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Electrophysiological studies show that the decrease in the amount of gamma-aminobutyric acid (GABA) present in the temporal lobe of humans is because of a decrease in the number of GABA transporters which affects the release of GABA. In the epileptogenic hippocampi, the potassium-stimulated release of GABA increases while the glutamate-induced, calcium-independent release of GABA decreases. However, the number of GABA containing cells and receptors in the neurons of the epileptogenic hippocampi is the same as that in normal neurons. GABA is probably necessary to mediate synaptic transmission and decreases are linked to epileptic seizures.

This paper examines the role of prescription drug coverage on a group of indigent patients with severe hypertension in an urban setting with established access to primary care. A unique data set was created using emergency department, pharmacy, and primary care records to assess the impact of prescription coverage. Binary logistic regressions with emergency department use as the dependent variable were conducted. Model specifications using all visits and first visit only data were conducted. Both models show that African-Americans were significantly more likely to use the emergency department (p < .01). Prescription drug coverage at the time of the visits was highly significant in reducing the probability of emergency department use (p < .01); the percentage of scheduled primary care visits attended was also highly significant (p < .01). Prior alcohol use, illicit drug use, gender, Hispanic, age, and previously controlled blood pressure were all insignificant in predicting the probability of emergency department use. [ABSTRACT FROM PUBLISHER]

Background: The aim of clinical peer review (PR) is to improve facility health care quality. However, prior authors have shown that PR may be biased, have rater reliability concerns, or be used for punitive reasons. It is important to determine whether facility PR processes are related to objective facility quality of care., Methods: We collected proportion of PR findings that "most experienced and competent clinicians may have managed the case differently" or "most experienced and competent clinicians would have managed the case differently" as an objective measure of facility PR processes and outcomes. We correlated these with facility quality metrics for 2019., Results: PR findings were not associated with facility quality metrics but were strongly associated with previous year findings., Conclusions: This study describes a potentially new source of bias in PR and demonstrates that objective facility outcomes are not related to individual PR findings., Competing Interests: Author disclosures The authors report no actual or potential conflicts of interest or outside sources of funding with regard to this article., (Copyright © 2022 Frontline Medical Communications Inc., Parsippany, NJ, USA.)

This paper summarizes the results of a recent report on diabetes in Tennessee. Diabetes has reached epidemic proportions in Tennessee. In 2001, an estimated 7.7% of the population was diabetic, an increase from 5.8% a decade earlier. This increase is largely due to widespread unhealthy eating habits, physical inactivity, and associated obesity. The majority of diabetes is preventable and can be effectively treated through daily exercise and a healthy diet. Diabetes prevention efforts in Tennessee schools and communities, however, are grossly inadequate. Providers and payers underemphasize prevention. Since the causes of diabetes can be traced to childhood habits, early prevention is the key to reversing the diabetes epidemic. Immediate statewide action must be taken to promote daily exercise and decrease access to high-calorie, high-fat "junk" food in our schools and communities. Physicians, health professional organizations, health plans, government, churches, schools, and employers must work together to battle the diabetes epidemic through public education, community-wide health promotion programs, and efforts to improve quality of diabetes care for all Tennesseans.