tbuckley/cabot-search huggingface dataset:
Are the Manpower Needs of Academic Medicine Being Met?
Authors: THOMAS W. BURNS
Journal: Annals of Internal Medicine (1979)

Editorials1 September 1979Are the Manpower Needs of Academic Medicine Being Met?THOMAS W. BURNS, M.D.THOMAS W. BURNS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-91-3-484 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptFor good reasons, health manpower questions are receiving much attention from the government and the public. The main issues being examined are the number of physicians needed for the future, their geographic distribution, and the proportion of primary-care doctors to subspecialists. Outside the medical academic community itself, little notice has been given to another manpower issue: the decline in the number of physicians being trained to serve as clinical investigators and teachers in our medical schools. It is paradoxical that when apparently too many subspecialists are being produced for clinical practice, too few subspecialists are being trained for academic medicine....References1. . Personnel Needs and Training for Biomedical and Behavioral Research. Washington D.C.: National Academy of Sciences; 1978. Google Scholar2. Financial report of medical schools. JAMA. 1977;238:2777-80. Google Scholar3. CHALLONER D. The AFCR: administrative ischemia. Clin Res. 1976; 24:237-43. MedlineGoogle Scholar4. HAUG J, ROBACK G, THEODORE C, and BALFE B. Distribution of Physicians, Hospitals, and Hospital Beds in the U.S., 1968. Chicago: Center for Health Services Research and Development, American Medical Association; 1969. Google Scholar5. GOODMAN L. Distribution of Physicians in the U.S., 1975. Chicago: Center for Health Services Research and Development, American Medical Association; 1976. Google Scholar6. FUNKENSTEIN D. Medical Students, Medical Schools, and Society During Five Eras: Factors Affecting the Career Choices of Physicians 1958-1976. Cambridge, Massachusetts: The Ballinger Publishing Co.; 1978. Google Scholar7. KIPNIS D. Clinical biomedical research and training: a challenge for the medical subspecialties. J Lab Clin Med. 1979;93:1-5. MedlineGoogle Scholar8. WYNGAARDEN J. The clinical investigator: an endangered species. Trans Assoc Am Physicians. 1979. In press. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: THOMAS W. BURNS, M.D.Affiliations: Division of Endocrinology and Metabolism University of Missouri School of Medicine Columbia, Missouri PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byManpower Needs for Academic MedicineTHOMAS W. BURNS, M.D. 1 September 1979Volume 91, Issue 3Page: 484-486KeywordsAcademic medicineForecastingSub-specialty care ePublished: 1 December 2008 Issue Published: 1 September 1979 PDF downloadLoading ...
Regulation of Dendritic Cell Differentiation and Antitumor Immune Response in Cancer by Pharmacologic-Selective Inhibition of the Janus-Activated Kinase 2/Signal Transducers and Activators of Transcription 3 Pathway
Authors: Yulia Nefedova, Srinivas Nagaraj, Amsler Rosenbauer, Carlos Muro-Cacho, Said M. Sebti, Dmitry I. Gabrilovich
Journal: Cancer Research (2005)

Abstract Abnormal dendritic cell differentiation and accumulation of immunosuppressive myeloid cells in cancer is one of the major factors of tumor nonresponsiveness. We have previously shown that hyperactivation of the Janus-activated kinase 2/signal transducers and activators of transcription 3 (JAK2/STAT3) induced by tumor-derived factors (TDF) is responsible for abnormal dendritic cell differentiation. Here, using a novel selective inhibitor of JAK2/STAT3 JSI-124, we investigated the possibility of pharmacologic regulation of dendritic cell differentiation in cancer. Our experiments in vitro have shown that JSI-124 overcomes the differentiation block induced by TDF and promotes the differentiation of mature dendritic cells and macrophages. JSI-124 significantly reduced the presence of immature myeloid cells in vivo and promoted accumulation of mature dendritic cells. In addition to a direct antitumor effect in several animal models, JSI-124 significantly enhanced the effect of cancer immunotherapy. This indicates that pharmacologic inhibition of the JAK2/STAT3 pathway can be an important new therapeutic strategy to enhance antitumor activity of cancer immunotherapy.
Functional subclasses of T lymphocytes bearing different Ly antigens. II. Cooperation between subclasses of Ly+ cells in the generation of killer activity.
Authors: H Cantor, E A Boyse
Journal: The Journal of Experimental Medicine (1975)

Lymphocytes from BALB/c or C57B6/6 mice that develop killer activity to alloantigens belong to the numerically small Ly-23 subclass of peripheral T cells, distinguished by selective expression of Ly-23 determinants on their surfaces. The maturation of these cells to killer cells can be amplified by Ly-1+ cells, which do not themselves contribute to the killer cell pool. This amplification was abolished by escluding Ia("Beta")+ cells from the stimulator population during mixed lymphocyte culture (MCL), suggesting that amplification is due to selective recognition of I region antigens by L-1+ cells, a conclusion already drawn from our previous evidence that Ia differences activate Ly-1+ cells but not Ly-23+ cells. These and other experiments indicate that amplification of killer cell production in vitro by Ly-1+ cells is not due to their conversion to Ly-23+ cells during MLC, but to their ability to recognize major histocompatibility complex determinants not recognized by Ly-23+ cells.
Glutamine: A Trojan horse in ammonia neurotoxicity
Authors: Jan Albrecht, Michael D. Norenberg
Journal: Hepatology (2006)

Mechanisms involved in hepatic encephalopathy still remain to be defined. Nonetheless, it is well recognized that ammonia is a major factor in its pathogenesis, and that the astrocyte represents a major target of its CNS toxicity. In vivo and in vitro studies have shown that ammonia evokes oxidative/nitrosative stress, mitochondrial abnormalities (the mitochondrial permeability transition, MPT) and astrocyte swelling, a major component of the brain edema associated with fulminant hepatic failure. How ammonia brings about these changes in astrocytes is not well understood. It has long been accepted that the conversion of glutamate to glutamine, catalyzed by glutamine synthetase, a cytoplasmic enzyme largely localized to astrocytes in brain, represented the principal means of cerebral ammonia detoxification. Yet, the "benign" aspect of glutamine synthesis has been questioned. This article highlights evidence that, at elevated levels, glutamine is indeed a noxious agent. We also propose a mechanism by which glutamine executes its toxic effects in astrocytes, the "Trojan horse" hypothesis. Much of the newly synthesized glutamine is subsequently metabolized in mitochondria by phosphate-activated glutaminase, yielding glutamate and ammonia. In this manner, glutamine (the Trojan horse) is transported in excess from the cytoplasm to mitochondria serving as a carrier of ammonia. We propose that it is the glutamine-derived ammonia within mitochondria that interferes with mitochondrial function giving rise to excessive production of free radicals and induction of the MPT, two phenomena known to bring about astrocyte dysfunction, including cell swelling. Future therapeutic approaches might include controlling excessive transport of newly synthesized glutamine to mitochondria and its subsequent hydrolysis. (HEPATOLOGY 2006;44:788–794.)
All GPs to be required to have defence cover
Authors: J. Warden
Journal: BMJ (1999)

All general practitioners in Great Britain will be required in future to have professional indemnity cover under amendments made to the Health Bill in the House of Lords last week.

At present, neither doctors nor dentists are required legally to maintain such cover, although almost all do so. Hospital doctors are covered by NHS indemnity but GPs are not.

Junior health minister Baroness …
Halothane hepatotoxicity and the reduced derivative, 1,1,1-trifluoro-2-chloroethane.
Authors: B R Brown, I G Sipes, R K Baker
Journal: Environmental Health Perspectives (1977)

Halothane (1,1,1-trifluoro-2-bromo-2-chloroethane) is a safe, clinically useful inhalation anesthetic. Rare, unpredictable cases of liver necrosis have been reported following its use. Although the mechanism of this reaction in man is unknown the most plausible is biotransformation to reactive intermediates compounds. The oxidative metabolism of halothane appears to be benign. There is early evidence that reductive (nonoxygen dependent) may be harmful. Since the bromine atom of halothane appears to possess weak bond energy, the reduced, debrominated derivative of halothane, 1,1,1-trifluoro-2-chloroethane, was synthesized and tested for hepatotoxicity in the rat. The derivative is unstable and thus was prepared anaerobically and trapped in propylene glycol solvent. Injection of small amounts of this compound into the portal vein of rats produces extensive liver necrosis. It is postulated that biotransformation of halothane via a reductive pathway could produce this reactive intermediate metabolite.
Smoke-Free Skies-- A Reality
Authors: T. Hensley
Journal: JNCI Journal of the National Cancer Institute (1990)

Journal Article Smoke-Free Skies— A Reality Get access Tim Hensley Tim Hensley Search for other works by this author on: Oxford Academic PubMed Google Scholar JNCI: Journal of the National Cancer Institute, Volume 82, Issue 5, 7 March 1990, Page 350, https://doi.org/10.1093/jnci/82.5.350 Published: 07 March 1990
ABC of Healthy Travel
Authors: Nancy E. Neff
Journal: Annals of Internal Medicine (1998)

Medical Writings15 March 1998ABC of Healthy TravelNancy E. Neff, MDNancy E. Neff, MDBaylor College of Medicine, Houston, TexasSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-6-199803150-00037 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail 5th edition. Walker E, Williams G, Raeside F, Calvert L. 76 pages. London: BMJ; 1997. $17.00 for ACP members; $24.00 for nonmembers. ISBN 0727911384. Order phone 800-523-1546, ext. 2600.Field of medicine: Primary care, general medicine, and family practice.Format: Softcover book.Audience: Primary care practitioners, travel clinics, travel agents, and frequent international travelers. Although geared toward residents of the United Kingdom, the recommendations seem to be universal. Practitioners in the United States may be unfamiliar with some of the terminology, but generic nomenclature is used for medications.Purpose: To provide updated information on health promotion, prevention of malaria and ... Author, Article, and Disclosure InformationAffiliations: Baylor College of Medicine, Houston, Texas PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 March 1998Volume 128, Issue 6Page: 512KeywordsAvidin biotin complexChild healthChildrenElderlyEnvironmental healthHealth information technologyHealth promotionInfectious diseasesMalaria ePublished: 15 August 2000 Issue Published: 15 March 1998 Copyright & PermissionsCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Comment on the letter to the Editor of Weissmann D et al. in Endoscopy 1991; 23: 354-355.
Authors: O. Friedrichs
Journal: Endoscopy (1993)

See also: Colonoscopic Polypectomy in Patients with Bleeding DisordersEndoscopy 1991; 23(06): 354-355DOI: 10.1055/s-2007-1009123
Adaptive Evolution of the Insulin Gene in Caviomorph Rodents
Authors: Juan C. Opazo, R. Eduardo Palma, Francisco Melo, Enrique P. Lessa
Journal: Molecular Biology and Evolution (2005)

Insulin is a conservative molecule among mammals, maintaining both its structure and function. Rodents that belong to the Suborder Hystricognathi represent an exception, having a very divergent molecule with unusual physiological properties. In this work, we analyzed the evolutionary pattern of the insulin gene in caviomorph rodents (South American hystricomorph rodents). We found that these rodents have higher rates of nonsynonymous:synonymous substitutions (dN/dS) than nonhystricomorph rodents and that values are heterogeneous inside the group. We estimated codons under positive selection, specifically the second binding site (A13 and B17) and others related with hexamerization (B18, B20, and B22). In the monomer structure, all selected sites formed a single patch around the second binding site. In the hexamer structure, these amino acids were grouped into three major patches. In this structure, contacts between B chains involved all selected sites (except B18), and between faces in the center of the molecule, all contacts were among selected sites. While there is no clear hypothesis regarding the cause of this drastic change, experimental evidence does show that this group of rodents has some peculiarities in growth function, and, whether coincidental or not, these changes appeared together with important changes in life-history traits.
Is HbA1c Influenced More Strongly by Preprandial or Postprandial Glycemia in Type 1 Diabetes?
Authors: Natalia Hillman, Lucrecia Herranz, Cristina Grande, Africa Villaroel, Luis F. Pallardo
Journal: Diabetes Care (2002)

The relative contribution of preprandial and postprandial glycemia to HbA1c has been the subject of increased interest in recent years; however, according to the American Diabetes Association, there are insufficient data to determine this accurately (1).

The objective of our study was to evaluate the accuracy of preprandial and postprandial glycemia in predicting overall glycemic control as estimated by HbA1c in type 1 diabetes.

We analyzed 112 consecutive home blood glucose records from type 1 diabetic patients who were on an intensive diabetes therapy program and who had had diabetes for >5 years. Each home blood glucose record included the blood glucose values performed before and 2 h after breakfast, lunch, and dinner during a period of 6 weeks (mean number of glucose measures performed: 237). HbA1c was measured at the end of each record period by …
Suppurative cholangitis induced by a fully covered self-expandable metal stent covering cystic stumps in a post-liver transplant patient
Authors: Arnaud Lemmers, Vincent Huberty, Delphine Degré, Celso Matos, Olivier Moine, Jacques Devière
Journal: Endoscopy (2013)

A 34-year-old woman presented with hepatalgia, fever, and chills. She had previously undergone three successive liver grafts. Most recently, she had developed a symptomatic biliary anastomotic stricture, which was treated by placement of plastic stents. Three weeks before her admission, she was treated for cholangitis related to the distal migration of the plastic stents. A 10-mm diameter × 80-mm long fully covered self-expandable metal stent (Fc-SEMS) (Wallflex; Boston Scientific, Natick, Massachusetts, USA) was placed across the stricture, with the expectation of good results [1].
Streptokinase in acute aortic dissection.
Authors: J Butler, A H Davies, S Westaby
Journal: BMJ (1990)

The benefits of treatment with thrombolytic agents in acute coronary thrombosis are well established.''°For optimal effect these agents must be given early in the course of the event before irreversible ischaemic necrosis occurs."Accurate diagnosis in patients with chest pain is therefore essential.We describe four cases of acute aortic dissection in which streptokinase was mistakenly given.
The District of Columbia And the Alcoholic
Authors: David G. Logan
Journal: JAMA (1968)

<h3>To the Editor:—</h3> I am responding to the article, "The District of Columbia's Experiences With the Alcoholic," by Grant and Tatham and the accompanying editorial (<b>202</b>:931, 980, 1967). The medical model implicit in these pieces distorts the problem of alcoholism in a subtile and destructive way. Let me illustrate with the following example: When an alcoholic stumbles home inebriated, he must be cared for. It would be mean and useless to abuse him; he is senseless and uncomprehending. So his wife must nurse him back to health. Often this is a tremendous source of gratification to the oraldependent alcoholic. He drinks precisely to reach a state of infantilism requiring such care be given him. If the wife silently condones this behavior by staying with her husband and caring for his needs, she invites further regression, and he repeatedly drinks himself happily into her arms and sweet oblivion. The ultimate
A BRIEF HISTORY OF INSANITY AND TUBERCULOSIS IN THE SOUTHERN NEGRO.
Authors: THOS. J. McKIE
Journal: JAMA (1897)

As a further elucidation of the subject of the etiology of tuberculosis and insanity in the southern negro is not without interest to the readers of theJournal, as indicated by the able article of Dr. Powell and the discussion following, which appeared in theJournalof December 5 of the year just past, the following brief history is offered as a record of the rise and progress of these allied diseases in a small portion of Edgefield County, on the extreme western border of South Carolina, and lying immediately between Stevens' Creek on the east and the Savannah River on the west. Going back to 1848, when these observations began, it may be generally stated that tuberculosis and insanity were unknown and rarely heard of as diseases of the negro, in this section of our State; but, on the other hand, it was an admitted fact that he was
Amelioration of Neurologic Abnormalities after Enzyme Replacement in Adenosine Deaminase Deficiency
Authors: Rochelle Hirschhorn, Photini S. Papageorgiou, Hermant H. Kesarwala, Lawrence T. Taft
Journal: New England Journal of Medicine (1980)

INHERITED deficiency of the purine salvage enzyme adenosine deaminase (ADA) results in the fatal infantile syndrome of severe combined immunodeficiency.1 2 3 4 The accumulation of the purine substrates of ADA, adenosine and deoxyadenosine and their metabolites, including deoxyadenosine triphosphate (deoxy ATP) and cyclic AMP, appears to provide pathophysiologic mechanisms for lymphoid toxicity.5 6 7 8 9 10 Children with severe combined immunodeficiency due to ADA deficiency are generally indistinguishable clinically from patients with severe combined immunodeficiency of other origins, 2 3 4 but they may have several additional nonimmunologic abnormalities. Bony abnormalities are found in a substantial proportion of ADA-deficient patients, 2 3 4 , 11 and in vitro abnormalities of platelet function have been . . .
A CASE OF PULMONARY INSUFFICIENCY
Authors: ROBERT ABRAHAMS
Journal: JAMA (1913)

Writers and clinicians consider pulmonary insufficiency the rarest valvular lesion of the heart. Of 24,000 admissions to the Johns Hopkins Hospital only three such cases were found, and of this number the diagnosis in only one was made during life.<sup>1</sup> In my clinic at the New York Post-Graduate Medical School and Hospital, in which nearly 800 heart cases are studied every year, the following is the first one of its kind which has come to my notice in eleven years: Mrs. J. S., aged 26, born in Hungary, no children, one miscarriage three years ago, had measles at the age of 2, and never any other infectious disease. Six years ago she was troubled with a cough which lasted six months and then abruptly disappeared. The patient tells of mild pain in the joints, but it never amounted to much. There is no such pain at present. July 1,
Association of asthma and total IgE levels with human leucocyte antigen-DR in patients with grass allergy
Authors: G. Woszczek, M.L. Kowalski, M. Borowiec
Journal: European Respiratory Journal (2002)

Exposure to grass pollens during the pollen season, reveals in sensitive patients symptoms of allergic rhinitis, conjunctivitis and/or bronchial asthma. It is not well understood why, in some patients, only symptoms of rhinitis occur while in others similar exposure causes symptoms of asthma and rhinitis. An association study is reported here, where the possible contribution of human leucocyte antigen (HLA)-DR gene polymorphisms to differential phenotypic expression of symptoms in patients with grass-pollen allergy was determined. HLA-DR genotyping was performed by the polymerase chain reaction with the sequence-specific primers method in 82 patients with symptoms of seasonal allergic rhinitis and/or bronchial asthma and 52 healthy nonatopic control subjects. A significant association was found between HLA-DRB1*02, B5* haplotype and asthma phenotype in patients with grass-pollen allergy when compared to patients with rhinitis only. Significantly higher total serum immunoglobulin E levels were observed in patients with HLA-DRB1*01 alleles in comparison to patients without these alleles. The data in this study suggest that human leucocyte antigen-DR locus, or other genes in linkage disequilibrium, may play an important role in asthma phenotype expression in patients with grass-pollen allergy as well as in determining total immunoglobulin E levels in these patients.
I Lost a King
Authors: Richard T. Watson
Journal: JAMA (1964)

The King of Siam had an intestinal obstruction. An American doctor tried to save his life but the Royal Princes refused to let a foreigner meddle—until it was too late. This is only one episode in the doctor's autobiography but, he remarks, it proved to be one of the most interesting experiences of his life. Ralph Mendelson spent his childhood at La Junta, Colo, as a member of the only Jewish family in the community. He graduated from Northwestern University Medical School. As a member of the American Red Cross Sanitary Commission during the first World War, he encountered many difficulties in trying to curb the epidemics in the Balkans. Between the wars he spent ten years in Siam as "Principal Civil Medical Officer of Health," and he gives the reader an insight into the problems of medical practice in an underdeveloped country. Preventive medicine entails a continual expenditure of
Water purification and the incidence of fractures in patients receiving home haemodialysis supervised by a single centre: evidence for "safe" upper limit of aluminium in water.
Authors: M M Platts, G Owen, S Smith
Journal: BMJ (1984)

Between 1968 and 1980 fractures occurred in 56 of 284 patients treated by home haemodialysis in the Sheffield area for longer than one year. Patients sustained four times as many fractures while using dialysate prepared with water containing more than 1.0 mumol aluminium per 1 (2.7 micrograms/100 ml) than while using water containing a smaller concentration. When aluminium was removed from water by deionisation the incidence of fractures diminished during the next year and no patient developed dialysis encephalopathy. These findings show that 1.0 mumol/l is a safe maximum concentration of aluminium in water for use in home haemodialysis. It can be detected by the colorimetric aluminium analyses used by many water authorities. When financial resources are limited it is expedient to reserve aluminium analyses by electrothermal atomic absorption for plasma from patients receiving regular haemodialysis. Ingestion of aluminium hydroxide contributes significantly to the increased plasma aluminium concentration of these patients.