tbuckley/cabot-search huggingface dataset:
PWE-092 Symptom Response Following Advice On A Diet Low In Short-chain Fermentable Carbohydrates (fodmaps) For Functional Bowel Symptoms In Patients With Ibd: Abstract PWE-092 Table 1
Authors: T Joyce, H Staudacher, K Whelan, P Irving, M Lomer
Journal: Gut (2014)

<h3>Introduction</h3> The low FODMAP diet is an effective dietary intervention for people with functional bowel disorders (FBD), which are common in patients with inflammatory bowel disease (IBD). One study has reported that half of patients with IBD report improvements in abdominal pain, bloating, flatulence and diarrhoea after following a low FODMAP diet. Up to 70% of patients reported adherence to the diet. We aimed to assess the effectiveness of low FODMAP diet advice in patients with IBD in the UK. <h3>Methods</h3> Patients with inactive IBD and FBD (as diagnosed by their gastroenterologist), who had been referred to the dietitian and advised on a low FODMAP diet were included in this evaluation of clinical practice. Symptoms were measured pre and post (at least 6 weeks) low FODMAP dietary advice as part of normal clinical practice using the global symptom question (GSQ)’Do you currently have satisfactory relief of your gut symptoms?’ and the gastrointestinal symptom rating scale (GSRS). Stool frequency was considered ‘normal’ if between 2–3 times per week to 2–3 times per day. Types 3–5 on the Bristol stool form scale were considered normal stool consistency. Comparisons were made using the McNemar test for categorical data and a paired t-test for continuous data. <h3>Results</h3> Data from 35 patients with IBD (17 ulcerative colitis, 17 Crohn’s disease, one IBD unclassified, 63% female, mean age 39y) were analysed. There was a significant increase in the number of patients reporting positively to the GSQ (n[%] pre: 8 [23] versus post: 29 [83]; p &lt; 0.001) and the GSRS composite score (mean [SD] pre: 1.25 [0.48] versus post: 0.77 [0.45]; p &lt; 0.001). Fewer patients reported symptoms including abdominal pain, bloating, flatulence and urgency, increased stool frequency, and type 6 or 7 Bristol stool form post dietary advice compared with pre dietary advice (Table). <h3>Conclusion</h3> The low FODMAP diet appears to be an effective treatment option for patients with IBD and FGD particularly for those with symptoms of abdominal bloating, flatulence, faecal urgency and lethargy. However, this is an evaluation of clinical practice and prospective randomised controlled evidence in IBD is currently lacking. <h3>Disclosure of Interest</h3> None Declared.
'Brain Death'-Reply
Authors: Alan J. Weisbard
Journal: JAMA (1989)

<h3>In Reply. —</h3> These somewhat contradictory letters demonstrate the difficulty of achieving clarity in discussing the definition of death. Rabbi Tendler and Dr Rosner misread our editorial as proposing a rejection of whole-brain criteria and a return to the old, heart-lung definition of death, while Dr Oro takes us to task for endorsing a new, "higher brain" definition. In fact, the editorial explicitly endorses current laws based on the irreversible loss of all functions of the entire brain as the best approach for the present. Our aim was to question the too-little examined assumption that the whole-brain definition has a solid conceptual foundation, above and beyond its evident practical utility. The debate over defining death has focused on three rival definitions: the traditional version, based on permanent cessation of heart and lung function; the recently accepted whole-brain revision, involving irreversible cessation of all brain functions; and the so-called higher brain
Human diabetes associated with defects in nuclear regulatory proteins for the insulin receptor gene.
Authors: A Brunetti, L Brunetti, D Foti, D Accili, I D Goldfine
Journal: Journal of Clinical Investigation (1996)

The control of gene transcription is mediated by sequence-specific DNA-binding proteins (trans-acting factors) that bind to upstream regulatory elements (cis elements). We have previously identified two DNA-binding proteins that specifically interact with two unique AT-rich sequences of the 5' regulatory region of the insulin receptor gene which have in vivo promoter activity. Herein we have investigated the expression of these DNA-binding proteins in cells from two unrelated patients with insulin resistance and non-insulin-dependent diabetes mellitus. In these patients, the insulin receptor gene was normal. In EBV-transformed lymphoblasts from both patients, insulin receptor mRNA levels and insulin receptor expression were decreased. The expression of nuclear-binding proteins for the 5' regulatory region of the insulin receptor gene was markedly reduced, and this defect paralleled the decrease in insulin receptor protein expression. These studies indicate that DNA-binding proteins to the regulatory region of the insulin receptor gene are important for expression of the insulin receptor. Further, they suggest that in affected individuals, defects in the expression of these proteins may cause decreased insulin receptor expression and insulin resistance.
The Start of Something Good: The Discovery of HbA1c and the American Diabetes Association Samuel Rahbar Outstanding Discovery Award
Authors: Erika Gebel
Journal: Diabetes Care (2012)

Sometimes, a scientific achievement merits its own prize. The American Diabetes Association (ADA) acknowledged Samuel Rahbar, MD, PhD, with just such an honor—the Samuel Rahbar Outstanding Discovery Award—for a contribution to the study and treatment of diabetes that resonates to this day.

Rahbar is the person who discovered that HbA1c is elevated in people with diabetes. This breakthrough came in 1968 and was not immediately appreciated broadly, but over the next few decades HbA1c became arguably the most important indicator of blood glucose control, enabling doctor and patient to, for the first time, critically assess the impact of lifestyle changes and medication on long-term health (Table 1).

View this table:

Table 1 
HbA1c: a history



Rahbar was born in 1929 in Tehran the youngest of seven children. “My mother was a teacher at a French school,” he says. “My father had a small shop selling fabrics, but my mother was the pillar of our house. We were all educated.” Rahbar became highly educated indeed, receiving both a medical degree and a doctorate at the University of Tehran. He stayed there for his postdoctoral studies as well.

By then, it was the 1960s, and hemoglobin was the rising star of molecular biology. Rahbar started his fellowship in 1962 with plans to study immunoglobulins. However, shortly into his fellowship, he became interested in protein structure and “discovered hemoglobin was the molecule du jour,” he says.

Not only was hemoglobin easy to come by (making up 97% of erythrocytes’ dry weight) but in 1960, it became one of the first proteins to have its structure solved (1). That gave researchers unprecedented insight into the connection between a protein’s structure and its function. Linus Pauling, working on the protein from another angle, discovered that the hemoglobin of people with sickle cell anemia (HbS) was …
Vitronectin is up-regulated after vascular injury and vitronectin blockade prevents neointima formation
Authors: P Dufourcq
Journal: Cardiovascular Research (2002)

Smooth muscle cell (SMC) migration involves interactions with extracellular matrix (ECM) and is an important process in response to arterial wall injury. We investigated the expression and the functional role of vitronectin (VN) in the response after vascular injury.VN and alpha v beta 3/beta 5 integrin expressions were investigated after balloon carotid injury of Sprague-Dawley rats. Adventitial delivery of blocking antibodies to VN, alpha v beta 5 and beta 3 integrins were performed to assess their roles in neointima formation. In vitro, migration assays were carried out on human SMC.Immunohistochemistry and in situ hybridization for VN showed an upregulation of VN during the early time points of intima formation. alpha v beta 3/beta 5 integrins expression correlated with VN expression. After 7 days, blocking antibodies to VN, alpha v beta 5 and beta 3 induced a significant decrease on intimal area associated with a decrease in intimal cell counts. A slight decrease in intimal cell proliferation without any effect on apoptosis was observed after VN blockade. In vitro, migrating SMC strongly expressed VN after injury and neutralizing anti-VN antibody inhibited SMC migration. Blocking experiment with anti-alpha v beta 5 and -alpha v beta 3 integrin antibodies showed that not only VN-alpha v beta 3 but also VN-alpha v beta 5 interactions are required for SMC migration.This study characterizes the VN-ECM interaction in SMC and supports the role of VN in mediating SMC migration and neointimal formation in response to injury.
Review rates of pathology findings for head and neck cancer vary hugely between hospitals, report finds
Authors: Nigel Hawkes
Journal: BMJ (2013)

New data on the outcomes of surgery for head and neck cancer show variations between hospitals in the frequency with which pathology findings after surgery are discussed with other members of the multidisciplinary team.

This form of team review is considered an “important standard of care,” a report published on the NHS Choices website says,1 adding, “all cases undergoing major resective surgery should be discussed.”

But the data, which cover 3200 major operations broken down by hospital and by individual surgeon, show that this advice is not universally followed.

Review rates vary from zero to 100%, the figures show. Of 217 operations at Aintree University Hospital on patients whose cancer was recorded between 1 November 2011 and 31 October 2012, for example, …
Potential benefits of "well engaged patients" are akin to those from a blockbuster drug, say experts
Authors: B. Roehr
Journal: BMJ (2013)

Patient engagement could become “the blockbuster drug of the century,” researchers have said. This was because well informed and engaged patients were better at self management and were associated with lower healthcare costs, they told a forum on the topic held in Washington, DC, to unveil the February issue of Health Affairs , which focuses on patient engagement.1

“We believe that outcomes of quality, safety, and cost will be improved—and improved in a sustainable fashion—by meaningfully focusing on patients and their families,” said George Bo-Linn, chief program officer of the Gordon and Betty Moore Foundation, which aims to “create positive outcomes for future generations” in the San Francisco Bay …
The real ethics of rationing
Authors: D. W Light
Journal: BMJ (1997)

Since 1996, the BMJ has published a series of articles about the nature of rationing in health care, several by the Rationing Agenda Group, an influential group of policy advisers.1 This brief essay will question some of their arguments and then suggest that the real ethics of rationing should first address the sociological and managerial forms of inequality, power, and privilege upstream that force rationing downstream at the point where doctors treat patients.

There is a strange kind of schizophrenia in the arguments about rationing. One part holds that funding for the NHS is adequate and likely to be so for the foreseeable future2; another holds that rationing takes place in the NHS and always will, because rationing is inevitable.3 Yet these two central themes of policy are not joined. Surely the amount and kind of rationing, affects perceptions of the adequacy of funding. If it does not, then “rationing is inevitable” can be a paternalistic justification for playing Scrooge. It can justify as low a level of funding and supply of doctors and nurses as those in power want. If we conclude from the start that we can never adequately meet all needs, why bother trying to meet them as inadequately as we do already? Why not cut the NHS budget by 10% or 20%?

If we examine the funding article2 of the Rationing Agenda Group3 more closely, we learn that the extra burdens of aging fall within the projected growth of real NHS expenditures and that changes of morbidity will neither accelerate nor retard expenditures. The authors show that so called efficiency and activity gains are increasing faster than expenditures. Expectations may change, but they are subjective, political, cultural, and impossible to predict; so on balance NHS funding is likely to be …
Inflammasomes and rheumatic diseases: evolving concepts
Authors: P I Sidiropoulos, G Goulielmos, G K Voloudakis, E Petraki, D T Boumpas
Journal: Annals of the Rheumatic Diseases (2007)

The realisation that the production of inflammatory cytokines in inflammatory rheumatic diseases may be induced by non-infectious endogenous signals has encouraged researchers to explore mechanisms of innate immunity and their contribution to the pathogenesis of these diseases. The nucleotide-binding and oligomerisation domain (NOD)-like receptors (NLRs) sense pathogens, products of damaged cells or endogenous metabolites and could potentially be involved in the initiation, amplification and progression of the inflammatory response in rheumatic diseases. NLRs are involved in the regulation of innate immune responses with some of them promoting the activation of inflammatory caspases within multiprotein complexes, called inflammasomes. A typical inflammasome consists of a sensor, an NLR protein, an adaptor protein such as ASC (for apoptosis-associated speck-like protein containing a caspase recruitment domain (CARD)) and an effector protein that is a caspase that activates pro-inflammatory cytokines such as interleukin (IL)1beta and IL18. Recent data suggest a role of the inflammasome in the pathogenesis of autoinflammatory as well as inflammatory rheumatic diseases such as juvenile chronic arthritis, adult onset Still disease, rheumatoid arthritis and gout. Modulation of these pathways may be a potential therapeutic target for inflammatory rheumatic diseases.
Actinomycosis of the Liver and 67Ga Citrate Scintigraphy
Authors: Shantilal Lunia, Robert B. Chodos, Ramarao Sundaresh
Journal: Clinical Nuclear Medicine (1976)

Intense uptake of 67Ga was demonstrated in a 15-year-old female with actinomycosis of the liver. The 67Ga uptake in the liver corresponded precisely with the cold area detected on the radiocolloid scan. Early detection of an unusual site for an actinomycotic abscess was greatly facilitated by a 67Ga scan.
Effect of recombinant Factor VIIa on outcome of acute variceal bleeding: An individual patient based meta-analysis of two controlled trials
Authors: Flemming Bendtsen, Gennaro D’Amico, Ea Rusch, Roberto de Franchis, Per Kragh Andersen, Didier Lebrec, Dominique Thabut, Jaime Bosch
Journal: Journal of Hepatology (2014)
Sympathetic nerve discharge is coupled to muscle cell pH during exercise in humans.
Authors: R G Victor, L A Bertocci, S L Pryor, R L Nunnally
Journal: Journal of Clinical Investigation (1988)

We used phosphorus nuclear magnetic resonance spectroscopy (31P-NMR) to probe the cellular events in contracting muscle that initiate the reflex stimulation of sympathetic outflow during exercise. In conscious humans, we performed 31P-NMR on exercising forearm muscle and simultaneously recorded muscle sympathetic nerve activity (MSNA) with microelectrodes in the peroneal nerve to determine if the activation of MSNA is coupled to muscle pH, an index of glycolysis, or to the concentrations (II) of inorganic phosphate (Pi) and adenosine diphosphate (ADP) which are modulators of mitochondrial respiration. During both static and rhythmic handgrip, the onset of sympathetic activation in resting muscle coincided with the development of cellular acidification in active muscle. Furthermore, increases in MSNA were correlated closely with decreases in intracellular pH but dissociated from changes in phosphocreatine [( PCr]), [Pi], and [ADP]. The principal new conclusion is that activation of muscle sympathetic outflow during exercise in humans is coupled to the cellular accumulation of protons in contracting muscle.
A unique form of endemic pemphigus in northern Colombia
Authors: Ana María Abrèu-Velez, Takashi Hashimoto, Wendy B. Bollag, Sergio Tobón Arroyave, Clara Eugenia Abrèu-Velez, Martha Luz Londoño, Fernando Montoya, Ernst H. Beutner
Journal: Journal of the American Academy of Dermatology (2003)
Crim1KST264/KST264 Mice Implicate Crim1 in the Regulation of Vascular Endothelial Growth Factor-A Activity during Glomerular Vascular Development
Authors: Lorine Wilkinson, Thierry Gilbert, Genevieve Kinna, Leah-Anne Ruta, David Pennisi, Michelle Kett, Melissa H. Little
Journal: Journal of the American Society of Nephrology (2007)

Crim1, a transmembrane cysteine-rich repeat-containing protein that is related to chordin, plays a role in the tethering of growth factors at the cell surface. Crim1 is expressed in the developing kidney; in parietal cells, podocytes, and mesangial cells of the glomerulus; and in pericytes that surround the arterial vasculature. A gene-trap mouse line with an insertion in the Crim1 gene (Crim1(KST264/KST264)) displayed perinatal lethality with defects in multiple organ systems. This study further analyzed the defects that are present within the kidneys of these mice. Crim1(KST264/KST264) mice displayed abnormal glomerular development, illustrated by enlarged capillary loops, podocyte effacement, and mesangiolysis. When outbred, homozygotes that reached birth displayed podocyte and glomerular endothelial cell defects and marked albuminuria. The podocytic co-expression of Crim1 with vascular endothelial growth factor-A (VEGF-A) suggested a role for Crim1 in the regulation of VEGF-A action. Crim1 and VEGF-A were shown to interact directly, providing evidence that cysteine-rich repeat-containing proteins can bind to non-TGF-beta superfamily ligands. Crim1(KST264/KST264) mice display a mislocalization of VEGF-A within the developing glomerulus, as assessed by immunogold electron microscopy and increased activation of VEGF receptor 2 (Flk1) in the glomerular endothelial cells, suggesting that Crim1 regulates the delivery of VEGF-A by the podocytes to the endothelial cells. This is the first in vivo demonstration of regulation of VEGF-A delivery and supports the hypothesis that Crim1 functions to regulate the release of growth factors from the cell of synthesis.
Australia Antigen in Chronic Hepatitis in Australia
Authors: J. D. Mathews, I. R. Mackay
Journal: BMJ (1970)

Of 53 cases of active chronic liver disease two were found to be carriers of Australia antigen Au (1)-an elderly woman with typical lupoid hepatitis and an elderly mortuary attendant with serologically atypical active chronic hepatitis. Au (1) was detected also in the serum of 7 out of 20 patients with clinically atypical acute hepatitis-one was an elderly Italian woman, one had hepatitis in the puerperium, and five had a history of transfusion or inoculation. The antigen was not found in 20 typical cases of infectious hepatitis in young people in 86 patients with other diseases. Antibody to Au (1) was present in only 2 out of 102 patients who had received numerous transfusions.We conclude, firstly, that Au (1) antigen is rare in white Australians (in keeping with the low incidence of serum hepatitis in Australia), and, secondly, that Au (1) positivity in hepatitis patients is associated with transfusions and with older age. We suggest that active chronic hepatitis and lupoid hepatitis may follow infection of susceptible individuals with Au (1)-positive hepatitis virus, but persistence of the virus in high titre does not appear to be necessary for chronicity of the disease.
Biology of Brain Dysfunction
Authors: Frank R. Freemon
Journal: JAMA (1976)

Gaull has commissioned a number of neuroscientists to review various areas of basic research in brain disease. In order to decrease the timelapse between writing and publication, a book is issued whenever sufficient contributions accumulate. This third volume in the series has development neurobiology as its predominant theme, with chapters on intrauterine brain infections, perinatal hypoxic brain damage, congenital brain malformations, and inborn errors of amino acid metabolism and of other organic acid metabolism. The volume also reviews slow viral infections, the effects of brain irradiation, the neural effects of certain vitamin deficiencies, and biological aspects of depression and mania. Of special distinction is the clear, short, authoritative review of Wilson disease by Scheinberg and Sternlieb, who point out that this recessively inherited complex disorder of copper accumulation can appear clinically as liver failure; or as hemolytic anemia if the liver suddenly discharges its copper overload; or, as a neurological
An Animal Model of Tourette’s Syndrome
Authors: Jane R. Taylor, Syed A. Morshed, Salina Parveen, Marcos T. Mercadante, Lawrence Scahill, Bradley S. Peterson, Robert A. King, James F. Leckman, Paul J. Lombroso
Journal: American Journal of Psychiatry (2002)

An animal model was used to investigate an autoimmune etiology for some cases of Tourette's syndrome.Sera from 12 patients with Tourette's syndrome with high levels of antineural or antinuclear antibodies were infused bilaterally into the ventrolateral striatum of rats. Sera from 12 additional Tourette's syndrome patients and 12 normal subjects (both groups with low levels of autoantibodies) were infused for comparison. Rates of oral stereotypies were recorded by observers who were blind to the origin of the infused sera.Oral stereotypies significantly increased in the rats infused with sera from the patients with high levels of autoantibodies.The results are consistent with an autoimmune etiology in a subset of cases of Tourette's syndrome.
Medical directors of trusts Should have clinical duties..
Authors: R Scorgie, R B McGucken
Journal: BMJ (1994)

EDITOR, - My duties as medical director of Grampian Healthcare NHS Trust, the largest and most diverse trust in Scotland, accord closely with those described by the BMA's committee for public health medicine and community health and include the lead role for disciplinary procedures for medical staff.1 I attend meetings of the trust medical advisory committee as of right but as a non-voting member. The committee's chairperson continues to be elected from among the consultants in the trust.

I firmly believe, however, that to be successful a medical director must have clinical credibility among medical colleagues. This implies a continuing clinical commitment (in my case, four sessions a week in geriatric orthopaedic rehabilitation) and, perhaps more importantly, that the medical director should be appointed from the …
The Role of the Private Sector in an Economy of Limited Health-Care Resources
Authors: James F. Gifford, William G. Anlyan
Journal: New England Journal of Medicine (1979)

Home care and the lack of scientific and technical knowledge were features of the first century of medical care in the United States. Although medical care today makes available hospital treatment, a solid scientific base and an advanced and costly technology, we are now facing an era in which economic resources will be limited and in which we will have to live with more restraints than has been the case. "Rationing" of health care is a term repugnant to most Americans. The word evokes the specters of arbitrary refusal of needed services and unwarranted interference in the private practice of . . .