tbuckley/cabot-search huggingface dataset:
Abstract 15439: Obese Children With Concentric Hypertrophy and Impaired Cardiac Strain: A Potentially High-risk Subgroup Identified With Cardiac Magnetic Resonance
Authors: Linyuan Jing, Cassi M Friday, Jonathan D Suever, Nivedita Umasankar, Christopher M Haggerty, Gregory J Wehner, Sean M Hamlet, David K Powell, Aurelia Radulescu, H. Lester Kirchner, Frederick H Epstein, Brandon K Fornwalt
Journal: Circulation (2015)

Objectives: Obesity affects nearly one in five children and is associated with increased risk of premature death. Heart disease may contribute to this premature death. We aimed to use cardiac magnetic resonance (CMR) to comprehensively assess the prevalence and severity of heart disease in obese children, with the hypothesis that obese children have cardiac remodeling and impaired cardiac function compared to healthy weight children. Methods and Results: Twenty obese (age 12 ± 3 years, 60% female) and 20 healthy weight children (age 13 ± 3 years, 50% female) underwent CMR, including both standard cine imaging and displacement encoded imaging, for a complete assessment of left ventricular (LV) structure and function. After adjusting for age, obese children had a 27% increase in LV mass (p &lt;0.001, Figure 1A) and a 12% increase in LV thickness (obese = 5.5 ± 0.7 mm, healthy = 5.0 ± 0.7 mm, p = 0.01). This evidence of cardiac remodeling was present in obese children as young as age 8. Forty percent of obese children had concentric hypertrophy, 40% had normal geometry and 20% had either eccentric hypertrophy or concentric remodeling. LV ejection fraction and peak strains were not different between the healthy weight and obese groups. However, peak longitudinal strain showed a significant relationship with the type of LV remodeling, and was most impaired in obese children with concentric hypertrophy (Figure 1B). Conclusions: Obese children show evidence of significant heart disease, which begins as young as age 8. The presence of concentric hypertrophy in 40% of obese children along with the association with impaired cardiac strain in these children may represent a high-risk subgroup. Given the associations between pediatric obesity and early mortality, these early signs of heart disease in obese children demand further investigation.
Impact of estrogens in males and androgens in females
Authors: Stephen R. Hammes, Ellis R. Levin
Journal: Journal of Clinical Investigation (2019)

Androgens and estrogens are known to be critical regulators of mammalian physiology and development. While these two classes of steroids share similar structures (in general, estrogens are derived from androgens via the enzyme aromatase), they subserve markedly different functions via their specific receptors. In the past, estrogens such as estradiol were thought to be most important in the regulation of female biology, while androgens such as testosterone and dihydrotestosterone were believed to primarily modulate development and physiology in males. However, the emergence of patients with deficiencies in androgen or estrogen hormone synthesis or actions, as well as the development of animal models that specifically target androgen- or estrogen-mediated signaling pathways, have revealed that estrogens and androgens regulate critical biological and pathological processes in both males and females. In fact, the concept of "male" and "female" hormones is an oversimplification of a complex developmental and biological network of steroid actions that directly impacts many organs. In this Review, we will discuss important roles of estrogens in males and androgens in females.
Abstract 17798: Cardiac Nuclear High-Mobility Group Box 1 Attenuates Angiotensin II Induced Pathological Cardiac Hypertrophy by Inhibiting Dna Damage Response Pathway
Authors: Tetsuya Takahashi, Tetsuro Shishido, Ken Watanabe, Takayuki Sugai, Taku Toshima, Satoshi Nishiyama, Hiroki Takahashi, Takanori Arimoto, Takuya Miyamoto, Tetsu Watanabe, Isao Kubota
Journal: Circulation (2017)

Introduction: It is well-known that oxidative stress causes the cellular DNA damage. However, the mechanism by which oxidative DNA damage and following DNA damage response (DDR) contribute to cardi...
Haematology at a Glance
Authors: Nick Jenkins
Journal: BMJ (2000)

Textbooks get you honours. I am convinced that the vast majority of students can pass even final medical exams without any recourse to books. They certainly don't need reference to those weighty tomes that seem only ever to be found on dusty shelves in medical school libraries. Perhaps the odd vade mecum such as the Oxford Handbook of Medicine and the British National Formulary are almost essential to a good student, but people pass exams without them.

The …
One foot in the past
Authors: Steve Ainsworth
Journal: BMJ (2002)

One of the most enjoyable ways to delve into medicines past is to visit a museum devoted exclusively to the subject. The newest such museum in the country, though one with a long pedigree, is the Thackray Museum, next door to “Jimmys” hospital, Leeds.



Thats infotainmentTHACKRAY MUSEUM



The museum was the brainchild of Paul Thackray, grandson of the founder of the Thackray Medical Supplies Company. With the aid of a £3m grant from the National Lottery, the museum was moved to a wholly refurbished former workhouse, and it opened in March 1997.

In common with similar institutions today, the Thackray was keen to shed the often associated dusty image of museums. “Infotainment” is at least part of the plan to attract the paying public. A loud “Oy! …
Students could help get free insulin to developing countries
Authors: Mohamad Faris Hussain
Journal: BMJ (2000)

An elective project has been set up to help launch the International Insulin Foundation. This will pilot a programme to distribute insulin free and educate people about type 1 diabetes in the Highly Indebted Poor Countries (HIPCs).

Professor John Yudkin, director of the International Health and Medical Education Centre at University College London, proposed the project under which students going to any of the HIPC countries …
Writing from an author's perspective
Authors: Deborah Cohen
Journal: BMJ (2002)

Deborah Cohen has been on both sides of the Student BMJ. She is one of our student advisers and is also a regular author. She shares some pearls of wisdom that she's picked up from both experiences

When I decided to write about my experiences of writing for the Student BMJ I had to sit down and really think about the issues that most affected me when I first started sending in work.

I later spoke to a couple of friends who also write fairly regularly for the journal, and many of their thoughts echoed my own. We all agreed that seeing our work in print is rewarding, but it can be difficult to know where to start, and the editorial process has the potential to be demoralising.

On the whole, writing for the Student BMJ tends to be a much less soul destroying experience than working for other large publishing houses, and I always try to bear this in mind. It's a much more writer friendly experience, both in terms of guidance before and after rejection, and the fact that it also give authors the opportunity to rewrite copy if they like the idea--something almost unheard of in journalism. But that's not to say it's all been easy.

The first hurdle has to be coming up …
Non-traditional medical students feel in the way
Authors: Karen Hebert
Journal: BMJ (2004)

“Non-traditional” medical students feel marginalised and “in the way,” says a study looking at the climate of medical education in this month's Medical Education (2004;38:659-69).

Mary Seabrook, a freelance education consultant, did a five year longitudinal study between1995-2000 at Guys, Kings, and St Thomas's Medical School, London. “It interested me because coming from a school teaching background I was interested in the differences between …
Abstract 15890: Medicaid Expansion and Hospitalization for Ambulatory Care Sensitive Conditions Among Adults With Diabetes
Authors: Favel L Mondesir, Meredith L Kilgore, Lei Huang, Maria Pisu, Kevin R Riggs, John P Shelley, April A Agne, Yufeng Li, Janet M Bronstein, Emily B Levitan, Andrea L Cherrington
Journal: Circulation (2017)

Background: Increased access to care through Medicaid expansion may reduce the number of hospitalizations for ambulatory care sensitive conditions (ACSCs), including acute preventable complications...
Viewpoint: Deterred by the doctor's salary?
Authors: Brendan Spooner
Journal: BMJ (2007)

Where would you want the brightest people in the country to work? Would you have them making you money as stockbrokers; defending you in court as lawyers; writing your next headline as journalists; or would you have them saving lives as doctors? Most people would rank their health as one of the most important aspects of their lives, but is medicine financially attractive enough to entice the cream of the crop? I am not sure. In financial terms medicine might not be the best choice for the bright young future of tomorrow.



A UK junior doctor's salary begins at £ 20,741 (€ 29,698; $42,127) in England for 2006-7, according to the BMA (www.bma.org.uk/ap.nsf/Content/ddrbfactcard0607). In comparison, the median starting salary for a graduate in 2006 is £23,136, according to a recent survey of more than 230 of the United Kingdom's leading graduate employers (www.agr.org.uk/news/agr\_in\_the_news/id.55.html). That is nearly £2500 more than a medic. To make matters worse the medical degree is long and the extra time studying compared with other graduates means more debt at the end. Therefore, junior doctors potentially lose out twice; they have more debt and earn less.

This is not to say that every graduate will get a job or earn more than a doctor, but medicine is …
Progress Toward Measles Elimination — European Region, 2009–2018
Authors: Laura A. Zimmerman, Mark Muscat, Simarjit Singh, Myriam Ben Mamou, Dragan Jankovic, Siddhartha Datta, James P. Alexander, James L. Goodson, Patrick O’Connor
Journal: MMWR Morbidity and Mortality Weekly Report (2019)

In 2010, all 53 countries* in the World Health Organization (WHO) European Region (EUR) reconfirmed their commitment to eliminating measles and rubella and congenital rubella syndrome (1); this goal was included as a priority in the European Vaccine Action Plan 2015-2020 (2). The WHO-recommended elimination strategies in EUR include 1) achieving and maintaining ≥95% coverage with 2 doses of measles-containing vaccine (MCV) through routine immunization services; 2) providing measles and rubella vaccination opportunities, including supplementary immunization activities (SIAs), to populations susceptible to measles or rubella; 3) strengthening surveillance by conducting case investigations and confirming suspected cases and outbreaks with laboratory results; and 4) improving the availability and use of evidence for the benefits and risks associated with vaccination (3). This report updates a previous report (4) and describes progress toward measles elimination in EUR during 2009-2018. During 2009-2017, estimated regional coverage with the first MCV dose (MCV1) was 93%-95%, and coverage with the second dose (MCV2) increased from 73% to 90%. In 2017, 30 (57%) countries achieved ≥95% MCV1 coverage, and 15 (28%) achieved ≥95% coverage with both doses. During 2009-2018, >16 million persons were vaccinated during SIAs in 13 (24%) countries. Measles incidence declined to 5.8 per 1 million population in 2016, but increased to 89.5 in 2018, because of large outbreaks in several EUR countries. To achieve measles elimination in EUR, measures are needed to strengthen immunization programs by ensuring ≥95% 2-dose MCV coverage in every district of each country, offering supplemental measles vaccination to susceptible adults, maintaining high-quality surveillance for rapid case detection and confirmation, and ensuring effective outbreak preparedness and response.
Letter to the Editor: Is Emricasan (IDN‐6556), an Oral Pan‐Caspase Inhibitor, Ready for Controlled Trials?
Authors: Sandeep Khurana, Harshit S. Khara
Journal: Hepatology (2019)

Potential conflict of interest: Nothing to report. To the Editor: We read with interest the study by Garcia‐Tsao et al.1 regarding the impact of emricasan, a pan‐caspase inhibitor, on portal hypertension. We commend the authors for this investigation as there is an unmet need for medical therapies to reduce portal hypertension and its consequences. However, there are significant concerns that need clarification to adequately assess the impact of emricasan on hepatic venous pressures. The majority of the Results section is focused on patients in whom emricasan reduced hepatic venous pressure gradient (HVPG), while ignoring the fact that in many patients emricasan increased HVPG (in their Fig. 2, compared to day 0, at day 28 many lines slope upward). Additionally, lack of a placebo arm and analysis of responders alone gives an impression that emricasan may be effective, while in many cases it may be detrimental. Though their Fig. 2 is a comprehensive representation of data, because of many overlapping lines and data points, it is hard to determine the impact on individual patients. Readers would benefit from HVPG data from days 0 and 28 for all 22 patients, which could be provided in a small table. Emricasan had no impact on pulse rate or blood pressure. However, it reduced serum aspartate aminotransferase/alanine aminotransferase, cleaved cytokeratin 18, and caspase‐3/7 levels. Others showed a similar response, especially in patients with fatty liver disease.2 Collectively, this evidence points to an impact on intrahepatic resistance rather than portal flow. Emricasan‐induced changes in free and wedged hepatic venous pressures may shed light on this. If the authors could share these data with the readers, it will enhance the understanding of the results of this study. The authors indicated that all 44 HVPG tracings from 22 patients were of “adequate” quality. This could have been described better with example tracings. A portion of the Results section is focused on analysis of patients who had a 10% or 20% decrease in HVPG, which may be easier in tracings from patients with HVPG > 15 mm Hg. However, a 10% change in patients with HVPG ≤ 10 mm Hg may be hard to assess. Therefore, we argue that due to the lack of a placebo arm and the increase of HVPG in a subset of patients, the results of this study should be interpreted with caution. Further, free and wedged hepatic venous pressure data would enhance our understanding of emricasan’s impact on hepatic venous resistance.
Sex not recommended for under 17 year olds
Authors: Amina Hussain
Journal: BMJ (1999)

Healthcare professionals should be communicating to under 17 year olds that it is medically unwise to have sex, according to Dr Stammer, a general practice tutor at St George's Hospital Medical School, London. His controversial statement was recently reported in the Postgraduate Medical Journal (1999;75:641-2) and comes at a time of increasing unease about the unremittingly high rate of teenage pregnancies in the United Kingdom-the highest in western Europe, with more than 8000 unplanned pregnancies per year …
You should know you're a medic: Live yoghurt drinks
Authors: Guy Hagan
Journal: BMJ (2001)

Are they just a con? Guy Hagan examines the issues

“It's all a con,” exclaimed my medic housemate, as an advertisment for a live yoghurt drink was shown on the television. “All the bacteria would be broken down in the stomach and do nothing,” he went on.

Live yoghurt drinks refer to a group of drinks made from fermented milk containing cultures of specific types of bacteria. The bacteria cultured are genera of human origin, such as Lactobacillus acidophilus , L. Casei , Bifidobacterium bifidum , and B. Longum .1 The advertised philosophy behind live yoghurt drinks is that when they are eaten they can replenish levels of “good” bacteria found in the bowel that may have been lowered by a stressful lifestyle and an unpredictable diet. The result is a well balanced intestinal flora, which helps maintain a healthy immune system.2

The suspicion that consumption of live fermented milk drinks may have positive health effects has been around for nearly 100 years, since Metchnikof postulated that the longevity of rural Bulgarians was due to their large consumption of these drinks.3

For the bacteria in the drink to exert any health effects, they would …
THE TEACHING OF MATERIA MEDICA AND THERAPEUTICS.
Journal: JAMA (1896)

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 HomeNew OnlineCurrent IssueFor Authors 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) Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Get yourself connected
Authors: Ruth Chambers
Journal: BMJ (2005)

“I'm all right thank you; I can manage quite well by myself.” Is that you? Is that you keeping yourself and your dilemmas to yourself? As Ruth Chambers ;explains, you need a mentor A mentor could help you at any stage in your career. Sure, you can manage without, but a mentor could help to guide you and challenge you about your career. The increasing pressures in the NHS mean that it's vital to find new ways of coping and thriving at work. A mentor could enable you to reflect on your current situation, your strengths and weaknesses, and your aspirations. They could help you to grow and develop in your career, not spoon feed or sponsor you, but help you to give yourself a push or find solutions to your career or personal issues. Box 1 describes the benefits for you. ### Box 1: Why have a mentor?1 Mentoring 1. Boosts your development: … RETURN TO TEXT
Abstract P123: Lipid-lowering Therapy Prescription Patterns and Predictors of High Intensity Statin Prescriptions in Patients With Diabetes or Atherosclerotic Cardiovascular Disease
Authors: Alanna M Chamberlain, Sarah S Cohen, Jill M Killian, Keri L Monda, Elizabeth O Hedgeman, Susan A Weston, Ted Okerson
Journal: Circulation (2017)

Background: Many patients with atherosclerotic cardiovascular disease (ASCVD) or diabetes mellitus (DM) do not receive guideline-recommended lipid lowering therapy (LLT). We characterized LLT treatment patterns and identified predictors of high intensity statin prescriptions (Rx) in patients with ASCVD and DM. Methods: Olmsted County, MN residents with DM or ASCVD (MI, unstable angina, revascularization, ischemic stroke/TIA) from 2005-2012 were followed for 2 years capturing all LDL-C and LLT Rx. Cox regression examined predictors of high intensity statin Rx, modeling LDL-C as a time-dependent variable. Results: 8408 patients with DM (n=4881) or ASCVD (n=3527) were identified (mean age 63.1, 55.1% male). Over 2 years, mean (SD) number of LDL-C measurements was 2.7 (1.9); 12.1% had none. Among those with ≥1 LDL-C, the first was ≥100 mg/dL in 46.2%. LLT Rx increased within 30 days after the first LDL-C. (Table). However, among those with LDL-C ≥100, 40.1% were not prescribed LLT; these patients were younger (mean age 56.9 vs 60.8), more likely female (52.7% vs 45.6%) and more likely to have DM vs ASCVD (84.5% vs 54.6%) than those prescribed LLT. High intensity statin Rx increased more for those with LDL-C ≥100 than those with LDL-C &lt;100. Men [HR 1.29 (CI 1.13-1.48)] and patients with ASCVD vs DM [6.12 (5.25-7.12)] were more likely to be prescribed high intensity statins. Higher LDL-C was associated with greater high intensity statin Rx, although associations differed between ASCVD and DM (p-interaction=0.004). Compared to DM, ASCVD patients were more likely prescribed high intensity statins at every level of LDL-C [2.73 (1.70-4.37), 6.47 (4.94-8.47), 5.68 (4.45-7.25), and 7.88 (5.89-10.53) for LDL-C &lt;70, 70-99, 100-130, and ≥130]. Conclusions: Although high intensity statin Rx increased in response to increasing LDL-C, a large proportion of patients do not receive guideline-concordant care. Efforts should be made to encourage more aggressive treatment of elevated LDL-C and to understand why treatment is neglected or delayed.
A levels alone are a poor predictor of performance at medical school
Authors: Clare Hughes
Journal: BMJ (2003)

Medical schools may be picking the wrong students, who are less likely to do well in clinical medicine, by using inappropriate selection criteria, according to researchers at Nottingham University.

Traditional selection procedures considering A levels, a personal statement, and references are not the best predictors of performance at medical school, according to the study recently published in the BMJ.1

Students starting at Nottingham medical school in …
Classic Book: Veronika Decides to Die
Authors: Neil Chanchlani
Journal: BMJ (2009)

“When she had achieved almost everything she wanted in life, she had reached the conclusion that her existence had no meaning, because every day was the same. And she had decided to die.” Paulo Coelho’s story is of a 24 year old woman, Veronika, who attempts to commit suicide by taking an overdose of tranquillisers. However, things go awry when she wakes up in Villette, “the famous and much feared lunatic asylum.”

As far as Veronika can tell, she had made a rational, thoughtful decision that she wanted to die. Her expectations of life had been met, and she no longer …