tbuckley/cabot-search huggingface dataset:
Abstract P293: The Effect of Diet Beverage Intake on Measures of Diabetes Control: A Pilot Study
Authors: Andrew Odegaard, Kristin Hirahatake
Journal: Circulation (2017)

Introduction: Diet beverages are calorie free beverages sweetened with non-nutritive sweeteners (NNS). People with diabetes are at high macro and microvascular risk and are the highest per capita consumers of diet beverages as they tend to consume them directly in place of sugar sweetened beverages. This behavior has been endorsed by dietetic and scientific organizations; and diet beverages are marketed synonymously with better health, suitable for weight loss, and thus advantageous for diabetes control. The underlying public health concern is the lack of data to support or refute this concept. To begin addressing this evidence gap we carried out a randomized, two period crossover trial testing the effect of habitual diet beverage intake compared to habitual bottled water intake (avoidance of all NNS) on clinical markers of diabetes control and potential mechanistic pathways. Hypothesis: Habitual diet beverage intake will raise glycemia, lower kidney function, and lower diet quality compared to water intake. Methods: We carried out a randomized, two period crossover trial of 12 adults with type 2 diabetes who were being treated with oral medications and were free of other major chronic disease. In two separate 4 week periods with a washout period between them, participants were randomized to consume 24 oz. a day of a diet beverage (DB) of choice in 1 period and 24 oz. a day of bottled water (H2O) in the other while maintaining usual lifestyle habits and diabetes treatment regimens across periods. The primary outcome was change in glycemia (fructosamine). Secondary outcomes were kidney function (eGFR via serum creatinine) and diet quality (healthy eating index score, HEI-2010). All clinical measures were collected by standardized protocol and laboratory measurement. Diet was assessed by 3 random 24 hour recalls each period (1 weekend, 2 weekday) using a web based automated self-administered platform and diet quality was calculated by estimating the HEI-2010. Mixed-model repeated measures linear regression was used to analyze the continuous outcomes data. Results: 10 women and 2 men, mean (SD) age 58.3 (7.9) years with mean (SD) HbA1c % of 7.1 (1.4) at baseline were randomized and completed the study. Glycemia (fructosamine) was reduced, mean (SE) of -3.9 (3.2) umol/L during the H2O period and increased 0.6 (3.2) umol/L during the DB period, p=0.36. The results for kidney function (eGFR) were: H2O: -0.4 (3.7) v. DB: -2.3 (-3.7) mL/min/1.73m 2 , p=0.72. Diet quality was lower during the DB period relative to the H2O period (58.0 v. 61.5, p=0.25). Conclusion: Although the magnitude and precision of the treatment effects limits the inference, these results suggest the need for larger and longer trials to more definitively test this hypothesis and inform the role diet beverages may have in diabetes control.
Life and loathes of a new doctor: Team colours
Authors: Stephen Goldie
Journal: BMJ (2004)

During my recent stint as a receiving preregistration house officer in surgery I spent several hours running around the accident and emergency department each day meeting the patients sent up by their general practitioners. “Acute complaints” ranged from the sublime--boils on bottom--to the ridiculous--three year history of constipation. While in the emergency department you work with colleagues from every specialty in the medical world, from rookie house officer to senior consultant. I found that as there is …
“JVP not seen”
Authors: Andrew King
Journal: BMJ (2009)

Am I the only one who has struggled to estimate jugular venous pressure (JVP)? Almost certainly not: scanning patients’ notes I often see “JVP not seen” written by other junior doctors. But why is there such a problem? Probably because much of the teaching we receive on observing JVPs is wrong.

In medical school, when asked by consultants what the correct angle to observe the JVP is, we learnt that the answer that they wanted was 45° to the horizontal. But is this correct?

The JVP is an estimate of central venous pressure. Because the right jugular vein lies directly above the right atrium, it acts as a manometer, displaying the pressure in the right atrium. Traditionally, the height of JVP is measured relative to the …
Abstract 16728: Translating Thrombolytic Efficacy of Von Willebrand Factor Aptamer Inhibition From a Small to Large Animal Model of Carotid Occlusion
Authors: David L Dornbos, Debra G Wheeler, Matthew E Joseph, George A Pitoc, Julie M Layzer, Allyson Huttinger, Spencer Talentino, Nicholas Venetos, Nicholas Musgrave, Cheyenne Jones, Camille Bratton, Jay L Zweier, Richard C Becker, Bruce A Sullenger, Shahid M Nimjee
Journal: Circulation (2017)

Introduction: While recombinant tissue plasminogen activator (rTPA) is the mainstay of ischemic stroke treatment, recanalization is only achieved in 25-50% of patients. Previous work demonstrated t...
Avoidable deaths: poorest people continue to have the greatest risk in England and Wales
Authors: Nigel Hawkes
Journal: BMJ (2019)

Wealth is the key to a longer life, but even among the poorest people small differences in deprivation have a marked effect, the latest data show.1

Between 2014 and 2017, the rates of avoidable mortality among men in England fell for all socioeconomic groups, with the greatest gains being made by those in the second and third most deprived areas. The poorest areas gained about as much as the richest, meaning that the absolute gap between the extremes remained very wide.

Among women, the picture was different. Neither rich nor poor woman showed any great improvement, and avoidable mortality increased among the poorest women.

Men living in the most deprived areas were 4.5 times …
The long noncoding RNA Lnczc3h7a promotes a TRIM25-mediated RIG-I antiviral innate immune response
Authors: Hongyu Lin, Minghong Jiang, Lun Liu, Zongheng Yang, Zhongfei Ma, Shuo Liu, Yuanwu Ma, Lianfeng Zhang, Xuetao Cao
Journal: Nature Immunology (2019)
A brief history of medical drama
Authors: Thomas McAnea
Journal: BMJ (2001)

First there was Dr Kildare. If you don't remember Richard Chamberlain, ask your parents, or go and see Towering Inferno. Life was simple for a doctor in the 1960s. He just had to look good and be reassuring. His white coat gleamed almost as much as his teeth. Moral dilemmas happened elsewhere, life was mainly simple choices. Patients liked to cooperate, the doctor was God, his hair was perfect, and he dutifully maintained an expression of concern.

Emergency Ward 10 was another American import of the time. It covered similar territory to the above but without the attractive backdrop that was Mr Chamberlain. Enough said.



AP PHOTO/NICK UT



The 1970s gave us Quincy , which I can vaguely remember. Quincy ME no less. That's medical examiner or coroner if you prefer. He was a heroic pathologist come detective. He had a nose for dastardly deeds (literally) and would conveniently clear up any wrongdoing or criminal conspiracy within the allotted 50 minutes, before the fantastically upbeat theme tune would kick in. Given the post-mortem room setting there was limited glamour. Sadly, he rated poorly in the white coat department, preferring some comedy tunic when he wasn't wearing a beautifully checked sports jacket, cream shirt with enormous collar, and psychedelic kipper tie. Good car though.

I always wondered why no …
Sixty seconds on . . . emergency department waits app
Authors: Elisabeth Mahase
Journal: BMJ (2019)

So I’ve heard. Technology fan Matt Hancock, England’s health secretary, has been spreading the news about the WaitLess app.1 It was developed by technology company Transforming Systems and allows people in need of urgent, but not life threatening, care to check how long the wait is at nearby emergency departments, so they can choose the one with the shortest queue.

Not really. It was first launched in …
Wales signals intent to abolish tuition fees
Authors: Helen Barratt
Journal: BMJ (2002)

The Welsh first minister, Rhodri Morgan, announced that he would seek powers to scrap tuition fees in Wales, if the long awaited Department for Education and Skills review of student funding reaches the “wrong” conclusion.

The Welsh Assembly does not currently have the power to abolish student fees but has already introduced grants for around 43 000 students from low-income backgrounds, as well as earmarking an extra £41m ($62m; €70m) for the education budget. Morgan said, however, that he would be …
The forkhead-box family of transcription factors: key molecular players in colorectal cancer pathogenesis
Authors: Paul Laissue
Journal: Molecular Cancer (2019)

Colorectal cancer (CRC) is the third most commonly occurring cancer worldwide and the fourth most frequent cause of death having an oncological origin. It has been found that transcription factors (TF) dysregulation, leading to the significant expression modifications of genes, is a widely distributed phenomenon regarding human malignant neoplasias. These changes are key determinants regarding tumour's behaviour as they contribute to cell differentiation/proliferation, migration and metastasis, as well as resistance to chemotherapeutic agents. The forkhead box (FOX) transcription factor family consists of an evolutionarily conserved group of transcriptional regulators engaged in numerous functions during development and adult life. Their dysfunction has been associated with human diseases. Several FOX gene subgroup transcriptional disturbances, affecting numerous complex molecular cascades, have been linked to a wide range of cancer types highlighting their potential usefulness as molecular biomarkers. At least 14 FOX subgroups have been related to CRC pathogenesis, thereby underlining their role for diagnosis, prognosis and treatment purposes.This manuscript aims to provide, for the first time, a comprehensive review of FOX genes' roles during CRC pathogenesis. The molecular and functional characteristics of most relevant FOX molecules (FOXO, FOXM1, FOXP3) have been described within the context of CRC biology, including their usefulness regarding diagnosis and prognosis. Potential CRC therapeutics (including genome-editing approaches) involving FOX regulation have also been included. Taken together, the information provided here should enable a better understanding of FOX genes' function in CRC pathogenesis for basic science researchers and clinicians.
Risky Business - The management of Risk and Uncertainty
Authors: Séamus Phillips
Journal: BMJ (1999)

Statistically, it is common knowledge that flying is less dangerous than driving a car. But have you ever thought why people behave as if the opposite is true? Why is it safer on the roads now than when cars were first invented? And why did the government feel that killing so many cattle in the wake of the crisis surrounding bovine spongiform encephalopathy was justified?

Risk is something that plays a part in everyone's life. Calculations about risk are …
Learning anatomy on cadavers: for
Authors: Samena Chaudhry
Journal: BMJ (2001)

Many medical schools no longer use traditional dissection to teach their students anatomy. Three dimensional models and computer simulations are replacing cadavers. Does this mean that medical students miss out? <b>Samena Chaudhry</b> and <b>Shahid Mohammed</b> argue for and against the method that they themselves have not experienced
Endoscopic submucosal dissection of a large squamous cell cancer using the proximal mucosal bridge technique
Authors: Salmaan Jawaid, Dennis Yang, Peter V. Draganov
Journal: Endoscopy (2019)

During endoscopic submucosal dissection (ESD) of large esophageal lesions, adjunct strategies are needed to generate adequate tissue tension besides the traditional distal attachment cap [1] [2]. These tension-generating maneuvers are moderately effective, require additional devices [3], and can be time consuming. In this video, we demonstrate the successful use of a proximal “mucosal bridge technique” to efficiently and quickly complete ESD of a large squamous cell carcinoma (SCC) in the esophagus, obviating the need for supplementary traction devices ([Video 1]).
The Year of Wonders
Authors: Anja Weidmann
Journal: BMJ (2002)

On the Pennine route, between Manchester and Sheffield, there is an intriguing sign marking the turning to “plague village.” This sign points towards the rustic village of Eyam, a picture of countryside tranquillity, complete with flower boxes, coffee shop, and, more unusually, a museum detailing the tragic events after the discovery of plague among the villagers in 1666.

These events are seen through the eyes of Anna Frith, widow, mother, and servant to the rector and his …
Progressively heavier menstrual bleeding
Authors: Bushra A Khawaja, Wai Yoong
Journal: BMJ (2007)

A 46 year old woman presented to her general practitioner with a one year history of progressively heavier menstrual bleeding. Her menstrual cycle remained regular (her usual 28 day cycle), but at times the bleeding would continue for longer, up to 10 days compared with her usual six days. She was now using 10 sanitary towels a day and was feeling very tired. Occasionally she was not able to go to work because the bleeding was so heavy. Her general practitioner referred her to hospital for investigation. 1. What is shown in the figure? 2. How could it present? 3. How is menstrual blood loss assessed clinically? 4. What are the options for treatment?
Culture, Health and Illness
Authors: Carolyn Rubens
Journal: BMJ (2001)

How much do we fully understand the clinical importance of cultural and social factors in illness, health, and the delivery of health care? In what sense can health problems be understood in terms of their cultural and social settings? This is the scope of the relatively young discipline of medical anthropology to which this book gives a comprehensive introduction. The book has wide application and will interest all those thinking of working abroad or going on electives. But it will also be useful …
Time Cells in the Hippocampus Are Neither Dependent on Medial Entorhinal Cortex Inputs nor Necessary for Spatial Working Memory
Authors: Marta Sabariego, Antonia Schönwald, Brittney L. Boublil, David T. Zimmerman, Siavash Ahmadi, Nailea Gonzalez, Christian Leibold, Robert E. Clark, Jill K. Leutgeb, Stefan Leutgeb
Journal: Neuron (2019)
Abstract P021: Association of AHA Cardiovascular Health Metrics With Cognitive Function, Depression, and Anxiety: The Emory Healthy Aging Study
Authors: Alvaro Alonso, Felicia C Goldstein, Viola Vaccarino, Allan I Levey, James J Lah, Michele Marcus
Journal: Circulation (2017)

Background: The American Heart Association (AHA) has developed the Life’s Simple 7 metric (no smoking, high levels of physical activity, normal body mass index, no hypertension, no diabetes, no hyperlipidemia, healthy diet) to track behaviors and risk factors associated with cardiovascular health (CVH). Given the potential role that CVH has in cognition and psychological well-being, we aimed to study the association of the Life’s Simple 7 with cognitive function, anxiety, and depressive symptoms in the Emory Health Aging Study (EHAS). Methods: EHAS is an ongoing cohort study with the overall goal of understanding determinants of healthy aging in the general population. Participants 18 years of age or older are recruited at primary care clinics, community events, and through social media, primarily from the Atlanta (GA) area. Information on sociodemographic variables (age, sex, race, education, income), anthropometrics (weight, height), lifestyles (smoking, physical activity), and clinical variables (history of hypertension, diabetes, hypercholesterolemia, cardiovascular disease [CVD]) was collected through online questionnaires. Life’s Simple 7 score (excluding diet; information not available) was defined based on self-reported data, giving 1 point per achieved metric [range 0 (lowest)-6(highest CVH)]. Neurobehavioral variables were measured using validated scales (Cognitive Function Instrument (CFI), range 0-14, for cognition; Patient Health Questionnaire (PHQ)-8, range 0-24, for depressive symptoms; Generalized Anxiety Disorder (GAD) questionnaire, range 0-21, for anxiety; higher scores represent worse function/symptoms). Cross-sectional associations between Life’s Simple 7 score and these scales were assessed using multivariable linear regression adjusting for sociodemographic variables. Results: We included 3,774 participants [mean age (standard deviation, SD) 58 (13), 79% women, 84% white, 9% African American, 7% other) free of self-reported CVD, recruited between October 2015 and October 2016. Levels of CVH in the cohort were relatively high, with 62% participants meeting at least 4 health criteria [mean (SD) score 3.9 (1.3)]. The mean (SD) of CFI, PHQ-8, and GAD were 1.9 (2.1), 3.2 (3.8), 2.4 (3.4), respectively. In analyses adjusted for age, sex, race, education, and income, higher values of Life’s Simple 7 score were related to better cognitive function and lower levels of depressive symptoms and anxiety: estimates (95% confidence interval) per 1-point in Life’s Simple 7 score were -0.16 (-0.22, -0.11) for CFI, -0.5 (-0.6, -0.4) for PHQ-8, and -0.3 (-0.4, -0.2) for GAD. Conclusion: Higher levels of CVH, as assessed with the AHA Life’s Simple 7, were cross-sectionally associated with a beneficial neurobehavioral profile. Prospective studies should evaluate the impact of improving CVH on cognitive and emotional health.
Use of adrenaline for specimen fixation after endoscopic submucosal dissection
Authors: Toshihiro Nishizawa, Satoshi Kinoshita, Hideki Mori, Ai Fujimoto
Journal: Endoscopy (2019)

To judge how likely an endoscopic submucosal dissection (ESD) is to have been curative and the necessity for additional treatment, accurate histological diagnosis is critical. The resected specimen is stretched and fixed, mucosal side up, onto a rubber or cork plate, so that the mucous membrane surrounding the lesion is evenly flattened and the mucous membrane surface can be observed. The resected specimen often curls up ([Fig.1 a]), so fixing of the specimen can be difficult and stressful.
Patients prefer anecdotes
Authors: Teresa Pun
Journal: BMJ (2006)

The medical world thrives on evidence based medicine. The numbers and the large studies make the medicine we practice seem safer, but what effect does this have on our patients?

“They're antibiotics. You're supposed to finish the whole thing.”

“That's stupid. If you feel better, stop taking it. You're just making your body weaker.”

Shortly after finishing an entire course of antibiotics, my brother's stomach “blew up.” That was not pleasant, and the next time he took antibiotics, years later, he stopped after three days. I told him about the weak bugs and the strong bugs, but …
Abstract P044: Difference of Body Composition Between Urban and Rural Overweight Children in Taiwan - Reappraisals Using of BMI as the Criteria for Childhood Obesity
Authors: Nain-Feng Chu, Juy-Ting Hsu, Fu-Hung Lin
Journal: Circulation (2016)

To evaluate the prevalence of overweight among school children at urban and rural area and also examine the difference of body fat compositions of normal and overweight status children in Taiwan. We conducted school-wide survey among junior-high school children at Taipei (as urban area) and Taitung (as rural area) in 2006 and 2012. Anthropometric variables of body height and weight were measured using standard scales and BMI was calculated as kg/m2. We measured body composition using the Tanita body composition analyzer (TBF-410GS). Total body fat (TBF) and percentage of body fat (%BF) were obtained for further analyses. There are 1263 urban and 577 rural children included for this survey. The mean (SD) of BMI for boys was 21.6 (4.2) at urban and 21.0 (4.2) at rural area and for girls was 20.5 (3.5) and 20.3 (3.4) at urban and rural area (no statistical difference). But the percentage of body fat was 22.2 (7.9) and 18.9 (6.9) for urban and rural boys (p &lt; 0.001), and was 26.2 (7.8) and 24.5 (7.1) for urban and rural girls (p&lt; 0.01). The overall prevalence of overweight was 38.3% in boys and 24.6% in girls for urban children and was 30.4% and 20.5% for rural children. The prevalence of overweight was 41.7, 37.1 and 35.8 for age 13, 14 and 15 yo urban boys and was 33.3, 33.7, and 25.2% for rural boys. For girls, the prevalence of overweight was 23.5, 25.8 and 24.6 for age 13, 14 and 15 yo at urban area was 28.1, 20.9, and 17.1% at rural area. There is no statistical difference of mean BMI between urban and rural area (26.0 vs. 26.3 for boys and 25.4 vs. 25.4 for girls). However, the percentage of body fat was higher for urban overweight children when compared with rural overweight children (28.8 vs. 26.5 for boys, p&lt;0.05 and 36.5 vs. 32.9 for girls, p&lt;0.001). Using BMI as cot-off points of overweight for children at urban and rural area may be biased (or underestimate for the urban children). Body fat composition may be more appropriate criteria for children or for children comparing with different areas or countries.
Reasons for working abroad
Authors: Marko Bukurov
Journal: BMJ (2005)

Where will you be working in five or 10 years time? At home or abroad, nobody can be sure. Although medicine is a universal profession with doctors needed everywhere, becoming a practising doctor abroad is almost always difficult. It is the same with medical research, academia, or any other area you might think you can become involved as a doctor.



PHOTOS.COM



People might want to leave their country for many reasons. Some may be running away from war and misery, some are escaping from environmental disasters, and some are looking for opportunities or just wanting to have a …
Minerva: July 2003
Authors: Stephen G Riley, Prem Thurairajah, Bryonie F Read, Kieron L Donovan
Journal: BMJ (2003)

Soaring caesarean section rates in the United States provide food for thought. The rate in 2001 reached an all time high of 24.4%, while that of women having a vaginal delivery after a previous section dropped to an all time low of 16.5%. An editorial in the Journal of Obstetric, Gynecologic, and Neonatal Nursing (2003;32:283-4) asks whether this situation has arisen because the demand for perfection forces unnecessary intervention, and calls for a return to common sense guided by evidence rather than fear of litigation.

Professional dancers have high rates of injuries that potentially put them out of work. A retrospective cohort study of one troupe of 42 dancers found that the introduction of ‘comprehensive management’ (case management and intervention) reduced the number of new workers compensation cases from 81% to 17%, and the number of days lost from work went down by 60% ( American Journal of Sports Medicine 2003;31:365-73). Other high risk occupations might benefit from similar programmes.

The person who interviewed David Lammy, the parliamentary undersecretary of state for health, for Emergency Medicine Journal (2003;20:supplement) makes an interesting observation. Lammy was the youngest member of parliament when he was elected in 2000 and is still only 30. For someone who holds such a powerful position in …
Madness: A Brief History
Authors: Sabina Dosani
Journal: BMJ (2004)

As thousands of medical students past and present will testify, Roy Porter was an exceptional teacher and medical historian. His untimely death at 55 continues to haunt those of us lucky enough to have enjoyed meeting him.

Fortunately, he was also a prolific writer who wrote or edited more than 100 books. His last book was a history of madness from prehistory to today. Madness: A Brief History opens with …