tbuckley/cabot-search huggingface dataset:
Professionalism and the Medical Student
Authors: Nancy R. Angoff
Journal: Annals of Internal Medicine (2005)

Letters1 February 2005Professionalism and the Medical StudentNancy R. Angoff, MD, MPH, MEdNancy R. Angoff, MD, MPH, MEdFrom Yale University, New Haven, CT 06510.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-3-200502010-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In an effort to “bring professionalism down to earth and closer to the bedside” (1), the Editors plan to publish a series of essays and accompanying commentary on the application of the principles of professionalism as discussed in the Charter on Medical Professionalism (2). Unfortunately, the Charter on Medical Professionalism glaringly omits an important principle that is given great weight in the Hippocratic Oath but nowhere else in an ethical code. That principle mandates the teaching of the medical profession by one generation to the next. Charles K. Francis (3) points out that the story chosen to ...References1. Laine C, Sox HC. Bringing professionalism to the bedside. Ann Intern Med. 2004;141:735. [PMID: 15520435] LinkGoogle Scholar2. Medical professionalism in the new millennium: a physician charter. Ann Intern Med. 2002;136:243-6. [PMID: 11827500] LinkGoogle Scholar3. Francis CK. Professionalism and the medical student [Editorial]. Ann Intern Med. 2004;141:735-6. [PMID: 15520434] LinkGoogle Scholar4. Helms E. A lesson from the third year. Ann Intern Med. 2004;141:736. [PMID: 15520436] LinkGoogle Scholar Author, Article, and Disclosure InformationAuthors: Nancy R. Angoff, MD, MPH, MEdAffiliations: From Yale University, New Haven, CT 06510. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMedical Professionalism in the New Millennium: A Physician CharterProject of the ABIM Foundation, ACP–ASIM Foundation, and European Federation of Internal Medicine*A Lesson from the Third Year Eric Helms Bringing Professionalism to the Bedside Christine Laine and Harold C. Sox Professionalism and the Medical Student Charles K. Francis Metrics Cited byMeasuring wellness among resident physicians 1 February 2005Volume 142, Issue 3 Page: 229 Keywords Behavior Eating Medical education ePublished: 1 February 2005 Issue Published: 1 February 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Bullet Embolism From the Head to the Heart
Authors: Clement A. Hiebert
Journal: JAMA (1974)

A bullet entered the cranial vault of a boy and migrated via the transverse venous sinus to the opposite side of the skull and thence via the great veins to the right ventricle. Emergency craniotomy arrested hemorrhage, and 19 days later, the bullet was retrieved by open cardiotomy. Its location astride the left anterior descending coronary artery illustrates that removal of an apparently trivial foreign body from the heart is occasionally justified. (<i>JAMA</i>229:442-443, 1974)
Metoclopramide and Exercise-Induced Nausea
Authors: Keith Berndtson
Journal: JAMA (1990)

<h3>To the Editor.—</h3> Drs Goldschmiedt and Feldman<sup>1</sup>address the issue of exerciserelated nausea and emesis in a 25-yearold jogger. We report the case of a 29-year-old cyclist who responded to treatment with metoclopramide hydrochloride. <h3>Report of a Case.—</h3> The patient presented with a 3-year history of nausea and emesis during and immediately following 3- to 4-hour rides of 60 or more miles. Altering the content and intake patterns of replenishing fluids had no effect. Seat and stem adjustments made no difference either. Decreases in splanchnic blood flow are known to accompany exercise. Concurrent changes in the splanchnic neurohormonal milieu are less well defined. In some people, prolonged exercise apparently produces sufficient gastric stasis to cause nausea and emesis, presumably via afferent pathways to the medullary chemoreceptor trigger zone. Metoclopramide has distinct mechanisms of action as an intestinal motility stimulant and as an antiemetic. To counteract the presumed gastric stasis,
Hepatitis B Vaccine Appears Headed for Pediatric Immunization Schedule
Authors: Charles Marwick
Journal: JAMA (1991)

NINE YEARS after an effective vaccine against hepatitis B became available, and after trying numerous strategies for controlling the disease, an advisory committee of the Centers for Disease Control (CDC), Atlanta, Ga, has recommended adding hepatitis B to the pediatric immunization schedule. Thus, in time, hepatitis B should join the current standard pediatric vaccines that are used against diphtheria, tetanus, pertussis, rubella, rubeola, mumps, and poliomyelitis. This addition of hepatitis B immunization has the blessing of the American Academy of Pediatrics. Still, "since hepatitis B tends to occur among adults, it may take 15 to 20 years after its implementation before we see the effects of this policy," says Harold S. Margolis, MD, chief of the CDC's hepatitis branch. But, says Saul Krugman, MD, professor of pediatrics, New York (NY) University School of Medicine, when it is implemented, it will result in the ultimate control of hepatitis B. <h3>Rising Incidence</h3>
Beneath the surface
Authors: R. Ferner
Journal: BMJ (2013)

The three and three quarter miles from Bishop’s Road, Paddington to Farringdon Street in the City of London mark out the route of the world’s first underground railway, opened 150 years ago this month. The Times saw it as “the great engineering triumph of the day,” that afforded “a direct and expeditious means of conveyance for the enormous traffic between the east and west ends of London.”1 It had the great advantage that it avoided the increasingly tangled street traffic above, although it also had disadvantages. The trains were hauled by steam engines, and the “sulphureous gas” they emitted made it “most unpleasant to the officials, and . . . in a less degree, to the passengers themselves.”2 Indeed, two …
Unknown White Male
Authors: Piyal Sen
Journal: BMJ (2006)

A young British man wakes up on a subway train in New York City to realise that he has lost all memory of the past. He is a man without an identity. What follows is his search to rediscover himself. The chance discovery of a telephone number on his person leads him to a friend. He is thus able to find out about his home, job, friends, and family.

Doctors investigate his condition and find a pituitary tumour. The tumour is taken out but this does not improve his memory. His procedural memory is completely preserved. What he has lost is semantic memory, memory …
Administration of Hematopoietic Cytokines in the Subacute Phase After Cerebral Infarction Is Effective for Functional Recovery Facilitating Proliferation of Intrinsic Neural Stem/Progenitor Cells and Transition of Bone Marrow-Derived Neuronal Cells
Authors: Hiroshi Kawada, Shunya Takizawa, Tomomi Takanashi, Yuko Morita, Jun Fujita, Keiichi Fukuda, Shigeharu Takagi, Hideyuki Okano, Kiyoshi Ando, Tomomitsu Hotta
Journal: Circulation (2006)

Background— Hematopoietic cytokines, granulocyte colony-stimulating factor (G-CSF), and stem cell factor (SCF) were reported to show a neuroprotective effect or to support neurogenesis. These cytokines also mobilize bone marrow (BM) cells into the brain, and the BM-derived cells differentiate into neuronal cells. We administered these hematopoietic cytokines after focal cerebral ischemia and assessed their effects and the therapeutic time window for neuronal regeneration. Methods and Results— We induced permanent middle cerebral artery occlusion in mice whose BM had been replaced with BM cells from green fluorescent protein (GFP)-transgenic mice. The occluded mice were treated with G-CSF and SCF in the acute phase (days 1 to 10) or subacute phase (days 11 to 20), and the brain functions and histological changes were evaluated. Separately, we injected bromodeoxyuridine during cytokine treatment to assess cell kinetics in the brain. Six mice were prepared for each experimental group. Administration of G-CSF and SCF in the subacute phase effectively improved not only motor performance but also higher brain function, compared with acute-phase treatment. Acute-phase and subacute-phase treatments identically reduced the infarct volume relative to vehicle treatment. However, subacute-phase treatment significantly induced transition of BM-derived neuronal cells into the peri-infarct area and stimulated proliferation of intrinsic neural stem/progenitor cells in the neuroproliferative zone. Conclusions— Administration of G-CSF and SCF in the subacute phase after focal cerebral ischemia is effective for functional recovery, enhancing cytokine-induced generation of neuronal cells from both BM-derived cells and intrinsic neural stem/progenitor cells. Because G-CSF and SCF are available for clinical use, these findings suggest a new therapeutic strategy for stroke.
Foreign Bodies and Operations
Authors: C. V. Braimbridge
Journal: BMJ (1963)

BDlcBL jORNAL 1609the only tonometer which can be used by opticians, and over 200 cases of incipient glaucoma are said to have been detected and referred to ophthalmic surgeons through its use.Its routine use may well enable many patients to avoid the consequence of established glaucoma.The principle of this instrument is the same as that of the guard-ring electromanometer developed in this hospital for obstetric work and described in the Journal of Physiology' and the Journal of Obstetrics and Gynaecology,2 and it is made by Biotronics, Inc., Oak- land 12, California, by agreement with the National Research Development Corporation.It would be interesting to learn whether opticians in this country should be encouraged to screen patients for abnormal intraocular pressures with this type of device.-Iam, etc.,
Abstract 14742: A Concomitant Switch Towards Th17 And Treg Responses Mediates Atheroprotection In T-bet-deficient Mice
Authors: Charlotte Lahoute, Rabia Bentata, Melissa Romain, Olivier Herbin, Bruno Esposito, Ludivine Laurans, Christoph Binder, Andrew Lichtman, Alain Tedgui, Ziad Mallat
Journal: Circulation (2011)

T-box transcription factor (T-bet) is required for Th1 differentiation. A previous study showed that T-bet deficiency in Ldlr-/- mice reduced lesion development, which was associated with a clear T...
Fortnightly review: Drug treatment during pregnancy
Authors: P. Rubin
Journal: BMJ (1998)

For most doctors prescribing a drug to a pregnant woman is like taking a journey through uncharted territory; navigation is made no easier by the darkness cast by “thalidomide's long shadow.”1 The usual benchmarks are absent because evidence from large clinical trials doesn't exist for drug treatment during pregnancy. Information on many drugs includes non-specific warnings along the lines of “not to be used in pregnancy unless the benefits outweigh the risks,” even though the benefits may not have been confirmed and the risks are not specified. Also, the disease being treated may affect or be affected by pregnancy. Nevertheless, at least a third of all pregnant women in the United Kingdom are prescribed at least one course of drug treatment.2 The purpose of this review is to summarise some of the important points that should be considered when prescribing drugs for pregnant women.

#### Summary points

For obvious ethical reasons there are few randomised and placebo controlled clinical trials designed to evaluate the safety and efficacy of drugs in pregnancy. Exceptions to this rule include studies of aspirin in the prevention of pre-eclampsia 3 4 and some small studies of antihypertensive agents. 5 6 Studies of drug treatment during pregnancy are usually done as retrospective analyses (performed by reviewing charts or monitoring prescriptions) or case reports. Case reports are important in recording alleged adverse effects but suffer from the weakness of being anecdotal evidence. The problem is that in 1-2% of all pregnancies in developed countries …
Complex Pattern of Coalescence and Fast Evolution of a Mitochondrial rRNA Pseudogene in a Recent Radiation of Tiger Beetles
Authors: J. Pons
Journal: Molecular Biology and Evolution (2005)

Transposed copies of mitochondrial DNA into the nucleus (numts) are widespread, but to date they have not been described from the Coleoptera (beetles). Here we report the discovery of a numt derived from a mitochondrial ribosomal RNA gene in Australian tiger beetles (genus Rivacindela). The loss of function of the numt was confirmed by high proportion of transversions, numerous noncompensatory substitutions in stem regions, and large deletions in functionally important sequences. Phylogenetic analysis of orthologous numt sequences was performed together with the corresponding mtDNA lineage for a study of origination and establishment of the transposed copies in closely related populations and species. All numt sequences were strongly supported to be monophyletic, indicating a single origin of this element. However, populations were polymorphic for the presence of the numt, and phylogenetic trees based on the numt sequences showed inconsistencies with the corresponding mtDNA phylogeny, suggesting slower processes of fixation compared to the mtDNA sequences. In a side-by-side comparison with their mtDNA sister lineage, the nucleotide substitution rate of 1.66 x 10(-8) substitutions/site/year in the numts was approximately equal to the average rate of mtDNA in this group but substantially higher than previous estimates of neutral nuclear rates in vertebrates. The numt clade was affected by several deletions but no insertions, with estimates of nucleotide loss exceeding the rate of nucleotide substitutions by approximately five times. The young age of the Rivacindela numt clade, their absence in species outside of a narrow lineage of related individuals, and the high rate of deletions suggest that insertions do not persist in this group, which is consistent with the view that comparatively small genomes as those of Coleoptera harbor fewer mitochondrial and other nuclear pseudogenes.
Quantitating Abdominal Pain
Authors: Nathaniel Shafer
Journal: JAMA (1967)

ABSTRACT To the Editor:— In reply to the letter of J.V. Gilkey, MD, (202:152, 1967) in which he comments on my paper Technique for Quantitating Abdominal Pain (201:558, 1967) I would say that technically Dr. Gilkey is correct in his semantic argument.Pain may be defined as the subjective complaint of the patient, whereas tenderness is the pain the patient suffers when the physician applies pressure. However, I fail to understand the practical significance of this point, and it appears that Dr. Gilkey, is indeed, engaged in an academic quibble. For that matter, we are not measuring pain or tenderness but the pressure which the physician must apply to elicit pain.Concerning his implication that the proposed technique is potentially misleading, I would direct him again to my statement obviously, this technique is not to be used to the exclusion of the usual methods of examining the abdomen, but
Expression of the MDR1 Gene in Human Gastric and Colorectal Carcinomas
Authors: T. Mizoguchi, K. Yamada, T. Furukawa, K. Hidaka, T. Hisatsugu, H. Shimazu, T. Tsuruo, T. Sumizawa, S.-i. Akiyama
Journal: JNCI Journal of the National Cancer Institute (1990)

We measured expression of the MDR1 gene (also known as the PGY1 gene) in the human gastrointestinal tract. MDR1 messenger RNA (mRNA) levels were elevated in 13 of 15 colorectal carcinoma specimens and in six of 13 gastric carcinoma specimens. Well-differentiated colorectal carcinomas contained significantly higher concentrations of MDR1 mRNA than moderately differentiated colorectal carcinomas. Similarly, moderately differentiated gastric carcinomas contained higher concentrations of MDR1 mRNA than poorly differentiated gastric carcinomas. MDR1 gene expression in normal colorectal and gastric tissues adjacent to carcinomas was similar to that in the carcinomas. MDR1 gene expression in xenografts of colorectal and gastric carcinomas in nude mice was also investigated. Elevated expression of the MDR1 gene was seen in only four of 18 xenografts of colorectal carcinoma and was not seen in any xenografts of gastric carcinoma. P-glycoprotein was distributed over the luminal surface of the colorectal carcinoma. These results imply that the higher levels of MDR1 mRNA found in well-differentiated carcinomas derived from colorectal tissues are the results of increased expression of the MDR1 gene in the luminal surface cells. The level of expression of the MDR1 gene in colorectal and gastric carcinomas appears to correlate with the degree of differentiation and also appears to be affected by transplantation into nude mice.
Late Effects of Botulinum Intoxication
Authors: Joseph C. Maroon
Journal: JAMA (1977)

To the Editor.—  After reading the article by Barker et al (237:456,1977) regarding the outbreak of bolulism and the subsequent management of the involved patients, we had occasion to examine their case 1 3 1/2 years after his intoxication. He was seen because of persistent fatigue, intermittent diplopia, and decreased sexual ability. Prior to the patient's botulism intoxication, he was physically and sexually active for his age; subsequent to this, although not incapacitating, these symptoms remain substantially distressing and have resulted in multiple consultations with different specialists.  Barker et al reported good, immediate response to the trivalent botulism antitoxin and further commented that all cases of intoxication returned to normal after a few weeks. Although this is usually the case with botulism intoxication, we believe it is quite easy to overlook, at times, the subtle disturbances that may persist but are not incapacitating. Cherington 1 notes, for example, that recovery
HINTS ON THE USE OF DRAINAGE TUBES.
Authors: Y W. L. GETZ
Journal: JAMA (1885)

Some months ago we had occasion to evacuate a pelvic abscess, and use a drainage tube as a means of thorough drainage. Not having at hand at the time a regular drainage tube, we constructed one out of a piece of plain (small size) rubber tubing. After being in the opening for several days we desired to replace it by another tube; we attempted to remove it, found that the opening in the tissues through which the tube had passed had contracted so as to hold tightly the tube, and although we made but slight traction, anticipating the possibility of the tube's breaking, to our extreme discomfort and dissatisfaction, we soon realized that our anticipations were realities, a portion of the tube, an inch in length, remaining within the pelvic cavity. We succeeded in removing it by dilating the opening through which the tube was passed; then introducing a small
Abstract 1696: Regulation of sensitivity to the platinum-containing drugs by the sec61 translocon
Authors: Paolo B. Abada, Stephen B. Howell
Journal: Cancer Research (2011)

Abstract The Sec61 protein translocon is a multimeric complex that allows the transport of proteins across or laterally into a lipid bilayer. Components of the sec61 complex are involved in retrotranslocation, Golgi structure and vesicle transport. We have discovered that one component of this complex, the sec61β subunit, modulates cellular sensitivity to the platinum-containing drugs. As part of an effort to enhance sensitivity to the platinum drugs we sought to determine the mechanism of this effect. Sec61β expression in human 2008 ovarian cancer cells was constitutively knocked down by infection with a lentivirus producing an shRNA targeting sec61β, and knockdown was confirmed by qRT-PCR and western blot analysis which demonstrated a 96% reduction in mRNA expression and 87% reduction at the protein level. Effects on drug sensitivity were measured using an SRB assay, and platinum drug accumulation was quantified by inductively coupled plasma mass spectrometry. Sec61β knockdown (KD) did not alter cell viability or growth rate but resulted in 8-, 16.8- and 9-fold resistance to cisplatin, carboplatin, and oxaliplatin, respectively. Resistance to several other clinically relevant chemotherapeutics including paclitaxel, doxorubicin, vincristine, and etoposide was also increased but to a smaller extent (1.7 to 7-fold). Sec61β KD reduced the cellular accumulation of cisplatin to 67% of that in the parental cells. Given that transporters and chaperones that manage copper homeostasis regulate platinum drug accumulation and efflux, their expression in 2008 sec61β KD cells was analyzed by western blot. Among these, ATP7A was found to be 2-fold over-expressed while no change in ATP7B, ATOX1, or CTR2 could be detected. This increase in ATP7A expression was not altered by pretreatment with copper, cisplatin, or the copper chelator bathocuproine disulfonate. We conclude that the sec61β translocon modulates the cytotoxicity of many chemotherapeutic agents with the largest effect being on sensitivity to the platinum drugs. Sec61β regulates expression of the copper export transporter ATP7A that we have previously shown to control platinum drug sequestration and efflux. 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 1696. doi:10.1158/1538-7445.AM2011-1696
Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial
Authors: David A Fitzmaurice, F D Richard Hobbs, Sue Jowett, Jonathon Mant, Ellen T Murray, Roger Holder, J P Raftery, S Bryan, Michael Davies, Gregory Y H Lip, T F Allan
Journal: BMJ (2007)

<b>Objectives</b> To assess whether screening improves the detection of atrial fibrillation (cluster randomisation) and to compare systematic and opportunistic screening. <b>Design</b> Multicentred cluster randomised controlled trial, with subsidiary trial embedded within the intervention arm. <b>Setting</b> 50 primary care centres in England, with further individual randomisation of patients in the intervention practices. <b>Participants</b> 14 802 patients aged 65 or over in 25 intervention and 25 control practices. <b>Interventions</b> Patients in intervention practices were randomly allocated to systematic screening (invitation for electrocardiography) or opportunistic screening (pulse taking and invitation for electrocardiography if the pulse was irregular). Screening took place over 12 months in each practice from October 2001 to February 2003. No active screening took place in control practices. <b>Main outcome measure</b> Newly identified atrial fibrillation. <b>Results</b> The detection rate of new cases of atrial fibrillation was 1.63% a year in the intervention practices and 1.04% in control practices (difference 0.59%, 95% confidence interval 0.20% to 0.98%). Systematic and opportunistic screening detected similar numbers of new cases (1.62% <i>v</i> 1.64%, difference 0.02%, −0.5% to 0.5%). <b>Conclusion</b> Active screening for atrial fibrillation detects additional cases over current practice. The preferred method of screening in patients aged 65 or over in primary care is opportunistic pulse taking with follow-up electrocardiography. <b>Trial registration</b> Current Controlled Trials ISRCTN19633732.