tbuckley/cabot-search huggingface dataset:
Differentiation Between Restrictive Cardiomyopathy and Constrictive Pericarditis by Early Diastolic Doppler Myocardial Velocity Gradient at the Posterior Wall
Authors: Przemysław Palka, Aleksandra Lange, J. Elisabeth Donnelly, Petros Nihoyannopoulos
Journal: Circulation (2000)

The differential diagnosis between restrictive cardiomyopathy (RCM) and constrictive pericarditis (CP) is challenging and, despite combined information from different diagnostic tests, surgical exploration is often necessary.A group of 55 subjects (mean age, 63+/-11 years; 36 men and 19 women) were enrolled in the study; 15 had RCM, 10 had CP, and 30 were age-matched, normal controls. The diagnosis of RCM was supported by a biopsy; in the CP group, the diagnosis was confirmed either surgically or at autopsy. All patients underwent a transthoracic echocardiogram that included the assessment of Doppler myocardial velocity gradient (MVG), as measured from the left ventricular posterior wall during the predetermined phases of the cardiac cycle. MVG was lower (P<0.01) in RCM patients compared with both CP patients and normal controls during ventricular ejection (2. 8+/-1.2 versus 4.4+/-1.0 and 4.7+/-0.8 s(-1), respectively) and rapid ventricular filling (1.9+/-0.8 versus 8.7+/-1.7 and 3.7+/-1.4 s(-1), respectively). Additionally, during isovolumic relaxation, MVG was positive in RCM patients and negative in both CP patients and normal controls (0.7+/-0.4 versus -1.0+/-0.6 and -0.4+/-0.3 s(-1), respectively; P<0.01). During atrial contraction, MVG was similarly low (P<0.01) in both RCM and CP patients compared with normal controls (1.6+/-1.7 and 1.7+/-1.8 versus 3.8+/-0.9 s(-1), respectively).Doppler myocardial imaging-derived MVG, as measured from the left ventricular posterior wall in early diastole during both isovolumic relaxation and rapid ventricular filling, allows for the discrimination of RCM from CP.
Intra-uterine Development
Authors: Wayne L. Johnson
Journal: JAMA (1968)

This is not the usual textbook of embryology. The growth and development of organ systems are reviewed but take up only one third of the total pages. The work includes fetal and placental development from conception to birth of the newborn and discusses the anatomy, physiology, and pathology of the embryonic and fetal phases of a child's lifetime. This well-organized summary of intrauterine development has three major portions: (1) conception and placentation, (2) growth and development, and (3) chromosomal aberrations. The first portion considers ovulation, sperm transport, fertilization, implantation, anatomy and physiology of the placenta, and amniotic fluid. I regard the chapters on anatomy of the placenta and fetal water metabolism as highlights in communication of facts and ideas. The second portion considers embryology and fetal development of the various organ systems, with emphasis on metabolic and hormonal aspects. The chapters on hemoglobin and fetal thyroid are too long and
PTU-166 Detection Rates Of Gastric Cancer At The Queen Elizabeth Hospital Birmingham 2009–2013
Authors: N Sagar, N Bhala
Journal: Gut (2014)

<h3>Introduction</h3> Despite open-access endoscopy, previous series have suggested that between 8–20% of early gastric cancers (GC) are potentially missed at prior endoscopy.<sup>1,2</sup> Although upper gastrointestinal alarm symptoms are more frequently associated with malignancy, this may represent advanced cancer with poorer survival rates, as patients with early GCs may be asymptomatic. The false-negative rate for the diagnosis of GC may also be a measure of quality for endoscopy services. This is based on a reported median duration of 37 months between endoscopic diagnosis of early GC and progression to advanced GC,<sup>2,3</sup> so we assessed all oesophagogastroduodenoscopy (OGD) findings to assess detection of GC in a large tertiary hospital in the West Midlands. <h3>Methods</h3> Patients with histologically confirmed GC were identified from histopathology and endoscopy records. Patients who had undergone at least one OGD before the diagnosis were studied. Detection of GC within 3 years of a negative OGD was interpreted as a false negative. <h3>Results</h3> Between September 2009 and September 2013, 16823 OGDs were performed. GC was diagnosed in 75 (0.45%) patients (male/female ratio 1.78; median age 74; 85% Caucasian). Sixty-seven (89%) of the 75 patients with GC presented with alarm symptoms. 33% (25) were done as inpatients, with 43% (at least 32 of 50 outpatients) being referred as urgent outpatients. Five of the 75 (7%) patients had previous OGDs within three years preceding diagnosis. Only one of these was planned because of a suspicious gastric ulcerative lesion at the same site, with other causes being gastric polyps (2); normal (1) and gastritis (1). There were 53 (71%) deaths in total, 47 (89%) of these patients had alarm symptoms at diagnosis of GC. <h3>Conclusion</h3> The absolute rates of GC are low (0.1%/OGD/year) and false-negative rates of 5% (within 3 years) for diagnosis of GC are reassuring with only a minority of preceding OGDs in this series demonstrating suspicious lesions. Whilst GC presents with alarm symptoms in the vast majority, the prognosis remains very poor, so continued quality measures in endoscopy will be required to ensure that early gastric cancers are not missed. <h3>References</h3> Vradelis S, Maynard N, Warren BF <i>et al</i>. Quality control in upper gastrointestinal endoscopy: detection rates of gastric cancer in Oxford 2005–2008. <i>Postgrad Med J</i>. 2011 May;87(1027):335–9 Hosokawa O, Tsuda S, Kidani E, <i>et al</i>. Diagnosis of gastric cancer up to three years after negative upper gastrointestinal endoscopy. <i>Endoscopy</i> 1998:30:669–74 Tsukuma H, Mishima T, Oshima A. Prospective study of “early” gastric cancer.<i> Int J Cancer</i> 1983:31:421–6 <h3>Disclosure of Interest</h3> None Declared.
THE RELATION OF THE SPLEEN TO BLOOD DESTRUCTION AND REGENERATION AND TO HEMOLYTIC JAUNDICE
Authors: Howard T. Karsner, Richard M. Pearce
Journal: The Journal of Experimental Medicine (1912)

1. The erythrocytes of splenectomized dogs show increased resistance to the action of hypotonic salt solutions and to specific hemolytic immune serum. The degree of resistance appears to increase with the length of time that has elapsed after splenectomy. 2. This increased resistance of the erythrocytes is not due to an increased antihemolytic power of the animal's serum or to a diminished complementary value of the serum, but is a property depending upon the erythrocytes themselves. 3. Non-splenectomized animals receiving a single injection of specific hemolytic immune serum and developing a temporary anemia show likewise on recovery an increased resistance of the corpuscles without the presence of antihemolysin in demonstrable amount. 4. As anemia of varying grade is a characteristic result of splenectomy, it would appear that the increased resistance of the corpuscles is a concomitant of the regeneration of the red cells following such anemia and is thus analogous to the increased resistance of such cells not infrequently observed in various forms of experimental anemia. 5. There is no evidence to indicate that the anemia after splenectomy is due to the presence of hemolytic bodies, or that the increased resistance of the cells is due to antihemolytic bodies, accumulating in the serum as the result of the ablation of the spleen. It is evident therefore that the spleen in some way controls or regulates blood destruction (and regeneration ?), and in the hope of throwing light on the subject, an investigation of the bone marrow and lymph nodes of splenectomized dogs is now under way.
Mycobacterium leprae DNA in peripheral blood may indicate a bacilli migration route and high-risk for leprosy onset
Authors: E.M. Reis, S. Araujo, J. Lobato, A.F. Neves, A.V. Costa, M.A. Gonçalves, L.R. Goulart, I.M.B. Goulart
Journal: Clinical Microbiology and Infection (2013)
Better services needed for "ME"
Authors: L. Beecham
Journal: BMJ (1998)

Everyone in the United Kingdom with the chronic fatigue syndrome (sometimes referred to as myalgic encephalomyelitis or “ME”) should have access to a doctor who can diagnose and manage the condition, according to a report from the National Task Force on the condition.

It is estimated that 172000 to 1500000 people in the United Kingdom have the condition …
Dietary Folate Intake and Breast Cancer Risk: European Prospective Investigation Into Cancer and Nutrition
Authors: J. de Batlle, P. Ferrari, V. Chajes, J. Y. Park, N. Slimani, F. McKenzie, K. Overvad, N. Roswall, A. Tjonneland, M. C. Boutron-Ruault, F. Clavel-Chapelon, G. Fagherazzi, V. Katzke, R. Kaaks, M. M. Bergmann, A. Trichopoulou, P. Lagiou, D. Trichopoulos, D. Palli, S. Sieri, S. Panico, R. Tumino, P. Vineis, H. B. Bueno-de-Mesquita, P. H. Peeters, A. Hjartaker, D. Engeset, E. Weiderpass, S. Sanchez, N. Travier, M. J. Sanchez, P. Amiano, M. D. Chirlaque, A. Barricarte Gurrea, K. T. Khaw, T. J. Key, K. E. Bradbury, U. Ericson, E. Sonestedt, B. Van Guelpen, J. Schneede, E. Riboli, I. Romieu
Journal: JNCI Journal of the National Cancer Institute (2014)

There is limited evidence on the association between dietary folate intake and the risk of breast cancer (BC) by hormone receptor expression in the tumors. We investigated the relationship between dietary folate and BC risk using data from the European Prospective Investigation into Cancer and Nutrition (EPIC).
Energy intake in pregnant women carrying boys or girls: Energy intake may correlate with prebirth knowledge of sex of child
Authors: S. D Shay
Journal: BMJ (2003)

Editor—Tamimi et al report that energy intake during pregnancy is affected by the sex of the child.1 As an idea for further study, a dummy variable might be included in the regression analysis which indicates whether the mother knew the sex of her child before birth (or at the beginning of the study). One possible explanation for mothers with male embryos who eat more could be connected to socialisation.
Cost of Obstetric Services-Reply
Authors: Herman A. Hein
Journal: JAMA (1979)

We hope our article is not being used as a defense for freestanding obstetric services of any size. We feel strongly that all obstetric services should be linked to a referral center, and this linkage should include regular patient care review and appropriate remedial education. A careful review of the article will show that we did not attempt to show that small hospitals are more cost-effective than large hospitals. Such a study would be practically impossible, since methods of cost accounting vary widely among hospital administrators. Rather, we hoped to draw attention to the fact that health planners are unpersuasive in their argument that consolidation of obstetric services will improve the quality of care and the efficiency of the service (240:2070, 1978; 240:2051, 1978). Our data are really straightforward. They show what the patient pays for basic services in the different hospital categories. We cannot make any attempt
Pulmonary hypertension in patients with pulmonary fibrosis awaiting lung transplant
Authors: A. F. Shorr, J. L. Wainright, C. S. Cors, C. J. Lettieri, S. D. Nathan
Journal: European Respiratory Journal (2007)

Pulmonary hypertension (PH) may complicate idiopathic pulmonary fibrosis (IPF) but the prevalence of PH in IPF remains undefined. The present authors sought to describe the prevalence of PH in IPF. The lung transplant registry for the USA (January 1995 to June 2004) was analysed and IPF patients who had undergone right heart catheterisation (RHC) were identified. PH was defined as a mean pulmonary arterial pressure ( P̄ pa ) ≥25 mmHg and severe PH as a P̄ pa &gt;40 mmHg. Independent factors associated with PH were determined. Of the 3,457 persons listed, 2,525 (73.0%) had undergone RHC. PH affected 46.1% of subjects; ∼9% had severe PH. Variables independently associated with mild-to-moderate PH were as follows: need for oxygen, pulmonary capillary wedge pressure ( P pcw ) and forced expiratory volume in one second (FEV 1 ). Independent factors related to severe PH included the following: carbon dioxide tension, age, FEV 1 , P pcw , need for oxygen and ethnicity. A sensitivity analysis in subjects with P pcw &lt;15 mmHg did not appreciably alter the present findings. Pulmonary hypertension is common in idiopathic pulmonary fibrosis patients awaiting lung transplant, but the elevations in mean pulmonary arterial pressure are moderate. Lung volumes alone do not explain the pulmonary hypertension. Given the prevalence of pulmonary hypertension and its relationship with surrogate markers for quality of life ( e.g. activities of daily living), future trials of therapies for this may be warranted.
Picture of Better Health: Prioritizing Air Pollution Control in China
Authors: Cynthia Washam
Journal: Environmental Health Perspectives (2010)

Research in China Assesses ExposuresHuman activities such as mining, smelting, and coal combustion dis perse mercury that can be methylated by bacteria to produce methyl mercury, a potent neurotoxicant.Methylating bacteria thrive in aquatic sediments rich in organic matter, and methylmercury biomagnification eventually leads to heavy contamination of top predators, including fish consumed by humans.Although fish and seafood are the most common dietary sources of methylmercury worldwide, new research from China demonstrates that rice, a staple food for billions, can be a primary source of methylmercury in areas where there is substantial inorganic mercury pollution, with calculated exposure exceeding cur rent tolerable daily intakes [EHP 118( 9):1183-1188; Zhang et al.].The research was conducted in four regions in Guizhou province, an area of inland China with rich deposits of cinnabar (a mercury ore).Mercury mining and smelting have led to heavy pollution in Wanshan, while zinc smelting and coal combustion, which also release mercury, are the main contributors in Weining and Qingzhen, respectively.The fourth region, Leigong, is a remote nature reserve selected to represent an area with no sources of direct mercury contamination.Methylmercury and total mercury exposure through drinking water, diet, and respiration were assessed for adults in the four regions.Previous sampling provided data for air, water, fish, meat, and poultry, while agricultural products (rice, corn, and vegetables), drinking water from Wanshan and Leigong, and total gaseous mercury in Wanshan were newly evaluated in this study.These data were collectively used to calculate probable daily intakes for the general adult population.In all regions rice, vegetables, and meat (not including poultry and fish) accounted for 89-97% of total mercury exposure, whereas rice consumption accounted for 94-96% of methylmercury exposure.Fish contributed little; most of the fish consumed here are farmed species that grow rapidly and eat a diet that precludes significant methyl mercury bioaccumulation.
A Fear of Pheromones
Authors: Lewis Thomas
Journal: New England Journal of Medicine (1971)

WHAT are we going to do if it turns out that we have pheromones? What on earth would we be doing with such things? With the richness of speech, and all our new devices for communication, why would we want to release odors into the air to convey information about anything? We can send notes, telephone, whisper cryptic invitations, announce the giving of parties, even bounce words off the moon and make them carom around the planets. Why a gas, or droplets of moisture made to be deposited on fenceposts?Comfort1 has recently reviewed the reasons for believing that we . . .
Frontiers in Gastrointestinal Cancer
Authors: Z. Myron Falchuk
Journal: JAMA (1985)

<i>Frontiers in Gastrointestinal Cancer</i>is the first in a series of books that will review in detail some of the latest information in the field of oncology. Levine and Riddell have edited the present volume and have done an outstanding job of choosing chapters, headings, and authors. The material presented represents both the results and many of the latest trials of therapy for gastrointestinal and hepatic malignancy and such topics as ideas of general pathogenesis, the role of food, nutrients in cancer, the effect and action of hepatitis virus type b in liver cell cancer, and the concepts of regional and infusion chemotherapy. There are chapters on experimental cancer models, including pancreatic cancer in the hamster and the effect of indomethacin in rats with intestinal tumors, immunotherapy, radiation therapy, and mechanisms of adenoma formation. In this era of cost consciousness, there is even an analysis of the cost-effectiveness of colorectal
The site of disruption of the bronchial epithelium in asthmatic and non-asthmatic subjects.
Authors: S Montefort, J A Roberts, R Beasley, S T Holgate, W R Roche
Journal: Thorax (1992)

BACKGROUND: Attention has recently been focused on the basal cells of the tracheobronchial epithelium as the mechanism of anchorage of the tall columnar cells, which themselves do not appear to form hemidesmosomes with the basement membrane of the epithelium. Residual basal cells have been described as remaining attached to the basement membrane after epithelial denudation. This led this group to formulate the hypothesis that there may be a potential plane of cleavage between the basal cells and the overlying columnar cell layer within the bronchial epithelium, which becomes disrupted in asthma. METHODS: Bronchoalveolar lavage samples were obtained during bronchoscopy from eight patients with atopic asthma and four normal controls. Ultrathin sections of lavage cell pellets were examined by electron microscopy and the number of columnar and basal cells found in each epithelial cell cluster was counted. Cytocentrifuge preparations of the lavage samples from the same subjects were also examined for free epithelial cells and epithelial cell clusters. RESULTS: Electron microscopic examination of the cell pellets showed that basal cells were present in very small numbers in the epithelial clusters in all subjects (mean 0.03 (SE 0.02)/cluster) and the ratio of columnar cells to basal cells was far greater than was encountered in the intact bronchial epithelium (167 nu 4). The cytocentrifuge preparations showed an increased number of epithelial cell clusters and epithelial cells in the asthmatic patients. Although these clusters were similar in size in the two groups of subjects (6.3 nu 5.1 cells/cluster) the ratio of free epithelial cells to cells within the cluster was higher in the non-asthmatic subjects. CONCLUSIONS: It is proposed that shedding of epithelial cells occurs along a suprabasal plane and that there is a potential plane of cleavage between the suprabasal and the basal cell layers, which might be more vulnerable to the various insults.
The evolution of religious misbelief
Authors: Ara Norenzayan, Azim F. Shariff, Will M. Gervais
Journal: Behavioral and Brain Sciences (2009)

Abstract Inducing religious thoughts increases prosocial behavior among strangers in anonymous contexts. These effects can be explained both by behavioral priming processes as well as by reputational mechanisms. We examine whether belief in moralizing supernatural agents supplies a case for what McKay &amp; Dennett (M&amp;D) call evolved misbelief, concluding that they might be more persuasively seen as an example of culturally evolved misbelief.
HYGIENIC MANAGEMENT OF CHILDREN.
Authors: A. E. MILLER
Journal: JAMA (1898)

This subject is so broad that one hardly knows where to begin. To have children as perfect as possible we should begin several generations back. The Mosaic statement, "visiting the iniquities of the fathers upon the children even unto the third and fourth generation," is a physical fact, which applies no less to the mothers than to the fathers. If parents would have the best possible children, they should get themselves in the best condition previous to the begetting of the children. It is a humiliating fact that the most important act of a man's life is too often accidental. In the breeding of the lower animals the greatest care is used. If a farmer is breeding for milk, beef, or beauty, he selects the parent stock with the greatest care, with an eye to the particular point to which he is building. It is interesting to note with what
Loss-of-Function Mutations in the Cardiac Calcium Channel Underlie a New Clinical Entity Characterized by ST-Segment Elevation, Short QT Intervals, and Sudden Cardiac Death
Authors: Charles Antzelevitch, Guido D. Pollevick, Jonathan M. Cordeiro, Oscar Casis, Michael C. Sanguinetti, Yoshiyasu Aizawa, Alejandra Guerchicoff, Ryan Pfeiffer, Antonio Oliva, Bernd Wollnik, Philip Gelber, Elias P. Bonaros, Elena Burashnikov, Yuesheng Wu, John D. Sargent, Stefan Schickel, Ralf Oberheiden, Atul Bhatia, Li-Fern Hsu, Michel Haïssaguerre, Rainer Schimpf, Martin Borggrefe, Christian Wolpert
Journal: Circulation (2007)

Cardiac ion channelopathies are responsible for an ever-increasing number and diversity of familial cardiac arrhythmia syndromes. We describe a new clinical entity that consists of an ST-segment elevation in the right precordial ECG leads, a shorter-than-normal QT interval, and a history of sudden cardiac death.Eighty-two consecutive probands with Brugada syndrome were screened for ion channel gene mutations with direct sequencing. Site-directed mutagenesis was performed, and CHO-K1 cells were cotransfected with cDNAs encoding wild-type or mutant CACNB2b (Ca(v beta2b)), CACNA2D1 (Ca(v alpha2delta1)), and CACNA1C tagged with enhanced yellow fluorescent protein (Ca(v)1.2). Whole-cell patch-clamp studies were performed after 48 to 72 hours. Three probands displaying ST-segment elevation and corrected QT intervals < or = 360 ms had mutations in genes encoding the cardiac L-type calcium channel. Corrected QT ranged from 330 to 370 ms among probands and clinically affected family members. Rate adaptation of QT interval was reduced. Quinidine normalized the QT interval and prevented stimulation-induced ventricular tachycardia. Genetic and heterologous expression studies revealed loss-of-function missense mutations in CACNA1C (A39V and G490R) and CACNB2 (S481L) encoding the alpha1- and beta2b-subunits of the L-type calcium channel. Confocal microscopy revealed a defect in trafficking of A39V Ca(v)1.2 channels but normal trafficking of channels containing G490R Ca(v)1.2 or S481L Ca(v beta2b)-subunits.This is the first report of loss-of-function mutations in genes encoding the cardiac L-type calcium channel to be associated with a familial sudden cardiac death syndrome in which a Brugada syndrome phenotype is combined with shorter-than-normal QT intervals.
The dying deserve better from GPs
Authors: Des Spence
Journal: BMJ (2013)

Modern medicine is overcomplicated and pseudoscientific. We talk obsessively of structures and organisations, but in truth quality of care is simple. Being a doctor is about stepping into the breach; quality of care is about taking responsibility.The current problems in the NHS stem from a failure of accountability, leadership, and commitment—and an unwillingness to get involved. This explains the poverty of end of life care and the now discredited Liverpool care pathway.1 

I have witnessed too many undignified, distant, and fear filled deaths. Patients should die with dignity, ideally at home …