tbuckley/cabot-search huggingface dataset:
The Social Mission of Medical Education
Authors: Norman H. Edelman
Journal: Annals of Internal Medicine (2010)

Letters5 October 2010The Social Mission of Medical EducationNorman H. Edelman, MDNorman H. Edelman, MDFrom Stony Brook University, Stony Brook, NY 11794.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-153-7-201010050-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The recent study by Mullan and colleagues (1) is troublesome for several reasons. First, there are mechanical problems. Table 1 has 2 readily apparent errors. The University of Medicine and Dentistry of New Jersey comprises 3 distinctly different medical schools, and the University at Albany, State University of New York, has no medical school. Are there more errors? Second, the cohort used may have been necessary to determine practice choices, but it was not necessary to determine diversity of entering classes. My own school made dramatic improvements over the next 10 years in this regard and thus ...Reference1. Mullan F, Chen C, Petterson S, Kolsky G, Spagnola M. The social mission of medical education: ranking the schools. Ann Intern Med. 2010;152:804-11. [PMID: 20547907] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Stony Brook University, Stony Brook, NY 11794.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoThe Social Mission of Medical Education: Ranking the Schools Fitzhugh Mullan , Candice Chen , Stephen Petterson , Gretchen Kolsky , and Michael Spagnola The Social Mission of Medical Education Pojen Deng The Social Mission of Medical Education Fitzhugh Mullan and Candice Chen The Social Mission of Medical Education Eric A. Mellon The Social Mission of Medical Education Scott Barnhart and James LoGerfo The Social Mission of Medical Education Martin Donohoe The Social Mission of Medical Education John A. Brockman , Matthew J. Stull , and Elizabeth Wiley The Social Mission of Medical Education Gregg S. Meyer Metrics 5 October 2010Volume 153, Issue 7Page: 486KeywordsConflicts of interestDeceptionDentistryMedical education ePublished: 5 October 2010 Issue Published: 5 October 2010 Copyright & PermissionsCopyright © 2010 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Physician Education and Cost Containment-Reply
Authors: Steven A. Schroeder
Journal: JAMA (1985)

<h3>In Reply.—</h3> Soumerai and Avorn take issue with the conclusions that we drew from a recent prospective cost containment experiment at the University of California, San Francisco. Based on our study and other published (and unpublished) work, we concluded that "in the absence of other cost containing incentives, physician education alone is not an effective hospital cost containment strategy." Frankly, we are puzzled by their objections. Our study was prospective and randomized, with concurrent control groups. Contrary to what Soumerai and Avorn suggest, as described in our article, we had sufficient statistical power to detect an economically significant difference between the intervention and control groups had it occurred. They cite in refutation two studies that show changes in prescribing patterns by community-based physicians for Medicaid patients after educational interventions. One of these studies dealt only with prescribing in office practices<sup>1</sup>; the other appears to be limited to office prescriptions,
Neutrophil Granule Proteins in Bronchoalveolar Lavage Fluid from Subjects with Subclinical Emphysema
Authors: TOMOKO BETSUYAKU, MASAHARU NISHIMURA, KIMIHIRO TAKEYABU, MISHIE TANINO, PER VENGE, SHENGYUAN XU, YOSHIKAZU KAWAKAMI
Journal: American Journal of Respiratory and Critical Care Medicine (1999)

Evidence for the contribution of neutrophils to the pathogenesis of pulmonary emphysema is not convincing. We evaluated neutrophil involvement in subclinical pulmonary emphysema by measuring human neutrophil lipocalin (HNL) and two matrix metalloproteinases, gelatinase B (MMP-9) and neutrophil collagenase (MMP-8), in bronchoalveolar lavage fluid (BALF) from 65 community-based older volunteers. HNL is a recently isolated 24-kD protein secreted from secondary granules of activated neutrophils. Despite no appreciable increase in the number of neutrophils, the level of HNL was significantly increased in BALF from subjects with emphysema evidenced by computed tomography regardless of current smoking, as compared with smokers without emphysema. The levels of MMP-9 and MMP-8 were also significantly higher in current smokers with emphysema than in those without emphysema. The appearance of a 130-kD HNL/MMP-9 complex on gelatin zymography and HNL immunoblot indicated neutrophils to be a significant source of MMP-9 in the subjects' BALF. In a 24-h culture medium of alveolar macrophages, only a latent form of MMP-9 was detected, and there was no difference in the level of MMP-9 between the groups. These data provide further evidence for neutrophil involvement in subclinical pulmonary emphysema.
In vivo blockade of OX40 ligand inhibits thymic stromal lymphopoietin driven atopic inflammation
Authors: Dhaya Seshasayee, Wyne P. Lee, Meijuan Zhou, Jean Shu, Eric Suto, Juan Zhang, Laurie Diehl, Cary D. Austin, Y. Gloria Meng, Martha Tan, Sherron L. Bullens, Stefan Seeber, Maria E. Fuentes, Aran F. Labrijn, Yvo M.F. Graus, Lisa A. Miller, Edward S. Schelegle, Dallas M. Hyde, Lawren C. Wu, Sarah G. Hymowitz, Flavius Martin
Journal: Journal of Clinical Investigation (2007)

Thymic stromal lymphopoietin (TSLP) potently induces deregulation of Th2 responses, a hallmark feature of allergic inflammatory diseases such as asthma, atopic dermatitis, and allergic rhinitis. However, direct downstream in vivo mediators in the TSLP-induced atopic immune cascade have not been identified. In our current study, we have shown that OX40 ligand (OX40L) is a critical in vivo mediator of TSLP-mediated Th2 responses. Treating mice with OX40L-blocking antibodies substantially inhibited immune responses induced by TSLP in the lung and skin, including Th2 inflammatory cell infiltration, cytokine secretion, and IgE production. OX40L-blocking antibodies also inhibited antigen-driven Th2 inflammation in mouse and nonhuman primate models of asthma. This treatment resulted in both blockade of the OX40-OX40L receptor-ligand interaction and depletion of OX40L-positive cells. The use of a blocking, OX40L-specific mAb thus presents a promising strategy for the treatment of allergic diseases associated with pathologic Th2 immune responses.
Trends in the Prevalence of Low Risk Factor Burden for Cardiovascular Disease Among United States Adults
Authors: Earl S. Ford, Chaoyang Li, Guixiang Zhao, William S. Pearson, Simon Capewell
Journal: Circulation (2009)

Cohorts consistently show that individuals with low levels of cardiovascular risk factors experience low rates of subsequent cardiovascular events. Our objective was to examine the prevalence and trends in low risk factor burden for cardiovascular disease among adults in the US population.
Blood groups in ankylosing spondylitis.
Authors: A M Kornstad, L Kornstad, D Guldberg
Journal: Annals of the Rheumatic Diseases (1968)

<h3>Abstract</h3> <h3>Objective</h3> To compare the ability of users of 2 medical search engines, InfoClinique and the Trip database, to provide correct answers to clinical questions and to explore the perceived effects of the tools on the clinical decision-making process. <h3>Design</h3> Randomized trial. <h3>Setting</h3> Three family medicine units of the family medicine program of the Faculty of Medicine at Laval University in Quebec city, Que. <h3>Participants</h3> Fifteen second-year family medicine residents. <h3>Intervention</h3> Residents generated 30 structured questions about therapy or preventive treatment (2 questions per resident) based on clinical encounters. Using an Internet platform designed for the trial, each resident answered 20 of these questions (their own 2, plus 18 of the questions formulated by other residents, selected randomly) before and after searching for information with 1 of the 2 search engines. For each question, 5 residents were randomly assigned to begin their search with InfoClinique and 5 with the Trip database. <h3>Main outcome measures</h3> The ability of residents to provide correct answers to clinical questions using the search engines, as determined by third-party evaluation. After answering each question, participants completed a questionnaire to assess their perception of the engine’s effect on the decision-making process in clinical practice. <h3>Results</h3> Of 300 possible pairs of answers (1 answer before and 1 after the initial search), 254 (85%) were produced by 14 residents. Of these, 132 (52%) and 122 (48%) pairs of answers concerned questions that had been assigned an initial search with InfoClinique and the Trip database, respectively. Both engines produced an important and similar absolute increase in the proportion of correct answers after searching (26% to 62% for InfoClinique, for an increase of 36%; 24% to 63% for the Trip database, for an increase of 39%; <i>P</i> = .68). For all 30 clinical questions, at least 1 resident produced the correct answer after searching with either search engine. The mean (SD) time of the initial search for each question was 23.5 (7.6) minutes with InfoClinique and 22.3 (7.8) minutes with the Trip database (<i>P</i> = .30). Participants’ perceptions of each engine’s effect on the decision-making process were very positive and similar for both search engines. <h3>Conclusion</h3> Family medicine residents’ ability to provide correct answers to clinical questions increased dramatically and similarly with the use of both InfoClinique and the Trip database. These tools have strong potential to increase the quality of medical care.
Withdrawing or withholding life prolonging treatment
Authors: S. Luttrell
Journal: BMJ (1999)

News p 1717 

The advice of the House of Lords about persistent vegetative state in the 1993 Anthony Bland case left some British doctors in an odd and uncomfortable position.1 Although decisions about the withholding or withdrawal of life prolonging treatment for a small number of younger patients with very severe cognitive and physical disability have to be reviewed by the courts in England, Wales, and Northern Ireland, many more frequent decisions to withdraw or withhold life prolonging treatment for older patients suffering strokes, dementia, or other serious illness continue to take place in the absence of explicit guidance and without any regulatory or monitoring process.

The Bland case concerned the legality of withdrawing life prolonging treatment from Anthony Bland, a young man left in a persistent vegetative state after being crushed at the Hillsborough football stadium disaster. There is no doubt that the case substantially clarified the law relating to withholding or withdrawing life prolonging treatments and highlighted several important legal points: medical decisions for a mentally incapable patient should be made by the treating doctor in the best interests of the patient; if a decision to withdraw or withhold life prolonging treatment is …
The Emergency-Accident Room of a Hospital as a Cancer Detection Center
Authors: James Henry Ferguson, Sergio Leon
Journal: JAMA (1963)

An emergency-accident room is an effective gynecologic cancer detection center. In a 2½-yr study period cervical smears were obtained from 3,697 patients in a hospital unit of this kind. Two-hundred and sixty-one patients had positive smears, although 43% of these patients with positive smears had no gross cervical lesion. The predominant decade was from 20 to 29 yr of age, but an appreciable number of patients were teenagers. The obstetrics-gynecology department was able to obtain tissue studies on 165 of the 261 positive-smear patients, either when the smear was made (cases with visible cervical lesions) or during follow-up investigations. Eighty-two cases of malignancy were found; 33 were invasive carcinoma of the cervix.
Aspartic acid racemization: evidence for marked longevity of elastin in human skin
Authors: S. Ritz-Timme, I. Laumeier, M.J. Collins
Journal: British Journal of Dermatology (2003)

In extracellular proteins, aspartic acid racemization (AAR) has the potential to identify long-lived or permanent proteins.We present data to show an age-dependent increase in AAR in chronologically aged skin elastin.Elastin was purified in a multistep procedure designed to remove contaminating proteins and to avoid induced racemization. As a control experiment, elastin was also purified from the richest elastin bearing tissue, the yellow ligaments of the spine.In total skin, specimens displayed a slight age-dependent increase in d-aspartyl residues, but in purified elastin the rate of increase was rapid and highly correlated with age (r = 0.98). Similar rates were observed in the control data from the yellow ligaments. The AAR rates were found to be higher in elastin from skin (and yellow ligaments) than previous studies of lung parenchyma and from aorta had shown. These differences appear to be related to the purity of the extracted elastin product, and to a significant in vivo degradation of elastin in skin.The age-dependent accumulation of modified aspartic acid residues appears to be a common feature in ageing elastin, independent of the tissue source. This indicates a lack of turnover and an accumulation of elastin damage in diverse ageing tissues, possibly as part of programmed ageing.
Plastic Surgery of the Abdomen
Authors: Norman E. Hugo
Journal: JAMA (1980)

The impetus for this volume stems from the considerable clinical experience of the two authors who have accumulated a personal series of more than 300 abdominoplasties and thus can speak with authority. The monograph is divided into 12 brief chapters. Chapters on blood supply to the abdominal wall, mechanical properties and aging of the abdominal wall, operative technique, and complications of the operations are especially informative. In some, original material is presented. The chapters on review of operative techniques, classification of lesions of the abdominal wall, and anesthetic problems contribute marginally to the overall worth. The monograph could be improved by better and more extensive use of photographs and a less pedantic translation. The overall presentation of the material is above average but falls short of being excellent.
Human epithelial cells trigger dendritic cell–mediated allergic inflammation by producing TSLP
Authors: Vassili Soumelis, Pedro A. Reche, Holger Kanzler, Wei Yuan, Gina Edward, Bernhart Homey, Michel Gilliet, Steve Ho, Svetlana Antonenko, Annti Lauerma, Kathleen Smith, Daniel Gorman, Sandra Zurawski, Jon Abrams, Satish Menon, Terri McClanahan, Rene de Waal-Malefyt, Fernando Bazan, Robert A. Kastelein, Yong-Jun Liu
Journal: Nature Immunology (2002)
Geriatric Emergency Medicine
Authors: Paul Rousseau
Journal: JAMA (1992)

The editors of this unique tome have assembled a plenitude of knowledgeable contributors who, in 53 chapters, competently cover a neglected but consequential field of geriatric medicine. Unfortunately, inaugural publications often contain omissions, oversights, and errors, and this book is no exception, although such errors do not detract from its clinical utility. One of the notable deficiencies of this book is a paucity of references for statements that clearly require substantiation. During a discourse on drug therapy in chapter 5, the author devotes three paragraphs to the discussion of a five-year multicenter trial on the use of diltiazem in postinfarction patients, but fails to reveal a source for the data; comparable omissions occur at least three times in the same chapter. A similar circumstance occurs in chapter 7, in which text presented in table format implies that age-related loss of brain weight contributes to dementia. Lamentably, such a contention lacks
Frequency-dependent effects of diltiazem on the atrioventricular node during experimental atrial fibrillation.
Authors: M Talajic, M Nayebpour, W Jing, S Nattel
Journal: Circulation (1989)

Calcium channel blockers depress atrioventricular (AV) nodal properties in vivo in a frequency-dependent manner, suggesting that selective drug action during supraventricular arrhythmias may result from use-dependent properties. The present study was designed to examine whether or not the rate-dependent actions of diltiazem account for its therapeutic effects during atrial fibrillation. The determinants of the ventricular response to atrial fibrillation (concealed AV nodal conduction and AV node functional refractory period, AVFRP) were evaluated at multiple cycle lengths (with extrastimulus techniques) and during electrically induced atrial fibrillation (with indirect indexes from RR interval histograms) in anesthetized dogs. In the presence of diltiazem, AVFRP increased progressively relative to control as rate accelerated. At cycle lengths comparable to sinus rhythm in humans, AVFRP increased 10%, 17%, and 32% after doses 1, 2, and 3 of diltiazem, respectively. Drug-induced increases in AVFRP were greater at basic cycle lengths just above the Wenckebach point (17%, 48%, and 81%) and were maximal during atrial fibrillation (39%, 86%, and 154% increases for doses 1, 2, and 3, respectively). Diltiazem also increased the AV conduction system effective refractory period, thereby increasing the potential zone of concealment into the AV node. Frequency-dependent increases in the zone of concealment were produced by diltiazem and were associated with marked increases in the standard deviation of RR interval histograms during atrial fibrillation (257%, 526%, and 923% increases after doses 1, 2, and 3, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)
Characterization of the IGF axis components in isolated rat hepatic stellate cells
Authors: Jens-Gerd Scharf, Thomas Knittel, Frank Dombrowski, Lars Müller, Bernhard Saile, Thomas Braulke, Heinz Hartmann, Giuliano Ramadori
Journal: Hepatology (1998)

The insulin-like growth factors I and II (IGF-I, -II) are circulating peptides known to participate in the regulation of metabolism, growth, and cellular differentiation. In the present study, "early cultured" (days 2-3 of culture) and "culture-activated" (days 6-7 of culture) rat hepatic stellate cells (HSCs) were analyzed for expression of individual components of the IGF axis. Northern blot analysis of IGF-I messenger RNA (mRNA) revealed transcripts of 7.5, 4, 2, and 1.0 to 1.5 kb in culture-activated HSCs, while early cultured HSCs did not express IGF-I mRNA. In culture-activated HSCs, an IGF-I secretion of 8.3+/-2.5 ng/10(6) cells per 24 hours was determined radioimmunologically. In media from early cultured HSCs, IGF-I was not detectable. The IGF-I receptor (IGF-I-R) mRNA expression was three-fold higher in early cultured HSCs than in culture-activated HSCs. By immunohistochemistry, a decrease of IGF-I-R expression of HSCs in vivo following CCl4-induced liver damage was noted as well. IGF binding proteins (IGFBPs) were detected in conditioned media from HSCs by 125I-IGF-I ligand blotting at apparent molecular masses of 24 and 41 to 45 kd that were immunologically identified as IGFBP-4 and -3, respectively. Synthesis of these IGFBPs increased with time of culture. At neutral pH, no IGFBP proteolysis was observed in conditioned media of early cultured and culture-activated HSCs, whereas at acidic pH, protease activities against IGFBP-3 and -4 were detectable. IGFBP protease activities were completely abolished by inhibitors of aspartyl and cysteine proteases. Addition of 100 nmol/L IGF-I stimulated cell proliferation of early cultured HSCs 5.6+/-1.1- and 4.6+/-0.2-fold as measured by [3H]thymidine and 5-bromo-2'-deoxyuridine incorporation, respectively. In culture-activated HSCs, proliferation was increased 1.2+/-0.1-fold in the presence of 100 nmol/L IGF-I in both proliferation assays. It can be concluded that due to a higher expression of the IGF-I-R and lower levels of IGFBPs, early cultured HSCs are more susceptible to the mitogenic actions of IGFs than the culture-activated HSCs. The present data suggest a role for the IGF axis components in the initiation rather than the perpetuation of HSC proliferation during hepatic fibrogenesis.
CEVITAMIC ACID (ASCORBIC ACID) IN THE TREATMENT OF INFANTILE SCURVY
Authors: Arthur F. Abt
Journal: JAMA (1935)

Not only is the isolation of a vitamin in crystalline form a matter of theoretical importance but such a discovery also has possibilities in practical clinical application. In 1928 Szent-Györgi<sup>1</sup>isolated a chemical which he thought was hexuronic acid and which he believed to be identical with vitamin C. Well controlled experiments on laboratory animals with this substance demonstrated that it protected against scurvy and cured this disease when experimentally produced. Zilva<sup>2</sup>in 1932 and Waugh and King<sup>3</sup>in the same year published the results of such work. In 1933 the name of the isolated acid was changed to ascorbic acid, as its chemical formula became better known and it was found not to be a hexuronic acid. More recently the Council on Pharmacy and Chemistry of the American Medical Association has designated cevitamic acid as the approved nonproprietary name for this substance.<sup>4</sup> Merck and Company, who have supplied us with
Cell proliferation in three types of Barrett's epithelium
Authors: L J Pellish, J A Hermos, G L Eastwood
Journal: Gut (1980)

Barrett9s epithelium is a columnar, possibly premalignant, metaplasia of the oesophagus. To study the pattern of epithelial renewal in this disorder, we localised the lower oesophageal sphincter by manometry in 12 patients with known Barrett9s epithelium, obtained multiple suction biopsies above the sphincter, and organ cultured the biopsies over 3H-TdR-containing medium to label proliferating cells. Of 23 biopsies from the 12 patients, 13 were specialised columnar type, three were junctional type, and seven were fundic type. None of the patients showed clinical evidence of oesophageal carcinoma, and oesophageal cytological examinations were uniformly negative for neoplastic cells. When compared with control gastric fundic biopsies from normal volunteers, mean values for the labelling index and the proportion of the pit which was occupied by the proliferative zone in Barrett9s biopsies were not significantly different. However, four individual Barrett9s biopsies (three specialised columnar type and one junctional type) did have a proliferative zone which occupied a greater proportion of the pit than did the widest control zone. We propose that the pattern of epithelial proliferation in Barrett9s epithelium in general is similar to that found in other gastrointestinal columnar epithelia. However, a minority of patients with Barrett9s epithelium may have an expanded proliferative zone. The clinical implications of an expanded proliferative zone with regard to the subsequent development of oesophageal carcinoma require further investigation.
THE TREATMENT OF XANTHOMATOSIS WITH ATROMID.
Authors: PETER BORRIE
Journal: British Journal of Dermatology (1964)

Journal Article THE TREATMENT OF XANTHOMATOSIS WITH ATROMID. Get access PETER BORRIE, M.A., M.D., F.R.C.P. PETER BORRIE, M.A., M.D., F.R.C.P. Department of Dermatology, St. Bartholomew's Hospital, London, E.C.I Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 76, Issue 2, 1 February 1964, Pages 53–55, https://doi.org/10.1111/j.1365-2133.1964.tb14474.x Published: 01 February 1964