tbuckley/cabot-search huggingface dataset:
Daily energy and substrate metabolism in patients with cirrhosis
Authors: Aldo V. Greco, Geltrude Mingrone, Giuseppe Benedetti, Esmeralda Capristo, Pietro A. Tataranni, Giovanni Gasbarrini
Journal: Hepatology (1998)

Twenty-four-hour energy expenditure (EE) and substrate oxidation (respiratory chamber), and whole-body glucose uptake and oxidation rates (euglycemic hyperinsulinemic clamp [EHC] and indirect calorimetry) were measured in 10 male patients with posthepatitis, Child B cirrhosis, and 8 healthy male controls matched for age, body size, and body composition. Twenty-four-hour EE was higher in cirrhotic patients than in controls (8,567 +/- 764 vs. 6,825 +/- 507 kJ/d; P < .001). Resting energy expenditure (REE) was also higher in cirrhotic patients than in controls (7,881 +/- 1,125 vs. 5,868 +/- 489 kJ/d; P < .01). Twenty-four-hour respiratory quotient (RQ) (trend) and fasting RQ (0.76 +/- 0.05 vs. 0.82 +/- 0.04; P < .05) were lower in cirrhotic patients than in controls, reflecting higher lipid oxidation rates in the former group. Whole-body glucose uptake was markedly reduced in cirrhotic patients when compared with controls (22.4 +/- 3.2 vs. 44.5 +/- 7.6 mmol/kg/min; P < .001). Carbohydrate oxidation rates, computed during the last 40 minutes of the clamp, were 8.5 +/- 1.1 mmol/kg/min in cirrhotic patients and 22.6 +/- 6.1 mmol/kg/min in controls (P < .001). Nonoxidative glucose disposal was 13.9 +/- 2.5 mmol/kg/min in cirrhotic patients and 22.0 +/- 5.5 mmol/kg/min in normal controls (P < .01). In conclusion, our data indicate that patients with Child B cirrhosis who still maintain a nutritional status (i.e., body composition) comparable with healthy controls are characterized by a cluster of metabolic defects that include hypermetabolism, increased lipid utilization, and insulin resistance. This suggests that the above metabolic syndrome precedes and probably leads to malnutrition in the natural history of the liver disease. In fact, in spite of the absence of a significant difference in caloric intake between cirrhotic patients and normal controls, the elevated 24-hour EE might allow for a relevant weight loss in cirrhotic patients, because, with time, the differences may be cumulative. However, whether this hypermetabolism can lead to a real weight loss remains to be evaluated in a longitudinal study.
Do Physicians Preach What They Practice?
Authors: Kenneth B. Wells
Journal: JAMA (1984)

We examined the relation of physicians' clinical specialty, personal health habits, and health-related beliefs to their practices in counseling about smoking, weight, exercise, and alcohol. We surveyed a random sample of members of a county medical society in selected specialties. Physicians with better personal health habits and more positive attitudes toward counseling counsel a broader range of patients and counsel more aggressively. Surgeons counsel less than nonsurgeons, even after controlling for differences in health-related attitudes and personal habits. (<i>JAMA</i>1984;252:2846-2848)
New European Union regulation of clinical trials is not conflicting on deferred consent in emergency situations
Authors: M. Sheehan
Journal: BMJ (2013)

There is no conflict between the conditions in the proposed regulations as Gamble and colleagues suggest.1 The first stipulation mentions patients and consent from patients; the second refers to patients’ representatives.

It makes sense to distinguish between the two: if consent cannot be obtained from patients, we should ask their representatives for advice on their preferences. If …
S117 Respiratory muscle fatigue following exercise in patients with interstitial lung disease
Authors: D. Elia, J. L. Kelly, D. Martolini, E. Renzoni, A. K. Boutou, A. Chetta, M. I. Polkey, N. S. Hopkinson
Journal: Thorax (2011)

<h3>Background</h3> Patients with interstitial lung disease (ILD) experience progressive breathlessness and exercise limitation. Although respiratory muscle fatigue has been investigated in healthy subjects and patients with COPD, it is unknown whether it occurs during exercise in ILD patients and, if so to what extent it is related to changes in dynamic lung volumes. <h3>Methods</h3> Patients with ILD performed incremental, symptom-limited cycle ergometry with inspiratory capacity manoeuvres used to measure changes in end-expiratory lung volume (EELV). Twitch transdiaphragmatic pressure (TwPdi), in response to bilateral anterolateral magnetic phrenic nerve stimulation and twitch gastric pressure (TwT<sub>10</sub>Pga) in response to magnetic stimulation over the 10th thoracic vertebra were used to assess the development of fatigue. <h3>Results</h3> Sixteen ILD patients (11 women) were studied. TwPdi did not differ significantly pre and post exercise (21.8±8 vs 20.2±8 cmH<sub>2</sub>O; p=0.10), while TwT<sub>10</sub>Pga fell from 28.6±18 to 25.2±14 cmH<sub>2</sub>O (p=0.02) (Abstract S117 figure 1). EELV fell from 2.18±0.65 l to 1.91±0.59 l following exercise (p=0.04). The fall in TwT10Pgas correlated with peak VO<sub>2</sub> (r=−0.52, p=0.041) increase in heart rate (r=0.53 p=0.032) and with the decrease of EELV during exercise (r=0.57, p=0.021). Abdominal muscle fatiguers (n=9, 56%), defined as a ≥10% fall in TwT10Pga, had a fall in EELV of 22±22% compared to 0.7±8% in non-fatiguers (p=0.016). <h3>Conclusion</h3> Abdominal muscle fatigue develops during exercise in ILD patients in association with increased expiratory muscle activity manifest by reduced EELV.
Chlorofluorocarbon-free inhalers: are we ready for the change?
Authors: MR Partridge, AA Woodcock, AL Sheffer, A Wanner, A Rubinfeld
Journal: European Respiratory Journal (1998)

Chlorofluorocarbons (CFCs) damage stratospheric ozone permitting enhanced levels of ultraviolet B radiation to reach the Earth's surface. As a result, production of CFCs is now banned under the Montreal Protocol with the exception of their temporary continued use in pressurized metered dose inhalers used to treat those with airway disorders. Replacement propellants have now been identified and shown to be safe and a major exercise is under way to reformulate the commonly used aerosolized medicines with the new propellants. The new products are now undergoing clinical trials and the first reformulated beta-agonist and corticosteroid inhalers have reached the marketplace. The majority of the current products will have been changed over to the new types over the next 3 yrs, and each country will adapt a transition strategy to oversee this process. The politicians, the environmentalists, the pharmaceutical industry and the regulatory authorities have fulfilled their part in this changeover, and respiratory interested health professionals now need to address what this means for them and their patients so that there may be a seamless transition for the millions of people who use inhaled medicines worldwide.
Fibrinolytic capacity of arm and leg veins after femoral shaft fracture and acute myocardial infarction.
Authors: J M Rawles, C Warlow, D Ogston
Journal: BMJ (1975)

The local fibrinolytic activity generated in the leg and arm veins during venous occlusion (fibrinolytic capacity) and the systemic fibrinolytic activity were measured at intervals in 11 patients after fracture of the femoral shaft and in 11 patients after acute myocardial infarction. In both groups the fibrinolytic capacity of the leg veins and the systemic fibrinolytic activity were significantly reduced two days after the onset of tissue injury. The fibrinolytic capacity of the arm veins was not altered. These results provide a possible explanation for the predilection of venous thrombosis for the leg veins after accidental trauma and acute myocardial infarction.
Aging promotes the development of diet-induced murine steatohepatitis but not steatosis
Authors: Luis Fontana, Enpeng Zhao, Muhammad Amir, Hanqing Dong, Kathryn Tanaka, Mark J. Czaja
Journal: Hepatology (2012)

The prevalence of the metabolic syndrome and nonalcoholic fatty liver disease (NAFLD) in humans increases with age. It is unknown whether this association is secondary to the increased incidence of risk factors for NAFLD that occurs with aging, reflects the culmination of years of exposure to lifestyle factors such as a high-fat diet (HFD), or results from physiological changes that characterize aging. To examine this question, the development of NAFLD in response to a fixed period of HFD feeding was examined in mice of different ages. Mice aged 2, 8, and 18 months were fed 16 weeks of a low-fat diet or HFD. Increased body mass and insulin insensitivity occurred in response to HFD feeding irrespective of the age of the mice. The amount of HFD-induced hepatic steatosis as determined biochemically and histologically was also equivalent among the three ages. Liver injury occurred exclusively in the two older ages as reflected by increased serum alanine aminotransferase levels, positive terminal deoxynucleotide transferase–mediated deoxyuridine triphosphate nick end-labeling, and caspase activation. Older mice also had an elevated innate immune response with a more pronounced polarization of liver and adipose tissue macrophages into an M1 phenotype. Studies of cultured hepatocytes from young and old mice revealed that aged cells were selectively sensitized to the Fas death pathway. Conclusion : Aging does not promote the development of hepatic steatosis but leads to increased hepatocellular injury and inflammation that may be due in part to sensitization to the Fas death pathway and increased M1 macrophage polarization. (Hepatology 2013)
OCCURRENCE OF THE GLYOXYLATE-SHUNT IN THE EPIDERMIS OF RATS
Authors: V. K. H. BROWN, Valerie L. Box
Journal: British Journal of Dermatology (1968)

SUMMARY.— The glyoxylate-shunt is a relatively rare metabolic pathway in mammals. Spectrophotometric determination of the 2,4-dinitrophenylhydra-zone of glyoxylic acid, formed by the incubation of rat epidermis with iso Citrate, is presented as corroborative evidence that the shunt is operative in rat skin.
The Influence of Antibiotics on the Origin of Small Colonies (G Variants), of Micrococcus Pyogenes var. Aureus1
Authors: Robert I. Wise, Wesley W. Spink
Journal: Journal of Clinical Investigation (1954)

In attempting to select out penicillin-resistant colonies of staphylococcus from sensitive cultures by the method of Kirby (1), small G colonies were obtained.When isolated on plates of agar, the colonies in some instances appeared so minute, that growth was detected only with the aid of magnification.A study of this phenomenon was pursued further with many cultures of staphylo- coccus and with different antibiotics, and minute colonies were again isolated.The small colonies reverted to the normal larger colonies when cul- tured in the absence of antibiotics.Since the minute colonies originated under the influence of antibiotics commonly used in the therapy of staphylococcal diseases, the possibility presented itself that these colonies might also appear in pa- tients while undergoing treatment with antibiotics.This report is concerned first, with a brief sum- mary of the literature on G colonies; second, experiments relating to the in vitro conditions under which the minute colonies appeared with the dif- ferent antibiotics; third, changes in virulence and resistance to the antibiotics displayed by the parent colonies, small colonies, and the reverted large colonies; fourth, the sensitivity to bacterio- phage of parent colonies, G colonies and reverted colonies; and, lastly, the isolation of minute col- onies from human patients with staphylococcal disease.REVIEW OF LITERATURE Small colony variants have been described for many species of bacteria.Most of the variants reported by investigators were obtained from cul- tures submitted to unfavorable metabolic influ- ences, such as chemicals, antibiotics, and aging.In some instances, isolation was from patients
The QT interval during reflex cardiovascular adaptation.
Authors: T A Davidowski, S Wolf
Journal: Circulation (1984)

We examined the relationship between changes in heart rate and the measured QT interval of the electrocardiogram in healthy subjects after exercise and during breath holding, hyperventilation, the dive reflex, the Valsalva maneuver, and the cold-pressor test. The tachycardia of exercise was accompanied by the familiar shortening of the QT interval, but substantial heart rate changes encountered in other more "sedentary" maneuvers were accompanied by very small changes in QT. Calculating the corrected QT in the latter instances, therefore, yielded spurious results. The data suggest very little, if any, direct effect of heart rate on the QT interval. The length of the interval in healthy subjects appears to be determined largely by reflexly elicited discrete autonomic influences. Those associated with exercise result in QT shortening but, during neurally mediated cardiovascular adjustments that do not involve exercise, QT is maintained within narrow limits.
Efficacy of a Telephone-Delivered Sexually Transmitted Infection/Human Immunodeficiency Virus Prevention Maintenance Intervention for Adolescents
Authors: Ralph J. DiClemente, Gina M. Wingood, Jessica M. Sales, Jennifer L. Brown, Eve S. Rose, Teaniese L. Davis, Delia L. Lang, Angela Caliendo, James W. Hardin
Journal: JAMA Pediatrics (2014)

Behavioral change interventions have demonstrated short-term efficacy in reducing sexually transmitted infection (STI)/human immunodeficiency virus (HIV) risk behaviors; however, few have demonstrated long-term efficacy. To evaluate the efficacy of a telephone counseling prevention maintenance intervention (PMI) to sustain STI/HIV-preventive behaviors and reduce incident STIs during a 36-month follow-up. In a 2-arm randomized supplemental treatment trial at 3 clinics serving predominantly minority adolescents in Atlanta, Georgia, 701 African American adolescent girls aged 14 to 20 years received a primary treatment and subsequently received a different (supplemental) treatment (PMI) to enhance effects of the primary treatment. Participants in the experimental condition (n = 342) received an adapted evidence-based STI/HIV intervention (HORIZONS) and a PMI consisting of brief telephone contacts every 8 weeks over 36 months to reinforce and complement prevention messages. Comparison-condition participants (n = 359) received HORIZONS and a time- and dose-consistent PMI focused on general health. The primary outcomes were percentage of participants with a laboratory-confirmed incident chlamydial infection and percentage of participants with a laboratory-confirmed gonococcal infection during the 36-month follow-up. Behavioral outcomes included the following: (1) proportion of condom-protected sexual acts in the 6 months and 90 days prior to assessments; (2) number of sexual episodes during the past 90 days in which participants engaged in sexual intercourse while high on drugs and/or alcohol; and (3) number of vaginal sex partners in the 6 months prior to assessments. During the 36-month follow-up, fewer participants in the experimental condition than in the comparison condition had incident chlamydial infections (94 vs 104 participants, respectively; risk ratio = 0.50; 95% CI, 0.28 to 0.88; P = .02) and gonococcal infections (48 vs 54 participants, respectively; risk ratio = 0.40; 95% CI, 0.15 to 1.02; P = .06). Participants completing more telephone contacts had a lower risk of chlamydial infection (risk ratio = 0.95; 95% CI, 0.90 to 1.00; P = .05). Participants in the experimental condition reported a higher proportion of condom-protected sexual acts in the 90 days (mean difference = 0.08; 95% CI, 0.06 to 0.11; P = .02) and 6 months (mean difference = 0.08; 95% CI, 0.06 to 0.10; P = .04) prior to assessments and fewer episodes of sexual acts while high on drugs and/or alcohol (mean difference = -0.61; 95% CI, -0.98 to -0.24; P < .001). Sustaining the long-term impact of an STI/HIV intervention is achievable with brief, tailored telephone counseling. clinicaltrials.gov Identifier: NCT00279799.
Efficacy of treating pain to reduce behavioural disturbances in residents of nursing homes with dementia: cluster randomised clinical trial
Authors: B. S. Husebo, C. Ballard, R. Sandvik, O. B. Nilsen, D. Aarsland
Journal: BMJ (2011)

<b>Objective</b> To determine whether a systematic approach to the treatment of pain can reduce agitation in people with moderate to severe dementia living in nursing homes. <b>Design</b> Cluster randomised controlled trial. <b>Setting</b> 60 clusters (single independent nursing home units) in 18 nursing homes within five municipalities of western Norway. <b>Participants</b> 352 residents with moderate to severe dementia and clinically significant behavioural disturbances randomised to a stepwise protocol for the treatment of pain for eight weeks with additional follow-up four weeks after the end of treatment (33 clusters; n=175) or to usual treatment (control, 27 clusters; n=177). <b>Intervention</b> Participants in the intervention group received individual daily treatment of pain for eight weeks according to the stepwise protocol, with paracetamol (acetaminophen), morphine, buprenorphine transdermal patch, or pregabaline. The control group received usual treatment and care. <b>Main outcome measures</b> Primary outcome measure was agitation (scores on Cohen-Mansfield agitation inventory). Secondary outcome measures were aggression (scores on neuropsychiatric inventory-nursing home version), pain (scores on mobilisation-observation-behaviour-intensity-dementia-2), activities of daily living, and cognition (mini-mental state examination). <b>Results</b> Agitation was significantly reduced in the intervention group compared with control group after eight weeks (repeated measures analysis of covariance adjusting for baseline score, P&lt;0.001): the average reduction in scores for agitation was 17% (treatment effect estimate −7.0, 95% confidence interval −3.7 to −10.3). Treatment of pain was also significantly beneficial for the overall severity of neuropsychiatric symptoms (−9.0, −5.5 to −12.6) and pain (−1.3, −0.8 to −1.7), but the groups did not differ significantly for activities of daily living or cognition. <b>Conclusion</b> A systematic approach to the management of pain significantly reduced agitation in residents of nursing homes with moderate to severe dementia. Effective management of pain can play an important part in the treatment of agitation and could reduce the number of unnecessary prescriptions for psychotropic drugs in this population. <b>Trial registration</b> ClinicalTrials.gov NCT01021696 and Norwegian Medicines Agency EudraCTnr 2008-007490-20.
Implications of new diagnostic criteria for abnormal glucose homeostasis in women with previous gestational diabetes.
Authors: E Kousta, N J Lawrence, A Penny, B A Millauer, S Robinson, A Dornhorst, M de Swiet, P J Steer, A Grenfell, H M Mather, D G Johnston, M I McCarthy
Journal: Diabetes Care (1999)

OBJECTIVE: To determine the consequences of applying revised American Diabetes Association (ADA) (1997) and World Health Organization (WHO) (1998) recommendations for the classification of glucose intolerance in women with previous gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: There were 192 women with previous GDM who took an oral glucose tolerance test (OGTT) 1-86 months after delivery and were classified by WHO (1985), ADA (1997, fasting glucose), and revised WHO (1998) guidelines. RESULTS: Among the 165 women without a preexisting diagnosis of diabetes, WHO-1985 and ADA-1997 provided similar estimates of diabetes prevalence (13.3% vs. 11.5%) but widely differing estimates of impaired glucose homeostasis (31.5% impaired glucose tolerance [IGT] by WHO-1985 vs. 10.9% impaired fasting glucose by ADA-1997 criteria). Overall, 56 women (34%) showed a classification discrepancy between WHO-1985 and ADA-1997 criteria, including 44 with normal fasting glucose by ADA-1997 criteria, but abnormal 2-h glucose by WHO-1985 criteria (40 IGT, 4 diabetes). The cardiovascular risk profile of these women was more favorable than that of 18 women with impaired fasting glucose. WHO-1998 recommendations reproduced ADA-1997 findings when used as a fasting screen, but behaved similarly to WHO-1985 criteria when 2-h glucose values were also analyzed. CONCLUSIONS: All criteria produced similar estimates of diabetes prevalence. However, analyses based on a single fasting glucose screen (and a threshold of 6.1 mmol/l) failed to identify 60% of women with abnormal 2-h glucose levels. Screening women with previous GDM (and by analogy, other groups at high risk of diabetes) with a single fasting glucose has low sensitivity for the detection of abnormal glucose tolerance. Recent guidelines recommending this approach require reevaluation.
TCT-791 Percutaneous or surgical repair for functional mitral regurgitation – comparison of patient characteristics and clinical outcomes
Authors: Lenard Conradi, Paul Graumüller, Volker Rudolph, Moritz Seiffert, Marusha Knap, Johannes Schirmer, Edith Lubos, Stefan Blankenberg, Hermann Reichenspurner, Hendrik Treede, Stephan Baldus
Journal: Journal of the American College of Cardiology (2012)
Progressive Reduction of Temporal Lobe Structures in Childhood-Onset Schizophrenia
Authors: Leslie K. Jacobsen, Jay N. Giedd, F. Xavier Castellanos, A. Catherine Vaituzis, Susan D. Hamburger, Sanjiv Kumra, Marge C. Lenane, Judith L. Rapoport
Journal: American Journal of Psychiatry (1998)

OBJECTIVE: A previous cross-sectional study of brain morphology in childhood-onset schizophrenia indicated sparing of the temporal lobes from processes reducing total cerebral volume in this population. In the present study, subjects with childhood-onset schizophrenia and healthy subjects were rescanned at 2-year follow-up to determine whether this pattern of temporal lobe sparing persists with ongoing illness. METHOD: Anatomic brain magnetic resonance imaging scans were acquired for 10 adolescent patients with average onset of schizophrenia at 10.4 years (SD=1.7) and 17 healthy adolescents. Scans were obtained on initial admission and at 2-year follow-up by using identical equipment and measurement methodology. RESULTS: Schizophrenic subjects showed significantly greater decreases than healthy subjects in right temporal lobe, bilateral superior temporal gyrus and posterior superior temporal gyrus, right anterior superior temporal gyrus, and left hippocampal volumes during the follow-up interval. Decline in right posterior superior temporal gyrus was associated with high total scores on the Scale for the Assessment of Positive Symptoms at baseline and at follow-up. CONCLUSIONS: Progressive reduction of temporal lobe structures occurs with ongoing illness in childhood-onset schizophrenia.
A Hospital Riot: Its Determinants and Implications for Treatment
Authors: RICHARD C. MAROHN, DIANE DALLE-MOLLE, DANIEL OFFER, ERIC OSTROV
Journal: American Journal of Psychiatry (1973)

Several factors were responsible for a riot on an inpatient treatment unit for delinquent adolescents: individual dynamics of patients and staff, group problems of patients and staff, and issues involving the entire patient-staff group. The unit is viewed as an open system comprising the individual dynamics of staff and patients as well as their interrelationships. Achieving and maintaining internal homeostasis are essential to that organism. The authors discuss the implications of their findings for hospital treatment.
DOUBLE-BLIND, PLACEBO-CONTROLLED STUDY OF LUTEINISING-HORMONE- RELEASING-HORMONE NASAL SPRAY IN TREATMENT OF UNDESCENDED TESTES
Authors: S.M.P.F. DE MUINCK KEIZER-SCHRAMA, F.W.J. Hazebroek, S.L.S. Drop, A.W. Matroos, J.C. Molenaar, H.K.A. Visser
Journal: The Lancet (1986)
Osteoblastic differentiation of human mesenchymal stem cells with platelet lysate
Authors: Nathalie Chevallier, Fani Anagnostou, Sebastien Zilber, Gwellaouen Bodivit, Sophie Maurin, Aurelie Barrault, Philippe Bierling, Philippe Hernigou, Pierre Layrolle, Helene Rouard
Journal: Biomaterials (2009)