tbuckley/cabot-search huggingface dataset:
The Future of Pediatrics-Reply
Authors: Thomas M. Gorey
Journal: JAMA (1987)

<h3>In Reply.—</h3> While the Council does not directly address the issue of AIDS, or for that matter other specific disease systems, in its environmental analysis of the pediatric specialty, the report highlights the rise in a "new morbidity" associated with changes in family structures and the social environment that have resulted in an increased awareness of the needs of children and adolescents for behavioral counseling and sex education. Pediatric practice associated with the rise in the new morbidities and adolescent medicine clearly should include appropriate educational efforts to reduce the spread of AIDS.
A Reply to Dr. Donald Maclean's "Open Letter to the Members and Friends of the Medical Profession (Regular) in Michigan."
Authors: E. L. Shurly
Journal: JAMA (1896)

Detroit, Mich., July 27, 1896. <h3>To the Editor:</h3> —The Michigan Medical Legislation League is the outcome of a series of<i>public</i>meetings called (through the newspapers) by the Wayne County Medical Society (regular) for the purpose of enlisting the coöperation of all registered practitioners of medicine in this State, in an effort to secure from the next legislature a law to establish an adequate standard of qualification for all persons who may desire to practice medicine in Michigan in the future. These meetings were composed of all sorts of medical practitioners, many of whom were " Regulars"<i>good</i>and<i>true</i>. The sentiments expressed in Dr. Maclean's open letter are good; but his sweeping censure of the organization in question, would seem<i>mal apropos</i>, because "The League" is merely a<i>political body</i>, with no object or purpose except the one set forth, viz: that of<i>promot-</i><i>ing legislation</i>for the protection of
Primary Care — The Best Job in Medicine?
Authors: Beverly Woo
Journal: New England Journal of Medicine (2006)

Interview with Beverly Woo on the rewards and challenges of primary care medicine. (08:11)Download I first met Mr. B. during my internship, when he was a 29-year-old musician who had been admitted to the hospital with atypical pneumonia. After he was discharged, he kept his follow-up appointment with me, and I became his primary care physician. During the next 10 years, he succeeded in stopping smoking, and his major concern was his lack of steady employment. Just before turning 40, Mr. B. developed idiopathic thrombocytopenic purpura (ITP). His thrombocytopenia responded to corticosteroids, but it recurred when the dose was tapered. Between the medication and the uncertainty, he became depressed.During the next 10 years, . . .
The Lipid Accumulation Product Is Better Than BMI for Identifying Diabetes: A population-based comparison
Authors: H. S. Kahn
Journal: Diabetes Care (2006)

Gaining weight is associated with diabetes risk (1–3). It may be, however, that gaining lipid is associated more specifically with the development of insulin resistance, pancreatic exhaustion, and diabetes. According to a current pathophysiological model, when available fuels exceed the adipose tissue’s capacity for buffering and safe storage, lipid will be ectopically deposited in nonadipose tissues such as liver, skeletal muscle, and the pancreatic β-cell (4–6). These ectopic lipid deposits are associated with lipotoxicities that in turn lead to insulin resistance and the eventual decline of β-cell function (7, 8). To simplify the recognition of lipid overaccumulation, researchers have devised dichotomous risk markers based on waist circumference and fasting triglyceride concentration (9–11). However, lipid accumulation, like body weight, may not be adequately described by a dichotomous index. This report explores whether a continuous “lipid accumulation product” (LAP) performs better than the continuous BMI (in kilograms divided by the square of height in meters) for identifying adults with insulin resistance, elevated glucose, and diabetes.

The LAP was developed from population-based frequency plots of adult waist circumferences and circulating triglyceride concentrations (10, 12). With aging, the waist circumference increasingly moves away from its minimal adult value (empirically 65 cm for men and 58 cm for women) …
389 Comparison of hepatitis C virus population in plasma, peripheral blood mononuclear cells (PBMC) and cerebrospinal fluid (CSF) of HIV/HCV coinfected patients
Authors: S. Bagaglio, S. Racca, P. Cinque, S. Lodrini, M.A. Grasso, A. Lazzarin, G. Morsica
Journal: Journal of Hepatology (2004)
Audit of admission to medical school: I--Acceptances and rejects.
Authors: I C McManus, P Richards
Journal: BMJ (1984)

A prospective study of the process of application, selection, and admission to medical school was performed. St Mary's Hospital Medical School received 1478 UCCA applications for admission in October 1981: 94 (6.4%) applicants entered St Mary's in October 1981, 436 (29.5%) entered other medical schools, 176 (11.9%) read a subject other than medicine, and 772 (52.2%) did not enter university. The study included 12.6% of all applicants and 12.9% of all entrants to British medical schools in October 1981. Educational qualifications, demographic variables, type of schooling, family background, and the manner of application were examined in relation to overall selection. A level achievement was the major determinant of acceptance. O level achievement, early application, and medical parents had significant but smaller independent effects on the chance of acceptance. Social class, age, sex, and school type did not predict acceptance when corrected for academic and other factors. Few differences in personality, career preference, cultural interests or attitudes were found between those accepted and those rejected.
FDG Uptake in Obturator Internus as an Indicator of Diarrhea
Authors: Nozomi Ozawa, Terue Okamura, Koichi Koyama, Masafumi Noda, Yuichi Inoue
Journal: Clinical Nuclear Medicine (2007)

A 70-year-old man with a history of rectal cancer was examined for recurrence by FDG whole body positron emission tomography (PET). As a result, marked FDG uptake was seen in the perineum. Comparison of the PET image with a CT scan taken 10 days before indicated that the site of FDG uptake was the obturator internus muscle. The patient reported suffering from diarrhea on the day of PET. This case illustrates an unusual pattern of increased FDG uptake in the obturator internus muscle, probably related to contraction because of diarrhea.
Methadone concentrations taken as indicating deaths due to overdose need to be reviewed
Authors: J. Merrill, T. Garvey, C. Rosson
Journal: BMJ (1996)

not injected and is a good alternative to injectable methadone.In detoxification it seems much easier to reduce.Rather than suggesting that the treatment of drug use should be a single strand management package-the use of oral methadone in a restricted and supervised manner-it would be useful to point out the many complex issues relating to drug dependence, which require exploration and constant innovation, evaluation, and modification of policies.
mTOR Kinase Inhibition Causes Feedback-Dependent Biphasic Regulation of AKT Signaling
Authors: Vanessa S. Rodrik-Outmezguine, Sarat Chandarlapaty, Nen C. Pagano, Poulikos I. Poulikakos, Maurizio Scaltriti, Elizabeth Moskatel, José Baselga, Sylvie Guichard, Neal Rosen
Journal: Cancer Discovery (2011)

Abstract mTOR kinase inhibitors block mTORC1 and mTORC2 and thus do not cause the mTORC2 activation of AKT observed with rapamycin. We now show, however, that these drugs have a biphasic effect on AKT. Inhibition of mTORC2 leads to AKT serine 473 (S473) dephosphorylation and a rapid but transient inhibition of AKT T308 phosphorylation and AKT signaling. However, inhibition of mTOR kinase also relieves feedback inhibition of receptor tyrosine kinases (RTK), leading to subsequent phosphoinositide 3-kinase activation and rephosphorylation of AKT T308 sufficient to reactivate AKT activity and signaling. Thus, catalytic inhibition of mTOR kinase leads to a new steady state characterized by profound suppression of mTORC1 and accumulation of activated AKT phosphorylated on T308, but not S473. Combined inhibition of mTOR kinase and the induced RTKs fully abolishes AKT signaling and results in substantial cell death and tumor regression in vivo. These findings reveal the adaptive capabilities of oncogenic signaling networks and the limitations of monotherapy for inhibiting feedback-regulated pathways. Significance: The results of this study show the adaptive capabilities of oncogenic signaling networks, as AKT signaling becomes reactivated through a feedback-induced AKT species phosphorylated on T308 but lacking S473. The addition of RTK inhibitors can prevent this reactivation of AKT signaling and cause profound cell death and tumor regression in vivo, highlighting the possible need for combinatorial approaches to block feedback-regulated pathways. Cancer Discovery; 1(3); 248–59. © 2011 AACR. Read the Commentary on this article by Keniry and Parsons, p. 203 This article is highlighted in the In This Issue feature, p. 189
A High-Resolution Spatiotemporal Atlas of Gene Expression of the Developing Mouse Brain
Authors: Carol L. Thompson, Lydia Ng, Vilas Menon, Salvador Martinez, Chang-Kyu Lee, Katie Glattfelder, Susan M. Sunkin, Alex Henry, Christopher Lau, Chinh Dang, Raquel Garcia-Lopez, Almudena Martinez-Ferre, Ana Pombero, John L.R. Rubenstein, Wayne B. Wakeman, John Hohmann, Nick Dee, Andrew J. Sodt, Rob Young, Kimberly Smith, Thuc-Nghi Nguyen, Jolene Kidney, Leonard Kuan, Andreas Jeromin, Ajamete Kaykas, Jeremy Miller, Damon Page, Geri Orta, Amy Bernard, Zackery Riley, Simon Smith, Paul Wohnoutka, Michael J. Hawrylycz, Luis Puelles, Allan R. Jones
Journal: Neuron (2014)
Delay in GMC hearing breached doctor's human rights
Authors: C. Dyer
Journal: BMJ (2001)

A surgeon who has been suspended on full pay for nearly four years won an unprecedented legal victory last week when the General Medical Council agreed to drop its case against him on the grounds that delay had breached his right to a fair trial under the Human Rights Act.

John Rogers, an honorary consultant at the Royal London Hospital and senior lecturer at Queen Mary and Westfield College of the University of London, was suspended by the college in January 1998 …
Cefoperazone-treated mice as an experimental platform to assess differential virulence of<i>Clostridium difficile</i>strains
Authors: Casey M. Theriot, Charles C. Koumpouras, Paul E. Carlson, Ingrid I. Bergin, David M. Aronoff, Vincent B. Young
Journal: Gut Microbes (2011)

The toxin-producing bacterium C. difficile is the leading cause of antibiotic-associated colitis, with an estimated 500,000 cases C. difficile infection (CDI) each year in the US with a cost approaching 3 billion dollars. Despite the significance of CDI, the pathogenesis of this infection is still being defined. The recent development of tractable murine models of CDI will help define the determinants of C. difficile pathogenesis in vivo. To determine if cefoperazone-treated mice could be utilized to reveal differential pathogenicity of C. difficile strains, 5–8 week old C57BL/6 mice were pretreated with a 10 d course of cefoperazone administered in the drinking water. Following a 2-d recovery period without antibiotics, the animals were orally challenged with C. difficile strains chosen to represent the potential range of virulence of this organism from rapidly fatal to nonpathogenic. Animals were monitored for loss of weight and clinical signs of colitis. At the time of harvest, C. difficile strains were isolated from cecal contents and the severity of colitis was determined by histopathologic examination of the cecum and colon. Cefoperazone treated mice challenged with C. difficile strains VPI 10463 and BI1 exhibited signs of severe colitis while infection with 630 and F200 was subclinical. This increased clinical severity was correlated with more severe histopathology with significantly more edema, inflammation and epithelial damage encountered in the colons of animals infected with VPI 10463 and BI1. Disease severity also correlated with levels of C. difficile cytotoxic activity in intestinal tissues and elevated blood neutrophil counts. Cefoperazone treated mice represent a useful model of C. difficile infection that will help us better understand the pathogenesis and virulence of this re-emerging pathogen.
Authors' reply to McMinn and colleagues and Caan
Authors: T. M. Marteau, P. A. Hall
Journal: BMJ (2013)

McMinn and colleagues describe evidence to support the bidirectional nature of the association between executive function and health related behaviour in older people.1 This highlights the potential for intervention across the lifespan to break the negative feedback loops described in our recent editorial.2

Nuance is invariably lost in an editorial …
Pharmaceutical Price Controls and Patient Welfare
Authors: John E. Calfee
Journal: Annals of Internal Medicine (2001)

Price controls could have a substantial negative effect on pharmaceutical research and development. Extensive research is required before the development costs of a new drug or its benefits are known; most new drug development projects fail, sometimes after substantial financial and time costs. These conditions pose intractable practical problems for the operation of price controls, which cannot rest on objective, predictable standards such as the benefits or costs of individual drugs. In the absence of objective standards, pressure from health care providers and others would create powerful incentives for price regulators to decrease drug prices toward marginal costs of production and distribution, well below levels sufficient to reward innovative research. This downwardly biased price-setting mechanism would apply with particular force to the few successful projects that yield innovative drugs, whose prices would not be set by regulatory authorities until after research expenditures have been incurred and the new drugs are ready to enter the market. Manufacturers will expect price controls to reduce the potential payoffs from breakthrough drugs. This expectation would substantially reduce the incentives to pursue innovative research, as is evident in advanced economies in which price controls are now in force. Once established, price controls for pharmaceuticals, like those for medical services in the Medicare system, would also tend toward complexity and entrenchment of vested interests and could easily become permanent regardless of the harm they cause to patients.
Death From Myocardial Infarction After Exercise Test With Normal Result
Authors: Arthur B. Lintgen
Journal: JAMA (1976)

Death from acute myocardial infarction immediately followed a submaximal exercise test with a normal result in a 56-year-old man. Hemorrhage into an intimal atherosclerotic plaque with superimposed, intraluminal clot formation was the cause of coronary artery occlusion. It is probable that the exercise precipitated an intramural capillary rupture and intimal hemorrhage or caused further hemorrhage into a preexisting intimal hematoma. The resulting luminal narrowing and intimal rupture with superimposed clot formation caused coronary artery occlusion. (<i>JAMA</i>235:837-839, 1976)
OHIO-DISTRICT OF COLUMBIA RECIPROCITY
Authors: H. M. Platter
Journal: JAMA (1930)

<h3>To the Editor:</h3> —My attention has been called to a letter inThe Journal, February 15, in which Dr. W. C. Fowler, secretary-treasurer for the Commission on Licensure for the District of Columbia, writes concerning the action of the Ohio board in severing reciprocal relations in medical licensure with the district. For the first time the Ohio board learns that the District of Columbia Basic Science Board is not satisfied with the examinations given by Ohio in the subjects of anatomy, physiology, chemistry, bacteriology and pathology. No request has been made to this office to furnish the Basic Science Board with the questions given in Ohio. The District of Columbia could easily have obtained this information directly or could have learned from the American Medical Association offices that the Ohio examination occupies a period of three days—two days of written and one of practical, oral and bedside work, and further
Puzzling Jaundice
Authors: Telfer B. Reynolds
Journal: JAMA (1970)

Four women, ages 47 to 86 years, had a similar, moderately severe illness characterized by fatigue, vague abdominal symptoms, jaundice, and moderate hepatomegaly. Laboratory abnormalities consisted of hyperbilirubinemia, moderate to marked increase in transaminase activity (peak serum glutamic pyruvic transaminase level, 640 to 2,160 Karmen units/ml), and moderate alkaline phosphatase level increase. Liver biopsy in two patients showed portal lymphoid proliferation and evidence of moderate hepatocellular necrosis. All patients had been taking a laxative containing dioctyl sodium sulfosuccinate, carboxymethylcellulose sodium, and oxyphenisatin acetate (Dialose Plus). Two of the ingredients contained in Dialose Plus (dioctyl sodium sulfosuccinate and carboxymethylcellulose sodium) are nonabsorbable while the other ingredient (oxyphenisatin acetate) is a propellant which is excreted in the bile and is presumed to be the cause of the hepatic reaction. Jaundice subsided when Dialose Plus therapy was stopped and recurred in two patients when it was restarted. The other two patients under observation in the hospital were challenged with Dialose Plus with positive results.
THE ASEPTIC TANNIC ACID TREATMENT OF DIFFUSE SUPERFICIAL BURNS
Authors: DONALD B. WELLS
Journal: JAMA (1933)

Since the time of Hippocrates,<sup>1</sup>who left detailed and complicated prescriptions for the treatment of burns, probably every medical practitioner of any considerable experience has followed some favorite or original treatment of the burns that have come under his care. I am no exception to this rule. Such ideas of treatment as I have formulated are based entirely on clinical experience. I have no foundation of controlled scientific experiment to support my results, no extensive laboratory data to substantiate my beliefs, very little to prove my point, except the clinical records. I have been stimulated to present the details of this treatment through the interest taken in it not only by the staff of the Hartford Hospital, but by the Massachusetts General Hospital, where burns have been made a special assignment under the direction of Dr. Richard H. Wallace,<sup>2</sup>and the method of treatment here presented is being
Time course of smooth muscle cell proliferation in the intima and media of arteries following experimental angioplasty.
Authors: H Hanke, T Strohschneider, M Oberhoff, E Betz, K R Karsch
Journal: Circulation Research (1990)

Smooth muscle cell (SMC) proliferation is known to be an important factor for the development of restenosis after percutaneous transluminal coronary angioplasty. To determine the time course of intimal and medial SMC proliferation and morphological changes after experimental angioplasty, an intimal atheroma was produced with repeated weak electrical stimulations in the right carotid artery of 45 male New Zealand White rabbits. Angioplasty was subsequently performed in 35 rabbits, and the proliferative responses were analyzed with histomorphological and immunohistological criteria at 3, 7, 14, 21, 28, and 42 days after intervention. A hemodynamic relevant stenosis after angioplasty was found in eight (23%) of 35 dilated arteries. In five rabbits the stenosis was due to a mural thrombus, and in three animals restenosis was caused by intimal SMC proliferation. In all dilated arteries the intimal wall thickness increased from 13 +/- 5 intimal cell layers (after electrical stimulation) to 33 +/- 14 cell layers during 28 days after angioplasty (p less than 0.05). Later than 4 weeks after angioplasty, no additional increase of intimal thickening occurred. Application of bromodeoxyuridine 18 and 12 hours before excision of the vessels allowed determination of the percent of cells undergoing DNA synthesis in the intima and media using monoclonal antibody against bromodeoxyuridine. SMCs were identified by alpha-actin staining. Immunohistological quantification of intimal SMC proliferation showed a maximum of cells undergoing DNA synthesis within the first 7 days after angioplasty (p less than 0.01). In contrast, medial proliferation of SMCs was delayed and showed a small but significant increase 21 days after dilatation (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Smoking and Lung Function of Lung Health Study Participants after 11 Years
Authors: Nicholas R. Anthonisen, John E. Connett, Robert P. Murray
Journal: American Journal of Respiratory and Critical Care Medicine (2002)

Section:ChooseTop of pageAbstract <<METHODSRESULTSDISCUSSIONAPPENDIXReferencesCITING ARTICLES
THE OCCURRENCE OF GOUT IN THE UNITED STATES: WITH AN ANALYSIS OF THIRTY-SIX CASES.
Authors: THOMAS B. FUTCHER
Journal: JAMA (1902)

hesions; the consequent limitation of motion is a fatal hindrance to the restoration of muscular tone.In studying the surgical relations of traumatisms •of the peripheral nerves the following conclusions are justified :1. Section or laceration of a nerve, if of some size, is usually recognized at the first examination.2. Contusions of nerves are common, the symptoms often being latent until neuritis develops ; the latter may be delayed some days.3. Contusion of a nerve may complicate any fracture or dislocation, but is especially frequent in dislocations of the shoulder.4. Injury to the circumflex nerve merits special men- tion because of its frequency, the ease with which it is overlooked and its serious consequences.5. The "reflex paralysis" after joint injury is prob- ably due to a traumatic neuritis.6.The management of the joint tendon and muscular complications comprises in the main the treatment of traumatic neuritis.
Regional myocardial blood flow in the dog studied with radioactive microspheres
Authors: N. J. Fortuin, S. Kaihara, L. C. Becker, B. Pitt
Journal: Cardiovascular Research (1971)

Regional myocardial blood flow was studied in the anaesthetized dog by determining the distribution of 15 and 50μ radioactive microspheres after left atrial injection. Doses of the 15μ spheres below 4 × 106 did not significantly alter coronary or systemic haemodynamics. Larger doses produced a significant increase in mean aortic pressure. Less than 1% of the 15μ spheres delivered to the heart passed into the coronary sinus. The myocardial distribution of 15 and 50μ spheres was not significantly different except for the ratio of left ventricular endocardium to epicardium (1·12 for 15μ and 1·45 for 50μ, P<0.001). Using 15μ spheres, it was found that the ratio of endocardial to epicardial radioactivity in the left ventricular wall was increased by propranolol, decreased by isoprenaline, and unchanged by nitroglycerin.
Transient Disturbances of Consciousness in Hepatic Cirrhosis
Authors: A. G. W. Whitfield, W. M. Arnott
Journal: BMJ (1951)

The occurrence, in hepatic cirrhosis, of transient dis turbances of consciousness which cannot be related to cholaemia was mentioned by Osier in 1892. Himsworth (1947) states :  Coma is peculiar in possessing no strik ing features. The patient seems quietly asleep?limbs have a peculiar ' clasp-knife ' rigidity, not unlike that in Parkinson's syndrome, and the plantar reflexes are extensor . . . the majority then quietly die, but recovery sometimes occurs even at this stage. Otherwise this syndrome has received scant attention in the medical literature, and it was thought that it might be of value to revive interest in the condition by publishing a brief account of three such cases.