tbuckley/cabot-search huggingface dataset:
The Effect of Importing Physicians — Return to a Pre-Flexnerian Standard
Authors: Robert J. Weiss, Joel C. Kleinman, Ursula C. Brandt, Dan S. Felsenthal
Journal: New England Journal of Medicine (1974)

Abstract Increasing concern about the control of the quality of medical care raises the question of the dilution of the physical manpower pool with foreign medical graduates, who constituted 46 per cent of new licentiates in medicine in the United States in 1972. The use of the Educational Council for Foreign Medical Graduates examination as a minimal level of educational quality for graduates entering the United States from medical schools in developing countries and the increasing number of such graduates entering the United States each year from those countries have produced a dual standard. Medical schools in the United States established controls over the input and process of medical education after the Flexner Report in 1910. Such controls do not exist in many foreign medical schools. Recommendations are made for control of a minimal educational level for physicians entering the United States health-care system and implications of these recommendations are discussed. (N Engl J Med 290:1453–1458, 1974)
Postmenopausal Hormone Therapy
Authors: Holly L. Thacker
Journal: Annals of Internal Medicine (1993)

Letters15 August 1993Postmenopausal Hormone TherapyHolly L. Thacker and Delbert BooherHolly L. ThackerSearch for more papers by this author and Delbert BooherSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-119-4-199308150-00030 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Overall, the review and guidelines on hormone replacement therapy [1, 2] were conservative, except for the statement that endometrial evaluation is commonly performed to evaluate bleeding that begins at any time other than on days 5 to 15 of the month on the cycled estrogen-progestin program. This statement should be corrected to refer to bleeding that occurs at times other than on days 10 to 20. Bleeding after the 10th of the calendar month can be related to a normal secretory endometrium [3].Until long-term studies are published on the effects of the continuous combined program of ...References1. Grady D, Rubin SM, Petitti DB, Fox CS, Black D, Ettinger B, et al. Hormone therapy to prevent disease and prolong life in postmenopausal women. Ann Intern Med. 1992; 117:1016-37. Google Scholar2. American College of Physicians. Guidelines for counseling postmenopausal women about preventive hormone therapy. Ann Intern Med. 1992; 117:1038-41. Google Scholar3. Padwick MI, Davies JP, Whitehead MI. A simple method for determining the optimal dosage of progestin in postmenopausal women receiving estrogens. N Engl J Med. 1986; 315:930-4. Google Scholar4. Bergkvist L, Adami HO, Persson I, Hoover R, Schairer C. The risk of breast cancer after estrogen and estrogen-progestin replacement. N Engl J Med. 1989; 321:293-7. Google Scholar5. Stampfer MJ, Colditz GA, Willett WC, Manson JE, Rosner B, Speizer FE, et al. Postmenopausal estrogen therapy and cardiovascular disease. Ten-year follow-up from the Nurses' Health Study. N Engl J Med. 1991; 325:756-62. Google Scholar Author, Article, and Disclosure InformationAuthors: Holly L. Thacker; Delbert Booher PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 August 1993Volume 119, Issue 4Page: 347-348KeywordsBreast cancerCardiovascular diseasesEndometriumEstrogen replacement therapyEstrogensHemorrhageHormone replacement therapyLongitudinal studies ePublished: 15 August 2000 Issue Published: 15 August 1993 Copyright & PermissionsCopyright © 1993 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Pulmonary vasodilatory action of endogenous atrial natriuretic factor in rats with hypoxic pulmonary hypertension. Effects of monoclonal atrial natriuretic factor antibody.
Authors: B Raffestin, M Levame, S Eddahibi, I Viossat, P Braquet, P E Chabrier, M Cantin, S Adnot
Journal: Circulation Research (1992)

We administered ascitic fluid containing atrial natriuretic factor (ANF) monoclonal antibody to rats after 3 weeks of exposure to hypoxia while the rats were still hypoxic. In additional chronically hypoxic rats, we infused synthetic rat ANF. In conscious chronically instrumented rats, after a bolus dose of 5 micrograms i.v. ANF, pulmonary arterial pressure fell significantly from 26.5 +/- 2 to 21 +/- 2 mm Hg (p less than 0.01), reaching its nadir at 5 minutes without change of systemic arterial pressure, cardiac output, or heart rate. Pulmonary arterial pressure increased gradually from 26 +/- 4 to 34 +/- 4 mm Hg within 30 minutes (p less than 0.05) after acute administration of ANF monoclonal antibody and decreased transiently to return to baseline within 15 minutes after infusion of control ascitic fluid containing monoclonal antibody against an apolipoprotein. Cardiac output and heart rate remained unchanged after both ANF monoclonal antibody and control ascitic fluid. In normoxic rats, acute administration of ANF monoclonal antibody did not cause significant changes in pulmonary arterial pressure, cardiac output, or heart rate. Rats receiving weekly intravenous injections of ANF monoclonal antibody that were started before initiation of exposure to hypoxia experienced significantly aggravated pulmonary hypertension and right ventricular hypertrophy compared with rats receiving repeated infusions of control ascitic fluid. However, there was no significant difference in small pulmonary arterial wall thickness or percentage of muscularized arteries at the alveolar duct level. These results suggest that endogenous ANF attenuates hypoxic pulmonary hypertension by decreasing pulmonary vascular tone.
Regulation of Bone Formation and Vision by<i>LRP5</i>
Authors: Millan S. Patel, Gerard Karsenty
Journal: New England Journal of Medicine (2002)

Osteoporosis affects several million people and is associated with medical costs of up to $15 billion per year in the United States alone.1,2 Thus, identifying the molecular mechanisms that control bone mass is a task of the utmost importance. The recent identification of the role of the low-density lipoprotein receptor–related protein 5 (LRP5) gene in the regulation of bone mass is a landmark discovery.36 We examine the lock-and-key mechanism involving LRP5 that regulates two different functions: bone formation and vision.The LockThe low-density lipoprotein receptor–related proteins are a family of cell-surface receptors involved in diverse biologic processes, . . .
Broad targeting of resistance to apoptosis in cancer
Authors: Ramzi M. Mohammad, Irfana Muqbil, Leroy Lowe, Clement Yedjou, Hsue-Yin Hsu, Liang-Tzung Lin, Markus David Siegelin, Carmela Fimognari, Nagi B. Kumar, Q. Ping Dou, Huanjie Yang, Abbas K. Samadi, Gian Luigi Russo, Carmela Spagnuolo, Swapan K. Ray, Mrinmay Chakrabarti, James D. Morre, Helen M. Coley, Kanya Honoki, Hiromasa Fujii, Alexandros G. Georgakilas, Amedeo Amedei, Elena Niccolai, Amr Amin, S. Salman Ashraf, William G. Helferich, Xujuan Yang, Chandra S. Boosani, Gunjan Guha, Dipita Bhakta, Maria Rosa Ciriolo, Katia Aquilano, Sophie Chen, Sulma I. Mohammed, W. Nicol Keith, Alan Bilsland, Dorota Halicka, Somaira Nowsheen, Asfar S. Azmi
Journal: Seminars in Cancer Biology (2015)

Apoptosis or programmed cell death is natural way of removing aged cells from the body. Most of the anti-cancer therapies trigger apoptosis induction and related cell death networks to eliminate malignant cells. However, in cancer, de-regulated apoptotic signaling, particularly the activation of an anti-apoptotic systems, allows cancer cells to escape this program leading to uncontrolled proliferation resulting in tumor survival, therapeutic resistance and recurrence of cancer. This resistance is a complicated phenomenon that emanates from the interactions of various molecules and signaling pathways. In this comprehensive review we discuss the various factors contributing to apoptosis resistance in cancers. The key resistance targets that are discussed include (1) Bcl-2 and Mcl-1 proteins; (2) autophagy processes; (3) necrosis and necroptosis; (4) heat shock protein signaling; (5) the proteasome pathway; (6) epigenetic mechanisms; and (7) aberrant nuclear export signaling. The shortcomings of current therapeutic modalities are highlighted and a broad spectrum strategy using approaches including (a) gossypol; (b) epigallocatechin-3-gallate; (c) UMI-77 (d) triptolide and (e) selinexor that can be used to overcome cell death resistance is presented. This review provides a roadmap for the design of successful anti-cancer strategies that overcome resistance to apoptosis for better therapeutic outcome in patients with cancer.
Abstract 1728: Genetic variations in epidermal growth factor receptor pathway predict recurrence and response to chemotherapy in early stage non-small cell lung cancer
Authors: Eric S. Kim, Yuanqing Ye, Ara A. Vaporciyan, Jinliang Xing, Maosheng Huang, Jian Gu, Jack A. Roth, Scott M. Lippman, Xifeng Wu
Journal: Cancer Research (2012)

Abstract Purpose: We hypothesized that genetic variants within EGFR pathway would have significant predictive value for recurrence and response to chemotherapy after curative resection in early-stage NSCLC. Methods: This study included 467 patients with histologically confirmed NSCLC who were enrolled from 1995 to 2008 in an ongoing, prospective epidemiologic lung cancer study at MD Anderson Cancer Center. A total of 387 single nucleotide polymorphisms (SNPs) within 26 genes from EGFR pathway were genotyped in patients who were treated with surgery only (N=340) or surgery plus chemotherapy (N=127). The risk of recurrence was estimated as hazard ratios (HRs) and 95% confidence intervals (CIs) using a multivariate Cox proportional hazard regression model. Results: We identified 5 top SNPs that significantly (P&amp;lt;0.05) predicted risk of recurrence in both surgery only and surgery plus chemotherapy groups. To identify a subgroup of patients who may benefit from adjuvant chemotherapy, we divided these 5 SNPs into two different groups according to varying hazard ratios for the analysis performed in surgery only or surgery plus chemotherapy group; A (2 SNPs)=should receive surgery only (HR&amp;lt;1 in surgery only and HR&amp;gt;1 in surgery+chemotherapy); B (3 SNPs)=should receive chemotherapy in addition to surgery (HR&amp;gt;1 in surgery only and HR&amp;lt;1 in surgery+chemotherapy). Cumulative genotype analysis reveals that patients with 1 or 2 SNPs from Group A had risk of recurrence that was 0.57-fold that of the reference group without any of these two SNPs (HR=0.57; 95% CI=0.34-0.96; P=0.035). However, if patients with the same 1 or 2 SNPs undergo chemotherapy, the risk of recurrence increases to 3.3-fold that of the reference group (HR=3.28; 95% CI=1.51-7.12; P=0.003). On the other hand, patients with one or greater number of SNPs from Group B after surgery only had 2.3-fold increased risk of recurrence compared to the reference group without any of these SNPs (HR=2.30; 95% CI=1.36-3.88; P=0.002). However, with addition of chemotherapy the risk of recurrence in patients with the same SNPs decreased significantly to 0.24-fold that of the reference group (HR=0.24; 95% CI=0.12-0.51; P=0.001). Conclusions: Our proposed SNPs from EGFR pathway may help identify a subgroup of patients at high risk of recurrence after resection and guide decision for adjuvant chemotherapy in early-stage NSCLC. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1728. doi:1538-7445.AM2012-1728
THE SELECTION OF PSYCHIATRIC AIDES: I. CRITICAL REQUIREMENTS OF THE JOB
Authors: DONALD P. SCHMIDT, DAVID COHEN
Journal: American Journal of Psychiatry (1955)

The present paper is the first in a series reporting on the development of a pre-employment selection program for psychiatric aides at the VA Hospital, Coatsville, Pennsylvania. 1. A survey of previous research in the area of aide selection suggests that equivocal, ambiguous, and only partly useful results have been obtained because of the lack of an adequate criterion of effectiveness of job performance. 2. Flanagan's Critical Incident Technique was used to develop a list of critical requirements for the job of psychiatric aide. Critical incidents were collected in prepared booklets from the professional staff of the hospital, supervisory and floor nurses, student nurses, and other personnel who routinely come into contact with aides in the course of their work. 3. An attempt to use booklets for the collection of critical incidents from aides was unsuccessful. Satisfactory response was obtained by interviewing the aides individually. 4. A total of 1,123 incidents was obtained from 325 respondents. These were sorted and categorized into 7 major areas and 22 subareas of job requirements. 5. Suggestions are made as to how these findings may be applied in other hospitals. Later papers will report on their specific application in this hospital.
Iodide Mumps after Intravenous Urography
Authors: Ralph M. Sussman, Jay Miller
Journal: New England Journal of Medicine (1956)

SALIVARY-gland swelling is an infrequent manifestation of "iodism" or iodide idiosyncrasy, occurring after therapy with inorganic, iodine compounds. Its appearance may suggest the possibility of mumps or stone in the salivary ducts and lead to embarrassing, tedious and sometimes costly investigations. The following cases are reported because salivary-gland swelling occurred as a sequel to intravenous urography with new organic iodide preparations, diatrizoate sodium (Hypaque) and sodium methylglucamine diacetylamino-triiodobenzoates (Renografin), and introduced the diagnostic possibilities of epidemic parotitis and salivary-duct calculus.Case ReportsCase 1. M.E., a 68-year-old merchant, complained of right-sided facial swelling and tenderness. He had recently had a . . .
Granulocyte-Macrophage Colony-Stimulating Factor Amplifies Lipopolysaccharide-induced Bronchoconstriction by a Neutrophil- and Cyclooxygenase 2-Dependent Mechanism
Authors: LUTZ WOLLIN, STEFAN UHLIG, ROLF NÜSING, ALBRECHT WENDEL
Journal: American Journal of Respiratory and Critical Care Medicine (2001)

Granulocyte-macrophage colony-stimulating factor (GM-CSF) is used to ameliorate neutropenia in patients after antineoplastic treatment. It has also been suggested as an adjunct treatment in septic patients; however, the recruitment and priming of leukocytes by GM-CSF bears the hazard of a hyperinflammatory response. In particular, the role of GM-CSF in pulmonary functions in septic lungs is still unclear. Therefore, we pretreated rats in vivo with GM-CSF (50 microg/kg, intravenous) and assessed the pulmonary functions of their subsequently prepared isolated perfused lungs when exposed to subtoxic concentrations of lipopolysaccharide (LPS, 2 microg/ml). These lungs showed enhanced expression of cyclooxygenase 2 (COX-2), a significant increase in thromboxane (TX) and tumor necrosis factor (TNF) release into the venous perfusate, and bronchoconstriction. COX-2 inhibition or blocking of the TX receptor abolished the GM-CSF/LPS-induced bronchoconstriction, but not the TNF release. Neutralizing antibodies against TNF did not prevent GM-CSF/LPS-induced bronchoconstriction. After GM-CSF pretreatment, massive neutrophil invasion into the lung occurred. Neutropenic rats were protected against GM-CSF/ LPS-induced lung injury. Similar results were obtained in rats pretreated with G-CSF instead of GM-CSF. We conclude that GM-CSF pretreatment exacerbates pulmonary injury by low-dose LPS via COX-2 expression, TX release, and bronchoconstriction by initiating neutrophil invasion and activation.
Inhaled Corticosteroids or Antileukotrienes for Asthma?
Authors: Neil B. Hampson
Journal: Annals of Internal Medicine (1999)

Letters7 December 1999Inhaled Corticosteroids or Antileukotrienes for Asthma?Neil B. Hampson, MDNeil B. Hampson, MDVirginia Mason Medical Center; Seattle, WA 98111 (Hampson)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-131-11-199912070-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The editorial (1) that accompanied the report by Malmstrom and coworkers (2) states that “the antileukotrienes are a good first choice” for patients with mild persistent asthma. The results of the clinical trial seem to suggest otherwise.In Malmstrom and colleagues' study, patients with chronic asthma were randomly assigned to receive montelukast, inhaled beclomethasone, or placebo (2). When one compares the results in patients receiving one of the active treatments, it is apparent that beclomethasone therapy resulted in 77% greater improvement in FEV1 than montelukast, 64% greater improvement in morning peak expiratory flow rates, 51% greater improvement ...References1. Smith LJ. Newer asthma therapies [Editorial]. Ann Intern Med. 1999;130:531-2. LinkGoogle Scholar2. Malmstrom K, Rodriguez-Gomez G, Guerra J, Villaran C, Piñeiro A, Wei LX, et al . Oral montelukast, inhaled beclomethasone, and placebo for chronic asthma. A randomized, controlled trial. Ann Intern Med. 1999;130:487-95. LinkGoogle Scholar3. Red Book. Montvale, NJ: Medical Economics; 1999. Google Scholar Author, Article, and Disclosure InformationAuthors: Neil B. Hampson, MDAffiliations: Virginia Mason Medical Center; Seattle, WA 98111 (Hampson) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoNewer Asthma Therapies Lewis J. Smith Oral Montelukast, Inhaled Beclomethasone, and Placebo for Chronic Asthma Kerstin Malmstrom , Guillermo Rodriguez-Gomez , Jeremias Guerra , Cesar Villaran , Andres Piñeiro , Lynn X. Wei , Beth C. Seidenberg , and Theodore F. Reiss , for the Montelukast/Beclomethasone Study Group*Inhaled Corticosteroids or Antileukotrienes for Asthma? Theodore F. Reiss Metrics 7 December 1999Volume 131, Issue 11Page: 865KeywordsAsthmaClinical trialsCorticosteroid therapyDrugsForced expiratory volume in the first second of expiration ePublished: 15 August 2000 Issue Published: 7 December 1999 Copyright & PermissionsCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
Contribution of connexins to the function of the vascular wall
Authors: Jacques-Antoine Haefliger, Pascal Nicod, Paolo Meda
Journal: Cardiovascular Research (2003)

Gap junction channels provide an enclosed conduit for direct exchanges of signalling molecules, including ions and small metabolites between cells. This system of communication allows cells to monitor the functional state of their neighbours, and is rapidly modulated to continuously adapt to the immediate needs of groups of coupled cells. In the major arteries, endothelial cells may express three connexins isotypes, namely Connexin 37 (Cx37), Cx40 and Cx43, whereas the underlying smooth muscle cells may express Cx37, Cx40, Cx43 and Cx45. Moreover, myoendothelial gap junctions have also been shown to be involved in the regulation of vascular tone. This review highlights the regulation of vessel connexins in response to injury, as observed during experimental hypertension or wound repair, as well as the consequences of loss of one connexin in different transgenic null mice. In view of the major endocrine role of the kidney in the control of blood pressure, we also discuss the distribution of connexins in the kidney vasculature. Cx40 is present between endothelial cells of vessels and glomeruli, as well as between renin-secreting cells, the modified smooth muscle cells which form the wall of the terminal part of afferent arterioles. Modulation of Cx40 expression in a model of renin-dependent hypertension suggests that this connexin may be implicated in the function of renin-secreting cells. Finally, to address the possible regulation of connexin expression by fluid pressure, we summarize the effects of elevated transmural urine pressure on bladder Cx43 expression.
Effect of antibiotic prescribing on antibiotic resistance in individual children in primary care: prospective cohort study
Authors: Angela Chung, Rafael Perera, Angela B Brueggemann, Abdel E Elamin, Anthony Harnden, Richard Mayon-White, Susan Smith, Derrick W Crook, David Mant
Journal: BMJ (2007)

<b>Objective</b> To assess the effect of community prescribing of an antibiotic for acute respiratory infection on the prevalence of antibiotic resistant bacteria in an individual child. <b>Study design</b> Observational cohort study with follow-up at two and 12 weeks. <b>Setting</b> General practices in Oxfordshire. <b>Participants</b> 119 children with acute respiratory tract infection, of whom 71 received a β lactam antibiotic. <b>Main outcome measures</b> Antibiotic resistance was assessed by the geometric mean minimum inhibitory concentration (MIC) for ampicillin and presence of the ICE<i>Hin1056</i> resistance element in up to four isolates of <i>Haemophilus </i>species recovered from throat swabs at recruitment, two weeks, and 12 weeks. <b>Results</b> Prescribing amoxicillin to a child in general practice more than triples the mean minimum inhibitory concentration for ampicillin (9.2 µg/ml <i>v</i> 2.7 µg/ml, P=0.005) and doubles the risk of isolation of <i>Haemophilus</i> isolates possessing homologues of ICE<i>Hin1056</i> (67% <i>v</i> 36%; relative risk 1.9, 95% confidence interval 1.2 to 2.9) two weeks later. Although this increase is transient (by 12 weeks ampicillin resistance had fallen close to baseline), it is in the context of recovery of the element from 35% of children with <i>Haemophilus</i> isolates at recruitment and from 83% (76% to 89%) at some point in the study. <b>Conclusion</b> The short term effect of amoxicillin prescribed in primary care is transitory in the individual child but sufficient to sustain a high level of antibiotic resistance in the population.
The Kidney and Erythropoiesis
Authors: Frederick Stohlman
Journal: New England Journal of Medicine (1968)

THE clinical and experimental observations of more than a decade ago that led to the conclusion that red-cell production is under hormonal control also pointed to the fact that an organ below the diaphragm was the site of production of the hormone erythropoietin.1 The notion that the kidney might be the site of erythropoietin production derived from a number of observations: the association of polycythemia with renal neoplasms and cysts; the presence of anemia in patients with renal disease; and studies on nephrectomized animals and those with bilateral ureteral ligations. In rodents it was noted that bilateral nephrectomy led to . . .
Surgeons who don't report results to a central registry have worse outcomes
Authors: N. Hawkes
Journal: BMJ (2010)

Surgical teams that do not report their results to a central registry have worse outcomes than those that do, a study of colorectal surgery has shown.

The finding, published in the British Journal of Surgery (doi:10.1002/bjs.7301), is open to two interpretations: either that publication of results improves outcomes or that surgeons who know or suspect that their outcomes may be worse are those who are least likely to submit them voluntarily.

In either case, the authors say, making submission compulsory is worth considering, as it would either improve overall performance or …
Small-bowel obstruction secondary to wireless capsule enteroscopy: extraction of the capsule without enterotomy
Authors: O. Irkorucu, O. Tascilar, A. Emre, G. Cakmak, K. Karakaya, B. Ucan, M. Comert
Journal: Endoscopy (2007)

Although wireless capsule enteroscopy is a relatively noninvasive diagnostic tool for exploring the whole small intestine endoscopically [1] [2], the contraindications and complications of this new technique have not yet been fully described.