tbuckley/cabot-search huggingface dataset:
Changes in Medical Education
Authors: RICHARD E. THOMPSON
Journal: Annals of Internal Medicine (1973)

Comments and Corrections1 December 1973Changes in Medical EducationRICHARD E. THOMPSON, M.D.RICHARD E. THOMPSON, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-79-6-907_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: In his article, "The Crisis in Medical Education" (Ann Intern Med 79:119-123, 1973), Dr. Barry Stimmel raises many obvious questions about proposed changes in medical education. But he errs, with many, in failing to perceive any possible good in these changes, beyond increased numbers of physicians. Being educated under the Flexnerian system, it is difficult for us to let our minds "free-wheel" and consider that the present "existing high quality of medical training" is beyond question only if we are discussing the training of tertiary-care physicians.There is much interest in changes in medical education because the...Reference1. HICKS N: Later licensing of doctors asked. New York Times, 23 July 1973 MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Pediatric Services The Medical Center Hospital Columbus, Georgia PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 December 1973Volume 79, Issue 6Page: 907-908KeywordsMedical education Issue Published: 1 December 1973 PDF downloadLoading ...
TCT-298 Predictive value of Carotid Inflammation for the Presence of Multivessel Coronary Artery Disease
Authors: Georgios Benetos, Konstantinos Toutouzas, Maria Drakopoulou, Georgios Trantalis, Archontoula Michelongona, Andreas Katsaros, Iosif Koutagiar, Eleftherios Tsiamis, Elias Siores, Christodoulos Stefanadis
Journal: Journal of the American College of Cardiology (2014)
Inflammatory mechanisms of dilative remodeling after intracoronary beta radiotherapy
Authors: Pawel T. Zymek, Nikolaos G. Frangogiannis, Phong Nguyen-Ho, Spyridion Akrivakis, Alida J. Evans, Daryl G. Schulz, Mark L. Entman, Grzegorz L. Kaluza, Albert E. Raizner
Journal: Journal of the American College of Cardiology (2003)
Occupational hazards in window cleaning.
Authors: B F Ribeiro
Journal: BMJ (1975)

Accidental falls involving window cleaners treated at the Middlesex Hospital over five years are reviewed. Failure to use safety belts and the lack of suitable anchorage points were contributary factors in all 20 patients. The use of protective equipment and the provision of anchorage points should be enforced. While the doctor9s duty is to treat injuries he also has the opportunity to draw attention to their prevention.
Hypophosphataemic osteomalacia associated with prostatic carcinoma.
Authors: P Murphy, G Wright, G S Rai
Journal: BMJ (1985)

Etude de 4 observations: sur 15 malades atteints de cancer de la prostate, 4 presentent une hypophosphatemie avec osteomalacie; la phosphatase alcaline est tres augmentee. Ces malades sont traites par alfacalcidol et stilbœstrol. Amelioration clinique
IMPACT OF MYOCARDIAL BRIDGE ON CLINICAL OUTCOME: IN CASES OF SIROLIMUS-ELUTING-STENT IMPLANTATION ON LEFT ANTERIOR DESCENDING CORONARY ARTERY
Authors: Daiji Hasegawa, Kazushige Kadota, Yuki Tsujimoto, Kentaro Shibayama, Naoki Saito, Suguru Otsuru, Yoji Okamoto, Mana Kusunose, Masao Imai, Hiroshi Tasaka, Ippei Kosedo, Yoshikazu Shigemoto, Seiji Habara, Hiroyuki Tanaka, Tekeshi Maruo, Akitoshi Hirono, Yoshiharu Nishibori, Shingo Hosogi, Yasushi Fuku, Naoki Oka, Harumi Katoh, Hiroyuki Yamamoto, Satoki Fujii, Tsuyoshi Goto, Kazuaki Mitsudo
Journal: Journal of the American College of Cardiology (2010)
Flexible Use of Nuclear Import Pathways by HIV-1
Authors: KyeongEun Lee, Zandrea Ambrose, Thomas D. Martin, Ilker Oztop, Alok Mulky, John G. Julias, Nick Vandegraaff, Joerg G. Baumann, Rui Wang, Wendy Yuen, Taichiro Takemura, Kenneth Shelton, Ichiro Taniuchi, Yuan Li, Joseph Sodroski, Dan R. Littman, John M. Coffin, Stephen H. Hughes, Derya Unutmaz, Alan Engelman, Vineet N. KewalRamani
Journal: Cell Host & Microbe (2010)
Hepatic collagen synthesis and degradation during liver regeneration after partial hepatectomy
Authors: Hiroko Yamamoto, Yoshikazu Murawaki, Hironaka Kawasaki
Journal: Hepatology (1995)

To elucidate hepatic collagen metabolism during liver regeneration after partial hepatectomy, we measured collagen content, collagen synthesis, and collagen-degrading enzyme activity in the remnant livers of rats 3, 5, 7, and 14 days after a partial hepatectomy of 68%. Hepatic collagen synthesis was significantly higher 3, 5, and 7 days after partial hepatectomy than it was in sham-operated control rats, but there was no such difference 14 days after surgery, the maximal hepatic collagen synthesis being observed 5 days after surgery. Although the collagen concentration in the remnant liver was similar to that in the control liver, the total collagen content of the remnant liver increased rapidly with liver regeneration until 7 days after partial hepatectomy. Hepatic collagenase activity was similar to the control; however, hepatic cathepsin B and cathepsin L activity and the intracellular degradation of newly synthesized collagen were markedly decreased 3, 5, and 7 days after partial hepatectomy compared with the controls. Hepatic collagen synthesis was significantly and inversely correlated with cathepsin L activity and with the intracellular degradation of newly synthesized collagen. These findings suggest that a combination of increased collagen synthesis and decreased intracellular collagen degradation contributes to the rapid supply of collagen that is observed during the early phase of liver regeneration.
Respiratory Myoclonus (Leeuwenhoek's Disease)
Authors: James R. Phillips, Frederic L. Eldridge
Journal: New England Journal of Medicine (1973)

Electromyographic studies in a patient with repetitive involuntary contractions of the diaphragm (generally termed diaphragmatic flutter) revealed not only abnormal electrical activity in the diaphragm but synchronous abnormalities in other inspiratory muscles. The abnormalities were consistent with a form of myoclonus involving the respiratory muscles and similar to palatal myoclonus. A Central-nervous-system lesion probably caused the myoclonus, as suggested by evidence of a defect in neural respiratory control in this patient. In the past, the only effective form of therapy has been phrenicectomy. However, results suggest that diphenylhydantoin may be an effective pharmacologic mode of therapy in some patients. (N Engl J Med 289:1390–1395, 1973)
Delivering inhaled corticosteroids to patients
Authors: C. O'Callaghan, P. Barry
Journal: BMJ (1999)

Inhaled steroids play an extremely important part in the treatment of asthma. They are now regarded as the first line prophylactic drug for adults1 and are used by many as a first line prophylactic agent for children. Important side effects are rarely seen in users of low dose inhaled steroids, but there is concern over the potential effects of high dose inhaled steroids. The Committee on Safety of Medicines has recently concluded that clinically important systemic adverse effects can occur at licensed doses of inhaled corticosteroids,2 the risks being increased after prolonged high dose therapy. Effects mentioned included adrenal suppression, osteoporosis or changes in bone mineral density, growth retardation in children, cataracts, and glaucoma. A major problem in trying to identify possible side effects—and, indeed, in assessing clinical trials of inhaled steroids—is determining the amount of drug patients have actually inhaled. Compliance and inhaler technique vary considerably, but even when these are optimal the dose of drug inhaled may vary by up to fourfold without the …
The diagnosis of Alzheimer-type dementia. A preliminary comparison of positron emission tomography and proton magnetic resonance
Authors: R. P. Friedland
Journal: JAMA (1984)

DESPITE recent advances in our understanding of the pathophysiology of Alzheimer's disease (AD), we remain unable to make the diagnosis noninvasively, except by exclusion. While computed tomography (CT) is of great value in indicating the absence of other dementing illnesses, it cannot be relied on to confirm the diagnosis of AD. The cortical and ventricular atrophy present in AD is not apparent in all cases and often cannot be distinguished from the changes on CT in healthy, aged persons.<sup>1</sup>The more recently developed technique of positron emission tomography (PET) has been used with a labeled glucose analogue (<sup>18</sup>F)-2-fluoro-2-deoxy-D-glucose (FDG) to study glucose metabolism in dementia non-invasively. Specific regional alterations, particularly in the temporalparietal cortex, have been found.<sup>2-5</sup>Magnetic resonance (MR) imaging is another powerful new technology that is beginning to be applied to dementia. In this report we present a comparison of the findings in PET-FDG studies
Association of palmoplantar keratoderma, cutaneous squamous cell carcinoma, dental anomalies, and hypogenitalism in four siblings with 46,XX karyotype: A new syndrome
Authors: Giuseppe Micali, Maria Rita Nasca, Daniele Innocenzi, Lucretia A. Frasin, Orietta Radi, Pietro Parma, Giovanna Camerino, Robert A. Schwartz
Journal: Journal of the American Academy of Dermatology (2005)
Medical Students’ Paradox: Drug Company Materials Biased Yet Helpful, They Say
Authors: Rebecca Voelker
Journal: JAMA (2011)

tion wants the United States to sustain and protect its investment in global health research and product development, develop concrete plans to incorporate research and development as a key priority within US global health programs, and ensure that US investments in global health research are coordinated, efficient, and streamlined. The report also focuses on the US Food and Drug Administration (FDA) and its ability to regulate health products to prevent, diagnose, and treat widespread infectious diseases. Specifically, the report suggests that the FDA make public the recommendations of its neglected disease review group (which advises the FDA commissioner about potential options to support and facilitate the development and evaluation of medical products to prevent, diagnose, and treat neglected diseases of the developing world) and allow for public comment. The coalition is urging the FDA to establish stronger partnerships with other regulatory stakeholders, suchas the World Health Organization and the European Medicines Agency, and to enhance its capacity in handling neglected diseases and better engage with groups developing global health tools. “The current system for global health products is complex, and the FDA has an opportunity to partner with the World Health Organization and nonprofits developing and distributing those products,” Christenson said.
Activation of the aryl hydrocarbon receptor in vivo primes human T cells for interleukin 22 production and inhibits Th17 cells
Authors: J-M Ramirez, N C Brembilla, O Sorg, R Chicheportiche, T Matthes, J-M Dayer, J-H Saurat, E Roosnek, C Chizzolini
Journal: Annals of the Rheumatic Diseases (2010)

Ligands of the aryl hydrocarbon receptor (AHR), a transcription factor mediating dioxin effects, favour Th17 cell differentiation and exacerbate autoimmunity in mice. The authors investigated how AHR ligands affect human T cell polarisation. The high affinity and stable AHR ligand dioxin as well as the natural AHR ligand …
REPORT ON THE PROGRESS IN ACTINOTHERAPY DURING THE PAST YEAR.
Authors: WILLIAM S. GOTTHEIL
Journal: JAMA (1905)

My report will be comparatively brief, since the past year has not been marked by any very important changes or improvements in the actinotherapeutic method. The workers in the field are still few, and for obvious reasons. The apparatus required for its effective employment is, it must be confessed, large and expensive. It is essentially one forinstitution use; for the cost of installation, the room required, the length of time of treatment, and the restricted classes of patients for which it is useful, do not commendit to the general practitioner. Nevertheless, in the cases for which it is suited it is pre-eminently useful; and this has been generally recognized in Europe, where all the larger cities now have special institutions for the Finsen light treatment. St. Petersburg, for instance, has no less than three,<sup>1</sup>and through the bounty of the queen a very perfectly
Epilepsy: 199 Answers: A Doctor Responds to His Patients' Questions
Authors: Fritz E. Dreifuss
Journal: JAMA (1997)

The subtitle of this book,"A Doctor Responds to His Patients' Questions," introduces the reader to the format of responses to many of the questions that follow on a diagnosis of a seizure disorder. Several things become obvious right away. The author is an experienced epileptologist who has thought carefully about the problems encountered by patients, their friends and relatives, physicians, nurses, and social workers. The realization that one is suffering from a seizure disorder, or that this is the affliction suffered by a loved one, frequently comes as a shock, and the medical interview during which this comes about may not be the time to formulate or to answer all the questions that arise. A sympathetic physician and, in a comprehensive epilepsy program, associated health care providers will make time available to discuss questions and problems that arise after the dust has settled and an overall management plan can be
The Mystery of the Mind: A Critical Study of Consciousness and the Human Brain
Authors: William C. Gibson
Journal: JAMA (1976)

This little volume is a veritable odyssey. Truly, Wilder Penfield could say with the poet, "I am a part of all that I have met." Nonspecialist health practitioners of all types will share with lay readers the thrill of reading at first hand the words of conscious patients, part of whose brain is gently stimulated with minute electrodes, as the vulnerable speech area is delineated protectively. Excellent line drawings set the stage for the elegant explanations, and for the detective story drama that unfolds. The central theme is, of course, the contentious issue of the brain and the mind. Historians will find refreshingly modern the words of Hippocrates: "To consciousness the brain is messenger." Equally refreshing is Dr Penfield's habit—too often lacking in younger surgeons—of listening to the patient. He used to tell us in clinics that an intelligent patient could usually make the diagnosis for the physician—if the latter
Generalized Reactions to Thyrotropin
Authors: Robert E. Mack
Journal: JAMA (1965)

<h3>To the Editor:—</h3> I read with considerable interest the report of Drs. Sherman and Werner (<i>JAMA</i><b>190</b>: 244 [Oct 19] 1964) of a generalized allergic reaction which occurred after the injection of bovine thyrotropin ( TSH). This case report emphasizes a complication which may be encountered when TSH is used on repeated occasions for radioactive iodine studies. In a previous publication (Mack, R.E., et al: Management of Thyroid Carcinoma,<i>JAMA</i><b>163</b>:15 [Jan 5] 1957) the occurrence of a generalized reaction (vascular collapse, hives, and angioneurotic edema) after TSH injection in one of the illustrative cases (Case 1) is described. Reference is made in the text (p 19, Comment section) to a similar reaction which was encountered after administration of TSH in a patient with primary hypothyroidism. In neither of our cases was any attempt made to distinguish between TSH and the contaminating serum proteins as the offending antigen. Because of
Safety of coprescribing NSAIDs with multiple antihypertensive agents
Authors: D. Nitsch, L. A. Tomlinson
Journal: BMJ (2013)

Current guidelines by the National Institute for Health and Clinical Excellence (NICE) recommend treatment with angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) for conditions such as hypertension, 1 chronic heart failure, 2 and proteinuric chronic kidney disease. 3 In England, the prescription of these drugs has increased by 15.8% over the past four years. 4Because ACE inhibitors and ARBs are often coprescribed with non-steroidal anti-inflammatory drugs (NSAIDs) and diuretics, particularly in older people, 5 we need to know more about the safety of such combinations.In a linked paper (doi:10.1136/bmj.e8525),Lapi and colleagues used a large database that was representative of UK primary care to examine data on 487 372 patients taking antihypertensive drugs. 6They used a nested case-control design to examine whether adding an NSAID to an ACE inhibitor, ARB, or diuretic in double or triple therapy combinations increased the risk of subsequent hospital admission with acute kidney injury.Acute kidney injury is seen in more than 20% of hospital inpatients and is associated with around half of all potentially preventable deaths in hospital. 7 8Although recent observational evidence suggests a link between this condition and use of diuretics, NSAIDs, ACE inhibitors, and ARBs, 9 such studies are confounded by indication.Patients who are prescribed a combination of these agents are usually at high risk of acute kidney injury, which makes it difficult to establish a causal association.
Contributions of neuroimaging, balance testing, electrophysiology and blood markers to the assessment of sport-related concussion
Authors: G A Davis, G L Iverson, K M Guskiewicz, A Ptito, K M Johnston
Journal: British Journal of Sports Medicine (2009)

Objective: To review the diagnostic tests and investigations used in the management of sports concussion, in the adult and paediatric populations, to (a) monitor the severity of symptoms and deficits, (b) track recovery and (c) advance knowledge relating to the natural history and neurobiology of the injury. Design: Qualitative literature review of the neuroimaging, balance testing, electrophysiology, blood marker and concussion literature. Intervention: PubMed and Medline databases were reviewed for investigations used in the management of adult and paediatric concussion, including structural imaging (computerised tomography, magnetic resonance imaging, diffusion tensor imaging), functional imaging (single photon emission computerised tomography, positron emission tomography, functional magnetic resonance imaging), spectroscopy (magnetic resonance spectroscopy, near infrared spectroscopy), balance testing (Balance Error Scoring System, Sensory Organization Test, gait testing, virtual reality), electrophysiological tests (electroencephalography, evoked potentials, event related potentials, magnetoencephalography, heart rate variability), genetics (apolipoprotein E4, channelopathies) and blood markers (S100, neuron-specific enolase, cleaved Tau protein, glutamate). Results: For the adult and paediatric populations, each test has been classified as being: (1) clinically useful, (2) a research tool only or (3) not useful in sports-related concussion. Conclusions: The current status of the diagnostic tests and investigations is analysed, and potential directions for future research are provided. Currently, all tests and investigations, with the exception of clinical balance testing, remain experimental. There is accumulating research, however, that shows promise for the future clinical application of functional magnetic resonance imaging in sport concussion assessment and management.
FLUCTUATIONS IN STRIKE INDEX AND SPATIOTEMPORAL PARAMETERS IN PREVIOUSLY INJURED VS UNINJURED RUNNERS
Authors: R Mann, K Meijer, L Malisoux, R Brunner, A Urhausen, C Nuehrenboerger, D Theisen
Journal: British Journal of Sports Medicine (2014)

Background Long-range correlations in running stride interval have been proposed as an indicator of running-related injury (RRI) and found to change with running speed. They have not yet been used to distinguish running style between runners having previously sustained a RRI or not. Objectives To compare long-range correlations and stride-to-stride variability of strike index (SI) and spatiotemporal parameters in previously injured and uninjured runners over various running speeds. We hypothesized significant effects of groups and running speed for these parameters. Design Retrospective, case-control study. Setting Recreational runners. Participants 69 regular male and female runners (currently asymptomatic) either having sustained a RRI during the previous year (n=26) or not (n=43). Risk factor assessment Five 2-minute incremental running intervals were performed at 80, 90, 100, 110 and 120% of the individual typical running speed on a treadmill. SI, contact time (CT), flight time (FT), stride time (ST), duty factor (CT/ST), stride length (SL) and frequency were measured using an insole-based system. Coefficient of variance (CV) and the scaling exponent α of the detrended fluctuation analysis were calculated, and effects were analysed using repeated measures analyses of variance. Main outcome measurements RRI, defined as a pain or complaint to the lower limbs, progressive in nature and influencing running activity for &gt;1 week. Results The RRI group displayed lower CV than the controls for CT (P=.01) and FT (P=.027). Significant differences in α between normalised speeds were found for all variables (P&lt;.048) except SL. CV differed significantly between normalised speeds for ST and SL. No significant interactions were found. Conclusions Previously uninjured runners display significantly greater CV in CT and FT. Long-range correlations of SI and spatiotemporal parameters change according to running speed, but are not significantly different between previously injured and uninjured runners. Further prospective study to confirm these findings is warranted.