tbuckley/cabot-search huggingface dataset:
The football club doctor system
Authors: S Boyce
Journal: British Journal of Sports Medicine (2001)

The football club doctor system EDITOR,-I read with interest the paper by Waddington et al 1 highlighting the inadequacies of the football club doctor system in Britain.This paper confirms the situation that many people already knew to exist.Advertisements for club doctors are rarely published in medical journals, doctors normally being appointed on a "who you know" basis.It is also particularly disappointing that, at a time when the specialty of sports and exercise medicine is being established in this country, the majority of doctors working with professional footballers have no qualifications or little experience in the specialty.However, this is not confined to football clubs and probably also applies to rugby clubs and many other sporting associations.One aspect not mentioned in the paper is medical litigation.It is to be hoped that doctors involved with football clubs have arranged medical defence cover, because, if a situation arises in which a player's sporting career is threatened by medical mismanagement and the doctor involved has no professionally recognised sports medicine qualification, he or she could be found guilty of medical negligence.With the amount of money involved in professional football, this could lead to dire consequences for the medical career of the practitioner involved.From a report commissioned by the Football League on the Hillsborough tragedy, the concept of the "crowd doctor" was introduced, meaning that any doctor involved in the medical care of the crowd at a football stadium would be required to possess at least the Diploma in Immediate Medical Care. 2 Before that, the situation was similar to that of the present club doctor system, and few doctors held any recognisable qualifications or training in medical emergencies and resuscitation.A similar recommendation by sports medicine authorities is required to enhance the quality of service provided to football clubs and increase the stature of the specialty.However, it is not a one sided situation.Football clubs must realise the importance of a medical team in looking after their prime assets, the players.Advertising of jobs in medical journals, insisting on experience and qualifications, adequate remuneration, and the provision of job descriptions and contracts should all be implemented.By working together to improve the current situation, a service can be provided in which both professional football players and the medical profession can have confidence.
Drug-induced peripheral neuropathies.
Authors: Z Argov, F L Mastaglia
Journal: BMJ (1979)

Review of the various drugs in current clinical use showed that over 50 of them may cause a purely sensory or mixed sensorimotor neuropathy. These include antimicrobials, such as isoniazid, ethambutol, ethionamide, nitrofurantoin, and metronidazole; antineoplastic agents, particularly vinca alkaloids; cardiovascular drugs, such as perhexiline and hydrallazine; hypnotics and psychotropics, notable methaqualone; antirheumatics, such as gold, indomethacin, and chloroquine; anticonvulsants, particularly phenytoin; and other drugs, including disulfiram, calcium carbimide, and dapsone. Patients receiving drug treatment who complain of paraesthesie, pain, muscle cramps, or other abnormal sensations and those without symptoms who are receiving drugs that are known or suspected to be neurotoxic should undergo neurological examination and studies of motor and sensory nerve conduction. This will allow the incidence of drug-induced peripheral neuropathy to be determined more precisely.
The Echo Score Revisited
Authors: Maria Carmo P. Nunes, Timothy C. Tan, Sammy Elmariah, Rodrigo do Lago, Ronan Margey, Ignacio Cruz-Gonzalez, Hui Zheng, Mark D. Handschumacher, Ignacio Inglessis, Igor F. Palacios, Arthur E. Weyman, Judy Hung
Journal: Circulation (2013)

Current echocardiographic scoring systems for percutaneous mitral valvuloplasty (PMV) have limitations. This study examined new, more quantitative methods for assessing valvular involvement and the combination of parameters that best predicts immediate and long-term outcome after PMV.Two cohorts (derivation n=204 and validation n=121) of patients with symptomatic mitral stenosis undergoing PMV were studied. Mitral valve morphology was assessed by using both the conventional Wilkins qualitative parameters and novel quantitative parameters, including the ratio between the commissural areas and the maximal excursion of the leaflets from the annulus in diastole. Independent predictors of outcome were assigned a points value proportional to their regression coefficients: mitral valve area ≤1 cm(2) (2), maximum leaflets displacement ≤12 mm (3), commissural area ratio ≥1.25 (3), and subvalvular involvement (3). Three risk groups were defined: low (score of 0-3), intermediate (score of 5), and high (score of 6-11) with observed suboptimal PMV results of 16.9%, 56.3%, and 73.8%, respectively. The use of the same scoring system in the validation cohort yielded suboptimal PMV results of 11.8%, 72.7%, and 87.5% in the low-, intermediate-, and high-risk groups, respectively. The model improved risk classification in comparison with the Wilkins score (net reclassification improvement 45.2%; P<0.0001). Long-term outcome was predicted by age and postprocedural variables, including mitral regurgitation, mean gradient, and pulmonary pressure.A scoring system incorporating new quantitative echocardiographic parameters more accurately predicts outcome following PMV than existing models. Long-term post-PMV event-free survival was predicted by age, degree of mitral regurgitation, and postprocedural hemodynamic data.
Surgeons to the Poor: The Harlem Hospital Story
Authors: Marjorie C. Meehan
Journal: JAMA (1978)

In 1926, Aubre Maynard was one of the first three black interns appointed to the Harlem Hospital. That municipal hospital, serving an almost completely black community, hitherto had had an almost entirely white staff. Dr Maynard's whole professional life was associated with the hospital, where he finally became surgeon in chief and, after the hospital was affiliated with Columbia University, clinical professor of surgery at the College of Physicians and Surgeons. Maynard tells the story of his own struggles and growth, as well as those of the hospital. Race relations, political manipulations, the medical problems of a ghetto community, personal jealousies, and honest differences of opinion all enter into this story of four decades of conflict and effort. The result is a large teaching hospital, where outstanding work is being done by an integrated though largely black staff. This is an exciting history, well told. It should interest a wide
Enhancing the Antitumor Activity of Adriamycin and Ionizing Radiation
Authors: Wenqing Sun, Amanda L. Kalen, Brian J. Smith, Joseph J. Cullen, Larry W. Oberley
Journal: Cancer Research (2009)

Overexpression of manganese superoxide dismutase (MnSOD), when combined with certain chemicals that inhibit peroxide removal, increases cancer cell cytotoxicity. Elevating MnSOD levels in cells enhances the conversion of superoxide (O(2)(*-)) to hydrogen peroxide (H(2)O(2)), combined with inhibiting the removal of H(2)O(2), further increases H(2)O(2) levels, leading to increased cytotoxicity. We hypothesized that increasing endogenous O(2)(*-) production in cells that were pretreated with adenoviral MnSOD (AdMnSOD) plus 1,3-bis(2-chloroethyl)-1-nitrosourea (BCNU) would lead to an increased level of intracellular H(2)O(2) accumulation and increased cell killing. The cytotoxic effects of Adriamycin or radiation, agents known to produce O(2)(*-), were determined in MDA-MB-231 breast cancer cells pretreated with AdMnSOD plus BCNU both in vitro and in vivo. In vitro, AdMnSOD plus BCNU sensitized cells to the cytotoxicity of Adriamycin or radiation. In vivo, AdMnSOD, BCNU, and Adriamycin or ionizing radiation inhibited tumor growth and prolonged survival. The results suggest that agents that produce O(2)(*-) in combination with AdMnSOD plus BCNU may represent a powerful new antitumor regimen against breast cancer.
Staff Assessment of Interns and Residents
Authors: Harry A. Towsley
Journal: JAMA (1966)

In reviewing the titles assigned to the discussants on the panels being presented this morning, one finds it difficult to believe that any other profession or skill subjects its members and potential members to such scrutiny in the analysis of competence. Medical school admission committees have tried to sort out those who qualify academically, morally, and ethically, whom they think are capable of becoming responsible for the health care of the people of our nations. With equal diligence, medical school faculties have weeded out those whose intellectual ability and concern for human dignity in health and disease do not measure up to a general set of standards by which physicians may be judged. Those of us who have been granted the privilege of providing graduate medical educational programs, internships, and residencies in either affiliated or nonaffiliated hospitals have an equal, if not greater, responsibility than admission committees and medical school
Leg Ulcers in Rheumatoid Arthritis
Authors: Joseph Beninson
Journal: JAMA (1961)

Ulceration occurred in the legs of 9 patients as a complication of rheumatoid arthritis. Treatment consisted essentially in the initial application of absorbable gelatin powder, with an overlay of a pressure-sandwich of gauze dressings, and the subsequent use of a pressuregradient technique employing an elastic stocking, custom-made according to certain specified measurements. These measures, with a high-protein diet, attention to shoes, and moderate walking exercise, controlled the edema and led to healing in every case.
Bowel function and irritable bowel symptoms after hysterectomy and cholecystectomy--a population based study.
Authors: K W Heaton, D Parker, H Cripps
Journal: Gut (1993)

Because unsubstantiated beliefs link hysterectomy and cholecystectomy with bowel function, this study examined all the women who had had these operations in a defined population (79 and 37 respectively, out of 1058) with respect to bowel habits, irritable bowel syndrome symptoms, and whole gut transit time calculated from records of three defecations. Compared with unoperated controls, women after hysterectomy were more likely to consider themselves constipated; they also strained more and admitted more often to bloating and feelings of incomplete evacuation. Their stools tended to be lumpier and, in women over 50 years, transit time was longer. When women treated by cholecystectomy were compared with women having newly discovered, asymptomatic gall stones, they more often described defecation as urgent but had no other detectable differences. In conclusion symptomatic constipation is frequent in women after hysterectomy; after cholecystectomy, bowel habit is not consistently changed but the rectum seems to be more irritable.
Sutton's Law: Rob Banks Because You Enjoy It
Authors: Leslie M. Klevay
Journal: JAMA (1991)

<h3>To the Editor.—</h3> In his eulogy to Dr William Dock, Dr Bing<sup>1</sup>mentions Dock's cardinal rule of medicine, "Sutton's Law," as a revision of a statement by the "bank robber who said he robbed banks because 'that's where the money is." Having learned this maxim from one of my mentors, I was tempted to learn more about Willie Sutton. In his autobiography, there is a chapter on Sutton's Law in which its origin is attributed to Dock and its popularization is attributed to Petersdorf and Beeson.<sup>2</sup>Sutton mentions the irony of teaching medicine with the words of a bank robber, confesses that "I never said it," gives credit to some enterprising reporter, and states that he robbed banks "because I enjoyed it." The Law remains useful in medicine even though its concept is clearer than its origin. This letter was shown to the author, who declined to reply
Changes in the Use of Postmenopausal Hormone Therapy after the Publication of Clinical Trial Results
Authors: Jennifer S. Haas, Celia P. Kaplan, Eric P. Gerstenberger, Karla Kerlikowske
Journal: Annals of Internal Medicine (2004)

Background: The recent publication of clinical trial results has led to a dramatic shift in the evidence about postmenopausal hormone therapy. Objective: To examine whether the publication of clinical trial results, specifically the Heart and Estrogen/progestin Replacement Study (HERS) in 1998 and the Women's Health Initiative (WHI) in 2002, has influenced the use of hormone therapy among postmenopausal women. Design: Observational cohort (1997 to 2003). Setting: San Francisco Mammography Registry, San Francisco, California. Participants: Postmenopausal women between the ages of 50 and 74 years without a personal history of breast cancer who underwent mammography (151862 mammograms). Measurements: Self-reported current use of hormone therapy. Results: Among menopausal women who had mammography, it was estimated that 41% were currently using hormone therapy in 1997. Before the publication of HERS, the use of hormone therapy was increasing at a rate of 1% (95% CI, 0% to 2%) per quarter. After the publication of HERS, use decreased by 1% (CI, −3% to 0%) per quarter. In contrast, the publication of the WHI in 2002 was associated with a more substantial decline in the use of hormone therapy of 18% (CI, −21% to −16%) per quarter. Similar associations were observed for most subgroups of women, including women older than 65 years of age; women with a previous hysterectomy; and women who described their race or ethnicity as white, African American, Latina, Chinese, or Filipina. Conclusions: The release of the HERS data was temporally associated with a modest decline in the use of hormone therapy. In contrast, the release of the principal findings from the WHI was associated with a more substantial decline in use by postmenopausal women. The reason for the differences in decline may relate to the fact that the WHI results were widely publicized or were more applicable to most postmenopausal women because the WHI study was performed in healthy women.
BMA division disagrees with association's stance over advance directives
Authors: I M C D Jessiman
Journal: BMJ (1996)

EDITOR,—Bromley division of the BMA is seriously concerned by the association's stance over advance directives. The BMA originally expressed the view that “mutual respect and common accord is better achieved without legislation” and stated that “the BMA does not support legally binding advance directives.” Despite this and the decision of the annual representative meeting in 1993 that “in the matter of advance directives, no doctor should be obliged by patients, relatives or hospital administrative …
Is Magnetic Resonance Image Guidance the Key to Opening Chronic Total Occlusions?
Authors: Donald S. Baim, Raymond Y. Kwong
Journal: Circulation (2006)

hrough progressive plaque growth or fibrotic organization of occlusive thrombus, atherosclerosis may result in chronic total occlusion (CTO) of a major arterial conduit.If CTO develops slowly, collateral pathways may supply sufficient perfusion to retain tissue viability despite occlusion of the major inflow conduit.However, such collateral-mediated perfusion rarely matches that provided by an open main conduit, particularly during the peak demand of regional muscular activity.Although strategies to limit regional oxygen demand (eg, ␤-blockers for the treatment of angina pectoris) or to enhance collateral function (eg, a walking program for superficial femoral occlusion, experimental angiogenesis) may be of some benefit, these approaches generally offer less complete return of normal physiology and relief of ischemic symptoms than does direct revascularization of the occluded vessel.With surgical bypass, the nature of the occlusion (its length, duration, tortuosity, calcification) is less important than the presence of a suitable distal anastomotic target.On the other hand, with catheter-based techniques, success depends heavily on these lesion characteristics.In fact, crossing such occluded segments with a guidewire remains the dominant barrier to catheter-based treatments of occluded arterial segments.Once the guidewire has been passed successfully into the distal true lumen, the process of dilating and stenting the segment is usually straightforward and durable, at least with the use of drug-eluting stents in coronary CTOs. 1,2
Out of hours GP services are criticised after death of patient
Authors: Zosia Kmietowicz
Journal: BMJ (2007)

Wiltshire police investigating unspecified allegations against a paediatrician at Southampton General Hospital are seeking expert medical evidence outside the UK.The case concerns a paediatrician who was involved in the care of a child whose mother was later charged with murder.Marianne Williams, then 22, was charged in 2004 with the murder of her 15 month old son, Joshua Taylor, whom she was alleged to have poisoned with salt.She was found not guilty in October last year after a six week trial at Winchester Crown Court.Wiltshire police officers are also under investigation for their role in the case.The Independent Police Complaints Commission said that it was "midway through" an investigation into a complaint about the conduct of the criminal investigation.Six officers had been served with official notice of the inquiry, although "this in no way implies guilt or wrongdoing on the part of any officer," the commission said.Detective Superintendent James Vaughan, the officer leading the Wiltshire force's inquiry into the allegations against the doctor, confirmed that Wiltshire Police would not be seeking medical advice in the case from any British doctors-a claim posted on the website forum Mothers Against Munchausen Allegations."In order to maintain the confidence of Joshua's family, and to identify an independent specialist who has had no connection with this or any other similar sets of circumstances in the United Kingdom, it has been necessary to seek assistance from overseas," Detective Superintendent Vaughan said.This was, he insisted, "not a reflection on the Wiltshire police's confidence in the United Kingdom experts."However, the Royal College of Paediatrics and Child Health said it was "confident that we have eminent experts in the UK who can offer an independent and authoritative opinion." Police look abroad for salt case expertUK NEWS Remedy UK loses court case, p1134
Invasive meningococcal infection after splenectomy
Authors: R J Condon, T V Riley, H Kelly
Journal: BMJ (1994)

EDITOR, - Various articles have emphasised the lifelong risk of overwhelming sepsis after splenectomy,1 and the importance of immunising asplenic patients with polyvalent pneumococcal vaccine.2,3 Mary McMullin and George Johnston point out that, while Streptococcus pneumoniae is the most common infecting organism, Haemophilus influenzae, Neisseria meningitidis, and Escherichia coli are also important potential pathogens after splenectomy.1 We report two recent deaths from fulminant meningococcal septicaemia in people in Western Australia who had undergone …
Early Treatment of Cystic Fibrosis-Reply
Authors: Terry S. Langbaum
Journal: JAMA (1982)

<h3>In Reply.—</h3> We think that our difference of opinion with Dr Orenstein is not one of substance but rather one of semantics that is related to the definition of<i>early intervention</i>. In our letter, we meant to emphasize that a beneficial effect of "prophylactic" therapy, initiated before the onset of clinically apparent pulmonary disease, has not been verified in patients with CF. The data presented by Orenstein et al<sup>1</sup>do not address this point. The authors looked at the clinical status at 7 years of age of 16 patients with CF whose conditions were diagnosed and treated before the onset of pulmonary disease (mean age, 6 months) compared with 16 older siblings, most of whose conditions were diagnosed after the onset of pulmonary disease (mean age, 4 years). This was a comparison of early therapy<i>v</i>late therapy. In five of the 16 sibling pairs, the diagnosis of CF
Predictive Genomic Testing of Children for Adult Onset Disorders: A Canadian Perspective
Authors: Michael J. Szego, M. Stephen Meyn, James A. Anderson, Robin Hayeems, Cheryl Shuman, Nasim Monfared, Sarah Bowdin, Randi Zlotnik Shaul
Journal: The American Journal of Bioethics (2014)

The American Academy of Pediatrics (AAP)/American College of Medical Genetics (ACMG) guidelines discourage predictive genetic testing of children at risk for adult-onset diseases, while the ACMG ex...
Localization of Lymphatic Leakage Site in Chylothorax by Thoracic Duct Scintigraphy by Orally Administered 123I BMIPP Using SPECT/CT
Authors: Kentaro Takanami, Hirofumi Ichikawa, Shoki Takahashi
Journal: Clinical Nuclear Medicine (2012)

A 58-year-old man with chylothorax after graft replacement of the aortic arch underwent thoracic duct scintigraphy by orally administered 123I–labeled 15-(4-iodophenyl)-3(R,S)-methylpentadecanoic acid with single-photon emission computed tomography combined with computed tomography (SPECT/CT). SPECT/CT fusion image clearly showed the increased uptake near the vascular anastomotic site of the aortic arch. Therefore, a chylothorax due to a traumatic rupture of a thoracic duct was suspected. This report indicates the clinical usefulness of thoracic duct scintigraphy by orally administered 123I–labeled 15-(4-iodophenyl)-3(R,S)-methylpentadecanoic acid using SPECT/CT for the localization of the lymphatic leakage site in chylothorax.
Physiological pulsatile flow culture conditions to generate functional endothelium on a sulfated silk fibroin nanofibrous scaffold
Authors: Xianghui Gong, Haifeng Liu, Xili Ding, Meili Liu, Xiaoming Li, Lisha Zheng, Xiaoling Jia, Gang Zhou, Yuanwen Zou, Jinchuan Li, Xuejin Huang, Yubo Fan
Journal: Biomaterials (2014)
To Tell or Not to Tell: The Community Wants to Know About Expensive Anticancer Drugs As a Potential Treatment Option
Authors: Linda Mileshkin, Penelope E. Schofield, Michael Jefford, Emilia Agalianos, Michele Levine, Alan Herschtal, Julian Savulescu, Jacqui Ann Thomson, John R. Zalcberg
Journal: Journal of Clinical Oncology (2009)

Many new cancer treatments are available only at significant financial cost to the patient. We previously reported that Australian medical oncologists commonly do not discuss unsubsidized, expensive anticancer drugs (EACD) because of concern about causing distress. We argued that this position was not consistent with modern ethical principals but wanted to seek the community viewpoint.A cross-sectional telephone survey of the Australian general public was performed. Respondents' views were sought about three hypothetical scenarios in which they were diagnosed with incurable cancer and an EACD treatment (out-of-pocket cost US$25,000) was available.Responses were obtained from 1,255 respondents (response rate, 43%). One hundred thirty-seven (11%) had a prior cancer diagnosis. Ninety-one percent of respondents wanted to be told by their doctor about an EACD that could improve survival by an additional 4 to 6 months, with 51% prepared to pay for it. People were more willing to pay if the drug could improve quality of life (71%) or if there was no effective standard treatment (76%). Sixty-eight percent believed the government should pay. Cost would be a significant financial burden for 31% of those willing to pay. Those more likely to want to be informed were younger, employed, better-educated, or had higher income levels (P < .05). Responses did not vary with the person's personal experience of cancer. Of the 9% who did not wish to be informed, half of these were concerned about the information causing distress.The Australian general public wants to be informed about EACD as potential treatment options, even if they are not willing or readily able to pay for them.