Thyroid control over biomembranes: VI. Lipids in liver mitochondria and microsomes of hypothyroid rats

The lipids of liver mitochondria prepared from normal rats and from rats made hypothyroid by thyroidectomy and injection with131INa contained similar amounts, per mg protein, of total lipids, phospholipids, neutral lipids and lipid phosphorus. Hypothyroidism caused a doubling of the relative amounts of mitochondrial cardiolipins (CL; to 20.5% of the phospholipid P) and an accompanying trend (although statistically not significant) toward decreased amounts of both phosphatidylcholines (PC) and phosphatidylserines (PS), with phosphatidylethanolamines (PE) remaining unchanged. The pattern of elevated 18∶2 fatty acyl content and depleted 20∶4 acyl groups of the mitochondrial phospholipids of hypothyroid preparations was reflected to varying degrees in the resolved phospholipids, with PC showing greater degrees of abnormality than PE, and CL showing none. Hypothyroidism produced the same abnormal pattern of fatty acyl distributions in liver microsomal total lipids as was found in the mitochondria. Hypothyroid rats, when killed 6 hr after injection of [1‐14C] labeled linoleate, showed the following abnormalities: the liver incorporated less label into lipids, and converted 18∶2 not exclusively to 20∶4 (as normals do) but instead incorporated the label mainly into saturated fatty acids. These data, together with the known decrease in β‐oxidation, suggest that hypothyroidism involves possible defective step(s) in the conversion of 18∶2 to 20∶4.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142296/1/lipd0328.pd

A life less ordinary: growing up and coping with congenital heart disease

There is growing evidence to suggest that advances in the surgical treatment of congenital heart disease should be accompanied by assessments and interventions which attend to the psychosocial needs of adolescents. As yet, these needs are imperfectly understood. We interviewed 37 adolescents using a semi-structured protocol based on Leventhal’s Illness Representation model. In-depth analysis of the resulting data was conducted using the well established ‘framework’ method. Five key themes emerged from this analysis: difficulty coping with the presence of disease, physical limitation, social exclusion, discrimination and bullying, and hopes for life improvement. Together, these themes develop a wider picture of the experience of congenital heart disease through childhood and adolescence. They identify an opportunity for health professionals to meet the educational and psychological, as well as the physiological, needs of this particular patient group as part of an overall approach to improving their quality of life

Updated risk factors should be used to predict development of diabetes

Aims Predicting incident diabetes could inform treatment strategies for diabetes prevention, but the incremental benefit of recalculating risk using updated risk factors is unknown. We used baseline and 1-year data from the Nateglinide and Valsartan in Impaired Glucose Tolerance Outcomes Research (NAVIGATOR) Trial to compare diabetes risk prediction using historical or updated clinical information. Methods Among non-diabetic participants reaching 1 year of follow-up in NAVIGATOR, we compared the performance of the published baseline diabetes risk model with a “landmark” model incorporating risk factors updated at the 1-year time point. The C-statistic was used to compare model discrimination and reclassification analyses to demonstrate the relative accuracy of diabetes prediction. Results A total of 7527 participants remained non-diabetic at 1 year, and 2375 developed diabetes during a median of 4 years of follow-up. The C-statistic for the landmark model was higher (0.73 [95% CI 0.72–0.74]) than for the baseline model (0.67 [95% CI 0.66–0.68]). The landmark model improved classification to modest (< 20%), moderate (20%–40%), and high (> 40%) 4-year risk, with a net reclassification index of 0.14 (95% CI 0.10–0.16) and an integrated discrimination index of 0.01 (95% CI 0.003–0.013). Conclusions Using historical clinical values to calculate diabetes risk reduces the accuracy of prediction. Diabetes risk calculations should be routinely updated to inform discussions about diabetes prevention at both the patient and population health levels. © 2017 Elsevier Inc

Ethical Subjectivity and Politics in Organizations: A Case of Health Care Tendering.

This paper examines the relationship between ethics and politics in organizations with a specific focus on ethical subjectivity - that is, how people at work constitute themselves as subjects in relation to both their conduct and their sense of ethical responsibility to others. To investigate this we consider those ethics that were politically mobilized when five clinical partners tendered to buy out the medical practice in which they worked. We provide a detailed reading of a letter of complaint written by one of the partners and sent to their employer - a letter we consider to be a deliberate, political, ethically motivated and overt act of resistance. Drawing on the ethical philosophy of Emmanuel Levinas we argue that the practice of ethics is characterized by a tension where ethical commitments and realpolitik come crashing together. The implication we draw from this is that in organizations the ethical subject is always a political subject; the one who takes action in response to the call of the ethical demand. It is answering the call to political action by the ethical subject - a subject prepared to act in response to the experience of injustice while not resting easy on their own ethical righteousness - that provides an affirmative possibility for researching and theorizing ethics within a critical framework.21 page(s