tbuckley/cabot-search huggingface dataset:
Cumulative risks of stent migration and gastrointestinal bleeding in patients with lumen-apposing metal stents
Authors: Francisco Garcia-Alonso, Ramón Sanchez-Ocana, Irene Peñas-Herrero, Ryan Law, Sergio Sevilla-Ribota, Raúl Torres-Yuste, Paula Gil-Simón, Carlos de la Serna Higuera, Manuel Perez-Miranda
Journal: Endoscopy (2018)

Abstract Background: Delayed gastrointestinal (GI) bleeding and stent migration are known adverse events which may occur following placement of lumen-apposing metal stents (LAMSs). Methods: All consecutive patients who underwent LAMS placement between May 2011 and June 2017 at a single tertiary medical center were included. Demographics and procedural details were prospectively collected. Post-procedure follow-up and outcome measures were retrospectively collected. The cumulative risks of migration and LAMS-related GI bleeding were estimated using the life-table method. Risk predictors were assessed using Cox proportional hazards models. Results: We analyzed 250 patients (64.8 % men; median age 71.6 [interquartile range (IQR) 57.9 – 83.6]). Median follow-up was 78.5 days (IQR 31 – 246.5 days). Thirty-four stent migrations (13.6 %) occurred (5 symptomatic). On multivariable analysis, associations with migration included nasocystic drains (hazard ratio [HR] 6.5, 95 % confidence interval [CI] 2.2 – 19.3), pancreatic fluid collections (PFCs; HR 4.2, 95 %CI 1.8 – 10.1), and double-pigtail stents (HR 2.4, 95 %CI 1.2 – 4.9). Migration risk at 12 months was 25.5 % (95 %CI 17.9 % – 35.7 %) and was higher for PFCs 48.9 % (33.4 % – 66.9 %) than other indications 8.4 % (4.9 % – 17.5 %; P &lt; 0.001). LAMSs placed for longer durations (i. e. enteral anastomoses, biliary and gallbladder drainage) presented an 8.4 % cumulative risk at 2 years. There were 13 LAMS-related GI hemorrhages (5.2 %), two of them fatal, presenting a median of 3 days (IQR 1 – 9 days) after deployment. The cumulative risk of bleeding at 12 months was 6.9 % (3.6 % – 12.7 %). Conclusions: LAMS migration occurs in 1 out of 7 cases and is most common when treating PFCs. Bleeding related to LAMS placement occurs much less commonly but can be life-threatening.
False-Positive Uptake of 131I Due to Tubal Ligation in a Patient With Papillary Thyroid Cancer
Authors: Junyu Tong, Yuchen Jin, Min Liu, Zhongwei Lv, Libo Chen
Journal: Clinical Nuclear Medicine (2018)

Abstract A 39-year-old woman with papillary thyroid cancer underwent 131 I therapy after thyroidectomy. Posttherapeutic 131 I whole-body scan accidentally showed symmetric “hot spots” in the pelvic region beyond known bone metastases. SPECT/CT was immediately added and revealed metal artifacts with 131 I accumulation in the nearby uterus. Further inquiry discovered that she underwent tubal ligation 19 years ago. Our case demonstrates that 131 I accumulation can occur at the site of oviducts many years after tubal ligation, which should be distinguished from 131 I-avid metastases.
Government approves plan to allow fitness to practise panels to recoup costs from doctors
Authors: Abi Rimmer
Journal: BMJ (2015)

The government has approved plans to allow the Medical Practitioners Tribunal Service (MPTS) to recoup costs from doctors.

The Department of Health for England has published its report on the responses to its consultation on changes to how the General Medical Council and the Professional Standards Authority work.1 As part of the response the government said that it had approved plans that would allow the MPTS to recoup costs from doctors who had failed to follow its rules or who demonstrated unreasonable behaviour.2 The MPTS will also become a statutory committee of the …
Single nucleotide polymorphisms of mir-608, LCS-6, and overall survival in the MAGIC trial.
Authors: Elizabeth Catherine Smyth, Kyriakos Kouvelakis, David Cunningham, Clare Peckitt, Matthew Guy Nankivell, William H. Allum, Andrew Wotherspoon, Jens Hahne, Andrea Lampis, Ruth E. Langley, Nicola Valeri
Journal: Journal of Clinical Oncology (2018)

58 Background: Single nucleotide polymorphisms (SNPs) in mir-608 (rs4919510) are prognostic in colorectal cancer (CRC) and hepatocellular cancer. SNPs of the let-7 complementary site 6 (LCS-6) 3'-untranslated region of KRAS (rs61764370) are associated with prognosis in CRC and platinum sensitivity in head and neck cancer. We investigated the prognostic effects of these SNPs in patients treated with surgery and with perioperative epirubicin, cisplatin and 5-fluorouracil chemotherapy plus surgery in the MRC MAGIC trial. Methods: DNA was extracted from tumour tissue using the QIAamp DNA FFPE Tissue Kit (Qiagen, Hilden, Germany). Samples were genotyped using the Taqman assay (Life Technologies, Carlsbad, CA) for rs4919510 in mir-608 and rs61764370 in LCS-6. SNP status was assessed for association with patient characteristics and survival. Results: 305 patients (of 456 operated) had mir-608 and/or LCS-6 results available. SNPs mir-608 and LCS-6 were in Hardy-Weinberg equilibrium. Pathological tumour regression grading was not different for any SNP genotype. No genotype was statistically significantly associated with overall survival in either surgery arm or chemotherapy plus surgery arm of the trial (Table). Conclusions: Germline polymorphisms in mir-608 and LCS-6 showed no evidence of a prognostic effect in patients with gastric and gastroesophageal cancer treated with surgery or chemotherapy plus surgery in the MAGIC trial. However, the small number of patients with selected genotypes means that these analyses may be underpowered to detect survival differences. [Table: see text]
Utilizing NT-proBNP for Eligibility and Enrichment in Trials in HFpEF, HFmrEF, and HFrEF
Authors: Gianluigi Savarese, Nicola Orsini, Camilla Hage, Ola Vedin, Francesco Cosentino, Giuseppe M.C. Rosano, Ulf Dahlström, Lars H. Lund
Journal: JACC Heart Failure (2018)
Statin Denial: An Internet-Driven Cult With Deadly Consequences
Authors: Dena S. Davis
Journal: Annals of Internal Medicine (2018)

Letters6 March 2018Statin Denial: An Internet-Driven Cult With Deadly ConsequencesDena S. Davis, JD, PhDDena S. Davis, JD, PhDLehigh University, Bethlehem, Pennsylvania (D.S.D.)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0625 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Nissen argues that not continuing a statin after an adverse event is unreasonable behavior, equivalent to membership in “a statin denial cult” (1). This analysis fails to take into account some implications of what we might call the public health paradox. From an aggregate perspective, Nissen is right: Statins are effective at decreasing the risk for cardiovascular events in certain populations. However, from the perspective of the individual health care consumer, things look very different.Taking any medication involves a certain amount of inconvenience and expense. Now add an adverse event, which the consumer attributes (rightly or ...Reference1. Nissen SE. Statin denial: an Internet-driven cult with deadly consequences [Editorial]. Ann Intern Med. 2017;167:281-2. [PMID: 28738422]. doi:10.7326/M17-1566 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Lehigh University, Bethlehem, Pennsylvania (D.S.D.)Disclosures: The author has disclosed no conflicts of interest. The form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L17-0625. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoStatin Denial: An Internet-Driven Cult With Deadly Consequences Steven E. Nissen Statin Denial: An Internet-Driven Cult With Deadly Consequences Steven E. Nissen Statin Denial: An Internet-Driven Cult With Deadly Consequences Andrew Bamji Metrics 6 March 2018Volume 168, Issue 5Page: 382KeywordsAdverse eventsBehaviorConflicts of interestDisclosureDrugsHealth carePopulation statisticsPrevention, policy, and public healthStatins ePublished: 6 March 2018 Issue Published: 6 March 2018 Copyright & PermissionsCopyright © 2018 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
因“无效”而从依那西普临床试验中“退出”的银屑病患者的时间、PASI和DLQI--十项临床试验的汇总分析
Authors: A. Nast, M. Dilleen, W. Liyanage, L. Aikman, P. Szczypa, C. Dressler
Journal: British Journal of Dermatology (2018)

银屑病是一种常见的皮肤病,而临床试验则用于衡量不同的治疗对银屑病的具体功效如何。在此类试验中,研究人员一般会利用特定的方法来衡量患者症状的改善和生活质量的提升情况,其中包括银屑病面积和严重程度指数(PASI,分数越低,病情就越严重)、医生全面评估指标(PGA)和皮肤病生活质量指数(DLQI)。如果一项治疗到特定的时间点上还未有效,则可能会增加患者不满并退出临床研究的可能性。在此项研究中,研究人员查看了涉及一种名为依那西普的银屑病药物的临床试验,以深入了解因“无效”而退出试验的患者(常见做法)数量以及这种做法与他们的PASI和DLQI之间的关系。在参与此项研究的共6119名患者中,有128名患者因“无效”而退出了试验。患者退出的高峰出现在第75天和85天之间。退出患者最低的PASI分数为6.3(在120天内)。PASI得分大于等于75分的退出患者非常罕见。作者总结道,80天左右是一个关键时间,届时许多患者可能渐渐失去了等待依那西普产生更好疗效的意愿。大部分退出试验的患者的银屑病病情几乎或根本没有改善,甚至出现了恶化。
Hematocrit-corrected Pulmonary Vascular Resistance
Authors: Rebecca R. Vanderpool, Robert Naeije
Journal: American Journal of Respiratory and Critical Care Medicine (2018)

The diagnosis and evaluation of severity of pulmonary vascular disease rests on the invasive determination of a pulmonary vascular resistance (PVR). It is often overlooked that PVR is linearly related to the viscosity of the blood, which in turn is curvilinearly related to hematocrit. We propose a correction diagram for patients with anemia or with polycythemia. Based on a distensibility model of the pulmonary circulation, we show that magnitude of hematocrit correction of PVR is increased in proportion to pulmonary artery wedge pressure (PAWP) and the measured levels of PVR or hematocrit, and decreased in case of preserved resistive vessel distensibility and absence of pulmonary hypertension. We also demonstrate that hematocrit correction of PVR is independent of the absolute levels of pulmonary artery pressure or cardiac output. A PVR of 1.5 Wood units (WU) at a hematocrit of 20 % and a high-normal PAWP becomes 4.1 WU at a hematocrit of 45 % and 10.8 WU at a hematocrit of 80 %. A review of reported hemo...
DRUG REACTIONS XXI.
Authors: John Almeyda, Ashley Levantine
Journal: British Journal of Dermatology (1973)

Journal Article DRUG REACTIONS XXI: Cutaneous Reactions to Cardiovascular Drugs Get access John Almeyda, John Almeyda The Enfield Group of Hospitals Search for other works by this author on: Oxford Academic Google Scholar Ashley Levantine Ashley Levantine The Mliddlesex Hospital, London, W.I Search for other works by this author on: Oxford Academic Google Scholar British Journal of Dermatology, Volume 88, Issue 3, 1 March 1973, Pages 313–319, https://doi.org/10.1111/j.1365-2133.1973.tb07558.x Published: 01 March 1973
Abstract 15646: Role of SDF-1/CXCR4 Axis in Diabetic Cardiomyopathy
Authors: Maritza Mayorga, Matthew Kiedrowski, Marc Penn, Feng Dong
Journal: Circulation (2016)

Introduction: Diabetes is associated with a defect in stem cell homing due to blunted SDF-1 signaling. We investigated the role of the SDF-1:CXCR4 axis in diabetic cardiomyopathy (DCM). Hypothesis:...
STIMULATION OF COLLATERAL VESSEL GROWTH BY INHIBITION OF GALECTIN-2 IN MICE USING A SINGLE-DOMAIN LLAMA-DERIVED ANTIBODY
Authors: Maurits Hollander, Matthijs Jansen, Tineke Van der Pouw-Kraan, Edward Dolk, Paul Knaapen, Anton Horrevoets, Esther Lutgens, Niels Van Royen
Journal: Journal of the American College of Cardiology (2018)
The rat in the residence
Authors: Nicola Sharp
Journal: BMJ (2004)

⇓



“It's all right, it's dead,” said Douglas.

Janet stood on a chair in the middle of Douglas's room and screamed. “Eeeeeeeh.”

“I said you can get down. It's dead.”

Janet stayed on the chair. “I will not spend another night in this residence.”

“We'll make a complaint. The hospital will sort it out.”

“This hospital never sorts anything out. Besides, I can't sleep in a bed with a dead rat underneath it.”

“I'll put the rat in the bin before we go to bed tonight.”

“And what about Ratty's friends and relations?”

“You're getting carried away now.”

“Douglas, I cannot live here any longer. If you want us to be together then you will have to find us somewhere else to live.”

“You'll feel better tonight.”

“Twelve hours in casualty will not make me feel better. Go and find us somewhere else to live now.”

“But it's Sunday. What can I do on a Sunday?”

\* * *|

“I've not got many friends,” said David Millstone. He put down his beer glass.

“Nor me,” said James Fatterley. “Let's have another pint.”

“I need some advice,” said David.

“You're the psychiatrist,” said James.

“It's Martha,” said David. “Now that we know she's not going …
Erratum. Impact of Lifestyle and Metformin Interventions on the Risk of Progression to Diabetes and Regression to Normal Glucose Regulation in Overweight or Obese People With Impaired Glucose Regulation. Diabetes Care 2017;40:1668–1677
Authors: William H. Herman, Qing Pan, Sharon L. Edelstein, Kieren J. Mather, Leigh Perreault, Elizabeth Barrett-Connor, Dana M. Dabelea, Edward Horton, Steven E. Kahn, William C. Knowler, Carlos Lorenzo, Xavier Pi-Sunyer, Elizabeth Venditti, Wen Ye
Journal: Diabetes Care (2018)

In the article cited above, Fig. 3 was updated: the number 5 in the x-axis of panels A and B were deleted.Also, two consecutive sentences on page 1675 were revised to read: . . .NGR was greatest in the quartile at lowest risk of progressing to DM (35 vs. 17% and difference of 18%).In those at highest risk of progressing to DM, the corresponding rates were 24 and 11% (difference of 13%).
GMC is an “effective regulator,” independent review concludes
Authors: Caroline White
Journal: BMJ (2013)

The General Medical Council has met all the standards required of good professional regulation over the past year, its annual performance check-up shows. The regulator has also won praise for its new fitness to practise procedures and revalidation scheme.

The GMC was one of nine health and social care professional regulators in England to be scrutinised by the overarching regulator, the Professional Standards Authority (formerly the Council for Health and Regulatory Excellence), on how well it has protected the public and promoted confidence in its practitioners over the …
What are the implications of withdrawing from an SHO post after accepting it?
Authors: Trevor Pickersgill
Journal: BMJ (2006)

Have a career or related problem that needs answering? Can9t find the right person to point you in the right direction? Log on to the Advice Zone for reliable medical careers advice. You can post a question or see if one of our 300 advisers has already answered a similar question. Here is a selection of questions and answers posted on the site. <b>www.bmjcareers.com/advicezone</b>
PERFORMANCE OF HIGH-SENSITIVITY TROPONINS IN THE EXCLUSION OF ACUTE CORONARY SYNDROME IN PATIENTS WITH CHEST PAIN IN THE EMERGENCY DEPARTMENT
Authors: Hong Jie Gabriel Tan, Swee Han Lim, Terrance Chua, Aaron Wong, Anders Olof Sahlen, Su-Mei Angela Koh, Khung Keong Yeo, Natalie Koh, Weiting Huang, Calvin Chin, Fei Gao, Faraz Zarisfi, Eng Hock Marcus Ong, Sohil Equbal Pothiawala, Yuzeng Shen, Jing Jing Chan, Paul Weng Wan, Chin Pin Yeo, Wai Yoong Ng, Jack Tan
Journal: Journal of the American College of Cardiology (2018)
I have MRCOG (membership of the Royal College of Obstetricians and Gynaecologists) Part 1 and DRCOG (diploma of the Royal College of Obstetricians and Gynaecologists). I have some years' experience in obstetrics and gynaecology, and I now want to switch to general practice. I'm in Ireland. Can you advise me?
Authors: Judith Harvey
Journal: BMJ (2006)

Have a career or related problem that needs answering? Can9t find the right person to point you in the right direction? Log on to the Advice Zone for reliable medical careers advice. You can post a question or see if one of our 300 advisers has already answered a similar question. Here is a selection of questions and answers posted on the site. <b>www.bmjcareers.com/advicezone</b>
EPH receptor signaling as a novel therapeutic target in NF2-deficient meningioma
Authors: Steven P Angus, Janet L Oblinger, Timothy J Stuhlmiller, Patrick A DeSouza, Roberta L Beauchamp, Luke Witt, Xin Chen, Justin T Jordan, Thomas S K Gilbert, Anat Stemmer-Rachamimov, James F Gusella, Scott R Plotkin, Stephen J Haggarty, Long-Sheng Chang, Gary L Johnson, Vijaya Ramesh, Annette Bakker, Salvatore La Rosa, Wade Clapp, Jaishri Blakeley, Helen Morrison, Bradley Welling, James Gusella, Stephen Haggarty, Scott Plotkin, Vijaya Ramesh, Anat Stemmer-Rachamimov, Long-Sheng Chang, Robert Allaway, Abhishek Pratap, Justin Guinney, Sage Bionetworks, Cristina Fernandez-Valle, Gary Johnson
Journal: Neuro-Oncology (2018)

Meningiomas are the most common primary brain tumor in adults, and somatic loss of the neurofibromatosis 2 (NF2) tumor suppressor gene is a frequent genetic event. There is no effective treatment for tumors that recur or continue to grow despite surgery and/or radiation. Therefore, targeted therapies that either delay tumor progression or cause tumor shrinkage are much needed. Our earlier work established mammalian target of rapamycin complex mTORC1/mTORC2 activation in NF2-deficient meningiomas. High-throughput kinome analyses were performed in NF2-null human arachnoidal and meningioma cell lines to identify functional kinome changes upon NF2 loss. Immunoblotting confirmed the activation of kinases and demonstrated effectiveness of drugs to block the activation. Drugs, singly and in combination, were screened in cells for their growth inhibitory activity. Antitumor drug efficacy was tested in an orthotopic meningioma model. Erythropoietin-producing hepatocellular receptor tyrosine kinases (EPH RTKs), c-KIT, and Src family kinase (SFK) members, which are biological targets of dasatinib, were among the top candidates activated in NF2-null cells. Dasatinib significantly inhibited phospho-EPH receptor A2 (pEPHA2), pEPHB1, c-KIT, and Src/SFK in NF2-null cells, showing no cross-talk with mTORC1/2 signaling. Posttreatment kinome analyses showed minimal adaptive changes. While dasatinib treatment showed some activity, dual mTORC1/2 inhibitor and its combination with dasatinib elicited stronger growth inhibition in meningiomas. Co-targeting mTORC1/2 and EPH RTK/SFK pathways could be a novel effective treatment strategy for NF2-deficient meningiomas.
Association Between Hemodynamic Markers of Pulmonary Hypertension and Outcomes in Heart Failure With Preserved Ejection Fraction
Authors: Rebecca R. Vanderpool, Melissa Saul, Mehdi Nouraie, Mark T. Gladwin, Marc A. Simon
Journal: JAMA Cardiology (2018)

<h3>Importance</h3> Heart failure with preserved ejection fraction (HFpEF) is highly prevalent, yet there are no specific therapies, possibly due to phenotypic heterogeneity. The development of pulmonary hypertension (PH) in patients with HFpEF is considered a high-risk phenotype in need of targeted therapies, but there have been limited hemodynamic and outcomes data. <h3>Objective</h3> To identify the hemodynamic characteristics and outcomes of PH-HFpEF. <h3>Design, Setting, and Participants</h3> Cohort study of participants who had a right heart catheterization from January 2005 to September 2012 (median [interquartile range] follow-up time, 1578 [554-2513] days) were analyzed. Hemodynamic catheterization data was linked to the clinical data repository of all inpatient and outpatient encounters across a health system. Single tertiary referral center for heart failure and PH within a large health care network using a common clinical data repository was studied. There were 19 262 procedures in 10 023 participants. <h3>Exposures</h3> Participants were classified as having no PH, precapillary PH, or PH in the setting of left heart disease (reduced or preserved ejection fraction). Pulmonary hypertension associated with HFpEF was defined as mean pulmonary artery pressure of 25 mm Hg or more, pulmonary artery wedge pressure of 15 mm Hg or more, and left ventricular ejection fraction of 45% or more. Pulmonary hypertension severity was quantified by the hemodynamic parameters transpulmonary gradient, pulmonary vascular resistance, and diastolic pulmonary gradient. <h3>Main Outcomes and Measures</h3> The primary outcome was time to all-cause mortality. Secondary outcomes were time to acute hospitalization and cardiovascular hospitalization. <h3>Results</h3> The mean (SD) of all study individuals was 65 (38) years. Of 10 023 individuals, 2587 (25.8%) had PH-HFpEF. Mortality was 23.6% at 1 year and 48.2% at 5 years. Cardiac hospitalizations occurred in 28.1% at 1 year and 47.4% at 5 years. The frequency of precapillary PH using clinically defined cut-offs for transpulmonary gradient (&gt;12 mm Hg), pulmonary vascular resistance (3 Woods units), and diastolic pulmonary gradient (≥7 mm Hg) were 12.6%, 8.8%, and 3.5%, respectively. Transpulmonary gradient, pulmonary vascular resistance, and diastolic pressure gradient were predictive of mortality and cardiac hospitalizations. <h3>Conclusions and Relevance</h3> In a large cohort referred for invasive hemodynamic assessment, PH-HFpEF was common. Transpulmonary gradient, pulmonary vascular resistance, and diastolic pulmonary gradient are all associated with mortality and cardiac hospitalizations.
AORTIC ROOT DILATATION ASSOCIATED WITH COLLEGIATE AMERICAN STYLE FOOTBALL PARTICIPATION
Authors: Jonathan H. Kim, Casey Hollowed, Keyur Patel, Zaina Gowani, Mohamad Gafeer, Danielle Harlan, Ali Haider, Salman Sher, Angelo Galante, James Shoop, Craig Clark, Arshed Quyyumi, Aaron Baggish
Journal: Journal of the American College of Cardiology (2018)
Diploma of Otolaryngology-Head and Neck Surgery (DO-HNS)
Authors: Simon Gane
Journal: BMJ (2005)

Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Diploma of Otolaryngology-Head and Neck Surgery (DO-HNS) Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Trends in Melanoma Incidence Among Non-Hispanic Whites in the United States, 2005 to 2014
Authors: Dawn M. Holman, MaryBeth B. Freeman, Meredith L. Shoemaker
Journal: JAMA Dermatology (2018)

Skin cancer is a major public health concern in the United States. 1 Melanoma, the third most common type of skin cancer, is diagnosed in over 70 000 individuals and causes more than 9000 deaths each year. 2 Melanoma is often caused, in part, by overexposure to ultraviolet (UV) radiation from the sun and indoor tanning devices, and incidence rates are highest among non-Hispanic whites (NHW). 1 Previous reports 3 have indicated that melanoma incidence rates were increasing among NHW adults of all ages, but analyses of more recent data by age group are warranted.This study provides the latest national data on melanoma incidence trends among NHWs by 10-year age groups.
INCIDENCE AND COST OF MAJOR CARDIOVASCULAR EVENTS AMONG PATIENTS WITH CHRONIC CORONARY ARTERY DISEASE OR PERIPHERAL ARTERY DISEASE IDENTIFIED IN A LARGE UNITED STATES HEALTHCARE DATABASE
Authors: Ariel Berger, Tarun Bhagnani, Brian Murphy, Beth Nordstrom, Qi Zhao, Windsor Ting, Nicholas Leeper
Journal: Journal of the American College of Cardiology (2018)
I have done my MD in dermatology at JIPMER, India. The degree is recognised by the Medical Council of India. Can I do the MRCP (dermatology)?
Authors: John Lear
Journal: BMJ (2007)

Have a career related problem that needs answering? Can9t find the person to point you in the right direction? Log on to the Advice Zone for reliable medical careers advice. You can post a question or see if one of our 300 advisers has already answered a similar question. Here is a selection of questions and answers posted on the site <b>www.bmjcareers.com/advicezone</b>