tbuckley/cabot-search huggingface dataset:
Impact of Objectively Assessing Surgeons’ Teaching on Effective Perioperative Instructional Behaviors
Authors: Cheryl I. Anderson, Rama N. Gupta, Joseph R. Larson, Omar I. Abubars, Andrew J. Kwiecien, Alexander D. Lake, Ahmed E. Hozain, Adam Tanious, Trevor O’Brien, Marc D. Basson
Journal: JAMA Surgery (2013)

IMPORTANCE Advancing surgical technology and decreasing resident learning hours have limited exposure to perioperative training, necessitating more effective and efficient perioperative teaching by faculty surgeons.Participation in collaborative efforts and process improvement can change behaviors and enhance teaching.OBJECTIVES To promote deliberate teaching of residents, change resident perception of their teachers, and produce sustainable improvements by objectively measuring surgeons' perioperative teaching performance. DESIGN, SETTING, AND PARTICIPANTSThis 3-phase observational study of surgeons' perioperative teaching behaviors included university-based surgeons, general surgery residents, and preclinical student observers and involved elective cases at a 600+ bed tertiary hospital.Initially, we measured teaching behaviors by surgeons unaware of study objectives, provided aggregate and confidential individual feedback, and developed standardized preoperative briefings and postoperative debriefings.Phase 2 applied a deliberate teaching model and reinforced behaviors with continuous process improvement efforts (Plan, Do, Check, Act) and repeat observations.Phase 3 used resident prompts to enhance teaching behaviors and demonstrate sustainability.Resident surveys conducted 3 times assessed perceptions of deliberate guidance by faculty when compared with national benchmarks. INTERVENTIONS Introduction of deliberate faculty preprocedural focusing and postprocedural reinforcement to facilitate resident learning.MAIN OUTCOMES AND MEASURES More frequent and complete perioperative teaching by faculty and the perception of enhanced teaching by residents.RESULTS Faculty more commonly and more completely performed the 10-step preoperative briefings and postoperative debriefings (P < .001)during phase 2 (250% improvement over baseline).Intraoperative teaching styles significantly improved and residents' survey-reported assessments of faculty teaching improved over national data for describing procedural steps (P = .02)and requests for resident self-evaluation (P = .006). CONCLUSIONS AND RELEVANCEObjective recording of teaching behavior frequency motivated adoption of deliberate guided teaching behaviors by surgeons, resulting in both subjective reports by residents of more frequent teaching and objective recording of parallel improvements.A deliberate focus on objectively assessing surgeon educators' periprocedural teaching may motivate improved teaching.
Ascitic Fluid Acidosis in Bacterial Peritonitis: A Poor Prognostic Sign?
Authors: Norman Gitlin
Journal: Hepatology (1990)

The aim of this retrospective study was to define prognostic factors for cure and survival after spontaneous bacterial peritonitis. In a 4–year period from 1982 to 1986, spontaneous bacterial peritonitis wasdiagnosed in 38 consecutive hospitalized cirrhotic patients (positive ascites culture and polymorphonuclear cell concentrations greater than 250 cells per mm 3 ). Twenty–five patients recovered from their infection (69 p. 100) in a mean time of 9 ± 7 days. The cumulative survival was 68 p. 100 at one week, 50 p. 100 at one month, and 25 p. 100 at one year. The best independant prognostic factors for lack of cure from peritonitis were a low ascitic pH value (p &lt; 0.001), an elevated serum creatinine level (p = 0.001), an elevated serum creatinine level (p = 0.01) and the presence of hepatocellular carcinoma (p &lt; 0.05). The best prognostic factors for death were low ascitic pH value (p = 0.001) and gastrointestinal hemorrhage (p = 0.005). A low ascitic pH value was correlated with other signs of severe infection (signs of generalized infection, ongoing infection during the first week after diagnosis), with signs of severe liver disease (encephalopathy, hepatocellular carcinoma) or severe renal dysfunction (high serum creatinine level, low arterial pH value). Because of the late high–death rate associated with spontaneous bacterial peritonitis, liver transplantation should be considered in these patients.
REPORTS OF THALLIUM ACETATE POISONING FOLLOWING THE USE OF KOREMLU
Authors: Sigmund S. Greenbaum
Journal: JAMA (1931)

Miss I. S., aged 24, was referred to me by Dr. Louis B. Schatz, April 8, 1931, because of a loss of hair. The patient stated that the hair had begun to come out rather suddenly about three or four weeks before. The alopecia was incomplete but very marked.  Close questioning of the patient revealed the fact that on or about January 15 she started to use a new depilatory (Koremlu Cream), costing $10 per jar and put up in the form of a cream. A small amount was to be rubbed in daily and, at certain intervals, some of the loosened hairs were to be extracted.  The cream had been purchased at one of the large department stores. The drug buyer of the store stated that this was the first untoward result in 400 sales but that they had discontinued the sale of this depilatory, although it is still
Increased left ventricular arrhythmogenicity in metabolic syndrome and relationship with myocardial performance, risk factors for atherosclerosis, and low-grade inflammation
Authors: Christina Voulgari, Nicholas Tentolouris, Dimitrios Papadogiannis, Ioannis Moyssakis, Despoina Perrea, Despoina Kyriaki, Nicholas Katsilambros
Journal: Metabolism (2009)
Co-Operation in Evaluating New Technics
Authors: Stanley Baum
Journal: New England Journal of Medicine (1968)

The need for comprehensive, well controlled studies comparing the accuracy of different diagnostic tests in specific diseases is obvious to all those who follow the many new procedures published each month. A great number of these fade into oblivion and are never heard of again despite their glowing descriptions in "that article" two years before. Other technics are embraced with a great deal of initial enthusiasm, but since indications are frequently vague, new tests tend to be overused and diseases overdiagnosed. In a few years, however, the true importance of a diagnostic test tends to become clear. A good example . . .
Parliaments and Screening: Ethical and Social Problems Arising from Testing and Screening for HIV and Genetic Disease
Authors: P. Singer
Journal: BMJ (1996)

Ed Wayland Kennet John Libbey Eurotext, Ffr 168, pp 351 ISBN 2 7420 0095 X

When the cover and the title page of a book cannot agree on what the book is about, the wise reader anticipates problems ahead. The title and subtitle of Parliaments and Screening appear as above on the cover of the book, but the title page makes no mention of genetic disease and offers “studies of the handling of bioethics in the twelve national parliaments of the European Union.”

Why is “genetic disease” part …
Detection of Hepatitis B Virus DNA Directly in Human Serum by a Simplified Molecular Hybridization Test: Comparison to HBeAg/ Anti-HBe Status in HBsAg Carriers
Authors: Harvey M. Lieberman, Douglas R. Labrecque, Michael C. Kew, Stefanos J. Hadziyannis, David A. Shafritz
Journal: Hepatology (1983)

A simple, direct molecular hybridization test was employed to detect hepatitis B virus (HBV) DNA sequences in human serum. In 61 HBsAg carriers, many with HBV-related diseases (chronic persistent hepatitis, chronic active hepatitis, or posthepatitic cirrhosis), 28/28 (100%) who were HBeAg* and 16/32 (50%) who were anti-HBe + had HBV DNA sequences in their serum. Among 22 South African black patients with hepatocellular carcinoma, 7 (32%) had detectable HBV DNA in their serum but at reduced levels when compared to HBsAg carriers without hepatocellular carcinoma, suggesting that viral replication is suppressed or inactive in many hepatocellular carcinoma patients. Hybridization analysis also distinguished carriers with high, moderate, or low amounts of HBV DNA in serum. Ten to 20% of HBsAg + /HBeAg + carriers showed high serum levels of HBV DNA but, surprisingly, a similar percentage of HBsAg + /anti-HBe + carriers also showed relatively high serum levels of HBV DNA. Five patients who had undergone immunosuppression therapy and most of whom were on chronic hemodialysis had very high serum levels of HBV DNA, in the range observed during acute HBV infection. By epidemiologic analysis, two of these individuals were implicated in transmission of hepatitis to other hemodialysis patients, paramedical personnel, or intimate family contacts. Serum HBV DNA hybridization analysis identifies carriers with high serum levels of HBV irrespective of HBeAg/anti-HBe status and may define individuals with potentially high risk of transmitting infection to their immediate contacts.
The Effect of Lignocaine on the Stimulation Threshold and Conduction Disturbances in Patients Treated with Pacemaker
Authors: L. Ryden, M. Korsgren
Journal: Cardiovascular Research (1969)

Journal Article The Effect of Lignocaine on the Stimulation Threshold and Conduction Disturbances in Patients Treated with Pacemaker Get access Lars Rydén, Lars Rydén From the Medical Clinic, Falu Lasarett, Falun, Sweden Search for other works by this author on: Oxford Academic PubMed Google Scholar Magnus Korsgren Magnus Korsgren From the Medical Clinic, Falu Lasarett, Falun, Sweden Search for other works by this author on: Oxford Academic PubMed Google Scholar Cardiovascular Research, Volume 3, Issue 4, October 1969, Pages 415–418, https://doi.org/10.1093/cvr/3.4.415 Published: 01 October 1969 Article history Received: 11 March 1969 Published: 01 October 1969
Intravenous extended infusion of recombinant human soluble thrombomodulin prevented tissue factor‐induced disseminated intravascular coagulation in rats
Authors: Mitsunobu Mohri, Michiko Oka, Yoshikazu Aoki, Yasunori Gonda, Sigeto Hirata, Komakazu Gomi, Takao Kiyota, Taisuke Sugihara, Shuji Yamamoto, Torao Ishida, Ikuro Maruyama
Journal: American Journal of Hematology (1994)

Abstract This study demonstrated that intravenous infusion of recombinant human soluble thrombomodulin (rhs‐TM) could Inhibit disseminated Intravascuiar coagulation (DIC) caused by 4 hr infusion of tissue factor (TF) in rats. Extended infusion of TF reduced fibrinogen and platelet counts and elevated serum FDP level. Pretreatment and coinfusion of rhs‐TM could block changes of these DIC‐parameters without prolongation of APTT. Heparin, which is a potent anti‐DIC drug, could also inhibit these changes with extra prolongation of APTT and PT. Thus, these results suggest thrombomodulin prevent DIC less bleeding tendency than heparin. © 1994 Wiley‐Liss, Inc.
Anthony Charles William Mosbergen da Roza
Authors: A. Linch
Journal: BMJ (2002)

An expert on venomous creatures and one of the great larrikins of Australian medicineIn a country famous for its deadly snakes and spiders, Struan Sutherland became a household name for his expertise on venomous creatures.He was also well known as one of the great larrikins of Australian medicine and as a prolific author.While working at the Commonwealth Serum Laboratories (CSL), Sutherland led efforts to develop an antivenom to the Sydney funnel-web spider and revolutionised treatment of snake bites by developing the pressure-immobilisation first aid technique and venom detection kits.After an acrimonious departure from CSL, Sutherland founded the Australian Venom Research Unit at the University of Melbourne's department of pharmacology in 1994, where he worked until retiring in 1999.But Sutherland, who spent his final years battling a rare, degenerative brain diseasestriatonigral degeneration-was writing until the end.The second edition of the textbook Australian Animal Toxins, which he co-wrote, was published several months before his death.In typical Sutherland style, he wrote asking colleagues to review chapters of the text, offering a multiple choice reply.Recipients could tick either "send me a copy asap" or "stuff off."Sutherland once said that what he enjoyed most about his
Development and evaluation of an e-learning package for teaching skin examination. Action research
Authors: H. Farrimond, T.L. Dornan, A. Cockcroft, L.E. Rhodes
Journal: British Journal of Dermatology (2006)

Background Dermatology is one of many specialities competing for space in the undergraduate curriculum, and recent review reveals that in some medical schools only a minority of students receives direct teaching from dermatologists. Enlargement of medical schools and dispersion of students over multiple sites further increase the strain on teaching resources. Objectives To develop and obtain 'proof of concept' for a technology to teach skin examination, using an approach grounded in modern theories of learning. Methods The requirements for an e‐learning technology were identified through literature review and qualitative analysis of stakeholders' requirements with respondent and expert validation. A method of teaching skin examination was developed by applying Anderson's theory of skills acquisition. It was prototyped first on paper, then electronically, and its usability as an instructional tool was evaluated. Results The project delivered, firstly, a specification for skin examination derived from published evidence, textbook content, and staff and student consensus; and secondly, a very useable technology to help students learn skin examination (http://www.skillsbase.man.ac.uk). A validation task was completed in 20 min without significant usability problems, and evaluators found it simple, intuitive, interactive and enjoyable to use. Students saw it as an adjunct that would help them build confidence and revise for examinations. Nonstakeholder teachers expressed concern about the apparent simplicity of its contents and felt that it should only be used in association with traditional teaching methods. Conclusions Students, educationalists and teachers were able to codesign a useable skin examination package, which merits evaluation of efficacy. In view of the logistic difficulties of teaching dermatology to the growing student population, the technology may be a useful adjunct to traditional teaching methods. Our approach may inform further developments in educational technology in dermatology.
Introduction to the Pierre Fabre supplement
Authors: A. Wollenberg
Journal: British Journal of Dermatology (2014)

Atopic dermatitis (AD) is one of the most common reasons for consulting a dermatologist (or, indeed, a general practitioner or paediatrician). It is physically and emotionally distressing for the patient and, as many of our patients are children, for their parents also. For many decades, therapy for AD was limited largely to flare prevention through the avoidance of trigger factors and use of emollients, or to flare treatment using emollients and topical corticosteroids of varying strengths. More recently the new class of topical calcineurin inhibitors has been introduced for AD treatment. This has gone hand in hand with a deeper understanding of the causes of AD, including both genetic traits and biochemical pathways. Nowadays, we are better placed to help our patients and their carers understand their condition and we can provide better advice on avoiding triggers in addition to the use of new therapies to alleviate symptoms. This increased understanding has led to the development of proactive therapy, which is defined as the long‐term, low‐dose, intermittent use of topical anti‐inflammatory drugs in the frequently relapsing 'problem zones' of the patient with AD. Ample evidence has shown a reduced incidence and duration of flares with proactive therapy, and this can have a real effect on patients' quality of life.
Clinical Spectrum of the Sick Sinus Syndrome
Authors: JOEL J. RUBENSTEIN, CHARLES L. SCHULMAN, PETER M. YURCHAK, ROMAN W. DESANCTIS
Journal: Circulation (1972)

The clinical spectrum of the sick sinus syndrome (SSS) is described in a series of 56 patients who demonstrated either persistent unexplained sinus bradycardia (group I: eight patients); sinus arrest (group II: 15 patients); or bradycardia with episodic supraventricular tachyarrhythmias (group III: 33 patients). Coronary disease was the most common form of heart disease where etiology could be determined, but in 25 patients no clear etiologic diagnoses could be established. Thirty-three patients showed associated electrocardiographic conduction disturbances. Symptoms were common and were produced by both bradycardia and tachycardia. Eight patients in the bradycardia-tachycardia group experienced cerebral embolization. Despite bother-some symptoms, only six of the 56 patients died over an average follow-up of 7 years, and only one of these deaths appeared related to an arrhythmia. Drug therapy of bradycardia was generally ineffective, but digitalis was frequently helpful in patients with tachycardia. Electrical pacing was uniformly successful in treating symptoms of bradycardia but was disappointing in preventing tachyarrhythmias.
Is Real-Time Testing for<i>Helicobacter Pylori</i>and Corpus Atrophy Clinically Useful in 2005?
Authors: D. Y. Graham
Journal: Endoscopy (2005)

Tucci et al. describe a new approach to the rapid detection of Helicobacter pylori infection and atrophic gastritis [1]. They present details of their new device that automatically and accurately measures both gastric juice ammonia levels and pH. The device is attached directly to the suction channel of the endoscope where it automatically collects and assays the sample and then provides the results verbally while the endoscopic procedure is still in progress. The cost per test (excluding the cost of the device and its maintenance) is low and the reported accuracy was excellent.
Plasma levels of vascular endothelial growth factor (VEGF) and its receptor, flt-1, in haematological cancers: A comparison with breast cancer
Authors: Funmi M. Belgore, Gregory Y. H. Lip, David Bareford, Martin Wadley, Paul Stonelake, Andrew D. Blann
Journal: American Journal of Hematology (2000)

Raised plasma VEGF is found in some cancers but levels of its receptor soluble Flt-1 (sFlt-1) are unreported. Hypothesising increased levels to be present in haematological cancers, we measured both by ELISA in 22 patients with haematological cancer, 22 with breast cancer, and in age- and sex-matched controls. VEGF was raised in both patients groups compared to controls (P < 0.01) but was higher in haematological cancer compared to breast cancer (P = 0.0238). There was no difference in levels of sFlt-1. Our data point to changes in levels of plasma VEGF, but not sFlt-1, in haematological cancer that may have pathophysiological consequences.
Antimalarial therapy and early retinal changes in patients with rheumatoid arthritis.
Authors: G. B. Arden, H. Kolb
Journal: BMJ (1966)

Patients with rheumatoid arthritis who are treated with large doses of the antimalarial drugs chloroquine and hydroxy chloroquine (Plaquenil) may develop a severe disturbance of vision due to retinal damage. This retinopathy is irreversible, and may progress for long periods even though the treatment has stopped (Cambiaggi, 1957 ; Hobbs, Sorsby, and Freedman, 1959 ; Hobbs, Eadie, and Somerville, 1961). In this condition the electro-oculogram, an electrodiagnostic test, shows very abnormal results (Arden and Fojas, 1962), suggesting that the primary site of the lesion is the cells in the pigment-epithelium which produce the measured electrical potential. This hypo thesis has since been proved in experimental chloroqmne retino pathy induced in cats (Meier-Ruge, 1965). Furthermore, in patients who are taking antimalarials, but in whom the fundus and visual functions are normal, the electro-oculogram may be low (Arden, Friedmann, and Kolb, 1962). During prolonged chloroquine treatment abnormalities may appear in the fundus while the patient's vision is still unaffected. The earliest change consists of slight pigmentary mottling of the macula and perimacular region (Henkind and Rothfield, 1963). At a later stage retinal and subretinal oedema, accom panied by definite pigmentary changes, give the picture of the macular  bull's-eye  (Henkind, Carr, and Siegel, 1964). In one case the appearance of a  bull's-eye  was followed by loss of visual field as a true retinopathy developed. However, if treatment is withdrawn at this stage the process may be arrested.
Access to emergency care in Palestinian West Bank: Methods were incomplete
Authors: Leonard Thaler
Journal: BMJ (2006)

Editor—The study by Rytter et al on the effects of armed conflict on access to emergency health care in the Palestinian West Bank does not include any baseline comparison of emergency room admission rates, either from different time periods, other geographical areas, or similar healthcare systems.1 There is no discussion of acuity, case mix, age stratification, and other standard analyses of scientific measurement.
Scintigraphic Evaluation of Multifocal Hemangioendothelioma of Bone
Authors: LUIS F. ANEZ, SHIV M. GUPTA, DAVID BERGER, JOHN SPERA, WILLIAM D. JOHNS
Journal: Clinical Nuclear Medicine (1993)

Multifocal bone involvement was seen on bone scintigraphy in a young woman being examined for a suspected bone lesion noted on pelvic radiographs. Biopsy of the third lumbar vertebral body demonstrated a vascular lesion. The tumor was resected and a bone graft was performed. The patient was followed with serial scans to assess the viability of the bone graft and course of the disease. This report analyzes the scintigraphic characteristics of this rare tumor and emphasizes the importance of bone scintigraphy in the diagnosis, treatment, and follow up of this condition.
Health Values of the Seriously Ill
Authors: Joel Tsevat
Journal: Annals of Internal Medicine (1995)

Objective: To assess 1) the health values and health ratings of seriously ill hospitalized patients, their surrogate decision makers, and their physicians; 2) the determinants of health values; and 3) whether health values change over time. Design: Prospective, longitudinal, multicenter study. Setting: 5 academic medical centers. Participants: 1438 seriously ill patients with at least one of nine diseases who had a projected overall 6-month mortality rate of 50%; their surrogates; and their physicians. Measurements: Time-tradeoff utilities (reflecting preferences for a shorter but healthy life) and health ratings. Results: At study day 3, patients had a mean time-tradeoff utility of 0.73 ±0.32 (median [25th, 75th percentile], 0.92 [0.63, 1.0]), indicating that they equated living 1 year in their current state of health with living 8.8 months in excellent health. However, scores varied widely; 34.8% of patients were unwilling to exchange any time in their current state of health for a shorter life in excellent health (utility, 1.0), and 9.0% were willing to live 2 weeks or less in excellent health rather than 1 year in their current state of health (utility, 0.04). Health rating scores averaged 57.8 ±24.0 (median [25th percentile, 75th percentile], 60 (50, 75) on a scale of 0 (death) to 100 (perfect health). The patients' mean time-tradeoff score exceeded that of their paired surrogates (n = 1041) by 0.08 (P < 0.0001). Time-tradeoff scores were related to psychosocial well-being; health ratings; desire for resuscitation and extension of life rather than relief of pain and discomfort; degree of willingness to live with constant pain; and perceived prognosis for survival and independent functioning. Scores of surviving patients increased by an average of 0.06 after 2 months (P < 0.0001) and 0.08 after 6 months (P < 0.0001). Conclusions: Health values of seriously ill patients vary widely, are higher than patients' surrogates believe, are related to few other preference and health status measures, and increase over time.