tbuckley/cabot-search huggingface dataset:
Religion must not influence medical practice
Authors: Stephen J Goldie
Journal: BMJ (2003)

> The great socialist leader Karl Marx famously said, “Religion … is the opium of the people,” and I agree entirely. Marx and I share similar principles and priorities when it comes to looking after people. We believe that humans are so subdued by their unerring faith in an omnipotent being that they accept the hand life has dealt them. They fail to rise up and fight the real evils in life-poverty, oppression, and disease.

I have deliberately not mentioned if I have any affiliation, past or present, with a secular group, as I think this would cloud the issue concerning my revulsion towards religion. I am not an atheist (someone who does not believe that there is a god) nor am I an agnostic (someone who believes that human beings know nothing of things outside the material world). But why should I need to be anything? Why do we need religious labels? Religions are no more than social clubs; ways to pass some time in the company of people with similar interests. I do not have to defend my absence of religion to anyone; if anything the reverse is true-the pious have to convince me.

> The same standard of medical care must be provided equally by …
Mental health after natural disaster
Authors: Hassan Mustafa Minhas
Journal: BMJ (2006)

This October marks a year since Pakistan was hit by a devastating earthquake. Hassan Mustafa Minhas looks at how the earthquake has affected people's mental health In situations of severe damage to physical and economic wellbeing after a natural disaster, it is easy to overlook the associated psychological trauma. The observer's eye is overwhelmed with images of destruction, and the true psychological impact sinks in only after these have been digested. Although the dent in the psyche is less evident, the consequences are no less profound. RICHARD VOGEL/AP/EMPICS This is just one side of the coin One commonly believed reason for the debilitating nature of mental distress is that mental bruises take much longer to heal than their physical counterparts, and even when they do, they leave indelible scars. Also, unlike physical damage, which is usually restricted to only the person affected, psychological damage affects many people around him, and society as a whole. When the tsunami hit South East Asia, ministries of health, the World Health Organization, and other partners quickly assessed people's health to determine the most pressing needs. Surveys of the worst affected regions categorised peoples' mental health into three groups:
Heart sounds and murmurs
Authors: Lorna M Gibson
Journal: BMJ (2008)

The University of Dundee's human Heart Sounds and Murmurs website (www.dundee.ac.uk/medther/Cardiology/hsmur.html) is ideal for a basic introduction or a quick refresher of heart sounds and murmurs. It includes audio files of examples of S3, S4, gallop rhythm, aortic stenosis, aortic regurgitation, mitral stenosis, mitral regurgitation, pulmonary stenosis, atrial fibrillation, and pericardial rubs. Each sound is accompanied by a brief description of the physiology behind it, where to hear it, and what else might be found on examination.



For more detail about auscultation findings visit Blaufuss Multimedia (www.blaufuss.org). Each …
Podocyte-Specific Sialylation-Deficient Mice Serve as a Model for Human FSGS
Authors: Kristina M. Niculovic, Linda Blume, Henri Wedekind, Elina Kats, Iris Albers, Stephanie Groos, Markus Abeln, Jessica Schmitz, Esther Beuke, Jan H. Bräsen, Anette Melk, Mario Schiffer, Birgit Weinhold, Anja K. Münster-Kühnel
Journal: Journal of the American Society of Nephrology (2019)

The etiology of steroid-resistant nephrotic syndrome, which manifests as FSGS, is not completely understood. Aberrant glycosylation is an often underestimated factor for pathologic processes, and structural changes in the glomerular endothelial glycocalyx have been correlated with models of nephrotic syndrome. Glycans are frequently capped by sialic acid (Sia), and sialylation's crucial role for kidney function is well known. Human podocytes are highly sialylated; however, sialylation's role in podocyte homeostasis remains unclear.We generated a podocyte-specific sialylation-deficient mouse model (PCmas-/- ) by targeting CMP-Sia synthetase, and used histologic and ultrastructural analysis to decipher the phenotype. We applied CRISPR/Cas9 technology to generate immortalized sialylation-deficient podocytes (asialo-podocytes) for functional studies.Progressive loss of sialylation in PCmas-/- mice resulted in onset of proteinuria around postnatal day 28, accompanied by foot process effacement and loss of slit diaphragms. Podocyte injury led to severe glomerular defects, including expanded capillary lumen, mesangial hypercellularity, synechiae formation, and podocyte loss. In vivo, loss of sialylation resulted in mislocalization of slit diaphragm components, whereas podocalyxin localization was preserved. In vitro, asialo-podocytes were viable, able to proliferate and differentiate, but showed impaired adhesion to collagen IV.Loss of cell-surface sialylation in mice resulted in disturbance of podocyte homeostasis and FSGS development. Impaired podocyte adhesion to the glomerular basement membrane most likely contributed to disease development. Our data support the notion that loss of sialylation might be part of the complex process causing FSGS. Sialylation, such as through a Sia supplementation therapy, might provide a new therapeutic strategy to cure or delay FSGS and potentially other glomerulopathies.
Medical students and their faith - being a Hindu medic
Authors: Sumita Kini
Journal: BMJ (2002)

Habit can become a way of life, and living in a traditional Hindu house surrounded by non-Hindus in Barnsley, is no exception. I was always quite adept at keeping the two apart; home was where I left my views and Hindu ideologies, and school was where I learnt the essence of being “cool.” Unlike school, medicine encourages individualism, and for me this involved accepting the culture my parents have been trying to instil into me at home. I never understood the fuss, until I came to the clinical phase in my third year of studying.

It could be seen as a norm for British Asian children to join medicine after A levels. This culture has also seeped into television, as you will be sure to find an Asian doctor pottering about in the background of a soap, ready to stun us with his one liner, “We are doing all that we can, but the chances look slim.” It's not that all Asians are being bred to be doctors, but this path can be inevitable when exposure to medicine, and particularly hard work, has …
The fashion doctor
Authors: Lucy Modra
Journal: BMJ (2006)

“Who'd want to be a surgeon? Study for years and years, only to have to wear pyjamas to work every day!” my flatmate commented. And she's right: despite their portrayal in TV hospital dramas as outfits for seduction, scrubs are not attractive clothes. Monochrome and sack-like, scrubs are a triumph of function over form. This got me thinking: what should doctors wear? Does it matter?

Ask the infection control department of your teaching hospital what doctors should wear, and they are likely to emphasise cleanliness. Ask hospital administration and the word “cheap” will soon enter the conversation. Scrubs represent the marriage of these practical considerations: they're clean, cheap and two sizes fit most (if you pull hard enough on the drawstrings). Certainly, I don't think anyone could justify spending public health dollars on designer scrubs. Hence my surprise on discovering TC's Uniforms, a US company that markets a variety of fashion scrubs.1

But doctors don't spend all their time wandering around in scrubs. And in many of the hospitals in which I've trained, medical staff are distinguished by the fact that they don't have a uniform. With this privilege comes the timeless fashion quandary, “What should I wear?”

This is a quandary doctors initially encounter as university students. On starting clinical attachments, medical students must abandon their comfortable jeans and learn to dress like a grown-up. And not just any old grown-up: a grown up with a decent salary (a doctor). Such confusion. How to dress like a well paid adult while subsisting on a student loan, part time job, or the Bank of Mum & Dad? In an attempt to avert sartorial disaster, …
A guide to medical etiquette-how to conduct yourself at meetings
Authors: David McAllister
Journal: BMJ (2000)

Lifetime learning, it seems, must take place over lunchtime. At midday in hospitals across the United Kingdom medical staffs are engaged in learning and lunching.

You as a medical student are required to attend such meetings. Pharmaceutical companies seeking to peddle their wares often provide small bribes by way of coffee and sandwiches. Medical students are usually permitted to partake of the morally ambiguous offerings. You will need self denial to create a good impression. Make sure …
Electives in the United States and Canada
Authors: Matas Morkevicius
Journal: BMJ (2004)

Once you decide to seek an elective in the United States, the difficult part is to find an appropriate hospital that will accept you. One way is to visit each medical school website www.aamc.org/members/listings/msalphaae.htm) and find out if they accept international medical students. But this is an inefficient way of getting information. Often the school's website has limited information or no information at all …
Are patients or doctors responsible?
Authors: Teresa Pun
Journal: BMJ (2008)

The doctor's role is to diagnose a condition and recommend an appropriate plan of management based on current evidence. With that information, a patient can make an informed decision. But what if the patient makes the “wrong” decision?

My friend was prescribed a corticosteroid inhaler and unbeknown to her doctor, she was only taking one puff every other day instead of two puffs twice a day. When I asked her why, she said that she didn't like the idea of having to take a drug every …
Understanding the Consultation. Evidence Theory and Practice
Authors: Amy McLaughlin
Journal: BMJ (2000)

Tim Usherwood Buckingham: Open University Press, 1999; £14.99 ISBN 0 335 19998 4

This book brings together many of the theories and views about the general practice consultation into one short volume. In today's era of evidence based medicine it describes the studies and research findings behind the ideas.

These are basically concepts that …
Peer led training in communication skills
Authors: Saman Saidi, Alison Lievesley, Michelle Lee, Louise Gent, Richard Lin, Laura Jones
Journal: BMJ (2008)

Role play can be a valuable learning experience for student facilitators and students being trained. Saman Saidi and colleagues describe an interesting initiative Despite recent changes to the medical curriculum there are still regular reports in the media that criticise the bedside manner and communication skills of doctors and medical students.12 These shortcomings may also be the reason for official complaints and legal action against doctors.3 So, without looking for someone to blame for this continuing trend, what can be done to improve the communication skills of tomorrow's doctors? Perhaps a student led scheme at Lewisham Hospital offers an answer. In 2004 a young psychiatrist, Dr Sarah Stringer, inspired by her undergraduate training in communication skills at Cambridge University's Anatomy B course, decided to implement an arrangement for informal feedback to her psychiatry teaching, with the intention of improving student doctors' communication skills as well as preparing them for their upcoming objective structured clinical examinations (OSCEs; box 1). ### Box 1: What is the OSCE? The objective structured clinical examination (OSCE) is the medical practical skills exam, consisting of numerous time limited clinical situations, where the student's basic knowledge of … RETURN TO TEXT
Abstract 19154: Emergency Department Overcrowding is Not Associated With Outcome of Out-of-hospital Cardiac Arrest
Authors: Euigi Jung, Jiwon Kang, Ji eun Hwang, Jungyoup Lee, Joonghee Kim, Jae Hyuk Lee, You Hwan Jo, Taeyun Kim, Kyuseok Kim
Journal: Circulation (2015)

Aim of the study: Emergency department (ED) overcrowding is a worldwide problem associated with adverse outcomes. This study was performed to investigate the association between ED overcrowding and outcome and quality of cardiopulmonary resuscitation for out-of-hospital cardiac arrest (OHCA). Methods: Prospectively collected data including patient demographics, Utstein factors and outcomes on 608 consecutive OHCA patients at a single ED from January 2008 to December 2012 were retrospectively analyzed. The patients were categorized into 4 groups according to ED occupancy rate. The primary outcome was resuscitation outcome, a composite of rates of return of spontaneous circulation (ROSC), survival at discharge and neurological outcome at 6 months. The secondary outcome was resuscitation quality assessed by time to advanced airway, time to first drug administration, resuscitation duration in refractory cases and rate of initiation of therapeutic hypothermia after ROSC in the ED. Results: There was no significant difference in rates of ROSC, survival at discharge and good neurological outcome according to ED occupancy rate in the univariate and multivariate analyses (p &gt; 0.05). In addition, ED overcrowding was not associated with resuscitation quality (p &gt; 0.05). Conclusion: ED overcrowding was not associated with outcome of OHCA or resuscitation quality.
Artificial Intelligence Algorithms for Medical Prediction Should Be Nonproprietary and Readily Available
Authors: Ben Van Calster, Ewout W. Steyerberg, Gary S. Collins
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
Abstract 10779: Exosomes Derived From Cardiac Progenitor Cells Attenuate Left Ventricular Dysfunction and Remodeling After Myocardial Infarction via Epigenetic Modulations
Authors: Qianhong Li, Dinesh Devadoss, Yibing Nong, Ashraf Khallaf, Azam Mohammed, Huda Kutmah, Ning Chen, Yiru Guo, Roberto Bolli
Journal: Circulation (2018)

Increasing evidence shows that exosomes (Exsm) are being developed as an alternative to cellular therapies because of its important role as mediators via an autocrine/paracrine manner in promoting ...
Filling in the Evidence About Sunscreen
Authors: Robert M. Califf, Kanade Shinkai
Journal: JAMA (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 HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More 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 journal
Privacy over progress
Authors: Eva Brencicova
Journal: BMJ (2009)

Soon I will be a qualified doctor, expected to perform gynaecological examinations. Despite developing an early interest in obstetrics and gynaecology and opting for voluntary placements in this discipline to expand my practical skills, I have never been allowed to perform one of the most important procedures, a pelvic examination. Doctors keen to protect their ethical integrity often argue that privacy would be compromised if they permitted students to carry out this investigation. But is preserving the privacy of today’s patients’ worth inadequate training of tomorrow’s doctors?

Media focus on intimate examinations tends to concentrate on patients …
Laboratory medicine in primary care Glycated haemoglobin (HbA1c) monitoring
Authors: Timothy M Reynolds, W Stuart A Smellie, Patrick J Twomey
Journal: BMJ (2007)

Glycation of haemoglobin to produce HbA1c occurs throughout the 120 day average lifespan of the red blood cell. Repeat testing in fewer than 120 days or situations that shorten this lifespan will produce HbA1c results that do not fully reflect current diabetic control. <b>Timothy M Reynolds</b> and colleagues discuss
Selection of rapid responses
Authors: Hilary Butler, Simon Grant, Leilah McCracken, John Hopkins
Journal: BMJ (2001)

EDITOR - In response to the article “Learning respect” and the response of Ashley Williams who considers the words “uncorrupted by medical training” insulting, there are perhaps some useful learning issues.

Firstly, the person “uncorrupted by medical training” may actually be a medical student, not a lay person. Whether it was by jest, or not many a true word is spoken in jest and often people get upset precisely for that reason. The person concerned may have chosen to disassociate herself from her training.

Secondly, is it an issue of learning respect? The whole practice of “using” other people without consideration stemmed from an old fashioned patronising attitude that used to prevail, that “doctors were gods” who could do what they liked. Their castle (the hospital) was where their “study material” came to receive their “benificence.” Since they were “gods,” with a social status elevated way above others, who knew everything, and since people who were …
A broken kidney
Authors: Steven Kennish, M Murphy
Journal: BMJ (2005)

A 17 year old man was brought in to the accident and emergency department in the early hours of the morning having sustained an obvious head injury. He had been found wanW, dering by the roadside, smelled of alcohol, was agitated, and could not remember what had happened. On examination, doctors found a small scalp laceration and right flank bruising. No focal neurological signs could be elicited and no major musculoskeletal injuries were detected on examination. However, a urine specimen showed the patient had frank haematuria (blood in the urine altering its colour to the naked eye). The consultant radiologist arranged urgent contrast enhanced computed tomography of the abdomen. 1. What abnormality does the figure show? 2. What other radiological test(s) could be useful to assess renal injury? 3. What are the indications for further intervention? 4. Apart from the loin injury, what else concerns you about the history and examination findings 1. Fractured right kidney with associated haematoma. 2. Intravenous urogram (IVU) gives information on whether the urine collecting system is intact, and renal angiography shows whether the blood supply to the kidneys is intact. CT, however, also provides accurate information on these and provides better definition than ultrasound examination. 3. Haemodynamic instability indicating continued haemorrhage. 4. The head injury combined with apparent retrograde amnesia may warrant CT of the head to assess for intracranial haemorrhage. ### Organ injury scaling: kidney #### Minor
Abstract 18614: Pre-Diabetes, Diabetes and Predictors of Incident Angina During Long-term Evaluation in Older Women and Men in the Cardiovascular Health Study
Authors: Njambi Mathenge, Wenjun Fan, Nathan D Wong, Calvin Hirsch, Joseph A Delaney, Ezra A Amsterdam, Bruce Koch, Rico Calara, Julius M Gardin
Journal: Circulation (2017)

Introduction: Diabetes mellitus (DM) is an important risk factor for coronary heart disease (CHD) and has been considered to be a relatively stronger predictor for CHD in women than men. Angina pec...
The students' perspective
Authors: Daniel Goldstein
Journal: BMJ (2002)

The new BSc in international health at Leeds was created as a direct result of pressure from students and members of MedSIN (Medical Students International Network). We felt that conventional intercalated bachelors degrees didn't cover the issues that were of interest and importance to us. We were also convinced that many other students would be interested in such a course.

We first met with Rhys Williams, …
Women medical students exceed quota in Singapore
Authors: Samena Chaudhry
Journal: BMJ (2002)

Women applicants made up 41% of the medical students accepted by the National University of Singapore last year, despite a quota, imposed by the Singapore government in 1979 restricting their number to one third of the total.

The quota has been exceeded for three years. In 1999, 70 women or 35% of the total were accepted in the intake of 200. Last year, the percentage of females hit 41%. …
Wine losing credibility
Authors: Helen Morant
Journal: BMJ (2000)

Drinking red wine and spirits may increase the risk of cardiovascular disease by increasing serum concentrations of the amino acid homocysteine, researchers in the Netherlands have found. Beer does not have the same effect.

In a crossover study of healthy middle aged men, drinking wine increased serum homocysteine levels by 8% and drinking gin increased levels by 9%. These levels of …
Picture quiz Disc swelling or papilloedema?
Authors: Marie-Noëlle Lazaridou, Syed Muhammad Asad Ali, Bal Manoj
Journal: BMJ (2007)

A 10 year old girl presented with a two week history of back pain and a one day history of vomiting and headache. She did not have any significant deterioration of visual acuity, but colour vision was impaired, as were the visual fields. Fundus photographs of both eyes are shown below (figs 1 and 2). Computed tomography and magnetic resonance imaging of the brain did not show any abnormality. Lumbar puncture showed an opening cerebrospinal fluid pressure > 40 cm H2O.



Fig 1 
Right eye





Fig 2 
Left eye







We believe that a detailed reference to the topics of disc swelling and papilloedema is beyond the scope of this educational illustrative snapshot, as …