tbuckley/cabot-search huggingface dataset:
Betaine for nonalcoholic fatty liver disease: Results of a randomized placebo-controlled trial
Authors: Manal F. Abdelmalek, Schuyler O. Sanderson, Paul Angulo, Consuelo Soldevila-Pico, Chen Liu, Joy Peter, Jill Keach, Matt Cave, Theresa Chen, Craig J. McClain, Keith D. Lindor
Journal: Hepatology (2009)

Based on animal studies and pilot studies in humans, betaine, a methyl donor for the remethylation of homocysteine, may be a therapeutic agent for nonalcoholic steatohepatitis (NASH). We evaluated the safety and efficacy of betaine for patients with NASH and whether betaine positively modified factors postulated to be "second hits" and underlying mechanisms of NASH. We conducted a randomized placebo-control study of 55 patients with biopsy-proven NASH who received either oral betaine (20 g daily) or placebo for 12 months. Pre- and posttreatment variables were analyzed using the paired t test or Wilcoxon rank test. Treatment groups were comparable at baseline. Of the 35 patients (17 betaine, 18 placebo) who completed the study, 34 patients (16 betaine, 18 placebo) underwent posttreatment liver biopsy. Patients randomized to betaine had a decrease in steatosis grade. No intra- or intergroup differences or changes in nonalcoholic fatty liver disease activity score or fibrosis stage were noted. Elevations of insulin, glucose, and proinflammatory cytokines and the reduced antioxidant status noted in NASH patients did not improve with betaine therapy. The antiinflammatory agent adiponectin was significantly reduced in both groups and did not change with therapy. Lastly, S-adenosylhomocysteine was approximately twice normal and was not reduced by betaine therapy.Compared to placebo, betaine did not improve hepatic steatosis but may protect against worseningsteatosis [corrected]. High-dose betaine supplementation failed to reduce S-adenosylhomocysteine and did not positively affect any of the second hit mechanisms postulated to contribute to NASH that we studied. Although betaine has been proven effective in treating hepatic steatosis in several animal models, translating novel therapeutic options noted in animal studies to humans with NASH will prove challenging.
Underwater births should be limited to clinical trials, says US pediatric and obstetrics panel
Authors: M. McCarthy
Journal: BMJ (2014)

Immersion in water during the first stage of labor may have some beneficial effects such as decreasing pain, the use of anesthesia, and the duration of labor, but immersion during the second stage of labor—so called “underwater births”—should be considered an experimental procedure that should only be performed in the setting of a clinical trial, an expert panel has concluded.1 The panel was convened by the American College of Obstetricians and Gynecologists and the American Academy of Pediatrics.

“Laboring in water may offer some potential benefits, but delivering underwater does not seem to have clear advantages, and the risk of rare, but serious, consequences to a delivering baby’s health is something women and providers should all be aware of,” said Jeffrey L Ecker, chairman of the Committee …
Host-microbial interactions in childhood atopy: Toll-like receptor 4 (TLR4), CD14, and fecal Escherichia coli
Authors: John Penders, Carel Thijs, Monique Mommers, Ellen E. Stobberingh, Edward Dompeling, Naomi E. Reijmerink, Piet A. van den Brandt, Marjan Kerkhof, Gerard H. Koppelman, Dirkje S. Postma
Journal: Journal of Allergy and Clinical Immunology (2010)
Balloon Dilation of the Sphincter of Oddi
Authors: R. A. Kozarek
Journal: Endoscopy (1988)

No controlled studies document either clinical or biochemical efficacy following balloon dilation of the sphincter of Oddi. Because of this and the unacceptable rates of pancreatitis and cholangitis associated with sphincter dilation when compared with the other available modalities of sphincterotomy, stent placement and surgery, this technology currently has little place when dealing with a spastic or stenotic sphincter mechanism.
EVALUATION OF PERCUTANEOUS CORONARY INTERVENTION: OUTCOMES FROM THE FIVE YEAR FOLLOW-UP OF THE NHLBI DYNAMIC REGISTRY
Authors: Anna Bortnick, Faith Selzer, Kelly Epps, Saif Anwaruddin, Elizabeth Holper, Vankeepuram Srinivas, Oscar Marroquin, Robert Wilensk
Journal: Journal of the American College of Cardiology (2012)
Caring for those who refuse help
Authors: Melvyn Jones
Journal: BMJ (2004)

John is 85 years old, and his condition has been getting worse over the past few months. He is forgetful, not taking his drugs, and forgetting to eat his “meals on wheels.” His family are helpful but cannot be with him all day. His prostate specific antigen concentration is sky high, and nobody knows quite what happened when he went to the urology outpatient clinic: he never saw the registrar and somehow found his own way home.

The deputising GP service saw him last night and said he must be urgently reviewed today, Saturday. He is lying on the floor, crumpled, his pants are soiled, and his food is down his trousers. His mini-mental state score is 13. He has dementia and is prone to falling over. His digoxin box should be half empty, but it is still …
Predictors of Low and Very Low Birth Weight and the Relation of These to Cerebral Palsy
Authors: Karin B. Nelson
Journal: JAMA (1985)

In a large prospective study, we investigated predictors of moderately low (1,501 to 2,500 g) and very low (&lt;1,501 g) birth weight. Maternal age, height, and socioeconomic status, related to moderately low birth weight on univariate analysis, were not on multivariate analysis significant predictors for either low-birth-weight outcome. The leading predictors of very low birth weight were low weight (&lt;2,000 g) of last live birth, fetal malformation, nonwhite race, early vaginal bleeding, cigarette smoking, and chorionitis. Some of these were also predictors of moderately low birth weight. About 20% of births under 1,501 g could be attributed to chorionitis, a characteristic of less than 3% of the births. Of the major predictors of low birth weight, only prolonged rupture of membranes, chorionitis, and congenital malformations contributed to the risk of cerebral palsy beyond their contribution to the risk of low birth weight. (<i>JAMA</i>1985;254:1473-1479)
INCIDENCE OF HOOKWORM DISEASE AMONG PERSONS WHO WERE CURED FIVE YEARS AGO
Authors: DWIGHT L. SISCO
Journal: JAMA (1923)

This paper reports certain results obtained during a resurvey of an area on the island of Antigua, British West Indies, in which measures for the relief and control of hookworm disease were terminated five years ago. Both the treatment campaign, extending from September, 1915, to June, 1917, and the resurvey, made during April and May, 1922, were conducted under the auspices of the International Health Board of the Rockefeller Foundation. The paper is of interest primarily because it records the results of a careful study of hookworm infection among persons whom microscopic examination had previously shown to be cured of the disease. The findings which it presents are in complete accord with observations made by Smillie<sup>1</sup>under analogous circumstances in Brazil. It demonstrates certain falla[ill]ies in campaign procedure, and emphasizes the need for definite measures in order that permanent hookworm control may be attained. <h3>PHYSICAL FEATURES OF THE ISLAND</h3>
P113 Procalcitonin (PCT) is a safe and reliable biomarker of bacterial infection in exacerbations of COPD--so why is it so challenging to introduce it into a large UK hospital?
Authors: L. Burke, M. Alhajji, N. Todd, J. S. White
Journal: Thorax (2010)

<h3>Background</h3> Antibiotics have only marginal efficacy in treating acute exacerbations of COPD (AECOPD). There is a large body of evidence that supports the use of PCT as a marker of bacterial infection. In York hospital patients with AECOPD account for a significant proportion of acute admissions and many are treated with antibiotics without strong evidence of a bacterial cause. <h3>Objective</h3> To conduct a service evaluation of antibiotic prescribing following the introduction of PCT in patients with AECOPD. To observe attitudes towards and uptake of the test, and identify barriers to implementation. <h3>Methods</h3> The evaluation ran from November 2009 to June 2010. Information on PCT was introduced to all physicians, and an algorithm for use was provided. Medical notes were reviewed from patients where PCT was requested. Evidence of documentation of PCT and whether it had been acted upon were recorded along with antibiotic use, length of stay and readmission within 1 month of discharge. <h3>Results</h3> 54 PCT tests were performed and 49 were included in the final analysis. 32 (65%) of samples were below the cut-off for antibiotics, but were still prescribed in 11 cases. Of those above the threshold for treatment three did not receive antibiotics. PCT was documented and acted upon in only 12 (24%) patients. Overall, antibiotics were used in 25 (51%) patients. Two patients were readmitted with AECOPD within 1 month of discharge having been managed according to PCT results, with one receiving antibiotics. 24 (49%) samples were not reported on the day they were taken. <h3>Conclusion</h3> 11 RCTs from different countries enrolling over 3500 patients have demonstrated the feasibility and safety of PCT in guiding antibiotic prescribing. Our service evaluation showed that despite this, introducing it into a hospital setting is challenging. If the algorithm had been followed correctly 65% of patients would not have received antibiotics. Physicians often rely on clinical judgement and well-known markers of infections such as CRP and WCC. Education of physicians along with timely availability of the test play significant roles. We intend to persevere and report our results aiming to improve the use of PCT within our hospital.
No escape: HIV transmission in jail.
Authors: S M Gore, A G Bird
Journal: BMJ (1993)

<h3>ABSTRACT</h3> <h3>Background</h3> Stuttering is a speech disorder that affects more than 70 million people worldwide, limiting their ability to communicate and socialize. In recent decades, several studies have demonstrated a link between stuttering and a deficit of <i>β</i> electroencephalographic (EEG) power. <h3>Aim and Methods</h3> This study investigates the efficacy of a novel auditory neuro modulating technology that leverages euphonic music tracks with broad-spectrum binaural beats to induce selective EEG spectral power changes. Adults with stuttering (AWS, <i>n</i>=6) and participants from the control group (<i>n</i>=6) were exposed to euphonic binaural stimuli for 5 minutes. The EEG and electrocardiographic (ECG) bio-signals were recorded prior, during, and after exposure. <h3>Results</h3> During standard reading tasks without stimulation, <i>β</i>-power in the left hemisphere in the adults without stuttering and with stuttering differed. The left-right hemisphere asymmetry in <i>β</i>-wave power was observed in the control group but not in AWS. After the stimulation, the power of <i>β</i>-band in AWS participants in the left hemisphere increased 1.54-fold, while changes in the right hemisphere activity were not significant. Average <i>β</i>-band power within left frontotemporal area and temporoparietal junction after stimulation in AWS participants shows an increase of <i>β</i>-band in left frontotemporal junction by 1.65-fold and in left temporoparietal by 1.72-fold. The changes in the quality of speech were assessed based on the speech rate and the rate of speech disfluencies evaluated by speech therapists. The rate of disfluencies dropped significantly after the stimulation (median 74.70% of the baseline rate), but the effect was not significantly different from the baseline 10 min later (median 65.51% of the baseline rate). Similarly, the speech rate significantly increased immediately after the stimulation (median 133.15%) but was not significantly different 10 min later (median 126.63% of the baseline rate). In this study, we found significant correlations of <i>β</i>-activation level in left temporoparietal projection (Spearman <i>ρ</i>=-0.54,) and left frontotemporal area (Spearman <i>ρ</i>=-0.58) with disfluency rate of speech. <h3>Conclusions</h3> We show for the first time that auditory binaural beats stimulation can substantially improve speech fluency in AWS and its effect is related to boost of EEG <i>β</i>-band power in speech-production centers. The changes in <i>β</i> power are detected immediately after the exposure and persist 10 min later. Additionally, these effects are accompanied by a reduction in stress level as monitored by ECG markers. This suggests that auditory binaural beats stimulation temporarily improves speech quality in AWS by increasing <i>β</i>-band power of EEG in speech centers of the brain.
Adiponectin in Youth
Authors: Fida Bacha, Rola Saad, Neslihan Gungor, Silva A. Arslanian
Journal: Diabetes Care (2004)

OBJECTIVE—Adiponectin is an adipose tissue protein that enhances insulin sensitivity and has antiatherogenic properties. The present study investigated the relationship of adiponectin levels in adolescents to 1) obesity and body fat distribution and 2) insulin sensitivity and the components of syndrome X. RESEARCH DESIGN AND METHODS—Twenty-three normal-weight and 26 obese adolescents had fasting adiponectin, lipid profile, and proinsulin measurements performed. Hepatic and peripheral insulin sensitivity were assessed with constant-rate [6,6-2H2]glucose infusion and a 3-h hyperinsulinemic-euglycemic clamp, respectively. Body composition was evaluated by dual-energy X-ray absorptiometry, and visceral adipose tissue (VAT) and subcutaneous adipose tissue were measured by computed tomography scan at the L4-L5 level. RESULTS—Obese adolescents had ∼50% lower adiponectin than normal-weight adolescents. Moreover, obese adolescents with high (111.8 ± 9.3 cm2) versus low (55.4 ± 2.1 cm2) VAT had lower adiponectin levels (6.2 ± 0.9 vs. 9.0 ± 1.0 μg/ml, P = 0.05). Plasma adiponectin correlated positively with peripheral and hepatic insulin sensitivity (r = 0.67, P &amp;lt; 0.001 and r = 0.54, P &amp;lt; 0.001, respectively) and HDL (r = 0.52, P &amp;lt; 0.001) and negatively with fasting proinsulin and the proinsulin-to-insulin ratio (r = −0.64, P &amp;lt; 0.001 and r = −0.43, P = 0.003, respectively). In a multiple regression analysis, adiponectin, independently and together with BMI, explained 73% (R2 = 0.73, P &amp;lt; 0.001) of the variance in insulin sensitivity. Adiponectin, but not adiposity, was the significant independent determinant of the proinsulin-to-insulin ratio (R2 = 0.18, P = 0.008) and of HDL (R2 = 0.45, P &amp;lt; 0.001). CONCLUSIONS—In summary, hypoadiponectinemia in youth is a strong and independent correlate of insulin resistance, β-cell dysfunction, visceral adiposity, and syndrome X. The antidiabetogenic and antiatherogenic properties of adiponectin are evident early in life and compromised in youth-onset obesity.
Nutrition and Physical Activity and Chronic Disease Prevention: Research Strategies and Recommendations
Authors: R. L. Prentice, W. C. Willett, P. Greenwald, D. Alberts, L. Bernstein, N. F. Boyd, T. Byers, S. K. Clinton, G. Fraser, L. Freedman, D. Hunter, V. Kipnis, L. N. Kolonel, B. S. Kristal, A. Kristal, J. W. Lampe, A. McTiernan, J. Milner, R. E. Patterson, J. D. Potter, E. Riboli, A. Schatzkin, A. Yates, E. Yetley
Journal: JNCI Journal of the National Cancer Institute (2004)

A shortage of credible information exists on practical dietary and physical activity patterns that have potential to reverse the national obesity epidemic and reduce the risk of major cancers and other chronic diseases. Securing such information is a challenging task, and there is considerable diversity of opinion concerning related research designs and priorities. Here, we put forward some perspectives on useful methodology and infrastructure developments for progress in this important area, and we list high-priority research topics in the areas of 1) assessment of nutrient intake and energy expenditure; 2) development of intermediate outcome biomarkers; 3) enhancement of cohort and cross-cultural studies; and 4) criteria for and development of full-scale nutrition and physical activity intervention trials.
P-selectin blockade attenuates microvascular platelet deposition and increases myocardial salvage after reperfusion
Authors: JoséA. Barrabés, David Garcia-Dorado, Maribel Mirabet, Javier Inserte, Luis Agulló, Bernat Soriano, Anna Massaguer, Ferran Padilla, Rosa M. Lidón, Jordi Soler-Soler
Journal: Journal of the American College of Cardiology (2003)
BXL628, A Novel Vitamin D3 Analog Arrests Prostate Growth in Patients with Benign Prostatic Hyperplasia: A Randomized Clinical Trial
Authors: Enrico Colli, Patrizio Rigatti, Francesco Montorsi, Walter Artibani, Stefano Petta, Nicola Mondaini, Roberto Scarpa, Paolo Usai, Lorenza Olivieri, Mario Maggi
Journal: European Urology (2005)
Lack of palliative care causes unnecessary suffering for India's terminally ill people
Authors: P. Moszynski
Journal: BMJ (2009)

Although India is one of the world’s leading suppliers of medical opium, many thousands of its citizens experience excruciating pain every year because they do not have access to the drug, says a report published this week by the charity Human Rights Watch.

It says that most cancer hospitals, including those that receive direct support from the government to offer cancer care, do not have morphine or doctors trained in using it.

Lead researcher Diederik Lohman told the BMJ , “This is despite the fact that more than 70% of their patients are incurable and likely to require pain treatment and palliative care.

“Many of the patients we interviewed for our study …
Surgery of the Elbow
Authors: A. H. Woodward
Journal: JAMA (1972)

This is the second edition of a book originally published 18 years ago. The author freely admits that little has been changed in the text. The greater part is devoted to the care of fractures of the lower humerus and the proximal radius and ulna, and to dislocations of the elbow. Dr. Smith clearly describes, classifies, and illustrates each type of injury. A few helpful sentences point out how to avoid likely errors in diagnosing these injuries and what other injuries may occur at the same time. Methods of treatment are described in sufficient detail that even those unused to dealing with elbow injuries could easily complete the procedures suggested. Line sketches further clarify the text. Dr. Smith stresses again and again the importance of encouraging active motion of the elbow as soon as the injury permits. He strongly urges early definitive treatment for these fractures and dislocations. No one
Late sucessful treatment of splenic rupture in a haemophilic boy.
Authors: B Gibson, F W Wright, C R Rizza, N E Dudley
Journal: BMJ (1976)

The recognition of traumatic splenic rupture in an 11-year-old severely affected haemophilic boy was delayed for over five weeks. Splenectomy was carried out successfully after the demonstration of splenic rupture by an isotope spleen scan. Splenic rupture is difficult to differentiate from more simple causes of retroperitoneal haematomata in haemophiliacs when there is no massive acute peritoneal bleeding, but it may be identified with isotopic spleen scans so long as the possibility of rupture is borne in mind.
Ketoacid Salts in Portal-Systemic Encephalopathy
Authors: R. Molimard, H. F. Herlong, Willis C Maddrey, M. Walser
Journal: Annals of Internal Medicine (1981)

Letters and Corrections1 October 1981Ketoacid Salts in Portal-Systemic EncephalopathyROBERT MOLIMARDROBERT MOLIMARDSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-95-4-521_2 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: The paper by Herlong and colleagues (1), published in the October 1980 issue, deserves critical remarks. The study of only 13 patients with such an unstable disorder as hepatic encephalopathy needed a very well-planned design and appropriate statistical methods to draw such clear-cut inferences.Study 1 is presented as a double-blind crossover trial designed to compare ornithine salts of branched-chain ketoacids (Orn BCKA) to the corresponding branched-chain amino acids (RCAA). In fact, two patients only (out of 13) received the branched-chain amino acids as the first treatment, and eight patients only were given the second treatment. Thus,...References1. HERLONGMADDREYWALSER HWM. The use of ornithine salts of branched-chain ketoacids in portal systemic encephalopathy. Ann Intern Med. 1980;93:545-50. LinkGoogle Scholar2. MOLIMARDMORINESKENAZI RRP. Etude pharmacologique de l'alpha—cétoglutarate de L ( + ) ornithine. In: Problemes de reanimation. 5e série. Nancy:Spei éditeur: 1968:868-81. Google Scholar3. PARISMERVEILLEMOLIMARD JPR. L'alpha-cétoglutarate de L ( + ) ornithine dans les encéphalopathies des hépatiques. Presse Med. 1970;78:1367-8. MedlineGoogle Scholar4. CHAINUVATTIPLENGVANITVIRANUVATTI TUV. Ornicetil on enceophalopathy: effect of Ornicetil (ornithine γ ketoglutarate) on encephalopathy in patients with acute and chronic liver disease. Acta Hepatogastroenter. 1977;24:434-9. MedlineGoogle Scholar1. HERLONGMADDREYWALSER HWM. The use of ornithine salts of branched-chain ketoacids in portal-systemic encephalopathy. Ann Intern Med. 1980;93:545-50. LinkGoogle Scholar2. GIBBONS J. Nonparametric Methods for Quantitative Analysis. New York: Holt, Rinehart & Winston; 1976:123. Google Scholar3. PARISMERVEILLEMOLIMARD JPR. L'alpha-cétoglutarate de L( + ) ornithine dans les encéphalopathies des hépatiques. Presse Med. 1970;78:1367-8. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: ROBERT MOLIMARDAffiliations: Hopital de la Maison de Nanterre 92014—Nanterre France PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 1 October 1981Volume 95, Issue 4Page: 521-522KeywordsAmino acidsBrain diseasesPatientsSaltsStatistical methods ePublished: 1 December 2008 Issue Published: 1 October 1981 PDF downloadLoading ...
α1B-adrenergic receptors in rat renal microvessels
Authors: L M Canessa, M M Piccio, P Vachvanichsanong, A Sidhu, C C Porter, J E Robillard, R A Felder, P A Jose
Journal: Kidney International (1995)

Although several alpha-adrenergic receptor genes are expressed in the rat kidney, their expression in the renal vasculature has not been studied. Since pharmacological studies have suggested that an alpha 1B-adrenergic receptor may mediate renal vasoconstriction, we studied the expression of alpha 1B-adrenergic receptors in renal microvessels, from 10- to 14-week-old male spontaneously hypertensive rats (SHR) and their normotensive control, the Wistar-Kyoto rat (WKY). In these microvessels, isolated by perfusion with iron, alpha 1B-adrenergic receptor mRNA levels (by ribonuclease protection assay) were similar in SHR and WKY rats. Photo-affinity labeling with [125I]-arylazidoprazosin demonstrated the presence of alpha 1B-adrenergic receptor protein. Maximum receptor density (determined by 3H-prazosin binding: Bmax 59.8 +/- 4.1 and 58.7 +/- 4.3; Kd 0.48 +/- 0.05 nM and 0.31 +/- 0.06 nM in SHR and WKY, respectively) and chloroethylclonidine (CEC)-sensitive binding sites (determined by [125I]-(2-beta(4-hydroxyphenyl)-ethylaminomethyl)-tetralone binding) (125I-HEAT) were similar in SHR and WKY rats. There are two novel findings in these studies: (1) the alpha 1B-adrenergic receptor gene is expressed in renal microvessels of WKY and SHR; (2) alpha 1B-adrenergic receptor gene expression in renal microvessels is not altered in adult SHR. The failure to down-regulate expression of the alpha 1B-adrenergic receptor at the mRNA and protein level in the SHR could result in persistence of alpha 1B-adrenergic receptor effects and contribute to the increased vascular resistance in hypertension.