tbuckley/cabot-search huggingface dataset:
Teaching Medical Students in Primary and Secondary Care: a Resource Book
Authors: Amanda Howe
Journal: Journal of the Royal Society of Medicine (2004)

If you know little about principles of clinical education and want to know more, or if you want to match some experience to basic theory, then this is a useful book. It declares its aim to be a resource book, and the index and contents allow the reader to dip in and out as needed. It has practical tips and short summary boxes which also act as rapid reminders of key practical and conceptual issues, so can be used for quick reference. However, its format is A4 size, so it has to be a shelf book, more suitable for a practice or hospital library than a jacket pocket.

Its chapters cover the core content of any ‘teaching the teachers’ course—how people learn, making the best use of different settings, planning a tutorial, designing a course and so on. It reflects the methods used in ‘modern’ curricula, and is very generic, so can be used by staff from any specialty background. The information is mostly evidence-based, sensible and relevant.

Inevitably, a brief introductory text will overgeneralize, and also underrepresent the full range of possibilities, as medical education is rapidly altering and new models are appearing of how to make the best use of clinical settings. For instance, there are far more examples of how general practice and community settings are now used for clinical learning than are suggested by this text. Similarly, the box on change management understates the difficulties of securing curricular innovations. The communication skills teaching implies a need for a ‘suite’ of facilities, which are valuable but not essential to such learning, and could risk discouraging those without physical kit from attempting to teach these. Nevertheless, the text is up to date with its comprehensive summary of the role of patients in teaching and learning, and strong in its summary of the cognitive development of new knowledge and skills, making an excellent argument for why interactive methods are essential for most learning. The diagrams supplement the text effectively through some rather cynical cartoons, giving a voice to negative reactions to learning, tend to undermine the ‘can do’ tone of the text. Its market is probably the ‘novice’ educator and the full-time clinician who is occasionally called on to teach. There are competitors, but if you do not have a book of this kind and want a quick guide then I highly recommend it.
Splenectomy during partial remission in thrombotic thrombocytopenic purpura with prolonged plasma exchange dependency
Authors: Michael J. Mant, A. Robert Turner, D. Bruce, C. Ritchie, Loree M. Larratt
Journal: American Journal of Hematology (1999)

Some patients with thrombotic thrombocytopenic purpura (TTP) remain plasma-exchange-dependent for prolonged periods of time. This exposes patients to risk, uses substantial resources, and requires prolonged hospitalization. We have splenectomized 7 such patients following 25-42 plasma exchanges while patients were in partial remission only and were clinically stable. In 6 patients, including 1 with TTP secondary to mitomycin C, thrombocytopenia promptly resolved. Relapse has not occurred during 18 or more months of observation. The seventh patient did not respond. We conclude that splenectomy should be considered as an alternative to continued plasma-exchange therapy in such patients.
Assessing the Subjective Experience of Being a Participant in Psychiatric Research
Authors: Randall D. Marshall, Robert L. Spitzer, Susan C. Vaughan, Roger Vaughan, Lisa A. Mellman, Roger A. MacKinnon, Steven P. Roose
Journal: American Journal of Psychiatry (2001)

OBJECTIVE: To address both clinical and ethical concerns in psychiatric research, the study assessed the subjective experience of being a participant in a feasibility study of outcome in long-term psychodynamic psychotherapy and psychoanalysis. METHOD: A questionnaire assessing positive and negative reactions to three typical research methodologies (self-report questionnaires, structured diagnostic interviews, and tape-recording of sessions) was administered to 23 patient-therapist pairs. RESULTS: Patients reported that questionnaires and interviews were slightly to moderately helpful in promoting self-realization and facilitating therapy, and not at all to slightly intrusive and disruptive. Adjustment to audiotaping of sessions was rapid (within two sessions). Therapists significantly overestimated the negative effects and underestimated the positive benefit patients reported from participating in research. CONCLUSIONS: Traditional objections to research in dynamic psychotherapy on the grounds that patients experience research procedures as significantly intrusive and disruptive appear to be unfounded.
770 STOPPING LONG-TERM NUCLEOS(T)IDE ANALOGUE THERAPY BEFORE HBsAg LOSS IN HBeAg NEGATIVE CHB PATIENTS: FOLLOW-UP OF LONG TERM RESPONDERS
Authors: J. Petersen, P. Buggisch, H. Hinrichsen, T. Berg, H. Wedemeyer, M. Cornberg, A. Stoehr
Journal: Journal of Hepatology (2013)
Using cerebrospinal fluid for the diagnosis of tuberculous meningitis with GeneXpert
Authors: Claudia M. Denkinger, Madhukar Pai
Journal: European Respiratory Journal (2014)

concentration.However, four replicate samples using the same protocol also demonstrated a 1.7 cycle mean difference, similar to the up to 1.9 cycle difference seen across protocols.The similarity in cycle differences suggests that differences in cycle threshold values may be due to intra-assay variation and not related to the sample processing protocol used.These results show that centrifugation may not be necessary for testing CSF.Additionally, as CSF samples tend to be paucibacillary compared to sputum, less sample reagent may be needed to produce an adequate tuberculocidal effect.Further research, ideally on paired samples from TB meningitis patients, will help elucidate the most sensitive and safest method to test CSF with the Xpert MTB/RIF test, particularly in settings that may not have access to centrifugation.
Conservatives blame rationing for winter crisis
Authors: J. Warden
Journal: BMJ (1999)

The Conservative party sharpened its attack on UK government health policy this week by claiming that rationing of health care is behind the winter crisis affecting the NHS.

At a Commons debate on Monday the health secretary, Frank Dobson, dismissed the accusation of rationing made by Ann Widdecombe, shadow health secretary. He said that government initiatives this year should ensure that …
NIH 'Research Risks Office' Reprimands Hospital Institutional Review Board
Authors: Charles Marwick
Journal: JAMA (1990)

IN WHAT is believed to be a unique action, the Office for Protection from Research Risks at the National Institutes of Health (NIH) has reprimanded an institutional review board for failing to ensure that all subjects in a clinical trial were informed. There have been instances when investigators have failed to protect research subjects properly, but none involving institutional review boards, according to Charles R. McCarthy, PhD, director of the research risks office in Bethesda, Md. McCarthy and the deputy director of the office, Alan L. Sandler, DDS, jointly sent a letter to Peter H. Wolff, MD, chair of the committee on clinical investigation at Children's Hospital, Boston, Mass, pointing out that prerandomization to a study is unacceptable when consent is being sought in only one arm of that study. Prerandomization is a procedure in which patients are randomized to receive the treatments that are being tested before being asked
Isolation and Storage of Artificially Oxygenated Mammalian Hearts
Authors: Jerome F. Levy
Journal: JAMA (1965)

A satisfactory method by which viable and uninjured mammalian hearts may be removed and stored is important to the study of cardiac homotransplantation. This report describes a method of cardiac isolation and storage. <h3>Methods</h3> All animals were anesthetized with pentobarbital (30 mg/kg) and ventilated by an automatic respirator using room air. Series 1 consisted of 24 experiments using 48 mongrel dogs (10 to 20 kg) to study the technical aspects of cardiac isolation, storage, and parallel transplantation. Series 2 consisted of 16 experiments using 16 mongrel dogs (10 to 23 kg) to study improvements in the methods for isolation and storage of the heart. <h3>Series 1.—</h3> A bilateral anterior thoracotomy was performed and both sides of the heart of the donor animal were perfused with a variety of cold (4 C) electrolyte containing solutions after ligation of the vena cava. All vessels were then ligated and divided and the heart
The pravastatin-induced decrease of biliary cholesterol secretion is not directly related to an inhibition of cholesterol synthesis in humans
Authors: Götz Kallien, Kerstin Lange, Eduard F. Stange, Jürgen Scheibner
Journal: Hepatology (1999)

3-Hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors have been reported to suppress biliary cholesterol secretion and saturation. It remains unproven whether this is mediated by inhibition of cholesterol synthesis. Therefore, the effect of a long-term administration of pravastatin on cholesterogenesis and on biliary lipid secretion was investigated in seven healthy volunteers. Placebo or 40 mg of pravastatin were taken daily at bedtime for 5 weeks using a double-blind crossover design. During the last week, 12 hours after the last drug intake 0.04 mmol [1-13C]acetate/kg. h and 0.5 g polyethylene glycol 4,000/h were infused intraduodenally for 15 hours. Plasma and duodenal bile samples were collected hourly. Thereafter, the decay of [13C]labeled plasma cholesterol was measured during the following 3 days. The fractional and absolute syntheses of plasma and biliary cholesterol were determined by gas chromatography mass spectrometry using mass isotopomer distribution analysis. At the end of the pravastatin period plasma total and low-density lipoprotein (LDL) cholesterol had decreased by 20% and 24%, respectively. Similarly, pravastatin suppressed biliary secretion rates of cholesterol, total bile acids and phospholipids (P <.05) by 46%, 36%, and 51%. As a consequence, cholesterol saturation index remained unchanged. However, fractional syntheses of cholesterol were comparable (P >.05) on placebo compared with pravastatin with 3.1% versus 4.0% in plasma and 4.3% versus 5.2% in bile after 15 hours, respectively. The mean absolute synthesis rates amounted to 0.3 mg/kg/h on placebo versus 0.4 on pravastatin (P >. 05). In conclusion, the pravastatin-induced reduction of biliary cholesterol secretion is not directly related to an inhibition of cholesterol synthesis.
The beneficial effects of ciprofloxacin on survival and hepatic regenerative activity in a rat model of fulminant hepatic failure
Authors: Kelly D. Kaita, Nimar Assy, Tony Gauthier, Manna Zhang, Adrienne F. Meyers, Gerald Y. Minuk
Journal: Hepatology (1998)

Recently, we reported that ciprofloxacin, an antimicrobial agent with γ-aminobutyric acid (GABA A ) receptor antagonist properties, significantly increases hepatic regenerative activity in animal models of alcohol-induced liver disease and cirrhosis. In the present study, we documented the effects of ciprofloxacin on survival and hepatic regeneration in a d -galactosamine ( d -gal)-induced model of acute hepatic injury in rats. One hundred nineteen adult, male Sprague-Dawley rats (n = 19-20/group) were treated with intraperitoneal d -gal (total dose: 2.5 g/kg), followed by gastric gavage with either saline, ciprofloxacin (10, 50, or 100 mg/kg), norfloxacin (250 mg/kg), or intraperitoneal putrescine (300 μmol/kg), a potent hepatic growth promoter. Mortality rates were then documented over a 4-day period. An additional 45 rats (n = 15/group) received a sublethal dose of d -gal (1.0 g/kg), followed by gastric gavage with either saline or ciprofloxacin (100 mg/kg), or intraperitoneal putrescine (300 μmol/kg). In these rats, hepatic regenerative activity was documented at 12, 24, and 60 hours post- d -gal by 3 H-thymidine incorporation into hepatic DNA and proliferating cell nuclear antigen (PCNA) staining. In the survival study, a dose-response effect of ciprofloxacin on survival was observed (ciprofloxacin: 10 mg/kg, 10%; 50 mg/kg, 26%; and 100 mg/kg, 35%) with the results in the 100-mg/kg-treated group being significant when compared with the 5% survival rate in saline-treated controls ( P &lt; .05). Survival figures in the norfloxacin- and putrescine-treated groups were not significantly improved (15% and 25%, respectively). In the regeneration study, compared with the d -gal + saline-treated control group, DNA synthesis rates at 60 hours were increased in the d -gal + ciprofloxacin and d -gal + putrescine groups (10.2 ± 3.3 vs. 18.2 ± 5.1 and 18.8 ± 6.8 × 10 3 dpm/mg DNA respectively; P &lt; .05). The results of PCNA staining also supported enhanced hepatic regeneration in the ciprofloxacin-treated group at 60 hours (saline, 13.4 ± 3.7; ciprofloxacin, 47.4 ± 7.3; and putrescine, 8.4% ± 2.8% hepatocytes staining positive). Ciprofloxacin at a dose of 100 mg/kg significantly improves survival and hepatic regenerative activity in this animal model of acute hepatic injury.
QUANTITATIVE STUDIES ON THE TOTAL PLASMIN AND THE TRYPSIN INHIBITOR OF HUMAN BLOOD SERUM
Authors: Edgar W. Todd
Journal: The Journal of Experimental Medicine (1949)

THE TOTAL PLASMIN AND THE TRYPSIN INHIBITOR WERE TITRATED SEPARATELY IN SAMPLES OF SERUM TAKEN AT WEEKLY INTERVALS FROM THREE DIFFERENT GROUPS OF SCARLET FEVER PATIENTS: (a) those who did not develop any complications, (b) those who developed purulent complications, and (c) those who developed rheumatic fever. When these determinations were plotted, it was found that the resulting curves showed characteristic patterns for each of the diseases investigated. The uncomplicated cases had plasmin curves which were considerably higher on the charts than the inhibitor curves. The septic cases had plasmin and inhibitor curves which were closer together on the charts. The rheumatic cases had plasmin and inhibitor curves which were close together and which crossed at the time of rheumatic activity so that the inhibitor curve reached a higher level than the plasmin curve.
Personal Metrics for Practice — How'm I Doing?
Authors: Richard J. Baron
Journal: New England Journal of Medicine (2005)

Interview with Dr. F. Daniel Duffy on internal medicine’s new recertification requirements. (07:08)Download Part of the challenge of being happy in medical practice arises from the difficulty of ascertaining whether we are truly succeeding as doctors. In primary care, we take on complex problems and often feel as if we're failing. So we take whatever encouragement we can get. I was flattered recently when the husband of a dying patient thanked me for my care and said, “You're one of those people who really should be a doctor.” The good feeling didn't last, however — I soon ran into a man who had changed doctors after I had counseled caution on screening with . . .
Applied Anatomy of the Eye.
Authors: David Shoch
Journal: JAMA (1963)

The late Dr. Kestenbaum was known primarily for his interest in neuro-ophthalmology and his textbook on clinical methods of neuro-ophthalmological examinations has been a standard in the field for the past 15 years. It is now apparent that he was just as deeply involved in the anatomy of the end organ as he was in the central connections of the eye. This is a most unusual book. It is not a detailed study of ocular structures like Duke-Elder or Whitnall or Wolff but it is certainly more than a mere outline of eye anatomy. Perhaps it is best described as an architectonic approach to the subject, that is, an attempt to systematize the known facts and give them a physiological interpretation. To this end there is much more emphasis on structural and physiological optics than is found in the usual eye anatomy text. (This must have delighted Dr. Arthur Linksz
Effectiveness of Coronary Care Units in Small Community Hospitals
Authors: JEOFFREY K. STROSS
Journal: Annals of Internal Medicine (1976)

A prospective study was undertaken from 1969 to 1974 to evaluate a program establishing coronary care units in small community hospitals. Crude mortality rates from acute myocardial infarction in these small hospitals were 14.5%, slightly higher but not statistically different from concurrently collected data in three larger comparison hospitals (11.5%). Multivariate discriminate analysis of clinical characteristics was used to calculate a risk score for each patient admitted. Observed deaths exceeded expected deaths (134 versus 119) (P > 0.30) in small hospitals but observed deaths were less than expected (55 versus 77) (P < 0.05) in comparison hospitals. Mortality was significantly greater in those units admitting fewer than 60 patients with infarctions yearly (20.9%) than in those admitting more than 60 (10.7%) (P < 0.001). These data suggest that coronary care units in small community hospitals can provide adequate coronary care, but their level of performance drops when fewer than 60 patients with infarctions are admitted yearly.
Mobile Coronary Care Unit.
Authors: William J. Grace
Journal: Annals of Internal Medicine (1969)

s1 May 1969Mobile Coronary Care Unit.William J. Grace, M.D., F.A.C.P., John A. Chadbourn, M.D.William J. Grace, M.D., F.A.C.P.Search for more papers by this author, John A. Chadbourn, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-70-5-1076_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe mobile coronary care unit consists of a team of physicians and nurses. This team carries, via ambulance, battery-operated portable instruments. With these the team sets up a coronary care unit outside the hospital at the site of a call from a patient with an acute myocardial infarction. Our team responds to the New York City Ambulance Dispatching Agency when a "cardiac" call is announced. On arriving at the site an electrocardiogram is taken, the monitor is attached to the patient, and an intravenous is begun. Appropriate treatment for arrhythmia may be given by drugs or electrical cardioversion. Oxygen is... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: William J. Grace, M.D., F.A.C.P.; John A. Chadbourn, M.D.Affiliations: New York, New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1969Volume 70, Issue 5 Page: 1076-1076 Keywords Acute myocardial infarction Ambulances Arrhythmia Cardiac care unit Drugs Electrocardiography Oxygen ePublished: 1 December 2008 Issue Published: 1 May 1969 PDF downloadLoading ...
A USEFUL LAMPSTAND ATTACHMENT
Authors: E. M. Bixby
Journal: JAMA (1913)

As an illumination for eye work more directly above the patient than could be obtained from the Coaklev lamp at the side of the table was needed, the desired result was secured at small cost by having a blacksmith drill a quarter-inch hole through one leg of the stand and put in a link of quarterinch iron (Fig. 1).  A stout hook was serewed in the wall at the proper height to bring the lamp about 18 inches above the table (Fig. 2).  The sliding extension and the pivoted yoke of the Coakley stand permit the lamp to be placed at any desired angle or to be pushed back out of the way while the patient is getting on or off the table.
Correction: Baylor University and Baylor College of Medicine
Authors: ERIC A. ORZECK
Journal: Annals of Internal Medicine (1985)

Letters and Corrections1 January 1985Correction: Baylor University and Baylor College of MedicineERIC A. ORZECK, M.D.ERIC A. ORZECK, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-102-1-139_4 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: I write with reference to Dr. Thomas' editorial (1) on extracorporeal shock-wave lithotripsy. Baylor University is in Waco, Texas. Baylor College of Medicine is in Houston, Texas. There is a distinct and widely maintained separation between these two similarly named institutions.The lithotripter, however, is located at the Methodist Hospital in Houston, which is a teaching hospital for Baylor College of Medicine with physically distinct funding and its own separate governing board....Reference1. FINLAYSONTHOMAS BW. Extracorporeal shock-wave lithotripsy. Ann Intern Med. 1984;101:387-8. LinkGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: 8181 N. Stadium Drive, Suite 200; Houston, TX 77054 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 January 1985Volume 102, Issue 1Page: 139-140KeywordsHospital medicine Issue Published: 1 January 1985 PDF downloadLoading ...
CORONARY REVASCULARIZATION IN PATIENTS THAT BECOME STABLE
Authors: Olivia Manfrini, Markku Eskola, Pekka Karhunen, Borejda Xhyheri, Kari Niemela, Carmine Pizzi, Heini Huhtala, Kjell Nikus, Raffaele Bugiardini
Journal: Journal of the American College of Cardiology (2012)
Biologic-Marker Studies in Alcoholism
Authors: Theodore Reich
Journal: New England Journal of Medicine (1988)

A recent large-scale, multiple-site household survey has found that alcohol abuse or dependence is extremely common. Using systematic interview techniques and reliable diagnostic criteria, researchers found that the six-month prevalence among men ranged between 8 and 10 percent, and among women, between 1 and 2 percent. Rates were highest among respondents 18 to 44 years of age and dropped sharply after the age of 45.1 Approximately 69,000 Americans died in 1980 as a direct or indirect consequence of alcohol abuse, and its estimated cost to society in 1980, including the cost of reduced productivity, was approximately $90 billion.2 , 3 Although these . . .
Polyunsaturated fatty acids in maternal diet, breast milk, and serum lipid fatty acids of infants in relation to atopy
Authors: P. Kankaanpää, K. Nurmela, A. Erkkilä, M. Kalliomäki, D. Holmberg‐Marttila, S. Salminen, E. Isolauri
Journal: Allergy (2001)

Background: The increased consumption of n‐6 polyunsaturated fatty acids (PUFA) has been shown to coincide with the increased prevalence of atopic diseases. We aimed to investigate whether maternal diet and atopic status influence the PUFA composition of breast milk and the serum lipid fatty acids of infants. Methods: Maternal diet was assessed by a food questionnaire. The PUFA composition of breast milk obtained at 3 months from 20 allergic and 20 healthy mothers and of their infants' (10 atopic and 10 nonatopic/group of mothers) serum lipids was analyzed. Results: Although no differences in maternal PUFA intake were observed, the breast milk of allergic mothers contained less γ‐linolenic acid (18:3 n‐6) than that of healthy mothers. Similarly, atopic infants had less γ‐linolenic acid in phospholipids than healthy infants, although n‐6 PUFA were elevated in other serum lipid fractions in atopic infants. The serum lipid fatty acids in atopic infants did not correlate with those in maternal breast milk. Conclusions: Our results suggest that dietary n‐6 PUFA are not as readily transferred into breast milk or incorporated into serum phospholipids, but may be utilized for other purposes, such as eicosanoid precursors, in allergic/atopic individuals. Subsequently, high dietary proportions of n‐6 PUFA, or reduced proportions of regulatory PUFA, such as γ‐linolenic acid and n‐3 PUFA, may be a risk factor for the development of atopic disease.