tbuckley/cabot-search huggingface dataset:
A New Medical School's Expectations of the University
Authors: Glidden L. Brooks
Journal: JAMA (1965)

That a medical school should properly be a part of a university has come to be a usually accepted principle in the United States. This concept, rooted in Old World tradition, restimulated by the Flexner report, early epitomized by the establishment of Johns Hopkins University Medical School, Baltimore, and effectively promulgated by the late Alan Gregg and others, is based upon the recognition that medicine is a broad and scholarly undertaking which requires the nurture to be found in a university "community of scholars." Over a period of nearly half a century, there has been much written, and even more talked, about the necessity for medicine to utilize the university milieu as a source of strength in breadth and in depth. Much of this has been earnest, thoughtful, and sophisticated, but some of it has been in the realm of rather vague and spongy philosphy with little practical conception of
EARLY VALUABLE RISK STRATIFICATION WITH HEMOGLOBIN LEVEL AND NEUTROPHIL TO LYMPHOCYTE RATIO IN PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION UNDERGOING PRIMARY PERCUTANEOUS CORONARY INTERVENTION
Authors: Kyung Hoon Cho, Myung Ho Jeong, Khurshid Ahmed, Daisuke Hachinohe, Hong Sang Choi, Soo Young Chang, Min Chul Kim, Seung Hwan Hwang, Keun-Ho Park, Min Goo Lee, Jum Suk Ko, Doo Sun Sim, Nam Sik Yoon, Hyun Ju Yoon, Young Joon Hong, Kye Hun Kim, Ju Han Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang
Journal: Journal of the American College of Cardiology (2011)
The Cesarean Section Rate
Authors: John M. Pascoe
Journal: JAMA (1990)

<h3>To the Editor.—</h3> I read with interest Dr Stafford's<sup>1</sup>review of six strategies for controlling the rising cesarean section rate. I write this letter to suggest that there is another effective strategy that should be considered. In the past decade, several studies have examined the effect of birth companions on duration of labor<sup>2-4</sup>and cesarean section rates.<sup>3-5</sup>The findings have been remarkably consistent. Women who experience the constant presence of a supportive companion during parturition have shorter labors (eg, 7.7 vs 15.5 hours,<i>P</i>&lt;.001)<sup>4</sup>and fewer complications, including a lower rate of cesarean sections (eg, 8.1% vs 18.1%,<i>P</i>&lt;.003).<sup>5</sup>The birth companions in these studies provided both emotional and physical support; they rubbed mothers' backs, held their hands, and shared information as well as encouragement. Social support during parturition is one of several interventions that should be considered to reduce the cesarean section rate and
The liver in celiac disease
Authors: Alberto Rubio-Tapia, Joseph A. Murray
Journal: Hepatology (2007)

Celiac disease is a common (1% prevalence) chronic immune-mediated disorder of the small intestine induced by dietary wheat, barley, and rye. Several hepatic disorders have been described in association with celiac disease. Isolated hypertransaminasemia with nonspecific histologic changes in a liver biopsy is the commonest hepatic presentation of celiac disease. A gluten-free diet normalizes liver enzymes and histologic changes in most patients. Moreover, celiac disease can coexist with autoimmune liver disorders such as autoimmune hepatitis, primary biliary cirrhosis, and primary sclerosing cholangitis. Celiac disease has increasingly been reported with a variety of other liver diseases. Thus, the hepatologist needs to consider celiac disease in the differential of abnormal liver blood tests and to be aware of the clinical implications of this frequent disease in patients with liver disorders. The possible mechanisms of liver injury and those common factors that explain the association of celiac disease with liver disorders are discussed. The aims of this article are (1) to review the spectrum and pathogenesis of liver injury related to celiac disease and (2) to provide direction to those caring for patients with chronic liver diseases regarding the detection and effective treatment of celiac disease.
Fetuin, an inhibitor of lymphocyte transformation. The interaction of fetuin with phytomitogens and a possible role for fetuin in fetal development.
Authors: S Yachnin
Journal: The Journal of Experimental Medicine (1975)

Fetuin, the bovine alpha-fetoprotein, contains glycopeptide sequences similar to those found on red cells. As a result, it is capable of strong physical interaction with the phytohemagglutinin isomitogens (H-PHAP) which possess two or more R (red cell binding) subunits as part of their tetrameric structures. Fetuin shows little or no interaction with L-PHAP, a phytohemagglutinin made up of four L subunits which also lack red cell affinity. Despite these differences fetuin is able to inhibit both H- and L-PHAP-induced lymphocyte transformation and is also capable of inhibiting the mitogenic effects of pokeweed mitogen, concanavalin A, antithymocyte antiserum, and the one-way mixed lymphocyte culture. In the case of L-PHAP, the inhibitory effect of fetuin is proportional to the intensity of the mitogenic stimulus. The inhibitory effects of fetuin upon lymphocyte transformation may result from perturbation or "blindfolding" of the cell membrane in a manner analogous to other immunosuppressive serum alpha-globulins. Alpha-Fetoproteins may play an immunoregulatory role during fetal development.
Public Disclosure of Medicare Payments to Individual Physicians
Authors: Robert Steinbrook
Journal: JAMA (2014)

Public disclosure of individual physician payment data has been advocated as a powerful tool to control health care costs and to improve the delivery of care—and criticized as invading clinicians’ privacy. The Centers for Medicare & Medicaid Services (CMS) recently announced that it would modify its long-standing policy to routinely deny requests for the disclosure of the amounts that had been paid to individual physicians under the Medicare program.1 Instead, as of March 18, 2014, CMS, as a result of a recent court decision and the requirements of the Freedom of Information Act, “will make case-by-case determinations” that “weigh the balance between the privacy interest of individual physicians and the public interest in disclosure of such information.” The identities of patients will not be revealed.2
Induction of Rat Aortic Smooth Muscle Cell Growth by the Lipid Peroxidation Product 4-Hydroxy-2-Nonenal
Authors: Johannes Ruef, Gadiparthi N. Rao, Fengzhi Li, Christoph Bode, Cam Patterson, Aruni Bhatnagar, Marschall S. Runge
Journal: Circulation (1998)

Atherosclerotic lesion formation is a complex process, in part mediated by inflammatory and oxidative mechanisms including lipid peroxidation. To further characterize the potential role of lipid peroxidation products in atherogenesis, we studied the effects of 4-hydroxy-2-nonenal (HNE) on rat aortic smooth muscle cell growth.HNE, at concentrations of 1.0 and 2.5 micromol/L, significantly stimulated rat aortic smooth muscle cell growth as determined by cell counts, [3H]-thymidine uptake, and incorporation of bromo-deoxyuridine. To characterize the mechanism of HNE-induced mitogenesis, its effect on activation of intracellular growth signaling pathways was examined. Treatment with HNE resulted in activation of extracellular signal-regulated protein kinases ERK1 and ERK2, induction of c-fos and c-jun protein expression, and an increase in transcription factor AP-1 DNA binding activity. In addition, HNE induced expression of platelet-derived growth factor-AA (PDGF-AA) protein, and an anti-PDGF-AA antibody specifically inhibited HNE-mediated DNA synthesis, suggesting that growth factor induction may play a role in HNE-induced vascular smooth muscle cell growth. The role of redox-sensitive mechanisms in this process was further supported by the observation that HNE-induced DNA synthesis and AP-1 activation were inhibited by the antioxidants N-acetylcysteine and pyrrolidine dithiocarbamate.These data demonstrate that HNE, one of several important lipid peroxidation products, induces rat aortic smooth muscle cell growth through redox-sensitive mechanisms and growth factor expression. These observations are consistent with a role for lipid peroxidation products in vascular smooth muscle cell growth in atherogenesis.
Clinical Characteristics of Early Oral Cancer
Authors: Donald P. Shedd
Journal: JAMA (1971)

Recognition of a moderately advanced cancer in the oral mucosa is not difficult provided the examiner can visualize the area. Most doctors and dentists will react appropriately when they see a lesion over 2 cm in diameter of an ulcerative or fungating nature. However, such prompt recognition frequently does not take place in early oral cancers, in those which are less than 1 cm in diameter, or in those which are in a stage prior to fungation or ulceration. The purpose of this presentation is to describe the clinical characteristics of the early oral cancer and to define it in histopathologic terms. In recent years, some clinicians have had the opportunity to see a significant number of such lesions and to develop a concept of the beginning of neoplasia in oral mucosa. <h3>Clinical Recognition.—</h3> Many oral cancers are found against a background of a basically abnormal mucosa, which may be
Positive skin tests to aero‐allergens and month of birth
Authors: E. Quoix, J. C. Bessot, M. C. Kopferschmitt‐Kubler, P. Fraisse, G. Pauli
Journal: Allergy (1988)

The month of birth distribution for 1301 French patients born between 1953 and 1975 with at least one positive skin test was compared to that of the whole population. A chisquare test was performed, and the expected birth month distribution of the groups calculated from the INSEE * data for 1953‐1975. All patients underwent skin testing with house dust, Dermatophagoides pternyssinus (Dpt), cat and dog allergens, grass, tree and weed pollens, and moulds. The only study criterion was a positive skin test unrelated to any specific disorder. A significant difference in month of birth distribution was observed 1) for patients with positive skin test to grass pollen, with a high rate of births from January to May, and 2) for patients with mould sensitization, with a low rate of births in April, May and December. Tree and weed pollens, house dust and Dpt showed no significant relation with month of birth. For cat and dog allergens, the observed and expected distributions of birth month were similar. For the whole sensitized population the birth rate tended to be low in December except for the cat and dog sensitized. Our study confirms the well‐known seasonal peak of births in the first 5 months of the year for grass pollen sensitized patients. No consistent monthly or seasonal tendency could be statistically demonstrated for other allergens except moulds.
A defective type 1 response to rhinovirus in atopic asthma
Authors: N G Papadopoulos
Journal: Thorax (2002)

Rhinoviruses (RVs) are the most frequent precipitants of the common cold and asthma exacerbations, but little is known about the immune response to these viruses and its potential implications in the pathogenesis of asthma.Peripheral blood mononuclear cells (PBMC) from patients with atopic asthma and normal subjects were exposed to live or inactivated RV preparations. Levels of interferon (IFN)gamma and interleukins IL-12, IL-10, IL-4, IL-5 and IL-13 were evaluated in the culture supernatants with specific immunoassays.Exposure of PBMC to RVs induced the production of IFNgamma, IL-12, IL-10, and IL-13. Cells from asthmatic subjects produced significantly lower levels of IFNgamma and IL-12 and higher levels of IL-10 than normal subjects. IL-4 was induced only in the asthmatic group, while the IFNgamma/IL-4 ratio was more than three times lower in the asthmatic group.This evidence suggests that the immune response to RVs is not uniquely of a type 1 phenotype, as previously suggested. The type 1 response is defective in atopic asthmatic individuals, with a shift towards a type 2 phenotype in a way similar, but not identical, to their aberrant response to allergens. A defective type 1 immune response to RVs may be implicated in the pathogenesis of virus induced exacerbations of asthma.
Medical interviews: no further questions
Authors: D. Spence
Journal: BMJ (2010)

As a medical student I worked where I could. Working on building sites was good money, but as I knocked on the plywood door of every building site around Liverpool Street station I was turned away. In the 1980s you had to be Irish to work on a London building site. Demoralised, I walked up to Islington looking for bar work. This was terrible money, and irritatingly the staff were stoned much of the time. Eventually I did get work: “We like the look of you; can you start tonight?” Job interviews were simple affairs. Even after I qualified, some …
THE TREND OF AMERICAN OPHTHALMOLOGY
Authors: JOHN O. McREYNOLDS
Journal: JAMA (1923)

For thirty years, we have watched with interest the currents and countercurrents in ophthalmic practice, and a few facts of some prophetic value have gathered above the horizon. In the brief span of three decades, we have seen modes of practice rise and fall, and then be forgotten. The very demands of the times are changing, and ophthalmology will meet these demands with her accustomed wisdom and zeal. Whole groups of diseases have lost their serious menace, and in the future will become relatively rare. Ophthalmia neonatorum will no longer take its heavy toll among the children of our country. The advanced and destructive forms of trachoma are being rapidly eliminated, and with this progress will go the necessity for operations correcting lid deformities resulting from this disease. With the marked diminution in severe, chronic conjunctival affections, and with the improvement in the treatment of nasal affections, there has been
T cell receptor repertoire of infiltrating T cells in lips of Sjögren's syndrome patients.
Authors: T Sumida, F Yonaha, T Maeda, E Tanabe, T Koike, H Tomioka, S Yoshida
Journal: Journal of Clinical Investigation (1992)

Infiltrating T cells around salivary glands in the lips of Sjögren's syndrome (SjS) patients are crucial in the pathogenesis of this disease. To analyze the nature of infiltrating T cells, their T cell receptor repertoire was examined with quantitative polymerase chain reaction. The repertoire of V beta transcripts in lips of SjS was not restricted; however, the V beta 2 and V beta 13 genes were predominantly expressed on the T cells of lip specimens in six and four of seven lips, respectively. Predominance of these genes was specific in lips because no predominant V beta transcripts were found in lips from healthy subjects and PBLs from SjS patients. These results indicated that the V beta 2- and V beta 13-positive T cells expanded specifically and preferentially in SjS lips, thereby suggesting the possible role in triggering the autoimmunity of this disease.
Effect of Reduced-Dose Schedules With 7-Valent Pneumococcal Conjugate Vaccine on Nasopharyngeal Pneumococcal Carriage in Children
Authors: Elske J. M. van Gils, Reinier H. Veenhoven, Eelko Hak, Gerwin D. Rodenburg, Debby Bogaert, Ed P. F. IJzerman, Jacob P. Bruin, Loek van Alphen, Elisabeth A. M. Sanders
Journal: JAMA (2009)

The effects of reduced-dose schedules of 7-valent pneumococcal conjugate vaccine (PCV-7) on pneumococcal carriage in children are largely unknown, although highly relevant in the context of subsequent herd effects.To examine the effects of a 2-dose and 2 + 1-dose PCV-7 schedule on nasopharyngeal pneumococcal carriage in young children compared with controls.A randomized controlled trial of nasopharyngeal carriage of Streptococcus pneumoniae enrolling 1003 healthy newborns and 1 of their parents in a general community in The Netherlands, with follow-up to age 24 months and conducted between July 7, 2005, and February 14, 2008.Infants were randomly assigned to receive 2 doses of PCV-7 at 2 and 4 months; 2 + 1 doses of PCV-7 at 2, 4, and 11 months; or no dosage (control group).Vaccine serotype pneumococcal carriage rates in infants in the second year of life.At 12 months, vaccine serotype pneumococcal carriage was significantly decreased after both PCV-7 schedules, with vaccine serotype pneumococcal carriage rates of 25% (95% confidence interval [CI], 20%-30%) and 20% (95% CI, 16%-25%) in the 2-dose and 2 + 1-dose schedule groups, respectively, vs 38% (95% CI, 33%-44%) in the control group (both P < .001). At 18 months, in the 2 + 1-dose schedule group, vaccine serotype pneumococcal carriage had further decreased to 16% (95% CI, 12%-20%) and, at 24 months, to 14% (95% CI, 11%-18%; both P < .001); whereas in the 2-dose schedule group, vaccine serotype pneumococcal carriage had remained stable at 18 months (24%; 95% CI, 20%-29%), but at 24 months had further decreased to 15% (95% CI, 11%-19%; both P < .001). In the control group, vaccine serotype pneumococcal carriage remained around 36% to 38% until 24 months.Compared with no pneumococcal vaccination, a 2 + 1-dose and 2-dose schedule of PCV-7 resulted in significant reductions of vaccine serotype pneumococcal carriage in the second year of life.clinicaltrials.gov Identifier: NCT00189020.
Fatal Ascariasis in a Negrito Child
Authors: Forrest S. Warner
Journal: JAMA (1961)

ASCARIS infection occurs in almost every part of L the world, with a high incidence in the tropical areas and especially in the Orient. Ascariasis is particularly common where sanitation is poor. The incidence in some areas of Europe and the Orient is reported to be as high as 90 to 94%. Endemic regions exist in the United States, especially in the southeastern part, where 30 to 40% of the rural population have been found to be infected.<sup>1</sup>We have had occasion to observe the health of a Negrito tribe who live adjacent to Clark Air Base in the Philippine Islands and receive medical care at the USAF Hospital. These individuals are small due to an inherited lack of the adolescent growth spurt.<sup>2</sup>However, the lack of protein in the diet, similar to that reported among other primitive people, contributes to their small stature.<sup>3</sup>Medical care has
The Royal College of General Practitioners replies to the BMJ
Authors: K. Hawthorne, A. Freeman, A. Rughani, S. Rendel, B. Lewis, B. Irish
Journal: BMJ (2013)

A suggestion of racial discrimination in a professional licensing examination is a serious matter.1 We are surprised to see it in the paper in the BMJ by Esmail and Roberts2 when the corresponding GMC report using the same data explicitly states that the same authors found no bias in the clinical skills assessment (CSA) of the examination for membership of the Royal College of General Practitioners (MRCGP).3 It is misleading at best to suggest that discrimination in the CSA is the cause of differential pass rates when the paper presents no such evidence.

Table 1 shows that black and minority ethnic (BME) candidates who are international medical graduates (IMG) and/or from the European Economic Area (EEA) also seem to do less well than white IMG/EEA candidates in the GMC’s Professional and Linguistic Assessment Board (PLAB) part 2 examination. …
Congenital Syphilis of the Lungs
Authors: P. W. Edmondson
Journal: BMJ (1953)

The assessment of the quality of isochromatic tables can only be empirical.Since their principal use, however, is for the detection of grossly colour-defective individuals who, by confusing red and green, are a danger to, and endangered by, modern traffic, a merely superficial test may provide a sufficiently valid result.But when a detailed answer is desirable, as when a certain amount of colour confusion can be tolerated, it will be found that clear-cut answers are obtained but rarely. Criterion for ComparisonIn the comparison of two different editions of the Ishihara tables it is necessary to test a given patient with both sets of tables in a random order so that the effect of memory becomes unimportant.Some sort of criterion must obviously be developed in order to evaluate the answers numerically.In the present instance, adequacy (A) and inconsist- ency (I), which are defined below, were chosen to compare the ninth and tenth editions of the Ishihara tables.All tables show at least one figure which the patient can or cannot read according to his colour vision.Some of them provide an alternative reading: thus Table 4 is designed to elicit the answer 29 or 70.If neither of these answers is given, and the patient reads 20 or 79 or any other number, this is considered to be a failure (F).The total number of F is subtracted from the number of tables (24, if the sample No. 1 is omitted) to yield the adequacy, A.In itself, however, the adequacy is not a sufficient criterion.It may happen that the patient is diagnosed as normal following one table, red-green blind following another, and totally colour-blind according to a third.Again, another man may be completely red-blind by Table 22 and com- pletely green-blind according to Table 24.Such diagnoses are not self-consistent.If, for example, the first patient gives six " normal " replies, then there are six inconsistencies (I = 6), since if he were normal he would have shown it more than six times.Similarly, in the second case 1=1, as one of the answers is unsuitable for an adequate diagnosis.A perfected diagnosis consequently requires A=24, and I=0-that is, all the answers must have been foreseen
English government consults on new law to reduce spread of infection
Authors: Susan Mayor
Journal: BMJ (2007)

Powers to reduce the risk of serious threats to public health should be strengthened, the English government has indicated, in a consultation paper designed to update legislation to take account of recent developments such as severe acute respiratory syndrome (SARS) as well as chemical and radiation hazards.

The government's proposals are designed to update the current law—the Public Health (Control of Disease) Act, 1984—which gives local authorities powers to prevent and control the spread of infectious disease. The government proposes that these powers be updated, with more modern and flexible provisions that can apply to contamination by chemicals and radiation as well as infectious diseases.

“Infectious diseases were once seen as a problem that would disappear in the foreseeable future. The emergence of new diseases, such as HIV/AIDS and SARS, and the re-emergence of old diseases, such as tuberculosis, have shown that that is not the case,” the consultation paper warns.

To cope with these challenges, the paper recommends supplementing current powers that allow an infected person to be medically examined and detained in hospital …