Sleeve Gastrectomy Compared to Gastric Bypass as a Treatment for Type 2 Diabetes in those with a BMI \u3c 35

Background: Thirty million people in the United States have diabetes, of which, nearly 90% are considered overweight or obese. Bariatric surgery, with the two most popular types being sleeve gastrectomy (SG) and gastric bypass (GB), is currently indicated as a treatment of type 2 diabetes (T2D) in those with a BMI \u3e 35. However, recent studies have shown bariatric surgery to be an effective treatment in those with BMI \u3c 35. Therefore, the aim of this systematic review was to determine if SG is comparable to GB for treating T2D in those with a BMI \u3c 35. Methods: An exhaustive literature search was completed using the following search engines: CINAHL-EBSCOhost, Web of Science, and MEDLINE-PubMed, and the following search terms: bariatric surgery, type 2 diabetes, and BMI \u3c 35. The quality of relevant articles was assessed using the GRADE Working Group guidelines. Results: A total of 2 studies met specific inclusion criteria and were included in this systematic review. Both studies were randomized controlled trials. One study of 60 overweight or non-morbidly obese adults with T2D found GB to be superior to SG in regards to treating T2D. The other study consisted of 64 overweight or non-morbidly obese adults with T2D and found that there was no significant difference in the remission or improvement of T2D between SG and GB. Conclusion: Whether GB is superior to SG remains unclear; however, SG may be a reasonable alternative to GB. Other studies with larger sample sizes, longer follow-ups, and the use of non-surrogate outcomes are needed to elucidate the differences in SG and GB for treating T2D in those with a BMI \u3c 35

A trace mineral survey of some roughages fed to cattle in southeastern Kansas

Call number: LD2668 .T4 1953 S9Master of Scienc

The Reduction of Flavins by Borohydride: 3,4-Dihydroflavin

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66296/1/j.1432-1033.1969.tb00621.x.pd

Testosterone therapy in men with Parkinson disease : results of the TEST-PD study

Background: Testosterone deficiency has been reported in patients with Parkinson disease (PD), Alzheimer disease, and Huntington disease. It is not known whether testosterone therapy (TT) in men with borderline hypogonadism and neurodegenerative diseases will be of substantial benefit. Previously, we reported that testosterone deficiency is more common in patients with PD compared with age-matched control subjects, and we also reported in 2 small open-label studies that some nonmotor symptoms responded favorably to TT. Objective To define the effects of TT on nonmotor and motor symptoms in men with PD and probable testosterone deficiency. Design: Double-masked, placebo-controlled, parallel-group, single-center trial. Patients: Two experimental groups: patients with PD who were receiving either TT or placebo. Interventions: Participants received either the study drug by intramuscular injection (200 mg/mL of testosterone enanthate every 2 weeks for 8 weeks) or placebo (isotonic sodium chloride solution injections). In patients in each group, the testosterone serum concentration was obtained at each study visit. During 2 study visits, testosterone levels were blindly evaluated and the intramuscular testosterone dose was increased by 200 mg/mL if the free testosterone value failed to double from the baseline value. Main Outcome Measures: The primary outcome variable was the St Louis Testosterone Deficiency Questionnaire, and secondary outcome measures included measures of mood, cognition, fatigue, motor function, and frequency of adverse events. At the end of the double-blind phase, all patients were offered open-label TT and were followed up after 3 and 6 months. Results: Fifteen patients in the placebo group (mean age, 69.9 years), receiving a mean total levodopa equivalent dose of 924 mg/d, had a baseline free testosterone level of 47.91 pg/mL, compared with 15 patients in the TT group (mean age, 66.7 years), receiving an average total levodopa equivalent dose of 734 mg/d, who had a baseline free testosterone level of 63.49 pg/mL. Testosterone was generally well tolerated. More subjects in the TT group experienced lower extremity edema (40% vs 20%). In 2 patients, 1 in each group, prostate-specific antigen levels were elevated from baseline. The improvement in the TT group compared with the placebo group (1.7 vs 1.1) on the St Louis Testosterone Deficiency Scale was not statistically significant. In addition, there were no significant differences in motor and nonmotor features of PD between the 2 groups, although a few subscales showed improvements (Hopkins Verbal Learning Test, P<.04; and Backward Visual Span subtrial, P<.03). However, long-term open-label TT resulted in delayed but sustained improvement in subjects in the TT group who continued to receive treatment (n = 6) compared with subjects in the placebo group who elected not to receive TT (n = 3). Conclusions: Testosterone therapy was generally well tolerated in elderly men with PD and probable testosterone deficiency. While there was no significant difference in the motor and nonmotor scales between the TT and placebo groups at the end of 8 weeks compared with baseline, this may be due to several study limitations, including small sample size, a strong placebo effect with intramuscular therapy, and short follow-up that did not allow measurement of delayed effects of TT in some subjects. Until more definitive studies are reported, practitioners should be particularly cautious in treatment of low testosterone concentrations in men with PD and borderline testosterone deficiency, and careful consideration should be given to the risks vs the benefits of TT

Models of lon and substrate cotransport and the effect of the membrane potential

The implications of a carrier model of ion and substrate cotransport are worked out. Each carrier is assumed to have one ion and one substrate binding site. The model includes features that have not been included in previously published models. These features are the effect of the membrane potential and of the assumption that all carrier forms, with or without bound substrate and with or without various bound ions, can cross the membrane. The model is of a two-state (gate-type) carrier with transition rate constants. In one state the carrier interacts with outer bulk phase; in the other state it interacts with the inner bulk phase. Equilibrium in the reactions between ion, substrate, and carrier is assumed at each surface.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34163/1/0000451.pd