tbuckley/cabot-search huggingface dataset:
Teaching Professionalism in Undergraduate Medical Education
Authors: Herbert M. Swick
Journal: JAMA (1999)

There is a growing consensus among medical educators that to promote the professional development of medical students, schools of medicine should provide explicit learning experiences in professionalism.To determine whether and how schools of medicine were teaching professionalism in the 1998-1999 academic year.A 2-stage survey was sent to 125 US medical schools in the fall of 1998. A total of 116 (92.3%) responded to the first stage of the survey. The second survey led to a qualitative analysis of curriculum materials submitted by 41 schools.Presence or absence of learning experiences (didactic or experiential) in undergraduate medical curriculum explicitly intended to promote professionalism in medical students, with curriculum evaluation based on 4 attributes commonly recognized as essential to professionalism: subordination of one's self-interests, adherence to high ethical and moral standards, response to societal needs, and demonstration of evincible core humanistic values.Of the 116 responding medical schools, 104 (89.7%) reported that they offer some formal instruction related to professionalism. Fewer schools have explicit methods for assessing professional behaviors (n = 64 [55.2%]) or conduct targeted faculty development programs (n = 39 [33.6%]). Schools use diverse strategies to promote professionalism, ranging from an isolated white-coat ceremony or other orientation experience (n = 71 [78.9%]) to an integrated sequence of courses over multiple years of the curriculum (n = 25 [27.8%]). Of the 41 schools that provided curriculum materials, 27 (65.9%) addressed subordinating self-interests; 31 (75.6%), adhering to high ethical and moral standards; 17 (41.5%), responding to societal needs; and 22 (53.7%), evincing core humanistic values.Our results suggest that the teaching of professionalism in undergraduate medical education varies widely. Although most medical schools in the United States now address this important topic in some manner, the strategies used to teach professionalism may not always be adequate.
HIGH SENSITIVITY TROPONIN HAS NO DIAGNOSTIC VALUE FOR MYOCARDIAL INFARCTION IN STAGE IV-V OF RENAL INSUFFICIENCY
Authors: Luigi M. Biasucci, Massimo Gustapane, Gina Biasillo, Maria Teresa Cardillo, Maria Giulia Marini, Chiara Sonnino, Francesco Franceschi, Martina Zaninotto, Mario Plebani, Filippo Crea
Journal: Journal of the American College of Cardiology (2014)
DNA Synthesizing Cells in Rabbit Heart Tissue After Cholesterol Feeding
Authors: Sanford C. Spraragen, Victor P. Bond, Lewis K. Dahl
Journal: Circulation Research (1962)

Suggestive evidence that cholesterol feeding may increase the number of thymidine-H 3 labeled cells in the heart tissues of rabbits was presented. This increment appeared to be primarily restricted to the interstitial cells and was not related to associated degenerative, necrotic, or inflammatory changes. Evidence of DNA synthesis was also found in capillary endothelial cells and, rarely, in what were considered to be myocardial muscle cells.
Value and limitations of transesophageal echocardiography in assessment of mitral valve prostheses.
Authors: B K Khandheria, J B Seward, J K Oh, W K Freeman, B A Nichols, L J Sinak, F A Miller, A J Tajik
Journal: Circulation (1991)

Transthoracic Doppler echocardiography examination has become an integral part of the investigations performed in patients with mitral valve prostheses. The limitations of the transthoracic approach are well documented. Transesophageal echocardiography provides a unique window for achieving a clear view of the mitral prosthesis.This study shows the usefulness of transesophageal echocardiography in clinical practice for assessment of patients with a mitral valve prosthesis. This technique demonstrated an abnormality in 48% of patients who had normal results on transthoracic examination. The overall sensitivity of transesophageal echocardiography was 96%.Transesophageal echocardiography constitutes an essential part of a comprehensive two-dimensional/Doppler echocardiographic examination in patients with suspected malfunction of mitral prostheses.
Comparison of fibreoptic endoscopy in acute upper gastrointestinal haemorrhage in Africans and Europeans.
Authors: A C Wicks, G E Thomas, D J Clain
Journal: BMJ (1975)

The results of endoscopy in acute upper gastrointestinal haemorrhage were compared in a group of 138 Africans and one of 84 Europeans. Contrary to widely held clinical opinion, the incidence of gastric and duodenal ulceration was similar in the two races. Peptic ulcers were the main source of bleeding in both groups and were surprisingly more common than varices in the Africans. Bleeding from varices, however, was far more common in the Africans than in the Europeans. Stomal ulcers were confined to Europeans. Gastric erosions, often attributed to herbal medicines, were more common in the Africans but the difference was not significant. The study was not designed to determine reduced mortality since the introduction of endoscopy, but management, especially in the Africans, was aided by early recognition of haemorrhage from oesophageal varices and acute gastric erosions.
Mucormycotic Infection of Arteriosclerotic Thrombus of the Abdominal Aorta
Authors: Robert Fienberg, Thomas S. Risley
Journal: New England Journal of Medicine (1959)

THE importance of mucormycosis as a clinical entity is becoming more and more evident as indicated by the increasing number of cases in the literature. The case reported below is submitted because of the uniqueness of the localization, no similar localization having been found in the literature. Furthermore, the progress in vascular surgery that has led to increased use of thrombendarterectomy and segmental aortic resection, with prosthetic replacement, suggests the need of focusing attention on this type of mycotic infection, with its ominous prognosis.Case ReportA 45-year-old housewife was admitted to the Beverly Hospital 2 weeks after the onset . . .
Alteration of hypothalamic cellular dynamics in obesity
Authors: Edward B. Lee, Rexford S. Ahima
Journal: Journal of Clinical Investigation (2011)

The number of people who suffer from obesity and one or more of its adverse complications is rapidly increasing. It is becoming clear that diet, exercise, and other lifestyle modifications are insufficient strategies to combat this growing problem. Greater understanding of the mechanisms controlling our desire to feed and our ability to balance energy intake with energy expenditure are key to the development of pharmacological approaches for treating obesity. Although great strides have been made in our understanding of how the hypothalamus regulates feeding and energy balance, much less is known about how obesity affects the structure of the hypothalamus. The authors of two papers in this issue of the JCI have addressed this issue by examining the effects of obesity on neurons and glia in the hypothalamus. These studies reveal that obesity may be in part due to hypothalamic injury, which leads to inflammation and reduced neurogenesis. These findings support the notion that obesity is a disease that affects multiple organs, including the brain, and that disruption of normal brain function leads to abnormal regulation of peripheral metabolism.
Dynamic Control of Synaptic Vesicle Replenishment and Short-Term Plasticity by Ca2+-Calmodulin-Munc13-1 Signaling
Authors: Noa Lipstein, Takeshi Sakaba, Benjamin H. Cooper, Kun-Han Lin, Nicola Strenzke, Uri Ashery, Jeong-Seop Rhee, Holger Taschenberger, Erwin Neher, Nils Brose
Journal: Neuron (2013)
Changes in the Expression of Somatostatin Receptor Imaging Following Y-90 Lanreotide Therapy for Carcinoid Tumor: A Flare Response?
Authors: Silvija Popadic, Adil Al-Nahhas, Qais Naili, Jonathan Todd, Karim Meeran
Journal: Clinical Nuclear Medicine (2005)

A 53-year-old man with In-111 octreotide-positive metastatic hepatic carcinoid was referred for Y-90 lanreotide therapy. A diagnostic In-111 lanreotide scan, performed to assess suitability for therapy, showed less uptake in lesions compared with In-111 octreotide. After 3 therapy doses of Y-90 lanreotide, a repeat In-111 lanreotide scan showed intense uptake in old lesions, appearance of new lesions, and uptake in the spleen. This was associated with improvement in flushing and regression of liver size. Computed tomography scan showed stable disease. Increased expression of somatostatin receptors has been observed with In-111 octreotide but not with In-111 lanreotide. If this is a flare response, then pretreatment with “cold” lanreotide may be beneficial before Y-90 lanreotide therapy.
The Changing Face of Teenage Drug Abuse — The Trend toward Prescription Drugs
Authors: Richard A. Friedman
Journal: New England Journal of Medicine (2006)

When Eric, an 18-year-old who lives in San Francisco, wants to get some Vicodin (hydrocodone–acetaminophen), it's a simple matter. "I can get prescription drugs from different places and don't ever have to see a doctor," he explained. "I have friends whose parents are pill addicts, and we `borrow' from them. Other times I have friends who have ailments who get lots of pills and sell them for cheap. As long as prescription pills are taken right, they're much safer than street drugs."Eric's habits reflect an emerging pattern in drug use by teenagers: illicit street drugs such as "ecstasy" (3,4-methylenedioxymethamphetamine) . . .
The immunopathology of herpes gestationis. Immunofluorescence studies and characterization of "HG factor".
Authors: R E Jordon, K G Heine, G Tappeiner, L L Bushkell, T T Provost
Journal: Journal of Clinical Investigation (1976)

Nine skin biopsies from seven herpes gestationis patients were studied by immunofluorescence (IF) techniques. Basement membrane zone (BMZ) deposition of C3 and properdin was present in all nine skin specimens, while IgG deposition was apparent in only one. With in vitro C3 IF staining, positive BMZ staining (HG factor activity) was noted with all seven of our patients' serum samples tested. By standard indirect IF staining, however, only one of these serum samples contained BMZ antibodies of the IgG type. Two cord serum samples, tested by these same methods, yielded positive in vitro C3 staining (HG factor activity) but negative indirect IF staining (IgG). HG factor activity was found to be stable at 56 degrees C for 30 min and in two of three specimens at 56 degrees C for 1 h. Treatment of the complement source (normal human serum) used in the in vitro C3 staining assay with Mg2-EGTA or use of C2-deficient serum as the complement source inhibited HG factor activity. HG factor blocked the specific staining of the BMZ of normal human skin by labeled bullous pemphigoid antibodies. By sucrose density gradient ultracentrifugation and gel chromatography (Sephadex G-200), HG factor activity eluted with IgG-containing fractions. The highly purified IgG fraction of two herpes gestationis sera was also positive for HG factor activity. Our studies suggest that HG factor is an IgG antibody that may not be demonstrable by conventional IF methods, but which activates the classical complement pathway.
Mortality Rates for Medicare Beneficiaries Admitted to Critical Access and Non–Critical Access Hospitals, 2002-2010
Authors: Karen E. Joynt, E. John Orav, Ashish K. Jha
Journal: JAMA (2013)

Critical access hospitals (CAHs) provide inpatient care to Americans living in rural communities. These hospitals are at high risk of falling behind with respect to quality improvement, owing to their limited resources and vulnerable patient populations. How they have fared on patient outcomes during the past decade is unknown.To evaluate trends in mortality for patients receiving care at CAHs and compare these trends with those for patients receiving care at non-CAHs.Retrospective observational study using data from Medicare fee-for-service patients admitted to US acute care hospitals with acute myocardial infarction (1,902,586 admissions), congestive heart failure (4,488,269 admissions), and pneumonia (3,891,074 admissions) between 2002 and 2010.Trends in risk-adjusted 30-day mortality rates for CAHs and other acute care US hospitals.Accounting for differences in patient, hospital, and community characteristics, CAHs had mortality rates comparable with those of non-CAHs in 2002 (composite mortality across all 3 conditions, 12.8% vs 13.0%; difference, -0.3% [95% CI, -0.7% to 0.2%]; P = .25). Between 2002 and 2010, mortality rates increased 0.1% per year in CAHs but decreased 0.2% per year in non-CAHs, for an annual difference in change of 0.3% (95% CI, 0.2% to 0.3%; P < .001). Thus, by 2010, CAHs had higher mortality rates compared with non-CAHs (13.3% vs 11.4%; difference, 1.8% [95% CI, 1.4% to 2.2%]; P < .001). The patterns were similar when each individual condition was examined separately. Comparing CAHs with other small, rural hospitals, similar patterns were found.Among Medicare beneficiaries with acute myocardial infarction, congestive heart failure, or pneumonia, 30-day mortality rates for those admitted to CAHs, compared with those admitted to other acute care hospitals, increased from 2002 to 2010. New efforts may be needed to help CAHs improve.
1065 IMPACT OF SCREENING FOR HEPATOCELLULAR CARCINOMA (HCC) IN HIV/HCV-COINFECTED PATIENTS ON STAGING, THERAPY AND SURVIVAL
Authors: L. Kikuchi, M. Núñnez, P. Barreiro, M. Nelson, M.E. Vispo, E. Page, M. Puoti, R. Fox, M. Sherman, F. Carrilho, N. Bräu
Journal: Journal of Hepatology (2010)
RESULTS OF THE WORK OF THE COMMISSION ON MEDICAL EDUCATION
Authors: SAMUEL P. CAPEN
Journal: JAMA (1933)

Educational reforms can be brought about in a number of different ways. One way is by decree. That way is quick and relatively easy, provided agencies exist to issue and enforce the decree. Up to twenty-five years ago, reform by decree had not been tried very extensively in America. The machinery for it was lacking. The federal government exercised no authority over education, and, except in a single state, no comprehensive scheme of state control had been developed. Indeed, the state's obligation to protect the public against malpractice in those professions that deal with health and property had only just been begun to be taken seriously. In attempting to afford this protection, however, the state concerned itself solely with the individual practitioner and not with the school that trained him. Then suddenly, just about twenty-five years ago, the possibility of effecting educational reform by decree, even in the absence of
Comparison Between Left Ventricular Electromechanical Mapping and Radionuclide Perfusion Imaging for Detection of Myocardial Viability
Authors: Ran Kornowski, Mun K. Hong, Martin B. Leon
Journal: Circulation (1998)

Background —A novel 3-dimensional left ventricular (LV) mapping system uses low-intensity magnetic field energy to determine the location of sensor-tipped electrode catheters within the LV. Using this system, we sought to distinguish between infarcted, ischemic, and normal myocardium by comparing LV electromechanical mapping data with myocardial perfusion imaging studies. Methods and Results —Unipolar voltage potentials and local endocardial shortening (LS) were measured in 18 patients (mean age, 58±12 years) with symptomatic chronic angina having reversible and/or fixed myocardial perfusion defects on single photon emission computed tomography imaging studies using 201 Tl at rest and 99m Tc-sestamibi after adenosine stress. Overall, a significant difference in voltage potentials and LS values was found between groups ( P &lt;0.001 for each comparison by ANOVA). The average voltage potentials (14.0±2.0 mV) and LS values (12.5±2.8%) were highest when measured in myocardial segments (n=56) with normal perfusion and lowest (7.5±3.4 mV and 3.4±3.4%) when measured in myocardial segments with fixed perfusion defects (n=20) ( P &lt;0.0001). Myocardial segments with reversible perfusion defects (n=66) had intermediate voltage amplitudes (12.0±2.8 mV, P =0.048 versus normal and P =0.005 versus fixed segments) and LS values (10.3±3.7%, P =0.067 versus normal and P =0.001 versus fixed segments). Conclusions —In patients with myocardial ischemia, LV mapping, compared with myocardial perfusion imaging, shows (1) mild reduction of endocardial voltage potentials and LS in segments with reversible perfusion defects and (2) profound electromechanical impairment in segments with fixed perfusion defects. Thus, such an LV mapping procedure may allow the detection on-line of myocardial viability in the catheterization laboratory.
Pigmentation in Megaloblastic Anaemia Associated with Pregnancy and Lactation
Authors: N. Baumslag, J. Metz
Journal: BMJ (1969)

Generalized skin pigmentation in five African women with megaloblastic anaemia in the postnatal period was associated with low serum folate levels, as distinct from vitamin B(12) deficiency. It is suggested that the occurrence of pigmentation in both folate and vitamin B(12) deficiency may reflect a common abnormality of metabolism.
Government leaves science advice to last minute in emergencies, find MPs
Authors: M. Limb
Journal: BMJ (2011)

A cross party group of MPs has criticised the government’s preparedness for dealing with emergencies, saying that it is not good enough that scientific advice is often only sought after events have struck

The House of Commons Science and Technology Committee’s report Scientific Advice and Evidence in Emergencies says that although science is used effectively to inform responses in emergencies, it is seriously concerned about the detachment of the government chief scientific adviser from preparing the National Risk Assessment—an unpublished document of risks facing the UK over the next five years.

Scientific evidence should inform all stages of the risk assessment, say MPs. But this does not seem to be happening. The fact that the transport secretary announced in December 2010 that the chief scientific adviser should look …
Effects of lung inflation on blood flow during cardiopulmonary resuscitation in the canine isolated heart-lung preparation.
Authors: M J Hausknecht, R A Wise, R G Brower, C Hassapoyannes, M L Weisfeldt, J Suzuki, S Permutt
Journal: Circulation Research (1986)

Using an isolated, fibrillated canine heart-lung preparation, we studied the effects of simultaneous lung inflation and chest compression on blood flow in a model of cardiopulmonary resuscitation. The heart and lungs were placed in an artificial thorax with the great vessels and trachea exteriorized and attached to an artificial perfusion circuit and respirator, respectively. The blood volume of the system was adjusted to obtain various levels of static equilibrium pressure. Blood flow was obtained by cyclically raising and lowering the pressure in the artificial thorax, simulating the changes in pleural pressure that occur during cardiopulmonary resuscitation. Lung inflation during the compression phase caused an increase in cardiopulmonary resuscitation blood flow when the change in pleural pressure was small and when static equilibrium pressure was high. In contrast, lung inflation caused a decrease in blood flow when changes in pleural pressure were high and when blood volume was low. These results suggest that the driving pressure for blood flow during chest compression may be increased by lung inflation when the pulmonary blood vessels are filled with blood. However, blood may become trapped in the right heart and unavailable for transfer to the periphery during chest compression if lung inflation causes the alveolar blood vessels to collapse.
Precautions, Skills Key for Child Sedation
Authors: Bridget M. Kuehn
Journal: JAMA (2007)

be reused. Once there, the device is sterilized and tested at the hospital where the operation will take place. Patients receiving the device are also not charged for the surgery, hospital stay, or follow-up care. Heart Too Heart doesn’t buy or sell the used devices. After a device is implanted, he writes to the donor’s next of kin “thanking them for the pacemaker and letting them know it’s been put to the best possible medical use.” HeartTooHeart’seffortsaside,thepracticeofmakingusedcardiacdevicesavailable to individuals in developing countriesisapparentlynotwidespread,despite thepreferencesofsurveyedmorticiansand patients for explanting such devices for reuse inotherpatients.DevicemanufacturerMedtronic Inc (Minneapolis), says thecompanydoesnotsupport thereprocessingorreuseof its implantablecardiac devices,sayingsuchpracticeshavethepotential to introduceunacceptable risks to patients safety and quality medical care. AspokeswomanfortheUSFoodandDrug Administration (FDA) said the agency does not recommend the practice of exporting used cardiac devices. However, she added, the sending of such a device outside the country does not need FDA approval provided the importing country allows it and the device is not resold back to the United States.
Guide to Diagnostic Imaging
Authors: John R. Amberg
Journal: JAMA (1984)

These monographs are the combined efforts of two gastroenterologists and a radiologist. The stated purpose is to acquaint the physician with the numerous diagnostic modalities available and offer guidance to their use. This goal is accomplished, and, in addition, anatomy, pathophysiology, clinical presentation, and laboratory findings are included. The end result is a compact review of the diseases of these organs, with a slight emphasis on diagnostic imaging. The writing is unusually clear and succinct. The illustrations are clear and adequate. The text and bibliography are current. The single adverse criticism is that some of the diagnostic techniques, such as intravenous cholangiography and hypotonic duodenography, are not properly downgraded as to their need and efficacy in current clinical practice. Any physician who wishes to review the current status of diseases of these organs and their diagnosis will find these volumes time effective.
The County Corner and The Post Office Step
Authors: G. G. Liddle
Journal: JAMA (1966)

<h3>To the Editor:—</h3> As a reader of your lusty journal, I discovered that lately a retired physician died of a heart attack; not unusual, to be sure, but his obituary reads, "for many years a county corner." "No doubt he lived an open and sunny life," said a colleague. This tasteless effort at jest brought to memory my schoolboy hero, Jimmy Wilson. Jimmy enjoyed a large career as a post office step. On graduating from high school, he established riparian rights to the southern exposure of the more western step. He arrived at work regularly at 10 AM, and spent the day smoking Sweet Caporal cigarettes, occasionally exchanging for the more luxurious Melachrino. Jimmy was the original girl-watcher of the community, and although the Protestants damned him for a moral degenerate, and the Catholics for a heretic, he served a useful purpose as a model for degeneracy, sloth, and general
Employment outside the NHS of doctors registered in the United Kingdom.
Authors: J. P. Nicholl, B. T. Williams
Journal: BMJ (1988)

ratchet.If the opening bar of the cuff is not applied accurately this could result in a blow to the radial styloid, which lies superficially.Sudden compression inside the metal ring may also be a causal mechanism.Though further narrowing of the cuff after application may be prevented by tripping a small spring, this is not always possible in the circumstances of an arrest.The handcuffs may tighten if the detainee continues to struggle, resulting in further compression.We believe that the injuries described were caused by handcuffs and conclude that a claim of pain, weakness, or altered sensation after the detention of a patient in handcuffs should not be dismissed.Con- sideration should also be given to preventing such injuries.