tbuckley/cabot-search huggingface dataset:
Peripheral Nerve Injuries
Authors: H. J. Seddon
Journal: BMJ (1941)

<h3>ABSTRACT</h3> Lipoic acid is a sulfur containing cofactor, indispensable for the function of several metabolic enzymes. In microorganisms, lipoic acid can be salvaged from the surroundings by Lipoate protein ligase A (LplA), an ATP-dependent enzyme. Alternatively, it can be synthesized by the sequential action of Lipoate protein ligase B (LipB) and Lipoyl synthase (LipA), in a two-step reaction. LipB uptakes octanoyl-chain from C<sub>8</sub>-acyl carrier protein (C<sub>8</sub>-ACP), a byproduct of the type II fatty acid synthesis pathway, and transfers it to a conserved lysine of the lipoyl domain of a dehydrogenase. The molecular basis of substrate recognition by LipB is still not fully understood. Using <i>E. coli</i> LipB as a prototype, we show that the enzyme mainly recognizes the 4'-phosphopantetheine tethered acyl-chain of its donor substrate, and weakly binds the apo-acyl carrier protein. It can accept octanoate-from its own ACP, noncognate ACPs, as well as C<sub>8</sub>-CoA. Further, our NMR studies demonstrate the presence of an adenine and phosphate binding site in LipB, akin to LplA. A loop containing <sup>71</sup>RGG<sup>73</sup> sequence, analogous to the lipoate binding loop of LplA is also conserved. Collectively, our studies highlight commonalities between LipB and LplA in their mechanism of substrate recognition. This knowledge might be of significance in the treatment of mitochondrial fatty acid synthesis related disorders.
Primate Smooth Muscle Cell Migration From Aortic Explants Is Mediated by Endogenous Platelet-Derived Growth Factor and Basic Fibroblast Growth Factor Acting Through Matrix Metalloproteinases 2 and 9
Authors: R. D. Kenagy, C. E. Hart, W. G. Stetler-Stevenson, A. W. Clowes
Journal: Circulation (1997)

Background Migration of arterial smooth muscle cells (SMCs) is regulated by basic fibroblast growth factor (bFGF), platelet-derived growth factor (PDGF), and matrix metalloproteinases (MMPs) in the injured rat carotid artery. We have recently shown that migration of SMCs from baboon aortic explants depends on the activity of MMPs, but the identity of the stimulatory MMPs and the role of bFGF and PDGF in this primate system are not known. Methods and Results These experiments were designed to determine whether MMP2, MMP9, bFGF, or PDGF plays a role in SMC migration from medial explants of baboon aorta. Explants were cultured in serum-free medium with insulin, transferrin, and ovalbumin. Neutralizing antibodies to MMP2 and antibodies that inhibit activation of proMMP9 decreased SMC migration from the aortic explants. Antibodies to bFGF and to the α- and β-subunits of the PDGF receptor also inhibited migration from the explants. Addition of bFGF and PDGF-BB but not PDGF-AA increased migration. The antibodies to bFGF but not the antibodies to the PDGF receptor subunits decreased the levels of MMP9, whereas all the antibodies decreased activated MMP2. Conclusions These data demonstrate that SMC migration from primate aortic explants is dependent on endogenous MMP2, MMP9, PDGF, and bFGF. The data also suggest that PDGF-induced (PDGF-BB or possibly PDGF-AB) migration is dependent on MMP2, whereas bFGF-induced migration depends on both MMP2 and MMP9.
Hypertensive Reaction to Naloxone
Authors: Gerald Y. Tanaka
Journal: JAMA (1974)

<h3>To the Editor.—</h3> Naloxone hydrochloride (Narcan or<i>n</i>-allyloxymorphone) antagonizes the pharmacologic effects of narcotics like nalorphine and levallorphan. But unlike the other two antagonists, naloxone does not by itself cause respiratory depression or other narcotic effects.<sup>1</sup>Naloxone hydrochloride is relatively free of adverse side effects; however, a high incidence of nausea and vomiting (90%) has been reported after its administration.<sup>2</sup>Systolic blood pressure usually falls slightly after giving a narcotic antagonist.<sup>2</sup>The purpose of this letter is to describe a patient who developed a paradoxical hypertensive reaction to naloxone hydrochloride. <h3>Report of a Case.—</h3> A 51-year-old man was admitted to the hospital for coronary artery bypass grafting. He had a previous history of mild essential hypertension, type IV hyperlipidemia, and mild diabetes mellitus. On Aug 7, 1973, the patient underwent cardiac surgery, assisted by cardiopulmonary bypass under morphine-nitrous oxide-oxygen anesthesia. The procedure was uneventful, requiring two
Vaccinate people at risk and healthcare workers against flu, says European public health office
Authors: R. Watson
Journal: BMJ (2009)

<h3>Background:</h3> Rheumatoid arthritis (RA) patients experience reduced health-related quality of life (HRQOL). Previous studies suggest that yoga, a mind-body practice, can improve physical and mental health but it has not been extensively studied in RA. <h3>Objectives:</h3> To investigate the effect of yoga on HRQOL and secondary on fatigue, anxiety, depression and disease activity in RA patients <h3>Methods:</h3> 43 RA patients (mean (SD) age 55 (10) years, median (IQR) disease duration 5 (3,8) years, 93% female), stable on standard pharmacological treatment and DAS28CRP &lt; 5.1 were randomly assigned to 12 weeks yoga intervention (2x/week 90 min; n=22) or arthritis-related educational lectures control (1x/week 60 min; n=21). Yoga based on „Yoga in daily life system“ included asanas, relaxation, pranayama and meditation. Study evaluations at baseline, post-intervention and 3-month follow-up included The Short Form-36 (SF-36) scores for Physical Component Summary (PCS) and Mental Component Summary (MCS), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Hospital Anxiety and Depression scale (HADS) and Disease Activity Score-28CRP (DAS28CRP) questionnaires. Data were presented as change from baseline to each time point. Between group differences were analyzed using the t-test for normally and Mann-Whitney U test for non-normally distributed variables. P values &lt;0.05 were considered statistically significant. <h3>Results:</h3> 35 patients (17 = intervention, 18 = control group) completed the trial period. Significant improvement in FACIT-F (p=0.013), HADS anxiety (p=0.047) and HADS depression (p=0.004) was found in yoga group compared to control at post-intervention and maintained at follow-up (p=0.025, p=0.02 and p=0.045, respectively). There was no significant difference found between groups for SF-36 MCS, PCS and DAS28CRP at all time points (all p&gt;0.05). No serious adverse events were observed during trial period. <h3>Conclusion:</h3> Although no change in SF-36 scores and disease activity was observed, yoga practice produced significant and sustained improvement in fatigue and mood which strongly account for decreased life quality in RA. Despite limitations our findings suggest that yoga may be of benefit in management of RA patients. <h3>Disclosure of Interests:</h3> Silva Puksic: None declared, Josko Mitrovic: None declared, Melanie-Ivana Culo: None declared, Marcela Zivkovic: None declared, Biserka Orehovec: None declared, Marko Lucijanic: None declared, Dubravka Bobek: None declared, Jadranka Morovic-Vergles Speakers bureau: Abbvie., Roche, MSD, Eli Lilly, Pfizer, Mylan, Amgen, Fresenius Kabi
Value of Hepatobiliary Scintigraphy After Type 1 Choledochal Cyst Excision and Roux-en-Y Hepatojejunostomy
Authors: Murat Tuncel, Eser Lay Ergün
Journal: Clinical Nuclear Medicine (2006)

This report describes a pediatric patient with cholecystectomy, excision of type 1 choledochal cyst, and Roux-en-y hepatojejunostomy in whom hepatobiliary scintigraphy played an important role to find out the reason of her postoperative symptoms, helped her surgeons to make the postoperative diagnosis as ascending cholangitis, and plan the patient's secondary therapy.
Effect of Health Insurance and Facility Quality Improvement on Blood Pressure in Adults With Hypertension in Nigeria
Authors: Marleen E. Hendriks, Ferdinand W. N. M. Wit, Tanimola M. Akande, Berber Kramer, Gordon K. Osagbemi, Zlata Tanovic, Emily Gustafsson-Wright, Lizzy M. Brewster, Joep M. A. Lange, Constance Schultsz
Journal: JAMA Internal Medicine (2014)

<h3>Importance</h3> Hypertension is a major public health problem in sub-Saharan Africa, but the lack of affordable treatment and the poor quality of health care compromise antihypertensive treatment coverage and outcomes. <h3>Objective</h3> To report the effect of a community-based health insurance (CBHI) program on blood pressure in adults with hypertension in rural Nigeria. <h3>Design, Setting, and Participants</h3> We compared changes in outcomes from baseline (2009) between the CBHI program area and a control area in 2011 through consecutive household surveys. Households were selected from a stratified random sample of geographic areas. Among 3023 community-dwelling adults, all nonpregnant adults (aged ≥18 years) with hypertension at baseline were eligible for this study. <h3>Intervention</h3> Voluntary CBHI covering primary and secondary health care and quality improvement of health care facilities. <h3>Main Outcomes and Measures</h3> The difference in change in blood pressure from baseline between the program and the control areas in 2011, which was estimated using difference-in-differences regression analysis. <h3>Results</h3> Of 1500 eligible households, 1450 (96.7%) participated, including 564 adults with hypertension at baseline (313 in the program area and 251 in the control area). Longitudinal data were available for 413 adults (73.2%) (237 in the program area and 176 in the control area). Baseline blood pressure in respondents with hypertension who had incomplete data did not differ between areas. Insurance coverage in the hypertensive population increased from 0% to 40.1% in the program area (n = 237) and remained less than 1% in the control area (n = 176) from 2009 to 2011. Systolic blood pressure decreased by 10.41 (95% CI, −13.28 to −7.54) mm Hg in the program area, constituting a 5.24 (−9.46 to −1.02)–mm Hg greater reduction compared with the control area (<i>P</i> = .02), where systolic blood pressure decreased by 5.17 (−8.29 to −2.05) mm Hg. Diastolic blood pressure decreased by 4.27 (95% CI, −5.74 to −2.80) mm Hg in the program area, a 2.16 (−4.27 to −0.05)–mm Hg greater reduction compared with the control area, where diastolic blood pressure decreased by 2.11 (−3.80 to −0.42) mm Hg (<i>P</i> = .04). <h3>Conclusions and Relevance</h3> Increased access to and improved quality of health care through a CBHI program was associated with a significant decrease in blood pressure in a hypertensive population in rural Nigeria. Community-based health insurance programs should be included in strategies to combat cardiovascular disease in sub-Saharan Africa.
724-6 Resetting Responses During Atrioventricular Nodal Reentrant Tachycardia Suggest an Anisotropic Mechanism
Authors: Kevin M. Monahan, Noel G. Boyle, Marco Zardini, Panos Papageorgiou, Joseph Zebede, Mark E. Josephson
Journal: Journal of the American College of Cardiology (1995)
Primary and Secondary Transport Systems for Amino Acids in the Intact Intestine
Authors: Francis A. Jacobs, William G. Tarnasky
Journal: JAMA (1963)

IN OUR PREVIOUS INVESTIGATIONS we have been able to demonstrate the net and absolute absorption rates for amino acids from the small intestine in the intact rat.<sup>1</sup>We also demonstrated that absorption could be inhibited by inducing pyridoxine deficiency and by the antimetabolites deoxypyridoxine and 2, 4-dinitrophenol (DNP). Alleviation of this inhibition was dependent upon the B6-vitamin factor in the form of pyridoxal-5-phosphate.<sup>1,2</sup> The problem with which we were confronted was to investigate whether or not this inhibition of mediated intestinal absorption was one in which the cells of the mucosa were affected so that they could not selectively take up the amino acid, or could accept a normal load but not pass this on to the circulation. These experiments are intended to show that the inhibited absorption is involved in what we might postulate as a secondary transport system from the loaded intestinal cells rather than
Alcohol as a Modifiable Lifestyle Factor Affecting Multiple Sclerosis Risk
Authors: Anna Karin Hedström, Jan Hillert, Tomas Olsson, Lars Alfredsson
Journal: JAMA Neurology (2014)

<h3>Importance</h3> Alcohol consumption may be a modifiable lifestyle factor that affects the risk of developing multiple sclerosis (MS). Results of previous studies have been inconsistent. <h3>Objective</h3> To investigate the possible association of alcohol consumption with the risk of developing MS and to relate the influence of alcohol to the effect of smoking. <h3>Design, Setting, and Participants</h3> This report is based on 2 case-control studies: Epidemiological Investigation of Multiple Sclerosis (EIMS) included 745 cases and 1761 controls recruited from April 2005 to June 2011, and Genes and Environment in Multiple Sclerosis (GEMS) recruited 5874 cases and 5246 controls between November 2009 and November 2011. All cases fulfilled the McDonald criteria. Both EIMS and GEMS are population-based studies of the Swedish population aged 16 to 70 years. In EIMS, incident cases of MS were recruited via 40 study centers, including all university hospitals in Sweden. In GEMS, prevalent cases were identified from the Swedish national MS registry. In both studies, controls were randomly selected from the national population register, matched by age, sex, and residential area at the time of disease onset. <h3>Main Outcome and Measure</h3> Multiple sclerosis status. <h3>Results</h3> There was a dose-dependent inverse association between alcohol consumption and risk of developing MS that was statistically significant in both sexes. In EIMS, women who reported high alcohol consumption had an odds ratio (OR) of 0.6 (95% CI, 0.4-1.0) of developing MS compared with nondrinking women, whereas men with high alcohol consumption had an OR of 0.5 (95% CI, 0.2-1.0) compared with nondrinking men. The OR for the comparison in GEMS was 0.7 (95% CI, 0.6-0.9) for women and 0.7 (95% CI, 0.2-0.9) for men. In both studies, the detrimental effect of smoking was more pronounced among nondrinkers. <h3>Conclusions and Relevance</h3> Alcohol consumption exhibits a dose-dependent inverse association with MS. Furthermore, alcohol consumption is associated with attenuation of the effect of smoking. Our findings may have relevance for clinical practice because they give no support for advising patients with MS to completely refrain from alcohol.
Veno-occlusive Disease of the Liver and Multiorgan Failure after Bone Marrow Transplantation: A Cohort Study of 355 Patients
Authors: George B. McDonald
Journal: Annals of Internal Medicine (1993)

Objective: To determine the incidence and clinical course of veno-occlusive disease of the liver (VOD) after bone marrow transplantation and to analyze risk factors for severe VOD. Design: Cohort study of 355 consecutive patients. Setting: A bone marrow transplantation center. Measurements: Each patient was prospectively evaluated for VOD, and many risk factors for severe VOD were analyzed using logistic regression models. The relation of VOD to renal and cardiopulmonary failure was analyzed using time-dependent proportional hazards models. Results: Veno-occlusive disease developed in 190 of 355 patients (54%; 95% CI, 48% to 59%): Fifty-four patients had severe VOD and 136 had mild or moderate VOD. Independent variables derived from a multivariate model for predicting severe VOD included elevated transaminase values before transplantation (relative risk, 4.6; P < 0.0001); vancomycin therapy during cytoreductive therapy (relative risk, 2.9; P = 0.003); cytoreductive therapy with a high-dose regimen (relative risk, 2.8; P = 0.01); acyclovir therapy before transplantation (relative risk, 4.8; P = 0.02); mismatched or unrelated donor marrow (relative risk, 2.4; P = 0.02); and previous radiation therapy to the abdomen (relative risk, 2.2; P = 0.04). Vancomycin therapy was a marker for persistent fever. Multiorgan failure was more frequent among patients with VOD and usually followed the onset of liver disease. Conclusions: Veno-occlusive disease, which developed in 54% of bone marrow transplant recipients, is frequently associated with renal and cardiopulmonary failure. Pretransplant transaminase elevations, use of high-dose cytoreductive therapy, and persistent fever during cytoreductive therapy are independent predictors of severe VOD.
Problems in Forensic Medicine
Authors: Raymond D. Cotton
Journal: JAMA (1971)

Developed by the physician-lawyer authors as a problem-oriented legal case book to be used in teaching both medical and law students, this work will have great interest for the medical profession. The problems dealt with include professional liability, medical proof in litigation, and profession responsibility. Also presented is a fascinating section which explores the relationship between public policy and medical science. The method of presenting the issues proves to be almost as intriguing as the issues themselves. Use of the "case method" means that actual law cases are reproduced, with the nonessentials edited out and the cases themselves linked together with editorial commentary. The introductory chapter discusses a subject which runs as a thread throughout the book: the harm "done to the mutual esteem in which the professions ought to hold one another when the practitioner in one seeks to treat another professional as a mere technician." The authors declare
What is the best way to deliver subcutaneous insulin to infants, children, and young people with type 1 diabetes mellitus?
Authors: J. C. Blair, M. Peak, J. W. Gregory
Journal: BMJ (2011)

Type 1 diabetes is a common disease of childhood affecting approximately 23 000 children and young people in England.1 The daily management of type 1 diabetes is burdensome. However, over a lifetime, long term complications are likely to have the greatest adverse impact on quality of life, and pose a significant economic burden to society and the NHS. The prevalence of long term complications is lowest in those with good glycaemic control using intensive insulin regimes in the form of insulin pump therapy or multiple daily injections.2 A recent review of paediatric diabetes services in the United Kingdom reported that 94% of centres offered intensive insulin regimes, and 78% offer treatment with insulin pump therapy.3 Despite the widespread availability of insulin pump therapy, data published by the National Diabetes Information Service in 2010 reported that only 1812 people aged less than 18 years were treated with insulin pumps in England.4

The National Institute for Health and Clinical Excellence recommends insulin pump therapy as a treatment option from diagnosis of type 1 diabetes for patients aged less than 12 years and for those aged 12 years and above with inadequate glycaemic control on multiple daily injections or disabling hypoglycaemia,5 with the intention of optimising glycaemic control and quality of life. However, the authors of this guideline recognise that the evidence supporting their recommendations is poor. The additional cost of insulin pump therapy is estimated to be £1700 (€1950; $2770) per annum.6 At present there is little robust evidence that this additional investment significantly improves glycaemic control, reduces the prevalence of long term complications, or improves quality of life in the paediatric population. We consider the strengths and weaknesses of the key evidence informing national guidelines and clinical practice.

We searched the Cochrane Library, the Health Technology …
Drinking-Water Disinfection By-products and Semen Quality: A Cross-Sectional Study in China
Authors: Qiang Zeng, Yi-Xin Wang, Shao-Hua Xie, Liang Xu, Yong-Zhe Chen, Min Li, Jing Yue, Yu-Feng Li, Ai-Lin Liu, Wen-Qing Lu
Journal: Environmental Health Perspectives (2014)

Background: Exposure to disinfection by-products (DBPs) has been demonstrated to impair male reproductive health in animals, but human evidence is limited and inconsistent.Objective: We examined the association between exposure to drinking-water DBPs and semen quality in a Chinese population.Methods: We recruited 2,009 men seeking semen analysis from the Reproductive Center of Tongji Hospital in Wuhan, China, between April 2011 and May 2012. Each man provided a semen sample and a urine sample. Semen samples were analyzed for sperm concentration, sperm motility, and sperm count. As a biomarker of exposure to drinking-water DBPs, trichloroacetic acid (TCAA) was measured in the urine samples.Results: The mean (median) urinary TCAA concentration was 9.58 (7.97) μg/L (interquartile range, 6.01–10.96 μg/L). Compared with men with urine TCAA in the lowest quartile, increased adjusted odds ratios (ORs) were estimated for below-reference sperm concentration in men with TCAA in the second and fourth quartiles (OR = 1.79; 95% CI: 1.19, 2.69 and OR = 1.51; 95% CI: 0.98, 2.31, respectively), for below-reference sperm motility in men with TCAA in the second and third quartiles (OR = 1.46; 95% CI: 1.12, 1.90 and OR = 1.30; 95% CI: 1.00, 1.70, respectively), and for below-reference sperm count in men with TCAA in the second quartile (OR 1.62; 95% CI: 1.04, 2.55). Nonmonotonic associations with TCAA quartiles were also estimated for semen parameters modeled as continuous outcomes, although significant negative associations were estimated for all quartiles above the reference level for sperm motility.Conclusion: Our findings suggest that exposure to drinking-water DBPs may contribute to decreased semen quality in humans.Citation: Zeng Q, Wang YX, Xie SH, Xu L, Chen YZ, Li M, Yue J, Li YF, Liu AL, Lu WQ. 2014. Drinking-water disinfection by-products and semen quality: a cross-sectional study in China. Environ Health Perspect 122:741–746; http://dx.doi.org/10.1289/ehp.1307067
Old Age and New Policy-Reply
Authors: Daniel Callahan
Journal: JAMA (1990)

<h3>In Reply.—</h3> The last paragraph of the letter in criticism of my article raises directly the problem I am concerned with. The very nature of rationing and allocation decisions is that they must be made for the collective good of society as a whole, not simply for the individuals involved. Our projected costs for health care for the elderly in the years ahead are simply astronomical, well beyond any reasonable capacity to pay for them. The idea that we can deal with those problems by having individual physicians, patients, and families make decisions about allocation makes no sense in the long run. What is good for individuals and families is not necessarily good for society as a whole. That is the painful truth of the matter when we must make rationing decisions. The fundamental question, then, is how we can assure the elderly of decent care up to a reasonably
Phenotypic and genotypic risk factors for cardiovascular events in an incident dialysis cohort
Authors: G. Pernod, J.-L. Bosson, D. Golshayan, C. Barro, G. Forneris, G. Martina, G. Bonfant, J.-M. Hurot, C. Turc-Baron, C. Jouet, J. Theytaz, A. Jeantet, J.-P. Wauters, D. Cordonnier
Journal: Kidney International (2006)