tbuckley/cabot-search huggingface dataset:
Recent Events of Special Interest to Medical Education
Authors: C. H. William Ruhe
Journal: JAMA (1975)

This section includes information about special studies, reports, legislation, and other events and activities that currently have an influence on, or relation to, medical education and that might be expected to influence the future course of events in medical education. Most of the items listed are extensions of reports given in earlier years and are still in development or in transition. Some of these items are also considered in other sections of the EDUCATION NUMBER.  Coordinating Council on Medical Education  The Coordinating Council on Medical Education (CCME) was established late in 1972 by the five major medical organizations having the greatest involvement and interest in medical education: the American Medical Association, the American Board of Medical Specialties (ABMS), the American Hospital Association (AHA), the Association of American Medical Colleges (AAMC), and the Council of Medical Specialty Societies (CMSS). The membership includes three representatives each from these five organizations and one
Acidic and neutral sialidase in the erythrocyte membrane of type 2 diabetic patients
Authors: Bruno Venerando, Amelia Fiorilli, Gianluigi Croci, Cristina Tringali, Giancarlo Goi, Laura Mazzanti, Giovanna Curatola, Giovanni Segalini, Luca Massaccesi, Adriana Lombardo, Guido Tettamanti
Journal: Blood (2002)
The effects of a professionally produced videotape on education and anxiety/distress levels for patients with newly diagnosed melanoma: A randomized, prospective clinical trial
Authors: Jeffrey S. Orringer, A. Mark Fendrick, Peter C. Trask, Christopher K. Bichakjian, Jennifer L. Schwartz, Timothy S. Wang, Darius J. Karimipour, Timothy M. Johnson
Journal: Journal of the American Academy of Dermatology (2005)
Is hip strength a risk factor for patellofemoral pain? A systematic review and meta-analysis
Authors: M S Rathleff, C R Rathleff, K M Crossley, C J Barton
Journal: British Journal of Sports Medicine (2014)

Objective To evaluate and synthesise the literature on hip strength among patients with patellofemoral pain (PFP) to address the following: (1) differentiate between hip strength as a risk factor and associated deficit in PFP; (2) describe hip strength in men and women with PFP across different age ranges; (3) investigate the effects of hip strengthening on biomechanical knee variables associated with PFP development. Methods MEDLINE, CINAHL, Web of Science, SportDiscus and Google Scholar were searched in November 2013 for studies investigating hip strength among patients with PFP. Two reviewers independently assessed papers for inclusion and quality. Means and SDs were extracted from each included study to allow effect size calculations and comparisons of results. Results Moderate-to-strong evidence from prospective studies indicates no association between isometric hip strength and risk of developing PFP. Moderate evidence from cross-sectional studies indicates that men and women with PFP have lower isometric hip musculature strength compared to pain-free individuals. Limited evidence indicates that adolescents with PFP do not have the same strength deficits as adults with PFP. Conclusions This review highlights a possible discrepancy between prospective and cross-sectional research. Cross-sectional studies indicate that adult men and women with PFP appear to have lower hip strength compared to pain-free individuals. Contrary to this, a limited number of prospective studies indicate that there may be no association between isometric hip strength and risk of developing PFP. Therefore, reduced hip strength may be a result of PFP rather than the cause.
Sleep in children with asthma: results of the PIAMA study
Authors: Annette van Maanen, Alet H. Wijga, Ulrike Gehring, Dirkje S. Postma, Henriëtte A. Smit, Frans J. Oort, Roos Rodenburg, Anne Marie Meijer
Journal: European Respiratory Journal (2012)

Children with asthma are thought to have impaired sleep quality and quantity. In this study, we investigated which of the many sleep aspects are associated with asthma. Our sample consisted of 2529 children (aged 11 years) who participated in the Prevention and Incidence of Asthma and Mite Allergy (PIAMA) birth cohort study. Parents reported about asthma symptoms (wheezing, dyspnoea, prescription of inhaled corticosteroids and asthma diagnosis) and children reported about different aspects of sleep (bedtime, rise time, sleep quality and daytime sleepiness/tiredness). Results were analysed with (logistic) regression analysis. Children with frequent asthma symptoms significantly more often reported that they felt sleepy or tired during the day (34.4% experienced daytime sleepiness/tiredness at least once a week) than children without asthma symptoms (22.2%) and children with infrequent asthma symptoms (21.9%). This association was not confounded by sex, age of the child, parental educational level or smoking inside the house; the effect was also not modified by sex. There were no associations between asthma and bedtime, time spent in bed or sleep quality. Children with frequent asthma symptoms experienced daytime sleepiness/tiredness more often than children with infrequent or no asthma symptoms. Otherwise, children with asthma did not differ much from children without asthma with regard to sleep.
Time course of increased collateral arterial and venous endothelial cell turnover after renal artery stenosis in the rat.
Authors: N Ilich, N K Hollenberg, D H Williams, H L Abrams
Journal: Circulation Research (1979)

We induced left renal artery stenosis in rats and studied collateral arterial formation by angiography, histology, and radioautography with tritiated thymidine. Endothelial cell turnover was estimated by radioautography with tritiated thymidine in the periureteric blood supply of 10 normal and 38 collateral-forming kidneys 1 to 100 days after stenosis. Periureteric arterial endothelial cell labeling showed a highly significant (P less than 0.005) increase, apparent within 1 day and gradually falling as the vessels grew, until a baseline was reached in 35 days. A smaller but statistically significant increase in the labeling index also was found in endothelial cells of the renal vein during the first week (P less than 0.01), and had a similar time course. A marked increase in epithelial cell labeling in the ureters draining the stenotic kidneys also was evident (P less than 0.005). Thus, collateral vessel development is characterized by active DNA synthesis in the cellular elements which is maximal during the first week. A humoral factor is implicated in the vascular response by the parallel proliferation of venous and uretic cellular elements that are unlikely to experience the biophysical forces, such as increased blood flow or tangential wall force, which might stimulate proliferation in ther arterial vessels.
Quality of HIV Care Provided by Nurse Practitioners, Physician Assistants, and Physicians
Authors: Ira B. Wilson, Bruce E. Landon, Lisa R. Hirschhorn, Keith McInnes, Lin Ding, Peter V. Marsden, Paul D. Cleary
Journal: Annals of Internal Medicine (2005)

Background: Nurse practitioners (NPs) and physician assistants (PAs) are primary care providers for patients with HIV in some clinics, but little is known about the quality of care that they provide. Objective: To compare the quality of care provided by NPs and PAs with that provided by physicians. Design: Cross-sectional analysis. Setting: 68 HIV care sites, funded by Ryan White Comprehensive AIDS Resources Emergency (CARE) Act Title III, in 30 different states. Participants: The authors surveyed 243 clinicians (177 physicians and 66 NPs and PAs) and reviewed medical records of 6651 persons with HIV or AIDS. Measurements: 8 quality-of-care measures assessed by medical record review. Results: After adjustments for patient characteristics, 6 of the 8 quality measures did not statistically significantly differ between NPs and PAs and either infectious disease specialists or generalist HIV experts. Adjusted rates of purified protein derivative testing and Papanicolaou smears were statistically significantly higher for NPs and PAs (0.63 and 0.71, respectively) than for infectious disease specialists (0.53 [P = 0.007] and 0.56 [P = 0.001], respectively) or generalist HIV experts (0.47 [P < 0.001] and 0.62 [P = 0.025], respectively). Nurse practitioners and PAs had statistically significantly higher performance scores than generalist non–HIV experts on 6 of the 8 quality measures. Limitations: These results may not be generalizable to care settings where on-site physician HIV experts are not accessible or to measures of more complex clinical processes. Conclusions: For the measures examined, the quality of HIV care provided by NPs and PAs was similar to that of physician HIV experts and generally better than physician non–HIV experts. Nurse practitioners and PAs can provide high-quality care for persons with HIV. Preconditions for this level of performance include high levels of experience, focus on a single condition, and either participation in teams or other easy access to physicians and other clinicians with HIV expertise.
Immunosuppressive Therapy for Patients With Myelodysplastic Syndrome: A Prospective Randomized Multicenter Phase III Trial Comparing Antithymocyte Globulin Plus Cyclosporine With Best Supportive Care—SAKK 33/99
Authors: Jakob R. Passweg, Aristoteles A.N. Giagounidis, Mathew Simcock, Carlo Aul, Christiane Dobbelstein, Michael Stadler, Gert Ossenkoppele, Wolf-Karsten Hofmann, Kristina Schilling, André Tichelli, Arnold Ganser
Journal: Journal of Clinical Oncology (2010)

Immunosuppressive treatment is reported to improve cytopenia in some patients with myelodysplastic syndrome (MDS). Combined antithymocyte globulin (ATG) and cyclosporine (CSA) is most effective in patients with immune-mediated marrow failure.This trial was designed to assess the impact of immunosuppression on hematopoiesis, transfusion requirements, transformation, and survival in patients with MDS randomly assigned to 15 mg/kg of horse ATG for 5 days and oral CSA for 180 days (ATG+CSA) or best supportive care (BSC), stratified by treatment center and International Prognostic Scoring System (IPSS) risk score. Primary end point was best hematologic response at 6 months. Eligible patients had an Eastern Cooperative Oncology Group performance status of ≤ 2 and transfusion dependency of less than 2 years in duration.Between 2000 and 2006, 45 patients received ATG+CSA (median age, 62 years; range, 23 to 75 years; 56% men) and 43 patients received BSC (median age, 65 years; range, 24 to 76 years; 81% men). IPSS score was low, intermediate-1, intermediate-2, high, and not evaluable in eight, 24, seven, one, and five patients on ATG+CSA, respectively, and eight, 25, five, zero, and five patients on BSC, respectively. Refractory anemia, refractory anemia with ringed sideroblasts, refractory anemia with excess of blasts (RAEB) -I, RAEB-II, and hypoplastic disease were present in 21, six, nine, zero, and nine patients on ATG+CSA, respectively, and 18, eight, 11, two, and four patients on BSC, respectively. By month 6, 13 of 45 patients on ATG+CSA had a hematologic response compared with four of 43 patients on BSC (P = .0156). Two-year transformation-free survival (TFS) rates were 46% (95% CI, 28% to 62%) and 55% (95% CI, 34% to 70%) for ATG+CSA and BSC patients, respectively (P = .730), whereas overall survival (OS) estimates were 49% (95% CI, 31% to 66%) and 63% (95% CI, 42% to 78%), respectively (P = .828).This open-label randomized phase III trial demonstrates that ATG+CSA treatment seems to be associated with hematologic response in a subset of patients without apparent impact on TFS and OS.
IRREVERSIBLE OR HYPERGLYCEMIC INSULIN COMA
Authors: JOSEPH WORTIS, RICHARD H. LAMBERT
Journal: American Journal of Psychiatry (1939)

1. Irreversible or hyperglycemic insulin presents a typical picture consisting of a sustained high blood sugar (following intravenous glucose administration), fever, rapid pulse and respiration and frequently fits, vomiting or diarrhea. It is a serious complication occurring not only in shock treatment but no doubt in the management of diabetes as well. It may result in death or in permanent brain damage, but recovered psychiatric cases often show dramatic improvement in their mental state. 2. Hyperglycemic coma is probably due to over-prolongation of therapeutic coma beyond an hour or an hour and a half. 3. Over-prolongation of coma is often unintentionally allowed, because the presence of gastric retention makes termination by tube feeding ineffective. 4. As a practical consequence coma should generally not be allowed to last more than an hour or an hour and a half, especially in cases that tend to rouse slowly, and sugar should be given by vein in all cases that do not begin to rouse 15 or 20 minutes after tube feeding. 5. Treatment of irreversible coma by intravenous glucose and blood transfusion of 500 cc. of citrated blood appeared effective in three successive cases. 6. It would appear that the whole blood contains substances, other than oxygen or sugar, essential for brain metabolism, which have been destroyed or depleted by protracted coma. 7. The dramatic psychiatric improvement in certain cases following prolonged coma suggests that if a safe method for prolongation of coma could be devised, it would further extend the value of shock treatment.
Cardiomyopathy of the aging human heart. Myocyte loss and reactive cellular hypertrophy.
Authors: G Olivetti, M Melissari, J M Capasso, P Anversa
Journal: Circulation Research (1991)

To determine the effects of aging on the human myocardium, 67 hearts were obtained from individuals who died from causes other than cardiovascular disease. The age interval examined was 17-90 years. Regression analysis demonstrated that the aging process was characterized by a loss of 38 million and 14 million myocyte nuclei/yr in the left and right ventricular myocardium, respectively. This loss in muscle mass was accompanied by a progressive increase in myocyte cell volume per nucleus in both ventricles. Left ventricular myocytes enlarged by 110 microns3/yr, whereas right ventricular myocytes increased by 118 microns3/yr, resulting in a preservation of ventricular wall thickness. However, the cellular hypertrophic response was unable to maintain normal cardiac mass. Left and right ventricular weights decreased by 0.70 and 0.21 g/yr, respectively. In conclusion, loss of cells and enlargement of the remaining myocytes may represent the structural basis for the reduced compensatory capacity of the aged heart and together may contribute to the development of myocardial dysfunction and failure in the elderly.
Exploiting the Cancer Genome: Strategies for the Discovery and Clinical Development of Targeted Molecular Therapeutics
Authors: Timothy A. Yap, Paul Workman
Journal: The Annual Review of Pharmacology and Toxicology (2011)

Our biological understanding of the molecular basis of cancer has benefited from advances in basic research, accelerated recently by cancer genome sequencing and other high-throughput, genome-wide profiling technologies. Given the diverse heterogeneity among tumors, the traditional cytotoxic chemotherapy and one-size-fits-all approaches to cancer discovery and development are not appropriate for molecularly targeted agents. Selection of new drug targets is based on achieving cancer selectivity through exploiting specific dependencies and vulnerabilities predicted from tumor genetics. Discovery of highly target-selective agents is enhanced by integrating multiple modern technologies, particularly structure-based design. Efficient clinical evaluation requires smart, hypothesis-testing studies using validated pharmacodynamic and predictive biomarkers. We discuss and exemplify biomarker-driven clinical development and the concept of the Pharmacologic Audit Trail. We detail the exciting approaches offered by drugging the cancer genome, focusing on blocking oncogene addiction, drugging the oncogenic lipid kinome, addressing nononcogene addiction, exploiting synthetic lethality, and overcoming apoptotic resistance, leading to personalized molecular medicine.
Differential Predictors of Response to Preventive Cognitive Therapy in Recurrent Depression: A 2-Year Prospective Study
Authors: Claudi L.H. Bockting, Philip Spinhoven, Maarten W.J. Koeter, Luuk F. Wouters, Ieke Visser, Aart H. Schene
Journal: Psychotherapy and Psychosomatics (2006)

&lt;i&gt;Background:&lt;/i&gt;Major depressive disorder is a recurrent disease. Brief cognitive therapy (CT), added to either regular care or medication, is helpful in preventing relapse/recurrence. Little is known which type of persons benefit from preventive CT, the so called ‘aptitude treatment interaction’ effect. &lt;i&gt;Method:&lt;/i&gt;The present cohort included exclusively patients with at least two previous episodes remitted on various types of treatments (n = 172). They were assessed within a clinical trial comparing treatment as usual (TAU) with preventive CT added to TAU. Differential demographic, illness-related, psychological and biological risk factors in postponing recurrence by preventive CT were examined. &lt;i&gt;Results:&lt;/i&gt;Significant aptitude-treatment-interaction effects were found for the number of previous episodes, daily hassles and life events, avoidant coping, gender, and morning cortisol levels. Preventive CT seemed ineffective in patients with life events (as more frequently reported by women in our study) and in patients with high episode number characterized by higher levels of avoidant coping. Generic predictors indicate that in CT, as in TAU, patients with more residual depressive symptomatology and higher levels of dysfunctional attitudes profit less from preventive CT. &lt;i&gt;Conclusion:&lt;/i&gt;The finding that preventive CT protects against the influence of a consistently found risk factor of relapse/recurrence, i.e. the number of depressive episodes, underlines the potential of psychological preventive interventions. Preventive CT seemed to be especially effective in reducing presumably internally provoked, relapse/recurrence but may be quite ineffective in reducing externally provoked relapse/recurrence. CT possibly prevents either stress generation or disrupts kindling effects. Kindling effects probably cannot be disrupted in patients with higher levels of avoidant coping who experienced a high number of episodes, and patients who experienced life events.
Atrial Catheter and Lumbar Disk Surgery
Authors: Maurice S. Albin
Journal: JAMA (1978)

<h3>To the Editor.—</h3> We disagree with the opinion of Tarlov (238:253, 1977) that insertion of a right atrial catheter is unnecessary in patients undergoing lumbar disk surgery. It is a common misunderstanding among the medical community that venous air embolism can occur only in the sitting position and that only the large noncollapsible veins and dural sinuses are involved. The entrainment of venous air into the right atrium necessitates a relatively negative gravitational gradient between the incised vessel and the right atrium. Naturally, in the 90° sitting position this gradient is severely enhanced. On the other hand, Shenkin and Goldfedder (210:726, 1969) reported a fatal case of venous air embolism in the prone position where the head was raised only by 10.0 cm above heart level and where 6.0 to 8.0 cm of negative pressure was applied to the expiratory phase of the ventilatory cycle, which further enhanced the gradient.
American Diabetes Association Postgraduate Meetings—2011
Authors: Zachary T. Bloomgarden
Journal: Diabetes Care (2011)

At the American Diabetes Association(ADA) Postgraduate Meetings held 25–26 February 2011 in New York, a discussion of health-care reform and diabetes was opened by Herbert Pardes, chief executive officer of New York-Presbyterian Hospital, who stated that “the focus on health care by the entire country … and the world has never been so great.” His medical center is one of the largest hospital networks in the country, with 2,300 beds and two medical schools, and is the largest private enterprise in New York. He discussed the Naomi Berry Diabetes Center, treating >10,000 diabetic individuals, with one of the largest pediatric diabetes practices in the U.S. At the Weill Cornell Hospital, surgical treatment for diabetes is being studied. Safety programs are being developed in hand washing and in error prevention. Information technology is being expanded, with (as an example) software tools to reduce deep vein thrombosis. More online access to medical records by patients and initiatives such as health information exchanges are being studied to avoid “costly, redundant tests.”

Hospitals around the country are, along with politicians and the general public, focusing on health-care reform because of increasing costs, large numbers of uninsured individuals, and increasing numbers of individuals with chronic diseases, in part because of increasing longevity. Cost-effectiveness is an issue, with the U.S. ranking first in per capita spending but far lower in health outcomes. “A lot of populations,” Pardes said, “are not getting the kind of care that they should.” Health-care reform efforts include measures to increase coverage, eliminate exclusions for preexisting illnesses and “lifetime caps,” allow older dependent children to remain on parents’ plans, and to eliminate costs to patients for annual preventive care. All these concepts are relevant to the treatment of diabetes. Quality has also become an important focus, with proposals that “the provider needs …
TNFα decreases αMHC expression by a NO mediated pathway: role of E-box transcription factors for cardiomyocyte specific gene regulation
Authors: Denise Hilfiker-Kleiner, Andres Hilfiker, Bernhard Schieffer, David Engel, Douglas L Mann, Kai C Wollert, Helmut Drexler
Journal: Cardiovascular Research (2002)

Tumor necrosis factor alpha(TNFalpha) is thought to play a key role in the pathogenesis of cardiac failure. In the myocardium, TNFalpha enhances the expression of inducible nitric oxide synthase (iNOS). Nitric oxide (NO) has been shown to affect beta-agonist-dependent cardiac contractility and relaxation. It is not clear, however, whether TNFalpha mediated NO release has sustained cardiac effects, by altering expression of cardiomyocyte specific genes such as alpha-myosin heavy chain (alphaMHC).Neonatal rat ventricular cardiomyocytes (CM) were stimulated with TNFalpha and/or the NOS inhibitor nitro-L-arginine (L-NNA). Protein binding to the E-box enhancer element in the alphaMHC promoter was evaluated by electrophoretic mobility shift assay (EMSA) and transcriptional activity of the E-box consensus motif was determined by luciferase assay. mRNA levels of the endogenous alphaMHC gene were assessed by RT-PCR. In vivo studies were performed in transgenic mice with cardiac specific over-expression of TNFalpha.CM treated with TNFalpha exhibited decreased levels of alphaMHC transcripts (69 +/- 8% of control), the effect of TNFalpha was reversed by L-NNA (94 +/- 14% of control). As shown by EMSA, TNFalpha reduced protein binding to the alphaMHC E-box enhancer motif via NO dependent pathways. Addition of the NO-donor sodium nitroprusside (SNP) to CM nuclear extracts dose dependently disrupted protein binding to the alphaMHC E-box. Furthermore, exposure of CM to TNFalpha or SNP decreased transcription from an E-box luciferase-reporter construct (TNFalpha: 74 +/- 12%; SNP 250 microM: 72 +/- 10%; SNP 500 microM: 66 +/- 11% of control). In myocardial tissue of TNFalpha transgenic mice, increased nitrotyrosine staining, decreased protein binding to the alphaMHC E-box motif and reduced expression of alphaMHC (62 +/- 26%) were observed.The present study shows that TNFalpha reduces alphaMHC transcript levels in cardiomyocytes. Our data obtained in cultured CM and in TNFalpha transgenic mice support the notion that TNFalpha exerts these effects by NO and E-box dependent mechanisms in vitro and possibly in vivo.