tbuckley/cabot-search huggingface dataset:
Big Brother for medics
Authors: Jenny Blythe
Journal: BMJ (2001)

Five medical students from Dundee University spent four days in November living, eating, and sleeping at the Edinburgh branch of IKEA, in a Big Brother style weekend, to be televised on Channel 5 this month.

The students, along with four other groups, were expected to take part in various tasks for the entertainment of the customers during their stay. These included a Swedish meatball eating contest, judging an ABBA dancing contest, a fancy dress …
Oral Mucosal Organoids as a Potential Platform for Personalized Cancer Therapy
Authors: Else Driehuis, Sigrid Kolders, Sacha Spelier, Kadi Lõhmussaar, Stefan M. Willems, Lot A. Devriese, Remco de Bree, Emma J. de Ruiter, Jeroen Korving, Harry Begthel, Johan H. van Es, Veerle Geurts, Gui-Wei He, Richard H. van Jaarsveld, Rurika Oka, Mauro J. Muraro, Judith Vivié, Maurice M.J.M. Zandvliet, Antoni P.A. Hendrickx, Nino Iakobachvili, Priya Sridevi, Onno Kranenburg, Ruben van Boxtel, Geert J.P.L. Kops, David A. Tuveson, Peter J. Peters, Alexander van Oudenaarden, Hans Clevers
Journal: Cancer Discovery (2019)

Previous studies have described that tumor organoids can capture the diversity of defined human carcinoma types. Here, we describe conditions for long-term culture of human mucosal organoids. Using this protocol, a panel of 31 head and neck squamous cell carcinoma (HNSCC)-derived organoid lines was established. This panel recapitulates genetic and molecular characteristics previously described for HNSCC. Organoids retain their tumorigenic potential upon xenotransplantation. We observe differential responses to a panel of drugs including cisplatin, carboplatin, cetuximab, and radiotherapy in vitro. Additionally, drug screens reveal selective sensitivity to targeted drugs that are not normally used in the treatment of patients with HNSCC. These observations may inspire a personalized approach to the management of HNSCC and expand the repertoire of HNSCC drugs. SIGNIFICANCE: This work describes the culture of organoids derived from HNSCC and corresponding normal epithelium. These tumoroids recapitulate the disease genetically, histologically, and functionally. In vitro drug screening of tumoroids reveals responses to therapies both currently used in the treatment of HNSCC and those not (yet) used in clinical practice.See related commentary by Hill and D'Andrea, p. 828.This article is highlighted in the In This Issue feature, p. 813.
Get Through Medical School: 1000 SBAs/BOFs and EMQs
Authors: Andrew Papanikitas
Journal: BMJ (2003)

As a final year medical student, I find myself getting mildly anxious about exams. As if to exploit this anxiety, which research must show is endemic in the undergraduate medical population, books of multiple choice questions (MCQs) and extended matching questions (EMQs) seem to proliferate. For many years, the best book for revising MCQs was Wai-Ching Leungs Clinical Medicine: Key Questions Answered , which covers just about everything that can be asked in a written exam and explains the …
Dendritic cell NLRC4 regulates influenza A virus–specific CD4+ T cell responses through FasL expression
Authors: Emma E. Hornick, Jargalsaikhan Dagvadorj, Zeb R. Zacharias, Ann M. Miller, Ryan A. Langlois, Peter Chen, Kevin L. Legge, Gail A. Bishop, Fayyaz S. Sutterwala, Suzanne L. Cassel
Journal: Journal of Clinical Investigation (2019)

Influenza A virus (IAV)-specific T cell responses are important correlates of protection during primary and subsequent infections. Generation and maintenance of robust IAV-specific T cell responses relies on T cell interactions with dendritic cells (DCs). In this study, we explore the role of nucleotide-binding domain leucine-rich repeat containing receptor family member NLRC4 in modulating the DC phenotype during IAV infection. Nlrc4-/- mice had worsened survival and increased viral titers during infection, normal innate immune cell recruitment and IAV-specific CD8 T cell responses, but severely blunted IAV-specific CD4 T cell responses compared to wild-type mice. The defect in the pulmonary IAV-specific CD4 T cell response was not a result of defective priming or migration of these cells in Nlrc4-/- mice but was instead due to an increase in FasL+ DCs, resulting in IAV-specific CD4 T cell death. Together, our data support a novel role for NLRC4 in regulating the phenotype of lung DCs during a respiratory viral infection, and thereby influencing the magnitude of protective T cell responses.
Student soapbox: learning respect
Authors: Andrew West, Christopher Bulstrode, Victoria Hunt
Journal: BMJ (2001)

When as a medical student you dissected a cadaver, were there things said and done that left you deeply worried about the respect that you might be shown when you are dead? Do you remember the first time that you performed a vaginal or a rectal examination? Were you in a queue of students lining up to practise on an anaesthetised patient who might or might not have known what was going to be done to them? Were you a bit embarrassed then as well? Perhaps this was expressed as ribald humour, a common defence in ethically challenging situations. Or was the examination performed on an uncomplaining conscious patient, who felt that they did not have the right to question why this nasty thing had to be done again and again? You may have felt a sense of unease at the time. You may even have decided that the procedure was wrong. But you were quickly taught that those doubts were immature and not to be heeded. And you …
Intuition and the ill infant
Authors: Denis Gill
Journal: BMJ (2001)

Nowhere in medicine is the use of observation, instinct, and innate experience more important than in attempting to make a clinical diagnosis in an acutely ill infant. I like to refer to this as veterinary paediatrics, as sick animals and sick children share many attributes they refuse to eat; they lie down when they are sick; their language and communication skills are limited; they depend on others to sort out their problems; and when ill they prefer to be left alone.

Sir William Osler said, There is no more difficult art to acquire than the art of observation. This is well captured in the illustration of the sick child, a painting which used to hang on the wall of many doctors' surgeries (fig 1). It shows the doctor carefully observing an ill child placed across the chairs in a poor household. His posture is pensive, his look inquiring, but the child's position and that of the parents tell the viewer that the child is critically ill.



Figure 1 
Sir Luke Fildes “The doctor” shows the doctor carefully observing an ill child



I like to quote to my students the saying of Auguste Bier (1861-1949): “A smart mother makes often a better diagnosis than a poor doctor.” In reality, of course, any mother is likely to make a better diagnosis than a “poor” doctor. About 70 to 80% of paediatric diagnoses are basedlargely on history. It is essential that students ask the mother what her worries are. Figure 2 displays the fundamental problem the child or young infant being limited in his or her clinical vocabulary and yet needing to communicate to the mother or the attending doctor. Fortunately, most mothers are excellent barometers of their children's wellbeing and are good communicators of their problems if doctors are attuned to listen. …
Direct infant ultraviolet light exposure is associated with eczema and immune development: a critical appraisal
Authors: D. Maslin, D. Veitch, H.C. Williams
Journal: British Journal of Dermatology (2019)

Rueter et al. aimed to 'determine the effects of early postnatal vitamin D supplementation on infant eczema and immune development'. This was a double‐blind randomized placebo‐controlled trial with an additional nonrandomized exploratory analysis on the effects of ultraviolet (UV) exposure led from a hospital setting. Vitamin D (400 iU daily) drops or placebo drops (coconut and palm kernel oil) were allocated randomly to 195 infants born to families with a first‐degree relative with atopic disease. Eighty‐six of these infants were allocated personal UV dosimeters in a nonrandomized fashion to measure UV light (290–380 nm) exposure until 3 months of age. Eczema and wheeze were assessed at 3 and 6 months, and 25 immune function markers were assessed at 6 months of age. Infant vitamin D levels and immune functions were measured at 6 months of age. Although vitamin D levels were significantly greater in infants in the intervention group than in those in the placebo group at 3 and 6 months of age, there was no difference in eczema between groups at either time point (10·0% vs. 6·7% at 3 months and 21·8 vs. 19·3% at 6 months for the vitamin D and placebo groups, respectively). In the subset of infants given a dosimeter, those with eczema had less UV light exposure (median 555 J m−2) than infants who did not develop eczema (median 998 J m−2). Across the 25 immune functions, UV light exposure was inversely correlated with interleukin‐2, granulocyte macrophage colony‐stimulating factor and eotaxin production by Toll‐like receptor ligands. Vitamin D supplementation in high‐risk infants increased vitamin D levels but did not reduce eczema. Exploratory post‐hoc analyses in a nonrandomized subset showed an association between greater direct UV light exposure and reduction of eczema. The authors claim that their 'findings indicate that UV light exposure appears more beneficial than vitamin D supplementation as an allergy prevention strategy in early life'.
A novel human <i>IL2RB</i> mutation results in T and NK cell–driven immune dysregulation
Authors: Isabel Z. Fernandez, Ryan M. Baxter, Josselyn E. Garcia-Perez, Elena Vendrame, Thanmayi Ranganath, Daniel S. Kong, Karl Lundquist, Tom Nguyen, Sidney Ogolla, Jennifer Black, Csaba Galambos, James C. Gumbart, Noor Dawany, Judith R. Kelsen, Edwin F. de Zoeten, Ralph Quinones, Hesham Eissa, Michael R. Verneris, Kathleen E. Sullivan, Rosemary Rochford, Catherine A. Blish, Ross M. Kedl, Cullen M. Dutmer, Elena W.Y. Hsieh
Journal: The Journal of Experimental Medicine (2019)

The pleiotropic actions of interleukin-2 (IL-2) are essential for regulation of immune responses and maintenance of immune tolerance. The IL-2 receptor (IL-2R) is composed of IL-2Rα, IL-2Rβ, and IL-2Rγ subunits, with defects in IL-2Rα and IL-2Rγ and their downstream signaling effectors resulting in known primary immunodeficiency disorders. Here, we report the first human defect in IL-2Rβ, occurring in two infant siblings with a homozygous IL2RB mutation in the WSXWS motif, manifesting as multisystem autoimmunity and susceptibility to CMV infection. The hypomorphic mutation results in diminished IL-2Rβ surface expression and dysregulated IL-2/15 signaling, with an anticipated reduction in regulatory T cells. However, in contrast to the IL-2Rβ−/− animal model, which lacks NK cells, these siblings demonstrate an expansion of NK cells, particularly the CD56bright subset, and a lack of terminally differentiated NK cells. Thus, the early-onset autoimmunity and immunodeficiency are linked to functional deficits arising from altered IL-2Rβ expression and signaling in T and NK cells.
The truth about fad diets
Authors: Sarah Schenker
Journal: BMJ (2001)

Fad diets are everywhere. If you believed what various celebrities and women9s magazines are preaching, <b>high protein</b> diets, <b><i>detox</i></b> diets, <b>food combining</b> diets and such like are the saviours of the Western world--here to save us from becoming <b>fat</b>. Perhaps you have been tempted to try one yourself or know of friends, relatives, or patients who are on them. We do need all the help we can get as obesity rates are climbing like never before. But what happened to good old fashioned healthy eating? Too <b>boring</b> and not <b>trendy</b> enough? We asked <b>Sarah Schenker</b>, a nutrition scientist at the British Nutrition Foundation, to shed some light on the subject
Medicine is a life of filling in forms
Authors: Siddartha Dutta
Journal: BMJ (2004)

From the moment we decide to join medical school it is a huge commitment; not to academic achievement or public service but rather to filling in forms. Filling in forms is as much a part of medical life as miserable canteen food and long hours. But are these forms useful, or are they just more bits of paper to push around?



SVEN MARTSON/THE IMAGE WORKS/TOPFOTO



University entrance forms are where it all begins. The dread of fitting all your qualifications and their awarding bodies into tiny boxes is surpassed …
Analyze Patient Tests for Importance Before Ordering
Authors: Steven H. Horowitz
Journal: JAMA Internal Medicine (2019)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
New UK doctors cannot handle smoking cessation
Authors: Chibuzo Odigwe
Journal: BMJ (2004)

A new study across 24 medical schools in the United Kingdom has shown that most newly qualified UK doctors are ill equipped to deliver smoking cessation and rehabilitation interventions.

The study, published in Tobacco Control (2004;13:74-7), found that training in smoking cessation was seriously neglected as three fifths of preregistration house officers reported that they were unable to deliver smoking cessation interventions in accordance with national guidelines. Just 17% of preregistration house officers …
Widen inquiry into sexist behaviour at BMA, say women behind allegations
Authors: Melanie Newman
Journal: BMJ (2019)

A group of female doctors who drew public attention to sexism and inappropriate behaviour in the BMA have challenged the terms of reference of an inquiry set up to investigate their concerns.

In March GP Online reported allegations of sexist comments being made to senior BMA General Practitioners Committee representatives Zoe Norris and Katie Bramall-Stainer at the conference of UK local medical committees in Belfast.1 These allegations prompted other doctors, including Stephanie deGiorgio and Amy Small, to speak out about their own experience of sexism and harassment while taking part in BMA activities.2 …
The Enhanced Recovery After Surgery in Cardiac Surgery Revolution
Authors: Olle Ljungqvist
Journal: JAMA Surgery (2019)

Daniel T. Engelman, MD; Walid Ben Ali, MD; Judson B. Williams, MD, MHS; Louis P. Perrault, MD, PhD; V. Seenu Reddy, MD; Rakesh C. Arora, MD, PhD; Eric E. Roselli, MD; Ali Khoynezhad, MD, PhD; Marc Gerdisch, MD; Jerrold H. Levy, MD; Kevin Lobdell, MD; Nick Fletcher, MD, MBBS; Matthias Kirsch, MD; Gregg Nelson, MD; Richard M. Engelman, MD; Alexander J. Gregory, MD; Edward M. Boyle, MD
Abstract 17337: Ivabradine and Carvedilol on Rest and Stress Coronary Diastolic Perfusion Time in Patients With Stable Coronary Artery Disease
Authors: Ercole Tagliamonte, Fausto Rigo, Costantino Astarita, Roberta Astarita, Antonino Coppola, Maria Rosaria Tagliamonte, Nicola Capuano
Journal: Circulation (2016)

Background: We have already demonstrated that ivabradine has a better effect on coronary flow velocity reserve (CFVR) compared with bisoprolol, in patients with stable coronary artery disease (CAD)...
Chew gum and beat exams
Authors: Debbie Cohen
Journal: BMJ (2002)

Chewing gum, a pet hate of lecturers, could improve your chances of exam success, according to a study at Northumbria University. Dr Andrew Scholey and Lucy Wilkinson have found that chewing gum while performing memory tests increases long and short term memory by up to 35%.

Computerised memory tests measured participants' attention span, response rates, and both …
Beyond breaking bad news: Helping patients who suffer
Authors: Michael W Rabow, Stephen J McPhee
Journal: BMJ (2000)

Michael W Rabow and Stephen J McPhee take you through a difficult task ### Box 1 - Summary points Despite the fact that clinicians are responsible for delivering bad news, this skill is rarely taught in medical schools or residencies in the United States, and clinicians are generally poor at it.1–4 Experienced clinicians who have offered recommendations for delivering bad news will agree on many points.5–8Box 2 lists the clinician's most important goals for the initial breaking of bad news, as cited in the medical literature. ### Box 2 - Initial goals in delivering bad newsRETURN TO TEXT Box 3 summarises specific recommendations offered in the literature for delivering bad news, organised into a simple mnemonic ("ABCDE"). Experts also point out that clinicians invariably respond with their own feelings about the bad news.9 ### Box 3 - Techniques for delivering bad news well: ABCDE #### Advance preparation #### Build a therapeutic environment/relationshipRETURN TO TEXT
Antibiotic use: don’t blame doctors for trying to manage patient expectations
Authors: Eugene Y H Yeung
Journal: BMJ (2019)

Glover and colleagues claim that there is little evidence to show that patients are unreasonably pressuring general practitioners for antibiotics.1 By the same token, there is little evidence that patient expectation is not a factor in doctors’ decision making. Similarly, there is little evidence that doctors are always “blaming” patients for antibiotic resistance.

Some …
Medics who mentor
Authors: Alice Cook
Journal: BMJ (2007)

The school bell rings, shaking the corridor, and I'm 13 again. The excitement at the thought of going home is accompanied by a dread at the thought of maths next. An anticipatory tummy rumble cries for lunch break. But I'm not 13, and fortunately I'll never have maths again. I'm 21 and about to meet a 14 year old girl who wants to find out more about doing medicine.

No I'm not a sadist; I'm a mentor for teenagers who want a career in health care. It's part of a scheme to widen participation. The teenagers, affectionately called mentees, have to fulfil a …
Taking a history: Conclusion and closure
Authors: Nayankumar Shah
Journal: BMJ (2005)

In the second part of the series, Nayankumar Shah takes us from medical and surgical history to conclusion and closure Following the first part of the series on history taking, which considered introduction and the presenting complaint, we move on to medical and surgical history. Questions that can be asked include: You will often have to use a variety of questions to prompt the patient as: The medical history is useful as it determines: This should include: Patients are often unsure of the drugs they are taking. Under these circumstances, it is worthwhile using the medical history and asking if they are on any treatment for each problem: "Do you take anything for your arthritis?" and so on. Alternatively, if the patient knows the treatments, it is helpful to ask him or her what they are for-sometimes this gives additional information as to the patient's illnesses. For instance, the patient may have forgotten to tell you that he or she has hypertension, and this is discovered only from the treatment and other drug history. ### Over the counter drugs Many drugs can be obtained without prescription, so it is essential to ask about over the counter drugs:
Aberrant splicing contributes to severe α-spectrin–linked congenital hemolytic anemia
Authors: Patrick G. Gallagher, Yelena Maksimova, Kimberly Lezon-Geyda, Peter E. Newburger, Desiree Medeiros, Robin D. Hanson, Jennifer Rothman, Sara Israels, Donna A. Wall, Robert F. Sidonio, Colin Sieff, L. Kate Gowans, Nupur Mittal, Roland Rivera-Santiago, David W. Speicher, Susan J. Baserga, Vincent P. Schulz
Journal: Journal of Clinical Investigation (2019)

The etiology of severe hemolytic anemia in most patients with recessive hereditary spherocytosis (rHS) and the related disorder hereditary pyropoikilocytosis (HPP) is unknown. Whole exome sequencing of DNA from probands of 24 rHS or HPP kindreds identified numerous mutations in erythrocyte membrane α-spectrin (SPTA1). Twenty-eight mutations were novel, with null alleles frequently found in trans to missense mutations. No mutations were identified in a third of SPTA1 alleles (17/48). Whole genome sequencing revealed linkage disequilibrium between the common rHS-linked α-spectrinBug Hill polymorphism and a rare intron 30 variant in all 17 mutation-negative alleles. In vitro minigene studies and in vivo splicing analyses revealed the intron 30 variant changes a weak alternate branch point (BP) to a strong BP. This change leads to increased utilization of an alternate 3' splice acceptor site, perturbing normal α-spectrin mRNA splicing and creating an elongated mRNA transcript. In vivo mRNA stability studies revealed the newly created termination codon in the elongated transcript activates nonsense mediated decay leading to spectrin deficiency. These results demonstrate a unique mechanism of human genetic disease contributes to the etiology of a third of cases of rHS, facilitating diagnosis and treatment of severe anemia, and identifying a new target for therapeutic manipulation.
Half of young British men visiting Ibiza have unprotected sex
Authors: Richard Hurley
Journal: BMJ (2004)

One in 10 men visiting Ibiza have sex with at least six people, half do not use condoms, and the proportion of visitors having unprotected sex is increasing, according to new research ( Sex Transm Infect 2004;80:43-7). One in four men and one in seven women had sex with more than one person during an average 10 day stay, fuelling concern over the spread of sexually transmitted …
Obliged to participate
Authors: Faisal R Ali
Journal: BMJ (2007)

In the United Kingdom, the General Medical Council affords patients the right to refuse a medical student to be involved in their care but seldom considers patients' moral duty to participate in medical education1. Increasing numbers of medical trainees; reduction in the training pool as more patients are treated privately; and the refusal of some patients to participate in medical training makes this obligation paramount if we are to protect vulnerable people in society from exploitation while maintaining high standards of training.



Barry Lewis/Alamy

No moral right to refuse



I will highlight my objection to the current system before considering the debate from two perspectives-using John Rawls' “veil of ignorance”2 and an analogy between taxation, tools already used to explore allocation of resources 34, and participation in medical research.5

Currently, we place the entire burden of medical education on patients who, through altruism or disempowerment, do not veto students being involved …