Authors: Giampaolo Niccoli, Francesca Marzo, Antonella Paglia, Eleonora Santucci, Cristina Spaziani, Domenico D’Amario, Felicita Andreotti, Filippo Crea
Journal: Circulation (2007)

Background : No-reflow after primary percutaneous coronary intervention (PCI) remains a clinical challenge. Erythropoietin (EPO) has been associated with reduced infarct size due to EPO’s antiapoptotic and nitric oxide enhancing effects. We aimed to assess the association between EPO serum levels measured on admission and angiographic no-reflow in patients undergoing primary PCI. Methods : From a consecutive series of 60 patients presenting with ST elevation myocardial infarction within 12 h of chest pain onset and undergoing successful primary PCI (i.e. residual stenosis &lt; 20%), we included 48 patients (age 61±12 years, male sex 89%), comprising the first 24 with no-reflow and the first 24 without no reflow. Patients with iron deficiency, recent transfusions, liver or lung failure, other haematological disorders or undergoing treatment with EPO were excluded. EPO levels were measured by ELISA before PCI. Clinical, enzymatic, procedural and angiographic data were also collected. No-reflow was defined as a coronary TIMI flow grade ≤ 2 after vessel reopening or as a TIMI flow grade of 3 with a final myocardial blush grade &lt;2. Multivariate predictors of no-reflow were assessed by logistic regression analysis (SPSS 13). Results : Patients with and without no-reflow did not differ significantly in age, sex, cardiovascular risk factors or standard therapy for acute myocardial infarction. Thrombus aspiration was used in 16 patients (32%) whereas abciximab in 31 (63%), and they did not differ between the two groups. Patients with angiographic no-reflow had lower EPO serum levels compared to those having angiographic reflow (4.2 (0.56 –9.5) vs 12.2 (5.7–20.2) mUI/ml, p=0.001). The left anterior descending artery (LAD) was the culprit vessel in 83% of patients having no-reflow as compared to 30% of those having reflow (p&lt;0.0001). At multivariate analysis, including EPO levels, culprit artery and symptoms to balloon time, the independent predictors of no-reflow were LAD as culprit vessel (OR 15, 95% CI 3–75, p=0.001) and low EPO serum levels (OR 0.91, 95% CI 0.84 – 0.99, p=0.048). Conclusion : These data suggest a significant role for EPO in modulating microcirculatory injury after mechanical reperfusion in patients with ST elevation myocardial infarction.
Abstract 20685: Differences in Atrial Fibrillation Characteristics Between Normal and Heart Failure Atria -- A Tale of Two Substrates
Authors: Jason Ng, Hemanth Koduri, Ivan Cokic, David Gordon, Richard Lee, Alan H Kadish, Jeffrey J Goldberger, Rishi Arora
Journal: Circulation (2010)

Introduction: AF substrate is different in normal vs diseased hearts. Both fibrosis and autonomic remodeling contribute to AF substrate in heart failure (HF). We examined differences in AF electrog...
Mutant U2AF1 Expression Alters Hematopoiesis In Transgenic Mice
Authors: Cara Lunn Shirai, Justin Tibbitts, Jin Shao, Matthew Ndonwi, James N Ley, Sanghyun Kim, Manorama Tripathi, Theresa Okeyo-Owuor, Timothy A. Graubert, Matthew J. Walter
Journal: Blood (2013)
Abstract 15660: Tissue Remodeling and Pulmonary Fibrosis Development in Chronic Heart Failure
Authors: Marie-Francoise Doursout, Ji Chu, Yang Yan Liang, Shu Jun Dou, Karen Uray
Journal: Circulation (2011)

Over 5 million people suffer from heart failure (HF) in the USA (1). Chronic HF leads to irreversible changes in the lung architecture including tissue remodeling and the development of pulmonary f...