tbuckley/cabot-search huggingface dataset:
Medical Education and Practice
Authors: EUGENE A. STEAD
Journal: Annals of Internal Medicine (1970)

Educational units convert green manpower into professionally competent manpower. This conversion is inefficient in terms of production of services or new information. Educational units are efficient producers of manpower but inefficient producers of services. Community hospitals provide service with trained manpower. Whenever they try to become prime converters of manpower, they become inefficient in service. New categories of trained manpower should be produced by the educational system to support doctors practicing in community hospitals. Duke University is now training physician's assistants to give the practicing doctor the opportunity to build a more flexible clinical support system. The doctor is given an education that should prevent his becoming technologically obsolete: [1] preparation to function as a citizen, [2] language preparation, [3] skills in problem-solving, and [4] application of known knowledge to medical practice. Traditionally, bioscience has been used for [2] and [3]. System engineering, information sciences, law, business administration, and economics are also suitable for [2] and [3]. Our profession would profit if the education of doctors were not so obligatorily coupled to its bioscience base.
Assessing properly the usefulness of clinical prediction rules and tests
Authors: H. Llewelyn
Journal: BMJ (2012)

<h3>Purpose</h3> Lifestyle plays an important role in the development of ischaemic stroke (IS). The objective of this study was to evaluate the association between combined lifestyle factors and the risk of IS in an eastern Chinese population. <h3>Methods</h3> We collected lifestyle information from 191 patients with IS admitted to the second affiliated hospital of Soochow University and 575 control subjects from community clinics using a structured questionnaire. After division into training and test datasets, regularised stepwise logistic regression, least absolute shrinkage and selection operator regression and genetic algorithm models were used to identify lifestyle factors associated with IS. The improved discriminative ability by adding the lifestyle factors was determined by c-index and reclassification analysis. The final model was validated in the test dataset. <h3>Results</h3> After controlling for conventional cardiovascular disease (CVD) risk factors, preferences for fruits (OR (95% CI): 0.29 (0.18–0.46), p&lt;0.001) and soy products (0.47 (0.29–0.75), p=0.002) were negatively associated with IS, while lower life satisfaction (mildly satisfied: 2.15 (1.27–3.63), p=0.004; not satisfied: 6.39 (1.76–25.44), p=0.006) was positively associated with IS. Adding these factors to a basic CVD risk model improved the c-index (0.825 vs 0.753, p&lt;0.001) and reclassification for IS (net reclassification index (95% CI): 18.49% (7.90%–29.08%), integrated discrimination index (95% CI): 0.11% (0.08%–0.14%), p&lt;0.001). The model with lifestyle factors achieved a c-index of 0.813 and good calibration in the test dataset. <h3>Conclusions</h3> Our results showed that combined lifestyle factors including dietary pattern and life satisfaction are independently associated with the risk of IS.
Abstract SY16-01: Transcriptional regulation and epigenetics in zebrafish cancer.
Authors: Leonard I. Zon
Journal: Cancer Research (2013)

Abstract Melanoma is a devastating disease for which few therapies lead to long term remission after metastasis has occurred. We have been using the zebrafish to model melanoma. A transgenic fish carrying human V600E BRAF mutation in combination with p53 mutation leads to a rapid melanoma model in the zebrafish. Using a transposon based approach, we have been able to overexpress particular potential oncogenes to look for acceleration of the melanoma. One such oncogene (SETDB1) is amplified in 30% of human melanomas and accelerates tumor rate in the zebrafish. Using a library of chromatin factors that are full length, we have been able to overexpress over 80 factors and found several new factors that activate and induce more melanoma. This approach has led to a fundamentally new insight into melanoma and epigenetic regulation. We also have found a chemical (leflunomide) that lowers nucleotide levels and induces a transcriptional pause of neural crest genes. Leflunomide and a BRAF inhibitor is now in clinical trial for patients with metastatic melanoma. To understand the mechanism of action, we have focused on PTEFb that is a kinase that regulates the elongation step in transcription. We found that the HEXIM complex is able to sequester PTEFb into an inactive state. HEXIM is a new tumor suppressor gene for melanoma. Our studies have led to a better understanding of transcription in melanoma and have developed a novel therapeutic that is being tested in the clinic. Citation Format: Leonard I. Zon. Transcriptional regulation and epigenetics in zebrafish cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr SY16-01. doi:10.1158/1538-7445.AM2013-SY16-01
Academic medicine: time for reinvention: Academic medicine is failing women
Authors: A. Holdcroft
Journal: BMJ (2004)

Editor—The question “Why is academic medicine failing?” could be rephrased “Why is academic medicine failing women?”1 One reason is the recruitment and retention of senior female academics, and the other is the application of gender issues to medical research.

The failure of academic medicine to come to terms with clinical workforce interests and population healthcare issues is exemplified by the role and aspirations of female students, potential female clinical scientists, and women as patients. Recognition of the high quality skills of female science students and their subsequent loss during early postgraduate years has led to a reappraisal of the culture of a male dominated hierarchy in universities.2 The same process has yet to be applied to medicine.

What exclusions are academic medical women facing, and to what extent does this impact on the crisis in academic medicine, where men dominate and the NHS is an alternative employer? The obstacles of childrearing are very clear. It is a myth that great discoveries are made by scientists before the age of 40 years. The biological clock for women may be different; “life starts at 40 years” may be an attitude to consider.

Today's female doctors are demanding improved working conditions, better equity, and less hierarchy at work. They see their female counterparts in academic medicine with fewer resources and awards, less space, and lower salaries than male doctors. A BMA working paper identifies the monitoring tools required to support equity in the workforce and considers that a fair representation of women in scientific institutions can bring benefits to academic medicine.3

If women continue to be excluded in the university system, as the evidence from science faculties suggests, academic medicine will be unable to meet the challenges of medicine in the 21st century.
S157 Prevalence of asthma related to employment in the UK
Authors: J. Szram, S. J. Schofield, S. J. MacNeill, P. Cullinan
Journal: Thorax (2010)

<h3></h3> It is widely held that 10–15% of adult asthma is causally related to occupation. It is likely that this fraction varies importantly depending on historical and international variations in employment. Further uncertainties arise from misclassification in the diagnosis of asthma and in exposure assessment, particularly if based on self-report. We carried out a postal survey of adults listed as asthmatic through general practices across the UK. Cases, who were defined as those who had experienced onset of asthma or worsening of pre-existing childhood asthma within 2 years of starting a new job, were compared to controls who declared an equivalent onset or deterioration more than 2 years from the start of a job. Of 8535 individuals targeted, 3115 (37%) returned a completed questionnaire. Almost 40% of these (n=1198) experienced a deterioration of pre-existing childhood asthma or onset of adult asthma whilst working; 441 were cases and 757 controls. A priori analysis of risk was performed using an asthma-specific JEM, the ECRHS asthma ‘high risk occupations’ and data from the UK SWORD surveillance scheme. Odds ratios (adjusted for sex, smoking and era of onset and stratified by onset type)—displayed in Abstract S157 Table 1—did not suggest an increased risk of asthma within 2 years of starting a high-risk job. A posteriori analysis of all occupations demonstrated an increased risk of asthma within 2 years of starting a new job in sales and elementary occupations. The calculated population attributable risk (PAR) for these occupations was 15.9% and was higher in women than men. The results from this study suggest that a priori assessment of risk does not identify occupation as a significant cause of asthma in this contemporary adult workforce in the UK. Jobs which do appear to increase risk of new asthma are not those typically associated with an excess risk of the disease. These findings highlight the disparity between epidemiological and clinical assessments of asthma related to occupation, and the need to consider novel occupations as a cause of asthma.
Impaired Modulation of Sympathetic Excitability by Nitric Oxide After Long-term Administration of Organic Nitrates in Pigs
Authors: Johannes Zanzinger, Jürgen Czachurski, Horst Seller
Journal: Circulation (1998)

Background —Endogenous nitric oxide (NO) reduces sympathetic vasoconstriction by attenuating neuronal excitability in the brain stem and inhibition of postganglionic neurotransmission. We studied whether this modulation of sympathetic circulatory control by NO may be altered during chronic administration of NO donor drugs in pigs. Methods and Results —Nitrate tolerance was induced by oral administration of isosorbide dinitrate (ISDN, 4 mg/kg per day for 4 weeks) in eight pigs. Four of them were chronically instrumented for the measurement of mean arterial blood pressure and cardiac output in the conscious state. ISDN treatment caused hemodynamic tolerance to NO donors and significantly increased the hypotensive responses to pharmacologic ganglionic blockade in conscious pigs. In general anesthesia, ISDN-treated animals and age-matched controls (n=5) had similar baseline renal sympathetic nerve activity and in both groups neither inhibition of NO synthases (NOS) nor administration of NO donors to the brain stem by intracerebroventricular (ICV) infusions caused significant changes in baseline renal sympathetic nerve activity. However, whereas sympathoexcitatory responses to glutamate (0.5 mL, 0.1 mol/L, ICV) or electrical stimulation of somatic nerve afferents were significantly potentiated by central NOS inhibition and attenuated by NO donors in controls, these treatments no longer had significant effects in ISDN-treated pigs. Furthermore, reflex sympathetic activation in response to intravenous NO donor treatment was more pronounced in nitrate tolerant animals, which suggests loss of central sympathoinhibitory effects of NO. Subsequent histology on brain stem slices with NADPH-diaphorase as NOS marker revealed significant reduction of NOS density in ISDN-treated pigs. Conclusions —Long-term administration of organic nitrates reduces the number of NO-producing neurons in the brain stem and causes loss of inhibitory effects of NO on sympathetic excitability. This component of tolerance to organic nitrates may be important in patients confronted frequently with sympathetic activation caused by mental and/or physical stressors.
Does Deinstitutionalization Cause Criminalization?
Authors: H. Richard Lamb
Journal: JAMA Psychiatry (2014)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Psychiatry HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Psychiatry journal
125 PEGYLATED INTERFERON-ALPHA INDUCED SIGNALLING IN THE LIVER IS TRANSIENT AND FOLLOWED BY A LONG-LASTING REFRACTORINESS OF STAT1 ACTIVATION
Authors: M. Sarasin-Filipowicz, X. Wang, M. Yan, F.H.T. Duong, E.J. Oakeley, D.J. Hilton, L. Terracciano, W. Filipowicz, D.-E. Zhang, M.H. Heim
Journal: Journal of Hepatology (2009)
Risk Factors for Intracranial Hemorrhage in Outpatients Taking Warfarin
Authors: Elaine M. Hylek
Journal: Annals of Internal Medicine (1994)

Objective: To explore the rational use of anticoagulants, especially among the elderly, balancing antithrombotic efficacy and risk for hemorrhage. Previous prospective studies have not provided powerful assessments of risk factors for intracranial hemorrhage, the dominant complication in reversing the anticoagulant decision. Design: Case-control analysis. Setting: A large general hospital and its anticoagulant therapy unit. Patients: 121 consecutive adult patients taking warfarin who were hospitalized with intracranial hemorrhage were each matched to three contemporaneous controls randomly selected from among outpatients managed by our hospital anticoagulant therapy unit. Results: 77 patients had intracerebral hemorrhage (46% fatal) and 44 had subdural hemorrhage (20% fatal). The prothrombin time ratio (PTR) was the dominant risk factor for intracranial hemorrhage. For each 0.5 increase in PTR over the entire range, the risk for intracerebral hemorrhage doubled (odds ratio, 2.1; 95% CI, 1.4 to 2.9). For subdural hemorrhage, the risk was unchanged over the PTR range from 1.0 to 2.0 but rose dramatically above a PTR of 2.0 (approximate international normalized ratio, 4.0). Age was the only other significant independent risk factor for subdural hemorrhage (odds ratio, 2.0 per decade; CI, 1.3 to 3.1). For intracerebral hemorrhage, age was of borderline significance (odds ratio, 1.3 per decade; CI, 1.0 to 1.6) after controlling for PTR and the two other independent risk factors: history of cerebrovascular disease (odds ratio, 3.1; CI, 1.7 to 5.6) and presence of a prosthetic heart valve (odds ratio, 2.8; CI, 1.3 to 5.8). Conclusions: The results emphasize the importance of maintaining the prothrombin time ratios under 2.0 and the need for especially careful use of warfarin in the elderly.
Simulation of Ectopic Ventricular Rhythms By Aberrant Conduction
Authors: Albert H. Douglas
Journal: JAMA (1966)

To the Editor:—  In a recent issue ofThe Journal, Marriott1has properly redirected attention to the similarities and differences between the electrocardiographic patterns of supraventricular and ventricular arrhythmias. We are in full agreement with the author's contention that accurate diagnosis of these arrhythmias has become increasingly important with recent advances in therapy.  Unfortunately, neither Marriott1nor Sandler and Marriott,2have listed the diagnoses in the cases they studied. In our experience, diagnostic problems of the type discussed have involved primarily patients with ischemic heart disease and it is this same group which most frequently confronts the physician with arrhythmias of ventricular origin which have serious prognostic implications.  Furthermore, Marriott has assumed that impairment of conduction is the mechanism involved. The possibility of accelerated conduction as an explanation is an alternate hypothesis and this seems to account better for some cases of paroxysmal supraventricular tachycardia observed in ischemic
Molecular insights into the pathogenesis of hereditary haemochromatosis
Authors: A Pietrangelo
Journal: Gut (2006)

In the past few years not many fields in medicine have been so profoundly transformed by seminal discoveries as the iron field. Key missing proteins in iron homeostasis have been characterised and their regulatory pathways or function dissected. Seemingly, the causative genes of the most important human diseases associated with deregulated iron metabolism and responsible for tissue iron overload have been identified. These giant steps forward have dramatically transformed the way we look at iron related diseases, their pathogenesis, diagnosis, and treatment. One of the best examples is the disorder known as haemochromatosis (HC) or hereditary haemochromatosis. This term was introduced to define the association of widespread tissue injury with massive tissue iron deposition1 and likely referred to a clinical entity named “bronze diabetes”2 and “cirrhose pigmentaire”3 first reported in France in the second half of the 19th century. After only one century the term was associated with an hereditary disease4 and linked to the major histocompatibility class I complex A3, on the short arm of chromosome 6.5,6 In 1996, the most prevalent HC gene, HFE , was cloned.7 However, once the HFE gene was identified, it appeared immediately clear that HFE mutations accounted for most but not all cases of HC.8 Since then, unprecedented progress in the field of iron genetics has led to the identification of new genes involved in iron metabolism whose mutations are responsible for cases of hereditary iron storage disorders.

The term haemochromatosis (HC) (synonymous for hereditary or idiopathic or primary haemochromatosis) defines an autosomal recessive disorder of iron metabolism characterised by tissue iron overload potentially leading to multiorgan disease, such as liver cirrhosis, endocrinopathy, and cardiomyopathy. The syndrome is the result of a genetically determined failure to stop iron from entering the circulatory pool when it …
Laparoscopic Splenic Biopsy
Authors: G. Dagnini, M.W. Caldironi, G. Marin, M. Patella
Journal: Endoscopy (1984)

The authors report their experiences with 1243 laparoscopic splenic biopsies performed between 1968 and 1982 at the Laparoscopy Center of the Regional Hospital in Padua. We may conclude that: The risk of laparoscopic splenic biopsy in minimal and fears regarding its performance are unjustified. The diagnostic value of splenic biopsy is evident if a comparison is made, in the different groups, between the percentage and the accuracy of the diagnoses made with the single macroscopic and the histological examinations, respectively. As well as the staging and follow-up of malignant lymphomas, examination of the spleen in clinically suspected splenopathy is a new and interesting indication for laparoscopy, for it is now possible to take one or more biopsies.
Low 25-OH vitamin D serum levels correlate with severe fibrosis in HIV-HCV co-infected patients with chronic hepatitis
Authors: Benjamin Terrier, Fabrice Carrat, Guillaume Geri, Stanislas Pol, Lionel Piroth, Philippe Halfon, Thierry Poynard, Jean-Claude Souberbielle, Patrice Cacoub
Journal: Journal of Hepatology (2011)
NEPHROTOXIC SERUM NEPHRITIS IN RATS
Authors: Howard C. Goodman, James H. Baxter
Journal: The Journal of Experimental Medicine (1956)

A soluble protective factor, capable of absorbing nephrotoxic antibodies from anti-rat kidney serum, can be obtained in high concentration by tryptic digestion of rat kidney homogenate. The factor is no longer antigenic or at most only slightly so. It is stable at 60 degrees , destroyed by boiling, is non-dialyzable, can be precipitated by ammonium sulfate, but resists destruction by proteolytic and other enzymes. In accord with previous studies on the organ localization of the rat tissue antigen responsible for the production of nephrotoxic antibodies, the soluble protective factor, or antigen derivative, can be obtained by tryptic digestion of rat lung, skeletal muscle, heart, and liver.
<i>Shigella</i> Strains Are Not Clones of <i>Escherichia Coli</i> but Sister Species in the Genus <i>Escherichia</i>
Authors: Guanghong Zuo, Zhao Xu, Bailin Hao
Journal: Genomics Proteomics & Bioinformatics (2012)

Abstract Shigella species and Escherichia coli are closely related organisms. Early phenotyping experiments and several recent molecular studies put Shigella within the species E. coli. However, the whole-genome-based, alignment-free and parameter-free CVTree approach shows convincingly that four established Shigella species, Shigella boydii, Shigella sonnei, Shigella felxneri and Shigella dysenteriae, are distinct from E. coli strains, and form sister species to E. coli within the genus Escherichia. In view of the overall success and high resolution power of the CVTree approach, this result should be taken seriously. We hope that the present report may promote further in-depth study of the Shigella-E. coli relationship.
Clinical Aspects of Inhaled Particles
Authors: John S. Chapman
Journal: JAMA (1973)

The purpose of this volume is to furnish the reader with an understanding of the behavior of airborne material as it reaches the respiratory tract. Professor Muir leads off with an excellent discussion of the physics of aerosols, essential to understanding of effects. His lucid presentation of air-flow characteristics in the successive orders of bronchi, the effective diameter of particles in the aerosols, sites of deposition along the airways, and clearance mechanisms is full yet concise. He expands these ideas further and effectively in two other chapters, one dealing with airborne allergens, the other with physical properties of therapeutic aerosols. Professor Lawther presents the chapter on "Air Pollution and Tobacco Smoke" and points out the numerous inadequacies in our knowledge of effects. Dr. Williams deals with airborne microbial infection, and is particularly good on the subject of air disinfection. Dr. Schilling presents byssinosis, while Dr. Elmes discusses asbestosis. The chapter