tbuckley/cabot-search huggingface dataset:
U.S. Needs More Physicians Soon, but How Many More Is Debatable
Authors: Jennifer Fisher Wilson
Journal: Annals of Internal Medicine (2005)

Current Clinical Issues20 September 2005U.S. Needs More Physicians Soon, but How Many More Is DebatableJennifer Fisher WilsonJennifer Fisher WilsonSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-6-200509200-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail When Richard A. Cooper, MD, first starting investigating the question of how many physicians the United States needed in its work force, the common wisdom of the early 1990s held that the country was facing a major physician surplus. The surplus would push down physician salaries and leave some searching for employment. But as Cooper spent more time studying the numbers of graduates from U.S. medical schools and residents in training, he determined a completely different future: The United States instead faced a looming shortage that threatened to overtax and weaken the health care system by the early 21st century. ...References1. Cooper RA, Getzen TE, McKee HJ, Laud P. Economic and demographic trends signal an impending physician shortage. Health Aff (Millwood). 2002;21:140-54. [PMID: 11900066] CrossrefMedlineGoogle Scholar2. Garber AM, Sox HC. The U.S. physician workforce: serious questions raised, answers needed [Editorial]. Ann Intern Med. 2004;141:732-4. [PMID: 15520433] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Disclosures: None disclosed.E-mail:[email protected]org. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byHealth Care Policy, Quality Improvement, and Patient Safety in Pain Medicine PracticeAmerican College of Rheumatology response to the 2006 rheumatology workforce studyThe Physician-Scientist Career Pipeline in 2005: Build It, and They Will Come 20 September 2005Volume 143, Issue 6Page: 469-472KeywordsForecastingGraduate medical educationHealth careHealth care providersHealth economicsHispanic peopleMedical servicesPrevention, policy, and public healthResidencySurgery ePublished: 20 September 2005 Issue Published: 20 September 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
The Smokeless Pipe
Authors: H. H. Jones
Journal: JAMA (1970)

<h3>To the Editor:—</h3> Dr. Friederici's invention (<b>211</b>:2016, 1970) delighted me and filled me with hope. I found a suitable mouthpiece at Kress's and constructed one of my very own. Alas, on first trial, it was obvious that it was a failure. The delightful searing pain along the lateral margin of the tongue was just not there. After considerable experimentation, I found that a concentrated extract of used pipe cleaners applied to the mouthpiece produced the desired effect, especially if heated. I developed a small kit to facilitate the use of this extract. It consists of a spoon, a medicine dropper, and a few matches. Yesterday, I was heating my extract and, for reason beyond my comprehension, lost a great deal of time discussing the invention with a state narcotics agent. I have gone back to a tobacco pipe but research continues. Soon I shall receive a supply of betel
NICE outraged by ousting of pain society president
Authors: M. Rawlins, P. Littlejohns
Journal: BMJ (2009)

The British Pain Society has voted to force its president, Professor Paul Watson, out of office because some members disagreed with a recommendation in the recent guideline on low back pain from the National Institute for Health and Clinical Excellence (NICE) that he helped to develop.1 The society’s sustained campaign against a highly respected pain management …
[309] IMPACT OF COLITIS ON BILE SECRETION AND HEPATOBILIARY TRANSPORTER EXPRESSION IN MICE: POSSIBLE IMPLICATIONS FOR PATHOGENESIS OF SCLEROSING CHOLANGITIS
Authors: J. Jahnel, M. Wagner, C. Langner, C. Hoegenauer, P. Fickert, D. Silbert, J. Gumhold, A. Fuchsbichler, H. Denk, M. Trauner
Journal: Journal of Hepatology (2007)
SarCNU, a Nitrosourea Analog on a Day 1, 5, and 9 Oral Schedule: A Phase I and Pharmacokinetic Study in Patients With Advanced Solid Tumors
Authors: L. Panasci, S.F. Stinson, D. Melnychuk, V. Sandor, W.H. Miller, G. Batist, F. Patenaude, N. Bangash, L. Panarello, M. Alaoui-Jamali, E. Sausville
Journal: Journal of Clinical Oncology (2003)

2-Chloroethyl-3-sarcosinamide-1-nitrosourea (SarCNU) is a novel chloroethylnitrosourea that demonstrates selective cytotoxicity in athymic mice bearing human glioma. SarCNU demonstrates selective cytotoxicity in vitro against human glioma at least in part because of the selective SarCNU uptake by the extraneuronal monoamine transporter. The purpose of this phase I study was to determine the maximum-tolerated dose (MTD), the toxicity profile, the pharmacokinetics profile, and recommended phase II dose.Forty-three eligible patients with advanced solid tumors were enrolled. SarCNU was administered orally on days 1,5, and 9 every 28 days. The dose ranged from 30 to 1,075 mg/m2. Pharmacokinetic evaluation was done on the first cycle (one dose was given intravenously on day 1 or 5 of the first cycle to determine bioavailability).Delayed myelosuppression (thrombocytopenia and neutropenia occurring 4 to 6 weeks after administration) was the dose-limiting toxicity (DLT). Anemia occurred but was mild. Nonhematologic toxicity was generally mild, but one patient died with pulmonary toxicity that was probably secondary to SarCNU. There were no partial or complete responses, but eight patients had stable disease for 19 to 46 weeks. The oral bioavailability of SarCNU was 80% +/- 37%. The terminal phase half-life was similar after intravenous (58.4 +/- 23.5 minutes) or oral (64.0 +/- 34.8 minutes) administration. The total plasma clearance was 20.4 +/- 8.8 L/h/m2, and the apparent volume of distribution was 29.9 +/- 17.6 L/m2. The area under the plasma concentration-time profile increased proportionally with the dose, and the pharmacokinetics seemed to be independent of the route of administration and the number of doses.SarCNU was well tolerated and the MTD was 1,075 mg/m2. The recommended starting dose for phase II trials is 860 mg/m2 orally on days 1, 5, and 9 every 6 weeks.
S5-2: PAM50 HER2−Enriched Subtype Enriches for Tumor Response to Neoadjuvant Anthracyclines/Taxane and Trastuzumab/Taxane Containing Regimens in HER2−Positive Breast Cancer.
Authors: MCU Cheang, A Prat, C Fan, CM Perou
Journal: Cancer Research (2011)

Abstract Background: Patients with clinically HER2−positive (clinHer2+) tumors often receive trastuzumab in combination with chemotherapy as their standard of care. This study sought to determine the predictive value of the HER2−enriched (HER2−E) molecular subtype for sensitivity to neoadjuvant anthracycline/taxane containing chemotherapy and a trastuzumab plus taxane-based regimen within clinHer2+ disease. Materials and methods: Gene expression data on pre-treatment fresh-frozen tumor tissues were collected from a combined cohort of MDACC/I-SPY trial (GSE25055/65), and the XeNA trial (GSE22358). Patients from MDACC/I-SPY were treated with doxorubicin/cyclophosphamide (AC) or 5-fluorouracil/epirubicin or doxorubicin/C (FEC or FAC) sequentially with paclitaxel. All patients from XeNA received capecitabine/docetaxel (and trastuzumab if clinHer2+). Intrinsic subtypes were determined using PAM50. Chisquare test and multivariable logistic regression analysis were used to test significance of association between subtype and pathological complete response (pCR or residual cancer burden [RCB] 0/1) and residual disease (RD or RCB2/3) adjusted with pre-treatment tumor size. Kaplan Meier was used for distant relapse-free survival (DRFS) estimates. Results: For the MDACC/I-SPY cohort (n=595), pCR rates for intrinsic subtypes were 3% (5/168) for LumA, 16% (14/90) for LumB, 33% (23/69) for HER2−E and 37% (76/208) for Basal-like. Tumors achieving RCB0/1 were significantly associated with better DFRS compared to those tumors with RCB 2/3, even within each intrinsic subtype. The 5-year DFRS for HER2−E with RCB0/1 and RCB2/3 was 100% and 31% (p=0.007), respectively. ClinHer2+ status was also significantly associated with pCR (34% vs. 19%, p=0.016). Strikingly, among the clinHer2+ tumors (n=47), 75% (12/16) of the responders were classified as HER2−E (Table 1A) and those tumors that were clinHer2+/HER2−E had 6 times odds to achieve pCR when compared to clinHer2+/non-HER2−E. In the XeNA trial (n=122), the HER2−E subtype was significantly associated with response, composing 85% (7/8) of the clinHer2+ who achieved a pCR. Finally, clinHer2+/HER2−E tumors were 34 times more likely to achieve pCR than clinHer2+/non-HER2−E tumors (Table1B). Conclusion: The sensitivity of clinHer2+ tumors to neoadjuvant anthracycline/taxane-based regimens, and trastuzumab-based chemotherapy is mainly contained within tumors of the HER2−E subtype. Given that this molecular subtype cannot simply be recapitulated using clinical ER and HER2 status, our results highlight the importance of identifying patients with HER2−E tumors as this appears to greatly enrich for responsiveness and treatment benefit. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr S5-2.
Can Stress Management at the Workplace Prevent Depression? A Randomized Controlled Trial
Authors: Yoshio Mino, Akira Babazono, Toshihide Tsuda, Nobufumi Yasuda
Journal: Psychotherapy and Psychosomatics (2006)

&lt;i&gt;Background:&lt;/i&gt; Stress, mental health and depression at the workplace have emerged as common and significant problems. The effectiveness of a stress-management program at the workplace was investigated. &lt;i&gt;Methods:&lt;/i&gt; The effectiveness of a stress-management program was examined in workers at a highly stressful workplace using a randomized controlled trial. The 58 workers in the office were randomly assigned into a stress-management group (n = 28) and a control group (n = 30). The stress-management program included lectures on the perception of stress, measures to cope with it, stress-management recording sheets, and e-mail counseling. This program was based on the cognitive behavioral approach. The stress-management program was carried out for 3 months, and perceived work-related stress and psychological symptoms were evaluated using: General Health Questionnaire (GHQ)-30, Center for Epidemiologic Study for Depression (CES-D), the Questionnaire of Work-Related Stress and the Effort-Reward Imbalance Questionnaire. Twenty-one out of the 28 in the stress-management group and all in the control group were successfully followed up. &lt;i&gt;Results:&lt;/i&gt; In the stress-management group, a significant improvement in the depressive symptoms was observed, compared with the control group in CES-D (p = 0.003 by two-tailed paired t-test, and p = 0.042 by repeated measure analysis of variance). In the multiple regression analysis, the effect of stress management on depressive symptoms at follow-up was significant (p = 0.041), controlling for potential confounding factors. However, the alleviation of perceived occupational stress was limited. &lt;i&gt;Conclusions:&lt;/i&gt; A stress-management program based on the cognitive behavioral approach at the workplace may have potential for the prevention of depression.
Factitial Epinephrine-Only Secreting Pheochromocytoma
Authors: ROBERT O. BRANDENBURG
Journal: Annals of Internal Medicine (1979)

Brief Reports1 May 1979Factitial Epinephrine-Only Secreting PheochromocytomaROBERT O. BRANDENBURG Jr., M.D., LEONARD M. GUTNIK, M.D., ROGER L. NELSON, M.D., CHARLES F. ABBOUD, M.D., ANTHONY J. EDIS, M.D., SHELDON G. SHEPS, M.D.ROBERT O. BRANDENBURG Jr., M.D.Search for more papers by this author, LEONARD M. GUTNIK, M.D.Search for more papers by this author, ROGER L. NELSON, M.D.Search for more papers by this author, CHARLES F. ABBOUD, M.D.Search for more papers by this author, ANTHONY J. EDIS, M.D.Search for more papers by this author, SHELDON G. SHEPS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-90-5-795 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFactitial illness, frustrating from both a diagnostic and therapeutic standpoint, is a well-recognized entity. Metabolic malingerers are a major subgroup, and their problems include factitial thyrotoxicosis, myxedema, and hyperinsulinism. We describe here the case of a patient who added epinephrine to a urine sample.A 27-year-old white female nurse was seen at the Mayo Clinic in November 1977 with a referral diagnosis of pheochromocytoma. Her illness started in February 1976 when she began having recurrent "attacks" of tachycardia, anxiety, diaphoresis, and dizziness. She was hospitalized in August 1976 after 12 such episodes; elevated levels of urinary catecholamines had been found...References1. VON EULER U as cited by GOODALL M, STONE C: Adrenaline and noradrenaline producing tumors of the adrenal medulla and sympathetic nerves. Ann Surg 151:391-398, 1960 CrossrefMedlineGoogle Scholar2. MANGERGIFFORD WR: Pheochromocytoma. New York, Springer-Verlag, 1977, p. 19 CrossrefGoogle Scholar3. LURVEYYUSSINDEQUATTRO AAV: Pseudopheochromocytoma after self-administered isoproterenol. J Clin Endocrinol Metab 36:766-769, 1973 CrossrefMedlineGoogle Scholar4. WOCIALJANUSZEWICZ BW: Urinary excretion of catecholamines and their metabolites in patients with pheochromocytoma. Ann Endocrinol (Paris) 35:237-246, 1974 MedlineGoogle Scholar5. VON EULERSTRöM UG: Present status of diagnosis and treatment of pheochromocytoma. Circulation 15:5-13, 1957 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Mayo Clinic and Mayo Foundation Rochester, Minnesota PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byFactitious hypertensive crises unraveled by Doppler ultrasoundFactitious Hypertension by PseudoephedrinePheochromocytoma: Update on Diagnosis, Localization, and ManagementFactitious disorders presenting as acute emergencies.Diagnostic Evaluation of PheochromocytomaPheochromocytoma 1 May 1979Volume 90, Issue 5Page: 795-796KeywordsAnxietyCatecholaminesEpinephrineHyperinsulinemiaNursesPheochromocytomaTachycardiaUrine Issue Published: 1 May 1979 PDF downloadLoading ...
Active Currents Regulate Sensitivity and Dynamic Range in C. elegans Neurons
Authors: Miriam B Goodman, David H Hall, Leon Avery, Shawn R Lockery
Journal: Neuron (1998)

Little is known about the physiology of neurons in Caenorhabditis elegans. Using new techniques for in situ patch-clamp recording in C. elegans, we analyzed the electrical properties of an identified sensory neuron (ASER) across four developmental stages and 42 unidentified neurons at one stage. We find that ASER is nearly isopotential and fails to generate classical Na+ action potentials. Rather, ASER displays a high sensitivity to input currents coupled to a depolarization-dependent reduction in sensitivity that may endow ASER with a wide dynamic range. Voltage clamp revealed depolarization-activated K+ and Ca2+ currents that contribute to high sensitivity near the zero-current potential. The depolarization-dependent reduction in sensitivity can be attributed to activation of K+ current at voltages where it dominates the net membrane current. The voltage dependence of membrane current was similar in all neurons examined, suggesting that C. elegans neurons share a common mechanism of sensitivity and dynamic range.
Effect on restenosis with a paclitaxel eluting stent: factors associated with inhibition in the elutes clinical study
Authors: Bernard Chevalier, Ivan De Scheerder, Anthony Gershlick, Edouardo Camezind, Antoine Gommeaux, Christian Vrints, Nicholas Relfart, Luc Missault, Jean-Jacques Goy, Alan Heldman, Jeffrey Brinker, Albert E. Raizner
Journal: Journal of the American College of Cardiology (2002)
Inquiry found surgeon had high death rate for operation
Authors: C. Dyer
Journal: BMJ (1998)

An independent inquiry into paediatric cardiac surgery at Bristol Royal Infirmary found that James Wisheart, the senior surgeon, had a substantially higher death rate for one type of operation than his junior colleague, Janardan Dhasmana.

The report, which did not name the surgeons, said that consultant 1 (Mr Wisheart) had a mortality of 87% for repairing atrioventricular canals, while the rate for consultant 2 (Mr Dhasmana) was only 8.6%. Mr Wisheart carried out eight such operations between 1992 and 1995 and seven of the patients died. For tetralogy of Fallot, Mr Wisheart had a 13.5% mortality, while Mr Dhasmana's was nil.

But the report was amended before publication to remove any comparison between surgeons, the General Medical Council heard on the 54th day of its long running inquiry into allegations of serious professional misconduct against the two surgeons. Both are charged …
Association of Variants in Two Vitamin E Transport Genes with Circulating Vitamin E Concentrations and Prostate Cancer Risk
Authors: Margaret E. Wright, Ulrike Peters, Marc J. Gunter, Steven C. Moore, Karla A. Lawson, Meredith Yeager, Stephanie J. Weinstein, Kirk Snyder, Jarmo Virtamo, Demetrius Albanes
Journal: Cancer Research (2009)

Significant reductions in prostate cancer incidence and mortality were observed in men randomized to receive 50 mg supplemental vitamin E (alpha-tocopherol) per day in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study. We hypothesized that variation in key vitamin E transport genes might directly affect prostate cancer risk or modify the effects of vitamin E supplementation. Associations between prostate cancer risk and 13 polymorphisms in two genes, TTPA and SEC14L2, were examined in 982 incident prostate cancer cases and 851 controls drawn from the ATBC Study. There was no association between the genetic variants and prostate cancer risk. Significant interactions were observed, however, between two variants in SEC14L2 (IVS11+931A>G and IVS11-896A>T) and the trial alpha-tocopherol supplement such that vitamin E supplementation reduced prostate cancer risk among men who were homozygous for either common allele [odds ratios (OR) and 95% confidence intervals (95% CI), 0.52 (0.30-0.90) and 0.64 (0.46-0.88), respectively] and nonsignificantly increased risk among those who carried one or two copies of either variant allele [ORs and 95% CIs, 1.27 (0.90-1.79) and 1.21 (0.96-1.52), respectively; both P for interaction < 0.05]. Genotype-phenotype analyses revealed significant but modest differences in baseline circulating concentrations of alpha-tocopherol and serum responses to the vitamin E supplementation for several polymorphisms. This study shows that genetic variation in TTPA and SEC14L2 is associated with serum alpha-tocopherol but does not have a direct effect on prostate cancer. Our results do, however, suggest that polymorphisms in SEC14L2 may modify the effect of vitamin supplementation regimens on prostate cancer risk.
REPORT OF A CASE OF GONOCOCCIC ENDOCARDITIS
Authors: H. A. Benson
Journal: JAMA (1918)

The rare occurrence and the difficulty of establishing the diagnosis would seem to warrant the reporting of this case of gonorrheal endocarditis. <h3>History.</h3> —Private F., aged 19, admitted to the medical service of the Post Hospital, Plattsburg Barracks, N. Y., Sept. 19, 1917, complained of frequency of urination accompanied by a sense of burning, dull pain in the lumbar region, painful erections, and a profuse, purulent urethral discharge. The patient gave a definite history of exposure seven days prior to admission, and stated that he did not report for the regulation venereal prophylactic treatment. The fourth day after exposure he noticed a swelling of the meatus urinarius, and experienced a stinging sensation on urination. The following day the pain grew worse, and milking of the penis revealed a drop of mucopurulent discharge. Subsequently the discharge became more profuse and purulent, and chordee developed, which established clinically the outward picture of
Expression of Concern Reaffirmed
Authors: Gregory D. Curfman, Stephen Morrissey, Jeffrey M. Drazen
Journal: New England Journal of Medicine (2006)

On December 8, 2005, we published an expression of concern1 regarding an article by Bombardier et al. on the Vioxx Gastrointestinal Outcomes Research (VIGOR) study that was published in the Journal on November 23, 2000.2 Our expression of concern was prompted by evidence that the VIGOR article did not accurately represent the safety data available to the authors when the article was being reviewed for publication. More than four months before the article was published, at least two of its authors were aware of critical data on an array of adverse cardiovascular events that were not included in the VIGOR . . .
Dietary Fat and Risk of Prostate Cancer
Authors: J. Michael Gaziano, Charles H. Hennekens
Journal: JNCI Journal of the National Cancer Institute (1995)

Journal Article Dietary Fat and Risk of Prostate Cancer Get access J. Michael Gaziano, J. Michael Gaziano Search for other works by this author on: Oxford Academic PubMed Google Scholar Charles H. Hennekens Charles H. Hennekens Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 87, Issue 19, 4 October 1995, Pages 1427–1428, https://doi.org/10.1093/jnci/87.19.1427 Published: 04 October 1995
A PHASE II, DOSE-RANGING STUDY WITH CD-NP, A CHIMERIC NATRIURETIC PEPTIDE, IN ACUTE DECOMPENSATED HEART FAILURE PATIENTS WITH RENAL COMPROMISE
Authors: Hsiao Dee Lieu, James Young, Uri Elkayam, Amos Katz, Harald Darius, Sidney Goldstein, Barry Massie, Lisa Costello-Boerrigter, John Burnett
Journal: Journal of the American College of Cardiology (2011)
Advanced Glycosylation End Products in Tissue and the Biochemical Basis of Diabetic Complications
Authors: Jeffrey S. Flier, Lisa H. Underhill, Michael Brownlee, Anthony Cerami, Helen Vlassara
Journal: New England Journal of Medicine (1988)

IN this seminar we review recent studies suggesting that the central pathologic features of diabetic complications are caused by the hyperglycemia-accelerated formation of nonenzymatic advanced glycosylation end products in tissue. We will emphasize new research findings with important clinical implications, since older information is available in previously published reviews.1 , 2 Other biochemical mechanisms by which hyperglycemia may contribute to the development of diabetic complications are not discussed here, since they are comprehensively reviewed elsewhere.3 4 5 6 7 8 Differences between Early and Advanced Glycosylation ProductsThe central pathophysiologic features of diabetic vascular complications are an abnormal leakage of proteins from the circulation and a progressive . . .
Lymphadenopathy syndrome in homosexual men. Evidence for continuing risk of developing the acquired immunodeficiency syndrome
Authors: J. E. Kaplan
Journal: JAMA (1987)

Seventy-five homosexual men with lymphadenopathy syndrome (LAS) for three months or more and antibody against the human immunodeficiency virus were enrolled in a prospective study in Atlanta in 1982 and 1983. Fourteen developed the acquired immunodeficiency syndrome (AIDS) three to 38 months after enrollment in the study and five to 56 months after onset of LAS. The five-year cumulative incidence rate of AIDS after onset of LAS was 29%; yearly incidence rates showed no decreasing trend with time. Of 18 patients with constitutional symptoms and a low T-helper cell count at their first visit, nine developed AIDS; of the remaining 57 patients, five developed AIDS (five-year cumulative incidence rates, 57% and 18%, respectively,<i>P</i>&lt;.001). Patients with lymphadenopathy syndrome are at continuing risk for the development of AIDS. Those with constitutional symptoms and a low T-helper cell count at their first visit appear to be at higher risk; other LAS patients are at lower risk but may still develop AIDS. (<i>JAMA</i>1987;257:335-337)