tbuckley/cabot-search huggingface dataset:
Perceptions of Medical School Deans and State Medical Society Executives About Physician Supply
Authors: Richard A. Cooper
Journal: JAMA (2003)

Physician shortages are appearing, yet controversy about their significance and uncertainty about their remedy exist.To sample the perceptions of medical school deans and state medical society executives about the adequacy of physician supply, to determine the perceived impact of any shortages on medical schools, and to assess the capacity of medical schools to expand.Medical school deans in the United States and Puerto Rico were surveyed by means of a structured questionnaire, and officials of US state medical societies were queried by means of open-ended telephone interviews. Information was obtained from 58% of medical school deans and 86% of state medical society executives.Reported perceptions of shortages or surpluses of physicians by specialty and plans to increase medical school class size.Approximately 85% of both deans and medical society respondents perceived shortages of physicians, usually in multiple specialties, while 10% perceived surpluses, usually coexisting with shortages. Among deans reporting shortages, 83% described a negative impact on their schools. Recent or planned increases in class size were reported by 27% of deans and expansion capacity by another 34%, but 7% noted recent decreases in class size. Applied generally, these changes in class size could yield 7.6% additional matriculants annually.Physician shortages are prevalent and they are negatively affecting medical schools. Little capacity exists to alleviate these shortages through class size expansion.
PATIENT RISK STATUS, CENTER VOLUME AND OUTCOME FOLLOWING THE NORWOOD OPERATION
Authors: Sara K. Pasquali, Jennifer S. Li, Xia He, Audra Hodges, Christoph P. Hornik, Robert D.B. Jaquiss, Marshall L. Jacobs, Sean M. O'Brien, Eric D. Peterson, Jeffrey P. Jacobs
Journal: Journal of the American College of Cardiology (2011)
Intraoperative molecular detection of lymph node metastases and micro-metastases: Results of the first UK centre using the one step nucleic acid amplification assay
Authors: Mahwash Babar, Rana Madani, Haresh Devalia, Lara Thwaites, Peter Jackson, Arun Chakravorty, Tracey Irvine, Mark Kissin, Graham Layer
Journal: International Journal of Surgery (2011)
Varying Carbohydrate Intake in NIDDM
Authors: Herbert Ratner
Journal: JAMA (1994)

<h3>To the Editor.</h3> —Apparently a high-fat diet, ie, fat constituting 60% of energy intake, is on its way to replacing the high-carbohydrate diet (55% energy intake) in non-insulin-dependent diabetes mellitus (NIDDM).<sup>1</sup>Sixty years ago, from 1934 to 1936, we were research assistants under Louis H. Newburgh, MD, chief of the Division of Clinical Investigation in the Department of Internal Medicine at the University of Michigan. Dr Newburgh was a pioneer in the preinsulin development of a high-fat diet for the control of diabetes mellitus, a diet he carried over into the postinsulin era. Though experience "taught [Newburgh] that most diabetic children require insulin to permit a diet adequate for really normal growth... three out of every four adult diabetics treated in the clinic could tolerate a satisfactory diet of the high-fat type without insulin."<sup>2</sup> Newburgh's 1500-calorie skeletal diet included 134.85 g of fat derived from eggs, bacon, 32%
Polycythemia vera treated with recombinant interferon-alpha 2a: Evidence of a selective effect on the malignant clone
Authors: Paolo Massaro, Paolo Foa, Mauro Pomati, Maria Luisa LaTargia, Alessandra Iurlo, Claudia Clerici, Sarah Caldiera, Monica Fornier, Anna Teresa Maiolo
Journal: American Journal of Hematology (1997)

We periodically analyzed bone-marrow cytogenetic features in 8 patients belonging to a series of 38 subjects with polycythemia vera (PV), all treated with recombinant interferon-alpha 2a (rIFN-alpha) at a weekly dose of 9,000,000 IU. Six out of these 8 patients never showed any chromosome alterations, while 2 displayed at diagnosis the presence of trisomy 8 in all bone-marrow metaphases. Interestingly enough, in these 2 patients rIFN-alpha treatment was able to induce not only complete hematological response but also the disappearance of trisomy 8, as shown by conventional cytogenetic investigation and fluorescence in situ hybridization performed on bone-marrow cells after 1 year of treatment. This finding indicates that, as previously shown in chronic myeloid leukemia, in PV rIFN-alpha can also eradicate the malignant clone by means of a selective effect on bone-marrow transformed cells. Am. J. Hematol. 56:126–128, 1997. © 1997 Wiley-Liss, Inc.
Coagulopathy Associated With Vitamin E Ingestion
Authors: James J. Corrigan
Journal: JAMA (1974)

Although hypervitaminosis E causes a prolonged prothrombin time and a hemorrhagic state in animals, excessive vitamin E has not previously been found to cause bleeding in normal humans. We have seen a prolonged prothrombin time and ecchymoses develop in a patient who was taking warfarin sodium and clofibrate concomitant with self-administration of vitamin E. The prothrombin time returned to base line after vitamin E ingestion was stopped while warfarin and clofibrate treatment was continued. Coagulation studies demonstrated enhanced reduction of the levels of vitamin K-dependent coagulation factors during the period of vitamin E ingestion, which returned to base-line levels after the patient stopped taking the vitamin. Plasma warfarin levels did not change and platelet function remained normal. The data suggest that patients with vitamin K deficiency may risk hemorrhage if they take vitamin E. (<i>JAMA</i>230:1300-1301, 1974)
A piece of my mind. The venetian blinds
Authors: L. Litvinas
Journal: JAMA (1990)

The morning sun filtered through the venetian blinds, casting dancing columns of light on the wall beside my hospital bed. Today will be the day. No more suffering for my family and myself. No more sleepless, sweatful, painful nights. Life will go on for the masses, struggling with the meaning of their existence. Today, I, like others before me, will experience the truth and freedom that only death can bring. Yes, today is the day. The doctors have played all their cards. They have worked their pseudo-miracles, filling me with toxins, technology, and nausea. Safe, uneventful passage is all I desire, and yet this is precisely what is denied me. I have no appetite, yet I am fed through my veins. I have lost inspiration, yet I receive manufactured air through a hot, oily machine. So foreign now are the pictures coming from the television suspended near the ceiling of
The ethics of boxing
Authors: Charlotte Cowie
Journal: British Journal of Sports Medicine (2000)

<h3>Abstract</h3> The use of assisted reproductive technologies (ART) in cattle can result in large/abnormal offspring syndrome (LOS/AOS) which is characterized by macrosomia. LOS can cause dystocia and lead to the death of dam and calf. Currently, no test exists to identify LOS pregnancies. We hypothesized that fetal ultrasonography and/or maternal blood markers are useful to identify LOS. Bovine fetuses were generated by artificial insemination (control) or ART. Fetal ultrasonographies were taken on gestation day 55 (D55) and fetal collections performed on D56 or D105 (gestation in cattle ≈280 days). ART fetuses weighing ≥97 percentile of the control weight were considered LOS. Ultrasonography results show that the product of six D55 measurements can be used to identify extreme cases of LOS. To determine whether maternal blood can be used to identify LOS, leukocyte mRNA from 23 females was sequenced. Unsupervised hierarchical clustering grouped the transcriptomes of the two females carrying the two largest LOS fetuses. Comparison of the leukocyte transcriptomes of these two females to the transcriptome of all other females identified several misregulated transcripts on gestation D55 and D105 with <i>LOC783838</i> and <i>PCDH1</i> being misregulated at both time-points. Together our data suggest that LOS is identifiable during pregnancy in cattle.
Molecular and clinical pharmacology of intranasal corticosteroids: clinical and therapeutic implications
Authors: H. Derendorf, E. O. Meltzer
Journal: Allergy (2008)

Intranasal corticosteroids (INSs) are effective treatments for allergic rhinitis, rhinosinusitis, and nasal polyposis. In recent years, increased understanding of corticosteroid and glucocorticoid receptor pharmacology has enabled the development of molecules designed specifically to achieve potent, localized activity with minimal risk of systemic exposure. Pharmacologic potency studies using affinity and other assessments have produced similar rank orders of potency, with the most potent being mometasone furoate, fluticasone propionate, and its modification, fluticasone furoate. The furoate and propionate ester side chains render these agents highly lipophilic, which may facilitate their absorption through nasal mucosa and uptake across phospholipid cell membranes. These compounds demonstrate negligible systemic absorption. Systemic absorption rates are higher among the older corticosteroids (flunisolide, beclomethasone dipropionate, triamcinolone acetonide, and budesonide), which have bioavailabilities in the range of 34–49%. Studies, including 1‐year studies with mometasone furoate, fluticasone propionate, and budesonide that evaluated potential systemic effects of INSs in children have generally found no adverse effects on hypothalamic–pituitary–adrenal axis function or growth. Clinical data suggest no significant differences in efficacy between the INSs. Theoretically, newer agents with lower systemic availability may be preferable, and may come closer to the pharmacokinetic/pharmacologic criteria for the ideal therapeutic choice.
The preparation of sub-200 nm biodegradable colloidal particles from poly(β-malic acid-co-benzyl malate) copolymers and their surface modification with Poloxamer and Poloxamine surfactants
Authors: S. Stolnik, M.C. Davies, L. Illum, S.S. Davis, M. Boustta, M. Vert
Journal: Journal of Controlled Release (1994)
Management of endometrial cancer in Italy: A national survey endorsed by the Italian Society of Gynecologic Oncology
Authors: Stefano Greggi, Massimo Franchi, Giovanni Aletti, Nicoletta Biglia, Antonino Ditto, Anna Fagotti, Giorgio Giorda, Giorgia Mangili, Franco Odicino, Maria Giovanna Salerno, Enrico Vizza, Cono Scaffa, Paolo Scollo
Journal: International Journal of Surgery (2014)
A Warning Against a Possible Swindler.
Authors: Solomon Solis-Cohen
Journal: JAMA (1900)

Philadelphia, Dec. 10, 1900. <h3>To the Editor:</h3> —I learn by inquiries addressed to me, and by a letter returned from the Washington (D. C.) postoffice, that some swindler has gotten hold of some of my notepaper, cards and envelopes. Probably while pretending to wait for me in my absence he has slipped into my office and gotten them from my desk. He has been writing himself letters of recommendation upon my notepaper, and using my cards as introductions. He calls himself by various names. Dr. Von Liebig, Max Weil, and Dr. M. Lobo, are three that I have heard of. Will you kindly let me say throughThe Journalthat I have given no letter of recommendation to anybody, except special letters addressed to special persons, and recommending medical men for special positions for which they have been candidates. I never give a letter of general introduction or recommendation, and
Molecular characterization of the role of orphan receptor small heterodimer partner in development of fatty liver
Authors: Jiansheng Huang, Jahangir Iqbal, Pradip K. Saha, Jun Liu, Lawrence Chan, Mahmood M. Hussain, David D. Moore, Li Wang
Journal: Hepatology (2007)

The orphan receptor Small Heterodimer Partner (SHP, NROB2) regulates metabolic pathways, including hepatic bile acid, lipid, and glucose homeostasis. We reported that SHP-deletion in leptin-deficient OB(-/-) mice increases insulin sensitivity, and prevents the development of fatty liver. The prevention of steatosis in OB(-/-)/SHP(-/-) double mutants is not due to decreased body weight but is associated with increased hepatic very-low-density lipoprotein (VLDL) secretion and elevated microsomal triglyceride transfer protein (MTP) mRNA and protein levels. SHP represses the transactivation of the MTP promoter and the induction of MTP mRNA by LRH-1 in hepatocytes. Adenoviral overexpression of SHP inhibits MTP activity as well as VLDL-apoB protein secretion, and RNAi knockdown of SHP exhibits opposite effects. The expression of SHP in induced in fatty livers of OB(-/-) mice and other genetic or dietary models of steatosis, and acute overexpression of SHP by adenovirus, result in rapid accumulation of neutral lipids in hepatocytes. In addition, the pathways for hepatic lipid uptake and lipogenic program are also downregulated in OB(-/-)/SHP(-/-) mice, which may contribute to the decreased hepatic lipid content.These studies demonstrate that SHP regulates the development of fatty liver by modulating hepatic lipid export, uptake, and synthesis, and that the improved peripheral insulin sensitivity in OB(-/-)/SHP(-/-) mice is associated with decreased hepatic steatosis.
Association of Epstein–Barr Virus with Thymic Carcinoma
Authors: Serge Leyvraz, Werner Henle, A. Philippe Chahinian, Catharina Perlmann, George Klein, Ronald E. Gordon, Marc Rosenblum, James F. Holland
Journal: New England Journal of Medicine (1985)

The Epstein–Barr virus is a ubiquitous B-cell lymphocytotropic virus that is known to cause infectious mononucleosis1 and lymphoproliferative disorders in immunodeficient patients2 and has been implicated in the genesis of Burkitt's lymphoma3 and primary intracerebral lymphoma.4 The association of Epstein–Barr virus with epithelial cells has been more puzzling, but recent studies have shown that the virus can penetrate and replicate in some epithelial cells.5 6 7 Undifferentiated nasopharyngeal carcinoma is consistently associated with Epstein–Barr virus.8 Another undifferentiated tumor with histopathological characteristics similar to those of undifferentiated nasopharyngeal carcinoma is the lymphoepithelioma-like carcinoma of the thymus. This subtype of thymic carcinomas has a . . .
Contrast M-mode echocardiography in diagnosis of atrial septal defect in acyanotic patients.
Authors: G Kronik, J Slany, H Moesslacher
Journal: Circulation (1979)

Contrast echocardiograms during normal quiet respiration and during the Valsalva maneuver were performed in 15 patients with atrial septal defect (ASD) by injecting saline solution into an antecubital vein. Contrast shunting (the appearance of contrast echoes in the left heart) was observed not only in four patients with severe pulmonary hypertension (group 2), but also in 11 patients with uncomplicated ASD (group 1). Contrast shunting was prominent in all group 2 patients. In group 1, contrast shunting was sometimes subtle and difficult to recognize, but at other times was very obvious and similar to the findings in group 2. Contrast shunting was generally more pronounced during the Valsalva maneuver than during normal respiration, although there were exceptions. The amount of contrast appearing in the left heart did not correlate with the size of the defect. Small right-to-left shunts which are clinically insignificant but detectable by contrast echocardiography are present, or can be provoked by the Valsalva maneuver, in most patients with ASD. Contrast echocardiography is a useful, noninvasive method to detect interatrial communication, even in acyanotic patients.
Prevention of Anxiety
Authors: R. G. Gordon
Journal: BMJ (1940)

GONORRHOEAL MYOCARDITIS THE DARITJSHtions, just as we are looking for syphilis and rheumatic fever.A prominent feature of gonococcal infection is its obstinate persistence-that is, the tendency to formation of chronic foci.This fact seems to reflect itself to some extent in the course of the complement-fixation reaction.Investigation into this reaction is now being made in co-operation with Dr. Peter Krag of the State Serum Institute.One of the results may be mentioned in this connexion-namely, the surprisingly high incidence of positive reactions found among patients without apparent signs of recognized sequels to gonococcal infection.The Wassermann reaction has aided in the evaluation of many a syphilitic manifestation that would scarcely have been diagn'osed as such without this serologic evidence.Perhaps in future the gonococcal complement-fixation reaction will help to reveal that chronic gonococcal infec- tion plays a part in one or more diseases not hitherto attributed to this cause.Certain heart diseases may be among them. Summary of ConclusionsApart from the myocardial involvement in the bacterial endocarditis of gonococcal septicaemia, myocarditis is seldom established as a complication in gonococcal infection.In view of this it seems surprising that a series of six instances of what is regarded as gonorrhoeal myocarditis was encountered in the course of one year in an ordinary medical ward.It seems probable that this condition often escapes detection, since suggestive symptoms may be absent.The diagnosis was made on the ground that all six cases had changes in the electrocardiogram occurring in the course of acute or chronic complicated gonococcal infection.In some instances the myocarditis7 was slight and transitory, as may be the case in many simple infections-for example, pneumonia.However, in two cases incomplete bundle-branch block developed and persisted, and in a third case the anginal pain still troubled the patient considerably when he was re-examined a year later.Such a course suggests the possibility that some of these patients will return to hospital sooner or later with chronic heart disease.It is possible, also, that some of the chronic "degenerative'" heart diseases which we see to-day arise from gonococcal infection.The gonococcal complement-fixation reaction has been instrumental in pointing out how great a proportion of so-called rheumatic arthritis cases were really gonorrhoeal.It may be worth while to search the anamnesis of heart patients for gonorrhoea as we search it for syphilis and rheumatic -fever, and the complement- fixation reaction may reveal that some instances of heart lesion attributed to rheumatic infection ought to be regarded as following on persistent gonococcal infection.
A Preliminary Study of the Effect of Estrogen Dose on Growth in Turner's Syndrome
Authors: Ross Jl, Cassorla Fg, Skerda Mc, Valk Im, Loriaux Dl, Cutler Gb
Journal: New England Journal of Medicine (1983)

PATIENTS with Turner's syndrome are short and lack a pubertal growth spurt.1 Estrogen has been implicated as one factor that stimulates the normal pubertal growth spurt, yet estrogen in high doses has also been used to inhibit growth.2 3 4 This suggests that there is a biphasic dose–response curve for the effect of estrogen on growth. To evaluate this possibility, we studied the effect of estrogen dose on growth rate in patients with Turner's syndrome. We assessed the growth response by using the four-week ulnar growth rate, a sensitive index of short-term growth that correlates with height velocity.5 We found that administration . . .
Heme oxygenase‐1–mediated autophagy protects against hepatocyte cell death and hepatic injury from infection/sepsis in mice
Authors: Evie H. Carchman, Jayashree Rao, Patricia A. Loughran, Matthew R. Rosengart, Brian S. Zuckerbraun
Journal: Hepatology (2011)

Adaptive responses to sepsis are necessary to prevent organ failure and death. Cellular signaling responses that limit cell death and structural damage allow a cell to withstand insult from sepsis to prevent irreversible organ dysfunction. One such protective pathway to reduce hepatocellular injury is the up-regulation of heme oxygenase-1 (HO-1) signaling. HO-1 is up-regulated in the liver in response to multiple stressors, including sepsis and lipopolysaccharide (LPS), and has been shown to limit cell death. Another recently recognized rudimentary cellular response to injury is autophagy. The aim of these investigations was to test the hypothesis that HO-1 protects against hepatocyte cell death in experimental sepsis in vivo or LPS in vitro via induction of autophagy. These data demonstrate that both HO-1 and autophagy are up-regulated in the liver after cecal ligation and puncture (CLP) in C57BL/6 mice or in primary mouse hepatocytes after treatment with LPS (100 ng/mL). CLP or LPS results in minimal hepatocyte cell death. Pharmacological inhibition of HO-1 activity using tin protoporphyrin or knockdown of HO-1 prevents the induction of autophagic signaling in these models and results in increased hepatocellular injury, apoptosis, and death. Furthermore, inhibition of autophagy using 3-methyladenine or small interfering RNA specific to VPS34, a class III phosphoinositide 3-kinase that is an upstream regulator of autophagy, resulted in hepatocyte apoptosis in vivo or in vitro. LPS induced phosphorylation of p38 mitogen-activated protein kinase (p38 MAPK), in part, via HO-dependent signaling. Moreover, inhibition of p38 MAPK prevented CLP- or LPS-induced autophagy.Sepsis or LPS-induced autophagy protects against hepatocellular death, in part via an HO-1 p38 MAPK-dependent signaling. Further investigations are needed to elucidate how autophagic signaling prevents apoptosis and cell death.
Supplementary enteral nutrition maintains remission in paediatric Crohn's disease.
Authors: M Wilschanski, P Sherman, P Pencharz, L Davis, M Corey, A Griffiths
Journal: Gut (1996)

BACKGROUND--Liquid diets given enterally combined with "bowel rest9 are efficacious in the treatment of active Crohn9s disease, but rapid recrudescence of gastrointestinal symptoms after resumption of a normal diet is common. AIMS--This study examined whether continuation of enteral nutrition as a nocturnal supplement to an ad libitum daytime intake of a normal diet increased the length of remission of Crohn9s disease in children. PATIENTS AND METHODS--Children and adolescents with active Crohn9s disease treated successfully with exclusive enteral nutrition were classified retrospectively according to whether they continued supplementary enteral nutrition or not. Time to relapse and linear growth were compared between the two cohorts. RESULTS--Between January 1986 and December 1992, 65 patients aged 7-17 years (mean (SD) 13.6 (2.1) years) (36 males, 29 females) with Crohn9s disease in exacerbation were treated for &gt; or = four weeks by bowel rest and nasogastric tube feeding of an oligopeptide or amino acid based formula. At first follow up visit, remission (fall in Paediatric Crohn9s Disease Activity Index, PCDAI to &lt; or = 20) was achieved in 47 of 65 (72%) patients. Subsequently, 20 of these 47 (43%) relapsed by six months and 28 of 47 (60%) by 12 months. Patients who continued nasogastric supplementary feeding (n = 28) after resumption of an otherwise normal diet remained well longer than those who discontinued nocturnal supplements completely (n = 19) (p &lt; 0.02). Furthermore, continued use of nasogastric supplements before completion of puberty was associated with improved linear growth. CONCLUSION--After successful treatment of active Crohn9s disease by exclusive enteral nutrition, supplementary enteral nutrition without restriction of normal diet is associated with prolongation of remission and improved linear growth in children and adolescents.
Violence in Intimate Relationships and the Practicing Internist: New “Disease” or New Agenda?
Authors: Elaine J. Alpert
Journal: Annals of Internal Medicine (1995)

Domestic violence is endemic in U.S. society and is seen in nearly every venue of medical care. A history of abuse should be considered and routinely queried in all women who present for emergency care, should be suspected in any woman who presents with an injury, and should be routinely screened for in primary care settings.