tbuckley/cabot-search huggingface dataset:
Contrasting Effects of Pharmacological, Procedural, and Surgical Interventions on Proportionate and Disproportionate Functional Mitral Regurgitation in Chronic Heart Failure
Authors: Milton Packer, Paul A. Grayburn
Journal: Circulation (2019)

Two distinct pathways can lead to functional mitral regurgitation (MR) in patients with chronic heart failure and a reduced ejection fraction. When remodeling and enlargement of the left ventricle (LV) cause annular dilatation and tethering of the mitral valve leaflets, there is a linear relationship between LV end-diastolic volume and the effective regurgitant orifice area of the mitral valve. These patients, designated as having proportionate MR, respond favorably to treatments that lead to reversal of LV remodeling and a decrease in LV volumes (eg, neurohormonal antagonists and LV assist devices), but they may not benefit from interventions that are directed only at the mitral valve leaflets (eg, transcatheter mitral valve repair). In contrast, when ventricular dyssynchrony causes functional MR attributable to unequal contraction of the papillary muscles, the magnitude of regurgitation is greater than that predicted by LV volumes. These patients, designated as having severe but disproportionate MR, respond favorably to treatments that are directed to the mitral valve leaflets or their supporting structures (eg, cardiac resynchronization or transcatheter mitral valve repair), but they may derive little benefit from interventions that act only to reduce LV cavity size (eg, pharmacological treatments). This novel conceptual framework reflects the important interplay between LV geometry and mitral valve function in determining the clinical presentation of patients, and it allows characterization of the determinants of functional MR to guide the most appropriate therapy in the clinical setting.
Minerva: April 2000
Authors: Marianne Shiew, Michael Spolton
Journal: BMJ (2000)

The United Kingdom's dead citizens charter was established last year to improve end of life experiences and promote better funeral practices. It identifies 30 areas that need an overhaul, including the availability of information for relatives organising a funeral. Institutions such as hospitals, hospices, and nursing homes need funeral advisers, say the National Funerals College, to guide relatives rationally through a choice of funeral directors and disposal options. A pilot study is planned.

Many general practitioners dream of paperless surgeries, where piles of patient records, BMJ s, and guidelines no longer litter the carpet tiles. For now, however, 96% of practices are stuck with paper, according to a recent British survey ( British Journal of General Practice 2000;50:46.7). Most respondents blamed high costs for slow progress with computerisation. Others were worried about the legal status of purely electronic records. The NHS Executive's plans to convert all practices to electronic records by 2005 are beginning to look overoptimistic.

Seasonal mood changes are common in western Europe, and they tend to occur over winter. Chinese medical students, however, go gloomy in the summer ( American Journal of …
A biological infrastructure for communication underlies the cultural evolution of languages
Authors: J. P. de Ruiter, Stephen C. Levinson
Journal: Behavioral and Brain Sciences (2008)

Abstract Universal Grammar (UG) is indeed evolutionarily implausible. But if languages are just “adapted” to a large primate brain, it is hard to see why other primates do not have complex languages. The answer is that humans have evolved a specialized and uniquely human cognitive architecture, whose main function is to compute mappings between arbitrary signals and communicative intentions. This underlies the development of language in the human species.
Quite Ugly One Morning
Authors: Alisdair McNeill
Journal: BMJ (2002)

Christopher Brookmyre is one of Scotlands foremost young authors, his acerbic literary career beginning with Quite Ugly One Morning , an irreverent tale of murder and money grabbing within the Edinburgh medical establishment.

Quite Ugly One Morning opens with hungover journalist Jack Parlabane locking himself out of his flat and attempting to get back in by lowering himself through an open window from the flat above. But, when he slips into his neighbours flat he …
First degree in international health starts in UK medical school
Authors: Rhona MacDonald
Journal: BMJ (2001)

The International Health and Medical Education Centre based at University College London has started the first intercalated BSc in international health in Europe. The course aims to provide students with an understanding of health and health care in the context of changing global processes and consists of three compulsory and two optional modules plus a project, and compulsory attendance at all seminars. Fifteen (nine of them preclinical) ethnically diverse medical students …
Planning your elective: Solomon Islands
Authors: Mark Wilson
Journal: BMJ (2003)

<b>Mark Wilson</b> gives you the low down on how to arrange your elective in the Solomon IslandsThe Solomon Islands sound like a tropical paradise, and in years gone by they were. But, unfortunately, that is not the case at the moment. With the civil unrest that has escalated in the past few weeks, the UK government is advising against travel to either the island of Guadalcanal or Malaita, except for essential business. Up to date advice on these and other islands can be found on the British Foreign and Commonwealth Office website (www.fco.gov.uk). Despite this, some of the remote hospitals do offer fantastic experiences both within and outside the hospital--the diving is said to be some of the best in the world.
Impact of secondhand smoke on cystic fibrosis: is there a link to fatty acid metabolism?
Authors: Stefan Zielen, Daniela Fussbroich
Journal: Thorax (2019)

Cystic fibrosis (CF) is an autosomal recessive disease caused by genetic mutations of the cystic fibrosis transmembrane conductance regulator ( CFTR ) gene leading to viscous secretions, chronic respiratory infections and airway inflammation. Although survival of patients has been markedly improved due to better care and new treatment options, lung failure is still the major cause of mortality.

Thus, controlling respiratory infection and excessive airway inflammation is an important goal in the treatment of CF lung disease. Interestingly, heterogeneity in disease severity has been noted for a long time and airway inflammation may already be present in young children even in the absence of infection.1 Multiple factors have been proposed to explain the variety of disease severity even in young patients. These factors include differences in CFTR mutations, poor compliance with treatment, external factors like early viral infections and environmental factors like secondhand smoke exposure (SHSe). Many clinicians believe that SHSe is a major contributing factor for disease progression, although the mechanisms associated with increased inflammation and infection due to SHSe in infants and young …
A surgeon in seven hours
Authors: Jessie Colquhoun
Journal: BMJ (2009)

Fancy performing a laparoscopic operation on a patient after just seven hours of training? A team of researchers in Denmark have assessed 24 junior obstetrics and gynaecology registrars who were using virtual reality training. None of them had any previous experience of laparoscopic surgery. After the training they performed their first laparoscopic operation on a real patient. On average the juniors performed at the same level as someone who had completed 20-50 laparoscopic procedures. Read the editorial, doi:10.1136/bmj.b1001, for more and watch the video.

Unintended injuries …
Medics are as likely to be smokers as other students
Authors: Manjulika Das
Journal: BMJ (2004)

Medical education has little effect on medical students' decision to start smoking, according to a recent research done in China.1

Researchers questioned 1896 students from 12 Chinese universities--about half of whom were medical students--about their smoking habits and their perceptions of the harm and benefits of smoking. They found that that the prevalence of smoking does not differ significantly between medical and non-medical students and medical students were more likely (75.3%) to be occasional smokers than non-medical students (60.6%).

Shu-Hong Zhu, an author of the study and associate professor at the family and preventive medicine department of the University of California at San Diego said that smoking behaviour might be determined by two kinds of factor. Social norms regarding smoking for certain groups influence the decision to start smoking: “Our study has revealed that medical students, like any other college students in China, are increasingly expected to smoke, as they grow older. Medical education seems to help little in preventing them from taking up smoking,” he said.



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So, what got you into medicine?



“The second kind of factor influences the choice of how much to smoke. Medical education does seem to influence this decision making process. It appears that medical students try to control their consumption level by smoking fewer cigarettes. Their medical knowledge about the harm of smoking contributes to such a decision,” he added.

“What is needed is a shift in societal norms regarding smoking, a shift that would make it easier not to smoke,” Zhu said. “We recommend …
Extensive global movement of multidrug-resistant <i>M. tuberculosis</i> strains revealed by whole-genome analysis
Authors: Keira A Cohen, Abigail L Manson, Thomas Abeel, Christopher A Desjardins, Sinead B Chapman, Sven Hoffner, Bruce W Birren, Ashlee M Earl
Journal: Thorax (2019)

Background While the international spread of multidrug-resistant (MDR) Mycobacterium tuberculosis strains is an acknowledged public health threat, a broad and more comprehensive examination of the global spread of MDR-tuberculosis (TB) using whole-genome sequencing has not yet been performed. Methods In a global dataset of 5310 M . tuberculosis whole-genome sequences isolated from five continents, we performed a phylogenetic analysis to identify and characterise clades of MDR-TB with respect to geographic dispersion. Results Extensive international dissemination of MDR-TB was observed, with identification of 32 migrant MDR-TB clades with descendants isolated in 17 unique countries. Relatively recent movement of strains from both Beijing and non-Beijing lineages indicated successful global spread of varied genetic backgrounds. Migrant MDR-TB clade members shared relatively recent common ancestry, with a median estimate of divergence of 13–27 years. Migrant extensively drug-resistant (XDR)-TB clades were not observed, although development of XDR-TB within migratory MDR-TB clades was common. Conclusions Application of genomic techniques to investigate global MDR migration patterns revealed extensive global spread of MDR clades between countries of varying TB burden. Further expansion of genomic studies to incorporate isolates from diverse global settings into a single analysis, as well as data sharing platforms that facilitate genomic data sharing across country lines, may allow for future epidemiological analyses to monitor for international transmission of MDR-TB. In addition, efforts to perform routine whole-genome sequencing on all newly identified M. tuberculosis , like in England, will serve to better our understanding of the transmission dynamics of MDR-TB globally.
Inhibition of glycolysis: a novel strategy to overcome drug resistance in CD133+ tumor initiating cells under hypoxic microenvironment
Authors: yunfei zhou, Yan Zhou, Li Feng, Seiji Kondo, Peng Huang
Journal: Cancer Research (2007)

LB-94  Increasing evidences suggest that the existence of a subpopulation of drug resistant tumor initiating cells or cancer stem cells likely attributes to the failure of clinical cancer treatment and disease recurrence. Development of new strategies to effectively eliminate the cancer stem cells is critical to improve treatment outcomes. Based on our recent observations, we hypothesize that tumor initiation cells (or stem-like cells) favor hypoxic conditions and maintain the stemness through high glycolytic activity, and that glycolytic inhibition might represent a novel approach to eliminating cancer stem cells. To test the hypothesis, we established a CD133+ enriched cell model (U87-SC) by isolating tumor cells from human malignant glioma U87 xenograft pre-selected in vivo by doxorubicin treatment, and maintaining the cells in a simplified brain tumor stem cell medium. At earlier passages, U87-SC cells readily formed neuroshere-like clusters in hypoxia but not in normoxia, indicating that hypoxia significantly favored the maintenance of neurosphere-forming capacity. There was a 2-fold increase of expression of CD133 in hypoxic U87-SC compared with normoxia as analyzed by flow cytometry. Interestingly, the neurosphere phenotype was eventually lost when cells were cultured in regular DMEM with 10% FBS. The neurosphere-like cells highly expressed nestin, a neural progenitor cell marker, suggesting that the neurosphere-forming capacity may reflect a stemness stage in proper culture conditions. Colony formation and anchorage-independent assay in soft-agar showed a higher colony formation capacity for hypoxic U87-SC cells. Furthermore, in vivo tumorigenecity of the hypoxic U87-SC cells was 100-fold higher than the parental U87 cells as quantitatively tested by by inoculation in nude mice. MTT assay showed that hypoxic U87-SC cells were less sensitive to doxorubicin, vincristin, and BCNU compared with normoxic conditions. The residual U87-SC cells after doxorubicin treatment re-grew when the drug was removed. Importantly, the sphere-forming U87-SC cells exhibited less oxygen consumption, and were highly sensitive to glycolytic inhibition, leading to severe ATP depletion. Combination with glycolytic inhibition with doxorubicin was able to eliminate the residual cells and abolish cell re-growth. Apoptosis induction by the combination treatment was confirmed by PARP cleavage and caspase activation using Western blot. Furthermore, this in vitro drug combination treatment effectively eliminated the tumorigenesic capacity of the hypoxic U87-SC cells to form tumors in vivo. Our data suggest that the chemotherapy resistance phenotype of hypoxic brain tumor cells is likely due to an enrichment of highly glycolytic tumor-initiating cells, which can be eliminated by a combination treatment of chemotherapeutic agents with glycolytic inhibition.
Applying for your first job
Authors: Benjamin C Brown, Allan M Conway, Robert P Jones, Judy Stokes, Caroline R M Boggis
Journal: BMJ (2007)

You made it through medical school, but they never taught you to fill in a personal statement. Benjamin C Brown and colleagues have some advice Applications for your first job after finishing medical school have always been competitive, with some students invariably failing to get their first choice. Formerly, a combination of application forms, CVs, and interviews were used by consultants to select the most able candidates for UK jobs. This article gives guidance on how to construct a successful application based on the most recent UK system. This advice is also relevant for programmes in other countries,1 which require similar personal statements, such as the Electronic Residency Application Service2 in the United States and the Canadian Resident Matching Service.3 Since October 2005 UK medical students reaching the end of their training apply for posts in the foundation training programme using anonymous proformas, which are scored using predetermined criteria. There are no interviews, and offers are made to the applicants who score highest. The process has stirred up much debate, which has spilled over into the national press. How can applicants score enough points to ensure they get a job—ideally the one they most want? All UK applications are now standard and are completed online, which was previously done via the now defunct medical training application service website (MTAS).4 However, a similar system and application form are to remain in place, especially given that the personal specification and eligibility criteria have not changed.56 The application asks for examples of:
Finding the Magic in Magic Mouthwash—Reply
Authors: Angad S. Uberoi, Timothy J. Brown, Arjun Gupta
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
Honey, Mud, Maggots and other medical marvels: the science behind folk remidies and old wives tales
Authors: Andy Conway Morris
Journal: BMJ (1999)

Medicine has been a crucial part of human society since we first came down from the trees and started to bang the rocks together. As civilisations grew medical knowledge became concentrated among a few specialists. Many lay people, however, practised and continue to practise medical care, often guided by folk tales, tradition, and intuition. In countries such as South Africa traditional or “Shamanic” healing is part of the state healthcare system.

The Root-Bernsteins attempt to explore the scientific basis of many of …
Undue Risk: Secret State Experiments on Humans
Authors: Adrian M Viens
Journal: BMJ (2001)

Any fan of science fiction knows that movies and television series such as the X-Files often incorporate stories about top secret government medical research projects. While one may reasonably dismiss the plausibility of projects involving aliens or cyborgs, the existence of secret government experiments on unwitting citizens is well documented.

There is a long and varied history of medical experimentation in the United States by government operated or sanctioned institutions in the mid to late 20th century. …
Severe Emphysema in the SU5416/Hypoxia Rat Model of Pulmonary Hypertension
Authors: Baktybek Kojonazarov, Stefan Hadzic, Hossein Ardeschir Ghofrani, Friedrich Grimminger, Werner Seeger, Norbert Weissmann, Ralph Theo Schermuly
Journal: American Journal of Respiratory and Critical Care Medicine (2019)
GP at Hand in talks to form its own primary care network
Authors: Gareth Iacobucci
Journal: BMJ (2019)

Babylon’s GP at Hand practice is in talks over becoming a single primary care network, in a move which GP leaders warned risked further destabilising the wider system.

GP practices across England are in the process of forming collaborative networks covering 30-50 000 patients, which will allow them to access additional funding for patient services. Practices have until 15 May to submit their application to register to join a network.

GP at Hand has almost 50 000 patients registered at its “digital first” NHS GP practice in Hammersmith, west London, and believes it is “well placed” to become a single network.

But GP leaders said such an agreement would contradict requirements agreed by the BMA and NHS England1 that networks must be developed within local geographical boundaries, given that a vast …
A career in psychiatry
Authors: Kirsty Passmore, Wai-Ching Leung
Journal: BMJ (2001)

Kirsty Passmore and Wai-Ching Leung give some insight into what is involved Myths about psychiatry abound in medical schools. Contrary to popular belief, most psychiatrists are “normal” people who generally do not have beards and do not always want to know about your childhood. The distinctions between psychologists, psychotherapists, and psychiatrists are often poorly understood and in the United States these terms are often used interchangeably. In brief, psychologists are concerned with the way the mind works. They may specialise in areas such as education or they may focus on mental health problems. Psychotherapists are trained in different types of “talking therapies.” Psychiatrists are doctors who specialise in mental health problems. Until recently, psychiatry was often regarded as a Cinderella specialty as it does not share the adrenaline fuelled excitement of emergency medicine or the glamour of other acute specialties, such as general medicine and surgery. Other medics often perceive psychiatry as an easy option for those who fail to progress in other acute specialties. This is certainly not the case and a career in psychiatry has a great deal to offer in its own right. People with psychiatric problems appear at some time or other in all other specialties, particularly general practice, and some doctors are trained in both general practice and psychiatry. ### Pros and cons #### Pros
Abstract 13170: Endothelial Function is Impaired in Relation to Alcohol Consumption in Men in a Large General Population
Authors: Nozomu Oda, Yukihito Higashi, Masato Kajikawa, Tatsuya Maruhashi, Akimichi Iwamoto, Shinji Kishimoto, Takayuki Hidaka, Ayumu Nakashima, Kensuke Noma, Hirofumi Tomiyama, Bonpei Takase, Akira Yamashina, Yasuki Kihara
Journal: Circulation (2015)

Introduction: Endothelial function is impaired in heavy or binge drinking. Heavy drinking should be a predictor of endothelial dysfunction. However, there is little information on the effects of dose-dependent alcohol consumption on endothelial function. Therefore, we evaluated the relationship between alcohol consumption and endothelial function in a large general population. Methods and Results: We measured flow-mediated vasodilation (FMD) in 2734 men who provided self-report about habitual alcohol intake. The subjects were divided into five groups by alcohol consumption: none (0 g/week), light (0 g/week&lt; to ≤140 g/week), moderate (140 g/week&lt; to ≤280 g/week), heavy (280 g/week&lt; to ≤420 g/week), and excessive (420 g/week&lt;). Age, systolic blood pressure, diastolic blood pressure, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, gamma glutamyl transpeptidase, uric acid, plasma glucose, hemoglobin A1c, and current smoking were significantly correlated with alcohol consumption. FMD showed a gradual decrease according to increased alcohol consumption (none, 6.6±3.4%; light, 6.2±3.0%; moderate, 6.0±3.0%; heavy, 5.5±2.9%; excessive, 5.3±3.0%; P&lt;0.01). There was a significant difference in FMD between the non-drinker group and the light drinker group (P=0.018). After adjusted risk factors, we showed the significantly smaller FMD in the 4 drinker groups than in the non-drinker group: light drinker group (OR, 1.38; 95% CI, 1.10 to 1.75), moderate drinker group (OR, 1.36; 95% CI, 1.01 to 1.82), heavy drinker group (OR, 2.05; 95% CI, 1.46 to 2.87), excessive drinker group (OR, 2.04; 95% CI, 1.43 to 2.89). Conclusions: These findings suggest that even light alcohol consumption impair the endothelial function. Alcohol drinking may be harmful for vascular function.