Can eradicating H pylori prevent gastric cancer?
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Biomedical subjects
Publications and source records attributed to G Kerr.
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BACKGROUND: There are few reports which describe the management of unselected groups of patients with lung cancer. This study was undertaken to audit prospectively the presentation, diagnosis, management, and outcome of patients presenting with lung cancer in South East Scotland. METHODS: Data were recorded on all patients with newly diagnosed lung cancer who presented to a multidisciplinary group of clinicians over a 12 month period. Subsequent follow up data on treatment and survival were collected. RESULTS: Six hundred and twenty two patients were registered, 80% of whom were referred from primary care. There was a considerable variation in the length of history, but the diagnosis was rapidly made after referral (87% within two weeks). In 82% of patients the pathological examination was positive; 70% were treated with palliative intent. Only 36% of patients who underwent surgery had computed tomographic scanning and 55% had sampling of mediastinal nodes. A wide variety of regimens was used for treatment with radiotherapy and chemotherapy, and follow up data were difficult to obtain in these patients. Survival was poor in all patients treated with palliative intent. CONCLUSIONS: This audit confirms the importance of previously noted prognostic factors. Significant variation in referral practice, diagnostic and management evaluation has been shown. The data serve as a useful background for the formation of local management guidelines.
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A "discrete" movement sequence is defined as a movement with a single goal that involves a series of overlapping joint rotations. Reaching-and-grasping and throwing are examples of discrete movement sequences. The central nervous system (CNS) can use reafferent proprioceptive information from one joint rotation in a sequence to coordinate subsequent rotations at other joints. The experiments reported in this paper demonstrate how the human CNS uses proprioceptive information to coordinate discrete movement sequences. We examined the mechanism (at an information processing level) underlying proprioceptive coordination and the generality (i.e., the boundary conditions) of these mechanisms as they apply to everyday movement sequences. Adult human subjects performed a discrete movement sequence that resembles backhand throwing: elbow extension followed by hand opening. The task was to open the hand as the elbow passed through a prescribed "target" angle. We eliminated visual information and made the arrival time at the target angle unpredictable so that the available kinematic information was provided exclusively by proprioception. The subjects were capable of performing this motor task with a high degree of precision, thereby demonstrating that the nervous system can use proprioceptive input to coordinate discrete movement sequences. Our data indicate that precise coordination is achieved by extracting kinematic information related to both the velocity of elbow rotation as well as the elbow position during movement (i.e., "dynamic position"). Dynamic position information appears to be encoded as both absolute joint angle and angular distance, although more precisely as angular distance. Although our experiments were conducted under rather restrictive laboratory conditions, this mechanism of motor coordination might also apply to everyday movement. Our results suggest that this mechanism could be employed for passive as well as active movement sequences, with and without opposing loads; it could exert its influence in discrete movement sequences as brief as 210 ms or as long as 1.5 s; and it does not involve any significant degree of learning (this proprioceptive mechanism appears to be readily available for use on the first attempt of a novel motor task).
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Takayasu's arteritis has become increasingly recognized as a worldwide entity with a variable spectrum of disease expression. Although evidence for immune mechanisms of disease exist, the precise etiopathogenesis remains elusive. Improvements in the evaluation of disease activity beyond the current parameters of clinical symptoms, erythrocyte sedimentation rate, and angiographic findings are needed. Assessment of disease is handicapped by radiologic techniques that may detect diseased vessels but do not distinguish active from chronic lesions. A large proportion of patients with active disease respond to treatment with glucocorticoids, but a significant proportion will either require additional immunosuppression to prevent steroid toxicity or will remain unresponsive to treatment. At present, methotrexate appears to be an effective steroid-sparing agent in the treatment of active Takayasu's arteritis. Surgery continues to play a critical role in the long-term management of Takayasu's arteritis and is recommended when appropriate during inactive disease. Renal autograft transplantation has been offered as a new technique in the management of hypertension in Takayasu's arteritis.
Increasing the concentration of arterial plasma K+ to 6-8 mM increased ventilation in two sedated analgesic-treated rhesus monkeys who had their end-tidal CO2 held constant during euoxia (arterial oxygen pressure, Pa,O2, ca 100 Torr) and hypoxia (Pa,O2, ca 40 Torr). During euoxia and hypoxia, hyperkalaemia increased ventilation up to 40 and 250%, respectively. This effect was reduced in euoxia and virtually abolished in hypoxia following an abrupt switch to 100% oxygen. Thus the ventilatory response of this primate to hyperkalaemia is at least as sensitive as that of the cat and if hypoxia is added the two stimuli generate a powerful drive to breathing.
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A wheelchair user's mobility may be hampered by narrow doorways and restricted turning spaces. Mobility may be improved by undertaking expensive building alterations in the wheelchair user's own home and work environment. However, other environments, including modes of public transport, may still present considerable difficulties. One way of improving mobility is to reduce the overall width of a wheelchair with the occupant still seated within it. This is achieved by using a clamp, known as a "wheelchair narrower" which can be fitted and operated either by the wheelchair user or an attendant. The narrower takes advantage of the inherent design of a wheelchair which permits folding for storage. A universal wheelchair narrower was manufactured and tested at Tayside Rehabilitation Engineering Services. It was designed to be used on 69% of wheelchairs issued through the National Health Service in Scotland. Tests revealed that wheelchairs could be narrowed by between 38 and 127 mm depending upon the type of wheelchair. Active wheelchair users reported that the device was particularly useful when travelling.
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A device is described which is capable of accurately measuring angular alignment changes made during the alignment stages of the production of a below-knee prosthesis.
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Retrospective analysis was made of 3,918 cases of breast cancer seen during 1954-1964. Median survival was 4.5 years and 30% of patients survived through a 10-year period. For stages I, II, and III patients, the mortality increased during 1-4 years after diagnosis and then slowly declined. Beyond 15 years, stage III patients assumed the same mortality (5%) as those with lesser disease; 58% excess of deaths from all causes after 15-20 years showed that breast cancer was not curable within 20 years but ultimately, taking account of clinical status, 51% of 5-year survivors with stages I-III disease are cured.
In diagnosing and treating temporomandibular joint (TMJ) dysfunctions, the oral and maxillofacial surgeon can use the radiographic technique of "corrected-axis" lateral tomography of the mandibular condyles. The theory, technique, and equipment necessary for making "corrected-axis" lateral tomograms of the mandibular condyles are presented. Once familiar with this technique, the surgeon can educate the radiologist and technician if it is one with which they are unfamiliar.
In search for a practical solution to analyse a large quantity of medical information, rheumatic disease data base system (RDDS) is described. Details of data configuration, data entry and retrieval are discussed in some detail. The system incorporates a range of commonly used statistical tests and provisions for more advanced data analysis are made. Additional facilities include provisions for a variety of printed reports, back up facilities and a word processor. The ease of system operation and flexibility are emphasised. Technical support requirements are minimal even when new applications are being developed. The system is fully operational at present and can be implemented on a number of computer systems.