tbuckley/cabot-search huggingface dataset:
The College's Ethics Manual
Authors: John E. Foran
Journal: Annals of Internal Medicine (1989)

Letters and Corrections15 December 1989The College's Ethics ManualJohn E. Foran, MDJohn E. Foran, MDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-111-12-1045 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the Editor:There is an instance of seriously flawed logic in theAmerican College of Physicians Ethics Manual(1). TheManualstates that "a physician who objects to abortion on moral, religious, or ethical grounds need not become involved either by proffering advice to the patient or by involvement in the surgical procedure" (2). Immediately after this recognition of the primacy of the physician's properly formed conscience, there follows a contradictory statement: "The physician does have a duty to assure that the patient is provided the option of receiving competent medical advice and care from a qualified colleague who...References1. . American College of Physicians ethics manual. Ann Intern Med. 1989;111:245-52, 327-35. LinkGoogle Scholar2. . American College of Physicians ethics manual. Part 2: the physician and society; research; life-sustaining treatment; other issues. Ann Intern Med. 1989;111:335. Google Scholar3. Higgins T. Man as Man: The Science and Art of Ethics. Milwaukee, Wisconsin: Bruce Publishing Company; 1949:353. Google Scholar4. Hippocrates . Aphorisms. In: Adams F, trans. Hippocratic Writings. Chicago: University of Chicago Press; 1952. Google Scholar1. . American College of Physicians ethics manual. Ann Intern Med. 1989;111:245-52, 327-35. LinkGoogle Scholar2. . American College of Physicians ethics manual. Part 2: the physician and society; research; life-sustaining treatment; other issues. Ann Intern Med. 1989;111:335. Google Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: John E. Foran, MDAffiliations: 111 North Wabash Avenue Chicago, IL 60602 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 December 1989Volume 111, Issue 12Page: 1045-1045 ePublished: 1 December 2008 Issue Published: 15 December 1989 PDF downloadLoading ...
Plasma Cholesterol Levels during Rapid Weight Reduction
Authors: WELDON J. WALKER, JAMES A. WIER
Journal: Circulation (1951)

Twenty-seven obese individuals underwent rapid weight reduction by rigid caloric restriction. During this time there was a slight over-all drop in plasma cholesterol levels. Patients undergoing most rapid weight loss showed the greatest drop in plasma cholesterol. Fear of elevating the plasma cholesterol need not deter the physician from subjecting obese patients to rapid weight reduction
Spanish health workers are granted public authority status to deter patient attacks
Authors: A. G. Rada
Journal: BMJ (2014)

Workers in the Spanish national health service will be granted similar public status to that of police officers under new rules designed to protect them from attacks by patients. 

New legislation that will consider medical professionals as public authorities while exercising their job will be introduced by the end of this year, said Jose Antonio Becerra, coordinator of the assaults observatory (Observatorio de Agresiones) at the organisation of Spanish medical colleges (Organizacion Medica Colegial). The measure will grant all of Spain’s 600 000 health workers similar status to that of police forces and state security bodies and will introduce tougher penalties against patients or their …
Another Abusable Amphetamine
Authors: Basil Jackson
Journal: JAMA (1970)

To  Editor:—  Over  past six months  abuse of yet another type of amphetamine has come to our attention. The drug is methylenedioxyamphetamine (MDA). We have been led to believe that  origin of abuse of this drug is local to Wisconsin, and presently it is one of  most frequently abused drugs within our drug subculture. Recently there has been a largescale arrest of producers of MDA within Wisconsin.  The effects of  drug have been related to us by several adolescent patients. Physically,  only visible change described was widely dilated pupils. However, subjectively,  patients described a mild sense of physical well-being with some increase in taste sensation. This was accompanied by a feeling of numbness or a decreased awareness of bodily sensations. Psychic effects of  drug center around an increased need for interpersonal relationships. This, perhaps, accounts for MDA being known as the
“Doctor, Would You Prescribe a Pill to Help Me … ?” A National Survey of Physicians on Using Medicine for Human Enhancement
Authors: Timothy D. Hotze, Kavita Shah, Emily E. Anderson, Matthew K. Wynia
Journal: The American Journal of Bioethics (2011)

Using medical advances to enhance human athletic, aesthetic, and cognitive performance, rather than to treat disease, has been controversial. Little is known about physicians' experiences, views, and attitudes in this regard. We surveyed a national sample of physicians to determine how often they prescribe enhancements, their views on using medicine for enhancement, and whether they would be willing to prescribe a series of potential interventions that might be considered enhancements. We find that many physicians occasionally prescribe enhancements, but doctors hold nuanced and ambiguous views of these issues. Most express concerns about the potential effects of enhancements on social equity, yet many also believe specific enhancements that are safe and effective should be available but not covered by insurance. These apparently contradictory views might reflect inherent tensions between the values of equity and liberty, which could make crafting coherent social policies on medical enhancements challenging.
Current Psychiatric Therapies
Authors: Joel Shilling
Journal: JAMA (1961)

This is the first of a series of annual publications dealing with current psychiatric therapy. Efforts have been made to present each subject in clear and easily readable form. The volume is of convenient reference size and is reasonably priced. There are 40 contributors to this collection of 28 works. The works are presented under 8 general sections which include: preventive psychiatry; child and adolescent psychiatry; psychophysical methods; psychoanalysis; couples and groups; clinic, institution, and community; after-care programs; and review and integration. The chapters are short and to the point. Particularly outstanding in this regard are the chapters, "Present Status of Child Psychiatry," "Campus Psychiatry," and "An Adolescent Treatment Service in a State Hospital." The book also includes a résumé of current psychopharmacology. The résumé divides drugs into 3 categories—stimulants, drugs that decrease reactivity, and behavior-disrupting drugs. The practicing psychiatrist will find the book especially interesting. The general physician will
QUININ IN PNEUMONIA.
Authors: A. L. GUSTETTER
Journal: JAMA (1906)

Following the cases of pneumonia reported in Dr. Galbraith's article inThe JournalFeb. 10, 1906, I have had many other cases, in all of which I have treated the patients according to Dr. Galbraith's method, but with a very much better result. Pneumonia is a very prevalent disease in Nogales and vicinity. My mortality in pneumonia cases was formerly nearly 80 per cent. So fatal had the disease become that all persons possessing enough of this world's goods to carry them to the sea level refused to remain here after becoming aware of the nature of their affliction. The results reported in the following cases, I am pleased to state, are the rule and not the exception. Thus far I have not had a death from pneumonia since I began the quinin treatment according to Dr. Galbraith's method. <h3>Case 1.</h3> —A male, aged 24, helper on railroad. <h3>History.</h3> —On
Investment in health could be good for Europe's economies
Authors: Marc Suhrcke, Martin McKee, Regina Sauto Arce, Svetla Tsolova, Jørgen Mortensen
Journal: BMJ (2006)

offices and headquarters closer together, so that all parts of the organisation share a core mission and communicate common information, with a particular focus on getting information from the field to Geneva.To get there, a re-read of the WHO constitution might be in order-there is room within it for regions to be more directly linked to the main part of WHO than they currently are.Global health has never enjoyed a higher profile on the world stage, and WHO must figure out how to take the most constructive role possible, within the bounds of its institutional constraints.We need an international health agency that leads, focused on providing strong, uncompromised technical expertise to improve the health of poor people and fortify the international community's ability to confront global health risks.Good leadership, bolstered by support from the many outsiders who want WHO to succeed, can do just that.Contributors and sources: RL is a health economist with experience designing, implementing, and evaluating health programmes at the World Bank and InterAmerican Development Bank.Her current work focuses on ways to improve the effectiveness of donor spending in the health sector.
Website of the week: Bioterrorism
Authors: G. Jones
Journal: BMJ (2003)

While the United Nations weapons inspectors continue their search for weapons of mass destruction in Iraq, the discovery of ricin in a flat in north London has focused attention on weapons of mass destruction a little closer to home. I, like the average punter, have a pretty good understanding of what ricin is (a chemical warfare agent), where it comes from (castor oil beans), and how it is spread (not very effectively, it seems). However, if you'd have asked me what it was two months ago I would probably have guessed it was some kind of raising agent used in bread making.

This has made me wonder what other chemical or biological agents are out there that I don't know about, and how would we recognise and treat them? One answer comes from the National Electronic Library for Health Emergency Care website (www.nelh-ec.warwick.ac.uk/), which provides information for emergency clinicians dealing with victims of real or suspected biochemical attack. There's also a link for members of the public to gain access to health information through NHS Direct. The site covers everything from anthrax, botulism, and smallpox to less well known agents such as tularaemia, glanders, and melioidosis. You can download a PDF of the Public Health Laboratory Service guidelines, which summarise the clinical features, management, and decontamination measures. There are also some helpful clinical tips and photographs of cardinal clinical signs.
F-18 FDG Gastric and Anterior Abdominal Muscle Uptake Secondary to Nausea and Vomiting
Authors: HUSSEIN M. ABDEL-DAYEM, SLEIMAN NADDAF, HOSSAM EL-ZEFTAWY
Journal: Clinical Nuclear Medicine (1998)

A case is presented of increased fluorine-18 fluorodeoxyglucose (F-18 FDG) uptake in the stomach and the rectus abdominis muscle due to postchemotherapy nausea and vomiting at the time of the 18-FDG injection. This case of abnormal uptake in the stomach and abdomen illustrates the problems that can occur in interpretation.
Evolutionary divergence of AP-PCR (RAPD) patterns
Authors: L. Espinasa, R. Borowsky
Journal: Molecular Biology and Evolution (1998)

Rates at which AP-PCR patterns diverge among isolated taxa were examined to test whether they exhibit clocklike regularity. The results showed that rates of divergence differed significantly among the groups examined (primates, antelopes, and Hawaiian Drosophila grimshawi). Therefore, AP-PCR divergence rates cannot be used as a "universal clock" with an invariant rate in all animals. Nevertheless, within each group, a strong relationship existed between degree of AP-PCR pattern divergence and time since separation of isolated taxa. Thus, AP-PCR divergence may prove useful for dating evolutionary events if calibrated within a more limited taxon.
Human Breast Milk Contamination with Phthalates and Alterations of Endogenous Reproductive Hormones in Infants Three Months of Age
Authors: Katharina M. Main, Gerda K. Mortensen, Marko M. Kaleva, Kirsten A. Boisen, Ida N. Damgaard, Marla Chellakooty, Ida M. Schmidt, Anne-Maarit Suomi, Helena E. Virtanen, Jørgen H. Petersen, Anna-Maria Andersson, Jorma Toppari, Niels E. Skakkebæk
Journal: Environmental Health Perspectives (2005)

Phthalates adversely affect the male reproductive system in animals. We investigated whether phthalate monoester contamination of human breast milk had any influence on the postnatal surge of reproductive hormones in newborn boys as a sign of testicular dysgenesis.DesignWe obtained biologic samples from a prospective Danish–Finnish cohort study on cryptorchidism from 1997 to 2001. We analyzed individual breast milk samples collected as additive aliquots 1–3 months postnatally (n = 130; 62 cryptorchid/68 healthy boys) for phthalate monoesters [mono-methyl phthalate (mMP), mono-ethyl phthalate (mEP), mono-n-butyl phthalate (mBP), mono-benzyl phthalate (mBzP), mono-2-ethylhexyl phthalate (mEHP), mono-isononyl phthalate (miNP)]. We analyzed serum samples (obtained in 74% of all boys) for gonadotropins, sex-hormone binding globulin (SHBG), testosterone, and inhibin B.ResultsAll phthalate monoesters were found in breast milk with large variations [medians (minimum–maximum)]: mMP 0.10 (< 0.01–5.53 μg/L), mEP 0.95 (0.07–41.4 μg/L), mBP 9.6 (0.6–10,900 μg/L), mBzP 1.2 (0.2–26 μg/L), mEHP 11 (1.5–1,410 μg/L), miNP 95 (27–469 μg/L). Finnish breast milk had higher concentrations of mBP, mBzP, mEHP, and Danish breast milk had higher values for miNP (p = 0.0001–0.056). No association was found between phthalate monoester levels and cryptorchidism. However, mEP and mBP showed positive correlations with SHBG (r = 0.323, p = 0.002 and r = 0.272, p = 0.01, respectively); mMP, mEP, and mBP with LH:free testosterone ratio (r = 0.21–0.323, p = 0.002–0.044) and miNP with luteinizing hormone (r = 0.243, p = 0.019). mBP was negatively correlated with free testosterone (r = −0.22, p = 0.033). Other phthalate monoesters showed similar but nonsignificant tendencies.ConclusionsOur data on reproductive hormone profiles and phthalate exposures in newborn boys are in accordance with rodent data and suggest that human Leydig cell development and function may also be vulnerable to perinatal exposure to some phthalates. Our findings are also in line with other recent human data showing incomplete virilization in infant boys exposed to phthalates prenatally.
EXTRA-UTERINE PREGNANCY.
Authors: T. F. PREWITT
Journal: JAMA (1897)

In fulfilling the functions for which the sex was created, no accident more dreadful can befall a woman than that of extra-uterine pregnancy. She may have reason to suspect that pregnancy has occurred, but in that fact she finds nothing to excite apprehension of the future. On the contrary it may kindle in her bosom the fondest aspirations of motherhood; the instincts of maternity may arouse in her heart the tenderest emotions and visions of that supreme happiness which fill the soul of the mother, when, having passed the period of probation, she clasps her firstborn to her breast with rapture. Should she already have been a mother, there is nothing different from past experiences and she has no dread of the future. Soon the inevitable catastrophe comes, it may be with the suddenness of the lightning's flash; an agony of pain, collapse and death. It may be all so
Dopamine D2 Receptors Regulate the Anatomical and Functional Balance of Basal Ganglia Circuitry
Authors: Maxime Cazorla, Fernanda Delmondes de Carvalho, Muhammad O. Chohan, Mariya Shegda, Nao Chuhma, Stephen Rayport, Susanne E. Ahmari, Holly Moore, Christoph Kellendonk
Journal: Neuron (2014)
Successful Pregnancy despite Placental Cystine Crystals in a Woman with Nephropathic Cystinosis
Authors: Rosemary E. Reiss, Toichiro Kuwabara, Margaret L. Smith, William A. Gahl
Journal: New England Journal of Medicine (1988)

CYSTINOSIS is an autosomal recessive disorder characterized by intracellular accumulation of cystine due to failure of the normal carrier-mediated system that transports cystine out of lysosomes.1 , 2 Intracellular cystine storage results in crystal formation in many tissues of the body. Clinical findings include growth retardation, photophobia, renal tubular Fanconi's syndrome, and renal glomerular failure, generally occurring by the age of 10 years.3 , 4 Before the era of renal transplantation,5 female patients with cystinosis did not survive past adolescence, and their reproductive capacity was unknown. We report a successful pregnancy in a woman with cystinosis and a renal allograft, along with the unusual . . .
Bridge over troubled water: Protection against hepatitis C virus persistence?
Authors: Robert Thimme, Hans-Christian Spangenberg, Hubert E. Blum
Journal: Hepatology (2002)

Background: Neither previous hepatitis C (HCV) infection nor vaccination with HCV-derived antigens protects against reinfection. However, HCV infection and vaccination in chimpanzees has been shown to reduce the magnitude and duration of viraemia with re-challenge. We aimed to establish whether similar immunity could be achieved in man. Methods: From a study of injecting drug users, we identified 164 people who had no evidence of previous HCV infection and 98 individuals who had been previously, but were not currently, infected with HCV. We compared the incidence and persistence of HCV viraemia in these two groups over four consecutive 6-month periods. Findings: Of participants without previous HCV infection, the incidence of HCV infection was 21% (35/164). By contrast, people previously infected were half as likely to develop new viraemia (12% (12/98)), even after accounting for risk behaviour (hazard ratio, 0.45; 95% CI 0.23-0.88). Furthermore, in HIV-negative people, those previously infected were 12 times less likely than people infected for the first time to develop persistent infection (odds ratio 0.05, 95% CI 0.01-0.3), and median peak HCV RNA concentration was two logs lower. HCV persisted in six of six HIV-1 positive people, even in one man who had previously cleared HCV infection when he was HIV-1 negative. Interpretation: There is an alarming frequency of HCV infection and persistence among injecting drug users. Our data suggest that immunity against viral persistence can be acquired, and that vaccines should be tested to reduce the burden of HCV-related liver disease.
Calcifications in a Continent Urinary Diversion
Authors: Marc A. Bjurlin, Courtney M.P. Hollowell
Journal: New England Journal of Medicine (2010)

A 37-year-old man with spina bifida and a history of cystectomy with a continent cutaneous urinary diversion presented with an audible knocking sound coming from his abdomen during ambulation. Physical examination revealed a well-healed, functional stoma and a palpable mass in the right side of the abdomen.
Whispers of Spring
Authors: William Kim
Journal: Annals of Internal Medicine (1996)

Ad Libitum1 August 1996Whispers of SpringWilliam KimWilliam KimProvidence, RI 02906-5032Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-125-3-199608010-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail new seeds ... Author, Article, and Disclosure InformationAffiliations: Providence, RI 02906-5032Corresponding Author: William Kim, 767 Blackstone Boulevard, Providence, RI 02906-5032. Previousarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 August 1996Volume 125, Issue 3Page: 252KeywordsHeartMortality ePublished: 15 August 2000 Issue Published: 1 August 1996 Copyright & PermissionsCopyright © 1996 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Progressive multifocal leukoencephalopathy; positive brain scan
Authors: M. B. Mosher
Journal: JAMA (1971)

A 47-year-old woman with Hodgkin's disease developed progressive multifocal leukoencephalopathy (PML). Sodium pertechnetate Tc 99m brain scans were initially abnormal, but in time reverted to normal. At autopsy, gross demyelinating lesions diagnostic of PML were present in areas corresponding to the defects seen on the original scan.
Visualization From Projected Slides
Authors: Elton Watkins
Journal: JAMA (1972)

<h3>To the Editor.—</h3> I was delighted to read the scientific explanation by Packer and Robertson (221:1163,1972) concerning the visual acuity required to read projected slides. Many lecturers still seem to think that tabular data, suitable only for publication, can be used interchangeably as slide material. Some slides I have seen must have required definition in fractions of a minute of arc. The data might be discernible using high-powered binoculars in the front row if one had the time to assimilate all of it. Lecturers should recognize the entirely different requirements for comprehension of slide material contrasted to published tables. I hope that increasing use will be made of columns in various colors to code tabular data on simple slides. I have found a black background useful in this application. The difficulty with a white background relates to the quality of most of the electrical pointers made available to lecturers. They
RADON (RADIUM EMANATION) AS A PALLIATIVE AGENT IN THE TREATMENT OF INTRA-ORAL CANCER
Authors: FRANK EDWARD SIMPSON
Journal: JAMA (1926)

In intra-oral cancer, when should the primary lesion be submitted to surgery and when to irradiation? Evidently the operable lesions may be excised and the inoperable ones should receive irradiation. The greatest difference of opinion exists, however, as to what cases are really operable and what are inoperable. Judd and New1of the Mayo Clinic rightly state that the statistics of the operative treatment of intra-oral cancer will depend largely on what one considers operable and inoperable. Some take the position that in dealing with the primary lesion in intra-oral cancer, surgery has no place at all. Others take a diametrically opposite view and believe that only in the hopelessly advanced cases should irradiation be done, and that in all other cases operation should be performed. Our position is that distinctly operable cases may receive the benefits of surgery, and all other cases should be treated with radon.  What
Diabetic ketoalkalosis: a readily misdiagnosed entity.
Authors: K C Lim, C H Walsh
Journal: BMJ (1976)

Diabetic ketoalkalosis: a readily misdiagnosed entityAn essential part of the treatment of diabetic ketoacidosis.is the replacement of fluid and electrolytes.Though routine use of alkali is questionable, it is often used in the early stages of treatment.We describe two patients diagnosed as having diabetic ketoacidosis who were later found to have a metabolic alkalosis.The use of alkali replacement in these patients would have been inappropriate and potentially hazardous. Case reportsCase 1-A 24-year-old woman who had been treated with insulin for 11 years was admitted to hospital in December 1974 with a history of nausea for three weeks, severe vomiting for 24 hours, and diarrhoea for four hours.She was drowsy, hiccuping, dehydrated, and overbreathing, with acetone on her breath.Urine analysis showed 2 00 glucose and 3 + ketones.Diabetic
Oesophageal and gastric cancer need to be detected earlier to improve outcomes, audit finds
Authors: Z. Kmietowicz
Journal: BMJ (2014)

The number of patients surviving surgery for oesophageal and stomach cancer has reached its highest ever, but many cases are still being diagnosed too late for patients to benefit from treatment, an audit has found.

The national oesophagogastric cancer audit found that 30 day mortality after surgery fell from 4.1% in 2008-10, when the audit started, to 2.3% in 2011-13.1 Similarly, 90 day mortality fell from 6.5% to 4.5% over the same period.

The audit collects data on all patients in England and Wales who are given a diagnosis of oesophageal or stomach cancer. Altogether 22 832 patients received a diagnosis of oesophageal or stomach cancer between 1 …