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At least 19 recordsLinked to original sources

PubMed1991

[Renal sodium handling and renal dopaminergic activity in overweight normotensive subjects].

Recently, we reported that the blunted natriuretic ability related to an attenuation of renal dopaminergic activity might play an important role in the hypertensive mechanisms of overweight patients with essential hypertension. On the other hand, the interrelationships between obesity, blood pressure and renal sodium handling in normotensives (NT) have not been clear. The purpose of the present study is to reveal the role of renal dopaminergic activity on renal sodium handling in overweight NT. The study consisted of 52 hospitalized NT receiving a regular diet containing 200mEq of sodium, 75mEq of potassium, 2400kcal/day, who were divided into two groups of 31 non-obese (NNT) and 21 obese (ONT) subjects. NNT was categorized as the body mass index (BMI) less than, and ONT as the BMI equal to or more than, 25kg/m2. In the early morning, after overnight fasting, all subjects remained in a supine state and were examined for renal clearance. During the clearance period, mean arterial pressure (MAP), heart rate (HR), endogenous creatinine clearance (Ccr), urinary excretion of sodium (UNaV), fractional excretion of sodium (FENa) and of inorganic phosphorus (FEP) and urinary excretion of free dopamine (uDA) were determined. There were no significant differences in age, HR, Ccr or UNaV between the two groups. Higher MAP and lower FENa) were observed in ONT than in NNT, but the differences in these parameters were not statistically significant. However, FENa in ONT was significantly lower than in MAP-and Ccr-matched NNT. In addition, FENa correlated negatively with BMI in ONT, unlike in NNT. MAP was correlated positively with FENa, and a similar tendency was found between MAP and FEP in NNT, but not in ONT. On the other hand, there was no significant correlation between BMI and uDA in either NNT or ONT. This result was different from our previous data in patients with essential hypertension (EHT) in which BMI correlated with uDA positively in non-obese EHT and negatively in obese EHT. These findings suggest that blunted natriuretic ability may exist in ONT, and the role of renal dopaminergic activity related to the attenuated natriuretic ability in ONT may be less important than in obese EHT.

Adult↗

PubMed1992

Observations from a cluster survey on seasonality in neonatal tetanus.

This report presents the observations on seasonality and neonatal tetanus (NNT) mortality from a cluster survey on NNT mortality conducted in Kano metropolis, Northern Nigeria. A two stage cluster sampling method was used for the survey. There were 2,623 live-births with 1778 (67%) occurring in the dry season (October-May). The NNT mortality rate was 20.6/1000 live-births. The magnitude of neonatal mortality and NNT mortality were 47.3 and 30.8 per 1000 live-births respectively for the wet season. These were much higher than the comparative figures for dry season. There was, however, no significant association between seasonality and NNT mortality since the same trend was observed for non-NNT deaths.

Birth Rate↗

PubMed1992

[The role of insulin on renal sodium handling and sympathetic nerve activity in overweight normotensive subjects].

Recently, it was suggested that the role of hyperinsulinemia on the hypertensive mechanism of essential hypertension might be related to renal sodium handling and sympathetic nerve activity, especially in obese hypertensive patients. However, the interrelationship between insulin, obesity, renal sodium metabolism and sympathetic nerve activity in normotensive subjects (NT) still remains unclear. The present study, therefore, was undertaken to clarify the role of insulin on renal sodium handling and sympatho-adrenal function in overweight NT. The study consisted of 24NT, who were divided into two groups of twelve non-obese (NNT) and twelve obese (ONT) subjects. NNT was categorized as a body mass index (BMI) less than, and ONT as a BMI equal to or more than 25kg/m2. In the early morning, after overnight fasting, all subjects remained in a supine state and were examined for renal clearance test. During the two-hour clearance period, mean arterial pressure (MAP), heart rate (HR), endogenous creatinine clearance(CCr), urinary excretion of sodium (UNaV), fractional excretion of sodium (FENa), plasma immunoreactive insulin (IRI), plasma norepinephrine concentration (pNE), and plasma epinephrine concentration (pE) were determined. Although no significant difference was found in age, MAP, HR, pE, CCr or UNaV between the two groups, a significantly higher IRI (p less than 0.05) and lower FENa (p less than 0.05) were observed in ONT than in NNT. There was no significant correlation between IRI and UNaV, FENa or pE in ONT or in NNT. In addition, no significant correlation was shown between FENa and pNE or pE in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Medulla↗

PubMed1991

A reassessment of risk factors for neonatal tetanus.

A hospital-based case-control study was conducted to further examine the risk factors for neonatal tetanus (NNT) in the North-west Frontier Province of Pakistan. Three control infants were concurrently evaluated for each of 102 consecutively diagnosed NNT cases hospitalized over an 8-week period. Application of clarified butter (ghee) during the first few days of life was shown to be a significant risk factor, confirming our previously reported finding. However, the risk appeared to be limited to ghee made in the home from cow's milk. The tool used to cut the umbilical cord was again refuted to be a risk factor; application of topical antibiotics conferred significant protection. Multivariate analysis of the matched data showed that delivery by persons with academic training (physicians, nurses, and lady health visitors) was also protective. Mothers with a past history of NNT babies were shown to have a significantly increased risk, and accounted for more than one-third of all cases in the present study. The findings suggest possible ways to augment the effectiveness of NNT elimination programmes.

Butter↗

PubMed2026

Nicotinamide nucleotide transhydrogenase directly couples redox homeostasis to proline biosynthesis in human glioma.

Cancer cell proliferation requires a precise balance between biomass production and nutrient catabolism. The pyridine nucleotide cofactors nicotinamide adenine dinucleotide NAD(H) and NAD phosphate NADP(H) are central to this process, but their compartment-specific regulation is incompletely understood. Using in vivo isotope-labeled metabolite tracing in an orthotopic xenograft model, we find that human gliomas extensively synthesize proline, an amino acid previously associated with hypoxia tolerance. In glioma cells, we identify a hypoxia-enhanced proliferative sensitivity to environmental proline dependent on NADH to NADPH transhydrogenation from a spatially compartmentalized mitochondrial pool by the enzyme nicotinamide nucleotide transhydrogenase (NNT). We demonstrate NNT-dependent generation of mitochondrial NADPH is important for proline accumulation, maintenance of antioxidant systems, and reductive metabolism in hypoxic glioma cells in vitro and tumor progression in vivo. Collectively, these results highlight proline accumulation as a marker of mitochondrial NAD(P)(H) homeostasis and NNT as a specific metabolic dependency in human glioma.

NNT↗

PubMed1992

Community-based evaluation survey of immunizations in Burkina Faso.

A cluster sample survey was conducted in January 1989 in 3 provinces of Burkina Faso to evaluate an immunization programme (based on two contacts, providing inactivated poliomyelitis vaccine plus DPT) that had been launched in 1982-84. The objectives were to estimate neonatal tetanus (NNT) mortality and poliomyelitis prevalence in the study area. The target population (using the same sample of households comprised 2107 live infants born during the preceding year for the NNT survey, and 17,154 children aged 0-9 years for the poliomyelitis survey. The NNT mortality rate was 3.3 per 1000 live births, and the poliomyelitis prevalence rate was 2.8 per 1000 children aged 5-9 years. Dates of onset of poliomyelitis cases among children aged 0-9 years and the numbers of children at risk during the 10-year recall period, reconstituted with demographic indicators taken from standardized life-tables, were used to calculate the incidence rates of poliomyelitis. These rates could be compared in the 5-year period preceding the survey, and showed a decreasing trend consistent with routine surveillance data.

Burkina Faso↗

PubMed2026

Laparoscopic Surgery Is Associated With Reduced Small Bowel Obstruction Risk After Colorectal Cancer Surgery: A Nationwide Cohort Study of 5458 Patients.

INTRODUCTION: Postoperative small bowel obstruction (SBO) is a major complication following colorectal cancer surgery, yet evidence-based prevention strategies remain unclear. We aimed to clarify site-specific risk factors for SBO and evaluate the effectiveness of laparoscopic surgery and adhesion prevention materials (APMs) in preventing SBO after colorectal cancer surgery. METHODS: This retrospective cohort study analyzed 5458 patients who underwent colorectal cancer surgery at 32 Japanese institutions between 2012 and 2014. The primary endpoint was the 5-year risk of SBO. We evaluated the effects of laparoscopic surgery, APM use, and stoma creation on SBO risk. Clinical variables included demographics, tumor site, operative approach, operative details, and postoperative complications. Hospital-level clustering was addressed using mixed-effects logistic regression. RESULTS: Overall SBO incidence was 5.2% (n = 283). Rectal cancer had the highest risk, whereas all colonic sites except the descending colon showed significantly lower odds. Laparoscopic surgery was associated with a 42% reduction in odds (OR 0.58; 95% CI 0.45-0.74; p < 0.001), with significant reductions in ascending (NNT = 22.2, p = 0.001) and sigmoid colon surgery (NNT = 30.2, p = 0.003). APMs showed no protective effect (OR 1.01; 95% CI 0.78-1.32; p = 0.94). Stoma creation significantly increased SBO risk (OR 1.84; 95% CI 1.35-2.51; p < 0.001). Secondary analysis identified reoperation and postoperative ileus as additional independent risk factors. DISCUSSION: Laparoscopic surgery was associated with reduced long-term SBO risk, with significant benefits in ascending and sigmoid colon surgery. APMs showed no measurable benefit. Stoma creation increased SBO risk, with no observed difference between ileostomy and colostomy.

adhesion prevention material↗

PubMedDate not supplied

Neonatal tetanus: observations on antenatal immunization, natal and immediate post-natal factors.

The objective is to study the present status of the antenatal immunization with tetanus toxoid and the natal and immediate postnatal factors among the cases of neonatal tetanus and the changes over time. Retrospective analysis of 61 case records of Neonatal Tetanus (NNT) during 1987-88 and prospective study of 19 cases of 1989 was done. The number of cases have decreased considerably from 88 in 1984 to 19 in 1989. 80% of cases were from residents outside the city. Antenatal checkup improved from 37.7% in 1987 to 73.7% in 1989. The proportion of mothers of NNT cases who received = greater than 2 doses have increased from 19.7% in 1987-88 to 31.6% in 1989. In the year 1989, 21% and 10.5% have received the I and II doses of TT respectively at the 9th month of pregnancy, the value of which is doubtful. Majority (73.7%) were domiciliary deliveries conducted by dhais and this has not changed over the years. The importance of antenatal booking, immunization at the appropriate time, hygienic obstetric and cord care are stressed.

Female↗

PubMed1992

Maternal tetanus toxoid coverage during pregnancy in Ile-Ife, Nigeria.

A cluster survey on maternal tetanus toxoid (TT) coverage was carried out in the Ile-Ife Central Local Government Area. Out of the 896 mothers of babies 0-12 months old who were interviewed, 668 (74.6%) claimed they received TT during pregnancy, this was confirmed in 37 (4.1%) and in only 25 (2.8%) of these cases could the babies be said to have been protected from neonatal tetanus (NNT) at birth. About 35% of the babies were delivered at home/churches where most babies with NNT are usually born.

Adult↗

PubMed1992

Neonatal tetanus estimates of mortality derived from a cluster survey in northern Nigeria.

A two-stage cluster survey of deaths from neonatal tetanus (NNT) was carried out in Kano metropolis, Northern Nigeria in order to estimate the mortality from the disease. Estimates of mortality were obtained by three different methods which were compared. According to clinical diagnosis, mortality was 20.6/1000 live-births while reports of 4-14 day deaths gave a figure of 11.4/1000 live-births. From information volunteered by informants, it appeared to be only 4.6/1000 live-births. NNT accounted for 68% neonatal deaths. The sex-specific mortality rates were 23.4 and 17.9 per 1000 live-births for males and females respectively. There was, however, no significant association between sex and death from neonatal tetanus. The mortality for the first 6 months of recall period was 15.2/1000 live-births and 24.2/1000 live-births for the last 6 months. There was also no significant association between recall period and death. In view of the markedly different estimates by the various methods of diagnosis, retrospective clinical diagnosis is suggested for community-based surveys of mortality related to neonatal tetanus.

Birth Rate↗

PubMed1990

Cross-reactive asparagine-rich determinants shared between several blood-stage antigens of Plasmodium falciparum and the circumsporozoite protein.

From a Plasmodium falciparum cDNA expression library derived from mRNA of the asexual blood stages, we isolated and sequenced five different cDNA clones whose predicted protein products were unusually rich in asparagine (Asn). Two of the clones, R5 and G5, contain tandem imperfectly repeated sequences based on Asn-Asn-Thr (NNT) and Asn-Asn-Met (NNM) respectively. The other three, E4, C5 and R13, as well as G5, contain stretches of polyasparagine varying in length from 2 to 26 residues. Results of DNA blotting experiments with the individual cDNA sequences as probes suggest that each of the five clones corresponds to a different P. falciparum gene. The fragments of P. falciparum proteins expressed by the cDNA clones shared cross-reactive antigenic determinants which were present on multiple P. falciparum proteins. In immunoblotting experiments, owl monkey antibodies selected for binding to the polypeptide expressed by clone E4, C5 or G5 reacted with the expressed proteins from all 5 clones, and with at least 10 proteins from schizont infected erythrocytes. The cross-reactive epitopes could be modeled by two Asn-rich peptide structures: (1) (NNT)8, whose sequence was based on the R5 repeat; and (2) (NPNA)6, whose sequence was based on the Asn-rich repeat of the P. falciparum circumsporozoite protein (CSP). Antibodies that bound to each peptide were selected from sera of immune monkeys that had never been exposed to sporozoites. The selected antibodies bound all 5 expressed proteins in immunoblotting assays and also bound to several proteins from parasitized erythrocytes. Such cross reactivity between the CSP repeating unit and several blood-stage antigens has not been previously reported.

Amino Acid Sequence↗

PubMed2026

Plasma signals of lung tumor promotion for molecular cancer prevention.

Predicting lung cancer risk would enhance prevention trials. Although the Canakinumab Anti-inflammatory Thrombosis Outcome Study (CANTOS) trial demonstrated reduced lung cancer incidence with interleukin (IL)-1β inhibition, the high number needed to treat (NNT) to prevent lung cancer limits its use in unselected populations. Using machine learning, we identified a 14-protein plasma signature predicting lung cancer more than 5 years before diagnosis. The signature, validated across eight cohorts, was elevated in current smokers and individuals exposed to particulate matter (PM) and linked to lung myeloid and alveolar cells. In epidermal growth factor receptor (EGFR)-driven lung adenocarcinoma, diverse epithelial lineages converged on a keratin8+/claudin4+ alveolar transitional state (KAC), whose transcriptional programs correlated with signature emergence. Components of the signature were induced by PM, oncogenic EGFR, or IL-1β, whereas IL-1β inhibition restrained PM-driven KAC expansion and early tumorigenesis. In CANTOS, the signature identified individuals who seemed to benefit more from anti-IL-1β therapy, lowering the NNT threshold and nominating circulating signals of tumor promotion for prevention.

Humans↗

PubMed1989

Ghee applications to the umbilical cord: a risk factor for neonatal tetanus.

A case-control study was done to elucidate risk factors for neonatal tetanus (NNT) in rural Pakistan; three controls were selected for each of the 69 cases. Factors commonly believed to be associated with NNT, such as the tool used to cut the umbilical cord and the method of preparing the tool, were not confirmed as risk factors. However, applying ghee to the wound stump was. New prevention opportunities deriving from the finding should be pursued aggressively while efforts to develop effective delivery systems to immunise mothers against tetanus continue, a task made difficult by sociocultural factors.

Butter↗

PubMed1992

Septicaemia among neonates with tetanus.

In a study of 149 cases of neonatal tetanus (NNT) admitted into the University of Calabar Teaching Hospital, 49 (33 per cent) were also found to have septicaemia. The dominant organisms were coliforms and Staphylococcus aureus. A comparison of the clinical features of the septicaemic and non-septicaemic neonates showed umbilical cord infection to be an indicator of septicaemia. There was no significant difference in the case fatality rates of the two groups of patients and the overall case fatality was low (37 per cent). This is attributable to early diagnosis and treatment of the septicaemia cases. It is suggested that paediatricians should have a high index of suspicion of septicaemia among cases of NNT as a means of reducing case fatality.

Ampicillin↗

PubMed1979

[Atenolol in the treatment of angina pectoris].

18 patients with angina pectoris participated in a double blind trial with atenolol (100 mg and 200 mg once daily, or 100 mg twice daily) and propranolol (80 mg twice daily). The number of anginal attacks (NAP), the number of days free of pain (NAFT), consumption of sublingual nitroglycerin (NNT) and bicycle ergometry data (EFE) were recorded. Atenolol given in a dose of 100 g twice daily significantly reduced NAP and NNT as compared with the other dose schedules for atenolol and propranolol. There was, however, no difference between NAFT and EFE under any of the treatment schedules mentioned above. Only with 100 mg atenolol twice daily was it possible to reduce heart rate at rest and immediately after exercise testing, and also diastolic blood pressure (at rest, upright and after stress testing). In spite of the long plasma T 1/2 (= 24 hours) reported by others, atenolol given twice daily seems to be the most effective schedule. It is concluded that atenolol (100 mg twice daily) has a more potent anti-anginal effect than propranolol (80 mg twice daily). In addition, atenolol has the advantage of being cardioselective.

Aged↗

PubMed2024

Effects of Sacubitril/Valsartan on All-Cause Hospitalizations in Heart Failure: Post Hoc Analysis of the PARADIGM-HF and PARAGON-HF Randomized Clinical Trials.

IMPORTANCE: Sacubitril/valsartan is indicated to reduce the risk of cardiovascular death and heart failure (HF) hospitalizations in patients with chronic HF. However, many of these patients are older and have multiple comorbidities that increase the risk of hospitalization for causes other than HF. OBJECTIVE: To assess the effects of sacubitril/valsartan on hospitalizations of any cause across the spectrum of left ventricular ejection fraction (LVEF). DESIGN, SETTING, AND PARTICIPANTS: This post hoc, participant-level, pooled analysis of the PARADIGM-HF (in patients with an LVEF ≤40%) and PARAGON-HF (in patients with an LVEF ≥45%) randomized clinical trials was conducted from February 5, 2024, to April 5, 2024. Participants with chronic HF, New York Heart Association classes II through IV symptoms, and elevated natriuretic peptides were randomized to treatment with either sacubitril/valsartan or a renin-angiotensin system inhibitor (RASi)-enalapril in the PARADIGM-HF trial or valsartan in the PARAGON-HF trial. INTERVENTION: Sacubitril/valsartan vs RASi (enalapril or valsartan). MAIN OUTCOMES AND MEASURES: The effects of sacubitril/valsartan on time to first investigator-reported all-cause and cause-specific hospitalizations were examined using Cox proportional hazards models, stratified by geographic region and trial. Effect modification by LVEF as a continuous function was examined. RESULTS: Among 13 194 participants in the PARADIGM-HF and PARAGON-HF trials, mean (SD) patient age was 67 (11) years, 8883 patients (67.3%) were male, and mean (SD) LVEF was 40% (15%). Sacubitril/valsartan significantly reduced the risk of all-cause hospitalization (ACH) compared with RASi over a median (IQR) follow-up period of 2.5 (1.8-3.1) years (hazard ratio [HR], 0.92; 95% CI, 0.88-0.97; P = .002). The incidence rate of first ACH was 25 (95% CI, 24-26) per 100 patient-years in the sacubitril/valsartan arm and 27 (95% CI, 26-28) per 100 patient-years in the RASi arm. The absolute risk reduction (ARR) was 2.1 per 100 patient-years, corresponding to a number needed to treat (NNT) of 48 patient-years of treatment exposure to prevent 1 ACH. Reductions in overall hospitalizations seemed primarily driven by lower rates of cardiac and pulmonary hospitalizations with sacubitril/valsartan. Patients in the 2 treatment arms had similar rates of composite noncardiac hospitalizations. Treatment heterogeneity on ACH by LVEF was observed (P for interaction = .03), with benefits most apparent in patients with an LVEF less than 60% (HR, 0.91; 95% CI, 0.86-0.96), but not in patients with an LVEF of 60% or more (HR, 0.97; 95% CI, 0.86-1.09). CONCLUSIONS AND RELEVANCE: In this post hoc pooled analysis of 13 194 patients with chronic HF in the PARADIGM-HF and PARAGON-HF randomized clinical trials, sacubitril/valsartan significantly reduced hospitalization for any reason, with benefits most apparent in patients with an LVEF below normal. This reduction appeared to be principally driven by lower rates of cardiac and pulmonary hospitalizations. TRIAL REGISTRATIONS: ClinicalTrials.gov Identifiers: NCT01035255 (PARADIGM-HF) and NCT01920711 (PARAGON-HF).

Humans↗

PubMed1989

5-azacytidine-induced tumorous transformation and DNA hypomethylation in Nicotiana tissue cultures.

The phenomenon of habituation is considered in plant tissue cultures to be a real process of chemical tumorogenesis; the cultures acquire the capacity of autonomous growth in a hormone-free medium under the influence of a variety of chemical and physical agents. Treatments with 5-azacytidine (AzaC) of in vitro cultured cells of the Nicotiana glauca x N. langsdorffii nontumorous hybrid (NNT) during the culture cycle led to the induction of a habituated phenotype. The repetitive DNA sequences showed a significant lower level of endogenous methylation in the treated cells in comparison with the normal ones. It is worth noting that it was impossible until now to habituate this strain by conventional methods and that the treatments were effective only in the first 5 days of subculturing; various evidence (cytological and biochemical) pointed out a phenomenon of DNA amplification, occurring in the same period. Moreover, analysis of DNA from control and treated cells shows the induction of variations in the endogenous methylation pattern by AzaC in a critical period of cell culture. These results suggest that demethylation can act as a switch from hormone-dependent to autonomous proliferation by activation of genes coding for or regulating the synthesis of growth factors.

5-Methylcytosine↗

PubMed2026

Short-term psychodynamic psychotherapy for functional neurological disorder: A pilot randomized controlled trial.

BACKGROUND: Evidence-based psychotherapeutic treatments for Functional Neurological Disorder (FND) remain limited. This pilot trial evaluated the preliminary efficacy of Short-term Psychodynamic Psychotherapy (STPP) plus Standard Medical Care (SMC) compared with SMC alone in reducing FND symptom frequency. METHODS: Adults with FND were randomized (1:1) to receive either SMC alone or 12 weekly sessions of STPP plus SMC. The primary outcome was symptom frequency (days with symptoms in the last 4 weeks) assessed at the end of treatment (3 months) and at 6-month follow-up. Secondary outcomes included treatment response (≥50% reduction in symptom frequency) and scores on the Hamilton Depression Rating Scale (HAM-D), Hamilton Anxiety Rating Scale (HAM-A), and World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0). RESULTS: Of 91 randomized patients (mean age 38.2 years, 75.8% female), 81.3% completed follow-up. Intention-to-treat analysis using Linear Mixed Models showed that STPP plus SMC significantly reduced symptom frequency compared with SMC alone (estimated mean difference -5.72 [95% CI -8.68 to -2.77]; Cohen's d = 0.77; p < 0.001).Treatment response was achieved by 65.8% in the intervention group versus 16.7% in controls (OR 8.21 [95% CI 2.79-24.19]; p < 0.001; NNT 2.0).Significant improvements were also observed for depression (HAM-D: estimated mean difference -10.80; d = 1.45), anxiety (HAM-A: -7.94; d = 1.06), and disability (WHODAS 2.0: -5.77; d = 0.74), all p < 0.001. CONCLUSIONS: STPP was associated with clinically meaningful improvements in FND symptom frequency and all secondary outcomes, with large effect sizes and high treatment response rates. These findings support the preliminary efficacy of STPP for FND and justify larger, multicenter confirmatory trials.

Humans↗