tbuckley/cabot-search huggingface dataset:
Practice research. Training for general practice: clinical behaviour in trainers and trainees.
Authors: D J Bain
Journal: BMJ (1984)

A study of 20 trainers and their trainees in general practice showed that trainees had a statistically significant improvement in their diagnosis of otitis media during their trainee year and also became quicker in the time taken for history taking and examination. There was a fall in trainees' prescribing of antibiotics for otitis media during the study but this was accompanied by a notable rise in prescribing of decongestant-antihistamine mixtures to a level similar to that of the trainers. Trainees seemed to accept readily their trainers' prescribing policies and were hesitant to challenge them. An important finding was that trainees had little influence on trainers' prescribing, the latter showing no appreciable changes during the study.
TCT-704 Long Term Results of COSTAS-I First-in-Human Study of the Colibri Heart Valve, A Pre-mounted, Pre-packaged, Low Profile Transcatheter Aortic Valve in a 14 French Delivery System
Authors: Richard D. Fish, Pedro E. Urena, Ingrid Valdez, Ramon Almanzar, Erika M. Perez, GERARDO DELAROSA, David Paniagua, Bernard Chevalier
Journal: Journal of the American College of Cardiology (2014)
Medical Ethics and Human Rights Violations: The Iraqi Occupation of Kuwait and Its Aftermath
Authors: Troyen A. Brennan, Robert Kirschner
Journal: Annals of Internal Medicine (1992)

Immediately after the liberation of Kuwait by a coalition of allied forces in March 1991, representatives of Physicians for Human Rights traveled to Kuwait and conducted an inquiry into human rights violations allegedly perpetrated by Iraqi forces. The inquiry focused on the abuses that were said to have occurred in health care institutions. Human rights abuses by the Iraqis in Kuwaiti hospitals were documented, but certain allegations proved to be unfounded. However, Kuwaiti abuses of those accused of collaborating with the Iraqi invaders, in particular Palestinian citizens of Kuwait, were also observed. The trip and inquiry generated questions about the scope and applicability of medical ethical principles to physicians in different cultures and in situations unlike those in which medicine is normally practiced. In light of the Kuwait experience, Physicians for Human Rights has drawn tentative conclusions about the universal nature of medical ethics.
The Nature, Qualities, and Varieties of Medical Research
Authors: JAY TEPPERMAN
Journal: Annals of Internal Medicine (1962)

Special Article1 April 1962The Nature, Qualities, and Varieties of Medical ResearchJAY TEPPERMAN, M.D.JAY TEPPERMAN, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-56-4-645 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThe title of my paper is: "The Nature, Qualities, and Varieties of Medical Research." I hasten to assure you that this title was not composed by me, and that, while it permits almost limitless room for maneuver, my qualifications allow me to explore only a small corner of the subject with you.From my vantage point in Syracuse, which my downstate friends persist in believing to be only two or three miles south of Hudson Bay, I have seen enough of the complex world of medical research to welcome this opportunity to attempt a kind of panoramic view. However, I...References1. CONN JW: Primary aldosteronism. J. Lab. Clin. Med. 45: 661, 1955. MedlineGoogle Scholar2. MESELSONSTAHL MFW: The replication of DNA in Escherichia coli. Proc. Nat. Acad. Sci. 44: 671, 1958. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Syracuse, New YorkThis paper was presented, with illustrative lantern slides, as one in a series of Lectures to the Laity at the New York Academy of Medicine, on February 8, 1961. The author is grateful to Dr. Iago Galdston, Secretary of the Academy, for permission to reprint this essay.Requests for reprints should be addressed to Jay Tepperman, M.D., Department of Pharmacology, State University of New York at Syracuse, College of Medicine, 766 Irving Avenue, Syracuse 10, New York. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByEVALUATION OF PROGRAMS IN OCCUPATIONAL HEALTH 1 April 1962Volume 56, Issue 4Page: 645-657KeywordsBiologicsResearch quality assessment Issue Published: 1 April 1962 PDF DownloadLoading ...
Germline<i>TP53</i>Mutations in Patients With Early-Onset Colorectal Cancer in the Colon Cancer Family Registry
Authors: Matthew B. Yurgelun, Serena Masciari, Victoria A. Joshi, Rowena C. Mercado, Noralane M. Lindor, Steven Gallinger, John L. Hopper, Mark A. Jenkins, Daniel D. Buchanan, Polly A. Newcomb, John D. Potter, Robert W. Haile, Raju Kucherlapati, Sapna Syngal
Journal: JAMA Oncology (2015)

Li-Fraumeni syndrome, usually characterized by germline TP53 mutations, is associated with markedly elevated lifetime risks of multiple cancers, and has been linked to an increased risk of early-onset colorectal cancer.To examine the frequency of germline TP53 alterations in patients with early-onset colorectal cancer.This was a multicenter cross-sectional cohort study of individuals recruited to the Colon Cancer Family Registry (CCFR) from 1998 through 2007 (genetic testing data updated as of January 2015). Both population-based and clinic-based patients in the United States, Canada, Australia, and New Zealand were recruited to the CCFR. Demographic information, clinical history, and family history data were obtained at enrollment. Biospecimens were collected from consenting probands and families, including microsatellite instability and DNA mismatch repair immunohistochemistry results. A total of a 510 individuals diagnosed as having colorectal cancer at age 40 years or younger and lacking a known hereditary cancer syndrome were identified from the CCFR as being potentially eligible. Fifty-three participants were excluded owing to subsequent identification of germline mutations in DNA mismatch repair genes (n = 47) or biallelic MUTYH mutations (n = 6).Germline sequencing of the TP53 gene was performed. Identified TP53 alterations were assessed for pathogenicity using literature and international mutation database searches and in silico prediction models.Frequency of nonsynonymous germline TP53 alterations.Among 457 eligible participants (314, population-based; 143, clinic-based; median age at diagnosis, 36 years [range, 15-40 years]), 6 (1.3%; 95% CI, 0.5%-2.8%) carried germline missense TP53 alterations, none of whom met clinical criteria for Li-Fraumeni syndrome. Four of the identified TP53 alterations have been previously described in the literature in probands with clinical features of Li-Fraumeni syndrome, and 2 were novel alterations.In a large cohort of patients with early-onset colorectal cancer, germline TP53 mutations were detected at a frequency comparable with the published prevalence of germline APC mutations in colorectal cancer. With the increasing use of multigene next-generation sequencing panels in hereditary cancer risk assessment, clinicians will be faced with the challenge of interpreting the biologic and clinical significance of germline TP53 mutations in families whose phenotypes are atypical for Li-Fraumeni syndrome.
US ready for healthcare reform, conference told
Authors: Richard Smith
Journal: BMJ (2008)

The United States finally has a chance to reform health care, said Len Nichols, director of the health policy programme of the New America Foundation, a non-profit public policy institute based in Washington and California, at a conference on innovation in health care in San Diego last month.

The main driver, said Dr Nichols, is the cost of health insurance to middle class families. In 1987 the median spend on health insurance was 7% of family income, but now it’s 17%. Cost was also a driver of the failed reforms of Hillary Clinton, but last time the pain was caused by the recession and went away when the recession ended. “Now,” said Dr Nichols, “it’s systemic.”

Another crucial driver is the cost to business, accompanied by the growing intensity …
THE UTILITY OF ADENOSINE STRESS-REST CARDIAC MAGNETIC RESONANCE IMAGING IN EVALUATING CARDIAC FUNCTION AND PERFUSION IN WOMEN WITH SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Pavel Goykhman, Louise E.J. Thomson, Yuching Yang, Leslee J. Shaw, Daniel S. Berman, Edward Gill, Mariko L. Ishimori, Rebecca Martin, Daniel J. Wallace, Jay N. Schapira, Chrisandra L. Shufelt, Michael H. Weisman, C. Noel Bairey Merz
Journal: Journal of the American College of Cardiology (2010)
European training of paediatricians to paediatric pulmonologists
Authors: J. Gerritsen, K-H. Carlsen
Journal: European Respiratory Journal (2002)

Paediatric pulmonology is a relatively young subspeciality of paediatrics that started in the midst of the 20th century. In many countries in Europe, paediatricians took the initiative to start a separate section or department dedicated to paediatric pulmonology. They were all trained paediatricians who recognised the importance of subspecialisation in paediatric pulmonology, as the pulmonary diseases occurring in infants and children, such as cystic fibrosis, asthma, congenital lung diseases, etc. , are different from those seen in adults. In some cases, they also had close connections with adult pulmonology departments as well as paediatric departments. At the same time, research projects focusing on paediatric pulmonology were started. Nowadays, many high-quality studies are published within the field of paediatric pulmonology and the European Respiratory Journal has found its own place in this important field.

Training programmes and guidelines were started in the 1970s in Australia and, later, in the USA. In Europe, the development of training …
Books Needed by Dayton Physicians to Replace Those Destroyed by the Flood
Authors: Horace Bonner
Journal: JAMA (1913)

including many unfortunates who are nigh unto death and are »pending all the money they have under the delusion, fostered by the cure-all doctors, that they can be fully restored to health."A CLEANUP PROMISED In Washington a law has been enacted providing for the prosecution pf persons who publish untrue, deceptive or mis¬ leading advertisements.The prosecuting attorney of the county in which Seattle is located has given it as his opinion that these advertising quack specialists can undoubtedly be icachcd under the law and driven from the city, and he expresses it us his intention to undertake prosecutions when the law becomes elfective in June of this year.The work of the Seattle Sun in thus exposing quack organizations similar to that of the "United Doctors" in the central West, deserves the highest praise.It is understood that the Post-1 nicUigencer, another lending paper of Seattle, has recently adopted the policy of excluding from its advertising columns all fraudu¬ lent medical advertising.
Abstract 811: Co-inhibition of cyclooxygenase-2 and inducible nitric oxide synthase prevents N-nitrosomethylbenzylamine-induced esophageal squamous cell carcinoma in rats
Authors: Huaji Guan, Fei Yan, Yufen Wang, Carter Battista, Xin Huang, Gary D. Stoner, Ronald G. Nines, Alexandria M. Edmonds, Tong Chen
Journal: Cancer Research (2011)

Abstract Hyperactivation of cyclooxygenase-2 (COX-2) and inducible nitric oxide synthase (iNOS) has been observed separately in esophageal squamous cell carcinoma (ESCC) in rats that is induced by N-nitrosomethylbenzylamine (NMBA), a powerful carcinogen found in some human diets. In approach to discover new prevention strategies for ESCC, celecoxib and S,S′-1,4-phenylene-bis(1,2-ethanediyl)bis-isothiourea (PBIT), selective inhibitors respectively to COX-2 and iNOS, were evaluated in the NMBA-rat preclinical esophageal cancer model. F344 rats were treated with NMBA (0.30mg/kg b.w.) three times per week for five weeks. Seventy-two hours after the last NMBA treatment, rats were fed with control diet with or without different doses of celecoxib and PBIT. At week 35, rats were sacrificed and esophageal tumors were counted. Celecoxib (1000 ppm) or PBIT (100 ppm) alone, and a combination treatment with celecoxib (500 ppm) and PBIT (50 ppm), significantly decreased the NMBA-induced tumor multiplicity (from 4.73 ± 0.45 to 2.00 ± 0.25, 1.89 ± 0.23, and 1.61 ± 0.27, respectively), which were accompanied by the inhibition of transcription, translation and kinase activity of both COX-2 and iNOS in all these treatments. By using this COX-2/iNOS co-inhibition strategy, celecoxib/PBIT combination inhibited cancerous esophagus cell proliferation by immunohistochemistry staining of PCNA, and decreased c-Myc expression in NMBA-induced papillomas by Western blot analysis. In addition, the histopathological examination of rat esophagus showed that celecoxib/PBIT combination significantly prevented NMBA-induced tumor transformation (from 8.373% to 1.765%). In conclusion, our results indicated that co-inhibition of COX-2 and iNOS by Celecoxib/PBIT combination prevented NMBA-induced ESCC in rats, which represents a new means of esophageal cancer prevention. (Supported by NIH/NCI RO1 CA131073-01A1). Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 811. doi:10.1158/1538-7445.AM2011-811
Merck to pay $5bn in rofecoxib claims
Authors: Fred Charatan
Journal: BMJ (2007)

the consultant pathologist whose failure to disclose the results of micro biological tests on one of Sally Clark's two baby sons led to the quashing of her murder convictions, lost his High Court appeal last week against a finding of serious professional misconduct.Mrs Clark was convicted in 1999 of kill ing babies Christopher and Harry but was cleared on appeal in 2003 after spending three and a half years in prison.She died earlier this year at the age of 42.A coroner ruled this week that the cause of her death was acute alcohol intoxication.A General Medical Council fitness to practise panel found Dr Williams, aged 58, guilty of serious professional misconduct in 2005 for not disclosing the results of tests on her second son, Harry, at or before her trial.Dr Williams was banned from doing Home Office forensic pathology or coro ners' work for three years, although he was allowed to continue working as a consult ant histopathologist at Macclesfield General Hospital, in Cheshire.His lawyers appealed on a range of issues, including delays in bringing his case before the GMC.But Mr Justice Davis ruled last week, "In my judg ment this appeal fails on essentially every ground advanced.There was no procedural unfairness giving rise to injustice; nor were the findings and conclusions of the panel wrong."Mrs Clark was cleared after a second appeal, when previously unreported micro biological results came to light.They showed the presence of Staphylococcus aureus at eight sites of the baby's body, including cerebro spinal fluid, raising the possibility that Harry died from natural causes.Dr Williams told the GMC panel that he had not considered the tests to be relevant and that if the defence had wished to see them, they should have asked for them. Court upholds GMC decision over Sally Clark case pathologistUK NEWS Charity warns of proposed restrictions to asylum seekers' access to care, p 1012 World NEWS �erck to pay ���n in rofeco�i� claims, p 1011 �erck to pay ���n in rofeco�i� claims, p 1011 , p 1011 �mj.com �o�ernment may lea�e some patients out of 1�� week tar�et �o�ernment may lea�e some patients out of 1�� week tar�et
Medical causes of seizures
Authors: Norman Delanty, Carl J Vaughan, Jacqueline A French
Journal: The Lancet (1998)

Seizures are commonly encountered in patients who do not have epilepsy. Factors that may provoke such seizures include organ failure, electrolyte imbalance, medication and medication withdrawal, and hypersensitive encephalopathy. There is usually one underlying cause, which may be reversible in some patients. A full assessment should be done to rule out primary neurological disease. Treatment of seizures in medically ill patients is aimed at correction of the underlying cause with appropriate short-term anticonvulsant medication. Phenytoin is ineffective in the management of seizures secondary to alcohol withdrawal, and in those due to theophylline or isoniazid toxicity. Control of blood pressure is important in patients with renal failure and seizures. Non-convulsive status epilepticus should be considered in any patient with confusion or coma of unclear cause, and electroencephalography should be done at the earliest opportunity. Most ill patients with secondary seizures do not have epilepsy, and this should be explained to patients and their families. Only those patients with recurrent seizures and uncorrectable predisposing factors need long-term treatment with anticonvulsant medication.
TREATMENT OF POST-OPERATIVE SHOCK BY PITUITARY EXTRACT
Authors: G. G. Wray
Journal: BMJ (1909)

BF Ir4ithe telescope.The shutters can be moved into the field from right and left respectively, each by its own micrometer screw, and to each screw is attached a drum, the one being on the right and the other on the left of the telescope.On each of these drums is cut a helical slot in which runs an index, and the drum is engraved (see Fig. 3) in such a man- ner that the __ ' i : reading of the index gives the position in the spectrum of the corresponding shutter in wave- lengths direct.~~~~~'Thus, it will be seen that if, for instance, the left drum- -~~~head is 5,320
Prenatal Screening for Down's Syndrome — A Search for the Family's Values
Authors: Joshua A. Copel, Ray O. Bahado-Singh
Journal: New England Journal of Medicine (1999)

Since the introduction of amniocentesis for the prenatal detection of genetic diseases, there has been a progressive refinement of the criteria used to determine who should be offered the test. Initially, amniocentesis was offered to women considered to be at high risk for having a pregnancy affected by Down's syndrome solely on the basis of age, because of the high rates of miscarriage associated with the procedure.Maternal age by itself is not an efficient screening marker for Down's syndrome: its sensitivity is too low. Only 20 percent of infants with Down's syndrome are born to women 35 years of . . .
Epidemic-Typhus Antibodies in Human Subjects in Boston, Massachusetts
Authors: E. S. Murray, S. Cohen, J. Jampol, A. Ofstrock, J. C. Snyder
Journal: New England Journal of Medicine (1952)

WHEN a clinician is consulted by a patient who formerly lived in an epidemic typhus zone and who now has fever, headache and possibly a rash, he must include Brill's disease in his differential diagnosis.1 , 2 The confirmation or elimination of the diagnosis of Brill's disease depends on the use of the complement-fixation test with epidemic typhus antigen.1 , 3 The interpretation of the results of the complement-fixation test is influenced by Zinsser's concept,4 which postulates that a patient with Brill's disease has previously suffered an attack of louseborne typhus fever. This hypothesis has been considerably strengthened by recent studies.1 2 3 Anyone suspected of . . .
<i>Effective Clinical Practice</i>: A New Journal, Another Point of View
Authors: Frank Davidoff
Journal: Annals of Internal Medicine (1999)

Editorials6 July 1999Effective Clinical Practice: A New Journal, Another Point of ViewFrank Davidoff, MDFrank Davidoff, MDEditor (Davidoff)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-1-199907060-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In August 1998, a new journal, Effective Clinical Practice, appeared on the biomedical scene (1). With thousands of journals already out there, and health professionals struggling to stay ahead of the information explosion, why another journal at this time?The answer is that Effective Clinical Practice is not really new, just better. The Alliance of Community Health Plans (formerly the HMO Group), the major professional association of nonprofit managed care organizations, had for some years published the predecessor of Effective Clinical Practice, HMO Practice, which was distributed to about 15 000 physicians and other health professionals. As the managed care ...References1. Effective Clinical Practice. 1999; 1:1-48. Google Scholar2. Davidoff F. Medicine and commerce. 1: Is managed care a “monstrous hybrid”? [Editorial]. Ann Intern Med. 1998;128:496-9. LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Editor (Davidoff) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 6 July 1999Volume 131, Issue 1Page: 64-65KeywordsComputed axial tomographyDecision makingEpidemiologyHealth information technologyHealth maintenance organizationsHealth services researchPrevention, policy, and public healthQuality improvementRivers ePublished: 15 August 2000 Issue Published: 6 July 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
ATP dependence of calcium uptake by the Na-Ca exchanger of adult heart cells.
Authors: R A Haworth, A B Goknur
Journal: Circulation Research (1992)

The ATP dependence of the Na-Ca exchanger was investigated in isolated adult rat heart cells to evaluate the extent to which ATP depletion after a period of ischemia plus reperfusion in whole hearts could limit calcium uptake by Na-Ca exchange. A standard state for measurement of Na-Ca exchange activity that could be used with cells depleted of ATP to different degrees was defined. This was a state of zero sarcolemmal gradient for sodium, potassium, and pH and was achieved by incubation of the cells for 5 minutes with EDTA, EGTA, ouabain, and nigericin. Heterogeneity of cell ATP levels was minimized by using a protocol of total ATP depletion by incubation under conditions similar to ischemia, followed by reoxygenation to give partial restoration of ATP levels. No ATP was regenerated when cells were reoxygenated in the presence of rotenone, and such cells showed a very low rate of calcium uptake. Without rotenone, cells showed an almost complete restoration of Na-Ca exchange activity, in spite of a restoration of ATP levels to only one third of control values. Thus, the dependence of calcium uptake on ATP was highly nonlinear under these conditions. The calculated Km for ATP was no more than 10% of normal ATP levels. We conclude that ATP depletion after ischemia plus reperfusion is unlikely to limit the rate of calcium uptake through Na-Ca exchange in the whole heart if at least one quarter of the ATP is restored. In addition, we measured the apparent ATP dependence of calcium uptake by Na-Ca exchange in cells under conditions in which we previously had concluded that cell ATP distributions were very heterogeneous: when cells undergo contracture during incubation with oligomycin and without glucose. A linear relation between calcium uptake rate and ATP was observed at all ATP levels. This can be understood if cells in contracture that are incubated with oligomycin cannot take up calcium because of low ATP, whereas rod-shaped cells are able to retain a full uptake capability. This result further supports our conclusion that the ATP level declines catastrophically to near zero in these oligomycin-incubated cells just before contracture.