tbuckley/cabot-search huggingface dataset:
Language tests for EU doctors set to start in June in UK
Authors: A. Rimmer
Journal: BMJ (2014)

The General Medical Council has announced that it will be able to test the English language competence of doctors from other European Union countries from June this year.

The Department of Health in England confirmed in January that it would implement a UK-wide plan to allow the GMC to begin the tests.1

After a public consultation the regulator announced that it would require doctors from other European Union countries to provide evidence of their English skills or to undergo a language assessment if it had concerns about their ability to communicate effectively.2 The GMC said that it expected to introduce the checks in June, subject to the legislative process.

At the same time …
WOMEN IN MEDICINE
Authors: Hulda E. Thelander
Journal: JAMA (1952)

With the demand for more doctors and the obvious difficulty in expanding training facilities rapidly, a study of the effectiveness of women in medicine was deemed timely. The investigation was designed to determine to what extent women physicians utilized their training in their communities and within their profession. It was hoped also that the findings might prove of value for student counseling during college and premedical training as well as during the undergraduate medical years. Very little attention has been given to determine how effectively any physician's time is utilized after graduation. There is therefore no available study of medical manpower with which to contrast these findings. In this limited undertaking the main comparison or the most obvious one that might prove of value was between the careers of the unmarried and those of the married women. This comparison is really not just. It might be more logical to compare
Undergraduate medical education.
Authors: L Rees, J Wass
Journal: BMJ (1993)

Pressures from students and teachers, from professional bodies, and from changes in the way health care is delivered are all forcing a rethink of how medical students should be taught. These pressures may be more intense in London but are not confined to it. The recommendation the Tomlinson report advocates that has been generally welcomed is for more investment in primary care in London. General practitioners have much to teach medical schools about effective ways of learning, but incentives for teaching students in general practice are currently low, organising such teaching is difficult and needs resources, and resistance within traditional medical school hierarchies needs to be overcome. Likewise, students value learning within local communities, but the effort demanded of public health departments and community organisations is great at a time when they are under greater pressure than ever before. The arguments over research that favour concentration in four multifaculty schools are less clear cut for undergraduate education, where personal support for students is important. An immediate concern is that the effort demanded for reorganising along the lines suggested by Tomlinson will not leave medical schools much energy for innovating.
Clinical and radiographic features of psittacosis infection.
Authors: I I Coutts, S Mackenzie, R J White
Journal: Thorax (1985)

Forty three cases of psittacosis infection were identified retrospectively over a five year period. The commonest clinical presentation was of a bronchitic illness with a productive cough and features of systemic upset. In 12 (28%) cases no radiographic abnormality was detected on the chest film. Segmental shadowing was the commonest abnormality but lobar and more extensive consolidation occurred. There were no radiographic features that allowed confident differentiation from other causes of pneumonia. The total and differential white cell counts were usually normal and this feature may help to differentiate psittacosis from bacterial pneumonia.
Life as a medical secretary---a new learning experience for the aspiring consultant
Authors: J. Alis
Journal: BMJ (2003)

It is 8 50 am and, clutching my notepad and biro in one hand and my mug of coffee in the other, I sit down for my Monday morning meeting with consultant paediatrician Mitch Blair. As he rattles through this week's “to do” list, I am jotting down the essentials: blood test results to chase, grant applications to complete, meetings to organise, patients to contact—it's all in a week's work for a medical secretary.

But there's a twist. In fact, I am no medical secretary, merely a medical student trying to pay off an ever increasing debt. However, my stint as a medical secretary has provided me with more insight into what life is like as a consultant than anything I have yet done. It is strange that, having aspired to be one of these folk for the past seven years, I actually stumble across what it's like …
Effect of a sequential education and monitoring programme on quality‐of‐life components in heart failure
Authors: Fátima das Dores Cruz, Victor Sarli Issa, Silvia Moreira Ayub‐Ferreira, Paulo Roberto Chizzola, Germano Emilio Conceição Souza, Luiz Felipe Pinho Moreira, José Ramón Lanz‐Luces, Edimar Alcides Bocchi
Journal: European Journal of Heart Failure (2010)
Polyethylene Intrauterine Contraceptive Device
Authors: William B. Ober
Journal: JAMA (1970)

Pathological study of endometrial biopsy specimens from 393 women who used the Lippes loop for intrauterine contraception for 18 months or longer showed that about 60% of the women were asymptomatic and had a low incidence of endometritis (2.5%). About 20% of women developed symptoms between 18 and 35 months; endometrial biopsy from this group showed inflammatory lesions in about 20% of this group. The rate of detection of inflammatory lesions in endometrial biopsies was doubled to about 40% in the remaining 20% of women who developed symptoms after use of the polyethylene device for 26 months or longer.
Persistent systemic inflammation in unstable angina is largely unrelated to the atherothrombotic burden
Authors: Claudia Monaco, Elisabetta Rossi, Diego Milazzo, Franco Citterio, Francesca Ginnetti, Giuseppe D'Onofrio, Domenico Cianflone, Filippo Crea, Luigi M. Biasucci, Attilio Maseri
Journal: Journal of the American College of Cardiology (2005)
The role of fat and calcium in the production of foci of aberrant crypts in the colon of rats fed 2-amino-1-methyl-6-phenylimidazo[4,5-b]-pyridine.
Authors: J H Weisburger, J Braley, J Reinhardt, C Aliaga, A Rivenson, G C Hard, X M Zhang, M Takahashi, H Esumi, T Sugimura
Journal: Environmental Health Perspectives (1994)

The modulation by dietary fat levels of intestine carcinogenesis is well documented. New developments suggest that calcium ions may also play a role. A rapid bioassay, the induction of foci of aberrant crypts in the colon, was used to explore the interaction between dietary fat and calcium. Male F344 rats 6 weeks of age were placed on diets containing 5 or 20% corn oil, and 0.04 or 0.32% calcium ion, as calcium lactate. Each dietary group was fed 400 ppm 2-amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhlP), and negative controls received the diets alone. A positive control group was given 2 mg N-nitrosomethylurea (NMU) intrarectally four times in a 2-week period. All rats were killed after 9 weeks. The intestinal tract was rinsed with Krebs-Ringer buffer. After staining a 6-cm segment of the descending colon and rectum with 0.2% methylene blue, foci of aberrant crypts were evaluated microscopically. With PhlP as a carcinogen, the rats on a high-fat, low-calcium level had more foci of aberrant crypts than animals on a low-fat level. With the higher calcium level, there were fewer foci and aberrant crypts, but the effect of fat was still significant. With NMU and a low-calcium level, the effect of fat level was evident. However, with the higher calcium intake, there were considerably more foci of aberrant crypts than on the low-calcium level, and the effect of the dietary fat level was not obvious.(ABSTRACT TRUNCATED AT 250 WORDS)
Chronic Myelogenous Leukemia: Biology and Therapy
Authors: Stefan Faderl, Moshe Talpaz, Zeev Estrov, Hagop M. Kantarjian
Journal: Annals of Internal Medicine (1999)

Chronic myelogenous leukemia is a myeloproliferative disorder. It is characterized by a biphasic or triphasic clinical course in which a benign chronic phase is followed by transformation into an accelerated and blastic phase. On a cytogenetic and molecular level, most patients with chronic myelogenous leukemia demonstrate BCR-ABL fusion genes in hematopoietic progenitor cells, which result from a reciprocal translocation between chromosomes 9 and 22; this translocation leads to a shortened chromosome 22, called the Philadelphia chromosome. Translation of the fusion products yields chimeric proteins of variable size that have increased tyrosinekinase activity. Conventional chemotherapy with hydroxyurea or busulfan can achieve hematologic control but cannot modify the natural disease course, which inevitably terminates in a rapidly fatal blastic phase. Since its introduction in the 1980s, allogeneic stem-cell transplantation has provided the groundwork for a cure of chronic myelogenous leukemia. However, few patients are eligible for this treatment because of donor availability and age restrictions. Therapy with interferon-α alone or in combination with cytarabine suppresses theleukemic clone, produces cytogenetic remissions, and prolongs survival. It is an effective alternative first-line treatment for patients ineligible for transplantation. New drugs active against chronic myelogenous leukemia may show increased activity in the transformed phases of the disease. Novel therapies and concepts are developing rapidly; targeted molecules are tyrosine kinases, ras, and messenger RNA through antisense oligonucleotides. Alternative transplantation options, such as stem cells from autologous sources and matched unrelated donors, are expanding. Immunomodulation by adoptive immunotherapy and vaccine strategies hold significant promise for the cure of chronic myelogenous leukemia.
Postoperative patients fare better when readmitted to the hospital where they had surgery, study finds
Authors: M. McCarthy
Journal: BMJ (2014)

Postoperative patients who were readmitted to a hospital other than the one where they had had their surgery were significantly more likely to die than were those who returned to the same hospital, a new study has found.

The US study, published online in JAMA Surgery , was led by Thomas C Tsai of Harvard School of Public Health in Boston, Massachusetts.1

Tsai and colleagues used Medicare claims data from 1 January 2009 to 30 November 2011 to identify patients aged 65 and older who had undergone coronary artery bypass grafting, pulmonary lobectomy, endovascular …
How to Best Forecast Adverse Outcomes Following Geriatric Trauma
Authors: Thomas N. Robinson, Emily Finlayson
Journal: JAMA Surgery (2014)

A tension exists in the surgical literature about using chronological age to forecast surgical risk.Largedatabasestudieshave generally concluded that advancing age independently predicts adverse surgical outcomes. In contrast, singleinstitution case series have noted that excellent surgical outcomes can be achieved in the oldest old. An explanation thatmay reconcile theseopposing conclusions is the concept of physiological, rather than chronological, age that is quantified using frailty assessment. Joseph and colleagues1 are leading the way in defining physiological age in geriatric trauma patients. Using thewellaccepted (although lengthy)CanadianStudyofHealthandAging definition of frailty, the authors conclude that an older adult’s Frailty Index following a traumatic injury is superior to chronological age in forecasting in-hospital complications and adverse discharge disposition. The question is what can be done with this information? Trauma is a nonelective event, a fact that does not allow for altering pre-event clinical decision making. The authors recommend their Frailty Index for improving risk stratification of elderly trauma patients across institutions. Beyond this, could a frailty score in the trauma setting be used to improve patient care? Twopotential avenues for a frailty scoremightdirectly influence the care of trauma patients. First, individuals with frailty could be managed differently by implementing evidence-based inpatient care pathways (eg, the Acute Care for Elders model2) proven to improve outcomes of hospitalized olderadults. Second, clinicaldecisionsaboutwhocanbesafely discharged after a fall from standing height may be influenced by a frailty score. Joseph and colleagues are to be congratulated on this important work highlighting the relative effect of chronological andphysiological ageon traumaoutcomes.Although thebest frailty tool for traumacaseshasyet tobedetermined, this study should trigger further research and quality improvement efforts targeting thegrowingpopulationof traumapatientswith frailty.
Eplerenone for early cardiomyopathy in Duchenne muscular dystrophy: a randomised, double-blind, placebo-controlled trial
Authors: Subha V Raman, Kan N Hor, Wojciech Mazur, Nancy J Halnon, John T Kissel, Xin He, Tam Tran, Suzanne Smart, Beth McCarthy, Michael D Taylor, John L Jefferies, Jill A Rafael-Fortney, Jeovanna Lowe, Sharon L Roble, Linda H Cripe
Journal: The Lancet Neurology (2014)
Medical Consultations with Hom opaths
Authors: Wm. Adams
Journal: BMJ (1862)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Medical Consultations with Homœopaths Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Targeting the renin-angiotensin system: Potential beneficial effects of the angiotensin II receptor blockers in patients with nonalcoholic steatohepatitis
Authors: Silvia Sookoian, Carlos J. Pirola
Journal: Hepatology (2010)

We read, with great interest, the article by Torres et al. about the efficacy of combination therapy with rosiglitazone and metformin or losartan on improving liver histology in patients with nonalcoholic fatty liver diseases; the investigators conclude that adjuvant therapies are ineffective.1 It is certainly a very interesting study to find out some prospect ideas about the therapeutic potential of "combination effects" or "combination therapy," because we are still uncertain as to whether or not disregarding combination therapy is a good option for nonalcoholic steatohepatitis (NASH) patients. As discussed by the investigators, an interesting drug to consider is telmisartan, which also acts as a partial agonist of peroxisome proliferator-activated receptor gamma. In fact, in addition to the observed effects on fatty liver reversion, telmisartan is able to improve insulin resistance, but is less effective than losartan in preventing plasminogen-activator inhibitor-1 gene expression.2 Therefore, combining both actions in one molecule may improve some aspects of NASH, but not all of them. At any rate, there are other reasons to think about the importance of the blockade of the renin-angiotensin system (RAS) in the liver of NASH patients. Perhaps, in the study of Torres et al., improvement in body weight was not as expected, because treatment with thiazolidinediones may prevent an interesting, poorly explored effect of angiotensin receptor blockers (ARBs) on the regulation of body weight.2 In addition, we recently observed a local upregulation of the angiotensin I–converting enzyme in the liver of patients with NASH, suggesting a putative role of the RAS in the progression of liver histology.3 Finally, the investigators speculated that both environmental and genetic influences are likely involved in the lack of universal improvement observed in the patients enrolled in this trial. Can we expect that all patients are equal responders to the therapy? Certainly, we cannot. We previously showed that a gene variant (A1166C) in the angiotensin II type 1 receptor predicts the therapeutic response to losartan; we found a higher response to losartan among AA homozygous.4 We wonder whether, before discharging ARBs, we might improve our ability to select patients who are able to respond better, tailoring the therapy, depending on their genetic background. Silvia Sookoian M.D. Ph.D.*, Carlos J. Pirola Ph.D. , * Department of Clinical and Molecular Hepatology, Institute of Medical Research A Lanari-IDIM, University of Buenos Aires-National Council of Scientific and Technological Research (CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina, Department of Molecular Genetics and Biology of Complex Diseases, Institute of Medical Research A Lanari-IDIM, University of Buenos Aires-National-Council of Scientific and Technological Research (CONICET), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
Additive Effects of Glucagon-Like Peptide 1 and Pioglitazone in Patients With Type 2 Diabetes
Authors: Mette Zander, Allan Christiansen, Sten Madsbad, Jens Juul Holst
Journal: Diabetes Care (2004)

To evaluate the effect of combination therapy with pioglitazone and glucagon-like peptide (GLP)-1 in patients with type 2 diabetes.Eight patients with type 2 diabetes (BMI 32.7 +/- 1.3 kg/m(2) and fasting plasma glucose 13.5 +/- 1.2 mmol/l) underwent four different treatment regimens in random order: saline therapy, monotherapy with continuous subcutaneous infusion of GLP-1 (4.8 pmol x kg(-1) x min(-1)), monotherapy with pioglitazone (30-mg tablet of Actos), and combination therapy with GLP-1 and pioglitazone. The observation period was 48 h. End points were plasma levels of glucose, insulin, glucagon, free fatty acids (FFAs), and sensation of appetite.Fasting plasma glucose decreased from 13.5 +/- 1.2 mmol/l (saline) to 11.7 +/- 1.2 (GLP-1) and 11.5 +/- 1.2 (pioglitazone) and further decreased to 9.9 +/- 1.0 (combination) (P < 0.001). Eight-hour mean plasma glucose levels were reduced from 13.7 +/- 1.1 mmol/l (saline) to 10.6 +/- 1.0 (GLP-1) and 12.0 +/- 1.2 (pioglitazone) and were further reduced to 9.5 +/- 0.8 (combination) (P < 0.0001). Insulin levels increased during monotherapy with GLP-1 compared with monotherapy with pioglitazone (P < 0.01). Glucagon levels were reduced in GLP-1 and combination therapy compared with saline and monotherapy with pioglitazone (P < 0.01). FFAs during breakfast (area under the curve, 0-3 h) were reduced in combination therapy compared with saline (P = 0.03). Sensation of appetite was reduced during monotherapy with GLP-1 and combination therapy (P < 0.05).GLP-1 and pioglitazone show an additive glucose-lowering effect. A combination of the two agents may, therefore, be a valuable therapeutic approach for the treatment of type 2 diabetes.
Commentary: Promoting testing is no substitute for recognising risk
Authors: N. Gill
Journal: BMJ (1998)

Given the continuing transmission of HIV infection in western Europe, preventing new infections and mitigating the effects of infections that have already occurred are major public health priorities. Testing blood donations for HIV has an established role in preventing transmission of the virus. In other areas of primary and secondary prevention, the case for large scale HIV testing is less clear.

With the advent of effective measures to prevent mother to infant transmission, including the use of zidovudine in pregnancy for HIV infected women, there is a strong case for these women to have their infection diagnosed well before they give birth. In England, especially in London, much needs to be done to improve the situation; less than a quarter of …
Antimicrobial susceptibility profiles of aerobic and facultative Gram-negative bacilli isolated from patients with intra-abdominal infections in the Asia-Pacific region according to currently established susceptibility interpretive criteria
Authors: Yen-Hsu Chen, Po-Ren Hsueh, Robert E. Badal, Stephen P. Hawser, Daryl J. Hoban, Samuel K. Bouchillon, Yuxing Ni, David L. Paterson
Journal: Journal of Infection (2011)
Cooperative signaling through the signal transducer and activator of transcription 3 and nuclear factor-κB pathways in subtypes of diffuse large B-cell lymphoma
Authors: Lloyd T. Lam, George Wright, R. Eric Davis, Georg Lenz, Pedro Farinha, Lenny Dang, John W. Chan, Andreas Rosenwald, Randy D. Gascoyne, Louis M. Staudt
Journal: Blood (2007)
Pioglitazone Treatment of Insulin Resistance in a Patient With Werner’s Syndrome
Authors: Sachiko Hattori, Makiko Kasai, Takashi Namatame, Yoshiyuki Hattori, Kikuo Kasai
Journal: Diabetes Care (2004)

Werner’s syndrome (WS) is a disease of adult progeria characterized by various phenotypical abnormalities, including prematurely graying hair, a bird-like face, slender extremities, cataracts, and endocrine dysfunction. Mutations in the DNA helicase gene WRN have been shown to be responsible for this disorder. The condition is associated with glucose intolerance in ∼70% of patients, a complication predominantly resulting from insulin resistance. Since thiazolidinediones have been shown to enhance insulin sensitivity in patients with insulin resistance, we have treated a WS patient with pioglitazone.

A 58-year-old woman with WS was admitted for improvement of glycemic control. The diagnosis of WS was based on her clinical features and the reduced life-span of her fibroblasts in vitro. The genotype of this patient was …
Downregulation of the Wnt inhibitor CXXC5 predicts a better prognosis in acute myeloid leukemia
Authors: Andrea Kühnl, Peter J. M. Valk, Mathijs A. Sanders, Adam Ivey, Robert K. Hills, Ken I. Mills, Rosemary E. Gale, Martin F. Kaiser, Richard Dillon, Melanie Joannides, Amanda Gilkes, Torsten Haferlach, Susanne Schnittger, Estelle Duprez, David C. Linch, Ruud Delwel, Bob Löwenberg, Claudia D. Baldus, Ellen Solomon, Alan K. Burnett, David Grimwade
Journal: Blood (2015)
Training and Brief Psychotherapies
Authors: G. Hougardy, D. Luminet
Journal: Psychotherapy and Psychosomatics (1980)

The authors report their experience on a workshop centered on brief psychotherapy (the STAPP model defined by Sifneos) in a postgraduate training in psychotherapy. STAPP, its extensed frame of reference and its relatively 'easy' access to study of essential paradigms, seems to constitute a priviledged tool in training psychiatrists to-be to the fundamental psychodynamics processes involved in psychotherapy. Provided the transferential and countertransferential issues are adequately met with (in individual and group supervision), it is lived very positively by trainees as such and has, moreover, a positive carry-over in so-called supportive therapies.
Statins: numbers needed to treat and personal decision making
Authors: R. S. Bhopal
Journal: BMJ (2014)

As a South Asian in Scotland I am at risk for coronary heart disease (CHD) according to the Scottish Health and Ethnicity Linkage Study.1 2 Cardiologist friends and colleagues have advised statins. So I looked for numbers needed to treat (NNTs) to guide me, as called for by Tresidder,3 and found them in a review by Enas.4 These numbers have …
PROBUCOL VERSUS EPTASTATIN IN HYPERCHOLESTEROLAEMIC DIABETICS
Authors: Gen Yoshino, Tsutomu Kazumi, Rinzo Uenoyama, Toshio Kasama, Masahide Iwai, Makoto Otsuki, Akio Inui, Ippei Iwatani, Koichi Yokono, Shigeaki Baba
Journal: The Lancet (1986)