FN Thomson Reuters Web of Science™ VR 1.0 PT J AU Sergi, MJ Green, MF Widmark, C Reist, C Erhart, S Braff, DL Kee, KS Marder, SR Mintz, J AF Sergi, Mark J. Green, Michael F. Widmark, Clifford Reist, Christopher Erhart, Stephen Braff, David L. Kee, Kimmy S. Marder, Stephen R. Mintz, Jim TI Cognition and neurocognition: Effects of risperildone, olanzapine, and haloperldol SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID SOCIAL COGNITION; ANTIPSYCHOTIC TREATMENT; EMOTION PERCEPTION; SCHIZOAFFECTIVE DISORDER; CHRONIC-SCHIZOPHRENIA; NEURAL BASIS; RISPERIDONE; HALOPERIDOL; DEFICITS; COMMUNICATION AB Objective: This study examined the short-term effects of first- and second-generation antipsychotic medications on social cognition and basic cognition. Method: One hundred patients with schizophrenia or schizoaffective disorder participated in an 8 week, double-blind study of risperidone, olanzapine, and haloperidol. Participants were administered multiple measures of social cognition, basic cognition, and clinical symptoms at baseline, the end of week 4, and the end of week 8. Seventy-three patients completed the baseline assessment and at least one other assessment. Data were analyzed with mixed-effects analyses of covariance. For data reduction, the social cognitive measures were clustered into a summary score, and-the cognitive measures were clustered into two summary scores: general cognitive ability and processing speed. (The effects on thinking of risperidone and olanzapine can be found at NCT00108368, www.clinicaltrials.gov.) Results: There were no treatment-related differences on any of the three summary scores. Social cognition did not show within-group changes over time either by itself or after control for the cognitive clusters. One cognitive score (general cognitive ability) increased during the study period for all three medication groups. Conclusions: The present study included a rather thorough assessment of social cognition and did not find any evidence of between-group or within-group effects of antipsychotic medication on social cognition. C1 Calif State Univ Northridge, Dept Psychol, Northridge, CA 91330 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Geffen Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA USA. Univ Calif Irvine, Sch Med, Dept Psychiat & Human Behav, Irvine, CA USA. VA Long Beach Healthcare Syst, Long Beach, CA USA. Univ Calif Los Angeles, Med Ctr, Dept Psychiat, Sylmar, CA USA. Univ Calif San Diego, Sch Med, Dept Psychiat, San Diego, CA 92103 USA. Calif State Univ, Psychol Program, Camarillo, CA USA. RP Sergi, MJ (reprint author), Calif State Univ Northridge, Dept Psychol, 18111 Nordhoff St, Northridge, CA 91330 USA. EM mark.sergi@csun.edu RI Mintz, Jim/N-7385-2014 OI Mintz, Jim/0000-0002-8299-5851 FU NIMH NIH HHS [MH042228] NR 47 TC 78 Z9 78 U1 1 U2 5 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD OCT PY 2007 VL 164 IS 10 BP 1585 EP 1592 DI 10.1176/appi.ajp.2007.06091515 PG 8 WC Psychiatry SC Psychiatry GA 218XP UT WOS:000250049600024 PM 17898351 ER PT J AU Buchanan, RW Javitt, DC Marder, SR Schooler, NR Gold, JM McMahon, RP Heresco-Levy, U Carpenter, WT AF Buchanan, Robert W. Javitt, Daniel C. Marder, Stephen R. Schooler, Nina R. Gold, James M. McMahon, Robert P. Heresco-Levy, Uriel Carpenter, William T. TI The Cognitive and Negative Symptoms in Schizophrenia, Trial (CONSIST): The efficacy of glutamatergic agents for negative symptoms and cognitive impairments SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID HIGH-DOSE GLYCINE; CYCLOSERINE ADJUVANT THERAPY; N-METHYLGLYCINE SARCOSINE; PLACEBO-CONTROLLED TRIAL; TRANSPORTER-I INHIBITOR; D-SERINE; DEFICIT SYNDROME; ANTIPSYCHOTICS; NEUROLEPTICS; CLOZAPINE AB objective: Patients with schizophrenia frequently present with negative symptoms and cognitive impairments for which no effective treatments are known. Agents that act at the glycine site of the N-methyl-D-aspartic acid (NMDA) glutamatergic receptor have been suggested as promising treatments for moderate to severe negative symptoms and cognitive impairments. Method: The Cognitive and Negative Symptoms in Schizophrenia Trial (CONSIST) was a 16-week double-blind, double-dummy, parallel group, randomized clinical trial of adjunctive glycine, D-cycloserine, or placebo conducted at four sites in the United States and one site in Israel. The participants were 157 inpatients and outpatients who met DSM-IV criteria for schizophrenia or schizoaffective disorder and retrospective and prospective criteria for moderate to severe negative symptoms without marked positive, depressive, or extrapyramidal symptoms. The primary outcome measures were the average "rate of change" of Scale for the Assessment of Negative Symptoms (SANS) total scores and change in the average cognitive domain z scores. Results: There were no significant differences in change in the SANS total score between glycine and placebo subjects or D-cycloserine and placebo subjects. A prespecified test for the site-by-treatment-by-time interaction was significant in post hoc tests. One site had greater reduction in the SANS total score for patients receiving D-cycloserine relative to patients receiving placebo. A second site had greater reduction in the SANS total score for placebo patients compared with glycine patients. There were no significant differences between glycine and placebo or D-cycloserine and placebo subjects on the average cognition z score. Conclusions: The study results suggest that neither glycine nor D-cycloserine is a generally effective therapeutic option for treating negative symptoms or cognitive impairments. C1 Univ Maryland, Sch Med, Maryland Psychiat Res Ctr, Baltimore, MD 21228 USA. Nathan S Kline Inst Psychiat Res, Orangeburg, NY 10962 USA. Univ Calif Los Angeles, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Zucker Hillside Hosp, Glen Oaks, NY USA. Hebrew Univ Jerusalem, Hadassah Med Sch, Ezrath Nashim Herzog Mem Hosp, IL-91010 Jerusalem, Israel. Hebrew Univ Jerusalem, Hadassah Med Sch, Dept Psychiat, IL-91010 Jerusalem, Israel. RP Carpenter, WT (reprint author), Univ Maryland, Sch Med, Maryland Psychiat Res Ctr, POB 21247, Baltimore, MD 21228 USA. EM wcarpent@mprc.umaryland.edu RI McMahon, Robert/C-5462-2009 FU NIMH NIH HHS [5 R01 MH69807, 5 R01 MH59687, 5 R01 MH59750, 5 R01 MH59784, P30 MH06850] NR 50 TC 210 Z9 213 U1 0 U2 9 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD OCT PY 2007 VL 164 IS 10 BP 1593 EP 1602 DI 10.1176/appi.ajp.2007.06081358 PG 10 WC Psychiatry SC Psychiatry GA 218XP UT WOS:000250049600025 PM 17898352 ER PT J AU Sun, BC Loffinan, JR AF Sun, Benjamin C. Loffinan, Jerome R. TI Clinical prediction rule for pediatric blunt head injury - In reply SO ANNALS OF EMERGENCY MEDICINE LA English DT Letter ID INSTRUMENT; TRAUMA C1 Univ Calif Los Angeles, W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Ctr Emergency Med, Los Angeles, CA 90024 USA. RP Sun, BC (reprint author), Univ Calif Los Angeles, W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90095 USA. NR 4 TC 0 Z9 0 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD OCT PY 2007 VL 50 IS 4 BP 484 EP 484 DI 10.1016/j.annemergmed.2007.06.478 PG 1 WC Emergency Medicine SC Emergency Medicine GA 216RZ UT WOS:000249898000027 ER PT J AU Sonnen, JA Larson, EB Crane, PK Haneuse, S Li, G Schellenberg, GD Craft, S Leverenz, JB Montine, TJ AF Sonnen, Joshua A. Larson, Eric B. Crane, Paul K. Haneuse, Sebasuen Li, Ge Schellenberg, Gerald D. Craft, Suzanne Leverenz, James B. Montine, Thomas J. TI Pathological correlates of dementia in a longitudinal, population-based sample of aging SO ANNALS OF NEUROLOGY LA English DT Article ID VASCULAR COGNITIVE IMPAIRMENT; ALZHEIMER-DISEASE PATHOLOGY; CEREBROVASCULAR PATHOLOGY; NEUROFIBRILLARY PATHOLOGY; CEREBRAL INFARCTIONS; LEWY BODIES; DIAGNOSIS; NEUROPATHOLOGY; PURIFICATION; PREVALENCE AB Objective: Previously published community- or population-based studies of brain aging and dementia with autopsy were restricted to a single sex, a single ethnic group, Roman Catholic clergy, or focused pathological assessments. Our goal was to determine the independent pathological correlates associated with dementia in a typical US population. Methods: We evaluated autopsy data from the Adult Changes in Thought study, an ongoing longitudinal, population-based study of brain aging and dementia. Analyses were based on data collected from about 3,400 people 65 years or older who were cognitively intact at the time of enrollment in the Group Health Cooperative in King County, Washington. Alt consecutive autopsies (n = 221; 20% of deaths) from this cohort were evaluated and analyzed by weighted multivariate analysis to account for potential participation bias. Results: After adjusting for age, sex, education, and APOE, independent correlates of dementia (relative risk, 95% confidence interval; overall p value) included Braak stage (V/VI vs 0/I/II: 5.89, 1.62-17.60; p < 0.05), number of cerebral microinfarcts in standardized sections (> 2 vs none: 4.80, 1.91-10.26; p < 0.001), and neocortical Lewy bodies (any vs none: 5.08, 1.37-18.96; P < 0.05). Estimates of adjusted population attributable risk for these three processes were 45% for Braak stage, 33% for microinfarcts, and 10% for neocortical Lewy bodies. Interpretation: Our results underscore the therapeutic imperative for Alzheimer's and Lewy body diseases, and provide evidence to support the immediate use of strategies that target cerebral microinfarcts as a means to partially prevent or delay the onset of dementia. C1 Univ Washington, Dept Pathol, Seattle, WA 98104 USA. Univ Washington, Ctr Hlth Studies, Grp Hlth Cooperat, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Mental Illness, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Geriatr, Seattle, WA USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Parkinsons Res, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Educ, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Clin Ctr, Seattle, WA USA. RP Sonnen, JA (reprint author), Univ Washington, Dept Pathol, 325 9th Ave,Box 359791, Seattle, WA 98104 USA. EM jsonnen@u.washington.edu RI Crane, Paul/C-8623-2014; Sonnen, 37382016/H-3738-2016 OI Sonnen, 37382016/0000-0001-9267-8705; Crane, Paul/0000-0003-4278-7465 FU NIA NIH HHS [R01 AG023801, AG000258, AG023801, AG06781]; NINDS NIH HHS [NS48595] NR 47 TC 216 Z9 219 U1 0 U2 9 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0364-5134 J9 ANN NEUROL JI Ann. Neurol. PD OCT PY 2007 VL 62 IS 4 BP 406 EP 413 DI 10.1002/ana.21208 PG 8 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 227WU UT WOS:000250689300012 PM 17879383 ER PT J AU Ellis, MW Griffith, ME Dooley, DP McLean, JC Jorgensen, JH Patterson, JE Davis, KA Hawley, JS Regules, JA Rivard, RG Gray, PJ Ceremuga, JM DeJoseph, MA Hospenthal, DR AF Ellis, Michael W. Griffith, Matthew E. Dooley, David P. McLean, Joseph C. Jorgensen, James H. Patterson, Jan E. Davis, Kepler A. Hawley, Joshua S. Regules, Jason A. Rivard, Robert G. Gray, Paula J. Ceremuga, Julia M. DeJoseph, Mary A. Hospenthal, Duane R. TI Targeted intranasal mupirocin to prevent colonization and infection by community-associated methicillin-resistant Staphylococcus aureus strains in soldiers: A cluster randomized controlled trial SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID FIELD GEL-ELECTROPHORESIS; PANTON-VALENTINE LEUKOCIDIN; NASAL CARRIAGE; ANTERIOR NARES; HEALTHY-ADULTS; UNITED-STATES; PROPHYLAXIS; EMERGENCE; PREVALENCE; OINTMENT AB Community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) is an emerging pathogen that primarily manifests as uncomplicated skin and soft tissue infections. We conducted a cluster randomized, double-blind, placebo-controlled trial to determine whether targeted intranasal mupirocin therapy in CAMRSA-colonized soldiers could prevent infection in the treated individual and prevent new colonization and infection within their study groups. We screened 3,447 soldiers comprising 14 training classes for CA-MRSA colonization from January to December 2005. Each training class was randomized to either the mupirocin or placebo study group, and the participants identified as CA-MRSA colonized were treated with either mupirocin or placebo. All participants underwent repeat screening after 8 to 10 weeks and were monitored for 16 weeks for development of infection. Of 3,447 participants screened, 134 (3.9%) were initially colonized with CAMRSA. Five of 65 (7.7%; 95% confidence interval [95% CI], 4.0% to 11.4%) placebo-treated participants and 7 of 66 (10.6%; 95% CI, 7.9% to 13.3%) mupirocin-treated participants developed infections; the difference in the infection rate of the placebo- and mupirocin -treated groups was -2.9% (95% CI, -7.5% to 1.7%). Of those not initially colonized with CA-MRSA, 63 of 1,459 (4.3%; 95% CI, 2.7% to 5.9%) of the placebo group and 56 of 1,607 (3.5%; 95% CI, 2.6% to 5.2%) of the mupirocin group developed infections; the difference in the infection rate of the placebo and mupirocin groups was 0.8% (95% CI, -1.0% to 2.7%). Of 3,447 participants, 3,066 (89%) were available for the second sampling and completed follow-up. New CA-MRSA colonization occurred in 24 of 1,459 (1.6%; 95% CI, 0.05% to 2.8%) of the placebo group participants and 23 of 1,607 (1.4%; 95% CI, 0.05% to 2.3%) of the mupirocin group participants; the difference in the infection rate of the placebo and mupirocin groups was 0.2% (95% CI, -1.3% to 1.7%). Despite CA-MRSA eradication in colonized participants, this study showed no decrease in infections in either the mupirocin -treated individuals or within their study group. Furthermore, CA-MRSA eradication did not prevent new colonization within the study group. C1 Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX USA. DD Eisenhower Army Med Ctr, Dept Med Infect Dis, Ft Gordon, GA USA. Brooke Army Med Ctr, Dept Med Infect Dis, Ft Sam Houston, TX 78234 USA. Brooke Army Med Ctr, Dept Prevent Med, Ft Sam Houston, TX 78234 USA. Brooke Army Med Ctr, Pathol & Area Lab Serv, Ft Sam Houston, TX 78234 USA. Univ Texas, Hlth Sci Ctr, Dept Pathol, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Med Infect Dis, San Antonio, TX USA. RP Ellis, MW (reprint author), Brooke Army Med Ctr, Infect Dis Serv, MCHE MDI, 3581 Roger Brooke, Ft Sam Houston, TX 78234 USA. EM michael.w.ellis@us.army.mil NR 53 TC 80 Z9 82 U1 1 U2 5 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD OCT PY 2007 VL 51 IS 10 BP 3591 EP 3598 DI 10.1128/AAC.01086-06 PG 8 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 215FX UT WOS:000249794800017 PM 17682105 ER PT J AU Johnson, SC Ries, ML Hess, TM Carlsson, CM Gleason, CE Alexander, AL Rowley, HA Asthana, S Sager, MA AF Johnson, Sterling C. Ries, Michele L. Hess, Timothy M. Carlsson, Cynthia M. Gleason, Carey E. Alexander, Andrew L. Rowley, Howard A. Asthana, Sanjay Sager, Mark A. TI Effect of Alzheimer disease risk on brain function during self-appraisal in healthy middle-aged adults SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article ID MILD COGNITIVE IMPAIRMENT; CORTICAL MIDLINE STRUCTURES; E EPSILON-4 CARRIERS; PREFRONTAL CORTEX; APOLIPOPROTEIN-E; OLDER-ADULTS; HIPPOCAMPAL ACTIVATION; MACAQUE MONKEY; FAMILIAL RISK; FMRI EVIDENCE AB Context: Asymptomatic middle- aged adult children of patients with Alzheimer disease ( AD) recently were found to exhibit functional magnetic resonance imaging ( fMRI) deficits in the mesial temporal lobe during an encoding task. Whether this effect will be observed on other fMRI tasks is yet unknown. This study examines the neural substrates of self- appraisal ( SA) in persons at risk for AD. Accurate appraisal of deficits is a problem for many patients with AD, and prior fMRI studies of healthy young adults indicate that brain areas vulnerable to AD such as the anterior mesial temporal lobe and posterior cingulate are involved during SA tasks. Objective: To determine whether parental family history of AD ( hereafter referred to as FH) or presence of the epsilon 4 allele of the apolipoprotein E gene ( APOE4) exerts independent effects on brain function during SA. Design: Cross- sectional factorial design in which APOE4 status ( present vs absent) was one factor and FH was the other. All participants received cognitive testing, geno-typing, and an fMRI task that required subjective SA decisions regarding trait adjective words in comparison with semantic decisions about the same words. Setting: An academic medical center with a research-dedicated 3.0- T MR imaging facility. Participants: Cognitively normal middle- aged adults ( n= 110), 51 with an FH and 59 without an FH. Main Outcome Measure: Blood oxygen - dependent contrast measured using T2*- weighted echo- planar imaging. Results: Parental family history of AD and APOE4 status interacted in the posterior cingulate and left superior and medial frontal regions. There were main effects of FH ( FH negative > FH positive) in the left hippocampus and ventral posterior cingulate. There were no main effects of APOE genotype. Conclusions: Our results suggest that FH may affect brain function during subjective SA in regions commonly affected by AD. Although the participants in this study were asymptomatic and middle- aged, the findings suggest that there may be subtle alterations in brain function attributable to AD risk factors. C1 William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Madison, WI 53705 USA. Univ Wisconsin, Dept Med, Sch Med & Publ Hlth, Madison, WI USA. Univ Wisconsin, Dept Med Phys, Sch Med & Publ Hlth, Madison, WI 53706 USA. Univ Wisconsin, Dept Radiol, Sch Med & Publ Hlth, Madison, WI 53706 USA. RP Johnson, SC (reprint author), William S Middleton Mem Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, 2500 Overlook Terr 11G, Madison, WI 53705 USA. EM scj@medicine.wisc.edu FU NIA NIH HHS [R01 AG 21155, R01 AG021155, R01 AG021155-01A2, R01 AG021155-02, R01 AG021155-03, R01 AG021155-04, R01 AG021155-05] NR 68 TC 23 Z9 23 U1 6 U2 7 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-990X J9 ARCH GEN PSYCHIAT JI Arch. Gen. Psychiatry PD OCT PY 2007 VL 64 IS 10 BP 1163 EP 1171 DI 10.1001/archpsyc.64.10.1163 PG 9 WC Psychiatry SC Psychiatry GA 215YI UT WOS:000249844500007 PM 17909128 ER PT J AU Wilde, MC Castriotta, RJ Lai, JM Atanasov, S Masel, BE Kuna, ST AF Wilde, Mark C. Castriotta, Richard J. Lai, Jenny M. Atanasov, Strahil Masel, Brent E. Kuna, Samuel T. TI Cognitive impairment in patients with traumatic brain injury and obstructive sleep apnea SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article; Proceedings Paper CT 34th Annual Meeting of the International-Neuropsychological-Society CY FEB 01-04, 2006 CL Boston, MA SP Int Neuropsychol Soc DE brain injuries; hypersomnia; neuropsychology; rehabilitation; sleep apnea; obstructive; sleep disorders; trauma ID PSYCHOMOTOR VIGILANCE PERFORMANCE; MILD HEAD-INJURY; DAYTIME SLEEPINESS; ADULTS; DISORDERS; RECOVERY; NIGHT AB Objective: To examine the impact of comorbid obstructive sleep apnea (OSA) on the cognitive functioning of traumatic brain injury (TBI) patients. Design: A case-control study. Neuropsychologic test performances of TBI patients with OSA were compared with those who did not have OSA. The diagnosis of OSA was based on standard criteria using nocturnal polysomnography. Setting: Three academic medical centers with level I trauma centers, accredited sleep disorders centers, and rehabilitation medicine programs. Participants: Thirty-five TBI patients who were part of a project that assessed the effect of sleep disorders in a larger sample of consecutively recruited TBI patients. There were 19 patients with TBI and OSA. They were compared with 16 TBI patients without OSA who were comparable in terms of age, education, severity of injury (when available), time postinjury, and Glasgow Coma Scale scores (when available). Interventions: Not applicable. Main Outcome Measures: The Psychomotor Vigilance Test, Rey Complex Figure Test, Rey Auditory Verbal Learning Test, digit span test from the Wechsler Memory Scale-Revised, and finger-tapping test. Results: The TBI patients with OSA performed significantly worse than the non-sleep disordered TBI patients on verbal and visual delayed-recall measures. The groups performed comparably on motor, visual construction, and attention tests. The TBI patients with OSA made more attention lapses (reaction times >= 500ms), but showed comparable fastest and slowest reaction times on a measure of sustained attention. Conclusions: OSA is associated with more impairment of sustained attention and memory in TBI patients. It is possible that early identification and treatment of OSA may improve cognitive, and thus potentially functional, outcomes of TBI patients with this disease. C1 Univ Texas Hlth Ctr, Houston, TX USA. Mem Hermann Hosp Sleep Disorders Ctr, Houston, TX USA. Univ Texas, Med Branch, Galveston, TX USA. Transit Learning Ctr, Galveston, TX USA. Univ Penn, Sch Med, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Castriotta, RJ (reprint author), Univ Texas, Hlth Sci Ctr, Div Pulm & Crit Care & Sleep Med, 6431 Fannin St, Houston, TX 77030 USA. EM Richard.J.Castriotta@uth.tmc.edu RI Castriotta, Richard/B-1158-2009; Sanguansri, Luz/B-6630-2011 OI Sanguansri, Luz/0000-0003-1908-7604; Castriotta, Richard/0000-0003-3502-4558 NR 30 TC 51 Z9 53 U1 0 U2 4 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD OCT PY 2007 VL 88 IS 10 BP 1284 EP 1288 DI 10.1016/j.apmr.2007.07.012 PG 5 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 220MT UT WOS:000250161500009 PM 17908570 ER PT J AU Saam, T Yuan, C Chu, BC Takaya, N Underhill, H Cai, JM Tran, N Polissar, NL Neradilek, B Jarvik, GP Isaac, C Garden, GA Maravilla, KR Hashimoto, B Hatsukami, TS AF Saam, Tobias Yuan, Chun Chu, Baocheng Takaya, Norihide Underhill, Hunter Cai, Jianming Tran, Nam Polissar, Nayak L. Neradilek, Blazej Jarvik, Gail P. Isaac, Carol Garden, Gwenn A. Maravilla, Kenneth R. Hashimoto, Beverly Hatsukami, Thomas S. TI Predictors of carotid atherosclerotic plaque progression as measured by noninvasive magnetic resonance imaging SO ATHEROSCLEROSIS LA English DT Article DE Magnetic resonance imaging; Carotid arteries; Atherosclerosis; Plaque; Progression AB The purpose of this in vivo MRI study was to quantify changes in atherosclerotic plaque morphology prospectively and to identify factors that may alter the rate of progression in plaque burden. Sixty-eight asymptomatic subjects with >= 50% stenosis, underwent serial carotid MRI examinations over an 18-month period. Clinical risk factors for atherosclerosis, and medications were documented prospectively. The wall and total vessel areas, matched across time-points, were measured from cross-sectional images. The normalized wall index (NWI = wall area/total vessel area), as a marker of disease severity, was documented at baseline and at 18 months. Multiple regression analysis was used to correlate risk factors and morphological features of the plaque with the rate of progression/regression. On average, the wall area increased by 2.2% per year (P = 0.001). Multiple regression analysis demonstrated that statin therapy (P = 0.01) and a normalized wall index >0.64 (P = 0.001) were associated with a significantly reduced rate of progression in mean wall area. All other documented risk factors were not significantly associated with changes in wall area. Findings from this study suggest that increased normalized wall index and the use of statin therapy are associated with reduced rates of plaque progression amongst individuals with advanced, asymptomatic carotid atherosclerosis. (c) 2006 Elsevier Ireland Ltd. All rights reserved. C1 [Hatsukami, Thomas S.] VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. [Saam, Tobias; Yuan, Chun; Chu, Baocheng; Takaya, Norihide; Underhill, Hunter; Cai, Jianming; Maravilla, Kenneth R.] Univ Washington, Dept Radiol, Seattle, WA USA. [Saam, Tobias] Univ Munich, Dept Clin Radiol, Munich, Germany. [Takaya, Norihide] Juntendo Univ, Sch Med, Dept Cardiol, Tokyo 113, Japan. [Tran, Nam; Isaac, Carol; Hatsukami, Thomas S.] Univ Washington, Dept Surg, Seattle, WA 98195 USA. [Polissar, Nayak L.; Neradilek, Blazej] Mt Whisper Light Stat Consulting, Seattle, WA USA. [Jarvik, Gail P.] Univ Washington, Div Med Genet, Dept Med, Seattle, WA 98195 USA. [Garden, Gwenn A.] Univ Washington, Dept Neurol, Seattle, WA 98195 USA. [Hashimoto, Beverly] Virginia Mason Med Ctr, Dept Radiol, Seattle, WA 98101 USA. RP Hatsukami, TS (reprint author), VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM tomhat@u.washington.edu RI Jarvik, Gail/N-6476-2014 OI Jarvik, Gail/0000-0002-6710-8708 FU NHLBI NIH HHS [R01 HL073401, P01 HL072262, P01 HL072262-050002, R01 HL061851, R01 HL061851-04, R01 HL067406, R01 HL067406-06, R01 HL073401-04, R01 HL074366, R01 HL074366-04, R01 HL61851, R01 HL67406] NR 18 TC 59 Z9 62 U1 0 U2 4 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0021-9150 J9 ATHEROSCLEROSIS JI Atherosclerosis PD OCT PY 2007 VL 194 IS 2 BP E34 EP E42 DI 10.1016/j.atherosclerosis.2006.08.016 PG 9 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA V26XU UT WOS:000208579100005 PM 16978632 ER PT J AU Jarrett, ME Kohen, R Cain, KC Burr, RL Poppe, A Navaja, GP Heitkemper, MM AF Jarrett, Monica E. Kohen, Ruth Cain, Kevin C. Burr, Robert L. Poppe, Ann Navaja, Grace P. Heitkemper, Margaret M. TI Relationship of SERT Polymorphisms to depressive and anxiety symptoms in irritable bowel syndrome SO BIOLOGICAL RESEARCH FOR NURSING LA English DT Article DE irritable bowel syndrome; serotonin transporter; protein (SERT); 5-HTTLPR; STin2 VNTR; depression; anxiety; adult ID SEROTONIN TRANSPORTER GENE; AFFECTIVE-DISORDERS; PROMOTER POLYMORPHISM; DOUBLE-BLIND; MAJOR DEPRESSION; 5-HTT GENE; ASSOCIATION; METAANALYSIS; WOMEN; SUSCEPTIBILITY AB This study investigates the association of psychological symptoms with the distribution of two serotonin transporter gene (SERT) polymorphisms, located in the promoter region (5-HTTLPR) and in intron 2 (STin2 VNTR), in patients with irritable bowel syndrome (IBS). Participants, 21 men and 117 women, were assessed for mental health history and current psychological distress. A blood sample was used for genotyping. Participants who were homozygous for the short allele of 5-HTTLPR or carried a STin2.9 VNTR allele were significantly more likely to have a history of depression. Participants did not differ by genotype in their history of anxiety or suicidal ideation nor in their current levels of depression, anxiety, or general psychological distress. The results support a biopsychosocial model of IBS in which SERT genotype modifies the risk for depressive episodes. Long term, practitioners may individualize treatment of patients with IBS using genotype as one of the factors. C1 Univ Washington, Dept Biobehav & Nursing Hlth Syst, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth, Dept Biostat, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Geriat Res Educat & Clin Ctr, Seattle, WA USA. RP Jarrett, ME (reprint author), Univ Washington, Dept Biobehav & Nursing Hlth Syst, Seattle, WA 98195 USA. EM jarrett@u.washington.edu FU NINR NIH HHS [NR04142, P30 NR04001] NR 42 TC 44 Z9 48 U1 1 U2 3 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1099-8004 J9 BIOL RES NURS JI Biol. Res. Nurs. PD OCT PY 2007 VL 9 IS 2 BP 161 EP 169 DI 10.1177/1099800407307822 PG 9 WC Nursing SC Nursing GA 216XU UT WOS:000249913100007 PM 17909168 ER PT J AU Katz, WF Garst, DM Carter, GS McNeil, MR Fossett, TR Doyle, PJ Szuminsky, NJ AF Katz, William F. Garst, Diane M. Carter, Gregory S. McNeil, Malcolm R. Fossett, Tepanta R. Doyle, Patrick J. Szuminsky, Neil J. TI Treatment of an individual with aphasia and apraxia of speech using EMA visually-augmented feedback SO BRAIN AND LANGUAGE LA English DT Meeting Abstract C1 [Katz, William F.] Univ Texas, Callier Ctr Commun Disorders, Dallas, TX 75235 USA. [Katz, William F.; Garst, Diane M.; Carter, Gregory S.] Dallas Vet Adm Med Ctr, Dallas, TX USA. [McNeil, Malcolm R.; Fossett, Tepanta R.; Doyle, Patrick J.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [McNeil, Malcolm R.; Fossett, Tepanta R.; Doyle, Patrick J.; Szuminsky, Neil J.] Univ Pittsburgh, Pittsburgh, PA 15260 USA. EM wkatz@utdallas.edu NR 3 TC 10 Z9 10 U1 0 U2 2 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0093-934X J9 BRAIN LANG JI Brain Lang. PD OCT-NOV PY 2007 VL 103 IS 1-2 BP 213 EP 214 DI 10.1016/j.bandl.2007.07.121 PG 2 WC Audiology & Speech-Language Pathology; Linguistics; Neurosciences; Psychology, Experimental SC Audiology & Speech-Language Pathology; Linguistics; Neurosciences & Neurology; Psychology GA 227MF UT WOS:000250660100104 ER PT J AU McNeil, MR Fossett, TRD Katz, WF Garst, D Carter, G Szuminsky, N Doyle, PJ AF McNeil, Malcolm R. Fossett, Tepanta R. D. Katz, William F. Garst, Diane Carter, Gregory Szuminsky, Nell Doyle, Patrick J. TI Effects of on-line kinematic feedback treatment for apraxia of speech SO BRAIN AND LANGUAGE LA English DT Meeting Abstract C1 [McNeil, Malcolm R.; Fossett, Tepanta R. D.; Doyle, Patrick J.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. [McNeil, Malcolm R.; Fossett, Tepanta R. D.; Szuminsky, Nell; Doyle, Patrick J.] Univ Pittsburgh, Pittsburgh, PA 15260 USA. [Katz, William F.; Garst, Diane] Univ Texas, Callier Ctr Commun Disorders, Dallas, TX 75235 USA. [Carter, Gregory] Dallas Vet Adm Med Ctr, Dallas, TX USA. EM mcneil@pitt.edu NR 3 TC 3 Z9 3 U1 0 U2 2 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0093-934X J9 BRAIN LANG JI Brain Lang. PD OCT-NOV PY 2007 VL 103 IS 1-2 BP 223 EP 225 DI 10.1016/j.bandl.2007.07.025 PG 3 WC Audiology & Speech-Language Pathology; Linguistics; Neurosciences; Psychology, Experimental SC Audiology & Speech-Language Pathology; Linguistics; Neurosciences & Neurology; Psychology GA 227MF UT WOS:000250660100109 ER PT J AU Steinman, MA Baron, RB Marlow, B AF Steinman, Michael A. Baron, Robert B. Marlow, Bernard TI Is continuing medical education a drug-promotion tool? SO CANADIAN FAMILY PHYSICIAN LA English DT Editorial Material ID PHYSICIANS; INDUSTRY; COMPANIES; SALE C1 Coll Family Physicians Canada, Mississauga, ON L4W 5A4, Canada. Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, Div Geriatr, San Francisco, CA USA. RP Steinman, MA (reprint author), Coll Family Physicians Canada, 2630 Skymark Ave, Mississauga, ON L4W 5A4, Canada. EM mike.steinman@ucsf.edu NR 16 TC 12 Z9 12 U1 0 U2 0 PU COLL FAMILY PHYSICIANS CANADA PI MISSISSAUGA PA 2630 SKYMARK AVE, MISSISSAUGA, ONTARIO L4W 5A4, CANADA SN 0008-350X J9 CAN FAM PHYSICIAN JI Can. Fam. Phys. PD OCT PY 2007 VL 53 BP 1650 EP 1653 PG 4 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA 226JG UT WOS:000250584700005 PM 17934022 ER PT J AU Choi, IJ Fujimoto, S Yamauchi, K Graham, DY Yamaoka, Y AF Choi, Il Ju Fujimoto, Saori Yamauchi, Kazuyoshi Graham, David Y. Yamaoka, Yoshio TI Helicobacter pylori environmental interactions: effect of acidic conditions on H-pylori-induced gastric mucosal interleukin-8 production SO CELLULAR MICROBIOLOGY LA English DT Article ID FACTOR-KAPPA-B; ENDOTHELIAL GROWTH-FACTOR; IL-8 GENE-EXPRESSION; EPITHELIAL-CELLS; LOW-PH; CLINICAL PRESENTATION; PROMOTER ACTIVATION; MESSENGER-RNA; SURFACE PH; CANCER AB To explore the interactions between the host, environment and bacterium responsible for the different manifestations of Helicobacter pylori infection, we examined the effect of acidic conditions on H. pylori-induced interleukin (IL)-8 expression. AGS gastric epithelial cells were exposed to acidic pH and infected with H. pylori [wild-type strain, its isogenic cag pathogenicity island (PAI) mutant or its oipA mutant]. Exposure of AGS cells to acidic pH alone did not enhance IL-8 production. However, following exposure to acidic conditions, H. pylori infection resulted in marked enhancement of IL-8 production which was independent of the presence of the cag PAI and OipA, indicating that H. pylori and acidic conditions act synergistically to induce gastric mucosal IL-8 production. In neutral pH environments H. pylori-induced IL-8 induction involved the NF-kappa B pathways, the extracellular signal-regulated kinase (ERK)-> c-Fos/c-Jun -> activating protein (AP-1) pathways, JNK -> c-Jun -> AP-1 pathways and the p38 pathways. At acidic pH H. pylori-induced augmentation of IL-8 production involved markedly upregulated the NF-kappa B pathways and the ERK -> c-Fos -> AP-1 pathways. In contrast, activation of the JNK -> c-Jun -> AP-1 pathways and p38 pathways were pH independent. These results might explain the clinical studies in which patients with duodenal ulcers had higher levels of IL-8 in the antral gastric mucosa than patients with simple H. pylori gastritis. C1 Michael E DeBakey Vet Affairs Med Ctr, Dept Med Gastroenterol, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. RP Yamaoka, Y (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med Gastroenterol, Houston, TX 77030 USA. EM yyamaoka@bcm.tmc.edu FU NIDDK NIH HHS [R01 DK062813-05, R01 DK062813, DK62813, DK56338, P30 DK056338, R01 DK062813-03] NR 34 TC 13 Z9 14 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1462-5814 J9 CELL MICROBIOL JI Cell Microbiol. PD OCT PY 2007 VL 9 IS 10 BP 2457 EP 2469 DI 10.1111/j.1462-5822.2007.00973.x PG 13 WC Cell Biology; Microbiology SC Cell Biology; Microbiology GA 206ZP UT WOS:000249221700013 PM 17517062 ER PT J AU Shapiro, S Waxman, A Schilz, R Strootman, D Rollins, K Feldman, BJ AF Shapiro, Shelley Waxman, Aaron Schilz, Robert Strootman, Deb Rollins, Kristan Feldman, B. Jeremy TI Multicenter experience with the rapid transition to intravenous treprostinil from epoprostenol in pulmonary arterial hypertension SO CHEST LA English DT Meeting Abstract CT CHEST 2007 Conference CY OCT 20-25, 2007 CL Chicago, IL SP Amer Coll Chest Phys C1 [Shapiro, Shelley; Waxman, Aaron; Schilz, Robert; Strootman, Deb; Rollins, Kristan; Feldman, B. Jeremy] W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD OCT PY 2007 VL 132 IS 4 SU S BP 635S EP 635S PG 1 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 222FY UT WOS:000250282700730 ER PT J AU Huang, CY Beer, TM Higano, CS True, LD Vessella, R Lange, P Garzotto, M Nelson, PS AF Huang, Chung-Ying Beer, Tomasz M. Higano, Celestia S. True, Lawrence D. Vessella, Robert Lange, Paulh. Garzotto, Mark Nelson, Peter S. TI Molecular alterations in prostate carcinomas that associate with in vivo exposure to chemotherapy: Identification of a cytoprotective mechanism involving growth differentiation factor 15 SO CLINICAL CANCER RESEARCH LA English DT Article ID MACROPHAGE INHIBITORY CYTOKINE-1; GENE-EXPRESSION; NEOADJUVANT DOCETAXEL; BREAST-CANCER; PACLITAXEL RESISTANCE; RADICAL PROSTATECTOMY; MITOXANTRONE; CDNA; PREDNISONE; DIAGNOSIS AB Purpose: To identify molecular alterations associating with in vivo exposure of prostate carcinoma to chemotherapy and assess functional roles modulating tumor response and resistance. Experimental Design: Patients with high-risk localized prostate cancer (tumor-nodemetastasis >= T-2b or prostate-specific antigen 15 ng/mL or Gleason glacle. >= 4+3) were enrolled into a phase II clinical trial of neoadjuvant chemotherapy with clocetaxel and mitoxantrone followed by prostatectomy. Pretreatment prostate tissue was acquired by needle biopsy and posttreatment tissue was acquired by prostatectomy. Prostate epithelium was captured by microdissection, and transcript levels were quantitated by cDNA microarray hybridization. Gene expression changes associated with chemotherapy were determined by a random variance t test. Several were verified by quantitative reverse transcription PCR. In vitro analyses determining the influence of growth differentiation factor 15 (GDF15) on chemotherapy resistance were done. Results: Gene expression changes after chemotherapy were measured in 31 patients who completed four cycles of neoadjuvant chemotherapy. After excluding genes shown previ6usly to be influenced by the radical prostatectomy procedure, we identified 51 genes with significant transcript level alterations following chemotherapy. This group included several cytokines, including GDF15, chemokine (C-X-C motif) ligand 10, and interleukin receptor 1 p, Overexpression of GDF15 or exposure of prostate cancer cell lines to exogenous recombinant GDF15 conferred resistance to clocetaxel and mitoxantrone. Conclusions: Consistent molecular alterations were identified in prostate cancer cells exposed to clocetaxel and mitoxantrone chemotherapy. These alterations include transcripts encoding cytokines known to be regulated through the nuclear factor-kappa B pathway. Chemotherapy- induced cytokines and growth factors, such as GDF15, contribute to tumor cell therapy resistance and may serve as targets to improve responses. C1 Fred Hutchinson Canc Res Ctr, Div Human Biol & Clin Res, Seattle, WA 98105 USA. Univ Washington, Dept Med, Seattle, WA USA. Univ Washington, Dept Pathol, Seattle, WA 98195 USA. Univ Washington, Dept Urol, Seattle, WA 98195 USA. Oregon Hlth & Sci Univ, Dept Med, Inst Canc, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Div Urol, Inst Canc, Portland, OR 97201 USA. Portland VA Med Ctr, Urol Sect, Portland, OR USA. RP Nelson, PS (reprint author), Fred Hutchinson Canc Res Ctr, Div Human Biol & Clin Res, Mailstop D4-100,1100 Fairview Ave, Seattle, WA 98105 USA. EM pnelson@fhcrc.org FU NCI NIH HHS [CA97186, R01 CA119125, P01 CA098912] NR 30 TC 40 Z9 46 U1 0 U2 0 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1078-0432 J9 CLIN CANCER RES JI Clin. Cancer Res. PD OCT 1 PY 2007 VL 13 IS 19 BP 5825 EP 5833 DI 10.1158/1078-0432.CCR-07-1037 PG 9 WC Oncology SC Oncology GA 218CN UT WOS:000249993700024 PM 17908975 ER PT J AU Michael, P Rumsfeld, JS Peterson, PN Masoudi, FA Strunk, A Ross, C Lyons, EE Smith, SS Lauer, MS Magid, DJ AF Michael, P. Rumsfeld, John S. Peterson, Pamela N. Masoudi, Frederick A. Strunk, Adam Ross, Colleen Lyons, Ella E. Smith, S. Scott Lauer, Michael S. Magid, David J. TI Chest pain on exercise treadmill test predicts future cardiac Hospitalizations SO CLINICAL CARDIOLOGY LA English DT Article DE treadmill testing; epidemiology; morbidity ID CORONARY-ARTERY DISEASE; MYOCARDIAL-INFARCTION; MORTALITY; ISCHEMIA; DEATH; MEN; PROGNOSIS; SILENT; SCORE AB Background: Patients often have chest pain during exercise treadmill testing (ETT). However, the evidence supporting chest pain as an independent adverse prognostic factor during ETT has been inconsistent. The objective of this study was to determine the importance of chest pain during ETT in predicting future nonfatal cardiac hospitalizations. Methods: This was a prospective cohort study of all patients undergoing ETT between July 2001 and June 2004 in a large managed care organization. The primary outcome of interest was nonfatal cardiac hospitalizations including myocardial infarction and unstable angina. Multivariable Cox proportional hazards regression assessed the independent association between chest pain during ETT and subsequent nonfatal cardiac hospitalizations, adjusting patient, clinical and other treadmill variables. Results: Of the 8,459 patients undergoing ETT, 697 (8.2%) patients had chest pain during the test. Patients with chest pain during ETT had more nonfatal cardiac hospitalizations compared to patients without chest pain (11.9% vs. 2.6%; p < 0.0001). In multivariable Cox regression analysis, patients with chest pain during ETT remained at significantly increased risk of nonfatal cardiac hospitalizations (HR 3.44; 95% CI 2.60-4.56). The association between chest pain and adverse outcomes was consistent among prespecified subgroups including patients without ST-segment changes and with good functional capacity on ETT. Conclusions: Chest pain during ETT, even without ECG changes, predicts subsequent cardiac hospitalizations. Future studies should evaluate whether aggressive management of such patients can prevent subsequent hospitalizations. C1 Denver VA Med Ctr, Denver, CO USA. Univ Colorado Hllt Sci Ctr, Denver, CO USA. Dencer Hlth Med Ctr, Denver, CO USA. Clin Res Unit, Denver, CO USA. Internal Med, Kaiser Permanente Colorado, Denver, CO USA. Cleveland Clin Fdn, Cleveland, OH USA. RP Michael, P (reprint author), 1055 Clermont St,111b, Denver, CO 80220 USA. EM Michael.ho@uchsc.edu RI Lauer, Michael/L-9656-2013 OI Lauer, Michael/0000-0002-9217-8177 NR 17 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0160-9289 J9 CLIN CARDIOL JI Clin. Cardiol. PD OCT PY 2007 VL 30 IS 10 BP 505 EP 510 DI 10.1002/clc.20139 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 222US UT WOS:000250323500004 ER PT J AU Welzel, TM Graubard, BI El-Serag, HB Shaib, YH Hsing, AW Davila, JA McGlynn, KA AF Welzelt, Tania M. Graubard, Barry I. El-Serag, Hashem B. Shaib, Yasser H. Hsing, Ann W. Davila, Jessica A. McGlynn, Katherine A. TI Risk factors for intrahepatic and extrahepatic Cholangiocarcinoma in the United States: A population-based case-control study SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article ID PRIMARY SCLEROSING CHOLANGITIS; HEPATITIS-C-VIRUS; FATTY LIVER-DISEASE; HEPATOCELLULAR-CARCINOMA; HELICOBACTER-PYLORI; NATURAL-HISTORY; STEM-CELLS; STEATOSIS; HEPATOLITHIASIS; CIRRHOSIS AB Background & Aims: Intrahepatic and extrahepatic cholangiocarcinomas are rare and highly malignant cancers of the bile duct. Although the incidence of extrahepatic cholangiocarcinoma (ECC) has remained constant, the incidence of intrahepatic cholangiocarcinoma (ICC) has increased in the United States. Because the etiology of both tumors is poorly understood, a population-based case-control study was conducted to examine the association of ECC and ICC with preexisting medical conditions. Methods: Medical conditions among 535 ICC patients, 549 ECC patients (diagnosed 1993-1999), and 102,782 cancer-free controls were identified by using the Surveillance, Epidemiology and End Results-Medicare databases. Logistic regression analysis was used to calculate adjusted odds ratios. Results: In addition to established risk factors (choledochal cysts, cholangitis, inflammatory bowel disease), several other conditions were significantly associated with ECC and ICC: biliary cirrhosis (ECC, ICC: P <.001), cholelithiasis (ECC, ICC: P <.001), alcoholic liver disease (ECC, P <.001; ICC, P =.01), nonspecific cirrhosis (ECC, ICC: P <.001), diabetes (ECC, ICC: P <.001), thyrotoxicosis (ECC, P =.006; ICC, P =.04), and chronic pancreatitis (ECC, ICC: P <.001). Conditions only associated with ICC were obesity (ECC, P =.71; ICC, P =.01), chronic nonalcoholic liver disease (ECC, P =.08; ICC, P =.02), HCV infection (ECC, P =.67; ICC, P =.01), and smoking (ECC, P =.07; ICC, P =.04). Conclusions: Several novel associations with ECC and ICC were identified. HCV infection, chronic nonalcoholic liver disease, and obesity, all of which are increasing in incidence, and smoking were associated only with ICC, suggesting that these conditions might explain the divergent incidence trends of the tumors. C1 NCI, Div Canc Epidemiol & Genet, NIH, DHHS, Bethesda, MD 20892 USA. Michael E Debakey Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX USA. Michael E Debakey Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. RP Welzel, TM (reprint author), NCI, Div Canc Epidemiol & Genet, NIH, DHHS, 6120 Execut Blvd,EPS Suite 550,MSC-7234, Bethesda, MD 20892 USA. EM weizelt@mall.nih.gov FU Intramural NIH HHS [Z99 CA999999] NR 53 TC 204 Z9 214 U1 1 U2 16 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1542-3565 J9 CLIN GASTROENTEROL H JI Clin. Gastroenterol. Hepatol. PD OCT PY 2007 VL 5 IS 10 BP 1221 EP 1228 DI 10.1016/j.cgh.2007.05-020 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 223IN UT WOS:000250363600019 PM 17689296 ER PT J AU Wheat, LJ Freifeld, AG Kleiman, MB Baddley, JW McKinsey, DS Loyd, JE Kauffman, CA AF Wheat, L. Joseph Freifeld, Alison G. Kleiman, Martin B. Baddley, John W. McKinsey, David S. Loyd, James E. Kauffman, Carol A. TI Clinical practice guidelines for the management of patients with histoplasmosis: 2007 update by the infectious diseases society of America SO CLINICAL INFECTIOUS DISEASES LA English DT Review ID CENTRAL-NERVOUS-SYSTEM; ACQUIRED-IMMUNODEFICIENCY-SYNDROME; CHRONIC PULMONARY HISTOPLASMOSIS; AMPHOTERICIN-B; MEDIASTINAL FIBROSIS; TRANSPLANT RECIPIENTS; ITRACONAZOLE THERAPY; FUNGAL-INFECTIONS; CEREBRAL HISTOPLASMOSIS; FLUCONAZOLE THERAPY AB Evidence-based guidelines for the management of patients with histoplasmosis were prepared by an Expert Panel of the Infectious Diseases Society of America. These updated guidelines replace the previous treatment guidelines published in 2000 (Clin Infect Dis 2000; 30: 688-95). The guidelines are intended for use by health care providers who care for patients who either have these infections or may be at risk for them. Since 2000, several new antifungal agents have become available, and clinical trials and case series have increased our understanding of the management of histoplasmosis. Advances in immunosuppressive treatment for inflammatory disorders have created new questions about the approach to prevention and treatment of histoplasmosis. New information, based on publications from the period 1999-2006, are incorporated into this guideline document. In addition, the panel added recommendations for management of histoplasmosis in children for those aspects that differ from aspects in adults. C1 MiraVista Diagnosit MiraBella Technol, Indianapolis, IN 46241 USA. Indiana Univ, Sch Med, Indianapolis, IN 46241 USA. Univ Nebraska Med Ctr, Omaha, NE USA. Univ Alabama, Birmingham, AL 35487 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. Vanderbilt Univ, Med Ctr, Nashville, TN USA. Univ Michigan, Sch Med, Vet Affairs Med Ctr, Ann Arbor, MI USA. RP Wheat, LJ (reprint author), MiraVista Diagnosit MiraBella Technol, 4444 Decatur Blvd,Ste 300, Indianapolis, IN 46241 USA. EM jwheat@miravistalabs.com NR 105 TC 318 Z9 337 U1 1 U2 7 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD OCT 1 PY 2007 VL 45 IS 7 BP 807 EP 825 DI 10.1086/521259 PG 19 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 207FV UT WOS:000249237900001 PM 17806045 ER PT J AU Oster, TJ Anderson, A Filley, CM Wortzel, HS Arciniegas, DB AF Oster, Timothy J. Anderson, Alan Filley, Christopher M. Wortzel, Hal S. Arciniegas, David B. TI Quetiapine for mania due to traumatic brain injury SO CNS SPECTRUMS LA English DT Article ID ATYPICAL ANTIPSYCHOTIC TREATMENT; PLACEBO-CONTROLLED TRIALS; BIPOLAR DISORDER; HEAD-INJURY; RANDOMIZED-TRIAL; VALPROATE; SCHIZOPHRENIA; CARBAMAZEPINE; HALOPERIDOL; RISPERIDONE AB Secondary mania develops in as many as 9% of persons with traumatic brain injuries. The treatment of posttraumatic mania is not well defined, and agents traditionally used for the treatment of idiopathic manic episodes may not be well suited for use among individuals wit h traumatic brain injuries. Atypical antipsychotics are indicated for the treatment of idiopathic bipolar disorder, and have been used for other purposes among individuals with posttraumatic neu ro psychiatric disturbances. This article offers the first description of the treatment of posttraumatic mania using the atypical antipsychotic quetiapine. Beneficial effects of this agent on posttraumatic mania, cognitive impairments, and functional disability in the subacute post-injury period are described. Possible mechanisms of action are discussed and the need for additional investigation of quetiapine for posttraumatic mania is highlighted. C1 Univ Colorado, Sch Med, Dept Psychiat, Neurobehav Disorders Program, Denver, CO 80262 USA. HealthONE Spalding Rehabil Hosp, Brain Injury Rehabil Unit, Aurora, CO USA. Univ Colorado, Sch Med, Dept Neurol, Behav Neurol Sect, Boulder, CO 80309 USA. Denver Vet Affairs Med Ctr, VISN MIRECC 19, Denver, CO USA. RP Arciniegas, DB (reprint author), Univ Colorado, Sch Med, Dept Psychiat, Neurobehav Disorders Program, Campus Box C268-25,4200 E 9th Ave, Denver, CO 80262 USA. EM David.Arciniegas@UCHSC.edu RI Arciniegas, David/A-3792-2009 NR 59 TC 10 Z9 10 U1 0 U2 1 PU M B L COMMUNICATIONS, INC PI NEW YORK PA 333 HUDSON ST, 7TH FLOOR, NEW YORK, NY 10013 USA SN 1092-8529 J9 CNS SPECTRUMS JI CNS Spectr. PD OCT PY 2007 VL 12 IS 10 BP 764 EP 769 PG 6 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 223HE UT WOS:000250359900010 PM 17934381 ER PT J AU Pumbwe, L Skilbeck, CA Wexler, HM AF Pumbwe, Lilian Skilbeck, Christopher A. Wexler, Hannah M. TI Impact of anatomic site on growth, efflux-pump expression, cell structure, and stress responsiveness of Bacteroides fragilis SO CURRENT MICROBIOLOGY LA English DT Article DE adaptation; colonization; membrane proteins; regulation ID OUTER-MEMBRANE VESICLES; ELECTRON MICROSCOPY; BILE-SALTS; RESISTANCE; GINGIVALIS AB This study investigated whether B. fragilis from various human sites acquired stable traits enabling it to express certain efflux pumps (EPs), adopt a particular cell structure, and tolerate certain stressors. Isolates from blood, abscess, and stool (n = 11 each) were investigated. Bacteria from various sites portrayed different ultrastructres and EP expression. Blood isolates were tolerant to nutrient limitation and stool isolates to NaCl and bile salt stress. Stressors significantly increased EP expression. These data demonstrate that (1) B. fragilis acquires stable traits from various in vivo microenvironments; (2) that EPs are involved in stress responsiveness; and (3) that EP expression is tightly controlled and site dependent. C1 Univ Calif Los Angeles, Greater Los Angeles Vet Adm Healthcare Syst, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RP Pumbwe, L (reprint author), Univ Calif Los Angeles, Greater Los Angeles Vet Adm Healthcare Syst, Los Angeles, CA 90095 USA. EM lilskil@ucla.edu NR 21 TC 2 Z9 2 U1 1 U2 2 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0343-8651 J9 CURR MICROBIOL JI Curr. Microbiol. PD OCT PY 2007 VL 55 IS 4 BP 362 EP 365 DI 10.1007/s00284-007-0278-8 PG 4 WC Microbiology SC Microbiology GA 212UC UT WOS:000249621300016 PM 17882508 ER PT J AU Streblow, DN Orloff, SL Nelson, JA AF Streblow, Daniel N. Orloff, Susan L. Nelson, Jay A. TI Acceleration of allograft failure by cytomegalovirus SO CURRENT OPINION IN IMMUNOLOGY LA English DT Review ID MUSCLE-CELL MIGRATION; TRANSPLANT VASCULAR SCLEROSIS; SOLID-ORGAN TRANSPLANTATION; REPLACE PREEMPTIVE THERAPY; PDGF BETA-RECEPTOR; CHRONIC REJECTION; RENAL-TRANSPLANTATION; RAT CYTOMEGALOVIRUS; HEART-TRANSPLANTATION; EXTRACELLULAR-MATRIX AB A number of human herpesviruses are important opportunistic pathogens that have been associated with increased morbidity and mortality in transplant recipients including human cytomegalovirus (HCMV), HHV6, HHV7, HHV8 as well as HSV-1, VZV. However, HCMV has been linked both epidemiologically and through the use of animal models to the acceleration of acute and chronic allograft rejection. This review will cover the pathophysiology, epidemiology, and mechanisms of CMV-associated disease in the setting of transplantation. C1 OHSU, MMI, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. OHSU, Dept Surg, Portland, OR USA. OHSU, Vaccine & Gene Therapy Inst, Beaverton, OR 97006 USA. RP Nelson, JA (reprint author), OHSU, MMI, Portland, OR USA. EM nelsonj@ohsu.edu FU NHLBI NIH HHS [R01 HL065754, HL71695, R01 HL071695, HL65754, R01 HL083194, HL083194, HL 66238-01, R01 HL066238]; NIAID NIH HHS [AI21640, R01 AI021640] NR 64 TC 68 Z9 70 U1 0 U2 1 PU CURRENT BIOLOGY LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0952-7915 J9 CURR OPIN IMMUNOL JI Curr. Opin. Immunol. PD OCT PY 2007 VL 19 IS 5 BP 577 EP 582 DI 10.1016/j.coi.2007.07.012 PG 6 WC Immunology SC Immunology GA 224RR UT WOS:000250464600016 PM 17716883 ER PT J AU Wallace, TM Utzschneider, KM Tong, J Carr, DB Zraika, S Bankson, DD Knopp, RH Kahn, SE AF Wallace, Tara M. Utzschneider, Kristina M. Tong, Jenny Carr, Darcy B. Zraika, Sakeneh Bankson, Daniel D. Knopp, Robert H. Kahn, Steven E. TI Relationship of liver enzymes to insulin sensitivity and Intraw-abdominal fat SO DIABETES CARE LA English DT Article ID GAMMA-GLUTAMYL-TRANSFERASE; C-REACTIVE PROTEIN; MIDDLE-AGED MEN; ALANINE AMINOTRANSFERASE; METABOLIC SYNDROME; HEPATIC STEATOSIS; SUBCUTANEOUS FAT; UNITED-STATES; RESISTANCE; RISK AB OBJECTIVE - The purpose of this study was to determine the relationship between plasma liver enzyme concentrations, insulin sensitivity, and intra-abdominal fat (IAF) distribution. RESEARCH DESIGN AND METHODS - Plasma gamma-glutamyl transferase (GGT), aspartate transaminase (AST), alanine transaminase (ALT) levels, insulin sensitivity (insulin sensitivity index [S,]), IAF area, and subcutaneous fat (SCF) area were measured in 177 nondiabetic subjects (75 men and 102 women, aged 31-75 years) with no history of liver disease. On the basis of BMI (< or >= 27.5 kg/m(2)) and S-1 (< or >= 7.0 X 10(-5) min/pmol) subjects were divided into lean insulin sensitive (LIS, n = 53), lean insulin resistant (LIR, n = 60), and obese insulin resistant (OIR, n = 56) groups. RESULTS- Levels of all three liver enzymes were higher in men than in women (P < 0.0001 for each). In men, GGT levels were higher in insulin-resistant than in insulin-sensitive subjects (P < 0.01). In women, GGT levels were higher in the OIR than in the LIS group (P < 0.01) but no different in the LIR group. There was no difference in ALT and AST levels among the LIS, LIR, and OIR groups. GGT was associated with SI (r = -0.26, P < 0.0001), IAF area (r = 0.22, P < 0.01), waist-to-hip ratio (WHR) (r = 0.25, P = 0.001), BMI (r = 0.17, P < 0.05), and SCF area (r = 0.16, P < 0.05) after adjustments for age and sex. In men, only S, (r = -0.29, P < 0.05) remained independently correlated with GGT in multiple regression analysis. In women, IAF area (r = 0.29, P < 0.01) and WHR (r = 0.29, P < 0.01) were independently associated with GGT, but S, was not. CONCLUSIONS- in nondiabetic men GGT but not AST or ALT levels, are inversely related to insulin sensitivity independent of IAF area. However in women, GGT is related to measures of central body fat rather than to insulin sensitivity. C1 VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. Univ Washington, Dept Obstet & Gynecol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Dept Pathol & Lab Med, Seattle, WA USA. Univ Washington, Harborview Med Ctr, Seattle, WA 98104 USA. RP Kahn, SE (reprint author), VA Puget Sound Hlth Care Syst 151, 1660 S Columbian Way, Seattle, WA 98108 USA. EM skahn@u.washington.edu FU NCRR NIH HHS [RR-16066, RR-37]; NHLBI NIH HHS [HL-07028, HL-30086]; NIDDK NIH HHS [DK-02654, DK-17047, DK-35747, DK-35816] NR 35 TC 27 Z9 27 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD OCT PY 2007 VL 30 IS 10 BP 2673 EP 2678 DI 10.2337/dc06-1758 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 221JN UT WOS:000250223400053 PM 17666458 ER PT J AU Barth, JL Yu, Y Song, W Lu, K Dashti, A Huang, Y Argraves, WS Lyons, TJ AF Barth, J. L. Yu, Y. Song, W. Lu, K. Dashti, A. Huang, Y. Argraves, W. S. Lyons, T. J. TI Oxidised, glycated LDL selectively influences tissue inhibitor of metalloproteinase-3 gene expression and protein production in human retinal capillary pericytes SO DIABETOLOGIA LA English DT Article DE diabetic retinopathy; gene array; glycation; lipoprotein; metalloproteinase; oxidation ID SMOOTH-MUSCLE-CELLS; VASCULAR ENDOTHELIAL-CELLS; EARLY DIABETIC-RETINOPATHY; LOW-DENSITY-LIPOPROTEIN; MATRIX METALLOPROTEINASES; MACULAR DEGENERATION; DCCT/EDIC COHORT; TIMP-3; GROWTH; INFLAMMATION AB Aims/hypothesis Matrix metalloproteinases (MMPs) and their natural inhibitors, tissue inhibitor of metalloproteinases (TIMPs), regulate important biological processes including the homeostasis of the extracellular matrix, proteolysis of cell surface proteins, proteinase zymogen activation, angiogenesis and inflammation. Studies have shown that their balance is altered in retinal microvascular tissues in diabetes. Since LDLs modified by oxidation/glycation are implicated in the pathogenesis of diabetic vascular complications, we examined the effects of modified LDL on the gene expression and protein production of MMPs and TIMPs in retinal pericytes. Methods Quiescent human retinal pericytes were exposed to native LDL (N-LDL), glycated LDL (G-LDL) and heavily oxidised and glycated LDL (HOG-LDL) for 24 h. We studied the expression of the genes encoding MMPs and TIMPs mRNAs by analysis of microarray data and quantitative PCR, and protein levels by immunoblotting and ELISA. Results Microarray analysis showed that MMP1, MMP2, MMP11, MMP14 and MMP25 and TIMP1, TIMP2, TIMP3 and TIMP4 were expressed in pericytes. Of these, only TIMP3 mRNA showed altered regulation, being expressed at significantly lower levels in response to HOG- vs N-LDL. Quantitative PCR and immunoblotting of cell/matrix proteins confirmed the reduction in TIMP3 mRNA and protein in response to HOG-LDL. In contrast to cellular TIMP3 protein, analysis of secreted TIMP1, TIMP2, MMP1 and collagenase activity indicated no changes in their production in response to modified LDL. Combined treatment with N- and HOG-LDL restored TIMP3 mRNA expression to a level comparable with that after N-LDL alone. Conclusion/interpretation Among the genes encoding for MMPs and TIMPs expressed in retinal pericytes, TIMP3 is uniquely regulated by HOG-LDL. Reduced TIMP3 expression might contribute to microvascular abnormalities in diabetic retinopathy. C1 Univ Oklahoma, Hlth Sci Ctr, Sect Endocrinol & Diabet, Oklahoma City, OK 73104 USA. Med Univ S Carolina, Dept Cell Biol & Anat, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. Med Univ S Carolina, Div Endocrinol Diabet & Med Genet, Charleston, SC 29425 USA. VA Med Ctr, Oklahoma City, OK USA. RP Lyons, TJ (reprint author), Univ Oklahoma, Hlth Sci Ctr, Sect Endocrinol & Diabet, WP1345, Oklahoma City, OK 73104 USA. EM timothy-lyons@ouhsc.edu FU NCI NIH HHS [CA095841, R24 CA095841]; NCRR NIH HHS [M01 RR-14467, P20 RR016434, P20RR016434]; NHLBI NIH HHS [R01 HL061873, HL61873] NR 49 TC 23 Z9 23 U1 0 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD OCT PY 2007 VL 50 IS 10 BP 2200 EP 2208 DI 10.1007/s00125-007-0768-z PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 208DI UT WOS:000249299600023 PM 17676308 ER PT J AU Zickmund, SL Brown, KE Bielefeldt, K AF Zickmund, Susan L. Brown, Kyle E. Bielefeldt, Klaus TI A systematic review of provider knowledge of hepatitis C: Is it enough for a complex disease? SO DIGESTIVE DISEASES AND SCIENCES LA English DT Article DE hepatitis C; provider; knowledge; attitude; stigmatization; barriers ID PRIMARY-CARE PHYSICIANS; CROSS-SECTIONAL SURVEY; INFECTED PATIENTS; GENERAL-PRACTICE; NATIONAL-SURVEY; UNITED-STATES; MANAGEMENT; VIRUS; EXPERIENCES; RESIDENTS AB As studies indicate that patients with hepatitis C face poor provider knowledge and even stigmatization, we conducted a systematic review of provider knowledge about and attitudes toward hepatitis C. We searched Medline for original studies between 1990 and 2005. Articles were abstracted to define target population, recruitment strategies, study design, and key findings. Twenty-six publications performed in nine countries were identified. Whereas studies demonstrated an understanding of the nature of hepatitis C, significant knowledge deficits existed related to natural history, diagnostic approaches, and treatment. The relevance of simple measures, such as vaccinations against hepatitis A and B, was underappreciated. While providers were aware of risk factors for the disease, there were substantial misperceptions, with 5%-20% of providers considering casual contact as a risk for disease acquisition. We conclude that while healthcare providers understand the nature of hepatitis C, important knowledge gaps persist, which may constitute barriers to appropriate therapy. C1 Univ Pittsburgh, Sch Med, Dept Med, VA Pittsburgh Healthcare Syst,Ctr Hlth Equ Res &, Pittsburgh, PA 15240 USA. Univ Iowa, Roy J & Lucille A Carver Coll Med, Dept Internal Med, Iowa City Vet Adm Med Ctr, Iowa City, IA USA. Univ Pittsburgh, Sch Med, Dept Med, Div Gastroenterol, Pittsburgh, PA USA. RP Zickmund, SL (reprint author), Univ Pittsburgh, Sch Med, Dept Med, VA Pittsburgh Healthcare Syst,Ctr Hlth Equ Res &, 151C-U Univ Dr C, Pittsburgh, PA 15240 USA. EM Susan.Zickmund@med.va.gov NR 48 TC 25 Z9 27 U1 0 U2 0 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0163-2116 J9 DIGEST DIS SCI JI Dig. Dis. Sci. PD OCT PY 2007 VL 52 IS 10 BP 2550 EP 2556 DI 10.1007/s10620-007-9753-0 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 208DN UT WOS:000249300100014 PM 17406823 ER PT J AU Leung, FW Go, VLW Scremin, OU Obenaus, A Tuck, ML Golub, MS Eggena, P Leung, JW AF Leung, Felix W. Go, Vay Liang W. Scremin, Oscar U. Obenaus, Andre Tuck, Michael L. Golub, Michael S. Eggena, Peter Leung, Joseph W. TI Pilot studies to demonstrate that intestinal mucosal afferent nerves are functionally linked to visceral adipose tissue SO DIGESTIVE DISEASES AND SCIENCES LA English DT Article DE capsaicin; capsaicin-sensitive afferent nerves; pulse Doppler flowmetry; hydrogen gas clearance; laser Doppler flowmetry; adipose tissue blood flow; mesenteric artery blood flow ID HYDROGEN GAS CLEARANCE; CAPSAICIN-DESENSITIZED RATS; LASER DOPPLER FLOWMETRY; BLOOD-FLOW MEASUREMENTS; ULCER MARGIN HYPEREMIA; REFLECTANCE SPECTROPHOTOMETRY; MESENTERIC HYPEREMIA; GLUCOSE-TOLERANCE; FAT ACCUMULATION; BODY-FAT AB Dietary capsaicin reduces rodent visceral fat weight. We tested the hypothesis that intact intestinal mucosal afferent nerve function is necessary for fat deposition in visceral adipose tissue sites. Rats were treated daily for 2 weeks with intragastric ( chronic treatment) vehicle or capsaicin. Superior mesenteric artery blood flow and mesenteric and inguinal fat blood flow were measured before and after capsaicin was administered into the duodenum ( acute treatment). Fat from all sites was dissected and weighed. Chronic capsaicin significantly attenuated acute capsaicin-induced mesenteric hyperemia but did not abolish the reflex wiping of the eye exposed to capsaicin, indicating that functional ablation was limited to the intestinal mucosal afferent nerves. The associated vasoconstriction in adipose tissue was inhibited at the visceral ( mesenteric) site and maintained but attenuated at the subcutaneous ( inguinal) site. The onset of vasoconstriction was instantaneous, indicating a reflex mechanism. There was a redistribution of fat from visceral to subcutaneous sites, reflected by a decrease and an increase in the percentage of body fat in the visceral and subcutaneous sites, respectively. These pilot studies reveal for the first time that normal intestinal mucosal afferent nerve function is necessary for the physiologic accumulation of fat in visceral adipose tissue sites. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr & Nursing Home, Div Gastroenterol 111G, Sepulveda, CA 91343 USA. Sepulveda Ambulatory Care Ctr & Nursing Home, Res & Med Serv, Sepulveda, CA 91343 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. Loma Linda Univ, Dept Radiat Med, Loma Linda, CA 92350 USA. Univ Calif Davis, Sacramento, CA 95655 USA. No Calif Healthcare Syst, Sacramento Vet Affairs Med Ctr, Sacramento, CA 95655 USA. RP Leung, FW (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr & Nursing Home, Div Gastroenterol 111G, 16111 Plummer St, Sepulveda, CA 91343 USA. EM felix.leung@va.gov FU NCI NIH HHS [1 P01 CA42710] NR 50 TC 7 Z9 7 U1 0 U2 1 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0163-2116 J9 DIGEST DIS SCI JI Dig. Dis. Sci. PD OCT PY 2007 VL 52 IS 10 BP 2695 EP 2702 DI 10.1007/s10620-006-9645-8 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 208DN UT WOS:000249300100036 PM 17393331 ER PT J AU Lu, M Malladi, V Agha, A Abudayyeh, S Han, C Siepman, N Graham, DY AF Lu, Maggie Malladi, Vikram Agha, Aamer Abudayyeh, Suhaib Han, Cong Siepman, Nancy Graham, David Y. TI Failures in a proton pump inhibitor therapeutic substitution program: Lessons learned SO DIGESTIVE DISEASES AND SCIENCES LA English DT Article DE proton pump inhibitor; lansoprazole; rabeprazole; therapeutic substitution; gastroesophageal reflux disease; clinical trial ID GASTROESOPHAGEAL-REFLUX DISEASE; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; RHEUMATOID-ARTHRITIS; INTERCHANGE PROGRAM; OMEPRAZOLE; LANSOPRAZOLE; NONRESPONDERS; RESPONDERS; RESPONSES; SYMPTOMS AB The pathogenesis of patient dissatisfaction following involuntary therapeutic substitutions involving proton pump inhibitors (PPIs) is poorly understood. The aim of this study was to describe the patient population experiencing therapeutic failure and investigate whether failure was related to individual differences in response to the different PPIs. Treatment failures in a lansoprazole-rabeprazole therapeutic substitution program were compared to switch successes. A subgroup was randomized in a double-blind, double-dummy, crossover study to four 2-week periods of lansoprazole-rabeprazole-lansoprazole-rabeprazole or vice versa. Measures included overall rating of gastrointestinal reflux disease (GERD) symptoms for the past week as well as the frequency and distress scales of the GERD Symptom Assessment Scale. One hundred fifteen nonresponders were compared with 54 successful responders. Nonresponders consisted primarily of patients with GERD (74%, vs. 44% of responders; P = 0.005) who had undergone upper gastrointestinal endoscopy ( 50%, vs. 31% of responders; P = 0.02). Twelve patients completed the randomized treatment study. The interrater kappa coefficient for responder status was estimated to be 0.80 for lansoprazole and 0.21 for rabeprazole. The majority of PPI nonresponders had a clinical diagnosis of GERD and were receiving >= 40 mg of rabeprazole daily. This pilot study provides new insights into the design of subsequent studies of nonresponders in PPI therapeutic substitution programs. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX 77030 USA. VA Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. TAP Pharmaceut Prod Inc, Lake Forest, IL USA. RP Graham, DY (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Room 3A-320 111D,2002 Holcombe Blvd, Houston, TX 77030 USA. EM dgraham@bcm.tmc.edu FU NIDDK NIH HHS [DK56338] NR 19 TC 3 Z9 3 U1 0 U2 0 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0163-2116 J9 DIGEST DIS SCI JI Dig. Dis. Sci. PD OCT PY 2007 VL 52 IS 10 BP 2813 EP 2820 DI 10.1007/s10620-007-9811-7 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 208DN UT WOS:000249300100053 PM 17393309 ER PT J AU Nicosia, MA Robbins, J AF Nicosia, Mark A. Robbins, JoAnne TI The usefulness of the line spread test as a measure of liquid consistency SO DYSPHAGIA LA English DT Article DE deglutition; deglutition disorders; dysphagia; viscosity; thickened liquids ID VISCOSITY; FOODS AB Although dietary modification is a common treatment strategy used to manage dysphagic patients who aspirate thin liquids, there are no standard definitions for thickened liquid preparation. This lack of standardization leads to variability in practice and points to the need for a simple tool for clinicians to assess thickened liquid consistency. The current study analyzed the utility of the Line Spread Test (LST) in this regard. Twenty-six liquids (10 powder-thickened "nectar" juices, 10 powder-thickened "honey" juices, and 6 barium mixtures) were assessed using both a viscometer for objective measurement of viscosity and the LST. Whereas the LST was able to separate the juices into nectar and honey categories, it was not able to separate barium mixtures into these categories nor compare barium to juices. Furthermore, the LST was not predictive of viscosity. Thus, the results of the current study suggest that the LST may be useful in the broad categorization of fluids into therapeutically significant groupings but that it cannot be used more specifically to measure fluid viscosity. Further studies of this and other tools are necessary to identify inexpensive practical tools for quantification of thickened liquid consistency. C1 William S Middleton Mem Vet Adm Med Ctr, GRECC, Madison, WI 53705 USA. Univ Wisconsin, Inst Aging, Madison, WI 53706 USA. Univ Wisconsin, Dept Med, Madison, WI 53706 USA. Commun Sci & Disorders Res Grp Invest, Rockville, MD USA. RP Robbins, J (reprint author), William S Middleton Mem Vet Adm Med Ctr, GRECC, 2500 Overlook Terrace,11G, Madison, WI 53705 USA. EM jrobbin2@wisc.edu FU NIA NIH HHS [T32 AG00213]; NIDCD NIH HHS [U01 DC03206]; NINDS NIH HHS [R01 NS24427] NR 24 TC 13 Z9 13 U1 0 U2 4 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0179-051X J9 DYSPHAGIA JI Dysphagia PD OCT PY 2007 VL 22 IS 4 BP 306 EP 311 DI 10.1007/s00455-007-9086-3 PG 6 WC Otorhinolaryngology SC Otorhinolaryngology GA 219VN UT WOS:000250116400004 PM 17581694 ER PT J AU Bagby, S Xue, H Kupfer, P Lin, B DuPriest, E Roulliet, J AF Bagby, S. Xue, H. Kupfer, P. Lin, B. DuPriest, E. Roulliet, J. TI Maternal protein restriction in microswine: food restriction from weaning to prevent excess intake corrects vascular dysfunction in juvenile offspring SO EARLY HUMAN DEVELOPMENT LA English DT Meeting Abstract C1 [Bagby, S.; Kupfer, P.; Lin, B.; DuPriest, E.; Roulliet, J.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA. [Bagby, S.; Xue, H.; Kupfer, P.; Lin, B.; DuPriest, E.] Portland VA Med Ctr, Portland, OR USA. NR 0 TC 2 Z9 2 U1 0 U2 0 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0378-3782 J9 EARLY HUM DEV JI Early Hum. Dev. PD OCT PY 2007 VL 83 SU 1 BP S87 EP S87 DI 10.1016/S0378-3782(07)70187-1 PG 1 WC Obstetrics & Gynecology; Pediatrics SC Obstetrics & Gynecology; Pediatrics GA 232YS UT WOS:000251058200188 ER PT J AU Spitz, M Anderson, CA Wortzel, HS Maa, EH Strom, LS AF Spitz, Mark Anderson, C. A. Wortzel, H. S. Maa, E. H. Strom, L. S. TI Disrobing in epilepsy SO EPILEPSIA LA English DT Meeting Abstract CT 61st Annual Meeting of the American-Epilepsy-Society CY NOV 13-DEC 04, 2007 CL Philadelphia, PA SP Amer Epilepsy Soc C1 [Spitz, Mark; Anderson, C. A.; Wortzel, H. S.; Maa, E. H.; Strom, L. S.] Univ Colorado, Ctr Hlth Sci, Denver, CO 80309 USA. [Anderson, C. A.; Wortzel, H. S.] Denver Vet Affairs Med Ctr, MIRECC, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD OCT PY 2007 VL 48 SU 6 BP 17 EP 17 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 259CY UT WOS:000252917900041 ER PT J AU Lee, CL Antalffy, B Frost, JD Hrachovy, RA Swann, JW AF Lee, Chong L. Antalffy, B. Frost, J. D., Jr. Hrachovy, R. A. Swann, J. W. TI Persistent focal neocortical abnormalities in the TTX model of infantile spasms SO EPILEPSIA LA English DT Meeting Abstract CT 61st Annual Meeting of the American-Epilepsy-Society CY NOV 13-DEC 04, 2007 CL Philadelphia, PA SP Amer Epilepsy Soc C1 [Lee, Chong L.; Swann, J. W.] Cain Fdn Labs, Baylor Coll Med, Houston, TX 77030 USA. [Lee, Chong L.; Antalffy, B.; Frost, J. D., Jr.; Hrachovy, R. A.; Swann, J. W.] Baylor Coll Med, Houston, TX 77030 USA. [Hrachovy, R. A.] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. NR 0 TC 3 Z9 3 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD OCT PY 2007 VL 48 SU 6 BP 295 EP 295 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 259CY UT WOS:000252917900797 ER PT J AU Pugh, MJV VanCott, A Knoefel, JE Cramer, JA Berlowitz, DR AF Pugh, Mary Jo V. VanCott, A. Knoefel, J. E. Cramer, J. A. Berlowitz, D. R. TI Potential drug interactions among older veterans newly treated for epilepsy: A common event SO EPILEPSIA LA English DT Meeting Abstract CT 61st Annual Meeting of the American-Epilepsy-Society CY NOV 13-DEC 04, 2007 CL Philadelphia, PA SP Amer Epilepsy Soc C1 [Pugh, Mary Jo V.] S Texas Vet Hlth Care Syst, VERDICT 11C6, San Antonio, TX USA. [Pugh, Mary Jo V.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78285 USA. [VanCott, A.] VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. [VanCott, A.] Univ Pittsburgh, Sch Med, Pittsburgh, PA 15260 USA. [Knoefel, J. E.] VA New Mexico Hlth Care Syst, Albuquerque, NM USA. [Berlowitz, D. R.] Boston Univ, Sch Publ Hlth, Hlth Serv Res & Policy, Boston, MA 02215 USA. [Berlowitz, D. R.] Bedford VA Hosp, CHQOER, Bedford, MA USA. [Cramer, J. A.] Yale Univ, New Haven, CT 06520 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD OCT PY 2007 VL 48 SU 6 BP 326 EP 326 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 259CY UT WOS:000252917900877 ER PT J AU Zhao, S Aviles, ER Fujikawa, DG AF Zhao, Shuangping Aviles, E. R., Jr. Fujikawa, D. G. TI Translocation to neuronal nuclei of mitochondrial and lysosomal death-promoting proteins within the first 60 minutes of generalized seizures SO EPILEPSIA LA English DT Meeting Abstract CT 61st Annual Meeting of the American-Epilepsy-Society CY NOV 13-DEC 04, 2007 CL Philadelphia, PA SP Amer Epilepsy Soc C1 [Zhao, Shuangping; Aviles, E. R., Jr.; Fujikawa, D. G.] VA Greater LA Healthcare Syst, North Hills, CA USA. [Fujikawa, D. G.] Univ Calif Los Angeles, Geffen Sch Med, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0013-9580 J9 EPILEPSIA JI Epilepsia PD OCT PY 2007 VL 48 SU 6 BP 387 EP 387 PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 259CY UT WOS:000252917901044 ER PT J AU Muller, FL Jang, YM Liu, YH Van Remmen, H AF Muller, Florian L. Jang, Youngmok Liu, Yuhong Van Remmen, Holly TI Does superoxide-induced mitochondrial dysfunction lead to muscle atrophy? SO FREE RADICAL RESEARCH LA English DT Meeting Abstract CT European Meeting of the Society-for-Free-Radical-Research-Europe (SFRR-Europe) CY OCT 10-13, 2007 CL Vilamoura, PORTUGAL SP Soc Free Rad Res Europe, Portuguese Grp Free Rad, Spanish Grp Free Rad C1 [Muller, Florian L.; Jang, Youngmok; Liu, Yuhong; Van Remmen, Holly] Univ Texas Hlth Sci Ctr San Antonio, Barshop Inst Longev & Aging Studies, S Texas Vet Hlth Care Syst, San Antonio, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1071-5762 J9 FREE RADICAL RES JI Free Radic. Res. PD OCT PY 2007 VL 41 SU 1 BP S11 EP S11 PG 1 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 250JP UT WOS:000252296300022 ER PT J AU Marro, S Barisani, D Chiabrando, D Fagoonee, S Muckenthaler, MU Stolte, J Meneverv, R Haile, D Silengo, L Altruda, F Tolosano, E AF Marro, Samuele Barisani, Donatella Chiabrando, Deborah Fagoonee, Sharmila Muckenthaler, Martina U. Stolte, Jens Meneverv, Raffaella Haile, David Silengo, Lorenzo Altruda, Fiorella Tolosano, Emanuela TI Lack of haptoglobin affects iron transport across duodenum by modulating ferroportin expression SO GASTROENTEROLOGY LA English DT Article ID HEMOGLOBIN SCAVENGER RECEPTOR; PLASMA-PROTEIN; LIVER-CELLS; HEPCIDIN; HEMOCHROMATOSIS; METABOLISM; MICE; RAT; CIRCULATION; ABSORPTION AB Background & Aims: Haptoglobin is an acute phase protein responsible for the recovery of free hemoglobin from plasma. Haptoglobin-mill mice were previously shown to have an altered heme-iron distribution, thus reproducing what occurs in humans in cases of congenital or acquired anhaptoglobinemia. Here, we report the analysis of iron homeostasis in haptoglobin-mill mice. Methods: Iron absorption was measured in tied-off duodenal segments. Iron stores were evaluated on tissue homogenates and sections. The expression of molecules involved in iron homeostasis was analyzed at the protein and messenger RNA levels both in mice and in murine RAW264.7 macrophages stimulated in vitro with hemoglobin. Results: Analysis of intestinal iron transport reveals that haptoglobin-null mice export significantly more iron from the duodenal mucosa to plasma compared with control counterparts. Increased iron export from the duodenum correlates with increased duodenal expression of ferroportin, both at the protein and messenger RNA levels, whereas hepatic hepcidin expression remains unchanged. Up-regulation of the ferroportin transcript, but not of the protein, also occurs in haptoglobin-null spleen macrophages, which accumulate free hemoglobin-derived iron. Finally, we demonstrate that hemoglobin induces ferroportin expression in RAW264.7 cells. Conclusions: Taking together these data, we suggest that haptoglobin, by controlling plasma levels of hemoglobin, participates in the regulation of ferroportin expression, thus contributing to the regulation of iron transfer from duodenal mucosa to plasma. C1 Univ Turin, Ctr Mol Biotechnol, Dept Genet Biol & Biochem, I-10126 Turin, Italy. Univ Milano Bicocca, Dept Expt Med, Milan, Italy. Univ Heidelberg, Dept Pediat Oncol Hematol & Immunol, Heidelberg, Germany. EMBL, Genom Core Facil, Heidelberg, Germany. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. Audie L Murphy Mem Vet Adm Med Ctr, San Antonio, TX 78284 USA. RP Tolosano, E (reprint author), Univ Turin, Ctr Mol Biotechnol, Dept Genet Biol & Biochem, I-10126 Turin, Italy. EM emanuela.tolosano@unito.it RI Marro, Samuele/I-4493-2014; Tolosano, Emanuela/A-4684-2015 OI Marro, Samuele/0000-0002-9326-6945; Tolosano, Emanuela/0000-0002-1622-2340 FU Telethon [GGP04181] NR 35 TC 17 Z9 18 U1 0 U2 4 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD OCT PY 2007 VL 133 IS 4 BP 1261 EP 1271 DI 10.1053/j.gastro.2007.07.004 PG 11 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 218SW UT WOS:000250036200023 PM 17919498 ER PT J AU Olson, JS Lieberman, DA Sonnenberg, A AF Olson, Jeffrey S. Lieberman, David A. Sonnenberg, Amnon TI Practice patterns in the management of patients with esophageal strictures and rings SO GASTROINTESTINAL ENDOSCOPY LA English DT Article ID GASTROESOPHAGEAL REFLUX DISEASE; SINGLE DILATION; NATURAL-HISTORY; SCHATZKIS RING; COMPLICATIONS; DILATATION; BALLOON; STENOSES; THERAPY AB Background: Only few data exist on the epidemiology and management of esophageal strictures and rings. Objective: To study the epidemiology and management of esophageal strictures and rings. Design: Case-control study Setting: Endoscopic data repository of U.S. gastroenterology practices from 1998 to 2003 (Clinical Outcomes Research Initiative). Patients: Case subjects included 7287 patients with strictures and 4993 patients with rings. The control group consisted of 124,120 patients without endoscopic evidence of esophageal stenosis. Interventions: Esophageal dilation. Main Outcome Measurements: Patient demographics, types and diameters of esophageal dilators, frequency of repeat dilations. Results: Strictures displayed a male predominance, and rings displayed a small female predominance. Compared with the control population, strictures and rings both occurred most frequently in elderly white patients. Dysphagia and reflux were the most common indications for dilation in both conditions. Compared with strictures, rings were treated more often with larger dilators and rubber bougies. One-year rates of repeat dilation for strictures and rings were 13% and 4%, respectively. The mean interval length between repeat dilations was 82 days for Strictures and 184 days for rings. Limitations: Only a limited amount of information about individual patients was retrievable from the electronic database. Conclusions: The variations in the demographic characteristics and the treatment practice allude to differences in the Underlying pathophysiology of these 2 benign obstructing lesions of the esophagus. C1 Portland VA Med Ctr, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. RP Sonnenberg, A (reprint author), Portland VA Med Ctr, P3-G1,3710 SW US Vet Hosp Rd, Portland, OR 97239 USA. FU NIDDK NIH HHS [U01-DK057132-06A1] NR 26 TC 8 Z9 8 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD OCT PY 2007 VL 66 IS 4 BP 670 EP 675 DI 10.1016/j.gie.2007.02.031 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 220OO UT WOS:000250166200006 PM 17905007 ER PT J AU Spiegel, BMR Esrailian, E Eisen, G AF Spiegel, Brennan M. R. Esrailian, Eric Eisen, Glenn TI The budget impact of endoscopic screening for esophageal varices in cirrhosis SO GASTROINTESTINAL ENDOSCOPY LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; PROTON PUMP INHIBITORS; UPPER GI ENDOSCOPY; TERM-FOLLOW-UP; PRIMARY PROPHYLAXIS; PORTAL-HYPERTENSION; COST-EFFECTIVENESS; CAPSULE ENDOSCOPY; NATURAL-HISTORY; GASTROINTESTINAL ENDOSCOPY AB Background: The cost-effectiveness of screening for esophageal varices in cirrhosis remains uncertain. Previous analyses found that screening with upper endoscopy (EGD) may not be cost effective versus empiric beta-blocker (BB) therapy. However, these models were conducted before advances in variceal screening, including capsule endoscopy (CE), and they did not measure the budget impact (vs cost-effectiveness) of variceal screening. Objective: To compare the managed care budget impact of variceal screening strategies. Design: Budget impact model. Setting: Hypothetical managed care organization with 1 million covered lives. Patients: Patients with compensated cirrhosis. Interventions: Compared 5 strategies: (1) empiric BB, (2) screening EGD followed by BB if varices present (EGD -> BB), (3) EGD followed by endoscopic band ligation if varices present (EGD -> EBL), (4) CE followed by BB if varices present (CE -> BB), and (5) CE followed by EBL if varices present (CE -> EBL). Main Outcome Measurement: Per-member per-month cost. Results: BB was the least expensive, and CE -> EBL was the most expensive. Substituting CE -> BB in lieu of BB cost each member an additional $0.20 per month to subsidize. Compared with CE -> BB, both EGD-based strategies were more expensive. However, CE was not viable in managed care organizations capable of reducing the cost of endoscopy below $410, unless the cost of CE was reduced in lockstep. Limitations: Data on CE remain limited. Conclusions: Screening for varices may have an acceptable budget impact but is highly sensitive to local costs of EGD and CE. In managed care organizations willing to subsidize EBL for variceal prophylaxis, it is inefficient to screen with CE compared with EGD. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, VA Ctr Outcomes Res & Educ,Div Gastroenterol, Los Angeles, CA 90073 USA. CURE Digest Dis Res Ctr, Los Angeles, CA USA. Oregon Hlth & Sci Univ, Div Gastroenterol, Portland, OR 97201 USA. RP Spiegel, BMR (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, VA Ctr Outcomes Res & Educ,Div Gastroenterol, 11301 Wilshire Blvd,Bldg 115 Rm 215, Los Angeles, CA 90073 USA. FU NCI NIH HHS [U01 CA89389-01]; NIDDK NIH HHS [T32 DK07180-30, R33 DK61778-01, 2P30 DK041301-17] NR 86 TC 24 Z9 24 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0016-5107 J9 GASTROINTEST ENDOSC JI Gastrointest. Endosc. PD OCT PY 2007 VL 66 IS 4 BP 679 EP 692 DI 10.1016/j.gie.2007.02.048 PG 14 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 220OO UT WOS:000250166200008 PM 17905009 ER PT J AU Million, M Wang, L Adelson, DW Roman, F Diop, L Tache, Y AF Million, M. Wang, L. Adelson, D. W. Roman, F. Diop, L. Tache, Y. TI Pregabalin decreases visceral pain and prevents spinal neuronal activation in rats SO GUT LA English DT Letter C1 CNS, CURE, VA Greater Los Angeles Hlthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Digest Dis Res Ctr, Ctr Neurovisceral Sci & Women Hlth, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Digest Dis Res Ctr, Ctr Neurovisceral Sci & Women Hlth, Div Digest Dis, Los Angeles, CA USA. RP Million, M (reprint author), CNS, CURE, VA Greater Los Angeles Hlthcare Syst, Bldg 115,Rm 118B,1130 Wilshire Blvd, Los Angeles, CA 90073 USA. EM milllionmulugeta@mednet.ucla.edu FU NIAMS NIH HHS [P50 AR 049550]; NIDDK NIH HHS [DK 41301, R01 DK 33061, R21 DK 068155] NR 5 TC 22 Z9 23 U1 0 U2 0 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD OCT PY 2007 VL 56 IS 10 BP 1482 EP 1484 DI 10.1136/gut.2007.129304 PG 5 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 210JU UT WOS:000249453300044 PM 17872585 ER PT J AU Kerr, EA Hofer, TP Hayward, RA Adams, JL Hogan, MM McGlynn, EA Asch, SM AF Kerr, Eve A. Hofer, Timothy P. Hayward, Rodney A. Adams, John L. Hogan, Mary M. McGlynn, Elizabeth A. Asch, Steven M. TI Quality by Any Other Name?: A Comparison of Three Profiling Systems for Assessing Health Care Quality SO HEALTH SERVICES RESEARCH LA English DT Article DE Quality of care; performance profiling; quality monitoring ID OF-CARE; HOSPITAL-CARE; POOR QUALITY; PHYSICIAN; EXPLICIT; CRITERIA AB Objective. Many performance measurement systems are designed to identify differences in the quality provided by health plans or facilities. However, we know little about whether different methods of performance measurement provide similar answers about the quality of care of health care organizations. To examine this question, we used three different measurement approaches to assess quality of care delivered in veteran affairs (VA) facilities. Data Sources/Study Setting. Medical records for 621 patients at 26 facilities in two VA regions. Study Design. We examined agreements in quality conclusions using: focused explicit (38 measures for six conditions/prevention), global explicit (372 measures for 26 conditions/prevention), and structured implicit review physician-rated care (a single global rating of care for three chronic conditions and overall acute, chronic and preventive care). Trained nurse abstractors and physicians reviewed all medical records. Correlations between scores from the three systems were adjusted for measurement error in each using multilevel regression models. Results. Intercorrelations of scores were generally moderate to high across all three systems, and rose with adjustment for measurement error. Site-level correlations for prevention and diabetes care were particularly high. For example, adjusted for measurement error at the site level, prevention quality was correlated at 0.89 between the implicit and global systems, 0.67 between implicit and focused, and 0.73 between global and focused systems. Conclusions. We found moderate to high agreement in quality scores across the three profiling systems for most clinical areas, indicating that all three were measuring a similar construct called "quality." Adjusting for measurement error substantially enhanced out ability to identify this underlying construct. C1 [Kerr, Eve A.; Hofer, Timothy P.; Hayward, Rodney A.; Hogan, Mary M.] Vet Affairs Ann Arbor Healthcare Syst, Ctr Practice Management & Outcomes Res, Ann Arbor, MI USA. [Kerr, Eve A.; Hofer, Timothy P.; Hayward, Rodney A.] Univ Michigan, Sch Med, Dept Internal Med, Ann Arbor, MI USA. [Adams, John L.; McGlynn, Elizabeth A.; Asch, Steven M.] Rand Corp, Santa Monica, CA USA. [Asch, Steven M.] Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. [Asch, Steven M.] Univ Calif Los Angeles, Geffen Sch Med, Dept Med, Los Angeles, CA USA. RP Kerr, EA (reprint author), Vet Affairs Ann Arbor Healthcare Syst, Ctr Practice Management & Outcomes Res, Ann Arbor, MI USA. RI Kerr, Eve/I-3330-2013 FU Department of Veterans Affairs Health Services Research and Development Service [IIR#98-103]; NIDDK of the National Institutes of Health [P60DK-20572] FX This study was supported by the Department of Veterans Affairs Health Services Research and Development Service (IIR#98-103). Additional support was provided by the Michigan Diabetes Research and Training Center Grant P60DK-20572 from the NIDDK of the National Institutes of Health. NR 30 TC 14 Z9 14 U1 3 U2 5 PU WILEY-BLACKWELL PUBLISHING, INC PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD OCT PY 2007 VL 42 IS 5 BP 2070 EP 2087 DI 10.1111/j.1475-6773.2007.00730.x PG 18 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 210AL UT WOS:000249429000017 PM 17850534 ER PT J AU Lieber, CS Leo, MA Wang, XL Ponomarenko, A DeCarli, LM AF Lieber, Charles S. Leo, Maria A. Wang, Xiaolei Ponomarenko, Anatoly DeCarli, Leonore M. TI Effect of chronic alcohol consumption on nuclear gene regulators of mitochondrial function SO HEPATOLOGY LA English DT Meeting Abstract CT 58th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY NOV 02-06, 2007 CL Boston, MA SP Amer Assoc Study Liver Dis C1 James J Peters VA Med Ctr, Bronx, NY USA. Mt Sinai Hosp, Mt Sinai Sch Med, New York, NY 10029 USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2007 VL 46 IS 4 SU S MA 203 BP 327A EP 328A PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 216WT UT WOS:000249910400209 ER PT J AU Butt, AA Skanderson, M McGinnis, KA Kwoh, CK Justice, AC AF Butt, Adeel A. Skanderson, Melissa McGinnis, Kathleen A. Kwoh, C. K. Justice, Amy C. TI Real-life rates of treatment completion for HCV SO HEPATOLOGY LA English DT Meeting Abstract CT 58th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY NOV 02-06, 2007 CL Boston, MA SP Amer Assoc Study Liver Dis C1 Univ Pittsburgh, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. VA Connecticut Healthcare Syst, West Haven, CT USA. Yale Univ, Sch Med, New Haven, CT USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2007 VL 46 IS 4 SU S MA 281 BP 364A EP 364A PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 216WT UT WOS:000249910400287 ER PT J AU Ryan, JC Monto, A Lehil, M Kim, M Tracy, D George, S Kennedy, AP Wright, TL Currie, S AF Ryan, James C. Monto, Alexander Lehil, Mandeep Kim, Michael Tracy, Daniel George, Sally Kennedy, Alan P. Wright, Teresa L. Currie, Sue TI Hepatitis C resolution correlates with patterned KIR receptor expression on killer lymphocytes SO HEPATOLOGY LA English DT Meeting Abstract CT 58th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY NOV 02-06, 2007 CL Boston, MA SP Amer Assoc Study Liver Dis C1 Univ Calif San Francisco, GI Div, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, Div Gastroenterol, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2007 VL 46 IS 4 SU S MA 488 BP 455A EP 455A PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 216WT UT WOS:000249910400494 ER PT J AU Currie, S Shen, H Brau, N Anand, BS Aytaman, A Chang, KM Cheung, RCM Morgan, TR Pedrosa, M Schmidt, WN Monto, A McQuaid, R Wright, TL Bini, EJ AF Currie, Sue Shen, Hui Brau, Norbert Anand, Bhupinderjit S. Aytaman, Ayse Chang, Kyong-Mi Cheung, Ramsey Chi-Man Morgan, Timothy R. Pedrosa, Marcos Schmidt, Warren N. Monto, Alexander McQuaid, Rosemary Wright, Teresa L. Bini, Edmund J. TI Does gender matter? A prospective evaluation of risk factors for HCV infection and treatment candidacy in women SO HEPATOLOGY LA English DT Meeting Abstract CT 58th Annual Meeting of the American-Association-for-the-Study-of-Liver-Diseases CY NOV 02-06, 2007 CL Boston, MA SP Amer Assoc Study Liver Dis C1 Univ Calif San Francisco, GI Div, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, Div Gastroenterol, San Francisco, CA USA. New York VA Harbor Hlth Care Syst, New York, NY USA. Houston VAMC, GI Div, Houston, TX USA. Brooklyn VAMC, GI Div, Brooklyn, NY USA. Bronx VAMC, Bronx, NY USA. Philadelphia VAMC, GI Div, Philadelphia, PA USA. Palo Alto VAMC, Palo Alto, CA USA. Long Beach VAMC, GI Div, Long Beach, CA USA. Boston VAMC, GI Div, Boston, MA USA. Iowa City VAMC, GI ID Div, Iowa City, IA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD OCT PY 2007 VL 46 IS 4 SU S MA 890 BP 632A EP 632A PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 216WT UT WOS:000249910401153 ER PT J AU Weintraub, D Xie, S Karlawish, J Siderowf, A AF Weintraub, Daniel Xie, Sharon Karlawish, Jason Siderowf, Andrew TI Differences in depression symptoms in patients with Alzheimer's and Parkinson's diseases: evidence from the 15-item Geriatric Depression Scale (GDS-15) SO INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE rating scale; depression; Alzheimer's disease; Parkinson's disease; geriatric depression scale ID PROVISIONAL DIAGNOSTIC-CRITERIA; RATING-SCALE; WORK GROUP; DEMENTIA; POPULATION; COMMUNITY; VALIDITY AB Objective Depression occurs frequently inpatients with both Alzheimer's disease (AD) and Parkinson's disease (PD), but there has been little comparison of depression symptoms in the two populations. Method The 15-item Geriatric Depression Scale (GDS-15) was administered as a depression screening instrument to 232 AD patients and 266 PD specialty care patients with at most mild dementia. Logistic regression models were used to determine disease-specific associations with individual GDS-15 items, and factor analysis was used to assess GDS-15 factor structure in the two populations. Results Controlling for total GDS-15 score and other covariates, AD patients reported more dissatisfaction with life (p=0.03) and memory problems (p<0.001), while PD patients reported more fearfulness (p=0.01), helplessness (p < 0.01), a preference to stay at home (p = 0.02), and diminished energy (p < 0.01). Three factors were generated in PD (explaining 55% of the total variance) and five in AD (explaining 59% of the total variance), and the two main factors generated in both populations related primarily to unhappiness and negative thoughts. Conclusions The factor structure of the GDS-15 is similar in AD and PD patients with at most mild stage dementia, but between-group differences on 6 of the GDS-15 items suggests the non-specificity of certain items in the two populations. Copyright (c) 2007 John Wiley & Sons, Ltd. C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, MIRECC, Philadelphia, PA USA. Univ Penn, Dept Biostat & Epidemiol, Philadelphia, PA 19104 USA. Univ Penn, Div Geriatr, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Alzheimers Dis Ctr, Philadelphia, PA 19104 USA. Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Bioeth, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, PADRECC, Philadelphia, PA USA. RP Weintraub, D (reprint author), 3535 Market St,Room 3003, Philadelphia, PA 19104 USA. EM weintrau@mail.med.upenn.edu FU NIA NIH HHS [P30 AG010124, P30-AG10124]; NIMH NIH HHS [K23 MH067894-04, K23 MH067894]; PHS HHS [K23-067894] NR 23 TC 8 Z9 8 U1 1 U2 4 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 0885-6230 J9 INT J GERIATR PSYCH JI Int. J. Geriatr. Psychiatr. PD OCT PY 2007 VL 22 IS 10 BP 1025 EP 1030 DI 10.1002/gps.1785 PG 6 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 221OS UT WOS:000250237800015 PM 17562521 ER PT J AU Custovic, A Bush, RK AF Custovic, Adnan Bush, Robert K. TI Two blind mice: New insights into mouse allergy SO JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY LA English DT Editorial Material ID INNER-CITY CHILDREN; PRESCHOOL-CHILDREN; ASTHMA MORBIDITY; LUNG-FUNCTION; EXPOSURE; SENSITIZATION C1 Univ Manchester, Univ S Manchester Hosp, N W Lung Ctr, NHS Fdn Trust, Manchester, NH USA. Univ Wisconsin, Dept Med, Sect Allergy Immunol Resp Crit & Sleep Med, Madison, WI USA. Univ Wisconsin Hosp & Clin, William S Middleton Mem Vet Adm Hosp, Madison, WI 53792 USA. RP Bush, RK (reprint author), K4-910,CSC 9988,600 Highland Ave, Madison, WI 53792 USA. EM robert.bush@med.va.gov RI Custovic, Adnan/A-2435-2012 OI Custovic, Adnan/0000-0001-5218-7071 NR 14 TC 3 Z9 3 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0091-6749 J9 J ALLERGY CLIN IMMUN JI J. Allergy Clin. Immunol. PD OCT PY 2007 VL 120 IS 4 BP 758 EP 759 DI 10.1016/j.jaci.2007.08.018 PG 2 WC Allergy; Immunology SC Allergy; Immunology GA 220LH UT WOS:000250157700007 PM 17931560 ER PT J AU Mensinger, JL Lynch, KG TenHave, TR Mckay, JR AF Mensinger, Janell Lynn Lynch, Kevin G. TenHave, Thomas R. Mckay, James R. TI Mediators of telephone-based continuing care for alcohol and cocaine dependence SO JOURNAL OF CONSULTING AND CLINICAL PSYCHOLOGY LA English DT Article DE substance abuse; aftercare treatment; continuing care; telephone monitoring; longitudinal mediation analysis ID SUBSTANCE USE; DRINKING BEHAVIOR; CLINICAL-TRIALS; SOCIAL SUPPORT; USE DISORDERS; GROUP-THERAPY; SELF-REPORTS; OUTCOMES; RELAPSE; RELIABILITY AB A previous randomized trial with 224 alcohol and/or cocaine addicts who had completed an initial phase of treatment indicated that 12 weeks of telephone-based continuing care yielded higher abstinence rates over 24 months than did group counseling continuing care. The current study examined mediators of this treatment effect. Results suggested that self-help involvement during treatment and self-efficacy and commitment to abstinence 3 months after treatment mediated subsequent abstinence outcomes. These analyses controlled for substance use prior to the assessment of mediators. Conversely, there was no evidence that self-help beliefs or social support mediated the treatment effect. These results are consistent with a model in which treatment effects are first accounted for by changes in behavior, followed by changes in self-efficacy and in commitment to abstinence. C1 Reading Hosp Med Ctr, Clin Res Unit, Reading, PA 19612 USA. Univ Penn, Dept Psychiat, Sch Med, Philadelphia, PA 19104 USA. Univ Penn, Ctr Clin Epidemiol & Biostat, Sch Med, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Mensinger, JL (reprint author), Reading Hosp Med Ctr, Clin Res Unit, Reading, PA 19612 USA. EM mensingerj@readinghospital.org RI Mensinger, Janell/F-1175-2014 FU NIAAA NIH HHS [R01-AA10341]; NIDA NIH HHS [R01-DA10262]; NIMH NIH HHS [T32-MH-065218, R01 MH078016, R01 MH078016-01A2, R01-MH-61892] NR 55 TC 18 Z9 18 U1 2 U2 5 PU AMER PSYCHOLOGICAL ASSOC/EDUCATIONAL PUBLISHING FOUNDATION PI WASHINGTON PA 750 FIRST ST NE, WASHINGTON, DC 20002-4242 USA SN 0022-006X J9 J CONSULT CLIN PSYCH JI J. Consult. Clin. Psychol. PD OCT PY 2007 VL 75 IS 5 BP 775 EP 784 DI 10.1037/0022-006X.75.5.775 PG 10 WC Psychology, Clinical SC Psychology GA 214PG UT WOS:000249750000011 PM 17907859 ER PT J AU Rhoads, RP Kim, JW Van Amburgh, ME Ehrhardt, RA Frank, SJ Boisclair, YR AF Rhoads, R. P. Kim, J. W. Van Amburgh, M. E. Ehrhardt, R. A. Frank, S. J. Boisclair, Y. R. TI Effect of nutrition on the GH responsiveness of liver and adipose tissue in dairy cows SO JOURNAL OF ENDOCRINOLOGY LA English DT Article ID GROWTH-HORMONE RECEPTOR; MESSENGER-RIBONUCLEIC-ACID; NEGATIVE-ENERGY BALANCE; LACTATING COWS; FACTOR-I; IGF-I; BOVINE SOMATOTROPIN; SKELETAL-MUSCLE; INSULIN-RESISTANCE; HEPATIC TISSUE AB Dairy cows enter a period of energy insufficiency after parturition. In liver, this energy deficit leads to reduced expression of the liver-specific GH receptor transcript (GHR1A) and decreased GHR abundance. As a consequence, hepatic processes stimulated by GH, such as IGF-I production, are reduced. In contrast, adipose tissue has been assumed to remain fully GH responsive in early lactation. To determine whether energy insufficiency causes contrasting changes in the GH responsiveness of liver and adipose tissue, six lactating dairy cows were treated for 4 days with saline or bovine GH when adequately fed (AF, 120% of total energy requirement) or underfed (UF, 30% of maintenance energy requirement). AF cows mounted robust GH responses in liver(plasma IGF-I and IGF-I mRNA) and adipose tissue (epinephrine-stimulated release of non-esterified fatty acids in plasma, IGF-I mRNA, and p85 regulatory subunit of phosphatidylinositol 3-kinase mRNA). Reductions of these responses were seen in the liver and adipose tissue of UF cows and were associated with decreased GHR abundance. Reduced GHR abundance occurred without corresponding reductions of GHR1A transcripts in liver or total GHR transcripts in adipose tissue. In contrast, undernutrition did not alter the abundance of proteins involved in the early post-receptor signaling steps. Thus, a feed restriction reproducing the energy deficit of early lactation depresses GH actions not only in liver but also in adipose tissue. It remains unknown whether a similar reduction of GH action occurs in the adipose tissue of early lactating dairy cows. C1 Cornell Univ, Dept Anim Sci, Ithaca, NY 14853 USA. Univ Arizona, Dept Anim Sci, Tucson, AZ 85721 USA. Gyeongsang Natl Univ, Coll Agr & Life Sci, Dept Dairy Sci, Div Appl Life Sci, Jinju 660701, South Korea. Birmingham VAMC, Med Serv, Endocrinol Sect, Birmingham, AL 35233 USA. Univ Alabama, Dept Med, Div Endocrinol Diabet & Metab, Birmingham, AL 35294 USA. RP Boisclair, YR (reprint author), Cornell Univ, Dept Anim Sci, 259 Morrison Hall, Ithaca, NY 14853 USA. EM yrb1@cornell.edu RI Rhoads, Robert/F-2861-2016 OI Rhoads, Robert/0000-0002-5205-5834 FU NIDDK NIH HHS [DK51624, DK58259] NR 50 TC 25 Z9 25 U1 0 U2 2 PU SOC ENDOCRINOLOGY PI BRISTOL PA 22 APEX COURT, WOODLANDS, BRADLEY STOKE, BRISTOL BS32 4JT, ENGLAND SN 0022-0795 J9 J ENDOCRINOL JI J. Endocrinol. PD OCT PY 2007 VL 195 IS 1 BP 49 EP 58 DI 10.1677/JOE-07-0068 PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 224HX UT WOS:000250439200006 PM 17911396 ER PT J AU Ando, T Latif, R Davies, TF AF Ando, Takao Latif, Rauf Davies, Terry F. TI Antibody-induced modulation of TSH receptor post-translational processing SO JOURNAL OF ENDOCRINOLOGY LA English DT Article ID HUMAN THYROTROPIN RECEPTOR; THYROID-STIMULATING ANTIBODY; AMINO-ACID MOTIF; INTRAMOLECULAR CLEAVAGE; MONOCLONAL-ANTIBODIES; HORMONE-RECEPTOR; SITE 1; ECTODOMAIN; BINDING; CELLS AB The post-translational processing of the TSH receptor (TSHR) includes intra-molecular cleavage with the loss of a 50 amino, acid ectodomain region and the formation of two subunits (alpha and beta), followed by likely a subunit shedding. TSHR antibodies (TSHR-Abs), which are directed at the ectodomain, may influence thyroid function by stimulating or inhibiting TSHR, signaling or may bind without any such influence (the neutral group of antibodies). When we examined the characteristics of a series of monoclonal TSHR-Abs, we found that many were able to inhibit receptor cleavage and enhance TSHR expression. This was especially apparent with the neutral type of TSHR-Abs directed to the cleaved region of the ectodomain (aa 316-366). Indeed, such inhibition appeared to be epitope dependent with TSHR-Abs directed to regions after residues 335-354 showing no such activity. We propose that this aberrant process, whereby TSHR-Abs influence antigen processing, is a novel mechanism for the maintenance and exacerbation of autoimmune thyroid disease. C1 CUNY Mt Sinai Sch Med, James J Peters VA Med Ctr, Thyroid Res Unit, New York, NY 10029 USA. RP Davies, TF (reprint author), CUNY Mt Sinai Sch Med, James J Peters VA Med Ctr, Thyroid Res Unit, Box 1055,1 Gustave L Levy Pl, New York, NY 10029 USA. EM terry.davies@mssm.edu FU NIDDK NIH HHS [DK069713, DK052464] NR 32 TC 11 Z9 12 U1 0 U2 0 PU SOC ENDOCRINOLOGY PI BRISTOL PA 22 APEX COURT, WOODLANDS, BRADLEY STOKE, BRISTOL BS32 4JT, ENGLAND SN 0022-0795 J9 J ENDOCRINOL JI J. Endocrinol. PD OCT PY 2007 VL 195 IS 1 BP 179 EP 186 DI 10.1677/JOE-07-0058 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 224HX UT WOS:000250439200019 PM 17911409 ER PT J AU Kressin, NR Saha, S Weaver, F Rubenstein, L Weinberger, M AF Kressin, Nancy R. Saha, Somnath Weaver, Frances Rubenstein, Lisa Weinberger, Morris TI Career and time management strategies for clinical and health services researchers SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article ID GENERAL INTERNAL-MEDICINE; INVESTIGATORS C1 Ctr Hlth Qual Outcomes & Econ Res, Dept Vet Affairs, Bedford, MA 01730 USA. Boston Univ, Sch Med, Sect Gen Internal Med, Boston, MA 02215 USA. Portland VA Med Ctr, Sect Gen Internal Med, Portland, OR USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. Hines VA Hosp, Ctr Management Complex Chron Care & Spinal Cord I, Hines, IL USA. Northwestern Univ, Inst Healthcare Studies, Chicago, IL 60611 USA. Sepulveda Ambulatory Care Ctr & Nursing Home, VA Greater Los Angeles Healthcare Syst, VA HSR&D Ctr Excellence Study Healthcare Provider, Sepulveda, CA USA. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. Durham VAMC, Ctr Excellence Hlth Serv Res Primary Care, Durham, NC USA. Univ N Carolina, Dept Hlth Policy & Adm, Chapel Hill, NC 27514 USA. RP Kressin, NR (reprint author), Ctr Hlth Qual Outcomes & Econ Res, Dept Vet Affairs, 200 Springs Rd Bldg 70 152, Bedford, MA 01730 USA. EM nkressin@bu.edu OI Kressin, Nancy/0000-0003-2767-4286 NR 11 TC 0 Z9 0 U1 0 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD OCT PY 2007 VL 22 IS 10 BP 1475 EP 1478 DI 10.1007/s11606-007-0337-7 PG 4 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 213FF UT WOS:000249650900017 PM 17717715 ER PT J AU Maheshwari, S Sarraj, A Kramer, J El-Serag, HB AF Maheshwari, Shail Sarraj, Amrou Kramer, Jennifer El-Serag, Hashem B. TI Oral contraception and the risk of hepatocellular carcinoma SO JOURNAL OF HEPATOLOGY LA English DT Article DE epidemiology; risk factors; meta-analysis; hormones; liver cancer ID PRIMARY LIVER-CANCER; STEROIDS; TUMORS; WOMEN AB Backgrounds/Aims: We performed a meta-analysis of observational epidemiological studies to examine the association between oral contraceptives (OC) and hepatocellular carcinoma (HCC). Methods:Two independent researchers conducted PubMed searches followed by systematic abstraction of studies that compared OC use between patients with HCC and a group of controls. Pooling of ORs was conducted using a random effects model. Heterogeneity and publication bias among studies were examined. Results: Twelve case-control studies that included 739 cases and 5223 controls met the inclusion and exclusion criteria. The pooled estimate of ORs (age- and sex-matched only) from all 12 studies was 1.57 (95% CI = 0.96-2.54, p = 0.07) with a heterogeneity of I-2 = 39.9. Exclusion of one large multi-national European study decreased the heterogeneity to I-2 = 16.9 and increased the pooled OR to 1.70 (95% CI = 1.12-2.59, p = 0.01). Eight studies reported adjusted ORs (in addition to age and sex); the pooled estimate was 1.45 (95% CI = 0.93-2.27, p = 0.11) with a heterogeneity of I-2 = 20.4. Only few studies identified or adjusted for other HCC risk factors. Six studies showed a significant 2- to 20-fold increase in HCC risk with longer durations of OC use; however, the reporting was too inconsistent to allow meta-analysis. Conclusions: The evidence is inconclusive to establish a relation between oral contraceptives and the risk of hepatocellular carcinoma. Future studies should focus on the duration, intermittency, and recency of OC use. (C) 2007 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. C1 Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Hlth Serv Res, Gastroenterol Sect, Houston, TX 77030 USA. RP El-Serag, HB (reprint author), Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Hlth Serv Res, Gastroenterol Sect, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu FU PHS HHS [56338] NR 26 TC 43 Z9 46 U1 1 U2 7 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0168-8278 J9 J HEPATOL JI J. Hepatol. PD OCT PY 2007 VL 47 IS 4 BP 506 EP 513 DI 10.1016/j.jhep.2007.03.015 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 218OQ UT WOS:000250025200013 PM 17462781 ER PT J AU Brau, N Fox, RK Xiao, PY Marks, K Naqvi, Z Taylor, LE Trikha, A Sherman, M Sulkowski, MS Dieterich, DT Rigsby, MO Wright, TL Hernandez, MD Jain, MK Khatri, GK Sterling, RK Bonacini, M Martyn, CA Aytaman, A Llovet, JM Brown, ST Bini, EJ AF Braeu, Norbert Fox, Rena K. Xiao, Peiying Marks, Kristen Naqvi, Zeenat Taylor, Lynn E. Trikha, Anita Sherman, Morris Sulkowski, Mark S. Dieterich, Douglas T. Rigsby, Michael O. Wright, Teresa L. Hernandez, Maria D. Jain, Mamta K. Khatri, Gajendra K. Sterling, Richard K. Bonacini, Maurizio Martyn, Catherine A. Aytaman, Ayse Llovet, Josep M. Brown, Sheldon T. Bini, Edmund J. CA North Amer Liver Canc HIV Study TI Presentation and outcome of hepatocellular carcinoma in HIV-infected patients: A US-Canadian multicenter study SO JOURNAL OF HEPATOLOGY LA English DT Article DE hepatocellular carcinoma; HIV; hepatitis C; hepatitis B; treatment ID HUMAN-IMMUNODEFICIENCY-VIRUS; HEPATITIS-C VIRUS; STAGING-SYSTEM; UNITED-STATES; ANTIRETROVIRAL THERAPY; PROSPECTIVE VALIDATION; FIBROSIS PROGRESSION; PROGNOSTIC FEATURES; COINFECTED PATIENTS; NATURAL-HISTORY AB Background/Aims: HIV-infected patients now live longer and often have complications of liver disease, especially with hepatitis B or C virus coinfection. Limited data are available on those with hepatocellular carcinoma (HCC). Methods:A retrospective analysis from 1992 to 2005 in 6 centers identified 63 HIV-infected HCC patients. Controls were 226 consecutive HIV-negative HCC patients from four sites. Results: HIV-positive patients were younger than controls (52 vs. 64 years, p < 0.001), more commonly had chronic hepatitis B or C (97% vs. 73%, p < 0.001), were more frequently symptomatic (51% vs. 38%, p = 0.048), had a higher median alfa-fetoprotein level (227 vs. 51 ng/ml, p = 0.005), but a similar mean Child-Turcotte-Pugh score (7.0 vs. 7.5, p = 0.05) and HCC staging score (Barcelona-Clinic-Liver-Cancer stages C + D in 50% vs. 58%, p = 0.24). HCC developed faster in HIV/HCV-coinfected than in HCV-monoinfected patients (mean, 26 vs. 34 years after HCV infection, p = 0.002). HIV-positive patients received proven therapy more often (48% vs. 31%, p = 0.017), but median survival was similar (6.9 vs. 7.5 months, p = 0.44). Independent factors predicting survival were symptomatic presentation (hazard ratio [HR], 0.437; p < 0.001), any proven therapy (HR, 2.19; p < 0.001), diagnosis after 01-Jan-2002 (HR, 1.52; p = 0.010), Barcelona-Clinic-Liver-Cancer stages C + D (HR, 0.491; p < 0.001), AST/ALT >= 2.00 (HR, 0.597; p = 0.001), AFP >= 400 ng/mL (HR, 0.55, p = 0.003), and platelets >= 100,000/mm(3) (HR, 0.651; p = 0.012), but not HIV-serostatus (p = 0.19). In HIV-infected patients without HCC therapy (n = 33), median survival was longer with undetectable HIV RNA (<400 copies/mL) than with HIV viremia (6.5 vs. 2.6 months, p = 0.013). Conclusions: HIV-positive HCC patients are younger and more frequently symptomatic and infected with HCV or HBV than HIV-negative patients. Tumor staging and survival are similar. In untreated patients, undetectable HIV RNA independently predicts better survival. (C) 2007 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. C1 Mt Sinai Sch Med, Bronx Vet Affairs Med Ctr, Div Infect Dis & Liver Dis, New York, NY 10029 USA. Mt Sinai Sch Med, Div Infect Dis, New York, NY USA. Mt Sinai Sch Med, Div Liver Dis, New York, NY USA. Univ Calif San Francisco, VA Med Ctr, Sch Med, San Francisco, CA USA. Cornell Univ, Presbyterian Hosp, Weill Coll Med, New York, NY USA. Miriam Hosp, Brown Med Sch, Providence, RI 02906 USA. Univ Turin, Toronto Gen Hosp, Sch Med, Toronto, ON, Canada. Johns Hopkins Sch Med, Baltimore, MD USA. Yale Univ, VA Med Ctr, Sch Med, New Haven, CT USA. Univ Texas, SW Med Ctr, Dallas, TX USA. VA Med Ctr, Salisbury, NC USA. Virginia Commonwealth Univ, Med Coll Virginia, Richmond, VA 23298 USA. Calif Pacific Med Ctr, San Francisco, CA USA. SUNY Downstate Hlth Sci Ctr, VA New York Harbor Hlth Care Syst, Brooklyn, NY USA. NYU, Sch Med, VA New York Harbor Hlth Care Syst, New York, NY USA. RP Brau, N (reprint author), Mt Sinai Sch Med, Bronx Vet Affairs Med Ctr, Div Infect Dis & Liver Dis, New York, NY 10029 USA. EM norbert.brau@va.gov RI Llovet, Josep M /D-4340-2014 OI Llovet, Josep M /0000-0003-0547-2667 NR 36 TC 126 Z9 131 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0168-8278 J9 J HEPATOL JI J. Hepatol. PD OCT PY 2007 VL 47 IS 4 BP 527 EP 537 DI 10.1016/j.jhep.2007.06.010 PG 11 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 218OQ UT WOS:000250025200016 PM 17692986 ER PT J AU Balas, B Belfort, R Harrison, SA Darland, C Finch, J Schenker, S Gastaldelli, A Cusi, K AF Balas, Bogdan Belfort, Renata Harrison, Stephen A. Darland, Celia Finch, Joan Schenker, Steven Gastaldelli, Amalia Cusi, Kenneth TI Pioglitazone treatment increases whole body fat but not total body water in patients with non-alcoholic steatohepatitis SO JOURNAL OF HEPATOLOGY LA English DT Article DE non-alcoholic steatohepatitis (NASH); pioglitazone; total body fat; total body water ID RANDOMIZED CONTROLLED-TRIAL; CONGESTIVE-HEART-FAILURE; PLACEBO-CONTROLLED TRIAL; TYPE-2 DIABETIC-PATIENTS; INSULIN SENSITIVITY; BIOELECTRICAL-IMPEDANCE; GLYCEMIC CONTROL; ENERGY-EXPENDITURE; METFORMIN; THIAZOLIDINEDIONES AB Background/Aims: Non-Alcoholic Steatohepatitis (NASH) is a chronic liver disease frequently associated with insulin resistance and type 2 diabetes mellitus (T2DM). Pioglitazone reverses the metabolic and histological abnormalities of patients with impaired glucose tolerance or T2DM and NASH, but also leads to weight gain. To understand the nature of weight gain associated with pioglitazone treatment in NASH we analyzed 35 patients who completed tests for determination of whole body fat (WBF) and total body water (TBW). Methods: Twenty-one patients received pioglitazone and 14 placebo in a double-blind, randomized fashion for a period of 6 months. WBF and TBW were measured before and after treatment using DXA, a water dilution technique and bioimpedance. Results: Pioglitazone increased body weight (from 93.6 +/- 4.2 to 96.1 +/- 4.5 kg, p < 0.003) and WBF measured with DXA (from 32.9 +/- 2.1 to 35.4 +/- 2.5 kg, p < 0.002) while no changes were seen with placebo. Total body water was not altered significantly either after pioglitazone (from 45.4 +/- 2.3 to 45.6 +/- 2.7 1, p = NS) or placebo. Muscle hydration and extracellular water were unchanged both by pioglitazone and placebo treatments. Conclusions: Six months of pioglitazone treatment in patients with NASH is associated with weight gain that is attributable to an increase in adipose tissue mass and not to water retention. (C) 2007 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Diabet Div, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Med, Div Gastroenterol, San Antonio, TX USA. Audie L Murphy Mem Vet Adm Med Ctr, Diabet Div, San Antonio, TX USA. Audie L Murphy Mem Vet Adm Med Ctr, Div Nutr, San Antonio, TX USA. Brooke Army Med Ctr, Div Gastroenterol, Houston, TX USA. CNR, Inst Clin Physiol, Pisa, Italy. RP Cusi, K (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Diabet Div, Room 3 308S,7703 Floyd Curl Dr, San Antonio, TX 78284 USA. EM cusi@uthscsa.edu RI Gastaldelli, Amalia/H-3319-2014 OI Gastaldelli, Amalia/0000-0003-2594-1651 FU NCRR NIH HHS [M01-RR-01346] NR 50 TC 41 Z9 41 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0168-8278 J9 J HEPATOL JI J. Hepatol. PD OCT PY 2007 VL 47 IS 4 BP 565 EP 570 DI 10.1016/j.jhep.2007.04.013 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 218OQ UT WOS:000250025200020 PM 17560678 ER PT J AU Dellavalle, RP Schilling, LM Rodriguez, MA Van de Sompel, H Bollen, J AF Dellavalle, R. P. Schilling, L. M. Rodriguez, M. A. Van de Sompel, H. Bollen, J. TI The effect of PageRank adjustment on dermatology journal impact factor SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Meeting Abstract CT 37th Annual Meeting of the European-Society-for-Dermatological-Research CY SEP 05-08, 2007 CL Zurich, SWITZERLAND SP European Soc Dermatol Res C1 [Dellavalle, R. P.] Denver VA Med Ctr, Denver, CO USA. [Schilling, L. M.] Univ Colorado, Hlth Sci Ctr, Aurora, CO USA. [Rodriguez, M. A.; Van de Sompel, H.; Bollen, J.] Los Alamos Natl Lab, Los Alamos, NM USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD OCT PY 2007 VL 127 SU 2 BP S27 EP S27 PG 1 WC Dermatology SC Dermatology GA 217FI UT WOS:000249933400163 ER PT J AU Atlas, SA AF Atlas, Steven A. TI The renin-angiotensin aldosterone system: Pathophysiological role and pharmacologic inhibition SO JOURNAL OF MANAGED CARE PHARMACY LA English DT Article DE renin-angiotensin aldosterone system; hypertension; angiotensin II; renin; ACE inhibitors; angiotensin receptor blockers ID ACUTE MYOCARDIAL-INFARCTION; CONVERTING ENZYME-INHIBITORS; LEFT-VENTRICULAR DYSFUNCTION; CORONARY-ARTERY-DISEASE; CHRONIC HEART-FAILURE; HIGH-RISK PATIENTS; ESSENTIAL-HYPERTENSION; RANDOMIZED-TRIAL; CARDIOVASCULAR MORBIDITY; TREATING HYPERTENSION AB BACKGROUND: The renin-angiotensin aldosterone system (RAAS) is a hormonal cascade that functions in the homeostatic control of arterial pressure, tissue perfusion, and extracellular volume. Dysregulation of the RAAS plays an important role in the pathogenesis of cardiovascular and renal disorders. OBJECTIVES: To review the role of the RAAS in the development of hypertensive cardiovascular disease and related conditions and provide an overview of the classes of pharmacologic agents that inhibit this system. RESULTS: The RAAS is initiated by the regulated secretion of renin, the rate-limiting enzyme that catalyzes the hydrolysis of angiotensin (Ang) I from the N-terminus of angiotensinogen. Ang I is in turn hydrolyzed by angiotensin-converting enzyme (ACE) to form Ang II, a potent vasoconstrictor and the primary active product of the RAAS. Recent evidence has suggested that other metabolites of Ang I and II may have biological activity, particularly in tissues. Development of agents that block the RAAS (e.g., beta blockers, ACE inhibitors [ACEIs], and angiotensin receptor blockers [ARBs]) began as a therapeutic strategy to treat hypertension. Preclinical and clinical studies have indicated important additional cardiovascular and renal therapeutic benefits of ACEIs and ARBs. However, blockade of the RAAS with these agents is incomplete. CONCLUSION: Therapeutic approaches that target more complete inhibition of the RAAS may offer additional clinical benefits for patients with cardiovascular and renal disorders. These approaches may include dual blockade using ACEIs and ARBs in combination, or new therapeutic modalities such as direct renin inhibition with aliskiren, recently approved for the treatment of hypertension. C1 CUNY Mt Sinai Sch Med, New York, NY 10029 USA. James J Peters VA Med Ctr, Hypertens Res Lab, Bronx, NY USA. RP Atlas, SA (reprint author), 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM steven.atlas@med.va.gov NR 61 TC 79 Z9 82 U1 2 U2 27 PU ACAD MANAGED CARE PHARMACY PI ALEXANDRIA PA 100 N PITT ST, 400, ALEXANDRIA, VA 22314-3134 USA SN 1083-4087 J9 J MANAGE CARE PHARM JI J. Manag. Care Pharm. PD OCT PY 2007 VL 13 IS 8 SU B BP S9 EP S20 PG 12 WC Health Care Sciences & Services; Pharmacology & Pharmacy SC Health Care Sciences & Services; Pharmacology & Pharmacy GA 228UB UT WOS:000250757000002 ER PT J AU Brickell, KL Leverenz, JB Steinbart, EJ Rumbaugh, M Schellenberg, GD Nochlin, D Lampe, TH Holm, IE Van Deerlin, V Yuan, WX Bird, TD AF Brickell, Kiri L. Leverenz, James B. Steinbart, Ellen J. Rumbaugh, Malia Schellenberg, Gerard D. Nochlin, David Lampe, Thomas H. Holm, Ida E. Van Deerlin, Vivianna Yuan, Wuxing Bird, Thomas D. TI Clinicopathological concordance and discordance in three monozygotic twin pairs with familial Alzheimer's disease SO JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY LA English DT Article ID APOLIPOPROTEIN-E; LEWY BODIES; ONSET; MUTATIONS; DEMENTIA; GENE; CONSORTIUM; DIAGNOSIS; PATHOLOGY; SERIES AB Aim: Neuropathological examination of both individuals in a monozygotic ( MZ) twin pair with Alzheimer's disease ( AD) is rare, especially in the molecular genetic era. We had the opportunity to assess the concordance and discordance of clinical presentation and neuropathology in three MZ twin pairs with AD. Methods: The MZ twins were identified and characterised by the University of Washington Alzheimer's Disease Research Center. We reviewed the available clinical and neuropathological records for all six cases looking specifically for concordance and discordance of clinical phenotype, neuritic amyloid plaques ( NP), neurofibrillary tangles ( NFT) and Lewy related pathology ( LRP). Results: Discordance in age of onset for developing AD in the MZ twins varied from 4 to 18 years. Clinical presentations also differed between twins. One twin presented with a dementia with Lewy Body clinical syndrome while the other presented with typical clinical AD. Neuropathology within the MZ twin pairs was concordant for NP and NFT, regardless of duration of disease, and was discordant for LRP. This difference was most marked in the late onset AD twin pair. One pair was found to have a mutation in presenilin- 1 ( PS1) ( A79V) with remarkably late onset in a family member. Conclusions: MZ twins with AD can vary considerably in age of onset, presentation and disease duration. The concordance of NP and NFT pathological change and the discordance of LRP support the concept that, in AD, the former are primarily under genetic control whereas the latter ( LRP) is more influenced by disease duration and environmental factors. The A79V mutation in PS1 can be associated with very late onset of dementia. C1 GRECC, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Bird, TD (reprint author), GRECC, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM tomnroz@u.washington.edu FU NIA NIH HHS [P01 AG017586, P50 AG005136, P50 AG 005136-22, AG17586] NR 30 TC 31 Z9 33 U1 0 U2 5 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0022-3050 J9 J NEUROL NEUROSUR PS JI J. Neurol. Neurosurg. Psychiatry PD OCT PY 2007 VL 78 IS 10 BP 1050 EP 1055 DI 10.1136/jnnp.2006.113803 PG 6 WC Clinical Neurology; Psychiatry; Surgery SC Neurosciences & Neurology; Psychiatry; Surgery GA 211LB UT WOS:000249524200005 PM 17615170 ER PT J AU Valente, S Murray, L Fisher, D AF Valente, Sharon Murray, Lillian Fisher, Diane TI Nurses improve medication safety with medication allergy and adverse drug reports SO JOURNAL OF NURSING CARE QUALITY LA English DT Article DE adverse drug reactions; documentation; medication allergy; medication safety AB Medicine-related illnesses cost more than $75 billion annually, Adverse drug reactions (ADRs) are the fourth to sixth leading causes of death in the United States. An educational campaign to reduce ADRs and improve documentation included (1) an allergy awareness campaign, (2) staff nurses' training on documentation of allergies/ADRs, (3) patient-oriented brochures to encourage allergy reporting and ADRs, and (4) a fact sheet about ADRs. As a result, the documentation of medication allergies and ADRs improved significantly in our organization. C1 Vet Affairs Greater Losangeles Hearthcare Syst, Los Angeles, CA USA. RP Valente, S (reprint author), 346 N Bowling Green Way, Los Angeles, CA 90073 USA. EM sharon.valente@va.gov NR 9 TC 9 Z9 9 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1057-3631 J9 J NURS CARE QUAL JI J. Nurs. Care Qual. PD OCT-DEC PY 2007 VL 22 IS 4 BP 322 EP 327 PG 6 WC Nursing SC Nursing GA 215TO UT WOS:000249832100006 PM 17873729 ER PT J AU Qaseem, B Shea, J Connor, SR Casarett, D AF Qaseem, Brye Shea, Judy Connor, Stephen R. Casarett, David TI How well are we supporting hospice staff? Initial results of the survey of team attitudes and relationships (STAR) validation study SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Article DE job satisfaction; hospice care; end-of-life care; work environment ID PHYSICIAN JOB-SATISFACTION; PRIMARY-CARE; PERFORMANCE; NURSES; ENVIRONMENT; PREDICTOR; OUTCOMES; SIZE AB Despite the emotional and interpersonal challenges that hospice staff face in providing care to patients near the end of life, no systematic effort has been made to evaluate the work environment that hospices provide to their staff. The aim of this project was to develop a job satisfaction survey that could be used to evaluate the hospice work environment and, ultimately, to guide interventions to improve the work experience for hospice staff. A first draft of the Survey of Team Attitudes and Relationships (STAR) was developed through semi-structured interviews with an interdisciplinary sample of staff from nine hospices, and then refined with input from additional interviews and from an expert panel. The draft was tested on larger samples of staff (n = 160)from six hospices and revised with input from, the expert panel. The final survey was tested with 599 staff from 10 hospices. The final survey contains 45 items in six domains: individual work rewards, teamwork, management support, organizational support, workload issues, and global assessment of job satisfaction. Items had excellent psychometric characteristics, with acceptable floor and ceiling effects. The overall STAR had a Cronbach's alpha of 0.93, indicating good homogeneity, and each domain had alpha values that are appropriate for between-group comparisons (range 0.74-0.84). These results suggest that the STAR offers a unique instrument to measure the work environment hospices provide to their staff. C1 Univ Penn, Ctr Hlth Equ Res & Promot, VAMC Res, Philadelphia, PA 19104 USA. Univ Penn, Dept Med, Philadelphia, PA 19104 USA. Natl Hosp & Palliat Care Org, Alexandria, VA USA. RP Casarett, D (reprint author), Univ Penn, Ctr Hlth Equ Res & Promot, VAMC Res, 3615 Chestnut St, Philadelphia, PA 19104 USA. EM casarett@mail.med.upenn.edu OI Connor, Stephen/0000-0003-0332-2067 NR 39 TC 5 Z9 5 U1 1 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0885-3924 J9 J PAIN SYMPTOM MANAG JI J. Pain Symptom Manage. PD OCT PY 2007 VL 34 IS 4 BP 350 EP 358 DI 10.1016/j.jpainsymman.2007.06.003 PG 9 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 220MA UT WOS:000250159600005 PM 17716854 ER PT J AU Duffy, SA Copeland, LA Hopp, FP Zalenski, RJ AF Duffy, Sonia A. Copeland, Laurel A. Hopp, Faith P. Zalenski, Robert J. TI Diagnostic classifications and resource utilization of decedents served by the department of veterans affairs SO JOURNAL OF PALLIATIVE MEDICINE LA English DT Article ID DEPRESSIVE SYMPTOMS; ADVANCE DIRECTIVES; SOCIAL SUPPORT; LIFE; CARE; PREFERENCES; ETHNICITY; END; ATTITUDES; SMOKING AB Background: Given the volume and cost of inpatient care during the last year of life, there is a critical need to identify patterns of dying as a means of planning end-of-life care services, especially for the growing number of older persons who receive services from the Veterans Health Administration (VHA). Methods: A retrospective computerized record review was conducted of 20,933 VHA patients who died as inpatients between October 1, 2001 and September 30, 2002. Diagnoses were aggregated into one of five classification patterns of death and analyzed in terms of health care resource utilization ( mean number of inpatient days and cumulative outpatient visits in the year preceding the patient's death). Results: Cancer deaths were the most common (30.4%) followed by end-stage renal disease (ESRD) (23.2%), cardiopulmonary failure (21.4%), frailty (11.6%), "other" diagnoses (7.3%), and sudden deaths (6.1%). Those with ESRD were more likely to be male and nonwhite (p < 0.05) and those with frailty were more likely to be older and married (p < 0.05). Controlling for demographic variables, those with frailty had the highest number of inpatient days while those with ESRD had the highest number of outpatient visits. Nonmarried status was associated with more inpatient days, especially among younger decedents. Conclusion: As a recognized leader in end-of-life care, the VHA can play a unique role in the development of specific interventions that address the diverse needs of persons with different dying trajectories identified through this research. C1 VA Ctr Clin Management Res, Hlth Serv Res & Dev, Ann Arbor, MI USA. Univ Michigan, Ann Arbor, MI 48109 USA. S Texas Vet Hlth Care Syst VERDICT HSR, Dept Vet Affairs, San Antonio, TX USA. Wayne State Univ, Sch Social Work, Detroit, MI 48202 USA. Wayne State Univ, Sch Med, Ctr Adv Palliat Care Excellence, Dept Emergency Med, Detroit, MI 48202 USA. Wayne State Univ, Ctr Adv Palliat Care Excellence, Detroit, MI 48202 USA. RP Duffy, SA (reprint author), VA HSR&D Ctr Clin Management Res, VA Ann Arbor Heathcare Syst, Dept Vet Affairs, PO Box 130170, Ann Arbor, MI 48113 USA. OI Hopp, Faith/0000-0002-4536-3089; Copeland, Laurel/0000-0002-9478-0209 NR 39 TC 7 Z9 7 U1 3 U2 10 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1096-6218 J9 J PALLIAT MED JI J. Palliat. Med. PD OCT PY 2007 VL 10 IS 5 BP 1137 EP 1145 DI 10.1089/jpm.2006.0256 PG 9 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 233JB UT WOS:000251086100023 PM 17985970 ER PT J AU Knight, SJ Emanuel, L AF Knight, Sara J. Emanuel, Linda TI Processes of adjustment to end-of-life losses: A reintegration model SO JOURNAL OF PALLIATIVE MEDICINE LA English DT Review ID TERMINALLY-ILL PATIENTS; PSYCHOLOGICAL CONSIDERATIONS; SELF-TRANSCENDENCE; PALLIATIVE CARE; BAD-NEWS; DEATH; APPRAISAL; QUALITY; HEALTH; AGE AB The processes surrounding psychological adjustment to losses due to advancing and end-stage illness have not been well delineated. While adjustment to losses due to death are often thought of as the bereaved's lot, dying persons experience multiple, accumulating, and profound losses of functions, abilities, roles, and relationships and therefore have to adjust as well. Many people who are facing death in the near future negotiate these losses, still achieving quality of life in all dimensions. Others fare less well. It is hard to intervene helpfully without a clear understanding of how either trajectory occurs. Building from current literature on loss and adjustment, we describe a conceptual framework of key adjustment processes that allow for quality of life during terminal illness. We term this the reintegration model. It has comprehension, creative adaptation and reintegration components, each involving the physical, psychological, social, and existential domains in ways that are characteristic of the needs, tasks and options available to a seriously ill and dying person. In this paper, we discuss the model, focusing on normal adjustment processes, and describe the implications of the framework for the dying person, caregivers, and the palliative care team. C1 Univ Calif San Francisco, San Francisco VA Med Ctr, Dept Psychiat, San Francisco, CA 94143 USA. Univ Calif San Francisco, San Francisco VA Med Ctr, Dept Urol, San Francisco, CA 94143 USA. Northwestern Univ, Buehler Ctr Aging Hlth & Soc, Chicago, IL 60611 USA. RP Knight, SJ (reprint author), Univ Calif San Francisco, San Francisco VA Med Ctr, Dept Psychiat, San Francisco, CA 94143 USA. EM sara.knight@ucsf.edu NR 61 TC 26 Z9 26 U1 0 U2 2 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1096-6218 J9 J PALLIAT MED JI J. Palliat. Med. PD OCT PY 2007 VL 10 IS 5 BP 1190 EP 1198 DI 10.1089/jpm.2006.0068 PG 9 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 233JB UT WOS:000251086100028 PM 17985975 ER PT J AU Tkachenko, MA Zhannat, NZ Erman, LV Blashenkova, EL Isachenko, SV Isachenko, OB Graham, DY Malaty, HM AF Tkachenko, Mikhail A. Zhannat, Nurgalieva Z. Erman, Lev V. Blashenkova, Elena L. Isachenko, Sergey V. Isachenko, Olga B. Graham, David Y. Malaty, Hoda M. TI Dramatic changes in the prevalence of Helicobacter pylori infection during childhood: A 10-year follow-up study in Russia SO JOURNAL OF PEDIATRIC GASTROENTEROLOGY AND NUTRITION LA English DT Article DE Helicobacter pylori infection; epidemiology; Russia; transmission; childhood ID SOCIOECONOMIC-STATUS; GASTRIC-CANCER; PERUVIAN CHILDREN; BIRTH COHORT; AGE; RISK; EPIDEMIOLOGY; ACQUISITION; ASSOCIATION; ADULTS AB Background: The prevalence and rate of acquisition of Helicobacter pylori infection in children from developing countries is higher than in developed countries. This phenomenon has been related to differences in socioeconomic status, sanitation, and household hygiene. Russia is in the process of transforming from an underdeveloped to a developed country. Aim: To examine the effect of recent improvements in standards of living on the prevalence of H pylori in Russian children. Patients and Methods: We conducted 2 cross-sectional studies among children in St Petersburg, Russia. The first study was conducted in 1995 and the second was conducted a decade later. H pylori status was evaluated by the same enzyme-linked immunoassay method for anti-H pylori immunoglobulin G. Demographic data were obtained from each individual, and socioeconomic class was assessed by the education level of the mother and family income. Results: In 1995 the overall prevalence of H pylori infection was 44%; 10 years later it had decreased to 13%. In both studies, the prevalence increased with age. In 1995 the prevalence was 30% among children younger than 5 years. A decade later the prevalence in the same age group was 2% (P=0.001). The age-specific prevalence of H pylori infection increased significantly with age in both study periods. During 1995 the prevalence of the infection increased from 30% at age < 5 years to 48% in the age group 15 to 19 years (P = 0.001). In the 2005 study the prevalence of the infection increased from 2% at age < 5 years to 25% in the age group 15 to 19 years (P = 0.00 1). The crude and the age-adjusted odds ratio risk of infection in children showed an inverse correlation between the mothers' and fathers' educational levels and H pylori seropositivity (OR 1.8, 95% Cl 1-3.2; P = 0.06). No associations were found between the prevalence of H pylori and any factor tested, including sex, type of dwelling, income, or the number of people living in the home. Conclusions: Improvements in standards of living in Russia have resulted in a marked reduction in H pylori transmission. Different rates of acquisition of Hpylori form the basis for the differences in prevalence of infection between and among populations. The change in the prevalence of H pylori within 10 years among the Russian population is an example of how sensitive Hpylori acquisition is to improvement in standards of living. Increased use of anti-H pylori eradication therapy played an important role in the reduction of the prevalence of Hpylori infection. JPGN 45:428-432, 2007. C1 Vet Affairs Med Ctr 111D, Dept Med, Houston, TX 77030 USA. St Petersburg State Pediat Med Acad, Dept Pediat 1, St Petersburg, Russia. St Petersburg State Pediat Med Acad, Div Otorhinolaryngol, Med Ctr Children 2, St Petersburg, Russia. Baylor Coll Med, Houston, TX 77030 USA. RP Malaty, HM (reprint author), Vet Affairs Med Ctr 111D, Dept Med, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM Hmalaty@bcm.tmc.edu NR 30 TC 55 Z9 59 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0277-2116 J9 J PEDIATR GASTR NUTR JI J. Pediatr. Gastroenterol. Nutr. PD OCT PY 2007 VL 45 IS 4 BP 428 EP 432 PG 5 WC Gastroenterology & Hepatology; Nutrition & Dietetics; Pediatrics SC Gastroenterology & Hepatology; Nutrition & Dietetics; Pediatrics GA 212OQ UT WOS:000249607100007 PM 18030208 ER PT J AU Putterman, DB Munhall, AC Kozell, LB Belknap, JK Johnson, SW AF Putterman, Daniel B. Munhall, Adam C. Kozell, Laura B. Belknap, John K. Johnson, Steven W. TI Evaluation of levodopa dose and magnitude of dopamine depletion as risk factors for levodopa-induced dyskinesia in a rat model of Parkinson's disease SO JOURNAL OF PHARMACOLOGY AND EXPERIMENTAL THERAPEUTICS LA English DT Article ID ABNORMAL INVOLUNTARY MOVEMENTS; NMDA RECEPTOR SUBUNITS; MOTOR FLUCTUATIONS; STRIATAL LESIONS; MESSENGER-RNA; 6-OHDA LESION; EXPRESSION; INCREASE; PRODYNORPHIN; STIMULATION AB Levodopa dose and severity of Parkinson's disease (PD) are recognized risk factors for levodopa-induced dyskinesia ( LID) in humans. The purpose of the present study was to evaluate the ability of these variables to predict severity of LID in a rat model of PD. Varied concentrations of 6-hydroxy-dopamine were injected into the midbrain to produce wide ranges of dopamine depletion in striatum. Three weeks later, rats were given daily injections of levodopa (2-10 mg/kg i.p.) plus benserazide (12.5 mg/kg i.p.) for 15 days. Abnormal involuntary movements (AIMs) were measured for limb, axial, orolingual, and rotatory movements. Dose-response analysis for total AIM scores yielded a levodopa ED50 value of 3.2 mg/kg on treatment day 15. There were strong interrelated correlations between individual AIM categories (rho > 0.7) and for each AIM category in regard to total AIM score (rho > 0.7). In rats that received levodopa doses that were greater than the ED50, rates of amphetamine-induced rotation were significantly correlated with total AIM scores (rho=0.413). However, of those rotating > 5 times/min, 34% had relatively low AIM scores (< 8). Likewise, there was a significant correlation between percentages of tyrosine hydroxylase (TH) loss and total AIM scores (rho=0.388). However, in those rats that had > 85% TH loss, 30% had AIM scores < 8. Our results show that given an adequate dose and magnitude of striatal dopamine depletion, levodopa produces dyskinesia with a continuous spectrum of severity. Although levodopa dose and level of dopamine depletion are significant risk factors for LID, we conclude that other factors must contribute to LID susceptibility. C1 Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Behav Neurosci, Portland, OR 97201 USA. RP Johnson, SW (reprint author), Portland VA Med Ctr, Res Serv, RD-61,3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. EM johnsost@ohsu.edu OI Kozell, Laura/0000-0003-3059-2046 FU NINDS NIH HHS [NS38715, R01 NS038715] NR 41 TC 39 Z9 40 U1 1 U2 2 PU AMER SOC PHARMACOLOGY EXPERIMENTAL THERAPEUTICS PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3995 USA SN 0022-3565 J9 J PHARMACOL EXP THER JI J. Pharmacol. Exp. Ther. PD OCT PY 2007 VL 323 IS 1 BP 277 EP 284 DI 10.1124/jpet.107.126219 PG 8 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 212IF UT WOS:000249588900032 PM 17660384 ER PT J AU Bouali, H Nietert, P Nowling, TM Pandey, J Dooley, MA Cooper, G Harley, J Kamen, DL Oates, J Gilkeson, G AF Bouali, Henda Nietert, Paul Nowling, Tamara M. Pandey, Janardan Dooley, Mary Anne Cooper, Glinda Harley, John Kamen, Diane L. Oates, Jim Gilkeson, Gary TI Association of the G-463A myeloperoxidase gene polymorphism with renal disease in African Americans with systemic lupus erythematosus SO JOURNAL OF RHEUMATOLOGY LA English DT Article DE systemic lupus erythematosus; myeloperoxidase; polymorphism; African American; lupus nephritis ID NITRIC-OXIDE SYNTHASE; PROMOTER POLYMORPHISMS; RISK; MICE; DNA; ATHEROSCLEROSIS; PEROXIDASES; EXPRESSION; KIDNEY; MPO AB Objective. Myeloperoxidase (MPO) is an enzyme expressed in neutrophils that is involved in tissue damage in inflammatory renal diseases. A functional G to A single-nucleotide polymorphism (SNP) is present at position -463 of the MPO promoter region and is associated with altered MPO expression. We hypothesized that the G-463A MPO SNP is a risk factor for developing lupus nephritis (LN) due to its potential influence on the inflammatory response. Methods. DNA from 229 patients with SLE and 277 controls from the Carolina Lupus cohort, 58 African American patients from the Sea Island Lupus Cohort, and 51 African American patients from the Lupus Multiplex Registry and Repository were genotyped by PCR. A linear regression model was used to examine relationships between the MPO genotype, case/control status, demographic characteristics, and LN. Results. There was no association of MPO genotype with systemic lupus erythematosus (SLE). However, the odds of developing LN were significantly higher among those with an A allele, compared to those without, in African American cases of all 3 cohorts. When the likelihood of developing LN was compared across MPO genotypes, the risk of developing LN was significantly higher among cases with a GA genotype versus GG (OR 2.11, 95% CI 1.12 to 3.97) and even higher with AA versus GG (OR 3.52, 95% CI 1.41 to 8.77). Conclusion. While the G-463A MPO SNP is not a risk factor for developing SLE, the low expressing A allele is a significant risk factor for developing LN that is gene dosage-dependent in African Americans. C1 Med Univ S Carolina, Dept Med, Div Rheumatol, Charleston, SC 29425 USA. Univ N Carolina, Affiliated Hosp, Dept Med, Chapel Hill, NC 27515 USA. Natl Inst Environm Hlth Sci, Res Triangle Pk, NC USA. Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Gilkeson, G (reprint author), Med Univ S Carolina, Dept Med, Div Rheumatol, 96 Jonathan Lucas St,Suite 912,POB 250623, Charleston, SC 29425 USA. EM gilkeson@musc.edu OI Nietert, Paul/0000-0002-3933-4986 FU NCRR NIH HHS [M01 RR001070, M01 RR001070-220263, M01 RR001070-230263, M01 RR001070-240263, M01 RR001070-24S50263, M01 RR001070-25A10263, M01 RR001070-25A1S10263, M01 RR001070-25A1S20263, M01 RR001070-260263, M01 RR001070-270263, M01 RR001070-280263]; NIAMS NIH HHS [P60 AR049459, AR47469, P30 AR053483] NR 49 TC 15 Z9 18 U1 0 U2 0 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD OCT PY 2007 VL 34 IS 10 BP 2028 EP 2034 PG 7 WC Rheumatology SC Rheumatology GA 217OB UT WOS:000249956100015 PM 17896805 ER PT J AU McGory, ML Zingmond, DS Tillou, A Hiatt, JR Ko, CY Cryer, HM AF McGory, Marcia L. Zingmond, David S. Tillou, Areti Hiatt, Jonathan R. Ko, Clifford Y. Cryer, Henry M. TI Negative appendectomy in pregnant women is associated with a substantial risk of fetal loss SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Article ID SUSPECTED ACUTE APPENDICITIS; LAPAROSCOPIC APPENDECTOMY; DIAGNOSTIC-ACCURACY; MANAGEMENT; OUTCOMES; SURGERY AB Background: The preoperative diagnosis of acute appendicitis is often inaccurate in pregnant women, and complicated appendicitis is associated with a high rate of fetal loss. The study objective was to evaluate rates of fetal loss and early delivery in pregnant patients undergoing appendectomy, using a large population-based database. Study Design: Using the California Inpatient File, we retrospectively analyzed all women undergoing appendectomy between 1995 and 2002 for pregnancy, diagnosis, operative technique, fetal loss, and early delivery during the same hospitalization as appendectomy. Results: Of 94,789 women who underwent appendectomy, 3,133 were pregnant. Complicated appendicitis was found in 30% of pregnant women and 29% of nonpregnant women (p = NS). The rate of negative appendectomy was considerably higher in pregnant compared with nonpregnant women (23% versus 18%, p < 0.05). Rates of fetal loss and early delivery were considerably higher in women with complex appendicitis (6% and 11% respectively; p < 0.05) in comparison with negative (4% and 10%) and simple (2% and 4%) appendicitis. Using multivariate logistic regression, complicated and negative appendicitis (odds ratio [OR] 2.69 and 1.88 respectively, compared with simple) remained major positive predictors of fetal loss. Also, laparoscopy was associated with a higher rate of fetal loss compared with open appendectomy (odds ratio = 2.31). Conclusions: The current approach to possible acute appendicitis in pregnant women puts 23% at risk for fetal loss, even though they have a normal appendix. These data indicate that reducing fetal loss in pregnant women suspected of having acute appendicitis will require more accurate diagnosis to avoid unnecessary operation. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Ctr Surg Outcomes & Qual, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Gen Internal Med & Hlth Serv Res, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA USA. RP McGory, ML (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Ctr Hlth Sci 72 215, 10833 Le Conte Ave,Box 956904, Los Angeles, CA 90095 USA. NR 30 TC 76 Z9 85 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1072-7515 J9 J AM COLL SURGEONS JI J. Am. Coll. Surg. PD OCT PY 2007 VL 205 IS 4 BP 534 EP 540 DI 10.1016/j.jamcollsurg.2007.05.025 PG 7 WC Surgery SC Surgery GA 222QP UT WOS:000250312300002 PM 17903726 ER PT J AU Bilimoria, KY Bentrem, DJ Merkow, RP Tomlinson, JS Stewart, AK Ko, CY Talamonti, MS AF Bilimoria, Karl Y. Bentrem, David J. Merkow, Ryan P. Tomlinson, James S. Stewart, Andrew K. Ko, Clifford Y. Talamonti, Mark S. TI Application of the pancreatic adenocarcinoma staging system to pancreatic neuroendocrine tumors SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Article ID LONG-TERM SURVIVAL; ENDOCRINE TUMORS; CLASSIFICATION; SURGERY AB Background: The American Joint Committee on Cancer (AJCC) 6(th) edition staging system for pancreatic adenocarcinoma specifically excludes pancreatic neuroendocrine tumors (PNETs), and a widely accepted staging classification does not exist. Our objective was to evaluate the feasibility of applying the AJCC pancreatic adenocarcinoma staging system to PNETs. Study Design: Patients with PNETs were identified from the National Cancer Data Base (1985 to 2004). Overall survival was estimated using the Kaplan-Meier method and compared using the logrank test. Cox proportional hazards modeling was used to evaluate the effect of tumor size, nodal status, and distant metastases on survival. Results: Of 4,793 patients with PNETs, 93.6% were of islet cell origin, and 6.4% were carcinoid tumors; 1,815 (37.9%) underwent resection. Overall 5-year survival rates were 29.2% for all patients, 55.4% for resected patients, and 15.6% for unresected patients. The AJCC staging system provided good prognostic survival discrimination between stage groups for resected patients (p < 0.0001). When comparing outcomes to those of patients with pancreatic adenocarcinoma, the estimated median survival was significantly better for resected patients with PNETs (60 versus 13 months, p < 0.0001). Distant metastasis was the only independent predictor of survival (p < 0.0001). Conclusions: When applied to PNETs, the AJCC staging system for pancreatic adenocarcinoma provides survival discrimination by stage for surgical and nonsurgical patients. Survival rates are better for PNETs than for pancreatic adenocarcinoma, but the staging system can effectively stratify patients with PNETs. C1 Northwestern Univ, Feinberg Sch Med, Dept Surg, Chicago, IL 60611 USA. Amer Coll Surg, Canc Programs, Chicago, IL USA. Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Talamonti, MS (reprint author), NW Mem Hosp, Dept Surg, Div Surg Oncol, 675 N St Clair St,Galter 10-105, Chicago, IL 60611 USA. NR 21 TC 54 Z9 55 U1 0 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1072-7515 J9 J AM COLL SURGEONS JI J. Am. Coll. Surg. PD OCT PY 2007 VL 205 IS 4 BP 558 EP 563 DI 10.1016/j.jamcollsurg.2007.05.009 PG 6 WC Surgery SC Surgery GA 222QP UT WOS:000250312300005 PM 17903729 ER PT J AU Fried, LF Boudreau, R Lee, JS Chertow, G Kurella-Tamura, M Shlipak, MG Ding, J Sellmeyer, D Tylavsky, FA Simsonick, E Kritchevsky, SB Harris, TB Newman, AB AF Fried, Linda F. Boudreau, Robert Lee, Jung Sun Chertow, Glenn Kurella-Tamura, Manjula Shlipak, Michael G. Ding, Jingzhong Sellmeyer, Deborah Tylavsky, Frances A. Simsonick, Eleanor Kritchevsky, Stephen B. Harris, Tamara B. Newman, Anne B. CA Hlth, Aging Body Composition Study TI Kidney function as a predictor of loss of lean mass in older adults: Health, aging and body composition study SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE kidney function; elderly; weight loss; body composition; sarcopenia ID MUSCLE PROTEIN BREAKDOWN; CHRONIC-RENAL-FAILURE; SKELETAL-MUSCLE; WEIGHT-LOSS; HEMODIALYSIS-PATIENTS; NUTRITIONAL-STATUS; DISEASE; INFLAMMATION; MORTALITY; MEN AB OBJECTIVES: To assess the association between kidney function and change in body composition in older individuals. DESIGN: Prospective cohort study. SETTING: Two sites, Pittsburgh, Pennsylvania, and Memphis, Tennessee. PARTICIPANTS: Three thousand twenty-six well-functioning, participants aged 70 to 79 in the Health, Aging and Body Composition Study. MEASUREMENTS: Body composition (bone-free lean mass and fat mass) was measured using dual x-ray absorptiometry annually for 4 years. Kidney function was measured at baseline according to serum creatinine (SCr). Comorbidity and inflammatory markers were evaluated as covariates in mixed-model, repeated-measures analysis. RESULTS: High SCr was associated with loss of lean mass in men but not women, with a stronger relationship in black men (P=.02 for difference between slopes for white and black men). In white men, after adjustment for age and comorbidity, higher SCr remained associated with loss of lean mass (-0.07 +/- 0.03 kg/y greater loss per 0.4 mg/dL (1 standard deviation (SD)), P=.009) but was attenuated after adjustment for inflammatory factors (-0.05 +/- 0.03 kg/y greater loss per SD, P=.10). In black men, the relationship between SCr and loss of lean mass (-0.19 +/- 0.04 kg/y per SD, P <.001) persisted after adjustment for inflammation and overall weight change. CONCLUSION: Impaired kidney function may contribute to loss of lean mass in older men. Inflammation appeared to mediate the relationship in white but not black men. Future studies should strive to elucidate mechanisms linking kidney disease and muscle loss and identify treatments to minimize loss of lean mass and its functional consequences. C1 VA Pittsburgh Healthcare Syst, Renal Sect, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Renal Electrolyte Div, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Div Geriatr Med, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA USA. Univ Georgia, Dept Foods & Nutr, Athens, GA 30602 USA. Univ Calif San Francisco, Div Endocrinol & Metab, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Med, Div Nephrol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, Div Nephrol, San Francisco, CA 94143 USA. Vet Affairs Med Ctr, Gen Internal Med Sect, San Francisco, CA 94121 USA. Univ Tennessee, Dept Biostat & Epidemiol, Memphis, TN USA. NIA, NIH, Bethesda, MD 20892 USA. Wake Forest Univ, Sch Med, Sticht Ctr Aging, Winston Salem, NC 27109 USA. RP Fried, LF (reprint author), VA Pittsburgh Healthcare Syst, Renal Sect, Univ Dr,Mailstop 111F-U, Pittsburgh, PA 15240 USA. EM Linda.Fried@va.gov RI Newman, Anne/C-6408-2013; Kurella Tamura, Manjula/C-8284-2014 OI Newman, Anne/0000-0002-0106-1150; Kurella Tamura, Manjula/0000-0001-5227-2479; Boudreau, Robert/0000-0003-0162-5187; Kritchevsky, Stephen/0000-0003-3336-6781 FU Intramural NIH HHS; NIA NIH HHS [N01-AG-6-2101, N01-AG-6-2103, N01-AG-6-2106] NR 31 TC 13 Z9 13 U1 0 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 IS 10 BP 1578 EP 1584 DI 10.1111/j.1532-5415.2007.01398.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 215RA UT WOS:000249825500011 PM 17908060 ER PT J AU Sayers, SL Hanrahan, N Kutney, A Clarke, SP Reis, BF Riegel, B AF Sayers, Steven L. Hanrahan, Nancy Kutney, Ann Clarke, Sean P. Reis, Brendali F. Riegel, Barbara TI Psychiatric comorbidity and greater hospitalization risk, longer length of stay, and higher hospitalization costs in older adults with heart failure SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE heart failure; psychiatric comorbidity; depression; hospitalization costs; economic analysis; Medicare; sex; socioeconomic status; race/ethnicity ID PRIMARY-CARE; LATE-LIFE; DEPRESSION; PREVALENCE; DISORDERS; DIAGNOSIS; MORTALITY; BIAS AB OBJECTIVES: To explore associations between psychiatric comorbidity and rehospitalization risk, length of hospitalization, and costs. DESIGN: Cross-sectional study of 1-year hospital administrative data. SETTING: Claims-based study of older adults hospitalized in the United States. PARTICIPANTS: Twenty-one thousand four hundred twenty-nine patients from a 5% national random sample of U.S. Medicare beneficiaries aged 65 and older, with at least one acute care hospitalization in 1999 with a Diagnostic-Related Group of congestive heart failure. MEASUREMENTS: The number of hospitalizations, mean length of hospital stay, and total hospitalization costs in calendar year 1999. RESULTS: Overall, 15.8% of patients hospitalized for heart failure (HF) had a coded psychiatric comorbidity; the most commonly coded comorbid psychiatric disorder was depression (8.5% of the sample). Most forms of psychiatric comorbidity were associated with greater inpatient utilization, including risk of additional hospitalizations, days of stay, and hospitalization charges. Additional hospitalization costs associated with psychiatric comorbidity ranged up to $7,763, and additional days length of stay ranged up to 1.4 days. CONCLUSIONS: Psychiatric comorbidity appears in a significant minority of patients hospitalized for HF and may affect their clinical and economic outcomes. The associations between psychiatric comorbidity and use of inpatient care are likely to be an underestimate, because psychiatric illness is known to be underdetected in older adults and in hospitalized medical patients. C1 Vet Affairs Med Ctr, VISN Mental Illness Res Educ & Clin Ctr 4, Philadelphia, PA 19104 USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Hlth Outcomes & Policy Res, Philadelphia, PA 19104 USA. Univ Penn, Sch Nursing, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Widener Univ, Inst Grad Clin Psychol, Philadelphia, PA USA. RP Sayers, SL (reprint author), Vet Affairs Med Ctr, VISN Mental Illness Res Educ & Clin Ctr 4, MIRECC 116,3900 Woodland Ave, Philadelphia, PA 19104 USA. EM steven.sayers@va.gov FU NINR NIH HHS [P30-NR-005043, T32-NR-007104] NR 30 TC 36 Z9 37 U1 0 U2 2 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 IS 10 BP 1585 EP 1591 DI 10.1111/j.1532-5415.2007.01368.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 215RA UT WOS:000249825500012 PM 17714458 ER PT J AU Arora, VM McGory, ML Fung, CH AF Arora, Vineet M. McGory, Marcia L. Fung, Constance H. TI Quality indicators for hospitalization and surgery in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Review DE quality indicators; hospitalization; surgery; vulnerable elders ID COMMUNITY-ACQUIRED PNEUMONIA; CONFUSION ASSESSMENT METHOD; INTENSIVE-CARE-UNIT; MAJOR NONCARDIAC SURGERY; MECHANICALLY VENTILATED PATIENTS; INDWELLING URINARY CATHETERS; PROSPECTIVE PAYMENT SYSTEM; SURGICAL SITE INFECTIONS; FATAL PULMONARY-EMBOLISM; CORONARY-ARTERY DISEASE C1 Univ Chicago, Dept Med, Chicago, IL 60637 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Ctr Surg Outcomes & Qual, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RAND Corp, Santa Monica, CA USA. RP Arora, VM (reprint author), Univ Chicago, Dept Med, 5841 S Maryland Ave,MC 2007 W216, Chicago, IL 60637 USA. EM varora@medicine.bsd.uchicago.edu OI Arora, Vineet/0000-0002-4745-7599 NR 125 TC 26 Z9 26 U1 6 U2 8 PU WILEY-BLACKWELL PI HOBOKEN PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA SN 0002-8614 EI 1532-5415 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S347 EP S358 DI 10.1111/j.1532-5415.2007.01342.x PG 12 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400014 PM 17910557 ER PT J AU Bates-Jensen, BM MacLean, CH AF Bates-Jensen, Barbara M. MacLean, Catherine H. TI Quality indicators for the care of pressure ulcers in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Review DE pressure ulcer prevention; pressure ulcer treatment; quality indicators ID NURSING-HOME RESIDENTS; RISK-ASSESSMENT SCALES; RANDOMIZED TRIAL; CHRONIC WOUNDS; HYDROCOLLOID DRESSINGS; COST-EFFECTIVENESS; INTENSIVE-CARE; HEALTH-CARE; SORES; DEBRIDEMENT C1 VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. RAND Hlth, Santa Monica, CA USA. RP Bates-Jensen, BM (reprint author), VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, 16111 Plummer St 11E, Sepulveda, CA 91343 USA. EM bbatesjensen@sonnet.ucla.edu NR 126 TC 9 Z9 9 U1 3 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S409 EP S416 DI 10.1111/j.1532-5415.2007.01349.x PG 8 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400021 PM 17910564 ER PT J AU Chang, JT Ganz, DA AF Chang, John T. Ganz, David A. TI Quality indicators for falls and mobility problems in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Review DE quality indicators; quality of care; falls; mobility problems; gait; instability; balance; exercise; elderly; vulnerable elders ID RANDOMIZED CONTROLLED-TRIAL; LOWER-EXTREMITY STRENGTH; HOME-BASED EXERCISE; TAI-CHI EXERCISE; OLDER-ADULTS; RISK-FACTORS; PREVENT FALLS; VITAMIN-D; INJURIOUS FALLS; MULTIFACTORIAL INTERVENTION C1 Univ Calif Los Angeles, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Specialty Training & Adv Res Program, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. RP Chang, JT (reprint author), Univ Calif Los Angeles, Div Gen Internal Med & Hlth Serv Res, 911 Broxton Ave,3rd Floor, Los Angeles, CA 90095 USA. EM jtchang@ucla.edu NR 108 TC 38 Z9 40 U1 6 U2 10 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S327 EP S334 DI 10.1111/j.1532-5415.2007.01339.x PG 8 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400011 PM 17910554 ER PT J AU Cheng, EM Fung, CH AF Cheng, Eric M. Fung, Constance H. TI Quality indicators for the care of stroke and atrial fibrillation in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE stroke; atrial fibrillation; quality indicators ID ACUTE ISCHEMIC-STROKE; AMERICAN-HEART-ASSOCIATION; PLACEBO-CONTROLLED TRIAL; ACADEMY-OF-NEUROLOGY; HIGH-RISK PATIENTS; TISSUE-PLASMINOGEN ACTIVATOR; RANDOMIZED CONTROLLED-TRIALS; THROMBOLYTIC THERAPY; ANTITHROMBOTIC THERAPY; OCCUPATIONAL-THERAPY C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Neurol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RAND Corp, Santa Monica, CA USA. RP Cheng, EM (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Dept Neurol, 11301 Wilshire Blvd,ML 127,B500, Los Angeles, CA 90073 USA. EM Eric.Cheng@va.gov NR 72 TC 5 Z9 5 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S431 EP S437 DI 10.1111/j.1532-5415.2007.01352.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400024 PM 17910567 ER PT J AU Etzioni, S Chodosh, J Ferrell, BA MacLean, CH AF Etzioni, Shiri Chodosh, Joshua Ferrell, Bruce A. MacLean, Catherine H. TI Quality indicators for pain management in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE pain management; quality of care; process measures ID CANCER PAIN; NURSING-HOME; GENERAL-POPULATION; OLDER PERSONS; PREVALENCE; HEALTH; GUIDELINES; COMPLAINTS; RESIDENTS; EDUCATION C1 RAND Hlth Corp, Santa Monica, CA 90407 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Wellpoint Inc, Programs Clin Excellence, Thousand Oaks, CA USA. RP MacLean, CH (reprint author), RAND Hlth Corp, 1776 Main St,M4337, Santa Monica, CA 90407 USA. EM maclean@rand.org OI Chodosh, Joshua/0000-0001-7784-4306 NR 52 TC 10 Z9 10 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S403 EP S408 DI 10.1111/j.1532-5415.2007.01348.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400020 PM 17910563 ER PT J AU Feil, DG MacLean, C Sultzer, D AF Feil, Denise G. MacLean, Catherine Sultzer, David TI Quality indicators for the care of dementia in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Review DE dementia; cognitive screening; quality indicators; health care ID SEVERE ALZHEIMERS-DISEASE; ACADEMY-OF-NEUROLOGY; RANDOMIZED CONTROLLED-TRIAL; PLACEBO-CONTROLLED TRIALS; NURSING-HOME PLACEMENT; INAPPROPRIATE DRUG-USE; COGNITIVE IMPAIRMENT; DOUBLE-BLIND; STANDARDS SUBCOMMITTEE; PRACTICE PARAMETER C1 Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RAND Hlth, Santa Monica, CA USA. WellPoint Inc, Programs CLin Excellence, Thousand Oaks, CA USA. RP Feil, DG (reprint author), W Los Angeles Vet Affairs Med Ctr, Bldg 500 3-S,116-AE,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM denise.feil@med.va.gov NR 136 TC 23 Z9 23 U1 5 U2 8 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S293 EP S301 DI 10.1111/j.1532-5415.2007.01335.x PG 9 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400007 PM 17910550 ER PT J AU Fung, CH Spencer, B Eslami, M Crandall, C AF Fung, Constance H. Spencer, Benjamin Eslami, Michelle Crandall, Carolyn TI Quality indicators for the screening and care of urinary incontinence in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE urinary incontinence; quality of health care; quality indicators; health care ID OVERACTIVE BLADDER; NATURAL-HISTORY; INJECTION THERAPY; RISK-FACTORS; OLDER WOMEN; SYMPTOMS; HEALTH; EPIDEMIOLOGY; PREVALENCE; URGE C1 RAND Corp, Santa Monica, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Columbia Univ Coll Phys & Surg, New York, NY 10032 USA. RP Fung, CH (reprint author), 1776 Main St,POB 2138,M5S, Santa Monica, CA 90407 USA. EM cfung@rand.org NR 62 TC 9 Z9 10 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S443 EP S449 DI 10.1111/j.1532-5415.2007.01354.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400026 PM 17910569 ER PT J AU Gnanadesigan, N Fung, CH AF Gnanadesigan, Nallini Fung, Constance H. TI Quality indicators for screening and prevention in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE vulnerable elders; quality of health care; preventive health services; quality indicators; health care ID COMPREHENSIVE GERIATRIC ASSESSMENT; CORONARY-HEART-DISEASE; BRIEF PHYSICIAN ADVICE; CANADIAN TASK-FORCE; OLDER-ADULTS; PRIMARY-CARE; RECOMMENDATION STATEMENT; CONTROLLED-TRIALS; RANDOMIZED-TRIAL; ALCOHOL-PROBLEMS C1 Los Angeles Jewish Home Aging, Reseda, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RAND Hlth, Santa Monica, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Gnanadesigan, N (reprint author), 4322 Vanalden Ave, Tarzana, CA 91356 USA. EM nallini.desigan@gmail.com NR 75 TC 4 Z9 5 U1 3 U2 4 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S417 EP S423 DI 10.1111/j.1532-5415.2007.01350.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400022 PM 17910565 ER PT J AU Lorenz, KA Rosenfeld, K Wenger, N AF Lorenz, Karl A. Rosenfeld, Kenneth Wenger, Neil TI Quality indicators for palliative and end-of-life care in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Review DE quality of care; palliative care; evidence-based medicin; end-of-life care ID OBSTRUCTIVE PULMONARY-DISEASE; RANDOMIZED CONTROLLED-TRIAL; ADVANCE DIRECTIVES; COMPLICATED GRIEF; ADVANCED CANCER; DYING PATIENTS; NURSING-HOME; LUNG-CANCER; INTENSIVE COMMUNICATION; SUSTAINING TREATMENTS C1 VA Greater Los Angeles Healthcare Syst, Div Gen Internal Med, Vet Integrated Palliat Program, Los Angeles, CA 90064 USA. RAND Hlth, Santa Monica, CA USA. Univ Calif Los Angeles, Geffen Sch Med, Los Angeles, CA USA. RP Lorenz, KA (reprint author), VA Greater Los Angeles Healthcare Syst, Div Gen Internal Med, Vet Integrated Palliat Program, 11301 Wilshire Blvd,Code 11-G, Los Angeles, CA 90064 USA. EM karl.lorenz@med.va.gov NR 101 TC 38 Z9 37 U1 1 U2 14 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S318 EP S326 DI 10.1111/j.1532-5415.2007.01338.x PG 9 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400010 PM 17910553 ER PT J AU Martin, JL Fung, CH AF Martin, Jennifer L. Fung, Constance H. TI Quality indicators for the care of sleep disorders in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE sleep; sleep disorders; geriatrics; quality indicators ID LIMB MOVEMENT-DISORDER; RESTLESS LEGS SYNDROME; COGNITIVE-BEHAVIOR THERAPY; POSITIVE AIRWAY PRESSURE; LATE-LIFE INSOMNIA; OLDER-ADULTS; PRACTICE PARAMETERS; HEART HEALTH; CLINICAL-TRIAL; FOLLOW-UP C1 VA GLAHS GRECC, North Hills, CA 91343 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Div Gen Internal Med, North Hills, CA 91343 USA. Univ Calif Los Angeles, Dept Med, David Geffen Sch Med, Los Angeles, CA 90024 USA. RP Martin, JL (reprint author), VA GLAHS GRECC, 11E,16111 Plummer St, North Hills, CA 91343 USA. EM jennifer.martin@va.gov FU NIA NIH HHS [AG10415] NR 57 TC 1 Z9 1 U1 1 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S424 EP S430 DI 10.1111/j.1532-5415.2007.01351.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400023 PM 17910566 ER PT J AU Min, LC Mehrotra, R Fung, CH AF Min, Lillian C. Mehrotra, Rajnish Fung, Constance H. TI Quality indicators for the care of hypertension in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE hypertension; quality indicators; aged ID RANDOMIZED CONTROLLED-TRIALS; ISOLATED SYSTOLIC HYPERTENSION; 2004 CANADIAN RECOMMENDATIONS; CONVERTING ENZYME-INHIBITORS; LEFT-VENTRICULAR HYPERTROPHY; CHRONIC KIDNEY-DISEASE; BLOOD-PRESSURE; HEART-FAILURE; CARDIOVASCULAR OUTCOMES; NONPHARMACOLOGIC INTERVENTIONS C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Harbor Med Ctr, Dept Med, Los Angeles, CA 90024 USA. RAND Corp, Santa Monica, CA USA. Vet Affairs Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. RP Min, LC (reprint author), 10945 Le Conte Ave,Suite 2338,Box 951687, Los Angeles, CA 90095 USA. EM lmin@mednet.ucla.edu FU NCRR NIH HHS [RR18298] NR 76 TC 8 Z9 8 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S359 EP S365 DI 10.1111/j.1532-5415.2007.01343.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400015 PM 17910558 ER PT J AU Watson, K Fung, CH Budoff, M AF Watson, Karol Fung, Constance H. Budoff, Matthew TI Quality indicators for the care of ischemic heart disease in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE ischemia; heart; age ID ACUTE MYOCARDIAL-INFARCTION; CORONARY-ARTERY-DISEASE; RANDOMIZED CONTROLLED-TRIAL; TISSUE PLASMINOGEN-ACTIVATOR; LEFT-VENTRICULAR DYSFUNCTION; CONVERTING-ENZYME INHIBITOR; ESTROGEN PLUS PROGESTIN; ST-SEGMENT ELEVATION; SMOKING-CESSATION; CARDIAC REHABILITATION C1 Univ Calif Los Angeles, Med Ctr, Dept Cardiol, Div Cardiol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RAND Corp, Los Angeles, CA USA. Univ Calif Los Angeles, Harbor Med Ctr, Los Angeles, CA 90024 USA. RP Watson, K (reprint author), Univ Calif Los Angeles, Med Ctr, Dept Cardiol, Div Cardiol, Box 951679,4780 MRL, Los Angeles, CA 90095 USA. EM KWatson@mednet.ucla.edu RI bashzar, salman/R-5748-2016 NR 78 TC 4 Z9 4 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S366 EP S372 DI 10.1111/j.1532-5415.2007.01344.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400016 PM 17910559 ER PT J AU Wenger, NS Roth, CP Shekelle, P AF Wenger, Neil S. Roth, Carol P. Shekelle, Paul CA ACOVE Investigators TI Introduction to the assessing care of vulnerable elders-3 quality indicator measurement set SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Editorial Material DE quality of care; vulnerable elders; geriatric care measurement ID OLDER PATIENTS; HEALTH-CARE; OF-CARE; COMMUNITY; PEOPLE; ADULTS AB OBJECTIVES: To update and increase the comprehensiveness of the Assessing Care of Vulnerable Elders (ACOVE) set of process-of-care quality indicators (QIs) for the medical care provided to vulnerable elders and to keep up with the constantly changing medical literature, the QIs were revised and expanded. DESIGN: The ACOVE Clinical Committee expanded the number of measured conditions to 26 in the revised (ACOVE-3) set. For each condition, a content expert created potential QIs and, based on systematic reviews, developed a peer-reviewed monograph detailing each QI and its supporting evidence. Using these literature reviews, multidisciplinary panels of clinical experts participated in two rounds of anonymous ratings and a face-to-face group discussion to evaluate whether the QIs were valid measures of quality of care using a process that is an explicit combination of scientific evidence and professional consensus. The Clinical Committee evaluated the coherence of the complete set of QIs that the expert panels rated as valid. RESULTS: ACOVE-3 contains 392 QIs covering 14 different types of care processes (e.g., taking a medical history, performing a physical examination) and all four domains of care: screening and prevention (31% of QIs), diagnosis (20%), treatment (35%), and follow-up and continuity (14%). All QIs also apply to community-dwelling patients aged 75 and older. CONCLUSION: ACOVE-3 contains a set of QIs to comprehensively measure the care provided to vulnerable older persons at the level of the health system, health plan, or medical group. These QIs can be applied to identify areas of care in need of improvement and can form the basis of interventions to improve care. C1 RAND Hlth, Santa Monica, CA 90407 USA. Univ Calif Los Angeles, Div Gen Internal Med & Hlth Serv Res, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Wenger, NS (reprint author), RAND Hlth, 1776 Main St, Santa Monica, CA 90407 USA. EM nwenger@mednet.ucla.edu NR 28 TC 73 Z9 75 U1 1 U2 8 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S247 EP S252 DI 10.1111/j.1532-5415.2007.01328.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400001 PM 17910544 ER PT J AU Yueh, B Shekelle, P AF Yueh, Bevan Shekelle, Paul TI Quality indicators for the care of hearing loss in vulnerable elders SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE hearing loss; hearing screening; mass screening; otolaryngology; audiology; hearing aids; cochlear implantation ID OLDER-ADULTS; OF-LIFE; COCHLEAR IMPLANTATION; COGNITIVE DYSFUNCTION; RANDOMIZED TRIAL; IMPAIRMENT; PREVALENCE; POPULATION; PEOPLE; AGE C1 Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv, Surg Perioperat Care Serv, Seattle, WA USA. Univ Washington, Dept Otolaryngol Head & Neck Surg, Dept Hlth Serv, Seattle, WA 98195 USA. Vet Affairs Ctr Regular Hlth Care Syst, Los Angeles, CA USA. RAND Corp, Santa Monica, CA USA. RP Yueh, B (reprint author), Univ Minnesota, Dept Otolaryngol Head & Neck Surg, MMC 396,420 Delaware St SE, Minneapolis, MN 55455 USA. EM byueh@umn.edu OI Yueh, Bevan/0000-0003-1380-1053 NR 51 TC 3 Z9 4 U1 0 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD OCT PY 2007 VL 55 SU 2 BP S335 EP S339 DI 10.1111/j.1532-5415.2007.01340.x PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 218IY UT WOS:000250010400012 PM 17910555 ER PT J AU Haas, LB AF Haas, Linda B. TI Optimizing insulin use in type 2 diabetes: Role of basal and prandial insulin in long-term care facilities SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Review DE long-term care; oral antidiabetic drugs; insulin; type 2 diabetes mellitus ID GLYCEMIC CONTROL; NPH INSULIN; DOUBLE-BLIND; ELDERLY-PEOPLE; CLINICAL-TRIAL; ORAL-THERAPY; NURSING-HOME; WEIGHT-LOSS; MELLITUS; SULFONYLUREA C1 Univ Washington, Sch Nursing, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Haas, LB (reprint author), Univ Washington, Sch Nursing, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way,S-118, Seattle, WA 98108 USA. EM Linda.Haas@va.gov NR 94 TC 23 Z9 23 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1525-8610 J9 J AM MED DIR ASSOC JI J. Am. Med. Dir. Assoc. PD OCT PY 2007 VL 8 IS 8 BP 502 EP 510 DI 10.1016/j.jamda.2007.08.002 PG 9 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 223GP UT WOS:000250358200003 PM 17931573 ER PT J AU French, DD Campbell, RR Spehar, AM Rubenstein, LZ Cunningham, FE AF French, Dustin D. Campbell, Robert R. Spehar, Andrea M. Rubenstein, Laurence Z. Cunningham, Francesca E. TI Drug costs and use in VHA nursing homes: A national overview of long-stay residents SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Article DE nursing homes; long-term care; drug costs; drug use; Medicare Part D; veterans AB Objectives: The aim of this study was to provide national annualized estimates of drug costs and use by drug classes for long-stay nursing home (NH) residents. Design: National, descriptive, secondary data analysis. Setting: National, Veterans Health Administration (VHA), 136 NHs. Participants: Our study population consisted of 6554 VHA long-stay NH residents, identified from the Minimum Data Set (MDS), who had an annual assessment during FY 2005 linked with 8,847,561 inpatient pharmacy claims. Measurement: Descriptive statistics of the annual drug costs and use by VHA therapeutic drug classes obtained from FY 2005 national pharmacy claims linked at the individual resident level. Results: The total cost of the drugs was $23,782,717 in 326 drug classes for 6554 VHA NH residents. Average annual drug cost was $3629 per resident (99% Confidence Interval [CI], $3343-$3915). The top 20 drug classes accounted for nearly 70% of total drug costs for long-stay NH residents. Approximately three quarters (73.3%) of these residents received a nonopioid analgesic (eg, acetaminophen, aspirin). Over half of these residents received antidepressants (selective serotonin reuptake inhibitors [SSRIs]) (54.3%), or other anti-infective drugs (eg, bacitracin, ciprofloxacin) (53.3%). Conclusions: This is the first national study of drug costs and use for long-stay veterans in VHA NHs. It is essential in any study analyzing drug costs and use in NH patients to differentiate long-stay residents from short-stay patients. This kind of detailed cost and use analysis has implications for projecting future costs associated with the Medicare Part D prescription benefit for dually eligible NH residents. C1 James A Haley Vet Adm Med Ctr, VISN Patient Safety Ctr Inquiry 8, Tampa, FL 33612 USA. Univ Calif Los Angeles, David Geffen Sch Med, Sepulveda, CA USA. GRECC, VA Greater Los Angeles Healthcare System, Tampa, FL USA. W Los Angeles Div, North Hills, CA USA. Univ Illinois Chicago, Hines, IL USA. VHA Ctr Medicat Safety Pharm Benefits Management, Hines, IL USA. RP French, DD (reprint author), James A Haley Vet Adm Med Ctr, VISN Patient Safety Ctr Inquiry 8, 13000 Bruce B Downs Blvd,118M, Tampa, FL 33612 USA. EM Dustin.French@va.gov OI French, Dustin/0000-0003-4064-3206 NR 16 TC 5 Z9 5 U1 0 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1525-8610 J9 J AM MED DIR ASSOC JI J. Am. Med. Dir. Assoc. PD OCT PY 2007 VL 8 IS 8 BP 515 EP 518 DI 10.1016/j.jamda.2007.02.001 PG 4 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 223GP UT WOS:000250358200005 PM 17931575 ER PT J AU Mehrotra, R Kermah, D Fried, L Kalantar-Zadeh, K Khawar, O Norris, K Nissenson, A AF Mehrotra, Rajnish Kermah, Dulcie Fried, Linda Kalantar-Zadeh, Kamyar Khawar, Osman Norris, Keith Nissenson, Allen TI Chronic peritoneal dialysis in the United States: Declining utilization despite improving outcomes SO JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article; Proceedings Paper CT 39th Annual Meeting of the American-Society-of-Nephrology CY NOV 14-19, 2006 CL San Diego, CA SP Amer Soc Nephrol ID STAGE RENAL-DISEASE; ESRD PATIENTS; MODALITY SELECTION; PATIENT; HEMODIALYSIS; SURVIVAL; CHOICE AB In the United States, chronic peritoneal dialysis take-on has declined among incident ESRD patients. Although increasing age, co-morbidity, and body size may explain part of this decline, other factors likely contribute. Among incident ESRD patients in the United States, we found that peritoneal dialysis take-on significantly decreased from 11% in 1996 to 1997 to 7% in 2002 to 2003 (P < 0.001 for the trend). This decrease remained after adjusting for patient demographics, case-mix, and laboratory data, suggesting the involvement of other factors. This decline in utilization occurred during a time of improving outcomes for incident peritoneal dialysis patients, measured as reduced hazards for death or for the need to transfer to hemodialysis. In contrast, among patients initially treated with hemodialysis, the 12-month adjusted hazards for death or transfer to peritoneal dialysis slightly worsened or were unchanged over this same period. Therefore, the decline in peritoneal dialysis take-on cannot be entirely explained by increasing age, co-morbidity and body size of incident ESRD patients. The decline in utilization has occurred at a time when the early outcomes of CPD patients have improved. C1 Harbor UCLA Med Ctr, Loa Angeles Biomed Res Inst, Torrance, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. Charles Drew Univ, Los Angeles, CA USA. VA Pittsburgh Hlth Care Syst, Pittsburgh, PA USA. RP Mehrotra, R (reprint author), 1124 W Carson St, Torrance, CA 90502 USA. EM rmehrotra@labiomed.org OI Kalantar-Zadeh, Kamyar/0000-0002-8666-0725 FU NCRR NIH HHS [RR18298, RR03026, RR11145, RR14616]; NIMHD NIH HHS [MD00148] NR 22 TC 88 Z9 89 U1 0 U2 0 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1046-6673 J9 J AM SOC NEPHROL JI J. Am. Soc. Nephrol. PD OCT PY 2007 VL 18 IS 10 BP 2781 EP 2788 DI 10.1681/ASN.2006101130 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 231YU UT WOS:000250985900022 PM 17804675 ER PT J AU Zhang, P Guccione, JM Nicholas, SI Walker, JC Crawford, PC Shamal, A Acevedo-Bolton, G Guttman, MA Ozturk, C McVeigh, ER Saloner, DA Wallace, AW Ratcliffe, MB AF Zhang, Peng Guccione, Julius M. Nicholas, Susan I. Walker, Joseph C. Crawford, Philip C. Shamal, Amin Acevedo-Bolton, Gabriel Guttman, Michael A. Ozturk, Cengizhan McVeigh, Elliot R. Saloner, David A. Wallace, Arthur W. Ratcliffe, Mark B. TI Endoventricular patch plasty for dyskinetic anteroapical left ventricular aneurysm increases systolic circumferential shortening in sheep SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY LA English DT Article ID VOLUME REDUCTION SURGERY; FINITE-ELEMENT-ANALYSIS; MECHANICAL DYSFUNCTION; BORDER ZONE; MR-IMAGES; MODEL; RESTORATION; CARDIOMYOPATHY; RECONSTRUCTION; MYOCARDIUM AB Objective: Endoventricular patch plasty ( Dor procedure) has gained favor as a surgical treatment for heart failure associated with large anteroapical myocardial infarction. We tested the hypotheses that the Dor procedure increases systolic circumferential shortening and longitudinal shortening in noninfarcted left ventricular regions in sheep. Methods: In 6 male Dorsett sheep, the left anterior descending coronary artery and its second diagonal branch were ligated 40% of the distance from the apex to the base. Sixteen weeks after myocardial infarction, a Dor procedure was performed with a Dacron patch that was 50% of the infarct neck dimension. Two weeks before and 2 and 6 weeks after the Dor procedure, animals underwent magnetic resonance imaging with tissue tagging in multiple short- axis and long- axis slices. Fully three- dimensional strain analyses were performed. All 6 end- systolic strain components were compared in regions 1 cm, 2 cm, 3 cm, and 4 cm below the valves, as well as in the anterior, posterior, and lateral left ventricular walls and the interventricular septum. Results: Circumferential shortening increased from before the Dor procedure to 6 weeks after repair in nearly every left ventricular region ( 13/ 16). The greatest regional change in circumferential shortening was found in the equatorial region or 2 cm below the base and in the posterior wall ( from 9.0% to 18.4%; P <.0001). Longitudinal shortening increased 2 weeks after the Dor procedure but then returned near baseline by 6 weeks after the Dor procedure. Conclusion: The Dor procedure significantly increases systolic circumferential shortening in nearly all noninfarcted left ventricular regions in sheep. C1 Univ Calif San Francisco, Dept Surg, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Bioengn, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Anesthesia, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. Dept Vet Affairs Med Ctr, San Francisco, CA USA. NHLBI, Lab Cardiac Energet, NIH, Bethesda, MD 20892 USA. RP Guccione, JM (reprint author), San Francisco VA Med Ctr, Div Surg Serv, 4150 Clement St, San Francisco, CA 94121 USA. EM julius.guccione@med.va.gov RI Ozturk, Cengizhan/A-6177-2016 OI Ozturk, Cengizhan/0000-0002-6966-0774 FU NHLBI NIH HHS [R01 HL063348, R01-HL-77921, R01 HL077921-01A2, R01 HL063348-01A1, R01-HL-63348, R01 HL077921] NR 32 TC 21 Z9 23 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5223 J9 J THORAC CARDIOV SUR JI J. Thorac. Cardiovasc. Surg. PD OCT PY 2007 VL 134 IS 4 BP 1017 EP U80 DI 10.1016/j.jtcvs.2007.03.060 PG 9 WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery SC Cardiovascular System & Cardiology; Respiratory System; Surgery GA 215IB UT WOS:000249800600029 PM 17903523 ER PT J AU Hindorff, LA Heckbert, SR Smith, N Marciante, KD Psaty, BM AF Hindorff, L. A. Heckbert, S. R. Smith, N. Marciante, K. D. Psaty, B. M. TI Common VKORC1 variants are not associated with arterial or venous thrombosis SO JOURNAL OF THROMBOSIS AND HAEMOSTASIS LA English DT Letter ID MYOCARDIAL-INFARCTION; VITAMIN-K; WARFARIN; STROKE; HAPLOTYPES; RISK; GENE C1 Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle Epidemiolog Res & Informat Ctr, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. Grp Hlth, Ctr Hlth Studies, Seattle, WA USA. RP Hindorff, LA (reprint author), Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. EM lah@u.washington.edu FU NHLBI NIH HHS [T32 HL07902, HL43201, HL68986, HL53375, HL74745, HL60739, HL73410, HL68639, HL40628]; NIA NIH HHS [AG09556] NR 8 TC 15 Z9 17 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1538-7933 J9 J THROMB HAEMOST JI J. Thromb. Haemost. PD OCT PY 2007 VL 5 IS 10 BP 2025 EP 2027 DI 10.1111/j.1538-7836.2007.02705.x PG 3 WC Hematology; Peripheral Vascular Disease SC Hematology; Cardiovascular System & Cardiology GA 215RW UT WOS:000249827700007 PM 17883699 ER PT J AU Yehuda, R Morris, A Labinsky, E Zemelman, S Schmeidler, J AF Yehuda, Rachel Morris, Adam Labinsky, Ellen Zemelman, Shelly Schmeidler, James TI Ten-year follow-up study of cortisol levels in aging holocaust survivors with and without PTSD SO JOURNAL OF TRAUMATIC STRESS LA English DT Article ID POSTTRAUMATIC-STRESS-DISORDER; EXCRETION; SYMPTOMS; SYSTEM AB To investigate the longitudinal course of mean 24-hour urinary cortisol excretion in posttraumatic stress disorder (PTSD), the authors evaluated 24-hour cortisol excretion in 28 Holocaust survivors 10 years after obtaining an initial estimate. Cortisol levels increased in participants whose PTSD had remitted (n = 3) but declined in participants who developed PTSD (n = 3) or whose PTSD status did not change over time (PTSD+: n = 14, PTSD-: n = 8). Cortisol levels at Time I predicted diagnostic status change better than psychological variables, including exposure to traumatic events between assessments. The authors conclude that cortisol levels are affected by change in PTSD status and age. C1 Mt Sinai Sch Med, Dept Psychiat, Div Traumat Stress Studies, Bronx, NY USA. James J Peters Vet Affairs Med Ctr, Bronx, NY USA. RP Yehuda, R (reprint author), Vet Adm Med Ctr, Psychiat OOMH, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM rachei.yehuda@med.va.gov FU NCRR NIH HHS [5 M01 RR00071]; NIMH NIH HHS [R01 MH64675-01] NR 16 TC 31 Z9 33 U1 2 U2 4 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0894-9867 J9 J TRAUMA STRESS JI J. Trauma Stress PD OCT PY 2007 VL 20 IS 5 BP 757 EP 761 DI 10.1002/jts.20228 PG 5 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 228NK UT WOS:000250736400011 PM 17955524 ER PT J AU Barber, JP Triffleman, E Marmar, C AF Barber, Jacques P. Triffleman, Elisa Marmar, Charles TI Considerations in treatment integrity: Implications and recommendations for PTSD research SO JOURNAL OF TRAUMATIC STRESS LA English DT Article; Proceedings Paper CT Conference on Innovations in Trauma Research Methods CY NOV 03-04, 2006 CL Hollywood, CA ID POSTTRAUMATIC-STRESS-DISORDER; COLLABORATIVE-COCAINE-TREATMENT; COGNITIVE-PROCESSING THERAPY; RANDOMIZED CONTROLLED-TRIAL; IMAGINAL EXPOSURE; PROLONGED EXPOSURE; SEEKING-SAFETY; TRAUMA THERAPY; CLINICAL-TRIAL; BATTERED WOMEN AB In this article, the authors address the rationale for and uses of treatment integrity measurement in psychotherapy research, focusing on therapists' adherence and competence in trauma and posttraumatic stress disorder treatment research. The following issues are examined: (a) distinctions between adherence monitoring, performed contemporaneously with ongoing study treatments, and adherence evaluation, and the implications for outcomes analysis; (b) simultaneous measurement of adherence and competence, (c) selection of sessions for adherence/competence assessment and the need for concurrent outcome measurement, and (d) the association between therapist adherence, competence, alliance and treatment outcome. Recommendations regarding common problems in the implementation of adherence and competence measurement are made throughout. The article concludes with a summary of steps and considerations in decision-making with regard to treatment integrity. C1 Univ Penn, Sch Med, Dept Psychiat, Ctr Psychotherapy Res, Philadelphia, PA 19104 USA. San Francisco VA Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Barber, JP (reprint author), Univ Penn, Sch Med, Dept Psychiat, Ctr Psychotherapy Res, Suite 648,3535 Market St, Philadelphia, PA 19104 USA. EM Barberj@mail.med.upenn.edu FU NIMH NIH HHS [MH 061410, MH 070664] NR 44 TC 25 Z9 25 U1 2 U2 7 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0894-9867 J9 J TRAUMA STRESS JI J. Trauma Stress PD OCT PY 2007 VL 20 IS 5 BP 793 EP 805 DI 10.1002/jts.20295 PG 13 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 228NK UT WOS:000250736400015 PM 17955529 ER PT J AU Scales, CD Presti, JC Kane, CJ Terris, MK Aronson, WJ Amling, CL Freedland, SJ AF Scales, Charles D., Jr. Presti, Joseph C., Jr. Kane, Christopher J. Terris, Martha K. Aronson, William J. Amling, Christopher L. Freedland, Stephen J. CA SEARCH Database Study Grp TI Predicting unilateral prostate cancer based on biopsy features: Implications for focal ablative therapy-results from the SEARCH database SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; biopsy; prostatectomy ID RADICAL PROSTATECTOMY; UROLOGY LITERATURE; GLEASON SCORE; NEEDLE-BIOPSY; ANTIGEN ERA; SPECIMENS; ACCURACY; GRADE; CARCINOMA AB Purpose: For men with low risk prostate cancer it was recently proposed that ablative treatment to the affected side may decrease morbidity, while maintaining good oncological outcomes. However, few studies have assessed the correlation between biopsy parameters and pathological outcome (unilateral vs bilateral disease). Materials and Methods: Using the Shared Equal Access Regional Cancer Hospital Database of men treated with radical prostatectomy at multiple equal access medical centers we retrospectively examined the records of 261 men with clinical stage T1c or T2a prostate cancer, prostate specific antigen less than 10 ng/ml, Gleason sum 6 or less and only 1 or 2 ipsilateral positive cores on at least sextant biopsy. We compared clinical characteristics between men with pathologically unilateral disease or less (pT2b or less) and men with pathologically bilateral disease or extraprostatic extension (pT2c or greater). To determine the significant predictors of pT2c or greater disease we used a multivariate logistic regression model. Results: Of the cohort of 261 men with low risk prostate cancer only 93 (35.1%) had unilateral or no evidence of disease following examination of radical prostatectomy specimens. Men with pathologically unilateral or less disease did not differ from those with bilateral or more advanced disease by age, prostate specific antigen, clinical stage, body mass index or number of positive biopsy cores (1 vs 2). On multivariate analysis no clinical feature was significantly related to pathologically unilateral or less vs bilateral or greater disease. Conclusions: The majority of men with low risk prostate cancer and 1 or 2 ipsilateral positive biopsy cores have pathologically bilateral disease. Therefore, strategies for unilateral treatment of prostate cancer are unlikely to be curative for these men. C1 Duke Univ, Med Ctr, Div Urol Surg, Dept Surg,Sch Med, Durham, NC 27710 USA. Duke Univ, Sch Med, Dept Pathol, Durham, NC 27710 USA. Duke Univ, Sch Med, Duke Prostate Ctr, Durham, NC 27710 USA. Vet Affairs Med Ctr, Urol Sect, Durham, NC USA. Stanford Univ, Dept Urol, Sch Med, Palo Alto, CA 94304 USA. Vet Affairs Med Ctr, Urol Sect, Dept Surg, Palo Alto, CA 94304 USA. Vet Affairs Med Ctr, Urol Sect, Dept Surg, San Francisco, CA 94121 USA. Univ Calif San Francisco, Sch Med, Dept Urol, San Francisco, CA 94143 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Urol Sect, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Urol, Sch Med, Los Angeles, CA USA. Med Coll Georgia, Urol Sect, Augusta, GA USA. Vet Affairs Med Ctr, Augusta, GA USA. Univ Alabama, Dept Urol, Birmingham, AL USA. RP Freedland, SJ (reprint author), Duke Univ, Med Ctr, Div Urol Surg, Dept Surg,Sch Med, Box 2626, Durham, NC 27710 USA. EM steve.freedland@duke.edu OI Terris, Martha/0000-0002-3843-7270 FU NCI NIH HHS [P50 CA92131-01A1, R01CA100938] NR 19 TC 41 Z9 42 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD OCT PY 2007 VL 178 IS 4 BP 1249 EP 1252 DI 10.1016/j.juro.2007.05.151 PN 1 PG 4 WC Urology & Nephrology SC Urology & Nephrology GA 212BI UT WOS:000249568200030 PM 17698131 ER PT J AU Shao, TC Li, H Ittmann, M Cunningham, GR AF Shao, T. C. Li, H. Ittmann, M. Cunningham, G. R. TI Effects of dutasteride on prostate growth in the large probasin-large T antigen mouse model of prostate cancer SO JOURNAL OF UROLOGY LA English DT Article DE prostate; dutasteride; mice; transgenic; prostatic hyperplasia; prostatic neoplasms ID 5-ALPHA-REDUCTASE INHIBITOR; VENTRAL PROSTATE; FINASTERIDE; HYPERPLASIA; MEN; TYPE-1; RATS; CHEMOPREVENTION; APOPTOSIS; EFFICACY AB Purpose: We evaluated the effects of dutasteride for preventing or delaying prostate growth and neoplastic changes in a transgenic model of prostate cancer. Materials and Methods: Large probasin-large T antigen mice were treated for 4 or 8 weeks with dutasteride. The prostate and seminal vesicles were compared with those from intact and castrated large probasin-large T antigen mice and WT mice. Results: Dutasteride greatly decreased the transgene induced increase in prostate weight but castration caused greater reduction. Dutasteride inhibited type I and 2, 5alpha-reductase activities, decreased DNA and protein, and increased apoptotic bodies and TUNEL staining in the dorsolateral prostate. No evidence of poorly differentiated cancer was seen. Dutasteride did not decrease the weight of the androgen dependent levator ani or bulbocavernosus muscle. Conclusions: Dutasteride inhibited type 1 and 2, 5alpha-reductase activities, and decreased DNA and protein content of the dorsolateral. prostate without affecting androgen responsive muscle weight in large probasin-large T antigen mice. These studies provide support for the hypothesis that a 5alpha-reductase inhibitor inhibits the initiation and/or progression of clinical prostate cancers. C1 Michael E DeBakey Vet Affairs Med Ctr, Res Serv 151, Dept Med, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Dept Pathol, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol & Cellular Biol, Houston, TX 77030 USA. RP Cunningham, GR (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Res Serv 151, Dept Med, 2002 Holcombe Blvd, Houston, TX 77030 USA. NR 19 TC 6 Z9 6 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD OCT PY 2007 VL 178 IS 4 BP 1521 EP 1527 DI 10.1016/j.juro.2007.05.118 PN 1 PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 212BI UT WOS:000249568200094 PM 17707058 ER PT J AU Brothers, TE Robison, JG Elliott, BM AF Brothers, Thomas E. Robison, Jacob G. Elliott, Bruce M. TI Prospective decision analysis for peripheral vascular disease predicts future quality of life SO JOURNAL OF VASCULAR SURGERY LA English DT Article; Proceedings Paper CT 31st Annual Meeting of the Southern-Association-for-Vascular-Surgery CY JAN 17-20, 2007 CL Rio Grande, PR SP So Assoc Vasc Surg ID CRITICAL LIMB ISCHEMIA; INFRAINGUINAL BYPASS; REVASCULARIZATION; SURGERY; SALVAGE; PREFERENCES; UTILITY AB Objective: Decision making for peripheral vascular disease can be quite complex as a result of pre-existing compromise of patient functional status, anatomic considerations, uncertainty of favorable outcome, medical comorbidities, and limitations in life expectancy. The ability of prospective decision-analysis models to predict individual quality of life in patients with lower extremity arterial occlusive disease was tested. Methods. This was a prospective cohort study. The settings were university and Veterans Administration vascular surgery practices. All 214 patients referred with symptomatic lower extremity arterial disease of any severity over a 2-year period were screened, and 206 were enrolled. A Markov model was compared with standard clinical decision-making. Utility assessment and generalized (Short Form-36; SF-36) and disease-specific (Walking Impairment Questionnaire; WIQ) quality of life were derived before treatment. Estimates of treatment outcome probabilities and intended and actual treatment plans were provided by attending vascular surgeons. The main outcome measures were generalized (SF-36) and disease-specific (WIQ) variables at study entry and at 4 and 12 months. Results. Primary intervention consisted of amputation for 9, bypass for 42, angioplasty for 8, and medical treatment for 147 patients. Considering all patients, no improvement in mean overall patient quality of life measured by the SF-36 Physical Component Score (27 +/- 8 vs 28 +/- 8; P =.87) or WIQ (39 +/- 22 vs 39 +/- 23; P =.13) was noted 12 months after counseling and treatment by the vascular surgeons. Individually considered SF-36 categories were improved only for Bodily Pain (40 +/- 23 vs 49 +/- 25; P =.03), with the most significant improvement observed among patients with the most severe pain (68 +/- 25 vs 37 +/- 23; P =.02) and among those undergoing bypass (60 +/- 29 vs 31 +/- 22; P =.02). It is noteworthy that when the treatment chosen was incongruent with the Markov model, patients were more likely to report a poorer quality of life at I year (Physical Component Score, 25 +/- 8 vs 29 +/- 8; P < .001). The quality of life predicted at baseline by the Markov model correlated positively with the Physical Component Score (r = 0.23), Bodily Pain (r =0.33), and Fatigue (r = 0.44) and negatively with WIQ (r = -0.08) observed 1 year later. Conclusions. Prospective application of an individualized decision Markov model in patients with vascular disease was predictive of patient quality of life at 1 year. The patient's outcome was worse when the treatment received did not follow the model's recommendation. This decision analysis model may be useful to identify patients at risk for poor outcomes with standard clinical decision making. C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson Dept Vet Affairs Med Ctr, Charleston, SC USA. RP Brothers, TE (reprint author), 96 Jonathan Lucas,Ste 424, Charleston, SC 29425 USA. EM brothete@musc.edu NR 39 TC 16 Z9 17 U1 2 U2 3 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD OCT PY 2007 VL 46 IS 4 BP 701 EP 708 DI 10.1016/j.jvs.2007.05.045 PG 8 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 216JY UT WOS:000249875500013 PM 17765449 ER PT J AU Butt, AA Skanderson, M McGinnis, KA Ahuja, T Bryce, CL Barnato, AE Chang, CCH AF Butt, A. A. Skanderson, M. McGinnis, K. A. Ahuja, T. Bryce, C. L. Barnato, A. E. Chang, C.-C. H. TI Impact of hepatitis C virus infection and other comorbidities on survival in patients on dialysis SO JOURNAL OF VIRAL HEPATITIS LA English DT Article DE CKD; dialysis; HCV; HIV; survival; USRDS ID ALPHA-2A PLUS RIBAVIRIN; PEGINTERFERON ALPHA-2A; HEMODIALYSIS-PATIENTS; MOLECULAR EVIDENCE; NOSOCOMIAL TRANSMISSION; UNITED-STATES; HIV; MORTALITY; VETERANS; COINFECTION AB The impact of hepatitis C virus (HCV) and other comorbid conditions upon survival is not well quantified in patients on dialysis. We identified HCV-infected and uninfected persons in the USRDS using claims data in 1997-1998 and followed until September 22, 2002 or death. We used Gray's time-varying coefficients model to examine factors associated with survival. Subjects with a renal transplant were excluded. A total of 5737 HCV-infected and 11 228 HCV-uninfected persons were identified. HCV-infected subjects were younger (mean age 57.8 vs 65.3 years), more likely to be male (57.6%vs 49.6%) and black (54.0%vs 36.4%). They were more likely to have a diagnosis of drug (16.5%vs 4.6%) and alcohol use (14.0%vs 3.1%), and to be human immunodeficiency virus (HIV) co-infected (7.4%vs 1.8%) (all comparisons, P < 0.0005). In an adjusted Gray's time-varying coefficient model, HCV was associated with an increased risk of mortality (P < 0.0005). The hazards were highest at the time of HCV diagnosis and decreased to a stable level 2 years after diagnosis. Other factors associated with increased risk of mortality were (P < 0.0005 unless stated) HIV coinfection; diagnosis of drug use (P = 0.001); coronary artery disease (P = 0.006); stroke; diabetes as the primary cause for renal failure; peripheral vascular disease; depression and presence of anaemia. HCV was associated with higher risk of death in patients on dialysis, even after adjusting for concurrent comorbidities. The risk was highest at the time of HCV diagnosis and stabilized over time. Clinical trials of HCV screening and treatment to reduce mortality in this population are warranted. C1 Univ Pittsburgh, Med Ctr, Div Infect Dis, Pittsburgh, PA USA. Va Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Unin Ctr Social & Urban Res, Pittsburgh, PA USA. Univ Texas, Med Branch, Galveston, TX 77550 USA. Univ Pittsburgh, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. RP Butt, AA (reprint author), Univ Pittsburgh, Med Ctr, 3601 Fifth Ave,Suite 3A,Falk Bldg, Pittsburgh, PA 15213 USA. EM butta@dom.pitt.edu OI Bryce, Cindy/0000-0001-6356-6675 FU NCATS NIH HHS [UL1 TR000005]; NIDA NIH HHS [DA016175-01A1] NR 34 TC 27 Z9 30 U1 1 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1352-0504 J9 J VIRAL HEPATITIS JI J. Viral Hepatitis PD OCT PY 2007 VL 14 IS 10 BP 688 EP 696 DI 10.1111/j.1365-2893.2007.00853.x PG 9 WC Gastroenterology & Hepatology; Infectious Diseases; Virology SC Gastroenterology & Hepatology; Infectious Diseases; Virology GA 210ZB UT WOS:000249493000002 PM 17875003 ER PT J AU Watson, GR AF Watson, Gale R. TI Untitled - Letter to the editor SO JOURNAL OF VISUAL IMPAIRMENT & BLINDNESS LA English DT Letter ID TRAUMATIC BRAIN-INJURY C1 Atlanta VA Med Ctr, US Dept Vet Affairs, Natl Blind Rehabil Program, Decatur, GA 30033 USA. RP Watson, GR (reprint author), Atlanta VA Med Ctr, US Dept Vet Affairs, Natl Blind Rehabil Program, 1670 Clairmont Rd, Decatur, GA 30033 USA. EM gate.watson@va.gov NR 4 TC 0 Z9 0 U1 0 U2 0 PU AMER FOUNDATION BLIND PI NEW YORK PA J VISUAL IMPAIRMENT BLINDNESS 11 PENN PLAZA SUITE 300, NEW YORK, NY 10001 USA SN 0145-482X J9 J VISUAL IMPAIR BLIN JI J. Vis. Impair. Blind. PD OCT PY 2007 VL 101 IS 10 BP 581 EP 582 PG 2 WC Rehabilitation SC Rehabilitation GA 227GC UT WOS:000250644200002 ER PT J AU Kilpatrick, LA Ornitz, E Ibrahimovic, H Craske, M Nazarian, M Mayer, EA Naliboff, BD AF Kilpatrick, Lisa A. Ornitz, Edward Ibrahimovic, Hana Craske, Michelle Nazarian, Maria Mayer, Emeran A. Naliboff, Bruce D. TI Sex-related differences in irritable bowel syndrome (IBS) prepulse startle modification SO JOURNAL OF WOMENS HEALTH LA English DT Meeting Abstract C1 Univ CA, David Geffen Sch Med, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA 90095 USA. Univ CA, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90095 USA. Univ CA, David Geffen Sch Med, Dept Psychol, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1540-9996 J9 J WOMENS HEALTH JI J. Womens Health PD OCT PY 2007 VL 16 IS 8 BP 1110 EP 1110 PG 1 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA 225GW UT WOS:000250506100041 ER PT J AU Frayne, SM Yu, W Yano, EM Ananth, L Iqbal, S Thrailkill, A Phibbs, CS AF Frayne, Susan M. Yu, Wei Yano, Elizabeth M. Ananth, Lakshmi Iqbal, Samina Thrailkill, Ann Phibbs, Ciaran S. TI Gender and use of care: Planning for tomorrow's veterans health administration SO JOURNAL OF WOMENS HEALTH LA English DT Article ID AFFAIRS MEDICAL-CENTER; WOMEN VETERANS; MENTAL-HEALTH; FEMALE VETERANS; AVERAGE COST; VA; SERVICES; HOSPITALS; MILITARY; SATISFACTION AB Historically, men have been the predominant users of Veterans Health Administration (VHA) care. With more women entering the system, a systematic assessment of their healthcare use and costs of care is needed. We examined how utilization and costs of VHA care differ in women veterans compared with men veterans. Methods: In this cross-sectional study using centralized VHA administrative databases, main analyses examined annual outpatient and inpatient utilization and costs of care (outpatient, inpatient, and pharmacy) for all female (n = 178,849) and male (n = 3,943,532) veterans using VHA in 2002, accounting for age and medical/mental health conditions. Results: Women had 11.8% more outpatient encounters, 25.9% fewer inpatient days, and 11.4% lower total cost than men; after adjusting for age and medical comorbidity, differences were less pronounced (1.3%, 10.9%, and 2.8%, respectively). Among the 30.8% of women and 24.4% of men with both medical and mental health conditions, women used outpatient services more heavily than men (31.0 vs. 27.3 annual encounters). Conclusions: VHA's efforts to build capacity for women veterans must account for their relatively high utilization of outpatient services, which is especially prominent in women who have both medical and mental health conditions. Meeting their needs may require delivery systems integrating medical and mental healthcare. C1 VA Palo Alto Hlth Care Syst, Ctr Hlth Care Evaluat, Menlo Pk, CA 94025 USA. Stanford Univ, Sch Med, Div Gen Internal Med, Palo Alto, CA 94304 USA. Stanford Univ, Sch Med, Ctr Hlth Policy, Palo Alto, CA 94304 USA. Stanford Univ, Sch Med, Ctr Primary Care & Outcomes Res, Palo Alto, CA 94304 USA. VA Palo Alto Hlth Care Syst, Womens Hlth Ctr, Palo Alto, CA USA. VA Palo Alto Hlth Care Syst, Hlth Econ Resource Ctr, Menlo Pk, CA 94025 USA. VA Greator Los Angeles HSR&D Ctr Study Heathcare, Sepulveda, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. Stanford Univ, Sch Med, Dept Hlth Res & Policy, Palo Alto, CA 94304 USA. Stanford Univ, Sch Med, Dept Pediat, Palo Alto, CA 94304 USA. RP Frayne, SM (reprint author), VA Palo Alto Hlth Care Syst, Ctr Hlth Care Evaluat, 795 Williow Rd,152-MPD, Menlo Pk, CA 94025 USA. EM sfrayne@stanford.edu NR 47 TC 32 Z9 32 U1 2 U2 3 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1540-9996 J9 J WOMENS HEALTH JI J. Womens Health PD OCT PY 2007 VL 16 IS 8 BP 1188 EP 1199 DI 10.1089/jwh.2006.0205 PG 12 WC Public, Environmental & Occupational Health; Medicine, General & Internal; Obstetrics & Gynecology; Women's Studies SC Public, Environmental & Occupational Health; General & Internal Medicine; Obstetrics & Gynecology; Women's Studies GA 225GW UT WOS:000250506100063 PM 17937572 ER PT J AU McCarter, R Mejia, W Ikeno, Y Monnier, V Kewitt, K Gibbs, M McMahan, A Strong, R AF McCarter, Roger Mejia, Walter Ikeno, Yuji Monnier, Vincent Kewitt, Kristen Gibbs, Michael McMahan, Alex Strong, Randy TI Plasma glucose and the action of calorie restriction on aging SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID TRANSGENIC MICE; FISCHER-344 RATS; TRANSPORTER GENE; HUMAN GLUT4; LONGEVITY; AGE; EXPRESSION; MECHANISM; LESIONS AB We tested the hypothesis that retardation of aging by caloric restriction is due in part to decreased levels of plasma glucose over the life span. Male C57BL/6 mice expressing a human GLUT4 minigene (transgenic [TG] mice) and their nontransgenic littermates (NTG mice) were maintained under specific pathogen-free conditions. Mice were fed ad libitum (A mice) or 40% less than ad libitum (R mice) from age 6 weeks. Over the life span there were three different levels of plasma glucose, with NTGA mice having the highest daily levels, TGR mice the lowest daily values, and TGA and NTGR mice having similar levels intermediate between these values. Despite differences in plasma glucose, the differences measured in longevity (50% and 10% survival), physiology and tissue pathology were associated with diet rather than with levels of plasma glucose. We conclude that decreased plasma glucose over the life span is not an important factor in the action of calorie restriction on aging processes. C1 [McCarter, Roger; Mejia, Walter; Kewitt, Kristen] Univ Texas Hlth Sci Ctr San Antonio, Dept Physiol, San Antonio, TX 78229 USA. [Ikeno, Yuji] Univ Texas Hlth Sci Ctr San Antonio, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. [McMahan, Alex] Univ Texas Hlth Sci Ctr San Antonio, Dept Pathol, San Antonio, TX 78229 USA. [Strong, Randy] Univ Texas Hlth Sci Ctr San Antonio, Dept Pharmacol, San Antonio, TX 78229 USA. [Ikeno, Yuji] Univ Texas Hlth Sci Ctr San Antonio, Barshop Inst Longev & Aging Studies, San Antonio, TX 78229 USA. [Ikeno, Yuji; Strong, Randy] S Texas Vet Hlth Care Syst, Audie L Murphy Div, Res Serv, San Antonio, TX USA. [Gibbs, Michael] Pfizer Res Labs, Groton, CT USA. [Monnier, Vincent] Case Western Reserve Univ, Dept Pathol, Cleveland, OH 44106 USA. RP McCarter, R (reprint author), Penn State Univ, Ctr Dev & Hlth Genet, Gardner House, University Pk, PA 16802 USA. EM rjm28@psu.edu FU NIA NIH HHS [P01 AG-14674] NR 37 TC 26 Z9 26 U1 0 U2 2 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD OCT PY 2007 VL 62 IS 10 BP 1059 EP 1070 PG 12 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 272AF UT WOS:000253829100001 PM 17921417 ER PT J AU Johnson, JK Lui, LY Yaffe, K AF Johnson, Julene K. Lui, Li-Yung Yaffe, Kristine TI Executive function, more than global cognition, predicts functional decline and mortality in elderly women SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID LUIS VALLEY HEALTH; OLDER PERSONS; INSTRUMENTAL ACTIVITIES; ALZHEIMER-DISEASE; NEUROPSYCHOLOGICAL TESTS; DYSEXECUTIVE SYMPTOMS; PREFRONTAL GRAY; RISK-FACTORS; IMPAIRMENT; DISABILITY AB Background. Functional impairment in community-dwelling older adults is common and is associated with poor outcomes. Our goal was to compare the contribution of impairment in executive function or global cognitive function to predicting functional decline and mortality. Methods. We studied 7717 elderly women enrolled in a prospective study (mean age 73.3 years) and identified women with poor baseline executive function (score > 1 standard deviation [SD] below the mean on the Trail Making Test B (Trails B; n = 957, 12.4%), poor global cognitive function (score > 1 SD below the mean on a modified Mini-Mental State Examination [mMMSE], n = 387, 5.0%), impairment in both (n = 249, 3.2%), or no impairment (n = 6124, 79.4%). We compared level of functional difficulty (Activities of Daily Living [ADLs] and Instrumental ADLs [IADLs]) at baseline and at 6-year follow-up and survival at follow-up. We also determined if the association was independent of age, education, depression, medical comorbidities, and baseline functional ability. Results. At baseline, women with Trails B impairment only or impairment on both tests reported the highest proportion of ADL and IADL dependence compared to the other groups. At the 6-year follow-up after adjusting for age, education, medical comorbidities, depression, and baseline ADL or IADL, women with only Trails B impairment were 1.3 times more likely to develop an incident ADL dependence (adjusted odds ratio [OR] = 1.34; 95% confidence interval [CI], 1.07-1.69) and 1.5 times more likely to develop a worsening of ADL dependence (adjusted OR = 1.48; 95% CI, 1.16-1.89) when compared to women with no impairment on either test. In addition, women with only Trails B impairment had a 1.5-fold increased risk of mortality (adjusted hazard ratio [HR] = 1.48; 95% CI, 1.21-1.81). In contrast, women with impairment on only mMMSE were not at increased risk to develop incident ADL or IADL dependence, a worsening of ADL or IADL dependence, or mortality. Conclusion. Compared to women with no impairment, women with executive function impairment had significantly worse ADL and IADL function cross-sectionally and over 6 years. Individuals with executive dysfunction also had increased risk of mortality. These results suggest that screening of executive function can help to identify women who are at risk for functional decline and decreased survival. C1 [Johnson, Julene K.; Yaffe, Kristine] Univ Calif San Francisco, Dept Neurol, Memory & Aging Ctr, San Francisco, CA 94117 USA. [Yaffe, Kristine] Univ Calif San Francisco, Dept Med, San Francisco, CA 94117 USA. [Yaffe, Kristine] Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94117 USA. [Yaffe, Kristine] San Francisco VA Med Ctr, San Francisco, CA USA. [Lui, Li-Yung] Calif Pacific Med Ctr, Res Inst, San Francisco, CA USA. RP Johnson, JK (reprint author), Univ Calif San Francisco, Dept Neurol, Memory & Aging Ctr, 350 Parnassus,Suite 706, San Francisco, CA 94117 USA. EM jjohnson@memory.ucsf.edu FU NIA NIH HHS [R01 AG021918-01, AG05394, AG05407, L30 AG024692, R01 AG005394, R01 AG005407, R01 AG021918, R01 AG022538, R01 AG022538-04, R01 AG026720, R01 AG026720-01, R01-AG22538]; NIAMS NIH HHS [AR35582, AR35583, AR35584, R01 AR035582, R01 AR035583, R01 AR035584] NR 54 TC 112 Z9 118 U1 1 U2 11 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD OCT PY 2007 VL 62 IS 10 BP 1134 EP 1141 PG 8 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 272AF UT WOS:000253829100011 PM 17921427 ER PT J AU Chuang, PY Yu, Q Fang, W Uribarri, J He, JC AF Chuang, P. Y. Yu, Q. Fang, W. Uribarri, J. He, J. C. TI Advanced glycation endproducts induce podocyte apoptosis by activation of the FOXO4 transcription factor SO KIDNEY INTERNATIONAL LA English DT Article DE phosphorylation; RAGE; Akt; advanced glycation endproducts; transcription factor ID GLYCOSYLATION END-PRODUCTS; DIABETIC-NEPHROPATHY; OXIDANT STRESS; OXIDATIVE STRESS; BINDING-PROTEINS; CELL-SURFACE; KINASE; EXPRESSION; RECEPTOR; GLOMERULOSCLEROSIS AB Advanced glycation endproducts ( AGEs) and a receptor for AGEs ( RAGE) have been linked in the pathogenesis of diabetic nephropathy. RAGE is usually localized to podocytes and is increased in diabetes. RAGE activation increases reactive oxygen species production, which mediates hyperglycemia-induced podocyte apoptosis in early diabetic nephropathy. Here, we examined the interaction of AGE and RAGE on podocyte apoptosis. When we exposed murine cultured podocytes to bovine serum albumin ( BSA) that was modified by AGEs or to carboxymethyl-lysine BSA, more apoptosis was found when compared with unmodified BSA. Similarly, more podocytes underwent detachment and apoptosis when cultured on AGE-modified collagen IV than on native collagen IV. AGEs isolated from sera of patients with chronic kidney disease also caused apoptosis of podocytes. Apoptosis was diminished by small interference RNA ( siRNA) for RAGE in podocytes exposed to AGE-BSA, but not to AGE-modified collagen IV. Both AGE- and carboxymethyl-lysine modified-BSA activated p38MAP kinase and inhibition of this kinase reduced the apoptotic effect of AGE-BSA. Exposure to AGE-BSA was associated with Akt dephosphorylation and FOXO4 transcriptional activation leading to an increase in the expression of an effector protein of apoptosis, Bim. siRNA for FOXO4 abolished AGE-BSA-induced apoptosis of podocytes. Our study suggests that an AGE-RAGE interaction contributes to podocyte apoptosis by activation of the FOXO4 transcription factor. C1 CUNY Mt Sinai Sch Med, Dept Med, Div Nephrol, New York, NY 10029 USA. James J Peters VA Med Ctr, New York, NY USA. RP He, JC (reprint author), CUNY Mt Sinai Sch Med, Dept Med Nephrol, 1 Gustave L Levy Pl,Box 1243, New York, NY 10029 USA. EM cijiang.he@mssm.edu FU NIDDK NIH HHS [K08 DK065495, K08 DK-65495, R01 DK078897] NR 35 TC 70 Z9 79 U1 0 U2 3 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 0085-2538 J9 KIDNEY INT JI Kidney Int. PD OCT PY 2007 VL 72 IS 8 BP 965 EP 976 DI 10.1038/sj.ki.5002456 PG 12 WC Urology & Nephrology SC Urology & Nephrology GA 219NB UT WOS:000250090800011 PM 17667983 ER PT J AU Rademakers, R Baker, M Gass, J Adamson, J Huey, ED Momeni, P Spina, S Coppola, G Karydas, AM Stewart, H Johnson, N Hsiung, GY Kelley, B Kuntz, K Steinbart, E Wood, EM Yu, CE Josephs, K Sorenson, E Womack, KB Weintraub, S Pickering-Brown, SM Schopeld, PR Brooks, WS van Deerlin, VM Snowden, J Clark, CM Kertesz, A Boylan, K Ghetti, B Neary, D Schellenberg, GD Beach, TG Mesulam, M Mann, D Grafman, J Mackenzie, IR Feldman, H Bird, T Petersen, R Knopman, D Boeve, B Geschwind, DH Miller, B Wszolek, Z Lippa, C Bigio, EH Dickson, D Graff-Radford, N Hutton, M AF Rademakers, Rosa Baker, Matt Gass, Jennifer Adamson, Jennifer Huey, Edward D. Momeni, Parastoo Spina, Salvatore Coppola, Giovanni Karydas, Anna M. Stewart, Heather Johnson, Nancy Hsiung, Ging-Yuek Kelley, Brendan Kuntz, Karen Steinbart, Ellen Wood, Elisabeth McCarty Yu, Chang-En Josephs, Keith Sorenson, Eric Womack, Kyle B. Weintraub, Sandra Pickering-Brown, Stuart M. Schopeld, Peter R. Brooks, William S. van Deerlin, Vivianna M. Snowden, Julie Clark, Christopher M. Kertesz, Andrew Boylan, Kevin Ghetti, Bernardino Neary, David Schellenberg, Gerard D. Beach, Thomas G. Mesulam, Marsel Mann, David Grafman, Jordan Mackenzie, Ian R. Feldman, Howard Bird, Thomas Petersen, Ron Knopman, David Boeve, Bradley Geschwind, Dan H. Miller, Bruce Wszolek, Zbigniew Lippa, Carol Bigio, Eileen H. Dickson, Dennis Graff-Radford, Neill Hutton, Mike TI Phenotypic variability associated with progranulin haploinsufficiency in patients with the common 1477C -> T (Arg493X) mutation: an international initiative SO LANCET NEUROLOGY LA English DT Article ID FRONTOTEMPORAL LOBAR DEGENERATION; NULL MUTATIONS; GENE-MUTATIONS; DEMENTIA; TAU; CHROMOSOME-17; INCLUSIONS; DISEASE; NEUROPATHOLOGY; PATHOLOGY AB Background The progranulin gene (GRN) is mutated in 5-10% of patients with frontotemporal lobar degeneration (FTLD) and in about 20% of patients with familial FTLD. The most common mutation in GRN is Arg493X. We aimed to establish the contribution of this mutation to FTLD and related disorders. Methods We measured the frequency of Arg493X in 3405 unrelated patients with various neurodegenerative diseases using Taqman single-nucleotide polymorphism (SNP) genotyping. Clinicopathological characterisation and shared haplotype analysis were done for 30 families with FTLD who carry Arg493X. To investigate the effect of potential modifying loci, we did linear regression analyses with onset age as the covariate for GRN variants, for genotypes of the apolipoprotein E gene (APOE), and for haplotypes of the microtubule-associated protein tau gene (MAPT). Findings Of 731 patients with FTLD, 16 (2%) carried Arg493X. This mutation was not detected in 2674 patients who did not have FTLD. In 37 patients with Arg493X from 30 families with FTLD, clinical diagnoses included frontotemporal dementia, primary progressive aphasia, corticobasal syndrome, and Alzheimer's disease. Range of onset age was 44-69 years. In all patients who came to autopsy (n=13), the pathological diagnosis was FTLD with neuronal inclusions that contained TAR DNA-binding protein or ubiquitin, but not tau. Neurofibrillary tangle pathology in the form of Braak staging correlated with overall neuropathology in the Arg493X carriers. Haplotype analyses suggested that Arg493X arose twice, with a single founder for 27 families. Linear regression analyses suggested that patients with SNP rs9897528 on their wild-type GRN allele have delayed symptom onset. Onset ages were not associated with the MAPT H1 or H2 haplotypes or APOE genotypes, but early memory deficits were associated with the presence of an APOE epsilon 4 allele. Interpretation Clinical heterogeneity is associated with GRN haploinsufficiency, and genetic variability on the wild-type GRN allele might have a role in the age-related disease penetrance of GRN mutations. C1 Mayo Clin, Coll Med, Dept Neurosci, Jacksonville, FL 32224 USA. NINDS, NIH, Cognit Neurosci Sect, Bethesda, MD 20892 USA. Texas Tech Univ, Hlth Sci Ctr, Dept Neurol, Lubbock, TX 79409 USA. Indiana Univ, Sch Med, Dept Pathol & Lab Med, Indianapolis, IN USA. Univ Siena, I-53100 Siena, Italy. Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA USA. Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94143 USA. Vancouver Gen Hosp, ALS Ctr, Vancouver, BC, Canada. Northwestern Univ, Feinberg Sch Med, Cognit Neurol & Alzheimer Dis Ctr, Chicago, IL USA. Univ British Columbia, Div Neurol, Vancouver, BC V5Z 1M9, Canada. Mayo Clin, Coll Med, Dept Neurol, Rochester, MN USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA USA. Univ Penn, Sch Med, Ctr Neurodegenerat Dis Res, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA. Univ Washington, Ctr Geriatr Res Educ & Clin, VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Dept Med Neurol, Seattle, WA USA. Univ Washington, Dept Pharmacol, Seattle, WA USA. Univ Texas, SW Med Ctr, Dept Neurol, Dallas, TX USA. Univ Manchester, Fac Med & Hlth Sci, Manchester, Lancs, England. Prince Wales Med Res Inst, Sydney, NSW, Australia. Univ Penn, Sch Med, Rush Alzheimers Dis Ctr, Dept Neurol, Philadelphia, PA 19104 USA. Univ Western Ontario, London, ON, Canada. Mayo Clin, Coll Med, Dept Neurol, Jacksonville, FL 32224 USA. Sun Hlth Res Inst, Sun City, AZ USA. Univ British Columbia, Dept Pathol & Lab Med, Vancouver, BC, Canada. Drexel Univ, Coll Med, Dept Neurol, Philadelphia, PA 19104 USA. RP Rademakers, R (reprint author), Mayo Clin, Coll Med, Dept Neurosci, 4500 San Pablo Rd, Jacksonville, FL 32224 USA. EM rademakers.rosa@mayo.edu RI Pickering-Brown, Stuart/D-4008-2009 OI Pickering-Brown, Stuart/0000-0003-1561-6054; Dickson, Dennis W/0000-0001-7189-7917; Grafman, Jordan H./0000-0001-8645-4457; Snowden, Julie/0000-0002-3976-4310; Womack, Kyle/0000-0002-6060-9075; Feldman, Howard/0000-0002-9258-4538 FU Intramural NIH HHS; Medical Research Council [G0400356]; NIA NIH HHS [P30 AG12300, P01 AG017216, P01 AG019724, P01 AG17586, P30 AG10133, P30 AG13854, P30 AG19610, P50 AG03006, P50 AG05136, P50 AG16574, R01 AG026251, R01 AG026938]; NINDS NIH HHS [P50 NS40256] NR 37 TC 128 Z9 130 U1 1 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1474-4422 J9 LANCET NEUROL JI Lancet Neurol. PD OCT PY 2007 VL 6 IS 10 BP 857 EP 868 DI 10.1016/S14744422(07)70221-1 PG 12 WC Clinical Neurology SC Neurosciences & Neurology GA 218SQ UT WOS:000250035600016 PM 17826340 ER PT J AU Matsunaga, J Medeiros, MA Sanchez, Y Werneid, KF Ko, AI AF Matsunaga, James Medeiros, Marco A. Sanchez, Yolanda Werneid, Kristian F. Ko, Albert I. TI Osmotic regulation of expression of two extracellular matrix-binding proteins and a haemolysin of Leptospira interrogans: differential effects on LigA and Sph2 extracellular release SO MICROBIOLOGY-SGM LA English DT Article ID SURFACE-EXPOSED LIPOPROTEIN; SEROVAR LAI; OUTER-MEMBRANE; MOLECULAR CHARACTERIZATION; FILAMENTOUS HEMAGGLUTININ; BORDETELLA-PERTUSSIS; MAMMALIAN INFECTION; SIGNAL-TRANSDUCTION; MYXOCOCCUS-XANTHUS; ADENYLYL-CYCLASE AB The life cycle of the pathogen Leptospira interrogans involves stages outside and inside the host. Entry of L. interrogans from moist environments into the host is likely to be accompanied by the induction of genes encoding virulence determinants and the concomitant repression of genes encoding products required for survival outside of the host. The expression of the adhesin LigA, the haemolysin Sph2 (Lk73.5) and the outer-membrane lipoprotein LipL36 of pathogenic Leptospira species have been reported to be regulated by mammalian host signals. A previous study demonstrated that raising the osmolarity of the leptospiral growth medium to physiological levels encountered in the host by addition of various salts enhanced the levels of cell-associated LigA and LigB and extracellular LigA. In this study, we systematically examined the effects of osmotic upshift with ionic and non-ionic solutes on expression of the known mammalian host-regulated leptospiral genes. The levels of cell-associated LigA, LigB and Sph2 increased at physiological osmolarity, whereas LipL36 levels decreased, corresponding to changes in specific transcript levels. These changes in expression occurred irrespective of whether sodium chloride or sucrose was used as the solute. The increase of cellular LigA, LigB and Sph2 protein levels occurred within hours of adding sodium chloride. Extracellular Sph2 levels increased when either sodium chloride or sucrose was added to achieve physiological osmolarity. In contrast, enhanced levels of extracellular LigA were observed only with an increase in ionic strength. These results indicate that the mechanisms for release of LigA and Sph2 differ during host infection. Thus, osmolarity not only affects leptospiral gene expression by affecting transcript levels of putative virulence determinants but also affects the release of such proteins into the surroundings. C1 Res Serv, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA. Brazilian Minist Hlth, Oswaldo Cruz Inst, Rio De Janeiro, Brazil. Cornell Univ, Weill Med Coll, Div Int Med & Infect Dis, New York, NY 10021 USA. Brazilian Minist Hlth, Oswaldo Cruz Fdn, Goncalo Moniz Res Ctr, Salvador, BA, Brazil. RP Matsunaga, J (reprint author), Res Serv, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. EM jamesm@ucla.edu RI Ko, Albert/P-2343-2015 OI Ko, Albert/0000-0001-9023-2339 FU FIC NIH HHS [TW00919]; NIAID NIH HHS [AI052473] NR 48 TC 28 Z9 28 U1 0 U2 1 PU SOC GENERAL MICROBIOLOGY PI READING PA MARLBOROUGH HOUSE, BASINGSTOKE RD, SPENCERS WOODS, READING RG7 1AG, BERKS, ENGLAND SN 1350-0872 J9 MICROBIOL-SGM JI Microbiology-(UK) PD OCT PY 2007 VL 153 BP 3390 EP 3398 DI 10.1099/mic.0.2007/007948-0 PN 10 PG 9 WC Microbiology SC Microbiology GA 222ES UT WOS:000250279500019 PM 17906138 ER PT J AU Kaddurah-Daouk, R McEvoy, J Baillie, RA Lee, D Yao, JK Doraiswamy, PM Krishnan, KRR AF Kaddurah-Daouk, R. McEvoy, J. Baillie, R. A. Lee, D. Yao, J. K. Doraiswamy, P. M. Krishnan, K. R. R. TI Metabolomic mapping of atypical antipsychotic effects in schizophrenia SO MOLECULAR PSYCHIATRY LA English DT Article DE lipidomics; metabolomics; schizophrenia; antipsychotics; metabolic profiling ID MEMBRANE PHOSPHOLIPID-METABOLISM; MAGNETIC-RESONANCE SPECTROSCOPY; COA DESATURASE ACTIVITY; FATTY-ACID-COMPOSITION; DRUGS ACTIVATE SREBP; H-1-NMR-BASED METABONOMICS; PLASMA; ROSIGLITAZONE; ABNORMALITIES; CHOLESTEROL AB Schizophrenia is associated with impairments in neurotransmitter systems and changes in neuronal membrane phospholipids. Several atypical antipsychotic drugs induce weight gain and hypertriglyceridemia. To date, there has not been a comprehensive evaluation and mapping of global lipid changes in schizophrenia, and upon treatment with antipsychotics. Such mapping could provide novel insights about disease mechanisms and metabolic side effects of therapies used for its treatment. We used a specialized metabolomics platform 'lipidomics' that quantifies over 300 polar and nonpolar lipid metabolites (across seven lipid classes) to evaluate global lipid changes in schizophrenia and upon treatment with three commonly used atypical antipsychotics. Lipid profiles were derived for 50 patients with schizophrenia before and after treatment for 2-3 weeks with olanzapine (n = 20), risperidone (n = 14) or aripiprazole (n = 16). Patients were recruited in two cohorts (study I, n = 27 and study II, n = 23) to permit an internal replication analyses. The change from baseline to post-treatment was then compared among the three drugs. Olanzapine and risperidone affected a much broader range of lipid classes than aripiprazole. Approximately 50 lipids tended to be increased with both risperidone and olanzapine and concentrations of triacylglycerols increased and free fatty acids decreased with both drugs but not with aripiprazole. Phosphatidylethanolamine concentrations that were suppressed in patients with schizophrenia were raised by all three drugs. Drug specific differences were also detected. A principal component analysis (PCA) identified baseline lipid alterations, which correlated with acute treatment response. A more definitive long-term randomized study of these drugs correlating global lipid changes with clinical outcomes could yield biomarkers that define drug-response phenotypes. C1 Duke Univ, Med Ctr, Dept Psychiat, Durham, NC 27710 USA. Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC 27710 USA. Lipom Technol Inc, Sacramento, CA USA. VA Pittsburgh Healthacare Syst, Med Res Serv, Pittsburgh, PA USA. Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Pharmaceut Sci, Pittsburgh, PA 15213 USA. RP Kaddurah-Daouk, R (reprint author), Duke Univ, Med Ctr, Dept Psychiat, Box 3950, Durham, NC 27710 USA. EM kaddu001@mc.duke.edu NR 52 TC 128 Z9 136 U1 7 U2 30 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1359-4184 J9 MOL PSYCHIATR JI Mol. Psychiatr. PD OCT PY 2007 VL 12 IS 10 BP 934 EP 945 DI 10.1038/sj.mp.4002000 PG 12 WC Biochemistry & Molecular Biology; Neurosciences; Psychiatry SC Biochemistry & Molecular Biology; Neurosciences & Neurology; Psychiatry GA 217AK UT WOS:000249920500011 PM 17440431 ER PT J AU Bartzokis, G Lu, PH Tishler, TA Fong, SM Oluwadara, B Finn, JP Huang, D Bordelon, Y Mintz, J Perlman, S AF Bartzokis, George Lu, Po H. Tishler, Todd A. Fong, Sophia M. Oluwadara, Bolanle Finn, J. Paul Huang, Danny Bordelon, Yvette Mintz, Jim Perlman, Susan TI Myelin breakdown and iron changes in Huntington's disease: Pathogenesis and treatment implications SO NEUROCHEMICAL RESEARCH LA English DT Article DE brain; neurodegeneration; ferritin; FDRI; Huntingtin; BDNF; excitotoxicity; prevention; onset; oligodendrocyte ID VISUAL-CORTEX AREA-17; BRAIN FERRITIN IRON; IN-VIVO EVALUATION; ALZHEIMERS-DISEASE; PARKINSONS-DISEASE; COGNITIVE DECLINE; WHITE-MATTER; NEURODEGENERATIVE DISORDERS; NEURONAL DEGENERATION; MORPHOMETRIC-ANALYSIS AB Background Postmortem and in vivo imaging data support the hypothesis that premature myelin breakdown and subsequent homeostatic remyelination attempts with increased oligodendrocyte and iron levels may contribute to Huntington's Disease (HD) pathogenesis and the symmetrical progress of neuronal loss from earlier-myelinating striatum to later-myelinating regions. A unique combination of in vivo tissue integrity and iron level assessments was used to examine the hypothesis. Methods A method that uses two Magnetic resonance imaging (MRI) instruments operating at different field-strengths was used to quantify the iron content of ferritin molecules (ferritin iron) as well as tissue integrity in eight regions in 11 HD and a matched group of 27 healthy control subjects. Three white matter regions were selected based on their myelination pattern (early to later-myelinating) and fiber composition. These were frontal lobe white matter (Fwm) and splenium and genu of the corpus callosum (Swm and Gwm). In addition, gray matter structures were also chosen based on their myelination pattern and fiber composition. Three striatum structures were assessed [caudate, putamen, and globus pallidus (C, P, and G)] as well as two comparison gray matter regions that myelinate later in development and are relatively spared in HD [Hippocampus (Hipp) and Thalamus (Th)]. Results Compared to healthy controls, HD ferritin iron levels were significantly increased in striatum C, P, and G, decreased in Fwm and Gwm, and were unchanged in Hipp, Th, and Swm. Loss of tissue integrity was observed in C, P, Fwm, and especially Swm but not Hipp, Th, G, or Gwm. This pattern of findings was largely preserved when a small subset of HD subjects early in the disease process was examined. Conclusions The data suggest early in the HD process, myelin breakdown and changes in ferritin iron distribution underlie the pattern of regional toxicity observed in HD. Prospective studies are needed to verify myelin breakdown and increased iron levels are causal factors in HD pathogenesis. Tracking the effects of novel interventions that reduce myelin breakdown and iron accumulation in preclinical stages of HD could hasten the development of preventive treatments. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Div Brain Mapping, Dept Neurol, Lab Neuroimaging, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Neurosci Interdept Grad Program, Los Angeles, CA 90095 USA. Greater Los Angeles VA Healthcare Syst, Dept Psychiat, Los Angeles, CA 90073 USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurol, Los Angeles, CA 90095 USA. EM gbar@ucla.edu RI Bartzokis, George/K-2409-2013 FU NIA NIH HHS [AG 16570, R01 AG027342]; NIMH NIH HHS [MH066029-01A2, MH51928, MH6357-01A1] NR 97 TC 100 Z9 102 U1 1 U2 5 PU SPRINGER/PLENUM PUBLISHERS PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013 USA SN 0364-3190 J9 NEUROCHEM RES JI Neurochem. Res. PD OCT PY 2007 VL 32 IS 10 BP 1655 EP 1664 DI 10.1007/s11064-007-9352-7 PG 10 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 212FH UT WOS:000249578500005 PM 17484051 ER PT J AU Chen, WL Song, BB Lao, L Perez, OA Kim, W Marvizon, JCG AF Chen, Wenling Song, Bingbing Lao, Lijun Perez, Orlando A. Kim, Woojae Marvizon, Juan Carlos G. TI Comparing analgesia and mu-opioid receptor internalization produced by intrathecal enkephalin: Requirement for peptidase inhibition SO NEUROPHARMACOLOGY LA English DT Article DE aminopeptidase; dipeptidyl carboxypeptidase; EC.3.4.11.7; EC.3.4.15.1; EC.3.4.24.11; endomorphin; enkephalin; delta opioid receptor; dorsal horn; intrathecal; Mu opioid receptor; neutral endopeptidase; peptidase inhibitors; tail-flick test ID RAT SPINAL-CORD; DORSAL-HORN NEURONS; NOXIOUS MECHANICAL STIMULI; MEDIAL PREOPTIC NUCLEUS; D-ASPARTATE RECEPTORS; SUBSTANCE-P; DEGRADING ENZYMES; PRIMARY AFFERENTS; CHRONIC CATHETERIZATION; ELECTRICAL-STIMULATION AB Opioid receptors in the spinal cord produce strong analgesia, but the mechanisms controlling their activation by endogenous opioids remain unclear. We have previously shown in spinal cord slices that peptidases preclude p-opioid receptor (MOR) internalization by opioids. Our present goals were to investigate whether enkephalin-induced analgesia is, also precluded by peptidases, and whether it is mediated by MORs or delta-opioid receptors (DORs). Tail-flick analgesia and MOR internalization were measured in rats injected intrathecally with Leu-enkephalin and peptidase inhibitors. Without peptidase inhibitors, Leu-enkephalin produced neither analgesia nor MOR internalization at doses up to 100 nmol. whereas with peptidase inhibitors it produced analgesia at 0.3 nmol and MOR internalization at I nmol. Leu-enkephalin was 10 times more potent to produce analgesia than to produce MOR internalization, suggesting that DORs were involved. Selective MOR or DOR antagonists completely blocked the analgesia elicited by 0.3 nmol Leu-enkephalin (a dose that produced little MOR internalization), indicating that it involved these two receptors, possibly by an additive or synergistic interaction. The selective MOR agonist endomorphin-2 produced analgesia even in the presence of a DOR antagonist, but at doses substantially higher than Leu-enkephalin. Unlike Leu-enkephalin, endomorphin-2 had the same potencies to induce analgesia and MOR internalization. We concluded that low doses of enkephalins produce analgesia by activating both MORs and DORs. Analgesia can also be produced exclusively by MORs at higher agonist doses. Since peptidases prevent the activation of spinal opioid receptors by enkephalins, the coincident release of opioids and endogenous peptidase inhibitors may be required for analgesia. (c) 2007 Elsevier Ltd. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Div Digest Dis,Digest Dis Res Ctr, Los Angeles, CA 90073 USA. RP Marvizon, JCG (reprint author), VA Greater Los Angeles Healthcare Syst, Bldg 115,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM marvizon@ucla.edu RI Chen, Wenling/A-4490-2012 FU NIDA NIH HHS [R01 DA012609, R01 DA012609-08, R01 DA012609-07] NR 73 TC 21 Z9 23 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0028-3908 J9 NEUROPHARMACOLOGY JI Neuropharmacology PD OCT PY 2007 VL 53 IS 5 BP 664 EP 676 DI 10.1016/j.neurophann.2007.07.010 PG 13 WC Neurosciences; Pharmacology & Pharmacy SC Neurosciences & Neurology; Pharmacology & Pharmacy GA 228PD UT WOS:000250741000010 PM 17845806 ER PT J AU Drevets, WC Thase, ME Moses-Kolko, EL Price, J Frank, E Kupfer, DJ Mathis, C AF Drevets, Wayne C. Thase, Michael E. Moses-Kolko, Eydie L. Price, Julie Frank, Ellen Kupfer, David J. Mathis, Chester TI Serotonin-1A receptor imaging in recurrent depression: replication and literature review SO NUCLEAR MEDICINE AND BIOLOGY LA English DT Article; Proceedings Paper CT Workshop on After Bench to Bedside - Impact on Clinical Outcome CY 2007 CL La Jolla, CA ID POSITRON-EMISSION-TOMOGRAPHY; MESSENGER-RNA EXPRESSION; ANTIDEPRESSANT DRUG-TREATMENT; 5-HT1A RECEPTOR; MAJOR DEPRESSION; HUMAN-BRAIN; MINERALOCORTICOID RECEPTOR; AUTORADIOGRAPHIC ANALYSES; BIPOLAR DEPRESSION; DORSAL HIPPOCAMPUS AB Introduction: Serotonin-1A receptor (5-HT(1A)R) function appears to be decreased in major depressive disorder (MDD) based on physiological responses to 5-HT(1A)R agonists in vivo and to 5-HT(1A)R binding in brain tissues postmortem or antemortem. We have previously assessed 5-HT(1A)R binding potential (BP) in depression using positron emission tomography (PET) and [carbonyl-(11)C]WAY-100635, and we have demonstrated reduced 5-HT(1A)R BP in the mesiotemporal cortex (MTC) and raphe in depressives with primary recurrent familial mood disorders (n=12) versus controls (n=8) [Drevets WC, Frank E, Price JC, Kupfer DJ, Holt D, Greer PJ, Huang Y, Gautier C, Mathis C. PET imaging of serotonin I A receptor binding in depression. Biol Psychiatry 1999;46(10):1375-87]. These findings were replicated by some, but not other, studies performed in depressed samples that were more generally selected using criteria for MDD. In the current study, we attempted to replicate our previous findings in an independent sample of subjects selected according to the criteria for primary recurrent depression applied in our prior study. Methods: Using PET and [carbonyl-(11)C]WAY-100635, 5-HT(1A)R BP was assessed in 16 depressed subjects and 8 healthy controls. Results: Mean 5-HT(1A)R BP was reduced by 26% in the MTC (P<.005) and by 43% in the raphe (P<.001) in depressives versus controls. Conclusions: These data replicate our original findings, which showed that BP was reduced by 27% in the MTC (P<.025) and by 42% in the raphe (P<.02) in depression. The magnitudes of these reductions in 5-HT(1A)R binding were similar to those found postmortem in 5-HT(1A)R mRNA concentrations in the hippocampus in MDD [Lopez JF, Chalmers DT, Little KY, Watson SJ. Regulation of serotonin 1A, glucocorticoid, and mineralocorticoid receptor in rat and human hippocampus: implications for neurobiology of depression. Biol Psychiatry 1998;43:547-73] and in 5-HT(1A)R-binding capacity in the raphe in depressed suicide victims [Arango V, Underwood MD, Boldrini M, Tamir H, Kassir SA, Hsiung S, Chen JJ, Mann JJ. Serotonin 1A receptors, serotonin transporter binding and serotonin transporter mRNA expression in the brainstem of depressed suicide victims. Neuropsychopharmacology 2001-,25(6):892-903]. There exists disagreement within the literature, however, regarding the presence and direction of 5-HT(1A)R-binding abnormalities in depression, which may be explained in some cases by differences in anatomical location (e.g., [Stockmeier CA, Shapiro LA, Dilley GE, Kolli TN, Friedman L, Rajkowska G. Increase in serotonin-1A autoreceptors in the midbrain of suicide victims with major depression -postmortem evidence for decreased serotonin activity. J Neurosci 1998;18(18):7394-401]) and in other cases by pathophysiological heterogeneity within MDD (e.g., some depressives hypersecrete cortisol, which would be expected to down-regulate 5-HT(1A)R expression [Lopez JF, Chalmers DT, Little KY, Watson SJ. Regulation of serotonin 1A, glucocorticoid, and mineralocorticoid receptor in rat and human hippocampus: implications for neurobiology of depression. Biol Psychiatry 1998;43:547-73]). Antidepressant drug treatment does not alter these abnormalities in 5-HTIAR binding [Sargent PA, Kjaer KH, Bench CJ, Rabiner EA, Messa C, Meyer J, Gunn RN, Grasby PM, Cowen PJ. Brain serotonin(1A) receptor binding measured by positron emission tomography with [(11)C]WAY-1 00635: effects of depression and antidepressant treatment. Arch Gen Psychiatry 2000;57(2):174-80; Moses-Kolko EL, Price JC, Thase ME, Meltzer CC, Kupfer DJ, Mathis CA, Bogers WD, Berman SR, Houck PR, Schneider TN, Drevets WC. Measurement of 5-HT(1A) receptor binding in depressed adults before and after antidepressant drug treatment using positron emission tomography and [(11)C]WAY-100635. Synapse 2007;61(7):523-30] but may compensate for blunted 5-HT(1A)R function by increasing post-synaptic 5-HT(1A)R transmission [Chaput Y, de Montigny C, Blier P. Presynaptic and postsynaptic modifications of the serotonin system by long-terin administration of antidepressant treatments. An in vivo electrophysiologic study in the rat. Neuropsychopharmacology 1991;5(4):219-29]. C 2007 Elsevier Inc. All rights reserved. C1 MINH Mol Imaging Branch, Mood & Anxiety Disorders Program, Bethesda, MD 20892 USA. Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 19213 USA. Univ Pittsburgh, Dept Radiol, Pittsburgh, PA 19213 USA. Univ Penn, Sch Med, Philadelphia Vet Affairs Med Ctr, Dept Psychiat, Philadelphia, PA 19104 USA. RP Drevets, WC (reprint author), NIH NIMH DIRP, Sect Neuroimaging Mood & Anxiety Disorders, Bethesda, MD 20892 USA. EM drevetsw@mail.nih.gov FU Intramural NIH HHS [Z01 MH002788-06]; NIMH NIH HHS [K23 MH064561] NR 109 TC 215 Z9 224 U1 2 U2 31 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0969-8051 J9 NUCL MED BIOL JI Nucl. Med. Biol. PD OCT PY 2007 VL 34 IS 7 BP 865 EP 877 DI 10.1016/j.nuemedbio.2007.06.008 PG 13 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 222WI UT WOS:000250328100016 PM 17921037 ER PT J AU Ham, M Horton, K Kaunitz, J AF Ham, Maggie Horton, Kelli Kaunitz, Jonathan TI Fistuloclysis: Case report and literature review SO NUTRITION IN CLINICAL PRACTICE LA English DT Article ID TOTAL PARENTERAL-NUTRITION; CONTINUOUS ENTERAL NUTRITION; C-REACTIVE PROTEIN; ENTEROCUTANEOUS FISTULA; GASTROINTESTINAL FISTULAS; SOMATOSTATIN ANALOG; ELEMENTAL DIET; SERUM-ALBUMIN; SMALL-BOWEL; MANAGEMENT AB Enterocutaneous fistulae are a common postoperative entity, causing serious complications such as sepsis, malnutrition, and electrolyte and fluid abnormalities. Because sepsis coupled with malnutrition is the leading cause of death in these patients, it is especially important to provide nutrition support. Although parenteral nutrition (PN) is widely used in these patients, it is not without risks, because PN is known to cause liver dysfunction, among other problems. We report a case in which a male patient with an enterocutaneous fistula, having experienced increased liver enzymes receiving PN, began receiving enteral nutrition (EN) via a feeding tube placed in the fistula. Known as fistuloclysis, this method provided adequate nutrition and improved his serum albumin and prealbumin levels, body weight, and liver function tests. Upon stabilization of his nutrition status, he was able to undergo successful surgical repair of the enterocutaneous fistula. According to our experience and that of others, we recommend that patients with high-output enterocutaneous fistulae be considered for EN via fistuloclysis after nutrition stabilization with PN; then the fistulae can be surgically repaired if not spontaneously healed. Use of EN via fistuloclysis, if used appropriately, avoids the complications of long-term PN and may promote faster fistula healing. C1 Univ Calif Los Angeles, David Geffen Sch Med, Sch Med, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Sch Med, Los Angeles, CA USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. RP Kaunitz, J (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Sch Med, Dept Med, Bldg 114 Room 217E,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jake@ucla.edu NR 42 TC 7 Z9 7 U1 0 U2 2 PU AMER SOC PARENTERAL & ENTERAL NUTRITION PI SILVER SPRING PA 8630 FENTON STREET SUITE 412, SILVER SPRING, MD 20910 USA SN 0884-5336 J9 NUTR CLIN PRACT JI Nutr. Clin. Pract. PD OCT PY 2007 VL 22 IS 5 BP 553 EP 557 DI 10.1177/0115426507022005553 PG 5 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 218BU UT WOS:000249991800011 PM 17906279 ER PT J AU Friedlander, AH AF Friedlander, Arthur H. TI Atheromas on panoramic radiographs often denote stenotic lesions and portend adverse vascular events SO ORAL SURGERY ORAL MEDICINE ORAL PATHOLOGY ORAL RADIOLOGY AND ENDODONTOLOGY LA English DT Letter C1 Univ Calif Los Angeles, Med Ctr, Hosp Dent Serv, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Dent, Los Angeles, CA 90024 USA. RP Friedlander, AH (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. NR 4 TC 0 Z9 0 U1 0 U2 0 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 1079-2104 J9 ORAL SURG ORAL MED O JI Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. PD OCT PY 2007 VL 104 IS 4 DI 10.1016/j.tripleo.2007.04.036 PG 3 WC Dentistry, Oral Surgery & Medicine SC Dentistry, Oral Surgery & Medicine GA 220QA UT WOS:000250170300003 ER PT J AU Reiber, GE Raugi, GJ Rowberg, D AF Reiber, Gayle E. Raugi, Gregory J. Rowberg, Donald TI The process of implementing a rural VA wound cave program for diabetic foot ulcer patients SO OSTOMY WOUND MANAGEMENT LA English DT Article DE diabetes; foot ulcer; systems of care; electronic medical records; wound care ID MANAGEMENT; TRIAL AB Delivering and documenting evidence-based treatment to all Department of Veterans Affairs (VA) foot ulcer patients has wide appeal. However, primary and secondary care medical centers where 52% of these patients receive care are at a disadvantage given the frequent absence of trained specialists to manage diabetic foot ulcers. A retrospective review of diabetic foot ulcer patient records and a provider survey were conducted to document the foot ulcer problem and to assess practitioner needs. Results showed of the 125 persons with foot ulcers identified through administrative data, only, 21% of diabetic foot patients were correctly coded. Chronic Care and Microsystem models were used to prepare a tailored intervention in a VA primary care medical center. The site Principal Investigators, a multidisciplinary site wound care team, and study investigators jointly implemented a diabetic foot ulcer program. Intervention components include wound care team education and training, standardized good wound care practices based on strong scientific evidence, and a wound care template embedded in the electronic medical record to facilitate data collection, clinical decision making, patient ordering, and coding. A strategy for delivering offloading pressure devices, regular case management support, and 24/7 emergency assistance also was developed. It took 9 months to implement the model. Patients were enrolled and followed for 1 year Process and outcome evaluations are on-going. C1 VA Puget Sound, Hlth Care Syst, Seattle, WA 98101 USA. Univ Washington, Epidemiol & Hlth Serv, Seattle, WA 98195 USA. VA Puget Sound, Hlth Care Syst, Dermatol Sect, Seattle, WA 98101 USA. Univ Washington, Seattle, WA 98195 USA. Walla Walla VA Med Ctr, Walla Walla, WA USA. RP Reiber, GE (reprint author), VA Puget Sound, Hlth Care Syst, 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM greiber@u.wash-ington.edu NR 15 TC 5 Z9 5 U1 1 U2 1 PU H M P COMMUNICATIONS PI MALVERN PA 83 GENERAL WARREN BLVD, STE 100, MALVERN, PA 19355 USA SN 0889-5899 J9 OSTOMY WOUND MANAG JI Ostomy Wound Manag. PD OCT PY 2007 VL 53 IS 10 BP 60 EP 66 PG 7 WC Surgery SC Surgery GA 225TX UT WOS:000250541700010 PM 17978416 ER PT J AU Wiedemer, NL Harden, PS Arndt, IO Gallagher, RM AF Wiedemer, Nancy L. Harden, Paul S. Arndt, Isabelle O. Gallagher, Rollin M. TI The Opioid Renewal Clinic: A primary care, managed approach to opioid therapy in chronic pain patients at risk for substance abuse SO PAIN MEDICINE LA English DT Review DE opioids; primary care; chronic noncancer pain; substance abuse; pharmacy costs; pain medicine ID CHRONIC NONMALIGNANT PAIN; DRUG-ABUSE; BACK-PAIN; MEDICINE; DISORDERS; ADDICTION; COMMUNITY; INHIBITORS; CHALLENGE; EFFICACY AB Objective: To measure the impact of a structured opioid renewal program for chronic pain run by a nurse practitioner (NP) and clinical pharmacist in a primary care setting. Patients and Settings: Patients with chronic noncancer pain managed with opioid therapy in a primary care clinic staffed by 19 providers serving 50,000 patients at an urban academic Veterans hospital. Design: Naturalistic prospective outcome study. Intervention: Based on published opioid prescribing guidelines and focus groups with primary care providers (PCPs), a structured program, the Opioid Renewal Clinic (ORC), was designed to support PCPs managing patients with chronic noncancer pain requiring opioids. After training in the use of opioid treatment agreements (OTAs) and random urine drug testing (UDT), PCPs worked with a pharmacist-run prescription management clinic supported by an onsite pain NP who was backed by a multi-specialty Pain Team. After 2 years, the program was evaluated for its impact on PCP practice and satisfaction, patient adherence, and pharmacy cost. Results: A total of 335 patients were referred to the ORC. Of the 171 (51%) with documented aberrant behaviors, 77 (45%) adhered to the OTA and resolved their aberrant behaviors, 65 (38%) self-discharged, 22 (13%) were referred for addiction treatment, and seven (4%) with consistently negative UDT were weaned from opioids. The 164 (49%) who were referred for complexity including history of substance abuse or need for opioid rotation or titration, with no documented aberrant drug-related behaviors, continued to adhere to the OTA. Use of UDT and OTAs by PCPs increased. Significant pharmacy cost savings were demonstrated. Conclusion: An NP/clinical pharmacist-run clinic, supported by a multi-specialty team, can successfully support a primary care practice in managing opioids in complex chronic pain patients. C1 Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP Wiedemer, NL (reprint author), Philadelphia VA Med Ctr, 118, 3900 Woodland Ave, Philadelphia, PA 19104 USA. EM nancy.wiedemer@med.va.gov NR 59 TC 75 Z9 76 U1 1 U2 11 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1526-2375 J9 PAIN MED JI Pain Med. PD OCT PY 2007 VL 8 IS 7 BP 573 EP 584 DI 10.1111/j.1526-4637.2006.00254.x PG 12 WC Medicine, General & Internal SC General & Internal Medicine GA 215RN UT WOS:000249826800006 PM 17883742 ER PT J AU Jasser, SA Garvin, JH Wiedemer, N Roche, D Gallagher, RM AF Jasser, Samar A. Garvin, Jennifer H. Wiedemer, Nancy Roche, Dominic Gallagher, Rollin M. TI Information technology in mental health research: Impediments and implications in one chronic pain study population SO PAIN MEDICINE LA English DT Article DE coding; IT; schizophrenia; chronic pain ID ADMINISTRATIVE DATA; PREVALENCE; SCHIZOPHRENIA; DIAGNOSIS AB Objective. The Department of Veterans Affairs and Veterans' Administration hospitals began using the electronic medical record in 1994, streamlining provider-to-provider communication of vital clinical information, and simultaneously providing investigators access to vast amounts of clinical data for research purposes. Administrative and coded data, including symptoms and diagnoses as derived from chart content, are one of the most ready substrates for analysis of these massive databases to answer various research-related inquiries. We evaluated the capability of this type of coded data to accurately identify patients with schizophrenia from a group of 819 patients taking opioids for chronic pain in the primary care clinic of the Philadelphia Veterans' Administration Medical Center. Methods. Patients were identified for inclusion in this analysis by their sequential enrollment in an Opioid Renewal Clinic as referred by their primary care providers, as well as a nonreferred cohort of chronic pain patients maintained on opioids by their primary care providers (N = 819). The prevalence of schizophrenia obtained by coded diagnostic labeling by computerized chart review was compared with the prevalence of schizophrenia obtained by systematic independent manual chart review of all cases by a research psychiatrist. Results. Based purely on coded diagnostic labeling, the prevalence of schizophrenia in this population was 14%, nearly 14 times the estimated general population prevalence. However, manual independent chart review of the identified cases by a research psychiatrist (N = 119) resulted in the actual prevalence in this group to be estimated at 1.8%. None of the patients with three or less incidents of diagnostic labeling by code had schizophrenia. Of those with four or more incidents, 74% had schizophrenia. Conclusions. Better accuracy is obtained when cases of schizophrenia are identified by multiple coding incidents derived from longitudinal clinical encounters. These findings suggest that the extraction of up to three coding incidents for schizophrenia alone is not an accurate means of identifying this clinical population for research and epidemiological purposes. Further, when designing automated, information technology-based approaches to the identification of subjects for clinical research and extracting their data from electronic medical records using International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes, mental health diagnoses must be uniquely considered on a disease-by-disease basis. C1 Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia VA Med Ctr, Pain Serv, Philadelphia, PA USA. Philadelphia VA Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Sch Med, Dept Anesthesiol, Philadelphia, PA 19104 USA. RP Jasser, SA (reprint author), Univ Penn, Sch Med, Dept Psychiat, 3535 Mrkt St,2nd Floor,2065, Philadelphia, PA 19104 USA. EM samarj@gmail.com NR 12 TC 1 Z9 1 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1526-2375 J9 PAIN MED JI Pain Med. PD OCT PY 2007 VL 8 SU 3 BP S176 EP S181 DI 10.1111/j.1526-4637.2007.00380.x PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 211HA UT WOS:000249513700011 ER PT J AU Doyle, PJ McNeil, MR Bost, JE Ross, KB Wambaugh, JL Hula, WD Mikolic, JM AF Doyle, Patrick J. McNeil, Malcolm R. Bost, James E. Ross, Katherine B. Wambaugh, Julie L. Hula, William D. Mikolic, Joseph M. TI The Burden of Stroke Scale (BOSS) provided valid, reliable, and responsive score estimates of functioning and well-being during the first year of recovery from stroke SO QUALITY OF LIFE RESEARCH LA English DT Article DE stroke; health-status; health-related quality of life; patient-reported outcomes (PROs); responsiveness; functioning; well-being ID QUALITY-OF-LIFE; HEALTH SURVEY SF-36; NEGATIVE AFFECT; IMPACT SCALE; RELIABILITY; INDEPENDENCE; SURVIVORS; VERSION; TESTS AB Ojectives To examine the reliability, validity, and responsiveness of the Burden of Stroke Scale (BOSS). Study Design A prospective cohort of stroke survivors were assessed at 3 (T1, T2), 6 (T3), and 12 (T4) months post onset (MPO) of stroke. Test-retest reliability was evaluated by calculating intra-class correlation coefficients (ICCs) between T1 and T2 scale scores. Convergent validity was evaluated by calculating Pearson product moment correlation coefficients between T1 BOSS, Stroke Impact Scale and MOS SF-36 scale scores assessing similar health concepts. Responsiveness was evaluated using a repeated measures ANOVA and the linear trend test in the full study sample and by calculating standardized response means (SRM) and a probability of change statistic, (p) over cap between T1, T3, and T4 scale scores in participants demonstrating change on external criteria. Results ICCs ranged from 0.78 to 0.94. Pearson coefficients ranged from -0.57 to -0.86. Moderate to high responsiveness estimates were obtained for 9 of 12 subscales with SRM ((p) over cap )values ranged from .497 (.690) to 1.161 (.877). Composite scale SRM ((p) over cap) values ranged from .661 (.746) to 1.192 (.883). Conclusions The BOSS provided valid and reliable score estimates that were responsive to positive changes in functioning and well-being during the first year of recovery from stroke. C1 VA Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Dept Commun Sci & Disorders, Pittsburgh, PA USA. Univ Pittsburgh, Dept Med, Pittsburgh, PA USA. Carl T Hayden VA Med Ctr, Phoenix, AZ USA. VA Salt Lake City Healthcare Syst, Salt Lake City, UT USA. Novum Pharmaceut Res Serv, Pittsburgh, PA USA. RP Doyle, PJ (reprint author), VA Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, 7180 Highland Dr, Pittsburgh, PA 15206 USA. EM patrick.doyle@med.va.gov NR 45 TC 10 Z9 10 U1 1 U2 2 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0962-9343 J9 QUAL LIFE RES JI Qual. Life Res. PD OCT PY 2007 VL 16 IS 8 BP 1389 EP 1398 DI 10.1007/s11136-007-9247-8 PG 10 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 212XK UT WOS:000249630100012 PM 17665314 ER PT J AU Inagami, S Cohen, DA Finch, BK AF Inagami, Sanae Cohen, Deborah A. Finch, Brian K. TI Non-residential neighborhood exposures suppress neighborhood effects on self-rated health SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE self-rated health; multi-level modeling; neighborhood; disadvantage; mobility; USA ID CORONARY HEART-DISEASE; SOCIOECONOMIC CONTEXT; ATHEROSCLEROSIS RISK; MULTILEVEL ANALYSIS; ALLOSTATIC LOAD; TRAVEL BEHAVIOR; MENTAL-HEALTH; DEPRIVATION; MORTALITY; COMMUNITY AB In prior research, neighborhood effects have often been weak or inconsistent in predicting specific causes of mortality and morbidity. To determine whether residential neighborhood effects are suppressed by exposure to other environments, we examined the effect on adult self-rated health of non-residential environments that figure in individuals' daily routines. We linked the 2000 US Census data with the Los Angeles Family and Neighborhood Study (L.A.FANS) database, which consists of 3323 adults sampled from neighborhoods in LA County. Characteristics of census tracts where respondents lived, worked, shopped, sought medical care, worshipped and spent "other" time were obtained from the 2000 US Census. Weighted multilevel linear and clustered generalized ordered logistic regressions were used to estimate associations between self-rated health and non-residential neighborhood exposures after adjustment for individual-level factors and exposure to residential neighborhoods. We found that residence in disadvantaged neighborhoods was associated with worse self-rated health. In a dose-response fashion, the greater the exposure to less disadvantaged non-residential neighborhoods in the course of routine activities, the greater the magnitude in improved self-rated health. Models including non-residential neighborhood exposure increase the magnitude and significance of the association between residential neighborhoods and health. In conclusion, individuals' exposure to non-residential neighborhoods confounds and suppresses the association of residential neighborhoods with health and could explain why previous studies may not have found robust associations between residential neighborhood predictors and health. Published by Elsevier Ltd. C1 VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. RP Inagami, S (reprint author), VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA 90073 USA. EM sinagami@ucla.edu; deborah_cohen@rand.org; bfinch@mail.sdsu.edu NR 60 TC 89 Z9 91 U1 0 U2 13 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PD OCT PY 2007 VL 65 IS 8 BP 1779 EP 1791 DI 10.1016/j.socscimed.2007.05.051 PG 13 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA 222BP UT WOS:000250271400020 PM 17614175 ER PT J AU Ioannou, GN Spector, J Rockey, DC AF Ioannou, George N. Spector, Jeremy Rockey, Don C. TI Predictors of endoscopic and laboratory evaluation of iron deficiency anemia in hospitalized patients SO SOUTHERN MEDICAL JOURNAL LA English DT Article DE colonoscopy; esophagogastroduodenoscopy; ferritin; gastrointestinal bleeding ID GASTROINTESTINAL-TRACT; DIAGNOSIS AB Background: Many hospitalized anemic patients do not undergo appropriate evaluation. We hypothesized that specific clinical variables were likely to be important in triggering evaluation for iron deficiency anemia. Methods: We prospectively identified 637 consecutive anemic patients without acute gastrointestinal bleeding admitted over a three-month period to medical inpatient teams of two teaching hospitals and examined clinical variables that predicted diagnostic evaluation. Results: Serum ferritin or serum transferrin saturation (TS) were measured in 43% (271/637) of subjects and were low in 38% (102/ 271). Predictors of serum ferritin or TS measurement included low hemoglobin concentration and a history of iron supplementation, Predictors of iron deficiency included low hemoglobin concentration (OR 1.9,95% CI 1.06-3.5) and low mean cell volume (OR 4.6, 95% CI 2.5- 8.6). Of 102 patients with iron deficiency anemia, 3 1% underwent endoscopic evaluation, and 39% had serious gastrointestinal lesions. The only significant predictor of having an endoscopic evaluation was a positive fecal occult blood test (FOBT) (OR 5.2, 95% CI 1.7-16.2). Conclusions: In patients with anemia, tests to ascertain iron status are not appropriately performed in hospitalized patients. Patients found to have iron deficiency anemia who are FOBT-positive undergo endoscopic evaluation more frequently than FOBT-negative patients. C1 Univ Texas, SW Med Ctr, Div Digest & Liver Dis, Dallas, TX 75390 USA. Univ Texas, SW Med Ctr, Dept Med, Dallas, TX 75390 USA. Duke Univ, Med Ctr, Dept Med, Durham, NC USA. Duke Univ, Med Ctr, Div Gastroenterol, Durham, NC USA. Vet Affairs Puget Sound Hlth Care Syst, Res Enhancement Award Program, Seattle, WA USA. Univ Washington, Med Ctr, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Div Gastroenterol, Seattle, WA USA. RP Rockey, DC (reprint author), Univ Texas, SW Med Ctr, Div Digest & Liver Dis, 5323 Harry Hines Blvd, Dallas, TX 75390 USA. EM don.rockey@utsouthwestern.edu NR 18 TC 10 Z9 10 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0038-4348 J9 SOUTH MED J JI South.Med.J. PD OCT PY 2007 VL 100 IS 10 BP 976 EP 984 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 222BS UT WOS:000250271700010 PM 17943040 ER PT J AU Iwai, M Cao, GD Yin, W Stetler, RA Liu, JL Chen, J AF Iwai, Masanori Cao, Guodong Yin, Wei Stetler, R. Anne Liu, Jialing Chen, Jun TI Erythropoietin promotes neuronal replacement through revascularization and neurogenesis after neonatal hypoxia/ischemia in rats SO STROKE LA English DT Article DE erythropoietin; neonatal hypoxia/ischemia; neurogenesis; neuronal replacement; revascularization ID NEURAL STEM-CELLS; HYPOXIC-ISCHEMIC INJURY; SUBVENTRICULAR ZONE; BRAIN-INJURY; ENHANCES NEUROGENESIS; STROKE; PROGENITORS; MOUSE; ISCHEMIA/HYPOXIA; PROLIFERATION AB Background and Purpose - Erythropoietin (EPO) has been well characterized and shown to improve functional outcomes after ischemic injury, but EPO may also have unexplored effects on neurovascular remodeling and neuronal replacement in the neonatal ischemic brain. The current study investigates the effects of exogenous administration of EPO on revascularization and neurogenesis, 2 major events thought to contribute to neuronal replacement, in the neonatal brain after hypoxia/ischemia (H/I). Methods - Seven-day-old rat pups were treated with recombinant human EPO or vehicle 20 minutes after H/I and again on postischemic days 2, 4, and 6. Rats were euthanized 7 or 28 days after H/I for evaluation of infarct volume, revascularization, neurogenesis, and neuronal replacement using bromodeoxyuridine incorporation, immunohistochemistry, and lectin labeling. Neurological function was assessed progressively for 28 days after H/I by gait testing, righting reflex and foot fault testing. Results - We demonstrate that exogenous EPO-enhanced revascularization in the ischemic hemisphere correlated with decreased infarct volume and improved neurological outcomes after H/I. In addition to vascular effects, EPO increased both neurogenesis in the subventricular zone and migration of neuronal progenitors into the ischemic cortex and striatum. A significant number of newly synthesized cells in the ischemic boundary expressed neuronal nuclei after EPO treatment, indicating that exogenous EPO led to neuronal replacement. Conclusions - Our data suggest that treatment with EPO contributes to neurovascular remodeling after H/I by promoting tissue protection, revascularization, and neurogenesis in neonatal H/I-injured brain, leading to improved neurobehavioral outcomes. C1 Univ Pittsburgh, Dept Neurol, Sch Med, Pittsburgh, PA 15261 USA. Univ Calif San Francisco, Dept Neurol Surg, San Francisco, CA 94143 USA. Vet Affairs Pittsburgh Hlth Care System, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Chen, J (reprint author), Univ Pittsburgh, Dept Neurol, Sch Med, 507 S Biomed Sci Tower,200 Lothrop St, Pittsburgh, PA 15261 USA. EM chenj2@upmc.edu RI Liu, Jialing/A-8627-2012 OI Liu, Jialing/0000-0003-4420-4382 FU NINDS NIH HHS [NS051576, NS36736, NS43802, NS45048] NR 28 TC 92 Z9 102 U1 1 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD OCT PY 2007 VL 38 IS 10 BP 2795 EP 2803 DI 10.1161/STROKEAHA.107.483008 PG 9 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 213VJ UT WOS:000249694900029 PM 17702962 ER PT J AU Chang, EY Minjarez, RC Kim, CY Seltman, AK Gopal, DV Diggs, B Davila, R Hunter, JG Jobe, BA AF Chang, E. Y. Minjarez, R. C. Kim, C. Y. Seltman, A. K. Gopal, D. V. Diggs, B. Davila, R. Hunter, J. G. Jobe, B. A. TI Endoscopic ultrasound for the evaluation of Nissen fundoplication integrity: a blinded comparison with conventional testing SO SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES LA English DT Article; Proceedings Paper CT Annual Meeting of the Society-of-American-Gastrointestinal-and-Endoscopic-Surgeons CY APR 28, 2006 CL Dallas, TX SP Soc Amer Gastrointestinal Endoscop Surg DE antireflux surgery; endoscopic ultrasound; failure; gastroesophageal reflux disease; Nissen fundoplication; reoperation ID LAPAROSCOPIC ANTIREFLUX SURGERY; FUNCLOPLICATION FAILS; INTEROBSERVER; MANAGEMENT; QUALITY; REFLUX; REDO AB Background: For patients whose symptoms develop after Nissen fundoplication, the precise mechanism of anatomic failure can be difficult to determine. The authors have previously reported the endosonographic hallmarks de. ning an intact Nissen fundoplication in swine and the known causes of failure. The current clinical trial tested the hypothesis that a defined set of endosonographic criteria can be applied to determine fundoplication integrity in humans. Methods: The study enrolled seven symptomatic and nine asymptomatic subjects at a mean of 6 years ( range, 1-30 years) after Nissen fundoplication. A validated gastroesophageal reflux disease (GERD)-specific questionnaire and medication history were completed. Before endoscopic ultrasound (EUS), all the patients underwent complete conventional testing ( upper endoscopy, esophagram, manometry, 24-h pH). A diagnosis was rendered on the basis of combined test results. Then EUS was performed by an observer blinded to symptoms, medication use, and conventional testing diagnoses. Because EUS and esophagogastro-duodenoscopy (EGD) are uniformly performed in combination, the EUS diagnosis was rendered on the basis of previously established criteria combined with the EGD interpretation. The diagnoses then were compared to examine the contribution of EUS in this setting. Results: The technique and defined criteria were easily applied to all subjects. All symptomatic patients had heartburn and were taking proton pump inhibitors (PPI). No asymptomatic patients were taking PPI. All diagnoses established with combined conventional testing were detected on EUS with upper endoscopy. Additionally, EUS resolved the etiology of a low lower esophageal sphincter pressure in two symptomatic patients and detected the additional diagnoses of slippage in two subjects. Among asymptomatic subjects, EUS identified additional diagnoses in two subjects considered to be normal by conventional testing methods. Conclusion: According to the findings, EUS is a feasible method for evaluating post-Nissen fundoplication hiatal anatomic relationships. The combination of EUS and EGD allows the mechanism of failure to be detected in patients presenting with postoperative symptoms after Nissen fundoplication. C1 Oregon Hlth & Sci Univ, Dept Surg, Portland, OR 97201 USA. Univ Wisconsin, Div Gastroenterol, Madison, WI 53706 USA. Oregon Hlth & Sci Univ, Div Gastroenterol, Portland, OR 97201 USA. Portland VA Med Ctr, Surg Serv P3GS, Portland, OR 97207 USA. RP Jobe, BA (reprint author), Oregon Hlth & Sci Univ, Dept Surg, Portland, OR 97201 USA. OI Diggs, Brian/0000-0003-3586-3757 FU NIDDK NIH HHS [K23 DK066165-02] NR 19 TC 2 Z9 2 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0930-2794 J9 SURG ENDOSC JI Surg. Endosc. PD OCT PY 2007 VL 21 IS 10 BP 1719 EP 1725 DI 10.1007/s00464-007-9234-8 PG 7 WC Surgery SC Surgery GA 211XB UT WOS:000249555500007 PM 17345143 ER PT J AU Hess, R Bryce, CL Paone, S Fischer, G McTigue, KM Olshansky, E Zickmund, S Fitzgerald, K Siminerio, L AF Hess, Rachel Bryce, Cindy L. Paone, Suzanne Fischer, Gary McTigue, Kathleen M. Olshansky, Ellen Zickmund, Susan Fitzgerald, Katharine Siminerio, Linda TI Exploring challenges and Potentials of personal health records in diabetes self-management: Implementation and initial assessment SO TELEMEDICINE JOURNAL AND E-HEALTH LA English DT Article ID CHRONIC CARE MODEL AB The University of Pittsburgh Medical Center (UPMC) has implemented a personal health record grounded in the Chronic Care Model, UPMC HealthTrak, to assist patients with diabetes self- management. UPMC HealthTrak is based in the physician office and connects the patient, physician, and electronic medical record (EMR). Its functionalities include secure, electronic communication with the physician's office, along with preventive healthcare reminders, and disease-specific tools and information. In this paper, we describe challenges to office-based implementation of and initial patient reaction to the technology in the context of diabetes care. UPMC has deployed a secure Web-based patient portal, UPMC HealthTrak. We implemented UPMC HealthTrak in the ambulatory setting and assessed its impact on patient - practice communication. We conducted 10 90-minute focus groups ( five pre- and five postimplementation) to assess patient reaction to UPMC HealthTrak. Focus groups were analyzed using grounded theory techniques. During the period September 2004-January 2007, there was no significant change in number of patient encounters or telephone calls received in our office, but the number of HealthTrak messages increased. Our 39 pre- and postimplementation focus group participants felt that the system would enhance communication with the office, and that the reminder system would be helpful. They also liked having access tolaboratory tests remotely. They were frustrated when tests were not released and messages not answered. A Web-based patient portal can be integrated into a clinical office, although patients may not quickly change communication patterns. Patients are responsive to technology. Future work should focus on diabetes-related outcomes assessment and intensifying interventions. C1 Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Hlth Policy & Management, Pittsburgh, PA 15260 USA. Univ Phoenix, Phoenix, AZ USA. Univ Pittsburgh, Med Ctr, Informat Serv Dept, Pittsburgh, PA 15260 USA. Univ Calif Irvine, Program Nursing Sci, Irvine, CA 92717 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Inst Diabet, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Sch Nursing, Dept Hlth & Community Syst, Pittsburgh, PA 15260 USA. RP Hess, R (reprint author), Ctr Res Hlth Care, 230 McKee Pl,Suite 600, Pittsburgh, PA 15213 USA. EM hessr@upmc.edu OI Bryce, Cindy/0000-0001-6356-6675 FU NCRR NIH HHS [UL1 RR024153]; NIA NIH HHS [AG024254]; NIDDK NIH HHS [DK067192] NR 12 TC 54 Z9 54 U1 1 U2 16 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1530-5627 J9 TELEMED J E-HEALTH JI Telemed. J. e-Health PD OCT PY 2007 VL 13 IS 5 BP 509 EP 517 DI 10.1089/tmj.2006.0089 PG 9 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 233JA UT WOS:000251086000020 PM 17999613 ER PT J AU Halpern, SD Ubel, PA Asch, DA AF Halpern, Scott D. Ubel, Peter A. Asch, David A. TI Harnessing the power of default options to improve health care SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Editorial Material ID ACUTE LUNG INJURY; CRITICALLY-ILL PATIENTS; MECHANICAL VENTILATION; RECOMMENDATIONS; PATERNALISM; DECISIONS; PNEUMONIA; CHOICE C1 Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Ctr Bioeth, Dept Med, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Vet Affairs Med Ctr, Dept Med, Ann Arbor, MI USA. Univ Michigan, Ctr Behav & Decis Sci Med, Ann Arbor, MI 48109 USA. RP Halpern, SD (reprint author), Univ Penn, Ctr Clin Epidemiol & Biostat, 711 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM scott.halpern@uphs.upenn.edu NR 30 TC 104 Z9 105 U1 1 U2 10 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD SEP 27 PY 2007 VL 357 IS 13 BP 1340 EP 1344 DI 10.1056/NEJMsb071595 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 214BR UT WOS:000249711500013 PM 17898105 ER PT J AU Steinman, MA AF Steinman, Michael A. TI Number of medical conditions and quality of care SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 San Francisco VA Med Ctr, San Francisco, CA 94121 USA. RP Steinman, MA (reprint author), San Francisco VA Med Ctr, San Francisco, CA 94121 USA. EM mike.steinman@ucsf.edu NR 4 TC 1 Z9 1 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD SEP 27 PY 2007 VL 357 IS 13 BP 1350 EP 1351 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 214BR UT WOS:000249711500022 PM 17898109 ER PT J AU Higashi, T Wenger, NS Shekelle, PG AF Higashi, Takahiro Wenger, Neil S. Shekelle, Paul G. TI Number of medical conditions and quality of care - Reply SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 Kyoto Univ, Kyoto 6068501, Japan. Univ Calif Los Angeles, Los Angeles, CA 90024 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA 90073 USA. RP Higashi, T (reprint author), Kyoto Univ, Kyoto 6068501, Japan. EM shekelle@rand.org NR 2 TC 0 Z9 0 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD SEP 27 PY 2007 VL 357 IS 13 BP 1351 EP 1351 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 214BR UT WOS:000249711500023 ER PT J AU Gold, MC Robinson, TL Cook, MS Byrd, LK Ehlinger, HD Lewinsohn, DM Lewinsohn, DA AF Gold, Marielle C. Robinson, Tammie L. Cook, Matthew S. Byrd, Laura K. Ehlinger, Heather D. Lewinsohn, David M. Lewinsohn, Deborah A. TI Human Neonatal Dendritic Cells Are Competent in MHC Class I Antigen Processing and Presentation SO PLOS ONE LA English DT Article AB Neonates are clearly more susceptible to severe disease following infection with a variety of pathogens than are adults. However, the causes for this are unclear and are often attributed to immunological immaturity. While several aspects of immunity differ between adults and neonates, the capacity of dendritic cells in neonates to process and present antigen to CD8(+) T cells remains to be addressed. We used human CD8(+) T cell clones to compare the ability of neonatal and adult monocyte-derived dendritic cells to present or process and present antigen using the MHC class I pathway. Specifically, we assessed the ability of dendritic cells to present antigenic peptide, present an HLA-E-restricted antigen, process and present an MHC class I-restricted antigen through the classical MHC class I pathway, and cross present cell-associated antigen via MHC class I. We found no defect in neonatal dendritic cells to perform any of these processing and presentation functions and conclude that the MHC class I antigen processing and presentation pathway is functional in neonatal dendritic cells and hence may not account for the diminished control of pathogens. C1 [Gold, Marielle C.; Lewinsohn, David M.] Oregon Hlth & Sci Univ, Dept Pulm & Crit Care Med, Portland, OR 97201 USA. [Gold, Marielle C.; Lewinsohn, David M.] Portland VA Med Ctr, Portland, OR USA. [Robinson, Tammie L.; Cook, Matthew S.; Byrd, Laura K.; Ehlinger, Heather D.; Lewinsohn, Deborah A.] Oregon Hlth & Sci Univ, Dept Pediat, Portland, OR 97201 USA. RP Gold, MC (reprint author), Oregon Hlth & Sci Univ, Dept Pulm & Crit Care Med, 3181 SW Sam Jackson Pk Rd, Portland, OR 97201 USA. EM goldm@ohsu.edu RI Lewinsohn, David/I-4936-2013 OI Lewinsohn, David/0000-0001-9906-9494; Gold, Marielle/0000-0003-2505-3291 FU NIH [5R01 AI054474] FX NIH 5R01 AI054474; The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NR 32 TC 11 Z9 11 U1 0 U2 1 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 185 BERRY ST, STE 1300, SAN FRANCISCO, CA 94107 USA SN 1932-6203 J9 PLOS ONE JI PLoS One PD SEP 26 PY 2007 VL 2 IS 9 AR e957 DI 10.1371/journal.pone.0000957 PG 5 WC Multidisciplinary Sciences SC Science & Technology - Other Topics GA V10HT UT WOS:000207455800035 PM 17895997 ER PT J AU Shen, KZ Kozell, LB Johnson, SW AF Shen, K.-Z. Kozell, L. B. Johnson, S. W. TI Multiple conductances are modulated by 5-HT receptor subtypes in rat subthalamic nucleus neurons SO NEUROSCIENCE LA English DT Article DE 5-HT; subthalamic nucleus; brain slice; patch clamp; burst firing ID EXTERNAL GLOBUS-PALLIDUS; LOCUS-CERULEUS NEURONS; DORSAL RAPHE NEURONS; MOTONEURONS IN-VITRO; BASAL GANGLIA; PARKINSONS-DISEASE; POTASSIUM CONDUCTANCE; K+ CURRENT; SEROTONIN; 5-HYDROXYTRYPTAMINE AB Firing patterns of subthalamic nucleus (STN) neurons influence normal and abnormal movements. The STN expresses multiple 5-HT receptor subtypes that may regulate neuronal excitability. We used whole-cell patch-clamp recordings to characterize 5-HT receptor-mediated effects on membrane currents in STN neurons in rat brain slices. In 80 STN neurons under voltage-clamp (-70 mV), 5-HT (30 mu M) evoked inward currents in 64%, outward currents in 17%, and biphasic currents in 19%. 5-HT-induced outward current was caused by an increased K+ conductance (1.4 +/- 0.2 nS) and was blocked by the 5-HT1A antagonist WAY 100135. The 5-HT-evoked inward current, which was blocked by antagonists at 5-HT2c and/or 5-HT4 receptors, had two types of current-voltage (I-V) relations. Currents associated with the type I I-V relation showed negative slope conductance at potentials < - 110 mV and were occluded by Ba2+. In contrast, the type 2 I-V relation appeared linear and had positive slope conductance (0.64 +/- 0.11 nS). Type 2 inward currents were Ba2+- insensitive, and the reversal potential of -19 mV suggests a mixed cation conductance. In STN neurons in which 5-HT evoked inward currents, 5-HT potentiated burst firing induced by N-methyl-D-aspartate (NMDA). But in neurons in which 5-HT evoked outward current, 5-HT slowed NMDA-dependent burst firing. We conclude that 5-HT receptor subtypes can differentially regulate firing pattern by modulating multiple conductances in STN neurons. (C) 2007 IBRO. Published by Elsevier Ltd. All rights reserved. C1 Portland VA Med Ctr, Portland, OR 97207 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR USA. RP Johnson, SW (reprint author), Portland VA Med Ctr, R D 61, 3710 SW US Veterans Hosp Rd, Portland, OR 97207 USA. EM johnsost@ohsu.edu OI Kozell, Laura/0000-0003-3059-2046 FU NINDS NIH HHS [NS38175, R01 NS038175, R01 NS038715, R01 NS038715-08] NR 50 TC 17 Z9 19 U1 0 U2 2 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PD SEP 21 PY 2007 VL 148 IS 4 BP 996 EP 1003 DI 10.1016/j.neuroscience.2007.07.012 PG 8 WC Neurosciences SC Neurosciences & Neurology GA 216WF UT WOS:000249909000015 PM 17706881 ER PT J AU Seeram, NP Aronson, WJ Zhang, Y Henning, SM Moro, A Lee, RP Sartippour, N Harris, DM Rettig, M Suchard, MA Pantuck, AJ Belldegrun, A Heber, D AF Seeram, Navindra P. Aronson, William J. Zhang, Yanjun Henning, Susanne M. Moro, Aune Lee, Ru-Po Sartippour, Niaryam Harris, Diane M. Rettig, Matthew Suchard, Marc A. Pantuck, Allan J. Belldegrun, Arie Heber, David TI Pomegranate ellagitannin-derived metabolites inhibit prostate cancer growth and localize to the mouse prostate gland SO JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY LA English DT Article DE pomegranate; ellagitannins; urolithins; metabolite; tissue disposition; prostate cancer ID ELLAGIC ACID; HUMAN PLASMA; JUICE; BIOAVAILABILITY; ANTIOXIDANT; POLYPHENOLS; PUNICALAGIN; EXTRACT; CELLS; RAT AB Our group has shown in a phase 11 clinical trial that pomegranate juice (PJ) increases prostate specific antigen (PSA) doubling time in prostate cancer (CaP) patients with a rising PSA. Ellagitannins (ETs) are the most abundant polyphenols present in PJ and contribute greatly towards its reported biological properties. On consumption, ETs hydrolyze to release ellagic acid (EA), which is then converted by gut microflora. to 3,8-dihydroxy-6H-dibenzo[b,d]pyran-6-one (urolithin A, UA) derivatives. Despite the accumulating knowledge of ET metabolism in animals and humans, there is no available data on the pharmacokinetics and tissue disposition of urolithins. Using a standardized ET-enriched pomegranate extract (PE), we sought to further define the metabolism and tissue distribution of ET metabolites. PE and UA (synthesized in our laboratory) were administered to C57BL/6 wild-type male mice, and metabolite levels in plasma and tissues were determined over 24 h. ET metabolites were concentrated at higher levels in mouse prostate, colon, and intestinal tissues as compared to other tissues after administration of PE or UA. We also evaluated the effects of PE on CaP growth in severe combined immunodeficient (SCID) mice injected subcutaneously with human CaP cells (LAPC-4). PE significantly inhibited LAPC-4 xenograft growth in SCID mice as compared to vehicle control. Finally, EA and several synthesized urolithins were shown to inhibit the growth of human CaP cells in vitro. The chemopreventive potential of pomegranate ETs and localization of their bioactive metabolites in mouse prostate tissue suggest that pomegranate may play a role in CaP treatment and chemoprevention. This warrants future human tissue bioavailability studies and further clinical studies in men with CaP. C1 Univ Calif Los Angeles, David Geffen Sch Med, Ctr Human Nutr, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Urol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Greater Los Angeles VA Med Ctr, Los Angeles, CA 90095 USA. RP Seeram, NP (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Ctr Human Nutr, Los Angeles, CA 90095 USA. EM nseeram@mednet.ucla.edu FU NCI NIH HHS [CA 42710, P50 CA 92131]; NIDDK NIH HHS [T32 DK07688] NR 21 TC 124 Z9 127 U1 0 U2 6 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0021-8561 J9 J AGR FOOD CHEM JI J. Agric. Food Chem. PD SEP 19 PY 2007 VL 55 IS 19 BP 7732 EP 7737 DI 10.1021/jf071303g PG 6 WC Agriculture, Multidisciplinary; Chemistry, Applied; Food Science & Technology SC Agriculture; Chemistry; Food Science & Technology GA 210KM UT WOS:000249455100017 PM 17722872 ER PT J AU Plomondon, ME Ho, PM Wang, L Greiner, GT Shore, JH Sakai, JT Fihn, SD Rumsfeld, JS AF Plomondon, Mary E. Ho, P. Michael Wang, Li Greiner, Gwendolyn T. Shore, James H. Sakai, Joseph T. Fihn, Stephan D. Rumsfeld, John S. TI Severe mental illness and mortality of hospitalized ACS patients in the VHA SO BMC HEALTH SERVICES RESEARCH LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; ACUTE CORONARY SYNDROMES; HEALTH-CARE-SYSTEM; GENDER DISPARITIES; HEART-DISEASE; MANAGEMENT; DISORDERS; REVASCULARIZATION; OUTCOMES; QUALITY AB Background: Severe mental illness (SMI) has been associated with more medical co-morbidity and less cardiovascular procedure use for older patients with myocardial infarction. However, it is unknown whether SMI is associated with increased long term mortality risk among patients presenting with acute coronary syndromes (ACS). We tested the hypothesis that SMI is associated with higher one-year mortality following ACS hospitalization. Methods: All ACS patients (n = 14,194) presenting to Veterans Health Administration (VHA) hospitals between October 2003 and September 2005 were included. Survival analysis evaluated the association between SMI and one-year all-cause mortality, adjusting for demographics, co-morbidities, in-hospital treatment, and discharge medications. Results: Overall, 18.4 % of ACS patients had SMI. Patients with SMI were more likely female, younger, Caucasian race, have a history of alcohol abuse, liver disease, dementia, hypertension and more likely to be a current smoker; however, prior cardiac history was similar between the 2 groups. There were no significant differences in cardiac procedure use, including coronary angiogram (38.7% vs. 40.3%, p = 0.14) or coronary revascularization (31.0% vs. 32.3%, p = 0.19), and discharge medications between those with and without SMI. One-year mortality was lower for patients with SMI (15.8% vs. 19.1%, p < 0.001). However, in multivariable analysis, there were no significant differences in mortality (HR 0.91; 95% Cl 0.81-1.02) between patients with and without SMI. Conclusion: Among ACS patients in the VHA, SMI is prevalent, affecting almost 1 in 5 patients. However, patients with SMI were as likely to undergo coronary revascularization and be prescribed evidence-based medications at hospital discharge, and were not at elevated risk of adverse 1-year outcomes compared to patients without SMI. C1 Denver VA Med Ctr, Cardiol Sect, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO USA. Puget Sound Hlth Care Ctr, Dept Vet Affairs, Hlth Serv Res & Dev, Seattle, WA USA. Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Denver, CO USA. RP Plomondon, ME (reprint author), Denver VA Med Ctr, Cardiol Sect, Denver, CO USA. EM meg.plomondon@va.gov; michael.ho@va.gov; li.wang2@va.gov; gwendolyn.greiner@va.gov; jay.shore@uchsc.edu; joseph.sakai@uchsc.edu; stephan.fihn@va.gov; John.Rumsfeld@va.gov NR 20 TC 17 Z9 18 U1 1 U2 1 PU BIOMED CENTRAL LTD PI LONDON PA MIDDLESEX HOUSE, 34-42 CLEVELAND ST, LONDON W1T 4LB, ENGLAND SN 1472-6963 J9 BMC HEALTH SERV RES JI BMC Health Serv. Res. PD SEP 18 PY 2007 VL 7 AR 146 DI 10.1186/1472-6963-7-146 PG 6 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 234NC UT WOS:000251169800001 PM 17877804 ER PT J AU Katiyar, SK AF Katiyar, Santosh K. TI UV-induced immune suppression and photocarcino genesis: Chemoprevention by dietary botanical agents SO CANCER LETTERS LA English DT Review DE chemoprevention; DNA repair; immunosuppression; interleukins; photocarcinogenesis; ultraviolet radiation ID RADIATION-INDUCED IMMUNOSUPPRESSION; HEART-TRANSPLANT RECIPIENTS; DELAYED-TYPE HYPERSENSITIVITY; GREEN TEA POLYPHENOLS; SKIN-CANCER; ULTRAVIOLET-RADIATION; CONTACT HYPERSENSITIVITY; DNA-REPAIR; IN-VIVO; PREVENTS PHOTOCARCINOGENESIS AB Studies of immune-suppressed transplant recipients and patients with biopsy-proven skin cancer have confirmed that ultraviolet (UV) radiation-induced immune suppression is a risk factor for the development of skin cancer in humans. UV radiation suppresses the immune system in several ways. The UVB spectrum inhibits antigen presentation, induces the release of immunosuppressive cytokines, and elicits DNA damage that is a molecular trigger of UV-mediated immunosuppression. It is therefore important to elucidate the mechanisms underlying UV-induced immunosuppression as a basis for developing strategies to protect individuals from this effect and subsequent development of skin cancer. Dietary botanicals are of particular interest as they have been shown to inhibit UV-induced immune suppression and photocarcinogenesis. In this review, we summarize the most recent investigations and mechanistic studies regarding the photoprotective efficacy of selected dietary agents, including, green tea polyphenols, grape seed proanthocyanidins and silymarin. We present evidence that these chemopreventive agents prevent UVB-induced immunosuppression and photocarcinogenesis through: (i) the induction of immunoregulatory cytokine interleukin (IL)-12; (ii) IL-12-dependent DNA repair; and (iii) stimulation of cytotoxic T cells in the tumor microenvironment. The new information regarding the mechanisms of action of these agents supports their potential use as adjuncts in the prevention of photocarcinogenesis. (c) 2007 Elsevier Ireland Ltd. All rights reserved. C1 Univ Alabama, Dept Dermatol, Birmingham, AL 35294 USA. Univ Alabama, Dept Environm Hlth Sci, Birmingham, AL 35294 USA. Univ Alabama, Clin Nutr Res Ctr, Birmingham, AL 35294 USA. Univ Alabama, Ctr Comprehens Canc, Birmingham, AL 35294 USA. Univ Alabama, Birmingham VA Med Ctr, Birmingham, AL 35294 USA. RP Katiyar, SK (reprint author), Univ Alabama, Dept Dermatol, Birmingham, AL 35294 USA. EM skatiyar@uab.edu FU NCCIH NIH HHS [AT002536, R01 AT002536, R01 AT002536-02]; NCI NIH HHS [CA105368, CA089738, CA104428, R03 CA089738, R03 CA105368, R03 CA105368-02, R21 CA104428, R21 CA104428-01A2, R21 CA104428-02]; NIEHS NIH HHS [ES11421] NR 60 TC 66 Z9 70 U1 3 U2 8 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0304-3835 J9 CANCER LETT JI Cancer Lett. PD SEP 18 PY 2007 VL 255 IS 1 BP 1 EP 11 DI 10.1016/j.canlet.2007.02.010 PG 11 WC Oncology SC Oncology GA 210XK UT WOS:000249488700001 PM 17382466 ER PT J AU Bilimoria, KY Bentrem, DJ Ko, CY Tomlinson, JS Stewart, AK Winchester, DP Talamonti, MS AF Bilimoria, Karl Y. Bentrem, David J. Ko, Clifford Y. Tomlinson, James S. Stewart, Andrew K. Winchester, David P. Talamonti, Mark S. TI Multimodality therapy for pancreatic cancer in the US - Utilization, outcomes, and the effect of hospital volume SO CANCER LA English DT Article; Proceedings Paper CT Annual Symposium of the American-Society-of-Clinical-Oncology-Gastrointestinal Cancers CY JAN 19-21, 2007 CL Orlando, FL SP Amer Soc Clin Oncol Gastrointestinal Canc DE pancreatic neoplasms; surgery; chemotherapy; radiation therapy; multimodality therapy; National Cancer Data Base ID LONG-TERM SURVIVAL; OPERATIVE MORTALITY; CURATIVE RESECTION; CONSECUTIVE PANCREATICODUODENECTOMIES; ADJUVANT CHEMOTHERAPY; GENERAL-POPULATION; COLORECTAL-CANCER; RADIATION-THERAPY; LAST DECADE; ADENOCARCINOMA AB BACKGROUND. Despite decreased perioperative morbidity and mortality and clinical trials suggesting improved outcomes with adjuvant therapy, national practice patterns in the management of pancreatic cancer remain poorly defined. The purpose of the current study was to evaluate multimodality therapy utilization and outcomes relative to hospital type and Volume. METHODS. Using the National Cancer Data Base, stage-specific treatment patterns were analyzed for 301,033 patients with pancreatic adenocarcinoma. Logistic regression was used to evaluate treatment utilization. Cox proportional hazards modeling was utilized to evaluate the effect of multimodality therapy on survival. RESULTS. Stage at presentation did not differ from 1985-1994 to 1995-2003; however, the percentage of patients receiving cancer-directed treatment increased from 45.1% to 51.8% (P < .001). Pancreatectomy for localized disease (AJCC 6th edition stages I and 11) increased from 36.9% to 49.3% (P < .001). After resection, the use of adjuvant chemotherapy alone increased from 4.1% to 5.7% (P < .001), but the use of adjuvant radiation alone decreased from 7.0% to 4.6% (P < .001). Adjuvant chemoradiation use increased from 26.8% to 38.7% (P < .001). The use Of Surgery alone decreased from 62.1% (5213 of 8400 cases) to 49.9% (10,807 of 21,679 cases) (P < .001), Patients with localized pancreatic cancer were more likely to receive pancreatectomy and adjuvant chemoradiation at academic and high-volume centers (P < .001). Survival for localized disease was better after surgery with adjuvant therapy (hazards ratio [HR], 0.44; 95% confidence interval [95% CI], 0.42-0.47) and surgical resection alone (HR, 0.54; 95% CI, 0.52-0.57) compared with no treatment. CONCLUSIONS. To the authors' knowledge, the current study is the largest study regarding pancreatic cancer performed to date, and the first to investigate national practice patterns for multimodality therapy utilization. Multimodality therapy utilization has increased over time and appears to have a beneficial impact on survival. C1 Northwestern Univ, Feinburg Sch Med, Div Surg Oncol, Dept Surg, Chicago, IL 60611 USA. Amer Coll Surg, Natl Canc Data Base, Canc Programs, Chicago, IL USA. Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. Vet Adm Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Evanston NW Hosp, Dept Surg, Evanston, IL USA. RP Talamonti, MS (reprint author), Northwestern Univ, Feinburg Sch Med, Div Surg Oncol, Dept Surg, 675 N St Clair St,Galter 10-105, Chicago, IL 60611 USA. EM mtalamonti@nmff.org NR 53 TC 105 Z9 109 U1 0 U2 4 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER JI Cancer PD SEP 15 PY 2007 VL 110 IS 6 BP 1227 EP 1234 DI 10.1002/cncr.22916 PG 8 WC Oncology SC Oncology GA 208FA UT WOS:000249304000008 PM 17654662 ER PT J AU Powers, KM Kay, DM Factor, SA Zabetian, CP Higgins, D Samii, A Nutt, JG Griffith, A Leis, B Roberts, JW Martinez, ED Montimurro, JS Checkoway, H Payami, H AF Powers, K. M. Kay, D. M. Factor, S. A. Zabetian, C. P. Higgins, D. Samii, A. Nutt, J. G. Griffith, A. Leis, B. Roberts, J. W. Martinez, E. D. Montimurro, J. S. Checkoway, H. Payami, H. TI Combined effects of smoking, coffee, and NSAIDs on Parkinson's disease risk SO MOVEMENT DISORDERS LA English DT Meeting Abstract CT 21st Annual Symposium on Etiology, Pathogenesis, and Treatment of Parkinsons Disease and Other Movement Disorders CY OCT 07, 2007 CL Washington, DC SP Parkinson Study Grp, Huntinton Study Grp, Dystonia Study Grp, Myoclonus Study Grp, Tourette Syndrome Study Grp, Cooperat Ataxia Grp, Tremor Res Grp, Movement Disorder Soc C1 Univ Washington, Sch Publ Hlth & Community Med, Dept Environm & Occupat Hlth, Seattle, WA 98195 USA. New York State Dept Hlth, Gen Inst, Albany, NY USA. Emory Univ, Sch Med, Dept Neurol, Atlanta, GA 30322 USA. Albany Med Ctr, Parkinsons Dis & Movement Disorder Clin, Albany, NY USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA USA. Va Puget Sound Hlth Care Syst, Parkinsons Dis Res Educ & Clin Ctr, Seattle, WA USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. Evergreen Hosp Med Ctr, Booth Gardner Parkinsons Care Ctr, Kirkland, WA USA. Virginia Mason Med Ctr, Seattle, WA 98101 USA. NR 0 TC 0 Z9 0 U1 1 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD SEP 15 PY 2007 VL 22 IS 12 BP II EP II PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 218CD UT WOS:000249992700037 ER PT J AU Kim, HM Samii, A Martinez, E Richards, G Zabetian, C Leverenz, JB AF Kim, H. M. Samii, A. Martinez, E. Richards, G. Zabetian, C. Leverenz, J. B. TI The Washington Parkinson disease registry (WPDR): A state-wide research registry SO MOVEMENT DISORDERS LA English DT Meeting Abstract CT 21st Annual Symposium on Etiology, Pathogenesis, and Treatment of Parkinsons Disease and Other Movement Disorders CY OCT 07, 2007 CL Washington, DC SP Parkinson Study Grp, Huntinton Study Grp, Dystonia Study Grp, Myoclonus Study Grp, Tourette Syndrome Study Grp, Cooperat Ataxia Grp, Tremor Res Grp, Movement Disorder Soc C1 Univ Washington, Dept Neurol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, NW Parkinsons Dis Res Educ & Clin Ctr, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Mental Illness Res Educ & Clin Ctr, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD SEP 15 PY 2007 VL 22 IS 12 MA 17 BP IX EP IX PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 218CD UT WOS:000249992700059 ER PT J AU Kim, HM Samii, A Factor, SA Griffith, A Roberts, J Mosley, AD Leis, BC Yearout, D Hutter, CM Edwards, KL Richards, G Nutt, JG Higgins, DS Payami, H Zabetian, CP AF Kim, H. M. Samii, A. Factor, S. A. Griffith, A. Roberts, Jw. Mosley, A. D. Leis, B. C. Yearout, D. Hutter, C. M. Edwards, K. L. Richards, G. Nutt, J. G. Higgins, D. S. Payami, H. Zabetian, C. P. TI HFE variants C282Y and H63D do not alter risk of Parkinson's disease SO MOVEMENT DISORDERS LA English DT Meeting Abstract CT 21st Annual Symposium on Etiology, Pathogenesis, and Treatment of Parkinsons Disease and Other Movement Disorders CY OCT 07, 2007 CL Washington, DC SP Parkinson Study Grp, Huntinton Study Grp, Dystonia Study Grp, Myoclonus Study Grp, Tourette Syndrome Study Grp, Cooperat Ataxia Grp, Tremor Res Grp, Movement Disorder Soc C1 Univ Washington, Dept Neurol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, NW Parkinsons Dis Res Educ & Clin Ctr, Seattle, WA USA. Emory Univ, Sch Med, Dept Neurol, Atlanta, GA 30322 USA. Evergreen Hosp, Med Ctr, Booth Gardner Parkinsons Care Ctr, Kirkland, WA 98034 USA. Virginia Mason Med Ctr, Dept Neurol, Seattle, WA 98101 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. Portland VA Med Ctr, NW Parkinsons Dis Res Educ & Clin Ctr, Portland, OR USA. Albany Med Ctr, Dept Neurol, Albany, NY USA. New York State Dept Hlth, Wadsworth Ctr, Albany, NY USA. VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD SEP 15 PY 2007 VL 22 IS 12 MA 28 BP XII EP XII PG 1 WC Clinical Neurology SC Neurosciences & Neurology GA 218CD UT WOS:000249992700070 ER PT J AU Tennyson, H Helling, ER Wiseman, J Dick, E Lyons, RC AF Tennyson, Heath Helling, Eric R. Wiseman, Joseph Dick, Edward Lyons, Robert C. TI The effect of topical mitomycin c on full-thickness burns SO PLASTIC AND RECONSTRUCTIVE SURGERY LA English DT Article ID EXPOSURES; SCALE AB Background: Burns result in substantial morbidity because of fibroblast proliferation and contracture. Mitomycin C is a chemotherapeutic agent known to suppress fibroblast proliferation. It is used in ophthalmologic disorders and reduces scarring in upper aerodigestive surgery. No study of the effect of mitomycin C on cutaneous burns has been performed. This study examined burn healing in the presence of topical mitomycin C by evaluation of wound appearance, contraction, and histology in a pig model. Methods: Standardized full-thickness burns were produced on the flanks of three pigs. One animal received no further therapy and was an external control. Two animals under-went placement of topical mitomycin C, 0.4 mg/ml, on selected burn sites for 5 minutes. This was repeated 2 and 4 weeks after injury. Evaluation was performed at 2 and 6 months using a clinical assessment scale and a visual analogue scale. Scar length and histologic analysis were also evaluated. Results: Clinical assessment scale and visual analogue scale scores showed improved appearance in the untreated external control wounds versus the untreated internal control and treated wounds (p < 0.001). Wound contraction was not significantly different between groups. Histologic characteristics between groups were similar except for epidermal hyperplasia, which was decreased in the untreated external control (p < 0.05) at 2 months after treatment. Conclusions: Topical mitomycin C treatment of full-thickness burn wounds at 0.4 mg/cc for three courses does not improve, and may worsen, clinical appearance and scarring during early healing. There is no difference in histology during the long. term healing process. Scar contraction was unchanged. C1 Univ Texas, Hlth Sci Ctr, Plast Surg Serv, San Antonio, TX USA. Ft Sam Houston, Brooke Army Med Ctr, Otolaryngol Serv, San Antonio, TX USA. Landstuhl Reg Med Ctr, Otolaryngol Serv, Landstuhl, Germany. US Army Inst Surg Res, Vet Serv, Ft Sam Houston, San Antonio, TX USA. Audie L Murphy Vet affairs Med Ctr, Plast Surg Serv, San Antonio, TX USA. RP Helling, ER (reprint author), Tripler Army Med Ctr, Plast Surg Serv, 1 Jarrett White Rd, Honolulu, HI 96859 USA. EM eric.helling@us.army.mil NR 13 TC 5 Z9 6 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0032-1052 J9 PLAST RECONSTR SURG JI Plast. Reconstr. Surg. PD SEP 15 PY 2007 VL 120 IS 4 BP 879 EP 886 DI 10.1097/01.prs.0000277666.07097.55 PG 8 WC Surgery SC Surgery GA 208XK UT WOS:000249352300008 PM 17805114 ER PT J AU Edderkaoui, M Hong, P Lee, JK Pandol, SJ Gukovskaya, AS AF Edderkaoui, Mouad Hong, Peggy Lee, Jong K. Pandol, Stephen J. Gukovskaya, Anna S. TI Insulin-like growth factor-I receptor mediates the prosurvival effect of fibronectin SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID SMOOTH-MUSCLE-CELLS; EXTRACELLULAR-MATRIX PROTEINS; PANCREATIC-CANCER CELLS; FOCAL ADHESION KINASE; IGF-I; ALPHA-V-BETA-3 INTEGRIN; APOPTOSIS; PHOSPHORYLATION; PROLIFERATION; STATISTICS AB We recently showed that extracellular matrix ( ECM) proteins, which are abundant in desmoplastic pancreatic tumor, are as potent as growth factors in inhibiting apoptosis in pancreatic cancer ( PaCa) cells. Here we show that fibronectin, a major ECM component, engages insulin-like growth factor-I receptor ( IGF-IR) to inhibit PaCa cell death. We found that fibronectin-induced protection from apoptosis is fully mediated by IGF-IR and is independent of IGF-I. Pharmacologic and molecular inhibitions of IGF-IR stimulated apoptosis and prevented the prosurvival effect of fibronectin in PaCa cells. Our data indicate that fibronectin protects from apoptosis through trans-activation of IGF-IR. We showed that fibronectin stimulated complex formation between its receptor beta 3 integrin and protein-tyrosine phosphatase SHP-2. This process of complex formation, in turn, prevents SHP- 2 from dephosphorylating IGF-IR resulting in sustained phosphorylation of IGF-IR and leading to the downstream activation of Akt kinase, up-regulation of antiapoptotic BclxL, and inhibition of apoptosis. Among ECM proteins tested only fibronectin and laminin but not vitronectin and collagen I stimulated trans-activation of IGF-IR. Interaction of fibronectin with beta 3 but not beta 1 integrin receptors mediates the survival pathway. In contrast, fibronectin-induced adhesion is mediated through beta 1 integrin receptor and is IGF-IR-independent. Thus, our results indicate that the prosurvival effect of fibronectin in PaCa cells is mediated by trans-activation of IGF-IR induced by the beta 3 integrin receptor. The data suggest IGF-IR as a key target for prevention of the prosurvival effects of ECM proteins and growth factors in pancreatic cancer. C1 W Los Angeles Vet Affairs Hlth Ctr, Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Los Angeles, CA 90073 USA. Sungkyunkwan Univ, Sch Med, Seoul 135710, South Korea. RP Gukovskaya, AS (reprint author), W Los Angeles Vet Affairs Hlth Ctr, Vet Affairs Greater Los Angeles Healthcare Syst, Dept Med, 11301 Wilshire Blvd,Bldg 258,Rm 340, Los Angeles, CA 90073 USA. EM agukovsk@ucla.edu FU NCI NIH HHS [R01 CA 119025-01] NR 30 TC 29 Z9 31 U1 0 U2 0 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD SEP 14 PY 2007 VL 282 IS 37 BP 26646 EP 26655 DI 10.1074/jbc.M702836200 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 208FJ UT WOS:000249304900003 PM 17627944 ER PT J AU Patel, DN King, CA Bailey, SR Holt, JW Venkatachalam, K Agrawal, A Valente, AJ Chandrasekar, B AF Patel, Devang N. King, Carter A. Bailey, Steven R. Holt, Jeffrey W. Venkatachalam, Kaliyamurthi Agrawal, Alok Valente, Anthony J. Chandrasekar, Bysani TI Interleukin-17 stimulates C-reactive protein expression in hepatocytes and smooth muscle cells via p38 MAPK and ERK1/2-dependent NF-kappa B and C/EBP beta activation SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID CORONARY-HEART-DISEASE; NECROSIS-FACTOR-ALPHA; SERUM AMYLOID-A; CARDIOVASCULAR-DISEASE; NUCLEAR-FACTOR; TNF-ALPHA; ENDOTHELIAL-CELLS; INFLAMMATION; COMPLEMENT; CYTOKINE AB Elevated systemic levels of the acute phase C-reactive protein (CRP) are predictors of future cardiovascular events. There is evidence that CRP may also play a direct role in atherogenesis. Here we determined whether the proinflammatory interleukin (IL)-17 stimulates CRP expression in hepatocytes (Hep3B cell line and primary hepatocytes) and coronary artery smooth muscle cells (CASMC). Our results demonstrate that IL-17 potently induces CRP expression in Hep3B cells independent of IL-1 beta and IL-6. IL-17 induced CRP promoter-driven reporter gene activity that could be attenuated by dominant negative I kappa B alpha or C/EBP beta knockdown and stimulated both NF-kappa B and C/EBP DNA binding and reporter gene activities. Targeting NF-kappa B and C/EBP beta activation by pharmacological inhibitors, small interfering RNA interference and adenoviral transduction of dominant negative expression vectors blocked IL-17-mediated CRP induction. Overexpression of wild type p50, p65, and C/EBP beta stimulated CRP transcription. IL-17 stimulated p38 MAPK and ERK1/2 activation, and SB203580 and PD98059 blunted IL-17-mediated NF-kappa B and C/EBP activation and CRP transcription. These results, confirmed in primary human hepatocytes and CASMC, demonstrate for the first time that IL-17 is a potent inducer of CRP expression via p38 MAPK and ERK1/2-dependent NF-kappa B and C/EBP beta activation and suggest that IL-17 may mediate chronic inflammation, atherosclerosis, and thrombosis. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. E Tennessee State Univ, Dept Pharmacol, Johnson City, TN 37614 USA. S Texas Vet Hlth Care Syst, Dept Vet Affairs, San Antonio, TX 78229 USA. RP Chandrasekar, B (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM chandraseka@uthscsa.edu FU NHLBI NIH HHS [HL 68020, R01 HL068020, R01 HL071233] NR 58 TC 113 Z9 123 U1 0 U2 1 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD SEP 14 PY 2007 VL 282 IS 37 BP 27229 EP 27238 DI 10.1074/jbc.M703250200 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 208FJ UT WOS:000249304900064 PM 17652082 ER PT J AU Tauaj, JA Kirklin, JK Brown, RN Rayburn, BK Bourge, RC Benza, RL Pinderski, L Pamboukian, S McGiffin, DC Naftel, DC AF Tauaj, Jose A. Kirklin, James K. Brown, Robert N. Rayburn, Barry K. Bourge, Robert C. Benza, Raymond L. Pinderski, Laura Pamboukian, Salpy McGiffin, David C. Naftel, David C. TI Post-heart transplant diastolic dysfunction is a risk factor for mortality SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID VENTRICULAR EJECTION FRACTION; CARDIAC TRANSPLANTATION; EXERCISE CAPACITY; FAILURE; PHYSIOLOGY; SURVIVAL AB Objectives The purpose of this study was to evaluate the incidence and prognostic implication of diastolic dysfunction (DD) occurring in the first year after transplant. Background Diastolic dysfunction is a recognized complication in heart transplant recipients, but its true incidence and natural history has been poorly characterized. We studied the prognostic implication of DD, as defined by elevated filling pressures with normal systolic function, occurring in the first year after transplant. Methods Between June 1992 and June 2002, all patients who underwent heart transplantation at a single institution were included in the study (231 at 6 weeks and 250 at 6 months and 1 year). Diastolic dysfunction was defined as right atrial pressure (RAP) :15 mm Hg (right ventricular [RV] DD) or pulmonary capillary wedge pressure >= 18 mm Hg (left ventricular [LV] DD) with normal systolic function by echocardiogram and without severe mitral or tricuspid insufficiency. In addition, RV DD was defined by a RAP/stroke volume (SV) ratio. Results The incidence of DID was 22%, 8%, and 12% at 6 weeks, 6 months, and I year, respectively. The incidence of LV DD was more frequent than that of RV DD at any time point (p < 0.0001). By multivariable analysis RV DD, as manifested by an elevated RAP/SV, but not LV DD was a strong predictor of cardiac mortality at all time points. Conclusions Diastolic dysfunction is common early after transplant, and its incidence decreases during the first year. Right ventricular DD, as measured by an elevated RAP/SV ratio, but not LV DD is a strong predictor of cardiac mortality. Further studies are needed to evaluate the functional status of patients with RV or LV DD and whether aggressive medical therapy for early DD could alter outcome. C1 Univ Alabama, THT 338, Dept Cardiovasc Dis, Birmingham, AL 35294 USA. Univ Alabama, Dept Cardiovasc Surg, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Dept Med, Birmingham, AL USA. RP Tauaj, JA (reprint author), Univ Alabama, THT 338, Dept Cardiovasc Dis, 1900 Univ Blvd, Birmingham, AL 35294 USA. EM jtallaj@uab.edu NR 15 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD SEP 11 PY 2007 VL 50 IS 11 BP 1064 EP 1069 DI 10.1016/j.jacc.2007.06.007 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 208VU UT WOS:000249348100009 ER PT J AU Shrank, WH Agnew-Blais, J Choudhry, NK Wolf, MS Kesselheim, AS Avorn, J Shekelle, P AF Shrank, William H. Agnew-Blais, Jessica Choudhry, Niteesh K. Wolf, Michael S. Kesselheim, Aaron S. Avorn, Jerry Shekelle, Paul TI The variability and quality of medication container labels SO ARCHIVES OF INTERNAL MEDICINE LA English DT Article ID PRESCRIPTION DRUG LABELS; READABILITY; FORMAT; COMPREHENSION; LITERACY; ADULTS AB Background: Medication errors occur frequently, and poor medication labeling is cited as a potential cause. We assessed the format, content, and variability of prescription drug container labels dispensed in the community. Methods: Identically written prescriptions for 4 commonly used medications (atorvastatin calcium [Lipitor], alendronate sodium [ Fosamax], trimethoprim-sulfamethoxazole [Bactrim], and ibuprofen) were filled in 6 pharmacies (the 2 largest chains, 2 grocery stores, and 2 independent pharmacies) in 4 cities (Boston, Chicago, Los Angeles, and Austin [Texas]). Characteristics of the format and content of the main container label and auxiliary stickers were evaluated. Labels were coded independently by 2 abstractors, and differences were reconciled by consensus. Results: We evaluated 85 labels after excluding 11 ibuprofen prescriptions that were filled with over-the-counter containers that lacked labels printed at the pharmacy. The pharmacy name or logo was the most prominent item on 71 (84%) of the labels, with a mean font size of 13.6 point. Font sizes were smaller for medication instructions (9.3 point), medication name (8.9 point), and warning and instruction stickers (6.5 point). Color, boldfacing, and highlighting were most often used to identify the pharmacy and items most useful to pharmacists. While the content of the main label was generally consistent, there was substantial variability in the content of instruction and warning stickers from different pharmacies, and independent pharmacies were less likely to use such stickers (P < . 001). None of the ibuprofen containers were delivered with Food and Drug Administration-approved medication guides, as required by law. Conclusions: The format of most container labels emphasizes pharmacy characteristics and items frequently used by pharmacists rather than use instructions or medication warnings. The content of warning and instruction stickers is highly variable depending on the pharmacy selected. C1 Harvard Univ, Sch Med, Brigham & Womens Hosp, Div Pharmacoepidemiol & Pharmacoecon, Boston, MA 02120 USA. Northwestern Univ, Feinberg Sch Med, Inst Healthcare Studies, Chicago, IL 60611 USA. Northwestern Univ, Feinberg Sch Med, Div Gen Internal Med, Chicago, IL 60611 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Div Gen Internal Med, Los Angeles, CA USA. RP Shrank, WH (reprint author), Harvard Univ, Sch Med, Brigham & Womens Hosp, Div Pharmacoepidemiol & Pharmacoecon, 1620 Tremont St,Ste 3030, Boston, MA 02120 USA. EM wshrank@partners.org RI Agnew-Blais, Jessica/L-9236-2015 OI Agnew-Blais, Jessica/0000-0002-0755-6867 NR 25 TC 44 Z9 46 U1 1 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD SEP 10 PY 2007 VL 167 IS 16 BP 1760 EP 1765 DI 10.1001/archinte.167.16.1760 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 208TV UT WOS:000249343000009 PM 17846395 ER PT J AU Merrell, MA Wakchoure, S Lehenkari, PP Harris, KW Selander, KS AF Merrell, Melinda A. Wakchoure, Savita Lehenkari, Petri P. Harris, Kevin W. Selander, Katri S. TI Inhibition of the mevalonate pathway and activation of p38 MAP kinase are independently regulated by nitrogen-containing bisphosphonates in breast cancer cells SO EUROPEAN JOURNAL OF PHARMACOLOGY LA English DT Article DE Bisphosphonates; p38; mevalonate pathway; cell cycle ID ADJUVANT CLODRONATE TREATMENT; RANDOMIZED CONTROLLED-TRIAL; INDUCED GROWTH-INHIBITION; HUMAN-MELANOMA CELLS; IN-VITRO; ZOLEDRONIC ACID; SKELETAL METASTASES; MEMBRANE LOCALIZATION; PROTEIN PRENYLATION; MESOTHELIOMA CELLS AB Bisphosphonates are widely used inhibitors of bone resorption. They also inhibit the growth of various cancer cells in vitro, but the clinical significance of this effect is unclear. The cancer growth inhibitory effects of nitrogen-containing bisphosphonates, (i.e. zoledronate) have been attributed to their ability to inhibit the mevalonate pathway. We have shown that bisphosphonates also induce p38 activation, which signals resistance against the drug-induced growth inhibition through an unknown mechanism. We show here that zoledronate induces a G1/S cell cycle arrest in human MDA-MB-231 breast cancer cells. Furthermore, p38 inhibitor augments bisphosphonate-induced growth inhibition by inducing an additional G2-phase cell cycle arrest. We also show that the nitrogen-containing bisphosphonate-induced effects on p38 phosphorylation occur before accumulation of unprenylated Rap1A or Rac1 activation. Geranylgeranyl pyrophosphate, an end-product of the mevalonate pathway, reversed the accumulation of unprenylated Rap1A but not phosphorylation of p38. Geranylgeranyl pyrophosphate also reversed n-BP induced growth inhibition, but the completeness of this reversal was nitrogen-containing bisphosphonate concentration dependent. Also mevastatin induced the accumulation of unprenylated Rap I A, but it did not induce p38 phosphorylation. In conclusion, our results suggest that in addition to the previously reported effects on apoptosis, nitrogen-containing bisphosphonates also inhibit the growth of MDA-MB-231 breast cancer cells by inducing G1/S cell cycle arrest. The bisphosphonate-induced p38 activation signals for resistance against these drugs, by promoting progression through the G2/M-checkpoint. Of these pathways only growth inhibition is mediated via inhibition of the mevalonate pathway in MDA-MB-231 cells. Combining p38 inhibitors with bisphosphonates may result in increased anti-cancer efficacy. (c) 2007 Elsevier B.V. All rights reserved. C1 Univ Alabama, Dept Med, Div Hematol Oncol, Birmingham, AL 35294 USA. Oulu Univ, Clin Res Ctr, Dept Surg, Oulu, Finland. Birmingham Vet Affairs Med Ctr, Birmingham, AL USA. RP Selander, KS (reprint author), Univ Alabama, Dept Med, Div Hematol Oncol, WTI T558,1824 6th Ave S, Birmingham, AL 35294 USA. EM Katri.Selander@ccc.uab.edu RI Lehenkari, Petri/O-3009-2016 OI Lehenkari, Petri/0000-0002-0055-5183 NR 45 TC 28 Z9 29 U1 0 U2 0 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0014-2999 J9 EUR J PHARMACOL JI Eur. J. Pharmacol. PD SEP 10 PY 2007 VL 570 IS 1-3 BP 27 EP 37 DI 10.1016/j.ejphar.2007.05.075 PG 11 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 208BP UT WOS:000249295100004 PM 17640631 ER PT J AU Forbes, A Wadehra, M Mareninov, S Morales, S Shimazaki, K Gordon, LK Braun, J AF Forbes, Ashley Wadehra, Madhuri Mareninov, Sergei Morales, Shawn Shimazaki, Kaori Gordon, Lynn K. Braun, Jonathan TI The tetraspan protein EMP2 regulates expression of caveolin-1 SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID EPITHELIAL MEMBRANE PROTEIN-2; HUMAN BREAST-CANCER; ONCOGENICALLY TRANSFORMED-CELLS; ANCHORAGE-INDEPENDENT GROWTH; HIGH-GRADE OSTEOSARCOMA; SURFACE EXPRESSION; PLASMA-MEMBRANE; IN-VIVO; TYROSINE PHOSPHORYLATION; ENDOPLASMIC-RETICULUM AB Caveolin-1 is the primary component of caveolae and functions in a variety of intracellular activities, including membrane trafficking and signal transduction. EMP2(epithelial membrane protein 2) is a tetraspan protein recently identified as a novel regulator of caveolin-1 expression. In this study, we analyzed the mechanism of EMP2-mediated caveolin-1 regulation. In NIH 3T3 cells and in the human retinal pigment epithelium cell line (ARPE-19), EMP2 regulates caveolin-1 transcription and more substantially its protein levels. EMP2-mediated down-regulation of caveolin-1 does not affect caveolin-1 translational efficiency, phosphorylation, or proteasome-mediated degradation. Analysis of caveolin-1 protein half-life indicates the EMP2-mediated loss of caveolin-1 occurs rapidly. Protease inhibition and laser confocal microscopy associates this fate with specific intracellular compartmentalization, including early lysosomal delivery. These findings elucidate a new mechanism of caveolin-1 regulation and define an additional role for EMP2 as a key regulator of cell membrane composition. C1 Greater Los Angeles Vet Affairs Healthcare Syst, Dept Surg, Los Angeles, CA 90099 USA. Univ Calif Los Angeles, Dept Ophthalmol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Inst Mol Biol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Ctr Hlth Sci 13 222, Los Angeles, CA 90095 USA. RP Braun, J (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Pathol & Lab Med, Ctr Hlth Sci 13 222, Los Angeles, CA 90095 USA. EM jbraun@mednet.ucla.edu OI Braun, Jonathan/0000-0003-1646-2974 FU NCI NIH HHS [CA16042, CA9120, P30 CA016042]; NIAID NIH HHS [AI52031]; NICHD NIH HHS [HD48540, R03 HD048540]; NIGMS NIH HHS [GM7185] NR 59 TC 21 Z9 22 U1 0 U2 3 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD SEP 7 PY 2007 VL 282 IS 36 AR 26542 DI 10.1074/jbc.M702117200 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 207GM UT WOS:000249239600058 PM 17609206 ER PT J AU Olavarria, JF van Brederode, JFM Spain, WJ AF Olavarria, J. F. van Brederode, J. F. M. Spain, W. J. TI Retinal influences induce bidirectional changes in the kinetics of N-methyl-D-aspartate receptor-mediated responses in striate cortex cells during postnatal development SO NEUROSCIENCE LA English DT Article DE striate cortex; interhemispheric callosal commissure; maps; NMDA receptor; plasticity; ifenprodil ID OCULAR DOMINANCE PLASTICITY; HETEROMERIC NMDA RECEPTORS; NR2A SUBUNIT EXPRESSION; RAT VISUAL-CORTEX; THALAMOCORTICAL SYNAPSES; IFENPRODIL SENSITIVITY; FUNCTIONAL-PROPERTIES; CALLOSAL CONNECTIONS; SYNAPTIC PLASTICITY; ENUCLEATED RATS AB Development of the visual callosal projection in rodents goes through an early critical period, from postnatal day (P) 4 to P6, during which retinal input specifies the blueprint for normal topographic connections, and a subsequent period of progressive pathway maturation that is largely complete by the time the eyes open, around P13. This study tests the hypothesis that these developmental stages correlate with age-related changes in the kinetics of synaptic responses mediated by the N-methyl-D-aspartate subclass of glutamate receptors (NMDARs). We used an in vitro slice preparation to perform whole-cell recordings from retrogradely-labeled visual callosal cells, as well from cortical cells with unknown projections. We analyzed age-related changes in the decay time constant of evoked as well as spontaneous excitatory postsynaptic currents mediated by N-methyl-D-aspartate subclass of glutamate receptors (NMDAR-EPSCs) in slices from normal pups and pups enucleated at different postnatal ages. In normal pups we found that the decay time constant of NMDAR-EPSCs increases starting at about P6 and decreases by about P13. In contrast, these changes were not observed in rats enucleated at birth. However, by delaying the age at which enucleation was performed we found that the presence of the eyes until P6, but not until P4, is sufficient for inducing slow NMDAR-EPSC kinetics during the second postnatal week, as observed in normal pups. These results provide evidence that the eyes exert a bidirectional effect on the kinetics of NMDARs: during a P4-P6 critical period, retinal influences induce processes that slow down the kinetics of NMDAR-EPSCs, while, near the age of eye opening, retinal input induces a sudden acceleration of NMDAR-EPSC kinetics. These findings suggest that the retinally-driven processes that specify normal callosal topography during the P4-P6 time window also induce an increase in the decay time constant of NMDAR-EPSCs. This increase in response kinetics may play an important role in the maturation of cortical topographic maps after P6. Using ifenprodil, a noncompetitive NR213-selective blocker, we obtained evidence that although NR1/NR2B diheteromeric receptors contribute to evoked synaptic responses in both normal and enucleated animals, they are not primarily responsible for either the age-related changes in the kinetics of NMDAR-mediated responses, or the effects that bilateral enucleation has on the kinetics of NMDAR-EPSCs. (c) 2007 IBRO. Published by Elsevier Ltd. All rights reserved. C1 Univ Washington, Dept Psychol, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Physiol & Biophys, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Olavarria, JF (reprint author), Univ Washington, Dept Psychol, Box 351525, Seattle, WA 98195 USA. EM jaime@u.washington.edu FU BLRD VA [I01 BX000386]; NEI NIH HHS [EY016045]; PHS HHS [34769] NR 57 TC 4 Z9 5 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PD SEP 7 PY 2007 VL 148 IS 3 BP 683 EP 699 DI 10.1016/j.neuroscience.2007.07.005 PG 17 WC Neurosciences SC Neurosciences & Neurology GA 216LG UT WOS:000249878900009 PM 17706364 ER PT J AU Singh, BN Connolly, SJ Crijns, HJGM Roy, D Kowey, PR Capucci, A Radzik, D Aliot, EM Hohnloser, SH AF Singh, Bramah N. Connolly, Stuart J. Crijns, Harry J. G. M. Roy, Denis Kowey, Peter R. Capucci, Alessandro Radzik, David Aliot, Etienne M. Hohnloser, Stefan H. CA EURIDIS Investigators ADONIS Investigators TI Dronedarone for maintenance of sinus rhythm in atrial fibrillation or flutter SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Article ID CONTROLLED CLINICAL-TRIAL; AMIODARONE-LIKE AGENT; ANTIARRHYTHMIC-DRUGS; PROGNOSTIC FACTORS; SR-33589; EFFICACY; THERAPY; HEART; ARRHYTHMIAS; MECHANISMS AB Background Amiodarone is effective in maintaining sinus rhythm in atrial fibrillation but is associated with potentially serious toxic effects. Dronedarone is a new antiarrhythmic agent pharmacologically related to amiodarone but developed to reduce the risk of side effects. Methods In two identical multicenter, double-blind, randomized trials, one conducted in Europe (ClinicalTrials.gov number, NCT000259428) and one conducted in the United States, Canada, Australia, South Africa, and Argentina (termed the non-European trial, NCT000259376), we evaluated the efficacy of dronedarone, with 828 patients receiving 400 mg of the drug twice daily and 409 patients receiving placebo. Rhythm was monitored transtelephonically on days 2, 3, and 5; at 3, 5, 7, and 10 months; during recurrence of arrhythmia; and at nine scheduled visits during a 12-month period. The primary end point was the time to the first recurrence of atrial fibrillation or flutter. Results In the European trial, the median times to the recurrence of arrhythmia were 41 days in the placebo group and 96 days in the dronedarone group (P=0.01). The corresponding durations in the non-European trial were 59 and 158 days (P=0.002). At the recurrence of arrhythmia in the European trial, the mean (+/-SD) ventricular rate was 117.5+/-29.1 beats per minute in the placebo group and 102.3+/-24.7 beats per minute in the dronedarone group (P<0.001); the corresponding rates in the non-European trial were 116.6+/-31.9 and 104.6+/-27.1 beats per minute (P<0.001). Rates of pulmonary toxic effects and of thyroid and liver dysfunction were not significantly increased in the dronedarone group. Conclusions Dronedarone was significantly more effective than placebo in maintaining sinus rhythm and in reducing the ventricular rate during recurrence of arrhythmia. C1 Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Div Cardiol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90073 USA. Univ Hamilton, Hamilton, ON, Canada. Univ Maastricht, Maastricht, Netherlands. Univ Montreal, Montreal, PQ, Canada. Lankenau Hosp & Inst Med Res, Philadelphia, PA USA. Osped Clin, Taverna, Italy. Sanofi Aventis, Paris, France. Cent Hosp, Nancy, France. Univ Frankfurt, D-6000 Frankfurt, Germany. RP Singh, BN (reprint author), Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Div Cardiol, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM bsingh@ucla.edu NR 39 TC 359 Z9 384 U1 1 U2 8 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD SEP 6 PY 2007 VL 357 IS 10 BP 987 EP 999 DI 10.1056/NEJMoa054686 PG 13 WC Medicine, General & Internal SC General & Internal Medicine GA 206VK UT WOS:000249210800005 PM 17804843 ER PT J AU Volpp, KG Rosen, AK Rosenbaum, PR Romano, PS Even-Shoshan, O Wang, YL Bellini, L Behringer, T Silber, JH AF Volpp, Kevin G. Rosen, Amy K. Rosenbaum, Paul R. Romano, Patrick S. Even-Shoshan, Orit Wang, Yanli Bellini, Lisa Behringer, Tiffany Silber, Jeffrey H. TI Mortality among hospitalized Medicare beneficiaries in the first 2 years following ACGME resident duty hour reform SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID QUALITY-OF-CARE; WORK HOURS; ADMINISTRATIVE DATA; SLEEP-DEPRIVATION; PATIENT SAFETY; COMORBIDITY MEASURES; PERFORMANCE; ICD-9-CM; REGULATIONS; INFORMATION AB Context The Accreditation Council for Graduate Medical Education (ACGME) implemented duty hour regulations for physicians-in-training throughout the United States on July 1, 2003. The association of duty hour reform with mortality among patients in teaching hospitals nationally has not been well established. Objective To determine whether the change in duty hour regulations was associated with relative changes in mortality among Medicare patients in hospitals of different teaching intensity. Design, Setting, and Patients An observational study of all unique Medicare patients (N= 8 529 595) admitted to short-term, acute-care, general US nonfederal hospitals ( N= 3321) using interrupted time series analysis with data from July 1, 2000, to June 30, 2005. All Medicare patients had principal diagnoses of acute myocardial infarction, congestive heart failure, gastrointestinal bleeding, or stroke or a diagnosis related group classification of general, orthopedic, or vascular surgery. Logistic regression was used to examine the change in mortality for patients in more vs less teaching-intensive hospitals before (academic years 2000-2003) and after (academic years 20032005) duty hour reform, adjusting for patient comorbidities, common time trends, and hospital site. Main Outcome Measure All-location mortality within 30 days of hospital admission. Results In medical and surgical patients, no significant relative increases or decreases in the odds of mortality for more vs less teaching-intensive hospitals were observed in either postreform year 1 (combined medical conditions group: odds ratio [OR], 1.03; 95% confidence interval [Cl], 0.98-1.07; and combined surgical categories group: OR, 1.05; 95% Cl, 0.98-1.12) or postreform year 2 ( combined medical conditions group: OR, 1.03; 95% Cl, 0.99-1.08; and combined surgical categories group: OR, 1.01; 95% Cl, 0.95-1.08) compared with the prereform years. The only condition for which there was a relative increase in mortality in more teaching-intensive hospitals postreform was stroke, but this association preceded the onset of duty hour reform. Compared with nonteaching hospitals, the most teaching-intensive hospitals had an absolute change in mortality from prereform year 1 to postreform year 2 of 0.42 percentage points (4.4% relative increase) for patients in the combined medical conditions group and 0.05 percentage points (2.3% relative increase) for patients in the combined surgical categories group, neither of which were statistically significant. Conclusion The ACGME duty hour reform was not associated with either significant worsening or improvement in mortality for Medicare patients in the first 2 years after implementation. C1 Vet Adm Hosp, Philadelphia Vet Affairs Med Ctr, CHERP, Philadelphia, PA 19104 USA. Childrens Hosp Philadelphia, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Pediat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Anesthesiol & Crit Care, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Dept Hlth Care Syst, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Dept Stat, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Boston Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02215 USA. Vet Adm Hosp, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA USA. Univ Calif Davis Sch Med, Div Gen Med, Sacramento, CA 95817 USA. Univ Calif Davis Sch Med, Ctr Healthcare Policy & Res, Sacramento, CA 95817 USA. RP Volpp, KG (reprint author), Vet Adm Hosp, Philadelphia Vet Affairs Med Ctr, CHERP, 3900 Woodland Ave, Philadelphia, PA 19104 USA. EM volpp70@wharton.upenn.edu RI Rosenbaum, Paul/H-8687-2012; Romano, Patrick/N-4225-2014 OI Romano, Patrick/0000-0001-6749-3979 FU NHLBI NIH HHS [R01 HL082637] NR 54 TC 202 Z9 203 U1 0 U2 6 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD SEP 5 PY 2007 VL 298 IS 9 BP 975 EP 983 DI 10.1001/jama.298.9.975 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 206OH UT WOS:000249192300012 PM 17785642 ER PT J AU Volpp, KG Rosen, AK Rosenbaum, PR Romano, PS Even-Shoshan, O Canamucio, A Bellini, L Behringer, T Silber, JH AF Volpp, Kevin G. Rosen, Amy K. Rosenbaum, Paul R. Romano, Patrick S. Even-Shoshan, Orit Canamucio, Anne Bellini, Lisa Behringer, Tiffany Silber, Jeffrey H. TI Mortality among patients in VA hospitals in the first 2 years following ACGME resident duty hour reform SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Article ID QUALITY-OF-CARE; WORK HOURS; ADMINISTRATIVE DATA; COMORBIDITY MEASURES; VETERAN POPULATION; SAFETY; ICD-9-CM; LIMITS; ASCERTAINMENT; REGULATIONS AB Context Limitations in duty hours for physicians-in-training in the United States were established by the Accreditation Council for Graduate Medical Education (ACGME) and implemented on July 1, 2003. The association of these changes with mortality among hospitalized patients has not been well established. Objective To determine whether the change in duty hour regulations was associated with relative changes in mortality in hospitals of different teaching intensity within the US Veterans Affairs (VA) system. Design, Setting, and Patients An observational study of all unique patients (N=318 636) admitted to acute-care VA hospitals (N=131) using interrupted time series analysis with data from July 1, 2000, to June 30, 2005. All patients had principal diagnoses of acute myocardial infarction (AMI), congestive heart failure, gastrointestinal bleeding, or stroke or a diagnosis related group classification of general, orthopedic, or vascular surgery. Logistic regression was used to examine the change in mortality for patients in more vs less teaching-intensive hospitals before ( academic years 2000-2003) and after (academic years 2003-2005) duty hour reform, adjusting for patient comorbidities, common time trends, and hospital site. Main Outcome Measure All-location mortality within 30 days of hospital admission. Results In postreform year 1, no significant relative changes in mortality were observed for either medical or surgical patients. In postreform year 2, the odds of mortality decreased significantly in more teaching-intensive hospitals for medical patients only. Comparing a hospital having a resident-to-bed ratio of 1 with a hospital having a resident-to-bed ratio of 0, the odds of mortality were reduced for patients with AMI (odds ratio [ OR], 0.48; 95% confidence interval [Cl], 0.33-0.71), for the 4 medical conditions together (OR, 0.74; 95% Cl, 0.61-0.89), and for the 3 medical conditions excluding AMI (OR, 0.79; 95% Cl, 0.63-0.98). Compared with hospitals in the 25th percentile of teaching intensity, there was an absolute improvement in mortality from prereform year 1 to postreform year 2 of 0.70 percentage points (11.1% relative decrease) and 0.88 percentage points (13.9% relative decrease) in hospitals in the 75th and 90th percentile of teaching intensity, respectively, for the combined medical conditions. Conclusions The ACGME duty hour reform was associated with significant relative improvement in mortality for patients with 4 common medical conditions in more teaching intensive VA hospitals in postreform year 2. No associations were identified for surgical patients. C1 Vet Adm Hosp, Philadelphia Vet Affairs Med Ctr, CHERP, Philadelphia, PA 19104 USA. Childrens Hosp Philadelphia, Ctr Outcomes Res, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Pediat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Anesthesiol & Crit Care, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Dept Hlth Care Syst, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Dept Stat, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Boston Univ, Sch Publ Hlth, Dept Hlth Policy & Management, Boston, MA 02215 USA. Vet Adm Hosp, Ctr Hlth Qual Outcomes & Econ Res, Bedford, MA USA. Univ Calif Davis Sch Med, Div Gen Med, Sacramento, CA USA. Univ Calif Davis Sch Med, Ctr Healthcare Policy & Res, Sacramento, CA USA. RP Volpp, KG (reprint author), Vet Adm Hosp, Philadelphia Vet Affairs Med Ctr, CHERP, 3900 Woodland Ave, Philadelphia, PA 19104 USA. EM volpp70@wharton.upenn.edu RI Rosenbaum, Paul/H-8687-2012; Romano, Patrick/N-4225-2014 OI Romano, Patrick/0000-0001-6749-3979 FU NHLBI NIH HHS [R01 HL082637] NR 53 TC 165 Z9 166 U1 0 U2 4 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD SEP 5 PY 2007 VL 298 IS 9 BP 984 EP 992 DI 10.1001/jama.298.9.984 PG 9 WC Medicine, General & Internal SC General & Internal Medicine GA 206OH UT WOS:000249192300013 PM 17785643 ER PT J AU Asch, DA Epstein, A Nicholson, S AF Asch, David A. Epstein, Andrew Nicholson, Sean TI Evaluating medical training programs by the quality of care delivered by their alumni SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Editorial Material ID MORTALITY-RATES C1 Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Yale Univ, Sch Publ Hlth, Div Hlth Policy & Adm, New Haven, CT USA. Cornell Univ, Dept Policy Anal & Management, Ithaca, NY USA. Natl Bur Econ Res, Cambridge, MA 02138 USA. RP Asch, DA (reprint author), Univ Penn, Leonard Davis Inst Hlth Econ, 3641 Locust Walk, Philadelphia, PA 19104 USA. EM asch@wharton.upenn.edu NR 7 TC 7 Z9 7 U1 0 U2 3 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD SEP 5 PY 2007 VL 298 IS 9 BP 1049 EP 1051 DI 10.1001/jama.298.9.1049 PG 3 WC Medicine, General & Internal SC General & Internal Medicine GA 206OH UT WOS:000249192300020 PM 17785650 ER PT J AU Hepner, KA Rowe, M Rost, K Hickey, SC Sherbourne, CD Ford, DE Meredith, LS Rubenstein, LV AF Hepner, Kimberly A. Rowe, Melissa Rost, Kathryn Hickey, Scot C. Sherbourne, Cathy D. Ford, Daniel E. Meredith, Lisa S. Rubenstein, Lisa V. TI The effect of adherence to practice guidelines on depression outcomes SO ANNALS OF INTERNAL MEDICINE LA English DT Article ID RANDOMIZED CONTROLLED-TRIAL; DISSEMINATING QUALITY IMPROVEMENT; PROSPECTIVE PAYMENT SYSTEM; PRIMARY-CARE PRACTICE; COLLABORATIVE CARE; STANDARDIZED PATIENTS; MAJOR DEPRESSION; HEALTH-CARE; MANAGEMENT; PHYSICIANS AB Background: Few studies have assessed clinician adherence to depression practice guidelines and the relationship between clinician adherence and depression outcomes. Objective: To estimate how frequently specific guideline recommendations are followed and to assess whether following guideline recommendations is linked to improved depression outcomes. Design: Observational analysis of data collected from 1996 to 1998 in 3 randomized clinical trials. Setting: 45 primary care practices in 13 U.S. states. Patients: 1131 primary care patients with depression. Measurements: Expert panel methods were used to develop a patient survey-based index that measured adherence to clinical practice guidelines on depression. Rates of adherence to the 20 indicators that form the index were evaluated. Multivariable regression that controlled for case mix was used to assess how index scores predicted continuous and dichotomous depression measures at 12, 18, and 24 months. Results: Quality of care was high (clinician adherence >= 79%) for 6 indicators, including primary care clinician detection of depression. Quality of care was low (adherence, 20% to 38%) for 8 indicators, including management of suicide risk (3 indicators), alcohol abuse (2 indicators), and elderly patients; assessment of symptoms and history of depression; and treatment adjustment for patients who did not respond to initial treatment. Greater adherence to practice guidelines significantly predicted fewer depressive symptoms on continuous measures (P < 0.001 for 12 months, P < 0.01 for 18 months, and P < 0.001 for 24 months) and dichotomous measures (P < 0.05 for 18 and 24 months). Limitations: Data are based on patient self-report. Possible changes in practice since 1998 may limit the generalizability of the findings. Conclusions: Adherence to guidelines was high for one third of the recommendations that were measured but was very low for nearly half of the measures, pointing to specific needs for quality improvement. Guideline-concordant depression care appears to be linked to improved outcomes in primary care patients with depression. C1 RAND Corp, Hlth Program, Santa Monica, CA 90407 USA. Florida State Univ, Tallahassee, FL 32306 USA. Johns Hopkins Sch Med, Baltimore, MD USA. Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RP Hepner, KA (reprint author), RAND Corp, Hlth Program, 1776 Main St, Santa Monica, CA 90407 USA. EM hepner@rand.org FU AHRQ HHS [R01-HS08349]; NIMH NIH HHS [MH 63651, P50MH54623, R01 MH54444, R01MH64658] NR 50 TC 68 Z9 69 U1 1 U2 8 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD SEP 4 PY 2007 VL 147 IS 5 BP 320 EP 329 PG 10 WC Medicine, General & Internal SC General & Internal Medicine GA 207ZO UT WOS:000249289800005 PM 17785487 ER PT J AU Grippi, MA Mulrow, C AF Grippi, Michael A. Mulrow, Cynthia TI Trials that matter: Minimizing treatment of mild, persistent asthma SO ANNALS OF INTERNAL MEDICINE LA English DT Editorial Material C1 Amer Coll Physicians, Customer Serv, Philadelphia, PA 19106 USA. Hosp Univ Penn, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Grippi, MA (reprint author), Amer Coll Physicians, Customer Serv, 190 N Independence Mall W, Philadelphia, PA 19106 USA. NR 7 TC 1 Z9 1 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD SEP 4 PY 2007 VL 147 IS 5 BP 344 EP 345 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 207ZO UT WOS:000249289800009 PM 17785491 ER PT J AU Roe, MT Chen, AY Mehta, RH Li, Y Brindis, RG Smith, SC Rumsfeld, JS Gibler, WB Ohman, EM Peterson, ED AF Roe, Matthew T. Chen, Anita Y. Mehta, Rajendra H. Li, Yun Brindis, Ralph G. Smith, Sidney C., Jr. Rumsfeld, John S. Gibler, W. Brian Ohman, E. Magnus Peterson, Eric D. TI Influence of inpatient service specialty on care processes and outcomes for patients with non-ST-segment elevation acute coronary syndromes SO CIRCULATION LA English DT Article DE coronary disease; patients; patient care; medical specialties; guidelines ID ACUTE MYOCARDIAL-INFARCTION; QUALITY-OF-CARE; PRACTICE GUIDELINES COMMITTEE; ASSOCIATION TASK-FORCE; PHYSICIAN SPECIALTY; AMERICAN-COLLEGE; ELDERLY-PATIENTS; UNSTABLE ANGINA; MANAGEMENT; CARDIOLOGISTS AB Background-Since the broad dissemination of practice guidelines, the association of specialty care with the treatment of patients with acute coronary syndromes has not been studied. Methods and Results-We evaluated 55 994 patients with non -ST-segment elevation acute coronary syndromes ( ischemic ST-segment changes and/or positive cardiac markers) included in the CRUSADE ( Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC/AHA Guidelines) Quality Improvement Initiative from January 2001 through September 2003 at 301 tertiary US hospitals with full revascularization capabilities. We compared baseline characteristics, the use of American College of Cardiology/American Heart Association guidelines class I recommendations, and in-hospital outcomes by the specialty of the primary in-patient service ( cardiology versus noncardiology). A total of 35 374 patients (63.2%) were primarily cared for by a cardiology service, and these patients had lower-risk clinical characteristics, but they more commonly received acute (<= 24 hours) medications, invasive cardiac procedures, and discharge medications and lifestyle interventions. Acute care processes were improved when care was provided by a cardiology service regardless of the propensity to receive cardiology care. The adjusted risk of in-hospital mortality was lower with care provided by a cardiology service ( adjusted odds ratio 0.80, 95% confidence interval 0.73 to 0.88), and adjustment for differences in the use of acute medications and invasive procedures partially attenuated this mortality difference ( adjusted odds ratio 0.92, 95% confidence interval 0.83 to 1.02). Conclusions-Non-ST-segment elevation acute coronary syndrome patients primarily cared for by a cardiology inpatient service more commonly received evidence-based treatments and had a lower risk of mortality, but these patients had lower-risk clinical characteristics. Results from the present analysis highlight the difficulties with accurately determining how specialty care is associated with treatment patterns and clinical outcomes for patients with acute coronary syndromes. Novel methodologies for evaluating the influence of specialty care for these patients need to be developed and applied to future studies. C1 Duke Clin Res Inst, Durham, NC 27705 USA. Duke Univ, Med Ctr, Durham, NC USA. Univ Michigan, Dept Biostat, Ann Arbor, MI 48109 USA. San Francisco Med Ctr, San Francisco, CA USA. Univ N Carolina, Sch Med, Chapel Hill, NC USA. Univ Colorado, Hlth Sci Ctr, Div Cardiol, Denver Vet Affairs Med Ctr, Denver, CO 80262 USA. Univ Cincinnati, Coll Med, Cincinnati, OH USA. RP Roe, MT (reprint author), Duke Clin Res Inst, 2400 Pratt St, Durham, NC 27705 USA. EM matthew.roe@duke.edu NR 18 TC 29 Z9 29 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0009-7322 J9 CIRCULATION JI Circulation PD SEP 4 PY 2007 VL 116 IS 10 BP 1153 EP 1161 DI 10.1161/CIRCULATIONAHA.107.697003 PG 9 WC Cardiac & Cardiovascular Systems; Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 207FZ UT WOS:000249238300008 PM 17709638 ER PT J AU Nakashima-Yasuda, H Uryu, K Robinson, J Xie, SX Hurtig, H Duda, JE Arnold, SE Siderowf, A Grossman, M Leverenz, JB Woltjer, R Lopez, OL Hamilton, R Tsuang, DW Galasko, D Masliah, E Kaye, J Clark, CM Montine, TJ Lee, VMY Trojanowski, JQ AF Nakashima-Yasuda, Hanae Uryu, Kunihiro Robinson, John Xie, Sharon X. Hurtig, Howard Duda, John E. Arnold, Steven E. Siderowf, Andrew Grossman, Murray Leverenz, James B. Woltjer, Randy Lopez, Oscar L. Hamilton, Ronald Tsuang, Debby W. Galasko, Douglas Masliah, Eliezer Kaye, Jeffrey Clark, Christopher M. Montine, Thomas J. Lee, Virginia M. -Y. Trojanowski, John Q. TI Co-morbidity of TDP-43 proteinopathy in Lewy body related diseases SO ACTA NEUROPATHOLOGICA LA English DT Article DE frontotemporal lobar degeneration; TDP-43; dementia with Lewy bodies; Parkinson's disease ID FRONTOTEMPORAL LOBAR DEGENERATION; AMYOTROPHIC-LATERAL-SCLEROSIS; NUCLEAR FACTOR TDP-43; ALPHA-SYNUCLEIN; NEURODEGENERATIVE DISEASES; UBIQUITIN PATHOLOGY; DEMENTIA; TAU; INCLUSIONS; GENE AB Here, we investigated if TAR-DNA-binding protein-43 (TDP-43), the disease protein-in frontotemporal lobar degeneration and ubiquitin inclusions with or without motor neuron disease as well as amyotrophic lateral sclerosis, also formed inclusions in Lewy body (LB) disorders including Parkinson's disease (PD) without or with dementia (PDD), and dementia with LBs (DLB) alone or in association with Alzheimer's disease (AD). Immunohistochemical analyses of TDP-43 in clinically well characterized and pathologically confirmed cases of DLB + AD, PD and PDD demonstrated TDP-43 pathology in the following percentage of cases: DLB + AD = 25/80 (31.3%); PD = 5/69 (7.2%); PDD 4/21 (19%), while DLB and normal controls exhibited Do (0/10, 0%) and one cases (1/33, 3%) presenting TDP-43 pathology, respectively. Significant differences in the prevalence of TDP-43 lesions were noted between disease versus normal brains (P < 0.001) as well as demented versus non-demented brains (P < 0.001). Statistical analyses revealed a positive relationship between TDP-43 lesions and several clinical and pathological parameters in these disorders suggesting the TDP-43 pathology may have co-morbid effects in LB diseases. This study expands the concept of TDP-43 proteinopathies by implicating TDP-43 lesions in mechanisms of neurodegeneration in LB disorders. C1 Univ Penn, Sch Med, Ctr Neurodegenerat Dis Res, Dept Pathol & Lab Med, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Inst Aging, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Neurol, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia VAMC, Parkinsons Dis Res, Educ & Clin Ctr, Philadelphia, PA USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Pathol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Mental Illness Res, Educ & Clin Ctr, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Parkinsons Dis Res, Educ & Clin Ctr, Seattle, WA USA. RP Trojanowski, JQ (reprint author), Univ Penn, Sch Med, Ctr Neurodegenerat Dis Res, Dept Pathol & Lab Med, HUP-Maloney 3rd Floor, Philadelphia, PA 19104 USA. EM trojanow@mail.med.upenn.edu RI Arnold, Steven/J-7546-2012; Tsuang, Debby/L-7234-2016 OI Tsuang, Debby/0000-0002-4716-1894; Kaye, Jeffrey/0000-0002-9971-3478 FU NIA NIH HHS [AG-09215, AG-10124, AG-17586, P01 AG009215, P01 AG017586] NR 31 TC 198 Z9 201 U1 0 U2 4 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0001-6322 J9 ACTA NEUROPATHOL JI Acta Neuropathol. PD SEP PY 2007 VL 114 IS 3 BP 221 EP 229 DI 10.1007/s00401-007-0261-2 PG 9 WC Clinical Neurology; Neurosciences; Pathology SC Neurosciences & Neurology; Pathology GA 205XT UT WOS:000249149200003 PM 17653732 ER PT J AU Morgenstern, J McKay, JR AF Morgenstern, Jon McKay, James R. TI Rethinking the paradigms that inform behavioral treatment research for substance use disorders SO ADDICTION LA English DT Review DE behavioral treatments; mechanisms of change; substance use disorders; treatment process ID COCAINE-DEPENDENT PATIENTS; MARIJUANA TREATMENT PROJECT; INTERACTIONAL GROUP-THERAPY; ALCOHOL-USE DISORDERS; DRUG-USE DISORDERS; RELAPSE PREVENTION; COPING-SKILLS; OUTPATIENT TREATMENT; BRIEF INTERVENTIONS; RANDOMIZED-TRIAL AB Aim Over the last three decades, the randomized controlled trial or 'psychotherapy technology' approach has been the dominant model of inquiry in research on addiction treatment. This period has yielded impressive discoveries, but recent failures to confirm core research hypotheses such as occurred in Project MATCH and the Cocaine Collaborative Treatment Study have raised questions about future research directions. The paper identifies several testable assumptions of the psychotherapy technology model. A review is conducted on four substance use disorder behavioral interventions-motivational interviewing, cognitive-behavioral treatment, behavioral couples treatment and 12-Step-oriented treatment-to determine whether these assumptions are supported by research findings. Results Overall, the review suggests weak support for the technology model of psychotherapy research. Lack of support is interpreted as indicating flaws in several model assumptions about how to conceptualize and measure patient responsivity and the interaction of non-specific and specific therapeutic factors. The paper offers alternative strategies for addressing these issues drawn from the general psychotherapy process literature and provides illustrative examples of how these could be used to spur innovation in addiction treatment research. The addiction treatment research field is coming up against the limitations of the psychotherapy technology model as the dominant paradigm guiding treatment research. It is important for addiction treatment researchers to explore alternative conceptualizations and methodologies in order to understand more clearly how treatment works. C1 Columbia Univ, Dept Psychiat, Med Ctr, New York, NY USA. Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Morgenstern, J (reprint author), Substance Abuse Serv, Dept Psychiat, 180 Ft Washington Ave,HP 236, New York, NY 10032 USA. EM jm977@columbia.edu FU NIAAA NIH HHS [1R01 AA13873, R01 AA14850]; NIDA NIH HHS [1R01 DA15971, K02 DA000361] NR 99 TC 77 Z9 78 U1 4 U2 16 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0965-2140 J9 ADDICTION JI Addiction PD SEP PY 2007 VL 102 IS 9 BP 1377 EP 1389 DI 10.1111/j.1360-0443.2007.01882.x PG 13 WC Substance Abuse; Psychiatry SC Substance Abuse; Psychiatry GA 198ZK UT WOS:000248665800012 PM 17610541 ER PT J AU Covell, NH Weissman, EM Schell, B McCorkle, BH Summerfelt, WT Weiden, PJ Essock, SM AF Covell, Nancy H. Weissman, Ellen M. Schell, Bonnie McCorkle, Brian H. Summerfelt, W. Thomas Weiden, Peter J. Essock, Susan M. TI Distress with medication side effects among persons with severe mental illness SO ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH LA English DT Article; Proceedings Paper CT 44th Annual Meeting of the New-Clinical-Drug-Evaluation-Unit CY JUN 01-04, 2004 CL Phoenix, AZ SP New Clin Drug Evaluat Unit, NIMH DE COSP; consumer-operated; medication; side effects; serious mental illness ID QUALITY-OF-LIFE; WEIGHT-GAIN; ANTIPSYCHOTIC MEDICATIONS; SUBJECTIVE EXPERIENCES; SCHIZOPHRENIC-PATIENTS; CLOZAPINE; DRUGS; NEUROLEPTICS; PERSPECTIVE; OBESITY AB We examined prevalence and perceived distress resulting from self-reported side effects (SEs) attributed to psychotropic medications among individuals with severe mental illness participating in a study of consumer-operated services. We examined gender and racial differences using logistic regression, conducted factor analyses of SEs, and examined correlations between distress and self-reported symptoms. Over 90% reported at least one SE, and nearly two-thirds reported a high level of distress with at least one SE. The most distressing SEs reported were embarrassment from weight gain, weight gain, dry mouth, and sedation. The likelihood of distress by particular SEs varied by gender and race. C1 Connecticut Dept Mental Hlth & Addict Serv, Div Res, Hartford, CT 06134 USA. Mt Sinai Hosp, Mt Sinai Sch Med, Div Hlth Serv Res, New York, NY 10029 USA. James J Peters Vet Affairs Med Syst, Mental Illness Res Educ & Clin Ctr, Bronx, NY USA. Piedmont Behav Healthcare, Off Consumer Affairs, Concord, NC USA. Boston Univ, Albert & Jessie Danielsen Inst, Ctr Study Religion & Psychol, Boston, MA 02215 USA. Univ Chicago, Ctr Hlth & Social Sci, Chicago, IL 60637 USA. Univ Illinois, Dept Psychiat, Chicago, IL 60612 USA. Columbia Univ, Dept Mental Hlth Serv, Coll Phys & Surg, New York, NY USA. Columbia Univ, Dept Policy Res, Coll Phys & Surg, New York, NY USA. New York State Psychiat Inst & Hosp, New York, NY USA. RP Covell, NH (reprint author), Connecticut Dept Mental Hlth & Addict Serv, Div Res, 410 Capitol Ave,MS 14RSD,POB 341431, Hartford, CT 06134 USA. EM nancy.covell@po.state.ct.us FU CMHS SAMHSA HHS [SM-52362, SM-52367, SM-52355, SM-52363, SM-52352, SM-52328, SM-52372, SM-52332] NR 53 TC 6 Z9 6 U1 0 U2 0 PU MAIK NAUKA/INTERPERIODICA/SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013-1578 USA SN 0894-587X J9 ADM POLICY MENT HLTH JI Adm. Policy. Ment. Health PD SEP PY 2007 VL 34 IS 5 BP 435 EP 442 DI 10.1007/s10488-007-0131-1 PG 8 WC Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 205MG UT WOS:000249117400002 PM 17653845 ER PT J AU Covell, NH McCorkle, BH Weissman, EM Summerfelt, T Essock, SM AF Covell, Nancy H. McCorkle, Brian H. Weissman, Ellen M. Summerfelt, Tom Essock, Susan M. TI What's in a name? Terms preferred by service recipients SO ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH LA English DT Article DE COSP; consumer-operated; client; patient; label ID MENTAL-HEALTH-SERVICES; USERS AB In a large (n = 1,827) multi-site study examining effectiveness of consumer operated service programs as an adjunct to traditional mental health services, we examined individuals' preferred term describing their status as service recipients, and we applied logistic regression to examine whether preference varied by gender, race or diagnosis. Preferred terms were client (39%), patient (22%), consumer (16%), survivor (11%), other (11%) and ex-patient (1%), varying by site. Controlling for site, preferences did not vary by gender, race, or diagnosis. The lack of consensus suggests clinicians, researchers, program administrators, and policymakers should be sensitive to individuals' preferences. C1 Connecticut Dept Mental Hlth & Addict Serv, Div Res, Hartford, CT 06134 USA. Mt Sinai Sch Med, Dept Psychiat, Div Hlth Serv Res, New York, NY USA. Boston Univ, Ctr Study Religion & Psychol, Albert & Jessie Danielsen Inst, Boston, MA 02215 USA. James J Peters Vet Affairs Med Syst, Mental Illness Res Educ & Clin Ctr, Bronx, NY USA. Univ Chicago, Ctr Hlth & Social Sci, Chicago, IL 60637 USA. Columbia Univ, Dept Mental Hlth Serv & Policy Res, Dept Psychiat, Coll Phys & Surg, New York, NY USA. New York State Psychiat Inst & Hosp, New York, NY USA. RP Covell, NH (reprint author), Connecticut Dept Mental Hlth & Addict Serv, Div Res, 410 Capitol Ave,MS 14RSD,341431, Hartford, CT 06134 USA. EM nancy.covell@po.state.ct.us NR 9 TC 14 Z9 14 U1 0 U2 2 PU MAIK NAUKA/INTERPERIODICA/SPRINGER PI NEW YORK PA 233 SPRING ST, NEW YORK, NY 10013-1578 USA SN 0894-587X J9 ADM POLICY MENT HLTH JI Adm. Policy. Ment. Health PD SEP PY 2007 VL 34 IS 5 BP 443 EP 447 DI 10.1007/s10488-007-0123-1 PG 5 WC Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 205MG UT WOS:000249117400003 PM 17464558 ER PT J AU Ho, PM Luther, SA Masoudi, FA Gupta, I Lowy, E Maynard, C Sales, AE Peterson, ED Fihn, SD Runisfeld, JS AF Ho, P. Michael Luther, Stacie A. Masoudi, Frederick A. Gupta, Indra Lowy, Elliott Maynard, Charles Sales, Anne E. Peterson, Eric D. Fihn, Stephan D. Runisfeld, John S. TI Inpatient and follow-up cardiology care and mortality for acute coronary syndrome patients in the Veterans Health Administration SO AMERICAN HEART JOURNAL LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; PHYSICIAN SPECIALTY; ELDERLY-PATIENTS; ADMITTING PHYSICIAN; OUTCOMES; PREVALENCE; THERAPY; DISEASE; DISCONTINUATION; GENERALISTS AB Background The impact of inpatient and follow-up cardiology care on patient outcomes after acute coronary syndrome (ACS) hospital discharge is unknown. Methods This was a retrospective cohort study of all patients with ACS discharged from Veterans Health Administration facilities from 2003 to 2004. Patients were stratified into 2 categories of cardiology care: (1) inpatient and follow-up cardiology care within 60 days after discharge and (2) other levels of cardiology care (inpatient only, outpatient only, and neither inpatient nor outpatient). Multivariable regression assessed the association between inpatient and follow-up cardiology care with all-cause mortality, adjusting for demographics, comorbidities, hospital presentation and treatment variables, and clustering by site. Results Of 933 patients with ACS, the majority (71.6%) had inpatient and follow-up cardiology care. Patients with inpatient and follow-up cardiology care were more likely to have prior coronary disease and diabetes and to present with myocardial infarction (vs unstable angina). All-cause mortality was lower for patients with inpatient and follow-up cardiology care (18.8% vs 22.1 %, P = .009). In multivariable analysis, patients with inpatient and follow-up cardiology care remained at lower mortality risk (hazard ratio 0.73, 95% CI 0.62-0.87) compared with patients with other levels of cardiology care. The findings were consistent when cardiology follow-up was defined as 30 or 90 days after hospital discharge. Conclusions Patients with inpatient and follow-up cardiology care have lower mortality risk after ACS. Future studies should identify mediators of this potential benefit and determine if interventions enhancing continuity of care in general, and continuity of subspecialty care in particular, after ACS will improve patient outcomes. C1 Denver VA Med Ctr, Med Serv, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80202 USA. Denver Hlth Med Ctr, Dept Med, Denver, CO USA. Puget Sound Hlth Care Syst, Hlth Serv Res, Seattle, WA USA. Univ Washington, Seattle, WA 98195 USA. Univ Alberta, Edmonton, AB T6G 2M7, Canada. Duke Clin Res Inst, Durham, NC USA. RP Ho, PM (reprint author), 1055 Clermont St, Denver, CO 80220 USA. EM michael.ho@uchsc.edu RI Sales, Anne/D-9678-2012; Maynard, Charles/N-3906-2015 OI Maynard, Charles/0000-0002-1644-7814; Sales, Anne/0000-0001-9360-3334 NR 30 TC 15 Z9 15 U1 0 U2 3 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-8703 J9 AM HEART J JI Am. Heart J. PD SEP PY 2007 VL 154 IS 3 BP 489 EP 494 DI 10.1016/j.ohi.2007.05.018 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 209LN UT WOS:000249390100015 PM 17719295 ER PT J AU Dunbar, NM Bankson, DD AF Dunbar, Nancy M. Bankson, Daniel D. TI Role of cardiac marker screening panels in the detection of acute myocardial infarction SO AMERICAN JOURNAL OF CLINICAL PATHOLOGY LA English DT Meeting Abstract CT 42nd Annual Meeting of the Academy-of-Clinical-Laboratory-Physicians-and-Scientists CY JUN 07-09, 2007 CL San Diego, CA SP Acad Clin Lab Phys & Scientists C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. RI Dunbar, Nancy/D-8883-2011 NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC CLINICAL PATHOLOGY PI CHICAGO PA 2100 W HARRISON ST, CHICAGO, IL 60612 USA SN 0002-9173 J9 AM J CLIN PATHOL JI Am. J. Clin. Pathol. PD SEP PY 2007 VL 128 IS 3 MA 6 BP 504 EP 505 PG 2 WC Pathology SC Pathology GA 201QO UT WOS:000248847900020 ER PT J AU Burgio, KL Borello-France, D Richter, HE FitzGerald, MP Whitehead, W Handa, VL Nygaard, I Fine, P Zyczynski, H Visco, AG Brown, MB Weber, AM AF Burgio, Kathryn L. Borello-France, Diane Richter, Holly E. FitzGerald, Mary Pat Whitehead, William Handa, Victoria L. Nygaard, Ingrid Fine, Paul Zyczynski, Halina Visco, Anthony G. Brown, Morton B. Weber, Anne M. CA Pelvic Floor Disorders Network TI Risk factors for fecal and urinary incontinence after childbirth: The childbirth and pelvic symptoms study SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Article ID ANAL-SPHINCTER DISRUPTION; VAGINAL DELIVERY; WOMEN; PREVALENCE; PREGNANCY; OLDER; MODE AB OBJECTIVE: To identify risk factors for postpartum FI and UI. METHODS: Secondary analysis of data from the CAPS study, which estimated the prevalence of postpartum FI and UI in primiparous women with clinically recognized anal sphincter tears after vaginal delivery, compared with women who delivered vaginally without recognized tears or by cesarean before labor. A total of 921 women were enrolled while in the hospital and 759 (82%) were interviewed by telephone 6 months postpartum. FI was assessed using the FISI and UI using the Medical, Epidemiological, and Social Aspects of Aging Questionnaire. FI risk factor analyses were conducted within each group, because of higher prevalence in the tear group. UI analyses were conducted with the groups combined. RESULTS: In women with sphincter tears, FI at 6 months was associated with white race (OR 6.1, 95% CI 1.3-29.4), antenatal UI (OR 2.2, CI 1.1-4.3), 4th versus 3rd degree tear (OR 2.0, CI 1.0-4.0), older age at delivery (OR 1.6 per 5 yr, CI 1.2-2.1), and higher body mass index (BMI) (OR 1.3 per 5 kg/m(2), CI 1.0-1.7). No factors were associated with FI in the vaginal or cesarean control groups. Across all groups, risk factors for postpartum UI were antenatal UI (OR 3.5, CI 2.4-5.2), less education (OR 2.0, CI 1.4-2.8), and higher BMI (OR 1.2 per 5 kg/m(2), CI 1.1-1.4); cesarean delivery was protective (OR 0.5, CI 0.3-0.9). CONCLUSIONS: Postpartum FI and UI are associated with few modifiable risk factors. However, the presence of antenatal UI and high BMI may help clinicians target at-risk women for early intervention. C1 Univ Alabama, Birmingham, AL 35294 USA. Birmingham VA Med Ctr, Birmingham, AL USA. Duquesne Univ, Pittsburgh, PA 15219 USA. Loyola Univ, Chicago, IL 60611 USA. Univ N Carolina, Chapel Hill, NC USA. Johns Hopkins Univ, Baltimore, MD USA. Univ Utah, Salt Lake City, UT USA. Baylor Coll Med, Houston, TX 77030 USA. Univ Pittsburgh, Pittsburgh, PA USA. Univ Michigan, Ann Arbor, MI 48109 USA. NICHHD, NIH, Bethesda, MD 20892 USA. RP Burgio, KL (reprint author), Univ Alabama, Birmingham, AL 35294 USA. FU NICHD NIH HHS [U10 HD41248, U01 HD41249, U10 HD041261, U10 HD041263, U10 HD41250, U10 HD41261, U10 HD41263, U10 HD41267, U10 HD41268, U10 HD41269] NR 21 TC 43 Z9 46 U1 1 U2 6 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD SEP PY 2007 VL 102 IS 9 BP 1998 EP 2004 DI 10.1111/j.1572-0241.2007.01364.x PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 202SA UT WOS:000248922500024 PM 17573795 ER PT J AU Amaratunge, H Tran, T Lu, L Qureshi, WA AF Amaratunge, Harshinie Tran, Thomas Lu, Lee Qureshi, Waqar A. TI Metastatic cholangiocarcinoma presenting as left shoulder pain SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Meeting Abstract CT 72nd Annual Scientific Meeting of the American-College-of-Gastroenterology CY OCT 12-17, 2007 CL Philadelphia, PA SP Amer Coll Gastroengerol C1 Baylor Coll Med, Houston, TX 77030 USA. VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD SEP PY 2007 VL 102 SU 2 MA 504 BP S301 EP S301 PG 1 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 209OL UT WOS:000249397800502 ER PT J AU Gross, RG Reiter, B Korsten, MA AF Gross, Rebekah G. Reiter, Bruce Korsten, Mark A. TI Pyogenic liver abscess complicating colonoscopic polypectomy SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Meeting Abstract CT 72nd Annual Scientific Meeting of the American-College-of-Gastroenterology CY OCT 12-17, 2007 CL Philadelphia, PA SP Amer Coll Gastroengerol C1 Mt Sinai Sch Med, New York, NY USA. James J Peters Vet Affairs Med Ctr, Bronx, NY USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD SEP PY 2007 VL 102 SU 2 MA 815 BP S418 EP S419 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 209OL UT WOS:000249397800813 ER PT J AU Toracchio, S El-Zimaity, H Urmacher, C Katz, S Graham, DY AF Toracchio, Sonia El-Zimaity, Hala Urmacher, Carlos Katz, Seymour Graham, David Y. TI Mycobacterium paratuberculosis in Crohn's Disease granulomas SO AMERICAN JOURNAL OF GASTROENTEROLOGY LA English DT Meeting Abstract CT 72nd Annual Scientific Meeting of the American-College-of-Gastroenterology CY OCT 12-17, 2007 CL Philadelphia, PA SP Amer Coll Gastroengerol C1 Baylor Coll Med, Houston, TX 77030 USA. CBL Path Inc, Rye Brook, NY USA. VA Med Ctr, Houston, TX USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-9270 J9 AM J GASTROENTEROL JI Am. J. Gastroenterol. PD SEP PY 2007 VL 102 SU 2 MA 932 BP S460 EP S461 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 209OL UT WOS:000249397800930 ER PT J AU Balsis, S Woods, CM Gleason, MEJ Oltmanns, TF AF Balsis, Steve Woods, Carol M. Gleason, Marci E. J. Oltmanns, Thomas F. TI Overdiagnosis and underdiagnosis of personality disorders in older adults SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE age bias; item response theory; personality disorder ID UNITED-STATES; AGE; PREVALENCE AB Objective: Recent evidence suggests that some of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition personality disorder ( PD) criteria contain measurement bias across age groups. Specifically, this research showed that younger and older adults were differentially likely to endorse certain PD criteria, even when both groups were statistically matched using mechanisms of item response theory ( IRT) for degree of PD pathology. For the analyses presented here, the authors used data from a large epidemiological study ( N = 43,093), the National Epidemiologic Survey on Alcohol and Related Conditions, to examine the influence of this item-level measurement bias for reaching accurate algorithmic PD diagnoses of older adults. Methods: Joint probability analyses were used to determine the net effect of the item-level bias on the possible over-or underdiagnosis of six PDs in older adults. Results: When older adults were compared to younger adults at equivalent levels of PD pathology, they were more likely to receive diagnoses of obsessive-compulsive and schizoid PDs. In contrast, they were less likely to receive diagnoses of avoidant and dependent PDs. Younger and older adults were equally likely to receive diagnoses of histrionic and paranoid PDs. Of the seven PDs assessed in this dataset, only these six lend themselves to this type of analysis; antisocial PD differs because a diagnosis depends upon the presence of conduct disorder. Conclusion: These findings raise concerns regarding the interpretation of existing older adult PD prevalence data. C1 Washington Univ, Vet Affairs Med Ctr, St Louis, MO USA. Washington Univ, Dept Psychol, St Louis, MO 63130 USA. RP Balsis, S (reprint author), Houston VA Med Ctr, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM smbalsis@wustl.edu FU NIMH NIH HHS [1F31-MH075336-01A1, F31 MH075336, R01 MH051187, R01 MH077840, R01-MH51187] NR 22 TC 25 Z9 25 U1 0 U2 10 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD SEP PY 2007 VL 15 IS 9 BP 742 EP 753 DI 10.1097/JGP.0b013e31813c6b4e PG 12 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 207WO UT WOS:000249282000003 PM 17804828 ER PT J AU Thompson, AN Osgood, TS Ragucci, KR AF Thompson, Amy N. Osgood, Tracie S. Ragucci, Kelly R. TI Patient care interventions by pharmacy students in the intensive care unit SO AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY LA English DT Letter C1 Med Univ S Carolina, Charleston, SC 29425 USA. Med Univ S Carolina Campus, S Carolina Coll Pharm, Dept Vet Affairs, Ralph H Johnson VA Med Ctr,Pharm Serv 119, Charleston, SC 29401 USA. Med Univ S Carolina Campus, S Carolina Coll Pharm, Charleston, SC 29425 USA. RP Thompson, AN (reprint author), Med Univ S Carolina, 43 Sabin St,Suite QE213,POB 250132, Charleston, SC 29425 USA. EM thompsan@musc.edu NR 11 TC 5 Z9 5 U1 0 U2 0 PU AMER SOC HEALTH-SYSTEM PHARMACISTS PI BETHESDA PA 7272 WISCONSIN AVE, BETHESDA, MD 20814 USA SN 1079-2082 EI 1535-2900 J9 AM J HEALTH-SYST PH JI Am. J. Health-Syst. Pharm. PD SEP 1 PY 2007 VL 64 IS 17 BP 1788 EP 1789 DI 10.2146/ajhp060476 PG 2 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 206YP UT WOS:000249219100005 PM 17724354 ER PT J AU Petersen, LA Urech, TH Byrne, MM Pietz, K AF Petersen, Laura A. Urech, Tracy H. Byrne, Margaret M. Pietz, Kenneth TI Do financial incentives in a globally budgeted healthcare payment system produce changes in the way patients are categorized? A five-year study SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID PAY-FOR-PERFORMANCE; REGIONAL-VARIATIONS; MEDICARE PATIENTS; QUALITY; OUTCOMES; IMPLEMENTATION; HOSPITALS; UNDERUSE AB Objective: To assess the responses to financial incentives after a change in the payment system in a capitation-style healthcare payment system over a 5-year period. Study Design: Cross-sectional and longitudinal examination of cost, utilization, and diagnostic data. Methods: Using Veterans Health Administration (VHA) administrative data on healthcare users between fiscal years 1998 and 2002, we calculated the proportion of new patients entering each of the payment classes, the illness burden of patients entering the payment classes, and the profitability index (a ratio of payment to costs) for each class suspected of gaming and each control class. Our main dependent variables of interest were the differences in the measures between each utilization-based class and each diagnosis-based class. We used 2 different analytic approaches to assess whether these differences increased or decreased over time. Results: No clear evidence of gaming behavior was present in our results. A few comparisons were significant, but they did not show a consistent pattern of responses to incentives. For example, 6 of 16 comparisons of profitability index were significant, but (contrary to the hypothesis) 4 of these had a negative value for the time parameter, indicating decreasing profitability in the utilization-based classes versus the diagnosis-based classes. Conclusions: Although the payment system could be manipulated to increase payment to VHA networks, no such consistent gaming behavior was observed. More research is needed to better understand the effects of financial incentives in other healthcare payment systems. C1 Baylor Coll Med, Houston Vet Affairs Med Ctr, Hlth Serv Res & Dev 152, Div Hlth Policy & Qual,Houston Ctr Qual Care & Ut, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Univ Miami, Dept Epidemiol & Publ Hlth, Miami, FL 33152 USA. RP Petersen, LA (reprint author), Baylor Coll Med, Houston Vet Affairs Med Ctr, Hlth Serv Res & Dev 152, Div Hlth Policy & Qual,Houston Ctr Qual Care & Ut, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM laurap@bcm.tmc.edu FU NHLBI NIH HHS [R01 HL079173-01] NR 34 TC 5 Z9 5 U1 1 U2 4 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD SEP PY 2007 VL 13 IS 9 BP 513 EP 522 PG 10 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 210JN UT WOS:000249452600003 PM 17803365 ER PT J AU Li, JZ Winston, LG Moore, DH Bent, S AF Li, Jonathan Z. Winston, Lisa G. Moore, Dan H. Bent, Stephen TI Efficacy of short-course antibiotic regimens for community-acquired pneumonia: A meta-analysis SO AMERICAN JOURNAL OF MEDICINE LA English DT Article; Proceedings Paper CT 46th Interscience Conference on Antimicrobial Agents and Chemotherapy CY SEP 27-30, 2006 CL San Francisco, CA DE antibiotics; community-acquired pneumonia; pneumonia; short-course ID RESISTANT STREPTOCOCCUS-PNEUMONIAE; RANDOMIZED CONTROLLED-TRIALS; ANTIMICROBIAL THERAPY; ATYPICAL PNEUMONIA; CLINICAL-EFFICACY; UNITED-STATES; AZITHROMYCIN; ADULTS; GUIDELINES; MANAGEMENT AB PURPOSE: There is little consensus on the most appropriate duration of antibiotic treatment for community-acquired pneumonia. The goal of this study is to systematically review randomized controlled trials comparing short-course and extended-course antibiotic regimens for community-acquired pneumonia. METHODS: We searched MEDLINE, Embase, and CENTRAL, and reviewed reference lists from 1980 through June 2006. Studies were included if they were randomized controlled trials that compared short-course (7 days or less) versus extended-course (> 7 days) antibiotic monotherapy for community-acquired pneumonia in adults. The primary outcome measure was failure to achieve clinical improvement. RESULTS: We found 15 randomized controlled trials matching our inclusion and exclusion criteria comprising 2796 total subjects. Short-course regimens primarily studied the use of azithromycin (n = 10), but trials examining beta-lactams (n = 2), fluoroquinolones (n = 2), and ketolides (n = 1) were found as well. Of the extended-course regimens, 3 studies utilized the same antibiotic, whereas 9 involved an antibiotic of the same class. Overall, there was no difference in the risk of clinical failure between the short-course and extended-course regimens (0.89, 95% confidence interval [CI], 0.78-1.02). In addition, there were no differences in the risk of mortality (0.81, 95% CI, 0.46-1.43) or bacteriologic eradication (1.11, 95% CI, 0.76-1.62). In subgroup analyses, there was a trend toward favorable clinical efficacy for the short-course regimens in all antibiotic classes (range of relative risk, 0.88-0.94). CONCLUSIONS: The available studies suggest that adults with mild to moderate community-acquired pneumonia can be safely and effectively treated with an antibiotic regimen of 7 days or less. Reduction in patient exposure to antibiotics may limit the increasing rates of antimicrobial drug resistance, decrease cost, and improve patient adherence and tolerability. (C) 2007 Elsevier Inc. All rights reserved. C1 Univ Calif San Francisco, San Francisco VA Med Ctr, Dept Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, San Francisco VA Med Ctr, Infect Dis Sect, San Francisco, CA 94143 USA. Univ Calif San Francisco, San Francisco VA Med Ctr, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Univ Calif San Francisco, San Francisco VA Med Ctr, Gen Internal Med Sect, San Francisco, CA 94143 USA. RP Li, JZ (reprint author), Univ Calif San Francisco, San Francisco VA Med Ctr, Dept Med, Box 0862,5H22, San Francisco, CA 94143 USA. EM jli22@partners.org NR 59 TC 68 Z9 73 U1 0 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9343 J9 AM J MED JI Am. J. Med. PD SEP PY 2007 VL 120 IS 9 BP 783 EP 790 DI 10.1016/j.amjmed.2007.04.023 PG 8 WC Medicine, General & Internal SC General & Internal Medicine GA 205ON UT WOS:000249123800012 PM 17765048 ER PT J AU Chiou-Tan, FY Bloodworth, DM Kass, JS Li, XQ Gavagan, TF Mattox, K Rintala, DH AF Chiou-Tan, Faye Y. Bloodworth, Donna M. Kass, Joseph S. Li, Xiaoqi Gavagan, Thomas F. Mattox, Kenneth Rintala, Diana H. TI Physical medicine and rehabilitation conditions in the astrodome clinic after Hurricane Katrina SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Article DE disaster preparedness; physical medicine and rehabilitation; Hurricane; emergency relief AB Objective: To report the physical medicine and rehabilitation (PMR) conditions seen in the Astrodome Clinic after Hurricane Katrina. Design: Retrospective chart analysis from the county hospital-sponsored disaster-relief clinic in large urban city, including a study of 239 patients with 292 PMR conditions. The total number of patients seen in the Astrodome Medical Clinic was 11,245. The Astrodome database was reviewed for PMR condition diagnostic codes. A retrospective chart analysis was conducted, including date of visit, age, gender, ethnicity, and PMR diagnosis category. Descriptive statistics were obtained for the entire sample. X-2 or t tests were used to determine gender, age, or date-of-service predominance for the most common diagnostic categories. Results: Mean +/- SID age was 45.7 +/- 14.3 yrs; 56% were women, 43% were men (1% unspecified), and 76% were African American. The majority (75%) of PMR conditions presented in the first week. Most frequent were swollen feet and legs (22%), leg pain and cramps (17%), and neck and back pain (10%). Persons with head-headache (112%), aches were younger than those without (41.3 vs. 46.3 yrs, P = 0.048). Persons with neck and/or back pain were older than those without those conditions (51.3 vs. 44.8 yrs, P = 0.004). Women had more headaches (20.9%) than did men (6.7%, P = 0.002). There were no Caucasians with leg pain/cramps, whereas 20.2% of African Americans had this condition (P = 0.028). Conclusions: This study documents the time of clinic presentation and most frequent types of PMR conditions of patients treated in the Astrodome Clinic after a historic hurricane. Most PMR conditions were treated by PMR personnel during the first week. Thus, future disaster planning should include PMR professionals as early responders. C1 Baylor Coll Med, Dept Phys Med & Rehabil, Houston, TX 77030 USA. Res Harris Cty Hosp Dist, Ctr Trauma Rehabil, Houston, TX USA. Baylor Coll Med, Dept Neurol, Houston, TX 77030 USA. Baylor Coll Med, Ctr Med Eth & Hlth Care Policy, Houston, TX 77030 USA. Baylor Coll Med, Dept Family & Community Med, Houston, TX 77030 USA. Baylor Coll Med, Dept Surg, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. RP Chiou-Tan, FY (reprint author), Quentin Mease Hosp, Dept Phys Med & Rehabil, 3601 N MacGregor Way,Suite 240, Houston, TX 77004 USA. NR 6 TC 5 Z9 6 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0894-9115 J9 AM J PHYS MED REHAB JI Am. J. Phys. Med. Rehabil. PD SEP PY 2007 VL 86 IS 9 BP 762 EP 769 DI 10.1097/PHM.0b013e31813e61cc PG 8 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 205SC UT WOS:000249133900010 PM 17710001 ER PT J AU Colston, JT de la Rosa, SD Koehler, M Gonzales, K Mestril, R Freeman, GL Bailey, SR Chandrasekar, B AF Colston, J. T. de la Rosa, S. D. Koehler, M. Gonzales, K. Mestril, R. Freeman, G. L. Bailey, S. R. Chandrasekar, B. TI Wnt-induced secreted protein-1 is a prohypertrophic and profibrotic growth factor SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE cysteine-rich 61; connective tissue growth factor; and nephroblastoma; overexpressed family; myocardial infarction; myocardial remodeling; Akt; cardiomyocyte hypertrophy ID ACUTE MYOCARDIAL-INFARCTION; GLYCOGEN-SYNTHASE KINASE-3-BETA; ADULT CARDIAC FIBROBLASTS; NECROSIS-FACTOR-ALPHA; SMOOTH-MUSCLE-CELLS; FACTOR-KAPPA-B; GENE-EXPRESSION; TGF-BETA; PLASMA-CATECHOLAMINES; SIGNALING PATHWAY AB Wnt1-induced secreted protein-1 (WISP-1) is a member of the cysteine-rich 61, connective tissue growth factor, and nephroblastoma overexpressed (CCN) family of growth factors and is expressed in the heart at low basal levels. The purpose of this study was to investigate whether WISP-1 is upregulated in postinfarct myocardium and whether WISP-1 exerts prohypertrophic and mitogenic effects stimulating myocyte hypertrophy, cardiac fibroblast (CF) proliferation, and collagen expression. Male C57B1/6 (25 g) mice underwent permanent occlusion of the left anterior descending coronary artery. mRNA and protein levels were analyzed by Northern and Western blot analyses. Cardiomyocyte hypertrophy was quantified by protein and DNA synthesis. CF proliferation was quantified by CyQuant assay, and soluble collagen release by Sircol assay. A time-dependent increase in WISP-1 expression was detected in vivo in the noninfarct zone of the left ventricle, which peaked at 24 h (3.1-fold, P < 0.01). Similarly, biglycan expression was increased by 3.71-fold (P < 0.01). IL-1 beta and TNF-alpha expression preceded WISP-1 expression in vivo and stimulated WISP-1 expression in neonatal rat ventricular myocytes in vitro. WISP-1- induced cardiomyocyte hypertrophy was evidenced by increased protein (2.78- fold), but not DNA synthesis, and enhanced Akt phosphorylation and activity. Treatment of primary CF with WISP-1 significantly stimulated proliferation at 48 h (6,966 +/- 264 vs. 5,476 +/- 307 cells/ well, P < 0.01) and enhanced collagen release by 72 h (18.4 +/- 3.1 vs. 8.4 +/- 1.0 ng/cell, P < 0.01). Our results demonstrate for the first time that WISP-1 and biglycan are upregulated in the noninfarcted myocardium in vivo, suggesting a positive amplification of WISP-1 signaling. WISP-1 stimulates cardiomyocyte hypertrophy, fibroblast proliferation, and ECM expression in vitro. These results suggest that WISP-1 may play a critical role in post-myocardial infarction remodeling. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. Loyola Univ, Med Ctr, Dept Physiol, Maywood, IL 60153 USA. Loyola Univ, Med Ctr, Cardiovasc Inst, Maywood, IL 60153 USA. Audie L Murphy Div, S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Chandrasekar, B (reprint author), 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM chandraseka@uthscsa.edu FU NHLBI NIH HHS [HL-68020, HL-67971] NR 56 TC 58 Z9 63 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD SEP PY 2007 VL 293 IS 3 BP H1839 EP H1846 DI 10.1152/ajpheart.00428.2007. PG 8 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 207FU UT WOS:000249237800065 PM 17616748 ER PT J AU Bitondo, C Goodwin, JS Pickens-Pace, S Burnett, J Kelly, PA AF Bitondo, Carmel Goodwin, James S. Pickens-Pace, Sabrina Burnett, Jason Kelly, P. Adam TI Self-neglect among the elderly: A model based on more than 500 patients seen by a geriatric medicine team SO AMERICAN JOURNAL OF PUBLIC HEALTH LA English DT Article ID EXECUTIVE CONTROL; FUNCTIONAL STATUS; FREEDOM HOUSE; OLDER-ADULTS; COMMUNITY; SERVICE; ASSOCIATION; MORTALITY; BREAKDOWN; STRESS AB Objectives. We sought to identify the functional, cognitive, and social factors associated with self-neglect among the elderly to aid the development of etiologic models to guide future research. Methods. A cross-sectional chart review was conducted at Baylor College of Medicine Geriatrics Clinic in Houston, Tex. Patients were assessed using standardized comprehensive geriatric assessment tools. Results. Data analysis was performed using the charts of 538 patients; the average patient age was 75.6 years, and 70% were women. Further analysis in 460 persons aged 65 years and older showed that 50% had abnormal Mini Mental State Examination scores, 15% had abnormal Geriatric Depression Scale scores, 76.3% had abnormal physical performance test scores, and 95% had moderate-to-poor social support per the Duke Social Support Index. Patients had a range of illnesses; 46.4% were taking no medications. Conclusions. A model of self-neglect was developed wherein executive clyscontrol leads to functional impairment in the setting of inadequate medical and social support. Future studies should aim to provide empirical evidence that validates this model as a framework for self-neglect. If validated, this model will impart a better understanding of the pathways to self-neglect and provide clinicians and public service workers with more effective prevention and intervention strategies. C1 [Bitondo, Carmel; Pickens-Pace, Sabrina; Burnett, Jason] Baylor Univ, Coll Med, Houston, TX 77030 USA. [Bitondo, Carmel; Pickens-Pace, Sabrina; Burnett, Jason] Harris Cty Hosp Dist, Houston, TX USA. [Goodwin, James S.] Univ Texas Galveston, Med Branch, Galveston, TX 77550 USA. [Kelly, P. Adam] Baylor Coll Med, Houston, TX 77030 USA. [Kelly, P. Adam] Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. RP Bitondo, C (reprint author), Univ Texas Houston, Hlth Sci Ctr, 6431 Fannin,Suite 4-200, Houston, TX 77030 USA. EM carmel.h.dyer@uth.tmc.edu FU NCRR NIH HHS [P20 RR020626, P20RR20626] NR 29 TC 8 Z9 11 U1 1 U2 9 PU AMER PUBLIC HEALTH ASSOC INC PI WASHINGTON PA 800 I STREET, NW, WASHINGTON, DC 20001-3710 USA SN 0090-0036 J9 AM J PUBLIC HEALTH JI Am. J. Public Health PD SEP PY 2007 VL 97 IS 9 BP 1671 EP 1676 DI 10.2105/AJPH.2006.097113 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 297WM UT WOS:000255648100031 PM 17666694 ER PT J AU Skinner, ML Schlosser, RJ Lathers, D Neal, JG Woodworth, BA Hall, J Newton, DA Baatz, JE AF Skinner, Margaret L. Schlosser, Rodney J. Lathers, Deanne Neal, Jeffrey G. Woodworth, Bradford A. Hall, Jeffrey Newton, Danforth A. Baatz, John E. TI Innate and adaptive mediators in cystic fibrosis and allergic fungal rhinosinusitis SO AMERICAN JOURNAL OF RHINOLOGY LA English DT Article; Proceedings Paper CT Combined Otolaryngology Spring Meeting CY MAY 19-22, 2006 CL Chicago, IL DE adaptive immunity; AFRS; allergic fungal smusitis; cystic fibrosis; innate immunity; rhinosinusitis; surfactant ID SURFACTANT PROTEIN-D; ASPERGILLUS-FUMIGATUS; ALVEOLAR MACROPHAGES; SP-A; PHAGOCYTOSIS; INFLAMMATION; BACTERIA; ASTHMA AB Background: Surfactant-associated proteins (SP) A and D are both innate immunity mediators and produced in normal and diseased sinus mucosa. Cystic fibrosis (CF) is associated with Th1 adaptive inflammation whereas allergic fungal rhinosinusitis (AFRS) is associated with Th2 adaptive inflammation. The purpose of this study is to show and quantify the presence of SP A, SP D, tumor necrosis factor (TNF) alpha, (a Th1 marker), and eotaxin (a Th2 marker) in normal and diseased sinus mucosa. Methods: Intraoperative sinus mucosal biopsy specimens from human volunteers were obtained during endoscopic sinus surgery for CF (n = 4), AFRS (n = 10), and normal controls (CTLs; n = 4). Specimens were evaluated for presence and quantity of SPA, SP D, and TNF-alpha using Western blot with semiquantitative immunoblot analysis. Eotaxin was quantified using ELISA immunoassay. Results were standardized and reported as picograms of mediator per microgram of total protein. Results: SPA, SP D, and TNF-alpha levels in CF tissue extracts were 2-10 times higher than levels in AFRS tissue (with SP D and TNF-alpha reaching statistical significance) but CF tissue was not significantly higher than CTL tissue. SP A, SP D, and TNF-alpha were not significantly elevated in AFRS. Eotaxin showed elevated levels in CF and AFRS when compared with CTLs (p = 0.03 and 0.003, respectively). Conclusion: SP D and TNF-alpha are significantly increased in CF compared with AFRS, suggesting activation of both innate immunity and Th1-mediated inflammation and potential correlation between SPs and downstream adaptive immune responses. C1 Childrens Hosp, Dept Otolaryngol & Commun Enhancement, Boston, MA 02115 USA. Med Univ S Carolina, Dept Otolaryngol Head & Neck Surg, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Hosp Med Ctr, Res Serv 151, Charleston, SC USA. Med Univ S Carolina, Dept Pediat, Div Pulmonol, Charleston, SC 29425 USA. RP Skinner, ML (reprint author), Childrens Hosp, Dept Otolaryngol & Commun Enhancement, 300 Longwood Ave LO367, Boston, MA 02115 USA. EM margaret.skinner@childrens.harvard.edu OI Baatz, John/0000-0001-5870-1000 NR 17 TC 9 Z9 9 U1 0 U2 0 PU OCEAN SIDE PUBLICATIONS INC PI PROVIDENCE PA 95 PITMAN ST, PROVIDENCE, RI 02906 USA SN 1050-6586 J9 AM J RHINOL JI Am. J. Rhinol. PD SEP-OCT PY 2007 VL 21 IS 5 BP 538 EP 541 DI 10.2500/ajr.2007.21.3070 PG 4 WC Otorhinolaryngology SC Otorhinolaryngology GA 228ZB UT WOS:000250770000003 PM 17999785 ER PT J AU Cohen, AN Wang, MB AF Cohen, Alen N. Wang, Marilene B. TI Minitrephination as an adjunctive measure in the endoscopic management of complex frontal sinus disease SO AMERICAN JOURNAL OF RHINOLOGY LA English DT Article; Proceedings Paper CT Meeting of the the Middle-Section-of-the-Triological-Society CY FEB 02-05, 2006 CL San Diego, CA SP Triol Soc, Middle Sect DE allergic fungal sinusitis; chronic sinusitis; endoscopic sinus surgery; frontal recess; frontal sinus; frontal sinusitis; minimally invasive sinus surgery; minitrephination; mucoceles; trephine ID SURGERY; TREPHINATION; MUCOCELES AB Background: Frontal sinus disease and its surgical management continues to remain an area of controversy among rhinologists. This is evidenced by the multitude of surgical procedures, both external and endoscopic, that have been developed in its management. This study was performed to evaluate the safety and efficacy of frontal sinus minitrephination in combination, with endoscopic frontal sinus exploration for the management of complex frontal sinus disease. Methods: A retrospective chart review identified 13 patients treated with minitrephination, in conjunction with endoscopic frontal sinus exploration, at the University of California at Los Angeles Medical Center or West Los Angeles VA Medical Center from July 2004 to October 2005. Results: Thirteen patients with diagnoses of chronic sinusitis (n = 10), nasal polyposis (n = 7),frontal mucocele (n = 4), allergic fungal sinusitis (n = 3), and inverting papilloma (n = 1) underwent either unilateral (n = 9) or bilateral (n = 4) minitrephination during primary or revision functional endoscopic sinus surgery. Median follow-up was 14.2 months. There were no complications attributed to the procedure, and all patients had improvement of their sinus symptoms and displayed no evidence of recurrence of their frontal sinus disease at last follow-up. Conclusion: Minitrephination is a safe and effective adjunct in the management of complex frontal sinus disease, as it allows identification of the frontal recess and vigorous irrigation of the sinus contents. C1 Univ Calif Los Angeles, David Geffen Sch Med, Div Head & Neck Surg, Los Angeles, CA 90095 USA. VA Greater Los Angeles Hlth Care Syst, Dept Surg, Los Angeles, CA USA. RP Wang, MB (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Head & Neck Surg, CHS 62-132,10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM inbwang@ucla.edu NR 22 TC 10 Z9 10 U1 0 U2 1 PU OCEAN SIDE PUBLICATIONS INC PI PROVIDENCE PA 95 PITMAN ST, PROVIDENCE, RI 02906 USA SN 1050-6586 J9 AM J RHINOL JI Am. J. Rhinol. PD SEP-OCT PY 2007 VL 21 IS 5 BP 629 EP 636 DI 10.2500/ajr.2007.21.3083 PG 8 WC Otorhinolaryngology SC Otorhinolaryngology GA 228ZB UT WOS:000250770000022 PM 17999804 ER PT J AU Peacock, WF Varon, J Garrison, N Ebrahimi, R Dunbar, L Pollack Jr AF Peacock, W. F. Varon, J. Garrison, N. Ebrahimi, R. Dunbar, L. Pollack, Jr. TI IV clevidipine for hypertension: Safety, efficacy, and transition to oral therapy SO ANNALS OF EMERGENCY MEDICINE LA English DT Meeting Abstract CT Research Forum of the American-College-of-Emergency-Physicians CY OCT 08-09, 2007 CL Seattle, WA SP Amer Coll Emergency Phys C1 Cleveland Clin, Cleveland, OH 44106 USA. Univ Texas, Hlth Sci Ctr, Houston, TX USA. Jackson Hosp, Montgomery, AL USA. VA Greater Los Angeles Healthcare Ctr, Los Angeles, CA USA. Louisiana State Univ, Hlth Sci Ctr, New Orleans, LA USA. Univ Penn, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 1 U1 0 U2 1 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-0644 J9 ANN EMERG MED JI Ann. Emerg. Med. PD SEP PY 2007 VL 50 IS 3 SU S MA 24 BP S8 EP S9 DI 10.1016/j.annemergmed.2007.06.055 PG 2 WC Emergency Medicine SC Emergency Medicine GA 211PL UT WOS:000249535600026 ER PT J AU Bilimoria, KY Bentrem, DJ Ko, CY Stewart, AK Winchester, DP Talamonti, MS Sturgeon, C AF Bilimoria, Karl Y. Bentrem, David J. Ko, Clifford Y. Stewart, Andrew K. Winchester, David P. Talamonti, Mark S. Sturgeon, Cord TI Extent of surgery affects survival for papillary thyroid cancer SO ANNALS OF SURGERY LA English DT Article; Proceedings Paper CT 127th Annual Meeting of the American-Surgical-Association CY APR, 2007 CL Colorado Springs, CO SP Amer Surg Assoc ID DIFFERENTIATED CARCINOMA; COLORECTAL-CANCER; RADIATION-THERAPY; PROGNOSTIC INDEX; UNITED-STATES; RISK-GROUP; CHEMOTHERAPY; INFORMATION; MANAGEMENT; OUTCOMES AB Background: The extent of surgery for papillary thyroid cancers (PTC) remains controversial. Consensus guidelines have recommended total thyroidectomy for PTC >= 1 cm; however, no study has supported this recommendation based on a survival advantage. The objective of this study was to examine whether the extent of surgery affects outcomes for PTC and to determine whether a size threshold could be identified above which total thyroidectomy is associated with improved outcomes. Methods: From the National Cancer Data Base (1985-1998), 52,173 patients underwent surgery for PTC. Survival was estimated by the Kaplan-Meier method and compared using log-rank tests. Cox Proportional Hazards modeling stratified by tumor size was used to assess the impact of surgical extent on outcomes and to identify a tumor size threshold above which total thyroidectomy is associated with an improvement in recurrence and long-term survival rates. Results: Of the 52,173 patients, 43,227 (82.9%) underwent total thyroidectomy, and 8946 (17.1%) underwent lobectomy. For PTC < 1 cm extent of surgery did not impact recurrence or survival (P = 0.24, P = 0.83). For turnors >= 1 cm, lobectomy resulted in higher risk of recurrence and death (P = 0.04, P = 0.009). To minimize the influence of larger tumors, 1 to 2 cm lesions were examined separately: lobectomy again resulted in a higher risk of recurrence and death (P = 0.04, P = 0.04). Conclusions: The results of this study demonstrate that total thyroidectomy results in lower recurrence rates and improved survival for PTC >= 1.0 cm compared with lobectomy. This is the first study to demonstrate that total thyroidectomy for PTC >= 1.0 cm improves outcomes. C1 Northwestern Univ, Feinberg Sch Med, Dept Surg, Chicago, IL USA. Amer Coll Surgeons, Chicago, IL USA. Univ Calif Los Angeles, Dept Surg, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Evanston NW Healthcare, Dept Surg, Evanston, IL USA. RP Sturgeon, C (reprint author), NW Mem Hosp, Dept Surg, 675 N St Clair St,Galter 10-105, Chicago, IL 60611 USA. EM csturgeo@nmh.org NR 42 TC 246 Z9 277 U1 5 U2 13 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-4932 J9 ANN SURG JI Ann. Surg. PD SEP PY 2007 VL 246 IS 3 BP 375 EP 384 DI 10.1097/SLA.0b013e31814697d9 PG 10 WC Surgery SC Surgery GA 206HQ UT WOS:000249174900004 PM 17717441 ER PT J AU Yehuda, R Teicher, MH Seckl, JR Grossman, RA Morris, A Bierer, LM AF Yehuda, Rachel Teicher, Martin H. Seckl, Jonathan R. Grossman, Robert A. Morris, Adam Bierer, Linda M. TI Parental posttraumatic stress disorder as a vulnerability factor for low cortisol trait in offspring of holocaust survivors SO ARCHIVES OF GENERAL PSYCHIATRY LA English DT Article ID PRENATAL EXPOSURE; MATERNAL-CARE; DUTCH FAMINE; PTSD; TRAUMA; SCHIZOPHRENIA; SEVERITY; DISEASE; RISK; RAPE AB Context: Lower cortisol levels in posttraumatic stress disorder ( PTSD) may reflect a preexisting vulnerability associated with developing the disorder after trauma exposure. Because offspring of trauma survivors with PTSD have a greater prevalence of PTSD after their own life events than offspring of trauma survivors without PTSD and offspring of nonexposed persons, examination of patterns of basal cortisol secretion in such offspring provides an opportunity to test this hypothesis. Objective: To characterize the patterns of basal cortisol secretion in offspring of Holocaust survivors with and without parental PTSD and children of nonexposed parents. Design: Cortisol secretion was measured every 30 minutes for 24 hours. The raw hormonal data were subjected to a chronobiological analysis by applying single-oscillator and multioscillator cosinor analyses, a nonlinear least squares curve-fitting program, to determine circadian and ultradian regulatory dynamics. Setting: The study was conducted under controlled conditions at the General Clinical Research Center at the Mount Sinai School of Medicine. Participants: Twenty-three Holocaust offspring with parental PTSD and 10 without parental PTSD were compared with 16 children of nonexposed parents. No participant had PTSD. Main Outcome Measures: Mean cortisol levels during the 24-hour cycle and other chronobiological parameters ( amplitude, acrophase, circadian quotient, and goodness-of-fit coefficient) derived from singleoscillator and multioscillator models. Results: Offspring with parental PTSD displayed lower mean cortisol levels, reflected by the circadian mesor and reduced cortisol amplitude, compared with offspring without parental PTSD and children of nonexposed parents. This effect seemed to be specifically related to the presence of maternal PTSD. Conclusions: Low cortisol levels and other chronobiological alterations in offspring are associated with the risk factor of maternal PTSD, raising the possibility that these alterations are acquired via glucocorticoid programming either from in utero exposures or in response to maternal behaviors early in life. C1 James J Peters Vet Affairs Med Ctr, Dept Psychiat, Bronx, NY 10468 USA. Mt Sinai Sch Med, Dept Psychiat, Traumat Stress Studies Program, Bronx, NY USA. Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA. McLean Hosp, Dev Biopsychiat Res Program, Belmont, MA 02178 USA. Univ Edinburgh, Queens Med Res Inst, Endocrinol Unit, Edinburgh, Midlothian, Scotland. RP Yehuda, R (reprint author), James J Peters Vet Affairs Med Ctr, Dept Psychiat, 130 W Kingsbridge Rd,116A, Bronx, NY 10468 USA. EM rachel.yehuda@va.gov RI Seckl, Jonathan/C-3555-2013 FU NCRR NIH HHS [M01 RR00071]; NIMH NIH HHS [R01 MH64675-01] NR 39 TC 84 Z9 87 U1 2 U2 15 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-990X J9 ARCH GEN PSYCHIAT JI Arch. Gen. Psychiatry PD SEP PY 2007 VL 64 IS 9 BP 1040 EP 1048 DI 10.1001/archpsyc.64.9.1040 PG 9 WC Psychiatry SC Psychiatry GA 206AS UT WOS:000249156900007 PM 17768269 ER PT J AU Landry, GJ Liem, TK Mitchell, EL Edwards, JM Moneta, GL AF Landry, Gregory J. Liem, Timothy K. Mitchell, Erica L. Edwards, James M. Moneta, Gregory L. TI Factors affecting symptomatic vs asymptomatic vein graft stenoses in lower extremity bypass grafts SO ARCHIVES OF SURGERY LA English DT Article; Proceedings Paper CT 78th Annual Meeting of the Pacific-Coast-Surgical-Association CY FEB 18, 2007 CL Kohala Coast, HI SP Pacific Coast Surg Assoc ID DUPLEX SCAN SURVEILLANCE; PATENCY; REVISION; REPAIR AB Objective: To determine differences in patients undergoing lower extremity vein graft revisions presenting with and without recurrence of preoperative symptoms. Design: Retrospective case-control study of a prospectively maintained database. Setting: University and veterans' administration hospitals Patients: Two hundred nineteen lower extremity vein graft revisions were performed in 161 patients from January 1995 to January 2007. Patients were categorized as asymptomatic or symptomatic (recurrence of initial symptoms) at the time of revision. Main Outcome Measures: Univariate analysis was performed to assess differences in patient demographics, details of initial operation, site of recurrent lesion, and follow-up surveillance data between symptomatic and asymptomatic patients. Independent predictors of symptomatic recurrence were identified with multivariate logistic regression. Primary assisted patency was compared between revisions performed for symptomatic and asymptomatic lesions. Results: Vein graft stenoses were asymptomatic in 125 cases (57%) and symptomatic in 94 cases (43%). Symptomatic recurrences were associated with a significantly greater drop in ankle brachial index than asymptomatic lesions (mean [SD], 0.21 [0.03] vs 0.11 [0.021; P=.003). Distal graft or outflow lesions were significantly associated with symptom recurrence (P=.048). Multivariate analysis identified ankle brachial index decrease (odds ratio, 6.803; 95% confidence interval, 1.418-32.258; P=.02) and the use of alternate graft conduit (odds ratio, 2.633,95% confidence interval, 1.243-5.578; P=.01) as independent predictors of recurrent symptoms. Overall 5-year patency was the same regardless of preoperative symptoms (82% symptomatic and 88% asymptomatic; P=30). Conclusions: Symptomatic recurrences are associated with larger decreases in ankle brachial index, distal lesions, and alternate conduit grafts. Duplex surveillance is necessary to identify asymptomatic vein graft stenoses. Because graft patency is independent of preoperative symptoms, surveillance consisting of clinical follow-up with ankle brachial index evaluation warrants further consideration. C1 Oregon Hlth & Sci Univ, Dept Surg, Div Vasc Surg, Portland, OR 97239 USA. Portland VA Med Ctr, Dept Surg, Portland, OR USA. RP Landry, GJ (reprint author), Oregon Hlth & Sci Univ, Dept Surg, Div Vasc Surg, 3181 SW Sam Jackson Pk Rd,Mail Code OP11, Portland, OR 97239 USA. EM landryg@ohsu.edu NR 18 TC 5 Z9 6 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0004-0010 J9 ARCH SURG-CHICAGO JI Arch. Surg. PD SEP PY 2007 VL 142 IS 9 BP 848 EP 853 DI 10.1001/archsurg.142.9.848 PG 6 WC Surgery SC Surgery GA 210KB UT WOS:000249454000009 PM 17875839 ER PT J AU Frey, BN Andreazza, AC Nery, FG Martins, MR Quevedo, J Soares, JC Kapczinski, F AF Frey, Benicio N. Andreazza, Ana C. Nery, Fabiano G. Martins, Marcio R. Quevedo, Joao Soares, Jair C. Kapczinski, Flavio TI The role of hippocampus in the pathophysiology of bipolar disorder SO BEHAVIOURAL PHARMACOLOGY LA English DT Review DE animal model; bipolar disorder; brain imaging; hippocampus; mood stabilizers; pathophysiology; postmortem ID DORSOLATERAL PREFRONTAL CORTEX; STANLEY NEUROPATHOLOGY CONSORTIUM; DECLARATIVE MEMORY IMPAIRMENT; TEMPORAL-LOBE STRUCTURES; LONG-TERM POTENTIATION; MOOD DISORDERS; MAJOR DEPRESSION; POSTMORTEM BRAIN; RAT HIPPOCAMPUS; NEUROTROPHIC FACTOR AB Bipolar disorder (BD) is thought to be associated with abnormalities within discrete brain regions associated with emotional regulation, particularly in fronto-limbic-subcortical circuits. Several reviews have addressed the involvement of the prefrontal cortex in the pathophysiology of BD, whereas little attention has been given to the role of the hippocampus. This study critically reviews data from brain imaging, postmortem, neuropsychological, and preclinical studies, which suggested hippocampal abnormalities in BD. Most of the structural brain imaging studies did not find changes in hippocampal volume in BD, although a few studies suggested that anatomical changes might be restricted to the psychotic, pediatric, or unmedicated BD subgroups. Functional imaging studies showed abnormal brain activation in the hippocampus and its closely related regions during emotional, attentional, and memory tasks. This is consistent with neuropsychological findings that revealed a wide range of cognitive disturbances during acute mood episodes and a significant impairment in declarative memory during remission. Postmortem studies indicate abnormal glutamate and GABA transmission in the hippocampus of BD patients, whereas data from preclinical studies suggest that the regulation of hippocampal plasticity and survival might be associated with the therapeutic effects of mood stabilizers. In conclusion, the available evidence suggests that the hippocampus plays an important role in the pathophysiology of BD. C1 McGill Univ, Montreal Neurol Inst, McConnell Brain Imaging Ctr, Montreal, PQ H3A 2B4, Canada. Hosp Clin Porto Alegre, Bipolar Disorders Program, Porto Alegre, RS, Brazil. Hosp Clin Porto Alegre, Lab Mol Psychiat, Porto Alegre, RS, Brazil. Univ Fed Rio Grande do Sul, ICBS, Dept Biochem, BR-90046900 Porto Alegre, RS, Brazil. Univ Sao Paulo, Sch Med, Inst Psychiat, Dept Psychiat, Sao Paulo, Brazil. Univ Extremo Sul Catarinense, Program Posgrad Ciencias Saude, Neurosci Lab, Santa Catarina, Brazil. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Psychiat Serv, Audie L Murphy Div, San Antonio, TX USA. Univ N Carolina, Sch Med, Dept Psychiat, Chapel Hill, NC USA. RP Frey, BN (reprint author), McGill Univ, Montreal Neurol Inst, McConnell Brain Imaging Ctr, 3801 Univ St, Montreal, PQ H3A 2B4, Canada. EM benicio.frey@gmail.com RI Andreazza, Ana/B-7485-2008; Kapczinski, Flavio/D-3175-2013; Kapczinski, Flavio/J-5803-2014; Quevedo, Joao/E-5491-2013 OI Quevedo, Joao/0000-0003-3114-6611 NR 143 TC 85 Z9 87 U1 4 U2 11 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0955-8810 J9 BEHAV PHARMACOL JI Behav. Pharmacol. PD SEP PY 2007 VL 18 IS 5-6 BP 419 EP 430 DI 10.1097/FBP.0b013e3282df3cde PG 12 WC Behavioral Sciences; Neurosciences; Pharmacology & Pharmacy SC Behavioral Sciences; Neurosciences & Neurology; Pharmacology & Pharmacy GA 203FK UT WOS:000248960300008 PM 17762510 ER PT J AU Baron, F Sandmaier, BM Storer, BE Maris, MB Langston, AA Lange, T Petersdorf, E Bethge, W Maziarz, RT McSweeney, PA Pulsipher, MA Wade, FC Chauncey, TR Sbizuru, FA Sorror, ML Woolfrey, AE Maloney, DG Storb, R AF Baron, Frederic Sandmaier, Brenda M. Storer, Barry E. Maris, Michael B. Langston, Amelia A. Lange, Thoralf Petersdorf, Effie Bethge, Wolfgang Maziarz, Richard T. McSweeney, Peter A. Pulsipher, Michael A. Wade, Fames C. Chauncey, Thomas R. Sbizuru, Fudith A. Sorror, Mohamed L. Woolfrey, Ann E. Maloney, David G. Storb, Rainer TI Extended mycophenolate mofetil and shortened cyclosporine failed to reduce graft-versus-host disease after unrelated hematopoietic cell transplantation with nonmyeloablative conditioning SO BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION LA English DT Article DE unrelated hematopoietic cell transplantation; mycophenolate mofetil; cyclosporine; graft-versus-host disease ID BONE-MARROW-TRANSPLANTATION; TOTAL-BODY IRRADIATION; HEMATOLOGIC MALIGNANCIES; MYELOID-LEUKEMIA; T-CELLS; ENGRAFTMENT; CHIMERISM; OUTCOMES; THERAPY; RISK AB We previously reported data from 103 patients with hematologic malignancies (median age 54 years) who received peripheral blood stem cell (PBSC) grafts from HLA-matched unrelated donors after nonmycloablative conditioning and were given postgrafting immunosuppression consisting of mycophenolate mofetil (MMF; administered from day 0 until day + 40 with taper through day + 96) and cyclosporine (CSP; given from day -3 to day + 100, with taper through day 180) (historical patients). The incidences of grade II-IV acute and extensive chronic graft-versus-host disease (aGVHD, cGVHD) were 52% and 49%, respectively, and the 1-year probabilities of relapse, nonrelapse mortality (NRM), and progression-free survival (PFS) were 26%, 18%, and 56%, respectively. Here, we treated 71 patients with hematologic malignancies (median age 56 years) with unrelated PBSC grafts and investigated whether postgrafting immunosuppression with an extended course of NMF, given at full dosing until day + 150 and then tapered through day + 180, and a shortened course of CSP, through day + 80, would promote tolerance induction and reduce the incidence of GVHD (current patients). We observed 77% grade ll-1V aGVHD and 45% extensive cGVHD (P =.03, and P =.43, respectively, in current compared to historical patients). The 1-year probabilities of relapse, NRM, and PFS were 23%, 29%, and 47%, respectively (P =.89, P =.02, and P =.08 compared to the historical patients). We conclude that postgrafting immunosuppression with extended MMF and shortened CSP failed to decrease the incidence of GVHD among unrelated PBSC recipients given nonmyeloablative conditioning. (c) 2007 American Society for Blood and Marrow Transplantation C1 Fred Hutchinson Canc Res Ctr, Seattle, WA 98109 USA. Univ Liege, B-4000 Liege, Belgium. Univ Washington, Sch Med, Seattle, WA 98195 USA. Rocky Mt Blood & Marrow Transplant Program, Denver, CO USA. Emory Univ, Atlanta, GA 30322 USA. Univ Leipzig, D-7010 Leipzig, Germany. Univ Tubingen, D-72074 Tubingen, Germany. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. Univ Utah, Salt Lake City, UT 84112 USA. Med Coll Wisconsin, Milwaukee, WI 53226 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Stanford Univ, Stanford, CA 94305 USA. RP Storb, R (reprint author), Fred Hutchinson Canc Res Ctr, 1100 Fairview Ave N,D1-100,PO Box 19024, Seattle, WA 98109 USA. EM rstorb@fhcrc.org FU NCI NIH HHS [P30 CA015704-33, P30 CA015704-29, P01 CA049605-16, P30 CA015704-26, K23 CA092058-04, P30 CA015704-34, P01 CA078902, P01 CA018029-29, P30 CA015704-27, P30 CA015704, CA92058, P01 CA049605-18, P01 CA018029, CA78902, P01 CA018029-32, P01 CA018029-25, CA15704, P01 CA018029-27, CA49605, P01 CA049605-17, P30 CA015704-31, P01 CA049605-14, P01 CA018029-26, P01 CA018029-28, K23 CA092058-01, P01 CA018029-24, P01 CA049605-19, K23 CA092058-02, P01 CA078902-09, CA18029, P01 CA049605-13, P01 CA018029-30, P01 CA049605, P01 CA049605-15, K23 CA092058-05, K23 CA092058-03, P30 CA015704-32, P30 CA015704-30, P01 CA018029-31, K23 CA092058, P30 CA015704-28]; NHLBI NIH HHS [R00 HL088021, P01 HL036444-27, K99 HL088021, HL088021, K99 HL088021-01, P01 HL036444, HL36444] NR 38 TC 17 Z9 17 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1083-8791 J9 BIOL BLOOD MARROW TR JI Biol. Blood Marrow Transplant. PD SEP PY 2007 VL 13 IS 9 BP 1041 EP 1048 DI 10.1016/j.bbmt.2007.05.011 PG 8 WC Hematology; Immunology; Transplantation SC Hematology; Immunology; Transplantation GA 205YX UT WOS:000249152200006 PM 17697966 ER PT J AU Kelly, MAR Sereika, SM Battista, DR Brown, C AF Kelly, Morgen A. R. Sereika, Susan M. Battista, Deena R. Brown, Charlotte TI The relationship between beliefs about depression and coping strategies: Gender differences SO BRITISH JOURNAL OF CLINICAL PSYCHOLOGY LA English DT Article; Proceedings Paper CT 39th Annual Meeting of the Association-for-the-Advancement-of Behavior-Therapy CY NOV, 2005 CL Washington, DC SP Assoc Advancement Behav Therapy ID ILLNESS PERCEPTIONS; COGNITIVE REPRESENTATION; PERSONAL MODELS; PRIMARY-CARE; QUESTIONNAIRE; SYMPTOMS; MOOD; RUMINATION; DISORDERS; INVENTORY AB Objective. Leventhal's common-sense model of illness representation provides a conceptual framework for exploring the relationship between beliefs about depressive illness and use of coping strategies. We explored this relationship among depressed patients both across genders and in terms of gender differences. Design. Depressed primary care patients prescribed antidepressants provided self-report measures of beliefs about depression, emotional reaction to depression, beliefs about medications and coping strategies used. Baseline data from a longitudinal study is presented. Method. Primary data analyses were conducted using canonical correlation analysis, a multivariate statistical method akin to principal component and regression analyses. It allows for parsimonious description of the association between two multivariate sets of variables (in this case, beliefs about depression and coping strategies) by identifying pairs of linear combinations that account for the majority of the between association from the two sets of variables. Results. The sample consisted of 189 depressed primary care patients (70.4% female). Results indicated that emotional reaction to depression is a major factor in determining coping strategies. Greater emotional reaction to depression was associated with maladaptive coping for men and women, while women showed additional relationships between greater perceived control over depression and more adaptive coping techniques as well as between perception of consequences of depression and problem solving. Conclusions. The present research provides preliminary evidence that beliefs about depression are related to coping styles. Further, men and women may differ in the way in which their perceptions about depression influence coping styles adopted. C1 Univ Pittsburgh, Med Ctr, Pittsburgh, PA 15213 USA. SUNY Buffalo, Buffalo, NY 14260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Kelly, MAR (reprint author), Univ Pittsburgh, Med Ctr, 3811 Ohara St, Pittsburgh, PA 15213 USA. EM kellym2@upmc.edu FU NIMH NIH HHS [R01 MH60763] NR 46 TC 12 Z9 12 U1 1 U2 18 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0144-6657 J9 BRIT J CLIN PSYCHOL JI Br. J. Clin. Psychol. PD SEP PY 2007 VL 46 BP 315 EP 332 DI 10.1348/014466506X173070 PN 3 PG 18 WC Psychology, Clinical SC Psychology GA 201AO UT WOS:000248804100005 PM 17535525 ER PT J AU Montgomery, RB Nelson, PS Lin, D Ryan, CW Garzotto, M Beer, TM AF Montgomery, R. Bruce Nelson, Peter S. Lin, Daniel Ryan, Christopher W. Garzotto, Mark Beer, Tomasz M. TI Diethylstilbestrol and docetaxel - A phase II study of tubulin active agents in patients with metastatic, androgen-independent prostate cancer SO CANCER LA English DT Article DE docetaxel; diethylstilbestrol; chemotherapy; hormone-refractory prostate cancer; estrogen ID MITOXANTRONE PLUS PREDNISONE; TRANSDERMAL ESTRADIOL; ESTRAMUSTINE PHOSPHATE; ESTROGEN; CELLS; CARCINOMA; INHIBITION; THERAPY; INVITRO; TRIAL AB BACKGROUND. The addition of diethylstilbestrol to docetaxel modified tubulin composition and improved the response of prostate cancer to chemotherapy in preclinical models. An attempt was made to recapitulate the observations in a clinical trial. METHODS. Twenty-nine patients with progressive, metastatic, chemotherapy-naive androgen-independent prostate cancer were treated with diethylstilbestrol 1 mg daily and 5 mg on the day before docetaxel and docetaxel 36 mg/m(2) intravenously weekly for 3 weeks of a 4-week cycle. Prophylactic anticoagulation was used in all patients. Patients were assessed by prostate-specific antigen (PSA) monthly and computed tomography (CT) and bone scans every 3 cycles. The Response Evaluation Criteria in Solid Tumors (RECIST) criteria and PSA decline by > 50% maintained for 4 weeks were used to assess activity. RESULTS. The median age was 68 years (range, 56-84 years), Southwest Oncology Group performance status 0 (score range, 0-2), alkaline phosphatase 120 U/L (range, 49-523), hemoglobin (Hgb) 12.6 g/dL (range, 9.2-16.3), PSA 66 ng/dL (range, 4-1962). The median number of cycles administered was 6. Soft tissue metastases were present in 51% of patients and bone metastases in 93%. Twentynine patients are evaluable for response. Of these, 20 patients (69%, 95% confidence interval [CI], 49%-85%) had a PSA decline of >50% and the PSA declined by > 90% in 12 patients (41%, 95% Cl, 23.1%-58.9%). Of 15 patients with measurable disease, 6 (40%, 95% CI, 23.5%-61%) had a partial response. Median time to progression was 6 months (range, 3-19 months). Fifteen patients (51%) suffered grade 3/4 toxicity. Two patients died of causes unrelated to therapy and another died from a steroid-induced ulcer. Six patients developed thrombosis and of those tested 75% had Factor V mutations. Pretreatment PSA, performance status, Hgb, and alkaline phosphatase had no impact on the likelihood of response. CONCLUSIONS. The combination of diethylstilbestrol and docetaxel produces a significant level of activity, measured by PSA decline and measurable disease response rate, and except for venous thrombosis the toxicity appears similar to that seen with docetaxel plus prednisone. These results suggest that tubulin modulation with diethylstilbestrol may improve the therapeutic efficacy of docetaxel and the combination is worthy of further study. Cancer 2007;110:996-1002. (c) 2007 American Cancer Socieity. C1 VA Puget Sound HCSm, Dept Med, Seattle, WA 98108 USA. Univ Washington, Sch Med, Seattle, WA USA. Seattle Canc Care Alliance, Dept Med Oncol, Seattle, WA USA. VAPSHCS, Dept Urol, Seattle, WA USA. Portland VA Med Ctr, Dept Urol, Portland, OR USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. RP Montgomery, RB (reprint author), VA Puget Sound HCSm, Dept Med, 1660 S Columbian Way 111ONC, Seattle, WA 98108 USA. EM rbmontgo@u.washington.edu FU NCI NIH HHS [CA97186] NR 36 TC 13 Z9 17 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER JI Cancer PD SEP 1 PY 2007 VL 110 IS 5 BP 996 EP 1002 DI 10.1002/cncr.22917 PG 7 WC Oncology SC Oncology GA 206NV UT WOS:000249191100009 PM 17639587 ER PT J AU Lanza, E Yu, BB Murphy, G Albert, PS Caan, B Marshall, JR Lance, P Paskett, ED Weissfeld, J Slattery, M Burt, R Iber, F Shike, M Kikendall, JW Brewer, BK Schatzkin, A AF Lanza, Elaine Yu, Binbing Murphy, Gwen Albert, Paul S. Caan, Bette Marshall, James R. Lance, Peter Paskett, Electra D. Weissfeld, Joel Slattery, Marty Burt, Randall Iber, Frank Shike, Moshe Kikendall, James W. Brewer, Brenda K. Schatzkin, Arthur CA Polyp Prevention Trial Study Grp TI The polyp prevention trial-continued follow-up study: No effect of a low-fat, high-fiber, high-fruit, and -vegetable diet on adenoma recurrence eight years after randomization SO CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION LA English DT Article ID SURROGATE END-POINTS; COLORECTAL-CANCER; CARCINOMA SEQUENCE; LIFE-STYLE; RISK; TUMORIGENESIS; QUESTIONNAIRE; INTERVENTION; POLYPECTOMY; NUTRITION AB The Polyp Prevention Trial (PPT) was a multicenter randomized clinical trial to evaluate the effects of a high-fiber (18 g/1,000 kcal), high-fruit and -vegetable (3.5 servings/1,000 kcal), and low-fat (20% of total energy) diet on the recurrence of adenomatous polyps in the large bowel over a period of 4 years. Although intervention participants reported a significantly reduced intake of dietary fat, and increased fiber, fruit, and vegetable intakes, their risk of recurrent adenomas was not significantly different from that of the controls. Since the PPT intervention lasted only 4 years, it is possible that participants need to be followed for a longer period of time before treatment differences in adenoma recurrence emerge, particularly if diet affects early events in the neoplastic process. The PPT Continued Follow-up Study (PPT-CFS) was a post-intervention observation of PPT participants for an additional 4 years from the completion of the trial. Of the 1,905 PPT participants, 1,192 consented to participate in the PPT-CFS and confirmed colonoscopy reports were obtained on 801 participants. The mean time between the main trial end point colonoscopy and the first colonoscopy in the PPT-CFS was 3.94 years (intervention group) and 3.87 years (control group). The baseline characteristics of 405 intervention participants and 396 control participants in the PPT-CFS were quite similar. Even though the intervention group participants increased their fat intake and decreased their intakes of fiber, fruits, and vegetables during the PPT-CFS, they did not go back to their prerandomization baseline diet (P < 0.001 from paired t tests) and intake for each of the three dietary goals was still significantly different from that in the controls during the PPT-CFS (P < 0.001 from t tests). As the CFS participants are a subset of the people in the PPT study, the nonparticipants might not be missing completely at random. Therefore, a multiple imputation method was used to adjust for potential selection bias. The relative risk (95% confidence intervals) of recurrent adenoma in the intervention group compared with the control group was 0.98 (0.88-1.09). There were no significant intervention-control group differences in the relative risk for recurrence of an advanced adenoma (1.06; 0.81-1.39) or multiple adenomas (0.92; 0.77-1.10). We also used a multiple imputation method to examine the cumulative recurrence of adenomas through the end of the PPT-CFS: the intervention-control relative risk (95% confidence intervals) for any adenoma recurrence was 1.04 (0.98-1.09). This study failed to show any effect of a low-fat, high-fiber, high-fruit and -vegetable eating pattern on adenoma recurrence even with 8 years of follow-up. C1 NCI, Ctr Canc Res, Lab Can Prevent, Bethesda, MD 20892 USA. Informat Management Serv Inc, Rockville, MD USA. NCI, Canc Prevent Fellowship Program, Div Canc Prevent, Bethesda, MD 20892 USA. Kaiser Fdn Res Inst, Oakland, CA USA. Roswell Pk Canc Inst, Buffalo, NY 14263 USA. Univ Arizona, Arizona Canc Ctr, Tucson, AZ USA. Ohio State Univ, Ctr Comprehens Canc, Columbus, OH 43210 USA. Univ Pittsburgh, Pittsburgh, PA USA. Univ Utah, Salt Lake City, UT USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Vet Affairs Med Ctr, Hines, IL 60141 USA. Mem Sloan Kettering Canc Ctr, New York, NY 10021 USA. Westat Corp, Rockville, MD 20850 USA. Walter Reed Army Med Ctr, Washington, DC 20307 USA. RP Murphy, G (reprint author), NCI, Ctr Canc Res, Lab Can Prevent, 6116 Execut Blvd,Room 7206, Bethesda, MD 20892 USA. EM murphygw@mail.nih.gov RI Murphy, Gwen/G-7443-2015 NR 40 TC 48 Z9 49 U1 5 U2 12 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1055-9965 J9 CANCER EPIDEM BIOMAR JI Cancer Epidemiol. Biomarkers Prev. PD SEP PY 2007 VL 16 IS 9 BP 1745 EP 1752 DI 10.1158/1055-9965.EPI-07-0127 PG 8 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 213CN UT WOS:000249643600009 PM 17855692 ER PT J AU Campbell, KL McTiernan, A Li, SSY Sorensen, BE Yasui, Y Lampe, JW King, IB Ulrich, CM Rudolph, RE Irwin, ML Surawicz, C Ayub, K Potter, JD Lampe, PD AF Campbell, Kristin L. McTiernan, Anne Li, Shuying S. Sorensen, Bess E. Yasui, Yutaka Lampe, Johanna W. King, Irena B. Ulrich, Cornelia M. Rudolph, Rebecca E. Irwin, Melinda L. Surawicz, Christina Ayub, Kamran Potter, John D. Lampe, Paul D. TI Effect of a 12-month exercise intervention on the apoptotic regulating proteins Bax and Bcl-2 in colon crypts: a randomized controlled trial SO CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION LA English DT Article ID PHYSICAL-ACTIVITY; COLORECTAL-CANCER; POSTMENOPAUSAL WOMEN; UNITED-STATES; CARCINOGENESIS; ADENOMAS; RISK; RATS; ONCOPROTEIN; PROGRESSION AB Background: Cellular proliferation and apoptosis (cell death) are highly regulated in the colon as insufficient apoptosis may lead to polyps and cancer. Physical activity decreases risk of colon cancer in observational studies, but the biological basis is not well defined. The objective of this study is to examine the effects of a 12-month aerobic exercise program on expression of proteins that promote (Bax) or inhibit (Bcl-2) apoptosis in colon crypts. Methods: Two hundred two sedentary participants, 40 to 75 years, were randomly assigned to moderate-to-vigorous intensity exercise for 60 min per day, 6 days per week for 12 months, or usual lifestyle. Colon crypt samples were obtained at baseline and 12 months. Bcl-2 and Bax expression was measured by immunohistochemistry. Results: Bax density at the bottom of crypts increased in male exercisers versus controls (+0.87 versus -0.18; P = 0.05), whereas the ratio of Bcl-2 to Bax at the bottom and middle of crypts decreased as aerobic fitness (VO(2)max) increased (P trend = 0.02 and 0.05, respectively). In female exercisers, Bax density in the middle of crypts decreased (-0.36 versus +0.69; P = 0.03) and Bcl-2 to Bax ratio at the top of crypts increased versus controls (+0.46 versus -0.85; P = 0.03). Bax density in the middle of crypts also decreased as minutes per week of exercise increased (P trend = 0.03). Conclusions: A 12-month exercise intervention resulted in greater expression of proteins that promote apoptosis at the bottom of colon crypts in men and decreased expression of proteins that promote apoptosis at the middle and top of colon crypts in women. The difference in effect by gender and location of observed changes warrants further study. C1 Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Canc Prevent Program, Seattle, WA 98109 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Pathobiol, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res, Seattle, WA 98108 USA. Vet Affairs Puget Sound Hlth Care Syst, Dev Program, Seattle, WA 98108 USA. Virginia Mason Med Ctr, Seattle, WA 98101 USA. Univ Alberta, Dept Publ Hlth Sci, Edmonton, AB, Canada. Yale Univ, Sch Med, Dept Publ Hlth, New Haven, CT 06510 USA. RP McTiernan, A (reprint author), Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Canc Prevent Program, 100 Fairview Ave N,M4-B402, Seattle, WA 98109 USA. EM amctiern@fhcrc.org RI Yasui, Yutaka/E-2564-2015 OI Yasui, Yutaka/0000-0002-7717-8638; Potter, John/0000-0001-5439-1500 FU NCI NIH HHS [R01 CA 77572-01] NR 37 TC 21 Z9 23 U1 0 U2 1 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1055-9965 J9 CANCER EPIDEM BIOMAR JI Cancer Epidemiol. Biomarkers Prev. PD SEP PY 2007 VL 16 IS 9 BP 1767 EP 1774 DI 10.1158/1055-9965.EPI-07-0291 PG 8 WC Oncology; Public, Environmental & Occupational Health SC Oncology; Public, Environmental & Occupational Health GA 213CN UT WOS:000249643600012 PM 17855695 ER PT J AU Jett, JR Schild, SE Keith, RL Kesler, KA AF Jett, Janws R. Schild, Steven E. Keith, Robert L. Kesler, Kenneth A. TI Treatment of non-small cell lung cancer, stage IIIB - ACCP evidence-based clinical practice guidelines (2nd edition) SO CHEST LA English DT Article DE chemoradiotherapy; hyperfractionated radiotherapy; radiotherapy; treatment stage IIIB ID SUPERIOR VENA-CAVA; PALLIATIVE RADIOTHERAPY; PHASE-III; RANDOMIZED-TRIAL; 2 FRACTIONS; SEQUENTIAL CHEMORADIOTHERAPY; ACCELERATED RADIOTHERAPY; BRONCHOGENIC-CARCINOMA; THORACIC RADIOTHERAPY; PROGNOSTIC-FACTORS AB Objective: To develop evidence-based guidelines on best available treatment options for patients with stage IIIB non-small cell lung cancer (NSCLC). Methods: A review was conducted of published English-language (abstract or full text) phase H or phase III trials and guidelines from other organizations that address management of the various categories of stage IIIB disease. The literature search was provided by the Duke University Center for Clinical Health Policy Research and supplemented by any additional studies known by the authors. Results: Surgery may be indicated for carefully selected patients with T4N0-1M0. Patients with N3 nodal involvement are not considered to be surgical candidates. For individuals with unresectable disease, good performance score, and minimal weight loss, treatment with combined chemoradiotherapy results in better survival than radiotherapy (RT) alone. Concurrent chemoradiotherapy seems to be associated with improved survival compared with sequential chemoradiotherapy. Multiple daily fractions of RT when combined with chemotherapy have not been shown to result in improved survival compared with standard once-daily RT combined with chemotherapy. The optimal chemotherapy agents and the number of cycles of treatment to combine with RT are uncertain. Conclusion: Prospective trials are needed to answer important questions, such as the role of induction therapy in patients with potentially resectable stage IIIB disease. Future trials are needed to answer the questions of optimal chemotherapy agents and radiation fractionation schedule. The role of targeted novel agents in combination with chemoradiotherapy is just starting to be investigated. C1 Mayo Clin, Div Pulm Med & Med Oncol, Rochester, MN 55905 USA. Mayo Clin, Dept Radiat Oncol, Scottsdale, AZ USA. Univ Colorado, Hlth Sci Ctr, Denver VA Med Ctr, Div Pulm Sci & Crit Care Med, Denver, CO 80202 USA. Indiana Univ, Sch Med, Div Thorac Surg, Indianapolis, IN 46204 USA. RP Jett, JR (reprint author), Mayo Clin, Div Pulm Med & Med Oncol, 200 1st St SW, Rochester, MN 55905 USA. EM JETT.JAMES@mayo.edu OI schild, steven/0000-0002-2850-4126 NR 52 TC 78 Z9 79 U1 0 U2 4 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD SEP PY 2007 VL 132 IS 3 SU S BP 266S EP 276S DI 10.1378/chest.07-1380 PG 11 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 216OZ UT WOS:000249889400018 PM 17873173 ER PT J AU Shapiro, S Hill, NS AF Shapiro, Shelley Hill, Nicholas S. TI Transition from IV to subcutaneous prostacyclin: Premature withdrawal? SO CHEST LA English DT Editorial Material ID PULMONARY-ARTERIAL-HYPERTENSION; TREPROSTINIL; EPOPROSTENOL; BOSENTAN; INFUSION C1 Univ Calif Los Angeles, Sch Med, Greater Los Angeles VA Med Ctr, Los Angeles, CA 90073 USA. RP Shapiro, S (reprint author), Univ Calif Los Angeles, Sch Med, Greater Los Angeles VA Med Ctr, 11301 Wilshire Blvd,Cardiol Sect 111e, Los Angeles, CA 90073 USA. EM Shelley.Shapiro@va.gov NR 7 TC 6 Z9 6 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD SEP PY 2007 VL 132 IS 3 BP 741 EP 743 DI 10.1378/chest.07-1992 PG 3 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 214MN UT WOS:000249742100002 PM 17873184 ER PT J AU Chang, V McCurdy, D Gordon, LK AF Chang, Vicky McCurdy, Deborah Gordon, Lynn K. TI Etanercept associated optic neuropathy SO CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY LA English DT Letter DE adalimumab; etanercept; infliximab; optic neuritis; optic neuropathy ID NEURITIS; INFLIXIMAB; ARTHRITIS; THERAPY AB We report the case of a 14-year-old boy who developed optic neuropathy subsequent to the use of etanercept. There have been 15 reported cases of anti-TNF-alpha-associated optic neuropathy to date and their characteristics are reviewed in this report, as well as possible pathophysiologic mechanisms behind such phenomenon. Such cases demonstrate the importance of prompt ophthalmologic evaluation of visual changes in patients being treated with anti-TNF-alpha antagonists. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Div Rheumatol Allergy & Immunol, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Ophthalmol, Los Angeles, CA USA. Greater Los Angeles VA Healthcare Syst, Sect Ophthalmol, Los Angeles, CA USA. RP Chang, V (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA 90024 USA. NR 12 TC 7 Z9 7 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1442-6404 J9 CLIN EXP OPHTHALMOL JI Clin. Exp. Ophthalmol. PD SEP-OCT PY 2007 VL 35 IS 7 BP 680 EP 682 DI 10.1111/j.1442-9071.2007.01541.x PG 3 WC Ophthalmology SC Ophthalmology GA 213XJ UT WOS:000249700300019 PM 17894694 ER PT J AU Reddy, RD Keshavan, MS Yao, JK AF Reddy, Ravinder D. Keshavan, Matcherl S. Yao, JeffTey K. TI Reduced platelet serotonergic responsivity as assessed by dense granule secretion in first-episode psychosis SO CLINICAL BIOCHEMISTRY LA English DT Article DE platelets; dense granule secretion; serotonin; schizophrenia; mood disorder ID SCHIZOPHRENIA; ACTIVATION AB Objectives: To determine whether blunted serotonergic responsivity, indicated by decreased platelet dense granule secretion (DGS), occurs in neuroleptic-naive patients with schizophrenia, as observed previously in chronic schizophrenia. Design and methods: Serotonin (5-HT)-amplified DGS was examined in 40 first-episode neuroleptic-naive patients (24 with schizophrenia and 16 with mood disorders) and 24 healthy subjects. Results: Healthy controls showed robustly increased DGS. Schizophrenic patients showed very modest DGS increases; mood disorder patients showed inten-nediate response. Conclusions: Blunted DGS appears to a characteristic of schizophrenia that is observed in the treatment-naive condition. (C) 2007 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved. C1 Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15213 USA. VA Pittsburgh Hlthcare Syst, Pittsburgh, PA 15206 USA. Wayne State Univ, Detroit, MI 48201 USA. Univ Pittsburgh, Sch Med, Dept Pharm, Pittsburgh, PA 15213 USA. RP Reddy, RD (reprint author), Univ Pittsburgh, Sch Med, Western Psychiat Inst & Clin, Dept Psychiat, 3811 OHara St, Pittsburgh, PA 15213 USA. EM reddyr@upme.edu FU NCATS NIH HHS [UL1 TR000005]; NCRR NIH HHS [M01 RR00056, M01 RR000056]; NIMH NIH HHS [K08 MH064118-03, R01 MH058141-04, R01 MH058141-01A2, R01 MH058141-05, MH-45203, R01 MH060902-01A2, MH45156, MH-58141, R01 MH058141-03, K08 MH064118-02, K08 MH064118-01A1, K08 MH064118-04, R01 MH060902-05, K08 MH064118-05, R01 MH060902-03, R01 MH060902-04, R01 MH060902, R01 MH058141, R01 MH058141-02, P50 MH045156, R01 MH060902-02, MH-46118] NR 10 TC 1 Z9 2 U1 1 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0009-9120 J9 CLIN BIOCHEM JI Clin. Biochem. PD SEP PY 2007 VL 40 IS 13-14 BP 1081 EP 1083 DI 10.1016/j.clinbiochem.2007.04.019 PG 3 WC Medical Laboratory Technology SC Medical Laboratory Technology GA 209XV UT WOS:000249422200027 PM 17601524 ER PT J AU Weisbord, SD Fried, LF Mor, MK Resnick, AL Unruh, ML Palevsky, PM Levenson, DJ Cooksey, SH Fine, MJ Kimmel, PL Arnold, RM AF Weisbord, Steven D. Fried, Linda F. Mor, Maria K. Resnick, Abby L. Unruh, Mark L. Palevsky, Paul M. Levenson, David J. Cooksey, Stephen H. Fine, Michael J. Kimmel, Paul L. Arnold, Robert M. TI Renal provider recognition of symptoms in patients on maintenance hemodialysis SO CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID QUALITY-OF-LIFE; SPIRITUAL BELIEFS; MINI-COG; DISEASE; DIALYSIS; PAIN; DEPRESSION; SEVERITY; PREVALENCE; SAMPLE AB Background and Objectives: Although several studies have found that the burden of symptoms in patients who are on maintenance hemodialysis is substantial, little is known about renal providers' awareness of these symptoms. The aim of this study was to assess renal provider recognition of symptoms and their severity, in hemodialysis patients. Design, Setting, Participants, & Measurements: The Dialysis Symptom Index, a 30-item measure of symptoms and their severity was administered to patients during a routine hemodialysis session. Immediately after surveying patients, the renal provider who evaluated the patient completed the Dialysis Symptom Index to report the symptoms that he or she believed were present in that patient. Sensitivity, specificity, and positive and negative predictive values of provider reports of symptoms were calculated using patient reports as the reference standard. Patient-provider agreement on the presence and severity of symptoms was assessed using the K statistic. Results: Surveys were completed by 75 patients and 18 providers. For 27 of 30 symptoms, the sensitivity of provider responses was < 50%, and provider responses for 25 symptoms were characterized by positive predictive values of < 75%. K scores for 25 symptoms including those pertaining to pain, sexual dysfunction, sleep disturbance, and psychologic distress were < 0.20, indicating poor provider recognition of these symptoms. Providers underestimated the severity of 19 of 30 symptoms. Conclusions: Renal providers are largely unaware of the presence and severity of symptoms in patients who are on maintenance hemodialysis. Implementation of a standardized symptom assessment process may improve provider recognition of symptoms and promote use of symptom-alleviating treatments. C1 VA Pittsburgh Healthcare Syst, Med Special Serv Line, Renal Sect, Pittsburgh, PA 15240 USA. VA Pittsburgh Healthcare Syst, Med Special Serv Line, Ctr Hlth Equity Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Renal Electrolyte Div, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Div Gen Internal Med, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA. George Washington Univ, Med Ctr, Dept Med, Div Renal Dis & Hypertens, Washington, DC 20037 USA. RP Weisbord, SD (reprint author), VA Pittsburgh Healthcare Syst, Med Special Serv Line, Renal Sect, Mailstop 111F-U,7E Room 120, Pittsburgh, PA 15240 USA. EM weisbordsd@upmc.edu FU NCATS NIH HHS [UL1 TR000005]; NIAID NIH HHS [K24 AI001769] NR 34 TC 74 Z9 77 U1 1 U2 2 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1555-905X J9 CLIN J AM SOC NEPHRO JI Clin. J. Am. Soc. Nephrol. PD SEP PY 2007 VL 2 IS 5 BP 960 EP 967 DI 10.2215/CJN.00990207 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 204JJ UT WOS:000249039500016 PM 17702730 ER PT J AU Renaud, B Coma, E Hayon, J Gurgui, M Longo, C Blancher, M Jouannic, I Betoulle, S Roupie, E Fine, MJ AF Renaud, B. Coma, E. Hayon, J. Gurgui, M. Longo, C. Blancher, M. Jouannic, I. Betoulle, S. Roupie, E. Fine, M. J. CA PNEUMOCOM Study Investigators TI Investigation of the ability of the Pneumonia Severity Index to accurately predict clinically relevant outcomes: a European study SO CLINICAL MICROBIOLOGY AND INFECTION LA English DT Article DE adverse outcomes; community-acquired pneumonia; mortality; Pneumonia Severity Index; prediction rules; validity ID COMMUNITY-ACQUIRED PNEUMONIA; LOW-RISK PATIENTS; CONTROLLED-TRIAL; CARE; MANAGEMENT; VALIDATION; GUIDELINES; DIAGNOSIS; RULE; HOSPITALIZATION AB In order to confirm the validity of the Pneumonia Severity Index (PSI) for patients in Europe, data from adults with pneumonia who were enrolled in two prospective multicentre studies, conducted in France (Pneumocom-1, n = 925) and Spain (Pneumocom-2, n = 853), were compared with data from the original North American study (Pneumonia PORT, n = 2287). The primary outcome was 28-day mortality; secondary outcomes were subsequent hospitalisation for outpatients, and intensive care unit admission and length of stay for inpatients. All outcomes within individual risk classes, and mortality rates in low-risk (PSI I-III) and higher-risk patients, were compared across the three cohorts. Overall mortality rates were 4.7% in Pneumonia PORT, 6.3% in Pneumocom-2 and 10.6% in Pneumocom-1 (p < 0.01), ranging from 0.4% to 1.6% (p 0.06) for low-risk patients and from 13.0% to 19.1% (p 0.24) for high-risk patients. Despite significant differences in baseline patient characteristics, none of the study outcomes differed within the low-risk classes. The sensitivity and negative predictive value of low-risk classification for mortality exceeded 93% and 98%, respectively. Thus, in two independent European cohorts, the PSI predicted patient outcomes accurately and reliably, particularly for low-risk patients. These findings confirm the validity of the PSI when applied to patients from Europe. C1 Hop Henri Mondor AP HP, Serv Accueil & Urgence, F-94000 Creteil, France. Ctr Hosp Univ Henri Mondor AP HP, Dept Emergency Med, Creteil, France. VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. Univ Pittsburgh, Dept Med, Div Gen Internal Med, Pittsburgh, PA USA. Hosp Mataro, Dept Emergency Med, Mataro, Spain. Ctr Hosp Intercommunal, Dept Emergency Med, St Germain En Laye, France. Hosp Santa Creu & Sant Pau, Dept Emergency Med, Barcelona, Spain. Ctr Hosp Reg Hotel Dieu, Dept Emergency Med, Nantes, France. Ctr Hosp Univ Grenoble, Dept Emergency Med, Rennes, France. Ctr Hosp Univ Rennes, Dept Emergency Med, Rennes, France. Ctr Hosp Gen Dangouleme, Dept Emergency Med, Angouleme, France. Ctr Hosp Univ Caen, Dept Emergency Med, Caen, France. RP Renaud, B (reprint author), Hop Henri Mondor AP HP, Serv Accueil & Urgence, 51 Ave Marechal Delattre Tassigny, F-94000 Creteil, France. EM bertrand.renaud@hmn.aphp.fr FU NIAID NIH HHS [K24 AI00149] NR 32 TC 21 Z9 21 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1198-743X J9 CLIN MICROBIOL INFEC JI Clin. Microbiol. Infect. PD SEP PY 2007 VL 13 IS 9 BP 923 EP 931 DI 10.1111/j.1469-0691.2007.01772.x PG 9 WC Infectious Diseases; Microbiology SC Infectious Diseases; Microbiology GA 197YW UT WOS:000248594300012 PM 17617186 ER PT J AU Berenji, GR Iker, E Glass, EC AF Berenji, Gholam R. Iker, Emily Glass, Edwin C. TI Lymphoscintigraphic findings in chylous reflux in a lower extremity SO CLINICAL NUCLEAR MEDICINE LA English DT Editorial Material DE lymphoscintigraphy; chylous reflux; swollen extremities ID NONINVASIVE EVALUATION; LYMPHEDEMA; DISORDERS; CHYLURIA C1 Med Imaging Ctr So Calif, Santa Monica, CA USA. Lymphedema Ctr Santa Monica, Santa Monica, CA USA. RP Glass, EC (reprint author), VA Greater Los Angeles Healthcare Syst, Nucl Med Serv 115, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM edwin.glass@va.gov NR 16 TC 7 Z9 8 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0363-9762 J9 CLIN NUCL MED JI Clin. Nucl. Med. PD SEP PY 2007 VL 32 IS 9 BP 725 EP 728 DI 10.1097/RLU.0b013e318123eddd PG 4 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 203EX UT WOS:000248959000013 PM 17710029 ER PT J AU Schiller, DS Fung, HB AF Schiller, Daryl S. Fung, Horatio B. TI Posaconazole: An extended-spectrum triazok antifungal agent SO CLINICAL THERAPEUTICS LA English DT Review DE posaconazole; invasive fungal infections; neutropenia; graft-vs-host disease; oropharyngeal candidiasis ID IN-VITRO ACTIVITIES; ANTIMICROBIAL SURVEILLANCE PROGRAM; BLOOD-STREAM INFECTIONS; SCH 56592 POSACONAZOLE; STEM-CELL TRANSPLANT; OF-THE-LITERATURE; AMPHOTERICIN-B; CRYPTOCOCCUS-NEOFORMANS; ASPERGILLUS-FUMIGATUS; INVASIVE ASPERGILLOSIS AB Background: The incidence of invasive fungal infections (IFIs) caused by opportunistic filamentous molds is increasing, along with emerging fungal resistance. Posaconazole, a structural analogue of itraconazole that was approved for marketing in the United States in 2006, appears to be a promising antifungal agent. Objective: This article provides an overview of the pharmacology, efficacy, and tolerability of posaconazole when used for the prophylaxis and treatment of various common and rare fungal infections. Methods: Relevant information was identified through a search of MEDLINE (1966-April 2007), International Pharmaceutical Abstracts (1970-April 2007), and abstracts of the Interscience Conference on Antimicrobial Agents and Chemotherapy using the terms posaconazole and SCH 56592. Additional resources were found by searching the reference lists of the identified articles and the US Food and Drug Administration Web site. Results: Posaconazole is available as an oral suspension. It is highly distributed to various sites, including bone, the central nervous system, and eye tissue. Its Vd is 2447 L when administered in multiple daily doses (up to 800 mg/d) in the presence of a highfat meal. Because it is excreted mostly as unchanged drug in the feces (77%), posaconazole can be administered to patients with poor renal function without any dose adjustment. Posaconazole has shown in vitro and in vivo activity against a wide variety of fungi, including those that are rare and relatively resistant. Two clinical trials have compared posaconazole with fluconazole or itraconazole for the prophylaxis of IFIs in immunocomprormsed patients. The first, a randomized, double-blind trial in 600 recipients of hematopoletic stem cell transplants, found that overall rates zole and fluconazole (5% vs 9%, respectively). The other, a randomized, open-label trial in 602 neutropenic patients, reported significantly fewer IFIs in patients receiving posaconazole compared with those receiving fluconazole or itraconazole (>2% vs >8%, respectively; P = 0.001). An additional 2 trials have investigated posaconazole for the treatment of oropharyngeal candidiasis (OPC) in patients with HIV infection. A randomized, controlled, evaluator-blinded study in 350 HIV-infected patients with OPC found similar 14-day clinical success rates with posaconazole and fluconazole (91.7% and 92.5%, respectively; 95% CI, -6.61 to 5.04), whereas an open-label study in 176 HIV-infected patients with a history of refractory OPC reported a 28-day clinical success rate of 75%. Numerous small studies and case reports have described successful posaconazole treatment of zygomycosis, aspergillosis, fusariosis, endemic dimorphic fungal infection, and superficial and subcutaneous fungal infections that were refractory to conventional antifungal agents or in patients who were unable to tolerate these agents. Posaconazole has been well tolerated. The most common complaints have been gastrointestinal in nature, including nausea (7%-8%) and diarrhea (3%-11%), although these have rarely led to permanent discontinuation of therapy. Other common adverse effects have included vomiting (4%-7%), headache (2%-8%), and liver enzyme elevations (2%-3%). Conclusions: Posaconazole suspension administered at up to 800 mg/d is a reasonable alternative to conventional antifungal agents for the prevention and treatment of IFIs in high-risk populations. It may also be suitable in patients with infections caused by rare or relatively resistant fungi, and those who are unable to tolerate long-term therapy with other antifungal agents. C1 James J Peters Vet Adm Med Ctr, Med Surg Patient Care Ctr, Bronx, NY 10468 USA. St Barnabas Hosp, Dept Pharm Serv, Livingston, NJ USA. RP Fung, HB (reprint author), James J Peters Vet Adm Med Ctr, Med Surg Patient Care Ctr, 130 W Kings Bridge Rd, Bronx, NY 10468 USA. EM horatio.fung@va.gov NR 140 TC 50 Z9 57 U1 1 U2 10 PU ELSEVIER PI BRIDGEWATER PA 685 ROUTE 202-206, BRIDGEWATER, NJ 08807 USA SN 0149-2918 J9 CLIN THER JI Clin. Ther. PD SEP PY 2007 VL 29 IS 9 BP 1862 EP 1886 DI 10.1016/j.clinthera.2007.09.015 PG 25 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 222GH UT WOS:000250283700005 PM 18035188 ER PT J AU Hendrickson, RG Spivak, L Horowitz, BZ AF Hendrickson, R. G. Spivak, L. Horowitz, B. Z. TI Clinical characteristics of methamphetamine body stuffers SO CLINICAL TOXICOLOGY LA English DT Meeting Abstract C1 Oregon Hlth & Sci Univ, Portland, OR 97201 USA. Oregon Poison Ctr, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 0731-3810 J9 CLIN TOXICOL JI Clin. Toxicol. PD SEP PY 2007 VL 45 IS 6 MA 22 BP 608 EP 609 PG 2 WC Toxicology SC Toxicology GA 214UE UT WOS:000249762900023 ER PT J AU Anzueto, A AF Anzueto, Antonio TI Disease modification in chronic obstructive pulmonary disease SO CLINICS IN CHEST MEDICINE LA English DT Article ID FLUTICASONE PROPIONATE; MAINTENANCE THERAPY; LUNG-FUNCTION; COPD PATIENTS; SALMETEROL; TIOTROPIUM; EFFICACY; HEALTH; LONG; REHABILITATION AB Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease in which patients experience a progressive decline in lung function, worsening exercise capacity, and frequent exacerbations. Based on clinical evidence, the progression of COPD could be modified by focus on earlier diagnosis; risk reduction through smoking cessation; symptom reduction with pharmacotherapy, improving health-related quality of life, and pulmonary rehabilitation; and decreasing complications by reducing exacerbations. Smoking cessation has been shown to slow lung function decline and reduce mortality, including deaths due to cardiovascular disease, lung cancer, and other respiratory disease (including COPD). C1 Audie L Murphy Mem Vet Adm Med Ctr, Pulm Dis Sect, S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. RP Anzueto, A (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, Pulm Dis Sect, S Texas Vet Hlth Care Syst, 7400 Merton Minter Blvd,111 E, San Antonio, TX 78229 USA. EM anzueto@uthscsa.edu NR 28 TC 1 Z9 2 U1 0 U2 0 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0272-5231 J9 CLIN CHEST MED JI Clin. Chest Med. PD SEP PY 2007 VL 28 IS 3 BP 609 EP + DI 10.1016/j.ccm.2007.05.001 PG 9 WC Respiratory System SC Respiratory System GA 214FB UT WOS:000249720300010 PM 17720047 ER PT J AU Klein, D O'Brien, CP AF Klein, Donald O'Brien, Charles P. TI Introduction SO CNS SPECTRUMS LA English DT Editorial Material C1 [Klein, Donald] Columbia Univ, New York, NY 10027 USA. [Klein, Donald] New York State Psychiat Inst & Hosp, New York, NY 10032 USA. [Klein, Donald] New York Presbyterian Hosp, New York, NY 10021 USA. [O'Brien, Charles P.] Univ Penn, Inst Neurol Sci, Philadelphia, PA 19104 USA. [O'Brien, Charles P.] Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Klein, D (reprint author), Columbia Univ, New York, NY 10027 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU M B L COMMUNICATIONS, INC PI NEW YORK PA 333 HUDSON ST, 7TH FLOOR, NEW YORK, NY 10013 USA SN 1092-8529 J9 CNS SPECTRUMS JI CNS Spectr. PD SEP PY 2007 VL 12 IS 9 SU 16 BP 2 EP 2 PG 1 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 256BP UT WOS:000252703000001 ER PT J AU Delgado-Escueta, AV AF Delgado-Escueta, Antonio V. TI Advances in Lafora progressive myoclonus epilepsy SO CURRENT NEUROLOGY AND NEUROSCIENCE REPORTS LA English DT Review ID CARBOHYDRATE-BINDING DOMAIN; POLYGLUCOSAN BODY DISEASE; PROTEIN PHOSPHATASE; GENE-PRODUCT; GLYCOGEN; MUTATIONS; FORM; INTERACTS; TARGETS; R5 AB Lafora progressive myoclonus epilepsy is an autosomal recessive, fatal, generalized polyglucosan storage disorder that occurs in childhood or adolescence with stimulus sensitive epilepsy (resting and action myoclonias, grand mal and absence), dementia, ataxia and rapid neurologic deterioration. Mutations in EPM2A/laforin cause 58% of cases and mutations in EPM2B/malin cause 35% of cases. Accumulating evidence points to Lafora disease as primarily a disorder of cell death with impaired clearance of misfolded proteins, as shown by ubiquitin-positive aggressomes in HeLa cells transfected with mutated laforin, ubiquitin-positive polyglucosan inclusion bodies, and malin/E3 ubiquitin ligase polyubiquitination of laforin. How polyglucosan inclusion bodies accumulate is still a mystery. Polyglucosan accumulates hypothetically because of an overactive polyglucosan biosynthetic pathway or a breakdown in polyglucosan degradation. Five separate laboratories are looking for the biochemical pathways that connect laforin and malin to polyglucosan synthesis or degradation. A curative therapy for human Lafora disease with laforin replacement therapy using neutral pegylated immunoliposomes is being investigated. C1 VA Greater Los Angeles Healthcare Syst, Epilepsy Genet Genom Labs, Comprehens Epilepsy Program, Los Angeles, CA 90073 USA. RP Delgado-Escueta, AV (reprint author), VA Greater Los Angeles Healthcare Syst, Epilepsy Genet Genom Labs, Comprehens Epilepsy Program, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM escueta@ucla.edu NR 37 TC 50 Z9 51 U1 0 U2 2 PU CURRENT SCIENCE INC PI PHILADELPHIA PA 400 MARKET STREET, STE 700, PHILADELPHIA, PA 19106 USA SN 1528-4042 J9 CURR NEUROL NEUROSCI JI Curr. Neurol. Neurosci. Rep. PD SEP PY 2007 VL 7 IS 5 BP 428 EP 433 DI 10.1007/s11910-007-0066-7 PG 6 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 279RH UT WOS:000254371800010 PM 17764634 ER PT J AU Xu, P Cuthbertson, D Greenbaum, C Palmer, JP Krischer, JP AF Xu, Ping Cuthbertson, David Greenbaum, Carla Palmer, Jerry P. Krischer, Jeffrey P. CA Diabetes Prevention Trial-Type 1 S TI Role of insulin resistance in predicting progression to type 1 diabetes SO DIABETES CARE LA English DT Article ID BETA-CELL FUNCTION; GLUCOSE-TOLERANCE TEST; RISK-FACTOR; SENSITIVITY; CHILDREN; AUTOANTIBODIES; IDDM AB OBJECTIVE - The purpose of this study was to determine whether insulin resistance is a risk factor for the development of type 1 diabetes in autoantibody-positive first-degree relatives of diabetic family members. RESEARCH DESIGN AND METHODS - Subjects (n = 186) who had a projected 25-50% risk for diabetes and subjects (n = 170) who had a projected > 50% risk for type 1 diabetes in 5 years were followed until clinical diabetes onset or the end of the study as part of the Diabetes Prevention Trial-Type 1. We assessed insulin secretion with the first-phase insulin response (FPIR) and insulin resistance with homeostasis model assessment of insulin resistance (HOMA-IR) from an intravenous glucose tolerance test. The median follow-up was 4.3 years for moderate-risk subjects and 3.7 years for high-risk subjects. RESULTS- During the follow-up period, 53 subjects in the moderate-risk group and 70 subjects in the high-risk group developed type 1 diabetes. After adjustments for confounders using multivariate analysis, HOMA-IR and the FPIR-to-HOMA-IR ratio were significantly associated with type 1 diabetes in both risk groups. in the moderate-risk population, the hazard ratio (HR) of HOMA-IR was 2.70 (95% CI 1.45-5.06) and the HR of FPIR-to-HOMA-IR was 0.32 (95% CI 0.18-0.57). in the high-risk population, the HR of HOMA-IR was 1.83 (95% CI 1.19-2.82) and the HR of FPIR-to-HOMA-IR was 0.56 (95% CI 0.40-0.78). CONCLUSIONS - There is clear evidence of the association between insulin resistance and progression to type 1 diabetes. The combination of FPIR and HOMA-IR could be used as a better metabolic indicator for type 1 diabetes risk for prediction and suggests possible intervention strategies for diabetes prevention. C1 Univ S Florida, Pediat Epidemiol Ctr, Div Informat & Biostat, Tampa, FL 33612 USA. Benaroya Res Inst Virginia Mason, Seattle, WA USA. Univ Washington, Vet Affairs Puget Sound, Seattle, WA 98195 USA. RP Krischer, JP (reprint author), Univ S Florida, Pediat Epidemiol Ctr, Div Informat & Biostat, 3650 Spectrum Blvd,Suite 100, Tampa, FL 33612 USA. EM jpkrischer@epi.usf.edu NR 24 TC 56 Z9 59 U1 0 U2 0 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD SEP PY 2007 VL 30 IS 9 BP 2314 EP 2320 DI 10.2337/dc06-2389 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 210IA UT WOS:000249448700030 PM 17536068 ER PT J AU Nadeau, KJ Ehlers, LB Aguirre, LE Reusch, JEB Draznin, B AF Nadeau, K. J. Ehlers, L. B. Aguirre, L. E. Reusch, J. E. B. Draznin, B. TI Discordance between intramuscular triglyceride and insulin sensitivity in skeletal muscle of Zucker diabetic rats after treatment with fenofibrate and rosiglitazone SO DIABETES OBESITY & METABOLISM LA English DT Article DE diabetes; insulin sensitivity; lipid metabolism; muscle lipid; PPAR ID PHOSPHATIDYLINOSITOL 3-KINASE ACTIVITY; ELEMENT-BINDING PROTEIN-1C; RECEPTOR-ALPHA ACTIVATORS; TRANSCRIPTION FACTORS; OXIDATIVE CAPACITY; HEPATIC STEATOSIS; GENE-EXPRESSION; FATTY RATS; EXERCISE; RESISTANCE AB Aim: Intramyocellular triglyceride (IMTG) correlates with insulin resistance, but there is no clear causal relationship. Insulin resistance and associated hyperinsulinaemia may increase IMTG, via the insulin-regulated transcription factor, sterol regulatory element-binding protein 1 (SREBP-1). PPAR agonists may also affect IMTG via changes in insulin sensitivity, SREBP-1 or other factors. Methods: We examined skeletal muscle IMTG and SREBP-1 expression, and metabolic parameters in Zucker diabetic fatty rats (ZDF) after 25 weeks of PPAR-g or PPAR-a administration. Results: Compared with Zucker lean rats (ZL), untreated ZDF had significantly higher weights, serum glucose, insulin, free fatty acids, total cholesterol and triglycerides. IMTG and SREBP-1c messenger RNA (mRNA) were also higher in untreated ZDF; both were decreased by fenofibrate (FF). Rosiglitazone (Rosi), despite marked improvement in glycaemia, hyperinsulinaemia and hyperlipidaemia, failed to affect SREBP-1 expression, and increased body weight and IMTG. Rosi/FF combination caused less weight gain and no IMTG increase, despite metabolic effects similar to Rosi alone. Conclusions: IMTG and SREBP-1c mRNA are high in the ZDF. FF and Rosi both improved insulin sensitivity but had opposite effects on IMTG. Thus, there was a clear discordance between insulin sensitivity and IMTG with PPAR agonists, indicating that IMTG and insulin sensitivity do not share a simple relationship. C1 Univ Colorado, Childrens Hosp, Hlth Sci Ctr, Dept Pediat,Div Pediat Endocrinol, Denver, CO 80218 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Div Endocrinol Diabet & Metab, Denver, CO 80218 USA. Denver VA Med Ctr, Vet Affairs Res Serv, Denver, CO 80218 USA. RP Nadeau, KJ (reprint author), Univ Colorado, Childrens Hosp, Hlth Sci Ctr, Dept Pediat,Div Pediat Endocrinol, Box 265,1056 E 19th Ave, Denver, CO 80218 USA. EM nadeaukj@hotmail.com OI Aguirre, Lina/0000-0003-0711-314X FU NCRR NIH HHS [1K23 RR020038-01]; NIDDK NIH HHS [5 P30 DK48520-10]; PHS HHS [R01-DIC06741, P0156481] NR 49 TC 12 Z9 18 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1462-8902 J9 DIABETES OBES METAB JI Diabetes Obes. Metab. PD SEP PY 2007 VL 9 IS 5 BP 714 EP 723 DI 10.1111/j.1463-1326.2006.00696.x PG 10 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 203HO UT WOS:000248965900012 PM 17697064 ER PT J AU Haffner, SM Kahn, SE Zinman, B Holman, RR Viberti, GF Herman, WH Lachin, JM Kravitz, BG Heise, MA AF Haffner, S. M. Kahn, S. E. Zinman, B. Holman, R. R. Viberti, G. F. Herman, W. H. Lachin, J. M. Kravitz, B. G. Heise, M. A. TI Greater reductions in C-reactive protein with rosiglitazone than with glyburide or metformin despite greater weight gain SO DIABETOLOGIA LA English DT Meeting Abstract CT 43rd Annual Meeting of the European-Association-for-the-Study-of-Diabetes CY SEP 18-21, 2007 CL Amsterdam, NETHERLANDS SP European Assco Study Diabet C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. Mt Sinai Hosp, Toronto, ON M5G 1X5, Canada. Churchill Hosp, OCDEM, Diabet Trials Unit, Oxford OX3 7LJ, England. Kings Coll London, Dept Endocrinol & Diabet, Sch Med, London, England. Univ Michigan, Ann Arbor, MI 48109 USA. George Washington Univ, Ctr Biostat, Rockville, MD USA. GlaxoSmithKline Inc, King Of Prussia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD SEP PY 2007 VL 50 SU 1 MA 0074 BP S36 EP S36 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 209NP UT WOS:000249395600075 ER PT J AU Herman, WH Haffner, SM Kahn, SE Zinman, B Holman, RR Viberti, GE Lachin, JM Kravitz, BG Heise, MA AF Herman, W. H. Haffner, S. M. Kahn, S. E. Zinman, B. Holman, R. R. Viberti, G. E. Lachin, J. M. Kravitz, B. G. Heise, M. A. TI ADOPT: The effectiveness of metformin versus glyburide in type 2 diabetes SO DIABETOLOGIA LA English DT Meeting Abstract CT 43rd Annual Meeting of the European-Association-for-the-Study-of-Diabetes CY SEP 18-21, 2007 CL Amsterdam, NETHERLANDS SP European Assco Study Diabet C1 Univ Michigan, Ann Arbor, MI 48109 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. Mt Sinai Hosp, Toronto, ON M5G 1X5, Canada. Churchill Hosp, OCDEM, Diabet Trials Unit, Oxford OX3 7LJ, England. Kings Coll London, Sch Med, Dept Endocrinol & Diabet, London SE5 9PJ, England. George Washington Univ, Ctr Biostat, Washington, DC 20052 USA. GlaxoSmithKline Inc, King Of Prussia, PA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD SEP PY 2007 VL 50 SU 1 MA 0877 BP S362 EP S362 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 209NP UT WOS:000249395600877 ER PT J AU Holman, RR Kahn, SE Haffner, SM Zinman, B Viberti, GF Herman, WH Lachin, JM Kravitz, BG Heise, MA AF Holman, R. R. Kahn, S. E. Haffner, S. M. Zinman, B. Viberti, G. F. Herman, W. H. Lachin, J. M. Kravitz, B. G. Heise, M. A. TI Determinants of monotherapy failure in ADOPT - (A diabetes outcome progression trial) SO DIABETOLOGIA LA English DT Meeting Abstract CT 43rd Annual Meeting of the European-Association-for-the-Study-of-Diabetes CY SEP 18-21, 2007 CL Amsterdam, NETHERLANDS SP European Assco Study Diabet C1 Churchill Hosp, OCDEM, Diabet Trial Unit, Oxford OX3 7LJ, England. VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. Mt Sinai Hosp, Toronto, ON M5G 1X5, Canada. Kings Coll London, Sch Med, Dept Endocrinol & Diabet, London WC2R 2LS, England. Univ Michigan, Ann Arbor, MI 48109 USA. George Washington Univ, Ctr Biostat, Washington, DC 20052 USA. GlaxoSmithKline Inc, King Of Prussia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD SEP PY 2007 VL 50 SU 1 MA 0862 BP S356 EP S356 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 209NP UT WOS:000249395600862 ER PT J AU Kahn, SE Haffner, SM Lachin, JM Herman, WH Zinman, B Holman, RR Heise, MA Aftring, RP Viberti, GF AF Kahn, S. E. Haffner, S. M. Lachin, J. M. Herman, W. H. Zinman, B. Holman, R. R. Heise, M. A. Aftring, R. P. Viberti, G. F. TI Increased incidence of fractures in women who received rosiglitazone in ADOPT (A Diabetes Outcome Progression Trial) SO DIABETOLOGIA LA English DT Meeting Abstract CT 43rd Annual Meeting of the European-Association-for-the-Study-of-Diabetes CY SEP 18-21, 2007 CL Amsterdam, NETHERLANDS SP European Assco Study Diabet C1 VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. George Washington Univ, Ctr Biostat, Rockville, MD USA. Univ Michigan, Ann Arbor, MI 48109 USA. Mt Sinai Hosp, Toronto, ON M5G 1X5, Canada. Churchill Hosp, OCDEM, Diabet Trials Unit, Oxford OX3 7LJ, England. GlaxoSmithKline Inc, King Of Prussia, PA USA. Kings Coll London, Dept Endocrinol & Diabet, London WC2R 2LS, England. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0012-186X J9 DIABETOLOGIA JI Diabetologia PD SEP PY 2007 VL 50 SU 1 MA 0077 BP S37 EP S38 PG 2 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 209NP UT WOS:000249395600078 ER PT J AU Leung, FW Chan, CC AF Leung, Felix W. Chan, Chi Chung TI Intragastric nitroglycerin at a vasodilatory dose attenuates acidified aspirin-induced gastric mucosal injury SO DIGESTIVE DISEASES AND SCIENCES LA English DT Article DE nitroglycerin; gastric blood flow; gastric volume; gastric mucosal injury; acidified aspirin ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; OXIDE-RELEASING ASPIRIN; NITRIC-OXIDE; NICOTINE PROTECTION; RELAXING FACTOR; RAT STOMACH; LESIONS; RISK; CYTOPROTECTION; PREVENTION AB Clinical studies reveal that aspirin intake to prevent myocardial and cerebral ischemia is associated with a significant increase in upper gastrointestinal hemorrhage requiring hospitalization and that nitroglycerin or long-acting nitrates significantly lower this risk. Nitroglycerin can increase gastric blood flow and slow gastric emptying. We hypothesized that both features contribute to its gastroprotective property. Fasted anesthetized rats (Study 1) and conscious mice (Studies 2 to 4) received intragastric nitroglycerin or vehicle. The effects of these two treatments on various parameters were assessed in Study 1, on blood pressure and gastric blood flow; Study 2, on acidified aspirin-induced gastric mucosal lesions; and Study 3, on the weight of gastric content. In Study 4, the effect of nitroglycerin, vehicle, or vehicle plus saline, on acidified aspirin-induced gastric mucosal lesion was assessed. Compared with vehicle, nitroglycerin decreased blood pressure and produced a mild but significant increase in gastric vascular conductance, blood flow, and volume of gastric content. The number and length of gastric mucosal lesions induced by acidified aspirin were significantly attenuated by intragastric nitroglycerin in a vasodilatory dose. Exogenous saline in a volume equivalent to the increase produced by nitroglycerin, however, did not attenuate the lesions. These experimental data are consistent with the clinical observation that nitrates lower the risk of aspirin-induced gastrointestinal complications. Confirmation of the efficacy of nitroglycerin and nitrates in preventing such aspirin-induced complications in controlled trials is worthy of consideration by clinical investigators. C1 VA Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr, Div Gastroenterol, Res & Med Serv, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. Merck Frosst Ctr Therapeut Res, Dept Pharmacol, Quebec City, PQ, Canada. RP Leung, FW (reprint author), VA Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr, Div Gastroenterol, Res & Med Serv, 111G,16111 Plummer St, Sepulveda, CA 91343 USA. EM felix.leung@med.va.gov NR 28 TC 1 Z9 1 U1 1 U2 1 PU SPRINGER PI DORDRECHT PA VAN GODEWIJCKSTRAAT 30, 3311 GZ DORDRECHT, NETHERLANDS SN 0163-2116 J9 DIGEST DIS SCI JI Dig. Dis. Sci. PD SEP PY 2007 VL 52 IS 9 BP 2229 EP 2235 DI 10.1007/s10620-006-9266-2 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 201CY UT WOS:000248810300033 PM 17420937 ER PT J AU Nelson, KM Reiber, G Kohler, T Boyko, EJ AF Nelson, Karin M. Reiber, Gayle Kohler, Ted Boyko, Edward J. TI Peripheral arterial disease in a multiethnic national sample: The role of conventional risk factors and allostatic load SO ETHNICITY & DISEASE LA English DT Article DE peripheral vascular disease; race/ethnicity ID ANKLE-BRACHIAL INDEX; NUTRITION EXAMINATION SURVEY; C-REACTIVE PROTEIN; UNITED-STATES; ARM INDEX; CARDIOVASCULAR-DISEASE; VASCULAR-DISEASE; PREVALENCE; HEALTH; POPULATION AB Background: Limited data exist on the prevalence of peripheral arterial disease (PAD) among ethnically diverse populations. Our objectives were to assess the prevalence of PAD in a multiethnic national sample and examine risk factor control and allostatic load (a marker of dysregulation of the inflammatory, metabolic, and cardiovascular systems) by race/ethnicity among individuals with PAD. Methods: We analyzed data from the 19992002 National Health and Nutrition Examination Surveyfor individuals aged >= 40 with a measured ankle brachial index (N=5,083). PAD was defined as an ankle brachial index <0.9. We performed bivariate and multivariate analyses to describe the association of race/ethnicity with PAD, controlling for sociodemographic factors, clinical risk factors and allostatic load. Results: Rates of PAD were higher among African Americans (7.8%) than Whites (3.4%) or Mexican Americans (5.1%) (P<.001). African Americans with PAD were more likely to be taking antihypertensive medications, were less likely to report vigorous physical activity, and had higher allostatic load scores than Whites. Although 95% of individuals with PAD report a routine place for care, almost half had a measured blood pressure >140/90 mm Hg, 28% were smokers, and 61% had a cholesterol value >= 200 mg/dL. Conclusions: Within this nationally representative sample, African Americans had the highest rates of PAD. Although conventional risk factor control, including control of hypertension and hyperlipidemia, were similar between racial groups, African Americans with PAD had higher allostatic load scores. Among all individuals with PAD, evidence showed suboptimal cardiovascular risk factor control. C1 VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, Seattle, WA 98108 USA. Washington Univ, Dept Med, St Louis, MO 63130 USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA 98108 USA. Washington Univ, Dept Epidemiol & Hlth Serv, St Louis, MO 63130 USA. VA Puget Sound Hlth Care Syst, Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA. RP Nelson, KM (reprint author), VA Puget Sound Hlth Care Syst, Primary & Specialty Med Care Serv, 1660 S Columbian Way,S-111-GIMC, Seattle, WA 98108 USA. EM karin.nelson@va.gov OI Boyko, Edward/0000-0002-3695-192X NR 40 TC 16 Z9 16 U1 32 U2 35 PU INT SOC HYPERTENSION BLACKS-ISHIB PI ATLANTA PA 100 AUBURN AVE NE STE 401, ATLANTA, GA 30303-2527 USA SN 1049-510X J9 ETHNIC DIS JI Ethn. Dis. PD FAL PY 2007 VL 17 IS 4 BP 669 EP 675 PG 7 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 233UK UT WOS:000251115600012 PM 18072377 ER PT J AU Mckelvie, RS Komajda, M Mcmurray, J Zile, M Ptaszynska, A Bhaumik, A Carson, P Massie, B AF Mckelvie, R. S. Komajda, M. Mcmurray, J. Zile, M. Ptaszynska, A. Bhaumik, A. Carson, P. Massie, B. CA I-PRESERVE Investigators TI Baseline plasma NT-proBNP concentrations in relation to clinical characteristics: results from the irbesartan in heart failure with preserved systolic function trial SO EUROPEAN HEART JOURNAL LA English DT Meeting Abstract C1 [Mckelvie, R. S.] Hamilton Hlth Sci, Hamilton, ON, Canada. [Komajda, M.] Hop La Pitie Salpetriere, Paris, France. [Mcmurray, J.; Bhaumik, A.] Univ Glasglow, Glasgow, Lanark, Scotland. [Zile, M.] Med Univ S Carolina, RHJ Dept VAMC, Charleston, SC USA. [Ptaszynska, A.] Bristol Myers Squibb Co, Pharmaceut Res Inst, Princeton, NJ 08543 USA. [Carson, P.] VAMC, Washington, DC USA. [Massie, B.] Univ Calif San Francisco, San Francisco, CA 94143 USA. [Massie, B.] San Francisco VA Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0195-668X J9 EUR HEART J JI Eur. Heart J. PD SEP PY 2007 VL 28 SU 1 BP 145 EP 145 PG 1 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA V28TD UT WOS:000208702200569 ER PT J AU Singh, BN Aliot, E AF Singh, Bramah N. Aliot, Etienne TI Newer antiarrhythmic agents for maintaining sinus rhythm in atrial fibrillation: simplicity or complexity? SO EUROPEAN HEART JOURNAL SUPPLEMENTS LA English DT Article; Proceedings Paper CT 1st Annual Advisory Meeting on Cardiac Rhythm/ Electrophysiology and Targeted Education CY OCT 10, 2006 CL Paris, FRANCE DE antiarrhythmic drug; atrial fibrillation; atrial selectivity; cardioversion; sinus rhythm ID CONGESTIVE-HEART-FAILURE; VENTRICULAR MYOCYTES; DOSE-RESPONSE; AMIODARONE; DRONEDARONE; EFFICACY; TRIAL; TEDISAMIL; FLUTTER; PREVENTION AB The morbidity and mortality associated with atrial fibrillation (AF), the most frequent cardiac arrhythmia, remain substantial. The efficacy and safety of current antiarrhythmic drugs continue to be less than optimal. The development of newer antiarrhythmic drugs has recently been made possible through a greater understanding of the pathophysiotogy of AF and knowledge of atrial electrophysiology relative to the properties of the congeners of known antiarrhythmic agents. Highly specific atrially acting drugs are currently being explored, their major merit concerning safety. In contrast, their rote may be somewhat limited in view of the etectrophysiological complexity of AF as an arrhythmia. The data suggest that complex antiarrhythmic agents with a multiplicity of actions may be preferable, although currently there are few data on the precise effectiveness of atrial.-specific agents in maintaining sinus rhythm in AF It is of interest that combining antiarrhythmic and non-antiarrhythmic agents, such as anti-inflammatory or antioxidant drugs, may increase the effectiveness of antifibrillatory actions in patients with AF, although these data have been obtained in uncontrolled, small or retrospective studies. Thus, at present, it is not certain whether it is preferable to target single antiarrhythmic drugs with antiadrenergic properties or to combine 'purely' antiarrhythmic drugs with other drugs devoid of anti-adrenergic effects. Controlled clinical trials are required to precisely define the effectiveness of single agents vs. various combinations of agents in maintaining sinus rhythm in patients with AF. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Cardiol, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Univ Nancy, Ctr Hosp, Hop Brabois, Vandoeuvre Les Nancy, France. RP Singh, BN (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Dept Cardiol, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM b.singh@ucla.edu NR 52 TC 12 Z9 13 U1 0 U2 2 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 1520-765X J9 EUR HEART J SUPPL JI Eur. Heart J. Suppl. PD SEP PY 2007 VL 9 IS G BP G17 EP G25 DI 10.1093/eurheartj/sum049 PG 9 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 225JW UT WOS:000250515200005 ER PT J AU Lee, SA Jones, J Khalique, Z Kot, J Alba, M Bernardo, S Seghal, A Wong, B AF Lee, Samuel A. Jones, Jason Khalique, Zachary Kot, John Alba, Mercedes Bernardo, Stella Seghal, Alfica Wong, Brian TI A functional analysis of the Candida albicans homolog of Saccharomyces cerevisiae VPS4 SO FEMS YEAST RESEARCH LA English DT Article DE Candida albicans; protein secretion; vacuole; secreted aspartyl proteases; VPS ID SECRETED ASPARTYL PROTEINASES; DOMINANT-NEGATIVE ALLELE; PHOSPHATIDYLINOSITOL 3-KINASE; FILAMENTOUS GROWTH; INHIBITS GROWTH; GERM TUBE; YEAST; VIRULENCE; GENE; PATHOGENESIS AB To investigate the role of the prevacuolar secretion pathway in the trafficking of vacuolar proteins in Candida albicans, the C. albicans homolog of the Saccharomyces cerevisiae vacuolar protein sorting gene VPS4 was cloned and analyzed. Candida albicans VPS4 encodes a deduced AAA-type ATPase that is 75.6% similar to S. cerevisiae Vps4p, and plasmids bearing C. albicans VPS4 complemented the abnormal vacuolar morphology and carboxypeptidase missorting in S. cerevisiae vps4 null mutants. Candida albicans vps4 Delta null mutants displayed a characteristic class E vacuolar morphology and multilamellar structures consistent with an aberrant prevacuolar compartment. The C. albicans vps4 Delta mutant degraded more extracellular bovine serum albumin than did wild-type strains, which implied that this mutant secreted more extracellular protease activity. These phenotypes were complemented when a wild-type copy of VPS4 was reintroduced into its proper locus. Using a series of protease inhibitors, the origin of this extracellular protease activity was identified as a serine protease, and genetic analyses using a C. albicans vps4 Delta prc1 Delta mutant identified this missorted vacuolar protease as carboxypeptidase Y. Unexpectedly, C. albicans Sap2p was not detected in culture supernatants of the vps4 Delta mutants. These results indicate that C. albicans VPS4 is required for vacuolar biogenesis and proper sorting of vacuolar proteins. C1 S Texas Vet Healthcare Syst, Div Infect Dis, San Antonio, TX 78229 USA. Yale Univ, Sch Med, Infect Dis Sect, New Haven, CT USA. Oregon Hlth & Sci Univ, Div Infect Dis, Portland, OR 97201 USA. Univ Texas, Hlth Sci Ctr, Div Infect Dis, San Antonio, TX 78229 USA. RP Lee, SA (reprint author), S Texas Vet Healthcare Syst, Div Infect Dis, 7703 Floyd Curl Dr,Mail Code 7881, San Antonio, TX 78229 USA. EM lees7@uthscsa.edu FU NIAID NIH HHS [R01-AI64085, R01-AI47442] NR 33 TC 14 Z9 18 U1 0 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1567-1356 J9 FEMS YEAST RES JI FEMS Yeast Res. PD SEP PY 2007 VL 7 IS 6 BP 973 EP 985 DI 10.1111/j.1567-1364.2007.00253.x PG 13 WC Biotechnology & Applied Microbiology; Microbiology; Mycology SC Biotechnology & Applied Microbiology; Microbiology; Mycology GA 203FF UT WOS:000248959800022 PM 17506830 ER PT J AU Wei, GW Wang, DM Lu, HF Parmentier, S Wang, Q Panter, S Frey, WH Ying, WH AF Wei, Guangwei Wang, Dongmin Lu, Huafei Parmentier, Sophie Wang, Qing Panter, Scott Frey, William H., II Ying, Weihai TI Intranasal administration of a PARG inhibitor profoundly decreases ischemic brain injury SO FRONTIERS IN BIOSCIENCE-LANDMARK LA English DT Article DE ischemia; brain injury; poly(ADP-ribose) polymerase; poly(ADP-ribose) glycohydrolase; neuronal death; oxidative damage ID APOPTOSIS-INDUCING FACTOR; POLY(ADP-RIBOSE) POLYMERASE INHIBITORS; OXYGEN-GLUCOSE DEPRIVATION; FOCAL CEREBRAL-ISCHEMIA; CENTRAL-NERVOUS-SYSTEM; NITRIC-OXIDE SYNTHASE; CELL-DEATH; NEURONAL DEATH; GLYCOHYDROLASE PARG; NAD(+) DEPLETION AB Cumulative evidence has indicated a critical role of poly(ADP-ribose) polymerase-1 activation in ischemic brain damage. Poly(ADP-ribose) glycohydrolase (PARG) is a key enzyme in poly(ADP-ribose) catabolism. Our previous studies showed that PARG inhibitors, gallotannin (GT) and nobotanin B, can profoundly decrease oxidative cell death in vitro. Here, we tested the hypothesis that intranasal delivery of GT can decrease ischemic brain damage by inhibiting PARG. Intranasal delivery of GT within 5 hours after the onset of focal brain ischemia markedly decreased the infarct formation and neurological deficits of rats. The GT administration also increased poly(ADP-ribose) in the ischemic brains, suggesting that GT acts as a PARG inhibitor in vivo. Furthermore, the GT treatment abolished nuclear translocation of apoptosis-inducing factor (AIF) in the ischemic brains, suggesting that prevention of AIF translocation may contribute to the protective effects of GT. In contrast, intravenous injection of GT, at 2 hours after ischemic onset, did not reduce ischemic brain damage. Collectively, our findings suggest that PARG inhibition can significantly decrease ischemic brain injury, possibly by blocking AIF translocation. This study also highlights distinct merits of intranasal drug delivery for treating CNS diseases. C1 [Wei, Guangwei; Wang, Dongmin; Lu, Huafei; Wang, Qing; Ying, Weihai] San Francisco VA Med Ctr, Dept Neurol 127, San Francisco, CA 94121 USA. [Wei, Guangwei; Wang, Dongmin; Lu, Huafei; Wang, Qing; Ying, Weihai] Univ Calif San Francisco, San Francisco, CA 94121 USA. [Frey, William H., II] HealthPartners Res Fdn, Reg Hosp, Alzheimers Res Ctr, St Paul, MN 55101 USA. RP Ying, WH (reprint author), San Francisco VA Med Ctr, Dept Neurol 127, 4150 Clement St, San Francisco, CA 94121 USA. EM Weihai.Ying@ucsf.edu OI Frey II, William/0000-0002-6373-0794 NR 52 TC 20 Z9 20 U1 0 U2 1 PU FRONTIERS IN BIOSCIENCE INC PI MANHASSET PA C/O NORTH SHORE UNIV HOSPITAL, BIOMEDICAL RESEARCH CENTER, 350 COMMUNITY DR, MANHASSET, NY 11030 USA SN 1093-9946 J9 FRONT BIOSCI-LANDMRK JI Front. Biosci. PD SEP 1 PY 2007 VL 12 BP 4986 EP 4996 DI 10.2741/2443 PG 11 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 273PJ UT WOS:000253943900017 PM 17569625 ER PT J AU Videlock, EJ Chang, L AF Videlock, Elizabeth J. Chang, Lin TI Irritable bowel syndrome: Current approach to symptoms, evaluation, and treatment SO GASTROENTEROLOGY CLINICS OF NORTH AMERICA LA English DT Review ID RANDOMIZED CONTROLLED-TRIAL; QUALITY-OF-LIFE; FUNCTIONAL GASTROINTESTINAL DISORDERS; COGNITIVE-BEHAVIOR THERAPY; VISCERAL SENSITIVITY INDEX; PLACEBO-CONTROLLED TRIAL; RECEPTOR PARTIAL AGONIST; DOUBLE-BLIND; CONSTIPATION-PREDOMINANT; ABDOMINAL-PAIN AB There are frequent advances in knowledge about the clinical presentation, pathophysiology, and treatment of irritable bowel syndrome. It is important for clinicians to be aware of available therapies and the supporting evidence for those therapies to increase patient satisfaction. This is best achieved with a collaborative and long-term clinician-patient relationship and mutual commitment to modify therapy and try new modalities until the greatest relief of symptoms and improvement in health-related quality of life is achieved. This article reviews symptoms, comorbidities, gender differences, and measure of severity in irritable bowel syndrome and current and evidence-based approaches to evaluation and treatment, and the new symptom-based Rome III diagnostic criteria are reviewed and explained. C1 Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, Ctr Neurovisceral Sci & Womens Hlth, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Chang, L (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, Ctr Neurovisceral Sci & Womens Hlth, CURE Bldg 115,Room 223,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM linchang@mednet.ucla.edu NR 101 TC 33 Z9 36 U1 6 U2 9 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0889-8553 J9 GASTROENTEROL CLIN N JI Gastroenterol. Clin. North Am. PD SEP PY 2007 VL 36 IS 3 BP 665 EP + DI 10.1016/j.gtc.2007.07.002 PG 22 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 233BU UT WOS:000251066200011 PM 17950443 ER PT J AU Egede, LE AF Egede, Leonard E. TI Major depression in individuals with chronic medical disorders: prevalence, correlates and association with health resource utilization, lost productivity and functional disability SO GENERAL HOSPITAL PSYCHIATRY LA English DT Article DE major depression; chronic medical disorders; National Health Interview Survey ID OBSTRUCTIVE PULMONARY-DISEASE; PRIMARY-CARE PATIENTS; ANTIDEPRESSANT TREATMENT; HEART-FAILURE; UNITED-STATES; OLDER ADULTS; MORTALITY; RISK; POPULATION; SYMPTOMS AB Objective: The objective of this study was to determine the prevalence and odds of major depression and the incremental effect of major depression on utilization, lost productivity and functional disability in individuals with common chronic medical disorders. Method: Data on 30,801 adults from the 1999 National Health Interview Survey were analyzed. The 12-month prevalence and age/sex-adjusted odds of major depression were calculated for adults with hypertension (HTN), diabetes mellitus (DM), coronary artery disease (CAD), congestive heart failure (CHF), stroke or cerebrovascular accident (CVA), chronic obstructive pulmonary disease (COPD) and end-stage renal disease (ESRD). The association between chronic condition status (with and without major depression) and utilization, lost productivity and functional disability was determined by controlling for covariates. Results: The 12-month prevalence and age/sex-adjusted odds of major depression by chronic conditions were as follows: CHF, 7.9% [odds ratio (OR)=1.96]; HTN, 8.0% (OR=2.00); DM, 9.3% (OR=1.96); CAD, 9.3% (OR=2.30); CVA, 11.4% (OR=3.15); COPD, 15.4% (OR=3.21); ESRD, 17.0% (OR=3.56); any chronic condition, 8.8% (OR=2.61). Compared to adults without chronic conditions, those with chronic conditions plus major depression had greater odds of >= 1 ambulatory visit [OR=1.50; 95% confidence interval (95% CI)=1.28, 1.77]; >= 1 emergency room visit (OR=1.94; 95% CI=1.55, 2.45); and >= 1 day in bed due to illness (OR=1.60; 95% CI=1.28, 2.00); and functional disability (OR=2.48; 95% CI=1.96, 3.15). Conclusion: The 12-month prevalence and odds of major depression are high in individuals with chronic medical conditions, and major depression is associated with significant increases in utilization, lost productivity and functional disability. (C) 2007 Elsevier Inc. All rights reserved. C1 Med Univ S Carolina, Ctr Hlth Disparities Res, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston VA TREP, Charleston, SC 29403 USA. RP Egede, LE (reprint author), Med Univ S Carolina, Ctr Hlth Disparities Res, Charleston, SC 29425 USA. EM egedel@musc.edu NR 51 TC 229 Z9 233 U1 1 U2 15 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0163-8343 J9 GEN HOSP PSYCHIAT JI Gen. Hosp. Psych. PD SEP-OCT PY 2007 VL 29 IS 5 BP 409 EP 416 DI 10.1016/j.genhosppsych.2007.06.002 PG 8 WC Psychiatry SC Psychiatry GA 217VS UT WOS:000249976000005 PM 17888807 ER PT J AU Guchhait, P Dasgupta, SK Le, A Yellapragada, S Lopez, JA Thiagarajan, P AF Guchhait, Prasenjit Dasgupta, Swapan K. Le, Anhquyen Yellapragada, Sarvari Lopez, Jose A. Thiagarajan, Perumal TI Lactadherin mediates sickle cell adhesion to vascular endothelial cells in flowing blood SO HAEMATOLOGICA-THE HEMATOLOGY JOURNAL LA English DT Letter DE lactadherin; sickle cell anemia; phosphatidyl-serine; endothelial adhesion AB Increased exposure of sickle red blood cells to phosphatidylserine promotes its adhesion to the endothelium. A monoclonal antibody to lactadherin, a phosphatidylserine binding protein, inhibits sickle cell adhesion to histamine-stimulated endothelial cells in flowing blood. Added lactadherin enhances the adhesion via the integrin alpha V beta 3. These results indicate that lactadherin can mediate phosphatidylserine-expressing sickle cell adhesion to the endothelium. C1 VA Med Ctr, Houston, TX 77030 USA. RP Thiagarajan, P (reprint author), VA Med Ctr, Mail Stop 113,2002 Holcombe Blvd, Houston, TX 77030 USA. EM perumalt@bcm.tmc.edu NR 10 TC 11 Z9 12 U1 0 U2 0 PU FERRATA STORTI FOUNDATION PI PAVIA PA STRADA NUOVA 134, 27100 PAVIA, ITALY SN 0390-6078 J9 HAEMATOL-HEMATOL J JI Haematol-Hematol. J. PD SEP PY 2007 VL 92 IS 9 BP 1266 EP 1267 DI 10.3324/haematol.11379 PG 2 WC Hematology SC Hematology GA 209QC UT WOS:000249402100021 PM 17768123 ER PT J AU Mendez, E Fan, W Choi, P Agoff, SN Whipple, M Farwell, DG Futran, ND Weymuller, EA Zhao, LP Chen, C AF Mendez, Eduardo Fan, Wenhong Choi, Peter Agoff, S. Nicholas Whipple, Mark Farwell, D. Gregory Futran, Neal D. Weymuller, Ernest A., Jr. Zhao, Lue-Ping Chen, Chu TI Tumor-specific genetic expression profile of metastatic oral squamous cell carcinoma SO HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK LA English DT Article DE oral squamous cell carcinoma; metastasis; genetic profiles; oral cancer; lymph nodes ID NECK-CANCER; MICROARRAY ANALYSIS; BREAST-CANCER; HEAD; IDENTIFICATION; SIGNATURE; TRANSGLUTAMINASE-3; DISCOVERY; DISEASE; MODEL AB Background. Metastasis is the most important predictor of survival in patients with oral squamous cell carcinoma (OSCC). We tested the hypothesis that there is a genetic expression profile associated with OSCC metastasis. Methods. We obtained samples from 6 OSCC node-positive primary tumors and their matched metastatic lymph nodes, and 5 OSCC node-negative primary tumors. Using laser capture microdissection, we isolated OSCC cells from metastatic lymph nodes and compared them with those from matched primary tumors and unmatched node-negative primary tumors using Affymetrix Human Genome Focus arrays. Results. Comparison of tumor cells from the lymph nodes with those from the unmatched, node-negative primary tumors revealed differential expression of 160 genes. Hierarchical clustering and principal component analysis using this 160-gene set showed that the node-negative samples were distinguishable from both, node-positive primary tumors and tumors in the lymph nodes. Many of the expression changes found in the metastatic cells from the lymph nodes were also found in the node-positive primary tumors. Immunohistochemical analysis for transglutaminase-3 and keratin 16 confirmed the differential genetic expression for these genes. C1 Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Surg & Perioperat Care Serv, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv, Seattle, WA 98108 USA. Fred Hutchinson Canc Res Ctr, Program Epidemiol, Seattle, WA 98109 USA. Fred Hutchinson Canc Res Ctr, Program Biostat, Seattle, WA 98109 USA. Virginia Mason Med Ctr, Dept Pathol, Seattle, WA 98111 USA. Univ Calif Davis, Dept Otolaryngol Head & Neck Surg, Sacramento, CA 95817 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. RP Chen, C (reprint author), Univ Washington, Dept Otolaryngol Head & Neck Surg, Seattle, WA 98195 USA. EM cchen@fbcrc.org FU NCI NIH HHS [R01 CA 095419]; NCRR NIH HHS [5 K12 RR023265-03]; NIDCD NIH HHS [T32 DC00018] NR 35 TC 25 Z9 27 U1 0 U2 3 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1043-3074 J9 HEAD NECK-J SCI SPEC JI Head Neck-J. Sci. Spec. Head Neck PD SEP PY 2007 VL 29 IS 9 BP 803 EP 814 DI 10.1002/hed PG 12 WC Otorhinolaryngology; Surgery SC Otorhinolaryngology; Surgery GA 207YZ UT WOS:000249288300001 PM 17573689 ER PT J AU O'Toole, TP Conde-Martel, A Gibbon, JL Hanusa, BH Freyder, PJ Fine, MJ AF O'Toole, Thomas P. Conde-Martel, Alicia Gibbon, Jeanette L. Hanusa, Barbara H. Freyder, Paul J. Fine, Michael J. TI Where do people go when they first become homeless? A survey of homeless adults in the USA SO HEALTH & SOCIAL CARE IN THE COMMUNITY LA English DT Article DE access to care; homelessness; help-seeking; substance abuse ID SOUP KITCHEN POPULATION; URBAN HOMELESS; MENTALLY-ILL; MEDICAL-CARE; HOUSED POOR; DRUG; SERVICES; ALCOHOL; HEALTH; READINESS AB The longer a person is homeless, the more likely he or she is to experience poor health and be placed at higher risk for premature death. This makes interventions early in one's homelessness an important prevention strategy. However, little is known about where someone goes for help when they first become homeless and how well those sites are prepared to address the multitude of issues facing a homeless person. In order to address this question, we conducted a cross-sectional community-based survey in two US cities in 1997 using population proportionate sampling of homeless persons identified at 91 sites to identify 'first-stop' access sites and reasons for seeking help at those sites. A total of 230 persons participated in the face-to-face interview (93% response rate). From a list of 20 possible 'first-stop' sites, 105 (45.7%) reported going to a soup kitchen, 71 (30.9%) went to a welfare office, 64 (27.8%) sought admission to a detoxification centre, 60 (26.1 %) met with a homeless outreach team, 57 (24.8%) went to a family member, and 54 (23.5%) went to an emergency room. Individuals with a chronic medical or mental health condition were significantly more likely to access a healthcare site (medical: 62.6% vs. 47.6%, P = 0.02; mental health: 62.4% vs. 38.8%, P < 0.01) or social service agency (medical: 64.0% vs. 43.3 %, P = 0.02; mental health: 59.1 % vs. 40.7%, P < 0.01). Those persons reporting a need for alcohol treatment were significantly more likely to first go to a healthcare site (46.4% vs. 29.1 %, P < 0.01) and those with alcohol abuse/dependence were less likely to seek help from family or friends (66.7% vs. 81.9%, P < 0.01). Most respondents sought assistance for concerns directly associated with an immediate need as opposed to seeking care for issues causing their actual homelessness. These findings suggest the need to expand and integrate the availability of services at 'first-stop' access sites that facilitate early exits from homelessness. C1 Providence VA Med Ctr, Providence, RI 02908 USA. Brown Med Sch, Providence, RI 02912 USA. Hosp Univ Gran Canaria, Las Palmas Gran Canaria, Spain. Maricopa Cty Dept Publ Hlth, Phoenix, AZ USA. Univ Pittsburgh, Womens Behav Healthcare Program, Dept Psychiat, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Salvat Army Publ Inebriate Program, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, VA Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. RP O'Toole, TP (reprint author), Providence VA Med Ctr, 830 Chalkstone Ave, Providence, RI 02908 USA. EM thomas.o'toole@va.gov FU NIDA NIH HHS [K23 DA13988-01] NR 30 TC 22 Z9 22 U1 1 U2 16 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0966-0410 J9 HEALTH SOC CARE COMM JI Health Soc. Care Community PD SEP PY 2007 VL 15 IS 5 BP 446 EP 453 PG 8 WC Public, Environmental & Occupational Health; Social Work SC Public, Environmental & Occupational Health; Social Work GA 207HY UT WOS:000249243400006 PM 17685990 ER PT J AU El-Serag, HB AF El-Serag, Hashem B. TI Epidemiology of hepatocellular carcinoma in USA SO HEPATOLOGY RESEARCH LA English DT Article; Proceedings Paper CT 4th Single Topic Conference on HCC CY DEC 02-03, 2005 CL Awaji Isl, JAPAN SP Japan Soc Hepatol DE epidemiology; hepatitis B; hepatitis C; nonalcoholic steatohepatitis ID HEPATITIS-C VIRUS; CHRONIC LIVER-DISEASE; UNITED-STATES; RISK-FACTORS; VIRAL-HEPATITIS; MORTALITY; JAPAN; POPULATION; PREVALENCE; INFECTION AB Hepatocellular carcinoma (HCC) is increasing in frequency the USA. Age-adjusted incidence, hospitalization, and mortality rates have doubled over the past two decades. There are striking differences in the incidence of HCC related to age, gender, race, and geographic region. Although it remains an affliction of the elderly (mean age 65), there has been a considerable shift toward younger cases. There is a birth cohort effect with those born after 1945. Men are affected three times more frequently than women, Asians two times more than African American and Hispanic people, who are affected two times more often than Caucasians. However, the recent increase has disproportionately affected Caucasian (and Hispanic) men between ages 45 and 65. Hepatitis C virus (HCV) infection acquired 2-4 decades ago explains at least half of the observed increase in HCC; HCV-related HCC is likely to continue to increase for the next decade. A variable but significant proportion of cases (15-50%) do not have evidence for the risk factors of either viral hepatitis or heavy alcohol consumption. Insulin resistance syndrome manifesting as obesity and diabetes is emerging as a risk factor for HCC in the USA and may operate through the formation of non-alcoholic fatty liver disease (NAFLD); however, its effect on the current trend in HCC remains unclear. While there has been a small recent improvement in survival, it remains generally dismal (median 8 months). Population-based data in the USA indicate low application rate of HCC potentially curative therapy and marked regional differences. C1 Baylor Coll Med, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Michael E DeBakey Vet Adm Med Ctr, Houston, TX USA. RP El-Serag, HB (reprint author), Houston Vet Affairs Med Ctr 152, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM hasheme@bcm.tmc.edu NR 28 TC 191 Z9 197 U1 0 U2 12 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1386-6346 J9 HEPATOL RES JI Hepatol. Res. PD SEP PY 2007 VL 37 SU 2 BP S88 EP S94 DI 10.1111/j.1872-034X.2007.00168.x PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 228UP UT WOS:000250758400002 PM 17877502 ER PT J AU Darouiche, R AF Darouiche, R. TI Antimicrobial coating of devices for prevention of infection: Principles and protection SO INTERNATIONAL JOURNAL OF ARTIFICIAL ORGANS LA English DT Review DE antimicrobial coating; device; infection; prevention ID CENTRAL VENOUS CATHETERS; BLOOD-STREAM INFECTION; RANDOMIZED CONTROLLED-TRIAL; INTENSIVE-CARE UNIT; SURGICAL IMPLANTS; COATED CATHETERS; CLINICAL-TRIAL; EXCESS LENGTH; DOUBLE-BLIND; EFFICACY AB Device-associated infections are responsible for about half of nosocomial infections and can cause major medical and economical sequelae. Despite adherence to basic infection control measures, which constitute the mainstay for preventing infection, infections associated with certain devices continue to exist at unacceptably high rates. Potentially-preventive, antimicrobial-utilizing strategies include systemic antibiotic prophylaxis and local administration of antimicrobial agents (antibiotics or antiseptics), which includes antimicrobial irrigation of the surgical field, placement of antimicrobial carriers, antiseptic cleansing of the skin, dipping of surgical implants in antimicrobial solutions, and inserting antimicrobial-coated implants. Since bacterial colonization of the indwelling device is a prelude to infection, prevention of device colonization may lead to a lower rate of clinical infection. Different approaches for antimicrobial coating of devices have been variably successful in preventing device-associated infections. Optimal characteristics of antimicrobial coating can help predict the likelihood and degree of clinical protection against infection. This review addresses the impact of device-related infection, antimicrobial-utilizing approaches for preventing infection, clinical protection afforded by different types of antimicrobial coating, characteristics that predict the ability of antimicrobial coating of devices to prevent clinical infection, and future directions of antimicrobial coating. C1 Baylor Coll Med, Michael E Debakey Vet Affairs Med Ctr, Houston, TX 77030 USA. RP Darouiche, R (reprint author), Baylor Coll Med, Ctr Prostheses Infect, 1333 Moursund Ave,Suite A221, Houston, TX 77030 USA. EM rdarouiche@aol.com NR 45 TC 22 Z9 22 U1 2 U2 16 PU WICHTIG EDITORE PI MILAN PA 72/74 VIA FRIULI, 20135 MILAN, ITALY SN 0391-3988 J9 INT J ARTIF ORGANS JI Int. J. Artif. Organs PD SEP PY 2007 VL 30 IS 9 BP 820 EP 827 PG 8 WC Engineering, Biomedical; Transplantation SC Engineering; Transplantation GA 228LK UT WOS:000250731200011 PM 17918128 ER PT J AU Tebes, JK Feinn, R Vanderploeg, JJ Chinman, MJ Shepard, J Brabham, T Genovese, M Connell, C AF Tebes, Jacob Kraemer Feinn, Richard Vanderploeg, Jeffrey J. Chinman, Matthew J. Shepard, Jane Brabham, Tamika Genovese, Maegan Connell, Christian TI Impact of a positive youth development program in urban after-school settings on the prevention of adolescent substance use SO JOURNAL OF ADOLESCENT HEALTH LA English DT Article DE youth development; after school; urban; substance use; resilience; propensity scores; HLM ID RISK; COMPETENCE; ADJUSTMENT; PATTERNS; CHILDREN; STUDENTS; ABUSE; CARE AB Purpose: Positive youth development (PYD) emphasizes a strengths-based approach to the promotion of positive outcomes for adolescents. After-school programs provide a unique opportunity to implement PYD approaches and to address adolescent risk factors for negative outcomes, such as unsupervised out-of-school time. This study examines the effectiveness of an after-school program delivered in urban settings on the prevention of adolescent substance use. Methods: A total of 304 adolescents participated in the study: 149 in the intervention group and 155 in a control group. A comprehensive PYD intervention that included delivery of an 18-session curriculum previously found to be effective in preventing substance use in school settings was adapted for use in urban after-school settings. The intervention emphasizes adolescents' use of effective decision-making skills to prevent drug use. Assessments of substance use attitudes and behaviors were conducted at program entry, program completion, and at the 1-year follow-up to program entry. Propensity scores were computed and entered in the analyses to control for any pretest differences between intervention and control groups. Hierarchical linear modeling (HLM) analyses were conducted to assess program effectiveness. Results: The results demonstrate that adolescents receiving the intervention were significantly more likely to view drugs as harmful at program exit, and exhibited significantly lower increases in alcohol, marijuana, other drug use, and any drug use I year after beginning the program. Conclusions: A PYD intervention developed for use in an urban after-school setting is effective in preventing adolescent substance use. (c) 2007 Society for Adolescent Medicine. All rights reserved. C1 Yale Univ, Div Prevent & Community Res, New Haven, CT 06511 USA. Yale Univ, Consultat Ctr, New Haven, CT 06511 USA. Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA. RAND Corp, Santa Monica, CA USA. W Losangeles VA Healthcare Ctr, Santa Monica, CA USA. RP Tebes, JK (reprint author), Yale Univ, Div Prevent & Community Res, 389 Whitey Ave, New Haven, CT 06511 USA. EM jacob.tebes@yale.edu FU CSAP SAMHSA HHS [KD1 SP09280] NR 40 TC 45 Z9 45 U1 0 U2 16 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1054-139X J9 J ADOLESCENT HEALTH JI J. Adolesc. Health PD SEP PY 2007 VL 41 IS 3 BP 239 EP 247 DI 10.1016/j.jadohealth.2007.02.016 PG 9 WC Psychology, Developmental; Public, Environmental & Occupational Health; Pediatrics SC Psychology; Public, Environmental & Occupational Health; Pediatrics GA 204OS UT WOS:000249054500005 PM 17707293 ER PT J AU Page, ST Kalhorn, TF Bremner, WJ Anawalt, BD Matsumoto, AM Amory, JK AF Page, Stephanie T. Kalhorn, Thomas F. Bremner, William J. Anawalt, Bradley D. Matsumoto, Alvin M. Amory, John K. TI Intratesticular androgens and spermatogenesis during severe gonadotropin suppression induced by male hormonal contraceptive treatment SO JOURNAL OF ANDROLOGY LA English DT Article DE testosterone; dihydrotestosterone; INSL3; LH; FSH ID INSULIN-LIKE FACTOR-3; EXOGENOUSLY ADMINISTERED TESTOSTERONE; DEFICIENT HPG MICE; NORMAL MEN; LUTEINIZING-HORMONE; CIRCULATING HORMONE; INDUCED AZOOSPERMIA; HUMAN TESTIS; SERUM-LEVELS; MAINTENANCE AB Male hormonal contraceptive regimens function by suppressing gonadotropin secretion, resulting in a dramatic decrease in testicular androgen biosynthesis and spermatogenesis. Animal studies suggest that persistent intratesticular (iT)-androgen production has a stimulatory effect on spermatogenesis in the setting of gonadotropin suppression. We hypothesized that men with incompletely suppressed spermatogenesis (> 1 000 000 sperm/mL) during male hormonal contraceptive treatment would have higher iT-androgen concentrations than men who achieved severe oligospermia (: l 000 000 sperm/mL). Twenty healthy men ages 18-55 years enrolled in a 6-month male contraceptive study of transdermal testosterone (T) gel (100 mg/d) plus depomedroxyprogesterone acetate (300 mg intramuscularly every 12 weeks) with or without the gonaclotropin releasing hormone (GnRH) antagonist acyline (300 mu g/kg subcutaneously every 2 weeks for 12 weeks) were studied. During the 24th week of treatment, subjects underwent fine needle aspirations of the testes and iT-T and iT-dihydrotestosterone (iT-DHT) were measured in testicular fluid by liquid chromatography-tandem mass spectrometry. All men dramatically suppressed spermatogenesis; 15 of 20 men were severely oligospermic, and 5 of 20 suppressed to 1.5 million-3.2 million sperm per milliliter. In all subjects, mean iT-T and iT-DHT concentrations were 35 +/- 8 and 5.1 +/- 0.8 nmol/L. IT-androgen concentrations did not significantly differ in men who did and did not achieve severe oligospermia (P = .41 for iT-T; P = .18 for iT-DHT). Furthermore, there was no significant correlation between iT-T or iT-DHT and sperm concentration after 24 weeks of treatment. In this study of prolonged gonadotropin suppression induced by male hormonal contraceptive treatment, differences in iT-androgens did not explain differences in spermatogenesis. Additional studies to identify factors involved in persistent spermatogenesis despite gonaclotropin suppression are warranted. C1 Univ Washington, Dept Med Chem, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. Vet Adm Med Ctr, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Dept Med, Seattle, WA USA. RP Page, ST (reprint author), Box 357138,1959 NE Pacific, Seattle, WA 98195 USA. EM page@u.washington.edu FU NIA NIH HHS [K23 AG027238, K23 AG027238-04]; NICHD NIH HHS [K23 HD45386, U54 HD-42454, U54-HD-12629] NR 40 TC 22 Z9 23 U1 0 U2 1 PU AMER SOC ANDROLOGY, INC PI LAWRENCE PA C/O ALLEN PRESS, INC PO BOX 368, LAWRENCE, KS 66044 USA SN 0196-3635 J9 J ANDROL JI J. Androl. PD SEP-OCT PY 2007 VL 28 IS 5 BP 734 EP 741 DI 10.2164/jandrol.107.002790 PG 8 WC Andrology SC Endocrinology & Metabolism GA 207BG UT WOS:000249226000016 PM 17494097 ER PT J AU Kellogg, DL Hodges, GJ Orozco, CR Phillips, TM Zhao, JL Johnson, JM AF Kellogg, D. L., Jr. Hodges, G. J. Orozco, C. R. Phillips, T. M. Zhao, J. L. Johnson, J. M. TI Cholinergic mechanisms of cutaneous active vasodilation during heat stress in cystic fibrosis SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article ID VASOACTIVE-INTESTINAL-PEPTIDE; SKIN BLOOD-FLOW; GENE-RELATED PEPTIDE; HUMAN SWEAT GLANDS; NITRIC-OXIDE; HUMAN FOREARM; VASCULAR-RESPONSES; SUBSTANCE-P; HUMANS; NERVES AB To test the hypothesis that cutaneous active vasodilation in heat stress is mediated by a redundant cholinergic cotransmitter system, we examined the effects of atropine on skin blood flow (SkBF) increases during heat stress in persons with (CF) and without cystic fibrosis (non-CF). Vasoactive intestinal peptide (VIP) has been implicated as a mediator of cutaneous vasodilation in heat stress. VIP-containing cutaneous neurons are sparse in CF, yet SkBF increases during heat stress are normal. In CF, augmented ACh release or muscarinic receptor sensitivity could compensate for decreased VIP; if so, active vasodilation would be attenuated by atropine in CF relative to non-CF. Atropine was administered into skin by iontophoresis in seven CF and seven matched non-CF subjects. SkBF was monitored by laser-Doppler flowmetry (LDF) at atropine treated and untreated sites. Blood pressure [mean arterial pressure (MAP)] was monitored (Finapres), and cutaneous vascular conductance was calculated (CVC = LDF/MAP). The protocol began with a normothermic period followed by a 3-min cold stress and 30 -45 min of heat stress. Finally, LDF sites were warmed to 42 C to effect maximal vasodilation. CVC was normalized to its site-specific maximum. During heat stress, CVC increased in both CF and non-CF (P < 0.01). CVC increases were attenuated by atropine in both groups (P < 0.01); however, the responses did not differ between groups (P = 0.99). We conclude that in CF there is not greater dependence on redundant cholinergic mechanisms for cutaneous active vasodilation than in non-CF. C1 Univ Texas, Hlth Sci Ctr, Div Geriatr & Gerontol, Dept Med, San Antonio, TX 78229 USA. Audie L Murphy Mem Vet Adm Med Ctr, S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78284 USA. Christ Santa Rosa Hosp, Adult Cyst Fibrosis Clin, San Antonio, TX USA. RP Kellogg, DL (reprint author), Univ Texas, Hlth Sci Ctr, Div Geriatr & Gerontol, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM kelloggd@uthscsa.edu FU NHLBI NIH HHS [HL-059166, HL-065599] NR 47 TC 6 Z9 6 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD SEP PY 2007 VL 103 IS 3 BP 963 EP 968 DI 10.1152/japplphysiol.00278.2007 PG 6 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 204OU UT WOS:000249054700032 PM 17600158 ER PT J AU Bischoff, MPS Sakamoto, T Makhijani, NS Gruber, HE Yamayuchi, DT AF Bischoff, Mice. P. S. Sakamoto, T. Makhijani, N. S. Gruber, H. E. Yamayuchi, D. T. TI Analysis of cranial defect healing in CXC receptor2 knock-out (CXCR2(-/-)) mice SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 29th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 16-19, 2007 CL Honolulu, HI SP Amer Soc Bone & Mineral Res C1 [Bischoff, Mice. P. S.; Sakamoto, T.; Makhijani, N. S.; Yamayuchi, D. T.] VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. [Gruber, H. E.] Carolinas Med Ctr, Charlotte, NC 28203 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2007 VL 22 SU 1 MA M276 BP S185 EP S185 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 225IA UT WOS:000250509101053 ER PT J AU Hidalgo, A Florea, J Roodman, GD Kurihara, N Onate, S AF Hidalgo, A. Florea, J. Roodman, G. D. Kurihara, N. Onate, S. TI Changes in VDR coregulator recruitment result in 1 alpha,25(OH)(2)D-3 hypersensitivity in MVNP expressing cells SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 29th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 16-19, 2007 CL Honolulu, HI SP Amer Soc Bone & Mineral Res C1 [Hidalgo, A.; Florea, J.; Onate, S.] Roswell Pk Canc Inst, Buffalo, NY 14263 USA. [Roodman, G. D.] Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15260 USA. [Kurihara, N.] Univ Pittsburgh, Pittsburgh, PA 15260 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2007 VL 22 SU 1 MA W152 BP S399 EP S399 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 225IA UT WOS:000250509102239 ER PT J AU Hiruma, Y Kurihara, N Subler, MA Zhou, H Dempster, DW Ishizuka, S Roodman, GD Windle, JJ AF Hiruma, Y. Kurihara, N. Subler, M. A. Zhou, H. Dempster, D. W. Ishizuka, S. Roodman, G. D. Windle, J. J. TI Mutations in p62 linked to Paget's disease make the bone microenvironment highly osteoclastogenic. SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 29th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 16-19, 2007 CL Honolulu, HI SP Amer Soc Bone & Mineral Res C1 [Hiruma, Y.; Kurihara, N.] Univ Pittsburgh, Pittsburgh, PA USA. [Subler, M. A.; Windle, J. J.] Virginia Commonwealth Univ, Richmond, VA USA. [Zhou, H.; Dempster, D. W.] Helen Hayes Hosp, Reg Bone Ctr, New York, NY USA. [Ishizuka, S.] Teijin Biomed Res, Tokyo, Japan. [Roodman, G. D.] Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2007 VL 22 SU 1 BP S132 EP S132 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 225IA UT WOS:000250509100484 ER PT J AU Kim, W Meliton, V Amantea, CM Hahn, TJ Parhami, F AF Kim, W. Meliton, V. Amantea, C. M. Hahn, T. J. Parhami, F. TI Hairy enhancer of split 1 (HES-1) is an anti-adipogenic mediator of osteogenic oxysterols and hedgehog signaling SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 29th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 16-19, 2007 CL Honolulu, HI SP Amer Soc Bone & Mineral Res C1 [Kim, W.; Meliton, V.; Amantea, C. M.; Parhami, F.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. [Hahn, T. J.] VA Greater Los Angeles Healthcare Syst & Geriatr, Ctr Clin, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2007 VL 22 SU 1 MA W043 BP S373 EP S373 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 225IA UT WOS:000250509102130 ER PT J AU Kurihara, N Hiruma, Y Yamana, K Rousseau, C Morissette, J Brown, JP Roodman, GD AF Kurihara, N. Hiruma, Y. Yamana, K. Rousseau, C. Morissette, J. Brown, J. P. Roodman, G. D. TI Measles virus nucleocapsid gene expression is required for abnormal osteoclast activity in Paget's disease of bone SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 29th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 16-19, 2007 CL Honolulu, HI SP Amer Soc Bone & Mineral Res C1 [Kurihara, N.; Hiruma, Y.] Univ Pittsburgh, Pittsburgh, PA USA. [Yamana, K.] Biomed Res, Tokyo, Japan. [Rousseau, C.; Morissette, J.; Brown, J. P.] Univ Laval, CHUL Res Ctr, Quebec City, PQ, Canada. [Roodman, G. D.] VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2007 VL 22 SU 1 MA 1152 BP S43 EP S43 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 225IA UT WOS:000250509100153 ER PT J AU Lu, G Patrene, K Garcia-Palacios, V Anderson, J Boykin, C Del Prete, D Windle, JJ Roodman, GD AF Lu, G. Patrene, K. Garcia-Palacios, V. Anderson, J. Boykin, C. Del Prete, D. Windle, J. J. Roodman, G. D. TI ADAM8 binds alpha(9)beta(1) to increase OCL formation and function by interacting with pyk2 and activating paxillin SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 29th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 16-19, 2007 CL Honolulu, HI SP Amer Soc Bone & Mineral Res C1 [Lu, G.; Patrene, K.; Garcia-Palacios, V.; Anderson, J.] Univ Pittsburgh, Pittsburgh, PA 15260 USA. [Boykin, C.; Windle, J. J.] Virginia Commonwealth Univ, Richmond, VA 23284 USA. [Del Prete, D.] Univ Bari, Sch Med, Bari, Italy. [Roodman, G. D.] Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15260 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU AMER SOC BONE & MINERAL RES PI WASHINGTON PA 2025 M ST, N W, STE 800, WASHINGTON, DC 20036-3309 USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2007 VL 22 SU 1 MA 1099 BP S29 EP S29 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 225IA UT WOS:000250509100100 ER PT J AU Sarmasik, A Hiruma, Y Okumura, S Brown, JP Windle, JJ Roodman, GD Kurihara, N Galson, DL AF Sarmasik, A. Hiruma, Y. Okumura, S. Brown, J. P. Windle, J. J. Roodman, G. D. Kurihara, N. Galson, D. L. TI Measles virus nucleoprotein (MVNP) enhances NFATc1 activation during osteoclastogenesis in Paget's disease SO JOURNAL OF BONE AND MINERAL RESEARCH LA English DT Meeting Abstract CT 29th Annual Meeting of the American-Society-for-Bone-and-Mineral-Research CY SEP 16-19, 2007 CL Honolulu, HI SP Amer Soc Bone & Mineral Res C1 [Sarmasik, A.; Hiruma, Y.; Okumura, S.; Kurihara, N.; Galson, D. L.] Univ Pittsburgh, Ctr Bone Biol, Dept Med, Pittsburgh, PA 15260 USA. [Brown, J. P.] Univ Laval, CHUL Res Ctr, Quebec City, PQ G1K 7P4, Canada. [Windle, J. J.] Virginia Commonwealth Univ, Richmond, VA 23284 USA. [Roodman, G. D.] Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15260 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0884-0431 J9 J BONE MINER RES JI J. Bone Miner. Res. PD SEP PY 2007 VL 22 SU 1 BP S221 EP S221 PG 1 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 225IA UT WOS:000250509101184 ER PT J AU Shah, AP Ichiuji, AM Han, JK Traina, M El-Bialy, A Meymandi, SK Wachsner, RY AF Shah, Atman Prabodh Ichiuji, Anne Marie Han, Janet K. Traina, Mahmoud El-Bialy, Adel Meymandi, Sheba Kamal Wachsner, Robin Yvonne TI Cardiovascular and endothelial effects of fish oil supplementation in healthy volunteers SO JOURNAL OF CARDIOVASCULAR PHARMACOLOGY AND THERAPEUTICS LA English DT Article DE endothelium; fish oil; hemodynamics ID POLYUNSATURATED FATTY-ACIDS; FLOW-MEDIATED VASODILATION; MYOCARDIAL-INFARCTION; DIETARY SUPPLEMENTATION; EICOSAPENTAENOIC ACID; SUDDEN-DEATH; DOUBLE-BLIND; HEART-RATE; DOCOSAHEXAENOIC ACID; CONTROLLED TRIAL AB Consumption of fish oil (FO) is associated with reduced adverse cardiovascular events. In a randomized, blinded, placebo-controlled trial, 26 subjects (17 men and 9 women; mean age [ +/- SD] 31 +/- 3.7 years) received 1 g FO capsule (n = 14) or placebo (1 g of corn oil, n = 12) for 14 days. At day 0 and day 14, heart rate (HR), blood pressure, endothelium-dependent brachial artery flow-mediated vasodilation (EDV), and endothelium-independent nitroglycerin-mediated vasodilation (EIDV) were assessed with ultrasound. FO supplementation resulted in a significant increase in EDV (20.4% +/- 13.2% vs 9.9% +/- 5.4%; P = .036) and EIDV (32.6% +/- 16.8% vs 18.0% +/- 14.9%; P = .043 ). Resting HR decreased by a mean of 5.9 +/- 9.4 bpm (FO) compared with placebo (mean increase of 0.73 +/- 4.8 bpm [P = .05]). FO supplementation in healthy subjects is associated with improved endothelial function and decreased resting HR. C1 Univ Calif Los Angeles, David Geffen Sch Med, Harbor UCLA Med Ctr, St Johns Cardiovasc Res Ctr, Torrance, CA 90502 USA. Univ Calif Los Angeles, Olive View Med Ctr Sylmar, Los Angeles, CA USA. Greater Los Angeles VA Healthcare, Los Angeles, CA USA. Kaiser Permanente Med Ctr, Div Cardiol, Los Angeles, CA 90034 USA. RP Shah, AP (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Harbor UCLA Med Ctr, St Johns Cardiovasc Res Ctr, 1124 W Carson Ave,3rd Floor, Torrance, CA 90502 USA. EM apshah73@yahoo.com NR 40 TC 32 Z9 33 U1 0 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1074-2484 J9 J CARDIOVASC PHARM T JI J. Cardiovasc. Pharmacol. Ther. PD SEP PY 2007 VL 12 IS 3 BP 213 EP 219 DI 10.1177/1074248407304749 PG 7 WC Cardiac & Cardiovascular Systems; Pharmacology & Pharmacy SC Cardiovascular System & Cardiology; Pharmacology & Pharmacy GA 203EV UT WOS:000248958800005 PM 17875948 ER PT J AU Jeanne, BH Oberley, TD AF Bourdeau-Heller, Jeanne Oberley, Terry D. TI Prostate carcinoma cells selected by long-term exposure to reduce oxygen tension show remarkable biochemical plasticity via modulation of superoxide, HIF-l alpha levels, and energy metabolism SO JOURNAL OF CELLULAR PHYSIOLOGY LA English DT Article ID HYPOXIA-INDUCIBLE FACTOR-1-ALPHA; OXIDATIVE-PHOSPHORYLATION; CANCER-CELLS; COMPLEX-III; MITOCHONDRIA; INHIBITION; GLYCOLYSIS; PATHWAY; ADAPTATION; DISMUTASE AB Cancer cells are able to tolerate levels Of O-2 that are damaging or lethal to normal cells; we hypothesize that this tolerance is the result of biochemical plasticity which maintains cellular homeostasis of both energy levels and oxidation state. In order to examine this hypothesis, we used different 02 levels as a selective agent during long-term culture of DU 145 prostate cancer cells to develop three isogenic cell lines that grow in normoxic (4%), hyperoxic (2 1 %), or hypoxic (I %) 02 conditions. Growth characteristics and 02 consumption differed significantly between these cell lines without changes in ATP levels or altered sensitivity to 2-deoxy-D-glucose, an inhibitor of glycolysis. 02 consumption was significantly higher in the hyperoxic line as was the level of endogenous superoxide. The hypoxic cell line regulated the chemical gradient of the proton motive force (PMF) independent of the electrical component without O-2-dependent changes in Hif- I a levels. In contrast, the normoxic line regulated Hif- I alpha without tight regulation of the chemical component of the PMF noted in the hypoxic cell line. From these studies, we conclude that selection of prostate cancer cells by long-term exposure to low ambient levels Of 02 resulted in cells with unique biochemical properties in which energy metabolism, reactive oxygen species (ROS), and HIF- I alpha levels are modulated to allow cell survival and growth. Thus, cancer cells exhibit remarkable biochemical plasticity in response to various O-2 levels. C1 Univ Wisconsin, Sch Med & Publ Hlth, Madison, WI 53706 USA. William S Middleton Mem Vet Adm Med Ctr, Pathol & Lab Med Serv, Madison, WI USA. RP Oberley, TD (reprint author), William S Middleton Mem Vet Adm Med Ctr, Dept Pathol, 2500 Overlook Terrace, Madison, WI 53705 USA. EM toberley@wisc.edu NR 50 TC 0 Z9 0 U1 0 U2 2 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0021-9541 J9 J CELL PHYSIOL JI J. Cell. Physiol. PD SEP PY 2007 VL 212 IS 3 BP 744 EP 752 DI 10.1002/jcp.21069 PG 9 WC Cell Biology; Physiology SC Cell Biology; Physiology GA 200NQ UT WOS:000248770500022 ER PT J AU Matioc, AA Lopukhin, O AF Matioc, Adrian A. Lopukhin, Olga TI The Airtraq to facilitate endotracheal tube exchange in a critically ill, difficult-to-intubate patiently SO JOURNAL OF CLINICAL ANESTHESIA LA English DT Letter ID TRACHEAL INTUBATION; MACINTOSH LARYNGOSCOPE C1 Univ Wisconsin Hosp & Clin, Madison, WI 53792 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI 53705 USA. RP Matioc, AA (reprint author), Univ Wisconsin Hosp & Clin, Madison, WI 53792 USA. EM adrian.matioc@va.gov NR 5 TC 5 Z9 5 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0952-8180 J9 J CLIN ANESTH JI J. Clin. Anesth. PD SEP PY 2007 VL 19 IS 6 BP 485 EP 486 DI 10.1016/j.jclinane.2007.03.008 PG 2 WC Anesthesiology SC Anesthesiology GA 229PX UT WOS:000250817600020 PM 17967685 ER PT J AU Hennessy, S Bilker, WB Leonard, CE Chittams, J Palumbo, CM Karlawish, JH Yang, YX Lautenbach, E Baine, WB Metlay, JP AF Hennessy, Sean Bilker, Warren B. Leonard, Charles E. Chittams, Jesse Palumbo, Cristin M. Karlawish, Jason H. Yang, Yu-Xiao Lautenbach, Ebbing Baine, William B. Metlay, Joshua P. TI Observed association between antidepressant use and pneumonia risk was confounded by comorbidity measures SO JOURNAL OF CLINICAL EPIDEMIOLOGY LA English DT Article DE aged; antidepressive agents; pneumonia; pneumonia; aspiration; pharmacoepidemiology; confounding factors ID COMMUNITY-ACQUIRED PNEUMONIA; ASPIRATION PNEUMONIA; TRENDS; ADULTS; OLDER AB Objective: A prior study suggested that antidepressants might increase the risk of hospitalization for pneumonia in the elderly. This study sought to confirm or refute this hypothesis. Study Design and Setting: Case-control study of persons aged 65 and above nested in the UK General Practice Research Database. Results: We identified 12,044 cases of the hospitalization for pneumonia (the primary outcome) and 48,176 controls. The odds ratio (OR) for any antidepressant use, adjusting for age, sex, and calendar year was 1.61 (95% confidence interval 1.46-1.78). After further adjustment for comorbidity measures, the OR was 0.89 (0.79-1.00). We also identified 159 cases of hospitalization for aspiration pneumonia (the secondary outcome) and 636 controls. The OR for any antidepressant use, adjusted for age, sex, and calendar year was 1.45 (0.65-3.24). After further adjustment for comorbidity measures, the OR was 0.63 (0.23-1.71). Conclusion: These findings refute the prior hypothesis that use of antidepressants by elderly patients increases the risk of hospitalization for pneumonia or for aspiration pneumonia. Decisions regarding use of antidepressants in elderly persons should not be affected by concern about pneumonia risk. Data-derived hypotheses should be independently confirmed before being acted upon. (c) 2007 Elsevier Inc. All rights reserved. C1 Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Developing Evidence Inform Decis Effectiveness Ct, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Ctr Educ & Res Therapeut, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Dept Med, Philadelphia, PA 19104 USA. US Dept HHS, Agcy Healthcare Res & Qual, Ctr Outcomes & Evidence, Rockville, MD 20852 USA. Dept Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Hennessy, S (reprint author), 824 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM shenness@cceb.med.upenn.edu RI Leonard, Charles/K-3447-2012; Research Datalink, Clinical Practice/H-2477-2013; CPRD, CPRD/B-9594-2017 FU NIA NIH HHS [K23AG000987, K23 AG000987, K23 AG000987-01A1, K23 AG000987-02, K23 AG000987-03, K23 AG000987-04, K23 AG000987-05]; NIDDK NIH HHS [K08 DK062978, K08 DK062978-01A1, K08 DK062978-02, K08 DK062978-03, K08 DK062978-04, K08 DK062978-05, K08DK062978] NR 17 TC 10 Z9 10 U1 0 U2 0 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0895-4356 J9 J CLIN EPIDEMIOL JI J. Clin. Epidemiol. PD SEP PY 2007 VL 60 IS 9 BP 911 EP 918 DI 10.1016/j.jclinepi.2006.11.022 PG 8 WC Health Care Sciences & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 202VI UT WOS:000248931700007 PM 17689807 ER PT J AU Singal, AK Anand, BS AF Singal, Ashwani K. Anand, Bhupinder S. TI Mechanisms of synergy between alcohol and hepatitis C virus SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Review DE hepatitis C virus; alcohol; synergism; oxidative stress; abstinence ID SYMPTOMATIC LIVER-CIRRHOSIS; INJECTION-DRUG USERS; HEPATOCELLULAR-CARCINOMA; RISK-FACTORS; INTERFERON THERAPY; INFECTED PATIENTS; OXIDATIVE STRESS; CLINICAL-SIGNIFICANCE; FIBROSIS PROGRESSION; HIV-INFECTION AB Background: Since the discovery of the hepatitis C virus (HCV), extensive literature has emerged on alcohol and HCV interaction. Goal: To understand the impact of alcohol and HCV infection on the severity of liver disease and the mechanisms of interaction between the two. Study: Of 1269 articles (1991 to 2006) searched through MEDLINE and cited cross references, 133 were thoroughly reviewed to assess: (a) prevalence of combined alcohol use and HCV, (b) severity of liver disease (c) treatment response, and (d) mechanisms of interaction between HCV and alcohol. Data on study design, patient demographics, diagnostic tests used, and study outcomes were extracted for critical analysis. Results: Prevalence of HCV is Mold to 30-fold higher in alcoholics compared with the general population. Patients with HCV infection and alcohol abuse develop more severe fibrosis with higher rate of cirrhosis and hepatocellular cancer compared with nondrinkers. Increased oxidative stress seems to be the dominant mechanism for this synergism between alcohol and the HCV. Abstinence is the key to the management of liver disease due to HCV and alcohol. Data have shown that lower response rates to interferon in alcoholics with HCV infection are likely due to noncompliance. Conclusions: Alcoholics with HCV infection have more severe liver disease compared with nondrinkers. Patients should be encouraged to enroll in rehabilitation programs so as to improve treatment adherence and response. C1 James J Peters VA Med Ctr, Dept Med, Bronx, NY 10468 USA. CUNY Mt Sinai Sch Med, James J Peters Bronx Vet Affairs Med CTr, New York, NY 10029 USA. Baylor Coll Med, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. RP Singal, AK (reprint author), James J Peters VA Med Ctr, Dept Med, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM ashwanisingal.com@gmail.com NR 131 TC 64 Z9 65 U1 0 U2 8 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD SEP PY 2007 VL 41 IS 8 BP 761 EP 772 DI 10.1097/MCG.0b013e3180381584 PG 12 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 205SN UT WOS:000249135000007 PM 17700425 ER PT J AU Davila, JA Weston, A Smalley, W El-Serag, HB AF Davila, Jessica A. Weston, Allan Smalley, Walter El-Serag, Hashem B. TI Utilization of screening for hepatocellular carcinoma in the United States SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Article DE tomography; hepatocelluar carcinoma ID CIRRHOTIC-PATIENTS; PATIENT SURVIVAL; SURVEILLANCE; CANCER; EXPERIENCE; MANAGEMENT; HEPATITIS AB Background: Screening for hepatocellular carcinoma (HCC) has been recommended for patients at high-risk of developing HCC. Yet, the utilization and determinants of screening remain unclear. Methods: All patients diagnosed with HCC at 3 medical centers during 1998 to 2003 were identified. Information regarding receipt of HCC screening, demographics, risk factors, liver disease severity, number of HCC lesions, therapy, and date of death was abstracted from medical records. Multivariable logistic regression models were conducted to evaluate determinants of HCC screening and therapy. Cox proportional hazards models were developed to assess the effect of screening on risk of mortality. Results: We identified 157 patients diagnosed with HCC. The majority of patients were < 65 years (62%), white (59%), had a single mass (42%), and a Child-Pugh-Turcotte score B (41%). Approximately, 28% (n = 44) received at least one possible screening test (36% alpha-fetoprotein only, 23% abdominal ultrasound only. 7% computed tomography only; 34% had more than one test). Screened patients were younger [odds ratio (OR) = 2.70; 95% confidence interval (CI): 1.22-5.99) and were more likely to have underlying HCV (OR = 2.91; 95% CI: 1.36-6.23), or alcoholic liver disease (OR = 4.20; 95% CI: 1.89-9.35). The only predictors of receipt of therapy were presentation at tumor board conference (OR = 2.85; 95% CI: 1.42-5.72) and documented referral to oncology (OR = 2.33; 95% CI: 1.10-4.94). Conclusions: Less than one-third of patients who were diagnosed with HCC received screening before their diagnosis, and of those a large proportion received ail alpha-fetoprotein test only. In this study. the use of screening was too suboptimal to be expected to affect outcomes. C1 Michael E DeBakey VA Med Ctr, Houston, TX 77030 USA. Houston Vet Affairs Med Ctr, Sect Hlth Serv Res, Houston, TX USA. Houston Vet Affairs Med Ctr, Gastroenterol Sect, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Kansas City Vet Affairs Med Ctr, Gastroenterol Sect, Kansas City, KS USA. Tennessee Valley Vet Affairs Med Ctr, Gastroenterol Sect, Nashville, TN USA. Vanderbilt Univ, Nashville, TN USA. RP Davila, JA (reprint author), Michael E DeBakey VA Med Ctr, 2002 Holcombe Blvd 152, Houston, TX 77030 USA. EM jdavila@bcm.tmc.edu NR 18 TC 64 Z9 64 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD SEP PY 2007 VL 41 IS 8 BP 777 EP 782 DI 10.1097/MCG.0b013e3180381560 PG 6 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 205SN UT WOS:000249135000009 PM 17700427 ER PT J AU Lang, JD Teng, X Churnley, P Crawford, JH Isbell, TS Chacko, BK Liu, Y Jhala, N Crowe, DR Smith, AB Cross, RC Frenette, L Kelley, EE Wilhite, DW Hall, CR Page, GP Fallon, MB Bynon, JS Eckhoff, DE Patel, RP AF Lang, John D., Jr. Teng, Xinjun Churnley, Phillip Crawford, Jack H. Isbell, T. Scott Chacko, Balu K. Liu, Yuliang Jhala, Nirag Crowe, D. Ralph Smith, Alvin B. Cross, Richard C. Frenette, Luc Kelley, Eric E. Wilhite, Diana W. Hall, Cheryl R. Page, Grier P. Fallon, Michael B. Bynon, J. Steven Eckhoff, Devin E. Patel, Rakesh P. TI Inhaled NO accelerates restoration of liver function in adults following orthotopic liver transplantation SO JOURNAL OF CLINICAL INVESTIGATION LA English DT Article ID ISCHEMIA-REPERFUSION INJURY; NITRIC-OXIDE GENERATION; ISCHEMIA/REPERFUSION INJURY; ANOXIC TISSUES; BLOOD-FLOW; IN-VIVO; CELL; HEMOGLOBIN; REDUCTION; KINETICS AB Ischemia/reperfusion (IR) injury in transplanted livers contributes to organ dysfunction and failure and is characterized in part by loss of NO bioavailability. Inhalation of NO is nontoxic and at high concentrations (80 ppm) inhibits IR injury in extrapulmonary tissues. In this prospective, blinded, placebo-controned study, we evaluated the hypothesis that administration of inhaled NO (iNO; 80 ppm) to patients undergoing orthotopic liver transplantation inhibits hepatic IR injury, resulting in improved liver function. Patients were randomized to receive either placebo or iNO (n = 10 per group) during the operative period only. When results were adjusted for cold ischemia time and sex, iNO significantly decreased hospital length of stay, and evaluation of serum transaminases (alanine transaminase, aspartate aminotransferase) and coagulation times (prothrombin time, partial thromboplastin time) indicated that iNO improved the rate at which liver function was restored after transplantation. iNO did not significantly affect changes in inflammatory markers in liver tissue 1 hour after reperfusion but significantly lowered hepatocyte apoptosis. Evaluation of circulating NO metabolites indicated that the most likely candidate transducer of extrapulmonary effects of iNO was nitrite. In summary, this study supports the clinical use of iNO as an extrapulmonary therapeutic to improve organ function following transplantation. C1 Univ Washington, Sch Med, Dept Anesthesiol, Seattle, WA 98195 USA. Univ Birmingham, Dept Pathol, Birmingham, AL USA. Univ Birmingham, Dept Anesthesiol, Birmingham, AL USA. Univ Pittsburgh, Sch Med, Dept Anesthesiol, Pittsburgh, PA 15260 USA. Univ Alabama, Dept Biostat, Birmingham, AL USA. Univ Alabama, Dept Med, Birmingham, AL USA. Univ Alabama, Dept Surg, Birmingham, AL USA. Univ Alabama, Ctr Free Rad Biol, Birmingham, AL USA. RP Patel, RP (reprint author), Univ Washington, VA Puget Sound Hlth Care Syst, Dept Anesthesiol, 1660 S Columbian Way, Seattle, WA 98108 USA. EM rakeshp@uab.edu OI Isbell, Timothy/0000-0003-0979-0582; Patel, Rakesh/0000-0002-1526-4303 NR 41 TC 125 Z9 128 U1 0 U2 3 PU AMER SOC CLINICAL INVESTIGATION INC PI ANN ARBOR PA 35 RESEARCH DR, STE 300, ANN ARBOR, MI 48103 USA SN 0021-9738 J9 J CLIN INVEST JI J. Clin. Invest. PD SEP PY 2007 VL 117 IS 9 BP 2583 EP 2591 DI 10.1172/JCI31892 PG 9 WC Medicine, Research & Experimental SC Research & Experimental Medicine GA 209JK UT WOS:000249384600029 PM 17717604 ER PT J AU Citron, DM Goldstein, EJC Merriam, CV Lipsky, BA Abramson, MA AF Citron, Diane M. Goldstein, Ellie J. C. Merriam, C. Vreni Lipsky, Benjamin A. Abramson, Murray A. TI Bacteriology of moderate-to-severe diabetic foot infections and in vitro activity of antimicrobial agents SO JOURNAL OF CLINICAL MICROBIOLOGY LA English DT Article ID COAGULASE-NEGATIVE STAPHYLOCOCCI; VERTEBRAL OSTEOMYELITIS; SWAB CULTURES; RISK-FACTORS; SUSCEPTIBILITY; ULCERS; LUGDUNENSIS; PREVALENCE; MANAGEMENT; RESISTANCE AB As part of a United States-based multicenter clinical trial, conducted from 2001 to 2004, that compared ertapenern to piperacillin-tazobactam for the treatment of moderate-to-severe diabetic foot infections (DFIs), we obtained 454 pretreatment specimens from 433 patients. After debridement, the investigators collected wound specimens, mostly by curettage or biopsy, and sent them to the R. M. Alden Research Laboratory for aerobic and anaerobic culture. Among the 427 positive cultures, 83.8% were polymicrobial, 48% grew only aerobes, 43.7% had both aerobes and anaerobes, and 1.3% had only anaerobes. Cultures yielded a total of 1,145 aerobic strains and 462 anaerobic strains, with an average of 2.7 organisms per culture (range, I to 8) for aerobes and 2.3 organisms per culture (range, I to 9) for anaerobes. The predominant aerobic organisms were oxacillin-susceptible Staphylococcus aureus (14.3%), oxacillin-resistant Staphylococcus aureus (4.4%), coagulase-negative Staphylococcus species (15.3%), Streptococcus species (15.5%), Enterococcus species (13.5%), Corynebacterium species (10.1%), members of the family Enterobacteriaceae (12.8%), and Pseudonumas aeruginosa (3.5%). The predominant anaerobes were gram-positive cocci (45.2%), Prevotella species (13.6%), Porphyromonas species (11.3%), and the Bacteroides fragilis group (10.2%). Pure cultures were noted for 20% of oxacillin-resistant Staphylococcus aureus cultures, 9.2% of Staphylococcus epidermidis cultures, and 2.5% of P. aeruginosa cultures. Two or more species of Staphylococcus were present in 13.1% of the patients. Ertapenem and piperacillin-tazobactam were each active against > 98% of the enteric gram-negative rods, methicillin-sensitive S. aureus, and anaerobes. Among the fluoroquinolones, 24% of anaerobes, especially the gram-positive cocci, were resistant to moxifloxacin; 27% of the gram-positive aerobes but only 6% of the members of the family Enterobacteriaceae were resistant to levofloxacin. Moderate-to-severe DFIs are typically polymicrobial, and almost half include anaerobes. Our antibiotic susceptibility results can help to inform therapeutic choices. C1 RM Alden Res Lab, Santa Monica, CA 90404 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Univ Washington, Sch Med, Seattle, WA USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Merck & Co Inc, Merck Res Labs, West Point, PA USA. RP Citron, DM (reprint author), RM Alden Res Lab, 2001 Santa Monica Blvd,Suite 685W, Santa Monica, CA 90404 USA. EM d.m.citron@verizon.net RI Lipsky, Benjamin/B-4645-2013 OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 56 TC 118 Z9 129 U1 0 U2 3 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0095-1137 J9 J CLIN MICROBIOL JI J. Clin. Microbiol. PD SEP PY 2007 VL 45 IS 9 BP 2819 EP 2828 DI 10.1128/JCM.00551-07 PG 10 WC Microbiology SC Microbiology GA 211EK UT WOS:000249506900011 PM 17609322 ER PT J AU Shah, AP Rubin, SA AF Shah, Atman P. Rubin, Stanley A. TI Errors in the computerized electrocardiogram interpretation of cardiac rhythm SO JOURNAL OF ELECTROCARDIOLOGY LA English DT Article ID ATRIAL-FIBRILLATION; MISDIAGNOSIS; ARRHYTHMIA; DIAGNOSIS; ECG AB Background: More than 100 million computer-interpreted electrocardiograms (ECG-C) are obtained annually. However, there are few contemporary published data on the accuracy of cardiac rhythm interpretation by this method. Purpose: The purpose of this study is to determine the accuracy of ECG-C rhythm interpretation in a typical patient population. Methods: We compared the ECG-C rhythm interpretation to that of 2 expert overreaders in 2112 randomly selected standard 12-lead ECGs. Results: The ECG-C Correctly interpreted the rhythm in 1858 and incorrectly identified the rhythm in 254 (overall accuracy, 88.0%). Sinus rhythm was correctly interpreted in 95.0% of the ECGs (1666/1753) with this rhythm, whereas nonsinus rhythms were correctly interpreted with an accuracy of only 53.5% (192/359) (P < .0001). The ECG-C interpreted sinus rhythm with a sensitivity of 95% (confidence interval, 93.8-96.7), specificity of 66.3%, and positive predictive value of 93.2%. The ECG-C interpreted nonsinus rhythms with a sensitivity of 72%, (confidence interval, 68.7-73.7), a specificity of 93%, and a positive predictive value of 59.3%. Of the 254 ECGs that had incorrect rhythm interpretation, additional major errors were noted in 137 (54%). Conclusions: The ECG-C demonstrates frequent errors in the interpretation of nonsinus rhythms. In addition, incorrect rhythm interpretation by the ECG-C was frequently further compounded by additional major inaccuracies. Expert overreading of the ECG remains important in clinical settings with a high percentage of nonsinus rhythms. Published by Elsevier Inc. C1 Univ Calif Los Angeles, Sch Med, Div Cardiol 111 E, VA Greater Los Angeles, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90073 USA. RP Rubin, SA (reprint author), Univ Calif Los Angeles, Sch Med, Div Cardiol 111 E, VA Greater Los Angeles, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM sarubin@ucla.edu NR 21 TC 10 Z9 10 U1 0 U2 2 PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS PI PHILADELPHIA PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA SN 0022-0736 EI 1532-8430 J9 J ELECTROCARDIOL JI J. Electrocardiol. PD SEP-OCT PY 2007 VL 40 IS 5 BP 385 EP 390 DI 10.1016/j.jelectrocard.2007.03.008 PG 6 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 211EU UT WOS:000249507900001 PM 17531257 ER PT J AU Parker, CS Chen, Z Price, M Gross, R Metlay, JP Christie, JD Brensinger, CM Newcomb, CW Samaha, FF Kimmel, SE AF Parker, Catherine S. Chen, Zhen Price, Maureen Gross, Robert Metlay, Joshua P. Christie, Jason D. Brensinger, Colleen M. Newcomb, Craig W. Samaha, Frederick F. Kimmel, Stephen E. TI Adherence to warfarin assessed by electronic pill caps, clinician assessment, and patient reports: Results from the IN-RANGE study SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE patient adherence; warfarin; medication event monitoring system ID ANTICOAGULATION-CONTROL; ORAL ANTICOAGULANTS; ATRIAL-FIBRILLATION; DRUG-THERAPY; MEDICATION; PHYSICIANS; MANAGEMENT; OUTCOMES; TRIAL AB Background: Patient adherence to warfarin may influence anticoagulation control; yet, adherence among warfarin users has not been rigorously studied. Objective: Our goal was to quantify warfarin adherence over time and to compare electronic medication event monitoring systems (MEMS) cap measurements with both self-report and clinician assessment of patient adherence. Design: We performed a prospective cohort study of warfarin users at 3 Pennsylvania-based anticoagulation clinics and assessed pill-taking behaviors using MEMS caps, patient reports, and clinician assessments. Results: Among 145 participants, the mean percent of days of nonadherence by MEMS was 21.8% (standard deviation +/- 21.1%). Participants were about 6 times more likely to take too few pills than to take extra pills (18.8 vs. 3.3%). Adherence changed over time, initially worsening over the first 6 months of monitoring, which was followed by improvement beyond 6 months. Although clinicians were statistically better than chance at correctly labeling a participant's adherence (odds ratio=2.05, p=0.015), their estimates often did not correlate with MEMS-cap data; clinicians judged participants to be "adherent" at 82.8% of visits that were categorized as moderately nonadherent using MEMS-cap data (>= 20% nonadherence days). Similarly, at visits when participants were moderately nonadherent by MEMS, they self-reported perfect adherence 77.9% of the time. Conclusions: These results suggest that patients may benefit from adherence counseling even when they claim to be taking their warfarin or the clinician feels they are doing so, particularly several months into their course of therapy. C1 Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Div Infect Dis, Philadelphia, PA 19104 USA. Vet Affairs Med Ctr, Dept Med, Philadelphia, PA USA. Vet Affairs Med Ctr, Div Cardiovasc, Philadelphia, PA USA. Hosp Univ Penn, Philadelphia, PA 19104 USA. RP Kimmel, SE (reprint author), Univ Penn, Sch Med, Ctr Clin Epidemiol & Biostat, 717 Blockley Hall,432 Guardian Dr, Philadelphia, PA 19104 USA. EM skimmel@cceb.med.upenn.edu FU AHRQ HHS [P01 HS011530, P01-HS11530]; NCRR NIH HHS [P20 RR020741, P20RR020741]; NHLBI NIH HHS [R01 HL066176, R01-HL66176] NR 19 TC 57 Z9 57 U1 0 U2 3 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD SEP PY 2007 VL 22 IS 9 BP 1254 EP 1259 DI 10.1007/s11606-007-0233-1 PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 201EQ UT WOS:000248814700005 PM 17587092 ER PT J AU Vig, EK Starks, H Taylor, JS Hopley, EK Fryer-Edwards, K AF Vig, Elizabeth K. Starks, Helene Taylor, Janelle S. Hopley, Elizabeth K. Fryer-Edwards, Kelly TI Surviving surrogate decision-making: What helps and hampers the experience of making medical decisions for others SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 29th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 27-29, 2006 CL Los Angeles, CA SP Soc Gen Internal Med DE surrogate decision-making; advance care planning; substituted judgment; qualitative research ID OF-LIFE DECISIONS; MENTAL STATUS QUESTIONNAIRE; INTENSIVE-CARE-UNIT; SUBSTITUTED JUDGMENT; ADVANCE DIRECTIVES; INFORMATION NEEDS; ELDERLY PATIENTS; FAMILY-MEMBERS; HEALTH-CARE; END AB Background: A majority of end-of-life medical decisions are made by surrogate decision-makers who have varying degrees of preparation and comfort with their role. Having a seriously ill family member is stressful for surrogates. Moreover, most clinicians have had little training in working effectively with surrogates. Objectives:To better understand the challenges of decision-making from the surrogate's perspective. Design: Semistructured telephone interview study of the experience of surrogate decision-making. Participants: Fifty designated surrogates with previous decision-making experience. Approach: We asked surrogates to describe and reflect on their experience of making medical decisions for others. After coding transcripts, we conducted a content analysis to identify and categorize factors that made decision-making more or less difficult for surrogates. Results: Surrogates identified four types of factors: (1) surrogate characteristics and life circumstances (such as coping strategies and competing responsibilities), (2) surrogates' social networks (such as intrafamily discord about the "right" decision), (3) surrogate-patient relationships and communication (such as difficulties with honoring known preferences), and (4) surrogate-clinician communication and relationship (such as interacting with a single physician whom the surrogate recognizes as the clinical spokesperson vs. many clinicians). Conclusions: These data provide insights into the challenges that surrogates encounter when making decisions for loved ones and indicate areas where clinicians could intervene to facilitate the process of surrogate decision-making. Clinicians may want to include surrogates in advance care planning prior to decision-making, identify and address surrogate stressors during decision-making, and designate one person to communicate information about the patient's condition, prognosis, and treatment options. C1 Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Washington, Div Gerontol & Geriatr, Seattle, WA 98195 USA. Univ Washington, Dept Med Hist & Eth, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Anthropol, Seattle, WA 98195 USA. RP Vig, EK (reprint author), Vet Affairs Puget Sound Hlth Care Syst, 1660 S Columbian Way S-182 Eth, Seattle, WA 98108 USA. EM vigster@u.washington.edu FU NIA NIH HHS [K23 AG019635, K23 AG19635] NR 39 TC 84 Z9 84 U1 1 U2 9 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD SEP PY 2007 VL 22 IS 9 BP 1274 EP 1279 DI 10.1007/s11606-007-0252-y PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 201EQ UT WOS:000248814700008 PM 17619223 ER PT J AU Givens, JL Katz, IR Bellamy, S Holmes, WC AF Givens, Jane L. Katz, Ira R. Bellamy, Scarlett Holmes, William C. TI Stigma and the acceptability of depression treatments among African Americans and whites SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 29th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 27-29, 2006 CL Los Angeles, CA SP Soc Gen Internal Med DE stigma; depression treatment; patient preferences; ethnicity ID PRIMARY-CARE PATIENTS; MENTAL-HEALTH-SERVICES; TREATMENT PREFERENCES; PERCEIVED STIGMA; DISORDERS; REJECTION; ATTITUDES; SEVERITY; ILLNESS; HELP AB Background: Stigma is associated with depression treatment, however, whether stigma differs between depression treatment modalities is not known, nor have racial differences in depression treatment stigma been fully explored. Objective: To measure stigma for four depression treatments and estimate its association with treatment acceptability for African Americans and whites. Design: Cross-sectional, anonymous mailed survey. Pariticpants: Four hundred and ninety African-American and white primary care patients. Measurements: The acceptability of four depression treatments (prescription medication, mental health counseling, herbal remedy, and spiritual counseling) was assessed using a vignette. Treatment-specific stigma was evaluated by asking whether participants would: (1) feel ashamed; (2) feel comfortable telling friends and family; (3) feel okay if people in their community knew; and (4) not want people at work to know about each depression treatment. Sociodemographics, depression history, and current depressive symptoms were measured. Results: Treatment-specific stigma was lower for herbal remedy than prescription medication or mental health counseling (p <.01). Whites had higher stigma than African Americans for all treatment modalities. In adjusted analyses, stigma relating to self [AOR 0.43 (0.20-0.95)] and friends and family [AOR 0.42 (0.21-0.88)] was associated with lower acceptability of mental health counseling. Stigma did not account for the lower acceptability of prescription medication among African Americans. COnclusions: Treatment associated stigma significantly affects the acceptability of mental health counseling but not prescription medication. Efforts to improve depression treatment utilization might benefit from addressing concerns about stigma of mental health counseling. C1 Boston Univ, Med Ctr, Geriat Sect, Boston, MA 02118 USA. Univ Penn, Dept Psychiat, Sect Geriatr Psychiat, Philadelphia, PA 19104 USA. Philadelphia Vet Adm Med Ctr, Ctr Hlth Equ Res & Promot, Philadelphia, PA USA. Univ Penn, Div Gen Internal Med, Philadelphia, PA 19104 USA. Univ Penn, Ctr Clin Epidemiol & Biostat, Philadelphia, PA 19104 USA. RP Givens, JL (reprint author), 88 E Newton St,Robinson 2,Room 2702, Boston, MA 02118 USA. EM jane.givens@bmc.org NR 34 TC 51 Z9 53 U1 5 U2 16 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD SEP PY 2007 VL 22 IS 9 BP 1292 EP 1297 DI 10.1007/s11606-007-0276-3 PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 201EQ UT WOS:000248814700011 PM 17610120 ER PT J AU Shrank, WH Stedman, M Ettner, SL DeLapp, D Dirstine, J Brookhart, MA Fischer, MA Avorn, J Asch, SM AF Shrank, William H. Stedman, Margaret Ettner, Susan L. DeLapp, Dee Dirstine, June Brookhart, M. Alan Fischer, Michael A. Avorn, Jerry Asch, Steven M. TI Patient, physician, pharmacy, and pharmacy benefit design factors related to generic medication use SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article; Proceedings Paper CT 29th Annual Meeting of the Society-of-General-Internal-Medicine CY APR 27-29, 2006 CL Los Angeles, CA SP Soc Gen Internal Med DE patient; physician; pharmacy; pharmacy benefit; design; generic medications; medication costs ID INCENTIVE-BASED FORMULARIES; POTENTIAL SAVINGS; DRUG UTILIZATION; HYPERTENSION; ADHERENCE; SAMPLES; COSTS; PROXY; CARE AB Background: Increased use of generic medications conserves insurer and patient financial resources and may increase patient adherence. Objective: The objective of the study is to evaluate whether physician, patient, pharmacy benefit design, or pharmacy characteristics influence the likelihood that patients will use generic drugs Design, setting, and participants: Observational analysis of 2001-2003 pharmacy claims from a large health plan in the Western United States. We evaluated claims for 5,399 patients who filled a new prescription in at least 1 of 5 classes of chronic medications with generic alternatives. We identified patients initiated on generic drugs and those started on branded medications who switched to generic drugs in the subsequent year. We used generalized estimating equations to perform separate analyses assessing the relationship between independent variables and the probability that patients were initiated on or switched to generic drugs. Results: Of the 5,399 new prescriptions filled, 1,262 (23.4%) were generics. Of those initiated on branded medications, 606 (14.9%) switched to a generic drug in the same class in the subsequent year. After regression adjustment, patients residing in high-income zip codes were more likely to initiate treatment with a generic than patients in low-income regions (RR=1.29; 95% C.I. 1.04-1.60); medical subspecialists (RR=0.82; 0.69-0.95) and obstetrician/gynecologists (RR=0.81; 0.69-0.98) were less likely than generalist physicians to initiate generics. Pharmacy benefit design and pharmacy type were not associated with initiation of generic medications. However, patients were over 2.5 times more likely to switch from branded to generic medications if they were enrolled in 3-tier pharmacy plans (95% C.I. 1.12-6.09), and patients who used mail-order pharmacies were 60% more likely to switch to a generic (95% C.I. 1.18-2.30) after initiating treatment with a branded drug. Conclustions: Physician and patient factors have an important influence on generic drug initiation, with the patients who live in the poorest zip codes paradoxically receiving generic drugs least often. While tiered pharmacy benefit designs and mail-order pharmacies helped steer patients towards generic medications once the first prescription has been filled, they had little effect on initial prescriptions. Providing patients and physicians with information about generic alternatives may reduce costs and lead to more equitable care. C1 Harvard Univ, Sch Med, Brigham & Womens Hosp, Div Pharmacoepidemiol & Pharmacoecon, Boston, MA 02120 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RAND Hlth, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Med, Los Angeles, CA USA. Anthern Blue Cross Blue Shield, N Haven, CT USA. Anthem Prescript Management, N Haven, CT USA. RP Shrank, WH (reprint author), Harvard Univ, Sch Med, Brigham & Womens Hosp, Div Pharmacoepidemiol & Pharmacoecon, 1620 Tremont St,Suite 3030, Boston, MA 02120 USA. EM wshrank@partners.org OI Stedman, Margaret/0000-0001-9271-8332 NR 31 TC 36 Z9 36 U1 1 U2 3 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD SEP PY 2007 VL 22 IS 9 BP 1298 EP 1304 DI 10.1007/s11606-007-0284-3 PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 201EQ UT WOS:000248814700012 PM 17647066 ER PT J AU Gerrity, MS Corson, K Dobscha, SK AF Gerrity, Martha S. Corson, Kathryn Dobscha, Steven K. TI Screening for posttraumatic stress disorder in VA primary care patients with depression symptoms SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE posttraumatic stress disorder; depression; screening; primary care; veterans ID MENTAL-HEALTH PROBLEMS; PTSD CHECKLIST; VALIDATION; VETERANS; IRAQ; AFGHANISTAN; PREVALENCE; VALIDITY; UTILITY; SCALE AB Background: Unrecognized posttraumatic stress disorder (PTSD) is common and may be an important factor in treatment-resistant depression. Brief screens for PTSD have not been evaluated for patients with depression. Objective: The objective was to evaluate a 4-item screen for PTSD in patients with depression. Design: Baseline data from a depression study were used to evaluate sensitivity, specificity, and likelihood ratios (LRs) using the PTSD checklist (PCL-17) as the reference standard. Subjects: Subjects are 398 depressed patients seen in Veterans Affairs (VA) primary care clinics. Measures: The Patient Health Questionnaire (PHQ) for depression, PCL-17, and 4-item screen for PTSD were used. Results: Patients had a mean PHQ score of 14.8 (SD 3.7). Using a conservative PCL-17 cut point "(> 50)", the prevalence of PTSD was 37%. PCL-17 scores were strongly associated with PHQ scores (r=0.59, P < 0.001). Among the 342 (86%) patients endorsing trauma, a score of 0 on the remaining 3 symptom items had a LR=0.21, score of 1 a L=.62, score of 2 a LR=1.36, and score of 3 a LR=4.38. Conclusions: Most depressed VA primary care patients report a history of trauma, and one third may have comorbid PTSD. Our 4-item screen has useful LRs for scores of 0 and 3. Modifying item rating options may improve screening characteristics. C1 Portland VA Med Ctr, Columbia Ctr Study Chron Comorbid Mental & Phys, Portland, OR 97207 USA. Portland VA Med Ctr, Div Hosp & Specialty Med, Portland, OR USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR 97201 USA. RP Dobscha, SK (reprint author), Portland VA Med Ctr, Columbia Ctr Study Chron Comorbid Mental & Phys, POB 1034 R&D-66, Portland, OR 97207 USA. EM steven.dobscha@va.gov NR 26 TC 16 Z9 16 U1 1 U2 3 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD SEP PY 2007 VL 22 IS 9 BP 1321 EP 1324 DI 10.1007/s11606-007-0290-5 PG 4 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 201EQ UT WOS:000248814700016 PM 17634781 ER PT J AU Chen, P Kales, HC Weintraub, D Blow, FC Jiang, L Mellow, AM AF Chen, Peijun Kales, Helen C. Weintraub, Daniel Blow, Frederic C. Jiang, Lan Mellow, Alan M. TI Antidepressant treatment of veterans with Parkinson's disease and depression: Analysis of a national sample SO JOURNAL OF GERIATRIC PSYCHIATRY AND NEUROLOGY LA English DT Article; Proceedings Paper CT 18th Annual Meeting of the American-Association-for-Geriatric-Psychiatry CY MAR 03-06, 2005 CL San Diego, CA SP Amer Assoc Geriatr Psychiat DE Parkinson's disease; depression; antidepressants ID PRIMARY-CARE; SEROTONIN; MANAGEMENT; SYMPTOMS; RISK; LIFE AB We examined the impact of comorbid Parkinson's disease (PD) on depression treatment. Using national Veterans Affairs (VA) databases, fiscal year 2002 data were examined for 283 273 elderly males seen for depression. We compared 2 matched depression groups, one with (N = 7868) and one without (N = 7868) PD. In the 12-month period following a depression-related clinic visit, PD and non-PD patients were equally likely to fill an antidepressant prescription (77.8% vs. 77.4%), most commonly for a selective serotonin re-uptake inhibitor (SSRI) (62.9% vs 62.6%). Depressed PD patients had slightly higher rates of newer non-SSRI use (20.6% vs 19.2%, P <.05) and lower rates of tricyclic antidepressant use (7.4% vs 8.9%, P <.001). The presence of a PD diagnosis appears to have little impact on the frequency and type of antidepressant treatment. Efforts to improve the care of depressed PD patients should focus instead on improving recognition, ensuring adequacy of treatment, and evaluating the efficacy of existing antidepressants. C1 Case Western Reserve Univ, Cleveland VA Med Ctr, Psychiat Serv, Dept Psychiat, Brecksville, OH 44141 USA. Univ Michigan, Dept Psychiat, Div Geriatr Psychiat, Ann Arbor, MI 48109 USA. VA Natl Serious Mental Illness Treatment Res & Ev, Ann Arbor, MI USA. VA Ann Arbor Healthcare Syst, Geriatr Res Educ & Clin Ctr, Ann Arbor, MI USA. Univ Penn, Dept Psychiat, Philadelphia VA Med Ctr, Parkinsons Dis & Mental Illness Res,Educ & Clin C, Philadelphia, PA 19104 USA. Dept Vet Affairs, VISN Mental Hlth Serv Line 11, Cleveland, OH USA. RP Chen, P (reprint author), Case Western Reserve Univ, Cleveland VA Med Ctr, Psychiat Serv, Dept Psychiat, 116A B,1000 Breckville Rd, Brecksville, OH 44141 USA. EM Peijun.chen@med.va.gov FU NIMH NIH HHS [K23 MH067894-04, K23 MH067894] NR 17 TC 21 Z9 22 U1 0 U2 4 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0891-9887 J9 J GERIATR PSYCH NEUR JI J. Geriatr. Psychiatry Neurol. PD SEP PY 2007 VL 20 IS 3 BP 161 EP 165 DI 10.1177/0891988707301866 PG 5 WC Geriatrics & Gerontology; Clinical Neurology; Psychiatry SC Geriatrics & Gerontology; Neurosciences & Neurology; Psychiatry GA 201SD UT WOS:000248852000005 PM 17712099 ER PT J AU Cooke, CR Sheffield, JVL Hirschmann, JV AF Cooke, Colin R. Sheffield, John V. L. Hirschmann, Jan V. TI Fishing for a diagnosis SO JOURNAL OF HOSPITAL MEDICINE LA English DT Editorial Material ID ESOPHAGEAL-PERFORATION; PULMONARY-EMBOLISM; PATIENT; MANAGEMENT; MISDIAGNOSIS; MEDICINE; TIME AB A 54-year-old man with hypertension and type 2 diabetes A mellitus entered the Chest Pain Evaluation Unit of a teaching hospital after 12 hours of intermittent thoracic discomfort. The pain began during dinner and was sharp, bandlike, and located beneath the sternum and across the entire chest. He had dyspnea but no diaphoresis or nausea. A recumbent position relieved the pain after dinner, but it recurred during the night and again the following morning. He did not smoke and had no family history of coronary artery disease. C1 [Cooke, Colin R.] Univ Washington, Harborview Med Ctr, Div Pulm & Crit Care Med, Seattle, WA 98104 USA. [Sheffield, John V. L.] Univ Washington, Harborview Med Ctr, Div Gen Med, Seattle, WA 98104 USA. [Hirschmann, Jan V.] Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Div Gen Med, Seattle, WA 98195 USA. RP Cooke, CR (reprint author), Univ Washington, Harborview Med Ctr, Div Pulm & Crit Care Med, 325 9th Ave,Box 359762, Seattle, WA 98104 USA. EM crcooke@u.washington.edu OI Cooke, Colin/0000-0001-9713-5371 FU NHLBI NIH HHS [T32 HL007287] NR 27 TC 0 Z9 0 U1 0 U2 1 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1553-5592 J9 J HOSP MED JI J. Hosp. Med. PD SEP-OCT PY 2007 VL 2 IS 5 BP 345 EP 351 DI 10.1002/jhm.243 PG 7 WC Medicine, General & Internal SC General & Internal Medicine GA 292HY UT WOS:000255258300010 PM 17935255 ER PT J AU Ying, WH AF Ying, Weihai TI NAD(+) and NADH in neuronal death SO JOURNAL OF NEUROIMMUNE PHARMACOLOGY LA English DT Article DE NAD(+); NADH; neuronal death; brain injury; cerebral ischemia; neurodegenerative diseases ID POLY(ADP-RIBOSE) POLYMERASE INHIBITORS; DELETERIOUS NETWORK HYPOTHESIS; NITRIC-OXIDE SYNTHASE; CELL-DEATH; OXIDATIVE STRESS; ALZHEIMERS-DISEASE; PARKINSONS-DISEASE; AXON DEGENERATION; ASTROCYTE DEATH; BRAIN-INJURY AB Neuronal death is a key pathological event in multiple neurological diseases. Increasing evidence has suggested that NAD+ and NADH mediate not only energy metabolism and mitochondrial functions, but also calcium homeostasis, aging, and cell death. This article is written to provide an overview about the information suggesting significant roles of NAD+ and NADH in neuronal death in certain neurological diseases. Our latest studies have suggested that intranasal administration with NAD(+) can profoundly decrease ischemic brain damage. These observations suggest that NAD(+) administration may be a novel therapeutic strategy for some neurological diseases. C1 Univ Calif San Francisco, Dept Neurol 127, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, San Francisco, CA 94121 USA. RP Ying, WH (reprint author), Univ Calif San Francisco, Dept Neurol 127, 4150 Clement St, San Francisco, CA 94121 USA. EM Weihai.Ying@ucsf.edu NR 64 TC 13 Z9 13 U1 1 U2 2 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 1557-1890 J9 J NEUROIMMUNE PHARM JI J. Neuroimmune Pharm. PD SEP PY 2007 VL 2 IS 3 BP 270 EP 275 DI 10.1007/s11481-007-9063-5 PG 6 WC Neurosciences; Pharmacology & Pharmacy SC Neurosciences & Neurology; Pharmacology & Pharmacy GA 209MC UT WOS:000249391600007 PM 18040861 ER PT J AU Sano, Y Gomez, FE Kang, W Lan, J Maeshima, Y Hermsen, JL Ueno, C Kudsk, KA AF Sano, Yoshifumi Gomez, F. Enrique Kang, Woodae Lan, Jinggang Maeshima, Yoshinori Hermsen, Joshua L. Ueno, Chikara Kudsk, Kenneth A. TI Intestinal polymeric immunoglobulin receptor is affected by type and route of nutrition SO JOURNAL OF PARENTERAL AND ENTERAL NUTRITION LA English DT Article ID TOTAL PARENTERAL-NUTRITION; MAJOR ABDOMINAL-TRAUMA; MUCOSAL IMMUNITY; SEPTIC MORBIDITY; EPITHELIAL-CELLS; LYMPHOID-TISSUE; SECRETORY IGA; FED MICE; EXPRESSION; GUT AB Background: Secretory immunoglobulin A (SIgA) prevents adherence of pathogens at mucosal surfaces to prevent invasive infection. Polymeric immunoglobulin receptor (pIgR) is located on the basolateral surface of epithelial cells and binds dimeric immunoglobulin A (IgA) produced by plasma cells in the lamina propria. This IgA-pIgR complex is transported apically, where IgA is exocytosed as SIgA to the mucosal surface. Our prior work shows that mice fed intragastric (IG, an elemental diet model) and IV parenteral nutrition (PN) solution have reduced intestinal T and B cells, SIgA, and interleukin-4 (IL-4) compared with mice fed chow or a complex enteral diet (CED). Prior work also demonstrates a reduction in IgA transport to mucosal surfaces in IV PN-fed mice. Because IL-4 up-regulates pIgR production, this work studies the effects of these diets on intestinal pIgR. Methods: Male Institute of Cancer Research (ICR) mice were randomized to chow (n = 11) with IV catheter, CED (n = 10) or IG PN (n = 11) via gastrostomy and IV PN (n = 12) for 5 days. CED and PN were isocaloric and isonitrogenous. Small intestine was harvested for pIgR and IL-4 assays after mucosal washing for IgA. IgA and IL-4 levels were analyzed by enzyme-linked immunosorbent assay and pIgR by Western blot. Results: Small intestinal pIgR expression, IgA levels, and IL-4 levels decreased significantly in IV PN and IG PN groups. Conclusions: Lack of enteral stimulation affects multiple mechanisms responsible for decreased intestinal SIgA levels, including reduced T and B cells in the lamina propria, reduced Th-2 IgA-stimulating cytokines, and impaired expression of the IgA transport protein, pIgR. C1 William S Middleton Mem Vet Adm Med Ctr, Vet Adm Surg Serv, Madison, WI USA. Univ Wisconsin, Sch Med & Publ Hlth, Dept Surg, Madison, WI USA. RP Kudsk, KA (reprint author), 600 Highland Ave,H4-736 CSC, Madison, WI 53792 USA. EM kudsk@surgery.wisc.edu RI Lan, Jinggang/F-1776-2011 FU NIGMS NIH HHS [R01 GM53439] NR 37 TC 18 Z9 21 U1 0 U2 3 PU AMER SOC PARENTERAL & ENTERAL NUTRITION PI SILVER SPRING PA 8630 FENTON STREET SUITE 412, SILVER SPRING, MD 20910 USA SN 0148-6071 J9 JPEN-PARENTER ENTER JI J. Parenter. Enter. Nutr. PD SEP-OCT PY 2007 VL 31 IS 5 BP 351 EP 356 DI 10.1177/0148607107031005351 PG 6 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 206ID UT WOS:000249176200004 PM 17712142 ER PT J AU Kang, W Kudsk, KA Sano, Y Lan, J Yang-Xin, F Gomez, FE Maeshima, Y AF Kang, Woodae Kudsk, Kenneth A. Sano, Yoshifumi Lan, Jinggang Yang-Xin, Fu Gomez, F. Enrique Maeshima, Yoshinori TI Effects of lymphotoxin beta receptor blockade on intestinal mucosal immunity SO JOURNAL OF PARENTERAL AND ENTERAL NUTRITION LA English DT Article ID TOTAL PARENTERAL-NUTRITION; UPPER RESPIRATORY-TRACT; CELL-ADHESION MOLECULE-1; LYMPHOID-TISSUE; IMMUNOGLOBULIN-A; BACTERIAL PNEUMONIA; PEYERS-PATCHES; FED MICE; GUT; SYSTEM AB Background: Mucosal addressin cellular adhesion molecule-1 (MAdCAM-1) directs lymphocyte migration into gut-associated lymphoid tissue (GALT) through Peyer's patches (PPs). Parenteral nutrition (PN) impairs mucosal immunity by reducing PPs MAdCAM-1 expression, T and B cells in GALT, and intestinal and respiratory immunoglobulin (Ig) A levels. We previously showed that PN reduces lymphotoxin P receptor blockade (LT beta R) in PPs and intestine, and that stimulation with LT beta R agonist antibodies reverses these defects. To confirm that LT beta R regulates transcription of MAdCAM-1 message and more fully understand the effects of LT beta R on MAdCAM-1 function within the mucosal immune system, we studied the effect of LT beta R blockade with a chimeric LT beta R Ig-fusion protein on MAdCAM-1 mRNA levels, PP lymphocyte mass and IgA levels in the intestinal and respiratory tracts. Methods: Mice were cannulated and killed 3 days after receiving chow + control Ig, chow + LT beta R-Ig fusion protein (100 mu g IV), or PN + control Ig. The PPs of half of the animals were processed for lymphocyte count, and the other half were processed for complementary DNA and subsequent polymerase chain reaction (PCR). mRNA levels of MAdCAM-1 were determined by real-time PCR; intestinal and respiratory IgA levels were rneasured by ELISA. Results: PN significantly reduced PP lymphocyte mass, MAdCAM-1 mRNA, and intestinal IgA. As anticipated, LT beta R blockade significantly decreased PP cells and MAdCAM-1. mRNA, but not intestinal IgA because chow feeding was maintained. Both LT beta R blockade and PN decreased nasal IgA, but not significantly. Conclusions: LT beta R blockade in chow animals significantly reduces transcription of MAdCAM-1 gene and PPs lymphocyte mass. These data implicate inadequate LT beta R signaling as a major mechanism for decreased GALT cells with lack of enteral stimulation, and further establish the role of LT beta R in the mucosal immune system. C1 William S Middleton Mem Vet Adm Med Ctr, Vet Adm Surg Serv, Madison, WI USA. Univ Wisconsin, Coll Med & Publ Hlth, Madison, WI USA. Univ Chicago, Dept Pathol, Chicago, IL 60637 USA. RP Kudsk, KA (reprint author), 600 Highland Ave,H4-736 CSC, Madison, WI 53792 USA. EM kudsk@surgery.wise.edu FU NIGMS NIH HHS [R01 GM53439] NR 40 TC 6 Z9 7 U1 0 U2 2 PU AMER SOC PARENTERAL & ENTERAL NUTRITION PI SILVER SPRING PA 8630 FENTON STREET SUITE 412, SILVER SPRING, MD 20910 USA SN 0148-6071 J9 JPEN-PARENTER ENTER JI J. Parenter. Enter. Nutr. PD SEP-OCT PY 2007 VL 31 IS 5 BP 358 EP 364 DI 10.1177/0148607107031005358 PG 7 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 206ID UT WOS:000249176200007 PM 17712143 ER PT J AU Dobalian, A Tsao, JCI Putzer, GJ Menendez, SM AF Dobalian, Aram Tsao, Jennie C. I. Putzer, Gavin J. Menendez, Silvia M. TI Improving rural community preparedness for the chronic health consequences of bioterrorism and other public health emergencies SO JOURNAL OF PUBLIC HEALTH MANAGEMENT AND PRACTICE LA English DT Editorial Material ID PRIMARY-CARE; TERRORISM; ATTACKS; DISASTER; AMERICA; WORLD C1 VA Greater Los Angeles, Sepulveda Ambulatory Care Ctr & Nursing Home, Health Care Ctr Excellence Study Healthcare Provi, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Pediat, Pediat Pain Program, Los Angeles, CA 90024 USA. Univ Florida, Dept Hlth Serv Res Management & Policy, Gainesville, FL USA. RP Dobalian, A (reprint author), VA Greater Los Angeles, Sepulveda Ambulatory Care Ctr & Nursing Home, Health Care Ctr Excellence Study Healthcare Provi, 16111 Plummer St 152,Bldg 25,Rm B110, Sepulveda, CA 91343 USA. EM adobalia@ucia.edu FU AHRQ HHS [U01 HS14355]; PHS HHS [R04RH01310] NR 30 TC 6 Z9 6 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1078-4659 J9 J PUBLIC HEALTH MAN JI J. Public Health Manag. Pract. PD SEP-OCT PY 2007 VL 13 IS 5 BP 476 EP 480 PG 5 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 203RU UT WOS:000248992500008 PM 17762692 ER PT J AU Johansen, KL Chertow, GM AF Johansen, Kirsten L. Chertow, Glenn M. TI Chronic kidney disease mineral bone disorder and health-related quality of life among incident end-stage renal-disease patients SO JOURNAL OF RENAL NUTRITION LA English DT Article ID HEMODIALYSIS-PATIENTS; DIALYSIS PATIENTS; MEDICAL OUTCOMES; MORTALITY; ASSOCIATION; MORBIDITY; ANEMIA; HEMO AB Objective: Our objective was to determine the extent to which chronic kidney disease mineral bone disorder (CKD-MBD) is associated with health-related quality of life among incident dialysis patients. Design: This study's design was a cross-sectional analysis. Setting: This was part of the United States Renal Data System Dialysis Morbidity and Mortality Study (DMMS), Wave 2. Patients: The patients comprised 2590 adult participants in DMMS Wave 2, for whom quality of life and laboratory data were available. Methods: We stratified patients according to their serum concentrations of phosphorus, calcium, and parathyroid hormone (PTH), and compared health-related quality of life as a function of these indicators in analyses adjusted for demographic, clinical, and other laboratory variables. Main Outcome Measures: Main outcome measures included Physical Component Summary (PCS) and Mental Component Summary (MCS) scores, and the Symptom score of the Kidney Disease Quality of Life. Results: Both high and low serum phosphorus concentrations were associated with lower PCS scores (-1.25 to -1.48 points compared with the reference category), as was low PTH (-1.49 points). Low serum phosphorus was associated with more severe symptoms of kidney disease (-3.88 points), but there were no associations between high phosphorus or either extreme of PTH and the Symptom score. Serum calcium concentration and the calcium x phosphorus product were unassociated with PCS or Symptom scores. There were no associations among phosphorus, calcium, or PTH and MCS. Analyses simultaneously controlling for serum phosphorus, calcium, and PTH showed similar results. Conclusion: High and low serum phosphorus and low PTH are associated with slightly poorer self-reported physical functioning. Clinical trials will be necessary to determine whether and to what extent improvement in health status may occur with the correction of selected disorders of mineral metabolism. (C) 2007 by the National Kidney Foundation, Inc. C1 San Francisco VA Med Ctr, Nephrol Sect, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, Div Nephrol, San Francisco, CA USA. RP Johansen, KL (reprint author), San Francisco VA Med Ctr, Nephrol Sect, 111J,4150 Clement St, San Francisco, CA 94121 USA. EM kirsten.johartsen@ucsf.edu FU NIDDK NIH HHS [K24 DK085446, N01 DK022498, N01 DK022498-002, N01-DK-1-2450] NR 27 TC 12 Z9 14 U1 0 U2 2 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 1051-2276 J9 J RENAL NUTR JI J. Renal Nutr. PD SEP PY 2007 VL 17 IS 5 BP 305 EP 313 DI 10.1053/j.jrn.2007.06.005 PG 9 WC Nutrition & Dietetics; Urology & Nephrology SC Nutrition & Dietetics; Urology & Nephrology GA 213SW UT WOS:000249688400003 PM 17720099 ER PT J AU Naik, AD Issac, TT Street, RL Kunik, ME AF Naik, Aanand D. Issac, Tim T. Street, Richard L., Jr. Kunik, Mark E. TI Understanding the quality chasm for hypertension control in diabetes: A structured review of "Co-maneuvers" used in clinical trials SO JOURNAL OF THE AMERICAN BOARD OF FAMILY MEDICINE LA English DT Review ID BLOOD-PRESSURE CONTROL; LIPID-LOWERING TREATMENT; CORONARY-ARTERY-DISEASE; SHARED DECISION-MAKING; RANDOMIZED-TRIAL; PRIMARY-CARE; MICROVASCULAR COMPLICATIONS; ANTIHYPERTENSIVE TREATMENT; UNCONTROLLED HYPERTENSION; CARDIOVASCULAR MORBIDITY AB Background: Observational studies routinely describe a significant gap between rates of blood pressure control in routine diabetes care compared with those achieved in randomized controlled trials (RCTs). Methods: We performed a systematic review of the literature to identify co-maneuvers used in RCTs, defined as ancillary activities or agents administered before, during, or immediately after the main agent under investigation (ie, principal maneuver), but not effectively translated to routine diabetes care. We searched multiple databases for RCTs evaluating the efficacy of treatments for hypertension control in adults with type 2 diabetes mellitus. We considered only phase III human studies of interventions that achieved blood pressure control and scrutinized all elements related to the implementation of the principal maneuver in each candidate study. These elements were then sorted into a taxonomy of co-maneuvers. Results: Nearly all eligible RCTs used highly consistent groups of co-maneuvers. These typically began with ( 1) the use of consensual and clearly stated blood pressure goals; ( 2) frequent visits in which blood pressure levels were measured and compared with predefined goals; and, if the goal was not attained, ( 3) modifications to the treatment based on a detailed action plan that included communication of adverse events. Patient education, feedback to clinicians, and interventions for medication adherence were not commonly used among eligible trials. Conclusions: Clinicians should translate key behavioral co-maneuvers along with clinically proven treatments for hypertension control in diabetes. These co-maneuvers are conceptually similar to collaborative goal setting and action planning interventions used in innovative chronic care programs. C1 Michael E DeBakey Vet Affairs Med Ctr 152, Houston Ctr Qual Care & Utilizat Studies, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr 152, S Cent Mental Illness Res Educ & Clin Ctr, Houston, TX 77030 USA. Baylor Coll Med, Sect Hlth Serv Res, Houston, TX 77030 USA. Baylor Coll Med, Sect Geriatr, Houston, TX 77030 USA. Baylor Coll Med, Sect Diabetes & Endocrinol, Houston, TX 77030 USA. Baylor Coll Med, Dept Psychiat, Houston, TX 77030 USA. Texas A&M Univ, Dept Commun, College Stn, TX USA. RP Naik, AD (reprint author), Michael E DeBakey Vet Affairs Med Ctr 152, Houston Ctr Qual Care & Utilizat Studies, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM anaik@bcm.tmc.edu FU NIA NIH HHS [5K23AG027144-02, K23 AG027144, K23 AG027144-03] NR 61 TC 10 Z9 10 U1 1 U2 3 PU AMER BOARD FAMILY MEDICINE PI LEXINGTON PA 2228 YOUNG DR, LEXINGTON, KY 40505 USA SN 1557-2625 J9 J AM BOARD FAM MED JI J. Am. Board Fam. Med. PD SEP-OCT PY 2007 VL 20 IS 5 BP 469 EP 478 DI 10.3122/jabfm.2007.05.070026 PG 10 WC Primary Health Care; Medicine, General & Internal SC General & Internal Medicine GA 207YC UT WOS:000249286000006 PM 17823464 ER PT J AU Agopian, VG Wulkersdorfer, B Chen, DC Lee, J Stelzner, M AF Agopian, Vatche G. Wulkersdorfer, Beatrix Chen, David C. Lee, Jane Stelzner, Matthias TI Growth factors enhance neomucosal development in tissue-engineered intestine SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Meeting Abstract CT 93rd Annual Clinical Congress of the American-College-of-Surgeons CY OCT 07-11, 2007 CL New Orleans, LA SP Amer Coll Surg C1 Univ Calif Los Angeles, VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1072-7515 J9 J AM COLL SURGEONS JI J. Am. Coll. Surg. PD SEP PY 2007 VL 205 IS 3 SU S BP S14 EP S14 DI 10.1016/j.jamcollsurg.2007.06.027 PG 1 WC Surgery SC Surgery GA 209OG UT WOS:000249397300013 ER PT J AU Razani, J Kakos, B Orieta-Barbalace, C Wong, JT Casas, R Lu, P Alessi, C Josephson, K AF Razani, Jill Kakos, Bernadette Orieta-Barbalace, Carla Wong, Jennifer T. Casas, Rachel Lu, Po Alessi, Cathy Josephson, Karen TI Predicting caregiver burden from daily functional abilities of patients with mild dementia SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE activities of daily living; observation-based ADLs; informant-based ADLs; functional assessment; caregiver burden; caregiver psychological distress; functional ability; dementia; cognitive impairment ID ALZHEIMERS-DISEASE; FAMILY CAREGIVERS; HEALTH; CARE; INVENTORY; SYMPTOMS; DISTRESS; PEOPLE; ADULTS; IMPACT AB OBJECTIVES: To assess the relationship between performance- and informant-based measures of activities of daily living (ADLs) in patients with early dementia and burden or psychological distress experienced by the patients' caregivers. DESIGN: Descriptive study. SETTING: Ambulatory center. PARTICIPANTS: Thirty-four patient-caregiver dyads in which the patient had mild dementia (Mini-Mental State Examination score > 17). MEASUREMENTS: A performance-based ADL measure (the Direct Assessment of Functional Status (DAFS)) was administered to patients with mild dementia. Caregivers completed an informant-based measure of patient functional status (instrumental activities of daily living). Caregivers also completed the Caregiver Burden Inventory (CBI) and the Brief Symptom Inventory (BSI). RESULTS: Significant correlations were found between the informant-based ADL measure and caregiver burden (CBI) and psychological distress (BSI) (correlation coefficient (r)=-0.34 to -0.71, all P <.05). Alternatively, fewer and weaker relationships were observed between the DAFS (performance-based) ADL measure and caregiver burden or distress ratings (r=-0.32 to -0.43, all P <.05). Of the seven tasks assessed using the DAFS, impairments in orientation, communication, financial, and transportation skills in patients were associated with greater time and developmental burden and greater hostility in caregivers. Impairment in financial skills in patients was the strongest predictor of time-dependence burden and hostility in caregivers, whereas impairment in patient transportation skills was the best predictor of developmental burden. CONCLUSION: The ADL abilities of cognitively impaired patients can predict caregiver burden and psychological distress, with informant-based measures having the greatest association with patient impairment. C1 Calif State Univ Northridge, Dept Psychol, Northridge, CA 91330 USA. Univ Detroit Mercy, Dept Psychol, Detroit, MI 48221 USA. Univ Iowa, Dept Psychol, Iowa City, IA 52242 USA. Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Geriatr Res Educ & Clin Ctr, Vet Affairs Greater Los Angeles Healthcare Syst, North Hills, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. RP Razani, J (reprint author), Calif State Univ Northridge, Dept Psychol, 18111 Nordhoff St, Northridge, CA 91330 USA. EM jill.razani@csun.edu FU NIGMS NIH HHS [T34 GM008395, S06 GM048680, S06 GM048680-12A10013, R25 GM063787, GM08395, GM048680, GM63787] NR 26 TC 69 Z9 72 U1 1 U2 7 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD SEP PY 2007 VL 55 IS 9 BP 1415 EP 1420 DI 10.1111/j.1532-5415.2007.01307.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 206IZ UT WOS:000249178400014 PM 17767684 ER PT J AU Shay, K AF Shay, Kenneth TI Who is responsible for a nursing home resident's daily oral care? SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Editorial Material ID RISK-FACTORS; PNEUMONIA C1 US Dept Vet Affairs, Off Geriatr & Extended Care, Washington, DC USA. Univ Michigan, Sch Dent, Ann Arbor, MI 48109 USA. RP Shay, K (reprint author), US Dept Vet Affairs, Off Geriatr & Extended Care, Washington, DC USA. NR 15 TC 2 Z9 2 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD SEP PY 2007 VL 55 IS 9 BP 1470 EP 1471 DI 10.1111/j.1532-5415.2007.01280.x PG 2 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 206IZ UT WOS:000249178400023 PM 17767691 ER PT J AU Latini, DM Hart, SL Knight, SJ Cowan, JE Ross, PL DuChane, J Carroll, PR AF Latini, David M. Hart, Stacey L. Knight, Sara J. Cowan, Janet E. Ross, Phillip L. DuChane, Janeen Carroll, Peter R. CA CaPSURETM Investigators TI The relationship between anxiety and time to treatment for patients with prostate cancer on surveillance SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; anxiety; prostate-specific antigen ID CONSERVATIVE MANAGEMENT; RADICAL PROSTATECTOMY; CAPSURE; MEN; PREDICTORS; RECURRENCE; RADIATION; OUTCOMES; THERAPY; ANTIGEN AB Purpose: Little is known about psychosocial factors affecting the decision to move from surveillance to active treatment in men with localized prostate cancer. We examined the impact of cancer anxiety on the decision to move from surveillance to treatment. Materials and Methods: We analyzed data from CaPSURE, a national observational prostate cancer registry. A total of 105 participants had localized disease, selected surveillance vs treatment and had at least 3 prostate specific antigen values available after baseline. Cancer anxiety was measured with a 3-item scale (alpha = 0.78). We calculated the rate of change in prostate specific antigen with time (prostate specific antigen velocity) and used the same formula to calculate the rate of change in cancer anxiety. We fit a Cox regression model to determine predictors of receiving treatment in the 3-year observation period, controlling for prostate specific antigen velocity, demographics and baseline clinical characteristics. Results: Prostate specific antigen velocity and the cancer anxiety change rate were significant independent predictors of treatment receipt (HR 1.02, 95% CI 1.004, 1.035, each p <0.01). Men with higher prostate specific antigen velocity (1.51 ng/ml per year or greater) were significantly more likely to receive treatment than men with lower prostate specific antigen velocity (HR 3.18, 95% CI 1.122, 9.016). The 2 velocity measures correlated only modestly (r = 0.29, p <0.001). Conclusions: Rather than being based only on clinical presentation and disease progression, decisions about treatment receipt for some men are influenced by cancer related anxiety. Men should be provided with more psychosocial support to perhaps delay treatment and the ensuing decrements in health related quality of life. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care Utilizat Studies, Houston, TX 77030 USA. Baylor Coll Med, Dan L Duncan Canc Ctr, Scott Dept Urol, Houston, TX USA. Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Urol, Programs Urol Oncol & Genitourinary Canc E, San Francisco, CA 94143 USA. Univ Calif San Francisco, Ctr Comprehens Canc, San Francisco, CA 94143 USA. TAP Pharmaceut Prod Inc, Lake Forest, IL USA. RP Latini, DM (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care Utilizat Studies, 152,2002 Holcombe Blvd, Houston, TX 77030 USA. EM latini@bcm.tmc.edu RI Hart, Stacey/E-4819-2011 OI Latini, David/0000-0002-6161-4861 FU NCI NIH HHS [P50 CA89520, PC040796] NR 20 TC 101 Z9 106 U1 1 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD SEP PY 2007 VL 178 IS 3 BP 826 EP 831 DI 10.1016/j.juro.2007.05.039 PN 1 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 198PZ UT WOS:000248641300023 PM 17632144 ER PT J AU Sajadi, KP Terris, MK Hamilton, RJ Cullen, J Amling, CL Kane, CJ Presti, JC Aronson, WJ Freedland, SJ AF Sajadi, Kamran P. Terris, Martha K. Hamilton, Robert J. Cullen, Jennifer Amling, Christopher L. Kane, Christopher J. Presti, Joseph C., Jr. Aronson, William J. Freedland, Stephen J. TI Body mass index, prostate weight and transrectal ultrasound prostate volume accuracy SO JOURNAL OF UROLOGY LA English DT Article DE prostate; prostatic neoplasms; ultrasonography; obesity; prostatic hyperplasia ID RADICAL PROSTATECTOMY; SIZE; OBESITY; CANCER; HYPERPLASIA; OVERWEIGHT; DATABASE; RISK AB Purpose: Transrectal ultrasound can be used to calculate prostate volume, which has implications for benign and malignant prostate disease. We hypothesized that obesity may represent a technical challenge when performing transrectal ultrasound that decreases the accuracy of estimating prostate volume. Materials and Methods: We examined the records of men with previously untreated prostate cancer who underwent radical prostatectomy between 1995 and 2006 and who were in the Shared-Equal Access Regional Cancer Hospital database. Transrectal ultrasound volume calculations were correlated with radical prostatectomy specimen weight using the Spearman coefficient. We calculated the percent and absolute error, and evaluated the relationship between them and transrectal ultrasound volume, body mass index, age, prostate specific antigen and race using multivariate linear regression. Results: A total of 497 patients with preoperative transrectal ultrasound volume, specimen weight and body mass index data were identified in the Shared-Equal Access Regional Cancer Hospital database. Transrectal ultrasound volume correlated modestly with specimen weights (r = 0.692, p < 0.001). The median +/- SD absolute error was 9.6 +/- 11.4 gm and the median +/- SD percent error was 22.9% +/- 20.6%. Body mass index was not significantly related to absolute or percent error (p = 0.91 and 0.71, respectively). In addition, patient age, prostate specific antigen and race were not significantly related to absolute or percent error (p > 0.05). However, percent error but not absolute error was significantly predicted by transrectal ultrasound volume (p < 0.001 and 0.34, respectively). Smaller prostate size was associated with greater percent error, especially when transrectal ultrasound volume was less than 20 cc. Conclusions: Transrectal ultrasound volume correlates with specimen weight but it is an imperfect substitute with significant variation in error. The accuracy of transrectal ultrasound depends on measured volume but neither body mass index nor other patient specific variables had a significant impact. C1 Med Coll Georgia, Urol Sect, Augusta, GA 30912 USA. Augusta Vet Affairs Med Ctr, Augusta, GA USA. Durham Vet Affairs Med Ctr, Durham, NC USA. Duke Univ, Durham, NC USA. Ctr Prostate Dis Res, Rockville, MD USA. Univ Alabama, Birmingham, AL USA. San Francisco VA Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. Stanford Univ, Stanford, CA 94305 USA. Palo Alto Vet Affairs Med Ctr, Palo Alto, CA USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. RP Sajadi, KP (reprint author), Med Coll Georgia, Urol Sect, 1120 15th St,BA 8414, Augusta, GA 30912 USA. EM ksajadi@mcg.edu OI Hamilton, Robert/0000-0002-6715-5934; Terris, Martha/0000-0002-3843-7270 FU NCI NIH HHS [CA92131-01A1, R01CA100938] NR 19 TC 20 Z9 20 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0022-5347 J9 J UROLOGY JI J. Urol. PD SEP PY 2007 VL 178 IS 3 BP 990 EP 995 DI 10.1016/j.juro.2007.05.049 PN 1 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 198PZ UT WOS:000248641300074 PM 17632170 ER PT J AU Daniel, JC Huynh, TT Zhou, W Kougias, P El Sayed, HF Huh, J Coselli, JS Lin, PH AF Daniel, Jonathan C. Huynh, Tam T. Zhou, Wei Kougias, Panagiotis El Sayed, Hosam F. Huh, Joseph Coselli, Joseph S. Lin, Peter H. TI Acute aortic dissection associated with use of cocaine SO JOURNAL OF VASCULAR SURGERY LA English DT Article ID CRACK COCAINE; CARDIOVASCULAR COMPLICATIONS; ABUSE; ANEURYSMS; DISEASE AB Purpose: Cocaine use can result in a variety of cardiovascular complications, including myocardial infarction, arterial thrombosis, coronary dissection, and cardiomyopathy. Cocaine-induced aortic dissection is uncommon and has been described largely in case reports. The purpose of this study was to review our experience with aortic dissection associated with cocaine abuse. Methods. A retrospective chart review was performed of all hospital records during a 15-year period in patients diagnosed with aortic dissection. Among the 164 cases of acute aortic dissection, 16 patients (9.8%) had used cocaine or its derivative, crack cocaine, within 24 hours prior to the onset of symptoms. The remaining 148 patients (90.2%) had no history of cocaine usage. Clinical features, management, and outcome in these two groups were compared. Results. In the cocaine group, powder cocaine was inhaled intranasally in I I patients (69%) and crack cocaine was smoked in five cases (31%). The mean duration between cocaine use and the onset of aortic dissection was 12.8 hours (range, 4 to 24 hours). Patients in the cocaine group were younger in age and more likely to have a history of polysubstance abuse than the non-cocaine cohort. In the cocaine group, the incidence of DeBakey dissection type 1, 11, IIIa, and IIIb was 19%, 25%, 38%, and 19%, respectively. In the group without cocaine use, the incidence of DeBakey dissection type 1, 11, IIIa, and IIIb was 18%, 23%, 39%, and 20%, respectively. Surgical intervention for aortic dissection was performed in 50% of the cocaine group and 45% of the non-cocaine group. In patients who underwent surgical repair, greater pulmonary complications occurred in the cocaine group than the non-cocaine group (n = 0.02). No difference was noted in the hospital length of stay or 30-day operative mortality among the two groups. Conclusions. Cocaine-associated aortic dissection occurs in predominantly male patients with illicit drug abuse who were younger than patients with aortic dissection without cocaine use. Greater pulmonary complications can occur in patients with cocaine-related aortic dissection following surgical interventions. C1 Baylor Coll Med, Michael E DeBakey Dept Surg, Houston VAMC, Div Vasc Surg & Endovasc Therapy, Houston, TX 77030 USA. Baylor Coll Med, Michael E DeBakey Dept Surg, Div Cardiothorac Surg, Houston, TX 77030 USA. St Lukes Episcopal Hosp, Texas Heart Inst, Houston, TX 77030 USA. RP Lin, PH (reprint author), Baylor Coll Med, Michael E DeBakey Dept Surg, Houston VAMC, Div Vasc Surg & Endovasc Therapy, 2002 Holcomb Blvd, Houston, TX 77030 USA. EM plin@bcm.tmc.edu NR 27 TC 34 Z9 37 U1 0 U2 4 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD SEP PY 2007 VL 46 IS 3 BP 427 EP 433 DI 10.1016/j.jvs.2007.05.040 PG 7 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 208JL UT WOS:000249315500005 PM 17826227 ER PT J AU Kougias, P Lau, D El Sayed, HF Zhou, W Huynh, TT Lin, PH AF Kougias, Panagiotis Lau, Donald El Sayed, Hosarn F. Zhou, Wei Huynh, Tam T. Lin, Peter H. TI Determinants of mortality and treatment outcome following surgical interventions for acute mesenteric ischemia SO JOURNAL OF VASCULAR SURGERY LA English DT Article; Proceedings Paper CT 30th Annual Meeting of the Southern-Association-for-Vascular-Surgery CY JAN 18-21, 2006 CL Phoenix, AZ SP SO Assoc Vasc Surg ID PERCUTANEOUS TRANSLUMINAL ANGIOPLASTY; INTESTINAL ISCHEMIA; REPERFUSION INJURY; CT ANGIOGRAPHY; NITRIC-OXIDE; ARTERY; REVASCULARIZATION; MANAGEMENT; INFILTRATION; EXPERIENCE AB Background: Acute mesenteric ischemia (AMI) is associated with high morbidity and mortality due in part to its diagnostic difficulty and operative challenges. The purpose of this study was to review our experience of surgical management in patients with this condition and to identify variables associated with adverse outcomes following surgical interventions. Methods. Hospital records and clinical data of all patients undergoing surgical interventions for AMI were reviewed during a recent 12-year period. Clinical outcomes as well as factors influencing mortality were analyzed. Results. A total of 72 patients (41 females, overall mean age 65 years, range 34 to 83 years) were included in the study. Thrombosis and embolism were the cause of AMI in 48 patients (67%) and 24 patients (33%), respectively. Abdominal pain was the most common presenting symptom (96%), followed by nausea (56%). Preoperative angiogram was performed in 61 patients (85%). All patients underwent operative interventions, which included thromboembolectomy (n = 22, 3 1 %), mesenteric bypass grafting (n = 33, 46%), patch angioplasty (n = 9, 12%), reimplantation (n = 5, 7%), and endarterectomy (n = 3, 4%). Bowel resection was necessary in 22 patients (31%) during the initial operation, and second-look operation was performed in 38 patients (53%). Perioperative morbidity and 30-day mortality rates were 39% and 31%, respectively. Univariate analysis showed renal insufficiency (P <.02), age > 70 (P <.001), metabolic acidosis (P <.02), and symptom duration (P <.005), and bowel resection in second-look operations (P <.01) were associated with mortality. Logistic regression analysis showed age > 70 (P =.03) and prolonged symptom duration (P =.02) were independent predictors of mortality. Conclusions. Elderly patients and those with a prolonged duration of symptoms had worse outcomes following surgical intervention for AML A high index of suspicion with prompt diagnostic evaluation may reduce time delay prior to surgical intervention, which may lead to improved patient survival. Aggressive surgical intervention should be performed as promptly as possible in patients once the diagnosis of AMI is made. C1 Houston VAMC, Baylor Coll Med, Michael E DeBakey Dept Surg, Div Vasc Surg & Endovasc Therapy, Houston, TX 77030 USA. Michael E DeBakey VA Med Ctr, Houston, TX USA. RP Lin, PH (reprint author), Houston VAMC, Baylor Coll Med, Michael E DeBakey Dept Surg, Div Vasc Surg & Endovasc Therapy, 112,2002 Holcomb Blvd, Houston, TX 77030 USA. EM plin@bcm.tmc.edu NR 34 TC 75 Z9 85 U1 0 U2 3 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD SEP PY 2007 VL 46 IS 3 BP 467 EP 474 DI 10.1016/j.jvs.2007.04.045 PG 8 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 208JL UT WOS:000249315500014 PM 17681712 ER PT J AU Mitchell, KA Rawl, SM Schmidt, CM Grant, M Ko, CY Baldwin, CM Wendel, C Krouse, RS AF Mitchell, Kimberly A. Rawl, Susan M. Schmidt, C. Max Grant, Marcia Ko, Clifford Y. Baldwin, Carol M. Wendel, Christopher Krouse, Robert S. TI Demographic, clinical, and quality of life variables related to embarrassment in veterans living with an intestinal stoma SO JOURNAL OF WOUND OSTOMY AND CONTINENCE NURSING LA English DT Article ID RECTAL-CANCER PATIENTS; SURGERY; ILEOSTOMY; COLOSTOMY; BODY AB OBJECTIVE: The study aims were to identify demographic, clinical, and quality of life variables related to embarrassment for people living with ostomies and to determine the experiences and/or feelings of veterans who were embarrassed by their ostomy. DESIGN: This was a cross-sectional, correlational study. SETTING AND SUBJECTS: A convenience sample of veterans (n = 239) living with ostomies from 3 VA medical centers was studied. The veterans were primarily Caucasian (84%), male (92%), and older (M = 69). INSTRUMENTS: The modified City of Hope Quality of Life-Ostomy questionnaire was used. Additionally, an open-ended question related to living with an ostomy was asked. METHODS: The questionnaire packets were mailed to participants and self-administered. RESULTS: Approximately half of the participants (48%) rated their embarrassment as low, but 26% reported high embarrassment. Participants with high embarrassment were compared to those with low embarrassment on demographic, clinical, and quality of life variables. High embarrassment was associated with poorer total quality of life (P < .001) and poorer quality of life on the physical (P < .001), psychological (P < .001), social (P < .001), and spiritual (P < .001) subscales. Younger (P < .001) and unpartnered veterans (P < .001) were more likely to be highly embarrassed. Veterans with high embarrassment had higher anxiety (P < .001) and depression (P < .001), more difficulty with intimacy (P < .001), and felt more isolated (P < .001). Spiritual domain variables like hopefulness were associated with low embarrassment (P < .001). Sources of embarrassment included leakage, odor, and noise. CONCLUSIONS: Embarrassment may negatively impact a person's quality of life; therefore, the variables associated with high embarrassment should be recognized and addressed. C1 Purdue Univ, Indiana Univ, Sch Nursing, Indianapolis, IN USA. St Francis Med Ctr, Coll Nursing, Peoria, IL USA. Ctr Nursing Res, Indianapolis, IN USA. Richard L Roudebush Vet Affairs Med Ctr, Indianapolis, IN 46202 USA. Indiana Univ, Sch Med, Dept Biochem & Mol Biol, Indianapolis, IN 46204 USA. City Hope Natl Med Ctr, Dept Nursing Res & Educ, Duarte, CA 91010 USA. City Hope Natl Med Ctr, Beckman Res Inst, Duarte, CA 91010 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Los Angeles, CA USA. Arizona State Univ, SW Borderlands, Coll Nursing, Phoenix, AZ USA. So Arizona VA Hlth Care Syst, Tucson, AZ USA. Univ Arizona, Tucson, AZ USA. RP Krouse, RS (reprint author), 511 NE Greenleaf, Peoria, IL 61603 USA. EM kamitch@insightbb.com OI Baldwin, Carol/0000-0002-0732-2307; Rawl, Susan/0000-0003-2052-2853 NR 26 TC 29 Z9 30 U1 0 U2 5 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1071-5754 J9 J WOUND OSTOMY CONT JI J. Wound Ostomy Cont. Nurs. PD SEP-OCT PY 2007 VL 34 IS 5 BP 524 EP 532 PG 9 WC Nursing SC Nursing GA 215YE UT WOS:000249844100014 PM 17876215 ER PT J AU Ran, Q Liang, HY Ikeno, Y Qi, WB Prolla, TA Roberts, LJ Wolf, N VanRemmen, H Richardson, A AF Ran, Qitao Liang, Hanyu Ikeno, Yuji Qi, Wenbo Prolla, Tomas A. Roberts, L. Jackson, II Wolf, Norman VanRemmen, Holly Richardson, Arlan TI Reduction in glutathione peroxidase 4 increases life span through increased sensitivity to apoptosis SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID INNER MITOCHONDRIAL-MEMBRANE; 10-N-NONYL ACRIDINE-ORANGE; RAT-LIVER MITOCHONDRIA; CYTOCHROME-C; CALORIC RESTRICTION; OXIDATIVE STRESS; EXTENDED LONGEVITY; LIPID-PEROXIDATION; DNA-DAMAGE; CELL-LINE AB Glutathione peroxidase 4 (Gpx4) is an antioxidant defense enzyme that plays an important role in detoxification of oxidative damage to membrane lipids. Because oxidative stress is proposed to play a causal role in aging, we compared the life spans of Gpx4 heterozygous knockout mice (Gpx4(+/-) mice) and wild-type mice (WT mice). To our surprise, the median life span of Gpx4(+/-) mice (1029 days) was significantly longer than that of WT mice (963 days) even though the expression of Gpx4 was reduced approximately 50% in all tissues of Gpx4(+/-) mice. Pathological analysis revealed that Gpx4(+/-) mice showed a delayed occurrence of fatal tumor lymphoma and a reduced severity of glomerulonephritis. Compared to WT mice, Gpx4(+/-) mice showed significantly increased sensitivity to oxidative stress-induced apoptosis. Our data indicate that lifelong reduction in Gpx4 increased life span and reduced/retarded age-related pathology most likely through alterations in sensitivity of tissues to apoptosis. C1 [Ran, Qitao; Liang, Hanyu; Ikeno, Yuji; Qi, Wenbo; VanRemmen, Holly; Richardson, Arlan] Univ Texas Hlth Sci Ctr San Antonio, Barshop Inst Longev & Aging Studies, San Antonio, TX 78245 USA. [Ran, Qitao; Liang, Hanyu; Ikeno, Yuji; Qi, Wenbo; VanRemmen, Holly; Richardson, Arlan] Univ Texas Hlth Sci Ctr San Antonio, Dept Cellular & Struct Biol, San Antonio, TX 78245 USA. [Ran, Qitao; Ikeno, Yuji; VanRemmen, Holly; Richardson, Arlan] S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. [Prolla, Tomas A.] Univ Wisconsin, Dept Genet, Madison, WI 53706 USA. [Prolla, Tomas A.] Univ Wisconsin, Dept Med Genet, Madison, WI 53706 USA. [Roberts, L. Jackson, II] Vanderbilt Univ, Dept Pharmacol, Nashville, TN USA. [Roberts, L. Jackson, II] Vanderbilt Univ, Dept Med, Nashville, TN USA. [Wolf, Norman] Univ Washington, Dept Pathol, Seattle, WA 98195 USA. RP Richardson, A (reprint author), Univ Texas Hlth Sci Ctr San Antonio, Barshop Inst Longev & Aging Studies, 15355 Lambda Dr, San Antonio, TX 78245 USA. EM richardsona@uthscsa.edu RI Liang, Hanyu/A-1066-2010 FU NIA NIH HHS [P01 AG19316, P01AG020591, P30-AG13319]; NIGMS NIH HHS [R37GM42056] NR 64 TC 88 Z9 88 U1 1 U2 6 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD SEP PY 2007 VL 62 IS 9 BP 932 EP 942 PG 11 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 272AE UT WOS:000253829000002 PM 17895430 ER PT J AU Rosano, C Aizenstein, HJ Studenski, S Newman, AB AF Rosano, Caterina Aizenstein, Howard J. Studenski, Stephanie Newman, Anne B. TI A regions-of-interest volumetric analysis of mobility limitations in community-dwelling older adults SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID LOWER-EXTREMITY FUNCTION; WHITE-MATTER LESIONS; CARDIOVASCULAR HEALTH; MRI FINDINGS; GAIT SPEED; SUBSEQUENT DISABILITY; COGNITIVE FUNCTION; IMPAIRED MOBILITY; MOTOR FUNCTION; BRAIN AB Background. In community-dwelling older adults, greater mobility impairment is associated with greater burden of diffuse brain Structural abnormalities, such as higher white matter hyperintensities. This study examined the association between gray matter volumes of regions related to motor control, gait, and balance and whether this association is independent of burden of white matter hyperintensities. Methods. A random sample of 327 participants of the Cardiovascular Health Study (78.3 +/- 4.1 years old, 57% women) contributed brain magnetic resonance imaging (MRI) and mobility data. A brain imaging automated method measured gray matter volume in cerebellum, basal ganglia, and prefrontal and parietal cortex in both hemispheres. Gait speed was measured while walking 15 feet at usual pace. Standing balance was assessed by timing tandem stance. Associations between each region's volume and gait speed or balance were measured before and after adjustment for demographics, head size, cardiovascular risk factors, and 0-9 grading scores of white matter hyperintensities. Results. Smaller left cerebellum and left prefrontal regions were associated with slower gait, independently of covariates and of white matter hyperintensities. Smaller right putamen, right posterior superior parietal cortex, and both left and right cerebellum were associated with balance difficulty, independently of covariates and white matter hyperintensities. Conclusions. Smaller gray matter volumes in regions crucial for motor control are associated with slower gait and poorer balance, and the association appears to be independent of other diffuse brain abnormalities such as white matter hyperintensities. C1 [Rosano, Caterina; Newman, Anne B.] Univ Pittsburgh, Dept Epidemiol, Sch Publ Hlth, Pittsburgh, PA 15260 USA. [Aizenstein, Howard J.] Univ Pittsburgh, Western Psychiat Inst & Clin, Dept Psychiat, Pittsburgh, PA 15260 USA. [Studenski, Stephanie; Newman, Anne B.] Univ Pittsburgh, Dept Med, Div Geriatr Med, Sch Med, Pittsburgh, PA 15260 USA. [Studenski, Stephanie] VA Pittsburgh Healthcare Syst, GRECC, Pittsburgh, PA USA. RP Rosano, C (reprint author), 130 N Bellefield,Room 519, Pittsburgh, PA 15213 USA. EM rosanoc@edc.pitt.edu RI Newman, Anne/C-6408-2013 OI Newman, Anne/0000-0002-0106-1150; Rosano, Caterina/0000-0002-0909-1506; Rosano, Caterina/0000-0002-4271-6010 FU NHLBI NIH HHS [N01-HC-15103, N01-HC-35129, N01-HC-45133, N01-HC-55222, N01-HC-75150, N01-HC-85079, N01-HC-85086, U01 HL080295]; NIA NIH HHS [P30 AG024827, 1 P30 AG024827] NR 46 TC 70 Z9 70 U1 1 U2 2 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD SEP PY 2007 VL 62 IS 9 BP 1048 EP 1055 PG 8 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 272AE UT WOS:000253829000018 PM 17895446 ER PT J AU Kavirajan, H Schneider, LS AF Kavirajan, Harish Schneider, Lon S. TI Efficacy and adverse effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomised controlled trials SO LANCET NEUROLOGY LA English DT Article ID ALZHEIMERS-DISEASE; CEREBROVASCULAR-DISEASE; CLINICAL-TRIALS; DONEPEZIL; GALANTAMINE; MULTICENTER; CRITERIA AB Background Cholinesterase inhibitors and memantine do not have regulatory approval in most of the world for treatment of vascular dementia. A systematic review and meta-analysis was undertaken to assess the evidence for efficacy and safety of cholinesterase inhibitors and memantine in vascidar dementia. Methods PubMed, BIOSIS, International Pharmaceutical Abstracts, and Cochrane registries were searched for randomised, placebo-controlled trials on cholinesterase inhibitors and memantine in patients with vascular dementia. Trial methods, clinical characteristics, outcomes, and adverse events were extracted and checked. Meta-analytic methods using fixed-effects models were used to give summaries of each drug's effects. Findings Three donepezil, two galantamine, one rivastigmine, and two memantine trials, comprising 3093 patients on the study drugs and. 2090 patients on placebo, met the selection criteria. Trials were of 6-month duration with similar vascular dementia criteria and outcome measures. Cognitive effects on the Alzheimer's Disease Assessment scale were significant for all drugs, ranging from a -1.10 point mean difference (95% CI -2.15 to -0.05) for rivastigmine to -2.17 for 10 mg daily donepezil (95% CI -2.98 to -1.35). Only 5 mg daily donepezil had an effect on the Clinicians' Global Impression of Change scale (odds ratio 1.51 [95% CI 1.11-2.07]). No behavioural or functional benefits were observed, except for a -0.95 point difference (95% CI -1.74 to -0.16) with 10 mg daily donepezil on the Alzheimer's Disease Functional Assessment and Change Scale. Compared with placebo, more dropouts and adverse events (anorexia, nausea, vomiting, diarrhoea, and insomnia) occurred with the cholinesterase inhibitors, but not with memantine. Interpretation Cholinesterase inhibitors and memantine produce small benefits in cognition of uncertain clinical significance in patients with mild to moderate vascular dementia. Data are insufficient to support widespread use of these drugs in vascular dementia. Individual patient analyses are needed to identify subgroups of patients with vascular dementia who might benefit. C1 Univ Calif Los Angeles, Geffen Sch Med, Dept Gen Internal Med, Div Hlth Serv Res,Vet Affairs Greater Los Angeles, Los Angeles, CA USA. Univ Calif Los Angeles, Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. Univ So Calif, Leonard Davis Sch Gerontol, Los Angeles, CA USA. Univ So Calif, Keck Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA USA. Univ So Calif, Keck Sch Med, Dept Neurol, Los Angeles, CA USA. RP Kavirajan, H (reprint author), 950 S Coast Dr,Suite 202, Mesa, CA 92626 USA. EM hkaviraj@yahoo.com FU NIA NIH HHS [AG 05142] NR 38 TC 140 Z9 169 U1 4 U2 25 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 1474-4422 J9 LANCET NEUROL JI Lancet Neurol. PD SEP PY 2007 VL 6 IS 9 BP 782 EP 792 DI 10.1016/S1474-4422(07)70195-3 PG 11 WC Clinical Neurology SC Neurosciences & Neurology GA 204SV UT WOS:000249065200017 PM 17689146 ER PT J AU Guss, J Cohen, MA Mirza, N AF Guss, Joel Cohen, Marc A. Mirza, Natasha TI Hard palate necrosis after bilateral internal maxillary artery embolization for epistaxis SO LARYNGOSCOPE LA English DT Article; Proceedings Paper CT Meeting of the Combined Sections of the Triological-Society CY FEB 14-18, 2007 CL Marco Isl, FL SP Triol Soc DE epistaxis; embolization; necrosis; hard palate; nasal packing ID ANGIOGRAPHIC EMBOLIZATION; INTRACTABLE EPISTAXIS; POSTERIOR EPISTAXIS; MANAGEMENT AB Superselective embolization is an effective method of treating epistaxis that is refractory to conservative treatment. Soft tissue necrosis is a rare complication owing to the extensive collateral blood supply of the head and neck. We describe the case of a patient who developed unilateral necrosis of the mucosa overlying the hard palate after undergoing bilateral internal maxillary artery embolization. The presence of a nasopharyngeal balloon I and bilateral nasal packs for 2 days after embolization I may have compressed collateral vessels in the soft palate I and nose and contributed to this complication. Packing should be removed as soon as possible after embolization. C1 Univ Penn, Dept Otorhinolaryngol Head & Neck Surg, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. RP Guss, J (reprint author), 5 Ravdin Bldg,3400 Spruce St, Philadelphia, PA 19104 USA. EM joel.guss@uphs.upenn.edu NR 8 TC 13 Z9 16 U1 0 U2 2 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0023-852X J9 LARYNGOSCOPE JI Laryngoscope PD SEP PY 2007 VL 117 IS 9 BP 1683 EP 1684 DI 10.1097/MLG.0b013e318093ee8d PG 2 WC Medicine, Research & Experimental; Otorhinolaryngology SC Research & Experimental Medicine; Otorhinolaryngology GA 207QH UT WOS:000249265400027 PM 17667134 ER PT J AU DeRubertis, FR Craven, PA Melhem, MF AF DeRubertis, Frederick R. Craven, Patricia A. Melhem, Mona F. TI Acceleration of diabetic renal injury in the superoxide dismutase knockout mouse: effects of tempol SO METABOLISM-CLINICAL AND EXPERIMENTAL LA English DT Article ID NITRIC-OXIDE SYNTHESIS; OXIDATIVE STRESS; SIGNALING PATHWAYS; GLOMERULAR INJURY; NADPH OXIDASE; MICE; NEPHROPATHY; GENERATION; RATS; PEROXYNITRITE AB Indices of renal injury and oxidative stress were examined in mice with deficiency of cytosolic Cu2+/Zn2+ superoxide dismutase (SOD1-/-, KO) and their wild-type (WT) littermates with streptozotocin-induced diabetes. After 5 weeks of diabetes, KO diabetic (D) but not WT-D mice developed marked albuminuria, increases in glomerular content of transforming growth factor beta, collagen alpha 1(IV), and nitrotyrosine, and higher glomerular superoxide compared with corresponding values in nondiabetics. After 5 months of diabetes, increases in these parameters, mesangial matrix expansion, renal cortical malondialdehyde content, and severity of tubulointerstitial injury were all significantly greater, whereas cortical glutathione was lower, in KO-D than in WT-D. In contrast to WT-D, after 4 weeks of diabetes, KO-D mice did not develop the increase in inulin clearance (C-ln) characteristic of early diabetes. The nitric oxide synthase inhibitor N-omega-nitro-L-arginine methylester suppressed C-ln. in WT-D, but had no effect on C-ln in KO-D. Treatment of KO-D with the SOD mimetic tempol for 4 weeks suppressed albuminuria, increases in glomerular transforming growth factor beta, collagen alpha 1(IV), nitrotyrosine, and glomerular superoxide, and concurrently increased C-ln. The latter action of tempol in KO-D was blocked by the N-omega-nitro-L-arginine methylester. The findings provide support for a role for superoxide and its metabolism by SOD1 in the pathogenesis of renal injury in diabetes in vivo, and implicate increased interaction of superoxide with nitric oxide as a pathogenetic factor. Published by Elsevier Inc. C1 VA Pittsburgh Healthcare Syst, Dept Med, Pittsburgh, PA 15240 USA. VA Pittsburgh Healthcare Syst, Dept Pathol, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA 15240 USA. RP DeRubertis, FR (reprint author), VA Pittsburgh Healthcare Syst, Dept Med, Pittsburgh, PA 15240 USA. EM frederick.derubertis@med.va.gov NR 37 TC 53 Z9 56 U1 1 U2 3 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0026-0495 J9 METABOLISM JI Metab.-Clin. Exp. PD SEP PY 2007 VL 56 IS 9 BP 1256 EP 1264 DI 10.1016/j.metabol.2007.04.024 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 204NG UT WOS:000249050400015 PM 17697870 ER PT J AU Guan, S Chen, M Woodley, D Li, W AF Guan, Shengxi Chen, Mei Woodley, David Li, Wei TI Nck beta adapter controls neuritogenesis by maintaining the cellular paxillin level SO MOLECULAR AND CELLULAR BIOLOGY LA English DT Article ID PHOTORECEPTOR AXON GUIDANCE; GROWTH-FACTOR-BB; ACTIN POLYMERIZATION; SIGNAL-TRANSDUCTION; PROTEIN; SYSTEM; LOCALIZATION; FIBROBLASTS; ACTIVATION; DROSOPHILA AB The SH2/SH3 adapter Nck has an evolutionarily conserved role in neurons, linking the cell surface signals to actin cytoskelleton-mediated responses. The mechanism, however, remains poorly understood. We have investigated the role of Nck/Nck alpha/Nck1 versus Grb4/Nck beta/Nck2 side-by-side in the process of mammalian neuritogenesis. Here we show that permanent genetic silencing of Nck beta, but not Nck alpha, completely blocked nerve growth factor-induced neurite outgrowth in PC12 cells and dramatically disrupted the axon and dendrite tree in primary rat cortical neurons. By screening for changes among the components reportedly present in complex with Nck, we found that the steady-state level of paxillin was significantly reduced in Nck beta knockdown, but not Nck alpha knockdown, neurons. Interestingly, Nck beta knockdown did not affect the paxillin level in glial cells and several other cell types of various tissue origins. Genetic silencing of paxillin blocked neuritogenesis, just like Nck beta knockdown. Reintroducing a nondegradable Nck beta into Nck beta short interfering RNA-expressing PC12 cells rescued paxillin from down-regulation and allowed the resumption of neuritogenesis. Forced expression of paxillin in Nck beta knockdown PC12 also rescued its capacity for neuritogenesis. Finally, Nck beta, but not Nck alpha, binds strongly to paxillin and treatment of the neurons with proteosome inhibitors prevented paxillin down-regulation in Nck beta knockdown neurons. Thus, Nck beta maintains paxillin stability during neuritogenesis. C1 Univ So Calif, Keck Sch Med, Dept Dermatol, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, USC Norris Canc Ctr, Los Angeles, CA 90033 USA. VA Greater Los Angeles Healthcare Syst, Sepulveda, CA 91343 USA. RP Li, W (reprint author), 1303 N Mission Rd, Los Angeles, CA 90033 USA. EM wli@usc.edu FU NIAMS NIH HHS [GM/AR67100-01] NR 27 TC 13 Z9 13 U1 1 U2 5 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0270-7306 J9 MOL CELL BIOL JI Mol. Cell. Biol. PD SEP PY 2007 VL 27 IS 17 BP 6001 EP 6011 DI 10.1128/MCB.01807-06 PG 11 WC Biochemistry & Molecular Biology; Cell Biology SC Biochemistry & Molecular Biology; Cell Biology GA 203MQ UT WOS:000248979100006 PM 17591694 ER PT J AU Echchgadda, I Song, CS Oh, T Ahmed, M De La Cruz, IJ Chatterjee, B AF Echchgadda, Ibtissam Song, Chung S. Oh, Taesung Ahmed, Mohamed De La Cruz, Isidro John Chatterjee, Bandana TI The xenobiotic-sensing nuclear receptors pregnane x receptor, constitutive androstane receptor, and orphan nuclear receptor hepatocyte nuclear factor 4 alpha in the regulation of human Steroid- Bile acid-sulfotransferase SO MOLECULAR ENDOCRINOLOGY LA English DT Article ID VITAMIN-D-RECEPTOR; HUMAN CYTOSOLIC SULFOTRANSFERASES; DEHYDROEPIANDROSTERONE-SULFOTRANSFERASE; GENE-EXPRESSION; TRANSCRIPTIONAL CONTROL; MOLECULAR-CLONING; AGONIST LIGAND; MOUSE-LIVER; CAR; METABOLISM AB The nuclear receptors pregnane X receptor ( PXR) and constitutive androstane receptor ( CAR) are the primary transcription factors coordinating induced expression of the enzymes and proteins directing oxidative, conjugative, and transport phases of endobiotic and xenobiotic metabolism, whereas hepatocyte nuclear factor 4 alpha ( HNF4 alpha), a regulator of hepatic lipid homeostasis, can modify the PXR/ CAR response. Steroid- and bile acid-sulfotransferase ( SULT2A1) promotes phase II metabolism through its sulfonating action on certain endobiotics,including steroids and bile acids, and on diverse xenobiotics, including therapeutic drugs. This study describes characterization of a PXR- and CAR-inducible composite element in the human SULT2A1 promoter and its synergistic interaction with HNF4 alpha. Inverted and direct repeats of AG( G/ T) TCA ( IR2 and DR4), both binding to PXR and CAR, define the composite element. Differential recognition of the composite element by PXR and CAR is evident because single-site mutation at either IR2 or DR4 in the natural gene abolished the PXR response, whereas mutations at both repeats were necessary to abrogate completely the CAR response. The composite element conferred xenobiotic response to a heterologous promoter, and the cognate ligands induced PXR and CAR recruitment to the chromatin-associated response region. An HNF4 alpha element adjacent to the - 30 position enhanced basal promoter activity. Although functioning as a synergizer, the HNF4 alpha element was not essential for the PXR/ CAR response. An emerging role of SULT2A1 in lipid and caloric homeostasis suggests that illumination on the regulatory interactions driving human SULT2A1 expression may reveal new avenues to control certain metabolic disorders. C1 Univ Texas, Hlth Sci Ctr, Inst Biotechnol, Dept Mol Med, San Antonio, TX 78245 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. RP Echchgadda, I (reprint author), Univ Texas, Hlth Sci Ctr, Inst Biotechnol, Dept Mol Med, 15355 Lambda Dr, San Antonio, TX 78245 USA. FU NIA NIH HHS [AG10486] NR 44 TC 41 Z9 44 U1 1 U2 3 PU ENDOCRINE SOC PI CHEVY CHASE PA 8401 CONNECTICUT AVE, SUITE 900, CHEVY CHASE, MD 20815-5817 USA SN 0888-8809 J9 MOL ENDOCRINOL JI Mol. Endocrinol. PD SEP PY 2007 VL 21 IS 9 BP 2099 EP 2111 DI 10.1210/me.2007-0002 PG 13 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 204CG UT WOS:000249020200005 PM 17595319 ER PT J AU Schneider, SA Walker, RH Bhatia, KP AF Schneider, Susanne A. Walker, Ruth H. Bhatia, Kailash P. TI The Huntington's disease-like syndromes: what to consider in patients with a negative Huntington's disease gene test SO NATURE CLINICAL PRACTICE NEUROLOGY LA English DT Review DE Huntington's disease; Huntington's disease-like syndromes; junctophilin 3; prion disease; spinocerebellar ataxia type 17 ID DENTATORUBRAL-PALLIDOLUYSIAN ATROPHY; HALLERVORDEN-SPATZ-SYNDROME; TATA-BINDING PROTEIN; KINASE-ASSOCIATED NEURODEGENERATION; TRINUCLEOTIDE REPEAT EXPANSIONS; DOMINANT SPINOCEREBELLAR ATAXIA; CHOREA-ACANTHOCYTOSIS; CLINICAL-FEATURES; BASAL GANGLIA; DENTATORUBROPALLIDOLUYSIAN ATROPHY AB Huntington's disease (HD), which is caused by a triplet-repeat expansion in the IT15 gene (also known as huntingtin or HD), accounts for about 90% of cases of chorea of genetic etiology. In recent years, several other distinct genetic disorders have been identified that can present with a clinical picture indistinguishable from that of HD. These disorders are termed Huntington's disease-like (HDL) syndromes. So far, four such conditions have been recognized, namely disorders attributable to mutations in the prion protein gene (HDLI), the junctophilin 3 gene (HDL2), and the gene encoding the TATA box-binding protein (HDL4/SCAI 7), and a recessively inherited HD phenocopy in a single family (HDL3), the genetic basis of which is currently poorly understood. These disorders, however, account for only a small proportion of cases with the HD phenotype but a negative genetic test for HD, and the list of HDL genes and conditions is set to grow. In this article, we review the most important HD phenocopy disorders identified to date and discuss the clinical clues that guide further investigation. We will concentrate on the four so-called HDL syndromes mentioned above, as well as other genetic disorders such as dentatorubralpallidoluysian atrophy, neuroferritinopathy, pantothenate-kinase-associated neurodegeneration and chorea-acanthocytosis. C1 UCL, Inst Neurol, Sobell Dept Motor Neurosci & Movement Disorders, London WC1N 3BG, England. James J Peters Vet Affairs Med Ctr, Dept Neurol, Movement Disorders Clin, Bronx, NY USA. Mt Sinai Sch Med, Dept Neurol, New York, NY USA. RP Bhatia, KP (reprint author), UCL, Inst Neurol, Sobell Dept Motor Neurosci & Movement Disorders, London WC1N 3BG, England. EM kbhatia@ion.ucl.ac.uk NR 76 TC 44 Z9 45 U1 0 U2 7 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK ST, 9TH FLR, NEW YORK, NY 10013-1917 USA SN 1745-834X J9 NAT CLIN PRACT NEURO JI Nat. Clin. Pract. Neurol. PD SEP PY 2007 VL 3 IS 9 BP 517 EP 525 DI 10.1038/ncpneuro0606 PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA 205PI UT WOS:000249126700012 PM 17805246 ER PT J AU Harley, JB AF Harley, John B. TI IL-7R alpha and multiple sclerosis risk SO NATURE GENETICS LA English DT Editorial Material ID SINGLE NUCLEOTIDE POLYMORPHISMS; GENOMIC CONVERGENCE; CANDIDATE GENES; ASSOCIATIONS; DISEASE AB The discovery of genetic risk factors for multiple sclerosis has proven difficult. IL- 7R alpha, encoded by IL7R, is a pleiomorphic cytokine receptor now implicated in the pathogenesis of multiple sclerosis in independently replicated genetic association studies. C1 Oklahoma Med Res Fdn, Arthrit & Immunol Program, Oklahoma City, OK 73104 USA. US Dept Vet Affairs, Med Ctr, Oklahoma City, OK 73104 USA. RP Harley, JB (reprint author), Oklahoma Med Res Fdn, Arthrit & Immunol Program, 825 NE 13th St, Oklahoma City, OK 73104 USA. EM harley@omrf.org NR 14 TC 9 Z9 9 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 1061-4036 J9 NAT GENET JI Nature Genet. PD SEP PY 2007 VL 39 IS 9 BP 1053 EP 1054 DI 10.1038/ng0907-1053 PG 2 WC Genetics & Heredity SC Genetics & Heredity GA 205OA UT WOS:000249122400004 PM 17728770 ER PT J AU Zhang, XY Tan, YL Zhou, DF Haile, CN Wu, GY Cao, LY Kosten, TA Kosten, TR AF Zhang, Xiang Yang Tan, Yun Long Zhou, Dong Feng Haile, Colin N. Wu, Gui Ying Cao, Lian Yuan Kosten, Therese A. Kosten, Thomas R. TI Nicotine dependence, symptoms and oxidative stress in male patients with schizophrenia SO NEUROPSYCHOPHARMACOLOGY LA English DT Article DE schizophrenia; nicotine; cigarette smoking; oxidative stress; antioxidant enzymes; symptom ID LIPID-PEROXIDATION; PARKINSONS-DISEASE; CIGARETTE-SMOKING; TOBACCO SMOKING; DIFFERENT FORMS; IN-VITRO; ENZYMES; ASSOCIATION; RELEVANCE; DOPAMINE AB The high rate of smoking in schizophrenia may reflect patients' attempts to reduce the side effects of antipsychotic medications, and one mechanism for this reduction may be a reduction in oxidative stress and free radical-mediated brain damage that may contribute to schizophrenic symptoms and to complications of its treatment. Symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS), side effects were assessed with the Simpson and Angus Rating Scale ( SAS), and malondialdehyde (MDA), superoxide dismutase ( SOD), glutathione peroxidase (GSH- Px) and catalase ( CAT) activities were measured in plasma. All of these measures were compared in 130 male inpatients with DSM-IV schizophrenia: 104 smokers and 26 non-smokers. The results showed that the positive PANSS symptoms were lower in smokers than non-smokers (14.5 vs 17.5), while the negative symptoms were lower in those who smoked more cigarettes (r = -0.23). The SAS showed no differences. The CAT activity was correlated with both GSH- Px and SOD activities. Of the three enzymes only the CAT activity was significantly higher in smokers than non-smokers ( 2.9 vs 1.6 U/ml), but greater SOD activity correlated more cigarettes smoked ( r = 0.24). Consistent with some protection against oxidative stress, MDA also was significantly lower in smokers than non-smokers (9.2 vs 14.4 nmol/ml). The fewer positive symptoms in smokers and fewer negative symptoms in those who smoked more cigarettes may be a selection bias, but appears to be associated with decreased oxidative stress and lipid peroxidation in schizophrenics who smoke tobacco. C1 Baylor Coll Med, VA Med Ctr, Menninger Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Peking Univ, Inst Mental Hlth, Beijing 100871, Peoples R China. Beijing HuiLongGuan Hosp, Ctr Biol Psychiat, Beijing, Peoples R China. RP Zhang, XY (reprint author), Baylor Coll Med, VA Med Ctr, Menninger Dept Psychiat & Behav Sci, Res Bldg 109,Room 130,2002 Holcombe Blvd, Houston, TX 77030 USA. EM xyzhang@bcm.edu; zhoudf@bjmu.edu.cn OI Haile, Colin/0000-0001-8293-7291 FU NIDA NIH HHS [K05 DA 0454, P50 DA 18827] NR 39 TC 24 Z9 26 U1 3 U2 4 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD SEP PY 2007 VL 32 IS 9 BP 2020 EP 2024 DI 10.1038/sj.npp.1301317 PG 5 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 200US UT WOS:000248788900017 PM 17228336 ER PT J AU Aldredge, LM AF Aldredge, Lakshi M. TI The role of sentinel node biopsy in patients with cutaneous melanoma SO NURSING CLINICS OF NORTH AMERICA LA English DT Article AB The role of sentinel lymph node biopsy (SLNB) as a prognostic indicator in melanoma patients has been controversial in the fields of surgical oncology and dermatology for decades. This minimally invasive surgical technique was introduced in 1990 for diagnosing melanoma lymphatic metastases and has been deemed the standard of surgical care of cutaneous malignant melanoma by the World Health Organization and the Sunbelt Melanoma Clinical Trial. Its usefulness as a prognostic indicator of metastases led to expanded applications for breast, colon, gastric, esophageal, head and neck, thyroid, and lung cancers. This article first provides an overview of cutaneous melanoma and staging methods and treatment modalities. A brief study of the lymphatic system and the SLNB procedure are reviewed, followed by a discussion of its usefulness in patients who have melanoma, including risks and benefits. This article also discusses nursing considerations for patients undergoing the procedure, and patient education tips. Lastly, future indications for SLNB and new prognostic indicators for melanoma are discussed. C1 Portland VA Med Ctr, Serv Dermatol, Portland, OR 97207 USA. RP Aldredge, LM (reprint author), Portland VA Med Ctr, Serv Dermatol, POB 1034, Portland, OR 97207 USA. EM lakshi.aldredge@va.gov NR 14 TC 0 Z9 0 U1 0 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0029-6465 J9 NURS CLIN N AM JI Nurs. Clin. North Am. PD SEP PY 2007 VL 42 IS 3 BP 379 EP + DI 10.1016/j.cnur.2007.06.001 PG 16 WC Nursing SC Nursing GA 221MX UT WOS:000250233100003 PM 17825660 ER PT J AU Lieber, CS Leo, MA Cao, Q Mak, KM Ren, CL Ponomarenko, A Wang, XL DeCarli, LM AF Lieber, Charles S. Leo, Maria A. Cao, Qi Mak, Ki M. Ren, Chaoling Ponomarenko, Anatoly Wang, Xiaolei DeCarli, Leonore M. TI The combination of S-adenosylmethionine and dilinoleoylphosphatidylcholine attenuates nonalcoholic steatohepatitis produced by a high-fat diet in rats SO NUTRITION RESEARCH LA English DT Article DE nonalcoholic steatohepatitis; fat; S-adenosylmethionine; dilinoleoylphosphatidylcholine; rats ID ALCOHOLIC LIVER-DISEASE; ADENOSYL-L-METHIONINE; HEPATIC STELLATE CELLS; INJURY; DLPC; INTERVENTION; HEPATOCYTES; EXPRESSION; INDUCTION; THERAPY AB In the pathogenesis of nonalcoholic steatohepatitis (NASH), oxidative stress resulting from free radicals generated by cytochrome P4502E1 (CYP2E1) plays a major role suggesting the importance of antioxidants. The objective of this study was to assess in a high-fat (HF) diet rat model the effects of the combination of S-adenosylmethionine (SAMe) plus dilinoleoylphosphatidylcholine (DLPC) in the treatment of NASH. To test the hypothesis that these 2 antioxidants are beneficial in NASH, male Sprague-Dawley rats were fed 5 different diets for 6 weeks: control, HF diet and HF plus, SAMe, and DLPC or their combination. As expected, the HF diet significantly increased hepatic triacylglycerols and CYP2E1 levels. However, only the combination diet opposed this effect, consistent with different actions of the 2 antioxidants. Next, 24 additional rats divided in 2 groups were fed the HF or the HF + SAMe + DLPC diets for 3 weeks. Dietary intake was similar, but liver triacylglycerols dropped from 76.1 +/- 6.8 to 49.4 +/- 3.5 mg/g (P = .002), and hepatic CYP2E1 messenger RNA (mRNA) decreased after treatment (P = .01), with a trend for less CYP2E1 protein. This was accompanied by a 41% reduction of hepatic 4-hydroxynonenal (P = .008), reflecting control of oxidative stress. Furthermore, the hepatic inflammatory cytokine tumor necrosis factor alpha mRNA and tumor necrosis factor alpha protein decreased (P = .05 and P = .01, respectively) with attenuation of alpha 1(I) procollagen mRNA and type I collagen levels (P = .01 and P = .02, respectively). We concluded that the combination SAMe + DLPC might be beneficial in NASH by reducing oxidative stress and associated liver injury. (c) 2007 Elsevier Inc. All rights reserved. C1 Mt Sinai Sch Med, James J Peters VA Med Ctr, Ctr Alcohol Res & Treatment, Sect Liver Dis & Nutr, Bronx, NY 10468 USA. RP Lieber, CS (reprint author), Mt Sinai Sch Med, James J Peters VA Med Ctr, Ctr Alcohol Res & Treatment, Sect Liver Dis & Nutr, Bronx, NY 10468 USA. EM liebercs@aol.com FU NCCIH NIH HHS [R01 AT001583, R01 AT001583-04] NR 36 TC 15 Z9 15 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0271-5317 J9 NUTR RES JI Nutr. Res. PD SEP PY 2007 VL 27 IS 9 BP 565 EP 573 DI 10.1016/j.nutres.2007.07.005 PG 9 WC Nutrition & Dietetics SC Nutrition & Dietetics GA 210UB UT WOS:000249480000008 PM 18769506 ER PT J AU Gallagher, RM AF Gallagher, Rollin M. TI Selective, tailored, biopsychosocial pain treatment: Our past is our future SO PAIN MEDICINE LA English DT Editorial Material C1 Univ Penn, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. RP Gallagher, RM (reprint author), Univ Penn, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. NR 0 TC 4 Z9 4 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1526-2375 J9 PAIN MED JI Pain Med. PD SEP PY 2007 VL 8 IS 6 BP 471 EP 474 DI 10.1111/j.1526-4637.2007.00361.x PG 4 WC Medicine, General & Internal SC General & Internal Medicine GA 206PV UT WOS:000249196300001 PM 17716318 ER PT J AU Chattergoon, NN Louey, S O'Tierney, PF Girard, GD Thomburg, KL AF Chattergoon, N. N. Louey, S. O'Tierney, P. F. Girard, G. D. Thomburg, K. L. TI Thyroid hormone is a potent regulator of fetal sheep cardiomyocyte proliferation SO PEDIATRIC RESEARCH LA English DT Meeting Abstract CT Aspen Perinatal Biology Conference 2007 CY AUG 25-28, 2007 CL Aspen, CO C1 Oregon Hlth & Sci Univ, Dept Physiol & Pharmacol, Portland, OR USA. Oregon Hlth & Sci Univ, Sch Med, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. Oregon Hlth & Sci Univ, Heart Res Ctr, Portland, OR 97201 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU INT PEDIATRIC RESEARCH FOUNDATION, INC PI BALTIMORE PA 351 W CAMDEN ST, BALTIMORE, MD 21201-2436 USA SN 0031-3998 J9 PEDIATR RES JI Pediatr. Res. PD SEP PY 2007 VL 62 IS 3 BP 382 EP 382 PG 1 WC Pediatrics SC Pediatrics GA 203KJ UT WOS:000248973200042 ER PT J AU Jonker, S Giratid, M Giraud, G Chattergoon, N Louey, S Thornburg, K AF Jonker, S. Giratid, M. Giraud, G. Chattergoon, N. Louey, S. Thornburg, K. TI Myocyte proliferation contributes to anemia-induced fetal cardiac enlargement SO PEDIATRIC RESEARCH LA English DT Meeting Abstract CT Aspen Perinatal Biology Conference 2007 CY AUG 25-28, 2007 CL Aspen, CO C1 Oregon Hlth & Sci Univ, Heart Res Ctr, Dept Physiol & Pharmacol, Cardiovasc Med, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. RP Jonker, S (reprint author), Oregon Hlth & Sci Univ, Heart Res Ctr, Dept Physiol & Pharmacol, Cardiovasc Med, Portland, OR 97201 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU INT PEDIATRIC RESEARCH FOUNDATION, INC PI BALTIMORE PA 351 W CAMDEN ST, BALTIMORE, MD 21201-2436 USA SN 0031-3998 J9 PEDIATR RES JI Pediatr. Res. PD SEP PY 2007 VL 62 IS 3 BP 382 EP 382 PG 1 WC Pediatrics SC Pediatrics GA 203KJ UT WOS:000248973200043 ER PT J AU O'Tierney, PF Anderson, DF Loucy, S Thornburg, KL Giraud, GD AF O'Tierney, P. F. Anderson, D. F. Loucy, S. Thornburg, K. L. Giraud, G. D. TI Reduced systolic pressure load, in vivo, decreases cell cycle activity in the fetal sheep heart SO PEDIATRIC RESEARCH LA English DT Meeting Abstract CT Aspen Perinatal Biology Conference 2007 CY AUG 25-28, 2007 CL Aspen, CO C1 Oregon Hlth & Sci Univ, Hlth Res Ctr, Dept Physiol & Pharmacol, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Hlth Res Ctr, Dept Med, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. RP O'Tierney, PF (reprint author), Oregon Hlth & Sci Univ, Hlth Res Ctr, Dept Physiol & Pharmacol, Portland, OR 97201 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU INT PEDIATRIC RESEARCH FOUNDATION, INC PI BALTIMORE PA 351 W CAMDEN ST, BALTIMORE, MD 21201-2436 USA SN 0031-3998 J9 PEDIATR RES JI Pediatr. Res. PD SEP PY 2007 VL 62 IS 3 BP 382 EP 382 PG 1 WC Pediatrics SC Pediatrics GA 203KJ UT WOS:000248973200047 ER PT J AU Choate, M DuPriest, E Lin, B Xue, H Kupfer, P Roullet, JB Bagby, S AF Choate, M. DuPriest, E. Lin, B. Xue, H. Kupfer, P. Roullet, J. B. Bagby, S. TI Maternal protein restriction in swine: Increased aortic Nox 4 mRNA in both fetal and juvenile offspring parallels increased mesenteric NADPH oxidase-dependent ANGII reactivity in juveniles SO PEDIATRIC RESEARCH LA English DT Meeting Abstract CT Aspen Perinatal Biology Conference 2007 CY AUG 25-28, 2007 CL Aspen, CO C1 Oregon Hlth & Sci Univ, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU INT PEDIATRIC RESEARCH FOUNDATION, INC PI BALTIMORE PA 351 W CAMDEN ST, BALTIMORE, MD 21201-2436 USA SN 0031-3998 J9 PEDIATR RES JI Pediatr. Res. PD SEP PY 2007 VL 62 IS 3 BP 383 EP 383 PG 1 WC Pediatrics SC Pediatrics GA 203KJ UT WOS:000248973200052 ER PT J AU Lelievre, V Favrais, G Abad, C Adle-Biassette, H Lu, Y Germano, PM Cheung-Lau, G Pisegna, JR Gressens, P Lawson, G Waschek, JA AF Lelievre, V. Favrais, G. Abad, C. Adle-Biassette, H. Lu, Y. Germano, P. M. Cheung-Lau, G. Pisegna, J. R. Gressens, P. Lawson, G. Waschek, J. A. TI Gastrointestinal dysfunction in mice with a targeted mutation in the gene encoding vasoactive intestinal polypeptide: A model for the study of. intestinal ileus and Hirschsprung's disease SO PEPTIDES LA English DT Article DE vasoactive intestinal peptide; knockout; peristalsis; gastrointestinal transit ID CYCLASE-ACTIVATING POLYPEPTIDE; ADENOCARCINOMA CELL-LINES; SMOOTH-MUSCLE; EPITHELIAL-CELLS; SONIC HEDGEHOG; TROPHIC FACTOR; VIP RECEPTORS; RAT JEJUNUM; PEPTIDE; PROLIFERATION AB In 1970, Drs. Said and Mutt isolated a novel peptide from porcine intestinal extracts with powerful vasoactive properties, and named it vasoactive intestinal peptide (VIP). Since then, the biological actions of VIP in the gut as well as its signal transduction pathways have been extensively studied. A variety of in vitro and in vivo studies have indicated that VIP, expressed in intrinsic non-adrenergic non-cholinergic (NANC) neurons, is a potent regulator of gastrointestinal (GI) motility, water absorption and ion flux, mucus secretion and immune homeostasis. These VIP actions are believed to be mediated mainly by interactions with highly expressed VPAC(1) receptors and the production of nitric oxide (NO). Furthermore, VIP has been implicated in numerous physiopathological conditions affecting the human gut, including pancreatic endocrine tumors secreting VIP (VIPomas), insulin-dependent diabetes, Hirschsprung's disease, and inflammatory bowel syndromes such as Crohn's disease and ulcerative colitis. To further understand the physiological roles of VIP on the GI tract, we have begun to analyze the anatomical and physiological phenotype of C57BL/6 mice lacking the VIP gene. Herein, we demonstrate that the overall intestinal morphology and light microscopic structure is significantly altered in VIP-/- mice. Macroscopically there is an overall increase in weight, and decrease in length of the bowel compared to wild type (WT) controls. Microscopically, the phenotype was characterized by thickening of smooth muscle layers, increased villi length, and higher abundance of goblet cells. Alcian blue staining indicated that the latter cells were deficient in mucus secretion in VIP-/- mice. The differences became more pronounced from the duodenum to the distal jejunum or ileum of the small bowel but, became much less apparent or absent in the colon with the exception of mucus secretion defects. Further examination of the small intestine revealed larger axonal trunks and unusual unstained patches in myenteric plexus. Physiologically, the VIP-/- mice showed an impairment in intestinal transit. Moreover, unlike WT C57BL/6 mice, a significant percentage of VIP-/- mice died in the first postnatal year with overt stenosis of the gut. (c) 2007 Elsevier Inc. All rights reserved. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat, Los Angeles, CA 90095 USA. INSERM, U676, Paris, France. Univ Paris 07, Fac Med Denis Diderot, IFR02, IFR25, Paris, France. Hop Claude Bernard, Serv Anat Pathol, Paris, France. VA Greater Los Angeles Hlthcare Syst, Div Gastroenterol & Hepatol, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Lab Anim Med, Los Angeles, CA USA. RP Waschek, JA (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat, Los Angeles, CA 90095 USA. EM jwaschek@mednet.ucla.edu OI Abad, Catalina/0000-0001-9144-9310; Favrais, Geraldine/0000-0002-0301-2053; Lelievre, Vincent/0000-0003-4150-8233 FU NICHD NIH HHS [P01 HD006576-280021, HD0657, HD34475, P01 HD006576, P01 HD006576-240021, P01 HD006576-250021, P01 HD006576-260021, P01 HD006576-270021, P01 HD006576-27S10021, P01 HD006576-290011, R01 HD034475, R01 HD034475-03, R01 HD034475-04, R01 HD034475-05A1, R01 HD034475-06, R01 HD034475-07, R01 HD034475-08, R01 HD034475-09] NR 41 TC 43 Z9 46 U1 0 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0196-9781 J9 PEPTIDES JI Peptides PD SEP PY 2007 VL 28 IS 9 BP 1688 EP 1699 DI 10.1016/j.peptides.2007.05.006 PG 12 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy SC Biochemistry & Molecular Biology; Endocrinology & Metabolism; Pharmacology & Pharmacy GA 218TQ UT WOS:000250038200012 PM 17606312 ER PT J AU Bent, S AF Bent, Stephen TI Editorial: assessing the safety of dietary supplements SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Editorial Material ID MEDICINES C1 Univ Calif San Francisco, Osher Ctr Integrat Med, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, Dept Med, San Francisco, CA USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. RP Bent, S (reprint author), Vet Adm Med Ctr, 111-A1,4150 Clement St, San Francisco, CA 94121 USA. EM Stephen.Bent@ucsf.edu NR 11 TC 0 Z9 0 U1 0 U2 1 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1053-8569 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD SEP PY 2007 VL 16 IS 9 BP 958 EP 960 DI 10.1002/pds.1450 PG 3 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA 210TC UT WOS:000249477500002 PM 17705239 ER PT J AU Lewinsohn, DA Winata, E Swarbrick, GM Tanner, KE Cook, MS Null, MD Cansler, ME Sette, A Sidney, J Lewinsohn, DM AF Lewinsohn, Deborah A. Winata, Ervina Swarbrick, Gwendolyn M. Tanner, Katie E. Cook, Matthew S. Null, Megan D. Cansler, Meghan E. Sette, Alessandro Sidney, John Lewinsohn, David M. TI Immunodominant tuberculosis CD8 antigens preferentially restricted by HLA-B SO PLOS PATHOGENS LA English DT Article ID MYCOBACTERIUM-BOVIS BCG; T-CELL RESPONSES; 19-KDA LIPOPROTEIN; INFECTED-CELLS; MICE; IDENTIFICATION; COMPLEX; RESISTANCE; EXPRESSION; CLONING AB CD8(+) T cells are essential for host defense to intracellular bacterial pathogens such as Mycobacterium tuberculosis (Mtb), Salmonella species, and Listeria monocytogenes, yet the repertoire and dominance pattern of human CD8 antigens for these pathogens remains poorly characterized. Tuberculosis ( TB), the disease caused by Mtb infection, remains one of the leading causes of infectious morbidity and mortality worldwide and is the most frequent opportunistic infection in individuals with HIV/AIDS. Therefore, we undertook this study to define immunodominant CD8 Mtb antigens. First, using IFN-gamma ELISPOT and synthetic peptide arrays as a source of antigen, we measured ex vivo frequencies of CD8(+) T cells recognizing known immunodominant CD4(+) T cell antigens in persons with latent tuberculosis infection. In addition, limiting dilution was used to generate panels of Mtb-specific T cell clones. Using the peptide arrays, we identified the antigenic specificity of the majority of T cell clones, defining several new epitopes. In all cases, peptide representing the minimal epitope bound to the major histocompatibility complex (MHC)-restricting allele with high affinity, and in all but one case the restricting allele was an HLA-B allele. Furthermore, individuals from whom the T cell clone was isolated harbored high ex vivo frequency CD8(+) T cell responses specific for the epitope, and in individuals tested, the epitope represented the single immunodominant response within the CD8 antigen. We conclude that Mtb-specific CD8(+) T cells are found in high frequency in infected individuals and are restricted predominantly by HLA-B alleles, and that synthetic peptide arrays can be used to define epitope specificities without prior bias as to MHC binding affinity. These findings provide an improved understanding of immunodominance in humans and may contribute to a development of an effective TB vaccine and improved immunodiagnostics. C1 Oregon Hlth & Sci Univ, Dept Pediat, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Mol Microbiol & Immunol, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Div Pulm & Crit Care Med, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. La Jolla Inst Allergy & Immunol, San Diego, CA USA. RP Lewinsohn, DM (reprint author), Oregon Hlth & Sci Univ, Dept Pediat, Portland, OR 97201 USA. EM lewinsod@ohsu.edu RI Yehorov, Bohdan/Q-1365-2015; Lewinsohn, David/I-4936-2013 OI Yehorov, Bohdan/0000-0001-7526-0315; Lewinsohn, David/0000-0001-9906-9494 FU NIAID NIH HHS [R01 AI054474, R01 AI048090, R01AI054474, R01AI48090]; PHS HHS [N01-A1-400081] NR 62 TC 79 Z9 80 U1 1 U2 3 PU PUBLIC LIBRARY SCIENCE PI SAN FRANCISCO PA 185 BERRY ST, STE 1300, SAN FRANCISCO, CA 94107 USA SN 1553-7366 J9 PLOS PATHOG JI PLoS Pathog. PD SEP PY 2007 VL 3 IS 9 BP 1240 EP 1249 AR e127 DI 10.1371/journal.ppat.0030127 PG 10 WC Microbiology; Parasitology; Virology SC Microbiology; Parasitology; Virology GA 214WG UT WOS:000249768300007 PM 17892322 ER PT J AU Primack, BA Bost, JE Land, SR Fine, MJ AF Primack, Brian A. Bost, James E. Land, Stephanie R. Fine, Michael J. TI Volume of tobacco advertising in African American markets: Systematic review and meta-analysis SO PUBLIC HEALTH REPORTS LA English DT Article ID CLINICAL-TRIALS; MEDIA LITERACY; SMOKING; ADOLESCENTS; EXPOSURE; ALCOHOL; NEIGHBORHOODS; SEGMENTATION; VALIDATION; BILLBOARDS AB Objective. African Americans currently bear the greatest burden of morbidity and mortality due to smoking, and exposure to pro-tobacco media messages predicts smoking. This study compared the concentration (proportion of media messages that are for tobacco) and density (pro-tobacco media messages per person) of pro-tobacco media messages between African American and Caucasian markets. Methods. We searched Medline (1966 to June 2006), PsychlNF0 (1974 to June 2006), and CINAHL (1982 to June 2006) for studies from peer-reviewed journals directly comparing the volume of pro-tobacco media messages in African American and Caucasian markets. From each study, we extracted the number of total media messages, the number of tobacco-related messages, and the number of residents living in each market area. We calculated the concentration and density of tobacco advertising in each market. Results. Out of 131 studies identified, 11 met eligibility criteria, including seven comparing billboard/signage in African American and Caucasian markets and four comparing magazine advertising in African American and Caucasian markets. Meta-analysis estimated a pooled odds ratio of 1.7 (95% confidence interval [Cl] 1.1, 2.6) for a given billboard being smoking-related in African American vs. Caucasian market areas (i.e., concentration). The pooled rate ratio of the density of smoking-related billboards was 2.6 (95% Cl 1.5, 4.7) in African American vs. Caucasian market areas. Magazine data were insufficient for meta-analysis. Conclusion. Available data indicated that African Americans are exposed to a higher volume of pro-tobacco advertising in terms of both concentration and density. These findings have important implications for research, policy measures, and educational interventions involving racial disparities due to tobacco. C1 Univ Pittsburgh, Sch Med, Ctr Res Hlth Care, Div Gen Internal Med,Dept Med, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Ctr Res Hlth Care, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Div Adolescent Med, Dept Pediat, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Pittsburgh, PA USA. VA Pittsburgh Hlth Care Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA USA. RP Primack, BA (reprint author), Univ Pittsburgh, Sch Med, Ctr Res Hlth Care, Div Gen Internal Med,Dept Med, 230 McKee Pl,Ste 600, Pittsburgh, PA 15213 USA. EM bprimack@pitt.edu FU NCI NIH HHS [K07 CA114315, K07-CA114315]; NIAID NIH HHS [K24 AI001769, K24-AI01769] NR 34 TC 35 Z9 35 U1 2 U2 5 PU ASSOC SCHOOLS PUBLIC HEALTH PI WASHINGTON PA 1101 15TH ST NW, STE 910, WASHINGTON, DC 20005 USA SN 0033-3549 J9 PUBLIC HEALTH REP JI Public Health Rep. PD SEP-OCT PY 2007 VL 122 IS 5 BP 607 EP 615 PG 9 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 197NB UT WOS:000248561400008 PM 17877308 ER PT J AU Stover, EL Brady, L Marder, SR AF Stover, Ellen L. Brady, Linda Marder, Stephen R. TI New paradigms for treatment development SO SCHIZOPHRENIA BULLETIN LA English DT Article DE schizophrenia; treatment; pharmacology ID IMPROVE COGNITION; CHRONIC-SCHIZOPHRENIA; ILLNESS AB Wayne Fenton believed that government-particularly National Institute of Mental Health (NIMH)-could play a critical role in addressing important public health problems where the current system of treatment development was inadequate. Earlier experiences in HIV/AIDS convinced him and others that the NIMH can effectively facilitate the rapid development of new research in critical areas. This report will demonstrate how the work of Fenton and others brought together representatives from industry, government, and academia to address issues that included new preclinical approaches to drug development and defining new therapeutic targets in schizophrenia. An initiative to facilitate the development of new pharmacological agents to address the cognitive impairments in schizophrenia-titled Measurement and Treatment Research to Improve Cognition in Schizophreniaor MATRICS-is used as an example of a new paradigm for treatment development. C1 Univ Calif Los Angeles, Semel Inst Neurosci, Los Angeles, CA 90073 USA. Desert Pacific Mental Illness Res Educ & Clin Ctr, Los Angeles, CA 90073 USA. W Los Angeles Vet Affairs Med Ctr, Los Angeles, CA 90073 USA. NIMH, Bethesda, MD 20892 USA. RP Marder, SR (reprint author), Univ Calif Los Angeles, Semel Inst Neurosci, Bldg 210,Room 130,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM marder@ucla.edu NR 26 TC 12 Z9 12 U1 0 U2 1 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD SEP PY 2007 VL 33 IS 5 BP 1093 EP 1099 DI 10.1093/schbul/sbm085 PG 7 WC Psychiatry SC Psychiatry GA 214HD UT WOS:000249726700009 PM 17673495 ER PT J AU Brekke, JS Hoe, M Long, J Green, MF AF Brekke, John S. Hoe, Maanse Long, Jeffrey Green, Michael F. TI How neurocognition and social cognition influence functional change during community-based psychosocial rehabilitation for individuals with schizophrenia SO SCHIZOPHRENIA BULLETIN LA English DT Article DE social cognition; neurocognition; schizophrenia; rehabilitation; outcome ID SEVERE MENTAL-ILLNESS; PSYCHIATRIC RATING-SCALE; VOCATIONAL-REHABILITATION; ENHANCEMENT THERAPY; IMPROVE COGNITION; CASE-MANAGEMENT; DEFICITS; PERFORMANCE; PERCEPTION; SERVICES AB The purpose of this study was to assess how neurocognition and social cognition were associated with initial functional level and with rates of functional change in intensive community-based psychosocial rehabilitation interventions that have been shown to yield significant functional change for individuals diagnosed with schizophrenia. We also examined how service intensity was associated with rates of change and whether it served as a moderator of the relationship between functional change and both neurocognition and social cognition. The sample consisted of 125 individuals diagnosed with schizophrenia or schizoaffective disorder who were recruited upon admission to I of 4 community-based psychosocial rehabilitation facilities and were followed prospectively for 12 months. One hundred and two subjects completed the 12-month protocol. The findings suggested that (i) the initial level of psychosocial functioning was related to both social cognition and neurocognition at baseline, (ii) when significant rehabilitative change occurs, higher neurocognition and social cognition scores at baseline predicted higher rates of functional change over the subsequent 12 months, (iii) greater service intensity was related to higher rates of improvement in functional outcome over time, and (iv) service intensity moderated the relationship between neurocognition and initial functional level and moderated the relationship between social cognition and the rates of functional change at a trend level. These findings have relevance to our understanding of the heterogeneity in functional rehabilitative outcomes, to our understanding of the conditions of rehabilitative change and for the design of psychosocial interventions in the community. C1 Univ So Calif, Sch Social Work, Los Angeles, CA 90089 USA. Univ Minnesota, Dept Educ Stat, Minneapolis, MN 55455 USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90024 USA. RP Brekke, JS (reprint author), Univ So Calif, Sch Social Work, MC 0411, Los Angeles, CA 90089 USA. EM brekke@usc.edu NR 65 TC 95 Z9 102 U1 5 U2 9 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0586-7614 J9 SCHIZOPHRENIA BULL JI Schizophr. Bull. PD SEP PY 2007 VL 33 IS 5 BP 1247 EP 1256 DI 10.1093/schbul/sb1072 PG 10 WC Psychiatry SC Psychiatry GA 214HD UT WOS:000249726700028 PM 17255120 ER PT J AU Wynn, JK Green, MF Sprock, J Light, GA Widmark, C Reist, C Erhart, S Marder, SR Mintz, J Braff, DL AF Wynn, Jonathan K. Green, Michael F. Sprock, Joyce Light, Gregory A. Widmark, Clifford Reist, Christopher Erhart, Stephen Marder, Stephen R. Mintz, Jim Braff, David L. TI Effects of olanzapine, risperidone and haloperidol on prepulse inhibition in schizophrenia patients: A double-blind, randomized controlled trial SO SCHIZOPHRENIA RESEARCH LA English DT Article DE prepulse inhibition; schizophrenia; olanzapine; risperidone; treatment ID ACOUSTIC STARTLE REFLEX; GATING DEFICITS; ATYPICAL ANTIPSYCHOTICS; CIGARETTE-SMOKING; MENSTRUAL-CYCLE; HABITUATION; MODULATION; CLOZAPINE; ENDOPHENOTYPES; FACILITATION AB Prepulse inhibition (PPI), whereby the startle eyeblink response is inhibited by a relatively weak non-startling stimulus preceding the powerful startle eliciting stimulus, is a measure of sensorimotor gating and has been shown to be deficient in schizophrenia patients. There is considerable interest in whether conventional and/or atypical antipsychotic medications can "normalize" PPI deficits in schizophrenia patients. 51 schizophrenia patients participated in a randomized, double-blind controlled trial on the effects of three commonly-prescribed antipsychotic medications (risperidone, olanzapine, or haloperidol) on PPI, startle habituation, and startle reactivity. Patients were tested at baseline, Week 4 and Week 8. Mixed model regression analyses revealed that olanzapine significantly improved PPI from Week 4 to Week 8, and that at Week 8 patients receiving olanzapine produced significantly greater PPI than those receiving risperidone, but not haloperidol. There were no effects of medication on startle habituation or startle reactivity. These results support the conclusion that olanzapine effectively increased PPI in schizophrenia patients, but that risperidone and haloperidol had no such effects. The results are discussed in terms of animal models, neural substrates, and treatment implications. (c) 2007 Elsevier B.V. All rights reserved. C1 VA Greater Los Angeles Healthcare Syst, Mental Illness Res Educ & Clin Ctr, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Los Angeles, CA 90024 USA. Univ Calif San Diego, Sch Med, Dept Psychiat, San Diego, CA 92103 USA. Univ Calif Irvine, Sch Med, Dept Psychiat & Human Behav, Irvine, CA 92717 USA. VA Long Beach Healthcare Syst, Long Beach, CA USA. Univ Calif Los Angeles, Med Ctr, Dept Psychiat, Sylmar, CA USA. RP Wynn, JK (reprint author), VA Greater Los Angeles Healthcare Syst, Mental Illness Res Educ & Clin Ctr, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jkwynn@ucla.edu RI Wynn, Jonathan/H-3749-2014 OI Wynn, Jonathan/0000-0002-1763-8540 FU NIMH NIH HHS [MH-042228, R01 MH042228, R01 MH042228-18, R37 MH042228] NR 53 TC 51 Z9 54 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD SEP PY 2007 VL 95 IS 1-3 BP 134 EP 142 DI 10.1016/i.schres.2007.05.039 PG 9 WC Psychiatry SC Psychiatry GA 215VK UT WOS:000249836900018 PM 17662577 ER PT J AU Hung, EW Darouiche, RO Trautner, BW AF Hung, E. W. Darouiche, R. O. Trautner, B. W. TI Proteus bacteriuria is associated with significant morbidity in spinal cord injury SO SPINAL CORD LA English DT Article DE spinal cord injury; bacteriuria; Proteus; urinary stones ID URINARY-TRACT INFECTION; URETHRAL CATHETERS; MIRABILIS; RISK; EPIDEMIOLOGY; BIOFILMS; CALCULI; STONES AB Study Design: Retrospective chart review. Objectives: We investigated the morbidity associated with Proteus bacteriuria in a spinal cord injured (SCI) population. Setting: Michael E DeBakey Veterans A. airs Medical Center in Houston, Texas, USA. Methods: We reviewed the medical records of all veterans with SCI who received care in our medical center during the past 3 years. Proteus bacteriuria was defined as the growth of Proteus species in any urine culture during the study period. Urinary stones were defined as either renal or bladder calculi. Results: During the study period, 71 of the 501 subjects (14%) had Proteus and 90 (18%) had urinary stones. Twenty-seven percent of the subjects with Proteus had stones, and the association of Proteus with stones was significant (P<0.05). Proteus bacteriuria was likewise associated with complete injury, hospitalization, decubitus ulcers, and history of stones (P<0.001). Subjects using indwelling catheters, either transurethral or suprapubic, were significantly more likely to have Proteus, whereas subjects practising spontaneous voiding and clean intermittent catheterization were significantly less likely to have Proteus. In the 90 patients with stones, Proteus was associated with requiring treatment for stones and having multiple stones (P<0.01). Twenty-five of the 90 patients with stones (28%) required treatment, most often with lithotripsy, and 6 (7%) developed urosepsis. Conclusions: In persons with SCI, Proteus was found in subjects with a greater degree of impairment who were more likely to be hospitalized, to have decubiti, and to use indwelling catheters. Bacteriuria with Proteus predicted urologic complications in persons with SCI. Statement of Ethics: All applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this research. Sponsorship: This work was supported by USPHS grant HD42014. C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Dept Med, Infect Dis Sect, Houston, TX 77030 USA. Univ Penn, Dept Internal Med, Philadelphia, PA 19104 USA. Baylor Coll Med, Dept Phys Med & Rehabil, Houston, TX 77030 USA. RP Trautner, BW (reprint author), Michael E DeBakey Vet Affairs Med Ctr, 2002 Holcombe Blvd, Houston, TX USA. FU NICHD NIH HHS [HD42014, K23 HD042014-05, K23 HD042014, K23 HD042014-04] NR 15 TC 11 Z9 11 U1 0 U2 4 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1362-4393 J9 SPINAL CORD JI Spinal Cord PD SEP PY 2007 VL 45 IS 9 BP 616 EP 620 DI 10.1038/sj.sc.3102004 PG 5 WC Clinical Neurology; Rehabilitation SC Neurosciences & Neurology; Rehabilitation GA 207UN UT WOS:000249276700006 PM 17179975 ER PT J AU Howard, G Safford, MM Meschia, JF Moy, CS Howard, VJ Pulley, L Gomez, CR Crowther, M AF Howard, George Safford, Monika M. Meschia, James F. Moy, Claudia S. Howard, Virginia J. Pulley, LeaVonne Gomez, Camilo R. Crowther, Martha TI Stroke symptoms in individuals reporting no prior stroke or transient ischemic attack are associated with a decrease in indices of mental and physical functioning SO STROKE LA English DT Article DE cerebrovascular disorders; cohort studies; health-related quality of life ID RACIAL-DIFFERENCES; RISK-FACTORS; COGNITIVE IMPAIRMENT; GENERAL-POPULATION; SILENT STROKE; DEMENTIA; REASONS; BRAIN; QUESTIONNAIRE; PREVALENCE AB Background and Purpose - Stroke symptoms in the absence of recognized stroke are common, but potential associated dysfunctions have not been described. Methods - We assessed quality-of-life measures using the Physical and Mental Component Summary scores of the Short Form 12 (PCS-12 and MCS-12) in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. Differences in mean PCS-12 and MCS-12 scores were assessed among participant groups symptoms-free (n = 16 090); history of stroke symptoms but free of stroke/transient ischemic attack (n = 3404); history of stroke (n = 1491); and history of transient ischemic attack (n = 818). Results - Participants with symptoms (but no diagnosis) had average PCS-12 scores 5.5 (95% CI: 5.2 to 5.9) points lower than those without symptoms, a difference similar to transient ischemic attack (6.0; 95% CI: 5.3 to 6.7) and over one half the effect of stroke (8.4; 95% CI: 8.0 to 9.0). MCS-12 scores were 2.7 (95% CI: 2.4 to 3.0) points lower for those ith symptoms, -0.5 for transient ischemic attack (95% CI: 0.0 to -1.1), and -1.6 for stroke (95% CI: -1.2 to -2.0). Differences in demographic and vascular risk factors, health behaviors, physiological measures, and indices of socioeconomic status did not fully explain these differences. Those reporting history of weakness or numbness had larger current decrements in physical functioning, and those reporting history of inability to express themselves or understand language had larger current decrements in mental functioning. Conclusions - Individuals with clinically consistent symptoms but no stroke diagnosis have a lower quality of life than those without symptoms. The difference in physical functioning is substantial with a smaller decline in mental functioning. Apart from so-called "silent stroke," there appear to be many individuals with possibly symptomatic cerebrovascular disease - either stroke or transient ischemic attack - who are not being diagnosed. Furthermore, these symptomatic but undiagnosed strokes may not be benign. C1 Univ Alabama, Sch Publ Hlth, Dept Biostat, Birmingham, AL 35294 USA. Univ Alabama, Birmingham VA Med Ctr, Deep S Ctr Effectivenss, Birmingham, AL USA. Univ Alabama, Div Prevent Med, Birmingham, AL USA. Mayo Clin, Jacksonville, FL 32224 USA. NINDS, NIH, Bethesda, MD 20892 USA. Univ Alabama, Sch Publ Hlth, Dept Epidemiol, Birmingham, AL 35294 USA. Univ Arkansas Hlth Sci Univ, Dept Hlth Behav, Little Rock, AR 72204 USA. Alabama Neurol Inst, Birmingham, AL USA. Univ Alabama, Sch Publ Hlth, Dept Hlth Behav, Birmingham, AL 35294 USA. RP Howard, G (reprint author), Univ Alabama, Sch Publ Hlth, Dept Biostat, 1665 Univ Blvd, Birmingham, AL 35294 USA. EM ghoward@uab.edu RI crona, malin/B-7085-2012 FU NHLBI NIH HHS [R01 HL080477]; NINDS NIH HHS [NS 041588, R01 NS041588, U01 NS041588] NR 25 TC 22 Z9 22 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD SEP PY 2007 VL 38 IS 9 BP 2446 EP 2452 DI 10.1161/STROKEAHA.106.478032 PG 7 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 204FF UT WOS:000249028400011 PM 17673720 ER PT J AU Baruch, L Gage, BF Horrow, J Juul-Moller, S Labovitz, A Persson, M Zabalgoitia, M AF Baruch, Lawrence Gage, Brian F. Horrow, Jay Juul-Moller, Steen Labovitz, Arthur Persson, Maria Zabalgoitia, Miguel TI Can patients at elevated risk of stroke treated with anticoagulants be further risk stratified? SO STROKE LA English DT Article DE anticoagulation; atrial fibrillation; direct thrombin inhibitors; risk prediction; stroke ID NONVALVULAR ATRIAL-FIBRILLATION; CLINICAL CLASSIFICATION SCHEMES; ANTITHROMBOTIC THERAPY; NATIONAL REGISTRY; PREDICTING STROKE; SPORTIF-III; WARFARIN; ASPIRIN; XIMELAGATRAN; PREVENTION AB Background and Purpose - Patients with atrial fibrillation have a varied risk of stroke, depending on age and comorbid conditions. The objective of this study was to assess the predictive value of stroke risk classification schemes and to identify patients with atrial fibrillation who are at substantial risk of stroke despite optimal anticoagulant therapy. Methods - Seven recognized classification schemes - the American College of Chest Physicians 2001, American College of Chest Physicians 2004, Stroke Prevention in Atrial Fibrillation (SPAF), Atrial Fibrillation Investigators, Framingham, van Walraven, and CHADS(2) - were compared for their ability to predict ischemic stroke in patients receiving anticoagulant therapy. Data came from the Stroke Prevention using an ORal Thrombin Inhibitor in atrial Fibrillation III and V trials, which compared the efficacy of adjusted-dose warfarin and the direct thrombin inhibitor ximelagatran (36 mg twice daily) in preventing thromboembolic events in 7329 patients with chronic or paroxysmal nonvalvular atrial fibrillation who were at moderate or high risk of ischemic stroke. The main outcome measure was ischemic stroke, as determined by a central event adjudication committee. Results - During 11 245 patient-years of follow-up, 159 patients had an ischemic stroke (1.4%/year). As indicated by c statistics and hazard ratios, 3 of the classification schemes predicted stroke significantly better than chance: Framingham (c = 0.64), CHADS2 (c = 0.65), and SPAF (c = 0.61). Conclusions - In a large cohort of atrial fibrillation patients at moderate or high risk of ischemic stroke treated with warfarin or ximelagatran, the CHADS2, SPAF, and Framingham schemes had greater predictive accuracy than chance. This predictive ability may allow clinicians to target high-risk patients for more aggressive intervention. C1 Bronx VA Hosp, Bronx, NY 10468 USA. Bronx Vet Affairs Med Ctr, Dept Med, Bronx, NY USA. CUNY Mt Sinai Sch Med, New York, NY 10029 USA. Washington Univ, Dept Med, St Louis, MO USA. AstraZeneca LP, Wilmington, DE USA. Lund Univ, Malmo Univ Hosp, Dept Cardiol, Malmo, Sweden. St Louis Univ, Dept Med, St Louis, MO 63103 USA. AstraZeneca R&D, Molndal, Sweden. Univ Texas, Hlth Sci Ctr, San Antonio, TX USA. RP Baruch, L (reprint author), Bronx VA Hosp, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM baruchlarry@att.net NR 22 TC 44 Z9 46 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD SEP PY 2007 VL 38 IS 9 BP 2459 EP 2463 DI 10.1161/STROKEAHA.106.477133 PG 5 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 204FF UT WOS:000249028400013 PM 17673721 ER PT J AU Graham, DY Yamaoka, Y Malaty, HM AF Graham, David Y. Yamaoka, Yoshio Malaty, Hoda M. TI Thoughts about populations with unexpected low prevalences of Helicobacter pylori infection SO TRANSACTIONS OF THE ROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE LA English DT Article DE helicobocter pylori; epidemiology; prevalence; Malaysia; Java; Zanzibar; Africa ID MOLECULAR EPIDEMIOLOGY; GENOTYPES; NORTH AB Helicobacter pylori is one of the few remaining major pathogens that accompanied humans on their travels from Africa. A recently published study reports the unexpected finding of a low H. pylori prevalence among pregnant women in Zanzibar (Farag, T.H., Stolzfus, R.J., Khalfan, S.S., Tielsch, J.M., 2007. Unexpectedly low prevalence of Helicobacter pylori infection among pregnant women on Pemba Island, Zanzibar. Trans. R. Soc. Trop. Med. Hyg. 101). The apparent epidemiology of higher prevalence with higher socioeconomic status and decrease with age are unprecedented. As with many 'unexpected' events, a search of the literature reveals evidence of low prevalence populations in Java and Malaysia, with clues dating back to the mid-twentieth century. Why some populations apparently lost H. pylori infection remains an open question. However, the tools needed to resolve the dilemma are readily avaitable and we hope investigators will soon rise to the challenge. (c) 2007 Royal Society of Tropical Medicine and Hygiene. Published by ELsevier Ltd. All rights reserved. C1 Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. RP Graham, DY (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med, RM 3A-320 111D,2002 Holcombe Blvd, Houston, TX 77030 USA. EM dgraham@bcm.tmc.edu FU NIDDK NIH HHS [DK56338] NR 20 TC 20 Z9 20 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0035-9203 J9 T ROY SOC TROP MED H JI Trans. Roy. Soc. Trop. Med. Hyg. PD SEP PY 2007 VL 101 IS 9 BP 849 EP 851 DI 10.1016/j.trstmh.2007.06.006 PG 3 WC Public, Environmental & Occupational Health; Tropical Medicine SC Public, Environmental & Occupational Health; Tropical Medicine GA 207BX UT WOS:000249227700001 PM 17658569 ER PT J AU Yu, J Novgorodov, SA Chudakova, D Zhu, H Bielawska, A Bielawski, J Obeid, LM Kindy, MS Gudz, TI AF Yu, Jin Novgorodov, Sergei A. Chudakova, Daria Zhu, Hong Bielawska, Alicja Bielawski, Jacek Obeid, Lina M. Kindy, Mark S. Gudz, Tatyana I. TI JNK3 signaling pathway activates ceramide synthase leading to mitochondrial dysfunction SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Article ID NOVO SPHINGOLIPID BIOSYNTHESIS; LONGEVITY ASSURANCE GENE-1; FOCAL CEREBRAL-ISCHEMIA; PROGRAMMED CELL-DEATH; TUMOR-NECROSIS-FACTOR; N-TERMINAL KINASE; FOREBRAIN ISCHEMIA; TNF-ALPHA; NEURONAL APOPTOSIS; RESPIRATORY-CHAIN AB A cardinal feature of brain tissue injury in stroke is mitochondrial dysfunction leading to cell death, yet remarkably little is known about the mechanisms underlying mitochondrial injury in cerebral ischemia/ reperfusion (IR). Ceramide, a naturally occurring membrane sphingolipid, functions as an important second messenger in apoptosis signaling and is generated by de novo synthesis, sphingomyelin hydrolysis, or recycling of sphin-golipids. In this study, cerebral IR- induced ceramide elevation resulted from ceramide biosynthesis rather than from hydrolysis of sphingomyelin. Investigation of intracellular sites of ceramide accumulation revealed the elevation of ceramide in mitochondria because of activation of mitochondrial ceramide synthase via post- translational mechanisms. Furthermore, ceramide accumulation appears to cause mitochondrial respiratory chain damage that could be mimicked by exogenously added natural ceramide to mitochondria. The effect of ceramide on mitochondria was somewhat specific; dihydroceramide, a structure closely related to ceramide, did not inflict damage. Stimulation of ceramide biosynthesis seems to be under control of JNK3 signaling: IR- induced ceramide generation and respiratory chain damage was abolished in mitochondria of JNK3- deficient mice, which exhibited reduced infarct volume after IR. These studies suggest that the hallmark of mitochondrial injury in cerebral IR, respiratory chain dysfunction, is caused by the accumulation of ceramide via stimulation of ceramide synthase activity in mitochondria, and that JNK3 has a pivotal role in regulation of ceramide biosynthesis in cerebral IR. C1 Med Univ S Carolina, Dept Neurosci, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC 29401 USA. RP Gudz, TI (reprint author), Med Univ S Carolina, Dept Neurosci, 114 Doughty St, Charleston, SC 29425 USA. EM gudz@musc.edu OI obeid, lina/0000-0002-0734-0847 FU NCRR NIH HHS [P20 RR 17677-04]; NIA NIH HHS [AG16583] NR 70 TC 66 Z9 73 U1 0 U2 5 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD AUG 31 PY 2007 VL 282 IS 35 BP 25940 EP 25949 DI 10.1074/jbc.M701812200 PG 10 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 204AB UT WOS:000249014100079 PM 17609208 ER PT J AU Bhave, SV Hornbaker, C Phang, TL Saba, L Lapadat, R Kechris, K Gaydos, J McGoldrick, D Dolbey, A Leach, S Soriano, B Ellington, A Ellington, E Jones, K Mangion, J Belknap, JK Williams, RW Hunter, LE Hoffman, PL Tabakoff, B AF Bhave, Sanjiv V. Hornbaker, Cheryl Phang, Tzu L. Saba, Laura Lapadat, Razvan Kechris, Katherina Gaydos, Jeanette McGoldrick, Daniel Dolbey, Andrew Leach, Sonia Soriano, Brian Ellington, Allison Ellington, Eric Jones, Kendra Mangion, Jonathan Belknap, John K. Williams, Robert W. Hunter, Lawrence E. Hoffman, Paula L. Tabakoff, Boris TI The PhenoGen Informatics website: tools for analyses of complex traits SO BMC GENETICS LA English DT Article ID STANFORD MICROARRAY DATABASE; FACTOR-BINDING SITES; GENE-EXPRESSION; CANDIDATE GENES; INBRED STRAINS; NCBI GEO; PROFILES; SOFTWARE; MILLIONS; STORAGE AB Background: With the advent of "omics" ( e. g. genomics, transcriptomics, proteomics and phenomics), studies can produce enormous amounts of data. Managing this diverse data and integrating with other biological data are major challenges for the bioinformatics community. Comprehensive new tools are needed to store, integrate and analyze the data efficiently. Description: The PhenoGen Informatics website http://phenogen.uchsc.edu is a comprehensive toolbox for storing, analyzing and integrating microarray data and related genotype and phenotype data. The site is particularly suited for combining QTL and microarray data to search for "candidate" genes contributing to complex traits. In addition, the site allows, if desired by the investigators, sharing of the data. Investigators can conduct "in-silico" microarray experiments using their own and/or "shared" data. Conclusion: The PhenoGen website provides access to tools that can be used for high-throughput data storage, analyses and interpretation of the results. Some of the advantages of the architecture of the website are that, in the future, the present set of tools can be adapted for the analyses of any type of high-throughput "omics" data, and that access to new tools, available in the public domain or developed at PhenoGen, can be easily provided. C1 Univ Colorado, Dept Pharmacol, Hlth Sci Ctr, Aurora, CO 80045 USA. Univ Colorado, Dept Prevent Med & Biometr, Hlth Sci Ctr, Aurora, CO 80045 USA. Univ London Imperial Coll Sci Technol & Med, Fac Med, MRC, Ctr Clin Sci, London W12 0NN, England. US Dept Vet Affairs, Med Ctr, Portland, OR 97239 USA. Univ Tennessee, Ctr Hlth Sci, Dept Anat & Neurobiol, Memphis, TN 38163 USA. RP Tabakoff, B (reprint author), Univ Colorado, Dept Pharmacol, Hlth Sci Ctr, Aurora, CO 80045 USA. EM sanjiv.bhave@uchsc.edu; cheryl.hornbaker@uchsc.edu; tzu.phang@uchsc.edu; laura.saba@uchsc.edu; razvan.lapadat@uchsc.edu; katerina.kechris@uchsc.edu; jeanette.gaydos@uchsc.edu; djmcgoldrick@comcast.net; andrew.dolbey@uchsc.edu; sonia.leach@uchsc.edu; brian.soriano@uchsc.edu; allison.ellington@uchsc.edu; eric.ellington@uchsc.edu; kendra.jones@uchsc.edu; jon.mangion@csc.mrc.ac.uk; belknajo@ohsu.edu; rwilliams@nb.utmem.edu; larry.hunter@uchsc.edu; paula.hoffman@uchs.edu; boris.tabakoff@uchsc.edu OI Saba, Laura/0000-0001-9649-1294; Hunter, Lawrence/0000-0003-1455-3370; Williams, Robert/0000-0001-8924-4447 FU Medical Research Council [MC_U120061454]; NIAAA NIH HHS [P60 AA010760, R01 AA013162, R01 AA13162, U01 AA013524] NR 24 TC 31 Z9 32 U1 0 U2 2 PU BIOMED CENTRAL LTD PI LONDON PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND SN 1471-2156 J9 BMC GENET JI BMC Genet. PD AUG 30 PY 2007 VL 8 AR 59 DI 10.1186/1471-2156-8-59 PG 7 WC Genetics & Heredity SC Genetics & Heredity GA 226CA UT WOS:000250563600001 PM 17760997 ER PT J AU Cao, GD Xing, J Xiao, X Liou, AKF Gao, YQ Yin, XM Clark, RSB Graham, SH Chen, J AF Cao, Guodong Xing, Juan Xiao, Xiao Liou, Anthony K. F. Gao, Yanqin Yin, Xiao-Ming Clark, Robert S. B. Graham, Steven H. Chen, Jun TI Critical role of calpain I in mitochondrial release of apoptosis-inducing factor in ischemic neuronal injury SO JOURNAL OF NEUROSCIENCE LA English DT Article DE ischemia; apoptosis; mitochondria; caspase; neuroprotection; neuronal death ID TRANSIENT CEREBRAL-ISCHEMIA; CYTOCHROME-C RELEASE; POLY(ADP-RIBOSE) PAR POLYMER; OXYGEN-GLUCOSE DEPRIVATION; INDUCED CELL-DEATH; DNA FRAGMENTATION; PERMEABILITY TRANSITION; CASPASE-3 ACTIVATION; VULNERABLE NEURONS; NAD(+) DEPLETION AB Loss of mitochondrial membrane integrity and release of apoptogenic factors are a key step in the signaling cascade leading to neuronal cell death in various neurological disorders, including ischemic injury. Emerging evidence has suggested that the intramitochondrial protein apoptosis-inducing factor (AIF) translocates to the nucleus and promotes caspase-independent cell death induced by glutamate toxicity, oxidative stress, hypoxia, or ischemia. However, the mechanism by which AIF is released from mitochondria after neuronal injury is not fully understood. In this study, we identified calpain I as a direct activator of AIF release in neuronal cultures challenged with oxygen-glucose deprivation and in the rat model of transient global ischemia. Normally residing in both neuronal cytosol and mitochondrial intermembrane space, calpain I was found to be activated in neurons after ischemia and to cleave intramitochondrial AIF near its N terminus. The truncation of AIF by calpain activity appeared to be essential for its translocation from mitochondria to the nucleus, because neuronal transfection of the mutant AIF resistant to calpain cleavage was not released after oxygen-glucose deprivation. Adeno-associated virus-mediated overexpression of calpastatin, a specific calpain-inhibitory protein, or small interfering RNA-mediated knockdown of calpain I expression in neurons prevented ischemia-induced AIF translocation. Moreover, overexpression of calpastatin or knockdown of AIF expression conferred neuroprotection against cell death in neuronal cultures and in hippocampal CA1 neurons after transient global ischemia. Together, these results define calpain I-dependent AIF release as a novel signaling pathway that mediates neuronal cell death after cerebral ischemia. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Dept Mol Genet & Biochem, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Dept Pathol, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Sch Med, Dept Crit Care Med, Pittsburgh, PA 15261 USA. Fudan Univ, Sch Med, Natl Lab Med Neurobiol, Shanghai 200032, Peoples R China. Vet Affairs Pittsburgh Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA 15261 USA. RP Chen, J (reprint author), Univ Pittsburgh, Sch Med, Dept Neurol, S-507 Biomed Sci Tower, Pittsburgh, PA 15261 USA. EM chenj2@upmc.edu RI Gao, Yanqin/I-6790-2016 OI Gao, Yanqin/0000-0002-4915-9819 FU NINDS NIH HHS [NS36736, NS43802, NS44178] NR 63 TC 179 Z9 192 U1 1 U2 16 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD AUG 29 PY 2007 VL 27 IS 35 BP 9278 EP 9293 DI 10.1523/JNEUROSCI.2826-07.2007 PG 16 WC Neurosciences SC Neurosciences & Neurology GA 205UZ UT WOS:000249141400005 PM 17728442 ER PT J AU Li, G Larson, EB Sonnen, JA Shofer, JB Petrie, EC Schantz, A Peskind, ER Raskind, MA Breitner, JCS Montine, TJ AF Li, G. Larson, E. B. Sonnen, J. A. Shofer, J. B. Petrie, E. C. Schantz, A. Peskind, E. R. Raskind, M. A. Breitner, J. C. S. Montine, T. J. TI Statin therapy is associated with reduced neuropathologic changes of Alzheimer disease SO NEUROLOGY LA English DT Article ID AMYLOID PRECURSOR PROTEIN; PROSPECTIVE COHORT; INCIDENT DEMENTIA; CONTROLLED TRIAL; IN-VIVO; RISK; CHOLESTEROL; SIMVASTATIN; DIAGNOSIS; INDIVIDUALS AB Background: Treatment with 3-hydroxy-3-methylglutaryl-coenzyme-A reductase inhibitors ("statins") has been associated in some epidemiologic studies with reduced risk of Alzheimer disease (AD). However, direct evidence of statin effects on neuropathologic markers of AD is lacking. We investigated whether antecedent statin exposure is associated with neuritic plaque (NP) or neurofibrillary tangle (NFT) burden in a population-based sample of human subjects. Methods: Brain autopsies were performed on 110 subjects, ages 65 to 79 years, who were cognitively normal at enrollment into the Adult Changes in Thought Study. Neuropathologic findings were compared between statin users with >= 3 prescriptions of >= 15 pills of simvastatin, pravastatin, lovastatin, or atorvastatin vs nonusers, based on pharmacy dispensing records. Results: After controlling for age at death, gender, cognitive function at study entry, brain weight, and presence of cerebral microvascular lesions, the odds ratio (OR) for each unit increase in Braak NFT stage in statin users vs nonusers was 0.44 (95% CI: 0.20 to 0.95). The OR for each unit increase in Consortium to Establish a Registry for Alzheimer's Disease (CERAD) staging of NPs did not deviate significantly from unity (OR 0.69; 95% CI: 0.32 to 1.52). However, the risk for typical AD pathology (Braak stage >= IV and CERAD rating >= moderate) was reduced in statin users (OR 0.20; 95% CI: 0.05 to 0.86). Conclusions: These findings demonstrate an association between antecedent statin use and neurofibrillary tangle burden at autopsy. Additional study is needed to examine whether statin use may be causally related to decreased development of Alzheimer disease-related neuropathologic changes. C1 VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, MIRECC, Seattle, WA 98195 USA. Univ Washington, Dept Pathol, MIRECC, Seattle, WA 98195 USA. Univ Washington, Dept Med, MIRECC, Seattle, WA 98195 USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98101 USA. RP Li, G (reprint author), VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, 1660 S Columbian Way,Mail Code S-116 6 E, Seattle, WA 98108 USA. EM gli@u.washington.edu RI Sonnen, 37382016/H-3738-2016 OI Sonnen, 37382016/0000-0001-9267-8705 FU NIA NIH HHS [K08 AG023670, K08AG023670, K23AG020020, P50AG005136, R01 AG023801, R01AG023801, U01AG006781] NR 41 TC 145 Z9 149 U1 2 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD AUG 28 PY 2007 VL 69 IS 9 BP 878 EP 885 DI 10.1212/01.wnl.0000277657.95487.1c PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 204EA UT WOS:000249025200010 PM 17724290 ER PT J AU Turner, EH AF Turner, Erick H. TI Posting FDA new drug application reviews SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION LA English DT Letter ID CLINICAL-TRIALS C1 Portland VA Med Ctr, Mental Hlth & Neurosci Div, Portland, OR 97201 USA. RP Turner, EH (reprint author), Portland VA Med Ctr, Mental Hlth & Neurosci Div, Portland, OR 97201 USA. EM turnere@ohsu.edu RI Turner, Erick/A-4848-2008 OI Turner, Erick/0000-0002-3522-3357 NR 5 TC 1 Z9 1 U1 0 U2 0 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0098-7484 J9 JAMA-J AM MED ASSOC JI JAMA-J. Am. Med. Assoc. PD AUG 22 PY 2007 VL 298 IS 8 BP 863 EP 864 DI 10.1001/jama.298.8.863 PG 2 WC Medicine, General & Internal SC General & Internal Medicine GA 202CS UT WOS:000248880200018 PM 17712069 ER PT J AU Riscoe, MK Kelly, JX Smilkstein, MJ Winter, RW AF Riscoe, Michael K. Kelly, Jane X. Smilkstein, Martin J. Winter, Rolf W. TI Hemozoin formation as a target for antimalarial drug design SO ABSTRACTS OF PAPERS OF THE AMERICAN CHEMICAL SOCIETY LA English DT Meeting Abstract C1 [Riscoe, Michael K.; Kelly, Jane X.; Smilkstein, Martin J.; Winter, Rolf W.] Portland VA Med Ctr, Med Res Serv, Portland, OR 97239 USA. EM riscoem@ohsu.edu; ellyja@ohsu.edu; smilkste@ohsu.edu; winterr@ohsu.edu NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER CHEMICAL SOC PI WASHINGTON PA 1155 16TH ST, NW, WASHINGTON, DC 20036 USA SN 0065-7727 J9 ABSTR PAP AM CHEM S JI Abstr. Pap. Am. Chem. Soc. PD AUG 19 PY 2007 VL 234 MA 5-MEDI PG 1 WC Chemistry, Multidisciplinary SC Chemistry GA V12IW UT WOS:000207593906518 ER PT J AU Leung, JV Mann, S Leung, FV AF Leung, J. W. Mann, S. Leung, F. Vv. TI Options for screening colonoscopy without sedation: a pilot study in United States veterans SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Article ID PATIENT-CONTROLLED SEDATION; RANDOMIZED CONTROLLED-TRIAL; ROUTINE AB Background The direct and indirect costs of sedation limit access to screening colonoscopy amongst United States veterans. Aim To determine if offering the option of sedation on-demand reduces the need for sedation. Design A retrospective review of prospectively collected performance improvement data in an open access screening colonoscopy programme. Setting Performance improvement programme to minimize the burden of sedation at a single VA Medical Center. Subjects 44 consecutive veterans who accepted the option of sedation on-demand. They could choose to have premedications before the start of colonoscopy, or to begin colonoscopy without premedications and receive the medications upon their request during the examination. Method Two experienced endoscopists assisted by experienced nurse assistants performed all of the examinations. Insertion of the colonoscope was aided by infusion of warm water through the colonoscope without air insufflation. Medications were administered at the veterans' request. Results Offering the option of sedation on-demand to 44 consecutive veterans permitted 52% (N= 23) of the veterans to complete screening colonoscopy without any sedation. Conclusions This novel approach of sedation on-demand and water infusion for screening colonoscopy deserves to be further evaluated in a randomized-controlled study amongst patients undergoing colorectal cancer screening. C1 Vet Affairs N Calif Hlth Care Syst, Gastroenterol Sect, Sacramento VA Med Ctr, Mather, CA 95655 USA. Univ Calif Davis, Med Ctr, Div Gastroenterol & Hepatol, Davis, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Vet Affairs Greater Los Angeles Healthcare Syst, Sepulveda Ambulatory Care Ctr, Div Gastroenterol Med & Res Serv, Los Angeles, CA USA. RP Leung, JV (reprint author), Vet Affairs N Calif Hlth Care Syst, Gastroenterol Sect, Sacramento VA Med Ctr, Hosp Way, Mather, CA 95655 USA. EM jwleung@ucdavis.edu NR 21 TC 51 Z9 51 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0269-2813 J9 ALIMENT PHARM THERAP JI Aliment. Pharmacol. Ther. PD AUG 15 PY 2007 VL 26 IS 4 BP 627 EP 631 DI 10.1111/j.1365-2036.2007.03404.x PG 5 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 202FK UT WOS:000248887200011 PM 17661766 ER PT J AU Cooper, GS Treadwell, EL Clair, EW Gilkeson, GS Dooley, MA AF Cooper, Glinda S. Treadwell, Edward L. Clair, E. William St. Gilkeson, Gary S. Dooley, Mary Anne TI Sociodemographic associations with early disease damage in patients with systemic lupus erythematosus SO ARTHRITIS & RHEUMATISM-ARTHRITIS CARE & RESEARCH LA English DT Article DE ethnicity; income; age; lupus ID 3 ETHNIC-GROUPS; COLLABORATING CLINICS/AMERICAN-COLLEGE; SOCIOECONOMIC-STATUS; RISK-FACTORS; INDEX; MORTALITY; RACE; PREDICTOR; SURVIVAL AB Objective. To examine the extent of organ damage among recently diagnosed patients with systemic lupus erythematosus (SLE), and to assess the association between sociodemographic variables and total damage and organ-specific damage scores. Methods. We evaluated damage in 132 patients with SLE (70 African Americans and 62 whites), 2-6 years (median 4 years) after diagnosis, using the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index. The associations between demographic characteristics and total damage and organ-specific damage measures were evaluated using logistic regression, adjusting for age, income, and ethnicity. Results. A total of 61% of patients scored >= 1 point on the damage index. Damage was most prevalent in the musculoskeletal (28%), skin (20%), neuropsychiatric (16%), and renal (12%) subscales. African American ethnicity and lower household income were independently associated with total damage scores (score >= 2: adjusted odds ratio [95% confidence interval] 6.0 [2.3-16.2] in African Americans and 2.7 [1.1-6.7] in patients with an annual household income <=$30,000). The odds of having skin damage, alopecia, or diabetes were at least 5 times higher in African Americans compared with whites, but ethnicity was not associated with renal damage (adjusted odds ratio 1.6, 95% confidence interval 0.40-6.1). Conclusion. Considerable damage is seen in SLE patients early in the disease course, and the pattern varies between ethnic groups. This analysis also highlights the importance of sociodemographic characteristics (particularly income) in predicting damage. C1 US EPA, NCEA, Washington, DC 20460 USA. E Carolina Univ, Sch Med, Greenville, NC USA. Duke Univ, Med Ctr, Durham, NC USA. Med Univ S Carolina, Charleston, SC USA. Ralph H Johnson Vet Adm Med Ctr, Charleston, SC USA. Univ N Carolina, Chapel Hill, NC USA. RP Cooper, GS (reprint author), US EPA, NCEA, 8601-D,1200 Penn Ave NW, Washington, DC 20460 USA. EM cooper.glindal@epa.gov FU Intramural NIH HHS; NIEHS NIH HHS [N01-ES-85433, Z01-ES-49023] NR 18 TC 39 Z9 41 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0004-3591 J9 ARTHRIT RHEUM-ARTHR JI Arthritis Rheum-Arthritis Care Res. PD AUG 15 PY 2007 VL 57 IS 6 BP 993 EP 999 DI 10.1002/art.22894 PG 7 WC Rheumatology SC Rheumatology GA 199OT UT WOS:000248705800015 PM 17665464 ER PT J AU Bartzokis, G AF Bartzokis, George TI Acetylcholinesterase inhibitors may improve myelin integrity SO BIOLOGICAL PSYCHIATRY LA English DT Review DE AAMI; acetylcholinesterase; ADHD; Alzheimer; cholinergic; cognition; MCI; oligodendrocyte; schizophrenia; white matter ID MILD COGNITIVE IMPAIRMENT; CHOLINE-ACETYLTRANSFERASE ACTIVITY; MATTER STRUCTURAL INTEGRITY; EARLY ALZHEIMERS-DISEASE; WHITE-MATTER; HUMAN BRAIN; NICOTINIC RECEPTORS; PARKINSONS-DISEASE; CEREBRAL-CORTEX; HIPPOCAMPAL-FORMATION AB Recent clinical trials have revealed that cholinergic treatments are efficacious in a wide spectrum of neuropsychiatric disorders that span the entire human lifespan and include disorders without cholinergic deficits. Furthermore, some clinical and epidemiological data suggest that cholinergic treatments have disease modifying/preventive effects. It is proposed that these observations can be usefully understood in a myelin-centered model of the human brain. The model proposes that the human brain's extensive myelination is the central evolutionary change that defines our uniqueness as a species and our unique vulnerability to highly prevalent neuropsychiatric disorders. Within the framework of this model the clinical, biochemical, and epidemiologic data can be reinterpreted to suggest that nonsynaptic effects of cholinergic treatments on the process of myelination and myelin repair contributes to their mechanism of action and especially to their disease modifying/preventive effects. The ability to test the model in human populations with safe and noninvasive imaging technologies makes it possible to undertake novel clinical trial efforts directed at primary prevention of some of the most prevalent and devastating of human disorders. C1 Univ Calif Los Angeles, Rush Alzheimers Dis Ctr, Div Brain Mapping,Dept Neurol, Lab Neuroimaging, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA 90095 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Los Angeles, CA USA. RP Bartzokis, G (reprint author), Univ Calif Los Angeles, Rush Alzheimers Dis Ctr, Div Brain Mapping,Dept Neurol, Lab Neuroimaging, 710 Westwood Plaza,Room 2-238, Los Angeles, CA 90095 USA. EM gbar@ucla.edu RI Bartzokis, George/K-2409-2013 FU NIA NIH HHS [AG16570, R01 AG027342]; NIMH NIH HHS [MH0266029] NR 124 TC 21 Z9 21 U1 2 U2 9 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD AUG 15 PY 2007 VL 62 IS 4 BP 294 EP 301 DI 10.1016/j.biopsych.2006.08.020 PG 8 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 198WL UT WOS:000248658100003 PM 17070782 ER PT J AU Bilimoria, KY Bentrem, DJ Ko, CY Ritchey, J Stewart, AK Winchester, DP Talamonti, MS AF Bilimoria, Karl Y. Bentrem, David J. Ko, Clifford Y. Ritchey, Jamie Stewart, Andrew K. Winchester, David P. Talamonti, Mark S. TI Validation of the 6th Edition AJCC Pancreatic Cancer Staging System - Report from the National Cancer Database SO CANCER LA English DT Article DE pancreatic neoplasm; staging; surgery; survival; National Cancer Data Base AB BACKGROUND. with the development of stage-specific treatments for pancreatic cancer, controversies exist concerning optimal clinical and pathologic staging. The most recent edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual 6(th) Edition included some notable modifications. In anticipation of the 7(th) edition's publication, the authors evaluated the predictive ability of the current pancreatic adenocarcinoma staging system. METHODS. By using the National Cancer Data Base (1992-1998), 121,713 patients were identified with pancreatic adenocarcinoma. All patients were restaged by AJCC 6(th) edition guidelines. Stage-specific overall survival was estimated by using the Kaplan-Meier method and compared with log-rank tests. Concordance indices were calculated to evaluate the discriminatory power of the staging system. Cox modeling was used to determine the relative impact of T, N, and M classification on survival. RESULTS. For all patients, there was 5-year survival discrimination by stage (P <.0001). For patients who underwent pancreatectomy, stage predicted 5-year survival: stage IA, 31.4%; IB, 27.2%; IIA, 15.7%; IIB, 7.7%; III, 6.8%; IV, 2.8% (P <.0001). The concordance index for the staging system was 0.631 for all patients, 0.613 for those who underwent pancreatectomy, and 0.596 for patients who did not undergo resection. In patients who under-went pancreatectomy, tumor size, nodal status, and distant metastases were independent predictors of survival (P <.0001). CONCLUSIONS. This is the first large-scale validation of the pancreatic cancer staging system. AJCC 6(th) edition staging guidelines are accurate with respect to survival. Further investigation is needed to integrate new molecular and biochemical markers into the staging scheme. C1 Northwestern Univ, Dept Surg, Div Surg Oncol, Chicago, IL 60611 USA. Natl Canc Data Base, Amer Coll Surg, Canc Program, Chicago, IL USA. VA Greater Los Angeles Hlth Care Syst, Los Angeles, CA USA. RP Talamonti, MS (reprint author), Northwestern Univ, Dept Surg, Div Surg Oncol, Galter 10-105,675 N St Clair St, Chicago, IL 60611 USA. EM mtalamonti@nmff.org NR 10 TC 183 Z9 192 U1 2 U2 9 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0008-543X J9 CANCER JI Cancer PD AUG 15 PY 2007 VL 110 IS 4 BP 738 EP 744 DI 10.1002/cncr.22852 PG 7 WC Oncology SC Oncology GA 197WH UT WOS:000248586700005 PM 17580363 ER PT J AU Peloquin, CA Durbin, D Childs, J Sterling, TR Weiner, M AF Peloquin, Charles A. Durbin, David Childs, James Sterling, Timothy R. Weiner, Marc TI Stability of antituberculosis drugs mixed in food SO CLINICAL INFECTIOUS DISEASES LA English DT Letter ID FASTING CONDITIONS; PHARMACOKINETICS; ANTACIDS C1 Univ Colorado, Sch Pharm & Med, Denver, CO 80202 USA. Vanderbilt Univ, Sch Med, Dept Med, Div Infect Dis, Nashville, TN 37212 USA. Vet Affairs Med Ctr, San Antonio, TX USA. EM peloquinc@njc.org NR 4 TC 6 Z9 6 U1 0 U2 0 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD AUG 15 PY 2007 VL 45 IS 4 BP 521 EP 521 DI 10.1086/520011 PG 1 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 190SK UT WOS:000248079500023 PM 17638210 ER PT J AU Muller, FL Lustgarten, MS Jang, Y Richardson, A Van Remmen, H AF Muller, Florian L. Lustgarten, Michael S. Jang, Younginok Richardson, Arlan Van Remmen, Holly TI Trends in oxidative aging theories SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Review ID MANGANESE-SUPEROXIDE-DISMUTASE; NEMATODE CAENORHABDITIS-ELEGANS; REPLICATIVE LIFE-SPAN; METHIONINE SULFOXIDE REDUCTASE; HUMAN-DIPLOID CELLS; BREAST-CANCER RISK; MITOCHONDRIAL RESPIRATORY-CHAIN; GENE-KNOCKOUT MICE; TRANSGENIC DROSOPHILA-MELANOGASTER; EARLY EMBRYONIC LETHALITY AB The early observations on the rate-of-living theory by Max Rubner and the report by Gershman that oxygen free radicals exist in vivo culminated in the seminal proposal in the 1950s by Denham Harman that reactive oxygen species are a cause of aging (free radical theory of aging). The goal of this review is to analyze recent findings relevant in evaluating Harman's theory using experimental results as grouped by model organisms (i.e., invertebrate models and mice). In this regard, we have focused primarily on recent work involving genetic manipulations. Because the free radical theory of aging is not the only theorem proposed to explain the mechanism(s) involved in aging at the molecular level, we also discuss how this theory is related to other areas of research in biogerontology, specifically, telomere/cell senescence, genomic instability, and the mitochondrial hypothesis of aging. We also discuss where we think the free radical theory is headed. It is now possible to give at least a partial answer to the question whether oxidative stress determines life span as Harman posed so long ago. Based on studies to date, we argue that a tentative case for oxidative stress as a life-span determinant can be made in Drosophila melanogaster. Studies in mice argue for a role of oxidative stress in age-related disease, especially cancer; however, with regard to aging per se, the data either do not support or remain inconclusive on whether oxidative stress determines life span. (c) 2007 Elsevier Inc. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, San Antonio, TX 78229 USA. Univ Texas, Hlth Sci Ctr, Dept Physiol, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Barshop Inst Longev & Aging Studies, San Antonio, TX 78229 USA. RP Van Remmen, H (reprint author), Univ Texas, Hlth Sci Ctr, Dept Cellular & Struct Biol, 7703 Floyd Curl Dr,MSC 7762, San Antonio, TX 78229 USA. EM vanremmen@uthscsa.edu NR 368 TC 547 Z9 575 U1 5 U2 193 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0891-5849 EI 1873-4596 J9 FREE RADICAL BIO MED JI Free Radic. Biol. Med. PD AUG 15 PY 2007 VL 43 IS 4 BP 477 EP 503 DI 10.1016/j.freeradbiomed.2007.03.034 PG 27 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 195HX UT WOS:000248404200001 PM 17640558 ER PT J AU Figlewicz, DP Naleid, AM Sipols, AJ AF Figlewicz, Dianne P. Naleid, Amy MacDonald Sipols, Alfred J. TI Modulation of food reward by adiposity signals SO PHYSIOLOGY & BEHAVIOR LA English DT Article DE insulin; leptin; ventral tegmental area; dopamine; self-administration ID CONDITIONED PLACE PREFERENCE; DOPAMINE TRANSPORTER; INTRAVENTRICULAR INSULIN; NUCLEUS-ACCUMBENS; PHOSPHATIDYLINOSITOL 3-KINASE; MOTIVATED BEHAVIOR; SUCROSE SOLUTIONS; SELF-STIMULATION; ARCUATE NUCLEUS; MESSENGER-RNA AB Extensive historical evidence from the drug abuse literature has provided support for the concept that there is functional communication between central nervous system (CNS) circuitries which subserve reward/motivation, and the regulation of energy homeostasis. This concept is substantiated by recent studies that map anatomical pathways, or which demonstrate that hormones and neurotransmitters associated with energy homeostasis regulation can directly modulate reward and motivation behaviors. Studies from our laboratory have focused specifically on the candidate adiposity hormones, insulin and leptin, and show that these hormones can decrease performance in behavioral paradigms that assess the rewarding or motivating properties of food. Additionally we and others have provided evidence that the ventral tegmental area may be one direct target for these effects, and we are currently exploring other potential anatomical targets. Finally, we are beginning to explore the interaction between adiposity signals, chronic maintenance diet of rats, and different types of food rewards to more closely simulate the current food environments of Westernized societies including the U.S. We propose that future studies of food reward should include a more complex environment in the experimental design that takes into account abundance and variety of rewarding foods, psychological stressors, and choices of reward modalities. (C) 2006 Elsevier Inc. All rights reserved. C1 Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Latvia, Inst Expt & Clin Med, Riga, Latvia. VA Puget Sound Hlth Care Syst 151, Seattle, WA 98108 USA. RP Figlewicz, DP (reprint author), VA Puget Sound Hlth Care Syst, 1660 So Columbian Way, Seattle, WA 98108 USA. EM latte@u.washington.edu FU NCRR NIH HHS [5 P20 RR020774, P20 RR020774]; NIAAA NIH HHS [T32 AA007455]; NIDDK NIH HHS [R01 DK040963, R01 DK040963-18, R01 DK040963-19, R01 DK040963-20, R01 DK40963] NR 56 TC 79 Z9 80 U1 1 U2 5 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0031-9384 J9 PHYSIOL BEHAV JI Physiol. Behav. PD AUG 15 PY 2007 VL 91 IS 5 BP 473 EP 478 DI 10.1016/j.physbeh.2006.10.008 PG 6 WC Psychology, Biological; Behavioral Sciences SC Psychology; Behavioral Sciences GA 217JR UT WOS:000249944700002 PM 17137609 ER PT J AU Minzenberg, MJ Fan, J New, AS Tang, CY Siever, LJ AF Minzenberg, Michael J. Fan, Jin New, Antonia S. Tang, Cheuk Y. Siever, Larry J. TI Fronto-limbic dysfunction in response to facial emotion in borderline personality disorder: An event-related fMRI study SO PSYCHIATRY RESEARCH-NEUROIMAGING LA English DT Article DE anterior cingulate cortex; amygdala; fear; anger; functional magnetic resonance imaging ID POSITRON-EMISSION-TOMOGRAPHY; MEDIAL PREFRONTAL CORTEX; NEURAL RESPONSES; IMPULSIVE AGGRESSION; HEALTHY-VOLUNTEERS; BASAL FOREBRAIN; CHILDHOOD ABUSE; AMYGDALA VOLUME; FEMALE-PATIENTS; FEARFUL FACES AB Clinical hallmarks of borderline personality disorder (BPD) include social and emotional dysregulation. We tested a model of fronto-limbic dysfunction in facial emotion processing in BPD. Groups of 12 unmedicated adults with BPD by DSM-IV and 12 demographically-matched healthy controls (HQ viewed facial expressions (Conditions) of neutral emotion, fear and anger, and made gender discriminations during rapid event-related functional magnetic resonance imaging (fMRI). Analysis of variance of Region of Interest signal change revealed a statistically significant effect of the Group-by-Region-by-Condition interaction. This was due to the BPD group exhibiting a significantly larger magnitude of deactivation (relative to HQ in the bilateral rostral/ subgenual anterior cingulate cortex (ACC) to fear and in the left ACC to fear minus neutral; and significantly greater activation in the right amygdala to fear minus neutral. There were no significant between-group differences in ROI signal change in response to anger. In voxel-wise analyses constrained within these ROIs, the BPD group exhibited significant changes in the fear minus neutral contrast, with relatively less activation in the bilateral rostral/subgenual ACC, and greater activation in the right amygdala. In the anger minus neutral contrast this pattern was reversed, with the BPD group showing greater activation in the bilateral rostral/ subgenual ACC and less activation in the bilateral amygdala. We conclude that adults with BPD exhibit changes in fronto-limbic activity in the processing of fear stimuli, with exaggerated amygdala response and impaired emotion-modulation of ACC activity. The neural substrates underlying processing of anger may also be altered. These changes may represent an expression of the volumetric and serotonergic deficits observed in these brain areas in BPD. (c) 2007 Elsevier Ireland Ltd. All rights reserved. C1 Mt Sinai Sch Med, New York, NY USA. Bronx Vet Adm Med Ctr, Bronx, NY USA. Univ Calif Davis, Med Ctr, Sacramento, CA 95817 USA. RP Minzenberg, MJ (reprint author), UC Davis Hlth Syst, Imaging Res Ctr, 4701 X St, Sacramento, CA 95817 USA. EM michael.minzenberg@ucdmc.ucdavis.edu RI Fan, Jin/A-6716-2009 OI Fan, Jin/0000-0001-9630-8330 FU NCRR NIH HHS [M01 RR000071, M01 RR00071]; NIMH NIH HHS [R01 MH067918, R01 MH067918-01A1] NR 83 TC 134 Z9 136 U1 6 U2 23 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0925-4927 J9 PSYCHIAT RES-NEUROIM JI Psychiatry Res. Neuroimaging PD AUG 15 PY 2007 VL 155 IS 3 BP 231 EP 243 DI 10.1016/j.pseychresns.2007.03.006 PG 13 WC Clinical Neurology; Neuroimaging; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 203JV UT WOS:000248971800006 PM 17601709 ER PT J AU Greenberg, B Thomas, I Banish, D Goldman, S Havranek, E Massie, BM Zhu, Y Ticho, B Abraham, WT AF Greenberg, Barry Thomas, Ignatius Banish, Dorothy Goldman, Steven Havranek, Edward Massie, Barry M. Zhu, Ying Ticho, Barry Abraham, William T. TI Effects of multiple oral doses of an A(1) adenosine antagonist, BG9928, in patients with heart failure - Results of a placebo-controlled, dose-escalation study SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID WORSENING RENAL-FUNCTION; RECEPTOR ANTAGONIST; BG9719 CVT-124; DYSFUNCTION; THERAPY; IMPACT AB Objectives This study sought to assess the pharmacokinetics and clinical effects of oral BG9928 in heart failure (HF) patients. Background Declining renal function during HF treatment is associated with poor outcomes. BG9928, a selective inhibitor of the Al adenosine receptor, is proposed to cause natriuresis without causing a decline in renal function. Methods A randomized, double-blind, placebo-controlled study was conducted in patients with HF and systolic dysfunction who were receiving standard therapy. Patients were randomized to receive BG9928 (3, 15, 75, or 225 mg) or placebo orally for 10 days. The primary end point was change in sodium excretion. Changes in potassium excretion, creatinine clearance, and body weight also were evaluated. Results A total of 50 patients were studied. BG9928 increased sodium excretion compared with placebo, and natriuresis was maintained over 10 days with little kaliuresis. A linear trend in dose response was observed on day 1 (p = 0.04) but not on days 6 or 10. Adjusted creatinine clearance was unchanged over the 10 days. Patients who received 15, 75, or 225 mg of BG9928 had a reduction in body weight compared with placebo (-0.6, -0.7, -0.5, vs. +0.3 kg, respectively) at the end of study. BG9928 was well tolerated. The pharmacokinetic profile of BG9928 was consistent with once-daily dosing. Conclusions Oral BG9928 over the dose range of 3 to 225 mg/day produced significant increases in sodium excretion in patients with stable HF without causing kaliuresis or reducing renal function. (J Am Coll Cardiol 2007;50:600-6) (c) 2007 by the American College of Cardiology Foundation. C1 Univ Calif San Diego, Adv Heart Failure Treatment Program, San Diego, CA 92103 USA. Med Res Inst, Louisville, KY USA. Tchefunctr Cardiovasc Assoc, Louisville, KY USA. Tucson VA Med Ctr, SACAHCS, Sarver Heart Ctr, Tucson, AZ USA. Univ Tucson, Tucson, AZ USA. Denver Med Ctr, Denver, CO USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA 94143 USA. Biogen Idec Inc, Cambridge, MA USA. Ohio State Univ, Heart Ctr, Div Cardiol, Columbus, OH 43210 USA. RP Greenberg, B (reprint author), Univ Calif San Diego, Adv Heart Failure Treatment Program, 200 W Arbor Dr 8411, San Diego, CA 92103 USA. EM bgreenberg@ucsd.edu NR 15 TC 42 Z9 44 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD AUG 14 PY 2007 VL 50 IS 7 BP 600 EP 606 DI 10.1016/j.jacc.2007.03.059 PG 7 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 204MY UT WOS:000249049300006 PM 17692744 ER PT J AU Li, G Sokal, I Quinn, JF Leverenz, JB Brodey, M Schellenberg, GD Kaye, JA Raskind, MA Zhang, J Peskind, ER Montine, TJ AF Li, G. Sokal, I. Quinn, J. F. Leverenz, J. B. Brodey, M. Schellenberg, G. D. Kaye, J. A. Raskind, M. A. Zhang, J. Peskind, E. R. Montine, T. J. TI CSF tau/A beta(42) ratio for increased risk of mild cognitive impairment - A follow-up study SO NEUROLOGY LA English DT Article ID CEREBROSPINAL-FLUID TAU; INCIPIENT ALZHEIMERS-DISEASE; PHOSPHORYLATED-TAU; CLINICAL-DIAGNOSIS; APOLIPOPROTEIN-E; MCI SUBJECTS; BIOMARKERS; PROTEIN; BETA-AMYLOID(1-42); DEMENTIA AB Background: Processes of Alzheimer disease (AD) likely begin years prior to the onset of cognitive impairment (latent AD), progress though a prodromal phase of mild cognitive impairment (MCI), and culminate in dementia. While many studies have evaluated CSF tau and A beta(42) as biomarkers of the dementia or prodromal stages of AD, we are unaware of any study to evaluate these potential CSF biomarkers of latent AD. Methods: We determined the ratio of CSF tau/A beta(42) (T/A beta) using Luminex reagents in 129 control individuals that spanned from 21 to 100 years of age; for comparison we included patients with MCI (n = 12), probable AD (n = 21), or other neurodegenerative diseases (n = 12). Results: We identified 16% of the control group with abnormally elevated CSF T/A beta; all were 53 years or older. Using age-matched controls with normal CSF T/A beta we showed that the high CSF T/A beta subgroup of controls had significantly increased frequency of the epsilon 4 allele of the apolipoprotein E gene and significantly increased risk of conversion to MCI during follow-up of up to 42 months suggesting that they had latent AD at the time of lumbar puncture. Conclusions: These generally applicable methods establish cutoff values to identify control individuals at increased risk of conversion to mild cognitive impairment which may be useful to people weighing the risk-benefit ratio of new preventive therapeutics and to researchers striving to enrich clinical trial populations with people with latent Alzheimer disease. C1 Univ Washington, VA Puget Sound Hlth Care Syst, Ctr Clin, Seattle, WA 98195 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Dept Psychiat, Seattle, WA 98195 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Dept Behav Sci, Seattle, WA 98195 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Dept Pathol, Seattle, WA 98195 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Ctr Clin, Seattle, WA 98195 USA. Univ Washington, VA Puget Sound Hlth Care Syst, Dept Med, Seattle, WA 98195 USA. Oregon Hlth & Sci Univ, Vet Affairs Med Ctr, Portland, OR 97201 USA. Biosource Div Invitrogen, Camarillo, CA USA. RP Montine, TJ (reprint author), Univ Washington, Harborview Med Ctr, Dept Pathol, 300 9th Ave, Seattle, WA 98104 USA. EM tmontine@u.washington.edu OI Kaye, Jeffrey/0000-0002-9971-3478 FU NIA NIH HHS [AG05136, AG08017] NR 35 TC 171 Z9 175 U1 1 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD AUG 14 PY 2007 VL 69 IS 7 BP 631 EP 639 DI 10.1212/01.wnl.0000267428.62582.aa PG 9 WC Clinical Neurology SC Neurosciences & Neurology GA 199VP UT WOS:000248723600003 PM 17698783 ER PT J AU Silva, EF Medeiros, MA McBride, AJA Matsunaga, J Esteves, GS Ramos, JGR Santos, CS Croda, J Homma, A Dellagostin, OA Haake, DA Reis, MG Ko, AI AF Silva, Everton F. Medeiros, Marco A. McBride, Alan J. A. Matsunaga, Jim Esteves, Gabriela S. Ramos, Joao G. R. Santos, Cleiton S. Croda, Julio Homma, Akira Dellagostin, Odira A. Haake, David A. Reis, Mitermayer G. Ko, Albert I. TI The terminal portion of leptospiral immunoglobulin-like protein LigA confers protective immunity against lethal infection in the hamster model of leptospirosis SO VACCINE LA English DT Article DE leptospirosis; subunit vaccine; leptospiral immunoglobulin-like protein; recombinant protein; immunity; antibodies; hamsters ID INTERROGANS SEROVAR POMONA; OUTER-MEMBRANE PROTEINS; URBAN EPIDEMIC; VACCINATION; CHALLENGE; VACCINES; MICE; IMMUNOPROTECTION; EXPRESSION; DISEASE AB Subunit vaccines are a potential intervention strategy against leptospirosis, which is a major public health problem in developing countries and a veterinary disease in livestock and companion animals worldwide. Leptospiral immunoglobulin-like (Lig) proteins are a family of surface-exposed determinants that have Ig-like repeat domains found in virulence factors such as intimin and invasin. We expressed fragments of the repeat domain regions of LigA and Lig]B from Leptospira interrogans serovar Copenhageni. Immunization of Golden Syrian hamsters with Lig fragments in Freund's adjuvant induced robust antibody responses against recombinant protein and native protein, as detected by ELISA and immunoblot, respectively. A single fragment, LigANI, which corresponds to the six carboxy-terminal Ig-like repeat domains of the LigA molecule, conferred immunoprotection against mortality (67-100%, P < 0.05) in hamsters which received a lethal inoculum of L. interrogans serovar Copenhageni. However, immunization with this fragment did not confer sterilizing immunity. These findings indicate that the carboxy-terminal portion of LigA is an immunoprotective domain and may serve as a vaccine candidate for human and veterinary leptospirosis. (c) 2007 Elsevier Ltd. All rights reserved. C1 Ctr Pesquisas Goncalo Moniz, Fundacao Oswaldo Cruz, BR-40296710 Salvador, BA, Brazil. Brazilian Minst Hlth, Oswaldo Curz Fdn, Goncalo Moniz Res Ctr, Salvador, BA, Brazil. Univ Fed Pelotas, Ctr Biotechnol, Pelotas, Brazil. Vet Affairs Greater Los Angles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, David Giffen Sch Med, Dept Med, Los Angeles, CA USA. Cornell Univ, Weill Med Coll, Div Int Med & Infect Dis, New York, NY USA. RP Ko, AI (reprint author), Ctr Pesquisas Goncalo Moniz, Fundacao Oswaldo Cruz, Rua Waldemar Falcao,121, BR-40296710 Salvador, BA, Brazil. EM aik2001@med.cornell.edu RI Dellagostin, Odir/C-2331-2009; Ko, Albert/P-2343-2015; McBride, Alan/D-4106-2012 OI Dellagostin, Odir/0000-0003-2803-4088; Ko, Albert/0000-0001-9023-2339; McBride, Alan/0000-0001-9682-540X FU FIC NIH HHS [D43 TW000919, D43 TW000919-10, TW00919]; NIAID NIH HHS [AI052473, AI034431, R01 AI034431, R01 AI034431-10A1, R01 AI052473, R01 AI052473-04, R21 AI034431, R29 AI034431] NR 48 TC 85 Z9 85 U1 1 U2 6 PU ELSEVIER SCI LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND SN 0264-410X J9 VACCINE JI Vaccine PD AUG 14 PY 2007 VL 25 IS 33 BP 6277 EP 6286 DI 10.1016/j.vaccine.2007.05.053 PG 10 WC Immunology; Medicine, Research & Experimental SC Immunology; Research & Experimental Medicine GA 202MN UT WOS:000248905900016 PM 17629368 ER PT J AU Kusner, DJ Thompson, CR Melrose, NA Pitson, SM Obeid, LM Iyer, SS AF Kusner, David J. Thompson, Christopher R. Melrose, Natalie A. Pitson, Stuart M. Obeid, Lina M. Iyer, Shankar S. TI The localization and activity of sphingosine kinase 1 are coordinately regulated with actin cytoskeletal dynamics in macrophages SO JOURNAL OF BIOLOGICAL CHEMISTRY LA English DT Review ID PHAGOSOME-LYSOSOME FUSION; MYCOBACTERIUM-TUBERCULOSIS PHAGOSOME; DEPENDENT SIGNAL-TRANSDUCTION; MEDIATED CA2+ MOBILIZATION; PROTEIN-COUPLED RECEPTORS; PHOSPHOLIPASE-D ACTIVITY; FUNCTIONAL-CHARACTERIZATION; MOLECULAR-CLONING; PLASMA-MEMBRANE; ENDOPLASMIC-RETICULUM AB The physiologic and pathologic functions of sphingosine kinase (SK) require translocation to specific membrane compartments. Wetested the hypothesis that interactions with actin filaments regulate the localization of SK1 to membrane surfaces, including the plasma membrane and phagosome. Macrophage activation is accompanied by a marked increase in association of SK1 with actin filaments. Catalytically-inactive (CI)- and phosphorylation-defective (PD)-SK1 mutants exhibited reductions in plasma membrane translocation, colocalization with cortical actin filaments, membrane ruffling, and lamellipodia formation, compared with wild-type (WT)-SK1. However, translocation of CI- and PD-SK1 to phagosomes were equivalent to WT-SK1. SK1 exhibited constitutive- and stimulus-enhanced association with actin filaments and F-actin-enriched membrane fractions in both intact macrophages and a novel in vitro assay. In contrast, SK1 bound G-actin only under stimulated conditions. Actin inhibitors disrupted SK1 localization and modulated its activity. Conversely, reduction of SK1 levels or activity via RNA interference or specific chemical inhibition resulted in dysregulation of actin filaments. Thus, the localization and activity of SK1 are coordinately regulated with actin dynamics during macrophage activation. C1 Univ Iowa, Carver Coll Med, Inflammat Program, Div Infect Dis, Iowa City, IA 52245 USA. Univ Iowa, Carver Coll Med, Dept Internal Med, Iowa City, IA 52245 USA. Univ Iowa, Carver Coll Med, Dept Physiol & Biophys, Iowa City, IA 52245 USA. Univ Iowa, Carver Coll Med, Grad Program Immunol, Iowa City, IA 52245 USA. Univ Iowa, Carver Coll Med, Grad Mol Biol, Iowa City, IA 52245 USA. Vet Affairs Med Ctr, Iowa City, IA 52245 USA. Univ Adelaide, Sch Mol & Biomed Sci, Inst Med & Vet Sci, Div Human Immunol,Hanson Inst, Adelaide, SA 5005, Australia. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biochem & Mol Biol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Kusner, DJ (reprint author), 200 Hawkins Dr,SW54-8GH, Iowa City, IA 52245 USA. EM david-kusner@uiowa.edu OI obeid, lina/0000-0002-0734-0847 FU NIAID NIH HHS [R01 AI055916, P01 AI44642-08]; NIGMS NIH HHS [R01 GM062887, R01 GM62302]; PHS HHS [T32] NR 125 TC 19 Z9 22 U1 0 U2 3 PU AMER SOC BIOCHEMISTRY MOLECULAR BIOLOGY INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3996 USA SN 0021-9258 J9 J BIOL CHEM JI J. Biol. Chem. PD AUG 10 PY 2007 VL 282 IS 32 BP 23147 EP 23162 DI 10.1074/jbc.M700193200 PG 16 WC Biochemistry & Molecular Biology SC Biochemistry & Molecular Biology GA 197ST UT WOS:000248577500017 PM 17519232 ER PT J AU Marvizon, JCG Perez, OA Song, B Chen, W Bunnett, NW Grady, EF Todd, AJ AF Marvizon, J. C. G. Perez, O. A. Song, B. Chen, W. Bunnett, N. W. Grady, E. F. Todd, A. J. TI Calcitonin receptor-like and receptor activity modifying protein 1 in the rat dorsal horn localization in glutamatergic presynaptic terminal containing opioids and adrenergic alpha(2c) receptor SO NEUROSCIENCE LA English DT Article DE adrenergic receptor; calcitonin gene-related peptide; CGRP; colocalization; dynorphin; enkephalin ID GENE-RELATED-PEPTIDE; LAMINAE-I-III; SPINAL-CORD; SUBSTANCE-P; CALCIUM-CHANNELS; ALPHA(2C)-ADRENERGIC RECEPTOR; SUPERFICIAL LAMINAE; SYNAPTIC GLOMERULI; PRIMARY AFFERENTS; HUMAN CEREBELLUM AB Calcitonin gene-related peptide (CGRP) is abundant in the central terminals of primary afferents. However, the function of CGRP receptors in the spinal cord remains unclear. CGRP receptors are heterodimers of calcitonin receptor-like receptor (CRLR) and receptor activity modifying protein 1 (RAMP1). We studied the localization of CRLR and RAMP1 in the rat dorsal horn using well-characterized antibodies against them, which labeled numerous puncta in laminae I-II. In addition, RAMP1 was found in cell bodies, forming patches at the cell surface. The CRLR- and RAMP1-immunoreactive puncta were further characterized using double and triple labeling. Colocalization was quantified in confocal stacks using Imaris software. CRLR did not colocalize with primary afferent markers, indicating that these puncta were not primary afferent terminals. CRLR- and RAMP1-immunoreactive puncta contained synaptophysin and vesicular glutamate transporter-2 (VGLUT2), showing that they were glutamatergic presynaptic terminals. Electron microscopic immunohistochemistry confirmed that CRLR immunoreactivity was present in axonal boutons that were not in synaptic glomeruli. Using tyramide signal amplification for double labeling with the CRLR and RAMP1 antibodies, we found some clear instances of colocalization of CRLR with RAMP1 in puncta, but their overall colocalization was low. In particular, CRLR was absent from RAMP1-containing cells. Many of the puncta stained for CRLR and RAMP1 were labeled by antiopioid and anti-enkephalin antibodies. CRLR and, to a lesser extent, RAMP1 also colocalized with adrenergic alpha(2c) receptors. Triple label studies demonstrated three-way colocalization of CRLR-VGLUT2-synaptophysin, CRLR-VGLUT2-opioids, and CRLR-opioids-alpha(2c) receptors. In conclusion, CRLR is located in glutamatergic presynaptic terminals in the dorsal horn that contain alpha(2c) adrenergic receptors and opioids. Some of these terminals contain RAMP1, which may form CGRP receptors with CRLR, but in others CRLR may form other receptors, possibly by dimerizing with RAMP2 or RAMP3. These findings suggest that CGRP or adrenomedullin receptors modulate opioid release in the dorsal horn. (c) 2007 IBRO. Published by Elsevier Ltd. All rights reserved. C1 Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth & CURE, Digest Dis Res Ctr, Div Digest Dis,Dept Med,David Geffen Sch Med, Los Angeles, CA 90073 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif San Francisco, Dept Physiol, Dept Surg, San Francisco, CA 94143 USA. Univ Glasgow, Inst Biomed & Life Sci, Glasgow G12 8QQ, Lanark, Scotland. RP Marvizon, JCG (reprint author), Univ Calif Los Angeles, Ctr Neurovisceral Sci & Womens Hlth & CURE, Digest Dis Res Ctr, Div Digest Dis,Dept Med,David Geffen Sch Med, Bldg 115,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM marvizon@ucla.edu RI Todd, Andrew/A-6855-2011; Chen, Wenling/A-4490-2012 FU NIDA NIH HHS [2-R01-DA012609, R01 DA012609, R01 DA012609-06A1, R01 DA012609-07]; Wellcome Trust [, 076976] NR 54 TC 40 Z9 40 U1 1 U2 6 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PD AUG 10 PY 2007 VL 148 IS 1 BP 250 EP 265 DI 10.1016/j.neuroscience.2007.05.036 PG 16 WC Neurosciences SC Neurosciences & Neurology GA 206BC UT WOS:000249157900023 PM 17614212 ER PT J AU Guzman-Marin, R Bashir, T Suntsova, N Szymusiak, R McGinty, D AF Guzman-Marin, R. Bashir, T. Suntsova, N. Szymusiak, R. McGinty, D. TI Hippocampal neurogenesis is reduced by sleep fragmentation in the adult rat SO NEUROSCIENCE LA English DT Article DE sleep fragmentation; hippocampus; dentate gyrus; neurogenesis; BrdU ID DENTATE GYRUS; CELL-PROLIFERATION; SUPPRESSES NEUROGENESIS; DAYTIME FUNCTION; RECOVERY SLEEP; DEPRIVATION; BRAIN; PERFORMANCE; DISRUPTION; APNEA AB The adult hippocampal dentate gyrus (DG) is a site of continuing neurogenesis. This process is influenced by a variety of physiological and experiential stimuli including total sleep deprivation (TSD). In humans, sleep fragmentation (SF) is a more common sleep condition than TSD. SF is associated with several prevalent diseases. We assessed a hypothesis that SF would suppress adult neurogenesis in the DG of the adult rat. An intermittent treadmill system was used; the treadmill was on for 3 s and off for 30 s (SF). For sleep fragmentation control (SFC), the treadmill was on for 15 min and off for 150 min. SF was conducted for three durations: 1, 4 and 7 days. To label proliferating cells, the thymidine analog, 5-bromo-2-deoxyuridine (BrdU), was injected 2 h prior to the end of each experiment. Expression of the intrinsic proliferative marker, Ki67, was also studied. SF rats exhibited an increased number of non-rapid eye movement (NREM) sleep bouts with no change in the percent of time spent in this stage. The numbers of both BrdU-positive cells and Ki67-positive cells were reduced by similar to 70% (P<0.05) in the SF groups after 4 and 7 days of experimental conditions whereas no differences were observed after 1 day. In a second experiment, we found that the percentage of new cells expressing a neuronal phenotype 3 weeks after BrdU administration was lower in the SF in comparison with the SFC group for all three durations of SF. We also examined the effects of SF on proliferation in adrenalectomized (ADX) animals, with basal corticosterone replacement. ADX SF animals exhibited a 55% reduction in the number of BrdU-positive cells when compared with ADX SFC. Thus, elevated glucocorticoids do not account for most of the reduction in cell proliferation induced by the SF procedure, although a small contribution of stress is not excluded. The results show that sustained SF induced marked reduction in hippocampal neurogenesis. Published by Elsevier Ltd on behalf of IBRO. C1 VA Greater Los Angeles Healthcare Syst, Res Serv, North Hills, CA 91343 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Rostov State Univ, AB Kogan Res Inst Neurocybernet, Rostov Na Donu 344006, Russia. RP McGinty, D (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv, 16111 Plummer St, North Hills, CA 91343 USA. EM dmcginty@ucla.edu FU NHLBI NIH HHS [P50 HL060296, P50 HL060296-080010]; NIMH NIH HHS [R01 MH075076, R01 MH075076-01A2] NR 53 TC 66 Z9 69 U1 2 U2 3 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4522 J9 NEUROSCIENCE JI Neuroscience PD AUG 10 PY 2007 VL 148 IS 1 BP 325 EP 333 DI 10.1016/j.neuroscience.2007.05.030 PG 9 WC Neurosciences SC Neurosciences & Neurology GA 206BC UT WOS:000249157900029 PM 17630219 ER PT J AU Goy, ER Carter, JH Ganzini, L AF Goy, Elizabeth R. Carter, Julie H. Ganzini, Linda TI Parkinson disease at the end of life: Caregiver perspectives SO NEUROLOGY LA English DT Editorial Material C1 Oregon Hlth & Sci Univ, Vet Affairs Med Ctr, Columbia Ctr Study Chron, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Dept Psychiat, Portland, OR 97201 USA. Oregon Hlth & Sci Univ, Parkinsons Ctr Oregon, Portland, OR 97201 USA. RP Goy, ER (reprint author), Portland VA Med Ctr, P3 MHDC,3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. EM goye@ohsu.edu NR 6 TC 14 Z9 14 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD AUG 7 PY 2007 VL 69 IS 6 BP 611 EP 612 DI 10.1212/01.wnl.0000266665.82754.61 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 197RE UT WOS:000248573000017 PM 17679683 ER PT J AU Koeppen, AH Michael, SC Knutson, MD Haile, DJ Qian, J Levi, S Santambrogio, P Garrick, MD Lamarche, JB AF Koeppen, Arnulf H. Michael, Susan C. Knutson, Mitchell D. Haile, David J. Qian, Jiang Levi, Sonia Santambrogio, Paolo Garrick, Michael D. Lamarche, Jacques B. TI The dentate nucleus in Friedreich's ataxia: the role of iron-responsive proteins SO ACTA NEUROPATHOLOGICA LA English DT Article DE Friedreich's ataxia; atrophy; dentate nucleus; ferritin; ferroportin; iron; synapses ID SUPERFICIAL SIDEROSIS; HEREDITARY ATAXIAS; BRAIN; TRANSPORTER; FERROPORTIN; FERRITIN; CARDIOMYOPATHY; SYSTEM AB Frataxin deficiency in Friedreich's ataxia (FRDA) causes cardiac, endocrine, and nervous system manifestations. Frataxin is a mitochondrial protein, and adequate amounts are essential for cellular iron homeostasis. The main histological lesion in the brain of FRDA patients is neuronal atrophy and a peculiar proliferation of synaptic terminals in the dentate nucleus termed grumose degeneration. This cerebellar nucleus may be especially susceptible to FRDA because it contains abundant iron. We examined total iron and selected iron-responsive proteins in the dentate nucleus of nine patients with FRDA and nine normal controls by biochemical and microscopic techniques. Total iron (1.53 +/- 0.53 mu mol/g wet weight) and ferritin (206.9 +/- 46.6 mu g/g wet weight) in FRDA did not significantly differ from normal controls (iron: 1.78 +/- 0.88 mu mol/g; ferritin: 210.9 +/- 9.0 mu g/g) but Western blots exhibited a shift to light ferritin subunits. Immunocytochemistry of the dentate nucleus revealed loss of juxtaneuronal ferritin-containing oligodendroglia and prominent ferritin immunoreactivity in microglia and astrocytes. Mitochondrial ferritin was not detectable by immunocytochemistry. Stains for the divalent metal transporter 1 confirmed neuronal loss while endothelial cells reacting with antibodies to transferrin receptor 1 protein showed crowding of blood vessels due to collapse of the normal neuropil. Regions of grumose degeneration were strongly reactive for ferroportin. Purkinje cell bodies, their dendrites and axons, were also ferroportin-positive, and it is likely that grumose degeneration is the morphological manifestation of mitochondrial iron dysmetabolism in the terminals of corticonuclear fibers. Neuronal loss in the dentate nucleus is the likely result of trans-synaptic degeneration. C1 Stratton VA Med Ctr, Albany, NY 12208 USA. Vet Affairs Med Ctr, Res, Albany, NY USA. Vet Affairs Med Ctr, Albany, NY USA. Vet Affairs Med Ctr, Pathol Serv, Albany, NY USA. Albany Med Coll, Dept Neurol & Pathol, Albany, NY 12208 USA. Univ Florida, Dept Food Sci & Human Nutr, Gainesville, FL 32611 USA. Univ Texas, Vet Affairs Med Ctr, Hlth Sci Ctr, San Antonio, TX USA. Ist Sci San Raffaele, Milan, Italy. Vita Salute San Rafaelle Univ, Milan, Italy. SUNY Buffalo, Dept Biochem, Buffalo, NY USA. Univ Sherbrooke, Ctr Hosp, Sherbrooke, PQ J1K 2R1, Canada. RP Koeppen, AH (reprint author), Stratton VA Med Ctr, 113 Holland Ave, Albany, NY 12208 USA. EM arnulf.koeppen@va.gov RI Levi, Sonia/A-3161-2015 OI Levi, Sonia/0000-0002-5092-0847 FU NIDDK NIH HHS [DK065064]; PHS HHS [R01DLK59794] NR 33 TC 70 Z9 72 U1 0 U2 9 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0001-6322 J9 ACTA NEUROPATHOL JI Acta Neuropathol. PD AUG PY 2007 VL 114 IS 2 BP 163 EP 173 DI 10.1007/s00401-007-0220-y PG 11 WC Clinical Neurology; Neurosciences; Pathology SC Neurosciences & Neurology; Pathology GA 190GK UT WOS:000248046800007 PM 17443334 ER PT J AU Forcehimes, AA Tonigan, JS Miller, WR Kenna, GA Baer, JS AF Forcehimes, Alyssa A. Tonigan, J. Scott Miller, William R. Kenna, George A. Baer, John S. TI Psychometrics of the Drinker Inventory of Consequences (DrInC) SO ADDICTIVE BEHAVIORS LA English DT Article DE drinkers inventory of consequences; DrInC; psychometrics; SIP AB The Drinker Inventory of Consequences (DrInC) was developed for Project MATCH to assess the consequences of drinking in five domains. The present study, using baseline data from the 1382 participants involved in the COMBINE Study, analyzed the psychometrics of the 50-item DrInC and its shorter form, the 15-item SIP. Findings indicate the DrInC is reliable, valid, and clinically useful and that DrInC subscales are internally consistent and non-redundant. In an examination of the shorter version of the DrInC, findings suggest that the SIP is suitable when assessing the overall level of drinking-related consequences. (c) 2006 Elsevier Ltd. All rights reserved. C1 Univ New Mexico, CASAA, Albuquerque, NM 87106 USA. Brown Univ, Ctr Alcohol & Addict Studies, Providence, RI 02912 USA. Univ Washington, Dept Psychol, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Forcehimes, AA (reprint author), Univ New Mexico, CASAA, 2650 Yale Blvd SE, Albuquerque, NM 87106 USA. EM AForcehimes@comcast.net; jtonigan@unm.edu; wrmiller@unm.edu; George_Kenna@brown.edu; jsbaer@u.washington.edu NR 7 TC 34 Z9 34 U1 0 U2 1 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0306-4603 J9 ADDICT BEHAV JI Addict. Behav. PD AUG PY 2007 VL 32 IS 8 BP 1699 EP 1704 DI 10.1016/j.addbeh.2006.11.009 PG 6 WC Psychology, Clinical; Substance Abuse SC Psychology; Substance Abuse GA 179PS UT WOS:000247302800014 PM 17182194 ER PT J AU Miller, RA Harrison, DE Astle, CM Floyd, RA Flurkey, K Hensley, KL Javors, MA Leeuwenburgh, C Nelson, JF Ongini, E Nadon, NL Warner, HR Strong, R AF Miller, Richard A. Harrison, David E. Astle, Clinton M. Floyd, Robert A. Flurkey, Kevin Hensley, Kenneth L. Javors, Martin A. Leeuwenburgh, Christiaan Nelson, James F. Ongini, Ennio Nadon, Nancy L. Warner, Huber R. Strong, Randy TI An aging Interventions Testing Program: study design and interim report SO AGING CELL LA English DT Article DE aging; aspirin; longevity; mice; nordihydroguiaretic acid ID GENETICALLY HETEROGENEOUS MICE; TERT-BUTYL NITRONE; NORDIHYDROGUAIARETIC ACID NDGA; QUANTITATIVE TRAIT LOCI; GROWTH-FACTOR-I; LIFE-SPAN; SPIN-TRAP; ACETYLSALICYLIC-ACID; CHOLINE-DEFICIENT; GENE-EXPRESSION AB The National Institute on Aging's Interventions Testing Program (ITP) has developed a plan to evaluate agents that are considered plausible candidates for delaying rates of aging. Key features include: (i) use of genetically heterogeneous mice (a standardized four-way cross), (ii) replication at three test sites (the Jackson Laboratory, TJL; University of Michigan, UM; and University of Texas, UT), (iii) sufficient statistical power to detect 10% changes in lifespan, (iv) tests for age-dependent changes in T cell subsets and physical activity, and (v) an annual solicitation for collaborators who wish to suggest new interventions for evaluation. Mice in the first cohort were exposed to one of four agents: aspirin, nitroflurbiprofen (NFP), 4-OH-alpha-phenyl-N-tert-butyl nitrone (4-OH-PBN), or nordihydroguiaretic acid (NDGA). An interim analysis was conducted using survival data available on the date at which at least 50% of the male control mice had died at each test site. Survival of control males was significantly higher, at the interim time-point, at UM than at UT or TJL; all three sites had similar survival of control females. Males in the NDGA group had significantly improved survival (P = 0.0004), with significant effects noted at TJL (P < 0.01) and UT (P < 0.04). None of the other agents altered survival, although there was a suggestion (P = 0.07) of a beneficial effect of aspirin in males. More data will be needed to determine if any of these compounds can extend maximal lifespan, but the current data show that NDGA reduces early life mortality risks in genetically heterogeneous mice at multiple test sites. C1 Univ Michigan, Med Ctr, Geriatr Ctr, Dept Pathol, Ann Arbor, MI 48109 USA. Jackson Lab, Bar Harbor, ME 04609 USA. Oklahoma Med Res Fdn, Oklahoma City, OK 73104 USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX 78229 USA. Univ Florida, Dept Aging & Geriatr, Gainesville, FL 32610 USA. Univ Texas, Hlth Sci Ctr, Barshop Ctr Longev & Aging Studies, Dept Physiol, San Antonio, TX 78229 USA. Nicox Res Inst, Milan, Italy. NIA, Biol Aging Program, Bethesda, MD 20892 USA. S Texas Vet Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Res Serv, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Barshop Ctr Longev & Aging Studies, Dept Pharmacol, San Antonio, TX 78229 USA. RP Miller, RA (reprint author), Univ Minnesota, Coll Biol Sci, St Paul, MN 55108 USA. EM millerr@umich.edu FU NIA NIH HHS [AG022307, AG022303, AG022308, AG025707, AG13319] NR 59 TC 77 Z9 78 U1 0 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1474-9718 J9 AGING CELL JI Aging Cell PD AUG PY 2007 VL 6 IS 4 BP 565 EP 575 DI 10.1111/j.1474-9726.2007.00311.x PG 11 WC Cell Biology; Geriatrics & Gerontology SC Cell Biology; Geriatrics & Gerontology GA 190VF UT WOS:000248088000017 PM 17578509 ER PT J AU Zhao, XQ Phan, BAP Chu, BC Bray, F Moore, AB Polissar, NL Dodge, JT Lee, CD Hatsukami, TS Yuan, C AF Zhao, Xue-Qiao Phan, Binh An P. Chu, Baocheng Bray, Frank Moore, Andrew B. Polissar, Nayak L. Dodge, J. Theodore, Jr. Lee, Colin D. Hatsukami, Thomas S. Yuan, Chun TI Testing the hypothesis of atherosclerotic plaque lipid depletion during lipid therapy by magnetic resonance imaging: Study design of Carotid Plaque Composition Study SO AMERICAN HEART JOURNAL LA English DT Article ID IN-VIVO; CORONARY ATHEROSCLEROSIS; MYOCARDIAL-INFARCTION; LOWERING THERAPY; REGRESSION DIETS; CHOLESTEROL; PROGRESSION; PREVENTION; NIACIN; TRIAL AB Background In vivo testing of the lipid depletion hypothesis in human beings during lipid-modifying therapy has not been possible until recent developments in magnetic resonance imaging (MRI). Trial Design The Carotid Plaque Composition Study is a prospective, randomized study designed to test the lipid depletion hypothesis in vivo. One hundred twenty-three subjects with coronary artery disease (CAD) or carotid disease and with levels of apolipoprotein B >= 120 mg/dL (low-density lipoprotein levels 100-190 mg/dL) were enrolled and randomized to (1) single therapy-atorvastatin alone, placebos for extended release (ER)-niacin and colesevelam; (2) double therapy-atorvastatin plus ER-niacin (2 g/d), and placebo for colesevelam; (3) triple therapy-atorvastatin, ERniacin, plus colesevelam (3.8 9/d). All subjects will undergo MRI scans of bilateral carotid arteries at baseline and annually for 3 years for a total of 4 examinations while on active therapy., Among these 123 subjects with mean age of 55 years and mean body mass index of 30 kg/m(2), 73% are male, 43% have a family history of premature cardiovascular disease, 37% have had a previous myocardial infarction, 80% have clinically established CAD, 52% are hypertensive, 12% have diabetes, 23% are current smokers, and 47% meet the criteria for metabolic syndrome. The baseline carotid disease is evaluated using a MRI-modified American Heart Association lesion type definition. Of the 123 enrolled subjects, 40% have type III lesions with small eccentric plaque, 52% have type IV to V lesions with a necrotic core, and only 4% have calcified plaque based on the most diseased carotid location. Conclusions The Carotid Plaque Composition Study uses a state-of-the-art imaging technology and comprehensive lipid management to test the plaque lipid depletion hypothesis in CAD subjects. C1 Univ Washington, Div Cardiol, Dept Med, Seattle, WA 98103 USA. Univ Washington, Dept Radiol, Vasc Imaging Lab, Seattle, WA USA. Mt Whisper Light Stat Consulting, Seattle, WA USA. Yakima Heart Ctr, Yakima, WA USA. Idaho Cardiol Assoc, Boise, ID USA. Univ Washington, Div Vasc, Seattle, WA USA. VA Puget Sound Hlth Care, Seattle, WA USA. RP Zhao, XQ (reprint author), Univ Washington, Div Cardiol, Dept Med, Box 358771,1914 N 34th St,Suite 204, Seattle, WA 98103 USA. EM xueqiao@u.washington.edu FU NHLBI NIH HHS [R01 HL63895] NR 31 TC 28 Z9 28 U1 1 U2 5 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-8703 J9 AM HEART J JI Am. Heart J. PD AUG PY 2007 VL 154 IS 2 BP 239 EP 246 DI 10.1016/j.ahj.2007.04.035 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 196VT UT WOS:000248511000009 PM 17643572 ER PT J AU Singla, I Zahid, M Good, CB Macioce, A Sonel, AF AF Singla, Ish Zahid, Maliha Good, Chester B. Macioce, Alanna Sonel, Ali F. TI Effect of hyponatremia (< 135 mEq/L) on outcome in patients with Non-ST-elevation acute coronary syndrome SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID MYOCARDIAL-INFARCTION; HEART-FAILURE; MORTALITY; TERM AB Hyponatremia is associated with adverse outcomes in patients with heart failure and ST-elevation myocardial infarction (STEMI). We evaluated the effect of hyponatremia on outcomes in patients with suspected acute coronary syndrome and non-STEMI. All patients had a sodium level determined at time of admission, at 24 and 48 hours, and at discharge. Of 1,478 patients, 341 (23.1%) were hyponatremic (sodium < 135 mEq/L) on presentation. Patients who had hyponatremia on admission were significantly more likely to die or have recurrent myocardial infarction in the next 30 days (odds ratio 1.98, 95% confidence interval 1.35 to 2.89, p < 0.001). This relation persisted after adjusting for factors such as age, left ventricular ejection fraction, use of diuretics before admission, hypotension on presentation, anemia, chronic renal insufficiency, pulmonary edema, and high troponin levels (odds ratio 1.7, 95% confidence interval 1.1 to 2.5, p = 0.01). In conclusion, hyponatremia on admission is associated with 30-day adverse outcome in patients presenting with suspected acute coronary syndrome/non-STEMI. (c) 2007 Elsevier Inc. All rights reserved. C1 Univ Pittsburgh, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Ctr Hlth Equ & Res Promot, Pittsburgh, PA USA. RP Zahid, M (reprint author), Univ Pittsburgh, Pittsburgh, PA 15260 USA. EM maz7@pitt.edu NR 11 TC 17 Z9 18 U1 0 U2 0 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD AUG 1 PY 2007 VL 100 IS 3 BP 406 EP 408 DI 10.1016/j.amjcard.2007.03.039 PG 3 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 197TJ UT WOS:000248579100004 PM 17659918 ER PT J AU Caudle, DD Senior, AC Wetherell, JL Rhoades, HM Beck, JG Kunik, ME Snow, AL Wilson, NL Stanley, MA AF Caudle, Donald D. Senior, Ashley C. Wetherell, Julie Loebach Rhoades, Howard M. Beck, J. G. Kunik, Mark E. Snow, A. Lynn Wilson, Nancy L. Stanley, Melinda A. TI Cognitive errors, symptom severity, and response to cognitive behavior therapy in older adults with generalized anxiety disorder SO AMERICAN JOURNAL OF GERIATRIC PSYCHIATRY LA English DT Article DE generalized anxiety disorder; cognitive behavior therapy; older adults; Mini-Mental Status Examination ID EXECUTIVE DYSFUNCTION; GERIATRIC DEPRESSION; REALITY ORIENTATION; LIFE; PROGRESSION; VALIDATION; DISABILITY; AMSTERDAM; DISEASE; SCALE AB Objective: Recent research by Wetherell et al. investigating the differential response to group-administered cognitive behavior therapy ( CBT) for generalized anxiety disorder ( GAD) in older adults found that GAD severity, homework adherence, and psychiatric comorbidity predicted statistically significant improvement. The current study investigated whether the presence/absence of cognitive errors on separate domains of the Mini-Mental State Exam ( MMSE) predicted baseline differences in symptom severity and improvement following CBT, above and beyond already established predictors. Methods: Baseline characteristics were investigated in a sample of 208 older patients diagnosed with GAD. Predictors of treatment response were examined in a sub-sample of 65 patients who completed CBT and were included in a prior study by Wetherell et al. of response predictors. Results: Results from the baseline sample indicated that only subjects who committed an error on the MMSE Working Memory domain exhibited increased severity in anxiety and depressive symptoms. Results from the treatment sample indicated that an error on the MMSE Orientation domain was a significant predictor of outcome at 6-month follow-up, while controlling for previously established predictors. Patients who committed at least one error in this domain showed decreased response relative to patients who committed no errors. Conclusion: In this sample of older adults diagnosed with GAD, poor performance on the MMSE Working Memory domain was associated with increased baseline anxiety and depression, while baseline performance differences on the MMSE Orientation domain predicted outcome six months after CBT intervention. C1 Univ Houston, Dept Educ Psychol, Houston, TX USA. Univ Houston, Dept Psychol, Houston, TX USA. Baylor Coll Med, Houston Ctr Qual Care & Utilizat Studies MEDVAMC, Dept Psychiat & Behav Sci, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Houston, TX 77030 USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat & Behav Sci, Houston, TX USA. Michael E DeBakey Vet Affairs Med Ctr, Hlth Serv Res & Dev Serv, Houston Ctr Qual Care & Utilizat Studies, Houston, TX USA. Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA. Vet Affairs San Diego Hlth Care Syst, Psychol Serv, San Diego, CA USA. SUNY Buffalo, Dept Psychol, Buffalo, NY 14260 USA. Univ Alabama, Dept Psychol, Ctr Mental Hlth & Aging, Tuscaloosa, AL 35487 USA. RP Stanley, MA (reprint author), Baylor Coll Med, Houston Ctr Qual Care & Utilizat Studies MEDVAMC, Dept Psychiat & Behav Sci, 2002 Holcombe Blvd, Houston, TX 77030 USA. EM mstanley@bcm.tmc.edu NR 60 TC 30 Z9 30 U1 2 U2 15 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1064-7481 J9 AM J GERIAT PSYCHIAT JI Am. J. Geriatr. Psychiatr. PD AUG PY 2007 VL 15 IS 8 BP 680 EP 689 DI 10.1097/JGP.0b013e31803c550d PG 10 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 196MW UT WOS:000248487700006 PM 17670997 ER PT J AU Moran, A Simon, JA Shiboski, S Pickering, TG Waters, D Rotter, JI Lyon, C Nickerson, D Yang, H Saad, M Hsueh, W Krauss, RM AF Moran, Andrew Simon, Joel A. Shiboski, Stephen Pickering, Thomas G. Waters, David Rotter, Jerome I. Lyon, Christopher Nickerson, Deborah Yang, Huiying Saad, Mohammed Hsueh, Willa Krauss, Ronald M. TI Differential effects of Ramipril on ambulatory blood pressure in African Americans and Caucasians SO AMERICAN JOURNAL OF HYPERTENSION LA English DT Article DE ambulatory blood pressure; nondipping; pharmacotherapy; angiotensin-converting enzyme inhibitors; African American; Caucasian ID CONVERTING-ENZYME-INHIBITION; WHITE HYPERTENSIVE PATIENTS; ANTIHYPERTENSIVE RESPONSE; ETHNIC-DIFFERENCES; MANAGEMENT; BLACKS; THERAPY; PROFILE; RACE; MECHANISMS AB Background: On average, angiotensin-converting enzyme inhibitors produce less office blood-pressure lowering in African Americans compared with Caucasians. Past studies did not compare daytime and nighttime ambulatory blood-pressure responses to angiotensin-converting enzyme inhibitors in African Americans and Caucasians. Methods: We measured the office and ambulatory bloodpressure response to 8 weeks of a fixed dose of 10 mg daily of the angiotensin-converting enzyme inhibitor ramipril in a cohort of 72 African Americans and 89 Caucasians. Results: Ramipril lowered age-adjusted daytime ambulatory systolic blood pressure 6 mm Hg and diastolic blood pressure 3 mm Hg less in African Americans compared with Caucasians (both P =.02). This difference persisted after adjusting for baseline blood pressure, body mass index, urine sodium and potassium, plasma aldosterone, and other covariates. Despite the difference in mean response, there was a 72% overlap in daytime blood-pressure response to ramipril between African Americans and Caucasians. Among Caucasians, ramipril lowered systolic blood pressure 2 mm Hg less during nighttime compared with daytime, whereas among African Americans, blood pressure lowering was equivalent during day and night. Nighttime blood-pressure response to ramipril did not differ significantly between African Americans and Caucasians. Conclusions: Ramipril was more effective in lowering daytime blood pressure in Caucasians compared with African Americans, but appreciable differences in response did not persist at night. Despite the small difference in mean response between groups, the majority of African Americans and Caucasians had a similar blood-pressure response to a fixed dose of ramipril. C1 Childrens Hosp, Oakland Res Inst, Oakland, CA 94609 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA USA. San Francisco VA Med Ctr, Gen Internal Med Sect, San Francisco, CA USA. Univ Calif San Francisco, Dept Epidemiol & Biostat, San Francisco, CA 94143 USA. Columbia Univ, Dept Med, Sch Med, New York, NY USA. Columbia Univ, Behav Cardiovasc Hlth & Hypertens Program, Sch Med, New York, NY USA. Univ Calif San Francisco, San Francisco Gen Hosp, Dept Med, Sch Med, San Francisco, CA USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90024 USA. Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. Univ Washington, Dept Genome Sci, Seattle, WA USA. SUNY Hlth Sci Ctr, Dept Prevent Med, Stony Brook, NY USA. RP Krauss, RM (reprint author), Childrens Hosp, Oakland Res Inst, 5700 Martin Luther King, Oakland, CA 94609 USA. EM rkrauss@chori.org FU NHLBI NIH HHS [U01 HL69757] NR 30 TC 7 Z9 7 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0895-7061 J9 AM J HYPERTENS JI Am. J. Hypertens. PD AUG PY 2007 VL 20 IS 8 BP 884 EP 891 DI 10.1016/j.amjhyper.2007.02.006 PG 8 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 201ZR UT WOS:000248871700013 PM 17679038 ER PT J AU Plomondon, ME Magid, DJ Steiner, JF MaWhinney, S Gifford, BD Shih, SC Grunwald, GK Rumsfeld, JS AF Plomondon, Mary E. Magid, David J. Steiner, John F. MaWhinney, Samantha Gifford, Blair D. Shih, Sarah C. Grunwald, Gary K. Rumsfeld, John S. TI Primary care provider turnover and quality in managed care organizations SO AMERICAN JOURNAL OF MANAGED CARE LA English DT Article ID PATIENT SATISFACTION; PHYSICIAN TURNOVER; INTERPERSONAL CONTINUITY; HEALTH-CARE; BREAST; CANCER; SERVICES; DELIVERY; COSTS; ASSOCIATION AB Objectives:To examine the association between primary care provider turnover in managed care organizations and measures of member satisfaction and preventive care. Study Design: Retrospective cohort study of a national sample of 615 managed care organizations that reported HEDIS (R) data to the National Committee for Quality Assurance from 1999 through 2001. Methods: Multivariable hierarchical regression modeling was used to evaluate the association between health plan primary care provider turnover rate and member satisfaction and preventive care measures, including childhood immunization, well-child visits, cholesterol, diabetes management, and breast and cervical cancer screening, adjusting for patient and organizational characteristics, time, and repeated measures. Results:The median primary care provider turnover rate was 7.1% (range, 0%-53.3%). After adjustment for plan characteristics, health plans with higher primary care provider turnover rates had significantly lower measures of member satisfaction, including overall rating of healthcare (P < .01). A 10% higher primary care provider turnover rate was associated with 0.9% fewer members rating high overall satisfaction With healthcare. Health plans with higher provider turnover rates also had lower rates of preventive care, including childhood immunization (P = .045), well-child visits (P = .002), cholesterol screening after cardiac event (P = .042), and cervical cancer screening (P = .024). For example, a 10% higher primary care provider turnover was associated with a 2.7% lower rate of child-members receiving well-child visits in the first 15 months of life. Conclusions: Primary care provider turnover is associated with several measures of care quality, including aspects of member satisfaction and preventive care. Future studies should evaluate whether interventions to reduce primary care provider turnover can improve quality of care and patient outcomes. C1 Denver VAMC, Eastern Colorado Hlth Care Syst, Care Coordinat Res Program, Dept Vet Affairs Med Ctr, Denver, CO 80220 USA. Univ Colorado, Denver, CO 80202 USA. Hlth Sci Ctr, Denver, CO USA. Colorado Permanente Med Grp, Denver, CO USA. NCQA, Washington, DC USA. RP Plomondon, ME (reprint author), Denver VAMC, Eastern Colorado Hlth Care Syst, Care Coordinat Res Program, Dept Vet Affairs Med Ctr, Cardiol 111B,1055 Clermont St, Denver, CO 80220 USA. EM meg.plomondon@va.gov NR 54 TC 21 Z9 22 U1 1 U2 3 PU AMER MED PUBLISHING, M W C COMPANY PI JAMESBURG PA 241 FORSGATE DR, STE 102, JAMESBURG, NJ 08831 USA SN 1088-0224 J9 AM J MANAG CARE JI Am. J. Manag. Care PD AUG PY 2007 VL 13 IS 8 BP 465 EP 472 PG 8 WC Health Care Sciences & Services; Health Policy & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 202VG UT WOS:000248931500003 PM 17685827 ER PT J AU Dennison, AC Noorigian, JV Robinson, KM Fisman, DN Cianci, HJ Moberg, P Bunting-Perry, L Martine, R Duda, J Stern, MB AF Dennison, Andrew C. Noorigian, Joseph V. Robinson, Keith M. Fisman, David N. Cianci, Heather J. Moberg, Paul Bunting-Perry, Lisette Martine, Rebecca Duda, John Stern, Matthew B. TI Failing in Parkinson disease - Identifying and prioritizing risk factors in recurrent fallers SO AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION LA English DT Article DE Parkinson disease; falling; risk factors; movement disorders; aging; neurodegenerative diseases ID POSTURAL CONTROL; ELDERLY PERSONS; COMMUNITY; PREVENTION; PREDICTION; ETIOLOGY; VALIDITY; PEOPLE; TRIAL; TASK AB Objectives: To identify falling risk factors in a study population of recurrent fallers compared with nonfallers who have Parkinson disease, and to prioritize falling risk factors in this patient population to target them for modification. Design: Twenty-three recurrent fallers and 25 nonfallers who have Parkinson disease were recruited, and they participated in a comprehensive assessment probing for the presence of falling risk factors. To identify falling risk factors, a group comparative design was used to compare recurrent fallers and nonfallers across an array of variables. To prioritize modeling using recursive partitioning was performed, those risk factors, entering into the model falling, risk factors identified in this and other studies that were considered potentially modifiable. Results: A specific profile of variables distinguished recurrent fallers who have Parkinson disease in our study population: higher disease severity, higher level of motor impairment, higher level of disability, impaired leg agility or lower-limb coordination, impaired ability to arise from a chair or compromised proximal lower-limb motor control, impaired ambulation, impaired motor planning of the hands and feet, impaired dynamic balance as measured by ability to walk in tandem, and fear of falling. Recursive partitioning prioritized three risk factors: impaired ambulation, impaired lower-limb motor planning, and orthostasis. Conclusions: In this study, an idiosyncratic failing risk factor profile was demonstrated among our subjects who have Parkinson disease. Three variables were prioritized for potential modification: impaired ambulation, impaired lower-limb motor planning, and orthostasis. C1 Vet Affairs Med Ctr, Philadelphia, PA 19104 USA. Univ Texas, Baylor Coll Med, Houston Med Sch Phys Med & Rehabilitat Alliance, Houston, TX USA. Vet Affairs Med Ctr, Parkinsons Dis Res Educ & Clin Ctr, Philadelphia, PA USA. Vet Affairs Med Ctr, Dept Rehabil Med, Philadelphia, PA USA. Res Inst Hosp Sick Children, Child Hlth Evaluat Sci, Publ Hlth Lab Branch, Toronto, ON, Canada. Univ Penn HLth Syst, Penn Hosp, Dan Aaron Parkinsons Dis Rehabilitat Ctr, Philadelphia, PA USA. Univ Penn, Med Ctr, Dept Psychiat, Philadelphia, PA USA. Univ Penn Hlth Syst, Inst Neurol, Dept Neurol, Philadelphia, PA USA. RP Robinson, KM (reprint author), Vet Affairs Med Ctr, Univ & Woodland Ave, Philadelphia, PA 19104 USA. NR 41 TC 30 Z9 31 U1 2 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0894-9115 J9 AM J PHYS MED REHAB JI Am. J. Phys. Med. Rehabil. PD AUG PY 2007 VL 86 IS 8 BP 621 EP 632 DI 10.1097/PHM.0b013e318115f41b PG 12 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 194ZX UT WOS:000248383400004 PM 17667192 ER PT J AU Frank, JA Erle, DJ AF Frank, James A. Erle, David J. TI Progress toward a systems biology approach to acute lung injury SO AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY LA English DT Editorial Material ID GENE-EXPRESSION; STRESS C1 Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco VA Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94121 USA. Univ Calif San Francisco, San Francisco Gen Hosp, San Francisco, CA 94121 USA. Univ Calif San Francisco, Lung Biol Ctr, San Francisco, CA 94121 USA. RP Frank, JA (reprint author), Univ Calif San Francisco, Cardiovasc Res Inst, San Francisco VA Med Ctr, 4150 Clement St Box 111D, San Francisco, CA 94121 USA. EM James.frank@ucsf.edu OI Erle, David/0000-0002-2171-0648 FU NHLBI NIH HHS [HL-69900, R56 HL088440, R01 HL088440] NR 13 TC 4 Z9 5 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1040-0605 J9 AM J PHYSIOL-LUNG C JI Am. J. Physiol.-Lung Cell. Mol. Physiol. PD AUG PY 2007 VL 293 IS 2 BP L290 EP L291 DI 10.1152/ajplung.00220.2007 PG 2 WC Physiology; Respiratory System SC Physiology; Respiratory System GA 196CL UT WOS:000248459200005 PM 17575007 ER PT J AU Feliers, D Lee, MJ Ghosh-Choudhury, G Bomsztyk, K Kasinath, BS AF Feliers, Denis Lee, Myung-Ja Ghosh-Choudhury, Goutam Bomsztyk, Karol Kasinath, B. S. TI Heterogeneous nuclear ribonucleoprotein K contributes to angiotensin II stimulation of vascular endothelial growth factor mRNA translation SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE ANG II; VEGF; signal transduction; RNA-binding protein ID RENAL EPITHELIAL-CELLS; KINASE-C-DELTA; HNRNP-K; DIABETIC-NEPHROPATHY; INITIATION-FACTOR; TYROSINE-PHOSPHORYLATION; PROTEIN-SYNTHESIS; IN-VITRO; BINDING; ACTIVATION AB ANG II rapidly increases VEGF synthesis in proximal tubular epithelial cells through mRNA translation. The role of heterogeneous nuclear ribonucleoprotein K ( hnRNP K) in ANG II regulation of VEGF mRNA translation initiation was examined. ANG II activated hnRNP K as judged by binding to poly( C)- and poly( U)- agarose. ANG II increased hnRNP K binding to VEGF mRNA at the same time as it stimulated its translation, suggesting that hnRNP K contributes to VEGF mRNA translation. Inhibition of hnRNP K expression by RNA interference significantly reduced ANG II stimulation of VEGF synthesis. ANG II increased hnRNP K phosphorylation on both tyrosine and serine residues with distinct time courses; only Ser302 phosphorylation paralleled binding to VEGF mRNA. Src inhibition using PP2 or RNA interference inhibited PKC delta activity and prevented hnRNP K phosphorylation on both tyrosine and serine residues and its binding to VEGF mRNA. Under these conditions, ANG II- induced VEGF synthesis was inhibited. ANG II treatment induced redistribution of both VEGF mRNA and hnRNP K protein from light to heavy polysomal fractions, suggesting increased binding of hnRNP K to VEGF mRNA that is targeted for increased translation. This study shows that hnRNP K augments efficiency of VEGF mRNA translation stimulated by ANG II. C1 Univ Texas, Hlth Sci Ctr San Antonio, Dept Med Nephrol, O Brien Kidney Res Ctr, San Antonio, TX 78285 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Univ Washington, Med Lake Union, Seattle, WA 98195 USA. RP Feliers, D (reprint author), Univ Texas, Hlth Sci Ctr San Antonio, Dept Med Nephrol, O Brien Kidney Res Ctr, Mail Code 7882,7703 Floyd Curl Dr, San Antonio, TX 78285 USA. EM feliers@uthscsa.edu FU NIDDK NIH HHS [DK-50190, R01 DK-55815]; NIGMS NIH HHS [GM-45134]; PHS HHS [R01-KD-45978] NR 38 TC 21 Z9 22 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD AUG PY 2007 VL 293 IS 2 BP F607 EP F615 DI 10.1152/ajprenal.00497.2006 PG 9 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 196CJ UT WOS:000248459000022 PM 17581920 ER PT J AU Lenderink, AM Liegel, K Ljubanovic, D Coleman, KE Gilkeson, GS Holers, VM Thurman, JM AF Lenderink, Amanda M. Liegel, Katharine Ljubanovic, Danica Coleman, Kathrin E. Gilkeson, Gary S. Holers, V. Michael Thurman, Joshua M. TI The alternative pathway of complement is activated in the glomeruli and tubulointerstitium of mice with adriamycin nephropathy SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article DE proteinuria ID TUBULAR EPITHELIAL-CELLS; INHIBITORY MONOCLONAL-ANTIBODY; MEMBRANE ATTACK COMPLEX; RENAL-DISEASE; FACTOR-B; PROXIMAL TUBULES; INTERSTITIAL DISEASE; CHRONIC PROGRESSION; BRUSH-BORDER; MRL/LPR MICE AB The complement system effectively identifies and clears invasive pathogens as well as injured host cells. Uncontrolled complement activation can also contribute to tissue injury, however, and inhibition of this system may ameliorate many types of inflammatory injury. Several studies have demonstrated that the filtration of complement proteins into the renal tubules, as occurs during proteinuric renal disease, causes tubular inflammation and injury. In the present study, we tested the hypothesis that activation of the complement system in the urinary space requires an intact alternative pathway. Using a model of adriamycin- induced renal injury, which induces injury resembling focal segmental glomerulosclerosis, we examined whether mice deficient in factor B would be protected from the development of progressive tubulointerstitial injury. Complement activation was attenuated in the glomeruli and tubulointerstitium of mice with congenital deficiency of factor B ( fB(-/-)) compared with wild- type controls, demonstrating that complement activation does occur through the alternative pathway. Deficiency in factor B did not significantly protect the mice from tubulointerstitial injury. However, treatment of wild- type mice with an inhibitory monoclonal antibody to factor B did delay the development of renal failure. These results demonstrate that complement activation in this nonimmune complex- mediated model of progressive renal disease requires an intact alternative pathway. C1 Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80202 USA. Univ Zagreb, Univ Hosp Dubrava, Dept Pathol, Zagreb, Croatia. Ralph H Johnson Vet Affairs Med Ctr, Med Res Serv, Charleston, SC USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. RP Thurman, JM (reprint author), B-115, Aurora, CO 80045 USA. EM Joshua.thurman@uchsc.edu FU NIAID NIH HHS [AI31105]; NIDDK NIH HHS [DK064790] NR 41 TC 23 Z9 23 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD AUG PY 2007 VL 293 IS 2 BP F555 EP F564 DI 10.1152/ajprenal.00403.2006 PG 10 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 196CJ UT WOS:000248459000016 PM 17522263 ER PT J AU Baker, JF Schumacher, HR Krishnan, E AF Baker, Joshua F. Schumacher, H. Ralph Krishnan, Eswar TI Serum uric acid level and risk for peripheral arterial disease: Analysis of data from the multiple risk factor intervention trial SO ANGIOLOGY LA English DT Article ID CHRONIC HEART-FAILURE; CARDIOVASCULAR-DISEASE; SYSTOLIC HYPERTENSION; INDEPENDENT PREDICTOR; EVENTS; STROKE; URATE; ATHEROSCLEROSIS; METABOLISM; MORTALITY AB Although several studies report an association between hyperuricemia and coronary artery disease, little is known about the effect of hyperuricemia and gout on the risk of peripheral arterial disease (PAD). Data on 283 incident clinical cases of PAD during a randomized controlled trial of multiple cardiovascular risk factor intervention are evaluated. The serum uric acid levels among these individuals are compared with those of individuals who did not develop PAD during the study period. Multivariate logistic regression analyses measure the risk of developing PAD associated with higher levels of serum uric acid after adjusting for the effect of traditional vascular risk factors. Age and smoking are independently associated with development of PAD, with odds ratios of 1.08 (95% confidence interval [CI], 1.06-1.09) and 3.83 (95% CI, 2.49-5.91) per year, respectively. Hyperuricemia (serum uric acid level, > 7.0 mg/dL) is an independent risk factor, with an odds ratio of 1.23, but the confidence interval of the estimate is wide (95% CI, 0.98-1.54). In this multivariate model, a history of gout was associated with an odds ratio of 1.33 (95% CI, 1.07-1.66). Serum uric acid level is independently associated with a higher (but statistically nonsignificant) risk of PAD. A history of gouty arthritis is an independent and statistically significant predictor of incidence of PAD even after adjustment for the effect of underlying hyperuricemia. C1 Univ Pittsburgh, Dept Med, Div Rheumatol, Pittsburgh, PA 15261 USA. Univ Penn, Dept Med, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Dept Med, Philadelphia, PA 19104 USA. RP Krishnan, E (reprint author), Univ Pittsburgh, Dept Med, Div Rheumatol, S709 BST S,3500 Terrace St, Pittsburgh, PA 15261 USA. EM Arthritis.MD@gmail.com RI KRISHNAN, ESWAR/A-1072-2009 NR 33 TC 44 Z9 47 U1 1 U2 5 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0003-3197 J9 ANGIOLOGY JI Angiology PD AUG-SEP PY 2007 VL 58 IS 4 BP 450 EP 457 DI 10.1177/0003319707303444 PG 8 WC Peripheral Vascular Disease SC Cardiovascular System & Cardiology GA 204EH UT WOS:000249026000009 PM 17875958 ER PT J AU Zabetian, CP Hutter, CM Factor, SA Nutt, JG Higgins, DS Griffith, A Roberts, JW Leis, BC Kay, DM Yearout, D Montimurro, JS Edwards, KL Samii, A Payami, H AF Zabetian, Cyrus P. Hutter, Carolyn M. Factor, Stewart A. Nutt, John G. Higgins, Donald S. Griffith, Alida Roberts, John W. Leis, Berta C. Kay, Denise M. Yearout, Dora Montimurro, Jennifer S. Edwards, Karen L. Samii, Ali Payami, Haydeh TI Association analysis of MAPT H1 haplotype and subhaplotypes in Parkinson's disease SO ANNALS OF NEUROLOGY LA English DT Article ID PROGRESSIVE SUPRANUCLEAR PALSY; TAU-GENE HAPLOTYPE; LINKAGE DISEQUILIBRIUM; CORTICOBASAL DEGENERATION; ALPHA-SYNUCLEIN; POLYMORPHISM; POPULATION; DEMENTIA; SUSCEPTIBILITY; METAANALYSIS AB Objective: An inversion polymorphism of approximately 900kb on chromosome 17q21, which includes the microtubule-associated protein tau (MAPT) gene defines two haplorype clades, HI and H2. Several small case-control studies have observed a marginally significant excess of the H1/H1 diplotype among patients with Parkinson's disease (PD), and one reported refining the association to a region spanning exons 1 to 4 of MAPT. We sought to replicate these findings. Methods: We genotyped 1,762 PD patients and 2,010 control subjects for a single nucleotide polymorphism (SNP) that differentiates the HI and H2 clades. We also analyzed four SNPs that define subhaplotypes within HI previously reported to associate with PD or other neurodegenerative disorders. Results: After adjusting for age, sex, and site, we observed a robust association between the H1/H1 diplotype and PD risk (odds ratio for H1/H1 vs H1/H2 and H2/H2, 1.46; 95% confidence interval, 1.25-1.69; p = 8 x 10(-7)). The effect was evident in both familial and sporadic subgroups, men and women, and early- and late-onset disease. Within H1/H1 individuals, there was no significant difference between cases and control subjects in the overall frequency distribution of Hi subhaplotypes. Interpretation: Our data provide strong evidence that the H I clade, which contains MAPT and several other genes, is a risk factor for PD. However, attributing this finding to variants within a specific region of MAPT is premature. Thorough fine-mapping of the H1 clade in large numbers of individuals is now needed to identify the underlying functional variant(s) that alter susceptibility for PD. C1 VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth & Community Med, Dept Epidemiol, Seattle, WA 98195 USA. Emory Univ, Sch Med, Dept Neurol, Atlanta, GA 30322 USA. Oregon Hlth & Sci Univ, Dept Neurol, Portland, OR 97201 USA. Albany Med Ctr, Parkinsons Dis & Movement Disorder Clin, Albany, NY USA. Evergreen Hosp Med Ctr, Booth Gardener Parkinsons Care Ctr, Kirksville, WA USA. Virginia Mason Med Ctr, Seattle, WA 98101 USA. New York State Dept Hlth, Wadsworth Ctr, Genom Inst, Albany, NY USA. Vet Affairs Puget Sound Hlth Care Syst, Parkinsons Dis Res Educ & Clin Ctr, Seattle, WA USA. RP Zabetian, CP (reprint author), VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, S-182,1660 S Columbian Way, Seattle, WA 98108 USA. EM zabetian@u.washington.edu OI Zabetian, Cyrus/0000-0002-7739-4306; Kay, Denise/0000-0002-9928-2698 FU NIA NIH HHS [N1A P30 AG008017, P30 AG008017]; NINDS NIH HHS [K08 NS044138, K08 NS044138-04, R01 NS036960] NR 44 TC 75 Z9 75 U1 0 U2 1 PU WILEY-BLACKWELL PI MALDEN PA COMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USA SN 0364-5134 J9 ANN NEUROL JI Ann. Neurol. PD AUG PY 2007 VL 62 IS 2 BP 137 EP 144 DI 10.1002/ana.21157 PG 8 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 215TI UT WOS:000249831500007 PM 17514749 ER PT J AU Bilimoria, KY Bentrem, DJ Ko, CY Stewart, AK Winchester, DP Talamonti, MS AF Bilimoria, Karl Y. Bentrem, David J. Ko, Clifford Y. Stewart, Andrew K. Winchester, David P. Talamonti, Mark S. TI National failure to operate on early stage pancreatic cancer SO ANNALS OF SURGERY LA English DT Article ID LONG-TERM SURVIVAL; HOSPITAL VOLUME; ADMINISTRATIVE DATA; UNITED-STATES; CONSECUTIVE PANCREATICODUODENECTOMIES; DUCTAL ADENOCARCINOMA; GENERAL-POPULATION; COLORECTAL-CANCER; LAST DECADE; MORTALITY AB Background: Despite studies demonstrating improved outcomes, pessimism persists regarding the effectiveness of surgery for pancreatic cancer. Our objective was to evaluate utilization of surgery in early stage disease and identify factors predicting failure to undergo surgery. Methods: Using the National Cancer Data Base (1995-2004), 9559 patients were identified with potentially resectable tumors (pretreatment clinical Stage I:T1N0M0 and T2N0M0). Multivariate models were employed to identify factors predicting failure to undergo surgery and assess the impact of pancreatectomy on survival. Results: Of clinical Stage I patients 71.4% (6823/9559) did not undergo surgery; 6.4% (616/9559) were excluded due to comorbidities; 4.2% (403/9559) refused surgery; 9.1% (869/9559) were excluded due to age; and 38.2% (3,644/9559) with potentially resectable cancers were classified as "not offered surgery." Of the 28.6% (2736/9559) of patients who underwent surgery, 96.0% (2630/2736) underwent pancreatectomy, and 4.0% (458/2736) had unresectable tumors. Patients were less likely to undergo surgery if they were older than 65 years, were black, were on Medicare or Medicaid, had pancreatic head lesions, earned lower annual incomes, or had less education (P < 0.0001). Patients were less likely to receive surgery at low-volume and community centers. Patients underwent surgery more frequently at National Cancer Institute/National Comprehensive Cancer Network-designated cancer centers (P < 0.0001). Patients who were not offered surgery had significantly better survival than those with Stage III or IV disease but worse survival than patients who underwent pancreatectomy for Stage I disease (P < 0.0001). Conclusions: This is the first study to characterize the striking under-use of pancreatectomy in the United States. Of early stage pancreatic cancer patients without any identifiable contraindications, 38.2% failed to undergo surgery. C1 Northwestern Univ, Feinberg Sch Med, Dept Surg, Chicago, IL 60611 USA. Amer Coll Surg, Canc Programs, Natl Canc Data Base, Chicago, IL USA. Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Evanston NW Healthcare, Dept Surg, Evanston, IL USA. RP Talamonti, MS (reprint author), Northwestern Univ, Feinberg Sch Med, Dept Surg, 675 N St Clair St,Galter 10-105, Chicago, IL 60611 USA. EM mtalamonti@nmff.org RI qiao, zhixin/I-3408-2012; Tang, Amy/L-3226-2016 OI Tang, Amy/0000-0002-5772-2878 NR 55 TC 218 Z9 225 U1 2 U2 7 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0003-4932 J9 ANN SURG JI Ann. Surg. PD AUG PY 2007 VL 246 IS 2 BP 173 EP 180 DI 10.1097/SLA.0b013e3180691579 PG 8 WC Surgery SC Surgery GA 194TA UT WOS:000248365500003 PM 17667493 ER PT J AU Weiner, M Burman, W Luo, CC Peloquin, CA Engle, M Goldberg, S Agarwal, V Vernon, A AF Weiner, Marc Burman, William Luo, Chi-Cheng Peloquin, Charles A. Engle, Melissa Goldberg, Stefan Agarwal, Vipin Vernon, Andrew TI Effects of rifampin and multidrug resistance gene polymorphism on concentrations of moxifloxacin SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID P-GLYCOPROTEIN EXPRESSION; IN-VIVO; PHARMACOKINETICS; TUBERCULOSIS; INDUCTION; CONSEQUENCES; SPARFLOXACIN; HAPLOTYPES; VITRO AB Treatment regimens combining moxifloxacin and rifampin for drug-susceptible tuberculosis are being studied intensively. However, rifampin induces enzymes that transport and metabolize moxifloxacin. We evaluated the effect of rifampin and the human multidrug resistance gene (MDR1) C3435T polymorphisms (P-glycoprotein) on moxifloxacin pharmacokinetic parameters. This was a single-center, sequential design study with 16 volunteers in which sampling was performed after four daily oral doses of moxifloxacin (400 mg) and again after 10 days of combined rifampin (600 mg) and moxifloxacin. After daily coadministration of rifampin, the area under the concentration-time curve from 0 to 24 h (AUC(0-24)) for moxifloxacin decreased 27%. Average bioequivallence between moxifloxacin coadministered with rifampin and moxifloxacin alone was not demonstrated: the ratio of geometric means (RGM) of the moxifloxacin AUC(0-24) was 73.3 (90% confidence intervals [CI], 64.3, 83.5) (total P value, 0.87 for two one-sided t tests). Peak moxifloxacin concentrations, however, were equivalent: the RGM of the maximum concentration of the drug in serum was 93.6 (90% Cl, 80.2, 109.3) (total P value, 0.049). Concentrations of the sulfate conjugate metabolite of moxifloxacin were increased twofold following rifampin coadministration (AUC(0-24), 1.29 versus 2.79 mu g - h/ml). Concomitant rifampin administration resulted in a 27% decrease in the mean moxifloxacin AU(0-24),-,, and a marked increase in the AUC(0-24),, of the microbiologically inactive M1 metabolite. Additional studies are required to understand the clinical significance of the moxifloxacin-rifampin interaction. C1 Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, San Antonio, TX 78229 USA. Denver Publ Hlth, Denver, CO 80204 USA. Natl Jewish Med, Denver, CO 80206 USA. Ctr Dis Control & Prevent, Div TB Eliminat, Atlanta, GA 30333 USA. NE Bioanalyt Labs, Hamden, CT USA. RP Weiner, M (reprint author), VAMC, Div Infect Dis 111F, 7400 Merton Minter Blvd, San Antonio, TX 78229 USA. EM weiner@uthscsa.edu FU NCRR NIH HHS [M01 RR001346, M01 RR01346] NR 20 TC 57 Z9 57 U1 2 U2 6 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD AUG PY 2007 VL 51 IS 8 BP 2861 EP 2866 DI 10.1128/AAC.01621-06 PG 6 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 196ZZ UT WOS:000248523700027 PM 17517835 ER PT J AU Kirkpatrick, WR Najvar, LK Bocanegra, R Patterson, TF Graybill, JR AF Kirkpatrick, William R. Najvar, Laura K. Bocanegra, Rosie Patterson, Thomas F. Graybill, John R. TI New guinea pig model of cryptococcal meningitis SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID AMPHOTERICIN-B; INVASIVE ASPERGILLOSIS; VORICONAZOLE; FLUCONAZOLE; EFFICACY AB We developed a guinea pig model of cryptococcal meningitis to evaluate antifungal agents. Immunosuppressed animals challenged intracranially with. Cryptococcus neoformans responded to fluconazole and voriconazole. Disease was monitored by serial cerebrospinal fluid (CSF) cultures and quantitative organ cultures. Our model produces disseminating central nervous system disease and responds to antifungal therapy. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Audie Murphy Div, San Antonio, TX 78284 USA. RP Kirkpatrick, WR (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Infect Dis, 7703 Floyd Curl Dr 7781, San Antonio, TX 78229 USA. EM kirkpatrick@uthscsa.edu FU NIAID NIH HHS [N01AI25475, N01 AI25475] NR 9 TC 15 Z9 15 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD AUG PY 2007 VL 51 IS 8 BP 3011 EP 3013 DI 10.1128/AAC.00085-07 PG 3 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 196ZZ UT WOS:000248523700053 PM 17562797 ER PT J AU Dougherty, CM Johnston, SK Thompson, EA AF Dougherty, Cynthia M. Johnston, Sandra K. Thompson, Elaine Adams TI Reliability and validity of the self-efficacy expectations and outcome expectations after Implantable Cardioverter defibrillator implantation scales SO APPLIED NURSING RESEARCH LA English DT Article ID ARTERY BYPASS-SURGERY; CARDIAC REHABILITATION; HUMAN AGENCY; VALIDATION; EXERCISE; CONFIDENCE; INFARCTION; CARDIOLOGY AB The purpose of this study was to assess the reliability and validity characteristics of two new scales that measure self-efficacy expectations (Self-Efficacy Expectations After Implantable Cardioverter Defibrillator Implantation Scale [SE-ICD]) and outcome expectations (Outcome Expectations After ICD Implantation Scale [OE-ICD]) in survivors (N = 168) of sudden cardiac arrest, all of whom received an ICD. Cronbach's alpha reliability demonstrated good internal consistency (SE-ICD alpha =.93 and OE-ICD alpha =.81). Correlations with other self-efficacy instruments (general self-efficacy and social self-efficacy) were consistently high. The instruments were responsive to change across time with effect sizes of .46 for SE-ICD and .26 for OE-ICD. These reliable, valid, and responsive instruments for measurement of self-efficacy expectations and outcome expectations after an ICD can be used in research and clinical settings. (c) 2007 Elsevier Inc. All rights reserved. C1 Univ Washington, Sch Nursing, Biobehav Nursing & Hlth Syst, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Nursing, Psychosocial & Community Hlth, Seattle, WA 98195 USA. RP Dougherty, CM (reprint author), Univ Washington, Sch Nursing, Biobehav Nursing & Hlth Syst, Seattle, WA 98195 USA. EM cindyd@u.washington.edu FU NINR NIH HHS [R01 NR04766, R01 NR004766-01A1, R01 NR004766] NR 31 TC 11 Z9 11 U1 1 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0897-1897 J9 APPL NURS RES JI Appl. Nurs. Res. PD AUG PY 2007 VL 20 IS 3 BP 116 EP 124 DI 10.1016/j.apnr.2007.04.004 PG 9 WC Nursing SC Nursing GA 203IN UT WOS:000248968400003 PM 17693214 ER PT J AU Tomlinson, JS Jain, S Bentrem, DJ Sekeris, EG Maggard, MA Hines, OJ Reber, HA Ko, CY AF Tomlinson, James S. Jain, Sushma Bentrem, David J. Sekeris, Evangelos G. Maggard, Melinda A. Hines, O. Joe Reber, Howard A. Ko, Clifford Y. TI Accuracy of staging node-negative pancreas cancer - A potential quality measure SO ARCHIVES OF SURGERY LA English DT Article; Proceedings Paper CT 78th Annual Meeting of the Pacific-Coast-Surgical-Association CY FEB 18, 2007 CL Kohala Coast, HI SP Pacific Coast Surg Assoc ID ADJUVANT COMBINED RADIATION; CURATIVE RESECTION; LYMPH-NODES; PROGNOSTIC INDICATORS; ADENOCARCINOMA; PANCREATICODUODENECTOMY; SURVIVAL; NUMBER; HEAD; LYMPHADENECTOMY AB Objective: To determine the optimal number of lymph nodes to examine for accurate staging of node-negative pancreatic adenocarcinoma after pancreaticoduodenectomy. Design, Setting, and Patients: Data from the National Cancer Institute's Surveillance, Epidemiology, and End Results program (1988-2002) were used to identify 3505 patients who underwent pancreaticoduodenectonny for adenocarcinoma of the pancreas, including 1150 patients who were pathologically node negative (pN0) and 584 patients with a single positive node (pN1a). Perioperative deaths were excluded. Univariate and multivariate survival analyses were performed. Main Outcome Measure: Examination of 15 lymph nodes appears to be optimal for accurate staging of nodenegative adenocarcinoma of the pancreas after pancreaticoduodenectomy. Results: The number of nodes examined ranged from 1 to 54 (median, 7 examined nodes). Univariate survival analysis demonstrated that dichotomizing the pN0 cohort on 15 or more examined lymph nodes resulted in the most statistically significant survival difference (log-rank chi(2) = 14.49). Kaplan-Meier survival curves demonstrated a median survival difference of 8 months (P < .001) in favor of the patients who had 15 or more examined nodes compared with patients with fewer than 15 examined nodes. Multivariate analysis validated that having 15 or more examined nodes was a statistically significant predictor of survival (hazard ratio, 0.63; 95% confidence interval, 0.49-0.80; P < .0001). Furthermore, a multivariate model based on the survival benefit of each additional node evaluated in the pN0 cohort demonstrated only a marginal survival benefit for analysis of more than 15 nodes. Approximately 90% of the pN1a cohort was identified with examination of 15 nodes. Conclusions: Examination of 15 lymph nodes appears to be optimal to accurately stage node-negative adenocarcinoma of the pancreas after pancreaticoduodenectomy. Furthermore, evaluation of at least 15 lymph nodes of a pancreaticoduodenectomy specimen may serve as a quality measure in the treatment of pancreatic adenocarcinoma. C1 Vet Affairs Greater Los Angeles Healthcare Syst, Dept Surg, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Ctr Surg Outcomes & Qual, Dept Surg, Los Angeles, CA USA. Northwestern Univ, Div Surg Oncol, Dept Surg, Chicago, IL 60611 USA. RP Tomlinson, JS (reprint author), Vet Affairs Greater Los Angeles Healthcare Syst, Dept Surg, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM james.tomlinson@va.gov NR 29 TC 60 Z9 63 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0004-0010 J9 ARCH SURG-CHICAGO JI Arch. Surg. PD AUG PY 2007 VL 142 IS 8 BP 767 EP 773 DI 10.1001/archsurg.142.8.767 PG 7 WC Surgery SC Surgery GA 199UR UT WOS:000248721200017 PM 17709731 ER PT J AU Hazlett, EA Speiser, LJ Goodman, M Roy, M Carrizal, M Wynn, JK Williams, WC Romero, M Minzenberg, MJ Siever, LJ New, AS AF Hazlett, Erin A. Speiser, Lisa J. Goodman, Marianne Roy, Marcela Carrizal, Michael Wynn, Jonathan K. Williams, William C. Romero, Michelle Minzenberg, Michael J. Siever, Larry J. New, Antonia S. TI Exaggerated affect-modulated startle during unpleasant stimuli in borderline personality disorder SO BIOLOGICAL PSYCHIATRY LA English DT Article DE affective startle; borderline personality disorder; emotion; startle eyeblink ID BLINK MODULATION; EMOTION; REFLEX; ANXIETY; PSYCHOPATHY; SCHIZOTYPAL; DEPRESSION; REACTIVITY; MEN AB Background: Excessive emotional responding is considered to be a hallmark of borderline personality disorder (BPD). The affect-modulated startle response is a reliable indicator of emotional processing of stimuli. The aim of this study was to examine emotional processing in BPD patients (n = 27) and healthy control subjects (n = 21). Methods: Participants viewed an intermixed series of unpleasant, borderline-salient (e.g., "hate"), and neutral (e.g., "view") words and were instructed to think about the meaning of the word for them personally while eyeblink responses were assessed. Results: The BPD patients exhibited larger startle eyeblink during unpleasant but not neutral words, indicating exaggerated physiological affect. This finding remained significant when we controlled for comorbid diagnoses, including generalized anxiety disorder and posttraumatic stress disorder. Greater symptom severity was associated with greater affective-startle difference scores (unpleasant-neutral). Conclusions: Consistent with the symptom of affective clysregulation, these results suggest an abnormality in the processing of unpleasant emotional stimuli by BPD patients. C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. Bronx Vet Affairs Med Ctr, New York, NY USA. Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Educ & Clin Ctr, Los Angeles, CA USA. Eastern Washington Univ, Dept Psychol, Cheney, WA 99004 USA. RP Hazlett, EA (reprint author), Mt Sinai Sch Med, Dept Psychiat, Box 1505, New York, NY 10029 USA. EM erin.hazlett@mssm.edu RI Wynn, Jonathan/H-3749-2014 OI Wynn, Jonathan/0000-0002-1763-8540 FU NIMH NIH HHS [MH073911] NR 42 TC 41 Z9 42 U1 1 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD AUG 1 PY 2007 VL 62 IS 3 BP 250 EP 255 DI 10.1016/j.biopsych.2006.10.028 PG 6 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 192NF UT WOS:000248208100009 PM 17258691 ER PT J AU Ioannou, GN Splan, MF Weiss, NS McDonald, GB Beretta, L Lee, SP AF Ioannou, George N. Splan, Meaghan F. Weiss, Noel S. McDonald, George B. Beretta, Laura Lee, Sum P. TI Incidence and predictors of hepatocellular carcinoma in patients with cirrhosis SO CLINICAL GASTROENTEROLOGY AND HEPATOLOGY LA English DT Article ID HEPATITIS-C VIRUS; PRIMARY LIVER-CANCER; OF-VETERANS-AFFAIRS; B SURFACE-ANTIGEN; UNITED-STATES; RISK-FACTORS; COMPENSATED CIRRHOSIS; COST-EFFECTIVENESS; DIABETES-MELLITUS; NATURAL-HISTORY AB Background & Aims: Independent predictors of hepatocellular carcinoma in patients with cirrhosis are not well established. Methods: We created a cohort of 2126 patients (41% with hepatitis C virus [HCV] infection) who sought care from all Veterans Affairs health care centers in the northwest United States from 1994 to 2005 and who had a diagnosis of cirrhosis recorded in inpatient or outpatient medical records. Results: During a mean follow-up period of 3.6 years, 100 patients were diagnosed with hepatocellular carcinoma (incidence, 1.3 per 100 patient-years). Important predictors of hepatocellular carcinoma in multivariate models included HCV infection (adjusted hazard ratio [ahr], 3.0; 95% confidence interval [CI], 1.7-5.3); hepatitis B virus (HBV) surface antigen (ahr, 3.3; 95% CI, 1.4-7.7); HBV core antibody (ahr, 1.7; 95% CI, 1.1-2.8); obesity (ahr, 2.5; 95% CI, 1.3 - 4.9), and overweight (ahr, 2.8; 95% CI, 1.5-5.4) relative to patients with a body mass index of < 25 kg/m(2), diabetes (ahr, 1.5; 95% CI, 0.9 - 2.5), and low platelet count (relative to patients with a platelet count of > 266 thousands/mu L, the ahr was 2.1 [95% CI, 0.8-5.6] in patients with a platelet count of 180 - 266 thousands/mu L, 3.3 [95% CI, 1.3 - 8.0] in patients with a platelet count of 111 - 179 thousands/mu L, and the ahr was 4.7 [95% CI, 2.0 - 11.4] in patients with a platelet count of <= 110 thousands/mu L). Conclusions: We identified 6 important predictors of hepatocellular carcinoma in multivariate models (including relatively novel predictors such as increased body mass index, HBV core antibody, and low platelet count), which suggest a means of predicting the risk of hepatocellular carcinoma in patients with cirrhosis and optimizing surveillance strategies. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Div Gastroenterol, Dept Med, Seattle, WA 98108 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Res Enhancement Award Program, Seattle, WA 98195 USA. Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Hepatitis C Resource Ctr, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Fred Hutchinson Canc Res Ctr, Div Clin Res, Seattle, WA 98104 USA. Fred Hutchinson Canc Res Ctr, Div Publ Hlth Sci, Seattle, WA 98104 USA. RP Ioannou, GN (reprint author), Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Div Gastroenterol, Dept Med, S 111 Gastro,1660 S Columbian Way, Seattle, WA 98108 USA. EM georgei@medicine.washington.edu RI Lee, Sum Ping/C-4333-2009 NR 38 TC 71 Z9 73 U1 2 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1542-3565 J9 CLIN GASTROENTEROL H JI Clin. Gastroenterol. Hepatol. PD AUG PY 2007 VL 5 IS 8 BP 938 EP 945 DI 10.1016/j.cgh.2007.02.039 PG 8 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 199SB UT WOS:000248714400012 PM 17509946 ER PT J AU Waid, DM Wagner, RJ Putnam, A Vaitaitis, GM Pennock, ND Calverley, DC Gottlieb, P Wagner, DH AF Waid, Dan M. Wagner, Rebecca J. Putnam, Amy Vaitaitis, Gisela M. Pennock, Nathan D. Calverley, David C. Gottlieb, Peter Wagner, David H., Jr. TI A unique T cell subset described as CD4(10)CD40(+) T cells (T-CD40) in human type 1 diabetes SO CLINICAL IMMUNOLOGY LA English DT Article DE type 1 diabetes; auto-reactive T cells; autoimmunity; CD40 ID CLASS-II TETRAMERS; AT-RISK SUBJECTS; CHEMOKINE RECEPTORS; PERIPHERAL-BLOOD; INCREASED EXPRESSION; TCR REVISION; CUTTING EDGE; LYMPHOCYTES; CD40; AUTOIMMUNITY AB Human T1D pancreatic lymph nodes contain diabetes-autoantigen responsive T cells but identification of such T cells in the periphery has proven difficult. Here we describe a unique T cell subset defined by CD4(10) and CD40 expression (T-CD40) that is significantly expanded in peripheral blood of T1D but not control or T2D subjects. The HLA-DR3 and DR4 alleles are considered high risk factors for T1D and TCD40 expansion occurs in T1D subjects carrying HLA DR3 or DR4 haplotypes but, T1D subjects who do not carry either DR3 or DR4 haplotypes still have an expanded percentage of TCD40 cells. Non-autoimmune subjects, even DR3(+) and DR4(+), do not have elevated percentages of T-CD40 cells. The majority of T-CD40 cells in T1D carry a memory phenotype and a portion of those proliferates when exposed to diabetes-associated self-antigens. A greater number of memory T-CD40 cells express CXCR3 when compared to CD40(-) memory cells and that number is significantly expanded in T1D compared to control subjects. If only total CD4(+) T cells are compared no difference in CXCR3 is seen. Furthermore, T-CD40 cells produce a Th1, pro-inflammatory cytokine profile. In healthy controls, T-CD40 cells have equally Th1 and Th2 profiles. (c) 2007 Elsevier Inc. All rights reserved. C1 Univ Colorado, Dept Med, Denver, CO 80262 USA. Hlth Sci Ctr, Denver, CO 80262 USA. Univ Colorado Denver, Barbara Davis Ctr Childhood Diabet, Aurora, CO USA. Hlth Sci Ctr, Aurora, CO USA. Univ Calif San Francisco, UCSF Diabet Ctr, San Francisco, CA USA. Denver VA Med Ctr, Med & Res Serv, Denver, CO 80220 USA. RP Wagner, DH (reprint author), Univ Colorado, Dept Med, 4200 E 9th Ave, Denver, CO 80262 USA. EM David.Wagner@UCHSC.edu NR 43 TC 30 Z9 31 U1 0 U2 0 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1521-6616 J9 CLIN IMMUNOL JI Clin. Immunol. PD AUG PY 2007 VL 124 IS 2 BP 138 EP 148 DI 10.1016/j.clim.2007.05.003 PG 11 WC Immunology SC Immunology GA 194VE UT WOS:000248371100004 PM 17560173 ER PT J AU Paeng, CH Sprague, M Jackevicius, CA AF Paeng, Christine H. Sprague, Michael Jackevicius, Cynthia A. TI Interaction between warfarin and cranberry juice SO CLINICAL THERAPEUTICS LA English DT Article DE warfarin; cranberry juice; anticoagulation; drug interaction AB Introduction: Warfarin is commonly used to treat or prevent thromboembolic events. Cranberry Juice has been suggested to have an interaction with warfarin. However, there have been few reported cases of warfarin-cranberry juice interaction. Case summary: A 78-year-old, 86-kg man receiving warfarin at a total weekly dose of 45 mg for atrial fibrillation presented at the Bakersfield Healthcare Center of the VA Greater Los Angeles Healthcare System with an international normalized ratio (INR) of 6.45, having reported drinking a half gallon of cranberry/apple juice in the week prior to the elevated INR. After discontinuation of the cranberry Juice, maintaining the warfarin dose for 5 days, and resuming the warfarin at a total weekly dose of 40 mg, the INR returned to the therapeutic range of 2 to 3. Discussion: Possible warfarin-cranberry Juice interactions have been reported in the literature. Case reports illustrate INR elevation associated with cranberry juice ingestion concomitantly with warfarin administration and may be associated with bleeding (eg, pericardial, gastrointestinal). In the present case report, cranberry juice was the most likely cause of the patient's elevated INR. The Naranjo probability scale score was 3, suggesting that there was a possible interaction between warfarin and cranberry juice, while the modified Naranjo scale score adapted for anticoagulants was 5, rating the interaction as probable. Conclusion: The combination of warfarin administration and cranberry juice ingestion appeared to be associated with an elevated INR without bleeding in this elderly patient. (Clin Ther. 2007;29:1730-1735) Copyright (c) 2007 Excerpta Medica, Inc. C1 Western Univ Hlth Sci, Coll Pharm, Pomona, CA 91766 USA. Bakersfield Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, Bakersfield, CA USA. Univ Pacific, Sch Pharm, Stockton, CA 95211 USA. Univ So Calif, Sch Pharm, Los Angeles, CA USA. W Los Angeles Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Toronto, Fac Med, Dept Hlth Policy Management & Evaluat, Toronto, ON, Canada. RP Jackevicius, CA (reprint author), Western Univ Hlth Sci, Coll Pharm, 309 E 2nd St, Pomona, CA 91766 USA. EM cjackevicius@westernu.edu NR 16 TC 22 Z9 23 U1 1 U2 8 PU ELSEVIER PI BRIDGEWATER PA 685 ROUTE 202-206, BRIDGEWATER, NJ 08807 USA SN 0149-2918 J9 CLIN THER JI Clin. Ther. PD AUG PY 2007 VL 29 IS 8 BP 1730 EP 1735 DI 10.1016/j.clinthera.2007.08.018 PG 6 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 213QT UT WOS:000249682900018 PM 17919554 ER PT J AU Castle, SC Uyemura, K Fulop, T Makinodan, T AF Castle, Steven C. Uyemura, Koichi Fulop, Tamas Makinodan, Takashi TI Host Resistance and Immune Responses in Advanced Age SO CLINICS IN GERIATRIC MEDICINE LA English DT Article AB Immunosenescence results in populating immune tissues with less functional T cells, and perhaps B cells dendritic cells, that do not function well and produce more type 2 cytokines and fewer type I cytokines. Impaired immunity, distinct from immunosenescence, correlates more with disease burden than chronologic age. Older adults who have chronic diseases or chronic infections are more susceptible to common infections and have poor vaccine responses. Understanding specific mechanisms and targeting interventions are dependent on research to resolve the relationship between frailty-associated impaired immunity and the role of chronic infection versus immunosenescence in developing impaired immunity. C1 [Castle, Steven C.; Uyemura, Koichi; Makinodan, Takashi] Univ Calif Los Angeles, Sch Med, VA Greater Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Los Angeles, CA 90073 USA. [Fulop, Tamas] Univ Sherbrooke, Div Geriatr, Res Ctr Aging, Program Immunol, Sherbrooke, PQ J1K 2R1, Canada. RP Castle, SC (reprint author), Univ Calif Los Angeles, Sch Med, VA Greater Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Mail Code 11G,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM steven.castle@med.va.gov NR 70 TC 38 Z9 40 U1 1 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0749-0690 J9 CLIN GERIATR MED JI Clin. Geriatr. Med. PD AUG PY 2007 VL 23 IS 3 BP 463 EP + DI 10.1016/j.cger.2007.03.005 PG 18 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA V95WW UT WOS:000206481400002 PM 17631228 ER PT J AU Certain, H Mueller, M Jagodzinski, T Fleming, M AF Certain, H. Mueller, M. Jagodzinski, T. Fleming, M. TI Intimate partner violence in postpartum women SO CONTRACEPTION LA English DT Meeting Abstract C1 William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. NR 0 TC 0 Z9 0 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0010-7824 J9 CONTRACEPTION JI Contraception PD AUG PY 2007 VL 76 IS 2 BP 168 EP 168 DI 10.1016/j.contraception.2007.05.045 PG 1 WC Obstetrics & Gynecology SC Obstetrics & Gynecology GA 197DS UT WOS:000248534800056 ER PT J AU Goel, A Chiu, H Felton, J Palmer, JP Brooks-Worrell, B AF Goel, Amit Chiu, Harvey Felton, Jamie Palmer, Jerry P. Brooks-Worrell, Barbara TI T-cell responses to islet antigens improves detection of autoimmune diabetes and identifies patients with more severe beta-cell lesions in phenotypic type 2 diabetes SO DIABETES LA English DT Article ID GLUTAMIC-ACID DECARBOXYLASE; HOMEOSTASIS MODEL ASSESSMENT; ADULTS LADA; INSULIN REQUIREMENT; FOLLOW-UP; ANTIBODIES; MELLITUS; AUTOANTIBODIES; ONSET; PREDICTION AB Latent autoimmune diabetes in adults or type 1.5 diabetes is considered to be a T-cell-mediated autoimmune disease. However, identification of patients is based commonly on autoantibody (Ab) detection. To determine whether measuring T-cell reactivity to islet proteins compared with measuring Abs improves detection of autoimmune diabetes and how beta-cell function correlates with T-cell reactivity compared with Ab positivity, we assessed the T-cell proliferative responses and Ab responses (islet cell autoantibodies, insulin autoantibodies, insulinoma-associated protein-2 autoantibodies, and GAD Abs) to islet proteins of 36 phenotypic type 2 diabetic patients. To be considered Ab(+) or T-cell(+), patients were required to be positive for a minimum of two consecutive time points. beta-cell function was measured with fasting and glucagon-stimulated C-peptide. Independent of T-cell reactivity, Ab(+) and Ab(-)patients had comparable fasting and glucagon-stimulated C-peptide. Independent of Ab status, T-cell(+) patients demonstrated significantly lower glucagon-stimulated (P < 0.003) C-peptide compared with T-cell(-) patients. These data suggest that measuring T-cell responses to multiple islet proteins in phenotypic type 2 diabetic patients improves identification of patients with autoimmune diabetes and delineates those who have a more severe beta-cell lesion compared with Ab assessment alone. C1 Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. RP Brooks-Worrell, B (reprint author), Univ Washington, Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Metab Endocrinol & Nutr, 1660 S Columbian Way,Blvd 1,Room 609, Seattle, WA 98108 USA. EM bbrooks@u.washington.edu FU NCRR NIH HHS [M01-RR00037]; NIDDK NIH HHS [P01-DK053004, P30-DK17047] NR 36 TC 27 Z9 30 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0012-1797 EI 1939-327X J9 DIABETES JI Diabetes PD AUG PY 2007 VL 56 IS 8 BP 2110 EP 2115 DI 10.2337/db06-0552 PG 6 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 196HU UT WOS:000248473100019 PM 17473222 ER PT J AU Lipsky, BA AF Lipsky, Benjamin A. TI Diabetic foot infections: Microbiology made modern? Array of hope SO DIABETES CARE LA English DT Editorial Material ID RESISTANT STAPHYLOCOCCUS-AUREUS; DIAGNOSIS; MANAGEMENT; THERAPY C1 VA Puget Sound Hlth Care Syst, Primary & Specialty Care Serv, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Seattle, WA 98195 USA. RP Lipsky, BA (reprint author), VA Puget Sound Hlth Care Syst, Primary & Specialty Care Serv, 111 PCC,1660 S Columbian Way, Seattle, WA 98108 USA. EM balipsky@u.washington.edu OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 23 TC 9 Z9 9 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD AUG PY 2007 VL 30 IS 8 BP 2171 EP 2172 DI 10.2337/dc07-0935 PG 2 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 197QH UT WOS:000248570200046 PM 17855279 ER PT J AU Chiu, HK Tsai, EC Juneja, R Stoever, J Brooks-Worrell, B Goel, A Palmer, JP AF Chiu, Harvey K. Tsai, Elaine C. Juneja, Rattan Stoever, James Brooks-Worrell, Barbara Goel, Amit Palmer, Jerry P. TI Equivalent insulin resistance in latent autoimmune diabetes in adults (LADA) and type 2 diabetic patients SO DIABETES RESEARCH AND CLINICAL PRACTICE LA English DT Article DE latent autoimmune diabetes in adults (LADA); body mass index (BMI); homeostasis model assessment (HOMA); insulin resistance; pancreatic autoantibody ID HOMEOSTASIS MODEL ASSESSMENT; ISLET-CELL ANTIBODIES; BETA-CELL; GLUCOSE; OBESITY; MELLITUS; SENSITIVITY; AUTOANTIBODIES; METABOLISM; MUSCLE AB Insulin resistance is a primary component in the pathophysiology of type 2 diabetes. In latent autoimmune diabetes in adults (LADA), insulin resistance has been reported to be significantly lower than in autoantibody-negative type 2 diabetes (T2DM), but whether this might be related to differences in body mass index (BMI) has not been excluded. Furthermore, previous studies have used limiting inclusive criteria for LADA, requiring only the presence of GADA or IA-2A. To apply more inclusive criteria for LADA, consistent with recent recommendations, we defined LADA by clinical manifestations characteristic of T2DM, but with the presence of any combination of GADA, IA-2A, ICA, or IAA. We recruited 43 LADA patients, 70 T2DM patients, and 150 non-diabetic controls. Insulin resistance was assessed by both the homeostasis model assessment and the quantitative insulin sensitivity check index, and BMI was calculated. We found that insulin resistance in LADA is equivalent to that of T2DM. When insulin resistance is assessed as a function of BMI, both diabetic populations demonstrated an insulin resistance equally greater than normal controls. The interaction between insulin resistance and BMI in the two diabetic groups was significantly different from that demonstrated in non-diabetic controls. In summary, LADA demonstrates insulin resistance of similar magnitude to T2DM, but with the concurrent component of an immune attack against the pancreatic beta-cells. LADA patients may be at significant risk for metabolic consequences of insulin resistance other than glucose metabolism, such as those described in the metabolic syndrome. As complications and treatment regimen specific to LADA are realized, improved means of identification of LADA will become increasingly important. (C) 2006 Elsevier Ireland Ltd. All rights reserved. C1 Univ Washington, Dept Med, Div Metab Endocrinol & Nutr, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Chiu, HK (reprint author), Childrens Hosp & Med Ctr, 4800 Sand Point Way NE,POB 5371-MS M1-3, Seattle, WA 98105 USA. EM chiuh@u.washington.edu NR 36 TC 28 Z9 32 U1 1 U2 4 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0168-8227 J9 DIABETES RES CLIN PR JI Diabetes Res. Clin. Pract. PD AUG PY 2007 VL 77 IS 2 BP 237 EP 244 DI 10.1016/j.diabres.2006.12.013 PG 8 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 174EM UT WOS:000246924100013 PM 17234296 ER PT J AU Gerchman, F Tong, J Utzschneider, KM Hull, RL Zraika, S Udayasankar, J McNeely, MJ Andress, DL Leonetti, DL Boyko, EJ Fujimoto, WY Kahn, SE AF Gerchman, Fernando Tong, Jenny Utzschneider, Kristina M. Hull, Rebecca L. Zraika, Sakeneh Udayasankar, Jayalakshmi McNeely, Marguerite J. Andress, Dennis L. Leonetti, Donna L. Boyko, Edward J. Fujimoto, Wilfred Y. Kahn, Steven E. TI Superiority of the Modification of Diet in Renal Disease equation over the Cockcroft-Gault equation in screening for impaired kidney function in Japanese Americans SO DIABETES RESEARCH AND CLINICAL PRACTICE LA English DT Article DE MDRD; Cockcroft-Gault; creatinine clearance; glomerular filtration rate; diabetes ID GLOMERULAR-FILTRATION-RATE; SERUM CREATININE; PREDICTION EQUATION; GLUCOSE-TOLERANCE; DIABETIC-PATIENTS; BODY-FAT; 2ND-GENERATION; PREVALENCE; ASIANS; CLASSIFICATION AB The Cockcroft-Gault and the Modification of Diet in Renal Disease (MDRD) Study equations have not been validated in Asian Americans with varying degrees of glucose tolerance. We compared both equations to 24-h urinary creatinine clearance, the latter as a standard measurement of glomerular filtration rate (GFR), in 398 Japanese Americans (62.1 +/- 5.8 years, mean +/- S.D.) who had normal glucose tolerance (NGT) (n = 138), impaired glucose tolerance (IGT) (n = 136) and diabetes (n = 124). Although both the Cockcroft-Gault (r = 0.65, P < 0.001) and the MDRD (r = 0.74, P < 0.001) equations correlated well with creatinine clearance, the latter was significantly superior (P = 0.013 between r values). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for the MDRD equation was significantly greater than for the Cockcroft-Gault equation (AUC 0.86 versus 0.80, P = 0.015) in classifying subjects as having mildly reduced GFR (<90 ml/min per 1.73 m(2)). However, both equations overestimated the number of individuals with decreased GFR. We conclude therefore that while the MDRD equation more accurately identifies Asians who are in the early stages of kidney disease, as for other groups, a correction term appears necessary in order to reduce the number of Asian subjects being falsely diagnosed with CKD. (C) 2006 Elsevier Ireland Ltd. All rights reserved. C1 VA Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, Seattle, WA 98108 USA. Univ Washington, Dept Anthropol, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Div Gen Internal Med, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Dept Med, Div Nephrol, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Epidemiol Res Informat Ctr, Seattle, WA 98108 USA. RP Kahn, SE (reprint author), VA Puget Sound Hlth Care Syst, Div Metab Endocrinol & Nutr, 1660 S Columbian Way, Seattle, WA 98108 USA. EM skahn@u.washington.edu OI Kahn, Steven/0000-0001-7307-9002; Hull, Rebecca/0000-0001-9690-4087; Boyko, Edward/0000-0002-3695-192X FU NCRR NIH HHS [RR-37]; NICHD NIH HHS [R24 HD042828, R24 HD042828-10]; NIDDK NIH HHS [DK-02654, DK-02860, DK-35816, K24 DK002654, K24 DK002654-05, K24 DK002860, P30 DK035816, R01 DK055460] NR 26 TC 9 Z9 12 U1 0 U2 1 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0168-8227 J9 DIABETES RES CLIN PR JI Diabetes Res. Clin. Pract. PD AUG PY 2007 VL 77 IS 2 BP 320 EP 326 DI 10.1016/j.diabres.2006.11.001 PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 174EM UT WOS:000246924100025 PM 17141914 ER PT J AU Tang, Y Epstein, MP Anderson, GM Zabetian, CP Cubells, JF AF Tang, Yi-lang Epstein, Michael P. Anderson, George M. Zabetian, Cyrus P. Cubells, Joseph F. TI Genotypic and haplotypic associations of the DBH gene with plasma dopamine beta-hydroxylase activity in African Americans SO EUROPEAN JOURNAL OF HUMAN GENETICS LA English DT Article DE dopamine beta-hydroxylase; African American; linkage disequilibrium; genetic association; haplotype ID ATTENTION-DEFICIT/HYPERACTIVITY DISORDER; DEFICIT HYPERACTIVITY DISORDER; SINGLE NUCLEOTIDE POLYMORPHISM; LINKAGE DISEQUILIBRIUM; CEREBROSPINAL-FLUID; LOCUS; INDIVIDUALS; HEALTHY AB Several variants at DBH are significantly associated with plasma DbH activity (pDbH). However, the overwhelming majority of data on this genotype-phenotype relationship has been gathered in samples from Europeans and European Americans (EAs). In this study, we examined the relationship between DBH polymorphisms and pDbH in samples from African-American (AA) subjects. Genotypes were determined at a 19-bp insertion/deletion polymorphism (ins/del) and four single-nucleotide polymorphisms (SNPs) at DBH in 109 samples. Analyses were performed using analyses of variance (ANOVAs) ( for individual SNPs) and regression procedures (to assess the joint effects and the specific SNP-based haplotypes). We found: (1) single-variant analysis of all polymorphisms revealed apparent associations to pDbH, with rs1611115 accounting for the largest proportion of the variance in pDbH (28.7%) and ins/del the smallest (6.5%); ( 2) modest but significant linkage disequilibrium (LD) existed between ins/del and rs1611115; (3) LD between all other pairs of variants was not observed; (3) stepwise regression showed that a model containing rs1611115, rs2519152 and rs6271 accounted for 37.6% of the variance in pDbH, with rs6271 showing additional 7.6% above the effect of rs1611115, and rs2519152 showing additional 2% above rs1611115 and rs6271; (4) two common haplotypes, C-T-C and T-C-C at rs1611115-rs2519152-rs6271 were significantly associated with pDbH (P = 0.0025 and 0.0036, respectively). The data support the validity of prior reported associations and underscore the importance of analyzing multiple SNPs across DBH in future association studies examining disease and biochemical phenotypes. C1 Emory Univ, Sch Med, Dept Psychiat, Atlanta, GA 30322 USA. Emory Univ, Sch Med, Dept Behav Sci, Atlanta, GA 30322 USA. Yale Univ, Sch Med, VA Connecticut Healthcare Syst, Dept Psychiat, New Haven, CT 06520 USA. Emory Univ, Dept Human Genet, Atlanta, GA 30322 USA. Yale Univ, Sch Med, Ctr Child Study, New Haven, CT 06520 USA. Univ Washington, Sch Med, Geriatr Res Educ & Clin Ctr, Dept Neurol,VA Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Cubells, JF (reprint author), Emory Univ, Sch Med, Dept Human Genet, 615 Michael St,Suite 301, Atlanta, GA 30322 USA. EM jcubells@genetics.emory.edu FU NIDA NIH HHS [K02DA015766, R01 DA12422]; NINDS NIH HHS [K08 NS044138] NR 27 TC 27 Z9 30 U1 1 U2 2 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 1018-4813 J9 EUR J HUM GENET JI Eur. J. Hum. Genet. PD AUG PY 2007 VL 15 IS 8 BP 878 EP 883 DI 10.1038/sj.ejhg.5207838 PG 6 WC Biochemistry & Molecular Biology; Genetics & Heredity SC Biochemistry & Molecular Biology; Genetics & Heredity GA 194PQ UT WOS:000248356700010 PM 17457369 ER PT J AU Kulich, SM Horbinski, C Patel, M Chu, CT AF Kulich, Scott M. Horbinski, Craig Patel, Manisha Chu, Charleen T. TI 6-Hydroxydopamine induces mitochondrial ERK activation SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Article DE mitochondria; reactive oxygen species; Parkinson's disease; extracellular signal-regulated MAP kinases; 6-hydroxydopamine ID REGULATED KINASE ACTIVATION; EPIDERMAL-GROWTH-FACTOR; PARKINSONS-DISEASE; HYDROGEN-PEROXIDE; REACTIVE OXYGEN; PC12 CELLS; COMPLEX-I; DOPAMINERGIC-NEURONS; ENDOTHELIAL-CELLS; OXIDATIVE STRESS AB Reactive oxygen species (ROS) are implicated in 6-hydroxydopamine (6-OHDA) injury to catecholammergic neurons; however, the mechanism(s) are unclear. In addition to ROS generated during autoxidation, 6-OHDA may initiate secondary cellular sources of ROS that contribute to toxicity. Using a neuronal cell line, we found that catalytic metalloporphyrin antioxidants conferred protection if added 1 h after exposure to 6-OHDA, whereas the hydrogen peroxide scavenger catalase failed to protect if added more than 15 min after 6-OHDA. There was a temporal correspondence between loss of protection and loss of the ability of the antioxidant to inhibit 6-OHDA-induced ERK phosphorylation. Time course studies of aconitase inactivation, an indicator of intracellular superoxide, and MitoSOX red, a mitochondria targeted ROS indicator, demonstrate early intracellular ROS followed by a delayed phase of mitochondrial ROS production, associated with phosphorylation of a mitochondrial pool of ERK. Furthermore, on initiation of mitochondrial ROS and ERK activation, 6-OHDA-injured cells became refractory to rescue by metalloporphyrin antioxidants. Together with previous studies showing that inhibition of the ERK pathway confers protection from 6-OHDA toxicity, and that phosphorylated ERK accumulates in mitochondria of degenerating human Parkinson's disease neurons, these studies implicate mitochondrial ERK activation in Parkinsonian oxidative neuronal injury. (C) 2007 Elsevier Inc. All rights reserved. C1 Univ Pittsburgh, Sch Med, Dept Pathol, Div Neuropathol, Pittsburgh, PA 15261 USA. VA Pittsburgh Healthcare Syst, Dept Pathol, Pittsburgh, PA 15240 USA. Univ Colorado, Dept Pharmaceut Sci, Denver, CO 80262 USA. RP Kulich, SM (reprint author), Univ Pittsburgh, Sch Med, Dept Pathol, Div Neuropathol, 200 Lothrop St, Pittsburgh, PA 15261 USA. EM kulichsm@upmc.edu; ctc4@pitt.edu RI Chu, Charleen/B-1601-2008 OI Chu, Charleen/0000-0002-5052-8271 FU NIA NIH HHS [R01 AG026389-01A2, AG026389, R01 AG026389]; NINDS NIH HHS [NS045748, NS053777, NS40817, R01 NS040817, R01 NS040817-04, R01 NS045748, R01 NS045748-04, R21 NS053777, R21 NS053777-02] NR 81 TC 65 Z9 66 U1 1 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0891-5849 J9 FREE RADICAL BIO MED JI Free Radic. Biol. Med. PD AUG 1 PY 2007 VL 43 IS 3 BP 372 EP 383 DI 10.1016/j.freeradbiomed.2007.04.028 PG 12 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 190WH UT WOS:000248090800007 PM 17602953 ER PT J AU Valente, AJ El Jamali, A Epperson, TK Gamez, MJ Pearson, DW Clark, RA AF Valente, Anthony J. El Jamali, Amina Epperson, Terry Kay Gamez, Maria J. Pearson, Doran W. Clark, Robert A. TI NOX1 NADPH oxidase regulation by the NOXA1 SH3 domain SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Article DE NADPH oxidase; NOX1; NOXA1; SH3 domain; superoxide ID SUPEROXIDE-GENERATING OXIDASE; TISSUE EXPRESSION; NAD(P)H OXIDASE; MESSENGER-RNA; ACTIVATION; PROTEINS; CELLS; P67(PHOX); P47(PHOX); HOMOLOGY AB We investigated the role of the single SH3 domain of NOXA I in NOX I NADPH oxidase function using wild-type and mutated NOXA I and the products of two variant NOXA1 transcripts isolated from CaCo2 cells by reverse transcription polymerase chain reaction. The first variant, NOXA1(trunc), contained a number of point mutations, including A51T, T261A, and a nonsense mutation at position 274. On transfection into K562 cells stably expressing NOX1 and NOXO1, both NOXA1(trunc), and an equivalent truncated wild-type NOXAI(1-273) were expressed as similar to 29-kDa truncated NOXA I proteins lacking both PB I and SH3 domains, yet both were as active as wild-type NOXA I in phorbol-stimulated superoxide generation. Kinetic analysis demonstrated that truncated NOXAI activated the NOX1 system at an accelerated rate compared with NOXAL Deletion studies showed that the slower kinetics of wild-type NOXA I depended primarily on its SH3 domain, suggesting SH3 -dependent delay in forming the active NOX1/NOXO1/NOXA1 complex. The second variant, NOXA1(inhib), encoded a protein lacking the activation domain due to absence of exons 5 and 6 but including a heptapeptide (EPDVPLA) SH3 domain insertion resulting from alternative splicing in exon 14. NOXA1(inhib) failed to support superoxide-generating activity and exhibited transdominant inhibition of NOXA1. Insertion of the heptapeptide into the corresponding site in wild-type NOXAI inhibited its activity by similar to 90%, rendered it a transdominant inhibitor of wild-type NOXAI, and abrogated binding of its SH3 domain to NOXO1 and p47(phox). These studies demonstrate that, in reconstituted NOX1/NOXO1/NOXA1 systems, the NOXA I SH3 domain is not required for function but, when present, can critically modulate the activity of the enzyme system. (C) 2007 Elsevier Inc. All rights reserved. C1 Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78229 USA. S Texas vet Hlth Care Syst, Audie L Murphy Div, San Antonio, TX 78229 USA. RP Valente, AJ (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM valente@uthscsa.edu FU NIA NIH HHS [AG19519, R01 AG019519]; NIAID NIH HHS [R01 AI020866]; PHS HHS [A120866] NR 34 TC 9 Z9 10 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0891-5849 J9 FREE RADICAL BIO MED JI Free Radic. Biol. Med. PD AUG 1 PY 2007 VL 43 IS 3 BP 384 EP 396 DI 10.1016/j.freeradbiomed.2007.04.022 PG 13 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 190WH UT WOS:000248090800008 PM 17602954 ER PT J AU Yu, L Ioannou, GN AF Yu, Lei Ioannou, George N. TI Survival of liver transplant recipients with hemochromatosis in the United States SO GASTROENTEROLOGY LA English DT Article ID HEPATIC IRON OVERLOAD; HEREDITARY HEMOCHROMATOSIS; GRAFT-SURVIVAL; CIRRHOSIS; PATIENT AB Background & Aims: Earlier studies have suggested that patients with hemochromatosis have poor post-transplantation survival. We aimed to compare patients with hemochromatosis to those with other causes of liver disease with regard to post-transplantation survival. Methods: We compared the post-transplant survival of patients with and without hemochromatosis using data provided by the United Network for Organ Sharing on 50,306 adult, cadaveric liver transplantations performed in the United States between January 1, 1990, and July 18, 2006. Results: During 1990-1996, the post-transplantation survival of patients with hemochromatosis (n = 177) at I year (79.1%), 3 years (71.8%), and 5 years (64.6%) was lower than the average 1-year (86.4%), 3-year (79.S%), and 5-year (73.8%) survival of all other transplant recipients (hazard ratio for death, 1.38; 95% confidence interval [CI], 1.12-1.71). In contrast, during 1997-2006, patients with hemochromatosis (n = 217) had excellent 1-year (86.1%), 3-year (80.8%), and S-year (77.3%) post-transplantation survival, which was not different from the 1-year (88.4%), 3-year (80.3%), and 5-year (74.0%) post-transplantation survival of all other transplant recipients (hazard ratio for death, 0.89; 95% CI, 0.65-1.22). Adjustment for donor and recipient characteristics did not substantially change these results. Compared with recipients without hemochromatosis, those with hemochromatosis were more likely to die of cardiovascular diseases and less likely to die as a result of graft failure. Conclusions: The post-transplantation survival of patients with hemochromatosis, which was previously reported to be poor, has been excellent in the United States during the past 10 years. C1 Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Gastroenterol, Seattle, WA 98108 USA. Univ Washington, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Res Enhancement Award Program, Seattle, WA 98108 USA. RP Ioannou, GN (reprint author), Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Div Gastroenterol, S-111-Gastro,1660 S Columbian Way, Seattle, WA 98108 USA. EM georgei@medicine.washington.edu NR 17 TC 27 Z9 27 U1 0 U2 4 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0016-5085 J9 GASTROENTEROLOGY JI Gastroenterology PD AUG PY 2007 VL 133 IS 2 BP 489 EP 495 DI 10.1053/j.gastro.2007.05.054 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 197VW UT WOS:000248585600019 PM 17681170 ER PT J AU Hume, CR Bratt, DL Oesterle, EC AF Hume, Clifford R. Bratt, Debra Lee Oesterle, Elizabeth C. TI Expression of LHX3 and SOX2 during mouse inner ear development SO GENE EXPRESSION PATTERNS LA English DT Article DE LHX; LIM-homeodomain; MATH-1; inner ear; cochlea; ATOH1; SOX; Hmg box; hair cell; deafness; HLH; bHLH; genetics; hearing ID HAIR-CELLS; UNCONVENTIONAL MYOSINS; MOTOR-NEURONS; FATE DETERMINATION; SENSORY EPITHELIA; STEM-CELLS; IN-VIVO; MATH1; ORGAN; GENE AB A cascade of transcription factors is believed to regulate the coordinate differentiation of primordial inner ear cells into the subtypes of hair cells and supporting cells. While candidate genes involved in this process have been identified, the temporal and spatial patterns of expression of many of these have not been carefully described during the extended period of inner ear development and functional maturation. We systematically examined the expression of two such transcription factors, LHX3 and SOX2, from the time of hair cell terminal mitoses into adulthood. We show that LHX3 is expressed specifically in auditory and vestibular hair cells soon after terminal mitoses and persists into the adult in vestibular hair cells. While SOX2 expression is widespread in the inner ear sensory epithelia prior to hair cell differentiation, it has a unique pattern of expression in the mature auditory and vestibular organs. (c) 2007 Elsevier B.V. All rights reserved. C1 Univ Washington, Dept Otolaryngol Head & Neck Surg, Virginia Merrill Bloedel Hearing Res Ctr, VMBHRC,CHDD, Seattle, WA 98195 USA. VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Hume, CR (reprint author), Univ Washington, Dept Otolaryngol Head & Neck Surg, Virginia Merrill Bloedel Hearing Res Ctr, VMBHRC,CHDD, CD176,Box 357923,1959 NE Pacific, Seattle, WA 98195 USA. EM hume@u.washington.edu FU NICHD NIH HHS [P30 HD-02774]; NIDCD NIH HHS [DC-006437, DC-03944, K08 DC006437, K08 DC006437-04, P30 DC-04661, P30 DC004661, R01 DC003944] NR 53 TC 77 Z9 78 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1567-133X J9 GENE EXPR PATTERNS JI Gene Expr. Patterns PD AUG PY 2007 VL 7 IS 7 BP 798 EP 807 DI 10.1016/j.modgep.2007.05.002 PG 10 WC Developmental Biology; Genetics & Heredity SC Developmental Biology; Genetics & Heredity GA 208PF UT WOS:000249331000011 PM 17604700 ER PT J AU Volpp, KG Stone, R Lave, JR Jha, AK Pauly, M Klusaritz, H Chen, HY Cen, LY Brucker, N Polsky, D AF Volpp, Kevin G. Stone, Roslyn Lave, Judith R. Jha, Ashish K. Pauly, Mark Klusaritz, Heather Chen, Huanyu Cen, Liyi Brucker, Nancy Polsky, Daniel TI Is thirty-day hospital mortality really lower for black veterans compared with white veterans? SO HEALTH SERVICES RESEARCH LA English DT Article DE hospital mortality; racial disparities; hospitals; veterans ID ACUTE MYOCARDIAL-INFARCTION; HEALTH-CARE-SYSTEM; QUALITY-OF-LIFE; RACIAL-DIFFERENCES; ADMINISTRATIVE DATA; MEDICARE BENEFICIARIES; HEART-FAILURE; OUTCOMES; DISPARITIES; AFFAIRS AB Objective. To examine the source of observed lower risk-adjusted mortality for blacks than whites within the Veterans Affairs (VA) system by accounting for hospital site where treated, potential under-reporting of black deaths, discretion on hospital admission, quality improvement efforts, and interactions by age group. Data Sources. Data are from the VA Patient Treatment File on 406,550 hospitalizations of veterans admitted with a principal diagnosis of acute myocardial infarction, stroke, hip fracture, gastrointestinal bleeding, congestive heart failure, or pneumonia between 1996 and 2002. Information on deaths was obtained from the VA Beneficiary Identification Record Locator System and the National Death Index. Study Design. This was a retrospective observational study of hospitalizations throughout the VA system nationally. The primary outcome studied was all-location mortality within 30 days of hospital admission. The key study variable was whether a patient was black or white. Principal Findings. For each of the six study conditions, unadjusted 30-day mortality rates were significantly lower for blacks than for whites (p <.01). These results did not vary after adjusting for hospital site where treated, more complete ascertainment of deaths, and in comparing results for conditions for which hospital admission is discretionary versus nondiscretionary. There were also no significant changes in the degree of difference by race in mortality by race following quality improvement efforts within VA. Risk-adjusted mortality was consistently lower for blacks than for whites only within the population of veterans over age 65. Conclusions. Black veterans have significantly lower 30-day mortality than white veterans for six common, high severity conditions, but this is generally limited to veterans over age 65. This differential by age suggests that it is unlikely that lower 30-day mortality rates among blacks within VA are driven by treatment differences by race. C1 Philadelphia Vet Affairs Med Ctr, CHERP, Philadelphia, PA 19104 USA. Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Univ Penn, Wharton Sch, Hlth Care Syst Dept, Philadelphia, PA 19104 USA. Univ Pittsburgh, Dept Biostat, Pittsburgh, PA 15261 USA. Univ Pittsburgh, Grad Sch Publ Hlth, Dept Hlth Policy & Management, Pittsburgh, PA USA. Harvard Univ, Sch Publ Hlth, Boston, MA 02115 USA. Univ Penn, Sch Social Sci Policy & Practice, Philadelphia, PA 19104 USA. VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA USA. Univ Penn, Div Gen Internal Med, Philadelphia, PA 19104 USA. RP Volpp, KG (reprint author), Philadelphia Vet Affairs Med Ctr, CHERP, Univ & Woodland Ave, Philadelphia, PA 19104 USA. NR 56 TC 29 Z9 29 U1 1 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0017-9124 J9 HEALTH SERV RES JI Health Serv. Res. PD AUG PY 2007 VL 42 IS 4 BP 1613 EP 1631 DI 10.1111/j.1475-6773.2006.00688.x PG 19 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 184SM UT WOS:000247662300010 PM 17610440 ER PT J AU Carpiac-Claver, M Guzman, JS Castle, SC AF Carpiac-Claver, Maria Guzman, Jenice S. Castle, Steven C. TI The comprehensive care clinic SO HEALTH & SOCIAL WORK LA English DT Article ID HEALTH-CARE; COMORBIDITY C1 Univ Calif Los Angeles, Dept SocialWelfare, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Dept Nursing, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Los Angeles, CA USA. RP Carpiac-Claver, M (reprint author), Univ Calif Los Angeles, Dept SocialWelfare, 3225 Publ Policy Bldg, Los Angeles, CA 90095 USA. EM mcarpiac@ucla.edu NR 18 TC 1 Z9 1 U1 0 U2 0 PU NATL ASSOC SOCIAL WORKERS PI WASHINGTON PA 750 FIRST ST, NE, STE 700, WASHINGTON, DC 20002-4241 USA SN 0360-7283 J9 HEALTH SOC WORK JI Health Soc. Work PD AUG PY 2007 VL 32 IS 3 BP 219 EP 223 PG 5 WC Social Work SC Social Work GA 202XT UT WOS:000248938600008 PM 17896679 ER PT J AU Graham, DY Lu, H Yamaoka, Y AF Graham, David Y. Lu, Hong Yamaoka, Yoshio TI A report card to grade Helicobacter pylori therapy SO HELICOBACTER LA English DT Editorial Material ID PROTON PUMP INHIBITOR; 7-DAY TRIPLE-THERAPY; RANDOMIZED-TRIAL; SEQUENTIAL TREATMENT; QUADRUPLE THERAPY; NONULCER DYSPEPSIA; ERADICATION RATES; UNITED-STATES; PEPTIC-ULCER; DOUBLE-BLIND AB Helicobacter pylori causes a serious bacterial infectious disease, and the expectations of therapy should reflect this fact. increasing antibiotic resistance, especially to clarithromycin, has significantly undermined the effectiveness of legacy triple therapy consisting of a proton pump inhibitor, clarithromycin, and amoxicillin. Current cure rates are consistently below 80% intention-to-treat, the accepted threshold separating acceptable from unacceptable treatment results. Grading clinical studies into effectiveness categories using prespecified criteria would allow clinicians to objectively identify and compare regimens. We offer a therapy report card similar to that used to grade the performance of school children. The intention-to-treat cure rate categories are: For unacceptable (<= 80%), D or poor (81-84%), C or fair (85-89%), B or good (90-95%), and A or excellent (95-100%). The category of "excellent" is based on the cure rates expected with other prevalent bacterial infectious diseases. We propose that only therapies that score "excellent" (grade = A) should be prescribed. Regimens scoring as B or good" can be used if "excellent" results are not obtainable. In most regions legacy triple therapy should be abandoned as unacceptable. Quadruple therapy and sequential therapy are reasonable alternatives for initial therapy. C1 Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. Shanghai Jiao Tong Univ, Sch Med, Shanghai Inst Digest Dis, Renji Hosp,Dept Gastroenterol, Shanghai 200030, Peoples R China. RP Graham, DY (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med, RM 3A-320 111D,2002 Holcombe Blvd, Houston, TX 77030 USA. EM dgraham@bcm.tmc.edu FU NIDDK NIH HHS [DK 56338] NR 36 TC 146 Z9 165 U1 2 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1083-4389 J9 HELICOBACTER JI Helicobacter PD AUG PY 2007 VL 12 IS 4 BP 275 EP 278 DI 10.1111/j.1523-5378.2007.00518.x PG 4 WC Gastroenterology & Hepatology; Microbiology SC Gastroenterology & Hepatology; Microbiology GA 204BM UT WOS:000249017800001 PM 17669098 ER PT J AU Yamaoka, Y Yamauchi, K Choi, I Oigiwara, H Graham, DY AF Yamaoka, Y. Yamauchi, K. Choi, I. Oigiwara, H. Graham, D. Y. TI Up-regulation of interleukin-18 in Helicobacter pylori infection SO HELICOBACTER LA English DT Meeting Abstract CT 20th International Workshop on Helicobacter and Related Bacteria in Chronic Digestive Inflammation CY SEP 20-22, 2007 CL Istanbul, TURKEY SP European Helicobacter Study Grp C1 Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1083-4389 J9 HELICOBACTER JI Helicobacter PD AUG PY 2007 VL 12 IS 4 BP 400 EP 400 PG 1 WC Gastroenterology & Hepatology; Microbiology SC Gastroenterology & Hepatology; Microbiology GA 204BM UT WOS:000249017800073 ER PT J AU Chang, HT Krezolek, D Johnson, S Parada, JP Evans, CT Gerding, DN AF Chang, Heidi T. Krezolek, Dorota Johnson, Stuart Parada, Jorge P. Evans, Charlesnika T. Gerding, Dale N. TI Onset of symptoms and time to diagnosis of Clostridium difficile - Associated disease following discharge from an acute care hospital SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID RESISTANT STAPHYLOCOCCUS-AUREUS; DIARRHEA AB Objective. To identify patients with a diagnosis of Clostridium difficile-associated disease (CDAD) in the ambulatory care setting and determine the relationship of symptom onset and diagnosis to prior hospitalization and exposure to antimicrobials. Design. Single-center, retrospective study. Methods. Medical records were reviewed for outpatients and hospitalized patients with a stool assay positive for C. difficile toxin A from January 1998 through March 2005. Patients with recurrent CDAD or residing in an extended-care facility were excluded. CDAD in patients who had been hospitalized in the 100 days prior to diagnosis was considered potentially hospital-associated. Results. Of the 84 patients who met the inclusion criteria, 75 (89%) received a diagnosis 1-60 days after hospital discharge (median, 12 days), and 71 (85%) received a diagnosis within 30 days after discharge. Of the 69 patients whose records contained information regarding time of symptom onset, 62 (90%) developed diarrhea within 30 days of a previous hospital discharge, including 7 patients with symptom onset prior to discharge and 9 with onset on the day of discharge. The median time from symptom onset to diagnosis was 6 days. Of 84 patients, 77 (92%) had received antimicrobials during a prior hospitalization, but 55 (65%) received antimicrobials both as inpatients and as outpatients. Conclusion. If all cases of CDAD diagnosed within 100 days of hospital discharge were assumed to be hospital-associated, 71 (85%) of 84 patients with CDAD were identified within 30 days, and 75 (89%) of 84 were identified by day 60. Continued outpatient antimicrobial exposure confounds determination of whether late-onset cases are community-or hospital-associated. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Midwest Ctr Hlth Serv & Policy Res & Res Serv, Res Serv 151, Hines, IL 60141 USA. Loyola Univ Chicago, Stritch Sch Med, Maywood, IL USA. RP Gerding, DN (reprint author), US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Midwest Ctr Hlth Serv & Policy Res & Res Serv, Res Serv 151, Roosevelt Rd & 5th Ave, Hines, IL 60141 USA. EM dale.gerding2@va.gov NR 13 TC 31 Z9 31 U1 0 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD AUG PY 2007 VL 28 IS 8 BP 926 EP 931 DI 10.1086/519178 PG 6 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 205NS UT WOS:000249121500006 PM 17620239 ER PT J AU Sonnenberg, A AF Sonnenberg, Amnon TI Time trends of mortality from Crohn's disease and ulcerative colitis SO INTERNATIONAL JOURNAL OF EPIDEMIOLOGY LA English DT Article DE death rates; environmental risk factor; epidemiology; aetiology of Crohn's disease; aetiology of ulcerative colitis; inflammatory bowel disease; mortality ID INFLAMMATORY-BOWEL-DISEASE; GEOGRAPHIC-VARIATION; COUNTY; COHORT; SWEDEN AB Aims The present study served to test whether Crohn's disease and ulcerative colitis showed similarities in the temporal variation of their mortality rates among different countries. Methods Mortality data from 21 different countries between 1951 and 2005 were analysed, including Argentina, Australia, Austria, Belgium, Canada, Chile, Den-mark, England, Finland, France, Germany, Italy, Japan, Mexico, Netherlands, Scotland, Spain, Sweden, Switzerland, Taiwan and USA. The age-specific death rates of each individual country, as well as the average age-specific rates of all countries, were plotted against the period of death. Results Death rates from ulcerative colitis were initially 6-fold higher than those of Crohn's disease. Mortality from ulcerative colitis decreased continuously during the past 50 years. Mortality from Crohn's disease increased from 1951 to 1975 until reaching a similar level as mortality from ulcerative colitis. Since then the death rates of both diseases have followed a parallel time course. A same type of behaviour was found in the time trends of each individual age-group. The data from most countries revealed similar temporal patterns. Conclusions The relationships between the temporal changes of mortality from Crohn's disease and ulcerative colitis might suggest the presence of one primary risk factor responsible for the occurrence of both diseases, and at the existence of one additional secondary risk factor, responsible for the expression of Crohn's disease alone. C1 Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97239 USA. RP Sonnenberg, A (reprint author), Oregon Hlth & Sci Univ, Portland VA Med Ctr, Portland, OR 97239 USA. EM sonnenbe@ohsu.edu NR 21 TC 19 Z9 19 U1 0 U2 2 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0300-5771 J9 INT J EPIDEMIOL JI Int. J. Epidemiol. PD AUG PY 2007 VL 36 IS 4 BP 890 EP 899 DI 10.1093/ije/dym034 PG 10 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 218XW UT WOS:000250050300034 PM 17420164 ER PT J AU Haroutunian, V Davis, KL AF Haroutunian, Vahrant Davis, Kenneth L. TI Introduction to the Special Section: Myelin and oligodendrocyte abnormalities in schizophrenia SO INTERNATIONAL JOURNAL OF NEUROPSYCHOPHARMACOLOGY LA English DT Editorial Material DE gene expression; microarray; neuroanatomy; neuropathology; post-mortem; schizophrenia ID PREFRONTAL CORTEX; GENE-EXPRESSION; MOOD DISORDERS; DYSFUNCTION; NEUROPATHOLOGY; POSTMORTEM; DENSITY; MATTER AB A central tenet of modern views of the neurobiology of schizophrenia is that the symptoms of schizophrenia arise from a failure of adequate communication between different brain regions and disruption of the circuitry that underlies behaviour and perception. Historically this disconnectivity syndrome has been approached from a neurotransmitter-based perspective. However, efficient communication between brain circuits is also contingent on saltatory signal propagation and salubrious myelination of axons. The papers in this Special Section examine the neuroanatomical and molecular biological evidence for abnormal myelination and oligodendroglial function in schizophrenia through studies of post-mortem brain tissue and animal model systems. The picture that emerges from the studies described suggests that although schizophrenia is not characterized by gross abnormalities of white matter such as those evident in multiple sclerosis, it does involve a profound dysregulation of myelin-associated gene expression, reductions in oligodendrocyte numbers, and marked abnormalities in the ultrastructure of myelin sheaths. C1 Mt Sinai Sch Med, Dept Psychiat, New York, NY USA. RP Haroutunian, V (reprint author), Bronx Vet Adm Med Ctr, Room 4F-33A,130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM vahram.haroutunian@mssm.edu FU NCRR NIH HHS [M01-RR-00071]; NIMH NIH HHS [MH066392, MH064673] NR 25 TC 28 Z9 28 U1 0 U2 2 PU CAMBRIDGE UNIV PRESS PI NEW YORK PA 32 AVENUE OF THE AMERICAS, NEW YORK, NY 10013-2473 USA SN 1461-1457 J9 INT J NEUROPSYCHOPH JI Int. J. Neuropsychopharmacol. PD AUG PY 2007 VL 10 IS 4 BP 499 EP 502 DI 10.1017/S1461145706007449 PG 4 WC Clinical Neurology; Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 189BM UT WOS:000247963500006 PM 17583597 ER PT J AU Joiner, TE Cook, JM Hersen, M Gordon, KH AF Joiner, Thomas E., Jr. Cook, Joan M. Hersen, Michel Gordon, Kathryn H. TI Double depression in older adult psychiatric outpatients: Hopelessness as a defining feature SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE double depression; hopelessness; older adults; dysthymia; major depression ID PSYCHOMETRIC PROPERTIES; MAJOR DEPRESSION; INVENTORY; ANXIETY AB Background: There is a paucity of research on the distinguishing features of double depression, particularly in older adults. Preliminary studies have revealed that individuals with double depression diagnoses tend to have more severe depression than individuals with major depression or dysthymia alone, but few other distinctions between the diagnostic categories have been found. Method: We examined the possibility that hopelessness particularly characterizes double depression, by comparing older adults with double depression, dysthymia alone, or major depression alone, on hopelessness, as well as on internal and external locus of control. The sample included 54 older psychiatric outpatients who completed a battery of cognitive and symptom measures, and underwent structured clinical interviews. Results: Double depressed patients showed high levels of hopelessness, whereas patients with either major depression or dysthymia alone showed more moderate levels of hopelessness. Low internal locus of control characterized both groups with a dysthymia diagnosis (dysthymia alone and double depression), and differentiated them from the group with major depression alone. Limitations: The sample size was modest, and the results may not generalize to older adults with different demographic characteristics. Conclusions: Hopelessness may be important in understanding the phenomenology of double depression in older adults, and may inform diagnostics and psychotherapeutics as well. (c) 2007 Elsevier B.V. All rights reserved. C1 Florida State Univ, Dept Psychol, Tallahassee, FL 32306 USA. Vet Affairs Med Ctr, Philadelphia, PA USA. Pacific Univ, Sch Profess Psychol, Forest Grove, OR USA. RP Joiner, TE (reprint author), Florida State Univ, Dept Psychol, Tallahassee, FL 32306 USA. EM joiner@psy.fsu.edu NR 18 TC 8 Z9 10 U1 1 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD AUG PY 2007 VL 101 IS 1-3 BP 235 EP 238 DI 10.1016/j.jad.2005.03.019 PG 4 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 187PJ UT WOS:000247860000025 PM 17475340 ER PT J AU McElroy, SL Suppes, T Frye, MA Altshuler, LL Stanford, K Martens, B Leverich, GS Post, RM Keck, PE AF McElroy, Susan L. Suppes, Trisha Frye, Mark A. Altshuler, Lori L. Stanford, Kevin Martens, Brian Leverich, Gabriele S. Post, Robert M. Keck, Paul E., Jr. TI Open-label aripiprazole in the treatment of acute bipolar depression: A prospective pilot trial SO JOURNAL OF AFFECTIVE DISORDERS LA English DT Article DE aripiprazole; bipolar; depression; akathisia ID PLACEBO-CONTROLLED TRIAL; ATYPICAL ANTIPSYCHOTICS; DOUBLE-BLIND; II DEPRESSION; RATING-SCALE; WEIGHT-GAIN; DISORDER; MANIA; TOLERABILITY; PRAMIPEXOLE AB Background: Increasing evidence indicates that some second-generation antipsychotics are efficacious in bipolar depression, but there are few data on this illness for the novel agent aripiprazole. Methods: Aripiprazole response was prospectively assessed for 8 weeks with the Montgomery-Asberg Depression Rating Scale (MADRS), the Clinical Global Impression Scale Modified for Bipolar Illness (CGI-BP), and the Young Mania Rating Scale (YMRS) in 31 bipolar patients with acute depression inadequately responsive to 1 mood stabilizer. Side effects and body weight were also evaluated. Outcome measures were analyzed with repeated measures ANOVAs. Results: Patients showed a significant decrease in mean MADRS total and CGI-BP-Depression Severity scores, but only 14 (45%) completed the 8-week-trial. Thirteen (42%) patients met criteria for response (>= 50% reduction in MADRS total score), 11 (35%)patients met criteria for remission (final MADRS total score <= 12), and 9 (29%) patients discontinued aripiprazole for side effects, most commonly akathisia (N=4). As a group, patients showed statistically insignificant weight gain (0.8 +/- 2.5 kg) over the 8-week trial. Conclusion: Aripiprazole was associated with beneficial effects on mood in some patients with bipolar depression, but also had a high discontinuation rate, primarily due to side effects. Double-blind, placebo-controlled studies are necessary to determine aripiprazole's efficacy, tolerability, and safety in bipolar depression. (c) 2007 Published by Elsevier B.V. C1 Univ Cincinnati, Coll Med, Dept Psychiat, Psychopharmacol Res Program, Cincinnati, OH 45267 USA. Univ Texas, SW Med Ctr, Dallas, TX 75230 USA. Univ Calif Los Angeles, Inst Neuropsychiat, Los Angeles, CA 90024 USA. W Los Angeles VA Med Ctr, Los Angeles, CA USA. NIMH, Biol Psychiat Branch, NIH, DHHS, Bethesda, MD 20892 USA. RP McElroy, SL (reprint author), Univ Cincinnati, Coll Med, Dept Psychiat, Psychopharmacol Res Program, POB 670559,231 Albert Sabin Way, Cincinnati, OH 45267 USA. EM susan.mcelroy@uc.edu NR 37 TC 28 Z9 31 U1 1 U2 2 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0165-0327 J9 J AFFECT DISORDERS JI J. Affect. Disord. PD AUG PY 2007 VL 101 IS 1-3 BP 275 EP 281 DI 10.1016/j.jad.2006.11.025 PG 7 WC Clinical Neurology; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 187PJ UT WOS:000247860000033 PM 17229469 ER PT J AU Lipsky, BA Giordan, P Choudhri, S Song, J AF Lipsky, Benjamin A. Giordan, Philip Choudhri, Shurjeel Song, James TI Treating diabetic foot infections with sequential intravenous to oral moxifloxacin compared with piperacillin-tazobactam/amoxicillin-clavulanate SO JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY LA English DT Article; Proceedings Paper CT 46th Interscience Conference on Antimicrobial Agents and Chemotherapy CY SEP 27-30, 2006 CL San Francisco, CA DE complicated skin and skin structure infections; fluoroquinolones; penicillins; beta-lactam inhibitors ID IN-VITRO ACTIVITY; SOFT-TISSUE INFECTIONS; SKIN-STRUCTURE INFECTIONS; OPEN-LABEL TRIAL; COMPLICATED SKIN; AMOXICILLIN-CLAVULANATE; ANTIMICROBIAL AGENTS; ANAEROBIC-BACTERIA; MULTICENTER TRIAL; FLUOROQUINOLONES AB Objectives: Complicated skin and skin structure infections (cSSSIs), including diabetic foot infections (DFIs), are often polymicrobial, requiring combination or broad-spectrum therapy. Moxifloxacin, a broad-spectrum fluoroquinolone, is approved for cSSSI and can be administered by either intravenous (iv) or oral routes. To assess the efficacy of moxifloxacin for treating DFIs, we analysed a subset of patients with these infections who were enrolled in a prospective, double-blind study that compared the efficacy of moxifloxacin with piperacillin-tazobactam and amoxicillin-clavulanate. Methods: Patients >= 18 years of age with a DFI requiring initial iv therapy were randomized to either moxifloxacin (400 mg/day) or piperacillin-tazobactam (3.0/0.375 g every 6 h) for at least 3 days followed by moxifloxacin (400 mg/day orally) or amoxicillin-clavulanate (800 mg every 12 h orally), if appropriate, for 7-14 days. DFI was usually defined as any foot infection plus a history of diabetes. Our primary efficacy outcome was the clinical response of the infection at test-of-cure (TOC), 10-42 days post-therapy. Results: Among 617 patients enrolled in the original study, 78 with DFIs were evaluable for treatment efficacy. Clinical cure rates at TOC were similar for moxifloxacin and piperacillin-tazobactam/ amoxicillin-clavulanate (68% versus 61%) for patients with investigator-defined infection (P = 0.54). Overall pathogen eradication rates in the microbiologically-valid population were 69% versus 66% for moxifloxacin and comparator, respectively (P = 1.00). Conclusions: Intravenous +/- oral moxifloxacin was as effective as iv piperacillin-tazobactam +/- amoxicillin-clavulanate in treating moderate-to-severe DFIs. Moxifloxacin may have potential as a monotherapy regimen for DFIs. C1 Univ Washington, Seattle, WA 98195 USA. Orlando Reg Med Ctr Inc, Orlando, FL USA. Bayer Healthcare, West Haven, CT USA. Replidyne, Milford, MA USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. RP Lipsky, BA (reprint author), VA Puget Sound Hlth Care Syst, Seattle, WA USA. EM benjamin.lipsky@med.va.gov RI Lipsky, Benjamin/B-4645-2013 OI Lipsky, Benjamin A./0000-0001-9886-5114 NR 35 TC 45 Z9 45 U1 0 U2 4 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0305-7453 J9 J ANTIMICROB CHEMOTH JI J. Antimicrob. Chemother. PD AUG PY 2007 VL 60 IS 2 BP 370 EP 376 DI 10.1093/jac/dkm130 PG 7 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 203PM UT WOS:000248986500023 PM 17553812 ER PT J AU Bamman, MM AF Bamman, Marcas M. TI Take two NSAIDs and call on your satellite cells in the morning SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Editorial Material ID SKELETAL-MUSCLE; RESISTANCE EXERCISE; CARDIAC MYOCYTES; HYPERTROPHY C1 Univ Alabama, Dept Physiol & Biophys, Birmingham, W Midlands, England. Birmingham Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Birmingham, AL USA. RP Bamman, MM (reprint author), Univ Alabama, Dept Physiol & Biophys, Birmingham, W Midlands, England. EM mbamman@uab.edu NR 13 TC 2 Z9 2 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD AUG PY 2007 VL 103 IS 2 BP 415 EP 416 DI 10.1152/japplphysiol.00536.2007 PG 2 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 196CP UT WOS:000248459600001 PM 17525294 ER PT J AU Emery, MJ Eveland, RL Kim, SS Hildebrandt, J Swenson, ER AF Emery, Michael J. Eveland, Randy L. Kim, Seong S. Hildebrandt, Jacob Swenson, Erik R. TI CO2 relaxes parenchyma in the liquid-filled rat lung SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Review DE alveolar; pulmonary mechanics; ventilation-to-perfusion matching ID MECHANICAL-PROPERTIES; VENTILATION; PERFUSION; HYPOXIA; TISSUE; DOGS; HETEROGENEITY; DISSOCIATION; RESISTANCE; HYPEROXIA AB CO2 regulation of lung compliance is currently explained by pH- and CO2-dependent changes in alveolar surface forces and bronchomotor tone. We hypothesized that in addition to, but independently of, those mechanisms, the parenchyma tissue responds to hypercapnia and hypocapnia by relaxing and contracting, respectively, thereby improving local matching of ventilation ( V. A) to perfusion ( Q.). Twenty adult rats were slowly ventilated with modified Krebs solution ( rate = 3 min(-1), 37 degrees C, open chest) to produce unperfused living lung preparations free of intra-airway surface forces. The solution was gassed with 21% O-2, balance N-2, and CO2 varied to produce alveolar hypocapnia ( PCO2 = 26.1 +/- 2.4 mmHg, pH = 7.56 +/- 0.04) or hypercapnia ( PCO2 = 55.0 +/- 2.3 mmHg, pH = 7.23 +/- 0.02). The results show that lung recoil, as indicated from airway pressure measured during a breathhold following a large volume inspiration, is reduced similar to 30% when exposed to hypercapnia vs. hypocapnia ( P < 0.0001, paired t-test), but stress relaxation and flow-dependent airway resistance were unaltered. Increasing CO2 from hypo- to hypercapnic levels caused a substantial, significant decrease in the quasi-static pressure-volume relationship, as measured after inspiration and expiration of several tidal volumes, but hysteresis was unaltered. Furthermore, addition of the glycolytic inhibitor NaF abolished CO2 effects on lung recoil. The results suggest that lung parenchyma tissue relaxation, arising from active elements in response to increasing alveolar CO2, is independent of ( and apparently in parallel with) passive tissue elements and may actively contribute to V-A/Q. matching. C1 VA Puget Sound Hlth Care Syst, Pulm & Crit Care Med, Dept Vet Affairs, Seattle, WA 98108 USA. Washington Univ, Dept Physiol, Sch Med, St Louis, MO 63130 USA. Washington Univ, Dept Biophys, Sch Med, St Louis, MO 63130 USA. Washington Univ, Dept Med Pulm & Crit Care Med, Sch Med, St Louis, MO 63130 USA. RP Emery, MJ (reprint author), VA Puget Sound Hlth Care Syst, Pulm & Crit Care Med, Dept Vet Affairs, S-111-PULM,1660 S Columbian Way, Seattle, WA 98108 USA. EM mjemery@u.washington.edu FU NHLBI NIH HHS [HL-24163] NR 33 TC 9 Z9 9 U1 0 U2 1 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD AUG PY 2007 VL 103 IS 2 BP 710 EP 716 DI 10.1152/japplphysiol.00128.2006 PG 7 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 196CP UT WOS:000248459600041 PM 17495121 ER PT J AU Olvera, RL Caetano, SC Fonseca, M Nicoletti, M Stanley, JA Chen, HH Hatch, JP Hunter, K Pliszka, SR Soares, JC AF Olvera, Rene L. Caetano, Sheila C. Fonseca, Manoela Nicoletti, Mark Stanley, Jeffrey A. Chen, Hua Hsuan Hatch, John P. Hunter, Kristina Pliszka, Steven R. Soares, Jair C. TI Low levels of N-acetyl aspartate in the left dorsolateral prefrontal cortex of pediatric bipolar patients SO JOURNAL OF CHILD AND ADOLESCENT PSYCHOPHARMACOLOGY LA English DT Article ID MAGNETIC-RESONANCE-SPECTROSCOPY; DEFICIT HYPERACTIVITY DISORDER; PROTON MR SPECTROSCOPY; CHILDHOOD-ONSET SCHIZOPHRENIA; WHITE-MATTER HYPERINTENSITIES; PROSPECTIVE FOLLOW-UP; IN-VIVO EVIDENCE; ATTENTION-DEFICIT; MOOD DISORDERS; NEUROPSYCHIATRIC DISORDERS AB Background: Increasing evidence suggests abnormalities in the structure, function, and neurochemistry of the frontal cortex in pediatric bipolar ( BP) patients. We conducted a single-voxel proton magnetic resonance spectroscopy (H-1 MRS) of the left dorsolateral prefrontal cortex (DLPFC) of pediatric BP patients, expecting lower N-acetyl-aspartate (NAA) levels within that brain region compared to healthy comparison subjects. Methods: We studied 35 pediatric BP (23 BP type I, 12 BP type II; mean age +/- SD = 13.2 +/- 2.9 years; 18 females) and 36 healthy controls (mean age +/- SD = 13.7 +/- 2.6 years, 17 females). A short echo time, single-voxel H-1 spectroscopy approach point-resolved spectroscopy (PRESS) sequence, measurements of metabolites was performed on a 1.5T Philips MR system. Results: BP subjects had significantly lower NAA levels in the left DLPFC compared to healthy controls (F = 4.21, df = 1, 68, p = 0.04). There was not a significant difference between groups for phosphocreatine + creatine (PCr + Cr), glycerolphosphocholine + phosphocholine (GPC + PC), myo-inositol (mI), or glutamate. Further analyses revealed a significant reduction of NAA in our early puberty group compared to controls (Mann-Whitney U-test statistic = 52.00, p = 0.014), but not for BP versus controls in other pubertal groups. Conclusions: BP subjects have lower NAA levels in the left DLPFC compared to healthy subjects, suggesting neuronal dysfunction in this region. C1 Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Child & Adolescent Psychiat, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Mood & Anxiety Disorders,MOODS CNS Program, San Antonio, TX USA. S Texas Vet Hlth Care Syst, Psychiat Serv, Audie L Murphy Div, San Antonio, TX USA. Univ Sao Paulo, Sch Med, Inst Psychiat, Dept Psychiat, Sao Paulo, Brazil. Univ Fed Rio Grande do Sul, Sch Med, Dept Res Unit, Porto Alegre, RS, Brazil. Wayne State Univ, Sch Med, Dept Psychiat & Behav Neurosci, Detroit, MI USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Orthodont, San Antonio, TX USA. RP Soares, JC (reprint author), Univ Texas, Hlth Sci Ctr, Dept Psychiat, Div Child & Adolescent Psychiat, 7703 Floyd Curl Dr, San Antonio, TX 78284 USA. EM jsoares@med.unc.edu RI Caetano, Sheila/H-5010-2012 OI Caetano, Sheila/0000-0001-8403-7078 FU NCRR NIH HHS [M01-RR-01346, RR 020571]; NIMH NIH HHS [K23-MH068280, MH 01736, MH 068662, MH 068766, MH69774] NR 82 TC 27 Z9 27 U1 4 U2 8 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1044-5463 J9 J CHILD ADOL PSYCHOP JI J. Child Adolesc. Psychopharmacol. PD AUG PY 2007 VL 17 IS 4 BP 461 EP 473 DI 10.1089/cap.2007.0102 PG 13 WC Pediatrics; Pharmacology & Pharmacy; Psychiatry SC Pediatrics; Pharmacology & Pharmacy; Psychiatry GA 210SB UT WOS:000249474800006 PM 17822341 ER PT J AU Stewart, L Griffiss, JM Jarvis, GA Way, LW AF Stewart, Lygia Griffiss, J. McLeod Jarvis, Gary A. Way, Lawrence W. TI Gallstones containing bacteria are biofilms: Bacterial slime production and ability to form pigment solids determines infection severity and bacteremia SO JOURNAL OF GASTROINTESTINAL SURGERY LA English DT Article; Proceedings Paper CT 47th Annual Meeting of the Society-for-Surgery-of the Alimentary-Tract CY MAY 20-24, 2006 CL Los Angeles, CA SP Soc Surg Alimentary Tract DE gallstone; bacteremia; beta-glucuronidase; phospholipase; biofilm; slime; glycocalyx ID NECROSIS-FACTOR-ALPHA; BETA-GLUCURONIDASE; CHOLANGIOVENOUS REFLUX; ELECTRON-MICROSCOPY; CYSTIC-FIBROSIS; PATHOGENESIS; BILE; DISEASE; STONES; GLYCOCALYX AB Gallstone bacteria provide a reservoir for biliary infections. Slime production facilitates adherence, whereas beta-glucuronidase and phospholipase generate colonization surface. These factors facilitate gallstone formation, but their influence on infection severity is unknown. Two hundred ninety-two patients were studied. Gallstones, bile, and blood (as applicable) were cultured. Bacteria were tested for beta-glucuronidase/phospholipase production and quantitative slime production. Infection severity was correlated with bacterial factors. Bacteria were present in 43% of cases, 13% with bacteremia. Severe infections correlated directly with beta-glucuronidase/phospholipase (55% with vs 13% without, P < 0.0001), but inversely with slime production (55 vs 8%, slime < 75 or > 75, P=0.008). Low slime production and beta-glucuronidase/phospholipase production were additive: Severe infections were present in 76% with both, but 10% with either or none (P < 0.0001). beta-Glucuronidase/phospholipase production facilitated bactibilia (86% with vs 62% without, P=0.03). Slime production was 19 (+/- 8) vs 50 (+/- 10) for bacteria that did or did not cause bacteremia (P=0.004). No bacteria with slime > 75 demonstrated bacteremia. Bacteria-laden gallstones are biofilms whose characteristics influence illness severity. Factors creating colonization surface (beta-glucuronidase/phospholipase) facilitated bacteremia and severe infections; but abundant slime production, while facilitating colonization, inhibited detachment and cholangiovenous reflux. This shows how properties of the gallstone biofilm determine the severity of the associated illness. C1 Univ Calif San Francisco, Dept Surg, San Francisco, CA 94121 USA. San Francisco VA Med Ctr, Surg Serv, San Francisco, CA USA. San Francisco VA Med Ctr, Ctr Immunochem, San Francisco, CA USA. Univ Calif San Francisco, Dept Lab Med, San Francisco, CA 94143 USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Stewart, L (reprint author), Univ Calif San Francisco, Dept Surg, 4150 Clement St, San Francisco, CA 94121 USA. EM lygia.stewart@med.va.gov NR 38 TC 14 Z9 14 U1 1 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 1091-255X J9 J GASTROINTEST SURG JI J. Gastrointest. Surg. PD AUG PY 2007 VL 11 IS 8 BP 977 EP 983 DI 10.1007/s11605-007-0168-1 PG 7 WC Gastroenterology & Hepatology; Surgery SC Gastroenterology & Hepatology; Surgery GA 189DU UT WOS:000247970400007 PM 17546479 ER PT J AU Gordon, AJ Sullivan, LE Alford, DP Arnsten, JH Gourevitch, MN Kertesz, SG Kunins, HV Merrill, JO Samet, JH Fiellin, DA AF Gordon, Adam J. Sullivan, Lynn E. Alford, Daniel P. Arnsten, Julia H. Gourevitch, Marc N. Kertesz, Stefan G. Kunins, Hillary V. Merrill, Joseph O. Samet, Jeffrey H. Fiellin, David A. TI Update in addiction medicine for the generalist SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE primary health care; substance-related disorders; review literature ID RANDOMIZED CONTROLLED-TRIAL; SUSTAINED-RELEASE BUPROPION; RECEPTOR PARTIAL AGONIST; UNITED-STATES; ALCOHOL DEPENDENCE; SMOKING-CESSATION; SCREENING QUESTION; PROBLEM DRINKING; PRIMARY-CARE; INTERVENTIONS C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Mental Illness Res Educ & Clin Ctr, Pittsburgh, PA USA. Univ Pittsburgh, Ctr Res Hlth Care, Pittsburgh, PA USA. Yale Univ, Sch Med, New Haven, CT USA. Boston Univ, Sch Med, Dept Med, Gen Internal Med Sect,CARE Unit, Boston, MA USA. Albert Einstein Coll Med, New York, NY USA. Montefiore Med Ctr, New York, NY USA. NYU, Sch Med, New York, NY 10003 USA. Univ Alabama, Sch Med, Birmingham, AL USA. Birmingham Vet Affairs Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL USA. Univ Washington, Sch Med, Seattle, WA USA. RP Gordon, AJ (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equity Res & Promot, Mailcode 151-C,Univ Dr C, Pittsburgh, PA 15240 USA. EM adam.gordon@va.gov OI Samet, Jeffrey/0000-0002-0897-3400; Fiellin, David/0000-0002-4006-010X; Gourevitch, Marc/0000-0001-6865-2126 NR 39 TC 4 Z9 4 U1 0 U2 3 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD AUG PY 2007 VL 22 IS 8 BP 1190 EP 1194 DI 10.1007/s11606-007-0133-4 PG 5 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 189SF UT WOS:000248008100022 PM 17492327 ER PT J AU Werner, RM Greenfield, S Fung, C Turner, BJ AF Werner, Rachel M. Greenfield, Sheldon Fung, Constance Turner, Barbara J. TI Measuring quality of care in patients with multiple clinical conditions: Summary of a conference conducted by the society of general internal medicine SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE performance measurement; quality measures; clinically complex patients ID PAY-FOR-PERFORMANCE; COMPETING DEMANDS; DISEASE; DELIVERY; COMORBIDITY; DEPRESSION; GUIDELINES; MANAGEMENT; PROFILES; SYSTEM AB Performance measurement has been widely advocated as a means to improve health care delivery and, ultimately, clinical outcomes. However, the evidence supporting the value of using the same quality measures designed for patients with a single clinical condition in patients with multiple conditions is weak. If clinically complex patients, defined here as patients with multiple clinical conditions, present greater challenges to achieving quality goals, providers may shun them or ignore important, but unmeasured, clinical issues. This paper summarizes the proceedings of a conference addressing the challenge of measuring quality of care in the patient with multiple clinical conditions with the goal of informing the implementation of quality measurement systems and future research programs on this topic. The conference had three main areas of discussion. First, the potential problems caused by applying current quality standards to patients with multiple conditions were examined. Second, the advantages and disadvantages of three strategies to improve quality measurement in clinically complex patients were evaluated: excluding certain clinically complex patients from a given standard, relaxing the performance target, and assigning a greater weight to some measures based on the expected clinical benefit or difficulty of reaching the performance target. Third, the strengths and weaknesses of potential novel measures such change in functional status were considered. The group concurred that, because clinically complex patients present a threat to the implementation of quality measures, high priority must be assigned to a research agenda on this topic. This research should evaluate the impact of quality measurement on these patients and expand the range of quality measures relevant to the care of clinically complex patients. C1 Philadelphia VAMC, Ctr Hlth Equity Res & Promot, Philadelphia, PA USA. Univ Penn, Sch Med, Div Gen Internal Med, Philadelphia, PA 19104 USA. Univ Penn, Leonard Davis Inst Hlth Econ, Philadelphia, PA 19104 USA. Univ Calif Irvine, Dept Med, Irvine, CA 92717 USA. Univ Calif Irvine, Ctr Hlth Policy Res, Irvine, CA 92717 USA. VA Greater Los Angeles Healthcare Syst, Div Gen Internal Med, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. RAND Corp, Santa Monica, CA USA. RP Werner, RM (reprint author), 1230 Blockley Hall,423 Guardian Dr, Philadelphia, PA 19104 USA. EM rwerner@mail.med.upenn.edu NR 35 TC 43 Z9 43 U1 1 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD AUG PY 2007 VL 22 IS 8 BP 1206 EP 1211 DI 10.1007/s11606-007-0230-4 PG 6 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 189SF UT WOS:000248008100024 PM 17516106 ER PT J AU Ruelaz, AR Diefenbach, P Simon, B Lanto, A Arterburn, D Shekelle, PG AF Ruelaz, Alicia R. Diefenbach, Pamela Simon, Barbara Lanto, Andy Arterburn, David Shekelle, Paul G. TI Perceived barriers to weight management in primary care - Perspectives of patients and providers (vol 22, pg 518, 2007) SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Correction C1 Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA. Greater Los Angeles Vet Adm Healthcare Syst, Los Angeles, CA USA. VA Hlth Serv Res & Dev Ctr ESPB, Los Angeles, CA USA. Grp Hlth Ctr Hlth Studies, Seattle, WA USA. RP Ruelaz, AR (reprint author), Cedars Sinai Med Ctr, MD-8700 Beverly Blvd,8th Floor,Romm 8631, Los Angeles, CA 90048 USA. NR 1 TC 2 Z9 2 U1 0 U2 1 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD AUG PY 2007 VL 22 IS 8 BP 1223 EP 1223 DI 10.1007/s11606-007-0236-y PG 1 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 189SF UT WOS:000248008100030 ER PT J AU Khan, M Ansari, MA Hoda, NM Giri, S Singh, AK Singh, I AF Khan, M. Ansari, M. A. Hoda, N. M. Giri, S. Singh, A. K. Singh, I. TI Neuroprotection in a rat model of experimental stroke by hydralazine via neutralization of lipid aldehydes SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 21st Biennial Meeting of the International-Society-for-Neurochemistry/38th Annual Meeting of the American-Society-for-Neurochemistry CY AUG 19-24, 2007 CL Cancun, MEXICO SP Int Sco Neurochem, Amer Soc Neurochem C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD AUG PY 2007 VL 102 SU 1 BP 39 EP 40 PG 2 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 203RL UT WOS:000248991600093 ER PT J AU Kauppinen, TM Alano, CC Chan, WY Gan, L Swanson, RA AF Kauppinen, T. M. Alano, C. C. Chan, W. Y. Gan, L. Swanson, R. A. TI ERK2 and minocycline influence neuronal death and microglial activation by regulating PARP-1 SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 21st Biennial Meeting of the International-Society-for-Neurochemistry/38th Annual Meeting of the American-Society-for-Neurochemistry CY AUG 19-24, 2007 CL Cancun, MEXICO SP Int Sco Neurochem, Amer Soc Neurochem C1 Univ Calif San Francisco, San Francisco, CA 94143 USA. San Francisco VA Med Ctr, San Francisco, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD AUG PY 2007 VL 102 SU 1 BP 86 EP 86 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 203RL UT WOS:000248991600201 ER PT J AU Khan, M Singh, J Singh, AV Singh, I AF Khan, M. Singh, J. Singh, A. V. Singh, I. TI Modulation of plasmalogen metabolism by lovastatin: Implications for cerebral adrenoleukodystrophy SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 21st Biennial Meeting of the International-Society-for-Neurochemistry/38th Annual Meeting of the American-Society-for-Neurochemistry CY AUG 19-24, 2007 CL Cancun, MEXICO SP Int Sco Neurochem, Amer Soc Neurochem C1 Med Univ S Carolina, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD AUG PY 2007 VL 102 SU 1 BP 147 EP 147 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 203RL UT WOS:000248991600353 ER PT J AU Lopez-Meraz, ML Niquet, J Wasterlain, CG AF Lopez-Meraz, M. L. Niquet, J. Wasterlain, C. G. TI Caspase-8 and caspase-3 may contribute to status epilepticus-induced neuronal necrosis in the immature brain SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 21st Biennial Meeting of the International-Society-for-Neurochemistry/38th Annual Meeting of the American-Society-for-Neurochemistry CY AUG 19-24, 2007 CL Cancun, MEXICO SP Int Sco Neurochem, Amer Soc Neurochem C1 Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD AUG PY 2007 VL 102 SU 1 BP 219 EP 219 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 203RL UT WOS:000248991600519 ER PT J AU Conklin, SM Runyan, CA Leonard, S Reddy, RD Yao, JK AF Conklin, S. M. Runyan, C. A. Leonard, S. Reddy, R. D. Yao, J. K. TI Abnormal polyunsaturated fatty acids in postmortem brains of patients with depression SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 21st Biennial Meeting of the International-Society-for-Neurochemistry/38th Annual Meeting of the American-Society-for-Neurochemistry CY AUG 19-24, 2007 CL Cancun, MEXICO SP Int Sco Neurochem, Amer Soc Neurochem C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Pittsburgh, PA USA. MIT, Cambridge, MA 02139 USA. Denver VA Med Ctr, Denver, CO USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD AUG PY 2007 VL 102 SU 1 BP 230 EP 230 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 203RL UT WOS:000248991600552 ER PT J AU Messamore, E Yao, JK AF Messamore, E. Yao, J. K. TI Niacin sensitivity and arachidonic acid in schizophrenia SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 21st Biennial Meeting of the International-Society-for-Neurochemistry/38th Annual Meeting of the American-Society-for-Neurochemistry CY AUG 19-24, 2007 CL Cancun, MEXICO SP Int Sco Neurochem, Amer Soc Neurochem C1 Portland VA Med Ctr, Portland, OR USA. VA Pittsburhg Healthcare Syst, Pittsburgh, PA USA. Univ Pittsburgh, Pittsburgh, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD AUG PY 2007 VL 102 SU 1 BP 270 EP 270 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 203RL UT WOS:000248991600647 ER PT J AU Vandenbark, AA Burrows, GG Offner, H Link, J AF Vandenbark, A. A. Burrows, G. G. Offner, H. Link, J. TI From EAE to MS clinical trial: DR2/MOG-35-55 recombinant T cell receptor ligand (RTL) treats relapse of EAE in DR2 transgenic mice SO JOURNAL OF NEUROCHEMISTRY LA English DT Meeting Abstract CT 21st Biennial Meeting of the International-Society-for-Neurochemistry/38th Annual Meeting of the American-Society-for-Neurochemistry CY AUG 19-24, 2007 CL Cancun, MEXICO SP Int Sco Neurochem, Amer Soc Neurochem C1 Portland VA Med Ctr, Portland, OR USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD AUG PY 2007 VL 102 SU 1 BP 290 EP 290 PG 1 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 203RL UT WOS:000248991600697 ER PT J AU Elder, GA Cho, JY English, DF Franciosi, S Schmeldler, J Sosa, MAG De Gasperi, R Fisher, EA Mathews, PM Haroutunian, V Buxbaum, JD AF Elder, Gregory A. Cho, Julie Y. English, Daniel F. Franciosi, Sonia Schmeldler, James Sosa, Miguel A. Gama De Gasperi, Rita Fisher, Edward A. Mathews, Paul M. Haroutunian, Vahram Buxbaum, Joseph D. TI Elevated plasma cholestrol does not affect brain A beta in mice lacking the low-density lipoprotein receptor SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE Alzheimer's disease; Apolipoprotein E; dietary cholesterol and fat; low-density lipoprotein receptor; null mutation ID TRANSGENIC MOUSE MODEL; DIET-INDUCED HYPERCHOLESTEROLEMIA; AMYLOID PRECURSOR PROTEIN; CENTRAL-NERVOUS-SYSTEM; ALZHEIMERS-DISEASE; APOLIPOPROTEIN-E; KNOCKOUT MICE; LEARNING-DEFICITS; PLAQUE-FORMATION; MESSENGER-RNA AB Epidemiological studies support an association between vascular risk factors, including hypercholesterolernia, and Alzheimer's disease (AD). Recently, there has been much interest in the possibility that hypercholesterolernia might directly promote P-amyloid (A beta) production. Indeed, in vitro studies have shown that increasing cellular cholesterol levels enhances AP production. However, studies in AD transgenic mouse models have not consistently found that elevated plasma cholesterol leads to increased AP production or deposition in vivo. In this study, we determined whether elevated peripheral cholesterol influences AP production in mice with a null mutation of the low-density lipoprotein receptor (LDLR). We show that dramatically elevated plasma cholesterol levels, whether induced by high cholesterol, high fat, or high fat/high cholesterol diets, did not affect either levels of brain AP40, A beta 42, or APP, or the A beta 42/40 or APP-CTF/APP ratios, nor substantially alter brain cholesterol levels. ApoE protein levels in brain were, however, elevated, in LDLR-/mice by post-transcriptional mechanisms. Collectively, these studies argue that plasma cholesterol levels do not normally regulate production of brain A beta. C1 CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Dept Neurosci, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Dept Genet & Genom Sci, New York, NY 10029 USA. CUNY Mt Sinai Sch Med, Dept Biomath Sci, New York, NY 10029 USA. Vet Affairs Med Ctr, James J Peters Dept, Res & Dev Serv, Bronx, NY USA. CUNY Mt Sinai Sch Med, Lab Mol Neuropsychiat, New York, NY 10029 USA. NYU, Sch Med, Dept Med, Leon H Charney Div,Marc & Ruti Vasc Biol Program, New York, NY USA. Nathan S Kline Inst Psychiat Res, Ctr Dementia Res, Orangeburg, NY 10962 USA. NYU, Sch Med, Dept Psychiat, New York, NY USA. RP Buxbaum, JD (reprint author), CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. EM joseph.buxbaum@mssm.edu FU NHLBI NIH HHS [HL084312]; NIA NIH HHS [AG010491, AG002219, AG017617] NR 58 TC 23 Z9 24 U1 0 U2 3 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD AUG PY 2007 VL 102 IS 4 BP 1220 EP 1231 DI 10.1111/j.1471-4159.2007.04614.x PG 12 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 202EF UT WOS:000248884100021 PM 17472705 ER PT J AU Goody, RJ Beckham, JD Rubtsova, K Tyler, KL AF Goody, Robin J. Beckham, J. David Rubtsova, Kira Tyler, Kenneth L. TI JAK-STAT signaling pathways are activated in the brain following reovirus infection SO JOURNAL OF NEUROVIROLOGY LA English DT Article DE apoptosis; Janus-activated kinase; reovirus; signal transducer and activator of transcription; viral encephalitis ID CENTRAL-NERVOUS-SYSTEM; EPIDERMAL-GROWTH-FACTOR; GENE-EXPRESSION; MONOCLONAL-ANTIBODIES; TARGETED DISRUPTION; INDUCED APOPTOSIS; INTERFERON-GAMMA; INJURY; TRANSCRIPTION; INHIBITION AB Reovirus infection provides a classic experimental model system for studying the pathogenesis of viral infections of the central nervous system (CNS), with apoptosis acting as the major mechanism of cell death. The authors have examined the role of signal transducer and activator of transcription (STAT)1, a component of Janus-activated kinase (JAK)-STAT signaling, a pathway implicated in antiviral responses and pathways regulating apoptosis, following reovirus infection. Infection of primary cortical neuron cultures with reovirus serotype 3 strain Abney (T3A) resulted in phosphorylation of STAT1 at sites critical for transcriptional activity. Activated STAT1 was also detected in the brain of neonatal mice following T3A infection, with a nuclear pattern of expression in areas of virus-induced injury. Activation of STAT proteins is typically mediated by JAKs. The authors observed JAK2 phosphorylation (Tyr 1007/1008) in brain lysates from T3A-infected mice. Inhibition of JAK activity with the inhibitor AG-490 blocked reovirus-induced STAT1 activation in neuronal cultures, indicating reovirus-induced 'TAT activation is JAK dependent. Pretreatment of neuronal cultures with antibody raised against interferon (IFN)-alpha/beta R2 inhibited T3A-induced STAT1 phosphorylation, whereas neither IFN-gamma or IFN-gamma R2 antibody pretreatment had any effect on T3A-induced STAT1 phosphorylation. Mice lacking the STAT1 gene demonstrated increased susceptibility to reovirus infection, with increased mortality and higher viral titers in the brain compared to wild-type animals. The results demonstrate activation of a type I IFN-mediated, JAK-dependent STAT signaling pathway following reovirus infection and suggest that STAT1 is a key component of host defense mechanisms against reovirus infection in the brain. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Immunol, Denver, CO USA. Univ Colorado, Hlth Sci Ctr, Dept Microbiol, Denver, CO USA. Denver Vet Affairs Med Ctr, Denver, CO USA. RP Tyler, KL (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol, 4200 E Ninth Ave, Denver, CO 80262 USA. EM Ken.Tyler@uchsc.edu OI Tyler, Kenneth/0000-0003-3294-5888 FU NINDS NIH HHS [R01 NS051403, R01 NS050138-04, R01 NS051403-03, 5R01NS050138, 1R01NS051403, R01 NS050138] NR 35 TC 21 Z9 22 U1 0 U2 0 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1355-0284 J9 J NEUROVIROL JI J. Neurovirol. PD AUG PY 2007 VL 13 IS 4 BP 373 EP 383 DI 10.1080/13550280701344983 PG 11 WC Neurosciences; Virology SC Neurosciences & Neurology; Virology GA 210AY UT WOS:000249430300009 PM 17849321 ER PT J AU Penrod, JD Cortez, T Luhrs, CA AF Penrod, Joan D. Cortez, Therese Luhrs, Carol A. TI Use of a report card to implement a network-based palliative care program SO JOURNAL OF PALLIATIVE MEDICINE LA English DT Article ID QUALITY AB Objective: To report on implementation of a Veterans Affairs (VA) network-wide, standardized, high-quality palliative care (PC) program using a Web-based PC Report Card for performance monitoring and improvement. Intervention: The PC director and coordinator and facility directors established interdisciplinary teams at five acute care and three nursing home sites. Teams were trained together and subsequently met quarterly for ongoing training. Additionally, the PC director and coordinator developed and implemented a Web-based PC Report Card on the network Intranet for PC coordinator to report performance data monthly to the PC teams. Results: The number of patients in the network who received PC consults more than doubled in the first 4 years of the PC program. The percentage of deaths with PC consultation prior to death increased from 23% in fiscal year (FY) 2002 to 57% in FY06. Over the same period, the average days between the initial PC consultation and patients' death across all sites increased from 23 days to 106 days. Comment: All the sites established PC teams and the number of consultations showed a sustained increase over baseline in 2002. All sites improved on the key process measures captured by the Report Card. C1 James J Peters Vet Affairs Med Ctr, Program Res Serious Mental & Phys Illness, Bronx, NY USA. Vet Affairs New York Healthcare Syst, Brooklyn, NY USA. RP Penrod, JD (reprint author), James J Peters Vet Affairs Med Ctr, Program Res Serious Mental & Phys Illness, Bronx, NY USA. EM joan.penrod@mssm.edu NR 5 TC 4 Z9 4 U1 1 U2 1 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1096-6218 J9 J PALLIAT MED JI J. Palliat. Med. PD AUG PY 2007 VL 10 IS 4 BP 858 EP 860 DI 10.1089/jpm.2007.0026 PG 3 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 207LD UT WOS:000249251700012 PM 17803403 ER PT J AU Abdel-Karim, IA Sammel, RB Prange, MA AF Abdel-Karim, Isam A. Sammel, Robert B. Prange, Mark A. TI Causes of death at autopsy in an inpatient hospice program SO JOURNAL OF PALLIATIVE MEDICINE LA English DT Article ID 3 MEDICAL ERAS AB Background: Although postmortem examination has been reported in a variety of settings and diseases, the medical literature only makes sparse mention of postmortem findings regarding the manner of death in terminally ill patients receiving palliative care. We sought to identify causes of death in an inpatient hospice program as determined by autopsy. Methods: A retrospective chart review of all deaths from January 1998 through June 2000 of the inpatient hospice unit at Audie L. Murphy Veterans Affairs Hospital in San Antonio, Texas, was conducted. Autopsies were routinely offered to survivors of all deceased patients during this period. Basic demographic and clinical characteristics were collected for all patients, and pathologic reports were reviewed. Results: Forty-eight autopsies were conducted out of 260 deaths in the unit (18%). Patients who had autopsies were similar to nonautopsied patients in age, gender, length of stay, presence of cancer and whether this cancer was treated or not. Nonhispanic white patients were more likely to receive an autopsy and African American patients were less likely to receive one (p = 0.027). Most deaths were directly or indirectly related to the primary diagnosis. Pneumonia was present in 79% of all patients (n = 38), and appeared to be the major cause of death in 44% of patients (n = 21). Other deaths were determined to be due to cancer's direct effects, sepsis, ischemic heart disease, hepatic or renal failure, obstructive uropathy, subdural hemorrhage, pulmonary embolism, hypercalcemia and endocarditis. Conclusion: Pneumonia is the most frequent cause of death in patients in this inpatient hospice program. C1 Univ Texas, Hlth Sci Ctr, Dept Med, Div Geriatr & Gerontol, San Antonio, TX 78284 USA. Univ Texas, Hlth Sci Ctr, Dept Family & Community Med, San Antonio, TX 78284 USA. S Texas Vet Affairs Hlth Care Syst, Ctr Geriatr Res Educ & Clin, San Antonio, TX USA. RP Abdel-Karim, IA (reprint author), Univ Texas, Hlth Sci Ctr, Dept Med, Div Geriatr & Gerontol, San Antonio, TX 78284 USA. EM isamali@yahoo.com NR 14 TC 10 Z9 10 U1 0 U2 1 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1096-6218 J9 J PALLIAT MED JI J. Palliat. Med. PD AUG PY 2007 VL 10 IS 4 BP 894 EP 898 DI 10.1089/jpm.2006.0240 PG 5 WC Health Care Sciences & Services SC Health Care Sciences & Services GA 207LD UT WOS:000249251700019 PM 17803410 ER PT J AU Strack, S Millon, T AF Strack, Stephen Millon, Theodore TI Contributions to the dimensional assessment of personality disorders using million's model and the million clinical multiaxial inventory (MCMI-III) SO JOURNAL OF PERSONALITY ASSESSMENT LA English DT Article ID EMPIRICAL-EVALUATION; CONVERGENT VALIDITY; SCALES; POLARITIES AB For over 35 years, Millions (1996) model of personality and the Millon Clinical Multiaxial Inventory (Millon, 1977, 1987, 2006) have been useful resources for clinicians to understand and assess personality disorders (PDs) and clinical syndromes in psychiatric patients. In this article, we highlight significant features of the model and test that have proved valuable to personologists in their quest for a more satisfactory taxonomy of PDs based on continuously distributed traits. We also describe Millon's (1996) prototypal domain approach to personality that combines dimensional and categorical elements for the description of PDs and their normal counterparts. C1 US Dept Vet Affairs, Ctr Ambulatory Care, Los Angeles, CA USA. Inst Adv Studies Personal & Psychopathol, Coral Gables, FL USA. RP Strack, S (reprint author), VA LAACC, Psychol Serv 116B, 351 E Temple St, Los Angeles, CA USA. EM snstrack@aol.com NR 64 TC 22 Z9 29 U1 1 U2 10 PU LAWRENCE ERLBAUM ASSOC INC-TAYLOR & FRANCIS PI PHILADELPHIA PA 325 CHESTNUT STREET, STE 800, PHILADELPHIA, PA 19106 USA SN 0022-3891 J9 J PERS ASSESS JI J. Pers. Assess. PD AUG PY 2007 VL 89 IS 1 BP 56 EP 69 PG 14 WC Psychology, Clinical; Psychology, Social SC Psychology GA 198BZ UT WOS:000248603300006 PM 17604534 ER PT J AU Yehuda, R Golier, JA Tischler, L Harvey, PD Newmark, R Yang, RK Buchsbaum, MS AF Yehuda, Rachel Golier, Julia A. Tischler, Lisa Harvey, Philip D. Newmark, Randall Yang, Ren Kui Buchsbaum, Monte S. TI Hippocampal volume in aging combat veterans with and without post-traumatic stress disorder: Relation to risk and resilience factors SO JOURNAL OF PSYCHIATRIC RESEARCH LA English DT Article DE hippocampus; memory performance; cortisol; glucocorticoid receptors; post-traumatic stress disorder; risk; resilience ID VEHICLE ACCIDENT VICTIMS; URINARY CORTISOL-LEVELS; CHILDHOOD SEXUAL-ABUSE; HOLOCAUST SURVIVORS; MEMORY PERFORMANCE; N-ACETYLASPARTATE; PYRAMIDAL NEURONS; GENE-EXPRESSION; PTSD SYMPTOMS; TRAUMA AB Objective: To examine whether there are post-traumatic stress disorder (PTSD) related differences in hippocampal volume in middle-aged and elderly veterans and to examine the relationship of neuroendocrine activity, memory performance, and measures of risk and resilience for PTSD to hippocampal volume in this cohort. Methods: Seventeen veterans with chronic PTSD and 16 veterans without chronic PTSD received an MRI scan followed by neuroendocrine assessment (24-h urinary cortisol excretion and the lysozyme IC(50-DEX), a measure of glucocorticoid receptor (GR) responsiveness), and cognitive testing. Results: Veterans with PTSD did not differ from those without PTSD in hippocampal volume, but they did show significantly lower urinary cortisol levels, and poorer memory performance on the Wechsler Logical Memory test and Digit Span test. Smaller left hippocampal volumes were observed in veterans who developed PTSD in response to their first reported traumatic exposure, compared to veterans who had first experienced a traumatic event to which they did not develop PTSD, prior to experiencing a subsequent event that led to PTSD. In contrast, the two neuroendocrine measures were associated with risk factors related to early trauma exposure. Conclusion: Although hippocampal volume was not found to differ between subjects with and without PTSD, smaller hippocampal volumes in PTSD may be associated with specific risk and resilience factors. These may be distinct from vulnerability markers associated with increased responsiveness to glucocorticoids and/or other neuroendocrine measures that have been observed in combat-related PTSD. Published by Elsevier Ltd. C1 Mt Sinai Sch Med, Dept Psychiat, Traumat Stress Studies Program, New York, NY USA. Bronx Vet Affairs Med Ctr, New York, NY USA. RP Yehuda, R (reprint author), Mt Sinai Sch Med, Dept Psychiat, Traumat Stress Studies Program, New York, NY USA. EM Rachel.Yehuda@med.va.gov FU NCRR NIH HHS [RR00071] NR 72 TC 47 Z9 49 U1 4 U2 14 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0022-3956 J9 J PSYCHIATR RES JI J. Psychiatr. Res. PD AUG PY 2007 VL 41 IS 5 BP 435 EP 445 DI 10.1016/j.jpsychires.2005.12.002 PG 11 WC Psychiatry SC Psychiatry GA 141MW UT WOS:000244583900008 PM 16445942 ER PT J AU Schumacher, HR AF Schumacher, H. Ralph, Jr. TI Adel G. Fam MD, FRCPC, MACR October 14, 1936-April 16, 2007 - In tribute SO JOURNAL OF RHEUMATOLOGY LA English DT Biographical-Item C1 Univ Penn, Sch Med, Vet Affairs Med Ctr, Div Rheumatol, Philadelphia, PA 19104 USA. RP Schumacher, HR (reprint author), Univ Penn, Sch Med, Vet Affairs Med Ctr, Div Rheumatol, Philadelphia, PA 19104 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU J RHEUMATOL PUBL CO PI TORONTO PA 920 YONGE ST, SUITE 115, TORONTO, ONTARIO M4W 3C7, CANADA SN 0315-162X J9 J RHEUMATOL JI J. Rheumatol. PD AUG PY 2007 VL 34 IS 8 BP 1782 EP 1782 PG 1 WC Rheumatology SC Rheumatology GA 200AL UT WOS:000248736200027 ER PT J AU Eberwein, CA Pratt, SR McNeil, MR Fossett, TRD Szuminsky, NJ Doyle, PJ AF Eberwein, Cynthia A. Pratt, Sheila R. McNeil, Malcolm R. Fossett, Tepanta R. D. Szuminsky, Neil J. Doyle, Patrick J. TI Auditory performance characteristics of the computerized revised token test (CRTT) SO JOURNAL OF SPEECH LANGUAGE AND HEARING RESEARCH LA English DT Article DE language comprehension; auditory processing; auditory comprehension; auditory processing disorder ID SPEECH-RECOGNITION PERFORMANCE; FREQUENCY COMPRESSION; ELDERLY LISTENERS; WORD-RECOGNITION; COMPREHENSION; HEARING; CHILDREN; TIME; INTELLIGIBILITY; ADULTS AB Purpose: To assess the Computerized Revised Token Test (CRTT) performance of individuals with normal hearing under several intensity conditions and under several spectral and temporal perturbation conditions. Method: Sixty normal-hearing listeners were randomly assigned to 1 of 3 groups. Group 1 provided performance-intensity information about CRTT performance using uncompressed acoustic stimuli. Groups 2 and 3 completed the CRTT using temporally and spectrally compressed and expanded stimuli. CRTT performance functions were plotted for each group. Results: Group 1 required minimal audibility to perform maximally on this task. As expected, Groups 2 and 3 showed significant differences across subtests, regardless of distortion condition. Mean differences in performance between successive conditions for Group 2 increased beyond 40% time compressed. There was 1 significant difference for the time-expanded condition. There were no differences across frequency compressed and expanded conditions. Conclusion: Young listeners require limited signal gain on the CRTT to achieve maximum performance. Time and frequency compression and expansion results were consistent with previous findings with varying types of speech stimuli. The results have implications for administration and interpretation of the CRTT administered to persons from other populations and will help in the development of a normative database for the CRTT. C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15206 USA. Univ Pittsburgh, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA 15206 USA. Necess Consulting, Mars, PA USA. RP Eberwein, CA (reprint author), VA Pittsburgh Healthcare Syst, 7180 Highland Dr, Pittsburgh, PA 15206 USA. RI Pratt, Sheila/H-7139-2013 NR 46 TC 2 Z9 2 U1 0 U2 2 PU AMER SPEECH-LANGUAGE-HEARING ASSOC PI ROCKVILLE PA 10801 ROCKVILLE PIKE, ROCKVILLE, MD 20852-3279 USA SN 1092-4388 J9 J SPEECH LANG HEAR R JI J. Speech Lang. Hear. Res. PD AUG PY 2007 VL 50 IS 4 BP 865 EP 877 DI 10.1044/1092-4388(2007/061) PG 13 WC Audiology & Speech-Language Pathology; Linguistics; Rehabilitation SC Audiology & Speech-Language Pathology; Linguistics; Rehabilitation GA 200AQ UT WOS:000248736700006 PM 17675592 ER PT J AU Li, G Rhew, IC Shofer, JB Kukull, WA Breitner, JCS Peskind, E Bowen, JD McCormick, W Teri, L Crane, PK Larson, EB AF Li, Ge Rhew, Isaac C. Shofer, Jane B. Kukull, Walter A. Breitner, John C. S. Peskind, Elaine Bowen, James D. McCormick, Wayne Teri, Linda Crane, Paul K. Larson, Eric B. TI Age-varying association between blood pressure and risk of dementia in those aged 65 and older: A community-based prospective cohort study SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE blood pressure; hypertension; dementia; Alzheimer's disease ID WHITE-MATTER LESIONS; ALZHEIMERS-DISEASE; VASCULAR DEMENTIA; COGNITIVE DECLINE; FOLLOW-UP; APOLIPOPROTEIN-E; HYPOPERFUSION; INDIVIDUALS; PREVALENCE; ROTTERDAM AB Objectives: To assess variation in the association between blood pressure (BP) and risk for dementia across a spectrum of older ages and to examine BP changes before dementia onset. Design: Prospective cohort study. Setting: A large health maintenance organization in Seattle, Washington. Participants: A cohort of 2,356 members of a large health maintenance organization aged 65 and older who were initially without dementia. Measurements: Dementia diagnosis was assessed biennially, and systolic (SBP) and diastolic BP (DBP) were measured at baseline and at four follow-up assessments. Cox proportional hazards models were used to estimate hazard ratios (HRs) for dementia and Alzheimer's disease (AD) associated with baseline BP in different age groups. Results: Within the youngest age group (65-74 at enrollment) a greater risk for dementia was found in participants with high SBP (>= 160 mmHg) (hazard ratio (HR) = 1.60, 95% confidence interval (CI) = 1.01-2.55) or borderline-high DBP (80-89 mmHg) (HR = 1.59, 95% CI = 1.07-2.35) than for those with normal BP (SBP < 140 mmHg and DBP < 80 mmHg). The dementia risk associated with SBP declined with increasing age (SBP-by-age interaction, P = .01). SBP declined similarly with aging in subjects who developed dementia and those who did not. Thus, in this sample, the association between SBP and dementia risk was not dependent on when BP was measured in relation to onset of dementia. Conclusion: High SBP was associated with greater risk of dementia in the young elderly (< 75) but not in older subjects. Adequate control of hypertension in early old age may reduce the risk for dementia. C1 VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Mental Illness Res & Educ Clin Ctr, Seattle, WA 98108 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Dept Neurol, Seattle, WA 98195 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept psychosocial & Community Hlth, Seattle, WA 98195 USA. Grp Hlth Cooperat Puget Sound, Ctr Hlth Studies, Seattle, WA 98121 USA. RP Li, G (reprint author), VA Puget Sound Hlth Care Syst, Ctr Geriatr Res Educ & Clin, 1660 S Columbian Way,S-116,6 East, Seattle, WA 98108 USA. EM gli@u.washington.edu RI Crane, Paul/C-8623-2014 OI Kukull, Walter/0000-0001-8761-9014; Crane, Paul/0000-0003-4278-7465 FU NIA NIH HHS [AG06781, AG20020] NR 43 TC 50 Z9 52 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD AUG PY 2007 VL 55 IS 8 BP 1161 EP 1167 DI 10.1111/j.1532-5415.2007.01233.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 197HE UT WOS:000248544400001 PM 17661953 ER PT J AU Bates-Jensen, BM McCreath, HE Kono, A Apeles, NCR Alessi, C AF Bates-Jensen, Barbara M. McCreath, Heatber E. Kono, Ayuml Apeles, Neil Christopher R. Alessi, Cathy TI Subepidermal moisture predicts erythema and stage 1 pressure ulcers in nursing home residents: A pilot study SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE erythema; Stage 1 pressure ulcers; moisture ID BRADEN SCALE; SORE RISK; SKIN; MULTISITE; CARE AB Objectives: To examine the relationship between a measure of subepidermal moisture (SEM) and visual skin assessment (VSA) of erythema and Stage 1 pressure ulcers (PUs) performed a week later in nursing home (NH) residents. Design: Descriptive, cohort study. Setting: Two NHs. Participants: Thirty-five residents. Methods: Concurrent VSAs and SEM readings were obtained at the sacrum, right and left trochanters, buttocks, and ischial tuberosities weekly for 52 weeks. SEM was measured using a handheld dermal phase meter, with higher readings indicating greater SEM (range 0-999 dermal phase units [DPUs]). VSA was rated as normal, erythema/Stage 1 PU, or Stage 2+PU. SEM was modeled as a predictor of VSA of erythema and PUs 1 week later (controlling for clustering), with concurrent moisture, Braden Scale PU risk status, anatomic site, and ethnicity as covariates. Results: Participants had a mean age of 84.7, 83% were female, and 80% were non-Hispanic white. SEM measures were lowest for normal skin (97 +/- 122 DPU), higher for erythema/Stage 1 PUs (192 188 DPU), and highest for Stage 2+PUs (569 +/- 320 DPU) across all sites (all P<.001). SEM was responsive to changes in VSA, and higher SEM predicted greater likelihood of erythema/Stage 1 PU the next week (odds ratio = 1.26 for every 100-DPU increase in SEM, P =.04). Conclusion: SEM measures are associated with concurrent erythema and PUs and future (1 week later) development of erythema/Stage 1 PUs. SEM may assist in predicting early PU damage, allowing for earlier intervention to prevent skin damage. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, Sepulveda, CA 91343 USA. Osaka City Univ, Osaka 558, Japan. Valley Presbyterian Hosp, Van Nuys, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Sch Nursing, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Div Geriatr, Los Angeles, CA USA. RP Bates-Jensen, BM (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, Ctr Geriatr Res Educ & Clin, 16111 Plummer St,11E, Sepulveda, CA 91343 USA. EM bbatesjensen@sonnet.ucla.edu NR 32 TC 17 Z9 17 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD AUG PY 2007 VL 55 IS 8 BP 1199 EP 1205 DI 10.1111/j.1532-5415.2007.01261.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 197HE UT WOS:000248544400006 PM 17661958 ER PT J AU Chodosh, J Mittman, BS Connor, KI Vassar, SD Lee, ML DeMonte, RW Ganiats, TG Heikoff, LE Rubenstein, LZ Della Penna, RD Vickrey, BG AF Chodosh, Joshua Mittman, Brian S. Connor, Karen I. Vassar, Stefanie D. Lee, Martin L. DeMonte, Robert W. Ganiats, Theodore G. Heikoff, Lisa E. Rubenstein, Laurence Z. Della Penna, Richard D. Vickrey, Barbara G. TI Caring for patients with dementia: How good is the quality of care? results from three health systems SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE dementia; quality of care; comorbidity; caregiver ID MANAGING ALZHEIMERS-DISEASE; RANDOMIZED CONTROLLED-TRIAL; OLDER PATIENTS; DEPRESSION; GUIDELINES; OUTCOMES; WELL; ASSOCIATION; POPULATION; VALIDATION AB Objectives: To describe the quality of dementia care within one U.S. metropolitan area and to investigate associations between variations in quality and patient, caregiver, and health system characteristics. Design: Observational, cross-sectional. Setting and Participants: Three hundred eighty-seven patient-caregiver pairs from three healthcare organizations Measurements: Using caregiver surveys and medical record abstraction to assess 18 dementia care processes drawn from existing guidelines, the proportion adherent to each care process was calculated, as well as mean percentages of adherence aggregated within four care dimensions: assessment (6 processes), treatment (6 processes), education and support (3 processes), and safety (3 processes). For each dimension, associations between adherence and patient, caregiver, and health system characteristics were investigated using multivariable models. Results: Adherence ranged from 9% to 79% for the 18 individual care processes; 11 processes had less than 40% adherence. Mean percentage adherence across the four care dimensions was 37% for assessment, 33% for treatment, 52% for education and support, and 21% for safety. Higher comorbidity was associated with greater adherence across all four dimensions, whereas greater caregiver knowledge (in particular, one item) was associated with higher care quality in three of four care dimensions. For selected dimensions, greater adherence was also associated with greater dementia severity and with more geriatrics or neurologist visits. Conclusion: In general, dementia care quality has considerable room for improvement. Although greater comorbidity and dementia severity were associated with better quality, caregiver knowledge was the most consistent caregiver characteristic associated with better adherence. These findings offer opportunities for targeting low quality and suggest potential focused interventions. C1 GRECC, Dept Vet Affairs, Los Angeles, CA 90073 USA. Greater Los Angeles Hlth Serv Res & Dev Serv Ctr, Dept Vet Affairs, Sepulveda, CA USA. Multicampus Program Geriatr Med & Gerontol, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Div Geriatr, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Neurol, Los Angeles, CA USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Biostat, Los Angeles, CA USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif San Diego, Dept Family & Prevent Med, San Diego, CA 92103 USA. Scripps Clin, San Diego, CA 92103 USA. Kaiser Permanente Med Ctr, San Diego, CA USA. Permanente Federation, Care Management Inst, Oakland, CA USA. RP Chodosh, J (reprint author), GRECC, Dept Vet Affairs, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jChodosh@mednet.ucla.edu OI Mittman, Brian/0000-0003-3589-9178; Penna, Maria Pietronilla/0000-0002-0982-3893; Chodosh, Joshua/0000-0001-7784-4306 NR 43 TC 37 Z9 37 U1 3 U2 8 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD AUG PY 2007 VL 55 IS 8 BP 1260 EP 1268 DI 10.1111/j.1532-5415.2007.01249.x PG 9 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 197HE UT WOS:000248544400015 PM 17661967 ER PT J AU Keith, RL Jackson, MK Meisinger, V Miller, YE Franklin, WA Hirsch, F Kittelson, J Merrick, D Kelly, K Bunn, PA AF Keith, Robert L. Jackson, Mary K. Meisinger, Vicki Miller, York E. Franklin, Wilbur A. Hirsch, Fred Kittelson, John Merrick, Daniel Kelly, Karen Bunn, Paul A. TI Update on the use of oral iloprost for the chemoprevention of lung cancer SO JOURNAL OF THORACIC ONCOLOGY LA English DT Meeting Abstract C1 UCDHSC, Denver VA Med Ctr, Denver, CO USA. Colorado SPORE Lung Canc, Denver, CO USA. Univ Kansas, Kansas City, KS USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1556-0864 J9 J THORAC ONCOL JI J. Thorac. Oncol. PD AUG PY 2007 VL 2 IS 8 SU S BP S330 EP S331 DI 10.1097/01.JTO.0000283135.30305.c8 PG 2 WC Oncology; Respiratory System SC Oncology; Respiratory System GA 199IE UT WOS:000248688600221 ER PT J AU Merrick, DT Buyers, E Miller, YE Keith, RL Kennedy, T Franklin, WA AF Merrick, Daniel T. Buyers, Eliazbeth Miller, York E. Keith, Robert L. Kennedy, Timothy Franklin, Wilbur A. TI Angiogenesis in bronchial dysplasia and angiogenic squamous dysplasia is associated with the development of immature vasculature SO JOURNAL OF THORACIC ONCOLOGY LA English DT Meeting Abstract C1 Univ Colorado, HSC, Denver VAMC, Dept Pathol, Denver, CO 80202 USA. Univ Colorado, Denver VAMC, Dept Pulm Med, Denver, CO 80202 USA. St Lukes Hosp, Dept Pulm Med, Denver, CO USA. Univ Colorado, HSC, Dept Pathol, Denver, CO 80202 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1556-0864 J9 J THORAC ONCOL JI J. Thorac. Oncol. PD AUG PY 2007 VL 2 IS 8 SU S BP S442 EP S442 DI 10.1097/01.JTO.0000283360.45365.fe PG 1 WC Oncology; Respiratory System SC Oncology; Respiratory System GA 199IE UT WOS:000248688600444 ER PT J AU Merrick, DT Franklin, WA Keith, RL Hirsch, FR Kennedy, T Braudrick, S Miller, YE AF Merrick, Daniel T. Franklin, Wilbur A. Keith, Robert L. Hirsch, Fred R. Kennedy, Timothy Braudrick, Sarah Miller, York E. TI Outcomes in bronchial dysplasia: persistence of lesions and associations with development of invasive non-small cell lung cancer SO JOURNAL OF THORACIC ONCOLOGY LA English DT Meeting Abstract C1 Univ Colorado, Denver VAMC, Dept Pathol, Denver, CO USA. Univ Colorado HSC, Dept Pulm Med, Denver, CO USA. Univ Colorado, Dept Med, Denver, CO USA. St Lukes Hosp, Dept Pulm Med, Denver, CO USA. Univ Colorado, Canc Ctr, Denver, CO 80309 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1556-0864 J9 J THORAC ONCOL JI J. Thorac. Oncol. PD AUG PY 2007 VL 2 IS 8 SU S BP S331 EP S331 DI 10.1097/01.JTO.0000283136.37929.6b PG 1 WC Oncology; Respiratory System SC Oncology; Respiratory System GA 199IE UT WOS:000248688600222 ER PT J AU Wagner, AW Rizvi, SL Harried, MS AF Wagner, Amy W. Rizvi, Shireen L. Harried, Melanie S. TI Applications of dialectical Behavior therapy to the treatment of complex trauma-related problems: When one case formulation does not fit all SO JOURNAL OF TRAUMATIC STRESS LA English DT Article; Proceedings Paper CT 22nd Annual Meeting of the International-Society-for-Traumatic-Stress-Studies CY NOV, 2006 CL Los Angeles, CA SP Int Soc Traumat Stress Studies ID POSTTRAUMATIC-STRESS-DISORDER; BORDERLINE PERSONALITY-DISORDER; FEMALE ASSAULT VICTIMS; CHILDHOOD SEXUAL-ABUSE; RANDOMIZED-TRIAL; EXPERIENCES; SURVIVORS; EXPOSURE AB In this article, the authors take the perspective that effective treatment of complex trauma-related problems requires, in the absence of empirically supported treatments, a reliance on theory, idiographic assessment, and empirically supported principles of change. Dialectical behavior therapy (DBT; M. M Linehan, 1993) is used to demonstrate the applicability of this approach to the treatment of multiproblem, heterogeneous populations in general Two case studies are presented that highlight the utility of DBT principles to complex trauma-related problems specifically. C1 Portland VA Med Ctr, Portland, OR 97207 USA. New Sch Social Res, Dept Psychol, New York, NY 10011 USA. Univ Washington, Dept Psychol, Seattle, WA 98195 USA. RP Wagner, AW (reprint author), Portland VA Med Ctr, Box 1035, Portland, OR 97207 USA. EM amy.wagner@va.gov NR 23 TC 24 Z9 25 U1 2 U2 15 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0894-9867 J9 J TRAUMA STRESS JI J. Trauma Stress PD AUG PY 2007 VL 20 IS 4 BP 391 EP 400 DI 10.1002/jts.20268 PG 10 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 206KX UT WOS:000249183400003 PM 17721961 ER PT J AU Yehuda, R Flory, JD AF Yehuda, Rachel Flory, Janine D. TI Differentiating biological correlates of risk, PTSD, and resilience following trauma exposure SO JOURNAL OF TRAUMATIC STRESS LA English DT Article; Proceedings Paper CT 22nd Annual Meeting of the International-Society-for-Traumatic-Stress-Studies CY NOV, 2006 CL Los Angeles, CA SP Int Soc Traumat Stress Studies ID POSTTRAUMATIC-STRESS-DISORDER; PERIPHERAL MONONUCLEAR LEUKOCYTES; BRAIN; VULNERABILITY; SENSITIVITY; CORTISOL; RECOVERY; SYSTEM; FUTURE; DHEA AB Risk and resilience factors presumably explain the individual differences in the response to adversity. However little is known about how such factors are related. Risk and protective factors may reflect a quantitative difference along a single dimension (e.g., low IQ might be associated with risk and high IQ with resilience); however they may also refer to orthogonal constructs that interact and/or moderate stress effects to increase or diminish the probability of developing trauma-related psychopathology (e.g., good coping could offset low IQ). The authors illustrate experimental strategies for distinguishing between these possibilities for any putative measure relating to symptom development, using a database that includes published and unpublished psychological and biological variables from a relatively homogenous cohort of exposed and nonexposed veterans. C1 Bronx Vet Adm Med Ctr, Dept Psychiat, Bronx, NY USA. CUNY Mt Sinai Sch Med, Dept Psychiat, New York, NY 10029 USA. CUNY, Queens Coll, Dept Psychol, Flushing, NY USA. RP Yehuda, R (reprint author), Bronx Vet Affairs Med Ctr, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM rachel.yehuda@va.gov FU NIMH NIH HHS [R01 MH064675-02, R01 MH64104-01] NR 36 TC 47 Z9 47 U1 3 U2 9 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0894-9867 J9 J TRAUMA STRESS JI J. Trauma Stress PD AUG PY 2007 VL 20 IS 4 BP 435 EP 447 DI 10.1002/jts.20260 PG 13 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 206KX UT WOS:000249183400007 PM 17721957 ER PT J AU Schlenger, WE Kulka, RA Fairbank, JA Hough, RL Jordan, BK Marmar, CR Weiss, DS AF Schlenger, William E. Kulka, Richard A. Fairbank, John A. Hough, Richard L. Jordan, B. Kathleen Marmar, Charles R. Weiss, Daniel S. TI The psychological risks of Vietnam: The NVVRS perspective SO JOURNAL OF TRAUMATIC STRESS LA English DT Article; Proceedings Paper CT 22nd Annual Meeting of the International-Society-for-Traumatic-Stress-Studies CY NOV, 2006 CL Los Angeles, CA SP Int Soc Traumat Stress Studies ID POSTTRAUMATIC-STRESS-DISORDER; DIAGNOSTIC INTERVIEW SCHEDULE; PSYCHIATRIC-DIAGNOSIS; WAR; METAANALYSIS; RELIABILITY; VETERANS; VALIDITY; EXPOSURE; TRAUMA AB In recent years, controversy concerning the psychological consequences of service in the Vietnam war has rearisen. In this article, the Co-Principal Investigators of the National Vietnam Veterans Readjustment Study (NVVRS) provide a perspective on new findings reported by B. P Dohrenwend et al. (2006) that addresses criticisms of the NVVRS PTSD (posttraumatic stress disorder) prevalence findings, and on a perspective that was provided by R. J. McNally (2006) in an accompanying commentary. They find that Dohrenwend et al. study, which evaluated empirically a variety of the critics' alternative explanations and found little support for any of them, represents a landmark contribution to the trauma field. However, they found that McNally's commentary misrepresented the history and context of the NVVRS, and then misinterpreted Dohrenwend et al. findings and their importance. C1 Abt Associates Inc, Durham, NC 27703 USA. Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC USA. Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC USA. N Carolina State Univ, Dept Psychol, Raleigh, NC 27695 USA. Univ New Mexico, Dept Psychiat, Dept Family & Community Med, Albuquerque, NM 87131 USA. Univ Calif San Diego, Dept Psychiat, San Diego, CA 92103 USA. RTI Int, Res Triangle Pk, NC USA. San Francisco VA Med Ctr, San Francisco, CA USA. RP Schlenger, WE (reprint author), Abt Associates Inc, 4620 Creekstone Dr,Suite 190, Durham, NC 27703 USA. EM bill_schlenger@abtassoc.com RI Fairbank, John/F-8972-2013 OI Fairbank, John/0000-0003-2604-7256 NR 34 TC 9 Z9 9 U1 0 U2 1 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0894-9867 J9 J TRAUMA STRESS JI J. Trauma Stress PD AUG PY 2007 VL 20 IS 4 BP 467 EP 479 DI 10.1002/jts.20264 PG 13 WC Psychology, Clinical; Psychiatry SC Psychology; Psychiatry GA 206KX UT WOS:000249183400009 PM 17721970 ER PT J AU Saha, S Solotaroff, R Oster, A Bindman, AB AF Saha, Somnath Solotaroff, Rachel Oster, Ady Bindman, Andrew B. TI Are preventable hospitalizations sensitive to changes in access to primary care? The case of the Oregon Health Plan SO MEDICAL CARE LA English DT Article DE preventable hospitalizations; access to care; Medicaid ID UNINSURED PREGNANT-WOMEN; SOCIOECONOMIC-STATUS; MANAGED CARE; IMPACT; MASSACHUSETTS; INSURANCE; PROVIDER; COVERAGE; STATES; RATES AB Objective: To examine whether preventable hospitalization (PH) rates are sensitive to the impact of policies aimed at improving access, such as the Oregon Health Plan (OHP), which expanded Medicaid coverage to all adults with incomes under the federal poverty level. Study Design: We conducted a retrospective, time series analysis of PH rates in Oregon from 1990 to 2000. We calculated hospitalization rates for ambulatory-care sensitive conditions for the Medicaid + uninsured population and compared average annual rates from 1990 to 1993 (pre-OHP implementation) to those from 1995 to 2000 (post-OHP implementation). We compared changes in PH rates over time in the Medicaid + uninsured group to changes in the nonMedicaid insured population. We standardized rates by age and sex and used logistic regression models to compare rates. Results: Contrary to our hypothesis, annual PH rates in the Medicaid + uninsured population increased after the eligibility expansion, from an average of 46.1 to 54.9 per 10,000 persons. This rise was significant compared with the non-Medicaid insured population, who experienced a slight decline in annual PH rates, from 26.9 to 26.1 per 10,000 (P < 0.001, after adjusting for age, sex, and rates of unpreventable hospitalizations). The increase in overall PH rates for the Medicaid + uninsured population can be explained by an increase in PH rates for the newly insured group. Conclusions: Our results suggest that PH rates may vary not only with access to primary care (inversely) but also with access to hospital care (directly). The use of PH rates as a marker of health care access should take into account these dual influences. Limita tions in available data may also contribute to perceived variation in PH rates unrelated to health care access. C1 Oregon Hlth & Sci Univ, Portland Vet Affairs Med Ctr, Dept Med, Gen Internal Med Sect, Portland, OR 97207 USA. Charles B Wang Commnity Hlth Ctr, New York, NY USA. Univ Calif San Francisco, Dept Med, San Francisco Gen Hosp, Div Gen Internal Med, San Francisco, CA 94143 USA. RP Saha, S (reprint author), Oregon Hlth & Sci Univ, Portland Vet Affairs Med Ctr, Dept Med, Gen Internal Med Sect, P3 HSR&D,3710 SW US Vet Hosp Rd, Portland, OR 97207 USA. EM sahas@ohsu.edu NR 30 TC 32 Z9 32 U1 1 U2 9 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0025-7079 J9 MED CARE JI Med. Care PD AUG PY 2007 VL 45 IS 8 BP 712 EP 719 DI 10.1097/MLR.0b013e318053717c PG 8 WC Health Care Sciences & Services; Health Policy & Services; Public, Environmental & Occupational Health SC Health Care Sciences & Services; Public, Environmental & Occupational Health GA 197BZ UT WOS:000248529700004 PM 17667304 ER PT J AU Swanson, KA Bastani, R Rubenstein, LV Meredith, LS Ford, DE AF Swanson, Karen A. Bastani, Roshan Rubenstein, Lisa V. Meredith, Lisa S. Ford, Daniel E. TI Effect of mental health care and shared decision making on patient satisfaction in a community sample of patients with depression SO MEDICAL CARE RESEARCH AND REVIEW LA English DT Article DE patient satisfaction; quality of care; gender; shared decision making ID MANAGED CARE; MEDICAL-CARE; QUALITY; GENDER; WOMEN; COMMUNICATION; OUTCOMES AB This study sought to understand if shared decision making and/or receipt of mental health care was associated with patient satisfaction for patients with depression and to determine whether gender modified this relationship. The data are from the Quality Improvement for Depression study, a national collaborative study of 1,481 patients diagnosed with major depression in managed care settings. The cross-sectional analyses were performed using multiple logistic regression on a sample of 1,317 patients who answered both the baseline and month six questionnaires. Shared decision making and receipt of mental health care were both positively associated with patient satisfaction. Gender was not a moderator of this relationship. Health plans may be able to improve patient satisfaction levels by teaching physicians the importance of shared decision making. Contrary to expectations, patient gender made no difference in the effects of quality of care on patient satisfaction. C1 Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. Vet Adm Greater Los Angeles, Ctr Study Hlth Care Provider Behav, Los Angeles, CA USA. RAND Corp, Santa Monica, CA 90406 USA. Johns Hopkins Univ, Sch Med, Baltimore, MD 21218 USA. RP Swanson, KA (reprint author), Los Angeles Cty Dept Hlth Serv, Off Ambulatory Care, 313 N Figueroa St,Rm 704, Los Angeles, CA 90012 USA. EM kswanson@ladhs.org FU AHRQ HHS [R03 HS11407-01] NR 39 TC 42 Z9 44 U1 0 U2 5 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1077-5587 J9 MED CARE RES REV JI Med. Care Res. Rev. PD AUG PY 2007 VL 64 IS 4 BP 416 EP 430 DI 10.1177/1077558707299479 PG 15 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 194WE UT WOS:000248373700004 PM 17684110 ER PT J AU Pumbwe, L Skilbeck, CA Nakano, V Avila-Campos, MJ Piazza, RMF Wexler, HM AF Pumbwe, Lilian Skilbeck, Christopher A. Nakano, Viviane Avila-Campos, Mario J. Piazza, Roxane M. F. Wexler, Hannah M. TI Bile salts enhance bacterial co-aggregation, bacterial-intestinal epithelial cell adhesion, biofilm formation and antimicrobial resistance of Bacteroides fragilis SO MICROBIAL PATHOGENESIS LA English DT Article DE colonization; membrane; signaling; stress; tolerance ID ESCHERICHIA-COLI; VIBRIO-CHOLERAE; SALMONELLA-TYPHIMURIUM; ELECTRON MICROSCOPY; ANAEROBIC-BACTERIA; PROTEOMIC ANALYSIS; DNA INVERSIONS; EFFLUX SYSTEM; EXPRESSION; IDENTIFICATION AB Bacteroides fragilis is the most common anaerobic bacterium isolated from human intestinal tract infections. Before B. fragilis interacts with the intestinal epithelial cells, it is exposed to bile salts at physiological concentrations of 0.1-1.3%. The aim of this study was to determine how pre-treatment with bile salts affected B. fragilis cells and their interaction with intestinal epithelial cells. B. fragilis NCTC9343 was treated with conjugated bile salts (BSC) or non-conjugated bile salts (BSM). Cellular ultrastructure was assessed by electron microscopy, gene expression was quantified by comparative quantitative real-time RT-PCR. Adhesion to the HT-29 human intestinal cell line and to PVC microtitre plates (biofilm formation) was determined. Exposure to 0.15% BSC or BSM resulted in overproduction of fimbria-like appendages and outer membrane vesicles, and increased expression of genes encoding RND-type efflux pumps and the major outer membrane protein, OmpA. Bile salt-treated bacteria had increased resistance to structurally unrelated antimicrobial agents and showed a significant increase in bacterial co-aggregation, adhesion to intestinal epithelial cells and biofilm formation. These data suggest that bile salts could enhance intestinal colonization by B. fragilis via several mechanisms, and could therefore be significant to host-pathogen interactions. Published by Elsevier Ltd. C1 Greater Los Angeles Vet Adm Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Sao Paulo, Inst Ciencias Biomed, Dept Microbiol, Lab Anaeorbios, BR-05508 Sao Paulo, Brazil. Inst Butantan, Bacteriol Lab, Sao Paulo, Brazil. RP Pumbwe, L (reprint author), Wadsworth Anaerobe Lab, Bldg 304,Room E3-224,GLAVAHCS 691-151J, Los Angeles, CA 90073 USA. EM lilskil@ucla.edu RI Nakano, Viviane/D-7955-2012; Avila-Campos, Mario/D-7727-2012; Piazza, Roxane Maria/K-9807-2016 OI Avila-Campos, Mario/0000-0002-2378-7251; NR 44 TC 43 Z9 44 U1 1 U2 17 PU ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 0882-4010 J9 MICROB PATHOGENESIS JI Microb. Pathog. PD AUG-SEP PY 2007 VL 43 IS 2-3 BP 78 EP 87 DI 10.1016/j.micpath.2007.04.002 PG 10 WC Immunology; Microbiology SC Immunology; Microbiology GA 195FM UT WOS:000248397900003 PM 17524609 ER PT J AU Washington, DL Kleimann, S Michelini, AN Kleimann, KM Canning, M AF Washington, Donna L. Kleimann, Susan Michelini, Ann N. Kleimann, Kristin M. Canning, Mark TI Women veterans' perceptions and decision-making about veterans affairs health care SO MILITARY MEDICINE LA English DT Article; Proceedings Paper CT National Meeting of the VA-Health-Services-Research-and-Development-Service CY MAR 10, 2004 CL Washington, DC SP VA Hlth Serv Res Dev Serv ID MEDICAL-CENTER; AVAILABILITY AB The increase in women in the military is reshaping the veteran population and Veterans Affairs (VA) health care delivery imperatives. To determine women veterans' perspectives and decision-making about VA health care use, we conducted six focus groups (four VA users and two nonusers) and identified key themes. Barriers to VA use for both VA users and nonusers included lack of information about eligibility and available services. Nonusers often assumed the VA did not provide women's health care. All groups emphasized they required a health care system focused on quality and sensitivity to women's health issues. However, users and nonusers differed in perceptions of VA quality. VA environment and quality concerns led many women to limit their VA use to women's clinics. These qualitative findings provide a context to highlight where interventions and policies suggested by quantitative findings should focus. Dissemination of accurate information about VA eligibility and services, and continued responsiveness to women's perceptions of care are indicated. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90095 USA. Kleimann Commun Grp, Washington, DC 20005 USA. Univ Cincinnati, Cincinnati, OH 45221 USA. RP Washington, DL (reprint author), VA Greater Los Angeles Healthcare Syst, 11301 Wilshire Blvd 11G, Los Angeles, CA 90073 USA. NR 19 TC 25 Z9 25 U1 0 U2 3 PU ASSOC MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 J9 MIL MED JI Milit. Med. PD AUG PY 2007 VL 172 IS 8 BP 812 EP 817 PG 6 WC Medicine, General & Internal SC General & Internal Medicine GA 201JW UT WOS:000248828400006 PM 17803071 ER PT J AU Bean-Mayberry, BA Yano, EM Caffrey, CD Altman, L Washington, DL AF Bean-Mayberry, Bevanne A. Yano, Elizabeth M. Caffrey, Cynthia D. Altman, Lisa Washington, Donna L. TI Organizational characteristics associated with the availability of women's health clinics for primary care in the Veterans Health Administration SO MILITARY MEDICINE LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Academy-of-Health-Services-Research CY JUN 26-28, 2005 CL Boston, MA SP Amer Acad Hlth Serv Res ID PATCHWORK QUILT AB Objective: Women's health clinics (WHCs) offering integrated primary care (PC) and gender-specific services reduce fragmentation and improve quality of care for women. Our objective was to understand organizational influences on the development of WHCs for PC delivery in Veterans Health Administration (VA) facilities. Methods: We surveyed PC directors at 219 VA facilities about the presence of separate WHCs for PC and evaluated organizational characteristics (e.g., authority, staffing, and resources) associated with their development. Results: One hundred thirty-three VA medical centers (61%) have established WHCs for PC. VA facilities with WHCs for PC were significantly more likely to have PC leadership distinct from subspecialty care (odds ratio = 3.62; 95% confidence interval, 1.45-9.05). Local PC staff mix, team structure, and resource characteristics were not associated with WHCs. Conclusions: With the growth of women in the military and, in turn, in the VA, autonomy of PC leadership may drive VA-based innovations in women's health. C1 VA Greater Los Angeles Hlth Serv Res & Dev, Ctr Excellence, Ctr Study Healthcare Provider Behav, Sepulveda, CA 91343 USA. Univ Calif Los Angeles, Sch Med, Dept Med, Los Angeles, CA 90095 USA. Off Acad Affiliat, Dept Vet Affairs, Washington, DC 20420 USA. Kaiser Permanente So Calif, Santa Clarita, CA 91355 USA. VA Greater Los Angeles Healthcare Syst, Ambulatory Care Serv Line, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90095 USA. RP Bean-Mayberry, BA (reprint author), VA Greater Los Angeles Hlth Serv Res & Dev, Ctr Excellence, Ctr Study Healthcare Provider Behav, 16111 Plummer St 152, Sepulveda, CA 91343 USA. NR 19 TC 14 Z9 14 U1 0 U2 3 PU ASSOC MILITARY SURG US PI BETHESDA PA 9320 OLD GEORGETOWN RD, BETHESDA, MD 20814 USA SN 0026-4075 J9 MIL MED JI Milit. Med. PD AUG PY 2007 VL 172 IS 8 BP 824 EP 828 PG 5 WC Medicine, General & Internal SC General & Internal Medicine GA 201JW UT WOS:000248828400008 PM 17803073 ER PT J AU Nahas, Z Teneback, C Chae, JH Mu, QW Molnar, C Kozel, FA Walker, J Anderson, B Koola, J Kose, S Lomarev, M Bohning, DE George, MS AF Nahas, Ziad Teneback, Charlotte Chae, Jeong-Ho Mu, Qiwen Molnar, Chris Kozel, Frank A. Walker, John Anderson, Berry Koola, Jejo Kose, Samet Lomarev, Mikhail Bohning, Daryl E. George, Mark S. TI Serial vagus nerve stimulation functional MRI in treatment-resistant depression SO NEUROPSYCHOPHARMACOLOGY LA English DT Article; Proceedings Paper CT 43rd Annual Meeting of the American-College-of-Neuropsychopharmacology CY DEC 12-16, 2004 CL San Juan, PR SP Vanderbilt Univ, Sch Med, Dept Psychiat, Amer Coll Neuropsychopharmacol DE vagus nerve stimulation; fMRI; depression; antidepressant ID TRANSCRANIAL MAGNETIC STIMULATION; CEREBRAL-BLOOD-FLOW; MAJOR DEPRESSION; SLEEP-DEPRIVATION; PREFRONTAL CORTEX; BRAIN METABOLISM; PARTIAL EPILEPSY; BOLD FMRI; ANTIDEPRESSANT RESPONSE; GLUCOSE-METABOLISM AB Vagus nerve stimulation (VNS) therapy has shown antidepressant effects in open acute and long-term studies of treatment-resistant major depression. Mechanisms of action are not fully understood, although clinical data suggest slower onset therapeutic benefit than conventional psychotropic interventions. We set out to map brain systems activated by VNS and to identify serial brain functional correlates of antidepressant treatment and symptomatic response. Nine adults, satisfying DSM-IV criteria for unipolar or bipolar disorder, severe depressed type, were implanted with adjunctive VNS therapy (MRI-compatible technique) and enrolled in a 3-month, doubleblind, placebo-controlled, serial-interleaved VNS/functional MRI (fMRI) study and open 20-month follow-up. A multiple regression mixed model with blood oxygenation level dependent (BOLD) signal as the dependent variable revealed that over time, VNS therapy was associated with ventro-medial prefrontal cortex deactivation. Controlling for other variables, acute VNS produced greater right insula activation among the participants with a greater degree of depression. These results suggest that similar to other antidepressant treatments, BOLD deactivation in the ventro-medial prefrontal cortex correlates with the antidepressant response to VNS therapy. The increased acute VNS insula effects among actively depressed participants may also account for the lower dosing observed in VNS clinical trials of depression compared with epilepsy. Future interleaved VNS/fMRI studies to confirm these findings and further clarify the regional neurobiological effects of VNS. C1 Inst Psychiat, Mood Disorders Program, Brain Stimulat Lab, Dept Psychiat, Charleston, SC 29403 USA. Med Univ S Carolina, Dept Radiol, Charleston, SC 29425 USA. Med Univ S Carolina, Ctr Adv Imaging Res, Charleston, SC 29425 USA. Catholic Univ, Dept Psychiat, Seoul, South Korea. NINDS, Bethesda, MD 20892 USA. Ralph H Johson VA Med Ctr, Dept Psychiat, Charleston, SC USA. RP Nahas, Z (reprint author), Inst Psychiat, Mood Disorders Program, Brain Stimulat Lab, Dept Psychiat, 67 President St,Room 502 N, Charleston, SC 29403 USA. EM nahasz@musc.edu RI Kozel, Frank/I-5366-2012 FU NIMH NIH HHS [MH070615-01A1, R01 MH069896-01, R21 MH065630-01]; NINDS NIH HHS [R01 NS40956-01] NR 67 TC 58 Z9 60 U1 1 U2 9 PU NATURE PUBLISHING GROUP PI LONDON PA MACMILLAN BUILDING, 4 CRINAN ST, LONDON N1 9XW, ENGLAND SN 0893-133X J9 NEUROPSYCHOPHARMACOL JI Neuropsychopharmacology PD AUG PY 2007 VL 32 IS 8 BP 1649 EP 1660 DI 10.1038/sj.npp.1301288 PG 12 WC Neurosciences; Pharmacology & Pharmacy; Psychiatry SC Neurosciences & Neurology; Pharmacology & Pharmacy; Psychiatry GA 191QU UT WOS:000248146900001 PM 17203016 ER PT J AU Chen, SY Maciejewski, M Au, D AF Chen, Shih-Yin Maciejewski, Matthew Au, David TI Health and economic impacts of different approaches to disease management for adults with asthma SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Meeting Abstract C1 Univ N Carolina, Sch Pharm, Div Pharmaceut Outcomes & Policy, Chapel Hill, NC USA. HSR&D, Durham, NC USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA USA. Univ Washington, Dept Med, Seattle, WA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1053-8569 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD AUG PY 2007 VL 16 SU 2 MA 360 BP S171 EP S171 PG 1 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA 201GT UT WOS:000248820200360 ER PT J AU Kahler, KH Rajan, M Rhoads, GG Safford, MM Demissie, K Lu, SE Pogach, LM AF Kahler, Kristijan H. Rajan, Mangala Rhoads, George G. Safford, Monika M. Demissie, Kitaw Lu, Shou-En Pogach, Leonard M. TI Variation in diabetes drug utilization among medical facilities in the veterans health administration (VHA) SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Meeting Abstract C1 VA New Jersey Hlth Care Syst, Ctr Hlth Care Knowledge & Management, E Orange, NJ USA. Univ Med & Dent New Jersey, Piscataway, NJ USA. Birmingham VA Med Ctr, Deep S Ctr Effect, Birmingham, AL USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1053-8569 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD AUG PY 2007 VL 16 SU 2 MA 008 BP S4 EP S4 PG 1 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA 201GT UT WOS:000248820200009 ER PT J AU Vander Stichele, RH Avorn, J Ruths, S Elseviers, MM Steinman, M Gurwitz, J AF Vander Stichele, Robert H. Avorn, Jerry Ruths, Sabine Elseviers, Monique M. Steinman, Mike Gurwitz, Jerry TI The quality of pharmaceutical care among institutionalised elderly SO PHARMACOEPIDEMIOLOGY AND DRUG SAFETY LA English DT Meeting Abstract C1 Univ Ghent, Heymans Inst, B-9000 Ghent, Belgium. Harvard Univ, Sch Med, Brigham & Womens Hosp, Div Pharmacoepidemiol, Cambridge, MA 02138 USA. Univ Bergen, Dept Geriatr, Bergen, Norway. Univ Antwerp, B-2020 Antwerp, Belgium. San Francisco VA Med Ctr, San Francisco, CA USA. Univ Massachusetts, Sch Med, Amherst, MA 01003 USA. RI Vander Stichele, Robert/K-7203-2015 OI Vander Stichele, Robert/0000-0001-9118-9651 NR 0 TC 0 Z9 0 U1 0 U2 1 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 1053-8569 J9 PHARMACOEPIDEM DR S JI Pharmacoepidemiol. Drug Saf. PD AUG PY 2007 VL 16 SU 2 MA 160 BP S76 EP S77 PG 2 WC Public, Environmental & Occupational Health; Pharmacology & Pharmacy SC Public, Environmental & Occupational Health; Pharmacology & Pharmacy GA 201GT UT WOS:000248820200161 ER PT J AU Narita, M Tsuji, BT Yu, VL AF Narita, Masashi Tsuji, Brian T. Yu, Victor L. TI Linezolid-associated peripheral and optic neuropathy, lactic acidosis, and serotonin syndrome SO PHARMACOTHERAPY LA English DT Review DE linezolid; adverse effects; peripheral neuropathy; optic neuropathy; lactic acidosis; serotonin syndrome ID MITOCHONDRIAL PROTEIN-SYNTHESIS; REUPTAKE INHIBITORS; DRUG-INTERACTIONS; THERAPY; INFECTIONS AB Linezolid is an oxazolidinone antibacterial agent indicated for serious grampositive infections. Only minor adverse effects were seen in phase III trials. However, more serious adverse effects were reported after commercial release, including cases of lactic acidosis, peripheral and optic neuropathy, and serotonin syndrome. Peripheral and optic neuropathy was usually seen after several months of linezolid therapy (median 5 mo), lactic acidosis after several weeks (median 6 wks), and serotonin syndrome after several days (median 4 days). Death occurred in two of seven reported cases of lactic acidosis, and three of 15 reported cases of serotonin syndrome. Improvement or complete recovery occurred in all cases of optic neuropathy, whereas complete recovery failed to occur in any patient with peripheral neuropathy. Linezolid should be discontinued immediately in patients experiencing these adverse effects. Patients receiving linezolid for more than 28 days should be monitored for signs of peripheral and optic neuropathy C1 Univ Pittsburgh, Infect Dis Sect, Vet Affairs Pittsburgh Healthcare Syst, Pittsburgh, PA USA. SUNY Buffalo, Sch Pharm & Pharmaceut Sci, Buffalo, NY 14260 USA. RP Yu, VL (reprint author), VA Med Ctr, Infect Dis Sect, Univ Dr C, Pittsburgh, PA 15240 USA. NR 38 TC 87 Z9 91 U1 2 U2 5 PU PHARMACOTHERAPY PUBLICATIONS INC PI BOSTON PA NEW ENGLAND MEDICAL CENTER, 806, 750 WASHINGTON ST, BOSTON, MA 02111 USA SN 0277-0008 J9 PHARMACOTHERAPY JI Pharmacotherapy PD AUG PY 2007 VL 27 IS 8 BP 1189 EP 1197 DI 10.1592/phco.27.8.1189 PG 9 WC Pharmacology & Pharmacy SC Pharmacology & Pharmacy GA 195IG UT WOS:000248405100010 PM 17655517 ER PT J AU Van Stone, WW AF Van Stone, William W. TI Treating health anxiety and fear of death: A practitioner's guide SO PSYCHIATRIC SERVICES LA English DT Book Review C1 [Van Stone, William W.] US Dept Vet Affairs, Vet Affairs Cent Off, Off Mental Hlth Serv, Washington, DC USA. RP Van Stone, WW (reprint author), US Dept Vet Affairs, Vet Affairs Cent Off, Off Mental Hlth Serv, Washington, DC USA. NR 1 TC 0 Z9 0 U1 1 U2 3 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 1075-2730 J9 PSYCHIAT SERV JI Psychiatr. Serv. PD AUG PY 2007 VL 58 IS 8 BP 1129 EP 1130 DI 10.1176/appi.ps.58.8.1129 PG 2 WC Health Policy & Services; Public, Environmental & Occupational Health; Psychiatry SC Health Care Sciences & Services; Public, Environmental & Occupational Health; Psychiatry GA 265LN UT WOS:000253360500022 ER PT J AU Shaner, A Miller, G Mintz, J AF Shaner, Andrew Miller, Geoffrey Mintz, Jim TI Evidence of a latitudinal gradient in the age at onset of schizophrenia SO SCHIZOPHRENIA RESEARCH LA English DT Article DE schizophrenia; latitudinal gradient; age at onset; evolution; sexual selection; migration; fitness indicator ID LEK PARADOX; METAANALYSIS; DISORDERS; EVOLUTION; PSYCHOSIS; MENARCHE; DISEASE; PUBERTY; FITNESS; BIRTH AB Variation in the age at onset of a multifactorial disease often reflects variation in cause. Here we show a linear latitudinal gradient in the mean age at onset of schizophrenia in 13 northern hemisphere cities, ranging from 25 years old in Cali, Columbia (at 4 degrees north) to 35 years old in Moscow, Russia (at 56 degrees north). To our knowledge, this striking association has not been previously reported. We consider several explanations, including the effects of pathogen stress, natural selection, sexual selection, migration, life-history profiles, or some combination of these factors, and we propose a test of competing causal hypotheses. (C) 2007 Elsevier B.V. All rights reserved. C1 Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90073 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. Univ New Mexico, Dept Psychol, Albuquerque, NM 87131 USA. RP Shaner, A (reprint author), Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Andrew.Shaner@med.va.gov; gfmiller@unm.edu; JMintz@ucla.edu RI Miller, Geoffrey/C-4145-2008 NR 38 TC 5 Z9 5 U1 0 U2 4 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0920-9964 J9 SCHIZOPHR RES JI Schizophr. Res. PD AUG PY 2007 VL 94 IS 1-3 BP 58 EP 63 DI 10.1016/j.schres.2007.04.001 PG 6 WC Psychiatry SC Psychiatry GA 198OX UT WOS:000248638500008 PM 17509836 ER PT J AU Fan, J Li, YH Vodovotz, Y Billiar, TR Wilson, MA AF Fan, Jie Li, Yuehua Vodovotz, Yoram Billiar, Timothy R. Wilson, Mark A. TI Neutrophil NAD(P)H oxidase is required for hemorrhagic shock-enhanced TLR2 up-regulation in alveolar macrophages in response to LPS SO SHOCK LA English DT Article DE acute lung injury; innate immunity; IRAK4 ID FACTOR-KAPPA-B; NADPH OXIDASE; ENDOTHELIAL-CELLS; ORGAN INJURY; EXPRESSION; LUNG; LIPOPOLYSACCHARIDE; ACTIVATION; INFLAMMATION; THIOREDOXIN AB Alveolar macrophages (AMs) play an important role in the development of posttrauma lung inflammation through initiating polymorphonuclear neutrophil (PMN) migration by direct interactions with PMN, which is in turn mediated by the expression of chemokines and cytokines. We have recently reported that hemorrhagic shock-activated PMN sensitize AM to bacteria LPS for the up-regulation of Toll-like receptor (TLR)2; in turn, this TLR2 up-regulation results in the amplification of expression of cytokines and chemokines in the AM in response to the bacterial products LPS and peptidoglycan, associated with enhanced PMN sequestration in the lung. We sought to address the mechanism underlying the augmentation of TLR2 in AM by shock-activated PMN. We found that hemorrhagic shock/resuscitation (shock) followed by a low dose of i.t. LPS markedly increased TLR2 mRNA expression in AM in wild-type (WT) mice. In contrast, in mice lacking the gp91(phox) subunit of nicotinamide adenine dinucleotide phosphate (reduced form) oxidase (gp91(Phox-/-)) or in neutropenic WT mice, the increase in TLR2 mRNA was attenuated. Coculture of AM with PMN derived from WT-shocked mice caused a significantly higher level of TLR2 expression in the AM in response to LPS. However, this increase in TLR2 expression was less evident when the AMs were cocultured with PMN derived from gp91(Phox-/-) mice subjected to shock. The antioxidant polyethylene glycol catalase markedly decreased MyD88-dependent activation of IL-1 receptor associated kinase 4 and TLR2 expression in the AM in response to LPS. Thus, PMN nicotinamide adenine dinucleotide phosphate (reduced form) oxidase sensitizes hemorrhagic shock-primed AM to LPS, at least in part via enhancing IL-1 receptor associated kinase 4 activity. C1 VA Pittsburgh Healthcare Syst, Dept Surg, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Surg, Pittsburgh, PA 15260 USA. RP Fan, J (reprint author), VA Pittsburgh Healthcare Syst, Dept Surg, CHERP Bldg 28 151C-U,Univ Dr C, Pittsburgh, PA 15240 USA. EM jif7@pitt.edu FU NHLBI NIH HHS [R01 HL 079669]; NIGMS NIH HHS [P50 GM 53789] NR 29 TC 18 Z9 19 U1 0 U2 3 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1073-2322 J9 SHOCK JI Shock PD AUG PY 2007 VL 28 IS 2 BP 213 EP 218 DI 10.1097/shk.0b013e318033ec9d PG 6 WC Critical Care Medicine; Hematology; Surgery; Peripheral Vascular Disease SC General & Internal Medicine; Hematology; Surgery; Cardiovascular System & Cardiology GA 193SV UT WOS:000248295800014 PM 17515854 ER PT J AU Merkin, SS Roux, AVD Coresh, J Fried, LF Jackson, SA Powe, NR AF Merkin, Sharon Stein Roux, Ana V. Diez Coresh, Josef Fried, Linda F. Jackson, Sharon A. Powe, Neil R. TI Individual and neighborhood socioeconomic status and progressive chronic kidney disease in an elderly population: The Cardiovascular Health Study SO SOCIAL SCIENCE & MEDICINE LA English DT Article DE socioeconomic; kidney disease; neighborhood; elderly; USA ID STAGE RENAL-DISEASE; RISK-FACTORS; ATHEROSCLEROSIS RISK; UNITED-STATES; MORTALITY SELECTION; EXPLANATORY FACTORS; MULTILEVEL ANALYSIS; PHYSICAL-ACTIVITY; SERUM CREATININE; ALAMEDA COUNTY AB Few studies have focused on the association between socioeconomic status (SES) and progressive chronic kidney disease (pCKD) in an elderly population. We conducted a cohort study of 4735 Cardiovascular Health Study participants, ages 65 and older and living in 4 US communities, to examine the independent risk of pCKD associated with income, education and living in a low SES area. pCKD was defined as creatinine elevation >= 0.4 mg/dL (35 mu mol/L) over a 4-7 year follow-up or CKD hospitalization. Area SES was characterized using measures of income, wealth, education and occupation for 1990 (corresponding to time of enrollment) US Census block groups of residence. Age and study site-adjusted incidence rates (per 1000 person years) of pCKD by quartiles of area-level SES score, income and education showed decreasing rates with increasing SES. Cox proportional hazards models showed that living in the lowest SES area quartile, as opposed to the highest, was associated with 50% greater risk of pCKD, after adjusting for age, gender, study site, baseline creatinine, and individual-level SES. This increased risk and trend persisted after adjusting for lifestyle risk factors, diabetes and hypertension. We found no significant independent associations between pCKD and individual-level income or education (after adjusting for all other SES factors). As such, living in a low SES area is associated with greater risk of pCKD in an elderly US population. (c) 2007 Elsevier Ltd. All rights reserved. C1 Welch Ctr Prevent Epidemiol & Clin Res, Johns Hopkins Bloomberg Sch Publ Hlth, Baltimore, MD 21205 USA. Univ Michigan, Sch Publ Hlth, Dearborn, MI 48128 USA. Univ Pittsburgh, Sch Med, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15260 USA. Wake Forest Univ, Sch Med, Winston Salem, NC 27157 USA. RP Merkin, SS (reprint author), Univ Calif Los Angeles, Geffen Sch Med, Div Geriatr, Los Angeles, CA 90024 USA. EM smerkin@mednet.ucla.edu FU NIDDK NIH HHS [K24 DK02643, K24 DK002643]; NIMHD NIH HHS [P60 MD000206, P60 MD00206] NR 59 TC 68 Z9 68 U1 9 U2 13 PU PERGAMON-ELSEVIER SCIENCE LTD PI OXFORD PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, ENGLAND SN 0277-9536 J9 SOC SCI MED JI Soc. Sci. Med. PD AUG PY 2007 VL 65 IS 4 BP 809 EP 821 DI 10.1016/j.socscimed.2007.04.011 PG 13 WC Public, Environmental & Occupational Health; Social Sciences, Biomedical SC Public, Environmental & Occupational Health; Biomedical Social Sciences GA 203EA UT WOS:000248956700015 PM 17499411 ER PT J AU Zhang, F Wang, SP Signore, AP Chen, J AF Zhang, Feng Wang, Suping Signore, Armando P. Chen, Jun TI Neuroprotective effects of leptin against ischemic injury induced by oxygen-glucose deprivation and transient cerebral ischemia SO STROKE LA English DT Article DE brain ischemia; extracellular signal-related kinase 1/2; leptin; oxygen-glucose deprivation ID ERYTHROPOIETIN PROTECTS; IN-VIVO; BRAIN; ACTIVATION; APOPTOSIS; PATHWAY; CONTRIBUTES; RECEPTOR; NEURONS; KINASE AB Background and Purpose - Leptin is the major adipose hormone that regulates body weight and energy expenditure by activating leptin receptors in the hypothalamus. Leptin receptors are also present in other cell types, and a potent antiapoptotic effect for leptin has recently been reported. We investigated whether leptin was neuroprotective against ischemic brain injury. Methods - In vitro ischemic injury was induced in rat primary neuronal culture by oxygen-glucose deprivation for 90 minutes. In vivo ischemic brain injury was induced by middle cerebral artery occlusion in mice for 60 minutes. Results - Leptin receptors were detected in cultured rat cortical neurons, as well as in the mouse cortex, striatum, and hippocampus. In vitro results showed that leptin, 50 to 100 mu g/mL, protected primary cortical neurons against death induced by oxygen-glucose deprivation in a concentration-dependent manner. In vivo studies in the mouse brain demonstrated that the intraperitoneal administration of leptin, 2 to 8 mg/kg, dose-dependently reduced infarct volume induced by middle cerebral artery occlusion. Leptin was effective when injected 5 minutes before or 30 to 90 minutes after reperfusion, but not 2 hours after reperfusion. Leptin improved animal body weight recovery and behavioral parameters after cerebral ischemia. Leptin enhanced the phosphorylation of extracellular signal - related kinase 1/2. Both extracellular signal - related kinase 1/2 activation and neuroprotection were abolished by the administration of PD98059 in vitro and in vivo. Conclusions - Leptin is neuroprotective against ischemic neuronal injury. Our findings suggest that leptin is a legitimate candidate for the treatment of ischemic stroke. C1 Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Dept Pharmacol, Pittsburgh, PA 15213 USA. VA Pittsburgh Hlth Care Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA. RP Chen, J (reprint author), Univ Pittsburgh, Sch Med, Dept Neurol, S-507,Biomed Sci Tower, Pittsburgh, PA 15213 USA. EM chenj2@upmc.edu OI Zhang, Feng/0000-0001-7275-9989 FU NINDS NIH HHS [NS36736, NS43802, NS45048] NR 22 TC 98 Z9 106 U1 3 U2 11 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0039-2499 J9 STROKE JI Stroke PD AUG PY 2007 VL 38 IS 8 BP 2329 EP 2336 DI 10.1161/STROKEAHA.107.482786 PG 8 WC Clinical Neurology; Peripheral Vascular Disease SC Neurosciences & Neurology; Cardiovascular System & Cardiology GA 196AY UT WOS:000248455100025 PM 17600230 ER PT J AU Micev, M Todorovic, V Drndarevic, N Micev, MC Mitrovic, O Krsmanovic, M Pesko, P Heinrich, M AF Micev, Marjan Todorovic, Vera Drndarevic, Neda Micev, Milena Cosic Mitrovic, Olivera Krsmanovic, Mila Pesko, Predrag Heinrich, Michael TI Prognostic implications of immunoexpression of cell cycle regulatory proteins in gastrointestinal stromal tumours SO VIRCHOWS ARCHIV LA English DT Meeting Abstract C1 Clin Ctr Serbia, Inst Digest Dis, Belgrade, Serbia. Univ Belgrade, Med Res Inst, Belgrade, Serbia. Oregon Hlth & Sci Univ, Dept Med, Inst Canc, Portland, OR 97201 USA. Portland VA Med Ctr, Portland, OR USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0945-6317 J9 VIRCHOWS ARCH JI Virchows Arch. PD AUG PY 2007 VL 451 IS 2 MA PP2-85 BP 315 EP 315 PG 1 WC Pathology SC Pathology GA 210KH UT WOS:000249454600613 ER PT J AU Ketas, TJ Kuhmann, SE Palmer, A Zurita, J He, WJ Ahuja, SK Klasse, PJ Moore, JP AF Ketas, Thomas J. Kuhmann, Shawn E. Palmer, Ashley Zurita, Juan He, Weijing Ahuja, Sunil K. Klasse, Per Johan Moore, John P. TI Cell surface expression of CCR5 and other host factors influence the inhibition of HIV-1 infection of human lymphocytes by CCR5 ligands SO VIROLOGY LA English DT Article DE CCR5 inhibitor; viral entry; IC50; receptor density ID HUMAN-IMMUNODEFICIENCY-VIRUS; SMALL-MOLECULE INHIBITORS; SHORT-TERM MONOTHERAPY; ENTRY INHIBITORS; ANTIVIRAL ACTIVITY; TYPE-1 INFECTION; DISEASE PROGRESSION; CORECEPTOR USAGE; RECEPTOR DENSITY; TROPIC HIV-1 AB Several CCR5 ligands, including small molecules and monoclonal antibodies (MAbs), are being developed as therapies for infection with strains of human immunodeficiency virus type I (HIV-1) that use CCR5 for entry (R5 viruses). The efficacy of such therapies could be influenced by inter-individual differences in host factors, such as CCR5 expression levels. To study this, we used peripheral blood mononuclear cells (PBMCs) from humans and rhesus macaques. The half-maximal inhibitory concentrations (IC50) of the small-molecule CCR5 ligands CMPD 167, UK427,857 and SCH-D, and of the PRO 140 MAb, differ by > 2 logs in a donor-dependent manner. We studied this variation by using flow cytometry to measure CCR5 expression on PBMCs from six of the human donors: the IC50 values of both SCH-D and PRO 140 correlated with CCR5 expression (R-2=0.64 and 0.99, respectively). We also determined the efficacy of the CCR5 ligands against HIV-1 infection of HeLa-derived cell lines that express CD4 at the same level but vary 2-fold in CCR5 expression (JC.48 and JC.53 cells). The moderately greater CCR5 expression on the JC.53 than the JC.48 cells was associated with proportionately higher median IC50 values for a] I four CCR5 ligands but not for a soluble CD4-based inhibitor or a non-nucleoside reverse transcriptase inhibitor. We conclude that differences in CCR5 expression on human PBMCs, which can be affected by CCL3L1 gene dose, may influence the antiviral potency of CCR5 ligands in vitro, but other host factors are also likely to be involved. These host factors may affect the clinical activity of CCR5 inhibitors, including their use as topical microbicides to prevent HIV-1 transmission. (c) 2007 Elsevier Inc. All rights reserved. C1 Cornell Univ, Weill Med Coll, Dept Microbiol & Immunol, New York, NY 10021 USA. Univ Texas, Hlth Sci Ctr San Antonio, Vet Adm Res Ctr AIDS & HIV I Infect, S Texas Vet Hlth Care Syst, San Antonio, TX 78285 USA. Univ Texas, Hlth Sci Ctr San Antonio, Dept Med, San Antonio, TX 78285 USA. RP Moore, JP (reprint author), Cornell Univ, Weill Med Coll, Dept Microbiol & Immunol, 1300 York Ave,Box 62, New York, NY 10021 USA. EM jpm2003@mail.med.cornell.edu FU NIAID NIH HHS [AI41420, AI46326, AI65413, AI66329, R01 AI041420, R01 AI041420-12, R01 AI046326, R21 AI046326, R37 AI046326, U19 AI065413, U19 AI065413-02, U19 AI066329] NR 55 TC 46 Z9 46 U1 1 U2 2 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 0042-6822 J9 VIROLOGY JI Virology PD AUG 1 PY 2007 VL 364 IS 2 BP 281 EP 290 DI 10.1016/j.virol.2007.02.022 PG 10 WC Virology SC Virology GA 181FW UT WOS:000247423500004 PM 17428518 ER PT J AU Dore, GJ Torriani, FJ Rodriguez-Torres, M Brau, N Sulkowski, M Lamoglia, RS Tural, C Clumeck, N Nelson, MR Mendes-Correa, MC Godofsky, EW Dieterich, DT Yetzer, E Lissen, E Cooper, DA AF Dore, Gregory J. Torriani, Francesca J. Rodriguez-Torres, Maribel Brau, Norber Sulkowski, Mark Sola Lamoglia, Ricard Tural, Cristina Clumeck, Nathan Nelson, Mark R. Mendes-Correa, Maria C. Godofsky, Eliot W. Dieterich, Douglas T. Yetzer, Ellen Lissen, Eduardo Cooper, David A. TI Baseline factors prognostic of sustained virological response in patients with HIV-hepatitis C virus co-infection SO AIDS LA English DT Article DE APRICOT; co-infection; hepatitis C virus; sustained virological response ID ALPHA-2A PLUS RIBAVIRIN; PEGINTERFERON ALPHA-2A; INFECTED PATIENTS; PEGYLATED INTERFERON-ALPHA-2B; THERAPY AB Objective: To identify baseline characteristics predictive of a sustained virological response (SVR) in patients with HIV-hepatitis C virus (HCV) co-infection treated with interferon-based therapy. Design/methods: A stepwise multiple logistic regression analysis was used to explore the prognostic factors associated with SVR [undetectable HCV-RNA (< 50 IU/ml) at the end of untreated follow-up in week 72]. Results: In all patients (n = 853), in addition to the HCV therapy received, the factors most predictive of SVR were baseline HCV-RNA [<= versus > 400 000 IU/ml; odds ratio (OR) 4.77; 95% confidence interval (CI) 3.15-7.22; P < 0.0001] and HCV genotype (OR 2.87; 95% CI 2.00-4.12; P < 0.0001). HIV treatment (with a protease inhibitor or non-nucleoside reverse transcriptase inhibitor; P=0.034), race (P=0.027), and body mass index (P=0.039) were also weak predictors of HCV treatment response. Conclusions: In the AIDS PEGASYS Ribavirin International Co-infection Trial (APRICOT), the predictors of SVR among HIV-HCV co-infected patients treated with peginterferon alfa-2a plus ribavirin were similar to those in patients with HCV mono-infection. The HCV genotype and pretreatment HCV-RNA level had the greatest influence on SVR. (c) 2007 Lippincott Williams & Wilkins. C1 Univ New S Wales, Natl Ctr HIV Epidemiol & Clin Res, Sydney, NSW, Australia. St Vincent Hosp, Darlinghurst, NSW, Australia. Univ Calif San Diego, La Jolla, CA 92093 USA. Fdn Invest Diego, Santurce, PR USA. Ponce Sch Med, Santurce, PR USA. Bronx Vet Adm Med Ctr, New York, NY USA. Johns Hopkins Univ, Baltimore, MD 21205 USA. Autonomous Univ Barcelona, Hosp del Mar, E-08193 Barcelona, Spain. Hosp Univ Germans Trias & Pujol, Barcelona, Spain. Hop Univ St Pierre, Brussels, Belgium. Chelsea & Westminister Hosp, London, England. Univ Sao Paulo, Hosp Das Clin, BR-05508 Sao Paulo, Brazil. Bach & Godofsky, Bradenton, FL USA. Mt Sinai Sch Med, New York, NY USA. Roche, Nutley, NJ USA. Virgen Rocio Univ Hosp, Seville, Spain. RP Dore, GJ (reprint author), Univ New S Wales, Natl Ctr HIV Epidemiol & Clin Res, Level 2,376 Victoria St, Darlinghurst, NSW 2010, Australia. EM gdore@nchecr.unsw.edu.au RI mendes correa, maria cassia /A-6779-2013 NR 18 TC 31 Z9 31 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0269-9370 J9 AIDS JI Aids PD JUL 31 PY 2007 VL 21 IS 12 BP 1555 EP 1559 DI 10.1097/QAD.0b013e328216f2c7 PG 5 WC Immunology; Infectious Diseases; Virology SC Immunology; Infectious Diseases; Virology GA 196PV UT WOS:000248495400008 PM 17630550 ER PT J AU Samii, A Kelly, VE Slimp, JC Shumway-Cook, A Goodkin, R AF Samii, Ali Kelly, Valerie E. Slimp, Jefferson C. Shumway-Cook, Anne Goodkin, Robert TI Staged unilateral versus bilateral subthalamic nucleus stimulator implantation in Parkinson disease SO MOVEMENT DISORDERS LA English DT Article DE Parkinson disease; deep brain stimulation; staged surgery; subthalamic nucleus; dyskinesia ID DEEP-BRAIN-STIMULATION; RATING-SCALE AB In 17 consecutive patients with Parkinson disease (PD), bilateral subthalamic nucleus (STN) stimulators were implanted during staged surgeries. The Unified Parkinson Disease Rating Scale (UPDRS) and the Dyskinesia Disability Scale were completed both off and on medication prior to any surgery and also OFF and ON stimulation after each surgery. On-medication UPDRS activities of daily living (ADL) and motor examination scores changed little with unilateral or bilateral stimulation. Off-medication UPDRS motor examination scores improved to similar degrees after each staged STN electrode implantation. Most of the improvements in off-medication ADL scores, dyskinesia scores, complications of therapy, and medication dose reduction occurred after unilateral STN stimulation with smaller improvements after the second operation. (c) 2007 Movement Disorder Society. C1 Univ Washington, Dept Neurol, Seattle, WA 98108 USA. VA Puget Sound Hlth Care Syst, Neurol Sect, Parkinson Dis Res Educ & Clin Ctr, Seattle, WA USA. Univ Washington, Dept Rehabil Med, Seattle, WA 98195 USA. Univ Washington, Dept Neurol Surg, Seattle, WA 98195 USA. RP Samii, A (reprint author), Univ Washington, Dept Neurol, Mail Stop 127,1660 S Columbian Way, Seattle, WA 98108 USA. EM asamii@u.washington.edu OI Kelly, Valerie E./0000-0002-0099-9219 NR 13 TC 20 Z9 21 U1 0 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD JUL 30 PY 2007 VL 22 IS 10 BP 1476 EP 1481 DI 10.1002/mds.21554 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 197BJ UT WOS:000248527800016 PM 17523194 ER PT J AU Conklin, SM Harris, JI Manuck, SB Yao, JK Hibbeln, JR Muldoon, MF AF Conklin, Sarah M. Harris, Jennifer I. Manuck, Stephen B. Yao, Jeffrey K. Hibbeln, Joseph R. Muldoon, Matthew F. TI Serum omega-3 fatty acids are associated with variation in mood, personality and behavior in hypercholesterolemic community volunteers SO PSYCHIATRY RESEARCH LA English DT Article DE polyunsaturated fatty acids (PUFA); depression; impulsivity; personality ID POLYUNSATURATED FATTY-ACIDS; PLACEBO-CONTROLLED TRIAL; AMERICAN-HEART-ASSOCIATION; HEALTH-CARE PROFESSIONALS; PRELIMINARY DOUBLE-BLIND; BLOOD-CELL MEMBRANES; DOCOSAHEXAENOIC ACID; FISH CONSUMPTION; MAJOR DEPRESSION; CARDIOVASCULAR-DISEASE AB Low dietary intake of omega-3 polyunsaturated fatty acids has been linked to several features of psychiatric symptomatology, including depression, disorders of impulse control, and hostility. Preliminary intervention trials of omega-3 fatty acid supplementation for clinical depression and other disorders have reported benefit. However, few studies have investigated the relationships between these fatty acids and normative variability in mood, behavior and personality. Participants were 105 hypercholesterolemic, but otherwise healthy, non-smoking adults. Fasting serum alpha-linolenic (alpha-LNA), eicosapentaenoic (EPA) and docosahexacnoic acid (DHA) were assayed with gas chromatography. Participants completed the Beck Depression Inventory (BDI), the NEO Five Factor Personality Inventory (NEO-FFI) and the Barratt Impulsiveness Scale (BIS). In multivariate analyses, higher levels of the long chain omega-3 PUFAs, EPA and DHA, were associated with significantly reduced odds of scoring >= 10 on the BDI. Similarly, DHA and EPA covaried inversely with NEO-Neuroticism scores, whereas DHA was positively associated with NEO-Agreeableness. On the BIS, DHA was inversely related to cognitive impulsivity and alpha-LNA was inversely related to motor and total impulsivity. These findings suggest that omega-3 fatty acid status is associated with variability in affect regulation, personality and impulse control. (c) 2006 Elsevier Ireland Ltd. All rights reserved. C1 Univ Pittsburgh, Dept Psychiat, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Psychiat, Cardiovasc Behav Med Postdoctoral Training Progra, Pittsburgh, PA USA. Brown Univ, Dept Psychol, Providence, RI 02912 USA. Univ Pittsburgh, Dept Psychol, Pittsburgh, PA 15260 USA. Univ Pittsburgh, Dept Psychiat & Pharmaceut Sci, VA Pittsburgh Healthcare syst, Pittsburgh, PA USA. Natl Inst Alcohol Abuse & Alcoholism, Bethesda, MD USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. RP Conklin, SM (reprint author), Univ Pittsburgh, Dept Psychiat, 506 Old Engn Hall, Pittsburgh, PA 15260 USA. EM conklinsm@upmc.edu FU NHLBI NIH HHS [HL07560, HL46328] NR 72 TC 43 Z9 45 U1 2 U2 8 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0165-1781 J9 PSYCHIAT RES JI Psychiatry Res. PD JUL 30 PY 2007 VL 152 IS 1 BP 1 EP 10 DI 10.1016/j.psychres.2006.10.006 PG 10 WC Psychiatry SC Psychiatry GA 198UO UT WOS:000248653200001 PM 17383013 ER PT J AU Hsieh, GR Schnickel, GT Garcia, C Shefizadeh, A Fishbein, MC Ardehali, A AF Hsieh, George R. Schnickel, Gabriel T. Garcia, Consuelo Shefizadeh, Ali Fishbein, Michael C. Ardehali, Abbas TI Inflammation/oxidation in chronic rejection: Apolipoprotein A-I mimetic peptide reduces chronic rejection of transplanted hearts SO TRANSPLANTATION LA English DT Article DE T-lymphocyte; hemoxygenase-1; apolipoprotein; rejection ID LOW-DENSITY-LIPOPROTEIN; MONOCYTE CHEMOTACTIC PROTEIN-1; HEME OXYGENASE-1; CARBON-MONOXIDE; ALLOGRAFT-REJECTION; T-LYMPHOCYTES; MICE; D-4F; INJURY; CHOLESTEROL AB Background. Chronic rejection in transplanted hearts or cardiac allograft vasculopathy (CAV) is the leading cause of late death among heart transplant recipients. Strategies to control CAV traditionally have focused on lymphocyte functions. We hypothesized that D-4F, an apoA-I mimetic peptide with potent anti-inflammatory/antioxidant properties, will attenuate CAV. Methods. We used a previously characterized murine model of CAV.B6.C-H2(bm12) hearts were heterotopically transplanted into C57BL/6 mice. Recipient mice were treated with either 20 mu g of D-4F or carrier daily. Donor hearts were harvested on day 24 after transplantation. Results. Treatment of recipients with D-4F reduced the severity of intimal. lesions (62.5 +/- 3.4% vs. 31.1 +/- 8.7%, P<0.009). Treatment also resulted in a decrease in the number of graft-infiltrating CD4 and CD8 lymphocytes and CXCR3+ T-lymphocyte subsets. Heme oxygenase-1 (HO-1) gene transcript in the donor hearts was up-regulated with D-4F treatment, and HO-1 blockade partially reversed the beneficial effects of D-4F. In vitro studies showed that D-4F reduced allogeneic T-lymphocyte proliferation and effector cytokine production. These processes were HO-1 independent. Conclusion. This study suggests that D-4F, a prototypical apoA-I mimetic peptide, is effective in controlling CAV via induction of HO-1 in the graft and a direct effect on T-lymphocyte function. This class of peptides with anti-inflammatory/antioxidant properties provides a novel strategy in the treatment of CAV. C1 Univ Calif Los Angeles, Med Ctr, Div Cardiac Surg, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Gaffen Sch Med, Dept Surg, Div Cardiac Surg, Los Angeles, CA USA. W Los Angles VA Med Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, David Gaffen Sch Med, Dept Pathol & Lab Med, Los Angeles, CA 90024 USA. RP Ardehali, A (reprint author), Univ Calif Los Angeles, Med Ctr, Div Cardiac Surg, 62-182 CHS,10833 Conte Ave, Los Angeles, CA 90095 USA. EM aardehali@mednet.ucla.edu OI Schnickel, Gabriel/0000-0003-4392-2200 NR 36 TC 19 Z9 21 U1 0 U2 0 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0041-1337 J9 TRANSPLANTATION JI Transplantation PD JUL 27 PY 2007 VL 84 IS 2 BP 238 EP 243 DI 10.1097/01.tp.0000268509.60200.ea PG 6 WC Immunology; Surgery; Transplantation SC Immunology; Surgery; Transplantation GA 194ZG UT WOS:000248381700015 PM 17667816 ER PT J AU Lu, L Zheng, L Viera, L Suswam, E Li, YY Li, XL Estevez, AG King, PH AF Lu, Liang Zheng, Lei Viera, Liliana Suswam, Esther Li, Yanyan Li, Xuelin Estevez, Alvaro G. King, Peter H. TI Mutant Cu/Zn-superoxide dismutase associated with amyotrophic lateral sclerosis destabilizes vascular endothelial growth factor mRNA and downregulates its expression SO JOURNAL OF NEUROSCIENCE LA English DT Article DE AU-rich element; 3 '-untranslated region; RNA-binding proteins; posttranscriptional gene regulation; HuR translocation; motor neurons ID TUMOR-NECROSIS-FACTOR; BINDING PROTEIN HUR; AU-RICH ELEMENTS; MOTOR-NEURON DEGENERATION; G93A-SOD1 MOUSE MODEL; T-CELL-ACTIVATION; ANGIOGENIC FACTOR; MOTONEURON DEGENERATION; UNTRANSLATED REGION; PROLONGS SURVIVAL AB Vascular endothelial growth factor (VEGF) plays a neuroprotective role in mice harboring mutations of copper-zinc superoxide dismutase 1 (SOD 1) in familial amyotrophic lateral sclerosis (ALS). Conversely, the loss of VEGF expression through genetic depletion can give rise to a phenotype resembling ALS independent of SOD 1 mutations. Here, we observe a profound downregulation of VEGF mRNA expression in spinal cords of G93A SOD 1 mice that occurred early in the course of the disease. Using an in vitro culture model of glial cells expressing mutant SOD 1, we demonstrate destabilization and downregulation of VEGF RNA with concomitant loss of protein expression that correlates with level of transgene expression. Using a luciferase reporter assay, we show that this molecular effect is mediated through a portion of the VEGF 3'-untranslated region (UTR) that harbors a class II adenylate/uridylate-rich element. Other mutant forms of SOD 1 produced a similar negative effect on luciferase RNA and protein expression. Mobility shift assay with a VEGF 3'-UTR probe reveals an aberrantly migrating complex that contains mutant SOD I. We further show that the RNA stabilizing protein, HuR (human antigen R), is translocated from nucleus to cytoplasm in mutant SOD 1 cells in vitro and mouse motor neurons in vivo. In summary, our data suggest that mutant SOD 1 gains a novel function, possibly by altering the ribonucleoprotein complex with the VEGF 3'-UTR. We postulate that the resultant dysregulation of VEGF posttranscriptional processing critically reduces the level of this neuroprotective growth factor and accelerates the neurodegenerative process in ALS. C1 Univ Alabama, Dept Neurol, Birmingham, AL 35295 USA. Univ Alabama, Dept Genet, Birmingham, AL 35295 USA. Univ Alabama, Dept Physiol & Biophys, Birmingham, AL 35295 USA. Birmingham Vet Affairs Med Ctr, Birmingham, AL 35295 USA. Cornell Univ, Weill Med Coll, Lab Motor Neuron Biol, Burke Med Res Inst, White Plains, NY 10605 USA. Cornell Univ, Weill Med Coll, Dept Neurol & Neurosci, White Plains, NY 10605 USA. RP King, PH (reprint author), 1530 3rd Ave S, Birmingham, AL 35294 USA. EM pking@uab.edu FU NCI NIH HHS [CA97247]; NINDS NIH HHS [NS42834, NS36761] NR 73 TC 37 Z9 38 U1 0 U2 1 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD JUL 25 PY 2007 VL 27 IS 30 BP 7929 EP 7938 DI 10.1523/JNEUROSCI.1877-07.2007 PG 10 WC Neurosciences SC Neurosciences & Neurology GA 196MA UT WOS:000248484800006 PM 17652584 ER PT J AU Dublin, S Lumley, T Glazer, NL Psaty, BM French, B Wiggins, KL Smith, NL Heckbert, SR AF Dublin, Sascha Lumley, Thomas Glazer, Nicole L. Psaty, Bruce M. French, Benjamin Wiggins, Kerri L. Smith, Nicholas L. Heckbert, Susan R. TI Atrial fibrillation, obesity, and obstructive sleep apnea - Reply SO ARCHIVES OF INTERNAL MEDICINE LA English DT Editorial Material C1 VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA 98101 USA. RP Dublin, S (reprint author), VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Metropolitan Pk W,1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM Sascha.Dublin@va.gov NR 2 TC 0 Z9 0 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-9926 J9 ARCH INTERN MED JI Arch. Intern. Med. PD JUL 23 PY 2007 VL 167 IS 14 BP 1553 EP 1553 DI 10.1001/archinte.167.14.1553-a PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 192UY UT WOS:000248230100020 ER PT J AU Harel, O Zhou, XH AF Harel, Ofer Zhou, Xiao-Hua TI Multiple imputation: Review of theory, implementation and software SO STATISTICS IN MEDICINE LA English DT Review DE multiple imputation; sensitivity and specificity; diagnostic tests ID PATTERN-MIXTURE MODELS; DATA AUGMENTATION; IMPUTED DATA; MISSING DATA; POSTERIOR DISTRIBUTIONS; INCOMPLETE DATA; DROP-OUT; TESTS; VERIFICATION; ESTIMATORS AB Missing data is a common complication in data analysis. In many medical settings missing data can cause difficulties in estimation, precision and inference. Multiple imputation (MI) (Multiple Imputation for Nonresponse in Surveys. Wiley: New York, 1987) is a simulation-based approach to deal with incomplete data. Although there are many different methods to deal with incomplete data, MI has become one of the leading methods. Since the late 1980s we observed a constant increase in the use and publication of MI-related research. This tutorial does not attempt to cover all the material concerning MI, but rather provides an overview and combines together the theory behind MI, the implementation of MI, and discusses increasing possibilities of the use of MI using commercial and free software. We illustrate some of the major points using an example from an Alzheimer disease (AD) study. In this AD study, while clinical data are available for all subjects, postmortem data are only available for the subset of those who died and underwent an autopsy. Analysis of incomplete data requires making unverifiable assumptions. These assumptions are discussed in detail in the text. Relevant S-Plus code is provided. Copyright (C) 2007 John Wiley & Sons, Ltd. C1 Univ Connecticut, Dept Stat, Storrs, CT 06269 USA. VA Puget Sound Hlth Care Syst, HSR&D Ctr Excellence, Seattle, WA 98108 USA. Univ Washington, Sch Publ Hlth, Dept Biostat, Seattle, WA 98195 USA. RP Harel, O (reprint author), Univ Connecticut, Dept Stat, 215 Glenbrook Rd Unit 4120, Storrs, CT 06269 USA. EM oharel@stat.uconn.edu FU AHRQ HHS [R01HS013105]; NHLBI NIH HHS [R01HL62567]; NIA NIH HHS [U01 AG016976, U01 AG16976]; NIMH NIH HHS [K01 MH087219] NR 59 TC 136 Z9 138 U1 1 U2 31 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 0277-6715 J9 STAT MED JI Stat. Med. PD JUL 20 PY 2007 VL 26 IS 16 BP 3057 EP 3077 DI 10.1002/sim.2787 PG 21 WC Mathematical & Computational Biology; Public, Environmental & Occupational Health; Medical Informatics; Medicine, Research & Experimental; Statistics & Probability SC Mathematical & Computational Biology; Public, Environmental & Occupational Health; Medical Informatics; Research & Experimental Medicine; Mathematics GA 187GX UT WOS:000247836700001 PM 17256804 ER PT J AU Cushman, WC Grimm, RH Cutler, JA Evans, GW Capes, S Corson, MA Sadler, LS Alderman, MH Peterson, K Bertoni, A Basile, JN AF Cushman, William C. Grimm, Richard H., Jr. Cutler, Jeffrey A. Evans, Gregory W. Capes, Sarah Corson, Marshall A. Sadler, Laurie S. Alderman, Michael H. Peterson, Kevin Bertoni, Alain Basile, Jan N. CA ACCORD Study Grp TI Rationale and design for the blood pressure intervention of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID LIPID-LOWERING TREATMENT; JOINT NATIONAL COMMITTEE; MICROVASCULAR COMPLICATIONS; HYPERTENSIVE PATIENTS; ANTIHYPERTENSIVE TREATMENT; SYSTOLIC HYPERTENSION; DISEASE RISK; 7TH REPORT; OUTCOMES; MELLITUS AB The Action to Control Cardiovascular Disease in Diabetes (ACCORD) blood pressure trial is an unmasked, open-label, randomized trial with a sample size of 4,733 participants. This report describes the rationale, design, and methods of the blood pressure interventions in ACCORD. Participants eligible for the blood pressure trial are randomized to 1 of 2 groups with different treatment goals: systolic blood pressure < 120 mm Hg for the more intensive goal and systolic blood pressure < 140 mm Hg for the less intensive goal. The primary outcome measure for the trial is the first occurrence of a major cardiovascular disease (CVD) event, specifically nonfatal myocardial infarction or stroke, or cardiovascular death during a follow-up period ranging from 4-8 years. The ACCORD blood pressure trial should provide the first definitive clinical trial data on the possible benefit of treating to a more aggressive systolic blood pressure goal in reducing CVD events in patients with diabetes mellitus. (c) 2007 Elsevier Inc. All rights reserved. C1 Vet Affairs Med Ctr, Memphis, TN USA. Hennepin Cty Med Ctr, Berman Ctr Outcomes & Clin Res, Div Clin Epidemiol, Minneapolis, MN 55415 USA. NHLBI, Div Cardiovasc Dis, Vasc Biol & Hypertens Branch, Bethesda, MD 20892 USA. Wake Forest Univ, Sch Med, Dept Epidemiol & Prevent, Winston Salem, NC 27109 USA. McMaster Univ, Dept Med, Hamilton, ON, Canada. Univ Washington, Med Ctr, Dept Med, Div Cardiol, Seattle, WA 98195 USA. St Vincent Charity Hosp, Lipid Res Ctr, Cleveland, OH USA. Albert Einstein Coll Med, Dept Med & Epidemiol, Bronx, NY 10467 USA. Univ Minnesota, Phalen Village Clin, Minneapolis, MN USA. Ralph H Johnson Vet Affairs Med Ctr, Charleston, SC USA. RP Cushman, WC (reprint author), Vet Affairs Med Ctr, Prevent Med Sect 111Q, 1030 Jefferson Ave, Memphis, TN 38104 USA. EM william.cushman@va.gov OI Peterson, Kevin/0000-0002-6914-8586 FU NHLBI NIH HHS [Y1-HC-1010, N01-HC-95180, N01-HC-95181, N01-HC-95184, Y1-HC-9035, N01-HC-95183, N01-HC-95178, N01-HC-95179, N01-HC-95182] NR 33 TC 17 Z9 18 U1 0 U2 2 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD JUL 18 PY 2007 VL 99 IS 12A SU S BP 44I EP 55I DI 10.1016/j.amjcard.2007.03.005 PG 12 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 188RV UT WOS:000247937900005 PM 17599425 ER PT J AU Guzman-Marin, R Suntsova, N Bashir, T Szymusiak, R McGinty, D AF Guzman-Marin, Ruben Suntsova, Natalia Bashir, Tariq Szymusiak, Ronald McGinty, Dennis TI Cell proliferation in the dentate gyrus of the adult rat fluctuates with the light-dark cycle SO NEUROSCIENCE LETTERS LA English DT Article DE cell proliferation; dentate gyrus; hippocampus; circadian; BrdU ID NEUROGENESIS; SLEEP; HIPPOCAMPUS; PERIOD2; RHYTHMS AB This study measured cell proliferation in the hippocampal dentate gyrus in the adult rat at different times within a 12:12 It light-dark cycle. The experiments were conducted in animals living in either a complex environment or in standard lab cages. A single dose of the thymidine analog 5-Bromo-2'-deoxyuridine (BrdU) was injected 2 h before animals were sacrificed either 4, 11, 16, or 23 h after the beginning of the light phase of the light-dark cycle (designated ZT0). In both studies, we found a significant increase in the number of BrdU-positive cells in the subgranular cell layer (SGZ) following BrdU administration at ZT9 and sacrifice at ZT11, compared to other circadian times examined. BrdU administration at ZT9 was timed to primarily identify proliferating cells that were in the S phase of the cell cycle during the light phase. Our results suggest that cell proliferation is enhanced either by sleep or by other variables coupled to the light phase of the circadian cycle. Published by Elsevier Ireland Ltd. C1 VA Greater Los Angeles Healthcare Syst, Res Serv, North Hills, CA 91343 USA. Univ Calif Los Angeles, Dept Psychol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Rostov State Univ, AB Kogan Res Inst Neurocybernet, Rostov Na Donu 344006, Russia. RP McGinty, D (reprint author), VA Greater Los Angeles Healthcare Syst, Res Serv, 151A3,16111 Plummer St, North Hills, CA 91343 USA. EM dmcginty@ucla.edu FU NHLBI NIH HHS [HL 60296, P50 HL060296, P50 HL060296-090010]; NIMH NIH HHS [R01 MH075076, R01 MH075076-01A2]; PHS HHS [075076] NR 17 TC 22 Z9 22 U1 0 U2 4 PU ELSEVIER IRELAND LTD PI CLARE PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000, IRELAND SN 0304-3940 J9 NEUROSCI LETT JI Neurosci. Lett. PD JUL 18 PY 2007 VL 422 IS 3 BP 198 EP 201 DI 10.1016/j.neulet.2007.06.022 PG 4 WC Neurosciences SC Neurosciences & Neurology GA 203MV UT WOS:000248979600010 PM 17611030 ER PT J AU Hayden, KM Zandi, PP Khachaturian, AS Szekely, CA Fotuhi, M Norton, MC Tschanz, JT Pieper, CF Corcoran, C Lyketsos, CG Breitner, JCS Welsh-Bohmer, KA AF Hayden, K. M. Zandi, P. P. Khachaturian, A. S. Szekely, C. A. Fotuhi, M. Norton, M. C. Tschanz, J. T. Pieper, C. F. Corcoran, C. Lyketsos, C. G. Breitner, J. C. S. Welsh-Bohmer, K. A. CA Cache County Investigators TI Does NSAID use modify cognitive trajectories in the elderly? The Cache county study SO NEUROLOGY LA English DT Article ID NONSTEROIDAL ANTIINFLAMMATORY DRUGS; HORMONE REPLACEMENT THERAPY; ALZHEIMERS-DISEASE; CONTROLLED-TRIAL; OLDER WOMEN; DECLINE; AD; PLACEBO; ANTAGONISTS; PREVENTION AB Background: Epidemiologic studies have suggested that nonsteroidal anti-inflammatory drugs (NSAIDs) may be useful for the prevention of Alzheimer disease (AD). By contrast, clinical trials have not supported NSAID use to delay or treat AD. Few studies have evaluated cognitive trajectories of NSAID users over time. Methods: Residents of Cache County, UT, aged 65 or older on January 1, 1995, were invited to participate in the study. At baseline, participants provided a detailed inventory of their medications and completed a revised Modified Mini-Mental State Examination (3MS). Participants (n = 3,383) who were cognitively normal at baseline were re-examined after 3 and 8 years. The association between NSAID use and 3MS scores over time was estimated using random effects modeling. Results: Associations depended upon when NSAIDs were started and APOE genotype. In participants who started NSAID use prior to age 65, those with no APOE epsilon 4 alleles performed similarly to nonusers (a difference of 0.10 points per year; p = 0.19), while those with one or more epsilon 4 allele(s) showed more protection (0.40 points per year; p = 0.0005). Among participants who first used NSAIDs at or after age 65, those with one or more epsilon 4 alleles had higher baseline scores (0.95 points; p = 0.03) but did not show subsequent difference in change in score over time (0.06 points per year; p = 0.56). Those without an epsilon 4 allele who started NSAID use after age 65 showed greater decline than nonusers (-0.16 points per year; p = 0.02). Conclusions: Nonsteroidal anti-inflammatory drug use may help to prevent cognitive decline in older adults if started in midlife rather than late life. This effect may be more notable in those who have one or more APOE = 4 alleles. C1 Duke Univ, Med Ctr, Dept Psychiat & Behav Sci, Durham, NC USA. Johns Hopkins Bloomberg Sch Publ Hlth, Dept Mental Hlth, Baltimore, MD USA. Johns Hopkins Sch Med, Dept Neurol, Baltimore, MD USA. Khachaturian & Associates Inc, Baltimore, MD USA. Sinai Hosp, Baltimore, MD 21215 USA. Utah State Univ, Dept Family Consumer & Human Dev, Logan, UT 84322 USA. Utah State Univ, Dept Psychol, Logan, UT 84322 USA. Utah State Univ, Ctr Epidemiol Studies, Logan, UT 84322 USA. Utah State Univ, Dept Math & Stat, Logan, UT 84322 USA. Duke Univ, Dept Biometry & Bioinformat, Durham, NC USA. Duke Univ, Ctr Study Aging & Human Dev, Durham, NC USA. Johns Hopkins Univ, Sch Med, Dept Psychiat & Behav Sci, Baltimore, MD 21205 USA. VA Puget Sound Hlth Care Syst, Seattle, WA USA. Univ Washington, Sch Med, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. RP Hayden, KM (reprint author), Joseph & Kathleen Bryan ADRC, DUMC, 2200 W Main St,Suite A-200, Durham, NC 27705 USA. EM khayden@duke.edu RI Szekely, Christine/C-1342-2009; Corcoran, Chris/F-2155-2010; Tschanz, JoAnn/E-5986-2010; Norton, Maria/E-6994-2013; Hayden, Kathleen/B-6442-2012 OI Hayden, Kathleen/0000-0002-7745-3513; Fotuhi, Majid/0000-0002-0980-1176; Schwartz, Sarah/0000-0001-9980-7493 FU NIA NIH HHS [T32-AG00029, R01 AG011380, R01-AG11380]; NIMH NIH HHS [T32-MH14592] NR 28 TC 71 Z9 75 U1 0 U2 4 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0028-3878 J9 NEUROLOGY JI Neurology PD JUL 17 PY 2007 VL 69 IS 3 BP 275 EP 282 DI 10.1212/01.wnl.0000265223.25679.2a PG 8 WC Clinical Neurology SC Neurosciences & Neurology GA 190LN UT WOS:000248060400009 PM 17636065 ER PT J AU Song, BB Chen, WL Marvizon, JCG AF Song, Bingbing Chen, Wenling Marvizon, Juan Carlos G. TI Inhibition of opioid release in the rat spinal cord by serotonin 5-HT1A receptors SO BRAIN RESEARCH LA English DT Article DE 5-HT1A receptor; dorsal horn; enkephalin; internalization; Mu-opioid receptor; serotonin ID DORSAL-HORN NEURONS; ENKEPHALIN-DEGRADING ENZYMES; MEDIAL PREOPTIC NUCLEUS; D-ASPARTATE RECEPTORS; MIXED INHIBITOR; PRIMARY AFFERENTS; SUBTYPES; INTERNALIZATION; ACTIVATION; RESPONSES AB Neurotransmitter receptors that inhibit the release of opioid peptides in the spinal cord may play an important role in modulating pain. Serotonin is an important neurotransmitter in bulbospinal descending pathways, and 5-HT1, receptors have been shown to inhibit synaptic transmission. Our goal was to determine whether 5-HT1A receptors inhibit opioid release in the spinal cord. Opioid release was evoked from rat spinal cord slices by electrically stimulating one dorsal horn, and measured in situ through the internalization of mu-opioid receptors in dorsal horn neurons. Stimulation with 1000 square pulses at 500 Hz produced internalization in 60% of the mu-opioid receptor neurons in the stimulated dorsal horn, but not in the contralateral one. The selective 5-HT1A receptor agonist 8-hydroxy-2-dipropylaminotetralin (8-OH-DPAT) inhibited the evoked mu-opioid receptor internalization by about 50%, with an approximate IC50 of 50 nM. The effect of 8-OH-DPAT was attributed to inhibition of opioid release and not of the receptor internalization process, because 8-OH-DPAT did not inhibit the internalization induced by incubating the slices with a mu-opioid receptor agonist (endomorphin-2, 100 nM). The selective 5-HT1A receptor antagonist WAY100135 (10 mu M) blocked the inhibition produced by 1 mu M 8-OH-DPAT. These results show that 5-HT1A receptors inhibit opioid release in the spinal dorsal horn, probably from a subpopulation of enkephalin-containing presynaptic terminals. Therefore, 5-HT1A receptors likely decrease the analgesia produced by endogenously released opioids. (c) 2007 Elsevier B.V. All rights reserved. C1 VA Greater Los Angeles Hlthcare Syst, Los Angeles, CA 90073 USA. Univ Calif Los Angeles, David Geffen Sch Med, Ctr Neurovisceral Sci, Los Angeles, CA 90095 USA. Womans Hlth & CURE, Digest Dis Res Ctr, Dept Med, Div Digest Dis, Los Angeles, CA 90095 USA. RP Marvizon, JCG (reprint author), VA Greater Los Angeles Hlthcare Syst, Bldg 115,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM marvizon@ucla.edu RI Chen, Wenling/A-4490-2012 FU NIDA NIH HHS [2 RO1-DA012609, R01 DA012609-08, R01 DA012609-06A1, R01 DA012609, R01 DA012609-07] NR 47 TC 17 Z9 18 U1 0 U2 3 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 0006-8993 J9 BRAIN RES JI Brain Res. PD JUL 16 PY 2007 VL 1158 BP 57 EP 62 DI 10.1016/j.brainres.2007.05.006 PG 6 WC Neurosciences SC Neurosciences & Neurology GA 199QN UT WOS:000248710400006 PM 17555728 ER PT J AU Spiegel, B Schoenfeld, P Naliboff, B AF Spiegel, B. Schoenfeld, P. Naliboff, B. TI Systematic review: the prevalence of suicidal behaviour in patients with chronic abdominal pain and irritable bowel syndrome SO ALIMENTARY PHARMACOLOGY & THERAPEUTICS LA English DT Review ID QUALITY-OF-LIFE; CHILDHOOD SEXUAL ABUSE; PSYCHIATRIC-DISORDER; YOUNG ADULTHOOD; HEALTH; DEPRESSION; SYMPTOMS; RISK; STRATEGIES; IDEATION AB Background Chronic abdominal pain syndromes may increase the risk of suicidal behaviour - a feature well described in non-visceral pain syndromes. Aim To perform a systematic review to summarize and interpret published data linking chronic abdominal pain syndromes and suicidal behaviour. Methods We performed a structured search to identify studies pertaining to the following questions: (i) What is the prevalence of suicidal behaviour in patients with chronic abdominal pain syndromes, including bowel syndrome (IBS)? (ii) Is the prevalence of suicidal behaviour in chronic abdominal pain syndromes higher than in matched controls? And (iii) is suicidal behaviour in abdominal pain syndromes simply due to psychiatric co-morbidities? Results Thirty-two relevant titles were identified, of which six manuscripts, describing eight studies, met inclusion criteria. Patients with non-IBS syndromes were 3 - 11 times more likely to demonstrate suicidal behaviour vs. controls, while patients with IBS were two to four times more likely to have suicidal behaviour. Chronic abdominal pain was an independent predictor of suicidal behaviour after adjusting for co-morbid psychiatric conditions. Conclusions Chronic abdominal pain syndromes increase the risk for suicidal behaviours. This relationship may exist independently of co-morbid depression, although additional research is needed to better understand this link. These data indicate that clinicians should survey for suicidal behaviour in chronic abdominal pain patients. C1 VA Greater Los Angeles Healthcare Syst, Div Gastroenterol & Hepatol, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Div Digest Dis, Los Angeles, CA USA. Univ Calif Los Angeles, VA Ctr Outcomes Res & Educ, Los Angeles, CA USA. Univ Michigan, Med Ctr, Div Gastroenterol, Ann Arbor, MI 48109 USA. VA Ctr Excellence Hlth Sci Res, Ann Arbor, MI USA. RP Schoenfeld, P (reprint author), VAMC 111-D,2215 Fuller Rd, Ann Arbor, MI 48105 USA. EM pschoenf@med.umich.edu NR 34 TC 26 Z9 29 U1 8 U2 11 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0269-2813 J9 ALIMENT PHARM THERAP JI Aliment. Pharmacol. Ther. PD JUL 15 PY 2007 VL 26 IS 2 BP 183 EP 193 DI 10.1111/j.1365-2036.2007.03357.x PG 11 WC Gastroenterology & Hepatology; Pharmacology & Pharmacy SC Gastroenterology & Hepatology; Pharmacology & Pharmacy GA 181ZU UT WOS:000247475700005 PM 17593064 ER PT J AU Cavusoglu, E Eng, C Chopra, V Ruwende, C Yanamadala, S Clark, LT Pinsky, DJ Marmur, JD AF Cavusoglu, Erdal Eng, Calvin Chopra, Vineet Ruwende, Cyril Yanamadala, Sunitha Clark, Luther T. Pinsky, David J. Marmur, Jonathan D. TI Usefulness of the serum complement component C4 as a predictor of stroke in patients with known or suspected coronary artery disease referred for coronary angiography SO AMERICAN JOURNAL OF CARDIOLOGY LA English DT Article ID TRANSIENT ISCHEMIC ATTACK; REACTIVE PROTEIN; INDEPENDENT PREDICTOR; RISK; EVENTS; WOMEN; ATHEROSCLEROSIS; ACTIVATION; RECEPTOR-1; COMPLEXES AB The complement system has been implicated in the pathogenesis of atherosclerosis. In addition, complement activation and complement-mediated brain injury have been found in a variety of central nervous system diseases, including stroke. However, there are limited data about the value of complement components for prediction of stroke. Complement C3 and C4 levels, in addition to a variety of established biomarkers, were measured in 389 men with known or suspected coronary artery disease referred for coronary angiography for a variety of indications at a Veterans Affairs Medical Center. Patients were followed prospectively for the development of stroke, which was defined and classified according to criteria of the Trial of Org 10172 in Acute Stroke Treatment (TOAST). All strokes were confirmed with magnetic resonance imaging or computed tomography. For the 97% of patients in whom 24-month follow-up data were available, there were 23 strokes (5.9%). By multivariate Cox proportional hazard analysis, complement C4 was an independent predictor of stroke, with a hazard ratio of 1.57 (95% confidence interval 1.03 to 2.39, p = 0.0358). The 24-month stroke-free survival rate for the patients whose complement C4 levels were equal to or below the median value for the entire cohort was 96.1% compared with 90.1% for patients whose complement C4 levels were above the median value, p = 0.0127 by log rank test). In conclusion, in a cohort of men across a spectrum of risk referred for coronary angiography, a single baseline determination of serum complement C4 level is an-independent predictor of the future development of stroke. (C) 2007 Elsevier Inc. All rights reserved. C1 SUNY Downstate Med Ctr, Dept Med, Div Cardiol, Brooklyn, NY USA. Bronx Vet Affairs Med Ctr, Dept Med, Div Cardiol, Bronx, NY USA. Univ Michigan, Dept Med, Div Cardiovasc Med, Ann Arbor, MI USA. RP Cavusoglu, E (reprint author), SUNY Downstate Med Ctr, Dept Med, Div Cardiol, Brooklyn, NY USA. EM ecavusoglu@aol.com NR 25 TC 15 Z9 16 U1 0 U2 0 PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010 USA SN 0002-9149 J9 AM J CARDIOL JI Am. J. Cardiol. PD JUL 15 PY 2007 VL 100 IS 2 BP 164 EP 168 DI 10.1016/j.amjcard.2007.02.075 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 194DN UT WOS:000248324400002 PM 17631062 ER PT J AU Musher, DM Rueda, AM Kaka, AS Mapara, SM AF Musher, Daniel M. Rueda, Adriana M. Kaka, Anjum S. Mapara, Sulaiman M. TI The association between pneumococcal pneumonia and acute cardiac events SO CLINICAL INFECTIOUS DISEASES LA English DT Article ID ACUTE MYOCARDIAL-INFARCTION; C-REACTIVE PROTEIN; CARDIOVASCULAR RISK-FACTORS; HEAVY PHYSICAL EXERTION; CRITICALLY-ILL PATIENTS; CORONARY-HEART-DISEASE; NECROSIS-FACTOR-ALPHA; NATRIURETIC PEPTIDE; SEPTIC SHOCK; TROPONIN-I AB Background. Increased cardiac stress, hypoxemia, and inflammation may contribute to acute cardiac events, such as myocardial infarction ( MI), arrhythmia, and/or congestive heart failure ( CHF). We sought to determine the incidence of such events in patients who were hospitalized for community-acquired pneumococcal pneumonia. Methods. We studied the medical records of all patients who were admitted for pneumococcal pneumonia during a 5-year period ( 2001-2005) to identify those who had MI, atrial fibrillation or ventricular tachycardia, or new-onset or worsening CHF at the time of hospital admission. Results. Of 170 patients, 33 ( 19.4%) had >= 1 of these major cardiac events. Twelve had MI, of whom 2 also had arrhythmia and 5 had new-onset or worsening CHF. Eight had new-onset atrial fibrillation or ventricular tachycardia; 6 of these also had new CHF. Thirteen had newly diagnosed or worsening CHF, without MI or new arrhythmias. Hypoxemia and anemia were prominent. Importantly, patients with concurrent pneumococcal pneumonia and cardiac events had a significantly higher mortality than those with pneumococcal pneumonia alone (P < .008). The coexistence of pulmonary and cardiac disease was often overlooked by admitting physicians who, seeking a unifying diagnosis, emphasized one diagnosis to the exclusion of the other. Conclusions. Patients with pneumococcal pneumonia are at substantial risk for a concurrent acute cardiac event, such as MI, serious arrhythmia, or new or worsening CHF. This concurrence significantly increases mortality due to pneumonia. Admitting physicians tend to seek a unifying diagnosis, but the frequent coexistence of pneumonia and cardiac events indicates the importance of considering multiple diagnoses. C1 Michael E DeBakey Vet Affairs Med Ctr, Infect Dis Sect, Med Care Line, Houston, TX 77030 USA. Baylor Coll Med, Dept Med, Infect Dis Sect, Houston, TX 77030 USA. Baylor Coll Med, Dept Mol Virol & Microbiol, Houston, TX 77030 USA. RP Musher, DM (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Infect Dis Sect, Med Care Line, Rm 4B-370,2002 Holcombe Blvd, Houston, TX 77030 USA. EM daniel.musher@med.va.gov FU NIAID NIH HHS [5T32AI055413-03] NR 43 TC 102 Z9 112 U1 0 U2 5 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL 15 PY 2007 VL 45 IS 2 BP 158 EP 165 DI 10.1086/518849 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 180EC UT WOS:000247343900003 PM 17578773 ER PT J AU Chaiswing, L Bourdeau-Heller, JM Zhong, WX Oberley, TD AF Chaiswing, Luksana Bourdeau-Heller, Jeanne M. Zhong, Weixiong Oberley, Terry D. TI Characterization of redox state of two human prostate carcinoma cell lines with different degrees of aggressiveness SO FREE RADICAL BIOLOGY AND MEDICINE LA English DT Article DE cell growth; LNCaP; PC3; redox state; free radicals ID MANGANESE SUPEROXIDE-DISMUTASE; OXIDATIVE STRESS; HYDROGEN-PEROXIDE; CANCER-CELLS; ANTIOXIDANT ENZYMES; SIGNAL-TRANSDUCTION; NITRIC-OXIDE; TUMOR-GROWTH; STEM-CELLS; IN-VIVO AB We characterized the redox profiles in two different human prostate carcinoma cell lines (LNCaP vs PC3) that are known to exhibit varying degrees of invasiveness/metastatic ability. We confirmed that PC3 cells were more in-vasive than LNCaP cells through an in vitro analysis. The present study documented higher 8-hydroxy-2'-deoxyguanosine levels in PC3 cells than in LNCaP cells. The levels of lipid peroxidation were higher in LNCaP cells than in PC3 cells. The reduced glutathione (GSH)/glutathione disulfide (GSSG) ratio increased to a greater extent during cell growth in PC3 cells than in LNCaP cells, whereas both reduced GSH and GSSG levels were higher in the medium of PC3 cells than in that of LNCaP cells. The levels of reactive oxygen (ROS) and reactive nitrogen species (RNS), both intracellularly and in the medium, were higher for LNCaP cells than for PC3 cells during cell growth. In addition, our results demonstrated higher ROS/RNS levels in LNCaP cells than in PC3 cells in S and G2/M phases of the cell cycle during logarithmic growth. Each cell type showed distinct cytotoxic responses to low-molecular-weight redox-modulating compounds. Our results document that human prostate cancer cell lines of varying degrees of aggressive behavior have distinct redox properties, findings that could lead to novel therapeutic interventions. Published by Elsevier Inc. C1 William S Middleton Mem Vet Adm Med Ctr, Pathol & Lab Med Serv, Madison, WI 53705 USA. Univ Wisconsin, Sch Med & Publ Hlth, Dept Pathol & Lab Med, Madison, WI 53706 USA. RP Oberley, TD (reprint author), William S Middleton Mem Vet Adm Med Ctr, Pathol & Lab Med Serv, 2500 Overlook Terrace, Madison, WI 53705 USA. EM toberley@wisc.edu NR 42 TC 38 Z9 38 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0891-5849 J9 FREE RADICAL BIO MED JI Free Radic. Biol. Med. PD JUL 15 PY 2007 VL 43 IS 2 BP 202 EP 215 DI 10.1016/j.freeradbiomed.2007.03.031 PG 14 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 189TW UT WOS:000248012400007 PM 17603930 ER PT J AU Joos, B Fischer, M Schweizer, A Kuster, H Boni, J Wong, JK Weber, R Trkola, A Gunthard, HF AF Joos, Beda Fischer, Marek Schweizer, Andreas Kuster, Herbert Boeni, Juerg Wong, Joseph K. Weber, Rainer Trkola, Alexandra Guenthard, Huldrych F. TI Positive in vivo selection of the HIV-1 envelope protein gp120 occurs at surface-exposed regions SO JOURNAL OF INFECTIOUS DISEASES LA English DT Article; Proceedings Paper CT 15th International HIV Drug Resistance Workshop CY JUN 13-17, 2006 CL Sitges, SPAIN ID STRUCTURED TREATMENT INTERRUPTIONS; VIRUS TYPE-1 INFECTION; T-CELL RESPONSES; ANTIRETROVIRAL THERAPY; DISEASE PROGRESSION; IMMUNODEFICIENCY; EVOLUTION; NEUTRALIZATION; ACCESSIBILITY; GLYCOPROTEIN AB The rapid evolution of human immunodeficiency virus ( HIV) envelope represents a major challenge to vaccine and drug development, particularly because the underlying mechanisms are not completely understood. To explore whether distinct patterns of positive selection within the envelope glycoprotein ( gp) 120 exist and are associated with functionally relevant domains, we conducted a long- term survey of sequence evolution in 20 HIV- 1 - infected persons who interrupted antiretroviral therapy. In total, 1753 clonal sequences encompassing the C2- V3- C3 region of gp120 were derived. Strikingly, positively selected amino acids mapped almost exclusively (P=.0003) to externally accessible residues on the gp120 crystal structure. The current understanding of envelope structure and function associates the main determinants of viral entry and the targets for neutralizing antibodies with these exterior regions of gp120, strongly suggesting that the observed adaptive evolution of these sites occurs in response to respective selective forces. C1 Univ Zurich Hosp, Dept Med, Div Infect Dis & Hosp Epidemiol, CH-8091 Zurich, Switzerland. Swiss Natl Ctr Retroviruses, Zurich, Switzerland. Univ Calif San Francisco, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. RP Joos, B (reprint author), Univ Zurich Hosp, Dept Med, Div Infect Dis & Hosp Epidemiol, Ramistr 100, CH-8091 Zurich, Switzerland. EM beda.joos@usz.ch; huldrych.guenthard@usz.ch RI Joos, Beda/D-5547-2009; gunthard, huldrych/F-1724-2011; Kuster, Herbert/A-3912-2013; Infektiologie, USZ/A-6921-2011; Weber, Rainer/D-5175-2012; Trkola, Alexandra/K-2115-2012 OI Joos, Beda/0000-0002-3082-8875; gunthard, huldrych/0000-0002-1142-6723; Trkola, Alexandra/0000-0003-1013-876X FU NINDS NIH HHS [R01 NS51132] NR 30 TC 10 Z9 11 U1 1 U2 3 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0022-1899 J9 J INFECT DIS JI J. Infect. Dis. PD JUL 15 PY 2007 VL 196 IS 2 BP 313 EP 320 DI 10.1086/518935 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 186UF UT WOS:000247803100020 PM 17570120 ER PT J AU Weintraub, D Saboe, K Stern, MB AF Weintraub, Daniel Saboe, Kirsten Stern, Matthew B. TI Effect of age on geriatric depression scale performance in Parkinson's disease SO MOVEMENT DISORDERS LA English DT Article DE Parkinson's disease; depression; age; Geriatric Depression Scale ID NONMOTOR SYMPTOMS; RATING-SCALE; VALIDITY; INVENTORY; HAMILTON AB The purpose of this study was to compare the validity of the 15-item Geriatric Depression Scale (GDS-15) in nonelderly (< 65 years), young-elderly (age, 65-75), and old-elderly (> 75 years) patients with Parkinson's disease (PD). 57 nonelderly, 88 young-elderly, and 81 old-elderly PD patients were administered the GDS-15 and the Structured Clinical Interview for DSM-IV depression module. Receiver-operating characteristic (ROC) curves were plotted for GDS-15 scores against a DSM-IV diagnosis of major or minor depression. The discriminant validity of the GDS-15 was high for nonelderly, young-elderly, and old-elderly subjects (ROC area under curve = 0.92, 0.91, and 0.95, respectively), with optimal dichotomization at a cut-off of 415 (85% sensitivity and 84% specificity in nonelderly; 89% sensitivity and 82% specificity in young-elderly) and 5/6 (90% sensitivity and 90% specificity in old-elderly). In conclusion, the GDS-15 has comparable validity in younger and older PD patients, suggesting its appropriateness as a depression screening instrument in PD patients of all ages. (c) 2007 Movement Disorder Society C1 Univ Penn, Dept Psychiat, Philadelphia, PA 19104 USA. Univ Penn, Dept Neurol, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, PADRECC, Philadelphia, PA USA. Philadelphia Vet Affairs Med Ctr, MIRECC, Philadelphia, PA USA. RP Weintraub, D (reprint author), 3535 Market St,Rm 3003, Philadelphia, PA 19104 USA. EM weintrau@mail.med.upenn.edu FU NIMH NIH HHS [K23 MH067894, K23 MH067894-04]; PHS HHS [NIMH 067894] NR 21 TC 36 Z9 37 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0885-3185 J9 MOVEMENT DISORD JI Mov. Disord. PD JUL 15 PY 2007 VL 22 IS 9 BP 1331 EP 1335 DI 10.1002/mds.21369 PG 5 WC Clinical Neurology SC Neurosciences & Neurology GA 197BG UT WOS:000248527500021 PM 17546674 ER PT J AU Spinewine, A Schmader, KE Barber, N Hughes, C Lapane, KL Swine, C Hanlon, JT AF Spinewine, Anne Schmader, Kenneth E. Barber, Nick Hughes, Carmel Lapane, Kate L. Swine, Christian Hanlon, Joseph T. TI Prescribing in elderly people 1 - Appropriate prescribing in elderly people: how well can it be measured and optimised? SO LANCET LA English DT Review ID RANDOMIZED CONTROLLED-TRIAL; INAPPROPRIATE MEDICATION USE; DRUG-RELATED MORBIDITY; NURSING-HOME RESIDENTS; QUALITY-OF-CARE; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; CLINICAL PHARMACIST INTERVENTION; HOSPITALIZED OLDER-ADULTS; LONG-TERM-CARE; POTENTIALLY INAPPROPRIATE AB Prescription of medicines is a fundamental component of the care of elderly people, and optimisation of drug prescribing for this group of patients has become an important public-health issue worldwide. Several characteristics of ageing and geriatric medicine affect medication prescribing for elderly people and render the selection of appropriate pharmacotherapy a challenging and complex process. In the first paper in this series we aim to define and categorise appropriate prescribing in elderly people, critically review the instruments that are available to measure it and discuss their predictive validity, critically review recent randomised controlled intervention studies that assessed the effect of optimisation strategies on the appropriateness of prescribing in elderly people, and suggest directions for future research and practice. C1 Univ Catholique Louvain, Ctr Clin Pharm, Sch Pharm, B-1200 Brussels, Belgium. Duke Univ, Med Ctr, Sch Med, Dept Geriatr Med, Durham, England. Duke Univ, Med Ctr, Aging Ctr, Durham, England. Vet Affairs Med Ctr, Ctr Geriatr Res Educ & Clin, Durham, NC USA. Univ London, Sch Pharm, Dept Practice & Policy, London, England. Queens Univ Belfast, Sch Pharm, Belfast, Antrim, North Ireland. Brown Med Sch, Dept Community Hlth, Providence, RI USA. Univ Catholique Louvain, Mt Godinne Univ Hosp, Dept Geriatr Med, B-1200 Brussels, Belgium. Univ Pittsburgh, Inst Aging, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Geriatr Med, Pittsburgh, PA USA. Univ Pittsburgh, Sch Pharm, Dept Pharm & Therapeut, Pittsburgh, PA USA. Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equ Res, Pittsburgh, PA USA. Vet Affairs Pittsburgh Healthcare Syst, Ctr Geriatr Res Educ & Clin, Pittsburgh, PA USA. RP Spinewine, A (reprint author), Univ Catholique Louvain, Ctr Clin Pharm, Sch Pharm, UCL 73-70,Ave E Mounier 73, B-1200 Brussels, Belgium. EM anne.spinewine@facm.ucl.ac.be FU AHRQ HHS [U18HS016394]; NIA NIH HHS [P30 AG024827, R01 AG027017, R01AG14158]; NIAID NIH HHS [K24AI051324-01]; NICHD NIH HHS [K12HD049109] NR 152 TC 369 Z9 388 U1 4 U2 51 PU LANCET LTD PI LONDON PA 84 THEOBALDS RD, LONDON WC1X 8RR, ENGLAND SN 0140-6736 J9 LANCET JI Lancet PD JUL 14 PY 2007 VL 370 IS 9582 BP 173 EP 184 DI 10.1016/S0140-6736(07)61091-5 PG 12 WC Medicine, General & Internal SC General & Internal Medicine GA 190WP UT WOS:000248091600032 PM 17630041 ER PT J AU Zhang, NH Wei, WZ Mody, I Houser, CR AF Zhang, Nianhui Wei, Weizheng Mody, Istvan Houser, Carolyn R. TI Altered localization of GABAA receptor subunits on dentate granule cell dendrites influences tonic and phasic inhibition in a mouse model of epilepsy SO JOURNAL OF NEUROSCIENCE LA English DT Article DE immunogold labeling; electron microscopy; dentate gyrus; tonic inhibition; neurosteroids; pilocarpine; temporal lobe; epilepsy ID TEMPORAL-LOBE EPILEPSY; MESSENGER-RNA EXPRESSION; DELTA-SUBUNIT; RAT HIPPOCAMPUS; GAMMA-2 SUBUNITS; DEFICIENT MICE; OVARIAN CYCLE; SYNAPSES; NEURONS; GYRUS AB Complex changes in GABA(A) receptors (GABA(A)Rs) in animal models of temporal lobe epilepsy during the chronic period include a decrease in the delta subunit and increases in the alpha 4 and gamma 2 subunits in the dentate gyrus. We used postembedding immunogold labeling to determine whether the subcellular locations of these subunits were also altered in pilocarpine-treated epileptic mice, and related functional changes were identified electrophysiologically. The ultrastructural studies confirmed a decrease in delta subunit labeling at perisynaptic locations in the molecular layer of the dentate gyrus where these subunits are critical for tonic inhibition. Unexpectedly, tonic inhibition in dentate granule cells was maintained in the epileptic mice, suggesting compensation by other GABA(A)Rs. An insensitivity of the tonic current to the neurosteroid tetrahydrodeoxy-corticosterone was consistent with decreased expression of the delta subunit. In the pilocarpine-treated mice, alpha 4 subunit labeling remained at perisynaptic locations, but increased gamma 2 subunit labeling was also found at many perisynaptic locations on granule cell dendrites, consistent with a shift of the gamma 2 subunit from synaptic to perisynaptic locations and potential partnership of the alpha 4 and gamma 2 subunits in the epileptic animals. The decreased gamma 2 labeling near the center of synaptic contacts was paralleled by a corresponding decrease in the dendritic phasic inhibition of granule cells in the pilocarpine-treated mice. These GABA(A) R subunit changes appear to impair both tonic and phasic inhibition, particularly at granule cell dendrites, and could reduce the adaptive responses of the GABA system in temporal lobe epilepsy. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Dept Neurol, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Physiol, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Brain Res Inst, Los Angeles, CA USA. Vet Adm Greater Los Angeles Healthcare Syst, Res Serv, Los Angeles, CA 90073 USA. RP Houser, CR (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Neurobiol, 10833 Le Conte Ave, Los Angeles, CA 90095 USA. EM houser@mednet.ucla.edu FU BLRD VA [I01 BX000404]; NINDS NIH HHS [NS002808, NS035985, NS051311] NR 61 TC 128 Z9 130 U1 0 U2 2 PU SOC NEUROSCIENCE PI WASHINGTON PA 11 DUPONT CIRCLE, NW, STE 500, WASHINGTON, DC 20036 USA SN 0270-6474 J9 J NEUROSCI JI J. Neurosci. PD JUL 11 PY 2007 VL 27 IS 28 BP 7520 EP 7531 DI 10.1523/JNEUROSCI.1555-07.2007 PG 12 WC Neurosciences SC Neurosciences & Neurology GA 191RD UT WOS:000248147900017 PM 17626213 ER PT J AU Harel, O Zhou, XH AF Harel, Ofer Zhou, Xiao-Hua TI Rejoinder to multiple imputation for correcting verification bias SO STATISTICS IN MEDICINE LA English DT Letter ID INTERVAL ESTIMATION; SAMPLES C1 Univ Connecticut, Dept Stat, Storrs, CT 06269 USA. VA Puget Sound Hlth Care Syst, HSR&D Ctr Excellence, Seattle, WA 98108 USA. Univ Washington, Sch Publ Hlth, Dept Biostat, Seattle, WA 98195 USA. RP Harel, O (reprint author), Univ Connecticut, Dept Stat, 215 Glenbrook Rd Unit 4120, Storrs, CT 06269 USA. EM oharel@stat.uconn.edu; azhou@u.washington.edu NR 10 TC 2 Z9 2 U1 0 U2 0 PU JOHN WILEY & SONS LTD PI CHICHESTER PA THE ATRIUM, SOUTHERN GATE, CHICHESTER PO19 8SQ, W SUSSEX, ENGLAND SN 0277-6715 J9 STAT MED JI Stat. Med. PD JUL 10 PY 2007 VL 26 IS 15 BP 3047 EP 3050 DI 10.1002/sim.2843 PG 4 WC Mathematical & Computational Biology; Public, Environmental & Occupational Health; Medical Informatics; Medicine, Research & Experimental; Statistics & Probability SC Mathematical & Computational Biology; Public, Environmental & Occupational Health; Medical Informatics; Research & Experimental Medicine; Mathematics GA 181AF UT WOS:000247408400009 ER PT J AU Martin, LF Leonard, S Hall, MH Tregellas, JR Freedman, R Olincy, A AF Martin, Laura F. Leonard, Sherry Hall, Mei-Hua Tregellas, Jason R. Freedman, Robert Olincy, Ann TI Sensory gating and alpha-7 nicotinic receptor gene allelic variants in schizoaffective disorder, bipolar type SO AMERICAN JOURNAL OF MEDICAL GENETICS PART B-NEUROPSYCHIATRIC GENETICS LA English DT Article DE schizophrenia; bipolar disorder; chromosomes; human pair 15; receptors; nicotinic; evoked potentials; auditory ID SUSCEPTIBILITY LOCI; CHROMOSOME 15Q13-14; SUGGESTIVE EVIDENCE; LINKAGE ANALYSIS; NO EVIDENCE; SCHIZOPHRENIA; SCAN; DISEQUILIBRIUM; PEDIGREES; FAMILIES/ AB Objectives: Single nucleotide allelic variants in the promoter region of the chromosome 15 alpha-7 acetylcholine nicotinic receptor gene (CHRNA7) are associated with both schizophrenia and the P50 auditory evoked potential sensory gating deficit. The purpose of this study was to determine if CHRNA7 promoter allelic variants are also associated with abnormal P50 ratios in persons with schizoaffective disorder, bipolar type. Methods: P50 auditory evoked potentials were recorded in a paired stimulus paradigm in 17 subjects with schizoaffective disorder, bipolar type. The P50 test to conditioning ratio was used as the measure of sensory gating. Mutation screening of the CHRNA7 promoter region was performed on the subjects' DNA samples. Comparisons to previously obtained data from persons with schizophrenia and controls were made. Results: Subjects with schizophrenia, regardless of allele status, had an abnormal mean P50 ratio. Subjects with schizoaffective disorder, bipolar type and a variant allele had an abnormal mean P50 ratio, whereas those schizoaffective subjects with the common alleles had a normal mean P50 ratio. Normal control subjects had a normal mean ratio, but controls with variant alleles had higher P50 ratios. Conclusions: In persons with bipolar type schizoaffective disorder, CHRNA7 promoter region allelic variants are linked to the capacity to inhibit the P50 auditory evoked potential and thus are associated with a type of illness genetically and biologically more similar to schizophrenia. (c) 2006 Wiley-Liss, Inc. C1 Univ Colorado, Hlth Sci Ctr, Dept Psychiat, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO USA. Kings Coll London, Inst Psychiat, London WC2R 2LS, England. RP Martin, LF (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Psychiat, 4200 E 9th Ave,C268-71, Denver, CO 80262 USA. EM laura.martin@uchsc.edu RI Tregellas, Jason/J-3637-2015; Hall, Mei-Hua/A-3674-2008 OI Hall, Mei-Hua/0000-0002-4558-7023 FU NIMH NIH HHS [R01 MH038321, P50 MH068582-030001, R37 MH038321, MH 38321, P50 MH068582] NR 27 TC 38 Z9 39 U1 1 U2 1 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1552-4841 J9 AM J MED GENET B JI Am. J. Med. Genet. B PD JUL 5 PY 2007 VL 144B IS 5 BP 611 EP 614 DI 10.1002/ajmg.b.30470 PG 4 WC Genetics & Heredity; Psychiatry SC Genetics & Heredity; Psychiatry GA 187QU UT WOS:000247864000005 PM 17192894 ER PT J AU Good, CB AF Good, Chester B. TI Varicella-zoster vaccine SO NEW ENGLAND JOURNAL OF MEDICINE LA English DT Letter C1 VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. RP Good, CB (reprint author), VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. NR 1 TC 1 Z9 1 U1 0 U2 0 PU MASSACHUSETTS MEDICAL SOC PI WALTHAM PA WALTHAM WOODS CENTER, 860 WINTER ST,, WALTHAM, MA 02451-1413 USA SN 0028-4793 J9 NEW ENGL J MED JI N. Engl. J. Med. PD JUL 5 PY 2007 VL 357 IS 1 BP 89 EP 89 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 185OR UT WOS:000247720800030 PM 17615637 ER PT J AU Cronin-Fenton, DP Ries, LA Clegg, LX Edwards, BK AF Cronin-Fenton, Deirdre P. Ries, Lynn A. Clegg, Limin X. Edwards, Brenda K. TI Rising incidence rates of breast carcinoma with micrometastatic lymph node involvement SO JOURNAL OF THE NATIONAL CANCER INSTITUTE LA English DT Article ID HORMONE REPLACEMENT THERAPY; EARLY-STAGE MELANOMA; SENTINEL NODE; CANCER INCIDENCE; MULTICENTER TRIAL; BIOPSY; LYMPHADENECTOMY; DISSECTION; TRENDS; VALIDATION AB We investigated the increased incidence of early-stage breast cancer with micrometastatic lymph node involvement. Breast cancer incidence trends from 1990 through 2002 in the US Surveillance, Epidemiology, and End Results Program catchment area were analyzed. Joinpoint regression was used to show the annual percentage change (APC) in breast cancer incidence trends. The overall incidence of breast cancer among women aged 50-64 years increased 1.8% (95% confidence interval [CI] = 1.4% to 2.2%) per annum from 1990 through 2002 but decreased in all other age groups. Stage IIA and stage IIB tumor incidence increased (APC for stage IIA from 1996 to 2002 = 61.9%, 95% Cl = 51.1% to 73.4%, and APC for stage IIB from 1998 to 2002 = 53.7%, 95% Cl = 20.6% to 96.0%). The incidence of micrometastatic lymph node involvement for stage IIA and stage IIB tumors increased during the 1990s, especially after 1997 (APC = 17.3% for both stages), more for estrogen receptor-positive than estrogen receptor-negative disease. Increased use of mammography screening partly explains the increased incidence of early-stage breast cancer. Increases in small tumors with micrometastatic lymph node involvement may be attributable to the increased use of the sentinel lymph node biopsy in community practice. C1 Aarhus Univ Hosp, Dept Clin Epidemiol, DK-8000 Aarhus, Denmark. NCI, Surveillance Res Program, Div Canc Control & Populat Sci, Bethesda, MD 20892 USA. US Dept Vet Affairs, Off Healthcare Inspect, Off Inspector Gen, Washington, DC USA. RP Cronin-Fenton, DP (reprint author), Aarhus Univ Hosp, Dept Clin Epidemiol, Ole Worms Alle 1150, DK-8000 Aarhus, Denmark. EM dc@dce.au.dk NR 48 TC 15 Z9 15 U1 0 U2 0 PU OXFORD UNIV PRESS INC PI CARY PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA SN 0027-8874 J9 J NATL CANCER I JI J. Natl. Cancer Inst. PD JUL 4 PY 2007 VL 99 IS 13 BP 1044 EP 1049 DI 10.1093/jnci/djm026 PG 6 WC Oncology SC Oncology GA 191GF UT WOS:000248118900012 PM 17596573 ER PT J AU Vickrey, BG Mittman, BS Chodosh, J AF Vickrey, Barbara G. Mittman, Brian S. Chodosh, Joshua TI Disease management intervontion on quality and outcomes of dementia care - In response SO ANNALS OF INTERNAL MEDICINE LA English DT Letter C1 Univ Calif Los Angeles, Los Angeles, CA 90095 USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA 90095 USA. RP Vickrey, BG (reprint author), Univ Calif Los Angeles, Los Angeles, CA 90095 USA. NR 2 TC 0 Z9 0 U1 0 U2 0 PU AMER COLL PHYSICIANS PI PHILADELPHIA PA INDEPENDENCE MALL WEST 6TH AND RACE ST, PHILADELPHIA, PA 19106-1572 USA SN 0003-4819 J9 ANN INTERN MED JI Ann. Intern. Med. PD JUL 3 PY 2007 VL 147 IS 1 BP 69 EP 69 PG 1 WC Medicine, General & Internal SC General & Internal Medicine GA 186MN UT WOS:000247782900012 ER PT J AU Aguilar, D Bozkurt, B Pritchett, A Petersen, NJ Deswal, A AF Aguilar, David Bozkurt, Biykern Pritchett, Allison Petersen, Nancy J. Deswal, Anita TI The impact of thiazolidinedione use on outcomes in ambulatory patients with diabetes mellitus and heart failure SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY LA English DT Article ID QUALITY-OF-CARE; INSULIN-RESISTANCE; FLUID RETENTION; ROSIGLITAZONE; ASSOCIATION; AGONISTS; THERAPY; COHORT AB Objectives This study sought to examine the relationship between thiazolidinedione (TZD) use and outcomes in ambulatory patients with diabetes and heart failure (HF). Background Thiazolidinediones have been relatively contraindicated in diabetic patients with HF. Methods We conducted a retrospective study of a national cohort of veterans with HF and diabetes treated in ambulatory clinics at Veterans Affairs medical centers. Patients were classified into those using TZDs and those not using insulin-sensitizing medication based on prescriptions filled 90 days before or 30 days after the index outpatient visit. The outcomes were time to hospitalization for HF and time to death. Results Of 7,147 ambulatory HF patients receiving diabetic therapy, 818 (11.4%) were receiving a TZD and 4,700 (65.8%) were not receiving insulin sensitizers. Over 2 years of follow-up, 134 (16.4%) patients receiving TZDs and 741 (15.8%) patients not receiving insulin-sensitizing medications required HF hospitalization (adjusted hazard ratio 1.00, 95% confidence interval 0.81 to 1.24, p = 0.97). A total of 168 (20.5%) patients receiving TZDs and 1,192 (25.4%) patients not receiving insulin-sensitizing medications died (adjusted hazard ratio 0.98, 95% confidence interval 0.81 to 1.17, p = 0.80). Conclusions In ambulatory patients with established HF and diabetes, the use of TZDs was not associated with an increased risk of HF hospitalization or total mortality when compared with those not receiving insulin-sensitizing medications. C1 Baylor Coll Med, Dept Med, Winters Ctr Heart Failure Res, Cardiol Sect, Houston, TX 77030 USA. Michael E DeBakey Vet Affairs Med Ctr, Cardiol Sect, Houston, TX USA. Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care Utilizat Studies, Houston, TX USA. RP Aguilar, D (reprint author), Baylor Coll Med, Dept Med, Winters Ctr Heart Failure Res, Cardiol Sect, Houston, TX 77030 USA. EM daguilar@bcm.edu FU NCRR NIH HHS [5K12RR017665-05] NR 16 TC 26 Z9 27 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0735-1097 J9 J AM COLL CARDIOL JI J. Am. Coll. Cardiol. PD JUL 3 PY 2007 VL 50 IS 1 BP 32 EP 36 DI 10.1016/j.jacc.2007.01.096 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 186AD UT WOS:000247750600005 PM 17601542 ER PT J AU Chodosh, J Sultzer, DL Lee, ML Hahn, TJ Reuben, DB Yano, EM Mittman, BS Rubenstein, LZ AF Chodosh, Joshua Sultzer, David L. Lee, Martin L. Hahn, Theodore J. Reuben, David B. Yano, Elizabeth M. Mittman, Brian S. Rubenstein, Laurence Z. TI Memory impairment among primary care veterans SO AGING & MENTAL HEALTH LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Geriatrics-Society CY MAY 03-07, 2006 CL Chicago, IL SP Amer Geriatr Soc ID COGNITIVE IMPAIRMENT; ELDERLY PERSONS; DEMENTIA; PREVALENCE; DECLINE; QUALITY; SCREEN; HEALTH AB Memory impairment is the most frequent cognitive dysfunction for older patients. Though studies have shown that dementia is often overlooked in primary care settings, there has been minimal focus specifically on memory impairment, on patients' concerns about memory, or their desire to address these concerns. The objectives of this study were to (1) investigate the prevalence of memory impairment among patients without dementia diagnoses, (2) determine the degree of patients' concern about memory impairment and (3) identify other patient characteristics associated with memory impairment among older primary care patients. Using telephone versions of a four-item memory test and proxy-reported cognitive decline for patients unable to complete interviews, we performed memory assessment of randomly selected patients, 75 years and older, without dementia diagnoses who see primary care physicians at least twice every six months. Among 260 patients and 20 proxies, 19.8% had memory impairment at a level indicative of probable dementia. Adjusting for age, ethnicity, and education, subjects who were more concerned about memory impairment were more likely to be impaired. (Adjusted odds ratio [AOR]: 1.4 (for each additional level of concern); 95% confidence interval [Cl]: (1.0-2.0)). Similarly, subjects wanting their physician to discuss with them their memory concerns were more likely to be impaired (AOR: 1.4-95% Cl: 1.0-1.9). Memory impairment is common among older primary care patients without diagnosed dementia. Knowing patients' concerns about memory impairment and their desire to discuss these concerns may facilitate cognitive screening in this setting. C1 VA Greater Los Angeles Healthcare Syst, Los Angeles, CA 90073 USA. VA Greater Los Angeles Geriatr Res Educ & Clin Ca, Sepulveda, CA USA. VA Greater Los Angeles HSR&D Ctr Excellence, Sepulveda, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Multicampus Program Geriatr Med & Gerontol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, David Geffen Sch Med, Div Geriatr, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Biostat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Dept Hlth Serv, Los Angeles, CA 90024 USA. RP Chodosh, J (reprint author), VA Greater Los Angeles Healthcare Syst, 11G 11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM jchodosh@mednet.ucla.edu OI Mittman, Brian/0000-0003-3589-9178; Chodosh, Joshua/0000-0001-7784-4306 FU NIA NIH HHS [AG10415] NR 29 TC 4 Z9 4 U1 1 U2 2 PU ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXFORDSHIRE, ENGLAND SN 1360-7863 J9 AGING MENT HEALTH JI Aging Ment. Health PD JUL PY 2007 VL 11 IS 4 BP 444 EP 450 DI 10.1080/13607860601086272 PG 7 WC Geriatrics & Gerontology; Gerontology; Psychiatry SC Geriatrics & Gerontology; Psychiatry GA 187ST UT WOS:000247869500010 PM 17612808 ER PT J AU Durazzo, TC Rothlind, JC Gazdzinski, S Banys, P Meyerhoff, DJ AF Durazzo, Timothy C. Rothlind, Johannes C. Gazdzinski, Stefan Banys, Peter Meyerhoff, Dieter J. TI Chronic smoking is associated with differential neurocognitive recovery in abstinent alcoholic patients: A preliminary investigation SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Review DE alcoholism; alcohol dependence; chronic cigarette smoking; neurocognition; recovery ID CHRONIC CIGARETTE-SMOKING; FRONTAL-SUBCORTICAL CIRCUITS; CEREBRAL-BLOOD-FLOW; COGNITIVE PERFORMANCE; NEUROPSYCHIATRIC DISORDERS; FEMALE ALCOHOLICS; STIMULANT ABUSERS; POSTURAL STABILITY; MAJOR DEPRESSION; SOCIAL DRINKERS AB Background: Approximately 50 to 90% of individuals in North America seeking treatment for alcoholism are chronic smokers. A growing body of evidence suggests that chronic cigarette smokers show a pattern of neurocognitive dysfunction similar to that observed in alcoholic patients. However, previous studies investigating neurocognitive recovery in abstinent alcoholic patients did not specifically consider the potential effects of chronic cigarette smoking. Methods: This study comprehensively compared longitudinal neurocognitive changes over 6 to 9 months of abstinence among 13 nonsmoking recovering alcoholic patients (ALC) and 12 actively smoking ALC. The neurocognitive performance of the alcoholic groups was compared with nonsmoking light-drinking controls (nonsmoking LD). Results: Nonsmoking ALC exhibited a significantly greater magnitude of longitudinal improvement than smoking ALC on measures of cognitive efficiency, executive skills, visuospatial skills, and working memory. Both nonsmoking ALC and smoking ALC demonstrated equivalent improvement on auditory-verbal learning, auditory-verbal memory, and processing speed. Nonsmoking LD showed no significant changes in neurocognition over time. In cross-sectional comparisons at 6 to 9 months of abstinence, nonsmoking ALC were superior to smoking ALC on measures of auditory-verbal learning, auditory-verbal memory, cognitive efficiency, executive skills, processing speed, and working memory. The longitudinal and cross-sectional neurocognitive differences observed between nonsmoking and smoking ALC remained significant after covarying for group differences in education, estimated premorbid intelligence alcohol consumption, and other potentially confounding variables. In smoking ALC, greater smoking severity was inversely related to longitudinal improvement on multiple neurocognitive measures. Conclusions: These preliminary results suggest that chronic smoking may modulate neurocognitive recovery in abstinent alcoholic patients. More generally, chronic smoking may impact neurocognition in other conditions where is it a prevalent behavior. C1 San Francisco Vet Adm Med Ctr, Ctr Imaging Neurodegenerat Dis, San Francisco, CA 94121 USA. No Calif Inst Res & Educ, San Francisco, CA USA. Univ Calif San Francisco, Dept Radiol, San Francisco, CA 94143 USA. Univ Calif San Francisco, Dept Psychiat, San Francisco, CA 94143 USA. RP Durazzo, TC (reprint author), San Francisco Vet Adm Med Ctr, Ctr Imaging Neurodegenerat Dis, 114M,4150 Clement St, San Francisco, CA 94121 USA. EM timothy.durazzo@ucsf.edu FU NIAAA NIH HHS [AA10788] NR 122 TC 30 Z9 30 U1 2 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUL PY 2007 VL 31 IS 7 BP 1114 EP 1127 DI 10.1111/j.1530-0277.2007.00398.x PG 14 WC Substance Abuse SC Substance Abuse GA 179VO UT WOS:000247318400005 PM 17451399 ER PT J AU Bradley, KA DeBenedetti, AF Volk, RJ Williams, EC Frank, D Kivlahan, DR AF Bradley, Katharine A. DeBenedetti, Anna F. Volk, Robert J. Williams, Emily C. Frank, Danielle Kivlahan, Daniel R. TI AUDIT-C as a brief screen for alcohol misuse in primary care SO ALCOHOLISM-CLINICAL AND EXPERIMENTAL RESEARCH LA English DT Article DE alcohol screening; alcohol drinking; primary care ID IDENTIFICATION TEST AUDIT; AT-RISK DRINKING; BEHAVIORAL-COUNSELING INTERVENTIONS; GENERAL-POPULATION SAMPLE; BRIEF PHYSICIAN ADVICE; USE DISORDERS; CONTROLLED-TRIAL; CONSUMPTION; DRINKERS; VETERANS AB Background: The Alcohol Use Disorders Identification Test Consumption (AUDIT-C) questions have been previously validated as a 3-item screen for alcohol misuse and implemented nationwide in Veterans Affairs (VA) outpatient clinics. However, the AUDIT-C's validity and optimal screening threshold(s) in other clinical populations are unknown. Methods: This cross-sectional validation study compared screening questionnaires with standardized interviews in 392 male and 927 female adult outpatients at an academic family practice clinic from 1993 to 1994. The AUDIT-C, full AUDIT, self-reported risky drinking, AUDIT question #3, and an augmented CAGE questionnaire were compared with an interview primary reference standard of alcohol misuse, defined as a Diagnostic and Statistical Manual, 4th ed. alcohol use disorder and/or drinking above recommended limits in the past year. Results: Based on interviews with 92% of eligible patients, 128 (33%) men and 177 (19%) women met the criteria for alcohol misuse. Areas under the receiver operating characteristic curves (AUROCs) for the AUDIT-C were 0.94 (0.91, 0.96) and 0.90 (0.87, 0.93) in men and women, respectively (p=0.04). Based on AUROC curves, the AUDIT-C performed as well as the full AUDIT and significantly better than self-reported risky drinking, AUDIT question #3, or the augmented CAGE questionnaire (p-values < 0.001). The AUDIT-C screening thresholds that simultaneously maximized sensitivity and specificity were >= 4 in men (sensitivity 0.86, specificity 0.89) and >= 3 in women (sensitivity 0.73, specificity 0.91). Conclusions: The AUDIT-C was an effective screening test for alcohol misuse in this primary care sample. Optimal screening thresholds for alcohol misuse among men (>= 4) and women (>= 3) were the same as in previously published VA studies. C1 VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA 98101 USA. VA Puget Sound Hlth Care Syst, Ctr Excellence Substance Abuse Treatment & Educ, Seattle, WA 98101 USA. Univ Washington, Dept Med, Seattle, WA 98195 USA. Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Psychiat & Behav Sci, Seattle, WA 98195 USA. Baylor Coll Med, Dept Family & Community Med, Houston, TX 77030 USA. RP Bradley, KA (reprint author), VA Puget Sound Hlth Serv Res & Dev, 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM willi@u.washington.edu OI Volk, Robert/0000-0001-8811-5854 FU BHP HRSA HHS [D32-PE16033]; NIAAA NIH HHS [R03 AA09496, R21 AA14672] NR 50 TC 378 Z9 382 U1 4 U2 28 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0145-6008 J9 ALCOHOL CLIN EXP RES JI Alcoholism (NY) PD JUL PY 2007 VL 31 IS 7 BP 1208 EP 1217 DI 10.1111/j.1530-0277.2007.00403.x PG 10 WC Substance Abuse SC Substance Abuse GA 179VO UT WOS:000247318400014 PM 17451397 ER PT J AU de Boer, IH Ioannou, GN Kestenbaum, B Brunzell, JD Weiss, NS AF de Boer, Ian H. Ioannou, George N. Kestenbaum, Bryan Brunzell, John D. Weiss, Noel S. TI 25-hydroxyvitamin D levels and albuminuria in the Third National Health and Nutrition Examination Survey (NHANES III) SO AMERICAN JOURNAL OF KIDNEY DISEASES LA English DT Article DE vitamin D; albuminuria; microalbuminuria; kidney; epidemiology ID RENIN-ANGIOTENSIN SYSTEM; CHRONIC KIDNEY-DISEASE; NEGATIVE ENDOCRINE REGULATOR; VITAMIN-D; NEPHROTIC SYNDROME; SERUM 25-HYDROXYVITAMIN-D; 1,25-DIHYDROXYVITAMIN D-3; ALBUMIN/CREATININE RATIO; NONDIABETIC INDIVIDUALS; CARDIOVASCULAR EVENTS AB Background: Albuminuria is a risk factor for chronic kidney disease progression, end-stage renal disease, cardiovascular events, and mortality. Animal studies suggested that vitamin D insufficiency may contribute to the pathogenesis of albuminuria. Study Design: Cross-sectional study. Setting & Participants: 15,068 adults participating in the Third National Health and Nutrition Examination Survey. Predictor: Serum 25-hydroxyvitamin D concentration, examined in quartiles. Outcomes & Measurements: Albuminuria, defined using established sex-specific cutoff values for urine albumin-creatinine ratio (25 to 2,999 mg/g for women, 17 to 2,999 mg/g for men). Results: A stepwise increase in the prevalence of albuminuria was observed with decreasing quartiles of vitamin D concentration: 8.9%, 11.5%, 13.7%, and 15.8% (P < 0.001). Adjusting for age, sex, race/ethnicity, region and season of measurement, smoking status, body mass index, and estimated glomerular filtration rate, relative risks for albuminuria by decreasing quartile of vitamin D concentration were 1.00 (reference group), 1.14 (95% confidence interval, 0.95 to 1.37), 1.22 (95% confidence interval, 1.03 to 1.45), and 1.37 (95% confidence interval, 1.10 to 1.71; P = 0.006). Additionally adjusting for blood pressure and diabetes mellitus, these risks were somewhat attenuated and retained statistical significance. Limitations: The cross-sectional design of this study does not allow demonstration of temporal or causal relationships between vitamin D and albuminuria. Conclusions: Additional studies are needed to clarify the relationship of vitamin D with albuminuria and determine whether vitamin D therapy prevents or improves markers of kidney and cardiovascular disease. C1 Univ Washington, Div Nephrol, Seattle, WA 98117 USA. Vet Affairs Puget Sound Hlth Care Syst, Dept Med, Seattle, WA USA. Vet Affairs Puget Sound Hlth Care Syst, Div Gastroenterol, Seattle, WA USA. Univ Washington, Div Metab Endocrinol & Nutr, Seattle, WA 98195 USA. Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA. RP de Boer, IH (reprint author), Univ Washington, Div Nephrol, Box 356521,1959 NE Pacific, Seattle, WA 98117 USA. EM deboer@u.washington.edu FU NCRR NIH HHS [5 K12 RR023265-03] NR 50 TC 150 Z9 153 U1 0 U2 1 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0272-6386 J9 AM J KIDNEY DIS JI Am. J. Kidney Dis. PD JUL PY 2007 VL 50 IS 1 BP 69 EP 77 DI 10.1053/j.ajkd.2007.04.015 PG 9 WC Urology & Nephrology SC Urology & Nephrology GA 197QJ UT WOS:000248570400009 PM 17591526 ER PT J AU Bourla, DH Sarraf, D Schwartz, SD AF Bourla, Dan H. Sarraf, David Schwartz, Steven D. TI Peripheral retinopathy and Maculopathy in high-dose tamoxifen therapy SO AMERICAN JOURNAL OF OPHTHALMOLOGY LA English DT Article AB PURPOSE: To describe the clinical, angiographic, and optical coherence tomography (OCT) features of high-dose tamoxifen retinopathy in three male patients. DESIGN: Observational case series. METHODS: A review of history, clinical examination, and findings on fluorescein angiography (FA) and optical coherence tomography (OCT) was conducted. RESULTS: Three male patients receiving high-dose tamoxifen therapy sought treatment for vision loss and a crystalline maculopathy. Crystalline deposits were noted in the peripheral retina of two patients. All the patients showed macular leakage by FA, but cystoid macular edema (CME) on OCT was detected in two patients. Inner retinal hyperreflective deposits were identified by OCT in all the patients. CONCLUSIONS: High-dose tamoxifen therapy may result in peripheral crystalline retinopathy in addition to perifoveal opacities. Angiographic evidence of macular edema may not unanimously correlate with presence of CME on OCT in these cases. C1 Univ Calif Los Angeles, Jules Stein Eye Inst, Los Angeles, CA 90095 USA. Greater Los Angeles VA Med Ctr, Los Angeles, CA USA. King Drew Med Ctr, Los Angeles, CA USA. RP Bourla, DH (reprint author), Univ Calif Los Angeles, Jules Stein Eye Inst, 200 Stein Pl, Los Angeles, CA 90095 USA. EM bourla@jsei.ucla.edu NR 5 TC 21 Z9 22 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0002-9394 J9 AM J OPHTHALMOL JI Am. J. Ophthalmol. PD JUL PY 2007 VL 144 IS 1 BP 126 EP 128 DI 10.1016/j.ajo.2007.03.023 PG 3 WC Ophthalmology SC Ophthalmology GA 187SD UT WOS:000247867800023 PM 17601434 ER PT J AU Farris, W Schutz, SG Cirrito, JR Shankar, GM Sun, XY George, A Leissring, MA Walsh, DM Qiao, W Holtzman, DM Selkoe, DJ AF Farris, Wesley Schutz, Sonja G. Cirrito, John R. Shankar, Ganesh M. Sun, Xiaoyan George, Ana Leissring, Malcolm A. Walsh, Dominic M. Qiao, Wei Holtzman, David M. Selkoe, Dennis J. TI Loss of neprilysin function promotes amyloid plaque formation and causes cerebral amyloid angiopathy SO AMERICAN JOURNAL OF PATHOLOGY LA English DT Article ID INSULIN-DEGRADING ENZYME; ENDOTHELIN-CONVERTING ENZYME; ONSET ALZHEIMERS-DISEASE; PROTEIN A-BETA; LEVELS IN-VIVO; INTERSTITIAL FLUID; TRANSGENIC MICE; EXTRACELLULAR LEVELS; MOUSE-BRAIN; PEPTIDE AB Cerebral deposition of the amyloid 6 protein (A beta), an invariant feature of Alzheimer's disease, reflects an imbalance between the rates of A beta production and clearance. The causes of A beta elevation in the common late-onset form of Alzheimer's disease (LOAD) are largely unknown. There is evidence that the A beta-degrading protease neprilysin (NEP) is down-regulated in normal aging and LOAD. We asked whether a decrease in endogenous NEP levels can prolong the half-life of A,6 in vivo and promote development of the classic amyloid neuropathology of Alzheimer's disease. We examined the brains and plasma of young and old mice expressing relatively low levels of human amyloid precursor protein and having one or both NEP genes silenced. NEP loss of function 1) elevated whole-brain and plasma levels of human AB(40) and A beta 42, 2) prolonged the half-life of soluble A beta in brain interstitial fluid of awake animals, 3) raised the concentration of A beta dimers, 4) markedly increased hippocampal amyloid plaque burden, and 5) led to the development of amyloid angiopathy. A similar to 50% reduction in NEP levels, similar to that reported in some LOAD brains, was sufficient to increase amyloid neuropathology. These findings demonstrate an important role for proteolysis in determining the levels of A,6 and A beta-associated neuropathology in vivo and support the hypothesis that primary defects in A beta clearance can cause or contribute to LOAD pathogenesis. C1 Univ Pittsburgh, Dept Neurol, Sch Med, Pittsburgh Inst Neurodegenerat Dis, Pittsburgh, PA 15260 USA. VA Pittsburgh Healthcare Syst, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA. Brigham & Womens Hosp, Dept Neurol, Ctr Neurol Dis, Boston, MA 02115 USA. Harvard Univ, Sch Med, Boston, MA 02115 USA. Washington Univ, Sch Med, Dept Neurol, St Louis, MO 63110 USA. Washington Univ, Sch Med, Dept Psychiat, St Louis, MO 63110 USA. Washington Univ, Sch Med, Dept Mol Biol & Pharmacol, St Louis, MO 63110 USA. Washington Univ, Sch Med, Hope Ctr Neurol Disorders, St Louis, MO 63110 USA. Tufts Univ New England Med Ctr, Dept Psychiat, Boston, MA 02111 USA. Tufts Univ, Sch Med, Boston, MA 02111 USA. Scripps Res Inst, Jupiter, FL USA. Scripps Florida, Jupiter, FL USA. Univ Coll Dublin, Conway Inst, Lab Neurodegenerat Res, Dublin 2, Ireland. RP Farris, W (reprint author), Univ Pittsburgh, Dept Neurol, Sch Med, Pittsburgh Inst Neurodegenerat Dis, 3501 5th Ave,BST3 7019, Pittsburgh, PA 15260 USA. EM farrisw@upmc.edu; dselkoe@rics.bwh.harvard.edu OI Qiu, Wendy/0000-0002-2082-2410 FU NIA NIH HHS [AG12749, AG022476, AG13956, K23 AG022476, R01 AG012749, R01 AG013956, R37 AG013956]; NIDA NIH HHS [DA07261, T32 DA007261]; NINDS NIH HHS [K08 NS046324, NS046324] NR 53 TC 79 Z9 81 U1 1 U2 6 PU AMER SOC INVESTIGATIVE PATHOLOGY, INC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3993 USA SN 0002-9440 J9 AM J PATHOL JI Am. J. Pathol. PD JUL PY 2007 VL 171 IS 1 BP 241 EP 251 DI 10.2353/ajpath.2007070105 PG 11 WC Pathology SC Pathology GA 185LO UT WOS:000247712700024 PM 17591969 ER PT J AU Watson, PA Reusch, JEB McCune, SA Leinwand, LA Luckey, SW Konhilas, JP Brown, DA Chicco, AJ Sparagna, GC Long, CS Moore, RL AF Watson, Peter A. Reusch, Jane E. B. McCune, Sylvia A. Leinwand, Leslie A. Luckey, Stephen W. Konhilas, John P. Brown, David A. Chicco, Adam J. Sparagna, Genevieve C. Long, Carlin S. Moore, Russell L. TI Restoration of CREB function is linked to completion and stabilization of adaptive cardiac hypertrophy in response to exercise SO AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY LA English DT Article DE exercise; mitochondria; apoptosis; cyclic-nucleotide regulatory element binding protein ID ELEMENT-BINDING PROTEIN; MUSCLE CELL-PROLIFERATION; HEART-FAILURE; DILATED CARDIOMYOPATHY; CYTOCHROME-C; MITOCHONDRIAL BIOGENESIS; TRANSCRIPTION FACTOR; OXIDATIVE CAPACITY; BRAIN MITOCHONDRIA; MYOCYTE APOPTOSIS AB Potential regulation of two factors linked to physiological outcomes with left ventricular (LV) hypertrophy, resistance to apoptosis, and matching of metabolic capacity, by the transcription factor cyclic-nucleotide regulatory element binding protein (CREB), was examined in the two models of physiological LV hypertrophy: involuntary treadmill running of female Sprague-Dawley rats and voluntary exercise wheel running in female C57Bl/6 mice. Comparative studies were performed in the models of pathological LV hypertrophy and failure: the spontaneously hypertension heart failure (SHHF) rat and the hypertrophic cardiomyopathy (HCM) transgenic mouse, a model of familial idiopathic cardiomyopathy. Activating CREB serine-133 phosphorylation was decreased early in remodeling in response to both physiological (decreased 50-80%) and pathological (decreased 60-80%) hypertrophic stimuli. Restoration of LV CREB phosphorylation occurred concurrent with completion of physiological hypertrophy (94% of sedentary control), but remained decreased (by 90%) during pathological hypertrophy. In all models of hypertrophy, CREB phosphorylation/ activation demonstrated strong positive correlations with 1) expression of the anti-apoptotic protein bcl-2 ( a CREB-dependent gene) and subsequent reductions in the activation of caspase 9 and caspase 3; 2) expression of peroxisome proliferator-activated receptor-gamma coactivator-1 (PGC-1; a major regulator of mitochondrial content and respiratory capacity), and 3) LV mitochondrial respiratory rates and mitochondrial protein content. Exercise-induced increases in LV mitochondrial respiratory capacity were commensurate with increases observed in LV mass, as previously reported in the literature. Exercise training of SHHF rats and HCM mice in LV failure improved cardiac phenotype, increased CREB activation (31 and 118%, respectively), increased bcl-2 content, improved apoptotic status, and enhanced PGC-1 content and mitochondrial gene expression. Adenovirus-mediated expression of constitutively active CREB in neonatal rat cardiac recapitulated exercise-induced upregulation of PGC-1 content and mitochondrial oxidative gene expression. These data support a model wherein CREB contributes to physiological hypertrophy by enhancing expression of genes important for efficient oxidative capacity and resistance to apoptosis. C1 Denver VA Med Ctr, Denver, CO 80220 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. Univ Colorado, Boulder, CO 80309 USA. Myogen Inc, Boulder, CO USA. RP Watson, PA (reprint author), Denver VA Med Ctr, 111H,1055 Clermont St, Denver, CO 80220 USA. EM pete.watson@uchsc.edu RI Moore, Russell/D-1040-2013 OI Moore, Russell/0000-0002-6727-8985; LEINWAND, LESLIE/0000-0003-1470-4810 FU NHLBI NIH HHS [HL 40306-15]; NIDDK NIH HHS [R01 DK 06741]; PHS HHS [DERC 57576, P01 56481] NR 60 TC 47 Z9 47 U1 0 U2 4 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 0363-6135 J9 AM J PHYSIOL-HEART C JI Am. J. Physiol.-Heart Circul. Physiol. PD JUL PY 2007 VL 293 IS 1 BP H246 EP H259 DI 10.1152/ajpheart.00734.2006 PG 14 WC Cardiac & Cardiovascular Systems; Physiology; Peripheral Vascular Disease SC Cardiovascular System & Cardiology; Physiology GA 189DE UT WOS:000247968800031 PM 17337597 ER PT J AU Frank, JA Briot, R Lee, JW Ishizaka, A Uchida, T Matthay, MA AF Frank, James A. Briot, Raphael Lee, Jae Woo Ishizaka, Akitoshi Uchida, Tokujiro Matthay, Michael A. TI Physiological and biochemical markers of alveolar epithelial barrier dysfunction in perfused human lungs SO AMERICAN JOURNAL OF PHYSIOLOGY-LUNG CELLULAR AND MOLECULAR PHYSIOLOGY LA English DT Article DE alveolar epithelial fluid transport; acute lung injury; acute respiratory distress syndrome; lung transplantation; biological markers; pulmonary edema; primary graft failure; air space fluid clearance ID RESPIRATORY-DISTRESS-SYNDROME; FLUID CLEARANCE; PULMONARY-EDEMA; LIQUID CLEARANCE; PROTEIN CLEARANCE; UP-REGULATION; RAT LUNGS; IN-SITU; TRANSPLANTATION; INJURY AB To study air space fluid clearance ( AFC) under conditions that resemble the clinical setting of pulmonary edema in patients, we developed a new perfused human lung preparation. We measured AFC in 20 human lungs rejected for transplantation and determined the contribution of AFC to lung fluid balance. AFC was then compared with air space and perfusate levels of a biological marker of epithelial injury. The majority of human lungs rejected for transplant had intact basal ( 75%) and beta(2)-adrenergic agonist-stimulated ( 70%) AFC. For lungs with both basal and stimulated AFC, the basal AFC rate was 19 +/- 10%/ h, and the beta(2)-adrenergic- stimulated AFC rate was 43 +/- 13%/ h. Higher rates of AFC were associated with less lung weight gain ( Pearson coefficient -0.90, P < 0.0001). Air space and perfusate levels of the type I pneumocyte marker receptor for advanced glycation end products ( RAGE) were threefold and sixfold higher, respectively, in lungs without basal AFC compared with lungs with AFC ( P < 0.05). These data show that preserved AFC is a critical determinant of favorable lung fluid balance in the perfused human lung, raising the possibility that beta(2)-agonist therapy to increase edema fluid clearance may be of value for patients with acute lung injury and pulmonary edema. Also, although additional studies are needed, a biological marker of alveolar epithelial injury may be useful clinically in predicting preserved AFC. C1 Univ Calif San Francisco, Cardiovasc Res Inst, No Calif Inst Res & Educ, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Med, San Francisco, CA 94121 USA. Univ Calif San Francisco, Dept Anesthesia, San Francisco, CA 94121 USA. No Calif Inst Res & Educ, San Francisco Vet Adm Med Ctr, San Francisco, CA USA. Keio Univ, Dept Med, Tokyo, Japan. Tokyo Med & Dent Univ, Dept Anesthesiol, Tokyo, Japan. RP Frank, JA (reprint author), Univ Calif San Francisco, Cardiovasc Res Inst, No Calif Inst Res & Educ, San Francisco Vet Affairs Med Ctr, 4150 Clement St,Mail Stop 111D, San Francisco, CA 94121 USA. EM james.frank@ucsf.edu RI BRIOT, Raphael/M-6732-2014 FU NHLBI NIH HHS [HL-51856, HL-69900, K08 HL069900, R01 HL051856, R01 HL088440, R01 HL088440-01A1, R37 HL051856, R37 HL051856-14, R56 HL088440] NR 40 TC 60 Z9 61 U1 1 U2 2 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1040-0605 J9 AM J PHYSIOL-LUNG C JI Am. J. Physiol.-Lung Cell. Mol. Physiol. PD JUL PY 2007 VL 293 IS 1 BP L52 EP L59 DI 10.1152/ajplung.00256.2006 PG 8 WC Physiology; Respiratory System SC Physiology; Respiratory System GA 188FT UT WOS:000247905500008 PM 17351061 ER PT J AU Kaunitz, JD AF Kaunitz, Jonathan D. TI Sodium pumps: ouabain, ion transport, and signaling in hypertension - Reply to Blaustein et al. SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Letter ID BLOOD-PRESSURE REGULATION; VASCULAR SMOOTH-MUSCLE; MICE C1 Univ Calif Los Angeles, Greater Los Angles Vet Affairs Healthcare Syst, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA 90024 USA. Brentwood Biomed Res Inst, Los Angeles, CA USA. RP Kaunitz, JD (reprint author), W Los Angeles Vet Affairs Med Ctr, 11301 Wilshire Blvd,Bldg 114,Suite 217, Los Angeles, CA 90073 USA. EM jake@ucla.edu NR 15 TC 1 Z9 1 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD JUL PY 2007 VL 293 IS 1 BP F439 EP F439 DI 10.1152/ajprenal.00206.2007 PG 1 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 187LZ UT WOS:000247850500055 ER PT J AU Velez, JCQ Bland, AM Arthur, JM Raymond, JR Janech, MG AF Velez, Juan Carlos Q. Bland, Alison M. Arthur, John M. Raymond, John R. Janech, Michael G. TI Characterization of renin-angiotensin system enzyme activities in cultured mouse podocytes SO AMERICAN JOURNAL OF PHYSIOLOGY-RENAL PHYSIOLOGY LA English DT Article; Proceedings Paper CT 39th Annual Meeting of the American-Society-of-Nephrology/Annual Renal Week CY NOV 14-19, 2006 CL San Diego, CA SP Amer Soc Nephrol DE angiotensin II; angiotensin-(1-7); neprilysin; ACE2; aminopeptidase A ID HUMAN MESANGIAL CELLS; CONVERTING-ENZYME; HIGH GLUCOSE; PROXIMAL TUBULES; AMINOPEPTIDASE-A; MESSENGER-RNA; EXPRESSION; KIDNEY; RATS; GLOMERULOSCLEROSIS AB Intraglomerular ANG II has been linked to glomerular injury. However, little is known about the contribution of podocytes (POD) to intraglomerular ANG II homeostasis. The aim of the present study was to examine the processing of angiotensin substrates by cultured POD. Our approach was to use matrix-assisted laser desorption/ ionization time-of-flight (MALDITOF) mass spectrometry for peptide determination from conditioned cell media and customized AQUA peptides for quantification. Immortalized mouse POD were incubated with 1-2 mu M ANG I, ANG II, or the renin substrate ANG-(1-14) for different time intervals and coincubated in parallel with various inhibitors. Human mesangial cells (MES) were used as controls. POD incubated with 1 mu M ANG I primarily formed ANG-(1-9) and ANG-(1-7). In contrast, MES incubated with ANG I primarily generated ANG II. In POD, ANG-(1-7) was the predominant product, and its formation was inhibited by a neprilysin inhibitor. Modest angiotensin-converting enzyme (ACE) activity was also detected in POD, although only after cells were incubated with 2 mu M ANG I. In addition, we observed that POD degraded ANG II into ANG III and ANG-(1-7). An aminopeptidase A inhibitor inhibited ANG III formation, and an ACE2 inhibitor led to ANG II accumulation. Furthermore, we found that POD converted ANG-(1-14) to ANG I and ANG-(1-7). This conversion was inhibited by a renin inhibitor. These findings demonstrate that POD express a functional intrinsic renin-angiotensin system characterized by neprilysin, aminopeptidase A, ACE2, and renin activities, which predominantly lead to ANG-(1- 7) and ANG-(1- 9) formation, as well as ANG II degradation. These findings may reflect a specific role of POD in maintenance of intraglomerular renin-angiotensin system balance. C1 Med Univ S Carolina, Dept Med, Div Nephrol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Dept Res, Charleston, SC USA. RP Velez, JCQ (reprint author), Med Univ S Carolina, Dept Med, Div Nephrol, 96 Jonathan Lucas St,Clin Sci Bldg,Rm 829, Charleston, SC 29425 USA. EM velezj@musc.edu RI Velez, Juan Carlos/N-3782-2016 OI Janech, Michael/0000-0002-3202-4811 FU NHLBI NIH HHS [N01-HV-28181] NR 55 TC 57 Z9 64 U1 0 U2 3 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 1931-857X J9 AM J PHYSIOL-RENAL JI Am. J. Physiol.-Renal Physiol. PD JUL PY 2007 VL 293 IS 1 BP F398 EP F407 DI 10.1152/ajprenal.00050.2007 PG 10 WC Physiology; Urology & Nephrology SC Physiology; Urology & Nephrology GA 187LZ UT WOS:000247850500050 PM 17429035 ER PT J AU Limbos, MA Chan, LS Warf, C Schneir, A Iverson, E Shekelle, P Kipke, MD AF Limbos, Mary Ann Chan, Linda S. Warf, Curren Schneir, Arlene Iverson, Ellen Shekelle, Paul Kipke, Michele D. TI Effectiveness of interventions to prevent youth violence - A systematic review SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Review ID SERIOUS JUVENILE-OFFENDERS; AMERICAN ADOLESCENT MALES; SAFE DATES PROGRAM; DARE PLUS PROJECT; MIDDLE SCHOOL; FOLLOW-UP; CONFLICT-RESOLUTION; OUTCOME EVALUATION; REDUCING VIOLENCE; SUBSTANCE-ABUSE AB Objectives: To identify interventions effective in preventing youth violent behavior and commonalities of effective and ineffective interventions. Methods: A systematic review of the literature on the effectiveness of youth violence interventions was conducted. Interventions were categorized according to the level of the intervention: primary (implemented universally to prevent the onset of violence), secondary (implemented selectively with youth at increased risk for violence), and tertiary (focused on youth who had already engaged in violent behavior). An intervention was considered effective if one or more violence outcome indicators was reported as significantly different at the p < 0.05 level, and ineffective if none of the violence outcome indicators was significantly different at the p < 0.05 level. Data collection and analysis were conducted in 2003 and updated in 2006. Results: Forty-one studies were included in the review. Overall, 49% of interventions were effective. Tertiary-level interventions were more likely to report effectiveness than primary- or secondary-level interventions. Effective interventions evaluated by randomized controlled trials included Responding in Peaceful and Positive Ways, Aban Aya Youth Project, Moving to Opportunity, Early Community-Based Intervention Program, Childhaven's Therapeutic Child-Care Program, Turning Point: Rethinking Violence, and a multisystemic therapy program. Differences among programs and within subpopulations could not be assessed because of inadequate data. Conclusions: Increasing effectiveness was reported as the level of intervention increased from primary to tertiary. Approaches to evaluate prevention interventions need to be clarified and standardized. C1 RAND Corp, So Calif Evidence Based Practice Ctr, Santa Monica, CA USA. Univ So Calif, Dept Pediat, Keck Sch Med, Los Angeles, CA 90089 USA. Univ So Calif, Med Ctr, Div Gen Pediat, Los Angeles, CA USA. Univ So Calif, Med Ctr, Div Res Children Youth & Families, Los Angeles, CA USA. Univ So Calif, Med Ctr, Childrens Hosp Los Angeles, Div Biostat & Outcomes Assessment, Los Angeles, CA USA. Greater Los Angeles Vet Affair Healthcare Syst, Hlth Serv Res & Dev Serv, Los Angeles, CA USA. RP Limbos, MA (reprint author), Childrens Hosp Los Angeles, 4650 Sunset Blvd,Mailstop 76, Los Angeles, CA 90027 USA. EM mlimbos@chla.usc.edu NR 59 TC 42 Z9 42 U1 2 U2 32 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD JUL PY 2007 VL 33 IS 1 BP 65 EP 74 DI 10.1016/j.amepre.2007.02.045 PG 10 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 184WF UT WOS:000247672600011 PM 17572314 ER PT J AU Cunningham-Sabo, L Carpenter, WR Peterson, JC Anderson, LA Helfrich, CD Davis, SM AF Cunningham-Sabo, Leslie Carpenter, William R. Peterson, Jeffery C. Anderson, Lynda A. Helfrich, Christian D. Davis, Sally M. TI Utilization of prevention research - Searching for evidence SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Review ID BRIEF ALCOHOL INTERVENTION; PRIMARY-HEALTH-CARE; CONTINUOUS QUALITY IMPROVEMENT; CLINICAL-PRACTICE GUIDELINES; KONG CHINESE WOMEN; HIV PREVENTION; GENERAL-PRACTITIONERS; DECISION-MAKING; FAMILY-PRACTICE; SERVICE ORGANIZATIONS AB Objective: Understanding the process of translating prevention research into practice calls for systematic efforts to assess the state of the published literature on the utilization of prevention research in public health programs and policy. This review describes the search strategy, methods, results, and challenges in identifying and reviewing literature relevant to this objective. Methods: Systematic searches of topics related to prevention research in literature published in 1995-2002 revealed 86 empiric articles in 12 public health areas. Results: A lack of uniform terminology, variation in publication sources, and limited descriptions of the stages of research utilization (e.g., adoption and implementation) in the published literature posed major challenges to identifying articles that met study criteria. Most accepted articles assessed the adoption or implementation of prevention research; four examined long-term sustainability. There was approximately equal distribution of reported research set in either health services or public health settings. Few of the articles contained search terms reflecting all four concept areas (prevention, public health, research, and use) targeted by the literature search. Conclusions: Refining terms used in prevention research and research utilization could address lack of shared and unique definitions. Expanded reporting of research utilization stages in reports of prevention research could lead to improved literature searches and contribute to more successful adoption, implementation, and further use of prevention research products. C1 Colorado State Univ, Dept Food Sci & Human Nutr, Ft Collins, CO 80523 USA. Univ N Carolina, Lineberger Comprehens Canc Ctr, Chapel Hill, NC 27599 USA. Washington State Univ, Edward R Murrow Sch Commun, Pullman, WA 99164 USA. Ctr Dis Control & Prevent, Div Adult & Commun Hlth, Hlth Aging Program, Atlanta, GA USA. Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev, Seattle, WA USA. Univ New Mexico, Sch Med, Dept Pediat, Prevent Res Ctr, Albuquerque, NM 87131 USA. RP Cunningham-Sabo, L (reprint author), Colorado State Univ, Dept Food Sci & Human Nutr, Ft Collins, CO 80523 USA. EM Icsabo@cahs.colostate.edu RI Carpenter, William/E-5125-2013; Helfrich, Christian/D-2382-2016 OI Helfrich, Christian/0000-0002-9827-4768 FU PHS HHS [U48/CCU610818-08] NR 110 TC 6 Z9 6 U1 2 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD JUL PY 2007 VL 33 IS 1 SU 1 BP S9 EP S20 DI 10.1016/j.amepre.2007.03.010 PG 12 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 187YD UT WOS:000247884300003 PM 17584594 ER PT J AU Davis, SM Peterson, JC Helfrich, CD Cunningham-Sabo, L AF Davis, Sally M. Peterson, Jeffery C. Helfrich, Christian D. Cunningham-Sabo, Leslie TI Introduction and conceptual model for utilization of prevention research SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Editorial Material ID HEALTH-PROMOTION; INNOVATIONS; DIFFUSION; BARRIERS; DISEASE; CARE C1 Univ New Mexico Hlth Sci Ctr, Ctr Hlth Promot & Dis Prevent, Albuquerque, NM 87131 USA. Univ New Mexico, Sch Med, Dept Pediat, Prevent Res Ctr, Albuquerque, NM 87131 USA. Washington State Univ, Edward R Murrow Sch Commun, Pullman, WA 99164 USA. Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res Dev, Seattle, WA USA. Colorado State Univ, Dept Food Sci & Human Nutr, Ft Collins, CO 80523 USA. RP Davis, SM (reprint author), Univ New Mexico Hlth Sci Ctr, Ctr Hlth Promot & Dis Prevent, MSC11 6145,Albuquerque NM, Albuquerque, NM 87131 USA. EM sdavis@salud.unm.edu RI Helfrich, Christian/D-2382-2016 OI Helfrich, Christian/0000-0002-9827-4768 FU PHS HHS [U48/CCU610818-08] NR 27 TC 12 Z9 12 U1 1 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD JUL PY 2007 VL 33 IS 1 SU 1 BP S1 EP S5 DI 10.1016/j.amepre.2007.04.004 PG 5 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 187YD UT WOS:000247884300001 PM 17584588 ER PT J AU Helfrich, CD Savitz, LA Swiger, KD Weiner, BJ AF Helfrich, Christian D. Savitz, Lucy A. Swiger, Kathleen D. Weiner, Bryan J. TI Adoption and implementation of mandated diabetes registries by Community Health Centers SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID INNOVATIONS AB Background: Innovations adopted by healthcare organizations are often externally mandated. However, few studies examine how mandated innovations progress from adoption to sustained effective use. This study uses Rogers's model of organizational innovation to explore community health centers' (CHCs') mandated adoption and implementation of disease registries in the federal Health Disparities Collaborative (HDC). Methods: Case studies were conducted on six CHCs in North Carolina participating in the HDC on type 2 diabetes mellitus. Data were collected from semistructured interviews with key staff, and from site-level and individual-level surveys. Results: Although disease registry adoption and implementation were mandated, CHCs exercised prerogative in the timing of registry adoption and the functions emphasized. Executive and medical director involvement, often directly on the HDC teams, was the single most salient influence on adoption and implementation. Staff members' personal experience with diabetes also provided context and gave registries added significance. Participants lauded HDC's technique of small-scale, rapid-cycle change, but valued even more shared problem solving and peer learning among HDC teams. However, lack of cross-training, inadequate resources, and staff turnover posed serious threats to sustainability of the registries. Conclusions: The present study illustrates the usefulness of Rogers's model for studying mandated innovation and highlights several key factors, including direct, personal involvement of organizational leadership, and shared problem solving and peer learning facilitated by the HDC. However, these six CHCs elected to participate early in the HDC, and may not be typical of North Carolina's remaining CHCs. Furthermore, most face important long-term challenges that threaten routinization. C1 VA Puget Sound Hlth Care Syst, NW Hlth Serv Res, Seattle, WA 98101 USA. VA Puget Sound Hlth Care Syst, Dev Ctr Excellence, Seattle, WA 98101 USA. Res Triangle Inst, Res Triangle Pk, NC 27709 USA. Univ N Carolina, Hlth Policy & Adm, Chapel Hill, NC USA. VA Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv, Seattle, WA 98101 USA. RP Helfrich, CD (reprint author), VA Puget Sound Hlth Care Syst, NW Hlth Serv Res, 1100 Olive Way,Suite 1400, Seattle, WA 98101 USA. EM christian.helfrich@va.gov RI Helfrich, Christian/D-2382-2016 OI Helfrich, Christian/0000-0002-9827-4768 FU NCCDPHP CDC HHS [U48-DP-000059]; PHS HHS [U48/CCU409660] NR 23 TC 10 Z9 10 U1 0 U2 0 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD JUL PY 2007 VL 33 IS 1 SU 1 BP S50 EP S65 DI 10.1016/j.amepre.2007.04.002 PG 16 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 187YD UT WOS:000247884300006 PM 17584591 ER PT J AU Weiner, BJ Helfrich, CD Savitz, LA Swiger, KD AF Weiner, Bryan J. Helfrich, Christian D. Savitz, Lucy A. Swiger, Kathleen D. TI Adoption and implementation of strategies for diabetes management in primary care practices SO AMERICAN JOURNAL OF PREVENTIVE MEDICINE LA English DT Article ID CHRONIC ILLNESS; MODEL; QUALITY AB Background: Secondary and tertiary prevention of chronic illness is a major challenge for the United States healthcare system. Controlled studies show that interventions can enhance secondary prevention in primary care practices, but they shed little light on implementation of secondary prevention outside the experimental context. This study examines the adoption and implementation of an important set of secondary and tertiary prevention efforts-diabetes management strategies-for type 2 diabetes in the everyday clinical practice of primary care. It explores whether adoption and implementation processes differ by type of strategy or prevalence of diabetes among patients in the practice. Methods: Holistic case studies (those used to assess a single analytic unit, in this case, the physician group practice, as opposed to multiple embedded subunits) were conducted in 2001-2002 on six primary care practices in North Carolina identified from a statewide physician survey on strategies for diabetes management. Practices were selected by prevalence of diabetes and type of strategy for diabetes management-patient oriented (focused on self-management) versus biomedical (focused on secondary prevention practices). Results were derived from thematic analysis of interviews and secondary documents. Results: Adoption and implementation did not differ by diabetes prevalence or type of diabetes strategy. All practices had a routine forum for vetting new strategies, and most used traditional channels for identifying them. Implementation often required adaptation of the strategy and the organization. Sustained use of a diabetes strategy depended on favorable organizational policies and procedures (e.g., training,job redesign) and ongoing commitment of resources. Conclusions: Diabetes management strategies are often complex and require adoption and implementation processes different from those described by classic innovation diffusion models. Alternative conceptual models that consider organizational process, structure, and culture are needed. C1 Univ N Carolina, Hlth Policy & Adm, Chapel Hill, NC 27599 USA. Vet Affairs Puget Sound Hlth Care Syst, Hlth Serv Res & Dev Serv, Seattle, WA USA. Res Triangle Inst, Res Triangle Pk, NC 27709 USA. Advocate Partners, Arlington, VA USA. RP Weiner, BJ (reprint author), Univ N Carolina, Hlth Policy & Adm, Chapel Hill, NC 27599 USA. EM Bryan_Weiner@unc.edu RI Helfrich, Christian/D-2382-2016 OI Helfrich, Christian/0000-0002-9827-4768 FU NCCDPHP CDC HHS [U48-DP-000059]; PHS HHS [U48/CCU409660] NR 34 TC 9 Z9 9 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0749-3797 J9 AM J PREV MED JI Am. J. Prev. Med. PD JUL PY 2007 VL 33 IS 1 SU 1 BP S35 EP S49 DI 10.1016/j.amepre.2007.04.001 PG 15 WC Public, Environmental & Occupational Health; Medicine, General & Internal SC Public, Environmental & Occupational Health; General & Internal Medicine GA 187YD UT WOS:000247884300005 PM 17584590 ER PT J AU LaRowe, SD Myrick, H Hedden, S Mardikian, P Saladin, M McRae, A Brady, K Kalivas, PW Malcolm, R AF LaRowe, Steven D. Myrick, Hugh Hedden, Sarra Mardikian, Pascale Saladin, Michael McRae, Aimee Brady, Kathleen Kalivas, Peter W. Malcolm, Robert TI Is cocaine desire reduced by N-acetylcysteine? SO AMERICAN JOURNAL OF PSYCHIATRY LA English DT Article ID SEEKING AB objective: Animal models suggest that N-acetylcysteine inhibits cocaine-seeking. The present pilot study evaluated whether N-acetylcysteine would suppress reactivity to cocaine-related cues in cocaine-dependent humans. Method: in this double-blind, placebo-controlled trial, 15 participants received N-acetylcysteine or placebo during a 3-day hospitalization. Participants were crossed over to receive the opposite condition on a second, identical 3-day stay occurring 4 days later. During each hospital stay, participants completed a cue-reactivity procedure that involved collecting psychophysical and subjective data in response to slides depicting cocaine and cocaine use. Results: While taking N-acetylcysteine, participants reported less desire to use and less interest in response to cocaine slides and watched cocaine slides for less time. Conclusions: The inhibition of cocaine cue reactivity is consistent with existing preclinical data and supports the use of N-acetylcysteine as a treatment for cocaine dependence. C1 Med Univ S Carolina, Dept Neurosci, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biometry & Informat, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Rehabil Sci, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Mental Hlth Serv, Charleston, SC USA. RP Kalivas, PW (reprint author), Med Univ S Carolina, Dept Neurosci, 173 Ashley Ave,BSB 403, Charleston, SC 29425 USA. EM kalivasp@musc.edu RI McRae-Clark, Aimee/I-3341-2013 OI McRae-Clark, Aimee/0000-0002-9774-318X FU NCRR NIH HHS [RR-01070]; NIDA NIH HHS [DA-018501, DA-015369, DA-07288] NR 6 TC 115 Z9 118 U1 0 U2 4 PU AMER PSYCHIATRIC PUBLISHING, INC PI ARLINGTON PA 1000 WILSON BOULEVARD, STE 1825, ARLINGTON, VA 22209-3901 USA SN 0002-953X J9 AM J PSYCHIAT JI Am. J. Psychiat. PD JUL PY 2007 VL 164 IS 7 BP 1115 EP 1117 DI 10.1176/appi.ajp.164.7.1115 PG 3 WC Psychiatry SC Psychiatry GA 187TZ UT WOS:000247872700023 PM 17606664 ER PT J AU Bass, E French, DD Bradham, DD Rubenstein, LZ AF Bass, Elizabeth French, Dustin D. Bradham, Douglas D. Rubenstein, Laurence Z. TI Risk-adjusted mortality rates of elderly veterans with hip fractures SO ANNALS OF EPIDEMIOLOGY LA English DT Article DE hip fractures; risk adjusted; survival analysis; mortality; veterans ID QUALITY-OF-LIFE; NATIONAL VETERANS; OUTPATIENT MEDICATION; COMORBIDITY MEASURES; ADMINISTRATIVE DATA; THIAZIDE DIURETICS; FUNCTIONAL STATUS; GREATER RISK; OLDER-ADULTS; MEN AB PURPOSE: The goal of this research was to estimate 12-month survival rates for a large sample of elderly veterans after hip fracture with a risk-adjusted model and to compare the results of men to those of women. METHODS: The study design was a retrospective, secondary data analysis of national Veterans Health Administration (VHA) Medicare beneficiaries. The study population was 43,165 veterans with hip fracture first admitted to a Medicare-eligible facility during our specified enrollment period of 1999-2002. Measurement was a Cox proportional hazard model or survival analysis of hip fracture patients with an outcome of death over a I year period after discharge controlled by age, gender, and selected Elixhauser comorbidities. RESULTS: The unadjusted, I year mortality rates (30 days = 9.7%, 90 days = 17.5%, 180 days = 24%, 365 days = 32.2%) were slightly higher than the adjusted rates (30 days = 8.9%, 90 days = 15.6%, 180 days = 21.8%, 1 year = 29.9%). The mortality odds for women 12 months after hip fracture were 18%, compared with 32% for men. The comorbidity adjustment suggested that the presence of metastatic cancer increased the risk of death by almost 4 times compared with those patients without this diagnosis. Other particularly high-risk conditions included congestive heart failure, renal failure, liver disease, lymphoma, and weight loss, each of which increased the 1 year mortality risk by approximately two-fold. CONCLUSIONS: One in 3 elderly male veterans who sustain a hip fracture dies within I year. Our work represents the first large study of hip fractures with a predominantly male sample and confirms that men have a higher mortality risk than women, as reported by previous researchers who used smaller samples that were mostly female. Fracture patients with metastatic cancer, renal failure, lymphoma, weight loss, and liver disease have higher mortality risks. The adverse outcomes associated with hip fracture argue for clinical intervention strategies, such as gait and balance testing, and osteoporosis diagnosis that may prevent fractures in both genders. C1 James A Haley Vet Affairs Med Ctr, VISN Patient Safety Ctr Inquiry 8, Tampa, FL 33612 USA. Cooperat Studies Program Coordinating Ctr Perry P, Perry Point, MD USA. Univ Maryland, Dept Epidemiol & Prevent Med, College Pk, MD 20742 USA. Univ Calif Berkeley, Sch Med, Berkeley, CA 94720 USA. Vet Affairs Greater Los Angeles Healthcare Syst G, Educ & Clin Ctr, Sepulveda & W Los Angles Div, Los Angeles, CA USA. RP Bass, E (reprint author), James A Haley Vet Affairs Med Ctr, VISN Patient Safety Ctr Inquiry 8, 13000 Bruce B Downs Blvd 118M, Tampa, FL 33612 USA. EM Elizabeth.Bass@va.gov OI French, Dustin/0000-0003-4064-3206 NR 47 TC 104 Z9 110 U1 3 U2 7 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1047-2797 J9 ANN EPIDEMIOL JI Ann. Epidemiol. PD JUL PY 2007 VL 17 IS 7 BP 514 EP 519 DI 10.1016/j.annepidem.2006.12.004 PG 6 WC Public, Environmental & Occupational Health SC Public, Environmental & Occupational Health GA 187ZV UT WOS:000247888900005 PM 17420142 ER PT J AU Zivkovic, SA Lacomis, D AF Zivkovic, Sasa A. Lacomis, David TI Painful sensory neuropathy associated with hereditary spherocytosis SO ANNALS OF HEMATOLOGY LA English DT Letter ID PATIENT C1 Univ Pittsburgh, Med Ctr, Dept Neurol, Pittsburgh, PA 15213 USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15213 USA. Univ Pittsburgh, Sch Med, Dept Pathol Neuropathol, Pittsburgh, PA 15213 USA. RP Zivkovic, SA (reprint author), Univ Pittsburgh, Med Ctr, Dept Neurol, PUH F875,200 Lothrop St, Pittsburgh, PA 15213 USA. EM zivkovics@upmc.edu NR 5 TC 0 Z9 0 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0939-5555 J9 ANN HEMATOL JI Ann. Hematol. PD JUL PY 2007 VL 86 IS 7 BP 535 EP 536 DI 10.1007/s00277-007-0262-1 PG 2 WC Hematology SC Hematology GA 171IV UT WOS:000246730300012 PM 17265023 ER PT J AU Chun, LS Samii, A Hutter, CM Griffith, A Roberts, JW Leis, BC Mosley, AD Wander, L Edwards, KL Payami, H Zabetian, CP AF Chun, Lani S. Samii, Ali Hutter, Carolyn M. Griffith, Alida Roberts, John W. Leis, Berta C. Mosley, Anthony D. Wander, Luke Edwards, Karen L. Payami, Haydeh Zabetian, Cyrus P. TI DBH-1021C -> T does not modify risk or age at onset in Parkinson's disease SO ANNALS OF NEUROLOGY LA English DT Article ID DOPAMINE-BETA-HYDROXYLASE; LOCUS-COERULEUS LESIONS; PARKINSONS-DISEASE; FUNCTIONAL POLYMORPHISM; COMPLEX DISEASES; SUBSTANTIA-NIGRA; ASSOCIATION; TRAITS; GENEPD; SCAN AB DBH is a candidate gene in Parkinson's disease (PD) and contains a putative functional polymorphism (-1021C -> T) that has been reported to modify PD susceptibility. We examined -1021C -> T in a sample of 1,244 PD patients and 1,186 unrelated control subjects. There was no significant difference in allele (p = 0.14) or genotype (p = 0.26) frequencies between the two groups. A similar result was obtained after pooling our data with those previously published. Furthermore, we found no evidence for an effect of genotype on age at onset among patients. Our Findings argue against DBH -1021C -> T as a risk factor or age at onset modifier in PD. C1 Geriatr Res Educ, Seattle, WA 98108 USA. VA Puget Sound Health Care Syst, Clin Ctr S 182, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Neurol, Seattle, WA USA. VA Puget Sound Health Care Syst, Parkinsons Dis Res Educ, Seattle, WA USA. VA Puget Sound Health Care Syst, Clin Ctr, Seattle, WA USA. Univ Washington, Sch Publ Hlth & Community Med, Dept Epidemiol, Seattle, WA 98195 USA. Evergreen Hosp Med Ctr, Booth Gardner Parkinsons Care Ctr, Kirkland, WA 98034 USA. Virginia Mason Med Ctr, Seattle, WA 98101 USA. New York State Dept Hlth, Wadsworth Ctr, Genom Inst, Albany, NY USA. VA Puget Sound Hlth Care Syst, Clin Ctr, Seattle, WA USA. RP Zabetian, CP (reprint author), Geriatr Res Educ, 1660 S Columbian Way, Seattle, WA 98108 USA. EM zabetian@u.washington.edu OI Zabetian, Cyrus/0000-0002-7739-4306; Wander, Pandora/0000-0003-3671-1464 FU NIA NIH HHS [P30 AG 008017, P30 AG008017, U24 AG021886]; NINDS NIH HHS [R01 NS036960, K08 NS 044138, K08 NS044138, K08 NS044138-04, R01 NS 036960] NR 18 TC 2 Z9 2 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0364-5134 J9 ANN NEUROL JI Ann. Neurol. PD JUL PY 2007 VL 62 IS 1 BP 99 EP 101 DI 10.1002/ana.21149 PG 3 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 199CF UT WOS:000248673100017 PM 17503507 ER PT J AU Ibrahim, SA Groeneveld, RW Mor, M Geng, M Kwoh, K AF Ibrahim, S. A. Groeneveld, R. W. Mor, M. Geng, M. Kwoh, K. TI Trust in physicians as a predictor of preference for total joint replacement SO ANNALS OF THE RHEUMATIC DISEASES LA English DT Meeting Abstract CT Annual European Congress of Rheumatology (EULAR 2007) CY JUN 13-16, 2007 CL Barcelona, SPAIN SP European League Against Rheumatism C1 [Ibrahim, S. A.; Mor, M.; Geng, M.; Kwoh, K.] Univ Pittsburgh, Sch Med, VA CHERP, Pittsburgh, PA USA. [Groeneveld, R. W.] Philadelphia VA Med Ctr, Philadelphia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0003-4967 J9 ANN RHEUM DIS JI Ann. Rheum. Dis. PD JUL PY 2007 VL 66 SU 2 BP 262 EP 262 PG 1 WC Rheumatology SC Rheumatology GA 261SU UT WOS:000253101101117 ER PT J AU Ibrahim, SA Groeneveld, PW Maria, M Ming, G Kwoh, K AF Ibrahim, S. A. Groeneveld, P. W. Maria, M. Ming, G. Kwoh, K. TI Preference for joint replacement and relationship with patient rated quality of life or disease severity SO ANNALS OF THE RHEUMATIC DISEASES LA English DT Meeting Abstract CT Annual European Congress of Rheumatology (EULAR 2007) CY JUN 13-16, 2007 CL Barcelona, SPAIN SP European League Against Rheumatism C1 [Ibrahim, S. A.; Maria, M.; Ming, G.; Kwoh, K.] Univ Pittsburgh, Sch Med, VA CHERP, Pittsburgh, PA 15260 USA. [Groeneveld, P. W.] Philadelphia VA Med Ctr, Philadelphia, PA USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0003-4967 J9 ANN RHEUM DIS JI Ann. Rheum. Dis. PD JUL PY 2007 VL 66 SU 2 BP 263 EP 263 PG 1 WC Rheumatology SC Rheumatology GA 261SU UT WOS:000253101101118 ER PT J AU Almyroudis, NG Sutton, DA Fothergill, AW Rinaldi, MG Kusne, S AF Almyroudis, Nikolaos G. Sutton, Deanna A. Fothergill, Annette W. Rinaldi, Michael G. Kusne, Shimon TI In vitro susceptibilities of 217 clinical isolates of zygomycetes to conventional and new antifungal agents SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY LA English DT Article ID CARE CANCER CENTER; AMPHOTERICIN-B; FILAMENTOUS FUNGI; DISSEMINATED ZYGOMYCOSIS; ASPERGILLUS SPP.; SALVAGE THERAPY; POSACONAZOLE; ITRACONAZOLE; VORICONAZOLE; CASPOFUNGIN AB We evaluated the in vitro susceptibilities of 217 zygomycetes to amphotericin B, ketoconazole, fluconazole, itraconazole, voriconazole, posaconazole, caspofungin, and flucytosine. The significant in vitro activity of posaconazole against several species appears to support its reported clinical efficacy. Decreased susceptibility to amphotericin B was noted with Cunninghamella bertholletiae. C1 Roswell Pk Canc Inst, Dept Med, Buffalo, NY USA. Dept Pathol, Fungus Testing Lab, San Antonio, TX USA. Audie L Murphy Mem Vet Adm Med Ctr, S Texas Vet Hlth Care Syst, San Antonio, TX USA. Mayo Clin, Phoenix, AZ USA. RP Sutton, DA (reprint author), Univ Texas, Hlth Sci Ctr, Dept Pathol, Fungus Testing Lab, 7703 Floyd Curl Dr, San Antonio, TX 78229 USA. EM suttond@uthscsa.edu NR 30 TC 131 Z9 140 U1 0 U2 1 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0066-4804 J9 ANTIMICROB AGENTS CH JI Antimicrob. Agents Chemother. PD JUL PY 2007 VL 51 IS 7 BP 2587 EP 2590 DI 10.1128/AAC.00452-07 PG 4 WC Microbiology; Pharmacology & Pharmacy SC Microbiology; Pharmacology & Pharmacy GA 184TS UT WOS:000247665800039 PM 17452481 ER PT J AU Nithipongvanitch, R Ittarat, W Cole, MP Tangpong, J St Clair, DK Oberley, TD AF Nithipongvanitch, Ramaneeya Ittarat, Wanida Cole, Marsha P. Tangpong, Jitbanjong St. Clair, Daret K. Oberley, Terry D. TI Mitochondrial and nuclear p53 localization in cardiomyocytes: Redox modulation by doxorubicin (adriamycin)? SO ANTIOXIDANTS & REDOX SIGNALING LA English DT Article ID MANGANESE SUPEROXIDE-DISMUTASE; SEQUENCE-SPECIFIC DNA; NITRIC-OXIDE; INDUCED APOPTOSIS; REACTIVE OXYGEN; SIGNALING PATHWAYS; TRANSGENIC MICE; EXCISION-REPAIR; CANCER-CELLS; EXPRESSION AB Reactive oxygen (ROS) and nitrogen species (RNS) generation have been proposed to be an important mechanism of doxorubicin (Adriamycin; ADR)-induced cardiotoxicity and cardiomyocyte apoptosis, processes that may be mediated by p53 protein. We note that ADR treatment resulted in increased levels of p53 protein in cardiomyocyte mitochondria and nuclei. Modulation of the cardiomyocyte redox state in genetically engineered mice by modulation of enzymes involved in metabolism of ROS/RNS, manganese superoxide dismutase (MnSOD), or inducible nitric oxide synthase (iNOS), or a combination of these, regulated levels of mitochondrial/nuclear p53 in cardiomyocytes after ADR administration. These observations led to the hypothesis that mitochondrial/ nuclear p53 localization and function in the cardiomyocyte response to ADR may be regulated through redox-dependent mechanism(s). C1 Univ Wisconsin, Sch Med & Publ Hlth, Dept Pathol & Lab Med, Madison, WI 53706 USA. Mahidol Univ, Fac Med Technol, Bangkok 10700, Thailand. Univ Kentucky, Dept Toxicol, Lexington, KY 40506 USA. William S Middleton Mem Vet Adm Med Ctr, Madison, WI USA. RP Oberley, TD (reprint author), Univ Wisconsin, Sch Med & Publ Hlth, Dept Pathol & Lab Med, Madison, WI 53706 USA. EM dstc100@pop.uky.edu FU NCI NIH HHS [CA94853] NR 38 TC 38 Z9 41 U1 0 U2 3 PU MARY ANN LIEBERT, INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 1523-0864 EI 1557-7716 J9 ANTIOXID REDOX SIGN JI Antioxid. Redox Signal. PD JUL PY 2007 VL 9 IS 7 BP 1001 EP 1008 DI 10.1089/ars.2007.1632 PG 8 WC Biochemistry & Molecular Biology; Endocrinology & Metabolism SC Biochemistry & Molecular Biology; Endocrinology & Metabolism GA 170EW UT WOS:000246646200019 PM 17508921 ER PT J AU Marshall, GA Monserratt, L Harwood, D Mandelkern, M Cummings, JL Sultzer, DL AF Marshall, Gad A. Monserratt, Lorena Harwood, Dylan Mandelkern, Mark Cummings, Jeffrey L. Sultzer, David L. TI Positron emission tomography metabolic correlates of apathy in Alzheimer disease SO ARCHIVES OF NEUROLOGY LA English DT Article ID DEMENTIA; DEPRESSION; SPECT AB Background: Apathy is the most common neuropsychiatric manifestation in Alzheimer disease ( AD). Clinical, single-photon emission computed tomography, magnetic resonance imaging, and pathologic studies of apathy in AD have suggested an association with frontal dysfunction, most supportive of anterior cingulate abnormalities, but without a definitive localization. Objective: To examine the association between apathy and cortical metabolic rate on positron emission tomography in AD. Design: Forty-one subjects with probable AD underwent [ F-18] fluorodeoxyglucose positron emission tomography imaging and neuropsychiatric and cognitive assessments. Global subscale scores from the Scale for the Assessment of Negative Symptoms in Alzheimer Disease were used to designate the absence or presence of clinically meaningful apathy. Whole-brain voxel-based analyses were performed using statistical parametric mapping ( SPM2; Wellcome Department of Imaging Neuroscience, London, England), which yielded significance maps comparing the 2 groups. Results: Twenty-seven ( 66%) subjects did not have apathy, whereas 14 ( 34%) had apathy. Statistical parametric mapping analysis revealed significant reduced activity in the bilateral anterior cingulate region extending inferiorly to the medial orbitofrontal region ( P <.001) and the bilateral medial thalamus ( P=.04) in subjects with apathy. The results of the statistical parametric mapping analysis remained the same after individually covarying for the effects of global cognitive impairment, depressed mood, and education. Conclusions: Apathy in AD is associated with reduced metabolic activity in the bilateral anterior cingulate gyrus and medial orbitofrontal cortex and may be associated with reduced activity in the medial thalamus. These results reinforce the confluence of evidence from other investigational modalities in implicating medial frontal dysfunction and related neuronal circuits in the neurobiology of apathy in AD and other neuropsychiatric diseases. C1 Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Psychiat, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Dept Behav Sci, Los Angeles, CA 90024 USA. Vet Affairs Greater Los Angeles, Healthcare Syst, Psychiat Serv, Los Angeles, CA USA. Vet Affairs Greater Los Angeles, Healthcare Syst, Nucl Med Serv, Los Angeles, CA USA. Brigham & Womens Hosp, Dept Neurol, Boston, MA 02115 USA. Univ Calif Irvine, Irvine, CA 92717 USA. RP Sultzer, DL (reprint author), Univ Calif Los Angeles, Dept Neurol, Los Angeles, CA 90024 USA. EM dsultzer@ucla.edu FU NIMH NIH HHS [MH56031] NR 25 TC 104 Z9 106 U1 0 U2 2 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0003-9942 J9 ARCH NEUROL-CHICAGO JI Arch. Neurol. PD JUL PY 2007 VL 64 IS 7 BP 1015 EP 1020 DI 10.1001/archneur.64.7.1015 PG 6 WC Clinical Neurology SC Neurosciences & Neurology GA 188AZ UT WOS:000247892100014 PM 17620493 ER PT J AU Guihan, M Garber, SL Bombardier, CH Durazo-Arizu, R Goldstein, B Holmes, SA AF Guihan, Marylou Garber, Susan L. Bombardier, Charles H. Durazo-Arizu, Ramon Goldstein, Barry Holmes, Sally Ann TI Lessons learned while conducting research on prevention of pressure ulcers in veterans with spinal cord injury SO ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION LA English DT Article DE pressure ulcers; rehabilitation; spinal cord injuries; veterans ID METAANALYSIS; EFFICACY AB Objective: To describe the challenges of conducting a large randomized controlled trial (RCT) to assess the effectiveness of an intervention to prevent recurrent pressure ulcers among a high-risk population of subjects with spinal cord injury (SCI). Design: Prospective multisite, randomized design comparing outcomes of patients who received individualized education and structured telephone counseling follow-up with those of patients receiving customary care. This study was stopped early because of unanticipated recruitment problems. Setting: Six Veterans Affairs SCI specialty centers. Participants: Veterans (N = 150) treated for stage III or IV pelvic pressure ulcers. Interventions: Not applicable. Main Outcome Measure: Recurrence (defined as new skin breakdown in the pelvic area) and time to recurrence. The study was stopped early because of slow recruitment, so the focus of this study is lessons learned, not the main planned outcome measures. Results: Subject recruitment did not meet original expectations because almost 50% of those enrolled left the hospital with the study ulcer unhealed (having a healed ulcer was a requirement for participation). No significant differences were observed between groups on rate of or time to recurrence at the time the study was stopped. Among the 6 sites, variability in ulcer management (eg, length of stay, receipt of medical vs surgical treatment, sitting tolerance before discharge) and time to recurrence (median, 4mo) were observed. Conclusions: RCTs in real-world settings are the most robust method of assessing the effectiveness of prevention strategies. However, in complex, rapidly changing health care organizations, blinding is infeasible, it may be impractical to control for every variable that influences a study's outcome, and any assumptions that usual care is static are probably mistaken. Investigators must be prepared to use innovative approaches to maintain the integrity of the study design, including flexibility in inclusion and exclusion criteria to support accrual, obtaining a better understanding of the important aspects of usual care that may need to be standardized, continuous improvement within the intervention arm, and anticipation and minimization of risks from organizational changes. With attention to these delivery system issues and the usual design features of randomized trials, we believe real-world care settings can serve as important laboratories to test pressure ulcer prevention strategies in this population. C1 Vet Affairs Edward Hines Jr Hosp, Ctr Management Complex Chron Care, Hines, IL 60141 USA. Northwestern Univ, Inst Hlth Serv Res & Policy Studies, Chicago, IL USA. Michael E DeBakey Vet Affairs Med Ctr, Houston, TX USA. Baylor Coll Med, Dept Phys Med & Rehabil, Houston, TX 77030 USA. Univ Washington, Sch Med, Dept Rehabil Med, Seattle, WA 98195 USA. Harborview Med Ctr, Seattle, WA USA. Loyola Univ, Stritch Sch Med, Dept Prevent Med & Eoidemiol, Maywood, IL 60153 USA. Vet Hlth Adm Spinal Cord Injury & Disorders Strat, Seattle, WA USA. RP Guihan, M (reprint author), Vet Affairs Edward Hines Jr Hosp, Ctr Management Complex Chron Care, 151-H, Hines, IL 60141 USA. EM marylou.guihan@va.gov NR 12 TC 27 Z9 27 U1 0 U2 3 PU W B SAUNDERS CO-ELSEVIER INC PI PHILADELPHIA PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA SN 0003-9993 J9 ARCH PHYS MED REHAB JI Arch. Phys. Med. Rehabil. PD JUL PY 2007 VL 88 IS 7 BP 858 EP 861 DI 10.1016/j.apmr.2007.03.014 PG 4 WC Rehabilitation; Sport Sciences SC Rehabilitation; Sport Sciences GA 187SQ UT WOS:000247869200006 PM 17601465 ER PT J AU McGory, ML Zingmond, DS Sekeris, E Ko, CY AF McGory, Marcia L. Zingmond, David S. Sekeris, Evan Ko, Clifford Y. TI The significance of inadvertent splenectomy during colorectal cancer resection SO ARCHIVES OF SURGERY LA English DT Article; Proceedings Paper CT Annual Meeting of the American-Society-of-Colon-and-Rectal-Surgeons CY APR 30-MAY 05, 2005 CL Philadelphia, PA SP Amer Soc Colon & Rectal Surg ID SPLENIC INJURY; ADMINISTRATIVE DATA; SURGICAL-TREATMENT; SURVIVAL; INFECTION; OUTCOMES; CARE; MORBIDITY; SURGERY; QUALITY AB Objective: To examine the frequency, predictors, and outcomes following inadvertent splenectomy during colorectal cancer resection. Design: Retrospective study. Setting: Linkage of the California Cancer Registry and the California Patient Discharge Database from the Office of Statewide Health Planning and Development. Participants: Californians undergoing colorectal cancer resection from 1995 through 2001. Inadvertent splenectomy was defined as splenectomy occurring during non-T4 or non-stage IV resection. Main Outcome Measure: The rate of inadvertent splenectomy for the overall cohort and by tumor location (eg, splenic flexure, rectosigmoid). Multivariate risk-adjusted models identified predictors of inadvertent splenectomy and outcomes including length of stay and probability of death. Results: A total of 41 999 non-T4, non-stage IV colorectal cancer resections were studied. Mean age was 70.4 years; 50.4% were male; and 75.6% were non-Hispanic white. Although the overall rate of inadvertent splenectomy was less than 1%, the rate was 6% for splenic flexure tumors. A multivariate risk-adjusted model predicting inadvertent splenectomy demonstrated a statistically significant (P < .001) higher odds ratio if the tumor was located in the transverse (3.6), splenic flexure (29.2), descending (11.4), sigmoid (2.7), or rectosigmoid (2.6) regions. Using a risk-adjusted model, inadvertent splenectomy increased length of stay by 37.4% (P < .001). Perhaps most important, risk-adjusted survival analysis showed splenectomy increased the probability of death by 40% (P < .001). Conclusions: To our knowledge, this is the first large study evaluating the rates and outcomes after inadvertent splenectomy. In the population-based cohort, tumor locations from the transverse colon to the rectosigmoid significantly increased the odds of inadvertent splenectomy. In addition, inadvertent splenectomy during colorectal cancer resection increased both length of stay and probability of death. C1 [McGory, Marcia L.; Zingmond, David S.; Sekeris, Evan; Ko, Clifford Y.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Ctr Surg Outcomes & Qualit, Los Angeles, CA 90095 USA. [Zingmond, David S.] Univ Calif Los Angeles, David Geffen Sch Med, Dept Gen Internal Med, Los Angeles, CA 90095 USA. [Zingmond, David S.] Univ Calif Los Angeles, David Geffen Sch Med, Hlth Serv, Los Angeles, CA 90095 USA. [Ko, Clifford Y.] VA Greater Los Angeles Health Syst, Dept Surg, Los Angeles, CA USA. RP McGory, ML (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Dept Surg, Ctr Surg Outcomes & Qualit, 10833 Le Conte Ave,72 215 Ctr Hlth Sci,Box 956904, Los Angeles, CA 90095 USA. EM mmcgory@mednet.ucla.edu FU NCI NIH HHS [5U01CA086322-06] NR 26 TC 21 Z9 22 U1 0 U2 1 PU AMER MEDICAL ASSOC PI CHICAGO PA 515 N STATE ST, CHICAGO, IL 60610-0946 USA SN 0004-0010 J9 ARCH SURG-CHICAGO JI Arch. Surg. PD JUL PY 2007 VL 142 IS 7 BP 668 EP 674 DI 10.1001/archsurg.142.7.668 PG 7 WC Surgery SC Surgery GA 188IN UT WOS:000247913700020 PM 17638806 ER PT J AU Bearden, CE Thompson, PM Dalwani, M Hayashi, KM Lee, AD Nicoletti, M Trakhtenbroit, M Glahn, DC Brambilla, P Sassi, RB Mallinger, AG Frank, E Kupfer, DJ Soares, JC AF Bearden, Carrie E. Thompson, Paul M. Dalwani, Manish Hayashi, Kiralee M. Lee, Agatha D. Nicoletti, Mark Trakhtenbroit, Michael Glahn, David C. Brambilla, Paolo Sassi, Roberto B. Mallinger, Alan G. Frank, Ellen Kupfer, David J. Soares, Jair C. TI Greater cortical gray matter density in lithium-treated patients with bipolar disorder SO BIOLOGICAL PSYCHIATRY LA English DT Article DE bipolar disorder; cortical pattern matching; lithium; magnetic resonance imaging; mood disorders; neuroprotection ID VOXEL-BASED MORPHOMETRY; ANTERIOR CINGULATE CORTEX; MANIC-DEPRESSIVE ILLNESS; N-ACETYL-ASPARTATE; MOOD DISORDERS; ALZHEIMERS-DISEASE; PROTEIN BCL-2; HUMAN BRAIN; IN-VIVO; VOLUME AB Background: The neurobiological underpinnings of bipolar disorder are not well understood. Previous neuroimaging findings have been inconsistent; however, new methods for three-dimensional (3-D) computational image analysis may better characterize neuroanatomic changes than standard volumetric measures. Methods: We used high-resolution magnetic resonance imaging and cortical pattern matching methods to map gray matter differences in 28 adults with bipolar disorder, 70% of whom were lithium-treated (mean age = 36.1 +/- 10.5; 13 female subject), and 28 healthy control subjects (mean age = 35.9 +/- 8.5; 11 female subjects). Detailed spatial analyses of gray matter density (GMD) were conducted by measuring local proportions of gray matter at thousands of homologous cortical locations. Results: Gray matter density was significantly greater in bipolar patients relative to control subjects in diffuse cortical regions. Greatest differences were found in bilateral cingulate and paralimbic cortices, brain regions critical for attentional, motivational, and emotional modulation. Secondary region of interest (1301) analyses indicated significantly greater GMD in the right anterior cingulate among lithium-treated bipolar patients (n = 20) relative to those not taking lithium (n = 8). Conclusions: These brain maps are consistent with previous voxel-based morphometry reports of greater GMD in portions of the anterior limbic network in bipolar patients and suggest neurotrophic effects of lithium as a possible etiology of these neuroanatomic differences. C1 Univ Calif Los Angeles, Dept Psychiat & Behav Sci, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Semel Inst Neurosci & Human Behav, Dept Psychiat & Behav Sci, Lab Neurolmaging, Los Angeles, CA USA. Univ Texas, Hlth Sci Ctr, Dept Psychiat, San Antonio, TX USA. Univ Texas, Hlth Sci Ctr, Dept Radiol, San Antonio, TX USA. Univ Udine, Dept Pathol & Expt & Clin Med, I-33100 Udine, Italy. IRCCS, Inst Sci, Udine, Italy. Univ Fed Sao Paulo, Sch Med, Dept Psychiat, Sao Paulo, Brazil. Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. RP Bearden, CE (reprint author), Univ Calif Los Angeles, Dept Psychiat & Behav Sci, 300 Bldg Med Plaza, Suite 2265, Los Angeles, CA 90095 USA. EM cbearden@mednet.ucla.edu RI brambilla, paolo/B-4184-2010 OI brambilla, paolo/0000-0002-4021-8456 FU NCRR NIH HHS [K24 RR020571, R21 RR019771, RR019771, RR020571]; NIA NIH HHS [AG021431, R01 AG021431]; NIBIB NIH HHS [EB01651, R01 EB016516]; NIMH NIH HHS [R01 MH068766, K23 MH001736, K23 MH074644, K23 MH074644-01, MH01736, MH030915, MH068662, MH068766, MH29618, P20 MH068662, P30 MH030915, P30 MH086045, R01 MH029618, R37 MH029618] NR 43 TC 156 Z9 160 U1 0 U2 6 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0006-3223 J9 BIOL PSYCHIAT JI Biol. Psychiatry PD JUL 1 PY 2007 VL 62 IS 1 BP 7 EP 16 DI 10.1016/j.biopsych.2006.10.027 PG 10 WC Neurosciences; Psychiatry SC Neurosciences & Neurology; Psychiatry GA 184PH UT WOS:000247653500003 PM 17240360 ER PT J AU Woods, DL Martin, JL AF Woods, Diana Lynn Martin, Jennifer L. TI Cortisol and wake time in nursing home residents with behavioral symptoms of dementia SO BIOLOGICAL RESEARCH FOR NURSING LA English DT Article DE cortisol; wake time; behavioral symptoms; dementia; nursing home ID AGE-RELATED-CHANGES; MINI-MENTAL-STATE; ALZHEIMERS-DISEASE; CIRCADIAN-RHYTHMS; SLEEP-WAKE; STRESS; DISTURBANCES; AGITATION; BRAIN; GLUCOCORTICOIDS AB Alterations in sleep and behavioral symptoms are consistently reported among nursing home residents with dementia. Disregulation in the hypothalamic-pituitary-adrenal axis (HPA), indexed by basal cortisol levels, offers one explanation. The purpose of this study is to examine the relationship between wake time and cortisol slope in residents with behavioral symptoms. The study included 27 residents aged 71 to 84 years with dementia and behavioral symptoms. Using a within-subject longitudinal design, the researchers documented wake time and collected saliva samples for 4 consecutive days upon waking and at 30 min, 6 hr, and 12 hr after waking. Within-person cortisol slopes were categorized into zeropositive and negative slopes. The zero-positives (35%) exhibited an earlier wake time than the negatives (65%). These preliminary results suggest both a relationship between wake time and HPA diurnal profile and an association between the sleep-wake cycle and cortisol secretion among nursing home residents with dementia. C1 Univ Calif Los Angeles, Sch Nursing, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Multicampus Program Geriatr Med & Gerontol, Los Angeles, CA 90095 USA. VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. RP Woods, DL (reprint author), Univ Calif Los Angeles, Sch Nursing, 700 Tiverton Ave,Box 956919, Los Angeles, CA 90095 USA. EM lwoods@sonnet.ucla.edu NR 49 TC 12 Z9 12 U1 2 U2 3 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 1099-8004 J9 BIOL RES NURS JI Biol. Res. Nurs. PD JUL PY 2007 VL 9 IS 1 BP 21 EP 29 DI 10.1177/1099800407303982 PG 9 WC Nursing SC Nursing GA 184OS UT WOS:000247652000003 PM 17601854 ER PT J AU Ringman, JM O'Neill, J Geschwind, D Medina, L Apostolova, LG Rodriguez, Y Schaffen, B Varpetian, A Tseng, B Ortiz, F Fitten, J Cummings, JL Bartzokis, G AF Ringman, John M. O'Neill, Joseph Geschwind, Daniel Medina, Luis Apostolova, Liana G. Rodriguez, Yaneth Schaffen, Barbara Varpetian, Arousiak Tseng, Benjamin Ortiz, Freddy Fitten, Jaime Cummings, Jeffrey L. Bartzokis, George TI Diffusion tensor imaging in preclinical and presymptomatic carriers of familial Alzheimer's disease mutations SO BRAIN LA English DT Article DE familial Alzheimer's disease; presymptomatic; diffusion tensor imaging; fractional anisotropy; Presenilin-I; amyloid precursor protein; white matter; fornix; biomarker ID MILD COGNITIVE IMPAIRMENT; MATTER STRUCTURAL INTEGRITY; SPASTIC PARAPARESIS; MYELIN BREAKDOWN; BRAIN; AGE; DEMENTIA; AD; ROBUST; MODEL AB Measures are needed that identify persons that will develop Alzheimer's disease in order to target them for preventative interventions. There is evidence from animal, pathological and imaging studies that disruption of white matter occurs in the course of Alzheimer's disease and may be an early event. Prior studies have suggested that late-myelinating regions or white matter connecting limbic structures are particularly susceptible to degradation. Persons destined to develop the disease by virtue of fully penetrant genetic alterations (familial Alzheimer's disease or FAD) provide a model in which early and even presymptomatic changes of the disease may be identified. In this study we performed diffusion tensor imaging (DTI) on 2 demented and 21 subjects at-risk for inheriting an FAD mutation. We compared global and localized fractional anisotropy (FA) measures in white matter between FAD mutation carriers and non-carriers in the preclinical (clinical dementia rating <1, n = 20) and presymptomatic (clinical dementia rating = 0, n = 15) stages of the disease. There were no significant differences between mutation carriers and non-carriers with regard to absolute age, age relative to the typical age of disease diagnosis in their family, gender or Mini-Mental Status Examination Score. Among preclinical FAD mutation carriers (n = 12), mean whole brain white-matter FA (P = 0.045), FA of the columns of the fornix (P = 0.012), area of the perforant pathways bilaterally (right side: P = 0.028, left side: P = 0.027) and left orbitofrontal lobe (P = 0.024) were decreased relative to that of non-carriers (n = 8). We also found that FA in the columns of the fornix (P = 0.008) and left orbitofrontal lobe white matter (P = 0.045) were decreased in the eight presymptomatic mutation carriers compared to seven non-carriers. Logistic regression demonstrated that FA of the columns of the fornix was a better predictor of mutation status than was cross-sectional area of the fornix, global mean white-matter FA and left frontal lobe white-matter FA. In a linear regression analysis, white-matter volume (P = 0.002), hippocampal volume (P = 0.023) and mutation status (P = 0.032) significantly predicted fornix FA. We conclude that FA is decreased in the white matter in preclinical and even presymptomatic FAD mutation carriers, particularly in the late-myelinating tracts connecting limbic structures. Decreased FA in of the columns of the fornix is particularly robust in early FAD and may provide a biomarker for early disease in sporadic Alzheimer's disease. C1 Univ Calif Los Angeles, Alzheimers Dis Res Ctr, Dept Neurol, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, Los Angeles, CA USA. Natl Inst Neurol & Neurosurg, Expt Psychol Lab, Mexico City, DF, Mexico. Univ So Calif, Keck Sch Med, Rancho Los Amigos Natl Rehabilitat Ctr, Dept Neurol, Downey, CA USA. Univ Calif Los Angeles, Ahmanson Lovelace Brain Mapping Ctr, Los Angeles, CA USA. Univ Calif Los Angeles, Med Ctr, Neuropsychiat Res Memory Clin, Sylmar, CA USA. VA Greater Los Angeles Hlthcare Syst, Dept Psychiat, Los Angeles, CA USA. RP Ringman, JM (reprint author), Univ Calif Los Angeles, Alzheimers Dis Res Ctr, Dept Neurol, 10911 Weyburn Ave,Suite 200, Los Angeles, CA 90095 USA. EM jringman@mednet.ucla.edu RI Bartzokis, George/K-2409-2013 FU NCRR NIH HHS [M01-RR00865]; NIA NIH HHS [AG-16570, K08 AG-22228] NR 38 TC 131 Z9 136 U1 0 U2 6 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0006-8950 J9 BRAIN JI Brain PD JUL PY 2007 VL 130 BP 1767 EP 1776 DI 10.1093/brain/awm102 PN 7 PG 10 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 191SC UT WOS:000248151300007 PM 17522104 ER PT J AU Silverman, DHS Dy, CJ Castellon, SA Lai, J Pio, BS Abraham, L Waddell, K Petersen, L Phelps, ME Ganz, PA AF Silverman, Daniel H. S. Dy, Christine J. Castellon, Steven A. Lai, Jasmine Pio, Betty S. Abraham, Laura Waddell, Kari Petersen, Laura Phelps, Michael E. Ganz, Patricia A. TI Altered frontocortical, cerebellar, and basal ganglia activity in adjuvant-treated breast cancer survivors 5-10 years after chemotherapy SO BREAST CANCER RESEARCH AND TREATMENT LA English DT Article DE positron emission tomography; brain; breast cancer; tamoxifen; adjuvant chemotherapy; FDG; cerebral blood flow ID ESTROGEN REPLACEMENT THERAPY; QUALITY-OF-LIFE; RANDOMIZED CONTROLLED-TRIAL; STANDARD-DOSE CHEMOTHERAPY; HEALTH INITIATIVE MEMORY; CEREBRAL-BLOOD-FLOW; COGNITIVE FUNCTION; POSTMENOPAUSAL WOMEN; ALZHEIMERS-DISEASE; LONG-TERM AB Purpose To explore the relationship of regional cerebral blood flow and metabolism with cognitive function and past exposure to chemotherapy for breast cancer. Patients and methods Subjects treated for breast cancer with adjuvant chemotherapy remotely (5-10 years previously) were studied with neuropsychologic testing and positron emission tomography (PET), and were compared with control subjects who had never received chemotherapy. [O-15] water PET scans was acquired during performance of control and memory-related tasks to evaluate cognition-related cerebral blood flow, and [F-18] fluorodeoxyglucose (FDG) PET scans were acquired to evaluate resting cerebral metabolism. PET scans were analyzed by statistical parametric mapping and region of interest methods of analysis. Results During performance of a short-term recall task, modulation of cerebral blood flow in specific regions of frontal cortex and cerebellum was significantly altered in chemotherapy-treated subjects. Cerebral activation in chemotherapy-treated subjects differed most significantly from untreated subjects in inferior frontal gyrus, and resting metabolism in this area correlated with performance on a short-term memory task previously found to be particularly impaired in chemotherapy-treated subjects. In examining drug-class specific effects, metabolism of the basal ganglia was significantly decreased in tamoxifen + chemotherapy-treated patients compared with chemotherapy-only breast cancer subjects or with subjects who had not received chemotherapy, while chemotherapy alone was not associated with decreased basal ganglia activity relative to untreated subjects. Conclusion Specific alterations in activity of frontal cortex, cerebellum, and basal ganglia in breast cancer survivors were documented by functional neuroimaging 5-10 years after completion of chemotherapy. C1 Univ Calif Los Angeles, David Geffen Sch Med, Dept Mol & Med Pharmacol, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Dept Psychiat & Biobehav Sci, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Div Canc Prevent & Control Res, Jonsson Comprehens Canc Ctr, Los Angeles, CA USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA USA. RP Silverman, DHS (reprint author), Univ Calif Los Angeles, Med Ctr, Ahmanson Biol Imaging Div, CHS AR-144,MC694215, Los Angeles, CA 90095 USA. EM dsilver@ucla.edu NR 68 TC 194 Z9 201 U1 0 U2 7 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0167-6806 J9 BREAST CANCER RES TR JI Breast Cancer Res. Treat. PD JUL PY 2007 VL 103 IS 3 BP 303 EP 311 DI 10.1007/s10549-006-9380-z PG 9 WC Oncology SC Oncology GA 178YP UT WOS:000247256600005 PM 17009108 ER PT J AU Young, MRI Neville, BW Chi, AC Lathers, DMR Gillespie, MB Day, TA AF Young, M. Rita I. Neville, Brad W. Chi, Angela C. Lathers, Deane M. R. Gillespie, M. Boyd Day, Terry A. TI Oral premalignant lesions induce immune reactivity to both premalignant oral lesions and head and neck squamous cell carcinoma SO CANCER IMMUNOLOGY IMMUNOTHERAPY LA English DT Article DE cytotoxicity; head and neck cancer; HNSCC; oral lesions; premalignant ID EPIDERMAL-GROWTH-FACTOR; PRECANCEROUS LESIONS; CANCER; EXPRESSION; THERAPY; IDENTIFICATION; IMMUNOTHERAPY; LEUKOPLAKIA; RECEPTOR; GENES AB Head and neck squamous cell carcinoma (HNSCC) is an aggressive malignancy, and despite advances in treatments, the 5-year survival has remained at less than 50%. One treatment strategy is to focus on patients with premalignant oral lesions that carry a high-risk for developing recurrent premalignant lesions and HNSCC disease. As an initial attempt to determine if immune therapy has the potential to be protective in these patients, studies determined if premalignant lesions express tumor antigens that have previously been shown to be expressed on HNSCC. Immunohistochemical analyses showed prominent expression of epidermal growth factor receptor in premalignant lesions, even in lesions with mild dysplasia. MUC-1 and carcinoembryonic antigen were expressed in most patient samples, while NY-ESO-1 was less frequently expressed. Each of these antigens was expressed on HNSCC. This provided the rationale for determining if premalignant oral lesions could be used to stimulate autologous peripheral blood mononuclear leukocytes (PBML) to react against heterologous premalignant lesions and HNSCC. Following sensitization with autologous premalignant lesions, PBML responded to a challenge with either heterologous premalignant oral lesion cells or HNSCC by releasing IFN-gamma. In addition, sensitization with autologous premalignant lesion lysates generated cytolytic activity by both PBML and T cells against allogeneic premalignant lesion cells and HNSCC. These studies show the feasibility of using premalignant oral lesions to stimulate immune reactivity against both premalignant oral lesions as well as HNSCC. C1 Ralph H Johnson Vet Affairs Hosp, Res Serv 151, Charleston, SC 29401 USA. Med Univ S Carolina, Dept Med, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Otolaryngol Head & Neck Surg, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Stomatol, Charleston, SC 29425 USA. RP Young, MRI (reprint author), Ralph H Johnson Vet Affairs Hosp, Res Serv 151, 109 Bee St, Charleston, SC 29401 USA. EM rita.young@med.va.gov FU NCI NIH HHS [CA85266, CA97813] NR 27 TC 9 Z9 10 U1 0 U2 0 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0340-7004 J9 CANCER IMMUNOL IMMUN JI Cancer Immunol. Immunother. PD JUL PY 2007 VL 56 IS 7 BP 1077 EP 1086 DI 10.1007/s00262-006-0242-7 PG 10 WC Oncology; Immunology SC Oncology; Immunology GA 162NO UT WOS:000246094800012 PM 17096152 ER PT J AU Klein, AJ Messenger, JC Casserly, IP AF Klein, Andrew J. Messenger, John C. Casserly, Ivan P. TI Contemporary management of acute lower extremity ischemia following percutaneous coronary and cardiac interventional procedures using femoral access - A case series and discussion SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE complication; percutaneous coronary intervention; vascular closure device; endovascular therapy; acute limb ischemia ID PUNCTURE CLOSURE DEVICE; VASCULAR COMPLICATIONS; ARTERIAL HEMOSTASIS; MANUAL COMPRESSION; RANDOMIZED TRIAL; CATHETERIZATION; SUTURE; ANGIOPLASTY; ANGIO-SEAL(TM); ANGIOGRAPHY AB New onset of acute lower extremity ischemia following percutaneous coronary and cardiac interventional procedures using femoral access is an important clinical entity that requires emergent assessment to determine the precise etiology and institute appropriate therapy. We report four cases of this clinical event from our catheterization laboratories that serve to highlight the most frequent etiologies, the importance of immediate diagnostic angiography, and the potential for endovascular techniques to effectively manage this complication. (c) 2007 Wiley-Liss, Inc. C1 Univ Colorado Hosp, Denver, CO 80262 USA. Denver VA Med Ctr, Denver, CO USA. RP Casserly, IP (reprint author), Univ Colorado Hosp, 4200 E 9th Ave,B-132, Denver, CO 80262 USA. EM ivan.casserly@uchsc.edu NR 24 TC 4 Z9 4 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1522-1946 J9 CATHETER CARDIO INTE JI Catheter. Cardiovasc. Interv. PD JUL 1 PY 2007 VL 70 IS 1 BP 129 EP 137 DI 10.1002/ccd.21158 PG 9 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 186XR UT WOS:000247812400024 PM 17585383 ER PT J AU Klein, AJ Messenger, JC Casserly, IP AF Klein, Andrew J. Messenger, John C. Casserly, Ivan P. TI Endovascular treatment of intra-aortic balloon pump-induced acute limb ischemia SO CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS LA English DT Article DE intra-aortic balloon pump; acute limb ischemia; complication; endovascular therapy ID VASCULAR COMPLICATIONS; RISK ANALYSIS; FOLLOW-UP; OPERATIONS AB The development of acute limb ischemia in patients following intra-aortic balloon pump (IABP) placement remains a frequent event that presents a significant management challenge. We report two recent cases of this clinical event from our institution, which demonstrate that endovascular therapies may be used to treat acute limb ischemia in this setting without requiring removal of the IABP. (c) 2007 Wiley-Liss, Inc. C1 Univ Colorado, Hlth Serv Denver, Div Cardiol, Denver, CO 80262 USA. Denver VA Med Ctr, Denver, CO USA. RP Casserly, IP (reprint author), Univ Colorado, Hlth Serv Denver, Div Cardiol, 4200 E 9th Ave, Denver, CO 80262 USA. EM ivan.casserly@uchsc.edu NR 6 TC 1 Z9 1 U1 0 U2 0 PU WILEY-LISS PI HOBOKEN PA DIV JOHN WILEY & SONS INC, 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1522-1946 J9 CATHETER CARDIO INTE JI Catheter. Cardiovasc. Interv. PD JUL 1 PY 2007 VL 70 IS 1 BP 138 EP 142 DI 10.1002/ccd.21177 PG 5 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 186XR UT WOS:000247812400025 PM 17585391 ER PT J AU Hussein, MR AF Hussein, Mahmoud R. TI Expression of KIT receptor tyrosine kinase protein in normal human skin: Preliminary observations SO CELL BIOLOGY INTERNATIONAL LA English DT Article DE skin; KIT; melanocytes; keratinocytes ID HUMAN SCALP SKIN; C-KIT; GROWTH-FACTOR; METASTATIC MELANOMA; MALIGNANT-MELANOMA; IMATINIB MESYLATE; CLINICAL-EFFICACY; HAIR-FOLLICLES; CELLS; CD117 AB KIT proto-oncogene is a receptor tyrosine kinase critical for signal transduction in several cell types. An understanding of KIT distribution in normal skin may reveal new insights into its implication in cutaneous biology and its associated disease states. This study examines expression patterns of KIT protein in normal human skin. KIT protein expression was examined in 50 specimens of normal human skin using specific antibodies (CD 117) and immunoperoxidase staining methods. KIT protein expression was seen in keratinocytes (stratum basale), melanocytes, mast cells, and in both sebaceous and sweat glands. In contrast, KIT protein expression was absent in stratum spinosum, stratum granulosum, stratum comeum, blood vessels and arrector pili muscle. Thus, the expression of KIT protein in normal human skin suggests its possible role in regulation of cutaneous development and function. (c) 2007 International Federation for Cell Biology. Published by Elsevier Ltd. All rights reserved. C1 Assiut Univ, Sch Med, Dept Pathol, Assiut, Egypt. Univ Wisconsin, Sch Med, William S Middleton Mem Vet Hosp, Madison, WI 53705 USA. RP Hussein, MR (reprint author), Assiut Univ, Sch Med, Dept Pathol, Assiut, Egypt. EM mrh17@swissinfo.org NR 23 TC 6 Z9 7 U1 0 U2 1 PU ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD PI LONDON PA 24-28 OVAL RD, LONDON NW1 7DX, ENGLAND SN 1065-6995 J9 CELL BIOL INT JI Cell Biol. Int. PD JUL PY 2007 VL 31 IS 7 BP 748 EP 751 DI 10.1016/j.cellbi.2006.12.006 PG 4 WC Cell Biology SC Cell Biology GA 179RT UT WOS:000247308500014 PM 17337216 ER PT J AU Sosa, MAG De Gasperi, R Rocher, AB Perez, GM Simons, K Cruz, DE Hof, PR Elder, GA AF Sosa, Miguel A. Gama De Gasperi, Rita Rocher, Anne B. Perez, Gissel M. Simons, Kella Cruz, Daniel E. Hof, Patrick R. Elder, Gregory A. TI Interactions of primary neuroepithelial progenitor and brain endothelial cells: distinct effect on neural progenitor maintenance and differentiation by soluble factors and direct contact SO CELL RESEARCH LA English DT Article DE differentiation; culture; endothelial cells; neuroepithelial cells ID VESSEL NAVIGATION; NERVOUS SYSTEMS; ANGIOGENESIS; MECHANISMS; GUIDANCE AB Neurovascular interactions are crucial for the normal development of the central nervous system. To study such interactions in primary cultures, we developed a procedure to simultaneously isolate neural progenitor and endothelial cell fractions from embryonic mouse brains. Depending on the culture conditions endothelial cells were found to favor maintenance of the neuroprogenitor phenotype through the production of soluble factors, or to promote neuronal differentiation of neural progenitors through direct contact. These apparently opposing effects could reflect differential cellular interactions needed for the proper development of the brain. C1 NYU, Mt Sinai Sch Med, Dept Psychiat, New York, NY 10016 USA. James J Peters Dept Vet Affairs Med Ctr, Res & Dev Serv, Bronx, NY 10468 USA. NYU, Mt Sinai Sch Med, Dept Neurosci, New York, NY USA. RP Sosa, MAG (reprint author), NYU, Mt Sinai Sch Med, Dept Psychiat, 130 W Kingsbridge Rd, New York, NY 10016 USA. EM miguel.gama-sosa@mssm.edu NR 18 TC 16 Z9 16 U1 0 U2 1 PU INST BIOCHEMISTRY & CELL BIOLOGY PI SHANGHAI PA SIBS, CAS, 319 YUEYANG ROAD, SHANGHAI, 200031, PEOPLES R CHINA SN 1001-0602 EI 1748-7838 J9 CELL RES JI Cell Res. PD JUL PY 2007 VL 17 IS 7 BP 619 EP 626 DI 10.1038/cr.2007.53 PG 8 WC Cell Biology SC Cell Biology GA 203SW UT WOS:000248995300006 ER PT J AU Hoppe, H Kaufman, JA Barton, RE Petersen, BD Lakin, PC DeLoughery, TG Irani, Z Yavuz, K Keller, FS AF Hoppe, Hanno Kaufman, John A. Barton, Robert E. Petersen, Bryan D. Lakin, Paul C. DeLoughery, Thomas G. Irani, Zubin Yavuz, Kivilcim Keller, Frederick S. TI Safety of inferior vena cava filter retrieval in anticoagulated patients SO CHEST LA English DT Article DE pulmonary embolism; vena cava filters; venous thrombosis ID RECURRENT VENOUS THROMBOEMBOLISM; PULMONARY-EMBOLISM; FOLLOW-UP; CLINICAL-EXPERIENCE; REPORTING STANDARDS; RISK; PREVENTION; PLACEMENT; TEMPORARY; THERAPY AB Purpose: To evaluate the safety of inferior vena cava (IVC) filter retrieval in therapeutically anticoagulated patients in comparison to prophylactically or not therapeutically anticoagulated patients with respect to retrieval-related hemorrhagic complications. Materials and methods: This was a retrospective study of 115 consecutive attempted IVC filter retrievals in 110 patients. Filter retrievals were stratified as performed in patients who were therapeutically anticoagulated (group 1), prophylactically anticoagulated (group 2), or not therapeutically anticoagulated (group 3). The collected data included anticoagulant and antiplatelet medications (type, form and duration of administration, dosage) at the time of retrieval. Phone interviews and chart review was performed for the international normalized ratio (INR), activated partial thromboplastin time, platelet count, infusion of blood products, and retrieval-related hemorrhagic complications. Results: Group I included 65 attempted filter retrievals in 61 therapeutically anticoagulated patients by measured INR or dosing when receiving low-molecular-weight heparin (LMWH). Four retrievals were not successful. In patients receiving oral anticoagulation, the median INR was 2.35 (range, 2 to 8). Group 2 comprised 23 successful filter retrievals in 22 patients receiving a prophylactic dose of LMWH. Group 3 included 27 attempted filter retrievals in 27 patients not receiving therapeutic anticoagulation. Six retrievals were not successful. Five patients were receiving oral anticoagulation with a subtherapeutic INR (median, 1.49; range, 1.16 to 1.69). No anticoagulation medication was administered in 22 patients. In none of the groups were hemorrhagic complications related to the retrieval procedures identified. Conclusions: These results suggest that retrieval of vena cava filters in anticoagulated patients is safe. Interruption or reversal of anticoagulation for the retrieval of vena cava filters is not indicated. C1 Oregon Hlth & Sci Univ, Dotter Intervent Inst, Portland, OR 97239 USA. Oregon Hlth & Sci Univ, Div Hematol & Med Oncol, Portland, OR USA. Portland VA Med Ctr, Portland, OR USA. RP Hoppe, H (reprint author), Oregon Hlth & Sci Univ, Dotter Intervent Inst, L-605,3181 SW Sam Jackson Pk Rd, Portland, OR 97239 USA. EM hoppeh@ohsu.edu NR 24 TC 18 Z9 19 U1 0 U2 0 PU AMER COLL CHEST PHYSICIANS PI NORTHBROOK PA 3300 DUNDEE ROAD, NORTHBROOK, IL 60062-2348 USA SN 0012-3692 J9 CHEST JI Chest PD JUL PY 2007 VL 132 IS 1 BP 31 EP 36 DI 10.1378/chest.06-2897 PG 6 WC Critical Care Medicine; Respiratory System SC General & Internal Medicine; Respiratory System GA 191OL UT WOS:000248140600009 PM 17505040 ER PT J AU Kwabi-Addo, B Chung, WB Shen, L Ittmann, M Wheeler, T Jelinek, J Issa, JPJ AF Kwabi-Addo, Bernard Chung, Woonbok Shen, Lanlan Ittmann, Michael Wheeler, Thomas Jelinek, Jaroslav Issa, Jean-Pierre J. TI Age-related DNA methylation changes in normal human prostate tissues SO CLINICAL CANCER RESEARCH LA English DT Article ID CPG-ISLAND METHYLATION; TUMOR-SUPPRESSOR GENE; INTRAEPITHELIAL NEOPLASIA; HUMAN CANCERS; HYPERMETHYLATION; INACTIVATION; ESTROGEN; GROWTH; SERUM AB Purpose: Prostate cancer is a leading cause of cancer death among the aging male population but the mechanism underlying this association is unclear. Aberrant methylation of promoter CpG islands is associated with silencing of genes and age-dependent methylation of several genes has been proposed as a risk factor for sporadic cancer. We examined the extent of gene methylation in pathologically normal human prostate as a function of age. Experimental Design: We used pyrosequencing to quantitatively analyze the methylation status of nine CpG islands in normal prostate tissue DNA from 45 organ donors and 45 patients who had undergone cystoprostatectomy for bladder cancer. We also analyzed 12 pairs of matched benign and prostate cancer tissue DNA from patients with prostate cancer. Results: Linear regression analysis revealed a significant increase in promoter methylation levels correlating with age for CpG islands at RAR beta 2 (r = 0.4; P < 0.0001), RASSF1A (r = 0.27; P = 0.01), GSTP1 (r = 0.59; P < 0.0001), NKX2-5 (r = 0.27; P = 0.008), and ESR1 (r = 0.244; P = 0.023) in the normal prostate tissue samples studied. A calculated average methylation (z score) at all nine CpG loci analyzed in the normal prostate tissues showed a strong correlation with age (r = 0.6; P < 0.001). Comparison of the methylation level for the matched benign and prostate cancer tissues from individual patients with prostate cancer showed significantly higher methylation in the prostate cancer tissue samples for RAR beta 2 (P < 0.001), RASSF1A (P = 0.005), GSTP1 (P < 0.001), NKX2-5 (P = 0.003), ESR1 (P = 0.016), and CLSTN1 (P = 0.01). Conclusions: Our findings show aberrant hypermethylation as a function of age in the normal prostate tissues. Such age-related methylation may precede and predispose to full-blown malignancy. C1 Baylor Coll Med, Dept Pathol, Houston, TX 77030 USA. Univ Texas, MD Anderson Canc Ctr, Michael E DeBakey Dept Vet Affairs Med Ctr, Houston, TX 77030 USA. Univ Texas, MD Anderson Canc Ctr, Dept Leukemia, Houston, TX 77030 USA. RP Kwabi-Addo, B (reprint author), Baylor Coll Med, Dept Pathol, 1 Baylor Plaza, Houston, TX 77030 USA. EM bernardk@bcm.tmc.edu RI Jelinek, Jaroslav/A-8476-2008; Jelinek, Jaroslav/D-2282-2012; Kwabi-Addo, Bernard/A-6993-2016 OI Jelinek, Jaroslav/0000-0002-2533-0220; Kwabi-Addo, Bernard/0000-0003-3692-6350 FU NCI NIH HHS [P50CA058204, PC040326] NR 29 TC 134 Z9 143 U1 0 U2 4 PU AMER ASSOC CANCER RESEARCH PI PHILADELPHIA PA 615 CHESTNUT ST, 17TH FLOOR, PHILADELPHIA, PA 19106-4404 USA SN 1078-0432 J9 CLIN CANCER RES JI Clin. Cancer Res. PD JUL 1 PY 2007 VL 13 IS 13 BP 3796 EP 3802 DI 10.1158/1078-0432.CCR-07-0085 PG 7 WC Oncology SC Oncology GA 186IT UT WOS:000247773100008 PM 17606710 ER PT J AU Travison, TG O'Donnell, AB Araujo, AB Matsumoto, AM McKinlay, JB AF Travison, Thomas G. O'Donnell, Amy B. Araujo, Andre B. Matsumoto, Alvin M. McKinlay, John B. TI Cortisol levels and measures of body composition in middle-aged and older men SO CLINICAL ENDOCRINOLOGY LA English DT Article ID 11-BETA-HYDROXYSTEROID DEHYDROGENASE TYPE-1; FAT DISTRIBUTION; METABOLIC SYNDROME; CUSHINGS-SYNDROME; BLOOD-PRESSURE; RISK-FACTORS; OBESITY; SECRETION; PREVALENCE; HEALTH AB Introduction Similarities in the symptomatic expressions of excess adiposity and hypercortisolaemic conditions suggest that elevated glucocorticoid exposure may influence the pathogenesis of obesity. Circulating cortisol levels are not typically elevated in obese subjects, but data from large prospective samples are rare. We undertook an analysis to determine both cross-sectional and longitudinal associations between body composition and serum cortisol concentrations in a randomly chosen group of 999 community-dwelling men, aged 40-79 years. Methods Data were obtained from the two follow-up waves of the Massachusetts Male Ageing Study (T2: 1995-97; T3: 2002-04). Partial correlation and multivariate regression analyses were used to estimate cross-sectional (T2) and longitudinal associations between serum cortisol concentrations and a range of measures of subjects' body composition, including weight, body mass index (BMI), waist circumference (WC), waist-to-hip girth ratio (WHR), and percentage body fat (measured by bioelectrical impedance at T3); similar analyses were conducted to assess the association between change (T2 to T3) in serum cortisol and simultaneous change in body composition parameters. Results We observed weak negative associations between cortisol concentrations and all body composition parameters, with the exception of percentage body fat. Longitudinal results demonstrated similar relationships but associations were of lesser magnitude. T2 cortisol concentrations were not associated with change in body composition over time, whereas T2 body size was positively associated with longitudinal changes in cortisol concentrations, providing limited evidence that weight change drives changes in cortisol concentrations, rather than vice versa. Results were unchanged when age and other covariate effects were controlled. Conclusions Circulating cortisol concentrations are somewhat lower in obese than in nonobese community-dwelling men. There is some evidence that excess adiposity presages increases in cortisol concentrations, rather than the reverse. However, this observation should be greeted with caution, as age-related weight loss - and not gain - was associated with simultaneous increases in serum cortisol concentrations. C1 New England Res Inst, Watertown, MA 02472 USA. Univ Washington, Sch Med, Ctr Geriatr Res Educ & Clin, VA Puget Sound Hlth Care Syst,Dept Med, Seattle, WA 98195 USA. RP Travison, TG (reprint author), New England Res Inst, 9 Galen St, Watertown, MA 02472 USA. EM ttravison@neriscience.com RI Travison, Thomas/C-7098-2011 FU NIA NIH HHS [AG04673]; NIDDK NIH HHS [DK44995, DK51345] NR 42 TC 43 Z9 44 U1 0 U2 2 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0300-0664 J9 CLIN ENDOCRINOL JI Clin. Endocrinol. PD JUL PY 2007 VL 67 IS 1 BP 71 EP 77 DI 10.1111/j.1365-2265.2007.02837.x PG 7 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 180DC UT WOS:000247339300011 PM 17466009 ER PT J AU Mandell, LA Wunderink, RG Anzueto, A Bartlett, JG Campbell, GD Dean, NC Dowell, SF File, TM Musher, DM Niederman, MS Torres, A Whitney, CG AF Mandell, Lionel A. Wunderink, Richard G. Anzueto, Antonio Bartlett, John G. Campbell, G. Douglas Dean, Nathan C. Dowell, Scott F. File, Thomas M., Jr. Musher, Daniel M. Niederman, Michael S. Torres, Antonio Whitney, Cynthia G. TI Ethical considerations regarding the administration of oseltamivir for infection control indications - Reply SO CLINICAL INFECTIOUS DISEASES LA English DT Letter ID NEURAMINIDASE INHIBITOR OSELTAMIVIR; ACUTE INFLUENZA; ADULTS C1 Natl Univ Ireland Univ Coll Galway, Dept Bacteriol, Galway, Ireland. Northwestern Univ, Feinberg Sch Med, Chicago, IL 60611 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78285 USA. S Texas Vet Hlth Care Syst, San Antonio, TX USA. Michael E DeBakey VA Med Ctr, Houston, TX USA. Baylor Coll Med, Houston, TX 77030 USA. Johns Hopkins Univ, Sch Med, Baltimore, MD USA. Univ Mississippi, Sch Med, Div Pulm Crit Care & Sleep Med, Jackson, MS 39216 USA. LDS Hosp, Div Pulm & Crit Care Med, Salt Lake City, UT USA. Univ Utah, Salt Lake City, UT USA. Ctr Dis Control & Prevent, Atlanta, GA USA. Northeastern Ohio Univ Coll Med & Pharm, Rootstown, OH USA. Summa Hlth Syst, Akron, OH USA. SUNY Stony Brook, Stony Brook, NY 11794 USA. Winthrop Univ Hosp, Dept Med, Mineola, NY 11501 USA. Univ Barcelona, Cap Serv Pneumol & Allergia Resp, Inst Clin Torax, Hosp Clin Barcelona,Fac Med,Inst Invest Biomed Au, Barcelona, Spain. McMaster Univ, Sch Med, Hamilton, ON, Canada. RP Mandell, LA (reprint author), Natl Univ Ireland Univ Coll Galway, Dept Bacteriol, Newcastle Rd, Galway, Ireland. NR 6 TC 0 Z9 0 U1 0 U2 4 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 1058-4838 J9 CLIN INFECT DIS JI Clin. Infect. Dis. PD JUL 1 PY 2007 VL 45 IS 1 BP 134 EP 135 DI 10.1086/520486 PG 2 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 175RC UT WOS:000247029700025 ER PT J AU Overberger, P Pesacreta, M Palevsky, PM AF Overberger, Pamela Pesacreta, Matthew Palevsky, Paul M. CA VA NIH Acute Renal Failure Trial N TI Management of renal replacement therapy in acute kidney injury: A survey of practitioner prescribing practices SO CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article; Proceedings Paper CT 37th Annual Meeting of the American-Society-of-Nephrology CY OCT 27-NOV 01, 2004 CL St Louis, MO SP Amer Soc Nephrol ID RESPIRATORY-DISTRESS-SYNDROME; ACUTE LUNG INJURY; PATIENT SAFETY; TIDAL VOLUMES; TRIAL DESIGN; FAILURE; DIALYSIS; CARE AB Background: Data on current practices for management of renal replacement therapy (RRT) in acute kidney injury (AKI) are limited, particularly with regard to the dosing of therapy. Design, setting, participants, and measurements: A survey was conducted of practitioners at the 27 study sites that participate in the Veterans Affairs/National Institutes of Health Acute Renal Trial Network (ATN) Study before initiation of patient enrollment for ascertainment of the local prevailing practices for management of RRT in critically ill patients with AKI. Surveys were returned from 130 practitioners at 26 of 27 study sites; the remaining study site provided aggregate data. Results: Intermittent hemodialysis and continuous RRT were the most commonly used modalities of RRT, with sustained low-efficiency dialysis and other "hybrid" treatments used in fewer than 10% of patients. Intermittent hemodialysis was most commonly provided on a thrice-weekly or every-other-day schedule, with only infrequent assessment of the delivered dosage of therapy. Most practitioners reported that they did not dose continuous RRT on the basis of patient weight. The average prescribed dosage of therapy corresponded to a weight-based dosage of no more than 20 to 25 ml/kg per h. Conclusions: These results provide insight into clinical management of RRT and provide normative data for evaluation of the design of ongoing clinical trials. C1 VA Pittsburgh Healthcare Syst, Res Serv, Pittsburgh, PA 15240 USA. VA Pittsburgh Healthcare Syst, Renal Sect, Med Specialty Serv Line, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Med, Renal Electrolyte Div, Pittsburgh, PA USA. RP Palevsky, PM (reprint author), VA Pittsburgh Healthcare Syst, Res Serv, Room 7E123,111F-U,Univ Dr Div, Pittsburgh, PA 15240 USA. EM palevsky@pitt.edu OI Batuman, Vecihi/0000-0002-1800-9009; Palevsky, Paul/0000-0002-7334-5400 FU NIDDK NIH HHS [Y01 DK003508, Y01 DK3508-01, Y01 DK3508-02, Y01 DK3508-03, Y1-DK-3508-01] NR 21 TC 65 Z9 71 U1 1 U2 2 PU AMERICAN SOCIETY NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1555-905X J9 CLIN J AM SOC NEPHRO JI Clin. J. Am. Soc. Nephrol. PD JUL PY 2007 VL 2 IS 4 BP 623 EP 630 DI 10.2215/CJN.00780207 PG 8 WC Urology & Nephrology SC Urology & Nephrology GA 184AE UT WOS:000247612700003 PM 17699474 ER PT J AU Mohamed, OHK Wahba, IM Watnick, S Earle, SB Bennett, WM Ayres, JW Munar, MY AF Mohamed, Osama Hussein Kamel Wahba, Ihab M. Watnick, Suzanne Earle, Sandra B. Bennett, William M. Ayres, James W. Munar, Myrna Y. TI Administration of tobramycin in the beginning of the hemodialysis session: A novel intradialytic dosing regimen SO CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article ID RESIDUAL RENAL-FUNCTION; PERITONEAL-DIALYSIS PATIENTS; AMINOGLYCOSIDE THERAPY; RECEIVING HEMODIALYSIS; RELATIVE CONTRIBUTION; VESTIBULAR TOXICITY; GENTAMICIN; CLEARANCE; RATES; PHARMACOKINETICS AB Background: Aminoglycoside antibiotic efficacy is related to peak concentration (C-max) and postantibiotic effect, whereas toxicity is directly related to body exposure as measured by area under the serum concentration versus time curve (AUC). On the basis of pharmacokinetic simulation models, tobramycin administration during the first 30 min of high-flux hemodialysis achieves similar C-max but significantly lower AUC and prehemodialysis concentrations compared with conventional dosing in the last 30 min of hemodialysis. Design, setting, participants, and measurements: To test this hypothesis, a pilot study in which five adult chronic hemodialysis patients who were undergoing high-flux dialysis received one dose of tobramycin 1.5 mg/kg intravenously during the first or last 30 min of hemodialysis was conducted. After a 1-mo washout period, patients crossed over to the other treatment schedule. Tobramycin serum concentrations were measured to determine C-max, interdialytic and intradialytic elimination rate constants and half-lives, AUC, and clearance. Results: Tobramycin administration during the first and last 30 min of hemodialysis resulted in similar C-max of 5.63 +/- 0.49 and 5.83 +/- 0.67 mg/L (P > 0.05) but significantly lower prehemodialysis concentrations of 0.16 +/- 0.09 and 2.44 +/- 0.43 mg/L (P < 0.001) and AUC of 21.06 and 179.23 +/- 25.84 mg/h per L (P < 0.001), respectively. Conclusions: Tobramycin administration during the first 30 min of hemodialysis results in similar C-max but lower AUC to conventional dosing, which may translate into comparable efficacy but lower toxicity. C1 Oregon Hlth & Sci Univ, Oregon State Univ, Coll Pharm, Dept Pharm,Dept Pharm Practice, Portland, OR 97239 USA. Oregon State Univ, Coll Pharm, Dept Pharmaceut Sci, Corvallis, OR 97331 USA. Legacy Good Samaritan Hosp, Portland, OR USA. Findlay Univ, Sch Pharm, Dept Pharm Practice, Findlay, OH USA. Portland VA Med Ctr, Div Hosp & Specialty Med, Portland, OR USA. Oregon Hlth & Sci Univ, Dept Med, Div Nephrol & Hypertens, Portland, OR 97201 USA. Cairo Univ, Dept Pharmaceut, Fac Pharm, Cairo, Egypt. RP Munar, MY (reprint author), Oregon Hlth & Sci Univ, Oregon State Univ, Coll Pharm, Dept Pharm,Dept Pharm Practice, Portland Campus,3303 SW Bond Ave,Mail Code CH12C, Portland, OR 97239 USA. EM munarm@ohsu.edu NR 21 TC 13 Z9 13 U1 0 U2 0 PU AMERICAN SOCIETY NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1555-905X J9 CLIN J AM SOC NEPHRO JI Clin. J. Am. Soc. Nephrol. PD JUL PY 2007 VL 2 IS 4 BP 694 EP 699 DI 10.2215/CJN.01600407 PG 6 WC Urology & Nephrology SC Urology & Nephrology GA 184AE UT WOS:000247612700013 ER PT J AU Dalrymple, LS Koepsell, T Sampson, J Louie, T Dominitz, JA Young, B Kestenbaum, B AF Dalrymple, Lorien S. Koepsell, Thomas Sampson, Joshua Louie, Tin Dominitz, Jason A. Young, Bessie Kestenbaum, Bryan TI Hepatitis C virus infection and the prevalence of renal insufficiency SO CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY LA English DT Article; Proceedings Paper CT 38th Annual Meeting of the American-Society-of-Nephrology/Annual Renal Week CY NOV 08-13, 2005 CL Philadelphia, PA SP Amer Soc Nephrol ID MEMBRANOUS GLOMERULONEPHRITIS; MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS; ANTIVIRAL THERAPY; SERUM CREATININE; LIVER-DISEASE; BLOOD-FLOW; NEPHROPATHY; HCV; MANIFESTATIONS; GLOMERULOPATHY AB Background: Hepatitis C virus (HCV) is associated with pathologic changes in the kidney. However, the association between HCV and renal dysfunction is not well defined. Design, setting, participants, and measurements: This study estimated the prevalence of renal insufficiency among veterans who received care through the Veterans Affairs Puget Sound Health Care System. The study population consisted of veterans who underwent HCV antibody testing between January 1, 1999, and December 31, 2004, and had at least one primary care or medical subspecialty visit and at least one outpatient creatinine measurement within the 18 mo before antibody testing. Veterans were excluded when they had a history of chronic dialysis, creatinine > 5 mg/dl, or renal transplantation. Study data were extracted from the electronic medical record. Renal insufficiency was defined as a creatinine level >= 1.5 mg/dl. Multivariate logistic regression was performed to estimate the risk for renal insufficiency associated with HCV. Among 25,782 eligible veterans, 1928 were HCV antibody positive and 23,854 were HCV antibody negative. Results: Although the proportion with renal insufficiency was lower for antibody-positive versus-negative veterans (4.8 versus 6.0%), after adjustment for age, race, gender, diabetes, and hypertension, HCV-positive veterans had a 40% higher odds for renal insufficiency (odds ratio 1.40; 95% confidence interval 1.11 to 1.76) as compared with HCV-negative veterans. Conclusions: HCV was associated with an increased prevalence of renal insufficiency. C1 VA Puget Sound Healthcare Syst, Hlth Serv Res & Dev NW Ctr Excellence, Seattle, WA 98108 USA. VA Puget Sound Healthcare Syst, Epidemiol Res & Informat Ctr, Seattle, WA 98108 USA. VA Puget Sound Healthcare Syst, NW Hepatitis C Resource Ctr, Seattle, WA 98108 USA. VA Puget Sound Healthcare Syst, Primary & Specialty Med Care Serv, Seattle, WA 98108 USA. Univ Washington, Sch Med, Dept Med, Div Nephrol, Seattle, WA USA. Univ Washington, Sch Med, Dept Med, Div Gastroenterol, Seattle, WA USA. Univ Washington, Sch Med, Dept Med, Div Gen Internal Med, Seattle, WA USA. Univ Washington, Sch Publ Hlth & Community Med, Dept Epidemiol, Seattle, WA 98195 USA. Univ Washington, Sch Publ Hlth & Community Med, Dept Hlth Serv, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA USA. RP Dalrymple, LS (reprint author), VA Puget Sound Healthcare Syst, Hlth Serv Res & Dev NW Ctr Excellence, 1100 Olive Way,Suite 1400, Seattle, WA 98108 USA. EM dalrympt@u.washington.edu OI Dominitz, Jason/0000-0002-8070-7086 NR 49 TC 44 Z9 47 U1 0 U2 0 PU AMER SOC NEPHROLOGY PI WASHINGTON PA 1725 I ST, NW STE 510, WASHINGTON, DC 20006 USA SN 1555-9041 EI 1555-905X J9 CLIN J AM SOC NEPHRO JI Clin. J. Am. Soc. Nephrol. PD JUL PY 2007 VL 2 IS 4 BP 715 EP 721 DI 10.2215/CJN.00470107 PG 7 WC Urology & Nephrology SC Urology & Nephrology GA 184AE UT WOS:000247612700016 PM 17699487 ER PT J AU Allen, DN Caron, JE Duke, LA Goldstein, G AF Allen, Daniel N. Caron, Joshua E. Duke, Lisa A. Goldstein, Gerald TI Sensitivity of the Halstead category test factor scores to brain damage SO CLINICAL NEUROPSYCHOLOGIST LA English DT Article ID MULTIDIMENSIONAL INSTRUMENT; PRACTICAL SCALE; HEAD-INJURY; PERSEVERATION; INTELLIGENCE; SUBTESTS AB Recent factor-analytic studies of the Halstead Category Test (HCT) indicate that its seven subtests form three factors including a Counting factor (subtests I and II), a Spatial Positional Reasoning factor (subtests III, IV, and VII), and a Proportional Reasoning factor (subtests V, VI, and VII). The sensitivity and specificity of these factors to heterogeneous forms of brain damage was examined in a large sample of patients and a normal comparison sample. A prorated Impairment Index, which excluded the HCT error score, was used to assign participants with brain damage into mild, moderate, and severe impairment groups. Also, groups with various forms of neuropathology were contrasted. Results indicated that both the Spatial Positional Reasoning and the Proportional Reasoning factors were sensitive to brain damage. However, in all of the brain-damage groups, a greater percentage of errors were made on the Spatial Positional factor, suggesting that of the two it was more difficult for those with brain damage. The sensitivity and specificity of the Spatial Positional factor score for detection of brain damage was comparable to that of the total error score, which has been previously demonstrated to be an excellent indicator of brain damage. Findings provide further support for the validity of the HCT factors, and are consistent with the view that factor scores may be useful in interpreting the HCT. C1 Univ Nevada, Dept Psychol, Las Vegas, NV 89154 USA. Univ Pittsburgh, Sch Med, Pittsburgh, PA USA. VA Pittsburgh Healthcare Syst, Pittsburgh, PA USA. RP Allen, DN (reprint author), Univ Nevada, Dept Psychol, 4505 Maryland Pkwy, Las Vegas, NV 89154 USA. EM daniel.allen@unlv.edu NR 33 TC 5 Z9 5 U1 1 U2 3 PU TAYLOR & FRANCIS INC PI PHILADELPHIA PA 325 CHESTNUT ST, SUITE 800, PHILADELPHIA, PA 19106 USA SN 1385-4046 J9 CLIN NEUROPSYCHOL JI Clin. Neuropsychol. PD JUL PY 2007 VL 21 IS 4 BP 638 EP 652 DI 10.1080/13854040600744821 PG 15 WC Psychology, Clinical; Clinical Neurology; Psychology SC Psychology; Neurosciences & Neurology GA 195YP UT WOS:000248448700005 PM 17613982 ER PT J AU Rosenbach, M Werth, VP AF Rosenbach, M. Werth, Victoria P. TI Dermatologic therapeutics: thalidomide. A practical guide SO DERMATOLOGIC THERAPY LA English DT Review DE dermatologic use; dermatology; guidelines; thalidomide ID VERSUS-HOST DISEASE; NECROSIS-FACTOR-ALPHA; GIANT MUCOCUTANEOUS APHTHAE; DOUBLE-BLIND TRIAL; TNF-ALPHA; PYODERMA-GANGRENOSUM; ERYTHEMA MULTIFORME; BEHCETS-DISEASE; LEPRA REACTIONS; POTENTIAL USES AB Thalidomide was first introduced in the 1950s, and its widespread use led to thousands of birth defects through the 1960s; it was quickly withdrawn from the market. A fortuitous discovery identified during treatment of patients with erythema nodosum leprosum led to the recognition of the potent anti-inflammatory effects of thalidomide and a resurgence of interest in the drug. In the ensuing decades, thalidomide has been recognized as a potential treatment option in a number of dermatologic conditions. This article reviews the history, pharmacology, mechanisms of action, and off-label uses of thalidomide and serves as a guide for dermatologists to comfortably and safely institute and monitor thalidomide to patients with cutaneous disease. C1 Univ Penn, Sch Med, Dept Dermatol, Philadelphia, PA 19119 USA. Philadelphia VA Med Ctr, Philadelphia, PA USA. RP Werth, VP (reprint author), Univ Penn, Sch Med, Dept Dermatol, 2 Rhodes Pavilion,3600 Spruce St, Philadelphia, PA 19119 USA. EM werth@mail.med.upenn.edu NR 100 TC 12 Z9 12 U1 1 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1396-0296 J9 DERMATOL THER JI Dermatol. Ther. PD JUL-AUG PY 2007 VL 20 IS 4 BP 175 EP 186 DI 10.1111/j.1529-8019.2007.00132.x PG 12 WC Dermatology SC Dermatology GA 225DL UT WOS:000250497200003 PM 17970884 ER PT J AU Kahler, KH Rajan, M Rhoads, GG Safford, MM Demissie, K Lu, SE Pogach, LM AF Kahler, Kristijan H. Rajan, Mangala Rhoads, George G. Safford, Monca M. Demissie, Kitaw Lu, Shou-En Pogach, Leonard M. TI Impact of oral antihyperglycemic therapy on all-cause mortality among patients with diabetes in the Veterans Health Administration SO DIABETES CARE LA English DT Article ID BLOOD-GLUCOSE CONTROL; PROPENSITY SCORES; METFORMIN; AFFAIRS; SULFONYLUREAS; COMPLICATIONS; INFERENCE; DISEASE; RISK AB OBJECTIVE - The objective of this analysis was to evaluate the impact of several classes of oral antihyperglycemic therapy relative to sulfonylurea monotherapy on all-cause mortality among a cohort of patients with diabetes from the Veterans Health Administration (VHA). RESEARCH DESIGN AND METHODS - A retrospective cohort study using data obtained from the VHA Diabetes Epidemiology Cohort was used. Users of oral antihyperglycemic therapy were classified into the following cohorts: sulfonylurea monotherapy, metformin monotherapy, metformin plus sulfonylurea, thiazolidinedione (TZD) use alone or in combination with other oral agents (TZD users), and no drug therapy. All-cause mortality was the outcome of interest. Multivariate mixed models incorporating a propensity score to account for imbalance among cohorts were used to estimate drug effects on mortality with associated 95% ClS. RESULTS - A total of 39,721 patients with diabetes were included in the study. Adjusted odds ratios and 95% ClS for all-cause mortality were 0.87 (0.68-1.10) for metformin monotherapy users, 0.92 (0.82-1.05) for metformin plus sulfonylurea users, and 1.04 (0.75-1.46) for TZD users, relative to sulfonylurea monotherapy users. CONCLUSIONS - We did not find any significant drug effect on all-cause mortality for any oral treatment cohorts relative to sulfonylurea oral monotherapy. C1 VA New Jersey Hlth Care Syst, Ctr Hlth Care knowledge & Management, E Orange, NJ USA. Univ Med & Dent New Jersey, Sch Publ Hlth, Piscataway, NJ 08854 USA. Birmingham VA Med Ctr, Deep S Ctr Effectiveness, Birmingham, AL USA. RP Kahler, KH (reprint author), Nova Pharmaceut Corp, 1 Hlth Plaza,Room 405-3117, E Hanover, NJ 07936 USA. EM kristijan.kahler@novartis.com NR 23 TC 32 Z9 34 U1 0 U2 1 PU AMER DIABETES ASSOC PI ALEXANDRIA PA 1701 N BEAUREGARD ST, ALEXANDRIA, VA 22311-1717 USA SN 0149-5992 J9 DIABETES CARE JI Diabetes Care PD JUL PY 2007 VL 30 IS 7 BP 1689 EP 1693 DI 10.2337/dc06-2272 PG 5 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 186GZ UT WOS:000247768400001 PM 17440170 ER PT J AU Haas, L AF Haas, Linda TI Psychological insulin resistance - Scope of the problem SO DIABETES EDUCATOR LA English DT Article ID THERAPY; ASSOCIATION; CARE C1 Seattle Div, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Haas, L (reprint author), Seattle Div, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. EM linda.haas@va.gov NR 9 TC 2 Z9 2 U1 0 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0145-7217 J9 DIABETES EDUCATOR JI Diabetes Educ. PD JUL-AUG PY 2007 VL 33 SU 7 BP 228S EP 231S DI 10.1177/0145721707305694 PG 4 WC Endocrinology & Metabolism; Public, Environmental & Occupational Health SC Endocrinology & Metabolism; Public, Environmental & Occupational Health GA 203YF UT WOS:000249009200001 PM 17656738 ER PT J AU Haas, L AF Haas, Linda TI Provider psychological insulin resistance - Easing the transition SO DIABETES EDUCATOR LA English DT Article ID GLYCEMIC CONTROL; BASAL INSULIN; THERAPY; GLARGINE; INITIATION C1 Seattle Div, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. RP Haas, L (reprint author), Seattle Div, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM linda.haas@va.gov NR 12 TC 1 Z9 1 U1 0 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0145-7217 J9 DIABETES EDUCATOR JI Diabetes Educ. PD JUL-AUG PY 2007 VL 33 SU 7 BP 245S EP 247S DI 10.1177/0145721707305702 PG 3 WC Endocrinology & Metabolism; Public, Environmental & Occupational Health SC Endocrinology & Metabolism; Public, Environmental & Occupational Health GA 203YF UT WOS:000249009200004 PM 17656741 ER PT J AU Haas, L Polonsky, W AF Haas, Linda Polonsky, William TI The tipping point - Overcoming barriers SO DIABETES EDUCATOR LA English DT Article ID BASAL INSULIN; THERAPY C1 Seattle Div, VA Puget Sound Hlth Care Syst, Seattle, WA 98108 USA. Univ Calif San Diego, San Diego, CA 92103 USA. RP Haas, L (reprint author), Seattle Div, VA Puget Sound Hlth Care Syst, 1660 S Columbian Way, Seattle, WA 98108 USA. EM linda.haas@va.gov NR 5 TC 0 Z9 0 U1 0 U2 1 PU SAGE PUBLICATIONS INC PI THOUSAND OAKS PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA SN 0145-7217 J9 DIABETES EDUCATOR JI Diabetes Educ. PD JUL-AUG PY 2007 VL 33 SU 7 BP 248S EP 250S DI 10.1177/0145721707305703 PG 3 WC Endocrinology & Metabolism; Public, Environmental & Occupational Health SC Endocrinology & Metabolism; Public, Environmental & Occupational Health GA 203YF UT WOS:000249009200005 PM 17656742 ER PT J AU Humbert, IA Robbins, J AF Humbert, Ianessa A. Robbins, JoAnne TI Normal swallowing and functional magnetic resonance imaging: A systematic review SO DYSPHAGIA LA English DT Review DE deglutition; deglutition disorders; functional magnetic resonance imaging ID TRAUMATIC BRAIN-INJURY; CEREBRAL CORTICAL REPRESENTATION; DYSPHAGIA FOLLOWING STROKE; EVENT-RELATED FMRI; PARKINSONS-DISEASE; ALZHEIMERS-DISEASE; TONGUE MOVEMENT; ASPIRATION PNEUMONIA; MEDULLARY INFARCTION; HEMISPHERIC STROKE AB Unknowns about the neurophysiology of normal and disordered swallowing have stimulated exciting and important research questions. Previously, these questions were answered using clinical and animal studies. However, recent technologic advances have moved brain-imaging techniques such as functional magnetic resonance imaging (fMRI) to the forefront of swallowing neurophysiology research. This systematic review has summarized the methods and results of studies of swallowing neurophysiology of healthy adults using fMRI. A comprehensive electronic and hand search for original research was conducted, including few search limitations to yield the maximum possible number of relevant Studies. The participants, study design, tasks, and brain image acquisition were reviewed and the results indicate that the primary motor and sensory areas were most consistently active in the healthy adult participants across the relevant studies. Other prevalent areas of activation included the anterior cingulate cortex and insular cortex. Review limitations and suggested future directions are also discussed. C1 Univ Wisconsin, William S Middleton Mem Vet Hosp, Dept Med, Madison, WI 53705 USA. RP Humbert, IA (reprint author), Univ Wisconsin, William S Middleton Mem Vet Hosp, Dept Med, 2500 Overlook Terrace 11G, Madison, WI 53705 USA. EM humbert@wise.edu FU NCRR NIH HHS [K12 RR023268-02, 8K12RR023268-02, K12 RR023268]; NIDCD NIH HHS [L30 DC008513-01, L30 DC008513] NR 68 TC 35 Z9 40 U1 0 U2 5 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0179-051X J9 DYSPHAGIA JI Dysphagia PD JUL PY 2007 VL 22 IS 3 BP 266 EP 275 DI 10.1007/s00455-007-9080-9 PG 10 WC Otorhinolaryngology SC Otorhinolaryngology GA 187TY UT WOS:000247872600012 PM 17440775 ER PT J AU Chokshi, R Restrepo, MI Weeratunge, N Frei, CR Anzueto, A Mortensen, EM AF Chokshi, R. Restrepo, M. I. Weeratunge, N. Frei, C. R. Anzueto, A. Mortensen, E. M. TI Monotherapy versus combination antibiotic therapy for patients with bacteremic Streptococcus pneumoniae community-acquired pneumonia SO EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES LA English DT Article ID PNEUMOCOCCAL PNEUMONIA; MORTALITY; GUIDELINES AB The purpose of this study was to examine the impact of antimicrobial monotherapy vs combination therapy on length of stay and mortality for patients with Streptococcus pneumoniae pneumonia. Thirty-nine percent of patients received monotherapy, while 61% received combination therapy. Although there was no significant difference in mortality (OR 1.25, 95% CI = 0.25-6.8), there was a significant increase in length of stay for patients who received combination therapy (p = 0.02). Patients with bacteremic pneumococcal pneumonia treated with empiric combination therapy had no significant difference in mortality; however, they did have increased length of stay after adjusting for severity of illness. Randomized controlled trials are needed to determine what is the optimal empiric antimicrobial regime for patients with community-acquired pneumonia. C1 Audie L Murphy Mem Vet Adm Med Ctr, S Texas Vet Hlth Care Syst, San Antonio, TX 78230 USA. Univ Texas, Hlth Sci Ctr, Dept Med, San Antonio, TX 78284 USA. RP Mortensen, EM (reprint author), Audie L Murphy Mem Vet Adm Med Ctr, S Texas Vet Hlth Care Syst, 11C6,7400 Merton Minter Blvd, San Antonio, TX 78230 USA. EM mortensene@uthscsa.edu RI Restrepo, Marcos/H-4442-2014 OI Mortensen, Eric/0000-0002-3880-5563 NR 14 TC 20 Z9 20 U1 0 U2 4 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0934-9723 J9 EUR J CLIN MICROBIOL JI Eur. J. Clin. Microbiol. Infect. Dis. PD JUL PY 2007 VL 26 IS 7 BP 447 EP 451 DI 10.1007/s10096-007-0307-3 PG 5 WC Infectious Diseases; Microbiology SC Infectious Diseases; Microbiology GA 188OX UT WOS:000247930300001 PM 17534677 ER PT J AU Rosenbaum, JT Martin, TM Farris, KH Rosenbaum, RB Neuwelt, EA AF Rosenbaum, James T. Martin, Tammy M. Farris, Kendra H. Rosenbaum, Richard B. Neuwelt, Edward A. TI Can medical schools teach high school students to be scientists? SO FASEB JOURNAL LA English DT Article DE education; secondary school; science; scientific inquiry AB The preeminence of science in the United States is endangered for multiple reasons, including mediocre achievement in science education by secondary school students. A group of scientists at Oregon Health and Science University has established a class to teach the process of scientific inquiry to local high school students. Prominent aspects of the class include pairing of the student with a mentor; use of a journal club format; preparation of a referenced, hypothesis driven research proposal; and a "hands-on" laboratory experience. A survey of our graduates found that 73% were planning careers in health or science. In comparison to conventional science classes, including chemistry, biology, and algebra, our students were 7 times more likely to rank the scientific inquiry class as influencing career or life choices. Medical schools should make research opportunities widely available to teenagers because this experience dramatically affects one's attitude toward science and the likelihood that a student will pursue a career in science or medicine. A federal initiative could facilitate student opportunities to pursue research. C1 Oregon Hlth & Sci Univ, Portland, OR 97239 USA. Portland VA Med Ctr, Portland, OR USA. RP Rosenbaum, JT (reprint author), Oregon Hlth & Sci Univ, 3181 SW Sam Jackson Pk Rd L467Ad, Portland, OR 97239 USA. EM rosenbaj@ohsu.edu NR 4 TC 7 Z9 7 U1 1 U2 5 PU FEDERATION AMER SOC EXP BIOL PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814-3998 USA SN 0892-6638 J9 FASEB J JI Faseb J. PD JUL PY 2007 VL 21 IS 9 BP 1954 EP 1957 DI 10.1096/fj.06-7845lsf PG 4 WC Biochemistry & Molecular Biology; Biology; Cell Biology SC Biochemistry & Molecular Biology; Life Sciences & Biomedicine - Other Topics; Cell Biology GA 182JG UT WOS:000247500300005 PM 17351126 ER PT J AU Yeager, DE Magruder, KM Knapp, RG Nicholas, JS Frueh, BC AF Yeager, Derik E. Magruder, Kathryn M. Knapp, Rebecca G. Nicholas, Joyce S. Frueh, B. Christopher TI Performance characteristics of the Posttraumatic Stress Disorder Checklist and SPAN in Veterans Affairs primary care settings SO GENERAL HOSPITAL PSYCHIATRY LA English DT Article DE PCL; posttraumatic stress disorder; SPAN; screening; primary care ID PTSD CHECKLIST; FEMALE VETERANS; EPIDEMIOLOGY; CLINICS; VALIDATION; SYMPTOMS; VALIDITY; HEALTH AB Background: Posttraumatic stress disorder (PTSD) is a treatable disorder, and individuals with this condition may benefit from early detection. Many people with PTSD are not aware of its symptoms and do not seek treatment, making a brief and targeted screening program a worthwhile endeavor. For this reason, research aimed at improving screening instruments could yield substantial benefits. Objectives: The primary objective of this research was to assess the diagnostic performance of two popular PTSD screening assessments, the PTSD Checklist (PCL) and the SPAN, in a Veterans Affairs (VA) primary care setting. Additionally, we compared the screening performance of these two assessments by sex and race. Methods: The PCL and SPAN were compared with a gold standard, the Clinician-Administered PTSD Scale. Receiver operating characteristic curves were used in conjunction with sensitivity and specificity measures to assess the performance of each screening assessment. These analyses are based on a large database (it = 1076) that was derived from a multisite cross-sectional study conducted at four southeastern VA medical centers. Results: Results for the PCL support cutoff scores lower than those previously published, whereas results for the SPAN support the previously recommended cutoff score of 5 (sensitivity of 73.68% and specificity of 81.99%). We found no significant difference in areas under the curve (AUCs) by sex and by race between the PCL and SPAN. We did find that there was a highly significant difference (P <.0006) in overall diagnostic ability (as measured by the AUC) between the PCL (AUC=0.882) and SPAN (AUC=0.837), making the PCL the preferred screening tool, unless brevity is essential. Conclusions: Clinicians and researchers should consider lower cutoff scores for the PCL, but the originally suggested cutoff score for the SPAN is appropriate. Published by Elsevier Inc. C1 Med Univ S Carolina, Dept Psychiat & Behav Sci, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Biostat Bioinformat & Epidemiol, Charleston, SC 29425 USA. Ralph H Johnson Vet Affairs Med Ctr, Mental Hlth Serv, Charleston, SC 29452 USA. RP Magruder, KM (reprint author), Med Univ S Carolina, Dept Psychiat & Behav Sci, 67 President St, Charleston, SC 29425 USA. EM magrudkm@musc.edu NR 28 TC 68 Z9 68 U1 2 U2 4 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0163-8343 J9 GEN HOSP PSYCHIAT JI Gen. Hosp. Psych. PD JUL-AUG PY 2007 VL 29 IS 4 BP 294 EP 301 DI 10.1016/j.genhosppsych.2007.03.004 PG 8 WC Psychiatry SC Psychiatry GA 188CM UT WOS:000247896400002 PM 17591505 ER PT J AU Graham, DY Yomaoka, Y AF Graham, David Y. Yomaoka, Yoshio TI One- or two-week triple therapy for Helicobacter pylori: questions of efficacy and inclusion of a dual therapy treatment arm SO GUT LA English DT Letter ID PROTON PUMP INHIBITOR; UNITED-STATES; NONULCER DYSPEPSIA; ERADICATION; INFECTION; 7-DAY; CLARITHROMYCIN; AMOXICILLIN; METRONIDAZOLE; TRIAL C1 Michael E DeBakey Vet Affairs Med Ctr, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Houston, TX 77030 USA. RP Graham, DY (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Dept Med, RM 3A-320,111D,2002 Holcombe Blvd, Houston, TX 77030 USA. EM dgraham@bcm.tmc.edu FU NIDDK NIH HHS [DK56338] NR 19 TC 3 Z9 3 U1 0 U2 0 PU B M J PUBLISHING GROUP PI LONDON PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND SN 0017-5749 J9 GUT JI Gut PD JUL PY 2007 VL 56 IS 7 BP 1021 EP 1022 DI 10.1136/gut.2007.119362 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 178EW UT WOS:000247205000026 PM 17566035 ER PT J AU Doshi, JA Polsky, D Chang, VW AF Doshi, Jalpa A. Polsky, Daniel Chang, Virginia W. TI Prevalence and trends in obesity among aged and disabled US Medicare beneficiaries, 1997-2002 SO HEALTH AFFAIRS LA English DT Article ID UNITED-STATES; BARIATRIC SURGERY; OVERWEIGHT; COSTS; DISEASE; ADULTS AB Given Medicare's recent national coverage decision on bariatric surgery, as well as potential coverage expansions for other obesity-related treatments, data on obesity in the Medicare population have great relevance. Using nationally representative data, we estimate that. between 1997 and 2002, the prevalence of obesity in the Medicare population increased by 5.6 percentage points, or about 2.7 million beneficiaries. By 2002, 21.4 percent of aged beneficiaries and 39.3 percent of disabled beneficiaries were obese, compared with 16.4 percent and 32.5 percent, respectively, in 1997. Using 2002 data, we estimate that three million beneficiaries would be eligible for bariatric surgery coverage under current Medicare policy. C1 Univ Penn, Sch Med, Philadelphia, PA 19104 USA. Philadelphia Vet Affairs Med Ctr, Philadelphia, PA USA. RP Doshi, JA (reprint author), Univ Penn, Sch Med, Philadelphia, PA 19104 USA. EM jdoshi@mail.med.upenn.edu FU NIA NIH HHS [R01 AG024451, R01-AG024451]; NICHD NIH HHS [K12 HD043459, K12-HD043459] NR 18 TC 17 Z9 17 U1 3 U2 5 PU PROJECT HOPE PI BETHESDA PA 7500 OLD GEORGETOWN RD, STE 600, BETHESDA, MD 20814-6133 USA SN 0278-2715 J9 HEALTH AFFAIR JI Health Aff. PD JUL-AUG PY 2007 VL 26 IS 4 BP 1111 EP 1117 DI 10.1377/hlthaff.26.4.1111 PG 7 WC Health Care Sciences & Services; Health Policy & Services SC Health Care Sciences & Services GA 191GL UT WOS:000248119500024 PM 17630454 ER PT J AU Spiegel, BMR Bolus, R Han, S Tong, M Esraitian, E Talley, J Tran, T Karsan, HA Durazo, F Bacon, B Martin, P Younossi, Z Hwa-Ong, S Kanwal, F AF Spiegel, Brennan M. R. Bolus, Roger Han, Steven Tong, Myron Esraitian, Eric Talley, Jennifer Tran, Tram Karsan, Hetal A. Durazo, Francisco Bacon, Bruce Martin, Paul Younossi, Zobair Hwa-Ong, Siew Kanwal, Fasiha TI Development and validation of a disease-targeted quality of life instrument in chronic hepatitis B: The hepatitis B quality of life instrument, version 1.0 SO HEPATOLOGY LA English DT Article AB Despite the increasing realization that health-related quality of life (HRQOL) is an important outcome in chronic HBV infection, there are no validated, disease-targeted instruments currently available. We sought to develop and validate the first disease-targeted HRQOL instrument in noncirrhotic HBV. the Hepatitis B Quality of Life instrument, version 1.0 (HBQOL v1.0). We established content validity for the HBQOL v1.0 by conducting a systematic literature review, an expert focus group, and cognitive interviews with HBV patients. We administered the resultant questionnaire to 138 HBV patients. We used factor analysis to test hypotheses regarding HRQOL domains and measured construct validity by comparing HBQOL v1.0 scores across several anchors, including viral response to treatment, SF-36 scores, and global health. Finally, we measured test-retest and internal consistency reliability. Content validation revealed that HBV affects multiple aspects of psychological, social, and physical health. The resultant questionnaire summarized this HRQOL impact with 31 items across six subscales: psychological well-being anticipation anxiety, vitality, disease stigma, vulnerability, and transmissibility. Internal consistency and test-retest reliability were excellent. The HBQOL v1.0 discriminated between viral responders versus nonresponders and correlated highly with SF-36 scores and global health. Conclusion: Patients with chronic HBV infection attribute a wide range of negative psychological, social, and physical symptoms to their condition, even in the absence of cirrhosis or cancer. The HBQOL v1.0 is a valid and reliable measure that captures this HRQOL decrement. This instrument may be useful in everyday clinical practice and in future clinical trials. C1 Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, VA Ctr Outcomes Res & Educ,CURE Digest Dis Res Ct, Los Angeles, CA 90073 USA. VA Greater Los Angeles Healthcare Syst, Dept Internal Med, Div Gastroenterol & Hepatol, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Internal Med, David Geffen Sch Med, Div Digest Dis, Los Angeles, CA USA. Cedars Sinai Med Ctr, Dept Internal Med, Div Hepatol, Los Angeles, CA 90048 USA. Atlanta Gastroenterol Associates, Atlanta, GA USA. Emory Univ, Sch Med, Dept Internal Med, Div Hepatol, Atlanta, GA 30322 USA. Mt Sinai Sch Med, Dept Internal Med, Div Hepatol, New York, NY USA. Inova Fairfax Hosp, Ctr Liver Dis, Fairfax, VA USA. St Louis Univ, Dept Med, Div Gastroenterol & Hepatol, St Louis, MO 63103 USA. Novartis Pharma AG, Basel, Switzerland. RP Spiegel, BMR (reprint author), Univ Calif Los Angeles, VA Greater Los Angeles Healthcare Syst, David Geffen Sch Med, VA Ctr Outcomes Res & Educ,CURE Digest Dis Res Ct, 11301 Wilshire Blvd,Bldg 115,Room 215, Los Angeles, CA 90073 USA. EM bspiegel@mednet.ucla.edu FU NIDDK NIH HHS [T32 DK07180-30, 2P30 DK 041301-17] NR 9 TC 26 Z9 28 U1 0 U2 5 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 0270-9139 J9 HEPATOLOGY JI Hepatology PD JUL PY 2007 VL 46 IS 1 BP 113 EP 121 DI 10.1002/hep.21692 PG 9 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 184JJ UT WOS:000247637000016 PM 17596882 ER PT J AU Kim, AI Dorn, A Bouajram, R Saab, S AF Kim, A. I. Dorn, A. Bouajram, R. Saab, S. TI The treatment of chronic hepatitis C in HIV-infected patients: a meta-analysis SO HIV MEDICINE LA English DT Article DE hepatitis C; HIV; interferon treatment ID HUMAN-IMMUNODEFICIENCY-VIRUS; ALPHA-2A PLUS RIBAVIRIN; ANTIRETROVIRAL THERAPY; COINFECTED PATIENTS; CLINICAL-TRIALS; LIVER FIBROSIS; HEPATOCELLULAR-CARCINOMA; MORTALITY; PROGRESSION; CIRRHOSIS AB Objective Hepatitis C virus (HCV) disease progression appears to be accelerated in patients coinfected with HIV. The impact of HCV on coinfected patients is being realized as patients are now living longer. The objective of our study was to further elucidate incremental improvement and safety concerns with combinations of pegylated interferon (peginterferon), interferon and ribavirin based on data obtained from prospective randomized controlled trials. Methods A search of MEDLINE and the Cochrane database for material published between 1966 and 29 August 2005 and a hand search of abstracts from national meetings held between 2001 and August 2005 were performed. Trials comparing the use of peginterferon plus ribavirin vs peginterferon or interferon plus ribavirin were assessed. Results In six randomized controlled trials, 1756 patients were randomized. Sustained virological response was greater for patients treated with peginterferon plus ribavirin compared with patients treated with interferon plus ribavirin [odds ratio (OR) 3.00; 95% confidence interval (CI) 2.27-3.96]. This increased sustained virological response with peginterferon and ribavirin was found for patients with HCV genotype 1 or 4 (OR 4.40; 95% CI 2.75-7.03) and genotype 2 or 3 (OR 2.56; 95% CI 1.71-3.85). Sustained virological responses were also higher with peginterferon and ribavirin as compared with peginterferon monotherapy (OR 2.60; 95% CI 1.84-3.67). Severe adverse effects (OR 1.09; 95% CI 0.74-1.4) and withdrawal rates (OR 0.97; 95% CI 0.75-1.25) were similar between patients treated with peginterferon plus ribavirin and patients treated with interferon plus ribavirin. Conclusions Patients with chronic HCV/HIV coinfection have a greater likelihood of achieving a sustained virological response with peginterferon plus ribavirin. The likelihoods of serious adverse effects and study withdrawal were similar. C1 VA Greater Los Angeles Healthcare Syst, Div Infect Dis, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90024 USA. VA Greater Los Angeles Healthcare Syst, Dept Med, Los Angeles, CA USA. Univ Calif Los Angeles, Dept Surg, Los Angeles, CA 90024 USA. RP Saab, S (reprint author), Pfleger Liver Inst, 200 UCLA Med Plaza,Suite 214,Box 957302, Los Angeles, CA 90095 USA. EM Ssaab@mednet.ucla.edu NR 45 TC 15 Z9 16 U1 0 U2 1 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1464-2662 J9 HIV MED JI HIV Med. PD JUL PY 2007 VL 8 IS 5 BP 312 EP 321 DI 10.1111/j.1468-1293.2007.00476.x PG 10 WC Infectious Diseases SC Infectious Diseases GA 177CB UT WOS:000247130100008 PM 17561878 ER PT J AU Stout, JE Muder, RR Mietzner, S Wagener, MM Perri, MB DeRoos, K Goodrich, D Arnold, W Williamson, T Ruark, O Treadway, C Eckstein, EC Marshall, D Rafferty, ME Sarro, K Page, J Jenkins, R Oda, G Shimoda, KJ Zervos, MJ Bittner, M Camhi, SL Panwalker, AP Donskey, CJ Nguyen, MH Holodniy, M Yu, VL AF Stout, Janet E. Muder, Robert R. Mietzner, Sue Wagener, Marilyn M. Perri, Mary Beth DeRoos, Kathleen Goodrich, Dona Arnold, William Williamson, Theresa Ruark, Ola Treadway, Christine Eckstein, Elizabeth C. Marshall, Debra Rafferty, Mary Ellen Sarro, Kathleen Page, Joann Jenkins, Robert Oda, Gina Shimoda, Kathleen J. Zervos, Marcus J. Bittner, Marvin Camhi, Sharon L. Panwalker, Anand P. Donskey, Curtis J. Nguyen, Minh-Hong Holodniy, Mark Yu, Victor L. CA Legionella Study Grp TI Role of environmental surveillance in determining the risk of hospital-acquired legionellosis: A national surveillance study with clinical correlations SO INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY LA English DT Article ID NOSOCOMIAL LEGIONNAIRES-DISEASE; PNEUMOPHILA; WATER; PREVENTION; SEROGROUP-1; PNEUMONIA; MONOCHLORAMINE; DIAGNOSIS; PATTERNS; CULTURES AB Objective. Hospital-acquired Legionella pneumonia has a fatality rate of 28%, and the source is the water distribution system. Two prevention strategies have been advocated. One approach to prevention is clinical surveillance for disease without routine environmental monitoring. Another approach recommends environmental monitoring even in the absence of known cases of Legionella pneumonia. We determined the Legionella colonization status of water systems in hospitals to establish whether the results of environmental surveillance correlated with discovery of disease. None of these hospitals had previously experienced endemic hospital-acquired Legionella pneumonia. Design. Cohort study. kll;llSetting. Twenty US hospitals in 13 states. Interventions. Hospitals performed clinical and environmental surveillance for Legionella from 2000 through 2002. All specimens were shipped to the Special Pathogens Laboratory at the Veterans Affairs Pittsburgh Medical Center. Results. Legionella pneumophila and Legionella anisa were isolated from 14 (70%) of 20 hospital water systems. Of 676 environmental samples, 198 (29%) were positive for Legionella species. High-level colonization of the water system (30% or more of the distal outlets were positive for L. pneumophila) was demonstrated for 6 (43%) of the 14 hospitals with positive findings. L. pneumophila serogroup 1 was detected in 5 of these 6 hospitals, whereas 1 hospital was colonized with L. pneumophila serogroup 5. A total of 633 patients were evaluated for Legionella pneumonia from 12 (60%) of the 20 hospitals: 377 by urinary antigen testing and 577 by sputum culture. Hospital-acquired Legionella pneumonia was identified in 4 hospitals, all of which were hospitals with L. pneumophila serogroup 1 found in 30% or more of the distal outlets. No cases of disease due to other serogroups or species (L. anisa) were identified. Conclusion. Environmental monitoring followed by clinical surveillance was successful in uncovering previously unrecognized cases of hospital-acquired Legionella pneumonia. C1 Univ Pittsburgh, VA Pittsburgh Healthcare Syst, Pittsburgh, PA 15260 USA. Vet Affairs Med Ctr, Butler, PA USA. William Beaumont Hosp, Royal Oak, MI 48072 USA. Vet Affairs Med Ctr, Omaha, NE USA. So Arizona Healthcare Syst, Tucson, AZ USA. Vet Affairs Med Ctr, Wilmington, DE USA. Louis Stokes Vet Affairs Med Ctr, Cleveland, OH USA. Vet Affairs Med Ctr, Dayton, OH USA. Stratton Vet Affairs Med Ctr, Albany, NY USA. Vet Affairs Med Ctr, Iowa City, IA USA. Vet Affairs Med Ctr, Gainesville, FL 32608 USA. Vet Affairs Med Ctr, Palo Alto, CA USA. Vet Affairs Med Ctr, Long Beach, CA USA. RP Yu, VL (reprint author), Special Pahtogens Lab, 1401 Forbes Ave,Suite 209, Pittsburgh, PA 15219 USA. EM vly@pitt.edu NR 36 TC 66 Z9 70 U1 0 U2 8 PU UNIV CHICAGO PRESS PI CHICAGO PA 1427 E 60TH ST, CHICAGO, IL 60637-2954 USA SN 0899-823X J9 INFECT CONT HOSP EP JI Infect. Control Hosp. Epidemiol. PD JUL PY 2007 VL 28 IS 7 BP 818 EP 824 DI 10.1086/518754 PG 7 WC Public, Environmental & Occupational Health; Infectious Diseases SC Public, Environmental & Occupational Health; Infectious Diseases GA 205NR UT WOS:000249121400008 PM 17564984 ER PT J AU Amory, JK Page, ST Anawalt, BD Coviello, AD Matsumoto, AM Bremner, WJ AF Amory, John K. Page, Stephanie T. Anawalt, Bradley D. Coviello, Andrea D. Matsumoto, Alvin M. Bremner, William J. TI Elevated end-of-treatment serum INSL3 is associated with failure to completely suppress spermatogenesis in men receiving male hormonal contraception SO JOURNAL OF ANDROLOGY LA English DT Article DE azoospermia; oligospermia ID INSULIN-LIKE FACTOR-3; ENANTHATE-INDUCED AZOOSPERMIA; RELAXIN-LIKE FACTOR; TESTOSTERONE ENANTHATE; LUTEINIZING-HORMONE; GONADOTROPIN-LEVELS; TESTIS; OLIGOZOOSPERMIA; LEVONORGESTREL; CRYPTORCHIDISM AB The administration of testosterone plus a progestogen functions as a male contraceptive by inhibiting the release of pituitary gonadotropins. After 3 to 4 months of treatment, most men are azoospermic or severely oligospermic (<= 1 million sperm/mL). However, 10% to 20% of men have persistent sperm production despite profound gonadotropin suppression. Since insulin-like factor 3 (INSL3) has been shown to prevent germ cell apoptosis in mice, we hypothesized that INSL3 might be higher in men with persistent spermatogenesis during treatment with male hormonal contraceptives. In a retrospective analysis, we measured serum INSL3 in 107 men from 3 recent male hormonal contraceptive studies and determined the relationship between suppression of spermatogenesis and serum INSL3. At the end of treatment 63 men (59%) were azoospermic and 44 men (41%) had detectable sperm in their ejaculates. Baseline INSL3 did not predict azoospermia; however, end of treatment serum INSL3 was significantly higher in non-azoospermic men compared with those with azoospermia (median [interquartile range]: 95 [73-127] pg/mL vs 80 [67-101] pg/mL; P =.03). Furthermore, serum INSL3 was positively correlated with sperm concentration (r =.25; P =.009) at the end of treatment and was significantly associated with nonazoospermia by multivariate logistic regression (P =.03). After 6 months of treatment with a hormonal male contraceptive regimen, higher serum INSL3 concentrations were associated with persistent sperm production. INSL3 may play a role in preventing complete suppression of spermatogenesis in some men on hormonal contraceptive regimens. This finding suggests that INSL3 may be a potential target for male contraceptive development. C1 Univ Washington, Dept Med, Seattle, WA 98195 USA. Vet Affairs Puget Sound Hlth Care Syst, Educ & Clin Ctr, Dept Med, Seattle, WA USA. Boston Univ, Dept Med, Boston, MA 02215 USA. Educ & Clin Ctr, Dept Geriatr Res, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA. RP Amory, JK (reprint author), Univ Washington, Box 356429,1959 NE Pacif, Seattle, WA 98195 USA. EM jamory@u.washington.edu FU NIA NIH HHS [K23 AG027238, K23 AG027238-03]; NICHD NIH HHS [U54 HD 12629, K23 HD 45386, U54 HD 42454] NR 28 TC 35 Z9 36 U1 0 U2 2 PU AMER SOC ANDROLOGY, INC PI LAWRENCE PA C/O ALLEN PRESS, INC PO BOX 368, LAWRENCE, KS 66044 USA SN 0196-3635 J9 J ANDROL JI J. Androl. PD JUL-AUG PY 2007 VL 28 IS 4 BP 548 EP 554 DI 10.2164/jandrol.106.002345 PG 7 WC Andrology SC Endocrinology & Metabolism GA 186FO UT WOS:000247764700014 PM 17314233 ER PT J AU Aslam, S Darouiche, RO AF Aslam, Saima Darouiche, Rabih O. TI Prolonged bacterial exposure to minocycline/rifampicin-impregnated vascular catheters does not affect antimicrobial activity of catheters SO JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY LA English DT Article; Proceedings Paper CT 44th Annual Meeting of the Infectious-Diseases-Society-of-America CY OCT 12-15, 2006 CL Toronto, CANADA SP Infect Dis Soc Amer DE minocycline/rifampicin-impregnated catheters; MIC; antimicrobial resistance ID CENTRAL VENOUS CATHETERS; IN-VITRO; RESISTANCE; EFFICACY; RISK; ANTIBIOTICS; ANTISEPTICS; RIFAMPIN AB Objectives: We assessed the in vitro effect of exposing various bacteria to minocycline/rifampicin-impregnated vascular catheters on the antimicrobial activity of the catheters and the antimicrobial susceptibility of tested organisms. Methods: Segments of minocycline/rifampicin-impregnated catheters were placed in agar plates inoculated with methicillin-susceptible Staphylococcus aureus (MSSA), methicillin-resistant S. aureus (MRSA), methicillin-resistant Staphylococcus epidermidis (MRSE) and vancomycin-resistant Enterococcus (VRE). Zones of inhibition were measured at 24 h, and colonies from the edge of this zone were retrieved after 72 h and inoculated onto new agar plates. A total of seven 72 h cycles were completed. We then measured the MICs of minocycline, rifampicin, vancomycin and linezolid for the collected strains. Results: The zones of inhibition of the four organisms remained stable after 21 days of sequential exposure to the impregnated catheters. The MICs of the antimicrobials remained constant, except for the MICs of rifampicin for MRSA and linezolid for MRSE, which increased slightly but remained within the susceptible range. Conclusions: Minocycline/rifampicin-impregnated catheters remain effective against MSSA, MRSA, MRSE and VRE, as evidenced by stable zones of inhibition following 21 day sequential exposure to these catheters. The increase in MIC of rifampicin for MRSA may be clinically relevant if the catheter remains in place for > 12 days though the strain remained susceptible to minocycline, there was no concurrent increase in the MIC of other tested drugs, and the zones of inhibition remained stable. C1 Michael E DeBakey Vet Affairs Med Ctr, Infect Dis Sect, Houston, TX 77030 USA. Baylor Coll Med, Infect Dis Sect, Dept Med, Houston, TX 77030 USA. Baylor Coll Med, Ctr Prosthesis Infect, Houston, TX 77030 USA. RP Aslam, S (reprint author), Michael E DeBakey Vet Affairs Med Ctr, Infect Dis Sect, Med Care Line,Room 4B-370,2002 Holcombe Blvd, Houston, TX 77030 USA. EM saslam@bcm.tmc.edu NR 11 TC 5 Z9 5 U1 0 U2 0 PU OXFORD UNIV PRESS PI OXFORD PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND SN 0305-7453 J9 J ANTIMICROB CHEMOTH JI J. Antimicrob. Chemother. PD JUL PY 2007 VL 60 IS 1 BP 148 EP 151 DI 10.1093/jac/dkm173 PG 4 WC Infectious Diseases; Microbiology; Pharmacology & Pharmacy SC Infectious Diseases; Microbiology; Pharmacology & Pharmacy GA 192DE UT WOS:000248180200022 PM 17525051 ER PT J AU Parthasarathy, S Jubran, A Laghi, F Tobin, MJ AF Parthasarathy, Sairam Jubran, Amal Laghi, Franco Tobin, Martin J. TI Sternomastoid, rib cage, and expiratory muscle activity during weaning failure SO JOURNAL OF APPLIED PHYSIOLOGY LA English DT Article DE sternomastoid muscles; respiratory muscles; mechanical ventilation ID OBSTRUCTIVE PULMONARY-DISEASE; AIR-FLOW OBSTRUCTION; MECHANICALLY VENTILATED PATIENTS; PRESSURE SUPPORT VENTILATION; RESPIRATORY MUSCLES; DIAPHRAGMATIC FATIGUE; SCALENE; PATTERN; DYSPNEA; PATIENT AB We hypothesized that patients who fail weaning from mechanical ventilation recruit their inspiratory rib cage muscles sooner than they recruit their expiratory muscles, and that rib cage muscle recruitment is accompanied by recruitment of stemomastoid muscles. Accordingly, we measured stemomastoid electrical activity and changes in esophageal (Delta P-es) and gastric pressure (Delta P-ga) in 11 weaning-failure and 8 weaning-success patients. At the start of trial, failure patients exhibited a higher Delta p(ga)-to-Delta P-es ratio than did success patients (P = 0.05), whereas expiratory rise in P-ga was equivalent in the two groups. Between the start and end of the trial, failure patients developed additional increases in Delta P-ga-to-Delta P-es ratio (P < 0.0014) and the expiratory rise in P-ga also increased (P < 0.004). At the start of trial, stemomastoid activity was present in 8 of 11 failure patients contrasted with I of 8 success patients. Over the course of the trial, sternomastoid activity increased by 53.0 +/- 9.3% in the failure patients (P = 0.0005), whereas it did not change in the success patients. Failure patients recruited their respiratory muscles in a sequential manner. The sequence began with activity of diaphragm and greater-than-normal activity of inspiratory rib cage muscles; recruitment of sternomastoids and rib cage muscles approached near maximum within 4 min of trial commencement; expiratory muscles were recruited slowest of all. In conclusion, not only is activity of the inspiratory rib cage muscles increased during a failed weaning trial, but respiratory centers also recruit sternomastoid and expiratory muscles. Extradiaphragmatic muscle recruitment may be a mechanism for offsetting the effects of increased load on a weak diaphragm. C1 US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Div Pulm & Crit Care Med, Hines, IL 60141 USA. Loyola Univ, Stritch Sch Med, Hines, IL USA. RP Parthasarathy, S (reprint author), Univ Arizona, So Arizona VA Hlth Care Syst, Pulm & Crit Care Med Sect, 3601 S 6th Ave, Tucson, AZ 85723 USA. RI Parthasarathy, Sairam/L-1612-2013 NR 56 TC 32 Z9 35 U1 0 U2 0 PU AMER PHYSIOLOGICAL SOC PI BETHESDA PA 9650 ROCKVILLE PIKE, BETHESDA, MD 20814 USA SN 8750-7587 J9 J APPL PHYSIOL JI J. Appl. Physiol. PD JUL PY 2007 VL 103 IS 1 BP 140 EP 147 DI 10.1152/japplphysiol.00904.2006 PG 8 WC Physiology; Sport Sciences SC Physiology; Sport Sciences GA 195KK UT WOS:000248410900020 PM 17395760 ER PT J AU Nield, MA Hoo, GWS Roper, JM Santiago, S AF Nield, Margaret A. Hoo, Guy W. Soo Roper, Janice M. Santiago, Silverio TI Efficacy of pursed-lips breathing - A breathing pattern retraining strategy for dyspnea reduction SO JOURNAL OF CARDIOPULMONARY REHABILITATION AND PREVENTION LA English DT Article DE breathing exercises; chronic obstructive; dyspnea; pulmonary disease ID OBSTRUCTIVE PULMONARY-DISEASE; AIR-FLOW LIMITATION; HEALTH SURVEY SF-36; QUALITY-OF-LIFE; RESPIRATORY SENSATION; BREATHLESSNESS; EXERCISE; COPD; HYPERINFLATION; MANAGEMENT AB PURPOSE: Breathing pattern retraining is frequently used for exertional dyspnea relief in adults with moderate to severe chronic obstructive pulmonary disease. However, there is contradictory evidence to support its use. The study objective was to compare 2 programs of prolonging expiratory time (pursed-lips breathing and expiratory muscle training) on dyspnea and functional performance. METHODS: A randomized, controlled design was used for the pilot study. Subjects recruited from the outpatient pulmonary clinic of a university-affiliated Veteran Affairs healthcare center were randomized to: 1) pursed-lips breathing, 2) expiratory muscle training, or 3) control. Changes over time in dyspnea [modified Borg after 6-minute walk distance (6MWD) and Shortness of Breath Questionnaire] and functional performance (Human Activity Profile and physical function scale of Short Form 36-item Health Survey) were assessed with a multilevel modeling procedure. Weekly laboratory visits for training were accompanied by structured verbal, written, and audiovisual instruction. RESULTS: Forty subjects with chronic obstructive pulmonary disease [age = 65 +/- 9 (mean +/- standard deviation) years, forced expiratory volume 1 second/ forced vital capacity % = 46 +/- 10, forced expiratory volume 1 second % predicted = 39 +/- 13, body mass index = 26 +/- 6 kg/M-2, inspiratory muscle strength = 69 +/- 22 cm H2O, and expiratory muscle strength (PEmax) = 102 +/- 29 cm H2O] were enrolled. No significant Group x Time difference was present for PEmax (P = .93). Significant reductions for the modified Borg scale after 6MWD (P = .05) and physical function (P = .02) from baseline to 12 weeks were only present for pursed-lips breathing. CONCLUSION: Pursed-lips breathing provided sustained improvement in exertional dyspnea and physical function. C1 Univ Hawaii Manoa, Honolulu, HI 96822 USA. W Los Angeles Healthcare Ctr, VA Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Univ Calif Los Angeles, Geffen Sch Med, Los Angeles, CA USA. RP Nield, MA (reprint author), Univ Hawaii Manoa, 2528 McCarthy Mall,Webster 414, Honolulu, HI 96822 USA. EM mnield@earthlink.net NR 34 TC 37 Z9 39 U1 1 U2 9 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 1932-7501 J9 J CARDIOPULM REHABIL JI J. Cardiopulm. Rehabil. Prev. PD JUL-AUG PY 2007 VL 27 IS 4 BP 237 EP 244 PG 8 WC Cardiac & Cardiovascular Systems SC Cardiovascular System & Cardiology GA 200AO UT WOS:000248736500009 PM 17667021 ER PT J AU Hunt, RH Tytgat, GH Malfertheiner, P Fock, KM Heading, RC Katelaris, PH McCarthy, DM McColl, KEL Moss, SF Sachs, G Sontag, SJ Thomson, ABR Modlin, IM AF Hunt, Richard H. Tytgat, Guido H. Malfertheiner, Peter Fock, Kwong Ming Heading, Robert C. Katelaris, Peter H. McCarthy, Denis M. McColl, Kenneth E. L. Moss, Steven F. Sachs, George Sontag, Stephen J. Thomson, Alan B. R. Modlin, Irvin M. TI Whistler summary: "The slow rate of rapid progress" SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Editorial Material ID GASTROESOPHAGEAL-REFLUX DISEASE; PROTON-PUMP INHIBITORS; ESOPHAGOGASTRIC JUNCTION; BARRETTS-ESOPHAGUS; ACID SUPPRESSION; QUESTIONNAIRE; ESOMEPRAZOLE; METAANALYSIS; DYSPEPSIA; CONSENSUS AB Gastroesophageal reflux disease (GERD) is now the most common diagnosis made in gastroenterology outpatient practice. Increasing time and resources are spent on its management each year. Many conditions associated with, or the result of, GERD also appear to be on the rise-the most worrisome, esophageal adenocarcinoma, is steadily increasing in incidence, although it remains an uncommon cancer. Now that proton pump inhibitors (PPIs) are widely available, including over the counter in some countries, patients seen in consultation by gastroenterologists are becoming ever more challenging. In view of these trends, a meeting was convened in Whistler, British Columbia, Canada, in the fall of 2006 to review the current state-of-the-art approach to GERD, and to highlight areas of uncertainty in this field. The aim was to focus attention on patient needs, in an effort to provide better symptomatic care. The discussions were free ranging, on a variety of the most difficult problems, and the chairmen were instructed to lead the discussions into the unmet needs. The following pages highlight a summary of these discussions. C1 Yale Univ, Sch Med, New Haven, CT 06520 USA. McMaster Univ, Hlth Sci Ctr, Hamilton, ON, Canada. Univ Alberta, Edmonton, AB, Canada. Univ Amsterdam, Amsterdam, Netherlands. Univ Magdeburg, D-39106 Magdeburg, Germany. Changi Gen Hosp, Div Gastroenterol, Singapore, Singapore. Glasgow Royal Infirm, Glasgow G4 0SF, Lanark, Scotland. Univ Sydney, Concord Hosp, Sydney, NSW 2006, Australia. Univ New Mexico, Albuquerque, NM 87131 USA. USAF, Vet Affairs Med Ctr, Albuquerque, NM USA. Western Infirm & Associated Hosp, Glasgow, Lanark, Scotland. Rhode Isl Hosp, Providence, RI USA. Brown Univ, Providence, RI 02912 USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst, Los Angeles, CA USA. Vet Affairs Hosp, Hines, IL USA. RP Modlin, IM (reprint author), Yale Univ, Sch Med, 333 Cedar St, New Haven, CT 06520 USA. EM imodlin@optonline.net NR 28 TC 2 Z9 2 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD JUL PY 2007 VL 41 IS 6 BP 539 EP 545 DI 10.1097/MCG.0b013e31803d0fd8 PG 7 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 187FU UT WOS:000247833800001 PM 17577108 ER PT J AU Hunt, RH Tytgat, GN Malfertheiner, P Fock, KM Heading, RC Katelaris, PH McCarthy, DM McColl, KE Moss, SF Sachs, G Sontag, SJ Thomson, ABR Modlin, IM AF Hunt, Richard H. Tytgat, Guido N. Malfertheiner, Peter Fock, Kivong Ming Heading, Robert C. Katelaris, Peter H. McCarthy, Denis M. McColl, Kenneth El. Moss, Steven F. Sachs, George Sontag, Stephen J. Thomson, Allan B. R. Modlin, Irvin M. TI Whistler Consensus SO JOURNAL OF CLINICAL GASTROENTEROLOGY LA English DT Article; Proceedings Paper CT Meeting on Gastroesophageal Reflux Disease (GERD) CY SEP, 2006 CL Whistler, CANADA DE acid; PPI; esophagus; reflux ID GASTROESOPHAGEAL-REFLUX DISEASE; HEALTHY MALE-VOLUNTEERS; ACID SUPPRESSION; QUESTIONNAIRE; ESOMEPRAZOLE; METAANALYSIS; PPI AB There is a continuing increase in gastroesophageal reflux disease (GERD), its diverse manifestations and complications worldwide. Indeed the substantial increase in Asia remains is a major epidemiologic and a developing health care issue. This manifesto provides a contemporary review of the current status of areas of uncertainty and in particular highlights the lack of knowledge and unmet needs in the field of GERD biology and especially management. There seems to be no widely accepted rationale for the increasing incidence and prevalence of GERD globally. Although consideration has been given to the decline in Helicobacter pylori infection, others consider the steadily growing problem of obesity as the most likely etiologic factor. What actually comprises the disease entity of GERD continues to confound physicians, and the steady increase in new definitions suggests that a clear picture is still emerging. Of note, however, is the rising awareness of its protean systemic manifestations and the fact that while erosive reflux disease is easily recognizable endoscopically, nonerosive disease (NERD) comprises the majority of presentations in many populations. In view of this, GERD-specific questionnaires and other evaluative tools have been designed to capture the multidimensional nature of the symptom complexes in GERD patients who for the most part may have no endoscopic evidence of disease. Such tools have obvious utility in the evaluation of changes with treatment, especially because there is no endoscopic abnormality detectable. The recognition that NERD is becoming a major clinical entity that requires substantial further investigation is now clearly apparent. At this time, however, little is known of the cellular barrier mechanisms of the esophagus and what is responsible for their reconstitution after injury. Similarly, the neural basis of esophageal pain appreciation, or its relation to the visceral sensory mechanisms that may link NERD with aspects of functional bowel disease are as yet ill understood. Apart from the clinical concern with symptom-focused issues, it is the specter of Barrett esophagus, the most-feared complication of GERD that mostly continues to drive endoscopic practice in GERD. At this time, however, current surveillance strategies remain severely limited in their ability to adequately detect or prevent most esophageal adenocarcinoma. Although considerable effort has been directed at defining the neural circuitry of the esophagus in terms of both motility and sensation, the topography and function of the esophageal-brain-gut axis in respect of the generation of esophageal symptoms remains terra incognita. At this time therefore acid suppression remains the mainstay of therapy in terms of treating the GERD/NERD disease process. Despite the efficacy of the currently available proton pump inhibitor class of drugs, there are clearly unmet needs in this area and agents with a more rapid onset of action and prolonged effect, particularly at night remain important goals in the future advance of pharmacotherapy. C1 Yale Univ, Sch Med, New Haven, CT 06520 USA. McMaster Univ, Hlth Sci Ctr, Hamilton, ON, Canada. Univ Amsterdam, Amsterdam, Netherlands. Otto Von Guericke Univ, Magdeburg, Germany. Changi Gen Hosp, Div Gastroenterol, Singapore, Singapore. Glasgow Royal Infirm, Glasgow, Lanark, Scotland. Univ Sydney, Concord Hosp, Sydney, NSW 2006, Australia. Univ New Mexico, Albuquerque, NM USA. USAF, Vet Affairs Med Ctr, Albuquerque, NM USA. Western Infirm & Associated Hosp, Glasgow, Lanark, Scotland. Rhode Isl Hosp, Providence, RI USA. Brown Univ, Providence, RI 02912 USA. Univ Calif Los Angeles, David Gaffen Sch Med, Los Angeles, CA USA. Vet Affairs Greater Los Angeles Healthcare Syst G, Los Angeles, CA USA. Vet Affairs Hosp, Hines, IL USA. Univ Alberta, Edmonton, AB, Canada. RP Modlin, IM (reprint author), Yale Univ, Sch Med, 333 Cedar St, New Haven, CT 06520 USA. EM imodlin@optonline.net NR 16 TC 1 Z9 1 U1 0 U2 1 PU LIPPINCOTT WILLIAMS & WILKINS PI PHILADELPHIA PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA SN 0192-0790 J9 J CLIN GASTROENTEROL JI J. Clin. Gastroenterol. PD JUL PY 2007 VL 41 IS 6 SU S BP S47 EP S50 DI 10.1097/MCG.0b013e318064c7a3 PG 4 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 188RW UT WOS:000247938000002 ER PT J AU Jensen, RA Gilliam, LK Torn, C Landin-Olsson, M Karlsson, FA Palmer, JP Kockum, I Akesson, K Lernmark, B Lynch, K Breslow, N Lernmark, A AF Jensen, Richard A. Gilliam, Lisa K. Torn, Carina Landin-Olsson, Mona Karlsson, F. Anders Palmer, Jerry P. Kockum, Ingrid Akesson, Karin Lernmark, Barbro Lynch, Kristian Breslow, Norman Lernmark, Ake CA DISS grp TI Multiple factors affect the loss of measurable C-peptide over 6 years in newly diagnosed 15- to 35-year-old diabetic subjects SO JOURNAL OF DIABETES AND ITS COMPLICATIONS LA English DT Article DE type 1 diabetes mellitus; type 2 diabetes mellitus; c-peptide; autoantibodies ID GLUTAMIC-ACID DECARBOXYLASE; BETA-CELL FUNCTION; MATCHED CONTROL CHILDREN; ISLET-CELL; YOUNG-ADULTS; INSULIN REQUIREMENT; PREDICTIVE VALUE; ANTIBODIES; AUTOANTIBODIES; MELLITUS AB Objective: The aim of this study is to identify risk factors for the loss of measurable plasma C-peptide in newly diagnosed 15- to 35-year-old diabetic subjects. Methods: This Swedish study included 778 subjects. C-peptide levels were obtained each year for 6 years after diagnosis. Loss of measurable C-peptide was defined as a level at or below the lower detection limit of the local assay (0.13 nmol/1). In addition to C-peptide, other baseline covariates included gender, age, body mass index, HLA genotype, and autoantibody levels. Results: Compared with autoantibody-negative subjects, autoantibody-positive subjects had lower median baseline C-peptide (0.27 vs. 0.50, P<.001), their levels declined over the study period, and the risk of losing measurable C-peptide was significantly higher when more than one autoantibody was present [odds ratio (OR), 4.0; 95% confidence interval (CI), 2.13-7.54]. Among autoantibody-positive individuals, the presence of GAD65Ab (OR, 1.8; 95% CI, 1.24-2.51) and islet cell antibodies (OR, 1.6; 95% CI, 1.19-2.18) conferred a higher risk for loss of measurable C-peptide.as did female gender (OR, 1.6; 95% CI, 1.17-2.11) and time after diagnosis (OR, 1.5 for each additional year postdiagnosis; 95% CI, 1.41-1.57). Higher baseline C-peptide levels were protective (OR, 0.5 for each additional log, nanomoles per liter; 95% CI, 0.36-0.58). Conclusions: This study identified autoantibody status, gender, and baseline C-peptide levels as factors that will be useful for predicting the disease course of 15- to 35-year-old diabetic individuals. (C) 2007 Elsevier Inc. All rights reserved. C1 Univ Washington, Dept Med, RH Williams Lab, Med Ctr, Seattle, WA 98195 USA. Univ Washington, Dept Biostat, Seattle, WA 98195 USA. Univ Lund Hosp, Dept Clin Sci, S-22185 Lund, Sweden. Univ Uppsala Hosp, Inst Med Sci, Uppsala, Sweden. Univ Washington, Dept Med, Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. Karolinska Inst, Dept Mol Med, Stockholm, Sweden. Ryhovs Hosp, Dept Phys, Jonkoping, Sweden. Lund Univ, Dept Clin Sci, Univ Hosp MAS, Malmo, Sweden. RP Jensen, RA (reprint author), Univ Washington, Dept Med, RH Williams Lab, Med Ctr, 1959 NE Pacific St,Box 357710, Seattle, WA 98195 USA. EM richaj@u.washington.edu OI Landin-Olsson, Mona/0000-0003-0510-9112 FU NIDDK NIH HHS [DK26910, DK42654, DK17047, DK53004] NR 40 TC 16 Z9 18 U1 0 U2 1 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1056-8727 J9 J DIABETES COMPLICAT JI J. Diabetes Complications PD JUL-AUG PY 2007 VL 21 IS 4 BP 205 EP 213 DI 10.1016/j.jdiacomp.2006.01.004 PG 9 WC Endocrinology & Metabolism SC Endocrinology & Metabolism GA 191XU UT WOS:000248166100001 PM 17616349 ER PT J AU Walsh, TJ Porter, MP AF Walsh, Thomas J. Porter, Michael P. TI Ureteroscopic treatment of upper-tract urothelial lesions: A novel technique SO JOURNAL OF ENDOUROLOGY LA English DT Article ID TRANSITIONAL-CELL CARCINOMA; MANAGEMENT; BIOPSY AB We describe a simple and effective method of using a stone-extraction basket and electrocautery to treat pedunculated renal-pelvic neoplasms ureteroscopically. This technique may make it easier to obtain tissue from the urothelium and reduce operative times. C1 Univ Washington, Sch Med, Dept Urol, Seattle, WA 98195 USA. Va Puget Sound Hlth Care Syst, Seattle, WA 98195 USA. RP Walsh, TJ (reprint author), Univ Washington, Sch Med, Dept Urol, 1959 NE Pacific St,Box 356510, Seattle, WA 98195 USA. EM TWalsh@urology.ucsf.edu NR 7 TC 1 Z9 1 U1 0 U2 0 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 0892-7790 J9 J ENDOUROL JI J. Endourol. PD JUL PY 2007 VL 21 IS 7 BP 718 EP 720 DI 10.1089/end.2006.0344 PG 3 WC Urology & Nephrology SC Urology & Nephrology GA 202FN UT WOS:000248887500011 PM 17705757 ER PT J AU Lynch, CS Chang, JC Ford, AF Ibrahim, SA AF Lynch, Cheryl Sterling Chang, Judy C. Ford, Angela F. Ibrahim, Said A. TI Obese African-American women's perspectives on weight loss and bariatric surgery SO JOURNAL OF GENERAL INTERNAL MEDICINE LA English DT Article DE African American; obesity; body mass index; weight loss; bariatric surgery ID IN-HOSPITAL OUTCOMES; LONG-TERM MORTALITY; HEALTH-CARE USE; UNITED-STATES; LOSS MAINTENANCE; NATIONAL TRENDS; MORBID-OBESITY; US ADULTS; PREVALENCE; ATTITUDES AB Background: African-American (AA) women have higher rates of obesity and obesity-related diseases but are less likely than other women to undergo bariatric surgery or have success with conventional weight loss methods. Objective: To explore obese AA women's perceptions regarding barriers to weight loss and bariatric surgery. Design: Focus groups to stimulate interactive dialogue about beliefs and attitudes concerning weight management. Participants and approach: We partnered with a community organization to recruit women who were AA, were >= 18 years old, and had a body mass index (BMI) of >= 30 kg/m(2). We audiotaped the 90-minute focus groups and used content analysis for generating and coding recurring themes. Results: In our sample of 41 participants, the mean age was 48.8 years and mean BMI was 36.3. Most participants were unmarried, had some postsecondary education, and reported good or fair health. About 85% knew someone who had undergone bariatric surgery. Qualitative analysis of 6 focus group sessions revealed that the most common barriers to weight loss were lack of time and access to resources; issues regarding self-control and extrinsic control; and identification with a larger body size. Common barriers to bariatric surgery were fears and concerns about treatment effects and perceptions that surgery was too extreme or was a method of last resort. Conclusions: Only through the elimination of barriers can AA women receive the care needed to eliminate excess weight and prevent obesity-related morbidity and mortality. C1 VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Sch Med, Dept Med, Pittsburgh, PA USA. Univ Pittsburgh, Sch Med, Dept Obstet Gynecol & Reprod Sci, Pittsburgh, PA USA. Univ Pittsburgh, Grad Sch Publ Hlth, Ctr Minor Hlth, Pittsburgh, PA USA. RP Ibrahim, SA (reprint author), VA Pittsburgh Healthcare Syst, Ctr Hlth Equ Res & Promot, 151-C, Pittsburgh, PA 15240 USA. EM said.ibrahim2@med.va.gov FU NCATS NIH HHS [UL1 TR000005]; NIMHD NIH HHS [P60 MD-000-207-03] NR 50 TC 28 Z9 28 U1 4 U2 8 PU SPRINGER PI NEW YORK PA 233 SPRING STREET, NEW YORK, NY 10013 USA SN 0884-8734 J9 J GEN INTERN MED JI J. Gen. Intern. Med. PD JUL PY 2007 VL 22 IS 7 BP 908 EP 914 DI 10.1007/s11606-007-0218-0 PG 7 WC Health Care Sciences & Services; Medicine, General & Internal SC Health Care Sciences & Services; General & Internal Medicine GA 183DH UT WOS:000247552400002 PM 17447097 ER PT J AU Barrett, TW Mori, M De Boer, D AF Barrett, Thomas W. Mori, Motomi De Boer, David TI Association of ambulatory use of statins and beta-blockers with long-term mortality after vascular surgery SO JOURNAL OF HOSPITAL MEDICINE LA English DT Article DE vascular surgery; beta-blockers; statins; mortality ID MAJOR NONCARDIAC SURGERY; PERIOPERATIVE MYOCARDIAL-ISCHEMIA; PROPENSITY SCORE METHODS; AORTIC-ANEURYSM SURGERY; OF-VETERANS-AFFAIRS; HIGH-RISK PATIENTS; LOWER-EXTREMITY; REDUCTION; INFARCTION; MORBIDITY AB BACKGROUND: The use of drugs to improve postoperative outcomes has focused oil short-term end points and centered on beta-blockers. Emerging evidence suggests statins may also improve postoperative Outcomes. OBJECTIVE: We sought to ascertain if the ambulatory use of statins and/or beta-blockers was associated with a reduction in long-term mortality after vascular surgery. DESIGN: Retrospective cohort study with a median follow-tip of 2 7 years. SETTING: Regional multicenter study at Veterans Affairs medical centers. PATIENTS: Three thousand and sixty-two patients presenting for vascular surgery. MEASUREMENTS: Patients were categorized as using statins or beta-blockers if they filled a prescription for the study drug within 30 days of surgery. Survival analyses, propensity score methods, and stratifications by the revised cardiac risk index (RCRI) were performed. RESULTS: Propensity-adjusted ambulatory use of statins and beta-blockers was associated with a reduction in mortality over the study period compared with nonuse of these medications hazard ratio [HR] = 0.78 [95% CI: 0.67-0.921, P = .0021, and number needed to treat (NNT) = 22 for statins; HR = 0.84 [95% CI: 0.73-0.961, P = .0106, and NNT = 30 for beta-blockers. In addition, for propensity-adjusted use of both statins and beta-blockers compared with neither the HR was 0.56 [95% CI: 0.42-0.74] P < .0001, and NNT was 9. The RCRI confirmed combination statin and beta-blocker use was beneficial at all levels of risk. Use of the combination Study drugs by the highest-risk patients was associated with a 33% decrease in mortality after 2 years (P = .0106). CONCLUSIONS: The use of ambulatory statins alone or in combination with beta-blockers is associated with a reduction in long-term mortality after vascular surgery, and combination use benefits patients at all levels of risk. C1 [Barrett, Thomas W.] Oregon Hlth & Sci Univ, Div Gen Internal Med & Geriatr, Portland, OR 97201 USA. [Barrett, Thomas W.] Portland VA Med Ctr, Sect Gen Med, Portland, OR USA. [Mori, Motomi] Oregon Hlth & Sci Univ, Dept Publ Hlth & Prevent Med, Div Biostat, Portland, OR 97201 USA. [De Boer, David] Oregon Hlth & Sci Univ, Ctr Biostat Comp & Informat Biol & Med, Portland, OR 97201 USA. RP Barrett, TW (reprint author), 3710 SW US VA Hosp Rd,Portland P3MED, Portland, OR 97207 USA. EM barretth@ohsu.edu NR 33 TC 10 Z9 10 U1 0 U2 0 PU JOHN WILEY & SONS INC PI HOBOKEN PA 111 RIVER ST, HOBOKEN, NJ 07030 USA SN 1553-5592 J9 J HOSP MED JI J. Hosp. Med. PD JUL-AUG PY 2007 VL 2 IS 4 BP 241 EP 252 DI 10.1002/jhm.160 PG 12 WC Medicine, General & Internal SC General & Internal Medicine GA 292HQ UT WOS:000255257500007 PM 17702038 ER PT J AU Jansen, PL Rosch, R Jansen, M Binnebosel, M Junge, K Alfonso-Jaume, A Klinge, U Lovett, DH Mertens, PR AF Jansen, Petra Lynen Rosch, Raphael Jansen, Marc Binneboesel, Marcel Junge, Karsten Alfonso-Jaume, Alexandra Klinge, Uwe Lovett, David H. Mertens, Peter R. TI Regulation of MAV-2 gene transcription in dermal wounds SO JOURNAL OF INVESTIGATIVE DERMATOLOGY LA English DT Article ID GLOMERULAR MESANGIAL CELLS; A-DEFICIENT MICE; MATRIX METALLOPROTEINASE-2; IV COLLAGENASE; TUMOR PROGRESSION; EXPRESSION; YB-1; ANGIOGENESIS; INHIBITION; INFLAMMATION AB Matrix metalloproteinase-2 (MMP-2, gelatinase A) plays an essential role in angiogenesis, inflammation, and fibrosis. These processes are critical for wound healing and accordingly elevated levels of MMP-2 expression have been detected after skin injury. Our goal was to investigate the transcriptional activation of the MMP-2 gene in a model of skin injury by using two different MM P-2/LacZ-reporter mice. Upon skin injury MMP-2 expression was upregulated, whereas tissue from normal skin stained negative except for occasional macrophages, sweat glands, and hair follicles. Skin injury also activated MMP-2 proteolytic activity and reporter gene expression. We demonstrate that MMP-2 regulatory sequences -1686/+423 drive appropriate injury-induced MMP-2-promoter activation. Reporter gene expression was predominantly detectable in endothelial cells and in macrophages. Deletion of the 5' responsive element, denoted RE-1, residing at -1241/+423 bp of the regulatory sequence led to abrogated MMP-2 transcription in vivo. The findings define a crucial role for the enhancer element RE-1 in injury-induced MMP-2 transcription of the skin. C1 Univ Hosp Aachen, Interdisciplinary Ctr Clin Res BIOMAT, RWTH Aachen, D-52074 Aachen, Germany. Univ Hosp, RWTH Aachen, Dept Surg, Aachen, Germany. Williams Middleton Mem Univ Wisconsin, Dept Med, Madison, WI USA. Univ Hosp RWTH Aachen, Inst Appl Med Engn, Helmholtz Inst, Aachen, Germany. Univ Calif San Francisco, Dept Med, San Francisco Vet Affairs Med Ctr, San Francisco, CA 94143 USA. Univ Hosp Aachen, RWTH Aachen, Dept Nephrol, Aachen, Germany. Univ Hosp Aachen, RWTH Aachen, Dept Clin Immunol, Aachen, Germany. RP Jansen, PL (reprint author), Univ Hosp Aachen, Interdisciplinary Ctr Clin Res BIOMAT, RWTH Aachen, Pauwelsstr, D-52074 Aachen, Germany. EM plynen@ukaachen.de FU NIDDK NIH HHS [DK039776] NR 25 TC 23 Z9 23 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 0022-202X J9 J INVEST DERMATOL JI J. Invest. Dermatol. PD JUL PY 2007 VL 127 IS 7 BP 1762 EP 1767 DI 10.1038/sj.jid.5700765 PG 6 WC Dermatology SC Dermatology GA 184YB UT WOS:000247677400034 PM 17344928 ER PT J AU Khan, M Elango, C Ansari, MA Singh, I Singh, AK AF Khan, Mushfiquddin Elango, Chinnasamy Ansari, Mubeen A. Singh, Inderjit Singh, Avtar K. TI Caffeic acid phenethyl ester reduces neurovascular inflammation and protects rat brain following transient focal cerebral ischemia SO JOURNAL OF NEUROCHEMISTRY LA English DT Article DE antioxidant; caffeic acid phenethyl ester; inflammation; neurovascular protection; oxidative stress; therapeutic window ID NF-KAPPA-B; NITRIC-OXIDE SYNTHASE; ARTERY OCCLUSION; GENE-EXPRESSION; EXPERIMENTAL STROKE; S-NITROSYLATION; ENDOTHELIAL-CELLS; VASCULAR-DISEASE; OXIDATIVE STRESS; INJURY AB Ischemic stroke is a neurovascular disease treatable by thrombolytic therapy, but the therapy has to be initiated within 3 h of the incident. This therapeutic limitation stems from the secondary injury which results mainly from oxidative stress and inflammation. A potent antioxidant/anti-inflammatory agent, caffeic acid phenethyl ester (CAPE) has potential to mitigate stroke's secondary injury, and thereby widening the therapeutic window. We observed that CAPE protected the brain in a dose-dependent manner (1-10 mg/kg body weight) and showed a wide therapeutic window (about 18 h) in a rat model of transient focal cerebral ischemia and reperfusion. The treatment also increased nitric oxide and glutathione levels, decreased lipid peroxidation and nitrotyrosine levels, and enhanced cerebral blood flow. CAPE down-regulated inflammation by blocking nuclear factor kappa B activity. The affected mediators included adhesion molecules (intercellular adhesion molecule-1 and E-selectin), cytokines (tumor necrosis factor-alpha and interleukin-1 beta) and inducible nitric oxide synthase. Anti-inflammatory action of CAPE was further documented through reduction of ED1 (marker of activated macrophage/microglia) expression. The treatment inhibited apoptotic cell death by down-regulating caspase 3 and up-regulating anti-apoptotic protein Bcl-xL. Conclusively, CAPE is a promising drug candidate for ischemic stroke treatment due to its inhibition of oxidative stress and inflammation, and its clinically relevant wide therapeutic window. C1 Med Univ S Carolina, Dept Pathol & Lab Med, Children Res Inst 516, Charleston, SC 29425 USA. Med Univ S Carolina, Dept Pediat, Charleston, SC 29425 USA. Ralph H Johnson VA Med Ctr, Charleston, SC USA. RP Singh, AK (reprint author), Med Univ S Carolina, Dept Pathol & Lab Med, Children Res Inst 516, 173 Ashley Ave, Charleston, SC 29425 USA. EM khanm@musc.edu FU Intramural NIH HHS; NINDS NIH HHS [NS-37766, NS-22576, NS-34741, NS-40810, NS-40144] NR 66 TC 59 Z9 68 U1 0 U2 4 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0022-3042 J9 J NEUROCHEM JI J. Neurochem. PD JUL PY 2007 VL 102 IS 2 BP 365 EP 377 DI 10.1111/j.1471-4159.2007.04526.x PG 13 WC Biochemistry & Molecular Biology; Neurosciences SC Biochemistry & Molecular Biology; Neurosciences & Neurology GA 183OE UT WOS:000247581300008 PM 17437550 ER PT J AU Panizzon, K Mousavi, O Wallis, RA AF Panizzon, Kimberly Mousavi, Omid Wallis, Roi Ann TI Treatment with simvastatin protects against the increased susceptibility to trauma of CA1 hippocampal neurons in aged animals SO JOURNAL OF NEUROTRAUMA LA English DT Meeting Abstract CT 25th Annual National-Neurotrauma-Society Symposium CY JUL 29-AUG 01, 2007 CL Kansas City, MO SP Natl Neurotrauma Soc C1 VA Greater Los Angeles Healthcare Syst, North Hills, CA USA. Univ Calif Los Angeles, Sch Med, Los Angeles, CA USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU MARY ANN LIEBERT INC PI NEW ROCHELLE PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA SN 0897-7151 J9 J NEUROTRAUM JI J. Neurotrauma PD JUL PY 2007 VL 24 IS 7 MA P96 BP 1253 EP 1253 PG 1 WC Critical Care Medicine; Clinical Neurology; Neurosciences SC General & Internal Medicine; Neurosciences & Neurology GA 186DV UT WOS:000247760200106 ER PT J AU Laneader, A Angelos, P Ferrell, BR Kolker, A Miner, T Padilla, G Swaney, J Krouse, RS Casarett, D AF Laneader, Alice Angelos, Peter Ferrell, Betty R. Kolker, Ann Miner, Thomas Padilla, Geraldine Swaney, Julie Krouse, Robert S. Casarett, David TI Ethical issues in research to improve the management of malignant bowel obstruction: Challenges and recommendations SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Article; Proceedings Paper CT International Conference on Malignant Bowel Obstruction CY NOV 12-13, 2004 CL Pasadena, CA DE end of life; ethics; research ethics; palliative care ID PALLIATIVE CARE RESEARCH; CLINICAL RESEARCH; INFORMED CONSENT; DECISION-MAKING; ADVANCED CANCER; GUIDELINES; DELIRIUM AB Research to improve the care of patients with malignant bowel obstruction (MBO) is urgently needed. In particular, there is an urgent need for high-quality descriptive research, including prospective cohort studies, as well as randomized controlled trials to define optimal management strategies. However, investigators and clinicians face numerous barriers in conducting high-quality research in this patient population. These barriers include lack of funding, difficulties in identifying eligible patients, and a variety of practical and methodological challenges of designing these studies. In addition, there are a variety of ethical challenges that arise in the design and conduct of studies of MBO and particularly in the conduct of clinical trials. In this article, we address four categories of ethical issues: study design, recruitment, informed consent, and Institutional Review Board review. For each, we outline salient issues and suggest recommendations for enhancing the ethics of MBO studies, including interventional trials. C1 Univ Penn, Res Compliance & Qual Improvement, Philadelphia, PA 19104 USA. Univ Chicago, MacLean Ctr Clin Med Eth, Med Ctr, Chicago, IL 60637 USA. City Hope Natl Med Ctr, Dept Nursing Res & Educ, Duarte, CA 91010 USA. Ovarian Canc Natl Alliance, Washington, DC USA. Brown Univ, Sch Med, Dept Surg, Providence, RI 02912 USA. Univ Calif San Francisco, Sch Nursing, Dept Physiol Nursing, San Francisco, CA 94143 USA. Univ Arizona, Coll Med, Dept Surg, Tucson, AZ 85721 USA. Arizona Vet Affairs Hlth Care, Tucson, AZ USA. Univ Penn, Philadelphia VA Med Ctr, Philadelphia, PA 19104 USA. Univ Penn, Ctr Hlth Equ Res & Promot, Philadelphia, PA 19104 USA. RP Casarett, D (reprint author), Univ Penn, Res Compliance & Qual Improvement, 3615 Chestnut St, Philadelphia, PA 19104 USA. EM Casarett@mail.med.upenn.edu NR 33 TC 4 Z9 4 U1 0 U2 2 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0885-3924 J9 J PAIN SYMPTOM MANAG JI J. Pain Symptom Manage. PD JUL PY 2007 VL 34 IS 1 SU S BP S20 EP S27 DI 10.1016/j.jpainsymman.2007.04.007 PG 8 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 190JN UT WOS:000248055200003 PM 17532176 ER PT J AU Mularski, RA Rosenfeld, K Coons, SJ Dueck, A Cella, D Feuer, DJ Lipscomb, J Karpeh, MS Mosich, T Sloan, JA Krouse, RS AF Mularski, Richard A. Rosenfeld, Kenneth Coons, Stephen Joel Dueck, Amylou Cella, David Feuer, David J. Lipscomb, Joseph Karpeh, Martin S., Jr. Mosich, Tom Sloan, Jeff A. Krouse, Robert S. TI Measuring outcomes in randomized prospective trials in palliative care SO JOURNAL OF PAIN AND SYMPTOM MANAGEMENT LA English DT Article; Proceedings Paper CT International Conference on Malignant Bowel Obstruction CY NOV 12-13, 2004 CL Pasadena, CA DE death; quality of dying; outcome assessment; quality of health care; quality indicators; health care; end-of-life care; family; proxy; terminal care; attitude to death ID OF-LIFE CARE; MALIGNANT BOWEL OBSTRUCTION; HEALTH SURVEY SF-36; FAMILY-MEMBERS; DECISION-MAKING; QUALITY; END; CANCER; DEATH; VALIDATION AB Palliative care aims to improve the quality of life of patients and their families and reduce suffering from life-threatening illness. In assessing palliative care efficacy, researchers must consider a broad range of potential outcomes, including those experienced by the patient's family/caregivers, clinicians, and the health care system. The purpose of this article is to summarize the discussions and recommendations of an Outcomes Working Group convened to advance the palliative care research agenda, particularly in the context of randomized controlled trials. These recommendations address the conceptualization of palliative care outcomes, sources of outcomes data, application of outcome measures in clinical trials, and the methodological challenges to outcome measurement in palliative care populations. As other fields have developed and refined methodological approaches that address their particular research needs, palliative care researchers must do the same to answer important clinical questions in rigorous and credible ways. C1 Oregon Hlth & Sci Univ, Ctr Hlth Res, Kaiser Permanent NW, Portland, OR 97227 USA. NW Permanente PC Kaiser Sunnsyde Med Ctr, Portland, OR USA. Vet Adm Greater Los Angeles Healthcare Syst, Vet Integrated Palliat Program, Los Angeles, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90024 USA. Univ Arizona, Coll Pharm, Behav Measurement Shared Serv, Tucson, AZ 85721 USA. Univ Arizona, Coll Publ Hlth, Behav Measurement Shared Serv, Tucson, AZ 85721 USA. Arizona Canc Ctr, Tucson, AZ 85721 USA. Mayo Clin, Rochester, MN USA. Evanston NW Healthcare, Ctr Outcomes Res & Educ, Evanston, IL USA. Northwestern Univ, Feinberg Sch Med, Evanston, IL 60208 USA. Barts & London Natl Hlth Serv Trust, St Bartholomews Hosp, Barts & London Palliat Care Team, London, England. Emory Univ, Rollins Sch Publ Hlth, Atlanta, GA 30322 USA. SUNY Stony Brook, Univ Hosp, Div Surg Oncol, Stony Brook, NY 11794 USA. So Arizona Vet Affairs Hlth Care Syst, Amer Canc Soc, Tucson, AZ USA. Univ Arizona, Coll Med, Tucson, AZ 85721 USA. RP Mularski, RA (reprint author), Oregon Hlth & Sci Univ, Ctr Hlth Res, Kaiser Permanent NW, 3800 N Interstate,WIN 1060, Portland, OR 97227 USA. EM Richard.Mularski@kpchr.org NR 71 TC 22 Z9 23 U1 2 U2 8 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 0885-3924 J9 J PAIN SYMPTOM MANAG JI J. Pain Symptom Manage. PD JUL PY 2007 VL 34 IS 1 SU S BP S7 EP S19 DI 10.1016/j.jpainsymman.2007.04.004 PG 13 WC Health Care Sciences & Services; Medicine, General & Internal; Clinical Neurology SC Health Care Sciences & Services; General & Internal Medicine; Neurosciences & Neurology GA 190JN UT WOS:000248055200002 PM 17532180 ER PT J AU Freeman, SR Dellavalle, RP AF Freeman, Scott R. Dellavalle, Robert P. TI Substandard requirements for clinical research publication in dermatology journals SO JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY LA English DT Letter C1 Denver VA Med Ctr, Denver, CO USA. Univ Colorado Denver & Hlth Sci Ctr, Dept Dermatol, Aurora, CO USA. RP Dellavalle, RP (reprint author), 1055 Clermont St,165, Denver, CO 80220 USA. EM robert.dellavalle@uchsc.edu RI Dellavalle, Robert/L-2020-2013 OI Dellavalle, Robert/0000-0001-8132-088X FU NCI NIH HHS [K-07 CA92550] NR 6 TC 0 Z9 0 U1 0 U2 1 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0190-9622 J9 J AM ACAD DERMATOL JI J. Am. Acad. Dermatol. PD JUL PY 2007 VL 57 IS 1 BP 175 EP 176 DI 10.1016/j.jaad.2007.03.024 PG 2 WC Dermatology SC Dermatology GA 183MS UT WOS:000247577500023 PM 17572283 ER PT J AU Tonsfeldt, E Hickman, D Van Winkle, DM AF Tonsfeldt, E. Hickman, D. L. Van Winkle, D. M. TI An accessible and humane approach to mouse intubation SO JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE LA English DT Meeting Abstract C1 Portland VA Med Ctr, Vet Med Unit, Portland, OR USA. Oregon Hlth & Sci Univ, Portland, OR 97201 USA. RI Hickman, Debra/D-3289-2009 NR 0 TC 0 Z9 0 U1 0 U2 0 PU AMER ASSOC LABORATORY ANIMAL SCIENCE PI MEMPHIS PA 9190 CRESTWYN HILLS DR, MEMPHIS, TN 38125 USA SN 1559-6109 J9 J AM ASSOC LAB ANIM JI J. Amer. Assoc. Lab. Anim. Sci. PD JUL PY 2007 VL 46 IS 4 BP 102 EP 103 PG 2 WC Veterinary Sciences; Zoology SC Veterinary Sciences; Zoology GA 196ZK UT WOS:000248522000079 ER PT J AU Le, AT Albo, D Berger, DH AF Le, Anne T. Albo, Daniel Berger, David H. TI Quality of life in the elderly with rectal cancer SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS LA English DT Review ID ABDOMINO-PERINEAL RESECTION; COLORECTAL-CANCER; PREOPERATIVE RADIOTHERAPY; SEXUAL DYSFUNCTION; SURGERY; SURVIVAL; OUTCOMES; IMPACT; INSTRUMENT; MANAGEMENT C1 Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Surg, Houston, TX 77030 USA. Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Houston Ctr Qual Care & Utilizat Studies & Operat, Houston, TX 77030 USA. RP Berger, DH (reprint author), Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Dept Surg, Surg 112 OCL,2002 Holcombe Blvd, Houston, TX 77030 USA. NR 53 TC 2 Z9 2 U1 2 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1072-7515 J9 J AM COLL SURGEONS JI J. Am. Coll. Surg. PD JUL PY 2007 VL 205 IS 1 BP 124 EP 131 DI 10.1016/j.jamcollsurg.2007.02.028 PG 8 WC Surgery SC Surgery GA 186DD UT WOS:000247758400017 PM 17617341 ER PT J AU Lindner, SA Ben Davoren, J Vollmer, A Williams, B Landefeld, CS AF Lindner, Serge A. Ben Davoren, J. Vollmer, Andrew Williams, Brie Landefeld, C. Seth TI An electronic medical record intervention increased nursing home advance directive orders and documentation SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE advance directives; electronic medical record; computerized physician order entry; quality improvement; skilled nursing facility ID STATISTICAL QUALITY-CONTROL; LIFE-SUSTAINING TREATMENT; SELF-DETERMINATION ACT; CONTROLLED-TRIAL; CLINICAL REMINDERS; CARE; OUTCOMES; IMPLEMENTATION; PERFORMANCE; STRATEGIES AB OBJECTIVES: To develop an electronic medical record intervention to improve documentation of patient preferences about life-sustaining care, detail of resuscitation and treatment-limiting orders, and concordance between these orders and patient preferences. DESIGN: Prospective before-after intervention trial. SETTING: Veterans Affairs nursing home with an electronic medical record for all clinical information, including clinician orders. PARTICIPANTS: All 224 nursing home admissions from May 1 to October 31, 2004. MEASUREMENTS: Completion of an advance directive discussion note by the primary clinician, clinician orders about resuscitation and other life-sustaining treatments, and concordance between these orders and documented patient preferences. INTERVENTION: The electronic medical record was modified so that an admission order would specify resuscitation status. Additionally, the intervention alerted the primary clinician to complete a templated advance directive discussion note for documentation of life-sustaining treatment preferences. RESULTS: Primary clinicians completed an advance directive discussion note for five of 117 (4%) admissions pre-intervention and 67 of 107 (63%) admissions post-intervention (P <.001). In multivariate analysis, the intervention was independently associated with advance directive discussion note completion (odds ratio=42, 95% confidence interval=15-120). Of patients who preferred do-not-resuscitate (DNR) status, a DNR order was written for 86% pre-intervention versus 98% post-intervention (P=.07); orders to limit other life-sustaining treatments were written for 16% and 40%, respectively (P=.01). CONCLUSIONS: A targeted electronic medical record intervention increased completion of advance directive discussion notes in seriously ill patients. For patients who preferred DNR status, the intervention also increased the frequency of DNR orders and of orders to limit other life-sustaining treatments. C1 San Francisco VA Med Ctr, San Francisco, CA USA. Univ Calif San Francisco, San Francisco, CA 94143 USA. RP Lindner, SA (reprint author), Ctr Senior Hlth, 3015 Squalicum Pkwy,Ste 100, Bellingham, WA 98225 USA. EM linserge@yahoo.com FU NIA NIH HHS [AG000212, AG000912] NR 34 TC 20 Z9 20 U1 4 U2 5 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUL PY 2007 VL 55 IS 7 BP 1001 EP 1006 DI 10.1111/j.1532-5415.2007.01214.x PG 6 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 183YA UT WOS:000247607100004 PM 17608871 ER PT J AU Boockvar, KS Burack, OR AF Boockvar, Kenneth S. Burack, Orah R. TI Organizational relationships between nursing homes and hospitals and quality of care during hospital-nursing home patient transfers SO JOURNAL OF THE AMERICAN GERIATRICS SOCIETY LA English DT Article DE nursing homes; hospitals; organizational affiliation; patient transfer; safety management ID TRANSITIONAL CARE; POSTHOSPITAL CARE; INPATIENT; SETTINGS; OUTCOMES; SAFETY; NEEDS; OLDER AB OBJECTIVES: To identify organizational factors and hospital and nursing home organizational relationships associated with more-effective processes of care during hospital-nursing home patient transfer. DESIGN: Mailed survey. SETTING: Medicare- or Medicaid-certified nursing homes in New York State. PARTICIPANTS: Nursing home administrators, with input from other nursing home staff. MEASUREMENTS: Key predictor variables were travel time between the hospital and the nursing home, affiliation with the same health system, same corporate owner, trainees from the same institution, pharmacy or laboratory agreements, continuous physician care, number of beds in the hospital, teaching status, and frequency of geriatrics specialty care in the hospital. Key dependent variables were hospital-to-nursing home communication, continuous adherence to healthcare goals, and patient and family satisfaction with hospital care. RESULTS: Of 647 questionnaires sent, 229 were returned (35.4%). There was no relationship between hospital-nursing home interorganizational relationships and communication, healthcare goal adherence, and satisfaction measures. Geriatrics specialty care in the hospital (r=0.157; P=.04) and fewer hospital beds (r=-0.194; P=.01) were each associated with nursing homes more often receiving all information needed to care for patients transferred from the hospital. Teaching status (r=0.230; P=.001) and geriatrics specialty care (r=0.185; P=.01) were associated with hospital care more often consistent with healthcare goals established in the nursing home. CONCLUSION: No management-level organizational relationship between nursing home and hospital was associated with better hospital-to-nursing home transfer process of care. Geriatrics specialty care and characteristics of the hospital were associated with better hospital-to-nursing home transfer processes. C1 James J Peters VA Med Ctr, Ctr Geriatr Res Educ & Clin, Bronx, NY 10468 USA. Jewish Home & Hosp Lifecare Syst, New York, NY USA. Mt Sinai Sch Med, Brookdale Dept Geriatr & Adult Dev, New York, NY USA. RP Boockvar, KS (reprint author), James J Peters VA Med Ctr, Ctr Geriatr Res Educ & Clin, 130 W Kingsbridge Rd, Bronx, NY 10468 USA. EM kenneth.boockvar@mssm.edu OI Boockvar, Kenneth/0000-0003-1165-5558 NR 30 TC 15 Z9 15 U1 1 U2 6 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0002-8614 J9 J AM GERIATR SOC JI J. Am. Geriatr. Soc. PD JUL PY 2007 VL 55 IS 7 BP 1078 EP 1084 DI 10.1111/j.1532-5415.2007.01235.x PG 7 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 183YA UT WOS:000247607100015 PM 17608882 ER PT J AU Jung, S Colernan, A Weintraub, NT AF Jung, Susan Colernan, Anne Weintraub, Nancy T. TI Vision screening in the elderly SO JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION LA English DT Review ID QUALITY-OF-LIFE; NURSING-HOME RESIDENTS; VISUAL IMPAIRMENT; CATARACT-SURGERY; OLDER-ADULTS; DIABETIC-RETINOPATHY; HIP FRACTURE; PRIMARY-CARE; EYE DISEASE; POPULATION C1 Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. Jules Stein Eye Inst, Los Angeles, CA 90024 USA. Univ Calif Los Angeles, Sch Publ Hlth, Los Angeles, CA 90024 USA. VA Greater Los Angeles Hlth Care Syst & Geriatr R, Sepulveda, CA USA. UCLA Multicampus Program Geriatr & Gerontol, Los Angeles, CA USA. RP Weintraub, NT (reprint author), Univ Calif Los Angeles, Greater Los Angeles VA Geriatr Med, 16111 Plummer St 11E, Sepulveda, CA 91343 USA. EM nancy.weintraub@va.gov NR 46 TC 4 Z9 4 U1 1 U2 5 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1525-8610 J9 J AM MED DIR ASSOC JI J. Am. Med. Dir. Assoc. PD JUL PY 2007 VL 8 IS 6 BP 355 EP 362 DI 10.1016/j.jamda.2007.01.096 PG 8 WC Geriatrics & Gerontology SC Geriatrics & Gerontology GA 191NY UT WOS:000248139200004 PM 17619034 ER PT J AU Glassman, PA Belperio, P Lanto, A Simon, B Valuck, R Sayers, J Lee, M AF Glassman, Peter A. Belperio, Pamela Lanto, Andrew Simon, Barbara Valuck, Robert Sayers, Jeffrey Lee, Martin TI The utility of adding retrospective medication profiling to computerized provider order entry in an ambulatory care population SO JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION LA English DT Article; Proceedings Paper CT Annual Meeting of the VA HSR & D CY MAR 09-11, 2004 CL Washington, DC ID ADVERSE DRUG EVENTS; HOSPITALIZED-PATIENTS; PHYSICIAN; SYSTEMS; ALERTS; ERRORS; INTERVENTION; OUTPATIENTS; PREVENTION; MORTALITY AB Background: We assessed whether medication safety improved when a medication profiling program was added to a computerized provider order entry system. Design: Between June 2001 and January 2002 we profiled outpatients with potential prescribing errors using computerized retrospective drug utilization software. We focused primarily on drug interactions. Patients were randomly assigned either to Provider Feedback or to Usual Care. Subsequent adverse drug event (ADE) incidence and other outcomes, including ADE preventability and severity, occurring up to 1 year following the last profiling date were evaluated retrospectively by a pharmacist blinded to patient assignment. Measurements: Data were abstracted using a study-designed instrument. An ADE was defined by an Adverse Drug Reaction Probability scale score of I or more. Statistical analyses included negative binomial regression for comparing ADE incidence. Results: Of 913 patients in the analytic sample, 371 patients (41%) had one or more ADEs. Incidence, by individual, was not significantly different between Usual Care and Provider Feedback groups (37% vs. 45%; p = 0.06; Coefficient, 0.19; 95% CI: -0.008, 0.390). ADE severity was also similar. For example, 51% of ADEs in the Usual Care and 58% in the Provider Feedback groups involved symptoms that were not serious (95% CI for the difference, -15%, 2%). Finally, ADE preventability did not differ. For example, 16% in the Usual Care group and 17% in the Provider Feedback group had an associated warning (95% Cl for the difference, -7 to 5%; p = 0.79). Conclusion: Medications safety did not improve with the addition of a medication profiling program to an electronic prescribing system. C1 VA Greater Los Angeles Healthcare Syst, Div Gen Internal Med 111G, Los Angeles, CA 90073 USA. VA HSR & D Ctr Excellence Study Healthcare Provid, Sepulveda, CA USA. Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA USA. VA Publ Hlth Strateg Healthcare Grp Ctr Qual Mana, Palo Alto, CA USA. VA Ctr Medicat Safety, Hines, IL USA. Univ Colorado, Dept Clin Pharm, Denver, CO 80202 USA. Univ Colorado, Hlth Sci Ctr, Denver, CO USA. RP Glassman, PA (reprint author), VA Greater Los Angeles Healthcare Syst, Div Gen Internal Med 111G, W Los Angeles Campus,11301 Wilshire Blvd, Los Angeles, CA 90073 USA. EM Peter.Glassman@va.gov NR 35 TC 6 Z9 6 U1 2 U2 3 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1067-5027 J9 J AM MED INFORM ASSN JI J. Am. Med. Inf. Assoc. PD JUL-AUG PY 2007 VL 14 IS 4 BP 424 EP 431 DI 10.1197/jamia.M2313 PG 8 WC Computer Science, Information Systems; Computer Science, Interdisciplinary Applications; Information Science & Library Science; Medical Informatics SC Computer Science; Information Science & Library Science; Medical Informatics GA 191AU UT WOS:000248103000007 PM 17460134 ER PT J AU Handler, SM Altman, RL Perera, S Hanlon, JT Studenski, SA Bost, JE Saul, MI Fridsma, DB AF Handler, Steven M. Altman, Richard L. Perera, Subashan Hanlon, Joseph T. Studenski, Stephanie A. Bost, James E. Saul, Melissa I. Fridsma, Douglas B. TI A systematic review of the performance characteristics of clinical event monitor signals used to detect adverse drug events in the hospital setting SO JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION LA English DT Review ID PHYSICIAN ORDER ENTRY; COMPUTER-BASED MONITOR; INFORMATION-TECHNOLOGY; DECISION-SUPPORT; NATIONAL ACTION; HEALTH-CARE; HELP SYSTEM; QUALITY; COSTS; SURVEILLANCE AB Objective: We conducted a systematic review of pharmacy and laboratory signals used by clinical event monitor systems to detect adverse drug events (ADEs) in adult hospitals. Design and Measurements: We searched the MEDLINE, CINHAL, and EMBASE databases for the years 19852006, and found 12 studies describing 36 unique ADE signals (10 medication levels, 19 laboratory values, and 7 antidotes). We were able to calculate positive predictive values (PPVs) and 95% confidence intervals (CIs) for 15 signals. Results: We found that PPVs ranged from 0.03 (95% Cl, 0.03-0.03) for hypokalemia, to 0.50 (95% CI, 0.39-0.61) for supratherapeutic quinidine level. In general, antidotes (range = 0.09-0.11) had the lowest PPVs, followed by laboratory values (range = 0.03-0.27) and medication levels (range = 0.03-0.50). Conclusion: Data from this study should help clinical information system and computerized decision support producers develop or improve existing clinical event monitor systems to detect ADEs in their own hospitals by prioritizing those signals with the highest PPVs. C1 VAPHS, Div Clin Geriatr, Dept Med, Sch Med, Pittsburgh, PA USA. VAPHS, Dept Biomed Informat, Sch Med, Pittsburgh, PA USA. VAPHS, Grad Sch Publ Hlth, Dept Biostat, Pittsburgh, PA USA. VAPHS, Sch Pharm, Dept Pharm & Therapeut, Pittsburgh, PA USA. VAPHS, Ctr Res Hlth Care, Dept Med, Pittsburgh, PA USA. VAPHS, Geriatr Res Educ & Clin Ctr, Pittsburgh, PA USA. Vet Affairs Pittsburgh Healthcare Syst, Ctr Hlth Equ Res, Pittsburgh, PA USA. RP Handler, SM (reprint author), Univ Pittsburgh, Dept Med, Div Geriatr Med, 3471 5th Ave,Suite 500, Pittsburgh, PA 15213 USA. EM handlersm@upmc.edu OI Handler, Steven/0000-0002-3940-3224 FU NCATS NIH HHS [KL2 TR000146, UL1 TR000005]; NIA NIH HHS [P30 AG024827, 5T32AG021885, P30AG024827, R01 AG027017, R01AG027017, T32 AG021885]; NICHD NIH HHS [K12 HD049109] NR 81 TC 43 Z9 47 U1 9 U2 12 PU ELSEVIER SCIENCE INC PI NEW YORK PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA SN 1067-5027 J9 J AM MED INFORM ASSN JI J. Am. Med. Inf. Assoc. PD JUL-AUG PY 2007 VL 14 IS 4 BP 451 EP 458 DI 10.1197/jamia.M2369 PG 8 WC Computer Science, Information Systems; Computer Science, Interdisciplinary Applications; Information Science & Library Science; Medical Informatics SC Computer Science; Information Science & Library Science; Medical Informatics GA 191AU UT WOS:000248103000010 PM 17460130 ER PT J AU Fenton, SH Badgett, RG AF Fenton, Susan H. Badgett, Robert G. TI A comparison of primary care information content in UpToDate and the National Guideline Clearinghouse SO JOURNAL OF THE MEDICAL LIBRARY ASSOCIATION LA English DT Article; Proceedings Paper CT Annual Symposium of the American-Medical-Informatics-Association CY OCT, 2005 CL Washington, DC SP Amer Med Informat Assoc ID CLINICAL QUESTIONS; PATIENT-CARE; DOCTORS AB Objectives: The study sought to determine if two major resources for primary care questions have significant differences in information content and whether the number of documents found differs by disease category, patient age, or patient gender. Methods: Seven hundred fifty-two questions were randomly selected from the Clinical Questions Collection of the National Library of Medicine. UpToDate and the National Guidelines Clearinghouse (NGC) were searched utilizing keywords from the questions. The number of documents retrieved for each question in the resources was recorded. Chi-squared analysis was used to compare differences in retrieval between the resources. Logistic regression was used to evaluate the effect of patient age, patient gender, or disease category on the ability to find content. Results: UpToDate returned 1 or more documents for 580 questions, while NGC returned at least 1 document for 493 questions (77.1% versus 65.5% of question sampled, P = 0.001). In combination, the 2 resources returned content for 91% of searches (n = 685). NGC retrieved a mean of 16.3 documents per question versus 8.7 documents from UpToDate. Disease category was the only variable having a significant impact on the presence of online resource content. Conclusions: UpToDate had greater breadth of content than NGC, while neither resource provided complete coverage. Current practice guidelines, as reflected by those in the NGC, addressed at most two-thirds of the selected clinical questions. C1 Texas A&M Univ, Hlth Sci Ctr, Dept Hlth Policy & Management, Sch Rural Publ Hlth, San Antonio, TX 78248 USA. Univ Texas, Hlth Sci Ctr, San Antonio, TX 78229 USA. S Texas Vet Hlth Care Syst, Vet Evidence Based Res Disseminat & Implementat C, ALMD, San Antonio, TX 78229 USA. RP Fenton, SH (reprint author), Texas A&M Univ, Hlth Sci Ctr, Dept Hlth Policy & Management, Sch Rural Publ Hlth, 21 Inwood Manor, San Antonio, TX 78248 USA. EM shfenton@srph.tamhsc.edu; badgett@uthscsa.edu OI Badgett, Robert/0000-0003-2888-3303 NR 20 TC 11 Z9 11 U1 0 U2 0 PU MEDICAL LIBRARY ASSOC PI CHICAGO PA 65 EAST WACKER PLACE, STE 1900, CHICAGO, IL 60601-7298 USA SN 1536-5050 J9 J MED LIBR ASSOC JI J. Med. Libr. Assoc. PD JUL PY 2007 VL 95 IS 3 BP 255 EP 259 DI 10.3163/1536-5050.95.3.255 PG 5 WC Information Science & Library Science SC Information Science & Library Science GA 187KU UT WOS:000247847300009 PM 17641755 ER PT J AU Sarkey, JP Richards, MP Stubbs, EB AF Sarkey, J. P. Richards, M. P. Stubbs, E. B., Jr. TI Lovastatin attenuates nerve injury in an animal model of Guillain-Barre syndrome SO JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM LA English DT Meeting Abstract CT Annual Meeting of the Peripheral-Nerve-Society CY JUL 14-18, 2007 CL Snowbird, UT SP Peripheral Nerve Soc C1 Loyola Univ, Med Ctr, Maywood, IL 60153 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. NR 0 TC 0 Z9 0 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1085-9489 J9 J PERIPHER NERV SYST JI J. Peripher. Nerv. Syst. PD JUL PY 2007 VL 12 SU 1 BP 76 EP 76 PG 1 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 207IA UT WOS:000249243600206 ER PT J AU Shankarappa, SA Sarkey, JP Richards, MP Stubbs, EB AF Shankarappa, S. A. Sarkey, J. P. Richards, M. P. Stubbs, E. B., Jr. TI Forced-exercise protects against the development of early tactile hyperalgesia in experimental diabetes SO JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM LA English DT Meeting Abstract CT Annual Meeting of the Peripheral-Nerve-Society CY JUL 14-18, 2007 CL Snowbird, UT SP Peripheral Nerve Soc C1 Loyola Univ, Med Ctr, Maywood, IL 60153 USA. US Dept Vet Affairs, Vet Affairs Edward Hines Jr Hosp, Hines, IL 60141 USA. NR 0 TC 1 Z9 1 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 1085-9489 J9 J PERIPHER NERV SYST JI J. Peripher. Nerv. Syst. PD JUL PY 2007 VL 12 SU 1 BP 79 EP 80 PG 2 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 207IA UT WOS:000249243600216 ER PT J AU Kougias, P Lin, PH Dardik, A Lee, WA El Sayed, HF Zhou, W AF Kougias, Panagiotis Lin, Peter H. Dardik, Alan Lee, W. Anthony El Sayed, Hosam F. Zhou, Wei TI Successful treatment of endotension and aneurysm sac enlargement with endovascular stent graft reinforcement SO JOURNAL OF VASCULAR SURGERY LA English DT Article ID ABDOMINAL AORTIC-ANEURYSMS; REPAIR; PRESSURE; EXCLUDER AB Abdominal aortic aneurysm (AAA) enlarges after successful endovascutar repair because of endoleak, which is persistent blood flow within the aneurysm sac. In the absence of detectable endoleak, AAA may still expand, in part because of endotension, which is persistent pressurization within the excluded aneurysm. We report three patients who underwent successful endovascular AAA repair using the Excluder device (W. L. Gore & Associates, Flagstaff, Ariz). Although their postoperative surveillance showed an initial aneurysm regression, delayed aneurysm enlargement developed in all three, apparently due to endotension. Endovascular treatment was performed in which endograft reinforcement with a combination of aortic cuff and iliac endograft extenders were inserted in the previously implanted stent grafts. The endograft reinforcement procedure successfully resulted in aneurysm sac regression in all three patients. Our study underscores the significance of increased graft permeability as a mechanism of endotension and delayed aneurysm enlargement after successful endovascular AAA repair. In addition, our cases illustrate the feasibility and efficacy of an endovascular treatment strategy when endotension and aneurysm sac enlargement develops after endovascular AAA repair. C1 Baylor Coll Med, Div Vasc Surg & Endovasc Thrapy, Michael E DeBakey Dept Surg, Michael E DeBakey Vet Affairs Hosp, Houston, TX 77030 USA. Yale Univ, Sch Med, Dept Surg, VA Connecticut Hlthcare Syst, New Haven, CT 06520 USA. Univ Florida, Dept Surg, Div Vasc Surg & Endovasc Therapy, Coll Med, Gainesville, FL 32611 USA. RP Lin, PH (reprint author), Baylor Coll Med, Div Vasc Surg & Endovasc Thrapy, Michael E DeBakey Dept Surg, Houston VAMC, 112,2002 Holocomb Blvd, Houston, TX 77030 USA. EM plin@bcm.cdu NR 14 TC 16 Z9 20 U1 0 U2 1 PU MOSBY-ELSEVIER PI NEW YORK PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA SN 0741-5214 J9 J VASC SURG JI J. Vasc. Surg. PD JUL PY 2007 VL 46 IS 1 BP 124 EP 127 DI 10.1016/j.jvs.2007.02.067 PG 4 WC Surgery; Peripheral Vascular Disease SC Surgery; Cardiovascular System & Cardiology GA 185JO UT WOS:000247707500021 PM 17606128 ER PT J AU Beckham, JD Goody, RJ Clarke, P Bonny, C Tyler, KL AF Beckham, J. David Goody, Robin J. Clarke, Penny Bonny, Christophe Tyler, Kenneth L. TI Novel strategy for treatment of viral central nervous system infection by using a cell-permeating inhibitor of c-Jun N-terminal kinase SO JOURNAL OF VIROLOGY LA English DT Article ID ACTIVATED PROTEIN-KINASE; HERPES-SIMPLEX-VIRUS; REOVIRUS-INDUCED APOPTOSIS; PEPTIDE INHIBITOR; ENCEPHALITIS; INJURY; DEATH; JNK; TRANSCRIPTION; INDUCTION AB Viral encephalitis is a major cause of morbidity and mortality worldwide, yet there is no proven efficacious therapy for most viral infections of the central nervous system (CNS). Many of the viruses that cause encephalitis induce apoptosis and activate c-Jun N-terminal kinase (JNK) following infection. We have previously shown that reovirus infection of epithelial cell lines activates JNK-dependent apoptosis. We now show that reovirus infection resulted in activation of JNK and caspase-3 in the CNS. Treatment of reovinis-infected mice with a cell-permeating peptide that competitively inhibits JNK activity resulted in significantly prolonged survival of intracerebrally infected mice following an otherwise lethal challenge with T3D (100 X 501% lethal dose). Protection correlated with reduced CNS injury, reduced neuronal apoptosis, and reduced c-Jun activation without altering the viral titer or viral antigen distribution. Given the efficacy of the inhibitor in protecting mice from viral encephalitis, JNK inhibition represents a promising and novel treatment strategy for viral encephalitis. C1 Univ Colorado, Hlth Sci Ctr, Dept Neurol B182, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Med, Denver, CO 80262 USA. Univ Colorado, Hlth Sci Ctr, Dept Microbiol, Denver, CO 80262 USA. Denver Vet Affairs Med Ctr, Denver, CO 80220 USA. Xigen SA, CH-1003 Lausanne, Switzerland. RP Tyler, KL (reprint author), Univ Colorado, Hlth Sci Ctr, Dept Neurol B182, 4200 E 9th Ave, Denver, CO 80262 USA. EM ken.tyler@uchsc.edu OI Tyler, Kenneth/0000-0003-3294-5888 FU NIAID NIH HHS [T32AI07537, T32 AI007537]; NINDS NIH HHS [R01 NS050138-04, R01 NS051403-03, R01 NS051403, 5R01NS050138, 1R01NS051403, R01 NS050138] NR 40 TC 30 Z9 32 U1 0 U2 0 PU AMER SOC MICROBIOLOGY PI WASHINGTON PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA SN 0022-538X J9 J VIROL JI J. Virol. PD JUL PY 2007 VL 81 IS 13 BP 6984 EP 6992 DI 10.1128/JVI.00467-07 PG 9 WC Virology SC Virology GA 180YW UT WOS:000247404900021 PM 17475657 ER PT J AU Sims, RV Ahmed, A Sawyer, P Allman, RM AF Sims, Richard V. Ahmed, Ali Sawyer, Patricia Allman, Richard M. TI Self-reported health and driving cessation in community-dwelling older drivers SO JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES LA English DT Article ID INCREASED DEPRESSIVE SYMPTOMS; RATED HEALTH; PREDICTORS; DISABILITY; ADULTS; AGE AB Background. Stopping driving has significant negative consequences for older adults, but there is no simple, reliable screening tool to predict driving cessation. We sought to determine if self-rated health (SRH) was an independent predictor of driving cessation among older adults. Methods. Data on SRH (poor, fair, good, very good, or excellent), medical diagnoses, physical performance, visual acuity, driving status, and other relevant covariates were collected from 649 community-dwelling older Alabama drivers during in-home interviews. Using multivariable logistic regression analyses, we estimated the association of SRH with driving cessation 2 years later. Results. Participants had a mean age of 74 years; 43% were women, 41 % African American, and 48% rural. Overall, 36% reported poor to fair SRH at baseline, and 11 % had stopped driving after 2 years. Compared to 8% of drivers with good to excellent SRH, 17% with poor to fair health stopped driving (adjusted odds ratio [OR], 1.93; 95% confidence interval [CI], 1.09-3.41; p = .025). Lower Short Physical Performance Battery (SPPB) scores (adjusted OR, 0.86; 95% CI, 0.78-0.95; p = .001) and older age (adjusted OR, 1.06 per year; 95% CI, 1.01-1.11; p =.010) were also associated with driving cessation. Receiver operating characteristics curves documented similar predictive discrimination (c statistics) for SRH (0.72), the SPPB (0.70), and a count of comorbidities based on the Charlson Comorbidity Index (0.73). Conclusions. Poor to fair SRH predicted incident driving cessation after 2 years in a cohort of older adults. SRH can be easily obtained during clinic visits to identify at-risk drivers. C1 [Sims, Richard V.; Ahmed, Ali; Allman, Richard M.] Birmingham Atlanta GRECC, Birmingham, AL 35233 USA. [Sims, Richard V.; Ahmed, Ali; Allman, Richard M.] Birmingham VA Med Ctr, Birmingham, AL USA. [Sims, Richard V.; Ahmed, Ali; Sawyer, Patricia; Allman, Richard M.] Univ Alabama, Ctr Aging, Birmingham, AL USA. [Sims, Richard V.; Ahmed, Ali; Sawyer, Patricia; Allman, Richard M.] Univ Alabama, Div Geriatr Geriatr & Palliat Care, Birmingham, AL USA. RP Sims, RV (reprint author), Birmingham Atlanta GRECC, Room 8B-8213,700 19th St S, Birmingham, AL 35233 USA. EM richard.sims@med.va.gov RI Ahmed, Ali/A-2934-2008 OI Ahmed, Ali/0000-0002-6832-6424 FU NIA NIH HHS [K23 AG019211, 1-K23-AG19211-04, AG15062, K23 AG019211-04] NR 23 TC 17 Z9 17 U1 0 U2 3 PU GERONTOLOGICAL SOC AMER PI WASHINGTON PA 1030 15TH ST NW, STE 250, WASHINGTON, DC 20005202-842 USA SN 1079-5006 J9 J GERONTOL A-BIOL JI J. Gerontol. Ser. A-Biol. Sci. Med. Sci. PD JUL PY 2007 VL 62 IS 7 BP 789 EP 793 PG 5 WC Geriatrics & Gerontology; Gerontology SC Geriatrics & Gerontology GA 272AB UT WOS:000253828700015 PM 17634328 ER PT J AU Park, SH Yee, J Kim, SH Kim, YH AF Park, Seong Ho Yee, Judy Kim, Se Hyung Kim, Young Hoon TI Fundamental elements for successful performance of CT Colonography (Virtual colonoscopy) SO KOREAN JOURNAL OF RADIOLOGY LA English DT Review DE computed tomography (CT); colonography; CTC; virtual colonoscopy; review ID COMPUTED TOMOGRAPHIC COLONOGRAPHY; OPTIMIZING COLONIC DISTENSION; CONTRAST BARIUM ENEMA; AIDED POLYP DETECTION; CONVENTIONAL COLONOSCOPY; CATHARTIC PREPARATION; COLORECTAL NEOPLASIA; ASYMPTOMATIC ADULTS; NATIONAL-SURVEY; SPIRAL CT AB There are many factors affecting the successful performance of CT colonography (CTC). Adequate colonic cleansing and distention, the optimal CT technique and interpretation with using the newest CTC software by a trained reader will help ensure high accuracy for lesion detection. Fecal and fluid tagging may improve the diagnostic accuracy and allow for reduced bowel preparation. Automated carbon dioxide insufflation is more efficient and may be safer for colonic distention as compared to manual room air insufflation. CT scanning should use thin collimation of <= 3 mm with a reconstruction interval of <= 1.5 mm and a low radiation dose. There is not any one correct method for the interpretation of CTC; therefore, readers should be well-versed with both the primary 3D and 2D reviews. Polyps detected at CTC should be measured accurately and reported following the "polyp size-based" patient management system. The time-intensive nature of CTC and the limited resources for training radiologists appear to be the major barriers for implementing CTC in Korea. C1 Univ Ulsan, Coll Med, Dept Radiol, Asan Med Ctr, Seoul 138736, South Korea. Univ Ulsan, Coll Med, Res Inst Radiol, Asan Med Ctr, Seoul 138736, South Korea. Univ Calif San Francisco, San Francisco Vet Adm Med Ctr, San Francisco, CA 94121 USA. Seoul Natl Univ Hosp, Dept Radiol, Seoul 110744, South Korea. Seoul Natl Univ Hosp, Inst Radiat Med, Seoul 110744, South Korea. Seoul Natl Univ, Bundang Hosp, Dept Radiol, Songnam 468802, South Korea. RP Park, SH (reprint author), Univ Ulsan, Coll Med, Dept Radiol, Asan Med Ctr, 388-1 Poongnap-2Dong, Seoul 138736, South Korea. EM seongho@amc.seoul.kr RI Kim, Young Hoon/J-5416-2012 OI Park, Seong Ho/0000-0002-1257-8315 NR 71 TC 22 Z9 22 U1 0 U2 0 PU KOREAN RADIOLOGICAL SOC PI SEOUL PA 121-8 YANGJAE-DONG, SEOCHO-GU, SEOUL 137-130, SOUTH KOREA SN 1229-6929 J9 KOREAN J RADIOL JI Korean J. Radiol. PD JUL-AUG PY 2007 VL 8 IS 4 BP 264 EP 275 DI 10.3348/kjr.2007.8.4.264 PG 12 WC Radiology, Nuclear Medicine & Medical Imaging SC Radiology, Nuclear Medicine & Medical Imaging GA 200TN UT WOS:000248785800001 PM 17673837 ER PT J AU Shimazaki, K Wadehra, M Forbes, A Chan, AM Goodglick, L Kelly, KA Braun, J Gordon, LK AF Shimazaki, Kaori Wadehra, Madhuri Forbes, Ashley Chan, Ann M. Goodglick, Lee Kelly, Kathleen A. Braun, Jonathan Gordon, Lynn K. TI Epithelial membrane protein 2 modulates infectivity of Chlamydia muridarum (MoPn) SO MICROBES AND INFECTION LA English DT Article DE Chlamydia; epithelial membrane protein-2; infection; host-pathogen interaction ID EPITHELIAL MEMBRANE PROTEIN-2; SURFACE EXPRESSION; HEPARAN-SULFATE; TRACHOMATIS; CELLS; PNEUMONIAE; ATTACHMENT; RECEPTOR; MOUSE AB Chlamydiae are bacterial pathogens which have evolved efficient strategies to enter, replicate, and survive inside host epithelial cells, resulting in acute and chronic diseases in humans and other animals. Several candidate molecules in the host receptor complex have been identified, but the precise mechanisms of infection have not been elucidated. Epithelial membrane protein-2 (EMP2), a 4-transmembrane protein, is highly expressed in epithelial cells in sites of chlamydial infections. Here we show that infectivity of the Chlamydia muridarum (MoPn) is associated with host cellular expression of EMP2 in multiple cell lines. Recombinant knockdown of EMP2 impairs infectivity, whereas infectivity is augmented in cells recombinantly modified to over-express EMP2. An epithelial cell line without native expression of EMP2 is relatively resistant to MoPn infection, whereas infectivity is markedly increased by recombinant expression of EMP2 in that cell line. Blockade of surface EMP2 using a specific anti-EMP2 antibody significantly reduces chlamydial infection efficiency. In addition, MoPn infectivity as measured in the EMP2 overexpressing cell line is not heparin-dependent, suggesting a possible role for EMP2 in the non-reversible phase of early infection. These findings identify EMP2 as a candidate host protein involved in infection of C. muridarum (MoPn). (c) 2007 Elsevier Masson SAS. All rights reserved. C1 Univ Calif Los Angeles, Inst Mol Biol, Los Angeles, CA 90095 USA. Dept Pathol & Lab, Los Angeles, CA 90095 USA. Dept Physiol Sci, Los Angeles, CA 90095 USA. Univ Calif Los Angeles, David Geffen Sch Med, Jules Stein Eye Inst, Los Angeles, CA 90095 USA. Greater Los Angeles Vet Affairs Healthcare Syst, Dept Surg, Los Angeles, CA 90099 USA. RP Gordon, LK (reprint author), Univ Calif Los Angeles, David Geffen Sch Med, Jules Stein Eye Inst, 100 Stein Plaza, Los Angeles, CA 90095 USA. EM lgordon@ucla.edu OI Braun, Jonathan/0000-0003-1646-2974 FU NCI NIH HHS [CA009120, CA016042, P30 CA016042]; NIAID NIH HHS [2-T32-AI-07323, AI26328, R01 AI026328]; NICHD NIH HHS [HD48540, R03 HD048540]; NIGMS NIH HHS [GM007185] NR 27 TC 9 Z9 9 U1 0 U2 1 PU ELSEVIER SCIENCE BV PI AMSTERDAM PA PO BOX 211, 1000 AE AMSTERDAM, NETHERLANDS SN 1286-4579 J9 MICROBES INFECT JI Microbes Infect. PD JUL PY 2007 VL 9 IS 8 BP 1003 EP 1010 DI 10.1016/j.micinf.2007.04.004 PG 8 WC Immunology; Infectious Diseases; Microbiology SC Immunology; Infectious Diseases; Microbiology GA 197CN UT WOS:000248531300012 PM 17544801 ER PT J AU Brousseau, KM Arciniegas, DB Carmosino, MJ Corboy, JR AF Brousseau, K. M. Arciniegas, D. B. Carmosino, M. J. Corboy, J. R. TI The differential diagnosis of Axis I psychopathology presenting to a university-based multiple sclerosis clinic SO MULTIPLE SCLEROSIS LA English DT Article DE differential diagnosis; multiple sclerosis; psychophysiological disorders; neurobehavioral manifestations; somatoform disorders; examinations AB Patients carrying a presumptive diagnosis of multiple sclerosis (MS) sometimes present with nonspecific clinical signs and symptoms that may be, at least in part, somatic manifestations of psychiatric conditions. This retrospective study was undertaken to identify psychiatric diagnoses among 63 patients whose initial clinical evaluations suggested a primary psychiatric, rather than a primary neurological, etiology for their symptoms. Some 92% of patients met Diagnostic and Statistical Manual of Mental Disorders Fourth Edition Text Revision (DSM-IV-TR) criteria for one or more primary psychiatric disorders, most often including somatoform, mood, and anxiety disorders. Accurate identification and diagnosis of psychiatric conditions producing pseudo neurological or non-specific somatic symptoms is necessary for both treatment and medico-economic reasons. C1 Univ Colorado, Sch Med, Dept Med,Dept Psychiat,Div Infect Dis, VISN 19 MIRECC,Vet Affairs Med Ctr, Denver, CO 80220 USA. Univ Colorado, Sch Med, Dept Psychiat, Neuropsychiat Serv, Denver, CO USA. Univ Colorado, Sch Med, Univ Colorado Multiple Sclerosis Ctr, Dept Neurol, Denver, CO 80202 USA. Denver Vet Affairs Med Ctr, Denver, CO 80202 USA. RP Brousseau, KM (reprint author), Univ Colorado, Sch Med, Dept Med,Dept Psychiat,Div Infect Dis, VISN 19 MIRECC,Vet Affairs Med Ctr, Denver, CO 80220 USA. EM kristin.brousseau@uchsc.edu RI Arciniegas, David/A-3792-2009 NR 8 TC 4 Z9 4 U1 0 U2 0 PU SAGE PUBLICATIONS LTD PI LONDON PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND SN 1352-4585 J9 MULT SCLER JI Mult. Scler. PD JUL PY 2007 VL 13 IS 6 BP 749 EP 753 DI 10.1177/1352458506075032 PG 5 WC Clinical Neurology; Neurosciences SC Neurosciences & Neurology GA 193JK UT WOS:000248270100009 PM 17613603 ER PT J AU Khalid, A AF Khalid, Asif TI Do all patients with pancreatic cysts need to undergo resection or can some be monitored? SO NATURE CLINICAL PRACTICE GASTROENTEROLOGY & HEPATOLOGY LA English DT Editorial Material DE nonoperative management; operative management; pancreatic cysts; patient selection C1 Univ Pittsburgh, Pittsburgh, PA USA. VA Pittsburgh Hlth Care Syst, GI Sect, Pittsburgh, PA USA. RP Khalid, A (reprint author), Presbyterian Univ Hosp, M2,C Wing,200 Lothrop St, Pittsburgh, PA 15213 USA. EM khalida@upmc.edu NR 5 TC 0 Z9 0 U1 0 U2 0 PU NATURE PUBLISHING GROUP PI NEW YORK PA 75 VARICK STREET, 9TH FLOOR, NEW YORK, NY 10013-1917 USA SN 1743-4378 J9 NAT CLIN PRACT GASTR JI Nat. Clin. Pract. Gastroenterol. Hepatol. PD JUL PY 2007 VL 4 IS 7 BP 368 EP 369 DI 10.1038/ncpgasthep0840 PG 2 WC Gastroenterology & Hepatology SC Gastroenterology & Hepatology GA 185PD UT WOS:000247722000006 PM 17502883 ER PT J AU Yang, J Sadler, TR Givrad, TK Maarek, JMI Holschneider, DP AF Yang, J. Sadler, T. R. Givrad, T. K. Maarek, J.-M. I. Holschneider, D. P. TI Changes in brain functional activation during resting and locomotor states after unilateral nigrostriatal damage in rats SO NEUROIMAGE LA English DT Review DE brain mapping; functional neuroimaging; cerebral blood flow; plasticity; hemiparkinsonism; Parkinson's disease ID CEREBRAL-BLOOD-FLOW; PARKINSONS-DISEASE BEGIN; SUPPLEMENTARY MOTOR AREA; BASAL GANGLIA; SUBSTANTIA-NIGRA; CAUDATE-PUTAMEN; VENTRAL SUBICULUM; INDICATOR FRACTIONATION; SUBTHALAMIC NUCLEUS; STRIATAL DOPAMINE AB To evaluate functional neuronal compensation after partial damage to the nigrostriatal system, we lesioned rats unilaterally in the striatum with 6-hydroxydopamine. Five weeks later, cerebral perfusion was mapped at rest or during treadmill walking using [C-14]-iodoantipyrine. Regional CBF-related tissue radioactivity (CBF-TR) was quantified by autoradiography and analyzed by statistical parametric mapping and region-of-interest analysis. Lesions were confirmed by tyrosine hydroxylase immunohistochemistry and changes in rotational locomotor activity. Functional compensations were bilateral and differed at rest and during treadmill walking. Consistent with the classic view of striatopallidal connections, CBF-TR of lesioned compared to sham-lesioned rats increased in the ipsilateral subthalamic nucleus (STN) and internal globus pallidus, and decreased in the striatum and external globus pallidus. Contrary to the classic view, CBF-TR increased in the ipsilateral ventral lateral, ventral anterior thalamus and motor cortex, as well as in the central medial thalamus, midline cerebellum, and contralateral STN. During walking, perfusion decreased in lesioned compared to sham-lesioned rats across the ipsilateral striato-pallidal-thalamic-cortical motor circuit. Compensatory increases were seen bilaterally in the ventromedial thalamus and red nucleus, in the contralateral STN, anterior substantia nigra, subiculum, motor cortex, and in midline cerebellum. Enhanced recruitment of associative sensory areas was noted cortically and subcortically. Future models of compensatory changes after nigrostriatal damage need to address the effects of increased neural activity by residual dopaminergic neurons, interhemispheric interactions and differences between resting and locomotor states. Identification of sites at which functional compensation occurs may define useful future targets for neurorehabilitative or neurorestorative interventions in Parkinson's disease. (c) 2007 Elsevier Inc. All rights reserved. C1 Univ So Calif, Keck Sch Med, Dept Cell & Neurobiol, Los Angeles, CA 90003 USA. Univ So Calif, Keck Sch Med, Dept Psychiat & Behav Sci, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, Dept Neurol, Los Angeles, CA 90033 USA. Univ So Calif, Keck Sch Med, Dept Pathol, Los Angeles, CA 90033 USA. Univ So Calif, Sch Engn, Dept Biomed Engn, Los Angeles, CA 90089 USA. Greater Los Angeles VA Healthcare Syst, Los Angeles, CA 90073 USA. RP Holschneider, DP (reprint author), Univ So Calif, Keck Sch Med, Dept Cell & Neurobiol, 1333 San Pablo St,BMT 403,MC 9112, Los Angeles, CA 90003 USA. EM holschne@usc.edu FU NINDS NIH HHS [R01 NS050171, R01 NS050171-02, 1R01 NS050171, R01 NS050171-03] NR 103 TC 31 Z9 32 U1 0 U2 4 PU ACADEMIC PRESS INC ELSEVIER SCIENCE PI SAN DIEGO PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA SN 1053-8119 J9 NEUROIMAGE JI Neuroimage PD JUL 1 PY 2007 VL 36 IS 3 BP 755 EP 773 DI 10.1016/j.neuroimage.2007.03.010 PG 19 WC Neurosciences; Neuroimaging; Radiology, Nuclear Medicine & Medical Imaging SC Neurosciences & Neurology; Radiology, Nuclear Medicine & Medical Imaging GA 184IJ UT WOS:000247634400025 PM 17481921 ER PT J AU Burns, EK Levinson, AH Lezotte, D Prochazka, AV AF Burns, Emily K. Levinson, Arnold H. Lezotte, Dennis Prochazka, Allan V. TI Differences in smoking duration between Latinos and Anglos SO NICOTINE & TOBACCO RESEARCH LA English DT Article ID CIGARETTE-SMOKING; SOCIOECONOMIC-STATUS; LUNG-CANCER; CESSATION; BEHAVIOR; SMOKERS; RESTRICTIONS; EPIDEMIOLOGY; INITIATION; HOUSEHOLD AB A smoker's risk of disease and death from cigarettes is related directly to the duration of smoking. The present study compared duration of smoking between a state-level population of Anglo versus highly acculturated Latino ever-smokers (N=6,100). Kapla-Meier analysis was used to obtain weighted median smoking duration. Weighted Cox proportional hazard models were used to evaluate the relative likelihood of continued smoking, adjusted for demographics, smoking history, home and workplace smoking restrictions, and socioeconomic covariates (education, health insurance status, and poverty level). On average, Latinos continued smoking longer than Anglos (M=30 years vs. 27 years; weighted Cox HR=0.73; 95% CI=0.60-0.89). The disparity remained significant when adjusted for demographic, smoking history, and smoking-rule covariates but was not significant when adjusted for socioeconomic status (HR=0.89, 95%, CI=0.73-1.09). Education alone accounted for the majority of the disparity, more so than poverty or health insurance status. We conclude that highly acculturated Latino smokers may be at greater risk of cigarette disease and death related to longer duration of smoking associated with lower socioeconomic status. C1 Univ Colorado, Hlth Sci Ctr, Dept Prevent Med & Biometr, Denver, CO 80262 USA. AMC Canc Res Ctr, Lakewood, CO USA. Denver VA Med Ctr, Denver, CO USA. RP Burns, EK (reprint author), 1600 Pierce St, Denver, CO 80214 USA. EM emily.burns@uchsc.edu RI Levinson, Arnold/L-3274-2013 OI Levinson, Arnold/0000-0003-3167-0384 NR 34 TC 14 Z9 14 U1 1 U2 2 PU TAYLOR & FRANCIS LTD PI ABINGDON PA 4 PARK SQUARE, MILTON PARK, ABINGDON OX14 4RN, OXON, ENGLAND SN 1462-2203 J9 NICOTINE TOB RES JI Nicotine Tob. Res. PD JUL PY 2007 VL 9 IS 7 BP 731 EP 737 DI 10.1080/14622200701397882 PG 7 WC Substance Abuse; Public, Environmental & Occupational Health SC Substance Abuse; Public, Environmental & Occupational Health GA 189GR UT WOS:000247977900003 PM 17577802 ER PT J AU Agaimy, A Pelz, AF Corless, CL Wunsch, PH Heinrich, MC Hofstaedter, F Dietmaier, W Blanke, CD Wieacker, P Roessner, A Hartmann, A Schneider-Stock, R AF Agaimy, Abbas Pelz, Antje-Friederike Corless, Christopher L. Wuensch, Peter H. Heinrich, Michael C. Hofstaedter, Ferdinand Dietmaier, Wolfgang Blanke, Charles D. Wieacker, Peter Roessner, Albert Hartmann, Arndt Schneider-Stock, Regine TI Epithelioid gastric stromal tumours of the antrum in young females with the Carney triad: A report of three new cases with mutational analysis and comparative genomic hybridization SO ONCOLOGY REPORTS LA English DT Article DE gastrointestinal stromal tumour; Carney triad; comparative genomic hybridization; PDGFRA; KIT mutations ID OF-THE-LITERATURE; EXTRA-ADRENAL PARAGANGLIOMA; AUTONOMIC NERVE TUMORS; COPY NUMBER CHANGES; PULMONARY CHONDROMA; EXTRAADRENAL PARAGANGLIOMA; 12-YEAR-OLD GIRL; KIT; IMATINIB; ADULTS AB Carney triad is a rare non-hereditary condition affecting young females and characterized by metachronous or synchronous occurrence of epithelioid gastrointestinal stromal tumours (GISTs), pulmonary chondroma and extra-adrenal paraganglioma. The genetic alterations in Carney triad-related GISTs have not been well studied. We evaluated GISTs from three females with incomplete Carney triad for KIT and PDGFRA mutations and studied the DNA by comparative genomic hybridization (CGH). All GISTs originated in the antrum and had a monotonous epithelioid morphology. Two patients had GISTs and pulmonary chondroma and one had GISTs and paraganglioma. Initial manifestation was GIST (n=1), pulmonary chondroma (n=1) and bladder paraganglioma (n=1). Time to the second component was 2-13 years. Two patients were alive at 108 and 168 months (one with metastases) and one died of the disease 3 years later. All cases were wild-type for KIT exons 9, 11 13. 17 and PDGFRA exons 12 and 18. CGH revealed 14 aberrations (mean, 4.7/tumour) including I I gains (X, 1q, 5p, 8q 9p 12p 13q, 18p, 19q), 2 amplifications (1q, 19p) and one loss (13q). Carney triad-related GISTs do not only lack conventional KIT and PDGFRA mutations, but they also lack the non-random loss of 14q and 22q characteristic of their sporadic counterparts, suggesting an origin through a distinct pathogenetic pathway. C1 Klinikum Nurnberg, Inst Pathol, D-90419 Nurnberg, Germany. Univ Magdeburg, Inst Human Genet, D-39106 Magdeburg, Germany. Oregon Hlth & Sci Univ, Inst Canc, Portland, OR 97201 USA. Univ Regensburg, Inst Pathol, D-8400 Regensburg, Germany. Portland VA Med Ctr, Portland, OR USA. Univ Magdeburg, Inst Pathol, D-39106 Magdeburg, Germany. RP Agaimy, A (reprint author), Klinikum Nurnberg, Inst Pathol, Prof Ernst Nathan Str 1, D-90419 Nurnberg, Germany. EM abbas.agaimy@klinikum-nuernberg.de RI Schneider-Stock, Regine/H-8863-2012 NR 35 TC 27 Z9 29 U1 0 U2 1 PU PROFESSOR D A SPANDIDOS PI ATHENS PA 1, S MERKOURI ST, EDITORIAL OFFICE,, ATHENS 116 35, GREECE SN 1021-335X J9 ONCOL REP JI Oncol. Rep. PD JUL PY 2007 VL 18 IS 1 BP 9 EP 15 PG 7 WC Oncology SC Oncology GA 184GU UT WOS:000247629900002 PM 17549339 ER PT J AU Sonel, AF Shalaby, A Mcconnell, JP Czarnecki, T Hogen, S Zahid, M Amidi, M AF Sonel, Ali F. Shalaby, Alaa Mcconnell, Joseph P. Czarnecki, Tammy Hogen, Scott Zahid, Maliha Amidi, Morteza TI Detectable troponin levels predict poor prognosis in patients with left ventricular dysfunction undergoing internal defibrillator implantation SO PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY LA English DT Article DE implantable cardioverter defibrillator; troponins; risk stratification; cardiomyopathy ID CONGESTIVE-HEART-FAILURE; CARDIOVERTER-DEFIBRILLATOR; RISK STRATIFICATION; COST-EFFECTIVENESS; SUDDEN-DEATH; MYOCARDIAL DAMAGE; INJURY; AMIODARONE; PREVENTION; MARKERS AB Introduction: Troponin levels have been demonstrated to predict mortality in patients with cardiomyopathy. Implantable cardiac defibrillator (ICD) devices have been demonstrated to improve survival. It is not clear if ICDs would mitigate the negative outcome predicted by elevated troponin levels. Methods: We collected baseline blood samples for troponin T (TnT) and creatinine kinase-MB fraction in consecutive patients immediately before successful pectoral transvenous ICD implant. Patients were followed for total mortality. For analysis, patients were grouped by TnT detectablility (>= 0.01 ng/mL). Results: Fifty-two men, aged 68 +/- 10 years, were studied. Mean ejection fraction was 29 +/- 12% and 65% had ischemic cardiomyopathy. Follow-up duration was 17 8 months. None of the patients had abnormal creatinine kinase-MB fraction levels (1.7 +/- 1.1 ng/mL). There were 37 patients with no detectable TnT (Group I) and 15 with detectable TnT (Group 11). There was no difference between the two groups in terms of age (68 vs 69, P = NS), ejection fraction (30 vs 29 %, P = NS), or proportion of patients with ischemic cardiomyopathy (68 vs 60%, P = NS). During follow-up 16 (31 %) patients died. Patients in group I had mortality of 16% (6/37) compared to 67% mortality (10/15, P < 0.001) in group II. On multivariate analysis, detectable TnT remained an independent predictor of mortality (HR 4.5, Cl 1.4-14.25, P = 0.01). Conclusion: In a cohort of patients with cardiomyopathy undergoing ICD implantation for standard clinical indications, presence of detectable TnT was associated with high mortality despite ICD implantation. TnT obtained before ICD implantation may be useful for risk stratification. C1 VA Pittsburgh Healthcare Syst, Univ Dr Div, Dept Cardiol, Pittsburgh, PA 15240 USA. Univ Pittsburgh, Pittsburgh, PA USA. Mayo Clin, Rochester, MN USA. RP Shalaby, A (reprint author), VA Pittsburgh Healthcare Syst, Univ Dr Div, Dept Cardiol, 111C-U, Pittsburgh, PA 15240 USA. EM Alaa.Shalaby@med.va.gov NR 31 TC 7 Z9 7 U1 0 U2 0 PU BLACKWELL PUBLISHING PI OXFORD PA 9600 GARSINGTON RD, OXFORD OX4 2DQ, OXON, ENGLAND SN 0147-8389 J9 PACE JI PACE-Pacing Clin. Electrophysiol. PD JUL PY 2007 VL 30 IS 7 BP 839 EP 844 DI 10.1111/j.1540-8159.2007.00770.x PG 6 WC Cardiac & Cardiovascular Systems; Engineering, Biomedical SC Cardiovascular System & Cardiology; Engineering GA 187OE UT WOS:000247856800003 PM 17584264 ER EF