tbuckley/cabot-search huggingface dataset:
Reflux related symptoms in patients with normal oesophageal exposure to acid.
Authors: G Shi, S Bruley des Varannes, C Scarpignato, M Le Rhun, J P Galmiche
Journal: Gut (1995)

Several studies, using pH monitoring with event markers, have identified patients with normal oesophageal exposure to acid despite an apparent relation between symptoms and reflux episodes. In this series of 771 consecutive patients referred for 24 hour oesophageal pH monitoring, a probability calculation was used to evaluate the relation between symptoms and reflux episodes. Oesophageal exposure to acid was normal in 462 of 771 recordings (59.9%); despite this, 70.8% (327 of 462) of these patients used at least once the event marker. In 96 patients (12.5% of total patients) with normal oesophageal exposure to acid, there was a statistically significant association between symptoms and reflux episodes. The symptom cluster of such patients was similar to that usually seen in patients with gastro-oesophageal reflux disease, but symptoms like belching, bloating, and nausea were common thus overlapping with the symptom pattern of functional dyspepsia. In these patients both the duration and the minimum pH of reflux episodes (either symptom related or asymptomatic) were significantly shorter and higher, respectively, when compared with those of patients with gastro-oesophageal reflux disease. These results are consistent with the idea that oesophageal hypersensitivity to acid is the underlying pathophysiological feature of this syndrome.
Treatment for teenagers with epilepsy
Authors: C B S Wood
Journal: BMJ (1985)

ing retinopathy after the institution of diabetic control is concerned, we have only one lead: longstanding uncontrolled diabetes with' or without:3 pre-existent retinopathy is probably a risk factor.Whether "platelet activation" is a marker for the development of microangiopathv will be revealed by future prospective studies on similar patients.It is worth mentioning that hypoglycaemia "activates" platelets in normal7 and diabetic subjects.3Other coagulation factors like factor VIII may also increase during hypoglycaemia.9 1' Whether a reduction of blood glucose concentrations to normal levels after a spell of uncontrolled diabetes has a similar effect on platelet function and coagulation factors has yet to be shown.
The effect of base rate, careful analysis, and the distinction between decisions from experience and from description
Authors: Amos Schurr, Ido Erev
Journal: Behavioral and Brain Sciences (2007)

Abstract Barbey &amp; Sloman (B&amp;S) attribute base-rate neglect to associative processes (like retrieval from memory) that fail to adequately represent the set structure of the problem. This commentary notes that associative responses can also lead to base-rate overweighting. We suggest that the difference between the two patterns is related to the distinction between decisions from experience and decisions from description.
Author overestimated need in community population with faecal incontinence
Authors: S. Perry, R P. Assassa, K. Williams, N. K G Smith, C M. Castleden
Journal: BMJ (1998)

EDITOR—In his review on advances in the understanding of faecal incontinence Kamm focused on structural damage as an aetiological factor and surgical intervention as a treatment.1 A review of epidemiological evidence suggests that this focus is misplaced for several reasons.

Kamm states that the prevalence of faecal incontinence is 2% in the adult population and 7% in healthy independent adults aged over 65. These figures probably relate to anal incontinence (loss of gas or mucous as well as …
NOTE ON MEDIA FOR DISTINGUISHING B. COLI, B. TYPHOSUS AND RELATED SPECIES
Authors: A. S. Grunbaum, E. H. Hume
Journal: BMJ (1902)

that the white person is quite susceptible to filarial disease.'This is specially so as regards Barbadoes, where persons, whether resident in the island all their lives, or only visiting it temporarily, often contract the disease; the rich and poor are alike in this respect.Race.Number Infected.Infected.Negroes 0...1 4 357 44 Mulattos o... ... I60 142 18 Whites 5...... 39 25 14 Total 6oo 524 76 Equal to 12.66 per cent.In analysing the table, 27 or 4.5 per cent. of the total number examined, or 35.5 per cent. of the filarial cases, had definite pathological changes indicative of filarial disease such as elephantiasis, chyluria, filarial lymphangitis, etc.; whereas 49 of the filarial cases, or 8.I per cent. of the total examined, had no symptoms whatever, the diagnosis being come to by the discovery of embryos in the blood.This latter class is a dangerous one as regards the spread of the disease, for it is manifest that unless sleeping under mosquito nets, which if they are negroes they never do, they nightly infect many mosquitos, which in turn infect other people and so spread the disease.To get some idea of the number of infected mosquitos about,
Adenosine Inhibits Lipopolysaccharide-Induced Secretion of Tumor Necrosis Factor-α in the Failing Human Heart
Authors: Daniel R. Wagner, Charles McTiernan, Virginia J. Sanders, Arthur M. Feldman
Journal: Circulation (1998)

Background —The proinflammatory cytokine tumor necrosis factor-α (TNF-α) has been implicated in the pathogenesis of congestive heart failure. Recent studies have shown that adenosine inhibits lipopolysaccharide (LPS)-induced expression of TNF-α in macrophages and rat cardiomyocytes. The aim of this study was to determine whether adenosine has a similar effect in the failing human heart. Methods and Results —Left ventricular muscle strips were obtained from seven patients with end-stage congestive heart failure undergoing heart transplantation or insertion of a left ventricular assist device. The muscle strips were incubated at 37°C in 95% O 2 /5% CO 2 and stimulated with LPS (10 μg/mL). TNF-α release in the supernatant was measured with ELISA, and muscle sections were stained for TNF-α. Muscle strips released TNF-α in the absence of LPS (0.22±0.05 pg · mL −1 · mg wet wt −1 ). TNF-α was immunolocalized to the cardiac myocyte, suggesting that the myocyte is a source for TNF-α production. Adenosine (10 μmol/L) decreased TNF-α by 40% ( P &lt;.05). The selective adenosine A 2 receptor agonist DPMA (10 μmol/L) decreased TNF-α release by 87% ( P &lt;.001), whereas ITu (10 μmol/L), an adenosine-regulating agent that increases endogenous adenosine concentration, inhibited TNF-α release by 93% ( P &lt;.001). Conclusions —Adenosine can significantly diminish TNF levels in the failing human heart and may represent a new pharmacological intervention in congestive heart failure.
Pulmonary Angiography in Severe Chronic Pulmonary Hypertension
Authors: PASCAL NICOD
Journal: Annals of Internal Medicine (1987)

We have analyzed the safety of doing pulmonary angiography in 67 consecutive patients with moderate-to-severe primary pulmonary hypertension or hypertension secondary to chronic thromboembolic occlusions of the pulmonary arteries. The average (+/- SD) pulmonary arterial systolic and diastolic pressures were 74 +/- 19 and 34 +/- 10 mm Hg, respectively. Fourteen patients had a right ventricular end-diastolic pressure of 20 mm Hg or more. Selective left and right main pulmonary artery injections were done using ionic contrast agents in 56 patients and nonionic contrast agents in 11. No major rhythm disturbances or systemic hypotension requiring therapy occurred, and there were no deaths. Thrombotic occlusions of the pulmonary arteries were identified in 52 patients and confirmed in all 42 of those who had a thromboendarterectomy. At autopsy, 3 of the 15 patients who had normal angiograms were found not to have had thrombotic occlusions. We conclude that pulmonary angiography can be done safely despite the presence of severe pulmonary hypertension and right ventricular failure, and that the procedure leads to the identification of chronic, major-vessel thromboembolic pulmonary hypertension that may be alleviated by thromboendarterectomy.
Hormone therapy for menopausal symptoms
Authors: H. Roberts
Journal: BMJ (2012)

Recent evaluations of the methods of key studies should not change how we advise women 

A recently published and much publicised paper by Shapiro and colleagues, the last in a series of four, evaluated the effects of hormone therapy on the risk of breast cancer.1 The authors of the four review articles applied epidemiological principles to the findings of two randomised placebo controlled studies from the Women’s Health Initiative (WHI; 27 347 women) and two observational studies—the Collaborative Reanalysis (53 865 women) and the Million Women Study (MWS). Shapiro and colleagues concluded in their fourth paper that the MWS had design defects, that it contained multiple biases, and that its findings were thus not robust enough to show that hormone therapy increased the risk of breast cancer.

All observational studies are inherently biased because subjects are not randomly assigned to treatment or control. Adjustment for confounders and careful design of observational studies help to reduce bias. However, because there is no independent variable, such studies can tell us only about association not causation.

The MWS was published in the Lancet in August 2003,2 and a flurry of letters was published in a print issue later that year, many …
Cancer of the Urogenital Tract: Bladder Cancer
Authors: Philip Rubin
Journal: JAMA (1969)

Identification of the problem is essential in the management of invasive bladder cancer. Transurethral resection of the superficial lesion is acceptable, but fulguration of the superficial portion of a deep lesion is not. There is often a failure to distinguish the difference, not so often on first presentation, but with recurrent lesions. Patterns of care become established, and changes in direction in the course of the cancer demand that the urologist be continually vigilant. The progression to advanced bladder cancer under direct care should not be excused as biologic predeterminism. Deeply invading bladder cancer is a pelvic cancer (Introductory Figure). Procrastination in employing suitable diagnostic methods to clearly outline the full extent of the process and therapeutic measures to encompass the lesion is a major obstacle to cure. Once cancer in the bladder penetrates into the muscle layer, the potential for spread to lymph nodes rises significantly (40%).<sup>1</sup>If
Functional Kinomics Identifies Candidate Therapeutic Targets in Head and Neck Cancer
Authors: Russell Moser, Chang Xu, Michael Kao, James Annis, Luisa Angelica Lerma, Christopher M. Schaupp, Kay E. Gurley, In Sock Jang, Asel Biktasova, Wendell G. Yarbrough, Adam A. Margolin, Carla Grandori, Christopher J. Kemp, Eduardo Méndez
Journal: Clinical Cancer Research (2014)

To identify novel therapeutic drug targets for p53-mutant head and neck squamous cell carcinoma (HNSCC).RNAi kinome viability screens were performed on HNSCC cells, including autologous pairs from primary tumor and recurrent/metastatic lesions, and in parallel on murine squamous cell carcinoma (MSCC) cells derived from tumors of inbred mice bearing germline mutations in Trp53, and p53 regulatory genes: Atm, Prkdc, and p19(Arf). Cross-species analysis of cell lines stratified by p53 mutational status and metastatic phenotype was used to select 38 kinase targets. Both primary and secondary RNAi validation assays were performed on additional HNSCC cell lines to credential these kinase targets using multiple phenotypic endpoints. Kinase targets were also examined via chemical inhibition using a panel of kinase inhibitors. A preclinical study was conducted on the WEE1 kinase inhibitor, MK-1775.Our functional kinomics approach identified novel survival kinases in HNSCC involved in G2-M cell-cycle checkpoint, SFK, PI3K, and FAK pathways. RNAi-mediated knockdown and chemical inhibition of the WEE1 kinase with a specific inhibitor, MK-1775, had a significant effect on both viability and apoptosis. Sensitivity to the MK-1775 kinase inhibitor is in part determined by p53 mutational status, and due to unscheduled mitotic entry. MK-1775 displays single-agent activity and potentiates the efficacy of cisplatin in a p53-mutant HNSCC xenograft model.WEE1 kinase is a potential therapeutic drug target for HNSCC. This study supports the application of a functional kinomics strategy to identify novel therapeutic targets for cancer.
Epidemic Lead Absorption near an Ore Smelter
Authors: Philip J. Landrigan, Stephen H. Gehlbach, Bernard F. Rosenblum, Jimmie M. Shoults, P.E. Robert, M. Candelaria, William F. Barthel, John A. Liddle, Ann L. Smrek, Norman W. Staehling, JoDean F. Sanders
Journal: New England Journal of Medicine (1975)

Blood lead levels were determined on a random sample of persons in all age groups living near a lead-emitting smelter in El Paso, Texas. A blood lead level of greater than or equal to 40 mug per 100 ml, which was considered indicative of undue lead absorption, was found in 53 per cent of the children one to nine years old living within 1.6 km of the smelter and in 18 per cent of those from 1.6 to 6.6 km; beyond that distance in older persons levels were lower. Children in the first 1.6 km with blood levels of greater than or equal to mug per 100 ml were exposed to 3.1 times as much lead in dust as children there with lower blood values (6447 vs 2067 ppm). There was also airborne lead exposure (8 to 10 mug per cubic meter, annual mean). Paint, water, food, and pottery were less important as sources. The data suggest that particulate lead in dust and air accounted for most of the lead absorption in El Paso children. The smelter was the principal source of this lead, especially within 1.6km of itself.
Accumulation of Tc-99m DTPA in Ewing Sarcoma
Authors: Stanis??aw Pilecki, Marcin Gierach, Joanna Pufal, Katarzyna Jankowska, Mariusz Wysocki, Andrzej Kurylak, Sebastian Wa??ek, Roman Junik
Journal: Clinical Nuclear Medicine (2005)

Ewing sarcoma is the second most frequent primary bone tumor in children. The authors present the case of a 15-year-old girl with Ewing sarcoma situated in the right iliac ala. During chemotherapy, dynamic scintigraphy was performed with the use of Tc-99m DTPA to evaluate kidney function. Intensive, unusual accumulation of the radiotracer outside the urinary system around the tumor was seen during examination.
Government makes U turn over legal aid for some clinical negligence claims
Authors: C. Dyer
Journal: BMJ (2012)

Children who are severely injured at birth in England and Wales will continue to get legal aid to bring clinical negligence claims, after a last minute U turn by the UK government.

The Legal Aid, Sentencing and Punishment of Offenders Bill would have abolished legal aid for a swathe of civil claims, including those alleging negligent medical treatment, in a bid to shave £350m (€420m; $560m) a year from the legal aid budget.

But, faced with a possible defeat on the bill in the House of Lords next week, the Ministry …
A Retrospective Study of the Role of Delta Agent Infection in Children With Hbsag–Positive Chronic Hepatitis
Authors: Giuseppe Maggiore, Michelle Hadchouel, Fausto Sessa, Maria Vinci, Antonio Craxi, Maria D. Marzani, Constantino De Giacomo, Daniel Alagille
Journal: Hepatology (1985)

The prevalence of intrahepatic delta antigen and/or anti–delta antibody was retrospectively investigated in 102 children with chronic HBsAg–positive hepatitis who were seen consecutively in three medical institutions between 1974 and 1982. Delta infection markers were found in 13 patients (12.7%) who exhibited high serum titers of anti–delta antibody; intrahepatic delta antigen was detected in ten. Eleven of the 13 children had severe progressive liver disease associated in all but one with absence of hepatitis B virus replication as evaluated by analysis of serum hepatitis B virus DNA. The factors which seem to increase the risk of delta infection in children who are hepatitis B virus carriers are geographic origin, a history of exposure to blood derivatives and age. A further 37 of 102 children had chronic active hepatitis (20 patients) or cirrhosis (17 patients) without evidence of delta infection. These results indicate that delta infection occurs in children with chronic hepatitis. This possibility should be considered in investigation of children with HBsAg–positive chronic liver disease. Although the delta agent is an important cause of progressive liver disease in children who are chronic HBsAg carriers, severe liver injury and especially cirrhosis can occur without evidence of delta infection.
Abstract 392: Delineating genomic heterogeneity in paired primary and metastatic colorectal cancer by massively parallel sequencing.
Authors: Angela Rose Brannon, Efsevia Vakiani, Sasinya N. Scott, Brooke Sylvester, Krishan Kania, Agnes Viale, Nancy Kemeny, Martin Weiser, David B. Solit, Michael F. Berger
Journal: Cancer Research (2013)

Abstract Colorectal cancer (CRC) is the third most common cause of cancer and cancer death for men and women in the United States. While the genetic steps necessary for carcinogenesis are well-defined, the subsequent genetic alterations driving tumor evolution to metastasis are not well characterized. We have performed deep sequencing of 230 key cancer-associated genes in 60 patient-matched primary tumor, metastatic tumor, and normal samples from CRC patients. Genes were selected on the basis of recurrent and/or “actionable” mutations reported in human tumors. Our custom captured-based sequencing assay, termed IMPACT (Integrated Mutation Profiling of Actionable Cancer Targets), provided a median sequence coverage of 644-fold, allowing for the identification of low frequency genetic events involving target genes. Somatic mutations, insertions/deletions (indels), and copy number alterations were identified and compared in both primary and metastatic samples. The most frequently mutated genes have all been previously implicated in CRC: APC, TP53, KRAS, PIK3CA, and SMAD4. Most genetic events were identical between primary and metastatic tumors; however, we identified particular alterations specific to the metastatic samples. The majority of these alterations were members of two important proliferative pathways, further lending credence that they might play an important role in metastatic progression. For patients with metastasis-specific mutations, we have sampled multiple microdissected regions from primary tumors to quantify the extent of intratumor heterogeneity and ascertain whether these differences are caused by sampling biases. The identification of these genetic variations between primary and metastatic tumors could have significant impact on biomarker analysis as well as treatment decisions for CRC patients. Citation Format: Angela Rose Brannon, Efsevia Vakiani, Sasinya N. Scott, Brooke Sylvester, Krishan Kania, Agnes Viale, Nancy Kemeny, Martin Weiser, David B. Solit, Michael F. Berger. Delineating genomic heterogeneity in paired primary and metastatic colorectal cancer by massively parallel sequencing. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 392. doi:10.1158/1538-7445.AM2013-392
Further pay restrictions are a "bitter blow" to NHS staff, says BMA
Authors: H. Mooney
Journal: BMJ (2011)

The government has added to its already acrimonious dispute with public sector employees by announcing a cap of 1% on pay rises for the next two years.

On the back of the current pay freeze public sector workers can expect no more than an annual increase of 1% in their pay packets from 2013 to 2015. Announcing the new measures chancellor George Osborne also suggested that there could be an end to national bargaining in future.

Mr Osborne laid out plans to ask pay review bodies to look at how public sector pay could be made “more responsive to local labour markets” to ensure the private sector does not lose out.

The announcement in his autumn statement came as figures published by the Office for Budget Responsibility suggest that 710 000 public sector jobs …
Fentanyl is not best anaesthetic induction agent in rapid sequence intubation
Authors: I Taylor, D F Marsh
Journal: BMJ (1998)

EDITOROne of Minerva's paragraphs notes a recent study of rapid sequence intubation in the emergency department.12This Canadian study found fentanyl, a potent opioid analgesic, to be a superior induction agent to thiopentone or midazolam as …
DEAFNESS FOLLOWING THE USE OF SALVARSAN
Authors: C. A. Clapp
Journal: JAMA (1913)

The following is a case report of deafness following the use of salvarsan:  A man, white, aged 22, had an initial lesion in April, 1911, for which he was treated by the use of mercury until October 9, when 0.6 gm. salvarsan was given intravenously. November 21, he had a severe attack of giddiness and vomiting with impairment of hearing, which confined him to his bed. He was treated at this time by a recent graduate who considered the case acute indigestion.  When first seen in the office Dee. 12, 1911, the patient still showed marked giddiness which was worse on closing the eyes. The ear-drums were normal; there was no spontaneous nystagmus. The left side of the face was slightly flat, and hearing was reduced to watch at 4 inches in the right ear and contact in the left. Barany's caloric tests showed slight functioning on the right side
Plastic bullets in Northern Ireland.
Authors: A J Ritchie, J R Gibbons
Journal: BMJ (1990)

Clinically pseudo-seizures may be mistaken for genuine fits as they are usually tonic-clonic in appearance, although occasionally manifesting as complex partial seizures.Certain features are helpful in differentiation, including gaze aversion, resistance to passive limb movement or eye opening, prevention of the hand falling on to the face, and induction by suggestion.3Previously normal electroencephalograms, particularly during an attack, or normal serum prolactin concentrations during a pseudo-seizure can be useful in supporting the diagnosis.4Status epilepticus is a medical emergency that requires prompt treatment with anticonvulsants.Patients with pseudo-status epilepticus, however, are more at risk from medical treatment than from their condition, and early recognition of pseudo- seizures would avoid iatrogenic complications.This might be facilitated by rapid access to a register of patients with pseudo-seizures.The register should be held in local accident and emergency departments in the region as these patients may attend many hospitals.
Lymphocyte proliferative responses to the purified <i>Dermatophagoides farinae</i> major allergen in untreated and hyposensitized atopic patients
Authors: J.‐M. Cavaillon, C. Fitting, M.‐T. Guinnepain, R. Rassemont, B. David
Journal: Allergy (1988)

We investigated the proliferative response of lymphocytes from mite‐sensitive patients (RAST D.far &gt; 3.5 PRU/ml) in the presence of the major allergen Der.f.I purified from Dermatophagoides farinae . Comparative studies were carried out with peripheral blood mononuclear cells from non‐atopic donors (RAST = 0), and from patients undergoing hyposensitization treatment (5 to 24 months). According to Student's t‐test, there was no significant difference in the Der.f. I‐induced proliferation of peripheral blood mononuclear cells from normal donors, untreated atopic patients and hyposensitized patients. In conclusion, it was impossible to discriminate between normal donors, atopic patients and hyposensitized patients with regard to their circulating lymphocyte responses to the purified major allergen Der.f.I.