tbuckley/cabot-search huggingface dataset:
The Time of the Three Dynasties: Reflections on Imbalance in the Practice of Medicine
Authors: Lawrence J. Hergott
Journal: Annals of Internal Medicine (1998)

On Being a Doctor15 January 1998The Time of the Three Dynasties: Reflections on Imbalance in the Practice of MedicineLawrence J. Hergott, MDLawrence J. Hergott, MDDenver, CO 80207-3442Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-128-2-199801150-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail “From the time of the Three Dynasties men have been running in all directions. How can they find time to be human?”Chuang Tzu [1]My brother-in-law Robert died last week. He was 41.No one knows exactly how the accident occurred, but his family, and other farmers, could guess the specifics and especially the cause. He had a wife and six young children, worked three crop farms, kept some cattle, looked after his mother and her place, and was the executor of his uncle's contested will. Even to a doctor he seemed enormously over-extended.Robert's wife said his sleeping ...References1. Tzu C. The Way of Chuang Tzu. Thomas Merton, tr. New York: New Directions; 1965. Google Scholar2. Gracian B. The Art of Worldly Wisdom. Christopher Maurer, tr. New York: Doubleday; 1992. Google Scholar3. Tzu L. Tao Te Ching. Lau DC, tr. London: Penguin; 1963. Google Scholar4. Merton T. Loretto and Gethsemani. Nerinx, KY: Loretto Motherhouse; 1962. Google Scholar Author, Article, and Disclosure InformationAffiliations: Denver, CO 80207-3442Acknowledgments: The author thanks Mr. Ken Morris and the reviewers whose time, encouragement, and clarification greatly enriched the manuscript.Corresponding Author: Lawrence J. Hergott, MD, 2338 Leyden Street, Denver, CO 80207-3442. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 January 1998Volume 128, Issue 2Page: 149-151KeywordsBehaviorChildrenHabitsPatientsPreventive medicineResuscitationRunningSurgeonsSurgeryThorax Issue Published: 15 January 1998 CopyrightCopyright © 1998 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Asbestos Bodies and Fibers in Lung Tissues
Authors: A. Fondimare, J. Desbordes
Journal: Environmental Health Perspectives (1974)

It is suggested that the ratio of asbestos bodies observable by light microscopy to asbestos fibers counted by electron microscopy be examined in a series of cases of asbestosis of varying severity.If the ratio is reasonably constant an estimate of fiber content could be made from the more easily conducted count of asbestos bodies by light microscopy.
Psychological treatments are effective for depression in primary care, study shows
Authors: S. Mayor
Journal: BMJ (2015)

Psychological treatments such as cognitive behavioural therapy (CBT) are moderately more effective than standard care without talking therapies for treating depression in primary care, shows a systematic review that also demonstrated that minimal contact approaches have similar efficacy to individualised therapies.1

Most patients with depression are managed in primary care, but most studies of treatment strategies have been carried …
Membrane-anchored uPAR regulates the proliferation, marrow pool size, engraftment, and mobilization of mouse hematopoietic stem/progenitor cells
Authors: Marc Tjwa, Nicolai Sidenius, Rute Moura, Sandra Jansen, Koen Theunissen, Annapaola Andolfo, Maria De Mol, Mieke Dewerchin, Lieve Moons, Francesco Blasi, Catherine Verfaillie, Peter Carmeliet
Journal: Journal of Clinical Investigation (2009)

The mechanisms of BM hematopoietic stem/progenitor cell (HSPC) adhesion, engraftment, and mobilization remain incompletely identified. Here, using WT and transgenic mice, we have shown that membrane-anchored plasminogen activator, urokinase receptor (MuPAR) marks a subset of HSPCs and promotes the preservation of the size of this pool of cells in the BM. Loss or inhibition of MuPAR increased HSPC proliferation and impaired their homing, engraftment, and adhesion to the BM microenvironment. During mobilization, MuPAR was inactivated by plasmin via proteolytic cleavage. Cell-autonomous loss of the gene encoding MuPAR also impaired long-term engraftment and multilineage repopulation in primary and secondary recipient mice. These findings identify MuPAR and plasmin as regulators of the proliferation, marrow pool size, homing, engraftment, and mobilization of HSPCs and possibly also of HSCs.
LACK OF VALUE OF TRADITIONAL PREDICTORS FOR RESTENOSIS AFTER A RECURRENT DRUG-ELUTING STENT FAILURE
Authors: Gabriel Maluenda, Manuel A. Gonzalez, Cedric Delhaye, Itsik Ben-Dor, Michael A. Gaglia, Nicholas N. Hanna, Kohei Wakabayashi, Asmir I. Syed, Rebecca Torguson, Zhenyi Xue, William O. Suddath, Kenneth M. Kent, Lowell F. Satler, Joseph Lindsay, Augusto D. Pichard, Ron Waksman
Journal: Journal of the American College of Cardiology (2010)
(5) Objective assessments of portwine stains
Authors: S.W. Lanigan, J.A. Cotterill
Journal: British Journal of Dermatology (1987)

With advances in the treatment of portwine stains (PWS), it is important to develop more objective assessments than clinical observation to assist in predicting the outcome of therapy and quantification of results and in understanding the pathophysiology of PWS. Three variables have been measured in a temperature‐controlled environment: redness as a measure of haemoglobin content using a reflectance spectrophotometer,1 blood flow using laser doppler flowmetry and skin temperature using a thermocouple, in 11 patients with facial PWS (8 male, 3 female, mean age 29·8 years), in the normal contralateral skin and in the facial skin of five healthy volunteers (3 male, 2 female, mean age 29·6 years). Results are shown in Table 1. Both the haemoglobin content and skin blood flow were significantly elevated in PWS compared with normal contralateral skin and controls (P < 0·05). The PWS was warmer than the contralateral skin in 10 of 11 patients (mean difference 1·6°C, range 0·3·3°C). By cooling the PWS with ice, it was possible to reduce laser doppler flowmetry and skin temperature values to those of the contralateral normal skin, but there was no change in haemoglobin content as measured by reflectance spectrophotometry. Reflectance spectrophotometry gave a measure which correlated most closely with clinical appearances and may be used to monitor changes objectively in the laser treated PWS.
Outcome after interventional or conservative management of unruptured brain arteriovenous malformations: a prospective, population-based cohort study
Authors: Catherine J Wedderburn, Janneke van Beijnum, Jo J Bhattacharya, Carl E Counsell, Vakis Papanastassiou, Vaughn Ritchie, Richard C Roberts, Robin J Sellar, Charles P Warlow, Rustam Al-Shahi Salman
Journal: The Lancet Neurology (2008)
Pathologic Exhibit of A. M. A.
Authors: A. B. Richardson
Journal: JAMA (1900)

Washington, D. C., Jan. 3, 1900. <h3>To the Editor:</h3> —My attention has been called to the proposition to establish a national pathologic exhibit in connection with the meetings of theAmerican Medical Association, and I write you to say that I most heartily concur in the belief that it would prove of interest and value to the members of theAssociation. This Hospital has a large number of interesting pathologic specimens which we will gladly furnish to assist in such an exhibit, and I am sure there are many similar institutions throughout the country that would be able to contribute matter of decided value and interest also. I hope that all those interested in the subject of pathology will co-operate to make this proposed departure a success, and creditable to theAmerican Medical Association, Very truly yours,
Upper gastrointestinal endoscopy does not reassure patients with functional dyspepsia
Authors: L. van Kerkhoven, L. van Rossum, M. van Oijen, A. Tan, R. Laheij, J. Jansen
Journal: Endoscopy (2006)

Background and study aims: Upper gastrointestinal endoscopy in patients with functional dyspepsia is often carried out merely to reassure patients that symptoms are not due to serious pathology. The aim of this study was to compare anxiety, depression, and health-related quality of life as proxy values for reassurance in patients with functional dyspepsia before and after upper gastrointestinal endoscopy. Patients and methods: Consecutive patients referred for endoscopy between February 2002 and February 2004 were included in the study. They were asked to score anxiety and depression using the Hospital Anxiety and Depression Scale, health-related quality of life using the EuroQol-5D questionnaire, and their impression of their own general health using a visual analogue scale, 2 weeks before endoscopy and again 1 month afterwards. Results: A total of 420 patients were included, 42 % of whom were found to have an organic abnormality of some sort during upper gastrointestinal endoscopy. Neither the anxiety nor the depression frequencies differed significantly before and after endoscopy, either in patients with organic abnormalities at endoscopy or in those without. The general impression of health did not change after endoscopy either: organic abnormalities 62.7 ± 27.4 vs. 64.9 ± 24.2, P = 0.28; functional dyspepsia 61.0 ± 27.9 vs. 62.8 ± 27.2, P = 0.39. Only patients who had organic abnormalities reported a slightly improved quality of life 1 month after endoscopy: 0.74 ± 0.15 vs. 0.78 ± 0.12, P < 0.01. Conclusion: In patients with functional dyspepsia, upper gastrointestinal endoscopy does not improve psychological well-being or health-related quality of life. In view of the invasiveness, cost, and potential harm associated with endoscopy, careful consideration should be given to whether this procedure should be carried out merely for the sake of the patient's "peace of mind".
Parallel Molecular Pathways Mediate Expression of Distinct Forms of Intermediate-Term Facilitation at Tail Sensory–Motor Synapses in Aplysia
Authors: Michael A Sutton, Thomas J Carew
Journal: Neuron (2000)

Three distinct temporal phases of synaptic facilitation (short-, intermediate-, and long-term) are induced by serotonin (5-HT) at sensory (SN) to motor (MN) synapses in Aplysia. Here, we characterize two mechanistically distinct forms of intermediate-term facilitation (ITF) at tail SN-MN synapses. One form, activity-independent ITF, is produced by five spaced pulses of 5-HT in the absence of SN activity. Its induction requires protein synthesis, and its expression requires persistent activation of PKA but not PKC. The other form, activity-dependent ITF, is produced by a single pulse of 5-HT coincident with SN activation. Its induction does not require protein synthesis, and its expression requires persistent activation of PKC but not PKA. These results demonstrate that SN-MN synapses can exhibit two distinct forms of ITF that are mediated by parallel molecular pathways.
PPP and physiotherapy for senior citizens.
Authors: R. Beaconsfield
Journal: BMJ (1992)

or her partner together may enable the doctor to ask about the influence of the disease on their partnership and thus allow them to discuss emotionally loaded topics together.Local support groups can also be invaluable.Many patients and their partners find that the leaflets, meetings, and other facilities of the Multiple Sclerosis Society and Action for Research into Multiple Sclerosis provide support that neither health nor social service professionals can give.Offering to help patients with multiple sclerosis and their families in these ways is a vital aspect of management and will remain so until traditional therapeutic endeavours become effective.
Probing cortico-cortical interactions that underlie the multiple sensory, cognitive, and everyday functional deficits in schizophrenia
Authors: Gregory A. Light
Journal: Behavioral and Brain Sciences (2004)

Schizophrenia patients exhibit impairments across multiple clinical, cognitive, and functional domains. A fundamental abnormality of the timing and/or efficiency of neural processes across disparate brain regions (i.e., cortico-cortical communications) may underlie many of the deficits in schizophrenia. Because gamma synchrony is temporally correlated with many cognitive processes, probing patterns of gamma activation may shed light on the functional integrity of neural circuits in schizophrenia and related disorders.
Discussing Treatment Preferences With Patients Who Want “Everything”
Authors: Timothy E. Quill
Journal: Annals of Internal Medicine (2009)

When asked about setting limits on medical treatment in the face of severe illness, patients and their families often respond that they want "everything." Clinicians should not take this request at face value, but should instead use it as the basis for a broader discussion about what "doing everything" means to the patient. The discussion might include questions about what balances of treatment burden and benefit the patient can tolerate and about emotional, cognitive, spiritual, and family factors that underlie the request. After this initial exploration, the clinician can propose a philosophy of treatment and make recommendations that capture the patient's values and preferences in light of the medical condition. Clinicians should respond to emotional reactions, directly negotiate disagreements, and use harm-reduction strategies for the relatively infrequent instances in which patients continue to request burdensome therapy that is unlikely to help. By using this approach, patients, families, and clinicians will be better able to understand each other and join together to develop a treatment approach that best respects patient and family values in light of what is medically achievable.
Relationship Between Sinus Rhythm Activation and the Reentrant Ventricular Tachycardia Isthmus
Authors: Edward J. Ciaccio, Alexis C. Tosti, Melvin M. Scheinman
Journal: Circulation (2001)

Background In canine hearts with inducible reentry, the isthmus tends to form along an axis from the area of last to first activity during sinus rhythm. It was hypothesized that this phenomenon could be quantified to predict reentry and the isthmus location. Methods and Results An in situ canine model of reentrant ventricular tachycardia occurring in the epicardial border zone was used in 54 experiments (25 canine hearts in which primarily long monomorphic runs of figure-8 reentry were inducible, 11 with short monomorphic or polymorphic runs, and 18 lacking inducible reentry). From the sinus rhythm activation map for each experiment, the linear regression coefficient and slope were calculated for the activation times along each of 8 rays extending from the area of last activation. The slope of the regression line for the ray with greatest regression coefficient (called the primary axis) was used to predict whether or not reentry would be inducible (correct prediction in 48 of 54 experiments). For all 36 experiments with reentry, isthmus location and shape were then estimated on the basis of site-to-site differences in sinus rhythm electrogram duration. For long and short runs of reentry, estimated isthmus location and shape partially overlapped the actual isthmus (mean overlap of 71.3% and 43.6%, respectively). On average for all reentry experiments, a linear ablation lesion positioned across the estimated isthmus would have spanned 78.2% of the actual isthmus width. Conclusions Parameters of sinus rhythm activation provide key information for prediction of reentry inducibility and isthmus location and shape.
Abstract 3906: Gene expression profiling of ductal carcinoma in situ reveals novel alterations in the tumor and stromal compartments related to progession and outcome of invasive breast cancer
Authors: Agnieszka K. Witkiewicz, Adam Ertel, Jessica Kline, Elai Davicioni, Erik S. Knudsen
Journal: Cancer Research (2011)

Abstract An increasing number of women are diagnosed with ductal carcinoma in situ (DCIS). DCIS is non-obligate precursor to invasive breast cancer. Mechanisms leading to development and progression of DCIS to invasive breast cancer (IBC) are still largely unknown. When DCIS and IBC coexist in the same lesion, their transcriptional profiles are nearly identical; however, there are very few studies investigating gene expression in pure DCIS. The goal of this study was to compare gene expression profiles of microdissected epithelial and stromal components of pure DCIS and IBC. Epithelium and stroma were laser microdissected from 10 cases of pure DCIS and 10 invasive breast carcinomas. DCIS and IBC were matched with regard to estrogen, progesterone receptor and HER2 expression. Gene expression was analyzed using Affymetrix Human Exon 1.0 ST microarrays. Analyses of gene expression in IBC and DCIS revealed a number of differentially expressed genes in the epithelial (n=211) and stromal (n=143) LCM obtained cells. In the epithelial compartment many of the genes specifically associated with IBC are part of previously described epithelial to mesenchymal transition, metastasis and myoepithelial cell gene expression signatures. Consistent with these findings, gene ontology analyses found overrepresentation of GO Biological Process terms such as ‘cell adhesion’ (44 genes, p = 1.47E-14), ‘extracellular matrix organization’ (16 genes, p = 3.46E-09), ‘skeletal system development’ (22 genes, p = 5.87E-07) and ‘vasculature development’ (14 genes, P = 4.56E-03). Applying differentially expressed epithelial genes to a larger invasive breast cancer dataset showed association with decreased metastasis free and progression free survival. Our study reveals that pure dcis and invasive breast cancer are distinct at the transcriptome level. Future work will show if genes differentially expressed between IBC and pure DCIS may be useful for identifying at the time of diagnosis DCIS patients likely to progress to IBC. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 3906. doi:10.1158/1538-7445.AM2011-3906
PRACTICAL LIFE INSURANCE EXAMINATIONS.
Authors: JOHN L. DAVIS
Journal: JAMA (1895)

My justification for asking your attention to a subject that may appear trite and perfectly familiar to you is the fact that while physicians are receiving as fees from insurance companies and coöperative associations about $2,500,000 per annum, they are not in every instance giving a<i>quid pro quo.</i>I understand fully and we all agree that members of theAmerican Medical Associationalways give a<i>quid</i>much bigger than the<i>quo</i>; but it is the doctors who are not of us that I shall describe. My remarks will not apply to the strictly technical part of the examination, for I feel that after fifteen years' work in examining applicants' lungs and hearts and kidneys I have too much yet to learn to warrant my giving you instructions in physical diagnosis. Hence for the sake of avoiding argument I will assume that every man who has a diploma is<i>ipse</i>
Gout and Hyperuricemia
Authors: J. W. Hollingsworth
Journal: JAMA (1977)

Drs Wyngaarden and Kelley are among the foremost scholars of urate metabolism, and this book reflects their experience and wisdom. Although the two authors are of different temperaments and personality, the writing blends so well that I was unable to assign given sections to either individual. Thus, the book would seem to represent a truly close collaborative effort. The authors have a strong research interest in purine metabolism, and those sections of the book flow easily and are readily comprehended. The methodology of various metabolic studies was covered in principle, and the limits of interpretation of data derived from specific experiments was carefully presented. With all the research to date, we still do not have much understanding of the heterogenous disorders we recognize as hyperuricemia and clinical gout. There is an excellent discussion of renal mechanisms of urate excretion in gouty subjects. About 75% to 90% of patients show diminished
A high‐affinity monoclonal anti‐IgE antibody for depletion of IgE and IgE‐bearing cells
Authors: S. Laffer, C. Lupinek, I. Rauter, M. Kneidinger, A. Drescher, J.‐H. Jordan, M.‐T. Krauth, P. Valent, F. Kricek, S. Spitzauer, H. Englund, R. Valenta
Journal: Allergy (2008)

Background: We have identified a monoclonal anti‐human immunoglobulin E (IgE) antibody, which recognizes FcepsilonRI‐bound IgE and prevents binding of IgE to FcepsilonRI. In this study, we assessed the binding kinetics and affinity of monoclonal antibody 12 (mAb12) for IgE and investigated whether mAb12 can be used for depletion of IgE and isolation of IgE‐bearing cells from peripheral blood. Methods: Binding kinetics and affinity for IgE were studied using Biacore surface plasmon resonance technique experiments. IgE antibodies were depleted from serum using sepharose‐coupled mAb12 and IgE‐bearing cells were enriched from heparinized blood samples with mAb12. The extent and biological relevance of IgE depletion were studied by quantitative IgE measurements and basophil histamine release experiments. Specific binding of mAb12 to IgE‐bearing cells (basophils, mast cells, IgE‐secreting plasma cells) was demonstrated by FACS. Results: Monoclonal antibody 12 shows rapid association (k a = 5.46e5/Ms) with IgE, almost no dissociation (k d = 8.8e−5/s) and an affinity for IgE (K D = 1.61e−10 M), which is as high as that of FcepsilonRI. Immobilized mAb12 could be used to deplete IgE antibodies and isolate IgE‐bearing cells from peripheral blood in a single‐step procedure. Conclusions: Monoclonal antibody 12 is a high affinity anti‐human IgE antibody, which efficiently removes IgE and IgE‐bearing cells from peripheral blood and may thus be used for extracorporeal depletion of IgE and IgE‐bearing cells.
Who cares for head injuries?
Authors: B Jennett
Journal: BMJ (1975)

Patterns of management for head injury in the acute and late stages are reviewed in respect of both mild and severe injuries. Because so many disciplines are involved, continuity of care if often difficult to achieve; and no one discipline is concerned with planning for the care of head injuries in a strategic way. The needs of head-injured patients are defined and suggestions made for improving care by the reorganization of existing facilities. What is most needed is to concentrate on patients with head injuries, both in the acute and in the late stages. Only then can medical, nursing, and paramedical personnel become skilled in dealing with the many problems which such patients present.
Nicholas James Taffinder
Authors: Peter McDonald
Journal: BMJ (2007)

Educated at King's College, Taunton, Nicholas James Taffinder (“Nick”) won an exhibition to Cambridge in 1983, completing his clinical training at St Thomas' Hospital in 1989. After gaining his FRCS in 1993, he went to St Mary's Hospital, Paddington, as a surgical registrar, also completing his masters in laparoscopic surgery there. He spent …