tbuckley/cabot-search huggingface dataset:
Medical School and Student Characteristics That Influence Choosing a Generalist Career
Authors: Carlos J. M. Martini
Journal: JAMA (1994)

<h3>Objective.</h3> —To identify predictors in medical schools that can be manipulated to affect the proportion of graduates entering generalist practice. <h3>Design and Participants.</h3> —Cross-sectional and retrospective studies of medical schools and practicing generalist physicians; surveys of MD-granting and DO-granting medical schools; site visits to nine schools with a high proportion of graduates becoming generalist physicians; surveys of national samples of MD and DO generalist physicians. <h3>Independent Variables.</h3> —Characteristics of medical schools, including structural characteristics, financing, mission, admissions policies, student demographics, curriculum, faculty, and the production of generalist physicians; information on personal characteristics, background, perceptions, and attitudes of practicing generalist physicians. <h3>Dependent Variable.</h3> —Estimated proportion of graduates of the classes of 1989, 1990, and 1991 in family practice, general internal medicine, and general pediatrics. <h3>Results.</h3> —Institutional mission, certain admissions policies, characteristics of entering students, and the presence of a primary care—oriented curriculum explained statistically significant variation in the number of physicians choosing generalist careers, even after the structural characteristics of public or private status, age of the school, and class size were controlled for statistically. <h3>Conclusions.</h3> — Public and institutional policies, where implemented, have had a positive effect on students' choice of generalist careers. The most influential factors under the control of the medical school are the criteria used for admitting students and the design of the curriculum, with particular emphasis on faculty role models. Personal social values was the individual characteristic that most strongly influenced graduates' career choice. (<i>JAMA</i>. 1994;272:661-668)
The effect of a low‐phosphate diet on hematocrit and oxygen transport in uremic rats
Authors: Thomas J. Connelly, Jaime Caro, Allan J. Erslev, Ruth Silver
Journal: American Journal of Hematology (1982)

Abstract Dietary restriction of phosphate was found to prevent the development of anemia in partially nephrectomized rats. In an attempt to examine the reason for this beneficial effect, hematologic and nephrologic studies were carried out on normal and on partially nephrectomized rats fed either a normal or a low‐phosphate diet. It was first found that a low‐phosphate diet ameliorates the degree of renal impairment found four weeks after partial nephrectomy. Nevertheless, it did not eliminate it, and the degree of uremia actually observed should have been associated with a significant reduction in hemoglobin and red cell mass. However, it did reduce serum phosphate and red cell 2,3‐diphosphoglycerate (2,3 DPG) levels and increase hemoglobin affinity for oxygen to a degree that should impair oxygen transport to the tissues. That the low phosphate actually caused tissue hypoxia with increased stimulation of the bone marrow was furthermore suggested by the observation that normal rats fed a low‐phosphorous diet developed a significant increase above normal in hemoglobin concentration and red cell mass. It was concluded that the effect of a low‐phosphate diet on the anemia of uremia is caused by a combination of reduced renal failure and increased tissue hypoxia.
Management of Priapism by Therapeutic Defibrination
Authors: William R. Bell, W. R. Pitney
Journal: New England Journal of Medicine (1969)

THE management of long standing priapism is difficult and often unsuccessful despite an extensive variety of medications and surgical procedures. The clinical features and causes of priapism have been reviewed.1 This report describes two patients whose priapism was relieved during therapy with a new agent (Arvin), a proteolytic enzyme fractionated from the crude venom of the Malayan pit viper, Agkistrodon rhodostoma. The enzyme was administered intravenously at a dose of 1 unit per kilogram of body weight. The initial dose was infused slowly over a six-hour period. A second dose was given over 10 to 15 minutes at the completion . . .
Sumatriptan is not the only analgesic used inappropriately
Authors: P. J Goadsby
Journal: BMJ (1998)

EDITOR—As Gaist et al report, the problem of overuse of sumatriptan is of considerable concern.1 This is particularly so in the context of chronic daily headache.2 Catarci et al have suggested that sumatriptan may replace ergotamine in overuse syndromes.3 Staff at the headache …
Identification of novel downstream targets of platelet glycoprotein VI activation by differential proteome analysis: implications for thrombus formation
Authors: Christian Schulz, Nina V. Leuschen, Thomas Fröhlich, Michael Lorenz, Susanne Pfeiler, Christian A. Gleissner, Elisabeth Kremmer, Mirjam Kessler, Alexander G. Khandoga, Bernd Engelmann, Klaus Ley, Steffen Massberg, Georg J. Arnold
Journal: Blood (2010)
Changing Staphylococcal Phage Types in Therapy of Recurrent Furunculosis.
Authors: Walter G. Strauss
Journal: Annals of Internal Medicine (1965)

s1 May 1965Changing Staphylococcal Phage Types in Therapy of Recurrent Furunculosis.Walter G. Strauss, M.D., F.A.C.P., Howard I. Maibach, M.D., F.A.C.P., Valerie Hurst, M.D.Walter G. Strauss, M.D., F.A.C.P.Search for more papers by this author, Howard I. Maibach, M.D., F.A.C.P.Search for more papers by this author, Valerie Hurst, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-62-5-1087_3 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptThis study concerns a 43-year-old housewife with an 8-year history of recurring furuncles and carbuncles. For a 1½-year period repeated cultures of abscesses and multiple other sites, including the bowel, showed Staphylococcus phage type 52/52A/80. Previous therapeutic attempts to prevent these furuncles included hexachlorophene washings, disinfection of clothing, systemic and topical antibiotics, and staphylococcal toxoid. None produced significant benefit.To eradicate her resident staphylococcus, she was given oxacillin for 6 days. To substitute another strain we applied staphylococcus type 502A as described by Shinefield. Approximately 5 million organisms were placed daily for 6 days into the nostrils, axillae, umbilicus, groin,... This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: San Francisco, California PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 May 1965Volume 62, Issue 5Page: 1087-1087KeywordsAbscessesAntibioticsBacteriophagesDisinfectionStaphylococcusToxoids Issue Published: 1 May 1965 PDF DownloadLoading ...
Introducing new health interventions
Authors: John Gabbay, Tom Walley
Journal: BMJ (2006)

Throughout the world, healthcare innovations have put pressure on limited resources while governments and patients have demanded top quality, yet cost effective, services. This makes it increasingly difficult for anyone who plans, provides, or receives health services to judge which intervention to use—what works, how well, at what cost, for whom, in what circumstances, and with what impact? Health technology assessment (HTA) is a multidisciplinary specialty whose purpose is to bring together the evidence to answer those questions.1 It boasts a thriving international scientific society (Health Technology Assessment International; www.htai.org) and a global network of more than 40 public sector agencies (International Network of Agencies for Health Technology Assessment; www.inahta.org). It evaluates the costs, effectiveness, and sometimes the wider impact of any intervention used in the care of patients, including medicines, devices, techniques, and skills. In the UK, for example, the HTA programme (www.ncchta.org) has produced more than 300 reports that have had an impact on services, including novel research as well as syntheses of evidence on cost effectiveness on topics ranging from left ventricular assist devices to isolation procedures for containing Staphylococcus aureus.2-5 It also provides much of the evidence base for the guidance which the National Institute for Health and Clinical Excellence (NICE) provides for the NHS.6
Headaches Over Headaches
Authors: Leonard Sadoff
Journal: JAMA (1973)

<h3>To the Editor.—</h3> The editorial is, I suppose, a logical extension of the decade-old controversy of specialization (and presumably dehumanization) vs despecialization (return to humanism). First, there was specialization, then subspecialization. After that, there were disease-oriented clinics and "organ" specialists, and finally, the ultimate fractionization of the patient has occurred with the establishment of complaint-centered clinics. Such a trend, Dr. Jaffe states, is "potentially dangerous and inherently inefficient." The implication is that the "headache expert" does not treat the person (although he has been schooled in the same ground rules as his "unspecialized" colleagues), that he orders many expensive and unnecessary tests, and that, in the end, he sends most of his patients home with a bottle of aspirin. For purposes of debate, let us construct a hypothetical headache clinic. Let us say that it is staffed by a group of interested, intelligent, and studious physicians with equally capable nurses,
Sexually Transmitted Diseases in Disadvantaged Australian Communities
Authors: Christopher K. Fairley, Francis J. Bowden, Barbara A. Paterson, Suzanne M. Garland, Sepehr N. Tabrizi
Journal: JAMA (1997)

<h3>To the Editor.</h3> —A high prevalence of sexually transmitted diseases (STDs) in a disadvantaged community is often ascribed to a high rate of sexual partner change. This assumption can perpetuate adverse cultural stereotypes and produce a sense of hopelessness because of the difficulties in effecting a sustained change in sexual behavior in remote communities that have complex social structures. We present data from an isolated Australian community that suggest an alternative explanation for the high prevalence of STDs. The prevalence of a specific STD at endemic equilibriumin a community is dependent on 3 factors: the time for which an individual is infectious, the probability of transmission during sexual intercourse, and the rate of sexual partner change.<sup>1</sup>The probability of transmission may be similar for different racial groups, but the rate of sexual partner change and the duration of infectiousness may vary between communities. In particular, the duration of infectiousness
It's like standing on a deserted platform
Authors: F. Armanious
Journal: BMJ (2000)

I sit in our living room and look out of the window across the lake to the distant mountain silhouetted against a hazy blue horizon. People tell me it is a beautiful view. I used to think so, too. But now all that I see is the road on the other side of the lake where our son died in a car accident, and all I can think of is the moment before his death, when he must have known that he would never see his wife or children again. He was on his way home from a medical meeting to be present …
PM-09 * ESTABLISHMENT AND MOLECULAR CHARACTERIZATION OF PATIENT-DERIVED XENOGRAFT MODELS OF PEDIATRIC BRAIN TUMORS
Authors: S. Brabetz, H. Seker-Cin, S. N. Grobner, V. Hovestadt, D. T. W. Jones, P. A. Northcott, T. Milde, J. M. Rusert, K. Pedro, K. Bloom, X.-N. Li, R. J. Wechsler-Reya, J. M. Olson, S. M. Pfister, M. Kool
Journal: Neuro-Oncology (2015)

Brain tumors are the leading cause of cancer-related mortality in childhood. Based on the many recent genomic studies, we know now that multiple molecular subtypes of brain cancers exist that are not only biologically but also clinically highly distinct. These findings may lead to novel treatment strategies. For this we need better preclinical models that correctly reflect the proper tumor (sub)type. Orthotopic patient-derived xenograft (PDX) models generated by intracranial injection of primary patient material into the brain of NOD scid gamma (NSG) mice offer the unique possibility to test novel substances in primary patient tissue in an in vivo environment. Prior to drug selection and testing, extensive molecular characterizations are needed to learn about targetable oncogenic drivers in each model. Therefore, we aim to generate a large repertoire of PDX models reflecting the many different molecular subtypes of pediatric brain cancer. For each established PDX model, we perform DNA methylation profiling, gene expression profiling, low-coverage whole genome sequencing and whole exome sequencing and compare these data with the matching primary tumor. Thus far, as a collaborative effort between different laboratories, we have established and fully characterized 34 PDX models from 1 atypical teratoid rhabdoid tumor (ATRT), 4 ependymoma, 9 glioblastoma, 18 medulloblastoma, and 2 primitive neuroectodermal tumors (PNET). Molecular analysis of all available PDX models identified a clear overrepresentation of most aggressive tumors such as models characterized by MYC- or MYCN amplification. Other, less aggressive cancers, like Wnt medulloblastoma, are underrepresented. For in vivo imaging during treatment of PDX models we created luciferase labeled PDX sublines. Our data demonstrate that PDX models retain characteristics of the primary human tumors from which they were derived. These reagents provide an unprecedented resource to study tumor biology and pave the way for improving treatment strategies of malignant pediatric brain tumors.
A citric acid solution is an optimal test drink in the 13C-urea breath test for the diagnosis of Helicobacter pylori infection.
Authors: J E Dominguez-Munoz, A Leodolter, T Sauerbruch, P Malfertheiner
Journal: Gut (1997)

BACKGROUND: The 13C-urea breath test (13C-UBT) is a simple, non-invasive and reliable test for the diagnosis of Helicobacter pylori infection. The duration of the test, the timing of breath sampling, and the accuracy of the method vary according to the test meal used. AIM: To identify the optimal test meal or drink for rapid and accurate performance of the 13C-UBT for the detection of H pylori infection. PATIENTS: Eighty patients with dyspeptic symptoms were included. Of these, 48 patients had a positive H pylori status and 32 a negative one according to the results of the rapid urease test, histological examination, and culture. METHODS: A 13C-UBT was performed after an overnight fast, on three consecutive days. On each study day a different test meal or drink was given (0.1 N citric acid solution, a standard semiliquid meal, or a semiliquid fatty meal) 10 minutes before giving 75 mg 13C-urea. Breath samples were collected at 0, 15, 30, 45, and 60 minutes, and analysed by isotype ratio mass spectrometry. Results were expressed as delta (delta) and considered as positive for H pylori if the highest delta (peak) was greater than 4.0. RESULTS: The delta peak obtained with the citric acid drink in H pylori positive subjects (24.1 (SEM 1.5)) was significantly higher than that obtained with any of the semiliquid meals (13.3 (SEM 1.1) and 17.1 (SEM 1.0) respectively, p &lt; 0.001). Furthermore, this delta peak was obtained earlier with the citric acid drink (30 (SEM 2) minutes) than with the other two meals tests (53 (SEM 2) min and 45 (SEM 2) min, p &lt; 0.001). The sensitivity of the 13C-UBT for the diagnosis of H pylori infection was 96-100% with all three test meals. This high sensitivity was, however, obtained from 15 minutes by giving citric acid as the test drink, from 45 minutes by giving a semiliquid fatty meal, and at 60 minutes by giving the semiliquid standard meal. The specificity was 100% for all test meals. Citric acid is inexpensive and palatable to patients. CONCLUSIONS: The 13C-UBT procedure with citric acid as the test drink is superior to the previously proposed semiliquid test meals in terms of 13CO2 recovery, time requirement, and cost. In routine clinical sampling, collection at times 0 and 30 minutes seems to be optimal and gives a high diagnostic accuracy.
Suppression of the immunologic response to peanut during immunotherapy is often transient
Authors: Mark Gorelik, Satya D. Narisety, Anthony L. Guerrerio, Kristin L. Chichester, Corinne A. Keet, Anja P. Bieneman, Robert G. Hamilton, Robert A. Wood, John T. Schroeder, Pamela A. Frischmeyer-Guerrerio
Journal: Journal of Allergy and Clinical Immunology (2014)
Cyclosporin treatment for aplastic anemia: A case report demonstrating a second response to second exposure to cyclosporin
Authors: Murray M. Bern, Mark S. Roberts, David Yoburn
Journal: American Journal of Hematology (1987)

Abstract Cyclosporin has been used in the treatment of aplastic anemia, often in combination with other drugs, making it difficult to make a clear distinction between the effects of cyclosporin and those of other treatments. This report demonstrates a clear response of a patient with aplastic anemia to single drug cyclosporin therapy.
Sudden acute respiratory syndrome
Authors: M. Zambon
Journal: BMJ (2003)

News p 677 

Plagues are as certain as death and taxes.1 The optimism of the 1960s and 1970s has given way to a mature realism that the relationship between human beings and microbes is neither completely predictable nor biased in favour of humans. Over the past few decades several important human viruses have emerged. Some, such as HIV, prove to be sustainable modern plagues adding to the toll of human misery. Others, such as hepatitis F, occupy a seemingly silent niche, passengers in a human caravan but contributing little to the joint relationship. Whereas viruses such as Ebola, Hantaan, and Nipah spring from an animal reservoir, destroying life but unable to sustain transmission in a new environment, others such as human metapneumovirus2 are associated with respiratory illness in young children but their contribution to adult disease remains uncertain, suggesting a balance between virus and host immune system achieved after some evolutionary negotiation. Each of these viruses has been identified through the study of human disease processes, each of which exists along a spectrum of possible outcomes between virus and host.

Against this background, the emergence of new human infectious diseases or viruses is unsurprising. Severe acute respiratory syndrome was first recognised at the end of February in Hanoi, Vietnam.3

The agent is highly infectious, with attack rates of >50% among healthcare workers caring for patients with the syndrome.4 Preliminary data from the first cluster of about 60 probable cases in Hanoi indicate an incubation period of 5–9 days. The …
Rising Death Rates in the Soviet Union
Authors: Richard Cooper
Journal: New England Journal of Medicine (1981)

Age-adjusted overall death rates in men and women in the Soviet Union began to rise in the mid-1960s; an 18 per cent increase occurred in the entire population from 1964 to 1975. The epidemic of coronary heart disease (CHD) appears to be the primary cause of this trend and has been particularly widespread among middle-aged men. Prospective epidemiologic studies and autopsy reports confirm the high prevalence rates of atherosclerosis and its complications. The major risk factors for CHD occur frequently in the Soviet population. The epidemic nature of the modern chronic diseases is dramatically apparent in the secular trends in Soviet vital statistics. A similar pattern of life style as related to risk of CHD in the Soviet Union and in Western capitalist countries further suggests a similar social basis for this epidemic in both areas.
Stibophen in the Elimination of Worms
Authors: Germán E. Malaret
Journal: JAMA (1964)

<h3>To the Editor:—</h3> In the discussion on the treatment of schistosomes with stibophen (Fuadin) in the Sept 14, 1963, issue ofThe Journal(<b>185</b>:874) it is stated that "In adults, total doses of 90 to 100 ml produce cure rates approaching 100%. Treatment should not be interrupted or modified if severe joint and muscle aching develops during the course of therapy; on the other hand, if severe vomiting occurs, therapy should be discontinued for a day or two, and then the dose should be reduced and administered on alternate days for the remainder of the treatment, although the original calculated dose is unchanged." Lest these two sentences should give the wrong impression, I wish to state that (1) stibophen is a dangerous drug; (2) therapy should be discontinued if any toxic signs or symptoms appear, such as aching muscles and joints, or else there is grave danger of an
Promoting Primary Care: Where to Start?
Authors: Elizabeth H. Naumburg
Journal: JAMA (1993)

<h3>To the Editor.</h3> —As a graduate of Mount Sinai School of Medicine, New York (class of 1979) and the director of the family medicine residency program of Highland Hospital and the University of Rochester, I turned with interest to the article by Dr Stimmel.<sup>1</sup> I became a family physician in spite of my experience at Mount Sinai, not because of it. While I received an excellent clinical education, my exposure to primary care, let alone family medicine, was minimal. In addition to the absence of primary care exposure, the values imbedded in the process of medical education were clear. I remember members of the administration telling us with pride that our institution was in the business of training subspecialists. I took to subterfuge in my fourth year when asked about plans for my residency training. I was vague about my residency choices rather than submitting to the onslaught that followed
Lupus erythematosus vegetans
Authors: S.M. Khorshid, H.L.C. Beynon, M.H.A. Rustin
Journal: British Journal of Dermatology (1999)

A 29-year-old woman with known systemic lupus erythematosus presented with exudative and vegetative plaques bilaterally on her groins. The clinical and histological findings indicated a diagnosis of pyodermatitis vegetans. Direct immunofluorescence studies revealed the presence of a definite basement membrane zone band for IgG, IgM and C3, favouring lupus erythematosus. We propose the term lupus erythematosus vegetans for this combination of clinicopathological and immunohistological findings.