tbuckley/cabot-search huggingface dataset:
NHS change management (or how many people it take to change a light bulb)
Authors: Graham Ellis
Journal: BMJ (2004)

Chronic liver disease and hepatocellular carcinoma are major worldwide public health problems in countries with endemically high levels of viral hepatitis (B and C). 1 However, even in western countries chronic liver disease is an emerging problem, due not only to viral hepatitis but also to the effects of lifestyle factors such as heavy alcohol consumption and obesity. 2 3 Liver function tests are widely performed blood tests used in patients with suspected liver disease or unexplained illness and in some specific situations such as screening of blood donors.The most widely used tests are those used to detect the aminotransferases-alanine and aspartate-which are associated with hepatocellular injury.Raised concentrations may indicate serious underlying chronic liver disease, recognition of which is important for guiding interventions to modify lifestyle and use of specific therapies such as interferon for hepatitis C to prevent the risk of progression to cirrhosis.The sensitivity, specificity, and predictive values are important in assessing the clinical utility of such tests.Normal ranges have been based on distributions from healthy volunteers with two SD above the mean (that is, top 2.5% cut-off) being considered the upper normal range.Aminotransferase concentrations maybe within the normal range in people with chronic liver disease. 4 5There is ongoing debate about whether to lower the normal range to take account of changing lifestyle factors that influence aminotransferase concentrations, particularly obesity, which in Western countries would increase the detection of hepatitis C and alcoholic and non-alcoholic fatty liver disease (NAFLD). 6 7 Kim and colleagues have analysed the association between aminotransferase concentrations and mortality from liver disease in a large prospective cohort in Korea. 1 They found that there was a graded increase in risk of mortality from liver disease even within the normal range (20-40 IU/l) compared with the lowest concentrations ( < 20 IU/l) for both sexes.The performance of the test in identifying future risk of mortality from liver disease was maximised by lowering the threshold to about 30 IU/l.They propose identifying a borderline level of aminotransferase of 30-39 IU/l, suggesting that patients in this category should be
Cholera in Louisiana: Old Problem, New Light
Authors: Myron M. Levine
Journal: New England Journal of Medicine (1980)

As a resumé of the results of my inquiries, it may be set down as the unqualified opinion of all the physicians with whom I have consulted in the City of New Orleans, that the cholera of the spring of 1873 in that city and vicinity was native in its origin; that is, it was not brought here from abroad. (Communication of Assistant Surgeon, Van Buren Hubbard, U.S.A.., New Orleans, January 30, 1874.)Cholera, a diarrheal disease characterized by epidemic occurrence and ability to cause rapid dehydration and death in previously healthy persons, has long held the attention of epidemiologists, . . .
Suicide by Ingestion of Halothane
Authors: James A. E. Spencer
Journal: JAMA (1968)

High levels of halothane (Fluothane) were found at autopsy in the serum and various other tissues of a hospital employee and indicate for the first time the range of lethal concentration in man. Modern halogenated hydrocarbon anesthetics are not unpleasant to smell or taste and may be used as suicidal agents. Meticulous anaerobic technique is vital in assessing the role of such agents in autopsy material.
1164 susceptibility of wild-type and lamivudine-resistant hepatitis B virus to tenofovir and adefovir
Authors: O LADA, Y BENHAMOU, M VALANTIN, C KATLAMA, T POYNARD, A CAHOUR, V THIBAULT
Journal: Hepatology (2003)

To study the prevalence of drug-resistant HBV in patients with therapy failure in a Chinese tertiary referral liver centre.1223 HBV-infected patients who underwent genotypic resistance testing between 2010–2014 were studied.3TC genotypic resistance was the most common (46.5%), followed by LdT resistant (46.2%), ETV intermediate (37.9%), ADV resistant (11.4%), TDF intermediate (11.4%) and ETV resistant (1.7%). The 3TC resistance rate increased from 39.8% in 2010 to 56.6% in 2013, before decreasing to 49.5% in 2014, evidence of a lagging effect of l-nucleoside consumption. M204I, N236T and L180M + M204V + V173L/S202G were the most common substitutions for l-nucleoside (3TC and LdT), ADV and ETV genotypic resistant phenotypes, respectively. 3TC-exposed patients showed a high multiple genetic resistance rate (3TC-resistant + LdT-resistant + ETV intermediate; 58.8%). Resistance rates to 3TC, LdT and ETV in HCC patients were significantly higher than in cirrhosis and CHB patients. Resistance rates to different drugs showed no statistical difference between genotype B and C patients, whilst some amino acid substitution showed genotype bias, e.g. N236T incidence in genotype B was significantly higher than in genotype C (43.2% vs. 5.9%; P < 0.0001), and genotype C isolates had a significantly higher A181V/T incidence than genotype B (54.9% vs. 19.3%; P < 0.0001).3TC genotypic resistance was most common in this centre, whilst ETV had the lowest resistance rate. HBV genotypes had no impact on antiviral drug resistance, except for some drug resistance substitutions bias. Optional initial therapy and subsequent rescue treatment should be based on knowledge of nucleos(t)ide analogue resistance.
Insulin secretion in response to protein ingestion.
Authors: J C Floyd, S S Fajans, J W Conn, R F Knopf, J Rull
Journal: Journal of Clinical Investigation (1966)

W\e have reported previously that the oral or intravenous administration of the amino acid l-leucine to healthy subjects results in increases in plasma insulin and decreases in blood glucose and plasma free fatty acids (2, 3).After the ad- ministration of leucine to healthy subjects pre- treated with either chlorpropamide or tolbutamide (2, 3), and also to some patients with functioning islet cell tumors of the pancreas (4), increments in plasma leucine caused increases in plasma insulin and decreases in blood glucose that were sig- nificantly greater than those observed in healthy subjects not pretreated with sulfonylurea drugs.We have also shown that increased release of in- sulin from the pancreatic beta cells is the mecha- nism by which leucine increases peripheral levels of insulin (5).We suggested that a rising plasma level of leucine is a physiologic stimulus for the release of insulin, and that the more pronounced sensitivity to leucine hypoglycemia produced ex- perimentally by.administration of sulfonylureas and observed in some patients with idiopathic hypoglycemia or insulin-secreting tumors of the pan- creas represents a great exaggeration of a normal physiologic phenomenon (6, 7).In an effort to determine the effect of leucine on insulin release under physiologic circumstances, protein meals rich in leucine were fed to healthy subjects, and the levels of plasma insulin, leucine, amino nitrogen, free fatty acids, and blood glucose *
A mechanism for the effect of alginate on the gut microflora
Authors: I. Williams, T. Iqbal, M. Webber, C. Tselepis
Journal: Gut (2011)

<b>1407</b> <h3><b>Objectives</b></h3> The objective of the study was to analyse the relationship between macroscopic textural features as measured by pre-clinical PET and microscopic heterogeneity extracted from digital autoradiography (dA). <h3><b>Methods</b></h3> Two nude mice with xenografts of MDA-MB-468 human breast carcinoma were injected with 12 MBq of copper semicarbazone compound [64Cu]-diacetyl-bis(N4-methylthiosemicarbazone) (64Cu-ATSM) which has been used as a tracer for hypoxia imaging. One tumor was excised, freezed and cut up into 10 µm width every 500 µm for the purpose of this work. Sixteen slides were extracted and acquired during 16h using the Siemens Inveon PET system. PET images were reconstructed with two different algorithms: OSEM3D (3 iterations, 16 subsets) and OSEM3D+MAP (6 iterations, 16 subsets) without post-filtering. The same slides were subsequently imaged using a new high sensitivity dA (Beaver, Ai4R, France). PET and dA (scaled to the PET voxels size: 0.78[asterisk]0.78[asterisk]0.8 mm<sup>3</sup>) images were registered using mutual information. A unique delineation obtained using a level sets segmentation algorithm (Sethian, 1996) was extracted from the PET images and applied on the dA images. Eighteen textural features (TF) were subsequently calculated on both images using the co-occurence matrix (6 TFs), the grey level run length matrix (5 TFs) and the grey level size zone matrix (7 TFs) and compared using a Pearson correlation coefficient. <h3><b>Results</b></h3> Over the 18 TF, only 5 TFs presented a significant correlation (r&gt;0.7; p&lt;0.02) between PET and dA images (Entropy, Correlation, Energy, Contrast and ZLNU). However, only Entropy and Energy reached a robust 95% confidence interval (i.e: r in [0.8;1.0]). <h3><b>Conclusions</b></h3> These preliminary results suggest that textural features measured by PET may be representative of microscopic heterogeneity for only a limited number of TFs. The study is ongoing and supplementary data will be presented considering other tumors imaged with other isotopes.
Thyroid Hormone Treatment after Coronary-Artery Bypass Surgery
Authors: John D. Klemperer, Irwin Klein, Maureen Gomez, Robert E. Helm, Kaie Ojamaa, Stephen J. Thomas, O. Wayne Isom, Karl Krieger
Journal: New England Journal of Medicine (1995)

Thyroid hormone has many effects on the cardiovascular system. During and after cardiopulmonary bypass, serum triiodothyronine concentrations decline transiently, which may contribute to postoperative hemodynamic dysfunction. We investigated whether the perioperative administration of triiodothyronine (liothyronine sodium) enhances cardiovascular performance in high-risk patients undergoing coronary-artery bypass surgery.We administered triiodothyronine or placebo to 142 patients with coronary artery disease and depressed left ventricular function. The hormone was administered as an intravenous bolus of 0.8 microgram per kilogram of body weight when the aortic cross-clamp was removed after the completion of bypass surgery and then as an infusion of 0.113 microgram per kilogram per hour for six hours. Clinical and hemodynamic responses were serially recorded, as was any need for inotropic or vasodilator drugs.The patients' preoperative serum triiodothyronine concentrations were normal (mean [+/- SD] value, 81 +/- 22 ng per deciliter [1.2 +/- 0.3 nmol per liter]), and they decreased by 40 percent (P < 0.001) 30 minutes after the onset of cardiopulmonary bypass. The concentrations in patients given intravenous triiodothyronine became supranormal and were significantly higher than those in patients given placebo (P < 0.001). However, the concentrations were once again similar in the two groups 24 hours after surgery. The mean postoperative cardiac index was higher in the triiodothyronine group (2.97 +/- 0.72 vs. 2.67 +/- 0.61 liters per minute per square meter of body-surface area, P = 0.007), and systemic vascular resistance was lower (1073 +/- 314 vs. 1235 +/- 387 dyn.sec.cm-5, P = 0.003). The two groups did not differ significantly in the incidence of arrhythmia or the need for therapy with inotropic and vasodilator drugs during the 24 hours after surgery, or in perioperative mortality and morbidity.Raising serum triiodothyronine concentrations in patients undergoing coronary-artery bypass surgery increases cardiac output and lowers systemic vascular resistance, but does not change outcome or alter the need for standard postoperative therapy.
Secular decline in death rates due to ischemic heart disease in Mexican Americans and non-Hispanic whites in Texas, 1970-1980.
Authors: M P Stern, B S Bradshaw, C W Eifler, D S Fong, H P Hazuda, M Rosenthal
Journal: Circulation (1987)

Although the decline in ischemic heart disease mortality is now entering its third decade, there has been no definitive information on the experience of Mexican Americans, the nation's second largest minority group. Earlier studies carried out in the 1970s were hampered by the unavailability of satisfactory population data beyond 1970. In the present study we have used 1970 and 1980 census data to compute death rates in Mexican Americans and non-Hispanic whites from Texas for the periods 1969-1971 and 1979-1981. All four sex-ethnic groups showed statistically significant declines in death rates due to all causes, due to total ischemic heart disease, and due to acute myocardial infarction between 1969-1971 and 1979-1981. Declines in the latter two causes of death were least marked in Mexican American men. This sex-ethnic group was also the only one that failed to show a decline in death rates due to chronic ischemic heart diseases. The fact that Mexican Americans have been shown to be less well informed about and less likely to adopt lifestyle changes aimed at reducing heart disease risk than non-Hispanic whites may account for the less striking mortality decline observed in Mexican American men, but is harder to reconcile with the apparent equal decline in Mexican American women compared with non-Hispanic whites.
Huntington disease: natural history, biomarkers and prospects for therapeutics
Authors: Christopher A. Ross, Elizabeth H. Aylward, Edward J. Wild, Douglas R. Langbehn, Jeffrey D. Long, John H. Warner, Rachael I. Scahill, Blair R. Leavitt, Julie C. Stout, Jane S. Paulsen, Ralf Reilmann, Paul G. Unschuld, Alice Wexler, Russell L. Margolis, Sarah J. Tabrizi
Journal: Nature Reviews Neurology (2014)
Prenatal chromosomal analysis of fetal blood obtained at fetoscopy.
Authors: E Cordesius, B Gustavii, F Mitelman
Journal: BMJ (1980)

no known unique quality.Historically a major commitment to the cotton industry has been a feature of the high prevalence area, yet other towns also associated with the cotton industryfor example, Rochdale-have low prevalences.We are most grateful to the radiologists, radiographers, and x-ray records staff in the towns surveyed.Their kindness and help made the survey possible.
Genetic Basis for Congenital Heart Defects: Current Knowledge
Authors: Mary Ella Pierpont, Craig T. Basson, D. Woodrow Benson, Bruce D. Gelb, Therese M. Giglia, Elizabeth Goldmuntz, Glenn McGee, Craig A. Sable, Deepak Srivastava, Catherine L. Webb
Journal: Circulation (2007)

The intent of this review is to provide the clinician with a summary of what is currently known about the contribution of genetics to the origin of congenital heart disease. Techniques are discussed to evaluate children with heart disease for genetic alterations. Many of these techniques are now available on a clinical basis. Information on the genetic and clinical evaluation of children with cardiac disease is presented, and several tables have been constructed to aid the clinician in the assessment of children with different types of heart disease. Genetic algorithms for cardiac defects have been constructed and are available in an appendix. It is anticipated that this summary will update a wide range of medical personnel, including pediatric cardiologists and pediatricians, adult cardiologists, internists, obstetricians, nurses, and thoracic surgeons, about the genetic aspects of congenital heart disease and will encourage an interdisciplinary approach to the child and adult with congenital heart disease.
High-density lipoprotein in chronic renal failure and after renal transplantation.
Authors: E Savdie, J C Gibson, J H Stewart, L A Simons
Journal: BMJ (1979)

Serum high-density-lipoprotein (HDL) cholesterol and apoprotein (apo) A concentrations were significantly reduced at the time of renal transplantation in 26 patients with chronic renal failure. In a prospective evaluation the behaviour of HDL concentrations after grafting was found to depend on renal function. Graft function was sustained in 19 patients, in whom HDL-cholesterol and apo A concentrations increased to lie within normal limits by six months after the operation. Successful transplantation also restored to normal the lipid and protein content of HDL as expressed by the ratio of HDL cholesterol to apo A. When transplant function was not sustained (seven patients), however, no changes in HDL were observed up to the time of the graft loss. Such changes in HDL with successful kidney grafting augur well in a population with many risk factors for coronary heart disease.
ACUTE ANKLE SPRAIN INJURY ALTERS KINEMATIC AND CENTRE OF PRESSURE MEASURES OF POSTURAL CONTROL DURING THE STAR EXCURSION BALANCE TEST
Authors: C Doherty, E Delahunt, C Bleakley, J Hertel, J Ryan, B Caulfield
Journal: British Journal of Sports Medicine (2014)

Background Postural control assessments are frequently used in clinical and research settings to evaluate movement deficits following acute lateral ankle sprain (LAS). The Star Excursion Balance Test (SEBT) is one such postural control assessment tool. To date, no research has investigated the immediate post-injury movement strategies associated with LAS, as quantified by center of pressure (COP) and kinematic analyses during performance of selected reach directions of the SEBT. Objective To compare the kinematic and COP patterns of a group with acute LAS and a non-injured control group during performance of selected reach directions of the SEBT. Design Cross-sectional. Setting University biomechanics laboratory. Participants 81 participants with acute LAS and 19 non-injured controls. Main outcome measures 3D kinematics of the hip, knee and ankle joints as well as associated fractal dimension (FD) of the COP path during the performance of the anterior (ANT), posterior-lateral (PL) and posterior-medial (PM) reach directions of the SEBT. Results The LAS group had bilateral decreased reach distances normalised to leg length in the ANT, PL and PM reach directions of the SEBT compared to non-injured control participants (P&lt;.05). The LAS group were also characterized by altered temporal sagittal plane kinematic profiles at the hip, knee and ankle joints of their injured and non-injured limbs for each of the reach directions of the SEBT, compared to the control group (P&lt;.05). This altered kinematic profile was associated with a reduced FD of the COP path for each reach direction on the involved limb only (P&lt;.05). Conclusion Acute LAS is associated with bilateral deficits in postural control, evidenced by reduced angular displacements of the hip, knee and ankle joints, as well as reduced reach distances and FD of the COP path during the performance of a dynamic postural control assessment task.
GW25-e1111 Anti-inflammatory Effects of Tanshinone IIA on Oxidative-injured Vascular Endothelial Cells are Mediated by Estrogen Receptor Activation and Through ERK Signaling Pathway
Authors: Xin Liu, Chunyu Guo, Xiaojuan Ma, Ying Zhang, Mingyue Sun, Yuting Pan, Huijun Yin
Journal: Journal of the American College of Cardiology (2014)
Prevalence of Gulf war veterans who believe they have Gulf war syndrome: questionnaire study
Authors: T Chalder, M Hotopf, C Unwin, L Hull, K Ismail, A David, S Wessely
Journal: BMJ (2001)

<h3>Abstract</h3> <b>Objectives:</b> To determine how many veterans in a random sample of British veterans who served in the Gulf war believe they have "Gulf war syndrome," to examine factors associated with the presence of this belief, and to compare the health status of those who believe they have Gulf war syndrome with those who do not. <b>Design:</b> Questionnaire study asking British Gulf war veterans whether they believe they have Gulf war syndrome and about symptoms, fatigue, psychological distress, post-traumatic stress, physical functioning, and their perception of health. <b>Participants:</b> 2961 respondents to questionnaires sent out to a random sample of 4250 Gulf war veterans (69.7%). <b>Main outcome measure:</b> The proportion of veterans who believe they have Gulf war syndrome. <b>Results:</b> Overall, 17.3% (95% confidence interval 15.9 to 18.7) of the respondents believed they had Gulf war syndrome. The belief was associated with the veteran having poor health, not serving in the army when responding to the questionnaire, and having received a high number of vaccinations before deployment to the Gulf. The strongest association was knowing another person who also thought they had Gulf war syndrome. <b>Conclusions:</b> Substantial numbers of British Gulf war veterans believe they have Gulf war syndrome, which is associated with psychological distress, a high number of symptoms, and some reduction in activity levels. A combination of biological, psychological, and sociological factors are associated with the belief, and these factors should be addressed in clinical practice. <h3>What is already known on this topic</h3> The term Gulf war syndrome has been used to describe illnesses and symptoms experienced by veterans of the 1991 Gulf war Concerns exist over the validity of Gulf war syndrome as a unique entity <h3>What this study adds</h3> 17% of Gulf war veterans believe they have Gulf war syndrome Holding the belief is associated with worse health outcomes Knowing someone else who believes they have Gulf war syndrome and receiving more vaccinations were associated with holding the belief
Retinoid-induced inhibition of growth and reduction of spreading of human epidermal cells in culture
Authors: T. HASHIMOTO, P.J. DYKES, R. MARKS
Journal: British Journal of Dermatology (1985)

The effect of various retinoids (retinol, all-trans-retinoic acid, etretinate, 13-cis-retinoic acid and an arotinoid, Ro-13-6298) on cultured human epidermal cells has been investigated. Cell growth was inhibited in a dose-dependent fashion by retinol, all-trans-retinoic acid and 13-cis-retinoic acid, but to a lesser extent by etretinate. The arotinoid showed an enhancing effect on cell growth. The area of cells on the culture dish was reduced by all the retinoids in a dose-dependent fashion, but the arotinoid was especially active in this respect even at very low concentrations. The measurement of cell volume by cell size frequency analysis, using a Coulter counter channelyzer, showed no differences compared with control cultures, and so the reduction of cell area was considered to be due to reduced 'spreading' of cells on the substrate. These results suggest that the retinoids interfere with cell-to-cell and cell-to-substratum attachment. It is possible that the change in membrane configuration is responsible for the inhibition of cell proliferation in our culture system.
Digital heart rate meter
Authors: E. Emons, M. E. Conolly
Journal: Cardiovascular Research (1971)

Digital techniques were employed in a system used to obtain more accurate measurements of the heart rate after the administration of drugs. The R-wave of an ECG waveform is amplified, processed in logic circuits, and fed into a binary counter. The remainder of the waveform is inhibited. A selected time interval from the mains-triggered timer resets the counter. The information from this counter is converted into analogue form and written on a chart recorder.