tbuckley/cabot-search huggingface dataset:
“Practice Makes Perfect”…or Does It?
Authors: Ira Daniel Breite
Journal: Annals of Internal Medicine (2005)

Letters5 July 2005“Practice Makes Perfect”…or Does It?Ira Daniel Breite, MDIra Daniel Breite, MDFrom Westside Medical Associates LLP, New York, NY 10024.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-1-200507050-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:I do not necessarily disagree with Weinberger and colleagues' editorial (1). I recently became recertified and found the experience useful; I am also a proud dues-paying member of the American College of Physicians. What I do object to is that Drs. Weinberger, Duffy, and Cassel claimed that they had no potential financial conflicts of interest. Although they themselves may not personally financially benefit from recertification, the organizations they represent do. As an example, the American Board of Internal Medicine (ABIM) “self-assessment” modules link directly to the College Web site, which requires College membership. In fact, membership can ...Reference1. Weinberger SE, Duffy FD, Cassel CK. “Practice makes perfect”…or does it? [Editorial]. Ann Intern Med. 2005;142:302-3. [PMID: 15710964] LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Westside Medical Associates LLP, New York, NY 10024.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee Also“Practice Makes Perfect” … Or Does It? Steven E. Weinberger , F. Daniel Duffy , and Christine K. Cassel “Practice Makes Perfect”…or Does It? Steven E. Weinberger , F. Daniel Duffy , and Christine K. Cassel “Practice Makes Perfect”…or Does It? Richard L. Neubauer Metrics 5 July 2005Volume 143, Issue 1Page: 87-88KeywordsConflicts of interest ePublished: 5 July 2005 Issue Published: 5 July 2005 CopyrightCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...
Flexor Forces and Rheumatoid Metacarpophalangeal Deformity
Authors: Edwin M. Smith
Journal: JAMA (1966)

A new theory concerning dynamics of deformity formation in the rheumatoid metacarpophalangeal (MCP) joint has been advanced which is pertinent to the management of the rheumatoid hand. The theory implicates the large forces normally present in the flexor tendons during pinch or grasp. Because of the bends at the MCP joints in these tendons, there is a strong tendency for them to "bowstring" volarly in all fingers, and also ulnad in digits 2, 3, and 4. If diseased joint structures can no longer restrain this tendency, the deformity of volar subluxation and ulnar deviation may follow. In the fifth digit, however, ulnar deviation appears to be the result of the incompletely opposed pull of the hypothenar muscles. The implications of the theory are significant for the prevention, conservative management, and surgical treatment of rheumatoid MCP-joint deformity.
DNA Methylation–Dependent Repression of PDZ-LIM Domain–Containing Protein 2 in Colon Cancer and Its Role as a Potential Therapeutic Target
Authors: Zhaoxia Qu, Pengrong Yan, Jing Fu, Jing Jiang, Michael J. Grusby, Thomas E. Smithgall, Gutian Xiao
Journal: Cancer Research (2010)

Constitutive activation of the nuclear factor-kappaB (NF-kappaB) transcription factor plays a key role in chronic colonic inflammation and colon tumorigenesis. However, the mechanisms by which the tightly regulated NF-kappaB pathway becomes constitutively activated during colonic pathogenesis remain obscure. Here, we report that PDLIM2, an essential terminator of NF-kappaB activation, is repressed in various human colorectal cancer cell lines, suggesting one important mechanism for the constitutive activation of NF-kappaB. Indeed, expression of exogenous PDLIM2 inhibited constitutive NF-kappaB activation in these colorectal cancer cells. Importantly, the PDLIM2 expression was sufficient to suppress in vitro anchorage-independent growth and in vivo tumor formation of these malignant cells. We have further shown that the PDLIM2 repression involves promoter methylation. Accordingly, treatment of the colorectal tumor cell lines with the DNA methyltransferase inhibitor 5-aza-2'-deoxycytidine restored PDLIM2 expression and resulted in growth arrest. These studies thus provide new mechanistic insights into colon tumorigenesis by identifying a novel tumor suppressor role for PDLIM2.
Multi-modal contributions to detoxification of acute pharmacotoxicity by a triglyceride micro-emulsion
Authors: Michael R. Fettiplace, Kinga Lis, Richard Ripper, Katarzyna Kowal, Adrian Pichurko, Dominic Vitello, Israel Rubinstein, David Schwartz, Belinda S. Akpa, Guy Weinberg
Journal: Journal of Controlled Release (2014)
Epidermolysis bullosa simplex due to<i>KRT5</i>mutations: mutation-related differences in cellular fragility and the protective effects of trimethylamine<i>N</i>-oxide in cultured primary keratinocytes
Authors: J.C. Chamcheu, M. Virtanen, H. Navsaria, P.E. Bowden, A. Vahlquist, H. Törmä
Journal: British Journal of Dermatology (2010)

Background Epidermolysis bullosa simplex (EBS) is a mechanobullous skin fragility disease characterized by cytolysis of basal keratinocytes and intraepidermal blistering often caused by mutations in keratin genes (KRT5 or KRT14). No remedies exist for these disorders presenting a need for development of novel therapies. Objectives To identify new genotype–phenotype relationships in vivo and in cultured primary EBS keratinocytes in vitro, and to study the cytoskeletal stabilizing effects of trimethylamine N‐oxide (TMAO) in heat‐stressed EBS cells. Methods Genomic DNA and cDNA samples from three Swedish patients with EBS were analysed for keratin mutations. Primary EBS keratinocyte cultures were established, heat stressed with and without added TMAO, followed by evaluation of cellular fragility. Results In addition to the previously reported KRT5 mutation (V186L) in one patient, two patients were found to have a novel I183M and recurrent E475G replacements in KRT5. Cultured EBS keratinocytes did not exhibit keratin aggregates or cell loss, except in the patient with the p.I183M mutation who showed 3% aggregates and 2% cell loss. Upon transient heat stress the number of aggregate‐containing cells increased to 21%, 27% and 13%, respectively, in the p.I183M, p.E475G and p.V186L mutant cells. Interestingly, pretreatment with TMAO prior to heat stress, dose dependently reduced the number of aggregate‐containing cells and cell loss. Conclusion These results revealed a genotype–phenotype correlation in EBS keratinocytes upon heat stress and suggest protein stabilization as a new therapeutic strategy.
Brain stem death and organ donation.
Authors: A. Bodenham, J. C. Berridge, G. R. Park
Journal: BMJ (1989)

Organs for donation are in short supply in the United Kingdom, resulting in allegations that relatives of potential donors are not being asked for consent. Legislation on "required request" has been proposed to overcome this. The incidence, causes, complications, and patterns of organ donation in brain stem dead patients in one referral centre were studied over 12 months. Data were collected on all patients fulfilling criteria for brain stem death or considered suitable for donating organs after circulatory arrest. Forty two patients fulfilled the criteria for brain stem death, and in 10 further patients circulatory arrest occurred before formal testing was finished. The major causes of brain stem death were head injury (28) and intracranial haemorrhage (17). Consent to organ donation was obtained for 24 potential donors, and organs were donated by 23 of them. Twenty nine patients did not donate organs. The commonest reasons for failure to donate were medical unsuitability (13) and the coroner not releasing the body (eight). Consent was not sought in three cases, and the relatives refused consent in the remaining five. This study suggests that required request will not considerably increase the supply of donor organs.
beta Blockers for glaucoma and excess risk of airways obstruction: population based cohort study
Authors: J. F Kirwan
Journal: BMJ (2002)

Topical β blockers are the most commonly prescribed drugs in the United Kingdom for glaucoma.1 They are known to exacerbate bronchospasm in asthma and chronic obstructive pulmonary disease.2 This study examined whether topical β blockers are associated with excess respiratory disease in elderly patients not considered to be at excess risk.

We used the Mediplus database to identify patients with no previous diagnosis of airways obstruction. We defined exposed patients as patients who had used ophthalmic topical β blockers for the first time in the period 1993-7. Unexposed patients were randomly selected (loosely matched by age and sex to exposed patients). For validation we inspected a random sample of 40 full longitudinal records of exposed and unexposed patients.

We defined patients who had excess respiratory disease in two ways. Definition A patients were patients who in the 12 months after treatment with topical β blockers were given for the first time a drug …
Hospitalization for Tubal Sterilization-Reply
Authors: Peter M. Layde
Journal: JAMA (1981)

<h3>In Reply.—</h3> We appreciate learning of Drs Brown and Schanzer's experience but believe that present data do not permit a definitive assessment of the safety and efficacy of alternative methods of tubal sterilization. A preliminary analysis of recent data<sup>1</sup>does, however, support their belief that the length of hospitalization for tubal sterilization has declined further since the 1970 to 1975 period we studied. The recent data from the National Hospital Discharge Survey indicate that the length of hospitalization for tubal sterilization declined an additional 14% from 1976 to 1978.<sup>1</sup> A limitation of the analysis of recent hospital-based data on tubal sterilization is that an increasing proportion of tubal sterilizations are being performed in free-standing clinics that are not included in the National Hospital Discharge Survey. To clarify that impact of this trend, the Family Planning Evaluation Division of the Centers for Disease Control, in collaboration with the American Association
Cryptogenic Cerebral Embolism in Women Taking Oral Contraceptives
Authors: K. Enzell, G. Lindemalm
Journal: BMJ (1973)

Fourteen women taking oral contraceptives were admitted during a five-year period because of acute cerebrovascular lesions. A diagnosis of major cerebral embolism was established in four of them. No source of embolism was found, and thorough investigation failed to reveal any predisposing illness. Cerebral embolism was a probable diagnosis in several of the remaining 10 patients. A comparison was made with the strokes occurring in women not taking contraceptive pills in corresponding age groups.
SAFETY AND EFFICACY OF INTRAVENOUS ULTRASOUND CONTRAST IN EVALUATING SURGICALLY CORRECTED CONGENITAL HEART DISEASE PATIENTS WITH DIFFICULT WINDOWS
Authors: Shelby Kutty, Christopher Danford, Scott E. Fletcher, Christopher C. Erickson, David A. Danford, John D. Kugler, Joan Olson, Thomas R. Porter
Journal: Journal of the American College of Cardiology (2010)
Accuracy <b><i>and</i></b> error: Constraints on process models in social psychology
Authors: Alan J. Lambert, B. Keith Payne, Larry L. Jacoby
Journal: Behavioral and Brain Sciences (2004)

In light of an historical obsession with human error, Krueger &amp; Funder (K&amp;F) suggest that social psychologists should emphasize the strengths of social perception. In our view, however, absolute levels of accuracy (or error) in any given experiment are less important than underlying processes. We discuss the use of the process-dissociation procedure for gaining insight into the mechanisms underlying accuracy and error.
Selective dorsal rhizotomy remains experimental in cerebral palsy
Authors: M. A. Crilly
Journal: BMJ (2012)

The recent guideline from the National Institute for Health and Clinical Excellence (NICE) on the clinical management of children with cerebral palsy advises clinicians to consider selective dorsal rhizotomy to improve walking.1 The guideline, however, omits publications on the benefits and harms of the procedure.2 3 4

Only three small randomised clinical trials have assessed its effectiveness (combined with post-operative physiotherapy) compared with physiotherapy …
Policy priorities for tobacco control
Authors: Konrad Jamrozik
Journal: BMJ (2004)

Although many countries have implemented strategies for reducing tobacco use at individual and population level, no country to date has adopted a truly comprehensive control programme. In addition, the tobacco industry and the strategies it uses to counteract policies on tobacco control and thereby maintain and develop its commercial markets have both continued to evolve. All communities therefore face at least some “unfinished business” in relation to tobacco control, and those working in smoking cessation need to be familiar with the necessary policy responses.

Individuals and institutions in the healthcare industry have an important exemplar role. In many countries the prevalence of smoking among doctors differs little from that in the wider community. This considerably undermines individual practitioners' credibility in advising patients not to smoke and denies the profession as a whole the influence it might wield on public and political opinion and policy on tobacco.



Prevalence of smoking among doctors around the world, according to data collected from 493 medical schools in 93 countries (36% response rate) in 1995. Data from Mackay et al ( The tobacco atlas . Geneva: World Health Organization, 2002)



Institutions that train health professionals need to make more time available in both undergraduate and postgraduate curriculums for teaching about smoking and especially about effective cessation interventions. Coverage of these topics is currently, for the most part, inadequate. As assessment shapes learning, these topics also need to feature prominently and regularly in major examinations.

All healthcare facilities, including schools of medicine, nursing, and dentistry, should adopt and enforce comprehensive smoke-free policies across their entire campuses and not just in buildings. Where smoking rooms are provided for inpatients, these should have separate, externally ventilated air conditioning systems so that tobacco smoke is not recirculated into the rest of the building.

The smoking of tobacco should eventually become …
Toward improved immunocompetence of adoptively transferred CD8+ T cells
Authors: D. E. Speiser
Journal: Journal of Clinical Investigation (2005)

Adoptive transfer of autologous or allogenic T cells to patients is being used with increased frequency as a therapy for infectious diseases and cancer. However, many questions remain with regard to defining optimized procedures for preparation and selection of T cell populations for transfer. In a new study in this issue of the JCI, Gattinoni and colleagues used a TCR transgenic mouse model to examine in vitro–generated tumor antigen–specific CD8+ T cells at various stages of differentiation for their efficacy in adoptive immunotherapy against transplantable melanoma. The results confirm that CD8+ T cells progressively lose immunocompetence with prolonged in vitro cultivation and suggest that effector CD8+ T cells alone may be considerably less potent at protecting hosts with advanced tumors than are less differentiated T cells.
Retreatment with IFN alfa 2B + ribavirin (24 VS 48 weeks) for patients with chronic hepatitis C who relapsed or did not respond to IFN alone
Authors: A. Gallego, J. Garcia-Samaniego, M. Diago, M. Pérez-Olmeda, M.D. Valeros, J. Enríquez
Journal: Journal of Hepatology (2000)
The Ineffectiveness of Aluminum Subacetate in Rheumatoid Arthritis
Authors: Alfred Blazer, H. Harold Friedman, Otto Steinbrocker
Journal: New England Journal of Medicine (1948)

ENCOURAGING results from the use of aluminum salts in the treatment of 12 patients with rheumatoid arthritis, active and inactive, were reported by Helfet.1 In an effort to evaluate this therapy we employed aluminum salts according to his method for the treatment of a comparable series of patients with this disease. This report presents our results.Helfet predicated the use of aluminum salts in rheumatoid arthritis upon certain theoretical premises, which are briefly summarized as follows. The first of these was that, regardless of the etiology, the symptoms of rheumatoid arthritis are the outcome of a secondary or physiologic hyperparathyroidism; . . .
Transglutaminase-positive cells in psoriatic epidermis during treatment with calcitriol (1α, 25 dihydroxy vitamin D3) and tacalcitol (1α, 24 dihydroxy vitamin D3)
Authors: M.J.P. Gerritsen, P.E.J. Erp, P.C.M. Kerkhof
Journal: British Journal of Dermatology (1995)

Journal Article Transglutaminase‐positive cells in psoriatic epidermis during treatment with calcitriol (1α, 25 dihydroxy vitamin D3) and tacalcitol (1α, 24 dihydroxy vitamin D3) Get access M.J.P. Gerritsen, M.J.P. Gerritsen Department of Dermatology, University Hospital Nijmegen, PO Box 9101. 6500 HB Nijmegen, The Netherlands Search for other works by this author on: Oxford Academic Google Scholar P.E.J. VAN Erp, P.E.J. VAN Erp Department of Dermatology, University Hospital Nijmegen, PO Box 9101. 6500 HB Nijmegen, The Netherlands Search for other works by this author on: Oxford Academic Google Scholar P.C.M. van de Kerkhof P.C.M. van de Kerkhof Department of Dermatology, University Hospital Nijmegen, PO Box 9101. 6500 HB Nijmegen, The Netherlands Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 133, Issue 4, 1 October 1995, Pages 656–659, https://doi.org/10.1111/j.1365-2133.1995.tb02727.x Published: 01 October 1995
The Congress and Health Manpower: A Legislative Morass
Authors: Barry Stimmel
Journal: New England Journal of Medicine (1975)

To correct deficiencies in physicians' services, chiefly related to geographic maldistribution and overspecialization, numerous bills have been introduced in both the House and the Senate. These bills would increase the annual number of medical graduates, would mandate service in areas defined as lacking in physicians, and would promote the training of primary-care physicians as opposed to more specialized training. The number of foreign medical graduates would also be restricted. Almost all this legislation potentially may diminish the quality of medical education without substantially affecting the provision of health service. Recently introduced legislation (HR 3279), however, seems to deal more rationally with the problems of health manpower.
Long-Term Benefit of Postconditioning
Authors: Hélène Thibault, Christophe Piot, Patrick Staat, Laurence Bontemps, Catherine Sportouch, Gilles Rioufol, Thien Tri Cung, Eric Bonnefoy, Denis Angoulvant, Jean-François Aupetit, Gérard Finet, Xavier André-Fouët, Jean Christophe Macia, Franck Raczka, Rolland Rossi, Rolland Itti, Gilbert Kirkorian, Geneviève Derumeaux, Michel Ovize
Journal: Circulation (2008)

Background— We previously demonstrated that ischemic postconditioning decreases creatine kinase release, a surrogate marker for infarct size, in patients with acute myocardial infarction. Our objective was to determine whether ischemic postconditioning could afford (1) a persistent infarct size limitation and (2) an improved recovery of myocardial contractile function several months after infarction. Methods and Results— Patients presenting within 6 hours of the onset of chest pain, with suspicion for a first ST-segment–elevation myocardial infarction, and for whom the clinical decision was made to treat with percutaneous coronary intervention, were eligible for enrollment. After reperfusion by direct stenting, 38 patients were randomly assigned to a control (no intervention; n=21) or postconditioned group (repeated inflation and deflation of the angioplasty balloon; n=17). Infarct size was assessed both by cardiac enzyme release during early reperfusion and by 201 thallium single photon emission computed tomography at 6 months after acute myocardial infarction. At 1 year, global and regional contractile function was evaluated by echocardiography. At 6 months after acute myocardial infarction, single photon emission computed tomography rest-redistribution index (a surrogate for infarct size) averaged 11.8±10.3% versus 19.5±13.3% in the postconditioned versus control group ( P =0.04), in agreement with the significant reduction in creatine kinase and troponin I release observed in the postconditioned versus control group (−40% and −47%, respectively). At 1 year, the postconditioned group exhibited a 7% increase in left ventricular ejection fraction compared with control ( P =0.04). Conclusions— Postconditioning affords persistent infarct size reduction and improves long-term functional recovery in patients with acute myocardial infarction.
Therapeutic aerosols in children.
Authors: S H Thomas, S Batchelor, M J O'Doherty
Journal: BMJ (1993)

The use and variety of drugs administered to children as inhaled aerosols is increasing, but little is known about how much drug reaches the lung and how it is distributed there in different age groups. In this article the reasons for measuring aerosol deposition in children are discussed and the potential methods for doing this described. Of the methods available, only the use of radiolabelled aerosols gives accurate information on total lung deposition and distribution. The potential risk of the radiation exposure required for these measurements varies with the age of the child but seems to be small. Properly designed studies are expected to clarify the factors affecting lung deposition in children and identify methods of inhalation associated with efficient and predictable delivery of the drug. Measurements of radioaerosol deposition may therefore be justified in children when this information is expected to lead to improvements in the effectiveness or safety of their treatment.
Risk factors and pathogenic significance of bacteremic pneumonia in adult patients with community-acquired pneumococcal pneumonia
Authors: Cheol-In Kang, Jae-Hoon Song, So Hyun Kim, Doo Ryeon Chung, Kyong Ran Peck, Visanu Thamlikitkul, Hui Wang, Thomas Man-kit So, Po-Ren Hsueh, Rohani Md. Yasin, Celia C. Carlos, Pham Hung Van, Jennifer Perera
Journal: Journal of Infection (2012)
Cardiovascular safety of NSAIDs
Authors: W. A. Ray
Journal: BMJ (2011)

The cardiovascular risks should prompt evaluation of a broader range of alternatives

Millions of patients with chronic musculoskeletal symptoms are long term users of non-steroidal anti-inflammatory drugs (NSAIDs). Unfortunately, these drugs have common and potentially severe adverse effects, including renal impairment, gastrointestinal complications, and as has been shown for selective cyclo-oxygenase-2 inhibitors, cardiotoxicity. The last effect is particularly worrying because many patients have both cardiovascular disease and musculoskeletal disease. Given that both mechanistic and clinical data suggest that individual NSAIDS may have different cardiovascular risk profiles, a natural question is: which NSAID is safest for patients with high cardiovascular risk? In the linked study (doi:10.1136/bmj.c7086), Trelle and colleagues investigate this question by using network meta-analysis to assess the cardiovascular safety of individual NSAIDS.1 

All cyclo-oxygenase-2 inhibitors studied in large placebo controlled trials have been found to confer an increased risk of serious cardiovascular disease.2 3 4 Furthermore, rofecoxib increases risk more than naproxen.5 This suggests that patients with a high risk of cardiovascular disease should avoid cyclo-oxygenase-2 inhibitors. Although some trials suggest that celecoxib is safer in …