Background Current approaches to symptom-based classifications in gastroduodenal disorders are binary and substantially overlapping. We aimed to develop a standardized and quantitative system for classifying patient-level symptom profiles guided on physiological principles. Methods A large database (n = 787) of 4.5 h (30 min baseline; 4-h postprandial) Gastric Alimetry® (Alimetry, NZ) recordings were used to identify, and quantify distinct symptom patterns based on established gastroduodenal physiology concepts. Tests comprised a standardized meal challenge and symptoms were simultaneously recorded at minimum 15 minute intervals using a 10-point likert scale with pictograms encoded in a validated digital App. Key Results Six symptom profiles were defined. The meal change metric was used to define 'meal-induced' and 'meal-relieved' symptom profiles, defined as an increase (+2) or decrease (-2) in the average symptom severity between the first post- and pre-prandial hours of recordings. The continuous profile was defined as a reduced range (<3; i.e., difference between the 95th and 5th percentile symptom severity), and thresholded to the 5th percentile of symptom severity being > 2. The symptom/amplitude correlation metric defined the 'sensorimotor' profile, thresholded when the correlation was >0.5. The symptom/amplitude time lag metric was used to define 'activity-relieved' and 'post-gastric' symptom profiles, defined as negative (< -0.25) or positive (>0.25) average difference between the cumulative distribution functions of the symptom and amplitude curves. Conclusions & Inferences Standardized quantification of symptom profiles in relation to a meal-stimulus and gastric amplitude offer a novel classification scheme based on gastroduodenal physiology.

The disease type and demography of patients with culture confirmed tuberculosis (TB) diagnosed at St Vincent's Hospital, Melbourne between the years 1962 to 1989 were reviewed. Four hundred and eighty-two patients with culture-positive TB were identified whose origins were as follows: Australia 194; Northern Europe 38; The Mediterranean 98; Asia 60 and other or unknown 92. Patients whose country of birth was in Asia or the Mediterranean area accounted for 57% of patients in the 1980s; they presented at a younger age, with a higher proportion of extrapulmonary disease and a more equal sex distribution than did Australian born patients. The main types of extrapulmonary disease also differed for the various ethnic groups. The overall proportion of patients with an isolate resistant to at least one of the anti-TB drugs was 10.0% but in the Asian born was 21.7%. This survey, the longest series of bacteriologically confirmed cases of TB reported from a single institution in Australasia, has identified several changes in how TB is presenting for diagnosis.

No abstract