tbuckley/cabot-search huggingface dataset:
PWE-049 Effects of age, sex and obesity on satiation assessed by nutrient drink test and gastric emptying (GE) assessed by non-invasive gastric scintigraphy (GS) and MRI: analysis and comparison of methods
Authors: H Parker, C Hoad, N Hudders, E Tucker, A Perkins, P E Blackshaw, L Marciani, C Costigan, P Gowland, M Fox
Journal: Gut (2012)

<h3>Introduction</h3> The relationship of demographic and anthropometric factors on satiation and gastric functions is incompletely understood. Optimal methodology to assess meal intake factors and postprandial GE has not been established. Current test meals are small and may not be sufficient to assess satiation and postprandial responses. GS measures gastric meal retention only. MRI measures gastric content volume (meal and secretions). <h3>Aim</h3> This study assessed the effects of age, sex and obesity on maximum tolerated volume (MTV) assessed by nutrient drink test (NDT) in healthy volunteers (HVs). GS and MRI assessed gastric function and GE after ingestion of a 400 ml liquid test meal (same nutrient drink) that triggered sensation of fullness in &gt;90% HVs. <h3>Methods</h3> Adult HVs were recruited and stratified by sex and age aiming to study 10 men and women in age groups &lt;40, 40–60, &gt;60 yrs. Exclusions included history of GI surgery and obesity (BMI&gt;30 kg/m<sup>2</sup>). MTV was assessed at screening by NDT (0.75 kcal/ml at 40 ml/min), all HVs ingested &gt;400 ml. Eligible participants were randomised to gastric imaging by GS and MRI on two separate days. HVs ingested 400 ml liquid nutrient at 40 ml/min. Gastric content volume was monitored over 4 h. GS and MRI measured GE half-time [T50], GErate maximum and GErate@T50 [ml/min]. Univariate and multiple linear regression models assessed the effects of demographic and anthropometric parameters on gastric function. <h3>Results</h3> 53 HVs completed the study (6–10 in each group). MTV associated with male sex (R<sup>2</sup>=20%, p&lt;0.001), height (R<sup>2</sup>=9%, p=0.016) and weight (R<sup>2</sup>=15%, p&lt;0.003) but not age (R<sup>2</sup>=4%, p&gt;0.1) or obesity (WC or BMI, both p&gt;0.1). On multivariate analysis GS T50 and GErate@T50 were negatively associated with male sex (R<sup>2</sup>=12%, p&lt;0.005), height (R<sup>2</sup>=30%, p&lt;0.001) and weight (R<sup>2</sup>=23%, p&lt;0.001) but not age (R<sup>2</sup>=1%, p&gt;0.1) or obesity (BMI or WC, both p&gt;0.1). Similar associations were not present with MRI indicating gastric content by GS and MRI do not provide the same information. <h3>Conclusion</h3> HVs that are male, tall and heavy ingest more before MTV is reached; but no independent association with obesity was seen. These factors were associated with slower gastric emptying assessed by GS. A simple explanation is that large individuals have larger stomachs that can accommodate large volumes. 400 ml achieves lower relative gastric filling in large than small stomachs and does account also for slower GE. <h3>Competing interests</h3> None declared.
Is a smoking ban in UK parks and outdoor spaces a good idea?
Authors: A. Darzi, O. P. Keown, S. Chapman
Journal: BMJ (2015)

<b>Ara Darzi</b> and <b>Oliver P Keown</b> want a ban to help smokers quit and to protect children from seeing people lighting up. But, argues <b>Simon Chapman</b>, there is no scientific justification for such a draconian attack on basic freedoms
Some Vulgar Errors in Regard to Goitre
Authors: J. W. Linnell, G. Keynes, J. E. Piercy
Journal: BMJ (1946)

During the past generation the importance of goitre as a fount of many unsuspected ills has become more and more recog nized. It is but natural that new advances in any field of medicine should only gradually become known to the profes sion at large, and goitre is no exception to the rule. It is with the object of discussing some of the commoner fallacies con cerning its dangers, diagnosis, and treatment that we who have had the opportunity of studying the condition over a long period of years venture to write this article. We would say it was the intention of the late Cecil Joll, who worked at our clinic throughout the war, to collaborate with us in its produc tion, and that, though death prevented his doing so, he had already expressed his complete approval of the plan and the opinions embodied in it.
Isolated Aortic Stenosis in the Neonate
Authors: JEFFREY B. LAKIER, ALAN B. LEWIS, MICHAEL A. HEYMANN, PAUL STANGER, JULIEN I. E. HOFFMAN, ABRAHAM M. RUDOLPH
Journal: Circulation (1974)

We have reviewed the clinical and catheterization data and pathologic findings in ten infants under one month of age with isolated severe aortic valve stenosis. All presented with evidence of progressive cardiac failure and diminished cardiac output. A hyperdynamic right ventricular impulse was present in nine infants who were subsequently shown to have a left-to-right atrial shunt, through a stretched patent foramen ovale. Calculated aortic valve area ranged from 0.12 cm 2 /m 2 to 0.29 cm 2 /m 2 . Three patients died prior to surgical intervention because of low cardiac output and refractory metabolic acidosis. Aortic valvotomy was attempted in the remaining seven. Five died intraoperatively or in the immediate postoperative period and one other died six months after surgery. Necropsy was obtained in all nine patients who died. We believe that, in this group, the clinical course reflects fetal and postnatal hemodynamics. We have discussed the probable hemodynamic factors which occur and have related them to the morphological development of aortic stenosis in these infants. The poor prognosis of these patients probably results from a combination of factors which include left ventricular outflow obstruction, often associated with a small aortic annulus, a markedly thickened left ventricle, and left ventricular malfunction secondary to subendocardial ischemia and/or endocardial fibroelastosis.
Abstract 3262: Impact of the MESA Arterial Age Calculator Incorporating Coronary Calcium on CHD Risk Estimation
Authors: Jamalah Munir, Jody Bindeman, Kelly Bauer, Carole Byrd, Holly Wu, Patrick O’Malley, Allen Taylor
Journal: Circulation (2008)

Background: The MESA study recently published a web-based calculator for the computation of arterial age incorporating Framingham risk factors and coronary calcium to integrate the incremental predictive value of coronary calcium within the Framingham risk score, a reference-standard clinical coronary heart disease (CHD) risk calculator. We examined the impact of arterial age on the distribution of CHD risk estimation. Methods: We applied CHD risk factor data from the Prospective Army Coronary Calcium Project, a screening cohort of 2000 men and women between the ages of 40 and 50, to the MESA Arterial Age calculator (available at www.mesa-nhlbi.org). Subjects were studied with measured CHD risk factors and electron beam CT for the identification of coronary artery calcium. Framingham risk scores (FRS), using the 10 year CHD risk model with and without arterial age, were calculated using the MESA arterial age calculator. An estimate CHD risk between 6 and 20% was categorized as intermediate risk, and compared for the calculations using chronological age, and arterial age. Results: Demographics of the cohort included mean age 42.9 ± 2.7 yrs, male gender 82%, hypertension 8.0%, systolic blood pressure 123 ± 13 mm Hg, current smoking 7.7%, total cholesterol 203 ± 36 mg/dL, and HDL-C 53 ± 14 mg/dL. Mean FRS was 4.5 ± 3.6%. Coronary calcium was present in 394 subjects (19.7%). Application of the arterial age calculator increased mean age from 42.9 ± 2.7 to 43.6 ± 10.4 years (P &lt; .001), and the mean FRS increased from 4.5 ± 3.6 to 7.3 ± 8.1% (P &lt; .001). Reclassification was seen primarily among male subjects, in whom the mean age (chronological vs. arterial age) increased from 42.9 ± 2.7 to 44.2 ± 11.0 (P &lt; .001) and the prevalence of intermediate CHD risk increased from 26.2% (429 of 1639) to 37.4% (613/1639; P &lt; .001). Among women, mean age (chronological vs. arterial age) was reduced by calcium scoring (42.7 ± 2.6 vs. 40.7 ± 6.3%; P &lt; .001) and a shift to intermediate risk was seen in only 0.6% of subjects (from 10 to 18 out of 349). Conclusions: Among healthy middle-aged individuals, the MESA arterial age calculator modestly shifts predicted CHD risk estimation, and reclassifies 1 in 9 men from low to intermediate risk. Arterial age was lower than chronological age in women.
German hospital rankings questioned
Authors: Annette Tuffs
Journal: BMJ (2007)

The first nationwide hospital ranking in Germany has provoked controversial discussions about the importance and reliability of league tables in health care.

The statutory health insurance company Techniker Krankenkasse, with 6.1 million members, has published the results of a telephone survey of more than 100 000 patients on their recent stay in a hospital.

The patients were asked how satisfied they were with the results of treatment, the medical and nursing care, and the accommodation provided by the hospital. The survey was also covered in Germany's main tabloid newspaper, Bild , as a list of …
375 Dendritic cells co-transduced with an interleukin (IL)-12- or CD40L-expressing adenovirus and an AFP-encoding adenovirus enhance the cytotoxic activity of immunologic effector cells against AFP-expressing HCC cells
Authors: M.A. Gonzalez-Carmona, C. Schneider, A. Timmerman, S. Shabani, E. Sievers, I. Schmidt-Wolf, V. Schmitz, T. Sauerbruch, W.H. Caselmann
Journal: Journal of Hepatology (2006)
Note on the Technique of Serum Diagnosis of Acute Specific Fevers
Authors: A. E. Wright
Journal: BMJ (1897)

SERUAM DIAGNOSIS OF SPECIFIC FEVERS.[ 'ICAL ORAT I39The muscles of the body generally gradually recovered tone under a course of massage carried out on Eastern methods.REMARKS.It is noticeable that, as in Celli's case, very marked amelioration in the patient's condition occurred after the second injection.After a very careful inquiry, no cause for the occurrence of the disease could be discovered.The early symptoms seemed to point to conditions which might admit of the case being classified as one of rheumatic tetanus.
Learning from patients: A suggestion
Authors: K. Chaddah
Journal: BMJ (1997)

We are in a profession where listening to the patient, listening to his or her complaints, feelings, and fears is a major part of the job. Listening can also sometimes avert a major mishap.

I am a general practitioner. It was a busy antenatal checkup day for me as usual. One woman with a three month pregnancy, without any complaints …
Variability in Temperature-Related Mortality Projections under Climate Change
Authors: Tarik Benmarhnia, Marie-France Sottile, Céline Plante, Allan Brand, Barbara Casati, Michel Fournier, Audrey Smargiassi
Journal: Environmental Health Perspectives (2014)

Most studies that have assessed impacts on mortality of future temperature increases have relied on a small number of simulations and have not addressed the variability and sources of uncertainty in their mortality projections.
Fundamentals of Otolaryngology. A Textbook of Ear, Nose and Throat Diseases
Authors: G. S. Fitz-Hugh
Journal: JAMA (1964)

In both these new editions, the authors are well-known experienced clinicians and academicians, who have the ability to present their accumulated knowledge in a most acceptable manner. The information is not only useful to students but also to intern and resident groups, and to physicians in general medicine. Speaking of both texts in general, numerous well-prepared illustrations, plus diagrams, enhance the value, especially to the student, as do the sections dealing with methods of using instruments in the examination of the ear, nose, and throat. Indexing is quite adequate. At the end of each chapter is a good list of older key references (selective readings) and newer ones, some as late as 1963. A somewhat limited coverage of the subject, with compactness, has advantages. Nevertheless, since otolaryngologists actively participate in the wider aspects of the specialty and do much to improve general knowledge in areas such as facial nerve paralysis,
Nephrotic Syndrome in Association With Varicella
Authors: Richard A. Krebs
Journal: JAMA (1972)

CERTAIN viruses have been associated with histological abnormalities and dysfunction of the kidneys.<sup>1,2</sup>Although nearly all of the systemic viral illnesses may on occasion show renal abnormalities, the viruses which most commonly cause renal problems include coxsackie virus, echovirus, and mumps virus.<sup>1</sup>Much less commonly, varicella (chickenpox) has been associated with "nephritis."<sup>2</sup>This report will outline the clinical features of a patient who developed the nephrotic syndrome in association with chickenpox. <h3>Report of a Case</h3> A 46-year-old white man (No. 1314145) was admitted to the hospital with a history of swelling of the abdomen, hands, and feet of five days' duration. There was no apparent oliguria, dysuria, frequency, urgency, nocturia, or hematuria. He had gained 13.6 kg (30 lb) in the seven to ten days prior to hospitalization. Two weeks before the onset of edema his illness began with chills, fever, sweating, and the appearance of pruritic, papulovesicular
Vocational training schemes in south London have been improved
Authors: R. Savage, J. Hitchens, D. Misslebrook
Journal: BMJ (1996)

deaths due to Creutzfeldt-Jakob disease reported to the Office of Population Censuses and Surveys during the 15 years 1979-93 show a significant excess in 1992 (x2= 11-67, P< 0-01) and the interval 1987-93 (X2=4-29) P<0 05).The age adjusted mortality rose by 30%, from 0-6 to 0-8 deaths per million.Deaths from Creutzfeldt-Jakob disease in the two intervals 1979-85 and 1987-93 can also, however, be viewed as two samples taken from a common distribution, with the earlier sample being less complete than the later.The difference between the two distributions of cumulative mortality was minimal (X2=0*151, df= 16, P>0999), and a two by two analysis of the proportion of deaths below age 45 during the two intervals (8-8% and 11% respectively) did not show a significant difference (X2=O26l1 df=1, P=0-61).
Remarks on the so called Muscular Amaurosis
Authors: E. O. Hocken
Journal: BMJ (1842)

distressiing symptomns wlhich occurs in this (lisease- nainely gastric irritability; still tlhere, are soime patieints in wvloimi this disagreeable symptom assumes as much tlle character of iniflammatory actioni as of simiiple irritability; in these cases local bleeding will prove a valuable remedy.Patients are sometimes inet witlh oni this coast so weakened from the effects of the climate, that even local bleeding must be used with c.aiution, in order to avoi(l debility ; but in cases of primary fever this will seldom lhappein, as the patient is usually attacked before a twelvemoith's residence on the coast.In some patients dysenteric symptoms snpervene durinig the attack of fever, and if they are attenided by tlte slightest pain, or if uniacconmpanied by this symnptom, and the patient is not extremely debilitated, local bleeding by leeches must be had recourse to.Local abstraction of blood then is to be employed in this disease.First, for the purpose of preventing or removinig inflanunmatory affectionis of the brain.This indicationi is best fuilfille(d by applying leeches to the temples, or cupping glasses to the nape of the neck, or in some cases both mlay be required; the numinber of leechles uised, anid the quantity of blood drawn by the glasses, muist of couirse be regulated by the symiptoms present, but more so still by the strenigti and conistitution of the persoii utnder treatmeit.
RETARDATION OF THE PULSE IN MITRAL INSUFFICIENCY.
Authors: A. T. KEYT
Journal: JAMA (1884)

Read in the Section of Practice of Medicine and Materia Medica of American Medical Association, May, 1884. At the meeting of the Association last year, I read before this section a paper on Diminution of the Retradation of the Pulse in Aortic Insufficiency, in which were considered the reality, mechanism and diagnostic value of the phenomenon. In the present paper I wish to present the subject of augmentation of the retardation of the pulse in mitral insufficiency. This subject in its inception and literature seems to be peculiarly my own. For although none would question the importance of a new diagnostic sign of a lesion so common and grave as mitral insufficiency, and whose diagnosis by means of the old signs is not always infallible; and although I presented to the profession some years ago demonstrations of this phenomenon of mitral regurgitation which to me were conclusive, the announcement has
A copyright-free alternative to the mini-mental state examination is needed
Authors: M. Seshadri, N. Mazi-Kotwal
Journal: BMJ (2012)

With elderly people being the fastest increasing subgroup of the population in most developed countries, the prevalence of dementia will increase exponentially. Early diagnosis and support will improve quality of life and reduce financial costs to the state.1 2

Folstein’s mini-mental state examination (MMSE) has been used worldwide as a …
Detection of Pulmonary Teleangiectasia Using Dynamic Pulmonary Perfusion Imaging in Patients with Liver Cirrhosis
Authors: HIROSHI SHIJO, SHUSUKE HISANO, HARUKA SASAKI, KOHICHI YUH, HIROYUKI KUSUHARA, SEIGO SAKAGUCHI, MAKOTO OKUMURA, HIROMICHI SAKATA
Journal: Clinical Nuclear Medicine (1989)

Two cases of liver cirrhosis associated with marked hypoxemia are presented. Chest radiographs and cardiopulmonary function showed no abnormalities, except for the low diffusion capacity of carbon monoxide and slight elevation of the shunt ratio (20 and 6.2%, respectively), as estimated under conditions of 100% oxygen inhalation. Pulmonary perfusion imaging with Tc-99m macroaggregated albumin (MAA) revealed a significant radioisotope uptake in the lungs, brain, spleen, and both kidneys. Shunt ratios, estimated by the quantitative radionuclide method, were 60 and 68%, respectively. Dynamic pulmonary perfusion imaging revealed a gradual reduction in uptake in all areas of both lungs. The discrepancy of the shunt ratio between the two methods results from an abnormal dilatation of alveolar capillaries. The gradual reduction of radioactivity In areas of the lungs is caused by the passage of MAA particles through widened pulmonary capillaries.
Rheumatoid factor in sera of dermatitis herpetiformis patients
Authors: KIRSTI KALIMO
Journal: British Journal of Dermatology (1978)

Serum specimens from 44 patients with dermatitis herpetiformis (DH) and 42 control patients were analyzed with solid-phase radioimmunoassay (RIA) developed to detect IgG and IgM class antibodies against herpes simplex virus (HSV) envelope antigen. They were also tested with different tests to detect rheumatoid factor (RF) as well as serum antibodies to gastric parietal cells, glomerular basement membrane, smooth muscle, mitochondria and nuclei. Total serum IgG, IgM and IgA quantification was performed concurrently. IgM class antibodies reacting in HSV envelope antigen RIA were found in 47.8% of the DH patients, but in none of the controls. The age distribution of the IgM positive patients was in accordance with the appearance of RF, representing elderly persons. The presence of RF in serum specimens was confirmed by removing the IgM reactivity with heat aggregated human gamma globulin adsorption and in 13 patients with positive serological tests for RF. No correlation was found with the appearance of RF and duration or severity of the disease or with the detection of RF and serum total IgM concentration. In DH patients antibodies to gastric parietal cells were found in 6 and to smooth muscle in 1 of 32 specimens tested.
Isolation of Highly Purified, Functional Carboxy–Terminally Truncated Hepatitis B Virus Middle Surface Protein Activators From Eucaryotic Expression Systems
Authors: E Hildt, S Urban, C Eckerskorn, P H Hofschneider
Journal: Hepatology (1996)

Carboxy–terminally truncated hepatitis B virus (HBV) middle surface proteins (MHBst) show a transcriptional activator function. Two different subtypes of MHBst activators can be distinguished: an ER–localized type, represented here by MHBst76 (truncated at amino acid 76), and a cytosol–localized type, represented here by MHBst63. To characterize the MHBst activator on the protein level and to analyze posttranslational modifications, we established recombinant baculoviruses encoding for fusion proteins of MHBst76 or MHBst63 and of an amino terminal hexa–his tag. Both proteins could be obtained in high purity by affinity chromatography using Ni–nitrilo–tri–acetate agarose. In addition, 6H–MHBst76 was also isolated from transiently transfected HepG2 cells. Both the Spodoptera frugiperda (Sf9) cell–derived and the HepG2 cell–derived MHBst proteins were found to be unglycosylated. A detailed analysis of Sf9 cell–derived 6H–MHFBst76 by electrospray– ionization mass spectrometry showed that a fraction of this protein is N–terminally acetylated and phosphorylated or sulfated. Electric–field– mediated transfer of the highly purified proteins into reporter cells demonstrated that the isolated proteins are functional transcriptional activators. These experiments further showed that Sf9 cell–derived and HepG2 cell–derived 6H–MHBst do not differ in their functionality. This system allowed production and purification of functional 6H–MHBst in amounts sufficient enough to allow a further detailed analysis of MHBst activators on the protein level.
Anti-inflammatory drugs and variceal bleeding: a case-control study
Authors: V De Lédinghen, D Heresbach, O Fourdan, P Bernard, M P Liebaert-Bories, J B Nousbaum, A Gourlaouen, M C Becker, D Ribard, P Ingrand, C Silvain, M Beauchant
Journal: Gut (1999)

Background Non-steroidal anti-inflammatory drugs (NSAIDs) can have severe gastrointestinal effects and cause peptic ulcers to bleed. Acute bleeding from oesophageal varices is a major complication of cirrhosis of the liver. Aims To investigate the role, using a case-control study, of NSAIDs in first bleeding episodes associated with oesophageal or cardial varices in cirrhotic patients. Patients/Methods A structured interview was conducted of 125 cirrhotic patients with bleeding mainly related to oesophageal varices and 75 cirrhotic controls with oesophageal varices who had never bled. Results Cirrhotic patients who were admitted for bleeding related to portal hypertension were more likely to have used NSAIDs during the week before the index day (31 of 125 (25%)) than the cirrhotic controls (eight of 75 (11%); odds ratio = 2.8, p = 0.016). Use of aspirin alone or combined with other NSAIDs was also more prevalent in the cases (21 of 125 (17%)) than in the controls (three of 75 (4%); odds ratio = 4.9, p = 0.007). Logistic regression analysis showed that NSAID use (p = 0.022, odds ratio = 2.9, 95% confidence interval = 1.8 to 4.7) and variceal size (p&lt;0.001, odds ratio = 4.0, 95% confidence interval = 1.4 to 11.5) were the only variables independently associated with the risk of bleeding. Conclusions Aspirin, used alone or combined with other NSAIDs, was associated with a first variceal bleeding episode in patients with cirrhosis. Given the life threatening nature of this complication, the possible benefit of this treatment should be weighed against the risk shown here. No firm conclusions could be drawn on non-aspirin NSAIDs used alone.
Cholesterol testing for all: Author's reply
Authors: M. Rayner
Journal: BMJ (1989)

increase has been only 1 6'%o.Let this be compared with the previous five vears (under Wilson/ Callaghan), when the average annual growth was 3-6%.With 1-6% growth £100 of expenditure in 1979 would have increased to £115.36 in 1988.With 3 6% annual growth its value would have increased to £137.48.This represents a shortfall in revenue for 1988 of 19-15%.I am sure that many of the problems of the district health authorities would be solved if their present income was increased by that amount.Even worse, however, is the accumulated loss of funding over the period.With the same £100 base the total loss in income over those nine years is £103.40,equivalent to a loss of 89-6% of the 1988 annual budget.This will inevitably become rapidly