tbuckley/cabot-search huggingface dataset:
National Study of Internal Medicine Manpower: XIII. The Financing of Internal Medicine Residency and Fellowship Training, 1985 to 1986
Authors: Ronald M. Andersen
Journal: Annals of Internal Medicine (1988)

Hospital revenue is the most important source for residency and fellowship stipends in internal medicine. Medicare is especially important for residency programs in voluntary hospitals and hospitals not closely affiliated with a medical school. In the last decade state and local government support and federal training grant support for residency stipends declined, whereas Veterans Administration support increased. Fellowship stipend sources are much more diverse; federal training grants, professional fees, foundations, medical school funds, and research grants contribute significantly. Medicare support appears to be focused on subspecialties particularly important to the elderly, including critical care, rheumatology, cardiology, hematology, gastroenterology, and nephrology. Geriatric medicine, however, receives substantial Veterans Administration support. With growing revenue constraints and increasing concerns about excess physicians we need to monitor the impact of government regulations and other factors on funds available for training internal medicine specialists.
Age-dependent Dystrophin Loss and Genetic Reconstitution Establish a Molecular Link Between Dystrophin and Heart Performance During Aging
Authors: DeWayne Townsend, Michael Daly, Jeffrey S Chamberlain, Joseph M Metzger
Journal: Molecular Therapy (2011)

The aging-related decline in cardiac function is an important public health problem. The molecular basis of age-dependent loss of cardiac function is largely unknown and there are no effective therapies addressing this important form of heart disease. This study evaluates the role of the cytoskeletal protein dystrophin in the process of normal cardiac aging. Here, we show that the cytoskeletal protein dystrophin in the hearts of old mice is significantly decreased to a level of 36% that of young mice, whereas other key members of the dystrophin complex are unchanged. Age-dependent decreased ejection fraction was rescued by systemic delivery of an adeno-associated viral vector harboring a functional micro-dystrophin cassette (48.9 ± 2.5% in untreated aged vs. 61.6 ± 7.4% in treated aged mice, compared to 67.1 ± 2.6% in young mice). These data provide the first direct evidence that decreased dystrophin levels are an important modulator of cardiac function in the aged heart. The aging-related decline in cardiac function is an important public health problem. The molecular basis of age-dependent loss of cardiac function is largely unknown and there are no effective therapies addressing this important form of heart disease. This study evaluates the role of the cytoskeletal protein dystrophin in the process of normal cardiac aging. Here, we show that the cytoskeletal protein dystrophin in the hearts of old mice is significantly decreased to a level of 36% that of young mice, whereas other key members of the dystrophin complex are unchanged. Age-dependent decreased ejection fraction was rescued by systemic delivery of an adeno-associated viral vector harboring a functional micro-dystrophin cassette (48.9 ± 2.5% in untreated aged vs. 61.6 ± 7.4% in treated aged mice, compared to 67.1 ± 2.6% in young mice). These data provide the first direct evidence that decreased dystrophin levels are an important modulator of cardiac function in the aged heart.
To heal on wheels
Authors: G. Dunea
Journal: BMJ (1995)

Most people have heard of “meals on wheels,” a service that provides ready made food to the homes of sick and infirm pensioners. But now comes “therapy on wheels,” provided by Mobile Psychological Services of New York City. Patients enter a luxurious van, relax in plush leather seats, and discuss their problems with a psychologist while a chauffeur, seated in front of a soundproof glass for privacy, drives them to work, to shop, or, most often, to the airport.

Reflecting the trend towards less expensive outpatient care, this service is provided for only $175 per hour—a considerable saving for busy executives and housewives who otherwise would be unable to make …
Nature of Enhanced Performance of the Dilated Left Ventricle in the Dog during Chronic Volume Overloading
Authors: JOHN ROSS, WILLIAM H. MCCULLAGH
Journal: Circulation Research (1972)

The size and the performance of the left ventricle were examined in six conscious dogs early (within 1 week) and late (average 7 weeks) after the production of a large infrarenal arteriovenous fistula. Radiopaque beads were implanted near the endocardium of the left ventricle, and in each study the end-diastolic pressure was adjusted to 22 mm Hg by transfusion or bleeding. The shortening of the minor equator of the left ventricle and its mean velocity of shortening were compared in each dog before and after chronic left ventricular dilatation (ventricular end-diastolic volumes of 71 ml early and 101 ml late, P &lt; 0.05). In five dogs the stroke volume increased by an average of 42% ( P &lt; 0.05) between early and late studies, but the percent change in circumference and the mean velocity of shortening remained unchanged (24.2 ± 2% (SE) and 23.6 ± 2%, 1.43 ± 0.12 circumferences/sec and 1.44 ± 0.09 circumferences/sec, respectively) at comparable heart rates. In one animal with congestive heart failure, the percent change in circumference and the mean velocity of shortening fell progressively to 19% and 0.74 circumferences/sec. It is concluded that in the absence of myocardial failure the enhanced performances of the chronically dilated left ventricle is mediated by normal performance of each unit of circumference of the enlarged chamber. The nature of this adaptation supports the application of several measures of contractility used for the assessment of chronic variations of inotropic state. Previously, diastolic sarcomere lengths were shown to be maximal and essentially the same after acute over-transfusion as they were during chronic volume overloading, and the present studies provide physiological support for the view that the chronic adaptation to volume overload need not involve the Frank-Starling mechanism at the sarcomere level. The observed adaptation provides a reserve mechanism, in addition to the usual factors regulating cardiac performance, by which chronic alterations in ventricular geometry allow the delivery of more external work.
Role of interleukin-10 in idiopathic pulmonary fibrosis
Authors: P.G. Tsoutsou, K.I. Gourgoulianis
Journal: European Respiratory Journal (2003)

The natural killer cell activity was studied in 25 patients with primary, secondary, or latent syphilis before and after treatment. In primary syphilis natural killer cell activity was increased, especially in patients lacking circulating lipoidal antibodies. In patients who had become seroreactive in the lipoidal tests it was depressed in those with secondary and latent syphilis. The natural killer cell activity thus becomes activated by the syphilitic infection but is significantly reduced during progression of the disease. The importance of the natural killer cell activity in controlling syphilitic infection is questionable.
Aminoterminal propeptide of type III procollagen in methotrexate-induced liver fibrosis and cirrhosis
Authors: J. RISTELI, H. SOGAARD, A. OIKARINEN, L. RISTELI, J. KARVONEN, H. ZACHARIAE
Journal: British Journal of Dermatology (1988)

Twenty-four psoriatic patients on methotrexate were studied with liver biopsies and serum measurements of aminoterminal propeptide of type III procollagen (PIII NP). All but one of nine patients with serum levels of PIII NP above the normal range had liver fibrosis or cirrhosis and no normal liver biopsies were obtained in this group. In contrast, nine normal liver biopsies and two biopsies with minimal fibrosis were found among the 15 patients with normal serum levels of PIII NP. The study indicates that aminoterminal propeptide of type III procollagen can be utilized as a valuable non-invasive marker of fibrogenesis in the liver. This analysis is not specific for the liver, but it seems that the number of liver biopsies probably can be reduced in psoriatics on methotrexate who have normal levels of PIII NP.
Influx of kininogens into nasal secretions after antigen challenge of allergic individuals.
Authors: C R Baumgarten, A G Togias, R M Naclerio, L M Lichtenstein, P S Norman, D Proud
Journal: Journal of Clinical Investigation (1985)

We have recently demonstrated that kinins are generated in vivo after nasal challenge with antigen of allergic, but not nonallergic, individuals. The present study was undertaken as a first step in determining the mechanism(s) of kinin formation during the allergic reaction and was directed towards establishing the availability and origin of kininogens in nasal secretions. Allergic individuals (n = 6) and nonallergic controls (n = 5) were challenged with antigen; and by using specific radioimmunoassays, nasal washes, obtained before and after challenge, were assayed for high molecular weight kininogen (HMWK), total kininogen (TK), albumin, and kinins. Dramatic increases in HMWK (1,730 +/- 510 ng/ml), TK (3,810 +/- 1035 ng/ml), kinin (9.46 +/- 1.75 ng/ml), and albumin (0.85 +/- 0.2 mg/ml) were observed after challenge of allergic individuals which correlated (P less than 0.001) with increases in histamine and N-alpha-tosyl-L-arginine methyl esterase activity and with the onset of clinical symptoms. For nonallergic individuals, levels of kininogens, albumin, and all mediators after antigen challenge were not different from base line. Linear regression analysis revealed excellent correlations (P less than 0.001 in each case) between increases in HMWK, TK, kinin, and albumin during antigen titration experiments and between the time courses of appearance and disappearance of HMWK, TK, kinin, and albumin after antigen challenge. Gel filtration revealed no evidence of degradation products of kininogens in nasal washes. For each allergic individual the ratio of HMWK/TK in postchallenge nasal washes was similar to the ratio of these two proteins in the same individual's plasma. These data suggest that, during the allergic reaction, there is an increase in vascular permeability and a transudation of kininogens from plasma into nasal secretions, where they can provide substrate for kinin-forming enzymes.
Waterborne Mycobacterium avium Infection-Reply
Authors: G. C. du Moulin
Journal: JAMA (1989)

<h3>In Reply. —</h3> Drs Yagupsky and Menegus agree with us that<i>M avium</i>is frequently isolated from respiratory specimens of immunocompromised patients. Other airborne or aerosol-borne potential pathogens, notably<i>Cryptococcus neoformans and Neisseria meningitidis</i>, originate in the respiratory tract before they may invade the bloodstream without being "seen in lung tissue sections." The traditional concept that all species of aerosol-borne mycobacteria supposedly cause pulmonary tuberculosis before dissemination may have to be reexamined in the context of the immunoincompetent host. It certainly does not apply to<i>M avium</i>disease in chickens, in which the liver and spleen are involved.<sup>1</sup> Granted, gastrointestinal mycobacterial disease in AIDS patients may be the result of ingesting large amounts of<i>M avium</i>in the drinking water rather than inhaling aerosols. But why does the mode of transmission of<i>M avium</i>have to be further elucidated, and why is it premature now to discourage massive exposure
GP fundholder reported to GMC
Authors: L. Dillner
Journal: BMJ (1996)

A general practice fundholder who coauthored a paper in the BMJ describing how he reduced his prescribing costs has been reported to the GMC on the grounds that he may have misused public funds. The Medical Practitioners Union decided at its annual general meeting last weekend to ask the GMC to investigate Dr James Dunbar, from Downfield Surgery in Dundee.

In his paper entitled “Changing to generic formulary: how one fundholding …
The application of human bone marrow stromal cells and poly(dl-lactic acid) as a biological bone graft extender in impaction bone grafting
Authors: Benjamin J.R.F. Bolland, Janos M. Kanczler, Patrick J. Ginty, Steve M. Howdle, Kevin M. Shakesheff, Douglas G. Dunlop, Richard O.C. Oreffo
Journal: Biomaterials (2008)
Ectopic cushing’s syndrome caused by an 8 mm lung carcinoid localized by scintigram with the somatostatin analog111in-pentetreotide
Authors: João Filipe Raposo, Maria João Bugalho, Luís Gonçalves Sobrinho, Maria Conceição Pefeira, José Boavida, Margarida Loureiro, Maria Rosario Vieira, José Duro da Costa, José Manuel, Mendes Almeida, Kaiman Kovacs
Journal: Endocrine Pathology (1994)
Précis of<i>Beyond modularity: A developmental perspective on cognitive science</i>
Authors: Annette Karmiloff-Smith
Journal: Behavioral and Brain Sciences (1994)

Abstract Beyond modularity attempts a synthesis of Fodor's anticonstructivist nativism and Piaget's antinativist constructivism. Contra Fodor, I argue that: (1) the study of cognitive development is essential to cognitive science, (2) the module/central processing dichotomy is too rigid, and (3) the mind does not begin with prespecified modules; rather, development involves a gradual process of “modularization.” Contra Piaget, I argue that: (1) development rarely involves stagelike domain-general change and (2) domainspecific predispositions give development a small but significant kickstart by focusing the infant's attention on proprietary inputs. Development does not stop at efficient learning. A fundamental aspect of human development (“representational redescription”) is the hypothesized process by which information that is in a cognitive system becomes progressively explicit knowledge to that system. Development thus involves two complementary processes of progressive modularization and progressive “explicitation.” Empirical findings on the child as linguist, physicist, mathematician, psychologist, and notator are discussed in support of the theoretical framework. Each chapter concentrates first on the initial state of the infant mind/brain and on subsequent domain-specific learning in infancy and early childhood. It then goes on to explore data on older children's problem solving and theory building, with particular focus on evolving cognitive flexibility. Emphasis is placed throughout on the status of representations underlying different capacities and on the multiple levels at which knowledge is stored and accessible. Finally, consideration is given to the need for more formal developmental models, and a comparison is made between representational redescription and connectionist simulations of development. In conclusion, I consider what is special about human cognition by speculating on the status of representations underlying the structure of behavior in other species.
Honesty is the best policy
Authors: Faiyaz Mohammed
Journal: BMJ (2005)

settings.While we search for the magic bullet that would make research undeniably ethical, the complex challenge is to link research in resource poor settings to the services demanded by poor people. 29Today's AIDS research environment is no longer local but global in the actual conduct of research and in its implications for health policy and access to safe and effective methods of diagnosis, prevention, and treatment.The era of researchers, study participants, and activists living in separate silos must come to an end if meaningful progress is to be made in halting the HIV pandemic.
South London Hospital for Women
Authors: J. Boyd, E. Hicks, M. Louden
Journal: BMJ (1984)

This hospital has been established for the treat- ment of women by women physicians and surgeons, its objects being defined by the trust deed-as " To afford to poor women and women of small means the opportunity of obtaining medical and surgical treatment by qualified women, and to promote the medical education of women, as also to educate and train medical students and nurses in all professional duties."The new buildings, which were opened by Her Majesty the Queen on Tuesday last, are entirely devoted .toin-patients, the present out-patient department being situated in Newington Cause- way, S.E.
Deterioration of glycemic control after long-term treatment with troglitazone in nonobese type 2 diabetic patients.
Authors: Y Murase, T Wakasugi, K Yagi, H Mabuchi
Journal: Diabetes Care (2000)

A c k n o w l e d g m e n t s -This project was supp o rted through a cooperative agreement (U-32/ CCU-815663-02) with
Team Science and Critical Care
Authors: Constantine A Manthous, Andrea B Hollingshead
Journal: American Journal of Respiratory and Critical Care Medicine (2011)

Because critical care is administered by multidisciplinary teams, it is plausible that behavioral methods to enhance team performance may impact the quality and outcomes of care. This review highlights the social and behavioral scientific principles of team building and briefly reviews four features of teams--leadership, psychological safety, transactive memory, and accountability--that are germane to critical care teams. The article highlights how team principles might be used to improve patient care and navigate hospital hierarchies, and concludes with implications for future educational and scientific efforts.
REPORT OF A CASE OF COMPOSITE MONSTER—MONOMPHALIC ISCHIOPAGUS.
Authors: ELIZA H. ROOT
Journal: JAMA (1896)

M. J., Swede, blonde, age 26; domestic; primipara; entered the Chicago Hospital for Women and Children, March 18, 1893. Last menstrual period July 7, 1892. Patient was delivered May 4, 1893,301 days from the beginning of last menstruation. On entering the clinic the patient was pale and passing albuminous urine with low specific gravity, in excess of the normal quantity in the twenty-four hours. Under treatment the albumin disappeared, to again return for two weeks preceding labor. The patient complained of the weight of the tumor and of pain along the line of Poupart's ligaments. <h3>Examination.</h3> —Inspection found the abdominal tumor very large and prominent, abdominal muscles tense and the skin greatly stretched; size of pelvis normal. Palpation discovered two heads in fundal zone of the uterus and to right of median line. The head of the posterior fetus lay deeply in relation to the anterior uterine wall. Back
Abstract 4813: EMT inducers catalyze malignant transformation of mammary epithelial cells and drive tumorigenesis towards claudin-low tumors
Authors: Anne-Pierre Morel, Clémence Thomas, George Hinkal, Frederique Fauvet, Stephanie Courtois-Cox, Anne Wierinckx, Mojgan Devouassoux-Shisheboran, Agnes Tissier, Baptiste GRAS, Julie Pourchet, Isabelle Puisieux, Gareth Browne, Douglas B. Spicer, Joel Lachuer, Stephane Ansieau, Alain Puisieux
Journal: Cancer Research (2012)

Abstract The malignant transformation of human epithelial cells is generally described as a multistep process resulting from the accumulation of five to seven rate-limiting changes. Here, we challenge this dogma and demonstrate that this number is radically reduced when cells undergo an epithelial-mesenchymal transition (EMT). EMT is an embryonic transdifferentiation process that consists of the conversion of polarized epithelial cells into motile mesenchymal ones. EMT-inducing transcription factors, including Twist and Zeb proteins, are aberrantly expressed in multiple tumor types and are known to favor the metastatic dissemination process. We demonstrate that, beyond their prometastatic potential, EMT inducers also act as potent drivers of tumorigenesis. We indeed show that the Twist1 EMT-inducing transcription factor promotes breast and skin cancer development in vivo in cooperation with the K-RasG12D oncoprotein. Importantly, in the model of breast tumorigenesis, transgene expression in differentiated mammary epithelial cells leads to the development of undifferentiated tumors exhibiting all the characteristic features of the claudin-low subtype. These observations challenge the concept that this tumor subtype specifically arises from transformation of an early epithelial precursor with inherent stemness properties and metaplastic features. Consistently, oncogenic cooperation assays performed in human mammary epithelial cells with Twist or Zeb EMT-inducers in combination with H-RasG12V generate transformed cell lines displaying all characteristics of claudin-low tumors including mesenchymal features, undifferentiated traits, and stem-cell-like properties. EMT might thus drive the development of claudin-low tumors by exhibiting a dual role in cell transformation and dedifferentiation. In other terms, the claudin-low tumor subtype of breast cancers might thus constitute a first example of human adult malignancies driven by aberrant reactivation of an embryonic transdifferentiation program. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4813. doi:1538-7445.AM2012-4813
Erythropoietin mediates hepcidin expression in hepatocytes through EPOR signaling and regulation of C/EBPα
Authors: Jorge P. Pinto, Sara Ribeiro, Helena Pontes, Shifaan Thowfeequ, David Tosh, Félix Carvalho, Graça Porto
Journal: Blood (2008)

Abstract Hepcidin is the principal iron regulatory hormone, controlling the systemic absorption and remobilization of iron from intracellular stores. Recent in vivo studies have shown that hepcidin is down-regulated by erythropoiesis, anemia, and hypoxia, which meets the need of iron input for erythrocyte production. Erythropoietin (EPO) is the primary signal that triggers erythropoiesis in anemic and hypoxic conditions. Therefore, a direct involvement of EPO in hepcidin regulation can be hypothesized. We report here the regulation of hepcidin expression by EPO, in a dose-dependent manner, in freshly isolated mouse hepatocytes and in the HepG2 human hepatocyte cell model. The effect is mediated through EPOR signaling, since hepcidin mRNA levels are restored by pretreatment with an EPOR-blocking antibody. The transcription factor C/EBPα showed a pattern of expression similar to hepcidin, at the mRNA and protein levels, following EPO and anti-EPOR treatments. Chromatin immunoprecipitation experiments showed a significant decrease of C/EBPα binding to the hepcidin promoter after EPO supplementation, suggesting the involvement of this transcription factor in the transcriptional response of hepcidin to EPO.
Small intestine perforation after colonoscopy: rare complication in patients with previous abdominal surgery
Authors: C. Teruel, X. García, A. Ledo, J. Graus, L. del Árbol
Journal: Endoscopy (2009)

A 69-year-old woman with history of previous abdominal surgery (myomectomy and right hemicolectomy for an obstructive non-neoplastic inflammatory mass of uncertain etiology) presented with abdominal subocclusive episodes and weight loss. Blood analysis, tumor markers carcinoembryonic antigen (CEA) and CA 19.9, and abdominal computed tomography (CT) were normal. The patient underwent colonoscopy under conscious sedation and the surgical anastomosis was accessed without difficulty. No pathology was detected and no therapeutic measures were undertaken during the procedure. Two hours later, the patient had severe abdominal pain with peritonism and leukocytosis (14.5 × 109/L). An abdominal film revealed pneumoperitoneum, so the surgeon proceeded with an urgent laparotomy. Multiple peritoneal adhesions were found, some of which were adherent to both small intestine loops and the sigmoid colon. The colon was intact, but on removing the adhesions between the small intestine loops, a perforation was found in the mid-ileum. The perforated segment was resected and a primary anastomosis carried out. The patient was discharged 3 weeks after the surgery.